Stillbirth may be obesity related

Obese women are nearly twice as likely as their lean counterparts to have stillborn babies for several specific, potentially preventable medical reasons, a new Graduate School of Public Health analysis reveals.

Placental diseases and hypertension were the most common causes of stillbirth among obese women, according to the study, published in the American Journal of Clinical Nutrition. The research was supported by the National Institutes of Health (NIH).

Said lead author Lisa Bodnar, faculty member in the Department of Epidemiology: “We’ve known for some time that obese women are more likely to have stillbirths, but this is one of the first and most comprehensive efforts to figure out why. Our hope is that this work can be used to better counsel women on the importance of a healthy pre-pregnancy weight and monitor them for complications during pregnancy that may threaten the survival of their fetuses.

“This study also could be used to guide prevention efforts at a societal level,” she added. “If we can reduce pre-pregnancy obesity by even a small amount, through environmental or policy changes, we could significantly reduce the burden of stillbirth.”

Annually there are 3.2 million stillbirths worldwide and, of high-income countries, the U.S. is among those with the highest rates. Recent research shows that obesity is likely responsible for more stillbirths in high-income countries than other risk factors, such as smoking or advanced maternal age.

Bodnar and her colleagues examined records from 658 stillbirths that occurred 2003-10 at Magee-Womens Hospital, which has one of the largest labor and delivery units in the country. Stillbirths were defined as cases where the baby had reached at least 16 weeks gestation and showed no evidence of life after delivery. A panel of obstetricians reviewed each case and assigned a cause of the stillbirth.

The mothers were classified as lean (normal weight or underweight), overweight, obese or severely obese based on their pre-pregnancy body mass index, a measure of weight versus height.

The rate of stillbirth per 1,000 births ranged from 7.7 for lean women to 17.3 for severely obese women.

High blood pressure in the mother, placental diseases or disorders where the placenta does not properly sustain the unborn baby, fetal abnormalities where the baby would have been unlikely to live if it made it to birth and umbilical cord abnormalities all were more common in the more obese women.

Said senior author Hyagriv N. Simhan, faculty member in the School of Medicine’s Department of Obstetrics, Gynecology and Reproductive Sciences, chief of the Division of Maternal-Fetal Medicine and medical director of obstetrical services at Magee-Womens Hospital: “Obstetricians should monitor obese patients for these complications and quickly treat conditions like hypertension if they arise in order to reduce risk of stillbirth. However, we’d like to see these women before they even become pregnant. When a doctor has an obese patient who is considering pregnancy, she should be referred to a maternal-fetal medicine specialist who can counsel her on the benefits of losing weight before pregnancy, as well as safe approaches to weight loss.”

Additional Pitt authors on this research were W. Tony Parks, Kiran Perkins, Sarah J. Pugh, Maisa Feghali, Karen Florio, Omar Young and Sarah Bernstein. A colleague from McGill University also contributed to the research.

Social-media deals’ biz impact varies

A burger joint in Lawrenceville gives free orders of fries with every Foursquare check-in. A café on the South Side offers a discount on a dessert for every first-time visitor review submitted on Yelp.

Special deals such as these on social-media networks should provide a win-win situation for everyone involved. The consumer saves money by simply using the mobile app, while the business owner reaps the benefits of an inexpensive means of advertisement. A simple scenario in which everyone wins, right?

Not so fast, says a recent study conducted by researchers at the School of Information Sciences and the Stevens Institute of Technology in New Jersey.

According to the study, offering special deals on social media, while a useful tactic for increasing the visibility of an establishment, is not a reliable means for increasing patronage in isolation. Researchers point to a number of factors — such as venue type, area population density, the length of the special-deal offer and the manner in which potential customers learn of offers — that play a significant role in making special deals a worthwhile promotional strategy for business owners.

Said Konstantinos Pelechrinis, the study’s lead researcher and Pitt faculty member: “Our primary findings indicate that the positive impact of special deals through location-based social-media networks is not quite what the anecdotal success stories would lead one to believe. We are not saying that special deals are not useful to business owners — quite the contrary. What we are saying is that business owners should be well versed on the best means for using social media, and they should have realistic expectations on how social media can help their individual ventures grow.”

The study is the first large-scale analysis of the benefits of special deals through location-based social-media networks.

It originally was presented at the International Association for the Advancement of Artificial Intelligence Conference on Web and Social Media in Oxford, England.

For the study, Pelechrinis’ team used Foursquare’s public-venue application programming interface to collect data from more than 14 million venues over the course of seven months. The researchers analyzed variations in the number of daily check-ins before, during and after special deals were offered.

Their analysis showed that a large number of venues did enjoy an increase in check-ins during and after the special-deal period. An almost equal number of venues showed no such increase, suggesting that the benefits of special deals are contingent on outside features.

The study identified three categories of features that potentially contribute to the level of success of a special-deal promotion. Taken together, researchers say these features provide a road map for business owners to navigate their decision-making with social-media networks. The categories are:

• Venue-based features, which include the type of business as well as the existing popularity of the establishment, which, for the purposes of the study, was determined by the cumulative number of Foursquare check-ins.

• Promotion-based features, which focused on the details of each special-deal offer, including the duration of the special deal, the number of special deals offered in the given time span and the manner in which the consumer learned of the deal.

• Geography-based features, which examined the surrounding attributes in a given area, such as population density and proximity to other popular venues.

“Each one of these factors contributes to the success of the promotion,” said Pelechrinis.

“More importantly though, we believe that our work can shed light on possible tweaks of the way these promotions are offered through the underlying platform. Active notifications for nearby deals can increase awareness of the system’s user base and consequently their effectiveness. Foursquare, potentially realizing this, is actually moving towards this direction as far as we know.”

Pelechrinis leads the Network Data Science Lab, which conducts in-depth research on empirical and theoretical studies of networks and their applications in social, urban, technological, economic and biological networks.

Other authors of the study were Pitt doctoral candidate Ke Zhang and a Stevens Institute faculty member.

Ebola persistence in wastewater studied

The historic outbreak of Ebola virus disease in West Africa that began in March 2014 and has killed more than 11,000 people has raised new questions about the resilience of the virus and tested scientists’ understanding of how to contain it. The latest discovery by a group of microbial risk-assessment and virology researchers suggests that the procedures for disposal of Ebola-contaminated liquid waste might underestimate the virus’ ability to survive in wastewater.

Current epidemic response procedures from both the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) advise that after a period of days, Ebola-contaminated liquid can be disposed of directly into a sewage system without additional treatment. However, new data published by researchers from the Swanson School of Engineering, Drexel University and NIH indicate that Ebola can survive in detectable concentrations in wastewater for at least a week or longer.

Said Kyle J. Bibby, civil and environmental engineering faculty member in the Swanson school and principal investigator of the study: “Initial research by the WHO and CDC recommended disposing of Ebola-contaminated liquid waste into a latrine or treatment system without disinfection because the virus wasn’t expected to persist in wastewater. However, we found that the virus persisted over a period of at least eight days.”

The researchers gathered their data by observing the change in viral particle concentration in two samples, spiked with different concentrations of the virus, over an eight-day period. The testing was performed in a secured NIH lab. While the researchers observed a 99 percent decrease in concentration after the first day, the remaining viral particles were detectable for the duration of the experiment.

Said co-author Charles Haas of Drexel: “These results demonstrate a greater persistence of Ebola virus in wastewater than previously speculated. While the Ebola virus was found to be generally less persistent than enteric viruses in wastewater, the identified survival period might suggest a potential of a wastewater exposure route.”

Historically, it was believed that the virus could only be transmitted through direct contact with bodily fluids, but there have been cases where people contracted the disease without apparently coming into contact with infected fluids.

This, the study suggests, could be an indication that large liquid droplets might be a vector for the virus, which means greater care should be taken when handling contaminated liquid waste. Given that an infected patient may produce up to nine liters of liquid waste per day, if infected liquid could carry the virus to someone else, this could be a significant risk factor.

The team also notes that the virus’ seemingly early decay upon entry into wastewater might be due to the viral particles clumping together or latching onto other particles in the water, rather than the virus dying. These phenomena would actually make the viruses less susceptible to environmental factors, such as disinfectants, that normally would kill them.

A proposed solution, already adopted by the WHO, would be to hold the contaminated liquid waste for a longer period of time before releasing it into the sewage system. Another might be to pretreat it with an antiviral agent, such as chlorine, although performance data on disinfectants is needed. These options would provide more time for the viral concentration to decay and for the remaining viruses to be inactivated.

“These results indicate that further research is needed with a more holistic approach to assessment of Ebola-infected wastewater, from storage to treatment to disposal and continued monitoring, including a precautionary approach to wastewater handling in all epidemic responses,” Bibby said.

In addition to studying whether or not Ebola can be contracted from exposure to wastewater, the next step for this research would be to review variations in the wastewater composition, such as temperature, microbe population and pH level, the use of disinfectants and the viral concentration’s effect on the decay and inactivation of the virus.

The study was published in Environmental Science & Technology Letters.

UPG receives scholarships, grants

The National Science Foundation (NSF) has awarded Pitt-Greensburg a Scholarships in Science, Technology, Engineering and Mathematics (S STEM) program grant of more than $600,000 to increase the retention and graduation rates of students in biology and chemistry. The grant will fund UPG’s science learning community (SLC) scholarship program. During the next five years, the program is expected to recruit and retain STEM students from rural areas in Fayette, Washington and Westmoreland counties with the goal of having them graduate with baccalaureate degrees in biological science or chemistry. Students enrolled in the program will receive financial, academic and social support. Mark Stauffer, chemistry, and Olivia Long, biochemistry, are the principal and co-principal investigators for the grant, respectively.

Pitt-Greensburg also received funding for the following projects:

• The Private Industry Council (PIC) of Westmoreland/Fayette, Inc. accepted a bid proposal submitted by the Center for Applied Research to conduct program evaluation services for PIC’s Substance Abuse Education in Workforce Development Grant — a PA Commission on Crime and Delinquency/Substance Abuse Mental Health Services Administration grant.

• Two faculty members received funding through the Central Research Development Fund small grants program, which seeks to enhance opportunities for faculty at Pitt to engage in high-quality research, scholarship and creative endeavors.

Amber McAlister, faculty member in fine arts, will use the funding to support travel to Italy during summer 2016 to study the 33 surviving 15th-century murals of the Chiostro Verde (Green Cloister) at Santa Mara Novella. McAlister will explore the relationship between the miracle-working images of the Madonna and Child that flank the church and how they may have mediated the viewing experience of the Dominican friars and lay public moving through these spaces during that period of time.

Jessica Ghilani, UPG faculty member in communications, will use the funding to research her book project that examines the long-term relationship between the advertising industry and the American military to provide context for a growing body of scholarship.

Computer science faculty gain grants

Faculty in the Department of Computer Science in the Dietrich School of Arts and Sciences have been awarded the following grants:

• Daniel Mosse and Bruce Childers: From the NSF, $499,515 to carry out research in artifact evaluation and building community software.

• Panos Chrysanthis and Alex Labrinidis: A Mascaro Center for Sustainable Innovation 2015 Research Seed Grant.

Renewable energy catalyst study funded

To further his research in renewable energy catalysts, the American Chemical Society Petroleum Research Fund recently awarded a doctoral new investigator award to John A. Keith, faculty member and Richard King Mellon Faculty Fellow in Energy in the Swanson school’s Department of Chemical and Petroleum Engineering. The two-year, $110,000 grant, “Unraveling Heterocycle-Promoted Hydride Transfer Mechanisms for Energetically Efficient Fuel and Petrochemical Production,” will enable Keith to study design principles for renewable energy catalysts that efficiently convert CO2 into fuels and chemicals.

In particular, the funding will support Keith’s computational modeling research at the Center for Simulation and Modeling to better understand how molecules and materials can catalyze chemical reactions.

3-D printing projects in Swanson funded

Two Pitt research projects to improve design development for structures in additive manufacturing (AM), or 3-D printing, were among nine contracts funded by America Makes, the National Additive Manufacturing Innovation Institute. The two projects, directed by faculty in the Swanson school, will receive more than $1.7 million.

Principal investigator for “Integrated Design Tool Development for High Potential AM Applications” is Albert To, faculty member in mechanical engineering and materials science, in conjunction with Aerotech, ANSYS, EOS of North America, ExOne, Honeywell, Marcus Machinery, Materials Sciences Corp., RTI International Metals (Alcoa Titanium & Engineered Products), United Technologies Research Center and the U.S. Army Aviation and Missile Research Development and Engineering Center. This $961,112 contract supports an extension of research To previously undertook with a grant from America Makes.

M. Ravi Shankar, faculty member in industrial engineering, is principal investigator of “Parametric Design of Functional Support Structures for Metal Alloy Feedstocks.” Collaborators on the $805,966 contract include ITAMCO, Johnson & Johnson and the University of Notre Dame.

PPG funds fellows, chem poster session

The PPG Industries Foundation has donated $103,000 for programs in the Swanson school and the chemistry department of the Dietrich school. The funding supports PPG summer undergraduate research fellows in the Swanson school, two PPG Industries Foundation graduate fellows in civil and environmental engineering and the annual undergraduate chemistry laboratory poster session.

Bioengineering grants awarded

Faculty members in the Swanson school’s Department of Bioengineering have earned a variety of grants:

• Tracy Cui received $618,815 in support from NIH’s National Institute of Neurological Disorders and Stroke for “Inhibition of Neural Electrode-mediated Inflammation and Neuronal Cell Death.” Co-investigators are Robert Friedlander, Takashi Kozai and Alberto Vazquez; consultants/collaborators are Diane Carlisle and Simon Watkins.

• Fatima Syed-Picard received a $101,195 grant from NIH’s National Institute of Dental and Craniofacial Research for “Scaffold-Free Tissue Engineering: Using Principles From Developmental Biology to Support Craniofacial Regeneration.” She will be conducting part of the research under the mentorship of Lance Davidson. Her Pathway to Independence Award, according to NIH, is “designed to facilitate a timely transition from a mentored postdoctoral research position to a stable independent research position with independent NIH or other independent research support at an earlier stage than is currently the norm.”

• Primary investigator Steven Abramowitch and co-primary investigator Spandan Maiti received a $250,000 NSF collaborative research grant for “Impact of Pregnancy on the Mechanics of Vaginal Tissue.”

• David Vorp received a $439,225 NIH grant from the National Heart, Lung and Blood Institute (NHLBI) for: “Outside-In Regenerative Therapy for Abdominal Aortic Aneurysm.” Co-investigator is Justin Weinbaum, with co-PIs from Vanderbilt University.

• Yadong Wang received a $599,998 grant from NHLBI: “Computational Model Driven Design of Tissue Engineered Vascular Grafts.” Co-PIs are from Yale and Nationwide Children’s Hospital in Columbus.

• Gelsy Torres-Oviedo received a $231,000 scientist development grant (SDG) from the American Heart Association for “Understanding Patient-Specific Deficits Causing Step Asymmetry Post-Stroke: A Step Toward Personalizing Rehabilitation.” Subashan Pererais is a consultant. SDG grants are meant “to support highly promising beginning scientists in their progress toward independence.” She also received a $330,610 NSF grant for “The Role of Naturalistic Movements on the Generalization of Locomotor Learning,” with a consultant from Johns Hopkins University.

Heart disease fibrosis targeted

Bernard Kühn, pediatrics faculty member in the School of Medicine and scientist at the Richard King Mellon Foundation Institute for Pediatric Research at Children’s Hospital, was awarded a $200,000 grant from the Children’s Hospital of Pittsburgh Foundation’s Fund for Genomic Discovery.

Said Kühn: “This funding will allow my team to enter the field of fibrosis research, a new area of investigation for my lab. If successful, this project will provide a broadly applicable molecular-genetic blueprint for the field of cardiovascular development and for developing new drugs to reduce fibrosis in heart disease.” Kühn will team with Dennis Kostka, faculty member in the school’s Department of Developmental Biology, who will offer his expertise on the computational aspects of the research.

Kühn, also the director of research at Children’s Heart Institute, has been focused on the unique workings of heart muscle cells. His long-term objective is to provide novel approaches and molecular targets for the treatment of heart failure, primarily by studying the mechanisms of growth and regeneration of the myocardium, the muscle tissue of the heart.

Kühn and his research team are focused on cardiomyocytes, the cells of the heart muscle, and discovering ways to make them replicate and proliferate so as to enable the heart to heal itself in cases of heart failure or congenital defects.

Three grants for LRDC faculty

A trio of Learning Research and Development Center (LRDC) faculty were awarded support recently:

• Diane Litman (co-principal investigator, LRDC senior scientist and computer science faculty member in the Dietrich school), and Rebecca Hwa (principal investigator and computer science faculty member) have been awarded a grant by NSF to investigate whether natural language processing methods can help students learn to make a more concrete connection between the abstract principles of rewriting (e.g., “A paper should have a clear thesis”) and the particular contexts in which the revision is carried out.

• Two new Institute for Education Sciences grants have been awarded for the following projects: “For Argument’s Sake: Applying Questioning the Author Techniques to Support Comprehension and Composition of Written Argument” (principal investigator and LRDC research associate Amy Crosson; co-principal investigators LRDC senior scientists and School of Education faculty members Margaret McKeown, Lindsay Clare Matsumura and Richard Correnti) and “Returning to Our Roots: Development of a Morphology Intervention to Bolster Academic Vocabulary Knowledge for Adolescent English Learners” (principal investigator Amy Crosson; co-principal investigator Margaret McKeown).

• Jennifer Iriti, LRDC research associate and director of the Evaluation for Learning Group, received a grant from the United Way of Allegheny County to lead an impact evaluation study of the “Be a Middle School Mentor” program, a joint effort of the United Way and Pittsburgh Public Schools. She also has been awarded a grant by the Pittsburgh Promise, a postsecondary scholarship program, to analyze the postsecondary retention, persistence and degree attainment of its scholars.

• Ming-Te Wang, faculty member in psychology and education and LRDC research scientist, was named a winner of an Early Career Research Award by the Society for Research in Child Development 2015.

2 Pitt profs named McKnight Scholars

Neuroscientists Susanne Ahmari and Marlene Cohen have been named McKnight Scholar Award recipients for 2015. Granted to early-career scientists, McKnight awards give scholars $75,000 annually for three years to support their investigations. Pitt faculty received two of the six 2015 McKnight awards, which are considered among the most prestigious neuroscience fellowships in the nation.

Ahmari is a psychiatry faculty member in the School of Medicine and a member of the training faculty at the Center for the Neural Basis of Cognition (CNBC), a joint Pitt-Carnegie Mellon University program. Her McKnight fellowship will focus on “Identifying Neural Circuit Changes Underlying Obsessive Compulsive Disorder-Related Behaviors.”

Cohen is a neuroscience faculty member in the Dietrich school and a member of the CNBC training faculty. Her project is “Causal and Correlative Tests of the Hypothesis That the Neuronal Mechanisms Underlying Attention Involve Interactions Between Cortical Areas.”

New nanomaterial behavior discovered

Swanson school researchers have discovered new insights into nanoscale phenomena that provide a greater understanding of the overall functionality of nanoparticles. Their paper, “Au13: CO Adsorbs, Nanoparticle Responds,” appeared on the cover of the American Chemical Society’s publication Journal of Physical Chemistry C in August.

Giannis Mpourmpakis, chemical and petroleum engineering faculty member, was principal investigator, and departmental colleague J. Karl Johnson, co-director of the Center for Simulation and Modeling, and graduate student Natalie Austin co-authored the paper. The researchers found an unexpected adsorption, or adhesion, behavior of carbon monoxide (CO) molecules on Au13 nanoparticles, clusters containing exactly 13 gold atoms.

Unlike the well-established, size-dependent adsorption trend on nanoparticles (CO binding increases with decreasing nanoparticle size), Au13 exhibited shape-dependent behavior when binding to the CO molecules. A 3-dimensional Au13 nanoparticle is generated from the 2-dimensional stable structure in the presence of CO molecules. Interestingly, Mpourmpakis noted, the 3-dimensional Au13 nanoparticle binds the CO molecules stronger than it does the 2-dimensional structure, which is lacking bonds on its surface.

Said Mpourmpakis: “The binding of molecules to metal surfaces is critically important because it is the basic first step in all catalytic processes. This is critical to produce the building blocks for almost all manufactured products.”

The unusual behavior is the result of quantum electronic effects at the nanoscale, which dictate how electrons are distributed on nanoparticles having different shapes. The research team used atomically detailed computer simulations to reveal the behavior of Au13 adsorption.

Added Johnson: “Our simulations showed that, in the presence of CO, the 2-dimensional Au13 nanoparticle restructured to a 3-dimensional structure on an incredibly short time scale of just a few picoseconds,” which are trillionths of a second.

In their paper, the authors highlighted that other computer simulations can unravel very complicated phenomena at the nanoscale, including molecular adsorption and structural dynamics of nanoparticles in a chemical environment. The understanding of these phenomena determines, to a large extent, the overall functionality of nanoparticles, including in catalysis, chemical sensing, medical devices, optical materials and other applications.

Mpourmpakis leads his team in the Computer-Aided Nano and Energy Lab. Using theory and computation, the researchers investigate the physicochemical properties of nanomaterials with potential applications in diverse nanotechnological areas, ranging from green energy and storage to materials engineering and catalysis.

More dispensaries = more pot-related hospitalizations

People who live in areas of California with a higher density of marijuana dispensaries experience a greater number of hospitalizations involving marijuana abuse and dependence, a Graduate School of Public Health analysis discovered.

The NIH-funded research, published in Drug and Alcohol Dependence, could be informative as more states consider legalizing marijuana for medical and recreational use. It is the first analysis of the statewide impact of marijuana dispensaries on abuse and dependence, as well as the first look at population characteristics associated with marijuana-related hospitalization rates.

Said lead author Christina Mair, faculty member in the Department of Behavioral and Community Health Sciences: “As marijuana is approved for medical or recreational use, we need to carefully consider where we allow dispensaries to be placed. Our study indicates that there are real problems associated with a higher density of marijuana dispensaries in neighborhoods. More study and monitoring, coupled with thoughtful legislation and community discussion, will be prudent to ensure that marijuana laws have the fewest negative consequences for vulnerable populations.”

In 1996, California was the first state to legalize medical marijuana, allowing physicians to prescribe the drug for medical purposes. Since then, 22 states and the District of Columbia have enacted similar laws, and four of those states also have legalized recreational use. Pennsylvania doesn’t allow either, though it is considering permitting medical marijuana.

Mair and her team looked at data on California hospital discharges that had either a primary or secondary medical code for marijuana dependence or abuse with at least one overnight hospital stay. The research covered 2001-12, the most recent years for which consistent data were available.

Hospitalizations with marijuana abuse or dependence codes increased from 17,469 in 2001 to 68,408 in 2012. More than 85 percent of marijuana-related hospitalizations were coded as abuse, rather than dependence, and 99.2 percent were secondary codes, meaning the person was primarily hospitalized for something other than marijuana.

When the research team mapped the location of marijuana dispensaries and cross-referenced it with the ZIP code of each patient’s home, they found that each additional dispensary per square mile in a ZIP code was associated with a 6.8 percent increase in the number of hospitalizations linked to marijuana abuse and dependence.

In addition, Mair and her team found that marijuana dispensaries and hospitalizations were more likely to be located in areas with lower household incomes and lower educational attainment.

“It’s unclear if the marijuana dispensaries are simply locating in neighborhoods that tend to be more disadvantaged and already have underlying problems with marijuana abuse, or if the presence of the dispensaries is causing an increase in abuse and hospitalizations,” said Mair. “It could be a combination of both factors.”

Mair noted that research on the location of marijuana dispensaries has a parallel precedent in the location of liquor stores. This gives policymakers and public health practitioners the opportunity to learn from previous studies on the health effects of density and location of liquor stores in order to design studies that can provide similar data on marijuana dispensaries.

“Once dispensaries open, it is much harder to go back and create regulations to guide their location and density,” said Mair. “Passage of laws permitting marijuana use and sale is likely to continue, so it is critical that we continue to research the impact of dispensaries on the health of local communities to provide guidance on regulations and public health outreach to prevent abuse.”

Additional researchers on this project were from UCLA’s Luskin School of Public Affairs and the Prevention Research Center in Oakland, California.

The study was funded by NIH’s National Institute on Drug Abuse.

Cilia motion can diagnose disease

Science Translational Medicine has published research by Chakra Chennubhotla, faculty member in computational and systems biology in the School of Medicine, and his former graduate student, Shannon Quinn: “Automated identification of abnormal respiratory ciliary motion in nasal biopsies.” Other faculty authors were Cecilia Lo, Maliha J. Zahid, John R. Durkin and Richard J. Francis.

The movement of tiny cilia can be used to detect various lung and heart diseases. Normally, these cilia beat in unison to move foreign particles and mucus out of the body. When diseased, the cilia adopt asynchronous motions, which can be observed in nasal or bronchial biopsies under a microscope and in turn be used for diagnosis. To reduce the subjective nature of diagnostics involving manual evaluation of ciliary motion, the researchers devised a computational framework that objectively quantifies ciliary motion in digital biopsy videos.

In their approach, ciliary motion was characterized as a “dynamic texture,” much like a flickering flame or billowing smoke. The ciliary motion was broken down into elemental components, which were then pieced together to create a digital “signature” capturing cilia rotation and deformation as functions of time and magnitude. Using these digital signatures, the authors were able to formulate ciliary motion predictions for two independent cohorts from different institutions that included patients with primary ciliary dyskinesia, congenital heart disease and heterotaxy.

Their computational framework was able to correctly identify ciliary motion defects in over 90 percent of patients. Such a “black box” method would allow untrained medical professionals to sensitively diagnose challenging ciliopathies.

Study looks at how food choices can lower cancer risks

Thomas Kensler, pharmacology and chemical biology faculty member and co-leader of the cancer epidemiology and prevention program at the University of Pittsburgh Cancer Institute (UPCI), was awarded a $6.3 million Outstanding Investigator Award from the National Cancer Institute (NCI). This award acknowledges experienced researchers and provides them with long-term support for their work.

Kensler’s research focuses on chemoprevention, or how food can be used to lower the risk of developing cancer caused by unavoidable environmental toxins.

The seven-year grant is one of just 60 awarded in this inaugural year.

Research has shown that controlling diet, increasing exercise and quitting smoking can decrease the risk of developing cancer; however, environmental toxins such as fossil fuel combustion products are more difficult to mitigate. Past studies by Kensler’s team in China, where environmental controls are less rigorous, have examined the bioactive molecules in broccoli and how they may help people there detoxify air pollutants.

Said Kensler: “Pollution is a global problem and its effects are seen most often among the elderly, disabled, children and minorities. We need effective and affordable interventions, and using food-based strategies could be the ideal way to address this.”

He and his team will focus on a biological pathway known to play a role in detoxification, identify and validate biomarkers of its activity, and examine the molecular consequences of its chronic activation.

Childhood cancer research funded

Edward V. Prochownik, Paul C. Gaffney Professor of Pediatrics in the School of Medicine and director of oncology research at Children’s Hospital, was awarded a grant of $100,000 from the St. Baldrick’s Foundation for childhood cancer research.

The award to Prochownik, who also is a faculty member in molecular genetics and biochemistry, is one of 70 grants totaling more than $21.1 million nationally and internationally. Prochownik and his team will explore the implications of new observations of cancer cell growth.

Said Prochownik: “Cancer cells must alter their metabolism to provide the necessary energy and metabolic building blocks needed to support their rapid division. We have identified some of the key means by which the cell can control these changes. Confirming and extending these findings as we propose to do could provide novel and specific ways to interfere with this process and thus inhibit tumor growth while minimizing long-term side effects.”

Over the past year, Prochownik and his research team have developed a model of hepatoblastoma, the most common childhood liver cancer, which in advanced stages is difficult to treat and requires use of drugs that can cause long-term toxicities.

“We have discovered that the mitochondria of these hepatoblastoma cells appear to be reprogrammed so as to allow them to function at maximal capacity and thus provide large amounts of energy and metabolic building blocks needed by the rapidly growing and dividing cancer cells,” explained Prochownik. “We hope that our observations at this level can be translated into new and specific ways of treating this cancer while at the same time reducing toxicity.”

Treatment guidelines established for twin pregnancies

A monochorionic twin pregnancy, in which identical twins share one placenta, faces unique complications that can threaten the health and life of both babies, requiring an increased understanding of treatment techniques for the mother. Now, in work led by Stephen Emery, faculty member in obstetrics, gynecology and reproductive science and a maternal-fetal medicine surgeon with Magee-Womens Hospital, the North American Fetal Therapy Network has published evidence-based and consensus-driven recommendations for the management of such pregnancies in the journal Obstetrics and Gynecology.

Said Emery, the paper’s lead author: “Identical twin pregnancies present some of the most challenging complications a maternal-fetal medicine specialist can face. With timely diagnosis and intervention, we can improve pregnancy outcomes. We hope these guidelines help general obstetric practitioners understand some of the complexities that can affect the development of identical twins sharing one placenta. These guidelines also should help with patient counseling, including when a woman experiencing a complication should be referred to a regional treatment center and how to co-manage her care when she returns after treatment.”

The North American Fetal Therapy Network is a consortium of 30 medical institutions across the U.S. and Canada with established expertise in fetal therapy and complex fetal disorders. For this publication, the consortium identified nine disorders to highlight, including:

• Twin-to-twin transfusion syndrome, a disease of the placenta in which blood passes disproportionately from one baby to the other through connecting blood vessels within the shared placenta. One baby receives too much blood, overloading his or her cardiovascular system while the other baby doesn’t receive enough and develops low blood volume. Left untreated, this condition almost always is fatal for both twins.

• Selective growth restriction, when a disproportionate share of the placenta causes inadequate nutrition and consequently growth restriction in one of the twins. Increasingly, selective growth restriction is being recognized as a major complication for monochorionic twin pregnancies because it frequently is associated with pregnancy loss and poor neurological outcomes.

• Twin anemia polycythemia sequence, a form of twin-to-twin transfusion syndrome characterized by chronic, slow blood transfusion between the twins, which is believed to develop due to very small caliber artery-to-vein vessels that develop between the twins. One twin becomes severely anemic while the other has too many red blood cells (polycythemia), resulting in serious problems for both.

Center for Medical Innovation funds biomedical devices

The Center for Medical Innovation (CMI) awarded grants totaling $95,000 to four research groups through its 2015 round-1 pilot funding program for early stage medical technology research and development.

CMI, in the Swanson school, supports applied technology projects in the early stages of development with “kickstart” funding toward the goal of transitioning the research to clinical adoption. Proposals are evaluated on the basis of scientific merit, technical and clinical relevance, potential health care impact and significance, experience of the investigators and potential to obtain further financial investment to translate the particular solution to health care.

The awards went to the following researchers:

• George Stuart Mendenhall, medicine, and Mingui Sun, neurological surgery, electrical and computer engineering and bioengineering, for an interactive, real time wearable system for remote cardiac monitoring. The award will allow the researchers to design, build and test a wearable physiological monitoring system for use in intensive care.

• Luka Pocivavsek, surgery, and Sachin Velankar, chemical engineering, for the design of artificial polymeric cylindrical vascular grafts with tunable luminal topography, to develop a new, non-thrombogenic dynamic material for vascular stents.

• Marina V. Kameneva, surgery and bioengineering; Jonathan H. Waters, anesthesiology and bioengineering; and Mark Gartner, bioengineering, for reducing alloimmunization and sickle crisis in sickle cell disease patients using a novel method of replacing HbS with donor Hb in autologous RBCs. The award will foster the development of a novel method for treating sickle cell anemia.

• Changfeng Tai and Heidi Stephany, both of urology, and Mingui Sun, to apply the new technology of foot neuromodulation to prevent bedwetting in children.

Nursing prof gets NINR funding

School of Nursing faculty member Denise Charron-Prochownik was awarded $3,182,365 from the National Institute of Nursing Research for her project on “Supporting American Indian and Alaska Native Mothers and Daughters in Reducing Gestational Diabetes Risk.”

The five-year grant will permit her to extend her preconception counseling intervention (the READY-Girls program) to American Indian/Alaska Native adolescent females at risk for gestational diabetes mellitus (GDM). The project aims to enhance healthy lifestyle behaviors and family planning vigilance prior to a first pregnancy.

The READY-Girls program has been adopted by the American Diabetes Association as the model preconception counseling program for teens with diabetes. Using a sequential mixed-method design with a multi-tribal community-based participatory research approach (involving members of the Navajo and Cherokee tribes in Oklahoma), the project will raise awareness on the parts of both teens and their mothers about the risks of GDM and the potential for a healthy lifestyle to reduce these risks.

By also providing mothers with preconception counseling knowledge and skills, they can naturally weave cultural/social influences into their communications with their daughters. The intervention will be directed at the individual, familial and institutional levels simultaneously.

Charron-Prochownik is a pediatric nurse practitioner and pediatric diabetes clinical nurse specialist.

Park wins research development award

Nursing faculty member Mijung Park has earned a $280,000 Mentored Research Scientist Development Award from the NINR for “FACE-PC: Family-centered Care of Older Adults With Multiple Chronic Conditions.”

The goal of the NIH research career development program is to help ensure that a diverse pool of highly trained scientists is available in appropriate scientific disciplines to address the nation’s biomedical, behavioral and clinical research needs.

Park’s career goals are to improve the quality of care for older adults with multiple medical and psychosocial comorbidities and become an independent researcher with expertise in comparative effectiveness trials conducted in real-world health care settings. Comorbid depression and multiple medical conditions in older adults are a serious public health problem. As an important facilitator of health-related activities, families already are involved in various aspects of self-management of chronic disease in older adults. Such informal caregiving activities currently are organized outside the medical system, which potentially creates redundant or misaligned efforts.

Park’s research targets patient-family dyads to examine the feasibility and acceptability of FACE-PC, a theory-driven, multi-component, technology-assisted interdisciplinary team-based care model that systematically involves family in chronic disease care and treatment. It aims to optimize the patient and family’s collective ability to self-manage chronic disease.

Films instead of pills for women’s health

Lisa C. Rohan, faculty member in the pharmaceutical sciences department of the School of Pharmacy, was awarded a grant from the Bill & Melinda Gates Foundation for a study titled “Assessment of Films for Multi-purpose Prevention Technology (MPT) Development.”

There is a need for MPT to address sexual and reproductive health issues for women. Specifically, products that provide both contraception and HIV prevention to women represent an identified unmet need.

Studies planned within this funded program will help increase knowledge about possible applications of vaginal polymeric thin film dosage forms to address female sexual and reproductive health issues.

Monitoring HIV drug resistance in Africa

Infectious diseases researchers from the School of Medicine are leading a five-year, $5 million initiative to monitor drug resistance during the rollout of HIV prevention drugs in sub-Saharan Africa.

A cooperative agreement awarded by the U.S. Agency for International Development (USAID) will allow experts in the school’s Division of Infectious Diseases to conduct laboratory research and develop evidence-based policy guidance for monitoring drug resistance during the large-scale employment of drugs and microbicides that prevent HIV infection.

Said Urvi Parikh, medicine faculty member and senior project adviser: “HIV/AIDS is an epidemic in sub-Saharan Africa and, until now, we’ve been really focused on treating people who already have the disease. But to stem the epidemic, we also need to prevent new infections.”

Roughly 25 million people in sub-Saharan Africa have HIV, accounting for nearly 70 percent of the global total.

Pre-exposure prophylaxis (PrEP) and antiretroviral (ARV)-based microbicides help prevent new HIV infections through a regimen of daily pills, a monthly vaginal ring that slowly releases medication or a medicated gel used before and after sex.

A concern with widespread use of PrEP and ARV-based microbicides is that if a person becomes infected while on PrEP or microbicides, a strain of HIV could arise that resists drugs needed for treatment in the future. The resistant strain could then be spread to others.

The Pitt-led team is starting the project by analyzing laboratory data and previous research to create computer models and simulations that will balance the cost and inconvenience of testing with the risk of resistance to provide optimal testing recommendations, whether once a month, once every few months or once a year.

These findings will be presented to stakeholders in Africa, including the community leaders, doctors and health policy professionals who will be involved in implementing the prophylactic treatment effort.

In the third year, the team will provide finalized recommendations for HIV testing and then work with USAID and other groups, including the WHO and the United Nations Programme on HIV/AIDS, to implement recommendations in regions where PrEP and microbicides are distributed.

Finally, the team will train local clinics in using low-cost tests to detect drug resistance so data can continue to be collected and guide future HIV prevention initiatives.

Said John W. Mellors, chief of the Division of Infectious Diseases and project director: “Through this carefully crafted, step-by-step process, we’ll be able to provide critical data to develop cost-effective and appropriate HIV diagnostic and resistance testing and monitoring plans. As a result, we should be able to stay on top of any drug resistance that arises from antiretrovirals implemented for HIV prevention.”

Project administrator is April Churilla, with other researchers from FHI 360, Lancet Laboratories in South Africa, the Statistical Center for HIV/AIDS Research & Prevention in Seattle and the HIV Modeling Consortium in the United Kingdom.

The project is funded by the President’s Emergency Plan for AIDS Relief through USAID.

Ancient DNA proteins affect tumor development

By studying the yeast used in beer- and bread-making, researchers at the School of Medicine have uncovered the mechanism by which ancient proteins repair DNA damage and how their dysfunction could lead to the development of tumors.

Their findings, published in Nature Communications, could lead to new ways to tailor cancer therapies.

In humans, protein mutations called RAD51 paralogues have been associated with breast and ovarian tumors, noted senior investigator Kara Bernstein, faculty member in microbiology and molecular genetics and the University of Pittsburgh Cancer Institute, partner with UPMC CancerCenter.

Said Bernstein: “These are proteins that have been present throughout evolution in many species, but very little has been known about what they do. Our study shows for the first time the mechanism of how they are involved in the repair of damaged DNA.”

Because RAD51 paralogues are too difficult to work with in animal cells, the research team instead explored their function in yeast. They found the proteins interact with other proteins called the Shu complex to repair breaks in DNA strands, which can be caused by environmental toxins, radiation and other naturally occurring exposures.

Shu complex works synergistically with additional RAD51 paralogues to search for homologous, or complementary, DNA regions with double-strand breaks, in which both poles of the twisting DNA ladder have been broken, the researchers found. Pieces of the genetic code can be lost in such areas; the paralogues and complex repair the damage by filling in the missing pieces in a process called homologous recombination.

“Now that we understand what the proteins do, we can perhaps tailor therapies for patients who have cancer and mutations in these repair genes,” Bernstein said.

The team included Stephen K. Godin, Faiz F. Kabbinavar and Andrew P. Van Demark, with researchers from Yale.

The project was funded by NIH.

Social-emotional skills key in teaching

Teachers with strong social-emotional skills tend to implement new social-emotional intervention programs more faithfully, according to a study conducted by a School of Education faculty member published in the Society for Prevention Research’s journal, Prevention Science. This study is part of a larger special issue on schools’ readiness to implement new interventions, edited by Shannon Wanless and a colleague from the Collaborative for Academic, Social and Emotional Learning.

Said Wanless, faculty member in the Department of Psychology in Education and lead author of the study: “Often, interventions are not implemented with high fidelity in schools. If we knew beforehand who would be likely to implement well or to struggle, then we could offer those teachers extra support to increase their likelihood of success. Implementing with high fidelity — adhering to the program’s core components — is important because it increases the likelihood that programs have a positive impact on children’s skills.

“In some situations, we might even decide to offer a different kind of training to build capacity so they would be more ready to implement the intervention in the future. Based on our recent study, building capacity would include increasing teacher’s social-emotional skills.”

Wanless and her team analyzed a group of 126 fourth- and fifth-grade teachers from the treatment group of a randomized controlled trial of the Responsive Classroom approach, an academic intervention that aims to improve the instructional and social-emotional climate in the classroom. Prior to training, the researchers assessed factors believed to have the potential to represent the teachers’ readiness to implement the Responsive Classroom approach: observed emotional support; teacher-rated use of intervention practices; teacher-rated self-efficacy; teacher-rated collective responsibility; education level; and years of teaching experience.

“We hoped to discover what teacher characteristics could be seen before training in the intervention began, to give us a clue as to whether or not the teacher would be likely to implement the intervention well, or with high fidelity,” Wanless said. “These characteristics would be so useful to the field because they would give us a hint, before we spend money on training and coaching, if this intervention is going to be used well.

“What we found in the study is that other variables such as teacher demographics and background did not significantly relate to implementation. What did relate — in fact the only thing that related in this study — was how strong their social-emotional skills were, measured by the emotional-support dimension of the Classroom Assessment Scoring System, a measure created at the University of Virginia’s Center for Advanced Study of Teaching and Learning.”

Emotional support, as defined by the Classroom Assessment Scoring System, reflects teachers’ interactions with children in four dimensions: positive climate; negative climate; teacher sensitivity; and regard for students’ perspectives. It focuses, broadly, on the overall feeling of warmth and respect in the classroom.

“In schools of education, we should be training teachers to develop their social-emotional skills because it will increase their capacity to engage in future professional-development training and to implement cutting-edge teaching practices well,” Wanless said.

“Social-emotional skill training in teacher education programs may be one important way to prepare education students to successfully navigate new interventions as the field evolves throughout their careers.”

To address this need, Wanless and colleague Tanner LeBaron Wallace created a new series of courses for teacher education students called Attentional Teaching Practice.

Wanless conducted the study with colleagues at the University of Virginia, Arizona State University, Brigham Young University and Harvard.

The U.S. Department of Education’s Institute of Educational Sciences funded the research.

UPCI named outstanding center

The University of Pittsburgh Cancer Institute (UPCI) has been rated “outstanding” and renewed as a National Cancer Institute (NCI)-designated comprehensive cancer center, an award that recognizes the research that sets the center among an elite group nationwide. The five-year grant is for $25.6 million and comes as UPCI celebrates its 30th year.

UPCI is one of just 44 NCI-designated comprehensive cancer centers in the U.S.

Said Nancy E. Davidson, director of UPCI and UPMC CancerCenter, Hillman Professor of Oncology and distinguished professor of medicine at Pitt: “The NCI renewal is an incredible accomplishment that comes after an extensive application and review process.

“The award recognizes our strength in basic, clinical and population research, education and community outreach and reflects the dedication of everyone here who is working toward a future without cancer.”

DoD gives $3 million for nanoelectronics

The U.S. Department of Defense selected Jeremy Levy as one of seven distinguished university faculty scientists and engineers forming the next class of National Security Science and Engineering Faculty Fellows.

Levy, a distinguished professor of condensed matter physics in the Dietrich school and director of the Pittsburgh Quantum Institute, was awarded up to $3 million for up to five years.

Levy has pioneered research in reconfigurable nanoelectronics at oxide interfaces, which holds promise for a variety of future applications including the creation of materials that combine the functions of electronic and magnetic manipulation and storage of information.

This award will enable Levy to pursue a program that aims to merge two existing fields: semiconductor nanoelectronics and complex oxides.

Nanoelectronics have made impressive advances in the last few decades, enabling powerful computing architectures as well as scientific advances that probe fundamental quantum aspects. Complex oxides are materials that exhibit a variety of behaviors such as ferromagnetism and superconductivity, which are important for data storage and medical applications like magnetic resonance imaging.

Said Levy: “I will work to combine the successes of these two fields to create new types of nanoelectronics that take advantage of the rich physical behavior of complex oxides.”

Fat around heart in menopause risky

Late- and post-menopausal women have significantly greater volumes of fat around their hearts — a risk factor for heart disease — than their pre-menopausal counterparts, a Graduate School of Public Health study has shown for the first time.

The finding, published in The Journal of Clinical Endocrinology & Metabolism, likely can be attributed to changing hormone levels and could guide potentially life-saving interventions.

Said lead author Samar R. El Khoudary, faculty member in the Department of Epidemiology: “Cardiovascular disease is the leading cause of death in women, and it increases after age 50 — the average age when a woman is going through menopause. By showing that menopause appears to be associated with a shift in fat deposits that leads to more fat around the heart, we’ve uncovered a new potential contributor to increased risk of cardiovascular disease in women.”
Weight gain in women during and after menopause has long been attributed to aging, rather than menopause itself. However, recent research identified changes in body fat composition and distribution due to menopause-related hormonal fluctuations.

No previous study had evaluated whether those changes in fat distribution during menopause affect cardiovascular fat. Increased and excess fat around the heart and vasculature can be more detrimental than abdominal fat, causing local inflammation and leading to heart disease. Doubling certain types of cardiovascular fat can lead to a more than 50 percent increase in coronary events.

El Khoudary and her team evaluated clinical data, including blood samples and heart CT scans, on 456 women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women averaged about 51 years of age and were not on hormone replacement therapy.

As concentrations of the sex hormone estradiol — the most potent estrogen — declined during menopause, greater volumes of cardiovascular fat were found. The finding held even after the team took into account the effects of age, race, obesity, physical activity, smoking, alcohol consumption, medication use and chronic diseases.

“Developing prevention strategies to reduce cardiovascular fat in women at midlife may reduce their heart disease risk, especially knowing that the menopausal transition puts women at risk for excess fat around their hearts,” said El Khoudary. “Previous studies suggest that reducing heart fat is feasible through weight loss or weight management, but these studies only looked at small numbers of people and there have been no clinical trials linking cardiovascular outcomes with heart fat changes due to weight management interventions. Clearly there is a need for larger scale studies to determine the best intervention strategies to help post-menopausal women reduce fat near the heart.”

El Khoudary and her research team are seeking more funds to evaluate whether cardiovascular fat volumes progress over time in midlife women and, if so, whether this progression will be associated with greater evolution in atherosclerosis and more cardiovascular events in post-menopausal women.

Additional authors on this study were senior author Karen A. Matthews, Carrie Hanely and Emma Barinas-Mitchell, and co-authors from Allegheny Health Network, Rush University Medical Center, the Los Angeles Biomedical Research Institute and the University of Minnesota Medical School.

The work was funded by NIH and the American Heart Association.

There’s more to Homo & sapiens

Science is, in part, a system of categorization, but the human fossil record — including the genus Homo and species sapiens — is rather poorly categorized, contends Jeffrey Schwartz, faculty member in anthropology and the history and philosophy of science. This has led to a narrow view of a more complex and expansive evolutionary history than most anthropologists recognize, he believes.

In Science in August, Schwartz argues that “the boundaries of both the species and the genus remain as fuzzy as ever, new fossils having been haphazardly assigned to species of Homo, with minimal attention to morphology.”

The form and structure of hominid (a group consisting of modern humans, extinct human species and all our immediate ancestors) fossils are too often ignored in deference to tradition over objectivity, he adds.

As an example, Schwartz cites Jonathan and Mary Leakey’s 1960 discovery of 1.8-million-year-old fossils in Tanzania’s Olduvai Gorge. When the pair published their findings in 1964, they claimed the fossils represented a new species, Homo habilis.

“There was scant morphological justification for including any of this very ancient material in Homo,” Schwartz writes. “Indeed, the main motivation appears to have been the Leakeys’ desire to identify this hominid as the maker of the simple stone tools found in the lower layers of the gorge.”

According to Schwartz, including these fossils in Homo, when their age and appearance dictates otherwise, “so broadened the morphology of the genus that other hominids from other sites could be shoehorned into it almost without regard to their physical appearance. As a result, the largely unexamined definition of Homo became even murkier.”

To ultimately understand what is Homo and what is not, Schwartz contends, anthropologists must approach their science in a more systematic fashion in order to truly understand the evolutionary past that led to the human of today.

“If we want to be objective, we shall almost certainly have to scrap the iconic list of (genus and species) names in which hominid fossil specimens have historically been trapped and start from the beginning,” he says.

Preventative tinnitus drugs identified

Researchers have identified in an animal model the molecular mechanisms behind resilience to noise-induced tinnitus and a possible drug therapy that could reduce susceptibility to this chronic and sometimes debilitating condition. The findings by a team from the School of Medicine were published in eLife.

Tinnitus is typically induced by exposure to loud noise and causes whistling, clicking, roaring and other phantom sounds. It is estimated that 5-15 percent of Americans suffer from tinnitus, said Thanos Tzounopoulos, a member of the auditory research group in the Department of Otolaryngology, where he also holds the auditory physiology endowed chair.

The study results build on previous research in mouse models demonstrating that tinnitus is associated with hyperactivity of dorsal cochlear nucleus (DCN) cells, which fire impulses even when there is no actual sound to perceive.

The team’s work has shown that this hyperactivity is caused by a reduction in tiny channels, called KCNQ channels, through which potassium ions travel in and out of the cell. Based on this finding, KCNQ channel activators have emerged as clinical candidates for preventing the development of tinnitus.

Said Tzounopoulos: “However, a significant percentage of people are exposed to loud sounds and never develop tinnitus, and there was little known about why that is. That’s what we set out to examine in this study.”

This newest study found that mice that are exposed to loud noise but do not develop tinnitus show a transient reduction in KCNQ2/3 channel activity, which is followed by a recovery of KCNQ2/3 activity and a reduction in activity in the hyperpolarization-activated cyclic nucleotide-gated (HCN) channel, another channel through which positively charged ions travel in and out of the cell.

The investigators believe a combination of drugs that enhance KCNQ2/3 channel activity and reduce HCN channel activity could promote resilience and reduce susceptibility to tinnitus.

“We have already developed novel activators of KCNQ2/3 channels,” Tzounopoulos said, adding that the next step, in collaboration with Peter Wipf, a faculty member in chemistry, is to develop specific blockers of HCN channels.

Co-authors of the paper were Shuang Li, and Bopanna I. Kalappa.

The project was funded by the Department of Defense peer reviewed medical research program and the joint warfighter medical research program, and by NIH.

—Compiled by Marty Levine

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