PHILADELPHIA – The National Science Foundation (NSF) has awarded the University of Pennsylvania a $24 Million, five-year grant to establish a Science and Technology Center (STC) focused on engineering mechanobiology, or the way cells exert and are influenced by the physical forces in their environment. This award is part of an overall $94 million from NSF to support four new STCs. In addition to these latest awards NSF supports eight other STCs.

Yale E. Goldman, MD, PhD

Vivek Shenoy, PhD

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The Center for Engineering Mechanobiology will foster collaborations between Penn researchers and colleagues at the University of Washington at St. Louis (WUSTL), the University of Maryland, the New Jersey Institute of Technology (NJIT), Alabama State University, Bryn Mawr College, and Boston University (BU).

The Penn contingent draws from the Perelman School of Medicine and the School of Engineering and Applied Science. It will be led by co-directors Yale E. Goldman, MD, PhD, a professor of Physiology and of Biochemistry and Molecular Biophysics in Penn Medicine and Mechanical Engineering and Applied Mechanics in Penn Engineering, and Vivek Shenoy, PhD, a professor with appointments in Engineering’s departments of Materials Science and Engineering, Mechanical Engineering and Applied Mechanics, and Bioengineering.

Other members of the Center’s leadership include Rebecca Wells, MD, an associate professor of Medicine, Robert L. Mauck, PhD, the Mary Black Ralston Professor for Education and Research in Orthopaedic Surgery, E. Michael Ostap, PhD, a professor of Physiology and director of the Pennsylvania Muscle Institute, all from Penn Medicine;
William Hunter, PhD, a professor of Bioengineering at NJIT; Guy Genin, PhD, a professor of Bioengineering and Ram Dixit, PhD, an associate professor of Biology, both of WUSTL; and Christopher Chen, MD, PhD, a professor of Biomedical Engineering at BU.
Mechanical forces play a role in a wide range of biological phenomena in plants and animals, so insights generated by the Center could provide deeper understanding of embryonic development and stem-cell differentiation, cancer metastasis, the dynamic factors that influence gene expression, and many other clinically and agriculturally relevant topics.

These insights will also inform innovations like organs-on-chips that provide ideal testing platforms for human disease and “cyborg” leaf devices that can monitor plants’ natural mechanisms for responding to moisture and other environmental factors and report those conditions to farmers.

“We are at a crucial juncture in the biological sciences,” Goldman said. “We’re now just starting to understand how the force-sensing and mechanical outputs of cells pervade development, maintenance of health, and pathology of plants and animals, but we’re still doing this kind of research in isolated groups with limited interactions and separate goals.”

“By bringing together primary experts in plant and animal mechanobiology into an integrated framework of research and training, the Center will catalyze a new vision for biological, biomedical, and agricultural science,” Shenoy said.

The Center will also have faculty members dedicated to translating findings from basic research into applications. This knowledge transfer arm will be led by Mauck and Dan Huh, PhD, the Wilf Family Term Assistant Professor of Bioengineering in Penn Engineering.

To strengthen the pipeline of diverse young scientists entering the field, the Center will actively recruit from the minority-serving institutions in the partnership, providing summer programs, bootcamps, and Research Experiences for Undergraduates. Hunter will direct the Center’s diversity outreach, and Wellswill direct the Center’s educational program.

Research will be conducted in three groups, each dedicated to a different scale at which mechanobiological forces are at play: Individual cells’ molecular components and microenvironment, how cells use mechanical cues to signal to one another, and how these interactions come together to form larger assemblies and structures, which could be the inspiration for new biomaterials. Communication and coordination between the partner institutions will be led by Ostap.

The Center is supported by National Science Foundation Award CMMI-1548571.

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PHILADELPHIA – Penn Medicine received a five-year, $3.7 million grant from the Health Resources and Services Administration (HRSA) to support an academic unit to improve access to treatment for mental health disorders. The grant will establish a new Center for Integrated Behavioral Health in Primary Care in the department of Family Medicine and Community Health at the Perelman School of Medicine, in partnership with the Department of Psychiatry and the School of Nursing. The Center will serve as a national hub to develop, test, and share best practices and enhance training in integrated behavioral health.

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“This funding is timely for addressing unmet mental health needs in the new era of population health,” says project director Chyke A. Doubeni, MD, FRCS, MPH, chair and The Presidential Professor of Family Medicine and Community Health. “We have an epidemic of mental illness in this country and unacceptably large disparities in access to care persist in our communities. Mental health disorder is one of the biggest drivers of low-value care and high healthcare cost in the United States.”

Mental illness is one of the most common chronic conditions and is a major contributor to the overall global burden of disease. Depression is the leading cause of disability in the world. According to the Centers for Disease Control and Prevention, about 8 percent of US adults have depression and Americans make 8.0 million ambulatory care visits primarily for depression each year.

The World Health Organization states that an estimated 350 million people worldwide of all ages suffer from depression and that suicide is the second leading cause of death in 15-29-year-olds. An estimated 31 percent of adults in Philadelphia have a mental health diagnosis. Lack of access to trained health care professionals is a major barrier to receiving optimal treatment for mental health disorders. Integrating behavioral health into primary care is effective at improving access to care by providing services where people normally receive their primary care and allowing for warm handoffs to a mental health care team during the time of a visit with the primary care provider.

Up to one-in-four patients in primary care has depression, but less than one-third of these patients are accurately identified by primary care providers, and many are inadequately treated. Among patients seen in the Department of Family Medicine and Community Health’s ambulatory care practice, about 77 percent of frequent users of the emergency departments have a mental health and/or substance use diagnosis.

“Ensuring that patients have access to mental health care improves outcomes not only in terms of mental illness, but also in terms of other medical outcomes. This cutting edge project can serve as a model for the nation as we work towards integrated care for our patients and psychiatry is poised to be a robust partner in this endeavor,” said Maria A. Oquendo, MD, a professor of Psychiatry at Columbia University Medical Center who will become chair of the department of Psychiatry at Penn on January 1.

The HRSA grant is one of six Primary Care Training and Enhancement program grants nationwide targeting access, quality, and costs of medical care. The Penn site is the only one dedicated to integrative behavioral health. The program will help link academic programs/institutions, practice organizations and other stakeholders through advisory boards to promote the uptake of best practice behavioral health training and care. This project will be implemented under the auspices of the new Center for Community and Population Health (CCPH) in the Department of Family Medicine and Community Health, which focuses on research to reduce health disparities through improved access to care.

Additional faculty on the grant (HRSA-16-041) include Fran Barg; Margaret Baylson; Renée Betancourt; Hillary Bogner; Kent Bream; Peter Cronholm,Melissa Dichter; Anna Doubeni; Heather Klusaritz; Katherine Margo; Richard Neill; David Oslin; Julie Sochalski; and Anne Teitelman.

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PHILADELPHIA – Harold I. Feldman, MD, MSCE, FACE, the George S. Pepper Professor of Public Health and Preventive Medicine, chair of the department of Biostatistics and Epidemiology, and director of the Center for Clinical Epidemiology and Biostatistics at the Perelman School of Medicine at the University of Pennsylvania, became president of the American College of Epidemiology on September 15.

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The College is the professional organization of the nation’s epidemiologists—health professionals who examine patterns of diseases such as cancer, obesity, food poisoning, and influenza, and their causes, which range from lifestyle choices, to environmental exposures, to genetic factors.

In setting out his vision for the field and the College, its new president evoked epidemiology’s dual mission: “We must help prevent disease and we must aid the hundreds of millions whose chronic health conditions demand active management. We must help them to live better, more productive and longer lives,” Feldman said.

To serve that vision, one strategy Feldman proposes is to expand the College’s activities in clinical epidemiology—for instance by partnering with entities such as the National Center for Advancing Translational Science at the National Institutes of Health.

Feldman’s term as College president continues until fall 2017.

In addition, on January 1, 2017, Feldman will become editor-in-chief of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation. In this new role, Feldman will aim to expand the international content of this highly rated subspecialty journal by recruiting editors from outside North America. He also plans to broaden its content by featuring such topics as health policy, patient-centered outcomes research, transplantation, and pediatric nephrology.

Feldman, who is a board-certified physician in internal medicine and nephrology, earned his medical and undergraduate degrees from Boston University and a Master of Science in clinical epidemiology from the Perelman School of Medicine. He is an elected member of the American Society of Clinical Investigation, the Association of American Physicians, and the American Epidemiological Society. Feldman’s research, which focuses on diseases of the kidney, has been supported by more than $50 million in federal grants. Feldman has led many large epidemiological research initiatives in chronic kidney disease, including the Chronic Renal Insufficiency Cohort Study, known as the “Framingham Study of Renal Disease.” He also directs a number of NIH-funded institutional training grants in clinical epidemiology.

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PHILADELPHIA—For years, marketers and other commercial data-miners have been using Twitter’s vast database of “tweets” to gauge consumer attitudes and track events. Now medical researchers are getting in on the trend. Researchers from the Perelman School of Medicine at the University of Pennsylvania completed a pilot analysis of archived tweets on cardiovascular disease.

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In a study published today in JAMA Cardiology researchers sifted through a sample of approximately ten billion tweets posted between 2009 and 2015, and found more than 500,000 English-language, U.S.-originating tweets that related to cardiovascular disease.

“We demonstrated that Twitter can provide important information about heart disease, and represents a unique opportunity to listen to patients and understand more about what they talk about and care about related to cardiovascular health,” said senior author Raina M. Merchant, MD, MSHP, an assistant professor of Emergency Medicine and director of Penn’s Social Media and Health Innovation Lab.

Users in this sample who tweeted about cardiovascular themes were older and more likely to be female than the average Twitter user. The tweets mostly concerned risk factors, awareness and management of cardiovascular disease and related conditions such as diabetes and hypertension. Tweets included facts and statistics, tips, and links to new research related to heart health. Among examples: “Chronic Health Failure: Iron deficiently was found to be associated with 58% increased risk.” “October is Sudden Cardiac Arrest Month. How can you protect yourself and your loved ones?” “Exercise ‘just as good as drugs’ for treating heart failure and stroke.” “Working out for just 30 min a day, 5 days a week may help protect your body against diabetes.”
Twitter is a free online social messaging and “microblogging” service with more than 300 million active users worldwide. Twitter messages are 140 characters in length, and although private messages are possible, most “tweets” are public and go, at the rate of half a billion per day, into Twitter’s ever-expanding archive which now includes roughly one trillion tweets. Twitter offers researchers several options for accessing these data, including high-cost access to the full database (“full firehose”), lower-cost access to a randomly sampled tenth of the database (“decahose”) and free access to a 1/100th sample of the database (“Twitter spritzer”).

Merchant’s team used a combination of the decahose and spritzer options covering a period from July 2009 to February 2015. For finer-grained analysis they took a random subsample of 2,500 tweets and coded the contents of each – “self-reported diagnosis,” “news,” “advertisement,” “sentiment,” “symptoms” – to assess the incidence of tweets in different categories. For example, 42 percent of the tweets in the 2,500-tweet sample contained references to cardiovascular risk factors.

The information gleaned from the exploratory study is basic, but has paved the way for deeper research by demonstrating that Twitter data can be mined to obtain clear and potentially useful information. Merchant and her colleagues now are beginning a randomized clinical trial in which people with hypertension will join in a Twitter community with other participants and care providers, to see whether exposure to “heart health” messages by this medium lowers blood pressure.

“We are currently also working on using Twitter for epidemiologic purposes and mapping hypertension and diabetes across the US using Twitter data,” Merchant said.

Penn Medicine’s Lauren E. Sinnenberg was first author of the study. Additonal Penn authors include Christie L. DiSilvestro, Christina Mancheno, Karl Dailey, Christopher Tufts, Alison M. Buttenheim, Fran Barg, Lyle Ungar, H. Schwartz, Dana Brown, and David A. Asch. Funding was provided by the National Heart, Lung and Blood Institute (R01-HL1422457), Templeton Religious Trust, and the National Institutes for Health (K23 109083, R01 122457).

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PHILADELPHIA — More and more girls are expected to have to confront breast cancer fears as modern genomics technology makes it easier to detect strong risk factors such as inherited BRCA1/2 mutations. But a new study shows that adolescent girls in families with a history of breast cancer or a high-risk BRCA1/2 mutation do not experience negative psychological effects, on average, and even seem to have higher self-esteem than their peers. The study, from researchers at the Perelman School of Medicine at the University of Pennsylvania and the Basser Center for BRCA in Penn’s Abramson Cancer Center, is published this month in the Journal of Clinical Oncology.

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“Overall, girls in families with a history of breast cancer seem to cope pretty well over time; they do worry more about breast cancer than their peers do, particularly as they get older, but that doesn’t seem to impact them in terms of depression, anxiety, and general psychosocial adjustment,” said lead author Angela R. Bradbury, MD, an assistant professor of Hematology/Oncology in Penn’s Abramson Cancer Center.

The new study, which examines psychological adjustments of girls aged 11-19, follows a 2015 study from the same research team which showed similar results in pre-adolescent girls, aged 10-13.

The new research followed 320 girls, 208 of whom were from families with a history of breast cancer or BRCA1/2 mutations in near relatives, while 112 were “controls” with no such family history. The researchers interviewed the girls and their birth mothers and administered standard tests to assess their psychosocial adjustment, perception of breast cancer risk, and breast cancer-specific distress.

Predictably, the girls with a family breast cancer history scored much higher on measures of perceived breast cancer risk and breast-cancer-specific distress compared to the controls, yet they scored no worse on measures of general psychosocial adjustment including anxiety and depression. Intriguingly, the girls from breast cancer history families scored modestly—but significantly—higher on a measure of self-esteem.

“Self-esteem was higher among girls with a stronger family history of breast cancer, whereas depression was lower with increasing number of relatives with breast cancer,” Bradbury said. ”It may be that exposure to relatives with cancer fosters adaptive responses, although there may be other individual, mother, and family factors at work here.”

For all the girls in the study, perceptions of breast cancer risk rose as they grew older and matured mentally, and in terms of breast development. But the perceived risk was always higher among the girls with a breast cancer family history.

“Girls from breast cancer families do worry more about breast cancer than their peers do, and that’s not really surprising,” Bradbury said. “We don’t have evidence yet that that worry is a harmful thing; it may even be a motivating factor to adopt a healthier diet or to exercise more.”

The research team is examining how heightened concerns over breast cancer risk affect the behaviors of girls as they mature into women, and whether interventions are needed. “If it’s a harmful thing for a girl to know she’s at risk, we need to know which girls are anxious and how we can help them, and if it’s a beneficial thing we need to know how best to capitalize on it,” Bradbury said.

Penn co-authors on the study include Lisa A. Schwartz, Dare Henry-Moss, Susan M. Domchek, Rebecca Shorter, Kelsey Karpink, and Colleen Burke Sands.

The study was funded by the Basser Center for BRCA at the Abramson Cancer Center of the University of Pennsylvania.

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