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Tag: University of Utah Health

  • Largest-Ever Genetic Study of Suicide Finds New Risk Factors

    Largest-Ever Genetic Study of Suicide Finds New Risk Factors

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    BYLINE: Caroline Seydel

    Newswise — The reasons why people attempt suicide are complex and include external triggers like trauma and stress, as well as inherited genetic factors. A new study has identified 12 DNA variants, or variations in the human genetic code, that are associated with risk of attempting suicide. The research highlights strong genetic links between suicide attempt and factors that influence physical and behavioral health—including impulsivity, smoking, chronic pain, ADHD, pulmonary conditions, and heart disease. These findings suggest that some of the genetic underpinnings of suicide are shared with these conditions.

    One day, this information could lead to a better understanding of biological causes of suicide and improvements in prevention strategies. Eventually, such advances could help health care providers identify people who may need mental health support.

    “Many people who die from suicide have significant health conditions associated with that risk,” says Anna Docherty, Ph.D., the study’s corresponding author and associate professor of psychiatry at Huntsman Mental Health Institute at the University of Utah. “If we can use genetic information to characterize the health risks of those who attempt suicide, we can better identify those patients who need contact with the mental health care system.” The research published online on October 1 in the American Journal of Psychiatry.

    Scientists at HMHI, Icahn School of Medicine at Mount Sinai, Duke University School of Medicine, Durham Veterans Affairs Health Care System, and Vanderbilt University Medical Center led the collaboration with multiple institutions worldwide. They analyzed data from 22 different populations across the globe, including people of diverse ancestral and ethnic backgrounds.

    Understanding genetic risk of suicide

    No single gene causes suicide. Rather, the cumulative effect of many different genes influences a person’s risk. “In psychiatry, we have many tiny genetic effects, but when we account for all of them together, we start to see a real genetic risk signal,” Docherty explains.

    To tease out such a diffuse signal, researchers applied statistical methods to data collected from a large number of people and identified genetic variations that are more common among individuals who have attempted suicide. The new analysis combines data from the Million Veteran Program (MVP) and the International Suicide Genetics Consortium (ISGC). Together, these include 43,871 documented suicide attempts and 915,025 ancestry-matched controls, making this the largest genetic study of suicide to date.

    A meta-analysis of the studies identified new genetic variants that correlated with suicide attempt. The researchers then compared all variant signals with previously published genetic data on more than 1,000 other traits and disorders, including psychiatric conditions (e.g., ADHD), physical conditions (e.g., heart disease), and behaviors (e.g., smoking), and determined that genetic variants linked to suicide attempt are also linked to other health conditions.

    “That allowed us to look at how genetic risk for suicide overlaps with genetic risk for depression, heart disease, and many other risk factors,” Docherty says. “It showed significant overlap with mental health conditions, but also a lot of physical health conditions, particularly for smoking and lung-related illnesses. This is something we can’t necessarily see in medical records of people who die from suicide.”

    The results do not mean that people with any one of these health factors are at high risk for attempting suicide, notes Hillary Coon, Ph.D., study co-author and professor of psychiatry at HMHI. Rather, combining the genetic predisposition with other stressors—which could include other genetic risk factors, health conditions, life circumstances, or traumatic events—could increase that risk, she explains.

    Initial analyses support the idea that many of the DNA variants that the scientists identified are located in genes with known biological functions, bolstering the case that changes in these genes could affect a person’s physiology or behavior. Several of the genes control processes in cells such as managing cellular stress, repairing damaged DNA, and communicating with the immune system. Most are also highly expressed in the brain and are known targets of antipsychotic and antidepressant drugs.

    Scientists will need to carry out additional studies to determine whether the variants directly or indirectly impact suicide risk, and how. The research so far has shown an association and not cause and effect.

    Understanding how suicide is linked to other health conditions could open doors to new ways of assessing—and treating—suicide risk, Docherty adds. “We want to start to explore the biological underpinnings that are common across suicide and these health factors, because that will lead to the most convincing drug targets,” she says.

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    The research published as “Genome-wide association study meta-analysis of suicide attempt identifies twelve genome-wide significant loci and implicates genetic risks for specific health factors” with support from the National Institutes of Health, Huntsman Mental Health Institute, the American Foundation for Suicide Prevention, Janssen Research and Development, LLC, Clark Tanner Research Foundation, Clinical Science Research and Development Sevice of the Veterans Health Administraton Officde of Research and Development, and the Brain and Behavior Research Foundation.

    About Huntsman Mental Health Institute  

    Huntsman Mental Health Institute (HMHI) was established in 2021 following the Huntsman Foundation’s historic gift of $150 million to the University of Utah. HMHI is a university-wide Institute with a reputation throughout the Mountain West as a leader in advanced psychiatric treatment and care, serving a diverse population from young children to geriatric patients. Researchers at HMHI develop and apply the most advanced methods in genetics, imaging, epidemiology, and big data analysis. HMHI is also the regional training center for psychiatry and other mental health disciplines. HMHI’s main 170-bed full-service hospital is adjacent to the University of Utah campus, and HMHI’s 1,644 faculty, staff, and students provide clinical, research, and training programs in more than 20 locations across Utah and Idaho.   

    For more information, visit HMHI.utah.edu and join the conversation on TikTok, Instagram, Twitter, LinkedIn, YouTube, and Facebook. 

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  • Study Shows Technology Boosts Public Health Programs

    Study Shows Technology Boosts Public Health Programs

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    Newswise — An examination of the SCALE-UP Counts program was recently published in the journal Pediatrics. This analysis, led by Yelena Wu, PhD, investigator at Huntsman Cancer Institute and associate professor in the department of dermatology at the University of Utah (the U), and David Wetter, PhD, MS, investigator at Huntsman Cancer Institute and professor in the department of population health sciences at the U, received support from RADx-Underserved Populations (RADx-UP) and funding from the National Institute of Health (NIH).

    The SCALE-UP Counts program was designed to promote COVID-19 testing through collaboration with local schools, especially those who serve historically marginalized populations. This was done using two-way texting, meaning that staff, parents, or guardians could respond. Scale Up COUNTS sought to make it easier for schools to have access to COVID-19 testing and provided guidance to families and staff on when to test.

    Wu’s research is typically focused on cancer prevention in children, teens, and young adults. However, during the pandemic, along with Wetter, Adam Hersh, MD, PhD, Guilherme Del Fiol, MD, PhD, Kim Kaphingst, ScD, Jonathan Chipman, PhD, and Ben Haaland, PhD, she used her expertise to advise local K-12 schools on COVID-19 testing policies and logistics.

    Tammy Stump, PhD, visiting instructor at Huntsman Cancer Institute, helped lead a special article, which described initial findings from the Scale Up COUNTS study. Results from the analysis of the SCALE-UP Counts program, and the accompanying piece led by Stump, show that texting can increase participation in public health programs.

    “Text messaging and health navigation are feasible ways to reach staff in K-12 schools to provide health screening messages,” says Stump. “We found that 99% of staff had a valid cell phone number for the program, and fewer than 4% chose to opt out of the program. At the time of these analyses, four months after the program started, 19% of staff had engaged with the SCALE-UP Counts system in some way.”

    These results not only show that the program helped schools and families navigate the pandemic, but can help researchers understand how to increase participation in cancer prevention, screening, and education initiatives in the future.

    “We wanted to see if the use of readily available technology increased the participation of the public in health programs,” says Wu. “COVID-19 was a unique opportunity to test this while providing what we thought was an important service to our communities in Utah.”

    Wu’s team will continue to evaluate the reach and engagement of the SCALE-UP program, as well as the cost-effectiveness of using texting to communicate health information to large groups of people.

    “Text messaging seems to be an effective, and low-resource opportunity to meet people where they are at,” says Stump. “This is important when looking into how we can make public health initiatives more accessible.”

    In addition to funding from ABC Science Collaborative, and RAD-x UP, this study was supported by the NCI including P30 CA042014 and Huntsman Cancer Foundation.

    About Huntsman Cancer Institute at the University of Utah

    Huntsman Cancer Institute at the University of Utah (the U) is the official cancer center of Utah and the only National Cancer Institute-designated Comprehensive Cancer Center in the Mountain West. The institute is leading the world in scientific discovery, and turning it into unsurpassed cancer care, transforming hope into a reality. Huntsman Cancer Institute focuses on delivering a cancer-free frontier to Utah, Idaho, Montana, Nevada, and Wyoming (The Area We Serve). Huntsman Cancer Institute is home to over 300 clinical trials, with over 237 research teams studying cancer at any given time and more genes for inherited cancers have been discovered at Huntsman Cancer Institute than at any other cancer center. Huntsman Cancer Institute’s scientists are world renown for understanding how cancer begins and using that knowledge to develop innovative approaches to treat each patient’s unique tumor. Huntsman Cancer Institute was founded by Jon M. and Karen Huntsman.

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  • Clinical Trial Aims to Reduce Depression, Improve Quality of Life After Stroke

    Clinical Trial Aims to Reduce Depression, Improve Quality of Life After Stroke

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    BYLINE: Julie Kiefer

    Newswise — Following up on positive results from preliminary research, scientists at University of Utah Health are evaluating whether an eight-week program based on positive psychology techniques can improve the mood and well-being of people who have had a stroke and those who care for them. The National Institutes of Health-funded ReStoreD (Resilience in Stroke survivor-care partner Dyads) clinical trial involves both the stroke survivor and their spouse or care partner. Together, the couple takes part in planned activities that can be done at home.

    The study will recruit 200 couples in which one partner has had a stroke within the past three months to three years. Couples must have lived together for at least six months and may reside anywhere in the U.S.

    “This approach is different from others that address pathology or things that are wrong,” says Alexandra Terrill, Ph.D., leader of the new clinical trial and associate professor of occupational and recreational therapies at U of U Health. “Instead, we’re taking a ‘building what’s strong’ approach.”

    In the eight-week program, couples coping with stroke learn and practice goal setting, communication strategies, and positive psychology activities, such as expressing gratitude, finding meaning, and fostering connections. As a part of each module, participants view educational videos or read materials to learn about topics, such as resilience, coping, and well-being, that relate to adjusting to life after stroke. Then, they carry out activities related to the week’s theme. 

    Activities can be as simple as writing a thank you note, performing a good deed, or reflecting on an enjoyable experience.

    “We’re very good at prescribing blood pressure medicines and anti-thrombotics to help prevent the next stroke,” says Jennifer Majersik, M.D., a neurologist and stroke specialist at U of U Health who is a collaborator on the study. “But stroke survivors need something beyond just a pill to really help them reintegrate into their family lives and the community.”

    Addressing post stroke depression and resilience

    Preliminary research with 34 couples showed that the intervention decreased post stroke depression and improved resilience in stroke survivors, and these changes were maintained for at least three months after the program ended. Resilience is having the ability to adapt and cope when faced with challenges. Findings were more mixed for care partners, but those who had depressive symptoms and lower resilience also saw improvements. The studies’ results were based on self-report questionnaires and standardized measures. 

    The new trial seeks to confirm these results on a larger scale and provide additional evidence that the behavioral intervention lowers emotional distress in both partners. The trial will also examine effects on relationship quality, stroke-related stress, and engagement in meaningful activities.

    “There is a common assumption that feeling depressed or anxious is to be expected after sustaining a stroke and that mental health issues will resolve spontaneously once a person returns home,” Terrill says. “Unfortunately, this is often not the case.”

    Stroke is a leading cause of long-term disability, affecting nearly 800,000 people in the U.S. every year. The life-changing event can alter speech, movement, or cognition, causing a stroke survivor to lose their independence. As a result, 30 to 50 percent of people coping with stroke, along with their partners, experience depression or emotional distress. 

    Positive psychology could be a relatively simple, cost-effective solution to this problem, Terrill says. She is a clinical psychologist with specialized training in rehabilitation. More broadly, she researches the role of relationships and positive psychology in managing chronic conditions. If successful, the novel approach being tested in ReStoreD could become a sustainable and accessible means to improve recovery and quality of life.

    “I’ve seen it affect patients and their partners in a positive way,” Majersik says. “It’s shown me that we can continue to bend the curve of stroke recovery, not just by medicines or technology but also by using what I consider to be pretty simple tools. And that matters.”

    Watch this video to learn more about the research.

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  • Rocky Mountain Center for Occupational and Environmental Health Earns $8.6 Million Grant to Protect Workers

    Rocky Mountain Center for Occupational and Environmental Health Earns $8.6 Million Grant to Protect Workers

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    BYLINE: Bubba Brown

    Newswise — The Rocky Mountain Center for Occupational and Environmental Health (RMCOEH), a partnership between the University of Utah and Weber State University and one of the nation’s leading centers focused on the health and safety of workers and their environment, was recently awarded an $8.6 million grant that will allow it to further a mission that touches tens of thousands of people each year in Utah and across the West.  

    The purpose of the funding, from the National Institute for Occupational Safety and Health, is to provide students with graduate-level training in occupational and environmental health and safety, offer continuing education to professionals and businesses, and perform research that moves the needle on topics related to worker health and safety. RMCOEH is one of 18 NIOSH-sponsored Education and Research Centers in the U.S. RMCOEH has received funding from NIOSH since the center’s founding in 1977 and must reapply for the grant through a competing renewal process every five years. 

    “We are grateful for our partnership with NIOSH and pleased that we continue to demonstrate our ability to turn grant money into real-world impacts that improve lives of workers and aid businesses,” said Kurt Hegmann, M.D., who has directed RMCOEH since 2003. “We’re here to make sure as many workers as possible return to their families, healthy and whole, at the end of the day. That’s a responsibility that we, as well as the folks at NIOSH, take seriously.” 

    RMCOEH uses the NIOSH funding to support its academic programs in Occupational Medicine, Ergonomics and Safety, Industrial Hygiene, Occupational Injury Prevention, and Targeted Research Training, all housed at the University of Utah, as well as its Continuing Education program at Weber State. The grant also funds Outreach and Pilot Project Research Training initiatives.

    Since its inception, RMCOEH has produced 781 graduates from its degree programs. The vast majority of the center’s trainees assume professional positions in which they typically work to improve the health and safety of thousands of workers. The center’s Continuing Education and Outreach efforts, meanwhile, have touched an annual average of 93,000 people and 8,200 businesses over the last five years.

    RMCOEH’s research impacts are just as vast. Faculty and trainees publish approximately 80 peer-reviewed papers a year, producing groundbreaking work on topics ranging from musculoskeletal disorders among workers to wearable robotics that may enable people with debilitating conditions to return to work. During the pandemic, the center helped lead research on COVID-19 that resulted in two peer-reviewed articles in The New England Journal of Medicine, the world’s most prestigious medical journal, as well as several other papers. 

    “We’re immensely proud of what we have accomplished,” said RMCOEH Deputy Director Matthew Hughes, M.D. “It takes contributions from everyone involved with the center at both universities. It’s exciting to think about where we will be a few years from now when we are applying for this grant again.”

    This NIOSH award marks the first time RMCOEH has earned the funding as a multi-university partnership. After the center operated solely at the University of Utah for most of its existence, the Utah Legislature in 2021 passed a law bringing Weber State into its operating structure. Buoyed by the partnership, the first of its kind in Utah, RMCOEH has entered an era of growth that is unique in its history.

    The center is currently launching an Occupational Health Nursing graduate certificate program at Weber State alongside a bachelor’s degree in occupational safety and health. It will add graduate degree programs in Mining Safety and Occupational Health Psychology at the University of Utah next year. RMCOEH intends to apply for supplemental NIOSH support for the three new graduate-level offerings this fall.

    “Put simply, RMCOEH would not exist without the support NIOSH has given us over the last 40-plus years, and would certainly not have established such a remarkable legacy,” Hegmann said. “We are gratified that NIOSH continues to entrust us to carry out our mission, and we will do all we can to ensure that workers and employers would agree that it is money well spent.”

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  • Researchers Find Major Link Between Cardiovascular Health and Disorders Such as Carpal Tunnel Syndrome, Rotator Cuff Tendinitis

    Researchers Find Major Link Between Cardiovascular Health and Disorders Such as Carpal Tunnel Syndrome, Rotator Cuff Tendinitis

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    Newswise — People with higher risks of cardiovascular disease are significantly more likely to develop carpal tunnel syndrome, tennis elbow, golfer’s elbow, and rotator cuff tendinitis, according to a new study involving researchers at the University of Utah and the Rocky Mountain Center for Occupational and Environmental Health.

    The findings of the study, published June 2 in the Journal of Occupational and Environmental Medicine, have implications for the prevention and treatment of these common musculoskeletal disorders, which affect tens of millions of Americans each year and result in annual costs of more than $6 billion. 

    The lead author of the study is Kurt Hegmann, M.D., a University of Utah professor and the director of the Rocky Mountain Center for Occupational and Environmental Health, a partnership between the University of Utah and Weber State University. He said the strength of the associations the researchers discovered between cardiovascular disease risk factors and musculoskeletal disorders is staggering.

    “It’s rare that you see 17-fold risks of diseases,” Hegmann said. “These results tell us that prioritizing cardiovascular health is a key to preventing these musculoskeletal disorders, which can have a debilitating impact on people’s quality of life. This is something we and other researchers and medical professionals need to be paying a lot of attention to.”

    The authors based their research on data from a nine-year prospective cohort of 1,224 workers across various employment sectors in three states. Baseline data were collected at the beginning of the study, including from interviews, physical exams, anthropometric measurements, and nerve conduction studies, with follow-ups conducted monthly to track the development of symptoms of musculoskeletal disorders. The authors compared the development of musculoskeletal disorders to cardiovascular disease risk through a method based on the Framingham Heart Study model, a widely used tool to assess a person’s 10-year risk for cardiovascular disease. They adjusted their analyses for a number of factors that could skew the results, such as body mass index and the physical strain of participants’ jobs. 

    The findings suggest that poor cardiovascular health contributes to the development of musculoskeletal disorders. Participants at 15% or higher risk of cardiovascular disease were:

    • at four times greater risk of developing one or more musculoskeletal disorders than those at low risk of cardiovascular disease
    • at 17 times greater risk of developing four or more musculoskeletal disorders than those at low risk of cardiovascular disease

    “The importance of heart health is obviously no secret,” said Matthew Thiese, PhD, a co-author from the Rocky Mountain Center for Occupational and Environmental Health. “We know that people need to engage in healthy behaviors so they don’t develop diseases that can shorten their lives. But this study shows that bad outcomes related to musculoskeletal disorders may also be waiting for people who aren’t taking care of their cardiovascular health.” 

    The musculoskeletal disorders the researchers examined are common among Americans and can impair a person’s quality of life. Previous research estimates that up to 5% of the population suffers from carpal tunnel syndrome, for instance, with much higher prevalence among workers whose jobs require forceful movements, while up to 41% of people experience tennis elbow, or lateral epicondylitis. Up to one-third of people develop rotator cuff tears.

    According to the authors, the study prompts questions regarding whether these kinds of conditions are a potential “early warning” signal for cardiovascular disease. Musculoskeletal disorders may occur in a person with poor heart health years or decades before symptoms of cardiovascular disease emerge.

    The findings align with a growing body of evidence that systemic risk factors contribute to developing musculoskeletal disorders. Limitations of the research include that the study was not a randomized control trial. Randomized studies are the gold standard in proving causality, though these types of exposures cannot be randomized.

    The other co-authors associated with the University of Utah included Eric Wood, MD, and Richard Kendall, MD. They conducted the study in collaboration with researchers from the University of Wisconsin-Milwaukee, Infinity Healthcare in Wisconsin, and the Clement J. Zablocki Veterans Affairs Medical Center in Wisconsin.

    About University of Utah Health

    University of Utah Health  provides leading-edge and compassionate care for a referral area that encompasses Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences research and education in the region, U of U Health has a $458 million research enterprise and trains the majority of Utah’s physicians, and more than 1,670 scientists and 1,460 health care providers at its Colleges of Health, Nursing, and Pharmacy and Schools of Dentistry and Medicine. With more than 20,000 employees, the system includes 12 community clinics and five hospitals. U of U Health is recognized nationally as a transformative health care system and provider of world-class care.

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  • Digital Health Initiative Research Could Lead to More Reliable Health Apps

    Digital Health Initiative Research Could Lead to More Reliable Health Apps

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    BYLINE: Doug M Dollemore

    Newswise — Seven University of Utah Health projects have received seed grants that could promote the development and use of more scientifically based digital health applications in daily health care.  

    The grants, supported by the Digital Health Initiative (DHI), will focus on projects  designed to produce safer and more effective digital tools than are currently available, according to Guilherme Del Fiol, M.D., Ph.D., co-director of DHI and a professor in the Department of Biomedical Informatics at U of U Health.

    “There’s been a surge in the use of digital health applications in the past few years, both by patients and their doctors,” Del Fiol says. “But how many of these apps actually work as intended? Most are promoted with little or no rigorous scientific evidence.”

    In fact, a 2019 analysis of studies conducted by the 25 top-funded American producers of digital health tools, including wearable biosensors and mobile health apps, found that most of these products did not have a substantial impact on health outcomes, cost, or access to care. Another study of mental health apps concluded that only 14% of the 1,400 apps evaluated were based on real-world experiences, and none mentioned a certification or accreditation process.

    “We see these seed grants as a tremendous opportunity to alter that trajectory,” Del Fiol says. “They represent a starting point for taking innovative, reliable, and scientifically tested digital health applications from bench to bedside.”

    The seed grant projects will receive up to $50,000 for one year. The researchers will develop, test, and evaluate digital applications that fall within one of the four main areas of interest within the DHI: 

    • Mobile apps and games for health
    • Virtual reality and sensors
    • Clinical decision support tools
    • Integration with electronic health records (EHR)

    If successful, the projects will progress to clinical trials designed to assess their usefulness in a larger context, says Victoria Tiase, Ph.D., R.N.,  director of strategic development at DHI.

    “Clinicians treating patients at the bedside need better efficiency today,” Tiase says. “So, we need to get more practical and effective digital tools in the pipeline. We hope that these seed grants will be a jumping-off point for that effort.”

    Recipients of the seven seed grants represent 11 U of U Health disciplines, ranging from anesthesiology to nursing to population health.

    Project Titles, Summaries, & Awardees

    Health Records and Community Service Integration of the Going Home Toolkit

    Andrea Wallace, Ph.D. (Nursing)

    Roger Altizer, Ph.D. (Entertainment Arts Engineering, Population Health Sciences)

    Kensaku Kawamoto, M.D., Ph.D. (Biomedical Informatics)

    Wallace and colleagues will evaluate the effectiveness of a digital resource planner to help patients self-manage their health conditions after they leave the hospital. Called the “Going Home Toolkit”, the planner includes sections on transportation, medication, errands, meals, housework, personal care, billing, and insurance. It is also designed to help patients better communicate their needs to family, friends, and health care providers. 

    Broadening the Impact of Symptom Care at Home Through EHR Integration and Implementation Science 

    Elizabeth Sloss, Ph.D., M.B.A., R.N. (Nursing, Huntsman Cancer Institute)

    Kathi Mooney, Ph.D., R.N (Nursing)

    Justin D. Smith, Ph.D. (Population Health Sciences)

    Guilherme Del Fiol, M.D., Ph.D. (Biomedical Informatics)

    Kensaku Kawamoto, M.D., Ph.D. (Biomedical Informatics)

    Symptom Care at Home, a program that helps cancer patients reduce symptoms that occur during treatment for cancer, asks patients to report daily symptoms in a mobile application or by phone and receive automated coaching or follow-up from a nurse practitioner to manage their symptoms. With this DHI seed grant, the researchers will identify ways that Symptom Care at Home can incorporate patient-reported symptoms into their electronic health records.

    Patient Generated Health Data for Geriatrics Patients

    Jorie Butler, Ph.D. (Biomedical Informatics)

    Butler will collect patient-generated health data, using mobile devices like a Fitbit, from patients aged 65 and older with chronic pain. The participating patients will review and discuss their personal data with the research team to help them understand how these data are useful to patients in managing their own health. This research can be applied to future care of pain and other health conditions.

    Expanding the Capability of Intraprocedure Anesthesia Information Display and Pharmacology Forecasting

    Ken B. Johnson, M.D., M.S. (Anesthesiology)

    Beca Chacin (Anesthesiology Center for Patient Simulation)

    Soeren Hoehne (Anesthesiology Center for Patient Simulation)

    Cameron Jacobsen, M.S. (Anesthesiology)

    Noah Syroid, M.S. (Anesthesiology)

    Johnson and colleagues seek to combine an anesthesia forecasting system with electronic health records at U of U Health. With this system, an anesthesia provider will have visual guidance to monitor and predict the levels of sedation, analgesia (pain relief), and muscle relaxation for a patient who is undergoing general anesthesia.

    Explainable AI for Equitable Risk Stratification of Atrial Fibrillation and Stroke

    Mark Yandell, Ph.D. (Human Genetics, Bioinformatics)

    Martin Tristani Firouzi, M.D. (Pediatrics)

    Benjamin Steinberg M.D. (Cardiology)

    Using artificial intelligence, Yandell and colleagues seek to produce more accurate predictions of individual stroke risk. The computational model will account for socioeconomic disparities seldom considered in previous attempts at predicting strokes. These considerations include housing, transportation, and discrimination, and accessibility to nutritious foods and exercise. These refined predictions will enable doctors to offer patients more personalized stroke prevention advice.  

    Remote sensing of autonomic function and mobility coupling using wearables to monitor recovery after mild traumatic brain injury.

    Peter Fino, Ph.D. (Health and Kinesiology)

    Melissa Cortez, D.O. (Neurology)

    Leland Dibble, Ph.D., P.T. (Physical Therapy & Athletic Training) 

    Fino and his colleagues seek to develop a system to assess individuals who have persistent symptoms of mild traumatic brain injury (mTBI), such as concussions. The researchers will monitor activity, heart rate, and other key indicators of mTBI using wearable at-home devices. 

    By combining data streams from these devices worn at home, the researchers believe they can identify individuals with persistent mTBI symptoms earlier and expedite rehabilitation when they show signs of atypical recovery.

    Spanish Language Translation and Preliminary Feasibility of NeuroFlex: A Digital Cognitive Intervention for Late Life Depression

    Sarah Morimoto, Psy.D. (Population Health Sciences)

    Morimoto will translate and test a video game designed to relieve depression among older Spanish-speaking volunteers. The game, called Neurogrow, allows players to tend a virtual garden, performing tasks including watering, fertilizing, and eliminating pesky bugs.

    In previous research, the scientists found that Neurogrow helped relieve depression and improve cognitive function among English-speaking, non-Hispanic older men and women. The researchers hope to find similar results in Spanish-speaking volunteers. If successful, they plan to use Neurogrow more broadly in Latino/Hispanic communities.

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  • Can ChatGPT be Counted On?

    Can ChatGPT be Counted On?

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    Newswise — A study in the Journal of The National Cancer Institute Cancer Spectrum looked at chatbots and artificial intelligence (AI), as they become popular resources for cancer information. They found these resources give accurate information when asked about common cancer myths and misconceptions. In the first study of its kind, Skyler Johnson, MD, physician-scientist at Huntsman Cancer Institute and assistant professor in the department of radiation oncology at the University of Utah (the U), evaluated the reliability and accuracy of ChatGPT’s cancer information.

    Using the National Cancer Institute’s (NCI) common myths and misconceptions about cancer, Johnson and his team found that 97% of the answers were correct. However, this finding comes with some important caveats, including a concern amongst the team that some of the ChatGPT answers could be interpreted incorrectly. “This could lead to some bad decisions by cancer patients. The team suggested caution when advising patients about whether they should use chatbots for information about cancer,” says Johnson.

    The study found reviewers were blinded, meaning they didn’t know whether the answers came from the chatbot or the NCI. Though the answers were accurate, reviewers found ChatGPT’s language was indirect, vague, and in some cases, unclear.

    “I recognize and understand how difficult it can feel for cancer patients and caregivers to access accurate information,” says Johnson. “These sources need to be studied so that we can help cancer patients navigate the murky waters that exist in the online information environment as they try to seek answers about their diagnoses.”

    Incorrect information can harm cancer patients. In a previous study by Johnson and his team published in the Journal of the National Cancer Institute, they found that misinformation was common on social media and had the potential to harm cancer patients.

    The next steps are to evaluate how often patients are using chatbots to seek out information about cancer, what questions they are asking, and whether AI chatbots provide accurate answers to  uncommon or unusual questions about cancer.

    The study was supported by the National Institutes of Health/National Cancer Institute including P30 CA042014 and Huntsman Cancer Foundation.

    About Huntsman Cancer Institute at the University of Utah

    Huntsman Cancer Institute at the U is the official cancer center of Utah and the only National Cancer Institute-designated Comprehensive Cancer Center in the Mountain West. The campus includes a state-of-the-art cancer specialty hospital and two buildings dedicated to cancer research. Huntsman Cancer Institute provides patient care, cancer screening, and education at community clinics and affiliate hospitals throughout the Mountain West. It is consistently recognized among the best cancer hospitals in the country by U.S. News and World Report. The region’s first proton therapy center opened in 2021 and a major hospital expansion is underway. Huntsman Cancer Institute is committed to creating a diverse and inclusive environment for staff, students, patients, and communities. Advancing cancer research discoveries and treatments to meet the needs of patients who live far away from a major medical center is a unique focus. More genes for inherited cancers have been discovered at Huntsman Cancer Institute than at any other cancer center, including genes responsible for breast, ovarian, colon, head and neck cancers, and melanoma. Huntsman Cancer Institute was founded by Jon M. and Karen Huntsman.

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  • Step Forward in Gene Therapy to Treat Cause of Sudden Cardiac Arrest in Athletes

    Step Forward in Gene Therapy to Treat Cause of Sudden Cardiac Arrest in Athletes

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    BYLINE: Jennifer Michalowski

    Newswise — University of Utah Health scientists have corrected abnormal heart rhythms in mice by restoring healthy levels of a protein that heart cells need to establish connections with one another. That protein, GJA1-20k, is underproduced in people with a genetic condition called arrhythmogenic cardiomyopathy, one of the leading causes of sudden cardiac arrest in athletes under the age of 35.

    The finding, reported in the journal Circulation Research, suggests a new strategy for treating the abnormal heart rhythms caused by arrhythmogenic cardiomyopathy.

    The results may also have implications for treating dangerous arrhythmias associated with more common conditions, such as those that can develop soon after a heart attack.

    “This is really a new paradigm for the treatment of heart rhythm disorders,” says Joseph Palatinus, M.D., Ph.D., an investigator at the Nora Eccles Harrison Cardiovascular Research and Training Institute (CVRTI) and critical care cardiologist at Intermountain Healthcare. Palatinus is the first author of the study, which was led by U of U Health colleague Robin Shaw, M.D., Ph.D., director of the CVRTI.

    An unusual pattern in patients

    People with arrhythmogenic cardiomyopathy are born with normal hearts but begin to develop an irregular heartbeat in their 20s or 30s. These arrhythmias can raise the heart rate to dangerous levels and explain why some individuals with the condition experience sudden cardiac arrest during exercise.

    Patients diagnosed with arrhythmogenic cardiomyopathy are advised to restrict exercise. They may also benefit from an implantable defibrillator to control their heartbeat. As the disease progresses, the heart muscle becomes fatty and fibrotic. This prevents the heart from pumping blood efficiently, and eventually patients need a heart transplant.

    Palatinus, Shaw, and their colleagues studied heart tissue from patients with arrhythmogenic cardiomyopathy who underwent transplant and discovered a problem with a protein called Connexin 43. In healthy hearts, Connexin 43 forms channels between adjacent cells, facilitating communication. The diseased hearts made normal amounts of Connexin 43, but it wasn’t at the edges of cells where it belonged.

    This, the team determined, was likely because there wasn’t enough of a trafficking protein, called GJA1-20ka. The researchers knew from previous experiments that without it, the heart’s cells wouldn’t be able to get Connexin 43 to the right place.

    Fixing an abnormal heartbeat at the source

    To determine if they could restore the heart’s normal rhythm, the scientists turned to mice that have similarities to people with arrhythmogenic cardiomyopathy. They both have low levels of GJA1-20k and develop arrhythmias. Palatinus and colleagues used low doses of gene therapy to bring the trafficking protein GJA1-20k back to normal levels. This, they confirmed, enabled heart muscle cells to transport Connexin 43 to its proper locations.

    Most importantly, it gave the animals a more normal heartbeat. “The ease and low dose needed to fix the arrhythmias of even an inherited heart disease suggests that we have identified a critical pathway to stabilize cardiac electrical activity,” said Shaw.

    Although arrhythmia improved, the animals still had heart scarring, a symptom from a different underlying condition. Palatinus noted that was actually an encouraging result. It suggests arrhythmia and heart scarring can occur independently and that it could be possible to treat abnormal heart rhythms even when the heart is severely scarred. “This is a new paradigm,” he says.

    The treatment success in mice suggests that raising levels of GJA1-20k might restore normal heart rhythms in patients with arrhythmogenic cardiomyopathy, too. For patients, Palatinus says, it might be possible to deliver the therapeutic protein directly to the heart. Further research will be needed to develop the treatment for clinical use.

    Disruptions in protein trafficking are thought to contribute to arrhythmias beyond those caused by arrhythmogenic cardiomyopathy, and Palatinus is optimistic that a similar treatment strategy might be useful for those conditions, too. If so, that could one day give patients and their doctors an alternative to the ion channel-blocking drugs currently used to treat many arrhythmias, which can slow the heart and even lead to new rhythm problems for some patients.

    # # #

    The research was supported by the National Institutes of Health, The Harold Geneen Charitable Trust, and the Nora Eccles Treadwell Foundation and published as “GJA1-20k Rescues Cx43 Localization and Arrhythmias in Arrhythmogenic Cardiomyopathy.”

    About University of Utah Health

    University of Utah Health  provides leading-edge and compassionate care for a referral area that encompasses Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences research and education in the region, U of U Health has a $458 million research enterprise and trains scientists and the majority of Utah’s physicians and health care providers at its Colleges of Health, Nursing, and Pharmacy and Schools of Dentistry and Medicine. With more than 20,000 employees, the system includes 12 community clinics and five hospitals. U of U Health is recognized nationally as a transformative health care system and provider of world-class care.

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  • Language of Care: University of Utah Health Researchers Co-Design Health Care With the Deaf Community

    Language of Care: University of Utah Health Researchers Co-Design Health Care With the Deaf Community

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    Newswise — Navigating health care is hard enough when English is your first language—imagine the difficulty when American Sign is your first language. How can we bridge the linguistic and cultural gaps needed to better care for patients? University of Utah Health is proud to present Language of Care, an incredible story of how a community of Deaf patients are breaking barriers by co-designing their own care with University of Utah Health researchers.

    Made possible by generous support from the Kahlert Foundation, Language of Care premiered at Sundance Film Festival 2023. The film showcases an innovative approach to health care being co-created by Michelle Litchman, PhD, her research team, and members of the Deaf community from across the country. Together, they lead a program called Deaf Diabetes Can Together. Litchman is a nurse practitioner, diabetes researcher, and Medical Director of the Intensive Diabetes Education and Support (IDEAS) Program at the University of Utah.

    Nearly 40 million people in the U.S. live with diabetes, but the majority of Deaf people with diabetes do not have equal access to health care. The film tells the story of how Deaf Diabetes Can Together is creating solutions for health equity in the Deaf community. By understanding the community’s unique needs, the team is tailoring educational and other types of resources to increase access to accurate information and care. This model is being replicated for rural, Pacific Islander and other under-resourced communities.

    “Together, with our patients, we’re changing the way heath care works,” Litchman explains in Language of Care.

    Academy Award®-winning filmmaker Ross Kauffman came to Utah to document the Language of Care story. Kauffman has directed a number of award-winning films, including Born into Brothels, Of Medicine and Miracles, and Tigerland. Language of Care was produced by Robin Honan with executive producers Joe Borgenicht of U of U Health, award-winning documentarian Geralyn Dreyfous, and Heather Kahlert of the Kahlert Foundation.

    Language of Care is the third film in the U of U Health-produced series New Narratives in Health, which brings together scientists and artists to more broadly communicate advances in knowledge. The first film in the series, One in a Million, tells the story of how advanced genomic technologies combined with expert clinical insights vastly improved the quality of life for Tyler, a boy with a rare, debilitating disease. The second, Meet Me Where I Am, follows Adolphus Nickleberry through his journey at U of U Health’s Intensive Outpatient Clinic as he rewrites his story, which had been shaped by health disparities.

    Learn more at languageofcareutah.org.

    # # #

    About University of Utah Health

    University of Utah Health  provides leading-edge and compassionate care for a referral area that encompasses Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences research and education in the region, U of U Health has a $458 million research enterprise and trains scientists and the majority of Utah’s physicians and health care providers at its Colleges of Health, Nursing, and Pharmacy and Schools of Dentistry and Medicine. With more than 20,000 employees, the system includes 12 community clinics and five hospitals. U of U Health is recognized nationally as a transformative health care system and provider of world-class care.

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  • Gene that guides earliest social behaviors could be key to understanding autism

    Gene that guides earliest social behaviors could be key to understanding autism

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    Newswise — Little is known about how social behavior develops in the earliest stages of life. But most animals––including humans––are born with an innate ability to interact socially or form bonds with others. And that contributes to success throughout life.

    Now, a new animal study points to a gene that is important for the earliest development of basic social behaviors.

    The work also suggests that exposure to certain drugs and environmental risk factors during embryonic development can cause changes to this gene, leading to alterations in social behavior that are similar to those found in individuals who have autism. Much to their surprise, the researchers also found they could reverse some of the effects using an experimental drug.

    “This study helps us understand at the molecular level why sociability is disrupted during the very earliest stages of life,” says Randall T. Peterson, Ph.D., the corresponding author of the study and dean of the University of Utah College of Pharmacy. “It also gives us an opportunity to explore potential treatments that could restore sociability in these animals and, perhaps in time, eventually in humans as well.”

    More broadly, their findings suggest that the gene—TOP2a—controls a large network of genes that are known to increase the risk of autism. It also may serve as a link between genetic and environmental factors that contribute to onset of disorder, Peterson adds.

    The study, conducted by University of Utah Health researchers and colleagues nationwide, appears in the Nov. 23 issue of Science Advances.

    Anti-social animals

    Scientists suspect many social traits are determined before birth. But the precise mechanisms involved in this process remain murky. One promising area of research suggests that social behavior and other characteristics and traits are influenced not only by our genetic makeup but also how and where we live. 

    To test this model, the scientists evaluated whether environmental exposures during embryonic development could influence social behavior. Peterson and his colleagues exposed zebrafish embryos to more than 1,100 known drugs––one drug per 20 embryos––for 72 hours beginning three days after conception.

    The researchers determined that four of the 1,120 tested drugs significantly reduced sociability among the zebrafish. Fish exposed to these drugs were less likely to interact with other fish. It turned out that the four medications all belonged to the same class of antibiotics, called fluoroquinolones. These drugs are used to treat upper and lower respiratory tract infections in people.

    When the scientists gave a related drug to pregnant mice, the offspring behaved differently when they became adults. Even though they appeared normal, they communicated less with other mice and engaged in more repetitive acts—like repeatedly poking their head in the same hole—than other rodents.

    A basis for sociability

    Digging deeper, the researchers found that the drugs suppressed a gene called TOP2a, which, in turn, acted on a cluster of genes that are known to be involved in autism in humans.

    They also found that the cluster of autism-associated genes shared another thing in common—a higher than usual tendency to bind a group of proteins called the PRC2.  The researchers hypothesized that Top2a and the PRC2 work together to control the production of many autism-associated genes.

    To determine whether the anti-social behaviors could be reversed, the research team gave embryonic and young zebrafish an experimental drug called UNC1999, which is known to inhibit the PRC2. After treatment with the drug, fish exposed to fluoroquinolones were more likely to swim closer to other fish, demonstrating that the drug helped restore sociability. They saw similar results with other drugs known to inhibit the same key gene, TOP2a. 

    “That really surprised me because I would’ve thought disrupting brain development when you’re an embryo would be irreversible,” Peterson says. “If you don’t develop sociality as an embryo, you’ve missed the window. But this study suggests that even in those individuals later in life, you can still come in and inhibit this pathway and restore sociality.”

    Moving forward, the researchers plan to explore how and why this drug had this effect.

    Although the scientists only found four compounds that are Top2a inhibitors, evidence suggests hundreds of other drugs and naturally occurring compounds in our environment can inhibit its activity.

    “It’s possible that these four compounds are just the tip of the iceberg in terms of substances that could be problematic for embryonic exposure,” Peterson says.

    However, Peterson notes that this study was conducted in animals, and more research needs to be done before any of its results can be confirmed in humans. Therefore, he cautions against drawing conclusions about real-world applications.

    “We have no evidence that fluroquinolones or any other antibiotic causes autism in humans,” Peterson says. “So, there is no reason to stop using antibiotics. What this paper does identify is a new molecular pathway that appears to control social development and is worthy of further exploration.”

                                                    ###

    In addition to Dr. Peterson, U of U Health scientists Yijie Geng, Tejia Zhang, Ivy G. Alonzo, Sean C. Godar, Christopher Yates, Brock Plummer, and Marco Bortolato contributed to this study. Other participating institutions include the University of Chicago; Beth Israel Deaconess Medical Center in Boston; Massachusetts General Hospital and Harvard Medical School; the Broad Institute, Cambridge, Massachusetts; and MDI Biological Laboratory, Bar Harbor, Maine.

    The study, “Top2a promotes the development of social behavior via PRC2 and H3K27me3,” appears in the Nov. 23, 2022, issue of Science Advances. This research was supported by the L. S. Skaggs Presidential Endowed Chair and the National Institute of Environmental Health Sciences at the National Institutes of Health.

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  • mRNA Vaccines Significantly Reduce Severity of Delta, Omicron COVID-19 Infections

    mRNA Vaccines Significantly Reduce Severity of Delta, Omicron COVID-19 Infections

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    Newswise — People who have received two or three doses of an mRNA COVID-19 vaccine are significantly more likely to have milder illnesses if infected with the Delta or Omicron coronavirus variants than those who are unvaccinated, according to a nationwide study involving a team of University of Utah researchers.

    The study, which examined health care personnel, first responders and other frontline workers in Utah and five other states, builds on previous research that indicates mRNA vaccines provide protection against severe health outcomes associated with COVID-19 despite the variants’ increased transmissibility.

    “It’s encouraging that the mRNA vaccines hold up rather well against these variants,” said Sarang Yoon, D.O., associate professor in the Department of Family and Preventive Medicine at University of Utah Health. She is a study co-author who leads the Utah portion of the research and is part of the Rocky Mountain Center for Occupational and Environmental Health, a partnership between the University of Utah and Weber State University. “We know that breakthrough cases are more likely with Delta and Omicron than the initial strain, but the vaccines still do a good job of limiting the severity of the infection.”

    The study was published Tuesday in the Journal of the American Medical Association (JAMA). It is the latest of several peer-reviewed papers resulting from the nationwide HEROES-RECOVER project funded by the U.S. Centers for Disease Control and Prevention.

    Researchers examined 1,199 participants who developed COVID-19 infections. Of the participants, 24% were infected with Delta and 62% contracted Omicron, while 14% had the original virus strain.

    Delta highlights:

    • Participants who had received two vaccine doses were significantly less likely to be symptomatic than those who were unvaccinated (77.8% vs. 96.1%)
    • Symptomatic participants with a third dose were far less likely to experience fever or chills than those who were unvaccinated (38.5% vs. 84.9%) and experienced symptoms for an average of six fewer days (10.2 days vs. 16.4 days)

    Omicron highlights:

    • The risk of symptomatic infection was similar between participants with two vaccine doses and those who were unvaccinated, while those with three doses experienced a higher risk than the unvaccinated (88.4% vs. 79.4%)
    • Symptomatic participants with three doses were significantly less likely to experience fever or chills (51.5% vs 79%) or seek medical care (14.6% vs 24.7%) than the unvaccinated

    The authors noted that, while the study is among the largest of its kind examining COVID-19 vaccines over time and across variants, grouping participants by variant and vaccine status resulted in some combinations with relatively few people, affecting the precision of the findings. They also indicated that the study was not able to account for all factors influencing COVID-19 severity, which may skew the results. There were also results the authors characterized as “unexpected” among participants who received three doses and had symptomatic Omicron infections.

    Researchers gathered data between Dec. 14, 2020, and April 19, 2022. Participants submitted self-collected nasal swabs weekly regardless of COVID-19 symptoms, as well as at the beginning of experiencing signs of illness. Participants were excluded from the study if they had infections before the study start date, or if their infections occurred: sooner than 14 days after their second vaccine dose, sooner than seven days after their third dose or more than 149 days after their third dose.

    # # #

    Other co-authors associated with the University of Utah and Rocky Mountain Center for Occupational and Environmental Health include Kurt Hegmann, M.D.; Matthew Thiese, P.h.D; Andrew Phillips, M.D.; Jenna Praggastis, B.S.; and Matthew Bruner, B.S.

    About University of Utah Health

    University of Utah Health  provides leading-edge and compassionate care for a referral area that encompasses Idaho, Wyoming, Montana, and much of Nevada. A hub for health sciences research and education in the region, U of U Health has a $458 million research enterprise and trains the majority of Utah’s physicians and health care providers at its Colleges of Health, Nursing, and Pharmacy and Schools of Dentistry and Medicine. With more than 20,000 employees, the system includes 12 community clinics and five hospitals. U of U Health is recognized nationally as a transformative health care system and provider of world-class care.

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