Immune-disorder treatment in mice holds potential for multiple sclerosis patients

December 1, 2015
Doug Bennett

A University of Florida Health researcher has found a simple, rapid way to treat an immune-related disorder in mice, an approach that could eventually help multiple sclerosis patients after further research.

The process attaches disease-related protein fragments called autoantigens to spleen cells to prevent a disease known as experimental autoimmune encephalomyelitis, or EAE, which causes brain and spinal cord inflammation in animal models. EAE is commonly used in research because it mimics some of the traits of multiple sclerosis in humans.

MS is a disorder in which the immune system attacks brain, spinal cord and optic nerves, damaging the fatty substance that “insulates” nerve fibers and interrupting nerve impulses. An estimated 400,000 people in the United States and 2.5 million people worldwide have the disease, according to the Multiple Sclerosis Foundation.

An infusion of spleen cells coupled with an autoantigen completely prevented EAE in a mouse model, said Chang-Qing Xia, M.D., Ph.D., a research assistant professor in the UF College of Medicine’s department of pathology, immunology and laboratory medicine. The same method also “dramatically reversed” the disease in its early stages, researchers found.

The findings were published recently in the Journal of Immunology Research.

The approach used to treat autoimmune diseases isn’t new. But Xia and his collaborators from Capital Medical University in China coupled the autoantigens to the spleen cells using a different chemical known as sulfo-SMCC, or SMCC, that already is approved by the U.S. Food and Drug Administration for drug delivery in several clinical trials. Compared with the previously reported autoantigen-coupling method known as EDCI, this method makes the process faster, easier and less toxic to cells, Xia said.

While EAE in animals isn’t identical to MS, Xia said there are enough similarities to believe that the same immunotherapy approach could eventually be used to treat humans.

“The most important thing is that these findings are highly translatable to the clinic,” Xia said.

This is how the process works: Protein fragments of the nerve insulation substance known as myelin are coupled with spleen cells and injected into mouse models. After more than two months, researchers found that the treatments had completely prevented EAE from developing. Likewise, the same approach also reversed EAE in its early stages.

Researchers believe that the spleen cell-autoantigen combination activates the production of helpful immune system cells while suppressing the disease-causing activities of other cells linked to autoimmune diseases.

While no clinical trials have been scheduled, Xia said his new approach shows potential for making the leap from the laboratory to the clinic. Sulfo-SMCC, the chemical used to bind the autoantigen to spleen cells, has already been used for drug delivery in some clinical trials. Because the chemical is already in use, that could shorten the amount of time needed to get the new process tested in humans, Xia said.

If used in humans someday, it’s likely the protein fragments known as autoantigens would be coupled to peripheral white blood cells and delivered by transfusion. The same principle that makes the autoantigen therapy effective against EAE in mice should be able to benefit humans, according to Xia.

“If it works on EAE, it also should work on MS because the two diseases are similar immunologically and pathologically,” he hypothesized.

Next, Xia said he hopes to move the method into clinical trials if he can get other researchers interested in trying the technique.

Funding for the research was provided by two grants to Xia from the National Natural Science Foundation of China.

Science & Wellness

Researchers identify genes connecting endocrine disruption to genital malformations

December 3, 2015
Doug Bennett

University of Florida Health researchers have identified genes that are disrupted by abnormal hormone signaling at crucial points during development, a finding that may lead to a better understanding of how the most common male genital birth defects arise in humans.

The discovery that environmental signals can interfere with the activity of genes that orchestrate genital development in mouse embryos has potential implications for increasingly common genital birth defects that affect one out of every 125 boys in industrialized countries.

The findings have been published in the Proceedings of the National Academy of Sciences journal by a group led by principal investigator Martin J. Cohn, Ph.D., a professor of molecular genetics and microbiology in the UF College of Medicine and a member of the UF Genetics Institute.

Cohn and his collaborators, Zhengui Zheng, Ph.D., and Brooke Armfield, Ph.D., both postdoctoral associates in the department of molecular genetics and microbiology, found that androgen and estrogen — hormones produced by the endocrine system — control a suite of genes in the embryonic genitalia of mice.

When the balance between the two hormones was disrupted, the activity of those genes changed and the genitalia developed abnormally. That provides a new genetic link between endocrine disruption and genital defects, Cohn said.

However, it was not yet clear that disrupting the genes’ activity was the direct cause of the malformations. To answer that question, researchers manipulated the target genes and found that inactivating even one of them was enough to cause feminization of male genitalia.

The hormonal disruptions led to birth defects, including hypospadias, a congenital deformity of the urethra; genital curving, known as chordee; micropenis; and ambiguous genitals.

The timing of endocrine disruption was also determined to be crucial: Cohn’s team found a series of short periods of development when different genital deformities can arise in mice with otherwise normal, healthy genes. The type of genital malformation that develops is affected by the timing of the endocrine disruption, they found.

Blocking the androgen signal during early development caused complete feminization of the genitalia, whereas slightly later disruptions affected genes in a way that caused hypospadias and chordee. After birth, either disrupting the androgen signal or increasing the estrogen signal resulted in micropenis, according to the findings. Sexual differentiation of the genitalia begins before birth and continues through puberty.

“We identified very narrow windows of development that explain this broad spectrum of genital malformations,” Cohn said.

The researchers also pinpointed 22 genes expressed in embryonic genitalia that can be positively and negatively regulated by signals from the environment.

“I suspect that this could be the tip of the iceberg,” Cohn said.

Knowing which genes are responsible for genital birth defects and when the embryo is most vulnerable to endocrine disrupting signals is an important step forward, Cohn said. Over the past 40 years, the incidence of hypospadias has increased dramatically for unknown reasons. Mutations have been found in very few of the affected individuals. While there isn’t a scientific consensus about what causes genital birth defects, there is increasing evidence that environmental factors play a role.

 “Our results suggest that if environmental factors disrupt the expression of genes during one of these critical developmental periods, then this can lead to the same kinds of malformations that result from mutations,” Cohn said.

The chemicals that disrupt endocrine signaling are used in pesticides and herbicides, personal care products such as antibacterial soap, as well as in the manufacturing of plastics.

“They’re pretty hard to avoid. We are exposed to endocrine disruptors every day,” Cohn said.

With this in mind, Cohn hopes to better understand the mechanisms of endocrine disrupting chemicals that cause genital malformation.

 “If we can determine how the embryo responds to the precise levels and combinations of endocrine disrupting chemicals in the environment, then there is an opportunity to improve prenatal care,” he said.

 The ultimate goal, Cohn added, is finding ways to protect embryos from the chemicals that cause genital birth defects.

The research was funded by National Institutes of Health grant ES017099. 

Science & Wellness

UF Health researchers identify novel proteins linked to Huntington’s disease

December 7, 2015
Doug Bennett

University of Florida Health researchers have made a new discovery about Huntington’s disease, showing that the gene that causes the fatal disorder makes an unexpected “cocktail” of mutant proteins that accumulate in the brain.

The findings are significant because these newly identified mutant proteins kill neurons and build up in regions of the brain that are most affected by the disease, said Laura Ranum, Ph.D., director of the UF Center for NeuroGenetics and a professor in the UF College of Medicine department of molecular genetics and microbiology.

The findings were published Nov. 18 in the journal Neuron.

“We have to get to the bottom of why these junk proteins accumulate in the brain and we need to figure out how to block that process,” Ranum said.

Huntington’s disease is an inherited disorder that damages nerve cells and causes parts of the brain to deteriorate, leading to uncontrolled movements and behavioral and cognitive problems. There is no cure and no way to stop the disease’s progression, though medications can treat some symptoms.

About 30,000 people in the United States have the disorder and another 200,000 are at risk of inheriting it, according to the Huntington’s Disease Society of America.

The UF researchers examined the brains of 12 deceased adult and juvenile patients with Huntington’s disease. They found novel proteins that were abundant in areas of patients’ brains that showed cell death, neuronal loss and other signs of disease, including neuroinflammation.

Along with a protein already implicated in Huntington’s disease, the researchers found four proteins that also contribute to the disease pathology. The disease stems from a genetic mutation in the Huntingtin gene that produces too many copies of a DNA segment known as CAG, which gives rise to a longer Huntingtin protein with toxic effects. 

However, researchers found that this DNA repeat mutation can undergo a process known as repeat associated non-ATG (RAN) translation, producing four additional damaging repeat proteins that accumulate in the brain. This was a surprise to the researchers because these RAN proteins are made without a signal in the genetic code that was previously thought to be required for protein production. Each of the four RAN proteins contains long repeats of certain single protein building blocks, or amino acids. 

 “These repeat proteins are too long for cells to deal with and they build up as aggregated clusters that kill cells,” Ranum said.

Finding these novel RAN proteins in degenerated areas of the brain that were negative for the previously known mutant Huntington protein was crucial to linking them to the disease, said Monica Bañez-Coronel, Ph.D., a postdoctoral associate and the first author of the journal article.

Knowing that four proteins may underlie the disease also presents its own challenge.

“We now know that there are more players in the disease arena and it is likely that each one of these proteins contribute to Huntington disease,” Bañez-Coronel said.

In addition to finding that the RAN proteins accumulate in the striatum, a specific brain region predominantly affected in Huntington disease, researchers also found them in the frontal cortex, cerebellum and white matter regions of the brain. Bañez-Coronel said this was the first time the accumulated proteins related to Huntington’s disease were extensively found in white matter, an inner part of the brain containing cells that support neuronal function.

In the cerebellum — a part of the brain at the back of the skull that controls movement and motor coordination — the discovery of RAN proteins suggests that they may be responsible for some of the typical uncontrolled movements observed in Huntington disease patients, researchers said.

On the basis of their findings, the researchers believe there is a possibility that RAN proteins contribute to eight other similar neurodegenerative disorders, including spinobulbar muscular atrophy and several types of spinocerebellar ataxia, which are also caused by an abnormal increase in the number of CAG repeats.

Knowing that rogue proteins are implicated in Huntington’s disease is just the first step. Ranum said further research is needed, and it will be important to understand how these proteins are being made without the normal cellular signals and if strategies to block their production can be developed. In addition to the possibility of new therapies, detecting these proteins may be useful for predicting the disease’s onset, its progression and treatment responses, researchers said.

The University of Florida is one of 29 sites in the country designated as a Center of Excellence by the Huntington’s Disease Society of America. Patients at the centers get access to neurologists, psychiatrists and other professionals who work collaboratively to help families plan the best care possible.

The study was co-authored by University of Florida researchers Fatma Ayhan, Solaleh Khoramian Tusi and Barbara A. Perez, who are all Ph.D. candidates in the department of molecular genetics and microbiology; Tao Zu, M.D., a research assistant professor in the department of molecular genetics and microbiology;  David R. Borchelt, Ph.D., a professor of neuroscience in the department of neuroscience; Anthony T.Yachnis, M.D., a professor and chief of the neuropathology section in the department of pathology, immunology and laboratory medicine; Alex D. Tarabochia, a biological scientist who worked in Ranum’s lab; and Johns Hopkins University researchers Olga Pletnikova, M.D.; Christopher A. Ross, M.D., Ph.D.; Russell L. Margolis, M.D.; and Juan C. Troncoso, M.D.

The research was supported by grants from the National Institutes of Health, the W.F. Keck and CHDI foundations and other funding from the Spanish Ministry of Health, The Johns Hopkins University Alzheimer’s Disease Research Center, and the University of Florida and its Alumni Fellowship.

Science & Wellness

UF, Santa Fe College to launch program for graduating more underrepresented students in sciences

December 1, 2015
Steve Orlando

Santa Fe College and the University of Florida will receive an award of up to $1.4 million over five years from the National Institutes of Health for a new program aimed at increasing the number of underrepresented students who transfer from Santa Fe College to UF and graduate with bachelor’s degrees in biomedical and behavioral science-related disciplines.

The new program is led at UF by David Julian, an associate professor of biology, under NIH grant R25GM115298

The new SF2UF Bridge to Baccalaureate Program targets students who are underrepresented in majors related to the life sciences at Santa Fe College. It is one of more than 40 other Bridges to the Baccalaureate programs funded by NIH’s National Institute of General Medical Sciences to increase the diversity of community college students who go on to research careers in the biomedical sciences.

“Santa Fe College is well known for providing access to educational opportunity, including being a gateway for students to the University of Florida,” said Santa Fe College Provost Ed Bonahue. “This grant will strengthen both of our institutions and will help ensure that the students who transfer represent the rich diversity of our community and state.”

UF Provost Joe Glover echoed Bonahue regarding the benefit to students and the institutions.

“Santa Fe and UF have a decades-long track record as partners in helping students reach their goals, and the SF2UF Bridge Program is a wonderful new chapter in that relationship. This program is an important step toward increasing access to higher education,” Glover said.

Julian said more undergraduate students transfer to UF from Santa Fe College than from all other community colleges combined, “but within the biomedical and behavioral science-related disciplines, under-represented students at SF are half as likely as non-under-represented students to transfer to UF. SF2UF will increase the opportunities for our advisers, science faculty and students to work together to strengthen the bridge between our institutions, and to help transfer students hit the ground running when they arrive at UF.”

Beatriz Gonzalez, a professor of biology at Santa Fe College and the college’s SF2UF Bridge Program director, said, “With this exciting program, SF will build a new Biology and Chemistry Tutoring Center, purchase new equipment for our courses in science and behavior, and create a pipeline for our students to become directly involved in biomedical and behavioral research at UF.”

Over the course of the five-year program, Gonzalez said, 48 SF students will receive training in biomedical research techniques at UF and then be employed as laboratory assistants with NIH-funded faculty researchers at UF, both while they are students at SF but also continuing after they transfer to UF.

Funding for these students will also be provided by $200,000 from the UF College of Medicine and $80,000 from the UF colleges of Agricultural and Life Sciences and Liberal Arts and Sciences.

Joel Brendemuhl, associate dean for academic programs in the UF College of Agricultural and Life Sciences, said the program will identify underrepresented students to succeed in STEM fields.

“We’re hoping to provide a seamless transition for students working toward their baccalaureate degrees to then move on to graduate school,” he said. “Hopefully, some of these students will in turn become faculty members in STEM fields themselves.”

UF College of Liberal Arts and Sciences Dean David E. Richardson said, “We are pleased to partner with Santa Fe in a program that will help every student achieve his or her academic aspirations.”

Santa Fe College students can begin applying for acceptance to the SF2UF Bridge Program in January. Application instructions and additional information about the new program are available at http://www.sfcollege.edu/sf2ufbridge/.

Campus Life

How your genes influence what medicines are right for you

December 2, 2015
Julie A. Johnson

You have a headache. Do you reach for Tylenol or Advil? Most people have a preference because they have learned over time that one works better than the other at relieving their pain. This type of variability from person to person is true for nearly every medication, whether it requires a prescription or can be purchased over the counter.

Pharmacists, physicians and researchers have tried for decades to understand why the same medication, at the same dose, can work well for some people but not for others, or why some people need higher or lower doses of the same drug, or why some people have side effects, while others do not.

Many factors contribute to these differences in how people respond to the same medication, including age, other medications they may be taking, kidney function and cigarette smoking, to name a few. But it’s become increasingly clear that genetics can also be an important factor.

Genes influence how well drugs work

Understanding how these genetic differences work means that physicians can take a more personalized approach to selecting the right medication and dosage for each individual. This is called pharmacogenetics, and pharmacogenetic tests to guide use of certain medications are becoming increasingly common.

This kind of personalized treatment is an example of what is called precision medicine, which is being touted as an important part of the future of health care. In fact, President Obama announced in the 2015 State of the Union address his plan to launch the Precision Medicine Initiative:

“to bring us closer to curing diseases like cancer and diabetes – and to give all of us access to the personalized information we need to keep ourselves and our families healthier.”

Genes influence how well your liver breaks down medicine

Today the most frequently used tests looks for variations (also called polymorphisms) in the genes that carry instructions for making the enzymes in the liver that metabolize (break down) drugs.

For drugs that are already in an active form – which means that the drug has immediate effect on the body – enzymes in the liver break the drug down to make it inactive, so the body can then discard it. When the enzyme in the liver that breaks down a particular drug does not work properly due to a genetic variation, then the body can’t get rid of the active drug effectively. That can lead to too much drug in the body, which can in turn lead to serious side effects.

Other drugs are consumed in a form that is inactive, and are broken down in the liver into their active form. The liver enzymes that break the drug down are critical to making it work. For these medications, when the liver enzyme does not work properly because of a gene variation, the drug cannot be converted into its active form.

Differences in how enzymes break down drugs can mean that people need different doses of a particular drug to achieve the same effect, or that some drugs might not be as effective for them. And many of these gene variations are very common in the general population and can affect decisions about the right drug or right drug dose in several ways.

Using gene variations to choose the right medication

Children with leukemia are commonly tested for a gene variation for the enzyme that breaks down drugs called thiopurines. These drugs are commonly used to treat childhood leukemia, and are consumed in an active form.

If tests reveal that the enzyme that breaks down the drug and gets rid of it doesn’t work as well, they are given one-tenth the normal dosage. That tiny fraction of a dose gives them the same benefits as someone whose enzyme functions normally and gets 10 times the dose because their body breaks it down more efficiently. In cases like this, the genetic difference between people can be addressed by giving different dosages of the same medication.

For drugs that are converted into an active for in the liver, genetic variations can mean that a person needs to take a different kind of drug entirely. One example of this is the drug called Plavix® or clopidogrel, which is commonly used after heart attacks or balloon angioplasty to prevent blood clots from forming.

It has to be activated by the liver – but gene variations in the most important enzyme for this process mean that at least 25%-30% of people cannot fully convert Plavix® to its active form. When people with that gene variation take Plavix®, it is less effective at preventing heart attacks and strokes.

Here at the University of Florida, we began testing this gene in heart disease patients getting a balloon angioplasty and stent in 2012. For those who had the gene variation that made Plavix® a suboptimal choice, we recommended a different medication be used.

We followed patients who had this gene variation, and found that the ones who actually took an alternate drug had significantly fewer heart attacks, fewer strokes and were less likely to die than those who continued taking Plavix. These data highlight how using someone’s genetic information can lead to a personalized approach to their care, and in turn lead to better health.

These same approaches are also being used more and more often to select cancer drugs, although in most situations it is the genetics of the tumor, not the patient, that are being tested to pick the right drug. In fact, most of the new drugs that have been approved for the treatment of cancer in recent years are developed for specific tumor genotypes.

Where does pharmacogenetics go from here?

These are just a few examples of the potential for using genetic information to guide decisions about drug therapy. Currently over 100 drugs have pharmacogenetic information in their product label from the Food and Drug Administration. Over time, more and more medications will likely be added to the list of those for which genetic data may allow for more personalized treatment decisions.

And the way genetic information is obtained will change in the coming years. In the examples provided above, the genetic information is gathered through a laboratory test that specifically evaluates the gene or genes of interest.

However, in the future it is expected that an individual’s entire genome (all three billion letters of their genetic code) will be defined and stored for use throughout their lifetime. When that happens, using genetic information to inform decisions about the right drug and the right dose will likely involve computerized approaches that marry the genetic data with knowledge about drugs and genes, to lead to a personalized treatment recommendation.

We are probably at least a decade or more from this reality. In the meantime, the number of drugs whose use can be guided by genetics and the number of people who benefit are expected to grow.

Link to article on The Conversation site: https://theconversation.com/how-your-genes-influence-what-medicines-are-right-for-you-46904

Science & Wellness

How children with disabilities came to be accepted in public schools

December 7, 2015
Jean Crockett

When Alan joined my class in September, I knew he needed help. So did I.

Alan had lived in an orphanage ever since he was an infant and faced many challenges: he was older than the other kids and did not want to play with them. He didn’t use words – although he could make sounds. He was very different from his classmates and stayed to himself.

But then, every afternoon he was a bundle of energy, imitating the barking of a dog and crawling on the floor around his classmates at circle time. He also had a passion for shredding my teaching materials.

I didn’t know what to do.

That was 1978. I was teaching half-day kindergarten classes in a New York school that year to 33 five-year-olds in the morning and to another 30 youngsters in the afternoon.
I had no assistant, and safety was my first priority. I referred Alan for an evaluation to see if he was eligible for special education services.

Luckily for Alan, three years earlier, President Gerald Ford had signed the Education for All Handicapped Children Act (EAHCA) of 1975 into law. Public schools were given three years to get ready for some big changes.

By the time I referred Alan, Public Law 94-142 (as the act was known then) had taken effect nationwide. As we mark the 40th anniversary of the law, it is an important moment in which to reflect.

From my perspective as a teacher, school administrator and professor of special education – who has followed this nation’s journey toward equal educational opportunities – I believe this law enabled many young kids with disabilities, like Alan, to lead more productive lives.

What it was like in the 1970s

Back in the seventies, educating kids with special needs in regular schools was a new concept.

Before the law came in, 1.75 million children with disabilities were completely excluded from public schools. And of the three million children with disabilities who went to school, many did not receive an education that was appropriate to their needs. Most often they were taught in special classes or state-supported schools.

Children with mild visual or hearing problems, speech impairments or mild intellectual disabilities could spend at least some time in regular classes. But those who were totally deaf or had moderate intellectual difficulties were not allowed in regular classrooms. They were sent to separate schools or institutions – even if they did not need to be in those settings.

Some states even had strict laws excluding children who were considered “crippled,” “feebleminded” or “emotionally disturbed” from public education, based only on their “handicaps.” It was not unusual for them to be institutionalized.

The general belief was that children with a disability could not learn. Parents who could afford to pay sent their kids to private schools that provided special services through nonprofit organizations such as the Easter Seals Association or The Arc that were set up by parents early on to advocate for their kids.

The education of these children became an issue of public concern in their home communities only if there was enough money. At the time, education for children with special needs was seen to be more of a matter of privilege and not a right.

What changed with a new law

Once the EAHCA came in, however, it made the right to education a reality for students with disabilities across the United States.

It helped kids receive an Individualized Education Program so they could be taught the skills they needed in class or on the playground.

In Alan’s case, his special education teacher assessed his strengths and weaknesses – he needed to learn to recognize letters and numbers and learn to play with others. She also experimented with different teaching approaches and kept data on what he could and couldn’t do so she could target his learning problems. In addition, he received services from the speech-language therapist.

I remember, thanks to these services, Alan made good progress that year.

As this was 1978 and kids with special needs were rarely taught in regular classrooms, Alan never returned to my kindergarten class. He was taught in a separate special education classroom.

How the law evolved

In 1990, Congress updated the title and language of the law. It came to be known as the Individuals with Disabilities Education Act (IDEA).

A great deal of activism on behalf of people with disabilities led to this change. The term “handicapped” implied dependence. Its origins went back to medieval times, when the only source of income for many people with disabilities was begging with a cap in hand.

Putting the word “individuals” before the word “disabilities” in the title was also preferred as an example of “person-first” language. This implied that people were not to be defined by others only by their disability.

Several other changes were made as the law evolved: In 1986, it came to include services for children under six years old. In 1990, it incorporated services for older students to get help planning their transition to college, work and life in their communities. And in 1997, Congress reauthorized the law to increase accountability.

As a result, IDEA 1997 came to incorporate new goals – such as getting kids ready for school, improving academic achievement in reading and other subjects, increasing graduation rates, bringing in highly skilled teachers, making schools safer and building stronger partnerships with parents.

These changes meant that more kids could be taught in the regular classroom – they could access school activities and the same general curriculum as other students without disabilities. Consequently, for the past 40 years, public schools in the US have been required to make a free, appropriate, public education available to all children with disabilities.

Way forward

I imagine if Alan were in school today, he would be one of 6.4 million students in the US who receive IDEA services from birth to age 21. He would also likely be among the 95% of special education students taught in public schools who spend some part of their school day in regular classes.

I would also like to think that if Alan were born today, he would not be given up for adoption. His parents would learn to care for him with support from early intervention services for infants and toddlers.

He would be included in a local preschool program where he could learn to be with other kids and feel safe. That would help him get ready for his first day of kindergarten.

But he would also be facing some challenges.

In my experience, educating students with disabilities is complex. Too often, effective techniques and materials are not used in schools. And even when students are included in regular classes, they are not taught appropriately.

In 2004, changes were made in the law to overcome low expectations for these students. Today, the good news is that dropout rates for students with disabilities have decreased – 64% of special education students now graduate with a regular high school diploma.

But the sobering news is the reading and math performance of many students is well below proficiency.

The challenge is for teachers and school administrators to make sure students with disabilities in their schools are taught in ways that are proven by research to improve their learning.

Special education students need the extra services provided by IDEA to develop, learn and succeed. Without the extra interventions and personalized support, the performance of many is unlikely to improve. Unfortunately, this isn’t happening in enough schools.

The issue is, special and general education teachers need to work together for these students to make appropriate progress. They need to be sure they respond not only to their students' academic needs but also to their social and personal needs. To do that, school administrators need to help their teachers build the will and the skills to work together.

I’ve been through this journey for 40 years. And I am celebrating the birth of IDEA today. For when I think about Alan, I recall the impact it made – on him and many others.

Link to article on The Conversation site: https://theconversation.com/how-children-with-disabilities-came-to-be-accepted-in-public-schools-50820

Society & Culture

One in 10 globally suffer from foodborne diseases, WHO study finds

December 3, 2015
Evan Barton

One out of every 10 people worldwide suffer from foodborne diseases annually, and children and the poor suffer most, according to the findings of a World Health Organization task force headed by a University of Florida senior researcher.

One out of every 10 people worldwide suffer from foodborne diseases annually, and children and the poor suffer most, according to the findings of a World Health Organization task force headed by a University of Florida senior researcher.

The announcement, made Wednesday, comes after more than eight years of research and data analysis by a WHO task force composed to measure the effect of foodborne diseases on populations around the globe.

“The groups most adversely affected by the foodborne diseases are children and people in low-income regions of the world,” said task-force leader Dr. Arie Havelaar with UF’s Emerging Pathogens Institute. “Of those who lost years to ill-health, disability or early death, 40 percent were children under 5 years old, even though they constitute only 9 percent of the world population. Foodborne illnesses affect people on the African continent the most, followed by sub-regions of Southeast Asia and the eastern Mediterranean.”

The group will publish its research outcomes this week in a PLOS Collection. Papers on enteric diseases, parasitic pathogens, chemical and toxic hazards, and methodology will make up parts of the collection. The results are also presented in a WHO technical report.

“Estimating the burden of foodborne diseases is highly complex due to the many diseases involved,” Havelaar said. “The full extent of chemical and biological contamination of food, and its burden to society, is still unknown.”

The WHO created the Foodborne Disease Burden Epidemiology Reference Group in 2007 to study global variation in the impact of foodborne disease. After considering the known disease-causing agents that can be transmitted by food, the group identified 31 hazards as the most necessary to include.

The group found that these 31 foodborne hazards caused 600 million foodborne illnesses and 420,000 deaths in 2010. Results from the study indicate that up to 33 million healthy life years are lost each year due to foodborne diseases each year — a number on par with the “big three” infectious diseases — HIV/AIDS, malaria and tuberculosis — and air pollution, but clearly lower than the burden of dietary risk factors or unimproved water and sanitation.

Diarrheal disease agents were the most frequent causes of foodborne illness – particularly norovirus and Campylobacter spp. Non-typhoidal Salmonella enterica, also a diarrheal disease agent, is capable of causing blood poisoning in people with weakened immune systems and was a major cause of death among the pathogens chosen for the study.

Other major pathogens causing foodborne disease deaths included SalmonellaTyphi, a subspecies of Salmonella enterica; Taenia solium, a tapeworm that comes from pork products; and the hepatitis A virus.

Dr. Brecht Devleesschauwer, an assistant scientist at UF’s department of animal sciences, worked with Havelaar to analyze data from the study.

“We compiled information from a variety of data sources, including national surveillance systems and scientific literature, and used expert opinion and statistical modeling to fill data gaps,” Devleesschauwer explained. “In addition to disease incidence and deaths, we also quantified the disease burden in terms of Disability-Adjusted Life Years — the number of healthy years of life lost due to illness and death — to facilitate ranking between causes of disease and across regions.”

Dr. Kazuaki Miyagishima, the director of the Department of Food Safety and Zoonoses at the WHO, gave his support to the group’s analyses in a WHO statement.

“This report,” he said, “should enable governments and other stakeholders to draw public attention to this often under-estimated problem and mobilize political will and resources to combat foodborne diseases.”

In addition to his work with the Emerging Pathogens Institute, Havelaar is a core member of the Institute for Sustainable Food Systems at UF and a professor in the department of animal sciences.

Global Impact

In protecting coral reefs, fish can only do so much

December 7, 2015
Alisson Clark
coral reef, marine biology, environment, human impact

For years, many scientists thought we had a secret weapon to protect coral reefs from nutrients flushed into the seas by human activity. Experiments suggested that herbivores such as fish, urchins and sea turtles could keep corals and their ecosystems healthy by eating up extra algae that grew in the presence of these nutrients.

But a new University of Florida study sheds doubt on that idea, underscoring the importance of sustainable growth in coastal areas.

“We found that while herbivores can control the effects of nutrient pollution in small-scale experiments, nutrient pollution at larger, realistic scales can overwhelm them,” said Mike Gil, a marine biologist who conducted the study as a doctoral student at UF. “We can’t just focus on protecting fish to keep coral reefs healthy. We have to take a more holistic approach.”

You don't have to be a scuba diver to care about healthy reefs. In addition to sustaining sea turtles, whales and dolphins, these ecosystems deliver a host of benefits to people, from providing medicinal compounds and seafood to protecting our coastlines from storm surges. Nutrient enrichment can endanger these reefs: As our population grows, paving and development dump runoff laden with nitrogen and phosphorus into nearby bodies of water. Fertilizers intended for lawns and crops find their way into the seas, where sewer pipes might also be disgorging waste, especially in developing nations. The resulting enrichment can cause an overgrowth of algae that harms corals, sea grasses and kelp.

In Akumal, Mexico, where he leads a field course in marine ecology, Gil has seen coral reefs decline and algae increase, even as the population of algae-eating fish remained stable. He wondered if herbivores alone were really enough to defend the reefs. The field experiments that gave rise to that idea typically looked at areas of nutrient pollution of a square meter or less, but nutrient pollution zones can cover hundreds of square kilometers. Gil wanted to know if those results would scale up, but he knew larger field experiments weren't a viable option. (“It’s not ethical to nuke an entire system with nutrients.”) So Gil and his co-authors – fellow doctoral student Jing Jiao and former UF professor Craig Osenberg, now at the University of Georgia – turned to mathematical modeling. 

They found that as the area affected by nutrient pollution increased, herbivores' ability to control the resulting algae decreased, suggesting that these systems may be more vulnerable than many scientists thought.

Their findings could guide policy-makers in creating sustainable plans for industries such as tourism and fishing, which rely on healthy reefs.

Tourists can help, too – when visiting sensitive areas such as the Yucatán, Hawaii or the Great Barrier Reef, opting for sustainable accommodations and tour operators can reduce impact on reefs, Gil said. 

Global Impact

Road work ahead

December 7, 2015
Paul Bernard

Beginning this Wednesday and Thursday, Dec. 9-10, and again on Dec. 14-15, drivers can expect road construction and flagmen on Newell Drive between Archer Road and Diamond Road.

Intermittent lane closures may occur between Dec. 9 and 18. One lane of traffic will always be open in each direction during this construction, and no lane closures will be in effect from 6:30-8:30 a.m. and 4:30-6 p.m., Monday through Friday.

The construction is one phase of the Florida Department of Transportation Cross Campus Greenway project that is improving sidewalks and resurfacing this portion of Newell Drive with bike lanes. 

For additional information, please contact Linda B. Dixon at ldixon@ufl.edu or 352-273-4010.

Campus Life

An increase in alcohol tax appears to have decreased gonorrhea rates in Maryland by 24 percent

December 9, 2015
Elizabeth Hillaker Downs
Public Health

Increasing state alcohol taxes could help prevent sexually transmitted infections, such as gonorrhea, according to University of Florida Health researchers, who found that gonorrhea rates decreased by 24 percent in Maryland after the state increased its sales tax on alcohol in 2011.

Multiple prior studies have shown that increases in alcohol taxes decrease alcohol consumption. Less drinking reduces risky sexual behavior, such as having unprotected sex or having sex with new partners. In 2014, the rate of infection from gonorrhea, chlamydia and syphilis increased substantially nationwide, and young people accounted for nearly two-thirds of the cases of gonorrhea and chlamydia. This UF Health study is one of the first to quantify the effect of alcohol taxes on the rate of sexually transmitted infections.

“If policymakers are looking for methods to protect young people from harmful STIs, they should consider raising alcohol taxes, which have decreased remarkably over the years due to inflation,” said Stephanie Staras, Ph.D., MSPH, an assistant professor in the UF College of Medicine department of health outcomes and policy and the study’s lead researcher.

Sexually transmitted diseases can cause pain, infertility and certain types of cancer. In Maryland, the tax increase resulted in 2,400 fewer statewide cases of gonorrhea during the 18 months after the tax increase went into effect, according to findings published today (Dec. 9) in the American Journal of Preventive Medicine.

The tax increase in Maryland was only $0.03 per $1. The tax increased from 6 percent, which had been the sales tax rate on alcohol since July 1, 2008, to 9 percent on July 1, 2011.

The team used data from the National Notifiable Disease Surveillance System, which includes all state and local reports of select nationally notifiable diseases from public and private sources, for 102 months prior to the tax increase and 18 months after the tax increase.

To attribute the effects the team observed to the increase in alcohol taxes, the researchers compared the trends in sexually transmitted diseases in Maryland with three groups of other states. First, the researchers compared Maryland with those states that have a similar alcohol sales method but did not increase alcohol taxes and do not share a border with Maryland: California, Arizona, Colorado, Indiana, Wisconsin, New Mexico, Texas, North Dakota, South Dakota, Oklahoma, Louisiana, Florida and Rhode Island. To compare Maryland to states with similar trends in sexually transmitted diseases, the team compared rates in Maryland with the states with the most similar baselines, which was Oklahoma for chlamydia and Colorado for gonorrhea. To account for potential regional contributions to sexually transmitted disease trends, the team also compared Maryland with Rhode Island. The rate of gonorrhea infections decreased an additional 24 percent in Maryland compared with these control states after the increased tax went into effect.

The research team did not find any effect on chlamydia rates or any differences across age, race or ethnicity, or gender. This lack of difference across various demographics suggests the tax may have influenced all individuals similarly, Staras said.

The lack of effect on chlamydia rates could be due to the fact that chlamydia infections are more likely to be asymptomatic or mild compared with gonorrhea, which means people are less likely to seek testing and therefore the cases are less likely to be reported. In addition, gonorrhea infections are more geographically concentrated and restricted to higher-risk populations, magnifying the influence of small changes, such as a decrease in alcohol consumption. High-risk populations include individuals who engage in risky sexual behavior with concurrent partners or those who have sexual partners within an interconnected social group.

“Right now, the only population-level intervention for STIs recommended by the Centers for Disease Control and Prevention is condom distribution,” Staras said. “However, the effects we observed in this study are comparable to the effectiveness of condom distribution, and taxes generate revenue rather than spend it — making it a powerful option for policymakers to consider.”

This research was supported by the Zanvyl and Isabelle Krieger Fund via a grant to the Johns Hopkins Bloomberg School of Public Health, which provided the research team at the UF College of Medicine a sub-grant to conduct this research.

Science & Wellness

The secret side of science

December 12, 2015
Alisson Clark

The guest stars in Mike Gil's videos often steal the show – and the camera.

In the YouTube series Confessions of a Marine Biologist, Gil shares his adventures in the field as a University of Florida doctoral student. The meme-rich, heavy-metal-tinged videos, shot in locations from Tahiti to the Yucatán, follow his exploits amid killer waves, shark-infested waters and mucus-spewing spider snails – plus the aforementioned larcenous octopus and photobombing triggerfish that took out his research cameras.

The videos are Gil’s way of sharing a side of science he never saw growing up.

“I thought science was a boring list of facts you recited in a classroom. I never knew it could be a lot of fun,” he said.

That changed after his freshman year at the University of Texas at Austin, where Gil – then a journalism major – won a scholarship to a field course in Australia.

On an island where lizards outnumbered people, he studied the diversity of reef fishes and discovered a passion for science. Now he gets to spark that same discovery for students in his marine ecology field class in Akumal, Mexico – but he wanted to share the experience with others, as well.

He’s hoping the videos and his website, SciAll.org, will inspire students to explore science beyond the classroom.

“Scientists aren’t just people in lab coats in a basement. I’ve had amazing experiences in wonderful parts of the world,” he said. “That’s the secret I want to get out: Science, no matter the location, is true adventure.” 

Mike Gil works on coral reef research in Mexico.

Science & Wellness

Poinsettias to passports

December 20, 2015
Desirae Lee

Students in the University of Florida’s Environmental Horticulture Club saw a semester’s worth of work turn into a greenhouse full of 5,000 healthy poinsettias for the club’s annual sale — but the rewards didn’t end there. The sale also funds the group’s annual international trip.

The proceeds from more than 150 varieties of poinsettias will help pay for lodging, outings and airfare for about 25 members of the club to travel to Ireland this summer.

Club advisor and trip supervisor James Barrett, a professor in horticultural science with a specialization in poinsettias, has been affiliated with the organization since 1978. He says the international trip is highly beneficial to his students. 

“Every trip that we’ve done was purposeful and helpful because of the exposure students get. Just seeing other cultures and how they incorporate plants in agriculture or in home use is a rewarding learning experience,” he said.    

Barrett expects every part of the growing process to be student-run. 

“They start from day zero, managing each other and the plants.”

Campus Life

UF club 3D prints prosthetics for teens

December 11, 2015
Alisson Clark

A BuzzFeed article about 3D printing changed Jessica Bergau’s life. Now she’s changing the lives of teens born with upper-limb differences.

After reading the article, the junior zoology major at the University of Florida created a student organization – Generational Relief in Prosthetics – that 3D-prints hands and other assistive devices with the support of the UF Libraries.

Bergau teaches UF students from all over campus – including medicine, engineering, education and art majors – to print the devices using open-source designs that they customize for each recipient. The club involves the teen recipients in the process, from choosing the colors to assembling the devices. At the club's first weekend camp, teens from around the Southeast gathered to try out their devices, getting a lesson in 3D printing, as well.

“Many of these teens have gone their whole lives without prosthetics,” Bergau said. “Even if it isn’t something they are using every minute of every day, it still makes an impact.”

Campus Life

Quick clean-up: New process turns decades into hours for mining-water purification

December 10, 2015
Steve Orlando

Cleaning up the water left over from mining operations can literally take generations – 25 to 50 years on average – leaving billions of gallons of the precious resource locked up and useless.

Now, a University of Florida researcher has figured out how to trim that time dramatically – to just two to three hours, a potential boon to mining companies, the environment and global regions where water is scarce.

“I think the ability to save water is going to be really big, especially when you’re talking about China and other parts of the world,” said Mark Orazem a distinguished professor of chemical engineering in UF’s Herbert Wertheim College of Engineering.

His team’s idea has attracted the attention of the Minnesota-based Mosaic Company, which produces phosphate and potash for fertilizer and operates four phosphate mines in Central Florida.

“We value the longstanding partnership that we have with University of Florida. It’s important for us to continually seek research that improves efficiencies of our processes.” Said Paul Kucera, senior engineer advisor in research and development with Mosaic.

Mining operations use water for mineral processing, dust suppression and slurry transport. When they’re finished with it, the water holds particles of mineral byproducts, known in the phosphate mining business as clay effluent. In the case of phosphate mines that are so common in Florida, the clay effluent has the consistency of milk.

“It looks like a solid, but if you throw a stone into it, it’ll splash,” he said.

That water is pumped into enormous settling ponds – some are as large as a mile square with a depth of about 40 feet --- where the particles can sink to the bottom. Florida alone is home to more than 150 square miles of such ponds, an area that would cover about half of New York City.

But it’s a lengthy process because the particles are electrically charged. Like charges repel and opposite charges attract. The particles’ like charge causes them to repel each other, which keeps them suspended in the water instead of sticking together and sinking to the bottom.

That means mining companies can re-use the water only a bit at a time – the part skimmed off the top. Not only is the particle-filled water useless, the land those settling ponds occupy is a valuable asset that could be used for other purposes.

Ideas for speeding up that process go back centuries. In 1807, an early application of the battery invented by Volta in 1800 showed that clay particles moved in response to an electric field. In the 1990s, an electric field was used to separate clay and water in batches, but that concept was deemed uneconomical.

Orazem’s design is different because it allows a continuous feed of clay effluent into a separation system. There, upper and lower plates are used as electrodes. An electrical potential difference is applied across the electrodes, creating an electric field, which causes the charged particles to move toward the bottom, where they form a wet solid called a cake. In the cake dewatering zone, the particles can’t move, so the water is forced to the top.

The cake can then be used to fill the holes created by the mining operation, while the water is now clear enough to be reused to process mined phosphate ore.

“Instead of having the water tied up in these clay settling areas, water is sent back through the process and then reused and reused and reused,” Orazem said.

Orazem’s team has created a lab-sized prototype. The next step, he said, is to determine how to scale it up to a point where it can work in a real-world mine.

While Orazem’s concept was designed for Florida phosphate mines, he said it could be used anywhere and would be especially useful in arid North Africa. In Morocco and the Western Sahara, with 85 percent of the world’s phosphate reserves, water is especially in short supply.

“Recycling water is going to be critically important,” Orazem said. “So in Florida, it’s an issue. In the desert, it’s going to be a major issue.”

Global Impact

Explore “home” through the humanities

December 11, 2015

In spring 2016, a Gainesville-wide speaker series will invite Florida residents from all backgrounds to share their stories about making the Sunshine State their home.

“Imagining Florida” is a five-part series of lectures and discussions from Jan.-Apr. 2016. Talk writing with Gainesville author Lauren Groff at the ALCD Headquarters Branch Library. Unpeel the history of Florida citrus with Gary Mormino at the Matheson History Museum. Feast your eyes on African-Floridian art with Robin Poynor and Patricia Hilliard-Nunn at Santa Fe College. And dust off treasured artifacts from famous Floridians with curators from the UF Smathers Libraries.

Together, these events reveal how we use writing, art, storytelling and history to shape our lives and communities. Throughout the series, local residents will be invited to contribute their own stories and memories to create a crowd-sourced digital collage of Florida life. Join us to discover what “Florida” means to you and what it might mean to your neighbors.


Saturday, Jan. 9, 2:30 pm
“A Conversation on Writing” – with Award-Winning Gainesville Author, Lauren Groff
Alachua County District Library, Headquarters

Wednesday, Feb. 24, 3:30 pm
“Africa in Florida” – A Discussion with Patricia Hilliard-Nunn and Robin Poynor
Santa Fe College, Lawrence W. Tyree Library

Sunday, March 13, 3 p.m.
“Talking Objects, Global Voices” – Collecting Florida Treasures with UF Curators
University of Florida, Smathers Library (East), Room 100

Thursday, April 7, 6 p.m.
“Dream Fruit for a Dream State, or When Alachua County Was a Citrus Power” with Gary Mormino
Matheson History Museum

Saturday, April 23, 8:30 a.m. – 5 p.m.
THATCamp (The Humanities and Technology Camp)
Santa Fe College, Center for Innovation and Economic Development, 530 W. University Ave.

“Imagining Florida” is presented by the UF Center for the Humanities and the Public Sphere, Santa Fe College, the Alachua County Library District, the Matheson History Museum and the UF George A. Smathers Libraries.​

All events are free and public participation is encouraged. For details, visit humanities.ufl.edu or find us on Facebook. For specific questions, please contact Jordana Cox at jordana.cox@ufl.edu or 352-392-0796.


Campus Life

National Academy of Inventors honors UF professors

December 15, 2015

Two University of Florida scientists are among the 168 new Fellows of the National Academy of Inventors, which recognizes the contributions of researchers from universities and nonprofit organizations who are named inventors on U.S. patents.

Roy Curtiss III, a professor in the department of infectious diseases and pathology at the UF College of Veterinary Medicine; and Ann Progulske-Fox, program director and distinguished professor in the department of oral biology at the UF College of Dentistry, are being recognized for their contributions to innovation in areas such as patents and licensing, innovative discovery and technology, significant impact on society, and support and enhancement of innovation.

In a career spanning more than 50 years, Curtiss has lent his expertise to the fields of genetics, microbiology, biomedical sciences and vaccinology. He recently developed multiple new innovative means to construct recombinant attenuated salmonella vaccine strains. Curtiss has been a member of the United States National Academy of Sciences since 2001.

Progulske-Fox has made significant contributions in microbiology that have increased understanding of the links between oral and systemic health. Her research interests focus on how successful pathogens survive and cause disease, and how bacteria from the mouth cause disease in other parts of the body. She was elected as a fellow in the American Association for the Advancement of Science in October 2014.

Election to NAI Fellow status is a major professional distinction accorded to academic inventors who have demonstrated a prolific spirit of innovation in creating or facilitating outstanding inventions that have made a tangible impact on quality of life, economic development and the welfare of society.

Those named today bring the total number of NAI Fellows to 582, representing more than 190 prestigious research universities as well as governmental and nonprofit research institutions.


Campus Life

Expert tips for a healthy holiday

December 15, 2015
Alisson Clark
health, holidays

If you’re trying to avoid holiday weight gain, nutrition expert Michelle Cardel has some tips, tricks and advice to help you succeed.

“On average, most American adults gain 2 pounds a year. That doesn’t sound like a lot, but it can add up over the years,” says Cardel, an assistant professor at the University of Florida’s College of Medicine.

She offers these tips to stay healthy through the holidays and beyond.

1) Deprivation doesn’t work

“We like to dichotomize food into good and bad, but there is no food that you should feel guilty eating. It's all about portion control,” Cardel says. “If your mom makes amazing pecan pie, have a slice and then brush your teeth so you’re not tempted to have more. That’s better than not eating at all and watching everyone else enjoy it, because that doesn’t work over the long term.”


2) Watch for emotional triggers

It’s not just the festive mood that can lead to overeating.

“For some people, the holidays can be really stressful. That can influence people to eat in ways they wouldn't normally eat because they're stressed out. Being aware of your feelings and why you're reaching for that second piece of pie can help you stay on track.”


3) Revamp favorite recipes

“My family is from Puerto Rico, and we love to do Latin dishes. I substitute nonfat Greek yogurt instead of sour cream: It tastes exactly the same,” Cardel says.

Her other secret weapon? Avocado. She uses it instead of mayonnaise in deviled eggs and even blends it into chocolate mousse. “It’s super tasty and decadent.” 

She also makes lasagna with steamed cabbage in place of pasta. (Recipes below.)

“You don’t miss the pasta. I layer it with low-fat cottage cheese, sauce, ground turkey and sautéed veggies to amp up the nutrition.” 


4) Alcohol can be a triple whammy

Alcohol not only packs empty calories, but also can decrease your inhibitions, leading to overeating.

“There’s this idea that drinking gives you a beer belly, but it’s not necessarily the drinking, it’s the food that comes in association.”

Additionally, people who are dehydrated often mistakenly think they’re hungry, Cardel says. “Have a glass of water. If you still feel hungry in five minutes, then get something to eat,” she advises.


5) Start a new tradition

It might seem like a long shot to get your family up and about after a big holiday meal, but building in some activity can make the season healthier and more festive.

“It could be something simple like bocce or cornhole, or a big family walk. It’s about getting outside and moving instead of falling into food coma.”

One thing you shouldn’t do: “Never push your agenda when it comes to healthy behavior – it can easily be seen as shaming. Just get outside with the people who want to go. When everyone sees you guys having fun, they’ll be more likely to go out and have fun too.” 


6) Don’t beat yourself up 

If you fail, focus on figuring out why instead of berating yourself.

“Take time to think and assess why it happened. Were you stressed? Did you not get enough sleep? Be kind to yourself. Things happen. Life happens. It's about progress, not perfection.”

Michelle Cardel’s Cabbage Lasagna


Ground beef or turkey (about 1.25 pounds, seasoned however you like)
2 cloves of garlic
One head of cabbage
One big container of low-fat cottage cheese
1.5 cups of shredded mozzarella and cheddar cheese (or any cheeses you want) 
One jar of your favorite spaghetti sauce
16 oz. can of fire-roasted tomatoes
Veggies (I like to throw in some fresh tomatoes and sautéed onions, mushrooms and spinach)

  1. Preheat the oven to 400 degrees.
  2. Steam the cabbage and then dry it (if not, the lasagna becomes runny).
  3. Sauté any veggies you want added in to the mix.
  4. Sauté the seasoned meat with a little olive oil and the garlic. Add the fire-roasted tomatoes and mix in with the meat. 
  5. In a large lasagna pan, layer the cabbage, then add meat, spaghetti sauce, cottage cheese and then shredded cheese. Do another layer just like the first.
  6. Bake 30-40 minutes. Sometimes I like to broil it for a minute or two at the end to let the cheese get crusty.

Sea Salt Chocolate Avocado Mousse

1/3 cup honey
2 ripe avocados, chopped
4 oz dark chocolate pieces
1/3 cup cocoa powder
3 tablespoons coconut oil
2 tablespoons shredded coconut
1 teaspoon coarse sea salt

  1. Melt dark chocolate, honey and coconut oil over medium heat for 3-5 minutes in saucepan.
  2. Combine melted chocolate mixture with avocados, sea salt, coconut and cocoa powder in a food processor. Blend until smooth.
  3. Place in the fridge and chill for at least four hours. Makes 8 servings.
Science & Wellness

Personalized medicine drives better outcomes for certain heart patients

December 15, 2015
Doug Bennett

In the weeks and months after a patient gets a heart stent, blood clots can pose a major threat to recovery. Now, University of Florida Health researchers have found that a quick genetic test can tell doctors early on whether a crucial anti-clotting drug will work, they reported recently at the American Heart Association’s Scientific Sessions in Orlando.

They also are hailing the finding as a significant gain for personalized medicine, which tailors medical decisions based on individual patients’ genetic information and other unique characteristics.

Their research focused on clopidogrel, a drug that can prevent blood clots after a heart artery is propped open with a coronary stent. Yet the drug doesn’t work on everyone: About 30 percent of all patients have a genetic deficiency that prevents them from activating it. Treating those patients with a drug their bodies can’t use is akin to providing no medication, said associate professor Larisa Cavallari, Pharm.D., director of the Center for Pharmacogenomics at the UF College of Pharmacy and associate director of the UF Health Personalized Medicine Program.

That’s where the genetic testing made available through UF Health Pathology Laboratories and studied by UF Health researchers comes into play.

A patient’s genetic information is analyzed quickly and economically using a process known as genotyping. That tells a physician if clopidogrel will work effectively, allowing doctors to more precisely personalize treatment by prescribing a different medication. The genotyping also has lifesaving implications: Every patient gets the best possible drug at the right time, Cavallari said.

“This is tailoring therapy based on the patient’s genetic makeup, and recognizing that not everyone is going to respond well to one drug,” she said.

 The study is among the first to examine the effect of genotype-guided treatment on cardiovascular outcomes after a heart procedure known as percutaneous coronary intervention, or PCI, researchers said.

During the two-year study, researchers tracked 408 patients who had genotyping and had a PCI to open narrow or clogged heart arteries. Of that group, 126 patients had the genetic deficiency that prevents clopidogrel from working effectively. Fifty-eight of them were treated with clopidogrel and 68 received an alternative medication.

After six months, the risk of major cardiovascular problems such as death, heart attack, stroke and having a stent become blocked by blood clots was significantly reduced among patients with the genetic deficiency who were prescribed an alternative drug, researchers found. None of those patients had a major cardiovascular problem within 30 days of the PCI procedure. In contrast, 12.5 percent of patients who got clopidogrel but could not activate it had problems such as a heart attack or blood clot.

That shows exactly how genetic analysis can be used for a more effective and personalized health care experience, said Julie A. Johnson, Pharm. D., dean of the UF College of Pharmacy, the project’s principal investigator and the director of the UF Health Personalized Medicine Program.

“This is a way to identify a medication that isn’t going to be very good for some patients and choose an alternative that’s better for them,” she said.

In addition to saving lives and preventing medical problems, genotyping has significant implications for the business side of health care. Simple genotyping that costs several hundred dollars can prevent a heart attack by getting a patient on the correct antiplatelet medication early on.

“You don’t have to prevent a lot of heart attacks to achieve a cost savings,” Johnson said.

The Personalized Medicine Program is expanding genotype-guided therapy at UF Health to include additional medications for which genetic variations are known to influence effectiveness. Genotyping patients to determine the best drug dose or the most effective medication can also be used for other diseases such as hepatitis C, some pediatric cancers, inflammatory bowel disease and pain management, Johnson said.

Personalized medicine, also known as precision medicine, is already delivering benefits for PCI patients at UF Health Shands Hospital because genotyping is standard practice for most of these patients, Cavallari said.

Next, researchers want to make cardiologists and other health systems aware of the benefits of genotyping PCI patients. No randomized, controlled trial with PCI patients has been done and Cavallari doesn’t believe it is necessary.

“We believe the current data are strong enough to support using genotyping in a clinical setting. It provides data to support the idea that other health care institutions should do this,” she said.

The Personalized Medicine Program is collaborating with other institutions to study outcomes of genotype-guided anti-clotting therapy in a larger group of PCI patients. To help spur broader adoption, the UF Health team also is evaluating education and implementation strategies so others can build on the program’s experience.

UF Health’s Personalized Medicine Program is a multidisciplinary initiative created in 2011 within the Clinical and Translational Science Institute. Led by College of Pharmacy faculty, researchers work with health professionals and patients at UF Health and across the state to study and implement methods that allow genetic information to be used as a routine part of patient care.

Funding and other support for the PCI research was provided by UF Health, its Clinical and Translational Science Institute and National Institutes of Health grants U01 HG007269, U01 GM074492, U01 HL105198 and UL1 TR000064.

Science & Wellness

Kiplinger’s ranks UF No. 2 best value among nation’s top public universities

December 17, 2015
Steve Orlando

Kiplinger’s Personal Finance has ranked the University of Florida second among the nation’s top public universities and first in Florida on its 2016 list of best college values.

Other universities in the top five include the University of North Carolina at Chapel Hill, the University of Virginia, the University of California, Berkeley, and the University of Michigan.

On Kiplinger’s 2016 top 100 best values combining publics and privates, UF was ranked 52nd.

“I am pleased that UF is ranked No. 2 among the nation’s best public universities,” UF President Kent Fuchs said. “This is a result of our unique combination of quality and affordability.”

UF has been among Kiplinger’s top 10 best values in public colleges since 2005, ranking No. 2 from that year until 2012.

UF’s in-state tuition of $6,310 for a full-time undergraduate carrying a 30-credit load is considerably lower than the national average for four-year public universities of $9,410. In addition, 56 percent of UF undergraduate students graduate with no student loan debt. The average student loan debt load for UF undergraduates who graduated in 2014-15 is $21,028. For comparison, the national average for 2014 graduates of four-year public institutions was $28,950.

Kiplinger assesses value by measurable standards of academic quality and affordability. Quality measures include the admission rate, the percentage of students who return for sophomore year, the student-faculty ratio and four-year graduation rate. Cost criteria include sticker price, financial aid and average debt at graduation. Many schools have appeared on the list multiple times, a testament to the consistent value these colleges provide.

“We start with a universe of 1,200 schools, so each school on our rankings, from number 1 to number 300, is a best value,” said Janet Bodnar, editor of Kiplinger’s Personal Financemagazine. “Families can use the list as a starting point and then tailor it to each student’s preference for such things as size, location, campus culture and major.”

The complete rankings are now available online at Kiplinger.com/links/college and will appear in print in the February 2016 issue of Kiplinger’s Personal Finance, on newsstands Jan. 5.

Campus Life

These Michigan-UF dream teams are winning off the field

December 22, 2015
Alisson Clark
Citrus Bowl, Michigan, collaboration

The University of Michigan and the University of Florida are rivals in the Citrus Bowl, but off the field, the universities are working together to make lives better.

Mapping life on Earth

UF biologist Doug Soltis uses the Tree of Life, a map of all named species.

Some scientists said it couldn’t be done, but UF and Michigan researchers teamed up with colleagues around the country to make an interactive map of all 2.3 million named species. The Tree of Life, which debuted in September, is more than a catalog – it’s a tool that scientists can use to develop new approaches to challenges from climate change to disease.

Making science fun again

After elementary school, science can turn from hands-on fun to textbooks and lectures. UF researchers realized that many science teachers wanted to make their classes more engaging, but didn’t have the time or background to plan a curriculum. Enter U-FUTuRES. Collaborating with Michigan and other institutions, UF education researchers worked with scientists across the UF campus to develop a training program for middle-school science teachers. Now their work is helping keep kids interested in science – not just as a class, but as a career. 

Sports beyond the game

Does your devotion to your favorite team change how you treat people? UF sport management professor Brian Mills wants to find out. Along with fellow Michigan PhD grad Scott Tainsky, Mills uses an economics experiment called the ultimatum game to reveal how affinities and rivalries influence college football fans beyond gameday. He hopes the work eventually will suggest ways that sports can build bonds between opposing sides in areas from politics to business.

Protecting coastlines

UF engineering professor Christine Angelini at Guana Tolomato Matanzas research reserve.

Big boats making big waves can be bad news for coastal habitats. But with a collaborative research award from Michigan’s Water Center, UF engineers are finding ways to protect these areas, starting with a three-year project in Florida’s Guana Tolomato Matanzas research reserve. By developing ways to dissipate wave energy from boat traffic, they hope to protect and restore salt marshes and oyster reefs, habitats that protect us from storm surge and flooding, improve water quality and support commercial and recreational fishing. 

Help for liver disease  

Dr. David Nelson, director of UF's Clinical and Translational Science Institute, is leading a five-year study.

The leading cause of liver cancer could get one step closer to a cure, thanks to a clinical trial led by UF in cooperation with Michigan, Johns Hopkins University and the University of North Carolina. The $15.5 million, five-year study will evaluate three medications for hepatitis C, which affects about 150 million people worldwide.  


Global Impact

UF’s College of Design, Construction and Planning turns 90

December 18, 2015
Emily Buchanan

If UF’s School of Architecture’s first director could see what today’s college looks like, what would he think?

Would he be surprised that the College of Design, Construction and Planning has become one of the largest of its kind in the country with more than 1,300 students?

What would he make of all the 3D projects on view throughout the building, or the studio-model classrooms designed to create the college’s distinguished teaching environment?

DCP has grown exponentially in the 90 years since renowned architect Rudolph Weaver established it in 1925. Reflecting on Weaver’s strengths, current DCP dean Christopher Silver noted that Weaver wanted his architecture graduates to be engaged in society’s issues at large, not just designing buildings.

“I think Weaver would like the fact that the college has diversified to include all of these areas of expertise that he thought should be part of the architecture program, which are now all self-sustaining entities within themselves,” Silver said. “I believe Weaver would be proud of where we are today.”

To learn more about DCP and to view photos of the DCP 90 celebration, visit www.dcp.ufl.edu/dcp90-timeline.

Campus Life

Florida consumer sentiment ticks down slightly in December amid concerns of personal finances

December 23, 2015
Colleen Porter

Consumer sentiment fell slightly in December to 90.2, down almost 1 point from November’s revised reading but 2.6 points higher than last December, according to the latest University of Florida consumer survey.

Among the five components that make up the index, three declined and two increased.

The perception of personal financial situation now compared with a year ago dropped 7.3 points to 79.6. The expectation of personal finances one year from now fell one-tenth of a point to 98.4.

Views of the U.S. economy were mixed: Expectations over the next year fell less than half a point to 84.4, while the expectation of the U.S. economy over the next five years rose 2.5 points to 89.2.

Opinions as to whether now is a good time to buy a big-ticket item, such as a car or appliance, rose slightly more than half a point to 99.3, still 5.6 points lower than December last year.

The greatest declines were among women and people age 60 or older. Four of the five components decreased for women. For those aged 60 and over, perceptions of personal finance now compared with a year ago plummeted 13.6 points to 58.8. 

Among those with annual incomes under $50,000, perceptions of personal finances now compared with a year ago dropped 6.1 points to a reading of 71.5, while for those with income of $50,000 or more per year, the score tumbled 11.1 points to 90.0 from a year-long high of 101.1 in November.

The downturn in consumer sentiment comes despite an anticipated healthy finish to this holiday shopping season by the Florida Retail Federation. 

“The declines in perceptions of personal finance and the expectation of U.S. economic conditions over the next year possibly reflect the potential increase in the cost of borrowing in the medium and long run as a consequence of the announced raising of interest rates by the Federal Reserve,” said Hector Sandoval, director of the Economic Analysis Program at UF’s Bureau of Economic and Business Research.

Given the economic outlook, the Federal Reserve decided to gradually raise interest rates by a quarter percentage point on Dec. 16, marking the end to the zero interest rate policy to support the economy since the Great Recession.

“Although a quarter-point increase is expected to have an imperceptible impact, it is a sensible first step to stay ahead of inflation, which will rise over the medium term, according to the Fed,” Sandoval said.

Nonetheless, this hike would still leave rates at historically low levels. Although it might take time for the adjustment in the federal fund rate (the rate banks charge each other for short-term loans) to percolate through the economy, this change will increase the cost of borrowing for firms and households. This change could eventually spread to other interest rates, including car loans, credit cards and mortgages.

"The economy is growing, with more jobs added every month, and despite the slight decrease in this month’s consumer sentiment, it is quite unlikely that these first policy changes on the federal funds rate will bring the economic expansion to an end," Sandoval said.

Conducted Dec. 1-20, the UF study reflects the responses of 432 individuals who were reached on cellphones, representing a demographic cross section of Florida.

The index used by UF researchers is benchmarked to 1966, which means a value of 100 represents the same level of confidence for that year. The lowest index possible is a 2, the highest is 150.

Details of this month’s survey can be found at http://www.bebr.ufl.edu/csi-data

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