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ChristianaCare and The Wistar Institute advance partnership with new cancer research strategies

ChristianaCare’s Helen F. Graham Cancer Center & Research Institute is advancing its historic partnership with the Ellen and Ronald Caplan Cancer Center of The Wistar Institute in Philadelphia with three new research projects under way. The new research projects consist of a population health study targeting triple negative breast cancer. Other projects focus on a new therapeutic target for epithelial ovarian cancer, the most lethal gynecologic cancer in the developed world, and the development of “mini organs” derived from stem cells. Targeting triple negative breast cancer Delaware has one of the highest incidence rates of triple-negative breast cancer in the United States. This highly aggressive cancer has few treatment options, because the cells test negative for three known treatment targets – estrogen, progesterone and HER2 protein receptors. Working with patient data from the Graham Cancer Center, researchers are investigating potential contributing factors such as diet, alcohol use and genetic variants among women, and the effects of these on cancer metabolism. The team will also examine spatial relationships between cancer “hot spots”—geographic areas with a higher-than-expected prevalence—and modifiable risk factors. Key resources for the study are blood and tissue samples from the Graham Cancer Center’s Tissue Procurement Center and its statewide High-Risk Family Cancer Registry. The research team will be led by Director of Population Health Research at ChristianaCare Scott Siegel, Ph.D., and Lead Research Scientist Jennifer Sims Mourtada, Ph.D., at the Graham Cancer Center’s Cawley Center for Translational Cancer Research (CTCR). They will join Zachary Schug, Ph.D., at Wistar’s Molecular and Cellular Oncogenesis Program. Researching novel therapy for ovarian cancer The latest study supported by the Graham Cancer Center’s Tissue Procurement Program targets KAT6A expression as a novel therapy for ovarian cancer caused by a specific genetic mutation, called PP2R1A. Epithelial ovarian cancer is the most common form of ovarian cancer and the leading cause of gynecologic cancer deaths in the United States. Chemoresistance to currently available platinum-based drugs like cisplatin represents a major treatment challenge, as more than 50 percent of affected women ultimately relapse and die from this disease. Wistar’s Rugang Zhang, Ph.D., leader of the Immunology, Microenvironment and Metastases Program, is focused on developing novel therapeutics for subtypes of ovarian cancer that currently have no effective therapies and on improving the current standard of care. Dr. Zhang’s previous work suggests that KAT6A signaling plays a critical role in ovarian cancer progression. Targeting this signaling pathway could be an effective strategy for treating ovarian cancer. Working with Dr. Zhang on this project are Graham Cancer Center gynecologic oncologists Mark Cadungog, M.D., director of Robotic Surgery, and Sudeshna Chatterjee-Paer, M.D., and Cawley CTCR’s Stephanie Jean, M.D., director of Gynecologic Oncology Research. Also collaborating with the team is Wistar’s Alessandro Gardini, Ph.D., assistant professor in the Gene Expression & Regulation Program. ‘Mini organs’ offer hope for therapeutics Dr. Sims-Mourtada at the Cawley CTCR will lead a new program to culture organ-specific tissue from stem cells that could change the way diseases are studied and treated. These so called “mini organs” or “organoids” are three-dimensional tissue cultures grown in the lab that replicate the complexity and functions of a specific tissue or organ found in the body. Organoids offer scientists a better model for how drugs and other therapeutics might interact with a patient’s particular type of tumor, opening new avenues for precision medicine. “The ability to grow each patient’s tumor in a three-dimensional organoid along with our capability to create patient-derived xenograft or animal models as part of our PDX core, will allow us to fully capture the effects of genetic as well as gene altering behavioral and environmental influences that are lacking in current research models,” said Dr. Sims-Mourtada. “Our collaboration with Wistar to build these programs raises our clinical platform to the next level for studying new cancer biomarkers and treatments.” Advancing a Pioneering Partnership The Graham Cancer Center made history when it signed a first-of-its-kind agreement in 2011 with The Wistar Institute, pairing a National Cancer Institute, NCI-designated basic research institution with a community cancer center that is also an NCI Community Oncology Research Program (NCORP). “Our partnership with Wistar has attracted national recognition as a model of collaboration that leverages cutting-edge research to benefit cancer prevention and therapy statewide,” says Nicholas J. Petrelli, M.D., Bank of America endowed medical director of ChristianaCare’s Helen F. Graham Cancer Center and Research Institute. “With Wistar, our productive collaborations over the last decade continue to drive discovery research toward clinical trials to benefit patients here at the Graham Cancer Center and in communities everywhere.” “The Graham Center has been an ideal partner in our mission,” said Dario C. Altieri, M.D., Wistar president and CEO and director of the Ellen and Ronald Caplan Cancer Center. “Our scientists at Wistar have access to clinically-annotated primary patient specimens of the highest quality. As the majority of patients at the Graham Cancer Center are treatment naïve, this collaboration affords an opportunity to conduct unique, high impact mechanistic and correlative studies that will ultimately advance important scientific discoveries that hopefully will lead to better cancer therapies.”

The Rise of "Don't Weigh Me" Cards

Stepping on the scale is an inherent part of the American healthcare experience. But does it have to be? Healthcare professionals and patients say not necessarily. For patients struggling with mental health, eating disorders, or other body-related concerns, being forced to step on the scale may cause significant distress. Because of this, the "don't weigh me" card has become increasingly popular. Born from the desire to make a trip to the doctor a more inclusive, less stressful experience, the cards sit in waiting rooms across the country and allow patients to discreetly make a choice: Would I like to be weighed today? Similar in size and shape to a business card, patients may grab a card and hand it to the provider before the start of the appointment, indicating the patient should not be weighed and that any discussion around weight should only occur if permission is given. According to Rebecca Shenkman, MPH, RDN, LDN, director of the MacDonald Center for Obesity Prevention and Education at Villanova University, "to be effective and emphatic providers, it is important to ensure a safe and comfortable environment and for the patient to feel seen and heard—and one such way is asking permission to be weighed (if the medical situation does not require a weight)." "This shows patients that their provider respects their voice and choice” Shenkman says. "'Don't weigh me" cards are a tool that providers should recognize as a good 'pause button' that allows them to re-center patient care on the individual and not have a conversation guided by a scale number or attribute certain symptoms or conditions to weight." Healthcare providers may express weight biases that prevent patients from receiving effective care. The provider may correctly or incorrectly attribute a patient's health concerns to weight and overlook additional factors not correlated with obesity. And while obesity is certainly a chronic and progressive medical disease that should not be ignored, there is more to a patient than a number on a scale. "A barrier to effective healthcare utilization is the prevalence of weight bias towards individuals with obesity. A first step to reducing bias is to acknowledge the issue exists and to recognize one's own biases, which may intentionally or unintentionally result in unfavorable behaviors and attitudes towards individuals with obesity," says Shenkman. While communication about weight-related health is important and many times necessary, to center the dialogue on weight alone means missing out on other potential issues. "By letting patients lead the conversation, having an open dialogue and practicing shared decision-making, and approaching the discussion around eating habits and weight-related behaviors within the broader context of health, patients are likely to be more receptive to medical advice given and seek future care." When patients are allowed to choose to be weighed, they are empowered to make their own decisions surrounding their care. "Don't weigh me" cards help provide peace of mind and a comfortable environment for all people, allowing providers to act more effectively and patients to seek out effective care more often.

Opinion: Artists, influencers key to successful public health messages re: COVID

Can the artists and culture-bearers among us help move people who are unvaccinated to action? That’s the hope of a new initiative from the Centers for Disease Control and Prevention (CDC) to build vaccine confidence across the country. Read more from Jill Sonke in her op-ed in the Atlanta Journal-Constitution.

Trailblazing treatment by ChristianaCare physical therapists catches attention of NFL

ChristianaCare physical therapists have developed a trailblazing treatment to prevent muscle strains that has caught the attention of numerous sports teams, including the Los Angeles Rams and Baltimore Ravens. The treatment involves using a screening tool called the “core sling screen” to test the strength of trunk muscles, also known as core muscles, and is combined with a specialized exercise program to strengthen those muscles. Weakness in those muscles can lead to common athletic injuries such as strains in the abdomen, groin, quadriceps and lower back. A study on the treatment’s success was published this spring in the Journal of Sport Rehabilitation. Following that, ChristianaCare physical therapists, Brian Catania, MPT, SCS, ATC, and Travis Ross, PT, DPT, who co-authored the study and spearheaded the treatment, presented it to the NFL’s Professional Football Athletic Trainer Symposium. Athletic trainers with the Los Angeles Rams and the Baltimore Ravens met directly with Catania and Ross to learn how to use it to prevent their players from sustaining muscle injuries. “The research by ChristianaCare Rehabilitation Services regarding core slings is an extremely effective approach that is based off of sound reasoning and practical application,” said Jon Hernandez, PT, DPT, SCS, ATC, CSCS, physical therapist and assistant athletic trainer for the Rams. “The principles of the sling activation series are incorporated into our daily, clinical practice. Whether it be our injury prevention programs, corrective exercises, or rehabilitation practices, the sling activation series is applicable to a myriad of conditions we see in an NFL athletic training room.” Catania and Ross care for patients at ChristianaCare Rehabilitation Services at Glasgow, in Newark, Del. They began working on ways to increase resilience in core muscles nearly nine years ago. Through their research, they developed a screening tool, that they call the “core sling screen,” which detects weakness in those muscles. Strains are among the most common sports injuries, according to the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases. “We reasoned that if we could identify ways to improve the strength of the core muscles, common lower extremity injuries would be less likely to occur,” said Catania, who also is the program manager at ChristianaCare’s Rehabilitation Services location in Glasgow. “But it had to be a two-part approach. We needed to develop a reliable screening tool to examine the core muscles and then also come up with a targeted exercise program to strengthen those muscles.” The study was conducted by ChristianaCare’s departments of Rehabilitation Services and Sports Medicine. “At ChristianaCare, we are relentlessly curious and we continuously look for ways to innovate,” said Bradley Sandella, D.O., director of Sports Medicine at ChristianaCare, who also co-authored the study. “We don’t want to just treat injuries – we want to prevent them from ever occurring, even if it means that we have to come up with novel and progressive approaches.” A randomized-control study was performed to test out traditional exercises and compare them to a newly developed exercise program that involved rotational movements of the torso, known as rotary-based exercises. The study found that the rotary-based exercises increased the activation of targeted abdominal muscles and could make adjacent areas of the body, such as the groin, less injury-prone. The study included 31 female and male students from the University of Delaware. Catania and Ross have provided further instruction to both the Rams and Ravens. In May, they visited the Ravens’ facility in Owings Mills, Md., to personally instruct Ravens athletic trainers and physical therapists on how to perform the treatment. The treatment also has been presented at the National Athletic Trainers’ Association and the Eastern Athletic Trainers Association. “It has been meaningful through this research to contribute to the ongoing evolution in the field of physical therapy and sports medicine,” Ross said. “We are always looking for ways to protect our patients, many of whom are athletes, from injury. It makes physical therapy better, it makes patients better, and it makes players better.” To learn more about this treatment and the expertise ChristianaCare is bringing to organizations like the NFL - contact Bradley Sandella, D.O., director of Sports Medicine at ChristianaCare. He's available to speak with media, simply click on his icon now to arrange an interview today.

Children Face Type 2 Diabetes Health Concerns After a Year at Home

Some children are facing health concerns after a year of attending school online. During the pandemic, research found cases of type 2 diabetes among children more than doubled. Lisa Diewald, MS, RD, LDN, Program Manager for the MacDonald Center for Obesity and Education weighed in on causes and potential prevention methods going forward. “We know that physical activity level, eating habits, weight status and other lifestyle factors play a significant role in the development of type 2 diabetes in adults and in children,” said Diewald. “Because of disruptions for many children in all four factors during the pandemic, (on top of pre-existing challenges), we are starting to see trickle-down health effects involving lifestyle-related chronic diseases, such as type 2 diabetes and children are not immune to these health effects.” Type 2 diabetes is related to obesity, exercise habits and diet. Children who struggle with weight may also have many social, genetic and environmental factors impacted by the accelerated risk seen through the pandemic. For example, the absence of healthy school meals while learning from home negatively impacted some children, as processed foods became replacements. Eating habits are also largely impacted by one’s mental state. “Like adults, children learn to cope with stress and anxiety in different ways. For some, this means reaching for comfort foods, which are often high in refined carbohydrates, saturated fat and sugar-all risk factors for T2 diabetes if consumed in excess,” said Diewald. “These foods can contribute to unhealthy weight gain, especially when physical activity is limited as well. The bad news is that it does not take a lot of weight gain to put a child who is already at risk at greater risk for diabetes.” But families should be aware of the good news that small changes can make a big difference and that prevention is possible. Diewald recommends a few small changes to alter a sedentary routine for parents and schools: • Build 1 minute brain breaks during the day for activity such as stretching or running up and down the stairs • Keep healthy snacks available and sugar sweetened snacks and drinks less visible • Create safe and walkable opportunities for children to add physical activity • Look for outdoor community sponsored activities that encourage physical activity that can provide safe and accessible physical activity opportunities Additional measures for parents to prevent the unhealthy coping with foods including working with children to make a list of fun alternative activities (unrelated to food) to do when boredom kicks in and posting in an accessible place in the home. Parents can act as role models and let children see that parents are working on more effective ways to cope as well. Though the risk of type 2 diabetes has been increasing during the past year, many factors can continually increase a person’s risk. These tips can provide the valuable tools for prevention in the future. “Teaching children healthier ways to cope with boredom and depression than eating are skills that can help for a lifetime, well beyond the pandemic,” said Diewald. To speak with Diewald, email mediaexperts@villanova.edu.

Infrastructure and extreme weather expert on recent weather events

Hiba Baroud, assistant professor of civil and environmental engineering, is available for commentary on recent extreme weather events, including hurricanes, tropical storms and flooding. Baroud is an expert on infrastructure and climate change as they pertain to extreme weather events. She can speak to the potential dangers of the destruction and the cleanup decisions affected areas must make, including those that can help prepare for the future. Topics she can discuss include: How weathers and disasters are becoming more frequent and intense, therefore costing us more. Why cities must prepare before extreme weather hits, making future-based predictions and not just relying on historical data to understand potential concerns. With that, cities must also focus on restoration after an event happens, rather than prevention Additional dangers to residents' lives to be considered once the weather has passed - such as a lack of food and water, lack of power and road infrastructure issues

Covering World Breastfeeding Week? Our experts are here to help

August 1-7 is World Breastfeeding Week, and the University of Mary Washington has the ideal expert for any journalist looking to learn more or cover this important topic. Did you know that breastfeeding is one of the top maternal priorities for many organizations, including the World Health Organization (WHO), the American Academy of Pediatrics (AAP) and the Centers for Disease Control and Prevention (CDC)? Assistant Professor of Communication Elizabeth Johnson-Young has done extensive research on women’s intentions to breastfeed and how the communication they receive during pregnancy and postpartum from various sources such as doctors, lactation consultants, friends and family, magazines, books and parenting groups can impact the decision to breastfeed. She's also explored the connections between breastfeeding and body satisfaction. Dr. Elizabeth Johnson-Young is a published expert on health communication, especially maternal and family health. She is ready to help if you are looking to cover this topic - simply click on her icon now to arrange an interview today.

UMW professor discusses challenges of delivering vaccines through the ages on 'With Good Reason' Radio

If you thought today’s walk-up and drive-thru clinics to get vaccinated for COVID-19 were a lot of work, imagine how vaccines were safely transported across the Atlantic, without deep freezers or jets? Recently, UMW Professor of History and American Studies Allyson Poska was asked by 'With Good Reason' Radio - and the Centers for Disease Control and Prevention - to lend her expert opinion on the history of vaccines and the challenges the world has had trying to keep the public healthy and inoculated. Over two centuries ago, as the Spanish Empire embarked on the first-ever vaccination campaign against smallpox, "getting shots into arms" had an entirely different meaning. And government authorities back then faced as many challenges with promoting vaccinations as they do today.  The First Vaccine Allyson Poska (University of Mary Washington) There’s been a lot of coverage about the challenges of distributing the Covid-19 vaccine. How do we get it to distant areas? How do we use a whole vial before it expires? What about the special refrigerators needed to keep it cold enough? But these problems seem minor compared to the very first vaccine distribution in the early 1800s. Historian Allyson Poska shares the story of 29 orphan boys who crossed the Atlantic Ocean as live incubators for the smallpox vaccine and what lessons we can learn from this early campaign.  July 21 - With Good Reason This is a fascinating topic, and if you are a journalist looking to cover this topic, then let us help. Dr. Allyson Poska is available to speak with media regarding this subject - simply click on her icon now to arrange an interview today.

Aston University cybersecurity experts hold key to vaccine passport rollout

Vaccine passports are certificates to establish proof of vaccination linked to the identity of the holder Renowned expert, Koji Fusa, visiting professor at the Cyber Security Innovation Research Centre (CSI), on the project to develop a global database for citizens to use in real-time. The CSI Centre at Aston University say creating a clear framework of rules for digital identities is achievable Leading cybersecurity industry expert, Koji Fusa, has made progress towards developing a framework for the world’s citizens to store their digital identities and access them in real-time. Koji is a Visiting Professor at the Cyber Security Innovation Research Centre (CSI) at Aston University. The idea would see a platform that has the capability to distribute over 200 individual keys to each of the world’s eight billion people. Each key could be assigned to personal information such as vaccine passports. It will work by vaccine administrators sending the vaccination details of each individual to a dedicated server. That server will issue a QR code which will be passed to the vaccinated person as the digital key for access. The passport holder will keep the QR code which enables access to the server to check their own record at any time. The framework would segment private data in a separate database, which can only be accessed with the individual key along with fingerprint, face and voice recognition technology, making it extremely hard for cyber attackers and scammers to hack. Koji Fusa, a visiting professor at the CSI Centre, said: “The current EU Green Pass initiative and World Health Organisation's initiative have struggled to find the solution for private data protection and counterfeit prevention. This proposed system would solve these two challenges. We have a solution that is secure, something that others have failed to achieve so far. “By having a cloud security server which gives unique reference numbers to all devices, technology issues pointed out by The Royal Society* have been solved. “This will be a huge step forwards for digital identification globally. Not only for vaccine passports, but for people’s personal information too. The framework would make everyday life more secure and simpler. Professor Vladlena Benson, an industry-recognised expert in cybersecurity risk management and director of CSI Centre at Aston Business School, said: “I am delighted to be working on this project with Koji Fusa. With his experience, I’m confident this could become the first such system where the authenticity of the vaccine certification instantly can be checked globally, something that can’t be done currently. "This work is aligned to the trusted identities framework proposed by the UK Government and addresses the issues of data sovereignty and individual information privacy."

Tennis Pro Naomi Osaka Elevates the Conversation on Athletes and Mental Health

Though Naomi Osaka's announcement of her dropping out of the French Open and German Open tournaments came as a surprise to many of her followers, there has been plenty of support from fans and corporations for the 23-year-old tennis pro who chose to take time off because of mental health concerns. One company, the Calm App, offered to pay fines for tennis players skipping press briefings. And Formula 1 champion Lewis Hamilton—who, when he was 22 years old, found it difficult to deal with media commitments—offered encouragement to Osaka. "When you’re young and you're thrown into the limelight, it weighs heavily, and most of us are not prepared," Hamilton told The New York Times. Guy Weissinger, PhD, an assistant professor in Villanova's M. Louise Fitzpatrick College of Nursing whose research focuses on mental health, says, "Elite athletes are people. They have mental health struggles—good days and bad days—and it's important that we recognize that mental health is complicated, not just 'doing well' or 'not doing well.'  One may be capable of doing one thing (i.e., playing tennis) but not other things (i.e., being peppered by reporters with questions). It saddens me that she needed to withdraw from the tournament rather than the tournament organizers reaching out to find ways to accommodate her mental health needs." He noted that the 23-year-old Osaka is an amazing athlete who rose to global prominence beating Serena Williams in a match that got a lot of negative attention. "While no one was saying that she did not deserve her victory, the conversation was mostly focused on Serena, and Osaka was a teenager caught in a media firestorm. I could see how that would create a high level of baseline anxiety around the Opens and media interactions for her, in addition to the already stressful situation of participating at that elite level of sports. Combine that with the high level of stress that everyone has been experiencing over the last year and a half, with COVID, I'm surprised that she isn't the only person who has said that they would be unable to do media appearances." He says this is a great opportunity for discussion of mental health and how it's a concern for everybody. "Too often, we think of people that are successful as being immune to mental health struggles, but we have to acknowledge that people can be both successful and struggling. Sometimes they will be able to manage (as Naomi has in many circumstances), but sometimes even their best coping mechanisms are not enough." Weissinger hopes that we can find ways for people to 'tap out' of the things that overwhelm their ability to cope. "It's not fair or ethical to only wait until people are not just struggling but completely drowning before trying to support or accommodate them. Like with physical health, prevention before things get bad is better for everyone than trying to fix things when they get really bad."