For some, it is written in artifacts. For others, truth can be found in cool, hard genetic code.

Both kinds of data factor into an ambitious new study that reports genome-wide DNA information from 523 ancient humans collected at archaeological sites across the Near East and Central and South Asia. Washington University in St. Louis brought key partners to an international collaboration of more than 100 scholars who gathered archaeological skeletal samples — and pooled their expertise — to generate the largest study of ancient DNA published to date.

Their results, published this week in the journal Science, link the genetic and linguistic makeup of populations of Eurasia and India to the ebb and flow of people and cultures between 12,000 to 2,000 years ago that transformed Old World populations and civilizations.

“Often people assume populations change through simple migration processes, but regional genetic formation is nuanced, long-term and dynamic,” said Michael Frachetti, co-senior author of the study and professor of archaeology in Arts & Sciences at Washington University.

“In some cases, we see centuries of regional mobility alongside stochastic population movements. We also document cases of prolonged, multidirectional interaction. Often, it’s all of the above,” Frachetti said. “So we made every effort to combine deep archaeological knowledge with the DNA results to illustrate how different mechanisms produced genetic diversity and change at different times.”

Locking down the story

As the tools and methodologies for harvesting and analyzing DNA from bone samples improved and became more accessible, archaeologists and geneticists started to reshape the nature of their partnership in studying ancient societies.

“Early on, archaeologists were critical that ancient DNA studies were crafting huge narratives from limited data. That was a real limitation of early work, and I, too, had my concerns,” Frachetti said. “This project was conceived to explicitly merge different methods and kinds of expertise, thus our approach was intentionally more inclusive of numerous voices in hopes of getting the best possible results.”

Years in the making, the conceptual framework behind this research was sparked by David Reich, professor of genetics in the Blavatnik Institute at Harvard Medical School, the Howard Hughes Medical Institute, and the Broad Institute and Vagheesh Narashimhan, a postdoctoral scholar in his lab; Nick Patterson, a computational biologist at the Broad Institute of MIT and Harvard; Ron Pinhasi of the University of Vienna; and Frachetti. Their collaborative group grew to include dozens of archaeologists and geneticists around the world.

Said Reich: “The idea for this study grew out of a meeting we had in Cold Spring Harbor, N.Y., in May 2016, which was equally organized by geneticists and archaeologists. The goal of this meeting was explicitly to break down barriers between disciplines and find ways for these two communities with so many shared questions but different world views to come together.

“Michael’s perspectives were challenging and stimulating to us geneticists. After multiple intense conversations, he and Ron Pinhasi and I decided to develop an ancient DNA study that was explicitly framed by Michael’s archaeological questions, that would take advantage of innovations in ancient DNA technology that made it possible to massively increase the number of samples we could study, and that by focusing on Central Asia would address a huge gap in the world’s ancient DNA dataset — which until then was almost entirely restricted to Europe.”

The result is a study that in one fell swoop increases the worldwide total of published ancient genomes by about 25%, and that shifts the center of gravity of the world’s ancient DNA dataset far to the east.

“It’s a significant addition to the literature,” said Narasimhan, co-first author of the study. “We’ve been able to process and analyze samples at a scale that hadn’t been possible before.”

Added Pinhasi, a co-senior author: “We combined a wide range of approaches: linguistic data, archaeological data, modern-day genetic data and ancient DNA data. The new findings about the origins and spread of the Indo-European languages, in particular, highlights the power of studies that combine data, methods and perspectives from a diverse range of disciplines.”

Frachetti has worked for over two decades in Kazakhstan and at archaeological sites linked to the Great Silk Road, the ancient trade route between China and the Mediterranean. Frachetti led much of the skeletal sampling for the Science paper; his close relationships in the region helped in developing ethical collection partnerships with colleagues and institutions across Central Asia.

“For decades, local archaeologists have been working to provide nuanced pictures of the underlying forces of social complexity and organization,” Frachetti said.

“This study shows the explanatory power of relying on local scholars to help build the genetic datasets and shape the important questions on a variety of scales — from individual excavation sites and individual specimens to wider, macro-regional narratives. It’s a great example of how these collaborations should work.”

“The history of Central Asia shows that connected ancient societies innovated rapidly due to exchanges of technology and ideas, whereas more isolated groups often faced longer-term economic stagnation. Likewise, current developments in academia benefit from active international exchange,” said Farhod Maksudov, a study co-author and director of the Institute for Archaeological Research of the Uzbekistan Academy of Sciences. “For scholars from Uzbekistan (and likely other Central Asian countries), international academic collaboration is essential — this study, which significantly advances our knowledge of Central Eurasia’s deep history, shows the power of academic connectedness and cooperation on a large-scale.”

A new dimension for work at Dali

Roughly 5,000 years ago, as the spread of herding required the movement of animals between summer and winter pastures, farmers and nomads came into greater contact across the region.

“Our maps in this study illustrate how transcontinental gene flow evolved over vast territory and thousands of years, but one must be careful not to view these genetic arrows as colonial invasions — in fact, our data show that human mobility typically brought about gradual change over the span of centuries, and sometimes millennia,” Frachetti said.

This new genetic information adds another dimension to human histories previously informed by archaeological work at particular sites.

A perfect example of this comes from an ancient site in Kazakhstan, where Frachetti has been excavating for many years.

Known as Dali, the mountainous site is located near the crossroads of cultural and genetic change during the Early and Late Bronze Age in a region that Frachetti calls the Inner Asia Mountain Corridor. At Dali, student researchers participating in the Washington University archaeological field school excavated skeletal samples that are a key part of the current ancient DNA study.

The genetic results from burials at Dali show movement and admixture between groups with North Eurasian hunter gatherer ancestry and farmers from the Iranian plateau — defining a bi-directional flow of ancestry along the mountains and steppes of Eurasia approximately 5,000 years ago.

Separately, Frachetti and collaborators also sampled DNA from individuals of the Bactria-Margiana Archaeological Complex (or BMAC), a Bronze Age civilization of southern Central Asia, found in present-day Uzbekistan and Turkmenistan, which was discovered for the first time in the 1970s by Soviet archaeologists.

Within the large number of samples from the BMAC included in the new genetic study (more than 100 individuals where previously there was no data), researchers were able to identify several key “outliers” — individuals who reflect early steppe genetics, similar to those found at Dali — living among an otherwise homogenous group.

The discovery of a range of these genetically distinct individuals intermixed among regional populations fits with the archaeological evidence collected by Frachetti and his students over the past decade. They previously had determined that people in the large urban centers of the BMAC were trading goods with pastoral communities living along the mountains and nearby plains.

“We had made the argument, as did many others, that steppe pastoralists were interacting with the BMAC on the basis of ceramics, metals, etc.,” Frachetti said. “But there wasn’t enough research, and the data were few. The new information we are getting from ancient DNA is critical to understanding the complex connectivity between these diverse communities across Asia.”

“What we see in both in the isotopic information as well as the archeological information is trade and exchange of agricultural material and production happening in both directions: north and south along this corridor,” Harvard’s Narasimhan said.

“Now with the ancient DNA, we’re actually seeing that in the people,” he added. “It’s giving us confidence to understand what happened in the past and how this process is happening.”

Vivid narrative

The new genetic results also open up a wide array of additional questions that archaeologists can now probe with new eyes.

“The sort of questions you can ask now — the sky’s the limit,” Frachetti said. “Working with this team has definitely opened up new ways of thinking for me. Questions about the degree to which trade and exchange versus important population movements brought innovation to various peoples, and how it shaped their future directions.”

“I’ve asked a lot of these questions for 25 years without the benefit of the genetics,” Frachetti said. “So, it’s exciting to return to my laundry list of questions and say, ‘Wow, a lot of these are now made that much more crystal clear.’”

The power of this study comes from its breadth and reach, made possible by samples from so many contributing archaeologists.

“If you only have one archeologist help to tell the story, then likely that one might be inclined to support his or her own theories,” Frachetti said. “But if, for example, you bring together data and ideas from 10, 20, 50 archaeologists — many of whom have different, competing theories on the same topic — it forces everybody to look at the science, and that’s how progress is made!

“That’s really why teaming up with geneticists is so important. It’s still not totally perfect in terms of how everyone wants things to be explained,” Frachetti added. “But this paper brings us a rigorous, well-designed study with a massive baseline of ethically acquired data. Now all scholars can go back to it to focus on different sites or see how the data fit into their archaeological interpretation.

“This study, and the important genetic record it establishes, allows us to shade in the narrative so much more vividly,” he said.

The post Ancient DNA study tracks formation of populations across Central Asia appeared first on The Source.

The Washington University in St. Louis community — students, faculty, staff, alumni and friends — is invited to become a part of the Oct. 3 inauguration of Andrew D. Martin by submitting group photos and greetings.

The photos will live on the inauguration website and will be considered for slideshows and videos that will be shown before the 3 p.m. installation Oct. 3 and at other events throughout the day.

To be considered, the photo should be framed horizontally and must include a group of two or more. At least one person should be holding one or more of the printable signs available for download on the inauguration website.

The photo will include your group name, so leave extra room at the bottom or top for a graphic overlay. It must be submitted as a JPEG file and should be the highest resolution possible and no smaller than 2 MB (smaller files will not be viewable on a large screen).

A sample photo and photo submission is available on a special greetings page on the inauguration website. Get your group together quickly: The deadline for submission is Friday, Sept. 27.

The post Picture yourself part of the inauguration celebration appeared first on The Source.

The inauguration of Andrew D. Martin as the 15th chancellor of Washington University in St. Louis will take place Oct. 3 in a daylong, communitywide celebration. The theme for the event will be “Momentum,” signaling the significant opportunity that lies ahead for the university, building on its long history of academic distinction, excellence in research and commitment to the St. Louis community.

Martin began his tenure at the university on Jan. 1 as chancellor-elect and became chancellor June 1. The highlight of inauguration day will be his formal installation in Brookings Quadrangle at 3 p.m., an academic event open to the entire university community. Other events of the day will include a faculty symposium; an outdoor reception on the Olin Library lawn; and a student event on Mudd Field, all designed to celebrate the university’s past, present and future — and build upon the university’s momentum.

Martin will be formally installed as the university’s 15th chancellor by Andrew E. Newman, chairman of the Board of Trustees, with the Chancellor’s Medallion, the symbol of the university’s leadership. Martin will deliver his inaugural address immediately following.

The day will begin at 9 a.m. with a faculty symposium centered on two themes: research and St. Louis connections and partnerships. The symposium will be presented in two parts. At the beginning,  faculty members will give seven-minute presentations on their research and the momentum it has on the community at large. The second session will feature similar talks by faculty focusing on their work making connections and partnerships within the St. Louis community. More information about the symposium is available on the symposium page on the inauguration website.

The symposium will be livestreamed on the inauguration website, and viewing locations will be available in the Eric P. Newman Education Center on the Medical Campus and in the Jerzewiak Family Auditorium in Wrighton Hall on the Danforth Campus.

Beginning at 2:45 p.m., a procession of visiting delegates from other universities and Washington University faculty will make its way to Brookings Quadrangle for the installation ceremony, which begins at 3 p.m. The installation will be broadcast live online beginning with a pre-ceremony program at 1:30 p.m., hosted by faculty members Adrienne D. Davis, vice provost, the William M. Van Cleve Professor of Law and founding director of the new Center for the Study of Race, Ethnicity & Equity; and Todd Decker, chair and professor of music in Arts & Sciences.

Everyone is invited to participate in the festivities and share their good wishes for Chancellor Martin, his wife, Stephanie S. Martin, and daughter, Olive, by downloading special welcome signs and submitting photos for a slideshow that will be featured in the online broadcast and on screens around campus in the days leading up to and including Oct. 3. Learn more on the inauguration website.

Following the installation, a reception will be held on the lawn of Olin Library beginning at 4:30 p.m., and a student celebration, the inauguration concert, organized by the Social Programming Board (SPB), will take place from 6:30-9 p.m. on Mudd Field. After the concert, SPB will reveal the headliner for the fall WILD student concert, with Chancellor Martin’s help. Additionally, a student TEDx WUSTL event, focused on the “Momentum” theme, will be held at 3 p.m. Oct. 4 in Knight Hall’s Emerson Auditorium.

To learn more and RSVP for the ceremony and reception, visit inauguration.wustl.edu.

The post Preparation underway for inauguration of Chancellor Andrew D. Martin appeared first on The Source.

Riots that resulted in anywhere from 10 to 1,000-plus deaths in their hometowns ultimately influenced lending decisions among hundreds of loan managers in India — and the effect endured for decades, reveals a new study involving a researcher from Olin Business School at Washington University in St. Louis. The research shows a country’s ethnic fissures can create crevasses in its road to economic progress.

Those are the findings by Janis Skrastins, assistant professor of finance at Olin, and three other researchers, who analyzed the lending decisions of about 1,800 Hindu loan managers at a large, public sector Indian bank.

More than 250 of those loan managers had experienced fatal Hindu-Muslim riots in their hometowns when they were children. Later, as grown men, those loan managers favored lending to Hindu borrowers over Muslim borrowers.

“The most important takeaway is that your early childhood experiences of ethnic conflict can have long-lasting effects,” Skrastins said. And the experiences “can actually lead to misallocation of resources even in the longer term.”

The paper, “Experience of Communal Conflicts and Inter-group Lending,”  provides microeconomic evidence on the link between inter-group frictions and economic transactions. It is forthcoming in the Journal of Political Economy.

Muslim borrowers less likely to default

The loan managers’ favoritism persisted even as the loans they made to Muslims were less likely to default, the research showed.

“What’s very, very important is the money or the profit that the officers expect to make on one Muslim borrower is going to be higher than on a Hindu,” Skrastins said.

“So that means they’re just giving money as a favor to some of their own group,” and creating disadvantages for another.

The researchers also discovered that loan managers’ bias persisted throughout their careers, suggesting “the economic costs of ethnic conflict are long-lasting, potentially spanning across generations,” Skrastins said.

The paper documents the lifelong consequences of racially or ethnically divisive personal experiences in childhood, rather than shorter-term increases in in-group favoritism as a result of current events. The authors say that, to their knowledge, this is the first research on the topic.

Lending decisions over seven years

Skrastins, Raymond Fisman of Boston University and Arkodipta Sarkar and Vikrant Vig, both of the London Business School, analyzed loan managers’ lending decisions from 1999 to 2006.

In tandem, they used a database of Hindu-Muslim riots from 1950 to 1995, along with each loan manager’s year and city of birth. With that information, they could infer whether ethnics riots erupted in a loan officer’s hometown during his childhood.

All men in the sample were born after 1950 and joined the bank no later than 1995.

The researchers measured riot exposure based on riot deaths in the loan managers’ hometowns from the year they were born to when they joined the bank. Generally, new loan managers at the bank are in their early 20s. Since the bank forbids any loan manager from working in his hometown, they necessarily leave their birthplace when they join the bank.

Because the bank requires loan managers and borrowers to list their religion, the researchers also had access to that information.

‘Riot-exposure’ defined

In their main results — which used local riot deaths of 10 or more people to define “riot exposure” — they found this: The presence of a riot-exposed loan manager was associated with 4 percentage points higher lending to Hindu borrowers relative to all other borrowers.

They also found that the presence of a riot-exposed loan manager was associated with a 2.5 percentage point increase in defaults by Hindu borrowers relative to Muslim borrowers.

The researchers also examined lending decisions as a function of when the loan manager was first exposed to Hindu-Muslim violence. Riot exposure before he was 10 years old was “the most important determinant of later lending decisions,” they found.

In their final analysis, the researchers examined loan managers’ decisions tied to the 2002 Gujarat riots, which left more than 1,000 people dead.

They found that lending to Muslims declined by 8 percentage points with the arrival of a branch manager who had been stationed in Gujarat at the time of the riots.

At cross-purposes with themselves

In some ways, the loan managers hurt their business by shunning Muslim borrowers.

Loan managers in Indian state banks have incentives to perform well, the researchers noted. Some rewards are promotions to higher grades with higher compensation — or better postings. Loan managers may be dispatched to places with better perks such as better schools, larger houses, the use of a car, or control over a larger portfolio.

If a loan manager is performing poorly, he risks being sent to places with weak infrastructures and lousy schools. Basically, when a loan officer plays favorites in lending that worsens his repayment rates, he hurts himself, the researchers pointed out.

The post In India, riots have lasting impact on how loans are made appeared first on The Source.

The neurons in our brains are its basic computational units analogous to a computer transistor. They process information and send and receive messages to and from the rest of our bodies. Engineers from the McKelvey School of Engineering at Washington University in St. Louis want to know if they can control certain neurons using nanotechnology to better understand behavior and disease.

Srikanth Singamaneni, professor of mechanical engineering & materials science, and Barani Raman, associate professor of biomedical engineering, will combine their expertise in nanotechnology and neuroscience to develop an innovative toolkit that they anticipate will provide control of neural activity in the brain. They have received a four-year, $678,000 grant from the Air Force Office of Scientific Research to conduct the research.

Initial work was funded by a seed grant from the university’s McDonnell Center for Systems Neuroscience in 2015 and from a Collaboration Initiation Grant from the McKelvey School of Engineering in 2016.

In essence, the team will create heating elements on the nanoscale to efficiently convert light at specific wavelengths into heat. This effect is both rapid and local ensuring minimal damage to the tissue in which the nanoheaters will be embedded. The team will target certain neurons using antibodies specific to the receptors on the surface of neurons. Such a technique is unique in the field.

Read more on the McKelvey School of Engineering website

The post Light-activated nanoheaters may control nerve cells, locust mind appeared first on The Source.

In an effort to support the safety of the Washington University in St. Louis community, electric scooters, motorized skateboards, hoverboards and other motorized transportation devices will no longer be permitted on Danforth Campus sidewalks and pathways as well as on Wrighton Way and Hoyt Drive.

Riders may use scooters and other devices on Wallace, Shepley, Snow Way and Throop drives.

When not in use, scooters and other devices must be parked upright, near a bike rack and away from sidewalks.

Bruce Backus, assistant vice chancellor for the Office of Environmental Health & Safety, said the new policy will reduce accidents on campus. In the past year,  16 e-scooter and e-skateboard riders were injured on campus, according to the Washington University Police Department. In contrast, there are five or six bicycle accidents per year, not all of which result in an injury.

“The safety of our students always is our Number One priority,” Backus said. “This policy helps ensure campus safety while recognizing the convenience offered by e-scooters and other devices.”

The policy applies to the Danforth, North, South and West campuses. The School of Medicine will announce its policy later.

In addition, riders must obey the following regulations:

• Wear a helmet.
• Follow all local ordinances and rules of the road — including obeying traffic lights and riding with the direction of traffic.
• Yield the right-of-way to pedestrians and give an audible signal before passing a pedestrian or cyclist.
• Do not use earbuds in both ears.
• Do not ride with a passenger.
• Ride at a reasonable speed.
• Do not ride a scooter at dusk or in the evening without a front-facing white light and a rear-facing red reflector or red light.

The policy follows a comprehensive review of guidelines at universities and cities across the nation. Backus also consulted with emergency medicine experts at the School of Medicine. They report that one of every five scooter injuries requires hospitalization. They also found that few riders wear helmets.

In addition, the new policy prohibits university employees from using scooters or other motorized transportation devices during work hours while conducting university-related business.

Students who own a personal scooter may not charge it on campus; charging a motorized device in residence halls  or academic buildings could cause a  fire. E-scooter owners must register their device at Project 529.

Backus said the university will review the policy annually.

“The technology will evolve and the devices will become safer,” Backus said. “But for now, these measures balance our need for safety with the transportation preferences of our community.”

Visit the parking website for more information.

The post E-scooters banned from campus pathways, sidewalks appeared first on The Source.

Chancellor Andrew D. Martin and Interim Provost Marion G. Crain, the Wiley B. Rutledge Professor of Law at the School of Law, have appointed a 16-member committee to identify candidates for the position of dean of the faculty of Arts & Sciences at Washington University in St. Louis.

Barbara A. Schaal, dean of the faculty of Arts & Sciences and the Mary-Dell Chilton Distinguished Professor of Biology, announced in March her intention to step down as dean by the end of the 2019-20 academic year.

Schaal, who joined the biology department faculty in 1980 as an associate professor, has served as dean since Jan. 1, 2013.

Aaron F. Bobick, dean of the McKelvey School of Engineering and the James M. McKelvey Professor, will chair the search committee.

“The search committee comprises a broad representation of the university community, including faculty, staff, student and alumni members. Under the leadership of Dean Bobick as committee chair, I’m confident this exceptional group will help ensure we hire the very best and most well-suited dean of the faculty of Arts & Sciences as we continue our trajectory of academic distinction,” Martin said.

Other members of the search committee are:

• Todd R. Decker, chair and professor of music, Arts & Sciences;
• Ruth Durrell, a senior majoring in educational studies with a second major in sociology, Arts & Sciences, and an undergraduate student representative to the Board of Trustees;
• Marie Griffith, director of the John C. Danforth Center on Religion and Politics and the John C. Danforth Distinguished Professor;
• Peter J. Kastor, chair of history and the Samuel K. Eddy Professor, Arts & Sciences;
• Jennifer K. Lodge, vice chancellor for research, associate dean for research and professor of molecular microbiology, School of Medicine;
• Jonathan B. Losos, the William H. Danforth Distinguished University Professor in biology, Arts & Sciences, and director of the Living Earth Collaborative;
• T. Joseph MacDonald III, MA ’13, doctoral candidate in classics, Arts & Sciences;
• Beth Martin, senior lecturer in environmental studies in Arts & Sciences and associate director of the Washington University Climate Change Program;
• Michelle A. Purdy, associate professor of education, Arts & Sciences;
• Ebba Segerberg, associate dean of academic planning, Arts & Sciences;
• John W. Shareshian, professor of mathematics, Arts & Sciences;
• Margit Tavits, professor of political science, Arts & Sciences;
• Barbara Schaps Thomas, AB ’76, member of the Board of Trustees and chair of the Arts & Sciences National Council;
• Adia Harvey Wingfield, professor of sociology and associate dean for faculty development in Arts & Sciences; and
• Jeffrey M. Zacks, professor of psychological and brain sciences, Arts & Sciences.

Lisa M. Siddens, assistant provost for strategic projects and appointments, will assist the committee in this search.

The post Arts & Sciences dean search committee appointed appeared first on The Source.

People living in marginalized communities in St. Louis, particularly African Americans, have been enduring, as one study participant said, “real problems” such as violence and racism that are perceived as more immediate than issues of climate change, finds a study from the Brown School at Washington University in St. Louis.

“We suggest that threats like violence and racism play a significant role in shaping people’s awareness of, and engagement with, environmental issues,” said Joonmo Kang, a doctoral student at the Brown School and first author of the study, “’Let’s Talk About the Real Issue’: Localized Perceptions of Environment and Implications for Ecosocial Work Practice.” The study was recently published in the Journal of Community Practice.

“These imminent threats must be addressed alongside efforts to draw attention to environmental issues,” Kang said. “Despite this prioritization of violence and racism on the part of community residents, many of our participants applied an environmental justice lens to their experiences.”

While this finding echoes the history of violence and racism in St. Louis, Kang said, the study suggests that “this degree of alertness could serve as an opportunity in mobilizing in the face of these types of threats.”

Kang and co-authors Vanessa Fabbre and Christine Ekenga, both assistant professors at the Brown School, argue that ecological social work practice should incorporate localized perceptions of an environmental justice perspective in any education or community mobilization for environmental decision-making.

Stemming from calls to attend to localized perceptions of environmental issues, the study investigated how residents living in socio-economically challenged communities in St. Louis perceive and make meaning of their local environmental conditions, such as air, water and climate, and risks, especially with respect to their health and well-being.

The authors conducted interviews with residents on the north sides of both the City of St. Louis and St. Louis County.

“Participants’ perspectives reverberated the long history of racial inequality in St. Louis and demonstrated an awareness of environmental injustice and disproportionate health risks for African Americans,” Kang said. “Although they did not immediately see environmental issues like air pollution or climate change as having a direct impacts on their lives, they were sensitive to race-based environmental injustices.”

Particularly in places like St. Louis, where, Kang said, “racism informs the realities of people’s daily lives and the meanings people generate with respect to environmental issues,” social workers who are “knowledgeable about racism and environmental justice are well-positioned to carry out ecosocial work practice,” he said.

The post Violence and racism shape views of environmental issues appeared first on The Source.

Nearly all premature babies receive antibiotics in their first weeks of life to ward off or treat potentially deadly bacterial infections. Such drugs are lifesavers, but they also cause long-lasting collateral damage to the developing microbial communities in the babies’ intestinal tracts, according to research from Washington University School of Medicine in St. Louis.

A year and a half after babies leave the neonatal intensive care unit (NICU), the consequences of early antibiotic exposure remain, the study showed. Compared to healthy full-term babies in the study who had not received antibiotics, preemies’ microbiomes contained more bacteria associated with disease, fewer species linked to good health, and more bacteria with the ability to withstand antibiotics.

The findings, published Sept. 9 in Nature Microbiology, suggest that antibiotic use in preemies should be carefully tailored to minimize disruptions to the gut microbiome – and that doing so might reduce the risk of health problems later in life.

“The type of microbes most likely to survive antibiotic treatment are not the ones we typically associate with a healthy gut,” said senior author Gautam Dantas, professor of pathology and immunology, of molecular microbiology, and of biomedical engineering. “The makeup of your gut microbiome is pretty much set by age 3, and then it stays pretty stable. So if unhealthy microbes get a foothold early in life, they could stick around for a very long time. One or two rounds of antibiotics in the first couple weeks of life might still matter when you’re 40.”

Healthy gut microbiomes have been linked to reduced risk of a variety of immune and metabolic disorders, including inflammatory bowel disease, allergies, obesity and diabetes. Researchers already knew that antibiotics disrupt the intestinal microbial community in children and adults in ways that can be harmful. What they didn’t know was how long the disruptions last.

To find out whether preemies’ microbiomes recover over time, Dantas and colleagues – including first author Andrew Gasparrini, PhD, who was a graduate student at the time the study was conducted, and co-authors Phillip I. Tarr, MD, the Melvin E. Carnahan Professor of Pediatrics, and Barbara Warner, MD, director of the Division of Newborn Medicine – analyzed 437 fecal samples collected from 58 infants, ages birth to 21 months. Forty-one of the infants were born around 2 ½ months premature, and the remainder were born at full term.

All of the preemies had been treated with antibiotics in the NICU. Nine had received just one course, and the other 32 each had been given an average of eight courses and spent about half their time in the NICU on antibiotics. None of the full-term babies had received antibiotics.

The researchers discovered that preemies who had been heavily treated with antibiotics carried significantly more drug-resistant bacteria in their gut microbiomes at 21 months of age than preemies who had received just one course of antibiotics, or full-term infants who had not received antibiotics. The presence of drug-resistant bacteria did not necessarily cause any immediate problems for the babies because most gut bacteria are harmless – as long as they stay in the gut. But gut microbes sometimes escape the intestine and travel to the bloodstream, urinary tract or other parts of the body. When they do, drug resistance can make the resulting infections very difficult to treat.

Moreover, by culturing bacteria from fecal samples taken eight to 10 months apart, the researchers discovered that the drug-resistant strains present in older babies were the same ones that had established themselves early on.

“They weren’t just similar bugs, they were the same bugs, as best we could tell,” Dantas said. “We had cleared an opening for these early invaders with antibiotics, and once they got in, they were not going to let anybody push them out. And while we didn’t show that these specific bugs had caused disease in our kids, these are exactly the kind of bacteria that cause urinary tract and bloodstream infections and other problems. So you have a situation where potentially pathogenic microbes are getting established early in life and sticking around.”

Further studies showed that all of the babies developed diverse microbiomes by 21 months of age – a good sign since lack of microbial diversity is associated with immune and metabolic disorders in children and adults. But heavily treated preemies developed diverse microbiomes more slowly than lightly treated preemies and full-term infants. Further, the makeup of the gut microbial communities differed, with heavily treated premature infants having fewer healthy groups of bacteria such as Bifidobacteriaceae and more unhealthy kinds such as Proteobacteria.

The findings already have led Warner, who takes care of premature infants in the NICU at St. Louis Children’s Hospital, and her fellow neonatalogists to scale down their use of antibiotics.

“We’re no longer saying, ‘Let’s just start them on antibiotics because it’s better to be safe than sorry,’” Warner said. “Now we know there’s a risk of selecting for organisms that can persist and create health risks later in childhood and in life. So we’re being much more judicious about initiating antibiotic use, and when we do start babies on antibiotics, we take them off as soon as the bacteria are cleared. We still have to use antibiotics – there’s no question that they save lives – but we’ve been able to reduce antibiotic use significantly with no increase in adverse outcomes for the children.”

Gasparrini AJ, Wang B, Sun X, Kennedy EA, Hernandez-Leyva A, Ndao IM, Tarr PI, Warner BB, Dantas G. Metagenomic signatures of early-life hospitalization and antibiotic treatment in the infant gut microbiota and resistome persist long after discharge. Nature Microbiology. Sept. 9, 2019. DOI: 10.1038/s41564-019-0550-2

This work is supported by the National Institute of General Medical Sciences, grant numbers R01 GM099538 and T32 GM007067; the National Institute of Allergy and Infectious Diseases, grant number R01 AI123394; the U.S. Centers for Disease Control and Prevention, grant number 200-2016- 91955; the National Institutes of Health (NIH), grant number 5P30 DK052574; the Eunice Kennedy Shriver National Institute Of Child Health and Human Development, grant number R01 HD092414; the Children’s Discovery Institute at St Louis Children’s Hospital and Washington University School of Medicine; and the National Institute of Diabetes and Digestive and Kidney Diseases, Pediatric Gastroenterology Research Training Program award number T32 DK077653.

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by the School of Medicine

The post Use of antibiotics in preemies has lasting, potentially harmful effects appeared first on The Source.

The battle against HIV increasingly looks winnable, and Washington University in St. Louis is helping lead the charge. Rupa Patel, MD, an assistant professor of medicine, has received a grant for $3.9 million from the Centers for Disease Control and Prevention (CDC) to establish a regional resource center at the university to aid HIV prevention efforts in 12 Midwestern states.

The center is part of a nationwide push to end the HIV epidemic in the U.S.

“There’s a medication, a pill you can take every day, that protects you from getting HIV,” Patel said. “With this new medication, we’ve seen rates of new infections reduced fairly quickly around the world. So the U.S. political and health sectors came together and said, ‘Let’s end HIV in the U.S.’ At the federal level, there is a goal of ending the HIV epidemic in the U.S. by 2030. Our contribution to that goal is that we’re going to make sure that this pill gets to everyone who would benefit from it in the Midwest.”

About 39,000 people become infected with HIV in the U.S. every year, usually through sexual contact or by sharing needles with someone with HIV to inject drugs. With treatment, people with HIV can live as long as people without HIV. The virus never goes away, but people with HIV who take their medicine regularly are unlikely to pass the virus to someone else. But not everyone infected with HIV receives therapy, and so the virus continues to spread.

The development in 2012 of preexposure prophylaxis, or PrEP, changed the game of HIV prevention. One PrEP pill a day cuts risk of sexual transmission by 92 percent and of blood-borne transmission by more than 70 percent. When combined with tried-and-true methods of HIV prevention such as condoms and needle exchanges, PrEP could be the tool that finally puts a stop to new HIV infections.

As part of the federal initiative to end the HIV epidemic, the CDC launched a five-year, $120 million program to strengthen the nation’s HIV-prevention efforts and tapped 17 organizations to implement the program.

Patel and co-principal investigator Bradley Stoner, MD, PhD, an associate professor of anthropology in Art & Sciences and of medicine at the School of Medicine, were selected to establish the Midwest Capacity Building Assistance Network to provide individualized expertise, technology and resources to Midwestern organizations that want to scale up HIV prevention and PrEP services.

Both Patel and Stoner are experienced in the field. Patel directs Washington University’s PrEP Program, which provides PrEP care to HIV-negative people and which collaborated with the Missouri Department of Health to create a website and toolkit with resources for providers and consumers of PrEP care. Stoner is the medical director of the CDC-funded St. Louis STD/HIV Prevention Training Center, which provides health-care professionals with the latest research on sexually transmitted diseases. They will assist groups working in hard-hit communities in Missouri, Illinois, North Dakota, South Dakota, Nebraska, Kansas, Minnesota, Iowa, Wisconsin, Michigan, Indiana and Ohio.

“Every town, every region, has community-based organizations that do HIV prevention, but sometimes they run into problems they don’t know how to solve,” Stoner said. “Before you can give someone PrEP, you have to take a blood draw and make sure their kidney function is OK. Maybe they don’t know how to pay for that. Or they have people who are scared to get an HIV test, and the organization needs to know how to educate their community in a culturally sensitive way. We’re here to help them overcome these kinds of problems.”

Along with individualized advice and support, the center will provide workshops and training to share best practices for providing HIV testing and PrEP in the Midwest. Nancy Mueller, the assistant dean for planning and evaluation at the university’s Brown School, and colleagues at the Brown School Evaluation Center will help assess the center’s effectiveness at supporting HIV prevention efforts.

“HIV is an urban and a rural epidemic in the Midwest,” Patel said. “You can’t take the models verbatim from San Francisco or New York and try to apply them in Cleveland or Detroit. We have designed tools, standard operating procedures, checklists that are a lot friendlier to clinics that are smaller. The goal is not to say that every organization needs to start PrEP right now. But if we take the time to understand what their challenges are, we can help make sure that every organization gets their clients the best care they can. And in the long run, that will help put a stop to this epidemic.”

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by the School of Medicine

The post Halting spread of HIV in Midwest is aim of new network appeared first on The Source.

Three members of the Washington University in St. Louis faculty have been appointed to serve as faculty fellows in the Office of the Provost,  according to Interim Provost Marion Crain. During the 2019-20 academic year, they will focus on several high-priority academic initiatives. The fellows are:

• Brian Carpenter, professor of psychological and brain sciences in Arts & Sciences, who will provide strategic guidance and develop assessment tools on the new Beyond Boundaries program in partnership with its director, Rob Morgan. Beyond Boundaries allows talented and motivated students to tackle big societal and intellectual challenges. Carpenter also will  provide oversight of the Beyond Boundaries courses;
• Sean Joe, the Benjamin Youngdahl Professor of Social Development at the Brown School, who will lead a team of faculty and administrators to assess and inform the university’s strategic approach to the link between reporting metrics and academic decisions; and
• Laurie Maffly-Kipp, the Archer Alexander Distinguished Professor at the John C. Danforth Center on Religion and Politics, who will oversee the regular review process for several of the university’s centers and institutes.

“I am so pleased that these three esteemed members of our faculty have agreed to serve as fellows and lend their considerable talents to these important academic priorities,” Crain said. “Through their efforts, we will gain invaluable insight and ensure that faculty perspectives are well represented as we consider our path forward in these essential areas.”

The post Faculty fellows to lead key areas in provost’s office appeared first on The Source.

Restricting the sale of menthol cigarettes to tobacco specialty shops may reduce the number of retailers and increase the cost of smoking, according to new research from the Brown School at Washington University in St. Louis.

“Targeting the tobacco retail environment is rapidly emerging as the next frontier in tobacco control,” said Todd Combs, research assistant professor at the Brown School and lead author of the study “Modelling the Impact of Menthol Sales Restrictions and Retailer Density Reduction Policies: Insights From Tobacco Town Minnesota,” published Aug. 28 in the journal Tobacco Control.

“Policies focused on the places tobacco is sold can reduce tobacco use and tobacco-related health disparities by increasing the direct and indirect costs of tobacco to consumers,” Combs said.

Researchers used a computer model called Tobacco Town to test the effect of five retail restrictions on the reduction of retailer density; total cost per cigarette pack; and the average distance customers travel to buy cigarettes.

The model was based on data from six communities in Minnesota that are planning or have enacted menthol restrictions. During each simulated day in the model, computer-generated “people” smoke and make decisions on when and where to buy cigarettes.

Of those tested, the single policy with the largest impact on density reduction, especially in urban low-income areas, was restricting all cigarette sales to tobacco specialty shops. Restricting all cigarette sales or menthol cigarette sales in that way also may have the largest effect on the total direct and indirect costs of cigarettes.

In almost all of the simulations, low-income population and African Americans were the groups least impacted by policy changes, likely because they live in retailer-dense areas. That finding led the authors to suggest combining density restrictions and sales restrictions to reduce disparities.

“Communities often implement policies to reduce health disparities among priority populations,” Combs said. “Our results suggest that retail policies aimed at increasing direct and indirect costs of purchasing cigarettes and, presumably, reducing smoking among low-income or black or African-American populations might impact them less than for the overall population. This is likely because they live in retailer-dense areas (black or African-American smokers) or travel farther on average (lower income smokers) to purchase cheaper products.”

The post Menthol restrictions may hike cigarette costs, reduce health disparities appeared first on The Source.

Michael J. Holtzman, MD, director of the Division of Pulmonary & Critical Care Medicine at Washington University School of Medicine in St. Louis, has received awards totaling $7.5 million to support innovative research aimed at defining and controlling chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease (COPD).

The largest grant, a $6.6 million outstanding investigator award from the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH), recognizes physician-scientists who have a track record of highly successful and innovative research and are considered likely to make major advances in their respective fields with the support of continuous funding for seven years.

The award also recognizes that chronic respiratory disease has become the third most common cause of death in the U.S. and the fifth worldwide. Despite the devastating impact of respiratory diseases, most commonly in the form of asthma and COPD, there are still no drugs to precisely address the root causes of these disorders and provide long-lasting relief for such patients.

“Respiratory diseases are a major public health problem,” said Holtzman, the Selma and Herman Seldin Professor of Medicine. “But we still have no drug treatment to correct the most severe forms of this type of disease. In these cases, particularly COPD, all we can do is provide some degree of symptomatic relief. The disease continues to flare and progress toward increasing disability and mortality.

“In the case of asthma, we prescribe the same types of drugs today that we did 50 years ago, again with only temporary and partial improvement in symptoms,” he said. “There are new biologics marketed aggressively to control inflammation, but these agents only work about half of the time and even then only in a subset of patients. The approach also requires injections with increased costs, complications and side effects and comes with restrictions against use in children or during infections, which is often when the drug is needed most. Most of all, none of the existing treatments address the underlying abnormality that we propose is key to respiratory diseases.”

Holtzman argues for a new approach. He said his lab’s work suggests there may be a way to help patients with chronic lung disease if new drugs can target a distinct type of stem cell that becomes reprogrammed and then inappropriately drives airway inflammation and mucus production, the major drivers for clinical problems.

In healthy people, limited inflammation and mucus production act as an ancient but critical defense mechanism. But overproduction of mucus can turn deadly if left unchecked.

“Stem cells that give rise to mucus cells lining the airway and other sites are part of our immune defense strategy,” Holtzman said. “Those defenses are activated in response to inhaled troublemakers, especially common respiratory viruses, and this reaction prevents airway injury and promotes repair. Once the problem is resolved, the system should go back to a normal baseline level. But in some people, the stem cell is changed in a way that continues to promote inflammation and mucus production and ultimately compromises airway function even for normal breathing. We are identifying therapeutic targets and corresponding drugs that will dial back this stem cell response in a way that achieves a long-term correction.”

As a basis for his new grant, Holtzman and his team have identified a distinct subtype of stem cells in the lining of the airway. These cells are responsible for orchestrating the inflammation and mucus production of the respiratory system. They can switch into overdrive during disease, activating immune cells that promote inflammation and making daughter cells that respond to inflammation by turning into mucus-producing cells. Defining and controlling the mechanism that reprograms stem cells toward disease is a major goal of his new grant.

In that regard, the Holtzman group already has identified master regulators that are critical to the disease-producing behavior of lung stem cells. Through the efforts of an innovative drug discovery program launched 10 years ago, Holtzman and his colleagues also have developed new compounds that very effectively correct stem cell reprogramming and the associated inflammatory disease.

Research from his lab in animal models has shown that one of the most promising compounds, when given orally, is effective and safe for preventing airway inflammation and mucus production after a common type of respiratory viral infection. Based on these results and initial safety studies, Holtzman and his team have reached the stage of final testing and application to the Food and Drug Administration for the compound to be designated as an investigational new drug. Holtzman and his team then will be able to move forward with clinical trials in people with exacerbations of asthma, COPD and related upper airway disorders such as rhinitis and sinusitis.

In related work, the researchers also showed that similar stem cells are not just present in the airway, and decided to test their new inhibitors in other tissues and diseases. In a discovery that might seem surprising, they showed that some of their compounds were also very potent in blocking stem cell growth and invasiveness in models of breast cancer, including the most severe form, called triple-negative breast cancer, for which no specific and effective treatments are yet available.

“Your first reaction might be to wonder how in the world such similar compounds could be effective in what seem to be such different tissues,” Holtzman said. “But airway and breast tissues and other related sites share secretory function and overlap in how this function is controlled. As a result, our compounds can be precisely tailored to address whether the dysregulated stem cell is in airway versus breast tissue, or other sites as well.”

In addition to the new award to define and control stem cell behavior, Holtzman also formed a startup company to help bring the drug compounds to market. To support these efforts, he received a NIH Small Business Technology Transfer (STTR) grant for $300,000 for the compound specific to breast cancer and another STTR grant for $300,000 for a compound targeting airway disease. The research group also received a $250,000 award from the Siteman Investment Program to further support the development of the new compound for breast cancer. The strategy, he said, is to combine academic and commercial activities to finally get these new kinds of compounds into practice as quickly as possible.

This work is supported by an NHLBI Outstanding Investigator Award, grant number R35 HL145242-01, an NCI STTR Award R41 CA235943, an NHLBI STTR Award R41HL14952, and the Siteman Investment Program.

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by the School of Medicine 

The post $7.5 million to fund pioneering approaches to respiratory disease appeared first on The Source.

Washington University School of Medicine in St. Louis has received a $5 million grant from the Edward P. Evans Foundation to establish and endow a new center focused on advancing research and improving treatments for a rare set of blood disorders called myelodysplastic syndromes, or MDS, that leaves the body unable to make enough healthy blood cells.

The new Edward P. Evans Myelodysplastic Syndromes Center at Washington University will be led by oncologist Matthew J. Walter, MD, a professor of medicine who treats patients with MDS and related blood disorders at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine.

Difficult to diagnose, MDS is characterized by low blood cell counts. Symptoms can be vague, such as fatigue and shortness of breath. It can be fatal, but people with low-risk MDS may live for years with the disease and never realize they have it. Patients are diagnosed based on the appearance of their abnormal blood cells, and doctors often take a watchful waiting approach to see if their blood cell counts decrease or the number of abnormal blood cells increases before taking steps to intervene. In about one-third of MDS patients, the slow-growing disease takes an aggressive turn and progresses to acute myeloid leukemia (AML), a fast-growing cancer of the blood that is fatal unless successfully treated with a stem cell transplant. Even so, long-term prognosis for almost all AML patients is poor. About 40,000 people are diagnosed with MDS in the U.S. each year.

“The only way to cure MDS is a stem cell transplant,” Walter said. “And patients with MDS are usually older, say in their 70s, when it is much harder for the body to tolerate such a transplant. So we can treat the disease in older patients with chemotherapy and blood transfusions, but we have no way to cure it in people who aren’t candidates for a stem cell transplant. We want to study how MDS occurs so we can intervene and prevent it from progressing.”

Walter and his colleagues are interested in identifying healthy individuals with normal blood counts and mutations in a few key genes that are linked to MDS but who don’t have any symptoms. This condition is called age-related clonal hematopoiesis (ARCH). Individuals with ARCH have a higher than average but still relatively low risk of developing MDS — about 1% per year, as well as a higher risk of developing other age-related conditions, such as cardiovascular disease. Although relatively few will end up with MDS, studying this group of patients could help doctors understand the differences between those patients who go on to develop disease and those who don’t.

A major goal of the center is to launch an ARCH clinic that will see patients and conduct a long-term study tracking the courses of their disease. The researchers estimate that about 10% of 70-year-olds have ARCH.

According to Walter, almost all ARCH patients — about 95% — who go on to develop low blood counts will be diagnosed with MDS or leukemia sometime over the next 10 years. This suggests that ARCH may be a precursor to MDS. But why one person develops MDS and another doesn’t remains a mystery.

“We have a chance to understand the genetic factors or the environmental factors that might tip the balance, leading patients to develop MDS,” Walter said. “It’s a challenge to identify patients with ARCH because they are healthy. They have normal blood counts with just a very small number of abnormal cells. So we have to use genetic sequencing data to find people with mutations in certain genes that we know are involved in MDS and AML.”

Environmental risk factors for MDS include previous chemotherapy and radiation to treat other cancers as well as exposure to benzene or radiation on the job, for example. The researchers affiliated with the center would like to learn more about environmental stresses that could interact with gene mutations and drive the disease to progress. The goal would be to find ways to reduce those stresses and thereby reduce the risk of worsening the condition.

The center also will have the ability to collect and store blood samples for genetic analysis. The researchers ultimately would like to develop prevention strategies to stop ARCH from progressing to MDS. Walter and his colleagues also would like to develop new immunotherapies and new strategies for stem cell transplantation that might be less toxic than traditional approaches to treating MDS.

Currently, 16 investigators from oncology, cardiology and the McDonnell Genome Institute at Washington University are participating in the center. The center will foster collaborations between established MDS researchers and those new to the field and provide research funding for innovative projects. Its endowment also will support a fellowship for researchers-in-training and a professorship, both named for Edward P. Evans.

In addition to major support from the Department of Medicine and Siteman Cancer Center, the new center is positioned to benefit from other major initiatives supporting leukemia research at the School of Medicine, including the Genomics of Acute Myeloid Leukemia (AML) Program Project Grant led by Timothy J. Ley, MD, the Lewis T. and Rosalind B. Apple Professor of Medicine, and the Specialized Program of Research Excellence (SPORE) grant in leukemia led by Daniel C. Link, MD, the Alan A. and Edith L. Wolff Professor of Medicine. Those initiatives are funded by the National Cancer Institute of the National Institutes of Health (NIH). In addition, the center will benefit from the long-standing collaboration between MDS researchers and the McDonnell Genome Institute. Such resources make Washington University a national hub for innovative research and leadership in developing new therapies for patients with cancerous blood disorders.

Edward Parker Evans was a businessman, philanthropist and horseman. His Spring Hill Farm in Casanova, Virginia, was the largest thoroughbred breeding farm in the state. Evans established his foundation in 1984. Since his death from secondary acute myelogenous leukemia in 2010, the Edward P. Evans Foundation has supported collaborative and transformational research on MDS at leading institutions. Washington University will be hosting the EvansMDS Summit on Oct. 24 and 25,  where investigators working on the most groundbreaking MDS research will present their research.

“The Edward P. Evans Foundation has contributed more than $66 million since 2011 to medical research directed at improving outcomes and finding a cure for MDS patients,” said Michael D. Lewis, PhD, president of the foundation. “Washington University is an ideal location for our first Edward P. Evans Center for Myelodysplastic Syndromes. The center capitalizes on an array of world-renowned faculty and the resources of the Siteman Cancer Center and McDonnell Genome Institute. We eagerly anticipate the flow of new discoveries that will benefit MDS patients.”

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by the School of Medicine

The post $5 million grant endows research to advance blood disorder therapies appeared first on The Source.

Kristina Anderson, a survivor of the 2007 Virginia Tech shooting, will be the featured speaker for Ready Week, which will take place Sept. 16-20 and is organized by the Washington University in St. Louis Emergency Management Department.

In addition, Ready Week will emphasize the importance of emergency preparation through tuning in, learning more, looking around and taking action. A series of interactive events and presentations will take place on Danforth, Medical, North and West campuses. Students, faculty and staff are encouraged to participate.

Anderson will give two presentations: a lunch-and-learn session on lessons learned from active threats, at 11:45 a.m. Wednesday, Sept. 18, in the North Building’s Moore Auditorium on the Medical Campus; and a discussion on how to prepare a personal active-shooter response plan, at 6 p.m. that day in College Hall’s Risa Commons on the Danforth Campus.

“Even if someone cannot attend, I want them to choose to be proactive and hopeful, ask more questions about the nature of violence and become aware by checking their campus daily crime log,” Anderson said.

Anderson started the Koshka Foundation for Safe Schools with money she received in get-well cards from loved ones during her recovery. Today, she spends her time speaking to law enforcement officials and schools across the nation, providing information and resources for personal and emergency preparedness  and encouraging campus safety to prevent school violence.

“People that go through traumatic experiences often seek to find meaning,” Anderson said. “That meaning for me has been this understanding that we can prevent violence. We often feel very helpless. I want to provide hope and inspiration.”

In addition to Anderson’s presentations, community members can take part in lemonade events at 1 p.m. Monday, Sept. 16, at the Clocktower on the South 40 on the Danforth Campus  and at 11 a.m. Tuesday,  Sept. 17, on the Medical Campus’ food truck lawn. There also will be a scavenger hunt at the Clocktower beginning at 4 p.m. Thursday, Sept. 19.

The Emergency Management Department holds Ready Week every fall and spring to promote emergency preparedness and campus safety. For additional information and a full listing of events, visit the Ready Week webpage.

The post Virginia Tech shooting survivor to speak for Ready Week appeared first on The Source.

Inequities and inequalities are ever-evolving and surfacing in our society, presenting a shifting landscape of challenges and problems. Gaps in our social, economic, education and health systems all pose specific challenges on regional, national and global scales.

To address these challenges, Washington University in St. Louis will bring together the best research evidence from disciplines across the university to solve real-world challenges — which sums up both the mission and the vision of the new Social Policy Institute. The institute will serve as a hub for policy-focused efforts universitywide.

“Over the past decades, research has well documented the range of disparities in financial opportunities, housing, education and health that adversely affect the well-being of individuals and communities. What is needed now is to move from documenting disparities to finding and implementing solutions to the inequalities at the root of those disparities,” said Michal Grinstein-Weiss, the Shanti K. Khinduka Distinguished Professor at the Brown School, who will serve as director of the Social Policy Institute.

“It is our responsibility, as part of a leading research institution and as world citizens, to leverage our findings and effectively apply what we learn from research so we can discover and implement innovative ways to eliminate or reduce inequities,” she said.

In addition to collaborating and partnering with Washington University faculty, research centers and institutes already engaged in policy work, the Social Policy Institute will partner with corporate leaders and government officials, private foundations and think tanks to develop strong research partnerships at the local, state, federal and global levels. The institute’s work extends across a wide range of areas, delving into business, social work, engineering, design and liberal arts. Its multidisciplined, holistic and innovative approach is grounded in its ultimate goal of translating research findings into actionable policy to benefit communities in St. Louis, the nation and across the globe.

“The Social Policy Institute will enable us to continue strengthening Washington University’s capacity and capability to engage in empirical research and cross-sector collaborations,” Chancellor Andrew D. Martin said. “With nonprofit and industry partners, we’re investing in evidence-based policy ideas for people in the St. Louis region, the United States and beyond.”

The Social Policy Institute will officially launch at 3 p.m. Tuesday, Sept. 24, with an event in Hillman Hall featuring a remarkable group of speakers, including Richard Reeves, a  Brookings Institution senior fellow in economic studies, and Dan Ariely, the James B. Duke Professor of Psychology and Behavioral Economics at Duke University.

Afterward, Nisha Patel, managing director of narrative change and national initiatives at the poverty-fighting organization Robin Hood, will lead a panel of corporate and community partners from Intuit Inc., Centene Corp. and the St. Louis Federal Reserve, who  will offer thought-provoking perspectives on how cross-sector partnerships can find sustainable solutions to some of society’s most challenging problems.

“Frequently, research findings haven’t had the expected impact on policy because the evidence has not been given to ‘the right people, at the right time, in the right way’ — that is, translated into accessible information and delivered to those who can influence policy design and decision-making,” Grinstein-Weiss said.

“The institute is eagerly looking forward to serving as a hub for the work that faculty, students and the various university centers are already doing to address social policy,” she said. “We see one part of our mission as supporting and facilitating these ongoing efforts as well as using our network of contacts and resources to help broker future multidiscipline, cross-sector partnerships that will help to ensure research evidence is transformed into policy and programs that benefit our campus, communities and world.  We know we will be stronger in this effort together.”

The launch event will take place from 3-6:15 p.m. in Hillman Hall’s Clark-Fox Forum and is open to the Washington University community.  Click here to RSVP.

The post Social Policy Institute launches at Washington University appeared first on The Source.

Brown School researchers at Washington University in St. Louis have begun work on a five-year, $3.9 million study that tests an innovative approach to help low-income smokers quit.

Matthew Kreuter, the Kahn Family Professor of Public Health, is leading the effort. Amy McQueen is the study’s co-leader and co-director of the Health Communication Research Laboratory, where the research is based.

Funded by the National Cancer Institute at the National Institutes of Health (NIH), the study began in July and will recruit nearly 2,000 low-income smokers from nine states where smoking rates exceed the national average of 15%.

“There is an urgent need to get more low-income smokers engaged in activities that will help them to quit someday,” Kreuter said. “The current approach works for those who use it, but doesn’t reach nearly enough people.”

As a part of the large-scale study, half of participants will be offered the current standard for population-level treatment, cessation counseling with a quit coach through state telephone quit-smoking hotlines. A notable limitation of this approach is that to be eligible, smokers must plan to quit in the next 30 days. That requirement disqualifies 70% to 80% of low-income smokers.

Here, the other half of participants also will be offered quit-smoking line services, but those who don’t plan to quit in the next 30 days will then be offered an alternative: a proven program to help them establish rules banning smoking inside their homes.

Previous studies have shown that creating a smoke-free home reduces health risks to nonsmokers and ultimately helps smokers quit.

The study involves collaborators from Emory University; Optum, a quitline provider that will assist in providing the cessation and Smoke Free Homes interventions to participants; and 2-1-1 helplines, which will connect researchers with 1,980 low-income smokers from states with high smoking prevalence.

Researchers first conducted three pilot studies to investigate this approach. The researchers concluded that certain factors play a role in the effectiveness of the study’s approach: smokers’ readiness to quit; motivation to protect children and nonsmokers; and acceptance of a smoke-free home intervention.

Smokers participating in the study will be followed for six months. The study will examine differences in cigarettes smoked per day; attempts to quit smoking; and success in creating a smoke-free home. The goal is to assist those with limited income and resources in the process of quitting the deadly habit.

“Offering smokers another service besides quitting could help more people make incremental changes that pave the way to greater cessation rates down the road,” McQueen said.

Smoking rates in the U.S. are much higher among those in living in poverty. Those who receive health care through Medicaid, the uninsured, those with lower levels of education and people who have serious psychological stress also have  higher smoking rates. Smoking-related cancers are more common and are diagnosed at a later stage in low-income and low-education populations.

The post Brown School researchers begin low-income smoker study appeared first on The Source.

Nearly 1,000 women engaged in sex work in Uganda are being provided with savings accounts, financial literacy skills and vocational training in a study currently underway by researchers from the Brown School at Washington University in St. Louis.

“When women engaged in sex work have access to alternative forms of employment and start earning formal income outside of sex work, they may become motivated to explore alternative sources of income and ultimately reduce their exposure to HIV and other sexually transmitted infections,” said Fred Ssewamala, the William E. Gordon Distinguished Professor at the Brown School and a principal investigator for the study.

“We hope the study findings will advance our understanding of how best to implement gender-specific HIV prevention globally,” he said.

The outline of the study, “A Combination Intervention Addressing Sexual Risk-taking Behaviors Among Vulnerable Women in Uganda: Study Protocol for a Cluster Randomized Clinical Trial,” was published in August in the journal BMC Women’s Health.

Investigators hope that improving the women’s financial situations and job prospects will result in less sexual risk-taking and limit the spread of HIV.

Sub-Saharan Africa has the highest number of people living with HIV/AIDS, with Nigeria, South Africa and Uganda accounting for 48% of new infections. Women in sex work are at increased risk, and poverty is the most common reason for sex work.

The randomized control trial is recruiting 990 women engaged in sex work to participate in the five-year study, which began in 2018 and is funded by a $3 million grant from the National Institute of Mental Health.

One-third of the women will be given traditional HIV risk-reduction training. Another one-third will also receive a savings account that will match the savings that women deposit, along with financial literacy training on subjects such as budgeting and asset building. The last one-third will receive vocational training in addition to the other elements of the intervention.

Ssewamala is also the director of the SMART Africa Center, which is aimed at reducing gaps in child and adolescent mental health services and conducting research in Ghana, Kenya and Uganda.

The post Intervention in Uganda aims to stem HIV through economic empowerment for women appeared first on The Source.

A single high dose of radiation aimed at the heart significantly reduces episodes of a potentially deadly rapid heart rhythm, according to results of a phase one/two study at Washington University School of Medicine in St. Louis.

Patients in the study were severely ill and had exhausted other standard treatment options. The radiation used to treat the irregular heart rhythm — called ventricular tachycardia — is the same type of therapy used to treat cancer.

The research will be reported Sept. 15 at the American Society for Radiation Oncology (ASTRO) Annual Meeting in Chicago.

“Radiation therapy is a last line of defense for these patients, who are often too unwell to undergo additional traditional therapies to control heart arrhythmias,” said Clifford G. Robinson, MD, an associate professor of radiation oncology and of cardiology at Washington University. “It provides hope for patients with dangerous rhythms who have run out of options.”

In ventricular tachycardia (VT), the lower chambers of the heart beat exceedingly fast and fall out of sync with the upper chambers, interfering with blood flow and raising the risk of sudden cardiac death. Patients with VT typically are implanted with defibrillators that shock the heart back into a normal rhythm. In an effort to stop the episodes, patients often are treated with catheter ablation procedures, in which a catheter is inserted into the heart and used to create scars in the part of the damaged heart muscle that is causing the electrical signals to misfire. But catheter ablation is invasive, requires many hours under general anesthesia and often isn’t a permanent solution. The rapid heart rhythm returns in about half of such patients.

The new method is a noninvasive outpatient procedure that involves the use of electrocardiograms and computed tomography scans of a patient’s heart to locate the origin of the arrhythmia. The 3D visual and electrical maps of the heart then guide the noninvasive radiation therapy. Doctors can target the problem area of the heart with a single high-dose beam of radiation that often takes less than 10 minutes to administer and requires no anesthesia or hospitalization. The patient can go home right after treatment.

The phase one/two trial included 19 patients with ventricular tachycardia who had not responded to other therapies. In a study published in 2017 in The New England Journal of Medicine, the same research team reported a 90% reduction in episodes of tachycardia and improved survival in the six months after radiation therapy. Now, Robinson and his colleagues, including Washington University cardiologist Phillip S. Cuculich, MD, an associate professor of cardiology and of radiation oncology, report that the reduction in tachycardia episodes persists in about 80% of patients for at least two years following the single treatment. At one year after therapy, overall survival was 72%, and at two years, survival was 52%.

“These numbers are encouraging given the condition of the patients, who are too sick to undergo any more catheter ablation procedures,” Robinson said. “Given the relative novelty of this treatment approach, we are continuing to follow our patients closely.”

Of nine patient deaths, six were from cardiac causes, including heart failure and tachycardia recurrence, and three were from noncardiac causes, including an accident, amiodarone toxicity and pancreatic cancer. Two surviving patients experienced inflammation of the heart lining, a common side effect of this type of radiation therapy, and another developed a fistula between the stomach and the heart and needed surgery to repair it. All three of these adverse events occurred more than two years after therapy. Such side effects emphasize the importance of monitoring the patients for signs of cardiac injury, which is always a possibility following radiation therapy, according to Robinson.

Despite the severe adverse events, the researchers said they are to be expected when considering how ill these patients are. They emphasized that radiation therapy is the last option and only should be pursued when all other strategies have been exhausted. For such patients, the study suggests their tachycardia is likely to improve, leading to a reduced need for medications with adverse side effects and to an improved quality of life, at least over the first two years following treatment.

Robinson CG, et al. Longer-term results from a phase I/II study of EP-guided noninvasive cardiac radioablation for treatment of ventricular tachycardia (ENCORE-VT). ASTRO Annual Meeting. Sept. 15, 2019.

Washington University School of Medicine’s 1,500 faculty physicians also are the medical staff of Barnes-Jewish and St. Louis Children’s hospitals. The School of Medicine is a leader in medical research, teaching and patient care, ranking among the top 10 medical schools in the nation by U.S. News & World Report. Through its affiliations with Barnes-Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.

Originally published by the School of Medicine

The post Radiation therapy effective against deadly heart rhythm appeared first on The Source.

To lure customers, online retailer Alibaba often targeted existing customers when marketing resources were limited. Then along came a research project with a novel question: What if you pursued prospective customers, and then tracked their offline and online spending habits compared to frequent customers?

That’s how two Washington University in St. Louis researchers, along with a former fellow Olin Business School faculty member and Alibaba officials, flipped the pop-up business model, and possibly more. The co-authors found that inviting potential customers via text message could increase buying with both a pop-up shop retailer and similar product vendors online.

In fact, that online shopping hangover — which they labeled a “spillover effect” — spread over far more retailers than the original participants and lasted as long as six weeks to three months after the initial text/pop-up lure.

Their paper, “The Value of Pop-Up Stores on Retailing Platforms: Evidence from a Field Experiment with Alibaba,” was published online Sept. 5 and is forthcoming in the journal Management Science.

“Pop-up stores have become an increasingly popular channel for online retailers to reach offline customers,” said co-author Dennis Zhang, assistant professor of operations and manufacturing management at Olin. “Pop-up stores are cheap and fast to build, which means that those internet-based retailers can test building them in many different locations and find the best strategies.”

All this increased spending starts with a pop-up shop and a cellphone invite.

Co-authors Zhang and Lingxiu Dong, professor of operations and manufacturing management, worked on the huge project wiith former Olin colleague Hengchen Dai of UCLA and Alibaba’s Qian Wu, Lifan Guo and Xiaofei Liu. The group conducted the experiment tracking some 799,904 Alibaba-app customers during a pop-up week of jeans sales in October 2017 in Hangzhou, China, southwest of Shanghai. Next, they followed those customers’ habits online for six- and 12-week periods to follow.

They randomly split the customers into two sets living within 6.2 miles of the pop-up: those who received a text-message invite — making no mention of brands, coupons or participant retailers — and control-group members who didn’t get an invite. Using a type of “Internet of Things” (IoT) technology and the customers’ Alibaba apps, they were able to track customers even when the customers bought nothing in the pop-up, which mostly was an online portal that allowed them to use a virtual fitting-room function to “try on” jeans on a screen. (Customers also found coupons once they arrived at the physical store.)

Some of the findings:

• Foot traffic increased by 76.19% because of the text invites; using the tracking information to determine frequent/existing from infrequent/prospective customers, the researchers found that the text invites increased foot traffic among the former by 200% and the sought-after second group by 69%.
• Invitees spent 39.51% more money on participating retailers online long after the original pop-up visit. They also spent 17.17% more on non-participating retailers, defined as those beyond the pop-up vendors and carrying at least 10 jeans products on their online stores.
• The buzz continued for those non-participating retailers deep into the New Year, some 12 weeks after the October pop-up week. Their sales saw a 14.89% increase while participating retailers experienced no lingering effect, at least not one that was statistically significant either way.

“This suggests that customers are not only building trust with specific retailers on the platform but also with the platform itself.” Zhang said.

“The experiment offers insights into the relationship and dynamics of online and offline shopping behaviors, which can be very helpful for retailers to devise omni-channel strategies,” Dong said.

The co-authors surmised that the pop-up visits served as a “transient billboard”: The shop advertised the presence, and thereby increased awareness, of these retailers — existing, frequent customers were already under the tent, but the prospective customers could be won over a fiscal quarter at a time. The visits also provided “experiential learning” so customers could assess these retailers’ products.

They also realize this experiment centered on jeans, a product requiring a good fit, feel. Commodity products — entertainment devices, food, etc. — could be evaluated more easily “without touching or trying on.”

Then again, it revolved around the online retailer Alibaba rather than a line of physical stores/chains. The study suggests positives for both types via pop-ups and invites, though the next step in research is to study pop-up store effects for traditional, omni-channel retailers. Using data correctly, the co-authors said, many retailers could be able to create personalized shopping experiences for both offline and online sales.

“As we have shown, pop-up stores are very efficient in reaching offline customers and attracting them online. This will be a good strategy for retailers who face online growth pressure in certain areas.” Zhang said.

The post Invite consumers to pop-up, and pop goes the spending — offline and online appeared first on The Source.