UConn Health Logo Health

UConn Researchers Develop Fireproof Plastics Thanks to Mother-of-Pearl Mimic

Published by True Viral News on 7/20/2017

It’s a technicolour dreamcoat for your crisp packet – a strong, flame-retardant and airtight new material that mimics mother of pearl.

The natural version, also called nacre, is found on the inner shell of some molluscs, where it is built up of layers of the mineral aragonite separated by organic polymers such as chitin. It is remarkably strong, without being brittle or dense.

We would like to use nacre and similar materials as a protective coating in many situations. However, making them is a slow and delicate process that is difficult to recreate at any useful scale. Artificial nacre-like materials are usually painstakingly built up layer by layer, but Luyi Sun at the University of Connecticut in Storrs and his colleagues found a way to do it all in one go.

With their quick method, they were able to make their thin film coating 60 per cent stronger than stainless steel. A plastic sheet covered in the material was over 13,000 times less permeable to air and other gases than it was on its own. When the team tried to set it on fire, it became scorched where the flame directly touched the coated sheet, but would not ignite.

To form the film, the researchers mixed a type of clay that sheds layers when exposed to ultrasonic pulses with water and a polymer to stick the layers together. They then dipped strips of plastic the size of standard sheets of paper in the mixture to coat them.

When the coated sheets of plastic are hung up like drying laundry, the thin liquid layer flows towards the ground, pulling the nanometre-thick sheets of clay into alignment with one another like neatly laid bricks. This is crucial for keeping the coating strong and airtight.

Finally, the material was placed in an oven, drying the sticky polymer sandwiched between the clay layers. The whole process can be completed in a matter of minutes.

“Traditionally people make this kind of material very tiny, fingernail-sized, and it would take maybe a week to coat a small object like this,” says Sun. “Now we can do it easily on standard-sized paper in minutes.”

Fast and friendly

Because of the method’s speed and environmentally friendly components, it would be easy to apply it to a variety of applications that require an airtight or flame-retardant coating.

“Some biodegradable plastics have a bunch of bad properties – they have a poor barrier and they’re flammable,” says Jaime Grunlan at Texas A&M University in College Station. “With this coating, they could compete with higher-performance polymers.”

The coating could potentially be used in food-related products such as crisp bags, which are now generally coated in aluminium that can leak into the environment and has been linked to a number of health problems.

Applications in electronics generally require barriers against air and moisture that are stronger than what Sun and his colleagues were able to achieve, but in principle their nacre-mimicking coating could be used on cellphone parts to stop them from being ruined or combusting.

Sun says that his team is working with industry partners to commercialise the coating method so that objects can be continuously dipped, hung and baked. He hopes it will be widely used in the next year or so.

UConn Incubator Company’s Cardiovascular Connected Healthcare Provides A Solution for AFIB

Published by Med Device Online on 7/19/2017

Bob Marshall

Atrial fibrillation (also called AFib) is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure, and other heart-related complications. At least 2.7 million Americans are living with AFib, according the American Heart Association (AHA). A worldwide study of AFib epidemiology from 1990 to 2010 estimated its prevalence at 33.5 million males and 12.6 million females in the year 2010.

During AFib, the upper chambers of the heart (the atria) do not beat effectively to move blood into the ventricles, which can result in clotting. If a resulting clot breaks off, enters the bloodstream and lodges in an artery leading to the brain, a stroke results. About 15–20 percent of people who have strokes have this heart arrhythmia, and this clot risk is why patients with AFib are often put on blood thinners.

The AHA provides these examples of how patients have described their experience:

“My heart flip-flops, skips beats, and feels like it’s banging against my chest wall, especially if I’m carrying stuff up my stairs or bending down.”

“I was nauseated, light-headed, and weak. I had a really fast heartbeat and felt like I was gasping for air.”

“I had no symptoms at all. I discovered my AF at a regular check-up.”

This third example is most troubling – due to a lack of symptoms and the intermittent nature of AFib, many people are unaware they have a serious condition that doubles the risk of heart-related death and is associated with a 5X increased risk for stroke. In addition, the prevalence of AFib increased by nearly five percent between 1990 and 2010, and the mortality rate doubled during the same time period, according to the above study.

Historical means of detecting AFib have included traditional electrocardiographs (ECGs) used during stress tests, Holter monitors, and event monitors. Holter monitors are portable ECGs worn to measure and record heart activity, continuously, over a period of 24-48 hours. The recordings then are reviewed by medical professionals to look for occurrences of AFib. Event monitors are used over a longer period of time (up to 30 days), and they are triggered by the patient when that patient experiences an irregularity, or “flutter,” and pushes a button to note the sensation. Recordings from just prior to the trigger are sent to medical professionals, who review the irregularity experienced by the patient and recommend further action, if necessary.

These means of monitoring are able to help identify whether a patient is experiencing AFib in some cases, but given the intermittent nature of the condition, such devices’ use for limited amounts of time can fail to capture proof of the cardiac rhythm problem. The electrodes attached to the skin can cause irritation — especially in the case of an event monitor, where the electrodes have to be removed and replaced every day or two over a period of several weeks. Additionally, it is a nuisance to remove Holter and event monitors for showering and bathing, and subsequently to reconnect them.

Cardiovascular Connected Healthcare Provides A Solution

All of these challenges led Dr. David A. McManus, an electrophysiologist and cardiologist at UMass Memorial Medical Center, to research with his colleagues and develop an alternative device. McManus is clinical director for Mobile Sense Technologies in Farmington, CT, as well as inventor of the company’s SensBand. The SensBand, claims to fill the gap between short duration adhesive monitors and long duration sub-cutaneous implants. It connects with the patient’s smartphone to provide continuous monitoring for AFib, and to enable data sharing with the patient’s doctor. Connected cardiovascular care provides a means to better engage patients in managing their own care, and is aimed at producing value-based outcomes. Detecting and monitoring AFib reduces stroke risk, improves the quality of life for patients, and reduces the overall cost of healthcare.

In 2013, McManus published in HeartRhythm the article A Novel Application for the Detection of an Irregular Pulse using an iPhone 4S in Patients with Atrial Fibrillation. In the piece, he describes a clinical study of 76 adult subjects with persistent AFib. Pulsatile time series recordings were obtained before and after cardioversion using an iPhone 4S camera. A novel smartphone application conducted real-time pulse analysis using 2 different statistical methods. The sensitivity, specificity, and predictive accuracy of both algorithms were examined using the 12-lead electrocardiogram as the gold standard. An algorithm combining the 2 statistical methods demonstrated excellent sensitivity (0.962), specificity (0.975), and accuracy (0.968) for beat-to-beat discrimination of an irregular pulse during AFib from sinus rhythm.

The application was further evaluated in a study of 2000 people in India. McManus has stated that his goal is simple. He wants to keep people with AFib living longer and living well. “If the disease is diagnosed in time, it can go from life-threatening to an inconvenience – something you die with, not from,” he said.

UConn Research: In Frogs, Early Activity of Gut Microbiome Shapes Later Health

Published by UConn Today on 7/20/2017

Biologists at the University of Connecticut and University of South Florida have found that a crucial window in the development of tadpoles may influence a frog’s ability to fight infectious diseases as an adult.

The scientists showed that an early-life disruption of the gut and skin bacterial communities of tadpoles later affects the adult frogs’ ability to fight off parasitic gut worms. Led by Sarah Knutie of UConn, the team published its findings in the July 20 edition of Nature Communications.

“Our study found that a disruption of bacteria in tadpoles has enduring negative effects on how adult frogs deal with their parasites,” Knutie said. “These results suggest that preventing early-life disruptions of bacteria by factors such as nutrition, antibiotics, and pollution, might confer protection against diseases later in life.”

The project is significant not only for the insight it provides in threats to the health of the world’s frogs, but in its potential applicability to understanding the immune systems of mammals and even humans.

The impact of a healthy bacterial community in the gut is an increasing focus of scientists looking to understand a wide range of ailments in many species, including humans. Previous research has found that an early-life disruption of the gut microbiota in mammals can result in a hyper-reactive immune system that may increase the subsequent risk of immune-related health issues, such as allergies and autoimmune diseases.

Testing the effects of early-life disruption of the microbiota on later-life resistance to infections. Photos by Mark Yokoyama)
Testing the effects of early-life disruption of the microbiota on later-life resistance to infections. (Photos by Mark Yokoyama)

In their experiments, the scientific team manipulated the bacterial communities of Cuban tree frog tadpoles and then exposed them to parasites later in life. The tadpoles were either raised in natural pond water or one of three other treatments to manipulate the bacterial communities: sterile pond water, sterile pond water with short-term antibiotics, or sterile pond water with long-term antibiotics.

Adult frogs that had reduced bacterial diversity as tadpoles had three times more parasites than adults that did not have their microbiota disrupted as tadpoles, the study found. Those results suggest that preventing early-life disruptions of host-associated bacterial communities might reduce infection risk later in life.

“We think that the microbiota of juveniles likely played a role in priming the immune system against parasite establishment,” the researchers wrote. “We found that the relative abundance of certain bacteria … in juveniles was positively correlated with parasite resistance in adulthood.”

Knutie began the research as a postdoctoral researcher at the University of South Florida, and recently joined the UConn faculty.

The project was funded by the National Science Foundation, the British Ecological Society, the National Institutes of Health, the U.S. Department of Agriculture, and the Environmental Protection Agency.

To read the article, click here.

UConn Researcher: In Making Decisions, Are You an Ant or a Grasshopper?


Published by UConn Today on July 19, 2017

Elaina Hancock

In one of Aesop’s famous fables, we are introduced to the grasshopper and the ant, whose decisions about how to spend their time affect their lives and future. The jovial grasshopper has a blast all summer singing and playing, while the dutiful ant toils away preparing for the winter.

Findings in a recent publication by UConn psychology researcher Susan Zhu and colleagues add to a growing body of evidence that, although it may seem less appealing, the ant’s gratification-delaying strategy should not be viewed in a negative light.

“This decision strategy can be harder or more time-consuming in the moment, but it appears to have the best outcome in the long run, even if it isn’t fun,” says Zhu.

The ant is what the researchers would call a maximizer. A maximizer is someone who makes decisions that they expect will impact themselves and others most favorably: they seek to “maximize” the positive and make the best choices imaginable. Yet the ant may consider so many variables that the same tendency to maximize benefit may lead to difficulty in making decisions. Previous research suggested this, with maximizers being less happy overall, having higher stress levels, and possibly regretting decisions they made.

Zhu suggests that maximizing has beneficial consequences.

“Maximizers are forward thinking, conscientious, optimistic, and satisfied,” she says. “Though a lot of work and thought go into those decisions, maximizing has beneficial outcomes.”

Surviving the winter perhaps?

On the other end of the spectrum, the grasshopper is more of what researchers might refer to as a satisficer (satisfy plus suffice = satisfice), or someone who will be happy with things being “good enough,” who tends to opt for instant gratification and tends to live moment to moment.

“A satisficer will make a decision, feel good about making it, and move on,” says Zhu.

The ant and the grasshopper are of course extreme examples of each dispositional type, and most people exhibit both qualities. “There tends to be a bell curve and most people fall towards the middle and exhibit aspects of both tendencies,” Zhu says.

To conduct the study, the researchers used Amazon’s Mechanical Turk or MTurk service, where their survey was given to hundreds of participants, generating a pool of data.

Survey takers were asked questions regarding financial decisions, namely savings habits and tendencies. They rated various statements, such as “I never settle for second best,” on a five-point scale from strongly agree to strongly disagree. The questionnaire was designed to gauge whether participants tended to maximize their decisions, how they felt their decisions would impact the future, and how they viewed smaller immediate rewards or larger future rewards.

The survey also looked at how participants expected their decisions to affect the future. They were asked to rate statements like, “I consider how things might be in the future and try to influence those things with my day to day behavior,” and “I often think about saving money for the future,” and to provide information about lifetime savings amounts and current income.

“What we are measuring are tendencies,” says Zhu. “When we ask what people tend to do, they’re pretty stable and can be pretty good predictors for actual behavior.”

Once data was gathered, researchers crunched the numbers and observed trends. With maximizers, the data suggested a positive relationship with their future-oriented thinking, better money-saving habits, and concern for the future of others.

The main takeaway? Zhu says, “Maximizing can be a good thing. Previous research looked at decision-making difficulty and other negative outcomes, and that added a negative connotation to maximizing tendencies. We’re trying to frame it in light of the high standards and the beneficial outcomes, to help reshape the view of maximizing.”

No matter where you fall on the spectrum, take advice from both the forward thinking ant andthe fun-loving grasshopper. Plan for the future, but also have some fun now.

UConn Researchers: When Less Oxygen Means Better Performance

Published by UConn Today on 7/17/17

Colin Poitras

Researchers at the University of Connecticut have found that reducing oxygen in some nanocrystalline materials may improve their strength and durability at elevated temperatures, a promising enhancement that could lead to better biosensors, faster jet engines, and greater capacity semiconductors.

“Stabilizing nanocrystals at elevated temperatures is a common challenge,” says Peiman Shahbeigi-Roodposhti, a postdoctoral research scholar with UConn’s Institute of Materials Science and the study’s lead author. “In certain alloys, we found that high levels of oxygen can lead to a significant reduction in their efficiency.”

Using a special milling process in an enclosed box filled with argon gas, UConn scientists, working in collaboration with researchers from North Carolina State University, were able to synthesize nano-sized crystals of Iron-Chromium and Iron-Chromium-Hafnium with oxygen levels as low as 0.01 percent. These nearly oxygen-free alloy powders appeared to be much more stable than their commercial counterparts with higher oxygen content at elevated temperatures and under high levels of stress.

“In this study, for the first time, optimum oxygen-free nanomaterials were developed,” says Sina Shahbazmohamadi, an assistant professor of biomedical engineering at UConn and a co-author on the paper. “Various characterization techniques, including advanced aberration corrected transmission electron microscopy, revealed a significant improvement in grain size stability at elevated temperatures.”

Postdoctoral researcher Peiman Shahbegi and an undergraduate student in materials science work with a glove box to produce nanomaterials.
Postdoctoral researcher Peiman Shahbegi-Roodposhti and an undergraduate student in materials science work with a glove box to produce nanomaterials.

Grain size stability is important for scientists seeking to develop the next generation of advanced materials. Like fine links in an intricately woven mesh, grains are the small solids from which metals are made. Studies have shown that smaller grains are better when it comes to making stronger and tougher metals that are less prone to cracking, better conductors of electricity, and more durable at high temperatures and under extreme stress. Recent advances in technology have allowed materials scientists to develop grains at the scale of just 10 nanometers, which is tens of thousands of times smaller than the thickness of a sheet of paper or the width of a human hair. Such nanocrystals can only be viewed under extremely powerful microscopes.

But the process isn’t perfect. When some nanograins are created in bulk for applications such as semiconductors, the stability of their size can fluctuate under higher temperatures and stress. It was during the investigation of this instability that Shahbeigi-Roodposhti and the UConn research team learned the role oxygen played in weakening the nanocrystals’ stability at high temperatures.

“This is only a first step, but this line of investigation could ultimately lead to developing faster jet engines, more capacity in semiconductors, and more sensitivity in biosensors,” Shahbeigi-Roodposhti says.

Moving forward, the UConn researchers intend to test their theory on other alloys to see whether the presence or absence of oxygen impacts their performance at elevated temperatures.

The study, “Effect of oxygen content on thermal stability of grain size for nanocrystalline Fe10Cr and Fe14Cr4Hf alloy powders,” which was supported by funding from the U.S. Department of Energy, currently appears online in the Journal of Alloys and Compounds.

Also serving as co-authors on the paper were Mostafa Saber, an assistant professor at Portland State University; and Professors Ronald Scattergood and Carl Koch from North Carolina State University. DOE funding supporting the research was acquired by Scattergood’s lab.

UConn Study: No Chocolate Milk? No Problem, Kids Get Used to Plain Milk

Published by UConn Today on 7/14/2017

Daniel P. Jones

A new study by the Rudd Center for Food Policy and Obesity at the University of Connecticut has found that most students adjust to drinking plain milk after flavored milk is removed from school lunch menus.

Flavored milk served in the National School Lunch Program contains up to 10 grams of added sugar per serving, which is 40 percent of a child’s daily allowance of added sugar. Given the nation’s key public health target of limiting added sugars in children’s diets, flavored milk has come under scrutiny in the context of school nutrition.

The study measured plain milk selection and consumption in the years after flavored milk was removed in two schools. During the first year without flavored milk, 51.5 percent of students selected plain milk. Two years later, 72 percent of students selected plain milk. Both years, student selection and consumption of plain milk dropped significantly on days when 100 percent fruit juice was also available.

“The decision to remove flavored milk has both nutritional benefits and potential costs. It is clearly an effective way to lower student intake of added sugars at lunch, and over time, the majority of students will switch to plain milk,” said Marlene Schwartz, professor of human development and family studies, director of the UConn Rudd Center, and lead author of the study. “However, there will always be some students who don’t like plain milk. The challenge is finding a way to meet their dietary needs by providing other nutrient-rich options at lunch.”

The study, published July 14 in the Journal of the Academy of Nutrition and Dietetics, has implications for school nutrition policy and efforts to reduce added sugars in children’s diets.

The study was conducted in two elementary (K-8) schools in an urban New England school district during the 2010-2011 and 2012-2013 school years. Researchers assessed the selection and consumption of milk immediately after flavored milk was removed in the 2010-2011 school year, and two years later in the 2012-2013 school year.

The selection and consumption of milk were compared on days when 100 percent fruit juice was offered and not offered. The average number of students in the lunch line when data was collected was 369 in one school, and 391 in the other school.

The study’s key findings show:

  • The first school year after flavored milk was removed, 51.5 percent of students selected milk and drank 4 ounces per carton, indicating school-wide per-student consumption of 2.1 ounces.
  • Two years later, 72 percent of students selected milk and drank 3.4 ounces per carton, significantly increasing the school-wide per-student consumption to 2.5 ounces.
  • Older students and boys consumed significantly more milk.
  • The availability of 100 percent fruit juice at lunch was associated with a significant decrease in students selecting milk and lower milk consumption per carton throughout the years of the study.

“On days when schools had 100 percent juice, milk selection dropped considerably,” Schwartz said. “To maximize student nutrition, the best combination may be to offer plain milk and whole fruit every day.”

The study was funded by the Cornell Center for Behavioral Economics in Child Nutrition Programs and the Rudd Foundation.

Study co-authors include Kathryn Henderson of Henderson Consulting, Margaret Read, a research assistant at the UConn Rudd Center, and Talea Cornelius, a UConn graduate student.

UConn Professor: Should We Limit Spending on Lifesaving Drugs?

Published by The Conversation on 7/5/2017

C. Michael White

“It was the best of times, it was the worst of times” is a familiar quote from the opening of Charles Dickens’ “A Tale of Two Cities,” but the phrase is also applicable to the specialty drug market in the United States today.

Specialty drugs, usually complex biologic products created by genetic alterations of living tissues or organisms, have revolutionized patient care by creating human proteins, enzymes and antibodies that can treat diseases much more specifically than previously. These breakthroughs have come through a collective national choice to let drugmakers set prices and reap the profits with limited oversight – as opposed to many other countries with strict controls.

However, this choice has come at a steep price: Health care costs are soaring at an unsustainable pace, putting the finances of states, the federal government, companies and millions of Americans at risk.

Every American – especially our lawmakers preparing to remold our health care system for the second time in eight years – needs to understand the choice we have made and grapple with where to go from here. In the end, it comes down to one difficult question: What value should we place on a human life?

Prescription drugs have been lifesavers for millions, but are some miracles too expensive? AP Photo

Drug costs are crippling us financially

Between premiums, deductibles and co-pays, a typical family of four will directly pay US$11,000 of the estimated $27,000 it is expected to spend on health care in 2017, up 22 percent since 2013. That’s quite a lot, especially considering the average American workermade only $46,120 in 2015.

But it will be impossible to control these spiraling costs without getting a handle on prescription drug spending, which is growing at a rate at least three times faster than every other major medical category.

What many people don’t know is that spending on traditional drugs such as statins, acid controllers and antibiotics hasn’t changed much. It’s specialty and biologic drugs that are really taking a toll. Such drugs have been responsible for 73 percent of spending growth over the past five years.

A single prescription for one of the top five specialty drugs, for example, cost $6,621 in 2015, compared with $60 for traditional drugs like Nexium and Crestor. The situation for so-called orphan drugs, which are specialty biologic drugs used for rare diseases, is even worse. The average orphan drug cost $111,820 per person per year in 2014.

An expensive new treatment involves genetically modifying chickens to produce a vital enzyme missing in babies suffering from Liposomal Acid Deficiency.Lungkit/Shutterstock.com

Specialty drugs are godsends for patients

So the obvious question is, are the costs worth it? And the answer is – for those whose lives are affected – clearly yes.

Specialty drugs can do amazing things, especially in the realm of rare diseases (those that afflict fewer than 200,000 patients) in which there had been no serious research in the past. The term orphan drug was codified in 1983 to describe medications intended to treat diseases so rare that pharmaceutical companies are reluctant to develop them.

That changed with the passage of the Orphan Drug Act of 1983, which allowed special grants for research, a 50 percent tax credit on trial costs, shorter FDA approval times and a guaranteed seven years of patent exclusivity. Before the act, the FDA approved 34 drugs that would have qualified as orphan drugs from 1967 to 1983. The FDA approved 10 times as many – 347 – over the next 26 years, reflecting how the act helped provide the financial incentive to produce these specialty drugs.

Let’s look at just one rare disease, Liposomal Acid Deficiency. Also known as Wolman’s Disease, it affects only a handful of infants, but without this vital enzyme they accumulate fats in their digestive organs, leading to organ swelling, failure and death within the first year of life.

Before 2015, there were no treatments, but now chickens are genetically modified so that their eggs produce this human enzyme, sold under the name sebelipase alpha. Injecting this enzyme clears up patients’ debilitating symptoms and prolongs their lives, in some cases as long as decades, experts believe.

Make no mistake, this is a miracle for parents of a baby with this terrible infliction. But this miracle is expected to cost about $700,000 a year for the rest of the child’s life.

The British love their National Health Service, which covers health care costs but doesn’t reimburse many specialized drugs. Reuters/Neil Hall

What Europe does

Things work a lot differently in Europe, and it’s worth considering whether we’d be wise to follow its general approach.

Unlike in the U.S., countries in Europe have some form of socialized health care system in which the government covers the costs of drugs that meet certain criteria. That decision is made at the national level, while the European Medicine Agency determines whether to approve the drug for use.

Drugs are generally covered if the cost relative to benefits – known as a quality adjusted life year (QALY) – is under a certain threshold. Simply put, an extra year of life lived in perfect health is worth 1 QALY, while a sliding scale is used to quantify the value of an extra year in poor health (between 0 and 1 QALY).

In Britain, for example, medications are usually covered if each QALY gained costs less than £30,000 ($36,600) – although they do have some exceptions.

That means that few orphan drugs get reimbursed. Of the 116 orphan drugs the FDA approved for use outside of the hospital from 1983 to 2012, the U.K.‘s National Health Service didn’t even review about two-thirds of them for reimbursement, presumably because the cost was too high. Of the rest, it offered conditional reimbursement for a dozen, while 15 were denied.

In an assessment of orphan drugs that cost more than $225,000 per year per patient in the U.S., none of these drugs had been reviewed in Britain.

So what should we do?

The U.S. has created market incentives to study rare diseases, and with the help of human ingenuity we have created some amazing breakthroughs in solving complex problems.

This mentality has been radically different from in Europe, where similar research never would have gotten off the ground because policymakers efficiently target their health care dollars for maximum impact on society – not for creating miracles for unfortunate outliers with rare diseases.

However, the inherent generosity built into the Orphan Drug Act is one factor leading so many Americans to struggle to afford their premiums and move into high-deductible plans that make a simple visit to the doctor effectively unaffordable. And employers as well as state and federal governments are being financially crushed under increasing health care costs.

So what can be done? Unfortunately, there are no easy answers, and every potential solution has costly or even life-and-death consequences.

The debate shouldn’t be simply about what we can do to control costs but rather how much are we willing to spend to sustainably encourage new medical breakthroughs. I believe that we will need to apply a cost-effectiveness analysis to new and existing drugs and determine that at some point the costs outweigh the benefits.

Drawing that line – which comes down to defining how much a human life is worth – has been difficult for lawmakers, which is why the legislation underpinning the Affordable Care Act and its possible replacements have not addressed effective ways to control prescription drug spending.

But not choosing simply pushes the burden on those individuals, companies and taxpayers who fund health care. That burden is immense and will only continue to grow.

UConn Professor: We’re Not Ready for the ‘Silver Tsunami’ of Older Adults Living with Cancer

Published by The Conversation on 7/4/2017

Keith Bellizzi

In the next few decades, the number of adults living with cancer is expected to triple in size.

Age is the single greatest risk factor for cancer. By 2030, according to the Centers for Disease Control and Prevention, the population of Americans over the age of 65 will double.

The good news is that early detection, innovative treatments and supportive care have turned many cancers into chronic illnesses, one disease among other chronic health conditions that older adults may experience. But these coexisting health conditions are likely to complicate the treatment and management of older adults’ cancer.

Our current understanding of appropriate care for older adults with cancer and their unique needs is limited. As an expert in cancer survivorship and aging, I see several specific areas that warrant our attention.

Generational differences

Cancer in older adults is complex. For the elderly, cancer is often one of several coexisting health conditions that they may be managing, such as heart disease, arthritis or diabetes. Eighty percent of older adults with cancer report two or more additional health conditions. One in four cancer survivors between 65 and 74 years old have more than five concurrent health conditions.

Older adults with multiple chronic conditions are more likely to have poorly coordinated care, adverse interactions between medications and worse health outcomes. They also tend to use more health care services and, on average, take six or more prescription medications.

In older adults, the late health effects of cancer can be different or exacerbated by age. For example, cancer-related fatigue, reductions in cognitive function and chemotherapy-induced peripheral neuropathy can pose unique issues. The interplay between these treatment-related effects and common age-related issues presents challenges for care of older adults with cancer.

The psychological and social experience of cancer can also differ markedly for young and older adults. Roles, responsibilities and support systems change as people age. Many young adults with cancer are dealing with competing demands of work or family. Having fewer demands as an older adult might make the disease more manageable in some respects.

But a decrease in social networks and support – such as retirement or living farther away from family – may have negative effects. Many older adults will minimize their distress, so not to burden their families and caregivers. This leads to underdiagnosis of treatable distress.

These effects can be exacerbated by health care providers with competing priorities, short office visits and no organizational support for psychosocial distress screening.

Health care providers

In 2008, the National Academy of Medicine warned of a looming shortage of geriatric oncologists and nurses, as well as a lack of interest among medical professionals in geriatric oncology.

The number of oncology office visits required by older adults with cancer is projected to surpass the available oncologic workforce by 2020. What’s more, older adults may see up to 12 different health care specialists in a given year.

Who should coordinate this care? Oncologists are experts in the diagnosis and treatment of cancer, but many older adults have competing health concerns that require more than just an oncologist. Geriatricians are trained in managing multiple health conditions and optimizing functional performance in older adults, but may be less familiar with managing cancer.

We need to make a concerted effort to foster collaborative care partnerships between geriatricians and oncology – including geriatric nurses in both fields, as they are on the front lines interacting with older cancer patients. A team of health professionals could jointly share responsibility for managing the health of older adults with cancer, exchanging patient data and information between the team.

Research shows that this type of collaborative model leads to better cancer follow-up care, health outcomes and effective management of coexisting health conditions.

Focus on the family

Cancer is a disease that reverberates across the family system, leaving no one untouched. In fact, research suggests that caregivers and family members often report higher levels of distress than does the individual with cancer.

With more and more cancer care delivered on an outpatient basis, coupled with the changing nature of cancer as a chronic disease, there is a growing burden on family to help a loved one manage their disease. Moreover, many older family members may themselves be dealing with a chronic illness and other life stressors, adding to the burden.

Research suggests that providing psychological and educational support for cancer caregivers and family members may improve not only the health of patients, but the health of caregivers.

What’s next?

Planning for the health care needs of our aging cancer survivors represents a significant public health challenge.

What we know about caring for cancer survivors is largely based on the experiences of adult survivors of child-onset cancer and proactive groups of middle-aged breast cancer survivors. There is an urgent need for additional research on the needs and care of the burgeoning geriatric population.

In 2010, the U.S. Department of Health and Human Services released a report on multiple chronic conditions. It recommended including older adults with multiple chronic conditions in clinical trials, facilitating self-care management and promoting multiple chronic condition curricula in the health care sector. It also suggested educating the federal, private and public sectors about issues related to multiple chronic conditions.

While this national initiative is encouraged, it’s clear that the growing number of older adults with cancer outpaces current efforts. If we want to successfully respond to the demand, we must find ways to quickly conduct meaningful and targeted research on this unique population. This can help us develop best practices and offer high-quality care.

UConn Biologist Takes New Tack Against Herpes Virus

Published by Hartford Business Journal on July 10, 2017

Matt Pilon

Herpes is more common than you might think.

The virus’ various forms affect most people, though they are often unaware. Herpes can remain dormant in healthy people but sometimes lead to serious or fatal conditions in infants or those with weak immune systems.

While there are no cures for the various forms of herpes, antiviral drugs do exist to curb its effects but there is a constant search for new remedies.

Among the researchers searching for answers is UConn Health biologist Sandra Weller, who chairs UConn’s molecular biology and biophysics department. Her lab is researching treatments for a form of herpes called Cytomegalovirus, or CMV, which can cause serious problems in newborns, including developmental disabilities and deafness, as well as infections in organ and marrow transplant patients. It’s estimated that more than half of adults have been infected with CMV by age 40, according to the Centers for Disease Control and Prevention.

An antiviral drug does exist to treat CMV patients — Ganciclovir — but some can build a resistance to it and the drug can also cause kidney problems.

Weller spent decades researching treatments for the more well-known genital herpes virus, but she shifted gears recently at the urging of a fledgling state-backed program called PITCH (Program in Innovative Therapeutics), launched by Yale and UConn to facilitate collaboration among researchers and venture capitalists and to speed promising drug compounds into the commercial pipeline.

“We consider [CMV] as having a larger unmet clinical need,” Weller said in a recent interview.

She and her team are targeting a particular protein that is believed to be essential for CMV to replicate itself. The goal is to find a natural or synthetic compound that can restrain the protein and prevent dormant CMV infections from reactivating.

Weller is working with Yale’s Center for Molecular Discovery because the school has a large library of drug molecules and enough capacity to work on multiple projects.

Last month, researchers at that lab began running a series of tests on Weller’s targeted protein using high-end equipment in a process called “high throughput screening.”

At the conclusion of their work, Yale researchers will tell Weller which compounds reacted with the targeted protein.

The screening services provided by Yale aren’t cheap. Weller would have had to seek funding to pay for them if it weren’t for PITCH, which received $10 million in late 2015 from the Connecticut Bioscience Fund, administered by Connecticut Innovations.

The technology originated at pharmaceutical companies and started becoming more common in higher education 20 years ago.

Market potential

While Yale could vastly narrow down the list of potential promising compounds, their findings won’t be quite ready for prime time.

From there the work will shift back to UConn, where Dennis Wright, a professor of medicinal chemistry and co-founder of PITCH, will assess the compounds and tweak their structures with the aim of making them more potent drug candidates.

“It’s about starting to put together a package of data that would make a compelling case to investors looking for an early stage opportunity,” Wright said.

Weller has already formed a company called Quercus. Her younger brother Brad Weller, an attorney who has worked for public companies, is CEO.

Should her research progress far enough, Quercus would license the intellectual property from UConn. If she gets an antiviral drug to market, Connecticut Innovations would receive royalty payments for its investment. There are several big pharmaceutical companies in phase 3 trials for CMV drugs, though they are targeting different proteins, Weller said.

Because CMV is a more complex strain of the herpes virus, Weller is hoping that whatever she develops might also be effective against other, simpler forms.

She likens members of the virus to cars. They all have the same core parts, but some, like CMV, have added features.

“It’s got a sunroof and a retractable antenna,” she said.

That makes CMV harder to work with, but offers a potentially more promising payoff.

Banned Invasive Plant Returning as Environmentally Safe Thanks to UConn Researcher

Published by Times Union on July 5, 2017

Brian Nearing

For the last two years, customers  have come into Faddegon’s Nursery asking Manager Randy Herrington for Japanese barberry, a popular landscaping shrub with pretty flowers.

And they have left disappointed, as Herrington has had to tell them the plant is an invasive species, banned from sale in the state since the spring of 2015.

Now, the barberry — one of 11 plants on the state’s banned invasives list — will be returning to nurseries, likely next year, thanks to research from the University of Connecticut that renders new variants of the plant sterile. Without seeds, the plant is unable to spread.

“We won’t have them now, but I expect by spring 2018, we will,” said Herrington. “It was a pretty big part of the landscaping market before the ban.”

Known scientifically as berberis thundbergii, barberries are spiny shrubs that are attractive, easy to grow and that deer do not like to eat, making them a popular choice with landscapers and homeowners.

Last month, the state Department of Environmental Conservation approved sales of four sterile versions of barberry, as well as sterile versions of two other regulated invasive plants, Chinese silvergrass and Winter Creeper.

That was welcome news to the New York State Nursery and Landscape Association, said Melissa Daniels, who is chairwoman of the group’s advocacy committee.

Her group had encouraged DEC, when the state adopted its invasive species ban, to leave open an exemption for so-called “sterile cultivars,” which means plants that do not produce seeds and consequently, eliminate the risk of seeds being spread by birds, other animals and water.

Such spread is a problem with barberry, where birds eat the bright red seeds each fall, and then move undigested seeds in droppings to sprout in new areas, such as fields and forests. There, the plants out-compete native species by crowding out sunlight and changing soil chemistry, which establishes new colonies that allow for continued spread.

By crowding out seedlings on the forest floor, barberry also can prevent forests from regrowing normally, according to DEC.  This concern also led to the banning of barberry sales in Massachusetts and New Hampshire.

While the new barberry plant would end this aspect of continued expansion, it will not keep the seeds from existing patches of fertile barberry from spreading into new areas.

Daniels said that barberry, which arrived in the U.S. as an ornamental plant in 1875 when seeds were shipped to Boston from St. Petersburg, Russia,  was a “very important commercial species” in New York.

An environmental group that sits on the state’s Invasive Species Advisory Committee also said the new plant should not pose a threat.

“Of course, we still encourage homeowners to plant native, non-invasive species,” said Troy Weldy, director of ecological  management for The Nature Conservancy.

Some alternatives include smokebush, eastern ninebark, weigela, and old fashioned weigela.

Weldy said the return of Japanese barberry will also require “honest labeling” by plant sellers, since the average homeowner cannot distinguish between a fertile and sterile barberry. “Our concern is that some people could again begin selling the non-sterile barberries. That could be a challenge,” he said.

The University of Connecticut recently obtained U.S. patents on four infertile, seedless barberry varieties created by researcher Mark Brand.

The university has an agreement with a Connecticut-based plant grower, Prides Corner Farms, to grow and sell the new varieties.

Prides Corner will be the supplier to Faddegons, said Herrington. “It will take them a while to propagate enough plants,” he said.

Another university researcher is seeking a patent for a sterile version of another popular landscaping plant, the burning bush. With the scientific name of euonymous alatus, this plant is also popular with homeowners for its vivid red autumn foliage.

As a state-regulated plant, it can be sold in New York, but must be labeled as an invasive species that is “harmful to the environment.”

Herrington said that once an infertile burning bush is approved, that plant will also be sold at his nursery.

Barberry has also been linked to increased tick habitat, because the plants provide ground cover to mice, which can carry ticks, and also maintain higher humidity levels that ticks need to avoid drying out, said Weldy.

More ticks increases the risk of transmission of Lyme disease and other tick-born illnesses.

Weldy said barberry needs to be present in dense stands to encourage higher tick populations. A few plants around a typical home likely would not be a risk, although the plants could provide cover for mice, he said.