Mindfulness: Taking a step back to take a step forward
New ASU program provides tools to better manage stress
September 12, 2019
Imagine being fully aware of the present moment, all of your sensations, feelings and thoughts, and being OK with it. Now imagine taking a deep breath and just letting all of your stress dissipate.
That probably felt pretty good – and whether you know it or not, you were practicing mindfulness. Juan Hernandez and Erin Mistretta, clinical psychology graduate students and group leaders of ASU's Mindfulness Group at the Clinical Psychology Center. Photo by Robert EwingDownload Full Image
“The Mindfulness Group is an educational and experiential program with the goal of learning how to open up to the full experience of life from moment to moment and how to live life to the fullest,” said Erin Mistretta, a clinical psychology graduate student. “We hope to give students a tool to better manage their stress — something they can use while in school and take with them when they graduate.”
Mistretta became interested in mindfulness after a series of athletic injuries when she was an undergrad. She was overwhelmed with stress and became focused on how she could feel relief from those challenges. Mindfulness allowed her to develop a more holistic view of who she was in the world and helped her manage stress.
“Our society is very shame focused, and we might not display that externally, but internally we carry a lot of judgements about ourselves,” she said. “Mindfulness helps us to overcome those internal judgements and to make progress towards positive goals.”
The informal practice of mindfulness is simply paying attention to something you do every day, like eating or walking. The formal practice is closer to structured meditation. ASU’s Mindfulness Group provides training for the formal practice of mindfulness and explains ways people can integrate it into their lives.
“We identify what is stress for each group member,” said Juan Hernandez, a clinical psychology graduate student who runs the group with Mistretta. “Then we find ways for that person to implement mindfulness practices in their own lives.”
Mindfulness at ASU — starting Sept. 23
ASU’s Mindfulness Group is designed to help people cope with any of the challenges in their life — big or small — using mindfulness-based techniques. The group is open to ASU students, faculty and adults from the community. The goals of the eight-session program are:
Improve symptoms related to stress and anxiety
Discover techniques to decrease worry and regulate emotions
Improve the quality of daily living
Increase the capacity for staying mentally and physically healthy
Learn the benefits of incorporating mindfulness into daily routines
Each session is interactive and includes hands-on mindfulness exercises. The program is tailored to the needs of each individual participant. Group leaders are doctoral students in clinical psychology and are supervised by a licensed clinical psychologist. For more information contact the ASU Clinical Psychology Center at 480-965-7296. Call by Sept. 16 to ensure a spot.
ASU researchers working with Mayo Clinic hospitals devise effective needs-based patient prioritization
Even the most high-quality health care delivered by conscientious providers can fall short of optimal performance when hindered by inefficient patient access management.
The problem, says Arizona State University industrial engineer Esma Gel, is that many hospitals remain largely mired in “the traditional first-come, first-served routine” that can waste physicians’ time and effort and fail to most effectively serve patients.
What’s needed to remedy the faulty process is “data-driven, needs-based prioritization,” said Gel, an associate professor in the Ira A. Fulton Schools of Engineering at Arizona State University.
In the past four years, Gel has worked on separate projects at Mayo Clinic hospitals in Scottsdale, Arizona, and Rochester, Minnesota, to test machine learning and operations optimization methods for developing an advanced intelligent decision-making system to guide such prioritizing efforts.
Using advanced data analysis tools and operations optimization methods, Associate Professor Esma Gel and Mayo Clinic researchers are refining the system they’ve developed to improve patient access to health care services. Photo by Erika Gronek/ASU
Gel says use of such advanced analytics tools to understand patient behavior and treatment needs will help ensure better decisions are made about giving patients what she calls “3R health care access” — making sure the right patient sees the right provider at the right time to receive the best treatment.
In her first project at Mayo Clinic Arizona’s neurosurgery department, Gel and two graduate students studied a large volume of data and found, for instance, that neurosurgeons were spending significant time with patients whose conditions did not require surgical intervention or even immediate care.
“It’s a big waste of valuable resources when patients are not routed to an entry point into the system that matches the level of their need for care,” Gel said.
Encouraged by results showing that improved routing of patients through the health care system can result in more timely access — especially for patients with critical surgical needs — Gel and industrial engineering doctoral student Derya Kilinc developed methods to extract highly accurate decision tree algorithms from data to predict the need for surgical intervention for patients with lower back pain.
“This algorithm can be used even by an appointment scheduling agent without medical training to make sure that patients with urgent care needs can be prioritized, resulting in better patient health outcomes,” Gel said.
Findings from their work with collaborators at Mayo Clinic Arizona’s Department of Neurosurgery motivated her to pursue a new research agenda to improve patient access management. After that first project, she began collaborating with faculty members Dr. Kalyan Pasupathy and Dr. Mustafa Sir in the Department of Health Sciences Research at Mayo Clinic in Minnesota to construct a comprehensive plan to develop the data-driven patient access management system.
“Currently, the huge amounts of data collected on health care systems are not being used to improve the way that we provide patient access,” Gel said. “Our vision is to create a set of analytical tools and algorithms to learn patient preferences and behavior, accurately assess treatment needs and provide effective recommendations on how each patient should get timely access, given resource and provider constraints, to maximize patient health outcomes and minimize waste.”
Derya Kilinc helped to develop the predictive algorithm and key protocols used to develop a novel patient access prioritization system. Photo by Erika Gronek/ASU
Through a two-year collaboration, Gel, Pasupathy and Sir have achieved several milestones they set for the project. They have jointly filed an invention disclosure on the various components of their system they are developing as a step to explore the need for patent protection. They also produced two research manuscripts, with the help of Kilinc, who earned her doctoral degree this summer and has joined Pasupathy’s group at Mayo Clinic in Minnesota as a postdoctoral researcher.
The team’s results are receiving positive reaction from Mayo Clinic leadership, which Gel says should help attract federal funding and commercial investment to continue research and development of new patient access management system models.
“Our goal is to develop a novel set of integrated technologies to transform the current practice in health care access," Gel said. “Our work over the past four years has yielded several proof-of-concept results, which we are currently working to expand on.”
New ASU psychology certificate focuses on suicide prevention education
September 11, 2019
Suicide, which is responsible for more than 800,000 deaths annually worldwide, is now the second leading cause of death among young adults, ahead of homicide, drugs and alcohol, cancer and heart disease.
Why is suicide growing at such a rate among young adults? What can be done about it? People often fear that talking about suicide can lead to an increase in incidents, but research shows that this is not the case. Photo by Hannah Busing, UnsplashDownload Full Image
These questions have baffled scientists and educators alike. What we do know is that interventions can help prevent it, something that is reflected in Arizona’s recent passage of a bill requiring evidence-based training in suicide prevention and intervention for public educators and school personnel starting in the academic year 2020-21.
To help prepare students for careers in such fields, the ASU Department of Psychology launched a certificate in applied prevention science to advance science-based prevention in community settings. The certificate program is designed specifically for educators and organization leaders who want to learn about how to implement evidence-based programs for preventing a wide range of problems and difficulties.
The goal of prevention science is to intervene as early as possible, and evidence-based interventions have been shown to be effective at reducing juvenile delinquency, risky sexual behavior, alcohol abuse, poor academic performance and violent behavior in communities. There is also evidence that the risks associated with suicide are preventable.
“We want trainees in the graduate certificate program to become skilled advocates for prevention solutions that work,” said Armando Pina, associate professor of psychology. “To achieve this goal, we emphasize that to make a difference in organizations and communities, one must understand effective prevention practices, where to find them and how to sustain such solutions. We teach students to make a difference such that youth and families can live happy and productive lives.”
People often fear that talking about suicide can lead to an increase in incidents, but research shows that this is not the case. Awareness does not lead to suicide, and instead can actually help with finding resources to help someone in need.
Suicide is a multifaceted issue and is often the combination of many factors like depression, trauma, anxiety, bullying and social withdrawal. But suicide can occur in the absence of known mental illness.
“What we know is that symptoms and feelings of anxiety are all predictors of future depression and mental health concerns, including suicidality and self-harm,” said Ryan Stoll, an expert in prevention science and founder of the COMPASS for Courage intervention program for anxiety and stress in children. “So when we think about suicide prevention, it is not in isolation — we have to consider these other mental health concerns that we know predate it.”
Stoll’s involvement with suicide prevention started well before he started training as a clinical psychologist. He volunteered with the nonprofit To Write Love on Her Arms, helping to spread the message to struggling teens that they are not alone and they do matter. The organization traveled with the Vans Warped Tour for years and met with teenagers who were struggling with depression or mental health issues and provided resources for them to find help.
“If we are actually going to address this public health crisis, we have to talk about it,” Stoll said. “We need to have a culture of openness if we are going to find a collective solution.”
ASU Health Services medical director gives insight into the virus, protection tips
Local authorities are asking Phoenix metro area residents to protect themselves from mosquito bites and get rid of standing water where the insects can breed due to a sharp increase in West Nile virus cases here.
The Maricopa County Department of Public Health said the county is facing the highest levels of West Nile virus reported infections in the last decade with 135 new cases and eight deaths as of Aug. 28, compared with eight cases and two deaths at this time last year.
According to Centers for Disease Control and Prevention statistics, Arizona leads the nation in West Nile virus reports, followed by California (57 cases) and Nevada (25).
West Nile virus first appeared in Africa in the 1930s, with outbreaks occurring in parts of Africa, western Asia, the Middle East and Europe for the next two to three decades. The virus was first spotted in the U.S. in New York City in 1999. Today the virus can be found in most of the continental United States.
Dr. Stefanie Schroeder, medical director for ASU Health Services, answered key questions about West Nile virus to help educate the university community.
Question: What exactly is West Nile virus?
Answer: West Nile virus is a single-stranded ribonucleic acid (RNA) virus. It is a member of the Flavivirus family, which also contains Zika virus, dengue virus and yellow fever virus. It can lead to a wide range of clinical symptoms from asymptomatic diseases to severe meningitis and encephalitis. It is the leading cause of mosquito-borne disease in the continental United States.
Q: How do you know if you are infected? Any unique symptoms?
A: Most people — 8 out of 10 — infected with West Nile virus do not develop any symptoms. Of those, approximately 1 out of 4 develop West Nile fever and one out of 250 develop neuroinvasive disease. The typical incubation period for infection ranges from two to 14 days.
West Nile fever is a self-limited illness indistinguishable from dengue fever and other viral syndromes, characterized by abrupt onset of fever, headache, malaise, back pain, myalgia and anorexia. Acute symptoms typically last three to 10 days, but some report a prolonged recovery to their previous baseline function. Approximately 25% to 50% of patients with West Nile fever develop a rash when the fever breaks, which lasts for about one week.
Neuroinvasive disease risk factors include old age, male gender, diabetes, hepatitis C virus infection, alcohol misuse and or immunosuppression. Symptoms are similar to those of other viral meningitis conditions and include fever, headache, neck pain and light sensitivity and flaccid paralysis. This stage has a 10% mortality rate.
Q: What should people do if they think they are infected?
A: Like with any viral disease, they should rest, drink plenty of fluids and try to keep their fever under control. Blood tests are not diagnostic until about eight-plus days after the onset of symptoms. If they develop any signs of meningitis or are unable to tolerate symptoms at home, they need to go to the hospital for evaluation and treatment. Treatment is supportive; there is no effective treatment for West Nile virus at this time.
Q: Are there any theories on why we are seeing an increase in West Nile Virus cases in Arizona?
A: West Nile virus usually circulates between mosquitos and birds. It is not clear if more birds are infected with the virus or there are more mosquitos carrying the virus. Cases usually increase during monsoon season, due to standing water. It is still unclear why we are seeing an increased number of cases this year.
Q: What are some prevention strategies?
A: Avoid mosquito bites by using mosquito repellants like DEET, Picaridin and oil of lemon eucalyptus. Wear long-sleeved shirts and long pants when outside. Use screens on windows and doors and repair holes in screens. Per CDC guidelines, stop mosquitos from laying eggs in or near water by getting rid of standing water in buckets, planters, toys, pools, birdbaths, etc.
Q: Any other thoughts?
A: Remember that only a few cases develop the severe form of the disease. However, do seek medical care immediately if you have fever, headache, neck stiffness and other neurological symptoms. Prevention is the best strategy.
Linking the mind and body for better physical therapy
September 9, 2019
Nearly half of physical therapy patients are age 65 and older. Older bodies often have unique needs for therapy, but they’re not necessarily treated with different approaches than younger patients. But to get better results, all it might take is a pencil and paper.
Sydney Schaefer, an assistant professor of biomedical engineering in the Ira A. Fulton Schools of Engineering at Arizona State University, is working toward developing more personalized solutions for neurorehabilitation (treatment for a nervous system injury) that are tailored to older patients. She and her research team are exploring inexpensive and easy-to-implement solutions similar to current practices. Sydney Schaefer demonstrates visuospatial tests, which determine how well people can visually perceive objects and their features, that could help older patients with nervous system injures have more success with physical therapy. Photo by Erika Gronek/ASUDownload Full Image
“We use tools and assessments that are already being used by clinicians, but we are using them in nontraditional ways that could innovate standard care,” Schaefer said.
By identifying and testing a number of cognitive domains — memory, language and attention, for example — Schaefer and her team found visuospatial tests are the best predictors of success for physical therapy outcomes. These types of tests determine how well people can visually perceive objects and their features.
“We know that specific parts of the brain are involved in visuospatial function, and our hypothesis is that similar networks are critical for learning motor skills, which are fundamental to the rehabilitative process,” Schaefer said.
A common visuospatial test involves drawing the face of an analog clock and setting it to a particular time specified by a clinician or experimenter.
Schaefer and the research team are studying the use of pencil-and-paper tests, and sometimes computer-based tests, to evaluate older adults’ visuospatial skills. Questions include visualizing an object’s orientation, mentally rotating an object to a different orientation and recreating the shape of an object by drawing or building it, sometimes from memory.
The results the team has gotten so far suggest that clinicians focused on cognitive and physical rehabilitation can improve patient outcomes by communicating more with each other.
“In clinical care, motor and cognitive issues are often treated separately,” Schaefer said. “Neural circuitry may have more overlap than originally thought.”
Their research suggests that treating visuospatial deficits may have downstream effects on improving motor rehabilitation. Cognitive testing prior to motor rehabilitation can inform how patients should approach physical therapy to yield the best results.
The team was awarded a National Institutes of Health R03 grant, which supports two-year research projects to help develop larger-scale ideas.
Schaefer says the grant reviewers were particularly impressed by the significance of the work because “it has the potential to offer an inexpensive solution to a major problem in rehabilitation research and can alter how new clinical trials in stroke rehabilitation and other forms of motor skill training are implemented.”
Schaefer’s research team is using the grant to identify which visuospatial test is most predictive of skill learning in older adults, including older adults with a history of stroke, through the development of predictive cognitive algorithms and approaches that can enhance the success of physical therapy treatment.
The team is also developing low-cost tests that can be widely implemented in clinical and community-based settings.
“The simplicity of using existing clinical tests in the cognitive domain to better understand motor-based outcomes was viewed as novel,” Schaefer said.
She attributes much of the project’s success to the wealth of clinical partnerships available through the School of Biological and Health Systems Engineering, the accessibility of the ASU campus research space for working with older adults and the quality of graduate students the school recruits.
Her graduate student, Jennapher Lingo VanGilder, earned a National Institutes of Health Ruth L. Kirschstein Predoctoral Individual National Research Service Award Fellowship to support her neuroimaging work, which has contributed to the success of Schaefer’s research.
Going forward, Schaefer’s team is exploring additional therapeutic solutions and whether enhancing visuospatial function through neuromodulation can enhance skill learning.
Cheryl Hyman wants to leverage strengths of community college partners to ensure maximum access for students
Cheryl Hyman has traveled the pathway to success. Now, she wants to make sure it is available for others. Many, many others.
Arizona State University’s new vice provost for academic alliances, Hyman came from a family that lived in public housing on the west side of Chicago. She was once a high school dropout, and her road to a better life through education started in the community college system. From there, she went on to receive a bachelor’s degree, a master’s degree and an MBA. Her message? If I can do it, you can, too.
Hyman arrived at ASU in January of this year after six years as the chancellor of City Colleges of Chicago, replacing Maria Hesse, who retired from ASU as the 2019 spring semester came to a close. After a period of transition into America’s most innovative university, Hyman has developed a new strategic plan — one that builds on the foundation Hesse helped ASU establish.
“Maria did a tremendous job building a foundation with community colleges,” Hyman said. “My focus is taking us from a partnership to a platform. We need to have more integrated systems where we are leveraging each other’s strengths and offerings. So now, our community college partners become another platform for us to help figure out how to get people from where they are to where they want to be.”
Video by Deanna Dent/ASU Now
Providing service for universal learning is central to the mission, according to Hyman. And inevitably, that means a higher volume of students.
“Everybody in higher ed will be forced to deal with not just servicing students, but how to re-service, and re-service,” Hyman said. “People are not staying 30 years in jobs anymore. They are constantly transitioning in and out of education for various reasons, whether it be life, reschooling or retooling. And as they do that, we have to reposition to respond and change very rapidly.
“We need to use our alliances to help position ASU as the premier platform for universal learning.”
Hyman says that will require a focus in three areas: expansion, integration and opportunity identification.
From Hyman’s perspective, expansion is not about “growth just for the sake of growing ASU.” It’s about expanding opportunity for the large percentage of the population that is not pursuing a postsecondary education. And that means helping people find their way.
“The people who aren’t going to college, I don’t believe it’s because they don’t want to. I don’t believe it’s because they don’t see everything that’s happening in the world,” she said. “But I do believe it’s because no one is helping them understand what it means to them and then helping guide them through that process.”
So, when Hyman talks about expansion, she means helping people navigate their way through the system and helping them understand how to obtain the credentials that will translate into something tangible. With the volume of people who will need to behave as universal learners, the days of a one-on-one relationship with an adviser are over. ASU’s transfer tools offer students a way to do it themselves.
“ASU has a very robust transfer tool,” Hyman said. “It has been tried and tested with many of our community college partners and allows students to self-navigate. It enables them to create a pathway based on what’s offered at their community college, wherever it might be, and what’s offered at ASU. Students can go there and view their course equivalencies and figure out how to build a very robust associate degree that prepares them for the discipline they want at ASU. If they follow that pathway, they have guaranteed program admission into ASU, in their discipline of choice, without loss of time or credit.”
The tool functions independent of a traditional personal adviser — with a 1,000-to-1 adviser-to-student ratio in Arizona, the need for digital tools is critical.
“Right now, we have more than 600,000 course equivalencies with almost any public institution,” Hyman said. “In my opinion, all those institutions should have access to this tool, and so should their students. So it’s not a tool just for ASU. How do you create it so other institutions, no matter where they are, can have access? How do you get more students to use these tools so they don’t have loss of time or credit?”
That’s where Hyman’s focus on integration comes in.
“The universal learner is going to be weaving in and out of education for a lifetime,” Hyman said. “So, we want tools that work for anyone in any state that help them figure out how to transfer in and out, back and forth, that take them from where they are to where they want to be.”
The key is awareness — knowing what options exist.
“I believe that most people act on the limited information they have,” Hyman said. “If you don’t have access to a wide network of social capital, many people helping you navigate and make choices, a lot of times you’re stopped at just not knowing what to do.”
Hyman sees ASU as an innovator and a leader that can create models to be replicated by others in higher education.
Hence, her third focus — identifying opportunities. That, she says, is a team sport.
“The question for me is, how do I help everyone else in ASU leverage our alliances to service this population? How can we work with business, industry, state systems to help them service that population?” she said. “Creating a platform means ASU doesn’t have to do everything by itself. We can serve as a conduit for helping people get from where they are to where they want to be by connecting them to what they need through our alliance partners, not just transfer institutions.”
From Hyman’s perspective, addressing the challenge of disruption in the work environment and the need for more college-educated talent transcends her role at the university.
“Everything I do, not just here but in my past work, it’s not just for the institution itself; it’s aimed at how you solve the larger crisis,” she said. “Everything we're doing nationally, everything we’re doing locally — I’m doing it in a mindset of building a model for others.
“ASU can’t be the only institution for universal learning, but it certainly can be the designer of it.”
Top photo: Cheryl Hyman, vice provost for academic alliances, leads academic partnerships between ASU and community colleges, both locally and nationally, ensuring that students who wish to pursue an undergraduate degree have the resources and a pathway to successfully transition to ASU. Photo by Charlie Leight/ASU Now
During ASU speech, libertarian columnist and author calls for culture change to foster healthy civil discourse
Frequent incidents over the past few years in which appearances by conservative speakers have been shut down or canceled at college campuses are an alarming threat to free speech, according to libertarian author Robby Soave.
Soave spoke at Arizona State University on Wednesday night in a talk titled, “Panic Attack: Young Radicals in the Age of Trump,” which is also the name of his recently published book. The talk was sponsored jointly by the School of Civic and Economic Thought and Leadership and the Goldwater Institute in Phoenix.
“My book was my attempt to grapple with a phenomenon that probably many of you have taken notice of, which is the climate of hostility to certain principles that I believe in very strongly as a libertarian — things like free speech and due process,” said Soave, who is an associate editor at the website Reason.com.
Soave's new book discusses the state of free speech on college campuses. Photo by Charlie Leight/ASU Now
“Things that used to be so vital to the left that have been increasingly under attack.”
Soave said that the most glaring examples have been on college campuses, but it has also happened on social media, in offices and in government.
“It’s the drive to cancel people, to get them fired or run out of society for having said something that offends you, even if it was unintentional, even if it was misinterpreted and it wasn’t meant to trigger you at all,” he said.
“That drive to destroy people for menial sins has migrated from the college campus, where a small number of very radical students has prevented conservative speakers from coming to campus.
“And it has prevented their own often stridently progressive professors from instructing them because they’ll say something the students object to and then there will be an investigation and the professor learns they have to shut up out of a risk of offending perhaps one person in the classroom.”
The problem is not generational, he said.
“The problem is a small number, a radical cabal, who have gained some degree of power on campuses in the last two years and have been able to hijack the conversation,” he said.
Soave gave many examples from his book, including:
• In 2017, dozens of students at Middlebury College tried to shut down a speech by Charles Murray, who was invited by a conservative student group and whose books have linked socioeconomic status with race and intelligence. A Middlebury professor was injured in pushing and shoving after the speech.
• Evergreen State College biology Professor Bret Weinstein resigned, and was later awarded a $500,000 settlement, over campus protests that erupted after he challenged an event that asked white students and faculty to leave campus for a day. He was confronted by protesting students and campus police told him they couldn’t guarantee his safety.
• At Harvard, law Professor Ronald Sullivan Jr. was fired as a faculty dean in May after students protested his decision to represent disgraced Hollywood mogul Harvey Weinstein.
“Harvard has mounted what can only be called all-out war on the principles of free speech at an administrative level,” Soave said.
Not all of the incidents involved progressive students shutting down conservative speakers, he said, but conservative activists are usually outnumbered on campuses. He said some conservative groups have invited provocative speakers because they wanted to incite a shutdown.
“‘Who will trigger the left the most?’ If that is your mentality you are not making a good-faith effort to foster healthy civil discourse between two sides,” he said.
Soave described how the free speech movement started with liberals at the University of California at Berkeley in the 1960s, and how the activists were so dedicated to the idea that they invited an actual Nazi to campus and then dressed up in Nazi regalia as a stunt to publicize the talk.
“No one shut him down. They gleaned insight into how someone could hold those abhorrent views,” he said. “Can you imagine that happening today? And this was less than 20 years after Nazis were an existential threat to life on the planet.”
So what comes next? Not government interference, he said.
“What we need is a cultural change. We need to say, ‘No, we will not demand you lose your job or be run off campus.’ The people who want that to happen, I really do believe, are a minority.”
Often, it only takes one person to speak up, and he gave an example of a student who confronted protestors and asked that a speaker be allowed to continue.
“It robbed the mob of their power,” he said. “Calling out the canceler can work and I’ve seen it work and I encourage us all to be more bold in doing so.”
During the question period after his talk, Soave was asked to elaborate on his title, “.. In the Age of Trump.”
“Many of the phenomena I describe predate (Donald) Trump and have nothing to do with Trump,” he said, noting that all elections inflame tensions on campus.
“Because of who Trump is and his style, he has set aflame campus life the way no one else would. He is always with us because he is in the 24-hour news cycle. And he’s positioned the media as his rival tribe. And you have to pick one or the other, and there’s no room for anyone to pick Trump some of the time and to disagree with him some of the time, which is what I do,” he said.
“It bifurcates us.”
Gov. Doug Ducey at Wednesday's event. Photo by Charlie Leight/ASU Now
Gov. Doug Ducey introduced Soave, who he called “a beacon of common-sense reporting.”
“He puts in the hard work and does the fundamentals. He asks the right questions. He does the research,” Ducey said.
“He articulates clearly and isn’t afraid to take a stand in the face of pressure.”
Soave praised the School of Civic and Economic Thought and Leadership for promoting difficult conversations between people who disagree.
“This is exactly what a college campus is supposed to be about and has been lost at so many elite institutions.”
Top photo: Pundit, editor, author and columnist Robby Soave speaks about free speech and common sense on college campuses at the Memorial Union on Sept. 4, 2019. Photo by Charlie Leight/ASU Now
ASU expert discusses challenges of new technology's clinical trials
Last week, scientists began the first human clinical trials using the gene-editing tool CRISPR to combat cancer and blood disorders. Researchers remove some of a person’s cells, edit the DNA, and then inject the cells back in, where hopefully they will cure the diseases.
The technology hit the world stage in 2012, with the promise of curing more than 6,000 known genetic diseases. Samira Kiani is a health systems engineer at Arizona State University, where her lab works on using CRISPR and synthetic biology to create safe and controllable CRISPR gene therapies.
ASU Now talked with Kiani, an assistant professor in the School of Biological and Health Systems Engineering, about the trials.
Question: Do scientists fully understand the changes they’re making?
Answer: What I gather from these clinical trials is obviously they are based on years of preclinical studies that have been done in itself and in the animal models. The targets they have chosen in the blood disorders, these are two monogenetic diseases. There have been many studies before using CRISPR to target these genes that are responsible for these diseases in the cells and in the animal models. The exact modification they want to do in these patients, yes, it’s well-studied. How this is going to affect patients — because this is the first clinical trial — obviously that’s something we all have to wait and see.
Q: What are some of the obstacles to success in these trials?
A: The very first obstacle is how efficiently you can modify these cells outside the patient body. You get these cells, you introduce CRISPR to them and then you really have to hope for really high efficiency in repairing the type of disease abnormality they have. Usually, as you can imagine, the efficiency (of CRISPR) to really cut the genome and repair the disease genes is not 100%. One obstacle is to increase this efficiency. People are doing work to increase that efficiency. Obviously we are not there yet.
The other obstacle is that once you have a number of cells edited, how can you expand those? How can you make sure you expand those outside the patient body? That expansion strategy is very much challenged right now, so a lot of people are working on that. We are not there yet.
Q: If these trials are successful, what’s next?
A: If these types of trials are successful, one of the major advances for CRISPR would be if we could avoid getting the cells and modifying them outside of the body, and really move forward and modify these cells inside the patient body. You can imagine it’s very costly and also time consuming to get these cells from the patient, expand them outside the body, modify them, and infuse them back, you really need to have a really special facility and a lot of money is involved. You really want to be able to put the CRISPR directly in the patient and see your intended changes. Some of the clinical trials are already intended for this purpose.
Top photo: Assistant Professor Samira Kiani poses for a portrait in her lab in the School of Biological and Health Systems Engineering. Photo by Deanna Dent/ASU Now
ASU psychology professor studies the benefits of an inclusive workplace
August 23, 2019
Everyone wants to be appreciated at work, and inclusive and culturally diverse workplaces are more innovative and outperform competitors. But what about inclusivity with respect to weight?
Arizona State University’s Marisol Perez recently spoke at the Arizona Women Leading Government 2019 conference on her research about body image in the workplace. Haylie Smith, a former undergraduate research assistant to Perez and ASU alumna Cherese Mead also presented. ASU psychology professor studies the benefits of an inclusive workplace. Photo: Brooke Cagle via Unsplash.comDownload Full Image
At the conference, Perez discussed the importance of “body talk” in the workplace. Body talk is any conversation that mentions the body, including comments people say about themselves or about other people.
In her presentation, Perez said that 72 out of 90 executive women experienced negative body talk in the workplace.
“Negative body talk can impact leadership and performance,” said Perez, who is an associate professor of psychology. “In fact, body image concerns in the workplace prevent women from reaching their full potential.”
Perez recently completed a study on the impact of body talk in women executives. She found that over 83% of them said their performance in a presentation would be negatively impacted if they felt uncomfortable with their appearance. And, 87% of the women executives reported that feeling uncomfortable with their appearance would negatively affect their ability to represent their company at a conference or in a meeting.
When the same participants felt confident about their appearance, 57% reported feeling more confident at work. Over 28% said feeling confident in their appearance improved their work performance.
Common phrases at the workplace like, “Does this make me look fat?” or “I’m going to be bad and eat this cookie,” sound innocent at first glance, but they really are examples of negative body talk and help to propagate harmful body shaming in the workplace.
Perez said there are many ways that managers can improve weight inclusivity in the workplace, such as by congratulating people for an accomplishment while simultaneously not discussing people’s bodies or weights at work.
“People deserve to work in a place where they are valued and appreciated for their accomplishments, ideas, and work ethic, and where their body shape and weight is irrelevant,” Perez said.
Researchers offer new strategies for the use of extracellular vesicles as biomarkers
With advances in technology and our understanding of the human body come better techniques for diagnosing disease
August 22, 2019
With advances in technology and our understanding of the human body come better techniques for diagnosing disease. One recent innovation involves the use of extracellular vesicles as biomarkers for a range of illnesses. Extracellular vesicles are tiny bubbles of material emitted from most living cells that can offer vital clues about the status of the cells producing them.
However, the field of extracellular vesicle (EV) research is a relatively new one, and there are more refinements to be made to translate EV-based diagnostic tools into a clinical setting. Extracellular vesicles are lipid-bound particles containing nucleic acids or proteins that are naturally secreted from cells. Serving a variety of functions ranging from activation of the immune system to disposing of intracellular waste, these vesicles circulate the body continuously, and their contents shed light on potential diseases, including various types of cancer. Graphic by Jason DreesDownload Full Image
Arizona State University Biodesign researchers Tony Hu, Jia Fan and Bo Ning wrote a review paper, published in the Royal Society of Chemistry, outlining challenges in developing EV diagnostic tools and potential strategies to ameliorate these, all in the context of diagnosing cancer.
Much of this review paper explores the transition of this research from a theoretical framework to viable technologies ready for use and compatible with human samples.
“Previous reviews focus on EV cancer biomarker identification or isolation but lack translational value,” Hu said. “We aim to address the application of EVs as cancer biomarkers and recent progress in EV isolation and analysis methods, and we also discuss the challenges and recommendations for translating potential EV biomarkers for clinical disease diagnostics.”
Extracellular vesicles are lipid-bound particles containing nucleic acids or proteins that are naturally secreted from cells. Serving a variety of functions ranging from activation of the immune system to disposing of intracellular waste, these vesicles circulate the body continuously, and their contents shed light on potential diseases, including various types of cancer.
“Extracellular vesicles contain DNA, RNA and protein cargoes that reflect the status of their parent cells at the time of their formation, making them ideal for biomarker study,” Hu said.
These vesicles are of particular interest in diagnostics because they are found in high concentration and remain stable in easy-to-acquire human samples.
“EVs produced by diseased and healthy cells are secreted into most body fluids, including blood,” Hu said. “The unique composition, long in vivo half-life and physical durability of EVs make them qualified materials to serve as stable and sensitive biomarkers for cancer.”
Although EV research is rapidly evolving, the sheer volume of vesicles circulating the human body makes it challenging to detect disease-associated EVs. This warrants the use of technology that can sort, with high specificity, which vesicles’ contents are characteristic of diseases and which originate from healthy cells.
“Due to the volume and size of EVs, only a limited number of biomarkers are packaged in or on these vesicles,” Hu said. “Thus, a lower limit of detection will significantly improve the application of EV biomarkers.”
Determining how to characterize which proteins or DNA in the vesicles originate from a diseased cell also poses prominent challenges.
“Reliable cancer-derived EV biomarkers are critical for all these approaches. Which marker is specific for cancer but not normal tissue?” Hu said.
But what makes these vesicles a more promising approach for diagnostics than traditional practices, particularly in the context of cancer?
“One of the advantages of EV biomarker analysis is a noninvasive approach, so cancer types which are difficult for traditional biopsy to detect will benefit from this detection, such as pancreatic cancer,” Hu added.
The review paper puts these points into context by listing different biomarkers identified by various studies and the assays used in them. Assays are tools designed to measure the presence and quantity of a specified substance, which in this case would be EVs. The paper deconstructs these studies, listing their pitfalls, what makes them effective and how they can be improved.
Although this paper uses data accumulated from past studies, Hu’s lab also works extensively on developing EV biomarkers and characterization tools.
Their group developed an assay, the nanoplasmon enhanced scattering (nPES) assay, that quantifies the total number of EVs as well as number of EVs that originated from diseased cells. The lab utilized this assay to study EVs in the plasma samples of patients with chronic pancreatitis.
With this technology, they had great success in diagnosing pancreatic cancer, which is a testament to their state-of-the-art EV biomarker technology as well as the efficacy of such technology to provide diagnoses with higher specificity.
“We found that nPES signals distinguished healthy patients from patients with chronic pancreatitis, and the results corresponded with tumor burden, stage and early response to therapy.”