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John Wilckens, M.D., is an associate professor of orthopaedic surgery at The Johns Hopkins University School of Medicine. His areas of clinical expertise include baseball injuries, orthopaedic surgery and sports medicine. Dr. Wilckens serves as the medical director of Johns Hopkins Orthopaedics at White Marsh. Dr. Wilckens holds research interests in sports medicine, adolescent sports injuries, ligament reconstruction, running injuries and arthroscopy. Wilckens has served as the team physician to the Navy football team for 15 years and played for the Navy team himself during his time at the Naval Academy. His mission is to keep players safe and playing football and he is currently investigating injuries in players after a recent rash of significant foot injuries occurred across the NCAA and the NFL.

Newswise — A Case Western Reserve University School of Medicine researcher has received a $2.5 million grant from Gilead Sciences, a California-based biopharmaceutical company, to see if two so-far separately-used AIDS treatments are even more effective when used as a pair. Lead researcher Michael M. Lederman, MD, Scott R. Inkley Professor of Medicine, and colleagues will combine interleukin-2, a protein made by the body that stimulates human killer-cells, with a lab-engineered monoclonal antibody that targets HIV. “Administered alone, both Il-2 and certain monoclonal antibodies can reduce—but not necessarily eliminate— the presence of HIV in the body,” said Dr. Lederman. “Our study will go the next step and use them together. We want to see if they produce more of a wallop in tandem than when administered individually.” Both IL-2 and monoclonal antibodies that neutralize HIV have been given safely to HIV-infected persons but not yet in combination. Study participants will be monitored for safety and tolerance by study staff members. A key goal of the study is to determine if the new combined treatment can reduce latent HIV reservoirs, which consist of cells infected with HIV but not actively producing HIV. Reservoirs, which are difficult to measure, are present even in cases of treated HIV infection where there are no detectable levels of HIV in the blood. Although not active, the reservoirs are evidence that the infection is not cured since they can be reactivated by any of a number of reasons. IL-2 is approved by the Food and Drug Administration for treating certain cancers. It activates killer cells and also activates HIV from latency (a positive development since the activated cells die when expressing virus). Monoclonal antibodies that neutralize HIV are cloned protein antibodies that bind to the surface of HIV and keep it from infecting the body’s immune cells. They also can help killer cells attack HIV infected cells that have been activated from latency to express virus. In the 64-week study, patients in one treatment group will receive IL-2 and those in a second treatment group will receive IL-2 plus a monoclonal antibody that neutralizes HIV. The hope is that the size of the HIV reservoir will decrease in both groups and that the antibody will make the IL-2 treatment more potent. The study is set to include 16 patients and begin in the second half of 2017. A previous retrospective study suggested that IL-2 treatment could decrease the size of latent HIV reservoirs. “We think it’s important to try to confirm those findings in a prospective trial and just as important, see if the addition of a monoclonal antibody enhances the activity of IL-2,” said Dr. Lederman. He and his study colleagues are in discussions with the National Institutes of Health’s Vaccine Research Center to determine which monoclonal antibody to use among several the Center has developed to prevent or treat HIV infection. Other CWRU School of Medicine researchers involved in the study are Jonathan Karn, PhD, Reinberger Professor of Molecular Biology; Benigno Rodriguez, MD, associate professor of medicine; and Rafick-Pierre Sekaly, PhD, professor of pathology.###

Newswise — LA JOLLA, CA –  Biologists at The Scripps Research Institute (TSRI) have identified a brain hormone that appears to trigger fat burning in the gut. Their findings in animal models could have implications for future pharmaceutical development. “This was basic science that unlocked an interesting mystery,” said TSRI Assistant Professor Supriya Srinivasan, senior author of the new study, published today in the journal Nature Communications. Previous studies had shown that the neurotransmitter serotonin can drive fat loss. Yet no one was sure exactly how. To answer that question, Srinivasan and her colleagues experimented with roundworms called C. elegans, which are often used as model organisms in biology. These worms have simpler metabolic systems than humans, but their brains produce many of the same signaling molecules, leading many researchers to believe that findings in C. elegans may be relevant for humans. The researchers deleted genes in C. elegans to see if they could interrupt the path between brain serotonin and fat burning. By testing one gene after another, they hoped to find the gene without which fat burning wouldn't occur. This process of elimination led them to a gene that codes for a neuropeptide hormone they named FLP-7 (pronounced “flip 7”). Interestingly, they found that the mammalian version of FLP-7 (called Tachykinin) had been identified 80 years ago as a peptide that triggered muscle contractions when dribbled on pig intestines. Scientists back then believed this was a hormone that connected the brain to the gut, but no one had linked the neuropeptide to fat metabolism in the time since. The next step in the new study was to determine if FLP-7 was directly linked to serotonin levels in the brain. Study first author Lavinia Palamiuc, a TSRI research associate, spearheaded this effort by tagging FLP-7 with a fluorescent red protein so that it could be visualized in living animals, possible because the roundworm body is transparent. Her work revealed that FLP-7 was indeed secreted from neurons in the brain in response to elevated serotonin levels. FLP-7 then traveled through the circulatory system to start the fat burning process in the gut. “That was a big moment for us,” said Srinivasan. For the first time, researchers had found a brain hormone that specifically and selectively stimulates fat metabolism, without any effect on food intake. Altogether, the newly discovered fat-burning pathway works like this: a neural circuit in the brain produces serotonin in response to sensory cues, such as food availability. This signals another set of neurons to begin producing FLP-7. FLP-7 then activates a receptor in intestinal cells, and the intestines begin turning fat into energy. Next, the researchers investigated the consequences of manipulating FLP-7 levels. While increasing serotonin itself can have a broad impact on an animal’s food intake, movement and reproductive behavior, the researchers found that increasing FLP-7 levels farther downstream didn’t come with any obvious side effects. The worms continued to function normally while simply burning more fat. Srinivasan said this finding could encourage future studies into how FLP-7 levels could be regulated without causing the side effects often experienced when manipulating overall serotonin levels. In addition to Srinivasan and Palamiuc, authors of the study, “A tachykinin-like neuroendocrine signalling axis couples central serotonin action and nutrient sensing with peripheral lipid metabolism,” were Tallie Noble of Mira Costa College and Emily Witham, Harkaranveer Ratanpal and Megan Vaughan of TSRI.

Newswise — Could inflammatory bowel disease and colon cancer be prevented by changing the shape of a single protein? There is an intimate link between uncontrolled inflammation in the gut associated with inflammatory bowel disease and the eventual development of colon cancer. This uncontrolled inflammation is associated with changes in bacteria populations in the gut, which can invade the mucosal tissue after damage to the protective cellular barrier lining the tissue. But Virginia Tech researchers found that modifying the shape of IRAK-M, a protein that controls inflammation, can significantly reduce the clinical progression of both diseases in pre-clinical animal models. The altered protein causes the immune system to become supercharged, clearing out the bacteria before they can do any damage. The team’s findings were published in eBioMedicine. “When we tested mice with the altered IRAK-M protein, they had less inflammation overall, and remarkably less cancer,” said Coy Allen, an assistant professor of inflammatory disease in the Department of Biomedical Sciences and Pathobiology in the Virginia-Maryland College of Veterinary Medicine and a Fralin Life Science Institute affiliate. The next step, he said, will be to evaluate these findings in human patients through ongoing collaborations with Carilion Clinic and Duke University. The team is also evaluating their findings in laboratory-assembled ‘mini-guts’—live tissue models that Allen and his team assembled by growing intestinal stem cells on petri dishes to form highly complex small intestinal and colon tissue. “Ultimately, if we can design therapeutics to target IRAK-M, we think it could be a viable strategy for preventing inflammatory bowel disease and cancer,” said Allen. Colon cancer is the second leading cause of cancer-related deaths in the United States and the third most common cancer in men and women, according to the Centers for Disease Control and Prevention. More than ten Virginia Tech faculty members and students are working on the project, including co-principal investigator Liwu Li, a professor of biological sciences in the College of Science; Clay Caswell, an assistant professor of bacteriology in the veterinary college; Rich Helm, an associate professor of biochemistry in the College of Agriculture and Life Sciences; Dan Slade, an assistant professor of biochemistry in the College of Agriculture and Life Sciences; and Tanya LeRoith, a clinical associate professor of anatomic pathology in the veterinary college. Daniel Rothschild of Nevada City, California, currently in the combined Ph.D./D.V.M program in the veterinary college, is working in Allen’s lab, and was first author on the paper. “Working on this project alongside Dr. Allen and our fellow collaborators has personally been a great experience,” said Rothschild. “It’s really exciting when your findings have the potential for clinical implications that can be applied to help patients. From a scientist’s perspective, that’s what it’s all about, and hopefully our findings provide a good avenue for development of future therapeutics to treat maladies such as inflammatory bowel disease and colon cancer.”

Newswise — Posttraumatic stress disorder (PTSD) can develop after a traumatic event or events. Although it is most often associated with military personnel exposed to the trauma of combat, it can also disproportionately affect vulnerable American Indian and Alaskan-Native (AI/AN) populations. Because alcohol use disorders (AUDs) also have a disproportionate impact on AI/ANs, this study compared both lifetime PTSD and past-year AUD among AI/ANs and non-Hispanic Whites (NHWs). Researchers analyzed data from the 2012-2013 U.S. National Epidemiologic Survey on Alcohol and Related Conditions III, the fourth national survey conducted by the National Institute on Alcohol Abuse and Alcoholism. The researchers estimated the odds of AUD among adults with and without PTSD by race. Of the 19,705 participants, 511 (301 women, 210 men) were AI/AN and 19,194 (10,639 women, 8,555 men) were NHW. The investigators found that both PTSD and AUD were more common among AI/ANs than NHWs. Although PTSD was significantly associated with AUD in both populations, the association was significantly more prevalent among AI/ANs. Thus, among men the rate of both PTSD and AUD in AI/ANs was more than three times that of NHW men (9.5% vs. 3.1%). The authors suggested that screening and interventions for PTSD in tribal-government programs and in AI/AN health services could help to reduce the greater risk for AUD in AI/ANs. They also called for studies that measure trauma resulting from cultural losses and their chronic effects, as well as childhood and adolescent traumas that are specific to AI/ANs. SEE ORIGINAL STUDY    

Newswise — Researchers from the Chinese Academy of Sciences have discovered that the metabolic enzyme phosphoglycerate mutase 1 (PGAM1) helps cancer cells repair their DNA and found that inhibiting PGAM1 sensitizes tumors to the cancer drug Olaparib (Lynparza). Their findings in the study “Phosphoglycerate mutase 1 regulates dNTP pool and promotes homologous recombination repair in cancer cells,” which has been published in The Journal of Cell Biology, suggest that this FDA-approved ovarian cancer medicine has the potential to treat a wider range of cancer types than currently indicated. Cancer cells often alter their metabolic pathways in order to synthesize the materials they need for rapid growth. By producing the metabolite 2-phosphoglycerate, PGAM1 regulates several different metabolic pathways, and the levels of this enzyme are abnormally elevated in various human cancers, including breast cancer, lung cancer, and prostate cancer. Min Huang, Jian Ding, and colleagues at the Shanghai Institute of Materia Medica, Chinese Academy of Sciences, discovered that inhibiting PGAM1 made cancer cells more sensitive to drugs that induce breaks in both strands of the cells’ DNA. This was because the cells were unable to activate a pathway called homologous recombination that repairs this type of DNA damage. The researchers found that cells synthesized fewer deoxyribonucleotide triphosphates (dNTPs)—the building blocks of DNA—when PGAM1 was inhibited. This, in turn, activated a cellular stress response pathway that culminated in the degradation of a protein called CtIP that is required for homologous recombination repair. Cancers carrying mutations in the BRCA1 and BRCA2 tumor suppressor genes are unable to undergo homologous recombination and therefore rely on a different pathway to repair their DNA and continue growing. Olaparib blocks this second repair pathway by inhibiting an enzyme called poly ADP ribose polymerase (PARP). Olaparib was approved by the FDA in 2014 to treat ovarian cancers with BRCA mutations. In this study, the researchers tested the effects of Olaparib on the tumors formed by human breast cancer cells injected into mice. Olaparib had no effect on tumors formed by breast cancer cells containing functional BRCA1 and BRCA2 genes. But by combining the drug with a PGAM1 inhibitor to impair both homologous recombination and PARP-dependent DNA repair, the researchers were able to significantly suppress tumor growth.“This suggests that PGAM1 inhibitors can sensitize cancers to PARP inhibitors such as Olaparib, thereby expanding the benefits of PARP inhibitors to BRCA1/2-proficient cancers, particularly triple-negative breast cancers that currently lack effective therapies,” says author Min Huang. Qu et al., 2017. J. Cell Biol. http://jcb.rupress.org/cgi/doi/10.1083/jcb.201607008?PR # # #

Newswise — Believe it or not, winter has officially begun! And, although there has been a lack of significant snowfall and cold temperatures in our area, we should still be prepared for the possibility of more seasonable weather. Typical winters in the Northeast are beautiful, especially after a fresh snowfall. However, as many of us know, the arrival of snow means that it is time to dust off our shovels and get to digging! “We understand that shoveling snow is our winter norm, but did you know that shoveling snow can actually pose a serious cardiac health risk to some of us?” asks George Becker, M.D., Director, Emergency Department, The Valley Hospital, Ridgewood, NJ. In fact, although most people are not in danger from shoveling, the American Heart Association (AHA) still shares useful tips for anyone shoveling snow in the winter. To begin with, the AHA recommends that those who don’t exercise on a regular basis, those that have a medical condition, or those that are middle age or older consult with a doctor before shoveling. The AHA also has the following general tips for staying safe while shoveling: • Take frequent rest breaks during shoveling.• Don’t eat a heavy meal prior or soon after shoveling.• Use a small shovel or consider a snow thrower.• Don’t drink alcoholic beverages before or immediately after shoveling.• Be aware of the dangers of hypothermia. • Learn the heart attack warning signs and listen to your body.Some signs that you might be having a heart attack are pain in the chest, arm(s), back, neck, jaw or stomach. You might also break out in a cold sweat, feel short of breath, nauseated, lightheaded, or uncomfortable pressure, squeezing, fullness in the center of your chest. Adds Dr. Becker, “If you are concerned that you may be having a heart attack, you should not hesitate about seeking medical treatment—every minute is crucial when experiencing a heart attack. Call 911 immediately or head directly to the closest emergency room.” Shoveling Snow: Winter Chore or Health Hazard? Believe it or not, winter has officially begun! And, although there has been a lack of significant snowfall and cold temperatures in our area, we should still be prepared for the possibility of more seasonable weather. Typical winters in the Northeast are beautiful, especially after a fresh snowfall. However, as many of us know, the arrival of snow means that it is time to dust off our shovels and get to digging! “We understand that shoveling snow is our winter norm, but did you know that shoveling snow can actually pose a serious cardiac health risk to some of us?” asks George Becker, M.D., Director, Emergency Department, The Valley Hospital. In fact, although most people are not in danger from shoveling, the American Heart Association (AHA) still shares useful tips for anyone shoveling snow in the winter. To begin with, the AHA recommends that those who don’t exercise on a regular basis, those that have a medical condition, or those that are middle age or older consult with a doctor before shoveling. The AHA also has the following general tips for staying safe while shoveling: • Take frequent rest breaks during shoveling.• Don’t eat a heavy meal prior or soon after shoveling.• Use a small shovel or consider a snow thrower.• Don’t drink alcoholic beverages before or immediately after shoveling.• Be aware of the dangers of hypothermia. • Learn the heart attack warning signs and listen to your body.Some signs that you might be having a heart attack are pain in the chest, arm(s), back, neck, jaw or stomach. You might also break out in a cold sweat, feel short of breath, nauseated, lightheaded, or uncomfortable pressure, squeezing, fullness in the center of your chest. Adds Dr. Becker, “If you are concerned that you may be having a heart attack, you should not hesitate about seeking medical treatment—every minute is crucial when experiencing a heart attack. Call 911 immediately or head directly to the closest emergency room.” Our Emergency Department, located at 223 N. Van Dien Avenue in Ridgewood, NJ is open 24/7, 365 days a year and is staffed with physicians who are board certified in emergency medicine.

Newswise — TORONTO, Canada – In a bold and very challenging move, thoracic surgeons at Toronto General Hospital, University Health Network removed severely infected lungs from a dying mom, keeping her alive without lungs for six days, so that she could recover enough to receive a life-saving lung transplant. This is believed to be the first such procedure in the world, made possible by advanced life support technology, a dedicated and diverse surgical, respirology, intensive care and perfusion team, as well as the grit and gumption of the patient and her close-knit family. “This was bold and very challenging, but Melissa was dying before our eyes,” recalls Dr. Shaf Keshavjee, Surgeon-in-Chief, Sprott Department of Surgery at University Health Network (UHN), one of three thoracic surgeons who operated together on Melissa to remove both her lungs. “We had to make a decision because Melissa was going to die that night. Melissa gave us the courage to go ahead.” Melissa Benoit, then 32, was brought into Toronto General Hospital’s (TGH) Medical Surgical Intensive Care Unit (MSICU) in early April 2016, sedated and on a ventilator to help her laboured breathing. For the past three years, Melissa, who has cystic fibrosis, had been prescribed antibiotics to fight off increasingly frequent chest infections. A recent bout of influenza just before her hospital admission had left Melissa gasping for air, with coughing fits so harsh that she fractured her ribs. Her inflamed lungs began to fill with blood, pus and mucous, decreasing the amount of air entering her lungs, similar to a person drowning. As Dr. Niall Ferguson, Head of Critical Care Medicine at the University Health Network (UHN) and Mount Sinai, describes it, the influenza “tipped her over the edge into respiratory failure. She got into a spiral from which her lungs were not going to recover. Her only hope of recovery was a lung transplant.” Melissa’s oxygen levels dipped so low, conventional ventilation was no longer enough. To help her breathe, and to gain more time until donor lungs became available, physicians placed her on Extra-Corporeal Lung Support (ECLS), a temporary life-support medical device that supports the work of the lungs and heart. Despite this, Melissa’s condition worsened. The bacteria in her lungs developed resistance to most antibiotics, and spread throughout her body. Her blood pressure dropped. She slid into septic shock, triggering inflammation, leaky blood vessels and reduced blood flow. One by one, her organs began to shut down. She had to have kidney dialysis. Melissa was now on maximum doses of three medications to maintain her blood pressure, along with the most advanced respiratory support, and on last-line powerful antibiotics, the last option for patients resistant to other available antibiotics. The team was still waiting for donor lungs but, by this time, Melissa was too sick to have a lung transplant. Dr. Marcelo Cypel, the thoracic surgeon on call that late April weekend, kept a careful watch on Melissa. On a Sunday afternoon, with the clock ticking, he kept weighing her risk of death versus the risk of trying something which had never been done before. It was bold, but scientifically sound. Removing both her lungs - the source of bacterial infection – could save her life. Dr. Cypel gathered his colleagues, calling in Dr. Shaf Keshavjee, Dr. Tom Waddell, Head of Thoracic Surgery at UHN, Dr. Niall Ferguson, and respirologist Dr. Mathew Binnie – all seasoned and well-known for their skills in navigating complex cases, along with Melissa’s husband, mom and dad. The surgical team had been discussing the concept of this procedure for several years. They had observed patients with cystic fibrosis, waiting for a lung transplant, who developed severe lung infections. These infections spread through the bloodstream into their bodies, resulting in septic shock and death, despite maximum support on the ECLS device. While the team faced many unknowns – risk of bleeding into an empty chest cavity, whether her blood pressure and oxygen levels could be supported afterwards, and if she would even survive the operation – they agreed that Melissa was a possible candidate, and that it was her only chance, although a slim one. As Dr. Keshavjee explained, she likely still had enough strength to withstand the procedure and get better afterwards, the source of the infection was clear-cut and difficult to control in current circumstances, the family understood the risks and explained that Melissa had often told them she would want to try everything possible to live for her husband Christopher and two-year-old daughter, Olivia. “Things were so bad for so long, we needed something to go right,” remembers, Chris, “and this new procedure was the first piece of good news in a long time. We needed this chance.” As Melissa tells it, Chris was the one who “held my life in his hands...He had to trust in himself, knowing me, relying on past conversations, and he chose exactly what I would have told him to.” Melissa’s mom, Sue, was so eager to save her daughter’s life, she urged the team to go ahead: “Melissa always volunteers for any study or clinical trial. She would want to do this. Let’s not waste any more time and get her into the OR.” At 9:00 pm that Sunday evening in mid-April, a team of 13 operating room staff, including three thoracic surgeons – Drs. Cypel, Keshavjee and Waddell - removed Melissa’s lungs, one at a time, in a nine-hour procedure. Her lungs had become so engorged with mucous and pus that they were as hard as footballs, recalls Dr. Keshavjee. “Technically, it was difficult to get them out of her chest.” But within hours of removing her lungs, Melissa improved dramatically. She did not need blood pressure medication, and most of her organs began to improve. To keep Melissa alive, she was placed on the most sophisticated support possible for her heart and lungs. Two external life support circuits were connected to her heart via tubes placed through her chest. A Novalung device, a small portable artificial lung, was connected by arteries and veins to her heart to function as the missing lungs. Working with the pumping heart, the device added oxygen to her blood, removed carbon dioxide, while helping to maintain continuous blood flow. At the same time, another external device, extracorporeal membrane oxygenation (ECMO), which has an external pump, circuit and oxygenator for the gas exchange of oxygen and carbon dioxide, also helped to circulate oxygen-rich blood throughout her body. TGH is a leader in using these technologies, with the largest such program in Canada, performing up to 100 ECLS cases per year. ECLS specialists or perfusionists and MSICU nurses are specially trained in caring for patients on various ECLS devices. Six days later, a pair of donor lungs became available and Melissa was stable enough to receive a lung transplant in late April 2016. “The transplant procedure was not complicated because half of it was done already,” noted Dr. Cypel, “Her new lungs functioned beautifully and inflated easily. Perfect.” For the past several months, Melissa has been steadily improving. Her previously thick hair is growing back, she can play with her daughter for whole days without getting tired, and she has not needed a walker or cane for the past month. She is still on kidney dialysis. “It’s the simple things I missed the most,” she said, “I want to be there for Chris and Olivia, even through her temper tantrums! I want to hear Olivia’s voice, play with her and read her stories.” The medical team is developing criteria for the select types of patients who could be candidates for this novel procedure while waiting for a lung transplantation. The report of this case by Drs. Marcelo Cypel, Shaf Keshavjee, Tom Waddell, Lianne Singer, Lorenzo del Sorbo, Eddy Fan, Mathew Binnie and Niall Ferguson on Melissa Benoit entitled, “Bilateral pneumonectomy to treat uncontrolled sepsis in a patient awaiting lung transplantation” is published online in The Journal of Thoracic Cardiovascular Surgery, November, 2016.

Newswise — Adding further to its expanding scope of pediatric and neurological services, NYU Lutheran Medical Center is now making it easier for families to identify and treat neurological and psychological issues that could impair childhood development. The development of the brain in childhood has life-long effects on overall health and well-being, including cognition, learning ability, behavior, and social skills. When an injury involving the brain or the possibility of a developmental delay is presented early in life, it needs to be identified and treated to prevent future problems into adulthood. Gianna Locascio, PsyD, NYU Lutheran’s new pediatric neuropsychologist, has devoted her career to helping families identify these conditions and develop appropriate treatment plans for a healthy future. “When I evaluate a child, I create a neurocognitive profile to identify strengths and weaknesses in all areas of cognitive function,” says Locascio. Specifically, she looks at intellect, attention, concentration, memory, motor coordination, personality, language skills, and other factors. Planning, organizing, and shifting attention from one task to another efficiently also are key areas she assesses. Once an evaluation is completed, Locascio often refers patients to an appropriate, conveniently located therapist or specialist within the NYU Langone health system, and continues to monitor the child’s progress through development. Over time, she may update her comprehensive recommendations to maximize the child’s functioning at home and in social, community, and academic settings. “The key to providing comprehensive care is to ensure that the patient is healthy and thriving in a range of areas,” says Steven L. Galetta, MD, the Philip K. Moskowitz, MD, Professor and Chair of the Department of Neurology at NYU Langone Medical Center. “Monitoring progress and adjusting care recommendations based on lifestyle changes is important in all medical practices, but particularly neurological care. Dr. Locascio is a valuable addition to NYU Langone health system’s neuropsychological testing services and will play an important role in the comprehensive approach at NYU Lutheran.” Locascio specializes in cognitive issues related to traumatic brain injury, concussion, stroke, epilepsy, brain tumors, encephalitis, cerebral palsy, sickle cell disease, attention deficit hyperactivity disorder, anxiety, depression, Down syndrome, autism spectrum, spina bifida, Sturge-Weber syndrome, and other childhood and adolescent disorders. Her passion for pediatric neuropsychology is rooted in her love of science and desire to help young people develop into healthy adults. “It’s very rewarding to work with children and adolescents,” she says. “There are so many ways to help maximize function. I have seen patients go on to extraordinary progress.” Locascio is the only pediatric neuropsychologist in Brooklyn board certified in both clinical neuropsychology and pediatric neuropsychology. An undergraduate alumna of Lafayette College, she earned her master’s degree and doctorate from Rutgers University with dual concentration in school psychology and neuropsychology. She completed a fellowship in neuropsychology at Kennedy Krieger Institute at Johns Hopkins School of Medicine. To make an appointment with Gianna Locascio, PsyD, or for more information please call 718.630.7316.    

Newswise — New York and Boston — Improving dietary resilience and better integration of nutrition in the health care system can promote healthy aging and may significantly reduce the financial and societal burden of the “silver tsunami.” This is the key finding of a “Nutritional Considerations for Healthy Aging and Reduction in Age-Related Chronic Disease,” a new paper initiated under the auspices of the Sackler Institute for Nutrition Science Working Group on Nutrition for Aging Population, and published in Advances in Nutrition. By 2050, the number of persons aged 80 years old and over will reach 392 million, about three times the 2013 population. According to the report, an increasingly large portion of the population will be vulnerable to nutritional frailty, a state commonly seen in older adults, characterized by sudden significant weight-loss and loss of muscle mass and strength, or an essential loss of physiologic reserves, making the person susceptible to disability. Ironically, while increasing numbers of older adults are obese, many are also susceptible to nutritional frailty and, as a result, age-related diseases including sarcopenia, cognitive decline, and infectious disease. The review concludes that exploring dietary resilience, defined as a conceptual model to describe material, physical, psychological and social factors that influence food purchase, preparation and consumption, is needed to better understand older adults’ access to meal quality and mealtime experience. A recent model to frame food intake includes the addition of more randomized clinical trials that include older adults with disease and medication. This will help to identify their specific nutrient needs, biomarkers to understand the impact of advancing age on protein requirements, skeletal muscle turnover and a re-evaluation of how BMI guidelines are used. “A nutritional assessment model that takes into consideration the effect of aging on muscle mass, weight loss and nutrient absorption is crucial to overall wellness in our elderly population,” said Gilles Bergeron, Ph.D., executive director, The Sackler Institute for Nutrition Science at the New York Academy of Sciences, New York, NY. “However, nutrition recommendations are usually based on that of a typical healthy adult, and fail to consider the effect of aging on muscle mass, weight loss, and nutrient absorption and utilization.” Simin Nikbin Meydani, D.V.M., Ph.D., director of the Nutritional Immunology Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA concurs. “Much greater emphasis needs to be placed on prioritizing research that will fill the knowledge gaps and provide the kind of data needed by health and nutrition experts if we’re going to address this problem,” she said. “There also needs to be more education about on-going nutritional needs for those involved with elder-care – not only in a clinical setting, but also for family members who are responsible for aging adults.” Additional authors of this review are Julie Shlisky, Ph.D., consultant at The Sackler Institute for Nutrition Science; David E. Bloom, Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston; Amy R. Beaudreault, World Food Center, University of California, Davis, Davis, CA; Katherine L. Tucker, Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA; Heather H Keller, Schlegel-UW Research Institute for Aging, Applied Health Sciences, University of Waterloo, Ontario, Canada; Yvonne Freund-Levi, Department of Neurobiology, Care Sciences and Society (NVS), Division of Clinical Geriatrics, Karolinska Institutet, Stockholm, Sweden, Department of Geriatrics, Karolinska University Hospital, Huddinge, Sweden and Department of Psychiatry, Tiohundra Hospital, Stockholm, Sweden; Roger A Fielding, Nutrition, Exercise Physiology and Sarcopenia Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts; Feon W. Cheng, University of Vermont College of Medicine, Burlington, VT; and Gordon L. Jensen, The Pennsylvania State University, University Park, PA; and Dayong Wu, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA. Please see the review for conflicts of interest. Shlisky, J., Bloom, D. E., Beaudreault, A. R., Tucker, K. L., Keller, H. H., Freund-Levi, Y., Fielding, R. A., Cheng, F. W., Jensen, G. L., Wu, D., Meydani, S. M.. (2017, January); 8:17-26. Nutritional considerations for healthy aging and reduction in age-related chronic disease. Advances in Nutrition. doi:10.3945/an.116.013474. # # #