News Article | November 30, 2016
In a study published online by JAMA Surgery, Daniel E. Hall, M.D., M.Div., M.H.Sc., of the Veterans Affairs Pittsburgh Healthcare System and University of Pittsburgh, and colleagues examined the effect of a Frailty Screening Initiative (FSI) on death and complications by comparing the surgical outcomes of patients treated before and after implementation of the FSI. As the U.S. population ages, the number of operations performed on elderly patients will likely increase. Frailty predicts postoperative mortality and illness more than age alone, thus presenting opportunities to identify the highest-risk surgical patients and provide tailored clinical care to improve their outcomes. This study included 9,153 patients (average age, 60 years) from a Veterans Affairs medical center who presented for major, elective, noncardiac surgery. Preoperative frailty was assessed with the Risk Analysis Index (RAI; a 14-item questionnaire), and the records of all frail patients (as determined by a certain RAI score) were flagged for administrative review by the chief of surgery (or designee) before the scheduled operation. On the basis of this review, clinicians from surgery, anesthesia, critical care, and palliative care were notified of the patient's frailty and associated surgical risks; if indicated, perioperative plans were modified based on team input. The researchers found that overall 30-day mortality decreased from 1.6 percent (84 of 5,275 patients) to 0.7 percent (26 of 3,878 patients) after FSI implementation. Improvement was greatest among frail patients (12.2 percent to 3.8 percent), although mortality rates also decreased among the robust patients (1.2 percent to 0.3 percent). The magnitude of improvement among frail patients increased at 180 and 365 days. "The ultimate cause of the survival benefit is likely multifactorial, including changes in preoperative decision making, intraoperative management, and postoperative rescue," the authors write. "This study reveals the feasibility of facility-wide frailty screening in elective surgical populations. It also suggests the potential to improve postoperative survival among the frail through systematic administrative screening, review, and optimization of perioperative plans. The absolute reduction in 180-day mortality among frail patients was more than 19 percent, with improvement remaining robust even after controlling for age, frailty, and predicted mortality." Editor's Note: This investigation was supported by a grant from the U.S. Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Health Services Research and Development. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, etc.
News Article | March 1, 2017
Environmental research is needed now more than ever, insiders say As scientists begin to find their political voices, three former U.S. Environmental Protection Agency insiders on Wednesday said the Trump administration should not sacrifice environmental quality and the health of the American people "for a coterie of special-interest stakeholders." Their opinion piece was published on March 1 in the New England Journal of Medicine. "Unfortunately, sowing doubt about scientific evidence has become a widely used strategy for delaying or blocking actions that are purported to potentially affect the bottom lines for particular industries," the article stated. "We need to maintain the capacity to conduct cutting-edge research and to grapple with the application of the results in formulating evidence-based policies." The more than 2,300-word article is authored by Jonathan Samet, previous chair of the EPA Clean Air Scientific Advisory Committee and holder of the Flora L. Thornton Chair in Preventive Medicine at the Keck School of Medicine of USC; Thomas Burke, former EPA science adviser and former head of the EPA's Office of Research and Development under the Obama administration; and Bernard Goldstein, EPA assistant administrator for research and development during the Reagan administration. The article points at the key role of scientific evidence in driving public policy and its place in the laws and regulations that are critical in environmental policy. In the United States, there is a tradition of relying on scientific research. In fact, Abraham Lincoln created the National Academy of Sciences to provide advice to the government. Key environmental statutes, like the Clean Air Act, explicitly base action in research findings. Lessons from the past show the need for a strong EPA. Ronald Reagan initially sought to diminish the EPA but later warmed up to the agency and replaced his initial EPA leadership with people supportive of its environmental goals. Under Reagan's watch, the EPA removed lead from gasoline and provided the first EPA-funded studies related to climate change, the article said. Samet, Burke and Goldstein set up a five-point call to action for the administration: 1. Evidence-based decision-making on the environment should not be abandoned. 2. The Trump administration should continue to engage and seek advice from the broad community of scientists, reflecting the role of science and reason in democracy. 3. Research funding and environmental scientific capacity should be enhanced, not diminished, to reduce key uncertainties. 4. Experts need to continue to carefully track environmental surveillance and to be prepared to deal with emerging problems and disasters like the Deepwater Horizon oil spill. 5. There should be no pause in efforts to reduce greenhouse gas emissions so that people can lessen the unprecedented challenges of global climate change.
News Article | March 1, 2017
The White House has proposed deep cuts to the Environmental Protection Agency’s budget that would reduce the agency’s staff by one-fifth in the first year and eliminate dozens of programs, according to details of a plan reviewed by The Washington Post. While administration officials had already indicated that they intended to increase defense spending at the expense of other discretionary funding, the plan spells out exactly how this new approach will affect long-standing federal programs that have a direct impact on Americans’ everyday lives. “The administration’s 2018 budget blueprint will prioritize rebuilding the military and making critical investments in the nation’s security,” the document says. “It will also identify the savings and efficiencies needed to keep the nation on a responsible fiscal path.” The funding level proposed, which the document says “highlights the trade-offs and choices inherent in pursuing these goals,” could have a significant impact on the agency. Its annual budget would drop from $8.2 billion a year to $6.1 billion. And because much of that funding already goes to states and localities in the form of grants, such cuts could have an even greater effect on the EPA’s core functions. Though President Trump professes to care strongly about clean air and clean water, almost no other federal department or agency is as much in the crosshairs at the moment. As a candidate, he vowed to get rid of the EPA “in almost every form,” leaving only “little tidbits” intact. The man he chose to lead the agency, former Oklahoma attorney general Scott Pruitt, sued it more than a dozen times in recent years, challenging its legal authority to regulate such things as mercury pollution, smog and carbon emissions from power plants. The plan reflects those past sentiments. As proposed, the EPA’s staff would be slashed from its current level of 15,000 to 12,000. Grants to states, as well as its air and water programs, would be cut by 30 percent. The massive Chesapeake Bay cleanup project would receive only $5 million in the next fiscal year, down from its current $73 million. In addition, 38 separate programs would be eliminated entirely. Grants to clean up brownfields, or abandoned industrial sites, would be gone. Also zeroed out: the radon program, climate change initiatives and funding for Alaskan native villages. The agency’s Office of Research and Development could lose up to 42 percent of its budget, according to an individual apprised of the administration’s plans. And the document eliminates funding altogether for the office’s “contribution to the U.S. Global Change Research Program,” a climate initiative that President George H.W. Bush launched in 1989. The staffing reductions, which could be accomplished through a buyout offer as well as layoffs, were among several changes to which the EPA staff was asked to react by the close of business Wednesday. Multiple individuals briefed on the plan confirmed the request by the Office of Management and Budget, which did not immediately respond to a request for comment. The document acknowledges that the cuts “will create many challenges” but suggests that “by looking ahead and focusing on clean water, clean air and other core responsibilities, rather than activities that are not required by law, EPA will be able to effectively achieve its mission.” [Trump to propose 10 percent spike in defense spending, major cuts to other agencies] Any cuts would have to be codified through the congressional appropriations process and would probably face resistance from some lawmakers. Rep. Mike Simpson (R-Idaho), a former chairman of the House Appropriations subcommittee on interior, environment and related agencies, said he did not think Congress would approve such a steep drop in funding. “There’s not that much in the EPA, for crying out loud,” he said, noting that Republicans had already reduced the agency’s budget dramatically in recent years. Jennifer Hing, a spokeswoman for the House Appropriations Committee, declined to comment Wednesday on the cuts targeted but said in an email that the panel “will carefully look at the budget proposal once it is sent to Congress.” The EPA also would not comment on the budget proposal. But its new administrator cautioned this week that the particulars of the budget remain in flux. “I am concerned about the grants that have been targeted, especially around water infrastructure, and those very important state revolving funds,” Pruitt told the publication E&E News after Trump’s address to Congress on Tuesday. He said he already had spoken with OMB Director Mick Mulvaney about the agency’s funding. “What’s important for us is to educate OMB on what the priorities of the agency are, from water infrastructure to Superfund, providing some of those tangible benefits to our citizens,” he said, “while at the same time making sure that we reallocate, re-prioritize in our agency to do regulatory reform to get back within the bounds of Congress.” [Pruitt to EPA employees: ‘We don’t have to choose’ between jobs and the environment] It is unclear whether Pruitt’s appeal would produce any changes: The document states that any requests from agencies to increase or reallocate funds must be accompanied by budgetary offsets. Those could include “alternative funding cuts, balance cancellations or viable user fees.” It instructs agency officials to “make sure any appeal is consistent with campaigns or other policy statements.” Agencies must submit any alternative budget proposals to OMB’s Office of Information and Regulatory Affairs by Friday, the document states, and OMB will convene a meeting April 15 to discuss the “initial draft of the workforce reduction plan.” As details of the blueprint emerged, environmental advocates and the EPA’s most recent administrator blasted the White House proposal. “This budget is a fantasy if the administration believes it will preserve EPA’s mission to protect public health,” Gina McCarthy, who served as the agency’s leader from 2013 through the end of the Obama administration, said in a statement Wednesday. “It ignores the need to invest in science and to implement the law,” she said. “It ignores the lessons of history that led to EPA’s creation 46 years ago. And it ignores the American people calling for its continued support.” S. William Becker, executive director of the National Association of Clean Air Agencies, said in an email that the proposed budget would devastate critical federal financial support for communities across the country. “These cuts, if enacted by Congress, will rip the heart and soul out of the national air pollution control program and jeopardize the health and welfare of tens of millions of people around the country,” Becker said. The instructions to the EPA signal how the new administration plans to delegate many responsibilities to the states even as it decreases the money they will receive from the federal government. The document directs the agency to get states “to assume more active enforcement roles” when it comes to federal environmental standards. In addition, it says, the agency should curtail its compliance-monitoring activities. “Basically, the direction is to reduce enforcement, which is already pretty strained,” said Eric Shaeffer, head of the Environmental Integrity Project, an advocacy group, and a former head of the EPA’s Office of Regulatory Enforcement. He noted that state programs are often “woefully underfunded” and at the mercy of state politics and pressure from large companies. Environmental justice activists are particularly alarmed at what they may face with the new administration. The document states that it supports the idea of environmental justice, but it would eliminate that EPA office and “assumes any future EJ specific policy work can be transferred to the Office of Policy.” On the South Side of Chicago, the neighborhood where Cheryl Johnson lives is known as “the toxic doughnut” because of the 200 leaking underground storage tanks and 50 landfills there. The EPA office has given People for Community Recovery, for which Johnson is the executive director, and other organizations money to conduct technical assessment of local facilities and provide training to educate residents. And, Johnson added, it also has provided a place where residents could appeal to force local polluters to come into compliance with federal standards. Losing that resource “would devastate a community like mine,” she said. It would be “like putting us in a chamber, to be disposed of.” More from Energy and Environment: Hundreds of current, former EPA employees urge Senate to reject Trump’s nominee for the agency Scott Pruitt, longtime adversary of EPA, confirmed to lead the agency Trump EPA official juggles two jobs in two Washingtons, and it hasn’t gone well For more, you can sign up for our weekly newsletter here and follow us on Twitter here.
News Article | August 22, 2016
« CD-adapco accelerates development efforts for collaborative ICE simulation solutions | Main | Mercedes unveils electric all-wheel drive Vision Mercedes-Maybach 6 show car; CCS charging up to 350 kW » The US Environmental Protection Agency Office of Inspector General (OIG) has found that the EPA has not met certain statutory requirements to identify environmental impacts of Renewable Fuel Standard. In a newly released report, the OIG said that EPA’s Office of Research and Development has not complied with the requirement to provide a report every 3 years to Congress on the impacts of biofuels. The EPA provided a report to Congress in 2011, but has not provided subsequent reports as required. Further, the EPA’s Office of Air and Radiation has not fulfilled the anti-backsliding requirements for RFS, which are to analyze and address any negative air quality impacts of RFS. The anti-backsliding provisions are intended to ensure that new regulations intended to address one problem do not actually make other environmental problems worse. The law sets forth two anti-backsliding requirements for the EPA: The EPA has not met these requirements. Also, in 2010, the EPA completed a comprehensive lifecycle analysis to determine greenhouse gas reduction thresholds for RFS. Although not required to do so, the EPA committed to update this analysis as lifecycle science evolves, but does not have a process for initiating an update. The OIG noted that the RFS reporting requirement provides for an objective analysis on the environmental impacts and unintended consequences of US biofuel policy. Given the conflicting scientific opinions about biofuel impacts, potential impacts outside of the EPA’s regulatory control, and divergent RFS interests, such an analysis is important, OIG said. OIG recommended that EPA’s Assistant Administrator for Research and Development provide to Congress triennial reports on the impacts of biofuels as required. It further recommended the Assistant Administrator for Air and Radiation complete the anti-backsliding study as required; determine if additional mitigation is needed; and, although not required by statute, develop or identify the process for evaluating the lifecycle science and determining whether to update the greenhouse gas threshold determinations. The EPA agreed with all recommendations and provided planned completion dates; thus, OIG considers these recommendations resolved and open pending completion.
News Article | March 2, 2017
The Trump administration’s proposal to cut the Environmental Protection Agency is looking dramatic indeed. The plans call for laying off thousands of staff, eliminating entire programs and making deep cuts to the agency’s research office, the Office of Research and Development (ORD), according to recent reporting by The Washington Post. That’s not to say all of this will happen — or that any of it will. Congress makes the final decisions on funding the government. But it’s a stunning proposal to researchers familiar with the workings of the EPA. “I think a deep cut would be devastating to the nation’s capacity to do environmental health and ecosystem research,” said Jonathan Samet, a former chair of the agency’s Clean Air Scientific Advisory Committee who is now a professor of medicine at the University of Southern California. Samet and two other former EPA science officials — Thomas A. Burke, who served as the agency’s science adviser and headed up ORD under President Barack Obama, and Bernard Goldstein, who was EPA’s assistant administrator for research and development under President Ronald Reagan — went even further in a commentary published Wednesday, calling on President Trump to change course and stand up for the agency and science. “Evidence-based decision making on the environment should not be abandoned,” the two scientists write in a timely essay in the New England Journal of Medicine. “Reasoned action and acknowledgment of scientific truth are fundamental to democracy, public health, and economic growth. Scientific evidence does not change when the administration changes.” The researchers now all hold academic posts. They describe the EPA’s Office of Research and Development as the “preeminent environmental research organization, a cornerstone of our global leadership in environmental science, and a key player in the training of environmental health scientists.” The ORD had a budget of $521 million in 2015 with a staff of 1,755. And the Post reported Wednesday that the administration is considering a proposal to cut this office by “up to 42 percent.” There are many reasons that would be devastating, Samet said in an interview. One of them is that when environmental crises happen, like the Flint, Mich., or Deepwater Horizon disasters, you need a science infrastructure that’s ready to move. In these crises “that demand research and environmental surveillance and quickly trying to assess the toxicity of agents, the nation needs the capacity that ORD has,” Samet said. Samet and his co-authors aren’t the only academic scientists standing up for the EPA right now. Others are reacting to the first of many expected environmental rollbacks — Trump’s executive order this week directing the agency to rescind the “Waters of the U.S.” rule, which sweeps many smaller waterways under the protections of the Clean Water Act. Seven presidents of scientific organizations representing more than 200,000 members have signed a letter opposing the first of many expected environmental rollbacks: Trump’s executive order this week directing the agency to rescind the “Waters of the U.S.” rule, which would protect many small waterways. The researchers argued the rule was based on solid science when it comes to the understanding of the importance of wetlands and how they relate to larger bodies of water. The scientific societies weighing in are the Society of Wetland Scientists, the American Fisheries Society, the American Institute of Biological Sciences, the Ecological Society of America, the Phycological Society of America, the Society for Ecological Restoration, and the Society for Freshwater Science. The more Trump and his administration propose environmental rollbacks and cuts to environmental or other science funding, the more researchers can be expected to speak out. Thousands are expected to march on Washington, and around the globe, on April 22 — Earth Day.
News Article | December 13, 2016
A new report from the Environmental Protection Agency suggests that hydraulic fracturing does have the potential to affect drinking water resources in the U.S. The report represents a shift in the agency’s previous conclusions, published in a draft report in 2015, which suggested low impacts from fracking. The final report, released Tuesday, relies on a review of more than 1,200 previously cited scientific sources, as well as new research conducted for the report and an independent peer review by the EPA’s science advisory board. The report finds a range of possible impacts from fracking, from temporary changes in water quality to the complete contamination of drinking water wells. Drinking water can be affected at any stage of the fracking process, the report notes, from acquiring the water that will be used to injecting it into production wells and disposing of the wastewater afterward. Impacts are generally seen at sites close to production wells. “The value of high-quality science has never been more important in helping to guide decisions around our nation’s fragile water resources,” said Thomas Burke, EPA’s science adviser and deputy assistant administrator of the Office of Research and Development, in a statement. “EPA’s assessment provides the scientific foundation for local decision-makers, industry, and communities that are looking to protect public health and drinking water resources and make more informed decisions about hydraulic fracturing activities.” In 2015, a draft report found that fracking has caused isolated instances in which drinking water was affected, but did not bring about “widespread, systemic impacts” on drinking water. At the time, Burke added that “the number of documented impacts to drinking water resources is relatively low when compared to the number of fractured wells.” The 2015 draft was met with criticism from environmental groups. And earlier this year, the EPA’s science advisory panel issued a critique challenging the report’s conclusions. The final report includes a slightly stronger set of conclusions. It claims that fracking activities “can impact drinking water resources under some circumstances,” and notes that certain activities or conditions may make these impacts more severe. These include withdrawing water for fracking when water resources are already limited; injecting fluids directly into groundwater resources, or injecting them into wells that allow them to leak into the groundwater; failing to adequately treat wastewater before disposing of it, and dumping wastewater into unlined pits, where it can leak out. However, the report also notes that “significant data gaps and uncertainties in the available data prevented us from calculating or estimating the national frequency of impacts on drinking water resources from activities in the hydraulic fracturing water cycle.” And it adds that these uncertainties prevented the report from including “a full characterization of the severity of impacts.” In other words, the report still can’t make a detailed assessment of how often any given activity results harms water quality, or how serious the effects are on a broad scale. It also refrains from making direct policy recommendations from its scientific conclusions. The report has already met with criticism from the oil and gas industry. “It is beyond absurd for the administration to reverse course on its way out the door,” said Erik Milito, director of upstream and industry operations for the American Petroleum Institute, in a statement. “The agency has walked away from nearly a thousand sources of information from published papers, technical reports and peer reviewed scientific reports demonstrating that industry practices, industry trends, and regulatory programs protect water resources at every step of the hydraulic fracturing process.” He added that the API “look[s] forward to working with the new administration in order to instill fact-based science back into the public policy process.” While it’s unclear for now how the new report might influence public policy in the future, President-elect Donald Trump has vowed to scale back regulations that would hinder the expansion of oil and natural gas development. And his nominee to head the EPA, Oklahoma Attorney General Scott Pruitt, has fought against increased regulations on the oil and gas industry, notably joining a group of other state attorneys general suing the EPA over its proposal to curtail the methane emissions from the oil and gas sector. But the new report has been praised by environmental groups that have long argued that fracking presents a threat to the nation’s drinking water. “The EPA has confirmed what we’ve known all along: fracking can and does contaminate drinking water,” said Wenonah Hauter, executive director of Food & Water Watch, in a statement. “We are pleased that the agency has acted on the recommendations of its Science Advisory Board and chosen be frank about the inherent harms and hazards of fracking.”
News Article | March 14, 2016
A paper published March 11 in the journal Applied and Environmental Microbiology describes microbial communities found in shower hoses at a major U.S. hospital. The study documented bacteria – and related genes – using cutting-edge metagenomic techniques that allow the characterization of organisms that cannot be detected using traditional culture-based microbiology assays. Researchers from the U.S. Environmental Protection Agency and the Georgia Institute of Technology collaborated to study these biofilm communities, but can't say yet if these bacteria pose a threat to hospital patients. But because some of the genes could indicate pathogenic characteristics – such as resistance to antibiotics – the researchers want to learn more about the potential health implications, and whether other buildings house similar biofilms. Antibiotic resistance is a public health emerging priority identified by the World Health Organization, which in 2015 released a global action plan to address the problem. "We can say confidently that if pathogens are in there, they are not there in very high abundance," said Kostas Konstantinidis, an associate professor in the School of Civil and Environmental Engineering at Georgia Tech. "But the organisms that we detected as abundant in these biofilms appear to have characteristics that could be of interest because they are related to some bacteria that are opportunistic pathogens that could pose a threat, especially to immunocompromised hospital patients" The study began by culturing bacteria from 40 shower hoses removed from individual hospital rooms by EPA researchers. Nucleic acid was extracted from five of the shower hoses and processed using next-generation sequencing technology. The sequencing data was sent to Georgia Tech, where doctoral student Maria Juliana Soto-Girón matched the sequences against known bacteria – and genes that have known effects, such as virulence and antibiotic resistance. The microbiome study found an abundant population of bacteria that the researchers believe are novel "Mycobacterium-like" species not described previously, closely related to Mycobacterium rhodesiae and Mycobacterium tusciae. Traditional culture-based methods instead identified organisms affiliated with Proteobacteria – such as members of the genera Sphingomonas, Blastomonas and Porphyrobacter – as the most abundant. The biofilm communities harbored genes related to disinfectant tolerance, which constituted 2.3 percent of the total annotated proteins – and a lower abundance of virulence determinants related to colonization and evasion of the host immune system. Additionally, genes potentially conferring resistance to beta-lactam, aminoglycoside, amphenicol and quinolone antibiotics were identified. The frequency of these genes was higher than the frequency found in Lake Lanier, a natural freshwater ecosystem that has been studied by the Georgia Tech research team, suggesting that the drinking water pipe environments merit closer attention. The research grew out of an EPA research project to understand the issues of drinking water systems and building microbiomes – the collection of microbes found in such structures. While biofilms are common in building water pipes, this study generated the most metagenomic data so far for the organisms living in these water systems. Additionally, the researchers analyzed 94 partial genomes of isolated biofilm bacteria, including some that had not been reported before, though they are related to previously-characterized microorganisms. Though well-known pathogens weren't seen in abundance, the presence of genes for antibiotic resistance, resistance to water disinfectants and virulence raises concerns because bacteria can share such genes to potentially become more significant health threats. "If they have a core of genes, they may be receptive to acquiring other genes that will render these microorganisms more problematic," said Jorge Santo Domingo, a microbial ecologist with the EPA's Office of Research and Development in Cincinnati. "These organisms are very good at living in difficult environmental conditions with limited carbon sources, so fighting them could become a challenging proposition. We don't know if they constitute a problem, but we certainly want to find out." The analysis of material taken from the shower hoses is only a preliminary study, and much more research will be needed. Santo Domingo compared the findings to a "check engine" light in an automobile. The warning doesn't necessarily indicate an immediate problem, though it does show that attention – and potential action – may be required. "Some of the identified genes are the kind that we'd want to keep an eye on," he explained. "We would like to conduct more studies to gather data on the dynamics of these bacterial groups, but the fact that these genes are present indicates that more studies should be done." The potential clinical significance of the bacteria needs to studied, and any public health impacts understood, he added. Other questions include whether similar biofilms would be found in other hospitals, whether biofilms differ among facilities, how monitoring should be done – and whether shower heads and hoses should be replaced on a regular basis. The work could also provide a foundation for new research into the types of water disinfection used in hospitals. The chlorine compounds used in public drinking water may not provide sufficient protection for water supplies in these facilities. The sequencing data and bioinformatics analyses will help identify genetic markers that could be used to monitor these genes and determine their public health relevance. While Konstantinidis and his research group have been studying microbes in natural ecosystems such as Lake Lanier in Georgia, this represents their first metagenome analysis of microbial communities in the built environment. They are hopeful that the technique, which is still in the research and development stage, can help understand issues involving microbial populations and their virulence potential in buildings where humans spend most of their time. "Metagenomics gives you a more complete and quantitative picture of what microorganisms are there and how abundant they are," he said. "This shows that traditional culture methods are limited in what they can detect, and that they can often provide a biased look at what is there." Explore further: Antibiotic resistance genes are essentially everywhere More information: Maria J. Soto-Girón, et al., "Characterization of biofilms developing on hospital shower hoses and implications for nosocomial infections," (Applied and Environmental Microbiology, 2016). www.ncbi.nlm.nih.gov/pubmed/26969701
News Article | February 15, 2017
The VA Maryland Health Care System and the University of Maryland Fischell Department of Bioengineering are collaborating on a research project focused on multiple sclerosis (MS). Led by Christopher M. Jewell, PhD, an assistant professor in bioengineering, the project seeks to use nanotechnology to control the disease without compromising normal immune function that often occurs during autoimmune diseases. Ultimately the team hopes this pre-clinical research could contribute to reducing cost and burden of disease for MS patients and their families. Funded by the VA’s Office of Research and Development, Biomedical Laboratory Research and Development Service as a VA Merit Award--the first given to a University of Maryland College Park faculty member--the four-year, $1.1 million project is titled, “Tunable assembly of regulatory immune signals to promote myelin-specific tolerance.” The project will explore strategies that could control MS with a vaccine-like specificity that keeps the rest of the immune system functional. Currently, conventional treatments for MS often compromise the immune system, leaving patients vulnerable to infection. MS—for which there is no cure-- occurs when a patient’s immune system mistakenly attacks myelin in the brain, leading to slow loss of mobility over decades. “We are thrilled that Dr. Jewell will be joining the VA Maryland Research and Development Service,” said Thomas Hornyak, MD, PhD, associate chief staff for Research and Development at the VA Maryland Health Care System. “His study merges immunology, bioengineering, and chemistry, and presents an exciting new direction for biomedical research at our facility,” he added. Importantly, several pre-clinical reports and clinical trials have investigated the idea that co-administration of myelin peptide and tolerizing immune signals to lymph node tissues that coordinate immune response can promote the development of regulatory T cells (TREGS) that ameliorate disease. “This research will study a new idea to promote TREGS that control disease and importantly, test the idea in both pre-clinical models and in samples from human MS patients,” said Jewell, who will soon be a part of the VA Maryland Health Care System’s Research and Development Service. “One of the most exciting aspects is our multidisciplinary team that brings together engineers, clinicians, and immunologists from the VA, the University of Maryland College Park, and the University of Maryland, Baltimore. This will allow us to design new materials and test them in both pre-clinical models, and in samples from human MS patients. We hope the project will shed new light on some of the mechanisms of autoimmunity, and contribute to more specific and long-lasting treatment options for veterans that also reduce the financial burden on veterans and their families," he added. Thus, this research project could lead to permanent improvements for MS patients, improvements that could greatly reduce health care costs for them and their families. “This latest collaborative effort to advance multiple sclerosis research demonstrates how critical it is that engineers work together with fellow scientists and clinicians to create solutions to today’s most pressing health challenges,” said Darryll J. Pines, dean of the University of Maryland A. James Clark School of Engineering. The project also fosters interdisciplinary collaborations between other team members, including Dr. Walter Royal, MD, at the VA Multiple Sclerosis Center of Excellence located at the Baltimore VA Medical Center and with Dr. Jonathan Bromberg, MD/PhD, at the University of Maryland Medical School in Baltimore. “The potential outcomes of this research can bring lasting improvements to lives of veterans struggling with MS and to their families, who often serve as caregivers," said Dr. Adam Robinson, director of the VA Maryland Health Care System. “MS is a debilitating disease over time, and we’re excited that Dr. Jewell and his team are pushing forward with a project that can positively impact large numbers of veterans.” In collaboration with an array of academic centers such as University of Maryland, College Park and the University of Maryland School of Medicine, the VA Maryland Health Care System conducts a range of science and medical research projects, from basic science to clinical and rehabilitative medicine, totaling about $27 million annually. The VA Maryland Health Care System (VAMHCS) provides a broad spectrum of medical, surgical, rehabilitative, mental health and outpatient care to veterans at two medical centers, one rehabilitation & extended care center and five outpatient clinics located throughout the state. More than 52,000 veterans from various generations receive care from VAMHCS annually. Nationally recognized for its state-of-the-art technology and quality patient care, VAMHCS is proud of its reputation as a leader in veterans’ health care, research and education. It costs nothing for Veterans to enroll for health care with the VA Maryland Health Care System and it could be one of the more important things a Veteran can do. For information about VA health care eligibility and enrollment or how to apply for a VA medical care hardship to avoid future copayments for VA health care, interested Veterans are urged to call the Enrollment Center for the VA Maryland Health Care System, Monday through Friday, from 8 a.m. to 4:30 p.m. at 1-800-463-6295, ext. 7324 or visit http://www.maryland.va.gov.
News Article | March 2, 2017
In case there was any question whether President Trump’s administration has put a bull’s eye on the Environmental Protection Agency, the White House’s proposed budget cuts at the agency leave little doubt. Plans reviewed by The Washington Post this week outline a wish list for cutting the agency’s staff by one-fifth and eliminating dozens of programs entirely. But Thursday morning, new EPA Administrator Scott Pruitt — himself a longtime agency critic who has made clear he intends to scale back the EPA’s reach — told a group of mayors from around the country that he intends to defend at least some pieces of the EPA. “Superfund is an area that is absolutely essential,” Pruitt told a gathering of the U.S. Conference of Mayors at the Capital Hilton. “The brownfields program, as well.” EPA’s Superfund program, which has been around since 1980, is responsible for managing the cleanup of some of the country’s most contaminated hazardous waste sites, as well as responding to significant environmental emergencies. There are more than 1,300 Superfund sites around the country, and most past cleanups have been paid for by the parties responsible for polluting. The brownfields program, which began in 1995, involves EPA grants for communities to help clean up and redevelop abandoned industrial sites. The programs historically have been considered successes and are popular around the country among lawmakers and their constituents. The White House budget proposal this week, however, would shrink EPA grants to states by 30 percent and potentially cut the brownfields funding altogether. “There’s a brownfields in every congressional district,” Chris Bollwage, the mayor of Elizabeth, N.J., told Pruitt on Thursday. “It’s a program that’s worked really well in my city and throughout the nation.” “It’s a tremendous success,” Pruitt agreed, urging the mayors to send him details of where the program has worked best. “I want to hear from you about those successes. I want to be able to share those with the White House. … We need stories. We need illustrations about how important the brownfields program is to creating jobs and the environmental benefits that have been achieved.” Pruitt also said Thursday that he intends to advocate for water infrastructure funding as part of a broader infrastructure push by the Trump administration. “We know when it goes wrong, it goes wrong badly,” Pruitt said, in an apparent reference to the Flint, Mich., water crisis. “We have a water infrastructure issue right now across this country. It’s not just roads and bridges.” He said he planned to bring up the need for water infrastructure investment at a White House meeting Thursday afternoon. Pruitt did not address the wave of other deep cuts proposed at the agency. The White House’s initial proposal would reduce the agency’s staff by one-fifth in the first year — from 15,000 to 12,000 — and would slash the EPA’s budget from $8.2 billion a year to $6.1 billion. Grants to states, as well as the agency’s air and water programs, would be cut by nearly a third. The massive Chesapeake Bay cleanup project would receive only $5 million in the next fiscal year, down from its current $73 million. The agency’s Office of Research and Development could lose up to 42 percent of its budget. EPA’s environmental justice program could vanish. In total, 38 separate programs would be eliminated entirely. The blueprint preserves support for “greenhouse gas reporting, accounting and basic analytic capabilities, but substantially reduces funding for regulatory and voluntary climate change mitigation programs.” As a result, that climate program drops 70 percent, from $95.3 million to $29.2 million. Former EPA Administrator Gina McCarthy said in an interview Thursday that Pruitt’s support for the Superfund and brownfields programs are not surprising, given their widespread support around the country. “They’re clearly some of the most popular programs that we’d fully expect Congress would want to fund,” she said. But she remains troubled by some of the other severe cuts that the Trump administration seems intent on making at the agency. “The budget proposal that I’ve been reading about is much more extreme than, in fact, I ever thought it would be,” she said. “It’s such a frontal attack on the people in that agency and, in particular, on the scientists. Congress, of course, would have to approve any such cuts, some of which are deeply unpopular among lawmakers. But there is little doubt about Trump’s disdain for much of the agency’s work. As a candidate, he vowed to eliminate the EPA “in almost every form,” leaving only “little tidbits” intact. As Oklahoma attorney general since 2010, Pruitt also has been a key EPA adversary, suing the agency more than a dozen times to challenge its legal authority to regulate such things as mercury pollution, smog and carbon emissions from power plants. Pruitt to EPA employees: ‘We don’t have to choose’ between jobs and the environment Scott Pruitt, longtime adversary of EPA, confirmed to lead the agency On eve of confirmation vote, judge orders EPA nominee to release thousands
News Article | February 22, 2017
DURHAM, N.C. -- It may seem obvious, but the key to confirming whether someone is suffering from a cold or flu virus might lie at the misery's source -- the inflamed passages of the nose and throat. Duke Health scientists have identified a group of proteins that, when detected in specific quantities in the mucous, are 86 percent accurate in confirming the infection is from a cold or flu virus, according to a small, proof-of-concept trial published online in the journal EBioMedicine. The researchers hope their initial work identifying the protein signature could aid the development of a quick, noninvasive doctor's office test to determine the cause of upper respiratory illness and appropriate treatment. "Every day, people are taking time off from work, going to emergency rooms, urgent care or their primary care doctors with symptoms of an upper respiratory infection," said Geoffrey S. Ginsburg, M.D., Ph.D., a senior author of the paper and director of the Duke Center for Applied Genomics & Precision Medicine (DCAGPM), which led the study. "Looking for these proteins could be a relatively easy and inexpensive way of learning if a person has a viral infection, and if not, whether the use of antibiotics is appropriate." Although upper respiratory infections are among the most common reasons people visit the doctor in the U.S., health care providers lack tools to distinguish between a bacterial infection that might warrant antibiotics and a viral infection that would instead call for symptom relief. Widespread use of antibiotics for upper respiratory infections don't benefit patients with viral illness and can contribute to antibiotic-resistant superbugs, Ginsburg said. More precise diagnoses of these infections could be another tool to curb the development of superbugs, he said. For the trial, researchers infected 88 healthy adult volunteers with a common strain of cold or flu virus. Some participants didn't get sick. Among those who developed infections, researchers found a distinct set of 25 proteins in fluid samples they gathered by flushing about 2 teaspoons of saline through the participant's nasal passages. Duke researchers in genomics and precision medicine have spent the past decade exploring strategies for differentiating bacterial and viral infections with the goal of developing cost-effective diagnostic tools doctors could use in their offices. "In the past, science has focused on identifying the pathogen someone is infected with in the blood or other sample," said lead author Thomas Burke, Ph.D., director of technology advancement and diagnostics at the DCAGPM. "Our approach flips the paradigm of how we look for infection. Instead of looking for the pathogen, we study the individual's response to that pathogen and signature patterns in their genes, proteins, metabolites and other biomarkers." The Duke team has previously explored blood tests to examine a patient's RNA for gene signatures to distinguish bacterial and viral infections in the upper respiratory tract and is working with a private company to develop potential diagnostics. Analyzing proteins in mucous is a less invasive approach and requires less processing than blood samples. The researchers hope additional studies verify the initial results and lead to the development of a paper-based test that could be used in doctor's offices or even at home to determine whether a doctor's visit is necessary, said Christopher Woods, M.D., a senior author and associate director of applied genomics at the DCAGPM. "The protein targets offer a faster, more cost-effective model for rapid screening and diagnoses of viral infections," Woods said. "If the data are verified, the model could be valuable in many circumstances, such as rural settings or developing countries with less convenient access to health care, or even as an airport screening tool during an outbreak of a particularly threatening strain of flu." In addition to Ginsburg, Woods and Burke, study authors included Ricardo Henao; Erik Soderblom; Ephraim L. Tsalik; J. Will Thompson; Micah T. McClain; Marshall Nichols; Bradly P. Nicholson; Timothy Veldman; Joseph E. Lucas; M. Arthur Moseley; Ronald B. Turner; Robert Lambkin-Williams; and Alfred O. Hero III. The research was supported by the U.S. Defense Advanced Research Projects Agency (N66001-07-C-2024) and the Clinical Science Research and Development Service of the Veterans Affairs Office of Research and Development (1IK2CX000530, 1IK2CX000611). The authors disclosed no potential conflicts of interest.