October 02, 2020, NIH Record, Vol. LXXII, No. 20

October 2, 2020 Vol. LXXII, No. 20

has put a real time-consuming—structure” that governed focus on the how the world came to know about a novel inadequacies coronavirus that was first publicly reported TRACKING ‘DIGITAL EXHAUST’ of public on Dec. 30, 2019, when 7 patients in Wuhan, health data China, came down with a mysterious illness? Digital Disease Detection collection.” Early reports were linear and slow, Needs Boost, Brownstein Says Brownstein arising from the public, to health care BY RICH MCMANUS offered a workers, to laboratories, to ministries of whirlwind health (such as the CDC) and finally to The current global coronavirus pandemic overview of world bodies such as the WHO. is going to be a poster child for all sorts how digital “Our view is that all stakeholders in public of future public health preparation, but disease health should have access immediately,” perhaps nowhere more actionably than detection can said Brownstein. Monitoring public health in real-time surveillance of an infectious be improved at threats should be as obvious and simple as disease as it explodes across the world. the National whipping out your smartphone to check the “Every domain except health care has Library of weather, he said. data—shopping, travel, news, entertainment, Dr. John Brownstein Medicine/ “Why this doesn’t happen in public health learning—that helps with our decision-mak- Medical baffles us, right?” he continued. “A National ing,” said Dr. John S. Brownstein, professor Library Association’s annual Joseph Leiter Weather Service for disease outbreaks is of biomedical informatics at Harvard Lecture on Aug. 11. something people keep talking about. But Medical School and chief innovation officer “What data streams,” he asked, “can we we lack the underlying data sets, we lack at Boston Children’s Hospital. “Covid-19 tap into that unwind the hierarchical—and SEE BROWNSTEIN, PAGE 4

WHAT HAPPENS IN VAGUS Burgess Illuminates Light’s Experts Expound on Role in Health Interoceptive Processes BY ELLEN O’DONNELL BY DANA TALESNIK Many of us have Feeling thirsty or tired? With every breath, been spending heartbeat and hunger pang, there’s a vast, more time inside intricate maze of neural circuits commu- during the nicating these Covid-19 public signals and sen- health emergency, Tonnage of dunnage on CC roof; see story, p. 7. sations between and one of the your organs impacts is less ALSO THIS ISSUE and your brain. exposure to light. CC Offers Asymptomatic Testing for SARS- Research into In a virtual lecture CoV-2 to NIH Staff...... 3 these pathways titled “Lighting Up Our Lives: How D’Souza Selected as Next NIDCR Director. . .5 and how they can be modulated Light Influences Big Doings Behind, Atop the Clinical Center. .7 by different Our Physical and Dr. Helen Burgess Upcoming Talks Feature Women in Science. .9 practices and Mental Health,” Dr. Helen Burgess recently explored this topic. Digest...... 10 techniques— from yoga The event was part of NCCIH’s Integrative Milestones...... 11 to electrical Medicine Research Lecture Series. Foil the Flu!...... 12 stimulation—can Dr. Eleni Frangos Burgess is professor of psychiatry and SEE INTEROCEPTION, PAGE 6 SEE BURGESS, PAGE 8 BRIEFS

2020 NIH Director’s Awards Now Online This annual series highlights the achievements of Fauci Receives 2020 Lienhard Award An NIH Director’s Award is the most prestigious NIGMS’s early career grantees. It is designed to The National Academy of Medicine has named non-monetary award at NIH to recognize the introduce students to cutting-edge research and NIAID director Dr. Anthony Fauci as the recip- outstanding achievements of all institutes, centers inspire them to pursue careers in the biomedical ient of the 2020 Gustav O. Lienhard Award for and offices. Each nomination undergoes a rigorous sciences. Advancement of Health Care. review process that includes each institute/ NIH trainees are encouraged to watch via Zoom center director, the NIH awards review committee Fauci is honored for his role as a leader of federal and participate in the live Q&A. For more details, research and and selection by the NIH director for special visit https://www.nigms.nih.gov/News/meetings/ recognition. policy on infectious Pages/2020-nigms-directors-early-career- diseases and, in Historically, the in-person ceremony provided an investigator-lecture.aspx. particular, for his opportunity to showcase stellar service in the areas deft, scientifically of research, administration, technical and clerical Segre Set for Roberts Lecture, Nov. 3 grounded leadership support, mentorship, clinical care, Commissioned NHGRI senior investigator and Translational in shaping an effec- Corps, work/life and well-being and equity, and Functional tive response to the diversity and inclusion. This year, the remarkable Genomics Covid-19 pandemic. accomplishments of 660 NIH staff from the 2019 Branch chief Dr. The award will be calendar year are presented in a virtual format. The Julie Segre will presented at NAM’s site https://go.usa.gov/xGm6k was developed in present “Human annual meeting, held partnership with IC leadership across NIH. Microbiome: virtually for the first time ever, on Oct. 19. Nominations for the NIH Director’s Award are Friend and Foe,” accepted from late fall through mid-winter and the 2020 Anita B. Fauci is the 35th Roberts Lecture, should be based on accomplishments fulfilled recipient of the Dr. Anthony Fauci during the last full calendar year (January– on Tuesday, Nov. Lienhard Award. December). Any NIH employee with familiarity 3 from 12:30 to Given annually, the of the work performed either by an individual or 2 p.m. award recognizes outstanding national achieve- group can nominate. Nominations for the 2021 Segre’s research ment in improving personal health care in the NIH Director’s Awards will open soon and must be integrates United States. entered through the electronic honorary awards high-throughput and ranking system at https://go.usa.gov/xGm6Q. The Lienhard Award is funded by an endowment sequencing, from the Robert Wood Johnson Foundation. Dr. Email [email protected] for more information algorithm devel- Gustav O. Lienhard was chair of the foundation’s on the nomination process. opment and Dr. Julie Segre board of trustees from the organization’s establish- clinical studies ment in 1971 to his retirement in 1986. to explore the 5th NIGMS Early Career Investigator microbe diversity of human skin in both healthy and Lecture, Oct. 14 disease states. Her team established the first topo- 2020 Anti-Harassment Training Launched Dr. Michael D. L. Johnson, an assistant professor in graphical maps of human skin bacterial and fungal Online, Must Be Taken by Dec. 14 the department of immunology at the University diversity, enabling the study of alternations in those As part of its continued commitment to achieving of Arizona, will give the NIGMS Director’s Early populations that are associated with eczema and a harassment-free work environment, NIH recently Career Investigator Lecture on Wednesday, Oct. 14 other microbial-associated infections. launched the 2020 anti-harassment training. The at 1 p.m. via Zoom goals are to educate individuals in the workplace and NIH videocast. Segre’s laboratory also integrates genomic tools to to prevent harassment; raise awareness of what The lecture is track hospital-acquired infections, model out- constitutes harassment and the consequences of open to everyone breaks, monitor evolution of antibiotic resistance harassing behavior; and stamp out instances where in the scientific and develop risk assessment strategies. harassing behavior may exist. The online training community. She is a fellow of the American Academy of is mandatory and replaces the No FEAR and Prevention of Sexual Harassment (POSH) training. During his talk, Microbiology and the National Academy of titled “Microbes, Medicine and she received the Service to America All NIH federal employees, trainees, fellows and Metals, Music Medal in 2013. contractors are required to take the training annu- and Lessons in Segre is also an outstanding mentor and currently ally. The 2020 training must be completed by Dec. Disproving Your serves as a member of the NIH woman scientist 14. New hires must complete it within 90 days of Hypothesis,” executive committee. onboarding. Failure to comply with the training will Johnson will result in disablement of a person’s active directory describe his The seminar series is dedicated to the memory accounts until the requirement is met. Anyone research on how of Dr. Anita B. Roberts, former chief of NCI’s whose active directory account is disabled will be bacteria maintain Laboratory of Cell Regulation and Carcinogenesis. unable to sign into their computer or access emails. Dr. Michael D. L. Johnson homeostasis Lectures highlight outstanding research achieve- To learn more about EEO mandatory training, PHOTO: MARI CLEVEN within the metal ments of women scientists in the NIH Intramural milieu. He hopes Research Program. The virtual talk will be available visit the Office of Equity, Diversity and Inclusion that understanding how bacteria interact with via NIH videocast at https://videocast.nih.gov/ website at https://www.edi.nih.gov/training/ metals during infections will identify novel thera- watch=37780. mandatory-training. peutic strategies against bacterial infection. To arrange sign language interpretation, contact After a 30-minute lecture, Johnson will answer Joy Jackson Farrar or Dee Andrews at jacksjoy@ questions from participants about his research and ors.od.nih.gov or [email protected]. career path.

2 • NIH RECORD • OCTOBER 2, 2020 transmission from staff to patients.” The to prevent the spread of Covid-19. Staff CC Offers Asymptomatic CC has also helped to develop testing stay at least 6 feet away from each other, Testing for SARS-CoV-2 to programs for staff at NIEHS in Research wash their hands often, don’t attend large NIH Staff Triangle Park, N.C., NIDA and NIA in meetings and stay home if they are sick. Baltimore, NIAID in Hamilton, Mont., and All patients and visitors are screened for BY ERIC BOCK NIDDK in Phoenix, Ariz. symptoms at the hospital entrance. The Clinical Center is now offering asymp- Testing for SARS-CoV-2 involves a tra- “From our perspective, not enough staff tomatic testing for SARS-CoV-2 to all staff, ditional nasopharyngeal swab, which looks are volunteering to get tested. We really want including those who are not yet eligible like a 6-inch Q-tip. The swab is inserted more people to take advantage,” Gilman to return to their physical workspaces. through the nose to the back of the throat, concluded. “We encourage staff to get tested every week.” Although the  program is To sign up for asymptomatic testing voluntary, “From our perspective, not for SARS-CoV-2, NIH’ers can visit https:// employees clinweb.cc.nih.gov/cct. Those who sign up are strongly enough staff are volunteering must go in either the CC’s north or south encouraged to to get tested. We really entrance. Upon entry, staff will be tempera- participate. want more people to take ture-screened and given a surgical mask, “The main which must be worn at all times. They should purpose of advantage. We encourage then proceed directly to the 5th floor atrium the testing staff to get tested area to check in for the test. program is every week.” surveillance,” ~DR. JAMES GILMAN said CC CEO Dr. James  Gilman. “With surveillance, Dr. James Gilman rotated several times and left in place for the more you 10-15 seconds. test, the more “Psychologically, having your mid-turbi- data you have and can figure out what’s going nate area swabbed seems to bother people,” on in the hospital.” said Gilman, who gets tested weekly. The CC’s department of laboratory To increase participation, the CC now medicine has the capacity to conduct 5,000 offers Covid-19 saliva tests. “We hope that ON THE COVER: Tissue Chip in Space. An example of tests per week but is currently conducting will increase the acceptance of testing, which a tissue chip—research supported by NCATS. only 1,000 to 2,000 per week. Most CC staff will increase the number of people who get IMAGE: JOSH VALCARCEL, NASA have been tested, on average, 3 times over tested and the frequency with which people The NIH Record the past few months. are willing to get tested,” he added. “We have a lot of unused capacity,” In addition to surveillance testing, the CC Since 1949, the NIH Record has been published biweekly by the Editorial Operations Branch, Gilman said. has taken other infection control measures Office of Communications and Public Liaison, As the CC gets busier and accepts National Institutes of Health, Department of Health more patients, testing helps to and Human Services. For editorial policies, email editor or phone (301) 496-2125. ensure the safety of both patients Editor: Rich McManus and staff. Patients don’t have to [email protected] worry about contracting a virus after Associate Editor: Carla Garnett they’re admitted to the hospital. [email protected] Staff don’t have to worry about Staff Writers: getting sick at work. Eric Bock • [email protected] Asymptomatic testing helps Dana Talesnik • [email protected] identify people who have Covid-19 Subscribe via email: Follow: [email protected] http://nihrecord.nih.gov/ but aren’t presenting symptoms. “If Facebook “f” Logo CMYK / .eps Facebook “f” Logo CMYK / .eps we find people who are infected and The NIH Record send them home, we decrease the is recyclable as mixed paper. likelihood they will infect someone This image depicts a test tube with viral transport media else,” Gilman said. that contains a patient’s sample to be tested for the Since the testing program began presence of SARS-CoV-2, the virus that causes Covid-19. in late May, he noted, “We’ve had PHOTO: CDC/JAMES GATHANY no incidents to date of Covid-19

NIH RECORD • OCTOBER 2, 2020 • 3 Brownstein to develop a global human CONTINUED FROM PAGE 1 movement typology that can access to APIs [Application Programming track the spread of disease,” Interfaces, a software system that allows two said Brownstein. applications to talk to each other], there is no † Crowdsourcing, or ecosystem of tools that you can turn to.” “putting the public back It’s not that the clues aren’t everywhere, in public health,” on sites it’s that no one’s aggregating them, he argued. such as Flu Near You, where “People move through the world and they 100,000 users report weekly have a ‘digital exhaust,’” said Brownstein. on their symptoms. “They search online, they tweet, they use † Covid Near You—a their Fitbit. There is a subset of your digital collaboration with Amazon, exhaust that is health-related. We need to Google, Apple and others— tap into that data, at scale. If you aggregate it, has already been deployed Brownstein speaks virtually to NIH audience. you can get amazing insights about popula- in the U.S., Canada and tion-level events.” Mexico, attracting more than Fifteen years ago, Brownstein and others † In 2016, Zika virus expansion was 1 million users in the U.S. alone. A symp- envisioned such an early alert system. Using tracked by digital sleuths. tom-based tracker, it has been “incredibly funds from NLM, they created HealthMap, The technology is not foolproof. “We effective at identifying [pathogen] emer- with the goal of tapping into the huge troves found that tracking flu through Google gence in populations, determining age-based of online data. search query data did a poor job on H1N1,” attack rates, etc.,” said Brownstein. There are The effort now includes 171 public and Brownstein reported. However, “Wikipedia plans to merge the flu and covid versions. private sources, 15 languages and more than is incredibly valuable in tracking influenza, † EpiCore, already in use for Covid-19, 200,000 websites. just by counting the page views seeking flu which taps into a network of experts. “It can tease out important events,” said data.” “Essentially, it’s a Bat Phone for epidemi- Brownstein, “but we need to structure the Other unexpected klaxons of public ologists—an information exchange,” said massive noise of data.” Two common tools health issues include: Brownstein. “It pushes information to for modern librarians—natural language † Open Table, the online reservation stakeholders like WHO and the CDC.” processing and machine-learning—“help tag system “has been valuable in Covid-19,” † Health care chat boxes. “This is the next the information churned through daily on said Brownstein. The availability of table iteration of patient-engagement tools,” said HealthMap. This is how the WHO learned reservations is a predictor of flu-like illness; Brownstein. The Symptom Checker, for of the alarming spread of Covid-19, along cancellations are an indicator of social example, is a self-assessment questionnaire. with ProMED [the Program for Monitoring disruption. “These tools are providing an incredible Emerging Diseases, run by the International † Yelp reviews. Brownstein said that level of diagnostic accuracy, as well as triage Society for Infectious Diseases].” about 10 percent of all Yelp reviews relate accuracy—shifting care to the right place, anywhere from the ER to a telemedicine Sites in place before covid to food-poisoning. “That’s an incredibly valuable health care source.” visit…It also helps with surveillance. There’s These tracking sites were in place well † Through a partnership with Twitter, been massive growth in these tools as covid before Covid-19. Examples of their utility Brownstein and colleagues found that has emerged.” include: “many people, surprisingly, tweet about New platforms include Alexa, the † Detection of H1N1 (swine flu) in 2009 in their diarrhea and food-related issues. We voice-activated search tool. “If you’re using Veracruz, Mexico, which enabled authorities captured that information online from them in your consumer life, you can use to track the spread from country to country. millions of posts and built a tool for public them in health care as well,” Brownstein said. † Five years later, the same technology health. We created a social media dashboard Other online platforms include KidsMD, identified H7N9 flu in China. Brownstein for public health, to discuss food-poison- to quickly determine the level of care a suggested that parsing of data from Facebook ing data…There was a huge number of patient needs, and Flu Doctor, which is also and Twitter could be the next step in bolster- foodborne illness searches in the wake of applicable to covid; it is expected to help ing digital epidemiology. Hurricane Harvey.” with vaccine effectiveness and side-effect † Bots knew that Ebola was coming in reporting, and help counter misinformation. West Africa in 2014. “Access to [airline] More traditional platforms With the coronavirus pandemic, passenger data out of West Africa could Platforms that are more traditional in Brownstein said his team has been “heads- enable rapid threat assessment—where is structure and intent include: down for the last half year.” They are using the disease going next?” said Brownstein. † Google Mobility Project, which collects data-mining tools to track spread, but are His team built a zoonotic niche map to label data from 300 million users from 243 coun- limited by scans of news and social media. high-risk environments where Ebola might tries/territories, representing 65 percent But what began as a small volunteer effort flourish. of Earth’s habitable surface. “The goal is in January has now become a massive

4 • NIH RECORD • OCTOBER 2, 2020 enterprise. “We’ve built a global repository of cases, LONGTIME NIH PROPONENT with many partners around the world D’Souza Selected as Next [including Baidu, the Chinese version of NIDCR Director Google]. We used it to measure the impact of the lockdown in China. It proved that On Aug. 13, NIH director Dr. Francis Collins announced that he selected Dr. Rena N. lockdowns are effective.” D’Souza as next director of the National Institute of Dental and Craniofacial Research. New tools and tricks A licensed dentist, D’Souza is currently assistant vice president for academic affairs and education for health sciences at the University of Utah, Salt Lake City. There she The big new tool is Global.health, which also serves as a professor of dentistry, the Ole and Marty Jensen chair of the School of launched this summer. Although built Dentistry and professor of neurobiology and anatomy, pathology and surgery in the as a Covid-19 data science initiative, it is School of Medicine and the department of bio- expected to be a boon in future pandemics. medical engineering. She is expected to begin A collaboration between Google and a wide her new role as NIDCR director later this year. range of institutions, it will make public “Dr. D’Souza is renowned for her research health data freely available in real time. in craniofacial development, genetics, Even satellite data—photos taken from tooth development and regenerative dental space—has a public health application. By medicine,” said Collins. “She has worked as comparing images of parking lot usage at a proponent for NIH for decades, serving on hospitals in Wuhan taken a year before the critical advisory committees and as an expert outbreak, an uptick could be found last fall, consultant on multiple projects.” indicating more visits, more need for care. D’Souza will oversee the institute’s annual Parking lot photos have helped predict budget of more than $475 million, which flu season in Venezuela, too, reported supports basic, translational and clinical Brownstein. research in areas of oral cancer, orofacial pain, A partnership with the popular survey tooth decay, periodontal disease, salivary software SurveyMonkey, offered as an option gland dysfunction, craniofacial development for those doing other kinds of surveys, and disorders and the oral complications of showed Brownstein and his team that systemic diseases. “half of the people we surveyed in the U.S. D’Souza’s research focuses on develop- Dr. Rena N. D’Souza wouldn’t get a vaccine as soon as it became mental biology and genetics; matrix biology; PHOTO: UNIVERSITY OF UTAH available; 1 in 8 would not want to get it ever. biomaterials, tissue engineering and stem Those age 75 and older are the most eager to cells; and clinical research. Her group’s get it right away, without hesitation.” discovery that a novel mutation in PAX9 was responsible for a severe form of human The researchers also surveyed tooth agenesis opened a new field of research to discover genes and mutations as well mask-wearing, an important avenue to as therapies for common human inherited disorders of the craniofacial complex. The lowering R-naught, or the reproductive finding, published inNature Genetics, was highlighted in the Jan. 25, 2000, issue of the number, a measure of virus transmission. At NIH Record (p. 3 of https://nihrecord.nih.gov/sites/recordNIH/files/pdf/2000/NIH- least half the people in a population need to Record-2000-01-25.pdf). be masked to budge the number toward viral She was selected to be the inaugural dean of the University of Utah’s School of extinction. Dentistry, which was established in 2012. She is currently the elected chair in the Aware that Covid-19 has dispropor- dentistry and oral health sciences section and elected as a fellow of the American tionately ravaged minority communities, Association for the Advancement of Science. She also is a former president of the Brownstein’s team is also tracking access to American Association for Dental Research and the International Association for testing, including travel time to the nearest Dental Research, a fellow of the American College of Dentists and the recipient of testing center. They will apply Vaccine the 2017 American Association for Dental Research Irwin D. Mandel Distinguished Finder, a tool begun for H1N1 flu, to Covid-19, Mentoring Award. D’Souza served on the advisory committee to the NIH director to make testing more convenient. in 2013-2014, and on NIH study sections. She is a devoted mentor and champion The Joseph Leiter NLM/MLA of diversity in the biomedical research workforce. Since 1985, she has served as a Lectureship was established in 1983. volunteer dentist for women in need and people struggling with homelessness in Salt Brownstein’s full, and rather dizzying, Lake City, Dallas and Houston. version is available at https://videocast.nih. D’Souza received her bachelor’s degree in dental surgery from the University of gov/watch=38269. Bombay, India, after which she completed her general practice residency. She earned her D.D.S., Ph.D. and master’s degree in pathology/biomedical sciences from the University of Texas Health Science Center in Houston.

NIH RECORD • OCTOBER 2, 2020 • 5 Interoception “These 3 were the CONTINUED FROM PAGE 1 only scales out of 19 different physiological improve physical and emotional well-being. questionnaires that Breathing, heartbeat, cravings, fatigue, were able to predict even pain: these internal processes are part treatment outcomes,” of a mind-body connection called intero- said Mehling. ception, which encompasses our ability to Another way to sense and regulate signals from inside our probe interoception is bodies. Sometimes, we’re not even aware to modulate intero- they’re happening. ceptive pathways via “Importantly, these processes of the vagus nerve, the sensing, interpreting and integrating longest cranial nerve, include both conscious and unconscious which travels from phenomena, factors and mechanisms,” the digestive tract to explained NCCIH director Dr. Helene the brain. Dr. Eleni Langevin during introductory remarks at a Frangos, an NCCIH recent NCCIH virtual webinar. postdoctoral fellow, focused on afferent Focusing on the conscious aspects, Dr. Speakers at the NCCIH event included Dr. Wolf Mehling of UCSF and Dr. Wolf Mehling, professor of clinical family pathways, neural Jeanie Park of Emory. and community medicine, University of circuits ascending California, San Francisco, said numerous from a sense organ toward the brain or spinal used in patients with treatment-resistant studies have shown that mindful attention cord, or between brain regions. depression and epilepsy and has shown toward physical sensations from inside the Studies have shown that focusing on promise in decreasing pain sensation. body changes brain rhythms. He discussed sensations arising from our organs activates “There is plenty of evidence that suggests ways to measure interoceptive awareness— the insula, and these interoceptive signals vagal stimulation modulates affect [or mood] how we perceive, sense and respond to the converge and integrate with emotional and and so much so that it’s an FDA-approved inner workings of our bodies—and how this cognitive networks across the brain. This treatment option for refractory depression,” can be modified with mind-body approaches. complex web of interoceptive awareness said Frangos. “There’s also evidence that Mehling led an NCCIH-supported team has been confirmed in numerous studies, it’s beneficial for other treatment-resistant in developing the MAIA scale (multidi- including heartbeat and breathing disorders like OCD, panic disorder and mensional assessment of interoceptive detection tests. post-traumatic stress disorder [PTSD],” for awareness), a set of questionnaire scales Electrical stimulation of the vagus nerve up to 4 years after implantation. related to self-perception. Physiological tests can activate multiple brain regions that Newer noninvasive tools can access are important, he said, “but we also should are involved in interoception. An invasive vagal afferent nerve fibers with a handheld use questionnaires because they’re able to approach involving implanting electrodes, device used externally on the neck or ear. differentiate the [various] dimensions of vagus nerve stimulation (VNS) has been Preliminary research shows beneficial interoception.” effects in some patients with major depres- One key MAIA scale is sion and anxiety; improvements in memory, self-regulation, the ability to learning and reaction time; and reductions in regulate distress by paying headache pain, said Frangos. attention to body sensations, While stimulation of the vagus nerve such as our breathing. may reduce pain, so too can mindfulness. Mehling cited studies using “Taking someone’s attention away from meditation, yoga and tai a painful stimulus will decrease pain chi—incorporating breath perception, and these psychological awareness—that resulted in factors influence pain perception,” she reduced pain, fatigue, anxiety said. “Manipulating emotion affects pain and depression. unpleasantness, while manipulating In a study of patients attention affects pain intensity.” suffering from chronic For the descending (efferent) neural low-back pain, three pathways that wind down from the brain elements on the MAIA scale to innervate organs and tissues throughout proved particularly useful: the body, there are various ways to measure this nerve activity. Reliable measurements emotion awareness, self-reg- NCCIH’s Frangos speaks virtually during the seminar. ulation and body-listening. are important, explained Dr. Jeanie Park,

6 • NIH RECORD • OCTOBER 2, 2020 associate professor, Emory University TONNAGE OF DUNNAGE School of Medicine. Chronic overactivity of this efferent sympathetic nervous system Big Doings Behind, Atop the Clinical Center can have serious consequences leading to As part of E-wing renovation at the Clinical Center, a 600-ton crane was used to hoist steel to high blood pressure, heart failure or kidney the roof of Bldg. 10 during the last two weekends of August. disease. The steel, known as dunnage, was used to support rooftop mechanical/plumbing items “Microneurography is the gold standard such as exhaust ductwork stacks and fans, energy recovery units, piping, framing, air-cooled method by which we can measure and chillers and an air-handling unit. quantify sympathetic activity directly, in The project was coordinated by Jeanne Keegan of the Division of Design and Construction real-time, from awake humans,” said Park. Management, Office of Research Facilities. Developed 50 years ago, the technique involves inserting a microelectrode into a peripheral nerve to record sympathetic nerve activity directed to the blood vessels that supply the muscle (i.e., muscle sympathetic nerve activity). This technique offers insights into the effects of modulating interoceptive pathways on the sympathetic nervous system. “Not only can we use microneurography to characterize baseline resting differences between different patient groups,” said Park, “but we can also study the reactivity of the sympathetic nervous system to stress.” For example, muscle sympathetic activity tends to be elevated in response to stress in veterans with PTSD. “This is important,” she said, “because exaggerated sympathetic reactivity is associated with increased risk of hypertension and cardiovascular disease.” Using a biofeedback device, slow breath- At left, a 600-ton crane lifts dunnage steel to the Bldg. 10 roof. The crane worked for two full weekends and at night in order to provide a safe environment for occupants. At right, the crane parts had just ing—5 or 6 breaths per minute—strikingly been assembled and the crane is being prepared to hoist material to the roof. lowered the veterans’ muscle sympathetic nerve activity and blood pressure. The mechanisms may include unconscious components (such as activation of baroreceptors, nerve endings sensitive to changes in blood pressure) and a conscious component, such as increased breathing awareness. Vagus nerve stimulation also inhibits sympathetic nerve activity. A new paper recently reported the first successful vagus nerve recordings using microneurography, showing the nerve can be directly accessed and recorded from awake humans. Said Park, “It really opens up a lot of new, exciting opportunities to study both afferent and efferent vagus nerve activity.” Further study into interoceptive pathways and how to manipulate them can lead to effective new therapies and preventive strategies. There are potential applications across medicine, from neurol- ogy to mental health, pain and addiction, gastrointestinal to cardiovascular health, Workers receive the dunnage steel on the roof for assembly. The dunnage was installed to support and across the lifespan. mechanical equipment and large piping.

NIH RECORD • OCTOBER 2, 2020 • 7 Burgess Light also has CONTINUED FROM PAGE 1 physiological effects beyond its effect on co-director of the Sleep and Circadian circadian timing. For Research Laboratory at the University of example, light sup- Michigan and a grantee of NCCIH, NHLBI, presses melatonin. In NIMH and multiple other NIH components. many studies, lower She focused on the most well-studied levels of melatonin aspect of light and health: the circadian secretion overnight clock, an “ancient physiological system” were predictive of that is largely determined by genetics. Its development of breast two parts are the central circadian clock, cancer, hypertension, located in the hypothalamus, and a network insulin resistance of peripheral circadian clocks found in or type 2 diabetes almost every cell, tissue and organ. The Burgess spoke virtually from her office in Ann Arbor, where she co-directs in participants. An the University of Michigan’s Sleep and Circadian Research Laboratory. latter clocks have local control over many emerging literature of our biological systems, such as those for suggests that giving behavior, hormones, inflammation and viewers could leverage their light exposure to people supplemental melatonin might help immunity. If the circadian system were an benefit health. For example, “for those of us suppress systemic inflammatory markers, orchestra, Burgess said, the central clock is who need to shift earlier (i.e., phase advance), but this area needs further investigation. the conductor and the peripheral clocks are morning light is the most important light we Light may also affect neurotransmitters in the instruments. receive during the day. In contrast, evening the brain. A study conducted by Dr. Lily Yan In about 70 percent of us, the central light, light before bed and light during your at Michigan State University found light-de- clock takes a little more than 24 hours to sleep episode will shift you later. pendent increases in serotonin (a chemical complete one cycle. This creates a tendency “For many of us, evening light is not important in mood) in many different brain over time to “phase delay” (i.e., move the cir- our friend,” she continued. “But we know areas of a day-active rodent model. cadian clock later). How can affected people there’s a lot of light pollution at night, With respect to chronic pain, one of get and stay in sync with an environment and as human beings we tend to engage the speaker’s studies was a small, NCCIH- running on a 24-hour clock? Researchers in behaviors that are not always the best funded pilot project conducted in women are exploring strategies to “phase advance,” for us. Ninety percent of Americans use a with fibromyalgia. Participants received including by manipulating the properties of light-emitting technology device in the hour one hour of bright light treatment either light and exposure to it. Lifestyle measures before bedtime, according to one survey. So in the morning or evening from a light may also help. does it really matter whether our clock and box. The researchers examined outcomes Since the 1980s, light therapy has been sleep times shift a bit?” related to function, pain sensitivity and a mainstay of treating seasonal affective The answer is yes, over time. The term circadian timing. They found improvements disorder (SAD), a type of depression that “social jet lag,” coined by Dr. Till Roenneberg in function and pain sensitivity from both usually starts in late fall and early winter at Ludwig Maximilian University in Munich, morning and evening light treatments. (because of less sunlight) and often eases Germany, describes a syndrome similar But those improvements became clinically in the longer days of spring and summer. to normal jet lag but arising from lack of meaningful only from morning light, also Currently, an exciting avenue of research is alignment between a person’s biological and the only light treatment to improve pain extending investigation of light’s effects on social clocks. tolerance (phase-advancing was offered as a health to diseases and conditions beyond SAD. “Making subtle but chronic shifts of 2 possible mechanism). “The circadian system profoundly affects hours or more in your circadian timing A second NCCIH-supported study, in our health, and it’s one of the fundamental may have long-term health consequences,” military veterans with chronic low-back pillars of health, along with sleep, diet and Burgess cautioned. pain, found morning light treatment was exercise,” Burgess said, “We now know So far, cross-sectional studies have found helpful in reducing pain and suggested that more than 50 percent of genes express links to higher risk for depression; greater possible benefits for post-traumatic stress themselves with a circadian rhythm…It’s likelihood for alcohol and caffeine use and disorder. Light treatment, Burgess said, most fascinating to me that when we are smoking; higher body mass index; and is relatively easy to access compared to exposed to light, our physiological response negative changes in some common measures many other interventions and requires less will be completely different depending on such as resting heart rate, C-reactive protein, physical exertion for pain patients. It should the time of day we receive it, in relation to high-density lipoprotein cholesterol and also be studied in treatment combinations. our internal circadian clock.” In addition, trigylcerides. This situation might reflect To promote wellness, Burgess suggested light sensitivity and how one responds to some self-medication for difficult symptoms the following: light vary between individuals. of social jet lag. Results of longitudinal • Try to get more light during the day— Burgess offered some suggestions on how studies are pending. outdoors if possible, with 30 minutes to an

8 • NIH RECORD • OCTOBER 2, 2020 hour as a typical amount. “Morning light is good for most of us,” she said. However, UPCOMING TALKS two groups should first consult their health Hoyo To Give NCI Seminar, Oct. 21 care providers: older adults (because their circadian rhythms normally shift earlier in Dr. Cathrine Hoyo will give the next lecture in the NCI Center to Reduce Cancer Health Disparities’ Continuing Umbrella of Research Experiences (CURE) Distinguished Scholars Seminars on aging) and people with bipolar disorder (as Wednesday, Oct. 21 from 1 to 2:30 p.m., via Webex. Her talk is titled “Toxic Metal Exposure extra light might be overly stimulating). Disparities, Epigenomic Response and Hepatocellular • Usually, being outside offers brighter Carcinoma: The Developmental Origins of Health and Disease light than being inside (although not always). (DOHAD) Framework.” For most people, going outside for light as Hoyo is a professor of epidemiology in the department of soon as possible after waking up is the best biological sciences, co-director of the integrated health sciences time—but if the morning is too busy, one facility core in the Center for Human Health and the Environment can go out sometime before sunset (weather and director of the epidemiology and environmental epigenom- ics laboratory at North Carolina State University. She is a former permitting, of course). CURE K01 recipient. • Exposure to ultraviolet light carries risks to the eyes. You might choose to go Hoyo’s research improves our understanding of how early development influences risk of common chronic diseases, particularly without sunglasses for just part of your time those that exhibit racial/ethnic differences in incidence and/or outdoors or wear sunglasses the entire time, mortality, including in certain cancers. She will present about her in which case you will still receive some group’s two-pronged approach to this work—both following a benefits from light. cohort of newborns from the first trimester in order to pinpoint • When inside, try to sit by a window, if Dr. Cathrine Hoyo of North epigenetic targets, as well as conducting population-based case Carolina State University control studies of cancer in adults to assess to what extent the possible. epigenetic targets contribute to these cancers in adulthood. • After sunset, minimize your exposure to artificial light. Use distance and dim- To register for the seminar, visit https://cbiit.webex.com/cbiit/onstage/g.php?MTID=ea4d- 4327dc035986bdf8dd4805d226cda. Those who need reasonable accommodation to participate ming—e.g., watching a TV across the room is should contact Victoria Coan at (240) 276-7659 and/or the Federal Relay Service (1-800-877-8339) better than using a cell phone or tablet close at least 2 days before the meeting. to your eyes. The more you dim your evening light, the less you will phase delay (have your Woman Scientist Advisors Scholars Symposium, Oct. 5 circadian cycle move later). The 10th annual Woman Scientist Advisors (WSA) Scholars Symposium will be presented on • Don’t use light-emitting devices in the Monday, Oct. 5 from 1 to 2:30 p.m. online at https://nih.zoomgov.com/j/1617342999. hour before you go to bed. Speakers are Dr. Alix Warburton of • Set an alarm for a half hour before you NIAID and Dr. Ida Fredriksson of usually go to bed. Retiring at the earlier NIDA, postdoctoral fellows in the time will help in obtaining the 7 to 8 hours laboratories of Dr. Alison McBride and (at least) of sleep recommended by the Dr. Yavin Shaham, respectively. American Academy of Sleep Medicine. Warburton and Fredriksson were • Don’t treat yourself with melatonin selected as WSA scholars from the without talking to your health care provider women Fellows Award for Research Excellence FY2020 awardees in rec- first. Underlying medical conditions and ognition of their outstanding research potential drug interactions are among the achievements. factors to consider. Warburton’s topic is “Mechanisms • People who cannot get outside and don’t of Tandem Repeat Formation at have the benefit of a window sometimes HPV Integration Sites in Cervical consider light boxes. These are available Carcinoma Cells.” Fredriksson will and often less expensive than wearable light discuss “Incubation of Oxycodone Dr. Alix Warburton (l) of NIAID and Dr. Ida Fredriksson devices. If you have an eye disease, talk to Craving after Conflict-induced of NIDA Voluntary Abstinence.” your ophthalmologist first before consider- ing a light device, and if you have a mental The symposium highlights the research accomplishments of women fellows in the NIH Intramural health diagnosis, especially bipolar disorder, Research Program. talk to your mental health professional first. The full lecture is available at https:// videocast.nih.gov/watch=37830.

NIH RECORD • OCTOBER 2, 2020 • 9 DIGEST

Biomarkers Could Help Vaping, Marijuana Use Predict Time Needed for Rose in College-Age Athletes to Recover from Adults Concussion Vaping marijuana and vaping nicotine A collaborative study conducted by scientists rose sharply in the past 3 years among from NIH, the Department of Defense and college-age (19-22 years old) adults, multiple academic institutions has identified according to 2019 survey results from the blood biomarkers that could help predict which Monitoring the Future (MTF) study. The athletes need additional time to recover from a percentage of college students who said sports-related concussion. This collaboration, they vaped marijuana in the past 30 days known as the Concussion Assessment, Research rose from 5.2 percent in 2017 to 14 percent and Education consortium, is supported, in part, in 2019. The corresponding percentages by DoD and the National Collegiate Athletic for their non-college-attending peers Association. increased from 7.8 percent in 2017 to 17 In a collaborative study, scientists have identified blood percent in 2019. In this study, conducted at several sites across biomarkers that could help predict which athletes the U.S., 127 male and female collegiate athletes need additional time to recover from a sports-related MTF, an ongoing study of the trends in who had sustained a sports-related concussion concussion. substance use by adolescents and adults were tested at several time points: shortly after in the United States, is funded by NIDA. injury, when their symptoms resolved, and one people with IDD. It is vital to ensure that when The survey is conducted by scientists at week after returning to play. Each athlete had they return to work, care staff exercise tech- the University of Michigan’s Institute for Social also undergone preseason, baseline testing. niques and procedures to protect their clients Research. from infection, the authors write. Using an ultrasensitive assay that can detect The percentage of adults ages 19 to 22 who minute amounts of protein, the researchers Moreover, people with IDD depend on caregiv- vaped nicotine also rose dramatically between tested blood serum from these athletes ers and loved ones to help them bridge gaps 2017 and 2019. In 2017, 6.1 percent of college and identified two blood proteins that were in intellectual and communication abilities. In students and 7.9 percent of those not in college associated with the length of time needed by the the absence of this human contact, the authors said they vaped nicotine in the past month, athletes to return to play. call for virtual care and support, where viable. rising to 22 percent and 18 percent, respectively, Those who cannot benefit from screen-based in 2019. These increases in vaping marijuana and Amounts of these two proteins, tau protein and supports should be prioritized to receive nicotine are among the largest increases in use glial fibrillary acidic protein, were found to be in-person services. for any substance reported by the study in its significantly different in athletes who needed 45-year history. less or more than 14 days to return. Suspension of classroom time also disproportionately affects children with IDD, who often “We are seeing an increasingly concerning While further research is needed, the results require special educational services, increased trend,” said NIDA director Dr. Nora Volkow. of this study are an important step toward the teacher-student ratios and specialized interven- “Many young people may view vaping and development of a test that could help predict tions, many of which cannabis use as which athletes need more time to recover from a need to be administered ‘safer’, but the reality concussion before resuming activity. in person, the authors is that nicotine is highly addictive, and The study was published in JAMA Network Open. note. It is difficult for families to take on these cannabis can also be People with Intellectual, tasks, and qualified addictive, particularly in-home surrogates in younger adults for Developmental Disabilities should be mobilized whom the brain is still Disproportionately Affected whenever possible to developing.” by Covid-19 meet this need and to The MTF study has support parents’ efforts. been annually tracking The Covid-19 pandemic has taken a dispro- Also, people with IDD substance use among portionate toll on people with intellectual and college students and developmental disabilities (IDDs), write the often cannot verbalize their symptoms during non-college adults directors of the Intellectual and Developmental since 1980. Disabilities Research Centers Network, a telemedicine appoint- Vaping marijuana and vaping nicotine rose nationwide group funded by NICHD. Their article ments, and physicians Other highlights from need to use their best sharply in the past 3 years among college-age appears in the American Journal of Psychiatry. the 2019 survey: judgment in providing (19-22 years old) adults, according to 2019 survey results from the Monitoring the Future Cigarette smoking A large number of people with IDD who require in-person care for them (MTF) study. continued a downward in-person care have lost the support of trained when necessary, accord- trend; binge drinking caregivers and community service providers ing to the authors. showed no significant due to the pandemic. The authors note that the The article emphasizes that people with IDD who changes; and prescription opioid misuse contin- Centers for Disease Control and Prevention and ued to decline, as did amphetamine use. others have issued guidelines for group homes, are infected with Covid-19 should receive equal schools and others entrusted with the care of access to testing and appropriate medical care.

10 • NIH RECORD • OCTOBER 2, 2020 MILESTONES

Longtime Engineering while supporting Hamsters (an employee theater group) production himself by working of Guys and Dolls. Authority Eden Mourned the night shift as a “One of the many remarkable things about Murray Dr. Murray Eden, a renowned pioneer in junior clerk-typist with the Civil Service was that he had so many careers,” said Dr. Hank the field of biomedical engineering and Eden (no relation), who was deputy director of imaging and former director of the trans- Commission (thus began a term of the Biomedical Engineering and Physical Science NIH Biomedical Engineering and Physical Program. “He seemed to have known everyone. In Science Program for 18 years, died government service spanning more than fact, framed on Murray’s wall was a piece of paper peacefully in his sleep on Aug. 9. He would with equations scribbled on it from Albert Einstein’s have been 100 years old on Aug. 17. 50 years). Upon receiving his M.S. in wastebasket. [Murray retrieved it when he was a Eden was professor emeritus in electrical physical chemistry postdoc at Princeton.] Another aspect of Murray’s personality was that, despite all the things he engineering at MIT and worked at the Dr. Murray Eden elevated the from the University of accomplished and the famous people he knew, he intersection of mathematics, engineering, NIH Biomedical Engineering Maryland, he began biology and medicine during the infancy and Physical Science Program, work as a biophys- was really down to earth. He also had a great sense of biomedical engineering. which subsequently became the icist at the National of humor.” principal initial component of Bureau of Standards Eden’s personal research focus was pattern recog- In 1970, he co-authored the book NIBIB’s IRP. He is shown here in in 1943. During World 2018, when he was 98. nition and quantification of biomedical images and Engineering and Living Systems with War II, he worked in physician Dr. David D. Rutstein in which their efficient storage. “Basically, I’ve been working PHOTO: ABBY EDEN the Princeton facility on trying to model physiological processes,” he they described their new, interdisciplinary of the Manhattan vision for health care in the future. Eden once said. “I’m interested in how to make machines Project alongside then student Dick Feynman and do what humans can do because, by studying is also credited with foundational work in pattern others, helping produce uranium-235. recognition and its application in image processing how to mimic human performance, we will better for medical diagnoses. He returned to the government as a physicist understand how the human machine operates.” at the National Bureau of Standards. Six years He leaves a brother, Dr. Alvin Eden of New York Over his long career at MIT and NIH, he collab- later, he transferred to NCI as a biophysicist and orated with colleagues from many disciplines City; 5 children, Abigail Eden of Cherryfield, ME; completed his doctorate in physical chemistry and Susanna Eden of Tucson, AZ; Mark D. Eden of Taos, and mentored young researchers and students physics at the University of Maryland. From 1953 to who have gone on to distinguished careers. NIH NM; Shirley H. McDaniel, Venice, FL; and John W. 1955, he returned to Princeton to do postdoctoral Hartle, Juneau, AK; and 7 grandchildren. recruited him from MIT in 1976 to oversee the work as a Public Health Service fellow and then Bioengineering and Physical Science Branch (then returned to NIH within the Laboratory of Technical part of the former Division of Research Services, Development, NHLBI. In 1959, he took a job at MIT, OD), and he dramatically expanded and enhanced where he co-founded the cognitive information VOLUNTEERS the program. The program had a somewhat processing group and headed it until 1976. nomadic existence, moving over the years from DRS to NCRR to ORS and ultimately became the Eden found time over the years to serve as a principal initial component of NIBIB’s intramural lecturer, visiting professor or adjunct professor research program. Eden retired from NIH in 1994. at institutions such as Harvard Medical School, Looking for Covid-Positive People American University, Boston University Law Under Eden’s inspirational leadership, members of School, Johns Hopkins University, the Swiss NHLBI researchers seek Covid-19-positive the program collaboratively created numerous bio- Federal Polytechnic Institute at Lausanne and the patients in the DMV area for a new clinical trial. engineering firsts, ranging in scale from near-atomic University of Pennsylvania. The study hopes to help researchers understand resolution to applications for the clinic. These how coronavirus affects the function of the included: the first applications of wavelets to com- He also had numerous consultancies, including body’s immune system in controlling the infec- puted tomography; analytical methods (such as to the director-general of the World Health tion. Additionally, researchers want to understand using electron microscopy for quantitative imaging Organization in Geneva, Switzerland (1963 to how different organs of the body (such as the of distributions of atomic elements in tissues); 1992), and in 1983 he received the WHO Medical lungs, heart, brain and kidneys) respond to the mechanical and electrical engineering designs Society medal. He was also one of the principal infection from its early appearance to recovery, enabling laser capture microdissection; serial technical consultants for the symbol standard and whether there are any long-term effects. For block-face scanning electron microscopy; ground- subcommittee of the Uniform Grocery Product details, see https://go.usa.gov/xfcEh. All medical breaking work in pharmacokinetics, including Code Council (1971 to 1974). care is at no cost to the participant and compen- “convection-enhanced” delivery of drugs to brain sation for the entire study is provided. Contact tumors; analysis of macromo- “That was the group that established the bar codes [email protected] for more information. lecular interactions by analytical you see on all of the products you ultracentrifugation; advances in buy at the supermarket,” Eden NICHD Recruits Kids for Growth Study said. “It was my idea to put the the theoretical underpinnings NICHD study seeks children 2-18 years old and implementation of MRI, numbers underneath the code [as a failsafe], and I also picked with growth hormone excess to participate in including critical radiofrequency a research study. Researchers want to see if circuits and “shielded gradients” the typeface for the numbers.” With a grin he added, “That’s my pegvisomant, a drug that antagonizes growth enabling echo planar imaging; hormone action, can help children and ado- and creation of diffusion tensor 15 minutes [of fame], and nobody knows about it.” lescents with gigantism. See details at https:// imaging. go.usa.gov/xyqQu. If you are interested in After earning a B.S. degree Eden loved music and often had participating, contact the Clinical Center Office of resounding classical selections Patient Recruitment at 800-411-1222, TTY for the in chemistry from the City From the Nov. 17, 1958, NIH College of New York in 1941, on his radio as he worked. In deaf or hard-of-hearing 1-866-411-1010. Se habla Record, Eden performs onstage the 1950s, he played the role of Eden attended graduate school with NIH Hamsters. español. Email [email protected]. Refer to study at the University of Maryland Benny Southstreet in the NIH 19-CH-0071.

NIH RECORD • OCTOBER 2, 2020 • 11 There will be additional Covid-19 safety measures in place. The staff providing CELEBRATION CONTINUES vaccines will be carefully following infection control procedures. All staff arriving for a flu shot must wear a face cover and follow all NIMHD Anniversary Event physical distancing requirements. Features Muñoz, Oct 8 All teleworking employees in the Washington, D.C., area are encouraged to NIMHD continues to celebrate its 10th schedule an appointment at Shady Grove or anniversary virtually. On Thursday, Oct. the 6700B Rockledge locations. Extra dates 8, Dr. Ricardo F. Muñoz will present at and appointments have been added to those the NIMHD Director’s Seminar Series. sites to accommodate additional staff. Parking The title of his talk is “On the Potential at the Rockledge and Shady Grove locations of Massive Open Online Interventions Flu Vaccine Clinic for Staff are available at www.foiltheflu.nih.gov. and Digital Begins Please do not schedule an appointment Apothecaries at Baltimore/Harbor Hospital or Poolesville to Reduce The Office of Research Services and the unless you work onsite at those locations. Health Clinical Center will provide free flu shots to NIH ordered both high-dose and the Disparities staff with a valid NIH identification badge regular quadrivalent vaccines for all flu shot Worldwide.” from Sept. 28 through Nov. 6. sites. Staff ages 65 and older can receive Muñoz is This year’s immunization clinic will the high-dose vaccine. A limited number of a professor have some significant changes. Two big egg-free doses have been ordered and will emeritus differences are that the location on the only be administered to health care person- at the main campus has changed to the Bldg. 10, nel with a documented egg allergy. University of B1 cafeteria, accessible from the outside To learn more about the high-dose flu California, entrance only, and the vaccine will be given shot, visit https://www.cdc.gov/flu/prevent/ San by appointment only through an online qa_fluzone.htm. For directions, parking Francisco, registration system. Walk-in immunization and to schedule your flu vaccine, visit www. and a dis- Dr. Ricardo F. Muñoz will not be available. foiltheflu.nih.gov. tinguished of Palo Alto University professor 2020-2021 Immunization Schedule and Registration of clinical psychology at Palo Alto University. He has been a pioneer in research on internet interventions since the 1990s, conducting worldwide randomized controlled trials in Spanish and English on smoking cessation and, more recently, on depression. Muñoz founded i4Health, an institute dedicated to developing, evaluating and disseminating evidence-based psychological interventions in multiple languages. For reasonable accommodation, call (301) 402-1366 or the Federal Relay, 1-800-877-8339. The talk will be videocast at https:// videocast.nih.gov. To learn about the seminar series, visit https://nimhd.nih. gov/news-events/conferences-events/ directors-seminar-series/.

12 • NIH RECORD • OCTOBER 2, 2020