November 27, 2020 Vol. LXXII, No. 24

addressed surreal year called 2020” wherein we’re before we can experiencing “a prolonged example of a get back to any disaster wrought by an invisible virus,” MENTAL HEALTH A CONCERN kind of normal. Collins introduced the event. “Covid-19 For insights has profoundly affected all of us,” he said. JHU’s Everly Prescribes and coping “Nobody has gone through this without ‘Psychological First Aid’ strategies on having a range of emotions, from stress, During Pandemic the problem, anxiety, fear—just grief about all the things NIH director that have happened and the lives that have BY CARLA GARNETT Dr. Francis been lost and the terrible stresses and Founding father Thomas Paine certainly Collins called economic distress that have happened could have been writing about 2020, when on world-re- to people…and certainly loneliness, the he said in The American Crisis, “These are nowned expert Dr. George Everly inability to gather together the way many the times that try men’s souls.” (Of course, on psycholog- of us love to do, which has not been possible being enlightened, he would’ve included ical impacts of disaster Dr. George Everly, with our requirements to be safely sheltered women’s souls too, and noted that the crisis psychologist and professor at Johns Hopkins at home.” is global.) University’s Bloomberg School of Public The presentation was held on Sept. 10, Caveats aside, most authorities on mental Health. He gave a virtual presentation, World Suicide Prevention Day. Suicide is the health agree that the enormous psycho- “Psychological Aspects of Pandemic and nation’s 10th leading cause of death and is in logical toll of the Covid-19 pandemic—and Human Resilience,” aimed specifically at the many cases preventable. the measures we’ve all had to take to limit NIH workforce. “Concern in the U.S. about a rise in the its spread—must be acknowledged and Acknowledging this “really unique and SEE EVERLY, PAGE 4

Brown Studies Consequences MENDING BROKEN HEARTS of Adolescent Alcohol Use Fellow Explores DeBakey’s BY ERIC BOCK Far-Reaching Legacy Long-term BY DANA TALESNIK studies on ado- The late Dr. lescent alcohol Michael E. use are revealing DeBakey is a the effects of medical legend. alcohol exposure Dubbed the Rafters ringing yet? CRC bluegrass show, p. 2. on brain devel- Tornado by a col- opment and league, DeBakey—a ALSO THIS ISSUE the genetic and cardiac , Briefs...... 2 environmental innovator, educator factors for NIAAA Celebrates 50th Year...... 3 and research increased risk advocate—inspired NIH ‘Virtual Industry Day’ Features Dr. Sandra Brown of adolescent countless doctors Collaboration with HBCU...... 5 alcohol use, said and medical NINR Director To Give Straus Lecture. . . . .7 Dr. Sandra Brown at NIAAA’s 12th annual students in the Dr. Sara Farhan Jack Mendelson Honorary Lecture held via Digest...... 10 United States videoconference recently. during his 75-year career. His scientific con- Milestones...... 11 “For over 15 years now, we’ve had tributions and teachings also transcended Seen...... 12 evidence that the brains of youth exhibit national borders. The son of Lebanese SEE BROWN, PAGE 8 SEE DEBAKEY, PAGE 6 BRIEFS

Ends Dec. 14 Federal Benefits Open Season Is Underway The benefits open season began on Nov. 9 and runs through Dec. 14. Don’t miss this opportunity. If you plan to make an open season election, now is the time to do it. Unless you experience a qualifying life event during the year, the annual open season is your only opportunity to enroll, cancel your enrollment or make a change to your enrollment for the participating programs. For detailed information about the Federal Benefits Open Season, view the announcements at https://hr.nih.gov/benefits/change-open-season/ benefits-open-season. The three participating programs are: • Federal Employees Health Benefits (FEHB) Program—To enroll, cancel or change your FEHB enrollment, you must use myPay at https://mypay. dfas.mil/mypay.aspx. Open season elections will be effective on Jan. 3, 2021. Your current enroll- ment will automatically continue into next year, if Bluegrass Players Make Rafters Ring you do not take any action during open season. The bluegrass quintet We RNA String Band (Exception: If you will be retiring between now and performed in the atrium of the Clinical Jan. 2, 2021, do not use myPay to make your open Research Center on Nov. 10. Band members season change. Instead, you must submit a hard include NIH director Dr. (top, l) and Dr. Ivan Vujkovic-Cvijin on guitar, Dr. John copy Health Benefits Election Form, SF 2809, along Tisdale on bass, Dr. Dominic Golec on mandolin with your retirement paperwork to your benefits and Dr. William Sears on fiddle. “It was great specialist.) fun!” said Collins, who also played piano. The setlist included Whiskey Before Breakfast, • Federal Employees Dental and Vision Insurance Temperance Reel, Angeline the Baker, Ashokan Program (FEDVIP)—To enroll, cancel or change Farewell, House of the Rising Sun, Cherokee your FEDVIP enrollment, you must use the Shuffle, Redwing, Milkcow Blues, Old Joe Clark, BENEFEDS Portal at www.benefeds.com or call Tennessee Waltz and Orange Blossom Special. 1-877-888-3337 (TTY 1-877-889-5680). Open PHOTOS: CHIA-CHI CHARLIE CHANG season elections will be effective on Jan. 1, 2021. Your current enrollment will automatically continue into next year, if you do not take any action during open season. • Flexible Spending Accounts (FSA) Program—To enroll in an FSA for 2021, you must use the FSAFEDS website at www.fsafeds.com or call 1-877-372-3337 (TTY 1-866-353-8058). Note that your current enrollment will not automatically continue into next year. If you want an account in 2021, you must enroll during open season. Elections will be effective on Jan. 1, 2021. If you have questions, email [email protected] or your benefits contact. To locate your contact, visit https://hr.nih.gov/contacts/benefits.

Open Enrollment for NIH Leave Bank Fall open enrollment for the NIH Leave Bank runs until Dec. 14. The membership period will begin on Jan. 3, 2021. To become a Leave Bank member, access the Integrated Time and Attendance System during open The Leave Bank is a pooled bank of donated annual enrollment and select “Leave Bank Membership” to enroll. If you are a 2020 Leave Bank member, your and restored leave available to eligible members. membership will automatically continue into 2021, unless you opt out. The yearly membership contribution It acts like a safeguard for your paycheck and is one pay period’s worth of annual leave accrual. The membership contribution will be waived automati- amounts to paid leave for members who have cally if you lack sufficient leave. exhausted all of their own sick and annual leave and are affected by a personal or family medical For more information, visit http://hr.nih.gov/leavebank or contact (301) 443-8393 or send email to condition. [email protected].

2 • NIH RECORD • NOVEMBER 27, 2020 SYMPOSIUM SET Created in 1970, established scientists. The institute has renewed its NIAAA’s broad commitment to address the health needs of under- NIAAA Celebrates 50 Years of research portfolio served populations so that all members of society focuses on health may benefit from the work that NIAAA funds. Advancing Alcohol Research topics that touch the lives of almost The community of alcohol practitioners and every family and researchers has gained valuable knowledge This December marks the 50th anniversary of during NIAAA’s first five decades—knowledge the creation of the National Institute on Alcohol community across the United States. that provides a strong foundation upon which to Abuse and Alcoholism. Over the past five decades, build. However, there is still a lot more work to do. NIAAA-funded researchers have made tremendous Today, thanks to NIAAA’s legacy NIAAA looks forward to further scientific advances progress in advancing the understanding of how that will help prevent AUD and improve the lives of alcohol affects health. of supporting innovative research, those affected by it. NIAAA director Dr. George Koob said, “While we advances in To learn more about NIAAA’s history and plans for Dr. George Koob have much more work to do, today we know more evidence-based the symposium, visit https://www.niaaa.nih.gov/ about how alcohol affects the brain and body than interventions have niaaa-50-legacy-advancing-alcohol-research. ever before, and we have better interventions to contributed to a steady decrease in underage prevent and treat alcohol misuse, thanks largely to drinking over the past two decades. NIAAA has the determined and uncompromising efforts of the also made great strides in understanding the talented researchers supported by NIAAA. These deleterious effects of prenatal alcohol exposure efforts have provided the foundation for the recog- and in elucidating the biological underpinnings of nition of alcohol use disorder (AUD) as a medical AUD and alcohol-associated liver diseases, efforts disorder ranging from mild to severe, rather than a that are paving the way for improved diagnosis, moral failing.” prevention and treatment. To commemorate five decades of biomedical Just as expanding the knowledge base is import- discovery in the alcohol and health field, ant, so is translating the evidence into valuable NIAAA will host a virtual scientific symposium, resources for the public, such as Rethinking “Alcohol Across the Lifespan: 50 Years of Drinking (https://www.rethinkingdrinking.niaaa.nih. Evidence-Based Diagnosis, Prevention and gov/) and the NIAAA Alcohol Treatment Navigator ON THE COVER: Hydractinia tentacles, close up. A Treatment Research” on Nov. 30 and Dec. 1. The (https://alcoholtreatment.niaaa.nih.gov/), which little-known ocean-dwelling creature most commonly are resources to help people evaluate found growing on dead hermit crab shells may sound their drinking habits and find treatment, like an unlikely study subject for researchers, but this animal has a rare ability—it can make eggs and sperm respectively. for the duration of its lifetime. Called Hydractinia, Other resources include CollegeAIM the animal produces germ cells—precursors to eggs (https://www.collegedrinkingprevention. and sperm—nonstop throughout its life. Studying this unique ability could provide insight into the gov/collegeaim/), which helps colleges development of the human reproductive system and and universities identify effective the formation of reproductive-based conditions and evidence-based alcohol interventions, as diseases in humans. well as a youth alcohol screening guide IMAGE: ANDY BAXEVANIS, NHGRI (https://www.niaaa.nih.gov/sites/default/ files/publications/YouthGuide.pdf) The NIH Record designed to assist health professionals in efficiently conducting alcohol screening for Since 1949, the NIH Record has been published adolescents ages 9 to 18. Adding to these biweekly by the Editorial Operations Branch, resources, new evidence-based materials Office of Communications and Public Liaison, National Institutes of Health, Department of Health are on the way and will be available soon. and Human Services. For editorial policies, email NIAAA also remains nimble and mobilizes editor or phone (301) 496-2125. to pursue emerging avenues of research in Editor: Rich McManus addition to its long-standing priorities. For [email protected] example, the novel coronavirus pandemic Associate Editor: Carla Garnett has yielded many urgent research [email protected] questions, and NIAAA is funding research event can be viewed at https://www.niaaa.nih. Staff Writers: related to alcohol and the pandemic—and contrib- Eric Bock • [email protected] gov/news-events/meetings-events-exhibits/ uting to Covid-19 activities across NIH. Information Dana Talesnik • [email protected] niaaa-50th-anniversary-symposium. about NIAAA’s response to the pandemic and Subscribe via email: Follow: resources for the public, health care providers and It will include presentations by top research experts [email protected] http://nihrecord.nih.gov/ on the state of the science and opportunities to researchers is available on the NIAAA website. Facebook “f” Logo CMYK / .eps Facebook “f” Logo CMYK / .eps continue advancing the field. Featured topics will Of great importance is the need for diversity The NIH Record include updates on how to diagnose and treat is recyclable as and inclusion, both in terms of the research that mixed paper. AUD, as well as trends in the prevalence of and risk NIAAA supports, the individuals who conduct that factors for the disorder. Speakers will also cover research and the staff that supports the research topics related to the biology of alcohol use and enterprise. NIAAA’s commitment to increasing alcohol, such as the effects of alcohol exposure or diversity in the scientific workforce encompasses consumption on fetal and adolescent brain devel- intramural and extramural research programs opment, liver pathology and the stress system. and spans the pipeline from early education to

NIH RECORD • NOVEMBER 27, 2020 • 3  “A nation will never recover from the effects of disaster Everly CONTINUED FROM PAGE 1 until its people recover. Psychological recovery is not only important, but I would argue it’s the imperative.” suicide rate was already there before the pandemic, and now with covid, concern ~DR. GEORGE EVERLY has grown,” Collins said. “Maybe we don’t  entirely know the full impact of that yet, but certainly the sense of isolation, the loss of ultimately succumb to the multiple stressors more important to note are fear of infecting economic support [and] fear of illness cannot [that covid presents],” Everly explained. family members, physical fatigue, emotional help with this circumstance of causing “People who were already suffering from a exhaustion, feelings of isolation, fear of people who are already feeling the depres- mental condition may get worse.” furlough or losing a job and distractions sion to take even more drastic action. We Speaking directly to an NIH audience working from home or inability to stay want to talk about these issues. We want to replete with pandemic scientists, physicians, focused on task. reinforce and support the fact that we at NIH nurses and other health care providers and “I want to reassure you that if you’re care deeply about our staff and what you’re affiliated employees, Everly going through.” cautioned that performance of Everly first gave what he called a “30,000- such roles comes with tremen- foot overview” of what is now his third dous costs—the most obvious pandemic as a consultant. He has advised and pernicious perhaps being policymakers and other national officials burnout. in Hong Kong with SARS, Singapore with “Especially looking at H1N1 and now Covid-19, in addition to Ebola. frontline workers and first He also has worked around the globe to responders, we have seen address the mental health consequences of heroic efforts on their parts, natural disasters, terrorist attacks and other but not without a conse- catastrophes. quence—exhaustion being “[Covid] has been the most challenging,” one,” Everly pointed out. he admitted. He explained why studying “Anything that threatens mental health the psychology of an infectious NIH director Dr. Francis Collins wondered whether we should threatens the core of society,” Everly disease is important and looked employ different coping tactics for short-term catastrophes as declared. “A nation will never recover from at issues specifically related opposed to disasters that linger on. the effects of disaster until its people recover. to psychological impact of the experiencing any of these, you’re not alone,” Psychological recovery is not only important, pandemic. he said. but I would argue it’s the imperative.” Themes of distress that Everly’s team Everly also explored resilience and how He said the coronavirus pandemic may recorded among health care workers in some people seem better able to bounce back give rise to a “hidden pandemic” that finds a Arizona include lack of clear information; than others. high volume of folks in mental health crisis. new rules and responsibilities; overwhelm- He and his team found several key “People who previously coped well may ing emotions such as worry and frustration; characteristics that were common among and conflicting firefighters, police officers, Navy SEALs and emotions as well as other military special ops team members as concern for family well as people who had recovered from cat- members. astrophic medical issues—active optimism, In a sample of decisiveness, tenacity, following a moral more than 7,150 compass and connectedness. contacts compiled His group outlined several psycholog- from late April to ical phases of disasters, from impact to late August by the honeymoon through disillusionment until Mental, Emotional, recovery/moving on. Using that timeline, Spiritual Health Everly forecast a psychological trajectory Collaborative at and talked about estimating overall toxicity Johns Hopkins and casualty levels. Medicine, Everly He closed his lecture with specific recom- cited in excess mendations for fostering resiliency. of two dozen How do we help others bounce back? Everly explored resilience and how some people seem better able to bounce recurring common- back than others. Everly cited 2003 Institute of Medicine alities. Among the

4 • NIH RECORD • NOVEMBER 27, 2020 research that suggested, “In the past decade, there has been a growing movement in PATH TO the world to develop a concept similar to Collaboration Between HBCU, Business EXCELLENCE physical first aid for coping with stressful Featured on NIH Virtual Industry Day and traumatic events in life. This strategy…is most commonly referred to as ‘psychological A novel approach for combating Covid-19 developed by a minority business and a historically black first aid (PFA).’” university was demonstrated to participants in a Federal Industry Day sponsored by NIH recently. Not to be equated with mental health Typically, the last week of September is recognized by the White House Initiative on Historically diagnosis or treatment, PFA provides a Black Colleges and Universities (HBCUs) as National HBCU Week and includes a conference that “compassionate and supportive presence draws thousands of HBCU leaders and advocates to the nation’s capital. This year, because of the global designed to stabilize and mitigate acute pandemic, the meeting was held virtually rather than distress, instill hope and facilitate access to in a hotel conference center. continued mental health care,” Everly said. Events during the last 2 days of the conference Folks such as frontline workers who focused on increasing HBCUs’ competitiveness in themselves are “facing a pandemic of federal contracting. Three contracting workshops exhaustion” could stave off its most harmful were held on Sept. 24 and Federal Industry Day effects, Everly said, by adopting several followed on Sept. 25. strategies to recharge: exercise moderately According to Diane Frasier, head of contracting every day, limit consumption of caffeine and activity and director of the Office of Acquisition and other energy-boosting substances, get at Logistics Management at NIH, revenue from federal least 7 hours of sleep per night, take a power government contracts is relevant to HBCUs because “they can create more jobs on campus, which will nap when tired and practice some form also stimulate local economies and provide employ- of relaxation such as meditation, prayer, ment opportunities for students.” mindfulness or focused breathing. “As procurement forecasts and acquisition plans are Summing up, Everly shared several drafted for FY21, it is critical for Historically Black personal and family anecdotes about Colleges and Universities to have a seat at the table,” managing stress. said Annette Owens-Scarboro, who manages NIH’s The presentation ended with an open Small Business Program Office (SBPO). conversation between Everly and Collins, Dr. Oluwafemi Banjoko, senior She and Frasier have been working for several years who asked pointed questions about coping, contracts and grants specialist at UVI, to increase the agency’s engagement with HBCUs in including whether we should employ demonstrates the SafePass Intelligent accordance with White House Presidential Executive Disinfecting Station. different coping tactics for short-term Order 13779, which directs agencies to develop plans to assist in strengthening HBCUs’ ability to partici- catastrophes as opposed to disasters, like this pate equitably in federal programs through contracts, grants and cooperative agreements. pandemic, that linger on. “Different, definitely,” Everly replied. With that goal in mind, SBPO’s Path to Excellence & Innovation Initiative provides outreach, training and technical assistance to HBCUs interested in pursuing contracts at NIH and other federal agen- “The first thing is expectation. If we expect cies. The University of the Virgin Islands (UVI) is one of six HBCUs participating in the initiative’s this to be short-lived, we have been remark- pilot program. ably, if not catastrophically, disappointed.” Dr. David Hall, president of UVI, highlighted a partnership with entrepreneur and biologist Donald He drew on lessons that World War Toatley and his company SafePass IDS. Together, they developed a science-based technology II survivors recalled learning from the designed to mitigate the consequences of Covid-19: the SafePass Intelligent Disinfectant Station, a London Blitz, when what had at first been full-body, zero contact unit. According to Toatley, this product is possibly the first technology that forecast as a massive but short-term air raid combines 3 sanitizing modalities and 2 health mandates in 1 system. ultimately became a prolonged 9-month SafePass uses a vaporized disinfectant hydrogen peroxide mist that is gentle to the skin and bombing campaign. Once they realized the recommended by the Food and Drug Administration. Additional decontamination is provided by onslaught was going to continue beyond a Far UVC light at a wavelength between 200 and 400 nanometers, a sanitizing feature that is early predictions, survivors’ mindsets began routinely used to kill bacteria and viruses and is harmless to the human body, as well as blue light therapy, according to an informational video (https://youtu.be/DJnBmRoKOBA) presented at the to recalibrate and their resolve formed. conference by Hall. The acceptance seemed to be a turning point for emotional recovery, Everly sug- The station also distributes hand sanitizer, detects whether a person is wearing a face mask and takes his or her temperature. gested. “The expectation, the self-fulfilling prophecy—the ‘What are we in for? We’re in Along with the presentation on the SafePass station, NIH’s Federal Industry Day featured match- for a long haul’—That in and of itself may be a making sessions between representatives of 27 HBCUs and 43 government agencies. During these one-on-one conversations, HBCU representatives had the opportunity to present their institutions’ game changer.” technical capabilities to federal procurement officials responsible for acquiring goods and services The full session is archived at https:// for the government. videocast.nih.gov/watch=38425.

NIH RECORD • NOVEMBER 27, 2020 • 5 Dr. Michael DeBakey arrives in in 1965 to advise physicians there about the health of former Syrian President Shukri Kuwatli (1891-1967). Kuwatli had lived in exile in since 1958. PHOTO: EMBASSY OF LEBANON At right, Farhan delivers NLM’s 4th annual Michael DeBakey Lecture in the History of Medicine.

DeBakey “DeBakey’s heritage was a source of Farhan, who teaches history at the CONTINUED FROM PAGE 1 pride not only to doctors, but also to the American University of Sharjah in the immigrants, he was especially revered across general population in the Middle East,” United Arab Emirates, has been researching the Middle East. said Farhan, an Iraqi-born scholar. “When the internationalization of the medical The National Library of Medicine houses mentioned, almost always, his Lebanese profession—with a focus on medical schools an archive of DeBakey’s seminal papers heritage is underscored alongside his in Iraq and Lebanon—and DeBakey’s historic and further honors his legacy by hosting a innovation, research and professional role in the process. She highlighted his April namesake annual fellowship program and accomplishments.” 1954 visit to the region during which he lecture. Recently, Dr. Sara Farhan, one of six The pioneer of open-heart surgery, attended the Middle East Medical Assembly 2019 DeBakey fellows, spoke via videocast to DeBakey designed cardiac pumps and (MEMA) at the American University of offer the 4th NLM Michael DeBakey Lecture surgical instruments, some of which are Beirut (AUB). in the History of Medicine. still used today. Having learned to sew from DeBakey’s attendance at MEMA was • • • “DeBakey’s footprints in the Middle East were planted prior to his 1954 visit. Medical colleges in the Middle East studied, applied and taught DeBakey’s findings. His name was part of the medical lexicon in the region.”

~DR. SARA FARHAN • • • his mother, in the early 1950s, he stitched significant on multiple levels and was viewed the first Dacron grafts to replace sections of as an opportunity to bolster international blood vessels damaged by aneurysms. ties among and medical professors. In the 1960s, DeBakey performed the first “Doctors in the Middle East were successful coronary bypass and some of the members of an international professional first heart transplants. He performed more community where the exchange of knowl- than 60,000 surgeries in his lifetime and edge was rooted in lifelong learning,” Farhan operated on some internationally promi- said. Their networking with other prominent nent figures, including the shah of Iran and doctors from around the world symbolized members of the Saudi royal family. During that they did not work in a vacuum, she his 50-year affiliation with Baylor College of added, helping to dispel notions of the A statue honoring DeBakey on the American Medicine in , where he was chief of Middle East as a backward, isolated region. University of Science and Technology’s campus surgery, he trained surgeons from around From Beirut to Baghdad, doctors in Beirut the world. embraced new developments in medicine

6 • NIH RECORD • NOVEMBER 27, 2020 and had been captivated by DeBakey’s life-saving NINR Director To Address cardiovascular innova- Health Impacts of Where tions for years. People Live “DeBakey’s footprints in the Middle East were Dr. Shannon Zenk, the new director of NINR, will present “All Health Is Not Created Equal: planted prior to his Where You Live Matters” on Wednesday, Dec. 1954 visit,” Farhan said. 9, from noon to 1 p.m. Her talk (webcast only) “Medical colleges in the is the 2020 Stephen E. Straus Distinguished Middle East studied, Lecture in the applied and taught Science of Complementary DeBakey’s findings. His Therapies, which name was part of the honors NCCIH’s medical lexicon in the founding region.” director. The 1954 MEMA There’s a saying came at an auspicious that “you are time, when medical DeBakey stitches a Dacron graft artificial artery at home, on his wife’s what you eat,” sewing machine in 1955. One of DeBakey’s most important surgical educational ties were but maybe it innovations was the Dacron vascular graft, which he developed to should be “you replace sections of blood vessels damaged by aneurysms, especially flourishing between the are where you in the aorta. United States and the eat.” Social Middle East. After World PHOTO: BAYLOR COLLEGE OF MEDICINE and economic War II, anti-colonial New NINR director factors, such as Dr. Shannon Zenk movements across the Middle East pre- Arab nationalism—instruction in Arabic where a person will deliver the 2020 lives, powerfully Straus Lecture. sented new opportunities for collaboration. and the ban on foreign language books— influence health. As ties weakened with France and England, was hindering international networking Such factors the two major colonial powers, students opportunities there. affect one’s risk of exposure and susceptibility and doctors increasingly sought training at Medical journals in the Middle East to many diseases and conditions, as well American colleges, said Farhan. had cited DeBakey’s work as early as 1940, as various other health, functioning and quality-of-life outcomes and risks. During this period of heightened Arab describing his sleeve-valve transfusion nationalism, the work of medical pioneers syringe, one of his first inventions back in Zenk, a leading population health scientist and of Arab descent, including DeBakey— medical school at . a registered nurse, will explore the science behind social determinants of health, discuss whose Lebanese family name was “But the exchange of knowledge was development of effective interventions to Dabaghi—gained growing attention across not one-directional,” said Farhan. DeBakey address health and health inequities and share the region. “DeBakey became an extension collaborated with surgeons and had studied how we can better understand what affects of the region’s contribution to the history the works of doctors from the region, people’s health and drives health disparities. of advancement in modern medicine,” said including prominent Iraqi surgeon Dr. Yousif Her research focuses on social inequities and Farhan. al-Naaman and AUB’s Dr. Amin Khairallah. health with a goal of identifying effective, Against this backdrop, it’s not surprising “This is especially important because multilevel approaches to improve health and that the U.S. State Department encouraged it highlights that DeBakey celebrated the eliminate disparities. Zenk’s portfolio has included NIH-supported work examining DeBakey to travel to Beirut for the MEMA knowledge exchange shared between the urban food environments (including food in 1954. Middle East and the United States,” Farhan deserts), community health solutions and “I speculate that the State Department said. “He did not see himself as superior veterans’ health. More about the NINR hoped DeBakey would establish new ties in to medical professionals in the region, director is available at https://www.ninr.nih. Beirut in hopes of persuading doctors and but as their equal.” His relationships with gov/aboutninr/zenk. politicians alike to consider the United States medical professionals across the Middle East To attend this virtual event, register at https:// as a worthwhile ally for medical meetings, continued to flourish for decades, until his strauslecture2020.eventbrite.com. The lecture missions and campaigns,” said Farhan. death in 2008. will be archived at videocast.nih.gov. It is supported by the Foundation for the National The MEMA conference lasted 3 days, Farhan closed by sharing a poem she Institutes of Health with a gift from Bernard but DeBakey would remain in the Middle came across in NLM’s archival collection and Barbro Osher. East for a month, lecturing and touring that she thought highlighted DeBakey’s Individuals who need reasonable accommoda- at 5 medical colleges in 3 countries. His influence on the region. In his 1953 A Brief tion to participate should contact info@nccih. lectures mainly focused on the science. Medical Bible: Ethics in Medicine, Khairallah nih.gov or the Federal Relay, 1-800-877-8339, But in Syria, where he traveled to two wrote: “Today well-lived makes every by Dec. 2. medical colleges with a local doctor, yesterday a dream of happiness, and every DeBakey boldly expressed concern that tomorrow a vision of hope.”

NIH RECORD • NOVEMBER 27, 2020 • 7 Brown CONTINUED FROM PAGE 1

neuroanatomical differences across ages from childhood to adolescence to young adulthood,” said Brown, vice chancellor for research and distinguished professor of psychology and psychiatry at the University of California, San Diego. Adolescence—the transitional period that begins at puberty and continues to legal adulthood—is a pivotal time for children. During this period, they become more independent, develop social skills and learn to control their own behaviors, thoughts and emotions. They also take more risks, such as using alcohol and other substances. The behavior of adolescents has changed over the past 25 years, said Brown. Today, almost all youth have smartphones and fewer get driver’s licenses. The teen preg- nancy rate has decreased, while the rate of depression and anxiety in teens is increasing. Alcohol is an adolescent’s preferred Stress and trauma appear to be related to the onset of moderate to heavy alcohol use, said Brown. substance of use, she said. The rate of use increases dramatically from 8th to 12th after an adolescent starts drinking, research- consortium with Dr. Susan Tapert, said 5 grade. Eight percent of eighth graders ers set up a long-term study to observe the sites across the U.S. enrolled more than 830 reported drinking in the last month, in a effects in boys and girls ages 12-14. Three adolescents. national survey of substance use. By 12th years after the study started, they found that Each year, study participants undergo grade, 30 percent have consumed alcohol learning and memory problems followed brain imaging scans, neuropsychological in the last month and 20 percent reported testing and assessments of being drunk in that period. their behavioral functioning, Youth drink differently than adults, w w w including alcohol use and Brown continued. Those under 21 drink related problems. The group’s about half as often as adults, but when they “Impulsivity appears to be a strong goal is to determine the do drink, they consume twice as much. predictor of earlier consumption rather effects of alcohol use on the Because alcohol is illegal for underage than later consumption.” developing adolescent brain drinkers, they often drink faster. and examine brain character- There are consequences of teen drinking. ~DR. SANDRA BROWN istics that predict alcohol use A third of teens who drink say their grades w w w problems. suffered and one-fifth reported unsafe “Over the course of 10 years driving related to alcohol use. One in 2 of study, we will be observing say they regret their behavior while under the onset of heavy drinking. Not all of these these youth during key periods of time when the influence and 1 in 5 admit that alcohol problems are permanent, however. it’s most likely they will have onset and created relationship problems, including Brown found that when youth stop offset of alcohol disorders,” Brown said. early, unwanted or risky sex. drinking heavily, they spend more time So far, the consortium researchers Animal models of adolescent alcohol con- on homework and increase their exercise. have found that heavy drinking during sumption and its consequences have found Following abstinence, boys are more anxious adolescence disrupts normal brain growth that juvenile mice consume 2 to 3 times than girls initially, while girls showed poorer trajectories in inhibition and integration. more alcohol than adults, Brown explained. mood states for longer, her team found. It’s They’ve also discovered that youth drinkers They are more sensitive to the rewarding not clear why. have more sleep disturbances, suggesting effects of alcohol, and have memory and In 2012, NIAAA established the that alcohol and sleep influence each other. executive function problems because of it. National Consortium on Alcohol and “Impulsivity appears to be a strong To determine how early these neurolog- Neurodevelopment in Adolescence predictor of earlier consumption rather than ical problems and mood disruptions begin (NCANDA). Brown, who co-directs the later consumption,” Brown reported. These

8 • NIH RECORD • NOVEMBER 27, 2020 findings suggest that risk factors change as a person matures. Stress and trauma appear to be related to the onset of moderate to heavy alcohol use. In the NCANDA sample, almost 50 percent have experienced a traumatic event such as a death in the family, a natural disaster, severe accident or sexual assault or abuse. Brown said the consortium has also devel- oped a smartphone app called M-NCANDA to assess what youth are doing daily. Although NCANDA is a large study, “It takes much more than that, especially if we’re interested in looking at additional roles of genetics and other environmental factors,” cautioned Brown. Another study, the Adolescent Brain Cognitive Development (ABCD) Study that Brown co-directs with Dr. Terry Jernigan, has recruited almost 12,000 9- and 10-year- olds and will follow them for a decade. The objectives of the study are to develop standards for normal brain development CLOSE TO HOME and measure individual developmental Nature Made trajectories of cognitive function and health behaviors. Answering the NIH Record’s call for images spied in nature, Dr. Ji Luo, an investigator The larger sample size will enable in NCI’s Laboratory of Cancer Biology and researchers from the 21 sites across the Genetics, took these photos over the summer country, as well as scientists around the on outings not far from his home. world, to study the roles of genetic and Clockwise (from above): environmental factors on development and how physical activity, sleep and social This deer peered at him from the woods near Quince Orchard High School. activities influence development. Through ABCD, scientists will also be able to observe This vibrant dahlia was blooming at the how the onset of mental health disorders Agricultural History Farm Park in Derwood. might interact with substance use. Luo spotted this baby goat at Homestead “NCANDA and ABCD are not experimen- Farm in Poolesville. tal studies, they are observational studies,” Luo noticed this colorful mushroom sprouting Brown concluded. “Their data should lead up by the trail around Clopper Lake in Seneca to hypothesis-driven experiments that can Creek State Park. answer important developmental questions.” The Mendelson Lecture honors Dr. Jack Mendelson’s scientific contributions to the field of alcohol research. It features an investigator who has made significant contributions to understanding susceptibil- ity to alcohol use disorder (AUD), alcohol’s effects on the brain and other organs and the prevention and treatment of AUD.

NIH RECORD • NOVEMBER 27, 2020 • 9 DIGEST

Treatments for People with Early Covid-19 the section on endocrinology and genetics at NICHD, and colleagues. It appears in JCI Insight. Infection Is Urgent Research Focus Prkar2a contains the information needed to make 2 subunits—molecular Covid-19 treatments for people with early infection are needed urgently, components—of the enzyme protein kinase A. Enzymes speed up chemical according to a JAMA Viewpoint article by NIAID director Dr. reactions, either helping to combine smaller molecules into larger mole- and colleagues. Treating people early in the course of infection with SARS- cules, or to break down larger molecules into smaller ones. Protein kinase A CoV-2, the virus that is the central enzyme that speeds reactions inside cells in many species. In causes Covid-19, would a previous study, the NICHD team found that, despite being fed a high-fat speed their recovery, diet, mice lacking functioning copies of Prkar2a were less likely to become reduce the likelihood obese than wild type mice with normally functioning Prkar2a. that they develop severe outcomes and reduce Gut Trains Immune System to Protect Brain demand on the health care system, they write. The membranes surrounding our brains are in a never-ending battle against deadly infections, as germs constantly try to elude watchful immune Despite experiencing cells and sneak past a special protective barrier called the meninges. In a only mild symptoms early study involving mice and human autopsy tissue, researchers at NIH and in infection, many Covid- Cambridge University have shown that some of these immune cells are 19 patients progress to trained to fight these infections by first spending time in the gut. severe disease that leads to hospitalization. Some “This finding opens a new area of neuroimmunology, showing that gut-ed- also will experience Colorized scanning electron micrograph ucated antibody-producing cells inhabit and defend regions that surround lengthy recoveries and of an apoptotic cell (tan) heavily infected the central nervous system,” said Dr. Dorian McGavern, senior investigator with SARS-CoV-2 virus particles (orange), develop long-lasting at NINDS and co-senior author of the study, which was published in Nature. isolated from a patient sample fatigue, mental impair- The central nervous system (CNS) is protected from pathogens both by a ment and problems with IMAGE: NIAID INTEGRATED RESEARCH FACILITY, FORT DETRICK, MD. three-membrane barrier called the meninges and by immune cells within heart and lung function. those membranes. The CNS is also walled off from the rest of the body by While several treatments such as remdesivir and dexamethasone are either specialized blood vessels that are tightly sealed by the blood-brain barrier. available or in development for severe Covid-19, interventions that can This is not the case, however, in the dura mater, the outermost layer of the be administered early during the course of infection to prevent disease meninges. Blood vessels in this compartment are not sealed, and large progression and longer-term complications are urgently needed. venous structures, referred to as the sinuses, carry slow-moving blood back to the heart. The combination of slow blood flow and proximity to Studies are underway to assess whether existing antivirals can be repur- the brain requires strong immune protection to stop potential infections in posed for early treatment. Scientists also are exploring the effectiveness their tracks. of early treatment with therapies that specifically target SARS-CoV-2, such as convalescent plasma and monoclonal antibodies. Investigators also are “The immune system exploring strategies to deliver therapies by alternative routes other than by has invested heavily intravenous infusion, such as by inhalation or intramuscular injection. in the dura mater,” said McGavern. Continued research is needed to refine current treatment candidates and “The venous sinuses develop new drugs, and treatments will need to be administered easily and within the dura act made available widely at low cost, according to the authors. like drainage bins, and, consequently, NIH Researchers Identify Gene in Mice That are a place where Controls Food Cravings, Desire to Exercise pathogens can accu- mulate and potentially NIH researchers have discovered a gene in mice that controls the craving enter the brain. It for fatty and sugary foods and the desire to exercise. The gene, Prkar2a, is makes sense that highly expressed in the immune system the habenula, a tiny would set up camp in brain region involved this vulnerable area.” in responses to pain, stress, anxiety, sleep In this study, and reward. The McGavern’s team Researchers have shown that some immune findings could inform worked with researchers in a lab cells are trained to fight infections by first future research to spending time in the gut. prevent obesity and led by Dr. Menna its accompanying Clatworthy of the risks for cardiovas- UK’s University of Cambridge to look at what immune cell types reside in cular disease and the outer layers of the meninges of mice and humans. What they discovered diabetes. The study was rather surprising: there were many immune cells previously educated NIH researchers have discovered a gene in was conducted by to make antibodies against specific microbes. These antibody-producing mice that controls the craving for fatty and Dr. Edra London, cells, called IgA cells, are typically found in other barriers such as the sugary foods and the desire to exercise. a staff scientist in mucous membranes of the bronchial tree of the lungs and gut.

10 • NIH RECORD • NOVEMBER 27, 2020 MILESTONES

Farhat To conducting nationally representative, cancer treatments. During that time, she was Direct NIMHD population-based surveillance and cohort a clinical trials coordinator and an associate studies examining multilevel influences on investigator on two chemoprevention trials Office health and health disparities, to developing for women at increased risk of breast cancer. Dr. Tilda Farhat and evaluating interventions to improve Loud held leadership roles throughout has been named health. the division, at NCI and other professional director of the Farhat received her Ph.D. in health communities. She served on key commit- Office of Strategic behavior from the Gillings School of Global tees, including the technical evaluation of Planning, Public Health at the University of North questionnaires committee, committee of Legislation and Carolina at Chapel Hill and completed a scientists and the NCI women’s health activi- Scientific Policy fellowship in population studies at UNC’s ties committee. Her dedicated involvement at the National Carolina Population Center. She also earned with NCI’s Clinical Center institutional Institute on certificates in international development review board, first as affiliated scientist and Minority Health (UNC) and population policy communica- then as deputy chair, established her as an and Health Dr. Tilda Farhat tion (Population Reference Bureau). invaluable resource for human subjects Disparities. The Farhat received an M.P.H. in epide- research regulatory matters. office will soon be called the Office of Science miology and biostatistics and a B.S. in In the months before her retirement, Policy, Planning, Evaluation and Reporting. environmental health from the American Loud’s expertise in web-based data and Farhat will oversee NIMHD’s science University of Beirut. patient management systems was critical policy, scientific reporting, strategic to DCEG’s Covid-19 pandemic response, planning, program evaluation, data manage- Loud Retires bringing the COVIDcode study of genetic ment and analyses. She will collaborate with After 27 and immunologic contributions to the severity of disease from conception to staff across NIMHD to uncover scientific Years at NCI gaps, identify research opportunities and production in less than 6 months. facilitate informed decision-making to Dr. Jennifer “Jennifer’s kind and gentle spirit, clinical promote minority health and health dispari- Loud, adult nurse and scientific rigor and mentoring of staff at ties research. practitioner and all levels has been the foundation for CGB’s Prior to this role, she has served as a assistant chief continued success,” said Dr. Sharon Savage, health scientist administrator and lead for in the Clinical DCEG clinical director and chief of CGB. the data, analysis, resources and evaluation Genetics Branch “She has been my right hand, my voice of team in the office. (CGB), Division reason, my sound board—and she will be Farhat came to NIMHD from the National of Cancer missed dearly.” Cancer Institute, where, as a program Epidemiology director at the Center to Reduce Cancer and Genetics Health Disparities, she managed a portfolio (DCEG), retired Dr. Jennifer Loud retired of biomedical and behavioral research in August after 27 after 27 years of service programs designed to reduce disparities in years of service at NCI. VOLUNTEERS cancer prevention, diagnosis, treatment and to the National survivorship. She also provided expertise Cancer Institute. in monitoring and evaluation of program She played a pivotal role in multiple clinical performance and effectiveness in addressing and epidemiologic studies aimed at improv- Fatigue Study Needs Cancer Survivors cancer health disparities. ing our understanding of clinical cancer Prior to NCI, her research at NICHD’s genetics and the psychosocial impact of high NIH researchers are enrolling cancer survivors to better understand fatigue Division of Intramural Population Health genetic risk of cancer on affected individuals in people with cancer. Fatigue is a Research examined adolescent and young and families. common side effect of cancer and cancer adult health nationally and internationally “Jennifer was one of the first people I treatment, but it is poorly understood. through an ecological and developmental recruited to CGB,” said Dr. Mark Greene, Research has indicated that cancer-re- perspective. NIH scientist emeritus and former chief lated fatigue may be caused by a number of factors, including immune system Farhat’s research and areas of interest of CGB. “I could never have envisioned responses to cancer treatment. To learn focus on behavioral and social epidemiology, recruiting an investigator and colleague with more, or to participate, call the Office of intervention research for behavior change, the extraordinary array of traits, skills and Patient Recruitment, 800-411-1222 (800- adolescent and young adult health, social, potential that Jennifer embodied.” 877-8339 TTY/ASCII) or email PRPL@ ecological and developmental perspectives Prior to her arrival in DCEG, Loud spent cc.nih.gov. Refer to study 11-NR-0014. Read more at https://go.usa.gov/xGcgw. on health and health disparities, as well as 7 years as a nurse practitioner with NCI’s global health. Her public health program- Medical Oncology Branch, working with matic and research experience ranges from individuals enrolled in clinical trials of new

NIH RECORD • NOVEMBER 27, 2020 • 11 SEEN

A moment for love: A screenshot from NIH’s first virtual Halloween charity fair and mask contest

CFC Virtual Halloween Event Imaging and Bioengineering is leading the 2020 to worry about the weather and simply viewed the NIH CFC. proceedings in the comfort of their office or remote Raises Awareness location. Hosts Debra Gale, NIH CFC program manager, NIH’s first virtual Halloween charity fair and mask and Monica Hanson, CFC team and charity lead, The event included three CFC charities, which contest in support of the Combined Federal welcomed everyone to the event. Traditionally, the provided information about their mission and Campaign took place Oct. 29 and was available via CFC Halloween charity fair is held outside at Bldg. expressed how thankful they were for donations, NIH Videocast. The National Institute of Biomedical 31, rain or shine. This year, participants did not have acknowledging that every dollar counts. The highlight of the day was the 12 brave NIH staff who entered the mask contest. Contestants were asked to design original masks that were creative, inspirational, funny or scary, using different types of materials, to paint, decorate and draw messages. Designs that included a CFC message earned an extra point. Several masks included the CFC theme “Show Some Love,” which made it difficult for the judges to select the top three winners. Taking the top three places were “Love Conquers All” by Lisa King of NCI, “The Wishing Tree” by CSR’s Joyce Coffman and “Mask of the Causes” by Danielle Fenwick, also of NCI. To view the event, visit videocast.nih. gov and check past events. To learn more about the CFC, visit Costume prize winners speak (from l): “My mask is made of cardboard with pantyhose for the flesh for the face, https://cfc.nih.gov and consider makeup, sponge for the bulging eye, fake eyelashes, fake wounds, glitter, plastic teeth, paint, makeup, headband, making a pledge today. paper, string and spiders,” said top contestant Lisa King. “People travel from all around to hang their wishes on the Wishing Tree, which provides the people with hope that their wishes will come true,” said second-place finisher For more information, contact Joyce Coffman. “My mask celebrates the causes that aim to address health issues that have plagued my family and Gale at (301) 496-2370 or email friends,” said third-place finisher Danielle Fenwick. Those issues include breast cancer, mental health and epilepsy. [email protected].

12 • NIH RECORD • NOVEMBER 27, 2020