Medical Student Fellowship

Faculty Mentor/Project Options

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(Listed Alphabetically)

Andrea J. Apter, MD., MSc
Associate Professor, Medicine
Section of Allergy & Immunology
Division of Pulmonary, Allergy, & Critical Care Medicine
829 Gates Building
Hospital of the University of Pennsylvania
3600 Spruce Street
Philadelphia, PA 19104
Tel: (215) 615-3869 Fax: (215) 615-0780
apter@mail.med.upenn.edu

Project: Individualized Interventions to Improve Asthma

Introduction
Low-income minority adults have excessively high rates of morbidity from asthma. Poor adherence has been documented in these patients and contributes to this high morbidity. We will conduct a randomized controlled trial of Problem Solving (PS) compared with Attention Control (AC) to improve and sustain asthma self-management deliverable in a clinical setting that includes strategies to address contextual factors related to adherence. This research is an NIH-funded intervention study to reduce asthma morbidity. The intervention is based in clinics that treat low-income minority patients and involves individualizing a problem-solving approach to participant needs. The fellowship will introduce the student to research addressing health disparities and to the sub-specialty of allergy and immunology, to asthma management, to clinical research, and to a career in academic medicine.

The Role of the Medical Student
The fellow will work as a research coordinator for an NIH-funded project entitled “Individualized Interventions to Improve Asthma”. The fellow will interview potential and enrolled subjects. Some of the participants are Spanish-speaking and fluency in Spanish is required. The fellow will recruit participants. This will include telephoning and contacting patients, screening patients for eligibility, using spirometry and interviewing participants. The fellow will learn spirometry, interviewing techniques, the importance of the Institutional Review Board and HIPAA regulations, and the ethical issues surrounding patient-oriented research. The student will enter data and participate in some data management tasks. The student will learn about asthma, allergy & immunology, epidemiology, adherence, behavioral change theory through readings and conferences. We will apply for a fellowship for the fellow to attend a national meeting. If the student is sufficiently dedicated and creative, she/he will have the opportunity to develop a related research project.

Project Summary
PS addresses and integrates solutions to a problem of the participants' choosing, tailoring problem-solving to participants' needs with ways to maintain or improve adherence using a simple 4-step protocol. Specific aims are to test whether:

  1. PS improves adherence to inhaled corticosteroids (ICS) over AC among adults with moderate or severe persistent asthma receiving care from urban clinics serving low-income minority populations
  2. PS improves asthma control over AC
  3. PS improves asthma-related quality of life over AC

We will recruit 390 adults from 5 clinics and randomize these participants to PS or AC, stratifying by site and type of ICS. Because there are no electronic monitors providing date-time adherence data with the most frequently used dry powder inhalers, we have developed and tested one and will be able to obtain date-time data on all participants. The intervention will take place over 3 months. Participants will be followed for an additional 3 months.

We will explore whether improved knowledge of ICS, beliefs about ICS benefits, and self-efficacy provided by the intervention mediate the relationship between PS and adherence. We also will explore whether personal characteristics and contextual influences (e.g. ethnic group, educational attainment, asthma severity, etc.), social interactions (e.g. trust of and satisfaction with communication with the provider, social support) and generative capabilities such as innate problem-solving ability and absence of depression moderate this relationship. We will estimate the incremental cost-effectiveness of PS.

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Lily A. Arya, MD, MS
Associate Professor
Obstetrics and Gynecology
Urogynecology and Reconstructive Pelvic Surgery
Tel: 215 662 4147
Email: larya@mail.obgyn.upenn.edu

Project: African American women have been shown to have higher rates of urinary incontinence and bladder problems than Caucasian women. Unhealthy fluid intake patterns have been shown to be associated with urinary incontinence in women. We have extensively developed and validated a questionnaire that determines fluid intake pattern in women and correlates this with urinary symptoms. Dietary habits of adult women are established in early adolescent years. The medical student will develop the community- based aspect of the study of fluid intake pattern in minority adolescent women.

The Role of the Medical Student: An interventional study is planned in West Philadelphia High Schools. This will be done in close collaboration with the Office of Community Development of the University of Pennsylvania; which already has ongoing activities in these schools. It is expected that the student, under guidance of the faculty mentor, will determine fluid intake pattern in adolescent minority women using the validated questionnaire described above. Additionally, the student will determine knowledge, attitude, and behavioral aspects of fluid intake in teenage women. The student will then design and conduct a short teaching session that will educate teenage girls on healthy fluid intake. Finally, a 'post-test' will be conducted to determine the impact of the teaching session on actual fluid intake.

The medical student will work closely with the faculty mentor to develop the study protocol, administer it in adolescent women and conduct the teaching intervention. The student will be provided with statistical support in data collection and analysis. It is expected that through this project the student will learn about behavioral aspects of women's health as well as the design and conduct of a community-based epidemiologic investigation. The project will expose the student to all aspects of research ranging from study design, data collection and statistical analysis to final manuscript writing. It is expected that the student will present the research at a national meeting and author the manuscript under the faculty's mentorship.

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Ian M. Bennett, MD, PhD
Assistant Professor
Department of Family Practice and Community Medicine
2nd Floor Gates Building, HUP
3400 Spruce Street
Philadelphia, PA 19104
Tel: (215) 614-0849
ian.bennett@uphs.upenn.edu

Project: The period from initiation of pregnancy through prenatal care, delivery, postpartum and to the next pregnancy represents a critical time for women from vulnerable populations. The ongoing research projects that I am engaged in all focus on this time frame for women in populations which suffer from disparities in maternal child health. Our work aims to identify specific mechanisms by which these disparities are generated and perpetuated with the goal of developing interventions to reduce these disparities. Current projects include studying:

  1. the role of low literacy in reducing the delivery and utilization of maternal health services
  2. the treatment of depression among women who have recently had an early pre-term birth
  3. the delivery of an integrated maternal health and literacy program for pregnant women with low literacy
  4. the relationship between low literacy and teen pregnancy.

A FOCUS student would have the opportunity to choose a specific project from these areas and could carry out activities such as direct interviews with patients in pregnancy or immediately following delivery. Because of the diverse set of issues involved with the social factors affecting these women an individualized project would be developed with the student to ensure that the goals of the project match their own interests. The student would be fully integrated into the research team and participate in weekly research group meetings along with individual meetings with me as needed (a minimum of one per week) to ensure that the project is progressing adequately and to troubleshoot any obstacles. The results of the work will be constructed in the form of a paper which can be presented at appropriate meetings and published in scientific journals.

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Hillary Bogner MD MSCE
Assistant Professor
Department of Family Practice and Community Medicine
University of Pennsylvania
3400 Spruce Street - 2 Gates Building
Philadelphia, PA 19104
Tel: 215-615-0851
bogner@mail.med.upenn.edu

Project: My research interests center around women's health and depression. We are currently collecting data in the areas of mental health and preventive health behaviors among older women. Research leading to improvement of the quality of life of this growing segment of our population continues to be a priority. This study will evaluate how both depression and cognitive change affect the utilization of preventive health services among women from various ethnic groups using an interdisciplinary approach.

We know that many women do not receive the recommended preventive health services and do not adopt preventive health behaviors. One survey of American women found that substantial numbers of women had not had important preventive tests and did not follow a low-fat diet or do moderate aerobic exercise at least a few times a week. Women may not adhere to preventive health screening recommendations for a variety of reasons. Whether any relationship between preventive health behaviors and depression is consistent across different ethnic groups is not known. Our study will evaluate how both depression and cognitive change affect the utilization of preventive health services among women from various ethnic groups. In addition, we will utilize an interdisciplinary approach involving the fields of primary care, anthropology, psychiatry, and clinical epidemiology. The goal of this study is to investigate adherence to preventive health recommendations among community-dwelling older women with depressive symptoms. This project would provide the basis for data collection and analysis for a medical student interested in women's health. The medical student would be an integral part of the research team and participate actively in our work group meetings as well as other research meetings. As important as the research skills the student will learn are the insights the student would gain into how interdisciplinary research is carried out. The opportunity would be provided to draft a manuscript and submit the work for presentation and publication.

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Rhonda C. Boyd, Ph.D.
Assistant Professor
Department of Child and Adolescent Psychiatry
Children's Hospital of Philadelphia
Center for Family Intervention Science
3535 Market Street, Suite 1230
Philadelphia, PA 19104
Tel: 215-590-3945
email: rboyd@mail.med.upenn.edu

Project: Children of Depressed Mothers: Culture & Prevention

Extensive research has documented that children of depressed women are at a significantly high risk for developing a variety of psychological and socio-emotional difficulties. There is limited research focusing on African Americans. Nonetheless, depression is a psychological disorder that affects many African American women, and thus puts their children at risk. More research is needed to understand the transmission of psychopathology for African American families. Study 1 is a cross-sectional, descriptive study of depressed African American mothers and one of their school age children. Study 1 examines cultural and protective moderators (i.e., extended family support, social skills), mechanisms (i.e., negative parents, negative life events) and risks factors (i.e., exposure to community violence and racism) that may impact psychological outcomes in children of depressed African American mothers. Significant findings from Study 1 will be used to culturally adapt a cognitive psycho education preventive intervention for African American families with maternal depression in Study 2.

A medical student can participate in several research activities. These include assistance with recruitment of participants, conducting telephone interviews, administration of questionnaires to mothers and their children, data entry and analyses, and assistance with the adaptation of the intervention program. There is also an opportunity to be involved in presenting research and co-authoring a manuscript. In addition, the Center for Family Intervention Science has other projects focusing on maternal depression, which a medical student can become actively involved.

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Marcia S. Brose, MD, PhD
Assistant Professor
The University of Pennsylvania
Dept. of Otorhinolaryngology: Head and Neck Surgery
Dept. of Medicine, Div. of Hematology/Oncology
Abramson Cancer Center
BRB II/III, Room 1111
421 Curie Blvd
Philadelphia, PA 19104
Tel office: 215-746-6344
Tel lab: 215-898-2136
Fax:215-573-1934
e-mail: brosem@mail.med.upenn.edu

Project 1: Our first area of research aims to unravel the molecular basis of cancer by combining array Comparative Genomic Hybridization (aCGH) and Expression profiling to identify novel tumor suppressor genes, oncogenes, and therapeutic targets. Our approach involves the characterization of tissue already available to her in tissue banks across the campus by aCGH and expression profiling. Where appropriate, she will use high throughput genetic mutation screening to identify mutations in candidate genes in these tumors. She pursues research on all levels from clinical correlations of genomic profiles and expression data, to tissue culture experiments and immunohistochemistry. The data we generate is not only innovative and forms the basis of her own work but provides a valuable resource to others in the health system who are studying other aspects of the same tumors. Tumor specimens that we examine include thyroid cancer which is increasing in incidence and affects women four times more than men, and lung and head and neck cancers that affect both woman and men.

Project 2: The work that Dr. Brose proposes is born directly out of her previous work on BRAF mutations in melanoma and lung cancer and aims to delineate the role of newly described BRAF, RAS, EGFR and other point and frame shift mutations in several sporadic cancers, including thyroid cancer (which affects woman more than men). Her work on the underlying genetic changes that determine the development and behavior of disease will greatly contribute to the future development of novel therapeutic targets for the treatment. She has several projects already established involving active collaborations within the departments of Otorhinolaryngology-Head and Neck Surgery, Medicine (Endocrinology and Pulmonary divisions), and Pathology. Part of her work will aims to use genetic testing to improve the information obtained when patients undergo fine needle aspiration biopsies. Indeed she has already shown that genetic testing for BRAF and other common genetic alterations on these small samples is feasible, and has characterized over 300 samples. Thus, her work is truly on the cutting edge and will have major implications to both the treatment and diagnosis of several cancers. Tumor specimens actively under investigation in this part of the lab include breast, lung, head and neck and thyroid cancers.

Role of the Fellow: The medical student will become a full participant in the work of the lab, choosing a project and focus that appeals to their interest, and has a high probability to result in work that will be published, either in abstract or manuscript form. The lab follows a team approach to many of the projects allowing greater opportunity to participate in work that will be productive within a 6 to 12 month period. Potential projects range from completely lab-based projects, to those that involve the integration of laboratory and clinical data, to collecting and analyzing data and specimens associated with clinical trials.

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Samantha Butts, MD MSCE
Assistant Professor, Obstetrics and Gynecology
Division of Infertility and Reproductive Endocrinology
3701 Market Street, 8th Floor
Philadelphia, PA 19104
Tel: 215-662-2975
email: sbutts@mail.obgyn.upenn.edu

Project 1: Failure of Conservative treatment of Ectopic Pregnancy: Investigating the Role of Race

Description and Medical Student Project Goals: The incidence of ectopic pregnancy and the mortality associated with it represents a persistent racial health disparity in obstetrics and gynecology. According to the most recent estimates from the CDC, minority women have a nearly two-fold increased incidence of ectopic pregnancy and a nearly 4-fold greater risk of ectopic-related mortality compared to white women. Much of this racial divide has been attributed to differential healthcare access and delay of diagnosis.

Despite these well-documented disparities, there is no extant literature investigating differential outcomes of conservative management of ectopic pregnancy by race. Conservative treatment of ectopic pregnancy involves therapies in which the fallopian tube is not removed. The most commonly used conservative approaches include methotrexate administration and linear salpingostomy. Methotrexate, a folic acid antagonist which inhibits cellular division, is administered intramuscularly as a single- or multi-dose protocol. Linear salpingostomy involves incising the fallopian tube and removing the ectopic pregnancy. This permits the tube to heal by secondary intention. While extensive research has demonstrated these therapies to be highly effective, failure rates range from 5-10%. Successful treatment is determined by following B-hCG levels until they are undetectable. The consequences of failed conservative ectopic treatment include additional surgery, significant bleeding and inpatient hospitalization. In an attempt to identify risk factors for treatment failure, variables such as B-hCG levels, ectopic size and history of previous ectopic have emerged as significant; race as a risk factor for failure of conservative ectopic pregnancy treatment has not been adequately studied.

The objective of this investigation is to examine differences in effectiveness of conservative treatment of ectopic pregnancy by race. This area of investigation could shed light on the overarching health disparities associated with ectopic pregnancy and introduces the possibility that biology in addition to access plays a role. There is emerging data in the pharmacogenomics literature, for example, to support a possible genetic basis for racial differences in response to and toxicity from methotrexate. If clinical research such as this supports a difference, future studies investigating enzyme polymorphisms in the methotrexate pathway in patients with ectopic pregnancy would be warranted. It is hoped that results from studies such as these could optimize treatments for patients with ectopic pregnancy.

The medical student involved in this project would primarily assist with data collection and analysis. Patients with ectopic pregnancy are followed in a unique clinical database established at Penn which will need to be queried to track the patients of interest and acquire accurate clinical information. Regular individual meetings to discuss the progress of the project will occur during the fellowship. These will also be an opportunity for teaching so that the student may develop a solid understanding of clinical research concepts. Regular research-oriented meetings that occur in the infertility division will also be available for the student to attend to enhance exposure to research in women's health conducted here.

Project 2: Molecular markers of oocyte quality and reproductive aging

Description and Medical Student Project Goals: The focus of this research is the investigation of molecular markers that predict poor oocyte quality and premature ovarian aging in women treated for infertility with in vitro fertilization (IVF). There is mounting evidence that good human oocyte quality is a critical starting point for the development of a healthy embryo, fetus and placenta. Poor oocyte quality has been associated with infertility, miscarriage and fetal chromosomal abnormalities.

Despite the well-known correlation of ovarian and chronological aging, the molecular determinants of human oocyte quality are incompletely understood. Significant progress in this area is needed in order to optimize treatment protocols for infertility patients that result in the conception of healthy fetus. Furthermore, such research could enhance the ability of clinicians to better predict the odds of pregnancy with treatments such as IVF.

Specifically, the aim of this project is to evaluate the role of the following markers in human granulosa cells which support normal oocyte maturation:

  • Telomere attrition
  • Cellular Senescence
  • Oxidative Stress

It is anticipated that these factors either alone or in combination negatively impact granulosa cell survival and hence oocyte integrity.

A growing number of women in their late thirties and early forties who seek treatment for infertility are unsuccessful because these treatments are not fully able to circumvent the obstacle of diminished oocyte quality in this population. It is hoped that this line of investigation will elucidate some of the molecular pathways impacting human oocyte quality and contribute to the body of knowledge aimed at optimizing reproductive outcomes for women.

The medical student researcher involved in this project would have the opportunity to participate in an exciting translational research experience. He or she would be involved in multiple facets of the project and a fully integrated part of the team that manages this project. Some of the responsibilities of a student would include specimen processing and laboratory experiments (of which there are multiple), data entry and some analysis and regular meeting with the research team to trouble shoot and discuss the direction of the project. The opportunity to involved with both basic science and clinical epidemiologic research experience makes this a unique and potentially significant learning experience for the student. Part of the experience would include regular individual sessions to discuss issues unique to reproductive epidemiology and to reinforce the student's general understanding of clinical research themes.

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Youhai H. Chen, M.D., Ph.D.
Professor of Pathology and Laboratory Medicine
University of Pennsylvania School of Medicine
614 BRB II/III
421 Curie Blvd.
Philadelphia, PA 19104
Tel: (215) 898 4671. Fax: (215) 573 6725
yhc@mail.med.upenn.edu

Project: The major goals of Dr. Chen's research program are to understand the molecular mechanisms of autoimmune diseases (such as multiple sclerosis and type 1 diabetes) and to find a cure for these diseases. While it is well recognized that women are more susceptible to autoimmune diseases than men, the molecular basis of this disparity is not clear. The common pathological outcome of autoimmune diseases is the destruction of self-tissues by activated lymphoid and myeloid cells through a process called autoimmune inflammation. Development of autoimmune inflammation requires coordinated expression of myriad genes that mediate the activation, migration and effector functions of inflammatory cells. These include genes that encode antigen receptors, co-stimulatory molecules, cytokines, chemokines, and cytotoxic enzymes. To explore the spectrum and global patterns of gene expression during autoimmune inflammation, Dr. Chen's laboratory has recently performed functional genomic studies of autoimmune inflammation in the central nervous system (CNS) using a model of multiple sclerosis. Inflammation in the CNS not only induced the expression of many immune-related genes, but also significantly altered the gene expression profile of neural cells. A number of unique clusters of genes were identified which represent putative immune and nervous responses in autoimmune inflammation. Using models of immune tolerance and autoimmunity, Dr. Chen and colleagues are exploring the physiological and pathological roles of the following genes: the Rel/nuclear factor (NF)-kB family, Bim and trAIL as well as a newly cloned gene called inflammation-20 (INF-20). The following questions are being examined:

  1. What are the roles of these genes in the development, activation, migration and effector function of T cells recognizing self-antigens?
  2. What are the roles of these genes in the death of lymphoid cells, myeloid cells, oligodendrocytes and pancreatic beta cells?

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Lewis A. Chodosh, MD, PhD
Professor, Departments of Cancer Biology, Cell & Developmental Biology, and Medicine
Director, Cancer Genetics, Abramson Family Cancer Research Institute
612 BRB II/III
University of Pennsylvania School of Medicine
421 Curie Boulevard
Philadelphia, PA 19104-6160
Tel: 898-1321 Lab: 898-0006 Fax: 573-6725
email: chodosh@mail.med.upenn.edu

Project: Analyzing the mechanisms by which pregnancy protects women against breast cancer by using novel inducible transgenic animal models to activate oncogenic pathways relevant to human breast cancer, as well as microarray expression profiling of human, mouse, and rat samples, and standard molecular approaches. The participating medical student will be taught by - and interact with - a research team, but will assume primary responsibility for ongoing experiments.

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Emily F. Conant, M.D.
Professor of Radiology
Chief, Breast Imaging
Hospital of the University of Pennsylvania
3400 Spruce Street
Philadelphia, PA 19104
Tel: (215) 662-4032
email: Emily.Conant@uphs.upenn.edu

Project: Characterization and outcome of patients with non-mass enhancing breast MR lesions

This is a breast MR project pulling from the huge number of imaging cases that we have accrued through a large Program Project Grant ("Multi-modality Breast Imaging"). The case mix includes patients imaged under protocols for high risk breast cancer screening, breast lesion characterization and breast cancer staging . The patients have digital mammography, whole breast ultrasound and breast MRI. The purpose of the study is to better characterize non-mass enhancing breast lesions seen on MR. We are pretty good at giving a reasonable differential of benign versus malignant histologies for mass lesions on MR, but, when we have more non-specific, regional areas of enhancement, the disposition and outcome of the patients is less well understood.

Work effort:

  1. Query our large breast imaging database that has been developed for the grant for non mass MR lesions
  2. Create spreadsheet of these patients with information as to outcome (BIRADS category and Biopsy or follow-up and findings on other modalities - US, Mammo,PET
  3. Review images to create a cluster of finding groups (i.e.- ductal enhancement, clumped, regional, etc.)
  4. Develop a schema for these clusters with input from other imaging modalities; e. Develop predictive values for imaging findings based on outcomes
  5. Develop abstract for submission to RSNA (deadline April 15th, 2007) and write paper for publication

The FOCUS fellow would collaborate with the radiology and research staff as well as staff from the Biostats department. The goal would be for the fellow to complete both a publishable abstract and paper as a first author.

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Brian J Czerniecki, MD, PhD
Associate Professor of Surgery
Department of Surgery
University of Pennsylvania
4 Silver, HUP
3400 Spruce Street
Philadelphia, PA 19104
Tel: : 215-662-4392
email: brian.czerniecki@uphs.upenn.edu

Project: I conduct translational immunotherapy clinical trials for patients with Breast Cancer. We currently have an NIH funded dendritic cell clinical trial to evaluate the effect of vaccines in patients with early breast cancer (DCIS) prior to undergoing surgery. We have several projects in dendritic cell biology that are related to this clinical trial ongoing in the laboratory.

Goals: There are a couple of possibilities:

  1. The student can work on immune monitoring responses for the patients on the clinical trial including assays of tetrmers, Flow cytometry, T cell analysis using ELISPOT and in vitro sensitization assays. The student would also perform antibody quantitation assays all under the guidance of myself and a PhD Researcher. The student would have excellent mentoring in that regard. The student would learn quite a number of immunologic assays and as a result and could then generate a hypothesis to test for differences in responses among the patients. The student would become familiar with the latest advances in Breast Cancer Therapy, become familiar with pathologic types of DCIS and the variants. He/or she would also become very familiar with invasive breast cancer projects and help in the design of a similar clinical trial for use in the neoadjuvant treatment of invasive breast cancer.
  2. The second project that the student can become involved with is a molecular analysis of DCIS patients that recur. We have with the help of a former medical student developed a data base to analyze what factors are associated with DCIS that are more likely to lead to in breast recurrence when the patient is treated with breast conserving surgery. We hypothesize that those over-expressing HER-2/neu may have an increased risk of developing recurrence. This project involves immunohistochemistry, clinical epidemiology, and collection of tissue samples from a prospective cohort of patients as well as histology of archived material. This project is performed in collaboration with Dr. Zhang in pathology, and Dr. Xu in pathology.

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Richard L. Doty, Ph.D.
Professor, Dept. of Otorhinolaryngology
Director, Smell and Taste Center
University of Pennsylvania School of Medicine
5 Ravdin Building
3400 Spruce Street
Philadelphia, PA 19104
Tel: 215-662-6580 Fax: 215-349-5266
email: doty@mail.med.upenn.edu

Project: Postmenopausal Estrogen Influences on Olfaction

Since smell loss is among the first signs of Alzheimer's disease, and since estrogens may slow down the progression of cognitive deficits associated with aging and Alzheimer's disease, the question arises whether estrogen replacement therapy (ERT) is associated with preserving olfactory (smell) function after the menopause. The research study we are conducting has three main purposes:

  1. to determine, retrospectively, whether estrogen replacement therapy influences the ability of women 55 years of age and older to smell
  2. to determine whether an association exists between the amount/history of estrogen use and the olfactory test scores
  3. to determine if an association is present between olfactory function and measures of cognitive function (e.g., attention, memory).

The data to be collected in this study will provide important information as to the role of estrogen replacement therapy in mitigating age-related losses in the ability to smell. Importantly, this study will establish whether an association between estrogen use and the relative enhancement of olfactory function is paralleled by a similar association between estrogen use and the relative enhancement of cognitive function, as measured by tests of attention and memory. These findings have significance for the potential use of estrogen in the treatment and prevention of cognitive dysfunction in the later years. We are currently in the third year of this 5-year study. At this time 200 women have been enrolled in this project. At the conclusion of the study we will have 600 subjects.

The medical student who has the opportunity to participate on this research project will have many duties. He or she would be directly involved in recruiting and screening subjects as well administering the neuropsychological and psychophysiological tests to these subjects. He or she will also be involved in updating the current database as well as creating additional databases as needed. This student will assist in IRB renewal protocol including updating consent forms as well as screening criteria. Learning these skills will prepare them to be effective and competent researchers while pursuing their medical careers, in addition they will be working one on one with the public enhancing their skills as empathetic and patient caregivers.

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Susan M. Domchek, M.D.
Ann B. Young Associate Professor in Cancer Research
Abramson Cancer Center
University of Pennsylvania
3400 Spruce Street
Philadelphia PA 19104-4283
Tel: (215) 615-3360 Fax: (215) 615-3349
email: susan.domchek@uphs.upenn.edu

Project: My research focuses on inherited susceptibility to breast cancer, both in terms of identifying germline mutations and in optimizing the management of women at high risk. The Cancer Risk Evaluation Program at the University of Pennsylvania has a database of 2800 families with familial breast cancer. Detailed demographic information is available, as well as DNA in 1800 families.

Projects are ongoing regarding characteristics of families with B1/B2 mutations, attempts to identify mutations not apparent on standard B1/B2 testing, as well as ways to optimize the dissemination of information in families with known B1/B2 testing in order to enhance the uptake of genetic testing. A FOCUS student would have the opportunity to chose a specific project from among these areas. S/He would meet weekly with me and participate in weekly meeting of the research group. The expectation would be that the FOCUS student would develop a project and eventually prepare the results for publication.

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Lawrence Dougherty, Ph.D.
Research Associate Professor
Radiology / MRI
HUP
3400 Spruce Street
Philadelphia, PA 19104
Tel: 215-349-5274
DougheL@uphs.upenn.edu

Project: Development of a diagnostic interpretation model for breast cancer using dynamic and architectural MR imaging

Breast cancer is the most commonly diagnosed cancer and the second leading cause of cancer death among American women. It is estimated that one out of every nine women will develop breast cancer in her lifetime. While mammography has clearly become the gold standard in the detection of early, clinically occult breast cancer, it has limitations. These limitations in mammography have led to interest in developing new forms of breast imaging that may offer both higher sensitivity and higher specificity. Contrast-enhanced magnetic resonance (MR) imaging of the breast has been shown to be a potentially powerful technique for the detection and diagnosis of breast cancer. We have developed an interpretation model based on architectural features extracted from high-resolution breast MR images that has a high sensitivity for malignant disease. Other research has shown that an analysis of the time course enhancement can be used to predict malignant disease. We have developed an imaging method that allows us to reconstruct high spatial resolution images, as well high temporal resolution images, using the same data. With both kinetic and architectural enhancement data at our disposal, the overall goal of this study is to create a combined interpretation model. The model will be evaluated (400 subjects) for the diagnostic performance characteristics (sensitivity, specificity, positive predictive value [PPV], and the negative predictive value [NPV]) of the overall model in differentiating benign from malignant masses. With an effective prediction model, MR imaging can be a cost-effective step in the evaluation of patients with suspicious breast findings including a viable alternative to breast biopsy in some patients. The medical student will be involved in analysis of radiologists' reports, correlation with pathology and overall interpretation of results.

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Michal A. Elovitz, MD
Associate Professor
Department of Obstetrics and Gynecology
Maternal Fetal Medicine
Center for Research of Reproduction and Women's Health
Director of Resident Research
421 Curie Blvd., 1353 BRB 2/3
Philadelphia, PA 19104-6142
Tel: 215-573-0859
melovitz@obgyn.upenn.edu

Project: There are several different projects available for a motivated medical student. Possible projects include both basic science and translational research. Both 6 month and 12 month projects are available.

Inflammation-induced pre-term birth: Preterm birth is a leading contributor to perinatal morbidity and mortality. In the last decade, there has been a growing body of evidence correlating inflammation with pre-term birth. In that vein, we have created a mouse model of inflammation-induced pre-term birth. We have two broad aims:

  1. To elucidate the signal transduction pathways involved in inflammation-induced pre-term parturition
  2. To investigate the mechanisms by which inflammation-associated pre-term birth results in fetal and neonatal brain injury.

Each of these aims is independently funded. The majority of our research is focused in the laboratory. However, we use our results from our animal model to support translational research in the clinical realm of pre-term birth. Medical students choosing to work in our laboratory will gain experience in bench research involving molecular biology and the use of an animal model. Students will be encouraged to present their work at Center meetings as well as at national meetings.

Preeclampsia: Mechanisms and Consequences: Preeclampsia is a pregnancy specific disease. While this disease contributes to both maternal and fetal morbidity and mortality, the pathophysiology and etiologies of this disease remain poorly understood. While this disease occurs in pregnancy, it has long-term consequences for women's health. Specifically, women with a history of preeclampsia (pre-term) have an 8-fold risk of cardiovascular morbidity and mortality during their lifetime. To further elucidate the mechanisms and consequences of this disease, we have established a large prospective trail. This study is currently enrolling women with preeclampsia and control pregnant women. A diverse amount of demographic data is being collected as well as the following biological specimens (DNA for genotyping, maternal serum, placentas). Currently, we are investigating genetic polymorphisms that may significantly increase the risk of preeclampsia and cardiovascular disease, gene-gene interactions, gene-environment interactions, the role of metabolic syndrome in this disease, and the effect of preeclampsia on the fetus. A medical student would have the opportunity to partake in one of the existing studies and/or investigate a novel area within this cohort. The student would be expected to present and publish their findings under mentorship from the PI.

Medical students: Interested medical students should contact Dr. Elovitz. There is a wide range of potential projects in our laboratory.

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Gary D. Kao, MD, PhD
Associate Professor, Department of Radiation Oncology
University of Pennsylvania School of Medicine
Hamilton Walk
John Morgan 180H
Philadelphia, PA 19104
Tel: 215-573-5503 Fax: 215-898-0090
kao@xrt.upenn.edu

Synopsis

  1. The Candidate will apply translational, physiological, and cellular and molecular techniques to investigate and understand mechanisms leading to Breast Cancer viability and treatment resistance.
  2. The Candidate will undergo accelerated training in cancer biology, including that of Breast Cancer

Project Goals: Within the time frame of the Fellowship, we anticipate that the Candidate will become well-versed in standard investigative research techniques, initiate or complete a project, and participate in the composition and presentation of the results of the project, either via presentation or via manuscript. The Candidate will become an integrated member of and participate fully in all laboratory activities. The project assigned will be customized to fulfill the goals, inclinations, and talents of the Candidate.

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Sara B. Kinsman, MD, PhD
Assistant Professor of Pediatrics
University of Pennsylvania School of Medicine
Division of Adolescent Medicine
The Children's Hospital of Philadelphia
34th Street and Civic Center Boulevard
Philadelphia, PA 19104
Tel: 215-590-4734
kinsman@email.chop.edu

Project: Research as part of The Philadelphia Peer Influence Research Project (PPIP), a prospective study of 1,434 sixth graders, into the mechanisms by which peers influence adolescent sexual initiation in impoverished communities. Purpose of this study is to determine how popular young adolescent women, in particular, influence the behavior of peers during the sixth grade school year.

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Shiriki K. Kumanyika, PhD, MPH
Professor, Department of Biostatistics and Epidemiology
Senior Scholar, Center for Clinical Epidemiology and Biostatistics
Associate Dean for Health Promotion and Disease Prevention
Tel: (215) 898-2629
skumanyi@mail.med.upenn.edu

Project: Participation in research studies involving weight management in African American women. See http://www.sharestudy.org/

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Mary B. Leonard, MD, MSCE
Associate Professor of Pediatrics and Epidemiology
Division of Nephrology, Department of Pediatrics
The Children's Hospital of Philadelphia
Senior Scholar, Center for Clinical Epidemiology and Biostatistics
Phone: (215) 590-0874
leonard@email.chop.edu

Project: Women with end-stage renal disease suffer severe gonadal dysfunction and markedly increased risk of osteoporosis and hip fracture. The impact of chronic renal insufficiency (CRI) on gonadal function and bone structure, prior to requirements for dialysis therapy, are not known. We are currently conducting a longitudinal cohort study of bone density and structure (as measured by quantitative CT), gonadal function, nutrition and muscle function in 325 adults with CRI and 500 healthy controls. The objectives of the study are:

  1. To identify correlates of decreased bone dimensions, density and strength in CRI patients, such as the severity of renal dysfunction, PTH level, sex hormone deficiency, muscle strength, diabetes and prior therapies (e.g. vitamin D, calcium, and other phosphate binders)
  2. to determine the prevalence of hypogonadism in men and women with CRI, and to determine the association between the severity of renal dysfunction and hypogonadism.

Project goals and envisioned contribution of the medical student to the research: The overall objectives of the study are to identify correlates of decreased bone dimensions, density and strength in CRI patients, such as the severity of renal dysfunction, PTH level, sex hormone deficiency, muscle strength, diabetes and prior therapies (e.g. vitamin D, calcium, and other phosphate binders). The medical student would spearhead the analysis and interpretation of the sex hormone data (estradiol, testosterone, sex hormone binding globulin, prolactin, LH, FSH) and menstrual/reproductive data in the CRI patients at the time of the baseline visit (the final baseline visit was completed in March 2006) in order to determine the prevalence of hypogonadism in men and women with CRI, and to determine the association between the severity of renal dysfunction and hypogonadism. In addition, the student would assist with the on-going study visits in the control subjects, including collecting data on reproductive function and history. The student will also have the opportunity to contribute to the analyses of the relations between sex hormone data and bone structure.

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Steven Leff, PhD
Associate Professor of Clinical Psychology, Department of Pediatrics
University of Pennsylvania School of Medicine
Children's Hospital of Philadelphia
Tel: 215-590-7067
leff@email.chop.edu

Projects: We would be excited to have a medical student work with our team for the next year. The student could be involved in multiple aspects of the projects listed below, and would gain valuable experience with conducting community-based research in the urban schools. In addition, the student would have the opportunity to take a year-long Research Methods class that the principal investigator teaches at the Children's Hospital of Philadelphia, and to work collaboratively with research staff and diverse school personnel and children.

The Girls' Friend to Friend Program is an innovative school-based program that seeks to better understand and promote the social competence of at-risk 3rd and 4th grade girls. The program is supported by a 5 year grant from NIMH, and is currently being conducted at two urban elementary schools within the School District of Philadelphia. Main aspects of the project include:

  1. Designing three different behavioral observation systems on the playground to better understand and catalogue at-risk girls' play behaviors, aggressive actions, and strategies for entering social groups on the playground
  2. Developing cartoon-based social vignettes to better understand girls' thinking in potential conflict situations
  3. Designing and testing the efficacy of a 16 session friendship making and anger management group intervention that is jointly conducted by a research team member and a teacher partner. The friendship group uses cartoons, videotapes, and role-plays to teach children to develop anger coping, conflict resolution, and friendship making skills. The program has been conducted in five schools in the School District of Philadelphia over the past 3 years.

The Playground, Lunchroom, and Youth Success (PLAYS) Program is a positive-oriented, competency-based initiative that focuses upon empowering school staff members and community volunteers in supervising children across important school contexts. The key components of PLAYS include:

  1. Helping school personnel conduct a thorough safety assessment
  2. Clarifying school rules related to bullying and victimization
  3. Promoting proactive supervision in the lunchroom and playground
  4. Providing structured age- and gender-appropriate activities for children on the playground
  5. Helping educate school staff about the importance of recognizing characteristic ways in which girls' play behavior and aggression is distinctly different from boys. The program recently was cited as an example of “Best Practice” in the city of Philadelphia.

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Jun J. Mao, MD, MSCE
Assistant Professor
Department of Family Medicine and Community Health
Center for Clinical Epidemiology and Biostatistics
University of Pennsylvania School of Medicine
2 Gates Building / 3400 Spruce Street

Phone: (215) 615-4330
Fax: 215-662-3591
Email: Jun.Mao@uphs.upenn.edu

Project: Arthralgia, joint pain, is emerging as a major source of symptom burden in postmenopausal breast cancer surviviors (BCS) receiving Aromatase Inhibitors (AIs) as adjuvant therapy. Data from large clinical trials suggest that AIs increase the rate of arthralgia by 20 to 30%. Although the understanding of this symptom is poor, a recent study found that 70% of AI users report arthralgia. Arthralgia not only impairs daily functions but also can lead to treatment discontinuation. As a promising non-pharmacological approach to pain management, acupuncture stimulates CNS production of endogenous opioids, a natural pain-killer. We propose a two-phase study, both phases conducted with outpatient BCS receiving AIs: Phase I is a survey study that seeks to characterize the rate, location(s), severity, and functional impairment associated with arthralgia. Phase II uses a single-arm feasibility clinical trial to estimate the effect size and variance of an 8 week-course of acupuncture for anthralgia.

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Cynthia J. Mollen, MD, MSCE
Assistant Professor
Department of Pediatrics, University of Pennsylvania School of Medicine
Division of Emergency Medicine, The Children's Hospital of Philadelphia
34th St. and Civic Center Blvd.
Philadelphia, PA, 19104
Tel: 215-590-1944
mollenc@email.chop.edu

Project: Assessing Adolescents' Knowledge, Attitudes, and Beliefs about Intention to use Emergency Contraception

Introduction / Summary: Teenage pregnancy is a major public health issue. One avenue for pregnancy prevention that has received limited attention in the United States, particularly in the adolescent population, is emergency contraception (EC). Although EC is widely used in many other countries, many women in the U.S., particularly adolescents, are unaware of this pregnancy prevention option. In addition, little research has focused on adolescents' attitudes and beliefs about EC. In order to expand the body of knowledge related to adolescents' views and experiences surrounding EC, qualitative research methods can help the investigator understand an individual's experiences and the meanings he / she attributes to them without forcing the ideas to fit into previously determined constructs. Using qualitative interviews, this study will begin to assess which ideas and constructs related to EC are important to the adolescent in the context of her everyday life. We will interview 40 adolescent females about their beliefs and attitudes related to pregnancy, contraception in general, and EC. Using qualitative data analysis techniques, we will identify barriers to EC use that are important to this population. The data from this project will ultimately be used to design and pilot test an Emergency Department-based intervention aimed at improving adolescents' knowledge of and access to EC.

The Role of the Medical Student: The FOCUS student will work in several capacities. First, as a research coordinator, the student will arrange the details of the interviews after individuals have been consented for the study by the study investigators. This will include phone calls, arranging transportation, and reviewing the consent. Second, the student will participate as a primary interviewer. Prior to beginning the interviews the interviewers will undergo extensive training by a medical anthropologist who is a member of the study team. The student will be fully integrated into the team, and will participate in bi-weekly team meetings to review results of the interviews as well as address any issues that arise. Third, the student will participate in the coding of interview transcripts and the analysis of the qualitative data. This project provides the opportunity for the student to gain a knowledge base in medical anthropology as well as in-depth experience in qualitative research methods. In addition, the student will learn about submitting a project to the Institutional Review Board and the ethical issues that surround research focused on adolescents and pregnancy-related topics. The student will have the opportunity to prepare a manuscript and submit the work for presentation and publication.

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Jordan Orange MD, PhD
Associate Professor of Pediatrics
University of Pennsylvania School of Medicine
Children's Hospital of Philadelphia, Division of Immunology
3615 Civic Center Blvd, ARC-1216F
Philadelphia, PA 19104
Tel: 267-426-5622
orange@mail.med.upenn.edu

Project: Natural killer (NK) cells are lymphocytes that constitute approximately 70% of those at the decidual interface between a pregnant woman and her developing fetus. They have been proposed to:

  1. protect the fetus against infection
  2. prevent the mother's immune system from attacking the fetus
  3. promote appropriate vascularization of the decidua required for fetal survival

We are currently studying the basic biology NK cells and in particular their ability to produce a specific protein that selectively modulates their activity to play these important roles in promoting pregnancy. We are also performing collaborative research to evaluate the mechanisms by which NK cells may kill virus infected decidual cells to protect the fetus.

Although the study of NK cells relates to maternal-fetal health due to their function in the pregnant decidua (described above), there are two projects presently open to students that more directly relate to NK cells in pregnancy. Both are currently staffed by post-doctoral fellows and a prospective student would therefore have the opportunity to work in collaboration with the post-doc. The first involves the role of pregnancy-specific glycoprotein 14 (pp14), which we have found is produced by NK cells found in the decidua, but not by those in the periphery. This protein probably plays a role in curtailing cytotoxic function while promoting cytokine production. Fortunately we have identified an immortalized NK cell line that produces an abundance of pp14, in collaboration with the Tykocinski lab, and we are using this cell line to evaluate the immunomodulatory capacity of pp14. A student would be able to study the role of NK cell produced pp14 (as well as that derived from amniotic fluid) on NK cell cytotoxicity and cytokine production. The second project involves the induction of ligands for an NK cell activating receptor, NKG2D on decidual trophoblast cells infected with cytomegalovirus. To understand the NKG2D system in the destruction of these infected cells, we have been evaluating NKG2D expressing and non-expressing cell lines for their cytolytic capability against trophoblast cell lines. Although this effort is collaborative with Dr. Sam Parry, the student would have the opportunity to work with trophoblast cells and evaluate the role of NKG2D ligands as expressed on these cells in eliciting NK cell function. A student working on either of these projects would be trained in good laboratory practice and be able to contribute to ongoing projects. If the student expresses greater interest and has more significant time available, derivative projects can be designed which can be the sole possession of the student.

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David Sarwer, PhD
Associate Professor of Psychology in Psychiatry and Surgery
Director of Education, Weight and Eating Disorders Program
University of Pennsylvania School of Medicine
3535 Market Street
or
Center for Human Appearance
10 Penn Tower, 3400 Spruce St.
Philadelphia, PA 19104
Tel: 898-7314 or 662-7589 Fax: 349-5895
dsarwer@mail.med.upenn.edu

Project: The Weight and Eating Disorders Program (WEDP) of the School of Medicine is pleased to offer a training experience as part of the Medical Student Fellowship in Women's Health sponsored by FOCUS on Health & Leadership for Women. The WEDP is housed within the Department of Psychiatry. We are primarily a research-based unit that conducts clinical trials investigating the etiology and treatment of obesity. Approximately 90% of individuals enrolled in our studies are adult women from a range of racial and socioeconomic groups.

During the course of the fellowship, which can be either 6 or 12 months in length, the fellow will have the opportunity to work on one of several NIH-funded studies investigating the pre- and postoperative psychosocial status of severely obese individuals who present for bariatric surgery (i.e. stomach stapling). The fellow will learn how to conduct comprehensive psychosocial evaluations on these patients preoperatively and learn to assess changes in functioning postoperatively. The fellow also will have an opportunity to work on some of the other clinical trials in our unit. The fellowship can be tailored to fit the students particular learning objectives.

The fellowship would be a outstanding experience for a student with a specific interest in obesity, which is currently at epidemic proportions in the United States. In addition, it would be a wonderful training experience for a student interested in internal medicine, family practice or obstetrics-gynecology. Given the research-based focus of our unit, the fellow will likely encounter opportunities to contribute to manuscripts and professional presentations (our previous FOCUS fellow was the lead author of a published review paper based on his work and also co-authored 2 presentations at national meetings), making this a particularly attractive experience for a student interested in academic medicine.

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Kathryn H. Schmitz, PhD, MPH
Associate Professor, Department of Biostatistics and Epidemiology, Division of Clinical Epidemiology
Tel: 215-898-6604
schmitz@mail.med.upenn.edu

Projects: My work focuses on exercise and cancer survivorship, including developing interventions for late effects of cancer treatment. I have 2 possible projects in mind for which I would be interested in mentoring a student:

  1. PAVE (Physical Activity and Vasomotor Experiences): In this pilot study, a small number of breast cancer survivors who self-report experiencing hot flashes will be recruited from the Rena Rowan Breast Center. They will be asked to wear a skin conductance monitor and to fill out logs regarding hot flashes experiences. They will then be asked to do a specific low intensity, moderate duration, high frequency exercise program for 6-8 weeks. At the end of this time, the participants will be asked to wear the monitors and fill out the logs again. The purpose of this study is to learn about the use of the skin conductance instruments and to pilot the intervention.
  2. Functional Status in Breast Cancer Survivors: In this pilot study, 20 women will be recruited after having had curative breast cancer surgery. The extent of the surgeries will vary from excisional biopsies to mastectomies. The women will be recruited to complete surveys and to come for a 1 hour appt at the General Clinical Research Center to do functional status testing. The testing will be repeated at the end of the remainder of each participants adjuvant chemotherapy and/or radiation therapy. Women for whom chemo or radiation is not part of curative therapy will still be asked to return in a similar interval, as comparison subjects. The purpose of this study is to learn about the issues related to recruiting and retaining women in the proposed research study with the timing proposed. This pilot is in response to reviews for an R01.

For both of the projects noted above, the role of the medical student could extend from development of the IRB packet to data analysis to writing a manuscript for publication, and possibly assisting with preparation of an NIH grant application. The medical student would be expected to:

  1. complete all human subjects and HIPAA training required by both UPHS and the UPenn IRB
  2. be the primary contact for participants in the study
  3. write/revise IRB correspondence
  4. write/revise correspondence with the central clinic where activities take place (Rowan or GCRC, depending on the project)
  5. recruit and consent participants
  6. carry out all measures for the study, including scheduling appointments
  7. carry out intervention activities (PAVE only)
  8. translate all data into electronic media (either by double data entry or data transfer, depending on data source/type)
  9. prepare data for analysis
  10. participate in data analysis
  11. write up initial results (possible abstract for presentation)
  12. write up a manuscript based on the results.

All of these activities would take place under the direct supervision of Dr. Schmitz, with whom the student would meet at least weekly for at least 1 hour.

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Hao Shen, PhD
Associate Professor
Department of Microbiology
3610 Hamilton Walk
Philadelphia, PA 19104-6076
Tel: 215-573-5259 Lab: 573-2890, 898-6586 Fax: 215-573-9068
hshen@mail.med.upenn.edu
www.med.upenn.edu/micro/faculty/shen.html
www.med.upenn.edu/camb/faculty/mv/shen.html

Project: Listeria monocytogenes is a Gram-positive bacterium that is transmitted by contaminant food and often causes a mild influenza-like illness. In pregnant woman, L. monocytogenes can cause infection of the placenta and then the fetus, often resulting in abortion, premature delivery and still-birth. Several virulence factors have been identified in L. monocytogenes. We are interested in determining the role of these known virulence factors in mediating bacterial crossing the placental barrier and in contributing to the infection of uteroplacental region in a murine model of listeriosis. We are also interested in developing vaccines that can prevent bacterial spread into and infection of placenta and fetus. Medical students supported by the fellowship in Women's health will conduct independent research on one of the above two projects, with the expectation of publishing a research paper on the study.

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Emer Smyth, PhD
Research Assistant Professor
Pharmacology
Institute for translational Medicine and Therapeutics
Tel: 215-573-2323
Email: emer@spirit.gcrc.upenn.edu

Project: Prostacyclin-Dependent Mechanisms of Cardiovascular Protection by Estrogen

The prostanoids are family of lipid mediators generated by the cyclooxygenase (COX) enzymes. They are involved in a diverse number of biological and disease processes that include inflammation, cardiovascular disease and cancer. Drugs that inhibit their synthesis - aspirin and the NSAIDs, such as ibuprofen and naproxen - are used widely for relief of inflammation and pain. Prostacyclin (PGI2) is the major prostanoid generated from the COX-2 enzyme in the vascular endothelium. It's beneficial cardiovascular effects have been established in genetically altered mice and through the use of selective COX-2 inhibitors. This class of drugs, which include rofecoxib and celecoxib, are effective anti-inflammatory drugs and may be useful in chemoprevention of several human cancers. They are however, associated with a significant cardiovascular risk, in part because of depressed in PGI2 generation.

It has been known for sometime that estrogen increases COX-2 expression. We have shown that this is linked with PGI2 biosynthesis and reduced atherosclerosis in female mice. It is unclear, however, to what extent PGI2 is responsible for the cardioprotective effects of estrogen and how COX inhibition may modify this cardioprotective axis. This project aims to examine the estrogen-PGI2 connection in vascular cells cultured from genetically modified mice and in mouse models of vascular disease. These questions are important for clarifying the controversy surrounding estrogen's cardiovascular actions and for the potential use of COX-2 inhibitors in pre-menopausal women.

A medical student would work closely on this project with Dr Smyth, the PI, and a postdoctoral fellow. This individual would carry out biochemical assays of cell function in vascular smooth muscle cells, cultured from genetically modified mice and examine indices of cardiovascular function in control and diseased mice. Through this work the student would gain valuable research experience in a dynamic and productive research environment. Shared authorship on manuscript(s) is expected.

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Seema S. Sonnad PhD
Associate Professor, Department of Surgery
Director of Clinical Outcomes Research
4 Silverstein, 3400 Spruce Street
Philadelphia, PA 19104
Tel: 215-662-4464 Fax: 215-662-3118
seema.sonnad@uphs.upenn.edu

Project: The project is the representation of women on society and journal editorial boards. The idea is that while there might be a long pipeline and various other obstacles to women obtaining leadership positions in departments, most society and editorial roles are by appointment and would be a good vehicle for putting women into leadership roles.

We intend to research a list of journals and societies from all medical specialties (e.g. radiology, cardiology, thoracic surgery, etc) and compile lists of the editorial boards and society boards as well as the leaders (editors and co-editors; officers of societies) and then document what percentage of these are women for each journal and specialty. We will also look at how many women have duplicate roles and what the roles of those women are in their academic institutions. The student will assist in the searches and tallying and will also participate in writing an abstract for presentation and a manuscript. I envision this as a summer project.

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Sigrid Carlen Veasey, MD
Assistant Professor of Medicine, Division of Sleep Medicine
987 Maloney Bldg.
University of Pennsylvania
3600 Spruce St.
Philadelphia, PA 19104
Tel: 215-349-8015 Fax: 215-662-7749
veasey@mail.med.upenn.edu

Project: My lab is presently determining the mechanisms of the oxidative injury to wake regions in the brain from sleep apnea (present in 2-4% of all adults and 1% of children). We have found that NADPH oxidase contributes to this differential injury to these cells and that there is a vicious cycle of injury involving a microglial proinflammatory response.

Having identified NADPH oxidase as essential for most neural injuries from intermittent hypoxia, my next planned set of experiments examines the source of NADPH oxidase activation. Activation of NADPH oxidase in the neurons is critical for injury. I am fortunate that my lab has identified groups of neurons with increased susceptibility (oxidative injury and apoptosis) from intermittent hypoxia. A source of NADPH oxidase activation that would nicely explain the increased vulnerability to intermittent hypoxia in select wake, motor and autonomic regions is the presence of angiotensin 1A (AT1A) receptors on these neurons. Angiotensin increases with intermittent hypoxia. I hypothesize that intermittent hypoxia induces AT1A receptor activation on susceptible neurons resulting in NADPH oxidase activation. Our latest excitement is that AT1A null mice confer resistance to intermittent hypoxia wake impairments. We are in the process now of determining which neural groups are protected in AT1A null mice, and if this protection is through blockade of the NADPH oxidase response to intermittent hypoxia.

A great project for a medical student for the summer is to determine why female mice are not susceptible to intermittent hypoxia neural injury. We think this is estrogen protection at the AT1 receptor, but a student could confirm this this summer to show that only premenopausal females are resistant. Studies will include sleep studies in mice, immunohistochemistry looking for injury and tamoxifen drug trials in female mice and estradiol in male mice trials. Should be fun!!

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Name: Ragini Verma, PhD
Assistant Professor, Department: Radiology
Division Affiliations: Section of Biomedical Image Analysis
3600 Market St., Suite 380
Philadelphia, PA 19104
Tel: 215 662-7471
ragini.verma@uphs.upenn.edu

Specialization: Biomedical Imaging, Computational neuro-anatomy

Project: The primary goal of the project is to study the cognitive effects of estrogen and progestin therapies on menopausal women using a combination of MRI (magnetic resonance imaging) modalities like T1-weighted, T2-weighted, Proton Density and Fluid Attenuated Inversion Recovery (FLAIR). This involves the study and characterization of white matter lesions, degenerative changes in the brain, and as a result cognitive impairment and dementia in the women involved in the study. Our study is based on the Women's Health Initiative Memory Study (WHIMS), which found a heightened risk of developing dementia in women 65 and older taking a particular form of estrogen plus progestin hormone therapy, based on memory tasks that the volunteers did. Our project is a retrospective MRI study that we have undertaken at Penn, using the MRI scans collected from the volunteers of the WHIMS study, while it was in progress, to determine and quantify cognitive changes in the women involved in the study.

The medical student who has an opportunity to participate in this project will have several duties. He or she will be using advanced image processing tools to delineate white matter lesions and infarcts. Next, the student will perform a statistical analysis of changes in lesions and areas around it. The lesions delineated by the student will be used as a standard to train a fully automated lesion segmentation system and the analysis from the manual step will be correlated with those from the fully automated system. In the course of the project, the student will be exposed to cutting edge image processing research and receive training in advanced tools for the same.

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Joan M. Von Feldt.MD
Associate Professor of Medicine
Rheumatology Division
University of Pennsylvania
5 Maloney, Suite 509, 36th & Spruce Street
Philadelphia, PA l9104-4283
Tel: 215-662-4659; Fax: 215-662-4500
Admin. Asst.: Wenda Foster-Massey
Tel: 215-662-2789 email: wenda@mail.med.upenn.edu

Project: I have an ongoing project doing clinical research in SLE.

Systemic lupus erythematosus (SLE) is a chronic inflammatory, autoimmune disease that affects mainly young women, a group usually free of ASCVD. treatment for SLE has improved, and long-term survival has increased; however, it has become clear that patients with SLE still have substantially increased morbidity and mortality from cardiovascular disease The incidence of myocardial infarction is 5 times as high in patients with SLE as in the general population, and in young women the age-specific incidence is increased by a factor of as much as 50. The reasons for the dramatically increased risk of ASCVD in SLE are poorly understood. I have recently submitted a grant that expand on previous research looking at cardiovascular disease and biomarkers in SLE.

I am attaching a paper now in press on my previous work. Please note that many of the authors were trainees that worked with me during a year or summer, but contributed in a significant way to the science of the study. Below is the most recent specific aims that we will address in this upcoming study. I would welcome a student to participate in one or more of these aims.

The Role Of Homocysteine, Folate, and Insulin Resistance in Atherosclerotic Disease Progression in SLE (Click here to download pdf of article)


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