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Decision Makers Hold Overly Optimistic Expectations for Critically Ill Patient Outcomes

More than half of the family and friends making decisions for critically ill patients have significantly different estimates for the patient’s survival than their doctor—but that’s not only because of a misunderstanding, University of Pittsburgh School of Medicine researchers report in today’s issue of the Journal of the American Medical Association.

The majority of those differences also were due to the decision maker holding fundamentally different and overly optimistic beliefs about the patient’s prognosis. The research team anticipates that this finding will help in training physicians to better communicate with the family and friends of patients so they can make the best decisions for their loved one.

“It isn’t a bad thing for a patient’s family and friends to have hope that they will recover,” said lead author Douglas B. White, MD, MAS, professor in the Pitt School of Medicine’s Department of Critical Care Medicine, and director of the department’s Program on Ethics and Decision Making. “However, it is problematic when those overly optimistic expectations result in more invasive treatments in dying patients and delayed integration of palliative care that can alleviate suffering.”

Between 2005 and 2009, Dr. White and his colleagues surveyed 229 people who had agreed to be the “surrogate decision maker” for hospitalized patients in four intensive care units at the University of California, San Francisco Medical Center, where Dr. White previously was a faculty member. These surrogates were typically family members or friends of the patient. They also surveyed the physicians caring for the patients for which the surrogates were making decisions.

The researchers asked both the surrogates and the doctors to estimate the chances that the patient would survive hospitalization on a scale of 0 (no chance of survival) to 100 (definite survival). They did not know each other’s answers.

In 53 percent of cases, the answers differed by more than 20 percent. The surrogates were usually more optimistic than the doctors, however the doctors’ estimates of the patient prognosis were ultimately far more accurate.

The researchers then asked the surrogates to guess what they thought the patient’s doctor answered. Generally, the surrogates would guess somewhere in between their estimate and the doctor’s real estimate. That revealed that the surrogates understood they were being more optimistic than what the doctor had been communicating to them.

The surrogates explained this in many ways, the most common being that they believed if they maintained hope, then the patient would do better than expected, or that they knew the patient better than the doctor and believed the patient had strengths the doctor didn’t know about. They also often had an optimism grounded in religious beliefs.

“As doctors, we want to provide the best possible care for our patients. In critically ill patients, that means we must do a better job communicating with the people who are making decisions for our patients,” said Dr. White, who also holds the UPMC Endowed Chair for Ethics in Critical Care Medicine. “Given the results of this study, we’re working to develop and test interventions both  to improve the comprehensibility of the prognosis doctors give to surrogates, and to better attend to the emotional and psychological factors that may influence the surrogate’s expectations for their loved one’s outcome.”

Additional researchers on this study are Natalie Ernecoff, MPH, Praewpannarai Buddadhumaruk, RN, MS, and Seoyeon Hong, PhD, all of Pitt; Lisa Weissfeld, PhD, of Statistics Collaborative in Washington DC; J. Randall Curtis, MD, MPH, of the University of Washington; and John M. Luce, MD, and Bernard Lo, MD, both of the University of California, San Francisco.

This research was supported by National Institutes of Health grants KL2 RR024130 and R01 HL094553; and by the Greenwall Foundation.

Sally Wenzel Honored with Award from American Thoracic Society

WENZEL_SALLY_MD_PUL_20130926 (1)Sally Wenzel, MD, professor, Division of Pulmonary, Allergy and Critical Care Medicine, Pitt School of Medicine, and director of the University of Pittsburgh Asthma Institute at UPMC and the University of Pittsburgh School of Medicine, was recently honored with the Breathing for Life Award at the annual American Thoracic Society (ATS) Foundation Research Program Benefit. The award is the highest honor given to an ATS member for philanthropy.

Dr. Wenzel has had a passion for understanding and improving the treatment of asthma, in particular severe asthma. She served as Chair of the ATS workshop on severe asthma which developed the international consensus definition of severe asthma. She has worked to promote severe asthma as a disease whose pathogenesis goes beyond issues of non-compliance/adherence. Her studies of asthma phenotypes have led the field in understanding the complexities of asthma, and in explaining why mouse models of allergic inflammation do not adequately mirror the human condition.

The American Thoracic Society Annual Meeting, which brings together experts in pulmonary disease, critical illnesses, and sleep disorders, was held May 13-18 in San Francisco.

Read the full news announcement.

 

Pitt and UPMC Launch Microbiome Center at White House Event

The University of Pittsburgh Schools of the Health Sciences and UPMC are collaborating on a joint venture dedicated to better understanding the trillions of microbes that form an ecosystem inhabiting the human body, called the microbiome.

To be announced today as a participant at the launch of the National Microbiome Initiative hosted by the White House Office of Science and Technology Policy in Washington, DC, Pitt’s Center for Medicine and the Microbiome brings together scientists and clinicians to explore how the microbiome affects health and disease—and how it can be harnessed to develop new therapies to help patients. The initiative and its research and clinical partners aim to advance the understanding of microbiome behavior and enable protection and restoration of healthy microbiome function, including investigations of fundamental principles that govern microbiomes across diverse ecosystems and development of new tools to study microbiomes.

“The very nature of the microbiome involves many organs and affects many areas of medicine—from infectious disease, to cancer biology, to inflammatory bowel disease, to immunology—requiring collaboration between the many disciplines of science and medicine, something UPMC and Pitt have a proven track record of achieving,” said Mark T. Gladwin, MD, chair of medicine and Dr. Jack D. Myers Professor of Internal Medicine at Pitt.

The Center will be led by Alison Morris, MD, MS, who holds the UPMC Chair for Translational Pulmonary and Critical Care Medicine in Pitt’s School of Medicine and attended the White House event.

“Our bodies are not ours alone. A great variety of microscopic organisms call us home and, in turn, they perform critical functions for us, including digesting our food, modulating inflammation and fighting off bad bugs,” said Dr. Morris, also a professor of medicine in the Pitt  Department of Medicine’s Division of Pulmonary, Allergy, and Critical Care Medicine, with a joint appointment in the Department of Immunology. “We expect our Center for Medicine and the Microbiome to usher in a new era of care, with what we learn leading to therapies for diseases and conditions ranging from obesity to cancer.”

The Center for Medicine and the Microbiome is a joint venture, with more than $5 million in funding provided by Pitt’s Department of Medicine, UPMC and UPMC Enterprises. The Pitt School of Dental Medicine and uBiome, Inc., a microbial genomics company based in San Francisco, also have contributed to Center activities.

The center will enable several innovative projects. For example, in collaboration with Pitt’s School of Dental Medicine, the microbiomes of approximately 3,500 saliva samples previously collected with patient permission can be examined and anonymously linked to patient medical records to yield what is expected to be the largest study of human genetics and microbial communities.

In the near future, the center will launch the Pittsburgh Biome Project to crowd-source a large collection of gut microbiome samples from local community members. Those who participate could get an analysis of their own microbiome and contribute to a research project that would analyze the microbiome in relationship to current and future health. This project will establish a large biorepository of clinical samples that will be linked, with the participants’ consent, to electronic health records. It will be the first of its kind to engage a local community in large-scale microbiome research related not only to current health and disease but also to future disease risk.

“Having such a biorepository and database here in Pittsburgh, where we have such strong academic and medical resources, is going to be an incredible asset,” said Arthur S. Levine, MD, Pitt’s senior vice chancellor for the health sciences and John and Gertrude Petersen Dean of Medicine. “This initiative will enable studies that could explore the impact of the microbiome on cancer, lung conditions, hypertension, heart disease, malnutrition and myriad other conditions. We may discover that the balance of microbes in the gut can be adjusted to fight obesity, or that our microbiome could help or hinder certain cancers or the response of cancer to therapy. Our discoveries could lead to clinical trials that result in therapies to help people around the world.”

Other key research areas the center intends to tackle include the development and treatment of drug-resistant pathogens and the use of fecal transplantation for various diseases, such as Clostridium difficile colitis. UPMC’s existing fecal transplant program will become an important contributor to Pitt’s Center for Medicine and the Microbiome.

The center also will provide collaboration opportunities to give Pitt scientists access to microbial analyses previously unavailable to them.

“Sequencing technologies have evolved rapidly over the past several years and can generate large amounts of data on microbiome diversity, but unfortunately these types of tests are too expensive and the analytics too complex for many researchers,” said John W. Mellors, MD, professor of medicine and chief of the Division of Infectious Diseases in Pitt’s Department of Medicine. “We intend for our new center to facilitate this type of testing, incorporating microbiome research into existing studies and supporting development of novel studies.”

Pitt Study Shows Online Therapy Effective at Treating Depression and Anxiety

Doctors from the University of Pittsburgh showed that providing an online computerized cognitive behavioral therapy (CCBT) program both alone and in combination with Internet Support Groups (ISG) is a more effective treatment for anxiety and depression than doctors’ usual primary care. The preliminary findings were highlighted today at the annual meeting of the Society of General Internal Medicine (SGIM) in Hollywood, Florida.

The National Institutes of Mental Health-funded randomized trial, led by Bruce L. Rollman, MD, MPH, professor of medicine and director of the Center for Behavioral Health and Smart Technology at the University of Pittsburgh, enrolled 704 depressed and anxious patients from 26 UPMC-affiliated primary care offices across western Pennsylvania.

Patients 18 to 75 years old were referred into the trial by their UPMC primary care physician between August 2012 and September 2014. Eligible and consenting patients were then randomized to one of three groups: care manager-guided access to the eight-session Beating the Blues CCBT program; care manager-guided access to both the CCBT program and a password-protected ISG patients could access 24/7 via smartphone or desktop computer; or usual behavioral health care from their primary care physician.

Over the six-month intervention, 83 percent of patients randomized to CCBT started the program, and they completed an average of 5.3 sessions. Seventy-seven percent of patients assigned to the ISG logged into the site at least once, and 46 percent provided one or more posts or comments.

Six months later, those patients randomized to CCBT reported significant improvements in their mood and anxiety symptoms and the more CCBT sessions patients completed, the greater the improvement in mood and anxiety symptoms.

Although patients randomized to both CCBT and ISG had similar overall improvements in mood and anxiety symptoms compared to patients randomized to only CCBT, secondary analysis revealed those who engaged more with the ISG tended to experience greater improvements in symptoms.

Several CCBT programs have proven as effective as face-to-face cognitive behavioral therapy at treating mood and anxiety disorders and are used by many patients outside the U.S., but CCBT remains largely unknown and underutilized within the U.S., Dr. Rollman said. ISG that enable individuals with similar conditions to access and exchange self-help information and emotional support have proliferated in recent years, but benefits have yet to be established in randomized trials.

“Our study findings have important implications for transforming the way mental health care is delivered,” Dr. Rollman said. “Providing depressed and anxious patients with access to these emerging technologies may be an ideal method to deliver effective mental health treatment, especially to those who live in areas with limited access to care resources or who have transportation difficulties or work/home obligations that make in-person counseling difficult to obtain. We hope that these findings will focus further attention on the emerging field of e-mental health by other U.S. investigators.”

Researchers included Dr. Rollman, Bea Herbeck Belnap, PhD, Scott D. Rothenberger, PhD, Kaleab Abebe, PhD, Armando J. Rotondi, PhD, Michael Spring, PhD, and Jordan F. Karp, MD, all of the University of Pittsburgh.

Greater Social Media Use Tied to Higher Risk of Eating and Body Image Concerns in Young Adults

Logging on to social media sites frequently throughout the week or spending hours trolling various social feeds during the day is linked to a greater risk of young adults developing eating and body image concerns, a University of Pittsburgh School of Medicine analysis discovered.

Gender, specific age, race and income did not influence the association; the study found that all demographic groups were equally affected by the link between social media and eating and body image concerns, indicating that preventative messages should target a broad population. The results are reported in the Journal of the Academy of Nutrition and Dietetics and the research was funded by the National Cancer Institute (NCI).

“We’ve long known that exposure to traditional forms of media, such as fashion magazines and television, is associated with the development of disordered eating and body image concerns, likely due to the positive portrayal of ‘thin’ models and celebrities,” said lead author Jaime E. Sidani, PhD, MPH, assistant director of Pitt’s Center for Research on Media, Technology and Health. “Social media combines many of the visual aspects of traditional media with the opportunity for social media users to interact and propagate stereotypes that can lead to eating and body image concerns.”

Dr. Sidani and her colleagues sampled 1,765 U.S. adults ages 19 through 32 in 2014, using questionnaires to determine social media use. The questionnaires asked about the 11 most popular social media platforms at the time: Facebook, YouTube, Twitter, Google Plus, Instagram, Snapchat, Reddit, Tumblr, Pinterest, Vine and LinkedIn.

They cross-referenced those results with the results of another questionnaire that used established screening tools to assess eating disorder risk.

Eating disorders include anorexia nervosa, bulimia nervosa, binge eating disorder and other clinical and mental health issues where people have a distorted body image and disordered eating. These issues disproportionately affect adolescents and young adults. However, more general disordered eating, body dissatisfaction, and negative or altered body image likely affect a broader group of individuals.

The participants who spent the most time on social media throughout the day had 2.2 times the risk of reporting eating and body image concerns, compared to their peers who spent less time on social media. And participants who reported most frequently checking social media throughout the week had 2.6 times the risk, compared with those who checked least frequently.

Senior author Brian A. Primack, MD, PhD, assistant vice chancellor for health and society in Pitt’s Schools of the Health Sciences, noted that the analysis could not determine whether social media use was contributing to eating and body image concerns or vice versa – or both.

“It could be that young adults who use more social media are exposed to more images and messages that encourage development of disordered eating,” he said.

Previous research has shown that people tend to post images online that present themselves positively. For example, users are likely to select the scant few that may make them appear thinner from hundreds of more “accurate” photographs of themselves, resulting in others being exposed to unrealistic expectations for their appearance.

“Conversely, people who have eating and body image concerns might then be turning to social media to connect with groups of people who also have these concerns,” said Dr. Primack. “However, connecting with these groups for social support could inhibit recovery because of the desire to continue being a part of the shared identity such social media groups foster.”

In an effort to battle social media-fueled eating disorders, Instagram banned the hashtags ‘thinspiration’ and ‘thinspo,’ but users easily circumvented these barriers by spelling the words slightly differently. YouTube videos about anorexia nervosa that could be classified as “pro-anorexia” received higher viewer ratings than informative videos highlighting the health consequences of the eating disorder.

“More research is needed in order to develop effective interventions to counter social media content that either intentionally or unintentionally increases the risk of eating disorders in users,” said Dr. Sidani. “We suggest studies that follow users over time and seek to answer the cause-and-effect questions surrounding social media use and risk for eating and body image concerns.”

Additional authors on this research are Ariel Shensa, MA, Beth Hoffman, and Janel Hanmer, MD, PhD, all of Pitt.

This research was funded by NCI grant R01-CA140150.

UPMC Ranks 45th in InformationWeek’s Elite 100

UPMC was named to the InformationWeek Elite 100 for the third year in a row. The annually published list recognizes the top business technology innovators across varying industries. UPMC was ranked No. 45 in addition to receiving the newly established Decade Award.

Improving on last year’s No. 77 ranking, UPMC remains committed to integrating new technology into the health care it provides. Recently, advancements in telemedicine and collaborations with leading academic institutions and health care technology startups have reaffirmed UPMC’s role as a technology innovator.

This year, InformationWeek recognized ten companies that have consistently demonstrated innovation with the Decade Award. UPMC placed second on this list among companies that are models of innovation, consistently ranking highly in the InformationWeek Elite 100 over the last ten years.

“UPMC relies on advancements in technology to excel clinically and operationally. With the shift to patient-centric care, technology is needed now more than ever,” said Ed McCallister, UPMC’s senior vice president and chief information officer. “We are focused on providing the best possible experience for our patients through our integrated health care delivery and financing system, and our focus remains on developing and utilizing technology that furthers that goal.”

Consistently named a “Most Wired” health system by Hospitals & Health Networks, the journal of the American Hospital Association, UPMC has invested over $1.5 billion in recent years to support technology that advances clinical outcomes and administrative efficiency. UPMC continues to pioneer the use of electronic medical records, analytics and “big data.”

Additional information on the InformationWeek Elite 100 can be found online at http://www.informationweek.com/elite100.

Easy Ways to Improve Patient Comfort During Skin Cancer Screenings

New research from the University of Pittsburgh School of Medicine suggests two simple ways dermatologists can make patients more comfortable during full-body skin cancer checks: respect patient preferences for the physician’s gender as well as whether, and how, they prefer to have their genitals examined. The findings are published online today in JAMA Dermatology.

“This study identifies barriers to getting skin checks. Giving patients choices that reduce embarrassment during an exam may make a person more likely to get regular skin checks, leading to higher rates of skin cancer detection,” said lead author Laura Ferris, MD, PhD, associate professor, Department of Dermatology, Pitt School of Medicine and member of the Melanoma Program, University of Pittsburgh Cancer Institute.

Estimates suggest that one in five people will develop skin cancer over the course of a lifetime. Rates of melanoma, which account for less than one percent of skin cancer cases but the vast majority of skin cancer deaths, have tripled over the last 40 years.

The best way to prevent skin cancer is to use adequate protective measures during sun exposure, perform regular self-examinations, and, for those patients at increased risk of developing skin cancer, obtain annual full-body screenings from a dermatologist, said Ferris.

The current study was born out of an observation from Ferris’ own dermatology practice: many women wanted female physicians and were uncomfortable having male students in the room during their exams. While a strong preference for a same gender physician has been documented among patients undergoing colonoscopies, there wasn’t much data available about dermatology, Ferris explained.

In the new study, the researchers at three institutions, including UPMC, administered an anonymous survey to 443 adults undergoing a full-body screening for skin cancer.

Overall, people generally preferred a physician who shared their gender. Breaking the data down by gender, one third of women and nearly one fifth of men expressed a gender preference. Among this group, nearly all (99 percent) of the women preferred a female physician, and almost two thirds of the men preferred a male physician.

The biggest predictor of preferring a female physician among women was being under age 30. Young women have one of the fastest growing rates of melanoma, so taking physician gender preference into account in this group may have an especially large impact, Ferris noted.

Typically, patients are asked to completely disrobe for a skin cancer screening. When asked about clothing preferences, nearly half of women and 40 percent of men preferred to leave their undergarments in place during the exam.

“What we learned is that a substantial number of people preferred to leave their undergarments on and have us work around them,” said Ferris.

Less than 1 percent of melanomas are found in the genital region, so with 31 percent of women and 13 percent of men preferring not to have their genitals examined at all, another important message from the study is that physicians need to balance the benefit of occasionally finding a genital melanoma with causing a lot of people discomfort or anxiety, she added.

The researchers are now focused on putting their findings into practice. “When we think about the relative risks and benefits of cancer screening, if we’re causing people discomfort, then we need to think of that as doing harm. Our study provides some easy ways to reduce that harm,” Ferris said. “In the age of personalized medicine, taking simple steps, such as offering a choice of physician gender and degree of disrobement during an examination, can allow us to personalize the skin cancer screening examination to minimize discomfort.”

Co-authors of the study include Neil Houston, BA, and Westley Mori, BA, both of Pitt School of Medicine; Aaron Secrest, MD, PhD, and Mark Eliason, MD, both of University of Utah; and Ryan Harris, MD, and Charles Phillips, MD, both of East Carolina University.

The study was funded by National Institutes of Health grants UL1-TR-000005 and P50CA121973.

Pitt Research Yields Insight into the Mystery of Smell

Researchers at the University of Pittsburgh School of Medicine have uncovered the mechanism underlying a phenomenon in how we smell that has puzzled researchers for decades. In an article appearing online today in the Proceedings of the National Academy of Sciences, the team reports that, surprisingly, the mechanism follows a simple physics principle called cooperativity.

Inhalation of a scent sends a complex mixture of odor molecules swirling toward the back of the nose, where they bind to specialized receptors that are located on millions of olfactory neurons. Activation of these receptors sends signals from the olfactory neurons to the brain, where the smell is deciphered.

Individual neurons have only a single type of receptor and, therefore, recognize only specific odor molecules. However, the hundreds of different types of olfactory receptors are found, or expressed, in approximately equal numbers across the entire population of neurons, which allows a person to detect a wide variety of smells, explained senior investigator Jianhua Xing, PhD, associate professor of computational and systems biology, Pitt School of Medicine. Richard Axel, Columbia University, and Linda Buck, now at the Fred Hutchinson Cancer Research Center, received the 2004 Nobel Prize in Physiology or Medicine for discovering the receptors and making these observations.

“Over the past decades, neuroscientists have been trying to uncover how nature accomplishes these two goals: selecting one, and only one, type of olfactory receptor for each neuron, while at the same time ensuring that all receptor types are represented in the whole population of neurons,” said Dr. Xing.

The mysteries of how we smell have generated many experimental observations about how olfactory receptors actually work. In the new study, Dr. Xing and colleagues used these existing experimental data to create a computational model of how olfactory receptor expression can be both uniform across a single neuron, yet very diverse across the entire population of neurons. They then used this model to correctly predict several additional findings that have been demonstrated by other research groups, demonstrating that their model is valid.

Surprisingly, the model suggested a three-pronged regulation of olfactory receptor gene expression that follows a basic physics principle called cooperativity, in which elements in a system influence the behavior of one another rather than function independently. Cooperativity can explain many phenomena, such as the transition between liquid and vapor states, why oil and water do not mix, and even other biological processes such as how a protein folds.

“We are amazed that nature has solved the seemingly daunting engineering process of olfactory receptor expression in such a simple way,” said Dr. Xing.

The findings pave the way for new predictions about how olfactory receptors function that can be tested in future experiments, the results of which will help the team refine their model and make even more predictions.

The research team also included Xiao-Jun Tian, PhD, of Pitt; Jens Sannerud, former Pitt undergraduate summer research fellow, currently of Brown University; and Hang Zhang, PhD, of Virginia Polytechnic Institute and State University.

This research was funded by National Science Foundation awards DMS-1545771 and DMS-1462049.

Pitt-Developed Drug Works Against ‘Superbug’ Biofilms and Respiratory Virus

A potential drug therapy developed at the University of Pittsburgh Center for Vaccine Research (CVR) has proven effective against tough bacterial biofilms and a deadly respiratory virus simultaneously. The drug outperforms traditional therapies in the laboratory setting.

The results, reported in the journal mSphere, build on a recent discovery from Pitt’s School of Medicine showing that the virus encourages biofilm growth and point to a new way to treat drug-resistant bacteria, including so-called “superbugs” that are resistant to almost all existing antibiotics and have become the focus of worldwide efforts to limit their spread.

“This is really unusual. To the best of our knowledge, no other antibiotics out there work on both the bacteria and the virus during a co-infection,” said senior author Jennifer M. Bomberger, PhD, assistant professor in Pitt’s Department of Microbiology and Molecular Genetics. “Antibiotic-resistant chronic infections are an urgent public health threat, and the development of new therapies has been painfully slow. So to see something work on a virus and the incredibly resistant biofilms that bacteria form is very exciting.”

Chronic infections, such as those that kill cystic fibrosis patients, resist the body’s efforts to clear them from the lungs, sinuses or other areas. Often these infections are characterized by biofilms, which are bacteria that stick together forming colonies that are as much as 400 times as resistant to antibiotics as a single bacterium.

The potential drug therapy relies on an engineered cationic antimicrobial peptide, or “eCAP,” which is a synthetic and more efficient version of naturally occurring antimicrobial peptides that form a first line of defense against infections in humans. Developed by co-author Ronald C. Montelaro, PhD, professor and co-director of Pitt’s CVR, the eCAP works by “punching into” bacteria and viruses, thereby destroying them.

Dr. Bomberger and her team tested the eCAP in the laboratory by growing biofilms of drug-resistant Pseudomonas aeruginosa bacteria on the cells that line the airway and then treating them for one hour with the eCAP. The eCAP was 50 times more effective at fighting the biofilm than traditional treatment, but did not harm the airway cells.

The team then did the same test, this time on airway cells first infected with respiratory syncytial virus (RSV), which causes serious infection in infants and older adults, as well as people with compromised lungs. In February, Dr. Bomberger reported in the journal Proceedings of the National Academy of Sciences that RSV helps Pseudomonas aeruginosa biofilms grow.

“When the body responds to fight the virus, it inadvertently leaves an Achilles heel by fostering an environment rich in the nutrient iron, which aids the bacteria in forming a biofilm,” said Dr. Bomberger.

The eCAP was 10 times more effective at fighting the biofilm in a virus-bacteria co-infection compared with traditional therapy. And when the eCAP was used on airway cells infected only with RSV, the number of viable virus particles was reduced by more than 150-fold.

The eCAP also worked against bacterial biofilms grown on plastic, indicating that it could be a good treatment for cleaning medical equipment, such as bronchoscopes, where biofilms sometimes grow.

“We’re incredibly encouraged by these results,” said Dr. Montelaro. “Again and again, eCAPS are performing well in laboratory tests and mouse models. They’re an exciting possibility to help solve the antimicrobial-resistant superbug crisis that our world increasingly faces.”

Additional researchers on this study are Jeffrey A. Melvin, PhD, Lauren P. Lashua, BS, Megan R. Kiedrowski, PhD, and Berthony Deslouches, MD, PhD, all of Pitt; and Guanyi Yang, BS, of Pitt and Tsinghua University in Beijing, China.

This research was funded by National Institutes of Health grants T32AI49820, R00HL098342, R01HL123771 and P30DK072506; and Cystic Fibrosis Foundation grants MELVIN15F0 and BOMBER14G0.

Pitt Nursing Earns Worldwide Recognition

The University of Pittsburgh School of Nursing’s outstanding reputation for excellence has been confirmed again with recent recognition as 12th in the world on the 2016 QS World University Rankings by subject, based on academic reputation, employer evaluation and research impact.

This international recognition is the most recent of accolades bestowed on Pitt Nursing with other exceptional rankings, including 5th on the 2016 U.S. News & World Report list of Best Graduate Schools, and 8th on the 2017 U.S. News & World Report list of Best Doctor of Nursing Practice Programs.

“It is an honor to be valued as a world-class nursing program based upon our faculty’s research impact, measured through citations, a wide desire for our graduates, and a strong academic reputation. We are pleased to join our peers across the U.S. and the globe in advancing the education and science underlying nursing in a time of transformation of nursing around the world,” said Jacqueline Dunbar-Jacob, PhD, RN, FAAN, dean of Pitt’s School of Nursing.

The School of Nursing has more than 960 students enrolled in its bachelor’s, master’s, Ph.D. and doctor of nursing practice programs.

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