News & Announcements
In December, the Executive Committee of the University of Pennsylvania Board of Trustees approved plans for Princeton HealthCare System (PHCS) to become a part of the University of Pennsylvania Health System (UPHS). The agreement is contingent upon agreed upon closing conditions, including final approval by state and federal authorities. Founded in 1919 and located 40 miles northeast of Philadelphia, PHCS is a 429-bed, integrated health care system that serves more than 1.3 million people. PHCS has earned both regional and national accolades for high quality care. PHCS announced in June 2015 that it would begin evaluating partnership opportunities to ensure its continued success in the future and in July of 2016, executed a Letter of Intent with UPHS. The move to join Penn Medicine comes following PHCS officials’ consideration of 17 potential partners.
“We are proud of this exciting opportunity to combine Princeton HealthCare’s strong reputation for providing excellent care in the community with Penn Medicine’s strengths as a national leader in complex and specialty care,” said Ralph W. Muller, CEO of UPHS.
Penn President Amy Gutmann and Provost Vincent Price announced in January that J. Larry Jameson, MD, PhD, has been reappointed executive vice president of the University of Pennsylvania for the Health System and dean of the Perelman School of Medicine. The reappointment will run through June 30, 2023 and is subject to approval by the Board of Trustees. It follows a review of his first term by a consultative committee appointed by Gutmann and Price.
The committee found especially notable the comprehensive, inclusive and far-reaching strategic plan, developed with Jameson’s strong leadership and support. It also noted two overarching accomplishments that merit special mention: his abiding sense of University citizenship and his full embrace of the multi-dimensional and integrated mission of Penn Medicine.
“We agree with the committee’s conclusion that Dean Jameson’s first term was one of significant accomplishment,” Gutmann said. “The Perelman School and Penn Medicine have seen impressive and continued progress under his leadership.”
A new Master of Health Care Innovation (MHCI) degree from the Perelman School of Medicine will be the University of Pennsylvania’s first online master’s program. The program will recruit working health care professionals worldwide interested in health policy, behavioral economics, and operations management. The MHCI is designed for mid-career health care professionals and housed in the department of Medical Ethics and Health Policy. It will draw its faculty primarily from the Perelman School, with additional members coming from the Wharton School, School of Law, and School of Nursing.
“I realized this was the worst orthopedic problem I had ever seen, and there was no one working on it.”
- Frederick Kaplan, MD, Isaac & Rose Nassau Professor of Orthopaedic Molecular Medicine at the Perelman School of Medicine, in a CNN story, recalling the start of his interest in the rare bone-overgrowth disorder fibrodysplasia ossificans progressiva (FOP) more than 30 years ago. Kaplan (GME’81) and colleagues discovered the genetic mutation that causes FOP in 2006 and continue to seek treatments. Kaplan will be awarded the Perelman School’s Distinguished Graduate Award in 2017.
Research Countdown
800 patients at 20 medical centers enrolled in the largest study to date of the rare inflammatory condition sarcoidosis, yet many critical questions remained unanswered. Penn’s first mobile app developed with Apple’s ResearchKit framework has the potential to enroll many more sarcoidosis patients across the world, and to collect a broad array of data from their iPhones.
50 years ago, the Leonard Davis Institute of Health Economics at Penn (LDI) was established to fill critical gaps in evidence about health policy and management in the aftermath of the establishment of Medicare and Medicaid. As major health policies come up for debate in the U.S. Congress, LDI’s expertise is as critical as ever. Follow anniversary updates at the 50 at 50 webpage and #PennLDI50.
30 to 40 percent of melanoma cases are estimated to arise from a nevus, or mole composed of non-cancerous cells at the skin surface. A Penn-led study recently
identified a genetic biomarker to distinguish nevus from melanoma, which could be part of standard dermatology practice in as little as one to two years.
$20 offered as a financial incentive, whether as a payment, charitable donation, or both, helped older adults increase their walking activity compared to a randomized control group, in a Penn study published in the
American Journal of Preventive Medicine.
6 Penn teams with diverse, interrelated expertise will collaborate in the new Human Pancreas Analysis Program, the newest program in the Human Islet Research Network funded by the National Institute of Diabetes and Digestive and Kidney Diseases. The program is focused on procuring and phenotyping pancreatic tissues from individuals with or at risk for Type 1 diabetes, Type 2 diabetes, or other types of pancreatic islet dysfunction characterized by changes in beta cell mass.
5 known brain cell types—oligodendrocytes, microglia, neurons, endothelial cells, and astrocytes—were identified growing after three weeks, the
first time live adult human neurons were grown and studied in culture. The Penn study identified the cells’ patterns of gene expression. The cells came from patients ranging in age from their twenties to sixties, showing the potential of this system for use in human aging studies.
Doctors have found a way to manipulate wounds to heal as regenerated skin rather than scar tissue. The method involves transforming the most common type of cells found in wounds into fat cells—something that was previously thought to be impossible in humans.
“Essentially, we can manipulate wound healing so that it leads to skin regeneration rather than scarring,” said George Cotsarelis, MD’87, the chair of the department of Dermatology and the Milton Bixler Hartzell Professor of Dermatology at Penn, and the principal investigator of the project. “The secret is to regenerate hair follicles first. After that, the fat will regenerate in response to the signals from those follicles.”
The Cotsarelis lab previously discovered factors necessary for the formation of hair follicles. The new study, published online in Science Jan. 5, showed hair and fat develop separately but not independently, and identified additional factors produced by the regenerating hair follicle that convert the surrounding myofibroblasts (skin cells involved in healing wounds) to regenerate as fat cells (adipocytes) instead of forming a scar.
The study’s lead author, Maksim Plikus, PhD, an assistant professor of Developmental and Cell Biology at the University of California, Irvine, began this research as a postdoctoral fellow in the Cotsarelis laboratory at Penn, and the two institutions have continued to collaborate.
These discoveries have the potential to be revolutionary in the field of dermatology. The first and most obvious use would be to develop a therapy that signals myofibroblasts to convert into adipocytes— helping wounds heal without scarring. But the increase of fat cells in tissue can also be helpful for more than just wounds. Adipocyte loss is a common complication of other conditions, especially treatments for HIV, and right now there is no efficient strategy for treatment. The cells are also lost naturally because of the aging process, especially in the face, which leads to permanent, deep wrinkles, something anti-aging treatments can’t fix in a cosmetically satisfactory way.
Libraries routinely help patrons secure basic human needs that are fundamental to health. The Free Library of Philadelphia’s Edible Alphabet Program, for example, offers English language, cooking, and life skills instruction for refugees, and other programs address needs such as housing, food, employment, and health care. A Penn team conducted interviews with Philadelphia residents and library staff and analyzed ten of The Free Library’s largest programs to reach these conclusions, reported in the journal Health Affairs.
The team also found that library staff reported feeling under-prepared and stressed by the profound health and social needs of many library patrons. This finding led to “The Healthy Library Initiative” partnership between Penn and Philadelphia’s public library system, in which Penn advisors collaborated with librarians to integrate evidence-based public health programming in a library setting.
“Public libraries are a critically needed and trusted lifeline for many vulnerable citizens,” said Carolyn Cannuscio, ScD, director of research at Penn’s Center for Public Health Initiatives and an assistant professor in Family Medicine and Community Health at the Perelman School of Medicine.
The connection between Penn’s medical enterprise and the Free Library of Philadelphia is not a new one. The Free Library and the Hospital of the University of the Pennsylvania were both founded by William Pepper, Jr., a Penn provost who earned his medical degree at Penn in 1864.
Further Penn Medicine News Selections
‘Sniff Test’ May Be Useful in Diagnosing Early Alzheimer’s Disease
Most Primary Care Doctors “Strongly Endorse” Key Elements of the Affordable Care Act
New Zika Vaccine Candidate Protects Mice and Monkeys with a Single Dose
Fat Shaming Linked to Greater Health Risks
Bundled-Payments Model Cut Joint Replacement Costs By More than 20 Percent
Predictive Analytics: Harnessing Powerful Technology to Improve Patient Care
Some Patients Grow Wary of Opioids as Epidemic Looms
“There are a lot of common uses of medical cannabis where there’s insufficient data to say whether it’s therapeutic or not.”
- Sean Hennessy, PharmD, PhD, professor of pharmacology and epidemiology, in a news story in Science. Hennessy was a member of a National Academies of Sciences, Engineering, and Medicine committee that issued a comprehensive report in January about the health effects of marijuana and cannabis-derived products.
Honors & Awards
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J. Larry Jameson, MD, PhD
Executive Vice President, University of Pennsylvania for the Health System; Dean, Perelman School of Medicine
John Phillips Memorial Award from the American College of Physicians
This award is bestowed for outstanding, lifetime work in clinical medicine which has been innovative and/or had a regional or national impact. Jameson has identified the genetic basis of more than a dozen different hormonal disorders and has authored more than 300 scientific articles and chapters. As a leader at Penn Medicine, Jameson has championed pioneering translational research, access to advanced clinical care, innovation in medical education, and diversity as a means to catalyze discovery and societal impact.
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James D. Lewis, MD’91, MSCE’98
Professor, Gastroenterology and Epidemiology, Perelman School of Medicine
2016 Achievement in Inflammatory Bowel Disease (IBD) Clinical Science award from the Crohn’s and Colitis Foundation of America (CCFA).
Lewis was nominated by the medical and research community for his exceptional dedication to the field of IBD. Lewis, who is also a senior scholar in the Center for Clinical Epidemiology and Biostatistics, is among few researchers leading NIH-funded clinical trials for novel therapeutic strategies for IBD. Lewis is also the lead scientist behind CCFA’s IBD Plexus, which aims to be the largest IBD research and information exchange platform ever developed.
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Yvonne J. Paterson, PhD
Professor, Microbiology, Perelman School of Medicine
Fellow, National Academy of Inventors
Election to fellow status recognizes academic inventors named on U.S. patents who have “demonstrated a prolific spirit of innovation in creating or facilitating outstanding inventions that have made a tangible impact on quality of life, economic development, and the welfare of society.” Paterson works to harness the body’s immune system to provide protection against, and find cures for, cancer. She has been issued 32 U.S. patents and numerous foreign patents, with 12 more under review. Read more about Paterson in the Fall 2016 issue of Penn Medicine (“A Citizen of the University”).
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Malek Kamoun, MD, PhD
Professor, Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania; Director, Clinical Immunology and Histocompatibility Laboratory, Perelman School of Medicine
2016 American Society for Histocompatibility and Immunogenetics (ASHI) Distinguished Scientist Award
This award honors a scientist who has contributed significantly to the field of immunogenetics and/or transplant immunobiology and who is also an ASHI member. Kamoun is a past president of ASHI, an international society dedicated to the science, education, and application of immunogenetics and transplant immunology.
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Susan J. Mandel, MD, MPH
Professor, Diabetes, Endocrinology and Metabolism, Perelman School of Medicine; Director, Clinical Endocrinology and Diabetes, University of Pennsylvania Health System
President-elect of the Endocrine Society
Mandel’s clinical and research interests include the use of sonography in the evaluation of patients with thyroid nodules, the novel introduction of I-123 imaging in differentiated thyroid cancer, and thyroid disease during pregnancy. Over the course of her nearly 30-year career, Mandel established the model for thyroid nodule evaluative services and she was one of the first endocrinologists to teach neck ultrasound to endocrine practitioners.
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Lawrence N. Shulman, MD
Professor, Hematology-Oncology, Perelman School of Medicine; Deputy Director for Clinical Services, Abramson Cancer Center
Chair of the Commission on Cancer of the American College of Surgeons
Shulman aims to expand the Commission’s role in enhancing overall cancer-care quality in the United States, reinforce its relationship with its accredited hospital programs, and reduce cancer health disparities.
“There are proven steps we can take to address these disparities, such as promoting greater use of screening tests, enhancing access to care, improving the quality of that care, providing more dietary and lifestyle education, and increasing participation in clinical trials,” he said.
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Millar’s List
Sarah Millar, PhD, the Albert M. Kligman Endowed Professor and vice chair for basic science research in Dermatology at the Perelman School of Medicine at the University of Pennsylvania, always considered herself a feminist and mentored younger women from early on in her career. But, until a few years ago, she was heavily focused on pursuing her own research to earn tenure, and spent her personal time on raising her family—not actively working to make the system more equitable for women in academic medicine.
“But now I’m a full professor, I have tenure, my kids are almost grown up, and so I have time to think about it a little bit,” Millar said.
Beginning in 2012, Millar convened a group of colleagues to meet informally and discuss areas where they felt they could make progress. They created a list of priorities to address barriers to gender equality:
- An on-site daycare for the medical campus
- Greater transparency about faculty salaries and research space allocation
- Greater consideration of unconscious or implicit biases
List in hand and with support of Dean J. Larry Jameson, MD, PhD, Millar and colleagues across Penn got to work. Millar chaired a task force to find vendors for a new on-site childcare facility, projected to open in January 2019. The Office of Inclusion and Diversity released aggregate data about faculty salaries and, for the first time, about research space, broken down by gender and type of faculty role. And Millar spearheaded efforts to address implicit biases by pushing for greater consideration of qualified women for awards and promotions, and she co-organized a symposium about gender bias in academic publishing in April 2016 with Anh Le, DDS, PhD, chair of Oral and Maxillofacial Surgery at Penn’s School of Dental Medicine.
“It’s actually a relatively easy to issue to address because there is a pipeline,” Millar said. Half of medical students and doctoral students in biological sciences are women, and women are hired to tenure-track positions at the assistant professor level in healthy numbers. However, as women move further up the ranks their progress is impeded; there are fewer women in more senior levels. “It’s much more feasible to address the issues underlying this imbalance once you recognize their existence.”
For these efforts, Millar was awarded the 2016 FOCUS Award for the Advancement of Women in Medicine.
“[Global academics] encompasses everything in our view, from climate change to global health and global finance. What do you do in a world where states seem to have less and less power? Those are global questions.”
-Ezekiel Emanuel, MD, PhD, vice provost for global initiatives at the University of Pennsylvania and chair of the department of Medical Ethics and Health Policy in the Perelman School of Medicine, in a Q&A with the Chronicle of Higher Education.
New Leaders Connect Penn Schools
There is something unusual about the newest associate dean for Graduate Education and director of Biomedical Graduate Studies (BGS) in the Perelman School of Medicine: Her primary faculty appointment is in another school.
Kelly Jordan-Sciutto, PhD, chair and professor of Pathology at Penn’s School of Dental Medicine, took on this new role Feb. 1, but she has long been highly active in graduate education in biomedical sciences at Penn. Housed within the Perelman School, BGS draws approximately a quarter of its faculty from other schools at Penn, including Dental Medicine, Veterinary Medicine, Nursing, Arts and Sciences, and Engineering and Applied Science. Jordan-Sciutto’s appointment represents “a truly unique opportunity to further strengthen connections across programs, Schools and the University,” Jonathan Epstein, MD, executive vice dean and chief scientific officer of the Perelman School, said in his announcement to the faculty, in which he also thanked Michael P. Nusbaum, PhD, for his nearly four years of service preceding Jordan-Sciutto in this role.
“I’m excited to continue to advance Mike Nusbaum’s leadership in areas such as increasing diversity among our student body, keeping our graduate program on the cutting edge to create the next generation of leaders in all fields of science, and supporting students’ career development including alternative career trajectories and alumni networking,” Jordan-Sciutto said. “And as I pursue my own plans for the future, I look forward to working with all of the BGS faculty to help our students reach their scientific potential.”
The new role of associate dean for research integration in the Perelman School of Medicine will simultaneously advance the cause of cross-school discovery on another front. Louis J. Soslowsky, PhD, the Fairhill Professor of Orthopaedic Surgery in the Perelman School and a professor of Bioengineering in the School of Engineering and Applied Science, was appointed to this position in January to address and strategize on increasingly important collaborative opportunities across campus.
Perspectives on Medical Error
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“We must reconcile the seemingly conflicting hallmarks of the medical profession: our dedication to first do no harm and our lifelong commitment to learn, improve, and evolve.”
- Neha Vapiwala, MD’01, vice chair of education and advisory dean at the Perelman School of Medicine, about teaching about mistakes.
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“As my peers watched, I cajoled, reasoned, and pleaded with each of my ‘patients.’ Each task proved harder than I expected and humbled me.”
- Jason Han, MS4, about training with standardized patients at the Perelman School of Medicine to practice handling clinical scenarios, including medical errors.
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Vapiwala and Han wrote companion pieces for the Philadelphia Inquirer about learning to handle medical errors, from the perspective of the medical educator and of a medical student who was once a patient harmed by physician error.
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Letters
Blame Profit-Driven Systems
I was fascinated by "The Impact of Poverty on Health Care" by Dr. Richard Cooper, printed in the Penn Medicine Fall 2016 issue. I agree that poverty in our country is a major healthcare cost driver. But Dr. Cooper says not one word about the number one cost driver, the private for-profit health insurance industry, which spends millions if not trillions on advertising, dividends, buying each other out, corporate bonuses, and concocting hundreds of confusing plans (aka “products”). Medicare has none of those costs. Further, this capitalistic complexity carries massive additional costs for providers in the form of endless delays and mistakes, endless paperwork and endless befuddlement. I ran a practice for twenty years and I can tell you that dealing with hundreds of plans is a big overhead item.
Throw it all out! Medicare for all would not be perfect, but it would result in drastic cost decreases, drastic coverage increases, and lowering the toll of preventable deaths. But an entrenched health insurance industry will never let that happen. What a moral tragedy.
Speaking of waste, how many billions is Big Pharma spending on patient-directed advertising so they can go tell their doctor what to prescribe? This is illegal in most other “developed” countries. If patients have to do that, they should go to another doctor.
John K. Herpel, MD, GME’77
No Proof of Capitalism’s Villainy
I object to the extensive posthumous quoting of Dr. Richard Cooper’s book.
All Dr. Cooper has shown is that there is an association of ill health and extra medical expenses with poverty. He has in no way proven cause and effect.
In our pro-socialist world, big government proponents such as Dr. Cooper are always patted on the back for “proving” that the capitalist system is injurious to the population.
Benjamin D. Bernstein, MD, GME’78
Editor’s note: I welcome readers to share thoughts this issue’s articles by sending me an email.
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