Tossing and turning all night is enough to make you feel tired and cranky the next day – but USF Health researchers say sleep deprivation creates additional problems for your gut, immune, and heart health. Especially when combined with a high-fat diet, lack of sleep may trigger low-grade chronic inflammation that could lead to heart disease.

How’s that for a worry to keep you up at night?

In a new paper published in April in The FASEB Journal, the journal of the Federation of American Societies for Experimental Biology. a team of USF Health researchers address not only the relationship between diet and sleep, but the effect on the body’s defense system, including immune health and the microbiome.

The microbiome is made up of the bacteria, viruses and other microorganisms in the gut. Scientists are just beginning to realize that the makeup of the microbiome – whether it contains “good” or “bad” bacteria and other organisms – is greatly influenced by diet and has far broader impacts on human health than previously realized.

“The combination of a high-fat diet and sleep deprivation messes up the immune system,’’ said Ganesh Halade, Ph.D., lead author of the paper and an associate professor at the USF Health Heart Institute. “And when we review the status of the microbiome, then we have a better understanding of the root cause of chronic inflammation that can fuel cardiac failure.’’

Dr. Ganesh Halade

Researchers also studied the lipidome, which is the fats, oils, and their molecules inside the body.

It is well-known that a lipid-dense diet can lead to weight gain and low-grade chronic inflammation. But sleep also is key, being fundamental to heart health and fitness of the immune system. Because more and more people with “sleep fragmentation’’ are facing cardiovascular and cardiometabolic issues including obesity and diabetes, their condition has become a serious medical issue, the researchers report.

“Diet, sleep, and exercise – It’s all related, fundamental, and integrative,’’ Dr. Halade said. “If diet and sleep aren’t in balance, then you invite the array of diseases.  Low-grade chronic inflammation is a by product of imbalanced lifestyle. We know a lot about eating habits, but the real question we need to know more about is the interaction of sleep with diet and effect on immune and heart health.’’

This question has become increasingly important, given that the COVID-19 pandemic, working from home and long hours in front of computer screens have changed the way millions of people sleep. This has led to “a metabolic public health problem’’ due to the disruption of circadian cycles.

Heart disease has been the No. 1 cause of death in the United States every year since 1950.

Other USF Health researchers who worked on this study were: Yusuf Mat, MD, biological scientist; Shalini Jain, PhD, assistant professor, Department of Neurosurgery and Brain Repair; Hariom Yadav, PhD, associate professor, Internal Medicine and Neurosurgery and director of the USF Center for Microbiome Research; and Vasundhara Kain, PhD, senior researcher.

In their study, the researchers used male mice in randomized groups, with one group consuming a fat-rich diet and experiencing interrupted sleep patterns. Researchers measured the microbiome and lipidome in obese, sleep-deprived mice and analyzed gut germs and lipids. To determine the importance of sleep in the context of obesity, mice ate types of fat present in ultra-processed food products and then stayed awake before experiencing cardiac episodes.

Previous reports from Dr. Halade’s lab confirmed that omega-3 fats (fish oil-derived molecules) helped repair the heart in healthy mice after heart attack injuries, with the immune cells of the spleen, molecules called resolution mediators, making the repairs.  However, production of these molecules failed in the spleens of obese and sleep-deprived mice, and heart repair thus failed.  Furthermore, the researchers noted, omega-6 fats present in processed and packaged food products deplete omega-3 fatty acids in plasma and the heart, which causes low-grade chronic inflammation.

Dr. Halade and the team concluded that obesity and poor sleep patterns can lead to immune suppression and limits the body’s ability to repair a heart under stress or injury because prolonged chronic inflammation interferes with immune host defenses.

Dr. Halade is a cardiovascular research scientist working to better understand how inflammation and immune responsive metabolic dysregulation contributes to ischemic and non-ischemic heart failure. At the USF Health Heart Institute, he collaborates with other researchers, including Drs. Siddabasave Gowda B. Gowda and Shu-Ping Hui from Hokkaido University in Japan, on therapies and potential cures for people with heart problems.

— Story by Kurt Loft for USF Health News 

Countless people in the United States suffer from a condition called “leaky gut,’’ where the lining of the intestines becomes porous enough to allow toxins to seep through it and into the bloodstream.

Many are unaware of their condition, or that it can lead to serious health problems, such as chronic inflammation, type 2 diabetes, heart disease, dementia and even some types of cancer. The condition also can cause a variety of unpleasant gastrointestinal syndromes, such as indigestion, gas, bloating, abdominal pain and diarrhea.

In a new paper published in Gut, a leading high-impact international journal in gastroenterology and hepatology, USF Health researchers describe how the right balance of bacteria can deter leaky gut – and how the wrong mix can threaten a person’s health.

The study addresses how leaky gut can accelerate the progression of diabetes in overweight people, and how selective probiotics work to reduce that risk.

People with meat-rich diets are especially vulnerable, said Hariom Yadav, Ph.D., senior author of the study and director of the USF Center for Microbiome Research, Microbiomes Institute, and associate professor of Neurosurgery and Brain Repair.

Hariom Yadav, PhD

“We describe the unique role of the microbiome as a garbage cleaner of our body and our diet’s byproducts, such as how a meat-enriched diet increases the garbage in our gut that changes the microbiome,’’ he said. “This creates leaky gut and inflammation that ultimately induces diabetes.’’

The microbiome is the collection of microbes − bacteria, fungi, and viruses − that naturally live on our bodies. The balance of these tiny organisms can enhance or impair the body’s metabolic and immune functions.

Because everyone’s gastrointestinal tract is selectively porous, many of these organisms – along with nutrients − travel into the bloodstream. However, a person with increased intestinal permeability has too much “leakage,” allowing larger molecules into the bloodstream, creating inflammation. This inflammation impacts many organs in the body, potentially changing their normal functions if exposed for long periods of time and increasing the risk for developing such diseases as diabetes.

“These toxins keep circulating back and forth in our bodies and cause serious health problems,’’ Dr. Yadav added. “We wanted to know how these microbes work in the cleaning process, how they serve as garbage cleaners to remove toxins.’’

The new study discovered that leaky gut in both overweight people and mice diminished the microbiome’s capacity to metabolize a chemical called ethanolamine, a chemical found in beef and other animal food products. High levels of ethanolamine lead to increased permeability of the gut wall, and as a result, more proinflammatory molecules are released into the bloodstream.

Because ethanolamine is found in bovine muscle, people with diets heavy in beef ingest higher-than-normal levels of the chemical than people who eat meat less frequently.

“It’s an intrinsic part of animal meat,’’ Dr. Yadav said of ethanolamine. “So, eating a heavy meat diet contributes more of this chemical, and if the (probiotic) bacteria that metabolizes ethanolamine isn’t there to fight it, those people will be more likely to have leaky gut.’’

If ethanolamine-metabolizing bacteria are low or absent, then the accumulated ethanolamine acts on epithelial cells to cause leakiness. To counter this, the researchers suggest a novel probiotic therapy that would reverse elevated gut permeability, inflammation and dysfunction of glucose metabolism.

“What’s important is to know what kind of bacteria is in our gut and whether it can clear ethanolamine,’’ Dr. Yadav said. “Normally, people talk about what the microbiome produces, but in this study, we talk about what the microbiome utilizes or eats, and how it clears up all these toxins which either comes from our body or from diet. The therapy is where we put back these helpful bacteria in gut, and we can do this with oral probiotics therapy.’’

Dr. Yadav hopes this original research will benefit medical practitioners and policy makers in making better decisions on dietary guidelines.

Dr. Yadav has several ongoing research projects focused on the microbiome. Last year, he received a grant from the National Institute on Aging to help determine if a common medication can restore microbiome diversity in older patients who have a form of heart failure. Results of his three-year study could help prevent the subsequent problems that tend keep these patients inactive and cause their conditions to worsen. He also is working on another study funded by Florida Department of Health, called the Microbiome in Aging Gut and Brain (MiaGB) study, which focuses on how the microbiome impacts brain health, and teaches what to eat and avoid to keep the brain healthy during aging.

Armed with more knowledge about how the microbiome affects inflammation, type 2 diabetes, cardiovascular complications, dementia and even cancer, USF Health researchers hope to identify high-risk patient populations that could benefit from next-generation therapies. Rather than a general treatment, these people might receive more personalized care based on their microbiome and a leaky gut.

— Story by Kurt Loft for USF Health News; photo by Allison Long | USF Health  

This year’s USF Health Research Day set new records as more participants than ever filled the USF Tampa campus Marshall Student Center on March 3 to showcase the best of their scientific work.

The 33^rd USF Health Research Day included 457 research poster presentations by students, postdocs, residents, faculty, and staff across all health disciplines. Research Day is the largest research-oriented event of its kind at USF and remains the largest celebration of health sciences research collaboration across all four USF Health colleges (medicine, nursing, public health and pharmacy) as well as with colleagues in other USF colleges, including social work and engineering.

From left, Dr. Charles Lockwood, Dr. Kim Orth, Rhea Law, and Dr. Steve Liggett.

Research Day kicked off with the Annual Roy H. Behnke, MD, Distinguished Lectureship featuring speaker Kim Orth, PhD, professor of Molecular Biology and Biochemistry at University of Texas Southwestern Medical Center and an investigator at the Howard Hughes Medical Institute, at UT Southwestern Medical Center.

Dr. Orth’s presentation was titled “Black Spot, Black Death, Black Pearl: Tales of Bacterial Effectors” – click here for more about Dr. Orth and her work.

Dr. Kim Orth.

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Tampa General Hospital, the primary teaching hospital for USF Health Morsani College of Medicine, was the presenting sponsor for USF Health Research Day 2023.

Following Dr. Orth’s presentation was the judging of work. Judges reviewed the posters that lined the Marshall Center Ballroom, asking the students for more detail and clarifications about their research projects. Presentations ranged from pilot, preliminary, empirical and case studies to system reviews and reviews of literature or charts.

Following the 13^th Annual Joseph Krzanowski Invited Oral Presenters by select students representing medicine, nursing, public health, and pharmacy, Research Day culminated with an Awards Ceremony in the Oval Theatre announcing the winners in 29 competitive categories – including 18 monetary awards totaling $8,600.

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For the list of Research Day 2023 award winners, click here.

For the list of Research Day judges and sponsors, click here.

More photos

Photos by Freddie Coleman, video by Allison Long, USF Health Communications

Leaders from USF Health and the Global Virus Network (GVN) recently gathered on the University of South Florida campus in north Tampa to sign the final documents making it official that USF Health serves as GVN’s Southeast United States Regional Headquarters.

USF Health and GVN announced nearly two years ago that USF Health earned the designation, but COVID-19 delayed the official signing until this year. The signing took place at the USF Lifsey House Feb 27, 2023, and marks the advancement of the collaborative relationship among the two organizations.

From left, Dr. Charles Lockwood, Pres. Rhea Law, Mathew Evins, and Dr. Christian Brechot.

“What we are signing together today marks a first, that USF is the first regional headquarters to be created with GVN,” said Christian Bréchot, MD, PhD, president of GVN; associate vice president for International Partnerships and Innovation at USF; director of the USF Microbiomes Institute, and professor in the Division of Infectious Disease, Department of Internal Medicine at the USF Health Morsani College of Medicine. “This headquarters at USF will allow GVN to expand its outreach into Florida with USF’s academic, research and medical activities and expertise, including USF’s international activities. In turn, GVN will provide to USF increased visibility and critical mass across the globe in the field of virology.”

“We are so excited to be the headquarters for the Global Virus Network,” said USF President Rhea Law. “This is an initiative in which we can have enhanced collaborations that focus on huge issues affecting our world today. We can make a difference. Thank you so much for all you’ve done. We are looking forward to our collaboration and to our next steps in opportunities to change the world.”

“We are very grateful to be the Southeast Regional Headquarters and this is a significant stepping stone to where we are headed in virology,” said Charles J. Lockwood, MD, executive vice president of USF Health and dean of the USF Health Morsani College of Medicine. “One of the key elements of putting this all together is Christian Bréchot. He has been such an incredible resource, for recruitment of virologists, addressing microbiome, and strengthening many of our programs. It has been a joy to see this collaboration develop and grow. So now, the sky is the limit with this great team in place.”

“On behalf of Bob Gallo, the Board of Directors, and the leadership of the Global Virus Network, I would like to express our most profound appreciation to the University of South Florida for its invaluable and instrumental partnership,” Mathew Evins, executive chair and treasurer of the GVN Board of Directors and chair of Evins Communications, Ltd. “I’ve been involved with GVN from the beginning and I cannot think of a situation where I have been more proud. This is a very significant step for us because the key to the successes of GVN in the future are the kind of partnerships we have with the University of South Florida. This for us is not an incremental step; it is an exponential step. I could not be more grateful for your support, your encouragement, and your partnership.”

GVN encompasses the world’s foremost virologists from 71 centers of excellence and 9 affiliates in 40 nations – all working to prevent illness and death from viral diseases posing threats to humanity. Bridging academia, government and industry, the coalition is internationally recognized as an authority and resource for identifying, investigating, interpreting, explaining, controlling, and suppressing viral diseases.

USF Health was the first regional headquarters named by GVN to provide organizational and leadership support to GVN’s Global Headquarters in Baltimore, Md. In that capacity, USF Health will help strengthen GVN’s initial research response to emerging and re-emerging infectious diseases, such as COVID-19, and its collaborative efforts to plan for, and defend against, future epidemics and pandemics.

Since announcing USF Health’s designation as the GVN Southeast United States Regional Headquarters, the two organization have launched several programs, including the Global Health Conversation Series with USF Health International that hosted a recent webinar featuring Rachel Roper, MS, PhD, who spoke on Monkeypox virus, vaccines and virulence; Dr. Bréchot’s Health and Care Blog that provides updates on novel insights into the COVID-19 pandemic; One Health Codeathon, an effort between GVN and the USF Genomics Program that provides students the opportunity to learn how to harness data sciences against pandemics; and submission of several joint grant applications, including to the National Science Foundation and the National Institutes of Health.

The GVN Southeast U.S. Regional Headquarters based at USF Health will encompass the four health sciences colleges of the university: the USF Health Morsani College of Medicine, the College of Nursing, the College of Public Health, and the USF Health Taneja College of Pharmacy. USF Health is an integral part of USF, a high-impact global research university dedicated to student success. Over the past 10 years, no other public university in the country has risen faster in U.S. News and World Report’s national university rankings than USF.

The appearance of COVID-19 has transformed society almost beyond recognition, with lasting implications for health care, the economy and our social and psychological well-being. Together we can, and we must, be better prepared to meet the challenges of the next emerging virus.”

In addition to their leadership roles at GVN Global Headquarters in Baltimore, Md., Dr. Bréchot and GVN Vice President Linman Li of the USF Health Division of Infectious Disease and International Medicine will lead the new GVN Southeast U.S. Regional Headquarters and focus on regional efforts to expand government and other research funding, as well as research and training initiatives. The regional headquarters designation will enable USF Health scientists to partner with GVN experts worldwide to share ideas and research, to translate research into practical applications, to improve diagnostics and therapies, and to develop vaccines.

GVN members collaborate on science-driven, independent research in many areas, including immunology and vaccines, antiviral drug therapy, virus-host interaction, diagnostic virology and epidemiology, morphogenesis and structural biology, emerging and re-emerging viruses, viruses as biotechnological tools, and trending topics in virology. They also train the next generation of virologists to combat the epidemics of the future.

Video by Allison Long, photos by Freddie Coleman, USF Health Communications

This year’s top stories highlight USF Health as an academic medical center.  Stories of patient gratitude, innovative research and development, and affirmation that the USF Health Morsani College of Medicine is truly the fastest rising medical school in the country.

Take a look at the top USF Health stories of 2022.

1. USF Health and Weill Cornell Medicine earn funding to further develop artificial intelligence that uses voice to diagnose disease. 

2. A USF Health patient had very few answers to her condition until she met with Dr. Jolan Walter.

3. Congratulations to our USF Health physicians who made the 2022 list of the country’s top doctors. 

4. The USF Health Morsani College of Medicine is on the rise faster than any medical school in the country. 

5. A USF Health psychiatry expert explains how the COVID-19 pandemic led to an increased number of patients with Social Anxiety Disorder.

6.  No medical school in the country does Match Day like the USF Health Morsani College of Medicine. 

7. USF Health and Tampa General Hospital neurosurgeons are the first in Tampa Bay to offer game-changing ultrasound. 

8. USF Health was awarded $3.2 million to develop blood tests designed to detect Alzheimer’s Disease. 

9. Researchers begin to unlock how gut and oral microbiomes are linked to brain health in older adults. 

Hariom Yadav, PhD, (standing) and Shalini Jain, PhD, were recently recruited to research on the gut-brain connection (gut-brain axis) in relation to cognitive function.

10. Take a look at all of the USF Health physicians who made the Tampa Magazine list of Top Doctors in 2022. 

USF research teams led by Dr. Yu Chen and Dr. Xingmin Sun describe ways to control the No. 1 hospital-acquired bacterial infection in a paper published in the journal Nature Communications.

The ironic joke goes that if you want to get sick, stay in a hospital. That’s because hospitals can harbor germs that take advantage of a patient’s weakened state, complicating the illness that brought them there in the first place.

But health officials have an arsenal to keep people safe, including cephalosporins, strong antibiotics that fight bacteria such as staphylococcus and streptococcus. Cephalosporins are often used against skin, soft tissue and surgery related infections.

Dr. Yu Chen

However, treatment with β-lactam antibiotics – particularly cephalosporins – is a major risk factor for the virulent Clostridioides difficile infection (CDI), which attacks the large intestine and can cause diarrhea and life-threatening colitis.

These complications are explained in a recent paper published in the journal Nature Communications by teams that includes senior author Dr. Yu Chen, professor in the Department of Molecular Medicine in the USF Health Morsani College of Medicine, and co-corresponding author Dr. Xingmin Sun, associate professor in the Department of Molecular Medicine in the Morsani College of Medicine. Several other USF research teams, led by Rays Jiang, PhD, Prahathees Eswara, PhD, and Ioannis Gelis, PhD, also contributed to the study.

“When you give a person an antibiotic to treat a disease, one of the consequences is the antibiotic can wipe out a lot of the good bacteria in the gut,’’ Dr. Chen said. “But in this case, C. difficile is resistant to cephalosporins, so it creates a high-risk factor. And if people are under prolonged antibiotic treatment, they are at an even higher risk for CDI.’’

Cephalosporin resistance in CDI is well documented, but the underlying mechanism has, until this point, remained unclear. The USF Health team used a combination of experimental techniques to characterize the molecular basis of cephalosporin resistance in CDI, which is the No. 1 hospital-acquired bacterial infection in the United States, according to the Centers for Disease Control and Prevention.

Initially, antibiotics are administered for an unrelated infection or prophylaxis, causing the gut flora diversity to diminish. Without competition from the good bacteria in the large intestine, CDI can easily proliferate, secreting toxins that cause cell death.

“The primary risk factor for CDI are broad-spectrum antibiotics, specifically those with weak activity against C. difficile and strong activity against other gut bacteria,’’ the authors state.

These broad-spectrum antibiotics irreversibly inhibit a bacterium’s penicillin-binding proteins (PBPs), which are enzymes that assemble in the bacterial cell wall. These proteins are critical not only for the growth of C. difficile, but also to produce its spores, which are resistant to harsh environmental conditions and contribute to the high recurrent rates of CDI. The challenge for researchers is that, prior to the Nature Communications report, there was little information about the PBPs of C. difficile.

As a common hospital-acquired infection, the pathogenesis of CDI is well-understood. It causes about 500,000 infections each year in the United States, and one in about 10 people over 65 with the infection die within a month, according to the CDC.

“We want to know more about C. difficile resistance so it (data) can be used to create new therapies for the future,’’ Chen said. “This research will help us understand more about certain drugs that are risks factors for infection.’’

The researchers emphasized two key findings in the journal report. First, by elucidating the three-dimensional structures of key PBPs from C. difficile and how they interact with beta-lactam antibiotics, the USF Health teams showed that cephalosporins do not have strong inhibitory activity against the PBPs essential for C. difficile growth and are thus unable to kill the bacterium.

Second, they also found that many of these proteins require zinc to be functional, partly explaining why dietary zinc is also a risk factor for CDI. Furthermore, the results can be used to develop new inhibitors of these PBPs to kill C. difficile and eliminate its spores. Such compounds can be developed into new antibiotics to treat CDI.

CDI can affect anyone, and symptoms often are painful and life threatening. Risk factors include:

• Being 65 or older
• Recent stay at a hospital or nursing home
• A weakened immune system, such as people with HIV/AIDS, cancer, or organ transplant patients taking immunosuppressive drugs
• Previous infection with CDI or known exposure to the germs

For more information, visit https://www.cdc.gov/cdiff/risk.html

The journal Nature Communications is an open access, multidisciplinary journal dedicated to publishing high-quality research in all areas of the biological, health, physical, chemical and Earth sciences. Papers published by the journal aim to represent important advances of significance to specialists within each field.

Story by Kurt Loft

USF Health microbiome expert Hariom Yadav, PhD, has received a grant from the National Institute on Aging to help determine if a common medication can restore microbiome diversity in older patients who have a form of heart failure and, thus, prevent the subsequent problems that tend keep these patients inactive and cause their conditions to worsen.

Hariom Yadav, PhD, was recently recruited to lead the USF Microbiome Research Center and his research focuses on the gut-brain connection (gut-brain axis) in relation to cognitive function.

Dr. Yadav, associate professor in the Division of Digestive Diseases and Nutrition for the Department of Neurosurgery and Brain Repair and Internal Medicine in the USF Health Morsani College of Medicine and director of the USF Center for Microbiome Research in the Microbiomes Institute, is a co-principal investigator and is working with co-principal investigator and project lead Dalane Kitzman, MD, at Wake Forest University in Winston-Salem, North Carolina.

The 3-year NIH consortium project research, which will include patients diagnosed with heart failure with preserved ejection fraction (HFpEF), is titled “Repurposing of Metformin for Older Patients with HFpEF.”

Preclinical studies show that gut barriers, including mucin production, are reduced in older gut and cause ‘leaky gut’, which allows certain antigens to diffuse into blood circulation, thus causing systemic inflammation. Preliminary data also suggest that older HFpEF patients have markedly reduced microbiome diversity, including reduced production of beneficial metabolites such as butyrate, which maintain health and gut wall integrity, and may help reduce leaky gut.

Metformin prescription bottle. Metformin is a generic medication name and label was created by photographer.

Metformin is a generic FDA-approved medication used for diabetes. Earlier studies, including research in Dr. Yadav’s lab, shows that metformin decreases leaky gut by improving microbial diversity and increasing intestinal wall mucin production thereby reducing systemic inflammation and improving physical function in lab model studies.

This new study seeks to translate these findings to determine if metformin improves microbiome diversity, reduces leaky gut, and reduces the inflammation associated with HFpEF in patients, a common condition in older people, particular older women.

“Earlier research suggests that metformin can inhibit a root cause of systemic inflammation – leaky gut – and its adverse consequences which are highly relevant to HFpEF, including exercise intolerance, a known barrier for HFpEF patients for staying active,” Dr. Yadav said. “We propose to test repurposing of metformin, a promising medication for improving heart failure outcomes by improving gut leakiness and microbial diversity, and that metformin will restore gut microbiome diversity and increase gut wall mucin, which in turn will reduce leaky gut and systemic inflammation and improve physical function for HFpEF patients.”

This new study is a randomized, blinded, placebo-controlled trial over 20 weeks in 80 non-diabetic HFpEF patients age 60 and older. The Wake Forest and Atrium Health team will coordinate the patients, measuring physical function, provide a quality of life questionnaire, and collect stool and blood samples. The team in Dr. Yadav’s lab will examine the samples and measure microbiome diversity and the key markers of leaky gut and of inflammation.

This study is supported by the National Institute on Aging of the National Institutes of Health under Award Number U01AG076928.

Dr. Yadav is conducting similar research associated with leaky gut and inflammation, including their connections to Alzheimer’s disease and other related dementias.

The USF Health Morsani College of Medicine is the fastest-rising medical school in the country, climbing over the last decade from #80 to #46 in U.S. News & World Report rankings for medical schools for research.

Based on data from U.S. News & World Report Academic Insights, the Morsani College of Medicine has climbed 34 spots in rankings for 2014 to 2023. No other medical school in the data – public or private – has risen as far in rankings as fast as the Morsani College of Medicine.

In the last decade, the USF Health Morsani College of Medicine has made great strides, pushing metrics upward in the college’s three mission areas — education, research and patient care – in an effort to place the college among the best medical schools in the country.

With improved metrics, the college’s placement in the national rankings soared from No. 80 in the 2014 U.S. News list to No. 46 in the recently published 2023 list – a seismic 34 spots.

No other medical school in the country has experienced that same improvement in rankings, making the USF Health Morsani College of Medicine the fastest-rising medical schools in the country.

“Our sustained rise in national rankings reflects the rapidly increasing strength of our educational, research and clinical missions at the USF Health Morsani College of Medicine. We are now competing with the nation’s most storied and respected programs,” said Dr. Charles Lockwood, senior vice president for USF Health and dean of the USF Health Morsani College of Medicine. “These outstanding metrics also position us to attract the highest caliber students and faculty, further advancing our program into the national spotlight for its outstanding education, exceptional research and world class clinical care.”

Collaborative effort across Florida’s medical schools results in a statute expanding Medicaid coverage to include donor breastmilk

More Florida babies will have access to donor breastmilk with the recent passing of a bill in the Florida Legislature allowing Medicaid to help cover the cost. The bill, signed by Gov. Ron DeSantis last month, will become law July 1, 2022, and will greatly expand access to donor breastmilk for babies in neonatal intensive care units (NICUs) across the state. Hitherto, Florida Medicaid typically only covered infant formula for hospitalized babies who did not have access to their mothers’ milk.

The report that helped create the bill was provided by the Florida Medical Schools Quality Network (FMSQN), a cooperative of research, clinical, and educational experts from Florida’s medical schools that aims to improve quality of care in Florida’s Medicaid Program. FMSQN worked with USF Health College of Public Health alumnae Jan Gorrie, of Ballard Partners, to help navigate the bill through Florida Legislature’s bill processes. The FMSQN report was commissioned by the Agency for Health Care Administration.

“This collaboration among academic clinicians, State government policy makers, child advocates, government affairs professionals, and legislators converted data to action in supporting evidence-based access to donor breastmilk for Florida’s infants, and serves as an example of opportunities to improve health outcomes for infants, children, and adolescents in Medicaid programs.  We would like to thank Senator Lauren Book and Representative Fiona McFarland for sponsoring this legislation, and for Governor DeSantis’ timely approval during this time of a national critical formula shortage” said Charles J. Lockwood, MD, MHCM, senior vice president of USF Health, dean of the USF Health Morsani College of Medicine, and president of the FMSQN.

FMSQN member organizations include: Florida International University Herbert Wertheim College of Medicine; Florida State University College of Medicine; Lake Erie College of Osteopathic Medicine; Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine; Nova Southeastern University Dr. Kiran C. Patel College of Osteopathic Medicine; University of Central Florida College of Medicine; University of Florida College of Medicine; University of Miami Leonard M. Miller School of Medicine; and the USF Health Morsani College of Medicine.

FMSQN was instrumental in conducting a survey of Florida’s NICUs current usage of donor human milk. The results and subsequent meetings with state legislators informed the crafting of Florida Senate Bill (SB) 1770 / House Bill (HB) 1577, which mandated Florida Medicaid coverage of pasteurized donor human milk (PDHM) and derivatives by accredited donor human milk banks and regulatory agency approved private milk banks.

Data showed that, if these NICUs did not provide PDHM, there would be an estimated increase of 138 more infants per year developing necrotizing enterocolitis (NEC), a potential fatal, severe gastrointestinal disease frequently requiring surgery and long-term nutritional support at an annualized cost of $5,175,000. Thus, PDHM use in Florida would avoid an estimated $4 million in health care expenditures annually, and may save more when the hospital readmissions, home health care visits, and emergency department visits are considered that were not factored into the calculations.

“The initiative was a success because of a team effort with academic health centers, State leaders, child and mother advocates, and community stakeholders,” Dr. Lockwood said. “And it’s these fragile babies in our hospitals who will benefit the most from this successful piece of legislation.”

The multisite study may identify measures to help prevent or delay mild cognitive impairment and dementias like Alzheimer’s disease

TAMPA, Fla. (April 19, 2022) – The Florida Department of Health (FDOH) Ed and Ethel Moore Alzheimer’s Disease Research Program has awarded the University of South Florida total expected funds of $743,661 over the next four years for a multisite clinical study titled “Role of the Microbiome in the Aging Gut and Brain of Floridian Older Adults.”

Hariom Yadav, PhD, was recently recruited to lead the USF Microbiome Research Center and his research focuses on the gut-brain connection (gut-brain axis) in relation to cognitive function.

The multidisciplinary project will investigate how diet influences the gut and oral microbiomes linked to brain health in adults ages 60 and older.

The FDOH consortium grant allows researchers at the USF Health Morsani College of Medicine to expand an initial study examining the microbiome in the aging gut and brain, started in Tampa late last year, to three other sites across the state: Florida Atlantic University (FAU), Boca Raton; Miami Jewish Health, Miami; and the University of Central Florida (UCF), Orlando. The consortium’s investigators expect to enroll a total of 400 older participants — both those who are cognitively healthy as well as those diagnosed with mild cognitive impairment and early-stage dementia.

By the time people are clinically diagnosed with early Alzheimer’s disease, or even mild cognitive impairment, degeneration of neurons in the brain is already quite extensive. For any treatments to stop or delay disease progression, patients at risk for Alzheimer’s must be identified and treated very early, said Hariom Yadav, PhD, an associate professor of neurosurgery and brain repair at the USF Health Morsani College of Medicine and director of the USF Center for Microbiome Research. “We desperately need noninvasive, inexpensive, clinically validated prognostic markers for Alzheimer’s disease that can be easily measured.”

The USF Health-led clinical research consortium will analyze bacteria composition in stool samples and saliva samples donated by study participants one time at the beginning of the study and then once a year for three to four years. Researchers will track alterations over time in the populations of oral and gut microorganisms, collectively known as the microbiome.

“Our study is the first of its kind in Florida exclusively focused on determining whether microbiome ‘signatures’ (biomarkers) from the gut and mouth can accurately predict an older adult’s risk of developing cognitive decline or dementia,” said Dr. Yadav, principal investigator for the FDOH consortium grant. “We also want to know if the signatures we identify can do that early enough to figure out strategies to delay or prevent those age-related diseases – either by modifying the individual’s diet or the microbiome composition itself.”

Using an interactive mobile app, study participants complete a daily dietary recall questionnaire and yearly tests of their memory, speed of thinking, and other cognitive abilities. Researchers will evaluate the effects of certain types of foods (i.e., protein, fruits, vegetables, dairy, carbohydrates, fermented foods, and junk food) on the growth of specific types of bacteria and see how the mix of bacteria changes if an individual’s diet is modified.

A growing number of studies correlate healthy guts, characterized by a well-balanced diversity of microorganisms, with healthy aging. Alzheimer’s disease is among the growing number of medical conditions linked to an imbalance of microorganisms (more bad microorganisms than good microorganisms) within the intestines. Emerging evidence also suggests that oral health and brain health are connected, including a large National Institute on Aging study linking gum disease with dementia.

Ronald Day and his wife Ardell, both 74, were among the first to enroll in USF Health’s novel microbiome study. Day, a retired pastor and volunteer chaplain at his Tampa continuing care retirement community, said he was intrigued by the idea that gut microorganisms may affect brain function and possibly be altered to combat cognitive decline.

“In the future, I’m hoping researchers learn enough from studies like this to suggest individualized diets, or other interventions, tailored to our own microbiomes,” Day said. “Anything that can help us maintain mental acuity as we age is so important.”

Aging is not a disease, Dr. Yadav emphasized, but as people age it’s particularly important to keep a healthy balance of intestinal microbes so that a potentially harmful strain of bacteria does not overgrow and monopolize the food source of beneficial bacteria. “A healthy gut allows you to adequately absorb the healthier nutrients and keep a check on the stimulation of inflammation, which is a root cause of several age-related conditions, including declining cognitive function that increases the risk for Alzheimer’s and other dementias,” he said.

The investigators collaborating with Dr. Yadav are Shalini Jain, PhD, Amanda Smith, MD, and Ambuj Kumar, MD, MPH, all from USF Health; Peter Holland, MD, of FAU; Marc Agronin, MD, of Miami Jewish Health; and Michal Masternak, PhD, of UCF.

Florida is among 10 U.S. states with the highest rates of Alzheimer’s disease. Approximately 580,000 people in Florida live with Alzheimer’s disease and this number is projected to increase to over 720,000 by 2025, according to the Alzheimer’s Association.

For more information about the microbiome in aging gut and brain study, please email jains10@usf.edu or call (813) 974-6281.