UF Explore Magazine | Fall 2016

FALL 2016

Voting for a New Age Bringing Elections into the 21st Century

Fall 2016, Vol. 21, No. 3

About the cover: Professor Juan Gilbert believes people of all abilities should be able to vote privately.

Photo by John Jernigan

Dr. Kent Fuchs President

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Research Briefs

30 The Democracy Machine

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Ensuring people of all abilities can vote with confidence

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The Election Geek

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Michael McDonald makes big data count for democracy

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Overcoming Barriers

McKnight Brain Institute

Extracts

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Battling Brain Cancer

Making Sense of Smell

Addressing Addiction

Citrus crate labels offer a slice of life in early 20th century Florida

Explore is published by the UF Office of Research. Opinions expressed do not reflect the official views of the university. Use of trade names implies no endorsement by the University of Florida. Š 2016 University of Florida. explore.research.ufl.edu Editor: Joseph M. Kays joekays@ufl.edu Art Direction, Design and Illustration: Katherine Kinsley-Momberger

Web Editor: Jewel Midelis Copy Editor: Bruce Mastron Printing: StorterChilds Printing, Gainesville

The Conversation

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Board of Trustees James W. Heavener, Chair David L. Brandon Mori Hosseini Leonard H. Johnson Rahul Patel Marsha D. Powers Jason J. Rosenberg Steven M. Scott Nicole Stedman Robert G. Stern David M. Thomas Susan Webster Anita G. Zucker

Science Writers: Michelle Koidin Jaffee Cindy Spence

Period Pieces

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Dr. David Norton Vice President for Research

Keeping anxiety at bay

Member of the University Research Magazine Association www.urma.org

John Jernigan

n December 1991, the late William Luttge, then chair of the UF Department of Neuroscience, came across an obscure notice from the Department of Defense seeking proposals for a major national brain and spinal cord research center.

As the newly appointed director of the campuswide UF Brain Institute initiative to connect the university’s many neuro-related programs, Luttge thought UF had a shot and set about to gather the pieces for a proposal that ultimately ran to thousands of pages. In June 1992, the DOD awarded David Norton UF the first of three grants Vice President for Research totaling $38 million to build a state-of-the-art facility for studying our most complex organ.

The doors opened in October 1998 and when the McKnight Brain Research Foundation donated another $15 million that was matched by the state, the Evelyn F. and William L. McKnight Brain Institute was born.

A quarter century after Dr. Luttge had the vision to pursue that initial grant, the McKnight Brain Institute is a national leader in the study of the brain in all its complexity. More than 300 faculty from 51 academic departments and 10 colleges conduct research and education in nearly all aspects of basic, clinical and translational neuroscience.

This issue of Explore features a sampling of that research, including a large initiative led by Dr. Duane Mitchell to harness the body’s own defenses against brain tumors that have a devastatingly low survival rate. Mitchell and his team at UF, along with collaborators at Duke University and other institutions, are developing vaccines that fire up the immune system to fight back against these tumors.

Steven Munger and his colleagues in the Center for Smell and Taste are focused on our sense of smell, something most of us take for granted, but which eludes thousands of people, depriving them of some of life’s simple joys. In February, UF will host one of the first conferences ever on conditions that impact the sense of smell.

Another area of focus is addictions, whether they be to smoking, drugs or even food. Sara Jo Nixon’s team will be collaborating with colleagues at the University of Michigan and 17 other institutions to track nearly 10,000 children for more than a decade into late adolescence to better understand the relationship between intellectual development and addiction.

Neuroscience and the Brain is one of the major focus areas of the UF Preeminence Initiative, and Mitchell, Munger and opiate addiction researcher Jane Aldrich are examples of preeminent faculty we have recruited to enhance our already world-class faculty.

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Eric Zamora

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Brain research is a perfect example of the way UF’s comprehensiveness makes us uniquely equipped to conduct the kind of interdisciplinary studies needed to understand

complex problems. Over the next 25 years, we expect our researchers to discover even more about the mysteries of our brain.

Research Awards & Licensing 2016

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esearch focused on Alzheimer’s, agricultural pests and economic development was among the thousands of projects funded with a record $724 million in research awards to the University of Florida for the 2016 fiscal year that ended June 30.

The new total is a 2.4 percent increase over the previous record of $706.8 million set in fiscal year 2015. Over the last decade awards are up 24 percent.

“I applaud our dedicated faculty members for continuing to raise the bar with this new record in research funding,” said UF President Kent Fuchs. “The competition for this funding is intense, so this record demonstrates their research excellence while adding to UF’s

growing stature as one of the nation’s great public research universities.”

About $451 million of the funding came from federal agencies, led by the National Institutes of Health with $178.6 million, a 17 percent increase over last year’s NIH total.

U.S. Department of Agriculture funding was at $68 million; funding from the National Science Foundation was up nearly 35 percent to $63.3 million; and funding from the U.S. Department of Education more than doubled to $25.7 million.

The state of Florida provided another $50 million, up nearly 29 percent over 2015; and foundations and nonprofits provided $110 million in support, a 21 percent increase over the previous

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President Fuchs to join National Science Board

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resident Barack Obama has announced his intention to appoint University of Florida President Kent Fuchs to the National Science Board, the body that oversees the National Science Foundation.

Fuchs wil be the only NSB member from Florida.

“I am grateful for the opportunity to play a role in our nation’s support of science and engineering research and education,” Fuchs said.

“When members of the UF community are able to serve in this way, it increases our university’s visibility and influence.”

The NSB comprises 25 members appointed by the president. The NSF director

year. Industry, local governments and other sources funded the remaining $113 million.

“The diversity of our research portfolio has kept us on an upward trajectory for many years,” said David Norton, UF’s vice president for research. “Our faculty

is an ex officio member.

Members serve six-year terms.

With the exception of the NSF director, one-third of the board is appointed every two years. NSB members are drawn from industry and universities, and represent a variety of science and engineering disciplines and geographic areas.

The National Science Board has two roles. First, it establishes NSF policies within the framework of applicable national policies set forth by the president and the Congress.

Second, it serves as an independent body of advisers to both the president and Congress on policy matters related to science and

engineering, and education in science and engineering.

In addition to major reports, the NSB also publishes occasional policy papers or statements on issues of importance to U.S. science and engineering.

“These fine public servants bring a depth of experience and tremendous dedication to their important roles. I look forward to working with them,” Obama said in the White House news release.

Fuchs, who has been UF’s president since January 2015, is a fellow of the American Academy of Arts and Sciences, the American Association for the Advancement of Science, the Institute of Electrical and Electronics

Engineers, and the Association for Computing Machinery. He holds a B.S.E. from Duke University, a M.Div. from Trinity Evangelical Divinity School, and a M.S. and Ph.D. from the University of Illinois.

continue to be very strategic at pursuing funding from the source that is the best fit for their science – government agency, industry or foundation.”

The College of Medicine in Gainesville and Jacksonville brought in $298 million; the Institute of Food and

Agricultural Sciences, or IFAS, received $140 million; the College of Engineering was at $75 million; and the College of Liberal Arts and Sciences received $40 million. The remaining colleges had a combined $171 million.

Notable grants from NIH include $4 million to the Institute on Aging to develop strategies to address lowgrade chronic inflammation and movement disabilities in the elderly; $3.6 million to the Diabetes Institute to continue its research on type 1 diabetes; and nearly $3 million to the Center for Translational Research in Neurodegenerative Disease to establish an Alzheimer’s Disease Research Center.

Major U.S. Department of Agriculture grants to IFAS included $4.4 million to develop turfgrass with improved drought resistance; $3.4 million to try to stem the impact of laurel wilt on

avocados; and $3.4 million to combat a bacterial disease damaging tomatoes.

UF’s Office of Technology Licensing also had a record year, signing 122 licenses and options and launching 17 startup companies, topping last year’s total of 85 licenses by 43 percent.

“Our top-ranked tech transfer operation is driving economic development and cycling royalty dollars back into research,” Norton said “The success of our startups is a huge validation of UF’s efforts in science and of technology transfer,” added Fuchs. “Research discoveries don’t just automatically become therapies that save lives or products that improve our standard of living. It takes research excellence, superb tech transfer professionals and the right commercial partners. We’re fortunate to have that winning combination at UF.”

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Finding Dory

Researchers grow Pacific blue tang

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inally, it may be possible for regular folks to find their own Dory.

Researchers with the University of Florida Tropical Aquaculture Laboratory in Ruskin have for the first time successfully raised in captivity the Pacific blue tang, the colorful star of Disney’s “Finding Dory.” The breakthrough means aquarium hobbyists and marine life exhibits may soon have a source for blue tangs that doesn’t rely on wild captured fish.

“We worked with Rising Tide Conservation and the SeaWorld-Busch Gardens Conservation Fund to find a way to successfully breed Pacific blue tangs. It was a delicate, time-intensive endeavor, but one that has paid off,” said lab director Craig Watson.

The project began about six years ago, when Watson

was approached by Judy St. Leger from Rising Tide Conservation. The program’s primary goal is to develop production technologies for key marine ornamental species, including Pacific blue tang, he said.

Over the next six years, Rising Tide Conservation assembled a team of scientists from the Tropical Aquaculture Laboratory, the Indian River Research and Education Center and the Oceanic Institute of Hawaii Pacific University to get the fish to survive past a week.

The scientists placed newly hatched Pacific blue tang — which are just over 1 millimeter long, transparent and have no eyes or mouth – in a tank for three days while the fish larvae absorbed their yolk.

“During that first three days, the Pacific blue tangs develop eyes and a mouth. If

the food for the parents isn’t just right, the yolk won’t be enough, or of the right consistency to carry the larvae through,” Watson explained.

“Water quality, including temperature, is critical, and if anything goes wrong they can be dead in hours.”

The survival rate to day four reached as high as 80 percent, Watson said.

“We were very excited to get past that first crucial stage,” he said. But in the past, the fish ultimately would die before the week was out. “The best we achieved was to get a single blue tang to survive 21 days post hatch,” Watson said.

In late 2015, Chad Callan and his team in Hawaii successfully raised the first yellow tangs. UF sent biologist Kevin Barden to see first-hand how the Hawaii team reached success, Watson said.

Barden returned to UF and worked with colleagues Eric Cassiano, Matthew DiMaggio and Cortney Ohs to devise a strategy to replicate the procedures done in Hawaii. In May, just weeks before “Finding Dory” hit movie theaters nationwide, the researchers started a run at raising the first ever captive-bred Pacific blue tangs.

“As the weeks ticked by, the fish started behaving and growing like nothing seen before,” Watson said. “And, on Day 52, the first baby “Dory” was photographed with 26 siblings in a greenhouse in Ruskin, Florida.

It had finally developed the blue and black color and was thriving in the tank.”

The next step is to help commercial producers replicate UF’s success, Watson said. “Our industry partners are ready to gear up.”

Craig Watson, cawatson@ufl.edu

Beverly James

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Extortion Extinction Putting the brakes on ransomware

UF/IFAS Communications

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ansomware — what hackers use to encrypt your computer files and demand money in exchange for freeing those contents — is an exploding global problem with few solutions, but a team of University of Florida researchers says it has developed a way to stop it dead in its tracks.

The answer, they say, lies not in keeping it out of a computer but rather in confronting it once it’s there and, counterintuitively, actually letting it lock up a few files before clamping down on it.

“Our system is more of an early-warning system.

It doesn’t prevent the ransomware from starting ... it prevents the ransomware from completing its task … so you lose only a couple of pictures or a couple of documents rather than everything that’s on your hard drive, and it relieves you of the burden of having to pay the ransom,” said Nolen Scaife, a UF doctoral student and founding member of UF’s Florida Institute for Cybersecurity Research.

Scaife is part of the team that has come up with the ransomware solution, which it calls CryptoDrop.

Ransomware attacks have become one of the most urgent problems in the digital world. The FBI issued a warning in May saying the number of attacks has doubled in the past year and is expected to grow even more rapidly this year.

It said it received more than 2,400 complaints last year and estimated losses

from such attacks at $24 million last year for individuals and businesses.

Attackers are typically shadowy figures from other countries lurking on the Dark Web and difficult, if not impossible, to find. Victims include not only individuals but also governments, industry, health-care providers, educational institutions and financial entities.

Attacks most often show up in the form of an email that appears to be from someone familiar. The recipient clicks on a link in the email and unknowingly unleashes malware that encrypts his or her data. The next thing to appear is a message demanding the ransom, typically anywhere from a few hundred to a few thousand dollars.

“It’s an incredibly easy way to monetize a bad use of software,” said Patrick Traynor, an associate professor in UF’s Department of Computer & Information Science & Engineering and also a member of the Florida Institute for Cybersecurity Research. He and Scaife worked together on developing CryptoDrop.

Some companies have simply resigned themselves to that inevitability and budgeted money to cover ransoms, which usually must be paid in Bitcoin, a digital currency that defies tracing.

Ransomware attacks are effective because, quite simply, they work.

Antivirus software is successful at stopping them when it recognizes ransomware malware, but therein lies the problem.

“These attacks are tailored and unique every time they get installed on someone’s system,” Scaife said. “Antivirus is really good at stopping things it’s seen before …

That’s where our solution is better than traditional anti-viruses. If something that’s benign starts to behave maliciously, then what we can do is take action against that based on what we see is happening to your data. So we can stop, for example, all of your pictures from being encrypted.”

Scaife, Traynor and colleagues Kevin Butler at UF and Henry Carter at Villanova University laid out the solution in a paper published in the IEEE International

Conference on Distributed Computing Systems and presented June 29 in Nara, Japan.

The results, they said, were impressive.

“We ran our detector against several hundred ransomware samples that were live,” Scaife said, “and in those cases it detected 100 percent of those malware samples, and it did so after only a median of 10 files were encrypted.”

Patrick Traynor, traynor@ufl.edu

Steve Orlando

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Botanist Honored

Pam Soltis elected to National Academy of Sciences

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am Soltis, a distinguished professor and curator at UF’s Florida Museum of Natural History, was elected to the National Academy of Sciences in May in recognition of her distinguished achievement in original research.

“This is an incredible honor, and I’m very grateful to the academy,” Soltis said.

“It’s really a reflection of great collaborators, students and post-docs, and of the wonderful environment here at UF.” Soltis’ research interests are angiosperm phylogeny, phylogeography, polyploidy and conservation genetics. Among her most cited

Pam Soltis

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contributions are papers on plant evolution and on the role of genetic and genomic attributes in the success of polyploids.

“Pam’s work in genetics and biology has been truly groundbreaking,” said UF President Kent Fuchs. “The respect she has earned on the international stage is a testament to her contributions and leadership, and we are incredibly fortunate to have her at the University of Florida.”

Soltis’ research is motivated by her passion for biodiversity, especially plants.

She uses genomic methods and computational modeling to understand patterns and

processes of plant evolution and to identify conservation priorities.

Much of her current work focuses on plant diversity and conservation in Florida, but her research has taken her throughout the U.S. and Canada and to Costa Rica, New Caledonia, Spain, China and Brazil, and she presents her research at both national and international conferences.

She is the author of over 400 publications, including seven books. Her work is funded primarily by the National Science Foundation.

The National Academy of Sciences is a private, nonprofit institution that was

established under a congressional charter signed by President Abraham Lincoln in 1863. It recognizes achievement in science by election to membership, and — with the National Academy of Engineering and National Academy of Medicine — provides science, technology and health policy advice to the federal government and other organizations. Soltis joins more than two dozen UF members in the three academies.

Pamela Soltis, psoltis@ufl.edu

Steve Orlando

Pit Bull?

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NA results show that shelter workers are often mistaken when they label a dog as a pit bull, with potentially devastating consequences for the dogs, a new University of Florida study has found.

“Animal shelter staff and veterinarians are frequently expected to guess the breed of dogs based on appearance alone,” said Julie Levy, a professor of shelter medicine at the UF College of Veterinary Medicine and the lead author of a study published recently in The Veterinary Journal.

“Unlike many other things people can’t quite define but ‘know when they see it,’ identification of dogs as pit bulls can trigger an array of negative consequences, from the loss of housing, to being seized by animal control, to the taking of the dog’s life,” she said. “In the high-stakes world of animal shelters, a dog’s life might depend on a potential adopter’s momentary glimpse and assumptions about its suitability as a pet.

If the shelter staff has labeled the dog as a pit bull, its chances for adoption automatically go down in many shelters.”

The past few decades have brought an increase in ownership restrictions on breeds including pit bulls and dogs that resemble them.

The restrictions are based on assumptions that certain breeds are inherently dangerous, that such dogs can be reliably identified and that the restrictions will improve public safety, the study states.

The study focused on how accurately shelter staff

identified dogs believed to be pit bulls. ‘Pit bull’ is not a recognized breed, but a term applied to dogs derived from the heritage breeds American Staffordshire terrier or Staffordshire bull terrier. The purebred American pit bull terrier is also derived from these breeds and is often included in the loose definition of pit bull.

The research team evaluated breed assessments of 120 dogs made by 16 shelter staff members, including four veterinarians, at four shelters.

These staff members all had at least three years of experience working in a shelter environment. The researchers then took blood samples from the dogs, developed DNA profiles for each animal and compared the DNA findings against the staff’s initial assessments.

“We found that different shelter staffers who evaluated the same dogs at the same time had only a moderate level of agreement among themselves,” Levy said.

Results of the study also showed that while limitations in available DNA profiles make absolute breed identification problematic, when visual identification was compared with DNA test results, the assessors in the study fared even worse.

Dogs with pit bull heritage breed DNA were identified only 33 to 75 percent of the time, depending on which of the staff members was judging them. Conversely, dogs lacking any genetic evidence of relevant breeds were labeled as pit bull-type dogs from 0 to 48 percent

Mindy C. Miller

DNA studies reveal shelter workers mislabel dogs

Shelter medicine Professor Julie Levy plays with a shelter dog at the Alachua County Animal Services facility in Gainesville.

of the time, the researchers reported.

“Essentially we found that the marked lack of agreement observed among shelter staff members in categorizing the breeds of shelter dogs illustrates that reliable inclusion or exclusion of dogs as pit bulls is not possible, even by experts,” Levy said.

“These results raise difficult questions because shelter workers and veterinarians are expected to determine the breeds of dogs in their facilities on a daily basis. Additionally, they are often called on as experts as to whether a

dog’s breed will trigger confiscation or regulatory action.

The stakes for these dogs and their owners are in many cases very high.”

Julie Levy, LevyJk@ufl.edu

Sarah Carey

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Separate Lives C

onjoined twin girls who were connected at the heart and other organs have been successfully separated in an extremely rare surgery performed by physicians at University Florida Health Shands Children’s Hospital.

The girls, who were born at UF Health Shands Hospital in April and separated in June, each had their own complete set of organs but were attached at the liver, diaphragm, sternum and heart, called a thoracoomphalopagus connection.

Their hearts were the most critical element of the separation, according to Dr. Mark Bleiweis, chief of pediatric and congenital cardiovascular surgery at UF Health and the surgeon who performed the heart separation. The twins shared a connection at the upper chamber of the heart, called the atrium, where blood enters the heart.

“It was a really complex connection because it was close to very important veins in the hearts of both babies,” Bleiweis said. “In the world, there have not been many successful separations with a cardiac connection. It became a very challenging planning process for us, and, ultimately, a challenging separation.”

Dr. Jennifer Co-Vu specializes in fetal cardiac care. She first studied the physiology of the unborn twins during an hours-long ultrasound in the 21st week of pregnancy and she told the parents she thought that not only would the babies survive birth, they also would survive after they were born. The

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parents had two options: to attempt separation, or to be prepared to raise conjoined twins, Co-Vu said.

Co-Vu and the team used cardiac CT and MRI scans before and after the twins were born to create what appears to be the first-ever 3-D printed conjoined twin heart. The replica allowed the surgeons to examine the shared structures in the heart and plan how to separate them. The team — which included Co-Vu, Bleiweis and many others from the pediatric cardiac intensive care unit, radiology, neonatology, maternal fetal medicine, anesthesiology and plastic surgery units — met numerous times to create the preoperative plan for the twins, to practice the separation itself and to manage the twins’ care after the surgery.

“When I saw the heart structures and liver structures in utero, I had a feeling that we could separate them, but I had to examine the anatomy more closely and consult with my cardiology colleagues at the UF Health Congenital Heart Center,” said Co-Vu, director of the Fetal Cardiac Program. “I was able to give them hope, yet at the same time, I told them I was cautiously optimistic … We are very fortunate that this was a success.”

Conjoined twins occur only in about 1 in 200,000 live births. Between 40 and 60 percent of conjoined twins are stillborn, and 35 percent who live through birth survive only one day, according to the University of Maryland Medical Center. Only about

Jesse S. Jones

UF doctors separate conjoined twins connected at the heart and liver

Scarlett, left, and Savannah were born at UF Health Shands Hospital in April. Surgeon Mark Bleiweis checks on Savannah following the surgery.

5 to 25 percent of conjoined twins survive, and survival of twins connected at the heart is extremely rare. In addition to being joined at the heart, the girls also shared a large, fused liver, according to Dr. Saleem Islam, chief of the division of pediatric surgery in the UF College of Medicine.

“The liver, from all of the imaging we obtained both before the babies’ birth and after they were born, indicated that it was almost like one giant liver without any true plane of separation,” Islam said.

Without a clear picture of how to separate the liver

before the surgery took place, Islam and his team had to use a method called “intraoperative ultrasound” to guide the separation. Using this method, Islam looked for areas of the joined liver that were free from large blood vessels.

During the the procedure, which spanned eight hours, a pediatric surgery team with two surgeons, a cardiothoracic surgery team with two surgeons, two pediatric cardiac anesthesiology teams, a pediatric cardiac imaging team, and multiple nursing and ancillary staff worked to safely and successfully separate the infants. To keep

Cavity Pill

Daily supplement of bacteria could prevent decay the various equipment keeping the twins alive during the surgery separated and easily identifiable, the staff wrapped tubing and electrical wiring with orange tape for one of the twins and blue tape for her sister, according to anesthesiologist Andrew Pitkin.

Physicians at a different hospital discovered that mother Jacquelyn was carrying conjoined twins when the parents went for their first ultrasound at 20 weeks.

Up to that time, Jacquelyn had thought she was carrying one child. Previously, sonograms captured only one heartbeat because the babies’ hearts were in sync. Initially, Jacquelyn and partner Mark’s obstetrician at another institution told them the babies would not survive — or if they did, would only live a few days outside the womb.

“We went in to find the sex of one baby, and found out not only were they twins, but they were conjoined and weren’t going to make it,” Jacquelyn said. “Many opinions later, we found Dr. Co-Vu, and she told us not only were our twins going to live, but they thought they could separate them.”

And now, the family is preparing to take the twins home.

“The outlook is extremely optimistic,” Bleiweis said.

Between the separation surgery and other procedures to repair where the babies were connected, the twins have undergone more than a dozen surgeries each.

Morgan Sherburne

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niversity of Florida Health researchers have identified a new strain of bacteria in the mouth that may keep bad bacteria in check — and could lead to a way to prevent cavities using probiotics.

The researchers say the findings could lead to the development of a supplement that patients could take orally to prevent cavities.

While developing an effective oral probiotic will require more research, a possible candidate organism has been identified: a previously unidentified strain of Streptococcus, currently called A12.

Robert Burne, associate dean for research and chair of the UF College of Dentistry’s Department of Oral Biology, and Marcelle Nascimento, an associate professor in the UF College of Dentistry’s Department of Restorative Dental Sciences, published the findings in the journal Applied and Environmental Microbiology.

To maintain a healthy mouth, the oral environment must have a relatively neutral chemical makeup, or a neutral pH. When the environment in the mouth becomes more acidic, dental cavities or other disorders can develop, according to Burne.

“At that point, bacteria on the teeth make acid and acid dissolves the teeth. It’s straightforward chemistry,” Burne said. “We got interested in what activities keep the pH elevated.”

Previous research by Burne, Nascimento and others found two main compounds that are broken down into ammonia,

which helps neutralize acid in the mouth. These compounds are urea, which everyone secretes in the mouth, and arginine, an amino acid.

Burne and Nascimento had also previously found that both adults and children with few or no cavities were better at breaking down arginine than people with cavities.

Researchers knew bacteria were responsible for breaking down these compounds but needed to investigate which bacteria do this best, and how this inhibits cavities. Part of the answer is A12.

“Like a probiotic approach to the gut to promote health, what if a probiotic formulation could be developed from natural beneficial bacteria from humans who had a very high capacity to break down arginine?” said Burne. “You would implant this probiotic in a healthy child or adult who might be at risk for developing cavities. However many times you have to do that — once in a lifetime or once a week, the idea is that you could prevent a decline in oral health by populating the patient with natural beneficial organisms.”

A12 has a potent ability to battle a particularly harmful kind of streptococcal bacteria called Streptococcus mutans,

which metabolizes sugar into lactic acid, contributing to acidic conditions in the mouth that form cavities.

The UF researchers found that A12 not only helps neutralize acid by metabolizing arginine in the mouth, it also often kills Streptococcus mutans.

Nascimento, a clinician, collected plaque samples for the study. Dental plaque is a mass of bacteria that grows on the surface of teeth and can contribute to the formation of cavities. She isolated more than 2,000 bacteria that the researchers then screened to find bacteria that fit the bill.

“We may be able to use this as a risk assessment tool,” Nascimento said. “If we get to the point where we can confirm that people who have more of this healthy type of bacteria in the mouth are at lower risk of cavities, compared to those who don’t carry the beneficial bacteria and may be at high risk, this could be one of the factors that you measure for cavities risk.”

Robert Burne, rburne@dental.ufl.edu

Morgan Sherburne

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Photos by John Jernigan

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Democracy

Ensuring people of all abilities can vote with confidence

By Cindy Spence

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week before the 2012 presidential election, Juan Gilbert walked into Clemson Elementary School in South Carolina looking for the ideal test subjects for a technology he had been developing for almost a decade.

Gilbert, a computer scientist, wanted to see if the voting technology he had created, called Prime III, would work on the ultimate disenfranchised voting population: those who cannot read.

He placed his research in the hands of prekindergarten through second grade students and watched as they used pictures and touchscreens to cast ballots. At the end of the mock election he realized Prime III was, well, ready for prime time.

“We wanted these children to be able to vote without any training,” Gilbert says. “And Prime III worked. The kids could all vote.”

Gilbert isn’t advocating suffrage for the milk money set, but the children at Clemson Elementary were a population he knew could not read, so they were the perfect subjects to test Prime III. Prime III had already been tested by voters who could not see or hear and by voters who could not use their hands to pull a lever or punch a chad. It had worked in elections of all kinds, both mock and real. Passing muster with voters who could not read? Jackpot. For the first time in the United States, one voting system could be used by anyone who wished to vote. Anyone could cast a ballot privately, without the help of a poll worker. Voters would no longer be segregated by their abilities. No more separate but equal.

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“The people who could design it, couldn’t build it, the people who could build it didn’t understand how to design it, and the people who could secure it didn’t understand how to design it or build it.”

— Juan Gilbert

Who Votes and How For much of American history, voting has revolved around who has the right to vote. Our founders, mired in a contentious debate over the issue, opted to sidestep it, leaving voting rights in the hands of the states, with limited oversight by the federal government.

That vacuum in the Constitution has resulted in five separate amendments that deal with voting rights. [See timeline, page 18].

After the 2000 presidential election and all its problems, the focus shifted to how America votes.

Gilbert, a freshly minted Ph.D. and young professor, noticed. Figuring someone must be working to fix voting technology, he did a quick scan of computer science research literature. To his surprise, he found a huge gap.

“The embarrassment was that we’d just had this big dotcom boom and all

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this technology, so why are we punching a card? That seemed so primitive, given the advancement of our country and what we are capable of doing,” Gilbert says.

Not Stone Age perhaps, but punch cards had been around since the 1890 census, and punch card machinery had been adapted in the 1960s for voting.

That Palm Beach County’s Votomatic and butterfly ballot had failed in a large urban county, in a presidential election year with a huge turnout hardly surprised Gilbert. What did surprise him was that better technology was not available.

“This catastrophic failure decided the U.S. presidency,” Gilbert says.

“Who wouldn’t want to work on this?”

He assembled a team of students — to date, more than 50 have contributed to Prime III — and quickly discovered why no one had tackled

voting technology, why the experts said it could not be done. It wasn’t just hard, he says, it was harder than rocket science.

Voting is supposed to be simple, accessible to every eligible voter. Voting is supposed to be private, so no voter should have to tell his or her vote to another person to cast a ballot or require help with levers or touchscreens.

Voting is supposed to be secure and verifiable: one person, one vote.

Gilbert says the people with the chops to write the software, even those who specialized in human-centered computing, lacked the contextual expertise to adapt to voters of varied abilities.

They might design a system for blind voters and another for deaf voters.

Then, building the system required a second layer. And securing any system that got through the design and build stages added an even tougher third

University of Florida/ Lyon Duong

Juan Gilbert brought Prime III with him to a seminar on the UF campus called “Making Elections Work in the Sunshine State and Beyond,” and allowed participants to cast mock ballots. Touchscreen tablets, QR code scanners, microphones and headsets were all tested. Voting rights literature for the blind includes braille.

layer. Making voting the most accessible it could be, and the most secure it could be, proved to be a conundrum.

“Think about it: the most secure thing in the world is the thing that is most inaccessible,” Gilbert says.

“The people who could design it, couldn’t build it, the people who could build it didn’t understand how to design it, and the people who could secure it didn’t understand how to design it or build it,” Gilbert says. “The people in those camps were very far from each other. People had not succeeded on voting technology because these camps could never agree. No one was in that center space.”

Gilbert assembled a team and marched right into the void.

Prime III To a computer scientist, a voter is a user of technology, and the experience of voting needs to be seamless. On the surface, it looks simple. Show up at your polling place, take your ballot, vote and get your “I voted” sticker.

The process behind that picture of Americana, however, is complex, although Gilbert and his team have spent more than a decade making it look easy.

Prime III runs on the kind of touchscreen tablet with which most people are familiar. Compared to a traditional mechanical voting machine that can cost $6,000, these tablets represent a considerable savings.

The voter chooses a mode of communication — speaking or touching, or both. For visual voting, the fonts are large, and districts can choose to provide photos of candidates. Only one race or referendum appears per screen.

If a voter is blind or cannot read, a simple headset with a microphone is provided, and only the voter can hear the prompts. The voter can use textured buttons to navigate the ballot in response to the prompts or respond by speaking. The only words the voter utters — vote and continue — do not reveal voting intention. If the voter cannot speak, simply blowing into the microphone will make a selection. This feature is particularly helpful for voters with limited use of their hands, such as veterans wounded in war.

Voters who choose touch as the mode of communication can navigate the ballot as a touchscreen, selecting candidates or making referenda choices.

The machine confirms votes verbally or visually. When the voter is finished, a paper ballot is printed and turned in.

The votes are recorded on paper, which

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16  Fall 2016

Voters with impaired vision can use the textured buttons connected to the screen to navigate the ballot and record their votes.

PAPER BALLOT

Voters can use headsets to listen privately to ballot information and instructions.

They can respond verbally, by saying vote or continue, or use buttons or the touchscreen.

No matter the response, the ballot is recorded privately.

VOTE BY TOUCH

VOTE BY AUDIO

VOTE BY SCAN

Completed ballots also include a QR code, which is scanned so that the vote is recorded and can be counted electronically.

The completed ballot is printed on paper, which is placed into a ballot box. In the case of a recount or contested election, the paper ballot can be retrieved and counted, and it serves as the ballot of record.

The voter chooses a mode of communication — speaking or touching, or both. For visual voting, the fonts are large, and districts can choose to provide photos of candidates.

Only one race or referendum appears per screen.

is the ballot of record in the event of a recount.

Because that ballot is printed on regular paper, it represents a huge savings over traditional ballots, which average about $1 a page to produce.

Election officials never know how many voters will show up, so they must print many more of these custom ballots than they’ll probably need to ensure no voter is turned away. The leftovers are discarded after the election. With Prime III, any unused paper can just be tossed in another printer.

The entire process is private, regardless of a voter’s ability, and it is secure.

Since Prime III resides in the software, there is no reason for hacking since hacking would not change the paper ballot.

When people tell him how easy it is, Gilbert laughs. He is used to hearing people say, “I could’ve done that.” A job well done in human-centered computing sometimes does not come with a “wow” factor, he says.

“If we’ve done our jobs, it will look so easy that you will think you could have done it,” Gilbert says. And for students, that sometimes is not gratifying.

What is gratifying is changing the history of voting.

In a test at the Alabama Institute for the Deaf and Blind, one woman took her turn at the machine, then went through the line again and again. Gilbert was puzzled. Some of the other blind voters had struggled with the interface, which was still under development, but the woman did not report an issue.

“She just kept coming back, coming back, coming back,” Gilbert says.

“Finally, I asked her why, and she said, ‘This is the first time in my life I’ve ever been able to vote by myself.’”

Gilbert and his students had found the “wow” factor.

“That was very humbling. That wasn’t our original motivation; we were just trying to fix a problem,” Gilbert says. “And that was our first indication, ‘OK, this is bigger than we thought.’”

Florida – Election Ground Zero During the American Revolution, Thomas Paine said the right to vote is the right that protects all other rights.

In those days, voters lined up behind the candidate of choice or cast voice votes. Today, more than 3,000 counties run elections in more than 180,000 precincts.

For Gilbert’s team, which moved with him from Clemson to UF in 2014, Florida is the place to be. Election woes did not end in 2000. On Election Day 2012, an estimated 200,000 Floridians waiting at polling places gave up in frustration and went home without casting a ballot. In the 2006 mid-term elections, in Sarasota County, there was a delayed decision in the District 13 congressional race when it was discovered 15 percent of the voters had failed to vote for either candidate (a 2 percent undervote was typical in other races). That race was decided by just 369 votes.

The faculty and students Gilbert brought with him when he assumed the Andrew Banks Family Preeminence Endowed Chair in the Department of Computer & Information Science & Engineering had no qualms about diving into Florida’s election issues.

“We loved it. Florida is like a coming-home party for us. We’re at ground zero,” Gilbert says. “This is THE place for our voting work, and we’re excited about it.”

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UF political science Associate Professor Michael McDonald, another preeminence hire, says Prime III is the most advanced of the new voting technologies in development today.

“This is a big step, considering that one of the issues identified by the Florida fiasco in 2000 was the voting technology itself,” McDonald says. “The machines failed us in some fundamental ways.”

The voting machines purchased after 2000 to solve the technology issue are now showing their age. McDonald calls them legacy machines and says he knows of jurisdictions scouring eBay to find them when a voting population grows or other machines break down.

Using tablets solves that problem, and at a lower cost.

Prime III has been tested in real elections, including the 2014 midterm elections in Wisconsin and the 2016 primary in New Hampshire, which adopted Prime III for statewide use and plans to use Prime III again in November.

“We think one4all, powered by Prime III, was a huge hit with our election officials and our disability community,” says Thomas Manning, New Hampshire assistant secretary of state.

The research for Prime III has been funded by a $93,056 grant from the National Science Foundation and $4.5 million from the U.S. Election Assistance Commission.

18 Fall 2016

Gilbert released the Prime III code as open source in 2015 to keep it free of politics.

“When I started out with Prime III people asked me, ‘Who created this?’ and I said, ‘I did.’ Then they’d ask, ‘Who owns it,’ and I said, ‘I do.’ Their next question was, ‘How do you vote; are you a Democrat or a Republican?’

Because I owned it, they wanted to know my political leanings.

“In this domain, who owns the technology matters, because people will draw conclusions, politically speaking.”

Prime III has never been about ideology, Gilbert says. How a person votes does not matter to him. What matters is that their vote be counted.

Gilbert says his dream is for all 50 states to use Prime III and pay a fee to a research consortium, so that he and his students can keep it up to date, ready for the challenges of future elections.

Although he started out to fix the machinery of democracy, literally, Gilbert and his team may end up fixing much more.

“If you can’t vote, how is that different from not having the right to vote?”

Gilbert asks. “So there is a social justice aspect in making voting accessible for everyone. This is about more than widgets and gadgets and computer science. We have changed voting in the United States forever.”

Juan Gilbert Professor of Computer & Information Science & Engineering juan@ufl.edu Related website: www.PrimeVotingSystem.org

1787

1700s 1776: Only landowners can vote 1787: U.S. Constitution adopted without

national standards for voting, leaving

voting rights up to the states.

1789: George Washington elected; only

6 percent of U.S. population can vote.

1872

1800s 1828: Maryland is the last state to remove

religious restrictions for voting, allowing

Jewish men to vote.

1848: Women’s rights convention in Seneca

Falls calls for voting rights for women.

1856: North Carolina removes property

ownership requirements for voting,

giving all white men the right to vote.

1866: The Civil Rights Act of 1866 grants

citizenship, but not the right to vote, to

all native-born Americans.

1870: Congress ratifies the 15th Amendment

to the U.S. Constitution, giving African

American men the right to vote.

1872: Susan B. Anthony is arrested for

trying to vote in New York in the presi-

dential election, and Sojourner Truth,

a former slave, is turned away when

trying to vote in Michigan.

1890: Wyoming gains statehood and becomes

first state to put voting rights for women

in its constitution.

TIMELINE OF VOTING RIGHTS IN THE UNITED STATES

1966

1912-1913

1900s 1912 -1913: Suffragettes lead marches in

New York and Washington, D.C. 1920: The 19th Amendment to the U.S. Con-

stitution gives women the right to vote.

1943: The Chinese Exclusion Act is repealed,

giving Chinese immigrants the right to

citizenship and to vote.

1947: Remaining legal barriers that prevent

Native Americans from voting are removed.

1961: The citizens of Washington, D.C., gain

the right to vote for president.

1963 -1964: Voter registration movements

sweep through the South to register

African American voters.

1965: Voting Rights Act passes, ending legal

barriers to voting based on race or ethnicity.

1966: Activist James Meredith is shot during

a voter registration march from

Tennessee to Mississippi. The next

day, nearly 4,000 African Americans

register to vote.

1971: The voting age is lowered to 18 in

response to Vietnam War protesters

demanding voting rights for those who

are old enough to go to war.

1975: The Voting Rights Act is amended to

provide voting materials in languages

other than English.

1990: The Americans with Disabilities Act

requires polling sites to provide

services to allow people with disabili ties to vote.

1993: The National Voter Registration Act

is passed to increase the number of

eligible voters by making registration

available at the Department of Motor

Vehicles and other public venues.

2000

2000s 2000: Issues with ballots in Florida force a

recount in the presidential election,

sparking distrust of the voting system.

2002: The Help American Vote Act is passed

after the disputed 2000 presidential

election, requiring measures to protect the

vote, such as provisional ballots, and funding

to help states modernize outdated voting equipment.

2006: Despite a reform of voting systems

used in 2000, extreme undervotes result

in a delayed decision in the mid-term

elections in Sarasota County.

2008: Issues using optical character readers in

Minnesota result in an election decided

by 312 votes out of 2.4 million cast,

resulting in $11 million spent post election on attorneys and other fees.

2013: U.S. Supreme Court strikes down

Section 4 of the Voting Rights Act in

Shelby County v. Holder.

2014: In response to Shelby County v. Holder,

several states pass laws limiting voting rights.

1965

2015: Prime III released as open source.

2016

2016: Prime III is used in New Hampshire prima-

ries, providing access to voting for citizens

with disabilities.

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✯ ✯

✯

MICHAEL MCDONALD MAKES BIG DATA COUNT FOR DEMOCRACY

By Cindy Spence

W

hen you walk into your voting booth, chances are you think you are choosing the politicians who will represent you.

Actually, says University of Florida political scientist Michael McDonald, the politicians already have chosen you.

The shapes of voting districts — from school board to U.S. Senate — dictate much of an election before voters ever show up to cast ballots, says McDonald, who has studied the science of these political shapes from his earliest days in political science. McDonald says the way we draw these political districts affects the very health of our democracy.

The process is seemingly so simple: draw lines to sort voters into evenly populated districts. And yet it is maddeningly complex: do the voting boundaries respect geographic borders, for example, by keeping next-door neighbors in the same district? Do the boundaries allow all populations a reasonable chance at electing a representative? Are they fair?

Letting a computer handle the job seems like a reasonable solution, drawing perfectly apportioned squares and rectangles, but that would not be fair or sensible either. Those lines could go down the middle of a house, for example.

It is this complexity that has kept redistricting in the hands of incumbent politicians in the proverbial smoke-filled rooms for so long. By controlling their districts, politicians control voters, and they rely on voters’ disinterest in the tedious process, hours on end of drawing and erasing lines. After all, who wants to dive into this murky process?

As it turns out, McDonald did, and as a self-professed elections geek, he has come up with a way to draw districts that is transparent, easy to use, computerized and … fun.

At redistricting competitions across the United States, college students, regular citizens and even a 10-year-old have tackled districtbuilder.org, developed by McDonald and Micah Altman, a colleague at the Massachusetts Institute of 20 Fall 2016

In 1812, Massachusetts Gov. Elbridge Gerry signed a bill that created tortuous voting district boundaries, including one that looked like a salamander, giving rise to the term “gerrymandering.”

Technology. Student plans have even been used as a foundation for some districts, such as in Virginia, where a district was created that increased minority representation in Congress.

“That was something that had never happened before, students coming up with a very complex map, and it was actually legal,” McDonald says. “The student maps were more fair than the politician-created maps.”

It’s enough to make Elbridge Gerry turn over in his grave.

Gerrymandering, the practice of drawing districts to favor one party or the other, gets its name from the Massachusetts governor who, in 1812, presided over a district so convoluted that an opposition newspaper compared it to a salamander, hence the gerrymander. Can software cure the gerrymander?

McDonald hopes so.

✯

✯

John Jernigan

✯ ✯ “I work with Democrats, and I work with Republicans, but I don’t like gerrymandering,” McDonald says. “I don’t care who’s doing it.”

McDonald has watched the software at work across the U.S. Everywhere, citizens embraced districtbuilder. org, drawing lines according to their local rules and engaging in the political process. In Minneapolis, the first Somali and the first Latino were elected to the City Council, using publicly drawn districts that impressed the council enough to adopt them.

“We’ve gone well beyond whether it is possible for the public to draw maps to the ideal of collaborative mapping and representational gains for underrepresented communities,” McDonald says.

“We can do that in every state.”

✯ THE HYBRID ✯ McDonald moves freely between the worlds of computer science and social science, an unusual hybrid. He started out as an electrical engineering and computer science major at Caltech then switched to economics when he became interested in applying math to human behavior. Upon graduation in 1989, he worked on California reapportionment and for a campaign that was using software to microtarget voting districts.

McDonald views political science through a technological lens that helps him parse mountains of data.

The program was clunky.

“I was the only person on the ground who could use that software,” McDonald says.

In the next election cycle, McDonald offered to produce something better, and they told him to go for it.

“In a month, I wrote a program for microtargeting that the party adopted for 14 races,” McDonald says. “They won 13.”

The marriage of technology with political science suited him, and in his dissertation at the University of California San Diego, he tackled an age-old problem — can computers solve the challenges of redistricting — then went on to Harvard for a post-doctoral fellowship, where he met Altman. They began collaborating on redistricting software and presented an early version in 2007 at an American Mathematical

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✯ “That’s the point of

McDonald’s DistrictBuilder software is easy to use and open to anyone.

College students have used it at redistricting competitions across the nation, and a 10-year-old even used it in one competition. The goal is to demystify the process and invite citizens to engage in redistricting.

Association meeting, not a typical conference for political scientists. An officer from the Alfred P. Sloan Foundation was in the audience. He liked McDonald’s approach of using software but having people at the controls and contributed $1.5 million to develop the software and data.

McDonald and Altman worked to make districtbuilder.org even easier to use, with clues for users on whether the districts they were drawing were meeting the constitutional requirements of the state they were in. They added social media functions and collaborative functions, so users could share maps or even single districts. The whole system operated through a web browser, eliminating the need for special equipment.

By 2011, Virginia was in the midst of redistricting and districtbuilder.org had reached a turning point, highly developed, well-studied but not tested by the public. To accomplish that test run, McDonald decided to “crowdsource” redistricting. There had been

22 Fall 2016

redistricting competitions using old data or phony data. Why not try it for real?

“It was the first time ever there was a redistricting competition using real data in real time,” McDonald says.

The competitions were a hit — one even included a 10-year-old who won second place — and McDonald got valuable feedback on the software, which is open source, allowing anyone with the right skillset to use it, adapt it to their needs, and add to it. McDonald says a government official in Vermont called him out of the blue one day to ask a technical question, and McDonald told him he and Altman had not built that feature yet. No problem, the guy said, he’d do it.

“That’s the point of open source — having a community of people developing tools and making it better for everybody. The other thing about open source is everyone can evaluate what the code is doing. If they don’t think something is fair, they can evaluate it for themselves. It’s transparent.”

open source — having a community of people developing tools and making it better for everybody. The other thing about open source is everyone can evaluate what the code is doing. If they don’t think something is fair, they can evaluate it for themselves. It’s transparent.” ✯ — Michael McDonald

Florida has had its own journey through redistricting. In December 2015, the Florida Supreme Court approved a congressional district map after four exhausting years of bickering over how to sort voters into 27 districts.

There’s a chance, McDonald says, that one of his students, using districtbuilder.org, could have done it in days, or even hours.

For politicians, however, a transparent, open process that engages the public could be disastrous. McDonald says politicians have little to lose from making the process labyrinthine and engaging in gerrymandering.

“It’s sad to say, but there’s no incentive for a legislature not to gerrymander and wait for the courts to overturn their plans. The longer the process takes, the more elections can be held under redistricting maps that favor the party in power,” McDonald says. “Who pays for it? The voters, the citizens, the taxpayers who fund that litigation.

“Redistricting has a role in the corrosive politics we see today. With each redistricting cycle there are fewer and fewer competitive districts because they are not in the interest of the politicians,” McDonald says. “We’ve hollowed out the middle.

“There are lots of other things going wrong in our democracy,” McDonald says. “But this is one we can get a handle on.”

TURNOUT BY ✯THE NUMBERS✯ Redistricting is not McDonald’s only election obsession. By challenging the conventional wisdom a decade or so ago that fewer voters were going to the polls, he also became the nation’s guru of voter turnout.

Voter engagement, as it turns out, was stable. What had changed was that the number of ineligible voters had grown. From 1972-98, the non-citizen population of the U.S. grew from 2 percent to 8.5 percent. When they were removed from the equations, voter turnout was stable over time.

A 2001 paper co-authored by McDonald and colleague Samuel Popkin, titled “The Myth of the Vanishing Voter,” is one of the mostcited articles in political science.

Debunking the myth took data, however, and McDonald says it was clear then that better data were needed, so he started the United States Elections Project, www.electproject.org. The site — which aims “to provide timely and accurate election statistics, electoral laws, research reports and other useful information regarding the United States electoral system” — contains an archive of voter turnout data, along with a wealth of other data and useful links.

McDonald’s skill crunching election numbers has made him a popular source for national media. In 2002 he

helped ABC News “kluge together a system, a kind of Frankenstein system, on the fly in under a week,” after the network’s exit polling software failed a pre-election night test. With the revamped system, “ABC was calling everything faster than anyone else” on election night, McDonald says.

“I’m a very good data rat as it turns out.”

On election night 2016, McDonald expects reporters will be hounding him with voice mails and texts right up until he tweets his numbers in the wee hours of the morning.

“And that’s the number you read on the front page of the newspaper or hear on the morning newscast,” he says.

In preparation for the 2020 round of redistricting in the wake of that census, McDonald is working with a group of students and others on national voter registration, to take data from all the states and share it with the Census Bureau. Although partisan companies already pull some of this data together,

McDonald says a centralized impartial database is needed for non-partisan applications, such as academic research.

The kind of database he wants to build would help the Census Bureau, too, by providing more accurate populationbased statistics.

Viewing the chaos of voting and elections through the prism of science and bringing order to it is one of McDonald’s goals in districtbuilder.org, the U.S. Elections Projects and a future UF Elections Science Research Center.

Ultimately, he says data and democracy go hand in hand.

“Big data itself can’t tell us everything we want to know, we have to be able to interpret it. And so the social science background is very important, otherwise this is just data, and valueless.”

Michael McDonald Associate Professor of Political Science michael.mcdonald@ufl.edu Related websites: http://www.electproject.org/ http://www.districtbuilder.org/

On his U.S. Elections Project website, McDonald tracks a variety of voting statistics in real time and makes the data available to the public.

This chart breaks down a week of data on early voting in North Carolina by party, race, age and gender.

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Duane Mitchell 24  Fall 2016

Neuro team mobilizes immune system against tumors stories by

Michelle Koidin Jaffee photos by

Mindy C. Miller

Battling Brain Cancer lias Sayour spent years working toward becoming a pediatric oncologist so he could help kids fight cancer.

He always imagined taking care of patients; he didn’t think research was really his thing.

But as a fellow in training, Sayour was struck — overwhelmed, really — by two aspects of his work: One was the toxicity of current treatments and the toll they took, with young children

suffering the effects of systemic chemotherapy and radiation on their developing brains and surgeries that invariably removed portions of brain tissue along with tumors.

The other was that the therapy itself would sometimes kill by causing an infection or other medical issue.

Sayour was not sure he could continue on this path.

“Seeing it day-in and day-out, seeing these children go through the aftereffects of treatment, was something I had a very hard time with,” says Sayour.

“Even when we cured these patients, it came at such a cost.”

When a colleague asked about his focus for the research portion of his fellowship, Sayour said he wished there were something like a cancer vaccine — unaware such a thing was in development right where he was, at Duke University. His colleague told him, “You have to meet this guy, Duane Mitchell.”

“I met Dr. Mitchell,” Sayour says, “and he just spoke a completely different language. He said exactly what I wanted to hear: ‘This is unacceptable, Explore 25

Catherine Flores’ research is focused on developing immunotherapy regimens for children with treatment-resistant brain cancers.

we need to do something about it, we need to attack cancer in a focused, targeted way that spares normal tissue.’”

Sayour went on to do his research under Mitchell, whose focus was on developing techniques to fight brain cancer using immunotherapy, or prompting a patient’s own immune system to target malignant tumor cells.

Now, Sayour has joined Mitchell in his burgeoning Brain Tumor Immunotherapy Program at the University of Florida. In just three years since Mitchell moved from Duke to UF, he has built a team that is attracting national attention.

This year, Mitchell and his team were recognized nationally for outstanding achievement in clinical research.

Glioblastoma is the deadliest brain cancer in adults, with an average survival time of 15 to 18 months. The research conducted at UF and Duke has shown that patients who received an enhanced cancer vaccine had a significant improvement in overall survival length. The resulting paper was named

26 Fall 2016

Elias Sayour is striving to formulate vaccines that can reprogram the immune system to combat cancer.

by the Clinical Research Forum as one of the top 10 papers in clinical and translational science in all of U.S. scientific literature in 2015.

That accomplishment was the culmination of years and years of work, Mitchell says — lab work, preclinical work, animal models, a first-in-human clinical trial and follow-up care.

“Thinking about the number of people who worked together and contributed to that achievement, it was so nice to have it recognized,” he says.

His team believes it is only a start.

Their program, which is part of the Preston A. Wells Jr. Center for Brain Tumor Therapy at UF (co-directed

by Mitchell and neurosurgery Chair William A. Friedman), is now launching a large, phase 2 first-in-human trial to confirm the benefits of the cancer vaccine. With funding from the National Cancer Institute for a five-year study, they will enroll 120 glioblastoma patients in the randomized trial.

Moreover, Mitchell’s program is known for its focus on pediatric cancer

as well as adult cancer. Mitchell is also leading an immunotherapy trial for children with recurrent medulloblastoma, the most common type of pediatric malignant brain tumor.

“When I look at immunotherapy groups across the country, I cannot think of a single one that has as much effort in pediatric brain tumor immunotherapy as this group,” Sayour says.

The team of five M.D.s and Ph.D.s in addition to Mitchell — Sayour, Maryam Rahman, Catherine Flores, Jianping Huang and Sridharan Gururangan — came together under — and because of — his leadership.

“As clinicians, we need to bridge the gap with scientists, and scientists need to bridge the gap with clinicians,” says Gururangan, director of pediatric neuro-oncology and the newest member of the team. Mitchell “nurtures the protocol right through and is prepared to go back to the lab and use whatever is happening in the lab to fine-tune the protocol. That is very important.”

Glioblastoma is the deadliest brain cancer in adults, with an average survival time of 15 to 18 months. The research being conducted at UF and Duke has shown that patients who received an enhanced cancer vaccine had a significant improvement in overall survival length.

23,770

# of malignant tumors &

16,050 #

1in 4

childhood diagnosed DIE OF BRAIN c a n c e r s 13,350 10,420 & s p in a l c o r d are brain & spinal cord t u m o r s tumors m a l e s females 9 , 4 4 0 6 , 6 1 0 second to m a l e s females leukemia of brain

spinal cord

of people predicted to

The American Cancer Society’s estimates for brain and spinal cord tumors in the United States for 2015 include both adults and children.

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“We work together to make sure that the things we’re advancing within the laboratory setting ultimately have a focus on how we are going to make a difference for patients.”

— Duane Mitchell

NIH

The interplay of dendritic cells (green) and T cells (pink) is key to cancer immunotherapy.

Each of the six scientists is leading specific projects to advance new treatments, under an integrated, coordinated effort involving more than 30 nurses, postdoctoral fellows, graduate students and administrative staff members.

There are three phases to their work: A preclinical research team evaluates new approaches before they’re ready to be tested; a development team works to move treatments out of the lab and navigates Food and Drug Administration requirements; and a clinical research team carries out the clinical trials. The teams span at least nine different departments or divisions in the UF College of Medicine and include 16 additional faculty members.

“We work together to make sure that the things we’re advancing within the laboratory setting ultimately have a focus on how we are going to make a difference for patients,” Mitchell says.

“One of the distinguishing characteristics of the program here — and a testament to the University of Florida’s capacity and support for the work — is that we are able to take treatments that are literally discovered in the laboratory setting and then bring them to clinical

28 Fall 2016

application and make them available for clinical trial evaluation in patients.

“That translational capacity means that patients seek out the University of Florida because the trials are unique in being offered for the first time to patients,” he says. “A center that supports that type of work takes a huge amount of intellectual resources, physical resources, infrastructural resources and financial resources to have an environment where you conduct those trials and do it safely.”

Doing this work has been a longheld dream for Mitchell, whose interest in cancer immunotherapy dates back to when he was an undergrad at Rutgers University. That’s when he first came to understand the concept of a physicianscientist, one who treats as well as develops new treatments, and he was enthralled by the book “The Transformed Cell: Unlocking the Mysteries of Cancer,” by immunotherapy pioneer Steven A. Rosenberg.

Immunotherapy “made a lot of sense to me,” Mitchell says. “The lesson I remember from it is, the immune system should recognize tumors as foreign, and if it did that appropriately, it would reject those cancers and

have the ability to remember what it’s rejected, so if it ever comes back, attack it again. That was so different than any other modality for treating a disease I had heard about.”

From then on, Mitchell strove to assemble a personal roadmap toward what he now calls “translational neuro-oncology” or “translational immunotherapy.”

“I had a picture of what an institution needs to have in place as a vision to really make a significant impact in this field,” Mitchell says. “There has to be an institutional vision and a commitment not just from the scientists, not just the physicians, but the medical school, the hospital and the cancer center. The institution needs to be committed to being a leader and making a difference in this area to be successful.

“When I came to visit UF, I saw that those elements were here — all the requisite infrastructure was here to do that, and the commitment and institutional vision to make UF a leader was also here,” he says.

Among those he’s recruited in this effort is Huang, who worked under Rosenberg at the National Cancer

Elias Sayour, Catherine Flores, Postdoctoral Associate Kate Candelario and Duane Mitchell in their lab at the McKnight Brain Institute.

Institute for seven years and got to witness complete remissions in patients with metastatic melanoma. “That really inspired me to work hard on the project,” says Huang, now director of clinical laboratory operations for the UF Brain Tumor Immunotherapy Program, also known as BTIP. Huang felt drawn to working on brain tumors because survival is so short, she says. With brain tumor, compared with melanoma, immunotherapy is in the early stages. “It’s really a new field, and we can do a lot of things,” she says. “In my heart I think

we will do something. I have that hope and confidence that someday we will make a huge difference.”

It can’t come too soon.

Flores, principal investigator of BTIP’s hematopoietic stem cell engineering laboratory, says far too often she has written the following words on a grant application: “Median survival is about a year.”

“It’s very dim,” Flores says. “The standard of care for brain tumors for pediatrics and adults does very little.”

Nonetheless, she feels a great sense of hope for the future.

“I feel like at the rate Dr. Mitchell puts things in clinic, I think we’re definitely getting there,” she says.

“Hopefully, with the years to come and with funding and donors and more support, we will be able to overcome the dire need.”

Duane Mitchell Professor of Neurosurgery Duane.Mitchell@neurosurgery.ufl.edu Related website: http://neurosurgery.ufl.edu/research/laboratories/ UFBTIP-lab/

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Overcoming Barriers It was a serendipitous finding. In a follow-up clinic for brain cancer patients who had undergone a procedure known as laser ablation — in which a minimally invasive probe is used to heat and kill a tumor — Dr. David Tran and colleagues repeatedly noted a “new ring of enhancement” around the tumor appearing on MRI soon after the procedure.

To Tran, now chief of neuro-oncology in the UF College of Medicine, and colleagues at Washington University School of Medicine in St. Louis, the “enhancement” could only mean one thing: Contrast material given to patients for the purposes of MRI scanning was leaking into the brain tissue surrounding the tumor. And that, they postulated, could only happen if there was disruption of the blood-brain barrier.

The exciting, unexpected finding suddenly lent hope in the fight against glioblastoma, the most common and deadliest brain cancer in adults. If the blood-brain barrier, a natural barrier of tightly packed cells lining the wall of blood vessels inside the brain that serves to block out toxins, bacteria and viruses, could be disrupted, there could be a window of opportunity to deliver chemotherapy drugs that are normally rejected by the barrier.

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Before

laser ablation

After

laser ablation

New ring of disrupted blood-brain barrier

A second observation by the team was equally if not more important.

If the disruption of the barrier lasted only a few hours, it would not be all that significant. But the permeability appeared to last four to six weeks, enough time for impermeable chemotherapy drugs to become effective against the highly aggressive glioblastoma by gaining access to the tumor.

“We reason that if we can disrupt the barrier within that space — one inch around the tumor — to allow chemotherapy to get in during that time window, we’ll be able to kill those infiltrating microscopic cancer cells that the neurosurgeon could not remove and thus prevent them from coming back,”

Tran says. “That is a significant part of the discovery.”

The research, published in February in the journal PLOS One, was carried out at Washington University by a team led by Tran, neurosurgery Professor Dr. Eric C. Leuthardt and Dr. Joshua Shimony, associate professor of neuroradiology. The paper has generated so much interest the team was invited to do a live AMA (Ask Me Anything) on Reddit’s science page.

Now, the team is pushing ahead with two ongoing clinical trials being run at UF and Washington University. Early results suggest that a greater number of patients who receive the chemotherapy drug doxorubicin (which has limited

“We reason that if we can disrupt the barrier within that space — one inch around the tumor — to allow chemotherapy to get in during that time window, we’ll be able to kill those infiltrating microscopic cancer cells that the neurosurgeon could not remove and thus prevent them from coming back.”

— David Tran

permeability to the blood-brain barrier) while the barrier is disrupted appear to survive longer before a tumor comes back than those who receive it after the barrier has resealed. While further data is needed to confirm the preliminary findings in the trial of 40 patients, data thus far is encouraging, Tran says.

In a second ongoing trial, the team is using laser ablation to improve immunotherapy, a treatment that stimulates a patient’s own immune system to attack cancer cells. Typically, a patient’s immune system will kick in following

laser ablation and “clean up” the dead tissues, creating inflammation and an environment akin to that resulting from a vaccine, Tran says. The team will use ablation to activate the immune system first and then give a drug that prevents the cancer from “turning it off,” he says.

The result, Tran hopes, is a therapeutic synergy that will help keep the disease from coming back.

The research is being funded by the National Institutes of Health, the Foundation for Barnes-Jewish Hospital’s Cancer Frontier Fund, the Alvin

J. Siteman Cancer Center in St. Louis and Merck.

Results from the trials are expected within a couple of years; if prolonged survival is confirmed, larger definitive trials would be needed.

“I think we’re making inroads,” Tran says. “We’re prolonging patients’ lives incrementally, but any amount of survival advantage is welcome in this field when there are very few options.”

David Tran Professor of Neuro-Oncology David.Tran@neurosurgery.ufl.edu

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Making Sense of Smell hink of the smell of a rain shower. Of freshly baked apple pie. Of a baby.

We may not stop to ponder our sense of smell and how it connects us to experiences and memories. Unless, that is, we have lost it. Or never had it at all.

At the University of Florida Center for Smell and Taste, researchers are working to discover therapeutic treatments for the inability to smell.

In the lab of Jeffrey Martens, researchers have uncovered how to build a sense of smell in mice with congenital anosmia, or lack of sense of smell since birth. They have done this by pioneering an approach to growing cilia that are missing on neurons in the nasal cavity.

Their findings have been met with excitement: The new cilia can detect odors, thereby instilling a sense of smell where there had been none. The team has accomplished this by using gene therapy — artificially engineering a virus to a carry a gene for a mutated or missing one. The virus, injected into the nose, prompts neurons to start making proteins and regrow their cilia.

32 Fall 2016

“We’ve shown we can restore the ability to detect odor,” says Martens, chair of the UF Department of Pharmacology and Therapeutics.

Currently, there is no therapeutic treatment for lack of ability to smell, which afflicts an estimated 6.3 million Americans. Some were born without a sense of smell while others lost it due to causes such as head injury, neurodegenerative disease or inhalation of environmental toxins.

The Martens Lab, which moved to UF three years ago from the University of Michigan, is working to address the lack of available treatments. The lab is striving to develop a gene-therapeutic approach for the first curative therapy for smell loss in humans. Funded by the National Institutes of Health, the lab’s current studies are focused on refining delivery of the virus and understanding which genes can be restored.

The sense of smell significantly contributes to our understanding of our environment. Lack of it can be a safety issue — imagine not being able to smell smoke or spoiled food. Lack of it can also interfere with the desire to eat, as taste perception is greatly driven by the olfactory cue.

Olfactory neurons being activated through gene therapy.

What’s more, smell is key in social interactions: between partners, between mom and baby.

“Imagine how many of your social interactions involve food or drink,” says Steven Munger, director of the Center for Smell and Taste, part of the McKnight Brain Institute. “If you lose that, all of a sudden you’re disconnected from others.”

Many of those disconnected by their impaired sense of smell and taste will be gathering in Gainesville on Feb. 25-26 for SmellTaste2017, a first-ofits-kind conference co-hosted by the center and the U.K.-based charity Fifth Sense. The conference will spotlight new research findings, offer workshops and social events to build community,

Postdoctoral Associate Cedric Uytingco and fellow researchers in the UF Center for Smell and Taste are working to change the lack of available treatments for anosmia, or impairment of the sense of smell.

inform about strategies for dealing with smell/taste impairments and help connect patients, clinicians and chemosensory scientists working to advance research.

Duncan Boak, founder of Fifth Sense, lost his sense of smell from a head injury in 2005, when he was 22.

His doctor told him nothing could bring it back.

“It was a life-changing experience,” Boak says. “Think about being in a forest, a garden, a museum with old books. Take smell away and the whole experience becomes sterile.”

Over the years, Boak found support was scarce. He launched Fifth Sense with the goal of building a network of patients, researchers and clinicians and raising money for research.

“I realized there was a huge unmet need,” Boak says. “The way things have

gone over the past four years, the speed and interest demonstrates that I was right.”

He says Fifth Sense now is approaching 2,500 members, mostly in the UK. Boak says he drew inspiration from the book “Season to Taste: How I Lost My Sense of Smell and Found My Way,” by Molly Birnbaum, whose dream of becoming a chef suddenly fell apart when she was hit by a car while jogging and lost the ability to smell. She instead became a writer, sharing what she’s learned about the science and psychology of smell. Now executive editor of Cook’s Science at America’s Test Kitchen, Birnbaum will be a featured speaker at the conference.

Monique Selman of Miami plans to attend. The 48-year-old mother of two, who works in real-estate development

and construction, was born without a sense of smell.

“We know so little about anosmia,” Selman says. “Is there any chance I could ever get a sense of smell? Is there anything I can do?”

Asked what she would smell first, if given the chance, Selman pauses, a swell of emotion caught in her throat.

“People,” she replies. “My husband and my kids.”

Jeffrey Martens Professor and Chair of Pharmacology and Therapeutics martensj@ufl.edu Steven Munger Professor of Pharmacology and Therapeutics and director of the UF Center for Smell and Taste steven.munger@ufl.edu Related website: http://cst.ufl.edu/

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Addressing Addiction ow does drinking alcohol affect the developing brains of adolescents?

What is the impact of social, familial and biological factors on brain development during the pre-teen and teen years? Amid this period of great intellectual and emotional growth, how do culture and environment influence neurodevelopment and long-term outcomes?

University of Florida researchers are setting out to tackle these questions and more as part of a landmark National Institutes of Health study called ABCD — the Adolescent Brain Cognitive Development study. UF is one of 19 sites across the country that will follow some 10,000 children from ages 9-10 for 10 years, using advanced neuroimaging to examine brain structure and function, looking at academic achievement, cognitive skills and mental health and tracking use of alcohol, marijuana and other drugs.

With the $3.76 million NIH grant, UF is in the early phases of what will be the largest long-term U.S. study of brain development and child health.

UF will recruit about 400 children

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over the next two years, while partner site University of Michigan will recruit another 575.

“This study is going to be the first of its kind,” says psychiatry Professor Sara Jo Nixon, co-director of the UF Center for Addiction Research and Education, which is part of the Evelyn F. and William L. McKnight Brain Institute. Nixon will serve as co-principal investigator with Linda B. Cottler, founding chair of the Department of Epidemiology.

“It will provide an amazing opportunity to examine brain development and developmental trajectories from adolescence to early adulthood,” Nixon says.

The study is among a broad range of investigations being pursued by the Center for Addiction Research and Education, whose faculty has grown from 10 members in 2006 to 28 today.

That surge reflects a new era for the field of addiction medicine, which recently acquired recognition as a dedicated medical specialty.

Investigations span the UF campus, involving multiple colleges and departments, and focus on diverse topics from how college drinking affects stimulant use to how cocaine affects dopamine levels.

Jane Aldrich, a professor of medicinal chemistry, says the center is one of the things that drew her to UF from the University of Kansas. A leading researcher in opiates, Aldrich was attracted to the potential synergy of interactions with faculty in pharmacology, physiology, pain management and related fields.

Aldrich’s lab predominantly makes new compounds, focusing on those that act at opiate receptors, with the goals of both treating addiction and treating

47,055 18,893

LETHAL DRUG OVERDOSES

OVERDOSES

R EL AT ED TO

prescription

pain relievers

“It will provide an amazing opportunity to examine brain development and developmental trajectories from adolescence to early adulthood.”

— Sara Jo Nixon ABCD — Adolescent Brain Cognitive Development Study

Study coordinator Sarah Reaves demonstrates how game-like tasks would be used in the ABCD study.

pain with less potential for abuse and other serious side effects compared with current drugs.

High-profile deaths like that of Prince have put the issue of opioid misuse and abuse in the national spotlight, and even as treatment options expand, the need continues to grow.

250 MILLION

OPIOID

PRESCRIPTIONS WRITTEN IN U.S.

168,000

ADOLESCENTS ADD I CTED TO PRESCRIPTION PAIN RELIEVERS American Society of Addiction Medicine, 2014.

An analysis of health-care claims for treatment of opioid dependence showed a 3,000 percent increase from 2007 to 2014, according to UF psychologist Lisa J. Merlo and psychiatrist William Greene.

The current focus in Aldrich’s lab is how to prevent stress-induced relapse to drug use.

“If you ever knew someone who smoked and quit, and then something stressful happens in life — they lose a job, break up with a girlfriend, what happens? They go back to smoking in many cases,” Aldrich says. “The same happens for other addictive substances as well.”

Her lab is testing compounds that block “kappa” receptors in the brain — receptors that cause dysphoria, or a state of unease and dissatisfaction.

“There is a lot of evidence that activation of these kappa receptors may be involved in a number of stress responses, so if you can block that activation, you would block this miserable feeling and drug-seeking behavior,” Aldrich says.

At UF, ongoing addiction studies stretch from the chemistry lab to human clinical trials (such as a soon-tolaunch phase 2 trial for a novel medication for smoking cessation), from the effects of “bath salt” drugs to apps that could help people monitor their own drinking.

Genetics are a key focus as well.

Just as certain cardiovascular medications work in some and not in others, researchers are beginning to understand there are genotypes in other systems that may make someone more or less responsive to particular drugs.

“There is no one-size-fits-all,” Nixon says.

Jane Aldrich Professor of Medicinal Chemistry jaldrich@cop.ufl.edu Sara Jo Nixon Professor of Psychiatry sjnixon@ufl.edu Related websites: http://addictionresearch.health.ufl.edu/ http://abcdstudy.org/

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s e c e i P d o i r e P B y Cindy Spence

36  Fall 2016

life f o e sliocrida a ferry Fl f o belhscentu a l atey 20t r c rl us Citr in ea

F

lorida’s history is colorful, but perhaps no piece of its past is as colorful as its citrus crate labels.

The nostalgic images are an invitation to stroll down memory lane, one lined with orderly rows of citrus trees. The labels began as a simple marketing tool pasted onto wooden crates to identify the harvest of one grove from another. As rail travel opened national commerce after the Civil War, more and more Florida citrus was shipped to northern auction houses. The images grew in whimsy and artistry as groves and packing houses competed for a share of the northern market. Color was code for fruit quality, with a blue background and names like Blue Heron signaling grade A fruit, red for grade B, and yellow or green for boxes of mixed grades.

Today, the labels are a beloved historical art form, as well as an obsession for many collectors, like citrus baron Jerry Chicone Jr., who donated almost 4,000 labels to the University of Florida Libraries to create the Jerry Chicone Jr. Florida Citrus Label Collection.

The artists are mostly unknown, the lithographers who hired them now mostly out of business. In lithography, the image was first etched in stone or sometimes metal, which was then inked and used as a printing plate. James Cusick, curator of the P.K. Yonge Library of Florida History and caretaker of the collection, says the ink the lithographers used must have been good for the cheap paper labels to have stood the test of time, particularly in Florida’s heat and humidity.

The library has digitized all the labels and is now in the process of conserving them, carefully cleaning, repairing and then sealing them, so they can be viewed without being damaged.

Chicone grew up in Florida citrus and remembers hanging around packinghouses while he was in grammar school and watching workers glue labels onto crates of citrus grown in his family’s groves. Even as a child, the colorful images enchanted him.

Chicone says he started collecting the labels in 1976, when he heard a news report about the importance of collecting paper history because the paper past was disappearing. The heyday of the labels spanned the first half of the 20th century, and they began to disappear in the decades after World War II as cardboard boxes replaced the wooden crates. He estimates about 5,000 might have been in circulation, some simply lost to time.

Florida Grower Press in Tampa was one of the largest label printers, and Chicone discovered a vendor who sold the labels in the Ybor Square antiques mart. He and his wife, Sue, would travel to Tampa once a month on a Sunday to Ybor Square, with a budget of $50.

In 2014, the Florida citrus hall-of-famer drove from his Winter Garden home to Gainesville and wheeled his collection into UF’s Smathers Libraries, overnight creating one of the largest university-based citrus label collections.

“They took it all, and I’m happy they did,” says Chicone, a 1956 UF graduate, now 82 and still a force in Florida’s $9 billion a year citrus industry. “One of the best things I’ve ever done is donate that collection to the University of Florida.”

Scholars, historians and art students couldn’t agree more. A collection that had been stored in 21 archival scrapbooks in Chicone’s home is now open to physical inspection on campus and virtual inspection worldwide, via a website.

Art students have studied it as commercial art and examples of lithography.

Scholars and historians can use it to trace the geography of Florida’s citrus industry and track Americana with visual images.

The collection also provides a cornerstone for other citrus-related pieces in the Florida history collection, Cusick says.

“It’s one of the more fun elements in our collection,” Cusick says.

Chicone says he was not sorry to give up his collection because he knew the labels were going to a good home, where scholars and students can study them and people who share his appreciation of the nostalgic art and Florida’s past can enjoy them.

Besides, he says, “The great pleasure was in the hunt.”

James Cusick Curator of the P.K. Yonge Library of Florida History jamcusi@uflib.ufl.edu Related Website http://ufdc.ufl.edu/citruslabel

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Citrus labels often paid homage to the regions where the citrus was grown. Lake County, home to the Mount Dora Citrus Growers Association, was a hotspot for citrus. Farther south, a Tampa label used the city’s Gasparilla Festival, which started in 1904, and was named after the mythical pirate Jose Gaspar. In Marion County, Silver Springs was a popular tourist destination of the early and mid-20th century, making it an easily recognizable image for a label. In busy northern auction houses, an eye-catching label was an effective tool for selling citrus.

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Artists often used images of women for citrus label art, particularly the bathing beauty, a common stereotype of the time.

The “Flo” label was used in the 1930s, ‘40s and ‘50s, and her hairstyle changed over time. The swimsuit transitioned from a one-piece to this twopiece suit in the 1950s.

The risqué Nudist label was featured in Esquire magazine.

Florida’s heritage was often the inspiration for label art. Florida Cowboy and Florida Cracker both draw on Florida’s history of cattle ranching.

Some labels that depicted Native Americans were accurate although many depicted Indians of the western U.S. Depictions of African Americans often were stereotypical.

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Dogs were particularly popular as label models, and most are thought to be family pets.

A number of Florida cities were home to spring training for northern baseball teams.

Winter Haven was one such location, giving rise to the Umpire label. Other sports and hobbies, like football and hunting, also were common themes, and current events, such as World Wars I and II, inspired labels like Yankee Boy.

Information from “Florida Citrus Crate Labels,” by Jerry Chicone Jr. and Brenda Eubanks Burnette, and “Classic Crates From Florida,” by the Florida Citrus Showcase, was used in this report.

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Labels often used children connected with packing houses or groves as models. Boy Brand, from Walter Packing Co., showed Jim Walter as a boy. Billy Boy depicted Bill Edwards, who grew up to become chairman of the Florida Citrus Commission.

Label artists often found inspiration in Florida’s rich fauna, including cranes, herons and flamingoes. Crane was a top brand in the 1920s. Blue beak, with “blue” in its name and its coloration, was a symbol of top-quality citrus.

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skills, social resources and personality variables.

Anxiety is particular to the resources an individual is able to bring forward to cope with distress. For people with adequate coping strategies — which may come in the form of family, friends, spiritual resources, financial resources, etc. — the effects of anxiety will likely be much more mitigating versus a person who has few coping resources.

NONSTOP BAD NEWS

KEEPING ANXIETY AT BAY

BY DAVID CHESIRE

R

ecent violence and tragedies, such as police shootings, terrorist attacks, wars, even politics, can create unexpected anxiety. As a psychologist who has spent a great deal of my professional career studying the effects of trauma and grief, I have some knowledge of how to help people deal with this stress.

When people in the mental health community talk about anxiety, they are generally referring to a condition where a person’s individual ability to cope with stress becomes overwhelmed, leaving them incapable of functioning effectively with life’s demands.

Where does this sense of anxiety come from? Is it more prevalent now, in the wake of so many tragedies before our eyes? Though the questions seem simple, the answers may be difficult to uncover.

GROWING TENSION Major events, such as a terrorist attack, domestic shootings or a natural disaster, can exceed our psychological resources and lead to mental health fallout in the form of post-traumatic stress. It is also common for anxiety to be more insidious, with daily stressors slowly mounting over time, gradually becoming so cumbersome and convoluted that no single episode can account for where the anxiety is originating.

Such is also the case with repeated violent events shown in the media; with tragedy after tragedy, cumulative stress builds up incrementally, eroding our sense of safety.

In each case, the individual experience of anxiety can range from mildly inconvenient to completely debilitating, based on a multitude of factors, including coping 42 Fall 2016

Certainly our world has changed with regard to the number of stressful situations to which we are exposed.

With a 24-hour news cycle and a public that is hungry for graphic and sensational stories, it is increasingly difficult to shelter ourselves from disturbing news and images.

After 9/11, for example, it simply was not possible to escape the onslaught of information about the terrible events.

For people who had little room left in their psychological resources to cope with hardship, 9/11 may very likely have placed them at risk for a fullblown anxiety attack.

The specific symptoms of anxiety vary from one person to the next, but the general pattern is a feeling of unease and worry, an inability to relax often accompanied by sleep disturbance, irritability and edginess. In more extreme examples of anxiety, panic attacks may result, characterized by feelings of racing heartbeat, shallow breathing, cold sweats and terror.

In a pivotal study, researchers identified three protective factors for people facing life adversity: individual factors, family factors and community factors.

Individual factors include such things as personality variables, such as cheerfulness and friendliness. Family factors included having a close bond with at least one caregiver, as well as emotionally healthy environments that provided emotional encouragement and independence. Community variables included things like supportive schools, churches and neighbors.

The research also found that even when youths are affected adversely by life events, most are able to right the proverbial ship by adulthood and live healthy, productive lives.

WEATHERING THE STORM What then can individuals do to ward off the ill effects associated with anxiety? There is no one-size-fits-all approach. Consider the following ideas to get started with developing a stressreduction plan: • Give yourself a break. It is actually okay to not be plugged in on the latest atrocity that has happened. If you find yourself reacting negatively to what you see on the news, give yourself permission to turn the television off.

• Plan ahead and keep things realistic.

So much of anxiety has to do with ambiguity and uncertainty. Alleviate this by developing a game plan. You might surprise yourself by being able to come up with creative solutions

IN A PIVOTAL STUDY, RESEARCHERS IDENTIFIED THREE PROTECTIVE FACTORS FOR PEOPLE FACING LIFE ADVERSITY: INDIVIDUAL FACTORS, FAMILY FACTORS AND COMMUNITY FACTORS.

DAVID CHESIRE

when everything is laid out in front of you. Remind yourself that the world is generally a safe and friendly place, and don’t isolate yourself from connecting with family, friends and loved ones.

• Stay connected to others. Negative feelings can foster isolation, and isolated people lose the protective factors associated with community. Reach out to others and accept their help if they are willing and able to provide it.

• Keep things simple. Remember, one step at a time. When things get too big and unwieldy, they become unmanageable and seemingly impossible. Any progress is good progress, and focus on your successes when you have them.

• Plan for something fun. Give yourself permission to feel good and enjoy the things in life that make life worth living.

• Consult an expert. There may be people out there who can guide you even if things seem out of control right now. This includes mental health professionals who can help you to build coping resources and learn to relax and let go of the burdens of anxiety.

Unfortunately for all of us in today’s modern world, there’s no shortage of reasons to feel stressed or anxious. But at least there are some simple steps, founded in research, to help us.

David Chesire Associate Professor of Psychology david.chesire@jax.ufl.edu

A version of this column originally appeared in The Conversation, an online service that provides a vehicle for academics to address issues of the day and share their research. To read more columns by UF faculty, visit http://theconversation.com/institution/universityof-florida Explore 43

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UF medical student Andrea Caplin Aguilera created zoomed in, neon-enhanced paintings of molecules common in the hospital setting — such as chemotherapy drugs, antibiotics, proteins, hormones and the lipids illustrated here — as part of UF Health’s Arts in Medicine program.

“During my time as a medical student at the University of Florida, I have seen first-hand how art can help patients cope with their illnesses,” Aguilera says. http://artsinmedicine.ufhealth.org/

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