Medical research in the news

News outlet logo for favicons/newswise.com.png

Wayne State-led team explores link between diabetes, obesity and liver disease

Diabetes, obesity and nonalcoholic fatty liver disease (NAFLD) are all common diseases that can lead to serious health implications. NAFLD affects over 30% of Americans, and is characterized as a fatty liver, which can progress to an inflammatory and fibrotic liver, called nonalcoholic steatohepatitis (NASH), as well as liver cirrhosis. The molecular causes of NAFLD and NASH are still not fully understood and, to date, no FDA-approved drug is available for NAFLD. A major hurdle for scientists is understanding the causal relationships between NAFLD, diabetes and obesity, which are often presented together in patients and treated as comorbidities. Without a clear understanding of their causal relationship and root cause, drug development may fail. Faculty from Wayne State University’s Eugene Applebaum College of Pharmacy and Health Sciences are leading a team of researchers to understand the causal relationships between these three diseases in hopes of developing a treatment.Wanqing Liu, associate professor of pharmaceutical sciences at Wayne State, along with his collaborators, recently published a paper in the Journal of Hepatology that attempts to understand the molecular causes of NAFLD. The team conducted a large-scale genomic analysis called Mendelian randomization, a strategy similar to a randomized clinical trial that relies on a naturally occurred randomization of genetic alleles in human populations.
News outlet logo for favicons/news-medical.net.png

Study explains why fetuses and newborns are mostly spared by COVID-19

Why are newborns born to mothers with COVID-19 rarely infected? Researchers at the Wayne State University School of Medicine and the Perinatology Research Branch of National Institute of Child Health and Human Development/National Institutes of Health in Detroit have found that placental cells minimally express the instructions, or mRNA, to generate the cell entry receptor and protease required by the virus that causes COVID-19 to invade human cells. The pandemic caused by SARS-CoV-2 has infected more than 10 million people worldwide, including pregnant women, yet to date there is no consistent evidence that pregnant mothers pass the virus to their newborns. “The findings of this study help to understand why mother-to-fetus transmission is so rare (less than 2% of cases),” said Roberto Romero, M.D., D.Med.Sci, chief of the PRB. “The most likely explanation is that the cellular instructions for the production of the main receptor for SARS-CoV-2 are not expressed in the human placenta. In contrast, the receptors for other viruses known to cause fetal infection such as Zika and cytomegalovirus were found in placental cells.” Roger Pique-Regi, Ph.D., assistant professor of the WSU Center for Molecular Medicine and Genetics, and of Obstetrics and Gynecology, first author of the study, explained that the single-cell genomics technology the researchers employed allows them to study the transcriptome of individual cells isolated in tiny oil droplets using microfluidics.  
News outlet logo for favicons/scienmag.com.png

Addressing the toxicity of cancer treatment costs

Lauren Hamel, Ph.D., assistant professor and member of the Population Studies and Disparities Research Program at Karmanos Cancer Institute and the Wayne State University School of Medicine, was awarded a Research Scholar Grant by the American Cancer Society. She will use the grant to test the effectiveness of a patient-focused intervention to improve patient-provider treatment cost discussions and other patient outcomes related to the financial consequences of cancer treatment. Hamel and her team responded to the growing problem of financial toxicity, or the severe material and psychological burden of the cost of cancer treatment. Financial toxicity affects an estimated 30% to 50% of patients with cancer, especially patients who are racial/ethnic minorities, have lower incomes or are under 65. However, well-timed and effective patient-oncologist treatment cost discussions could help.
News outlet logo for favicons/theconversation.com.png

Fireworks can torment veterans and survivors of gun violence with PTSD – here’s how to celebrate with respect for those who served

Arash Javanbakht, associate professor of psychiatry, wrote an article for The Conversation about celebrating the Fourth of July with respect to individuals with PTSD. “For some combat veterans, the Fourth of July is not a time to celebrate the independence of the country they love. Instead, the holiday is a terrifying ordeal. That’s because the noise of fireworks – loud, sudden, and reminiscent of war – rocks their nervous system. Daily fireworks in many U.S. cities in recent weeks have no doubt been interfering with the sleep and peace of mind of thousands of veterans. This reaction is not unique to veterans with post-traumatic stress disorder, or PTSD. Also affected are millions of others, including civilians, refugees, and first responders. As a psychiatrist who specializes in trauma and PTSD, I urge you not to overdo an act which causes so much suffering for so many of your fellow Americans.”
News outlet logo for favicons/theconversation.com.png

Why safely reopening high school sports is going to be a lot harder than opening college and pro ball

Tamara Hew-Butler, associate professor of exercise and sports science, and Phillip D. Levy, assistant vice president for translational science and clinical research innovation, wrote an article for The Conversation about reopening school and club sports amidst the pandemic. “Along with the revival of professional sports comes the yearning for a return to amateur sports – high school, college and club. Governing officials are now offering guidance as to when and how to resume play. However, lost in the current conversation is how schools and club sports with limited resources can safely reopen. As an exercise scientist who studies athlete health and an emergency medicine physician who leads Michigan’s COVID-19 mobile testing unit, we wish to empower athletes, coaches and parents by sharing information related to the risks of returning to play without COVID-19 testing. This includes blood tests to see if athletes have already had COVID-19 plus nasal swabs to test for the active SARS-CoV-2 virus. Regular COVID-19 testing on all athletes may seem like overkill, but the current tally of 150 collegiate athletes, mostly football players, who have tested positive for COVID-19 grows longer by the day.”
News outlet logo for favicons/theconversation.com.png

Are we all OCD now, with obsessive hand-washing and technology addiction?

David Rosenberg, professor of psychiatry and neuroscience, wrote an article for The Conversation. “One of the hallmarks of obsessive-compulsive disorder is contamination fears and excessive hand-washing. Years ago, a patient with severe OCD came to my office wearing gloves and a mask and refused to sit on any of the “contaminated” chairs. Now, these same behaviors are accepted and even encouraged to keep everyone healthy. This new normal in the face of a deadly pandemic has permeated our culture and will continue to influence it. Many stores now prominently post rules mandating face masks and hand sanitizer use and limit the number of customers allowed inside at one time. Walkers and joggers politely cross the street to avoid proximity to each other. Only a few months ago, this type of behavior would have been considered excessive, irrational, even pathological, and certainly not healthy. So, where do doctors draw the line between vigilance to avoid being infected with the coronavirus and obsessive-compulsive disorder that can be harmful? This is an important question that I, a psychiatrist, and my co-author, a wellness and parenting coach, often hear.”
News outlet logo for favicons/nytimes.com.png

Doctors heavily overprescribed antibiotics early in the pandemic

The desperately ill patients who deluged the emergency room at Detroit Medical Center in March and April exhibited the telltale symptoms of the coronavirus: high fevers and infection-riddled lungs that left them gasping for air. With few treatment options, doctors turned to a familiar intervention: broad-spectrum antibiotics, the shot-in-the-dark medications often used against bacterial infections that cannot be immediately identified. They knew antibiotics are not effective against viruses, but they were desperate, and they feared the patients could be vulnerable to life-threatening secondary bacterial infections as well. “During the peak surge, our antibiotic use was off the charts,” said Dr. Teena Chopra, the hospital’s director of epidemiology and antibiotic stewardship, who estimated that more than 80 percent of arriving patients were given antimicrobial drugs. “At one point, we were afraid we would run out.” Chopra and other doctors across the country who liberally dispensed antibiotics in the early weeks of the pandemic said they soon realized their mistake. “Many physicians were inappropriately giving antibiotics because, honestly, they had limited choices,” she said. Chopra estimated that up to a third of coronavirus patients who died at the hospital were killed by opportunistic pathogens like C. difficile, a pernicious infection that causes uncontrolled diarrhea and is increasingly resistant to antibiotics. That figure, she said, was quite likely heightened by the poor underlying health of patients who also had diabetes or hypertension or were obese. “Even before Covid hit, our population in Detroit was very vulnerable to drug-resistant infections,” said Chopra, a professor of infectious diseases at Wayne State University.
News outlet logo for favicons/dbusiness.com.png

Wayne State University publishes new findings of potentially deadly bacterial infection linked to COVID-19 in older patients

A doctor at Detroit’s Wayne State University School of Medicine has published new findings of a trend in older patients who are severely ill with COVID-19 and also test positive for Clostridioides difficile — a bacteria sometimes referred to C. diff or CDI. The CDI bacteria causes life-threatening diarrhea and is usually a side effect of taking antibiotics, according to the CDC. Wayne State’s observations offer the inaugural CDC journal report of CDI infections in COVID-19 patients. “This is the first report highlighting COVID-19 patients who presented with diarrhea and were found to have both C. diff and diarrhea as a co-infection,” says Dr. Teena Chopra, who is also a professor of infectious diseases at the WSU School of Medicine and corporate medical director of infection prevention hospital epidemiology and antibiotic stewardship at WSU and the Detroit Medical Center. “Most of these patients were very sick and had a higher mortality. COVID-19 can present as diarrhea, and a lot of these patients are getting unnecessary antibiotics. We always think of C. diff when we have patients who have diarrhea, and now we have to think of COVID-19 in these patients, too.”
News outlet logo for favicons/mlive.com.png

Three weeks into Michigan’s coronavirus crisis, the numbers are rising exponentially

It was three weeks ago today that Michiganders woke to the start of the state’s coronavirus crisis. Between Wednesday, March 25, and Tuesday, March 31, the number of completed coronavirus tests for Michigan residents increased from 9,109 to 25,711. Of those 25,711 completed coronavirus tests on Michigan residents, 6,150-- or 24% -- were positive, according to the Michigan Department of Health and Human and Services. It’s unclear how many tests are pending. Some Michigan residents have been pushing for public data on the number of people who have recovered for coronavirus. But it’s too soon to have those numbers, considering the timetable of the epidemic and the timetable of illness and recovery for individual patients, said Dr. Paul Kilgore, a public-health doctor and epidemiologist at Wayne State University. He said that coronavirus symptoms typically last from 10 to 14 days and many are still recuperating “for a couple of weeks afterwards,” he said. “If you’re in the intensive care unit, your recovery is going to be even longer.” Considering the first cases in Michigan were confirmed only three weeks ago, “it’s not all” surprising there is no public data on recoveries from coronavirus, Kilgore said.
News outlet logo for favicons/newswise.com.png

Wayne State team receives $1.98 million NIH award to develop diagnostic tests for sarcoidosis

Sarcoidosis is an inflammatory disease of unknown causes that affects multiple organs in the body. It occurs in patients around the world and is highly prevalent in Detroit and Michigan. It is characterized by abnormal masses or nodules – granuloma formations – in various organs, including lungs and lymph glands, brains and heart. Sarcoidosis has been described for more than 150 years, but there are no specific and simple tests developed to diagnose this disease. A team of researchers led by Lobelia Samavati, M.D., associate professor in the Center for Molecular Medicine and Genetics and Department of Internal Medicine at Wayne State University’s School of Medicine, has been working for more than 10 years to discover specific serological biomarkers of sarcoidosis and tuberculosis. With the help of a recent $1.98-million grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Samavati’s research team aims to advance their work of developing biomarker technology for identification of biomarkers of sarcoidosis. “We believe that our technology will be able to harness the diversity of antibodies and can aid to identify protective antibodies in various diseases in humans, including viral respiratory infections such as the corona virus,” said Samavati. “We believe that this study is the beginning of new era to identify protective immunity in form of antibodies.” Sorin Draghici, the Robert J. Sokol, M.D. Endowed Chair in Systems Biology in Reproduction and professor of computer science in Wayne State’s College of Engineering, is collaborating with Samavati. He contributed to the design of the study and will supervise the data analysis.
News outlet logo for favicons/time.com.png

A coronavirus guide for older adults (and their family advocates)

A late February study in the Journal of the American Medical Association showed that children 10 and under accounted for just 1% of all COVID-19 cases, for example, while adults in the 30-79 age groups represented a whopping 87%. The World Health Organization (WHO) found something similar in China, with 78% of patients falling between the ages of 30 and 69. “Older people are more likely to be infected, especially older people with underlying lung disease,” says Dr. Teena Chopra, medical director of infection prevention and hospital epidemiology at Wayne State University. “For this population, mortality rates for COVID-19 are about 15%.” In this sense, COVID-19 behaves a lot like seasonal flu. From 70% to 85% of all flu deaths and 50% to 70% of flu-related hospitalizations occur among people in the 65-plus age group, according to the United States Centers for Disease Control and Prevention (CDC). The 2002-2003 SARS outbreak similarly proved lethal for more than 50% of people over 60 who contracted the disease. “People living in long care facilities have common meetings, they share common rooms,” says Chopra. Common meetings and common rooms can too often mean common pathogens. The health system itself may be playing a significant role in putting seniors at risk. People with multiple medical conditions typically visit multiple specialists, and every such visit means entering a health care environment that can be teeming with viruses and bacteria. For now, Chopra advises older patients to postpone doctor visits that aren’t absolutely essential, like “their annual eye visit. Dental cleaning can be avoided too.” Telemedicine—conducting doctor visits that don’t require hands-on treatment online—can be helpful too, as can e-prescribing, with drugs being delivered straight to patients, sparing them exposure to pharmacies.
News outlet logo for favicons/news-medical.net.png

Wayne State researchers receive grant to develop new treatments for Barth syndrome

A team from Wayne State University, led by Miriam Greenberg, Ph.D., professor of biological sciences in the College of Liberal Arts and Sciences, recently received a grant from the National Heart, Lung, and Blood Institute of the National Institutes of Health to work on potential new targets for treating Barth syndrome (BTHS). The four-year, nearly $1.5 million award, aims to identify specific metabolites as candidates for new treatments for Barth syndrome and other cardiomyopathies. Barth syndrome is a rare and life-threatening, X-linked genetic disorder that primarily affects males and is passed from mother to son; women who are carriers do not show symptoms of the disorder. Fifty percent of children born to a mother who is a carrier will inherit the defective gene, and all daughters born to an affected man will be carriers. BTHS is caused by a mutation in the tafazzin gene that results in decreased production of cardiolipin, an essential lipid for energy metabolism. According to Greenberg, BTHS causes numerous pathologies, including cardiomyopathy, a disorder of the heart muscle; neutropenia, a reduction in the number of white blood cells; hypotonia, reduced muscle tone; undeveloped skeletal muscles and muscle weakness; delayed growth; decreased stamina; physical disability; and methylglutaconic aciduria, an increase in an organic acid that is characteristic of abnormal mitochondrial function.
News outlet logo for favicons/npr.org.png

Taking zinc can shorten your cold. Thank a 91-year-old scientist for the discovery

The common cold is a top reason for missed work and school days. Most of us have two or three colds per year, each lasting at least a week. There's no real cure, but studies from the last several years show that some supplement containing zinc can help shorten the duration of cold symptoms by up to 40% — depending on the amount of the mineral in each dose and what it's combined with. Zinc has an interesting back story. It wasn't even acknowledged as an essential mineral for human health until the 1970s. But that changed thanks to the work of Dr. Ananda Prasad — a 91-year-old doctor who, decades ago, had a hunch that led to a better understanding of zinc's role in immunity. Back in the 1960s Prasad was studying a group of young men in Egypt who had not grown to normal heights and remained underdeveloped in other ways, too. Prasad wondered if the problem might be a lack of zinc. When Prasad gave them zinc supplements, the men grew significantly taller. "I couldn't believe it," he says. Prasad had never expected such significant growth. Some scientists challenged his findings, at the time, questioning the idea that zinc deficiency could even occur in humans. "It was controversial," Prasad says. But he pressed on with his research and  began to document the ways zinc influences immunity. Eventually, in the 1970's, the National Academy of Sciences (NAS) declared zinc an essential mineral, fundamental to many aspects of cell metabolism. NAS established a recommended daily allowance, which is the daily amount that's sufficient for good nutrition. Prasad says he felt vindicated by this action. "Absolutely," Prasad told us from his home in Michigan, where he's a researcher and professor at Wayne State University School of Medicine. What came next in his career may be just as surprising. Prasad had demonstrated that zinc had an effect on immunity — so he figured that it might help against a ubiquitous scourge — the common cold.
News outlet logo for favicons/michiganchronicle.com.png

Wayne State University launches new Office of Women’s Health

Wayne State University launched its new Office of Women’s Health, a comprehensive approach to improve the health of women overall, through a deep dive into medical research affecting more than half the population of Michigan and the nation, a segment often unintentionally overlooked in research. The Office of Women’s Health marked its official debut with an inaugural symposium Dec. 3 at the university’s McGregor Conference Center that brought together more than 130 researchers from across the university, community and grassroots partnering organizations, and a keynote address from Janine Clayton, M.D. Clayton, the National Institutes of Health’s associate director for Research on Women’s Health and director of the NIH Office of Research on Women’s Health, delivered the address, “Putting Women at Center Stage in Biomedical Research,” the very purpose of the new WSU office. “We have the resources and a wonderful research culture at the university,” WSU President M. Roy Wilson told the attendees. “That, coupled with our concentration on health equity, means we can come together with a focused effort on women’s health.
News outlet logo for favicons/usnews.com.png

Sharp decline seen in kids choking to death on household objects

Efforts to reduce choking deaths among young children seem to have paid off: A new report finds the number of kids dying from choking on household objects has plummeted 75 percent since 1968. Regulations, more education about choking hazards and guidelines from organizations such as the American Academy of Pediatrics have likely all played a role in the downward trend, said study author Dr. John Cramer. Cramer said that regulations may have played the most significant role in reducing child deaths from choking on small objects. "Some of the regulations from the last 50 years have forced people to do the right thing. When you buy toys or cribs now, products are designed so that they can't be choked on. If you're a parent and you go buy a crib, you don't have to think about buying a crib with small parts; it's already regulated," Cramer said. He's an assistant professor of otolaryngology -- head and neck surgery at Wayne State University. One example cited by the study authors is a 1979 law regarding products designed for young children. Products made for young children can no longer contain parts small enough to fit into a test cylinder that is approximately the size of the airway of a child younger than 3. Children under 3 are most at risk from choking, and they've also had the most significant drops in choking death rates over time, the study authors noted. "Choking hazard warnings for toys used in children under age 3 have probably had the biggest benefit over time. This is a developmental stage where kids are oral and exploratory, often putting things in their mouths," Cramer said.
News outlet logo for favicons/ctvnews.ca.png

Liberation therapy: What we know about the controversial MS treatment 10 years later

The theory of chronic cerebrospinal venous insufficiency, or CCSVI, was developed by Italian vascular surgeon Paolo Zamboni, who suggested that MS patients have abnormal veins that fail to properly drain blood from the brain and spinal cord. Opening those vessels, he reasoned, could restore blood flow and relieve symptoms -- a procedure widely known as "liberation therapy." The theory became one of the most bitterly contested in recent medical history, embraced by desperate patients and scorned by doctors. Yet every year on the anniversary of the program, MS patients write emails to say the experimental therapy changed their lives for the better. Mark Haacke, a scientist from Wayne State University who studies better ways to see inside the brain, helped found the Institute for Neurovascular Diseases (ISNVD) the year after Zamboni’s work first went public. Haacke, too remains undeterred by the firestorm over the theory. As imperfect as it may have been initially, he says, it opened the door to expanding the learning and understanding of the brain’s venous system. "The more data I see here ... the more I know he's right. There is some form of chronic hypertension (linked to certain brain diseases) ... but we don't know where it comes from," said Haacke. The physicist and his team have developed some increasingly detailed and striking images showing blood flow in and blood flow out and hopes to use the new way of visualizing blood flow to learn more about what’s going on upstream in the brain. The question really is "if there are flow obstructions, where are they taking place?"
News outlet logo for favicons/wxyz.com.png

After losing her dad to pancreatic cancer, Alicia Smith raises awareness through a survivor's story

November is Pancreatic Cancer Awareness Month, and Thursday, Nov. 21, is World Pancreatic Cancer Awareness Day. This disease is the third leading cause of cancer-related death in America – more than breast cancer. Dr. Asfar Azmi, assistant professor of oncology at Wayne State University School of Medicine, has been working on the front lines of finding new treatments. “We have a drug that can lock the good proteins at the right place. And when we see that locking, these are tumor suppressors. They can prevent a tumor from growing, and we see the pancreatic cancer cells die,” said Azmi. They are also researching how to catch pancreatic cancer sooner. “If we are able to bring a new biomarker – what we call – which can detect this disease early, that would change the game,” Azmi explained. The work is encouraging, but Dr. Philip Philip -- a gastrointestinal oncologist at Karmanos and professor of hematology-oncology at Wayne State University, says the research is lagging behind that being done into other major cancers. “[Pancreatic cancer] is difficult to fight for a number of reasons. One of them is because we often get the patients diagnosed at a late stage in their disease -- late as in it’s gone beyond the pancreas and spread to other parts of the body,” explained Philip. He says you need to know the signs and symptoms. “Patients often times ignore these symptoms thinking that it could be for ‘something I ate’ or ‘something I’m doing’… and they ignore those symptoms for a long time,” Philip explained.  “The key message here is that if you have symptoms that are persistent for a few days/weeks, you have to see your doctor,” said Philip.
News outlet logo for favicons/sciencenews.org.png

Mom’s immune system and microbiome may help predict premature birth

Roughly 10 percent of children worldwide — an estimated 15 million babies — are born prematurely, or before 37 weeks gestation, each year. In developed countries, surviving an early birth has become more likely, thanks to the availability of intensive medical care. More than 98 percent of U.S. preemies survive infancy, according to a study published in the American Journal of Obstetrics and Gynecology in 2016, though as many as 44 percent of the youngest preemies don’t make it. Survival is least likely in nations with the fewest resources. Worldwide, complications associated with preterm birth are the leading cause of death in children younger than 5 years old. Some of the signs of inflammation linked to preterm birth differ from those found during full-term birth, says Nardhy Gomez-Lopez, a reproductive immunologist at Wayne State University. For example, in 2017, she and colleagues reported in the American Journal of Reproductive Immunology that some proteins involved in inflammation, called cytokines, were present at higher than normal levels in amniotic fluid from a subset of women who delivered preterm. The earlier the women delivered their babies, the higher the cytokine levels. Infections, which are present in at least a quarter of preterm births, could be the cause, but inflammation and cytokine levels were also elevated when no infection was found. Part of the problem with developing a predictive test is that preterm labor isn’t just one condition. Thirty years ago, preterm labor was viewed simply as regular labor that happened early, says perinatologist Roberto Romero at Wayne State, who directs the perinatology research branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development. Although scientists now recognize that the biology of preterm labor is distinct, they still have to grapple with the reality that it varies depending on the underlying cause. Wayne State and NICHD recently released gene activity data from the whole blood of 150 Detroit women, 71 of whom delivered preterm, and encouraged researchers to use the data to find predictors of preterm labor, as part of a crowdsourcing collaboration called the DREAM challenge. The challenge is expected to be completed in January 2020. “We are at the beginning of an exciting period,” says Romero at Wayne State. The field is now equipped to start studying preterm birth as a collection of several different syndromes and seek out treatments to address each one, he says.
News outlet logo for favicons/msn.com.png

Why are uterine cancer rates rising so drastically in black women?

According to a December 2018 report from the CDC, the number of new uterine cancer diagnoses increased an average of 0.7 percent per year between 1999 and 2015, resulting in an overall 12 percent rise. Rates of endometrial cancer, specifically, jumped 4.5 percent per year on average. The uterine cancer mortality rate increased 1.1 percent per year on average between 1999 and 2016, amounting to a 21 percent leap overall. What’s more, the burden of uterine cancer is greatest for black women, and the disparity is increasing with time. While that same CDC report found that non-Hispanic white and black women had similar incidences of uterine cancer (about 27 cases out of 100,000 people), black women were more likely to be diagnosed with uterine sarcoma, the most aggressive form of uterine cancer, than women of other races, and also more likely to be diagnosed at a later stage than women of other races. Teasing apart the potential reasons behind this disparity is a complex task. The puzzle pieces start to come together when you look at some of the major risk factors for developing uterine cancer. Let’s start with endometrial cancer risk factors. “We do know that obesity is one risk factor,” Michele L. Cote, Ph.D., a professor of Oncology at Wayne State University and associate center director of Cancer Research Career Enhancement, tells SELF. This is because it’s a health condition that can increase the amount of estrogen in your body. Another endometrial cancer risk factor revolves around children. “The more children you have, the lower your risk,” Cote says. Pregnancy increases your output of progesterone, so you might benefit from its protective effects against this cancer. But people are generally having fewer kids these days, Cote explains, including black women. “Unfortunately, we don’t have a lot of research data yet on why black women are more likely to have a more aggressive form of uterine cancer,” Cote says.
News outlet logo for favicons/psychologytoday.com.png

“Joker”: A powerful psychological drama

Arash Javanbakht, M.D., director of the Stress, Trauma, and Anxiety Research Clinic (STARC) at Wayne State University, wrote a piece for Psychology Today about the film “Joker.” “I am a psychiatrist expert in trauma in adults and children, and a movie lover. When friends tried to convince me to watch "Joker" with them, I was hesitant. I was not interested in an action movie solely focused on the bad guy, especially given I liked Batman. However, a few minutes into the movie I realized what I had got myself into. "Joker" is not an action movie, it is a sad psychological drama, depicting the suffering of a man who was wronged, and got it wrong.”