More than half of all Michiganians live in counties where they should mask up indoors following a spike in COVID-19 cases, according to recommendations from the Centers for Disease Control and Prevention. Across the state, 16 counties – including Wayne, Oakland, and Macomb and many others near heavily-populated Metro Detroit – are now in “high” community levels, a CDC classification to show where COVID cases and hospitalizations have risen to the point that people are recommended to wear masks indoors. The city of Detroit is also at a high risk level. Dr. Matthew Sims, director of infectious disease research for Beaumont Health and a faculty member in the Wayne State University School of Medicine, said that upticks tend to follow a particular pattern. First, community levels rise, followed by a rise in hospitalizations, and then, a few weeks later, a rise in deaths. “We’re certainly not at a crisis point,” said Sims, acknowledging the number of COVID patients he has seen in recent days has risen. “But we could be there in a few weeks if things don’t go well. We’re going to keep watching this and doing everything we can.”  

A novel technique to measure the age of male sperm has the potential to predict the success and time it takes to become pregnant, according to a newly published study by researchers at the Wayne State University School of Medicine. “Sperm epigenetic clock associates with pregnancy outcomes in the general population,” published in the journal Human Reproduction, found that sperm epigenetic aging clocks may act as a novel biomarker to predict couples’ time to pregnancy. The findings also underscore the importance of the male partner in reproductive success. “Chronological age is a significant determinant of reproductive capacity and success among couples attempting pregnancy, but chronological age does not encapsulate the cumulative genetic and external – environmental conditions – factors, and thus it serves as a proxy measure of the ‘true’ biological age of cells,” said J. Richard Pilsner, Ph.D., lead author of the study. Dr. Pilsner is the Robert J. Sokol, M.D., Endowed Chair of Molecular Obstetrics and Gynecology and director of Molecular Genetics and Infertility at WSU’s C.S. Mott Center for Human Growth and Development. “Semen quality outcomes utilizing World Health Organization guidelines have been used to assess male infertility for decades, but they remain poor predictors of reproductive outcomes. Thus, the ability to capture the biological age of sperm may provide a novel platform to better assess the male contribution to reproductive success, especially among infertile couples.”

A southwest Michigan factory just a few miles from the Indiana border is at the center of an infant formula recall that’s helped fuel shortages across the U.S. and raised concerns about federal oversight of contamination in food production. Abbott Nutrition, a division of Abbott Laboratories that employs an estimated 420 people in its factory and R&D facility in Sturgis, voluntarily recalled various brands and lot codes of powdered formula – including Similac, the most sold brand in the U.S. – in February. The recall came five months after an initial complaint that an infant in Minnesota hospitalized with a bacterial infection had consumed Similac from the Sturgis factory. The Food and Drug Administration first inspected the plant last September, when it found contamination risks. By the end of February, the FDA had identified five infants who became seriously ill with bacterial infections after they consumed the formula. Four had been infected with Cronobacter sakazakii – an infrequent infection that can be deadly for babies – and one had been infected with salmonella. Two of the infected infants died. The FDA continues to investigate. “It’s super serious – one of the worst” infant infections, said Dr. Eric McGrath, director of Wayne Pediatrics. He said he had treated a child with a cronobacter infection years ago – the only one in his 12 years as a pediatric infectious disease specialist. “The reason that this germ is devastating is that can cause blood infections and meningitis, and complications that include brain abscesses,” McGrath said. At minimum, a baby with cronobacter infection is hospitalized for three weeks and likely subjected to a spinal tap and other trauma.  

By Chanel Stitt  Every time Sarah Brown-Derbah takes a stride down the Barbie aisle of a store, she sees a lot of professions that the doll is portraying — certified nursing assistant, doctor, nurse, teacher, social worker and politician. But she has never been able to find her profession — funeral home director. So she started a petition, which she plans to send to Mattel, the parent company of Barbie, in an effort to get the company to make a funeral director doll. She's collected 415 so far and plans to draft the letter to the toymaker once she feels she has gathered enough signatures.  “I've been looking for a funeral director Barbie for probably about 10 years, Brown-Derbah, of Southfield, said, "and I noticed the Barbie line has expanded.” The National Funeral Directors Association's membership reports that 81.1% of funeral home directors are men. But there is a shift happening within mortuary schools. In 2019, the organization reported that women made up 71.9% of mortuary school attendees. While Brown-Derbah was in mortuary school at Wayne State University, there were only seven men in her class.  

By Joe Guillen and Annalise Frank  Black women in Michigan already dealing with across-the-board health care inequities would especially suffer if Roe v. Wade is struck down, health care experts say. It's a matter of life and death. Restricted abortion access in Michigan would endanger Black women's lives because they are three times more likely to die from a pregnancy-related cause than white women. It's not just about access to health care. Even when Black women have access, structural racism within the medical community affects the care they receive. "We're not believed, we are rendered invisible and people don't believe our pain," Ijeoma Nnodim Opara, an assistant professor of internal medicine and pediatrics at Wayne State University, tells Axios. 

Over the last decade, more than half of young adults with depression reported not receiving treatment in a survey, and important reasons were related to cost and stigma. Cos of care was the most common problem for young patients with major depressive episodes, with the frequency of cost being cited as a barrier to mental health care going from 51.1% to 54.7% in 2019. Other barriers to care included people not knowing where to go for treatment, worrying about confidentiality, not wanting to take medication, and not having the time, researchers wrote in JAMA Network Open. Community-based education is vital to combat some of those beliefs, said Arash Javanbakht, associate professor of psychiatry at Wayne State University’s School of Medicine. He said the study’s results suggest the medical community is “behind in educating the public not only about mental illness but also [about] how to navigate the healthcare system, get evaluated, and receive needed care.” “Many patients think medications are addictive, zombify them, or change the way of their thinking,” said Javanbakht. “This also closely ties with the stigma of having mental illness [and] its personal, cultural, and media aspects…There is a need for more realistic education about the prevalence of mental illness, its biological nature, variety of treatment options, and similarities with other illnesses of the body. The government should definitely be more active in this area of public education via media and social media.”

Dr. Mark Favot, associate professor of EM ultrasound education at Wayne State University School of Medicine, spoke about how artificial intelligence guidance can make a different with point-of-care ultrasound. For patients who need care in rural areas, getting diagnostic testing can be a complicated process, and innovation in point-of-care ultrasound devices can help make care more broadly available and less expensive in remote regions. Dr. Favot noted that today’s medical students are very technology savvy, and that institutions, like Wayne State, that have strong point-of-care ultrasound curricula have seen increases in applications from prospective students. “…they will not stand idly by and accept that the 200-plus year-old technology like a stethoscope is the most effective diagnostic tool for their patients. They have and will continue to demand more out of their education,” Favot said.  

Arash Javanbakht, associate professor of psychiatry and the director of the Stress, Trauma, and Anxiety Research Clinic at Wayne State University, wrote an article explaining how images of disaster affect us and provides some practical tips about how to stay informed while minimizing harm. “A wide of body of evidence has shown that trauma affects not only those who suffer through it; it also affects other people who are exposed to the suffering in other ways. This is in part because humans are empathetic and social beings. Indirect and vicarious exposure to trauma often occurs in the lives of first responders, refugees, journalists and others, event when they do not directly experience the trauma themselves,” Javanbakht writes. He provides a list of tips to stay informed while minimizing harm, including limited exposure and emotional intensity from media, time away from the news, an awareness of positive news, finding activities that allow for emotional recharging, and talking to others. “We can also reduce the negative impact on ourselves through helping others, especially those affected by these calamities. When I feel affected by the traumatic experiences of my patients, remembering that the end goal is helping them and reducing their sufferings helps me process my feelings. Sadness, anxiety, anger, and frustration can be channeled into actions such as attending fundraising activities and volunteering to help the victims. This can even be a family activity that teaches children a mature and altruistic response to others’ suffering,” said Javanbakht.

Anyone can choke under pressure, as evidenced by a seemingly simple puzzle on “Wheel of Fortune” that stumped two players who have faced ridicule online. Physical and mental tasks you normally perform with ease become challenging under pressure, which comes from people watching, big rewards or losses at stake, fear of judgment, or even your own memories. Under stress, working memory is disrupted by external factors, like an audience, time pressure, or potential embarrassment. The clutter interferes with the prefrontal cortex’s communication with the rest of the brain. “Humans really only have one way of dealing with stress, and that’s our ‘fight, flight, or freeze’ reflex,” said Seth D. Norrholm, a professor of psychiatry at Wayne State University’s School of Medicine. “…Your body doesn’t discriminate between a game show versus a predator. It’s just going to kick in the responses inborn within us.”   

The team at Wayne Health knows to break the cycle of health disparities in Black and brown communities, they must take their tools on the road. For more than a year, the Wayne Health mobile unit has broken down the barriers to healthcare access in Detroit's Black neighborhoods, providing COVID vaccines, heart health awareness, and other services. Dr. Philip Levy, a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne State and chief innovation officer for Wayne State University Physician Group, said that his team has noticed that nearly 7 out of of every 10 visitors has elevated blood pressure. "Most of the folks have pretty profound hypertension, and a lot of them fall into the category of stage 2 hypertension, which is advanced hypertension that we need to do something about as soon as possible," said Dr. Levy. This summer, Wayne Health will officially being its Achieve Greater initiative, which will provide Detroiters with the resources to manage their health. After one visit with the mobile health unit, all other follow ups are done remotely. Wayne Health is partnering with a number of church groups, recreation centers, and other community groups to connect with more residents. Dr. Levy said the life expectancy of a Detroiter is up to 15 years less than Michigan's average life expectancy of 77.7 years, and that deaths linked to heart disease jumped 25-30% during the pandemic. Wayne Health wants to help future generations of Black families live longer. "Ultimately, we want everyone in the state, and especially in the City of Detroit and the Black community, to live as many years as everyone else," Dr. Levy said. 

By Lily Bohlke  An analysis of mobile health clinics launched in the Detroit metro area during the pandemic finds it’s a model that can deliver health screenings and health care and could be replicated in other communities. The Wayne Health Mobile Units are specially equipped vans with medical equipment and professionals. They began as testing sites for front-line workers in the early days of COVID-19, out of a partnership between Wayne State University and Ford Motor Co. Over time, they transitioned to what Dr. Phillip Levy, a professor of emergency medicine and assistant vice president for translational science and clinical research innovation at Wayne State and chief innovation officer for Wayne State University Physician Group, called a “vision of patient-centric, portable population health.” “If they have comorbidities and need doctors’ appointments or health care,” said Levy, who runs the program, “can we provide linkages around that? If they have food insecurity, can we help them get food access so that we can really be delivering on the holistic approaches that are needed in order to keep this person healthy and avoid complications?” Appointments are not necessary, and they don’t require insurance or identification – which can be barriers to care. Levy added that bringing care into communities also reduces the barriers of transportation time and cost. Beyond testing and treatment for COVID, Levy said the Mobile Health Units do blood screenings for high cholesterol, diabetes, and kidney disease, and provide prevention infrastructure – as well as blood pressure screenings for hypertension. Levy said they are also building out HIV screening and treatment, and have started working with the state’s needle-exchange program.  

By Arash Javanbakht  In the spring of 2020, COVID-19 brought rising levels of stress, anxiety and depression. But stay-at-home orders and a national emergency prompted many psychiatric and psychotherapy offices to shut down and cancel in-person appointments. The country needed a robust – and fast – transition to mental health telemedicine. And the pandemic turned out to be just the thing to make it happen. I was skeptical of telemedicine in 2015 when I began working at Wayne State University as a psychiatrist and researcher in the medical school. At that time, the department of psychiatry and its affiliated clinics were using telemedicine in primary and emergency care and for substance use recovery. But the idea of seeing patients via video had been around since long before then. In 1973, a team of behavioral scientists studied the two-way interactive television system Massachusetts General Hospital started using in 1969. The hospital provided mental health evaluations at an off-site medical station at Logan International Airport in Boston and a Veterans Affairs hospital outside the city. “The system has proven to be feasible and acceptable to individuals and institutions in the community, providing psychiatric skills on a much wider scale, in a more accessible way, and faster than any other system,” researchers wrote in their analysis. 

By Keenan Smith  COVID-19 cases are well off their omicron surge, but in the last week, cases have plateaued. Some communities are seeing an uptick in cases and hospitalizations. Health leaders across the country are watching the omicron BA.2 variant, which is more transmissible than the original omicron strain. COVID-19 wastewater surveillance, which includes the collection and sampling of wastewater to watch for outbreaks, can play a key role in public health and predicting future surges. Researchers Jeffrey Ram, a professor of physiology at Wayne State University’s School of Medicine, and William Shuster, professor and chair of civil and environmental engineering at Wayne State University’s College of Engineering, have been testing specimens from a sewer line 20 feet below the street in Midtown. “The signal in wastewater gives a couple of days, maybe even up to two weeks advance warning,” said Ram. Shuster added, “That gives us some time to get out to our public health authorities.”  

By Herbert Smitherman, Jr. Dr. Herbert Smitherman, Jr., professor at the Wayne State University School of Medicine and president and CEO of Health Centers Detroit Foundation, wrote an opinion piece celebrating the science that allowed us to fight back against a pandemic. “…we are the only generation in human history that has been able to fight back against a pandemic with science through the development of a vaccine, to end that same pandemic in real time. Please do not underestimate what we have accomplished as a human society and the impact of the 2020 COVID vaccine or the science behind it. The literal enormity of isolating the genetic code of COVID-19, developing a vaccine based on historic science, mass producing that vaccine, the logistics of distributing that vaccine across the globe, establishing sites and staff to administer the vaccine, agreeing to public policies and educating the public regarding COVID and the vaccine, getting shots in arms, developing a mechanism to test for the virus and the development of IV and oral treatments for COVID, has been a feat like no other in human history.”

By Danielle Salisbury People who regularly see primary care physicians tend to live long and healthier lives – if they can locate and secure doctors near home, Michigan doctors said. Despite the necessity of such practitioners, who handle patients from birth to death, there are too few of them and trends suggest there will be even fewer as current practitioners age and medical students with six-figure loan debts choose more lucrative specialties. Of Michigan’s 83 counties, 75 are at least partially designated as having shortages in primary care doctors. To address the situation, the state academy is calling on state leaders to invest an additional $31.4 million in existing programs, MIDOCS and the Michigan State Loan Repayment Program. MIDOCS, funded by the state, increases the number of medical residency training slots in primary care and other high-need specialties. Those accepted must commit to two years of practice in a rural or urban underserved area after they complete their residences. In exchange, they may receive up to $75,000 for repayment of eligible educational loans. The program partners with the medical schools at four state universities, including Wayne State.

Around 300 medical students from Wayne State University’s School of Medicine gathered at Motor City Casino on March 18 for Match Day, the nationwide event where medical students find out where they’ll spend their residencies. The event was the first in-person Match Day celebration since 2019. The match rate for School of Medicine students who participated in this year’s match was 97.4%. “I really care about service now that I’ve been in Detroit, so I’m so excited to bring it to the Bronx,” said Emily Nghiem, who matched at her first choice for a general surgery residency at Montefiore New Rochelle Hospital in New York.   

By Kimberly Craig  If you found yourself a tad grumpy Sunday after losing an hour of sleep, you’d be in good company. Studies show that most Americans would like to put an end to bidding farewell to that hour of sleep in March and waiting months to welcome that hour back in November. But while the U.S. Senate voted this week to eliminate that biannual clock change in the Sunshine Protection Act, it would also come with something sleep experts don’t want to see happen – making daylight saving time permanent in 2023. Supporters of living in daylight saving time year-round say it would give children more time to play outside in the afternoon and it would be good for the economy. But many physicians are urging lawmakers to make standard time a permanent thing, to allow our bodies’ internal clocks to be aligned with the timing of the sun. Wayne State University professor Dr. James Rowley, who also serves as the medical director at Detroit Receiving Hospital’s Sleep Disorder Center and as an officer with the American Academy of Sleep Medicine, firmly believes we should be on permanent standard time. “It’s well known that the changes in March result in increases in cardiovascular disease, heart attack, stroke, and driving accidents. And there are some subtle changes even when we go backwards again in the fall,” he said, noting that if lawmakers adopt a uniform daylight saving time, Michiganders won’t have sunlight until 9 a.m. in the winter. “There’s good evidence that we need sunshine in the morning to be awake during the day.” 

By Logan Tesmer  Dr. Hilary Marusak is the director of Wayne State University’s THINK lab and an assistant professor at the Wayne State University School of Medicine. THINK is an acronym for Trauma History Investigation of Neurodevelopment in Kids. The THINK lab studies brain development in children and adolescents and the impacts of environmental stress on the brain, as well as anxiety and PTSD. These traumas can be found in interpersonal forms, such as violence, as well as medical-related traumas from a cancer diagnosis or treatment. The lab’s work also targets the recovery from these traumas through exercise, meditation, or pharmaceuticals. Dr. Marusak joins for a segment of Community Connect to discuss her love of science, getting more girls into the industry, and how the THINK lab helps children in the community. “If you work with kids, I think you share this idea that if you intervene early, you can really change the course of that kid’s life. The brain is changing so rapidly and dynamically during that time, so it’s much easier to take advantage of that brain plasticity and get kids on a better chart for the rest of their life,” said Dr. Marusak.  

By Katherine Lee  Sleep apnea is a common and potentially serious sleep disorder. It causes you to stop breathing temporarily and occurs repeatedly during sleep. These pauses in breathing can happen as many as hundreds of times in one night. Your brain registers what’s going on and wakes you up, though sometimes only partially or for such short moments you may not even realize the arousals. Because the primary symptoms of sleep apnea occur during sleep, many people with sleep apnea may not even realize it’s happening. Sleep apnea can take a toll on the body and lead to a number of negative physical, cognitive, emotional, and behavioral effects, including inflammation throughout the body caused by chronic cycles of accelerated heart rate and increased blood pressure. “There’s good evidence that having obstructive sleep apnea puts you at increased risk for high blood pressure, stroke, heart disease, and death,” said James Rowley, professor of medicine and division chief of pulmonary, critical care and sleep medicine at Wayne State University School of Medicine.  

By Arash Javanbakht  Arash Javanbakht, associate professor of psychiatry and director of the Stress, Trauma, and Anxiety Research Clinic at Wayne State University, authored an article about the psychological wounds caused by the Russian invasion of Ukraine that could linger for generations. Javanbakht outlines research findings that human-caused catastrophes have a higher likelihood than natural disasters of causing severe consequences including PTSD, depression, and anxiety. Children are specifically vulnerable, and trauma can be transferred from parents to their current and future children. “Putting human suffering into numbers as I’ve done here is not in any way meant to convert a human tragedy into a cold statistical concept,” Javanbakht wrote. “The purpose is to show the enormous impact of such calamity. Each life or livelihood lost is a tragedy in and of itself.”