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November 21, 2024 49 mins

On this episode of The Middle we're exploring the work of three scientists from across the geographic middle, and discussing how their cutting edge research impacts all of us. We speak with Purdue University professor Majid Kazemian, Washington University professor Sophia Hayes, and Utah State University Professor Sophia Tschanz on topics like cancer research, causes of Alzheimer's and the intersection of helium capture and climate change. #science #technology #STEM #Purdue #USU #WashU #cancer #alzheimers #helium #carboncapture

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Speaker 1 (00:04):
Welcome to a special edition of The Middle. I'm Jeremy Hobson,
and we're going to get away from Washington politics this
hour and zoom in on some of the scientific research
that's happening in the geographic middle of our country, research
that is funded in part by all of US taxpayers,
and that's being done to tackle problems that affect all

(00:25):
of us. Problems like cancer, which, after heart disease, is
the leading cause of death in the United States. Now,
treatment for cancer is getting a lot better and more personalized,
and Majeet Kazmian, an Associate professor of biochemistry at Purdue
University in Indiana, is trying to take all the data
and use it to improve cancer treatment even more. He

(00:48):
joins us. Now, Majed, welcome to the Middle.

Speaker 2 (00:50):
Thank you for having me.

Speaker 1 (00:52):
So when you look at the numbers each year in
the United States, there are around two million new cancer diagnoses,
around six hundred thousand cancer deaths. There are obviously thousands
and thousands of cancer researchers, not just across this country
but around the world. Tell us about the piece of
the pie that you're looking into with your research.

Speaker 2 (01:13):
So our main question was always that how come. Certain
patients have exactly the same cancer type, the same stage
of cancer, about the same age of patients. Some of
them end up having a very good outcome and some
of them, unfortunately, have a very poor outcome of the

(01:36):
same cancers. And we turn to our computational tools and
ask can we identified the differences in these two cases,
and hopefully if we could identify those differences, we could
potentially have therapeutics that enable to push those poor survivors

(01:57):
who are the better response and better so viving ability.

Speaker 1 (02:01):
So what are the differences that you're looking at? Are
these genetic differences or these situational environmental differences?

Speaker 2 (02:08):
Those are mostly genetic differences and mostly something we call
biological passphase that are differentiating these tumor types or tumor
that are well responding or tumors that do not respond,
or tumors that are end up giving a poor outcome,

(02:30):
or tumors that are easier to fight off. And these
biological passphase you can think about them as a well
organized factory assembly, where the genes are the compartments of
this assembly line, providing the raw materials or pushing things
towards the final product. And our cells have thousands of

(02:56):
these factory lines or the thousands of these biological passphase,
and any of them that are dysregulated could cause some
cells to grow a little bit more, making it more
cancerus or sometimes some cells to grow a little bit less,
therefore to be a little bit providing a better response.
So then we asked whether or not computer tools could

(03:19):
identify these factories or biological passphase that are different between
patients that have a poor survival versus those that have
a better survival.

Speaker 1 (03:30):
So basically, in order to help people eventually with their cancer,
their cancer diagnosis, and their cancer treatment, you're taking all
of this data in and being able to use computer
tools to figure out exactly what leads to different outcomes.

Speaker 2 (03:47):
That's exactly right. So identifying those passphase become the key questions.
And one of the things that we have found is
that there are many tools that are developed over the
past three or four decades even to identify these, but
none of them are perfect for doing the job. We

(04:09):
found that if we combine a few of these tools
and optimize them, we could now more precisely identify these
factory lines or passphase that go wrong in one condition
and could potentially be therapeutically targeted, and.

Speaker 1 (04:26):
You're using artificial intelligence to do this.

Speaker 2 (04:30):
In this case, we have used the traditional methods of
computational tools to identify them, but our new works will
move toward artificial intelligence, and we believe that artificial intelligence
would enable us to even better identify drugs to start
targeting these passphase that are different.

Speaker 1 (04:53):
A lot of people when they think about artificial intelligence
right now, they're thinking about things like chat GPT, or
they're thinking about it as something that is going to
very quickly disrupt our entire economy that will get rid
of jobs. You see it right now as a good
thing for the work that you're doing.

Speaker 2 (05:11):
Yes, we see it as something that could be extremely
useful for let's say drug repurposing, and the rug repurposing
is something as following that we can reuse the drugs
that are approved for some different condition and test them
in a new settings. For example, a drug that has

(05:33):
been used for type two diabetes maybe is great for
fighting a specific type of cancer. And now artificial intelligence,
by evaluating these biological task phase could say whether or
not those are the possibilities and pick out out of
thousands of drugs that are already in hand, each of

(05:55):
them might be having a better.

Speaker 1 (05:58):
Use university which also has a big veterinary medicine school.
How is that proximity to that school impacted what you're
able to do.

Speaker 2 (06:08):
So one of the things that we found from the
human cancers was that specifically, some of the human bladder
cancers that have for survival outcome would respond well for
a new repurpose drug that we identified. So we said, like,
all right, Unfortunately, a lot of dog patients get bladder cancers.

(06:33):
So the bladder cancer is extremely common.

Speaker 3 (06:37):
In specific breeds of dogs, and we have a few
of these dog patients that come to the clinic and
they presented with these extremely aggressive bladder cancers.

Speaker 2 (06:50):
So we had already identified this drug that seems to
be working in human bladder cancer settings. We said, like,
the dog patients would respond to this, but we can't
directly test on that. So we took some of the
cell lines from the dog patients that have been stablished

(07:12):
at Purdue and treated inside the dish the cells from
these K nine species or dog species, and we saw
that this drug respond quite well, i e. It could
potentially limit the cancer quite well in that setting.

Speaker 1 (07:30):
Do you have a dog yourself.

Speaker 2 (07:31):
I do have the very tiny yorkey three years old.
We adopted him last year, and I could mention that
he had his heartworm vagacine on Saturday. He was a
little bit down on Saturday, which broke my heart. But

(07:54):
it was back on the unhappy and.

Speaker 1 (07:55):
Now he's turning around. That's good. What kind of an
impact do you think. I think your research there at
Purdue will eventually be able to have on cancer treatment
in the US and around the world.

Speaker 2 (08:09):
I think that science in general is a slow process.
Every year we have probably made one percent progress in
reducing the cancer mortality, and this is an extremely important task.
It's a slow process, and everyone who is working in
this area has contributions. I hope that some of the

(08:34):
drugs that we are identifying could help both dog patients
and human patients as well.

Speaker 1 (08:41):
What got you into this line of research.

Speaker 2 (08:44):
I actually had all of my background in computer science
right and at that time I had background also in
artificial intelligence. And then I got more and more into
the biology and I went to pursue my degrees in
PhD in bioformatics, and from there I started working on

(09:07):
human disease.

Speaker 1 (09:08):
It's interesting because I think most people when they hear
about somebody who went into computer science would not think
that this would be what they would end up working on.

Speaker 2 (09:17):
That's correct, This is not one of the areas that
you would probably pick. However, what I would say, computational
science as computational life sciences are becoming the reality because
one of the largest growing available data are data from

(09:38):
the health sciences, from genome sequences, from the things that
we had never taught before, and data science in that
area with AI could be extremely beneficial.

Speaker 1 (09:55):
You know, when I work with people who are younger
than me, which I often do, I find that when
it comes to technology, they're usually better than I am,
and probably the people younger than them will be better
than they are. What do you find in terms of
how your students at the university look at the kinds
of things you're doing. Do you learn from your students

(10:15):
about the research that you're doing.

Speaker 2 (10:18):
Oh, my goodness, every day I learn algorithm a new
tool that my students bring to me. I'm constantly amazed
and I'm constantly happy to have the next generation that
is extremely savvy with the tools at the hand.

Speaker 1 (10:39):
Where does the funding come from for what you do?

Speaker 2 (10:43):
So many of our fundings are from National Institute of Health.
We have other fundings that are coming from either Perdue
University Purdue Institute for Cancer Research support a lot of
research across different cancer type, which is also sponsoring the

(11:06):
trial in the god patients with bladder cancer, but National
Institute of Health is our main source of funding at them.

Speaker 1 (11:14):
I want to ask you one more question, just to
tie this back to the geographic middle. What does it
mean to you to be in the middle of Indiana
doing this work.

Speaker 2 (11:25):
It's fascinating. Of course. One of the great parts of
it is that we have one of the best veterinary
school which allows us to basically interact on daily basis
with oncologists, and this is something that is extremely unique

(11:49):
about Purdue and the environment.

Speaker 1 (11:51):
Majid kause Emian is an associate professor of biochemistry at
Purdue University in Indiana. Thank you so much for joining us.

Speaker 2 (11:58):
Thank you very much for having me.

Speaker 1 (12:00):
In a moment, we'll go to Washington University in Saint
Louis to talk with one of the world's leading helium experts.
It's used in a lot more than birthday balloons, and
some of the biggest reserves in the world are right
here in the United States. A reminder, The Middle is
available as a podcast in partnership with iHeart Podcasts on
the iHeart app or wherever you listen to podcasts. Don't

(12:21):
go anywhere. There's more ahead on the middle. This is
the Middle. I'm Jeremy Hobson. If you're just tuning. In
the Middle is usually a national call in show focused
on elevating voices from the middle politically, geographically, philosophically, or
maybe you just want to meet in the middle. But
this hour we're taking a break from Washington politics to
focus instead on some of the cutting edge scientific research

(12:44):
that's being done in the geographic middle of our country.
And did you know that the geographic middle of our
country has some of the biggest helium reserves in the world. Yes, helium,
which is used for a lot more than just party balloons.
And that parade that's happening.

Speaker 4 (12:58):
Next week, but never quite the same way.

Speaker 1 (13:01):
And I think we're about to see him, soo okay,
it's Snoopy Beagle Scout Snoopy Prue Thatt. Helium is critical
to the function of MRI machines and even space rockets.
One of the leading experts on helium is Sophia Hayes,
professor of chemistry at Washington University in Saint Louis. Sofia,
welcome to the middle.

Speaker 5 (13:21):
Hey, thank you for having me here.

Speaker 1 (13:22):
So let's talk about helium. I think when a lot
of people think about helium, they think about balloons, and
maybe it's like either filling up a balloon or taking
the air out of the balloon and making yourself talk
really in a high pitched voice. But it is so
much more important than that in our modern age.

Speaker 6 (13:39):
Think of helium as kind of a sustaining chemical, a
sustaining liquid for a bunch of us. When it's in
its liquid form, it's extremely cold, and it allows us
to cool materials that then form the insides of things
like MRI magnets, and so in the absence of helium,
we would have a big challenge about having MRI imaging,

(14:01):
you know, magnetic resonance imaging for medical applications. A number
of us in science use it. There are machines that
are cousins of those MRI imaging machines in every research
chemistry department across the United States in industries. So yeah,
it's a really important thing for us.

Speaker 1 (14:18):
In space exploration too.

Speaker 6 (14:20):
Yeah, so that's one that you wouldn't expect when you
see those rockets, you know, flying into the air to
deliver a satellite, you know, a GPS unit or something
like that. Basically, those rocket engines, which are generically called
lifting applications, those have hydrogen and oxygen a couple of
also liquid fuels that burn and combust to form that flame.

(14:43):
But it turns out heliums at the top of that
engine to push those gases out, and so today rocket
engines really require that helium also, So lifting applications are
another big area.

Speaker 1 (14:54):
So helium is not renewable. Are we in a shortage
or are we at risk of a shortage?

Speaker 6 (15:00):
When you say it's not renewable, what we mean by
that is that it is it escapes into outer space.
So what we release goes up out through the atmosphere.
It is unreactive, meaning as an atom, it doesn't really
pair with other things, and so it floats out into
outer space to be lost forever. Now, we're making a
little bit of helium and atom at a time, but

(15:21):
it's a very slow process, and so are we in
a shortage situation? So that's interesting because some of the
people listening to the show might be aware that they
weren't able to get helium for party balloons at times.
There have been four major supply shocks over the past
two decades, and part of this is just because we

(15:42):
used to have a really big storage container in the ground,
a big rock formation, and it was called the US
Strategic Helium Reserve, and it was recently privatized.

Speaker 5 (15:51):
It was sold off to a commercial entity.

Speaker 6 (15:53):
So what happens to that big container is uncertain, Its
future is uncertain. So this has thrown the resource, the
supply of helium, it's price, and all sorts of other
things into a bit of chaos.

Speaker 1 (16:05):
So what's the focus of your work when it comes
to helium.

Speaker 6 (16:09):
Well, yeah, so two things. One is, I'm in an
area related to lots of the quantum science and engineering
things that you hear about that are coming out from
the US government. Mine in particular involves looking at the
interaction between electrons who have a property called spin, and
the surrounding nuclei. And it turns out that with lasers,

(16:32):
I can point the electrons in one direction.

Speaker 5 (16:35):
I can we call it orientation.

Speaker 6 (16:37):
When we orient those electrons, it turns out the influence
the atoms that are nearby, and when those atoms have
another spin, a nuclear spin, that we can couple those
two things together. It's like one feels what the other
one is doing. Now, that's only true when you cool
down the matter to the coldest temperatures, in part because
when you sort of shake things and you'll vibrations, it

(17:01):
ruins some of those effects. Let me give you an analogy.
Picture a spinning top. You know those really beautiful ones
that spin and spin forever. So if you start shaking
the surface that that spinning top is moving on, you
know that the spin's going to go crazy. It's that
the top is going to sort of, you know, get
chaotic in its motion and topple over. But it spins

(17:24):
longer if it's on a very still table. So the
helium is what gives us that stillness, and so I
can see that property of that top that's spinning, for example,
for a longer time, or it does some really interesting
acrobatics that would be messed up if I shook the
surface on which it was traveling.

Speaker 5 (17:43):
So that's one way to think about it.

Speaker 1 (17:45):
And what is the practical application of that.

Speaker 6 (17:48):
Yeah, so people are trying to do these kinds of
interactions to look at new regimes in quantum science. So
sometimes you hear about quantum computing or the entanglement of
different energy states, and so these are some exotic phenomena
that can lead to new types of devices. You hear
about it in the areas of encryption. There are new

(18:11):
ways of sensing phenomena that we we are sort of
missing today. So if we created sensors that are sensitive
to these quantum effects, then we might have entirely new detectors.
And so this is an area that a lot of physicists,
a handful of chemists, and a lot of engineers are
exploring to look at these new applications.

Speaker 1 (18:32):
Now I understand your research also looks at carbon capture,
which is seen as a way to combat climate change.
Is that connected to the study of helium or is
the storage of carbon similar to the way that we
store helium. Oh?

Speaker 6 (18:48):
Yeah, So it's taking the let's say, the less exotic
physics route and using those MRI like instruments that are
cooled by liquid helium, using those high magnetic fields in
order to interrogate what's happening in carbon capture. So carbon
capture is where you take CO two, sometimes out of

(19:08):
the air or sometimes out of a flu stack, you know,
at a power plant, and what you want is you
want to have that CO two molecule carbon dioxide stick
to something. It turns out that's a little bit hard
to do because it's a very stable molecule. So we
have to work pretty hard to get the chemistry right
to get it to stick and then maybe release it
later when we want to squeeze it out, or maybe

(19:31):
it'll become something else. CO two convert either into bicarbonate,
something you can think of in baking soda sodium bicarbonate,
or even all the way to the end of the line,
which is a carbonate, which is sort of the material
of coral or chalk. Calcium carbonate is one example. So
we want CO two to go along that pathway, and

(19:53):
so the materials that can do that sometimes need a
way to You need a way to look and interrogate
what the reaction is. So a great way to do
that is through this direction that we take using spectroscopy
using magnetic resonance to figure out what the structures are
that are associated and in part why my technique of

(20:15):
magnetic resonance is ideal is it doesn't need to be crystalline.
It can look at mixtures of solids and liquids and gases,
and all of that is enabled by having helium to
make that cold, cold material that lets us have high
magnetic fields. And that's the basis for these interrogations.

Speaker 1 (20:35):
Do you see carbon capture as a really important part
of the puzzle in terms of solving climate change or
dealing with the effects of climate change?

Speaker 6 (20:44):
I personally do yes, and I think many of my
colleagues would agree. You know, we want to get to
a time and a place where we have alternate sources
of energy. But there's a high concentration of CO two
in the atmosphere. If we had ways to do what's
called direct to air capture to remove it from the
air and then reduce that high concentration, then we would

(21:05):
have hopefully less of a greenhouse gas effect.

Speaker 5 (21:08):
So these technologies already exist today.

Speaker 6 (21:11):
It's just that they're slightly expensive and because there isn't
a general you know, let's say a.

Speaker 5 (21:18):
Lot of political will to do this.

Speaker 6 (21:19):
Yet, there hasn't been a lot of buy in. But
those technologies do exist, and many, many scientists and engineers
are working on this worldwide, and so I think that
it's just a matter of time, and what these technologies
enable us to do is clean up the atmosphere that
we have. It also says it's hard to get away
from combustion of hydrocarbons as an energy source. We're kind

(21:42):
of no, we're adhering to it. In the transportation sector,
we might find alternatives with batteries and so on, but
ultimately there is this need, and it's even a need
in industries like the cement industry, for example, is very
energy intensive. The manufacturing of steel is energy intensive. So
we will always have a need for that kind of cleanup.

(22:03):
And so it's just a scrubbing, a filtering type of
thing that you know, is an enabling technology.

Speaker 1 (22:10):
I have to say, I have a heat pump now,
and if my heat pump can figure out a way
to get cold out of the air and put it
into my house, or heat out of the air and
put it into my house, I'm sure we can figure
out a way to grab the carbon.

Speaker 6 (22:23):
I know that we already have figured it out. It's
just a way to make it less costly. And you know,
heat pumps are a great analogy. They've been around for decades,
and we're seeing more and more uptake of those as
the technology gets a little bit better, the engineering gets
a little cheaper, and so, you know, it's great to
see new technologies out in the market.

Speaker 1 (22:42):
So you mentioned you know that the level of helium
that's available goes up and down. How does that affect
your ability to do your research?

Speaker 6 (22:51):
Yeah, so it's incredibly stressful for researchers, I will, I
will admit. And so what it says is it's kind
of like being a rancher on a far you need
water to sustain your herd of cattle, let's say. And
these are very expensive, million dollar pieces of equipment that
in the absence of helium will crash. In essence, it

(23:12):
will change the state of matter and therefore it may
not be a magnet after it warms up. And yes,
you could try to cool it down again, but there's
no guarantee that it will return. So it's stressful because
we have to make sure that we have helium accessible
every few weeks, every few months in some cases, depending
on the age of the magnet. And so new innovations

(23:35):
are coming into the marketplace to recycle the helium which
are very encouraging. There's a learning curve for those, and
they are a little bit expensive on the front end,
but I think that we're finding alternatives both to what
the magnet is made up of, you know, the materials.
Maybe we could have materials that don't need liquid helium.
There are promising new developments to use liquid nitrogen as

(23:57):
a cooling agent, but they have to be entirely new designs,
entirely new materials, and so I think that it is stressful,
but there's still hopeful steps in the direction to avoid helium.
Because again, as you as we said at the top
of the program, every time we release those helium gases
into the atmosphere, it's gone, and so you know, having

(24:20):
a long term supply is really important.

Speaker 1 (24:22):
What got you interested in this in the first.

Speaker 6 (24:25):
Place, Well, I was a young faculty member beating multiple
magnets and then doing low temperature experiments, you know, at
for kelvin and so it's roughly the temperature of outer space.
So I was using extraordinary amounts of helium. And then
a few of these price shocks, the price started going up,

(24:47):
the supply started getting more and more difficult to acquire,
and I'm at a private institution Washington University, that turns
out to have a lot of a large footprint in
the helium market. And what I mean by is that
when shortages happened, there were enough of us around that
we could maybe use a little less.

Speaker 1 (25:06):
So what is your great hope about what you will
be able to you know, when you eventually retire, what
will you be able to say I did this.

Speaker 6 (25:15):
Well, certainly in carbon capture and in things like these
quantum science areas. I'm always hoping that we can inspire
the next generation to continue that work. I'm you know,
standing on the shoulders of other giants, let's say, who've
really helped facilitate a lot of that research. And I
hope we've made steps to really further the research mission.
And then in the helium space, I think there's a

(25:37):
couple of things. One is that I'm a scientist, but
I can also use some of these skills to help
the public understand better what these needs are for the
scientific community, because you know, we're scattered throughout the United
States where you know, one or two professors at each
institution as opposed to a nice solid lobbying block. And
I think the other thing is you know, helium is

(25:59):
an incredibly magical element. If you thought about being a
Connecticut Yankee in King Arthur's court and bringing a balloon
and that would float, that would be like incredible, you know,
a spectacle. And we're so fortunate to have this thing
that we kind of take for granted because it shows
up at so many parties. And so if we look
at that balloon and realize that that is millions upon

(26:21):
millions of years of formation of helium, one atom at
a time, and then to think, this is this precious
item and it should be a luxury meaning that we
have that we see it for what it is, is
this thing of beauty. And I think that I hope
at the end of my career that people will look
at helium differently. They'll recycle it, they'll try to capture

(26:45):
every bit that they can, because we want it to
be around in one hundred or two hundred years so
that we can continue to have MRI instruments and kids'
birthday parties.

Speaker 1 (26:54):
Well, why did it become so associated with kid's birthday parties?
Why isn't it seen as a luxury. Why is it
more likely to be found at party city than you know,
you know I fault somewhere.

Speaker 6 (27:06):
I think it's because, you know, we've lived in a
time of plenty Others have commented on this that we
have so much abundance and not realizing that one day
it's going to run out.

Speaker 5 (27:17):
I mean, we've gone through oil.

Speaker 6 (27:18):
Shocks for those of us who've lived through eras of
not having enough gasoline, or when you know, Persian Gulf
conflicts lead to sort of a cessation of shipping. Those
kinds of shortages have informed us and the helium one, well,
you know, you can always forego some balloons at a party,
but researchers an MRI instrument, folks, and semiconductor lines, and

(27:42):
it turns out rockets and other things we can't forego
that helium. And so in these it just says this
is a precious commodity and knowing that we should conserve
it means that there's an opportunity to innovate in that space.

Speaker 1 (27:59):
Is most of your funding for your research coming from
the federal government?

Speaker 6 (28:03):
Yes, almost exclusively National Science Foundation, some from the Department
of Energy, And that's pretty typical for people in this
area that spans you know, physics and chemistry, and.

Speaker 1 (28:15):
What has kept you at Washington University. What do you
find that you're able to do there, especially in this
area of research, that has made you decide to stay.

Speaker 6 (28:26):
Washington University is very closely associated with magnetic resonance. In
my particular area. I would argue two of the biggest
revolutions in this area have come through senior colleagues here.
So it's kept me here in part because the students
are amazing and it turns out Saint Louis is a

(28:46):
great place to live.

Speaker 1 (28:47):
Well, let's end on that point. The students. What do
you learn from your students as you do your work.
Give me an example of something where a student has
come in with an idea that you've been like, wow,
oh you know what, let's let's explore that a little bit.

Speaker 6 (29:03):
You know it's it's actually every nearly every student in
my research group. I have to say that this happened
to me as a grad student and I can reflect
on it. So I have regularly told my grad students
when they come to me with an idea, they'll come
and propose something. I'll say, wow, that sounds really hard.
I don't think it's gonna work. And what they do

(29:23):
is they run off and they don't take my advice, fortunately,
and then they go ahead.

Speaker 5 (29:29):
They do the experiment anyway.

Speaker 6 (29:31):
And I can think of nearly every student that has
happened at least once they've tackled something on their own.
And every time I am bursting with pride that students
have had the boldness and the creativity to go against
my you know, let's say, hard won wisdom of years
and years to prove me wrong. And I when they graduate,

(29:54):
this is often the story I tell about each of
them about how, you know, it's this slightly self de
precating or poking fun at myself story, but it's actually
this moment of incredible pride that it says, youth always
wins out over.

Speaker 5 (30:09):
Let's say the elder folks.

Speaker 6 (30:11):
And even though I can bring that wisdom to the table,
we've made some incredible discoveries. And that is almost always
driven by some of the grad students and some postdocs
having these really cool ideas that are crazy.

Speaker 1 (30:25):
That is Sophia Hayes, Professor of chemistry at Washington University
in Saint Louis. Thank you so much for joining us
and telling us so much about helium.

Speaker 6 (30:33):
Well, thanks for having me, and really thanks for shining
a light on this incredibly important resource of ours.

Speaker 1 (30:39):
A reminder that The Middle is available as a podcast
in partnership with iHeart Podcasts on the iHeart app or
wherever you listen to podcasts. In a moment, we'll meet
our third and final guest, who's trying to figure out
what causes Alzheimer's disease and cognitive decline in the elderly.
Stay with us more than Middle coming up. This is
the Middle. I'm Jeremy Hobbs. In this hour, we're taking

(31:01):
a break from politics to explore some of the cutting
edge scientific research that's being done in the geographic middle
of our country. Our final guest has spent years studying
a disease that more than six million Americans have that
would be Alzheimer's. The cognitive disease chips away at a
person's memory and thinking skills and is particularly difficult and

(31:21):
emotionally tasking for those who treat and care for people
with Alzheimer's. There's a search for a treatment and a cure,
but Joanne Schantz, a clinical neuropsychologist and professor at Utah
State University, is also trying to figure out what we
can do to avoid getting it in the first place. Joanne,
Welcome to the middle.

Speaker 4 (31:39):
Thank you.

Speaker 1 (31:41):
So there are an estimated seven million or so people
in America with Alzheimer's, which has not just an enormous
effect obviously on the people who have the disease, but
also the people who care for them those around them.
There's so much we don't know. What are the big
questions you have that you're trying to answer with your work.

Speaker 4 (32:02):
I'm very interested in individual differences because there's so much
variability across individuals in terms of the risk that they
have in developing Alzheimer's disease or other dementias, as well
as the clinical expression after disease onset. So I'm curious

(32:23):
to understand what makes one person you know, exhibit or
develop Alzheimer's disease, you know, decades before another individual. Is
it all genetics or are there some modifiable factors things
that we can do to try to reduce our risk
for developing Alzheimer's disease? And then even after dementia onset,

(32:46):
what factors influence the clinical expression.

Speaker 1 (32:50):
Is it surprising to you that with so many people
in this country dealing with this disease, that we don't
know those things yet.

Speaker 4 (32:58):
No, because people are so different. You know, my background
is different from your background as well as others, and
we've experienced so many different events in our lives, you know,
stressful lives or also maybe some people have advantages that
others don't, So there are disparities that can also influence risk.

Speaker 1 (33:22):
I guess for our audience, we should also just make
a distinction between Alzheimer's and dementia. What is the difference
between the two.

Speaker 4 (33:29):
So, dementia is simply a syndrome of symptoms that indicate
an individual has declined in cognition, memory, other domains so
that they can't function independently. There are a number of
different causes of dementia, and that's where we get into

(33:51):
specific conditions such as Alzheimer's disease or vascular causes of dementia,
or Lewis body dementia and so forth. So Alzheimer's disease
is the most common cause of dementia in late life,
but it certainly is not the only cause.

Speaker 1 (34:10):
So what kind of progress have you made? What have
you found about the reasons that people develop Alzheimer's disease.

Speaker 4 (34:17):
So we have examined differences in the risk between men
and women, So women in our cohort study of five
thousand individuals, we've found that women had higher risk of
Alzheimer's disease, especially after age eighty five. We've also found
some individual risk factors modifiable factors associated with increased risk

(34:41):
as well as reduction and risk, So things like healthy
diets like the Mediterranean diet or others have found the
mind diet to be somewhat protective in developing Alzheimer's disease.
We've also found that increased stressful life events might increase
one's risk of developing Alzheimer's disease, and those taking anti

(35:04):
inflammatory medications, for example, are associated with the reduction risk.
But these are all associational studies, and so really the
gold standard is to look at clinical trials where you
can take individuals randomly, assign them to a treatment versus
a control group, and then make conclusions based on the

(35:27):
results of the trial.

Speaker 1 (35:29):
Now you're there at a state university, a public institution.
Where does the funding come from for the research that
you do?

Speaker 4 (35:35):
So much of the research in the past we had
received a number of grants from the National Institute on
Aging that funded our large population based study of five
thousand individuals, the Cache County Study on Memory and Aging.
We also received additional funding from the National Institute on

(35:56):
Aging for ancillary studies related to following individuals who had
developed dementia in our cohort and follow them over time
to look at differences in the expression of dementia. We also,
now in this sort of phase of the research that

(36:18):
I'm engaged in, we are receiving funding from the state.
The Utah Legislature funded Utah State Universities first Alzheimer's Disease
and Dementia Research Center, which it's in its like maybe
second to third year, and the goal of this was
to fund research across the state, but it's housed here

(36:40):
at Utah State University. I also received some funding from
private foundation, the Emma Eccles Jones Foundation, But this allows
us to again, you know, continue our studies on looking
at individual indicators and risk factors for develop dementia as

(37:01):
well as those that might enhance successful aging.

Speaker 1 (37:05):
I imagine that governments, whether they be state government or
federal government, would have an absolute interest in this kind
of research because of the amount of money that it's
going to cost to care for so many people around
the state, and around the country and around the world
with Alzheimer's.

Speaker 4 (37:19):
Yes, that's absolutely true. I mean, if we could even
you know, slow the onset of frank dementia by five
years or so, that would result in tremendous amounts of
savings caregivers. Much of the care lands on the person's

(37:40):
family members, you know what we call informal care supports.
And you know, you have issues with lost wages when
people can't go to work because they have to care.
They are providing care for the persons with dementia, and
with the increase in the older adult segments of our
popular this is going to be substantial in years to come.

Speaker 1 (38:05):
I remember the first time I ever encountered somebody with Alzheimer's.
I was a kid and a couple down the street.
The wife had Alzheimer's and I remember going over to
their house and she thought that I was one of
her sons, which was just a really sad thing to experience.
I have since had a family member die after struggling

(38:29):
with Alzheimer's. I can see it on a really personal level.
What about you? What got you into this line of
research and work?

Speaker 4 (38:38):
So I've always been interested in psychology and clinical psychology
and people who struggle with mental health conditions. And I
know Alzheimer's is a neurological condition, but as I went
through my training, especially in the clinical training on my
internship and clinical postdoc, I was struck by and really

(39:00):
love working with older adults. I mean, these older adults
are survivors. They've survived, you know, decades into their sixties, seventies,
and eighties, and they're resilient. And so seeing patients who
suffer at the end of their lives with dementia and
you know, and suffering really hit me. And so I

(39:22):
wanted to see what I could do to help, you know,
help in the process of diagnosis, where neuropsychology is quite important,
but you know, more so in research where just to
understand the various illnesses that cause dementia and what can
be done and if there is no cure, what can

(39:42):
be done to help enhance the individual's quality of life.

Speaker 1 (39:46):
Are your students interested in this kind of thing?

Speaker 4 (39:49):
Oh? Yeah, my students. You know, I love my students.
They are great. They have a curiosity that just kind
of feeds some of the excitement and thinking in our
lab and you know, I think the big thing is
they have so many rich ideas that we have to say, well,
we have to scale it back because you do need

(40:11):
to graduate. You do need to finish your thesis and
your dissertation.

Speaker 1 (40:16):
Some of the best mentorship I've ever gotten has been
people saying, Okay, slow it down, Let's just take it
one piece at a time. You don't have to do
it all at once. Although it's great to have that
kind of energy and enthusiasm, I guess as a as
a student and think.

Speaker 4 (40:29):
Big definitely, and I think it's you know, some of
the best questions that are asked are those you know
who are new in the field. So they're like, gee,
I wonder why this you know? And then you just
look into it and there's some really cool, cool things
that can be studied and important discoveries made. So I

(40:53):
think the students add kind of a nice level of
enthusiasm and energy and a curiosity that you know, it
just helps to bring in the novelty to the process.

Speaker 1 (41:09):
So we've talked a lot about risk factors and what
people might be able to do to prevent themselves from
getting Alzheimer's in the first place. What about the cure side.
What kind of progress have you seen on that side
or treatment that can make it easier for people who
are dealing with it.

Speaker 4 (41:26):
Yeah, So on the cure side, there have been a
number of medications that have been FDA approved that have
been used for years. So these are drugs that, you know,
they're not cures, but they maybe provide a boost in functioning. Now,
some of the concerns about these medications is their substantial

(41:49):
side effects. So somewhere around thirty percent, maybe forty percent
of individuals may suffer from significant side effects that are
associated with like swelling in the brain or microbleeds, and
there's a particular genotype that's associated for increased risk of
those side effects. And so individuals who go on these

(42:11):
medications just need to be closely monitored. They need to
have MRI scans, and so the treating healthcare providers can
maybe adjust dosage and titrate, you know, more slowly to
get to an effective dose.

Speaker 1 (42:29):
It may not be a medical answer, but what about
people who are helping their family members or their loved
ones with Alzheimer's. What can be done for them to
make their lives easier? Do you think?

Speaker 4 (42:42):
Yeah, So the caregivers and the family members. I mean,
those individuals are really warriors. I mean, they take on
so much of their loved ones care and they're so
critical because we have found in our studies that those

(43:03):
caregivers who are closer to their care recipients actually have
such a positive impact. The care recipients decline more slowly
among those individuals who have very close relationships with their caregivers.
And some of this is due to maybe nutritional factors
where they're providing greater nutrition, or they're providing a cognitively

(43:28):
stimulating environment that's appropriate for the care recipient. But those
caregivers do take on a lot, and it can take
on a wear and tear, and so the caregivers need
to kind of recognize that perhaps they need to spread
the care, you know, and they list multiple siblings or

(43:49):
family members or even friends to take on aspects of care.
You know, perhaps they can oversee elements, so they're kind
of like the lead caregiver that then doles out various activities.
But they certainly can't take on everything. I mean, there
are books out there on burden, and you know, there's

(44:11):
a book that's called The thirty six Hour Day that definitely,
you know.

Speaker 1 (44:17):
Says it all right there in the title, Yeah.

Speaker 4 (44:19):
Right, exactly. It's not twenty four hours. It's more than that.

Speaker 1 (44:24):
You know, if you zoom out here. We have made
so much progress in healthcare, in keeping people alive longer,
keeping our bodies working longer, but keeping our minds healthy
along with our bodies has been more of a challenge.
Why do you think that is?

Speaker 4 (44:42):
I think it's because perhaps the medical profession has been
great in terms of identifying diseases and finding treatments. Alzheimer's
and cognitive change over time is multidetermined, and so there's
like this Lancet Commission on Model Fible Risk Factors for
Dementia that reviewed all the modifiable risk factors and there's

(45:06):
you know, a host of them. There's like, you know,
ten or so that are listed cognitively stimulating activities, midlife obesity,
high blood pressure, high cholesterol, air pollution, hearing loss, past
head injury, things that come with life. Right. We don't
just live in a vacuum. There are multiple things that

(45:27):
act our survival as well as our thinking. And so
with cognition and cognitive change, you can't just identify one thing.
They'll say this this is it. This is the magic bullet.
It's like multiple factors. So all of these things can combine.
You know, the diet that one eight did they eat

(45:47):
a lot of foods rich in rich in fats and sugars,
you know, things that we all kind of enjoy. But
did that lead to obesity? Did that cause heart disease?
And did that heart disease, you know, increase some of
the cardiovascular conditions that then increase one's risk for Alzheimer's disease.

Speaker 1 (46:07):
That all affects your brain. You're saying, everything that's happened
to your entire life has some elution.

Speaker 4 (46:11):
You know, does that increase inflammation in the brain and
help drive some of the neuropathological processes. So it's really
a multidetermined, multifaceted problem, and so I think the solution
would be also multifaceted.

Speaker 1 (46:29):
Let me just finally bring it back to the middle,
the name of the show, the geographic middle. What has
kept you in Utah all this time doing your work?
And what do you think you gain from being Alzheimer's
researcher professor in the middle of the country.

Speaker 4 (46:47):
What's kept me in Utah? I think the institution here
has been fantastic. I mean, this is a great environment
to do research. We have a lot of support in
the college and now with the Alzheimer's Disease Research Center.
We have also private foundations that help support the research.

(47:09):
And honestly, the collaborators that I have here have been fantastic.
So you know, we're embarking on multidisciplinary and interdisciplinary work
to look at modifiable factors that can prevent Alzheimer's disease
and enhance aging. And it really provides a rich environment

(47:34):
where you have researchers that interact with community members and
hopefully apply you know, found what's discovered in research, apply
it back to individuals in the community.

Speaker 1 (47:48):
And when you yourself decide, you know what, I want to
reduce my risk factors, get some exercise, get some fresh air.
You're in just the right place you can go anywhere
in Utah.

Speaker 4 (47:57):
Yeah, exactly right. We have great, beautiful mountains. It's a
beautiful community here.

Speaker 1 (48:04):
That is Joanne Schantz, who's a clinical neuropsychologist and professor
at Utah State University researching Alzheimer's disease. Thank you so
much for joining us.

Speaker 4 (48:13):
Thank you really appreciate it.

Speaker 1 (48:15):
Well, that does it for this special edition of The
Middle looking at examples of scientific research being done across
the geographic middle of our country. Next week it is Thanksgiving,
so we're taking a break and bringing you a very
appropriate encore episode about the increasingly popular drugs that many
people are using to lose weight, o zempic Manjara and

(48:35):
the like. We've got two leading obesity medicine doctors on
the panel and calls, of course from around the country
for people sharing their thoughts. You can leave us a
message at eight four four four Middle that's eight four
four four six four three three five three, or write
in at listen to the Middle dot com and while
you're there, sign up for our free weekly newsletter. The
week after next, we're back to our normal live shows

(48:56):
and some great ones coming up in the month of December.
Is brought to you by Longnook Media, distributed by Illinois
Public Media in Urbana, Illinois, and produced by Harrison Patino,
John Barth, Danny Alexander, and Sam Burmas Dawes. Our technical
director is Jason Kroft. Our theme music was composed by
Andrew Hagen. Our intern is an Akadeshler. Thanks to our
podcast audience, our satellite radio listeners, and the more than

(49:19):
four hundred and twenty public radio stations making it possible
for people across the country to listen to the Middle
I'm Jeremy Hobson. Talk to you next week.
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