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• Admissions Virtual Info Sessions (Oct 18, 2021)
  Join representatives from the Admissions Office, the DrPH Program Office, the MPH Program Office, and a few academic departments of the Johns Hopkins Bloomberg School of Public Health during one or both of our chat sessions. Information for these sessions can be found below:

  Tuesday, October 26, 12pm to 1pm (Eastern Time) - https://jh.zoom.us/meeting/register/tJwkcOmpqz4tGtYV9fQ_AJQQjLAJ6L1WH7Mv

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 Press Releases

• Johns Hopkins Center for Communication Programs Launches Comprehensive Global COVID Behavior Dashboard (Sep 14, 2021)

  In a global survey fielded last month, more than half of those who are unvaccinated in more than 50 countries indicated they definitely or probably won’t get a COVID-19 vaccine. A new dashboard launched today by the Johns Hopkins Center for Communication Programs (CCP) unpacks the survey findings and helps explain why—and how experts can work to increase acceptance rates. The center is based at the Johns Hopkins Bloomberg School of Public Health.
  
  The researchers found that the primary reasons around the world for resisting vaccination include fears about side effects, a desire to wait until more people have had the shots so they know they are safe, and a lack of confidence in whether the vaccine really works. 
  
  These latest survey results, based on responses fielded between August 16 and 31, can be found in the new COVID Behaviors Dashboard. The new dashboard contains survey results based on responses from more than 12 million people from 115 countries, fielded every day since May 20, 2021. The survey—believed to be the world’s largest daily survey of global COVID knowledge, attitudes, and practices—is expected to continue until the end of this year and new data will become available every two weeks.
  
  The dashboard is intended to be used by policymakers, government officials, and public health practitioners at national and sub-national levels to better understand the behavioral drivers behind vaccine uptake, masking, and physical distancing that can prevent the spread of COVID-19. 
  
  “Our analysis of this large trove of data finds that while vaccine hesitancy is real, there are many people around the globe who can be encouraged to get their doses—if public health officials can build and share their messages to address their concerns,” says Dominick Shattuck, PhD, CCP’s director of monitoring evaluation and learning and one of the leaders of the COVID behaviors project. 
  
  Adds Marla Shaivitz, CCP’s director of digital strategy: “The dashboard can be used as a roadmap for policymakers to identify and engage with citizens to encourage them to be vaccinated to protect themselves and their families from COVID-19. In many countries, this dashboard fills an important data gap. It offers the most comprehensive data some governments have access to on how COVID behaviors are changing and what they can do to intervene.” 
  
  The dashboard is the product of a collaboration among CCP, the World Health Organization’s Global Outbreak Alert and Response Network, and Facebook. The data are generated from the COVID-19 Trends and Impact Survey, which is administered in the United States by the Delphi Group at Carnegie Mellon University and in other countries by the University of Maryland Social Data Science Center. The two universities collect the survey data from random samples of Facebook users and CCP analyzes the responses.
  
  A previous COVID behaviors dashboard, also led by CCP, was based on smaller, less frequent surveys from June 2020 through March 2021.  
  
  In this latest survey, reasons for vaccine hesitancy vary by country. In Senegal, the two most common reasons for hesitancy are concerns about side effects and whether the vaccine is safe. Education around vaccine science and side effects could work to encourage vaccine uptake in Senegal. Respondents in the Netherlands were more likely than those in other countries to say that they don't believe they need a vaccine. When asked why not, their main reasons were because they are not a member of a high-risk group, or they don’t believe COVID-19 is a serious illness. Each underlying perception requires a different messaging response.  
  
  The dashboard sheds light on how other behaviors have evolved over the last four months as well. In the United States, for example, 65 percent of those who responded to the survey between August 16 and 31 said they had been shopping indoors in the previous 24 hours, and two thirds of those who had been shopping said they wore masks. Mask wearing steadily decreased in the U.S. until the middle of July but has been rising since the highly transmissible Delta variant became the dominant strain, and case counts and hospitalizations began rising again to record levels in many states. 
  
  In India, where an outbreak has fallen from its May peak, only 29 percent of respondents had been shopping indoors in the previous 24 hours and the vast majority of them (87 percent) were wearing masks, suggesting there is a long way to go before things get back to normal. 
  
  Since March 2020, nearly 225 million COVID cases—and 4.6 million deaths—have been reported around the world, according to Johns Hopkins University’s COVID-19 dashboard. More than 5.3 billion vaccine doses have been administered globally, though just over two percent of those doses have been administered in Africa. USAID has sent more than 110 million doses to low- and middle-income countries and COVAX, a worldwide initiative aimed at equitable access to COVID-19 vaccines, has distributed more than 236 million doses. As vaccine access increases, governments will need to develop strategies to sensitize citizens to accurate information and the benefits of vaccines. 
  
  In addition to findings about vaccine hesitancy, the dashboard also features data on why many people who want vaccines can’t seem to access them. In Brazil, for example, where 65 percent of the unvaccinated respondents in the August 16–31 survey period said they probably or definitely want a vaccine, 23 percent of those who want one said they couldn’t get a shot because they are not eligible for one, and 34 percent said there were no appointments available.
  
  Armed with knowledge from the dashboard, officials in those countries can aim to work with local communities to make vaccine appointments more accessible—once vaccines are widely available—and to better spread the word about appointments that are available and when, where, and how to secure them. 
  
  “We are at a critical time for global COVID-19 vaccine rollouts, yet populations are oversaturated with information, disinformation, and rumors,” says Jeni Stolow, PhD, MPH, Risk Communication and Community Engagement Focal Point at WHO’s Global Outbreak Alert and Response Network. “Continuously producing timely evidence-based and effective health communication is a major challenge in this second year of the pandemic. This dashboard can support public health practitioners around the globe in their endeavors to tailor, target, and reinvigorate their local COVID-19 vaccine outreach efforts.”  
  
  While many unvaccinated people around the world say they are unlikely to get vaccinated, in many countries, large percentages of the population say they would choose to get their children vaccinated once a vaccine becomes available. In India and Guatemala, well over 90 percent of survey respondents said they would definitely or probably vaccinate their children. Data from August 16 through 31 show the figure was 86 percent in Mozambique, 72 percent in the United States, and 47 percent in Serbia. 
  
  “The volume of data that has and will continue to be collected on COVID-19 will be of great value to policymakers and health practitioners, if the data are strategically used,” says Douglas Storey, PhD, CCP’s director for communication science and research. “This dashboard offers deep insights into behaviors around the world and will be a guide for those aiming to stop the spread of this devastating disease.” 
  
  CCP is hosting a webinar about the new dashboard with experts from the center and WHO’s Global Outbreak Alert and Response Network on Tuesday, September 21, 2021, at 9:30 a.m., ET. Click here for more information and to register.  
  
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  Media contacts: Stephanie Desmon at sdesmon1@jhu.edu and Carly Kempler at ckemple2@jhu.edu.

• Food Insecurity During College Years Linked to Lower Graduation Rate (Sep 14, 2021)

  A study led by a researcher at Johns Hopkins Bloomberg School of Public Health found that food insecurity among college students is associated with lower college graduation rates and lower chances of obtaining a bachelor’s or advanced degree.

  Food insecurity is a household’s lack of consistent access to adequate food resources. The study examined a nationally representative sample of 1,574 college students in 1999–2003 to assess whether they lived in a household experiencing food insecurity. They found that nearly 15 percent of the students qualified as food insecure. Following up on data on educational attainment through 2015–2017, the researchers found that students in the food-insecure group were more than 40 percent less likely to graduate from college and more than 60 percent less likely to achieve a graduate or professional degree.

  Food-insecure students whose parents and grandparents had not attended college fared even worse in terms of educational attainment—less than half graduated from college.

  The study was published online July 31 in the journal Public Health Nutrition.

  “These results suggest that we really need robust policies to address food insecurity among college students, especially now with the higher food insecurity levels observed during the COVID-19 pandemic,” says study lead author Julia Wolfson, PhD, assistant professor in the Department of International Health at the Bloomberg School.

  For the study, Wolfson and her colleagues examined data from a long-running U.S. government-sponsored project called the Panel Study of Income Dynamics, which has followed a nationally representative set of several thousand families in the U.S. since 1968, using annual—or, since 1997, biennial—surveys to collect sociodemographic, economic, and health information on family members. The researchers drew from this dataset a sample of 1,574 individuals who were enrolled in higher education at any point during the 1999–2003 surveys and were still being tracked in the 2015 or 2017 surveys. They classified a student as food-insecure if they or their parents reported being food-insecure at any point when they were college students in 1999–2003. Most of the students in the sample attended college while living at home as dependents in a household.

  Even after adjusting for other factors known to be linked to higher or lower educational attainment, Wolfson and colleagues found a strong inverse association between household food insecurity and educational attainment. Students from food-insecure households were 43 percent less likely to graduate from college, including with an associate’s degree; 43 percent less likely to attain a bachelor’s degree;  and 61 percent less likely to attain a graduate or professional degree, compared to non-food-insecure students.

  The analysis suggested that being a “first-generation student”—the first in a family to attend college—was another factor strongly associated with lower educational attainment. While 76 percent of students who were “food secure” and not first-generation students graduated from college, only 59 percent of food secure but first-generation students graduated from college—and less than half, only 47 percent, of food-insecure first-generation students graduated.

  The study, Wolfson notes, is thought to be the first to examine food insecurity’s effects on educational attainment in a study that tracks data for the same group of people over time. These results suggest that food insecurity is not just associated with but a contributing cause of lower educational attainment.

  The study was written with colleagues at the University of Michigan and the Providence VA Healthcare System. The researchers are following up with studies of college-age food insecurity’s links to other outcomes such as employment and income.

  “The effect of food insecurity during college on graduation and type of degree attained: evidence from a nationally representative longitudinal survey” was written by Julia Wolfson, Noura Insolera, Alicia Cohen, and Cindy Leung.

  The research was supported by the Economic Research Service and Food and Nutrition Service in the U.S. Department of Agriculture; the National Institutes of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health (#K01DK119166); the Eunice Kennedy Shriver National Institute for Child Health and Human Development (#4R00HD084758); and the Department of Veterans Affairs Health Services Research & Development (#CDA20-037).
  
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  Media contacts: Brandon Howard at  brandonhoward@jhu.edu and Barbara Benham at bbenham1@jhu.edu.

• Use of Dexamethasone, Remdesivir Against COVID-19 Varied Widely Across U.S. Health Systems (Sep 14, 2021)

  As many as one-fifth of patients hospitalized with severe COVID-19 in the United States who may have benefitted from treatment with the anti-inflammatory steroid dexamethasone or closely related drugs were not given such treatment at the height of the pandemic, according to a large, nationwide study led by researchers at Johns Hopkins Bloomberg School of Public Health.

  The study also found that the use of dexamethasone and another drug, the antiviral remdesivir, varied greatly across health systems in the U.S. Dexamethasone and remdesivir are among a handful of recommended treatments for patients hospitalized with COVID-19 who require oxygen.

  For their study, the researchers analyzed anonymized health records of 137,870 people hospitalized in the United States with suspected or confirmed COVID-19 for the thirteen-month period from February 2020 through February 2021.

  The research is published online August 16 in Annals of Internal Medicine.

  “These findings underscore the wide variation in COVID-19 care across American health systems,” says study lead author Hemalkumar Mehta, PhD, assistant professor in the Department of Epidemiology at the Bloomberg School. “This variation is vital to understand, since it may indicate that many patients who would benefit from these treatments may not be receiving them.”

  Dexamethasone is an inexpensive and widely available steroid drug that has been in use in the U.S. since the early 1960s, chiefly to reduce serious inflammation in severe arthritis or allergic anaphylactic shock. The drug became a standard clinical weapon against severe COVID-19 worldwide after a U.K. clinical study, whose results were announced in June 2020, found that it reduced mortality by more than one-third when given to ventilated COVID-19 patients, and by more than one-fifth when given to patients who were getting supplemental oxygen.

  Remdesivir, an antiviral drug originally developed as a treatment for Hepatitis C virus infection, showed efficacy against the coronavirus that causes COVID-19 in early lab-dish tests. Later, in large clinical trials, its use significantly cut the lengths of COVID-19 patients’ hospital stays. In May 2020, remdesivir received emergency use approval in the U.S. for treating COVID-19, and in October 2020 it received full FDA approval.

  To get a sense of how these drugs were put to use against COVID-19 in the U.S., the researchers analyzed data from the National COVID Cohort Collaborative (N3C), a National Institutes of Health-sponsored collection of electronic health records on millions of COVID-19 patients from 43 health systems nationwide. The study covered 137,870 adults who were hospitalized with COVID-19, and met other criteria—for instance, those hospitalized for at least one day—between February 1, 2020 and February 28, 2021.

  The analysis showed that the rate of dexamethasone use in hospitalized COVID-19 patients—with or without mechanical ventilation—climbed steeply in June 2020 and continued to climb until it peaked in mid-November at just over 50 percent of patients. Usage then fell to about one-third of patients by late February 2021.

  The rate of remdesivir use showed a similar pattern, peaking in November 2020 at about 35 percent. The results also showed that the rate of use of the drug hydroxychloroquine rose to about 42 percent in March 2020 but fell back to near zero the following month, after clinical trial evidence suggested that it was ineffective against COVID-19.

  Dexamethasone use was higher among patients whose COVID-19 was severe enough to require mechanical ventilation to support the lungs. However, even after June 2020 when dexamethasone’s efficacy had been established, the rate of its use in ventilated patients varied widely across the 40 health systems represented by the data, with a median value of only 80 percent. The analysis revealed that the rate of remdesivir use in hospitalized COVID-19 patients also varied widely across health systems.

  The findings, the researchers say, suggest the possibility that dexamethasone has been underused in patients with severe COVID-19, and more generally that clinical practice for treating COVID-19 has not developed a set of uniform standards.

  In an accompanying editorial, Marshall J. Glesby, MD, PhD, and Roy M. Gulick, MD, MPH, of Weill Cornell Medicine, highlight the evolving evidence on COVID-19 treatments and its influence on treatment uptake, including considerable variation among U.S. health systems.

  “The COVID-19 pandemic unleashed a wave of scientific activity to identify new or repurposed treatments to halt the disease,” says G. Caleb Alexander, MD, MS, a study author and professor in the Bloomberg School’s Department of Epidemiology. “It is vital that these treatments are used consistently across hospitals and health systems, so as to prevent as much death and disability as possible.”

  The researchers note that their analysis did not take into account factors such as drug shortages and differences between COVID-19 patients receiving oxygen supplementation—differences that might help explain some of the apparent variation in treatment utilization rates.

  “It’s possible that, for example, some hospitals had sicker patients on average compared to other hospitals—it will be critical to understand the potential factors in future investigations,” Mehta says.

  “Use of Hydroxychloroquine, Remdesivir, and Dexamethasone Among Adults Hospitalized With COVID-19 In The United States” was co-authored by Hemalkumar Mehta, Huijun An, Kathleen Andersen, Omar Mansour, Vithal Madhira, Emaan Rashidi, Benjamin Bates, Soko Setoguchi, Corey Joseph, Paul Kocis, Richard Moffitt, Tellen Bennett, Christopher Chute, Brian Garibaldi, and G. Caleb Alexander.

  Support was provided in part by the National Institute on Aging (1K01AG070329-01) and the National Heart, Lung, and Blood Institute (T32HL139426-03).

  Disclosures:
  
  Caleb Alexander is past Chair of FDA’s Peripheral and Central Nervous System Advisory Committee; has served as a paid advisor to IQVIA; is a co-founding principal and equity holder in Monument Analytics, a health care consultancy whose clients include the life sciences industry as well as plaintiffs in opioid litigation; and is a member of OptumRx’s National P&T Committee.

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  Media Contacts: Carly Kempler at ckemple2@jhu.edu and Barbara Benham at bbenham1@jhu.edu.

• Sex Ed Curriculum Elevates Pregnancy Prevention Skills Among Native American Teens (Oct 15, 2021)

  A sex education program delivered in the setting of a two-week summer basketball camp in Arizona significantly impacted key factors associated with pregnancy prevention among Native American teens, researchers at the Johns Hopkins Bloomberg School of Public Health show in a new study.
  
  The findings, published online September 16, 2021 in the American Journal of Public Health, show the program provides Native teens with effective skills to avoid both pregnancy and sexually transmitted infections (STIs).
  
  Despite recent declines, U.S. rates of teen pregnancy are higher than any other developed nations, with 19 births per 1,000 girls, according to the Centers for Disease Control and Prevention. The rates for Native American teen births are nearly twice that, at 33 births per 1,000 girls, the highest teen birth rate in the U.S.
  
  ”Native teens need programs that are specifically designed for them and proven to work, which is what makes the results from this study so exciting,” says Lauren Tingey, associate director of the Johns Hopkins Center for American Indian Health and associate scientist in the Bloomberg School’s Department of International Health.
  
  Such teen births have numerous consequences to these young parents and society, notes Tingey. For example, babies born to teen mothers are more likely to be premature or of low birth weight, resulting in long-term health problems. Teen parents are more likely to live in poverty; drop out of high school; be incarcerated as teens; and their children are more likely to become teen parents themselves.
  
  Although the majority of U.S. teens receive school-based sexual health education aimed at preventing teen pregnancy and sexually transmitted infections, it is not required in Arizona. Fewer than one-third of Arizona schools offer sexual health programs, and parents are allowed to opt their children out.
  
  Seeking a better way to deliver sex education to tribal members, a Native American tribe in Arizona approached the Johns Hopkins Center for American Indian Health to develop a program specific to Native youth. After meetings and focus groups with stakeholders, including tribal youth, parents, public health experts, and health care providers, Tingey and colleagues adapted an existing intervention that includes nine different lessons aimed at increasing sexual health knowledge, self-efficacy, intention, and communication. The new curriculum, known as Respecting the Circle of Life, is culturally tailored to Native communities and recognizes their unique strengths and challenges, Tingey explains.
  
  To increase participant retention, the researchers delivered the first eight lessons during free two-week summer basketball camps in 2016, 2017, and 2018, rather than over eight weeks specified in the original program. A “control” group of participants in the same camps received eight lessons on topics unrelated to sexual health, such as nutrition, fitness, outdoor recreation, and nature. All participants received a ninth lesson at home three months after camp ended that incorporated a parent or other trusted adult.
  
  Before these lessons began and at 9 and 12 months after the camp ended, the 534 study participants filled out questionnaires that assessed a broad range of sexual health knowledge, attitudes, and behaviors. Results show that nine months after completing the lessons, those who received the Respecting the Circle of Life curriculum had significantly higher condom use self-efficacy, intention, and negotiation skills; other contraceptive use self-efficacy and negotiation skills; and intention to abstain from sex compared to those who received a separate curriculum on non-sexual topics.
  
  The results also showed longer-term impacts of the program. At nine months after the program ended, youth who received the Respecting the Circle of Life curriculum reported having more conversations with their parents about sexual and reproductive health. One year after completion, youth who participated in the Respecting the Circle of Life program had higher sexual and reproductive health knowledge scores and continued to have more communication with their family about sexual and reproductive health.
  
  Tingey notes that it’s yet unknown whether the education and skills imparted by Respecting the Circle of Life program will affect teen pregnancy rates and STI rates, something they plan to evaluate in the coming years. However, she says, the findings show promise in giving Native teens the knowledge and skills they need to accomplish this goal.
  
  “We think this program has real potential to empower Native youth to take control over their sexual and reproductive health,” Tingey says. “The program is being used in several other states and we think given this success it can be applied to even more.”
  
  “Prevention of Sexually Transmitted Diseases and Pregnancy Prevention Among Native American Youth” was co-authored by Rachel Chambers, Hima Patel, Shea Littlepage, Shauntel Lee, Angelita Lee, Davette Susan, Laura Melgar, Anna Slimp, and Summer Rosenstock.
  
  This study was supported by the Department of Health and Human Services’ Office of Population Affairs.

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  Media contacts: Rose Weeks at rweeks@jhu.edu and Carly Kempler at ckemple2@jhu.edu.

• Brain Organoid Study Highlights Potential Role of Genetic and Environmental Interaction in Autism Spectrum Disorder (Oct 15, 2021)

  Study Illustrates A Quicker And Less Expensive Way To Explore Gene-Plus-Environment Causes Of Autism Spectrum Disorder And Other Conditions

  Researchers at Johns Hopkins Bloomberg School of Public Health have shown in a brain organoid study that exposure to a common pesticide synergizes with a frequent autism-linked gene mutation.
  
  The results represent one of the clearest pieces of evidence yet that genetic and environmental factors may be able to combine to disturb neurodevelopment. Researchers suspect that genetic and environmental factors might contribute to the increased prevalence of autism spectrum disorder, a developmental disorder characterized by cognitive function, social, and communication impairments.
  
  The study’s use of brain organoids also points the way towards quicker, less expensive, and more human-relevant experimentation in this field when compared to traditional animal studies.
  
  The brain organoid model, developed by the Bloomberg School researchers, consists of balls of cells that are differentiated from human stem cell cultures and mimic the developing human brain. The researchers found in the study that chlorpyrifos, a common pesticide alleged to contribute to developmental neurotoxicity and autism risk, dramatically reduces levels of the protein CHD8 in the organoids. CHD8 is a regulator of gene activity important in brain development. Mutations in its gene, which reduce CHD8 activity, are among the strongest of the 100-plus genetic risk factors for autism that have so far been identified.
  
  The study, which appears online July 14 in Environmental Health Perspectives, is the first to show in a human model that an environmental risk factor can amplify the effect of genetic risk factor for autism.
  
  “This is a step forward in showing an interplay between genetics and environment and its potential role for autism spectrum disorder,” says study lead Lena Smirnova, PhD, a research associate in the Department of Environmental Health and Engineering at the Bloomberg School.
  
  Clinically rare as recently as 40 years ago, autism spectrum disorder now occurs in roughly two percent of live births, according to the Centers for Disease Control and Prevention.
  
  “The increase in autism diagnoses in recent decades is hard to explain—there couldn’t have been a population-wide genetic change in such a short time, but we also haven’t been able to find an environmental exposure that sufficiently accounts for it,” says study co-author Thomas Hartung, MD, PhD, professor and Doerenkamp-Zbinden Chair in the Bloomberg School’s Department of Environmental Health and Engineering. Hartung is also director of the Center for Alternatives to Animal Testing at the Bloomberg School. “To me, the best explanation involves a combination of genetic and environment factors,” says Hartung.
  
  How environmental factors and genetic susceptibilities interact to increase risk for autism spectrum disorder remains mostly unknown, in part because these interactions have been difficult to study. Traditional experiments with laboratory animals are expensive and, especially for disorders involving the brain and cognition, of limited relevance to humans.
  
  Advances in stem cell methods in the past decades have allowed researchers to use human skin cells that can be transformed first into stem cells and then into almost any cell type and studied in the lab. In recent years, scientists have expanded beyond simple lab-dish cell cultures to make cultures of three-dimensional organoids that better represent the complexity of human organs.
  
  For their study, the researchers used brain organoids to model the effects of a CHD8 gene disruption combined with exposure to chlorpyrifos. A group led by co-author Herbert Lachman, MD, professor at Albert Einstein College of Medicine, engineered the cells that make up the organoids to lack one of the two normal copies of the CHD8 gene. This modeled a substantial, but less-than-total, weakening of the CHD8 gene’s activity, similar to that seen in people who have CHD8 mutations and autism. The researchers then examined the additional effect of exposure to chlorpyrifos, which is still widely used on agricultural produce in the U.S. and abroad.
  
  “High-dose, short-term experimental exposures do not reflect the real-life situation, but they give us a starting point to identify genetic variants that might make individuals more susceptible to toxicants,” says Smirnova. “Now we can explore how other genes and potentially toxic substances interact.”
  
  The researchers found that the brain organoids with just one copy of the CHD8 gene had only two-thirds the normal level of CHD8 protein in their cells, but that chlorpyrifos exposure drove CHD8 levels much lower, turning a moderate scarcity into a severe one. The exposure demonstrated clearly how an environmental factor can worsen the effect of a genetic one, likely worsening disease progression and symptoms.
  
  As part of their study, the researchers compiled a list of molecules in blood, urine, and brain tissue that prior studies have shown to be different in autism spectrum patients. They found that levels of several of these apparent autism biomarkers were also significantly altered in the organoids by CHD8 deficiency or chlorpyrifos exposure, and moreso by both.
  
  “In this sense, we showed that changes in these organoids reflect changes seen in autism patients,” Smirnova says.
  
  The findings, according to the researchers, pave the way for further studies of gene-environment interactions in disease using human-derived organoids.
  
  “The use of three-dimensional, human-derived, brain-like models like the one in this study is a good way forward for studying the interplay of genetic and environmental factors in autism and other neurodevelopmental disorders,” Hartung says.
  
  “Gene–Environment Interactions in Developmental Neurotoxicity: A Case Study of Synergy between Chlorpyrifos and CHD8 Knockout in Human BrainSpheres” was written by Sergio Modafferi, Xiali Zhong, Andre Kleensang, Yohei Murata, Francesca Fagiani, David Pamies, Helena Hogberg, Vittorio Calabrese, Herbert Lachman, Thomas Hartung, and Lena Smirnova.
  
  The study was funded in part by the Alternatives Research and Development Foundation and the Environmental Protection Agency (R839505).
  
  Disclosures:
  
  Thomas Hartung, Helena Hogberg, and David Pamies are named inventors on a patent by Johns Hopkins University on the production of mini-brains (also called BrainSpheres), which is licensed to AxoSim, New Orleans, Louisiana, USA. Thomas Hartung, Lena Smirnova, David Pamies, and Helena Hogberg are consultants for AxoSim, New Orleans, and Thomas Hartung is also a consultant for AstraZeneca and American Type Culture Collection (ATCC) on advanced cell culture methods. All other authors declare they have no actual or potential competing financial interests.

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  Media contacts: Michael Hughes at mhughe18@jhu.edu and Carly Kempler at ckemple2@jhu.edu.