2021-2022 Annual Report by University of Miami Department of Psychiatry and Behavioral Sciences

University of Miami Miller School of Medicine Department of Psychiatry and Behavioral Sciences

Annual Report 2021–2022

Common Purpose Our mission is to conduct research that deepens our understanding of the development, pathophysiology, and prevention of psychiatric illness; oﬀer comprehensive treatment and care to our patients, their families and the community; and provide outstanding mental health education and multidisciplinary training to the next generation of health care providers and investigators. Soffer Clinical Research Center 1120 NW 14th Street Miami, Florida 33136 Telephone: 305.243.4000 psychiatry@med.miami.edu Editors Samantha Richter Robert S. Benchley

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Dear Friends: During 2021 and 2022, the COVID-19 pandemic continued to dominate much of the news coverage, as well as medical care overall. In the field of psychiatry, however, there were many exciting developments in a variety of other areas, and the Department of Psychiatry and Behavioral Sciences at the University of Miami Miller School of Medicine continued to do groundbreaking work.

Suppose you could predict which treatments might produce the best results — and test those predictions before administering treatment? Sound like science fiction? It isn’t, thanks to the “digital twin” program made possible by our new Media and Innovation Lab. Its MILBox contains the most cutting-edge, patient-worn and in-home devices on the market. This technology captures the patient’s data over seven days, enabling clinicians to virtually test therapies on the digital twin before applying them to the actual patient. It’s tomorrow’s health care today!

Our Center for Cognitive Neuroscience and Aging, a destination center for the treatment of Alzheimer’s disease and related disorders, reached new heights in advancing education, engaging the community and innovating in ways that led to significant increases in federal and state funding for its research programs. In a push toward increasing more diverse representation in our clinical trials, the Center recruited nearly 250 African American older adults to participate in Alzheimer’s research. Its training program helped more than two dozen students and young researchers prepare to be the next generation of Alzheimer’s disease clinician-scientists.

The problem of addiction continues unabated in the United States, and our Division of Addiction Psychiatry is stepping up to meet the challenge. First, we are creating new treatment pathways by training medical students, residents and other clinicians to have real therapeutic conversations with patients, dive into the unique complexities of each case and develop successful care plans. The key is finding the right combination of interventions for each patient. Second, our researchers are rethinking how addiction works in the brain. Learning more about how molecular mechanisms lead to relapse can help us devise better treatment strategies.

In 2021, for the first time, the Mild Cognitive Impairment Symposium, Workshop, and Public Educational Forum, was held virtually due to the pandemic, and our faculty made significant presentations. The 2022 Symposium, which we co-chaired, introduced the first Alzheimer’s Public Educational Forum for patients, family members and caregivers, as well as persons interested in participating in clinical research and clinical trials.

As our work progresses, we are developing new tools to address cognitive decline. Two of our faculty members, with others consulting, launched i-Function, a company that is developing online tools to identify mild cognitive decline at its earliest stages and help people develop new technological skills.

And while we all occasionally complain that we don’t get enough sleep, it can have serious health implications in areas such as cardiovascular disease and dementia. Our new Center for Translational Sleep and Circadian Sciences will look at how interventions aimed at better sleep quality can improve health — especially for minority populations that are disproportionately aﬀected by problems associated with sleep. The Center will also accelerate new sleep-related collaborations among our faculty and colleagues in other specialties.

Another significant contribution was our UHealth Therapeutic Program for Adult Suicide Prevention, which helps local at-risk adults get beyond extreme levels of distress and suicidal ideation. Suicide is the 11th-leading cause of death in the United States, and many of our patients have said that the quality of our program stands out compared with others they have participated in.

Overall, our faculty continued their world-class research activities and clinical care, with 14 members receiving recognition and awards for their work, which would not have been possible without the foresight and generosity of our funders and donors. In addition, we were joined by 11 new faculty members, who have brought their own innovative ideas and projects to strengthen our Department. I am extremely proud to lead this faculty, and I invite you to read about these exciting developments in this publication. Sincerely,

Barbara J. Coﬀey, M.D., M.S.

Center for Cognitive Neuroscience and Aging Excels in Outreach, Innovation

“Our community outreach in the past two years has been and continues to be one of our major accomplishments. We work hard to engage the communities that we serve to recruit cross-cultural demographics of people.” Elizabeth Crocco, M.D.

Photo: Dilok Klaisataporn

2021 and 2022 were pivotal years for the Center for Cognitive Neuroscience and Aging (CNSA). By employing state-of-the-art techniques to diagnose and treat cognitive disorders, the CNSA further solidified its position as a destination center for the treatment of Alzheimer’s disease (AD) and AD-related disorders. The Center reached new heights in advancing education, engaging the community, and innovating in ways that led to a significant increase in federal and state funding for its clinical research programs. Through building meaningful relationships with South Florida’s community leaders and residents, the CNSA recruited nearly 250 African American older adults to participate in AD research. “This exceeded expectations and was the result of years of building relationships,” said CNSA’s Director and leading researcher, David Loewenstein, Ph.D., ABPP/CN. “Engaging underrepresented groups to participate in Alzheimer’s research is part of the CNSA’s collaborative work with the 1Florida Alzheimer’s Disease Research Center (ADRC), a statewide consortium that makes up one of 37 NIA-designated Centers of Excellence in the U.S.,” according to Rosie Curiel Cid, Psy.D., the CNSA’s Chief of Cross-cultural Neuropsychology and Cognitive Neurosciences and the Director of the Outreach, Recruitment and Engagement Core of the ADRC. Currently, the CNSA hosts multiple federal and statefunded studies totaling over $15 million. Both Drs. Loewenstein and Curiel Cid also have $8.1 million in additional pending funding to

Dr. David Loewenstein

Dr. Elizabeth Crocco

further their scientific work. Dr. Loewenstein directs the Clinical Core of the 1Florida ADRC, located at the University of Miami (UM). Elizabeth Crocco, M.D., Professor and Chief of Geriatric Psychiatry, provides expert clinical leadership for the ADRC and all CNSA projects. Dr. Crocco is also the Medical Director of the University of Miami’s state-funded Memory Disorders Clinic. “Our community outreach in the past two years has been and continues to be one of our major accomplishments. We work hard to engage our local communities to engage older adults and educate them about brain health. We have recruited older adults who are representative of the rich cross-cultural landscape of Florida; particularly African Americans but also Hispanics and Afro-Caribbeans,” said Dr. Crocco. “And we accomplished this in the middle of the pandemic.” People who identify as Black or African American in particular are part of a cultural group that has been understudied and underrepresented in AD research. The CNSA is advancing toward the development of a cure for Alzheimer’s disease that includes the evaluation of diverse and often overlooked cultural groups. “We have been working hard to strengthen relationships and be of service to our community via faith-based organizations and community centers, as well as by engaging with physicians who serve individuals from these traditionally underrepresented groups,” Dr. Curiel Cid said. The CNSA has expanded its role in the 1Florida ADRC and directs all outreach across the entire state. The CNSA is one of the most prolific Centers at UM in terms of team science, novel tools for cognitive assessment

Dr. Rosie Curiel Cid

“It’s one thing to publish science in medical literature, but when you have the opportunity to share your scientific work with individuals in the community, it comes alive in diﬀerent, and meaning-filled ways.” Rosie Curiel Cid, Psy.D. of neurodegeneration and state-of-the-science neuroimaging and plasma biomarkers. CNSA investigators incorporate and quantify amyloid Positron Emission Tomography (PET), a minimally invasive diagnostic imaging scan that is able to look at the amyloid plaques that are being deposited in the brains of patients with Alzheimer’s disease in vivo. In addition, the Miller School is one of the only locations in Florida that also performs tau PET imaging, which identifies tau protein in the brain. Tau deposition in the brain helps to follow the progression of neurodegenerative disorders, like Alzheimer’s disease.

One unique aspect of the 1Florida ADRC as it relates to both professional and lay education is the Annual MCI Symposium and the accompanying Public Education Forum. Our academic-community partnerships thus far have facilitated broad dissemination of this forum that serve as a bridge to support the goals of the CNSA. This forum allows Alzheimer’s disease and related disorders stakeholders across the state and country to “meet the scientists” to foster some of the activities that the center very much cares about: education, recruitment of new participants, retention of existing participants and collaboration with other Alzheimer’s Disease Centers (ADC). This is one innovative example for the Center’s Outreach, Recruitment and

Dr. Crocco has developed a program to follow underrepresented older African Americans at risk for Alzheimer’s disease, a brain health registry that encompasses the diverse South Florida population. The CNSA uses the registry to educate older adults and care partners within the community. “The registry involves a detailed clinical examination, neuropsychological testing, and the interpretation of brain biomarkers and bloodwork,” Dr. Crocco said. The CNSA follows more than 1,000 people every year in its various research studies. “Once persons become research participants, we ask them to be partners for life,” Dr. Loewenstein said. “Not only can we determine what abnormal aging is, but we can also look at people who have pathology in the brain and still maintain their cognition to discover those factors that help keep people healthy and cognitively intact.” “We strive to bring more awareness about how to age healthily,” said Dr. Curiel Cid. “It’s one thing to publish science in medical literature, but when you have the opportunity to share your scientific work with individuals in the community, it comes alive in diﬀerent, and meaning-filled ways.”

Engagement Core, given the transition to a virtual event for the first time. This is a special educational event, a unique contribution from our 1Florida ADRC to the overall ADC network. In 2020, Dr. David Loewenstein, Director of the CNSA, and his team of expert investigators, together with other Florida institutions, were awarded a $15 million grant to collaborate on Alzheimer’s disease research. The five-year National Institutes of Health/National Institute on Aging grant brings together top Florida researchers to focus on better understanding how to diagnose, treat, prevent, and potentially cure Alzheimer’s in diverse populations. The consortium of these institutions is the 1Florida Alzheimer’s Disease Research Center.

Rosie Curiel Cid, Psy.D., Associate Professor, Co-Chairs the Alzheimer’s Public Educational Forum

“Everybody wants answers, disease-modifying treatments or a cure, and we are working determinedly to find them.” Rosie Curiel Cid, Psy.D.

In 2021, for the first time, the Mild Cognitive Impairment (MCI) Symposium, Workshop, and Public Educational Forum was held virtually. A restructure of the usually in-person program consisted of live presentations, Q&A sessions and panel discussions. Presented by The Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center and 1Florida Alzheimer’s Disease Research Center, the event offers a space where new information is provided and in-depth discussions take place about the earliest stages of Alzheimer’s disease and related disorders. Speakers included experts in the fields of neurology, neuropsychology, psychiatry, geriatrics, epidemiology, genetics, imaging and neuropathology. In 2022, the MCI Symposium introduced the first Alzheimer’s Public Educational Forum for patients, family members and caregivers, as well as persons interested in participating in clinical research and clinical trials. This segment originated in response to the need for increased information from the general public about risk factors, early detection, prevention and treatment of Alzheimer’s disease and related conditions. The prevalence of Alzheimer’s disease has continued to increase considerably.

By 2025, the number of people age 65 and older with Alzheimer’s dementia is projected to reach 7.1 million — almost a 22% increase from the 5.8 million age 65 and older aﬀected in 2020. The Public Educational Forum was sponsored by Mount Sinai Medical Center, Miami Beach, the University of Florida and the 1Florida ADRC. Rosie Curiel Cid, Psy.D., Associate Professor and Chief of Cross-Cultural Neuropsychology and Cognitive Neuroscience, co-chaired the virtual forum, and David Loewenstein, Ph.D., Director of the Center for Cognitive Neuroscience and Aging and Associate Director of the whole ADRC consortium, served as a presenter, answering the many thoughtful questions submitted by the public. More than 800 people registered. “The astonishing increase of those receiving a diagnosis of Alzheimer’s dementia or other related disorders continues to significantly impact our population,” Dr. Curiel Cid said. “From patients to families to caregivers, there are few people left unaﬀected by this disease. During the Covid pandemic alone, deaths in the U.S. due to Alzheimer’s or dementia increased 16%. This is monumental growth just in the last year and it was reflected in the vast forum audience. Everybody wants answers, disease-modifying treatments or a cure, and we are working determinedly to find them.”

A consortium of Florida institutions helping to change the current understanding of Alzheimer’s disease and related dementias from being incurable, inevitable and largely untreatable to a new reality in which these diseases are curable, preventable and treatable. Rosie Curiel Cid, Psy.D.

i-Function is Developing New Tools to Address Cognitive Decline

“With a focus on delivering online assessment and training, we can reach more people, improve quality of life and lay the groundwork for more intensive research.” Philip D. Harvey, Ph.D.

Many people who experience cognitive changes associated with aging, disease or mental illness, lose the ability to perform critical everyday activities. Unfortunately, the available solutions are expensive and difficult to scale. To help meet this challenge, Philip D. Harvey, Ph.D., and Professor Emeritus Sara J. Czaja, Ph.D., have founded a company called i-Function, which is developing online tools to identify mild cognitive decline at its earliest stages and help people develop new technological skills. “The problems we’re facing aﬀect many more people than those who could be seen in person,” said Dr. Harvey, who is Leonard M. Miller Professor of Psychiatry and Behavioral Sciences, Vice Chair for Research and Chief of the Division of Psychology. “With a focus on delivering online assessment and training, we can reach more people, improve quality of life and lay the groundwork for more intensive research.” Drs. Harvey and Czaja, now a Professor of Gerontology at Weill Cornell College of Medicine, and colleagues, have received support from U Innovation, the Wallace Coulter Innovation Foundation, and more than $5.5 million in federal grants. These grants have helped the i-Function team translate decades of research into an online platform that could help millions of people with mild cognitive decline. Functional Skills Assessment and Training (FUNSAT) While people can improve their cognition through drugs and computerized training, these do not help them acquire new skills. “The research is quite clear, if someone’s cognition is improved with computerized, cognitive training, it doesn't help them do things they’ve never done before,” said Dr. Harvey. “Previously performed activities, like driving, improve with cognitive training. But even if we give them 15 additional IQ points, they won’t be able to spontaneously speak French.”

To address this issue, i-Function created FUNSAT, an online functional skills training system that teaches people to perform key tasks, such as medication management, online shopping, operating ticketing kiosks and withdrawing money from an ATM. The system has two modes. In the assessment version there is no feedback, only in the training version. The training mode provides error messages and instructions to help people solve each task. In the ATM module, for example, the user must virtually insert a card, enter a PIN and follow instructions to correctly perform a necessary task, such as checking their balance. This platform was validated in a 2020 study, which showed the online training helped cognitively impaired participants improve their abilities to perform everyday tasks. The researchers believe this approach could be used to provide skills training for many adults facing Mild Cognitive Impairment. “In-person training is eﬀective, but it’s also quite expensive,” said Dr. Harvey. “If we provided 24 hours of in-person training, it might cost $10,000, but many older adults, or people with Serious Mental Illness, can’t aﬀord that. This gives them opportunities to pick up important skills without coming into an office to do the training.” To expand these services, i-Function is working with health care systems and memory clinics that care for people with mental illness, such as autism spectrum conditions, as well as older people with Mild Cognitive Impairment.

“With the LASSI-L, we are going to be detecting the disease at its earliest stages, which means drugs or psychosocial interventions could have greater impact.” Philip D. Harvey, Ph.D. Detecting Mild Cognitive Impairment There are interventions that can help people with Alzheimer’s disease maintain their cognitive abilities — but these work best when applied early. David Loewenstein, Ph.D., who directs the Miller School’s Center for Cognitive Neuroscience and Aging, and Associate Professor Rosie Curiel Cid, PsyD., developed a test called LASSI-L, which can detect cognitive changes in people at increased risk for Alzheimer’s disease. Drs. Curiel and Loewenstein are also advisors at i-Function. “LASSI-L detects the earliest stages of mild cognitive impairment, which could support medical interventions or fine-tune prevention studies,” said Dr. Harvey. “We’re taking something that had been previously administered in person by a psychologist and scaling it up so we can reach more people.” This could have a profound impact on clinical studies. Many prevention-focused Alzheimer’s disease interventions have been unsuccessful in trials, but it’s unclear whether they don’t work at all or are simply administered too late. A 2021 study confirmed 10

that the ability to precisely assess cognitive and functional declines could have a major impact on these trials. “These prevention trials may not achieve results because they may be trying to prevent Alzheimer’s in people who already have Alzheimer’s,” said Dr. Harvey. “With the LASSI-L, we are going to be detecting the disease at its earliest stages, which means drugs or psychosocial interventions could have greater impact.” LASSI-L is being adapted into a remotely administered version (LASSI-D), which will run on the same platform as FUNSAT. LASSI-D will be available for health care practitioners and researchers to support early detection. When fully developed, the program will use voice recognition technology to facilitate at-home self-administration and detailed feedback. “LASSI-D will be a major advancement in screening for Alzheimer’s disease risk and will make this screening available to health care providers who have no personal experience with these assessments,” said Dr. Harvey. “The clinical information from these assessments will allow for the earliest possible interventions to prevent or slow the process of age-related cognitive changes.” Opposite page: Professor Sara J. Czaja, Ph.D. (CSO); Professor Philip D. Harvey, Ph.D., (CSO); and Peter Kallestrup, MS (CEO). Dr. Czaja and Dr. Harvey are leading US researchers within cognition and functioning in aging and technology and neuropsychiatric conditions respectively. Peter Kallestrup comes with 20+ years of top leadership experience and results within the US and international health care markets.

55,000,000 Americans are over the age of 65 Up to 13M individuals 60+ have Mild Cognitive Impairment (MCI) ( a noticeable decline in cognitive abilities that does not yet interfere with daily functioning )

more are long-term survivors of stroke

experience sustained effects from Traumatic Brain Injury (TBI)

Even though

73%

Everyday functioning can pose significant challenges to these individuals due to increasing requirements for using technology to perform regular tasks.

of Americans 65+ are Internet users only.

26%

report feeling very confident using computers, smartphones and other devices.

No previous eﬀective, documented and aﬀordable solution has been developed to bridge the gap between functional skills and technology for these groups — until now!

What You Helped the CNSA Achieve The Center for Cognitive Neuroscience and Aging (CNSA) thanks our supporters for their ongoing partnership to help advance the science behind early detection of Alzheimer’s disease and related disorders. Expanding our reach in the community African Americans and Hispanic/Latinos are disproportionately aﬀected by dementia, yet individuals from these cultural groups are less likely to participate in research.

Thanks to our team members and research study participants, we exceeded our goal of recruiting 250 older adults from diverse communities representative of the many groups in the South Florida region.

We are proud of the new partnerships and friendships we have formed across our local African American communities, religious organizations, health fairs, and senior centers.

To raise awareness about brain health, our faculty participated in several media appearances that were shared across TV, radio, and social media.

Advancing early detection Participation in clinical trials provides us with important data to help us develop less invasive diagnostic tests and early interventions for cognitive disorders. Our program now includes innovative tests to measure early cognitive changes and a state-of-the-art

Educating future scientists Training the next generation of clinician-scientists as experts in the field of AD and other dementias is one of the things we are most proud of. Our training program ensures that future doctors are equipped to treat older adults and intervene early. Many of our trainees and staﬀ were recognized and rewarded for their exceptional work.

suite of biomarkers, neuroimaging and collaborations with Alzheimer’s disease scientists all over the world. Thanks to your contributions, the CNSA was awarded multiple prestigious grants to continue expanding our scientific program.

psychology students from local universities completed their pre-doctoral training

post-doctoral fellows were specialty trained in neuropsychiatry and neuropsychology

doctoral students began their theses using CNSA’s databases

posters with novel findings were presented at national conferences

research assistants were accepted into graduate programs and medical school

Progress Report: UHealth Program Guides Vulnerable Adults Safely Through Extreme Distress

“Over time, we see these people get better. Many patients who have tried other suicide prevention programs have told us that the quality of this program stands out.” Ingrid Barrera, Psy.D.

Thanks to the generosity of The Fields Galley Private Foundation, the UHealth Therapeutic Program for Adult Suicide Prevention continues to help local at-risk adults get beyond extreme levels of distress and suicidal ideation. An estimated 12 million Americans have serious thoughts of suicide, which is the 11th leading cause of death in the U.S. More than one-third of people who die by suicide are 55 years and older, according to the latest CDC statistics available. Launched at the start of the pandemic in April 2020, the UHealth program had to quickly pivot from planned in-person group sessions to operating remotely via Zoom. “There was definitely some concern about the eﬀectiveness of the program when we converted to online sessions,” said Ingrid Barrera, Psy.D., Assistant Professor in the Department of Psychiatry and Behavioral Sciences and Director of the Program. “Like other specialties, there was no research on administering certain treatments or therapies via telehealth — no evidence that demonstrated success. The specific techniques we use to treat these patients are all evidencebased, so we were a bit apprehensive. But our commitment is to provide the best possible care for our patients, in whatever format that requires. I am extremely grateful to the Fields Galley Private Foundation for their understanding and willingness to enter this uncharted territory of telepsychiatry with us.” The UHealth program has completed six cycles. Nearly 50 people who started the program at serious risk of suicide completed treatment free of suicidal thoughts and are now better able to manage their distress. “We created this program to help patients who are experiencing stress, suicidal ideation or thoughts of harming themselves and need a higher level of care,” said Program Coordinator Zili Khan, M.S.W., L.C.S.W. Each cycle of the program is 12 weeks and meets for 24 sessions. On average, eight members participate in each cycle of the treatment program. Expert clinicians in the department provide not only individual, group and needed medication therapy, but also measure members’ progress by assessing them before, during and at discharge from the program.

The UHealth Therapeutic Program for Adult Suicide Prevention uses a combined approach focused on evidence-based Dialectical Behavioral Therapy and Cognitive Behavioral Therapy to individually treat adults in crisis. “Our patients learn coping skills and techniques that have been shown in scientific studies to eﬀectively manage high levels of distress, emotional highs and lows and attention. Managing attention is important because often when people are distressed their minds race. We teach them how to bring their attention into the realm of their control, and patients find that to be stabilizing,” Khan said. “Because of the nature of the donation, we have provided quite a bit of pro bono assistance.” The success of the original program has led to an expansion in other areas where patients are considered high-risk for suicide. “We have since branched out with a separate program for adult oncology patients of all ages,” Dr. Barrera said. The oncology program, which has completed two cycles and focuses on Dialectical Behavior Therapy, is held weekly, allowing patients who are medically and psychiatrically vulnerable to have access to needed services. Serious illness and social isolation are risk factors for suicidality, according to the CDC. Being diagnosed with any condition that may be new or sudden or one that requires lengthy treatment or frequent visits can be very intrusive on one’s life and absolutely can impact mental health, explained Khan. Miller School psychologists are working at Sylvester Comprehensive Cancer Center to help patients in the oncology program who have extreme levels of distress and suicidal ideation. It has proven to be an important added level of patient support, she said. “In some cases, the cancer diagnosis may not even be at the forefront of why they are seeking help. It could be that they have had depression and the diagnosis is compounding it,” Khan said. “The goal is to continue expanding the general adult and oncology programs with more referrals from the community.” “We are so grateful for The Fields Galley Private Foundation’s support,” Dr. Barrera said. “Over time, we see these people get better. Many patients who have tried other suicide prevention programs have told us that the quality of this program stands out.”

Health Care Is Getting Personal

“The digital twin program is an opportunity to revolutionize how data is captured and utilized to better inform treatment teams about the health and well-being of their patients.” Azizi Seixas, Ph.D.

Illustration by Jacey

A study of “digital twins” marks a new Miller School center’s first step toward becoming an engine of change. What if we were able not only to predict which treatments or therapies might produce the best outcome for a patient, but also to test those predictions before administering treatment? Could we make the promise of precision medicine a reality? Could we harness clinical insights from thousands of individuals to improve overall population health? Azizi Seixas, Ph.D., Associate Professor of Psychiatry and Behavioral Sciences at the Miller School, is aiming to answer these big questions. He is disrupting the digital health and technology worlds with an ambitious research project to create a “digital twin” — an individual’s digital health proxy — to test treatment protocols and therapies before they are used with the patient. The project, named the MILBox, is the first from the Miller School’s newly established Media and Innovation Lab (The MIL). It is comprised of a digital box, which serves as a launchpad for apps, solutions, content, wellness resources and data, and a physical box that gets sent to study participants’ homes. The physical MILBox contains the most cutting-edge patient-worn and in-home devices on the market, such as an ambulatory blood pressure monitor, an actigraph to measure sleep and wake cycles, a smart scale and an air quality device, as well as a mobile phone to securely transmit data to the cloud. The components of the boxes are selected based on the participant’s initial health screening, providing an even more personalized profile. Unique, Like a Fingerprint The wearable technology and smart home devices will obtain the participant’s biological, clinical, behavioral and environmental data that will be used to create the digital twin. The longitudinal data, collected over seven

consecutive days, will be combined in a biological health algorithm that is unique to the individual, like a fingerprint. This algorithm essentially serves as a digital twin of the individual, allowing health care practitioners to employ artificial intelligence to virtually test and evaluate various treatment options and potential outcomes before applying them in the physical world. “The digital twin program is an opportunity to revolutionize how data is captured and utilized to better inform treatment teams about the health and well-being of their patients,” Dr. Seixas said. “Our approach to obtaining holistic, longitudinal patient data is designed to overcome the gaps and data drop-offs that have limited these kinds of efforts until now.” Based on his earlier research funded by the National Institutes of Health, Dr. Seixas will initially examine the connection between poor sleep and serious health conditions including heart disease and dementia. He hopes to recruit a diverse group of 1,500 participants — especially those from traditionally underserved communities or communities of color. The first participants were enrolled in 2021. Easing Burdens in Underserved Communities At a time when access to the latest innovations in health care is often limited to the few, Dr. Seixas’s vision is to provide affordable, quality and accessible health care and wellness to all.

“The MIL is an engine for change, driving new ways of learning, collaborating and investing in the emerging technologies, systems and solutions that will shape the future of health care for the benefit of all,” Azizi Seixas, Ph.D. The health disparities in underserved communities are undeniable. While average life expectancy is increasing, it is decreasing among racial and ethnic minorities, the underor uninsured, and low-income families. As health care costs continue to skyrocket, these communities are suﬀering consequences such as limited or no access to care, high disease burden and premature death. “Digital twins will help make health care more personal,” Dr. Seixas said. “We can demonstrate to an individual how changes in behaviors, treatment compliance and other common interventions will impact them using a model of themselves that takes into account who they are, the environment in which they live and the lifestyle choices they make. We evolve from providing generic advice to demonstrating how various factors are intricately interconnected. At its core, precision medicine is personal medicine.” From Silicon Valley to Silicon Beach, healthtech organizations are eager to partner with Dr. Seixas. The data collected from the MILBox will be analyzed using machine learning, powered by Amazon Web Services. Open Health Network, a company in Mountain View, California, will manage, process and protect the data using its proprietary technology platform PatientSphere 2.0. The platform is a personalized, fully HIPAAcompliant care coordination management system that will support the MILBox app on the user’s smartphone, maintain the cloud-based data acquisition system, manage the data analysis and construct the digital twin algorithm.

“The ultimate goal is to be regional, national and global leaders in digital health technology and innovation, with a special emphasis on making these solutions accessible to all,” Dr. Seixas said. A Training Ground for Providers and Researchers The MIL extends the Miller School’s mission to provide world-class clinical care, innovate medical education, conduct groundbreaking research and provide impactful community outreach. As an integral part of the Miller School, it will serve as a training ground for the next generation of compassionate health care providers and visionary researchers, and serve the University’s mission to promote health equity throughout South Florida and beyond. The MIL will focus on five key components of academic medicine, including medical education, clinical care, research, community service and outreach, and venture opportunities. With these pillars in mind, The MIL will serve as a locus for learning, collaboration and investment in the emerging technologies, systems and solutions to shape the future of health care. Additional projects include building state-ofthe-art digital therapeutics and innovative solutions to improve prevention, awareness, assessment and adherence to chronic disease management; improve clinical trial literacy and participation among underserved communities; and create smart cities and homes through interconnected digital solutions. “The MIL is an engine for change, driving new ways of learning, collaborating and investing in the emerging technologies, systems and solutions that will shape the future of health care for the benefit of all,” Dr. Seixas said. “The relationship between health care and technology is extraordinary, and we know relationships require work. I am grateful for the opportunity to work with experts at the Miller School and reimagine what a more accessible and equitable health care system looks like and what it can do for all.” This article was written by Samantha Richter and originally appeared in University of Miami Medicine magazine in Spring 2022.

UM Expands Addiction Psychiatry Program

“We need a continued care model for outpatient treatment, where qualified people help with medication management and therapeutic interventions to modify behaviors and provide social support in the community.” Dhruti Patel, M.D.

Dhruti Patel, M.D., helps coordinate comprehensive eﬀorts to tackle drug dependency. Substance abuse and addiction are serious public health issues, and the University of Miami’s Division of Addiction Psychiatry is stepping up to meet the challenge. The division recruited Dhruti Patel, M.D., a fellowship-trained addiction psychiatry specialist, to grow the program, forge internal and external collaborations and help UM and other groups address South Florida’s addiction crisis. Dr. Patel and colleagues have a lot of work to do. Fentanyl and other highly potent synthetic opiates are becoming increasingly common. Bizarre drug cocktails, such as fentanyl and the animal tranquilizer xylazine, are also a growing threat, generating depression, psychosis and other complications. “There is tremendous community need,” said Dr. Patel, who is an Assistant Professor of Psychiatry. “We have a high prevalence of substance use in Miami-Dade County: stimulants, opiates, alcohol. We are creating treatment pathways to get these people the help they need.” Helping High-Risk Populations Many addiction patients face socioeconomic, psychiatric and other issues. To help UM and Jackson clinicians adapt, Dr. Patel is applying her experience from NYU Langone Medical Center and other facilities: training medical students, residents and others to have real therapeutic conversations with patients, dive into the unique complexities of each case and develop successful care plans. From a psychiatric standpoint, addiction treatment can be a chicken or egg problem. Patients may have pre-existing mental health issues and that leads them to self-medicate. In other cases, their drug use may be driving their psychiatric problems. “There are major correlations between substance use and worsening psychosis, anxiety and mood,” said Dr. Patel. “Part of the process is separating the people with underlying mental health diagnoses and those whose

symptoms come from substance use. That way, we can identify who needs long-term treatment versus those who would benefit from a short course of medications to stabilize their mood.” The Continuum of Care Each patient is different, and it’s up to Dr. Patel and colleagues to find the right combination of interventions that will help them succeed. The clinical team has good medication to help people stop using opiates (Suboxone) and alcohol (Naltrexone), but unfortunately lacks equivalent medicines for methamphetamine or crack cocaine. Dr. Patel’s team often admits patients for inpatient detox, but that’s only one, hopefully brief, piece of the treatment continuum. “We need a continued care model for outpatient treatment, where qualified people help with medication management and therapeutic interventions to modify behaviors and provide social support in the community,” said Dr. Patel. “We have been collaborating with existing community care facilities to transition patients and make sure they are successful.” The UM team works closely with the Medication Assisted Treatment (MAT) Clinic at Jackson Behavioral Health Hospital and other outpatient facilities. In addition, a new program called MATTER oﬀers opiate use disorder patients free medications, peer specialists, therapists and social workers to support their recoveries. A Treatment Gateway Dr. Patel’s team also works closely with the IDEA Exchange, Florida’s first official needle exchange program. IDEA’s medical director Hansel Tookes, M.D., M.P.H., and behavioral health director, Edward Suarez, Jr., Psy.D., have a more groundlevel view of the addiction problem, meeting people where they live to get them more help. “We’re developing these wraparound services with Dr. Patel,” said Dr. Suarez. “We often identify people who need to be admitted for detoxification — hitting the reset button — and she helps us get them a bed. When they’ve been stabilized and are ready for discharge, we help coordinate their outpatient care.” The underlying ethos is no judgment. People come to the IDEA Exchange for clean needles 21

and that gives staﬀ many opportunities to build relationships and help address addiction, HIV, hepatitis and other problems. “We build bridges in the community,” said Dr. Suarez, “and we’re using them to lead patients where they need to go and provide them with a safety net. They come to IDEA for needles or suboxone and sometimes we get them to Dr. Patel for detox. It’s a point of engagement: Here are your needles; what else do you need?” Expanding Collaborations Dr. Patel wants to build on these existing collaborations to make addiction care more comprehensive and cohesive. At present, most patients being treated for substance abuse come through the psychiatric hospital. She would like to expand that to help more people receiving medical care. “We want to assemble a team of providers who can identify individuals who come in for medical reasons, like infections, and implement preventative measures,” said Dr. Patel. “We can identify underlying substance use disorder and get them connected to treatment or started on medications before they have acute

complications. Once we stabilize them, they can transition to our outpatient practice or wherever they need to go in the community.” The Team Approach Dr. Patel’s group is also pursuing research to better understand how many in the community are aﬀected by substance abuse. They hope this information will help them identify people who are not getting the treatment they desperately need. This data could be invaluable to apply for grant funding or support services. Dr. Patel’s eﬀorts have been well-received throughout UHealth, particularly by medical students, residents and other trainees. Many have had only limited exposure to addiction care, and these interactions are opening their eyes. This exposure to addiction medicine and harm reduction strategies, which decrease the potential health consequences associated with drug use, will pay health dividends for many years. “We are building a network of clinicians and services at UM, Jackson and other hospitals,” said Dr. Patel. “We really need a village of providers to successfully treat addiction.”

The U.S. has declared an opioid epidemic, with the U.S. Department of Health and Human Services pointing to these 2019 statistics: 2019 was a year when more than:

70,630

1.6 million

people died from an opioid drug overdose in 2019

people had an opioid use disorder in the past year

people misused prescription pain relievers for the first time

Each year, opioid overdose, misuse, and dependence account for

$35 billion in health care costs

10.1 million people misused prescription opioids in the past year

More than

760,000 people have died from a drug overdose since 1999

References: HHS.gov/opioids, jec.senate.gov

Nearly 75% of drug overdose deaths in 2020 involved an opioid

The U.S. Congress Joint Economic Committee estimates the opioid epidemic cost $1.04 trillion in 2018, $985 billion in 2019 and nearly

$1.5 trillion in 2020

Edward Suarez, Jr., Psy.D., behavioral health director of IDEA Exchange.

Rethinking How Addiction Works in the Brain to Treat Opioid Relapse

“Private donors and philanthropic gifts provide the crucial support to bridge the funding gap that leads to securing government grants, and, ultimately, a big discovery that paves the way to more eﬀectively treating this devastating disease.” Luis M. Tuesta, Ph.D.

Research efforts in addiction medicine have long focused on how drugs of abuse affect the function of neurons — the cellular messengers that relay information between different parts of the brain and the rest of the nervous system.

Dr. Tuesta said that beyond getting people to take fewer drugs, the more ambitious goal is getting people to stay clean once they get oﬀ drugs. “That’s the ultimate goal. If we can prevent drug relapse, then we’ve done a lot of good,” he said.

But Luis M. Tuesta, Ph.D., Assistant Professor in the Department of Psychiatry and Behavioral Sciences, is pursuing work on a population of brain cells relatively unstudied in addiction called microglia. Many refer to microglia, which make up about 10% of cells in the brain, as the brain’s immune defenders. As such, microglia help maintain a stable brain environment to allow for neurons to perform their important work. “Historically, most NIH funding for basic science in addiction has rightfully focused on the role of the neuron and its communication networks. Yet, neurons only compose a small percentage of all cells in the brain,” Dr. Tuesta said. “I liken this to a movie where the neuron has always been the hero — the protagonist. And the other cells have been the supporting cast. The work that we are doing is trying to look at addiction, not from the perspective of the neurons but rather from the perspective of the supporting cast in the brain, particularly microglia.” Microglia make up what Dr. Tuesta describes as the backbone of the brain’s immune system. These actors are the brain’s first line of defense, sounding the alarm when exposed to toxic chemicals, biological pathogens, and even drugs with high abuse potential such as prescription opioids. When somebody abuses drugs — especially when they stop and go through an intense withdrawal and craving — microglia become overactive and this overactivation triggers inflammation in the brain. Indeed, treatment with antinflammatory medications that target microglia reduced cravings for opioids in people with known opioid dependence. Dr. Tuesta’s laboratory is currently working on understanding the molecular mechanisms by which microglia regulate craving for opioids, as this may hold the key to preventing relapse. “As a result of this and other research, we have put a lot of our resources behind the idea that immune signaling in the brain can ultimately be an avenue to treat addiction,” he said.

Potential implications Rethinking addiction could have big implications for a medical field that has seen limited progress in terms of developing eﬀective therapeutics over the past few decades, according to Dr. Tuesta. “Most of the research has been directed through the perspective of the neuron, and rightfully so, as neurons do the heavy lifting. However, we’re going down a new path. We’re looking at the supporting cast in the brain for clues about how those cells may be regulating or supporting the function of the neuron in addiction,” he said. “Our knowledge about microglia is still developing, especially the genetic targets that set them apart from other cell types in the brain. If we are successful, this research will open an exciting new array of therapeutic targets that we didn’t have before for treating addiction — targets that may be clinically much more accessible than focusing on neuronal circuits. Perhaps treating inflammation in the brain would be a more feasible way to help people with substance use disorder than with medications that could upend basic brain functions, such as reward perception and motivation.” To pursue the research, Dr. Tuesta secured governmental and nongovernmental funding. The Shipley Foundation began its support of his study in 2021 and renewed it in 2022, with a grant totaling $93,000. The support from the private foundation helped Dr. Tuesta’s lab to double its animal testing capacity and increase the speed at which its researchers perform the study. Dr. Tuesta’s basic science research is anchored by two grants through the NIH’s National Institute on Drug Abuse. One is an independent scientist development grant, which was awarded during his postdoctoral fellowship at Harvard Medical School and which continues today; the other is an NIH Director’s Pioneer Award, which he received in 2020. 25

“The Avenir Award in Genetics and Epigenetics of Substance Abuse is a type of NIH Director’s Pioneer Award that is given annually to a handful of U.S. investigators in the field of addiction neuroscience; I am an epigeneticist and an addiction neuroscientist by training. We are now adding this immunology wrinkle to our strategy so that if we are successful, we will have uncovered a new class of therapeutic targets for preventing opioid relapse. Indeed, there may already be FDAapproved therapeutics that focus on some of these targets,” he said. In fact, earlier work (even some studies on humans done at other labs) has shown that drugs already approved by the FDA for other indications can help curb cigarette smoking, for example. Dr. Tuesta was lead author on a study published in 2017 in Nature Neuroscience that showed nicotine activates glucagon-like peptide-1 (GLP-1) neurons in the brain.

And the antidiabetic drug exenatide, which activates GLP-1 receptors, decreased nicotine intake in mice by a satiety-like mechanism. A similar effect on nicotine intake was later shown in a pilot clinical trial by a different group, and now more studies are being done to repurpose these drugs to maintain nicotine abstinence and reduce cravings, he said. “Going back to opioid relapse, we want to take a similar approach and explore drug targets for which there may already be FDA-approved therapeutics. The Shipley Foundation gave us the seed funds to begin to ask those questions,” Dr. Tuesta said. “Private donors and philanthropic gifts provide the crucial support to bridge the funding gap that leads to securing government grants, and, ultimately, a big discovery that paves the way to more effectively treating this devastating disease.”

Histone marks (H3K27me3 and H3K27Ac, red) in microglial cells (Iba1, green). These epigenetic marks help determine which genes get to be expressed so that the cell can adapt to changes in its environment, such as exposure to drugs of abuse.

Control

METH-taking (15 days)

METH-abstinent (21 days)

Microglia (green) are the resident immune cells of the brain and their activity has been associated with behavioral changes in various substance use disorders. Chronic (15-day) methamphetamine (METH) self-administration reduces microglial volume and surprisingly, this eﬀect persists 21 days into abstinence — when the animals no longer have access to the drug. Persistent activation of these cells suggest epigenetic regulation of gene expression and a potential new mechanism for shaping the behavioral course of addiction.

Miller School Program Focused on Leading Sleep Science Research, Training and Community Empowerment

“Our goals include developing and testing solution-focused interventions to reduce risks of cardiovascular and brain injury of Alzheimer’s disease through a better understanding of the role of sleep disruption and circadian misalignment.” Girardin Jean-Louis, Ph.D.

In 2021, the Department of Psychiatry and Behavioral Sciences welcomed Girardin Jean-Louis, Ph.D., and a team of talented investigators from New York to establish the Center for Translational Sleep and Circadian Sciences. One of the world’s leading experts on advancing the science and practice of sleep and circadian sciences, Dr. Jean-Louis, Director of the new Center, and his team have embraced South Florida and our ‘Canes community. The former Professor of Population Health and Psychiatry at NYU Langone Health recently received a National Institute of Aging Career Leadership Award to develop the program. He said he chose the Miller School as the program’s home for a few reasons. “The Miller School’s groundbreaking work on the role of African ancestry and dementia is crucial to delineating the eﬀects of poor sleep and circadian disorganization in added risks for cardiovascular disease and brain injury,” said Dr. Jean-Louis. “The Miller School also stood out for its outstanding leadership of investigators in Alzheimer’s disease and related dementia research, development of novel integrative therapeutics to forestall the onset of dementia or ameliorate its symptomatology, and access to a diverse population and community health champions.” Translational sleep and circadian sciences focuses on investigating how sleep deficiencies and circadian misalignment, or a misalignment of the body’s internal clock, impact development of cardiovascular disease, dementia and other chronic health problems. Translational sciences “translate” information learned in the laboratory to patient care in the clinic and populations in the community. The new Miller School program will look specifically at how interventions aimed at better sleep quality can improve the health of minority populations that are disproportionately aﬀected by problems associated with sleep. The new focus on translational sleep and circadian sciences at the Miller School is timely and representative of medicine’s future,

Girardin Jean-Louis, Ph.D.

according to Henri R. Ford, M.D., M.H.A., Dean and Chief Academic Officer of the Miller School. “The pandemic has highlighted the importance of mental health and wellness, and the sleep sciences are vital to both,” Dr. Ford said. “Personalized, multi-dimensional and inclusive care will be the hallmark of American medicine in the not-too-distant future. The Center checks all those boxes, adding an important dimension of care to not only the Department of Psychiatry and Behavioral Sciences but also influencing so many other specialties.” Barbara J. Coﬀey, M.D., M.S., Professor and Chair of the Department of Psychiatry and Behavioral Sciences added, “We are absolutely delighted and honored that Dr. Jean-Louis has chosen to bring his innovative program to the Miller School of Medicine. This program will not only advance translational science, future clinical care and address health care disparities, but will also accelerate new collaborations among our department faculty and our colleagues in neurology, sleep medicine, pulmonology, public health sciences and other specialties.” The Center for Translational Sleep and Circadian Sciences has three pillars: research, training, and community engagement and empowerment, explained Dr. Jean-Louis. “Our goals include developing and testing solution-focused interventions to reduce risks of cardiovascular and brain injury of Alzheimer’s disease type through a better understanding

and the NHLBI-funded R01 “Determinants of “My goal and dream are to be insufficient sleep among Blacks and effects on able to use my research and disparities in health outcomes” project, looking advanced knowledge about the at the cardiovascular effects of insufficient sleep among Blacks. This project leverages the impact of insufficient sleep success of the NYU Sleep Disparity Workgroup and chronic stress on racial, that Dr. Jean- Louis led and will continue at the Miller School. The workgroup has been ethnic or disenfranchised conducting community-engaged sleep research communities. Now I have a for more than a decade. platform with which to reach Among the faculty members of the Working Group who are joining Dr. Jean-Louis to launch the that goal.” Center is Azizi Seixas, Ph.D., formerly an Assistant Judite Blanc, Ph.D. Professor in the Departments of Population of the role of sleep disruption and circadian misalignment,” Dr. Jean-Louis said. “They also include training and mentoring new generations of sleep and circadian scientists, including under-represented minority investigators to attain the national mandate to achieve health equity in all U.S. communities. We will reach out to Miami-Dade County’s multicultural communities to learn from them about health issues plaguing their respective communities and assist them as they address their specific health needs.” Dr. Jean-Louis has authored more than 375 publications focused on sleep and cardiometabolic diseases, circadian rhythm, aging and health equity. He has been involved in many National Institutes of Health (NIH) funded studies and will continue his work at the Miller School as director of the National Heart, Lung, and Blood Institute (NHLBI) funded Program to Increase Diversity in Behavioral Medicine and Sleep Disorders Research (PRIDE) Summer Institute and the T32 Program on Translational Behavioral Cardiovascular Health Research, and as director of the National Institute of Neurological Disorders and Stroke (NINDS) funded program Congruent Mentorship to Reach Academic Diversity (COMRADE) in neuroscience research. Dr. Jean-Louis also will continue to lead the NIH-funded project “Mechanisms of sleep deficiency and effects on brain injury and neurocognitive functions among older Blacks,”

Health and Psychiatry at NYU Langone. Dr. Seixas is Associate Director of the Center. Named one of the 100 Most Inspiring Black Scientists in America by Cell Press, Dr. Seixas’s research focuses on multilevel determinants of sleep and cardiovascular disease disparities; long-term health consequences of cardiovascular disease disparities; and developing adaptive, group-tailored and personalized behavior modification interventions with the use of machine learning analytical tools to improve health and well-being. At the Miller School, Dr. Seixas will continue his work on the NHLBI-funded Determinants of Insufficient Sleep in Rural-Urban Settings (DORMIR) Study, in which he is studying multilevel determinants of insufficient sleep and insufficient sleep-related cardiovascular disease among Hispanics. Judite Blanc, Ph.D., also a part of the Working Group and NIH-T32 Postdoctoral Fellow under Dr. Jean-Louis, joins the Department as Assistant Professor in the Center for Translational Sleep and Circadian Sciences. “I can say I am a living example of this pipeline of researchers that Dr. Jean-Louis has built and is continuing to build,” Dr. Blanc said. “I am a young, Haitian-born psychologist. My goal and dream are to be able to use my research and advanced knowledge about the impact of insufficient sleep and chronic stress on racial, ethnic or disenfranchised communities. Now I have a platform with which to reach that goal.”

Faculty Awards and Recognition 2021–2022 Judite Blanc, Ph.D. Appointed Fellow, American Academy of Sleep Medicine (AASM) 2021-2022 Sleep Research Program for Advancing Careers (SOAR)

Daniel Jimenez, Ph.D. Appointed Fellow, Gerontological Society of America (GSA); Appointed to the Board of Directors, American Society of Hispanic Psychiatry

Mousa Botros, M.D. Appointed to selection committee of Alpha Omega Alpha (AOA) Honor Society

Deborah Jones-Weiss, Ph.D. 2022 Dean’s Annual Faculty Award for Mentoring

Barbara Coﬀey, M.D., M.S. Named Castle Connolly Top Doctor Best of Florida Magazine– Doctor Edition

Steve McLeod-Bryant, M.D. Elected President of the Black Psychiatrists of America 2022 University of Rochester School of Medicine and Dentistry Alumni Humanitarian Award

Rosie Curiel Cid, Psy.D. Appointed to NIH Study Section Membership Named Member of Clinical Neuroscience and Neurodegeneration Study Section, Center for Scientific Review, NIH

Samuel Mowerman, M.D. UM/JMH Clinical Teaching Award for Outpatient and CL Psychiatry

Dante Durand, M.D. Appointed Jackson Behavioral Health Hospital CMO; Appointed Member of the International Editor; Committee of Revista de Neuropsiquiatria; Peruvian Congress Award for Successful Peruvian Abroad

Luca Pani, M.D. Appointed Fellow, Royal Society of Medicine (London)

Phil Harvey, Ph.D. Stanley Dean Schizophrenia Award from the American College of Psychiatrists

Maria Rueda-Lara, M.D. Top Clinical Poster Award, Annual Conference of the American PsychoSocial Oncology Society Appointed to the Board of Directors, American Society of Hispanic Psychiatry

Girardin Jean-Louis, Ph.D. 2021 Mary A. Carskadon Outstanding Educator Award, Sleep Research Society Diversity, Equity, and Inclusion Leadership Award, Associated Professional Sleep Societies (a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society) Outstanding Contribution to Diversity, Equity, and Inclusion Award, Society of Behavioral Sleep Medicine

Luis Tuesta, Ph.D. Appointed Member, Cancer Epigenetics Program, Sylvester Comprehensive Cancer Center; Application titled “Microglial epigenetics and opioid use disorder” selected to represent UM for 2022 Pew Scholars Program in Biomedical Sciences

New Faculty 2021–2022

Yasin Bez, M.D. Associate Professor Focus Area: Child and Adolescent Psychiatry

Judite Blanc, Ph.D. Research Assistant Professor Focus Area: Sleep Disorders in Minority/Underserved Populations

Maria Hadjikyriakou, M.D. Assistant Professor Focus Areas: PsychologyOncology, Consultation Liaison Psychiatry

Girardin Jean-Louis, Ph.D. Distinguished Professor Focus Area: Sleep Disorders in Minority/Underserved Populations

Suchitra Joshi, M.D. Assistant Professor Focus Area: Child and Adolescent Psychiatry

Rhoda Moise, Ph.D. Research Assistant Professor Focus Area: Sleep Disorders in Minority/Underserved Populations

Daniel Maass, M.D. Assistant Professor Focus Area: Consultation Liaison Psychiatry

Azizi Seixas, Ph.D. Research Associate Professor Focus Area: Sleep Disorders in Minority/Underserved Populations, Technology and Innovation in Mental Health

Dhruti Patel, M.D. Assistant Professor Focus Area: Addiction Psychiatry

Arlener Turner, Ph.D. Research Assistant Professor Focus Area: Sleep Disorders in Minority/Underserved Populations

Brittany Wright, Ph.D. Assistant Professor Focus Area: Clinical Psychology

Department of Psychiatry and Behavioral Sciences Executive Committee Barbara J. Coﬀey, M.D., M.S. Professor and Chair, Department of Psychiatry and Behavioral Sciences Division Chief, Child and Adolescent Psychiatry; Director, Tourette Association Center of Excellence

Girardin Jean-Louis, Ph.D. Distinguished Professor, Psychiatry and Behavioral Sciences Director, Center for Translational Sleep and Circadian Sciences

Edmi Cortes-Torres, M.D. Assistant Professor, Clinical Psychiatry Associate Director, Psychiatry Residency Program

Daniel Jimenez, Ph.D. Associate Professor, Research Psychiatry

Elizabeth Crocco, M.D. Professor, Clinical Psychiatry; Division Chief, Geriatric Psychiatry; Medical Director, UM Memory Disorders Clinic Center for Cognitive Neuroscience and Aging; Training Director, Geriatric Psychiatry, Jackson Memorial Hospital

David Loewenstein, Ph.D. Professor, Psychiatry and Behavioral Sciences; Director, Center for Cognitive Neuroscience and Aging Associate Director, 1Florida Alzheimer’s Disease Research Center Director of the UM Clinical Core

Dante Durand, M.D. Associate Professor, Clinical Psychiatry Vice Chair, Clinical Services Chief Medical Officer, Jackson Behavioral Health Hospital

Radu Saveanu, M.D. Professor, Clinical Psychiatry Executive Vice Chair Director, Residency Training

Spencer Eth, M.D. Professor, Clinical Psychiatry Interim Chief, Division of Addiction Psychiatry Director, Forensic Psychiatry Fellowship Program; Chief of Mental Health, Miami VA Healthcare System

Claes Wahlestedt, M.D., Ph.D. Professor, Psychiatry and Behavioral Sciences Director, Center for Therapeutic Innovation (CTI) Associate Dean for Therapeutic Innovation

Philip D. Harvey, Ph.D. Professor, Psychiatry and Behavioral Sciences Chief Director, Division of Psychology Vice Chair for Research