“The AHA is such a big and well-respected organization, so it is a nice validation to see that they value my research and ideas,” says Weiss, a biomedical engineering doctoral student who received a competitive two-year pre-doctoral fellowship.

Weiss conducts her work in the lab of Tracy Hookway, assistant professor of biomedical engineering. The team uses cell culture, 3D modeling of stem cells and live imaging of tissue for regenerative medicine therapy.

“Natalie has been a huge asset to my lab,” Hookway says. “She’s incredibly intelligent and very ambitious, and she’s not afraid to ask questions.”

Weiss’ research involves creating working models of human hearts and then testing various drugs and therapies with the goal of resolving or improving cardiac fibrosis. She uses stem cells derived from human skin to make heart muscle cells and then combines them with proteins, sugars and a gel polymer, which is then piped into a 3mm donut ring mold (of sorts). The process takes about a week and a half, but once the cells are added to the mold, the ring forms overnight into a simplified, beating human heart model.

“By testing on these models, it saves time, money and testing on animals,” Weiss says, adding that she often has 40 rings going at a time. “What I’m hoping to do, once the models are a little more advanced, is replicate the stiffness of cardiac fibrosis in the model and then test a couple of drugs and see if it responds in a positive way.”

As a high school student in East Meadow, Long Island, Weiss knew she was interested in the medical field. She volunteered in an emergency room and got her EMT certification.

“I’ve also always loved problem solving — taking things apart and figuring out how they worked,” she says. “I wasn’t aware I could put those two interests together until a biomedical engineering major kept popping up again and again as I was researching college programs.”

She received her undergraduate degree in biomedical engineering at Stony Brook University in 2019, and then started her graduate career at Binghamton that fall. She selected the program because she was impressed with Hookway, who would become her advisor.

“I wanted someone who I can connect with,” Weiss says. “Dr. Hookway really seemed like someone who would advocate for her students, so I knew she was going to care about my progress and help me out.”

Once Weiss completes her doctorate, she hopes to complete a post-doctoral fellowship and then become a professor and run her own research lab.

Amber Doiron, assistant professor of bioengineering, says current methods of assessing atherosclerosis — commonly known as hardening of the arteries — are not terribly accurate. Some 30 percent of deaths worldwide can be attributed to the disease, which occurs when fat, cholesterol and other particles form hard structures called plaques in the walls of arteries.

“It’s really a guessing game right now,” she says. “Doctors use factors like blood pressure and cholesterol level to get an idea of a patient’s risk. Then they use plaque size as a general measure of whether a person has the disease. But there’s a fairly poor correlation between plaque size and heart attack or stroke.”

Doiron, who has an interest in molecular imaging as well as expertise in nanoscience, wants to help physicians do a better job of identifying which plaques are cause for concern.

She and a Temple University colleague recently received a two-year, $418,000 grant from the National Institute of Biomedical Imaging and Bioengineering to support this project. It’s a notable success in part because this was Doiron’s first National Institutes of Health grant proposal.

The researchers will use a combination of polymers and superparamagnetic iron oxide nanoparticles for the study. The nanoparticle is sensitive to oxidative stress, which occurs in atherosclerosis and has been linked to patients who have a higher prevalence of heart attack and stroke. Using an MRI scan, the researchers will be able to see how active the nanoparticle is, which will indicate whether the plaque is stable.

“A stroke or a heart attack doesn’t necessarily come when a plaque fully blocks the flow of blood through an artery,” Doiron explains. “What happens is the plaque ruptures and the gunk that underlies the plaque is exposed to blood and a clot forms. The clot builds quickly — on an hour time scale as opposed to over years — and the clot can grow there until it blocks flow, or it can dislodge and block flow somewhere else. Most heart attacks do not occur from a full blockage of plaque. It happens because the plaque bursts. Same thing with strokes. That’s why size isn’t necessarily indicative of how dangerous a plaque is.”

The discovery of a molecule or a cell type that indicated which plaques are safe and which ones are dangerous would be a huge breakthrough, Doiron says. She thinks oxidative stress may be such an indicator.

“Atherosclerosis is an incredibly complex disease that progresses over decades,” Doiron says. “It’s hard to tell who’s walking around with plaques that are stable, relatively safe, and who has plaques that may cause a heart attack tomorrow. For some patients, the first sign of trouble is a heart attack.”

But chest pain can signal a heart attack in a woman. Women also may experience a range of other symptoms, not all of them easy for the typical sufferer to identify.

“We believe that heart attacks in women go unrecognized 30 to 55 percent of the time,” says Stewart Fahs, professor and Decker Chair in Rural Nursing at Binghamton University’s Decker School of Nursing. Women who miss the warning signs fail to get help, or they head for the hospital only when the problem grows acute, increasing the risk that they will die or be gravely disabled.

In hopes of shortening women’s time to treatment, Stewart Fahs is collaborating with Melanie Kalman, associate professor and director of research in the College of Nursing at SUNY Upstate Medical University, on a project called  “Matters of  Your Heart.” The goal is to develop an effective program to educate women about heart attack symptoms and also to teach about the early warning signs that a heart attack might be on the way.

Heart disease is the No. 1 killer of women. In fact, 1 in 4 women in the United States dies from heart disease, according to the National Institutes of Health. The most recent national study on the subject, however, found that 49 percent of women don’t realize that they need to be concerned about heart disease, Stewart Fahs says.

That number is lower than in past years, and the medical community has gotten out the word that women’s heart attack symptoms may differ from men’s. However, as the story of the woman on the floor points out, there’s still room to improve education about women’s cardiovascular disease.

Intense pain might be the first obvious sign of an impending heart attack, Stewart Fahs says. But many women who look back on the period before an attack report that they first felt pressure or discomfort. “Some women will say, ‘It’s like I had a big knot up here,’” she explains, pointing to her upper chest. “‘Like I swallowed an orange whole.’” Overwhelming fatigue or pain that radiates into one or both arms or the neck or jaw are other common warning signs.

Kalman and Stewart Fahs conducted the first phase of their project under an intramural research grant from SUNY Upstate. Their first task was to develop a questionnaire to measure a woman’s knowledge of heart attack symptoms and warning signs. They then created a pilot version of an educational presentation.

Working with 141 post-menopausal women, Stewart Fahs and Kalman held small-group sessions to administer the questionnaire, present the program and then give the questionnaire again. “We did find that the educational program increased knowledge,” Stewart Fahs says.

The researchers based the presentation in part on a program that Stewart Fahs developed several years ago to teach rural residents about symptoms of a stroke. That program employed an acronym created by the American Heart Association — FAST, for Face, Arm, Speech and Time.

The new program uses a similar mnemonic device, and Stewart Fahs says the method has proven effective, especially when women practice putting it to use. “We have periods in the presentation when they work in groups of two to four and come up with different symptoms for heart attacks and the female warning signs,” she says. Members take turns naming the symptoms.

As a specialist in rural nursing, Stewart Fahs gave the questionnaire and program to women in rural areas, while Kalman concentrated on urban Syracuse. The population they have studied so far is too small to reveal whether the program works better for one demographic or the other, Stewart Fahs says.

In a second phase of their research, Kalman and Stewart Fahs plan to give the presentation to many more women over a broader geographical area. Eventually, they hope to do a longitudinal study to discover whether their program improves the way women respond when they experience signs of a possible heart attack. “Having knowledge doesn’t necessarily change your behavior,” Stewart Fahs says. “But if you don’t have the knowledge, you’re unlikely to change.”

Once they’ve perfected the program, the researchers will share it with hospitals, community health agencies and other healthcare organizations. Besides offering the PowerPoint slides for classroom use, they might someday use communication technologies to give the presentation a broader reach, Stewart Fahs says. “There should be a way, through cell phone apps or some kind of Internet application, to get this message out to women once it’s fully developed and tested.”

While looking for new ways to educate women about heart attacks, Stewart Fahs also continues helping to advance the discipline of rural nursing. In May, she became editor of the Online Journal of Rural Nursing and Health Care. She also serves as an external advisor to the Interdisciplinary Healthy Heart Center: Linking Rural Populations by Technology at the University of Nebraska Medical Center.

Her combined expertise in rural nursing and cardiovascular issues makes Stewart Fahs especially valuable as an advisor to the Healthy Heart Center, says Professor Carol Pullen, principal investigator on the project. One striking aspect of Stewart Fahs’ work is that, along with publishing articles on cardiac risk among rural women for academic journals, she also writes for media that reach a wider audience, Pullen says. “I think it’s important not only to get your work in scientific journals, but also to get it out to lay publications for everybody to enjoy the results of your research.”

Stewart Fahs hopes that the results of her latest research will include better outcomes for more female victims of heart attack. “The more aware you are of the signs and symptoms,” she says, “and the more aware you are of the risk of heart disease for women, the better able you are to take a proactive stance.”