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What salamanders can teach us about baseball

UofL researcher shows how amphibians use prediction to compensate for sensorimotor delays to connect with moving prey
What salamanders can teach us about baseball

Salamander catching a fly

If a baseball player waits until he sees the ball arrive in front of him to swing his bat, he will miss miserably. By the time the batter sees the ball’s position, plans his swing and moves the bat, the ball will be firmly in the catcher’s mitt.

This time lag is known as sensorimotor delay. University of Louisville researcher Bart Borghuis, Ph.D., has increased our understanding of how people and animals deal with this delay in day-to-day interactions by analyzing the hunting skills of salamanders. His article, The Role of Motion Extrapolation in Amphibian Prey Capture,” is published in today’s issue of The Journal of Neuroscience.

A skilled baseball player compensates for sensorimotor delay by predicting when the ball will cross the plate and starting his swing in time to meet it. Borghuis’ research reveals the salamander also predicts the future location of its prey as it catches moving fruit flies by projecting its long, sticky tongue.

The sensorimotor delay is caused by the time it takes for the visual image to be processed by the retina, time to plan the motor action and time to activate the motion. When a salamander hopes to catch a moving fly, in the time it takes to make the strike – about 230 milliseconds – the fly will have moved from the location it was in when the salamander launched its attack. If the salamander sends its tongue to the location where it sees the fly, by the time the tongue gets there, the fly will be gone. Despite this delay, salamanders are efficient hunters, catching their prey more than 90 percent of the time in Borghuis’ experiments.

Why are salamanders so effective in their attacks?

Borghuis, assistant professor in the Department of Anatomical Sciences and Neurobiology at UofL, and Anthony Leonardo, Ph.D., of the Howard Hughes Medical Institute, used high speed videography to capture 270 instances of salamanders striking at flies. Through analysis of the videos, Borghuis developed an algorithm that predicted where the salamander’s tongue would strike based on the fly’s path.

The algorithm mimics the salamanders’ process using extrapolation to anticipate the prey’s position in the future based on its bearing and velocity. The salamanders’ tongue strikes were consistent with the algorithm, and were consistently successful – unless the fly changed course between the time the salamander initiated the attack and the time of the actual strike.

In successful strikes, the salamander caught the fly by sending its tongue tip to the position where the fly was when the tongue arrived. When the salamanders missed, the salamander’s tongue struck the location where the fly would have been had it continued on the same path it had been following. However, in these cases, the fly had changed direction after the salamander launched its attack.

“The misses confirmed the model,” Borghuis said. “This is the first demonstration that the salamanders were making a prediction.”

The tongue struck where the fly never had been, yet would have been had the fly continued its previous course of motion. Thus the salamander was predicting where the fly would be at the time the tongue reached it based on the fly’s direction and speed.

“This information adds to a small set of clear examples of how vertebrates – including humans – use prediction for dealing with delays in motor processing,” Borghuis said. “Now that we know how the salamander does this, we can further investigate the neuromechanisms that make this happen.”

VIDEO

The videos above show the researchers’ trajectory duplicating the salamander’s prediction of the location of the fly at the point of impact with the tongue. In the first video, the salamander successfully predicts the path and catches the fly. In the second video, the fly alters its direction after the salamander launches its strike, so the tongue misses the fly, hitting instead the location where the fly would have been had it not changed its course. The final video is a 4000 fps video showing a salamander striking a fruit fly. In real time, this motion would take about 1/5 of a second or 180 milliseconds.

November 18, 2015

Nelleke C. van Wouwe, Ph.D., M.Sc., joins UofL research faculty

Nelleke C. van Wouwe, Ph.D., M.Sc., joins UofL research faculty

Nelleke C. van Wouwe, Ph.D., M.Sc.

Nelleke C. van Wouwe, Ph.D., M.Sc., joined the research faculty at the University of Louisville School of Medicine as assistant professor in the Department of Neurological Surgery on June 1.

At UofL, van Wouwe will be working on research to understand the function of the basal ganglia in patients with Parkinson’s disease, Huntington’s disease, Tourette syndrome and other conditions. The basal ganglia are located at the base of the forebrain and are associated with control of voluntary movements, cognition, emotion and other functions. She will be working with Joseph Neimat, M.D., chair of the Department of Neurological Surgery, on experiments conducted in the operating room during deep brain stimulation surgeries. Her NIH-funded research will investigate how the basal ganglia affect cognitive functions crucial to navigating daily life situations, such as the ability to stop or change action.

“For example, patients with Parkinson’s disease may find it difficult to stop and control voluntary actions. The ability to stop an action can also depend on whether a positive or negative outcome is expected,” van Wouwe said. “Generally, dopaminergic medication and deep brain stimulation restore the ability to control actions, but some patients develop impulse control disorders. A better understanding of failures in adaptive behavior in neurologic or neuropsychiatric disorders with altered frontal basal-ganglia circuitry could ultimately help tailor treatment to individual needs.”

Since 2012, van Wouwe has been researching cognition and movement disorders at Vanderbilt Medical Center in Nashville. She was educated at Leiden University in the Netherlands and conducted research at the Netherlands Organization for Applied Scientific Research in Soesterberg before moving to the United States.

Van Wouwe’s research uses cognitive behavioral tasks, neurophysiological measurements, neuropsychological instruments and interventions such as medication withdrawal and deep brain stimulation to identify changes in action control and action-outcome learning resulting from neurodegenerative diseases. She is investigating the role of the subthalamic nucleus in action control and action-valence learning by means of cognitive testing, deep brain stimulation and intraoperative recording studies.

 

 

June 4, 2018

UofL James Graham Brown Cancer Center discontinues The Julep Ball

The University of Louisville James Graham Brown Cancer Center today announced it will discontinue The Julep Ball. The gala has been held annually on the evening before the Kentucky Derby since 2009.

“While The Julep Ball has over the course of its history provided great visibility for the James Graham Brown Cancer Center and a wonderful venue for us to thank our supporters, the resources necessary to stage a quality event have grown too great to make it successful as a significant fund-raising effort,” said Michael Neumann, executive director of development for the cancer center.

“We have always worked to make The Julep Ball much more than simply an enjoyable evening for our patrons; it has become the singular premiere Derby Eve ‘Party with a Purpose,’” Neumann said. “Maintaining the standards of quality that we have set for ourselves has required more and more resources, particularly manpower, each year. This means we have to divert those resources away from other projects and activities equally important to our mission to provide world-class clinical care, education and research in the field of cancer.”

Neumann added that The Julep Ball and its predecessor, the Mint Jubilee, have generated over $1.5 million over the past decade to support the work of the James Graham Brown Cancer Center. The resource requirements involved in attracting celebrity guests and providing top-quality entertainment, food and drink in a gala setting, however, has continued to grow as other Derby Week events have mushroomed.

“When we began more than a decade ago, the field of Derby Week parties was quite limited,” he said. “We believe that our success encouraged and even helped give birth to other parties organized by individuals and groups who do not have the mission we do and with whom The Julep Ball now competes.”

Events organized by others in support of the cancer center will continue to receive assistance from university faculty and staff, he said. Art to Beat Cancer is traditionally held each fall and will be held Nov. 21 from 5:30-9:30 p.m. at the Green Building, 732 E. Market St. The Twisted Pink Masquerade Ballsupports metastatic breast cancer research at the cancer center and will be held Feb. 7, 2015, at The Gillespie, 421 W. Market St. Hats for Hope traditionally kicks off the Derby season and will be held April 16, 2015, at the Triple Crown Conference Center.

“We look forward to continuing to support these events in every way we can, and explore new events proposed by our supporters,” Neumann said.

He added that the university has retained ownership of the name and brand of The Julep Ball.

“The Julep Ball grew to become a wonderfully festive Derby Eve gala, and for that, we thank each of the many volunteers over the years who helped it thrive,” Neumann said. “We hope they continue to support the James Graham Brown Cancer Center in the months and years to come.”

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About the James Graham Brown Cancer Center:

The James Graham Brown Cancer Center is a key component of the University of Louisville Health Sciences Center. As part of the region's leading academic, research and teaching health center, the cancer center provides the latest medical advances to patients, often long before they become available in non-teaching settings. The JGBCC is a part of KentuckyOne Health and is affiliated with the Kentucky Cancer Program. It is the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery. For more information, visit our web site, www.browncancercenter.org.

 

 

 

Second protein associated with common cause of kidney failure identified

Blood test should reduce need for kidney biopsies
Second protein associated with common cause of kidney failure identified

An international team of researchers including Jon Klein, M.D., Ph.D., and Michael Merchant, Ph.D., of the University of Louisville has identified a protein that turns a person’s immune system against itself in a form of kidney disease called membranous nephropathy (MN). The findings are published online in the New England Journal of Medicine.

This is the second protein associated with MN and the development of an autoimmune response.

Through the identification of this second protein, a new blood test can be developed to diagnose this common form of kidney disease.

Unchecked, MN can lead to kidney failure, or end stage renal disease. In 2011, more than a million people worldwide suffered from kidney failure annually, with more than 570,000 in the United States. Approximately 14 percent of those cases are the result of glomerulonephritis of which MN is a common cause.

“Five years ago this team initially discovered a protein that has led to a blood test identifying between 70 and 80 percent of people with MN,” said Klein, vice dean of research at UofL’s School of Medicine. “We now have found another protein that impacts up to another 5 percent of patients with MN. Once a blood test is available, we will have been able to reduce the number of kidney biopsies necessary for disease detection and to assess the response to treatment by up to 85 percent.”

Membranous nephropathy occurs when the small blood vessels in the kidney that filter wastes from the blood become inflamed and thickened. As a result, proteins leak from the damaged blood vessels into the urine. For many people, loss of these proteins eventually causes signs and symptoms known as nephrotic syndrome.

In 2009, Klein and this team reported the discovery that antibodies to kidney expression of phospholipase A2 receptor 1 (PLA2R1), were diagnostic for MN. That work, also reported in the New England Journal of Medicine, led to an FDA-approved test to diagnose MN. The PLA2R1 antibody test is positive in 80 percent of patients with MN. This week’s disclosure is related to the protein THSD7A. Researchers examined the blood of people known to have MN. Of the 154 people studied, 15 had antibodies to THSD7A, but not PLA2R1.

“This is significant because it provides us with another marker of identification and enables us to lessen the physical burden on our patients and ultimately will decrease the need for kidney biopsy. These MN antibody tests also allow us to monitor disease activity without kidney biopsy as we treat the patient. This allows a more rapid approach to developing new therapies for MN,” Klein said.

As pointed out by senior author Gérard Lambeau, Ph.D., director of research at Centre National de la Recherche Scientifique and Université de Nice Sophia Antipolis, Valbonne and team leader at the Institute of Molecular and Cellular Pharmacology (Sophia Antipolis), “This week’s disclosure is related to the discovery of the protein THSD7A and the corresponding anti-THSD7A autoantibodies in a group of about 10 percent of MN patients who did not have anti-PLA2R1 autoantibodies.”

“The discovery of this second antigen-antibody system in membranous nephropathy will allow clinicians to diagnose this new form of primary (autoimmune) membranous nephropathy and provides a new method to monitor the disease activity in this subgroup of patients,” said co-lead authors Nicola Tomas, M.D. of University Medical Center Hamburg–Eppendorf and Laurence Beck, M.D., Ph.D., of Boston University School of Medicine.

Catherine Meyer-Schwesinger, M.D., Barbara Seitz-Polski, M.D., Hong Ma, Ph.D., Gunther Zahner, Ph.D., Guillaume Dolla, M.S., Elion Hoxha, M.D., Udo Helmchen, M.D., Anne-Sophie Dabert-Gay, Ph.D., Delphine Debayle, Ph.D., David J. Salant, M.D., and Rolf A.K. Stahl, M.D., are part of the research team.

In addition to the online version of the New England Journal of Medicine, the findings recently were presented at the American Society of Nephrology Kidney Week 2014 in Philadelphia.

Nominate an outstanding nurse for 3rd annual UofL Nightingale Awards in Nursing

Nominate an outstanding nurse for 3rd annual UofL Nightingale Awards in Nursing

University of Louisville School of Medicine faculty, staff, students, residents and alumni are invited to nominate outstanding nurses employed in Kentucky and Southern Indiana for the third-annual University of Louisville Florence Nightingale Awards in Nursing.

The awards honor exceptional nurses who have followed in the footsteps of Florence Nightingale, the founder of modern nursing.

Submit an essay of no more than 200 words about how a registered nurse meets at least one of the following categories:

  • Impacted patients through excellent and compassionate nursing care;
  • Improved health outcomes in a population or in the community;
  • Elevated the nursing profession through teaching, research and/or policy development;
  • Inspired others to consider nursing as a career.

People may nominate a nurse online. The nomination deadline is Sept. 8.

Winners will receive a cash prize and commemorative plaque at the Nightingale Awards dinner 5:30 to 8 p.m. Nov. 3 at the Mellwood Arts Center. Register to attend the dinner.

For more information, contact Karen Rose at karen.rose@louisville.edu or 502-852-5825.

Can parents genetically design their children? Beer with a Scientist, Nov. 15

Hear from medical experts in reproduction
Can parents genetically design their children? Beer with a Scientist, Nov. 15

Baby feet with hands

Leading experts in reproductive endocrinology, Kelly Pagidas, M.D., and Miriam Krause, M.D., will address issues and possibilities surrounding parents’ ability to determine specific genetic traits in their children at the next Beer with a Scientist event, Wednesday, Nov. 15.

Pagidas and Krause will answer the question:  Can we really engineer our children? They also will provide an overview of current genetic testing available with in-vitro fertilization and the ethical considerations that go along with that capability.

Pagidas practices with Ob/Gyn & Women’s Health at UofL Physicians and is a professor and the division and fellowship program director of the Division of Reproductive Endocrinology and Infertility in the UofL Department of Obstetrics, Gynecology & Women’s Health. Krause practices with Fertility and Endocrine Associates.

The talk begins at 8 p.m. on  Wednesday, Nov. 15, at Against the Grain Brewery, 401 E. Main St. in Louisville. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science. For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

Beer with a Scientist will take the month of December off. Dates are set for the first quarter of 2018:  Jan. 17, Feb. 21, Mar. 14.

Darrell A. Griffith named associate vice president for health affairs at UofL

Darrell A. Griffith named associate vice president for health affairs at UofL

Darrell A. Griffith has been named the new associate vice president for health affairs/finance and administration for the University of Louisville Health Sciences Center. He also will assume the position of vice president/CFO for University of Louisville Physicians. Griffith comes from the University of Kentucky/UK Healthcare, where he was the executive director for the faculty practice organization.

David L. Dunn, M.D., Ph.D., UofL executive vice president for health affairs, highlighted Griffith’s extensive financial experience within academic medicine and physician practices.

“I am very pleased to welcome Darrell to the UofL Health Sciences Center,” Dunn said. “He understands the complexity of an academic health center and the role of the faculty practice plan. His experience is critical as we begin the next steps in the transformation of the health sciences center.”

Griffith has spent the past 11 years at the University of Kentucky, initially as a senior manager of business development and decision support. He served two years as the interim associate dean for administration and finance for the College of Medicine before taking his current role in 2006. He was instrumental in developing the UK Healthcare strategic plan that saw unprecedented growth in revenues and outpatient care.

Prior to joining UK, Griffith was a senior consultant with Avalon Management Consulting LLC, in Knoxville, Tenn. He also has been with Promina-Dekalb Regional Healthcare System in Atlanta, Erlanger Health System in Chattanooga, Tenn., and Healthcare Resources Inc. in Somerset, Ky.

Griffith earned his bachelor of science in business administration and his master of public health/health care administration from the University of Tennessee. He is a certified medical practice executive from the American College of Medical Practice Executives. He is a member of the Academic Practice Plan Directors under the University Health Consortium.

UofL medical student earns national award

UofL medical student earns national award

Mickey Ising

Mickey Ising, a student at the University of Louisville School of Medicine and a two-time graduate of the UofL J.B. Speed School of Engineering, is one of 21 fourth-year medical students throughout the nation to earn an American Medical Association (AMA) Foundation Physicians of Tomorrow Award.

Ising was selected to receive this $10,000 national scholarship recognizing academic achievement. After graduating from Elizabethtown (Ky.) High School in 2005, he earned both bachelor’s and master’s degrees in bioengineering at UofL. He works at the Cardiovascular Innovation Institute at the UofL Health Sciences Center developing and evaluating medical devices and novel therapeutic techniques. Ising has authored eight manuscripts published in peer-reviewed journals and is vice president of the UofL School of Medicine Class of 2015.

Recipients were nominated by their medical schools and chosen based upon academic achievement and financial need.  The AMA Foundation has awarded over $61 million in scholarships to deserving medical students since 1950.

The AMA Foundation, a 501(c)(3) tax-exempt foundation, is dedicated to improving public health by raising funds and providing philanthropic support to high-impact health and medical scholarship programs. Visit www.amafoundation.orgto join the AMA Foundation in improving the health of Americans.

Lite 106.9 giving away Outlet Shoppes VIP Preview tickets

July 30 event benefits James Graham Brown Cancer Center at UofL

The University of Louisville James Graham Brown Cancer Center is teaming up with Lite 106.9 to give away tickets to the Opening Night VIP Preview Shopping Event at The Outlet Shoppes of the Bluegrass.

Five pairs of tickets to the preview event are being given away this week by the radio station. To win, listen to Lite 106.9 with Vicki Rogers during the noon hour for the call for entries, and then phone 502-571-1069 for a chance to win.

The Outlet Shoppes of the Bluegrass is holding the event to benefit the cancer center from 6-9 p.m., Wednesday, July 30, the evening before the facility opens to the general public.

Patrons will be able to get the jump on the rest of Kentuckiana in shopping at choice retail outlets such as Coach, Brooks Brothers, Saks Fifth Avenue Off 5th, Michael Kors, J Crew, Banana Republic, Nike, Talbots, Under Armour and more. They also will receive a goody bag of items that includes a free coupon book with over $300 in savings good for an entire year at many of the 80-plus retailers that make up The Outlet Shoppes of the Bluegrass. VIP preview event guests will also enjoy live music, light passed hors d’oeuvres, and the opportunity to bid on silent auction packages valued at $50 to $500 donated by Shoppes merchants.

Tickets are valued at $50 each, and for those not lucky enough to win, tickets can be purchased at www.shoppingforacure.org. Only patrons with tickets will be able to enter The Outlet Shoppes on opening night.

All proceeds from the VIP Preview go to the James Graham Brown Cancer Center, a part of KentuckyOne Health and the only cancer center in the region to use a unified approach to cancer care, with multidisciplinary teams of physicians working together to guide patients through diagnosis, treatment and recovery.

The Outlet Shoppes of the Bluegrass is located at Exit 28 on Interstate 64. For additional information on the Opening Night VIP Preview or the James Graham Brown Cancer Center, contact 502-562-4642.

Kentucky Cancer Program teams up with UofL Women's Basketball for 'Play4Kay Pink Out' Thursday

Kentucky Cancer Program teams up with UofL Women's Basketball for 'Play4Kay Pink Out' Thursday

UofL fans will get to see the Horses and Hope pink Mustang and Mobile Screening Unit as the Kentucky Cancer Program teams up with Louisville Women's Basketball this Thursday.

The UofL Women Basketball Cards, ranked fourth in the nation, will offer some health awareness along with the team’s matchup with the University of Virginia, Thursday, Feb. 22, at the KFC Yum! Center. Tip-off is at 7 p.m.

The Play4Kay Pink Out honors the late Kay Yow, a former NC State coach who died from cancer. The Kay Yow Cancer Fund is celebrating its 10th anniversary of providing funding and support for cancer research.

The Kentucky Cancer Program at the UofL James Graham Brown Cancer Center will be on hand at the game with giveaways and educational materials on the importance of early screening and detection of breast cancer. Louisville Women’s Basketball also will recognize breast cancer survivors on the court during halftime.

Fans are encouraged to wear pink, and representatives of Tom Drexler Plumbing and Remodeling will accept $5 donations for a breast cancer awareness t-shirt in the main concourse of the KFC Yum! Center. Proceeds will benefit Gilda's Club of Louisville.

Fans also will get to check out the Horses and Hope Mustang and Mobile Screening Unit, vehicles that are projects of Horses and Hope, an organization that brings cancer screening, detection and treatment services to workers in the equine industry in Kentucky.

Breast cancer survivors are eligible to receive one free ticket and a discounted ticket for $3 for all guests. Call the Louisville Cardinals' Ticket office for this offer at 502-852-5151. Other fans can receive discounted tickets for $3 by visiting My Cardinal Account and using promo code PLAY4KAY.

 

 

Identical adult twins undergo first-of-its-kind procedure performed by UofL physician

A woman who survived a rare childhood cancer successfully underwent a first-of-its-kind procedure with University of Louisville Physicians to help restore her appearance.

Jarrod Little, M.D., a plastic and reconstructive surgeon with UofL Physicians, used fat grafted from Janna Coleman’s identical twin, Jessie, to reshape Janna’s face from the damaging effects of radiation and chemotherapy. While fat grafting has been done for years, there are no instances in medical literature of it taking place from one person to another, and never before on identical twins. While tissue from twins has been used for organ transplants, soft tissue procedures between twins are rare, Little said.

The surgery took place at University of Louisville Hospital, part of KentuckyOne Health, over about three hours on Thursday, Nov. 19, and was a success.

“It will make a huge difference for her,” Little said. “She looks like a new person. I’m very happy with the results.”

Janna, 28, was diagnosed with an aggressive rhabdomyosarcoma at the age of 7. Childhood rhabdomyosarcoma is a disease in which malignant cells form in muscle tissue, and Janna’s formed behind her jaw. She was successfully treated, but the surgery, radiation and chemotherapy to her head and neck left lasting effects, damaging her pituitary gland, which disrupted her growth, most noticeably around her face. He jawbone never grew to an adult size.

While Janna is an identical twin, her sister, Jessie, did not have the same condition. Though they once looked so much alike even their father had trouble telling them apart, after her treatment Janna no longer looked as much like her sister.

“The cancer was the easy part; the aftermath is what’s been hard,” Janna said.

Janna went through more than 10 reconstructive surgeries over the years to help, but without much success. After moving to Louisville and working as an oncology nurse, she heard of Little and went to him to see if there was anything else that could be done.

With the jawbone in Janna's face damaged and stunted from radiation, Little determined reconstruction of her jaw was not an option. Fat grafting to help re-shape her face was, but Janna did not have enough fat, and was unable to gain weight because of her development issues.

But when Little learned Janna was an identical twin, he came up with the idea to take fat from Jessie and transplant it into Janna’s face. The procedure also was unique in that many people with Janna’s condition and location of her tumor do not survive to adulthood.

By increasing volume to the face and repairing some of the damaged tissues, the goal of the procedure was to give Janna’s face a more natural volume and contour so the size of the jaw bone will not be as noticeable, Little said.

Fat also was a good option for Janna because it has a high concentration of stem cells, which are beneficial because they can form into new types of cells. When they are introduced to a new area, they can regenerate surrounding soft tissue. And with the twins having a nearly 100 percent genetic match, the probability of success was high.

“I just want to look like my sister and more like a twin,” Janna said. "It is hard being her twin. She's gorgeous.”

To donate fat, Jessie had to make an effort to gain weight. For months, the normally health-conscious Jessie ate high-calorie foods – including ice cream, pizza and fast food – to develop enough fat that could be removed by liposuction for Janna.

“She’s my sister, my twin,” Jessie said before the surgery. “Of course I’m going to do anything I can to help.”

“I want her to be more confident in herself and be proud to say we're twins and not be shy about it because we're exactly alike.”

It will take several months to assess the full effects of the procedure. One or two more sessions may be needed before the reconstruction is complete.

While Janna’s portion of the procedure was covered by insurance, Jessie’s was not, so UofL Hospital donated her costs.

UofL leading nationwide efforts to improve lifelong care for people with intellectual/developmental disabilities

Partnership between UofL and Special Olympics aims to increase physicians’ comfort in treating adult patients with IDD
UofL leading nationwide efforts to improve lifelong care for people with intellectual/developmental disabilities

SOKY Athlete Ambassador Morgan Turner talks with medical students

At one time, people with intellectual/developmental disabilities (IDD) were mostly children. Thanks to medical advances and the deinstitutionalization movement, the number of adults living in the community with IDD has grown dramatically. These individuals require the same health-care services as any adult, but their care may come with added challenges. Most physicians in adult medical specialties have not been trained to work with these patients, and may not be comfortable with the communication challenges or other unique needs they may have.

Priya Chandan, M.D., M.P.H., assistant professor in the UofL School of Medicine and in the School of Public Health and Information Sciences, is leading nationwide efforts to help future physicians become more knowledgeable about caring for patients with IDD throughout their lives. Chandan, who has an older brother with Down syndrome, has a personal understanding of the need for physicians who can provide equitable care for people with IDD.

“This patient population is not just a pediatric population. All physicians need to be comfortable serving patients with IDD,” Chandan said.

To achieve that goal, Chandan is leading the National Curriculum Initiative in Developmental Medicine (NCIDM), a partnership between Special Olympics International (SOI) and the American Academy of Developmental Medicine and Dentistry (AADMD) to ensure future physicians receive training to care for individuals with IDD across their lifespan. Over four years, 12 medical school partners will design and implement their own curriculum enhancements. UofL is part of the first cohort for this training, along with Baylor College of Medicine and the University of Colorado. The second cohort includes Ohio State, Case Western Reserve and Georgetown Universities.

Chandan also is working with Amy Holthouser, M.D., senior associate dean of medical education, to develop the educational programs at UofL. One program is an elective rotation for fourth-year students at Lee Specialty Clinic, an interdisciplinary clinic that focuses on caring for people with IDD that is funded by the Commonwealth of Kentucky. Through working with the patients and staff at Lee Specialty Clinic, the students will become more comfortable treating these patients.

In addition, second-year medical students at UofL are participating in small group discussions led by Special Olympics Kentucky (SOKY) athletes in the Athlete Leadership Program. The goal of these discussions is to help the students better understand the needs of IDD patients by hearing their story and having the athletes express their needs.

Morgan Turner, a SOKY Athlete Ambassador who has met with the second-year students, said the most important message he wants to convey to the students is to include him in communication.

“When working with someone with a disability, be patient and ask questions to the patient and the parent. Don’t just talk to the parent,” Turner said.

“Communication is a big part of it,” Chandan said. “While this is a medical education project, we also see this as a way for people with intellectual and developmental disabilities to be self-advocates. Having them speak directly to medical providers about what it is like to be a patient and what they need from us is powerful.”

Chandan recently received two additional grants to expand her work. The first, an SOI Inclusive Health Innovation Grant, aims to improve education for resident and attending physicians regarding care for people with IDD. Chandan will be working with the American Academy of Physical Medicine & Rehabilitation (AAPM&R), leading efforts to educate resident and attending physicians regarding physiatrists’ role in the care of patients with IDD. Darryl Kaelin, M.D., chief, professor and residency director of the UofL Division of Physical Medicine and Rehabilitation and president of AAPM&R, also is working on the project.

The second grant is from the Working for Inclusive and Transformative Healthcare (WITH) Foundation to collaborate with the University of Kentucky’s Human Development Institute to develop a tool to aid with informed consent discussions. The tool will have the look of a graphic novel and will help facilitate conversations between health-care providers, patients with IDD and supporters.

“I went to medical school with the intention of being a physician who serves patients with IDD,” Chandan said. “Along the way, I realized that we have work to do in terms of health education and health-care delivery. My goal with these efforts is to improve care for these patients.”

 

 

 

February 21, 2018

UofL, AARP host free aging conference ‘Watch Party’ on July 13

Public, professionals invited to live-streamed 2015 White House Conference on Aging
UofL, AARP host free aging conference ‘Watch Party’ on July 13

The University of Louisville Institute for Sustainable Health & Optimal Aging and AARP will host a free “Watch Party” of the 2015 White House Conference on Aging, Monday, July 13. Registration opens at 9 a.m. and the conference will be held from 10 a.m. to 5 p.m.

The conference is open to the general public as well as to professionals engaged in all aspects of senior caregiving and service provision. Space is limited, so RSVPs are needed by contacting Ann Burke at optimalaging@louisville.edu or 502-852-5629. For additional information, contact Mary Romelfanger, associate director of the Institute for Sustainable Health & Optimal Aging, mary.romelfanger@louisville.edu.

The conference will be live-streamed in the recently renovated Lecture Hall, room B215 of the UofL School of Medicine Instructional Building, 500 S. Preston St. Metered parking is available on South Preston, East Muhammed Ali and East Chestnut streets and parking for a fee is available in the Chestnut Street Garage, 414 E. Chestnut St.

President Barack Obama is scheduled to be the keynote speaker at the White House Conference on Aging, an event held once a decade since 1961 that helps chart the course of aging policy. Watch Party attendees will be able to send questions and comments directly to the conference and a panel of local aging specialists will be available to answer questions at the event.

“The year 2015 marks the 50th anniversary of Medicare, Medicaid and the Older Americans Act, as well as the 80th anniversary of Social Security,” said Anna Faul, D.Litt., Executive Director of the Institute for Sustainable Health and Optimal Aging. “The 2015 White House Conference on Aging is an opportunity to recognize the importance of these key programs as well as to look ahead to the issues that will help shape the landscape for older Americans for the next decade.”

According to the conference website, the four areas the conference will examine were developed after hearing from older Americans in forums held across the country. The common themes that emerged from this input were the following:

  • Retirement security is a vitally important issue to older Americans. Financial security in retirement provides essential peace of mind for older Americans, but requires attention during their working lives to ensure that they are well prepared for retirement.
  • Healthy aging will be all the more important as baby boomers age. As medicine advances, the opportunities for older Americans to maintain their health and vitality should progress as well, and support from their communities, including housing, are important tools to promote their vitality.
  • Long-term services and supports remain a priority. Older Americans overwhelmingly prefer to remain independent in the community as they age. They need supports to do so, including a caregiving network and well-supported workforce.
  • Elder justice is important given that seniors, particularly the oldest older Americans, can be vulnerable to financial exploitation, abuse and neglect. The Elder Justice Act was enacted as part of the Affordable Care Act, and its vision of protecting seniors from scam artists and others seeking to take advantage of them must be realized.

Health professionals to train in transgender care

UofL School of Medicine to host sessions for 140 area providers on June 11

Physicians without formal training in transgender health can be unprepared when a transgender patient needs basic health care, or help with a transgender specific issue such as hormonal transition. If the physician is unfamiliar with the typical barriers faced by transgender people in the health-care system or current standards of care, the patient’s health may suffer.

The University of Louisville will host two events on June 11 at the School of Medicine to close this gap by providing physicians and other health-care providers with a better understanding of treatment practices and standard of care for transgender patients.

First, a panel of physicians and community members will discuss best practices in transgender health care in a grand rounds presentation for approximately 80 physicians and other health professionals. Following the panel presentation, about 60 health-care providers and transgender community leaders will meet to network, identify gaps in care and discuss steps needed to improve care for this population.

The events are part of a UofL initiative, known as the eQuality Project,* established to ensure that individuals who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming or born with differences of sex development (DSD) receive the best possible health care in the community.

“This is a topic that has been taboo for a long time. Physicians want to provide the best care for these patients, but they may not be aware of issues and how to address someone in a culturally responsive manner,” said Faye Jones, M.D., Ph.D., M.S.P.H., assistant vice president for health affairs -- diversity initiatives at UofL’s Office of Diversity and Inclusion. “This is a group that has many health disparities and this program will help alleviate these disparities.”

People who are LGBT, gender non-conforming or born with DSD often experience challenges when seeking care in doctors’ offices, community clinics, hospitals and emergency rooms. Research shows that these health disparities result in decreased access to care or willingness to seek care, resulting in increased medical morbidity and mortality for LGBT and DSD-affected patients.

“Ultimately, it is our goal to have an identified medical ‘home’ that provides all aspects of care for transgender patients in Louisville, as has been developed in other major clinical centers in the United States,” said Amy Holthouser, M.D., associate dean for medical education at the UofL School of Medicine.

Beginning in August, the UofL School of Medicine will serve as the nation’s pilot site for training future physicians on the unique health-care concerns and issues encountered by LGBT individuals and those who are gender nonconforming or DSD-affected.

The Institute of Medicine, The Joint Commission, the U.S. Department of Health and Human Services, and the Association of American Medical Colleges (AAMC) have all recently highlighted the need for more in-depth provider education on LGBT health.

“At least forty hours of content in the UofL school of medicine curriculum have been targeted for revision to be more inclusive and affirming of LGBT and DSD patients,” Holthouser said. “This will reinforce the core stance that a competent physician is skilled in the care of all patients within their community and can approach each patient with sensitivity, compassion and the knowledge necessary to promote health and wellness.”

For more information about attending the event on June 11, contact Stacie Steinbock, director of the LGBT Center Satellite Office on the Health Sciences Center Campus at Stacie.steinbock@louisville.edu.

 

*About the eQuality Project:  The eQuality Project at UofL is an interdisciplinary initiative that includes the School of Medicine’s Undergraduate Medical Education Office, the Health Sciences Center’s Office of Diversity and Inclusion, and the UofL LGBT Center. The purpose of the eQuality Project is to deliver equitable quality care for all people, regardless of identity, development or expression of gender/sex/sexuality.

Spike it to Cancer sand volleyball event benefits cancer center at UofL, June 13

Spike it to Cancer sand volleyball event benefits cancer center at UofL, June 13

Benefactors of a fund to support patients at the James Graham Brown Cancer Center at the University of Louisville are sponsoring their third annual sand volleyball event to raise money for the fund.

In 2013, Alex and Tommy Gift established the Mary Jane Gift Quality of Life Fund at the cancer center, a part of KentuckyOne Health, in honor of their late mother. The fund helps patients and their families enjoy life while facing a cancer diagnosis.

To benefit the fund, the Gifts are sponsoring the Third Annual Spike It to Cancer Sand Volleyball Tournament at Baxter Jack’s sand volleyball complex, 427 Baxter Ave. on Saturday, June 13. Player or spectator admission is $25 per person. Pre-registration is recommended and is now open at the cancer center’s secure online link. Games will begin at 2 p.m. and end by 6 p.m. Registration at the door will be accepted but only from 1-2 p.m.

“All proceeds from this event go to the Mary Jane Gift Quality of Life Fund that pays for extras provided to our patients and caregivers,” Michael Neumann, executive director of development, said. “Additionally, Ward 426 on Baxter Avenue directly across the street from Baxter Jack’s has agreed to donate a portion of all food and beverage sales to us during the event.

"These gifts go a long way in bringing cheer to our patients and their families. For example, the fund has provided Thanksgiving turkeys to many of our patients and their families over the past two years as well as provide picnic baskets to patients on Easter morning.”

For additional details, contact Neumann at 502-562-4642.

 

PRIDE Blood Drive nets needed units plus call for changes in blood donation policy

PRIDE Blood Drive nets needed units plus call for changes in blood donation policy

The numbers tell the story: 25, 45, 56, 188.

Helping local blood banks rebuild their critical supplies while also drawing attention to the FDA’s lifetime ban on blood donations from men who have sex with men (MSM77), was the goal of the Health Sciences Center PRIDE Blood Drive.

During the event, the goal of 25 units was greatly surpassed with 45 units of blood provided by 56 donors, and 188 people signed a petition to abolish the FDA MSM77 blood donation deferral policy. The event was organized by the School of Public Health and Information Sciences (SPHIS), Student Government Association, UofL LGBT Center and the American Red Cross.

SPHIS Dean Craig Blakely, Ph.D., offered remarks and was the first to sign the petition. “As a leading institution of public health, we want to continuously evaluate national public health policy to optimize the ability to provide exceptional health for all of our citizens with maximum participation in the process.

“The concern and initiative that the students of the LGBT Center at the University of Louisville have shown on the MSM 77 lifetime deferral policy is an excellent example of a diverse grass-roots effort to change government policy to improve health in the United States,” Blakely said.

“This lifetime deferral unfairly stigmatizes and discriminates against a large portion of the LGBT community, and keeps many healthy would-be donors from giving blood – creating a negative impact on the nation’s blood supply,” said Dustin Scott, event organizer and a student in the SPHIS master’s in public health program. “The FDA policy, established in 1983 after the onset of the AIDS epidemic, is outdated and needs to be abolished.”

Scott gave blood on a regular basis until his status as an MSM prevented him from continuing to do so.

“My parents were once in a car accident and donated blood saved their lives. This is why I am so passionate about blood donation, and I encourage friends, colleagues, family, and even strangers to donate blood in my place,” Scott said.

Scott plans to present research along with the signed petition to the FDA. He is working with medical student Mellad Khoshnood and Professor of Cardiovascular and Thoracic Surgery and Bioengineering George Pantalos, Ph.D., to provide an analysis of the effectiveness of the MSM blood donation ban.

The team has contacted the 20 countries that spend the most on health care per capita, and has asked for their stance on the MSM donor policy, prevalence of HIV, demographics of those affected, frequency of transfusion of HIV infections, blood screening processes and changes made to their MSM donor policy in the past 10 years.

“We are learning that countries such as the United Kingdom have modified bans, meaning that after an individual engages in risky sexual activity, they are deferred from donating blood for one year to allow for diseases that have prolonged dormant periods to present. We support that,” Scott said. “Our petition to the FDA asks them to rescind the lifetime deferral policy for a more reasonable policy that will permit healthy gay men to contribute to the needs of our society as blood donors.”

“At the LGBT Center, we love connecting students, faculty and the community around us to emerging health issues like this one, and bridging classroom topics with real-world issues. The HSC PRIDE student group expands our capacity to raise awareness and make novel connections to health issues spanning our various disciplines. I’m excited to see them fostering such interprofessional connections and engaging the community,” said Stacie Steinbock, director, LGBT Center Health Science Center satellite office.

 

UofL's James Graham Brown Cancer Center earns 3-year accreditation from American College of Radiology

UofL's James Graham Brown Cancer Center earns 3-year accreditation from American College of Radiology

The radiation oncology department at the University of Louisville's James Graham Brown Cancer Center, part of KentuckyOne Health, has been awarded another three-year term of accreditation in radiation oncology by the American College of Radiology (ACR).

The ACR is the nation’s oldest and most widely accepted radiation oncology accrediting body, with more than 600 accredited sites and 27 years of accreditation history. The accreditation is awarded only to facilities that meet the ACR's specific practice guidelines and technical standards following a peer-review evaluation by board-certified radiation oncologists and medical physicists who are experts in the field. Patient care and treatment, patient safety, personnel qualifications, adequacy of facility equipment, quality control procedures and quality assurance programs also are assessed by the ACR prior to accreditation.

The radiation oncology department has six board-certified physicians working with board-certified radiation therapists, a team of oncology nurses and a dosimetrist - the professional who determines how to deliver prescribed radiation treatment to a patient - among others.

“Our hospital, doctors and staff work extremely hard to make sure that we are doing everything we can to provide the best outcomes for our patients,” said Donald Miller, M.D., cancer center director. “Continued recognition from the American College of Radiology is an important confirmation that we continue to lead the way in cancer care in the region.”

The James Graham Brown Cancer Center opened on the UofL health sciences campus in 1981 with a $12 million gift from the James Graham Brown Foundation and the citizens of Louisville with a mission of relieving the pain and suffering caused by cancer in Kentucky. The center is a partnership between UofL and KentuckyOne Health and offers robust clinical and basic science research programs. Combining these research elements in a treatment environment provides the best opportunity for discovery of new techniques and therapies for the benefit of patients. It has been ranked as one of the best cancer care hospitals in Kentucky for 2014-15 by U.S. News & World Report, which recognizes hospitals that excel in treating the most challenging patients.

UofL's James Graham Brown Cancer Center is located at 529 S. Jackson St. For information, call 502-562-4158 or toll-free at 1-866-530-5516.

Science, politics and the giant moose

Learn how Thomas Jefferson used an oversized moose to influence Europeans’ views of America at the next Beer with a Scientist, May 11
Science, politics and the giant moose

Lee Dugatkin, Ph.D.

Lee Dugatkin, Ph.D., professor of biology at the University of Louisville, will regale guests at the next Beer with a Scientist with the story of how a Revolutionary War-era dispute over natural history took on important political overtones in European-American relations.

The story involves three individuals:  Thomas Jefferson, author of the Declaration of Independence; George-Louis Leclerc de Buffon, a French count and world-renowned naturalist who claimed that all life in America was "degenerate," weak and feeble; and a very large, dead moose. Jefferson believed the moose could help quash early French arrogance toward the fledgling United States and demonstrate that America was every bit the equal of a well-established Europe.

Despite Jefferson's passionate refutation, the theory of degeneracy far outlived both him and Buffon and continued to have scientific, economic and political implications for 100 years.

Dugatkin has written a book, Mr. Jefferson and the Giant Moose, on the impact of the disputeand has spoken on the topic at the Smithsonian Institution and Jefferson’s Monticello estate.

The program begins at 8 p.m. on Wednesday, May 11 at Against the Grain Brewery, 401 E. Main St. A 30-minute presentation will be followed by an informal Q&A session.

The Beer with a Scientist program began in 2014 and is the brainchild of UofL cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

 

May 4, 2016

Technology, along with therapy, helps individuals with chronic spinal cord injuries voluntarily take steps

New research published in the New England Journal of Medicine documents the effectiveness of epidural stimulation with locomotor training following chronic, complete spinal cord injury in restoring brain-to-spine connectivity, long thought to be impossible
Technology, along with therapy, helps individuals with chronic spinal cord injuries voluntarily take steps

Kelly Thomas, Claudia Angeli, Ph.D., Jeff Marquis and Susan Harkema, Ph.D.

Of four research participants living with traumatic, motor complete spinal cord injury, two are able to walk over ground with epidural stimulation following epidural stimulation paired with daily locomotor training. In addition, all four participants achieved independent standing and trunk stability when using the stimulation and maintaining their mental focus. The study was conducted at the Kentucky Spinal Cord Injury Research Center at the University of Louisville (UofL) and was published online early, and will appear in the Sept. 27 issue of New England Journal of Medicine. The study was funded by the Leona M. and Harry B. Helmsley Charitable Trust, University of Louisville Hospital and Medtronic plc.

See video story

This ground-breaking progress is the newest development in a string of outcomes at UofL, all pointing to the potential of technology in improving quality of life – and even recovery – following spinal cord injury. This latest study builds on initial research published in The Lancet in 2011 that documented the success of the first epidural stimulation participant, Rob Summers, who recovered a number of motor functions as a result of the intervention. Three years later, a study published in the medical journal Brain discussed how epidural stimulation of the spinal cord allowed Summers and three other young men who had been paralyzed for years to move their legs. Later research from UofL demonstrated this technology improved blood pressure regulation.

“This research demonstrates that some brain-to-spine connectivity may be restored years after a spinal cord injury as these participants living with motor complete paralysis were able to walk, stand, regain trunk mobility and recover a number of motor functions without physical assistance when using the epidural stimulator and maintaining focus to take steps,” said author Susan Harkema, Ph.D., professor and associate director of the Kentucky Spinal Cord Injury Research Center at the University of Louisville. “We must expand this research – hopefully, with improved stimulator technology – to more participants to realize the full potential of the progress we’re seeing in the lab, as the potential this provides for the 1.2 million people living with paralysis from a spinal cord injury is tremendous.”

Progress for Individuals Living with Paralysis

The American Spinal Injury Association Impairment Scale (AIS) was used to classify the spinal cord injuries of each of the four participants. When the four participants joined the study, they were at least 2.5 years post injury. They were unable to stand, walk or voluntarily move their legs. Eight to nine weeks prior to the implantation of an epidural stimulator, they started daily locomotor training – manual facilitation of stepping on a treadmill – five days per week for two hours each day. Although there were no changes to their locomotor abilities prior to the implant, following the epidural stimulation participants were able to step when the stimulator was on and the individual intended to walk. Participants 3 and 4 were able to achieve walking over ground – in addition to on a treadmill – with assistive devices, such as a walker and horizontal poles for balance while the stimulator was on.

“Being a participant in this study truly changed my life, as it has provided me with a hope that I didn’t think was possible after my car accident,” said Kelly Thomas, a 23-year-old from Florida, also referred to as Participant 4. “The first day I took steps on my own was an emotional milestone in my recovery that I’ll never forget as one minute I was walking with the trainer’s assistance and, while they stopped, I continued walking on my own. It’s amazing what the human body can accomplish with help from research and technology.”

Jeff Marquis, a 35-year-old Wisconsin native who now lives in Louisville, was the first participant in this study to attain bilateral steps. “The first steps after my mountain biking accident were such a surprise, and I am thrilled to have progressed by continuing to take more steps each day. In addition, my endurance has improved, as I’ve regained strength and the independence to do things I used to take for granted like cooking and cleaning,” said Marquis, who is participant 3 in New England Journal of Medicine study. “My main priority is to be a participant in this research and further the findings, as what the University of Louisville team does each day is instrumental for the millions of individuals living with paralysis from a spinal cord injury.”

“While more clinical research must be done with larger cohorts, these findings confirm that the spinal cord has the capacity to recover the ability to walk with the right combination of epidural stimulation, daily training and the intent to step independently with each footstep,” said Claudia Angeli, Ph.D., senior researcher, Human Locomotor Research Center at Frazier Rehab Institute, and assistant professor, University of Louisville’s Kentucky Spinal Cord Injury Research Center.

Advancements for Spinal Cord Injury Community

This research is based on two distinct treatments:  epidural stimulation of the spinal cord and locomotor training. Epidural stimulation is the application of continuous electrical current at varying frequencies and intensities to specific locations on the lumbosacral spinal cord. This location corresponds to the dense neural networks that largely control movement of the hips, knees, ankles and toes. Locomotor training aims to ultimately retrain the spinal cord to “remember” the pattern of walking by repetitively practicing standing and stepping. In a locomotor training therapy session, the participant’s body weight is supported in a harness while specially trained staff move his or her legs to simulate walking while on a treadmill.

“We are seeing increasing interest in the use of neuromodulation procedures and technologies such as epidural stimulation in the treatment of spinal cord injury and restoration of locomotor, cardiovascular and urodynamic functions,” said Maxwell Boakye, M.D., M.P.H., M.B.A., chief of spinal neurosurgery at the University of Louisville and clinical director of the Kentucky Spinal Cord Injury Research Center. “Epidural stimulation is likely to become a standard treatment with several improvements in design of the device to target more specific neurological circuits.”  

For more information on epidural stimulation research, visit Victoryoverparalysis.org.

 

September 24, 2018

Good sleep wards off cancer

UofL psychologist explains how disrupting your biological rhythm can lead to cancer at Beer with a Scientist, Sept. 12
Good sleep wards off cancer

Liz Cash, Ph.D.

When did you last travel overseas? Do you remember how long it took for your sleep cycle to return to normal?

That feeling of jet lag signals a disruption to your naturally occurring circadian, or daily, biological rhythms. Circadian rhythms help our bodies know when to eat, when to sleep and when to be active. They also control the life cycle of every cell in the body.

“When our circadian rhythms become disrupted, humans and animals are at greater risk for the rise and spread of cancer,” said Liz Cash, Ph.D., a clinical health psychologist and director of research for the Department of Otolaryngology Head and Neck Surgery and Communicative Disorders at the University of Louisville. She also holds adjunct positions in the Departments of Psychological and Brain Sciences, and Family and Geriatric Medicine.

At the next Beer with a Scientist, Cash will deliver, “Tick-tock:  How disrupting your body clock and sleep cycle gives rise to cancer … and what you can do about it.” Her talk will include evidence of how circadian disruption contributes to cancer incidence and progression, as well as some simple, effective strategies to maintain or regain good circadian rhythms. 

The talk begins at 8 p.m. on Wednesday, Sept. 12, at Against the Grain Brewery, 401 E. Main St. in Louisville. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer, other beverages or menu items is not required but is encouraged.

Organizers add that they also encourage Beer with a Scientist patrons to drink responsibly.

UofL cancer researcher Levi Beverly, Ph.D., created the Beer with a Scientist program in 2014 as a way to bring science to the public in an informal setting. At these events, the public is invited to enjoy exactly what the title promises:  beer and science.