News

Is it a healthy day in the neighborhood?

Posted by UofL News on July 28, 2023
Is it a healthy day in the neighborhood?

Simmons College of Kentucky students conducted neighborhood asset mapping surveys in Louisville in 2021 as part of a pilot study. (Simmons College Photo)

What characteristics of a neighborhood contribute to the health of its residents – or reduce it?

The University of Louisville and Simmons College of Kentucky are embarking on a new project to answer that question and discover how changing a place can improve the health of its residents. A $500,000 grant from the Robert Wood Johnson Foundation will fund an 18-month study to identify the features all neighborhoods should have in order to promote the health of all residents.

Researchers from Simmons’ Reverend Jesse Louis Jackson, Sr. Center for Racial Justice and UofL’s Christina Lee Brown Envirome Institute, along with urban studies expert Michael Emerson of Rice University and legal scholar Shavonnie Carthens of the University of Kentucky, will survey residents of two Louisville neighborhoods, review existing data on environmental factors that affect health and consider legal aspects of neighborhood development, all with the goal of defining a “universal basic neighborhood” (UBN). A universal basic neighborhood is one that has all the necessary community assets that help residents thrive in their place.

The most recent Health Equity Report from the Louisville Metro Department of Public Health and Wellness, published in 2017, highlights stark differences in morbidity and mortality of those living in different neighborhoods across the city. For example, in Louisville’s predominantly Black communities, life expectancy is as much as 12.6 years less than in the most affluent, predominantly white communities. Black babies born from 2011-2015 have a death rate 1.95 times higher than the Louisville Metro average and 2.31 times higher than white babies. Diabetes, heart disease and cancer rates vary by location, race and income.

“We live in one of the wealthiest countries in the world and we still have places where living conditions contribute to diseases that are entirely preventable,” said Ted Smith, director of the UofL Center for Healthy Air, Water and Soil, part of the Envirome Institute. “This work is about diagnosing and treating places so that the health benefits are shared by many.”

Most existing efforts to address health inequities focus on providing health resources to eligible individuals. This study instead looks for ways to improve health at the neighborhood level by providing resources that make it easier for residents to make healthy choices.

“Neighborhoods, no matter where they are, are not inherently bad or good. They're just neighborhoods. However, one thing that makes neighborhoods different from each other is access to health-supportive resources,” said Nancy Seay, chair of the James R. L. Diggs Department of Sociology at Simmons. “We know that every neighborhood has a rich fabric of local resources that residents access, and we want to uncover these and promote their utilization. Everyone, no matter where they live, wants and deserves to enjoy good health and a long life. This project can be a game changer for the way we think about designing and supporting neighborhoods and their residents.”

The scope of the research

The research team, led by Seay and Smith, will assemble evidence for place-based factors that are associated with good health, identify and map assets in two demographically distinct Louisville neighborhoods, examine the history of civic investment in Louisville and determine how to develop and implement city policy that supports health.

In the same vein as historic efforts to ensure clean drinking water and waste removal for entire communities, the UBN project will assess and rank factors that contribute to longer, healthier lives, such as opportunities for exercise and recreation, greenness and access to healthy food and transportation. This project approaches health equity with the idea that it is more efficient to invest in resources that benefit the health of all residents of underserved neighborhoods than in health interventions for individuals.

In the first stage of the project, set to start in September, Seay will lead work to map assets of Louisville’s Crescent Hill and California neighborhoods. Students in her Participatory Action Research class at Simmons will conduct door-to-door surveys, interviews and focus groups in those neighborhoods to reveal how residents of those communities find good health, what aspects of their environment they believe contribute to health and how empowered they feel to make changes. They also hope to identify important assets related to the specific interests and culture of those living in the neighborhoods that have not been studied previously. UofL students also may take the class through a reciprocal agreement with Simmons.

At UofL, Smith will lead a review of published studies that can help justify components of a UBN and provide criteria for weighting those components. Factors evaluated will include those that contribute to disease and those that promote health, such as access to parks, forms of transit and the variety of educational, recreational and entertainment venues.

Carthens, a legal scholar at the UK’s J. David Rosenberg College of Law and formerly at UofL’s Brandeis School of Law, will delve into the deep drivers of policies that must be reformed in order to achieve an optimal neighborhood environment. She will identify the legal framework required to support the public provision of a UBN and sectors of society best positioned to provide these resources.

The project also includes Emerson, Chavanne Fellow in Religion and Public Policy at Rice University’s Baker Institute and co-founder of Rice’s Kinder Institute for Urban Research.

At the project’s completion, the team expects to have a "playbook" that will assist communities in defining their own neighborhood needs and outline steps toward implementing the plan.

For more information:

Residents of the California and Crescent Hill neighborhoods who are interested in participating in surveys or focus group interviews for the project may contact Patricia Reeves at  patricia.reeves@simmonscollegeky.edu.

Community Partners who are interested in learning more about the project and opportunities for collaboration may contact Lauren Anderson at lauren.anderson@louisville.edu.

Project updates will be shared on social media at Simmons College and the Christina Lee Brown Envirome Institute.

Orientation week fosters smooth transition for new medical students

July 20, 2023

As the academic year approaches, the University of Louisville School of Medicine eagerly welcomes its incoming class of first-year medical students with an invigorating Orientation Week. Aimed at fostering a smooth transition into their medical journey, this week-long event has been designed to equip students with the necessary tools, connections, and experiences that will shape their future success as healthcare professionals.

Orientation Week begins July 24 at the School of Medicine and proves to be an extraordinary opportunity for matriculating medical students to begin acclimating to their new academic home, making lifelong friendships, and igniting their passion for medicine. Under the guidance of esteemed faculty and staff, this immersive experience serves as a steppingstone towards realizing their dreams of healing and saving lives.

Jeffrey Bumpous, MD, interim dean of the University of Louisville School of Medicine, expressed his enthusiasm for the significant role Orientation Week plays in a medical student's journey. He stated, "Orientation Week serves as a foundation for our students, allowing them to develop a sense of belonging and community. It is a time for them to embrace the challenges and triumphs they will encounter over their next four years."

One of the highlights of Orientation Week is the much-anticipated Trivia Night, where the students can showcase their knowledge, teamwork, and competitive spirit. This event will allow them to bond with their peers and create lasting connections, emphasizing the importance of collaboration in the medical field.

Another memorable event during the week is the enchanting Belle of Louisville Cruise, where students will experience the beauty of Louisville while cruising along the Ohio River. This relaxing evening fosters a sense of camaraderie amongst the students, offering them a chance to unwind and create cherished memories outside of the classroom.

The pinnacle of Orientation Week is the highly revered White Coat Ceremony slated for July 30. This significant rite of passage symbolizes the transition from aspiring medical students to professionals. With their families and loved ones in attendance, the new students will don their white coats for the first time, affirming their commitment to patient care, compassion, and lifelong learning.

“Both the White Coat Ceremony and Orientation Week are pivotal milestones that unite individuals from diverse backgrounds who share a profound passion for medicine,” said Monica Ann Shaw, MD, MA, vice dean of undergraduate medical education. “We are committed to the success of our students and are excited to accompany them on their journey to becoming physicians.”

The University of Louisville School of Medicine looks forward to witnessing the growth and accomplishments of these promising medical students as they contribute to the field of healthcare, making a positive impact on the lives of countless individuals in the years to come.

 

UofL School of Medicine hosts future healthcare scholars

July 13, 2023

The summer of 2023 marks the 18th year of the Summer Health Professions Education Program (SHPEP) at the University of Louisville. Each summer, 80 future healthcare professionals gather on the Health Science Campus for six weeks. The program is used to help scholars develop team-based learning to apply basic and social sciences centered on two major themes: Diabetes and Cardiovascular Disease. Students with future plans in dentistry, medicine, nursing, and pharmacy are welcome to participate in this experience.

“We believe in the power of diversity and the transformative impact it has on healthcare,” said Dwayne Compton, Ed.D., chief diversity officer for the School of Medicine. “Our SHPEP serves as a platform to empower our underrepresented students and enhance their academic and professional development to cultivate a diverse healthcare workforce reflecting the communities we serve.”

SHPEP emphasizes personal and professional development including study strategies, career planning, and clinical exposure in the health care profession. Its primary goal is to strengthen the academic proficiency and career development of students underrepresented in health professions and prepare them for successful application and matriculation to health professions schools. Scholars will gain exposure to advanced levels of science through participating in Organic Chemistry, Biochemistry, and Physiology. Health policy and equity are interwoven into the core of the program to ensure that each participating scholar with leave the program with a clear mindset of how to be a compassion and understanding health care profession.

“I am thrilled to participate in SHPEP and have the chance to learn from professionals in diverse healthcare fields” said Cheyla Tabares Cuesta, incoming scholar for SHPEP. "Learning networking skills and being exposed to opportunities will provide the necessary tools to confidently advance in my desired career. This opportunity will undoubtedly shape my understanding of healthcare and inspire me to make a meaningful impact in communities in need.”

The University of Louisville School of Medicine congratulates the 2023 cohort of SHPEP Scholars on completing the program. We look forward to the next generation of brilliant minds going into the healthcare profession.

ULSOM selected as Winn CIPP partner site

July 11, 2023
ULSOM selected as Winn CIPP partner site

Winn CIPP participants 2023

The University of Louisville School of Medicine was selected as one of only nine nationwide site partners to host the 2023 Robert A. Winn Diversity in Clinical Trials: Clinical Investigator Pathway Program (Winn CIPP). Led by La Creis Kidd, PhD, MPH, assistant dean of Research Diversity, this summer service-learning externship is designed to expose talented medical students of diverse backgrounds to community-engaged clinical and translational research. Co-investigators and champions of this program include Dr. V. Faye Jones, Dr. Christopher Seals, Dr. Barbara Clark, Dr. Susan Sawning, Sharon Gordon and Dr. Dwayne Compton.

“We could not be more thrilled to be selected as a site partner for the Winn CIPP,” said Kidd. “This program brings great opportunity for our research and training opportunities for the next generation of clinical scientist at the University of Louisville.”

The Winn CIPP offers a distinctive approach to increasing diversity in clinical trials by offering medical students a six-week intensive and immersive summer service-learning experience in underserved communities where underrepresented patients receive care. Pathway students gain exposures to clinical research, acquire community engagement and leadership skills, and are mentored by early-stage clinical investigators participating in the Winn Career Development Award (CDA).

In addition to Louisville, Winn CIPP Site Partners are located in the following cities: Chicago, IL, New Orleans, LA, New York, NY, Richmond, VA, Atlanta, GA, Los Angeles, CA, San Antonio, Tx, and Seattle, WA.

As a site partner, the School of Medicine commits to providing immersive community-based experiences in clinical trial research to four rising second-year medical students from various medical schools in the U.S. who are committed to increasing inclusion, equity, and diversity in the conduct of clinical and translational research. Each medical student scholar receives a $7,500 stipend to cover travel, living and lodging expenses during the six-week service-learning period.

Winn CIPP scholars that are currently training at the School of Medicine from June 5 to July 14 include:

  1. Yosef Ansarizadeh, DO Candidate, University of North Texas Health Science Center at Fort Worth – Texas College of Osteopathic Medicine, Faculty Mentors: Dr. Redman and Dr. Kidd.
  2. Iyabo Erinkitola, MD Candidate, University of Kentucky College of Medicine, Faculty  Mentor: Dr. Vatsalya Vatsalya
  3. Brianna Guillen, MD Candidate, University of Texas Rio Grande Valley School of Medicine, Faculty Mentor: Dr. Martin
  4. Brian Wadugu, MD Candidate, Carle Illinois College of Medicine, Faculty Mentor: Dr. Kellen Choi

“Being awarded the WINN CIPP fellowship at the Louisville site has been so positive for my professional development at this stage of my medical career,” said Erinkitola. “The University of Louisville School of Medicine has provided an abundance of support and encouragement as I learn to screen patients for more equitable clinical trials, perform biostatistics for relevant biologic investigations, and sharpen my goals in medical science.” 

New Interim Dean Addresses University of Louisville School of Medicine Community

July 6, 2023

It is with great pleasure and excitement that I write to you today as the new Interim Dean of the University of Louisville School of Medicine. I am deeply honored to have been entrusted with this role and to have the opportunity to work alongside such talented and dedicated individuals.

As one of the oldest medical schools in Kentucky, the UofL School of Medicine has a long heritage of medical education in Kentucky. I both respect our great history and understand our community has grown and our world has changed. But no matter the changes through our more than 185-year history, our commitment to taking care of our community remains one of our strengths. As such, I want our school to continue to be relevant. I want our school to continue to be useful. I want our school to continue to be an asset for our community, giving opportunity for students to become physicians or clinician scientists. I want to grow science and ideas. I want to give opportunity for our patients to stay here and receive the best possible care for the toughest types of problems. I want to make sure our state, our region and our community are healthy and whole. That’s why we’re here; that’s our purpose, and one that I will continue to bolster.

I want to keep and preserve the best things we have and the best things we’re doing and do that while growing and addressing new problems that are relevant to our community and our Commonwealth. Healthcare hasn’t always been afforded to every community in America. The opportunity we have in front of us is to uplift those communities by bringing students from around the globe into our medical school and allowing our health system to make reaching impact on those communities. I have my eyes open to the future and the horizon to make sure we’re growing our programs in research, education and clinical medicine in the best way possible to make the most impact.

We have exceptional faculty and staff, exceptional learners and exceptional research scientists, and an extraordinarily sophisticated health system. One of the first things that is so important for a new leader is to be a good learner and a good listener. Learning from people what makes Louisville work, what our strengths are and what our opportunities are will be increasingly important to me. My buzz word right now is strategic alignment and growth. We need to think about every part of our mission with honest conversations. If we can do that, I’m convinced that this medical school will remain strong, and we will be one of the best medical schools in the country.

I’m very passionate about the University of Louisville School of Medicine and feel lucky to have this job. I want this place to succeed, and I want it to be great for our patients, for our learners, for our faculty and for our staff. I want to allow people to realize their dreams and be strong contributors to society. As we embark on this new chapter together, I am committed to fostering a culture of excellence, collaboration, and innovation within our esteemed institution. Our shared goal is to continue advancing medical education, research, and patient care, making a positive impact on the health and well-being of our community, our Commonwealth and our world.

I look forward to getting to know each one of you, and I am confident that by working together, we will achieve remarkable accomplishments. Let us embark on this journey with passion, determination, and a collective vision of shaping the future of medicine.

Jeffrey M. Bumpous, M.D.
Interim Dean, School of Medicine

Farewell message to my SOM family

It is with both excitement and trepidation that I embark upon my journey of retirement after four wonderful decades with the University of Louisville and the School of Medicine. When I was asked to write a farewell message to my beloved “work family”, I eagerly agreed, because it gave me the opportunity to reflect upon memories, milestones, and points of pride.

As I look back on my career path, it followed four phases of service and leadership: ten years as an ENT clinician and clinician-educator; ten years as ENT clinical and academic leader; ten years as student affairs dean; and my final ten years as dean.

I was recruited in 1983 to UofL as an assistant professor of Otolaryngology by Dr. Serge Martinez, who had also been recruited a few years earlier by Dr. Hiram Polk to build ENT, a division of the department of surgery. Serge was one of my attendings and mentors in Nebraska during my ENT residency and specifically recruited me to build pediatric ENT, my area of interest and passion. At the same time, my husband, Brian was finishing his general surgery residency and exploring cardiac surgery residencies. Under Dr. Laman Gray’s leadership, Louisville was building an innovative Cardiovascular Surgery program, launching a transplant program, and greatly expanding the cardiovascular service line at Jewish Hospital. We essentially were recruited to Louisville as a “couple” with the idea we would be here three years and then return to Nebraska, where we had both been offered faculty positions and a chance to return home. My, how plans changed! We have been in Louisville ever since, blooming professionally where we were planted and raising our daughters here. Louisville is a special city.

Over the next ten years as a clinician, I helped to expand pediatric ENT and developed a passion for becoming an educational leader through such roles as clerkship director, admissions committee, and curriculum committee, as well as becoming a clinical leader through roles that included chief of the ENT service line at Children’s Hospital and president of Children’s Hospital Medical Staff. 

My second inflection point came when Serge Martinez left Louisville and Dr. Polk appointed me as division director of ENT. I will always be grateful for his mentorship and guidance over the next several years. We continued to grow and strengthen ENT and one of my points of pride was the recruitment of Dr. Jeff Bumpous, a brilliant head and neck surgeon and a highly effective academic leader, who I would go on several years later to pass the baton to as ENT Chair and then another several years later to pass the baton to as interim dean.

Phase three of development came with my appointment as student affairs dean in 2001.  I had just completed my MBA and wanted to pursue a broader leadership role across the institution. The student affairs dean position came open and it seemed like it would be a “dream job” because it married my passions for business and student engagement with my new goal of broader leadership. I applied for the position and was honored to be selected. And dream job it was! I had the opportunity to actively engage with students daily. We developed a student leadership program, strengthened our student support services, launched the advisory dean program, created the medical student distinction tracks, and developed a culture that truly valued students. I loved this position and even after ten years still felt like I had another decade of growth in the role.  

I did not anticipate the next opportunity I would be given, but when our previous dean announced he was leaving UofL, I was asked by Dr. David Dunn, our Executive Vice President for Health Affairs to step into the interim dean role, and I agreed to do so.

That inflection point brought me to the fourth and last phase of my career at UofL – my ten years as dean. I did not originally plan to apply for the permanent position but after a few months as interim dean, I found that I loved the new role and felt that I was making a difference for the school. There was a national search, and I was honored to have been selected as permanent dean—and the first woman dean at the School of Medicine.  

My year as interim dean and ten years as permanent dean have been the most challenging but also the most rewarding years of my career. The early years were tumultuous, and we were facing a major LCME accreditation challenge. But we used the challenge as a galvanizing force to come together and transform our educational program and our instructional facilities and we prevailed. Fast forward to our most recent accreditation site visit and we have a “perfect report card”. Our educational team is extraordinarily strong and committed and I am confident we will continue to provide an exceptional experience for our learners. 

Our clinical enterprise also faced challenges, with 33 disparate faculty practices, changing management at Jewish Hospital that weakened our alignment, and occasional transactional skirmishes with Norton Healthcare over Pediatrics. Again, we prevailed.  With strong clinical leadership at the school and the institution and a renewed commitment of our clinical affiliate leaders, a unified faculty practice was established, an extraordinarily successful UofL Health system was created and a truly integrated clinical partnership with Norton Health Care for Pediatrics was formed.

In the research area, we have become nationally recognized for our work in environmental health, liver disease, spinal cord injury, cardiovascular and cancer. This work continues to transform lives.

We seemed to be mostly firing on all cylinders when our world was upended in March of 2020 by the COVID 19 global pandemic. Again, we prevailed. We transitioned to virtual education but were fully present for our patients and served as a valuable resource for our community for testing, treatment, research and ongoing monitoring. We have emerged even stronger coming out of the pandemic.

It has been a joy and privilege to serve the school and the institution this past forty years. I owe a debt of gratitude to my outstanding leadership team, our amazing faculty, awesome students, incredible residents, and exemplary staff for their support and their unwavering commitment to help us carry out our mission of improving the health of our community, our commonwealth and our world. 

How lucky I am to have something that makes saying goodbye so hard. I wish each of you well and will think of you often.

School of Medicine welcomes new class of Residents and Fellows

The University of Louisville School of Medicine welcomes its newest class of residents and fellows to the Cardinal community. This year’s incoming class of 245 individuals is a testament to our continued efforts to a diverse and inclusive learning environment. Among them, 47% are female and 53% male, highlighting the importance of gender balance in our community. Additionally, 20% Asian, 4% Hispanic/Latino, 2% are African American, 0.5% American Indian/Alaska Native, and 5% Multiracial/Not specified individuals.

Murali Ankem, MD, vice dean of Graduate Medical Education, expressed his excitement about the incoming resident class, stating, “I am inspired by the diversity of our resident class this year. It reflects the university’s commitment to cultivating an inclusive learning environment where all learners feel valued and supported in pursuit of medical excellence. As we embrace different perspectives and backgrounds, we strengthen our ability to address the unique healthcare needs of our diverse Louisville community’s patient population.”

The University of Louisville School of Medicine is dedicated to providing a transformative educational experience for its residents, fellows and other learners. As they embark on this new chapter of their medical journey, they will discover that our institution offers an exceptional range of resources, programs, and opportunities designed to support and foster the needs of an incoming resident. Faculty members are passionate about nurturing the growth of future physicians and employ innovative teaching methods in pursuit of excellence. The hands-on experiences provided enable residents to be compassionate, competent, and well-rounded medical professionals.

“Congratulations and welcome to the School of Medicine,” said Ankem, “We’ve been eagerly awaiting your arrival and look forward to witnessing your growth and success as you embark on this incredible journey.”

New residents officially begin rotations on July 1 in various healthcare settings.

UofL Med student awarded scholarship for commitment to social justice and equitable healthcare

UofL Med student awarded scholarship for commitment to social justice and equitable healthcare

Zoha Mian, 3rd year medical student

Zoha Mian is a third-year medical student at the UofL School of Medicine, with a passion for helping diverse populations achieve equal health care.

“Social justice is at the foundation of why I pursued medicine,” said Mian. “I believe that healthcare is a human right and that people of all cultures and backgrounds deserve to be treated with equitable, high-quality care.”

This belief has motivated her throughout medical school and inspired her to apply for a master’s in public eye care in order to directly impact the healthcare conditions of impoverished populations locally and abroad. Mian realized her passion for ophthalmology when she shadowed a doctor who provided free eye surgeries and training. Inspired by how a simple surgery to cure blindness could empower someone to get an education, live independently without a disability, and pursue their dreams, Mian was dedicated to becoming an Ophthalmologist.

In May, Mian was awarded a $50,000 Rotary Global Grant Scholarship to attend the London School of Hygiene and Tropical Medicine. The scholarship is designed for students pursuing a career in an area of great humanitarian need and have a long-term commitment to measurable and sustainable change. Students must be sponsored by a local Rotary club in their place of permanent residence or full-time study.

“The rotary club has a long history of service and humanitarian work, and I found that I shared similar goals with the organization,” said Mian. “As a public eye care master’s candidate, I believe I can gain valuable knowledge and experience to be a successful social justice leader, physician, and policy maker.”

As a future Ophthalmologist, Mian hopes to create an equitable healthcare system for diverse populations. She believes her experience at the London School of Hygiene and Tropical Medicine will widen her cultural competence and knowledge in research and epidemiology and allow the opportunity to work intensely in preventing detrimental ocular disease.

Mian attributes her award to the support of her faculty mentors at the School of Medicine, Bethany Smith, PhD, and Susan Sawning, MSSW, as well as her community involvement during her first years of medical school. During her time as a medical student, she has been extensively involved with the American Medical Association creating health policy. She is the co-founder of Grow502— a professional student-led nonprofit organization aiming to address healthcare disparities in the Louisville community—and also the co-founder of Physicians for Human Rights. These experiences have led her to live a life of service.

The University of Louisville School of Medicine takes great pride in the accomplishments of its students and celebrates their achievements. It is with great excitement that we congratulate Zoha Mian on her scholarship award and recognize her for contributions to both our local and global communities.

Taming a frenzied immune system

Grants of $6.1 million allow UofL researchers to investigate immune dysregulation response they discovered during the pandemic
Taming a frenzied immune system

UofL researcher Jun Yan, center, in his lab. His team is expanding their work to better understand immune system dysregulation that is responsible for acute respiratory distress that can cause serious illness and sometimes death in patients with COVID-19.

LOUISVILLE, Ky. – Researchers at the University of Louisville have received $5.8 million in two grants from the National Institutes of Health to expand their work to better understand and prevent immune system dysregulation responsible for acute respiratory distress, the condition responsible for serious illness and death in some COVID-19 patients. A separate $306,000 NIH Small Business Innovation Research grant supports early testing of a compound developed at UofL as a potential treatment.

The three grants combined total $6.1 million.

During the pandemic, health care providers worked tirelessly to treat patients who became seriously ill with COVID-19. Some of those patients developed severe lung disease known as acute respiratory distress syndrome (ARDS) due to an excessive response of the immune system often called cytokine storm.

As they treated these critically ill patients, physicians and other providers at UofL Health shared their clinical insights and patient samples with researchers at UofL to discover the cause of the immune system overresponse.

“At one time we had over 100 patients with COVID in the hospital. Once they were on a ventilator, mortality was about 50%. We were looking at this issue to see why some people would do well while some developed bad lung disease and did not do well or died,” said Jiapeng Huang, anesthesiologist with UofL Health and professor and vice chair of the Department of Anesthesiology and Perioperative Medicine in the UofL School of Medicine.

The UofL researchers, led by immunologist Jun Yan, discovered that a specific type of immune cells, low-density inflammatory neutrophils, became highly elevated in some COVID-19 patients whose condition became very severe. This elevation signaled a clinical crisis point and increased likelihood of death within a few days due to lung inflammation, blood clotting and stroke. Their findings were published in 2021 in JCI Insight.

With the new NIH funding, Yan is leading research to build on this discovery with deeper understanding of what causes a patient’s immune system to respond to an infection in this way and develop methods to predict, prevent or control the response.

“Through this fruitful collaboration, we now have acquired NIH funding for basic and translational studies and even progress toward commercialization of a potential therapy,” Yan said. “That’s why we do this research – eventually we want to benefit the patients.”

Yan, chief of the UofL Division of Immunotherapy in the Department of Surgery, a professor of microbiology and immunology and a senior member of the Brown Cancer Center, will lead the new research, along with Huang and Silvia M. Uriarte, university scholar and professor in the Department of Oral Immunology and Infectious Diseases in the UofL School of Dentistry.

“COVID-19 continues to spotlight the impactful synergy between the clinical and research teams at the University of Louisville,” said Jason Smith, UofL Health chief medical officer. “Innovation is in the DNA of academic medicine. We collaborate to provide each patient the best options for prevention and treatment today, while developing the even better options for tomorrow.”

In addition to two research grants of $2.9 million each awarded directly to UofL, a $306,000 grant to a startup company will support early testing of a compound developed in the lab of UofL Professor of Medicine Kenneth McLeish that shows promise in preventing the dangerous cytokine storm while allowing the neutrophils to retain their ability to kill harmful bacteria and viruses. The compound, DGN-23, will be tested by UofL and Degranin Therapeutics, a startup operated by McLeish, Yan, Huang, Uriarte and Madhavi Rane, associate professor in the Department of Medicine.

“This is one more example of how UofL has led the charge in finding new and innovative ways to detect, contain and fight COVID-19 and other potential public health threats,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “This team’s new research and technology could help keep people healthy and safe here and beyond. 

The knowledge gained through these studies may benefit not only COVID-19 patients, but those with other conditions in which immune dysregulation can occur, such as other types of viral and bacterial pneumonia and autoimmune diseases, and patients undergoing cancer immunotherapy and organ transplantation.

The grants

Grant 1 – $2.9 million, four-year grant to UofL. Investigators will study the new subset of neutrophils Yan identified to better understand how they contribute to acute respiratory distress and clotting. They also will determine whether a novel compound will prevent these complications. They will use lab techniques and studies with animal models that allow for manipulation of certain conditions that cannot be done in human subjects.

Grant 2 – $2.9 million, five-year grant to UofL. This work examines a more comprehensive landscape to characterize different subsets of neutrophils and measure their changes over the course of COVID-19 disease progression and how neutrophils contribute to immune dysfunction.

Grant 3 – $306,000, one-year grant to Degranin Therapeutics and UofL for early testing of DGN-23, a compound developed at UofL, to determine its effectiveness in preventing or reducing immune dysregulation. 

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This research is supported by the National Heart, Lung, And Blood Institute under award numbers R01HL158779 and R43HL169129 and the National Institute of Allergy and Infectious Diseases under award number R01AI172873. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Student organization empowers students' creative expression

The Medical Humanities and Social Justice in Healthcare student organization has recently reestablished itself after a period of inactivity. Its mission remains focused on bringing light to social justice issues in healthcare through the perspective of the medical humanities and provides the opportunity for medical students to reflect on the intersection of societal factors and health. One way the organization reflects is through Systole, a journal comprised of works from various students attending the School of Medicine.

Systole is an opportunity to celebrate the creativity of our peers and shine a light on their unique talents,” said Fariha Rashid, co-president of the organization. “It gives students a chance to express their feelings through creativity and share it with the ULSOM community; it brought great comfort and affirmation in the sacrifices and endurances this line of work often requires of us to better the lives of others.”

Students have contributed works in various mediums, including painting, audio, photography, sculpting, and more. “There are limited opportunities for medical students to publish creative work, so we wanted to ensure an accessible way for students to do so. Our student body is diversely talented, and we wanted to showcase all the different ways students express their talent,” said Rashid.

The group is led by faculty advisor, Susan Sawning, associate professor, undergraduate medical education. “I am so very proud of them,” said Sawning, “Our students care so much about things that are important to the world and our community. More people need to hear about our special students here at the School of Medicine.”

The ULSOM community can support the organization by viewing Systole on the School of Medicine website and sharing it with others. The co-presidents also hope that students will continue their enthusiasm for Systole by submitting their work for future editions. Through their efforts, Medical Humanities and Social Justice in Healthcare and Systole are promoting creativity and social justice in the ULSOM community.

LOUMED announces ambassador program for downtown medical and education district

LOUMED announces ambassador program for downtown medical and education district

Representatives of LOUMED partners UofL Health Sciences Center, UofL Health, Norton Healthcare and JCTC, along with Louisville Mayor Craig Greenberg announced new ambassador program

The Louisville Medical & Education District, also known as LOUMED, has announced its new ambassador program in partnership with Block by Block. Block by Block is the nation’s leading provider of safety, cleaning and hospitality services for districts across the U.S. LOUMED includes the University of Louisville Health Sciences Center and downtown facilities of UofL Health, as well as Jefferson Community and Technical College and Norton Healthcare.

The ambassador program will provide concierge, cleaning and safety services to this vital downtown district.

“We are looking forward to having our LOUMED Ambassadors be additional positive representation for the employees, patients and students that call LOUMED home,” said Nadareca Thibeaux, executive director LOUMED. “It’s important for visitors and locals alike to experience a friendly, clean and safe downtown, and we expect this program to amplify those efforts.”

The LOUMED ambassadors play an important role in improving the experience of the public spaces within the district for visitors, employees, students and patients. The LOUMED ambassadors will be responsible for the following:

  • Visible Presence – Ambassadors will circulate throughout the district daily to create a highly visible, accessible, outgoing and inviting presence, with an attitude of friendly professionalism, superior customer service and hospitality. Ambassadors will be on foot and will be deployed in a manner that ensures resources are placed strategically to address critical issues or needs at key times of day, days of the week and as needed. All ambassadors are trained in ‘situational protocol’ to handle situations appropriately and courteously.
  • Reduced Impact of Quality-of-Life Issues & Safety Risk Aversion – Ambassadors will discourage aggressive solicitation and other prohibited behaviors, report crimes to the proper authority and provide information and support as it relates to improper behavior in the district. Ambassadors will build respect-based relationships with all persons to educate on ordinance violations, discourage problematic behavior and serve to connect individuals to available resources and assistance.
  • Hospitality and Wayfinding – Ambassadors will actively greet pedestrians and provide general assistance, wayfinding/directions, information on historic sites, shops, restaurants, public transportation, other places of interest and general information that may be helpful and welcoming. They will provide help and support to the public to address a wide range of situations and needs, such as assistance with the use of parking meter stations, repairing a flat tire, opening a door, escorting employees to parking garages and by offsetting any potentially negative experience with a positive interaction.
  • Property/Business Owner Networking & Cross Communication – Ambassadors will interact directly with property and business owners, managers and security personnel to build a network, provide and receive information relevant to LOUMED safety and hospitality and to raise public awareness of the program.

For more information about the LOUMED District, visit www.louisvillemedicaleducationdistrict.com

School of Medicine celebrates graduating class

On May 13th, the Galt House Hotel in downtown Louisville was filled with heartwarming celebrations as 142 medical students crossed the stage and graduated from the University of Louisville School of Medicine. The ceremony recognized the invaluable contributions the students have made to the school and to the Louisville community.

The students participated in the time-honored tradition of the hooding ceremony. It officially marks their transition from graduates into the medical profession as physicians. Each student had the opportunity to select a medical physician who had a profound impact on their medical school journey to administer the hooding. 

“I am grateful to have had the opportunity to study amongst my amazing peers at the School of Medicine,” said Ryan Anderson, class president. “I feel privileged to have learned from our dedicated faculty members, and I look forward to serving my community as a physician. 

The evening’s celebrations included awards such as the Thomas B. Calhoon Teaching award, which was presented to Steven Ellis, PhD., professor of Biochemistry and Molecular Genetics, for his contributions to the field. Additionally, 32 honors and awards were presented to the medical graduates, including the Leonard Tow Humanism in Medicine award which was given to Karen Tachi Udoh.

“I am incredibly proud of our graduates and the work they have accomplished during their time at the School of Medicine,” said Toni Ganzel, dean of the School of Medicine. “I am excited to see where their careers take them and know they will continue to make a positive impact in the medical field.”

View the photo gallery here.

Music to medicine – the unique pathway father of three takes to becoming a physician

Music to medicine – the unique pathway father of three takes to becoming a physician

Matthew Miracle, class of 2023

Congratulations to Matthew Miracle on this monumental occasion of his graduation from the University of Louisville School of Medicine! His hard work and dedication have paid off, and we are proud of all he has accomplished.

As a non-traditional medical student, Miracle overcame many challenges to reach this milestone in his life. As a former musician, he didn’t have any science-related background to speak of; the last biology class he had taken was years prior and he hadn’t had a chemistry class since high school. “I wanted to find a career where I could use some of the skills I’d gained through my experiences in business, the arts, and technology, and medicine seemed like the perfect place to do that,” said Miracle.

Switching from music to medicine was a challenge, but Miracle’s philosophy was always that if he could learn to be great at one thing, he could apply that same dedication and work ethic to become the excellent physician that his future patients deserve. Fortunately, the Post-Baccalaureate Pre-Med program at the University of Louisville is designed with career changers, like Miracle, in mind. The program guided him through the process of prerequisite coursework and applying to medical school.

Being a father of three added an extra layer of complexity to medical school but Miracle managed it with grace. During the pandemic, he had to balance his own classes with assisting his oldest in their virtual school. There were evenings during his clinical years that he had to FaceTime with his family at bedtime and then leave the house the next morning before his kids were awake. He credits his wife for being his rock during this time and getting his children involved in fun activities as much as possible.

Miracle’s advice to other non-traditional students is invaluable. “It's easy to get overwhelmed by the amount of work and information to learn but thinking of medical school as a new job helped a lot,” said Miracle. “I tried to be efficient and get my studying done during my childrens’ school day so that when they came home, I was able to put my work aside and spend the evening with my family. Time with your family is precious, so protect your weekends from work as much as you can and turn the usually boring trip to Costco into a way to get extra time with your family.”

As a medical student, Miracle had opportunities to participate in clinical activities and procedures that he would never have expected medical students could be part of and helped to push him outside of his comfort zone to become a better physician. “The faculty were some of the most invested in their students' education that I have seen in all my years of education,” said Miracle, reflecting on his time at UofL. “From the pre-clinical classroom teachers to the clinical physician faculty, I have always felt supported throughout an incredibly stressful process.”

Once again, congratulations to Matthew Miracle on his graduation from the University of Louisville School of Medicine. His achievements will undoubtedly inspire future medical students, and we wish him all the best in his future endeavors. Miracle will be continuing his medical career as a resident in Family Medicine at the University of Virginia.

In the pursuit of medicine

In the pursuit of medicine

Jordan Swindle, class of 2023

Congratulations to Jordan Swindle on his graduation from the University of Louisville School of Medicine! It's inspiring to see how his passion for science and the human body has led him to pursue a career in medicine, despite taking an unconventional path. Swindle's dedication and hard work have paid off, and we are proud of all that he has accomplished.

Swindle’s pursuit of medicine began when he fell in love with the science of the human body in undergraduate education at the University of Kentucky. However, his path to medicine did not begin there. After graduation, Swindle spent a brief period training in the NFL and CFL and later had a short career selling life insurance. After realizing his true calling for helping people, he returned to school to finish three semesters of pre-med requirements.

“I knew I wanted to return to medicine,” said Swindle. “My peak athletic ability was limited to a certain number of years. Turning to medicine where I could use my knowledge and skills was a more secure career choice for myself. In my opinion, there’s no better career combining the ability to help people with the science of the human body than becoming a physician.” 

For Swindle, there were similarities in playing a professional sport and pursuing a medical degree. Both required hard work, dedication, teamwork, and the ability to be coached. 

Swindle said the cadaver lab was his one of his favorite classroom activities during medical school. “I am so thankful for the cadavers’ gift to the School of Medicine because it allowed us to get a better understanding of the human body and the way the various parts relate to each other as a whole.”

The advice Swindle gives to non-traditional students pursuing medicine is that it is never too late to begin your career in medicine. “In my personal experience, it has given me a leg-up in certain situations,” said Swindle. “It is not a negative thing to be a non-traditional medical student, but it is more of an advantage.”

Swindle spends his free time with his wife and son, John, who was born during his third year of medical school. They enjoy being outdoors and watching great movies together. “Spending time with family and friends is a great way to destress after a long day of classes and clinical,” says Swindle.

After graduation, Swindle will continue pursuing his path to medicine as a resident in orthopedic surgery at the University of Chicago Medical Center. His dedication to science and medicine will aid him in a long, fulfilling career as a physician.

UofL Telemedicine Program Revolutionizes Mental Health Care in the Commonwealth

UofL Telemedicine Program Revolutionizes Mental Health Care in the Commonwealth

Robert Caudill, MD, DLFAPA, FATA

The University of Louisville School of Medicine is dedicated to implementing innovative technology to improve the lives of those in the community and the Commonwealth. Implemented by Robert Caudill, MD, professor and Residency Training Director in the Department of Psychiatry and Behavioral Sciences, the UofL Telemedicine program has revolutionized mental health care in Louisville. By creating a more accessible communication platform between patients and physicians, Telehealth has allowed medical care to be more easily obtained by people who may have otherwise gone without. As part of Mental Health Awareness Month, the University of Louisville School of Medicine interviewed Dr. Caudill to learn more of his contributions to the field of psychiatric medicine.

UofL School of Medicine: What has been your role in implementing telemedicine and information technology at the University of Louisville?

Dr. Caudill: I saw clearly the potential medical applications of video teleconferencing in 2001 after experiencing high-definition, real-time, videoconferencing conducted over the internet.  This followed the experience of having witnessed high-definition television transmissions replacing the previous standard definition resolution. In 2005, I developed a business plan and in 2009 brought the model to the UofL Department of Psychiatry, relocating my practice back to the medical school campus. I have sought to pioneer areas involving technology and mental health, volunteering to try new technologies and advocating for their mainstream adoption. In 2014, my role shifted from clinical innovation to also include an educational role as program director for the UofL psychiatry residency program. Before COVID-19, Telehealth technology was already mature enough to envision a larger role for it in healthcare. UofL psychiatry residents have been receiving this training for years. I promote the message that “telemedicine is medicine” through practice and education.

UofL School of Medicine: Explain the importance of Telehealth services for the general public?

Dr. Caudill: Patients have been way ahead of clinicians in terms of interest in and acceptance of Telehealth. Without Telehealth, most of the inconveniences associated with healthcare were borne by patients. At one point it might have been about bringing access to medical care to those who could otherwise not obtain it. Increasingly, it will be about bringing health care to the general public in a more patient friendly and cost-effective manner. We have required patients to make unnecessary and inconvenient trips to receive care that could easily have been rendered more efficiently via telehealth. “In-person” care has been held out as the “gold-standard” and of course it is the model against which alternative approaches must be measured. However, in-person care has its own drawbacks and a subset of patients who lacked the physical or emotional resources to access it has been uncovered and now is also eligible to receive high quality healthcare for the first time. It was never about replacing “in-person” care; Telehealth is simply another tool.  

UofL School of Medicine: How have Telehealth services changed modern day healthcare?

Dr. Caudill: I was highly influenced by the writings of Nicholas Negroponte and his exhortation to "Move bits not atoms." One need not have been terribly observant to live through and witness the fates of local bookstores, record stores, and video rental businesses to recognize that many of the cognitive services provided in healthcare were similarly situated. My hope would be that in the future we are not going around needlessly “moving atoms” when the same results can be obtained by “moving bits.” I hope that patients will not accept a future where their healthcare options are limited to those facilities to which they might easily drive which also coincidentally have an appointment available at a time and place where both clinician and patient can materially intersect in a timely fashion. Telehealth opens a wide array of options that would not have previously existed.

UofL School of Medicine: What are the benefits of having same day appointments with patients?

Dr. Caudill: Timeliness of the intervention has always been a factor in terms of outcomes. Telehealth is an amazing resource, yet it is not truly disruptive as the term is applied to technology innovations. That is to say that Telehealth does not allow a clinician to see more patients during a given unit of time – only different patients (often geographically distanced). Telehealth certainly offers the potential for gains in efficiency that are not possible in an exclusively “in-person” environment. Late cancelations are hard to replace if the waiting list patient must also arrange for transportation at the last minute. Telehealth can bring a patient into the virtual presence of a clinician with little more than a preparatory phone call. Time otherwise lost to practices can be gainfully recovered with this ability to rapidly fill vacated spots with patients hoping to be worked into such an opening in the schedule.  

UofL School of Medicine: What inspired you to create a partnership with PeaceNow?

Dr. Caudill: The planets just happened to align at the right time. The university now has a large referral base of primary care providers to complement its specialists and sub-specialists. I saw the potential to fill in a missing section in the continuum of care. The Covid response demonstrated the utility of Telehealth, and I have been doing Telehealth work with various rural community mental health centers in Kentucky since 2009. One of my contracts was up for renewal around the same time that PeaceNow was starting to take shape, and I saw the opportunity to play a role in creating a new virtual clinic. While PeaceNow can now efficiently direct patients from primary care to behavioral health services, there remains a great unmet need for skilled mental health care clinicians in the community. PeaceNow can be a highly effective endpoint for some, but its promise will be less than fully realized if it ceases to function as a conduit for moving patients from primary care into more definitive, long-term, behavioral health endpoints.

UofL School of Medicine: Who are the target populations for the Telehealth services? How has your program benefited these populations?

Dr. Caudill: While Telehealth enables the medical industry to serve certain populations better, there is still a small subset of patients who are not appropriate for virtual care. This group has historically been poorly managed, as they often self-selected their way out of existing health care systems. Telehealth has provided an opportunity to reach this elusive group. Certain populations, including those with mobility limitations, trauma issues relating to trust and travel, and many adolescents, are proving to be better served through virtual care. In the end, it is not about “either/or” but “both/and” as community-based, in-person interventions are still needed for some patients.

UofL School of Medicine: When working with people that lack resources such as a computer or internet, how do you see them coming to receive Telehealth services?

Dr. Caudill: This is a problem but the solution for it is bigger than the programs discussed here can solve. Telehealth doesn’t “replace” in-person care. Patients who struggle to receive Telehealth are also challenged when attending in-person care for many of the same reasons. The minimal point of entry increasingly appears to be the mobile phone. While I had been initially enticed about the potential of Telehealth after witnessing HD images transmitted over the internet and dreaming of the impending arrival of full-size 3-D hologram encounters, the introduction of the smart phone and its rapid rise to ubiquity took us in a different direction. At one distant time, not everyone had access to land line telephones. National, wireless networks and the widespread availability of internet-enabled smart phones are rapidly reducing the number of geographical locations inaccessible to virtual health care. Promising efforts to identify the barriers to care through use of digital health readiness screeners tied to systematic programs possibly offered through public health entities can help find, enroll, and socialize patients to virtual care.  

UofL School of Medicine: What advice would you give to someone dealing with mental health issues, but cannot afford a therapist? 

Dr. Caudill: Untreated mental health comes with its own associated costs, and sadly patients often prioritize activities of questionable benefit over addressing their mental health needs. Technology, including social media and Telehealth, has led to increased awareness of mental health concerns and the availability of definitive treatments. However, there is still a bewildering array of individuals and services offering mental health care, and not everyone has access to the necessary resources to obtain help through traditional mechanisms. Some options for those lacking resources include Seven Counties Services (our local public mental health center) and the teaching clinic at the University of Louisville Department of Psychiatry. While insurance often provides additional options, true parity of coverage with physical illness has not yet been achieved. Good clinicians motivate patients and help them achieve results that over time often offset the expenses incurred while working through difficulties. Telehealth reduces logistical requirements associated with in-person care, benefitting both patients and clinicians. Telehealth has rightfully taken its place in this group of options for care.

The University of Louisville School of Medicine recognizes Dr. Caudill and his revolutionary practices for providing more accessible mental healthcare to the Louisville community. If you or someone you know is struggling, we encourage you to reach out for help and seek treatment.  

UofL to host planting event for Arbor Day; honors late LGBTQ+ supporter

UofL to host planting event for Arbor Day; honors late LGBTQ+ supporter

The late Sarah McKinney was a staff member in the Department of Pediatrics and a longtime supporter of the Health Sciences Center's LGBT Center.

A planting event on the University of Louisville Health Sciences Center campus will observe Arbor Day 2023 as well as honor a late Department of Pediatrics staff member who was a strong supporter of the LGBTQ+ community.

The event will be held from 11:30 a.m.-1 p.m., April 28, at the Kosair Charities Clinical and Translational Research Building, 505 S. Hancock St.

At 11:30 a.m., volunteers will help plant native plants in the building’s planter bed. At 12:30 p.m., a memorial tree planting will be held in honor of Sarah McKinney who died in 2022 and was employed as a senior technology specialist and facilities coordinator in the School of Medicine’s Department of Pediatrics.

The event is sponsored by the university’s Sustainability Council, S.M.A.R.T. Staff (School of Medicine Advancement, Retention and Training), Department of Pediatrics, LGBT Center, Physical Plant and HSC Green Team. For more information and to volunteer, contact Glenn Gittings at 502-852-0141.

About Sarah McKinney

McKinney was known for her strong support of the Health Sciences Center’s LGBT Center and the people it serves. A trans individual herself, McKinney also was known in the Louisville community as an advocate for LGBTQ+ individuals. “In high heels and tool belt,” as she liked to express it, McKinney helped keep organizations in Louisville communicating with each other and provide a safe and thriving community for LGBTQ+ people.

McKinney restarted UofL’s LGBTQ+ Faculty Staff Association after it was dormant for 12 years and grew it to more than 100 members. She chaired the Transgender Wellness Summit and was one of the co-founders of the Kentuckiana Transgender Support Group. Additionally, she mentored several transgender individuals to help them through their transition. For her efforts, she was awarded the UofL LGBT Center’s Advocate Award in 2021.

Reduced sleep linked to air pollution, heat, carbon dioxide and noise

Reduced sleep linked to air pollution, heat, carbon dioxide and noise

Participant data from the Green Heart Project at UofL’s Christina Lee Brown Envirome Institute, led by director Aruni Bhatnagar, were utilized in the new sleep study.

  • Penn, UofL study finds drop in sleep efficiency for high exposures to environmental factors
  • Study published in Sleep Health is one of the first to measure multiple variables on sleep
  • Participant data from UofL’s Green Heart Project utilized to obtain results

Air pollution, a warm bedroom and high levels of carbon dioxide and ambient noise all may adversely affect our ability to get a good night’s sleep, suggests a study from researchers with the Perelman School of Medicine at the University of Pennsylvania and the University of Louisville’s Christina Lee Brown Envirome Institute (CLBEI).

The study, published April 18 in Sleep Health, is one of the first to measure multiple environmental variables in the bedroom and analyze their associations with sleep efficiency—the time spent sleeping relative to the time available for sleep. The analysis found that in a group of 62 participants tracked for two weeks with activity monitors and sleep logs, higher bedroom levels of air pollution (particulate matter <2.5 micrometers or PM2.5), carbon dioxide, noise and temperature were all linked independently to lower sleep efficiency.

The study was a collaboration between Penn Medicine and UofL’s CLBEI which is led by Aruni Bhatnagar. The researchers recruited participants from the CLBEI’s National Institutes of Health-funded Green Heart Project that investigates the effects of planting 8,000 mature trees on the cardiovascular health of Louisville residents.

“These findings highlight the importance of the bedroom environment for high-quality sleep,” said study lead author Mathias Basner, professor and director of the division of Sleep and Chronobiology in the department of Psychiatry at Penn Medicine.

The researchers suggest that more research is needed now on interventions that could improve sleep efficiency by reducing exposures to these sleep-disrupting factors.

“This could be as simple as leaving a bedroom door open to lower carbon dioxide levels, and using triple-pane windows to reduce noise,” Bhatnagar said. “We also applied for (future) funding that will allow us to investigate whether planting trees can improve sleep and cardiovascular health through improving health behaviors and the bedroom environment.”

About the study

In addition to work and family obligations that compete with sleep for time, a quickly changing environment due to growing urbanization and climate change seems to have made it harder to get a good night’s sleep. Sleep that is of inadequate duration, or inadequate efficiency due to frequent disruption (“tossing and turning”), affects work productivity and quality of life. It also has been linked to a higher risk of chronic diseases including heart disease, type 2 diabetes, depression and dementia.

This research is among a limited number of studies that looked at associations between multiple objectively measured factors in the sleep environment—such as noise and temperature—and objectively measured sleep.

For each of the environmental variables measured, the researchers compared sleep efficiency during exposures to the highest 20 percent of levels versus lowest 20 percent of levels. Through this analysis, they found that high noise was associated with a 4.7 percent decline in sleep efficiency compared to low noise, high carbon dioxide with a 4.0 percent decline compared to low levels, high temperature with a 3.4 percent decline compared to low temperature, and high PM2.5 with a 3.2 percent decline compared to low PM2.5. Two other sleep environment variables, relative humidity and barometric pressure, appeared to have no significant association with sleep efficiency among the participants.

Interestingly, only bedroom humidity was associated with sleep outcomes assessed with questionnaires, such that higher humidity was associated with lower self-reported sleep quality and more daytime sleepiness. This suggests that studies based on questionnaires may miss important associations readily detected by objective measures of sleep. This is not surprising as humans are unconscious and unaware of themselves and their surroundings during large portions of their sleep period.

Also, most study participants rated humidity, temperature and noise levels in the bedroom as “just right” regardless of the actual exposure levels.

“We seem to habituate subjectively to our bedroom environment, and feel there is no need to improve it, when in fact our sleep may be disturbed night after night as evidenced by the objective measures of sleep we used in our study,” said Basner.

University of Louisville's Alcohol Research Center Leads the Way to Recovery

University of Louisville's Alcohol Research Center Leads the Way to Recovery

Craig J McClain, M.D., AGAF, FACG, FAASLD, FACN

April is alcohol awareness month, and the University of Louisville Alcohol Research Center (ULARC) is paving the way to recovery with novel findings. The ULARC was created to serve as a regional and national resource to investigate interactions of nutrition and alcohol on alcohol-induced organ injury and to develop new agents/interventions to prevent/treat this organ injury, both of which represent important unmet research needs.

Led by Craig McClain, MD, director of the NIH-funded Alcohol Research Center and professor of Medicine and Pharmacology and Toxicology at the School of Medicine, the ULARC hopes to influence the commonwealth by addressing the effects alcohol has on a person’s body. Alcohol affects multiple organs and organ systems.  The ULARC studies the liver and the gut:liver:brain axis as well as fetal alcohol syndrome and lung injury through multidisciplinary research.

“Alcohol abuse, alcoholism and alcohol use disorder kill over 3 million people each year, accounting for up to 6% of global deaths,” said McClain. “During the COVID pandemic, we saw an increase in alcohol usage that has persisted since. One of our recent projects studies the effects of alcohol on COVID-19 infection. We are also in the process of publishing some of our findings as they relate to novel therapies for alcohol-associated hepatitis, including the use of a specific probiotic and a type of omega-3 fat supplementation.”

McClain’s passion for research in alcohol-associated liver injury and disease started at the University of Minnesota. His mentor was an expert on the subject which gave McClain an opportunity to work hands-on with this vulnerable patient population. As noted, alcohol effects the brain and other organs; it is associated with cancers, heart disease, premature aging, and dementia; and alcohol use can lead to automobile accidents, homicides, and suicides.

McClain was the first to find an association between pro-inflammatory cytokines and alcohol-associated liver injury. His group of researchers specialize in nutritional therapies for alcohol-associated liver injury/disease (ALD) and have used funding from the NIH to study the therapeutic effects of probiotics and over-the-counter nutrition supplements for ALD.

McClain’s advice for alcohol consumption is to “not exceed moderate drinking limits which is two standard drinks a day for men and one standard drink a day for women. A standard drink is 14 grams of alcohol.” He references the National Institute on Alcohol Abuse and Alcoholism as a resource to help rethink drinking for anyone struggling with addiction.

Brain-penetrating drug candidate shown to be effective against deadly encephalitis viruses

Brain-penetrating drug candidate shown to be effective against deadly encephalitis viruses

University of Louisville researcher Donghoon Chung examines specimens in his lab in this April 2023 photo.

A new antiviral compound that was designed, synthesized and tested by researchers at the University of Louisville, the University of Wisconsin–Madison’s School of Pharmacy and the University of Tennessee Health Sciences Center (UTHSC) has been shown to be highly effective against two types of devastating encephalitis viruses that cause harm to humans. The multidisciplinary team found that BDGR-49 protects against the deadly eastern equine encephalitis virus (EEEV) or Venezuelan equine encephalitis virus (VEEV).

The researchers described BDGR-49 and its efficacy against lethal infections of EEEV or VEEV in animal models in a study published April 12 in Science Translational Medicine.

“Collaboration across disciplines and capabilities was key to this discovery,” said Jennifer E. Golden, an associate professor in the UW–Madison School of Pharmacy and synthetic medicinal chemist who led the discovery and optimization effort.

Chemical virology studies were led by Donghoon Chung, an associate professor in the UofL Department of Microbiology and Immunology and the Center for Predictive Medicine, and animal efficacy studies were performed by Colleen Jonsson, a professor at UTHSC.

The team found that BDGR-49 potently inhibited EEEV and VEEV and was well tolerated. The compound provided significant protection to EEEV-infected animals. Meanwhile, it not only fully protected VEEV-infected animals, but could also be used as a therapeutic treatment days after infection.

An important feature of this antiviral compound is its ability to access the brain where these viruses cause damage, while other critical attributes include its improved stability, potency and efficacy compared to earlier prototypes. Based on resistance studies, BDGR-49 efficiently prevents these viruses from copying themselves, meaning it operates by disrupting the viral machinery needed for replication.

Classified as New World alphaviruses, equine encephalitis viruses are transmitted by the bite of a mosquito and can infect the brain, causing neurological effects, serious illness and death in humans as well as horses. There currently are no FDA-approved vaccines or treatments available specifically for preventing or treating alphavirus infection in humans.

Symptoms of EEEV infection include fever, headache, chills and vomiting. Severe infection can result in seizure, coma and death. About one-third of individuals who develop encephalitis (brain inflammation) from EEEV infection die, and many of those who do recover suffer permanent neurological effects.

Although, outbreaks of eastern equine encephalitis (EEE) are rare, with an average of 11 cases per year in the United States, in 2019 an outbreak of EEE across nine states resulted in 38 confirmed cases, 19 deaths and neurological effects in survivors.

VEE has a much lower mortality rate of 1%, but outbreaks can affect thousands of people, most often occurring in Central and South America. While insect bites are the typical cause of these infections, there is also concern the viruses could be leveraged as bioweapons.

“What we are trying to do is to develop a drug that can be used to treat infected people or as a prophylactic in case of bioterrorism,” Chung said. “Now we are seeing that it therapeutically protects from lethal infection. This is a big milestone in terms of the therapeutic development.”

The team has been developing and optimizing chemical structures against VEEV and EEEV for more than a decade. Golden, Jonsson and Chung are co-investigators in the Center of Excellence for Encephalitic Alphavirus Therapeutics, based at UTHSC. The center was created to refine the properties and activity of early-stage small molecule compounds discovered in the Golden lab and to develop them into clinical candidates for VEEV and EEEV that could be studied in humans. This work was funded with a five-year, $21-million grant from the National Institutes of Health in 2019.

The team is evaluating BDGR-49 in advanced preclinical studies while expanding the understanding of its antiviral properties. As RNA viruses such as EEEV and VEEV are prone to develop mutations, they can potentially evolve into more lethal or transmissible versions without warning, resulting in widespread infections.

“It is essential that we develop these countermeasures for viruses of pandemic potential so we don’t find ourselves unprepared to respond to an outbreak,” Golden says. “We can do better, and we intend to leverage this discovery as broadly as possible with respect to VEEV, EEEV and other viruses of concern.”

This research was supported by the National Institute of Allergy and Infectious Diseases (U19AI142762 and R01AI118814) and by a grant (S10OD016226) from the Office of the Director of the NIH. 

Paving the Way: A Doctor's Journey in Obstetrics and Gynecology to Improve Healthcare for Minority Women

Tanya Franklin, MD MSPH, is an associate professor for the Department of Obstetrics, Gynecology, and Women's Health. She serves as an advocate for mentorship in the medical field, and is a proud mentor for the Central High School Pre-Med program in the West Louisville Community. The University of Louisville School of Medicine interviewed Franklin to get insights on her life as a person of color within the medical field and her passions that persuaded her to pursue medicine.

UofL School of Medicine: What inspired you to pursue the area of General Obstetrics and Gynecology?

Dr. Franklin: As an adolescent I was surrounded by so many examples of unhealthy relationships, teen pregnancy, and missed potential of young women. I knew that these situations were avoidable with education, access to healthcare, and having a trusted doctor.  

UofL School of Medicine: What are some issues minority women face within OBGYN Health Care?

Dr. Franklin: Black women die in childbirth at rates 3-4x higher than their white counterparts. Some Black women enter the medical system with reluctance and mistrust. They may not see anyone at any level in the healthcare system who looks like them. They may feel guarded and unable to experience and express their vulnerability during a life-changing vulnerable time.

UofL School of Medicine: How does the University of Louisville School of Medicine and UofL Health address these issues?

Dr. Franklin: The University of Louisville has worked to diversify our medical school and faculty in addition to hiring a more diverse hospital staff. The goal is to have the healthcare staff represent the diversity of the patient population. During the first and second year of medical school, the curriculum includes clinical cases and discussions about their own personal bias and how it can impact the care is delivered and how race and racism negatively impacts the outcomes of black patients.

UofL School of Medicine: What challenges did you overcome when pursuing your field of study?

Dr. Franklin: When I joined the OBGYN residency program at UofL, I was the first black resident in 30 years. This position came with a lot of pressure, that I placed on myself, to represent myself and represent my community in the most positive light. It did not allow me to show much vulnerability and, at times, made me feel isolated. Knowing that my purpose was bigger than me helped me to overcome the pressure and sometimes unrealistic expectations I placed on myself. Knowing that I was paving the way for more residents of color, more faculty of color to come after me has been worth it all.  

UofL School of Medicine: What programs have you been a part of to advance OBGYN healthcare in Louisville, Kentucky?

Dr. Franklin: We have invested in the Central High School Pre-Medical Magnet Program, which launched in the Fall semester of 2022. This relationship gives West Louisville high school students an up-close and personal experience with a career in medicine. I was fortunate to take part in the White Coat Ceremony on Feb 26, 2023. As we placed white coats on each of the 33 students, their dreams of becoming doctors became a more tangible goal. They were able to show the community and their families that they were committed to being a part of the changing healthcare landscape. The energy in the room that day was powerful.  

UofL School of Medicine: As a woman of color, how do you use your background to show compassion and understanding to your patients?

Dr. Franklin: I understand what it was like to be an adolescent that had little knowledge about my body and felt like I had no power to advocate for myself. Every young woman needs someone in her life to tell her and remind her that she is powerful, smart, and in control of her own destiny. Medical decisions can be overwhelming when you don’t have the medical knowledge base to understand. With each patient, I try to serve as their doctor, their guide, and partner in all their healthcare decisions.

UofL School of Medicine: What are your favorite aspects of working in the medical field?

Dr. Franklin: I love being a doctor. I love building relationships with people and am seeing some of my relationships reach almost a decade and a half now. I am also mentoring a Central High School student who was one of the first babies I helped deliver while I was in residency! I know I have a unique role in people’s lives. I get the honor to be a part of very intimate moments with people. Some of these moments are very special and joyful like the birth of a child. Some moments are difficult like a cancer diagnosis or a miscarriage. I am grateful for the opportunity to support my patients through the brightest times and the darkest times of their lives.

UofL School of Medicine: What advice would you give to a student wanting to pursue a medical degree to become an OBGYN?

Dr. Franklin: Many students feel overwhelmed with the amount of time required to become a physician. My advice is always that time is going to pass anyway. The question is, will you be doing what you love during that time or wasting your time doing something else? The time goes by so fast and before you know it you will be mentoring those babies you delivered 17 years ago. Also, this is not meant for everyone to do. This is meant for YOU to do. At the white coat ceremony, the constant theme was that this white coat is like a cape. You do have superpowers when you put it on. You are able to diagnose and treat disease. You are able to remove a cancer from someone’s body and extend their lives. OBGYN is such a unique field because it combines primary care and surgery. You build long-lasting relationships with women across the entire life span and that is so special.  

The University of Louisville School of Medicine thanks Dr. Franklin for her insight into the medical field and her valuable work at UofL and within our community.