Research in cancer biology, spinal cord injury, birth defects, circulatory support devices and more will highlight Research!Louisville 2014, Sept. 16-19 at various locations in the Louisville Medical Center.

Now in its 19th year, Research!Louisville annually features reports on the latest research underway at the institutions and organizations in the medical center and is sponsored by the University of Louisville; University of Louisville Hospital, Jewish Hospital and St. Mary’s Foundation, all part of KentuckyOne Health; and Norton Healthcare.

Also included will be addresses from two internationally known leaders in medical research:

• Mary Woolley, president and CEO of Research!America, Alexandria, Va., will address “Your Role in Changing Hearts and Minds for Science” at 2 p.m., Thursday, Sept. 18, in Room 101/102 of the Kosair Charities Clinical and Translational Research (KCCTR) building, 505 S. Hancock St. Woolley will discuss the impact of a polarized Congress on federal health research agency budgets, share public opinion poll data and provide insights on how to effectively communicate with policy makers, the public and the media about research during an election year.

• Stefano Bonassi, Ph.D., head of the Clinical and Molecular Epidemiology Area of Systems Approaches and Non-Communicable Diseases of the Istituto di Ricovero e Cura a Carattere Scientifico, Rome, will speak on “From Exposure Assessment to P4 Medicine” at 1:30 p.m., Friday, Sept. 19, in Room 101/102 of the KCCTR. “P4 Medicine” is a term coined by biologist Leroy Hood, M.D., Ph.D., and is short for "Predictive, Preventive, Personalized and Participatory Medicine." The premise of P4 medicine is that, over the next 20 years, medical practice will be revolutionized by biotechnology, to manage a person's health instead of a person’s disease. Bonassi will discuss the scientific and clinical features of several systems medicine platforms.

Featured reports on ongoing research in Louisville include:

• Cancer Biology and Therapeutics Symposium: 10:30 a.m., Tuesday, Sept. 16, 101/102 KCCTR – Translational research results on the discovery of novel cancer targets and the development of cancer therapeutics. Chief presenter: Jason Chesney, M.D., Ph.D., Deputy Director, University of Louisville James Graham Brown Cancer Center, a part of KentuckyOne Health

• Recovery and Repair After Spinal Cord Injury: 2:30 p.m., Tuesday, Sept. 16, 101/102 KCCTR – Issues critical to rehabilitation after spinal cord injury and strategies employed by the UofL Kentucky Spinal Cord Injury Research Center, Kosair Charities Center for Pediatric Neurorecovery, Frazier Rehab Institute and Robley Rex VA Medical Center. Presenters: David S.K. Magnuson, Ph.D.; Dena Howland, Ph.D.; and Andrea Behrman, Ph.D., all of the UofL Department of Neurosurgery

• Molecular Determinants of Birth Defects: 10:30 a.m., Wednesday, Sept. 17, 101/102 KCCTR – Research supported by the UofL Center of Biomedical Research Excellence with the goal of illuminating the molecular etiologies of developmental defects and disabilities. Presenters: Jun Cai, Ph.D., UofL School of Medicine; Lisa Sandell, Ph.D., UofL School of Dentistry; and Rachel Neal, Ph.D., UofL School of Public Health and Information Sciences

• Symposium: Intravital Imaging and Diseased States: 10:30 a.m., Thursday, Sept. 18, 101/102 KCCTR – Use of state-of-the-art imaging techniques to track biological process in normal, diseased and damaged tissue. Presenters: Bart Borghuis, Ph.D, UofL Department of Anatomical Sciences and Neurobiology, and Lacey McNally, Ph.D., UofL James Graham Brown Cancer Center, a part of KentuckyOne Health

• Community Engagement and Engaged Scholarship: 3 p.m., Thursday, Sept. 18, 101/102 KCCTR – Four 15-20 minute presentations by faculty from the UofL Schools of Medicine, Nursing and Public Health and Information Sciences and UofL’s Kent School of Social Work followed by a panel discussion moderated by Erica R.H. Sutton, M.D., UofL Department of Surgery. Presenters: Vicki P. Hines-Martin, Ph.D., R.N., School of Nursing; Monica L. Wendel, Dr.P.H., School of Public Health and Information Sciences; and Riaan van Zyl, Ph.D., and Cheri Langley, Ph.D., both of Kent School of Social Work

• Clinical Translation of Mechanical Circulatory Support Devices for Treatment of Advanced Heart Failure: 10 a.m., Friday, Sept. 19, 101/102 KCCTR – Novel experimental models and innovative approaches for treating advanced heart failure. Presenters: Steven Koenig, Ph.D., UofL Speed School of Engineering; Guruprasad Giridharan, Ph.D., Cardiovascular Innovation Institute (CII), a joint initiative of UofL and Jewish Hospital and St. Mary’s HealthCare; Yu Wang, Ph.D., UofL Speed School of Engineering; Leslie Sherwood, D.V.M., CII and UofL Research Resource Facilities; Gretel Monreal, Ph.D., UofL Department of Cardiovascular and Thoracic Surgery; Kevin Soucy, Ph.D., UofL Department of Cardiovascular and Thoracic Surgery; and Mike Sobieski, R.N., CII

Other reports focused on research practice will be:

• Are We There Yet? Personal Reflection on Community-Based Participatory/Translational Research: 1 p.m., Wednesday, Sept. 17, 101/102 KCCTR – Perspectives from Ida Johnson-Spruill, Ph.D., R.N., of the Medical University of South Carolina whose research interests include chronic disease management, genetic literacy and reducing health disparities among vulnerable populations

• Auditing of Clinical Trials – GCP and Billing, a GEAR (Gaining Essentials About Research) symposium presented by Norton University and Norton Healthcare Office of Research Administration: 8:30 a.m.-2 p.m., Thursday, Sept. 18, Cranmer Auditorium, Norton Healthcare Pavilion, 315 E. Broadway – The combined auditing of clinical trials for both good clinical practice (GCP) and billing compliance leading to capitalization of revenue and ensuring principal investigators and research teams are following GCP guidelines. Presenters: Kelly M. Willenberg, principal of Research Compliance Advocates LLC, Chesnee, S.C., and Kathleen Hurtado, president and CEO of Health Research Association, Los Angeles

• Super Hero Evidence: Does Your Literature Have the Strength to Support Your Practice Change? Offered twice from 7:30 a.m.-noon and again from 11:30 a.m.-5 p.m., Friday, Sept. 19, Rudd Heart and Lung Conference Center, Jewish Hospital, 201 Abraham Flexner Way – An overview of evidence-based practice with a focus on establishing the worth of a study through the critical appraisal process. Organizer: Reeta Stikes, KentuckyOne Health

Also on tap will be scientific poster presentations by summer interns of the James Graham Brown Cancer Center and UofL graduate students, postgraduates, fellows and faculty. Poster presentation awards will be announced at 1 p.m., Friday, Sept. 19, in 101/102 KCCTR.

Admission to Research!Louisville is free. For information, contact Bonnie Dean, 502-852-2647 or bonnie.dean@louisville.edu.

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.

At three months of age, Emmalie Smith suffered a spinal cord injury leaving her paralyzed. Her parents, Amy and Bryce, took her to traditional physical and occupational therapy three times a week with the hope that their little girl would regain her ability to move.

Amy says the results were underwhelming, with Emmalie using her forehead to activate a motorized wheelchair.

Unsatisfied with that as an option, Amy contacted the University of Louisville and Andrea Behrman, Ph.D., who had brought to UofL her research into the use of Locomotor Training to provide better rehabilitation to children with paralysis from spinal cord injuries.

Nine months after the intense physical therapy at the Frazier Rehab Institute, a part of KentuckyOne Health, Emmalie was able to better move her arms, roll over and come to sit in bed, and use a manual wheelchair. After her most recent work with Behrman and the pediatric team, the now 4-year-old from Brighton, Mich., is beginning to stand. With an injury at such a very young age, these are new experiences in Emmalie’s growth and development.

“This has made a tremendous difference in Emmalie’s life,” Amy said. “Her core strength is to where she is able to sit on her own and doesn’t need a chest belt. She’s able to get herself around and is much more independent. Working with Dr. Behrman and her team has had a huge impact on Emmalie and our entire family.”

More children like Emmalie will be able to benefit from Behrman’s groundbreaking efforts, thanks to a three-year, $1.5 million grant provided by The Leona M. and Harry B. Helmsley Charitable Trust.

“The work of Dr. Behrman and her team is a perfect example of the goal of every researcher at the UofL Health Sciences Center -- transforming peoples’ lives through creating and translating into actions new knowledge about how to prevent, treat and cure medical issues,” said James R. Ramsey, Ph.D., president of the University of Louisville, in announcing the grant at a news conference today (Sept. 4). “We are very excited and grateful that the Helmsley Charitable Trust shares our vision and is providing significant support to help us achieve this ambitious objective.”

To date, the Helmsley Charitable Trust has provided nearly $16.5 million to support UofL researchers investigating both cancer prevention and cures and rehabilitation efforts for adults and children who are paralyzed.

“Dr. Behrman’s work has the potential to be truly transformative for adults and children who are affected by paralysis -- not just in Louisville and Kentucky, but around the world.” said John Codey, a trustee of the Helmsley Charitable Trust.  “With this latest grant that is focused on treating pediatric spinal cord injuries, the Trust is thrilled to build upon our relationship with UofL’s world-class team of researchers, who continue to break new ground in the quest to understand and solve some of the most critical medical challenges that we face today.”

“The importance of support from our partners cannot be over-emphasized,” said David L. Dunn, M.D., Ph.D., UofL executive vice president for health affairs. “The current research funding environment does not guarantee that projects like Dr. Behrman’s will receive support from the typical funding agencies. We are extremely grateful that the Helmsley Charitable Trust recognizes that the work taking place at the University of Louisville has the significant potential to change the lives of children throughout the world.”

Behrman, professor of neurosurgery and director of the UofL Kosair Charities Center for Pediatric Neurorecovery, is a pioneer in the use of Locomotor Training in children. The intense physical therapy regime was developed by Behrman and fellow UofL faculty member Susan J. Harkema, Ph.D., professor of neurological surgery and the Owsley B. Frazier Chair in Neurological Rehabilitation at UofL and the Rehabilitation Research Director of the UofL Kentucky Spinal Cord Injury Research Center.

Locomotor Training allows individuals with certain kinds of spinal cord injuries to repetitively practice standing and stepping using body weight support and a treadmill with manual facilitation from therapists and technicians. The ultimate goal is to re-train patients with spinal cord injuries to sit independently, stand and walk again. Further benefits including improved respiration, bladder control, and sensation have made a significant impact on the quality of life for children. Behrman’s goal is to help children who not only have spinal cord injuries, but also conditions such as head trauma and tumors.

“The generous support we are receiving from the Helmsley Charitable Trust will enable our team to develop equipment that better fits children as they participate in Locomotor Training,” Behrman said. “Also, we now will be able to develop a systematic database for immediate and long-term outcomes for the children who are participating in our program. We also will gain a better understanding of the value of sensory cues such as surface texture, heat/cold or vibrations and their potential impact on the child’s rehabilitation effort.”

An experimental regimen of once-weekly breast irradiation following lumpectomy provides more convenience to patients at a lower cost, results in better completion rates of prescribed radiation treatment, and produces cosmetic outcomes comparable to the current standard of daily radiation.

These interim results of the 5-year Phase II clinical trial using the experimental regimen were presented Sept. 4 at the Breast Cancer Symposium 2014 in San Francisco by Anthony E. Dragun, M.D., vice chair and associate professor of radiation oncology at the University of Louisville.

Dragun, a radiation oncologist with University of Louisville Physicians, launched the trial three years ago at UofL’s James Graham Brown Cancer Center, a part of KentuckyOne Health and the only site offering the experimental regimen in the United States. A second KentuckyOne Health site is being planned, he said, and is expected to begin enrolling patients this autumn.

Reviewing data from Europe – the United Kingdom in particular – Dragun found an alternative to the currently standard daily radiation treatments prescribed to patients after a lumpectomy. Physicians in the U.K. and other European countries were reporting excellent results with a regimen of radiation administered once-weekly.

“Instead of daily treatments for 25-30 days, five to six treatments administered once each week were being used,” he said. “I thought this regimen would give our patients here in Kentucky a great deal of access and choice, so we developed the trial and launched it in 2011.”

Approximately 150 female patients have been enrolled in the trial thus far, he said. Patients undergoing a lumpectomy following diagnosis of breast cancer are given a choice of the current standard of daily radiation treatments or the option to enroll in the trial and receive treatment one time per week.

The radiation dosing has been calibrated to compensate for the change in how the treatments are administered, but no adverse effects have been seen, Dragun said. “The outcomes with once-weekly treatments are absolutely in line with what we see in daily breast irradiation,” he said. “The standard of care is maintained.”

Giving women the choice of how their treatment is administered means more women complete their treatment, he said. “Finding time for daily treatments for 6 weeks or more just isn’t possible for many women,” Dragun said. “Scheduling once-weekly treatments is much easier to fit into the busy lives our patients lead.

“We also see many patients who depend on public transportation or live in rural areas that are 30 miles or more from our center, and they have told us that they would not have been able to complete a traditional course of daily radiation treatment.  Their only alternative would be a mastectomy,” he said.

Because radiation treatment is reimbursed on a per-treatment basis, Dragun said the overall cost is lowered. “We have reduced the number of treatments to about one-fourth to one-third of what the current daily treatment regimen is,” he said. “Medicare reimburses radiation costs on a per-treatment basis, and most private insurers do likewise.

“This means we’ve been able to reduce the cost by 50 to 60 percent without jeopardizing the quality of care.”

Dragun plans to enroll another 50 patients at the Louisville site and 30 at the future trial site. After the completion of this trial, he intends to expand into a multi-center Phase III trial at facilities in other states.

“We believe the once-weekly regimen such as this will become a standard option in the next decade,” he said.

A University of Louisville professor chaired a 10-member American Heart Association panel of experts in formulating the association’s first-ever policy statement on e-cigarettes.

Aruni Bhatnagar, Ph.D., the Smith and Lucille Gibson Chair in Medicine and director of the UofL Diabetes and Obesity Center, is lead author of the statement as published in the journal CirculationAug. 24.

While much is still unknown about the rapidly growing electronic cigarette industry, e-cigarettes are dangerous because they target young people, can keep people hooked on nicotine, and threaten to “re-normalize” tobacco use, according to the policy statement.

The battery-powered e-cigarettes that contain nicotine are tobacco products and should be subject to all laws that apply to these products, according to recommendations in the policy statement. The association also calls for strong new regulations to prevent access, sales and marketing of e-cigarettes to youth, and for more research into the product’s health impact.

“People need to know that e-cigarettes are unregulated and there are many variables that we don’t know about them,” Bhatnagar said. “Recent studies raise concerns that e-cigarettes may be a gateway to traditional tobacco products for the nation’s youth, and could re-normalize smoking in our society.”

Manufacturers present e-cigarettes as “cool and sexy and acceptable, which is a problem because you’re increasing addiction,” Bhatnagar said. Companies also use terms like “vaping” rather than smoking to gain public acceptance and try to break the connection between e-cigarettes and traditional, “combustible” cigarettes, he added.

In April the Food and Drug Administration proposed rules banning the sale of e-cigarettes to people under the age of 18 and subjecting the $2 billion industry to federal regulation for the first time. Such rules had been long sought by the AHA and other organizations.

The FDA’s proposal fell short of what was hoped for by the AHA and other public health advocates, however, because it did not go far enough in limiting online sales, advertising and flavored products, all tactics used to make e-cigarettes appealing to young people.

Liquid nicotine used by e-cigarettes comes in many flavors like bubble gum, caramel, chocolate, fruit and mint, all attractive to young people, and many brands use colorful, candy-like packaging.

“That’s an unfortunate trend, to make them palatable and attractive to children,” Bhatnagar said.

A professor in the Department of Ophthalmology and Visual Sciences in the University of Louisville School of Medicine has been named chair of a panel that reviews research grant applications, helping determine which are worthy for support from the National Institutes of Health.

Maureen McCall, Ph.D., has been named chair of the 20-member Neurotransporters, Receptors and Calcium Signaling Study Section of the NIH’s Center for Scientific Review. She is the only Kentuckian on the panel, which has representatives from universities in 14 states. Her term begins this month (August 2014) and will conclude in 2016.

The Center for Scientific Review is the gateway for NIH grant applications and their review for scientific merit. It recruits and organizes scientists into 174 study sections to review applications for funding made to the NIH.

Each study section has a precise focus so that applications receive expert reviews to help the NIH identify the most promising research. The Neurotransporters, Receptors and Calcium Signaling Study Section reviews studies that investigate signal transduction pathways in neurons, muscles and other excitable cells – those that can be stimulated to create an electric current.

McCall holds joint appointments as professor in the Departments of Anatomical Sciences and Neurobiology and Psychological and Brain Sciences. She came to UofL in 1997.

The author of approximately 60 journal articles, McCall uses electrophysiological techniques in her research to evaluate normal retinal function, dysfunction caused by blinding retinal diseases, and the restoration of function using a variety of therapeutic strategies. Particular areas of emphasis are in the study of retinitis pigmentosa, glaucoma and congenital stationary night blindness.

Ashley Flanary Jessup always wanted to be a doctor when she grew up. She just never imagined that along the way she would blaze a new trail for medical education in Kentucky. Growing up in the small rural town of Benton, Ky., Jessup didn’t fit the typical demographic for a medical school candidate. But she held on to her dream and now, at age 24, that determination has paid off.

When Jessup received her medical degree in June, the University of Louisville celebrated not only her success, but a historic first when Jessup became the first person to graduate the School of Medicine’s Rural Medical Accelerated Track program, or RMAT. This new program enables students to finish medical school in three years, reducing cost and time commitments for rural students who plan to open practices in small towns in Kentucky.

Rural doctors are desperately needed in the United States. Nationwide, 20 percent of the U.S. population is living in small towns or far away from big cities, but only 9 percent of physicians practice in those rural areas. Family doctors are distributed more evenly, with 22 percent practicing outside large cities, but the need is still greater. Proponents of the RMAT hope that more successes like Jessup’s will pave the way for more doctors to go where they are needed.

William Crump, M.D., associate dean of the University of Louisville School of Medicine, says that outcome is likely, considering Kentucky’s numbers. He stressed that “most of the counties in Kentucky that are underserved are only underserved by an average of 1.5 full-time equivalent positions. This means that placing one more physician permanently in a county may move it from being an underserved to an adequately served county.”

The idea for an accelerated medical track gained national attention in 2006 with an essay by the editor of Academic Medicine, an internationally renowned medical journal. The essay made the case that financial barriers may keep many students coming from families with more modest incomes—the ones most likely to choose a rural medical path—from considering medical school. At the same time, a strategic planning process by Kentucky Academy of Family Physicians supported a proposal for a three-year track to rural practice. The University of Louisville began the planning process in 2009.

Crump says the RMAT program will definitely help Kentucky’s shortage of doctors and healthcare providers in rural areas. In his opinion, “The best way to get a doctor to a rural area is to get a medical student from a rural area.” The program channels students from small towns that truly want to study family medicine, and then keeps them in that channel.

Students in RMAT have the same required curriculum as traditional four-year medical students, but the lens in which they filter the material is focused on a rural practice, and undertaken in a condensed amount of time.  It begins with a four-week experience in a rural community practice, and students must complete their capstone, a family medicine clerkship at the end of their final year.

Jessup says the program was fast-paced, but manageable. “At first glance, it sounds overwhelming, but if you take things one step at a time, it isn’t.” In fact, Jessup was able to find the time to get married during her time in the RMAT program. She says the biggest advantage of the program was the financial aspect. “One less year of school means one less year of tuition, and I was finished one year sooner,” she said.

Denying the label of a trailblazer, Jessup gives the credit to others. “I would consider all of the faculty and staff who envisioned the program as the trailblazers,” she said. “They laid the plans for me and made it all possible.”  She simply says she worked hard and did what every other medical student does—just in a smaller amount of time. She views herself as just another kid who dreamed of becoming a doctor, and hopes that more will follow in her footsteps at UofL.

Crump says students who have chosen to take the accelerated path have done very well with the course load despite initial fears to the contrary. “Even though the program is stressful and does not leave much wiggle room, students who are focused and efficient will succeed,” he says.

Two second-year medical students are currently taking part in the RMAT program and Crump says several first-year students have expressed an interest in the program.

In Crump’s view, the RMAT program has had an amazing start. “I tend to think of it as my ‘baby’,” he says. “When we started in 2006, we had a vision, and we have seen that vision come true. We have overcome the doubters and the skeptics.”

Jessup says she is proof of the RMAT program’s success. With her successful graduation from UofL’s program, Jessup hopes to return to her hometown of Benton to begin her practice after her residency in Madisonville. She says she is very excited to have the chance to make a difference in her community, and is optimistic about the program’s future. “We wanted to make the RMAT successful, and we all worked together to make it happen.”

A surgeon at University of Louisville Hospital, part of KentuckyOne Health, recently performed an extended endoscopic skull-based surgery of the brain, a unique surgery of its kind in Kentucky.

Performed by Dr. Mary Koutourousiou, assistant professor of neurosurgery and director of the skull base program, the minimally invasive surgery was done to help restore the eyesight of a 34-year-old man who suffered from a malignant brain tumor located at the base of the skull.

Extended endoscopic skull-based surgery is performed through the nose and enables surgeons to remove brain tumors and lesions – some as large as softballs. During the procedure, which takes an average of six hours, surgeons use a specially designed endoscope to view the tumor and additional instruments to dissect it piece-by-piece through the nasal cavity.

This approach reduces risks and recovery times for the patient who would otherwise need a craniotomy, which requires temporary removal of a bone flap from the skull to access the brain and brain retraction to reach the tumor.

“The base of the skull is one of the most challenging regions of the body to access,” Koutourousiou said. “Using an endoscopic endonasal approach provides a panoramic view of the base of the skull and the patient’s tumor.”

The minimally invasive nature of the procedure leaves no visible scarring, shortens a patient’s hospital stay, reduces overall recovery times and involves less trauma to the brain and critical nerves. Hospital stays following a craniotomy could be up to 30 days, compared to three to four days following an extended endoscopic skull-based procedure.

“This approach is the future of brain surgery,” said Ken Marshall, president, University of Louisville Hospital. “There are only a handful of surgeons with fellowship training on this procedure in the country. We are proud to have one of those surgeons on our team and to be able to offer this new option for patients in the Commonwealth.”

Koutourousiou completed a clinical fellowship in endoscopic skull base surgery and open skull base surgery at the University of Pittsburgh Medical Center. She has published extensively on the endonasal approach to brain surgery.

Researchers from the University of Louisville will lead an international effort to utilize tobacco plants to develop a gel containing a specific protein that will prevent the transmission of HIV. The project is being funded by a five-year, $14.7 million grant from the National Institutes of Health.

“Our researchers are looking to solve problems that affect the world,” said James R. Ramsey, Ph.D., president of the University of Louisville. “Globally, more than 34 million people are HIV positive. The development of a low-cost method to prevent transmission of HIV certainly is something that is desperately needed and the use of tobacco plants as a method of carrying the vaccine appears to be key in the process.”

“Approximately seven years ago, UofL and Owensboro Health created a joint venture to develop a world-class plant pharmaceutical program that would have an impact globally,” said David L. Dunn, M.D., Ph.D., executive vice president for health affairs at UofL. “Today’s announcement, coupled with the announcement we made in May about the Helmsley Charitable Trust providing funding to our research into two other cancer vaccines utilizing tobacco plants, demonstrates that the vision is becoming a reality.”

Kenneth Palmer, Ph.D., professor of pharmacology and toxicology and director of the Owensboro Cancer Research Program of UofL’s James Graham Brown Cancer Center, is leading a team of researchers from the University of Pittsburgh, the Magee-Women’s Research Institute in Pittsburgh, the Centers for Disease Control and Prevention, Karolinska Institutet in Stockholm, Sweden, the University of Manitoba in Winnipeg, Canada, the University of Maryland, Baltimore and Kentucky Bioprocessing Inc. and Intrucept Biomedicine LLC in Owensboro.

The team is working with the carbohydrate combining protein Griffithsin (GRFT), which is found in red algae. In laboratory work, the protein has shown to have broad-spectrum activity against HIV. GRFT binds to the dense shield of sugars that surrounds HIV cells and prevents these cells from entering other non-HIV cells. The team plans to develop a gel containing the protein for use during sexual intercourse by people at risk for HIV transmission.

To develop the microbicide, Palmer’s team takes a synthetic copy of the protein and injects it into a tobacco mosaic virus, which carries the protein into the tobacco leaves. After 12 days, the researchers harvest the leaves and extract the mass-produced protein for development into the vaccine.

“Our goal is to optimize the delivery system of the protective agent, which in this case is a gel, and determine its safety and estimates of its efficacy, leading to a first-in-humans clinical trial,” Palmer said.

“People may question why a cancer program is conducting research into HIV prevention,” said Donald Miller, M.D., Ph.D., director of the James Graham Brown Cancer Center, a part of KentuckyOne Health. “In fact, cancer can be a result of every major disease that we know about, and HIV infection is no exception.”

Overall, the grant contains three significant projects – The Critical Path Project; Preclinical Testing Project; and Clinical Trial Project.

The critical path project involves manufacturing the microbicide active ingredient, ensuring quality of the microbicide and the formulated gel product and production for actual use. This process is in collaboration with two Owensboro-based biotechnology companies (Kentucky Bioprocessing Inc. and Intrucept Biomedicine LLC), and Lisa Rohan, Ph.D., at the University of Pittsburgh and Magee-Women’s Research Institute. Rohan has significant experience developing delivery systems for similar medications.

The preclinical testing project is a collaboration with the Centers for Disease Control and Prevention in Atlanta to use an animal model to ensure that the vaccine is safe and to determine that it actually provides protection from infection.

The clinical trial project involves developing the application to conduct a clinical trial for the Food and Drug Administration, as well as conducting the first-in-humans testing.

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Editor’s note: Palmer is one of the founders and principal partners in Intrucept Biomedicine LLC.

More than a dozen silent auction items valued at $50 to $500 from The Outlet Shoppes of the Bluegrass will be available for bidding online beginning Friday, July 25, at 5 p.m. at www.shoppingforacure.org. Bidding online continues until 8:30 p.m. Wednesday, July 30, during the Opening Night VIP Preview Shopping Event.

The Outlet Shoppes of the Bluegrass is holding the event from 6-9 p.m. to benefit the James Graham Brown Cancer Center at the University of Louisville. The by-ticket-only VIP Preview is being held on the evening before the facility opens to the general public.

Patrons are encouraged to bring smart phones or tablets to the event to continue bidding until the silent auction closes. Among the merchants and items available are:

• Saks Fifth Avenue OFF FIFTH: $100 gift card
• Polo Ralph Lauren: 5 $100 gift cards
• Columbia: $500 gift card
• J Crew: $200 gift card
• Wilson’s Leather: ladies handbag
• Crabtree & Evelyn: $50 gift card and 2 gift sets
• Converse All Star: $100 gift card
• Auntie Anne’s: $150 in VISA gift cards and 3 At-Home Pretzel Kits
• Gold Toe, Hanes & Jockey: $250 in gift cards to Hanes Brands, $100 in gift cards to Jockey and a tote bag filled with Gold Toe socks

Patrons also will be able to beat the huge crowds expected for opening weekend and get the jump on the rest of Kentuckiana in shopping at the facility. Other retail outlets that will be open on the night of the VIP Preview include Coach, Brooks Brothers, Michael Kors, Banana Republic, Nike, Talbots, Under Armour and more. Patrons also will receive an exclusive 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.

Tickets to the event are $50 each and also can be purchased at www.shoppingforacure.org. Only patrons with tickets will be able to enter The Outlet Shoppes on VIP Preview night.

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 1155 Buck Creek Road, 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.

The president of the Institute of Medicine of the National Academies will present the 2014 Leonard Leight Lecture at the University of Louisville.

Victor J. Dzau, M.D., will speak at noon, Wednesday, Dec. 10, at Kornhauser Library Auditorium on the UofL Health Sciences Campus. Admission is free.

Dzau assumed the presidency of the IOM July 1 after having served as chancellor for health affairs at Duke University, president and CEO for Duke University Health System, and James B. Duke Professor, Duke University School of Medicine. He was elected to the IOM in 1988 and served on several leadership committees prior to being named president.

He has made a significant impact on medicine through his seminal research in cardiovascular medicine and genetics, his pioneering work in the discipline of vascular medicine, and recently his leadership in health care innovation. His work on the renin angiotensin system (RAS) – a hormonal system that regulates blood pressure and fluid balance – paved the way for the contemporary understanding of RAS in cardiovascular disease and the development of RAS inhibitors as therapeutics. Dzau also helped pioneer gene therapy for vascular disease. His most recent work provides novel insight into stem cell biology and regenerative medicine.

The Leonard Leight Lecture is presented annually by the Division of Cardiovascular Medicine in the Department of Medicine at the University of Louisville School of Medicine. For 30 years until 1996, Leight was a practicing cardiologist in Louisville and played a major role in developing cardiology services and bringing innovative treatment modalities in heart disease to Louisville.

The Leonard Leight Lecture series was established in 1994 and is made possible by gifts from Dr. and Mrs. Kurt Ackermann and Medical Center Cardiologists to the Jewish Hospital & St. Mary’s Foundation.

Craig McClain, M.D., has been named the Associate Vice President for Health Affairs/Research at the University of Louisville. McClain also serves as Distinguished University Scholar, UofL Associate Vice President for Translational Research, Director of the UofL Clinical and Translational Sciences Institute, Director of Research Affairs, Division of Gastroenterology, Hepatology and Nutrition, and Director of Gastroenterology at the Louisville VAMC.

“Dr. McClain brings a wealth of research experience to this position. I am confident that in this new position, which bridges research activities across the university and acts as a liaison between the Offices of the EVPHA and the Executive Vice President for Research and Innovation, he will continue to provide outstanding research leadership on behalf of the Health Sciences Center,” said David L. Dunn, M.D., Ph.D., executive vice president for health affairs.

McClain is a widely recognized expert in alcohol abuse, nutrition, and cytokine research, as well as hepatic drug metabolism. In 1980, he described the deleterious interactions in the liver between alcohol and acetaminophen, and he was the first to describe dysregulated cytokines in alcoholic hepatitis.

His laboratory currently focuses on nutrition and the gut: liver axis, especially as it relates to alcoholic liver disease. He has published more than 340 peer-reviewed articles and 100 book chapters/reviews, and he has mentored more than 100 medical students, residents, GI fellows, graduate students and post-doctoral fellows.

He has received multiple awards, such as the American Gastroenterology Association Foundation Research Mentoring Award, the Elizabeth Hurlock Beckman award for mentoring,  the Grace A Goldsmith Award in Nutrition, the University of Louisville Distinguished Faculty Award in Research for Basic and Applied Sciences, and teaching awards such as Outstanding Gastroenterology Education at UofL.

McClain also has been prominent nationally, serving as president of the American College of Nutrition. He also has served on several NIH and VA Study Sections. He was the first physician member of the NIH Peer Review Advisory Committee (PRAC) and currently serves on the NIAAA National External Advisory Council and on the NIH Council of Councils.

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 5^th, 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.

The next Beer with a Scientist program will shed light on the “incurable” condition of aging.

Leah Siskind, Ph.D., associate professor of pharmacology and toxicology at the University of Louisville, will present “Everyone is Aging: So Why Haven’t We Found a Scientific Cure?” from 8-9 p.m., Wednesday, July 16, at Against the Grain Brewery, 401 E. Main St.

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

The Beer with a Scientist program is now in its third month and is the brainchild of University of Louisville cancer researcher Levi Beverly, Ph.D. Once a month, the public is invited to Louisville’s Against the Grain brewpub for exactly what the title promises: beer and science.

Beverly created the monthly series as a way to connect with people who don’t have scientific backgrounds but want to know about scientific topics. “We lose sight of the fact that most people have never even met a Ph.D., never talked to one,” he said. “(However) whenever I go someplace, if I strike up a conversation at a bar and I tell someone what I do for a living, they always have questions. It leads to a whole conversation.”

Against the Grain’s Sam Cruz believes Beer with a Scientist bridges what he sees as a disconnect between scientists and the general public. “If you don’t know about something, it’s hard to care,” he said. “I think that’s why this works; what we’re doing with these talks is letting people take the time to think about these things.”

Organizers add that they 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.

University of Louisville President James R. Ramsey, Ph.D., and Donald Miller, M.D., Ph.D., director of UofL’s James Graham Brown Cancer Center, issue the following statements on the death July 2 from cancer of Asia Ludlow of Louisville:

“Asia Ludlow possessed great courage and an attitude that was so uplifting to all who came in contact with her. Her zest for life was an inspiration to all of us.

“Asia will always remain a driving force for everyone at UofL who work in the field of cancer to find the cures and preventions so that one day, no more lives are lost to this terrible disease.

“Cancer can be an all-encompassing experience, affecting every aspect of a person’s life. Asia dealt with cancer head-on with hope and optimism. The disease was in her body, never in her spirit.

“To her daughters and other loved ones, we express our deepest sympathies. As we grieve for her loss, we hope that memories of Asia will provide some comfort to all who knew and loved her.

James R. Ramsey, President

“It is with great sadness that all of us at the James Graham Brown Cancer Center, KentuckyOne Health and the University of Louisville mourn the loss of Asia Ludlow.

“Asia was a 2013 Survivor Ambassador at the Julep Ball, and the true champion that she was, she joined us again at the 2014 Julep Ball to share her story. We were honored again when she began volunteering at our M. Krista Loyd Cancer Resource Center, helping other patients with her unmatched spirit of hope and compassion.

“Asia first fought breast cancer and kept fighting as it spread throughout her body. She was strong and committed, keeping faithfully to the treatment regimen prescribed for her – but her experience reminds us again that cancer is still a formidable enemy despite all we have at our disposal to combat it.

“Her odyssey as a patient with cancer began in 2008 and ended all too soon this week in mid-2014. Her life, however, serves as a legacy to show how one person’s grace, courage and caring heart can and does make a difference for others.”

Donald Miller, M.D., Ph.D., Director, James Graham Brown Cancer Center

To see and hear Asia’s message of hope in her own words, visit the James Graham Brown Cancer Center video here, her profile on Jean West’s Medical Digest here and her interview with Urban Lifestylez here.

The University of Louisville Department of Pediatrics is reorganizing its general pediatrics division, positioning itself to respond better to the needs of the community’s children and to the changing health care enrivonment.

The division provides primary care services to children in Louisville and Campbellsville, Ky., and helps train students and residents in medicine, nursing, dentistry, psychology and social work.. In 2013, its 22 pediatricians were responsible for more than 22,000 patients. Approximately 12 percent of the children in metro Louisville sees a UofL pediatrician as their primary care provider.

“Health care reform has placed a greater emphasis on primary care, where providers can promote health and safety,” said Gerard Rabalais, M.D., MHA, chair of the UofL Department of Pediatrics. “Pediatric programs like ours may be the best place to achieve success with health care reform since we have the ‘longest runway’ to influence attitudes about prevention and healthy lifestyle.”

A number of changes are planned for the coming months.

Consolidating offices, redeploying physicians

The department created a single, expanded practice site in Downtown Louisville, moving the office formerly located on Broadway at Floyd Street a few blocks north  of the Children & Youth Project (C&Y) at 555 S. Floyd St.

C&Y will offer all of the services previously offered at the Broadway office, and the expanded downtown clinic will serve as a medical home with a wider array of on-site ancillary services: social work, psychology, dental care, home health, speech therapy, WIC nutrition services and legal counseling.

“This practice demonstrates the power of a university to bring multiple disciplines together to provide comprehensive health care for children,” Rabalais said.

Patients may see a UofL pediatrician at C&Y or one of the department’s other general pediatrics practices: the Stonestreet location at 9702 Stonestreet Road; or the Sam Swope Kosair Charities Centre at 982 Eastern Parkway.

Families who want a Spanish-speaking provider will have three office locations to choose from in Downtown Louisville, Germantown and South Louisville.

“Consolidating these two offices and deploying our physicians to different locations lays the groundwork for increasing access and building partnerships in the communities we serve,” said Gil Liu, M.D., chief of the UofL general pediatrics division. “Increasingly, we want to be able to say, ‘Our pediatricians are coming to a neighborhood near you.’”

Adding pediatric practices

This summer, the UofL Department of Pediatrics will partner with an East Louisville pediatric practice, bringing the number of general pediatricians and nurse practitioners in the department to 36.

The department will also expand its Campbellsville, Ky., practice – located at 73 Kingswood Dr. – later this summer, partnering with Taylor Regional Hospital to open a satellite office in Columbia, Ky.

Plans also are underway to provide general pediatric care in the West End of Louisville.

“We see these additions as opportunities to expand availability to patients and support community practitioners, who don’t have the resources to support multiple disciplines or the buying power and advantage in contract negotiations that we do,” Rabalais said.

Creating a network

All of the Louisville pediatric practices will soon operate as a network. That means patients will have a medical home for routine visits as well as access to urgent care at any of the other Louisville general pediatric practices. The network also will enable families to access ancillary services headquartered at C&Y and specialty care by UofL pediatric specialists.

“We think an arrangement that offers ‘one-stop shopping’ for multiple health care providers will be good for all our patients,” Dr. Liu said.

Creating additional learning opportunities for trainees

The department’s reorganization also ensures that residents, medical students and trainees from other programs will have places to learn primary care pediatrics. Historically, trainees have spent time in community pediatric practices but these practices may struggle to continue hosting students because of changes in the health care landscape.

“It is part of our educational mission to expand primary care opportunities,” Rabalais said.

Kentucky’s Horses and Hope is going international. Champion equestrian and Horses and Hope Pink Stable member Misdee Wrigley Miller will spread the message of breast cancer awareness as she competes next week in two European Equestrian World Cup qualifying events.

In 2008, the office of Kentucky First Lady Jane Beshear partnered with the Kentucky Cancer Program to create Horses and Hope. The program’s mission is to increase breast cancer awareness, education, screening and treatment referral among Kentucky’s horse industry workers and their families.

The University of Louisville and the University of Kentucky operate the Kentucky Cancer Program and staff Horses and Hope programs and events. UofL’s James Graham Brown Cancer Center, a part of KentuckyOne Health, manages the Kentucky Cancer Program for the western half of the Commonwealth.

On Thursday, July 3, Miller will compete in CAI3* horse driving competitions in Lähden and Riesenbeck, Germany, in the four-in-hand combined driving competition. Both competitions are FEI World Equestrian Game qualifying events. While there, she will spread awareness about the importance of breast cancer screening, early detection and education through the Horses and Hope program—sharing the program’s best practices and encouraging international participation.

Since 2009, she has served as a member of the Pink Stable, a committee of Kentucky horse owners, riders, trainers, farm owners and jockeys that support the Horses and Hope initiative.

“I have been grateful to serve as member of First Lady Jane Beshear's Horses and Hope Pink Stable committee, and even more honored to serve as an ambassador for this important initiative as I compete in Europe,” Miller said. “Women are traditionally care givers, especially so in the horse business; often they take care of their horses before they think of themselves. I have friends and family who have been touched by breast cancer, so I am aware of the importance of early detection. If I accomplish anything here, I want every woman, especially those with high risk, who hear my message to practice self-examination and get screened.”

Miller is a fourth-generation horsewoman and has been involved in the horse business her entire life. She is an accomplished rider and has competed as a United States team member twice in the FEI Pair Horse World Championships, was the 2013 USEF National Champion in Pairs and the 2014 USEF Reserve National Champion in 4-In Hands.

Horses and Hopehas hosted several breast cancer race days at Kentucky racetracks in the past six years, reaching nearly 1 million race track and horse show fans and educating nearly 16,000 equine employees. The program has screened close to 700 workers and detected breast cancer in two individuals, both of whom have received treatment.

The next Horses and Hope Race Day will be at Ellis Park in Henderson, Ky., on Aug. 2. For more information about Horses and Hope and all upcoming events, please visit www.horsesandhope.org.

For more information on breast cancer, please contact the Kentucky Cancer Program at UofL at http://kycancerprogram.org/kcp-west/.

A national publication for health care executives and managers has ranked the University of Louisville’s College of Business as one of the top business graduate schools for physician-executives.

UofL appears on a list Modern Healthcare compiled in May of the top graduate schools awarding advanced degrees in health care business administration in 2013-14. The ranking is based on how many full-time students are pursuing the degree at each school.

UofL placed at the 20^th spot with 45 students, just under Yale School of Management’s 48 students. Rice University’s graduate business school topped the list with 231 students.

UofL’s business school has offered an MBA degree with a health care focus since 2011. Students in the 20-month program take weekend courses preparing them for executive positions in hospital administration, senior care, health insurance, biomedicine and related areas.

For more details, see http://business.louisville.edu/wptest/images/Ranked20.pdf

Telemedicine is an effective strategy to screen for the potentially blinding disease known as retinopathy of prematurity (ROP), according to a study funded by the National Eye Institute (NEI). The investigators say that the approach, if adopted broadly, could help ease the strain on hospitals with limited access to ophthalmologists and lead to better care for infants in underserved areas of the country. NEI is a part of the National Institutes of Health.

The telemedicine strategy consisted of electronically sending photos of babies’ eyes to a distant image reading center for evaluation. Staff at the image reading center, who were trained to recognize signs of severe ROP, identified whether infants should be referred to an ophthalmologist for evaluation and potential treatment. The study tested how accurately the telemedicine approach reproduced the conclusions of ophthalmologists who examined the babies onsite.

“This study provides validation for a telemedicine approach to ROP screening and could help save thousands of infants from going blind,” said Graham E. Quinn, M.D., professor of ophthalmology at the Children's Hospital of Philadelphia and the lead investigator for the study, which is reported today in JAMA Ophthalmology.

The study was conducted by the e-ROP Cooperative Group, a collaboration that includes 12 facilities in the United States and one in Canada. The University of Louisville was the only site in Kentucky among the collaborative group. In addition to UofL, study sites were Johns Hopkins University, Boston Children’s Hospital, Vanderbilt University, Children’s Hospital of Philadelphia, Nationwide Children’s Hospital/Ohio State University Hospital, Duke University, University of Minnesota, University of Oklahoma, University of Pennsylvania, University of Texas Health Science Center at San Antonio, University of Utah and Hospital of the Foothills Medical Center (Calgary, Canada).

Some degree of ROP appears in more than half of all infants born at 30 weeks pregnancy or younger—a full-term pregnancy is 40 weeks—but only about 5 to 8 percent of cases become severe enough to require treatment. In ROP, blood vessels in the tissue in the back of the eye called the retina begin to grow abnormally, which can lead to scarring and detachment of the retina. Treatment involves destroying the abnormal blood vessels with lasers or freezing them using a technique called cryoablation. Early diagnosis and prompt treatment is the best prevention for vision loss from ROP, which is why the American Academy of Ophthalmology recommends routine screening for all babies who are born at gestational age 30 weeks or younger or who weigh less than 3.3 pounds at birth.

The study evaluated telemedicine for ROP screening during the usual care of 1,257 premature infants who were born, on average, 13 weeks early. About every nine days, each infant underwent screening by an ophthalmologist, who assessed whether referral for treatment was warranted. Those who were referred were designated as having referral-warranted ROP (RW-ROP). Either immediately before or after the exam, a non-physician staff member in the neonatal intensive care unit (NICU) took images of the infant’s retinas and uploaded them to a secure server at the University of Oklahoma, Oklahoma City. Trained non-physician image readers at the University of Pennsylvania, Philadelphia, then downloaded the photos, independently evaluated them following a standard protocol, and reported the presence or absence of RW-ROP.

Through the telemedicine approach, non-physician image readers correctly identified 90 percent of the infants deemed to have RW-ROP based on examination by an ophthalmologist. And they were correct 87 percent of the time when presented with images from infants who lacked RW-ROP. The examining ophthalmologists documented 244 infants with RW-ROP on exam. After referral, 162 infants were treated. Of these, non-physician image readers identified RW-ROP in all but three infants (98 percent).

“This is the first large clinical investigation of telemedicine to test the ability of non-physicians to recognize ROP at high risk of causing vision loss,” said Eleanor Schron, Ph.D., group leader of NEI Clinical Applications. “The results suggest that telemedicine could improve detection and treatment of ROP for millions of at-risk babies worldwide who lack immediate in-person access to an ophthalmologist,” she said.

About 450,000, or 12 percent,  of the 3.9 million babies born each year in the United States are premature. The number of preterm infants who survive has surged in middle income countries in Latin America, Asia and Eastern Europe. In these parts of the world, rates of childhood blindness from ROP are estimated at 15 to 30 percent—compared to 13 percent in the United States.

One advantage of telemedicine ROP screening is that it can be done more frequently than screening by an ophthalmologist. “It’s much easier to examine the retina when not dealing with a wiggling baby,” said Quinn said. “If a baby is too fussy or otherwise unavailable when the ophthalmologist visits the NICU, the exam may be delayed until the ophthalmologist returns—sometimes up to a week later.”

Weekly ROP screening—or even more frequently for high-risk babies—is a realistic goal for telemedicine and could help catch all cases needing treatment, according to the report. In the study, imaging was restricted to occasions when an ophthalmologist examined the baby. In practice, hospital staff could implement an imaging schedule based on the baby’s weight, age at birth and other risk factors. “With telemedicine, NICU staff can take photos at the convenience of the baby,” Quinn said.

Telemedicine for evaluating ROP offers several other advantages:

• Telemedicine may help detect RW-ROP earlier. In the study, about 43 percent of advanced ROP cases were identified by telemedicine before they were detected by an ophthalmologist—on average, about 15 days earlier.
• Telemedicine could save babies and their families the hardship and hazards of being unnecessarily transferred to larger nurseries with greater resources and more on-site ophthalmologists. “Telemedicine potentially gives every hospital access to excellent ROP screening,” Dr. Quinn said.
• Telemedicine might also bring down the costs of routine ROP screening by reducing the demands on ophthalmologists, whose time is better allocated to babies who need their attention and expertise. In a separate analysis, the study found that non-physicians and physicians had similar success in assessing photos for RW-ROP. Three physicians evaluated image sets from a random sample of 200 babies (100 with RW-ROP based on the eye exam findings; 100 without) using the standard grading protocol. On average, the physicians correctly identified about 86 percent of RW-ROP cases; the non-physicians were correct 91 percent of the time. The physicians correctly identified about 57 percent of babies without RW-ROP; non-physicians were correct 73 percent of the time.

The cost of establishing a telemedicine ROP screening program includes acquisition of a special camera for taking pictures of the retina, training of NICU personnel to take and transmit quality photos, and establishment and maintenance of an image reading center. “As we move along this road, advances in imaging and grading of images may streamline the process even more,” Dr. Quinn said.

For more information about ROP, visit http://www.nei.nih.gov/health/rop/.

To view a video about e-ROP, visit the NEI YouTube channel at http://youtu.be/7l_CqjV3NMA.

Andrea L. Behrman, Ph.D., was selected to give the Maley Lecture at the American Physical Therapy Association (APTA) in Charlotte, N.C., on June 13. The lecture honors a physical therapist that has made distinguished contributions to the profession of physical therapy in clinical practice.

Behrman is a professor in the Department of Neurological Surgery and Kentucky Spinal Cord Injury Research Center at the University of Louisville and is currently examining neuromuscular recovery in children with spinal cord injuries via both research and clinical practice. She also is a licensed physical therapist and is a Fellow of the American Physical Therapy Association.

Behrman’s lecture was titled, “I never thought that I would need to child-proof my home!” and focused on a paradigm shift for rehabilitation from the traditional view that “paralysis cannot be resolved” to an evidence-based physiological perspective that, with training, “paralysis can be resolved” and recovery is possible – to what degree has yet to be determined. As the mother whose comments inspired the lecture’s title said, “after locomotor training, my child became so mobile that I needed to child-proof my home” – something she never thought she would need to be concerned about.

Researchers have demonstrated that the spinal cord is in fact smart and that it can learn, Behrman said. By providing specific sensory input via intense training, therapists can activate the spinal circuitry and the neuromuscular system below and across the level of the injury.

Using a method known as “activity-based locomotor training,” therapists provide specific sensory information while patients are standing and walking on a treadmill with partial body weight support. Trainers also provide manual cues to promote muscle activation. Behrman demonstrated the benefits of locomotor training for developing trunk control and stepping in children who suffered a spinal cord injury when they were as young as 5 months and were paralyzed for nearly three years.

As director of the University of Louisville Kosair Charities Center for Pediatric Neurorecovery, Behrman and her fellow researchers and clinical partners work to change outcomes for children recovering from paralysis while undergoing locomotor training.

More information about Behrman’s lecture and work at UofL is available on the American Physical Therapy Association website.