First Lady Jane Beshear on Jan. 6, along with representatives from the Kentucky Cancer Program, the University of Louisville’s James Graham Brown Cancer Center and KentuckyOne Health, launched a new Horses and Hope campaign to raise $1 million for a mobile unit to provide free or significantly reduced cost cancer screenings to underserved populations across Kentucky.

To start strong out of the gate, Mrs. Beshear announced a $90,000 commitment from Churchill Downs and a $25,000 donation from Kroger for the new van.

“For years, the Horses and Hope program has been one of the driving forces behind the portable mammography unit that travels throughout the state offering breast cancer screenings and promoting the message that early detection saves lives,” Mrs. Beshear said. “We now have the opportunity to expand these services to screen for six additional forms of cancer, and continue our efforts to improve the health and wellness of Kentuckians throughout the Commonwealth.”

Kentucky has the highest incidence and death rates in the nation for several cancers, with an overall cancer incidence rate that is 14 percent greater than the national average. The new van will focus on educating Kentuckians about cancer prevention, and offer screenings for seven cancer types, including breast, cervical, colon, lung, prostate, skin and head/neck.

“When it comes to cancer, the people of our state suffer dearly,” said Dr. Donald Miller, director of the University of Louisville James Graham Brown Cancer Center, a part of KentuckyOne Health. “Through the First Lady’s leadership with Horses and Hope, we have been able to bring early detection about breast cancer to women throughout the state. Once we have this new van on the road, we will be able to have the same impact on so many more people, with the very achievable goal of reducing cancer deaths in Kentucky.”

“KentuckyOne has made it a priority to transform the health of the communities we serve with a special focus on vulnerable populations,” said Mark Milburn, Vice President of Oncology Services, KentuckyOne Health. “Through our partnership with the First Lady and Horses and Hope, the Kentucky Cancer Program and the University of Louisville, we have the resources available to dramatically reduce disparities in health access and enhance the health of our communities throughout the state.”

The custom-built coach will be 40 feet in length, with an exterior design featuring a Horses and Hope theme and acknowledgment of project partners. The interior will include a reception area with monitors for educational videos, patient changing rooms, a patient examination room with exam table, digital mammography equipment, space for supportive laboratory services and a passenger cab area. A motorized retractable awning on the outside of the coach will provide expanded space for patient reception, registration, and education.

Services and screenings will be delivered through the James Graham Brown Cancer Center, which has a Nationally Accredited Breast Center licensed by the American College of Radiology, KentuckyOne Health, and supported by the Kentucky Cancer Program.

“Our mission is to educate the people of Kentucky about cancer screening and prevention,” said Connie Sorrell, director of the Kentucky Cancer Program at the James Graham Brown Cancer Center. “The expansion of screenings and educational materials that will be available through this new, modern van should significantly enhance the lives of literally thousands of people throughout the Commonwealth.”

Horses and Hope

In 2008, the First Lady’s office 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.

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 nearly 700 workers and detected breast cancer in two individuals, both of whom have received treatment.

For more information and donation opportunities, visit the official Horses and Hope website at http://www.horsesandhope.org/.

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About the Kentucky Cancer Program: The Kentucky Cancer Program is the state mandated cancer control program jointly administered by the James Graham Brown Cancer Center at the University of Louisville and the Lucille Parker Markey Cancer Center at the University of Kentucky.  The mission of the Kentucky Cancer Program is to reduce cancer incidence and mortality by promoting cancer education, research and service.  For more information, visit our website, www.kycancerprogram.org or call 502-852-6318.

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

About KentuckyOne Health: KentuckyOne Health, the largest and most comprehensive health system in the Commonwealth, has more than 200 locations including hospitals, physician groups, clinics, primary care centers, specialty institutes and home health agencies in Kentucky and southern Indiana. KentuckyOne Health is dedicated to bringing wellness, healing and hope to all, including the underserved. The system is made up of the former Jewish Hospital & St. Mary’s HealthCare and Saint Joseph Health System, along with the University of Louisville Hospital and James Graham Brown Cancer Center. KentuckyOne Health is proud of and strengthened by its Catholic, Jewish and academic heritages.

Morris Animal Foundation has awarded a three-year, $155,000 grant to a team of Kentucky and Danish researchers to build a new reference genome sequence for the domestic horse. The sequence will be a much needed tool for animal researchers worldwide and the equine industry in particular because it will significantly improve our ability to understand the role of genetics in animal health and well being.

Ted Kalbfleisch, Ph.D., of the University of Louisville Department of Biochemistry and Molecular Biology, is the principal investigator on the grant. He will be joined in the research with Ludovic Orlando, Ph.D., of the Centre for GeoGenetics at the National History Museum, University of Copenhagen; and James MacLeod, V.M.D., Ph.D., of the Gluck Equine Research Center at the University of Kentucky.

Genome sequencing allows researchers to read and decipher genetic information found in DNA and is especially important in mapping disease genes – discovering the diseases a horse might be genetically predisposed to developing.

“In 2009, Morris Animal Foundation helped fund the first genome reference sequence for the domestic horse,” Kalbfleisch said. “We intend to build on this earlier work. In the past five years, there have been dramatic improvements in sequencing technology as well as the computational hardware and algorithms required to analyze the data generated by the technology. Therefore, we now have the tools necessary to vastly improve the reference genome for the horse.”

The current reference genome for the horse, known as “EquCab2,” has been beneficial in studying horses and their genetic predisposition to disease, but it is not without its shortcomings, Kalbfleisch said.

“The horse research community is working to understand the relationship among genomic structure, variation found within it and complex diseases and traits in the domestic horse,” he said. “The EquCab2 reference genome was developed prior to the development of today’s highly sophisticated technology.

“With the application of new high-throughput technologies we have available today, we will map the genome with a focus on what is known as the ‘GC-rich regulatory regions.’”

These GC-rich regulatory regions control how genes are expressed (turned on) in order to participate in normal cellular processes. This work will enable scientists to better catalog genetic variation in these regions and understand how it affects health and performance.

“We expect our research to have substantial impact because the horse research community has actively moved to the translational application of genomics in examining important questions in equine science,” Kalbfleisch said. “The improved reference genome we will map will directly improve both the quality and productivity of research being carried out in the equine industry.”

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Researchers at the University of Louisville’s James Graham Brown Cancer Center have identified for the first time mutations that destabilize a DNA structure that turns a gene off. These mutations occur at four specific sites in what is known as the “hTERT promoter” in more than 75 percent of glioblastomas and melanomas.

The research is published in the online journal PLOS ONE and is authored by Brad Chaires, Ph.D., John Trent, Ph.D., Robert Gray, William Dean, Ph.D., Robert Buscaglia, Shelia Thomas and Donald Miller, M.D., Ph.D.

Telomerase is an enzyme largely responsible for the promotion of cell division. Within DNA, telomerase activation is a critical step for human carcinogenesis through the maintenance of telomeres. However, the activation mechanism during carcinogenesis – why cancer gets turned “on” – is not yet wholly understood. What is known is that transcriptional regulation of the human telomerase reverse transcriptase (hTERT) gene is the major mechanism for cancer-specific activation of telomerase.

Miller and his colleagues have been interested in turning genes off therapeutically for some time. “We know that human telomerase is over-expressed in most human cancers, but we’ve never known why,” he said.

In 2013, two studies published in Science and another in Proceedings of the National Academy of Sciences gave the researchers a direction to explore. “These papers said that in most melanomas, mutations existed in the promoter of this telomerase gene. This was the first time that anyone reported common mutations in these promoters,” said Miller, who is director of the James Graham Brown Cancer Center and a specialist in the treatment of melanoma.

The UofL team has now shown that the mutations all occur in a region of the hTERT promoter that previously has been shown to form quadruplex DNA. Using a combination of biophysics and molecular modeling, a new form of a quadruplex transcription regulation element is reported. The formation of these quadruplexes in telomeres has been shown to decrease the activity of telomerase.

“We speculated that the occurrence of these mutations could destabilize or alter the recognition of quadruplexes formed by this sequence,” Miller said. “We found that the mutations inactivate the gene’s ‘off’ switch so it becomes locked on, destabilizing the quadruplex and allowing it to be over-expressed.

“This over-expression then drives the cells to continue to divide, which is the cause of the cancer.”

The researchers are next examining how to unlock the switch from on to off, Miller said. “What we have described in this PLOS ONE article is the on-off switch and provided an entirely new model for that structure. Our next step is to look at how to turn it off that will help lead us to new therapeutics to prevent the occurrence of cancer.”

The paper was posted online Dec. 19 in PLOS ONE.

Research to Prevent Blindness (RPB) has awarded a grant of $115,000 to the University of Louisville Department of Ophthalmology and Visual Sciences, bringing the total of grant funding awarded over the past 50 years from RPB to $3,959,800. The latest grant was awarded Dec. 3.

The funding supports research across a variety of eye diseases and conditions, said Henry J. Kaplan, M.D., department chair, Evans Professor of Ophthalmology and director of UofL’s Kentucky Lions Eye Center.

Among research conducted at UofL that RPB helps fund are studies examining the pharmacologic treatment of age-related macular degeneration, gene therapy in retinal degeneration, stem cell therapy in retinal degeneration, genetic mutations in hereditary night blindness, retinopathy of prematurity, autoimmune uveitis and more.

“We are grateful for the support from Research to Prevent Blindness,” Kaplan said. “With this help, we can continue to carry out groundbreaking research on the development, structure and function of the visual system and discover and develop new treatments for ocular disease.”

RPB is the world’s leading voluntary organization supporting eye research. Since it was founded in 1960, RPB has channeled hundreds of millions of dollars to medical institutions throughout the United States for research into all blinding eye diseases. For information on RPB, RPB-funded research, eye disorders and the RPB Grants Program, go to www.rpbusa.org.

Gregory Postel, M.D., who had been serving as interim CEO of University of Louisville Physicians, has been named permanent CEO of the organization.

Postel was chosen to lead the organization long term by its board.

“I’ve been involved with UofL Physicians since long before it formally existed,” Postel said. “I’ve been at the UofL School of Medicine for 20 years, and I care a lot about the school and the clinical practices. It’s exciting to see how far we’ve come, and what is on the horizon. I’m honored my colleagues have placed their trust in me to lead this effort.”

Along with his appointment as CEO, Postel was named vice dean of clinical affairs at the UofL School of Medicine, a decision approved by the University of Louisville’s Board of Trustees. In that position, Postel is responsible for the clinical faculty at the school.

All UofL faculty perform their clinical duties through UofL Physicians. Research and teaching are conducted through the school, and the chairs of the school’s clinical departments serve on the UofL Physicians board, which manages the clinical practice mission of the faculty. The vice dean of clinical affairs position had remained vacant as UofL Physicians developed.

“With Greg in both positions, it will provide continuity as we see more and more crossover between the school and the clinical practices,” said Toni Ganzel, M.D., dean of the UofL School of Medicine. “He is exceptionally skilled and talented and the right person to lead us in this new era.  He has been instrumental in integrating the practice groups into this new company and in helping to promote a more cohesive strategy and culture.”

Most medical schools have brought their faculty under a single organization for clinical purposes. UofL Physicians was created in 2011, bringing 26 practices affiliated with physicians from the school, which had operated as independent health care companies, into a single entity.

Today, UofL Physicians has about 600 physicians and 1,200 employees. The closer coordination, Postel said, is important amid health care reform.

Postel, who also serves as chairman of the board for UofL Physicians, had served as interim CEO since the departure of the organization’s first CEO, Mike Bukosky, in November 2013. When Postel was named permanent CEO, the UofL Physicians board voted to combine the position of CEO and board chairman.

Postel also leads the radiology practice at UofL Physicians and is chair of the Department of Radiology at the UofL School of Medicine.

“Dr. Postel brings considerable experience and skill to these new roles,” said Gerard Rabalais, M.D., a member of the board’s executive committee who also leads the pediatrics practices for UofL Physicians and is chair of the Department of Pediatrics at the school. “With his experience in integrating the practices for UofL Physicians, he is uniquely poised to lead this new organization forward as its first physician CEO. Having worked closely with him for four years through this process, I have the utmost confidence in Greg’s ability.”

Postel said UofL Physicians has grown and changed since it developed, shifting from a holding company “bringing many businesses together into one new business” to an operating company.

“We realized there was an opportunity, and as we transformed into an operating company, we needed a larger infrastructure. This will give us the scalability to grow and expand as opportunities arise.”

Two researchers at the University of Louisville have been named Fellows of the National Academy of Inventors (NAI). The announcement was made Dec. 16, 2014.

Suzanne T. Ildstad, M.D., director of UofL’s Institute for Cellular Therapeutics, and Kevin M. Walsh, Ph.D., director of the Micro/Nano Technology Center, were among 170 new Fellows named. They will be inducted by Deputy U.S. Commissioner for Patent Operations Andy Faile of the United States Patent and Trademark Office during the 4th Annual Conference of the National Academy of Inventors on March 20, 2015, at the California Institute of Technology in Pasadena.

“As a premier metropolitan research university, UofL strives to develop ideas into discoveries, then to translate these into forms that benefit all,” said UofL Executive Vice President for Research and Innovation William M. Pierce Jr., Ph.D. “Drs. Ildstad and Walsh are two of our many brilliant and dedicated scholars who do this every day. We are very proud of them and their achievements.”

Those named today bring the total number of NAI Fellows to 414, representing more than 150 prestigious research universities and governmental and non-profit research institutions.

Included among the NAI Fellows are 208 members of the other National Academies, 21 inductees of the National Inventors Hall of Fame, 16 recipients of the U.S. National Medal of Technology and Innovation, 10 recipients of the U.S. National Medal of Science, 21 Nobel Laureates, 11 Lemelson-MIT prize recipients, 107 American Association for the Advancement of Science Fellows, and 62 Institute of Electrical and Electronics Fellows, among other awards and distinctions.

To qualify for election, NAI Fellows must be academic inventors named on U.S. patents and nominated by their peers for outstanding contributions to innovation in areas such as patents and licensing, innovative discovery and technology, significant impact on society and support and enhancement of innovation.

About Suzanne Ildstad:

Ildstad is the Jewish Hospital Distinguished Chair in Transplantation and professor in the Department of Surgery in the UofL School of Medicine. She also holds associate appointments in the school’s Department of Physiology and Biophysics and Department of Microbiology and Immunology.

Ildstad has 20 patents related to her research and is the founding scientist of Regenerex LLC, a biotechnology company. Her research is being translated into the clinical arena with FDA approval to enroll patients in six different research protocols to treat autoimmune disease (multiple sclerosis) and red blood cell disorders (sickle cell anemia and thalassemia), inherited metabolic disorders and to induce tolerance to organ transplants (kidney).

In 2013, Ildstad, representing Regenerex, entered into collaboration with a multinational pharmaceutical company to provide access to stem cell technology she pioneered that has the potential to help transplant patients avoid taking anti-rejection medicine for life. The technology, known as Facilitating Cell Therapy, in early research enabled five of eight kidney transplant patients to stop taking about a dozen anti-rejection pills a day to suppress their immune systems. It was the first study of its kind where the donor and recipient did not have to be biologically related and immunologically matched.

Ildstad graduated from Mayo Medical School in Rochester, Minnesota, trained in Harvard Medical School’s general surgery program at Massachusetts General Hospital and was a staff fellow with the National Institutes of Health.  She was elected to the Institute of Medicine in 1997 in recognition of her contributions to cell therapies.

About Kevin Walsh:

Walsh is a professor and holder of the Samuel T. Fife Endowed Chair in the Department of Electrical and Computer Engineering at the J.B. Speed School of Engineering. He also is founding director of the Micro/Nano Technology Center (MNTC), home of the nationally-ranked, class 100, $30 million 10,000-square-foot cleanroom in which dust particles are totally eliminated so one can successfully design and prototype ultra-miniature devices and systems for a variety of  fields including  microelectronics, healthcare, consumer products and defense.

Walsh has 12 awarded patents and is co-founder of four technical start-up companies – Assenti, Intellirod Spine, UltraTrace Detection and Simon Sounds.  He has published over 150 technical papers in the areas of micro/nanotechnology and micro-electro-mechanical systems (MEMS) and his research group has won over $35 million in external research funding from the National Science foundation, NASA, National Institutes of Health and others. He has twice been presented with the school’s top Research Award for the 3-year periods of 1998-2000 and 2007-2009.

Under his leadership, the MNTC has brought in over $55 million of research awards into UofL. In 2008, Walsh and his team started the "KY nanoNET Initiative" a statewide network funded by the National Science Foundation for the coordination of micro and nanotechnology efforts in the Commonwealth.

Walsh earned bachelor’s and master’s degrees in electrical engineering from UofL and a Ph.D. degree in electrical engineering (microelectronics/MEMS) from the University of Cincinnati.

“It’s a tremendous honor to be one of the first researchers at the University of Louisville to be inducted into the National Academy of Inventors,” said Walsh. “It’s been very exciting these past 25 years building nationally competitive micro/nano capabilities at UofL and working with extremely talented faculty, engineers and students applying this futuristic technology to a  variety of challenging problems.”

Advanced Cancer Therapeutics (ACT), a privately held company dedicated to bringing new anti-cancer therapies to market, announced today that the University of Texas MD Anderson Cancer Center in Houston and the University of Texas Health Science Center at San Antonio have been added as human clinical trial sites for PFK-158, a first-in-man/first-in-class inhibitor of PFKFB3, an enzyme that controls glycolysis and that is overexpressed in most hematological and solid tumors. The two new clinical trial sites are expected to begin enrolling patients Jan. 1, 2015.

PFK-158 was discovered and developed by ACT and was based on the initial drug discovered at the University of Louisville’s James Graham Brown Cancer Center, a part of KentuckyOne Health. The cancer center began recruiting patients for clinical trials in May 2014. Within weeks of opening the first clinical trial site, ACT was able to open the second clinical trial site, Georgetown University Medical Center in Washington, also in May 2014.

“We were pleased to partner with MD Anderson and UT Health Science Center at San Antonio to expand the number of clinical trial sites for PFK-158,” said ACT President and CEO Randall B. Riggs. “PFK-158 is a first-in-man, novel anti-cancer drug that prevents tumor cells from using glucose as a fuel source for tumor survival, growth and metastasis and is currently in a Phase 1 clinical study in the United States.”

In November 2014, PFK-158 was chosen by Informa and Kantar Health as one of the “2014 Top 10 Most Interesting Oncology Projects to Watch.”

PFK-158 is a small molecule that inactivates a novel cancer metabolism target never before examined in human clinical trials. Last spring, the U.S. Food and Drug Administration (FDA) approved a Phase 1 dose escalation study that is evaluating the safety, tolerability and anti-tumor activity of PFK-158 in cancer patients with solid tumors such as prostate, lung, ovarian, melanoma, breast and pancreatic cancer.

PFK-158 is the first 6-phosphofructo-2-kinase/fructose-2,6-biphosphatase 3 (PFKFB3) inhibitor to undergo clinical trial testing in cancer patients. The target, PFKFB3, is activated by oncogenes and the low oxygen state in cancers, stimulates glucose metabolism and is required for the growth of cancer cells.

PFK-158, which has been licensed by ACT from the James Graham Brown Cancer Center, inhibits the substrate binding domain of PFKFB3 causing a marked reduction in the glucose uptake and growth in multiple preclinical cancer models.

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About Advanced Cancer Therapeutics (ACT):

ACT is a privately held company dedicated to advancing novel therapeutics for the prevention and treatment of cancer. ACT has successfully established a unique and innovative business model with the University of Louisville’s James Graham Brown Cancer Center (Brown Cancer Center) whereby ACT is able to obtain exclusive worldwide licenses to novel cancer therapeutics discovered at Brown Cancer Center under preset business terms. ACT then fast-tracks these discoveries, including the selection process for partnership, commercialization and manufacture, to the pharmaceutical industry, and ultimately to the patients who need them. For more information, please visit www.advancedcancertherapeutics.com.

About the James Graham Brown Cancer Center:

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

The University of Louisville School of Medicine Continuing Medical Education and Professional Development program has been notified by its accrediting body, the Accreditation Council for Continuing Medical Education (ACCME) that it is in full compliance with all required standards and has been released from its probationary status.

“We modified our review process within the office to create redundancies to prevent inadvertent errors in oversight, like the one that led to our being placed on probation,” said Dan Cogan, Ed.D., FAODME, assistant dean for continuing medical education and professional development. “Our previous process did not pick up on the single instance of an industry-employed individual providing instruction at a conference. That will not happen again.”

As part of its probationary status, UofL was required to enact new policies and procedures to prevent activities that are outside of the ACCME standards, and to demonstrate that those changes are being followed and are successful. During its probationary status, UofL has offered about 90 educational programs to more than 15,000 health care providers nationwide.

The program’s next periodic accreditation review will be in late 2017.

Cynthia Miller, Ph.D., assistant professor of physiology in the University of Louisville School of Medicine, recently was awarded the Outstanding Early Career in Post-Secondary Education Superlative at the Centennial Meeting of the Kentucky Academy of Science. She is one of four people to receive this award recognizing her accomplishments in teaching and research as well as service to the university and the community.

Miller also is the course director for physiology in the Prematriculation Program at both the UofL School of Medicine and the School of Dentistry.

Her work with innovative educational programs in and out of the classroom has led to significant increases in the learning and retention of students within the UofL dental program. The lectures and modules she has created through this research have been implanted into the dental physiology curriculum and have increased performance on unit exams.

In the Louisville community, Miller participates in several service activities, including the Louisville Regional Science Fair and Research!Louisville. She also received the Research Recognition Award from the American Physiological Society earlier in 2014.

Miller earned her doctorate degree from UofL in 2008 and joined the faculty in 2011. She focuses her research on how technology and active learning in the classroom impact student performance and motivation.

For more than 50 years, standardized patients have been a staple of medical school instruction. These individuals are trained in symptoms and problems associated with disease and act as patients to give medical students hands-on training in the practice of medicine.

Today, the University of Louisville School of Medicine has taken use of standardized patients (SPs) to a new level, allowing more students to achieve learning objectives in a compressed time period and learn more about managing the continuity of care for patients.

The Longitudinal Standardized Patient Project gives students a single SP to see throughout their two-year Introduction to Clinical Medicine course. In the course, students must successfully master the core patient history-taking, examination and communication skills they will need for their future training and ultimately, as practicing physicians.

“In the program, each student only sees ‘their’ patient, one of nine patient characters we have developed, in 19 different patient encounters,” said Charles Kodner, M.D., director of the Introduction to Clinical Medicine course. “This single SP enables the development of a continuity relationship, eliminating the need for the student to review the patient’s history with each encounter. Students gain time to focus on the purpose of the patient visit and the individual learning outcome they are expected to achieve.

“In short, the Longitudinal Standardized Patient Project more closely mirrors what our students will see when they start caring for actual patients later in their training and once they become practicing physicians.”

The ongoing student-SP relationship has strong benefits for the student, said Carrie Bohnert, director of the UofL Standardized Patient Program. “Students begin to realize much earlier in the medical education that patients are real people with potentially complex personal and medical histories,” she said. “They are able to experience a doctor-patient relationship that has continuity – something not otherwise available during the first two years of medical school.”

An unexpected benefit has been the growing role of the SP as teacher as well. “Our SPs have developed personal teaching relationships with their students and are able to identify subtle changes in student skill development or lack of development and other problems that might otherwise be missed without a strong continuity relationship,” Bohnert said.

The program has been well-received, Kodner said. “As we survey students both before and after the Longitudinal Standardized Patient Project, we have observed substantial increases in our students’ perceptions that the cases were realistic and that they could learn about medical problems and their patient as a person in the time available.”

Said Bohnert, “the outcomes of this program have exceeded expectations, allowing our students to experience both the joys and the challenges of a long-term doctor-patient relationship.”

Kodner and Bohnert discuss the program in an article, “The Longitudinal Standardized Patient Project: Innovation from Necessity,” in  Academic Medicine, published online Nov. 18 and scheduled for publication in an upcoming issue of the print version of the journal.

Academic Medicine is the scholarly journal of the Association of American Medical Colleges, the accrediting body and professional organization of medical schools in the United States and Canada.

Funding for the Longitudinal Standardized Patient Project was provided in part by a Paul Weber Award of $50,000 for Excellence in Teaching, awarded May 2010 by the University of Louisville.

For the convenience of parents, UofL Physicians will hold an eye clinic for children from 8 a.m. to noon on Saturday, Dec. 6. This special clinic will be held at The Springs Medical Center, 6400 Dutchmans Lane, Suite 310.

Appointments can be made by calling 502-742-2848 or 502-588-0550. UofL Physicians - Pediatric Eye Specialists sees patients from birth to age 18. Major forms of insurance are accepted.

“To help parents who can’t always bring their children in to our office during regular hours, we periodically schedule Saturday clinic hours to make it more convenient,” said Rahul Bhola, M.D., who leads UofL Physicians - Pediatric Eye Specialists and is director of pediatric ophthalmology for the UofL School of Medicine.

“All preschool children, even those without noticeable eye problems, should have at least one vision screening or comprehensive eye exam before the age of 5,” Bhola said. “After age 5, every child should have an annual eye exam.”

To help parents, Bhola offers eight signs that can signal a child has a vision problem:

• An eye appears to be misaligned, either crossed or drifting outward
• Squinting, closing or covering one eye
• Rubbing one or both eyes excessively
• Headache, nausea or dizziness with visual tasks
• Excessive or unusual clumsiness
• Tilting the head to one side
• One or both eyelids droop downward
• A sibling or other close family member has lazy eye or other eye problems

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Kentucky Gov. Steve Beshear and Lt. Gov. Crit Luallen announced Dec. 1 an innovative public/private partnership between Community Dental – a nonprofit of Kentucky and the University of Louisville Pediatrics to provide a multi-disciplinary health care home for Kentucky children enrolled in the Medicaid program.

Through co-located facilities, the two organizations will work to meet both the dental and medical needs while providing a health care home for children who qualify for health care services through the Medicaid program.

“Our citizens face a number of significant health issues, not the least of which is oral health,” Gov. Beshear said. “One of the most effective ways to combat chronic health conditions is to identify potential problems early and address them. This means ensuring that our children have easy access to the health care they need and deserve. This partnership seeks to meet that need, not just medical care, but also dental care. Through the creation of a health home for children, we believe we will be able to reverse some of the major health problems facing Kentucky.”

Community Dental of Kentucky is a full-service dental organization designed to increase access to health care in underserved communities with the goal of improving the overall health of the population. The clinic specializes in meeting the oral health needs of individuals who are enrolled in Medicaid, a population that has historically lacked sufficient access to dental services. Community Dental’s Kentucky clinic is located at 3438 Taylor Blvd. in Louisville. Community Dental is patterned after Sarrell Dental, which was founded in 2004 in Anniston, Alabama. Since then, Sarrell has grown to include 13 other offices in Alabama. The Sarrell Dental Team consists of more than 250 employees, including dentists, hygienists and managers.

“We are honored to partner with the Commonwealth and the University of Louisville,” said Jeffrey Parker, chairman of Community Dental of Kentucky. “Gov. Beshear has created the environment for preventive care as a major tool for combating the health care problems faced by the people in the state.”

Earlier this year, Gov. Beshear launched kyhealthnow, an initiative aimed at attacking the causes of many of the significant health care issues faced by the people of the Commonwealth, such as diabetes, heart disease, obesity and oral health.

“Part of the mission of kyhealthnow is to encourage Kentuckians to routinely visit primary care providers and dental professionals to detect potential issues before they escalate into major health problems,” Lt. Gov. Luallen said. “As chair of this initiative, I want to continue to help the Governor build strong partnerships with the dental and medical community to ensure Kentucky has a healthier population.”

“We continue to uncover the links between dental and medical health,” said David L. Dunn, M.D., Ph.D., UofL executive vice president for health affairs. “Co-locating primary care sites for both dentistry and pediatrics enables the inter-professional collaboration that can truly impact the disease state of many people. This partnership has the potential to be a national model for providing preventive care to children.”

UofL Pediatrics provides general pediatric care to children throughout the region. The physicians are faculty members of the UofL Department of Pediatrics and not only see patients, but also educate the next generation of pediatricians and conduct research that leads to new and improved treatments for children.

“One of our missions is to provide children of our region with the best possible health care,” said Gerard Rabalais, M.D., chair of the UofL Department of Pediatrics. “Partnering with other primary care providers who specialize in areas outside of medicine only brings children a better opportunity for healthier living opportunities. Establishing health care homes where children receive medical and dental care in a single location provides a level of convenience that should improve access and utilization of services.”

Researchers with the Child and Adolescent Health Research Design and Support Unit (CAHRDS Unit) at the University of Louisville have begun a study to examine one of Kentucky’s most vexing children’s health issues: the higher-than-average rate of psychotropic medication being prescribed to children in the Bluegrass State.

Psychotropic medications (PMs) alter chemical levels in the brain that impact mood and behavior. Antipsychotics, antidepressants, drugs for attention deficit disorder and attention deficit hyperactivity disorder, anti-anxiety medications and mood stabilizers are some of the more commonly used psychotropic drugs. While they produce good results among most patients, they also can cause worrisome side effects in others, and their interactions with each other can create problems as well.

Of the almost 600,000 children receiving Medicaid in Kentucky, one in seven – 14 percent – has been prescribed at least one of these powerful psychiatric drugs. Equally troublesome, almost half – 42 percent – of the children in Kentucky’s foster care system have been prescribed at least one.

Both statistics are almost twice the national average. Nationally, just 7.4 percent of kids receiving Medicaid and 26.6 percent of kids in the foster care system have been prescribed a PM.

An eight-member team at the CAHRDS Unit, a part of the UofL Department of Pediatrics, is working to find out why these drugs are given to Kentucky children at almost twice the national rate.  The team has been awarded a $75,000 Improved Health Outcomes Program grant from Passport Health Plan, the nonprofit community-based health plan administering Kentucky Medicaid benefits to more than 200,000 people statewide.

“Passport Health Plan has a common concern and this grant represents an opportunity, in addition to the programs we already have in place, to address this concerning trend.” said Stephen J. Houghland, M.D., Passport Health Plan’s chief medical officer.

“It’s very concerning to us that the rate of prescribing in Kentucky is higher than the national average,” said Gilbert Liu, M.D., the study’s principal investigator and the chief of the Division of General Pediatrics at UofL. “We also are concerned that children are getting prescriptions for psychotropic medications that are not FDA-approved. Also worrisome is that some children are being prescribed two or more of these very potent drugs.”

“Are these children getting a clear diagnosis?” said Charles Woods, M.D., director of the CAHRDS Unit and vice chair for faculty development of the UofL Department of Pediatrics. “Is there a primary care provider involved? Are they getting the appropriate psychiatric services they need along with these medications? These are the questions we intend to pose in this study.”

Three-phased study will take a year

The year-long study will consist of three phases. The researchers will first assess Kentucky Medicaid claims data to see if prescribing patterns emerge across geographic regions of the state as well as racial, ethnic, gender and socioeconomic class. The first phase also will include an examination of what type of providers are prescribing PMs to children – primary care providers, psychiatrists, pediatricians or others.

During the second phase of the study, the researchers will talk with providers who have higher-than-average rates of prescribing to find out why these higher rates occur. “It could be that in some cases, the higher rate of prescribing is medically warranted,” said Michael Smith, M.D., a clinician and researcher with UofL Physicians-Pediatrics. “However, it also could be that if appropriate psychiatric services are not available, a primary care physician feels this is the only way he has at his disposal to treat children who need these services.”

The third phase of the study will “get to the heart of the matter,” Liu said, in developing informed and thoughtful approaches to correcting overuse of PMs where it occurs. “We do not want to get in the way of providers with their patients,” he said. “However, we believe that with their help, we can provide alternate ways to care for children needing psychiatric services that lessens the need for PMs.”

“In Kentucky, we need to better understand patterns of PM use along with non-drug treatments and monitoring for children receiving Medicaid,” Woods said. Our intent is to develop the best solutions possible for improving the care of these vulnerable children.”

Multidisciplinary team of researchers

In addition to Woods, Liu and Smith, other members of the research team include Deborah Winders Davis, Ph.D., David Lohr, M.D., John Myers, Ph.D., Michelle Stevenson, M.D., and Michael Rowland, Ph.D.

“This is the type of work that calls for a multidisciplinary approach,” Woods said. “Among our group we are fortunate to have clinical and research expertise in general pediatrics, child and adolescent psychiatry, early childhood development, emergency medicine, biostatistics, qualitative data analysis and informatics. We look forward to being able to make a difference for children through our collective efforts on this project.”

Parents with concerns about PM use or those wanting more information about the study can contact Liu at 502-852-3737.

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About Passport Health Plan

Passport Health Plan is a provider-sponsored, non-profit, community-based Medicaid health plan serving more than 200,000 people around Kentucky. Recently named the No. 19 Medicaid health plan in the United States and the top Medicaid plan ranked in Kentucky by the National Committee for Quality Assurance (NCQA), Passport has been contracted with Kentucky’s Cabinet for Health and Family Services to administer Medicaid benefits since 1997 and has been serving the entire Commonwealth since Jan. 1, 2014. For additional information about Passport Health Plan, go online to passporthealthplan.com.

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 will discuss “Molecular Approaches to Cardiac Regeneration,” an area of research being explored at UofL. Roberto Bolli, M.D., director of UofL’s Institute of Molecular Cardiology, and his colleagues have successfully shown in 19 patients who previously suffered a heart attack that their stem cells, after processing, can be re-infused back into the damaged heart muscle and improve its function.

The Leonard Leight Lecture is presented annually by the Division of Cardiovascular Medicine, also headed by Bolli, in the Department of Medicine at UofL’s 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.

About Victor Dzau

Dzau assumed the presidency of the Institute of Medicine July 1 after having served as chancellor for health affairs at Duke University, president and CEO for Duke University Health System, and the 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 St. Baldrick’s Foundation, a volunteer-driven and donor-centered charity dedicated to raising money for childhood cancer research, has awarded a one-year, $50,000 grant to the University of Louisville (UofL). This grant is one of 40 infrastructure grants awarded as part of the foundation’s fall grant cycle, totaling more than $2.5 million and surpassing last year’s total awarded during this same period.

The University of Louisville Department of Pediatrics’ Division of Hematology, Oncology and Stem Cell Transplantation makes approximately 100 new diagnoses per year. One of the primary goals of the division is to offer novel therapies to allow patients to receive treatment within the region and not have to travel elsewhere. This grant will provide support to hire a nurse coordinator for neuroblastoma and sarcoma patients on clinical trials, providing them with additional access to those trials.

“The St. Baldrick’s Foundation grant will help children diagnosed with cancer to receive the best care here in Louisville,” explains Kerry Powell McGowan, M.D., pediatric oncologist at UofL. “With the grant we hope to help more children and their families stay close to home to get the treatment they need.”

The grant to UofL is part of a series of grants that, combined with the more than $24.7 million awarded in July to fund cutting-edge research, brings the St. Baldrick’s Foundation’s funding total to more than $27.2 million awarded in 2014. Grants were awarded based on the need of the institution and its patients, anticipated results of the grant and local participation in St. Baldrick’s fundraising events and activities.

“These grants are critically important to saving children’s lives, and would not be possible without our dedicated volunteers and generous donors who believe kids deserve better than medicine is currently able to provide,” said Kathleen Ruddy, chief executive officer for the St. Baldrick’s Foundation.

To learn how you can get involved visit www.StBaldricks.org, and connect with St. Baldrick’s on Facebook, Twitter,YouTube and Vimeo

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About St. Baldrick’s Foundation

The St. Baldrick’s Foundation is a volunteer-driven charity committed to funding the most promising research to find cures for childhood cancers and give survivors long and healthy lives. St. Baldrick’s coordinates its signature head-shaving events worldwide where participants collect pledges to shave their heads in solidarity with kids with cancer, raising money to fund research. Since 2005, St. Baldrick’s has awarded more than $154 million to support lifesaving research, making the Foundation the largest private funder of childhood cancer research grants. St. Baldrick’s funds are granted to some of the most brilliant childhood cancer research experts in the world and to younger professionals who will be the experts of tomorrow. Funds awarded also enable hundreds of local institutions to participate in national pediatric cancer clinical trials, and the new International Scholar grants train researchers to work in developing countries. For more information about the St. Baldrick’s Foundation please call 1.888.899.BALD or visit www.StBaldricks.org.

More than 60 works of art by 18 national and international artists will be featured at Art to Beat Cancer, Friday, Nov. 23. The event kicks off at 5:30 p.m. at the Green Building, 732 E. Market St.

Art to Beat Cancer benefits research being carried out by the University of Louisville’s James Graham Brown Cancer Center. Created by artist Doyle Glass, Art to Beat Cancer supports the Kim and Doyle Glass Endowment for Developmental Therapeutics. Doyle’s wife Kim is currently battling Stage IV breast cancer, and the Glasses have established the endowment with a goal of raising $1 million to provide critical funding to move new cancer-fighting drugs from the research stage to the clinical setting.

Bidding is currently open for each work of art on the Bidding For Good website. Additionally, for only $50 you can participate in an art ticket raffle for a 1 in 24 chance to win one of 18 paintings, each valued at up to $4,000. People also are welcome to make a cash donation, which will be matched on the Bidding for Good website. Winning bids will be announced at the event.

In addition to Doyle Glass, artists represented at Art to Beat Cancer are Eric Bowman, Jill Carver, J.M. Culver, Glenn Dean, Patrick Donley, Bato Dugarzhapov, Mark Haworth, Joshua Jenkins, Matthew Katz, Kevin Macpherson, Wanda Macpherson, Denise LaRue Mahlke, C.W. Mundy, Antonio Rodriguez, David Schuster, Michele Usibelli, Dan Young and Ekaterina Ziuzina.

For additional information, contact Michael Neumann, 502-852-4642.

One year ago, Michael Stillman, M.D., and his colleague, Monalisa Tailor, M.D., both physicians with the University of Louisville Department of Medicine, wrote a New England Journal of Medicine “Perspective” article about “Tommy Davis,” their pseudonym-named patient who delayed seeing a doctor because he lacked health insurance.

After spending a year experiencing severe abdominal pain and other symptoms, Davis finally sought care in the emergency room. The diagnosis? Metastatic colon cancer.

“If we’d found it sooner,” Davis said to the physicians, “it would have made a difference. But now I’m just a dead man walking,” a phrase so evocative, the physicians chose it as the headline of their article.

Today, however, Stillman and his colleagues are witnessing what another of his patients terms a “sea change in health care” because of the passage and implementation of the Affordable Care Act (ACA) in Kentucky.

Stillman has authored a follow-up “Perspective” article in the New England Journal of Medicine this week that notes the changes brought about by the ACA and Kentucky Gov. Steve Beshear’s decision to accept federal funding for Medicaid expansion that the act brought about.

One year later, the ACA rollout in Kentucky has been a success, he says. “…Our Commonwealth’s citizens – among the poorest and most (medically) underserved in the country – finally gained broad access to health insurance,” he says. “… allowing us to provide data-driven and thorough care without first considering our patients’ ability to pay.”

The contrast between last year and today is stark, writes Stillman. “Before … Medicaid expansion, the 60 percent of my clinic patients and 650,000 Kentuckians who lacked health insurance received disjointed and disastrous care.” Many avoided routine and preventative care because of worries over cost.

“But during the past year,” Stillman writes, “many of my lowest-income patients have, for the first time as adults, been able to seek non-urgent medical attention.” In Kentucky, 413,000 people gained medical coverage who did not have it prior to the ACA implementation.

The ACA has brought about other unexpected benefits as well. Expanded health care coverage has greatly improved residency training in Kentucky, enabling the doctor to spend more time doctoring and less time serving as a financial advisor.

“One year after the law’s implementation, residents at my hospital can finally provide guideline- and evidence-based care,” without first considering the cost, he writes. “Since 92 percent of our patients are now insured, we no longer receive fretful looks when we recommend laboratory tests; we screen for colorectal cancer with colonoscopies rather than with less sensitive fecal blood cards; and we spend more time examining patients and less time helping them knit together limited public-assistance resources.”

Another unanticipated benefit has been an increase in competition for patients. Before the ACA, patients without health insurance had a limited number of facilities in which they could receive care.

Today, however, “with increased enrollment in Medicaid and commercial (health) plans, these same patients are pursued by medical groups and hospitals and can be selective in choosing their sites of care.”

Stillman notes that the ACA remains threatened, both in Kentucky where its success is verified by data, and in other states throughout the country.

“Some Kentuckians question the adequacy of the newly purchased plans and are concerned that despite being ‘insured,’ people who have bought low-premium, high-deductible plans may (still) wind up accruing substantial medical debt,” he writes.

Also, he notes that 21 states have yet to expand Medicaid eligibility despite the example Kentucky shows of the success in doing so. Physicians, however, can help.

“First, we can challenge our elected officials to do a better job of seeing to their constituents’ needs,” he writes. “Furthermore, we can delineate for our patients the often-subtle links between current affairs and their own health,” including asking them if they are registered to vote and reminding them of candidates’ support of or opposition to the legislation that has palpably benefited them.

“I hope that an increasing number of state legislatures will help their vulnerable citizens receive the services they need and that the next generation of physicians will be shocked that our current efforts at health care inclusion were ever seriously questioned.”

The University of Louisville School of Medicine will serve as the nation’s pilot site for training future physicians on the unique health care concerns and issues encountered by people who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming or born with differences of sex development (DSD).

“We are very excited to serve as our nation’s learning ground in training the next generation of physicians in meeting the unique health care needs of our LGBT and DSD-affected population,” said Toni Ganzel, M.D., dean of the UofL School of Medicine. “Every segment of our population brings its own set of health care issues and concerns. As we strive to provide the highest quality training possible, it is a privilege to model that educational experience for our colleagues throughout the nation.”

UofL will spend the next few months developing the formal curriculum and begin the pilot program in the 2015-16 academic year, with full integration into the curriculum in 2016-17.

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

All aspects of patient care, from the intake forms and interaction with caregivers in the outpatient office to interactions during critical illness, require an accepting, informed, patient-centered approach from all physicians in order to improve the adverse health outcomes seen in this patient population.

In early November, the Association of American Medical Colleges identified 30 competencies that physicians must master. These competencies fall under eight domains of care critical to training physicians, including patient care, knowledge for practice, practice-based learning and improvement, interpersonal and communication skills, professionalism, systems-based practice, interprofessional collaboration and personal and professional development.

This competency-based framework will allow medical educators to integrate the new guidelines into existing curricula more easily and encourage faculty and health care professionals to move away from thinking of patients in these groups as separate from the general patient population.

“As a university, we continue to be a leader in recognizing the importance of understanding our diverse population and working to meet the varying needs,” said Brian Buford, assistant provost for diversity and director of the LGBT Center at UofL.

UofL School of Medicine will be assisted in this curriculum integration project by two of the primary authors of the competencies, Jennifer Potter, M.D., Harvard School of Medicine, and Kristen Eckstrand, Ph.D., Vanderbilt University School of Medicine and fourth-ear medical student. Additionally, John Davis, M.D. from The Ohio State University and the AAMC Group on Diversity & Inclusion LGBT Issues Representative also will assist in the project.

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

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

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

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

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

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

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

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

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

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About the James Graham Brown Cancer Center:

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