The University of Louisville and several west Louisville community clinics are offering a free June 23 event to educate women about preventing cervical cancer. The disease is preventable by vaccine and treatable if detected early; however, it kills about 70 Kentuckians annually.

The Women’s Wellness event will be 4-6 p.m. Sunday at Louisville Central Community Center, 1300 W. Muhammad Ali Blvd. Women can sign up for screenings and vaccinations; learn from experts, advocates and exhibits; and enjoy music and food.

Speakers will discuss HPV and vaccination; cervical cancer screening, prevention and survivorship; and ways to talk to family members about cancer; a question-and-answer session will follow.

Speakers will include patient advocate and volunteer Aquishala Ware and Drs. Bennett Jenson, UofL James Graham Brown Cancer Center; Andrea Woolfolk, Family Health Center; Giavonne Rondo, Shawnee Christian Healthcare Center; and Sula Hood, Indiana University Fairbanks School of Public Health.  

Although the event is free, attendees are encouraged to register by calling 502-276-5747 or signing up online at http://bit.ly/wellnesskickoff

UofL’s Kent School of Social Work and School of Public Health and Information Sciences are organizing the event, with grant support from the Cooperative Consortium for Transdisciplinary Social Justice Research.

Sponsors include Kentucky Cancer Program, Baptist Health and Gilda’s Club Kentuckiana.

For more information, contact Karen Kayser at 502-852-1946 or karen.kayser@louisville.edu.

University of Louisville Hospital has received the American Heart Association/American Stroke Association’s Get With The Guidelines^® Target: Stroke Honor Roll Elite Plus Gold Plus Quality Achievement Award. The award recognizes the hospital’s commitment to ensuring stroke patients receive the most appropriate treatment according to nationally recognized, research-based guidelines based on the latest scientific evidence.

UofL Hospital earned the award by meeting specific quality achievement measures for the diagnosis and treatment of stroke patients at a set level for a designated period. These measures include evaluation of the proper use of medications and other stroke treatments aligned with the most up-to-date, evidence-based guidelines with the goal of speeding recovery and reducing death and disability for stroke patients. Before discharge, patients should also receive education on managing their health, get a follow-up visit scheduled, as well as other care transition interventions.

“The UofL Hospital – Comprehensive Stroke Center is dedicated to improving the quality of care for our stroke patients by implementing the American Heart Association’s Get With The Guidelines-Stroke initiative,” said Kerri Remmel, M.D., Ph.D., medical director of the UofL Hospital – Comprehensive Stroke Center. “The tools and resources provided help us track and measure our success in meeting evidenced-based clinical guidelines developed to improve patient outcomes.”

UofL Hospital additionally received the association’s Target: Stroke^SM Elite Plus award. To qualify for this recognition, hospitals must meet quality measures developed to reduce the time between the patient’s arrival at the hospital and treatment with the clot-buster tissue plasminogen activator, or tPA, the only drug approved by the U.S. Food and Drug Administration to treat ischemic stroke.

“We are pleased to recognize UofL Hospital for their commitment to stroke care,” said Lee H. Schwamm, M.D., national chairperson of the Quality Oversight Committee and Executive Vice Chair of Neurology, Director of Acute Stroke Services, Massachusetts General Hospital, Boston. “Research has shown that hospitals adhering to clinical measures through the Get With The Guidelines quality improvement initiative can often see fewer readmissions and lower mortality rates.”

According to the American Heart Association/American Stroke Association, stroke is the No. 5 cause of death and a leading cause of adult disability in the United States. On average, someone in the U.S. suffers a stroke every 40 seconds and nearly 795,000 people suffer a new or recurrent stroke each year.

June 19, 2019

Anthem Blue Cross and Blue Shield in Kentucky has recognized the University of Louisville James Graham Brown Cancer Center with a Blue Distinction^® Centers for Cancer Care designation as part of the Blue Distinction Specialty Care program. By combining nationally consistent quality criteria with locally effective value-based programs, Blue Distinction Centers for Cancer Care deliver maximum value to members battling cancer by aligning health care payments with improved health outcomes.The designation is available for all cancer types and various care settings, including physician groups, cancer centers, hospitals and accountable care organizations (ACOs).

The UofL Brown Cancer Center received the designation by incorporating patient-centered and data-driven practices to better coordinate cancer care and improve quality and safety under a value based payment model. Blue Distinction Centers for Cancer Care are reimbursed based on how they perform against both quality and cost outcome targets in order to receive incentives and rewards for better health outcomes – rather than traditional fee-for-service. Research has shown that care delivery transformation to improve quality and affordability is most successful when accompanied by transformation to a value based payment model.

“This designation attests to our daily dedication to providing the very best care for each of our patients and to achieving the best possible results,” said Jason Chesney, M.D., Ph.D., director of the UofL Brown Cancer Center. “While outcomes are our greatest priority, we work hard to make sure the people we treat also have the best patient experience.”

“Cancer patients are unique, and so is the care that they receive,” said Jennifer Atkins, vice president of network solutions for the Blue Cross Blue Shield Association.  “Cancer patients often receive different kinds of specialized care in multiple settings with perhaps surgery at a distant medical center but chemotherapy at a local hospital. Medical professionals and facilities designated as Blue Distinction Centers for Cancer Care provide coordinated patient care and communication under a value based payment model.”

In 2018, the UofL Brown Cancer Center also received designation as a Blue Distinction Center+ for Transplants for Adult Bone Marrow/Stem Cell by Anthem Blue Cross Blue Shield.

Since 2006, the Blue Distinction Specialty Care program has helped patients find quality specialty care in the areas of bariatric surgery, cancer care, cardiac care, knee and hip replacements, maternity care, spine surgery and transplants while encouraging health care professionals to improve the care they deliver. For more information about the program, please visit www.bcbs.com/bluedistinction.

June 17, 2019

The University of Louisville has notified Catholic Health Initiatives and its affiliate, KentuckyOne Health, that it is ending negotiations to purchase KOH’s Louisville assets, which include Jewish Hospital where the university has several service lines and its physicians treat patients and teach medical residents.

Talks were halted because UofL could not find a suitable partner to help fund the acquisition. UofL officials were not willing to put the university at financial risk by taking on the acquisition alone.

“We regret ending our talks with CHI, but we must do what is fiscally responsible for the University of Louisville,” said UofL President Neeli Bendapudi. “Without a viable partner, we do not have the resources necessary to make the acquisition a reality.”

“KentuckyOne Health is disappointed that the university was not able to secure a financial partner,” said Deborah Lee-Eddie, interim market CEO for KentuckyOne Health. “We will now continue our discussions with other interested organizations.”

UofL and CHI have agreed to several steps as the two parties work on the changes in their relationship.

CHI will extend the Academic Affiliation Agreement to ensure that undergraduate and graduate/resident medical education programs continue at Jewish Hospital and Frazier Rehab Institute. If programs cannot be continued at those facilities, CHI will assign those residencies to another facility requested by the university.

The AAA is an agreement that provides conditions under which the university’s physicians and medical residents provide care for patients, serve in leadership roles for various hospital programs and services and conduct clinical trials that offer innovative treatments unavailable anywhere else in the region.

CHI also has agreed to continue the current professional services, medical directorships and similar provisions included in the Master Services Agreement while it and UofL discuss transition planning. CHI will provide at least 90 days notice before terminating any of those individual agreements.

“Our patients will continue to receive the highest quality care, and our students and residents will continue to receive the education and training they must have to become future providers,” Bendapudi said. “That is our unwavering commitment.”

KentuckyOne’s local properties also include Our Lady of Peace, Sts. Mary & Elizabeth Hospital, Jewish Hospital Medical Centers East, South, Southwest and Northeast, Jewish Hospital Shelbyville and the KentuckyOne Health Medical Group.

UofL and CHI have negotiated in good faith on the purchase of the portfolio only since December 2018.

Services provided by UofL physicians at Jewish Hospital include organ transplantation, cardiovascular medicine and neurological surgery. The hospital is home to the only solid organ transplant facility in the region, and UofL’s renowned clinical care and research in cardiovascular medicine and spinal cord injury are conducted at Jewish and Frazier Rehab.

Bendapudi applauded all those who tried to make a deal for the KentuckyOne assets a reality.

“Everyone involved in these talks put dedication and hard work into them, and I thank them all,” she said. “This endeavor did not fail for lack of effort on the part of either party.”

In her own words: UofL President Neeli Bendapudi, Ph.D., provides more information on ending the negotiations here. 

At a recent workshop at the Massachusetts Institute of Technology to discuss health risks associated with a potential manned mission to Mars, it became clear just how vitally we humans depend on our Earth’s environment.

“Those discussions forced us to think about how our physiology depends on the attributes of our home planet. The question about what to include in the Mars transport vehicle is a wake-up call for those insensitive to the elimination of biodiversity and poorly conceived urbanization globally,” said Ted Smith, Ph.D., deputy director of the Christina Lee Brown Envirome Institute at the University of Louisville. Smith also is a member of the Scientific Advisory Board for NASA’s Translation Research Institute for Space Health (TRISH) and organized the workshop.

At the next Beer with a Scientist, Smith will discuss what planning for long-range space travel reveals about the need to preserve our home planet’s health for our own survival.

Smith’s talk will begin at 7 p.m. on Wednesday, June 12, at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

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

Upcoming Beer with a Scientist events:

July 17:  Jason Chesney, M.D., Ph.D., will discuss recent advances in using our own immune cells to cure cancer.

For nearly two decades, a program administered at the University of Louisville has been helping scientists at institutions throughout the state get their foot in the door of biomedical research.   

A five-year, $18.2 million grant from the National Institutes of Health (NIH) awarded earlier this year will continue and enhance the work of the Kentucky Biomedical Research Infrastructure Network (KBRIN), the state’s Institutional Development Award (IDeA). The IDeA program builds research capacities in states with historically low levels of NIH funding by supporting basic, clinical and translational research as well as faculty development and infrastructure improvements. Kentucky is one of 23 states eligible for IDeA funding.

“Our goal is to enhance training in biomedical research for faculty, postdoctoral fellows and graduate and undergraduate students throughout the state,” said Nigel Cooper, Ph.D., director of KBRIN, based at UofL. “Since 2001, federal funding through the Institutional Development Award program has allowed us to work with other higher education institutions in Kentucky to build a network of resources and education.”

KBRIN includes partner institutions who share biomedical research expertise, data processing and infrastructure with early-stage researchers at partner and outreach institutions, including collaborative networks among scientists, funding workshops and access to equipment that may not be available at the researchers’ home institutions.

The new funding allows KBRIN to add an electron microscopy core, offering researchers access to electron microscopes at UofL, the University of Kentucky and Western Kentucky University. To launch this resource, KBRIN has issued a call for proposals for electron microscopy pilot projects, enabling students and researchers to prepare samples and use the electron microscopes. Submissions are due July 15.

Through IDeA, KBRIN also provides funding for research projects to assist early-stage researchers in their work. In addition to advancing research itself, the projects support increased student training and career development, including summer programs and mentored research for undergraduate students.

Amber Onorato, Ph.D., assistant professor of chemistry at Northern Kentucky University, recently received funding from KBRIN to support research that involves the synthesis of novel anti-inflammatory molecules. The KBRIN funds will allow Onorato and a group of her students to further advance the research project and work more closely with a collaborator at the University of Cincinnati to learn biological techniques.

“The funding allows me to spend more time with the students in the lab working on the project and to write grants and publications,” Onorato said. “It also allows me to pay the students who work with me over the summer, which gets more of my students in the lab. The ability to do this research in the field has made them more attractive candidates for professional schools as well as for their future careers.”

In the process of securing IDeA funding through KBRIN, the researchers also improve their potential for future direct NIH funding.

“We provide the infrastructure that allows newer researchers to ‘get in the game,’ but we also provide training for those researchers in the form of feedback on the grant proposals they submit to us for funding. This feedback prepares them to compete for NIH funding,” said Martha Bickford, Ph.D., associate program director of KBRIN.

Justin Yates, Ph.D., assistant professor of psychology at Northern Kentucky University, is an early-stage biomedical investigator who recently obtained funding from the NIH after working with KBRIN over the past four years. He studies the neuro-behavioral mechanisms leading to addiction.

“Being able to conduct research with funding through KBRIN has made me competitive. It enabled me to have my research published, to pay for an undergraduate student to help with the research and to recruit more students,” Yates said. “When you are applying for an R15 (grant from the NIH), an important aspect is training undergraduate students. By showing I could do that, it helped my application score.”

Robert Keynton, Ph.D., interim executive vice president for research and innovation at UofL, said the program is an important resource for developing future biomedical researchers in Kentucky.

“This project is an excellent example of the value of a multidisciplinary and multi-institutional program at building research infrastructure and capacity across the Commonwealth of Kentucky, which testifies as to why this is the longest, continuously funded NIH project at the University of Louisville,” Keynton said.

Since 2001, KBRIN has been funded continuously through IDeA, and has received more than $77 million in federal funding. Partner schools include the University of Kentucky, Western Kentucky University, Eastern Kentucky University, Northern Kentucky University, Murray State University, Morehead State University and Centre College, but the network is available to any college or university in Kentucky.

UofL will host the Southeast Regional IDeA Conference Nov. 6-8 in Louisville. In addition to scientific talks and poster presentations, the conference agenda includes workshops to introduce the new electron microscopy core and other facilities, as well as training in specific skills, such as bioinformatics and grant writing.

For women undergoing treatment for cancer, a little encouragement can mean the world.

Lara MacGregor, who lives with metastatic breast cancer, started Hope Scarves in 2012 to provide women undergoing cancer treatment a way to encourage one another by sharing a scarf and a story. In 2015, Hope Scarves established a Metastatic Breast Cancer Research Fund to raise funds to support research and patient care.

For 2019, Hope Scarves has provided a gift of $25,000 to the University of Louisville James Graham Brown Cancer Center, with an anonymous match of $25,000 for a total gift of $50,000. The funds are designated to bringing more clinical trials for metastatic breast cancer patients to Louisville.

Kentucky has one of the highest rates of breast cancer in the United States, and Jefferson County has one of the highest rates in Kentucky. Participation in clinical trials is one way to improve outcomes, not only for the patients who participate, but by bringing more and better treatments to market for all patients.

“Participation in clinical trials benefits not only the patients involved in the trial, but the field of cancer treatment in general,” said Beth Riley, M.D., deputy director for clinical affairs at UofL’s Brown Cancer Center. “Currently, metastatic breast cancer is not curable with standard treatment. By participating in trials, patients in Kentucky not only have early access to novel drugs or drug combinations, but they are helping physicians and scientists learn more about effective treatments and disease characteristics so we can move closer to a cure for this disease. Clinical trials involvement is vital to improve the lives of cancer patients here in Kentucky and worldwide.” 

One patient who benefitted from treatment in a clinical trial at the center is Brenda Craig, a Louisville native who was diagnosed with breast cancer in 2013. After several years in remission, her cancer returned; this time it was stage 4 and more challenging to treat.

“The treatments I was getting were not making me feel good and were not doing anything for my cancer,” Craig said. “When my doctor said, ‘Would you like to try the clinical trial?’ I wanted to live, so I said, ‘Yea! Sure, I’d try it.’”

Her condition improved while she was on the trial treatment, nearly bringing her to remission again. Unfortunately, she had to stop the trial drug when she came down with pneumonia. Nevertheless, she is grateful to have had the opportunity.

“The clinical trial brought me a long way. I was on it 8-10 months and I was doing great,” Craig said. She now is on another treatment, but her cancer has remained stable.

Craig said one of her most important missions on her cancer journey is to support others with the disease, a mission shared by Hope Scarves.

“We are human. We cry and we tell our stories to each other. My story helps you and your story helps someone else. We keep it going,” Craig said. “Even if I don’t make it, I hope I can be an example for someone else, that whatever they did for me, it can help someone else.”

MacGregor, a Louisville resident, has seen clinical trials benefit patients at the UofL Brown Cancer Center, and her own treatment includes a drug tested at the center. She wants Hope Scarves’ funds to invigorate that process.

“There is a huge burden to participate in clinical trials that are only available in another city. You have transportation and lodging to consider, and you are away from your home support system – your family and friends – who truly make a difference when you are fighting this disease,” MacGregor said.

By making more trials available in Louisville, not only local women benefit, but also future patients by allowing more people to participate in the trials, advancing medical research more quickly.

“Clinical trials are the future of cancer treatment, not a last resort,” MacGregor said. “These therapies are the next generation of care and may give patients better outcomes, and we are providing these funds to enable more women to have access to them.”

Runners in the Kentucky Derby Festival Marathon and Mini Marathon have raised funds for Hope Scarves as a team, Outrunning Cancer, for the past seven years. In 2015, Hope Scarves presented its first gift to the UofL Brown Cancer Center to support basic research. This year, in addition to UofL, Hope Scarves is providing funds for basic cancer research to Johns Hopkins Medical Center and the Dana-Farber Cancer Center at Harvard University.

“It is our intentional strategy to fund both basic science and patient access to care,” MacGregor said.

June 3, 2019

Passport Health Plan andEvolent Health, a company providing an integrated value-based care platform to the nation's leading providers and payers, announced on May 29 that Evolent has entered into a definitive agreement to partner with the current sponsors of Passport in continuing to serve the Kentucky Medicaid market. The current sponsors, which include The University of Louisville, University of Louisville Physicians, University Medical Center, Jewish Heritage Fund for Excellence, Norton Healthcare and the Louisville/Jefferson County Primary Care Association, have been seeking a partner to provide expanded management and operational support, as well as capital through joint ownership of the health plan, and haveselected Evolent as its long-term financial and operating partner.

Per the terms of the agreement, Evolent will acquire an ownership interest in Passport Health Plan and will expand the scope and term of its long-term Management Services Agreement with the health plan. Evolent will also provide interim balance sheet support if necessary to meet near-term regulatory capital requirements.

Passport has provided Medicaid managed care services in Kentucky since 1997 and currently serves more than 300,000 members statewide. The plan employs more than 600 Kentuckians, primarily at its headquarters in Louisville. Evolent has provided extensive services to Passport since 2016, when the organizations formed a relationship to launch the Medicaid Center of Excellence focused on improving health outcomes for Medicaid beneficiaries in Kentucky and in several states nationwide.

Passport will be jointly owned and operated through a partnership between Evolent, The University of Louisville, the University of Louisville Physicians, University Medical Center, Jewish Heritage Fund for Excellence, Norton Healthcare and the Louisville/Jefferson County Primary Care Association. The plan will be governed by a newly formed board of directors upon closing with joint representation from the current owners and Evolent Health. Evolent intends to maintain all Kentucky operations under the Passport name and looks forward to building upon the plan’s excellent history of service in the Commonwealth.  

“We strongly believe in Passport’s mission and have been proud to partner with Passport’s leadership team to serve the Commonwealth of Kentucky,” said Evolent Health Chief Executive Officer Frank Williams. “We are honored by the vote of confidence the owners of Passport have given us to continue to build on an extraordinary legacy of delivering an excellent member experience to Kentucky’s Medicaid beneficiaries. We are confident that by leveraging our value-based care platform and the full scope of our clinical programs, as well as providing enhanced functional expertise, we can drive strong operational and financial performance. We look forward to collaborating with The University of Louisville and other Passport owners—as well as local and state regulatory agencies and other key stakeholders—to continue driving improved health outcomes and critical support to one of the Commonwealth’s most vulnerable populations.”

“The University of Louisville helped create Passport Health Plan in 1997, paving the way for what has become a national model for managed care,” said University of Louisville President Dr. Neeli Bendapudi. “Now, we are proud to partner with Evolent Health to begin a new chapter that will continue to spark innovation in the delivery of care.”

“For the past 20 years, Passport has been proud to work with the Commonwealth, our provider partners and other valued supporters to deliver a quality health plan that promotes our members’ best interests and health outcomes,” said Passport Health Plan Chief Executive Officer Mark Carter. “I am confident that Passport has a bright future ahead, thanks to the solid foundation we’ve built and the significant investment, expertise and support that Evolent brings to the table. Evolent and Passport are dedicated to finding ways to bring the West Louisville Health and Wellbeing Campus to life, as we believe it will significantly positively impact the health of the community. Evolent and Passport will be working with developers and key stakeholders to create a definitive plan and select a real estate developer to bring the project to fruition.”

About Evolent Health

Evolent Health partners with leading provider and payer organizations to achieve superior clinical and financial results in value-based care and under full-risk arrangements. With a provider heritage and over 20 years of health plan administration experience, Evolent partners with more than 35 health care organizations to actively manage care across Medicare, Medicaid, commercial and self-funded adult and pediatric populations. With the experience to drive change, Evolent confidently stands by a commitment to achieve results. For more information, visit evolenthealth.com.

About Passport Health Plan

Passport Health Plan is a provider-sponsored, non-profit, community-based health plan administering Medicaid benefits to more than 300,000 Kentuckians. Named the top Medicaid plan in Kentucky by the National Committee for Quality Assurance (NCQA) for 2016-17, Passport has been contracted with the Commonwealth of Kentucky to administer Medicaid benefits since 1997. For details, please visit passporthealthplan.com or call toll-free (800) 578-0603. Passport also operates a Medicare Advantage program, called “Passport Advantage,” for residents of Jefferson, Bullitt, Hardin, Nelson, Breckinridge, Carroll, Grayson, Henry, Larue, Marion, Meade, Oldham, Shelby, Spencer, Trimble and Washington counties who are eligible for both Medicaid and Medicare. For details, go online to passportadvantage.com or call toll-free (844) 859-6152.

The University of Louisville shared its pioneering work in educating health professionals to provide quality health care to LGBTQ patients with faculty at Harvard Medical School in Boston last month. In New York, the university also received a national leadership award for workforce development for the same work on May 3. Earlier this year, UofL published The eQuality Toolkit, a clinical skills training manual to help others develop the specific clinical skills needed to provide high quality care to LGBTQ patients.

At the Seventh Annual National LGBT Health Workforce Conference, held last week in New York, UofL received the Organization Leadership Award from Building the Next Generation of Academic Physicians (BNGAP), an organization founded in 2008 to cultivate a more diverse workforce in academic medicine. The award highlights commitment, scholarship and dedication to the development of a health workforce that is responsive to the unique health issues and disparities of LGBT communities. Previous winners are Penn Medicine and the University of Rochester Medical Center.

A week prior, leaders from UofL’s eQuality program presented Grand Rounds to faculty at the Harvard Medical School Academy on incorporating training for the care of LGBTQ patients into the medical school curriculum. Amy Holthouser, M.D., senior associate dean for medical education, Susan Sawning, M.S.S.W., director of medical education research, and UofL School of Medicine alumni Rhiannon Ledgerwood, M.D., and Adam Neff, M.D., presented “Lessons from eQuality at University of Louisville: Successful collaborations for integrating sexual and gender minority health into medical education.”

David Hirsh, M.D., director of the Academy at Harvard Medical School, said the presentation from Holthouser and Sawning inspired the participants, who are planning to launch a similar program at Harvard.

“I was so moved by your advocacy and accomplishments and so taken by your style and grace, strength and conviction, wisdom and humility,” Hirsh said of the UofL group. “The grand rounds made an enormous difference. We will be speaking about it for a long time to come.  I am so grateful to learn from you and to have been present for such an important and transformative launch.”

Beginning in 2014, UofL served as the pilot program for the development of curriculum to incorporate competencies published by the Association of American Medical Colleges (AAMC) related to provision of care for LGBT individuals and other sexual and gender minorities (SGM). Through the eQuality program, information related to care for SGM patients was embedded throughout the curriculum studied by all students in the UofL School of Medicine.

Jennifer Potter, M.D., professor of medicine and advisory dean and director of William Bosworth Castle Society at Harvard Medical School, invited the UofL team to The Academy at Harvard Medical School, which is responsible for professional development of faculty who teach in the MD program.

“You care about the fact that SGM people experience health inequities,” Potter said of the UofL presenters. “You talk with your colleagues and students about the fact that these inequities are unacceptable. Then you go one step further – you actually TAKE ACTION to address the inequities with sheer grace, humility, positivity, a sense of humor and brilliance ... and in true collaboration with your local SGM community.”

“It is so rewarding to see the work that has been done here at UofL to improve health care for LGBT patients is valued by an institution as highly respected as Harvard,” said Toni Ganzel, M.D., M.B.A., dean of the UofL School of Medicine. “In addition, it is an honor to receive a national award from a well-respected organization such as BNGAP. We are pleased to be able to share this knowledge with educators and influencers throughout the United States.”

The eQuality Toolkit, published with funding from the National Institute of Health Care Management Foundation, is available to all health professionals at no charge to enhance competency nationwide in caring for LGBTQ patients.

What would you guess is the average age when someone starts smoking?

Perhaps early 20’s? Maybe even 16?

“The average chronic smoker begins smoking at 13.7 years old,” says Daniel Conklin, Ph.D. “And if you know anything about averages, that’s...not good.”

Conklin, a professor of medicine at the University of Louisville, specializes in cardiovascular research and what environmental pollutants do to our bodies. At this month’s Beer with a Scientist, Conklin will discuss smoking and what we do (and don’t) know about the harm caused by electronic cigarettes.

“Essentially, we’re trying to separate fact from fiction. We’re currently part of an American Heart Association Tobacco Regulation Center to investigate emerging tobacco products and their potential to cause harm to the cardiovascular system,” Conklin said. “We’re trying to figure out the best way to regulate these products.”

Scientists have known that conventional tobacco products are associated with cardiovascular disease risk since the 1960s, Conklin said. However, with new technology comes a new generation of health risks and the emerging science showing what vaping does to the body may shock you.

Conklin’s talk will begin at 7 p.m. on Wednesday, May 15, at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

Admission is free. Purchase of beer or other items is not required but is encouraged. Organizers encourage Beer with a Scientist patrons to drink responsibly.

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

Donghoon Chung, Ph.D., a virologist at the University of Louisville, is one of three principal investigators with a new center working to advance new drugs for the treatment of equine encephalitis viruses in humans. The project, Center of Excellence for Encephalitic Alphavirus Therapeutics, is funded by a $21 million grant from the National Institutes of Health over five years.

The center, headquartered at the University of Tennessee Health Science Center in Memphis, will develop therapeutic drugs to treat three mosquito-borne alphaviruses that cause serious illness in humans and horses: Venezuelan equine encephalitis virus (VEEV), Eastern equine encephalitis virus (EEEV) and Western equine encephalitis virus (WEEV). Although a vaccine is available for horses, there are no FDA-approved treatments or preventive vaccines for these viruses in humans.

Chung, an associate professor in the Center for Predictive Medicine and Department of Microbiology & Immunology at UofL, said the center’s goal is to refine potent small molecule compounds the researchers previously identified as promising as antiviral drugs for treating the encephalitis viruses, and enable those compounds to move to the next step of research, clinical trials in humans.

“In my previous research I found that these compounds inhibit the viral replication cycle. However, we want to further understand which target molecules are interacting with the compound,” Chung said. He described the mechanism of the compounds the group is investigating as similar to the way the drug nevirapine, a non-nucleoside reverse transcriptase inhibitor, works in treating human immunodeficiency virus (HIV).

“This project is to develop a new antiviral compound to treat these diseases in humans,” Chung said. “However, we do not limit our applications of this drug to only humans, as it may be possible to adapt it for treating horses as well.”

These equine encephalitis viruses infect humans and horses through the bite of an infected mosquito. According to the Centers for Disease Control and Prevention (CDC), symptoms of infection include fever, chills, headache and vomiting. Outbreaks of the Western and Venezuelan viruses are uncommon, and an average of only seven human cases of EEEV have been reported annually in the United States over the past ten years. However, the disease may leave people with permanent neurological symptoms, and approximately 30 percent of people who contract the Eastern equine encephalitis virus will die from the disease.

According to Chung, the potential for the viruses to be used in bioterrorism is perhaps even more worrisome. The CDC recognizes viral encephalitis as a Category B human biothreat, making the development of a treatment important.

Chung’s co-principal investigators in the center are Colleen Jonsson, Ph.D., of the University of Tennessee Health Science Center who directs the center, and Jennifer E. Golden, Ph.D., of the University of Wisconsin-Madison School of Pharmacy.

“The goal of our new Center of Excellence is to further develop novel therapeutic molecules discovered by our team that are highly potent across all three viruses, moving the optimal ones forward into pre-clinical development,” said Jonsson, formerly director of the UofL Center for Predictive Medicine.

Chung will test the compounds for toxicity against human cells in vitro, deciphering their molecular mechanisms and determining their resistance threshold utilizing the facilities and staff at the Regional Biocontainment Laboratory at UofL. He also will test the compounds’ resistance threshold that inevitably develops over time, along with Juw Won Park, Ph.D., assistant professor of computer engineering in the J.B. Speed School of Engineering at UofL.

Once their work is completed, the researchers expect the new drugs would be ready to begin clinical trial testing in humans.

Three years ago, Lana Boes of Charlestown, Ind., was at the end of her rope. She had been fighting colon cancer for nearly two years with multiple surgeries, two different chemotherapies, regular blood transfusions and more. But the cancer had returned and the chemotherapy no longer was working.

“I was down to 100 pounds. I really couldn’t eat. I had to take medicine to help me with my appetite. I just couldn’t do it anymore,” Boes said.

First diagnosed at age 43, Boes’s first surgery went well, but the cancer returned. After her second surgery, Boes started chemotherapy. Genetic testing revealed she had Lynch Syndrome, a genetic mutation that carries a higher-than-normal risk for cancer. When the first chemotherapy drug failed her, Boes started another, harsher chemo drug. That drug, too, eventually failed.

At that point, she was offered the chance to participate in a clinical trial for pembrolizumab, better known as Keytruda®, an immunotherapy drug previously successful in treating other types of cancer, but not yet FDA approved for the type of cancer Boes had.

“Lana started to suffer not only from the side effects of her cancer progressing, but also the side effects of treatment. It was clear that we needed something new and different,” said Rebecca Redman, M.D., Boes’s oncologist and deputy director of clinical research at the UofL James Graham Brown Cancer Center. “This clinical trial became available right around that time. It was based on some early evidence that suggested immunotherapy would be a really great option for Lana’s type of cancer.”

Keytruda is a type of immunotherapy that engages a patient’s own immune system to fight cancer. Cancer cells use a protein called PD-1 to hide from the immune system. Keytruda blocks the PD-1 pathway, Redman said, allowing the patient's immune system to recognize the cancer as something that doesn't belong and destroy it.

With support from her husband, Tim, Boes decided to enter the trial. She started receiving Keytruda in June 2016, and her condition improved almost immediately.

“With Keytruda, I got my life back. With chemo I went home and went to bed and you didn’t see me for the weekend,” Boes said. “With Keytruda, I didn’t go home and go to bed. I started getting an appetite and some strength back. I was able to enjoy doing things outside of my house again with family and friends.”

She remained on the immunotherapy drug for two years, completing the trial in June 2018. Regular checkups show that as of March 2019, Boes’s cancer is not detectable in scans or exams, and her cancer tumor marker numbers have remained within normal range. Redman considers her cancer in remission.

Boes says she has a fresh outlook on life, and can plan for her future.

“I used to refuse to book anything in advance. Everything we did was always last minute because I didn’t know if I was going to get to go,” Boes said. “I didn’t buy things that were for the future. I couldn’t talk about the future.”

Now she has plans to celebrate a special milestone in 2020.

“I never used to care about birthdays, but every birthday is a big deal to me now,” Boes said. “I turn 50 next November and I told my husband, ‘I never thought I was going to see 50, so I want to go to Italy.’ It’s huge for me in so many ways.”

While she is grateful for having the chance to participate in the trial with Keytruda, Boes also is grateful to Redman and to the staff at the Brown Cancer Center.

“Just seeing Dr. Redman made me feel better. She saved my life. She treats me with so much care. She sits down and she listens to me,” Boes said. “Every person at Brown is just so kind and they genuinely care. That makes such a huge difference when you are not feeling good.”

Redman, also associate professor at the UofL School of Medicine, said she has seen good results with immunotherapy in other patients with cancer like Boes’s. Unlike chemotherapy, which requires continued treatment, in some cases immunotherapy may allow a patient’s body to continue to control the cancer for an extended period of time.

“The most exciting thing about immunotherapy is that not only are we seeing remarkable tumor responses, but those responses seem to last a long time,” Redman said. “For some patients, it appears that once you train the immune system to attack the cancer, it may continue to do so for some time, possibly even after the immunotherapy has been stopped.”

Keytruda is the first drug approved by the FDA for the treatment of cancers based on a specific change in the DNA of the tumor, microsatellite instability (MSI), instead of where the cancer is in the body. MSI can be present in colon cancer but also in other organ cancers, and Keytruda is FDA-approved to treat cancers with MSI anywhere in the body.

Redman said that through her participation in the trial, Boes helped make it possible for other patients to have access to Keytruda for their MSI cancer. FDA approval typically means an insurance company will cover the treatment and makes the drug available to all patients.

“By participating in this trial, she has allowed this drug to move toward FDA approval, so immunotherapy now is a standard treatment for patients with microsatellite unstable cancers,” Redman said. “Thanks to patients like Lana who participate in clinical trials and take that extra step a little bit into the unknown, thousands of people will benefit and will have their lives turned around.”

Boes is most grateful to have the chance to live without cancer.

“I’m living my life normally,” Boes said. “I’m not cancer. Nobody treats me as cancer. I’m just me again and that is the best feeling ever.”

Participate in clinical trials

Volunteers always are needed to assist researchers solve health problems. Even if you do not have a health concern, you can be part of clinical trial research at UofL and at research institutions around the nation by registering at UofL.me/researchmatch. This nationwide database allows anyone to take part in important health research. Learn more by registering today.

To learn more about cancer clinical trials, visit the UofL James Graham Brown Cancer Center’s clinical trials page.

A half-million-dollar gift to the laboratory of University of Louisville cardiologist Andrew DeFilippis, M.D., by the late James Ryan will aid in research into biomarkers for cardiovascular disease.

The $500,000 gift to the Division of Cardiovascular Medicine at the UofL School of Medicine establishes the James Ryan Fund for Cardiovascular Biomarker Research. Ryan pledged the gift before he passed away at age 81 in 2018.

“Thanks to Jim, we can help physicians everywhere in diagnosing what is one of the most common causes of death in the world,” DeFilippis said. “He was always interested in others and what their dreams were, their goals in life, their happiness and how he could help.”

The fund will support annual operating expenses for the research led by DeFilippis, who is director of Cardiovascular Disease Prevention and an associate professor in cardiovascular medicine at UofL. DeFilippis is an expert in cardiovascular diseases and cardiac intensive care. His research focuses on cardiovascular risk prediction and the identification of biomarkers that will allow physicians to diagnose the cause of different types of heart attacks, also called myocardial infarction.

A heart attack is death of heart muscle. There are many causes, including the most well-recognized that occurs when one of the heart’s coronary arteries is suddenly blocked or has very slow blood flow secondary to the formation of a blood clot.

Atherosclerotic cardiovascular disease progresses over time, allowing time for screening and early detection. Advances in biomarker research and other developments have led to more sensitive screening methods and a greater emphasis on early detection and diagnosis.

“We’re working to develop biomarkers that will allow clinicians to differentiate among the many different types of heart attacks that can occur,” DeFilippis said. “Not all are the same, and even in the medical community that’s not always given much thought. But if we can differentiate, it will help us better treat patients, allowing us to limit or stop heart damage.”

A biomarker is a biological characteristic that can be measured and evaluated as an indicator of normal biological or pathological processes or a response to a therapeutic intervention. Examples include patterns of gene expression, levels of a particular protein in body fluids or changes in electrical activity in the heart.

Ryan, an active philanthropist and retired insurance executive, suffered from a heart condition himself. A native of Pittsburgh who graduated from UofL and lived most of his life in Louisville, he was on a quest to ensure his estate went to good use. He and DeFilippis forged a friendship through their activities with the American Heart Association. He visited DeFilippis’ lab within the Division of Cardiovascular Medicine several times, even bringing a group of friends.

“He was really involved – he was more than a donor,” DeFilippis said. “He gave advice and offered assistance in business, enabling us to partner with industry to bring our discoveries to market. We really enjoyed his company. The two of us went to lunch several times and talked about lots of things – the lab, his struggles with congestive heart failure and his bucket list. He had a great sense of humor.

“He was an extraordinarily happy man with a deep voice that was very distinctive,” DeFilippis said. “We will certainly miss his presence and his inspiring words about the work we were doing. We take it as a tremendous compliment that he chose to donate to us. Jim was looking for a quality program, great ideas and things that really make sense to improve the health of world.”

DeFilippis and one of his colleagues, Patrick Trainor, Ph.D., recently were invited editorialists for a new study published in the Annals of Internal Medicine that indicates current risk calculators for heart attack and stroke can sometimes be wrong, significantly overestimating some people’s risk while underestimating others' risk. As a result, many people may be unnecessarily taking medication to control risk factors such as high cholesterol and high blood pressure, and others may not be getting enough treatment. The researchers developed a new risk calculation method with a more sophisticated statistical model and newer population data, suggesting it could be more accurate.

To demonstrate the kinds of careers available to women in the science, technology, engineering, mathematics and health (STEM+H) fields, the University of Louisville is hosting its first Girls Rule STEM+H Summit event, Saturday, April 6.

More than 150 girls and young women ages 8-18 are registered to attend the 9 a.m.-2 p.m. event at the Belknap Academic Building. While the 3^rd to 12^th-grade students participate in hands-on workshops and activities, accompanying adults will be offered information sessions on how to prepare for higher education and careers in STEM+H.

Among the workshops, all taught by UofL students and faculty, will be robotics, medicine and genetics.

While UofL has hosted STEM introductory events for girls in past years, 2019 marks the first year health education and careers will be included. The event is co-sponsored by the J.B. Speed School of Engineering, the School of Medicine and the UofL Army ROTC program.

 “We are delighted to once again open our doors and show girls and women the variety of careers in these exciting areas,” said Emmanuel G. Collins, dean of the Speed School. “These careers of the future need more women and under-represented minorities and we hope to inspire by example.”

A short informational video can be found here.

For further information, contact Kari Donahue, 502-852-6279, kari.donahue@louisville.edu.

We’ve all been there. Perhaps you have a mild sore throat and cough on Friday but by Saturday afternoon the cough has worsened. Or you wake up in the middle of the night with extreme nausea and a high fever. What is the most appropriate place to receive care in the most timely manner? 

Primary Care Providers

One of the best ways to care for your own health is to establish a primary care provider (PCP), says Ashley Iles M.D., assistant professor in the University of Louisville Department of Family and Geriatric Medicine and a physician with UofL Physicians Centers for Primary Care at Cardinal Station.

“Primary care refers to medical care given by a provider - physician, nurse practitioner or physician’s assistant. This is the first point of contact for patients’ non-emergent symptoms, disease management and health concerns. 

“For an acute illness like a sinus infection or earache that comes on suddenly during the week, a primary care provider should be your first point of contact,” she said. 

PCPs also encompass preventative types of care including cancer screening, vaccinations, health maintenance exams and patient education. 

“Think of your PCP facility as your medical home,” Iles said. 

Urgent or Immediate Care

An urgent care or immediate care center, however, may be the best option for after hours for worsening acute illness or injuries like mild sprains. These facilities may have an X-ray machine and the ability to perform some lab tests on-the-spot. 

“Think episodic care for urgent care centers,” Iles said. “If you need non-emergency care at a time when you can’t get to your primary care provider, these are good alternatives.” 

But Iles says patients should understand that urgent care facilities don’t keep track of their medical problems, prescriptions or visits the way a primary care provider would. 

“Be sure to follow-up with your primary care provider if you’ve gone to immediate care so they can update your medical records,” Iles. 

Emergency Care

Emergency rooms should be reserved for life-threatening conditions or injuries that could result in serious complications if not immediately addressed, says Adam Ross, M.D., medical director of UofL’s Department of Emergency Medicine.

National statistics indicate that between 5.5 – 8 percent of ER visits are non-urgent.

“However, as you can imagine, someone may come in with chest pain, concerned about a heart attack, and after a workup in the emergency room (EKG, chest x-ray, blood tests, etc.), it’s determined their pain was from GERD or heartburn” Ross said. “While their diagnosis is not an emergent one, the symptom they presented with certainly is.”  

It is better to be safe than sorry, says Ross.

“Always go to the ER when you feel life or limb are at risk: chest pain, shortness of breath, severe headache, weakness, numbness or speech difficulty, severe cuts, excessive bleeding, broken bones or other symptoms with which you are emergently concerned,” he said.

Call 9-1-1 if you are experiencing what seems to be a life-threatening condition. Otherwise, patients can often call their medical insurance company hotlines to speak with an on-call providers that can give advice on what to do. UofL Centers for Primary Care at Cardinal Station can often see patients for acute illnesses or minor injuries the same week. Make an appointment by calling 502-588-8700. An on-call doctor is available to answer urgent medical questions after hours.

About UofL Centers for Primary Care at Cardinal Station

Located at 215 Central Ave. in Louisville, UofL Centers for Primary Care at Cardinal Station offer a full range of primary care services including acute illness visits, annual health maintenance visits, cancer screenings, STI screenings and vaccinations for both children and adults of any age. Additionally, the centers have a wide range of women’s health services including appropriate annual screenings and all types of non-surgical birth control including implantable devices. The office also is home to multiple Sports Medicine specialists who can offer on-site x-rays, acute injury management, chronic conditions management, physical therapy referrals and joint injections. For information and appointments, call 502-588-8700.

The UofL School of Medicine Disaster Medicine Certificate Series will hold an Active Shooter Disaster Drill on the Health Sciences Center campus from 6 a.m. to 3 p.m., Saturday, March 30.

This will be a live-action (not tabletop) drill, complete with actors portraying both perpetrators and victims, and visual, sound and other effects to simulate reality.  The location will be the Instructional Building and the HSC Plaza, 500 S. Preston St. The second floor of Kornhauser Library will be open.

Due to the large-scale nature of this drill, bystanders may hear simulated gunshots or explosions, and see a large police presence on campus. Bystanders should not be alarmed, and should not call 911 as this is only a drill.

In order for this drill to be safe and effective, the number of people on campus must be minimized. If anyone does not have to be on the HSC campus on March 30, please avoid the area.

For additional information, contact Madison Kommor, madison.kommor@louisville.edu, or Jill Scoggins, jill.scoggins@louisville.edu. 

Michael Snyder, a pioneer in the use of big data in biomedical research, will give a free public lecture at the University of Louisville Health Sciences Center on Monday, March 25.

Snyder’s talk, “Big Data and Health,” will take place at noon in room 101-102 at the Kosair Charities Clinical & Translational Research Building, 505 S. Hancock St. Snyder will focus on how information in large databases, or big data, can be used to develop improved and more individualized approaches to predicting, diagnosing and treating common diseases. 

The lecture is sponsored by the Department of Biochemistry and Molecular Genetics at the UofL School of Medicine. For more information, contact Janice Ellwanger at 502-852-5217 or David Samuelson at 502-852-7797.

Snyder, Ph.D., is an international leader in the fields of functional genomics and proteomics and is the director of the Center of Genomics and Personalized Medicine at Stanford University, where he is the Stanford W. Ascherman Professor and Chair of Genetics.

He wrote “Genomics & Personalized Medicine: What Everyone Needs to Know,” a book that explores the prospects and realities of genomics and personalized medicine for consumers. He was a key participant in the Encyclopedia of DNA Elements (ENCODE) project, which identified functional elements in the human genome.

Snyder’s research group was the first to perform a large-scale functional genomics project in any organism. Genomics is a branch of molecular biology that focuses on the structure, function, evolution and mapping of genomes in an organism’s complete set of DNA.

The Snyder Lab has made several groundbreaking findings, including the discovery that much more of the human genome is either transcribed or contains regulatory elements than previously known, and that a high diversity of binding of transcription factors – gene products that participate in regulating what genes are active – occurs between and within species.

Snyder also has combined different advanced “omics” technologies to perform the first longitudinal Integrative Personal Omics Profile (iPOP) of an individual and used the information to assess disease risk and monitor disease states for personalized medicine. He co-founded several biotechnology companies, including Protometrix (now part of Life Technologies), Affomix (now part of Illumina), Excelix, Personalis and Q Bio.

Snyder received his Ph.D. at the California Institute of Technology and postdoctoral training at Stanford University.

Fourth-year medical students now begin the process of planning where they will live and other logistics associated with a move to a new place. Most of the nearly 150 Class of 2019 students recently learned where they’ll complete the next three to seven years of residency training.

Each year, medical students throughout the United States receive their written match notices precisely at noon on the third Friday of March – Match Day. UofL medical students experienced a 97-percent match rate, with 42 percent going into primary care.

The National Resident Matching Program provides a uniform process for matching medical school applicants with residency programs based on the preferences of both. A matching algorithm uses those preferences to match individuals into positions.

Ethan Tomlinson already knew what was in his envelope because of a separate military match program, but he was excited to join his classmates in the Match Day celebration on Friday.

“The true beauty of my medical school experience is the friendships; those relationships and memories are what made the tough times better and the journey worthwhile,” he said.

Tomlinson, who also earned two undergraduate degrees at UofL, will continue his medical training in Internal Medicine as a captain in the U. S. Air Force at Brooke Army Medical Center, Fort Sam Houston in San Antonio.

A native of Louisville, Tomlinson has a family history of military service, including his grandfather who served in the Marines and an uncle who was a fighter pilot in the Air Force.

Although Tomlinson had no military experience prior to medical school, he was accepted into the Health Professions Scholarship Program, where students agree to serve as a military physician in exchange for a full tuition scholarship and monthly stipend. He then joined the Air Force, and went on to complete Commissioned Officer Training and a course in Aerospace Medicine.

Ian Bastian of Madisonville, Ky., also completed medical school through the Health Professions Scholarship Program.

“I have enjoyed my medical school rotations at military treatment facilities,” said Bastian, a second lieutenant in the Army. “Treating soldiers and their families is a rewarding experience, and I look forward to continuing it during residency.”

Bastian will go to Madigan Army Medical Center located on Joint Base Lewis-McChord just south of Tacoma, Wash., for neurology residency training.

“My first encounter with a patient in the neurology clinic at the end of my first year was perhaps the most memorable aspect of medical school,” Bastian said. “Prior to that patient evaluation, I had not considered neurology as a career choice - it was that experience that led me into the neurology specialty.”

Both Tomlinson and Bastian say they are excited about the next step in their educational journeys.

 “I don’t know where my future might take me, but I hope to return to Louisville one day because I love my city. It will always be my first home,” Tomlinson said.

Watch the video from Match Day 2019

A new public health campaign is highlighting the need for education and awareness on antibiotic overuse in Kentucky, the state with the highest rate of antibiotic use in the United States.

Although antibiotics are important life-saving drugs that treat bacterial infections – including strep throat and urinary tract infections – their overuse can lead to drug resistance, which occurs when antibiotics no longer cure infections that they should treat, said Bethany Wattles, Pharm.D., clinical pharmacist in the Department of Pediatrics at the University of Louisville School of Medicine.

Kentucky Antibiotic Awareness (KAA), a statewide campaign to reduce inappropriate antibiotic use, is led by health professional researchers at the UofL Department of Pediatrics Antimicrobial Stewardship Program with collaboration and financial support from the Kentucky Cabinet for Health and Family Services Department of Medicaid Services. The campaign provides education and resources to Kentucky health care providers and the public.

“If we continue to overuse antibiotics, even minor infections will become untreatable. This is a serious public health threat,” Wattles said. “To combat the spread of antibiotic resistance, we must use antibiotics only when necessary.”

Examining antibiotic prescriptions for Kentucky children on Medicaid, researchers found that the rate of antibiotic use has been especially high in Eastern Kentucky. In some areas, children are receiving three-times more antibiotic prescriptions than the national average, Wattles said.

Antibiotics are most frequently used for upper respiratory infections, many of which are caused by viruses that antibiotics do not kill.

The majority of antibiotic prescribing is done in outpatient settings, which include medical offices, urgent care facilities, retail clinics and emergency departments. An estimated 30 to 50 percent of this antibiotic use is considered inappropriate, Wattles said.

When antibiotics are prescribed, it is important to take them as instructed; do not share the medicine with others or save for later use.

To learn more, visit the KAA website and follow the campaign on Facebook and Twitter. Health care providers are also encouraged to join the KAA Listserv for newsletter updates, or email KYAntibx@louisville.edu with questions and suggestions.

Disclaimer: This project was supported by the following: Kentucky Cabinet for Health and Family Services: Department for Medicaid Services under the State University Partnership contract titled “Improving Care Quality for Children Receiving Kentucky Medicaid”, Norton Children’s Hospital, and the University of Louisville School of Medicine, Department of Pediatrics; School of Public Health and Information Sciences. This content is solely the responsibility of the authors and does not necessarily represent the official views of the Cabinet for Health and Family Services, Department for Medicaid Services.