Two brothers are working together to ensure that patients at the University of Louisville James Graham Brown Cancer Center have a happy Thanksgiving.

Alex and Tommy Gift lost their mother to a 20-plus year battle with cancer in 2010. In her memory, they established the Mary Jane Gift Quality of Life Fund at the cancer center in 2013.

Cancer treatment can be costly and leave many families with little resources during the holidays. The fund helps patients and their families enjoy life while facing a cancer diagnosis.

On Wednesday, Nov. 23, the brothers will distribute turkeys to more than 100 patients at the cancer center in memory of their mother. This will be the fourth annual turkey distribution sponsored by the Gift brothers.

“We experienced how cancer treatment can impact a family throughout my mother’s illness,” said Alex Gift. “Establishing this fund in her memory is our way of giving back to those who supported us and helping improve the lives of others battling cancer.”

As they have every year for the past 11 years, future providers throughout health care disciplines dedicated a day to improving their ability to provide health care to all patients – especially those with perhaps different backgrounds and experiences than their own. At the 2016 Culturally Effective Care Symposium, nearly 550 students learned about working with colleagues from different disciplines to improve health equity for patients and populations and participated in discussions on LGBT health and barriers to health care faced by immigrants and refugees. The day-long event, “Health Equity through Interprofessional Practice,” was coordinated by the University of Louisville Health Sciences Center Office of Diversity and Inclusion.

Previously known as Cultural Competency Day, the event was renamed this year to more accurately reflect its mission.

“Through one day events no one becomes ‘fully competent’ about any culture, including their own, so the name did not reflect the true purpose of the program,” said Ryan Simpson, assistant director of the UofL HSC Office of Diversity and Inclusion. “In these symposiums we are trying to provide participants foundational experiences in culturally effective care to equip future health professionals in achieving optimal patient care. Our planning committee renamed it the ‘Culturally Effective Care Symposium’ to better represent what we are there to achieve.”

Students from all four UofL Health Sciences Center schools, as well as the Sullivan University College of Pharmacy, and UofL Kent School of Social Work participated in the symposium, held at the Kentucky Center for African American Heritage (KCAAH) in Louisville. Participants included students and residents in nursing, dentistry, dental hygiene, speech pathology, pharmacy, social work, public health and medicine.

UofL’s Patricia Allen Cultural Competency Day was first held in 2006, the result of efforts by V. Faye Jones, M.D., Ph.D., assistant vice president for health affairs – diversity initiatives, and Patricia Allen, administrative associate for the Area Health Education Center (AHEC) program office at UofL, to improve cultural understanding of UofL Health Sciences Center students. The event is named for Allen, who helped lay the groundwork and planning for the event.

Nov. 17, 2016

• For women age 40 and over
• No cost to women without insurance
• Advance appointments required by calling 502-776-1177

• Take-home stool test (FIT Kits)
• For all men and women age 50 and over
• For African-American men and women age 45 and over
• No appointment needed

Blood pressure checks, health insurance information and free gifts

For additional information, contact Janikaa Sherrod, Kentucky Cancer Program, 502-852-6318, janikaa.sherrod@louisville.edu.

For patients with severe heart failure, a heart transplant or permanent artificial heart assist device have been considered the only permanent therapy as severe heart failure was not known to be reversible. However, a new study, led by Emma J. Birks, M.B.B.S., Ph.D., professor at the University of Louisville School of Medicine, is showing that an artificial heart assist device along with medications may actually help heal the heart, avoiding the need for a heart transplant and allowing for the removal of the device.

Birks presented preliminary results of the study at the American Heart Association’s Scientific Sessions this weekend in New Orleans, showing more than 40 percent of advanced heart failure patients treated with a combination of an artificial heart assist device, called a left ventricular assist device (LVAD), and intensive drug therapy have recovered their heart function enough to allow removal of the LVAD device.

The multicenter trial called RESTAGE, includes 40 patients at six different centers (including Jewish Hospital, a part of KentuckyOne Health) with very advanced or end stage heart failure implanted with an LVAD (HeartMate II) pump, 36 of whom were considered evaluable, and prescribed an aggressive combination of drugs (Lisinopril 40 mg, spironolactone 25 mg, digoxin 125 mic, losartan 150 mg daily and coreg 25 mg bid). All of the patients were so disabled from heart failure that the initial intent with the LVAD was to use it until they could receive a heart transplant or to leave the device in for the rest of their lives.

“This suggests that even very advanced heart failure can be reversed using these heart pumps, particularly when combined with additional drug therapy, avoiding the need for heart transplantation for these patients and making the donor heart available for another needy individual,” Birks said.

Researchers tested the 36 patients’ heart function to determine if their heart function had improved enough from the therapy to have the pumps removed, or if their heart function remained poor and needed a heart transplant or to remain on the pump. Sixteen patients receiving the combination therapy had recovered enough heart function (after an average of 330 days) to have the pump removed.

“The fact that this could be done in several centers suggests that using the device with this drug combination to reverse heart failure is possible on a larger scale. It has previously been thought that these devices rarely recover heart function enough to allow them to be removed, but this study suggests that this can occur in a much bigger number than originally thought, particularly if combined with drug therapy,” Birks said.

“The next step, we hope, is for more centers to start doing this and then to see if we can potentially add other drugs to further optimize recovery and create a good platform to recover heart function.”

Aaron W. McGee, Ph.D., assistant professor at the University of Louisville School of Medicine, has received the Disney Award for Amblyopia Research in the amount of $100,000 from Research to Prevent Blindness (RPB). McGee will use the award to investigate approaches for improving recovery from amblyopia, or “lazy eye.”

Established in 2002, the RPB Walt and Lilly Disney Award for Amblyopia Research is intended to stimulate, strengthen and promote research to improve the diagnosis and treatment of amblyopia. The grant is offered to exceptional ophthalmic scientists – M.D.s or Ph.D.s – with research pursuits of potential significance and promise. McGee is one of two scientists to receive the award in 2016.

“Dr. McGee’s funding from RPB addresses a major cause of blindness in children – namely, amblyopia. The potential to reverse ‘lazy eye’ through medical therapy would be a major advance in curing childhood visual disabilities and improve the quality of life for those affected. His research is exciting and has major potential translational clinical impact,” said Henry Kaplan, M.D., chair of the UofL Department of Ophthalmology and Visual Sciences.

Amblyopia occurs in 2-3 percent of children and presents with a number of impairments in spatial vision including stereopsis, or depth perception. Permanent visual deficits may result if amblyopia is not treated during a ‘critical period’ for development of the visual system that ends in early adolescence. The funded research builds on McGee’s previous work investigating how the timing and duration of critical periods in the visual system are determined. McGee will test methods for reversing the loss of depth perception resulting from amblyopia by ‘re-opening’ the critical period in adulthood to enhance the flexibility, or ‘plasticity,’ of brain circuitry.

“Previously, we discovered that a gene encoding a neuronal receptor is essential for closing the critical period for visual plasticity,” McGee said. “This award from RPB will enable my lab to explore whether neutralizing this receptor will improve depth perception in the murine model of amblyopia.”

McGee moved from the University of Southern California to join the UofL Department of Ophthalmology and Visual Sciences and Department of Anatomical Sciences and Neurobiology in September 2016. The goals of his research program are to identify treatments for low vision and aberrant eye dominance by understanding critical periods for neural plasticity and how experience drives changes in brain function.

The Disney Award for Amblyopia Research is a two-year award to help the awardee pursue promising scientific leads and take opportunities for which other funds are not readily available. RPB is the world’s leading voluntary organization supporting eye research. Since it was founded in 1960, RPB has provided hundreds of millions of dollars to support research into blinding eye diseases by medical institutions throughout the United States. For information on RPB, RPB-funded research, eye disorders and the RPB Grants Program, go to www.rpbusa.org.

November 14, 2016

University of Louisville School of Medicine faculty and staff will deliver four presentations at the annual meeting of the Association of American Medical Colleges (AAMC) beginning today in Seattle. At Learn Serve Lead 2016, UofL faculty and staff will share with other educators from medical schools around the nation their research conducted as part of developing medical education curricula.

The 2016 conference, which runs Nov. 11-15, brings deans, faculty, researchers, administrators, residents and students from medical schools across the United States and Canada together to network and share insights on academic medicine.

“Presentation of these scholarly educational works at the AAMC meeting affirms the knowledge and talent of our outstanding faculty and staff in developing curriculum,” said Toni Ganzel, M.D., M.B.A., dean of the UofL School of Medicine. “The innovations presented here will help advance medical education in institutions across the nation.”

Three of the four research presentations selected for the conference stem from the eQuality Project at UofL, which is developing and incorporating curriculum related to health care for individuals who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming or born with differences of sex development (DSD). UofL is serving as the nation’s pilot for implementing competencies for LGBT-DSD care published by the AAMC in 2014.

An oral presentation, “Baseline Bias:  Implicit Attitudes of First Year Medical Students Prior to a Health Equity Curriculum Intervention,” is co-authored by Katie Leslie, Ph.D., V. Faye Jones, M.D., Ph.D., Ryan Simpson, M.D.A., Susan Sawning, M.S.S.W., Leslee Martin, M.A., M. Ann Shaw, M.D., M.A., vice dean for undergraduate medical education, and Stacie Steinbock, M.Ed., director of the LGBT Center HSC Satellite Office. The presentation, scheduled for Saturday, Nov. 12 beginning at 10:30 a.m., assesses attitudes toward sexuality, race and weight among first and second-year medical students before and after debriefing sessions on mitigating implicit bias.

A related poster presentation addresses undergraduate medical students’ attitudes and knowledge about LGBT patient care. The poster was selected for a special presentation session on Monday, Nov. 14 at 6 p.m. Sawning, Martin, Steinbock, Amy Holthouser, M.D., Emily Noonan, M.A., Jones, Leslie and Shaw will present the poster.

A third poster presentation resulting from the eQuality Project describes initiatives to engage the transgender community to inform curriculum and prioritize initiatives via a community forum on transgender care. The work is presented by Noonan, Sawning, Ryan Combs, Ph.D., Steinbock, Holthouser, Martin and Shaw.

The fourth presentation examines challenges and opportunities in developing and assessing emotional intelligence in medical education and training. The presenting team includes medical educators from Vanderbilt University, Withrop University in N.Y., Florida International University, along with Sawning, UofL’s director of undergraduate medical education research.

The four presentations for this year’s conference double the number of presentations accepted in 2015. UofL faculty had two oral presentations accepted in 2015.

In addition to the scholarly presentations, UofL faculty will assume leadership roles with the AAMC. Karen Hughes Miller, Ph.D., associate professor of graduate medical education, is incoming chair for the AAMC Research in Medical Education (RIME) Program Planning Committee. Miller also is chair elect for 2017 of the Southern Group on Educational Affairs (SGEA), a regional subgroup of the AAMC. Miller and Sara Petruska, M.D., assistant professor at UofL, will host roundtable luncheon discussions on Saturday, Nov. 12 on preparing residents for scholarly activity and interprofessional education in core clerkships.

Lori Wagner, M.D., M.A., has been elected to the national steering committee for the AAMC Group on Women in Medicine and Science (G-WIMS). Wagner founded the Louisville Women in Medicine and Science (L-WIMS) Chapter in 2015.

November 11, 2016

Thanks to a donation from the Institute for Sustainable Health & Optimal Aging at the University of Louisville, the $25 application fee for an “End Alz” license plate will be waived for the remaining applications needed to reach the required 900 for issuance of plates. This limited opportunity is available on a first-come, first-serve basis to constituents throughout Kentucky.

“The Institute for Sustainable Health & Optimal Aging is honored to be able to support the Alzheimer’s Association and all Kentuckians who have been touched by Alzheimer’s disease. We believe that this license is a powerful symbol of our enduring love for those affected by Alzheimer’s, our unwavering support for their family members, and our commitment to working with our communities and the Alzheimer’s Association to end Alzheimer’s,” said Dr. Anna Faul, Executive Director of the Institute.  

The Alzheimer’s Kentucky specialty license plate features a “forget-me-not” flower on a purple background with the words: “Honor. Remember. Care. End Alzheimer’s.” It is an eye-catching design and phrase capturing both the hope and devastation of this disease.  “The Alzheimer’s Association is grateful to the Institute for Sustainable Health & Optimal Aging for understanding the value of helping to finalize this stage of the initiative.  Getting the End Alz plate on the roads of Kentucky has been a labor of love for the Association.  This awareness will shine an even brighter light on the impact of this disease for affected individuals and families as well as the vital need to find effective prevention, treatment and cure,” said Bari Lewis, Director of Community Outreach for the Association. 

Alzheimer’s affects 70,000 Kentuckians and over 5 million people nationwide.  There are over 270,000 Alzheimer’s family caregivers in Kentucky.  Every 67 seconds, someone in America develops Alzheimer’s and the number of people with Alzheimer’s is projected to triple by 2050.

Alzheimer’s is the sixth leading cause of death in the United States, the fifth for people over 65.  Research has not yet found a way to stop or reverse this disease. As many as half of people with dementia have never received a diagnosis, yet they could benefit from a variety of available medical and support services.

It is a disease that touches virtually everyone – including Faul. Her own father, the Rev. Japie Vermeulen of Ceres, South Africa, recently died after a 16-year battle with the disease.

“My education and training as a social worker specializing in older adults gave me knowledge about the hardship families endure when caring for a loved one with Alzheimer’s,” Faul said. “It was caring for my own father, however, that showed me the emotional burden this dreaded disease takes on both caregivers and the patients themselves.”

In order to receive a plate, constituents should fill out the application form located on alz.org/kyin and return to Alzheimer’s Association, 6100 Dutchman’s Lane, Suite 401, Louisville, KY 40205 or email to infoky-in@alz.org. Applicants will be notified by their local county clerk when plates are ready to be picked up. Plates will be available approximately three months after the 900 commitments are secured.

About the Alzheimer’s Association

The Alzheimer’s Association is the world’s leading voluntary health organization in Alzheimer’s research, care and support. Our mission is to eliminate Alzheimer’s disease through advancement of research, to provide and enhance care and support for all affected, and to reduce the risk of dementia through the promotion of brain health. For more information, visit www.alz.org/kyin.

The National Heart, Lung and Blood Institute (NHLBI) of the National Institutes of Health (NIH) recently announced a strategic vision of eight objectives that provide the framework for the institute’s research priorities for the coming decade.

Gary H. Gibbons, M.D., director of the NHLBI, will discuss that vision in the 24^th Leonard Leight Lecture at the University of Louisville on Friday, Nov. 4, at noon in the HSC Auditorium. In his talk, “Charting our future together:  Setting an agenda for the NHLBI,” Gibbons will outline the priorities set out in the vision, which support the NHLBI’s goals to understand and promote health, stimulate discoveries in the causes of disease, enable the translation of those discoveries into clinical practice and foster the next generation of scientists and physicians.

“The convergence of innovations in areas such as computational biology, data science, bioengineering and high-throughput ‘omics’ technologies is paving the way for a new appreciation of human health and disease,” Gibbons said as the institute published the NHLBI’s Strategic Vision in August. “We now have unprecedented opportunities to better understand the complex interplay of environmental, behavioral and molecular factors that promote health; a clearer picture of the earliest point of disease development; and the ability to repair damaged tissues with stem cell and tissue engineering techniques.”

The NHLBI provides global leadership for research, training and education programs to promote the prevention and treatment of heart, lung and blood diseases and enhance the health of all individuals so that they can live longer and more fulfilling lives.

The 24^th Leonard Leight Lecture is scheduled for Friday, Nov. 4, 2016, noon - 1 p.m. in the HSC Auditorium in Kornhauser Library on the UofL Health Sciences Center Campus.

The Leonard Leight Lecture is presented by the Division of Cardiovascular Medicine in the Department of Medicine at the UofL 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.

Gibbons is the second director of a National Institute to speak at UofL in three weeks. On Oct. 14, Linda S. Birnbaum, Ph.D., director of the National Institute of Environmental Health Sciences and the National Toxicology Program, discussed environmental research and the role of the NIEHS in human health at UofL as the keynote speaker of Research!Louisville.

Andrew N. Bankston, Ph.D., a postdoctoral fellow at the University of Louisville, has been elected to the board of directors for the National Postdoctoral Association (NPA). His three-year term of service begins Jan. 1, 2017.

The NPA is a national educational association created to advance research and serve as a national voice for postdoctoral scholars. Founded in 2003, the NPA serves more than 3,400 individual members and 200 institutional members of the postdoctoral community. A “postdoc” is an individual who has received a doctoral (Ph.D.) degree and is employed in a temporary research position for the purpose of gaining additional experience that will lead to an independent academic research or faculty position.

Bankston is a postdoctoral research fellow in the lab of Scott Whittemore, Ph.D., scientific director of the Kentucky Spinal Cord Injury Research Center at UofL. Bankston’s research at UofL focuses on the role of autophagy, or selective degradation of cell components, in developmental myelination and myelin repair after injury. Myelin is the insulating material surrounding nerve fibers. Bankston earned his doctorate in biochemistry, cell and developmental biology from Emory University in 2013.

Bankston, one of four newly elected board members for NPA, served as chair of the NPA Outreach Committee beginning in February 2015. At UofL, he is a member of the postdoctoral advisory board and a member of the planning committee for the Career Research Advancement Focused Training (CRAFT) seminar series, which hosts speakers to provide information on potential career options for postdoctoral fellows and graduate students. In addition, Bankston is a volunteer leader and member of event planning committees within the local chapter of the National Multiple Sclerosis Society.

October 31, 2016

From bees to birds to bats, species around the world are threatened at unprecedented rates. Many people feel powerless to help preserve local species because they think “real” nature can only be sustained in parks and reserves, but local urban park systems cannot do the job of maintaining native biodiversity alone.

About 120 square miles of plantable land in Jefferson County is residential property. However, much of this green space is planted in lawn, which is a food desert for many species of wildlife.

At the next Beer with a Scientist, Margaret Carreiro, Ph.D., will explain how residents in cities and suburbs can protect native species by weaving local nature into the very places where they live and work. She will describe Reconciliation Ecology, a concept in which habitats for wildlife are created within urban and suburban areas.

“I want people to know they can make a large difference in conservation of local species through their plantings at home,” Carreiro said. “They can use native plants to create food webs and friendly habitat for desired species, especially pollinators and birds. It's about keeping our common species common.”

Carreiro is associate professor in the Department of Biology at the University of Louisville. Her work focuses on understanding how urban environments interact with natural components of cities and suburbs. This includes studying the effects of atmospheric nitrogen from fossil fuel combustion and other sources, invasive species, habitat fragmentation, restoration management and socio-cultural legacies in affecting plant and soil communities and ecosystem processes.

The event begins at 8 p.m. onWednesday, Nov. 16, at Against the Grain Brewery, 401 E. Main St. in Louisville. A 30-minute presentation will be followed by an informal Q&A session.

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

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

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

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

November 7, 2016

For the final Optimal Aging Lecture for the fall semester, the Institute for Sustainable Health & Optimal Aging and the UofL Alumni Association present a panel discussion entitled “Expanded Medicare: A Single Payer Alternative.” This lecture will unpack the myths and realities of developing a national health insurance program. The lecture will be held on Nov. 9 from 11:30 a.m. – 1 p.m. at the University Club, 200 E. Brandeis Ave.

The panel presenters for this exploration of available health care options are Syed Quadri, M.D., Kay Tillow and Edgar Lopez, M.D., all from the national organization Physicians for a National Health Program. The PNHP is a non-profit research and education organization consisting of 20,000 physicians, medial students and other health professionals who support single-payer national health insurance.

The panelists will discuss their common belief that too many working individuals are unable to afford health care. In addition to their roles with PNHP, the speakers are Kentucky-based professionals with expertise and experience in the state’s health system. Quadri is the co-medical director of the Hardin County Free Clinic in Elizabethtown. Tillow is the coordinator of the All Unions Committee for Single Payer Health Care, a Kentucky advocacy organization. Lopez is a Louisville-based plastic and reconstructive surgeon. 

Admission is $30 per person and includes lunch. Reservations are required online. Click here to register. For information, call 502-852-5629 or email OptimalAging@louisville.edu.

Thanks to advances in medical science and a highly developed network of specialized pediatric health care services, people with intellectual and developmental disabilities (IDD) are much more likely to live into adulthood than they were several decades ago. However, once they reach age 18, they may find a limited number of providers available to address their unique and specialized health care needs.

To improve access to quality health care for adults with IDD, the University of Louisville School of Medicine, UofL School of Dentistry and the Lee Specialty Clinic are sponsoring the Second Annual Caring for Adults with Intellectual and Developmental Disabilities Conference on Saturday, Nov. 12 at UofL. The conference will inform physical, occupational and speech therapists, physicians, dentists, social workers, patients and their caregivers about best current practices and future treatment directions for adults with IDD and address the multidisciplinary approach needed for their care.

“These are individuals with neurologically based conditions who require interdisciplinary care from a variety of health care providers, including primary care, dentistry, cardiology, pulmonary, neurology, psychiatry and psychology, as well as physical therapy, speech therapy and occupational therapy,” said Michael Sowell, M.D., professor in the Department of Neurology at UofL and co-director of the conference.

One such individual is Steven Haburne, described by his mother as, “a 41-year-old man with a pleasant personality who was born with spastic quadriplegic cerebral palsy and developmental disability.” He moves in a wheelchair, is non-verbal and has a seizure disorder. Haburne’s mother, Shirley Haburne, said they have met with physicians over the years who did not speak to Steven directly or who made assumptions about his condition without listening to Shirley’s description of his individual needs. When Haburne was very young, his family’s dentist told Shirley he was not comfortable treating Steven.

“It did hurt my feelings, but I understand. He is not the same as other patients,” Shirley said. “It has taken a lifetime of finding doctors. It takes time to find a doctor who will listen to you and trust what you say.”

Steven now receives dental care at Lee Specialty Clinic in Louisville, which offers medical, dental, psychiatric and general health care services for patients with IDD, and he receives medical care from several specialists at University of Louisville Physicians. Shirley hopes the conference will help make optimal health care available for her son and others with IDD.

The conference will cover autism outreach, mobility and assistive technology, cognitive decline, advocacy for adults with IDD, and understanding the barriers in transitioning a child with neurodevelopmental disabilities into the adult provider network. Afternoon breakout sessions include topics in medicine, dentistry, developmental psychiatry and psychology, therapeutics and social work and are designed to stimulate discussions among health care providers, patients and their families that will lead to an improved standard of care in the region.

The event also is designed to support the physician specialty of adult developmental medicine.

“Developmental medicine as an emerging specialty pulls together a formal curriculum and training pathway to prepare physicians to provide the comprehensive care that these individuals need,” Sowell said. Learn more about this specialty at the American Academy of Developmental Medicine and Dentistry.

CONFERENCE DETAILS:  The Second Annual Caring for Adults with Intellectual and Developmental Disabilities (IDD) Conference is scheduled for Saturday, Nov. 12, from 8 a.m. to 3 p.m. at the UofL School of Medicine, Instructional Building B - Room 115, 500 S. Preston St., Louisville, Ky. Continuing education credit is available. Register for the conference at http://louisville.edu/medicine/cme/events/IDD16 or call 502-852-5329.

REMOTE ATTENDANCE: This conference also is available via a LIVE interactive video conference for all persons interested in caring for adult individuals with a diagnosis of an intellectual or a developmental disability. Register in advance of the conference at http://bit.ly/disabilities16.

November 1, 2016

Fine particulate matter air pollution may be associated with blood vessel damage and inflammation among young, healthy adults, according to new research in CirculationResearch, anAmerican Heart Association journal.

“These results substantially expand our understanding about how air pollutioncontributes to cardiovascular disease by showing that exposure is associated with a cascade of adverse effects,” said C. Arden Pope, Ph.D., study lead author and Mary Lou Fulton Professor of Economics at Brigham Young University in Provo, Utah.

“These findings suggest that living in a polluted environment could promote the development of high blood pressure, heart disease and stroke more pervasively and at an earlier stage than previously thought,” said Aruni Bhatnagar, Ph.D., study co-author and the Smith and Lucille Gibson Chair in Medicine at the University of Louisville. “Although we have known for some time that air pollution can trigger heart attacks or strokes in susceptible, high-risk individuals, the finding that it could also affect even seemingly healthy individuals suggests that increased levels of air pollution are of concern to all of us, not just the sick or the elderly.”

Air pollution is known to contribute to cardiovascular disease and related deaths. In 2004, the American Heart Association released a scientific statement, updated in 2010, warning of the risk and recommending that people talk to their doctor about avoiding exposure to air pollution specific to their area. What remained unclear, however, was how air pollution actually affects the blood vessels to increase the risk of disease.

For this study, investigators analyzed the component of air pollution known as fine particulate matter (PM_2.5) — the tiny pieces of solid or liquid pollution emitted from motor vehicles, factories, power plants, fires and smoking. They found that periodic exposure to fine particulate matter was associated with several abnormal changes in the blood that are markers for cardiovascular disease. As air pollution rose, they found:

• small, micro-particles indicating cell injury and death significantly increased in number;

• levels of proteins that inhibit blood vessel growth increased; and

• proteins that signify blood-vessel inflammation also showed significant increases.

Study participants included 72 healthy, nonsmoking, adults in Provo, Utah. Their average age was 23, most were white and more than half were male. During the winters of 2013, 2014 and 2015, participants provided blood samples, which researchers then tested for markers of cardiovascular disease. Due to the unique weather and geographical features of Provo, they were able to evaluate these informative blood markers with various levels of air pollution.

However, researchers noted that the third study year, 2015, was relatively unpolluted, which could have affected the results.

Other co-authors are James P. McCracken, Ph.D.; Wesley Abplanalp, Ph.D.; Daniel J. Conklin, Ph.D.; and Timothy O’Toole, Ph.D., all of UofL. The National Institutes of Health funded the study.

Additional Resources:

• Household air pollution linked to higher risk of heart attacks, death
• High blood pressure linked to short-, long-term exposure to some air pollutants
• Follow AHA/ASA news on Twitter @HeartNews
• For updates and new science from the Circulation: Research journal follow @CircRES

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Spinal cord injury researchers at the University of Louisville pioneered activity-based interventions that have helped individuals with spinal cord injury (SCI) improve mobility. The addition of epidural stimulation to the lumbosacral spinal cord has allowed individuals with SCI to stand without assistance. Susan Harkema, Ph.D., who leads this research at UofL, Claudia Angeli, Ph.D., Enrico Rejc, Ph.D., and Sunil Agrawal, Ph.D., an engineer at Columbia University, have won a $5 million grant to develop a robotic device that will aid individuals with SCI further by helping them regain balance. The Tethered Pelvic Assist Device (TPAD) will provide stimulation and feedback to aid in the recovery of balance, and will be integrated with activity-based training and epidural stimulation research at UofL.

Harkema, Angeli and Rejc, faculty members in the Department of Neurological Surgery at UofL, are working with Agrawal, professor of mechanical engineering and of rehabilitation and regenerative medicine at Columbia Engineering, to develop TPAD. Agrawal specializes in the development of novel robotic devices and interfaces that help patients retrain their movements.

The project has won a five-year, $5 million grant from the New York State Spinal Cord Injury Board. The project also includes Joel Stein, chair of the Department of Rehabilitation and Regenerative Medicine, and Ferne Pomerantz, M.D., assistant professor in that department at Columbia University Medical Center.

TPAD is a wearable, light-weight cable-driven device that can be programmed to provide motion cues to the pelvis and corrective forces to stabilize it. It consists of a pelvic belt with multiple cables connected to motors, a real-time motion capture system, and a real-time controller to regulate the tensions in the cables. The UofL researchers will incorporate the device into the training of SCI patients during standing.

“Our stand and step training, combined with epidural stimulation, have shown success in enabling individuals with SCI regain the ability to stand. We hope the integration of the TPAD device will help these individuals with balance, further improving their functional ability and quality of life,” said Harkema, who also is Director of Research at Frazier Rehab Institute, part of KentuckyOne Health.

In their work with the Kentucky Spinal Cord Injury Research Center (KSCIRC), the UofL researchers have studied the effects of stand and step training along with epidural stimulation in adults with spinal cord injury. Epidural stimulation involves surgically implanting an electrode array over the lower spinal cord to activate the neural circuits.

October 24, 2016

A Jeffersonville, Ind., woman has become the first female hand transplant recipient in Kentucky and the 10th patient to receive a hand transplant from the Louisville Vascularized Composite Allograft (VCA) program, a partnership of physicians, researchers and health care providers from the University of Louisville, Jewish Hospital, part of KentuckyOne Health, the Christine M. Kleinert Institute for Hand and Microsurgery (CMKI) and the Kleinert Kutz Hand Care Center.

During a 17-hour procedure on Sept. 17, Louella Aker underwent a double hand transplant at Jewish Hospital. The 69-year-old acquired an infection while involved in the cleanup of Henryville, Ind., after an EF4 tornado hit the area on March 2, 2012. Aker was later diagnosed with septicemia and underwent a bilateral, below-the-knee amputation on her legs, left forearm amputation, and right partial hand amputation. Aker was added to the organ donor registry in September 2015.

“There are so many things you cannot do without your hands. This will change my life and allow me to do the things I miss, like holding my granddaughter’s hand,” Aker said at a news conference on Oct. 19. “I spent many days praying for a donor, but also crying for the donor’s family for their loss. This is such a huge and exquisite gift they have given me and I thank and bless them for their sacrifice. I also want to thank the surgeons, my family and my church for their support.”

Twenty surgeons from UofL, CMKI and Kleinert Kutz performed the procedure. Fourteen staff members and six anesthesiologists also assisted with the surgery.

“Although a little slow, we are pleased with the progress that Louella has been making,” said Tuna Ozyurekoglu, M.D., lead surgeon on the procedure and assistant clinical professor of orthopedic surgery at UofL. “She is truly a fighter who has continued to grow stronger each day following this surgery. We look forward to watching her return to her normal activities, as she shows the world how successful transplantation can be.”

“Operations such as this help demonstrate the enormous importance of organ and tissue donation,” said Christopher Jones, M.D., associate professor of surgery at UofL and director of abdominal transplantation at Jewish Hospital. “If it were not for the donor family graciously agreeing to limb donation, the efforts of Kentucky Organ Donor Affiliates and neighboring organ procurement organizations, this certainly would not have been possible.”

Aker was placed on immunosuppressive medications to prevent rejection of the new hand.

“She is tolerating her medications, and to date, has no signs of clinical rejection,” said Jones, who is overseeing the patient’s immunosuppressive therapy by closely monitoring her for signs of rejection and adverse reaction to medications.

“It is amazing to be part of an extraordinary team, performing procedures such as this double hand transplant,” said Stuart K. Williams, II, PhD, director, Bioficial Organs Program, Cardiovascular Innovation Institute. “New innovations developed by investigators at the Cardiovascular Innovation Institute are being translated to help patients recover more quickly from transplant surgery.”

The Louisville team developed the pioneering hand transplant procedure and has performed hand transplants on 10 patients since 1999. The clinical trial is led by Ozyurekoglu with research at the CMKI and the Cardiovascular Innovation Institute, a partnership of UofL and the Jewish Heritage Fund for Excellence.

Funding for the surgical procedure was provided by the Jewish Hospital & St. Mary’s Foundation, part of KentuckyOne Health.

The success of the Louisville VCA program has led to additional funding for ongoing transplantation and research. Early funding for research on composite tissue allotransplantation and immunotherapy from the Jewish Hospital & St. Mary’s Foundation helped bring about the nation’s first hand transplant. Other hand transplants were funded by the Department of Defense.

In late 2012, the Jewish Hospital & St. Mary’s Foundation allocated $1.5 million for the Louisville VCA program to bring potential hand transplant recipients to Louisville for screening, hand transplantation surgery and patient therapy and rehabilitation after surgery.

In 2013, the Louisville VCA program was awarded $850,000 to fund a clinical trial of a new treatment that will help prevent rejection of hand transplants as part of the Armed Forces Institute of Regenerative Medicine (AFIRM) research program. AFIRM II is a five-year, $75 million federally funded project that will focus on applying regenerative medicine to battlefield injuries. Results of this trial will be far-reaching and benefit not only military patients, but all hand transplant recipients.

The AFIRM II funding enables Louisville VCA researchers to explore the potential for a cell-based therapy to help control the immune system’s response to a hand transplant, with a goal to lessen or eliminate the need for immune-suppressant drugs.
 

Two University of Louisville neurosurgeons are now providing image-guided laser technology to help patients with brain tumors and lesions. According to the National Brain Tumor Society, more than 688,000 Americans are living with a brain tumor. In the past, some tumors were considered too difficult to reach. However, the minimally invasive NeuroBlate laser is now allowing neurosurgeons to remove tumors and lesions that would traditionally be considered inoperable.

NeuroBlate laser therapy can be precisely controlled to kill abnormal tissue while doing as little harm as possible to surrounding healthy tissue. It also can be used in patients who have lesions in areas of the brain that are difficult to access by traditional open surgery without harming essential functions like speech, vision and muscle control. The procedure is performed at Jewish Hospital, a part of KentuckyOne Health.

The NeuroBlate^® System from Monteris Medical^® is a robotic laser technology that uses real-time magnetic resonance imaging (MRI) to precisely guide a laser probe. The laser applies heat to the growth, in controlled amounts, until the diseased tissue is destroyed. It can be used on tumors and lesions in many locations in the brain, near the surface or deep inside.

Neurosurgeons performing the procedure are Joseph S. Neimat, M.D., chair of the Department of Neurosurgery, and Brian J. Williams, M.D., assistant professor and director of the Brain Tumor Program. Both practice with University of Louisville Physicians.

“The procedure is performed while the patient is in an MRI machine, so physicians can see the lesion and surrounding healthy tissue to apply laser energy where it is needed. The temperature of nearby healthy tissue is monitored to help ensure that it is protected as much as possible,” Neimat said. “We are thrilled to have this technology at our fingertips, to be able to help more people suffering from brain tumors and lesions.”

“Laser interstitial thermal therapy or ‘LITT’ offers patients suffering from difficult-to-access or recurrent brain tumors a minimally invasive option for local treatment of their disease,” Williams said. “Because the recovery is quite a bit quicker than with traditional open surgery, patients are able to expeditiously move on to radiation and chemotherapy.”

Rather than making a large opening in the skull, the NeuroBlate laser technology requires just a small hole, about the diameter of a pencil. The procedure is considered minimally invasive surgery, a type of procedure that generally involves less pain, discomfort and scarring than traditional surgery, and allows patients to go home and resume normal activity sooner.

The NeuroBlate System was cleared by the FDA in April 2013 and is in use at more than 20 of the nation's leading health care institutions. It also was licensed by Health Canada in September 2014 as the first and only minimally invasive robotic laser thermal therapy tool available in that country.

Patients seeking appointments with Neimat and Williams should contact UofL Physicians-Neurosurgery at 502-588-6000.

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About Monteris Medical^®
Monteris Medical (Plymouth, Minn.) is a privately held company developing devices for minimally-invasive, MR-guided neurosurgery. Monteris markets the NeuroBlate^® System for controlled, volumetric ablation of brain lesions. Monteris also offers the various Stereotactic anchoring devices for image-guided trajectory alignment, and the AtamA™ Stabilization System for MR-based procedures requiring versatile head fixation. For more information on Monteris Medical, visit www.Monteris.com or the company’s patient information site www.MyBrainSurgeryOptions.com.

Shepherdsville and Bullitt County, Ky., are invited to “Think Pink” for breast cancer awareness at an event featuring the stories of three breast cancer survivors and recognition of everyone who has battled the disease.

“Think Pink: An Evening to Educate and Celebrate” will be held Tuesday, Oct. 18, from 5 to 7:30 p.m. at the Paroquet Springs Conference Centre, 395 Paroquet Springs Drive, Shepherdsville. Admission is free.

Emcee Bryan Shaw of WHAS11-TV will introduce three survivors who will share their individual journeys and accomplishments since being diagnosed: Lara McGregor, Mary Lee Edwards and Alana Auslander Price, all of Louisville.

Both McGregor and Edwards became activists as a result of their experience with breast cancer. McGregor is founder of Hope Scarves, a non-profit organization based in Louisville that raises funds for research and provides scarves to patients with breast cancer as a way to show support. Edwards is an instructor of LIVESTRONG classes at the Louisville YMCA. LIVESTRONG is a non-profit organization, based in Austin, Texas, that provides services, raises funds and advocates for patients and families.

Participants at “Think Pink” are invited to wear pink to show support for survivors and in recognition of October as Breast Cancer Awareness Month. Only 200 seats are available for the event so reservations in advance are required by calling 502-955-5355.

Breast cancer continues to plague the United States: One in eight American women will be diagnosed with breast cancer in her lifetime.

Great strides in fighting the disease have been made, however. In 1980, the five-year relative survival rate for women diagnosed with early stage breast cancer -- cancer confined to the breast -- was 74 percent. Today, that number is 99 percent.

“Think Pink” is sponsored by the Kentucky Cancer Program at the University of Louisville, Bullitt County Health Department and Bullitt County Cooperative Extension Service.

For information, contact Pam Temple-Jennings of the Kentucky Cancer Program, 502-852-6318, pam.templejennings@louisville.edu.

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Research at the University of Louisville and throughout the nation continually improves our understanding of how exposures to metals and other substances in the environment affect people’s health across their lifespan. The National Institute of Environmental Health Sciences (NIEHS) aims to enhance society’s ability to maintain healthy environments by ensuring that individuals and communities have access to the best scientific information. Linda S. Birnbaum, Ph.D., director of the NIEHS and the National Toxicology Program, will discuss environmental research and the role of the NIEHS in human health at UofL on Oct. 14 at 1 p.m. as the keynote speaker of Research!Louisville.

Research!Louisville is the annual exposition of health-related research in the Louisville Medical Center. The 2016 event, scheduled for Oct. 11-14, will include showcases of scientific research, lectures and activities for scientists of all ages.

Investigators from high school through professional faculty will present their research in five poster sessions on Tuesday, Wednesday and Thursday. Awards for top research presentations will be announced on Friday following the keynote address by Birnbaum.

Other events during the week include:

• Kentucky Science Center – S.T.E.M. careers – More than 200 high school students will be introduced to science careers through interactive sessions in which they will take a patient history, engage in patient-interaction role-play with standardized patients, and practice suturing in a workshopcourtesy of the UofL School of Medicine Standardized Patient Program and the Paris Simulation Center. Students also will have the opportunity to interact with the operating room at KentuckyOne Health in "Pulse in Surgery,” in which students observe a live-streamed open-heart surgery while asking questions of the operating room staff in real time. Sessions are Wednesday, Oct. 12, 9 a.m. – 1:30 p.m at the Kentucky Science Center.
• Beer with a Scientist – The leading-edge ways researchers and clinicians are diagnosing and curing cancer right here in Louisville. Wednesday, Oct. 12, 8 p.m. at Against the Grain Brewery, 401 E. Main St.
• Racial and Ethnic Disparities in Children's Health – Health inequities among children result in poorer quality of life for individuals in our nation. Glenn Flores, M.D., Distinguished Chair of Health Policy Research at the Medica Research Institute, a Research Affiliate in the Department of Health Sciences Research at the Mayo Clinic, will speak on “Racial and ethnic disparities in children’s health and health care and their successful elimination.” Thursday, Oct. 13, noon-2 p.m. in room 101 of the Kosair Charities Clinical and Translational Research Building (KCCTRB).
• InNet – The new online matchmaking tool to help UofL investigators match their skills with potential collaborators in industry and research will host a launch party on Tuesday, Oct. 11, from 10:30 a.m. – 2:30 p.m. in room 101 of KCCTRB.
• Science and Innovation in the Public Interest - Karen Kashmanian Oates, Ph.D., professor of biochemistry and dean of Arts & Sciences at Worcester Polytechnic Institute, will discuss science and innovation in the public interest. She will explore the role of educators in not only imparting knowledge to students, but helping them understand how to use that knowledge to benefit society. Thursday, Oct. 13, at 10:30 a.m. in room 124 of KCCTRB.
• Clinical/Translational Research Summit – A dozen areas of clinical and translational research will be highlighted with 10-minute presentations. Areas include cancer, cardiology, cardio-thoracic surgery, biomarkers, personalized medicine, gastro-intestinal metabolism, dentistry, infectious diseases, public health, nursing, neurosciences/spinal cord injury and transplant. The event is sponsored by UofL, KentuckyOne Health, Catholic Health Initiatives (CHI) and the Chi Institute for Research and Innovation (CIRI). Friday, Oct. 14, 8 a.m. – noon in room 101 of KCCTRB.

For additional information, poster abstract booklet and a program of events for the 21st annual Research!Louisville, visit http://ResearchLouisville.org.

Alzheimer’s disease (AD), Parkinson’s disease (PD) and Amyotrophic Lateral Sclerosis (ALS) are all characterized by clumped, misfolded proteins and inflammation in the brain. In more than 90 percent of cases, physicians and scientists do not know what causes these processes to occur.

Robert P. Friedland, M.D., the Mason C. and Mary D. Rudd Endowed Chair and Professor of Neurology at the University of Louisville School of Medicine, and a team of researchers have discovered that these processes may be triggered by proteins made by our gut bacteria (the microbiota). Their research has revealed that exposure to bacterial proteins called amyloid that have structural similarity to brain proteins leads to an increase in clumping of the protein alpha-synuclein in the brain. Aggregates, or clumps, of misfolded alpha-synuclein and related amyloid proteins are seen in the brains of patients with the neurodegenerative diseases AD, PD and ALS.

Alpha-synuclein (AS) is a protein normally produced by neurons in the brain. In both PD and AD, alpha-synuclein is aggregated in a clumped form called amyloid, causing damage to neurons. Friedland has hypothesized that similarly clumped proteins produced by bacteria in the gut cause brain proteins to misfold via a mechanism called cross-seeding, leading to the deposition of aggregated brain proteins. He also proposed that amyloid proteins produced by the microbiota cause priming of immune cells in the gut, resulting in enhanced inflammation in the brain.

The research, which was supported by The Michael J. Fox Foundation, involved the administration of bacterial strains of E. coli that produce the bacterial amyloid protein curli to rats. Control animals were given identical bacteria that lacked the ability to make the bacterial amyloid protein. The rats fed the curli-producing organisms showed increased levels of AS in the intestines and the brain and increased cerebral AS aggregation, compared with rats who were exposed to E. coli that did not produce the bacterial amyloid protein. The curli-exposed rats also showed enhanced cerebral inflammation.

Similar findings were noted in a related experiment in which nematodes (Caenorhabditis elegans) that were fed curli-producing E. coli also showed increased levels of AS aggregates, compared with nematodes not exposed to the bacterial amyloid. A research group led by neuroscientist Shu G. Chen, Ph.D., of Case Western Reserve University, performed this collaborative study.

This new understanding of the potential role of gut bacteria in neurodegeneration could bring researchers closer to uncovering the factors responsible for initiating these diseases and ultimately developing preventive and therapeutic measures.

“These new studies in two different animals show that proteins made by bacteria harbored in the gut may be an initiating factor in the disease process of Alzheimer’s disease, Parkinson’s disease and ALS,” Friedland said. “This is important because most cases of these diseases are not caused by genes, and the gut is our most important environmental exposure. In addition, we have many potential therapeutic options to influence the bacterial populations in the nose, mouth and gut.”

Friedland is the corresponding author of the article, Exposure to the functional bacterial amyloid protein curli enhances alpha-synuclein aggregation in aged Fischer 344 rats and Caenorhabditis elegans, published online Oct. 6 in Scientific Reports, a journal of the Nature Publishing Group. UofL researchers involved in the publication in addition to Friedland include Vilius Stribinskis, Ph.D., Madhavi J. Rane, Ph.D., Donald Demuth, Ph.D., Evelyne Gozal, Ph.D., Andrew M. Roberts, Ph.D., Rekha Jagadapillai, Ruolan Liu, M.D., Ph.D., and Richard Kerber, Ph.D. Additional contributors on the publication include Eliezer Masliah, M.D., Ph.D. of the University of California San Diego.

This work supports recent studies indicating that the microbiota may have a role in disease processes in age-related brain degenerations. It is part of Friedland’s ongoing research on the relationship between the microbiota and age-related brain disorders, which involves collaborations with researchers in Ireland and Japan.

“We are pursuing studies in humans and animals to further evaluate the mechanisms of the effects we have observed and are exploring the potential for the development of preventive and therapeutic strategies,” Friedland said.

October 6, 2016