Resilience Despite Uncertainty: The Journey of the Class of 2024

Posted on May 8, 2024
Resilience Despite Uncertainty: The Journey of the Class of 2024

Andrew Willet, class of 2024

The University of Louisville School of Medicine’s class of 2024 embarked on their medical journey amidst a time of great uncertainty in the world – the COVID-19 pandemic. In a time when physical classrooms were swapped for virtual ones, these aspiring physicians remained resilient in their journey to medicine. Andrew Willett, 2024 MD candidate, is among those who navigated through the unprecedented challenges of virtual learning as an added stressor to his medical school experience. Nonetheless, Willett was determined to continue pursuing his goal of becoming a physician.

“I was so grateful to be entering medical school that I didn’t think about the pros and cons of starting during a pandemic – I was simply ready to begin this next phase of my career and wasn’t going to alter my trajectory given the global circumstances,” said Willett.

Pursuing his medical career during a pandemic was not without challenge. Willett highlighted the difficulties of transitioning from an in-person curriculum to a virtual one. This transition created a learning curve and made it challenging to adapt to the pace of medical school. The virtual nature of his M1 year, along with the hospitals being overwhelmed by the pandemic, made clinical experiences as an early medical student difficult to pursue. Social gatherings were far and few in between which didn’t allow for much in-person connection as a class.

Through all the struggle of the virtual nature of his M1 year, Willett still feels fortunate to have started medical school when he did as it encouraged resiliency. “The biggest skill I learned from this experience was becoming comfortable with the unknown and learning how to deal with circumstances that I didn’t create,” said Willett. The commotion during the pandemic allowed Willett to grow in ways that will stay with him through the entirety of his medical career.

Willett recalled a moment that will stick with him forever as a result of this experience. “I remember being vaccinated early during the vaccination efforts while simultaneously learning about the principles of immunology and virology during the second semester of our M1 year – that was a very cool, full-circle experience that I won’t forget.”

Willett does not view the pandemic as an experience that negatively affected his medical career; instead, it made him more prepared for the next steps of his medical journey.

“I feel academically and clinically equipped to work as a physician, and feel like I have a unique mindset and attributes that will help me be effective at the next institution I join during residency,” said Willett, “I have learned and grown so much throughout my time at ULSOM and am forever thankful for the community of friends and mentors that have prepared me to enter into this next stage of my life and career.”

The University of Louisville School of Medicine holds deep admiration for the unwavering resilience and dedication demonstrated by our medical students throughout the challenges of the pandemic and the subsequent return to in-person learning. We are in awe of the accomplishments achieved by the class of 2024 as they continue their journey in the medical field. We look forward to seeing the remarkable contributions each graduate will make to the advancement of healthcare in our world.

Class of 2024 Graduation Live-Stream

Growing on her roots: UofL School of Medicine graduate Caitlan Jones hopes to practice close to her rural hometown

Posted by UofL News on May 1, 2024
Growing on her roots: UofL School of Medicine graduate Caitlan Jones hopes to practice close to her rural hometown

Caitlan Jones will graduate from UofL School of Medicine on May 11 and continue her training at the UofL Owensboro Family Medicine Residency Program. UofL photo.

Muhlenberg County native Caitlan Jones is completing medical school in the hospital where she was born in Madisonville, Kentucky.

Jones is part of the University of Louisville School of Medicine’s Trover Rural Track, based at Baptist Health Deaconess Madisonville, which offers students the opportunity to complete medical school in a small community.

It has been a perfect fit for Jones, who will receive her medical degree on May 11 from the UofL School of Medicine and hopes to practice in a rural community.


Caitlan Jones, 2024 School of Medicine graduate, with her husband, Christian. UofL photo.
Caitlan Jones, 2024 School of Medicine graduate, with her husband, Christian. UofL photo.


“I want to practice wide-spectrum family medicine in Western Kentucky. I like the community clinics and small towns,” Jones said. “My husband is from Owensboro and we both like our families, so we want to stay in Western Kentucky.”

Physicians are badly needed in rural areas of the commonwealth, where many communities are medically underserved.

“If you look on a map of health professional shortage areas, almost all of Western Kentucky is blocked out. They don’t have enough of anything,” Jones said.

Jones, who grew up on a farm with her three siblings, is grateful for her down-to-earth upbringing.

“I was raised by a great set of parents. My dad has made an impressive career in the coal mines, runs the family farm and in his little spare time he is a volunteer firefighter,” Jones said. “I am outgoing and talkative just like my dad, but I don’t think I could ever be as hardworking. My mom works as a bookkeeper, taught us about Jesus and was very involved in our education.”

She also is inspired by her parents’ generosity in the community.

“Seeing how hard my parents worked and how involved they were in communities was enough for me to say I want to come back somewhere similar to home and be involved in that same way.”

Jones sees medicine as a perfect way for her to be involved.

“I like that it’s challenging, I’m always reading and learning and problem solving,” she said. “I also think there is a gap in medicine. I have a really strong faith and I think you miss that a lot in the medical community—doctors that pray and believe in healing and the other side that so many patients also do. So, filling that gap is a big part of why I am in medicine. I want to love others.”

After being introduced to Trover as an undergraduate at Murray State University, Jones spent a summer participating in the Trover Campus Rural Scholars Program. That experience sealed her decision to practice rural medicine.

“I was offered acceptance at four medical school programs, but I chose UofL largely because of the great experience I had in undergrad at the Trover Campus,” Jones said.


Caitlan Jones and William Crump, associate dean of Trover Campus at the UofL School of Medicine. Students can spend part of medical school in Madisonville, Ky. preparing to practice in a small community. UofL photo.
Caitlan Jones and William Crump, associate dean of Trover Campus at the UofL School of Medicine. Students can spend part of medical school in Madisonville, Ky. preparing to practice in a small community. UofL photo.


Although she did part of her training in Louisville, Jones likes the environment in Madisonville, which provided more one-on-one time with attending physicians.

“I see people all the time I know. It’s different to be somewhere you know people but also, it’s a different feeling from a big university hospital,” Jones said. “People know my parents or I know people’s parents, so it’s a different level of connection.” 

Jones will reach her goal a year sooner than most medical students thanks to Trover’s Rural Medicine Accelerated Track (RMAT), a program allowing students who intend to practice in a rural Kentucky community to finish medical school in three years rather than the typical four.

Jones and Bradley Watson, the 2024 graduates of the RMAT, are completing the program a decade after the first graduate finished in 2014. Jones and Watson also both were awarded the 2023 Anthem Medicaid Rural Medicine Scholarship, which supports RMAT students.

In July, Jones will begin residency training at the UofL Owensboro Family Medicine Residency Program.

It doesn’t really feel real,” she said. “I am finishing a year early so it doesn’t feel like I’ve been doing it that long. But I’m really excited to see what comes next.”

Watch the video:

UofL researchers honored for groundbreaking study linking cancer and kidney disease

Posted by UofL News on May 1, 2024
UofL researchers honored for groundbreaking study linking cancer and kidney disease

Mass spectrometry image of a kidney showing changes characteristic of chronic kidney disease. (Photo by Dana Hammouri)

A team of researchers at the University of Louisville has been honored for their pioneering work in uncovering a new connection between cancer treatment and kidney disease.

Their award-winning study, named Paper of the Year by the American Journal of Physiology, sheds light on the heightened risk of kidney complications in cancer patients undergoing treatment. The study revealed that cancer itself may harm the kidneys, but that damage and scarring is intensified when patients take cisplatin, a commonly used chemotherapy drug. 

“Everything in your body is connected, from your internal systems to the medications we take,” said Andrew Orwick, lead author and recent doctoral graduate in pharmacology and toxicology.

Orwick’s doctoral research in the laboratory of researchers Leah Siskind and in collaboration with Levi Beverly, both from the UofL School of Medicine and Brown Cancer Center, examined the interplay of cisplatin and lung cancer, which is highly prevalent in Kentucky.

“By better understanding what those interactions are and how they happen,” he said, “we can take them into consideration and improve outcomes for the patient.”

Ultimately, that could lead to new diagnostics, more effective drugs and treatment plans that better consider the patient’s overall health and avoid or limit kidney damage.

Chronic damage to the kidneys can cause nausea, vomiting, fatigue, high blood pressure and even death, without transplant or dialysis. Because symptoms progress slowly, patients may not notice the condition until its advanced stages. Even so, current testing methods are difficult and invasive.

The UofL researchers think their work could help clinicians better predict not only which patients will react negatively to cisplatin and other chemotherapy drugs, but also identify potential kidney problems early. The goal is to better understand the underlying mechanisms and biomarkers, so clinicians can make more informed decisions.

“Obviously, addressing the cancer is first and foremost, but if we can do that while also preserving the patient’s overall health and feeling of health, that’s optimal,” said Siskind, a professor and senior author on the study. “The great news is that the fact that we’re even having this conversation means we’re making progress in solving cancer — we’re considering not only life, but the quality of that life.”

Siskind said the paper represents a paradigm shift in how researchers think about and treat both cancer and kidney disease. As it stands, no treatment for this form of kidney disease has made it past a phase 2 clinical trial or been approved for use in patients. This research could also help inform better drugs and experiments to fill that need. 

That innovative thinking and broad impact is likely part of why this work was selected as Paper of the Year, said Jon Klein, interim executive vice president for research and innovation.

“Being selected for this honor is a massive accomplishment and underpins the immense value of the research being done by this team and across UofL,” Klein said. “This is work that truly can save and improve lives.” 

Scientists can now better document health benefits of time spent in nature

Posted by UofL News on April 22, 2024
Scientists can now better document health benefits of time spent in nature

Leafy branches frame the entrance to Grawemeyer Hall on UofL’s Belknap Campus. UofL photo.

Many people enjoy spending time in nature, basking in the peaceful atmosphere of forests, parks and green spaces. It is widely believed that exposure to plants and trees improves physical and mental wellbeing, and living in areas with an abundant tree canopy is associated with better health. But can these health benefits be proven scientifically?

A new discovery at the University of Louisville may help scientists test the effects of exposure to green plants “greenness” on health. Pawel Lorkiewicz, associate professor of chemistry and environmental medicine at UofL’s Christina Lee Brown Envirome Institute, measured a person’s exposure to trees and plants by testing their urine.

Limonene is a nontoxic substance emitted into the air by many trees and plants. Concentrated limonene has a lemony smell and is used in perfumes, foods, cleaning and other household products. When a person breathes concentrated limonene, the body breaks it down into metabolites which can be measured in their urine.

These metabolites also are in a person’s urine after they spend time in a forest, according to Rachel Keith, associate professor at the Envirome Institute who conducted the study. This means the metabolites can be used to measure a person’s exposure to trees and plants. Comparing this exposure with health information may help researchers more accurately determine whether time spent in nature is beneficial for an individual’s health.

“Even though we may not smell limonene exactly, usually we can tell that we are surrounded by trees and greenness because of the smell. Parks and forests, or even meadows or larger green spaces have a characteristic smell because of plant volatile organic compounds such as limonene,” Lorkiewicz said.

For several years, Envirome Institute researchers have been studying the health effects of living near trees and greenness. As part of the Green Heart Project, they planted trees and shrubs in specific neighborhoods, measuring changes in the residents’ health compared with those living in areas with fewer trees. But the researchers found it challenging to accurately measure an individual’s actual exposure to trees. There may be many trees where they live, but they spend much of their time working in tree-sparse locations or indoors, insulated from trees and plants.

So the team searched for a way to measure how much time an individual spent around greenness. Because many trees and plants release significant amounts of limonene into the air, they developed a method to test for limonene exposure using urine, which is easy to collect.


A student amid trees on UofL’s Belknap Campus. UofL photo.
A student amid trees on UofL’s Belknap Campus. UofL photo.


After testing the urine of people who smelled pure limonene from a vial, they compared those results with urine from people who spent time walking in a forest. They found the same metabolites in the urine of both groups, tagging three of them as reliable biomarkers of exposure to greenness.

“It was very exciting. That’s what constitutes a biomarker, something was released by trees in real life, metabolized by our bodies and found in our urine, not just the result of smelling a pure chemical in a lab,” Lorkiewicz said. “So, we objectively can tell when someone is not working in an office at a desk, but they actually go outside and are surrounded by greenness.”

Keith said the biomarker for greenness exposure is a breakthrough for the Green Heart Project, the Trager MicroForest project in downtown Louisville and other studies.

“We have been working with the overall premise that trees affect health in a positive way. Our mission in the Green Heart Project is to understand in some ways how they do that,” she said. “We have turned to the idea of using the human as the biomonitor of greenness in the human. We hope to use this to see changes in people’s overall exposure to greenness as we plant trees and determine whether those changes correlate to changes in health.”

To assess people’s exposure to trees and plants, Keith combines the limonene biomarker test with satellite images showing tree density where people live and surveys of their time spent outdoors and compares the exposure information with health data such as blood pressure and heart rate.

In additional research, Keith and her team are using the biomarker to compare the health effects of limonene and other compounds emitted by plants on the body.

Interim Dean Bumpous named President of ABOHNS

Posted on April 19, 2024
Interim Dean Bumpous named President of ABOHNS

Interim Dean Jeffrey Bumpous, MD

The University of Louisville School of Medicine is proud to announce the appointment of interim dean Jeffrey Bumpous, MD, to president of the American Board of Otolaryngology – Head and Neck Surgery (ABOHNS).

The president of the American Board of Otolaryngology-Head and Neck Surgery (ABOHNS) holds a vital position within the organization, tasked with overseeing various facets of board operations, growth, and mission fulfillment. In this role, Bumpous will play a key role in leading the certification processes, which encompasses primary certification in the specialty, subspecialty certifications, focused practice designations, and continuous certification. This includes working with executive leadership and committee chairs to develop examination materials, organize assessments, and review credentials and ethics issues.

Bumpous is working with the board on significant enhancements to the primary certification process by incorporating additional peer review and an oral exam based on physicians' own cases in practice. The goal is to execute this process in a fair, equitable, meaningful, and efficient manner, thereby upholding public confidence and trust in the board. The board has a newly published strategic plan which aligns with its mission, vision, and core purpose; Bumpous hopes to embrace these strategic initiatives and drive positive initiatives within ABOHNS to advance its commitment to professional excellence and public trust.

The impact Bumpous hopes to have on ABOHNS is deeply rooted in the organization's rich history and commitment to serving the public. Entering its 100th year as a medical board, the organization remains dedicated to evolving with the medical landscape, embracing advancements such as technology, artificial intelligence, and changing practice models. By adopting a forward-thinking approach as outlined in its Strategic Plan, ABOHNS aims to uphold its core values while adapting to contemporary practices to ensure the delivery of high-quality healthcare services to the public.

“We aim to be innovative in how we adapt with the changing medical landscape and how that applies to the practice of Otolaryngology-Head and Neck Surgery,” said interim dean Jeffrey Bumpous, “It is an honor to get to be a part of leading that charge.”

The American Board of Otolaryngology-Head and Neck Surgery serves a critical role in the healthcare ecosystem by prioritizing the needs of the public above all else. Unlike many trade organizations that focus on promoting specialties or professionals, ABOHNS places a strong emphasis on serving the recipients of healthcare. The organization is committed to providing accessible, safe, caring, and effective healthcare services to individuals relying on its expertise. By maintaining a steadfast focus on patient welfare, ABOHNS demonstrates its unwavering dedication to upholding the highest standards of medical practice.

Read more on the ABOHNS and dean Bumpous’s appointment on the ABOHNS website.

University of Louisville Medical Students Crowned 2024 Derby Princess and Queen

Posted on April 18, 2024
University of Louisville Medical Students Crowned 2024 Derby Princess and Queen

ULSOM students, Ankita Nair and Sarah Downs, part of the KDF Royal Court 2024

The Kentucky Derby Festival Royal Court, a prestigious tradition in the state of Kentucky, not only emphasizes the glamour and elegance associated with the revered Kentucky Derby but also symbolizes a commitment to community engagement and personal growth. Two medical students from the University of Louisville School of Medicine were named Derby Princesses for the 2024 Kentucky Derby Festival. Ankita Nair, a third-year medical student, and Sarah Downs, a second-year medical student, were selected to represent the commonwealth.

The role of a Derby Princess embodies a unique blend of community engagement, tradition, and personal growth. Nair and Downs are both proud Kentucky natives and exemplify a deep-rooted connection to their community by embracing the rich traditions of the Kentucky Derby Festival.

Nair, a proud California-Kentuckian, embodies a strong connection to her roots, having divided her life between Louisville and San Diego. Her passion for community service and promoting preventative health initiatives shines through her involvement in the Kentucky Derby Festival. As a previous competitor in Miss Kentucky, she leverages her platform to educate and promote healthy lifestyle habits through her initiative "Let's Live Kentucky." Moreover, her involvement as a medical student demonstrates a holistic approach to her future career, combining academic pursuits with a deep commitment to community well-being.

Similarly, Downs believes being a Derby Princess allows her to serve her community and develop robust communication skills essential for her career as a physician. Her eagerness to connect with individuals from diverse backgrounds reflects in her understanding of others' stories and perspectives. Downs aspires to be a bridge between the local community and the global visitors who converge upon Kentucky during the Derby festivities.

Both Nair and Downs demonstrate a keen understanding of the significance of their roles as Derby Princesses. Their enthusiasm for the program is palpable as they share their eagerness to connect with people across various neighborhoods, support community initiatives, and contribute to the greater celebrations of Kentucky's traditions. Nair’s desire to engage with local businesses, volunteer in the West End, and bring attention to the diverse festivities symbolizes a deep commitment to community engagement. Similarly, Downs’s focus on impacting Kentucky’s youth and instilling in them the belief of pursuing one's dreams illustrates her dedication to inspiring and uplifting the next generation.

The experiences and aspirations of Nair and Downs exemplify the transformative impact of the Derby Princess role on their personal and professional development. Nair highlights how the role has equipped her with valuable time management, public speaking, and civic leadership skills, crucial for achieving a balance between professional endeavors and community engagement. Conversely, Downs emphasizes the role's contribution to refining her empathy and organizational skills, essential qualities for her future as a physician.

The attachment of Downs to the Kentucky Derby Festival, and her admiration for the Fillies and the Festival organizers, underlines the profound impact of these institutions on the social, cultural, and historical fabric of Kentucky. “We have some of the richest traditions here in our state and I am incredibly thankful for the opportunity to experience these traditions firsthand,” said Downs.

Nair’s admiration for the historical traditions of the Derby Festival highlights the significance of these organizations in uplifting the community and preserving Kentucky's traditions. “We started the Kentucky Derby 150 years ago and while many things have changed, the Derby continues to be a constant symbol of the rich history of Kentucky,” said Nair. “The Derby reminds me we have the grandson of Lewis and Clark to thank for the first running; that agriculture and horse farming have been and will always be something to be proud of; that steamboats like the Belle of Louisville tell the story of how Louisville came to be: first as a port city for Westward Expansion and now as a global UPS hub. The Kentucky Derby is a meaningful event that quintessentially shows our home to the rest of the world and is also something that we cherish here locally with all our festival events and traditions.”

As dedicated medical students and future healthcare professionals, they embody the essence of holistic engagement, combining academic pursuits with a commitment to community service and cultural celebration. Their dedication to embracing the Kentucky Derby Festival's traditions and uplifting the local community resonates as a testament to the enduring legacy of the Derby Princess program and its impact on shaping future leaders and advocates for social good.

The University of Louisville School of Medicine is proud of both Nair and Downs’ commitment to their academic pursuits and community engagement. Congratulations to Ankita Nair on being named the Derby Queen for the 150th running of the Kentucky Derby!

UofL scientists gain $11.6 million to study effects of chemical exposures on heart

Posted by UofL News April 12, 2024
UofL scientists gain $11.6 million to study effects of chemical exposures on heart

UofL researchers are working to better understand how pollutants and other factors affect heart health. UofL illustration.

Heart disease is the number one cause of death worldwide, according to the World Health Organization, but scientists still do not understand all the factors that affect heart health.

University of Louisville environmental medicine researchers are working to better understand how natural, social and personal environments affect health, particularly the cardiovascular system. In recent months, the National Institutes of Health have awarded four grants totaling $11.6 million to researchers affiliated with UofL’s Christina Lee Brown Envirome Institute to study factors affecting heart health. Through these projects, they hope to better understand how environmental exposures and tobacco products can affect the cardiovascular system, as well as how remodeling takes place in the heart after a heart attack.

“The unique and synergistic research collaborative we have built at the Envirome Institute already has resulted in new discoveries about the biological and the environmental factors that contribute to heart disease,” said Aruni Bhatnagar, chief of the UofL Division of Environmental Medicine and director of the Envirome Institute. “Our studies funded by these new grants will lead to better understanding of the causes and progression of cardiovascular disease and new ways to protect and improve cardiovascular health.”

The new projects address the cardiovascular effects of newly introduced ingredients in electronic cigarette liquids, exposure to benzene, prenatal and infant exposure to combinations of substances and their impact on sleep in adolescence and the metabolic processes occurring after a heart attack that result in scarring in the heart.

One grant provides $3.3 million to investigate how exposure to benzene affects blood vessels. Sanjay Srivastava, professor of medicine who leads the project, said preliminary research shows that benzene worsens atherosclerosis, an underlying cause of cardiovascular disease and stroke. Atherosclerosis, a buildup of fatty deposits in arteries, reduces blood flow and flexibility of the arteries. Benzene is one of the top 20 pollutants from industrial sources in the United States, primarily from gasoline refineries. Outside industrial locations, exposure is higher near gas stations and from automobile exhaust and cigarette smoke. Benzene is known to cause cancer, but this is the first study to evaluate the effects of the chemical on heart disease, especially at levels typically experienced in the environment.

Cardiac fibrosis is essential for upholding the structure of the heart after heart attack, but also tends to produce excessive scar tissue and stiffening of the heart. Bradford Hill is examining the processes behind stiffening and scarring in the heart following myocardial infarction. A $2.3 million grant is funding the professor of medicine’s work to investigate the metabolic processes underlying this process. Hill hopes the work will lead to a therapy that supports the repair process but also reduces excessive scarring, allowing heart attack patients to fare better down the road.

Clara Sears, assistant professor of environmental medicine, received a $2.1 million grant for a project to discover how exposure to mixtures of common chemicals and pollutants before birth and in infancy affects sleep health in adolescence. Ultimately, she hopes to understand whether exposures to phthalates (common components of plastics), metals and per-/polyfluoroalkyl substances (PFAS – known as “forever chemicals”) may be linked to cardiovascular issues later in life.

The largest of the grants, $3.9 million, will fund research into potential toxicity of new synthetic cooling compounds that are being used in electronic cigarette liquids. Daniel J. Conklin leads the project to learn whether these compounds are harmful to the cardiovascular and pulmonary systems when heated and inhaled. The compounds mimic the cooling effect of menthol, which can be irritating in high doses, but they have not been tested for safety or toxicity as inhaled substances. For this new project, Conklin, a professor of medicine who has studied the cardiovascular effects of e-cigarette and cigarette components for more than two decades, is testing the effects of the new constituents as well as documenting the impact of dual use – smoking conventional cigarettes along with vaping. The Food and Drug Administration’s Center for Tobacco Products will use the results of these studies to determine potential recommendations to regulate the products’ use.

“We are going to address the issue of dual use, where there are both cigarettes and e-cigarettes in use, because this is a very common phenomenon and the signals are coming that it’s actually worse than either one alone,” Conklin said.

UofL researchers win $1M to advance spinal cord injury technology

Posted by UofL News on April 4, 2024
UofL researchers win $1M to advance spinal cord injury technology

Spinal cord therapy research participant Jeff Marquis stands during therapy. Photo by Jessica Ebelhar.

University of Louisville researchers and their collaborators have won a Phase 2 prize in a $9.8 million National Institutes of Health innovation competition aimed at helping spinal cord injury patients regain function.

The four Phase 2 winners in the NIH’s Neuromod Prize competition each will receive $1 million, technical assistance and other resources to accelerate the development for neuromodulation therapies — those aimed at stimulating the nervous system to improve function and treat a range of conditions. At UofL, researchers are using these therapies to help patients with paralysis restore functions they may otherwise never have again.

“This technology holds enormous potential for people living with paralysis resulting from spinal cord injury,” said Susan Harkema, a UofL professor, researcher and lead on the Neuromod Prize project. “Our research so far, and the progress we will make supported by this new funding, could dramatically improve all aspects of their daily lives, from movement to cardiovascular function.”

The project team includes UofL Kentucky Spinal Cord Injury Research Center researchers Harkema and Charles Hubscher, working in collaboration with Johns Hopkins University Applied Physics Laboratory (APL), Medtronic and long-time clinical translational research partner, the Kessler Foundation. Together, they will develop a novel communication and analysis system, called StimXS, that integrates sensor information to both stabilize blood pressure and improve respiratory and bladder function.

This builds on past work and technology developed by UofL researchers, who have used neuromodulation to target and improve a range of health effects resulting from spinal cord injury, including cardiac, respiratory and bladder function and even the ability to walk — something previously thought to be impossible. To target these functions, the researchers use an implantable stimulation device that can send electrical signals to select areas of the spinal cord.

“With this new Phase 2 Neuromod funding, we can take a major step toward advancing this technology for broad use in patients,” said Hubscher, professor and co-director of the KSCIRC. “We’ve seen great results in the lab, but the true impact of this technology will be when it’s in a clinical setting and helping the people who need it most.”

This work has also been supported by several public and private sponsors, such as the Christopher and Dana Reeve Foundation, the Craig H. Neilsen Foundation, the Helmsley Charitable Trust and multiple grants from the NIH. As part of the Neuromod Prize, Phase 2 winners will be exclusively invited to participate in Phase 3, which will have a total potential prize pool of $5 million.  

“This is truly game-changing research with the power to improve lives,” said Jon Klein, UofL’s interim executive vice president for research and innovation. “I applaud the research team for their success in driving this important work forward and am excited to see them translate this for broad use in patients.”

The Neuromod Prize is part of the NIH Common Fund’s Stimulating Peripheral Activity to Relieve Conditions (SPARC) program, which is making critical progress to help accelerate the development of neuromodulation therapies, close fundamental knowledge gaps, and offer tools that enable open science and innovation through the SPARC Portal.

UofL medical students unveil the next step in their training

Posted March 18, 2024
UofL medical students unveil the next step in their training

University of Louisville School of Medicine fourth-year medical students had a lot to celebrate March 15th for Match Day. The highlight of Match Day is when prospective medical residents open their envelopes from the National Residency Match Program to discover where they have been matched for their future training as residents.

The Match is conducted annually by the NRMP and uses a computerized algorithm that aligns the preferences of applicants with the preferences of residency programs. These results are then used to fill thousands of training positions all throughout the United States.

“I am deeply pleased with this talented class of future residents and wish them all the best of luck in their pursuits wherever they matched.” said Jeffrey Bumpous, MD, interim dean for the School of Medicine.

This year’s Match Day was held at Angel’s Envy Bourbon Club at L&N Federal Credit Union Stadium. The event was attended by approximately 600 people excited to see where our future residents would match.

“Match Day marks a pivotal milestone,” said Umair Bhutto, 2024 class president. “It is a real testament to our hard work, and we now stand on the threshold of our futures. I am grateful I get to witness my peers as they discover where they will be during the next step in their medical journey.”

Congratulations to all our medical students who matched on match day! The University of Louisville School of Medicine is so proud and wishes you all the best of luck in your future endeavors both in medical residency and in your future careers.

Visit the photo gallery to view images from the event.

Age-Friendly Louisville: Building Inclusive Communities

Posted March 11, 2024

Age-Friendly Louisville (AFL) continues its mission to create an inclusive city for individuals of all ages and abilities. Led in partnership since 2016 by Louisville Metro Government, AARP Kentucky, KIPDA, and the UofL Trager Institute, AFL's efforts span various domains, from infrastructure and health services to social connections. AFL is in the process of drafting its 2024 – 2027 Strategic Plan within the new domain workgroups, focusing on Housing, Social Inclusion, and Outdoor Enhancement.

2024 Kickoff Event

AFL recently hosted its Kickoff Event on January 25th, reintroducing the new workgroup domains and inviting community participation. Workgroup meetings are held monthly at the Edison Center, providing residents with opportunities to shape AFL's future through engaging discussions and advocacy efforts. Join Us!

New Domains

Housing: Creating age-friendly, multigenerational communities and enhancing accessibility to home modifications.

Social Inclusion: Promoting accessible and affordable social activities, celebrating community diversity, and fostering collaboration.

Outdoor Enhancement: Improving public spaces, promoting mobility, and ensuring safer streets.

UofL researcher connecting the dots between pollution exposure in infancy and sleep health in adolescence

Posted by UL News on March 6, 2024
UofL researcher connecting the dots between pollution exposure in infancy and sleep health in adolescence

Clara Sears, assistant professor and researcher in UofL’s Christina Lee Brown Envirome Institute, is working to understand how exposure to pollutants before birth and in infancy affects sleep health in adolescence. UofL photo.

Clara Sears is fascinated by sleep. Quality sleep is essential to support growth and development and many adolescents in the U.S. are not getting enough.

“Everyone sleeps and it’s fascinating to me. We know so little about sleep scientifically that it really piqued my interest, and my project is right at the intersection of cardiovascular health and neurodevelopment, so it is kind of the perfect niche for my interest,” said Sears, assistant professor of environmental medicine, a researcher in the University of Louisville’s Christina Lee Brown Envirome Institute and a UofL alumna.

Sears is leading a project to discover how exposure to mixtures of common chemicals and pollutants during gestation and infancy affects sleep health in adolescence. Ultimately, she believes the exposures may be linked to cardiovascular issues later in life. Her work is part of research at the Envirome Institute to understand the relationships between the environment and human health.

“Sleep is increasingly recognized to be central to cardiovascular health. We know that a variety of lifestyle choices and environmental factors affect sleep, but we know little about the effects of chemical exposure and pollutants,” said Aruni Bhatnagar, professor of medicine and director the Envirome Institute. “Clara's work could provide new knowledge about factors that affect sleep, particularly in adolescents, so that we can improve their quality of sleep and future cardiovascular health.”

Sears’ team is examining exposure to combinations of phthalates (common components of plastics), metals and per-/polyfluoroalkyl substances (PFAS – known as “forever chemicals”). People are frequently exposed to these toxicants through their diet, as well as use of consumer goods and household products. Sears said they chose to study mixtures rather than individual chemicals because most people in the U.S. are exposed to them in combination.

“We know pregnant women and children are exposed to these chemicals in mixtures and sometimes they can affect similar biological pathways, or they can interact in ways that may magnify an effect on a health outcome,” Sears said. “So, if we study them in isolation, it is hard to get the real-world relevance of how they interact with each other to affect health.”

The work is funded by a five-year, $2.1 million grant from the National Institutes of Health to determine whether there are connections between these early exposures and poor sleep quality and increases in allostatic load in adolescents. Allostatic load is the cumulative burden of “wear and tear” on the body resulting from stressors that eventually can disrupt an individual’s immune, cardiovascular and metabolic functions. A person’s allostatic load can be assessed through biomarkers and other measures such as inflammation and body composition.

Sears is working with experts in pediatric environmental health, sleep and cardiometabolic health to analyze data from two long-term studies that track prenatal and early life exposures and other health information. The Health Outcomes and Measures of the Environment Study and the Maternal-Infant Research on Environmental Chemicals Study have documented exposures and other health measures in more than 550 children from before birth through pre-teen and teen years, along with sleep health in adolescence.

Sears hopes the study will lead to understanding the link between early life environmental factors and cardiovascular health later in life, informing efforts to improve the environment for infants and children so that they can be healthier into adulthood.

“Sleep impacts every aspect of your health and your day-to-day functioning, so if we can find ways to improve sleep it can have huge impacts on health overall.”


See previous sleep research from the Envirome Institute: Reduced sleep linked to environmental factors | UofL News

Shining a Spotlight on Eating Disorders: Why Awareness Week is Crucial, According to an Expert

Posted February 29, 2024
Shining a Spotlight on Eating Disorders: Why Awareness Week is Crucial, According to an Expert

The University of Louisville School of Medicine is committed to pursuing groundbreaking research that positively impacts the community, the commonwealth, and beyond. Eating disorders affect an estimated 9% of Americans — nearly 30 million people — and can impact a person’s eating behaviors and perceptions about food and their bodies. Cheri Levinson, Ph. D., HSP, is an associate professor at the University of Louisville and is the founder of the Louisville Center for Eating Disorders. Levinson specializes in the study and intervention of eating and anxiety disorders and leads innovative research funded by the National Institutes of Health (NIH). For National Eating Disorder Awareness Week, we sat down with Dr. Levinson to better understand her research in eating disorders.

ULSOM: What has been your motivation to pursue eating disorder research? 

Levinson: Growing up I had many friends and family members who had eating disorders and there was nowhere for them to go to get help. I wanted to understand the illnesses more and so when I started doing psychology research, I was drawn into research on eating disorders that would help me understand how to better help those impacted by these deadly diseases.

ULSOM: How did receiving the NIH New Innovator Award impact you? 

Levinson: I am just so excited! This award is amazing because it allows me and my team to do what I think is extremely important work developing a personalized treatment for eating disorders and doing it in the way that I think will lead to the most success. I've also always been told I am an ‘out of the box’ thinker, which is not always rewarded with traditional funding mechanisms, so it is extremely validating to get this award and know that so many people are rooting for these ideas to become a success in a way that can positively impact society.

ULSOM: Who do you hope to see impacted by your research in eating disorders? 

Levinson: Everyone with an eating disorder and everyone who has ever loved or cared for someone with an eating disorder. I also think that this work will end up being extended to the whole field of psychology and psychiatry, meaning it has the potential to impact treatment development for all mental illnesses. I am very hopeful that we are going to be able to build a data-based personalized treatment that works for everyone and is easy to scale and implement in communities globally.

ULSOM: What impact does the personalization of eating disorder treatment have on those being treated?

Levinson: We are finding that personalization really improves treatment adherence (meaning people are more likely to stick with treatment) and that it significantly reduces not only eating disorder symptoms, but also symptoms of depression, worry, and anxiety, and improves quality of life. I think the ability to personalize treatment to one person is so important because every eating disorder looks different. Using treatments not designed for the specific person leaves so much out of treatment that is needed for successful recovery.

ULSOM: In what ways do you see underserved populations go unnoticed in eating disorder research and treatment?

Levinson: Eating disorders impact people of all genders, ages, ethnicities, sexual identities, socioeconomic status, and body size. Unfortunately, most of our research and treatment access to date has been for white females. We need more research that includes everyone with all their unique identities and experiences.

ULSOM: How do you see eating disorder research and treatment changing for the next generation?

Levinson: I think we are going to see a huge focus on more inclusive research, the use of technology and digital treatments to improve treatments, and a focus on dismantling systems like food insecurity and weight stigma to improve outcomes.

ULSOM: How has the University of Louisville School of Medicine played a role in advancing your research?

Levinson: My primary appointment is in psychological and brain sciences in arts and sciences, and I just joined pediatrics this summer. Overall, UofL has always been extremely supportive of my work and providing the resources and support I need to grow the research impact and team of people who are dedicated to doing this type of work.

The University of Louisville School of Medicine recognizes Dr. Levinson and her advances in the field of eating disorder treatment. If you or someone you know is struggling, we encourage you to reach out for help and seek treatment.

UofL researchers develop AI-powered tool to diagnose autism earlier

Posted by UL News on February 19, 2024
UofL researchers develop AI-powered tool to diagnose autism earlier

University of Louisville researchers have developed a new AI-powered tool that could help doctors diagnose autism at a younger age.

Autism is a spectrum of developmental disabilities effecting social skills, language processing, cognition and other functions. The UofL tool has been shown to be 98.5% accurate in kids as young as two, which could give doctors more time to intervene with potentially life-changing therapy. Their results were published in the journal Biomedicines.

“Therapy could be the difference between an individual needing full-time care and being independent, holding a job and living a fulfilled life,” said Ayman El-Baz, a co-inventor and professor and chair in the J.B. Speed School of Engineering. He developed the technology with Gregory Barnes and Manuel Casanova of the UofL School of Medicine.

Research shows therapy can have the most impact if done in early childhood, when the brain is more elastic. However, currently, less than half of kids are tested before age three and even fewer are diagnosed by age eight. The problem, the researchers say, is one of supply and demand — there are too many patients and too few specialists to conduct the interviews and examinations needed for diagnosis.

“As a result, there’s an urgent need for a new, objective technology that can help us diagnose kids early,” said Barnes, a professor of neurology and executive director of the UofL Autism Center. “We think our tool can help fill that need, while providing more objectivity over the current interview method.” 

With the UofL technology, AI can make the initial diagnosis, which researchers think could reduce specialist workload by as much as 30%. The specialist would meet later with the patient to confirm the diagnosis and talk about next steps. 

The UofL technology works by using AI to analyze magnetic resonance imaging (MRI) scans for differences and abnormal connections that may indicate autism. Tested against scans of 226 children between the ages of 24 and 48 months, the technology was able to identify the 120-some children with autism with near perfect accuracy. 

By looking at the physical structures of the brain rather than using interviews, researchers believe they can make diagnoses more objective and target the specific parts of the brain that may benefit most from therapy. 

“The idea is that by drawing from both medicine and engineering, we can come up with a better solution that improves lives,” said Mohamed Khudri, a bioengineering undergraduate student and author on the paper. 

The diagnostic technology and intellectual property received support through UofL’s Office of Research and Innovation. That includes the office’s suite of innovation programs, aimed at developing research-backed inventions for market, including the prestigious national Innovation Corps (I-Corps) program through the National Science Foundation. UofL is one of only a handful of universities nationwide to have each of these programs — and it’s the only one to have them all.

Celebrating ULSOM Women in Science: Dawn Caster, MD

Posted February 12, 2024
Celebrating ULSOM Women in Science: Dawn Caster, MD

The University of Louisville School of Medicine is committed to uplifting the women who play a pivotal role in making the research and clinical care at our institution possible every day. For International Women and Girls in Science Day, we are highlighting one of our many dedicated women in science, Dr. Dawn Caster.

Caster is a clinician scientist who specializes in Nephrology (kidney diseases) specifically glomerular diseases which are autoimmune kidney diseases. She serves as an associate professor and the co-director of research for the division of Nephrology and Hypertension. Caster is a recognized researcher in the field of glomerular diseases, with a translational lab that is focused on identifying novel biomarkers in lupus nephritis and evaluating mechanisms of inflammation in lupus nephritis.

Pursuing medicine wasn’t always Caster’s plan for herself. She didn’t start college on the “pre-med” track. Instead, she obtained dual undergraduate degrees in Nutrition (BS) and Sociology (BA). She became more interested in medicine as she progressed through college because she enjoyed both her science and humanities courses. “I think that Medicine is a great intersection of science and humanities,” said Caster.

Many components inspired Caster’s motivation to pursue clinical medicine. Her mother was a teacher who encouraged her from a young age to pursue an education and a career. Her decision to specialize in Nephrology was motivated by both her mother’s diagnosis of kidney disease and the many strong role models and mentors in the division. “I was fortunate to have exposure to many amazing female faculty members,” said Caster. Caster highlighted Dr. Eleanor Lederer (former ULSOM interim chair of medicine and former president of the American Society of Nephrology) and Dr. Rosemary Ouseph (now ULSOM division chief) as faculty that directly inspired her to pursue academic medicine. 

The passion for research came to Caster later from a patient interaction during her training. During her Nephrology fellowship, she encountered a young patient with lupus nephritis that ended up in kidney failure at 18 years old. “I was frustrated with the outcome and wanted to understand more about the disease,” said Caster.  Soon after, she became involved in a research project on lupus nephritis and the project evolved into her scientific career. 

Caster hopes to make a difference for young girls pursuing a career in science or medicine. She highlighted the importance for young girls to have role models in their chosen career fields, as she did. “It is critical for girls and young women to see successful women in science so that they can know this is possible for them,” said Caster.

As the number of women and girls in science and medical fields grows, Caster hopes to see these young women and girls taking up space in these fields. “When I was younger, I was often worried about making the “wrong” choice or failing at something,” said Caster “I also hope that they will be inspired to speak up more, ask more questions, and not be afraid of failure.”

UofL Pre-Health Symposium arms students with skills to navigate higher education

Posted February 9, 2024

The 2024 University of Louisville Health Sciences Pre-Health Symposium will take place on Saturday, February 10th in the Instructional Building of the School of Medicine. The goal of the Pre-Health Symposium is to provide all high school, community college, and university students, who have an interest in the health sciences, with the information and tools necessary to succeed in the professional and graduate school admissions process. The University of Louisville Schools of Dentistry, Medicine, Nursing and Public Health & Information Sciences will have representatives on hand to discuss with students the skills needed to navigate the road to higher education.

This year's Pre-Health Symposium will feature Dr. Trinidad Jackson. In May 2022, Jackson earned his Ph.D. in Public Health Sciences. He is currently the inaugural Assistant Dean for Culture and Liberation and an assistant professor at SPHIS; he also holds a joint appointment as a Senior Advisor within the government sector and is the CEO of a company that prioritizes culture, liberation, art and science. His keynote will address “Leveling the Scales” highlighting social justice and equity in healthcare.

To learn more about the Pre-Health Symposium, the University of Louisville School of Medicine interviewed Sharon Gordon, MS, the Pre-Health Symposium event coordinator.

ULSOM: What is the Pre-Health Symposium? 

Gordon: A forum to share information about the professional schools at HSC and the many STEM careers available to their graduates.

ULSOM: Why was the Pre-Health Symposium created?

Gordon: The symposium was the brainchild of two former students, one medical and one dental, to provide information to those who would one day follow in their footsteps.Their hope was to educate, provide resources, and the opportunity for guidance and mentorship to college students, in return leading to an increase in the number of applicants from populations typically underrepresented in professional school. The symposium has now grown to provide these same opportunities to all students in the area.

ULSOM: What is the ultimate goal of the Pre- Health Symposium? 

Gordon: To connect local and regional youth interested in STEM careers with UofL professional students and administrators to share information, resources and advice.

ULSOM: Who do you hope to reach with the Pre-Health Symposium? 

Gordon: The symposium is open to everyone, especially student populations that have been historically underrepresented in dentistry, medicine, nursing and public health. 

ULSOM: Who is the ideal participant for the Pre-Health Symposium?

Gordon: A local high school or undergraduate student with an interest in dentistry, medicine, nursing or public health.

ULSOM: What topics will be covered at the Pre-Health Symposium? 

Gordon: Social justice, health equity, STEM careers, resumes, personal statements, mental health, shadowing, volunteering, admission requirements.

ULSOM: What effect have you observed the Pre-Health Symposium has had on those interested in pursuing health and medical fields? 

Participants who have attended the Pre-Health Symposium leave the forum with more knowledge of what is required to obtain a successful career in the STEM field; including the classes to enroll in as well as the extracurricular activities to involve themselves in before they apply.  Our hope is that by sharing these resources with a younger population, that they are better prepared and more confident as they navigate the road to professional school.

UofL researchers among the most-cited in the world

Posted to UL News on February 7, 2024

More than 100 University of Louisville researchers are among the top 2% most-cited in the world, according to a new list compiled by Stanford University and Elsevier. 

The list includes researchers whose work was the most cited — that is, referenced by another researcher — in either calendar year 2022 or over the course of their career. The list spans 22 disciplines, from business to engineering to medicine.

“Each and every day, UofL researchers are breaking ground by discovering new knowledge,” said Jon Klein, UofL’s interim executive vice president for research and innovation. “The citation of a scholar’s work is essentially a stamp of approval that the work is important and worthwhile. The fact that so many of our researchers are listed among the most cited shows that knowledge is truly groundbreaking and has impact. It shows UofL research is being used to help to improve lives and expand our understanding of the world and our place in it.” 

Citations, when one researcher references and builds on another’s work, are an important measure of success for academics. Typically, citations mean the researcher made a meaningful and original contribution to the world’s knowledge — and that their peers agree. 

The 118 current UofL researchers, representing eight UofL schools and colleges, included on the list are below. 

  • Thomas Abell, School of Medicine
  • Yousef Abu-Kwaik, School of Medicine
  • David Adamkin, School of Medicine
  • Manju Ahuja, College of Business
  • Bahaaldin Alsoufi, School of Medicine
  • Farrukh Aqil, School of Medicine
  • Richard Baldwin, College of Arts & Sciences
  • Charles Barr, School of Medicine
  • Richard Baumgartner, School of Public Health and Information Sciences
  • Aruni Bhatnagar, School of Medicine
  • Roberto Bolli, School of Medicine
  • Douglas Borchman, School of Medicine
  • Konrad Bresin, College of Arts & Sciences
  • Lu Cai, School of Medicine
  • Jeffrey Callen, School of Medicine
  • David Casey, School of Medicine
  • Matthew Cave, School of Medicine
  • William Cheadle, School of Medicine
  • Yanyu Chen, J.B. Speed School of Engineering
  • Jason Chesney, School of Medicine
  • Kevin Chou, J.B. Speed School of Engineering
  • Barbara Clark, School of Medicine
  • Daniel Conklin, School of Medicine
  • Michael Cunningham, College of Arts & Sciences
  • Douglas Dean, School of Medicine
  • Gill Diamond, School of Dentistry
  • Lee Dugatkin, College of Arts & Sciences
  • John Eaton, School of Medicine
  • Ayman El-Baz, J.B. Speed School of Engineering
  • Rif El-Mallakh, School of Medicine
  • Ronald Elin, School of Medicine
  • Adel Elmaghraby, J.B. Speed School of Engineering
  • Paul Ewald, College of Arts & Sciences
  • Mary Fallat, School of Medicine
  • Aly Farag, J.B. Speed School of Engineering
  • Wenke Feng, School of Medicine
  • James Fiet, College of Business
  • Eugene Fletcher, School of Medicine
  • Joseph Fowler, School of Medicine
  • Per Fredriksson, College of Business
  • Robert Friedland, School of Medicine
  • Hichem Frigui, J.B. Speed School of Engineering
  • Susan Galandiuk, School of Medicine
  • Yury Gerasimenko, School of Medicine
  • Mahesh Gupta, College of Business
  • Ramesh Gupta, School of Medicine
  • Lynne Hall, School of Nursing
  • Gerald Hammond, College of Arts & Sciences
  • Brian Harbrecht, School of Medicine
  • Susan Harkema, School of Medicine
  • Peter Hedera, School of Medicine
  • David Hein, School of Medicine
  • George Higgins, College of Arts & Sciences
  • Thomas Higgins, School of Medicine
  • Bradford Hill, School of Medicine
  • Joshua Hood, School of Medicine
  • Suzanne Ildstad, School of Medicine
  • Steven Jones, School of Medicine
  • Sham Kakar, School of Medicine
  • Mehmed Kantardzic, J.B. Speed School of Engineering
  • Carolyn Klinge, School of Medicine
  • Charles Kodner, School of Medicine
  • Richard Lamont, School of Dentistry
  • Gerald Larson, School of Medicine
  • Rainer Lenhardt, School of Medicine
  • Cheri Levinson, College of Arts & Sciences
  • Stanley Levinson, School of Medicine
  • Yongsheng Lian, J.B. Speed School of Engineering
  • Mark Linder, School of Medicine
  • Bertis Little, School of Public Health and Information Sciences
  • Yiyan Liu, School of Medicine
  • M. Cynthia Logsdon, School of Nursing
  • Frederick Luzzio, College of Arts & Sciences
  • Arthur Malkani, School of Medicine
  • Gary Marshall, School of Medicine
  • Robert Martin, School of Medicine
  • Craig McClain, School of Medicine
  • Stephen McClave, School of Medicine
  • William Paul McKinney, School of Public Health and Information sciences
  • Kelly McMasters, School of Medicine
  • Madhu Menon, J.B. Speed School of Engineering
  • Michael Merchant, School of Medicine
  • Carolyn Mervis, College of Arts & Sciences
  • Donald Miller, School of Medicine
  • Hiram Polk, School of Medicine
  • Julio Ramirez, School of Medicine
  • Janina Ratajczak, School of Medicine
  • Mariusz Ratajczak, School of Medicine
  • Brad Rodu, School of Medicine
  • William Scarfe, School of Dentistry
  • Arnold Schecter, School of Medicine
  • Charles Scoggins, School of Medicine
  • David Seligson, School of Medicine
  • Brad Shuck, College of Education and Human Development
  • Leah Siskind, School of Medicine
  • Mark Slaughter, School of Medicine
  • Joshua Spurgeon, J.B. Speed School of Engineering
  • Thomas Starr, J.B. Speed School of Engineering
  • J. Christopher States, School of Medicine
  • Yi Tan, School of Medicine
  • Sucheta Telang, School of Medicine
  • Kenneth Thomson, School of Medicine
  • Gordon Tobin, School of Medicine
  • Suresh Tyagi, School of Medicine
  • Neetu Tyagi, School of Medicine
  • Roland Valdes, School of Medicine
  • Jeffrey Valentine, College of Education and Human Development
  • Banrida Wahlang, School of Medicine
  • Hui Wang, J.B. Speed School of Engineering
  • Scott Whittemore, School of Medicine
  • Kim Williams, School of Medicine
  • Stephen Winters, School of Medicine
  • Richard Wittebort, College of Arts & Sciences
  • Roman Yampolskiy, J.B. Speed School of Engineering
  • Jun Yan, School of Medicine
  • Li Yang, J.B. Speed School of Engineering
  • Pavel Zahorik, School of Medicine
  • Jacek Zurada, J.B. Speed School of Engineering

UofL leader in medication management expands polypharmacy education, research

Posted to UL News on February 6, 2024
UofL leader in medication management expands polypharmacy education, research

Demetra Antimisiaris, second from left, was a visiting lecturer at the University of Poznan Schools of Medicine and Pharmacy in June 2023.

Demetra Antimisiaris, director of the Jean Frazier Polypharmacy and Medication Management Program (FPMMP) at the University of Louisville Schools of Medicine and Public Health and Information Sciences, shares a disturbing but all too common story that demonstrates the need for education about medication management.

She explains how one of her patients living in a long-term care facility was given a medication to treat osteoporosis, but the medicine was administered incorrectly by crushing it first, which led to burning of the patient’s esophagus. The patient stopped eating and almost died.

“Fortunately, we were able to save her and send her home, where she healed and gained her weight back,” Antimisiaris said. “This is an example of the critical importance of medication literacy from the patient to the entire health care team.”

Polypharmacy, the use of multiple medications together, often associated with medication use risk, is usually associated with older adults, but is increasingly becoming more common among younger adults and children. With approximately 20,000 prescription and more than 300,000 over-the-counter products available to consumers, understanding on how to use medications and how they interact together has never been more important. 

“There’s nowhere in the health care system that you can go if you’re taking 20 drugs and say, ‘Here’s what I’m taking. Is everything ok?’,” Antimisiaris said.

UofL’s distinctive program 

The UofL Jean Frazier Polypharmacy & Medication Management Program is unique among colleges and universities in its dedication to education, research and outreach on the growing challenge of polypharmacy.

Originally launched through the UofL Department of Family and Geriatric Medicine (DFGM), the FPMMP was launched in 2007 through the support of local citizen and philanthropist Jean Frazier whose long-standing concern about polypharmacy aligned with the work led by then DFGM chair,  James G. O’Brien.

Frazier’s interest in supporting a polypharmacy program was sparked after three people she knew well suffered from adverse medication issues within one year’s time – one of them, her mother.

“I started to wonder if there was anything I could do to help stop problems like this and I talked with Dr. O’Brien, who hired Dr. Antimisiaris, and that’s where it all started,” said Frazier.

Since 2007, Frazier said she is pleased with the progress in community awareness about polypharmacy through the efforts of the polypharmacy program.

“One of the things the program is doing that I am delighted with is a process of having people take an interest in their own health – understanding their illnesses and medications and knowing the side effects and interactions,” she said. “I think the program is beneficial and it is growing. It really is an asset for the community.”

Antimisiaris says 275,000 people die every year trying to use their medicines correctly, and adverse drug events account for more than 3.5 million doctor visits annually and 1 million emergency department visits.

“When you have one medicine from your cardiologist, one from your psychologist and three more you take over the counter, it’s a lot harder to monitor and predict the effects,” said Antimisiaris. “Usually, we don’t recognize it until they hit the emergency room doors. And by then, it’s often too late.” 

Making a global impact 

As a dedicated program focused on polypharmacy, UofL’s efforts are leading the way nationally and internationally in medication management expertise. In June 2023, the FPMMP worked with the Polish Ministry of Health and the Universities of Poznan and Warsaw to pilot a medication therapy management (MTM) project. Antimisiaris served as one of the ministry’s experts on MTM implementation and evaluation, providing advanced practice education.

Agnieszka Neumann Podczaska, Polish Ministry of Health’s Medication Management pilot project director, said the Frazier program partnership has been valuable for their program and for the field of polypharmacy.

“At Poznan University of Medical Sciences, the collaboration with Dr. Antimisiaris helped us to understand the need of providing research in all aspects of polypharmacy, not only the influence on clinical assessment but also on barriers to medication literacy and systems, or lack of systems, of polypharmacy management in clinic,” Podczaska said.

In addition, she said observing the program emphasized the importance of engagement with diverse experts in health systems of care delivery, policy, incentives, literacy, international perspectives and governance.

Antimisiaris said the FPMMP is extending its efforts across the European Union (EU) to help bring medication management to more populations. “We recognize they face the same problems we do with gaps in medication management caused by policy and systems of health care,” she said. “I think this is a credit to UofL and to Mrs. Frazier that we have the stakeholders and leaders in the EU looking to us.”

Collaboration within the UofL community

Closer to home, the FPMMP is looking to leverage public health expertise and education in medication literacy to develop innovative programming in the polypharmacy space. Population and societal approaches that empower people are especially important to address system gaps, said Antimisiaris.

For example, the School of Public Health and Information Sciences recently launched a new course open to undergraduate students called “Medication Use: History, Science and Humanity,” designed to raise awareness and skills of students who will be better equipped citizens and advocates, beyond those working in health care.

Creative inter-disciplinary approaches also led to a collaboration with colleagues in the J.B. Speed School of Engineering to examine pharmacy accessibility in care deserts (pharmacy deserts) that was funded by UofL’s Health Equity Innovation Hub.

With an average of 50 new prescription products approved for market annually, most of which are high-technology and unfamiliar, and nearly 50% of the US population taking at least one prescription medication, the challenge of effective and safe medication use will continue.

“What has happened is that our systems, policies and individual medication literacy have not kept up with the growth of medication consumption worldwide,” Antimisiaris said.

What motivates Antimisiaris is seeking innovative solutions to transform the way society interacts with polypharmacy and medication management.

“What are the systems and individual-level solutions needed to keep us healthy and safe? These are the questions we will continue to study,” she said.

Student affirms strength of UofL’s research community

Posted to UL News on January 29, 2024
Student affirms strength of UofL’s research community

Katelyn Sheneman is a doctoral student in microbiology and immunology at UofL School of Medicine.

Katelyn Sheneman, a doctoral student in microbiology and immunology at UofL, is studying Yersinia pestis, the bacteria that causes bubonic and pneumonic plague, to better understand how it evades the immune system.

A native of Southern Indiana, Sheneman completed her bachelor’s degree in biochemistry at the University of Southern Indiana before coming to UofL, where she is studying with Matt Lawrenz, a professor of microbiology and immunology in the School of Medicine.

UofL News asked Sheneman about her interest in science, her research project and her work with prospective young scientists through the Louisville Science Pathways program.

UofL News: How did you first become interested in science and microbiology and immunology in particular?

Katelyn Sheneman: During my undergraduate career, I was pursuing medicine. I worked full-time at the hospital during all four years, took the MCAT, got accepted into medical school — until I finally realized I didn’t have a desire to treat illnesses, but rather to study disease prevention. The upstream progression was pretty natural from there: in order to prevent illness, you need to study preventative medicine, but in order to study/develop those therapeutics, you have to understand the disease — you have to understand the pathogen and how it is causing the disease. My interests now lie within not only microbiology but also immunology, because you cannot understand one without also studying the other.

ULN: What has been the most exciting thing you have experienced in science so far?

Sheneman: I have been very fortunate to have many exciting experiences in science, but to answer this question, I think I would rather focus on defining experiences that validated my passion for research. During my rotation in the Lawrenz lab in my first year, my rotation involved establishing an entirely new project in the lab — we had no idea how difficult it would be or what results we would find. During my seven-week rotation, I was successful in my endeavor to establish successful protocols for this project and was fortunate enough to generate some exciting data that was included in a grant proposal Dr. Lawrenz was writing, which ultimately got funded. This was definitely a defining moment for me in my scientific career.

ULN: What are you investigating in your current research project?

Sheneman: My research is focused on the host-pathogen interactions during pneumonic plague, which is when Y. pestis infects the lungs. Specifically, I am studying the impact of Y. pestis on the production of extracellular vesicles (EVs) from neutrophils. EVs are produced by all cells in the body that facilitate communication between cells. Previous work by our lab has confirmed that Y. pestis can prevent immune cells from eliminating them. My work is focused on how Y. pestis alters the contents of the EVs and how other immune cells respond to EVs from infected neutrophil cells. Going forward, I plan to look  at how the EVs produced by infected neutrophils affect the development of pneumonic plague.

ULN: What inspired you to come to UofL and the Lawrenz lab?

Sheneman: When I was interviewing and choosing a graduate program, I was particularly interested in programs that offered biosafety level 3 lab training, which is part of the reason I was drawn to UofL. When I initially joined the program, the Lawrenz lab was not yet on my radar as I was more drawn to the biochemistry and virology labs (unsurprisingly as I joined during the pandemic). However, during orientation, the investigators who are recruiting students present their research to encourage students to rotate in their labs. During his presentation, Dr. Lawrenz showed some absolutely beautiful science, exemplifying Y. pestis as a sophisticated and “perfect” pathogen, if you will. As I do not come from a background in microbiology, I had never thought of infectious disease from the perspective of the pathogen, and I found this absolutely captivating. This led me to rotate in this lab where Dr. Lawrenz guided me to spearhead this new project. Our shared enthusiasm for this project is ultimately what led to me join the Lawrenz lab.

ULN: What do you appreciate about the research community at UofL?

Sheneman: The research community is composed of individuals who are all curious, driven and encouraging of students. What I appreciate most about the community is encouragement to seek a diverse repertoire of mentors. Dr. Lawrenz is an excellent principal mentor, but I have been fortunate enough to develop relationships with other mentors in other departments here at UofL as well as from other institutions across the country. These relationships allow for more well-rounded science — people from different backgrounds and expertise ask very different scientific questions. I believe these relationships have helped shape my project and steer it into new directions that I never anticipated.

ULN: Recently, you received a prestigious $100,000 research award for trainees from the National Institutes of Health to help fund your research. Competition is stiff for these awards. How did you react when you learned you would receive the F31 grant?

Sheneman: I did not anticipate getting awarded an F31 on my first submission of the proposal — I was extremely surprised to say the least. I am extremely grateful and humbled, and I hope I can convey my gratitude in the productivity of my future work.

ULN: You also work with high school students through Louisville Science Pathways. Why is this work important to you?

Sheneman: Louisville Science Pathways (LSP) is a summer program that offers high school students the opportunity to work in a research lab at UofL. The goal of the program is to bring unique opportunities in science to these students by promoting science education and literacy, as well as to introduce them to potential career prospects in STEM. I am currently serving in my second year as co-director of this program, but the Lawrenz lab has been actively involved in the program since before the pandemic. I initially sought involvement in LSP because it allows me to work with students that come from a similar background as I do, having to sacrifice opportunities for career development because they depend on summer employment. LSP really provides these students with the best of both worlds: development of the skills and experience from a research internship with all of the benefits of a summer job. The most rewarding part of working with LSP is helping develop opportunities for these young scientists that I wish had been available to me when I was in their shoes, with the ultimate goal that these students will be better prepared and more competitive candidates as they pursue further education.

ULN: What are your future plans?

Sheneman: I plan on staying in research and pursuing a post-doctoral fellowship/program? after I complete my PhD, but after that, my path is undecided. When I started this program, I was confident that I wanted to pursue a job in government (CDC, NIH, WHO, etc.) to work at the forefront of research in infectious disease, but the prospect of staying in academia has been growing on me these past few years. At this stage in my career, I would say I am quite open-minded when it comes to my future plans.

UofL researchers are unmasking an old foe’s tricks to thwart new diseases

Posted to UL News November 27, 2023
UofL researchers are unmasking an old foe’s tricks to thwart new diseases

Microbiology and immunology professor Matthew Lawrenz, right, and doctoral student Katelyn Sheneman have received new research funding to better understand how bacteria can outmaneuver the immune system.

When the body encounters bacteria, viruses or harmful substances, its innate immune cells, neutrophils, assemble at the site to combat the invader.

Bacteria and viruses have ways to avoid these defenses, however. Yersinia pestis, the bacteria that causes bubonic and pneumonic plague, for example, can hide from the immune system, allowing it to replicate in the body unhindered until it can overwhelm the host. This ability allowed Y. pestis to spread bubonic plague across Europe in the 14th Century, killing a third of the European population.

While plague may not be a serious threat to human health in modern times, researchers at the University of Louisville are studying Y. pestis to better understand its ability to evade the immune system and apply that understanding to control other pathogens.

“If you look at human plague, people don’t show symptoms right away even though they have an active infection because the bacteria is hiding from the immune system. Then all of a sudden there is a lot of bacteria, the immune system is overwhelmed and in the case of pneumonic plague, the individual dies from pneumonia,” said Matthew Lawrenz, professor in the UofL Department of Microbiology and Immunology.

Neutrophils are the immune system’s first responders, sending out protein molecules to summon other neutrophils to attack and destroy the invader. Among the first molecules sent out by neutrophils to signal an infection are Leukotriene B4 (LTB4) lipid molecules. Y. pestis interferes with the immune response by suppressing the LTB4 signals. Lawrenz has received a new $2.9 million, four-year grant from the National Institutes of Health to investigate how Y. pestis blocks LTB4. Ultimately, he expects this understanding will lead to ways to prevent Y. pestis from blocking the signals and hopefully, apply that understanding to other types of infections.

“This historic pathogen is really good at manipulating the immune system, so we use it as a tool to better understand how white blood cells like neutrophils and macrophages respond to bacterial infection,” Lawrenz said. “In this project, we are using Yersinia to better understand why LTB4 is so important to controlling plague. This understanding would apply to almost any infection of the lungs or other areas, and it probably could apply to viruses also.”

A member of the UofL Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases, Lawrenz has been studying plague bacteria for nearly two decades. His previous work includes discoveries of how Y. pestis acquires iron and zinc to overcome a host’s defense mechanism known as nutritional immunity and has increased understanding of how Y. pestis inhabits spaces within host macrophages to hide from the immune system.

Katelyn Sheneman, a doctoral student in Lawrenz’s lab, also has received a prestigious $100,000 research award for trainees from the NIH. This grant will fund her research to understand how Y. pestis changes the contents of extracellular vesicles, cellular containers produced by immune cells that contain proteins, lipids such as LTB4 and other components. These vesicles are released into the bloodstream to communicate to other cells what is happening in their part of the body, such as an infection.

“My project is looking at how Y. pestis alters the number of vesicles being produced, what is being packaged in them and how other cells are responding to them,” Sheneman said. “We have some good evidence that pestis is able to manipulate the production of these vesicles, so we are going to look at the role the vesicles play in pulmonary infection and how that influence contributes to overall systemic infection.”

Since there is no effective vaccine against infection by Y. pestis and it has the potential to be used as a bioweapon, Lawrenz and Sheneman study Y. pestis in UofL’s Biosafety Level 3 facilities at the Regional Biocontainment Laboratory, part of a network of 12 regional and 2 national biocontainment laboratories for studying infectious agents. Biosafety Level 3 facilities are built to exacting federal safety and security standards in order to protect researchers and the public from exposure to the pathogens being investigated.

American Heart Association grants UofL $750K to research AI in cardiac surgery

Posted by UL News January 23, 2024
American Heart Association grants UofL $750K to research AI in cardiac surgery

Jiapeng Huang, above, professor and vice chair of the anesthesiology and perioperative medicine department and principal investigator for the project.

Artificial intelligence continues to evolve our world and the medical field. The University of Louisville is investigating how AI could help improve patient outcomes during cardiac surgery with a $750,000 grant from the American Heart Association. 

The grant will allow researchers to advance AI specifically for acute kidney injury and complications during or following cardiac surgery. Acute kidney injury can result in increased mortality or persistent kidney dysfunction and, because it has a wide variety of contributing factors from patient-specific conditions to procedure complexity, this issue can be difficult for physicians to predict and prevent.

The project is a joint effort between UofL researchers from the School of Medicine, School of Public Health and Information Sciences, the J.B. Speed School of Engineering, UofL Health and researchers at SUNY Buffalo, Georgia Institute of Technology and Baylor Scott & White Heart and Vascular Institute.

The team will innovate machine-learning AI models to analyze detailed, clinical patient data and develop a personalized risk prediction and decision-making process for managing kidney injury in heart surgery patients. They then will validate the process using independent databases and clinical trials at UofL Health. 

UofL’s Jiapeng Huang, professor and vice chair of the anesthesiology and perioperative medicine department, is principal investigator for the project. As a cardiac anesthesiologist at UofL Health, he also sees numerous patients who deal with acute kidney injury. 

“Our goal is to use AI and machine learning methodology to do two things. One, to predict in real time when the patient might develop acute kidney injury or if the patient will be at risk for acute kidney injury,” he said. The second thing is to develop a clinical decision-support system to help the clinicians do the right thing for the patients at the right time to reduce chance of acute kidney injury after heart surgery.” 

While Huang and UofL faculty member Bert Little focus on the clinical procedures and decision-making process, Lihui Bai, professor of industrial engineering at the Speed School, Xiaoyu Chen, assistant professor of industrial and systems engineering at SUNY Buffalo and George (Guanghui) Lan, professor of industrial and systems engineering at Georgia Institute of Technology, will work with a team of engineers to build the AI technology. The tech will allow physicians to use patients’ clinical information before, during and after surgery to inform physicians of the best sequence of treatment for patients to reduce the chance of kidney injury after heart surgery.

For the last 10 years, AI has been used in the medical field to analyze large health care data. AI can more easily recognize patterns than the human eye or brain, according to Huang, and can be a significant benefit to patient outcomes.

“This is one of those research (projects) that will benefit patients directly,” he said Acute kidney injury happens in about 25% of patients after cardiac surgery. This study aims to protect patients from acute kidney injury after heart surgery.”

The three-year project, which is currently in phase one, began in July of this year. During this early phase, the team is establishing the database and prediction model. In year three, clinical trials conducted at UofL Health will be used to determine whether the predictive modeling and clinical decision support system will reduce the rate of acute kidney injury after cardiac surgery.

UofL Health is an excellent partner for this project as it is one of the premier cardiac programs in the nation, according to Huang. It was responsible for the first heart transplant in the state of Kentucky, as well as many innovations in artificial heart pumps. UofL Health cardiovascular surgeon Siddharth Pahwa and cardiologist Dinesh Kalra, for example, are involved in other studies, including cardiac imaging and data collection in addition to patient care.

“UofL Health always focuses on improving patient safety and outcomes,” Huang said. “UofL faculty and researchers are perfect partners to perform clinical studies to advance our knowledge and benefit our patients at UofL Health.”