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UofL School of Medicine residency program fuels physician supply for smaller communities, while offering career options to new doctors

UofL School of Medicine residency program fuels physician supply for smaller communities, while offering career options to new doctors

Glasgow Family Medicine Residency program 2021 graduates, left to right, Dillon Pender, Lauren Hansen, Laura Inabnitt and Emily Marsh.

While Elizabethtown, Kentucky, native Dillon Pender was a medical student at the University of Louisville, he realized that life and medical practice in an urban setting were not a good fit for him.

So, he chose a family medicine residency program that was close to his hometown and offered the environment of a community-based hospital.

“The Glasgow Family Medicine Residency is the best of both worlds,” Pender said. “As part of UofL, it offers the privileges and resources of a major institution, and as a community hospital, it provides the autonomy you can only have outside a large health care system.”

And now that Pender has completed his residency, he plans to stay in Glasgow, serving as a hospitalist at T. J. Samson Community Hospital and caring for the community’s population. That is a win both for the community of Glasgow and the Commonwealth of Kentucky.

A shortage of physicians has threatened the health of residents in rural communities in Kentucky for more than three decades. Approximately 40% of Kentuckians live in rural areas, yet only 17% of primary care physicians practice there, and Kentucky ranks 43rd nationally in its supply of primary care physicians relative to its population.

Primary care physicians – those in family medicine, internal medicine, pediatrics or other general health disciplines – ensure access to cost-effective management of illness and disability. Since more than half of physicians practice within 100 miles of where they do their residency training, it is important for physicians to train in the smaller communities where they are needed.

The UofL School of Medicine leads two family medicine residency programs in smaller communities in the state so that small and rural communities in Kentucky and beyond have access to primary care physicians.

The Glasgow Family Medicine Residency Program trains resident physicians in the south-central Kentucky community of approximately 14,000, preparing them to practice in a similar small or rural community. Glasgow’s T.J. Samson Community Hospital is the primary clinical training site for the residency program and was named one of  the Top 100 Rural & Community Hospitals for 2021 by the Chartis Center for Rural Health.

R. Brent Wright, associate dean for rural health innovation at UofL, was director of the Glasgow Family Medicine Residency Program from 2002 to 2013.

“In terms of a residency program, if you have a community that embraces graduate medical education, like Glasgow has done, they are taking a long-term approach for serving their stakeholders, ” Wright said.  “They are making a commitment to those they treat for decades to come. They know that by training physicians in a close-knit and caring community, they will most likely stay within that community, close by or in a similar setting.”

The program’s 24-year track record bears out its mission. Approximately 70% of the more than 80 physicians who have completed training in the program still practice within a 90-minute drive of Glasgow, including Wright, Pender, a 2021 graduate, and Kara Gilkey, who now leads the hospital’s emergency department.

Building on the success of the Glasgow program, Wright assisted with the creation of the University of Louisville Owensboro Family Medicine Residency Program, launched in 2020. As the academic sponsor for the program, UofL provides not only experience, but residency director Jon Sivoravong and other faculty. The three-year program currently has 13 residents and is approved for up to 18, graduating an average of six family medicine physicians per year.

UofL medical students also can become familiar with rural medicine during their medical school years. Through the School of Medicine’s Trover Rural Track, UofL medical students can complete their final two years of medical school in Madisonville, a community of about 20,000 in southwestern Kentucky. Currently, 51% of Trover students who have completed their training initially chose a rural practice, and 48% of students from rural Kentucky are now in a rural Kentucky practice.

“To get physicians to practice in a small town, you have to admit students who are from a small town and train them in a small town,” said William Crump, associate dean of Trover Campus for the UofL School of Medicine.

Crump and his colleagues at UofL and Baptist Health Madisonville also prepare students from rural Kentucky communities for careers in health care through the High School Rural Scholars and College Rural Scholars programs. Of the 290 students who have participated in High School Rural Scholars, 75% have completed some type of health career training program. Of 97 students who have completed the College Rural Scholars program, 50 are either enrolled or have graduated from medical school.

For Pender, living and practicing in Glasgow is the right choice. He said many physicians who practice in urban areas are missing out on great opportunities in smaller communities, citing less traffic, a lower cost of living and friendlier people, as well as a wider scope of practice for primary care physicians since access to sub-specialty care is not as readily available. 

“For most of the physicians in an urban environment, the countryside is not on their radar. They think there is nothing here,” Pender said. “But there is a lot of opportunity here and you can make a good life.”

UofL researchers lead call to increase genetic diversity in immunogenomics

UofL researchers lead call to increase genetic diversity in immunogenomics

Corey Watson, Ph.D., Melissa Smith, Ph.D., and Oscar Rodriguez, Ph.D.

Historically, most large-scale immunogenomic studies – those exploring the association between genes and disease – were conducted with a bias toward individuals of European ancestry. Corey T. Watson, Ph.D., assistant professor in the University of Louisville Department of Biochemistry and Molecular Genetics, is leading a call to actively diversify the genetic resources he and fellow immunogenomics researchers use in their work to advance genomic medicine more equitably.

Watson, along with UofL post-doctoral fellow Oscar Rodriguez, Ph.D., and visiting fellow Yana Safonova, Ph.D., are part of an international group of researchers who say the narrow studies limit their ability to identify variation in human adaptive immune responses across populations.

“We need to better understand how genetics influences immune system function by studying population cohorts that better represent the diversity observed across the globe if we are to fully understand disease susceptibility, as well as design more tailored treatments and preventative measures,” Watson said.

In an article published in Nature Methods, Diversity in immunogenomics: the value and the challenge, the group advocates for resources used in immunogenomics research to actively include and specifically identify additional populations and minority groups. They say such diversity will make their research more relevant and help in understanding population and ancestry-specific gene-associated disease, leading to improvements in patient care.

"As scientists, we have a say in which populations are investigated. Therefore, it is critical for us to be actively inclusive of individuals representative of the world we live in. This is especially critical for genes that are as diverse and clinically relevant as those that encode antibodies and T cell receptors," Rodriguez said.

Watson’s research focuses on immune function and molecular genetics. His team is studying a specific area of the genetic code that controls antibody function to better understand how differences in an individual’s genes determine their susceptibility to certain diseases or immune responses to vaccines.

In collaboration with Melissa Smith, Ph.D., assistant professor in the Department of Biochemistry and Molecular Genetics, the team is conducting the largest sequencing efforts of the antibody gene regions in humans and in animal models, Watson said.

“Specifically in humans, we are working to build catalogs of genetic variation in samples from multiple ethnic backgrounds and are engaged in projects that seek to understand how this genetic variation influences the immune response in infection, vaccination and other disease contexts,” he said.

Watson is involved in efforts to improve the resources and data standards for antibody and T cell receptor genes for immunogenomics researchers around the world.

The article in Nature Methods was co-authored by researchers from the United States, Canada, Norway, France, Sweden, the United Kingdom, Russia, Saudi Arabia, Israel, South Africa, Nigeria, Chile, Peru, China, Japan, Taiwan and French Polynesia with expertise in biomedical and translational research, population and public health genetics, health disparities and computational biology as well as immunogenomics.

UofL, UK and Kentucky Department for Public Health receive CDC grant to improve stroke care, outcomes in Kentucky

UofL, UK and Kentucky Department for Public Health receive CDC grant to improve stroke care, outcomes in Kentucky

Kerri Remmel, MD, PhD

The University of Louisville, UK HealthCare, the Kentucky Department for Public Health’s Heart Disease and Stroke Prevention Program (KHDSP) and other state partners have been awarded the prestigious Paul Coverdell National Acute Stroke Program Grant by the Centers for Disease Control and Prevention. This $1.8 million grant aims to optimize both stroke prevention among those at high risk as well as improve the care and outcomes for stroke patients throughout Kentucky.

The three-year grant will allow the coordination and expansion of existing efforts to improve stroke-related health outcomes. Kentucky health care systems and community providers will work together to implement comprehensive stroke systems for those at high risk for stroke and those who have had a stroke. 

“This program will allow expansion of our statewide efforts to serve rural and underserved citizens of the Commonwealth, to reduce disparities and monitor our progress,” said Kerri S. Remmel, chair of the UofL Department of Neurology, director of the UofL Hospital Stroke Center and co-chair of the KHDSP Task Force. “The program will facilitate continuous quality improvement in the full continuum of care from the moment a patient has a stroke through their emergency services, hospitalization and rehabilitation to their outpatient preventive care. We are extremely enthusiastic about collaborating with our partners in the Coverdell Program to improve stroke systems of care in Kentucky.”

“This award validates the voluntary efforts of stroke center personnel, EMS representatives, community partners, KHDSP staff and colleagues in public health, as well as all other stakeholders who have worked tirelessly across geopolitical boundaries in a collaborative effort to advance stroke systems of care in our state,” said Kari Moore, chair of the Stroke Encounter Quality Improvement Project (SEQIP) and project co-investigator. “We are excited to continue to build upon these efforts supported by the Coverdell award.”

KHDSP and SEQIP have made significant strides over the last 10 years improving stroke systems of care in the Commonwealth and growing access to stroke care by increasing the number of certified stroke centers in the state, increasing delivery of acute stroke treatments that can reverse or minimize stroke deficits and sharing best practices to help facilitate care delivery during hospitalization and after discharge.

This grant will coordinate and expand existing efforts in Kentucky to improve stroke-related health outcomes by working with Kentucky health care systems and community providers to implement comprehensive stroke systems for those at high risk for stroke and those who have had a stroke. 

The Coverdell award also will allow the group to target areas of the Commonwealth that are disproportionately affected by stroke, such as the Appalachian counties. The mortality rate due to stroke in that region is 14% higher than the national average and 8% higher than the rest of the state.

“This award could not come at a better time, because Kentucky has among the highest rates of stroke-related deaths in the country,” said Larry B. Goldstein, chairman of the University of Kentucky Department of Neurology and principal investigator on the project. “Over 2,000 Kentuckians die from stroke or stroke-related complications each year. Health behaviors and conditions that contribute to stroke are present at high rates in Kentucky with contributions from smoking, obesity, diabetes, hypertension, excessive alcohol use and physical inactivity. Although there are several existing stroke programs in Kentucky, we are excited that this project will coordinate and expand upon these efforts to improve stroke outcomes for Kentuckians.”

As part of the Coverdell initiative, the Kentucky Stroke Improvement Cooperative (KSIC) will be created to provide leadership for improving the quality of stroke care in the Commonwealth. Building from the KHDSP Taskforce and SEQIP, the UK and UofL Stroke Programs and the SCN, this group will lead the collaborative effort to transform Kentucky’s stroke care and outcomes by improving health approaches and practices.

Since its inception in 2005, The Coverdell Program has funded programs to ensure that all Americans receive the highest quality stroke care, a leading cause of death and long-term disability, by supporting coordinated stroke systems of care.

Joining nine other states currently funded by the Paul Coverdell National Acute Stroke Program, Kentucky’s program will:

  • Increase access and participation in the statewide Kentucky Heart Disease and Stroke Prevention Task Force from the current 38 hospitals to help close the gap in stroke care for high burden populations. In addition to focusing on hospitals, the project will expand participation to encompass the community, primary care clinics, EMS, rehabilitation centers and long-term care facilities.
  • Expand coordination between existing programs including the Kentucky SEQIP, the statewide UK/Norton Healthcare Stroke Care Network, and the 36 certified stroke centers in Kentucky.
  • Increase access, understanding, utilization, and compliance with evidence-based performance measures of the American Heart Association’s Get With the Guidelines Stroke Program.
  • Expand existing systems of care to coordinate and extend access to rural and underserved populations.
  • Increase the dissemination of evidence-based guidelines for improvement of hypertension, obesity and diabetes control, which are the leading risk factors for stroke disproportionately affecting high-burden populations.
  • Reduce stroke disparities and deaths over the long term and improve outcomes throughout Kentucky with a focus on Appalachia and underserved communities at highest risk.

UofL resident physician selected for prestigious national fellowship

UofL resident physician selected for prestigious national fellowship

Meena Vessell, M.D.

University of Louisville neurosurgery resident Meena Vessell, M.D. has been selected by the Council of State Neurosurgical Societies (CSNS) as 1 of 12 neurosurgery residents to serve as socioeconomic fellow for 2021-2022. The council selects three residents from each geographic quadrant of the U.S. annually. Vessell is the third UofL resident to serve as a CSNS socioeconomic fellow after Ian Mutchnick in 2008-09 and Paul Larson in 2001-02.

The fellowship is intended to broaden a neurosurgery resident’s working understanding of the socioeconomic issues affecting neurological surgery by working on various committees and dedicated mentorship from council members. The CSNS is made up of members of state neurosurgical societies and functions as a joint committee of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons (CNS). It began in the 1960s as a committee of the CNS, where it was charged with evaluating neurosurgery fees in the context of Medicare and a proliferation of other health insurance carriers. Today the CSNS is a collaborative organization of neurosurgeons and residents that serves as a resource and advocate on socioeconomic issues for the benefit of patients and the profession.

As a CSNS socioeconomic fellow, Vessell will participate actively in plenary sessions and on committees and will be expected to author or co-author a resolution or white paper on a relevant topic. During her fellowship year, Vessell will be trained in topics including the effects of socioeconomic issues on neurosurgical outcomes, the significance of billing/coding and reimbursements and practices that deliver cost-effective neurosurgical care.

Vessell is originally from Cincinnati, Ohio and earned her medical degree from Northeast Ohio Medical University. She will serve as a CSNS socioeconomic fellow during her seventh residency year. She has previously served as council representative to the American Medical Association (AMA) Council on Legislation, vice chair of the AMA Medical Student Section Council on Legislation and advocacy and government relations fellow for the Ohio State Medical Association. Vessell previously received the United States Public Health Service Excellence in Public Health Award on behalf of the Physicians Professional Advisory Committee of the Department of Health and Human Services and the United States Public Health Service, as well as the AMA Excellence in Medicine Award. 

UofL Health – Peace Hospital opens geriatric psychiatry inpatient unit

UofL Health – Peace Hospital opens geriatric psychiatry inpatient unit

UofL Health - Peace Hospital

UofL Health – Peace Hospital is expanding its care by opening a geriatric psychiatry inpatient unit providing short-term psychiatric treatment for adults aged 55 and older.

The secure 20-bed unit is specifically designed for the unique needs of the older adult and provides treatment for a range of mental health and substance use disorders.

“At our geriatric inpatient program, we will provide care for depression, schizophrenia, post-traumatic stress disorder, bipolar and agitation associated with dementia and more,” said Martha Mather, CAO of UofL Health – Peace Hospital. “This is another example of the commitment UofL Health has made to providing high-quality mental health care for people at all stages of life.”

The treatment team will focus on crisis stabilization and supporting the patient’s return to their home community or to a less restrictive level of care. The interdisciplinary team includes board-certified psychiatrists, gerontologists, nurse practitioners, registered nurses, Master’s level therapists, mental health technicians, activity therapists, occupational, speech and physical therapists, and chaplains.

“There’s not a one-size fits all solution when it comes to mental health treatments, so we use a team approach to make sure every patient gets exactly what he or she needs to thrive,” said Stephen Taylor, M.D., chief medical officer at UofL Health – Peace Hospital. “We’re excited to offer this geriatric program because we know there is a growing need for this care in our community.”

The Peace Hospital Geriatric Inpatient Program will be housed in downtown Louisville at UofL Health – Frazier Rehabilitation Institute to ensure a holistic approach by meeting both the behavioral health and physical health needs of the patient.

This expansion in services created approximately 40 new jobs in Louisville, including a program director, outreach coordinator, nurses, mental health technicians and more. UofL Health invested more than $1 million into this project.

With the addition of this new unit, Peace Hospital now operates 262 inpatient beds to children and adults in need of mental health treatment. Telehealth and 24/7 mobile assessments are also available.

UofL receives $11.3 million from NIH for liver research center

UofL receives $11.3 million from NIH for liver research center

Craig McClain, M.D., right, with Matthew Cave, M.D., liver researcher and H&T COBRE core director, center, and Jamie Young, Ph.D., using equipment known as the NanoDrop instrument to analyze RNA and DNA samples.

The University of Louisville Hepatobiology and Toxicology Center of Biomedical Research Excellence (COBRE) has received $11.3 million in funding from the National Institutes of Health to support its research into liver-related illness for an additional five years.

The UofL Hepatobiology and Toxicology Center was created in 2016 with an $11.5 million grant from the NIH to support unique research focused on liver injury and disease and toxicology. The center supports leading-edge research conducted by junior investigators with mentorship from senior researchers, as well as pilot projects and core laboratory facilities that support research across the university. The researchers’ goal is reducing the impact of many types of liver illness through prevention and the development of therapies.

Kentucky leads the nation in increases in cirrhosis-related deaths and in liver cancer-related deaths. According to research published in BMJ, mortality due to cirrhosis has been increasing in the U.S. since 2009, with the greatest increase in deaths from cirrhosis in Kentucky. Non-alcoholic fatty liver diseases affect approximately 25% of adults and 10% of children in the U.S.

“This vital research at the University of Louisville advances the health of Kentuckians and people throughout the world,” said UofL President Neeli Bendapudi. “Through this center, UofL researchers will continue to expand their work to find ways to prevent and treat liver illnesses, many of which today have no FDA-approved treatment.”

Researchers at the UofL H&T Center focus on liver injury, nutrition and gut-liver interactions as well as interactions between the liver and environment, toxicants and drugs. Their ultimate goal is to contribute to the prevention and treatment of non-alcoholic fatty liver disease, non-alcoholic steatohepatitis (a major cause of cirrhosis of the liver), alcoholic liver disease and liver cancer.

“This incredible cohort of researchers is discovering new ways to address the liver illnesses that afflict so many Kentuckians. I am thrilled that young researchers will continue to be supported with COBRE funding at UofL,” said Toni Ganzel, dean of the UofL School of Medicine.

In its first five years, four of the funded junior investigators in the UofL H&T Center received independent NIH research funding, making way for a new cohort of project researchers. The renewal of COBRE funding encourages a continuous supply of researchers in specialized areas of medicine and the search for new disease treatments.

“This unique thematic center is focused on liver injury, disease and toxicology. We evaluate critical barriers in our understanding of the development and progression of liver disease and we define potential therapeutic targets that could transform current practice,” said Craig McClain, associate vice president for health affairs and translational research and principal investigator for the UofL H&T Center. “This new phase will build on that success and extend and strengthen the scope of the program.”

“To push past the limitations of existing therapeutics, you need COBRE infrastructure grants to establish cutting-edge biomedical research centers and capabilities,” said Joshua L. Hood, a project investigator in the UofL H&T Center. “The more of these capabilities we have, the more we can explore multidisciplinary frontiers in biomedical science to facilitate the development of new treatments for liver-related cancer and other diseases.”

Current projects supported by the center include:

  • Yan Li, associate professor in the Department of Surgery, is investigating preventive strategies and possible mechanisms behind non-alcoholic steatohepatitis, a potential precursor of liver cancer.
  • Joshua L. Hood, assistant professor in the Department of Pharmacology & Toxicology, is examining how very small membrane-bound compartments known as nanovesicles that are released by cancer cells influence immune function in liver cancer.
  • Ming Song, assistant professor in the Department of Medicine, is studying the role of fructose consumption on the disruption of intestinal barrier function in non-alcoholic fatty liver disease.
  • Smita Ghare, instructor in the Department of Medicine, is investigating how alcohol-induced changes in the liver contribute to liver inflammation and injury.

UofL has a legacy of liver research dating to the 1970s when faculty members began investigating a cluster of cases of hepatic angiosarcoma, a rare liver cancer caused by exposure to vinyl chloride in a polymer manufacturing facility in an area of West Louisville known as Rubbertown. UofL researchers worked with the community and industry to document and reduce the effects of toxicants on worker health. UofL still maintains a biorepository of blood and liver tissue specimens begun during that research that serves as a resource for investigators studying the effects of environmental exposures on the liver.

In addition to research, the center provides support for community health. During the epidemic of Hepatitis A and C in the last decade, center investigators helped create the Kentucky Hepatitis Academic Mentorship Program. This program helped to train more than 140 primary care providers in the diagnosis and treatment of Hepatitis C. Those diseases now are declining.

COVID-19 vaccine clinical trial now open for children ages 6 months to 11 years

Norton Children’s Research Institute, affiliated with the UofL School of Medicine, to participate in COVID-19 investigational vaccine clinical trial for children ages 6 months to 11 years.
COVID-19 vaccine clinical trial now open for children ages 6 months to 11 years

The Norton Children’s Research Institute, affiliated with the UofL School of Medicine, will participate in a phase 2/3 clinical trial of the Pfizer-BioNTech COVID-19 investigational vaccine for healthy children ages 6 months to 11 years. The study will evaluate safety, tolerability and immune response in this age group. It is the only site in Louisville offering the trial and among 100 participating sites around the world.

“As of now, we do not have a vaccine that is authorized for use in children under age 12,” said Gary S. Marshall, M.D., chief of pediatric infectious diseases at Norton Children’s and the UofL School of Medicine, and principal investigator for the Louisville trial. “Having a safe and effective vaccine for children will not only keep them healthy but also would facilitate a return to normal in terms of school and other activities.”

In the randomized clinical trial, two children will be assigned to receive the vaccine for every one child who receives a placebo. The study is blinded, meaning that no one initially will know which injection they receive. Parents and caregivers will be asked to track changes to the child’s health in an electronic diary, and children will have at least six in-person visits over a two-year period, some to include blood draws.

Children who are randomly assigned to receive the placebo will be given the chance to receive the active vaccine after six months; therefore, all children in the study ultimately will have the opportunity to receive the active vaccine. 

The vaccine being studied is the same one that has been authorized for people ages 12 and older. In adults, this vaccine demonstrated 95% efficacy against COVID-19, and as of May 11, 2021, nearly 140 million people in the U.S. had received at least one dose. Preliminary data show the vaccine to be safe in children as well as able to generate a strong immune response.

The research team plans to enroll about 100 local volunteers for the trial; the overall enrollment will be about 4,500. Children ages 6 months to 11 years who are generally healthy are eligible to be included.

"The Pfizer-BioNTech vaccine has been shown to be very safe and effective in adults and adolescents," said Kimberly A. Boland, M.D., chief of staff, Norton Children's Hospital, and chair, UofL School of Medicine Department of Pediatriacs. "We have every reason to believe this study whill show the vaccine to be safe and effective in childrent and an important step forward for children's health and for protecting our communities."

Dr. Marshall is known for his work in vaccine development, advocacy and education. In fact, he has worked on many of the vaccines that children routinely receive today. The clinical trial team has responded to the pandemic, treating children with COVID-19 and its consequences.

“This is the most exciting vaccine trial I have ever been involved with, and I’ve been doing this for over 30 years,” Dr. Marshall said.

Parents and caregivers can sign children up to be considered for the trial by going to NortonChildrens.com/COVIDTrial.

UofL wastewater testing identifies new COVID-19 strain before traditional testing

University of Louisville research that uses wastewater to monitor the rates of COVID-19 infection was first to identify a variant in Louisville, alerting officials ahead of other testing methods and giving them valuable time to work to contain it.

UofL detected the variant, a Brazilian strain known as P.1, early in April in a wastewater sample from western Jefferson County. Once researchers received the results, they alerted the Louisville Metro Department of Health and Wellness as well as the state, which confirmed a positive case in the same zip codes with different testing methods a week later.

“The ability to detect viruses early, such as in this case, gives officials more time to take precautions and contain their spread,” said Aruni Bhatnagar, professor of medicine and director of UofL’s Christina Lee Brown Envirome Institute, which leads the wastewater research. “With pandemics, every second counts. In as little as one week, the virus can spread significantly, and then it becomes much harder to contain. This work gives us more time and an opportunity for targeted testing.”

UofL researchers began testing wastewater last year as part of the Co-Immunity Project, a groundbreaking partnership to track COVID-19 in Louisville Metro.

The Louisville/Jefferson County Metropolitan Sewer District has sent weekly samples from 12 sites representing multiple neighborhoods and five wastewater treatment facilities that aggregate the entire county.

Those samples are taken to the UofL Center for Predictive Medicine, where pharmacology and toxicology assistant professor Josh Fuqua and his team process the samples and isolate viral RNA, and to the UofL Genomics and Bioinformatics Core facilities, where computer science and engineering professor Eric Rouchka analyzes the virus sequences to detect variants.

UofL recently announced the expansion of this work, backed by an $8.6 million grant. That expansion goes one step further than previous work — from identifying whether disease exists in a neighborhood to estimating how prevalent it is there.

Bhatnagar said understanding that connection could “revolutionize the way we track and contain pandemics, and not just COVID-19.”

Rather than rely solely on direct testing, such as with nasal swabs, wastewater testing can give health departments another tool to gauge the severity of community infection and to identify areas where the infection is prevalent. The tool also is faster, more efficient and less invasive.

“This is cutting-edge work – and the fact that it’s being done right here in Louisville – right here at UofL – places us at the forefront of public health innovation,” said Louisville Mayor Greg Fischer. “It shows we’re doing the work to keep our city and cities around the world safe.”

Since the beginning of the pandemic, the Co-Immunity Project has conducted ongoing testing and surveys to better understand the spread of the coronavirus and COVID-19. In the past year, UofL researchers have tested more than 12,000 people for COVID-19 infection and antibodies, beginning with frontline health care workers. They also have worked to gauge how local citizens feel about COVID-19 vaccines, with 91% of Jefferson County residents in a recent poll saying they would like to be vaccinated.

“This is one more example of how UofL has led the charge in finding new and innovative ways to detect, contain and fight COVID-19,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “Developing these new, more efficient tools for tracking pandemics, such as wastewater monitoring, is a big step in advancing health for our community and beyond.” 

The Co-Immunity Project needs 2,000 residents to undergo random testing for COVID-19 infection and antibodies the week of May 17-23 as part of this ongoing research. To learn more, visit http://bit.ly/uoflcovid, call 833-313-0502 or email covidsupport@louisville.edu.

UofL Post COVID-19 Research Clinic documents long-term effects of infection

Study adds to knowledge of how COVID-19 affects people over time
UofL Post COVID-19 Research Clinic documents long-term effects of infection

Louisville resident and podcaster A. Dale Josey is a participant in the UofL Post-COVID-19 Research Clinic

When Sophie Fritschner came down with COVID-19 on New Year’s Eve, she had a low-grade fever, cough and body aches. It took her a few weeks to get over the cough and congestion, but the 69-year-old resident of Louisville’s Highlands neighborhood has had no symptoms since.

For Catherine Gamas, it was a different story. Her symptoms were more severe and have lingered. She lost her senses of taste and smell and experienced extreme fatigue and confusion. Months after her diagnosis, the 56-year-old Clarksville, Ind., resident still has intermittent loss of taste and smell, dizziness, daily headaches and hair loss and said she bruises easily.

“I would do one thing and have to sit down. I could go down the stairs but not back up,” she said. “The hair loss is most distressing. It used to take two hours for my hair to dry normally. Now it’s 15 minutes at best.”

A. Dale Josey, a Louisville resident and podcaster, also reported symptoms that disrupted daily routines. He developed lethargy and weakness, had painful joints and was extremely cold. He also experienced blinding headaches, nausea and loss of taste.

“It was too intense to eat,” he said.

To help researchers better understand these and other short- and long-term effects of COVID-19, Fritschner, Gamas and Josey are participants with the Post COVID-19 Research Clinic at the University of Louisville. They are committed to furthering knowledge of post-COVID-19 conditions by sharing their COVID-19 experiences to help UofL researchers learn more about how the disease affects people differently and hopefully improve treatment for others during and after the illness.

For Josey, participation in the research clinic is essential “to add to the body of scientific research.” For the same reason he regularly donates blood (7 gallons of lifetime donations), Josey is participating to improve the health of the Louisville community.

The UofL Division of Infectious Diseases created the multidisciplinary research clinic to study the wide variety of symptoms and effects of COVID-19. Volunteer participants from Louisville and surrounding areas who previously were diagnosed with COVID-19 can participate in the research study to document and monitor their symptoms and health changes over time.

“We will conduct comprehensive mental and physical assessments to determine the many possible effects of COVID-19,” said T’shura Ali, Ph.D., M.P.H., a UofL postdoctoral associate who manages the research clinic. “We want to expand the knowledge of how the disease progresses, to help improve treatments and interventions – both when patients are initially sick and after – to define, measure and prevent the long-term effects of COVID-19.”

Post-COVID symptoms can be any change in quality of life, health status or symptoms that emerge after the infection. COVID-19 patients have reported a wide variety of symptoms weeks and months following their initial infections, but some of the most common include:

  • Decreased cardiac function (fast-beating or pounding heart, heart palpitations, chest pains)
  • Decreased lung capacity (difficulty breathing or shortness of breath)
  • Joint or muscle pain
  • Blood clotting issues
  • Decline in mental health
  • Intense migraines or headaches
  • Fatigue
  • Brain fog (difficulty thinking or concentrating)
  • Continued loss of smell or taste

Participants for the study from Louisville and surrounding areas age 18 and over who have had COVID-19, confirmed by a diagnostic test, are eligible to participate in the study whether they have experienced long-term symptoms following infection or had no additional symptoms. Vaccination status does not affect eligibility.

Researchers will record study participants’ health history and all their COVID-19 symptoms and health changes over time. They will record vital signs, conduct physical examinations and administer validated health assessments, vision tests, lung function tests and electrocardiograms (EKG). Study participants also will be asked to provide blood and urine samples at each visit. The data will be analyzed by a group of experts led by Julio Ramirez, M.D., professor and chief of the Division of Infectious Diseases, including physicians and researchers in cardiovascular medicine, perioperative medicine, pulmonary care and critical care as well as clinical and translational researchers.

To further study decreased heart and lung function, some of the most common and severe symptoms associated with COVID-19, Jiapeng Huang, M.D., Ph.D., professor in the Department of Anesthesiology and Perioperative Medicine, is conducting a sub-study of the research clinic’s participants, supported by Gilead Sciences.

“For this project, we will study the heart, lungs and blood vessels of individuals who have been ill with COVID-19 using ultrasounds done at the clinic. This research will establish the foundation for future preventive and therapeutic strategies,” Huang said.

“These participants are helping to contribute to clinical care, research and science in understanding the burden of disease to help guide progress toward better treatment and care, which ultimately will improve the Louisville community’s overall health,” Ali said.

All appointments and tests are free for the participants. Information will be used for research purposes only and will remain confidential. The research clinic does not provide treatment or referrals, but abnormal findings will be reported to the participants. Study visits are conducted every three to six months and participants are followed for approximately one year.

To learn more, visit the division website, email COVClinic@louisville.edu or call 502-852-8680.

Republic Bank Foundation Optimal Aging Clinic recognized as an age-friendly health system

Republic Bank Foundation Optimal Aging Clinic recognized as an age-friendly health system

The UofL Trager Institute and the Republic Bank Foundation Optimal Aging Clinic

The Republic Bank Foundation Optimal Aging Clinic at the University of Louisville Trager Institute has been recognized as an Age-Friendly Health System by the Institute for Healthcare Improvement. The recognition acknowledges the clinic’s commitment to improve health care for older adults and comes just over one year after it opened.

“It is so exciting that the Republic Bank Foundation Optimal Aging Clinic received the Age-Friendly recognition so shortly after celebrating our one-year anniversary,” said Anna Faul, Ph.D., executive director of the UofL Trager Institute and the Optimal Aging Clinic. “This recognition serves as a testament to the impact we’ve made during our first year. We strive to be on the forefront of patient care for older adults and we look forward to continuing to provide every older adult with the best care possible as part of the Age-Friendly Health Systems initiative.”

As part of the Age-Friendly Health Systems initiative, The John A. Hartford Foundation and the Institute for Healthcare Improvement, in partnership with the American Hospital Association and the Catholic Health Association of the United States, are helping hospitals, clinics and other care settings implement evidence-based interventions specifically designed to improve care for older adults. 

The interventions are tested and adapted through participation in Age-Friendly Health Systems Action Communities. These collaborative entities are comprised of health care teams from across the country that are committed to sharing data and learning together. The teams work to implement best practices across emergency departments, intensive care units, medical-surgical units, general wards and primary and specialty care settings.

The Optimal Aging Clinic now joins more than 450 health systems working to make care for older adults even more tailored to patients’ goals and preferences and consistently of high-quality as part of the initiative, which is based on a series of practices focused on addressing four essential elements of care for older patients known as the 4Ms:

What Matters: Know and align care with each older adult's specific health outcome goals and care preferences including, but not limited to, end-of-life care, and across settings of care.

Medication: If medication is necessary, use age-friendly medications that do not interfere with What Matters to the older adult, Mobility, or Mentation across settings of care.

Mentation: Prevent, identify, treat and manage dementia, depression and delirium across settings of care.

Mobility: Ensure that older adults move safely every day in order to maintain function and do What Matters.

Joe D’Ambrosio, J.D., Ph.D., director of behavioral health at the UofL Trager Institute and Republic Bank Foundation Optimal Aging Clinic, says the Age-Friendly initiative also is infused in the organization’s Behavioral Health Services Organization.

“We are so happy to include this initiative in the work we do with our therapy patients,” D’Ambrosio said. “The 4Ms of the initiative align perfectly with the behavioral health interventions we share with patients in their efforts to age optimally and we are excited to build upon the progress we have made in our first year to continue to help older adults thrive as they age.”

Learn more about the Republic Bank Optimal Aging Clinic in a video created to celebrate the clinic’s first anniversary.

For more information or a tour of the Trager Institute and the Republic Bank Foundation Optimal Aging Clinic, please contact Lisa Warner, UofL Executive Director of Development at 502-852-7448.

UofL receives $8.6 million for COVID-19 wastewater research

Findings could lead to public health breakthrough for monitoring pandemics

The University of Louisville has received $8.6 million from the U.S. Centers for Disease Control and Prevention (CDC) to back research that could help health departments use wastewater to monitor the rate of COVID-19 infection.

UofL researchers already are testing wastewater to determine whether coronavirus infection exists in different neighborhoods around Jefferson County. This new work goes one step further, with the goal of estimating how many people within those neighborhoods are infected. If virus levels are high in the wastewater, it may be a signal of widespread infection in the community. 

“This could revolutionize the way we track and contain pandemics, and not just COVID-19,” said Aruni Bhatnagar, professor of medicine. “It gives us an invaluable tool that could offer a clearer view of where and how the virus spreads.”

Researchers at UofL’s Christina Lee Brown Envirome Institute, where Bhatnagar is director, began testing wastewater last year as part of the Co-Immunity Project, a groundbreaking partnership with the Louisville Healthcare CEO Council to track COVID-19 in Metro Louisville. 

As part of that effort, the Louisville/Jefferson County Metropolitan Sewer District has sent weekly samples from 12 sites representing multiple neighborhoods and five water quality treatment centers that aggregate the entire county to the UofL Center for Predictive Medicine for virus analysis.

In this new work, MSD and other community partners will continue collecting wastewater samples over the next six months. After analysis, UofL will also send the results to the CDC’s National Wastewater Surveillance System, which will help inform efforts across the U.S. 

As with previous rounds of COVID-19 testing conducted through the Co-Immunity Project, researchers will recruit participants by sending letters to selected households across Jefferson County. They hope to continue to enroll a few thousand people every month and will compare their COVID-19 infection and antibody results with wastewater samples from the same area, with the goal of finding how they correlate.

“The aim of the project is to figure out whether we can estimate how many people in a given area are infected by simply testing the community wastewater,” said Ted Smith, associate professor of medicine and a lead on the wastewater epidemiology project. “Additionally, this is a passive and comparatively low-cost way to monitor community infection and has the additional benefit of being inclusive of all communities in our city and is a promising step to ensuring public health equity.”

Since the beginning of the pandemic, the Co-Immunity Project has conducted ongoing testing and surveys to better understand the spread of the coronavirus and COVID-19. In the past year, UofL researchers have tested more than 12,000 people for COVID-19 infection and antibodies, beginning with frontline health care workers. They also have worked to gauge how local citizens feel about COVID-19 vaccines, with 91 percent of Jefferson County residents in a recent poll saying they would like to be vaccinated.

“This is critically important work in our fight against COVID-19,” said Kevin Gardner, UofL’s executive vice president for research and innovation. “Our hope is that by working with the CDC, we can develop these new, more efficient tools for tracking pandemics and take a big step in advancing health for all of our community.” 

Last year, U.S. Senator Mitch McConnell (R-KY), then the Senate majority leader, negotiated and championed five historic and completely bipartisan COVID-19 rescue packages. In addition to supporting workers and propping up the economy, these relief bills also allocated $33.4 billion for COVID-19 testing. McConnell personally called then-U.S. Secretary of Health and Human Services Alex Azar to request that the CDC direct a portion of that funding to UofL’s Co-Immunity Project.

Our country has responded to this terrible pandemic with innovation and discovery and Kentucky continues to play a major role in beating this virus. I’d like to congratulate Dr. Bhatnagar and UofL’s entire Co-Immunity Project on their groundbreaking study,” McConnell said. After hearing about their work, I took this project to the highest levels of the federal government to help accelerate their research with additional federal funding. As UPS and other Louisville employers are sending safe and effective vaccinations around the country, I’m proud top researchers right here at UofL are pushing the boundaries of knowledge in detection and prevention.”

 

UofL research could eliminate dangerous side effects of gene therapy delivery

UofL research could eliminate dangerous side effects of gene therapy delivery

Maureen McCall, Ph.D.

New research by the University of Louisville with colleagues at Harvard University could prevent dangerous and potentially life-threatening side effects the delivery mechanism for targeted gene therapies meant to slow everything from muscle atrophy to vision loss.

The work targets a leading delivery method for the therapies, adeno-associated virus (AAV), and recently was published in the journal Science Translational MedicinebyUofL’s Maureen A. McCall, Ph.D., and her colleagues from Harvard University and its Wyss Institute.

AAV is used in treating a number of conditions, including the retinal diseases McCall studies at UofL. However, it also has been known to cause serious side effects, such as elevated immune response and inflammation.

“It’s a real problem since there’s no real control,” said McCall, the Kentucky Lions Eye Research Endowed Chair and a professor in the Departments of Ophthalmology and Visual Sciences and Anatomical Sciences and Neurobiology. "Even with the best-laid plans, you see some inflammatory retinal response, and the amount can vary widely, including dangerous levels.”

The new research focuses on the role of the viral capsid, a component in AAV that’s believed to cause this response. Parts of the viral capsid interact with a protein known as Toll-like receptor 9 (TLR9), which senses foreign DNA in the body. TLR9 triggers the immune response, which causes inflammation and can reduce or eliminate the therapy's effects.

“So, the hypothesis was that if you could change that capsid code and mask it from the Toll-like receptor, that you could build a better delivery tool,” McCall said.

The idea is to “cloak” the deleterious part of the capsid with a series of synthetic DNA “inflammation-inhibiting oligonucleotide” sequences meant to stop TLR9’s reaction. In mouse models, the researchers saw a 95% reduction in inflammation.

In many cases, gene therapies for optical diseases are delivered through the retina since the blood-retina barrier helps to mitigate some of the immune response. Ying Kai Chan, Ph.D., a former postdoctoral fellow in George Church's group at the Wyss Institute, reached out to McCall in 2018 to partner on this work because of her research expertise and the experience of her UofL colleagues with these injections, especially Wei Wang, M.D., Ph.D., assistant professor of ophthalmology.

McCall's work at UofL specifically focuses on the use of gene therapies to treat retinal diseases, including retinitis pigmentosa and other conditions that eventually can cause blindness. For some of these conditions, there is no known cure and many therapies are still in development and clinical trials. McCall said eliminating side effects associated with AAV delivery gets researchers one step closer to successful treatment.

“Solving this key problem with delivery is huge," she said. “These therapies show promise in significantly increasing people's quality of life. My hope is that one day we can use these therapies to slow – or even stop – the progression of these diseases and restore sight.”

Co-Immunity Project survey of Jefferson County residents shows 91 percent of people would choose to be vaccinated against COVID-19

Most Jefferson County residents would choose to be vaccinated against COVID-19, according to a survey conducted by researchers in the University of Louisville Christina Lee Brown Envirome Institute. The survey was conducted as part of the Co-Immunity Project, ongoing research to better understand the impact of COVID-19 in Jefferson County.

In February, the researchers asked adults living in Jefferson County their perceptions about the coronavirus vaccine in order to identify potential barriers to vaccine uptake and to better understand vaccine hesitancy. Letters were mailed to 35,999 households across all geographic sectors of the county inviting the recipients to take part in the survey as well as to make an appointment for free testing for COVID-19, also part of the Co-Immunity Project.

“We wanted to better understand which residents had access to the vaccine as well as their attitudes toward the vaccine,” said Aruni Bhatnagar, Ph.D., director of the UofL Brown Envirome Institute. “This information would help us improve equity in vaccine availability as well as help us understand the reasons behind vaccine hesitancy in our community. So, we incorporated the survey opportunity into our outreach for random community testing for the virus.”

The survey included questions about whether the person had been vaccinated, where they received most of their information about the vaccine and where they would prefer to be vaccinated. They also had an option to indicate they would not get vaccinated. They also were asked what would make them more likely to be vaccinated and what influenced those who were hesitant to vaccination.

Participants completed the questionnaire on a website that also offered them the opportunity to schedule an appointment for COVID-19 infection and antibody testing. Most of the 1,296 survey participants were age 60 or over (44%), female (61%) and white (84%) and 90.2% reported being unvaccinated.

An overwhelming majority of participants (91%) indicated they would choose to be vaccinated, with slightly lower rates among minority participants. Vaccine-hesitant participants suggested that more evidence of safety and effectiveness or their health provider’s recommendation would increase their likelihood of getting vaccinated. Although vaccines are provided for free, concerns about cost were seen in more than half the participants.

While most vaccine-hesitant participants expressed concern about side effects and safety, followed by not “tested on enough people who are like me,” minority participants expressed these concerns at higher rates and many vaccine participants from all races had concerns about the timeline of vaccine development. Other concerns were related to the efficacy of the vaccines, vaccines in general and government mistrust.

About 3% of white and 8% of minority participants indicated they would never choose vaccination. Minority participants reported they were more likely to choose vaccination with celebrity endorsement, offerings by faith organizations and vaccination requirements. White participants were more likely to choose vaccination if their family and friends or elected officials were vaccinated and with evidence of efficacy.

Most participants would prefer to be vaccinated by their health care provider, followed by a mobile or walk-in clinic, a pharmacy or a hospital. Other sites, such as community organizations, community recreation centers, workplaces or schools were of interest to one-fourth or less of participants. Minority participants were less interested in vaccination at work, pharmacies, libraries and mobile or walk-up clinics and more interested in being vaccinated at food distribution centers or by their health care provider.

Compared with white participants, minority participants were less likely to report knowing how to find out their vaccine eligibility or sign up for a vaccination.

While they acknowledge limitations to the study due to the fact that it was delivered along with the testing invitation and that it required a computer and internet access to complete, the researchers believe analysis of the results will be helpful in increasing access and acceptance of vaccines among different populations.

“Obtaining information on how to get a vaccine continues to be burdensome and solutions to this problem will help with more equitable vaccine distribution,” said Rachel Keith, Ph.D., assistant professor in the UofL Department of Medicine and a lead investigator in the Co-Immunity Project.

Aging experts from across the U.S. to speak at Optimal Aging Conference

Aging experts from across the U.S. to speak at Optimal Aging Conference

Presenter Stan Craig at the 2019 Optimal Aging Conference

Experts on aging from across the United States will share their knowledge at the fourth Optimal Aging Conference, hosted by the University of Louisville Trager Institute and the Kentucky Association for Gerontology. With an emphasis on interdisciplinary approaches, the 2021 Optimal Aging Conference offers educational and networking opportunities for health care, social service and technology professionals, as well as older adults and their caregivers.

“Our strong line-up of speakers, breakout sessions and poster sessions is not to be missed for anyone working in the aging field or who has interest in inspiring our understanding of aging,” said Anna Faul, Ph.D., executive director of the Trager Institute. “After having to cancel last year’s event, we are excited to bring back the Optimal Aging Conference this year on a virtual platform that allows for an incredibly rich and engaging experience.”

The 2021 conference, scheduled for April 18-20, will feature experts in aging, dementia and Alzheimer’s research, innovation and public health and will be held virtually.

“The 2021 Optimal Aging Conference will provide outstanding resources, inspiring ideas and continuing education for Kentucky’s aging service professionals,” said Anne Wildman of the Kentucky Association of Gerontology. “The conference is a great opportunity for networking and professional development.”

2021 Optimal Aging Conference topics and speakers:

Aging Inspired in Kentucky: Directions in Aging Policy (Panel Discussion)

  • Sandy Markwood, CEO, National Association of Area Agencies on Aging
  • Eric Friedlander, acting secretary, Kentucky Cabinet for Health & Family Services
  • Lindsey Hix, deputy director, Office of Senior Protection & Mediation, Office of the Kentucky Attorney General
  • Victoria Elridge, commissioner, Department for Aging and Independent Living

 A Community Network Approach to Health

  • Eric Feigl-Ding, Ph.D., chief health economist, MicroClinic International; faculty member, Harvard Medical School and Brigham and Women’s Hospital, Boston

Ending the Alzheimer's Pandemic

  • Dale Bredesen, M.D., professor, UCLA; founding president and professor emeritus, Buck Institute for Research on Aging; author of New York Times bestseller, The End of Alzheimer’s

AARP Keynote: Words of Wisdom for #Agetech Entrepreneurs

  • Nigel Smith, M.B.A., director, Hatchery Ventures, AARP Innovation Labs, Washington

Alzheimer’s Update

  • Gregory Jicha, M.D., Ph.D., professor of neurology and director, Sanders-Brown Center on Aging at the University of Kentucky

Guided by the theme “Aging Inspired,” conference attendees also will hear from experts on how to prevent financial elder abuse, national programs and arts activism counteracting ageism, programs for caregivers of persons with Alzheimer’s disease and related dementias, the future impacts of artificial intelligence and robotics in senior care, trauma-informed care of older adults, international evidence-based falls programs, lifestyle medicine nutrition and more.

Register through April 16. Contact Kelly Nason at or Barbara Gordon at barbara.gordon@louisville.edu for more information.

UofL pulmonologists treat first local patient in COPD clinical trial

Targeted lung denervation may offer new option for COPD patients

Physicians from the University of Louisville are the first in Kentucky to perform an investigational procedure designed to help patients with chronic obstructive pulmonary disease, or COPD. The procedure, known as targeted lung denervation (TLD), may provide an additional treatment option for patients suffering from frequent COPD flare-ups, or lung attacks.

COPD causes restricted airflow from the lungs, resulting in breathing difficulty, cough, mucus production and wheezing. TLD involves the removal of tissue in the lungs that may be making symptoms worse. Performed via bronchoscopy, the procedure is designed to disrupt pulmonary nerve reflexes, which may have the potential to reduce COPD exacerbations.

AIRFLOW-3, a phase 3 clinical trial sponsored by Nuvaira, is enrolling patients with moderate-to-severe COPD, high symptom burden and a history of COPD exacerbations, including increased coughing, wheezing and breathing distress, to evaluate the safety and effectiveness of TLD. 

Umair A. Gauhar, M.D., associate professor at the UofL School of Medicine, led a medical team in the Division of Pulmonology that successfully treated a COPD patient with TLD therapy in one-hour-long outpatient procedure at UofL Health – UofL Hospital. The patient returned home the same day. 

“Many of our COPD patients experience exacerbations which cannot be controlled with their inhaler medications,” Gauhar said.  “As a pulmonary community, we need to embrace the development of interventional therapies which may stabilize COPD patients and help reduce their risk of exacerbation. Based on the existing evidence, we are enthusiastic about the potential of TLD to meet a true unmet medical need and are proud to have treated our first patient in the AIRFLOW-3 clinical trial.”

Debbie Sowers, a 58-year-old resident of Madison, Ind., said she participated in the trial at UofL to help develop better treatments for COPD.

“I participated to help everybody that has COPD and to try to better my breathing,” Sowers said. “There need to be more studies on COPD because it is a really bad disease. It stops your life.”

UofL is the only center in Kentucky enrolling COPD patients for AIRFLOW-3 and is one of up to 25 centers across the United States enrolling patients in the trial.

Nuvaira is headquartered in Minneapolis, Minn. The company’s proprietary Nuvaira® Lung Denervation System addresses airway hyper-responsiveness, a pathophysiologic underpinning of both COPD and asthma, with TLD therapy. The Nuvaira Lung Denervation System is an investigational device in the United States and has CE mark approval in the European Economic Area (EEA). Nuvaira has completed and published four clinical studies, including AIRFLOW-2, a randomized, sham-controlled, double-blind, multicenter clinical trial.

UofL medical students encourage youth affected by violence to become future healers

UofL medical students encourage youth affected by violence to become future healers

Christopher 2X with UofL medical students Jenci Hawthorne, Karen Udoh and Briana Coleman at the presentation of the Kelsie Small Future Healer Award on Feb. 23.

High rates of violence have plagued Louisville in recent years, escalating sharply in 2020. Students in the UofL School of Medicine are working to combat patterns of violence with action.

Students in the UofL Student National Medical Association (SNMA) are working with Christopher 2X Game Changers and UofL faculty in creating the Future Healers Program to help Louisville youth affected by violence in their neighborhoods navigate the trauma of violence and inspire them to build a better future for themselves and their communities.

Karen Udoh, UofL SNMA president and a second-year medical student, spearheaded the White Coats for Black Lives rally on the Health Sciences Center Campus in June 2020. But she and fellow SNMA members wanted to do more than only demonstrate to fight violence in the community.

“It’s not enough for us to be here in our white coats saying that we care and then go back to our offices and not do anything about it,” Udoh said. “That’s how we came to work with the UofL Department of Surgery, the Trauma Institute and the Christopher 2X Game Changers to create the Future Healers Program. We want to show these youth that we care about the environment they are in, we want to invest in them and change these issues.”

Udoh, Briana Coleman, Jenci Hawthorne and Satya Alluri worked with Department of Surgery faculty members Keith Miller, M.D., and Christopher Jones, M.D., to develop educational sessions to teach preschool and middle school students about general anatomy and surgery. The Future Healers Program is aimed to inspire youth in the neighborhoods most affected by violence to pursue lives of healing as health care professionals.

“We felt like this is our realm – medicine – so let’s inspire people. It’s a simple way we can at least show our youth, this is something you can aspire to be. You have a choice, you have options,” Udoh said.

In mid-February, the SNMA team conducted a pilot session of the Future Healers Program with approximately 50 preschool and middle school children at the Chestnut Street YMCA. The students conducted 45-minute interactive, virtual sessions that included pre-recorded videos with the faculty members, a mindfulness activity and hands-on activities for the kids. A “doctor’s bag” with masks, gloves and modelling clay for creating their own anatomy models was provided to each of the children.

“Seeing the children shape clay into stomachs and small intestines was such a joy. Together we crafted a space for intellectual curiosity and trust,” Hawthorne said. “Our goal is to create a trusting relationship with the youth that we hope can become our future healers. We want them to know that we see them and that we are here for them. We want them to see us as allies who love them and who care about them.”

With additional support from medical student, staff or trainee volunteers, sponsors, School of Medicine faculty members and Christopher 2X Game Changers, the UofL students plan to conduct future regularly scheduled sessions with the youth and to expand the program to more young people in the community.

“At the School of Medicine, we have a goal to create and train physicians who are culturally aware, culturally responsive and social-justice minded. We not only want to train the best doctors, but doctors who are willing to roll up their sleeves and get out into the community,” said Dwayne Compton, Ed.D., associate dean for community engagement and diversity in the School of Medicine and a faculty adviser for SNMA. “These students have created a program that will have a profound impact in our community.”

Earlier this week, Udoh and the SNMA joined Christopher 2X, UofL Health and the UofL Hospital Trauma Institute to present the first Kelsie Small Future Healer Award. The award honors the life of Kelsie Small, a nursing student at Northern Kentucky University who was shot and killed in Louisville in May 2020. Christopher 2X Game Changers will present the award annually to honor a skilled, compassionate health care worker. The first Future Healer Award was presented to Small’s mother, Delisa Love.

To support the SNMA Future Healers Program as a volunteer or through sponsorship, contact or faculty liaison .

UofL healers and researchers honored as health care heroes

UofL healers and researchers honored as health care heroes

V. Faye Jones, M.D., Ph.D., M.S.P.H.

Louisville Business First has named six medical professionals affiliated with the University of Louisville as 2021 Health Care Heroes, including a lifetime achievement award for V. Faye Jones, M.D., Ph.D., M.S.P.H.

A UofL School of Medicine alumna, Jones leads UofL’s diversity initiatives as senior associate vice president for diversity and equity. She also is associate vice president for health affairs/diversity initiatives, professor of pediatrics and vice chair, Department of Pediatrics-Inclusive Excellence.

In addition to the lifetime achievement award for Jones, the publication recognized the following faculty members and UofL Health providers as Health Care Heroes.

Front-line Hero:
Ruth Carrico, Ph.D., professor in the UofL Division of Infectious Diseases and a family nurse practitioner, UofL Health

Health Entrepreneur:
Suzanne Ildstad, M.D., professor, UofL Department of Surgery, director, UofL Institute for Cellular Therapeutics, founder and chief scientific officer, Talaris Therapeutics Inc., and Distinguished Professor of Transplantation Research at UofL Health - Jewish Hospital.

Innovator:
Paula Bates, Ph.D., professor of medicine at UofL School of Medicine, and Kenneth Palmer, Ph.D., professor of pharmacology and toxicology and Helmsley Charitable Trust Endowed Chair in Plant-based Pharmaceutical Research at UofL as well as director of the UofL Center for Predictive Medicine for Biodefense and Emerging Infectious Diseases and UofL’s Regional Biocontainment Laboratory.

Provider:
Valerie Briones-Pryor, M.D., medical director for the hospitalist team, UofL Health — Jewish Hospital and UofL Health — Mary & Elizabeth Hospital

Gary Weinstein, M.D., clinical associate professor for the UofL Department of Psychiatry and Behavioral Sciences, owner of Gary Weinstein MD and founder/volunteer of the Louisville Free Mental Health Clinic. Weinstein practices at Louisville VA Medical Center.

The 2021 Health Care Heroes will be profiled in the April 9 edition of Louisville Business First and recognized during a virtual event Thursday, April 8, from 11:30 a.m. to 12:30 p.m. The event also will include a panel discussion with the CEOs of Louisville's three largest health systems: Tom Miller of UofL Health, Gerard Colman of Baptist Health and Russell Cox of Norton Healthcare. Register to attend here.

Medical Schools See an Increase in Applications During the Pandemic

Medical schools across the country are reporting surges in applications. The COVID-19 pandemic has made an impact during the 2021-2022 cycle.

Prospective students are looking to join medical students like Lisa Anakwenze. Anakwenze is a first year medical student at the University of Louisville (UofL) School of Medicine. She thinks the heroism of frontline healthcare workers during the pandemic might’ve inspired more people to apply.

“Applying to medical schools is an insanely tough process, but I think that a lot of people are motivated about what was going on in the pandemic,” said Anakwenze.

Since UofL's School of Medicine is a state school, about 75% of the class is from Kentucky. Dr. Stephen Wheeler, the Associate Dean of Admissions at UofL School of Medicine, said that the school has seen a 35% increase in out-of-state applications during the past five years.

“Science has brought to the forefront in terms of helping people the past year the pandemic and that’s part of it,” Wheeler said.

Experts believe that students have more time for applications since college classes have shifted online. Many schools extended deadlines and fewer applications are taking a gap year because of limited opportunities. The interview process is cheaper due to travel restrictions — all of these factors on top of the work of frontline healthcare workers helped contribute to the trend.

“I had personal stories related to health that inspired me for a lot of students, potentially seeing the impacts of COVID[-19] in their community may have inspired them to apply as well,” said Anakwenze.

Wheeler said that usually 40% of people that take the MCAT apply to medical schools to at least get into one of the schools to which they applied. UofL’s out of state applications compete for very few spots. Out of about 4,500 applications, the school only selects 42.

“We are very selective about who we interview from out of state,” Wheeler said. “Most of the ones we interview from out of state have some connection to Kentucky."

Anakwenze’s advice for students who didn’t get into a school is to not be discouraged.

“You have to be able to continue pushing yourself and have that drive and know where you belong and what you want out of life as well as the positive impact you want to make on other people,” she said.

UofL Health and Kindred Healthcare announce plans for inpatient rehabilitation hospital

Joint venture will build and operate 40-bed hospital in Louisville, Kentucky

UofL Health and Kindred Healthcare LLC have announced a joint venture to build and operate an inpatient rehabilitation hospital in Louisville, Kentucky.

This new 40-bed inpatient rehabilitation hospital will be located at 5000 Chamberlain Lane, near the intersection of I-71 and I-265 in the northeast area of Jefferson County, and will serve the growing East End of Jefferson County and adjacent counties. The approximately 55,000-square-foot, two-story rehabilitation facility will have all private rooms and focus on acute rehabilitation for patients who suffer from stroke, traumatic brain injury, spinal cord injury, complex neurological disorders, orthopedic conditions, multiple trauma, amputation and other injuries or disorders. Large multidisciplinary therapy gymnasiums will be outfitted with the latest therapeutic technologies, including augmented reality balance training, therapy bionics and a full body exoskeleton. The hospital will also include a therapeutic courtyard with exterior amenities.

UofL Health – Frazier Rehab Institute is recognized nationally as an innovator in rehab care. For more than six decades, patients from across the world have sought out Frazier Rehab for life-enhancing treatments and therapies. The new facility is expected to help manage the growing needs of the region and will free up access to the array of specialty programs at its downtown location with one common goal – helping people of all ages with disabilities reach their fullest potential in physical and cognitive functioning.

“This new inpatient rehabilitation hospital will combine Kindred’s national expertise in rehab excellence with Frazier Rehab’s first-in-class care and leading innovation,” said Tom Miller, CEO of UofL Health. “The new hospital will increase access to our rehab services, addressing unmet needs in our growing community.”

“We are proud to partner with UofL Health to offer the Louisville community increased access to high-quality inpatient rehabilitation services,” said Jason Zachariah, Kindred’s president and chief operating officer. “Frazier Rehab has an impressive legacy, with more than 60 years in rehab care, and we are excited to work alongside them to improve patients’ lives. This new hospital will be dedicated to passionately advocating for and providing hope, healing and recovery to patients in its care.”

The partners expect the hospital to open by the fourth quarter of calendar year 2022, subject to several regulatory and other approvals.

UofL tapped for Lilly monoclonal antibody trial in long-term care facilities

Phase 3 clinical trial evaluating bamlanivimab for prevention of COVID-19 in response to increased exposure risk
UofL tapped for Lilly monoclonal antibody trial in long-term care facilities

Release and stability testing of clinical trial materials. Photo: Eli Lilly and Company

Researchers from the University of Louisville are working with Eli Lilly and Company in a clinical trial to determine whether its monoclonal antibody treatment, bamlanivimab, can reduce the risk of transmission of COVID-19 in long-term care facilities.

The Phase 3 trial enrolls residents and staff who live or work at facilities that have had a recently diagnosed case of COVID-19 and who now are at a high risk of exposure. The study, which included Essex Nursing and Rehabilitation Center in Louisville recently, is to evaluate the efficacy and safety of bamlanivimab for the prevention of COVID-19. The study also is exploring treatment of recently diagnosed SARS-CoV-2- and COVID-positive patients who are at high-risk of developing severe disease.

As the only Kentucky location for the Phase 3 clinical trial, UofL’s Division of Infectious Diseases worked with mobile units deployed by Lilly to the Louisville site to enroll and treat trial participants. Julio Ramirez, M.D., director of the division, leads the work, which includes follow-up monitoring for study participants at this facility and any others in Kentucky who may participate in the trial.

“We are thrilled to be partnering with NIH and Lilly for the implementation of their BLAZE-2 study in Kentucky. With nearly 30,000 residents in long-term care facilities in the state, there is an urgent need for therapeutic strategies to prevent the spread of COVID-19 in this vulnerable population. We are proud to be a part of this new type of clinical study for preventive treatment,” Ramirez said.

For this trial, Lilly deploys mobile research units to a long-term care site soon after an individual has tested positive for SARS-CoV-2. The unit team enrolls residents and staff members who volunteer to participate in the trial. The one-time study drug infusion and follow-up visits are administered to study volunteers at the long-term care facility. The UofL team works with the Lilly team during the initial site infusions and will monitor participants following the infusion for up to 25 weeks.

The first deployment in Kentucky was to Essex Nursing and Rehabilitation Center, where 20 residents and staff members were enrolled in the study in November.

“Our elderly population is at a much higher risk of complications from COVID-19 and our staff and residents are happy to be participating in this study. I have personally witnessed the negative impact COVID-19 has had on nursing facilities,” said Robert Flatt, R.N., B.S.N., Essex administrator. “I am extremely proud to be an active participant in this collaborative study in the hopes that we will soon put an end to this pandemic.”

The virus is known to spread rapidly among staff and residents of long-term care facilities, who account for a high percentage of hospitalizations and deaths resulting from the virus.

“I am glad to be a part of this research study with the University of Louisville to help find treatment and prevention options for COVID-19. As a member of our community, I am happy to participate in the hopes of helping others. I am also excited to participate as I am a huge fan of the University of Louisville,” said Patricia L. Rollie, an Essex resident and study participant.

Antibodies are produced naturally by the immune system in response to viruses and other foreign invaders and help the body neutralize and destroy these threats. However, it takes time for the body to produce its own antibodies. Bamlanivimab is an antibody engineered from a COVID-19 survivor. Testing and previous trials have shown that manufactured antibodies can speed recovery or possibly prevent SARS-CoV-2 infection.

“COVID-19 has had a devastating impact on nursing home residents. We’re working as fast as we can to create medicines that might stop the spread of COVID-19 to these vulnerable individuals,” said Daniel Skovronsky, M.D., Ph.D., Eli Lilly’s chief scientific officer and president of Lilly Research Laboratories. ”BLAZE-2 is a first-of-its-kind COVID-19 trial designed to address the challenging aspects of running a clinical trial in long-term care facilities, which normally do not conduct clinical trials.

As a result of a separate clinical trial, Lilly has received an emergency use authorization from the FDA for bamlanivimab to treat higher-risk patients recently diagnosed with mild-to-moderate COVID-19.

Bamlanivimab targets the spike protein of the SARS-CoV-2 virus. It is designed to block viral attachment and entry into human cells, thus neutralizing the virus and potentially preventing and treating COVID-19. Bamlanivimab emerged from the collaboration between Lilly and AbCellera and was discovered by AbCellera and scientists at the National Institute of Allergy and Infectious Diseases Vaccine Research Center. 

 

 

Feb. 8, 2021