J. Jeremy Thomas, M.D., M.B.A., has joined the University of Louisville School of Medicine faculty as chair of the Department of Emergency Medicine. The UofL Board of Trustees approved his appointment during a regular meeting on Jan. 23. Thomas also will serve as chief of service for emergency medicine at UofL Hospital.

Thomas, board certified by the American Board of Emergency Medicine, was a tenured professor and executive vice chair of the University of Alabama-Birmingham Department of Emergency Medicine prior to his appointment at UofL. He also served as associate chief medical officer of emergency services and sepsis at UAB Medicine, UAB Hospital, as well as director of emergency services for UAB Hospital.

“The program at UofL has a very strong reputation for clinical training and for outstanding patient care. The resident teaching and the service to the community are outstanding,” Thomas said. “With my clinical operations and education background, the opportunity to lead this department was appealing.”

As chair of the UofL Department of Emergency Medicine, Thomas will oversee the training of medical students and residents within the School of Medicine. As chief of service for UofL Hospital, Thomas will direct clinical services provided by the emergency department.

School of Medicine Dean Toni Ganzel said she was pleased to recommend Thomas for the position.

“I am confident that Dr. Thomas’s talent, skills and energy will be a good fit for leading the department into the future and he will build on the many strengths of the department,” she said.

UofL Health CEO Tom Miller also expressed confidence in his selection.

“Dr. Thomas’s leadership complements the outstanding care provided every day by our emergency medicine team,” Miller said.

Thomas, an Alabama native, attended medical school at the University of South Alabama and earned a master’s of business administration from Auburn University. He completed his emergency medicine residency at UAB and a cardiovascular emergencies fellowship at the University of Virginia. He received a bachelor of science degree in biology from Cumberland College (now University of the Cumberlands) in Williamsburg, Ky.

“Having been to college in Kentucky and having colleagues and friends who trained at UofL and some who still live in the area made it an easy transition for me from a personal standpoint,” Thomas said.

The affiliation between Norton Healthcare, UofL Physicians – Pediatrics and the University of Louisville School of Medicine was finalized on Sunday, March 1, 2020.

Under the newly formed Norton Children’s Medical Group, affiliated with the UofL School of Medicine, 21 former UofL general pediatric and pediatric subspecialist practices are now part of Norton Healthcare. Approximately 600 providers and staff have transitioned with the affiliation.

“By integrating the best pediatric providers who are committed to providing safe, high-quality care, we will make it easier for families to access comprehensive medical care for their children,” said Russell F. Cox, president and CEO, Norton Healthcare.

The UofL physicians and providers who are currently on the faculty of the school of medicine will remain in their academic role and will also work clinically within Norton Children’s Medical Group.

“UofL is committed to helping nurture healthy children and communities while maintaining our strong academic training programs and research. This agreement ultimately will translate into even better care for children,” said Neeli Bendapudi, Ph.D., president, UofL.

“Integrating allows the two organizations to move forward, capitalizing on each other’s strengths for the benefit of our patients and families,” said Steven T. Hester, M.D., MBA, division president, provider operations, and system chief medical officer, Norton Healthcare.

The affiliation is designed to make it easier for patients to access outpatient care within the practices and inpatient care at Norton Children’s Hospital. Access will be improved through:

• Scheduling enhancements
• Recruiting additional providers
• Increasing the number of multidisciplinary clinics, where patients with serious and chronic medical conditions can see multiple specialists on the same day
• Using a single integrated electronic medical record, which will make it easier for patients and families to access test results and communicate with their providers

“Ultimately, the goal is to develop and deliver the best possible programs, services and patient experience for the children of Kentucky and beyond,” said Jennifer C. Evans, M.D., MPH, FACOG, system vice president, women’s and pediatric services, Norton Healthcare. “Both organizations have been committed to providing a seamless transition.”

This new model also will allow the practices to enhance their focus on providing highly skilled clinical care that is integrated with world-class medical education and research. A strong continued commitment to innovation and education is an important component of the integration. UofL’s academic and research mission is key to teaching the next generation of pediatric providers, which is essential to growing a regionally and nationally recognized pediatric program. In addition, by working together, the organizations can recruit, train and retain key talent for pediatric programs.

“Children will benefit from the strong academic training programs and research that will continue through the UofL School of Medicine,” said Kimberly A. Boland, M.D., professor and chair, department of pediatrics, University of Louisville School of Medicine. “Working together will help us attract additional specialists to Louisville to care for children with the most complex medical issues. We look forward to seeing what great things we can accomplish together, not only in clinical care, but also in educating future pediatricians and making new discoveries in the field of child and adolescent health care.”

With an emphasis on interdisciplinary approaches, the 2020 Optimal Aging Conference offers unique educational and networking opportunities for health care, social service and technology professionals, alongside older adults and their caregivers.

The conference, now in its fourth year, will feature experts in aging, dementia and Alzheimer’s research, innovation and public health. The University of Louisville Trager Institute and the Kentucky Association for Gerontology are hosting the conference April 19-21 at the Brown Hotel, 335 W. Broadway, in Louisville.

“We are thrilled to present such a strong line-up of speakers,” said Anna Faul, PhD, executive director of the University of Louisville Trager Institute. “The presenters, along with our breakout and poster sessions, will provide an incredibly rich and engaging experience for anyone working in the aging field or who has interest in inspiring our understanding of aging,” she said.

2020 Optimal Aging Conference Topics and Speakers:

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

• Sandy Markwood, national CEO, National Association of Area Agencies on Aging
• Eric Friedlander, acting secretary, Kentucky Cabinet for Health & Family Services
• LaDonna Koebel, executive director, Office of Senior Protection & Mediation, Kentucky Office of the Attorney General

A Community Network Approach to Health
Eric Feigl-Ding, PhD,chief health economist,MicroClinic International; faculty member, Harvard Medical School and Brigham and Women’s Hospital, Boston

Ending the Alzheimer's Pandemic
Dale Bredesen, MD,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, MBA, director, Hatchery Ventures, AARP Innovation Labs, Washington, D.C.

Alzheimer’s Update
Gregory Jicha, MD, PhD, professor of neurology; 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 a number of topics including: 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.

“The 2020 Optimal Aging Conference provides outstanding resources, inspiring ideas, and continuing education for Kentucky’s aging service professionals. The conference is a great opportunity for networking and professional development,” said Stacey Watkins, president of the Kentucky Association of Gerontology.

The UofL Trager Institute also will host a mobile workshop for its new Republic Bank Foundation Optimal Aging Clinic. The clinic, located in Louisville’s Innovation Corridor, is a one-stop-shop that provides integrated life-long wellness by combining lifestyle and preventative medicine with specialized and acute care.

Early-bird registration ends March 22. Learn more about registration, keynote speakers, and continuing education online at: https://www.tragerinstitute.org/optimal-aging-conference. Contact Natalie Pope at natalie.pope@louisville.edu for more information.

Astrocytes, abundant, star-shaped glial cells in the central nervous system, are known to support neurons through such tasks as providing glue that helps neurons stick together, delivering nutrients and removing waste. However, research published last month in Proceedings of the National Academy of Sciences (PNAS) reveals they also play a commanding role in visual development.

University of Louisville researchers, working with colleagues at Virginia Tech Carillion (VTC), have discovered that astrocytes play a crucial role in directing interneurons, specialized neurons essential for vision, to the proper location in the brain during development. In response to visual stimulation, astrocytes express fibroblast growth factor 15, (FGF15), a molecule that directs the interneurons from germinal zones to their destination in the visual thalamus.

Neurobiologists William Guido, Ph.D., chair of the Department of Anatomical Sciences and Neurobiology at UofL, and Michael Fox, Ph.D., director of the Center for Neurobiology Research at Virginia Tech Carilion, worked in collaboration to reveal this process. The publication, “Retinal inputs signal astrocytes to recruit interneurons into visual thalamus,” also included significant lab work by graduate students at both universities.

“My lab identifies a neurocircuit and follows it during development to visualize it, manipulate it and understand how it works,” Guido said. “Dr. Fox provides the molecular mechanisms that underlie that circuit assembly. We combined our strengths to come up with these findings. Neither one of us could have done this on our own.”

Interneurons are part of a class of neurons that balance excitatory neurons and are essential in maintaining proper brain function. If the interneurons do not populate the thalamus correctly, neural circuits mediating vision do not develop properly. Therefore, the accuracy of the interneuron movement is essential for how the brain views the external world.

The proper balance between excitatory and inhibitory neurons is essential not only in visual processing, but in other brain functions as well. That means this research provides new targets for treating neurological diseases caused by an imbalance between inhibitory and excitatory activity in the brain.

“Neurological diseases such as epilepsy and schizophrenia can be attributed, in part, to abnormal interneuron levels and activity,” said Naomi Charalambakis, Ph.D., a UofL alumna who shares first authoriship of the publication. “This work not only reveals the importance of astrocytes in the development of thalamic interneuron circuitry, it also sparks more questions for future research: How does this affect the physiology patterns of other sensory systems? Does this phenotype manifest in behavioral differences?”

For this reason, Guido believes understanding how these cells migrate and are incorporated into brain circuitry could lead to new ways to ensure the proper balance of excitatory and inhibitory activity of other neurons.

“Knowing the importance of the location and incorporation of this type of neuron into the brain circuitry as well as the mechanism for its placement, we may be able to design strategies to make sure those neurons get where they should be or to overcome a deficit if they are missing,” Guido said. “This could allow us to correct some of these conditions.”

Another key finding of the work is that the astrocytes cue the migration of interneurons in response to external influences.

“Experience with the outside world is critical. When there is visual stimulation, that triggers the regulatory role for these cells in targeting,” Guido said.

Graduate students at both UofL and VTC conducted much of the lab work for this research. Charalambakis, whose 2018 doctoral dissertation resulted in this publication and another in The Journal of Neuroscience in May 2019, now is a senior science policy analyst at Federation of American Societies for Experimental Biology.

The synergistic research between the Guido and Fox labs has led to numerous discoveries of vital information about neurodevelopment and five high profile publications over the past decade. The National Eye Institute funds both research labs.

University of Louisville neurologist and researcher Robert P. Friedland, M.D., a professor in the Department of Neurology, will teach and conduct research in Japan during a one-year sabbatical beginning May 1. Friedland will conduct research on neurodegenerative diseases at the Kyoto Prefectural University of Medicine (KPUM). The work is funded by a long-term Invitational Fellowship for Research in Japan from the Japan Society for the Promotion of Science (JSPS) which was awarded through a competitive selection process.

Friedland has studied Alzheimer’s disease, dementia and related conditions for more than 30 years. His previous work has uncovered the role of amyloid proteins made by intestinal and oral bacteria in neurodegenerative diseases such as Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s disease), Alzheimer’s disease and Parkinson’s disease. Previously, Friedland worked with researchers at the National Cerebral and Cardiovascular Center in Osaka to reveal the important influence of oral bacteria on the development of hemorrhagic stroke.

In Kyoto, Friedland will further investigate the influence of the microbiota on neurodegenerative disease models in fruit flies. He plans tests to determine the influence of functional bacterial amyloid proteins on the aggregation of brain proteins, a key element of neurodegenerative diseases. Friedland will collaborate in this research with Toshiki Mizuno, Ph.D., of the KPUM Division of Neurology and Gerontology, one of several Japanese researchers with whom Friedland has worked for several decades.

He also will conduct research with collaborators at the Kyoto Institute of Technology.

“I am excited to have the opportunity to collaborate further with my Japanese colleagues and to conduct this research in Kyoto,” Friedland said.

JSPS awards fellowships to select international researchers to conduct collaborative work with researchers in Japan. Long-term fellowships for 2020 have been awarded in agriculture, engineering, chemistry, math, humanities and medicine. Friedland received one of four fellowships in the field of medicine.

After his year in Kyoto, Friedland will continue his research and clinical work at UofL, where his collaborators in the lab of Levi Beverly, Ph.D., currently are finishing data analysis on a study of the influence of bacterial amyloid on ALS in mice.

Flavors and aromas are the key to great beer. Kristy Holsopple and Sam Gambill have developed some uniquely flavored beers for their microbrewery, Holsopple Brewing, including brews flavored with blueberry, toasted hemp seeds and cinnamon, to name just a few.

Holsopple, a microbiologist, and Gambill met at a brewery and each have 15 years in the alcohol manufacturing industry. Now married with two young boys, they share their brewing talents with customers at the brewery. At the next Beer with a Scientist, Holsopple and Gambill will discuss beer sensory terms and how raw materials and yeast create beer aromas and flavor.

The talk begins at 7 p.m. on Wednesday, Feb. 26 at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

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

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

A new collaboration with Pfizer Inc. will enable the University of Louisville’s Division of Infectious Diseases to play a significant role in epidemiological research related to vaccine-preventable diseases affecting adults, including the elderly.

UofL has been designated the first Center of Excellence by Pfizer Vaccines.

“UofL’s Division of Infectious Diseases has a rich history of collaboration with Pfizer through the successful implementation of numerous clinical epidemiological research studies. We are excited to formalize a long-term collaboration that builds on these past successes,” said Julio Ramirez, M.D., chief of the Division of Infectious Diseases at the University of Louisville.

The Center of Excellence, directed by Ramirez, is a collaboration between the university and the pharmaceutical corporation aimed at determining the human health burden of important infectious diseases and potential vaccine effectiveness. The data will provide robust evidence to national health officials and independent policy makers who develop recommendations for the use of vaccines in immunization programs worldwide. Studies will take place in hospitals, long-term care facilities and the community.

UofL is the first Center of Excellence selected by Pfizer Vaccines Medical Development and Scientific/Clinical Affairs to be part of an international network of epidemiological research organizations. This designation is for a period of three years with an option for renewal. Pfizer selected UofL because of the university’s exceptional capabilities for conducting population-based surveillance and clinical research that engages multiple health care facilities, health care personnel, industry and communities-at-large.

“Pfizer has had an outstanding working relationship with the University of Louisville for more than 10 years,” said Luis Jodar, Ph.D., chief medical and scientific affairs officer, Pfizer Vaccines. “The quality of disease burden evidence varies widely worldwide. Deriving accurate and credible population-based incidence estimates require comprehensive surveillance to identify cases of diseases within a well-defined and well-characterized geographic area. Thanks to UofL’s excellent network of research partners, the population available for research studies in Louisville can provide the data to derive estimates of disease burden that can be generalized nationally.”

The demographics of Jefferson County, Kentucky, are similar to the United States in general, including racial and ethnic make-up, socioeconomic status, and the proportion of rural and urban populations.

The research studies conducted as part of the center may lead to economic growth and development for the city of Louisville and the Kentuckiana region, including jobs and educational opportunities in the health care industry.

“This collaboration will provide increased visibility for the university on a global scale, making UofL attractive for high-caliber researchers and research grants,” said Neeli Bendapudi, Ph.D., president of UofL. ”It also presents an exceptional opportunity for our researchers to improve the human condition by helping to reduce the burden of infectious diseases worldwide by generating data that will inform governments and health care policymakers.”

Pfizer studies anticipated for UofL include population-based surveillance of infectious diseases including Streptococcus pneumoniae, a bacteria which causes pneumonia and other infections, Clostridioides difficile, a bacteria that causes severe diarrhea and colitis, and respiratory syncytial virus (RSV), a common virus associated with mild cold-like symptoms but can cause severe infection in some people, including older adults. Visit CERIDLouisville.org/research for additional information on these diseases and two Center of Excellence studies already underway at UofL:

• The City of Louisville Diarrhea (CLOUD) study launched in September 2019. Pfizer will be providing up to $6.5 million in funding for a one-year study of the incidence of diarrhea among Louisville-area residents.
• The Louisville Pneumonia study is up to $4.5 million in funding provided by Pfizer for a one-year study of the incidence of pneumonia among adults in Louisville that launched in November 2019.

Watch a video here

Technologies in development by researchers at the University of Louisville are aimed at ensuring astronauts on long-range space missions have access to medical care. A UofL research team recently tested rehydrating dried red blood cells in a weightless environment. The UofL group completed more than 50 weightless cycles during two flights to test rehydrating the blood and the use of 3D-printed surgical instruments aboard a ZERO-G aircraft.

ZERO-G is a privately owned company that uses a modified Boeing 727 jet to create a weightless environment using parabolic flight patterns. The experiments, sponsored by NASA, are designed to ensure that crews have access to proper medical treatment during long-range exploration space flights, such as to Mars.

Michael Menze, Ph.D., associate professor of biology, and Jonathan Kopechek, Ph.D., assistant professor of bioengineering at UofL, lead a team that has developed several methods for drying blood to enable it to be stored for long periods of time without refrigeration. The dried blood then can be rehydrated using sterile water when it is needed. Current methods for storing blood require constant refrigeration and the blood can only be stored for six weeks, which would not be sufficient for crews on years-long space missions.

“If cosmic radiation reduces red blood cell count, for example, you are not going to have a donor and a recipient [with a four-person flight crew], you are going to have four people needing blood and there is no good way to store it during a long space trip of months or years,” said Brett Janis, a graduate research assistant who also is involved in the project. “So being able to store it in a dried state and then confidently rehydrate it is critical.”

The dried blood is typically rehydrated by adding water and inverting the container, Menze said. This method relies on normal gravity, however, so the researchers devised other methods for potential use in space. [See a video about the project HERE.]

To develop testing procedures, Menze worked with George Pantalos, Ph.D., professor in the Department of Cardiovascular and Thoracic Surgery. Pantalos tested medical equipment in a weightless environment in the past and customized a glovebox enclosure he developed for his research for these experiments.

“If you are in reduced gravity or zero gravity, will the red blood cells rehydrate correctly and will they function like normal red blood cells, transporting oxygen to the tissues of the body,” Pantalos said.

Pantalos, Menze and Janis, along with other researchers and five students, designed and prepared the tests to rehydrate the blood cells and traveled to Florida with the glovebox and equipment in November 2019 to conduct the experiments aboard the ZERO-G aircraft. During the tests, the team assembled a bag with the powdered blood cells, a syringe and sterilized water in the glovebox. There they tested multiple techniques to rehydrate the cells during the weightless phases of flight.

“We tested two different ways of assisting in the mixing of liquid and powdered red blood cells,” Menze said. “We used pliable plastic bags instead of hard-plastic containers for the mixing. The water was added to the bag from an attached syringe and the liquid and powder were mixed by ‘massaging’ the bag or by using a second attached syringe and moving the liquid in and out of the bag. The ‘massage’ methods seem to work a bit better.”

Pantalos said the glove box and planned experiment techniques worked well, allowing the scientists and students to complete all the planned tests on the blood cells, which had been dehydrated using two different methods -- spray-dried and freeze-dried -- in 5 milliliter and 10 milliliter volumes. After the aircraft landed, the rehydrated samples were analyzed by a ground crew for evaluation to see if they are suitable for infusion into a patient.

“We found that the oxygen-carrying capacity of the blood was comparable to what we find when we are rehydrating our blood at one-earth gravity,” Menze said. “I was really excited.”

During the flight, Pantalos also tested the use of 3D-printed instruments to simulate basic surgical tasks such as incision and retraction. By 3-D printing tools and instruments they need aboard the spacecraft, it is possible for the crew to take basic materials and create specific pieces according to needs that arise during the mission rather than trying to anticipate all potential medical needs in advance.

The NASA Flight Opportunities Program, which supports projects for developing technology appropriate for use in space flight, funded the preparation testing and the flights. The UofL team now is preparing for their next flight campaign, planned for later this year, to test rehydration processes for cells dehydrated using different methods and rehydrating up to 350 milliliters of blood, which would be needed in an actual transfusion therapy situation.

You may have heard about breakthroughs in medical research such as CRISPR, a technology that allows scientists to edit genes, or the microbiota, the bugs that live in and on us and are getting the credit and blame for any number of health conditions. But how can non-scientists understand these subjects and their effects on health and health care?

University of Louisville researcher Levi Beverly, Ph.D., is here to help.

At the next Beer with a Scientist, Beverly, associate professor in the Department of Medicine, will explain these and other recent developments in biomedical research for people without a degree in science.

“We will talk about CRISPR, microbiota and other topics, but we also are asking the audience what they want to learn about,” Beverly said. “People are invited to bring an article or headline they have seen that needs more explanation or to post questions or topics on our Facebook page, Louisville Underground Science.”

Beverly’s talk begins at 7 p.m. on Wednesday, Jan. 22 at Holsopple Brewing, 8023 Catherine Lane. A 30-minute presentation will be followed by an informal Q&A session.

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

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

Selected for her leadership in the area of geriatric education, Anna Faul, PhD, executive director, University of Louisville Trager Institute, has been elected to join the executive board of the National Association for Geriatric Education (N-AGE).

N-AGE is a non-profit membership organization representing geriatric education centers and other organizations that provide education and training to health professionals. The organization seeks to improve the quality of health care for older adults, including underserved and minority groups. N-AGE is a leading national voice for building a robust pipeline at every level of education to increase the size and skill set of students and professionals in the aging-related workforce.

“I am honored to be selected for this national leadership position. As a long-time educator in the field of gerontology, I am deeply passionate about increasing the workforce size and improving the skills of the aging-related workforce,” Faul said. “Workforce development is one of the UofL Trager Institute’s strategic initiatives and we have received several HRSA-funded grants to support this goal. I look forward to taking what we have learned from these programs to a national level.”

“We are thrilled that Dr. Faul has joined the N-AGE Board of Directors. She is an experienced leader in the field who brings a wealth of knowledge about aging services and geriatrics,” said Catherine P. Carrico, PhD, president of the N-AGE board.

As a new board member, Faul will serve as chair of the Education and Training Committee. In this role, she will further the committee’s goal of enhancing nationwide opportunities for the education of health care practitioners in geriatrics and gerontology. Specifically, Faul will work to increase the visibility of HRSA Geriatric Workforce Enhancement Programs and Geriatrics Academic Career Awards. This builds on her experience as principal investigator for both the UofL Trager Institute’s HRSA Geriatric Workforce Enhancement Program and HRSA Behavioral Health Workforce Enhancement Program. She also has served as mentor for Samantha Cotton, PhD, program manager at the UofL Trager Institute and 2019 Geriatrics Academic Career Award recipient.

Faul learned of her board selection during the 2019 Gerontological Society of America’s 2019 Annual Scientific Meeting in Austin, Texas. She begins her 3-year term on the N-AGE board in January 2020.

“I am grateful and excited to begin this new role on the National Association for Geriatric Education Board. This is an incredible opportunity to elevate the leadership of the UofL Trager Institute, and the University of Louisville in shaping the future of geriatric education in our country,” Faul said.

Rachel Safeek, a second-year medical student at the University of Louisville, is calling for medical schools to train future physicians in techniques to help prevent injuries and death caused by firearms. Her work has led to UofL being one of the first medical schools to incorporate this training for all students.

“About 40,000 Americans die and 85,000 others are injured each year from firearm-related causes, and the incidence of firearm-related morbidity and mortality has increased over the past decade,” Safeek said. “This is a very important public health issue. My classmates, colleagues and I believe that physicians have a role in counseling patients related to their health and we have an opportunity through those interactions to help reduce the number of firearm-related deaths and injuries.”

In September, Safeek and her colleagues wrote and presented a resolution that was adopted by the Kentucky Medical Association (KMA) to support training in Kentucky’s medical schools to reduce firearm-related morbidity and mortality in their curriculum. She presented a similar resolution at the American Medical Association conference in November, which was adopted by the American Medical Association Medical Student Section.

The resolution calls for all future physicians to have training to counsel patients in safe firearm use and storage, to know how to screen patients for suicide risk and to learn trauma-related first response techniques.

At UofL, Safeek presented a curriculum plan she coauthored with faculty members Suzanne McGee, M.D., and Charles Kodner, M.D., and Susan Sawning, M.S.S.W., to the School of Medicine’s Educational Program Committee, which voted to include it in the school’s curriculum beginning with the 2020-2021 academic year.

To jump-start the training effort, Safeek and other students and faculty have partnered with Whitney/Strong to organize a week-long series of optional events to educate UofL medical students, faculty and residents on firearm violence prevention, scheduled for February.

“Our hope is that more medical schools will incorporate this type of training into their programs and doctors will be able to help make a difference in this health crisis,” Safeek said.

For Priya Chandan, M.D., M.P.H., creating an inclusive world for individuals with intellectual disability is a life mission. Inspired by her older brother who has Down syndrome, Chandan is leading efforts to ensure all health care professionals are trained to treat adults with intellectual disabilities.

The American Academy of Physical Medicine and Rehabilitation (AAPM&R) has presented Chandan the Distinguished Public Service Award at the organization’s annual assembly in San Antonio, Texas. Chandan, assistant professor in the University of Louisville’s Division of Physical Medicine and Rehabilitation (PM&R) and the Department of Health Promotion and Behavioral Sciences, was selected thanks to her efforts at ensuring inclusive health through innovations in medical education and her work with Special Olympics.

In a ceremony last month, Chandan received the award, established to honor individuals who, in the course of public service activities, have significantly contributed to the growth and development of services that directly impact the specialty of PM&R. Previous winners of the award include Michelle Obama, Judith E. Heumann, an international disability rights activist, and numerous members of Congress.

Chandan is committed to inclusive health, the intentional inclusion of all people, including people with intellectual disabilities (ID), in mainstream health services, training programs, research, funding streams, policies and laws.

“Intentional inclusion of people with disabilities in the spaces physicians occupy — clinical, research and teaching environments — is critical for repairing trust with marginalized communities, including the 1 in 4 American adults with a disability,” Chandan said. “Historically, medicine has been part of the problem, which means we have a responsibility to be part of the solution moving forward by engaging in advocacy efforts together with the patients we serve.”

Chandan’s personal experience with her brother has given her a personal understanding of the need for physicians who can provide equitable care for people with ID. She led AAPM&R’s Inclusive Health Innovation grant from the Special Olympics, which involved policy, education and advocacy activities, including the creation of an AAPM&R Intellectual Disability Member Community.

“Dr. Chandan is taking her personal experience and has turned it into a passion that she uses every day in her career,” said Darryl Kaelin, M.D., chief of the UofL Division of Physical Medicine and Rehabilitation. “She is making better care for individuals with intellectual disability a local and national goal. She represents the University of Louisville well.”

Chandan directs the National Curriculum Initiative in Developmental Medicine, a partnership between Special Olympics International and the American Academy of Developmental Medicine and Dentistry to ensure future physicians receive training to care for individuals with ID across their lifespan. For this program, she oversees inclusive medical education efforts at 18 medical schools nationwide and led UofL’s participation in the program, partnering with Special Olympics Kentucky and Lee Specialty Clinic.

Chandan also received funding from WITH Foundation to further develop medical education in the form of a standardized patient experience for PM&R residents using actors from Down Syndrome of Louisville.

Chandan is involved in Special Olympics International's Inclusive Health movement, where she serves as a content expert for the Center for Inclusive Health, an online resource for health care providers and other audiences for ways to intentionally include people with intellectual disability in mainstream health care services, training programs and research. She also is a global clinical advisor for MedFest, the Special Olympics Healthy Athletes program that provides free pre-participation sports physical exams to athletes with ID. She has engaged residents and faculty in MedFest efforts in Virginia, North Carolina and Kentucky.

Chandan was a member of the 2018-19 cohort of the faculty leadership program at UofL, Leadership and Innovation in Academic Medicine (LIAM). As part of the year-long leadership curriculum, she and her group colleagues piloted interactive, online topic tournaments to increase active, self-directed learning opportunities in the medical school curriculum.

University of Louisville medical residents in collaboration with the UofL Office of Graduate Medical Education will make the holidays brighter for children in the community through their Toys for Tots toy drive. This is the fifth year 700 residents in 70-plus programs have made Toys for Tots the focus of their holiday service mission. This year the residents exceeded their goal of 1,000 toys. 

Children with spinal cord injuries have experienced remarkable results in recovery at the University of Louisville and Frazier Rehab Institute through locomotor training, a therapy designed to help them recover the ability to sit, stand and even walk. In locomotor training, the child is suspended over a treadmill and his or her feet are moved by trainers in a stepping motion. This taps into capability of the spinal cord to help the child regain movement and trunk control.

Andrea Behrman, Ph.D., of the UofL Department of Neurological Surgery and the Kentucky Spinal Cord Injury Research Center (KSCIRC), pioneered the use of locomotor training in children at UofL since 2012. Until now, however, Behrman’s team has used treadmills and harnesses designed for adults that have been adapted for children. The oversized equipment is cumbersome for children and working on cut-down adult-sized devices has resulted in unnecessary strain for the trainers and therapists who work with them.

So Behrman enlisted Tommy Roussel, Ph.D. of the Department of Bioengineering at UofL, to engineer a treadmill and harness system specifically for young children. Using engineering expertise, user feedback and a patent held by Susan Harkema, Ph.D., professor of neurosurgery and pioneer in spinal cord injury research in adults at UofL, a new treadmill was designed from the ground up just for children. [See video]

“It was kind of like putting a kid on an adult bicycle or watching kids play basketball with a ten-foot goal,” Roussel said. “So we have redesigned the system with the same operational capacity but with kids in mind.”

The new pediatric treadmill has multiple advantages for both children and trainers:

• Suspension tower is located behind the child on the treadmill so therapists can more easily and directly engage with the child
• Narrower tread, focusing the child’s steps and bringing trainers closer to the child’s legs and feet
• Trainers’ seats are more appropriately positioned closer to the child and are adjustable to accommodate trainers of different heights
• Treadmill tower swivels to allow the child to be hoisted from a wheelchair and onto the treadmill
• Smaller, more adaptable harness that is more comfortable and easier to adjust to the child’s changing capability

“The treadmill is a tool for us, but we want it to be a smart tool. By making it better, we are going to do our jobs better and the child is going to participate better,” Behrman said. “We changed it to make the child more accessible to the trainer with good body posture and position for all this repetitive activity.”

Thanks to funding and support from the Coulter Translational Partnership at UofL, the team was able to develop the initial prototype. Behrman and Roussel then collaborated with other specialized manufacturers, further refining the treadmill and harnesses. Once they had a customized treadmill, the team worked to commercialize the device and harness system to make it available to therapists in other centers.

“We starting thinking, ‘How can we make it better?’” Roussel said. “If we are going to move to manufacturing this, how can we make it more modular and with fewer parts that need to be assembled? That’s where the magic and the fun happened.”

The treadmill design was licensed to Power Neurorecovery and units are in place or on their way to facilities in Pittsburgh, Houston and New York, as well as in Louisville at Frazier Rehab Institute.

“In the last several years, we have been able to achieve things that have not historically happened in terms of rehabilitation outcomes for these children,” Behrman said. "Children once unable to sit on their own, for example, can now do so due to locomotor training. Such improvements open up other possibilities to play and engage, and help a child get back on the developmental track. This new treadmill system gives physical therapists and trainers a device that is state-of-the-art in design and utility and revolutionizes the way we deliver locomotor training specifically for children."

Oct. 28, 2019

Cancer patients in Louisville, in Kentucky and throughout the region soon will have access to some of the most advanced immunotherapy treatments available. Louisville resident Thomas E. Dunbar has pledged $1 million to the University of Louisville to create a specialized center to provide chimeric antigen receptor positive T (CAR T) cell therapies to patients at the UofL James Graham Brown Cancer Center and other centers in Kentucky and the Midwest. The new program will be named the Dunbar CAR T-Cell Program.

“This gift will allow both kids and adults to be treated right here in Kentucky with the most innovative cell-based immunotherapy being developed,” said Jason Chesney, M.D., Ph.D., director of the UofL Brown Cancer Center.

See a video of the announcement here.

In CAR T-cell therapies, immune cells are extracted from the patient’s own blood and then are genetically modified to fight cancer. The modified cells are infused back into the patient where they fight the cancer and create long-term immunity to its recurrence. In addition to dramatic treatment results, CAR T-cell immunotherapy leads to fewer toxic side effects than traditional chemotherapy.

“Patients who have been treated with all the conventional therapies who then underwent treatment in clinical trials with CAR T cells had dramatic response rates. Eighty-three percent of kids in the original trial who had lethal, terminal B-cell acute lymphoblastic leukemia responded to this therapy,” Chesney said.

CAR T-cell therapy is FDA approved for treating patients who have B-cell acute lymphoblastic leukemia, who are mostly children, as well as adults who have an adult form of a B-cell (non-Hodgkin’s) lymphoma. This technology also is being tested for treatment of other cancers through clinical trials. Until now however, these treatments have been available primarily in larger coastal cities outside of the Midwestern United States.

“At the UofL Brown Cancer Center, we feel strongly that these advanced therapies should be available not just to people in New York or California or Texas, but to people in Kentucky, Indiana, Tennessee and Illinois. If you live in these areas, it is going to be very hard for you to be treated a thousand miles away with a therapy like this,” Chesney said. “And any patient with health assistance through Medicaid is likely to be covered only if the treatment is delivered within the state.”

The Dunbar CAR T-Cell Program will include laboratories for manufacturing the CAR T cells and will administer both FDA-approved and clinical-trial therapies to adult and pediatric cancer patients. The program intends to expand clinical trials and clinical research using CAR T-cell therapy to treat additional cancer types in Louisville. The goal is for the facilities to be fully functional and receiving patients by Sept. 30, 2020.

Tom Dunbar’s son, Evan, lost his battle to cancer with neuroblastoma in 2001 at the age of 6. In 2009, Wally Dunbar, Tom Dunbar’s father, lost his battle with melanoma. This year, Tom’s physician wife, Stephanie Altobellis, M.D., helped identify his own cancer.

“Kentucky is at ground zero, with the nation’s highest rates of cancer diagnosis and death,” Tom Dunbar said. “It’s completely unacceptable. We have to lead the charge right here where the need is the greatest and we can do the most good. We need treatments that are not toxic. Watching our loved ones miserable with pain, often just from the treatments, and yet still die in front of us simply can’t be the best that we can do.”

How CAR T cells work

T cells are key immune cells in the body that attack cancer cells. CAR T cells are T cells that have been isolated from the patient’s blood and then genetically modified to more effectively destroy the cancer cells.

A non-infectious virus is used to insert genes into the T cells that express a receptor specific to proteins, or antigens, present on cells of the cancer to be treated. The armed, loaded T cell is drawn into close proximity to the cancer cell, and the new cell sends a signal for the T cell to kill the cancer cell.

“We add the receptor gene into the T cells, which makes them stick to the cancer cells like Velcro,” Chesney said. “In theory, all cancers have unique antigens on their surface that we can target with this approach. We are nudging the immune system on to really hit the target, in this case the cancer cells.”

The sophisticated technology requires the use of a specialized clean room for genetically manipulating the patients’ immune cells. The clean rooms, known as Good Manufacturing Practice (GMP) laboratories, require specialized documentation and equipment to protect the individuals working there and ensure a sterile and controlled environment for the cells.

The Dunbar CAR T-Cell Program will include two GMP laboratories, one for use in pediatric therapies to be named for Evan Dunbar and one for adult therapies to be named for Altobellis. These labs are intended to support not only clinical trials and patient treatment at the UofL Brown Cancer Center, but also in other health centers in Louisville, Lexington and elsewhere.

“Our goal for the Dunbar CAR T-Cell Program GMP labs is to be a hub manufacturing facility for CAR T cells, not just in Kentucky, not just in the region, but for the entire country,” Chesney said.

For Dunbar, the goal is to improve cancer treatment for patients.

“The burden is on each of us to create a better future for our children,” Dunbar said. “Working together, we can ensure Louisville is equipped to provide the durable cures, free of side-effects, that we desperately need.”

Clayton M. Smith, M.D., associate professor of medicine in the UofL School of Medicine and internal medicine physician with UofL Physicians, has received 1st place, Best Doctor in LEO Weekly’s Readers’ Choice Awards, winning over more than 100 nominees. Smith focuses his clinical practice on primary care internal medicine and LGBTQ health. He will be honored Oct. 3 at the Readers’ Choice Awards Party. 

See the LEO Readers Choice Awards list here.

In a moving speech on the difference between palliative “treatment” and palliative “care,” the University of Louisville’s Kelly McMasters, M.D., Ph.D., gave the keynote lecture today at the American Society of Clinical Oncology’s Gastrointestinal Cancers Symposium in San Francisco.

McMasters is the Ben A. Reid Sr., M.D., Professor and Chairman of the Department of Surgery at the University of Louisville School of Medicine. He also serves as director of the Multidisciplinary Melanoma Clinic and is associate director of the James Graham Brown Cancer Center at UofL.

In his keynote address, titled “The Fundamental Difference Between Palliative Treatment and Palliative Care,” McMasters noted the audience was filled with those who have devoted their lives to the care of patients with cancer, and will perform research that will relieve suffering, improve quality of life, extend survival and find a cure.

Using one of his patients as an example, he argued that while regular tests and treatments make sense for patients whose cancer can be cured or their lives extended (with good quality), for those with recurring cancer who will eventually die from the disease, there is no evidence early detection of asymptomatic recurrence is any better than waiting until they are symptomatic. For those patients, regular tests and treatments can rob them of their quality of life.

“Our duty to our patients is to care for them, not just for their disease, but for who they are,” McMasters said. “Sometimes, it doesn’t make sense to put the patient through treatments and tests that in the end, won’t affect whether they live or die. They are often better served by living free of pain and suffering, happily in the company of those they love, doing the things that make life worth living.”

McMasters has personal experience in losing a loved one to cancer. He lost his son, Owen, to leukemia.

Also speaking on the topic during the keynote address was Shishir Maithel, M.D., chair of the Winship Cancer Institute at Emory University.

McMasters specializes in melanoma, breast cancer, sarcoma, hepatobiliary tumors and pancreatic and gastric cancers.  At the Brown Cancer Center, he works to identify the most effective combination of treatment including surgery, immunotherapy, targeted therapies, and radiation therapy for patients with all stages of melanoma.

He has been principal investigator or co-investigator of over 30 clinical trials, and president of the Society of Surgical Oncology, the Society of Surgical Chairs, the Western Surgical Association and the Southeastern Surgical Association.  In 2018, he was named editor-in-chief of Annals of Surgical Oncology, and he has authored over 400 peer-reviewed publications and a book.

To hear more from McMasters, see this article on the difference between treatment and care in the Annals of Surgical Oncology: https://bit.ly/2DiZKHk.

For more information about society and the symposium, visit gicasym.org.

University of Louisville Hospital has opened its newly renovated and expanded Burn Center, currently the only dedicated burn unit in the state of Kentucky.

Dozens of hospital staff and emergency service workers, including members of the Louisville Fire Department, marked the occasion on Friday with a ribbon-cutting and celebration at the center.

The new Burn Center is on the hospital’s sixth floor, in 6 East, and holds 16 beds. The center was formerly housed on the hospital’s fifth floor, where it held six beds.

“What makes this space so unique is that from start to finish, it was specifically designed just for burn patients,” said Glen Franklin, M.D., a trauma surgeon and a professor in the Department of Surgery at the UofL School of Medicine. “It was made just for them, by the people who take care of them. It’s special. ”

Lori Sipes, clinical nurse manager for the Burn Center, said the renovation marks 35 years of UofL Hospital having a dedicated burn unit. She said the expansion and renovation will help provide even better service to the community and state.

“We are expanding all of our services, from beds to staff to therapy, to offer even better care for patients and their families,” she said. “Everything has been improved and updated, and they have a new state-of-the-art area to be treated in.”

Sipes said the center has 36 critical care nurses and technicians, all of whom have specialized education and training in the care of burn patients and the most up-to-date methods for their care. Its dedicated physical therapist is the only wound specialist in Kentucky dedicated to burns.

Sipes said the center’s brand-new beds are the newest and best surfaces for patients, and each room has its own temperature and humidity control and heat lamps, which she said is important for burn patients as the skin is a primary method of thermoregulation. A new, larger hydrotherapy room with a shower system is also part of the new center.

Even the color palate and interior design is designed to be more soothing for patients and families, she said, with a sitting area in each room, cubbyholes to charge cell phones and dedicated room where families can conference with staff or members can be alone.

Among those in attendance Friday were Louisville Fire Department Chief Greg Frederick and Romaine Knight, a firefighter assigned to Engine 5 downtown at Floyd and Jefferson streets. Knight has firsthand experience in UofL Hospital’s Burn Center as a patient.

On Sept. 20, 2017, he suffered serious burns to his left hand and was admitted to the Burn Center. He was in the center’s intensive care unit for eight days, where he underwent skin grafts to his hand.

“They really have a good team there,” he said. “Everyone was exceptional. They were all so nice, from the nurses, to the technicians, to the plastic surgeons. And they have so much experience, which really helped alleviate my worries. They were able to explain what was happening, and what I could expect - the next day, the next week, the next month, the next year, and even the next couple of years.”

After surgery, he went immediately into physical therapy, which he continued at the UofL Physicians Outpatient Center after he was released from the hospital.

“They did everything they could to ensure I didn’t lose function of my hand, which was vital for me,” he said. “They told me that they would do whatever it took to have the best outcome.”

Today, he said he has virtually normal function of his hand. 

“I really, really appreciate everyone’s service.”

Just before the new Burn Center’s opening, UofL Hospital was re-verified as a Level I Trauma Center by the American College of Surgeons, recognizing its dedication to providing the highest quality of trauma care for all injured patients.  UofL Hospital is one of just two adult Level I Trauma Centers in the state of Kentucky.

UofL Hospital has been re-verified as a Level I Trauma Center by the American College of Surgeons, recognizing the hospital’s dedication to providing the highest quality of trauma care for all injured patients.  

A team of experienced reviewers in the field of trauma conducted an on-site review of the hospital in July, and the hospital received word of the re-verification this month in an official letter. The verification process provides confirmation the hospital has demonstrated its commitment to providing optimal care.

“The re-verification is acknowledgement of all the hard work that happens here at UofL Hospital every day,” said Kim Denzik, MSN, RN, director of the UofL Hospital Trauma Institute. “There is a tremendous amount of work and preparation that goes into the trauma review. There are a lot of people to be thanked for their continued hard work, diligence and commitment to providing the very best care for our patients.”

The re-verification came from the American College of Surgeons’ Verification Review Committee, an ad hoc committee of the group’s Committee on Trauma.

The Committee on Trauma’s verification program does not designate trauma centers, rather it provides confirmation that a trauma center has demonstrated its commitment to providing the highest quality of trauma care. The actual establishment and designation of a trauma center is the function of local, regional or state agencies. However, verified trauma centers must meet essential criteria that ensure trauma care capability and institutional performance as outlined by the Committee on Trauma.

Having the expert level of care here in Louisville is important to patients like Brandon Clark, who was in a dirt bike accident in March 2017 at age 19.

“I was at my girlfriend’s house racing my brother when the throttle got stuck and I was thrown 53 feet,” Clark said. He was transported from Floyds Knobs, Ind., to UofL Hospital, where he was diagnosed with a broken femur and a separated shoulder. He underwent surgery with an orthopedic specialist at UofL Hospital the next morning.

“It was very rough in the beginning,” Clark said. “I was just 19, and I couldn’t even walk. I left the hospital in a wheelchair. I wanted to give up on life. But nobody there let me give up.”

By August 2018, he was walking again - at the Kentucky State Fair. It was there he ran into a member of the Trauma Center’s staff, Annabelle Pike.

“I wanted to tell her just how great it felt to be walking again. I wouldn’t be here without the staff at UofL Hospital. They work with you a lot. They want to help you out the most.”

Today, he’s going to the University of Northwestern Ohio to be a diesel mechanic, and driving home on weekends to do farming and construction work from his home in Ballardsville, Ky. On Oct. 16, he said he was able to run a mile, just a year and a half after his stay at UofL Hospital.

He said he’s appreciative of the second chance he was given. “It made me realize you can lose your life in the blink of an eye.”

Established by the American College of Surgeons in 1987, the Committee on Trauma’s Consultation/Verification Program for Hospitals promotes the development of trauma centers that provide the entire spectrum of care to address the needs of injured patient, from preventing injuries before they occur, to the hospital resources necessary for trauma care, all the way through the rehabilitation process.

There are five separate categories of verification in the Committee on Trauma’s program: Level I Trauma Center; Level II Trauma Center; Level III Trauma Center; Level I Pediatric Trauma Center; and Level II Pediatric Trauma Center. Each has specific criteria that must be met. UofL Hospital is one of just two adult Level I Trauma Centers in the state of Kentucky, with the other at the University of Kentucky’s Albert B. Chandler Hospital.

Founded in 1913, the American College of Surgeons is a scientific and educational association of surgeons to raise the standards of surgical practice and education and improve the care of the surgical patient. The College is an important advocate for surgical patients and has over 72,000 members, making it the largest association of surgeons in the world.

The College’s Committee on Trauma promotes leadership and cooperation of all participants in a trauma center so injured patients are provided with the best possible care.