Kyle Castaneda knows the value of mentors and connections for applying to medical school. A University of Louisville senior majoring in biochemistry, he credits the networking and advice he gained at events such as the Minority Pre-Health Symposium with helping him achieve admission to the UofL School of Medicine, where he will enroll this fall.

“I was from a very rural county. I was not prepared when I got to college to become a successful applicant for medical school,” Castaneda said. “I didn’t know a lot about when to shadow, when to volunteer or when to apply to medical school.”

High school and undergraduate students interested in health professions visited the UofL Health Sciences Center (HSC) campus Feb. 10 to learn about career and educational opportunities, tour the Schools of Dentistry, Medicine, Nursing and Public Health & Information Sciences, and meet with advisors and potential mentors. Representatives from the four HSC schools were on hand to discuss with students the skills needed to navigate the road to higher education in the health sciences.

Hannah Granholm, a high school sophomore from Louisville, attended the symposium to learn more about becoming a nurse practitioner. “I learned that a nurse practitioner does more than just give people shots and medicine. They do a lot more, and it takes a lot of work to do it,” Granholm said.

Glenda Granholm, Hannah’s mother, encouraged Hannah to attend. “I thought she could get exposure to different fields and could talk to people who know the field. That way she’ll be more comfortable asking questions.”

Vivian Doyle, a second-year UofL medical student, took a group of the students on a tour of the School of Medicine. She said a mentor provides essential support for students aspiring to careers in medicine, dentistry or graduate studies.

“It’s definitely important to find mentors – a physician, a medical student or an upper classman. That way, if you do get nervous or you have your doubts, you can go to your mentor and ask advice,” Doyle said.

Barbara Ekeh, another second year medical student, said the event also provided an opportunity to learn about the lesser-known careers in health-care, such as public health, graduate studies or dentistry.

“There are so many avenues in medicine and some are more visible than others. One student was asking, ‘What is public health?’ I didn’t know what that was until I was in college. Sometimes it can be a little overwhelming.” Ekeh said. “This is an avenue where they can meet other students to try and figure out what they are interested in doing.”

The event also allowed the students to connect with advisors and faculty members who could help them along in the process. Ashley O’Neil, a program coordinator in the UofL HSC Office of Diversity and Inclusion, helps students determine the best fit and guides them through the application process.

“There are people like me who will help you figure out your path and what it is going to take for you to succeed. I’m here to help in your journey with shadowing, clinical work, understanding the MCAT and its whole process, and the application itself,” O’Neil said.

Alona Pack, M.S.N., M.A., R.N., assistant professor in the UofL School of Nursing, said student organizations also can be important resources for the students.

“We have support systems for minority students here, particularly the Black Student Nurses Association. They provide mentorship and academic support to the students. They also do community outreach and develop leadership skills. It’s a good network for the students.”

The Student National Medical Association, Student National Dental Association, Health and Social Justice Scholars, Black Student Nurses Association, and the UofL Health Sciences Center Office of Diversity and Inclusion hosted the program, attended by 85 high school and undergraduate college students. The event was funded by the UofL Student Government Association Club Programming Committee (CPC) and the UofL Commission of Diversity and Racial Equality (CODRE).

Castaneda said events such as the symposium can help students connect with other programs and student organizations, which he found helpful. Castaneda attended the Professional Education Preparation Program (PEPP) prior to college, and joined the Multicultural Association of Pre-Medical Students (MAPS) once he arrived on campus.

“PEPP particularly got me up to speed and it made me feel a lot more comfortable when I got to college. I just kept doing the programs. They give you more exposure to the field. They let you meet great people and they help you along the process.”

See a photo gallery from the event here.

For more information on mentoring programs, visit the UofL HSC Office of Diversity and Inclusion website.

Among researchers exploring the mechanisms of muscle growth and health, there have been certain conceptions about the role of the signaling protein, transforming growth factor-ß-activated kinase 1 (TAK1). Convention was that TAK1 is detrimental to muscle health since it activates pathways associated with muscle wasting.

“TAK1 is a very important molecule in the body and it is involved in the regulation of almost all cell types. It is implicated in many signaling processes and many physiological roles in the body,” said Ashok Kumar, Ph.D., a professor and distinguished university scholar in the University of Louisville Department of Anatomical Sciences and Neurobiology. “But the role of TAK1 in skeletal muscle was not known at all.”

Kumar and Sajedah M. Hindi, Ph.D., a postdoctoral fellow in the department, hypothesized that by removing TAK1, they could mitigate the negative effects of two downstream pathways associated with muscle wasting with a single action. They and other members of the research team devised a series of cell culture and animal model experiments to determine if removal of TAK1 would preserve muscle mass and strength.

Their first clue to the significance of TAK1 was that mice genetically modified to remove TAK1 in skeletal muscle all died shortly after birth. Shifting their strategy, the researchers began working with adult mice. They found that in mature mice, instead of increasing muscle mass, reducing TAK1 resulted in severe muscle wasting, along with abnormalities in mitochondria and oxidative stress. These changes are consistent with those witnessed in muscle of individuals with amyotrophic lateral sclerosis (ALS), type II diabetes, cancer and aging.

“It did the opposite of what we were hoping it would do,” Hindi said. “In other tissues, having too much TAK1 has a bad effect. Knocking it down is actually positive. But in mature skeletal muscle, knocking TAK1 down had a negative effect.”

The research is detailed in TAK1 regulates skeletal muscle mass and mitochondrial function, published today in the journal JCI Insight, authored by Hindi, Kumar, Shizuka Uchida, Ph.D., associate professor and researcher in the UofL Cardiovascular Innovation Institute, Bradford Hill, Ph.D., associate professor and researcher in the UofL Diabetes and Obesity Center, and others at UofL.

This research reveals the essential role of TAK1 for the health of mature skeletal muscle, and adds to work by Kumar, Yuji Ogura, Ph.D., now of Japan, and Hindi, published in 2015 in Nature Communications, revealing that TAK1 is required for adult muscle cell proliferation and survival and for the regeneration of adult skeletal muscle upon injury. That research showed that when TAK1 is reduced, satellite stem cells do not vigorously self-renew and many eventually die. Alternately, when TAK1-regulated signaling is increased, the satellite cells prosper.

Kumar believes this understanding of the essential role of TAK1 in muscle health could lead to the development of therapies to preserve muscle mass in the elderly and in individuals with muscle wasting diseases such as muscular dystrophy, cancer, type II diabetes and ALS.

“This is a very fundamental discovery that people had a misconception about this pathway. This protein is very important for muscle maintenance,” Kumar said. “The next question is whether this is a mechanism for loss of muscle mass in all these conditions. We have approaches now to put this protein back into the body. If we put it back in the muscle or we have some drugs that activate this molecule, can we improve the muscle mass, can we preserve the muscle mass?”

Research shows that transgender youth experience higher rates of depression and are more likely to attempt suicide. Health-care providers are better equipped to care for these young patients and their families if they are familiar with their needs and struggles.

“As a mental health professional specializing in working with transgender and gender non-conforming youth, I am keenly aware of the prejudice, discrimination, rejection and bullying these youth face on a day-to-day basis,” said Christine Brady, Ph.D., a clinical psychologist with UofL Physicians’ Bingham Clinic and assistant professor in the University of Louisville Department of Pediatrics, Division of Child & Adolescent Psychiatry & Psychology.

“Rejection often comes out of fear, fear of the unknown. If I can reduce the fear of one person and facilitate that person approaching a transgender youth with more acceptance and compassion, I'll consider the summit a huge success.”

Brady will provide insight for health-care providers and the community as part of the LGBT Healthcare Summit at UofL, sponsored by Humana. Her talk, “Transgender and gender creative youth:  Mental health and evidence-based treatments,” will help familiarize participants with common terms and vocabulary used within the transgender community, communicate the prevalence of mental health issues and health disparities among transgender youth, and learn about both effective and potentially harmful mental health treatments across early, middle and late childhood development. Register for Brady’s talk, scheduled for noon at the UofL HSC Auditorium on Feb. 16, at http://www.summit_brady.eventbrite.com.

The LGBT Healthcare Summit also will feature "Substance use disorder treatment responsiveness for LGBT clients" by Brian Hurley, M.D., M.B.A. Hurley is an addiction psychiatrist and medical director for Substance Use Related Care Integration at the Los Angeles County Health Agency and assistant professor of addiction medicine at U.C.L.A. The presentation will include a panel of community members speaking to the challenges and successes around this issue in Louisville, including Jennifer Hancock, president of Volunteers of America Mid-States. Register for Hurley’s 9 a.m. presentation at http://www.summit_hurley.eventbrite.com.

The LGBT Healthcare Summit sponsored by Humana will be held Friday, Feb. 16 at the UofL Health Sciences Center Auditorium, 500 S. Preston St., Louisville, Ky. 40202.

Activity-based training has resulted in unexpected benefits for individuals with severe spinal cord injury (SCI). Researchers in the Kentucky Spinal Cord Injury Research Center (KSCIRC) at the University of Louisville have discovered that the training, designed to help individuals with SCI improve motor function, also leads to improved bladder and bowel function and increased sexual desire.

Research participants receiving activity-based training conducted by KSCIRC at Frazier Rehab Institute initially reported improvements in bladder, bowel and sexual function anecdotally. Charles Hubscher, Ph.D., professor and researcher at KSCIRC, has documented those changes in research published today in the journal PLOS ONE.

For individuals with severe spinal cord injury, bladder and bowel dysfunction are among the most detrimental factors to their quality of life, even more than the loss of independent mobility.

“Patients with spinal cord injury say they are most concerned by the problems associated with bladder function,” Hubscher said. “These issues contribute heavily to a decline in their quality of life and impacts overall health.”

Bladder dysfunction associated with SCI results in numerous health complications, requiring lifelong management and urological care in the form of catheterization, drug and surgical interventions, peripheral electrical stimulation and urethral stents. All of these therapies bring with them serious side effects and none substantially improves the basic functions.

To document changes in bladder, bowel and sexual function resulting from activity-based therapy, Hubscher and his colleagues performed urological testing (urodynamics) and asked research participants with severe spinal cord injury (SCI) to complete surveys about their bladder and other functions. Eight of the participants received activity-based training, which includes locomotor training, stepping on a treadmill with their body weight supported, and stand training in a specially designed frame. Four participants did not receive training.

The active participants’ functions following training were compared with their own condition prior to training and with individuals not receiving training. Following 80 daily sessions of locomotor training with or without stand training, the active individuals were found to store significantly more urine at safer pressures, reported fewer incidents of nighttime voiding and reduced general incontinence, as well as improved bowel functioning and increased sexual desire.

“Today’s published research indicates that activity-based training strengthens the neural circuits that control urogenital and bowel functions,” Hubscher said. “We hope to further validate those findings by determining if the improvements can lead to elimination of related medications and/or long-term reduction in the number of daily catheterizations. In addition, we are evaluating the effects of spinal cord epidural stimulation on those circuitries.”

Susan Harkema, Ph.D., professor and associate director of KSCIRC and an author of the study, said the publication highlights the value of the research collaborations at UofL.

“This work showcases the exceptional environment for research at UofL, with basic scientists working in parallel with clinicians in rehabilitation and neurosurgery,” Harkema said. “There are relatively few researchers addressing bladder, bowel and sexual function both in animals and humans in chronic spinal cord injury. Dr. Hubscher’s work adds a unique and valuable aspect to our research.”

Epidural Stimulation Research

Researchers at KSCIRC are investigating the use of spinal cord epidural stimulation (scES) to facilitate the ability of SCI patients to stand, voluntarily control leg movements, and improve other functions. Spinal cord epidural stimulation involves the delivery of electrical signals to motor neurons in the spine by an implanted device.

In concert with this research, Hubscher is investigating the effects of scES on bladder, bowel and sexual function in SCI patients. Funded by a $3.5 million grant from the National Institutes of Health, Hubscher has begun work to map the lumbosacral spinal cord for multiple aspects of bladder function. This work will identify locations on the spine and device configurations for using scES to improve bladder storage and voiding efficiency.

The funding is through the NIH Common Fund program Stimulating Peripheral Activity to Relieve Conditions (SPARC), which aims to increase the understanding of nerve-organ interactions and neuromodulation to advance treatment of diseases and conditions for which conventional therapies fall short.

Hubscher’s SPARC project has a three-year timeline and includes concurrent investigations in both animals and humans. His team will enlist six human research participants who have received scES devices and have completed the initial epidural stimulation study to assist with the development of device parameters, then test those parameters at home.

For the estimated 1,275,000 people in the United States who live with paralysis from SCI, therapies resulting from this research have the potential to increase their quality of life as well as reduce health-care costs.

#WeAreUofL

About the Kentucky Spinal Cord Injury Research Center at the University of Louisville

The Kentucky Spinal Cord Injury Research Center (KSCIRC), opened in 2001, provides the opportunity for basic scientists, physicians, neurosurgeons and physical therapists to work collaboratively with the common goal of curing paralysis. Through close association with clinical colleagues in the UofL Department of Neurological Surgery, KSCIRC is in a unique position to conduct research designed to ultimately lead to effective treatments for spinal cord injury. This continuum of research has facilitated a “bench-to-bedside” and “bedside-to-bench” approach, where basic science questions are examined from a translational perspective and findings in the clinical setting enlighten or guide future basic scientific studies.

Research supported by NICHHD grant no. R01HD080205, the Leona M. and Harry B. Helmsley Charitable Trust, the Christopher & Dana Reeve Foundation, and the Craig H. Neilsen Foundation. KSCIRC Neuroscience Core facilities supported by NIH/NCRR P30 grant no. 8P30GM103507. NIH:  Functional Mapping with Lumbosacral Epidural Stimulation for Restoration of Bladder Function After Spinal Cord Injury, grant no. 1OT2OD024898-01.

The millions of viewers watching the Super Bowl on Feb. 4 will no doubt witness exceptional physical abilities of the athletes as they execute precise passes, acrobatic catches and lightning-fast runs. However, research at the University of Louisville into the neurocognitive abilities of these players is revealing specific skills that allow them to excel at the mental game as well.

Brandon Ally, Ph.D., and researchers at the UofL Center for Sports Cognition have demonstrated that elite college and professional football defensive players have a greater ability to show steely focus, shielding their actions against interfering information on the field. Ally, an assistant professor in the Department of Neurological Surgery, has looked at the speed with which elite defensive players read a play and close on offensive threats.

In research recently accepted in Frontiers in Psychology: Movement Science and Sport Psychology, Ally and his colleagues compared reaction times in NCAA football players with non-athletes. The athletes and non-athletes show similar reaction times to simple stimuli. In an experimental task requiring the subjects to respond in the same direction as a series of five arrows, again there was no difference between NCAA football players and non-athlete controls.

However, when the center arrow is pointed in the opposite direction of the four other arrows (which were all moving in the same direction), the NCAA football players respond to the direction of the center arrow much more quickly than the non-athletes. 

“This means that football players are more proficient at shielding motor response execution speed from the interfering effects of distraction than non-athletes,” Ally said. “On the field, this will translate to the ability to more quickly spot key movements amidst the visual chaos of the offense and respond with decisive action.”

The same cancer screening services available at the University of Louisville’s James Graham Brown Cancer Center can be brought to workplaces, churches, schools or other organizations, with just a phone call to schedule.

The cancer center’s Mobile Screening Unit provides prevention and early detection services for breast and other types of cancers. People with private health insurance, Medicare or Medicaid will incur no additional charges for mobile services, and the cancer center will bill providers on behalf of the patients. Some co-pays may apply.

Services provided by the Mobile Screening Unit are furnished by staff at the cancer center and the Kentucky Cancer Program, the statewide cancer prevention and control program mandated by the Kentucky General Assembly.

For more than 25 years, the mobile unit has reached people at their place of business, church, school or community, first focusing on the provision of mammograms for breast cancer and later adding screening services for other types of cancer.

Business and organizational leaders who want to schedule the unit should contact Vera Hobbs at 502-562-4361, extension 4.

Heather Hibbard, B.S.N., R.N., manager of the medical oncology and infusion center at the University of Louisville James Graham Brown Cancer Center, is being honored for making a difference in the lives of cancer patients. Hibbard is one of seven health-care providers who will be in the spotlight at the Third Annual Commitment to Compassion Luncheon, sponsored by Passport Health Plan, Insider Louisville and the Compassionate Louisville Healthcare Constellation. The event is scheduled for Wednesday, Feb. 28, at the Muhammad Ali Center.

Hibbard uses her training as well as her personal experience to make life a little easier for cancer patients. Her father and grandfather were diagnosed with lung cancer within one month of each other, and passed away one month apart in 2013. Although it was a painful time for her, that experience helps her understand how to improve care provided to the patients at the Brown Cancer Center.

Hibbard says she wants to provide the kind of care for patients and families that she would want to receive. To help make things easier, she developed a lab and line room where patients can have their vitals and lab work done before seeing the physician. This reduced patient wait times by two thirds.

“Cancer does not have to be a death sentence, but the patients need top-notch, nurturing and individualized care,” Hibbard said. “My one goal in life is to make a difference in cancer care – to give others hope that we are doing everything we can as an oncology center. I have a great group of people who want better care for their patients and I help them in reaching that goal.”

It is often little things that make a difference for patients.

“You don’t ever hear, ‘thank you for accessing my port,’” Hibbard said. “But you do hear ‘thank you for being gentle with me,’ ‘thank you for listening,’ ‘thank you for calling home health and getting things set up so my life is a little easier.’”

The Commitment to Compassion luncheon, emceed by television health and science reporter Jean West, will include recognition of the compassionate care honorees, a performance by the West Louisville Boys Choir and a panel discussion on “Innovative and compassionate care in West Louisville.” Reservations are available online.

The Kentucky Academy of Family Physicians (KAFP) has recognized the work of William J. Crump, M.D., associate dean, University of Louisville School of Medicine Trover Campus. The organization recently awarded Crump the Distinguished Service Award, an award given to a family physician who has served in leadership roles with the KAFP and has advanced the specialty of family medicine.

Nominated by William Thornbury, M.D., Crump of Madisonville, Ky., is praised for his leadership and tireless effort promoting evidence-based medicine through the publication of scholarly work. Crump, who served as editor of the Kentucky Academy of Family Physicians Journal from 2006-2017, helped transform the journal into a peer-reviewed publication for the scholastic contributions of the Commonwealth’s family medicine community.

“Perhaps the most enjoyable part of my role was getting students, residents and young faculty through their first manuscript effort, from bright idea to published product. They are our future,” Crump said.

Not only has Crump led the academy in his role of bolstering the scholarship for health improvement of Kentuckians, as an educator-physician Crump teaches medical students at the  UofL School of Medicine Trover Campus in Madisonville. Preclinical students have the opportunity to spend two three-week summer sessions at the campus, working with primary care preceptors. Up to 12 students are selected to spend their third and fourth years of training in Madisonville where they help meet health care needs of rural Kentuckians.

January is a great time to start anew and take a health inventory. Luz Fernandez, M.D., medical director of UofL Physicians - Family Medicine Cardinal Station, encourages individuals to make yearly check ups a priority.

“Developing a lasting, trusted relationship with a primary care provider is important, regardless of a person’s age,” Fernandez said.

During an annual visit, a provider asks the patient about health habits, the health of close relatives and overall lifestyle. The information will determine risks of common medical conditions and whether further testing is needed. The check up, says Fernandez, is a good way to screen for and possibly detect medical conditions such as diabetes and high cholesterol so they can be treated at an early stage, minimizing risks of serious complications in the future.

A primary health care provider also can partner with patients in setting healthy habits. Fernandez hopes to inspire SMART goals:

• S: Specific, significant 
• M: Measurable
• A: Achievable
• R: Realistic and Results-oriented 
• T: Time based and Trackable

“You are much more likely to stick to an exercise plan if you commit to a 30 minute walk or jog three days a week instead of saying ‘I will exercise more,’ ” Fernandez said.

She says it is best to be as specific as possible and to make sure the goal is attainable, adding that accountability is important to success.

“Discuss your plans with a primary care provider, and rely on trusted family and friends for support,” she said. “Technology resources like the app, myfitnesspal can track food intake, exercise and weight loss; seeing a graph of progress may work to keep you motivated.”

New patients accepted at renovated facility

UofL Physicians – Family Medicine Cardinal Station, located at 215 Central Ave., Suite 100, recently updated its facility and is welcoming new patients for check ups and other health related purposes, including acute illness.

With 25 patient rooms, the practice offers a full spectrum of on-site services including:

• Well care visits, immunizations
• X-rays
• Lab work
• Spirometry
• EKG
• Toenail removal
• Mole removal
• Birth control placements
• Vision screenings
• Cancer screenings

Most insurance plans accepted. Free parking available on the surface lot in front of the office. For an appointment or more information, call 502-588-8720.

Joshua C. Gross, M.D., a first-year resident in training with the UofL Department of Ophthalmology and Visual Sciences, will present his research at the annual meeting of the Association of University Professors of Ophthalmology (AUPO) on Jan. 26 in Austin, Tex. At the RPB/AUPO Resident and Fellow Research Forum. Gross has conducted research into the association between blood flow in the retina and the progression of open-angle glaucoma and diabetes mellitus.

Working with colleagues at Indiana University School of Medicine and in Italy, Gross found that patients who had reduced retinal blood flow and optic nerve damage consistent with glaucoma who also had diabetes experienced faster visual deterioration than patients with similar characteristics but who did not have diabetes.

Open-angle glaucoma, the most common form of glaucoma, accounts for at least 90 percent of all glaucoma cases, affecting about 3 million Americans. It is caused by the slow clogging of the drainage canals, resulting in increased eye pressure. 

January 25, 2018

In a study of patients with head and neck cancer, even mild depressive symptoms were associated with poorer overall survival. Published early online today in CANCER, a peer-reviewed journal of the American Cancer Society, the findings indicate that patients should be screened and treated for depressive symptoms at the time of diagnosis. In addition, studies should examine parallel biological pathways linking depression to cancer survival.

Many patients diagnosed with head and neck cancer experience symptoms of depression, which can make it difficult for them to manage treatment side effects, quit smoking, or maintain adequate nutrition or sleep habits. A team led by Elizabeth Cash, Ph.D., of the University of Louisville School of Medicine, was interested to see if depressive symptoms might also affect patients’ health outcomes.

The researchers studied 134 patients with head and neck cancers being treated at the UofL James Graham Brown Cancer Center multidisciplinary head and neck clinic from October 2012 to October 2013 who reported depressive symptoms during the planning of their treatment. In this group, 67.2 percent expressed measureable depressive symptoms. When the investigators examined the patients’ clinical data over the following two years, they found that patients with greater depressive symptoms had shorter survival, higher rates of chemo-radiation interruption, and poorer treatment response.

“We observed that head and neck cancer patients who reported more depressive symptoms at their initial appointment were more likely to miss scheduled treatment appointments and were more likely to have tumors that persisted after medical treatment,” said Cash, who serves as the director of research for the Department of Otolaryngology-Head and Neck Surgery and Communicative Disorders at UofL. “We also observed that patients with depressive symptoms suffered greater two-year overall mortality rates, and this was especially true for those who did not achieve optimal response to medical treatment.”

Poorer treatment response partially explained the depression-survival relationship; however, there were no significant effects from factors commonly used to determine cancer prognosis—such as the patient’s age, the stage of tumor advancement or extent of smoking history.

“This suggests that depressive symptoms may be as powerful as the clinical features that physicians typically use to determine the prognosis of patients with head and neck cancer,” Cash said.

She also noted that most patients in the study did not meet criteria for diagnosis of major depressive disorder, suggesting that even mild symptoms of depression may interfere with head and neck cancer treatment outcomes. She said that while the findings need to be replicated in a larger study, they do suggest that depressive symptoms may affect head and neck cancer patients’ survival through mechanisms that potentially coincide with the activities of their tumor.

“We want patients to know that it is normal to get depressed when they are diagnosed, but it is important to seek help for any depression symptoms because (not doing so) may lead to poorer outcomes related to their cancer treatment,” Cash said.

She and her colleagues are hopeful that this information can facilitate discussions between patients and psycho-oncologists or behavioral oncology specialists to expedite the development of targeted behavioral interventions, which may have high potential to complement medical treatment efficacy.

Eating disorders affect about 8 million people in the United States at any one time. Although a large majority is young women, anorexia nervosa, bulimia nervosa and other types of eating disorders can affect men and people of any age. Cheri Levinson, Ph.D., assistant professor in the Department of Psychological and Brain Sciences and director of the Eating Anxiety Treatment Laboratory at the University of Louisville, will share some of her research in the treatment of eating disorders at the next Beer with a Scientist event, Wednesday, Jan. 17.

Levinson will discuss the lab’s research on the association between eating disorders and anxiety. In addition, she will describe therapies that incorporate technological innovations.

“The most common treatments for eating disorders only work for about 50 percent of individuals,” Levinson said. “In the Eating Anxiety Treatment Lab, we are working on developing novel treatments personalized to the individual,” Levinson said. “Many of our treatments use technology to help improve treatment and reach more people.”

Levinson’s talk begins at 8 p.m. onWednesday, Jan. 17, at Against the Grain Brewery, 401 E. Main St. in Louisville. A 30-minute presentation will be followed by an informal Q&A session.

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

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

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. Once a month, the public is invited to enjoy exactly what the title promises:  beer and science. For more information and to suggest future Beer with a Scientist topics, follow Louisville Underground Science on Facebook.

Upcoming Beer with a Scientist dates:  Mar. 14, Apr. 18.

January 9, 2018

Research in the past two decades has revealed that microbial organisms in the gut influence health and disease in many ways, particularly related to immune function, metabolism and resistance to infection. Recent studies have shown that gut microbes also may cause or worsen Parkinson’s disease, Alzheimer’s disease and other neurodegenerative conditions.

University of Louisville neurology professor Robert P. Friedland, M.D., and Matthew R. Chapman, Ph.D., professor at the University of Michigan, have proposed a new term to describe an interaction between gut microbiota and the brain in an article released today in PLOS Pathogens.

Friedland and Chapman propose the term “mapranosis” for the process by which amyloid proteins produced by microbes (bacteria, fungi and others) alter the structure of proteins (proteopathy) and enhance inflammation in the nervous system, thereby initiating or augmenting brain disease. The term is derived from Microbiota Associated Protepathy And Neuroinflammation + osis (a process).

Friedland hopes that giving the process a name will facilitate awareness of the process, as well as research leading to therapeutic opportunities.

“It is critical to define the ways in which gut bacteria and other organisms interact with the host to create disease, as there are many ways in which the microbiota may be altered to influence health,” Friedland said.

Research into the multitude of microbes that inhabit the human body has expanded considerably in recent years. Genomic analysis has begun to reveal the full diversity of bacteria, viruses, fungi, archaea and parasites living in and on the body, the majority of them in the gut. Even more recently, researchers have begun to explore how the proteins and other metabolites produced by microbes inhabiting the gut influence functions in other parts of the body, including the brain. However, we do not yet have a full understanding of how these systems work. The relationship between the microbiota and the brain has been called the “gut-brain axis.”

It is understood that the clumping of misfolded amyloid proteins, structures produced by neurons in the brain, are associated with neurodegeneration and conditions such as Alzheimer’s disease, Parkinson’s disease and amyotrophic lateral sclerosis (ALS).

“It is well known that patterns of amyloid misfolding of neuronal proteins are involved in age-related brain diseases. Recent studies suggest that similar protein structures produced by gut bacteria, referred to as bacterial amyloid, may be involved in the initiation of neurodegenerative processes in the brain,” Friedland said. “Bacterial amyloids are produced by a wide range of microbes that inhabit the GI tract, including the mouth.”

In research published in 2016 in Scientific Reports, Friedland and colleagues showed that when E. coli microbes in the gut of rats and worms (nematodes) produced misfolded amyloids, the amyloids produced in the animals’ brains and intestines also misfolded, a process called cross-seeding.

“Our work suggests that our commensal microbial partners make functional extracellular amyloid proteins, which interact with host proteins through cross-seeding of amyloid misfolding and trigger neuroinflammation in the brain,” Friedland said.

In today’s article, Friedland and Chapman also address other factors related to the microbiota and its products and how they influence neurodegenerative disorders.

1. The microbiota modulates (enhances) immune processes throughout the body, including the central nervous system.
2. The microbiota may induce oxidative toxicity (free radicals) and related inflammation that contributes to neurodegeneration.
3. Metabolites produced by the microbiota may be either beneficial (health sustaining) or damaging (pathogenic).
4. Host genetics influence microbiota populations, illustrating that the gut-brain axis is bidirectional.

Friedland believes further research in this area may lead to therapies for these neurodegenerative diseases, which are increasing in frequency and for which there are few effective treatments.

Chapman’s research is supported by the National Institutes of Health. Friedland’s work has been supported by The Michael J. Fox Foundation.

December 21, 2017

Nearly 900 toys swamped a Christmas tree in the University of Louisville Health Sciences Center administration building, ready to be delivered to local children who would otherwise go without presents this year.

For the third year, the UofL School of Medicine House Staff Council, the representative body for resident and fellow physicians, led a weeklong collection for Toys for Tots. Donations were received from individual residents and fellows as well as School of Medicine faculty, staff and students.

“Unfortunately, there are so many families in Louisville who cannot afford toys for their children,” said Svetlana Famina, M.D., a third-year psychiatry resident. “We work with these families a lot on a daily basis, so we know how much things like this are appreciated by children and their parents.”

Stock Yards Bank & Trust will provide a luncheon and plaque to the three residency programs that donated the most toys.

The winning program for the third straight year, the Department of Psychiatry and Behavioral Sciences, collected about 430 toys. Aside from gathering donated toys, psychiatry residents raised about $1,000 to buy additional gifts, Famina said.

The Department of Obstetrics, Gynecology and Women’s Health donated the second-most number of toys and the Department of Radiology finished third.

Jamie Morris, M.D., a radiology resident, said the annual toy drive has become an important way for UofL medical residents to give back to the community, especially children.

“It’s important to share what we have,” Morris said. “The residency program is a strong coalition and we have a lot to give the Louisville community.”

Staff members of the Office of Graduate Medical Education sorted and packed the toys in donation boxes, which were picked up by a Toys for Tots volunteer on Dec. 11.

The U.S. Marine Corps Reserve Toys for Tots Program collects new, unwrapped toys during October, November and December each year, and distributes those toys as Christmas gifts to underprivileged children in the community in which a campaign is conducted.

Senior citizens who live in Jefferson and surrounding Kentucky counties are encouraged to take a brief survey online or over the phone to help analyze social service needs for older adults and individuals with disabilities.

For the second year, the University of Louisville Institute for Sustainable Health and Optimal Aging will conduct a community needs assessment on behalf of the Kentuckiana Regional Planning & Development Agency (KIPDA).

Led by the institute’s Executive Director, Anna Faul, Ph.D., and Director of Health Innovation and Sustainability, Joe D’Ambrosio, Ph.D., the 2018 KIPDA needs assessment surveys people across the seven KIPDA counties – Bullitt, Henry, Oldham, Shelby, Spencer, Trimble and Jefferson. It looks at each county in regards to housing, outdoor spaces and buildings, transportation and streets, health and wellness, social participation, inclusion and education opportunities, volunteering and civic engagement and job opportunities.

The survey results, together with an analysis of current community services and gaps, will allow the institute to make specific and strategic recommendations to KIPDA. If adopted, these recommendations are designed to ensure that older adults and individuals with disabilities have their immediate social service needs met while more broadly enabling them to lead lives of dignity and independence.

Anyone living in the designated counties is invited to complete the Community Needs Assessment Survey. The more people that participate, the more likely service gaps can be addressed. Older adults, caregivers, and persons with disabilities are especially encouraged to participate in this research study. Survey participants do not have to be recipients of KIPDA services.

The assessment can be found online or by calling 502-852-8953. The institute can provide a paper copy upon request or at senior centers within the seven counties. The deadline to complete the assessment is Feb. 1, 2018.

For more information, visit www.optimalaginginstitute.org/kipda or contact Dr. D’Ambrosio at joe.dambrosio@louisville.edu or 502-852-7811.

University of Louisville Hospital opened a new center today to treat hepatitis C, a particular problem in Kentucky, which has the highest infection rate in the country.

A ribbon-cutting and open house marked the UofL Hospital Hep C Center’s official opening Wednesday morning, with the first patients scheduled later in the day.

“While Kentucky has the highest rate of new hep C cases in the U.S., few places exist here for treatment,” said Barbra Cave, a family nurse practitioner specializing in gastroenterology and hepatology who leads the center. “This is a much-needed service in the community.”

In the past, treating hepatitis C was difficult. It involved a triple therapy with interferons that lasted almost a year, with multiple side effects. Not everyone was a candidate for treatment. Doctors found it challenging, and some patients opted to not get treated at all.

“Many patients were scared off by treatment, knowing it was going to be hard,” Cave said. “Maybe they saw a friend go through it. But we want them to know it’s not hard anymore. We can help so many people.”

Today, treatment is one pill, once a day, for 8-12 weeks – with minimal side effects, said Ashutosh Barve, M.D., Ph.D., the center’s medical director and a gastroenterologist with the hospital and UofL Physicians. The center also uses FibroScan, which allows staff to perform a non-invasive assessment of the liver without a biopsy.

“This is truly a success story of modern medicine,” he said. “We went from discovering the basic science of the disease in the late ‘80s, early ‘90s, to finding a cure in 2014.”

Up to half of patients who have it may not know they are infected, Cave said. The U.S. Centers for Disease Control and Prevention has recommended screening for all baby boomers.

“People may carry the disease for decades before they have symptoms,” she said.

Hepatitis C is a blood-borne illness. It may have been contracted from a blood transfusion prior to 1992, contaminated tattoo equipment or IV drug use. Older veterans are particularly at risk due to the use of the old “jet gun” vaccinators by the military and combat injuries, Cave said.

Contaminated dental equipment can also spread hepatitis C, and the disease can be passed from mother to baby.

“The virus can live on a surface for weeks, if not sterilized properly,” Cave said.

Though hepatitis C is now easily curable with proper treatment, the disease can cause major complications if left untreated. It can cause cirrhosis of the liver or liver cancer. Barve, who also directs the Liver Cancer Program at the UofL School of Medicine, said hepatitis C is a leading cause of liver transplant.

Hepatitis C may predispose those infected to diabetes and depression, and it has an association with joint pain, regardless of the amount of liver damage.

The new center will see patients every weekday, and the hospital is expecting 2,000 patient visits per year, with space to expand as volume grows. 

How would scientists go about encouraging interest in their field and educating the public about science? Members of the Louisville chapter of the Society for Neuroscience found more than 30 ways to accomplish that goal, developing interactive exhibits at the Kentucky Science Center, speaking about scientific topics at public events and organizing seminars to encourage K-12 students’ interest in science and more.

For their work, the Louisville group was named the 2017 chapter of the year by the National Society for Neuroscience (SfN) earlier this month at the organization’s annual meeting in Washington, D.C.

The Society for Neuroscience is an organization of nearly 38,000 basic scientists and clinicians in more than 90 countries who study the brain and nervous system. The Louisville SfN chapter includes nearly 300 members, about 280 of whom are faculty, staff and students at the University of Louisville. Members also represent Bellarmine University, Morehead State University and Northern Kentucky University.

The SfN presents its Chapter-of-the-Year Award in recognition of a chapter’s accomplishments in outreach to the public, providing neuroscience resources for K-12 education and advocacy for issues related to research and science.

The Louisville chapter organized or participated in more than 30 events between June 2016 and July 2017 related to this mission. Members hosted 25 minority high school students interested in health professions for a tour at UofL, held a seminar to encourage middle school girls’ interest in STEM-related careers, developed “Brain Days:  An Interactive Neuroscience Experience” at the Kentucky Science Center, and helped organize the local March for Science in Louisville. The club estimates that through these and other events, 171 volunteers helped educate more than 5,000 people about the field of neuroscience.

In addition to the chapter award, the group’s outgoing president, Kristofer K. Rau, Ph.D., earned the organization’s Next Generation Award for junior faculty for his efforts to share neuroscience with the public throughcommunication, education and outreach activities. Rau, a senior research associate in the UofL Department of Anesthesiology, spearheaded community outreach efforts for SfN’s Louisville chapter designed to increase science education and literacy focused on nervous system function and careers in neuroscience research. Rau helped to establish adult education programs, initiated neuroscience awards at regional science fairs, and prepared materials and mobilized volunteers for a walk to end multiple sclerosis.

The Louisville SfN chapter will receive $3,000 for the two awards.

November 30, 2017

Putting action and investment behind commitment is evident at University of Louisville Hospital with two new technologies put into place that advance the goal of controlling infection.

The hospital, in conjunction with UofL’s James Graham Brown Cancer Center, recently renovated and enlarged its Bone Marrow Transplantation Unit, including the installation of all new copper fixtures that utilize the metal’s antimicrobial properties to control infection. UofL Hospital is the first facility in the Kentuckiana region to install the new fixtures.

The hospital also is the first in the area to begin using a new hand hygiene system that reminds staff to wash their hands, if they forget. Staff members wear a badge that displays a red, yellow or green hand that automatically communicates compliance status to patients, reassuring them they are safe. The system collects compliance data that can be shared with staff and administrators.

These efforts are not isolated events but are part of a dedicated effort to improve patient safety, said University Medical Center (UMC) Interim President/CEO Ken Marshall. UMC is the parent organization that has operated the hospital and cancer center since July 1.

“While we meet or exceed national standards of care once a hospital-acquired patient infection has been identified, our opportunity is around earlier recognition to prevent infection,” Marshall said. “To this end, we have enhanced the use of tools available to us through new technologies and have put in place a continual education and training process.”

While it is too soon to have verified data on the results of these efforts, hospital leaders are confident that the new measures will enable the hospital to increase its rates of infection control and reduce the incidence of hospital acquired infections (HAIs) in patients.

“HAIs can happen in any health care facility,” said UofL Hospital Chief Medical Officer Jason Smith, M.D., Ph.D., including hospitals, ambulatory surgical centers, long-term care facilities and others. “They are caused by bacteria, fungi, viruses or other less common pathogens. The new systems installed at UofL Hospital will have a significant impact in reducing the incidence of HAIs.”

HAIs can be a cause of illness and death, and they can have emotional, financial and medical consequences. At any given time, about 1 in 25 inpatients has an infection related to hospitals or other health care facilities in the United States. These infections lead to the loss of tens of thousands of lives and cost the U.S. health care system billions of dollars each year.

“As front-line care providers, our nurses know better than anyone about the toll that HAIs can have on patients and their families,” said Chief Nursing OfficerShari Kretzschmer, R.N. “Nurses at UofL Hospital and James Graham Brown Cancer Center play a key role in preventing the spread of HAIs and we are excited to embrace these new tools introduced for the first time in our region to help strengthen infection control.”

The effort was a worthwhile investment, Marshall said. “On July 1, a health care resource that has been vital to this community for nearly 200 years entered a new era of service to the people of Metro Louisville and Southern Indiana,” he said. “Our necessity to change, improve and grow is mandatory, and we will work to implement whatever investment is needed to achieve that growth.”

“Incorporating new technology shows our commitment to providing a safe environment for patient care,” said Director of Infection Prevention and ControlSarah Bishop, A.P.R.N., at UofL Hospital. “I’m proud to work for an organization that is an early adopter of these emerging technologies.”

The new technologies are CuVerro Bactericidal Copper Surfaces and the BioVigil Hand Hygiene System.

About CuVerro Bactericidal Copper Surfaces

Copper has been known to have inherent bactericidal properties for thousands of years. While its exact mechanism of action is not yet fully known, research suggests that copper surfaces affect bacteria in two sequential steps: the first step is a direct interaction between the copper surface and the bacterial outer membrane, causing the membrane to rupture. The second is related to the holes in the outer membrane through which the cell loses vital nutrients and water, causing a general weakening of the cell. CuVerro works with manufacturers to leverage this quality into the development of products that kill almost 100 percent of the bacteria that cause HAIs within two hours of contact.

CuVerro and JRA Architects of Louisville partnered with UofL Hospital in the renovation of the Bone Marrow Transplantation (BMT) Unit. Patients requiring BMT take anti-rejection drugs that compromise their immune systems, making them highly susceptible to bacterial infection. The copper surfaces on the fixtures in the BMT unit are an added protective measure against infection.

The surfaces are found in virtually every fixture touched by human hand: patient room sinks, bathroom sinks, faucets, electrical switch plates, door hardware, cabinetry hardware and shower safety grab bars. There are approximately 20 separate surfaces in each of the 16 rooms in the unit plus another 10-20 fixtures in each hallway, common area, office and treatment room.

About the BioVigil Hand Hygiene System

The BioVigil electronic hand hygiene solution reminds hospital staff to perform hand hygiene if they forget. BioVigil also visually communicates to and reassures patients and families that hand hygiene has been performed via a colored hand displayed on a badge worn by health care workers. Green confirms that hand hygiene has been performed. Yellow is a reminder that staff must wash their hands, and red means that staff must stop and wash their hands. To comply with hand hygiene, users apply sanitizer and place their hand over the badge, which detects the alcohol from the sanitizer.

Hand hygiene activities are automatically recorded by a badge and then securely downloaded to a cloud-hosted database once the badge is returned to a base station. The hospital retrieves monitoring and compliance reports through the system’s data suite or via email.

The system makes it easy for health care professionals to comply with hand hygiene, empowers patients to take an active role in their care and helps hospitals combat HAIs. The technology works with all sanitizer and soap products. It has been introduced in nine units thus far in UofL Hospital and will continue to be introduced to other units over time.

The system is manufactured by BioVigil Healthcare Systems Inc. of Ann Arbor, Mich.

#WeAreUofL

CuVerro, with brand headquarters in Louisville, is manufactured by GBC Metals LLC, doing business as Olin Brass, a wholly owned subsidiary of Global Brass and Copper Inc. which is a subsidiary of Global Brass and Copper Holdings Inc., the leading manufacturer and distributor of copper, copper‐alloy and bactericidal copper sheet, strip, plate, foil, rod, ingot and fabricated components in North America and one of the largest in the world. GBC Metals engages in the melting, casting, rolling, drawing, extruding and stamping of specialized copper and copper alloys finished products from scrap, cathode and other refined metals (OB-0047-1711). For more information visit cuverro.com or contact cuverro@olinbrass.com.

The University of Louisville continues to lead in educating future physicians to provide the best possible health care for patients who are lesbian, gay, bisexual, transgender (LGBT), gender nonconforming and those born with differences in sex development (DSD). UofL’s eQuality Project, the initiative to embed training in the care of these patients throughout its medical school curriculum, has won the 2016-2017 Innovation in Medical Education Award from the Southern Group on Educational Affairs (SGEA).

The SGEA presents a single Innovation in Medical Education Award each year for a good, replicable idea for other medical education institutions to consider. Chosen over three other nominees, UofL’s eQuality Project won thanks to the timely topic and the unique but practical approach, according to Karen “Sam” Miller, Ph.D., director of graduate medical education and research at UofL and chair of SGEA, a regional subgroup of the Association of American Medical Colleges (AAMC).

In 2014, UofL became the pilot program for the development of curriculum to incorporate competencies published by the AAMC related to provision of care for LGBT and DSD individuals.

“Every patient deserves to be cared for with respect and competence,” said Toni Ganzel, M.D., M.B.A., dean of the UofL School of Medicine. “The faculty and staff members who have devoted so many hours in the eQuality Project have made it their mission to provide the best education for our future physicians in the care of LGBTQ patients. I am extremely proud of their work and pleased that the SGEA is recognizing it as a model for other institutions.”

Susan Sawning, M.S.S.W., director of undergraduate medical education research, and Laura Weingartner, Ph.D., research manager, were recognized for the award at the SGEA Business Meeting during the 2017 AAMC Learn, Serve, Lead conference in Boston earlier this month. The award will be presented formally at the SGEA Regional Conference in April 2018 in Jackson, Miss.

“This has been a beautiful team effort,” Sawning said. “I am most proud that our LGBTQ community is feeling empowered and better cared for, and that makes it all worth it.”

The project included Sawning, Weingartner and other members of the eQuality Steering Committee:  Chaz Briscoe, M.A., Dwayne Compton, M.Ed., Amy Holthouser, M.D., Charles Kodner, M.D., Leslee Martin, M.A., David McIntosh, Ph.D., Emily Noonan, M.A., M. Ann Shaw, M.D., M.A., Stacie Steinbock, M.Ed., and Jennifer Stephens, B.A.

The AAMC is the not-for-profit association representing all 145 accredited United States and 17 accredited Canadian medical schools; nearly 400 major teaching hospitals and health systems, including 51 Department of Veterans Affairs medical centers; and nearly 90 academic and scientific societies. Through these institutions and organizations, the AAMC represents 148,000 faculty members, 83,000 medical students, and 110,000 resident physicians.

#WeAreUofL

November 28, 2017

NOTE: Watch a video of Dr. Coldwell talking about the new Discovery IGS 740 system at UofL Hospital here. 

University of Louisville Hospital is the first in the region to install and use a new imaging system that is more accurate, faster and safer than traditional units.

“This is the most advanced piece of arteriographic equipment in the world at the moment,” said Douglas Coldwell, M.D., Ph.D., director of vascular and interventional radiology and interventional oncology at UofL Hospital and a professor of radiology and bioengineering at the UofL School of Medicine. “And we are the only ones to have it in this area. This really is a big deal.”

The Discovery IGS 740 provides exceptionally detailed, 3-D images in real time of patient anatomy, which Coldwell said is invaluable in trauma cases.  Doctors can accurately determine the site of bleeding and close it off, saving lives.

He said Discovery’s laser-guided tools give doctors the ability to be much more precise in treatment.

“With this new system, we’ve taken a leap forward in patient care in this community and region,” Coldwell said.

With its unique mobile platform, the Discovery has the power and capability of traditional fixed imaging units, but rides on the floor, moving around the patient as necessary, free of interference from fixed floor or ceiling structures. At the touch of a button on bedside controls, doctors can use its laser guidance mechanism to precisely position it just about anywhere for the best possible images of parts of the anatomy. It can then be moved aside so medical professionals can work efficiently and have unobstructed access to patients.

Its exceptionally high-quality images allow doctors to perform delicate procedures such as blood vessel interventions with accuracy and confidence, Coldwell said.

“It allows us to get in, treat a patient and do it without complications, and have a better patient outcome,” he said. Even arteries can be looked at in 3-D, allowing doctors to “plan exactly where we’re going to go in treatments,” such as for stent and angioplasty.

Its large digital detector also gives doctors the ability to see more in a single exam with fewer X-ray images, and fewer injections of contrast dye, and carries just a fraction of radiation of traditional units, making it much safer for patients and staff.

“Everyone is concerned about radiation,” he said. “With this equipment, we get 1/10^th to 1/100^th of the radiation of other units.”

The Discovery unit’s precision makes it perfect for use in patients at the UofL James Graham Brown Cancer Center.

“It allows for amazingly targeted radiation,” Coldwell said.

Tumors can be treated by injecting radioactive beads the size of talcum powder particles into them via arteries. “This requires precise placement, which we can do with the Discovery system,” Coldwell said. “A very high dose of radiation can be given to the tumor, while sparing the surrounding tissues. That means fewer side effects for patients.”

The equipment has its own dedicated room at the hospital. Mike Goode, the hospital’s director of imaging and neurodiagnostic services, said installation was finished last month at a cost of around $2 million, including precision leveling of seamless floors to hold the sensitive, heavy equipment, which took nearly a month.

Doctors have been seeing patients with the system for a few weeks, and the difference is profound, Coldwell said.

“We’re pretty excited about it,” he said. “It’s a game-changer.”