A leading UMKC and Saint Luke’s Health System researcher, John Spertus, M.D., M.P.H., was heavily involved in important heart-procedure research that was published earlier this month and presented at the annual conference of the American Heart Association.
You can read an interview with Spertus about the research here.
A Washington Post story said the study, called ISCHEMIA, found that invasive procedures to unclog blocked arteries — in most cases, the insertion of a stent, a tiny mesh tube that props open a blood vessel after artery-clearing angioplasty — were no better at preventing heart attacks and death in patients with stable heart disease than were pills and improvements in diet and exercise. Overall, the study results suggest that invasive procedures, stents and bypass surgery, should be used more sparingly in patients with stable heart disease and the decision to use them should be less rushed, experts said.
Spertus is a UMKC professor of medicine and Daniel J. Lauer Endowed Chair in Metabolism and Vascular Disease Research. At Saint Luke’s Mid America Heart Institute, as clinical director of outcomes research, he developed technology that guides physicians and patients in medical-decision making by using models to measure and predict the risk factors of various procedures. Many experts cite two tools he created — the Seattle Angina Questionnaire and the Kansas City Cardiomyopathy Questionnaire — as the gold standards for measuring symptoms, function and quality of life in treating coronary artery disease and heart failure. Both have been translated into more than 95 languages.
A year ago he received the American Heart Association’s 2018 Distinguished Scientist Award. He previously received the association’s Lifetime Achievement Award in 2015 and the Council on Quality of Care and Outcomes Research Distinguished Achievement Award in 2013.
Surgeons world-wide currently perform more than 240,000 corneal transplants a year to address a wide range of eye diseases. Researchers and physicians, however, estimate as many as 10 million patients could benefit from the procedure if enough viable tissue was available.
The University of Missouri-Kansas City Vision Research Center is part of a $1.5-million National Institutes of Health grant-funded project exploring the capability of a novel, ultra-fast technique of cryopreservation that could help meet those far-reaching clinical needs in ophthalmology and a number of other fields of medicine.
The NIH awarded a phase II Small Business Innovation Research (SBIR) grant to CryoCrate, a Columbia, Missouri-based company active in biomedicine working with the University of Missouri-Kansas City Vision Research Center. The new two-year award is for $1,566,168 and includes a subcontract of $722,870 to UMKC’s Vision Research Center. It is a follow-up grant to previous phase I SBIR funding from the NIH for earlier collaborative work between CyroCrate and UMKC.
With current techniques, many types of cells and tissues, including cornea tissues, cannot be preserved at all or lose their function when subjected to the freeze-thaw process of cryopreservation. Peter Koulen, Ph.D., professor of ophthalmology, endowed chair in vision research at the UMKC School of Medicine and director of basic research at the UMKC Vision Research Center, and Xu Han, Ph.D., president and Chief Technology Officer of CryoCrate, jointly developed a new cryopreservation technique to preserve the viability and functionality of cornea and bioartificial ocular tissues. The new phase II SBIR funding will allow Han and Koulen to extensively test and refine the technology before taking it to the clinics.
Thus far, traditional methods of cryopreservation have been unsuccessful to preserve and store human corneas for use in patients due to the fact that cells critical for cornea function are lost during freezing. Corneas need adequate numbers of such cells to be present and properly functioning in the grafted tissue for the surgery to be successful. This currently limits storage of corneas to refrigeration, which is insufficient in delaying the deterioration of cornea tissue beyond a few days and creates numerous clinical challenges shared by other areas of transplantation.
CryoCrate is headquartered at the Missouri Innovation Center. It commercializes a new cooling method that better preserves tissue in a frozen state with only negligible mechanical damage to the tissue. The technology is co-developed and co-owned by CryoCrate and UMKC. It also eliminates the need for so called cryoprotectants, chemicals that facilitate successful recovery of live tissue from freezing, but pose a range of medical and regulatory challenges. International patents pending and patents by CryoCrate and UMKC protect the technology and will enable CryoCrate and Koulen’s team at UMKC to address the urgent worldwide clinical needs and rapidly evolving fields of transplantation medicine.
The new NIH SBIR phase II grant allows Han and Koulen to further develop an upgraded system that is equally effective in the cryopreservation of whole corneas and large bioartificial tissue. This would enable long-term storage of the tissues and could make them more readily available when and where needed for clinical use and research.
Early tests at the UMKC Vision Research Center detected no statistical difference in the number and quality of the cells that determine cornea health and function, when comparing corneas cryopreserved using the new technology with fresh cornea tissue. This level of efficiency in preserving corneal tissue has not been achieved previously with traditional corneal cryopreservation techniques.
If further tests prove to be equally effective, the goal is to introduce the new cryopreservation products for clinical use in patients following completion of the new NIH SBIR phase II grant and subsequent regulatory steps of product development.
A diagnostic process used in routine eye exams could hold a key to early stage detection and long-term monitoring of subclinical and clinical traumatic brain injury.
The Leonard Wood Institute awarded a $383,837 grant to the UMKC School of Medicine to explore the use of microperimetry to detect changes in visual function that are the result of traumatic brain injury. The project’s principal investigator is Peter Koulen, Ph.D., director of basic research at the UMKC School of Medicine’s Vision Research Center in the Department of Ophthalmology.
Microperimetry measures the light sensitivity of the central retina. It is currently used in ophthalmology to identify damage to the retina and vision loss due to eye diseases.
“We’re not looking for treatments for traumatic brain injury. We’re looking for a quantitative method to detect the disease that tells the patient, your disease severity is a 9 out of 10 or a 2 out of 10,” Koulen said. “Being able to quantify the disease will help physicians to better evaluate their patients. And then, when there is a treatment, it will help evaluate the treatment as well.”
Interventions to prevent or stop traumatic brain injuries are most effective early in the disease, but are not possible without reliable and easily repeatable early stage identification and diagnosis.
Current tests to conclusively show subclinical, or non-recognizable, forms of traumatic brain injury and the degree of acute and long-term damage are typically costly and often imprecise without accurate baseline data.
Using the microperimetry technology, Koulen’s research will sample mild to moderately concussed patients, subclinical traumatic brain injury and non-concussed patients to achieve a baseline. That data will then be used to create a defined number of quantitative parameters and produce a specific fingerprint of functional changes in vision that allow the researcher to optimally perform early stage detection, grading and long-term monitoring of subclinical and clinical traumatic brain injury.
Koulen said the UMKC School of Medicine’s Department of Ophthalmology and its Vision Research Center are uniquely positioned to conduct research on the new diagnostic technique because their faculty includes nationally recognized experts in the retina and neuro-ophthalmology sub-specialties.
If successful, the technology will ultimately enable diagnosis without invasive or subjective measures and will likely also enable an assessment of the severity and long-term impairment resulting from traumatic brain injury.
“Our technology will address this urgent clinical need,” Koulen said.
Keerthi Gondi, a fifth-year medical student, and Kathryn Kyler, a bioinformatics student, were selected as the School of Medicine’s winners of the 2019 Health Sciences Student Research Summit. This year’s research event on April 17 at the UMKC Student Union drew a record 66 student posters from the medical school.
A panel of faculty judges selected the top three poster presentations among BA/MD students and chose the top two presentations from School of Medicine graduate students.
Gondi presented the winning poster, Symptomatic Versus Asymptomatic Idiopathic Intracranial Hypertension in Children. The second-place award for BA/MD students went to Nikhil Havaldar, fourth-year student, with a poster presentation on Epidemiology of Human Rhinovirus in School-Aged Children and Adolescents with Medically Attended Acute Respiratory Infection. Yicheng Bao, fourth-year student, was the third-place winner with a poster on Visual Field Loss in Patients with Diabetes in the Absence of Clinically-Detectable Vascular Retinopathy.
In the graduate student category, Kyler presented the winning poster, The Association of Weight with Drug Dosing Variation in Children Hospitalized with Asthma. Second place went to Poghni Peri-Okonny, a graduate student in cardiovascular outcomes research, with the poster presentation, Blood Pressure Variability and Cardiovascular Outcomes in Heart Failure with Preserved Ejection Fraction.
This year’s faculty judges included Sarah Nyp, MD; Jessica Markham, MD; Maria Cole, PhD; Jennifer Qayum, MD; Amanda Montalbano, MD; Sean Riordan, PhD; Janelle Noel-Macdonnell; PhD; Jennifer Dilts, MD; Nilofer Qureshi, PhD; Alain Cuna, MD; Peter Koulen, PhD; Bridgette Jones, MD; Jared Bruce, PhD; Dan Heruth, PhD; Rosa Huang, PhD; Kamani Lankachandra, MD; Xiangping Chu, PhD; Wail Hassan, PhD; Jannette Berkley-Patton, PhD; and Mike Wacker, PhD.
The research summit also included students from the health sciences schools of dentistry, pharmacy, nursing and health sciences, as well UMKC’s School of Biological Sciences. This year’s summit drew a record 100 research posters.
Kizhan Muhammad knows an opportunity when she sees one. The fifth-year medical student used a particularly rare case that appeared during her critical care rotation in the hospital’s intensive care unit to produce a research poster for the annual UMKC Health Sciences Student Research Summit.
Muhammad was one of 59 students from the School of Medicine who presented a record 66 posters at the research summit on April 17 at the UMKC Student Union. Both medical students and students from the school’s graduate programs — bioinformatics, anesthesiologist assistant, physician assistant and health professions education — participated in the summit.
“I always have my eyes and ears open for an opportunity to do research,” Muhammad said. “We happened to have a case with a rare syndrome. My mentor had me read about previous cases. My role was to do a literature review, extrapolate the data and then write a manuscript on our own patient.”
The patient, a 73-year-old man, had come to the hospital with a rapid heartbeat. When mild electrical shock, or cardioversion, was applied to bring the heartbeat to a normal rhythm, the man experienced Takotsubo cardiomyopathy. Also known as broken-heart syndrome, the condition is a ballooning of the left ventricle that produces chest pain and shortness of breath. It’s typically a stress-related condition seen in older women.
“It’s a very benign disease that can be very scary,” Muhammad said. “It’s pretty rare, not something you’d typically see when you’re rounding.”
Muhammad produced a case report that compared her patient’s case with other recorded cases of the disease. The report was published in the Society of Critical Care Medicine journal and presented at the organization’s national convention.
She said her experience provided a good learning experience in the basics of conducting medical research as well as how to create and publish a manuscript and present the findings in a public forum such as the research summit.
“Research is a vital part of medicine,” Muhammad said. “It’s what gives us the potential to do better for our patients. I’m looking forward to doing more in our research program.”
The research summit also included students from the health sciences schools of dentistry, pharmacy, nursing and health sciences, as well UMKC’s School of Biological Sciences. This year’s summit drew a record 100 research posters.
A team of medical school faculty served as judges for the medical student posters and will select the top three poster presentations among medical students for awards and the top graduate student presentation.
Organizers of the annual UMKC Health Sciences Student Research Summit are encouraging students to submit their abstracts and posters to participate in this year’s event.
The 2019 summit will take place from 3-5 p.m. on April 17 at the UMKC Student Union, Room 401. Deadline for submissions is March 27.
The research summit fosters research collaborations across disciplines and school that will produce economic, health, education and quality-of-life benefits for the greater Kansas City community. It is an opportunity for students to present their research to School of Medicine faculty.
Students can also sign up for a time to practice their presentations by sending an email to the research office at email@example.com.
The School of Medicine sponsors individual awards for medical students and its graduate students.
This is the seventh year that the schools are participating in the program at one venue on the Volker Campus. Last year, 50 students from the School of Medicine’s M.D. and Allied Health programs presented 45 posters at the research summit.
Health Sciences Student Research Summit Important links
School of Medicine researcher Karl Kador, Ph.D., has received a $75,000 award from the Research to Prevent Blindness/Stavros Niarchos Foundation International Research Collaborators.
The grant is intended to support and promote international collaborations among researchers in the United States and abroad to gain new scientific knowledge and skills through activities within the department of ophthalmology. A researcher at the UMKC Vision Research Center, Kador has been working to develop a novel approach for treating patients suffering end-stage glaucoma.
Last year, Kador received a nearly $2-million National Institutes of Health grant to explore tissue engineering that could one day lead to a method of transplanting new retinal ganglion cells to replace old, dead cells.
The Research to Prevent Blindness award allows researchers to spend time working with one another to advance specific research goals. These international collaborations can have a positive impact on a world-wide population. They have the potential to speed the development of treatments for illnesses that lead to blindness.
The National Institutes of Health recently awarded School of Medicine researcher Mingui Fu, Ph.D., associate professor of biomedical sciences, a $465,000 grant to conduct a study of sepsis-induced systemic inflammation.
Fu said that when completed, his research could significantly advance scientists’ understanding of the regulatory mechanisms surrounding septic pathogenesis and identify a new therapeutic target to treat the devastating condition.
A potentially life-threatening illness, sepsis is a major health concern. It strikes nearly 700,000 people in the United States each year with a 30 percent mortality rate. A major contributor to mortality is sepsis-induced systemic inflammation followed by multi-organ injury.
Sepsis appears when infectious bacteria or other organisms enter the blood stream and cause an inflammatory immune response. There is currently no specific treatment available for sepsis.
Fu’s study will look at the essential role of a particular protein known as myeloid MCPIP1 in sepsis-induced systemic inflammation and death. It will also explore whether MCPIP1 may be a target for pharmacological therapy to improve the outcome of sepsis.
Charlie Inboriboon, M.D., associate professor of emergency medicine, will serves as a co-investigator on the study, which will also include the research efforts of School of Medicine students.
One mark of a good experiment is that its results can be replicated. By that standard, a required research project for third-year School of Medicine students appears to be a success.
The research exercise was introduced a year ago in the medical neuroscience course and drew positive comments from the students and the faculty members who judged their projects. The reactions were much the same for the assignment’s second go-round, the results of which were presented Dec. 4 in the school lobby.
“We wanted to give students an early research experience, to raise the bar of their baseline research knowledge,” said Jennifer Bickel, M.D. ’01, associate professor of pediatrics and director of the Comprehensive Headache Clinic at Children’s Mercy Hospital.
Whether or not conducting research becomes a part of their careers, Bickel said, it’s vital for all physicians to know how to use research.
“All research has some weakness, and without understanding of the process, you can’t properly interpret results,” she said.
In the exercise, teams of four students used data from the Cerner HealthFacts database, a nationwide compilation of data made available by Cerner Corp., one of the largest health care software companies in the world. The student teams, with the help of a faculty mentor and a supporting biostatistician, answered a unique question they identified related to a serious medical condition. The databases used this year covered such conditions as dystonia, migraines, catatonia, stroke and seizures.
After analyzing the data and drawing conclusions, each team made a poster displaying its question and hypothesis, telling how the team members went about testing their hypothesis, explaining their findings, and identifying questions for further study.
For many students it was their first medical research, and several of them said the assignment was helpful in many ways. Some said that before the exercise they were worried about how difficult it would be to do research, but now they looked forward to being able to do more.
“There was a first-time learning curve,” said one student, Michele Yang. “It was a good challenge to organize our information and narrow the focus of our project.”
One of her teammates, Courtney Dorris, said she was motivated to do more research and was looking into other opportunities with faculty.
“It was a good change of pace from the classroom to have real patient data and think about how to apply it,” she said.
Other students said they found value in learning more about how to use statistics; about the need for teamwork in research; about how to present data and frame conclusions; and how to think about research that could follow up on their projects.
The exercise was devised in 2017 by Bickel; Julie Banderas, Pharm.D., BCPS, professor of pharmacology in the Department of Internal Medicine and assistant dean for Graduate Studies and Allied Health; and Paula Monaghan-Nichols, Ph.D., professor and chair of the Department of Biomedical Sciences and associate dean for research.
The teams were judged for poster content, clarity, appearance and organization; their oral presentations; and demonstration of critical thinking. The top three teams and their mentors and research titles:
1st place – Group 22 – Michael Brancato, Madhavi Murali, Anna Davis, Varoon Kumar; Dr. Tyler Allison; “Relationship Between Payer Status and Length of Hospital Stay in Patients with Catatonia: Analysis of a Nationwide Sample.”
2nd place – Group 12 – Megan Schoelch, Eshwar Kishore, John Lin, Laraib Sani; Dr. Keith Coffman; “How Age Affects Length of Stay in Stereotactic Implantation.”
3rd place – Group 26 – Laura Mann, Christy Nwankwo, Dakota Owens, Ethan Williamson; Dr. Jennifer Goldman; “Herpes Simplex Virus 2 Distribution Among Urban and Rural Communities.”
The School of Medicine Student Research Program has awarded 12 Sarah Morrison Student Research Awards for the Fall 2018 cycle. Recipients included nine medical students and three graduate students.
Sarah Morrison awards of up to $2,500 are presented to School of Medicine students each year in April and October. The awards help students become involved in and learn about a wide variety of research activities based on their interests. The research may be in the basic sciences or in clinical medicine.
Students may develop their own hypothesis and work plan or work on an established research project with their mentor. Winners of the awards are expected to present the results of the research at a School of Medicine student research event such as the UMKC Health Sciences Student Research Summit) or a similar venue as recommended by Research Administration.
More than 100 students have received Sarah Morrison awards since 2013 with an estimated $155,000 of financial support provided from the program to conduct research projects at the School of Medicine.
The next application deadline for students interested in receiving a Sarah Morrison research award is March 1 for the April award. Applicants are reviewed by a committee of faculty judges and processed through the Office of Research Administration.
Fall 2018 Sarah Morrison Research Awards
(Recipient / Faculty Mentor / Project title)
Yicheng Bao, MS 4 / Betty Drees, M.D., Professor, Dean Emerita / Prevalence and Risk Factors of Depression Among Patients with Diabetic Retinopathy
Shannon Demehri, MS 6 / John Wang, M.D., Ph.D., Professor, Westport Anesthesia/Missouri Endowed Chair for Research / Regulation of Src Family Kinases in the Rat Brain by Adenosine
Abygail Dulle, MS 5/ Paula Monaghan-Nichols, Ph.D., Professor, Associate Dean for Research Administration / Prenatal Glucocorticoid Exposure for Preterm Birth: Investigating The Role Of Glucocorticoid Receptor Phosphorylation In The Development Of Neuropathology
Ankit Kadakia, MS 4 / Paula Monaghan-Nichols, Ph.D., Professor, Associate Dean for Research Administration / Role of Synthetic Glucocorticoid Exposure in Ocular Development and Pathology
Cynthia Liu, MS 4/ Gary Sutkin, M.D., Professor and Associate Dean of Women’s Health, Victor and Caroline Schutte Chair in Women’s Health / The Prevalence and Effects of Ambiguous Language on Communication Errors in the Operating Room
Andrew Peterson, MS 5 / Xiangping Chu, M.D., Ph.D., Associate Professor of Biomedical Sciences / Modulation of Heteromeric Acid-Sensing Ion 1 a/3 Channels by Zinc
Amber (Lelia) Sarvestani, MS 6 / Geetha Raghuveer, M.D., M.P.H., Professor of Pediatrics / Long Term Outcomes and Survival Following Repair of Truncus Arteriosus With and Without Interrupted Aortic Arch Utilizing Linkage of the Pediatric Cardiac Care Consortium with the National Death Index and Organ Procurement Transplantation Network Datasets
Som Singh, MS 2 / Li Zhang, M.D., Professor of Biomedical and Health Informatics / The Effect of GM26870 Gene Expression on Acetaminophen Hepatotoxicity
Kevin Varghese, MS 2 / Alain Cuna, M.D., Assistant Professor of Pediatrics / Effectiveness and safety of repeat use of postnatal steroids for bronchopulmonary dysplasia
Firas Al-Badarin, grad student / Tim Bateman, M.D., Professor of Internal Medicine and Radiology / Cardiovascular Outcomes of Patients with Normal Positron Emission Tomography and Single Photon Computed Tomography Myocardial Perfusion Imaging
Kathryn Kyler, grad student / Kim Smolderen, Ph.D., Assistant Professor of Biomedical and Health Informatics / Variation in medication dosing and guideline adherence by weight status for commonly prescribed medications during pediatric asthma hospitalizations
Ali O. Malik, grad student / Paul Chan, M.D., Professor of Internal Medicine / Association between hospital reimbursement models and rates of normal elective coronary angiograms