Tag Archives: Faculty

Beams of Light to Treat Diabetes: UMKC Invention Gets Federal Funding Boost

The University of Missouri-Kansas City School of Pharmacy has been awarded a $1.5 million grant from the National Institutes of Health (NIH) to continue work on an important advancement to help treat the tens of millions of people who have diabetes.

The lifetime burden of constantly checking blood sugar and injecting insulin is significant. UMKC research has developed a way of delivering insulin to diabetics that eliminates pumps and most injections.

“We’re aiming to improve the lives of diabetics all over the world,” said UMKC pharmacy professor Simon Friedman, the principal investigator on the grant.


Normally, diabetics must inject themselves with insulin numerous times per day to enable the body to absorb blood sugar. The amount of insulin needed and timing vary with what an individual eats and their activity level. With blood glucose continuously varying, the insulin requirement parallels the amount of glucose in the blood.

The only clinically-used method to permit continuously variable delivery of therapeutic proteins like insulin is a pump. But they do so at a high cost: a physical connection to the outside of the patient, where the drug reservoir resides, and the inside of the patient, where drug absorption will ultimately take place. This connection in insulin pumps is a cannula — or needle — which can be dislodged, crimped, snagged, infected and most importantly, rapidly gets biofouled from moisture after implantation. This leads to variable and unpredictable delivery.

For several years, Friedman and his lab associates have been developing a method in which a single injection of a material called a PAD (photo-activated depot) can take the place of multiple normal insulin injections and allow for minute-by-minute automatic updating of insulin release. The material is injected into the skin like insulin, but lies dormant until a beam of light stimulates release of insulin, in response to blood sugar information.

The new grant will help make the technology more reliable for someone to use and easier to manage.

“With the improvements, we anticipate creating a new and revolutionary approach to continuously variable protein delivery, one that minimizes invasiveness and maximizes the close matching of therapeutic with patient requirements,” Friedman said.

Karen Kover, associate professor of pediatrics at the UMKC School of Medicine and Children’s Mercy, has been an integral member of the research team for years, and Friedman is grateful for her collaboration.

Reviewers of the grant application praised the work, and Friedman, who has won previous NIH funding, said this was his highest rated grant award.

“We are grateful for the enthusiastic response from the NIH study section, given the very competitive nature of funding at this time during the pandemic,” said UMKC Vice Chancellor for Research Chris Liu.

The project is supported by the National Institute of Diabetes and Digestive and Kidney Diseases at the NIH.

In people with type 1 diabetes, the pancreas no longer makes insulin. Patients need insulin to process sugar from meals.

People with type 2 diabetes make insulin, but their bodies don’t respond well to it. At first the pancreas produces extra insulin to make up for it. But over time it isn’t able to keep up and can’t make enough insulin to keep blood sugar at normal levels.

About 34.2 million children and adults in the U.S. — 10.5% of the population — have diabetes, according to the Centers for Disease Control and Prevention. More than 25 percent use insulin shots. About 86 million people ages 20 and older in the U.S. have prediabetes.

Complications from diabetes include heart disease and stroke, high blood pressure, blindness, kidney disease, nervous system damage and amputation.

People with diabetes risk more serious complications from COVID-19 than others who do not have the disease.

“Through research at UMKC, we strive to improve the health of not just our community but our entire population,” said Chancellor Mauli Agrawal. “We are proud of Dr. Friedman and his team’s innovation, which could significantly benefit people around the world.”

On a mission to bridge the health care gap

When Chancellor C. Mauli Agrawal needed someone to head the new UMKC Health Equity Institute, he didn’t have to look far. The School of Medicine’s Jannette Berkley-Patton is a leader in community health research — just the right person to direct the institute, which is charged with combining the university’s research strengths with community groups’ grass-roots involvement to identify, quantify and reduce health care gaps.

Berkley-Patton, Ph.D., a professor in the school’s Department of Biomedical and Health Informatics, might be best known for her Taking It to the Pews project, an outreach effort through local churches that gets people tested for HIV. She also is director of the UMKC Community Health Research Group, putting her in an ideal position to bring together the university’s research programs and Kansas City social services groups and agencies.

In the year since Agrawal announced the institute, Berkley-Patton has made sure it got off to a running start. The institute has helped new projects large and small, with the goal of lasting improvements in health across social and economic classes. Anything that might improve health — from providing better transportation and more-affordable care to encouraging better eating and exercise — could be involved.

“We spend billions on health care but are still one of the unhealthiest countries in the world,” said Berkley-Patton, who has degrees in engineering, human development and family life, and child and developmental psychology. “Large federal grants can help create effective programs, but we need sustainable improvements that continue when the grants end.”

Berkley-Patton also is determined to keep the institute’s momentum moving forward, despite the COVID19 disruptions to health care and the wider economy.

“In fact,” she said, “the Health Equity Institute is even more important than ever given that these underserved folks who historically have had more challenges in accessing health care services are likely to be hurt the most by the disruptions.

Get on the bus

One big project for the institute will be tracking how free bus service affects people’s health. This year, Kansas City, Missouri, plans to become the first large city with free public transit — dropping bus fares to zero to match the city’s streetcars, which already are fare-free.

The institute, recognizing a golden opportunity to measure the benefits of free public transit, has drawn up a multi-step research plan and submitted ambitious applications for grants from the National Institutes of Health and the Centers for Disease Control.

The CDC grant calls for research into “a natural experiment,” Berkley-Patton said, “and if ever there was a natural experiment, offering free transit is it.”

She continued, “We know from other research that people who use public transit tend to get 5 to 15 minutes more physical activity than non-riders, just getting to and from public transit. So if free bus service increases ridership, we hope to also see improvements in the health of people in low-income areas.”

The institute will start by gathering baseline data, both from comparable cities’ transit systems and from 500 current riders. The plan for identifying those people and getting data from them has been approved by UMKC’s Institutional Review Board, which ensures that research subjects are treated ethically. That data gathering is on hold over COVID-19 concerns, but the institute is ready to go when the situation improves.

The CDC grant the institute seeks calls for data on 10,000 people, which defies individual recruitment. “So, we’re proposing to collaborate with the Truman Medical Centers,” Berkley-Patton said. “We have identified 11 low-income ZIP codes, and TMC has data on thousands of people that can serve as a measure of the health of those areas.”

Of those patients, the institute hopes to have 4,000 take a brief survey, to gauge some basics about them such as income and incidence of health problems including diabetes and obesity.

The institute also plans to recruit 200 occasional bus riders to track, to see whether free service turns them into regular riders, and whether that improves their health.

Berkley-Patton says the elimination of fares should be a good incentive, saving a regular rider an estimated $1,500 in transit costs. And the research should identify other possible benefits, such as having access to more and better jobs.

“We’ve had lots of collaboration on this already to design research and make our grant proposals,” Berkley-Patton said, ticking off allies from Children’s Mercy, the Kansas City Area Transportation Authority and Public Works Department, UMKC Departments of Economics and Psychology, and the Schools of Dentistry, Medicine, and Nursing and Health Studies.

Now the institute must wait — on whether it gets CDC and NIH money to go full bore on its plans, and on when people can resume more normal living and head to jobs, doctor’s appointments and other activities.

‘They miss recess’

Another project is Youth Engagement in Sports, or YES, led by Joey Lightner and Amanda Grimes, UMKC assistant professors in the School of Nursing and Health Studies. When their proposal received an $800,000 grant from the U.S. Department of Health and Human Services, Grimes described the need to increase activity in middle school students.

“The evidence is very clear that American youth suffer from high rates of obesity, inactivity and poor nutrition,” said Grimes, who has a master’s degree in health science and a doctorate in community health.

Joseph Lightner and Amanda Grimes of the School of Nursing and Health Studies
Joseph Lightner and Amanda Grimes of the School of Nursing and Health Sciences involve students in their community health research.

“Adolescence seems to be a critical time in a child’s life where behaviors are learned or reinforced. Girls are particularly prone to low rates of physical activity during adolescence.”

The YES program will help students at two Kansas City middle schools, Central and Northeast, said Lightner, who has a master’s in public health with an emphasis in physical activity, and a Ph.D. in kinesiology.

According to Lightner, sixth- through eighth-graders are in a tough place between elementary and high school. “In talking with them, we found out they miss recess. They don’t get to play anymore. And they’re suddenly supposed to be adults, often without all the information they need on health and nutrition.”

One goal of the institute is to come up with innovative programs, and YES is certainly that.

“So after school, we’re going to give them a big, healthy snack and then there’s a physical activity intervention — they get to play,” Lightner said. “We’re going to offer competitive and non-competitive games, because we’ve found that some students gravitate to one kind of sport or another.”

By reaching out to the students and their schools, the program also embodies the institute’s emphasis on community engagement. And it draws heavily on another institute strength — collaboration.

TMC’s Mobile Market, which brings healthy foods to underserved areas, will give students a weekly bag of produce along with recipes. Children’s Mercy consulted on the program, providing its expertise with young people’s health. The Kansas City Department of Parks and Recreation will help with the sports activities.

And Lightner, as director of the UMKC Public Health Program and a new bachelor’s degree under it, has recruited undergraduate students to help gather data — and get first-hand experience in devising and tracking the sorts of programs that could become integral in their careers.

The program’s aim is to help at least 300 students at the schools in summer sessions, and then again in the fall. Of course, the level of disruption and other unknowns caused by COVID-19 make it hard to plan. But when school is back in full swing, Lightner wants YES to be making a difference.

“We know this is a pivotal time for students, especially girls,” Lightner said. “Peer groups are really important; there’s a mentality of, ‘If my friends are doing it, I’ll do it.’ So if we get them engaged in physical activity with their friends at this age, they’re likely to continue. And so many benefits, from physical and mental health to staying in school and achieving academically, have been demonstrated.”

Seeding other efforts

Another goal of the institute is to communicate across the university and among hospitals, government health agencies and community groups. A database is being compiled for training and other resources, along with opportunities to collaborate.

The institute’s new website will be a clearinghouse for everything from health indicators to grant opportunities and processes. That could help community groups connect, for example, with the Health Forward Foundation, a Kansas City fund that promotes healthy communities.

The institute also will be awarding mini-grants, with the aim of giving several community groups a few hundred dollars each for health-related training, software, added staff help and other basics.

Overcoming health disparities is a huge task, made more daunting by the COVID-19 disruptions. But BerkleyPatton and other Health Equity Institute partners have had success in the past and will keep looking for new ways to reshape access to health care.

“It will be a while before we know how much damage the pandemic has done,” she said. “But we do know that research programs that involve people in improving their own health can make a real difference, and it’s going to take all the innovative, collaborative efforts we can build to help those most affected.

14 COVID-19 Myths and Misconceptions

Mary Anne Jackson, M.D., dean of the University of Missouri-Kansas City School of Medicine, is an infectious disease expert. Also an alumna from the UMKC School of Medicine’s innovative six-year B.A./M.D. program, she served as one of six physicians statewide advising Missouri Governor Mike Parson about COVID-19, and was recently named senior advisor of public health in a five-member volunteer group on how Jackson County should spend its $122 million in CARES Act funding.

On numerous media appearances, Jackson has answered questions about evidence-based practices in dealing with the coronavirus pandemic. Here are just a few examples she’s dispelled of legend and lore about COVID-19:

1. A chiropractor has been publicizing an IV vitamin C product as a possible treatment for COVID-19. Anything to that?

Jackson: While there is biologic plausibility based on the hypothesis that when an individual suffers a severe infection, vitamin C which is necessary for cellular and tissue function, is depleted, there is no scientific evidence to support the use of vitamin C in the management of hospitalized COVID-19 patients. There is no data to support its use as prophylaxis that would be given in a chiropractor’s office.

One study registered at clinicaltrials.gov, will investigate the use of IV vitamin C in SARS-CoV-2 pneumonia patients in China using a randomized control trial protocol. The randomized control trial using a standard control group receiving placebo vs. the treatment group excludes bias and allows the outcome variable to be clear. This is especially important for COVID-19 where we know many cases spontaneously improve. There have been two recently published studies that are “open label” (no control group) to study the use of vitamin C in non-SARS-CoV-2 infections where individuals suffered from shock and acute respiratory distress syndrome. Neither showed clear evidence of benefit.

What is interesting is that anti-vaxxers appear to be circulating information on social media to drive the unproven messaging around vitamin C. For treatment of disease, trust a well-trained healthcare professional who practices evidence-based medicine and has extensive clinical experience.

2. Does heat kill the coronavirus? For example, the sun? A hot bath? Drinking hot water?

Jackson: There is no evidence of a benefit to flushing the virus from your system by drinking hot water or taking a hot bath. Drinking water will keep one hydrated and that is recommended for all.

The concept that heat can affect the virus is one worth discussing. The virus that causes COVID-19 is an enveloped virus, and enveloped viruses do generally demonstrate sensitivity to temperature and therefore may be more likely to appear or disappear during certain seasons related to temperature.

Research on other enveloped viruses suggests that this oily outer coat makes the viruses more susceptible to heat than those that do not have one. In colder conditions, the oily coat hardens into a rubber-like state, much like fat from cooked meat will harden as it cools, to protect the virus for longer when it is outside the body.

Many viruses wax and wane in seasons. Influenza typically arrives with the colder winter months. So does norovirus and RSV. Measles cases drop during the summer in temperate climates, and increase when schools are in session.

But we have no information about how the virus that causes COVID-19 will change with the seasons.

For one thing, pandemic viruses often don’t follow the same seasonal patterns seen in more normal outbreaks. Spanish flu, for example, peaked in the summer, while the typical seasonal flu peaks occur during the winter.

Even if COVID-19 does show some seasonal variability, it likely will persist to some degree and not totally disappear in the summer. A dip in cases will bring benefits, however. If it decreases in the summer, it is likely to re-emerge again in the fall. But there will be fewer susceptible individuals at that point, too, so potentially fewer cases-depending on how much of the population remains susceptible after the first wave.

3. If there has been a day of rain followed by sunshine, is playground equipment safe from COVID-19?

4. Jackson: As the weather warms, people will want to be outdoors and I’ve seen more people in our community outdoor walking and running in neighborhoods and in areas of parks and trails. It’s important to be outside to keep healthy, physically and mentally. And I especially like that I’ve seen families outside with their kids, who need to be active especially since they have no school and can’t be out with friends.

CDC and the World Health Organization (WHO) have been emphasizing that to control the COVID-19 epidemic, we must “flatten the curve” — that is, reduce the amount of transmission of the virus. We know that one proven way to accomplish this is by physical distancing — keeping six feet or more from other individuals and taking precautions to wash hands, refrain from being in enclosed spaces with other people, disinfect surfaces and other precautions to prevent the spread of the virus.

But do not take the kids to public playgrounds–you’ll find that all are cordoned off so that equipment can’t be accessed. Not only would open play areas encourage the kind of close contact we are trying to limit, but also, contaminated surfaces have been found to have detectable virus–including plastic and stainless steel. The duration that virus could exist on wood is not clearly known. There is no good evidence that following rain and with a day of sunshine, the playground is safe. There is no present guidance from CDC on how best to manage these spaces, including recommended cleaning and disinfection for outdoor equipment to prevent transmission of the coronavirus.

Bottom line: Avoid the playground (and play dates) for kids while you are social distancing unless it is the playground in your own backyard for your family.

4. Should you consider deliberately exposing yourself to inoculate yourself?

Jackson: In the past, some parents participated in “chickenpox parties” to intentionally expose their unvaccinated children to a child with chickenpox in hopes that they would get the disease. CDC strongly recommends against hosting or participating in these events because serious complications and even death can follow infection and one cannot predict how severe the disease will be.

Now the same bad idea has emerged related to COVID-19. On March 24, it was announced that an individual in Kentucky tested positive for the novel coronavirus after they attended a “coronavirus party” for people in their 20s.

Young people are less at risk of developing serious complications of COVID-19, the disease caused by the novel coronavirus, but they may still require hospitalization for serious symptoms. And even someone who only contracts a mild case of the disease can spread it to vulnerable people.

We need to wait for the vaccine–and until then continue social distancing.

5. Can livestock pass COVID-19 on through our food supply?

Jackson: There are some food products that can be contaminated and pose a risk for transmission to humans–like E coli, norovirus and hepatitis A. That is why there is emphasis on food preparation safety in general.

The bacteria and viruses that are transmitted by food products are those that cause gastrointestinal infection. SARS-CoV-2 is a respiratory virus and there is no known foodborne risk for transmission.

There is no evidence that livestock or any other food product in the U.S. is a vector for transmission of the virus, and there is no evidence of human or animal food or food packaging to be associated with disease transmission.

There is no risk of food product recalls, and the U.S. food supply is safe.

6. Will drinking lots of water wash the virus down to your stomach where it will be killed by stomach acid? What about drinking bleach? Can you ward off the virus by eating food with higher PH level?

Jackson: Washing the virus down the esophagus will not reduce the risk of coronavirus and the virus is resistant to the diluted acid in the stomach

Gargling with water or with an antiseptic solution, compared to doing neither, did reduce reports of respiratory symptoms in a study from Japan. However, the findings don’t necessarily apply to COVID-19 – and it’s dangerous to assume that they do.

The main risk is from breathing in tiny droplets containing thousands of viral particles after an infected person coughs or sneezes within 6 feet from you.

The overwhelming evidence suggests that the best approach remains avoiding unnecessary social contact and washing your hands. So, put down the water and pick up the soap instead.

Drinking bleach is not a cure and is dangerous–it can result in vomiting, diarrhea and liver failure. Some bleach-based cleaners, however, are helpful for keeping surfaces virus-free.

7. Pets cannot spread the coronavirus, can they?

Jackson: This virus is thought to have jumped from animals to humans, but there is no evidence that it is spreading among pets or from cats and dogs to their owners. Cats have been infected, both at the zoo and in homes-but there is no evidence that cat to human transmission is a significant concern. There was one instance in Hong Kong where a dog tested positive, but the dog was well, and it was thought contaminated by secretions from the infected pet owner.

The CDC suggests letting family members without symptoms take on pet care and recommends that people with symptoms should avoid close contact such as “petting, snuggling, being kissed or licked, and sharing food.”

When you care for your pets, wash your hands before and after handling and feeding.

8. Does ibuprofen make COVID-19 symptoms worse?

Jackson: I first heard of the ibuprofen alert after a report from the French health minister, Olivier Veran, identified that it could be a factor in worsening the infection based on anecdotal reports from physicians treating patients in that country. Then there was a letter that was published in the British medical journal The Lancet Respiratory Medicine where it was hypothesized that ibuprofen could make it easier for the new coronavirus, SARS-CoV-2, to enter cells. The theory is that ibuprofen could increase the levels of ACE2, which is a protein that the coronavirus uses to enter cells and might therefore increase the risk of serious infection. However, there is no evidence that ibuprofen raises ACE2 levels.

The National Institute of Allergy and Infectious Diseases says more research is needed, but right now, there is “no evidence that ibuprofen increases the risk of serious complications or of acquiring the virus that causes COVID-19.”

There are reasons in general to avoid ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs) because they are known to have gastrointestinal, kidney and cardiovascular side effects, which may be especially dangerous in very ill or elderly patients or in those with preexisting conditions.

9. Does putting petroleum jelly in your nose prevent the virus from getting into pores? Will rinsing your nose with saline prevent the virus?

Jackson: In the face of the COVID-19 coronavirus outbreak, it’s natural that we’re looking for ways to stay healthy. Washing your hands and practicing social distancing are two proven pieces of advice that are more important than ever.

A dry nose can make one more vulnerable to viruses and certainly is an irritant for those who suffer allergies. A water-based product can help. Using saline or saltwater nose rinses will not prevent the virus, but in certain people with asthma for instance, who also have nasal and sinus symptoms, a saltwater nasal wash, or nasal irrigation, can help reduce nasal symptoms that can aggravate asthma.

According to National Jewish Health, a nasal wash:

  • Cleans mucus from the nose, so medication can be more effective
  • Cleans allergens and irritants from the nose, reducing their impact
  • Cleans bacteria and viruses from the nose, decreasing infections
  • Decreases swelling in the nose and increases airflow

But do not use tap water for the nasal wash. Do not use well water. Only use distilled or sterilized water for nasal rinses. And follow the CDC water preparation guidelines for proper preparation.

Avoid petroleum jelly in the nose–it can be inhaled and cause lung injury called lipid pneumonia. Don’t use antibiotic ointment either–that type of ointment does not fight viruses.

10. Can kids die from COVID-19?

Jackson: While children have been generally spared from COVID-19, pediatric cases requiring intensive care have occurred within our state and there are rare child deaths. The burden of disease is far less for children than influenza though.

A new syndrome, recently described, called Multisystem Inflammatory Syndrome in Children (MIS-C). MIS-C is an inflammatory response with organ dysfunction, thought to be triggered by prior exposure to SARS CoV-2. On May 14, 2020, the Centers for Disease Control issued a health advisory, to alert providers to this condition, which has now been identified in at least 19 different states and Washington DC. Parents should report to their pediatric provider if their child develops fevers especially associated with a rash. While the prognosis is good, children have suffered shock and required intensive care–the syndrome is extremely rare and we are still learning more about it.

11. If you can hold your breath for 10 seconds, does that mean you don’t have the virus?

Jackson: It is true that those with serious lung disease of many types, such as emphysema, may not be able to hold their breath for 10 seconds.

Many respiratory viral infections make it difficult to hold your breath because the airway is irritated. The inability to do so does not identify those who have COVID-19.

This false claim was first attributed to someone at Stanford University Medicine–and the spokesperson at Stanford denies it came from them, and on March 12, they posted on social media that this was misinformation.

The only way to know if one is infected by SARS-CoV-2 is by testing secretions obtained by a swab placed in the nose/throat and having the specimen tested in a laboratory.

12. Is cupping a treatment for COVID-19?

Jackson: Cupping is a process whereby the skin is bruised using a suction cup over the skin, and is used in traditional Chinese medicine for a variety of ailments. It is being studied in a Chinese population convalescing from COVID-19, but there is no evidence that it is beneficial at this point.

13. Is proning a treatment for COVID-19?


Jackson:
There is no specific treatment for COVID-19 and we currently rely on supportive intensive care including oxygen, IV fluids andmechanical ventilation. Of specific therapies targeting SARS-CoV-2, none have been adequately studied, but there are some encouraging reports. Prone positioning of those with respiratory failure, meaning having the patient on a ventilator lay face down, was shown in a small study to result in better lung function with better oxygen levels and this treatment is being incorporated into care now.

Other therapies which are being examined include the use of hydroxychloroquine, an antimalarial drug which was shown to inhibit virus in a small study when paired with an antibiotic called azithromycin. We now know that there is no data to support its efficacy and individuals accessing chloroquine products and suffering life-threatening toxicity.

There are a couple broad-spectrum antiviral agents (one used in Ebola called remdesivir) that are being studied. Remdesivir is an intravenous drug used for those with serious COVID who require hospitalization and treated patients have shown a shortened course of disease.

Drugs that modify an inflammatory over-response seen in COVID-19 appear promising. These agents inhibit IL-6, an immune modifier, and are also being studied in severe cases of COVID-19.

14. Even though COVID is here to stay, at least for the next six months to a year, is it okay for me to go out into the community now? Can I go to the doctor for my routine care?

Jackson: We have successfully flattened the curve here in Kansas City, but COVID is continuing to circulate. The chance that you’ll be exposed to SARS CoV-2, is related to three factors:

  • what activity you are involved in
  • your proximity to others
  • the duration of exposure

Risk is greatest for indoor exposure where individuals are in close quarters with a large group of people. After a choir practice that took place in Washington on March 17, 2020, among 122 choir members, 87% of the group became infected from one infected member–it appears the act of singing amplified the spread of the virus. In contrast, if one is outdoors for a limited time, and can socially distance from others, the risk is very low.

In terms of going back to your doctor for routine appointments, every provider in our community is prepared to care for patients even while the virus is still circulating. It is especially important that infants and children visit their pediatrician and get their immunizations on time. Many pediatricians are asking parents to call on arrival to the office, and the provider will text when the office is ready to place the patient directly into an examination room. We don’t want a measles outbreak in our community while we’re still tackling COVID!

Three UMKC faculty receive Fulbright Scholar Awards

Three University of Missouri-Kansas City faculty members, Charlie Inboriboon, M.D.; Brian Frehner, Ph.D.; and Clara Irazábal-Zurita, Ph.D.; received prestigious Fulbright U.S. Scholar Awards.

The Fulbright program is the U.S. government’s flagship international educational program. Award recipients teach, conduct research and provide expertise abroad in a program designed to build lasting connections between the people of the United States and other countries.

Charlie Inboriboon, M.D.

Inboriboon, director of International Emergency Medicine Programs at the School of Medicine and associate professor of emergency medicine, received an award to Thailand where he spend six months teaching at Chulalongkorn University in Bangkok. His project was designed to enhance emergency medicine education by incorporating active learning into the didactic curriculum. He will also developed online learning resources to enhance individual learner feedback.

Inboriboon has led several programs in Thailand during the country’s transition to competency-based medical education.

Frehner, associate professor in the UMKC History Department, received an award to Germany where he plans to teach and conduct research for three months. Much of his time will be spent working with colleagues at the University of Hamburg to expand upon an online course that examines themes in transatlantic history and German migration from Hamburg to St. Louis, Missouri.

He will also travel to Munich to review documents in the Deutsches Museum relating to the acquisition of oil exploration technology related to geophysicial oil exploration. The research is for a book he is working on that details the science and technology of exploration geophysics that seres as the basis for oil discovery throughout the world.

Clara Irazabal-ZuritaIrazabal-Zurita, director of the Latinx and Latin American Studies program and professor of planning in the Department of Architecture, Urban Planning + Design, received an award to lecture and conduct research at the Universidad de Costa Rica. She will focus on selective (dis)affiliations and (sub)urban implications of middle-class Venezuelan migration to Costa Rica.

The project is an extension of her study of migration and urban planning in U.S. Latinx/immigrant communities and in Latin America, including Costa Rica and Venezuela. Irazabal-Zurita plans to conduct her work in Costa Rica during the summers of 2021 and 2022.

Fulbright award recipients are selected on the basis of academic and professional achievement, record of service and demonstrated leadership in their respective fields. Funded through the U.S. Department of State, the program is also supported by and operates in more than 160 countries throughout the world.

Mayor appoints faculty, alumni to Kansas City Health Commission

From left: Erica Carney, Joseph Lighter, Austin Strassle

Three members of the UMKC community with expertise in emergency medicine and public health have been appointed by Mayor Quinton Lucas to the Kansas City Health Commission.

Erica Carney, M.D., was appointed co-chair of the commission, which provides oversight for the city’s Community Health Improvement Plan and fosters collaborative community efforts in the wider metropolitan area. Lucas said Carney’s work had been instrumental in the city’s response to COVID-19 and collaboration with area health providers.

Carney is a graduate of the UMKC School of Medicine’s innovative six-year B.A./M.D. program, an assistant professor in emergency medicine, an emergency care physician at Truman Medical Centers and the medical director of emergency medical services for the City of Kansas City.

“I was fortunate enough to complete my emergency medicine residency at UMKC, where I served as one of the emergency medicine chiefs,” Carney said. “I found my love for emergency medical services after responding to the Joplin tornado.”

Carney said her areas of interest included improving survival rates for out-of-hospital heart attack patients from lower socioeconomic ZIP codes, improving health care for people who need and use the system the most, and improving public safety, including response to disasters and special situations such as COVID-19.

“The best defense to the unknown is a united front in the name of public protection, and I truly feel that our region is leading the way,” Carney said.

The mayor also appointed to the commission Joseph Lightner, Ph.D., M.P.H., assistant professor and director of the Bachelor of Science in Public Health Program at the UMKC School of Nursing and Health Studies, and Austin Strassle, a housing stabilization specialist at Truman who earned his bachelor’s degree in urban studies/affairs from UMKC in 2016.

Lightner has helped launch the School of Nursing’s undergraduate public health degree and worked to involve undergraduates in innovative research bringing fitness and nutrition programs to area schools. In his research and outreach, Lightner has collaborated with community groups and institutions including Kansas City schools and the city’s Parks and Recreation Department and Health Department.

Strassle, who also has a master’s in city/urban, community and regional planning from the University of Kansas, has worked for three and a half years at Truman as a mental health caseworker. He also was the leader of a successful community campaign to get the Kansas City Council to ban the use of conversion therapy on minors by licensed medical practitioners.

The mayor, in making his appointments, said it was important to have “experts in outreach to at-risk communities” on the commission, along with “medical professionals with specialties in trauma, infectious disease treatment, pediatric and prenatal care; supporters for survivors of domestic violence; advocates for residents of nursing homes and other long-term care facilities; educators; long-time community health reformers; and more.”

 

Dr. Tyler Smith appointed Associate Dean of Diversity

The School of Medicine has announced Tyler Smith, M.D., M.P.H.,  assistant professor of pediatrics, as the new Associate Dean of Diversity, Equity and Inclusion beginning April 6, 2020. She is the first physician to hold this role.

Smith takes over for Nate Thomas, Ph.D., who served in that role from December 2017 to March 2020. She joined the Children’s Mercy Department of Pediatrics and UMKC faculty in February, 2018. In addition to her role as associate dean, she will continue to serve at Children’s Mercy as the General Academic Pediatrics Fellowship program director.

A graduate of the University of South Carolina School of Medicine, Smith completed her pediatric residency at the University of Maryland Medical System in 2008.

Smith completed her M.P.H. and fellowship in general academic pediatrics at Johns Hopkins School of Public Health and School of Medicine. She was recognized as mentor of the year by Hampton University, where she completed her undergraduate work.

A member of the National Medical Association Editorial Board, Smith is nationally known for her work in medical education, mentorship, diversity, health care disparities and physician wellness.

In August 2019, she was appointed by the Governor of Kansas to the Kansas Children’s Cabinet and Trust Fund. The initiative assists children and families in Kansas by developing and implementing a service delivery system.

 

UMKC Researcher Awarded $3.3 Million Grant to Prevent Diabetes

The National Institutes of Health awarded a $3.3 million grant to Jannette Berkley-Patton, professor, at the University of Missouri-Kansas City School of Medicine, to help improve diabetes prevention outcomes with African Americans.

“This is an extension of what we’ve been doing in the School of Medicine with Project FIT, which stands for Faith Influencing Transformation” says Berkley-Patton, Ph.D., director of the UMKC Health Equity Institute and the Community Health Research Group. With Project FIT, nearly 900 people have participated in the program and more than 200 medical, physician assistant, nursing and health studies and psychology students have been trained as FIT health coaches to help deliver the program.

At UMKC, Berkley-Patton has won other significant grants that focus on improving the health of African Americans, and each centers on health inequities and community-engaged research with African American community-based organizations, including places of worship because of their cultural importance. This new five-year grant, which starts on April 1, will include similar strategies. To date, Berkley-Patton’s work has been supported by more than $10 million in federal grants over the past 14 years.

The grant will tailor the Centers for Disease Control and Prevention’s National Diabetes Prevention Program, an evidence-based lifestyle change intervention, with 360 African American pre-diabetic participants recruited from Truman Medical Centers. The program includes 22 group sessions that take place over one year and primarily focuses on eating healthier and exercising regularly.

Preventing diabetes can help stave off other associated chronic health issues including blindness, kidney failure and heart disease.

People who participate in the CDC program aim to lose 5 to 7 percent of their body weight and exercise 150 minutes per week, which have been shown to reduce the risk of diabetes by up to 60 percent. The program has also been found to outperform pre-diabetes drugs such as Metformin.

However, African Americans typically don’t fare as well, especially women and those with low incomes. Some of the issues include barriers such as cost of the program, transportation, childcare, access to healthy food and places to exercise. These barriers are often referred to as social determinants of health.

“With the grant, we’re trying to address every barrier related to social determinants,” Berkley-Patton said. “The most successful outcomes are correlated with attending the sessions – the more sessions attended, the better the outcomes.”

The grant will support linking Truman Medical Centers patients to FIT Diabetes Prevention Program classes in their home communities via church, community center or neighborhood association settings. The program will be culturally-tailored for African American adults. The program is at no cost to the participant – typically it costs $450 per year. In addition to Truman Medical Centers, program partners include several urban Kansas City churches, Calvary Outreach Network, YMCA, Chestnut Resource Center, KC Care Health Center, Children’s Mercy and the University of Kansas.

Although the grant begins this week during a pandemic that has Americans sheltering in place and working from home, the first year of the grant is a planning year.

“With this grant, we are looking forward to further refining our current Project FIT program to have trained UMKC students and community members working side-by-side as FIT coaches,” says Carole Bowe Thompson, project director, UMKC Community Health Research Group.

The program will be launched by this time next year.

“We are looking forward to getting started,” Berkley-Patton said. “We want to show participants that here’s a premiere program designed just for you.”

UMKC researcher helped lead studies published in New England Journal of Medicine

UMKC School of Medicine researcher John Spertus, M.D., M.P.H., is part of two large NIH-funded clinical studies published in the New England Journal of Medicine, Monday, March 30. The studies indicate eliminating unnecessary revascularization treatments for cardiac patients could save the United States hundreds of millions of dollars annually.

Spertus serves as professor of medicine and Daniel J. Lauer, M.D., Endowed Chair in Metabolism and Vascular Disease Research at the School of Medicine, and Clinical Director of Outcomes Research at Saint Luke’s Hospital.

The studies looked specifically at coronary artery disease patients who had high-risk blockages with least 10 percent or more of the heart muscle being at risk. One focused on patients with preserved kidney function and the other targeted patients with end-stage kidney failure. That latter group has largely been excluded from almost all cardiovascular trials, despite having a high prevalence of coronary artery disease and death, Spertus said.

Both studies, conducted in unison, examined the most important outcomes for patients, clinical events (e.g. heart attacks, death) and patients’ symptoms, function and quality of life. Participants were randomized to undergo invasive angiography and revascularization with aggressive medical therapy or aggressive medical therapy alone. The goals of the medical treatment were cholesterol reduction, blood pressure control, aspirin and medications to treat chest pain.

The studies in patients with preserved kidney function showed that invasive medical procedures provided no reduction in clinical events, but did improve patients’ symptoms and quality of life, if they had chest pain within a month of entering the trial. These health status benefits were evident within three months and sustained out to four years.

“Importantly, this benefit was only observed in patients who had angina, chest pain, and not in asymptomatic patients,” Spertus said. “There is no indication for these procedures in patients whose symptoms are well-controlled with medications alone. If we avoided revascularization in asymptomatic patients, we could potentially save about $500 million to $750 million a year in the United States alone.”

Among patients with very severe kidney disease, there was no significant difference in clinical events or in patients’ symptoms and quality of life.

“While disappointing, this is a very ill patient population for whom an aggressive, invasive treatment strategy does not seem to offer much benefit,” Spertus said.

The NEJM is publishing four papers from these studies on March 30, one for each trial focusing on the clinical events and another for each trial focusing on the quality of life outcomes. Spertus was involved in writing all four and is the lead author on the two quality of life papers. He and his team designed, analyzed and led the health status, quality of life components of both trials.

Spertus is the author of the Seattle Angina Questionnaire (SAQ) that used in the studies. It is widely recognized throughout the world as the gold standard for quality of life measurement in cardiac medicine.

“Our group has led its use and analyses in multiple studies and quality improvement efforts,” Spertus said. “In light of these findings, the SAQ may start becoming a routine part of clinical care in cardiology.”

Community and Family Medicine residency director receives Women of Distinction honor

Beth Rosemergey, M.D., is being honored as a Woman of Distinction.

School of Medicine faculty member Beth Rosemergey, D.O., associate professor and director of the Community and Family Medicine Residency program, was honored recently as one of the outstanding women of Eastern Jackson County, Missouri.

For the past five years, the Independence Examiner newspaper has sponsored the annual Women of Distinction Awards. Women from the fields business, government, education and non-profit are honored based on their accomplishments and community involvement in Eastern Jackson County.

Rosemergey is the third honoree nominated by Truman Medical Center-Lakewood. Last year, Laura Doan, M.D., a 1984 UMKC School of Medicine graduate and University Health women’s care provider, was a Women of Distinction honoree. Lynette Wheeler, TMC Lakewood chief operating officer, was honored as Outstanding Woman of the Year in 2018.

An awards ceremony was to have been taken place on March 13. The event and announcement of this year’s Outstanding Woman of the Year and Lifetime Achievement Award have been postponed until the end of April.

The mother of an autistic child, Rosemergey is passionate in her advocation for special needs children and their families. She has worked with local schools to develop programs that address the needs of children with Autism Spectrum Disorder and was instrumental in developing state guidelines for the care of autism patients.

Rosemergey also serves as vice chair of the Department of Community and Family Medicine and medical director of the Bess Truman Family Medicine Center.

A graduate of the University of Health Sciences College of Osteopathic Medicine in Kansas City, she completed her family practice residency at UMKC and Truman Medical Center Lakewood and joined the School of Medicine faculty in 1992.

School of Medicine’s 2020 humanities magazine available online

The 2020 issue the UMKC School of Medicine publication, Human Factor, is now available online. Human Factor celebrates the connection between art, humanities and the practice of medicine.

The publication showcases the creativity, imagination and talent of our students, alumni, residents, faculty and staff. All of the printed words and images featured in this publication make the important link between an appreciation of art and compassionate patient care — illustrating the significant role of medical humanities.

This year’s issue features poetry, short stories, photos, drawings and and other original artwork including the cover image created by fifth-year medical student Rachana Kombathula.

Watch for a call for submissions to the 2021 edition of the Human Factor early next next fall.