blogshttps://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/rss-feedblogsen{A86B131E-4F77-4203-96C1-2DAD1B3787D8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/iu-krannert-study-brings-optimism-to-pathology-resident-with-sickle-cellIU Krannert Cardiovascular Research Center study brings optimism to pathology resident with sickle cell<p>“At any moment, in a matter of seconds, I could have a sickle cell crisis,” writes Indiana University School of Medicine <a href="https://medicine.iu.edu/pathology/education/residency">clinical pathology resident</a> Halimat Olaniyan, MD, in her book, “<a href="https://www.amazon.com/Breaking-Cycle-Pain-Halimat-Olaniyan/dp/1716022428">Breaking the Cycle of Pain, Short Stories on Living with Sickle Cell</a>.” </p> <p>“As the crescent-shaped red blood cells coursing through my veins turn on me,” she continues, “they stick together and block the flow of blood in my body. It’s surprising the sheer amount of pain caused by the lack of oxygen to a joint.” </p> <p>Olaniyan, who was diagnosed with sickle cell disease at age 7, said living with her illness can be very painful and debilitating. </p> <p>“The pain comes in what people call sickle cell crises or vaso-occlusive events. You’re not getting blood flow to a certain part of your body,” said Olaniyan. “When you don’t have blood flowing properly, we call it a stroke. If it’s in your heart, we call it a heart attack. So, we can have that anywhere in our body.”</p> <p>According to the U.S. Centers for Disease Control and Prevention, sickle cell disease, a red blood cell disorder that can cause harm to multiple organs when red blood vessels are blocked or break down, affects nearly 100,000 Americans. For those with the illness, the recurring pain often goes unnoticed by others unless shared with them. </p> <p>“It can feel like a sharp jabbing or sometimes a jolt,” Olaniyan said. “People say it can feel like getting hit by a car, or for a football player getting tackled by 20 players.”</p> <p>For some, it can be life-threatening and lead to heart conditions. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/news/2024/ankit-desai-md.jpg?h=204&w=300&rev=e7f3ab519f0c420c95ae3c634afe69c0&hash=7BC859547AE11A5D46A859B9A5A0CFAC" alt="Ankit Desai, MD" class="float-left" style="height: 204px; width: 300px;" /><a href="https://medicine.iu.edu/faculty/41953/desai-ankit">Ankit A. Desai, MD</a>, a physician scientist with the <a href="https://medicine.iu.edu/research-centers/cardiovascular">Krannert Cardiovascular Research Center</a> at IU School of Medicine, seeks to improve outcomes for patients with sickle cell disease who now have heart damage and are at risk of complications, including death. Desai, an associate professor of medicine at IU School of Medicine and a cardiologist at IU Health, is leading a $3 million grant received from the U.S. Department of Defense to evaluate the potential use of the inhibitor R-propranolol (R-prop), which is currently used as part of a mixture in propranolol, a beta blocker. </p> <p>Propranolol is routinely used to treat heart problems, hemangioma, migraines and anxiety. Evaluating an existing therapeutic for other uses could help accelerate accessibility for patients more quickly, which is paramount for those with sickle cell disease, for whom the <a href="https://www.annemergmed.com/article/S0196-0644(20)30649-1/fulltext">median age of death is 43 years of age</a>. </p> <p>The only difference between propranolol and R-prop is that R-prop does not demonstrate as much beta blocker activity, alleviating blood pressure concerns and heart rate side effects. </p> <p>Desai, a specialist in pulmonary hypertension and sickle cell disease, is collaborating with Bum-Rak Choi, PhD, associate professor of medicine at Rhode Island Hospital and Brown University. He will work closely with Choi on data related to the development of fatal arrhythmias in sickle cell disease, studying damage to the muscle and function of the heart.</p> <h3>Addressing arrhythmia to prevent complications</h3> <p>The grant, “Repurposing Propranolol to Treat Sickle Cell Cardiomyopathy and Ventricular Arrhythmias: Role of Nonadrenergic Signaling,” will be used to study heart injury impact as well as rhythm disturbance impact in preclinical models of sickle cell disease. </p> <p>“I think the Department of Defense support is doing so much more than just funding basic science,” Desai said. “It’s funding a disease that is underrecognized, underrepresented and supporting a broader goal in closing health care gaps at the same time.”  </p> <p>Currently, little is known about the true prevalence of sickle cell cardiomyopathy. But, based on Desai’s prior work, a significant proportion of individuals living with sickle cell disease appear to have fibrosis or scarring in their hearts. More recent work from others in the field shows that fibrosis may be present in even young children with sickle cell disease. </p> <p>Between 1979 and 2017, there were more than 25,000 sickle cell disease-related deaths reported among Black patients in the United States. While mortality rates declined in children, they increased among adults with the disease because of acute cardiac, pulmonary and cerebrovascular complications. </p> <p>“Cardiomyopathy or heart injury can predispose patients to a fatal rhythm disturbance called ventricular tachycardia,” said Desai, who leads the Center’s <a href="https://medicine.iu.edu/research-centers/cardiovascular/research/cardiopulmonary">Cardiopulmonary Research Program</a>. </p> <p>“We believe that inflammation plays a key role in both creating this injured heart and exacerbating it. We are deeply interested in translating this potential therapeutic to patients, developing a clinical trial and trying to understand the potential impact of R-propranolol, given that propranolol appears otherwise to be well tolerated in patients.”</p> <p>Olaniyan is optimistic about Desai’s study. <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/pain-poem-halimat-olaniyan-cropped.jpg?h=281&w=330&rev=4bb911e4e2b74226a08db0a3ef428bb3&hash=1B9518177E4291692BF0B8B34AB40681" alt="Sickle Cell Pain Poem by Halimat Olaniyan, MD" class="float-right" style="height: 281px; width: 330px;" /></p> <p>“I was literally so thrilled and I reached out to him,” said Olaniyan, who wants to pursue blood banking and transfusion medicine as a career. “The potential use of this beta blocker is a very new approach, and it’s really exciting.” </p> <p>She said there has been a lack of research in identifying different options for this significant patient population that includes a disproportionate number of patients from minoritized populations. </p> <p>“In the past five years, a lot of effort has been placed into developing new medications or repurposing different medications for sickle cell, which is amazing, said Olaniyan. “Before 2017, we had maybe one drug — Hydroxyurea, which is a great drug, and it’s still a mainstay of treatment.”</p> <p>Olaniyan said Desai’s study is not only looking at whether the beta blocker could slow down cardiomyopathy and fibrosis, but also if it would have the potential to reverse and create healthier blood vessels to improve blood flow to the heart. </p> <p>“For sickle cell, that would mean preventing or slowing any heart problems, and potentially reducing ‘sickling.’ If you can improve overall blood flow in your entire body it could mean reducing a lot of secondary consequences,” she said.</p> <p><a href="https://ashpublications.org/blood/article/137/9/1208/474137/IL-18-mediates-sickle-cell-cardiomyopathy-and">Previous research</a> conducted by Desai, and published in the journal <em>Blood</em>, shows that Interleukin-18, a proinflammatory cytokine with essential regulatory function in the immune response, contributes to the development of inflammation in the heart and damage to the heart muscle. They also found that when you inhibit IL-18, it seems to improve fibrosis. That led them to experiment whether ventricular tachycardia could go away by inhibiting IL-18 using IL-18 binding protein and reintroducing it. </p> <h3>Could a generation be saved using the beta blocker, R-Propranolol? </h3> <p>“We recognized IL-18 as a potential therapeutic for the abnormal rhythm disturbance in the heart and the damage that we see,” Desai said.  </p> <p>IL-18 binding protein is not FDA-approved for human use. So, researchers sought alternative therapies. Through the use of R-prop, they uncovered new, molecular pathways that led to the aggravation of the IL-18 pathway. </p> <p>“We found that R-propranolol was able to reduce the effects of Interleukin 18 in these sickled hearts and was able to stop abnormal rhythms,” Desai said. “Our grant will enable us to study how the drug does that. If we can better understand how, then we may be able to quickly translate its use in patients.”  </p> <p>Researchers also plan to evaluate potential for toxicity before introducing R-prop in a clinical trial. </p> <p>Despite the recent FDA approval of Vertex and Bluebird’s gene editing therapies for sickle cell disease, people who have lived with sickle cell disease are still suffering from cardiac complications and are at risk of death and need interventions. In fact, some of those advanced therapies may be far from reach for many patients given the estimated costs. </p> <p>Krannert Cardiovascular Research Center Executive Director <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Rohan Dharmakumar, PhD</a>, said in the absence of an effective therapy to address cardiomyopathy and tachycardia in sickle cell disease, we risk losing a generation of people prematurely.  </p> <p>“While new therapies are being explored, cleverly repurposed drugs that have already had human exposure with strong safety profile, such as R-propranolol, stand to make major headway in solving a long-standing health issue affecting the heart and cardiovascular system in the United States and abroad,” Dharmakumar said. </p>Thu, 29 Feb 2024 00:00:00 Z{E19C2519-04CF-4C82-9E75-888184E85C40}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/kovacs-advocates-for-cardiac-emergency-preparednessKovacs advocates for cardiac emergency preparedness<h3>IU sports cardiologist leads cardiac screening for NFL Scouting Combine, urges everyone to learn hands-only CPR </h3> <p>A fascination with electricity is what led <a href="/faculty/4943/kovacs-richard">Richard Kovacs, MD</a>, to a career in cardiology. While most people recognize the brain runs on electrical signals, so does the human heart.</p> <p> That’s why quick treatment with cardiopulmonary resuscitation and an automated external defibrillator, or AED, is essential when a person experiences cardiac arrest. Defibrillators are designed to “shock” the heart back into normal rhythm. As a specialist in sports cardiology, Kovacs stresses the importance of having AEDs at all athletic fields and arenas. </p> <p> “Have an emergency action plan that includes an automatic defibrillator at the competition site and proper training for coaches and trainers to operate the equipment,” said Kovacs, a primary investigator at the <a href="/sitecore/content/iu/iu-som/home/research-centers/cardiovascular">Krannert Cardiovascular Research Center</a> and interim director for the Division of Cardiovascular Medicine at Indiana University School of Medicine who specializes in heart and vascular care for IU Health Physicians Cardiology. </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2024/aed-at-courside_adobe-stock.jpeg?h=233&w=350&rev=2482403ae3a04afbbc73af224ebcf93f&hash=D2D7FA531203D63E7D0B0E3B452B8647" style="height: 233px; width: 350px;" alt="An AED stationed at an outdoor basketball court" class="float-left" />“If it’s locked in the trainer’s office at the high school and the cross-country team is running two miles away, it does no good.” </p> <p> The phenomenon of sudden cardiac arrest came into the public consciousness after basketball player Keyontae Johnson collapsed while playing a collegiate game for Florida State in 2020, followed closely by Danish soccer star Christian Eriksen collapsing on the field during the UEFA Tournament. In 2023, NFL football player Damar Hamlin suffered a sudden cardiac arrest after a blow to the chest. Later that year, collegiate basketball player Bronny James collapsed on the court from a previously unidentified congenital heart defect. All survived due to rapid treatment by team physicians using CPR and an AED. </p> <p>Although these events are rare, it’s something Kovacs works with the NFL to help prevent through heart screenings for potential players. Every year for more than a decade, Kovacs has led cardiovascular evaluations for the <a rel="noopener noreferrer" href="https://www.nfl.com/network/events/nfl-combine" target="_blank">NFL Scouting Combine</a>, held annually in Indianapolis. A former collegiate football player for the University of Chicago, Kovacs enjoys interacting with rising athletes and NFL team physicians during the combine, running this year from Feb. 29 to March 3 at Lucas Oil Stadium. </p> <p> The event, which is open to the public, is considered a “four-day interview” where more than 300 NFL hopefuls show off their skills. Kovacs’ job is to make sure their hearts aren’t harboring any potential timebombs. The risk of sudden cardiac arrest in the NFL is about 1 in 10,000, he said. </p> <p> “We are looking for rare things,” Kovacs said. “Most of those athletes identified for further evaluation or treatment have gone on to participate in the draft and played in the league.” </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/news/2013/02202013richardkovacs-26r.jpg?h=281&w=425&rev=f545b1593ae8460cae5f26bc157a76b6&hash=6D05A4D5F0B91EB994BDEF71340E43A8" style="height: 281px; width: 425px;" alt="02202013RichardKovacs-26R" class="float-right" />Sports cardiologists use tools like electrocardiograms (EKGs) to detect cardiac arrhythmias and echocardiograms (cardiac ultrasound) to look for heart muscle and valve abnormalities. Sometimes advanced testing, such as cardiac MRI or a cardiopulmonary stress test is warranted. All tests are completed during the few days the athletes are in Indianapolis. </p> <p> The cardiology team is part of a larger group of IU Health physicians evaluating everything from joints to neurological systems. </p> <p>“It’s like the world’s busiest clinic for three days for giant people,” said Kovacs, who stands at 6 feet but often feels small compared to the athletes. </p> <p>It’s rare Kovacs needs to sideline a player — he’s not out to be a dream crusher. </p> <p> “It’s a weird situation for players going through all these screenings,” Kovacs said. “They’re worried someone will say, ‘You can’t participate in the NFL,’ when that’s your life’s dream. Ninety-nine out of 100 times, I say everything’s fine. These athletes have trained for a decade or more to do what they really love to do.” </p> <p> Physicians working at the combine understand the bodies of elite athletes. Because of their training regimens, they can have healthy hearts that appear enlarged or have thicker heart muscles than nonathletes.</p> <p>“You need experts in sports cardiology who understand the sport, as well as how each position trains, to distinguish normal from abnormal,” Kovacs said. “A wide receiver’s heart doesn’t look like the offensive lineman’s heart, or the quarterback’s or the kicker’s.”</p> <p> As founding chair of the sports cardiology section for the American College of Cardiology (ACC), Kovacs successfully advocated for legislation in Indiana that mandates high school coaches be certified in CPR. He also supports the <a rel="noopener noreferrer" href="https://www.nfl.com/causes/smart-heart/" target="_blank">NFL Smart Heart Sports Coalition</a>, which advocates for every high school athletic venue to have an emergency action plan that is widely distributed and rehearsed, along with a clearly marked AED available within 1-3 minutes and coaches who are trained in both CPR and AED use. </p> <p> </p> <h3> Becoming a leader in cardiology </h3> <p> A first-generation physician, Kovacs worked his way through undergrad at the University of Chicago and then medical school at the University of Cincinnati as a researcher in sleep laboratories, examining brain electricity and neurophysiology. When his interest shifted to heart electricity, his search for top residency programs in cardiology led him to IU. </p> <p> “There weren’t a lot of great cardiology programs at the time, and Indiana was the premier place,” Kovacs said. </p> <p>Much credit for the program’s reputation goes to <a rel="noopener noreferrer" href="https://alliance.iu.edu/members/member/3707.html?_gl=1*retsbe*_ga*MTg3NjIyMzUwNy4xNzA2ODAwMzA2*_ga_61CH0D2DQW*MTcwODEwMDQ0Ni4zOS4xLjE3MDgxMDA5MTMuMzIuMC4w" target="_blank">Charles Fisch, MD</a>, Cardiology Division leader at IU School of Medicine from 1961 to 1990 and founding director of IU’s first heart clinic, predecessor to the Krannert Cardiovascular Research Center. Fisch became a key mentor for Kovacs, along with former Department of Medicine Chair August Watanabe, MD, who went on to become executive vice president of science and technology for Eli Lilly and Company. Kovacs briefly followed Watanabe to Lilly, steering his electrophysiological research toward drug development, but returned to IU School of Medicine in 2003. </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2024/acc_kovacs-and-colleagues.jpeg?h=300&w=450&rev=23dacfd03f5649b9b9beb45d90c8b6e4&hash=76AA1821B484D1825F28A769169FD9F2" style="height: 300px; width: 450px;" alt="Richard Kovacs with colleagues in front of a American College of Cardiology sign" class="float-left" />“The theme here is mentorship,” Kovacs said. “I had tremendous mentors who offered me leadership opportunities.” </p> <p>When Kovacs started in cardiology in the 1980s, there were no subspecialities. </p> <p>“Now with the complexity of technologies we can apply, we need to have experts,” he said. “Electrophysiology was the first subspecialty with the advent of defibrillators and pacemakers. Next came interventional cardiology to treat heart attacks acutely with stents and later to place heart valves.” </p> <p> Along with electrophysiology and interventional cardiology, IU School of Medicine fellowship programs include Advanced Heart Failure and Transplant, Cardiovascular Disease, and Adult Congenital Heart Disease. </p> <p> “Because of the outstanding work going on at Riley (Children’s Health), affected children are now surviving into adulthood at increasing rates,” Kovacs said. This means specialists are needed to care for patients with congenital heart diseases as they age. </p> <p> In 2019, Kovacs was elected president of the American College of Cardiology, and he has held many other leadership positions within the national organization over the years. </p> <p> “An important need in cardiology now is diversity and inclusivity,” Kovacs said. “Most of my mentors looked like me. Now I recognize that to care for patients, conduct better research and do clinical trials, those people (training cardiologists) should not all look like me.” </p> <p> <a href="/faculty/4793/clary-julie">Julie Clary, MD</a>, vice chair for clinical affairs in the Department of Medicine, is among several women Kovacs has informally mentored. </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2024/kovacssagwbsh091119.jpg?h=319&w=425&rev=ac38999f3226472292755b4cd4c3b8ff&hash=98A0957A50C5852EFF2E0DF37A681CA5" style="height: 319px; width: 425px;" alt="Jennifer Sullivan, Richard Kovacs and Julie Clary at Sagamore of the Wabash presentation" class="float-right" />“As someone who was interested in leadership, advocacy and being involved with the American College of Cardiology, I couldn't think of anyone better to act as a coach,” said Clary, who joined the IU School of Medicine faculty in 2015 and serves as director of cardiac rehabilitation with IU Health. “It truly is an honor to work alongside Dr. Kovacs and learn from him each day. He is respected nationally and internationally, but he chooses to practice here at Indiana University — we are lucky to have him.” </p> <p> <a href="/faculty/5256/rao-roopa">Roopa Rao, MD</a>, an associate professor of clinical medicine who specializes in heart failure and transplants, considers Kovacs a source of invaluable career guidance, an inspiring expert in EKG and a role model for leadership. </p> <p> “Rounding with him as a cardiology fellow in the hospital was an enjoyable experience, witnessing his adeptness in effortlessly solving challenging clinical cases,” she said. “I recall the strong attachment his patients had to him, demonstrating their unwavering trust and loyalty. It was remarkable to witness individuals willingly travel for hours just to continue their follow-up care under his guidance.” </p> <p> A leader in cardiology “must be in the trenches” to maintain clinical credibility, Kovacs said, which is why he still sees patients most days. </p> <p> To recognize Kovacs’ service as president of the ACC in 2019, Clary successfully nominated him for Indiana’s highest civilian honor, the Sagamore of the Wabash. Presenting the prestigious award on behalf of Indiana Gov. Eric Holcomb, <a href="/faculty/11988/sullivan-jennifer">Jennifer Sullivan, MD, MPH</a>, then-secretary of the Indiana Family and Social Services Administration, noted Kovacs’ “magical powers to know where he is needed at exactly the right time.” </p> <p> She was referencing a 2019 incident when an IU School of Medicine faculty member collapsed from sudden cardiac arrest while running in Paris. Amazingly, Kovacs was also in Paris for a cardiology conference and was able to attend to the faculty member in the hospital. He later served as a medical escort on the flight home. </p> <p> An important part of the story, Kovacs said, is that another runner quickly intervened to perform lifesaving CPR while waiting for paramedics to arrive. Unfortunately, the U.S. lags behind Europe in public training for cardiac emergencies, he noted. </p> <p> </p> <h3> Saving lives with CPR and AEDs </h3> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2024/cpr-training-stock_adobe.jpeg?h=267&w=400&rev=b677fc47b490401d8011a8b84395b830&hash=9B5A361478F45DFDA424B5AAD0FD28DF" style="height: 267px; width: 400px;" alt="Paramedic demonstrates CPR on a dummy" class="float-right" />Here's a sobering statistic Kovacs often shares: “If you collapse on the street in Prague, there is a 98% chance a bystander will start CPR. If you collapse in Indianapolis, there is about a 10% chance.” </p> <p> More than 356,000 people have out-of-hospital cardiac arrests in the U.S. every year, and nearly 90% of them are fatal, according to the American Heart Association Heart and Stroke Statistics—2023 Update. Most of these events occur in homes and public settings. Intervening with CPR immediately can double or triple a person’s chance of survival, according to the AHA. </p> <p> The <a rel="noopener noreferrer" href="https://www.redcross.org/take-a-class/cpr/performing-cpr" target="_blank">American Red Cross</a> website has step-by-step instructions and video tutorials for adult CPR, hands-only CPR, child and baby CPR, and pet CPR. The Red Cross also offers online and in-person CPR classes which include instructions for using an AED. There are even stations at the Indianapolis International Airport where anyone can practice CPR on a manikin, Kovacs noted. </p> <p> As much as he enjoys working with athletic organizations like the NFL, Kovacs stresses that the odds of an athlete having a sudden cardiac arrest on the field are low compared to the probability of encountering cardiac arrest in everyday life. </p> <p> His message for <a rel="noopener noreferrer" href="https://www.whitehouse.gov/briefing-room/presidential-actions/2024/01/31/a-proclamation-on-american-heart-month-2024/" target="_blank">American Heart Month</a> is this: “Lives would be saved if people learned hands-only CPR and were comfortable with using an AED.” </p>Fri, 16 Feb 2024 00:00:00 Z{5E065E13-1CB2-428C-8AFD-A248C4AC7464}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/december-2023-newsletterDecember 2023 Newsletter<h3>Cardiovascular Institute</h3> <p><em>One diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.<br /> <br /> Cheers to all you do for our patients, our families, and each other throughout the year. Here's wishing you and yours a joyful holiday season, and the best of health and happiness in the new year. </em></p> <br /> <br /> <h3>Connect to Purpose</h3> <br /> <br /> <h2>Ball Cardiology celebrates milestone for TAVR procedures</h2> <p> The IU Health Ball Cardiology team recently celebrated completing their 100th transcatheter aortic valve replacement (TAVR) procedure. TAVR is a minimally invasive procedure to treat aortic stenosis, a narrowing of the aortic valve. <br /> <br /> Patients Camile Peterson, 90, and Michael Brumback, 83, expressed their gratitude after undergoing this life improving procedure. Peterson was experiencing exhaustion and her primary care physician referred her to <a href="https://iuhealth.org/find-providers/provider/mohammed-eid-madmani-md-211303">Dr. Mohammed Madmani</a> and <a href="https://iuhealth.org/find-providers/provider/michael-j-moran-md-8246">Dr. Michael Moran</a>, to investigate abnormalities he observed. Brumback had similar experiences of exhaustion, after doing yard work. <br /> <br /> "It was amazing to me how much better I felt right away," Peterson said, after undergoing TAVR. "I could breathe better, and my body felt better overall."<br /> <br /> Brumback said he felt extremely weighed down, like he carried 5,000 pounds before the TAVR. Results from his echocardiogram indicated a calcified aortic valve, which was restricting blood flow. <br /> <br /> "The entire team is amazing," Brumback said. "I feel really good since the procedure, clearer, not as tired."<br /> <br /> Both Peterson and Brumback are now participating in cardiac rehabilitation services.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/ball-cardiology-tavr-team.jpg?h=481&w=600&rev=727f128948c04f86863443fe5678ae80&hash=98408146C9C17926872D1C8D4F799C85" style=" height:481px; width:600px" alt="IUH Ball Cardiology TAVR team" /> </p> <br /> <br /> <h2>With a new heart and a new life waiting to unfold, #AmazingAva goes home</h2> <p> The long wait is finally over after <a href="https://medicine.iu.edu/faculty/15000/turrentine-mark">Dr. Mark Turrentine</a> procured a donor heart for 10-year old Ava Graham, also known as #AmazingAva. On Oct. 28, <a href="https://medicine.iu.edu/faculty/10376/rodefeld-mark">Dr. Mark Rodefeld</a> and a full team of experts, successfully completed the transplant surgery. <br /> <br /> Several Riley team members celebrated and lined the hallways as Ava left her hospital room for the last time after spending 579 days in the Heart Center at Riley Children's Health. <br /> <br /> <a href="https://www.rileychildrens.org/connections/amazingava-goes-home-with-a-new-heart">Read the full story</a></p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/amazingava.png?h=318&w=600&rev=84e21089fe794bf0bc3a771307358cb7&hash=057D9614553077D7A043E840DA245A3F" style=" height:318px; width:600px" alt="Ava Graham with her Riley care team" />  <br /> <br /> <h3>News</h3> <br /> <br /> <h2>IU Health recognized as a preferred health system for cardiology in the U.S.</h2> <p>Indiana University Health (Indianapolis) was among 107 health systems in the United States that received the <a href="https://www.beckersasc.com/cardiology/the-107-health-systems-preferred-by-patients-for-cardiology.html?origin=CardioE&utm_source=CardioE&utm_medium=email&utm_content=newsletter&oly_enc_id=3358I0935423D4H">WebMD patient choice award</a> for cardiology, placing the hospital in the top 30% of patient preferences. The Choice Awards program is based upon the following procedures: angioplasty, coronary bypass, heart valve replacement, pacemaker or defibrillator placement and stent placement.</p> <br /> <br /> <h2>Fellowship Match Results</h2> <p>Following Fellowship Match Day on Nov. 29, we matched 5/5 openings for our General Cardiovascular Disease program and 1/1 for our Cardiac Electrophysiology program. The Cardiovascular Institute is excited to welcome a new group of physicians to our fellowship training program starting July 2024! </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2024/fellowship-program.jpg?h=457&w=716&rev=03c0e32c59f048e7869e19fc799c9e96&hash=485E95757D2D62914C7C71E55855F7A4" style=" height:457px; width:716px" alt="Cardiovascular Fellowship match results" /></p> <br /> <br /> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/harveyfeigenbaummd121123.png?h=350&w=297&rev=e883985052a04619ab78c718cabfb444&hash=987AD15EFD8D509361D345E352FFFB24" style=" height:350px; width:297px" alt="Harvey Feigenbaum, MD" class="float-left" /></p> <h2>IU cardiovascular pioneer, Harvey Feigenbaum, MD, celebrates 90th birthday</h2> <p>We wish our colleague, <a href="https://medicine.iu.edu/faculty/4952/feigenbaum-harvey">Harvey Feigenbaum, MD</a>, distinguished professor at Indiana University School of Medicine and a heart and vascular care specialist for IU Health Physicians Cardiology, a happy 90th birthday! Leaders of the world's major cardiovascular societies, including American College of Cardiology, World Heart Federation, American Heart Association, and the European Society of Cardiology share our sentiment with the recognition of Dr. Feigenbaum's <a href="https://image.e.iu.edu/lib/fe2e11717d64047c7d1d71/m/1/ff38863c-92a6-4079-93b9-6740a79a2fd1.pdf">special birthday congratulations</a>.<br /> <br /> Dr. Feigenbaum is a world-renowned physician scientist who introduced the most widely used cardiac imaging technique, echocardiography. He authored the first academic book on echocardiography in 1972 and developed the M-mode technique for measuring left ventricular dimension in 1968 and taught the first academic course dedicated to cardiac ultrasound here at the Indiana University School of Medicine. He was the founder and past president of the American Society of Echocardiography and received several award distinctions, including the establishment of the "Feigenbaum Lecture" by the American Society of Echocardiography in 2004, the Pioneer Award form the Mayo Clinic and the Primio Mantevergine Award as the "Father of Modern Echocardiography" in Naples. Dr. Feigenbaum received his medical degree from IU School of Medicine and completed an internship at Philadelphia General Hospital. He returned to IU for his residency and joined IU faculty, where he has served as the director of non-invasive diagnostic cardiac laboratories.</p> <p><a href="https://medicine.iu.edu/research-centers/cardiovascular/about/history">Learn more about IU's cardiovascular research history</a></p> <br /> <br /> <h2><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/james-dillon-md.jpg?h=317&w=255&rev=35b547bf4c7b464d854b01bc47ee6ff0&hash=312D0B1094D278A52767C28D1F8D10CB" style=" height:317px; width:255px" alt="James Dillon, MD" class="float-left" />James Dillon, MD, leaves legacy of public service and cardiovascular health</h2> <p>It is with sadness that the Department of Medicine and the Division of Cardiovascular Medicine at Indiana University School of Medicine announce the passing of our colleague, James Christian Dillon, MD, former cardiologist and professor emeritus of medicine for the school, on Nov. 15, 2023. He was 83.</p> <p><a href="https://medicine.iu.edu/blogs/the-beat/dillon-leaves-legacy-of-public-service">Learn more about Dr. Dillon's career at IU</a></p> <br /> <br /> <br /> <br /> <h3>Krannert Cardiovascular Research Center</h3> <br /> <br /> <h2><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/kcvrc-ihd-illustration-ccs-ami-classification-keyur-vora.jpeg?h=358&w=400&rev=07baed66b4ad4a3db23d6ec11a0b34df&hash=065D2224393B055F53A217D13B3E35DA" alt="The Canadian Cardiovascular Society classification of acute myocardial infarction (CCS-AMI)" style="height: 358px; width: 400px;" class="float-left" />KCVRC co-leads first clinical classification of heart attacks</h2> <p>Researchers from the Ischemic Heart Disease Program of the Krannert Cardiovascular Research Center at Indiana University School of Medicine helped formulate the world's first clinical classification of acute myocardial infarction (AMI) - or heart attack - based on heart tissue damage research. The four-stage classification was recently adopted by the Canadian Cardiovascular Society. KCVRC executive director, <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Rohan Dharmakumar, PhD</a>, and immediate past chief of cardiology and physician scientist, Andreas Kumar, MD, from Northern Ontario School of Medicine, conceptualized the classification. The classification was presented during <a href="https://ccs.ca/event/vascular-2023/">Vascular 2023</a> and published in the <em><a href="https://onlinecjc.ca/article/S0828-282X(23)01735-X/fulltext">Canadian Journal of Cardiology</a></em>. <br /> <br /> Clinical classifications are reviewed and developed by medical societies to introduce and adopt new standards of care and guidelines. Knowing what level of tissue damage has occurred on the heart muscle can help cardiologists determine how best to redirect care to prevent a patient case from escalating, even with treatments available today.</p> <p><a href="https://medicine.iu.edu/news/2023/10/heart-attack-tissue-damage-classification-developed">Learn more</a></p> <br /> <br /> <h3>Welcome to Our Team</h3> <p>The Cardiovascular Institute is thrilled to welcome new team members to IU Health! These specialists will serve Avon, Carmel, Indianapolis and Muncie IU Health Campuses.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/cvi-physician-new-hires.jpg?h=220&w=615&rev=c32f839c4a24416084aee107cb4ff815&hash=9D0E7BF501D059406EE460CC32412EE5" style=" height:220px; width:615px" alt="CVI Physician new hires" /></p> <br /> <br /> <h3>Kudos</h3> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/marathon-runners.jpg?h=317&w=238&rev=0399340984c14f1890e115d200063b5b&hash=6239A5A13903738BE26A9BCEFA4E9838" style=" height:317px; width:238px" alt="Division of Cardiovascular team members prepare for Indy's Monumental Marathon" class="float-left" /></p> <h2>Team members complete Indy's Monumental Marathon</h2> <p>On Oct. 28, a handful of cardiovascular team members joined the 16th running of the 2023 CNO Financial Indianapolis Monumental Marathon. The marathon ranks among the 15th largest nationally and includes a half marathon and a 5k. <br /> <br /> <a href="https://medicine.iu.edu/faculty/4793/clary-julie">Julie Clary, MD, MBA</a>, vice chair for clinical affairs in the Department of Medicine and the interim service line leader for cardiovascular medicine, and Annie Cheek, MBA, MS, executive director of the Cardiovascular Institute, completed the full marathon in an impressive record-breaking time. With a Boston Qualifying time, Cheek will be running the 2025 Boston Marathon. We look forward to cheering her on as she completes the Boston Marathon in April 2025!<br /> <br /> The half marathon runners included Adam Beach, Chris Corr and Michele Schlegelmilch with the Indiana University School of Medicine, Division of Cardiovascular Medicine.<br /> <br /> Congratulations to all of our finishers! Your commitment, resiliency and positive energy inspire us all. </p> <br /> <br /> <br /> <br /> <p><em>Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email <a href="mailto:oneiucv@iu.edu">OneIUCV</a> so we can share with the team! </em></p>Mon, 11 Dec 2023 00:00:00 Z{9C2FEA38-FD4E-4022-840D-13B86BB61E0C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/duncan-leads-quest-to-end-health-disparities-in-lung-cancerDuncan leads quest to end health disparities in lung cancer<p>When it comes to lung cancer, being Black—particularly a Black male—means increased risk. <a href="/faculty/42552/duncan-francesca">Francesca Duncan, MD, MS</a>, is determined to end disparities in the diagnosis and treatment of lung cancer—the leading cause of cancer deaths in the United States.</p> <p>“Black individuals have the highest incidence rates and mortality rates compared to any other race,” said Duncan, assistant professor of pulmonary medicine at Indiana University School of Medicine and an associate member of the <a rel="noopener noreferrer" href="https://cancer.iu.edu/" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>.</p> <p> While 15-20% of people who develop lung cancer are not smokers, in the majority of cases, smoking is linked. Curiously, research shows that smokers in the Black population tend to smoke less over time than their white counterparts yet still have worse outcomes. </p> <p> “That’s what I found really interesting,” Duncan said. “That’s what started my quest to learn more about the disparities in lung cancer.” </p> <p> Her initial interest in cancer research began in during graduate school where she studied cervical cancer. Later, she received an intramural research training award where she conducted breast cancer research at the National Institutes of Health/National Cancer Institute working with a physician scientist who studied tissue samples collected directly from patients.</p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/02/05/23/04/42552-francesca-duncan.png?h=400&w=267&rev=743c453d7dac492fbc968525c5603112&hash=20CBFD9573A436DA8FB327CB164F997E" style="height: 400px; width: 267px;" alt="42552-Duncan, Francesca" class="float-left" />“I thought it was remarkable that you can go from bedside to bench and back to bedside like that,” said Duncan, who would return to this lab each summer during her medical school training at Meharry Medical College, a historically Black medical school in Nashville, Tennessee. “When I began my fellowship training in pulmonary and critical care at IU School of Medicine, I was interested in finding a way that I could merge my interests in cancer research and health disparities.”</p> <p> As she developed her research niche, Duncan found a valuable mentor in <a href="/faculty/4855/sears-catherine">Catherine Sears, MD</a>, an extensively published physician-scientist with a focus on lung cancer. Sears’ lab at IU studies the impact of DNA damage in smoking-related lung cancers and potential therapeutic targets to repair that damage and prevent progression.</p> <p> “I was thrilled when Dr. Duncan approached me during her fellowship training with an interest in studying racial disparities in lung cancer outcomes and in lung cancer screening,” Sears said. “Now a junior faculty, she is leading a team to discover the root causes for these inequities and determine if interventions within lung cancer screening programs can mitigate their impact on those traditionally underserved in medicine.”</p> <p>Along with pulmonary medicine colleague <a href="/faculty/61256/jackson-edwin">Edwin Jackson, DO, MBA</a>, Duncan secured a grant from the federally funded <a href="/sitecore/content/iu/iu-som/home/blogs/the-beat/primegrants2022">Primary Care Reaffirmation for Indiana Medical Education</a> (PRIME) program designed to improve lung cancer screening through a provider educational curriculum and patient educational outreach, in hopes of increasing shared decision making surrounding lung cancer screening among patients and providers.</p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/p/prime-logo.png?h=200&w=388&rev=747df926074749f2a232e7624f0a9146&hash=880B91FB071C35BE3956CC9E5AB2AC52" alt="Red shape of the state of Indiana and the word PRIME in black capital letters.." class="float-right" style="height: 200px; width: 388px;" /> <p>“Lung cancer screening only became available about 10 years ago, so it’s very new,” Duncan explained. “Less than 6% of eligible people get screening, and even less among Black individuals who carry the burden of this disease.” </p> <p> Current guidelines, updated in 2021 to help screen more Black patients who tend to be younger and lighter smokers, call for screening of people ages 50-80 who have a “20-pack year smoking history” (people who smoked one pack/day for 20 years, 2 packs/day for 10 years or the equivalent) and who currently smoke or have stopped smoking within the last 15 years. </p> <p> Duncan is now conducting a pilot program to educate both primary care providers and patients on the process of lung cancer screening.</p> <p> “Studies have shown that if it’s your doctor talking to you about screening, you’re more likely to agree to it and follow through,” she said.</p> <p> Duncan recently broadened the impact of her disparities research to include the Hispanic/Latinx community via the work of an enthusiastic learner. <a href="/sitecore/content/iu/iu-som/home/blogs/spirit-of-medicine/mi-doctorita-medical-resident-fosters-mentorship-for-latinx-community">Mariel Luna Hinojosa, MD</a>, a third-year resident in internal medicine, is working on patient education in the Spanish language. </p> <p> For Luna, it’s personal. </p> <p> “My grandpa died from lung cancer,” she said. “I don’t think anybody every brought up lung cancer screening for him. His cancer was metastatic by the time he was diagnosed.” </p> <p> According to the American Lung Association’s <a rel="noopener noreferrer" href="https://www.lung.org/research/state-of-lung-cancer/racial-and-ethnic-disparities" target="_blank">State of Lung Cancer 2022</a>, Black Americans and Latinx Americans with lung cancer are 15% less likely to be diagnosed early compared to white Americans. Both groups are also more likely to not receive any treatment for lung cancer and are substantially less likely to survive five years compared to white Americans. </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/luna-and-duncan-presenting-research.jpeg?h=358&w=475&rev=c916d773c07e47e3bbef2362c56e8c6e&hash=7CD3E32B11C4D9A94F9E1AD7C79D2C5A" style="height: 358px; width: 475px;" alt="Duncan and Luna present their research" class="float-left" />“I want to identify all the barriers—socioeconomic factors, patient-doctor relationships and the language barrier—to understand why Latinos are less likely to be screened for lung cancer,” Luna said. </p> <p> Doing research with Duncan means Luna can be part of systemic change to help more people avoid the suffering of lung cancer. </p> <p> “Before I met Dr. Duncan, I knew I wanted to be a doctor that helps patients overcome health disparities, but I didn’t know I could do this at a larger scale and try to correct issues within the medical system to make big changes for a population,” Luna said. </p> <p> Duncan’s work includes the emerging field of "social epigenomics," an integrative field of research focused on the identification of socio-environmental factors—like limited access to health care, growing up in poverty, educational attainment, insurance status, and radon or secondhand smoke exposure—and examines their influence on human biology. </p> <p> “Social epigenomics basically is studying how social determinants of health impact genetic expression,” Duncan said. “It is looking to see how your environment influences your genes leading to the development of cancer.” </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/elcn2023sotto-sears-duncan-hanna.jpeg?h=300&w=450&rev=b46a45f3396949dca30afc8735f8a0ce&hash=229C098F170FE4C421A6096F29A178DD" style="height: 300px; width: 450px;" alt="Duncan holding white ribbon with with Sylk Sotto, Catherine Sears and Nasser Hanna" class="float-right" />Duncan’s research in racial and ethnic disparities contributes to a larger IU-led effort called <a rel="noopener noreferrer" href="https://cancer.iu.edu/community/elcn/index.html" target="_blank">End Lung Cancer Now</a>, an initiative spearheaded by <a href="/faculty/5014/hanna-nasser">Nasser Hanna, MD</a>, the Tom and Julie Wood Family Foundation Professor of Lung Cancer Clinical Research at IU School of Medicine and a member of the IU Simon Comprehensive Cancer Center. </p> <p> Hanna recently gave a “State of Lung Cancer” address that included some positive trends and plans for a new <a href="/sitecore/content/iu/iu-som/home/news/2023/11/mobile-lung-cancer-screening-program-funding">mobile lung cancer screening program</a>.</p> <p> “The good news is that the number of people in the U.S. who die from lung cancer is rapidly falling, largely due to significant reduction in cigarette consumption,” he said. “We are making gains with lung cancer screening, but the rates continue to be unacceptably low. There have been significant therapeutic advances in the treatment of lung cancer, including the incorporation of immunotherapy and targeted therapy in early-stage disease.” </p> <p> While that’s the good news, Hanna said, “there remains a lot of work to do.” </p> <p>Some of that work is in addressing disparities in outcomes for minoritized populations, most notably among Black men. </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/20200501_francesca_duncan_lk_044r-bw.jpg?h=301&w=450&rev=82e18a2f119e4d5b8c7f1663e8122ff4&hash=F8A8D1307F46DB1159209B6ED72487E2" style="height: 301px; width: 450px;" alt="Francesca Duncan, MD" class="float-left" /> <p>“Black men are more likely to get lung cancer than their white counterparts, despite a lower intensity of smoking,” Hanna said. “They are more likely to be diagnosed with late-stage disease, less likely to be offered surgery, less likely to survive, and less likely to participate in a lung cancer screening program. Black Americans are more likely to be impacted by second-hand smoke as well.” </p> <p> Duncan’s research is creating a better understanding of these disparities and what can be done to eliminate them. </p> <p> “Understanding the causes of racial disparities in lung cancer outcomes is critically important to narrow these differences,” Hanna said. “Dr. Duncan’s research and my research overlap in many ways. Our goals are similar—to reduce the suffering and death from lung cancer and to eliminate the gap in outcomes seen based on difference in race and ethnicity.” </p> <p> </p> <p> <em>Learn more about <a rel="noopener noreferrer" href="https://cancer.iu.edu/community/elcn/index.html" target="_blank">End Lung Cancer Now</a> and its goals for prevention, screening and clinical trials in lung cancer.</em> </p>Thu, 02 Nov 2023 20:50:00 Z{64543CAA-0D54-4F62-9EE2-4C746C9E4216}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/faculty-present-new-classification-of-acute-miIU Cardiovascular Medicine faculty to present new CCS classification of Acute MI: CCS-AMI<p><span>Clinical Investigators from the </span><a href="https://medicine.iu.edu/research-centers/cardiovascular"><span>Krannert Cardiovascular Research Center</span></a><strong><span> </span></strong><span>at the Indiana University School of Medicine will present an introduction into a new groundbreaking classification by the Canadian Cardiovascular Society regarding acute myocardial infarction during </span><a href="https://ccs.ca/event/vascular-2023/"><strong><span>Vascular 2023</span></strong></a><strong><span> at 8:30 am EDT</span></strong><span>, <strong>Sunday, Oct. 29,</strong> at the <strong>Palais, 518 ABC</strong>, in Montréal, Canada. </span></p> <p>KCVRC Executive Director <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan"><span>Rohan Dharmakumar, MS, PhD,</span></a><span> is co-chairing the session and speaking on the CCS-AMI along with <a href="https://medicine.iu.edu/faculty/60685/vora-keyur">Keyur Vora, MD, MS, FACC</a>, cardiologist and assistant research professor of medicine at the IU School of Medicine, who will present on CCS-AMI clinical case series. </span></p> <p><span>They are part of an expert consensus writing group and driving force that developed the framework for the new CCS classification of acute myocardial infarction alongside other eminent cardiovascular research experts, including Andreas Kumar, MD, MSC, of Northern Ontario School of Medicine, chair, and Michelle M. Graham, MD, FRCPC, FCCS-CAIC, CanCARE, co-chair, which will be featured in the upcoming special consensus paper in <a href="https://onlinecjc.ca/"><em>Canadian Journal of Cardiology</em></a>. </span></p> <p><span>Dr. Dharmakumar, a pioneer in the scientific development of hemorrhagic myocardial infarction, has dedicated two decades of groundbreaking work and collaborated with Dr. Kumar and other leading cardiovascular researchers. This collaborative effort has resulted in the new CCS-AMI classification, nearly 50 years after the establishment of the CCS-Angina classification in 1972. </span></p> <p><span>Dr. Keyur Vora, a dedicated cardiologist and trialist, is working toward developing innovative diagnostic and therapeutic solutions for hemorrhagic myocardial infarction. This is a monumental step forward in cardiology.</span></p> <p><span>“Join us for a groundbreaking introduction of the new CCS-AMI classification – a true game changer in cardiovascular care at Vascular 2023,” Dr. Dharmakumar said, “and look for our consensus paper in the <em>Canadian Journal of Cardiology</em> on Oct. 29. We look forward to sharing our pathway to this classification and fielding questions."<br /> </span></p>Wed, 25 Oct 2023 00:00:00 Z{309AF130-78B2-4A9B-8E93-27DEDF3AC22D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/dean/2023-fall-all-school-meeting-recap2023 Fall All School Meeting RecapThe Indiana University School of Medicine Fall All-School Meeting was held on September 12, 2023, and included Strategic Plan updates from Dean <a href="/faculty/6512/hess-jay">Jay L. Hess, MD, PhD, MHSA</a>, leadership announcements, research highlights and faculty and staff awards. <p> </p> <h3> Leadership announcements</h3> <ul> <li><a href="/sitecore/content/iu/iu-som/home/news/2023/06/allen-named-radiology-chair">Jason Allen, MD, PhD</a> – Radiology & Imaging Sciences <ul> <li>Highly respected physician scientist </li> <li>Comes from Emory University School of Medicine in Atlanta; he was director of the Division on Neuroradiology and Director of Laboratory Imaging Neurosciences </li> <li>NIH-funded researcher; he uses advanced MRI to study traumatic brain injury and cerebrovascular diseases </li> <li>Appointment effective October 1 </li> </ul> </li> <li><a href="/faculty/44611/lind-john">John Lind, MD</a> – Ophthalmology (interim) <ul> <li>Division Chief and Associate Professor of Ophthalmology </li> <li>Co-founder and co-course director of the Innovations in Glaucoma Surgery Continuing Medical Education Program </li> </ul> </li> </ul> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/new-department-chairs.png?h=321&w=600&rev=b1a36288fca240d9b850a4510eb6c71e&hash=7B08CEE5F7294932305255F080A9736E" style="height: 321px; width: 600px;" alt="Drs. Jason Allen and John Lind" /></p> <p>IU School of Medicine is currently recruiting for a number of other leadership positions: </p> <ul> <li>Chair, Medical and Molecular Genetics – final stages </li> <li>Chair, Family Medicine – search in progress </li> <li>Chair, Neurosurgery – search in progress </li> <li>Chair, Ophthalmology – search launched September 6, 2023 </li> <li>Director, Indiana Center for Musculoskeletal Health – search will launch this fall</li> </ul> <p> </p> <h1> Strategic Plan update</h1> <p> IU School of Medicine launched its <a href="/sitecore/content/iu/iu-som/home/strategic-plan">Strategic Plan</a> in the spring. The Strategic Plan was developed with the input of hundreds of people—faculty, staff and students in the school and beyond. Dean Hess presented an update of the school’s progress on executing on the three pillars of the plan, related to student success, accelerating discovery and translation, and improving the health of the school and the state.</p> <p> </p> <h3> Pillar 1: Maximize learner success statewide</h3> <p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0160_websize.jpg?h=282&w=500&rev=71c66e532fa548f1825e1140b2be8a34&hash=6A1743759D55FA917ECE023A122D52B1" style="height: 282px; width: 500px;" alt="Audience at Fall 2023 All School Meeting" class="float-right" />Project 1: Engage learners in Professional Learning Communities (PLCs)</strong></p> <p> IU School of Medicine is establishing <a href="/sitecore/content/iu/iu-som/home/blogs/internal-news/faculty-mentors-needed-for-new-professional-learning-communities">Professional Learning Communities</a> (PLCs) to help students connect, gain support and grow personally and professionally. The program is centered on social gatherings to build cohesion and school spirit while providing coaching, mentoring and advising throughout all four years of medical school through peer-to-peer, near-peer, and faculty-student interactions. </p> <p>The PLC program will be launching statewide, starting in January 2024, with 12 professional learning communities in Indianapolis, each with two PLC faculty. IU School of Medicine is currently <a href="/sitecore/content/iu/iu-som/home/blogs/internal-news/faculty-mentors-needed-for-new-professional-learning-communities">recruiting faculty members</a> to serve as PLC faculty. </p> <p> </p> <p> <strong>Project 2: Preparing for LCME reaccreditation</strong></p> <p> The School of Medicine’s preparations for reaccreditation by the Liaison Committee on Medical Education—known as the LCME—are well underway. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0413_websize.jpg?h=251&w=350&rev=b9ab94d70f284cfdb0cba1d84105a72a&hash=9D0B87B0F3CCBA7655C2C535116AAA62" style="height: 251px; width: 350px;" alt="Paul Wallach speaks" class="float-left" />Under the slogan “<a href="/sitecore/content/iu/iu-som/home/md/lcme-accreditation">Stairway to Accreditation</a>,” the school is preparing for the LCME survey team to visit all campuses in March 2025. IU School of Medicine is currently in a process of self-assessments and data collection. Throughout the year, several committees consisting of faculty, administrators, staff and students are conducting self-assessments to determine the school’s performance based on LCME accreditation standards.</p> <p> Another vital component of LCME accreditation is students’ opinions of their medical school education. As a part of the student satisfaction data collection, a committee made up of students from each class year and from several regional campuses will create and administer a survey to all their fellow students in October. The school is aiming for a 90% response rate. This is truly a team effort. </p> <p> </p> <h3> Pillar 2: Accelerate discovery and clinical translation</h3> <p> </p> <p><strong>Project 3: Build interdisciplinary team-based research programs</strong></p> <p> IU School of Medicine has a goal to increase NIH funding to be in the Top 10 public medical schools by 2030. One of the ways the school is doing this is by building interdisciplinary, team-based programs in areas where IU School of Medicine can be a national leader.</p> <p> A great example of this is Alzheimer’s disease. IU School of Medicine had a large presence at the Alzheimer’s Association International Conference (AAIC) in Amsterdam in July with many of our researchers from the Stark Neurosciences Research Institute presenting important discoveries.</p> <p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/snri-team.png?h=403&w=800&rev=e3d3c6d135c147d09eb41deed792b883&hash=D918B11EF4F73E22E775B3A18A57F5F0" alt="Stark Neurosciences Research Institute team" style="height: 403px; width: 800px;" /></strong></p> <p><strong></strong><a href="/faculty/27419/lasagna-reeves-cristian">Cristian Lasagna-Reeves, PhD</a>, was honored for the “<a href="/sitecore/content/iu/iu-som/home/blogs/research-updates/iu-school-of-medicine-scientists-produce-worlds-most-impactful-alzheimers-research">most impactful study published in Alzheimer’s research</a> over the preceding two years” and gave a plenary talk explaining his findings about the significance of the Bassoon protein as a contributor to neurotoxicity. </p> <p> In his acceptance speech, he commented that this might have been “just a paper” at another institution, but at IU School of Medicine, Lasagna-Reeves is working closely with researchers in the <a href="/sitecore/content/iu/iu-som/home/expertise/alzheimers/research/preclinical/drug-discovery">TREAT-AD</a> program, led by <a href="/faculty/42911/palkowitz-alan">Alan Palkowitz, PhD</a>, to develop a potential new drug therapy that would target Bassoon and stop tau tangles from forming. </p> <p> This type of collaborative team science is a gamechanger in speeding up development of new therapies that one day may prevent Alzheimer’s disease. IU School of Medicine’s goal is to continue to build disease-specific teams like these in cancer, cardiovascular disease and other areas.</p> <p> </p> <p> </p> <p> <strong>Project 4: Address research space needs</strong></p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/meded-building.png?h=331&w=400&rev=fc2e3c4707fe4b0992057ac92114f4bf&hash=51370ECE6D4A483444ACFF2905DEEA36" style="height: 331px; width: 400px;" alt="Research tower" class="float-right" />To provide more space for research growth and collaborative teams, IU School of Medicine received the IU Board of Trustees’ approval on August 24 to complete build out of the <a href="/sitecore/content/iu/iu-som/home/building-the-future/research-spaces">Research Tower</a> in the Medical Education and Research Building—<a href="/sitecore/content/iu/iu-som/home/building-the-future">Indianapolis’ new home for healing</a>. </p> <p> The research tower will create 48,000 gross square feet of new research laboratories, offices and laboratory support spaces on floors 8, 9 and 10. This space will facilitate recruitment of 18-20 new principal investigators, in areas such as neurodegeneration and cancer. In addition, the project will renovate space in the basement of the Neurosciences Research and Medical Education buildings to create more space for the Laboratory Animal Resource Center (LARC). Ultimately, this will increase the impact of scientific discovery and clinical translation.</p> <p> Take a look at how this flagship facility is taking shape in real time with <a rel="noopener noreferrer" href="https://app.truelook.cloud/dashboard/10939/11908/live?code=1sgtzhy5g0n359xno0ph6rl5q" target="_blank">TrueLook live video</a>.</p> <p> </p> <p> </p> <h3> Pillar 3: Improve health and wellness of the people of Indiana and beyond</h3> <p> <strong>Project 5: Clinical Cluster Recruitment Initiative </strong></p> <p> <a href="/faculty/17959/neal-chemen">Chemen Neal, MD</a>, executive associate dean for equity and inclusion and chief diversity officer, presented progress on this initiative which aims to increase the diversity of the school’s faculty, staff and learners so that the school is more reflective of state demographics. This also promotes health equity and addresses health disparities in key areas.</p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0218_websize.jpg?h=286&w=400&rev=4d51ec9eed534b78a8e0d2e95a6811ac&hash=676753B2E53A1AC211703E5068D2D5A7" style="height: 286px; width: 400px;" alt="Dr. Chemen Neal speaks at the Fall All School Meeting" class="float-left" />The <a href="/sitecore/content/iu/iu-som/home/cluster-recruitment-initiative">Clinical Cluster Recruitment Initiative</a> is one of several strategies IU School of Medicine and its clinical partners are employing to build a workforce that mirrors the communities they serve. Research shows patient outcomes improve when physicians look more like them or share common experiences.</p> <p>This initiative complements several other initiatives aimed at diversifying the school’s faculty:</p> <ol> <li><strong>Strategic Research Initiative</strong> (SRI 3.0): Recruitment and retention funds for URM candidates; all tenure track ranks eligible; $1 million cap with 50/50 match required. </li> <li><strong>Incentivizing Diverse Recruitment for Equity in Academic Medicine</strong> (iDREAM): Monthly early commitment stipends to residents, fellows and resident alumni; automatic acceptance into the Program to Launch URM Success (PLUS); available for academic and community medicine candidates. </li> <li><strong><a href="/sitecore/content/iu/iu-som/home/cluster-recruitment-initiative/_local/academic-clinician-cluster-hiring-initiative">Clinician Cluster Recruitment Initiative</a></strong>: Recruitment and development of diverse candidates; 20 faculty over four years. </li> <li><strong>Plan to Enhance Diversity</strong> (PED): Recruitment enhancement funds for candidates performing cancer-related research with IU Simon Cancer Center </li> <li><strong><a rel="noopener noreferrer" href="https://academicaffairs.iupui.edu/Diversity/iupfdif" target="_blank">Presidential Diversity Hiring Initiative</a></strong> (program continuing)</li> </ol> <p>The Clinical Cluster Recruitment Initiative offers holistic support combined with four career development tracks: </p> <ul> <li>Clinical Educator </li> <li>Health Systems Leadership </li> <li>Health Informatics </li> <li>Center for Inclusive Excellence Fellowship </li> </ul> <p>This initiative will help recruit clinicians that reflect the demographics and lived experiences of the Hoosier communities where health inequities are the most disparate. It will contribute to creating a diverse leadership infrastructure that reflects all the communities served by the medical school and health care system. And it will increase the number of role models and mentors that reflect the demographics and lived experiences of IU School of Medicine learners and trainees while improving health disparities in key areas. </p> <p> </p> <p> <strong>Project 6: Vital WorkLife </strong></p> <p> <a href="/faculty/14610/dankoski-mary">Mary Dankoski, PhD</a>, executive associate dean for faculty affairs and professional development, introduced the Vital Work Life program, a new resource designed for dually employed faculty that will be going live on October 1. This will help IU School of Medicine achieve its goal of improving the health of its faculty and school community.</p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0240_websize.jpg?h=253&w=450&rev=acaf2e92b54142dbb1efa503f7ab5ae3&hash=81F5CF3D84FDCFED6E1C170BFB054DC8" style="height: 253px; width: 450px;" alt="Mary Dankoski speaks at the All School Meeting" class="float-right" />Vital Work Life is a group that is custom-built for physicians and is used at many health systems across the country, including Community Health Network, Parkview Health and Hancock Health in Indiana. Vital Work Life is a network of therapists who understand physicians and their unique needs and the stigma they can often face when seeking support. It offers physician peer coaching, a work-life concierge virtual assistant, confidential counseling and more.</p> <p> Additionally, the <a rel="noopener noreferrer" href="https://hr.iu.edu/benefits/eap.html" target="_blank">Employee Assistance Program</a> (SupportLinc) is available to all staff, faculty, residents and fellows. SupportLinc offers many resources including short-term counseling, text-coaching, financial and legal consultation, and concierge service. </p> <p>IU School of Medicine students, residents and fellows may access counseling and other services through the <a href="/sitecore/content/iu/iu-som/home/mental-health-services">Department of Mental Health Services</a>. Under the leadership of <a href="/faculty/27141/hasan-samia">Samia Hasan, MD, EdM</a>, efforts to increase access and reduce stigma have resulted in many more trainees using mental health services; in 2022, 42% of medical students took advantage of mental health services. </p> <p> </p> <p> <strong>Project 7: Unified Medical Group </strong></p> <p> IU Health and IU School of Medicine are working together to integrate all five IU Health physician groups into a single unified medical group. This effort is being led by <a href="/faculty/14781/ingram-david">David Ingram, MD</a>, interim executive associate dean for clinical affairs at IU School of Medicine and executive vice president and chief medical officer at IU Health.  </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/umg-graphic.png?h=271&w=300&rev=0e76caa6884f4781801d36e85363d976&hash=27FBB7741D56DA4CFA69A5E4EC1B9CE7" style="height: 271px; width: 300px;" alt="UMG graphic" class="float-left" />The project is currently in phase one, which will bring greater alignment to IU Health’s medical groups so they function like one group ahead of the formal joining into a single entity in early 2025. Leaders from Ball Memorial Physicians, Southern Indiana Physicians, Arnett Physicians Group and IU Health Physicians are working together on the guiding principles for compensation model design, provider recruitment, cross coverage capabilities, quality structure and accountability, access, and capacity management strategy.</p> <p> Phase two, targeted for January 2025, will be the legal uniting into one medical group. The IU Health Physicians legal entity will become IU Health Medical Group. This will not result in any contractual changes for faculty physicians employed by IU Health Physicians.</p> <p> IU School of Medicine will launch a campaign this fall to move toward all IU Health employed physicians having a faculty appointment. This would include traditional dual employment within an academic department at the school and affiliate roles (non-paid appointments) for community medicine physicians. </p> <p> Having the Unified Medical Group will strengthen all three pillars of the Strategic Plan and its goals. It will result in:</p> <ul> <li>Greater access to clinical trials and support for other research initiatives. </li> <li>More opportunities for learners to engage in clinical rotations statewide. </li> <li>Improved flexibility for faculty clinicians to cross-cover, as well as share the responsibility for better coordinating care for patients.</li> </ul> <p> </p> <h1> Faculty Recognition & Awards</h1> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0259_websize.jpg?h=251&w=350&rev=b5b6ab67c44041f086b483784e0cb82e&hash=73D83C1A68D85834E9DB14DEF8777196" style="height: 251px; width: 350px;" alt="Greg Sachs and Dean Hess" class="float-right" />Many faculty and staff members were recognized for their excellence, commitment to diversity, scholarship, leadership and volunteerism.</p> <p> <strong>Excellence in Faculty Mentoring Award</strong></p> <ul> <li>Clinical: <a href="/faculty/5089/sachs-greg">Greg Sachs, MD</a>, Department of Medicine </li> <li>Basic Science: <a href="/faculty/1931/white-kenneth">Ken White, PhD</a>, Medical & Molecular Genetics </li> </ul> <p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0264_websize.jpg?h=251&w=350&rev=4bc7d973ea2e4522926adc55b1e017f1&hash=499415C908A7328F9C20663E0CCACB69" style="height: 251px; width: 350px;" alt="Ken White and Dean Hess" class="float-left" /></strong></p> <p><strong>Outstanding Community Engagement Award–Faculty </strong></p> <ul> <li><a href="/faculty/23508/wang-sophia">Sophia Wang, MD</a>, Psychiatry </li> </ul> <p> <strong>Inspirational Educator Award </strong></p> <ul> <li>Over 10 Years: <a href="/faculty/26393/oloughlin-valerie">Valerie O’Loughlin, PhD</a>, Anatomy, Cell Biology & Physiology </li> <li>Less than 10 Years: <a href="/faculty/23096/nelson-rick">Rick Nelson, MD, PhD</a>, Otolaryngology </li> </ul> <p> <strong>Scholar Educator Award </strong></p> <ul> <li><a href="/faculty/7371/sotto-sylk">Sylk Sotto, EdD, MBA, MPS</a>, Medicine</li> </ul> <p> </p> <h3> Volunteer & Adjunct Faculty Teaching Awards</h3> <p> <strong>Bloomington: </strong></p> <ul> <li>Mackenzie Lupov, MD </li> <li>Ryan Matthews, MD </li> <li>Jason Voorhies, MD </li> </ul> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0273_websize.jpg?h=286&w=400&rev=0bd54c6da2b94e4ba878010507567087&hash=CC339CB53C7B75B040771E2B0ED0251A" style="height: 286px; width: 400px;" alt="Valerie O'Loughlin with Dean Hess" class="float-right" />Evansville: </strong></p> <ul> <li>Santiago Arruffat, MD </li> <li>James Butler, MD </li> <li>Rick Crawford, MD </li> <li>Laura Finch, MD </li> <li>Kimberly Foster, MD </li> <li>Eric Goebel, MD </li> <li>Ahmed Jawad, MD </li> <li>Deepa Kumbar, MD </li> <li>Kristin La Fortune, MD </li> <li>Sally Primus, MD </li> <li>Melissa Reisinger, MD </li> <li>Robert Rusche, MD </li> <li>Roderick Warren, MD </li> </ul> <p><strong>Fort Wayne: </strong></p> <ul> <li>Kevin Berning, MD </li> <li>Keith Davis, MD </li> <li>Christopher Frazier, MD </li> <li>Robert Hathaway, MD </li> <li>Amber Hetrick, MD </li> <li>Jeffrey Sassmannshausen, MD </li> <li>Frank Shao, MD </li> </ul> <p><strong>Indianapolis:</strong></p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0342_websize.jpg?h=282&w=500&rev=494f0525d8794e93a8d8de585d4fd8c1&hash=885EC983AC4A5CE749C9C4784288F10A" alt="Audience applauds award winners" class="float-right" style="height: 282px; width: 500px;" /></strong> <div><strong><br /> </strong> <ul> <li>Rachel Hiday, PharmD, MBA </li> <li>Alicia Yilmaz, MD </li> </ul> <p><strong>Northwest-Gary: </strong></p> <ul> <li>Cheryl Brody, DO </li> </ul> <p><strong>South Bend:</strong></p> <ul> <li>Sara Baumgartner, MD </li> <li>Brian Carter, MD </li> <li>Swetha Chitta, MD </li> <li>Savita Collins, MD </li> <li>Julie Coyle, MD </li> <li>Manisha Deb Roy, MD </li> <li>Kyle Kownacki, MD </li> <li>Elizabeth Lindenman, MD </li> <li>Marion Mahone, MD, MPA </li> <li>Charbel Maskiny, MD</li> <li>Elizabeth Nafziger, MD </li> <li>Betsy Rossow, MD </li> <li>Brad Scott, MD </li> <li>Byars Wells, MD </li> </ul> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0299_websize.jpg?h=216&w=300&rev=5b92bfc6e0b449af85d3b75f209fbf19&hash=E28382161656C381812034B236A911AA" style="height: 216px; width: 300px;" alt="Tasneem Putliwala Sharma and Dean Hess" class="float-right" />Terre Haute: </strong></p> <ul> <li>George Andrew Wilson, MD </li> </ul> <p><strong> </strong></p> <p><strong>Outstanding Faculty Commitment to Diversity Award</strong></p> <ul> <li><a href="/faculty/39155/siddiqua-tasneem">Tasneem Putliwala Sharma, PhD</a>, Ophthalmology</li> </ul> <p> </p> <br/> <h3>Staff Recognition & Awards </h3> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0303_websize.jpg?h=287&w=400&rev=09978bf841244f119d0d40e585e0e17f&hash=0ED5118559B3D8181B41B495AF3F4A8E" style="height: 287px; width: 400px;" alt="Dawn Wright and Dean Hess" class="float-left" />Outstanding Staff Commitment to Diversity Award </strong></p> <ul> <li>Dawn Wright, Human Resources </li> <li>Nicole Garcia, Gastroenterology </li> </ul> <p> <strong>Deb Cowley Staff Leadership Award </strong></p> <ul> <li>Amanda Galbraith, MPA, Nephrology </li> </ul> <p><strong>Lynn Wakefield Unsung Hero Staff Award </strong></p> <ul> <li>Beth Chaisson, Education Administration & Finance </li> <li>Rachel Lahr, Gastroenterology </li> <li>Ethel DeGala Kussow, Ophthalmology </li> </ul> <p> <strong>Outstanding Community Engagement Award </strong></p> <ul> <li>Courtney Medlock, MPH, Family Medicine </li> <li>Montreca Releford, BS, RMA, CCRP, Gastroenterology </li> </ul> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0310_websize.jpg?h=216&w=300&rev=5314737978de4de896f9dab359badb54&hash=1771DB94C60B75E56796A815CB1C5003" alt="Nicole Garcia and Dean Hess" class="float-right" style="height: 216px; width: 300px;" /></strong></p> <div><strong><br /> </strong></div> <h3> Emerging Leaders</h3> <p> The Emerging Leaders program, sponsored by IU School of Medicine Human Resources, has had over 65 participants and was established to promote professional growth and leadership skills to emerging leaders within the school. An emerging leader is a staff member who has demonstrated the ability to lead others, directly or indirectly, and exhibits potential to advance into higher leadership roles.  </p> <p>Goals of the program are to empower staff members to take on leadership roles; build career plans and progression; provide concrete tools for members to put into action; and create a peer forum for growth through sharing experiences and challenging each other with discussion.</p> <p>Members of the 2023 cohort are: </p> <ul> <li>Melody Braun, Faculty Affairs </li> <li>Audra Bright, Medical & Molecular Genetics </li> <li>Danielle Bruno, Family Medicine </li> <li>Rose Case, Medical & Molecular Genetics </li> <li>Wendy Crandall, Office of the Dean </li> <li>Jessica Darling, Clinical & Pediatric Education </li> <li>Jalysa King, Family Medicine </li> <li>Demetrius Logwood, Human Resources </li> <li>James Lyons, Human Resources </li> <li>Jose Martinez, Financial Services </li> <li>Leslie Miller, Endocrinology </li> <li>Erin Orr, Human Resources </li> <li>Natalie Rollman, Family Medicine </li> <li>Trent Shaffer, Medical & Molecular Genetics </li> <li>Sarah VanHeiden, Radiology & Imagining Services </li> <li>Sierra Vaughn, Family Medicine </li> </ul> <p> </p> <h1> Highlighted Discoveries & Recognition of Grant Awards</h1> <p> <a href="/faculty/276/foroud-tatiana">Tatiana Foroud, PhD</a>, executive associate dean for research affairs, highlighted discoveries published in high impact journals and federal grants. In March, IU School of Medicine recognized 169 new federal grant awardees for 2022, including 61 first-time recipients and 30 recipients of multiple grants. In the first two quarters of 2023, IU School of Medicine has received a total of $43.3 million in federal funding for 81 research grants. The majority, 82%, came from the National Institutes of Health (NIH). Grant recipients included 88 primary investigators, including six with multiple grants and 16 with their first grants with IU School of Medicine. </p> <p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/new-grant-awards-reception-2023.jpg?h=215&w=425&rev=abb9c8769b4b4d6da12ff3411f83b586&hash=F4043D5FD9E0B576110897482783A4ED" style="height: 215px; width: 425px;" alt="Tatiana Foroud toasts new grant recipients" class="float-right" /></strong></p> <h3>New trainee grants:</h3> <ul> <li>Leslie Wagner (F31) </li> <li>Allyson Dir (K23) </li> <li>Dustin Hammers (K23) </li> <li>Lauren Nephew (K23) </li> <li>Al Hassanein (K08) </li> <li>Dan Peltier (K08, year 2 transferred from Michigan) </li> <li>Anthony Yang (K08, year 5 transferred from Northwestern)</li> </ul> <p> </p> <h3>New large grants with funding over $1 million/year: </h3> <ul> <li><strong>Sharon Moe, MD, and Sarah Wiehe, MD, MPH:</strong> NIH CTSA (renewal), Indiana Clinical and Translational Sciences Institute </li> <li><strong>Anthony Firulli, PhD:</strong> NIH P01 (renewal), Morphogenesis and Growth of the Ventricular Wall in Development and Disease </li> <li><strong>Brian Dixon, PhD, and Shaun Grannis, MD:</strong> CDC (new grant), Advancing the Epidemiology and Management of Post-COVID-19 Conditions through Surveillance and Research </li> <li><strong>David Kareken, PhD:</strong> NIH P60 (renewal), Center on Genetic Determinants of Alcohol Ingestion and Responses to Alcohol </li> <li><strong>Randy Brutkiewicz, PhD, and Xiaoming Jin, BMED, PhD:</strong> US Army, Prevention of Post-traumatic Epilepsy by Inhibiting the Initiation of Innate Immune Reaction </li> <li><strong>Wade Clapp, MD:</strong> Department of Defense, Identifying and Testing Molecular Therapies for Schwannoma</li> </ul> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0360_websize.jpg?h=253&w=450&rev=484503214b834aceb34293b6a99a88a7&hash=4BD28E2C14D4541C0343F7C3F59B1B9C" style="height: 253px; width: 450px;" alt="Dr. Tatiana Foroud presents at the Fall All School Meeting." class="float-left" />  <h3> New training grants: </h3> <ul> <li><strong>Michael Eadon and Desta Zeruesenay:</strong> T32, Indiana University Comprehensive Training in Clinical Pharmacology (renewal) </li> <li><strong>Sheri Robb:</strong> K12, CTSA K12 Program at Indiana University (new) </li> <li><strong>Ben Gaston and Brittney-Shea Herbert:</strong> T32, Indiana Medical Scientist/Engineer Training Program (renewal) </li> <li><strong>Gustavo Arrizabalaga and Tom Hurley:</strong> T32, Initiative for Maximizing Student Development (IMSD) at IU School of Medicine through Inclusive Biomedical Research Training Program (new) </li> <li><strong>Wade Clapp and Carmella Evans-Molina:</strong> K12, Indiana Pediatric Scientist Award (new)</li> </ul> <p> </p> <h3> High Impact Publications</h3> <p> IU School of Medicine researchers authored 625 publications in high-impact journals in 2022 and 343 in the first half of 2023. Foroud highlighted four recent publications advancing knowledge in heart disease, hemophilia, testicular cancer and blood disorders: </p> <ul> <li>Circulation: “<a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36382596/" target="_blank">Cardiac Troponin I-Interacting Kinase Affects Cardiomyocyte S-Phase Activity but Not Cardiomyocyte Proliferation</a>” (<a href="/sitecore/content/iu/iu-som/home/faculty-labs/field">Loren Field lab</a>)</li> <li>Blood: “<a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/37192286/" target="_blank">Factor VIII trafficking to CD4+ T cells shapes its immunogenicity and requires several types of antigen-presenting cells</a>” (<a href="/sitecore/content/iu/iu-som/home/faculty-labs/herzog">Roland Herzog lab</a>)</li> <li>Journal of Clinical Oncology: “<a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/36730902/" target="_blank">Primary Retroperitoneal Lymph Node Dissection for Stage II Seminoma: Is Surgery the New Path Forward?</a>” </li> <li>Blood: “<a rel="noopener noreferrer" href="https://pubmed.ncbi.nlm.nih.gov/35772013/" target="_blank">Physioxia-induced downregulation of Tet2 in hematopoietic stem cells contributes to enhanced self-renewal</a>” (<a href="/faculty/13517/kapur-reuben">Reuben Kapur lab</a>)</li> </ul> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-dean-ceremony_0476_websize.jpg?h=367&w=650&rev=0d21958828464fb88da952b456f20a64&hash=83CB63355893814DC6C300EAFBA0B158" style="height: 367px; width: 650px;" alt="Reception after the all school meeting" /></p> <strong>Did you miss the meeting? </strong>Anyone with an IU login may view a recording of the full <a rel="noopener noreferrer" href="https://iusm.mediaspace.kaltura.com/media/Fall+All+School+Meeting++September+12%2C+2023/1_jmxgngkq/184001721" target="_blank">Fall 2023 All-School Meeting</a>.</div>Tue, 12 Sep 2023 00:00:00 Z{11072997-F791-4D8C-BB4C-DB2EFA58628E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/dangerous-ignoranceDangerous Ignorance: What Patients Don’t Understand about Pharmacogenomics<p>Do you know what pharmacogenomics is? You might not, but you should, and all patients should. Pharmacogenomics (pronounced pharma-co-genomics), which we’ll abbreviate PGx, may well be the first type of genetic testing you will get. PGx checks for genes that interfere with the body’s response to certain medications, either reducing their effectiveness or increasing side effects. For instance, some people have a gene that stops a blood thinner called clopidogrel (or “Plavix”) from working. The result can be dangerous or even life threatening since clopidogrel is often prescribed to to keep blood flowing through cardiac stents that have been recently placed. Some people have a gene that makes common pain killers like codeine or hydrocodone more potent, potentially causing an overdose at even a low starting dose. If a provider knows that their patient has one of these genes, they can prescribe other medications or adjust the dosage.<br /> <br /> Over 250 medicines currently have PGx testing listed on their FDA-approved labeling. One study found that 63% of adults and 29% of children with pharmacy insurance coverage were prescribed medicines that were significantly affected by their genes (Liu et al. 2021) . Another study predicted that 99% of over seven million veterans had at least one genetic variant that could affect how medicines work for them. (Chanfreau-Coffinier et al. 2019).   <br /> <br /> PGx testing is not yet common in health care, though, for a number of reasons. One challenge is its price and getting insurance to pay for it, despite some evidence that PGx in the right settings could save money in the long run. Another big barrier is getting the results to providers and teaching them how to interpret the results and respond.  <br /> <br /> Another barrier is teaching patients about their test results and what they mean, so they will know which medicines they can’t take or should take differently from other people and why. Our team, led by <a rel="noopener noreferrer" href="https://bioethics.iu.edu/people/tom-doyle.html" target="_blank">Tom Doyle, PhD</a>, a post-doctoral fellow at IUCB, and <a rel="noopener noreferrer" href="https://bioethics.iu.edu/people/peter-schwartz.html" target="_blank">me</a> just published a paper that studied, for the first time, how well patients understand the results of their own PGx testing. The paper appears online in a journal called Patient Education and Counseling and can be accessed for free <a rel="noopener noreferrer" href="https://www.sciencedirect.com/science/article/pii/S0738399123002847?dgcid=author" target="_blank">here</a>.<sup></sup> (full citation in endnote) <br /> <br /> Here's the story: Thanks to a program funded by the IU Precision Health Initiative, patients at IU Health who are having cardiac catheterization now get tested for the CYP2C19 gene, the one that can change the effectiveness of clopidogrel (Plavix). Providers get the results through the electronic health record, and patients are sent a brochure, letter, and wallet card telling them about the result and what it means. Our team interviewed 31 patients to assess whether they know what PGx is, that they had PGx testing, and what their results are, including what the results could mean for their future healthcare.  <br /> <br /> The bottom line is that, sadly, the patients we interviewed didn’t know much. Only 4 of the 31 (13%) recognized the term “pharmacogenomics” and were able to give an acceptable definition of it. After being told what PGx is, only 10 of the 31 (32%) knew they had undergone this sort of testing. None knew the name of the gene that was tested, but 7 (23%) knew whether the result indicated that there are some medicines that might have lower effectiveness or unusual side effects. Four additional patients (13%) had saved the letter or wallet card and looked at it to tell the interviewer what the testing had shown. While only 10 participants (32%) remembered receiving the brochure, letter, or wallet card, these patients gave these materials high ratings. At the end of the interview, many patients said they wanted their future providers to have their PGx results and wanted to understand them as well.<br /> <br /> So, what’s the take home message? In short, healthcare professionals have to do a better job of educating patients about PGx, especially as it becomes more and more a part of everyday practice. It’s essential to get the information to providers, as some experts at IU School of Medicine are doing, using the electronic health record, and it’s essential to teach providers about PGx. PGx will only happen broadly if insurance companies to pay for it.  <br /> <br /> But it’s also essential to find ways to educate patients about what PGx is and what the results mean for their personal, individual health. Whatever systems are in place to get the information to providers, there will be times when these systems fail, and then lives are on the line, since patients could be prescribed medicines that the testing already showed will not work or could even be dangerous. This is particularly important as people move from place to place, and switch health systems, and electronic health records fail to talk to each other.  <br /> <br /> How could patients be educated better? One possibility is telling them more about PGx at the time of their testing and making sure a provider or staff member talks to them about the results afterwards. Providing a letter or wallet card, or some electronic reminder or link – such as a QR code, or something on a patient portal of the electronic health record – could also help.  Even if patients do not always understand the results, they could tell their providers that they were tested and help them find the results.<br /> <br /> I’m proud of our team for clarifying the limits of patient understanding in this area and pointing the field towards the challenge of doing better at educating patients. This is a great example of how increasing patient engagement and understanding is so important to improving care, even as it is so challenging. Our team will continue to work in this area, where improving patient understanding can save lives.</p> <p>This blog was written in reference to: </p> <p>Doyle TA, Schmidt KK, Halverson CME, Olivera J, Garcia A, Shugg TA, Skaar TC, Schwartz PH.  Patient understanding of pharmacogenomic test results in clinical care.  Patient Education and Counseling. <span><a href="https://www.sciencedirect.com/science/article/pii/S0738399123002847?dgcid=author"><span style="color: black;">https://doi.org/10.1016/j.pec.2023.107904</span></a> Free Access Link: <a href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fwww.sciencedirect.com%2Fscience%2Farticle%2Fpii%2FS0738399123002847%3Fdgcid%3Dauthor&data=05%7C01%7Colivnj%40iu.edu%7Cb64edd3652784453874c08dbae7d3600%7C1113be34aed14d00ab4bcdd02510be91%7C0%7C0%7C638295625023883256%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=eijX%2B3MdqrNrBbfnNDmJHS1ArPljMj9npLkw5cR35hM%3D&reserved=0" target="_blank" rel="noopener noreferrer" data-auth="Verified" originalsrc="https://www.sciencedirect.com/science/article/pii/S0738399123002847?dgcid=author" shash="f4AQvdo8YcZxtIb+oV+EYamvRyVi2ZXXMnEEfzlotgkjrtlLpyjSHskNgNlLcq2xBB3Fh7FnAwWybfdFXHwdXV37b9RXPd6/m6FfXc0jtJFvUcS3GLn5BHX9v9I9fj0BKSkJOYxC6VgpS80QfGRck+iLmZcN84d3y+/sGuHMWpI=" title="Original URL: https://www.sciencedirect.com/science/article/pii/S0738399123002847?dgcid=author. Click or tap if you trust this link." data-linkindex="0" style="background-color: rgb(255, 255, 255); margin: 0px; padding: 0px; border: 0px;">https://www.sciencedirect.com/science/article/pii/S0738399123002847?dgcid=author</a></span></p> <div></div>Wed, 30 Aug 2023 00:00:00 Z{36847FF1-6576-499E-A553-B0C7784740C2}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/naloxboxesNaloxBoxes<p> </p> <hr align="left" size="1" width="33%" /> <div> <div id="_com_1" language="JavaScript"></div> </div> <p><span>An odd looking box has shown up at the </span><a rel="noopener noreferrer" href="https://studentaffairs.iupui.edu/campus-center/index.html" target="_blank"><span style="color: rgb(0, 98, 152);">Campus Center</span></a><span style="color: rgb(51, 51, 51);"> </span><span>at Indiana University – Purdue University, Indianapolis (IUPUI) on the first floor in the Vermont Street parking garage.  It’s a </span><a rel="noopener noreferrer" href="https://studentaffairs.iupui.edu/health/wellness-programs/resources/naloxbox-opioid-rescue-kits.html" target="_blank"><span style="color: rgb(0, 98, 152);">24/7 “Opioid Rescue Kit” filled with naloxone nasal spray</span></a><span>, and seeing it should make us all ecstatic. There’s also a vending machine filled with free naloxone nasal spray bottles at the Eskenazi West 38<sup>th</sup> St. clinic, repurposed from selling snacks, to giving away these free devices.  These boxes and machines known as NaloxBoxes will save lives, help address an enormous public health problem, and could improve understanding and rational responses to drug addiction. While bioethics often focuses on debates and dilemmas, this is a case of clearly ethical action. Some people have concerns about NaloxBoxes and the attitude they reflect, which I will describe and try to address here, but let me explain why we should all embrace this approach..</span></p> <p><span style="white-space: pre;"> </span>In 2021 and 2022, there were more than <a rel="noopener noreferrer" href="https://www.in.gov/health/overdose-prevention/overdose-surveillance/indiana/" target="_blank">2,000</a> deaths each year from drug overdose in Indiana alone, a majority being in Marion County.   This number would have been higher without naloxone, a medicine that blocks the effects of opioids and is effective in treating overdoses. Naloxone, commonly known by the brand name Narcan, is an FDA-approved medication that binds to opioid receptors to block the effects of opioids; such as heroin, morphine, or oxycodone. Naloxone can be administered through intranasal spray or injected into a muscle, vein, or under the skin. The benefit of naloxone is that it is safe to administer to a person even if they are not overdosing. However, one drawback is that it wears off 30 to 90 minutes after administration, so the life-threatening effects of an overdose can return after this time. Treating an overdose sometimes requires multiple doses of naloxone, which is why it is crucial to seek medical help immediately after administering it. </p> <p><span style="white-space: pre;"> </span>Naloxone is available through emergency medical services and in some areas through pharmacies (prescription requirements vary), local health departments, or community-based distribution programs. The cost varies depending on where, how, and which form is administered.  Indiana is one of many states that have since acted in fighting the epidemic using <a href="https://nida.nih.gov/publications/drugfacts/naloxone">naloxone</a>. In 2021, Governor Eric Holcomb approved $1.3 million in funding, making it the state’s third investment in naloxone distribution since May 2020. In March 2023, the FDA approved Narcan’s nasal spray for over-the-counter use, thus no longer requiring a prescription, and capped the price at less than $50 for two doses. <br /> These are great steps for getting naloxone out there to save lives, but access remains an immense challenge. The price is an issue: $50 seems a small amount to pay to save a life, but many individuals, including those with opioid addiction, cannot or will not put out that money. Another barrier is that this is not widely accessible; it requires going to the pharmacy to get the medicine and asking a pharmacist for it.  </p> <p><span style="white-space: pre;"> </span>In May 2023 Indiana Health Centers, Inc. (IHC) made the decision to install NaloxBoxes at all their health centers and WIC locations across the state. Other organizations across Indiana are following in these footsteps. Marion County now has <a rel="noopener noreferrer" href="https://www.overdoselifeline.org/naloxone-indiana-distribution/" target="_blank">NaloxBox</a> installations at  Salvation Army, Indianapolis Fire Department stations, various churches, and Eskenazi Health Centers among several other locations, providing the public 24/7 access to free Narcan nasal spray. Vending machines dispensing the nasal spray in larger quantities can be found in locations such as Marion County Jail and the Eskenazi Health Center on 38th St.    </p> <p><span style="white-space: pre;"> </span>These boxes and vending machines are a great step:  People who use drugs or know people who do might notice a machine and pick up naloxone just in case they were to encounter an overdose.  Any of us can find ourselves in a situation where we see someone having an overdose, and if we have naloxone, it can save a life. This is a case where there is innovation in getting medicine to victims that can save lives.  It’s the essence of an ethical step.   </p> <p><span style="white-space: pre;"> </span>Could there be any reason to resist this step?  Some believe that naloxone holds the <a rel="noopener noreferrer" href="https://www.healio.com/news/primary-care/20180402/increased-narcan-availability-evokes-ethical-debat" target="_blank">potential to encourage drug abuse</a> in that it minimizes the consequences and risks of opioid abuse, in that when the risk of death is decreased, then risk-taking behaviors increases, such as the use of higher or more frequent doses, and/or the use of more potent drugs such as Fentanyl.   Some worry about the costs of naloxone distribution, with the concern that it consumes too much of the public’s funding and attention. <br /> Studies indicate that naloxone is cost-effective through <a rel="noopener noreferrer" href="https://ldi.upenn.edu/our-work/research-updates/expanding-access-to-naloxone-a-review-of-distribution-strategies/" target="_blank">various means of distribution</a>, specifically intranasal naloxone -- “one-time distribution of naloxone prevented 14 additional overdose deaths per 100,000 persons, with an incremental cost-effectiveness ratio of <a href="https://pubmed.ncbi.nlm.nih.gov/32327162/#:~:text=Results%3A%20One%2Dtime%20distribution%20of,compared%20with%20one%2Dtime%20distribution">$56,699 per quality-adjusted life yea</a>r”. Despite this high return on investment, opponents of naloxone argue that the cost may still be too high. Those who still oppose the distribution of naloxone despite the cost-effectiveness suggest that “if drug users just got out of the way by dying of an overdose, we’d have less of a problem.”   </p> <p><span style="white-space: pre;"> </span>Researchers and physicians that favor greater naloxone access say that these normative challenges additionally have no effect on the ethical issue at stake; “The moral component here is that a lot of people think drug use is ‘bad’ […] but we don’t deny people health care because they make bad decisions.”  Many who favor naloxone distribution, including addiction specialists, claim that the opposing argument stems from an incomplete understanding of addiction.</p> <p><span style="white-space: pre;"> </span>Most importantly, they emphasize that addiction is a chronic disease, not a choice, as some might think -- and whether it’s a disease or a choice, empathy with the person who’s made the poor choice, and/or suffers from the disease, is the essence of bioethical action. If we can save lives by making naloxone widely available, and it is affordable by at least some reasonable measures, then we should do it and do it as much as possible. The distribution of NaloxBoxes is an inspiration in continuing the fight for more affordable and accessible healthcare.</p> <div></div> <p> </p>Wed, 09 Aug 2023 00:00:00 Z{69CA6E38-7078-4072-BC6D-BCFF59BC4EC3}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/doyle-publishes-in-health-affairs-on-personal-experience-with-decision-aidsDoyle Publishes in Health Affairs on Personal Experience with Decision Aids<p>The last century of medicine has seen stunning advances in technology, clinical techniques, and the structuring of healthcare institutions. Within the last two decades alone, medicine has begun down a road of increasing sophistication by considering how therapies and treatments can be tailored to particular genetic markers, spurring on astonishing medical innovation. However, these advances and innovations come with a trade-off: these advances in medicine increase the number of difficult decisions that patients face. not so long ago, patients with cancer faced only one difficult decision—whether or not to undergo surgery to treat a solid tumor. Now, due to innovation, patients face a dizzying array of decisions. Patients with cancer can now decide whether to undergo surgery, chemotherapy, or radiation treatments. In some cases, patients might decide to undergo all three of these options or none of them. Such decisions, however, are not made easily. Often, navigating through these decisions requires careful consideration of clinical expertise, patient values, and available treatment options. Resources that help guide patients through difficult decisions become invaluable, as they help provide a factual basis from which patients can make informed decisions regarding their medical care. </p><p> I, myself, have personal experience with difficult medical decisions. At 23 years old, I was diagnosed with Hodgkin’s Lymphoma. While this cancer has a remarkably high survival rate, it required that I make a difficult treatment decision. After four rounds of chemotherapy, I was given the option of either undergoing radiation therapy or two additional rounds of chemo. Both options had their own sets of risks. Additional rounds of chemo would further expose me to the toxicity exhibited by these drugs whereas radiation would mean exposing my body to potentially cancer-inducing rays. I ultimately decided to undergo radiation, as I no longer wanted to undergo the side effects associated with chemo. </p><p> Recently, I reflected on my experience with making this decision in a Narrative Matters essay for the journal <i>Health Affairs</i> entitled <a rel="noopener noreferrer" href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2023.00196" target="_blank" id="Helping Cancer Patients Through Difficult Decisions">Helping Cancer Patients Through Difficult Decisions</a>. In this essay, I highlight the need for patients to be provided with resources when they are faced with life-altering treatment decisions like my own. Apart from the clinical expertise and opinions provided to me by my oncologists, I made my decision from a relatively uninformed point of view. As a result, I question whether the treatment decision I made was the best decision for me. In an attempt to remedy this decisional uncertainty for future patients, I highlight the need for high-quality patient decision aids to be developed and implemented in clinical care. </p><p> Patient decision aids provide patients with factual, evidence-based information regarding various treatment options and their outcomes. Additionally, these aids help patients recognize or clarify their personal values to assess which options are aligned with them. Often, these aids can assist patients and physicians engage in shared decision-making by providing patients with a resource that they can refer to when discussing treatment options with their physicians. </p><p> In the essay, I argue that the distribution of decision aids should become a standard-of-care practice in certain clinical situations. I reason that, before making decisions that could have an outsized impact on one’s future health, patients should be able to carefully consider the assorted options that are available to them. Properly designed and implemented decision aids provide patients with these options in a manner that is both factually informative and clarificatory of personal values. </p><p> <a rel="noopener noreferrer" href="https://decisionaid.ohri.ca/" target="_blank" id="decision aid link">Find more information about decision aids.</a> </p>Mon, 17 Jul 2023 00:00:00 Z{DA96AACF-3CC1-4575-BF71-70AE0895B331}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/july-2023-newsletterJuly 2023 Newsletter<h4>Cardiovascular Institute</h4> <p><em>One diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision. </em><br /> <br /> <strong>New Section </strong><br /> Please see the end of this issue for a new educational section with clinical news you can use in your practice today. <br /> <br /> <br /> </p> <h3> Connect to Purpose</h3> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/ilonze-and-patient.jpg?h=394&w=500&rev=da3f13199ace47ab833f5205faaf44d0&hash=4B25F69D290CD15FFB588122F12DDF94" style=" height:394px; width:500px" alt="Dr. Onyedika Ilonze and Mr. David Wilkerson" />  <h2>Indy resident completes Mini-Marathon nearly a year after heart transplant</h2> <p>David Wilkerson, an IU Health patient, was put on ECMO, the highest form of life support in February 2022 after his defibrillator fired five times. That same month, David received a heart transplant at IU Health Methodist Hospital by his surgeon, <a href="https://iuhealth.org/find-providers/provider/kashif-saleem-md-2685255">Kashif Saleem, MD</a>.<br /> <br /> In May, David successfully completed the OneAmerica 500 Festival Mini-Marathon, pictured at the finish line with his cardiologist, <a href="https://iuhealth.org/find-providers/provider/onyedika-j-ilonze-md-885481">Onyedika Ilonze, MD</a>. "Running is part of my healing process," Wilkerson said. "The recovery has been far more mentally challenging than physically. And I'm grateful that I get a second chance at life and an opportunity to continue doing what I love."<br /> <br /> <a href="https://www.wthr.com/article/news/community/500-festival/43-year-old-enters-indy-mini-nearly-a-year-after-heart-transplant-david-wilkerson-oneamerica-marathon-indianapolis/531-ea0dafce-fed4-4ab4-8505-5a17a0e6a27f">Read the full story</a></p> <p><a href="https://www.wthr.com/article/news/community/500-festival/43-year-old-enters-indy-mini-nearly-a-year-after-heart-transplant-david-wilkerson-oneamerica-marathon-indianapolis/531-ea0dafce-fed4-4ab4-8505-5a17a0e6a27f"></a><br /> <br /> </p> <h3> News</h3> <p> </p> <h2> IU Health hospitals honored with platinum American College of Cardiology award</h2> <p>IU Health Arnett, Ball Memorial, Bloomington, Methodist, North, Saxony and West hospitals were all recently honored with a platinum performance award from the American College of Cardiology for participating in the Chest Pain MI registry. The award recognizes the hospitals' success in implementing high quality standard of care to heart attack patients. <br /> <br /> </p> <h2> IU Health Ball Memorial Cardiopulmonary Rehab Center receives Ball State community partner award</h2> <p>The IU Health Ball Memorial Hospital Cardiopulmonary Rehabilitation Center recently received the Ball State University 2023 Outstanding Community Partner Award. The award is presented to a local organization that has demonstrated excellence as a collaborator and co-educator with Ball State faculty, students and staff. This partnership has been a long-standing relationship and had positively impacted many in the community. IU Health Ball Memorial's commitment and service to Ball State University has enriched students' immersive learning experiences and has improved quality of life for many participants. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/iu-health-ball-memorial.jpg?rev=054319343e13472480849aa0a8c584b6&hash=F6A97AA1BAFF1A1EB7AF3A5573E560FF" style=" height:350px; width:577px" alt="IU Health Ball Memorial Cardiopulmonary Rehab Team" /><br /> <br /> </p> <h2>IU Health Bloomington Hospital celebrates a milestone</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/capture.jpg?h=397&w=292&rev=510202d082fd4e329617479035964d66&hash=5196C753201367360DE0EEAFABE721F8" style=" height:397px; width:292px" alt="Kyle Hornsby, MD" class="float-left" /> <p><a href="https://iuhealth.org/find-providers/provider/kyle-p-hornsby-md-6818">Kyle Hornsby, MD</a>, hit a milestone on May 25 - his 100th placement of the world's smallest pacemaker. Kudos to Dr. Hornsby and the EP team in the south central region for making a positive difference and for providing this life-changing procedure to these 100 patients!</p> <p> <br /> <br /> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <h2>Indiana School of Medicine and IU Health use new heart ultrasound technique to detect coronary disease in liver transplant candidates</h2> <p>Indiana School of Medicine and IU Health use new heart ultrasound technique to detect coronary disease in liver transplant candidates</p> <p> IU Health is one of the nation's leading institutions performing life-saving liver transplants. Detection and treatment of heart artery blockages in advanced liver disease patients with coronary artery disease is a critical step in preparing these patients for transplant surgery. <br /> <br /> Visual assessment of heart muscle contraction by ultrasound during exercise stress or other forms of stress have been a traditional means of detecting coronary disease. Unfortunately, this method is less reliable in patients with advanced liver disease, sometimes detecting only 25% of liver patients who have known coronary disease. <br /> <br /> <a href="https://medicine.iu.edu/faculty/38340/anderson-wesley">Dr. Wesley Anderson</a>, a senior cardiology fellow, <a href="https://medicine.iu.edu/faculty/4952/feigenbaum-harvey">Dr. Harvey Feigenbaum</a>, distinguished professor of medicine, and the Methodist Hospital cardiac ultrasound and stress test staff performed a study utilizing a new, quantitative heart ultrasound technique for detection of coronary disease in 146 liver transplant candidates. The new technique, called strain imaging, automatically measures changes in heart muscle contraction during stress rather than relying on visual assessment by a trained expert. Their investigation showed that strain imaging improved detection of coronary disease to 78% from 28% using conventional visual analysis.<br /> <br /> Their study was published earlier this spring in the <a href="https://www.onlinejase.com/article/S0894-7317(23)00095-0/fulltext">Journal of the American Society of Echocardiography</a>, one of the world's leading cardiovascular publications. The technique of strain imaging is now being routinely applied in the evaluation of candidates for liver transplantation at IU Health. <br /> <br /> </p> <h3>Welcome to our Team</h3> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/nabeel-el-amir.jpg?h=309&w=250&rev=72326bc30fb84271a39d5724c2c7eafb&hash=E196C576DD19DA38DA891B3DB33DFB10" alt="Nabeel El-Amir, MD" class="float-left" style="height: 309px; width: 250px;" /> <p>Please join us in welcoming <a href="https://iuhealth.org/find-providers/provider/nabeel-g-el-amir-md-3269909">Nabeel El-Amir, MD</a>, as our newest cardiothoracic surgeon at Indiana University Health Ball Memorial Hospital. Dr. El-Amir earned his bachelor's degree and medical degree from Syracuse University. He completed his residency at the University of Michigan and fellowship in cardiothoracic surgery at Columbia-Presbyterian Medical Center. Dr. El-Amir previously practiced at Michigan Medicine in Muskegon as well as Sparrow Health System as a cardiovascular and thoracic surgeon and Mohawk Valley Health System as the medical director of the Cardiothoracic Surgeon and Lung Cancer Program. He is certified by the American Board of Surgery and the American Board of Thoracic Surgery. <br /> <br /> Outside of work, Dr. El-Amir enjoys jogging, swimming, basketball, automotive mechanics and repair and antique cars. </p> <p> </p> <h3> Krannert Cardiovascular Research Center</h3> <p> </p> <h2> Krannert Biennial garners praise from CV researchers</h2> <p>This past May, the Krannert Cardiovascular Research Center at Indiana University School of Medicine and the IU Health / IU School of Medicine Cardiovascular Institute hosted nearly 200 cardiovascular researchers and clinicians for the inaugural Krannert Biennial at the Eiteljorg Museum of American Indiana and Western Art in Indianapolis. <br /> <br /> The event included approximately 20 top cardiovascular speakers, including a special lecture by Valentin Fuster, MD, PhD, president of Mount Sinai Heart and physician-in-chief of the Mount Sinai Hospital as well as a look at regional STEMI care at IU Health, offered by <a href="https://iuhealth.org/find-providers/provider/nathan-d-lambert-md-7528">Nathan D. Lambert, MD</a>, an interventional cardiologist at IU Health and an assistant professor of clinical medicine at IU School of Medicine. Several other IU physicians and scientists spoke or moderated at the event, including <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Rohan Dharmakumar, PhD</a>, <a href="https://medicine.iu.edu/faculty/4906/field-loren">Loren Field, PhD</a>, <a href="https://medicine.iu.edu/faculty/60685/vora-keyur">Keyur Vora, PhD</a>, <a href="https://medicine.iu.edu/faculty/5070/kreutz-rolf">Rolf Kreutz, MD</a>, <a href="https://medicine.iu.edu/faculty/47775/raman-subha">Subha Raman, MD, MSEE</a>, <a href="https://medicine.iu.edu/faculty/4943/kovacs-richard">Richard Kovacs, MD</a>, <a href="https://medicine.iu.edu/faculty/44682/guglin-maya">Maya Guglin, MD</a><a href="https://medicine.iu.edu/faculty/44682/guglin-maya">, PhD</a>, <a href="https://medicine.iu.edu/faculty/4905/das-mithilesh">Mithilesh Das, MD</a> and <a href="https://medicine.iu.edu/faculty/61331/breathett-khadijah">Khadijah Breathett, MD</a>. Dr. Dharmakumar, executive director of the Krannert Cardiovascular Research Center, shared his groundbreaking research on hemorrhagic myocardial infarction. <br /> <br /> Seasoned scientists in attendance praised the scientific program and organization of the event, saying the Krannert Biennial "has been among the best meetings they have attended in decades," Dharmakumar said. There has also been interest to share the content of this event with the National Institutes of Health and leading cardiology research journals. <br /> <br /> The Krannert Biennial also featured an early investigator competition and poster session, where Shing Fai Chan, PhD, assistant research professor of medicine, received first place. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/biennial-audience.jpg?rev=7b5516a9e68446ec997c5f3f68c4f7cb&hash=F5698465167C1370F517BB9975D09731" style=" height:283px; width:500px" alt="Krannert Biennial Audience" /></p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/krannert-biennial-group-photo.jpg?rev=e55a9a176fea4dee800177ad9755b058&hash=6663DB972A798A3C5A63614F7A56A2C8" style=" height:332px; width:500px" alt="Krannert Biennial Group Photo" /></p> <p> </p> <h2> Krannert Biennial Early Investigator winners announced</h2> <p>Early investigators who attended the inaugural Krannert Biennial hosted by the Cardiovascular Institute and the Krannert Cardiovascular Research Center at the Indiana University School of Medicine had the opportunity to display posters for the Early Investigator Competition and be considered for an oral presentation during the conference that brought in leading cardiovascular researchers and clinicians from all over the world. <br /> <br /> <a href="https://medicine.iu.edu/faculty/41438/chan-shing-fai">Shing Fai Chan, PhD</a>, an investigator for the Krannert Cardiovascular Research Center at the IU School of Medicine, received 1st place honors for his presentation, "Hemorrhagic Myocardial Infarction Drives Lipomatous Metaplasia of Infarcted Myocardium". IU cardiovascular disease fellows <a href="https://medicine.iu.edu/faculty/38340/anderson-wesley">Wesley Anderson, MD</a> and <a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Asad Torabi, MD</a>, with the Division of Cardiovascular Medicine, received 2nd and 3rd place, respectively. <br /> <br /> Participants included <a href="https://medicine.iu.edu/faculty/38340/anderson-wesley">Wesley Anderson, MD</a>, <a href="https://medicine.iu.edu/faculty/41438/chan-shing-fai">Shing Fai Chan, PhD</a>, <a href="https://www.linkedin.com/in/conner-earl-160bb4b4">Conner Earl, MD/PhD student</a>, <a href="https://medicine.iu.edu/faculty/20268/gruionu-gabriel">Gabriel Gruionu, PhD</a>, Yuheng Huang, graduate student, <a href="https://medicine.iu.edu/faculty/38290/kauth-mark">Mark R. Kauth, MD</a>, <a href="https://cns-nrt.indiana.edu/students/trainees/2020/Varun-Rao.html">Varun Rao, PhD</a>, <a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Asad J. Torabi, MD</a>, each from IU School of Medicine, and Heesom Lim, PhD, from Lawson Health Research Institute, and Benjamin Wilk, PhD, from Western University Canada. <br /> <br /> Congratulations to all the young investigators! </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/krannert-biennial-abstract-winners.jpg?rev=a45d5e4f5969457689f223d05e43d351&hash=0AA98F897AA067DBB0D78D08F2B82D26" style=" height:375px; width:500px" alt="Krannert Biennial Abstract Winners" /><br /> <br /> </p>   <h2>Krannert cardiovascular researcher receives NIH-NHLBI research grant</h2> <h2><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/chen-zhenhui72123.jpg?h=309&w=206&rev=e807474508c645da871efdb57d1bb8bc&hash=54E8AE4DB1B29F94935AF111FAF783AC" alt="Zhenhui Chen, PhD" class="float-left" style="height: 309px; width: 206px;" /></h2> <p>Congratulations to <a href="https://medicine.iu.edu/faculty/4842/chen-zhenhui">Zhenhui Chen, PhD</a>, associate professor of medicine at the Indiana University School of Medicine and an investigator for the Krannert Cardiovascular Research Center, who was recently awarded a $2.58 million R01 grant for his research, "Critical Sorting Steps and Pathways in the Trafficking of Cardiac Sarcoplasmic Reticulum Proteins (R01HL169877)," from the <a href="https://www.nhlbi.nih.gov/">National Heart, Lung, and Blood Institute of the National Institutes of Health</a>. Chen's research aims to understand how membrane proteins are selectively distributed to different compartments in heart muscles, so they can perform specific functions in health and diseased hearts in men and women. The goal of his research is to identify and design new drug therapies targeting the selective shipment of these proteins to relieve adverse symptoms of heart disease. The study term will run through 2027. </p> <p> </p> <h3> Kudos</h3> <p> </p> <h2> IU Vascular Surgery resident receives SVS Foundation Vascular Initiatives Conference Trainee Award</h2> <p>Under the mentorship of <a href="https://medicine.iu.edu/faculty/17006/murphy-michael">Michael Murphy, MD</a>, IU vascular surgery resident, <a href="https://medicine.iu.edu/resident/44504/samra-humraaz">Humraaz Samra, MBBCH, BAO</a>, recently received the 2023 Society for Vascular Surgery (SVS) Foundation Vascular Research Initiatives Conference (VRIC) Trainee Award for his abstract, "Allogeneic Mesenchymal Stromal Cells Significantly Increase Type 1 Regulatory T-cells, Decrease Effector Th17 Cells, And Decrease Aneurysm Volume In A Dose Dependent Fashion In Patients With Small Abdominal Aortic Aneurysms - Results Of The Phase I Aneurysm Repression With Mesenchymal Stromal Cells (the Arrest Trial)”, which was presented at the annual conference in Boston, Massachusetts on May 10, 2023.<br /> <br /> Dr. Samra's work was also published in the <em>American Heart Association</em> <a href="https://newsroom.heart.org/news/abdominal-aortic-aneurysm-new-treatment-may-reduce-size-covid-infection-may-speed-growth">newsletter</a>. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/dr-humraaz-samra-2.jpg?rev=0dd5a0e6af8d427794887d5fd200c56e&hash=30FB1C4162C87618E62D262734D7C3A8" style=" height:375px; width:500px" alt="Dr. Michael Murphy and Dr. Humraaz Samra" /><br /> <br /> </p> <h2>2023 IUHP Nurse Excellence Award</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2023/achd-nurse-nikki-bradley.jpg?h=333&w=250&rev=71af58853d554560b9a5e74f1f72e1d2&hash=2012E7E404C5C96DE351C229176BA588" style=" height:333px; width:250px" alt="ACHD Nurse, Nikki Bradley, RN" class="float-left" /> <p>Cheers to <a href="mailto:nbradley2@iuhealth.org">Nikki Bradley, RN</a>, clinical nurse-ambulatory navigator at IUHP Cardiology, for receiving the 2023 IUHP Nurse Excellence Award! <br /> <br /> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <h3>Clinical News You Can Use</h3> <p>Did you know at least half of all patients with heart failure have a normal ejection fraction? Click the link below to view the educational bundle to help you improve diagnosis and treatment of patients with heart failure with preserved ejection fraction (HFpEF). </p> <p> <a href="https://indiana-my.sharepoint.com/:b:/g/personal/lsamboy_iu_edu/EZKLU62YBTNDrcrN1wLfHKkBlSkJoBmUZ61zJiFL0wwWyQ?e=ipVc1D">HFpEF Education Bundle</a><br /> <br /> <br /> <br /> <em>Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email <a href="mailto:oneiucv@iu.edu">OneIUCV</a> so we can share with the team!</em></p>Fri, 14 Jul 2023 00:00:00 Z{26DAABC5-0080-4BF8-A430-C04A465A767B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/neurosurgery-alum-reflects-on-robust-medical-education-at-iuNeurosurgery alum reflects on robust medical education at IU<p><span>Robert B. Sloan, MD, looks back on his time at Indiana University fondly.</span></p> <p><span>The Indianapolis physician spent his entire higher education career at IU. He earned his bachelor’s degree at IU-Bloomington and completed his medical degree and residency at IU School of Medicine. </span></p> <p><span>Sloan, who is the sole neurosurgeon at Community Hospital East, carried out the bulk of that time at IU studying medicine, specifically neurosurgery. As a resident in the <a href="https://medicine.iu.edu/neurological-surgery">Department of Neurological Surgery</a> from 2000-2006, Sloan said he studied neurosurgery “during the perfect time.” He said he received a classical medical education in his residency, and he was taught and experienced newer technologies making their way into the field of neurosurgery at the time.</span></p> <p><span>“I can do it the old school way, and I can do it the new school way,” Sloan said. “I got great training at IU.”</span></p> <p><span>Studying medicine wasn’t the first choice for Sloan. He was a finance major at IU as an undergraduate student and then worked for his father’s company before making a career change to medicine. Ever since graduating from IU School of Medicine, Sloan has been practicing general neurosurgery at Community Health Network in Indianapolis.</span></p> <p><span>Reminiscing on his time at IU School of Medicine, Sloan said each of the faculty physicians had their own strengths, providing him with a well-rounded education. </span></p> <p><span>Paul B. Nelson, MD, the department chair at the time of Sloan’s residency, taught Sloan to treat patients conservatively: first do a thorough physical exam and determine their core issue before beginning surgery. Sloan said Nelson’s goal for patients wasn’t to immediately operate but instead get to know the patient and their problem on a deeper level to make the best decision.</span></p> <p><span>“In today’s world, some people get big surgeries when they need a little surgery,” Sloan said. “It takes a lot more work to do a little surgery because you have to go through the process and find out where the exact problem is happening and make a very focused fix to it as opposed to retreating to everything that looks abnormal on the imaging.”</span></p> <p><span>Sloan said the Department of Neurosurgery has a family environment for its residents. He said Nelson set the tone to not only teach neurosurgery well but to take care of and respect residents. They were encouraged to have a life outside of the hospital, Sloan said. Most residents had families and spent time together at homes and participated in hobbies.</span></p> <p><span>That camaraderie of faculty, residents and staff, coupled with a robust neurosurgical education, still has a positive impact on Sloan now nearly two decades since his time at IU.</span></p> <p><span>“To this day, in the back of my head when I’m looking at patients, I hear my teachers, like Dr. Scott Shapiro, <a href="https://medicine.iu.edu/faculty/13463/shah-mitesh">Dr. Mitesh Shah</a> and Dr. Nelson, reminding me about the core values that they taught me, and I don’t forget that,” Sloan said.</span></p> <p><span>Sloan treat patients at Community Hospital East with a myriad of neurological ailments as a general neurosurgeon, and most of his practice is spent seeing patients with spinal cord issues. He continues to collaborate with the Department of Neurological Surgery by building referral relationships with IU neurosurgeons to treat patients that need more specialized care.</span></p> <p style="margin-left: 0in;"><span>“It’s been a good relationship,” Sloan said. “As much as I can send down to IU, I do.”</span></p>Wed, 28 Jun 2023 00:00:00 Z{13CB99E0-6A68-4DDE-BCE5-F58ADB4AF485}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/new-iu-cardiovascular-fellowship-program-to-boost-innovationNew IU Cardiovascular fellowship program to boost innovationThe Indiana University School of Medicine in cooperation with the Cardiovascular Institute (CVI) and CVI’s research pillar, the Krannert Cardiovascular Research Center (KCVRC), will launch a new cardiovascular (CV) fellowship program this summer that will fuel innovation in cardiovascular medicine. The<a rel="noopener noreferrer" href="https://medicine.iu.edu/internal-medicine/specialties/cardiovascular-medicine/fellowship/cardiovascular-innovations" target="_blank"><strong> Anderson Cardiovascular Innovation Fellowship</strong></a> is a 12-month training program designed to develop fellows from novice physicians to highly skilled cardiovascular innovators. <p>Fellows select an area in which to focus on across the CV spectrum, including coronary and ischemic heart disease, structural heart disease, heart failure, aortic disorders, peripheral vascular disease, rhythm disorders and CV risk and prevention.<span>  </span></p> <p>“To address unmet needs in the cardiovascular health of the diverse populations we serve, we need more professionals equipped with the skills to develop innovations that overcome a broad range of challenges in today’s approaches to health care. This means learning how to recognize unmet clinical needs, break them down into solvable problems and assemble the appropriate talent to develop innovative solutions,” said cardiologist and physician-scientist <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/47775/raman-subha" target="_blank">Subha V. Raman, MD</a>, CVI director, chief of the IU School of Medicine Division of Cardiovascular Medicine, and vice president for Cardiovascular Service at IU Health. </p> <p>During their training, fellows will: </p> <ul> <li>Recognize a key unmet need in cardiovascular medicine and curate a problem statement;</li> </ul> <ul> <li>Work with mentors and multidisciplinary teams in designing experimental procedures to advance innovative solutions; and</li> </ul> <ul> <li>Learn what it takes to incubate and integrate innovative solutions into clinical practice. </li> </ul> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/centers/cardiovascular/shah_chirag-resized.png?h=308&w=220&rev=0db048da082941568e089f2b36c2ad36&hash=A00286FEEFEE0C729523F2A2A1366549" style="width: 220px; height: 308px;" alt="Chirag D. Shah, MD, MPH, named Anderson Cardiovascular Innovation Fellow" class="float-left" /> <p><a rel="noopener noreferrer" href="https://medicine.iu.edu/resident/50282/shah-chirag" target="_blank">Chirag D. Shah, MD, MPH</a>, who specializes in internal medicine and has experience working in cardiovascular research labs, is the first fellow selected to participate in this newly designed fellowship program. As an Anderson CV Innovation Fellow, Dr. Shah will be involved in the cardiovascular care of patients at <a rel="noopener noreferrer" href="https://iuhealth.org/find-locations/iu-health-methodist-hospital" target="_blank">IU Health Methodist Hospital</a> and participate in innovative technology research and development with the KCVRC under the supervision of expert faculty. Dr. Shah will begin his fellowship in July. </p> <p>“I am very honored to be selected as the first Anderson CV Innovation Fellow to contribute to cardiovascular research on behalf of the <a rel="noopener noreferrer" href="https://medicine.iu.edu/institutes/cardiovascular" target="_blank">Cardiovascular Institute</a> and <a rel="noopener noreferrer" href="https://medicine.iu.edu/internal-medicine/specialties/cardiovascular-medicine/research" target="_blank">Krannert Cardiovascular Research Center</a>,” Dr. Shah said. “Currently, I am developing models using artificial intelligence to predict cardiovascular pathologies from EKG and echocardiography data in cooperation with <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/4905/das-mithilesh" target="_blank">Dr. Mithilesh Das</a>, and I look forward to taking these ideas and experiences into the fellowship where I can explore new solutions to support and enhance cardiovascular medicine.” </p> <p>Fellows will have a clinical mentor and R&D mentor tailored to their area of focus. Eligible trainees should have completed a fellowship in adult cardiovascular disease or residency in internal medicine accredited by the Accreditation Council for Graduate Medical Education (ACGME). Currently, the ACGME does not have a direct accreditation pathway for CV innovation training. Upon successful completion of the program, fellows will receive a <strong>Certificate of Advanced Qualifications in CV Innovation</strong>. </p> <p>The fellowship is overseen by Dr. Raman and <span></span><a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan" target="_blank">Rohan Dharmakumar, PhD</a>, executive director of CVI’s Krannert Cardiovascular Research Center. The fellow will also work closely with the IU Health Innovation Team, learning essential skills to translate innovations to clinical impact. </p> <p>“Innovation is a key component to drive new advances in cardiovascular medicine and the Krannert Cardiovascular Research Center is deeply rooted in driving translational science from the laboratories to clinical care for the cardiovascular patient,” Dr. Dharmakumar said. “We are eager to work with selected fellows to test and discover what new solutions may direct the future of cardiovascular care.” </p> <p><span>The Cardiovascular Innovation Fellowship is available through a generous gift from Gary M. Anderson, MD, and his wife, Kathy Ziliak Anderson, during the first two years of the training program. Dr. Anderson is the co-founder and emeritus managing general partner of TL Ventures, a technology investment group, and has served as associate dean of the Hahnemann Medical College, now the Drexel University College of Medicine. He completed his cardiology internship at IU School of Medicine, followed by a residency and fellowship program. Years later, Dr. Anderson taught at the </span><a href="https://kelley.iu.edu/"><span>Kelley School of Business</span></a><span> as part of the Entrepreneurship Faculty at the Johnson Center for Entrepreneurship and Innovation and remains involved in </span><a rel="noopener noreferrer" href="https://iuventures.com/" target="_blank"><span>IU Ventures</span></a><span>. Kathy Anderson is an IU alumna who has served on numerous university boards, including the </span><a rel="noopener noreferrer" href="https://iufoundation.planmylegacy.org/arbutus-society" target="_blank"><span>IU Foundation Arbutus Society</span></a><span>, Women’s Philanthropy Council, as well as the </span><a rel="noopener noreferrer" href="https://music.indiana.edu/" target="_blank"><span>Jacobs School of Music</span></a><span> dean’s national advisory board. Future philanthropic support will be made available through extramural agencies, private foundations, and individual gifts.  </span></p> <p>Applications for the 2024 fellowship program can be submitted via email to the <a href="mailto:plummers@iu.edu?subject=Cardiovascular%20Innovations%20Fellowship">fellowship coordinator</a><span> or to oneiucv@iu.edu</span>. Required application information should include a Curriculum Vitae, personal statement, a two-minute video, transcript and three letters of recommendation. Applications will be accepted through Nov. 1, 2023. <span></span></p> <p> </p> <p style="text-align: center;" align="center">###</p> <p> </p> <br class="t-last-br" /> <br class="t-last-br" />Tue, 09 May 2023 07:00:00 Z{0C6153C4-D9BD-4664-9922-1FD71AD62899}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/dean/2023-2025-strategic-planA closer look at the IU School of Medicine 2030 Strategic Plan<p>Founded in 1903, Indiana University School of Medicine has a long history of innovation and excellence in medical education, research and clinical care to improve health in Indiana and beyond. IU School of Medicine is the largest medical school in the country and the only allopathic medical school in Indiana. Over 6,500 full time and volunteer faculty educate over 2,000 MD, PhD, master’s and undergraduate students along with over 1,100 clinical residents and fellows. The school has been a pioneer in regional medical education, with nine campuses and partnerships with six universities and 50 health systems and clinics to deliver its curriculum. Our faculty developed the cure for testicular cancer, pioneered echocardiography, lithotripsy and umbilical cord transplantation, developed the first electronic medical record, and the country’s first and largest electronic health information exchange. That tradition of research excellence continues today, with our research funding more than doubling over the past decade to over $450 million. </p> <p>IU School of Medicine's primary clinical partner is IU Health (formerly Clarian Health), formed in 1997 as the result of a merger between University Hospital, Riley Children’s Hospital and Methodist Hospital.  IU Health has grown into a 16 hospital, $7.9 billion revenue statewide health system that has twice earned a place on the US News and World Report Honor Roll. Other important partners for IU School of Medicine include Eskenazi Hospital, the Roudebush VA Hospital along with over other 50 hospitals and clinics across the state.</p> <p>The new strategic plan for IU School of Medicine, part of the <strong><a rel="noopener noreferrer" href="https://strategicplan.iu.edu/" target="_blank">IU 2030 Strategic Plan</a></strong>, will be the roadmap for the school to advance excellence in all of its missions while supporting Indiana University’s strategic goals of Student Success and Opportunity, Transformative Research and Creativity, and Service to Our State and Beyond.</p> <p>The IU School of Medicine plan was made possible through the dedication of our faculty, staff and learners across our nine campuses. We are especially grateful to our co-chairs Michelle Artmeier, David Wallace and Sam Yeap who helped gather input from countless members of our community as well as those outside the school. </p> <p>Together with our executive associate deans, Dr. Patricia Treadwell as Special Advisor to the Dean on Diversity affairs, and project manager Katherine Eessalu, this team deserves most of the credit for revising, enhancing and bringing the plan to its current form. </p> <p>As we worked collectively to develop a plan for the School of Medicine, several <strong>cross-cutting themes</strong> emerged. The first was the importance of the School’s <strong>core values</strong> of excellence, respect, diversity, integrity and cooperation—they are fundamental for how we are going to treat each other and how we are going to work together. We need to reinforce them at every opportunity.</p> <p>Secondly, we recognized a need to address the <strong>vitality </strong>of our people, including faculty, staff and learners. We aren’t going to achieve our ambitious goals without their health, well-being and engagement. We have a responsibility to do all we can to prevent burnout, address mental health challenges and help people find meaning and joy in their work. We want to make sure professional development, leadership development and mentorship opportunities are available at all levels of the organization and we will strive to recognize and celebrate accomplishments of people across the school. </p> <p>Third, we heard the importance of <strong>bidirectional communication</strong> with our faculty, staff and learners and broader community including over 20,000 living alumni. Each person working in the school deserves to have clear roles, goals and responsibilities and a clear understanding of what we are trying to accomplish and how they fit into the school’s aspirations. In addition, we want to hear their ideas on how to make the School of Medicine and its work better.</p> <p>Fourth, whether it is improving outcomes for patients, graduation rates for our learners, or the climate in the school, we are going to use <strong>data to make better decisions</strong>. We will identify what data is most significant and useful, create systems for gathering and analyzing that data and most importantly act on that data.</p> <p>Finally, the School of Medicine must be a <strong>diverse </strong>place, reflecting the diversity of the State, where all are included, welcomed and supported—a place where they can be at their best. Through promoting diversity and equity within the school and, where possible, in the communities we serve we will be more successful in our mission of improving health for all. </p> <p><a href="/sitecore/content/iu/iu-som/home/strategic-plan" class="button">Explore IU School of Medicine's Strategic Plan</a></p>Tue, 11 Apr 2023 00:00:00 Z{CBA8399B-3753-4F59-AA61-D6EB9F3E8878}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/krannert-biennial-calls-for-cardiovascular-research-abstracts-from-young-investigatorsKrannert Biennial calls for cardiovascular research abstracts from young investigatorsThis May, the Krannert Cardiovascular Research Center (KCVRC) at the IU School of Medicine and the <a rel="noopener noreferrer" href="https://medicine.iu.edu/institutes/cardiovascular" target="_blank">IU Health/IU School of Medicine Cardiovascular Institute</a> (CVI) will host its Inaugural <a rel="noopener noreferrer" href="https://nam12.safelinks.protection.outlook.com/?url=https%3A%2F%2Fiu.cloud-cme.com%2Fcourse%2Fcourseoverview%3FP%3D5%26EID%3D81651&data=05%7C01%7Ceantonop%40iu.edu%7C38162ffc46374fb0aea208db36ccaddb%7C1113be34aed14d00ab4bcdd02510be91%7C0%7C0%7C638164024977389636%7CUnknown%7CTWFpbGZsb3d8eyJWIjoiMC4wLjAwMDAiLCJQIjoiV2luMzIiLCJBTiI6Ik1haWwiLCJXVCI6Mn0%3D%7C3000%7C%7C%7C&sdata=rc3SLGrILqTLr033m3w7bd7r2Zi2IXLF4g1DVFx%2F7PU%3D&reserved=0" target="_blank">Krannert Biennial</a>, and we would like to encourage all cardiovascular trainees, fellows and junior faculty at the assistant professor level to submit an abstract for our Young Investigator Competition. <p><strong>The Krannert Biennial, “Myocardial Infarction & Reperfusion Injury Conference: New Evidence to Shift Existing Paradigms</strong>,” will take place at the Eiteljorg Museum, 500 W. Washington St, Indianapolis, Indiana, May 12-13. Selected abstracts will be shared and/or presented at 5 pm, Friday, May 12, during Young Investigator Competition.</p> <p>Abstracts must be no more than 350 words and be submitted in a structured format (introduction, objective, methods, result and conclusion) with one figure or one table. Submitted PDFs should include title, author/full names, address (including email of presenting author) and abstract text with figure or table.</p> <p>To be considered, please submit an abstract by <strong>April 28, 2023</strong>, to: <a href="mailto:OneIUCV@iu.edu?subject=Krannert%20Biennial%20Abstract%20Submission">OneIUCV@iu.edu</a> </p>Thu, 06 Apr 2023 00:00:00 Z{9CB8B582-ED7E-4A5F-B3CA-FEFA58380B8B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/february-2023-newsletterFebruary 2023 Newsletter<h3>Cardiovascular Institute </h3> <br /> <em>One diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision. </em> <p><em> </em></p> <h3> BE ON THE LOOKOUT:</h3> <p>In February, eligible physicians will receive an email invitation (from Doximity) to complete the 2023-24 U.S. News & World Report Best Hospitals expert opinion survey and vote for the Best Hospital in Cardiology and Heart Surgery. The survey gives you the opportunity to vote for the top hospitals across the nation. Physicians are eligible to vote if they are board-certified and have a claimed Doximity profile. Please ensure that you have <a href="https://support.doximity.com/hc/en-us/articles/360047630573-How-to-Register-on-Doximity">claimed a profile</a>, as we strongly encourage participation in this year's survey by voting for <span style="text-decoration: underline;">Indiana University Health Medical Center</span>.<br /> <br /> In 2023, results of the expert opinion survey contribute to 24-27% of the adult specialty's ranking. Every vote counts - we hope you choose to further strengthen our hospital's distinction as a prestigious regional and national leader in cardiovascular care.</p> <p> </p> <h3> Top News</h3> <p> </p> <h2>First Thoracic Branch Graft Device Implant</h2> <p><a href="https://iuhealth.org/find-providers/provider/raghunandan-l-motaganahalli-md-8272">Dr. Raghu Motaganahalli</a> and the vascular team performed the first thoracic branch graft device implant procedure on Nov. 8 at IU Health Methodist Hospital. This procedure eliminates the need for a bypass procedure in the neck (left carotid artery to left subclavian artery) and the complications that may be associated with them. This is a less invasive procedure that enables a quick recovery for patients. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/thoracic-branch-graft-device-implant.jpg?h=300&w=600&rev=0a06d13d06bb4fc691eb6c6120a040a0&hash=44859525FF99D85D5D7BCE2924BBAC13" style=" height:300px; width:600px" alt="First Thoracic Graft Device Implant" class="float-left" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <h2>Cardiac Care Blue Distinction Designations</h2> <p>A number of Indiana University Health hospitals have been recognized by Blue Cross Blue Shield as Blue Distinction for providing our patients with safe, effective specialty care, including cardiac care. <br /> <br /> The following hospitals have met nationally established quality care and outcomes criteria developed by the medical community: <br /> <br /> • IU Health Arnett Hospital<br /> • IU Health Ball Memorial Hospital<br /> • IU Health Bloomington Hospital<br /> • IU Health Methodist Hospital</p> <p> </p> <h2> Fellowship Match Results</h2> <p>Following Fellowship Match Day on Dec. 1, we matched 6/6 openings for our Cardiovascular Disease program and 2/2 for our Electrophysiology program. We are excited to welcome a new group of physicians to our fellowship training program starting July 2023!</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/cardiology-fellows-2023.jpg?h=465&w=617&rev=a41f23e90c9b48909e19928dfab9383e&hash=F4FCC520555C157E514E684FB476DA10" style=" height:465px; width:617px" alt="Fellowship Match Results" /></p> <p> </p> <h2>February is American Heart Month</h2> <p>Heart disease continues to be the greatest health threat to American and is still the leading cause of death worldwide. Find great information compiled by the <a href="https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-month/fact-sheets">U.S. National Institutes of Health</a> to help take care of your heart and the hearts of those you love. The <a href="https://www.empoweredtoserve.org/en/community-resources/health-lessons-overview">American Heart Association</a> also has great online heart health lessons for co-workers, family and friends. </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/february-american-heart-month.jpg?h=250&w=450&rev=e449bcf4ccaf4792a697fd4401b83a4e&hash=106E0B6EBA74A2FFB36B59D7A55FA1C6" style="height: 250px; width: 450px;" alt="American Heart Month" class="float-left" /> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/annie-cheek-headshot-2017.jpg?h=250&w=200&rev=da02e031677b4b459b1f52e3a8879a95&hash=65B52661AEC4AFE99BA2394B187498AD" style="height: 250px; width: 200px;" alt="Annie Cheek, Executive Director of the CVI" class="float-left" /> <h3>Welcome To Our Team</h3> <p>Please join us in welcoming <a href="mailto:acheek2@iuhealth.org">Annie Cheek</a>, who now serves as the Executive Director of the Cardiovascular Institute. She comes to us with several years of experience, most recently from Grady Health System where she served as the Vice President of Cardiovascular Services. Annie earned her MBA from Webster University, masters in exercise physiology from Ball State University, and her bachelors in exercise science from Anderson University. Her vision and leadership will be instrumental in the growth of the Cardiovascular Institute. </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <h3>Kudos</h3> <p> </p> <h2> Clinical Trials </h2> <p>Congratulations to <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Dr. Rohan Dharmakumar</a>, whose <a href="https://www.nature.com/articles/s41467-022-33776-x">pre-clinical findings</a> in removing abnormal iron deposits were published in Nature Communications this fall. These iron deposits occur following damage to the heart muscle caused by acute myocardial infarction and in half of patients who undergo reperfusion therapy who experience delayed healing and ongoing fatty degeneration. A first-in-human clinical trial is now underway at IU Health to address hemorrhagic MI. This pilot study tests a novel therapy to efficiently remove the abnormal iron deposits within the heart muscle of hemorrhagic MI patients so that their hearts can be directed toward favorable remodeling and away from major adverse cardiovascular events. The pilot study has the potential to define a disruptive new therapy for heart attack patients that is fundamentally different from other therapies that are available to acute MI patients over the last 40 years.  </p> <p> </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/images/iu/iu-som/home/news/2022/12/acute-heart-attack-clinical-trial/cv-clinical-trial-first-patient-enrolled.jpg?h=345&w=500&rev=dbff549f09ee448482a2527682f55b60&hash=57BE5CCE583CD99B89165A693E011B3F" style="height: 345px; width: 500px;" alt="Keyur Vora, MD, MS, George Revtyak, MD, and Rohan Dharmakumar, PhD with the first patient to enroll in a new cardiovascular clinical trial." class="float-left" /></p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/dr-wayne-gray.jpg?h=225&w=200&rev=661c1e70038a4f9c9004bd551b7c3098&hash=CF6C47176D7CD7D575FD5FF8DE72F064" alt="Dr. Wayne Gray" class="float-left" style="height: 225px; width: 200px;" /> <h2>50 Years of Service!</h2> <div> <p>Congratulations to <a href="https://iuhealth.org/find-providers/provider/wayne-l-gray-md-6374">Dr. Wayne Gray</a> who has been in practice for 50 years at IU Health Ball Memorial Hospital! Over the course of his career, Dr. Gray has made innumerable contributions and has brought IU Health Ball Memorial Hospital to the forefront of cardiac care. He is an eminent figure in cardiology and his work has improved the lives of countless patients, both locally and abroad.</p> <p> </p> <p> </p> <div> <p> </p> <p> </p> <p> </p> <p> </p> <h2> Publications</h2> <p>Atrial fibrosis is thought to play a role in initiating and increasing atrial fibrillation. A way to evaluate the extent of fibrosis becomes important, especially for therapy. One current approach is to use bipolar voltage mapping of the atria, but there are several limitations to this, which are discussed in the recent <a href="https://www.heartrhythmjournal.com/article/S1547-5271(22)02685-6/fulltext">editorial commentary</a> written by <a href="https://medicine.iu.edu/resident/50282/shah-chirag">Dr. Chirag Shah</a> and <a href="https://medicine.iu.edu/faculty/4919/everett-thomas">Dr. Thomas Everett</a> and published in the Heart Rhythm Journal. These include limitations of the electrodes used to measure conduction as well as atrial tissue properties that can make measurements difficult. Additional research is necessary before bipolar voltage mapping could be considered as a guide for ablation therapy. <br /> <br /> </p> <h2> Presentations</h2> <p>In December, <a href="https://medicine.iu.edu/faculty/47578/gonzalez-andrew">Dr. Andrew Gonzalez</a> served as faculty at the 2022 Stanford AI + Health Online Conference during the session, Overcoming Key Barriers to Healthcare Provider Adoption of AI Tools. His panel discussed the recent joint Government Accountability Office/National Academy of Medicine two-part technology assessment on Artificial Intelligence in Healthcare, in a report entitled  "Meeting the Moment: Addressing Barriers and Facilitating Clinical Adoption of Artificial Intelligence in Medical Diagnosis". As a group, the authors expressed concern about the rapid expansion of healthcare AI technologies at the point of care. They provided a model for understanding the key drivers of clinical adoption and key determinants of success. These determinants fell into the domains: (1) reason to use; (2) means to use; (3) method to use; and (4) desire to use. Dr. Gonzalez led the primary responsibility for drafting the "means to use" section on infrastructure. <br /> <br /> </p> <h2> In the Media</h2> <p><a href="https://www.wthr.com/article/news/health/cardiologist-stresses-planning-ahead-to-respond-to-traumatic-injuries-cpr-aed-damar-hamlin/531-a2e18c5d-fad6-4590-a01f-80aac530fb3d">WTHR</a> featured <a href="https://iuhealth.org/find-providers/provider/richard-j-kovacs-md-7412">Dr. Richard Kovacs </a>in a piece about Buffalo Bills safety, Damar Hamlin, who collapsed from cardiac arrest during a football game. Dr. Kovacs said Hamlin's   terrifying injury on national TV can be a teaching moment about having an emergency action plan ready.  <br /> <br /> <a href="https://iuhealth.org/find-providers/provider/william-j-gill-md-6296">Dr. William Gill</a> warns that snow shoveling could trigger a heart attack in this recent <a href="https://www.wishtv.com/news/local-news/iu-health-cardiologist-snow-shoveling-could-trigger-a-heart-attack/">WishTV8 news article</a>. <br /> <br /> <br /> <br /> <br /> <em>Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email <a href="mailto:oneiucv@iu.edu">OneIUCV</a> so we can share with the team!</em></p> </div> </div>Thu, 09 Mar 2023 00:00:00 Z{FD33AABC-D4BD-481A-8648-F8BB28F7481A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/iu-otolaryngology-alumna-recognized-with-endowed-lectureshipIU otolaryngology alumna recognized with endowed lectureship<p><a href="https://medicine.iu.edu/faculty/44507/royer-allison"><span>Allison Royer, MD</span></a><span>, an Evansville-based physician and Indiana University School of Medicine alumna and adjunct clinical assistant professor, will be honored with a lectureship in her name.</span></p> <p><span>The </span><a href="https://medicine.iu.edu/otolaryngology"><span>Department of Otolaryngology—Head and Neck Surgery</span></a><span> is hosting the </span><a href="https://events.iu.edu/medicine/event/856662-1"><span>Inaugural Allison K. Royer Women in Otolaryngology Endowed Lectureship</span></a><span> on March 22, 2023, at IU School of Medicine in Indianapolis. It is one of the first women in otolaryngology endowed lectureships in the country.</span></p> <p><span>Royer, who graduated as valedictorian from IU School of Medicine in 2009 and completed her otolaryngology—head and neck surgery residency at IU in 2014, runs </span><a href="https://www.evansvillesinus.com/"><span>Family ENT Specialists</span></a><span> with her husband, </span><a href="https://medicine.iu.edu/faculty/12760/royer-mark"><span>Mark Royer, MD, MBA</span></a><span>, who was also an otolaryngology resident at IU.</span></p> <p><span>As an advocate and mentor for women in surgery, Royer, an Evansville native, was recognized for her early contributions and career achievements in medicine as an inductee into the </span><a href="https://www.evansvillerotary.com/20-under-40/"><span>Rotary Club of Evansville 20 Under 40</span></a><span> in 2020. Royer has also presented her published research at national and international conferences and consistently receives top patient satisfaction scores.</span></p> <p><span>Royer said her commitment to the Department of Otolaryngology at IU School of Medicine as an adjunct clinical assistant professor at the Evansville campus is due greatly to the impactful leadership of her mentor, </span><a href="https://medicine.iu.edu/faculty/14652/miyamoto-richard"><span>Richard Miyamoto, MD</span></a><span>, professor emeritus, who served as chair from 1987-2014, and her co-resident, </span><a href="https://medicine.iu.edu/faculty/16658/ting-jonathan"><span>Jonathan Ting, MD, MS, MBA</span></a><span>, current department chair.</span></p> <p><span>“We’re so fortunate to have engaged, talented residency alumni like Drs. Mark and Allison Royer part of the IU School of Medicine Otolaryngology family,” Ting said. “Their generosity in endowing this lectureship in perpetuity will provide an opportunity for future generations of trainees and faculty to hear from national thought leaders on how we can best support the career development of female otolaryngologists and those considering careers in otolaryngology—head and neck surgery.”</span></p> <p><span>The inaugural lecture in March will feature Jamie Litvack, MD, MS, faculty lead, surgical subspecialties in the Department of Medical Education and Clinical Services at Elson S. Floyd College of Medicine, and Dana Crosby, MD, MHP, chair of the Department of Otolaryngology—Head and Neck Surgery at Southern Illinois University School of Medicine.</span></p> <p><a href="https://medicine.iu.edu/"><span>IU School of Medicine</span></a><span> is the largest medical school in the U.S. and is annually ranked among the top medical schools in the nation by U.S. News & World Report. The school offers high-quality medical education, access to leading medical research and rich campus life in nine Indiana cities, including rural and urban locations consistently recognized for livability.</span></p>Wed, 01 Mar 2023 00:00:00 Z{FBF166AB-11EA-49C4-91E6-09D8D1268B56}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/november-2022-newsletterNovember 2022 Newsletter<h1>Cardiovascular Institute </h1> <p> <em>One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</em></p> <p> </p> <h3>Connect to Purpose</h3> <p>The IU Health CV Risk and Prevention Quality & Clinical Effectiveness Council is bringing innovations like virtual cardiac rehabilitation to improve patients experiences. Thanks to the leadership of <a href="mailto:kriggin@iuhealth.org">Katrina Riggin</a> in the East Central Region for bringing <a href="https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.114.001230?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed#d1e2120">Virtual Cardiac Rehabilitation</a> to IU Health. Hear directly from a patient on the impact of this program on his life. <br /> <br /> <em>"I just wanted to drop you a note and tell you how well the virtual cardiac rehab is going. Cara, Gary and Leroy have been great to work with! Everyone has been on time, personable, efficient and professional. <br /> <br /> The program itself works very well for someone like me who would have difficulty scheduling three sessions a week at a specific time to come to the hospital for rehab. Being able to log my exercise sessions on the app and have the community paramedics come out once a week has worked really great, along with the other information that is provided in the app, such as nutrition, food shopping, exercise tips, etc. <br /> <br /> This program could be a real asset for individuals who need to exercise on their own and still being held accountable. <br /> <br /> Have a great day."</em></p> <p><em>- A quote from Brian (graduated from IU Ball Cardiac Rehab Program)</em></p> <p><em> </em></p> <h3>Kudos</h3> <p> </p> <h2>Publications</h2> <p> • A multi-institution study led by <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Dr. Rohan Dharmakumar</a>, recently published in <em><a href="https://www.nature.com/articles/s41467-022-33776-x">"Nature Communications"</a></em>, identifies that iron drives the formation of fatty tissue in the heart and leads to chronic heart failure in about fifty percent of heart attack survivors. This study paves the way for treatments that have the potential to prevent heart failure in nearly half a million people a year in the United States, and many millions more worldwide. <br /> <br /> • The increasing use of endovascular aneurysm repair (EVAR) to treat abdominal aortic aneurysm (AAA) mandates solutions to the limitations of this operation including patients' needs for additional procedures. Kudos to <a href="https://iuhealth.org/find-providers/provider/david-a-peterson-md-70156">Drs. David Peterson</a>, <a href="https://iuhealth.org/find-providers/provider/duangnapa-s-cuddy-do-68824">Duangnapa Cuddy</a> and team on their patient's successful innovative endovascular repair highlighted in their recent case report published in the <em><a href="https://www.sciencedirect.com/science/article/pii/S2468428722001113">"Journal of Vascular Surgery Cases, Innovations and Techniques"</a></em>. <br /> <br /> • The study, recently accepted for publication in the <em><a href="https://pubmed.ncbi.nlm.nih.gov/35909017/">"American Journal of Cardiology"</a></em>, showed that patients with familial dilated cardiomyopathy have a significantly higher risk for reaching the composite primary endpoint of death, need for left ventricular assist device implant, or heart transplantation, as compared to patients with nonfamilial dilated cardiomyopathy. Patients with familial dilated cardiomyopathy were also at a significant risk of ventricular arrhythmia events than those with nonfamilial cardiomyopathy. This study highlights the value of family and genetic screening to identify the high risk-group of patients with dilated cardiomyopathy. The study was performed in collaboration of our heart failure team (<a href="https://iuhealth.org/find-providers/provider/roopa-a-rao-md-55326">Dr. Roopa Rao</a> and <a href="https://iuhealth.org/find-providers/provider/maya-e-guglin-md-70026">Dr. Maya Guglin</a>), electrophysiology team (<a href="https://iuhealth.org/find-providers/provider/mithilesh-k-das-md-5640">Dr. Mithilesh Das</a>), and involved internal medicine residents including <a href="https://medicine.iu.edu/resident/51830/kozaily-elie">Dr. Elie Kozaily</a>.<br />  <br /> • According to new research recently published in the journal <em><a href="https://www.ahajournals.org/doi/10.1161/CIRCHEARTFAILURE.122.009488">"Circulation: Heart Failure"</a></em>, cannabis users could be candidates for heart transplants. Lead author, <a href="https://iuhealth.org/find-providers/provider/onyedika-j-ilonze-md-885481">Dr. Onyedika Ilonze</a>, said heart transplantation can be life-saving in patients with end stage heart failure. Substance abuse has prevented patients from being candidates for heart transplantation. Increasing medical and recreational cannabis use, clinician bias and lack of standard ways of addressing cannabis use all serve to limit standardized decision making and worsen disparities in heart transplantation. This paper reviews the factors that need to be considered before and after heart transplant, compares attitudes between opiates and cannabis, and concludes by listing research priorities that will enable standardized decision making for patients with cannabis use who may require heart transplantation.<br /> <br /> • The Affordable Care Act Medicaid Expansion policy was associated with greater likelihood of White patients receiving cardiac resynchronization therapy +/- defibrillator based upon the study published in the <em><a href="https://www.ahajournals.org/doi/10.1161/JAHA.122.026766">"Journal of the American Heart Association"</a></em> by <a href="https://medicine.iu.edu/faculty/61331/breathett-khadijah">Dr. Khadijah Breathett</a> and team. Benefits were not observed among Hispanic nor Black patients. This study illustrates that additional strategies are needed to achieve equitable delivery of life saving therapies. <br /> <br /> </p> <h2>Awards</h2> <p> • <a href="https://medicine.iu.edu/faculty/40/khemka-abhishek">Dr. Abhishek Khemka</a> has secured the competitive national American College of Cardiology's Clinical Trial Research Award for his research proposal, Cardiometabolic Risk in African American Patients with Prostate Cancer.  The ultimate goal of this project is to improve health outcomes in prostate cancer patients and specifically bring parity to African American patients with cancer. Dr. Khemka and his team will use the risk prediction algorithm to develop an electronically integrated tool that clinicians can use quickly and easily to identify high-risk patients and offer interventions (referrals to dietician, adjust medications for blood pressure/cholesterol, refer to cardiology, etc.). The team will use the data for an RO1 to help develop the tool and do a prospective study to evaluate its benefit. If successful, it would be able to be expanded to other IU Health facilities as well as other institutions. <br /> <br /> • Through the National Comprehensive Cancer Network Oncology Research Program and in collaboration with Myovant Sciences and Pfizer, <a href="https://medicine.iu.edu/faculty/59823/tamarappoo-balaji">Dr. Balaji Tamarappoo</a> has secured a new award titled, Personalized Medical Treatment of Coronary Atherosclerosis in Prostate Cancer Patients Guided by Plaque Assesment with Quantitative Coronary CT Angiography. This research program seeks to improve cardiovascular management of patients with prostate cancer being treated with androgen-deprivation therapy (ADT). <br /> <br /> • In collaboration with Dr. Jordan Alexander Holmes with Radiation Oncology, <a href="https://medicine.iu.edu/faculty/59823/tamarappoo-balaji">Dr. Balaji Tamarappoo</a> and team have secured a 1 year community engagement pilot program grant by Indiana University Simon Comprehensive Cancer Center. To date, passive physician centered interventions to address cardiovascular screening and care for patients with prostate cancer have not been effective. This novel pilot study aims to measure health literacy and behavior among men who were treated for prostate cancer with androgen deprivation. Through partnership with Eskenazi Health, the team will oversample African American (AA) men to specifically explore differences in CVD health literacy and behavior between white and AA men. This study will inform future extramural funding applications to test the efficacy of patient or community-based interventions aimed at improving cardiovascular knowledge and care, and ultimately reduce CVD mortality among prostate cancer survivors. <br /> <br /> </p> <h2>In the Media</h2> <p> <a href="https://medicine.iu.edu/faculty/61331/breathett-khadijah">Dr. Khadijah Breathett</a> discussed <em><a href="https://www.medscape.com/viewarticle/978315?faf=1">Stepping Up To Achieve Health Equity</a></em> in Heart Failure in her recent editorial collaboration between Medscape and the American College of Cardiology. </p> <h2>Recognitions</h2> <p>Kudos to Dr. Pantila Bateman and <a href="https://iuhealth.org/find-providers/provider/richard-j-kovacs-md-7412v">Dr. Richard Kovacs</a> for working across interdisciplinary teams to develop the Endocarditis Due to Injection Drug Use Mini power plan. This first of its kind care pathway was stemmed from the 2nd Annual IUH/IUSM CVI Institute Summit on <em>High Value Cardiovascular Care: Opioid-Related Valvular Heart Disease</em> in August 2021 and went live in Cerner on September 12th.</p> <p> </p> <h3>Clinical Highlights</h3> <p> </p> <h2>First AngelMed Implantation at IU Health Bloomington Hospital</h2> <p> The first AngelMed Guardian implantation procedure was successfully completed on October 10th by <a href="https://iuhealth.org/find-providers/provider/john-s-strobel-md-9538">Dr. John Strobel</a> and team at IU Health Bloomington Hospital - the first in the state of Indiana! <br /> <br /> The AngelMed Guardian System is an implantable cardiac monitor with patient alerting capability and an additional external alarm device. The Guardian System is indicated for use in patients who have had prior acute coronary syndrome (ACS) events and who remain at high risk. The system detects potential ongoing ACS events, characterized by sustained ST segment changes, and alerts the patient to seek medical attention for those potential ACS events. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/dr-strobel.jpg?rev=ef76fafd04ab485ea182345706353091&hash=5391495CBC213B7B4424D10AD5C8806E" style=" height:450px; width:450px" alt="Dr. John Strobel and Team" /></p> <p> </p> <h2>IU Health Ball Memorial Hospital Reaches 7,000 Open-Heart Cases</h2> <p> Since its creation in 1977, the open-heart surgery program at IU Health Ball Memorial Hospital has reached a huge milestone: 7,000 open-heart cases. These cases include everything from coronary artery bypass grafts (CABG) to valve repairs and replacements, and the specialty cases in between. <br /> <br /> "These cases are life altering, and our team is so rightfully honored to have changed so many lives through this program", says <a href="https://iuhealth.org/find-providers/provider/glenn-n-carlos-md-5275">Dr. Glenn Carlos</a>. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/ball-open-heart-surgery.jpg?rev=551ab97af8a043ddb67ca8c9a6335daf&hash=65C743BC990FC5700930F119A80DB6A0" style=" height:433px; width:600px" alt="IU Health Ball Memorial Cardiovascular Surgery Team" /></p> <p> </p> <h3>Welcome to Our Team</h3> <p> <a href="mailto:eshin3@iuhealth.org">Erin Shin, MD</a>, an Interventional Cardiologist, has joined our team covering STEMI call for IU Methodist Hospital and West Hospital, as well as Eskenazi Hospital. At the Richard L. Roudebush VA Medical Center in Indianapolis, he is focusing on restarting the Interventional Program with the assistance of our Interventional Cardiology faculty. Dr. Shin completed his undergraduate at Northwestern with a BS in Biomedical Engineering and completed his Doctor of Medicine at Indiana University. His Residency, Post-Doctoral Research, Clinical Cardiology Fellowship, Interventional and Structural Heart and Valve Disease Fellowships were all completed at Emory University School of Medicine. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/dr-shin.jpg?rev=a79bebef3bc14a5cb50f960cb1a01cbd&hash=4C582694B03CCB07215E833F30C4D4E7" style=" height:369px; width:264px" alt="Dr. Eric Shin" /></p> <p> </p> <h3>Spotlights</h3> <p> </p> <h2>Education Mission</h2> <p> Our faculty educators including <a href="https://medicine.iu.edu/faculty/3192/jarori-upasana">Drs. Upasana Jarori</a>, <a href="https://medicine.iu.edu/faculty/38473/tsarova-kate">Katsiaryna Tsarova</a>, and Pantila Bateman recently spent time at the Simulation Center at Fairbanks Hall teaching 150 second-year medical students heart sounds and valvular heart disease. Cheers to the transmission of excellence through education!</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/faculty-educators.jpg?rev=91c2c00bc8db4c4681984c93116aa1e6&hash=4349E92AA0333B934CADE15B1288E034" style=" height:450px; width:350px" alt="Faculty Educators" /></p> <p> </p> <h2>Douglas and Joan Zipes Visiting Professorship</h2> <p>Dr. Douglas and Mrs. Joan Zipes established the Visiting Professorship that this year brought Dr. Emelia Benjamin, MD, ScM from Boston to Indiana. Her Zipes Visiting Professorship lecture entitled, "Time to Double Down on Preventing Atrial Fibrillation and Its Complications" offers a state-of-the-art roadmap to preventing AF.  </p> <p><strong><a href="https://indiana-my.sharepoint.com/personal/vbajpai_iu_edu/_layouts/15/stream.aspx?id=%2Fpersonal%2Fvbajpai%5Fiu%5Fedu%2FDocuments%2FRecordings%2FZipes%20Visiting%20Professor%5F%20Emelia%20J%2E%20Benjamin%2C%20MD%2CScM%2DTime%20to%20double%20down%20on%20preventing%20atrial%20fibrillation%20and%20its%20complications%2D20220928%5F001533%2DMeeting%20Recording%2Emp4">Watch the full lecture here</a></strong></p> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/dr-emelia-benjamin-1.jpg?rev=1ea68356c9004996999db0cbcf938717&hash=B4C7234D31B559F69EE6873C844420A4" style=" height:350px; width:500px" alt="Invited Zipes Visiting Professor, Dr. Emelia Benjamin" /></strong></p> <p><strong> </strong></p> <h2>Time of Celebration</h2> <p>Members of the IU Health Heart Failure/Transplant team saved a patient's life after 5 long months in the hospital. The patient's wedding that followed was conducted at the IU Health Methodist Chapel - the couple's choice for their special day so that their care team could be present. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/care-teamdr-rao.jpg?rev=74f125660e5942d8a39312fb4ba96d5d&hash=5252D3CF7C4F9C0BD4E78CE73A68412B" style=" height:333px; width:412px" alt="IUH Care Team_Dr. Roopa Rao" /></p> <p> </p> <h2>IU Health's Day of Service</h2> <p>Members of IU Health Physicians Cardiology's administrative leadership team participated in IU Health's Day of Service. As a team, they partnered with Groundwork Indy whose mission is to bring about the sustained regeneration, improvement, and management of the physical environment by developing community based partnerships which empower people, businesses, and organizations to promote environment, economic, and social well-being. They loaded and spread mulch at a local community garden which was a great way to grow as a team while benefiting the community. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/iuhp-cardiology-admin.jpg?rev=2711fbf3190f432ea296751a54e17fbc&hash=2873B2A213605052948AF40A9C1D0392" style=" height:600px; width:480px" alt="IUHP Cardiology Administrative Leadership Team" />   </p> <p> </p> <p> </p> <p><em><strong>Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email <a href="mailto:oneiucv@iu.edu">OneIUCV </a>so we can share with the team!</strong></em></p>Thu, 17 Nov 2022 00:00:00 Z{76284261-4C82-4F93-8675-56F5444E4ACB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/move-program-brightens-outlook-for-breast-cancer-patientsMOVE program brightens outlook for breast cancer patients<p>No one is ever prepared for the disruption a breast cancer diagnosis brings. Jen Hedges, a 41-year-old executive with a property management company, knew chemotherapy would be brutal. She knew she would be tired, but the extremity of her exhaustion coupled with rapid weight gain left her feeling defeated.</p> <p>When her nurse navigator mentioned a new exercise therapy program for breast cancer patients at the <a rel="noopener noreferrer" href="https://cancer.iu.edu/" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>, she didn’t hesitate.</p> <p> “The exhaustion that is experienced through the chemotherapy process is tough to combat, and I was ready for a change,” said Hedges, who describes herself as “active” before her diagnosis with Stage 3 breast cancer in May 2022. “I have a long road to go to get my body back in the best shape, but I am so glad the MOVE program is there to support me. I need the extra motivation and someone that can help me understand the ‘starting over’ process.” </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/02/07/16/51/3828-tarah-ballinger.png?h=350&w=234&rev=25556fdb39f441c691a6234f51d07016&hash=388D9A2954A0D26102C20E13A94A0899" style="height: 350px; width: 234px;" alt="3828-Ballinger, Tarah" class="float-left" />The Multidisciplinary Oncology Vitality and Exercise (MOVE) Program, developed by oncologist <a href="/faculty/3828/ballinger-tarah">Tarah Ballinger, MD</a>, gives cancer patients a personalized plan for exercise and physical therapy throughout all stages of their cancer journey. </p> <p> “Exercise works better than any medications to treat cancer-related fatigue,” said Ballinger, an assistant professor of clinical medicine at IU School of Medicine and the Vera Bradley Foundation Scholar in Breast Cancer Research. “It reduces the effects of cancer on both physical and mental health. It prevents the degradation of muscle that occurs during treatment, and exercise helps regulate our immune system.” </p> <p> The bottom line: “Exercise is important for quality of life and survival after cancer.” </p> <p> </p> <h3> Helping survivors get stronger </h3> <p> For years, breast cancer patients were told to “take it easy” through surgeries, chemotherapy and radiation. Turns out, that advice was wrong. Recent studies prove exercise during cancer treatment reduces negative side effects, improves mood and accelerates healing. </p> <p> “In practice seeing cancer patients, a common question is what patients can do for themselves to improve how they’re feeling,” said Ballinger, a pioneer in the emerging field of exercise oncology and a researcher at the IU Simon Comprehensive Cancer Center. “Patients wanted advice on exercise and fitness, and we didn’t have a lot of answers. It was a big gap in the care we were providing.” </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/j/jennifer-hedges-workout.jpeg?h=284&w=425&rev=6d75d1d0561a4ee9b1c759889ef475af&hash=A16BCEAE5121EB05C1CD0E14CF54DB4A" style="height: 284px; width: 425px;" alt="Jennifer Hedges on an exercise machine" class="float-right" />Ballinger conducted a survey of cancer center patients to determine their level of awareness and desire for physical activity and exercise support. </p> <p> “Most patients said they didn’t have the opportunity to discuss exercise or fitness with their care providers and weren’t given specific instructions—but they wanted to be,” Ballinger found. “Since different patients need different levels of support, it needs to be personalized. The best way to do this is precision medicine.” </p> <p> The cancer center piloted the MOVE program with 30 breast cancer patients in February 2022 and later expanded it to include esophageal cancer patients before opening the program for all types of cancers. </p> <p> Nearly 50 patients have acted on referrals from their oncology teams since August. One patient from a different health system transferred care specifically to gain access to the MOVE program, which is offered free to all cancer center patients, Ballinger noted. </p> <p> “Our breast cancer population is particularly excited about the program,” said Danielle Halsey, MS, lead exercise physiologist with MOVE. “It’s fun to see them after one or two weeks, feeling stronger and more confident in doing daily tasks such as going up and down stairs without feeling fatigued.” </p> <p> Hedges, who has gone through eight rounds of chemotherapy and is scheduled for a double mastectomy this month, completes weekly workouts directed by Halsey and does physical therapy with Bryce Showers, the cancer center’s first oncology-certified physical therapist. </p> <p> “I am less tired, I have more confidence in myself, and I have the desire back to push myself to maximize in all areas to get my health in its best possible shape,” Hedges said. “I am extremely grateful this program exists.” </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/janaiweb1.jpeg?h=268&w=475&rev=d451da46de324a0695b66f25b85a51c1&hash=C8E931351C9B7FD4C05433DA489453DE" style="height: 268px; width: 475px;" alt="Janai Mitchell works with physical therapist Bryce Showers" class="float-left" />Breast cancer survivor Janai Mitchell, 27, completes her final chemotherapy treatment in early October and has seen Halsey and Showers for exercise and physical therapy following each round. As an athlete, Mitchell was eager to join the pilot program for MOVE and provide her feedback. </p> <p> “I think it gets my mind off of what I’m going through and has taken away the fatigue I would otherwise get from the chemo,” Mitchell said. “It has helped me physically and mentally to have Bryce and Dani supporting me, telling me I’m doing great and that they’re seeing progress.” </p> <p> Breast cancer patients often benefit from strengthening exercises for their chest and back muscles following surgeries, Halsey said. They also frequently deal with lymphedema, a swelling of the arm on the side where lymph nodes have been removed, and chemotherapy-induced neuropathy, which causes pain or numbness in the hands and feet. </p> <p> “We used to think exercise would make lymphedema worse, but what we’ve proved is actually the opposite,” Ballinger said. “Progressive weightlifting for a year after breast surgery reduces the incidence of developing lymphedema by 75 percent.” </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/jennifer-hedges-and-danielle-halsey.jpeg?h=425&w=319&rev=6d8d2da412bb4a15be8df471dbfbdbf8&hash=CE40C37DC24C74376FA6D12974DF2521" style="height: 425px; width: 319px;" alt="Jennifer Hedges and Danielle Halsey" class="float-right" />Halsey, who has worked in exercise oncology since her undergraduate studies, vividly recalls the moment her first breast cancer patient, two months post-mastectomy, graduated from 2-pound to 5-pound weights. </p> <p> “It was the most exciting thing in the world for her,” Halsey said. “There was this switch and a new sense of confidence. It was a feeling of, ‘I can do this, I am strong, I am capable.’ That is my favorite moment—when they regain that piece of themselves.” </p> <p> Along with physical side effects of treatment, breast cancer survivors often experience anxiety and depression stemming from the loss of control over their life and health, Ballinger noted. </p> <p> “The MOVE program helps them feel more empowered,” she said. “We might be helping them exercise or move more or push through chemotherapy, but they’re the ones doing the work. Doing something like this helps them feel more confident and capable about what they can do. For me, that’s the biggest motivator.” </p> <p> </p> <h3> Expanding exercise oncology care </h3> <p> A former club boxer in college and a life-long athlete, Ballinger wears pink boxing gloves to pummel a training bag at her home—a visual reminder of her continual fight to improve the lives of her patients as they “knock out” breast cancer together. </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/tarah-ballinger-md-4-2018-19.jpg?h=301&w=450&rev=dce5e91a5e5d445a944b64ad02128ef2&hash=FBF4AE42DCCEA08A059A430DBCA133AF" style="height: 301px; width: 450px;" alt="Tarah Ballinger MD 4-2018 19" class="float-left" />In recent decades, cancer treatments have improved so cancer survivors are living longer. While that’s good news, it means more people are living with the adverse side effects of cancer treatments, Ballinger noted. Those who exercise have better long-term prognoses. </p> <p> “Higher levels of activity after cancer diagnosis are associated with a 38-percent reduction in cancer-specific death in breast cancer,” Ballinger said. “We spend billions of dollars to develop drugs, but exercise is freely available. We need to use our resources to help patients take advantage of its benefits.” </p> <p> The IU Simon Comprehensive Cancer Center is making it easy for patients to “fill” their prescription for exercise by giving them individualized exercise plans which evolve throughout the cancer journey. </p> <p> The program works for every stage of cancer, from initial diagnosis all the way to metastatic disease, Ballinger said. She’s currently collecting data on the benefits of physical activity and exercise in late-stage cancer. </p> <p> “The MOVE program is not just delivering a clinical service but also helping in research studies across the cancer center,” Ballinger added. “The grand vision is for this to be integrated into the plan of care for every patient who is going through cancer treatment.”</p>Tue, 04 Oct 2022 00:00:00 Z{C326D94D-6935-4AD1-9959-72053DB1817B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/meet-michele-coteQ&A with Michele Coté, PhD<p><span>Michele Coté, Ph.D., is just getting started in her new role as the second director of the </span><a href="https://komentissuebank.iu.edu/"><span>Susan G. Komen Tissue Bank at IU Simon Comprehensive Cancer Center</span></a><span>. </span></p> <p><span>An </span><span>internationally recognized molecular cancer epidemiologist and health disparities researcher, she began at IU on Sept. 1.</span></p> <p><span>In addition to her role with the Komen Tissue Bank, Coté is the inaugural Dr. Carrie Ann Glasscock West Chair in Breast Carcinogenesis at IU Simon Comprehensive Cancer Center and a professor in the Department of Epidemiology at the </span><a href="https://fsph.iupui.edu/"><span>IU Richard M. Fairbanks School of Public Health</span></a><span> at IUPUI.</span></p> <p><span>Dr. Coté answers questions about what brought her to IU, shares her connections with the Komen Tissue Bank, and more. </span></p> <p><strong><span>Q. What attracted you to IU?</span></strong></p> <p><span><strong>A. </strong>My first introduction to IU, other than being a graduate of another Big Ten school, was through the Komen Tissue Bank. Most of my work in molecular epidemiology utilizes tissue, typically tumor tissue, but I immediately understood the need for normal. So, the first draw was really scientific. </span></p> <p><span>After my first visit, I appreciated the fact that the IU Simon Comprehensive Cancer Center was recently awarded comprehensive status by the NCI, highlighting the fact that there are incredible clinicians and scientists with the goal of transforming cancer control and care through collaborative, translational research. I’m also very excited to be a part of the Fairbanks School of Public Health, where I can help train future epidemiologists and public health practitioners. </span></p> <p><strong><span>Q. You are a molecular epidemiologist who studies cancer and health disparities. Can you break down what that means?</span></strong></p> <p><span><strong>A.</strong> Sure. Epidemiologists are interested in the distribution and determinants of disease in a population—who is getting cancer? How are they different from people who aren’t? As a molecular epidemiologist, I use molecular biology tools to answer these questions at a cellular level. For example, we know cancer is a disease of your DNA. What genetic differences do we see in those who get cancer compared to those who don’t?  How do other factors (like the environment or behaviors) impact risk along with the DNA (genetic) differences? In all of my work, my end goal is to understand what drives health disparities in populations so that we can identify appropriate interventions and reduce the burden of cancer for all.</span></p> <p><strong><span>Q. What can you tell us about your research?</span></strong></p> <p><span><strong>A.</strong> I have a couple of different research programs I will continue at IU. In breast cancer, I’m very interested in understanding how benign breast disease impacts risk of a subsequent cancer. There are more than a million breast biopsies done annually in the United States, and the vast majority are benign. My earlier work, and that of others before me, suggests that having a benign breast biopsy increases risk of a subsequent breast cancer. I hope to define this higher risk population of women who have had a prior benign biopsy to identify ways to identify those at highest risk, and ultimately intervene to intercept the development of cancer. The KTB aligns perfectly with this work, as most of the participants do not have breast cancer and have varying levels of risk. </span></p> <p><span>I’m also focused on understanding why we are seeing increases in endometrial cancer incidence, particularly high-grade cancers with poorer survival. These cancers are more frequently diagnosed in African American women, and as a field we really have no idea why this happens. Finally, my dissertation work from nearly two decades ago was on the molecular epidemiology of lung cancer. While I’ve moved away from that area, I am engaged in work that assists people, particularly people who have had poor access to quality care, to get into evidence-based tobacco cessation and lung cancer screening programs. All of the areas I describe are challenges critical to the health of the people of Indiana.</span></p> <p><strong><span>Q. Before joining IU, you interacted with the Komen Tissue Bank. How did you become connected with the KTB?</span></strong></p> <p><span><strong>A. </strong>My awareness of the KTB was through a wonderful colleague of mine who was the chair of the Detroit Race for the Cure at the time, and a Komen advocate. She came back from a national advocacy conference with the idea that we should hold a collection event for the tissue bank in Detroit. We traveled down to Indianapolis to meet the KTB team, and I donated tissue. </span></p> <p><span>In 2016, we held the Detroit event where we recruited 189 women to donate tissue in a single day, plus hundreds of volunteers. I was the scientific lead, and she was the community lead, and we brought everyone together to host this successful event. I stayed in touch with the KTB team after that time and have even used the tissue in some of my research.</span></p> <p><strong><span>Q: What projects are you most looking forward to working on as director of the Komen Tissue Bank?</span></strong></p> <p><span><strong>A. </strong>Right now, I’m mostly excited about gaining a deeper understanding of the ongoing scientific projects, but also thinking about ways to keep the KTB at the forefront of research for the next decade and beyond.</span></p> <p><strong><span>Q. How do you envision the Komen Tissue Bank’s next five years?</span></strong></p> <p><span><strong>A.</strong> I expect that the KTB will continue to grow in the number of participants, will enhance follow-up and engagement of participants over time, all with the constant goal of remaining flexible and responsive to needs from the research community.</span></p> <p><strong><span>Q. What are the biggest questions in cancer research that keep you up at night?</span></strong></p> <p><span><strong>A.</strong> The biggest questions always go back to the “Why” for me—especially with breast cancer. We know there is a genetic component, where you see breast and ovarian cancers in multiple generations, but for most women, they have little or no family history. Why them? And it goes from there, into a broader why, “Why do women of African ancestry get triple negative breast cancers more frequently than those of other ancestral groups? How can we identify those at greatest risk, and focus screening there? How can we improve life after a cancer diagnosis? It keeps going!</span></p> <p><strong><span>Q. What has surprised you about your experiences as a cancer researcher?</span></strong></p> <p><span><strong>A.</strong> I am constantly surprised by how far we have come with respect to understanding the causes of cancer, how to detect it earlier, and how to treat it. At the same time, I’m also surprised with how far we have to go in these areas. It is a rapidly changing field, with breakthroughs monthly, and yet certain types of cancer are still difficult to treat. Once you think you have answered one question, five more appear.</span></p> <p><strong><span>Q. How has the re-location from Detroit to Indy been going?<img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/cote-family.jpg?h=420&w=300&rev=47db41bec43e4f91ac0e0ac3fde1419c&hash=3C0D0DF4C2ADDA4D2274D17784E6A285" style="height: 420px; width: 300px; float: right;" alt="Dr. Michelle Cote with her family" class="float-right" title="Dr. Coté at her son Jared's high school graduation with daughter, Leah, and husband, Bob." /> </span></strong></p> <p><span><strong>A. </strong>The relocation has been slow but steady! It is difficult to move after two decades, but I’m confident that we will settle in soon. Michigan and Indiana are similar in many ways, which helps. </span></p> <p><strong><span>Q. What do you like to do in your spare time?</span></strong></p> <p><span><strong>A. </strong>I have two kids, one starting high school and the other college, so most of my spare time has been taking them to and from and watching them develop into interesting young adults. I love watching Big 10 college sports, traveling to just about anywhere, going to concerts, and hot yoga. I bought a bicycle here and can’t wait to explore the Monon Trail and other off-road places. A koi pond came with my new house, so I imagine I’ll be learning how to take care of that over the next few months, especially as winter approaches.</span></p> <p><span><em>Photo: Dr. <span>Coté with her son, Jared, at his high school graduation and her daughter, Leah, and husband, Bob. </span></em></span></p>Thu, 01 Sep 2022 00:00:00 Z{3D87B43E-5A21-440B-BD1F-CD5AFC4697CB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/august-2022-newsletterAugust 2022 Newsletter<h1>Cardiovascular Institute</h1> <p><em>One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</em></p> <p><em> </em></p> <h3>Top News</h3> <h2>Quality Heart Care: Seven IU Health Hospitals Recognized</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/chest-pain_mi-registry.jpg?h=264&w=300&rev=755957802c234468b3bbb5cfa6f016da&hash=F04D5C676190AB1E83140707E2AE845C" style=" height:264px; width:300px" alt="2022 Chest Pain MI Registry Award" class="float-left" /> <p>Seven IU Health hospitals participating in the American College of Cardiology's Chest Pain - MI registry have received a platinum performance award for 2022. The recipients include IU Health Arnett, Ball Memorial, Bloomington, Methodist, North, Saxony and West hospitals. This award recognizes IU Health's commitment and success in implementing a higher standard of care for heart attack patients and signifies that each hospital has reached an aggressive goal of treating these patients to standard levels of care as outlined by the American College of Cardiology and American Heart Association clinical guidelines. <br /> <br /> To receive the Chest Pain - MI Registry Platinum Performance Achievement Award, our IU Health hospitals have demonstrated sustained achievement in the Chest Pain - MI Registry for two consecutive years (2020 and 2021), and performed at the highest level for specific performance measures. </p> <p> </p> <h2>IU Health: IC-OS Center of Excellence Award</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/indiana-university-coe-certificate.jpg?h=250&w=300&rev=751b1711501d488f8091394e72c6d2a8&hash=36B1743F285B42CAB50E70AC003FB767" style=" height:250px; width:300px" alt="IU COE Certificate" class="float-right" /> <p>With the leadership of <a href="https://iuhealth.org/find-providers/provider/suparna-c-clasen-md-134166">Dr. Suparna Clasen</a>, we are pleased to announce that the International Cardio-Oncology (IC-OS) Board of Directors has awarded Indiana University Health the Center of Excellence GOLD standard for outstanding professional contributions to the field of Cardio-Oncology, valid for a 3-year period. </p> <p> </p> <p> </p> <p> </p> <h2>Methodist Hospital: Get With the Guidelines Gold Award</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/g/gwtg-2022-afib-newsthumb.jpg?h=175&w=300&rev=84ad24819bb64057a1abb0b7bda604d4&hash=6A304F89663802608F02ABEA4D30BE3A" style=" height:175px; width:300px" alt="2022 AFIB Award" class="float-right" /> <p>In June, IU Health Methodist Hospital was awarded the Get With the Guidelines - Atrial Fibrillation (AFib) Gold award for sustained excellence providing care to AFib patients over two consecutive calendar years. The award, presented by the American Heart Association, also recognizes a commitment to following leading-edge treatment guidelines, ultimately reducing stroke risk for patients. <br /> <br /> The Get With the Guidelines - AFIB program combines expertise from the American Heart Association and American Stroke Association to provide the most up-to-date and research based guidelines for patient care. As a result, teams at the IU Health Adult Academic Health Center can provide quality care and education to patients. </p> <p> </p> <h2>Certificate of Achievement: Society for Vascular Surgery Patient Safety Organization</h2> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/motaganahalli_svs-awards.jpg?h=250&w=300&rev=89b25c1ca2d74edd8d010788c68a847c&hash=6F7F38075FDCCAF14C2D7AF0E0A58A3E" alt="SVS Award_Dr. Motaganahalli" style="height: 250px; width: 300px;" class="float-right" />A total of six IU Health Hospitals received the 2021 Certificate of Achievement from the Society for Vascular Surgery Patient Safety Organization at the annual meeting in Boston, Massachusetts. They are recognized for their performance at the 3 star level in the Vascular Quality Initiative (VQI) for being committed to improving care and fostering engagement with our patients! </p> <p>•<span> </span>IU Health Bloomington Hospital<br /> •<span> </span>IU Health Methodist Hospital<br /> •<span> </span>IU Health Saxony Hospital<br /> •<span> </span>IU Health Arnett Hospital<br /> •<span> </span>IU Health West Hospital<br /> •<span> </span>IU Health Ball Memorial Hospital</p> <p> </p> <h2>Patient Experience Monthly Recognition </h2> <p>Based upon feedback from our patients, the Cardiology MMP South clinic has earned the honor of being the IU Health Physicians Specialty Care Top Performer in patient experience for the month of April. Congratulations to <a href="https://iuhealth.org/find-providers/provider/yazid-y-fadl-md-5994">Dr. Yazid Fadl</a> and the entire team for delivering the best care and personalized approaches for every patient, every time! </p> <p> </p> <h2>Eric S. Williams, MD, Cardiovascular Fellowship</h2> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/01/26/17/26/4823-eric-williams.png?h=180&w=120&rev=4af8ecfb692b4944be4543ca1d3fe521&hash=21666F7BDFE314C55D7A79D4401C9047" style=" height:180px; width:120px" alt="4823-Williams, Eric" class="float-right" /> <p>In honor of Dr. Williams decades of commitment to cardiovascular education and patient care, we are establishing the Eric. S. Williams Cardiovascular Fellowship. Watch for additional information in your email or mailbox during the month of August. Contact our Development Director, <a href="mailto:kred@iu.edu">Kathryn Red</a>, about this campaign. </p> <p> </p> <p> </p> <h3>Vascular Surgery Fellowship Match Results</h3> <p>May 11th was Fellowship Match Day for the Department of Vascular Surgery. We matched our opening and are excited to welcome Dr. Mohineesh Kumar to our fellowship training Program in 2023! Dr. Kumar earned his medical degree at Indiana University and completed his residency at William Beaumont Hospital. </p> <p> </p> <h3>Kudos</h3> <h2>Awards</h2> <p><a href="https://medicine.iu.edu/faculty/4919/everett-thomas">Dr. Thomas Everett </a>and colleagues have secured a new NIH R01 grant titled: "SKNA as a Biomarker for Cardiovascular Events" based on their development of a new method to non-invasively measure sympathetic nerve activity from the skin. This research program proposes to determine if the nerve activity within the SKNA recordings can be used as a prognostic biomarker for neurological status during targeted temperature management for cardiac arrest and to risk stratify patients for recurrence of atrial fibrillation after ablation therapy.</p> <p>Prostate cancer is often treated with androgen deprivation therapy which has potent side effects, one of which is atherosclerosis plaque deposition in coronary arteries and increased likelihood of heart attacks. Coronary CT with contrast (CCTA) can identify arteries affected by plaque deposition. <a href="https://medicine.iu.edu/faculty/59823/tamarappoo-balaji">Dr. Balaji Tamarappoo</a> and his team have partnered with Dr. Nabil Adra and his team of GU oncologists at IUSCC to learn how androgen deprivation affects coronary artery plaque using CCTA. In this newly funded proposal by the Pfizer Myovant National Comprehensive Cancer Network (NCCN) titled,  "Personalized medical treatment of coronary atherosclerosis in prostate cancer patients guided by plaque assessment with quantitative coronary CT angiography", they will use advanced computer techniques to measure the amount of coronary artery plaque from CCTA in prostate cancer patients before they begin androgen deprivation therapy. These patients will undergo a follow-up CCTA exam at 1 year which will be analyzed for changes in both the amount of plaque and high-risk plaque features. This will be the first study to directly monitor how androgen deprivation alters coronary artery plaque and will provide information on whether CCTA should be performed in more men with prostate cancer before they begin treatment with these medications. </p> <p> </p> <h2>In the Media</h2> <p><a href="https://medicine.iu.edu/faculty/61331/breathett-khadijah">Dr. Khadijah Breathett </a>was quoted in the Forbes' article titled: <a href="https://www.forbes.com/sites/lipiroy/2022/06/28/bob-harpers-simple-advice-know-cpr-save-a-life/?sh=5c2521596270">"Bob Harper's Simple Advice: Know CPR, Save A Life"</a></p> <p>The Congenital heart team, including <a href="https://iuhealth.org/find-providers/provider/stephen-c-cook-md-1351756">Dr. Stephen Cook</a>, offers patient surgical bridge to transplant in this story featured on the <a href="https://www.facebook.com/IUHealth/videos/544774073778228/?extid=NS-UNK-UNK-UNK-IOS_GK0T-GK1C-GK2C">IU Health Facebook page</a>. </p> <p> </p> <h2>Presentations</h2> <p>IU Health had great representation at this year's Society of Vascular Surgery's 2022 annual meeting held in Boston, Massachusetts! </p> <p>•<span style="white-space: pre;"> </span><a href="mailto:lcamino@iuhealth.org">Lillian Camino</a> and <a href="https://medicine.iu.edu/faculty/19930/motaganahalli-raghu">Dr. Raghu Motaganahalli</a> received the Winner of Best Poster for their presentation titled: "Use of VQI Registry to Implement Appropriate Use Criteria  (AUC) for Atherectomy in Peripheral <span style="white-space: pre;"> </span>Vascular Interventions (PVI)". </p> <p> •<span style="white-space: pre;"> </span>As President Elect, <a href="https://medicine.iu.edu/faculty/14919/dalsing-michael">Dr. Michael Dalsing</a> moderated the Stanley Crawford Critical Issues Forum, providing a short introduction for 7 pertinent talks that followed and then a discussion. </p> <p> •<span style="white-space: pre;"> </span><span> </span>During the plenary session: "Care for All - An Aspiration Goal of Merit", <a href="https://medicine.iu.edu/faculty/47578/gonzalez-andrew">Dr. Andrew Gonzalez</a> gave a talk titled: "Urban Vascular Care Deserts: Challenges and Opportunities in Our Own Backyard."</p> <p> </p> <h2>Publications</h2> <p>•<span style="white-space: pre;"> </span><a href="https://medicine.iu.edu/faculty/5070/kreutz-rolf">Dr. Rolf Kreutz</a> and team recently published in <em><a href="https://www.jscai.org/article/S2772-9303(22)00360-X/fulltext">Journal of the Society for Cardiovascular Angiography</a></em> an analysis of access-related clinical outcomes in 26,111 IU Health patients undergoing heart catheterization through the femoral artery. Use of a femoral artery closure device, with some differences across available devices, was associated with significantly less access site complications and bleeding events in those undergoing percutaneous coronary intervention (PCI). Kudos to IU Health interventional cardiologists reducing femoral complications with such devices while also choosing radial access first per recommendations of the IUH Coronary/Ischemic Heart Disease Quality and Clinical Effectiveness Council.  </p> <p> •<span style="white-space: pre;"> </span><a href="https://medicine.iu.edu/faculty/4943/kovacs-richard">Dr. Richard Kovacs</a> and <a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Dr. Asad Torabi</a> prove that the use of standardized athlete interpretation criteria can help improve the accuracy of detecting abnormal ECGs in athletes in their recent study published in the <em><a href="https://www.sciencedirect.com/science/article/pii/S2666602222000702">American Heart Journal Plus</a></em>. </p> <p> •<span style="white-space: pre;"> </span>In this <em><a href="https://jamanetwork.com/journals/jamacardiology/fullarticle/2793312?guestAccessKey=24bc70f8-f9eb-424a-a52a-d44dd3ff940f&utm_source=jps&utm_medium=email&utm_campaign=author_alert-jamanetwork&utm_content=author-author_engagement&utm_term=1m">JAMA Cardiology</a></em> case report, <a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Dr. Asad Torabi</a>, <a href="https://medicine.iu.edu/faculty/38290/kauth-mark">Dr. Mark Kauth</a> and <a href="https://medicine.iu.edu/faculty/47730/suzuki-takeki">Dr. Takeki Suzuki</a> describe a young man with syncope. Initial electrocardiogram on presentation showed type 1 Brugada ECG morphology and the diagnosis of Brugada Syndrome was made. This case highlights the importance of the recognition of the Brugada type 1 pattern as a potential cause of cardio-arrhythmogenic syncope.</p> <p> </p> <h3>Upcoming Events</h3> <p>THE JOAN AND DOUGLAS ZIPES VISITING PROFESSORSHIP FEATURING:<br /> <br /> <strong>Emelia J. Benjamin, MD, ScM</strong><br /> Robert Dawson Evans Distinguished Professor of Medicine, Boston University School of Medicine<br /> <br /> <em>"Time to Double Down on Preventing Atrial Fibrillation and Its Complications"</em><br /> <br /> <strong>September 27, 2022: Lecture 4:30-5:30pm </strong><br /> Goodman Hall Neuroscience Auditorium<br /> 362 W. 15th Street, Indianapolis, IN 46202<br /> <br /> This will be followed by a reception and short State of the CVI update by<br /> CVI Physician Director, <a href="https://medicine.iu.edu/faculty/47775/raman-subha">Dr. Subha Raman</a>.<br /> <br /> <em>We hope to see you there!</em></p> <p> </p> <p> </p> <p>Do you have a story that reflects the strength of our statewide system for cardiovascular care?<br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</p>Wed, 17 Aug 2022 00:00:00 Z{BD8FCB88-F4D3-42BD-AC10-7A4CE368F8A7}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/grad-student-earns-f31-grantGrad Student Earns F31 GrantA PhD student in the Department of Orthopaedic Surgery earned a grant from the National Institutes of Health that will allow her to continue researching the impacts COVID-19 has on bone health. <p> Olatundun Awosanya earned a Ruth L. Kirschstein National Research Service (F31) Award in May. This five-year grant from the NIH aims to enhance medical research by providing funding to students from diverse backgrounds. </p> <p> Awosanya has worked in the Kacena Lab since she was an undergrad at IUPUI, studying megakaryocytes, led by Melissa Kacena, PhD, the Vice Chair of Research for the Department of Orthopaedic Surgery. </p> <p> Awosanya made the trip to Cape Canaveral, Florida in 2019 when the lab conducted its second spaceflight experiment. But when the lab shifted some of its work to COVID-19 research in the early months of the coronavirus pandemic, the work sparked Awosanya’s interest, and she took on key leadership roles in the project. </p> <p> Awosanya’s grant funded her study on the impacts of SARS-CoV-2 infections and age on musculoskeletal health. </p> <p> This work will build upon significant discoveries the Kacena Lab made related to the coronavirus. </p> <p> In 2021, researchers found that SARS-CoV-2 can cause quick and significant bone loss, even when infections appear to be mild. </p> <p> Awosanya was assigned to work in the Kacena Lab as an undergrad after being accepted into IUPUI’s Life-Health Science Internship (LHSI) program, which annually places 75 undergraduate students in immersive experiences around the Indianapolis campus, encouraging them to explore career goals while gaining important professional skills. </p> <p> As an IUPUI senior, Awosanya was named Intern of the Year by the state’s chamber of commerce for her work in the lab. </p> <p> Indiana INTERNnet—a program sponsored by the Indiana Chamber of Commerce—names an Intern of the Year as part of its annual IMPACT Awards to celebrate high school and college intern successes across the state. Awosanya was nominated for the award by Kacena.</p> <p> According to the NIH website, an F31 award helps “promising predoctoral students obtain individualized, mentored research training from outstanding faculty sponsors while conducting dissertation research in scientific health-related fields relevant to the missions of the participating NIH Institutes and Centers.” </p> <p> “The overall goal of the NIH Ruth L. Kirschstein National Research Service Award (NRSA) program is to help ensure that a diverse pool of highly trained scientists is available in appropriate scientific disciplines to address the nation’s biomedical, behavioral, and clinical research needs,” the NIH website states. </p> <p> Awosanya was awarded the grant on her first-ever grant submission. </p>Wed, 01 Jun 2022 00:00:00 Z{7AAB81C9-79BD-40B1-8B17-A1AC5CB1C1B4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/otolaryngology-alumni-continue-practice-of-collaborationOtolaryngology alumni continue practice of collaboration<p style="margin-top: 12pt;"><span>Even though their residency in the </span><a href="https://medicine.iu.edu/otolaryngology"><span>Department of Otolaryngology—Head and Neck Surgery at Indiana University School of Medicine</span></a><span> overlapped for only a few years, Michael Harris, MD and Aaron Moberly, MD collaborate to this day—carrying on a tradition of teamwork.</span> </p> <p style="margin-top: 12pt;"><span>The Department of Otolaryngology has a longstanding history of its residents placing into nationally recognized fellowship programs and hospitals. Most residents—about 60%—enter fellowship programs. The rest go straight to work in hospitals and private practices. And about half of the residents practice academic medicine.</span></p> <p style="margin-top: 12pt;"><span>After completing their residencies at IU School of Medicine, both Harris and Moberly separately matched into the neurotology/otology fellowship at The Ohio State University School of Medicine. They’ve since grown their academic medicine practices and research programs, attributing much of their success as faculty to what they learned while at IU.</span></p> <p style="margin-top: 12pt;"><span>"I've always appreciated the supportive nature of the Department of Otolaryngology at IU,” Moberly said. “They are really intentional about encouraging people in the direction that they want to pursue, and that’s the type of environment I want to foster as my career advances.” </span></p> <p style="margin-top: 12pt;"><strong><span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/department/otolaryngology/moberly-photo-1.jpg?h=270&w=180&rev=64a1d1f29f94454cab53eabe12212e3f&hash=2D899AC9EC35B00B8AC7464BB5604D42" style="width: 180px; height: 270px;" class="float-left" / alt="" />Aaron Moberly, MD</span></strong></p> <p style="margin-top: 12pt;"><span>Moberly spent nine years at IU School of Medicine, as both a medical student and resident in the Department of Otolaryngology.</span></p> <p style="margin-top: 12pt;"><span>The summer before his second year of medical school, he studied speech perception and language development in children with cochlear implants in the </span><a href="https://medicine.iu.edu/otolaryngology/research/devault-otologic-research-lab/grants-papers"><span>DeVault Otologic Research Laboratory</span></a><span>, under the leadership of </span><a href="https://medicine.iu.edu/faculty/26518/pisoni-david"><span>David Pisoni, PhD</span></a><span>, distinguished professor of psychological and brain sciences at IU, and Derek Houston, PhD, who Moberly now works with at Ohio State.</span></p> <p style="margin-top: 12pt;"><span>“Having that initial exposure to this group of psychologists studying cochlear implant outcomes very early on in my medical training gave me some insight into the importance of the brain and how it interprets and processes information coming through a cochlear implant,” Moberly said.</span></p> <p style="margin-top: 12pt;"><span>This unique perspective to cochlear implant research—how the ear connects to the brain—was formative, Moberly said, to how he has investigated cochlear implant outcomes throughout his career. The “team science” conducted in the DeVault Lab between scientists and clinicians is also a model to how he approaches his ongoing research.</span></p> <p style="margin: 12pt 0in 0in;"><span>“It was a really good environment as a junior trainee to see how productive that was and how mutually fulfilling that appeared for both the clinician and researcher,” Moberly said.</span></p> <p style="margin: 12pt 0in 0in;"><span>When Moberly began his fellowship at Ohio State, he reconnected with Pisoni—</span><a href="https://medicine.iu.edu/blogs/faculty-news/cognitive-science-researcher-celebrates-half-century-at-iu"><span>who has now been a mentor of his for well over a decade</span></a><span>—as he was starting to apply some of the research methods he learned while studying children with cochlear implants in the DeVault Lab to his current research looking into outcomes in older adult cochlear implant patients. That collaboration and research has continued to grow since he joined faculty at Ohio State in 2013 after his fellowship.</span></p> <p style="margin: 12pt 0in 0in;"><span>In summer 2021, Moberly received his first R01 grant from the National Institute on Deafness and Other Communication Disorders, a member of the National Institutes of Health, to support his research in speech perceptions in adults with cochlear implants. Moberly said he’s grateful to have assembled a team of other scientist co-investigators to tackle this research.</span></p> <p style="margin: 12pt 0in;"><span>“My training as a clinician really helped set the stage for that, but it also helps to rely on the expertise of people coming from different backgrounds,” Moberly said. “There’s something about building a team project that I’m really proud of.”</span></p> <strong><span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/department/otolaryngology/2019-harris-headshot_edit.jpg?h=270&w=180&rev=3bc8afef5e1149689aa732cbc93dc3a9&hash=1EE7BC41DDDEAB553294FE32042EF914" style="width: 180px; height: 270px;" class="float-left" / alt="" />Michael Harris, MD</span></strong> <p>Harris began his otolaryngology residency at IU School of Medicine in 2008. After completing his otolaryngology internship, Harris began a two-year postdoctoral research fellowship through the department’s NIH/NIDCD T32 training grant, which provided selected otolaryngology residents an opportunity to study speech recognition outcomes in children with cochlear implants in the DeVault Lab.</p> <p><span>The training program, which ran from 1980 through 2016, was created and mentored by Pisoni and </span><a href="https://medicine.iu.edu/faculty/14652/miyamoto-richard"><span>Richard Miyamoto, MD</span></a><span>, chair of the Department of Otolaryngology from 1987 to 2014 and now professor emeritus. </span></p> <p><span>“Being a part of the DeVault lab allowed me to hone my research skills and develop an understanding of the knowledge gaps in the field. It gave me a chance to meet and interact with many investigators working in different areas of cochlear implant research,” Harris said. “My time in the lab gave me a solid foundation for my career as a clinician-scientist.”</span></p> <p><span>Pisoni not only taught Harris the science behind the lab, but he instilled the importance of creative collaboration with other researchers in adjacent but distinct fields of study, Harris said. This spirit was exemplified by the lab’s invited speaker series, regularly bringing in internal and external researchers with a variety of intellectual backgrounds. </span></p> <p><span>“Having conversations with investigators working outside of your specific area of interest helps you see your own research challenges in a new light and consider different methodologies,” Harris said.</span></p> <p><span>After his fellowship in the DeVault Lab, Harris completed his clinical training in otolaryngology, where he worked closely with the department’s neurotologists at the time—Miyamoto, Michael Fritsch, MD, </span><a href="https://medicine.iu.edu/faculty/12192/yates-charles"><span>Charles Yates, MD</span></a><span>, and </span><a href="https://medicine.iu.edu/faculty/23096/nelson-rick"><span>Rick Nelson, MD, PhD</span></a><span>—all of whom had a big influence on his interest in the subspecialty.</span></p> <p><span>After completing fellowship in neurotology/otology at Ohio State, Harris returned to his hometown, Milwaukee, Wisconsin, to join the faculty at Medical College of Wisconsin (MCW) in the Department of Otolaryngology and Communication Sciences. He primarily treats adults with hearing loss, middle ear disorders and lateral skull base tumors.</span></p> <p><span>A significant component of Harris’ clinical practice is cochlear implantation, which dovetails with his research interest in surgical and patient factors that influence outcomes related to speech recognition and environmental sound perception. Additional research pursuits include the mechanisms linking hearing loss and cognitive decline and how hearing rehabilitation may affect that association.</span></p> <p><span>Harris’ research has been supported externally by several foundation grants, and in 2021, he received an R21 grant from the NIH/NIDCD for his work on safety-relevant environmental sound perception in adults with hearing loss.</span></p> <p><span>“The clinical and research training opportunities that I had at IU were very special and unique,” Harris said. “Several of my mentors and co-residents from IU are now close research collaborators and colleagues. I continue to benefit and grow thanks to my experiences at IU.”</span></p>Thu, 28 Apr 2022 00:00:00 Z{49C332FE-002B-4BFD-A1D0-8B2664325DA5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/april-2022-newsletterApril 2022 Newsletter<h3>Cardiovascular Institute </h3> <em>One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</em> <p> </p> <h3>Top News</h3> <h3><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/achd-accredidation.png?h=300&w=300&rev=7dc99a14491c48a8aa733d56d93a51a1&hash=F44C4276ACF6D28F16FC8A7220863B57" style=" height:300px; width:300px" alt="ACHD Accreditation" class="float-right" /></h3> <h2>National Accreditation Secured for Adult Congenital Heart Disease Program</h2> <p> With the leadership of ACHD Medical Director, <a href="https://iuhealth.org/find-providers/provider/stephen-c-cook-md-1351756">Stephen Cook, MD</a>, we are pleased to announce that the Adult Congenital Heart Association (ACHA) has awarded the Indiana University Health Adult Congenital Heart Disease Program a status of an ACHA ACHD Accredited Comprehensive Care Center, valid for a 5-year period. Already, this program is impacting the lives of many patients in Indiana and Beyond with ACHD, many of whom require cardiac surgery in adulthood to maintain healthy, active lives. </p> <p> </p> <h2>Blake Dye Announces His Retirement</h2> <h3><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/blake-dye.jpg?h=200&w=200&rev=c3a00589b7394e3299c226353cfffab2&hash=47A252B059BF5E8411A2A92BAD2B6176" alt="Blake Dye" class="float-right" style="height: 200px; width: 200px;" /></h3> After 43 years of exceptional service in healthcare, Blake Dye, Senior Vice President for System Administration, has announced his retirement effective July 1, 2022. From the time he joined IU Health in 2018, his leadership and vision have been instrumental in the development and growth of the Cardiovascular Institute, including the successful implementation of the Heart Attack Prevention Program. He is deeply respected by his healthcare colleagues for his willingness to listen and to serve as a mentor and the Cardiovascular Institute is fortunate for his many contributions and rich experience. Please join us in congratulating Blake on his well-deserved retirement. <p> </p> <p> </p> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/imag0336_2_14781767156_o.jpg?h=230&w=200&rev=47dbc3d120aa429f88054662f353fa75&hash=AADD0029CC04A55CE27E278712F3C746" alt="Kimberly McClish" class="float-left" style="height: 230px; width: 200px;" /> <h3>Welcome to Our Team</h3> <p>Please join us in welcoming <a href="mailto:kmcclish@iu.edu">Kimberly McClish, M.Ed</a>., to the CV Institute to serve as the Director of Educational Initiatives for the Krannert Cardiovascular Research Center. She comes to us with several years of experience, most recently from the IU School of Medicine Emergency Medicine and Purdue University at West Lafayette in Electrical and Computer Engineering. Kimberly is passionate about education and will lead our development through strategic collaborations and research education programs. </p> <p> </p> <p> </p> <p> </p> <p> </p> <h3>Kudos</h3> <h2>Awards</h2> <a href="mailto:masepulv@iu.edu">Marisa Sepulveda's, PhD</a>, AHA Career Development application, titled "The Role of Endothelial Serine Protease 23 and Its Post-Transcriptional Inhibitor in Ischemic Cardiac Injury", has been funded with an exceptional score for 3 years beginning April 1, 2022. In this study, they seek to understand heart protection controlled by one enzyme and its inhibitor following heart attack using human blood vessel cells. This research will show how changing the levels of the enzyme and its inhibitor can prevent muscle damage after a heart attack.  <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/kyle-frick-md.png?h=200&w=160&rev=7d5b43dbfec3431595f4a56b9865bcb5&hash=96FCE1A69365BF9F7F9B34C5B298F03D" alt="Kyle Frick, MD" style="height: 200px; width: 160px;" class="float-left" /> <h2>Honors and Recognitions</h2> <p><a href="https://medicine.iu.edu/faculty/1783/frick-kyle">Dr.</a><a href="https://medicine.iu.edu/faculty/1783/frick-kyle"> K</a><a href="https://medicine.iu.edu/faculty/1783/frick-kyle">yle Frick</a> was recently selected into <a href="https://medicine.iu.edu/internal-medicine/faculty/professional-development/aspire">IU School of Medicine's ASPIRE program</a>. He will be collaborating with the Regenstrief Institute on a project aiming to improve cardiovascular care and outcomes by directly integrating cardiovascular disease specific health information exchange data into the electronic health record. </p> <p> </p> <p> </p> <p> </p> <h2>In the Media</h2> Read the <a href="https://www.wthr.com/article/news/local/iu-healths-cardio-oncology-program-helps-patients-manage-side-effects-caused-by-cancer-treatments-heart-cardio-illness/531-4aa52964-c450-4ead-91ff-2fecc9773bef">13WTHR</a> article to learn how <a href="https://iuhealth.org/find-providers/provider/suparna-c-clasen-md-134166">Dr. Suparna Clasen</a> helps a Carmel woman manage side effects of cancer treatments<br />  <br /> Watch the <a href="https://www.youtube.com/watch?v=OLwIzvv-JSU">WRTV</a> interview to hear what <a href="https://iuhealth.org/find-providers/provider/richard-j-kovacs-md-7412">Dr. Richard Kovacs</a> had to say about how COVID-19 increases the risk of cardiovascular disease, effecting patients of all ages. <br />  <br /> A first-of-its-kind operation using cells from the donor's immune system to help the recipient recognize the new heart as his own. Read the <a href="https://www.nbcnews.com/health/kids-health/one-infant-novel-heart-transplant-technique-may-help-fight-organ-rejec-rcna19008">NBC</a> article to learn what <a href="https://medicine.iu.edu/faculty/61331/breathett-khadijah">Dr. Khadijah Breathett</a> had to say.  <p> </p> <h2>Presentations</h2> <p>Cheers to the <a href="https://image.e.iu.edu/lib/fe2e11717d64047c7d1d71/m/1/7f0ba746-c68b-4fbf-9383-07832cfcb3cc.pdf">OneIUCV Cardiology team</a> that contributed to over 40 sessions at the American College of Cardiology's 71st Annual Scientific Session and Expo in Washington, DC, April 2 - 4, 2022 as presenters or panelists. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/acc-jeapordy_fellows.jpg?h=250&w=300&rev=c1321df618424ff09bf3401edbc4f6b9&hash=EC6BD6522B26EB49DBF5E12490085EE1" style="height: 250px; width: 300px;" alt="ACC'22 Fellows Jeopardy " />            <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/accguglin--fellow.jpg?h=250&w=300&rev=853c69629cdc4015912fd756daf6c2a7&hash=D8843D0912E2D575FAF59273D7E13A44" style="height: 250px; width: 300px;" alt="Dr. Asad Torabi & Dr. Maya Guglin" /></p> <p> </p> <p>                                      <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/acc-group-photo.jpg?h=350&w=250&rev=0966aa90385440209d68a0d9e3ffe2f3&hash=77809111132A3DE87D1D1F50647FA580" style=" height:350px; width:250px" alt="OneIUCV at ACC'22" /></p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/accraman--team.jpg?h=250&w=300&rev=d35e68510734417783d4d480b0d5f727&hash=8497E71E3F9DF0DE7D3F4A2754EA406D" alt="OneIUCV Cardiology at ACC'22" style="height: 250px; width: 300px;" />          <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2022/accraman--breathett.jpg?rev=33529c6e8541455898772822f3c8e7e4&hash=8D71209BCF65F38C5819AAE1E215C60F" alt="Dr. Subha Raman & Dr. Khadijah Breathett" style="height: 300px; width: 250px;" /></p> <p> <br /> Watch <a href="https://iuhealth.org/find-providers/provider/subha-v-raman-md-348534">Dr. Subha Raman's</a> <a href="https://players.brightcove.net/794311885001/default_default/index.html?videoId=6298630898001">presentation</a> on COVID implications on the heart at the "Roundtable Discussion: Managing Post-COVID Symptoms for Your Patients".<br /> <br /> <a href="https://iuhealth.org/find-providers/provider/suparna-c-clasen-md-134166">Dr. Suparna Clasen</a> and <a href="https://iuhealth.org/find-providers/provider/balaji-k-tamarappoo-md-1428722">Dr. Balaji Tamarappoo</a> recently gave a joint <a href="https://iu.mediaspace.kaltura.com/media/t/1_d5x52rob">presentation</a> on "Cardio-Oncology at IU/IU Health: Mission Aligned Advances for 2022 and Beyond"  at IU Simon Comprehensive Cancer Center's Grand Rounds. </p> <p> </p> <h2>Publications</h2> The case report, recently published in <em><a href="https://jamanetwork.com/journals/jamacardiology/fullarticle/2789374?guestAccessKey=f1d8d999-653f-4519-9503-0a0dbdd6f697&utm_source=jps&utm_medium=email&utm_campaign=author_alert-jamanetwork&utm_content=author-author_engagement&utm_term=1m">JAMA Cardiology</a></em> by <a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Dr. Asad Torabi</a> and <a href="https://iuhealth.org/find-providers/provider/roopa-a-rao-md-55326">Dr. Roopa Rao </a>, highlights a rare complication and discusses management for a young woman who presented with shock from a viral infection and required mechanical heart support (Impella). <br />  <br /> CV Institute is committed to bringing high value cardiovascular care to Indiana communities. Read <a href="https://iuhealth.org/find-providers/provider/subha-v-raman-md-348534">Dr. Subha Raman's</a> recent <a href="https://academic.oup.com/eurheartj/advance-article-abstract/doi/10.1093/eurheartj/ehac079/6535890?redirectedFrom=fulltext">editorial</a> in European Heart Journal (IF 29.98) on how we get there, and listen to a recent European Society of Cardiology <a href="https://www.escardio.org/The-ESC/What-we-do/news/ESC-Cardio-Talk">podcast</a> by her and <a href="https://iuhealth.org/find-providers/provider/balaji-k-tamarappoo-md-1428722">Dr. Balaji Tamarappoo</a> discussing a high-value tool for CV diagnosis to guide effective management. <br /> <p> </p> <h3>Exciting Career Opportunities</h3> <p> <br /> KCVRC has, as its charge, the interdisciplinary advancement in understanding, preventing, and treating cardiovascular diseases, translating basic discoveries to favorably impact the cardiovascular health of the people of Indiana and beyond. The Center aims to advance the capabilities of high impact programmatic teams and a pipeline of talent to establish around strong pillars and cross-cutting themes in cardiovascular science. <br />  <br /> <strong>KCVRC Major Research Areas: </strong><br /> <strong>Themes:</strong> Ischemic Heart Disease l Rhythm Disorders l Heart Failure<br /> <strong>Pillars:</strong> Imaging l Informatics l Omics<br /> <br /> Spread the word and refer those in your network!<br /> <br /> For <strong>academic positions</strong>: postdoctoral fellowships, research scientists, and tenured/tenure track: <br /> At <a href="https://jobs.iu.edu/">Jobs.IU.edu</a> browse Faculty<br /> Click on IU School of Medicine<br /> Search on keywords cardiology cardiovascular medicine research<br /> <br /> For <strong>staff positions</strong>: basic, translational and clinical research, finance and administration: <br /> At <a href="https://jobs.iu.edu/">Jobs.IU.edu</a> under the header Staff Positions<br /> Select Current Employees or External Candidates<br /> Keywords: cardiology cardiovascular medicine research<br /> <br /> If you do not see a posting of interest, please refer your colleagues to <a href="mailto:cardadmn@iu.edu">cardadmn@iu.edu</a> to inquire about upcoming opportunities. <br /> <br /> <br /> </p> <p>Do you have a story that reflects the strength of our statewide system for cardiovascular care? <br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team! </p>Thu, 28 Apr 2022 00:00:00 Z{F8A0D890-C3D4-4524-AE46-EFC700982FC0}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/february-2022-newsletterFebruary 2022 Newsletter<h3>Cardiovascular Institute</h3> <p><em>One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</em></p> <p> </p> <h3>Connect to Promise</h3> <p>Four of our team members, <a href="https://iuhealth.org/find-providers/provider/rolf-p-kreutz-md-7442">Dr. Rolf Kreutz</a>, <a href="https://iuhealth.org/find-providers/provider/tanyanan-tanawuttiwat-md-296353">Dr. Tanya Tanawuttiwat</a>, <a href="https://iuhealth.org/find-providers/provider/tanyanan-tanawuttiwat-md-296353">Ashley Henthorn, NP</a>, and <a href="mailto:asnodgrass1@iuhealth.org">Angie Snodgrass</a>, showed true dedication to the health and safety of our patients by remaining in-house at Methodist and Eskenazi Hospitals during our most recent winter storm. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/capture.jpg?h=159&w=570&rev=e4acf02d868d44eeae7b72818783b8cc&hash=6F19ADAD645F89075F435EE98C3B00F0" alt="IUH Team Members: Dr. Rolf Kreutz, Dr. Tanya Tanawuttiwat, Ashley Henthorn, NP, & Angie Snodgrass" style="height: 159px; width: 570px;" /></p> <p> </p> <h3>Welcome to our Team</h3> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2022/02/17/02/08/61515-ankur-kalra.png?h=225&w=150&rev=43f23361878b4f358c6f910f882c187d&hash=87FBEBE852ECB1CB185743350105DCC8" style="height: 225px; width: 150px;" alt="61515-Kalra, Ankur" class="float-left" />We are thrilled to announce the successful recruitment of <strong>Dr. Ankur Kalra</strong> from the Cleveland Clinic to Indiana University School of Medicine by IUSM/IUH Cardiovascular Institute and IUSM Department of Medicine, as the CV Institute Director for Interventional Cardiology Quality and Innovation. Dr. Kalra is a nationally, and internationally, recognized interventional cardiologist through his work advancing interventional quality and innovation, with additional expertise in health economics, outcomes and management. He has published over 250 scientific manuscripts in various peer-reviewed journals, and routinely presents late-breaking clinical trial results at national and international scientific meetings. He has uniquely advanced the combination of peer-reviewed science with cardiovascular social media to further drive the impact of cardiovascular innovations.</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/linda-altmeyer.jpg?h=150&w=150&rev=2f82716b1c614bcb810f776142f7d7f3&hash=58CF3CC019C03C9BAFAFC3E0E7DA357A" alt="Linda Altmeyer, MPH" style="height: 150px; width: 150px;" class="float-left" /></p> <p>Please join us in welcoming <strong>Linda Altmeyer, MPH</strong>, to CV Institute to serve as the Director of Operations for the Krannert Cardiovascular Research Center and will be working on the operations and program development of the Center. She comes to us with over 20 years of experience, serving most recently as the Director of Education in the Department of Radiology at IU School of Medicine and prior to that as the Director of Programs for the Alzheimer's Association Greater Indiana Chapter. </p> <p> </p> <p> </p> <p> </p> <h3>Top News </h3> <p> </p> <h2>IUH Bloomington Cardiothoracic Surgery Program Receives Three-Star Rating</h2> <p>The IU Health Bloomington Cardiothoracic Surgery Program has earned a distinguished three-star rating from The Society of Thoracic Surgeons (STS) for its patient care and outcomes in isolated coronary artery bypass grafting (CABG) procedures. The three-star rating, which denotes the highest category of quality, places the IU Health Bloomington Cardiothoracic Surgery Program among the elites for heart bypass surgery in the United States and Canada. <br /> <br /> The STS star rating system is one of the most sophisticated and highly regarded overall measures of quality in health care, rating the benchmarked outcomes of cardiothoracic surgery programs across the United States and Canada. The star rating is calculated using a combination of quality measures for specific procedures performed by an STS Adult Cardiac Surgery Database participant. Approximately 20% of participants receive the three-star rating for isolated CABG surgery. The latest analysis of data for CABG surgery covers a 3-year period, from 7/1/2018 - 6/30/2021. </p> <p> </p> <h2>IU Health Methodist November 2021 Top Performer</h2> <p>Based on feedback from our patients, Cardiac Rehabilitation has earned the honor of being the IU Health Methodist Top Performer in patient experience for November 2021! This award recognizes the teams' efforts to deliver on the IU Health's Promise - The Best Care, Designed for You to build a culture where we demonstrate Whole Person Care and Personalized Approach with every person, every time. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/capture_team.jpg?rev=ac4f7d3190c34737ab5a2774ce0df72d&hash=FF7B39D09B9B948B8999631EB6DC8090" alt="IU Health Cardiac Rehabilitation Team " style="height: 340px; width: 490px;" /></p> <p> </p> <h2>Joint Commission Re-Designation Surveys</h2> <p> Congratulations to the following programs at IU Health Ball Memorial for an outstanding Joint Commission re-designation survey:<br /> <br /> • Cardiac Service Line - Chest Pain Certification<br /> • Stroke Program - Primary Stroke Certification<br /> • Heart Failure Program - Heart Failure Certification<br /> <br /> Our direct staff did an amazing job speaking with the surveyors and highlighting our programs. The surveyors were highly complementary of each program and were impressed with the quality of services sustained in difficult times during the pandemic. </p> <p> </p> <h2>Home is Where the Heart Is</h2> <p> Philanthropy-funded program enables cardiovascular patients in the East Central Region to participate in cardiac rehabilitation without leaving the comfort of their own homes.</p> <div><a href="https://iuhealth.org/thrive/home-is-where-the-heart-is?utm_source=newsletter&utm_medium=email&utm_campaign=feb_2022_stories&utm_id=feb_2022_stories&utm_source=MarketingCloud&utm_term=&utm_content=2/2/2022">Read More</a></div> <p> </p> <h2>Leadership Announcement</h2> <p> We are thrilled to share with you that effective January 2022, <a href="https://iuhealth.org/find-providers/provider/olexandr-v-smolensky-md-885491">Alexander Smolensky, MD</a> is the new IUHP Academic Cardiology Service Line (CSL) Director and IUSM/Division of Cardiovascular Medicine Director of Clinical Affairs, charged with further advancement of the clinical mission in line with the overall vision and strategy of the IUSM Division of Cardiovascular Medicine in the Department of Medicine. Dr. Smolensky was a postdoctoral research fellow at Krannert from 2002 to 2006 and completed his internal medicine residency at IU in 2009. After a postdoctoral research year in IUSM’s Division of Pulmonary & Critical Care Medicine, he attended Emory University from 2010-2014 for fellowship training in Cardiovascular Medicine and additional subspecialty training in Preventive Cardiology. After gaining 6 years’ experience in practice as a general cardiologist in Georgia, he was recruited back to join IUSM as faculty in 2020 and will matriculate from the Johns Hopkins University MBA program in 2022.<br />   <br /> We are grateful to Dr. Kovacs for his many years of service in this position, and excited about the work that Alex has already undertaken to ensure the highest quality, most contemporary cardiovascular care for our patients.</p> <p> </p> <h2>Dr. Williams Announces His Retirement </h2> <p> </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/01/26/17/26/4823-eric-williams.png?h=180&w=120&rev=4af8ecfb692b4944be4543ca1d3fe521&hash=21666F7BDFE314C55D7A79D4401C9047" alt="4823-Williams, Eric" style="height: 180px; width: 120px;" class="float-left" /></p> <p>After 46 years of service, <a href="https://iuhealth.org/find-providers/provider/eric-s-williams-md-10129">Dr. Eric Williams</a> has announced his retirement, effective June 30, 2022. Over the course of his career, Dr. Williams has made innumerable contributions to the clinical and education missions. His leadership and vision have been instrumental in the growth and success of IU Health Physicians Cardiology and the Division of Cardiovascular Medicine. He has trained generations of cardiologists, including two Presidents of the American College of Cardiology, defined the competencies required of the cardiologists of future generations, and has been recognized as a master clinician by both the American Heart Association and the American College of Cardiology. He is deeply loved by his patients and colleagues alike for his willingness to listen and provide thorough personable care. <br /> <br /> We celebrate Dr. Williams as a teacher, colleague, inspiring leader, and caring physician. His influence on cardiology in the United States will long continue in those he has trained and mentored. Please join us in congratulating him on his well-deserved retirement. </p> <p> </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/capture2.jpg?h=335&w=800&rev=ade7daec649748579d243ca0b26e23fa&hash=D8E2BEEBD24350914703A1C9615D1C6A" alt="American Heart Month Logo" style="height: 335px; width: 800px;" /></p> <p>Heart disease continues to be the greatest health threat to Americans and is still the leading cause of death worldwide. Find great information compiled by the <a href="https://www.nhlbi.nih.gov/health-topics/education-and-awareness/heart-month/fact-sheets">U.S. National Institutes of Health</a> to help take care of your heart and the hearts of those you love. The <a href="https://www.empoweredtoserve.org/en/community-resources/health-lessons-overview">American Heart Association</a> also has great online heart health lessons for co-workers, family and friends. <br /> <br /> Hear IU Health Heart specialists <a href="https://iuhealth.org/find-providers/provider/julie-m-clary-md-5400">Julie Clary, MD</a>, <a href="https://iuhealth.org/find-providers/provider/balaji-k-tamarappoo-md-1428722">Balaji Tamarappoo, MD, PhD</a>, and <a href="https://iuhealth.org/find-providers/provider/william-j-gill-md-6296">William Gill, MD</a> offer more about modern approaches to heart disease detection and prevention at this <a href="https://www.youtube.com/watch?v=qBKRL8q0ylo">'Talk with a Doc'</a> IU Health Webinar.</p> <p> </p> <h3>Krannert Cardiovascular Research Center Highlights</h3> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/r/rohan--dharmakumar-cropped.jpg?h=243&w=174&rev=6fbbee7b55874e20a777db6960570cbc&hash=8E0E94365F0D7174EB85FD1156646905" alt="Rohan Dharmakumar, PhD" style="height: 243px; width: 174px;" class="float-left" /></p> <p>Sudden blockage of coronary arteries supplying the myocardium contributes to millions of ST-elevation acute myocardial infarction (MI) in the world each year. Early reperfusion therapy in ST-elevation MI is lifesaving and is recommended by multiple societal guidelines as it can stop the initial wave of cardiomyocyte cell death and reduce the final MI size -- a key predictor of major adverse cardiovascular outcomes in the post MI setting. However, the benefit of reperfusion therapy is often paradoxically diminished as reperfusion itself can potentially double the MI size. Over the past few decades there have been extensive efforts to mitigate this reperfusion induced injury. Yet, why some patients experience extensive infarct expansion following reperfusion while others do not remains unclear.  As a result, all reperfused MI patients are treated the same and currently there are no highly effective therapies which can target those patients at the greatest risk for extensive myocardial damage following reperfusion – leading to a number of calls to gather further insight into reperfusion therapy.  <br /> <br /> One of the known, yet underappreciated, consequences of reperfusion therapy is myocardial hemorrhage, which is reported to occur in ~50% of the reperfused MI patients. However, whether reperfusion hemorrhage contributes to final infarct size is not known. In his paper that was recently published in the high impact <a href="https://www.jacc.org/doi/10.1016/j.jacc.2021.10.034">Journal of the American College of Cardiology</a>, <a href="https://medicine.iu.edu/faculty/60337/dharmakumar-rohan">Dr. Rohan Dharmakumar</a> and his team demonstrates that if the MI zone becomes hemorrhagic in response to reperfusion, it can significantly expand the MI size in post reperfusion period, independent of well-known predictors of MI size (ischemic extent and time). Their studies which followed MI size through the lens of time-resolved assessment of blood markers and noninvasive imaging confirmed their hypothesis. Controlling for infarct size immediately after reperfusion, they found that hemorrhage within the area at risk is a major determinant of final MI size. Dr. Dharmakumar and his team believe these findings transform the understanding of the role of hemorrhage in MI expansion and will trigger investigations for advancing acute care management, risk assessment and future therapeutics. </p> <p> </p> <h3>Kudos</h3> <p> </p> <h2>Emerging Leaders</h2> <p><a href="https://iuhealth.org/find-providers/provider/erin-l-wilkerson-np-10121">Erin Wilkerson, NP</a> completed the Emerging Leaders Program through IU Health. This program is a six-month curriculum developed by the Learning Institute. It is designed to develop hard and soft leadership skills in team members who have demonstrated leadership across many planes but that are currently not in official leadership positions. Participants explore basic leadership and management topics, including effective communication and presentation skills, building trust, leadership coaching and time management. In addition to classroom sessions, emerging leaders are offered mentorship, leader debriefs, small group work and a variety of exposure to leaders at all levels, through storytelling, interviewing, panel discussions and more. </p> <p> </p> <h2>Honors and Recognitions</h2> <p>Congratulations to <a href="https://iuhealth.org/find-providers/provider/onyedika-j-ilonze-md-885481">Dr. Onyedika Ilonze</a> for being selected as a member of the Heart Failure and Transplant Section Leadership Council for a three year term starting in April 2022. Additionally, Dr. Ilonze was selected to attend the ACC Upping Your Game clinical trials research training program that lasts for three sessions from January to November 2022.</p> <p> </p> <h2>Publications</h2> <p><a href="https://medicine.iu.edu/faculty/38253/torabi-asad">Dr. Asad Torabi</a> and colleagues demonstrated the impact of social deprivation on cardiovascular outcomes in their paper recently published in the <a href="https://onlinelibrary.wiley.com/doi/10.1002/ccd.30108">Catheterization & Cardiovascular Interventions Journal</a> . Higher social deprivation was associated with higher risk of all-cause death as well as specifically cardiovascular death and recurrent MI among patients with a diagnosis of diabetes. There was no significant association demonstrated among patients without diabetes. <br /> <br /> Cheers to our Advanced Heart Failure Team for their extensive comments on the topic "Heart Failure and Transplantation: Key Wins in 2021" in the <a href="https://bluetoad.com/publication/?m=14537&i=733621&p=30&ver=html5">Cardiology Magazine</a>. There were many great advances in the field of heart failure and cardiomyopathies last year. The whole new class of drugs - myosin modulators - were introduced and tested in randomized clinical trials for heart failure with reduced ejection fraction, and even more importantly, in hypertrophic obstructive cardiomyopathy. A number of other trials advanced the management of heart failure by testing SGLT-2 inhibitors. Moreover, a great deal of knowledge has been accumulated in the area of cardiac involvement in COVID-19, including <a href="https://link.springer.com/article/10.1007/s10741-021-10181-y">clinical outcomes and immunosuppression</a> strategies and <a href="https://link.springer.com/article/10.1007/s10741-021-10129-2">clinical variants</a>.<br /> <br /> <a href="https://medicine.iu.edu/faculty/5070/kreutz-rolf">Dr. Rolf Kreutz's</a> recent publication in the <a href="https://www.ahajournals.org/doi/10.1161/JAHA.121.024159">Journal of the American Heart Association</a> analyzed data from 9 centers in the IGNITE network pharmacogenetics working group where CYP2C19 genotyping was studied in the setting of PCI. Carriers of loss-of-function alleles of CYP2C19 who are treated with ticagrelor were at lower risk for major atherothrombotic events than those treated with clopidogrel. There was no significant differences in MACE events for patients with normal CYP2C19 metabolizer status (no loss-of-function) treated with clopidogrel as compared to ticagrelor or prasugrel. The results suggested that PCI patients treated with clopidrogrel should undergo genotyping so that CYPC219 loss-of-function carriers can be treated with alternate therapy. <br /> <br /> </p> <h3>Upcoming Events</h3> <p> </p> <h2>Hoosier Health Series</h2> <p>Learn why the opioid crisis has IU Health experts concerned about the drug's impact on heart health. Join <a href="https://iuhealth.org/find-providers/provider/pantila-vanichakarn-bateman-md-9843">Pantila Bateman, MD</a>, on and Michele Saysana MD, FAAP, on February 23 at noon for a discussion about how you can help stop the stigma and help reduce the impact of this crisis.<br /> <br /> <a href="https://teams.microsoft.com/registration/Y3DU2V4_6U2_mfCDZX-g_g,cS9FacNJ20qfclErcWlgMQ,EeP2cDZiTUydr6t3igspaw,UvRYHDicUUy4NF307vj1bg,uNoKdhmql0mc9UDLC9PbbA,eHD88tGiF0mbaMx4wzPTzw?mode=read&tenantId=d9d47063-3f5e-4de9-bf99-f083657fa0fe&utm_source=MarketingCloud&utm_term=&utm_content=2/2/2022">Register Here</a><br /> <br /> </p> <p><em> </em></p> <p><em>Do you have a story that reflects the strength of our statewide system for cardiovascular care? <br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</em></p>Mon, 21 Feb 2022 00:00:00 Z{D7B75CE5-8F4A-4D27-9C40-9D0E2B201007}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/meet-dr-mateusz-opyrchalMeet Mateusz Opyrchal, MD, PhD<p>Mateusz Opyrchal, M.D., Ph.D., began the New Year with a new job as the inaugural Vera Bradley Foundation Scholar in Breast Cancer Discovery in the Vera Bradley Foundation Center for Breast Cancer Research at the <a rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">IU Simon Comprehensive Cancer Cente</a>r. He also serves as the co-program leader of the cancer center’s <a rel="noopener noreferrer" href="https://www.cancer.iu.edu/research-trials/programs/therapeutics/index.php" target="_blank">Experimental and Development Therapeutics research program</a> with Xiongbin Lu, Ph.D., and director of the solid tumor Phase I program.<br /> <br /> Dr. Opyrchal’s research focuses on novel therapeutic approaches and enhancing immune responses in triple negative breast cancer. His recruitment, made possible by Vera Bradley Foundation for Breast Cancer funding, expands IU’s leadership and knowledge base for the immunotherapy initiative with the goal of developing innovative approaches to help patients with this disease.<br /> <br /> Dr. Opyrchal answered questions about what brought him to IU, his research, and more.<br /> <br /> <strong>Q. What attracted you to IU?<br /> </strong> <br /> A. I was drawn by the opportunity to build a great program to move great science being done at IU into the clinic.<br /> <br /> <strong>Q. What can you tell us about your research?<br /> </strong> <br /> A. I’m interested in discovering new cancer targets with an emphasis on how they affect the tumor cells directly and the microenvironment surrounding them.<br /> <br /> <strong>Q. How do you see immunotherapy transforming the future of cancer treatment?<br /> </strong> <br /> A. We have all seen the impact immunotherapy has had already on the treatment of many cancers. Unfortunately, most patients with solid tumors, outside of a few outliers like melanoma, receive limited or no benefit from current immunotherapy treatments. I’m hopeful that we will be able to increase the number of patients benefiting from treatments and overcome some of the resistance pathways to increase duration of response.<br /> <br /> <strong>Q. What do you find most exciting about your cancer research?<br /> </strong> <br /> A. I think we all start out with the big dream of curing cancer. The many years of reality have shown us how difficult it is, but I’m hopeful that my research will bring us one small step closer.<br /> <br /> <strong>Q. What is the most rewarding part of being a physician?<br /> </strong> <br /> A. There are many, but if I was going to highlight a few: the relationships with patients where often you learn more from them about yourself and life in general as you guide them through the disease treatments; the relationship with your colleagues is also very rewarding and allows you to continually learn; and the relationship with the mentees and seeing them grow into their roles and become successful.<br /> <br /> <strong>Q. As you look back on your career, which cancer research advances most stand out to you?<br /> </strong> <br /> A. I started my fellowship just as ipilimumab (an immunotherapy medication) was approved and the changes over the last 10 years have been amazing to observe. Also, the concept of personalized medicine has developed and how to concentrate on one patient at a time with their unique features.</p> <p><strong>Q. What are the biggest questions in cancer research that keep you up at night?<br /> </strong> <br /> A. I think we are all struggling with being better at preventing and curing metastatic disease without causing undue toxicities.<br /> <br /> <strong>Q. What do you like to do in your spare time?<br /> </strong> <br /> A. Trying to keep my two boys out of causing trouble seems to take up a lot of time. I find myself taking up taekwondo, golf and hiking in hopes of focusing their energies somewhere else–so far with not too much success outside of sore muscles for me.</p>Fri, 04 Feb 2022 00:00:00 Z{D94FD9A9-77F0-4A6C-8E0A-870D7345B3F5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/december-2021-newsletterDecember 2021 Newsletter<h1>Cardiovascular Institute </h1> One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.<br /> <br /> Cheers to all you do for our patients, our families, and each other throughout the year. Here's wishing you and yours a joyful holiday season, and the best of health and happiness in 2022.  <br /> <br /> <h3>Welcome to our Team</h3> <p>CV Institute and Krannert Cardiovascular Research Center are thrilled to announce our successful recruitment of Khadijah Breathett, MD. She is a nationally recognized heart failure & transplant cardiologist committed to achieving national health equity among populations with the highest prevalence of heart failure - patients of color and women. Dr. Breathett is leading national multicenter Clinical Trials, supported by a considerable portfolio of NIH funding, and is committed to translating advances to reduce CV health disparities in Indiana and beyond. </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/breathett.jpg?h=246&w=225&rev=39e150a782734387962f6cd0b917c6e8&hash=0719CC7FC37D035D856B3EE4EB769BCD" style="height: 246px; width: 225px;" alt="Dr. Khadijah Breathett" />  <p> </p> <h3>Top News</h3> <h2>IUHP Specialty Care Top Performer Award: Advanced Heart & Lung Clinic</h2> <p>Based upon feedback from our patients, the Advanced Heart & Lung Clinic has earned the honor of being the IU Health Physicians Specialty Care Top Performer in patient experience for Q3 2021 with a score of 95.52%. Congratulations to the entire team for delivering the best care and personalized approaches for every patient, every time! </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/ahc-heart--lung-clinic.jpg?h=375&w=282&rev=0655189896a946d383a4860088e836b8&hash=945EDCAB97A3155DD6B69898923E0820" style="height: 375px; width: 282px;" alt="AHC Heart and Lung Clinic " /></p> <p> </p> <h2>The President's Values Leadership Award: IU Health Ball Heart & Lung Center</h2> <p>Cheers to the IU Health Ball Heart & Lung Center team for being awarded the 2021 President's Values Leadership award,  demonstrating extraordinary dedication to the IU Health vision, values and promise, both at work and in their community. This team's most significant impact is the attainment of exceptional outcomes that exceed national metrics. The IU Health Ball Heart & Lung Center executes a unique model that combines all care modalities to provide the very best care to some of the most vulnerable patients with respect, kindness and empathy. </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/vla-hlc-team.jpg?h=250&w=375&rev=c9b4420297ba4ce9b337d9cbebd44931&hash=B4AEE7137724B8084DA7E47F98BB96F6" style="height: 250px; width: 375px;" alt="IU Health Ball Memorial Heart & Lung Center" />  <p> </p> <h2>Pivotal Vascular Case: Implantation of Human Acellular Vessel</h2> <p>The IU Health Vascular team provided a first-in-Indiana operations for a patient at the legacy IU Health Bloomington Hospital on December 2, 2021. The team led by Dr. <a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/duangnapa-s-cuddy-do-68824" target="_blank">Duangnapa Cuddy</a> and <a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/david-a-peterson-md-70156" target="_blank">Dr. David Peterson</a> implanted a Human Acellular Vessel (HAV) to improve outcomes for a female patient with kidney disease. The HAV is the first bioengineered blood vessel that once implanted will regenerate becoming indistinguishable from the patient's own tissue and is currently in phase lll clinical studies for use in AV access and trauma. This case embodies the values we seek to fulfil each day in both the ordinary, and extraordinary, work and that will contribute to fostering education, innovation, and collaboration. </p> <p> </p> <h3>Fellowship Match Results</h3> <p>December 1st was Fellowship Match Day. We matched 5/5 openings and are excited to welcome a new group of physicians to our fellowship training program! <br /> <br /> Our new Cardiovascular Disease Fellows starting July 2022: <br /> (Name and Residency)<br />  <br /> •<span> </span>Arjun Khadilkar, University of South Florida<br /> •<span> </span>Natalia Reborido-Campoy, Ascension St. Vincent Hospital<br /> •<span> </span>Jacob Sama, John Hopkins University, Bayview Medical Center<br /> •<span> </span>Marina Sharif, Virginia Commonwealth University<br /> •<span> </span>Nathan Wheeler, University of Wisconsin</p> <p> </p> <h3><span style="color: rgb(51, 51, 51);">Krannert Cardiovascular Research Center Highlights</span></h3> <h2>Awards</h2> <p> <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/4919/everett-thomas" target="_blank">Thomas Everett, PhD</a>, was recently awarded a National Institutes of Health RO1 for his application entitled: "SKNA as a Biomarker for Cardiovascular Events". He and his team have developed a new method to non-invasively measure skin sympathetic nerve activity and have recently documented that sympathetic nerve activity correlates to the onset of atrial and ventricular arrhythmias. This research program proposes to determine if the skin sympathetic nerve activity can be used as a prognostic biomarker for neurological status during targeted temperature management for cardiac arrest and to risk stratify patients for recurrence of atrial fibrillation after ablation therapy. </p> <p><a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/61027/sharif-behzad" target="_blank">Dr. Behzad Sharif</a> was selected as an awardee of the Indiana Collaborative Initiative for Talent Enrichment (INCITE) program funded by the Lilly Endowment to attract top biomedical scientists to IU School of Medicine. He will use this funding to foster new industry-academic partnerships between KCVRC and Cook Medical, leveraging a new platform of "low field" MRI scanners which have a wider bore. Using a combination of technologies including artificial intelligence, Dr. Sharif's collaborative efforts will focus on enabling the next generation of MRI-guided cardiovascular interventions and to expand the application of cardiac MRI to a much wider cohort of patients across the state.  </p> <p><span style="color: rgb(51, 51, 51);"><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/10/23/06/07/61027-behzad-sharif.png?h=299&w=200&rev=bb1519d2fc0749869599bbd15d704caa&hash=74DBBE0EA346EC3F23FF95DBC0BB854C" style="height: 299px; width: 200px;" alt="61027-Sharif, Behzad" /></span></p> <p> </p> <h2>Publications</h2> <p> Idiopathic pulmonary arterial hypertension (IPAH) is a rare but fatal syndrome requiring an invasive test called right heart catheterization for diagnosis. IPAH is characterized by significant heterogeneity with varied treatment responses between different patients. In <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/41953/desai-ankit" target="_blank">Dr. Ankit Desai's</a> recent publication in <em><a rel="noopener noreferrer" href="https://www.nature.com/articles/s41467-021-27326-0#Abs1" target="_blank">Nature Communications</a></em>, he participated with European colleagues to show how conventional clinical factors incorporated with genetic and genomic signatures identify three major patient sub-groups that account for 92% of patients with disease. This combined algorithm further classifies these three groups with either a poor, moderate, or good prognosis. The work provides evidence for the existence of 3 major subgroups within the IPAH classification and could improve risk stratification as well as provide molecular insights into the pathological development of IPAH.  </p> <p>Cheers to <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/4919/everett-thomas" target="_blank">Thomas Everett, PhD</a> for his recent publications on <a rel="noopener noreferrer" href="https://www.heartrhythmjournal.com/article/S1547-5271(21)02166-4/fulltext" target="_blank">obstructive sleep apnea</a> and abnormality increased sympathetic tone, improved with CPAP, use of <a rel="noopener noreferrer" href="https://www.heartrhythmjournal.com/article/S1547-5271(21)02212-8/fulltext" target="_blank">Holter monitoring</a> for both ECG and skin sympathetic nerve activity recording, and bursts of sympathetic nerve activity in patients with heart disease that may trigger <a rel="noopener noreferrer" href="https://www.frontiersin.org/articles/10.3389/fphys.2021.742844/full" target="_blank">arrhythmias</a>.  </p> <p><span style="color: rgb(51, 51, 51);"> </span></p> <h3><span style="color: rgb(51, 51, 51);">Kudos</span></h3> <h2>Emerging Leaders</h2> <p> <a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/roopa-a-rao-md-55326" target="_blank">Dr. Roopa Rao</a> and <a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/stephen-c-cook-md-1351756" target="_blank">Dr. Stephen Cook</a> have been accepted into the IUSM Department of Medicine/Kelley School of Business Program entitled, "Business of Medicine Leadership Program". This program is designated to provide clinical faculty and emerging leaders with a professional development opportunity to increase business acumen, leadership and expertise. </p> <p><a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/olexandr-v-smolensky-md-885491" target="_blank">Dr. Olexandr (Alex) Smolensky</a> has been selected by leaders across OneIUCV for the 2021-2022 Emerging Leaders Training Program. The goal of this program is to empower our physicians with the approaches and insights needed to be successful leaders at IU Health/IU School of Medicine.  </p>  <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/project/facultyprofileimages/2021/09/13/21/40/2428-alexander-smolensky.png?h=300&w=200&rev=d316a3b6c1a24ee785eba55a763a6614&hash=AFF856E93AFE7D4FBC5D49F719B1C0CB" style="height: 300px; width: 200px;" alt="2428-Smolensky, Alexander" /> <p> </p> <h2>Honors and Recognitions</h2> <div>Congratulations to <a rel="noopener noreferrer" href="https://iuhealth.org/find-providers/provider/michael-c-dalsing-md-5622" target="_blank">Dr. Michael Dalsing</a> who has been elected to serve as the President of the national Society of Vascular Surgeons for a one year term from 2022-2023. </div> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dalsing-headshot.png?h=299&w=225&rev=dcb5de9e32854f01a74b04982631248c&hash=CD565147450A142E0861DEBCA5D0BB64" style="height: 299px; width: 225px;" alt="Dr. Michael Dalsing" /></p> <p> </p> <h2>Publications</h2> <p><a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/52146/ilonze-onyedika" target="_blank">Dr. Onyedika Ilonze's</a> manuscript was recently accepted for publication in <em><a rel="noopener noreferrer" href="https://link.springer.com/article/10.1007/s10741-021-10181-y" target="_blank">Heart Failure Reviews</a></em>. The impact of SARS-CoV-2 infection and optimal immunosuppression strategy in heart transplant recipients is unknown. Literature is limited to case reports and series and recently, few single center studies. To better identify the clinical features, outcomes, and immunosuppression strategies of heart transplant recipients with COVID-19 infection, Dr. Ilonze and his team analyzed all the case reports and case series and analyzed the clinical outcomes and management strategies. In conclusion, in heart transplant recipients with SARS-CoV-2 infection, new onset LV dysfunction is uncommon. They also have a higher mortality than the general population; and a strategy of increasing steroids and discontinuation of antimetabolites was the most used immunosuppression strategy. <br /> <br /> <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/4905/das-mithilesh" target="_blank">Dr. Mithilesh Das</a> and <a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/39198/lee-lawrence" target="_blank">Dr. Lawrence Lee's</a> manuscript was accepted for publication in <em><a rel="noopener noreferrer" href="https://www.annalsthoracicsurgery.org/article/S0003-4975(21)00536-1/fulltext" target="_blank">The Annals of Thoracic Surgery</a></em>. The Convergent Procedure is a collaborative treatment option for atrial fibrillation that combines the strengths of both minimally invasive surgical and catheter-based ablations. This procedure is the only FDA-approved treatment for certain types of chronic atrial fibrillation (which are notoriously difficult to treat). The Convergent Procedure is performed in two parts: the first part consists of a surgical ablation performed by a cardiac surgeon through a small incision below the ribcage, and the second part consists of a catheter-based ablation performed by an electrophysiologist several weeks later. Recovery time is minimal and patients can resume normal activities almost immediately. The Convergent Procedure offers patients and their physicians an effective treatment strategy that combines the best of current surgical and catheter-based options that maximize successful outcomes while minimizing risks. </p> <p> </p> <p> </p> <p style="">Do you have a story that reflects the strength of our statewide system for cardiovascular care? <br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</p>Thu, 23 Dec 2021 00:00:00 Z{BA88A4EE-1B5A-49C4-8A36-CF27C810EE9C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/radiologic-alumni-return-after-50-yearsRadiologic and Imaging Sciences alumni return to campus 50 years after beginning their trainingWhen it comes to education at Indiana University School of Medicine, it’s not just the training that can last a lifetime but also the connections that students make with their peers. Recently, the <a href="https://medicine.iu.edu/radiology/education/undergraduate-degrees">Radiologic and Imaging Sciences Undergraduate Programs</a> welcomed five alumni back to campus after nearly 50 years since their graduation from the program. <br /> <br /> The visiting alumni included Karen Retzner, Joan Burton, Marty Perkins, Wendy Ross and Lorraine Woodard, all of whom graduated from the radiography program back in 1973. Since their graduation, the group has stayed connected through thick and thin, with many of their children growing up with one another. After their graduation, the group began an annual gathering where they reunite for a day of fun activities to commemorate their education on the IUPUI campus. As this year marks 50 years since they began their training, they decided it would be extra special to return to the program that helped establish their careers and begin their lifelong friendships. <br /> <br /> “It was heartwarming to be a part of their visit,” mentioned Donna DeVault Clark, MPA, MA, undergraduate programs specialist. “The reminiscing and love for their profession was evident in their eyes and smiles.”<br /> <br /> During their visit, the group connected with current students, staff and faculty, including  <a href="https://medicine.iu.edu/faculty/12488/reeser-marti">Marti Reeser, EdD</a>, assistant dean of <a href="https://medicine.iu.edu/undergraduate-health-professions">Health Professions and Pre-Doctoral Programs</a> at IU School of Medicine, who shared his congratulations with the group on celebrating their milestone. <p>As the visiting alumni explored the campus, they even returned to some of the same halls they walked when they were in the program themselves. They also toured other facilities where students train and uncover the latest innovations in radiology, including new equipment in the Nuclear Medicine Technology and Ultrasound labs. A highlight from the day was when the group swapped stories during a visit with current second-year students, proving though the training has changed through the years, the comradery and lasting connections gained through the program have remained the same.<br /> <br /> “It’s encouraging to have the alumni visit <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/t/thumbnail_20210930_115231_edit.jpg?h=240&w=360&rev=36fff65a09f54e4d9278a488e4cc2c04&hash=56F947821DDD77EF130A6AA7416F505E" style=" height:240px; width:360px" class="float-left" / alt="Seven individuals posing for a group photo in front of a poster board" />and see how the campus and program have changed,” said <a href="https://medicine.iu.edu/faculty/6555/cranfill-kellie">Kellie Cranfill, MSRS, RT (R)(BD)</a>, director of the Radiologic and Imaging Sciences Undergraduate Programs. “I hope our current students can look at these remarkable women and see how they can also achieve just as much one day.” <br /> <br /> Among the alumni who visited, three stayed in the field of radiology throughout their careers—both in hospital and outpatient work— while others also pursued careers outside of radiology. Retzner, who helped organize the event, is currently a practicing nurse in Indianapolis but kept her radiography licensing active until last year. For her, as well as the other alumni, the program helped open doors to opportunity throughout Indiana, especially in health care and continuing her education. <br /> <br /> “With the extensive training the program offered me, I never had to search for a job.  They always found me,” said Retzner.<br /> <br /> The Radiologic and Imaging Sciences Undergraduate Programs at IU School of Medicine has grown substantially since the early 1970s. In addition to new modalities like Medical Imaging Technology, the program now trains students in multiple hospitals throughout Indianapolis and across the state. As the program continues to grow, it’s introducing more students to radiology each year, allowing them to understand the significant role radiologic technologists play in health care.<br /> <br /> The alumni returning is a testament to the exceptional training and the comradery that the program enabled 50 years ago and continues to support to this day—building bonds on campus that can last a lifetime. </p>Tue, 16 Nov 2021 00:00:00 Z{CC53CEC3-CBDC-416C-8019-24F41A52F49B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/iu-school-of-medicine-professors-mission-end-lung-cancer-nowIU School of Medicine professor's mission: End Lung Cancer Now<p><em><strong>Editor's Note:</strong> Sadly, advocate Alesha Arnold passed away Feb. 5, 2023. Her legacy lives on through the work of End Lung Cancer Now.</em></p> <p> </p> <p>Lung cancer has an image problem, and <a href="/faculty/5014/hanna-nasser">Nasser Hanna, MD</a>, wants to change that. <br /> <br /> Nearly everyone in America could tell you what the pink ribbon stands for when it pops up on store displays, product packaging and social media feeds during the month of October. But how many people know that November is Lung Cancer Awareness Month or that the white ribbon represents ending the stigma surrounding the No. 1 cancer killer? <br /> <br /> “Lung cancer kills twice as many women every year as breast cancer,” said Hanna, the Tom and Julie Wood Family Foundation Professor of Lung Cancer Clinical Research at Indiana University School of Medicine and a member of the IU Melvin and Bren Simon Comprehensive Cancer Center Leadership Council. <br /> <br /> He is spearheading an awareness and advocacy initiative called <a rel="noopener noreferrer" href="https://www.endlungcancernow.iu.edu/" target="_blank">End Lung Cancer Now</a>. <br /> <br /> “We know through data on stigma that breast cancer is viewed as victimizing women. Lung cancer is viewed as, ‘You got what you deserved,’ which is beyond cruel,” he said. “No one deserves lung cancer.” <br /> <br /> According to the <a rel="noopener noreferrer" href="https://seer.cancer.gov/statfacts/html/lungb.html" target="_blank">National Cancer Institute</a>, an estimated 235,760 new cases of lung cancer and 131,880 deaths are projected in the United States this year. In Indiana—as well as nationally and globally—lung cancer is the leading cause of cancer deaths in both men and women. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/hanna-sept-2021-near-bamboo.jpg?h=267&w=400&rev=f9667b54f88b4336b2f4fc48e337d060&hash=2880E3BF4A2B855CC6E6448FD3FC2765" style="height: 267px; width: 400px;" alt="Nasser Hanna" class="float-left" />“Lung cancer is the big elephant in the room,” Hanna said. “It takes the lives every year of more people than breast cancer, colon cancer and prostate cancer combined.” <br /> <br /> Indiana ranks a dismal fifth out of all 50 states for the most new cases of lung cancer in 2020. The Hoosier state has three big problems when it comes to eradicating lung cancer—a high number of smokers, low number of eligible people who get lung cancer screenings, and low participation in clinical trials for lung cancer. <br /> <br /> With improvement in these three areas, most lung cancers could be prevented or successfully treated—now, Hanna said. <br /> <br /> “We don’t have to discover anything new—we just need to implement what we know works,” he said. <br /> <br /> <br /> </p> <h3> What does a lung cancer patient look like? </h3> When thinking of lung cancer, most people wouldn’t picture a vibrant, Black woman in her 40s who has never smoked—a registered nurse who practices a healthy lifestyle and leads her daughters’ Girl Scout troops. <br /> <br /> “Lung cancer doesn’t discriminate. If you have lungs, you can get lung cancer,” said Alesha Arnold, RN, BSN, CCRP, a clinical research nurse in breast oncology at the IU Simon Comprehensive Cancer Center who has Stage 4 lung cancer. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/alesha-arnold-and-family.jpg?h=300&w=450&rev=1b16f6b2905f49da87fbeda81fc7494e&hash=18AC2BBC3A67D73FEF71C02ADEBCB79E" style="height: 300px; width: 450px;" alt="Alesha Arnold and family" class="float-right" />About 20 percent of women and 7 percent of men who develop lung cancer have never smoked. <br /> <br /> For Arnold, breast cancer—not lung cancer—had long been of personal concern. Not only is she a breast cancer research nurse, but her mother died of breast cancer at age 51. Arnold knew the importance of doing breast self-exams and getting screening mammograms. <br /> <br /> She was shocked by her diagnosis with advanced lung cancer in 2019 at age 44. <br /> <br /> For several years, Arnold had a persistent cough. She and her primary care physician had been down the path of ruling out allergies and acid reflux. Then she developed back pain. A new doctor ordered some tests including a CT scan. It came back with an abnormality that turned out to be lung cancer. <br /> <br /> Arnold knew her grandfather had died of lung cancer, but he was much older and had been a smoker. After her diagnosis, she learned other relatives had also been diagnosed with lung cancer. <br /> <br /> “I discovered I had a genetic mutation that was germline which predisposed me to getting lung cancer,” Arnold said. <br /> <br /> <br /> <h3> Making white ribbons to raise awareness </h3> When people find out Arnold has lung cancer, their typical response is, “But you didn’t smoke, did you?” <br /> <br /> Arnold is fighting the stigma and growing lung cancer awareness as an advocate with End Lung Cancer Now and a grassroots movement called the <a rel="noopener noreferrer" href="https://www.thewhiteribbonproject.org/" target="_blank">White Ribbon Project</a>, which involves making and distributing large, wooden ribbons. These white ribbons are used to build a sense of community, promote awareness, tackle misconceptions about lung cancer, and promote messages of support, hope and empowerment. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/elyse-with-jigsaw-lead-photo.jpg?h=300&w=450&rev=535a203b68bb42cab626054bb4e3892b&hash=0E1D17DCE8BB53F9FD06ED02299CBB8C" style="height: 300px; width: 450px;" alt="Elyse Turula with jigsaw" class="float-left" />“We have brought the white ribbon project to Indianapolis and want people to be able to identify the lung cancer ribbon and know some of the statistics—that lung cancer is prevalent and anyone can get it,” Arnold said. <br /> <br /> Elyse Turula has joined the effort, using the tools left behind in her garage by her master carpenter husband, Harry, who died of lung cancer in 2017. To date, Turula has cut and sanded more than 100 ribbons, often using a shiny, metal Craftsman jigsaw that’s been in Harry’s family for about 60 years. <br /> <br /> “I hear his voice when I’m working: ‘Measure twice, cut once. Always know where your cord is—and where your fingers are!’” she said. <br /> <br /> As Turula was out in her garage in October painting her ribbons white, her neighbor’s mother stopped by to see what she was doing and asked, “Are you priming those to paint them pink?” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/harrys-jig-saw.jpg?h=250&w=375&rev=44b2f7d8d715486693eb2e7d0bace351&hash=648D23B5D01477ED2891F6A1D6ED2F41" style="height: 250px; width: 375px;" alt="Harry Turula's jigsaw" class="float-right" />“No,” Turula explained as she began to talk about her loyal, fun-loving, hardworking husband of 27 years who died shortly after his 62nd birthday. The white ribbons would go to lung cancer patients, survivors and advocates. <br /> <br /> Turula placed several ribbons in front of her own home on Halloween—the fourth anniversary of Harry’s passing. As trick-or-treating hours began, a man parked in front of her house and lit up a cigarette. Turula took the opportunity to compassionately strike up a conversation about lung cancer, asking him if he’d had a CT screening and directing him to resources on smoking cessation. <br /> <br /> “It’s about changing the conversation,” Turula said. “If you want to stop smoking, there are people and programs to help you. Don’t let guilt stand in the way. Just move forward—and get a CT scan.” <br /> <br /> <br /> <h3> Eliminating tobacco use in Indiana </h3> Anyone over the age of 50 has lived through an era when smoking was so ingrained into American culture that it was allowed everywhere—restaurants, hotels, schools, even in hospitals and on airplanes. <br /> <br /> Today in Indiana, about one out of every five adults smokes, ranking the state 10th in the nation for smoking. That’s not a Top 10 list anyone wants to be on. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/elcn-advocates-table_10.jpg?h=300&w=450&rev=d171f09abc204974889cfa03c9368dfd&hash=B1562CA07AF833E7557E09B7B523632E" style="height: 300px; width: 450px;" alt="End Lung Cancer Now advocates" class="float-left" />“We have to drive down smoking rates, and we know that will result in less suffering and death from cancer, cardiovascular disease, strokes and COPD,” Hanna said. “We have to put gasoline on existing evidence-based programs we know work for smoking cessation. That will have a marked effect on lung cancer.” <br /> <br /> The Indiana Tobacco Quitline is a free resource available to all Hoosiers by calling 1-800-Quit-Now; more resources are available on the <a rel="noopener noreferrer" href="https://www.quitnowindiana.com/" target="_blank">Quit Now Indiana</a> website. <br /> <br /> Community advocates are vital to getting the word out, especially in rural and low-income areas of the state, Hanna said. <br /> <br /> “Rural Indiana has higher rates of smoking, higher rates of cancer, lower socioeconomic status and less access to high-quality health care and prevention services,” he said. “This is where we must go.” <br /> <br /> <br /> <h3> Increasing lung cancer screenings to save lives </h3> Along with educating the public, End Lung Cancer Now aims to educate primary care providers about the importance of recommending screening CTs to patients who meet risk criteria. The organization also hopes to partner with radiologists throughout the state to bring mobile CT scanners into rural communities. <br /> <br /> “Research shows some primary care physicians are poorly educated on the importance of getting lung screening scans—they are grossly underordered,” Hanna said. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/harry-and-elyse-turula-4x3.jpeg?h=300&w=400&rev=ad7e4b148ba049219aedd173ad4c4547&hash=73BDAA5BB547BCCDED387E199089D025" style="height: 300px; width: 400px;" alt="Harry and Elyse Turula" class="float-right" />When Harry Turula developed a pain in his upper lung in 2015, his physician ordered an X-ray and said everything looked good—but failed to order a CT scan. It would be another year before a pulmonologist would order the screening, despite Harry’s family history of lung cancer and his personal smoking history. <br /> <br /> Fewer than 10 percent of people eligible for CT lung scans get them, Hanna said. By contrast, more than 70 percent of eligible people schedule their colonoscopies and mammograms. <br /> <br /> According to the National Cancer Institute, 57 percent of lung cancer is diagnosed at Stage 4. <br /> <br /> “Screening scans by themselves would reduce lung cancer mortality by at least 20 percent,” Hanna said. <br /> <br /> The <a rel="noopener noreferrer" href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening" target="_blank">U.S. Preventive Services Task Force</a> recommends annual lung cancer screening for anyone ages 50 to 80 who has a 20 pack-year smoking history and currently smokes or has quit smoking within the past 15 years. As part of the Affordable Care Act, lung cancer screening is free for eligible patients. <br /> <br /> <br /> <h3> Advancing research through clinical trials </h3> The last piece of the puzzle is increasing participation in clinical research trials for lung cancer—admittedly the most challenging component, Hanna said. <br /> <br /> Even when caught early—at Stage 1—lung cancer has a cure rate of less than 70 percent. Comparatively, Stage 1 breast and prostate cancers have close to 100 percent 10-year survival rates, Hanna said. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/h/hanna-2021.jpg?h=301&w=450&rev=ae16cfb1f2da46f9bc63503cd05dbd37&hash=D36225C991C8DB241FD49AB8D9A46DDC" style="height: 301px; width: 450px;" alt="Nasser Hanna MD" class="float-left" />Yet there has been progress in treating lung cancer. Many patients diagnosed with Stage 4 lung cancer now live two years or longer—up from an average of six to 12 months just five years ago, Hanna said. <br /> <br /> Advances are only made through clinical research to develop better therapies. <br /> <br /> “Less than 5 percent of Hoosiers with cancer participate in a clinical trial, which means 95 percent of people with advanced cancers are not getting the better therapies of tomorrow,” Hanna said. “Every advance in cancer that you will read and hear about in the next five years is available today, but you have to participate in the clinical trial.” <br /> <br /> End Lung Cancer Now seeks to increase enrollment in clinical trials through awareness campaigns, including dispelling myths and reducing barriers for underrepresented populations. Information about <a rel="noopener noreferrer" href="https://endlungcancernow.iu.edu/clinical-trials.php" target="_blank">current lung cancer clinical trials</a> is available on the End Lung Cancer Now website. <br /> <br /> In her role as a clinical research nurse, Arnold walks patients through the process of participating in clinical trials every day. Now her work seems even more vital—and personal. <br /> <br /> “For me, advocacy and research are really what I’m about,” Arnold said. “I’m about the advancement of finding a cure for this disease and allowing patients to live longer and healthier lives. We need to do what we can to create more options for patients, and that’s the importance of research.” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/elcn-advocates-table_31.jpg?h=267&w=400&rev=c427f2be194c4a17acb1f70170b8c0bf&hash=5165B5DE274AD51B7FE341A5D9F2A4B5" style="height: 267px; width: 400px;" alt="ELCN Advocate Alesha Arnold" class="float-right" />With the large number of people affected by lung cancer, Arnold sees huge potential for advocacy and fundraising. There’s no reason lung cancer couldn’t achieve the same level of support as generated by the well-known organizations dedicated to ending breast cancer, she said. <br /> <br /> “I would love to see that same type of energy and magnitude of patients and their family members who feel like they are supported,” Arnold said. “They need to know there is a community out there for them.” <br /> <br /> <p> <span><strong>End Lung Cancer Now</strong> is generously supported by a gift for lung cancer advocacy from Lilly Oncology. </span>For more information on the fight against lung cancer in Indiana, visit<em> <strong></strong></em><strong><a rel="noopener noreferrer" href="https://www.endlungcancernow.iu.edu/" target="_blank">End Lung Cancer Now</a></strong><em><strong></strong>.</em></p>Mon, 15 Nov 2021 00:00:00 Z{4D1BF47E-FA2A-4F13-A7D7-78B1CBC421C8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/a-conversation-about-fortitude-by-kurt-vonnegutA Conversation about Fortitude by Kurt Vonnegut<p style="margin: 0in;">            On Wednesday, October 13, 2021, IU Center for Bioethics, Medical Humanities and Health Studies Program at IU, and The Charles Warren Fairbanks Center for Medical Ethics hosted a reading of Kurt Vonnegut’s 1968 play, <em>Fortitude</em>, for the American Society for Bioethics and Humanities 2021 Annual Conference. After the reading, there was a panel that included Jane Hartsock, JD as the moderator and Dr. Elizabeth Nelson, PhD, Dr. Peter Schwartz, MD, PhD, and Dr. Lucia Wocial, PhD.</p> <p style="margin: 0in;">            <em>Fortitude</em> is a play about a scientist, Dr. Frankenstein, who has created a way to keep a person alive forever, by attaching their heads to machines that run the rest of their bodily functions. He has one patient to whom he has done this to, Sylvia, and in this play, she expresses her desire to die. However, Dr. Frankenstein is determined to keep her alive, despite the concerns of her beautician, Gloria, whom wants to discuss the potential for removing Sylvia from the machines. Dr. Frankenstein refuses and Gloria brings Sylvia a gun in order to die. However, Dr. Frankenstein planned for this and Sylvia’s arms do not allow her to shoot herself, and, out of desperation, she shoots Dr. Frankenstein. Dr. Frankenstein is then attached to the machines as well, allowing him to continue to live alongside Sylvia. </p> <p style="margin: 0in;">            Following the reading, the panelists discussed the major issues. Dr. Nelson went first, talking about the idea of self, and how much of the body one can lose and still be considered themself. Since Sylvia had lost all of her body parts, being replaced by machines as each organ failed, all she had left was her head and mind. This play raises the question of where the self lives and if it is only in the mind, or in the body as a whole. She also notes that Sylvia’s mood had been carefully been controlled by drugs, which also raises the question of if controlled substances could alter the personality to the point where the self is no longer there. </p> <p style="margin: 0in;">            Dr. Schwartz asked the question of what exactly Dr. Frankenstein is doing wrong? He argues that bioethics is to help medicine know its limits and to stop pursuing care after a certain point, but he notes that the points that medicine normally stops at is not here in this case. Sylvia is not suffering greatly, or perhaps she does but not often, expense is not a concern because Sylvia has a great wealth, Sylvia still has her consciousness, and end of life is not inevitable. Dr. Schwartz brings up that we may want to condemn Dr. Frankenstein because Sylvia has expressed a desire to die, however she also occasionally wants to live so which one is the authentic desire? There is no actual way of knowing.             </p> <p style="margin: 0in;">            Dr. Wocial spoke of the complete unwillingness of Dr. Frankenstein to dismiss any other path than the one that he has planned for Sylvia. She brings up that Dr. Frankenstein has chosen “life at all cost” and when Gloria expresses a thought that is contrary to that, he fires her. Dr. Wocial also notes the similarity in Sylvia and Gloria’s relationship to a nurse-patient relationship. She noted that the moral distress that was unaddressed in Gloria was probably the reason why she acted in a way that was inconsistent with her core values and was willing to give Sylvia the gun. Dr. Wocial stated that this was reflective of clinical practice in similar scenarios, where people may not be acting in the best interest of the patient but feel as though it is the only thing they can do. </p> <p style="margin: 0in;">            <em>Fortitude</em>, while written in the 1960s and heavily influenced by the new technologies at the time, still raises a lot of issues that are relevant in today’s time. It is important to continue to ask these questions, especially with the current medical advancements that continue to extend life. <em>Fortitude </em>raises an important question that we all must ask: how far are we willing to go to keep someone alive? </p>Wed, 10 Nov 2021 00:00:00 Z{1448466A-029D-4769-A6B3-6A8FFDD8B677}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/black-patients-play-key-role-in-advancing-breast-cancer-researchBlack patients play key role in advancing breast cancer researchIt’s common for people to ask friends to donate to a favorite charitable cause in lieu of birthday gifts, but Charlene Cheatham is taking it a step further. She’s asking her friends to donate their breast tissue. <br /> <br /> Some friends have questioned why she can’t just have a birthday dinner, but Cheatham, a community advocate with <a rel="noopener noreferrer" href="https://www.pink-4-ever.org/" target="_blank">Pink-4-Ever Ending Disparities</a>, wants to help them understand how vital it is for Black women to be involved in breast cancer research. <br /> <br /> “I tell them we’re doing this to help our families—the next generation—so if they’re diagnosed, they won’t have to suffer, or maybe there will be a cure. This is our contribution,” she said. <br /> <br /> While white women are more likely to develop breast cancer in their lifetimes, Black women are more likely to have aggressive types of cancers that occur at a younger age—and to die from breast cancer. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/20201007_hari.jpg?h=267&w=400&rev=a6abe672befb45e59e7e25a077a8bad3&hash=2DF1ED6FE6E47B43DAF10A2D7D822BD4" style="height: 267px; width: 400px;" alt="Harikrishna Nakshatri, PhD" class="float-left" />These disparities were once thought to be caused by socioeconomic factors, but medical scientists have discovered genetics are also at play. Researchers at Indiana University School of Medicine are studying how treatments can be tailored for people of different ethnicities to fight breast cancer more effectively and with fewer side effects. <br /> <br /> “The outcome in women of African ancestry is far worse than women of European ancestry—even if they have the same cancer type and even if they get the same access to care. My lab is very interested in finding out why,” said <a href="/faculty/13331/nakshatri-harikrishna">Harikrishna Nakshatri, PhD</a>, the Marian J. Morrison Professor of Breast Cancer Research at IU School of Medicine and co-leader of the breast cancer working group at the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a> at the IU Simon Comprehensive Cancer Center.<br /> <br /> Nakshatri is leading a project to map the breast at the single-cell level as part of the <a href="/sitecore/content/iu/iu-som/home/news/2019/06/chan-zuckerberg-initiative-picks-iu-team-for-human-cell-atlas-award">Human Cell Atlas</a> initiative. In the more than 5,000 samples of normal breast tissue that have been donated to the <a rel="noopener noreferrer" href="https://komentissuebank.iu.edu/" target="_blank">Susan G. Komen Tissue Bank</a> at the IU Simon Comprehensive Cancer Center, differences have been discovered based on the genetic ancestries of donors, Nakshatri noted. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/breast-health-advocates.jpeg?h=450&w=338&rev=b13053d3b56b467d9106ce361ee8a1f5&hash=1CD18C6CB513983731B4A4E164220B16" style="height: 450px; width: 338px;" alt="Community breast health advocates" class="float-right" />This is why Cheatham and other community advocates are partnering with IU School of Medicine to spread the word about the importance of including Black women in clinical research for breast cancer. <br /> <br /> <br /> <h3> Collaboration key to ending disparities </h3> “If you don’t have high enough participation from Black women, we’re kind of left out of the research, and they don’t know how different cancer drugs affect us,” said Lisa Hayes, executive director of Pink-4-Ever Ending Disparities, an Indianapolis organization with the mission to eliminate breast cancer disparities for Black women through advocacy, education, research and empowerment. <br /> <br /> In 2007, she and board president Nadia E. Miller were both diagnosed with triple negative breast cancer (TNBC)—an often deadly form of breast cancer that is not responsive to hormone therapies and is resistant to chemotherapy. Only recently have medical scientists discovered that African American women are more likely to carry a gene mutation which makes them at higher risk for developing TNBC—and having it recur. <br /> <br /> “The solution to being able to eradicate disparities is to substantially focus our efforts on understanding why there are differences and then attacking the cancer more effectively,” said <a href="/faculty/4858/schneider-bryan">Bryan Schneider, MD</a>, the Vera Bradley Professor of Oncology at IU School of Medicine. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/bryan-schneider-with-community-advocates.jpg?h=280&w=400&rev=7bfec725f23447738430ec043650dee6&hash=BAA0AD02FFE97C9393BE3A29E256552D" style="height: 280px; width: 400px;" alt="Bryan Schneider MD" class="float-left" />He discovered another issue contributing to the higher mortality rate for Black breast cancer patients. Peripheral neuropathy—a common side effect of some chemotherapy drugs—causes numbness or pain in the hands, feet or limbs and disproportionately affects African American patients. <br /> <br /> “We found, because this toxicity is so significant in our Black patient population, that it has resulted in physicians needing to reduce the dose of this curative chemotherapy, and this is one of the reasons Black patients have inferior outcomes for breast cancer—so it’s a very significant side effect to study,” Schneider said. <br /> <br /> He is leading one of the nation’s first National Cancer Institute-funded studies exclusively focused on improving outcomes for Black breast cancer patients. The <a rel="noopener noreferrer" href="https://cancer.iu.edu/breast/eaz171.php" target="_blank">EAZ171 trial</a> seeks to better understand and treat neuropathy induced by taxane chemotherapy drugs. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/saysha-wright-2.jpeg?h=443&w=264&rev=80bc5eca2aae4f92b8ff931dc32f99a0&hash=D0DE34C8434349A79CC841FFB556512A" style="height: 400px; width: 239px;" alt="Saysha Wright" class="float-right" />Saysha Wright was one of the early participants in the trial. A mother of two toddlers, Wright was diagnosed with Stage 2 breast cancer in July 2019. She agreed to participate in the research on neuropathy because, “Why not try to help somebody in the future?” <br /> <br /> Wright had an acquaintance whose neuropathy became so severe that she couldn’t walk. <br /> <br /> “I knew it could get bad,” Wright said. Thankfully, her own experiences with neuropathy were not severe, but they still impacted her everyday life. <br /> <br /> “It was kind of hard to button up stuff and do my daughter’s hair because I lost feeling in my fingertips,” she said. “My hope is that a woman doesn’t have to experience it at all in the future. I really hope they find a cure.” <br /> <br /> <br /> <h3> A ‘renaissance’ in breast cancer discoveries </h3> Back in 2007, Hayes and Miller were not invited to participate in any clinical trials. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/lisa-and-nadia2.jpeg?h=267&w=400&rev=3655b47bf95d436296430c4c98af23f6&hash=925919C5E3052932AA2199DEB2EFD1D1" style="height: 267px; width: 400px;" alt="Lisa Hayes and Nadia Miller" class="float-left" />“If you look back 10-15 years ago, our advances were sluggish—we were comparing ‘chemotherapy A versus chemotherapy B’ and identifying really incremental and small benefits for a broad population,” Schneider said. “As we’re better able to embrace our own genetic diversity and its impact on the way we tolerate drugs—and how we stimulate our own immune system to attacking the tumor—these major advances in our understanding are moving us into what I think to be a renaissance period of growth in terms of cancer therapy development.” <br /> <br /> In 2017, IU School of Medicine launched a TNBC study, led by Schneider, with the goal of discovering blood-based biomarkers to predict which patients were likely to have a recurrence of the disease. It was important to recruit Black patients to participate. <br /> <br /> “We had marketing images with Black women in them, but they weren’t performing well on social media,” said Casey Bales, MPH, program manager for the Triple Negative Breast Cancer Precision Health Initiative and Vera Bradley Monogrammed Medicine. “We realized we needed more help.” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/natasha-cannon-image.jpeg?h=301&w=450&rev=2e40af5e107d45e48d5e5a5bc26df705&hash=89048C305C80F5434454F4BA165A4514" style="height: 301px; width: 450px;" alt="image of woman with uplifted hands" class="float-right" />Schneider’s team reached out to Hayes and Miller for advice. They took a look at the existing imagery used in recruitment materials and gave their frank opinions: the pictures looked unwelcoming and “scary.” <br /> <br /> “It was an eye-opening experience for our entire group. We sat back and tried to learn from their amazing guidance,” Schneider said. <br /> <br /> Hayes and Miller connected the IU team with a local Black photographer<span>, Natasha Cannon,</span> and helped recruit breast cancer survivors to be featured in an <a rel="noopener noreferrer" href="https://precisionhealth.iu.edu/news-multimedia/_news/researchers-developing-minority-focused-breast-cancer-photo-library.html" target="_blank">image library</a> that conveyed hope and courage and connected with the Black community’s values of faith and family. <br /> <br /> As a result of this collaborative effort, 30 percent of the <a href="/sitecore/content/iu/iu-som/home/news/2020/07/iu-school-of-medicine-findings-set-new-standard-for-use-of-blood-based-biomarkers-in-clinical-trials-for-prediction-of-cancer-recurrence">BRE12-158 study</a> participants were Black—a number that is significantly higher than the national average of 5 percent participation from Black patients in clinical trials, Bales noted. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/lisa-hayes-casey-bales-barbara-bradley-baekgaard-susanna-scott-nadia-miller.jpeg?h=300&w=400&rev=dcbd71bb3417426699e9c471140b56f1&hash=0E7A20D78D3E2D3749AFA029F40940B2" style="height: 300px; width: 400px;" alt="Casey Bales, Lisa Hayes, Nadia Miller and others" class="float-left" />“Our partnership gave us an opportunity to create and brand materials that yielded great results. And we got new friends—it was a true collaboration,” Miller said of the relationship developed with IU School of Medicine. <br /> <br /> Community advocates like Miller, Hayes and Cheatham share resources—and their personal stories—at community outreach events and in everyday settings like church meetings. Their efforts have helped the Komen Tissue Bank achieve a high percentage of breast tissue donations from Black women—about 17 percent. Comparatively, Indiana’s Black population is less than 10 percent. <br /> <br /> “The message is about how their participation can really help—how important it is particularly for Black women to donate breast tissue,” Hayes said. “It’s a small sacrifice for something that can have a large impact in the future for their families.” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/eaz171-event.jpeg?h=300&w=400&rev=d76090dc48c845618e68848cfc321c81&hash=6CF472A8A9AB5FD3FB166D17E40DCBDC" style="height: 300px; width: 400px;" alt="Community advocates at IU School of Medicine event" class="float-right" />Now a <a rel="noopener noreferrer" href="https://clinicaltrials.gov/ct2/show/NCT04849364" target="_blank">new Phase 2 clinical trial</a> is launching called <a rel="noopener noreferrer" href="https://cancer.iu.edu/breast/persevere.php" target="_blank">PERSEVERE</a>. It aims to enroll 200 participants who are at high risk for a recurrence of TNBC to study the effectiveness of personalized cancer treatment combinations based on patients’ unique genetic data. Participation from Black patients will, again, be vital. <br /> <br /> With rapid advances in precision medicine, the medical community is figuring out what treatments work best for which people—and why. Breast cancer research is no longer a sluggish field but an energizing one, Schneider said. <br /> <br /> “You’re going to really see massive advances as we begin to learn at a really rapid pace, and our ability to personalize medicine will be markedly better,” he said. “The drugs that are designed to attack these genetic vulnerabilities will be much sharper, much more effective, and have fewer side effects. I think we’re going to improve the cure rates for many patients.”Mon, 25 Oct 2021 00:00:00 Z{6998466D-B510-4BFF-AE2D-F0CC46F3F6EF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/october-2021-newsletterOctober 2021 Newsletter<h1>Cardiovascular Institute </h1> <p><em>One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision. </em></p> <p> </p> <h3>Connect to Promise</h3> <p> Kudos to IU Health Bloomington for their remarkable, multidisciplinary team effort treating an individual who noticed blood in his urine; a CT scan identified a tumor on his kidney. In the operating room, it was found to be invading a vital vascular structure. Though she was at another facility, Dr. Cuddy's specialized vascular skills were needed - and she responded, arriving in the OR to help within 10 minutes. The patient underwent meticulous removal of the tumor and repair of the blood vessel, and is on his way home. Cheers to the South Central Region for delivering high quality vascular care to patients in their community! <br /> <br /> </p> <h3>Top News</h3> <p> </p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/afib-award.png?h=251&w=150&rev=e408dbef9e9f48eb853bef27ba76cdac&hash=21D10D669BD3715EE042124917180E1C" style="height: 251px; width: 150px;" alt="Get With The Guidelines Gold AFIB Award" class="float-right" />American Heart Association Gold Performance Award Recipients <p> IU Health Methodist Hospital is proud to be recognized with a GOLD Quality Achievement Award for our achievement in the American Heart Association's Get With the Guidelines AFIB quality program. This award recognizes a select group of hospitals achieving the highest compliance to core standard levels of care as outlined by the American Heart Association/American Stroke Association for 2 consecutive calendar years. For patients with this most common heart rhythm disorder, IU Health's recognition in this quality program assures patients are being treated according to the latest scientific guidelines. Award recipients are publicly recognized on the <a href="https://www.heart.org/en/professional/quality-improvement">AHA/ASA website</a> as well as in a US News and World Report recognition add that appears in the "Best Hospital" edition. </p>   <h2>Ventricular Assist Device Program Re-Certification</h2> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/gold-seal.png?h=153&w=150&rev=9ca200cd915445798daf5e704571ffcb&hash=7212102C6F6893A4559EB6CCA2BF1065" style="height: 153px; width: 150px;" alt="The Joint Commission Gold Seal" class="float-right" />The Ventricular Assist Device (VAD) program at IU Health Methodist Hospital has been re-certified by the Joint Commission, earning the Gold Seal of Approval. The certification cycle is effective beginning May 29, 2021 and is customarily valid for up to 24 months. </p> <p style="margin-left: 200px;"> <br /> <br /> </p> <p> </p> <p> </p> <h3>Welcome to our Team</h3> <p> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-brendan-cavanaugh.png?h=181&w=140&rev=d4bc3ad862bc4d71be31e5826bc5fc34&hash=ECCB41E0255882FA9B649CC449B05D34" style="height: 181px; width: 140px;" alt="Dr. Brendan Cavanaugh" class="float-left" />Brenda</strong><strong>n Cavanaugh, MD, FACC</strong>, recently joined IU Health Arnett Hospital as the Chief of Cardiology. Dr. Cavanaugh began practicing medicine in 2006. He earned his medical degree from Rush Medical College. and completed a residency in Internal Medicine with Dartmouth-Hitchcock Medical Center. Cavanaugh also completed a fellowship in Cardiology with Northwestern Medical Center. He is board certified through the American Board of Internal Medicine in Cardiovascular Disease.</p> <p> <br /> Dr. Cavanaugh chose cardiology because he feels that when heart disease is identified early, it can be modified dramatically and help prevent life threatening events. He believes in providing personalized care to each of his patients. Dr. Cavanaugh strives to make his patients and their families feel comfortable throughout their healthcare journey. In his free time, Cavanaugh enjoys spending time with his wife and two children, cycling, hiking and coaching baseball.</p> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/duangnapa-s-cuddy.jpg?h=158&w=140&rev=274776b104a64df3b3e31bc22b706250&hash=AAFCA06D55EE939410738571E3DE1EC6" style="height: 158px; width: 140px;" alt="Dr. Duangnapa Cuddy" class="float-left" />Duangnapa S. Cuddy, D.O., RPVI,</strong> recently joined Indiana University Health Bloomington Hospital as a Vascular Surgery Specialist, having more than 15 years of diverse experiences. She graduated with honors from Lake Erie College of Osteopathic Medicine, Erie in 2006. Dr. Cuddy completed her internship in General Surgery in 2008 from  Peninsula Hospital Center and her residency in General Surgery at NYU School of Medicine, Brooklyn Campus, in 2012. </p>   <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-emily-farkas.jpg?h=199&w=140&rev=caf8982f72e34e5299a77eed94e1cb91&hash=AB4CBDE1D135F3444A41BC902215A412" style="height: 199px; width: 140px;" alt="Dr. Emily Farkas" class="float-left" />Emily Farkas, MD</strong>  recently joined the Richard L. Roudebush VA Medical center via IU Health as a Cardiothoracic Surgeon, focusing on restarting the Cardiac Surgery Program, and is also involved with Global Health. Dr. Farkas earned her Bachelor of Science degree from Pepperdine University and her International Studies from the University of Canberra in New South Wales, Australia. She earned her MD from the Chicago Medical School in Chicago, IL and completed her residency at Ochsner Clinic Foundation in New Orleans, LA. Dr. Farkas holds the distinction of being the first woman to train as a heart surgeon at Yale University. She currently serves as an Attending Cardiothoracic Surgeon through Global Cardiac Surgical Volunteerism, CardioStart International, Emergency International.</p>   <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-bharath-raju.jpg?h=158&w=140&rev=51e4d8ee12864919a78d24f327799f08&hash=2D8866D426D7CA40951FADF27F7EAD38" style="height: 158px; width: 140px;" alt="Dr. Bharath Raju" class="float-left" />Bharath G. Raju, MD</strong> is originally from the Chicago suburbs and is a graduate of the University of Illinois. He completed cardiology fellowship at Baylor University where he worked closely with and published with Dr. Peter McCullough. Dr. Raju joins IUHP Cardiology trained in general cardiology and advanced cardiac imagining. Dr. Raju will practice at IUH North Hospital. He and his wife, Anusha, also a physician, reside in Zionsville with their new son, Yohan. </p> <p> <br /> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-behzad-sharif.png?h=192&w=140&rev=540f4093d01b4a3099507dcd404d4d38&hash=BAD8A11CBAEEEFD471DD7A5A3411B74B" style="height: 192px; width: 140px;" alt="Dr. Behzad Sharif" class="float-left" />Behzad Sharif, PhD</strong>,  from Cedars-Sinai Medical Center and University of California Los Angeles, has been selected as the Director of Cardiac Magnetic Resonance Research at Indiana University School of Medicine and Associate Professor of Medicine at the newly established Krannert Cardiovascular Research Center (KCVRC) within IU Health/IU School of Medicine Cardiovascular Institute. He most recently served as Director of the NIH-funded laboratory for Translational Imaging of Microcirculation at Cedars-Sinai Biomedical Imaging Research Institute. He concurrently held faculty appointments as Assistant Professor-in-residence of Medicine and Bioengineering at UCLA. Dr. Sharif earned his undergraduate degree in Electrical Engineering from Sharif University of Technology in Tehran, Iran, and MS and PhD in Electrical Engineering from University of Illinois at Urbana-Champaign. His research focuses on the development and clinical validation of innovate MRI technologies for quantitative imaging of the dynamics in the cardiovascular system, all geared towards solving ongoing challenges in non-invasive testing of coronary microvascular health and imagining-guided evaluation of therapies targeting coronary microcirculation. </p> <p> <br /> <strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-aaron-whipp.jpg?h=158&w=140&rev=dfff66ed7d1243008af43e383ae4a56e&hash=9569FC6DD6491C4581E337E651DFA42C" style="height: 158px; width: 140px;" alt="Dr. Aaron Whipp" class="float-left" />Aaron M. Whipp, DO, </strong>is from the Dayton area, and is a graduate of Ohio State University. He completed cardiology fellowship at the University of Arizona where he served as Chief Fellow. Dr. Whipp has been recognized with teaching and mentorship awards at both the resident and fellow level, and comes to IUHP Cardiology trained in general cardiology and advanced cardiac imaging. Dr. Whipp will see patients at IUH Saxony and IUH Tipton Hospitals. He and his wife, Sarah, and daughter, Maddie, reside in Fishers. </p>   <p> </p> <p> </p> <h3>Kudos</h3> <h2>Awards</h2> <p> <a href="https://iuhealth.org/find-providers/provider/georges-ephrem-md-64005">Dr. Georges Ephrem</a> was recently announced as an American College of Cardiology Clinical Trial Research Awardee. The ACC CTR program is intended to grow the next generation of cardiologists doing impactful clinical research by increasing the number of future leaders in cardiovascular clinical trials research. As part of this program, Dr. Ephrem submitted a research proposal entitled "Sacubitril/Valsartan Outcomes in Adult Congenital Heart Disease Patients With a Systemic Right Ventricle" aimed at prospectively studying the impact of Entresto in this subgroup of ACHD patients. The ACC's Research Fellowship Awards Committee (RFAC) reviewed and ranked the submitted proposals according to the NIH criteria and granted Dr. Ephrem the 20,000 USD prize to assist in launching this ambitious research project. <br /> <br /> </p> <h2>Honors and Recognitions</h2> <p><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/news/2019/kovacs-richard_6-5x7.jpg?h=182&w=130&rev=e59186374646402c83758e964689c548&hash=54669E381A5651D085428DD41564CC42" style="height: 182px; width: 130px;" alt="Kovacs Richard_6 5×7" class="float-left" />Richard Kovacs, MD, MACC Named ACC Chief Medical Adviser/Chief Medical Officer</strong></p> <p> Richard Kovacs, MD, MACC has worked with the American College of Cardiology to become its inaugural <a href="https://www.acc.org/latest-in-cardiology/articles/2021/10/06/14/21/richard-kovacs-named-acc-chief-medical-adviser-chief-medical-officer">Chief Medical Advisor/Chief Medical Officer</a>. Best wishes to Dr. Kovacs as he transitions 50% of his time to this ACC position effective November 1.</p>   <p><strong> </strong></p> <p><strong>Raghu Motaganahalli, MD, selected as the 44th President of the Midwestern Vascular Surgery Society</strong></p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-motaganahalli.jpg?h=174&w=130&rev=a9a1da463d5741b6819e9e2ef55bdee3&hash=AECFA51813209E48426DF6C9D2A33070" style="height: 174px; width: 130px;" alt="Dr. Raghu Motaganahalli with Dr. Kellie Brown" class="float-left" />Congratulations to <a href="https://iuhealth.org/find-providers/provider/raghunandan-l-motaganahalli-md-8272">Raghu Motaganahalli, MD</a>, for his appointment as the <a href="https://vascularspecialistonline.com/mvss-2021-midwestern-vascular-unveils-2021-22-leadership-changes/">44th President of the Midwestern Vascular Surgery Society</a>. This esteemed organization is one of the largest regional vascular societies to offer various opportunities for vascular surgeons to gather and discuss current trends, techniques and participate in special programs designed to advance its practice. Out of the organizations 45-year history, Motaganahalli is only the third person from the state of Indiana to hold this position. He is pictured below with the former president, Kellie Brown, MD. </p>   <p><strong>Courtland Blount, MD, MS, accepted into the ACC African American Cardiology Program</strong></p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-courtland-blount.jpg?h=189&w=130&rev=fca3fa48e58f4e5698fdd61b802f0430&hash=0F244136D0D684D61FE406EC2B19820D" style="height: 189px; width: 130px;" alt="Dr. Courtland Blount " class="float-left" />"As a new member of the American College of Cardiology's African American Cardiology Committee, I am excited to be given the opportunity to fulfill this organization's mission as it aligns with my own. I look forward to assisting with the improvement of cardiovascular health and increasing health literacy within the black community. As a native of Memphis, TN, I understand the importance of sharing the passion and concern for health and wellness with my patients, as I have seen first-hand how beneficial it is to build trust between healthcare professionals and the community. This organization consists of a cohort of physicians, from marginalized backgrounds among various professional levels, all focused on networking and strengthening the relationships amongst Black medical professionals interested and within the Cardiology field. Through stronger relationships amongst ourselves, we can better facilitate ways to create a leveled playing field for African Americans within the health care system." - <a href="https://medicine.iu.edu/faculty/60359/blount-courtland">Courtland Blount, MD, MS</a></p>   <p><strong>Mohammed Homsi, MD, Awarded the IUH West Physician Sanctuary Award</strong></p> <p> Cheers to IUHP Cardiac Electrophysiologist, <a href="https://iuhealth.org/find-providers/provider/mohamed-homsi-md-58716">Dr. Mohammed Homsi</a>, for being awarded the Physician Sanctuary Award at IU Health West Hospital, selected by his physician peers on the medical executive committee. This award is to recognize physicians who emulate the core values of IU Health. Dr. Homsi's attributes of respect, kindness, empathy for others, and knowledge elevate the care to patients in this institution. </p> <p style="margin-left: 200px;"><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/homsi-award.jpg?h=301&w=300&rev=660b690198fa4610be9c85775c09eda2&hash=3F49C092D90F3D174B895C136877CFA4" style="height: 301px; width: 300px;" alt="Dr. Mohammed Homsi and IU West Team" /></p> <div style="margin-left: 160px;"><em>Pictured left to right: Liz Nichols, RN; Kristen Combes, NP; </em></div> <div style="margin-left: 200px;"><em>Dr. Mohammed Homsi; Theresa Giannini, NP</em></div> <p> </p> <p> </p> <h2>In the Media</h2> <p><strong>2021 Health Care Heroes: Recognition of our Team's Support of Heart Transplant Patients' recovery</strong></p> <p> <a href="https://www.ibj.com/articles/2021-health-care-heroes-jump-starting-transplant-patients-recovery">Read</a> on to learn how the IU Health Center of Life for Thoracic Transplant (COLTT) was awarded the Health Care Hero Award by the <em><a href="https://www.ibj.com/">Indianapolis Business Journal</a></em>. </p> <p style="margin-left: 200px;"><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dr-roopa-rao.jpg?h=225&w=300&rev=4c955aa4df4d4661ae0c0fe27177fd26&hash=7CA84E978D175B9FA120A331A8E7BE01" style="height: 225px; width: 300px;" alt="Dr. Roopa Rao and Lindsay Tucker" /></p> <div style="margin-left: 120px;"><em>Pictured: <a href="https://iuhealth.org/find-providers/provider/roopa-a-rao-md-55326">Dr. Roopa Rao</a> and Lindsay Tucker representing IU Health</em></div> <p><em> </em></p> <p><strong>Onyedika Ilonze, MD, Featured in the IU Health Plans Commercial</strong></p> <p> Cheers to <a href="https://iuhealth.org/find-providers/provider/onyedika-j-ilonze-md-885481">Dr. Onyedika Ilonze</a> for his participation in the <a href="https://players.brightcove.net/794311885001/SynMkzsB_default/index.html?videoId=6277105772001">IU Health Plans Medicare Advantage commercial</a>. It will air on the following channels: WISH-TV (CW), WRTV-TV (CW), WRTV-TV (CBS), WTHR-TV (NBC), WTTV-S2 (ABC), WXIN-TV (FOX), ESPN, HGTV, and more.  <br /> <br /> </p> <h2>Presentations</h2> <p> Cheers to <a href="https://iuhealth.org/find-providers/provider/pantila-vanichakarn-bateman-md-9843">Dr. Pantila Bateman</a> for her lecture entitled, "Heart Health and COVID-19" at the 2021 Women of INfluence 10th Annual Virtual Symposium by IU National Center of Excellence in Women's Health on September 15th, 2021. <br /> <br /> </p> <h2>Publications</h2> <p> <a href="https://iuhealth.org/find-providers/provider/balaji-k-tamarappoo-md-1428722">Dr. Balaji Tamarappoo's</a> manuscript was recently accepted to the <em><a href="https://www.journalofcardiovascularct.com/article/S1934-5925(21)00427-5/fulltext#relatedArticles">Journal of Cardiovascular Computed Tomography</a></em>. Women with breast cancer are surviving longer thanks to early diagnosis and excellent targeted chemotherapy and radiation. One of the major causes of non-cancer death in these women is cardiovascular disease. Thus, early detection and treatment of coronary artery atherosclerosis has the potential to reduce cardiovascular events in breast cancer survivors. Women with metastatic breast cancer undergo whole body PET-CT for detection of metastases or to monitor effectiveness of treatment. In these women, coronary atherosclerosis can be detected by measuring coronary calcium in the CT scan. In Dr. Tamarappoo's research study, they demonstrated that CT from PET-CT scanning can provide an opportunity to identify women with coronary artery calcium who were previously not diagnosed as having coronary atherosclerosis and hence were not treated with lipid lowering therapies. In this study, in a small cohort of women, they concluded that breast cancer survivors with subclinical atherosclerosis and who were eligible for lipid lowering therapy could be identified using PET-CT that was performed for other clinical indications. Whether early detection of subclinical atherosclerosis in women with breast cancer will result in mortality benefit needs to be tested in multicenter studies in large population of women with breast cancer.  </p> <p> </p> <h3>Opportunities within #OneIUCV</h3> <p> </p> <ul> <li>Find your place at the Indiana University School of Medicine with this newly created Program Management Leader opportunity. The Krannert Cardiovascular Research Center (KCVRC) is seeking an experienced Program Management Leader who thrives in a dynamic team environment. This position will provide programmatic support for the KCVRC and will be responsible for the Center's fiscal and operational oversight. To learn more and to apply, visit the <a href="https://jobs.iu.edu/">IU careers page</a>, browse staff positions and search for keywords: Cardiovascular Research Program Management Leader. </li> </ul> <ul> <li>The KCVRC is also seeking a Postdoctoral Fellow with expertise in physiological data acquisition and analysis. To learn more and to apply, visit the <a href="https://indiana.peopleadmin.com/postings/11640">IU Career Page</a>. <br /> <br /> <br /> <br /> <br /> </li> </ul> <div style="margin-left: 120px;">Do you have a story that reflects the strength of our statewide system for cardiovascular care? <br />                     Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!<br /> <div></div> </div> <div></div> <p> </p> <div></div> <div></div> <p> </p>Wed, 20 Oct 2021 00:00:00 Z{046E0D41-4966-427B-AB18-109EA95C0EFA}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/whac-a-mole-clinical-trial-participant-experiences-remission-of-stage-4-triple-negative-breast-cancer'Whac-a-Mole' clinical trial participant experiences remission of Stage 4 triple negative breast cancer<h3>Indiana University School of Medicine scientists continue search for life-saving treatments for aggressive types of breast cancer </h3> <br/> <p> </p> <p>Jenny Larner Brown knew she had an aggressive form of breast cancer. She had been through surgery, chemotherapy and radiation therapy—twice. At every juncture in her difficult breast cancer journey, Brown’s oncologist, <a href="/faculty/4849/miller-kathy">Kathy Miller, MD</a>, had been there to assure her there was a path forward for treatment. <br /> <br /> This time was different. <br /> <br /> “She held my hand, and it was one of those surreal moments that freeze in time,” Brown recalled. “This time there were no treatment options.” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/kathy-miller-md/20180523_iusm_infusion_proc_12.jpg?h=301&w=450&rev=d6145e88105f4f439e0c3dd245432921&hash=C7EBDDC0775E68BABCB8A64DD3BB5BC8" style="height: 301px; width: 450px;" alt="Jenny Brown and Kathy Miller, MD" class="float-left" />Brown dreams of a day when no one would ever experience that kind of moment. <br /> <br /> “I hope in five or 10 years that nobody worries about dying of breast cancer,” she said. “I would love there to be a time when the most serious breast cancer can be managed as a chronic illness—and that no one has to sit down with their oncologist and hear that they’re out of options.” <br /> <br /> It’s now been more than two years since that terrifying moment when Brown learned her cancer was back for the third time—stage 4 of a rare, deadly combination of both triple negative and inflammatory breast cancers—and that she had an estimated 12-to-18 months to live. <br /> <br /> Yet here she is. Taking trips with her family and friends, hiking sections of the Appalachian Trail, pursuing a master’s degree, and savoring every moment. <br /> <br /> Because there was one option. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/20180523_iusm_infusion_proc_1.jpg?h=335&w=500&rev=4de9c72d4a604261b0a62f024718607b&hash=5BD70633B4837C1C2A157D94B9DA1EB7" style="height: 335px; width: 500px;" alt="Jenny Brown chemo infusion" class="float-right" />Brown was invited by Miller, co-leader of the breast cancer working group at the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a>, to participate in an Indiana University School of Medicine first-in-human clinical trial for women with recurrent triple negative breast cancer (TNBC). Called <a href="/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/popular-arcade-game-inspiring-new-treatment-aggressive-type-breast-cancer">Whac-a-Mole</a> after the popular arcade game, the trial aimed to test a two-drug knockout combination therapy. TNBC is tricky to treat because when one chemotherapy drug knocks out the cancer, another genetic pathway “pops up” allowing the cancer to persist, just like those pestilent moles in the game. <br /> <br /> With all clinical trials, there are risks, and participants are made aware that they may not personally benefit but will help advance the medical community’s understanding and future treatment of the disease. <br /> <br /> Brown and her medical team at the <a href="/sitecore/content/iu/iu-som/home/research-centers/cancer">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a> certainly did not expect what happened next. <br /> <br /> </p> <h3> The cancer exorcism </h3> <p> In four years of battling cancer, Brown had never vomited from chemotherapy. But that changed during the infusion of her first dose of the experimental drug therapy in August 2019.</p> <p> “It was really scary—my whole body went into shock. I was convulsing, teeth chattering, in a fog. I was in so much pain,” Brown recalled. “It felt like I had meningitis, epilepsy and hypothermia all at once—and I couldn’t stop throwing up. I truly feared I might not survive the treatment.” <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/jenny-brown_treatmentwink.jpg?h=401&w=300&rev=fa2a9d6eb7be4af9bc0a1279359821c0&hash=D9E3F6F2ECF0449CFBD7B286D5548C2E" style="height: 401px; width: 300px;" alt="Jenny Brown during treatment" class="float-left" />She was admitted to the hospital for two days to monitor and manage symptoms. It seemed her body had rejected the drugs, so she didn’t expect much from her first follow-up ultrasound to check the effect on her tumor. <br /> <br /> The result was indeed shocking—her tumor had vanished. <br /> <br /> “It was a total response after one treatment,” Brown still marvels. “That first crazy hit, it was like an exorcism. And ever since, my scans have been stable. It feels like a miracle.” <br /> <br /> Brown stayed on the trial drugs for nine months—at her own insistence—and never had another negative reaction. Today—18 months after ending all cancer drugs—she remains cancer free. <br /> <br /> Brown’s results were a remarkable exception rather than the norm in the Whac-a-Mole clinical trial. <br /> <br /> “What we really hope to do is understand it,” said Miller, the Ballvé Lantero Professor of Oncology at IU School of Medicine and associate director of clinical research at the IU Simon Comprehensive Cancer Center. “The better we can understand how that happened for her—what is unique about Jenny, her tumor and this therapy—the closer we get to being able to replicate it and get that response for others.” <br /> <br /> <br /> </p> <h3> The resurrection of everyday life </h3> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/brown-celebrating-her-daughters-first-vote.jpg?h=338&w=450&rev=d73aaffd457a41759b80ad1d3890de68&hash=1B415ACDA68950BE3C531A6353ED1970" style="height: 338px; width: 450px;" alt="Jenny Brown celebrating her daughter's first vote" class="float-right" />There was a time in Brown’s pre-cancer life when she might have allowed herself to be distracted when hearing the play-by-plays of her teen daughter’s school happenings. She might have worried about missing work or other obligations when helping her college-aged daughter set up her first rental house and utility bills. <br /> <br /> Now these normal life experiences seem magnificent. <br /> <br /> “Everything feels like a huge gift,” Brown said. “Getting this unexpected time has changed how I live and how I approach my relationships. I don’t put things off, and I try to be very present—and grateful—for the experiences I get to have.” <br /> <br /> If the trial drugs generated a cancer exorcism, Brown is now experiencing her resurrection—reawakening to life after years of impending death. <br /> <br /> Last summer, she enjoyed a road trip to Orlando with her daughters and hiked 33 miles of the Appalachian Trail in North Carolina with her husband, Danny. Brown aims to do the entire 2,180 or so miles of the rugged mountain trail in her lifetime—which now seems possible. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/jenny-and-danny-brown-on-the-appalachian-trail-in-nc.jpg?h=338&w=450&rev=27d336a533b34bd1964b4bd6ce660fae&hash=2358D35813C26380CD605F87B13E3320" style="height: 338px; width: 450px;" alt="Jenny and Danny Brown on the Appalachian Trail" class="float-left" />The first section of the Appalachian Trail she ever hiked was the 80-mile portion through Georgia in 2015—a year before her initial breast cancer diagnosis—and she did it solo. In the midst of her cancer treatments, she mentally drew strength from that experience, reminding herself she would make it if she just kept taking the next step forward. <br /> <br /> “The trail teaches you so much about resilience and resourcefulness,” Brown said. “You feel every emotion, and you manage to find strength you didn’t know you had. You’ve got to keep putting one foot in front of the other. You keep breathing; you keep walking—even when it hurts.” <br /> <br /> Now Brown is embarking on a new career in medical social work. Her aim is to become a breast cancer navigator. <br /> <br /> “Cancer has a way of taking away power and control from you. It’s a whole new world with a whole new language—things happen really fast, and it’s overwhelming,” Brown said. “I would love to work with people newly diagnosed with breast cancer and help them understand the different parts of treatment and empower them to make informed decisions about their course of treatment.” <br /> <br /> <br/> <h3>The testimony for clinical trials </h3> <br /> Brown is especially passionate about alleviating patients’ reluctance to participate in clinical research. After all, she’s a walking testament to the potential benefits. <br /> <br /> Brown recognizes the good fortune of her position at the time of her diagnosis. She was an IU School of Medicine staff member in the Office of Strategic Communications, so connecting with breast cancer experts was easy. She was aware of ongoing research into triple negative breast cancer and trusted the clinical trial designed by Miller and Milan Radovich, PhD. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/20191028_kathy-miller-and-hari.jpg?h=334&w=500&rev=a91b9cc6a2a4416fb9071f9ed1fbd585&hash=27B9FB18CFA06E30567A89EA01EB816A" style="height: 334px; width: 500px;" alt="Kathy Miller and Harikrishna Nakshatri" class="float-right" />The Whac-a-Mole trial was undergirded by years of research in Radovich’s lab, beginning by comparing samples of healthy breast tissue from the <a rel="noopener noreferrer" href="https://komentissuebank.iu.edu/" target="_blank">Susan G. Komen Tissue Bank</a> at the IU Simon Comprehensive Cancer Center with tissue samples from breast cancer patients with TNBC. Analyzing their molecular and genetic differences was key to discovering what had gone haywire in the cancerous cells—and determining which drugs might be most effective in knocking out the cancer. <br /> <br /> “It does really feel like a miracle to have been in exactly the right place, where this lab is looking into treatment options for the exact type of disease I have—it seems like divine intervention,” Brown said. <br /> <br /> About 43,600 women and 530 men in the United States are expected to die from breast cancer this year, according to the American Cancer Society. Miller and other medical scientists at IU School of Medicine will continue searching for better therapies—until there is a cure. <br /> <br /> “We’ve come a tremendous way, but we’re not done because people still die,” Miller said. “I think we’re in an incredibly encouraging and exciting time. I think we will see continued improvements in the effectiveness of the treatments we have to offer people as we learn more about the detailed breast cancer biology in all of its different forms.” <br /> <br /> Brown donated her breast and lymph tissue so medical scientists can continue studying her outstanding outcome. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/jenny-brown-on-a-colorado-friends-trip.jpg?h=338&w=450&rev=7596eab238614ba0be69460c480031dc&hash=2C4B05CD8363FA991F01A1C44A348A66" style="height: 338px; width: 450px;" alt="Jenny Brown with friends in Colorado" class="float-left" />“One of my early professors, a medical geneticist, was constantly reminding us to treasure our exceptions—that’s where you have the greatest potential to learn,” Miller said. “Jenny’s response is definitely the exception. It makes me smile every time I see her.” <br /> <br /> IU School of Medicine is soon launching a new clinical trial in triple negative breast cancer studying the effectiveness of personalized cancer treatment combinations based on patients’ unique genetic data. <br /> <br /> “I think at IU School of Medicine, we are very fortunate to have leadership that’s passionate about creating clinically meaningful work—meaning all of our efforts, from the laboratory to translational to clinical research, are focused on making an impact on patients,” said <a href="/faculty/4858/schneider-bryan">Bryan Schneider, MD</a>, the Vera Bradley Professor of Oncology at IU School of Medicine. “That is woven into the very fabric of how we look at things here. We have an incredible number of world-class investigators who are highly collaborative and really committed to the bigger picture of making the lives of cancer patients better.”Tue, 19 Oct 2021 00:00:00 Z{DEE59C81-F3ED-45A1-AD02-6EC326BBF1C7}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/engaging-in-research-within-rural-communitiesEngaging in Research with/in Rural Communities<p style="margin: 0in;">On September 17, 2021, Dr. Katharine Head, PhD, presented “Engaging in Research with/in Rural Communities” as part of the TREATs talks series by the Bioethics and Subject Advocacy Program of the Indiana CTSI . Dr. Head is an associate professor of Communication Studies at IUPUI who focuses on health and medical communication.</p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>In “Engaging in Research with/in Rural Communities”, Dr. Head identifies four pillars that guide her research in rural communities: gatekeepers, trust, relevance, and communication. These four pillars are important to connect to the community and help solve the health disparities that exist in rural populations.</p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>Gatekeepers act as intermediaries between researchers and participants. Gatekeepers are especially important to the project because they will help researchers gain the cooperation of participants in order to do research with the rural community rather than just in it. Gatekeepers cannot just simply be a part of the community, researchers must consider the different factors of each gatekeeper that may enhance or hinder the researcher. Dr. Head uses her research in rural Appalachia as an example, stating that while the local church could act as an intermediary since they were studying cervical cancer, the church could actually hinder their research. </p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>Trust needs to be built especially within marginalized groups. It is important to create relationships with the community and to build  rapport. There are also two different levels of trust that researchers may have, including the trust of the research institution that they are doing work with, along with the trust of individual researchers. If a research institution has a bad reputation with the rural community one is trying to enter, then it will be more difficult to build individual trust with that community. </p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>Relevance will be essential to work with the community. If the research is not relevant to them, it could create issues with trust and what researchers’ motivations for being there are. To truly be relevant, questions and outcomes must be co-produced and research should start with reflective listening.</p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>Communication is a critical pillar in research and must be clear, regular, and accessible. It also must be about the study purpose and methods that will be used and why they will be used. The findings and outcomes must also be communicated to the rural community that the research is about. To start communication, a lay summary would be helpful and continuing that communication during and after the research is very important. </p> <p style="margin: 0in;"><span class="Apple-tab-span" style="white-space:pre"> </span>Dr. Head states that we need to make an investment in these communities and there is more harm to just do the research and leave, with no impact on the community. She ends the talk with a quote “If you’ve visited one rural place, you’ve visited one rural place.”</p> <p style="margin: 0in;">You can find Dr. Head's talk <a href="https://bioethics.iu.edu/ethics-resources/reference-center/engaging-rural-research.html">here</a>. </p>Fri, 24 Sep 2021 00:00:00 Z{AF0D7248-35DD-4786-8927-B7EE1CF7F3C4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/ethical-challenges-in-ai-and-other-applied-technologiesEthical Challenges in AI and Other Applied Technologies<p>On September 1, 2021, Dr. Emily Webber, MD, FAAP, FAMIA presented “Ethical Challenges in AI and Other Applied Technologies” for the Fairbanks Lecture Series in Clinical Ethics. </p> <p>Dr. Webber is the Chief of Medical Information Officer for IU Health and Riley’s Children’s Health and an affiliate scientist at the Regenstrief Institute and chairperson for the American Academy for Pediatric Counsel on Clinical Information Technology. She is also a practicing pediatrician and is board certified in pediatrics, pediatric hospital medicine, and clinical informatics. Her work is currently focused on optimization of health IT, applications to improve quality care and patient safety and innovation. </p> <p>In “Ethical Challenges in AI and Other Applied Technologies”, Dr. Webber emphasized the importance of asking good questions in order to recognize the potential benefits/downfalls of a certain AI program for use in healthcare. She defined the most important questions to ask as:</p> <ol> <li>What is the range of intelligence of the AI?</li> <li>Does it detect patterns and observe outcomes?</li> <li>Did a human write all the logic rules?</li> <li>Is the machine/software algorithm adjusting on its own or adjusting based on a rule its programmers provided?</li> <li>Do the features of the learning model mean something to a human observer? </li> </ol> <p>She also warns of some risks that come along with AI that must be considered. The first risk she identifies is bias and she states that there are multiple points for bias such as not having enough data points in a set, misapplication of resulting output and inadequate measure of accuracy. In order for medical AI to properly serve the community, the data set must be large enough to adequately cover all persons that it may be used on.</p> <p>Another risk Dr. Webber identifies is the pressure to adopt and scale quickly, which, in response, we must ask if it will be likely to be used and if it will make it into the mainstream healthcare system, as many technologies do not make it that far. She also brings up the risk of public perception and about how we must consider convenience, privacy, choice, and individuality when looking at AI. There is a built-in reluctance to AI in healthcare and the public may not react well to having AI used on them. </p> <p>Dr. Webber also examines case studies that the important questions can be used and what raises red flags for her in AI technology. Despite these concerns though, she claims that we shouldn’t think we should never try AI but must keep a healthy skepticism and continue to question new technologies. She advocates for a balance between innovation and discipline to regulate and ask questions, analyze the data used, and look at the skills needed, including comparing human performance to AI and determining clinical consequences of AI.</p> <p>Find Dr. Webber's talk online, <a href="https://www.fairbankscenter.org/events/fairbanks-lecture-series-in-clinical-ethics">here</a><a href="http://https://www.fairbankscenter.org/events/fairbanks-lecture-series-in-clinical-ethics">.</a> </p>Tue, 14 Sep 2021 00:00:00 Z{0D1B8A9F-8EEB-41B8-98E4-C965280E4CC0}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/august-2021-newsletterAugust 2021 Newsletter<p>We strive to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</p> <p> </p> <h3> REGISTER NOW - CVI's 2nd Annual Summit on High Value Cardiovascular Care </h3> <h2> 2021 IUH/IUSM Cardiovascular Institute Summit on High Value Cardiovascular Care: Opioid-Related Valvular Heart Disease </h2> <p> The CV Institute is excited to announce its 2nd annual Summit on High Value Cardiovascular Care, focusing this year on Opioid-Related Valvular Heart Disease. This summit will highlight the current burden of caring for patients with valvular heart disease due to intravenous drug use. The program includes experts from cardiology, cardiac surgery, infectious disease, addiction medicine, nursing, ethics, and many more. The summit seeks to highlight solutions that clinical and community partners can use in helping Hoosiers affected by opioid-related valvular heart disease. </p> <p style="margin-left: 40px;"> <strong>When:</strong> Friday, August 27, 2021</p> <p style="margin-left: 40px;"><strong>Time:</strong> Summit from 12:30pm-3:30pm</p> <p style="margin-left: 40px;"><strong>Virtual:</strong> Zoom Link: <a href="https://iu.zoom.us/s/81306425731?pwd=Z2xkVUEvNTA3dTRSclBHUlNRZGFZdz09">https://iu.zoom.us/s/81306425731?pwd=Z2xkVUEvNTA3dTRSclBHUlNRZGFZdz09</a> </p> <p style="margin-left: 40px;"> <a href="https://iu.co1.qualtrics.com/jfe/form/SV_0DmFS03wKFTjXoi"><strong>Pre-Register Here</strong></a> </p> <p> </p> <h3>Top News </h3> <h2> Wilbert and Peggy Hamstra make $1 Million Gift to IU School of Medicine for Cardiology Research </h2> <p> On July 27th, a luncheon was held to celebrate the establishment of the Wilbert and Peggy Hamstra Cardiology Research Fund at Indiana University, organized by the Development Director for the Department of Medicine, Kathryn Red, and her team within the <a href="https://medicine.iu.edu/give/contacts">Office of Gift Development</a>. </p> <p> William Hamstra, the son of first-generation Dutch immigrants, is a native of Jasper County, Indiana, where he still lives part of the year. He was raised to believe in hard work and service to the community. He founded and operated Hamstra Builders, a home and commercial construction company that has built structures across the county. Now the Hamstra Group, the company's success provided Mr. Hamstra with the means to say thank you</p> <p> "God has blessed me immensely through our business financially, and I wanted to give back," Hamstra said. "I wanted to find a way to thank all the doctors, surgeons and staff, starting with Dr. Zipes, for the years of excellent care I have received from IU Health. I think they are the best in the world." </p> <p> <a href="https://medicine.iu.edu/faculty/47775/raman-subha">Dr. Subha Raman</a> welcomed the creation of The Wilbert and Peggy Hamstra Cardiology Research Fund. She said it will play a vital role in the division's future. "Mr. Hamstra's inspirational life of building with purpose will help a long line of builders at IU - people who recognize where we can do better for people affected by heart and vascular disease, and who do something about it through their work," Dr. Raman said.</p> <p style="margin-left: 240px;"><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/20210727_hamstra-lunch_cnm_024_.jpg?h=267&w=400&rev=63ae19c0ae4040f5a8a494b076043534&hash=DAB8135CFD9425F1DEE55AC1B22EA3B7" style=" height:267px; width:400px" alt="Mr. and Mrs. Wilbert Hamstra" /></p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/20210727_hamstra-lunch_cnm_044_.jpg?h=283&w=415&rev=987dfe5d8159499eabc06fcf0de9dec4&hash=CC44292342822E2EB6779DB8B8BE342B" style="width: 415px; height: 283px;" alt="Dr. Elizabeth von der Lohe with Mr. and Mrs. Wilbert Hamstra" />       <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/20210727_hamstra-lunch_cnm_049_.jpg?h=283&w=400&rev=340c2c8777fb4015b48826475f0ef392&hash=EA34446CDAAC71C7065586F46AA46E94" style=" width:400px; height:283px;" alt="Hamstra Luncheon" /></p> <p style="margin-left: 280px;"> <em>Story Reported by: Bobby King and Chelsea McClellan</em> </p> <p> </p> <h3>Welcome to our Team </h3> <p><strong>Myranda </strong><strong>Cornwel</strong><strong>l, MBA</strong> joined the Cardiovascular Institute on July 6 as the Program Manager. Myranda comes to us with great experience in Supply Chain Operations and CV. She earned her Bachelor of Science degree in May 2016 from Fairbanks School of Public Health, Indiana University Indianapolis and her Masters of Business Administration degree in December 2020 from Western Governors University. She will be managing a number of initiatives by CVI.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/myranda-cornwel.jpg?rev=3ce8941d7c1842f7a5b9086103fac591&hash=6D388D41B66BD3A57D2CCC82EAF50317" style=" height:200px; width:200px" alt="Myranda Cornwell" /></p> <div><strong>Ashley Gutwein, MD</strong> joined IU School of Medicine, Vascular Surgery as an Assistant Professor of Surgery on July 1. Dr. Gutwein grew up in Nebraska where she attended medical school. She completed her training here in Indianapolis with the IU Health Vascular Surgery team. Her interests are aneurysm, carotid disease, peripheral arterial disease and dialysis access. Dr. Gutwein will be primarily located at IU Health North and Arnett.</div> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/gutwein_ashley_md_2021.jpg?h=200&w=160&rev=56571eaedee54d9490e8f059b4e3a1c5&hash=B645BB3BC758B8D1AA4765CC60C7149F" style=" width:160px; height:200px;" alt="Dr. Ashley Gutwein" /></p> <p><strong>Ryan Mallory, MD</strong> joined IU Health Ball Memorial Hospital on August 2 as an interventional cardiologist. Dr. Mallory received his medical education at Ohio State University in Columbus, OH. He then completed his residency in Internal Medicine, followed by his fellowship in Cardiology and his interventional fellowship in Interventional Cardiology, at the Indiana University School of Medicine in Indianapolis, IN. He is a member of the Board of Governors for the Indiana State American College of Cardiology chapter. Dr. Mallory is board certified in internal medicine, cardiology, echocardiography and nuclear medicine.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/mallory.png?rev=89ee3f659763482fa1ba82de3c19e4bb&hash=AEF4D0DCB7DCE986D06D4D6D5DAC1F7C" style=" height:200px; width:140px" alt="Dr. Ryan Mallory" /></p> <div><strong>Katsiaryna Tsarova, MD</strong> joined the Division of Cardiology in August 2021 as a non-invasive cardiologist. She earned her medical degree from the University of Florida in 2014, then completed her Internal Medicine residency at Emory University in 2017. This was followed by Cardiovascular Disease training at Indiana  University during 2017-2020 and a fellowship in Advanced Cardiac Imaging in MR and CT at the University of Utah 2020-2021. Dr. Tsarova's academic interests include healthcare economics and medical education. She will be clinical based at IU Health West. Dr. Tsarova looks forward to joining the efforts to build a strong cardiac imaging program at IU Health.</div> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/tsarova.jpeg?h=200&w=160&rev=54f1eb5611d24038b88d3bf61d934833&hash=4AFA0E25755E1A081425A8789E2E8CCD" style=" width:160px; height:200px;" alt="Dr. Kate Tsarova" /></p> <div>   <p> </p> <h3>Required Training </h3> <p> Civility and Respect Training IU Health has been working to create a healthier organizational culture, based on the IU Health Way - the organization's vision, values and promise. While team members continue to learn how best to demonstrate the values of purpose, excellence, team and compassion with patients and each other, much work remains to be done.</p> <p> An ongoing learning curriculum is being developed to ensure all team members understand and know how to practice civility, inclusiveness and anti-racism. The first module, "A Civil and Respectful Workplace: Building a Strong Affirmative Culture," is available now in eLMS and <span style="text-decoration: underline;"><strong>must be completed by the end of this year.</strong></span> </p> <p> Additional modules will be introduced in September, December and early next year. </p> <p> <em>*Physicians can access the module via Center for Physician Education</em> </p> <p> <a href="https://click.e.iu.edu/?qs=f372ff8a6e7b15575713459dcf0a53a5cc9d54e9c3f63433717fa69f77f9ca930b84677eba6d318e3c958fb550da091ff42a5816a45fe3b2">Access eLMS</a> </p> <p> </p> <h3>Kudos </h3> <h2>Honors and Recognitions</h2> <p>Through a rigorous peer-review process, <a href="https://medicine.iu.edu/faculty/19930/motaganahalli-raghu">Dr. Raghu Motaganahalli</a> was recently selected into the prestigious Academy of Master Surgeon Educators. </p> <p> Cheers to <a href="https://medicine.iu.edu/faculty/5140/dasgupta-noel">Dr. Noel Dasgupta</a> for representing OneIUCV at the upcoming American College of Cardiology (ACC) Virtual Roundtable on Cardiac Amyloidosis: Clinical Gaps and Unmet Needs, October 25. Dr. Dasgupta is helping bring advanced treatments to help Hoosiers with this once deadly disease live longer, quality lives. Early diagnosis and treatment are key to improving survival and preventing irreversible organ damage. </p> <h2>Awards</h2> <p><a href="https://medicine.iu.edu/faculty/44716/clasen-suparna">Dr. Suparna Clasen</a> has been selected for a three-year IU Health Values Research Grant entitled: Detection of late subclinical cardiovascular disease in testicular cancer survivors exposed to high-dose platinum chemotherapy and bone marrow transplant . This study prospectively looks at testicular cancer survivors (TCS) who are affected by late atherosclerotic cardiovascular disease (ASCVD) events after platinum-based chemotherapy regimens. The goal of the study is to develop effective strategies to prevent ASCVD in TCS using clinical characteristics, biomarkers, and novel imaging studies. She also just received notice of a prestigious National Institutes of Health LRP Award - congratulations, Dr. Clasen! </p> <p> <a href="https://medicine.iu.edu/faculty/20268/gruionu-gabriel">Dr. Gabriel Gruionu</a> was selected as a 2021 Elevate Nexus Higher-Education recipient for his grant entitled: The Fast-In Catheter, A Novel Peripheral Intravenous Catheter for Easier Vein Access and Faster Infusion of Resuscitation Fluids in Critically Ill Cardiovascular Patients. Peripheral Intravenous Cannulation (PIVC) is the most common invasive medical procedure anywhere in the world with the purpose of collecting blood and administering nutrients and medicine to patients intravenously. Emergent PIVC, especially during resuscitation, is particularly difficult to perform in patients with small veins or in those who are critically ill or hypotensive. Dr. Gruionu's Fast-In Catheter (FIC) combines the small needle size of existing PIV catheters for less trauma and easier access to the vein, and a large bore catheter for faster resuscitation. They intend to translate this novel solution to medical practice and, in the future, develop a portfolio of a point of care applications for blood testing at bed side. </p> <p> Gastric electrical stimulation has been shown to be an effective treatment of nausea and vomiting in patients with Gastroparesis, a common chronic disorder in which gastric emptying is delayed in the absence of an anatomical obstruction. It is theorized that gastric electrical stimulation improves symptoms of gastroparesis by influencing vagal outflow. <a href="https://medicine.iu.edu/faculty/4919/everett-thomas">Dr. Thomas Everett</a> and his co-PIs will be investigating the mechanisms of vagal nerve activity on mediating the symptoms of nausea and vomiting, and if effecting the vagal outflow by gastric electrical stimulation also affects heart rate and cardiac function during their final year of funding for their NIH SPARC3 award. They will also be investigating the effects on Long-Haul COVID on vagal nerve activity and cardiovascular function. </p> <p> Cheers to our five recent Dr. Charles Fisch Awardee recipients! The objective of this award is to support cardiovascular research for young investigators or more senior investigators, embarking on a new research direction.</p> <p style="margin-left: 40px;"> • Dr. Yinan Shi - Project entitled: GALNT1 and GALNT13 as Novel O-GalNAc Glycosylation Mediators of Pulmonary Arterial Hypertension </p> <p style="margin-left: 40px;">• <a href="https://medicine.iu.edu/faculty/44716/clasen-suparna">Dr. Suparna Clasen</a> - Project entitled: Radiation-induced Coronary Microvascular Disease in Racially Diverse Breast Cancer Patients</p> <p style="margin-left: 40px;"> • <a href="https://medicine.iu.edu/faculty/20845/naidu-samisubbu">Dr. Samisubhu Naidu</a> - Project entitled: Targeting autocrine and paracine roles of endothelial CD38 in PAH </p> <p style="margin-left: 40px;">• <a href="https://medicine.iu.edu/faculty/20268/gruionu-gabriel">Dr. Gabriel Gruionu</a> - Project entitled: The Fast-In Catheter, A Novel Peripheral Intravenous Catheter for Easier Vein Access and Faster Infusion of Resuscitation Fluids in Critically Ill Cardiovascular Patients </p> <p style="margin-left: 40px;">• <a href="https://medicine.iu.edu/faculty/1783/frick-kyle">Dr. Kyle Frick</a> - Project entitled: IU Biobank and Registry of Cardiovascular Disease Associated with End-Stage Liver Disease and Cirrhotic Cardiomyopathy. </p> <h2>In the Media</h2> <p> <a href="https://iuhealth.org/find-providers/provider/richard-j-kovacs-md-7412">Dr. Richard Kovacs</a> has been fighting at the statehouse for education about sudden cardiac arrest and heart issues in student athletes. In this <a href="https://www.wrtv.com/news/working-for-you/protecting-student-athletes-from-sudden-cardiac-arrest">WRTV</a> interview, Governor Holcomb signed a bill requiring all Indiana high schools provide educational materials about sudden cardiac arrest to all student athletes, parents and coaches. </p> <p> </p> <h3>Team Selfie of the Month</h3> <p style=""><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/ep-team.jpg?h=250&w=401&rev=653ddd55ee014dd7ba7fc689292d576c&hash=1661DDED07FA291D8E2147227364008C" style=" width:401px; height:250px;" alt="Electrophysiology Team - Methodist Hospital" />   <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/navarrete.jpg?h=250&w=200&rev=301f9e07da444e0aac90b7fd10fdd7eb&hash=166D41619798434F13496B3079A9EE10" style=" height:250px; width:200px" alt="Dr. Antonio Navarrete" /></p> <p> <em>Pictured are some of our Cardiac Electrophysiology faculty members. From left to right: <a href="https://iuhealth.org/find-providers/provider/mithilesh-k-das-md-5640?utm_source=Google&utm_medium=Yext&y_source=1_MTE5NDEyOTEtNzE1LWxvY2F0aW9uLmdvb2dsZV93ZWJzaXRlX292ZXJyaWRl">Dr. Mithilesh Das</a>, <a href="https://iuhealth.org/find-providers/provider/tanyanan-tanawuttiwat-md-296353">Dr. Tanyana Tanawuttiwat</a>, <a href="https://iuhealth.org/find-providers/provider/john-m-miller-md-8140">Dr. John Miller</a>, <a href="https://iuhealth.org/find-providers/provider/mohamed-homsi-md-58716">Dr. Mohammed Homsi</a>, <a href="https://iuhealth.org/find-providers/provider/takeki-suzuki-md-259163">Dr. Takeki Suzuki</a> and <a href="https://iuhealth.org/find-providers/provider/antonio-j-navarrete-md-8358">Dr. Antonio Navarrete</a></em></p> <p> Our EP Team is focused on a better patient experience with individualized treatment of patients with the entire array of heart rhythm disorders. The team has a total of 8 highly experienced electrophysiologist and 2 advance providers. They aim to improve access to the outpatient evaluation visits, provide hassle-free and efficient testing to arrive at correct diagnoses of rhythm problems that directly leads to personalized treatment strategies - medication, device, ablation, or observation, as appropriate. They routinely perform cardiac implantable device procedures, which include pacemakers, ICDs, biventricular ICDs, subcutaneous ICDs, his-bundle pacing, left bundle pacing and leadless pacemaker implants. Ablations are performed with no or minimum X-ray exposure. The team also performs hybrid procedures for the management of atrial fibrillation and ventricular arrhythmia. </p> <p> The EP faculty are actively involved in clinical research and in investigator initiated clinical research, publishing routinely and participating in multicenter trials. They are an ACGME certified clinical cardiac electrophysiology training program. </p> <p> The team strives to be the go-to resource for difficult heart rhythm management problems in the state, having the equipment and skills to safely, effectively, and efficiently handle whatever may come their way. </p> <p> Please send a selfie of your team to <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> with a short caption of how you help achieve our Vision so we can share with the world! </p> <p> </p> <h3>Exciting Opportunity within #OneIUCV </h3> <p> IU Health Physicians and IU School of Medicine is seeking a patient-focused Medical Director for the Cardiovascular Critical Care Unit (CVCC) to collaborate with our highly skilled teams in Indianapolis. To apply, visit the <a href="https://iuhealthrecruitment.org/Physician_Job/Details/IU-Health-Physicians--Cardiovascular-Critical-Care-Unit-Medical-Director-Methodist-Hospital/40449">IU Health Career's page</a></p> <p> </p> <p><em>Do you have a story that reflects the strength of our statewide system for cardiovascular care? Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</em></p> </div>Wed, 11 Aug 2021 00:00:00 Z{43C166EA-8CD2-4352-9EF0-992A1068E323}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/study-recruitment-and-social-mediaStudy Recruitment and Social Media<p>Social media has emerged as a promising space for data acquisition and study recruitment, due to the vast number of diverse users and abundant, accessible data. Taking advantage of this incredible research resource also raises important ethical questions. As part of a larger project examining ethical challenges posed by digital technologies, the IU Ethics, Values, and Technology project recently hosted three webinars covering the promise and perils of research using social media, focusing on studies on sexual health, attitudes towards disease, and adverse drug-drug interactions. With support of Lilly Endowment Inc., Indiana University is studying ethical issues raised by digital technologies that span human activities “from science to business to culture to politics,” aiming to develop “integrated initiatives to better equip students and faculty to confront and address these ethical challenges presented by our digital world.”  All the webinars are available on the project’s website (<a href="https://digitalethics.iu.edu/">https://digitalethics.iu.edu</a>) and through the links provided at the end of this post. The researchers shed light on numerous topics involving research ethics but perhaps the most persistent and The challenging topics discussed in the webinars center on study recruitment and use of data from social media.</p> <p>Drs. Lisa Carter-Harris and Amanda Gesselman each focus on study recruitment as a part of their respective webinars. Dr. Carter-Harris shares her experience using social media to recruit for lung cancer screening studies, while Dr. Gesselman explains how social media has helped recruit participants in her sexology research. Taken together, these two webinars highlight the strengths but also raise important questions about consent and the relationship of the researcher to her participants when they are recruited over social media. </p> <p>There are several advantages to using social media for recruitment. First, this sort of recruitment can save researchers money, which may be reallocated elsewhere in their projects. Another benefit is keeping participants better informed and involved in the project. Social media offers an open and user-friendly avenue for communication between researchers and their participants. This is a promising area for creating stronger relationships and trust between researchers and the public. One final advantage is the potential to recruit a larger and more diverse participant pool. Not only does this increase the validity and reliability of the study’s results, but it also diversifies the participant groups and ethically represents historically excluded and exploited groups in the scientific literature. This can ultimately bring our scientific work towards more equitable and inclusive ends.</p> <p>One of the most ethically challenging parts of using social media to recruit participants is consent and communicating risk. While similar issues arise for other ways of recruiting, what is relatively unique is the increased risk to a participant’s social media contacts. Social media is a place where people message, post and repost, and tag other people regularly. These interactions increase the likelihood of an individual’s information finding its way into a study’s data set without their consent. Researchers must therefore be aware of the increased risk of unethically involving a participant’s contacts when recruiting on social media. </p> <p>For example, consider Dr. Gesselman’s current research on how members of the LGBTQ+ community use social media to mediate their relationships. Participants’ posts will often feature sensitive information about other users. Consequently, the researcher must must communicate not only the risks of identification to the participants themselves but also the risk they introduce to their contacts. The high social connectivity characteristic of social media makes this “bystander risk” a much more prominent consideration for social media researchers as they recruit in this space. </p> <p>Recruitment represents just one use for social media in furthering scientific research. It also has great potential as a place where people discuss their experiences with health and disease, which researchers can tap into to establish clinically important relationships.  Drs. Natalie Lambert, Wendy Miller, and Rion Correia each share their experiences using social media to discover information regarding health, disease, and treatments in their webinars. Dr. Lambert’s most recent work performs a qualitative analysis of posts in the Facebook group “Survivor Corps,” a group for people dealing with long-term COVID symptoms. Dr. Miller’s work largely focuses on correlations between post content and sudden unexpected death due in epilepsy (SUDEP). Lastly, Dr. Correia’s research bridges social media activity with electronic health records (EHRs) to better understand certain drug-drug interactions (DDIs). Using social media in these ways pose important questions regarding de-identification and obtaining consent to study social media behaviors. </p> <p>There are a few options available to researchers when turning to social media for data. One option is focusing on publicly-available activity (e.g., public posts and reposts), which often does not require the researcher to obtain permission to use the information in her data. Proper de-identification, however, is still necessary to protect the owner of the post. This also comes with the important caveat that study type (i.e., longitudinal studies) may necessitate stricter standards of consent regardless of whether the post is public or private. Another option is private posts. These often do require prior participant approval for research use. Ultimately, it is up to the type of study and IRB review process to determine the level of consent researchers must obtain for their social media studies. </p> <p>Other studies, like Dr. Correia’s on DDIs, not only perform qualitative analyses of posts involving certain drugs but also link the posts to information stored in health records. Linking these two is a promising step, but one which requires a much more involved consent process. </p> <p>Perhaps the most involved is reaching out and obtaining individual consent. Dr. Correia and Dr. Miller used such a strategy while studying SUDEP and social media post content by having the participants’ families posthumously donate their social media timelines. This type of research requires a lot of work, which is evidenced in their only having 12 participants in the study. Other ways to bridge the two is to use anonymized records. Though less time consuming, it is harder to draw concrete connections between an individual’s social media behaviors and their clinical health. We can expect researchers to find ways to make these connections easier, but participant confidentiality and privacy remain the key ethical consideration in these types of studies. Solving these problems of privacy and confidentiality will decide how rapidly researchers draw clinical connections to peoples’ social media presence.   </p> <p>Many of the considerations common to our discourse on research ethics receive added emphasis when considering social media as a recruitment tool and place for data acquisition. Among these are consent, risk communication, de-identification, and confidentiality. These webinars provide only a glimpse into the budding ethical conversation surrounding researchers’ social media usage, and we will be tasked with rethinking our ethical understandings to accommodate social media’s growing role in advancing our health sciences. To view the full webinars, follow the links below:</p> <p><a href="https://www.youtube.com/watch?v=pAOmypg5VdY">Ethically bridging digital health data: From social media to electronic health records</a></p> <p><a href="https://www.youtube.com/watch?v=plRseF_4DK0">Ethical Concerns and Strategies for Collecting Sexual Health Data</a></p> <p><a href="https://www.youtube.com/watch?v=gsptD_jB8xc">Using Social Media to Reveal Health Care Problems, Behaviors, and Information Needs</a></p>Tue, 03 Aug 2021 00:00:00 Z{4CBDB5C2-6790-431A-B2CD-CB97C6F36C0E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/chuckstrong-backyard-huddleChuckstrong Backyard Huddle raises nearly $2.5 million for cancer research<p>In a night that brought together cancer survivors, researchers and philanthropists, the Chuckstrong Backyard Huddle raised nearly than $2.5 million July 29 for cancer research at the <a rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>. </p> <p>Hosted by the Indianapolis Colts and former head coach Chuck Pagano at the home of Colts owner Jim Irsay, the event took a surprising turn that bridged football and basketball. Irsay spoke of the brilliance of IU cancer researchers who are working to improve treatment and search for cures.</p> <p>“We’re going to have a little bit of fun and put the coach under pressure,” Irsay said.</p> <p>Guests gathered in a basement basketball court where Irsay announced Pagano would be shooting baskets – each worth a $100,000 gift toward cancer research. Pagano sunk 10 shots for a total gift of $1 million. Irsay offered another $1 million for a free throw. After a pep talk from former Colts offensive tackle and Indiana native Joe Reitz, Pagano hit the shot amid cheers from guests (<a rel="noopener noreferrer" href="https://www.wishtv.com/sports/indianapolis-colts/must-see-free-throw-by-chuck-pagano-at-irsays-house-for-1m-for-cancer-research/?fbclid=IwAR2__gAjGf4k3BlcJc1pgKSKSFON0UAJfpdGeoOqBzaTyC74HCBhqt-qKL0" target="_blank">watch the shot captured by WISH-TV</a>). With that final shot, Irsay made a total gift of $2 million to cancer research.</p> <p>To date, the Chuckstrong initiative has raised nearly $10 million since 2013. <span>Funds have been used to help recruit new researchers, provide seed money for researchers to launch new ideas, and purchase laboratory instruments to support innovative cancer research.</span></p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/c/chuckstrong-2021_lee-pagano.jpg?h=320&w=400&rev=0401c63272024faeba58f1493ad6df8e&hash=73CA2677DDE1AA6CBED4E693EB536502" alt="Lee and Pagano speak during the Chuckstrong Backyard Huddle." class="float-right" style="margin: 6px 0px 6px 6px; width: 400px; height: 320px;" /> <p><span>“The Chuckstrong Backyard Huddle was a remarkable and inspirational evening that celebrated not only the importance of cancer research, but also the strength of survivors,” Kelvin Lee, M.D., director of the IU Simon Comprehensive Cancer Center, said. “We know that research cures cancer, and we are grateful to Mr. Irsay and so many others for their unwavering support of our mission to discover </span>better approaches to prevention, diagnosis and treatment of cancer.”</p> <p>During the event program, guests learned about the impact of IU cancer research and expertise in a <a rel="noopener noreferrer" href="https://youtu.be/G99NIRx3G0Q" target="_blank">moving video</a> about Stephanie Pemberton, a cancer survivor and Indianapolis Colts vice president of marketing. Pemberton detailed her triple negative breast cancer diagnosis journey and treatment.</p> <p>Due to the COVID-19 pandemic, the 2020 Chuckstrong event was canceled. This year’s event was reimagined as the Chuckstrong Backyard Huddle, which nearly 100 guests attended. Attendees included sponsors for the 2020 event, cancer survivors and researchers. </p> <p><strong>Pagano’s story</strong></p> <p>Chuck Pagano’s diagnosis of acute promyelocytic leukemia in September 2012 shocked Indianapolis with the reminder that we are all vulnerable to the devastating effects of cancer. The Chuckstrong movement quickly began providing an opportunity for our city to visibly support Pagano as his team rallied and marched toward the playoffs. </p> <p>Pagano endured difficult treatments under the guidance of Dr. <a rel="noopener noreferrer" href="https://cancer.iu.edu/research-trials/member-bio.shtml?id=1169&name=larry-cripe" target="_blank">Larry Cripe</a>, a hematologist and cancer center researcher, but he ultimately returned to his head coaching duties on Dec. 24, 2012 – a day that inspired and captivated all who have been touched by cancer. </p>Mon, 02 Aug 2021 00:00:00 Z{716B1A76-D88B-4F3F-BAC5-E56A72A50C0C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/imprs-students-take-on-summer-researchIMPRS students take on summer researchFourteen medical students are experiencing medical innovation first-hand as they work alongside several orthopaedic faculty members and conduct research as part of the Indiana University Medical Student Program for Research and Scholarship. <p> The program – known as IMPRS – pairs students who just completed their first year of medical training with a faculty mentor. For eight to 12 weeks of their summer, the students conduct laboratory/translational or clinical research, network and attend seminars. Their work culminates in an end-of-the-summer oral and poster presentation.</p> <p> IMPRS is IU School of Medicine’s official program for summer medical student research. This opportunity is specifically designed to attract those who are between their first and second years of medical school because it’s an ideal point in their education to take on such lengthy research projects. </p> <p> Here are the students and orthopaedic faculty mentors working together this year, and a bit about each students’ project:<br /><br /> </p> <h3> The Kacena Lab </h3> <h4>Faculty mentor: Melissa Kacena, PhD</h4> <p> Christopher Dalloul: Bone health in a mouse-adapted model of SARS-CoV-2</p> <p> Nicholas Hux: Effects of targeted TMP on fracture healing in aged mice </p> <p> Abduallah Elsayed: The effects of targeted SRT1720 on bone fracture healing and pain behavior in mice</p> <p> Samuel Zike: Effects of TMP and high fat diet on bone fracture healing</p> <p> Nikhil Tewari: Effects of megakaryocyte products on bone marrow angiogenesis</p> <p> </p> <p> </p> <h3> The Gingery Lab </h3> <p> </p> <h4> Faculty mentor: Anne Gingery, PhD </h4> <p> </p> <p> Nicholas Thelen: Studying the role of cellular senescence and immune evasion in musculoskeletal pathology, with the long-term goal of reducing senescent burden in aged and diseased tissues to improve healing.</p> <p> </p> <p> </p> <h3> The Meneghini Lab </h3> <p> </p> <h4> Faculty mentor: Michael Meneghini, MD </h4> <p> </p> Joshua Hsien-Shu Chang: The relative contribution of medical comorbidities in the OARA score to safe same-day and next-day discharge after total joint arthroplasty: A machine learning analysis <p> </p> Ethan Cornwell: The influence of medial collateral ligament and lateral collateral ligament pie crusting in primary total joint arthroplasty on patient-reported outcomes <p> </p> Colin Harris: Radiographic outliers, revisions, and functional outcomes in fixed-bearing medial unicompartmental arthroplasty <p> </p> Luci Hulsman: Time required for planned and unplanned episodes of care in aseptic and septic hip and knee revision surgery <p> </p> Amrit Parihar: Instability in patients with lumbar spine disease or lumbar fusion undergoing posterior approach vs. direct lateral approach primary total hip arthroplasty <p> </p> <p> </p> <h3>The McKinley Lab </h3> <p> </p> <h4> Faculty mentor: Todd McKinley, MD </h4> <p> </p> Rebecca Nunge and Kayla Gates: Both are working on a project entitled Developing a Minimally Invasive Cell-Based Model to Predict Response to Major Trauma. <p> </p> Taylor Luster: The objective of Taylor’s summer research is to measure trauma imposed by hemorrhagic shock and a femur fracture in a mouse model to determine if specific cytokines can serve as predictive values for response to trauma. This research will help determine how intrinsic differences between individuals can help predict survivability in polytrauma.Thu, 15 Jul 2021 00:00:00 Z{FF0D4B34-E2E1-4504-9D6E-4B69A164F21E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/vaccinating-in-indianaVaccinating in Indiana<p>From April-May 2021, I committed 94 volunteer hours to vaccinating the general public of Indianapolis against COVID-19 at IU Methodist Hospital, the IUPUI Student Campus Center, and the Indiana Motor Speedway. I’ve given at least several hundred vaccines, likely exceeding a thousand (as of this writing, 3,005,438 Indianans, or 44%, have received <a href="https://usafacts.org/visualizations/covid-vaccine-tracker-states/state/indiana">at least one COVID dose</a>).</p> <p>I am obviously a proponent of the COVID vaccines. The majority of the (vocal) people I vaccinate are of a similar, if not more neutral, mindset (it is, after all, the subset of Indianapolis that willingly seats itself beneath my waiting syringe). With the institution of mandatory vaccination for IUPUI students and IU Health faculty, though, the population at my stations has subtly changed, now hosting a larger proportion of the hesitant or undecided. I make a point to ask about my patients’ attitudes, and, though I had anticipated many of these arguments (the side effects, fear of needles, time constraints, autonomy…), others surprised me, both in content and fixedness.</p> <p><strong>A case:</strong> There was the man who feared the possible aftereffects of the injection; he complained to me about his sister, who had “three weeks” of malaise following vaccination, along with a mysterious tendency to drink “gallons of water.” Other patients claimed to have witnessed odd or unrelated side effects, including hair loss, unremitting gas, and an increased frequency of hiccups… in addition to the advertised (and better-documented) fevers, chills, aches, pains, and fatigue. <strong>My approach:</strong> I affirmed to this patient that the effects of the vaccine can be palpable, but they are usually not so… well, weird. My argument that was not heeded. It did little to quell this patient’s firsthand experience of puzzling, alarming, seemingly linked symptoms. <strong>In the end:</strong> I’ve been taught that logic and data don’t easily change minds. I was resigned to admit that some patients clearly did not or would not believe my evidence-based medical advice. The same goes for much of the data about the vaccines, immunology, and epidemiology. I was simply thankful the patient accepted the shot.</p> <p><strong>A case:</strong> Another patient had a strong history of anaphylaxis and was extremely anxious. He showed me his collection of epi-pens and his allergist on speed dial. Begrudgingly, he was vaccinated, and, to my knowledge, suffered no severe physiological reactions. <strong>My approach:</strong> I stood aside from this patient’s reasoning. He had considered the chance of a life-threatening reaction to a vaccine against a decreased chance of catching COVID-19 and had chosen the latter. I’m not sure if I would have made the same choice. <strong>In the end:</strong> for some, though a decision may not be literally ‘life and death,’ it bears similar significance. And, if I can’t argue with the anaphylactic patient’s personal cost-benefit analysis, then I probably shouldn’t try to argue with other patient’s analyses if their understanding of the situation is intact and they perceive grave consequences to any facet of a medical decision.</p> <p><strong>A case: </strong>A teenaged patient spoke to me about the threat of judgment from her family, who remain staunchly against vaccination, almost to the point of altogether disbelief in COVID. She told me her mother would most assuredly not let her visit over the summer if they knew she’d gotten the shot. She imagined her mother saying, “That’s not how we raised you.” She looked tearful at the imagined condemnation from her parents, but still submitted to vaccination because she though it was right. But it took her weeks of what seemed to me obviously heated internal discussion and turmoil. <strong>My approach:</strong> I told this patient I was glad she decided to get the shot, and that her secret was safe with me. <strong>In the end:</strong> some consequences are unfathomable by outsiders, and, though considered nonsensical or arbitrary by some, still have real sequelae.</p> <p><strong>A case:</strong> One spectator at the Speedway asked me, “Where are all those sick people? I haven’t seen anyone headed to the hospital.” He had been watching us vaccinate for several hours. <strong>My approach: </strong>I told this man about my parents-in-law, who both contracted difficult cases of COVID-19, but who luckily survived with only minor (though long-lasting) aftermath. I told him about the dozens of patients I’d seen in the ICU during rotations and shadowing palliative care unresponsive, hooked up to ventilators. <strong>In the end: </strong>This spectator refused vaccination but thanked me for speaking so intimately. Though shared vulnerability may occasionally work to convince people of a truth hard to swallow, they can also come off (unpalatably) as scare tactics.</p> <p><strong>A final case:</strong> I met a woman with countless self-harm scars covering her upper arms, down to her wrists. She said she didn’t want to get vaccinated because someone would see her arms. <strong>My approach</strong>: I took her behind a privacy curtain, and she wept as the rolled up her sleeves. <strong>In the end:</strong> I thought for hours about how brave this woman was. I wish I could say more. </p> <p>Vaccinating Indianapolis has been a pleasure, and a monumental opportunity for personal and professional growth. Medical school offers plenty of didactic instruction in speaking to patients, managing fear, and tempering expectations, but the skills go unpracticed and unanalyzed when unapplied to real encounters. We are primed to recognize the reasons why patients may feel a particular way towards a particular intervention, but we are not taught how to understand and process those reasons. We are not taught when those reasons are better left untouched. Vaccination is a personal choice, and I’ve offered a biased cross-section of those who accepted it with varying degrees of hesitation. Throughout my experience, I learned to argue patient’s hesitancies less and listen to them more.</p>Tue, 06 Jul 2021 00:00:00 Z{C8505990-2AD6-4AA3-B1C0-438D110B25CF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/june-2021-newsletterJune 2021 NewsletterWe strive to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.<br /> <br /> <br /> <h1>Top News</h1> <h3>Krannert CV Research Center Director Recruitment Update</h3> <p>Following a national search, Rohan Dharmakumar, PhD, from Cedars-Sinai Medical Center and the University of California Los Angeles, has been selected as the inaugural Director of the new Krannert Cardiovascular Research Center (KCVRC) within the Indiana University Health/Indiana University School of Medicine Cardiovascular Institute. He is a translational scientist, broadly trained in cardiovascular physiology and biophysics, and focused on addressing critical needs in cardiovascular health and disease. The cornerstones of his translational research are to discover new biomarkers, enable noninvasive detection of these biomarkers and precisely design imaging-guided personalized therapies. Seminal contributions to date have included visualization of myocardial oxygenation changes, inflammatory mechanisms accelerating risk of heart failure post-myocardial infarction, and novel markers of ventricular arrhythmia in patients with prior MI. The KCVRC has, as its charge, the interdisciplinary advancement in understanding, preventing, and treating cardiovascular diseases, translating basic discoveries to favorably impact the cardiovascular health of the people of Indiana and beyond. High impact programmatic teams and a pipeline of future talent will be established around strong pillars and cross-cutting themes in cardiovascular science. Stay tuned for more on Dr. Dharmakumar upon his arrival in Indianapolis later this year. Your engagement is appreciated in realizing a shared vision for us to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond.</p> <p> <span style="white-space: pre;"> </span> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/dharmakumarr.jpg?h=252&w=180&rev=2b9d0b57f4a247df992d3a2d1f0e6d40&hash=CCE9273BB8B4CC8E0BA0693C668DB751" alt="Rohan Dharmakumar, PhD" style="height: 252px; width: 180px;" /></p> <p> <em><span style="white-space: pre;"> </span>Pictured: Rohan Dharmakumar, PhD</em></p> <br/> <h3>IU Health Hospitals Receive 2021 Chest Pain-MI Registry Performance Achievement Awards</h3> <p>Congratulations to the 7 IU Health Hospitals on their 2021 Chest Pain-MI Registry Performance Achievement Awards from the American College of Cardiology, demonstrating their commitment to providing quality care to patients with heart attacks.<br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/platinum-award.jpg?h=208&w=217&rev=66a281efcd9f48a4865f878b3387706e&hash=15227EEDD14C460ABFCED0CC0418FCF8" alt="Platinum Chest Pain MI Registry Award" class="float-left" style="height: 208px; width: 217px;" /><br /> <br /> <strong>Platinum Performance Award</strong><br /> • IU Health Arnett Hospital<br /> • IU Health Ball Memorial Hospital<br /> • IU Health Bloomington Hospital<br /> • IU Health Methodist Hospital<br /> • IU Health Saxony Hospital<br /> • IU Health West Hospital</p> <p> </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/gold-award.jpg?h=214&w=216&rev=4a96dfa496034de4a9aa9be2583f1fc7&hash=330DFA9FC4218A9F658FE1857C1489D8" alt="Gold Chest Pain MI Registry Award" class="float-left" style="height: 214px; width: 216px;" /><br /> <br /> <strong>Gold Performance Award</strong><br /> • IU Health North Hospital<br /> <br /> <br /> <br /> <br /> <br /> </p> <p> </p> <p> </p> <h3>Top Performer in Likelihood to Recommend: IU Health Ball CV Surgery Q1 Specialty Care</h3> <p>Cheers to our IU Health Ball Cardiovascular Surgery team for achieving a Likelihood To Recommend score of 100.00 (100% of patients would recommend!) during Q1, evidence of their dedication to exceptional patient and family experiences.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/top-performers.jpg?h=376&w=500&rev=45cfa2867d734ce1bc22f94a32353f34&hash=2A3E16BA787B2A9EC886F3F161874F1F" alt="IU Health Ball CV Surgery Team" style="height: 376px; width: 500px;" /><br /> <em>Pictured from left to right: Kellie Sheets, Ashley Chalfant, Nicole Miller, <a href="https://iuhealth.org/find-providers/provider/glenn-n-carlos-md-5275">Dr. Glenn Carlos</a>, Miranda Patterson<br /> Not Pictured: <a href="https://iuhealth.org/find-providers/provider/john-f-kuhn-md-872946">Dr. John Kuhn</a></em><br /> <br /> </p> <br/> <h1>Welcome to our Team</h1> <p><strong>Stephen Cook, MD, FACC</strong> joined IU School of Medicine, Division of Cardiology in February 2021 as a Professor of Clinical Medicine and Director of the Indiana University Health Adult Congenital Heart Disease Program. Dr. Cook comes to IU Health from Helen DeVos Children's Hospital in Grand Rapids, where he served as the director of the ACHD program. He is a Fellow of the American College of Cardiology, serving on the ACC's Diversity and Inclusion Committee. Dr. Cook is board certified in pediatric cardiology, adult cardiovascular medicine and adult congenital heart disease (ACHD). Dr. Cook earned his medical degree from Boston University School of Medicine, Boston, MA. He completed a combined internal medicine and pediatric residency at Albert Einstein Medical Center, Philadelphia, PA followed by combined pediatric and adult cardiology fellowships at Nationwide Children's Hospital and The Ohio State University, Columbus, OH.</p> <p> <span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/cook.jpg?h=240&w=180&rev=8aded515610f4d7db10a1ad041881973&hash=17E85FFF1ADCA4B6E935E021B5173B3E" alt="Stephen Cook, MD" style="height: 240px; width: 180px;" /><br /> <br /> <br /> <strong>Balaji Tamarappoo, MD, PhD</strong>, joined IU Health in June 2021 as a general cardiologist. He completed his post graduate training in Internal Medicine Residency and his Cardiovascular Medicine Fellowship at Oregon Health and Sciences University, Portland, OR in July 2008. This was followed by two years of training in Nuclear CT and cardiac MRI at Cedars Sinai Medical Center in Los Angeles, CA. He was staff physician at Cleveland Clinic, Cleveland, OH from 2010-2016 and Cedars Sinai Medical Center from 2016-2021. Dr. Tamarappoo is board certified in Cardiology, Echocardiography, Nuclear Cardiology and Cardiovascular Computed Tomography. His research studies have included CT, MR, PET and SPECT imaging modalities and his NHLBI funded research study uses coronary CTA to characterize plaque remodeling in response to intensive medical therapy in women with nonobstructive coronary artery disease.</p> <p> <span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/tamarappoo.jpg?h=193&w=180&rev=267b6da0af6d4aafa761c4c50dbd4c7b&hash=449BAD84A0BF768820E54026A67849AA" alt="Balaji Tamarappoo, MD, PhD" style="height: 193px; width: 180px;" /><br /> <br /> <br /> <br /> <br /> </p> <h1> Patient Care Updates</h1> <p> </p> <h3>Vein Center opens at Methodist Professional Center 2</h3> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/vein-clinic.jpg?h=158&w=209&rev=634119fefb9d46c68b2f45933a849d01&hash=EAF2FC5644EC253909973D2F7B7658EC" style=" height:158px; width:209px" alt="IUH Methodist Vein Clinic" class="float-left" /></p> <p>Patients seeking comprehensive vein care treatment have the option of visiting a new vein center located in the third-floor vascular surgery outpatient office at IU Health Methodist Professional Medical Center 2. Over the last year, administrative space was converted into a clinical environment to accommodate surgeons and vascular lab technicians who will perform interventions and treatment in the expanded outpatient vein center.<br /> <br /> <span style="white-space: pre;"> </span><br /> <br /> <br /> </p> <br/> <h3>Personalized Medicine for Patients with Coronary Heart Disease</h3> <p>Clopidogrel is a commonly prescribed antiplatelet medication for patients with coronary artery disease. A common genetic variant present in 25-30% of the population has been shown to reduce the effectiveness of clopidogrel and increase the risk of recurrent heart attacks. Pharmacogenetic testing can identify carriers of the variant CYP2C19 gene, and effective alternate medications can be prescribed in place of clopidogrel. Routine pharmacogenetic testing for this genetic variant is now being offered to all patients who receive coronary stent procedures at IU Health cardiac catheterization laboratories as part of the Personalized Medicine Initiative.<br /> <br /> <br /> <br /> <br /> </p> <h1>KUDOS</h1> <p> </p> <h3>Honors and Recognitions</h3> <p><a href="https://medicine.iu.edu/faculty/6515/zipes-douglas">Dr. Douglas Zipes</a> has been awarded the JO Ritchey Society Award for his enduring commitments to IU School of Medicine.<br /> <br /> <a href="https://medicine.iu.edu/faculty/23373/bajpai-vatsal">Dr. Vatsal Bajpai</a> was awarded the Fellow of the Year by the Internal Medicine Housestaff for his outstanding teaching.<br /> <br /> <a href="https://medicine.iu.edu/faculty/52146/ilonze-onyedika">Dr. Onyedika Ilonze</a> has been accepted into the Program to Increase Diversity in Cardiovascular Health Related Research (PRIDE-CVD) at SUNY Downstate Health Sciences University for Summer 2021.<br /> <br /> Congratulations to <a href="https://iuhealth.org/find-providers/provider/roopa-a-rao-md-55326">Dr. Roopa Rao</a> and Dr. Stephen Cook for their selection in the IUSM Department of Medicine's Business of Medicine Leadership Program. This program includes training in business acumen, leadership skills, lean, and strategic thinking with equity and inclusion.<br /> <br /> <br /> </p> <h3>Publications</h3> <p>The recent study, published in <a href="https://www.jacc.org/doi/10.1016/j.jacc.2021.04.067%0A%0A%0A%0A%0Ahttps://www.jacc.org/doi/10.1016/j.jacc.2021.04.067"><em>JACC</em> </a>by <a href="https://iuhealth.org/find-providers/provider/julie-m-clary-md-5400">Dr. Julie Clary</a> and colleagues, analyzed data from over 700,000 stent procedures to develop a prediction tool that can be used by physicians at the bedside to help determine which patients are at a higher risk of mortality. They found that patients needing urgent procedures, those with unstable blood pressures and heart rates, and those who were not awake following a cardiac arrest were at a higher risk.<br /> <br /> It takes teamwork: In September, the Big 10 mandated extensive cardiac evaluation for all varsity athletes who tested positive for COVID-19. Not only did #OneIUCV provide excellent and timely care for these athletes, the results of the evaluations from around the Big 10 were published in <em><span style="text-decoration: underline;"><a href="https://jamanetwork.com/journals/jamacardiology/fullarticle/2780548?guestAccessKey=b6e46d92-d550-42fd-8916-7cc76d2ccd12&utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_content=tfl&utm_term=05721">JAMA Cardiology</a></span></em>. We learned that 2% of the athletes have evidence of myocarditis, and that symptoms were not always predictive of the finding of myocarditis on cardiac MRI. This information will guide return to play protocols for the fall semester at colleges around the country.<br /> <br /> <br /> Check out more publications in recent months from across OneIUCV<br /> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28vascular+surgery+AND+%22Indiana+university%22%29&sort=date"><span style="white-space: pre;"> </span>Vascular Surgery</a><br /> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28cardiac+surgery+AND+%22Indiana+university%22%29&sort=date"><span style="white-space: pre;"> </span>Cardiac Surgery</a><br /> <br /> <br /> </p> <h3>Milestone Work Anniversaries</h3> <p><strong>Celebrating 45 years</strong></p> <p><span style="white-space: pre;"> </span>• <a href="https://iuhealth.org/find-providers/provider/eric-s-williams-md-10129">Dr. Eric Williams</a> - June 30th</p> <p><strong>Celebrating 15 years</strong></p> <p><span style="white-space: pre;"> </span>• <a href="https://iuhealth.org/find-providers/provider/yazid-y-fadl-md-5994">Dr. Yazid Fadl</a> - July 10th<br /> <span style="white-space: pre;"> </span>• <a href="https://iuhealth.org/find-providers/provider/michael-s-byers-md-5222">Dr. Michael Byers</a> - July 1st</p> <p><strong>Celebrating 10 years</strong></p> <p><span style="white-space: pre;"> </span>• <a href="https://iuhealth.org/find-providers/provider/noel-r-dasgupta-md-5644">Dr. Noel Dasgupta</a> - July 1st<br /> <br /> <br /> <br /> <br /> </p> <h1>In Memory of Our Extended OneIUCV Family</h1> <p> </p> <h3>Leon Stein, MD</h3> <p>Dr. Stein was a native of Argentina and served as an Associate Professor of the IU School of Medicine. He worked primarily at Wishard (now Eskenazi) Hospital and the VA Hospital. He participated in many of the original trials investigating the application of vasodilator therapy in heart failure. He was 90 years old.<br /> <br /> <br /> </p> <h3>Jeffrey Riesmeyer, MD</h3> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/jeffrey-scott.jpg?h=233&w=180&rev=ec6dff65881445babaab395f6076e42a&hash=FD458B241DFBD356860804FAA971B397" alt="Jeffrey Riesmeyer, MD" class="float-left" style="height: 233px; width: 180px;" />Dr. Riesmeyer grew up in Crown Point, Indiana, and trained in Arizona and Texas. He came to Methodist Hospital from fellowship training at the University of Texas Health Science Center in San Antonio. He practiced interventional cardiology for 11 years before leaving for Eli Lilly, where he rose to the rank of Distinguished Medical Fellow. He was 65 years old.<br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <strong></strong></p> <p><strong> </strong></p> <p><strong> </strong></p> <p><strong>Do you have a story that reflects the strength of our statewide system for cardiovascular care?<br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</strong><br /> <br /> <br /> </p>Wed, 23 Jun 2021 00:00:00 Z{466D5956-D864-42CC-B824-EE9277F3C9E6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/april-2021-newsletterApril 2021 Newsletter<p>We strive to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</p> <br/> <h1>Top News</h1> <h3>Clinical Achievements</h3> <p style="">The first catheter-based ablation was performed at IU West on Monday, March 22nd. The patient had recurrent atrial flutter which was successfully ablated at IU West EP lab. The case went smoothly, and the patient was discharged the following day. This advanced treatment will now be offered to patients at IU West Hospital.<br /> <br /> <span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/homsi.jpg?h=225&w=200&rev=4cde02eb172d4076be4069dc2b79b197&hash=33FEA0B9D8EC274B7E7A990B3CD91946" style=" height:225px; width:200px" alt="Dr. Mohamed Homsi" /><br /> <br /> <em><a href="https://iuhealth.org/find-providers/provider/mohamed-homsi-md-58716"><span style="white-space: pre;"> </span>Pictured: Mohamed Homsi, MD</a></em><br /> <br /> <br /> <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/tavr-patient.jpg?h=167&w=250&rev=6693a5fc666b4f53b4b194b151e0146e&hash=1273E543E1E9BC55507223F01789AA55" style=" width:250px; height:167px;" alt="Patient at Ball Memorial Hospital underwent a brand new procedure, TAVR" class="float-left" />The first patient underwent a brand new procedure, TAVR (Transcather aortic valve replacement), in the Cath Lab at IU Health Ball Memorial Hospital. <a href="https://medicine.iu.edu/blogs/cv-institute/first-tavr-in-muncie">Read the full story here</a></p> <p style=""><em>Story reported by:<br /> Elizabeth Yates<br /> Marketing Associate<br /> IU Health East Central Region</em></p> <p style=""> </p> <p style=""> </p> <p style="">Indiana University Health Arnett Cardiovascular Services now offers Tippecanoe County's first transcatheter aortic valve replacement (TAVR) program. The team, which is led by cardiac surgeons, <a href="https://iuhealth.org/find-providers/provider/kyle-w-yancey-md-668981">Dr. Kyle Yancey</a> and <a href="https://iuhealth.org/find-providers/provider/thomas-k-kalmbach-md-7124">Dr. Thomas Kalmbach</a>; interventional cardiologists, <a href="https://iuhealth.org/find-providers/provider/m-ziaul-hoque-md-6808">Dr. M. Ziaul Hoque</a> and <a href="https://iuhealth.org/find-providers/provider/nivas-balasubramaniyam-md-4731">Dr. Nivas Balasubramaniyam</a>; and anesthesiologist, <a href="https://iuhealth.org/find-providers/provider/raymond-l-cooper-md-63933">Dr. Raymond Cooper</a> and <span style="text-decoration: underline;">Dr. Sunitha Govindaswamy</span>, performed the first two TAVR procedures in the cath lab at IU Health Arnett on February 9th, 2021.</p> <p style=""> <br /> <br /> </p> <h3>Launch of the CVI Website</h3> <p>Check out the newly published Cardiovascular Institute <a href="https://medicine.iu.edu/institutes/cardiovascular">website</a>.<br /> What's missing? Please let us know.<br /> <br /> </p> <p> </p> <h1>Fellowship ACGME Re-accreditation</h1> <p style="">The Review Committee for Internal Medicine, functioning in accordance with the policies and procedures of the Accreditation Council for Graduate Medical Education (ACGME), has accredited the following fellowship programs with continued accreditation (Program Directors included):<br /> <br /> <span style="white-space: pre;"> </span>Cardiovascular Disease<br /> <em><a href="https://medicine.iu.edu/faculty/4986/bhakta-deepak"><span style="white-space: pre;"> </span>Deepak Bhakta, MD</a></em></p> <p style=""><em><span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/bhakta-deepka.jpg?h=158&w=140&rev=9061ed94119840d78504fee11404f10d&hash=2DD1796BAA4328997B55CE3322CD313F" style="height: 158px; width: 140px;" alt="Deepak Bhakta, MD" /></em></p> <p style=""><span style="white-space: pre;"> </span>Interventional Cardiology<br /> <em><a href="https://medicine.iu.edu/faculty/4949/von-der-lohe-elisabeth"><span style="white-space: pre;"> </span>Elisabeth von der Lohe, MD</a></em><br /> <br /> <span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/von-der-lohe-elisabeth.png?h=180&w=120&rev=2a373c4b65ed4abcb8cafe76bc985e92&hash=4FB4256A2235DEB830702670506D48B6" style=" height:180px; width:120px" alt="Elisabeth von der Lohe, MD" /><br /> <br /> <span style="white-space: pre;"> </span>Clinical Cardiac Electrophysiology <br /> <em><a href="https://medicine.iu.edu/faculty/5005/miller-john"><span style="white-space: pre;"> </span>John Miller, MD</a></em> </p> <p style=""><span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/miller.png?h=180&w=120&rev=0961d2d7ce144859b76ef6104e3c55d6&hash=4D6EBF20EB86A131FCAECD52530BCAA3" style=" height:180px; width:120px" alt="John Miller, MD" /></p> <p style=""><span style="white-space: pre;"> </span>Vascular Surgery<br /> <em><a href="https://medicine.iu.edu/faculty/19930/motaganahalli-raghu"><span style="white-space: pre;"> </span>Raghu Motaganahalli, MD</a></em><br /> <br /> <span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/raghu.jpg?h=168&w=120&rev=ef18ffec750e43659ff7e8a1f81cfc7e&hash=01A233BE65AF2474D8F9966F3D207B21" style="height: 168px; width: 120px;" alt="Raghu Motaganahalli, MD" /><br /> <br /> <br /> Proudly, we continue to operate these programs free of citations, confirming our commitment and focus on strong cardiovascular and vascular training for future generations to come.<br /> <br /> <br /> <span style="white-space: pre;"> </span>Cardiology Fellowship Program Coordinator<br /> <em><span style="white-space: pre;"> </span>Stephanie Plummer</em></p> <p style=""><span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/plummers.jpg?h=165&w=120&rev=ef204f487680428ab3b673c70293a867&hash=3621C76217FE114EC8A4A66E88C2865B" style="height: 165px; width: 120px;" alt="Stephanie Plummer" /></p> <p style=""><span style="white-space: pre;"> </span>Vascular Fellowship Program Coordinator<br /> <em><span style="white-space: pre;"> </span>Vara Bonnell</em></p> <p style=""><em><span style="white-space: pre;"> </span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/vara.jpg?h=168&w=120&rev=d12a1e98b0aa41d8899f73e18802f701&hash=6DF0D248D23BF279B603AA113B685300" style="height: 168px; width: 120px;" alt="Vara Bonnell" /></em></p> <p style=""> </p> <h1> KUDOS</h1> <h3> Honors and Recognitions</h3> <p style=""> Through her outstanding contributions and dedication to the educational mission at the Indiana University School of Medicine, <a href="https://iuhealth.org/find-providers/provider/julie-m-clary-md-5400">Dr. Julie Clary</a> was selected to receive a 2021 Trustee Teaching Award.<br /> <br /> <a href="https://iuhealth.org/find-providers/provider/rana-zouveenoor-tariq-md-696613">Dr. Rana Zouveenoor</a> was elected to represent the southern district of the Indiana ACC. "I believe ACC has the potential to further influence practitioners involved in providing cardiovascular care for favorable patient outcomes. In my two-year tenure, I plan to represent the ideas of my colleagues at different advocacy levels, and I aspire to help bridge relationships between new cardiologists in Indiana and the mentorship program ACC can offer," says Dr. Zouveenoor. <br /> <br /> <a href="https://iuhealth.org/find-providers/provider/william-j-gill-md-6296">Dr. William Gill</a> and his team are the recipients of the first ever IUHP Excellence in Patient Experience Award for Specialty Care. This team achieved an Experience Score of 93.41% for the entire year of 2020. "This is a true 'team sport' at the Zionsville/Anson office," says Dr. Gill.</p> <p style=""><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/gill.jpg?h=375&w=500&rev=8ed49b391a33449c916293d1836d18dc&hash=76E73C30740645A16CEA7C21D99B0A90" style="height: 375px; width: 500px;" alt="Zionsville Cardiology group" /></p> <p style=""> </p> <h3> Awards</h3> <p style=""> <a href="https://medicine.iu.edu/faculty/4906/field-loren">Dr. Loren Field</a> was recently awarded an RO1. He and his colleagues have identified genetic variants in inbred strains of mice which profoundly impact the initiation of cardiomyocyte cell cycle activity following myocardial injury. The experiments proposed in this application will identify the gene (or genes) responsible for this cell cycle activity and determine if they have a beneficial impact on the heart following injury. Ultimately, the identification and validation of genes underlying intrinsic differences in cardiomyocyte cell cycle rates could suggest potential therapeutic targets with which to enhance regenerative growth in injured hearts. <br /> <br /> <br /> </p> <h3> Presentations</h3> <p style=""> <a href="https://iuhealth.org/find-providers/provider/lawrence-s-lee-md-14917">Dr. Lawrence Lee</a> and colleagues formed the Enhanced Recovery After Cardiac Surgery (ERAS-Cardiac) program at IUH Methodist in 2019 involving all phases of care. Since implementation in 2020, the program has decreased hospital opioid use by 57%, while patients remained Satisfied or Very Satisfied with their pain control during the hospital stay. Early postoperative mobility increased with no increase in adverse events or complications. Cheers to this multidisciplinary team for their ongoing work to deliver the highest quality postoperative care!</p> <p style=""> </p> <h3>Publications</h3> <p style=""> Physiologic pacing produces cardiac contraction that better mimics normal cardiac contraction, which may in turn improve patient's symptoms and lessen the risk of heart failure. <a href="https://iuhealth.org/find-providers/provider/john-s-strobel-md-9538">Dr. John Strobel</a> and colleagues recently published the results of a clinical trial in <em><span style="text-decoration: underline;"><a href="https://www.sciencedirect.com/science/article/abs/pii/S2405500X2030709X?via%3Dihub">JACC: Clinical Electrophysiology</a></span></em> on successful physiologic pacing by combining CT imaging to deliver effective, permanent His bundle pacing (HBP). The study demonstrated that lead tip locations at either the atrial or ventricular ends of the His bundle provide acceptable pacing parameters, though the ventricular location was preferable to avoid oversensing of atrial activity. <br /> <br /> <a href="https://iuhealth.org/find-providers/provider/pantila-vanichakarn-bateman-md-9843">Dr. Pantila Bateman</a> and colleagues introduced echocardiography to second year medical students at Indiana University using the Unit Modeler software, including "introduction to echocardiography" modules written by <a href="https://iuhealth.org/find-providers/provider/harvey-feigenbaum-md-6044?utm_source=Google&utm_medium=Yext&y_source=1_MTQ0MjI2OTMtNzE1LWxvY2F0aW9uLmdvb2dsZV93ZWJzaXRlX292ZXJyaWRl">Dr. Harvey Feigenbaum</a> and small group cases prepared by Dr. Bateman. The survey mentioned in their recent publication in <em><span style="text-decoration: underline;"><a href="https://onlinelibrary.wiley.com/doi/10.1111/echo.15013">Echocardiography - Wiley Online Library</a></span></em> showed the students enjoyed this experience and thought that learning echocardiography was helpful in understanding cardiology. The students who used the Unit Modeler significantly received higher cardiology test scores than those who did not. <br /> <br /> The study published in the recent <em><span style="text-decoration: underline;"><a href="https://www.jacc.org/doi/10.1016/j.jacc.2021.02.023">JACC</a></span></em> article by ACHD colleagues, including <a href="https://iuhealth.org/find-providers/provider/georges-ephrem-md-64005">Dr. Georges Ephrem</a> and <span style="text-decoration: underline;">Dr. Stephen Cook</span> reports that the presence of a structural congenital heart defect did not necessarily portend an increased risk of mortality or morbidity from COVID-19 infection. However, several factors were associated with mortality and severe infections including cyanosis and pulmonary hypertension, especially when combined (Eisenmenger syndrome). Furthermore, susceptibility might be based on physiological factors, not the complexity of the underlying anatomic defect, and are concordant with general population studies that showed risks associated with age, male sex, diabetes, and renal insufficiency. Targeted preventive measures are indicated for patients with CHD who are at greatest risk of mortality and severe morbidity due to COVID-19 such as those with Eisenmenger syndrome.<br /> <br /> Cardiology at IU, including the legacy of Krannert, has a long history of research in cardiac handling that is critical to heart function. The opportunity to test a CAM kinase inhibitor in the clinic was a natural extension of this effort. Cheers to our clinical research coordinators who made IU Health the #1 enrollment site in North America for this phase ll trial, published in one of the premier cardiovascular journals <em><span style="text-decoration: underline;"><a href="https://jamanetwork.com/journals/jamacardiology/article-abstract/2778551?guestAccessKey=1fbb7591-045f-4c6b-8fb8-baf8f5aa8ce9&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamacardiology&utm_content=olf&utm_term=041421">JAMA Cardiology</a></span></em> (IF 12.79) and guiding physicians and scientists to better ways to protect heart muscle after a heart attack. <br /> <br /> <br /> Check out more publications in recent months from across OneIUCV <br /> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28vascular+surgery+AND+%22Indiana+university%22%29&sort=date"><span style="white-space: pre;"> </span>Vascular Surgery</a><br /> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28cardiac+surgery+AND+%22Indiana+university%22%29&sort=date"><span style="white-space: pre;"> </span>Cardiac Surgery</a><br /> <br /> <br /> </p> <h3> In the Media</h3> <p style=""> Emotional trauma linked to deadly heart condition. Watch the <a href="https://www.wishtv.com/news/medical/emotional-trauma-linked-to-deadly-heart-condition/">Wishtv</a> interview to learn what <a href="https://iuhealth.org/find-providers/provider/kyle-a-frick-md-60979">Dr. Kyle Frick</a> had to say about a condition that's on the rise during the pandemic.<br /> <br /> <a href="https://iuhealth.org/find-providers/provider/elisabeth-von-der-lohe-md-9894">Dr. Elisabeth von der Lohe</a> was recognized in <a href="https://indiana-my.sharepoint.com/personal/lsamboy_iu_edu/_layouts/15/onedrive.aspx?id=%2Fpersonal%2Flsamboy%5Fiu%5Fedu%2FDocuments%2FOneIUCV%20Newsletter%2FElisabeth%20von%20der%20Lohe%20models%20excellence%20for%20Women%2Epdf&parent=%2Fpersonal%2Flsamboy%5Fiu%5Fedu%2FDocuments%2FOneIUCV%20Newsletter">The IU Health Daily</a> during Women's History Month for modeling excellence. <br /> <br /> <br /> <br /> <br /> </p> <h1> #OneIUCV Team Selfie of the Month</h1> <p style=""> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/int.jpg?h=431&w=500&rev=7b9cb45c8a26499b94d66bcb6065756b&hash=4AA017CBD313994D3C0FD948AD9BE29C" style="height: 431px; width: 500px;" alt="Interventional Cardiology Group" /><br /> <br /> <em>Pictured are some of our interventional cardiology faculty members. From left to right: <a href="https://medicine.iu.edu/faculty/43577/ephrem-georges">Dr. Georges Ephrem</a>, <a href="https://medicine.iu.edu/faculty/5020/breall-jeffrey">Dr. Jeffrey Breall</a>, <a href="https://medicine.iu.edu/faculty/4949/von-der-lohe-elisabeth">Dr. Elisabeth von der Lohe</a>, <a href="https://medicine.iu.edu/faculty/52146/ilonze-onyedika">Dr. Onyedika Ilonze</a> and <a href="https://medicine.iu.edu/faculty/5070/kreutz-rolf">Dr. Rolf Kreutz</a>.</em><br /> <br /> There is a total of 11 highly experienced operators with the majority having more than 20 years of experience. They offer state of the art interventional procedures with either femoral or radial access. This also includes high risk percutaneous coronary interventions such as left intervention, several forms of atherectomy, laser, intravascular ultrasound, percutaneous valve replacement such as TAVR and mitral clip, closure of the left atrial appendage for patients with atrial fibrillation and mechanical heart support with either intra-aortic balloon pumps or Impella. They participate in multicenter trials. In addition, they are an ACGME certified interventional training program and train 2 interventional fellows per year. <br /> <br /> <strong>Please send a selfie of your team to <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu </a>with a short caption of how you help achieve our Vision so we can share with the world!</strong> <br /> <br /> <br /> <strong>Do you have a story that reflects the strength of our statewide system for cardiovascular care?<br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</strong></p>Wed, 21 Apr 2021 00:00:00 Z{80C3303B-F1D4-493A-B66E-C06F6AD79708}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/einhorn-answers-questions-about-testicular-cancerLarry Einhorn, MD, answers questions about testicular cancer<p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">Testicular cancer, though rare, is a cancer that primarily affects young men. It also differs from other forms of cancer in that it has a high cure rate — but first, it has to be detected.</span></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">We asked the world’s foremost authority on testicular cancer, <a href="https://cancer.iu.edu/research-trials/member-bio.shtml?id=3017&name=lawrence-einhorn">Larry Einhorn</a>, MD,  the Livestrong Foundation Professor of Oncology and professor of medicine at IU School of Medicine and a physician scientist at <a rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">IU Simon Comprehensive Cancer Center</a>, about what can be done to discover and treat testicular cancer.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: What is the average age of a testicular cancer patient?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Most patients are teenagers or in their 20s or 30s, so it is a young man's disease.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: What are the signs of testicular cancer that men should watch for?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Twenty years ago when Lance Armstrong was diagnosed, he did a great job in raising public awareness. If a man feels pain in the testis or a fullness, a mass or a hardness in the testis, he shouldn't assume that it is just an infection or nothing of consequence. It should be checked out by a physician who will determine whether it is anything serious. Patients can’t do their own physical examination and make this diagnosis.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: Do men tend to overlook or minimize the signs and symptoms? Is that something you see contributing to occurrences of testicular cancer?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: I think men are less apt to overlook the symptoms now than before testicular cancer became more openly discussed. However, when you are 25 years old, which is the average age, the thought of getting cancer just doesn't cross your mind. And so there can be anywhere from a several-week to a several-month delay from the time a patient has the first symptoms to the time that the patient sees a doctor.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: Is it a type of cancer that a man could be genetically predisposed to get?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Well, yes and no. It occurs in only 1 percent of all men who have cancer so it is a relatively rare disease. We see about 8,000 to 9,000 new cases a year. The known risk factor for getting testis cancer is being born with an undescended testis where, as a small child or an infant, a pediatrician will arrange for a surgeon to push the testis back into the scrotum. If you have a brother or a father, what we call a first-degree relative, who had testis cancer, instead of the standard risk of 1 out of 400, it becomes a risk of 1 out of 300. So yes, it's an increased risk if you have a relative with testis cancer, but it's still a very rare disease.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: Are there any behavioral or lifestyle changes that someone can do to help prevent testicular cancer?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Unlike lung cancer which can occur in heavy smokers, many cancers -- such breast cancer and many other types of cancer -- there is no definitive reason people get it. Many times, people get malignancies just as they get heart disease or neurological diseases, for no particular reason.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: If a man gets screened and receives a testicular cancer diagnosis, what should his next steps be?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Once you have an ultrasound done and a mass is identified in the testis, the next step is to see a urologist, who will make an incision in the groin and surgically remove the testicle. Then the patient will receive tests to see whether the cancer is confined to the testis or whether it has spread to other parts of the body. That will determine whether the treatment will be observation alone after removal of the testis, or surgery to remove abdominal lymph nodes, or chemotherapy if the disease has metastasized and is more widespread.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: What is the outlook for testicular cancer patients whose disease has become metastatic?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: As is true with many cancers, the more extensive the disease, the harder it is to cure, but testis cancer is unique among all malignancies in that it has such a high cure rate. So, if we look at all patients who have metastatic disease that require chemotherapy, about 70 percent will be cured with their initial chemotherapy. Of the remaining 30 percent who are not cured with their initial chemotherapy, about half of those will be cured with subsequent chemotherapy. So, about 80 percent to 85 percent of patients will be cured.</span></p> <p style="margin-bottom: 0in;"><strong><span style="color: rgb(51, 51, 51);">Q: Can a man usually maintain his current lifestyle while undergoing treatment for testicular cancer?</span></strong></p> <p style="margin-bottom: 0in;"><span style="color: rgb(51, 51, 51);">A: Absolutely, and sexual function is not affected. The other remaining testis will work overtime and produce the amount of testosterone previously produced by both testicles. There are some patients for whom the testicle doesn’t work overtime and those patients will need to be on what we call replacement testosterone, which can be done as a gel applied to the skin once a day, or as an injection every two or three weeks. Most patients who are cured either with surgery alone or surgery plus chemotherapy are soon back to work and doing normal activity.</span></p>Tue, 13 Apr 2021 00:00:00 Z{790029E5-C381-456B-9C53-66B2A1246662}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/first-tavr-in-muncieTeam effort launches TAVR procedure at IU Health Ball Memorial Hospital92-year-old Faith Towriss Fouch was among the first patients to undergo a brand new procedure done in our Cath Lab called TAVR (Transcatheter aortic valve replacement) at IU Health Ball Memorial Hospital on Tuesday, March 9th, 2021. <p>This procedure is minimally invasive and is done to replace a narrowed aortic valve that has failed to open properly. The significance of this procedure means that these type of replacements can now be done even on people who would not be able to withstand an open-heart procedure.</p> <p> Faith's journey to receiving this procedure has been a rather long one. Over a year ago, Faith was at Ball to undergo a different procedure - it was while the doctors were figuring out how best to do this procedure that they noticed that she was having heart problems. Faith was then placed in the care of Dr. Bruce Graham, cardiology. It was at this time that Dr. Graham introduced Faith to the idea of the TAVR procedure.</p> <p> Before Dr. Graham's introduction of it, neither Faith, nor the members of her family, had heard of this procedure. But it was because of their faith in Dr. Graham that they continued to pursue this option. </p> <p>Not long after Faith was recommended for this procedure, she met with the doctors who would possibly be performing it on her - Drs. Kuhn and Madmani. </p> <p>"We had a lot of faith in Dr. Graham, and I liked these doctors, Kuhn and Madmani, very easy to talk to and so friendly," Faith said while waiting to be discharged the next day from her TAVR procedure. </p> <p>Since she's lived in Muncie for close to 70 years, Faith mentioned that she didn't want to go down to Indianapolis to have this procedure done. So it was almost fate that Ball was able to start doing these TAVR procedures in the timeframe of when she would need it done. </p> <p>After a few diagnostic procedures, Faith was deemed a candidate for TAVR. Faith and her family then conferred together to decide whether they wanted to move forward with the procedure. </p> <p>"We trust Dr. Graham, and then we met Dr. Kuhn," Tom Fouch, Faith's son, said about himself and his older brother, Mike, "and we both felt really confident with what he wanted to do and how he was going to do it." </p> <p>With her consent now given to proceed, all of Faith's physicians, as well as a panel of experts in the field, met together to finalize the particulars of the procedure. </p> <p>The day of the TAVR procedure came, and Faith was in and out of surgery in 3 hours. </p> <p>"I feel good!" Faith exclaimed just one day after this procedure.</p> <p> "There's a noticeable difference," Tom continued. "There was a lack of energy, we didn't know if it was because of her age and not letting her out of the house due to COVID, but after all the reports on her heart, we knew things were going that way [low energy] because of it." </p> <p>It was at this time in the interview that two of Faith's doctors, Dr. Kuhn and Dr. Madmani, came in to take a picture with Faith as one of their first of many TAVR success stories. Faith walked, yes WALKED, down to the end of the hall and back to pose for this picture - a mere 24 hours after one of her heart valves was replaced. </p> <p>"If anyone has to have this procedure done, I recommend all of my doctors!" Faith glowed. "Because they've done it before and they were successful." </p> <p>This success was only made possible by the great team effort that ensured the positive launch of the TAVR procedure at IU Health Ball - with many thanks also going to the Cardiovascular Institute leadership of Dr. Subha Raman and Blake Dye for their instrumental support in this launch as well.</p> <p><em>Story provided by Elizabeth Yates, Marketing Associate for IU Health East Central Region</em></p>Fri, 09 Apr 2021 00:00:00 Z{BFB7D04D-9E01-407D-BB89-8254B0DC4297}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/indiana-myeloma-registryIndiana Myeloma Registry tracks individual patient journeys, data in search of a cure<p style="margin-bottom: 0in;"><span>Hoosiers with multiple myeloma can provide important data to researchers at <a rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a> who are searching for a cure. The Indiana Myeloma Registry is seeking participants throughout Indiana.</span></p> <p style="margin-bottom: 0in;"><a href="https://www.cancer.iu.edu/myelomaregistry/index.php#MM"><span>Multiple myeloma</span></a><span> is a cancer of white blood cells called plasma cells. </span><span>While it’s a relatively uncommon cancer, it’s a devastating diagnosis. An </span><a href="https://cancerstatisticscenter.cancer.org/#!/cancer-site/Myeloma"><span>estimated</span></a><span> 670 Hoosiers will be diagnosed with myeloma this year and 260 will die from this blood cancer.</span></p> <p style="margin-bottom: 0in;"><span>“Myeloma is a very heterogeneous disease, meaning every patient story is unique to them—the way the disease presents itself, the way it affects them, and the way they respond to the treatment,” said </span><span>Mohammad</span><a href="https://cancer.iu.edu/research-trials/member-bio.shtml?id=18625&name=mohammad+issam-abu-zaid"><span> </span></a><span>Abu</span><a href="https://cancer.iu.edu/research-trials/member-bio.shtml?id=18625&name=mohammad+issam-abu-zaid"><span> </span></a><span>Zaid</span><span>, MD, a physician-scientist who helped launch the registry at IU before moving on to NYU Langone Health. “It makes my clinic very interesting because it's never the same story.” </span></p> <p style="margin-bottom: 0in;"><span>With the </span><a href="https://www.cancer.iu.edu/myelomaregistry/index.php"><span>Indiana Myeloma Registry</span></a><span>, researchers believe they can learn from each of those stories to gain a better understanding of multiple myeloma. The cancer takes many years to develop and goes through stages before it may be diagnosed. Because of this, the cancer cells are not only different from patient to patient, but also within a person.</span></p> <p style="margin-bottom: 0in;"><span>The registry allows patients with myeloma and precursor conditions to provide their medical history, treatment data and a saliva sample to researchers who will use the collective data to better understand the cancer.</span></p> <p style="margin-bottom: 0in;"><span>“With the Indiana Myeloma Registry, we're trying to write the story for each patient with myeloma from the time of their diagnosis and all through their treatments in real-time, so that we are capturing accurate data and all the data points that we believe are important,” Abu Zaid said. “We can then use all of that information to answer some of the most important questions in myeloma with the goal of finding a cure for myeloma.”</span></p> <p style="margin-bottom: 0in;"><span>The Indiana Myeloma Registry opened in 2018, and more than 500 patients treated at IU Health have joined so far. Now the registry is open to patients throughout the state, so researchers gather more myeloma patient journeys to better understand who is most likely to develop multiple myeloma, what treatment works best for which people and what causes the blood cancer.</span></p> <p style="margin-bottom: 0in;"><span>“We're trying to get every patient with myeloma to join this study so we can track more and more patients and include all Hoosiers with myeloma in the registry,” he said.</span></p> <p style="margin-bottom: 0in;"><span>Participants in the study provide a saliva sample via mail, complete health history and quality of life questionnaires, and allow researchers to collect medical records data to track information such as treatment and lab tests. Saliva samples will be used to extract DNA to learn if patients have inherited risk factors for myeloma or increased risks for side effects from treatment. Patients at IU can also donate blood and bone marrow samples to the registry.</span></p> <p style="margin-bottom: 0in;"><span>Patient data collected by the registry will be used by myeloma researchers at the cancer center such as Rafat Abonour, MD, Brian Walker, PhD, Fabiana Perna, MD, and others.</span></p> <p style="margin-bottom: 0in;"><span>Researchers know men are more likely to get myeloma and that Black men and women are twice as likely to develop the disease. Researchers are working with </span><a href="https://polis.iupui.edu/"><span>The Polis Center</span></a><span> at IUPUI to examine registry data to identify and understand other risk factors for myeloma, such as environmental or medical history.</span></p> <p style="margin-bottom: 0in;"><span><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/m/mm-map.png?h=528&w=700&rev=912e74bbbfeb4652869a00027804dddf&hash=E677A525AC08123528A24134B9C15523" style="height: 528px; width: 700px;" alt="" /></span></p> <p style="margin-bottom: 0in;"><span>The Indiana Myeloma Registry is also partnering with Indianapolis-based software development company LifeOmic. The company is building a platform where clinical data, surveys, biospecimens, and genetic data can all be visualized for researchers.</span></p> <p style="margin-bottom: 0in;"><span>Abu Zaid said he has been humbled by how willing patients are to join the registry, knowing it may not change their treatment, but could help others who will be diagnosed with myeloma. He hopes others throughout the state will join.</span></p> <p style="margin-bottom: 0in;"><span>“It's a great opportunity for myeloma patients to participate and be part of finding the cure for myeloma,” Abu Zaid said.</span></p> <p style="margin-bottom: 0in;"><span>Participants of all races and backgrounds throughout Indiana are needed. To learn more and enroll, visit: </span><a rel="noopener noreferrer" href="https://www.cancer.iu.edu/myelomaregistry/" target="_blank"><span>www.cancer.iu.edu/myelomaregistry/</span></a><span>. If you have questions about the study, email myeloma@iu.edu or call 317-278-0808.</span></p> <p style="margin-bottom: 0in;"><span>The Indiana Myeloma Registry is funded in part by support from the <a href="https://precisionhealth.iu.edu/">Indiana University Precision Health Initiative</a>, </span><a href="https://cancer.iu.edu/m4m/"><span>Miles for Myeloma</span></a><span>, the Harry and Edith Gladstein Chair and the Omar Barham Fighting Cancer Fund.</span></p>Thu, 25 Mar 2021 00:00:00 Z{8A2F0497-E1CE-4565-8056-974D27BE8BB2}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/february-2021-newsletterFebruary 2021<p>We strive to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision.</p> <p> </p> <p> </p> <h1>Welcome to our Team</h1> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/kevin-sumption.jpg?h=225&w=200&rev=1ced6ef6402b44f6842e77712a2490be&hash=BAAE2E10451C6080817021CA18746D02" style=" height:225px; width:200px" alt="Kevin Sumption, MD" class="float-left" />Kevin Sumption, MD joined IU Health Southern Indiana Physicians in October 2020 as a general cardiologist. He earned his BA from the University of Virginia, MS from George Mason University and MD from Virginia Commonwealth University. Dr. Sumption completed his post-graduate training in the United States Navy, serving for 17 years as a Commander. He then spent 10 years as an Assistant Professor and Staff Cardiologist at both Virginia Commonwealth University and the Richmond, Virginia, VA Medical Center. He retired from those positions last summer and is now happy to be affiliated with IU Health. Dr. Sumption is board certified in Internal Medicine, Cardiovascular Disease, Nuclear Cardiology, and Vascular Disease. He has a special interest in Cardiac Imaging including echocardiography, nuclear imaging, vascular ultrasound and cardiac MRI.</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/rana-zouveenor.jpg?h=225&w=200&rev=30c511bb5f064057ae787cef6d7b6749&hash=916B8A86BD82554665E4727662A504F7" style=" height:225px; width:200px" alt="Rana Zouveenor, MD" class="float-left" />Rana Zouveenoor Tariq, MD joined IU Health Southern Indiana Physicians in August 2020 as a general cardiologist. He completed his Internal Medicine Residency at Rush University Medical Center in July 2017 and his Cardiovascular Medicine Fellowship at Lahey Hospital and Medical Center in Burlington, Massachusetts in July 2020. Dr. Tariq is board certified in Internal Medicine, Echocardiography, Nuclear Cardiology, Cardiovascular Computed Tomography, and Cardiovascular Medicine. He has special interests in Cardiac Imaging, Preventive Cardiology, Critical Care Cardiology, and physician training/mentorship.</p> <p> </p> <p> </p> <p> </p> <p> </p> <p> </p> <h1>Top News</h1> <h3>Invasive CPET Soon to be Offered</h3> <p> In the world of heart failure, both with preserved and reduced ejection fraction, as well as in the patients with cardiomyopathies, adult congenital heart disease, and valvular defects, patients may be asymptomatic at rest, and therefore all tests done in resting condition are not too informative. Stress testing is a great tool, which helps to bring up symptoms and reveal a true condition. Through a multidisciplinary collaboration, the cardiovascular service line at the AHC is moving the stress testing up to the next level, expanding on the already existing cardio-pulmonary exercise program (CPET). Starting February 17th, invasive CPET will be offered. We will place the Swan-Ganz catheter in the cath lab, bring the patient to a testing area, and do the bicycle VO2 stress test. In addition to the already reported data on CPET, this test will allow for invasive hemodynamic assessment of cardiac chambers filling pressure and compliance during exercise. We will also supplement our "traditional" non-invasive CPET with echocardiography for the purpose of evaluating cardiac filling pressure, diastolic dysfunction, and pulmonary pressure with exercise. Both modalities will provide incremental important data and a comprehensive evaluation of cardiopulmonary reserve to assist in the diagnosis and management of a variety of patients including but not limited to unexplained dyspnea, fatigue, dizziness, etc. </p> <p>We hope this is a new direction which will provide a great clinical benefit as well as a wealth of knowledge for potential research. Because only limited number of institutions in the country carry this modality, we can pioneer important initiatives and hopefully attract referrals. <br /> <br /> <a href="mailto:kballut@iuhealth.org">Kareem Ballut, MD</a>, from the heart failure faculty, will lead this effort. To schedule a patient for clinical evaluation, please contact him via diagnotes, email, or cerner </p> <p> </p> <h3>Launch of the CVI Website</h3> The CVI Website is close to launch - we want to highlight your team. Please send a selfie of your team to <a href="mailto:oneiucv@iu.edu">OneIUCV@iu.edu </a>with a short caption of how you help achieve our Vision so we can share with the world! <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/4-40986_clip-art-clip-art-of-camera-clip-art.png?h=200&w=228&rev=4eb162af26ab472c9c5c4dd5c95ef8c5&hash=1CAE0A299637966448E0D754EF3F7CB1" style=" width:228px; height:200px;" alt="Camera" /></p> <p> </p> <h1>February is American Heart Month</h1> <p>Did you know that President Lyndon B. Johnson issued the first proclamation in 1964, making February American Heart Month? <br /> <br /> Heart disease continues to be the greatest health threat to Americans and is still the leading cause of death worldwide. About 80% of cardiac events can be prevented through education and lifestyle changes.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/hands_holding_animated_heart.jpg?h=200&w=304&rev=f12e80e201f9481bbc4f819a88d14940&hash=E46C4F4D44664469FE27D0B69F46BEE7" style=" width:304px; height:200px;" alt="Hands holding heart" /></p> <p>This February we ask that the survivors and supporters <strong>Go Red</strong> to help ensure a healthy, positive significant future for themselves and those they care for.<br /> <br /> For more information on the American Heart Association or to donate, click: <br /> <a href="https://www2.heart.org/site/SPageNavigator/feb21_wearred.html?s_src=21H1W1AEMG&s_subsrc=feb21_wrgd1_gen">Please give what you can today</a><br /> <br /> <br /> </p> <h1>KUDOS</h1> <h3>Honors and Recognitions</h3> <p>Dr. Subha Raman has been elected President of the <em><a href="https://scmr.org/default.aspx">Society for Cardiovascular Magnetic Resonance</a></em>. This international group includes cardiologists, radiologists, technologists, physicists, engineers, and many others seeking to deliver high value, mission-aligned advances in cardiovascular health. <br /> <br /> Biomedical journals play an important role in critically evaluating advances that, after careful peer review, impact how we provide cardiovascular care. The Journal of the American Society of Echocardiography (<em><a href="https://www.onlinejase.com/">JASE</a></em>) vets such advances related to cardiovascular ultrasound submitted from various parts of the world, read by ~17,000 members of the Society and many others. Kudos to #OneIUCV Cardiologist, Dr. Stephen Sawada , who was recently recognized by JASE for his ongoing service to the journal in various capacities including Associate Editor, Senior Consulting Editor, Editorial Board Member, and author. <br /> <br /> Congratulations to our Interventional Cardiology Fellow, Dr. Ryan Mallory, on being named to the ACC Fellow in Training Section Leadership Council. This position is a testament to his leadership potential. <br /> <br /> <br /> </p> <h3>Awards</h3> <p>The Indiana CTSI via its Collaboration in Translational Research (CTR) Award is catalyzing work to tackle the cardiovascular and psychiatric consequences of COVID-19. Spanning IUPUI's School of Science, Department of Psychology as well as IU School of Medicine's Departments of Internal Medicine (Division of Infectious Diseases and Cardiology) and Emergency Medicine, this new collaborative team will be delving into inflammatory and coagulation mechanisms underlying heart muscle damage, blood clots, anxiety and other complications that have been described after infection with the pandemic-causing virus. Stay tuned for this group's advances. <br /> <br /> <br /> </p> <h3>Publications</h3> <p>Dr. Thomas Everett's, recent manuscript was published in <em><a href="https://www.ahajournals.org/doi/10.1161/CIRCEP.120.008610">Circulation: Arrhythmia and Electrophysiology</a></em>. This paper demonstrates that nerve activity can be recorded with high-density mapping from the epicardial surface of the heart specifically in the region of the sinoatrial node. Nerve activity was observed before each atrial beat during heart rate acceleration induced by stimulation of the right stellate ganglion. <br /> <br /> Dr. Suparna Clasen's, recent manuscript was published in the <em><a href="https://www.redjournal.org/article/S0360-3016(20)34654-X/fulltext">International Journal of Radiation Oncology, Biology, Physics</a></em>. Radiation is often used in the treatment of breast cancer. Historically, there has been an increased risk of short and long term cardiovascular disease with inadvertent radiation exposure to the heart. With modern radiation planning techniques and decreasing heart dose exposure, Dr. Clasen has shown there are very minimal short term changes in the heart in breast cancer patients receiving radiation therapy. This study offers reassurance to patients receiving potentially life-saving, modern radiation therapy, while working to minimize any longer-term heart risks.<br /> <br /> Early rhythm-control therapy was associated with a lower risk of adverse cardiovascular outcomes than usual care among patients with early atrial fibrillation and cardiovascular conditions in the EAST-AFNET 4 Trial. It is a very important study in the EP field and Dr. Takeki Suzuki, wrote a letter to the Editor of the <em><a href="https://pubmed.ncbi.nlm.nih.gov/33534983/">New England Journal of Medicine</a></em> asking if there is any difference in the number of clinic visits between the groups (early rhythm-control strategy group vs. control). <br /> <br /> Check out more publications in recent months from across OneIUCV </p> <p><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28vascular+surgery+AND+%22Indiana+university%22%29&sort=date">Vascular Surgery</a><br /> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28cardiac+surgery+AND+%22Indiana+university%22%29&sort=date">Cardiac Surgery</a><br /> <br /> <br /> </p> <h3>In the Media</h3> <p>33 years on, IU Health's oldest living heart transplant recipient defies the odds. <a href="https://www.wthr.com/article/news/local/iu-healths-oldest-living-heart-transplant-recipient-defies-the-ddds-after-33-years/531-dc5e4941-db6d-4d9b-a6d4-f460401ef263">Read</a> on to learn about another incredible story of our heart team.<br /> <br /> Rachael Chisom, BSN, RN, was recently featured in the <em><a href="https://www.ibj.com/articles/still-a-long-way-to-go">Indianapolis Business Journal</a></em> for volunteering at the IU Heath COVID vaccine clinic where she personally vaccinated some of our very own CV providers, team members, and patients. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/rachael-chisom-bsn-rn.jpg?h=267&w=200&rev=20a3f8c190574ef49ccf387f8bf55f8e&hash=F480195FB3CB899186BE23EAF3EE3B53" style=" width:200px; height:267px;" alt="IBJ article with Rachael Chisom, BSN, RN" /></p> <p> </p> <h1>Keeping Hoosier hearts healthy after COVID-19</h1> <p>While our team is working to keep all heart healthy every day, we have recognized that the infection responsible for the COVID-19 pandemic can cause cardiovascular problems that deserve special attention. Read more about how we are keeping Hoosier hearts healthy post-COVID in this recent issue of the <em><a href="https://issues.ibj.com/ibj/magazines/heart-health/2021/?fbclid=lwAR30hwbWBH3-okEvKp_RbKXa8t_PZ4x85C_Kil7PD1zGkG-AhaxtaUL9frQ">Indianapolis Business Journal</a></em><br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/ibj-covid.jpg?h=600&w=276&rev=d8a4c1c490494fd4867cbb81a4f57ee3&hash=6B1C13522E5CC5414C5AC6A55FB0B441" style=" width:276px; height:600px;" alt="IBJ article" /><br /> <br /> </p> <h3>Do your patients have questions about the COVID-19 vaccine?</h3> <p>Check out the <a href="https://www.jacc.org/doi/pdf/10.1016/j.jacc.2021.02.017">American College of Cardiology's Health Policy Statement on Cardiovascular Disease Considerations for COVID-19 Vaccine Prioritization</a>.<br /> <br /> </p> <h3>Do you have a story that reflects the strength of our<br /> statewide system for cardiovascular care?</h3> <p> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</p>Mon, 15 Feb 2021 00:00:00 Z{A2C2327B-D582-48EC-B97E-38394D121DA3}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/vaccine-fairnessVaccine Fairness – The Big Picture<p>The vaccine is here and distribution is ramping up, providing hope that we are finally turning the corner on this pandemic. But along with the vaccine comes important ethical questions and debate. Here are my quick thoughts and opinions: </p> <p><strong>Rationing is inevitable</strong></p> <p> It’s nothing new for medicine, or for society, that there is greater need than supply. As <a rel="noopener noreferrer" href="https://www.nytimes.com/2009/08/15/health/policy/15beliefs.html" target="_blank">Dan Callahan</a> emphasized again and again in bioethics, it is inevitable that there is always more need for medical care (possible treatments that can help people) than can be provided at any time. Some people get more valuable healthcare than others, in any system. Price and access play a major role in the United States, due to our patchwork system of insurance, while elsewhere there’s more centralized planning and governmental choice. But it’s all rationing, no matter the system: a limited amount of precious resources are being directed to some and away from others. (See <a rel="noopener noreferrer" href="https://www.nytimes.com/2009/07/19/magazine/19healthcare-t.html" target="_blank">Peter Singer’s</a> excellent article from 2009 in the New York Times)</p> <p> Need that exceeds supply, and limited desirable resources, is also standard, of course, for society more generally. Everybody would like to have more of the things they like, but we can each only have some. All of us might enjoy a better car, more space in our home, nicer shoes, etc., but we only get some of those things. A society can distribute these things through a capitalist system (distribution by price and wealth), or with centralized planning (e.g. socialism or communism). But every system distributes goods, and any system can be evaluated for achieving or failing to achieve justice, specifically “distributive justice,” as philosophers call it.</p> <p><strong>Utilitarianism and Justice</strong></p> <p> Given we now have a limited amount of vaccine and many many people who could benefit from it, how should we decide who gets it first? How do we achieve distributive justice in this arena? So far, we are using a largely Utilitarian calculus, a common organizing principle for public health: We are trying to get the vaccine to people with the highest risk, where the shots will best improve the health of our population. That means healthcare workers and public safety workers first, then others who have the highest risk from infection, then moving on to those at lower risk. In many places, health risk is calculated simply by age, starting with those who are oldest, although especially prioritizing those living in nursing homes, since they have seen the greatest ravages in this pandemic. </p> <p> Philosophers call this “Utilitarian,” where the act is chosen that can be predicted to create the most happiness and reduce the most suffering for the most people. With vaccine distribution, we aim to best promote happiness and reduce suffering by protecting health in society overall. The question is not who deserves to get the vaccine first, but who should get it in order to benefit society, overall, best. The idea is a bit counterintuitive: From this perspective, the ethical reason to give the vaccine first to the people who will benefit the most is not for them, but since by benefiting them, you are best benefiting society overall. </p> <p> Even with such a clear goal, there are an uncountable number of different ways to pursue it. One could prioritize teachers, since it will benefit society so much to reopen schools, and with schools reopened they have significant risk. One could prioritize other essential workers such as grocery store employees, others in the food industry, or bus drivers, etc., since by prioritizing them you could improve and protect the services they offer.</p> <p> And one could try to parse that health risk more carefully than just prioritizing advanced age. People with certain diseases or conditions may have higher risk than many people older than them. With this reasoning, New Jersey decided to <a rel="noopener noreferrer" href="https://www.washingtonpost.com/nation/2021/01/15/newjersey-smokers-covid-19-vaccine/" target="_blank">give vaccines to smokers early</a>, given the increased risk that this habit brings.</p> <p><strong>Choice and Tradeoffs</strong></p> <p> First, there is no single right answer for distribution, even if there are some wrong ones. I’m glad to say that nobody has proposed selling the vaccine to the highest bidder, which would clearly be a bad approach. While all states are following a system aimed at maximizing health benefit - vaccinating healthcare workers and the elderly first - they differ in details. And there is something to be said for such variation, given that many different systems may be ethically acceptable. Imagine the pressure and delay in trying to settle on a single national system.</p> <p> Second, the goal of optimizing distribution more precisely – by more carefully identifying people’s risk levels - stands in tension with the inevitable inefficiencies that such a system creates, and dangers of people gaming the system. Take smokers: Do we know who is a smoker? If a person can get the vaccine by simply saying they’re a smoker, and maybe smoking a few packs to get their urine to turn positive for testing, then some people (many?) probably would. Or take asthma, another health condition that puts people at risk and could be used to prioritize some people to receive the vaccine. But how would we determine who has severe enough asthma to move up in line? Who would determine this and how, based on what testing? Should doctors be trying to make these decisions, writing letters and filling out forms to say which of their patients should get the vaccine, when they are so busy caring for the ill?</p> <p> I believe that age, and really only age, is the right metric, probably without trying to parse risk more carefully, though I admit uncertainty. The evidence is clear that those who are older have significantly elevated risk of mortality and severe disability from COVID. Age is easy to check on driver’s licenses or other ID cards and there are public records. All other ways of gauging risk get squishy and complicated and, again, open the door to gaming the system. I don’t say this blithely, since I realize that this sort of decision has life and death implications, as does every decision about vaccine distribution. Luckily, I’m in no position to make these decisions, only to say what I think.</p> <p><strong>Cheating</strong></p> <p> </p> <p> How bad is line jumping, of the sorts that have been <a rel="noopener noreferrer" href="https://www.nytimes.com/2021/01/08/nyregion/coronavirus-vaccine-wealthy-nyc.html" target="_blank">reported nationwide</a> and indeed worldwide? Answer: Bad, but please keep it in perspective. Just as there is an overall tension between the goals of optimizing impact and optimizing speed of getting the vaccine into millions of arms, so there is a tension between getting the vaccine out there, however we can, and stamping out all cheating. I abhor but can live with some people at low risk but high social power getting the vaccine, as long as it is a low percentage of the shots. I’m not saying to stop trying to block such cheating, but I’m also saying that we can’t get hung up on it.</p> <p> When the IU Center for Bioethics celebrated its 10th anniversary in 2011 (our 20th is later this year), Art Caplan, PhD, a noted bioethicist, gave a talk where he critiqued the claim by some that people in the United States will never accept rationing of healthcare. As he pointed out, we already ration care by price, as discussed above. And we even accept centrally planned rationing, for instance in distributing organs for transplantation. Every day, someone’s life is saved since they were selected to receive an organ like a liver or heart, while someone else dies waiting, since they did not receive that organ. And somehow this is accepted.</p> <p> Dr. Caplan proposed that there are two key reasons for this acceptance of rationing: First, the limited supply of organs is accepted as real and not artificially created. Nobody thinks that the scarcity was created intentionally or through incompetence of the government. Second, the system for selecting recipients is seen as fair and based on medical need, not on things like power, money, or connections.</p> <p> Our vaccine distribution system must aim at both goals: people must know that those in power are distributing vaccine as quickly as possible, and rationally and fairly. Prioritizing smokers, I think, has the danger of undermining the whole system by raising concerns about fairness. Rampant line jumping would have the same effect. We can stomach some cheating, even if we don’t like it. But if there is too much, and the entire system will start to look arbitrary and rigged, and it will crumble.</p> <p><strong>Take home points</strong></p> <p> Vaccine distribution must prioritize the health of society, choosing people to receive it first based on optimizing protecting health, and reducing disease and death, in the population overall.</p> <p> Higher age, especially over 60 or 65, is an important marker for risk, and thus an excellent way to distribute the vaccine. The fact that age can be relatively easily checked and verified is key to its being such a good way to prioritize some to receive the vaccine.</p> <p> Distributing the vaccine based on health risks from comorbid conditions or jobs faces challenges of line drawing, confirmation, and fairness. (Think of smokers again, a health risk that reflects choice, though also addiction.)</p> <p> And while some cheating is inevitable, it must be kept to a minimum, to protect the integrity of the system. Only with an ethical system can we move forward together. </p> <p> </p>Mon, 01 Feb 2021 00:00:00 Z{E929729B-FFCE-4506-9157-D4C8465B64CD}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cardiovascular/december-2020-newsletterDecember 2020We strive to be One, diverse academic health enterprise where people come to receive the highest quality heart and vascular care in their community while also enabling relentless innovation that fuels better health for Indiana and beyond. Read on to learn about recent advances in realizing this vision. <br /> <br /> We wish you and yours good health and happiness in this Holiday Season and in the New Year.<br /> <br /> <br /> <h1>Welcome to our Team</h1> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/gruionu.jpg?h=218&w=200&rev=9e4191e1b5e54297ac692f8e1bba5cb0&hash=C5EC757ECAB998AF611AE981017E459B" style="height: 218px; width: 200px;" alt="portait of Dr. Gruionu" class="float-left" /> <p>Gabriel Gruionu, PhD joined IU School of Medicine, Division of Cardiology as an Assistant Research Professor and Director of Cardiovascular IP Development in October 2020. He earned his MS Degree in Biomedical Sciences from the University of Missouri-Columbia, a Ph.D. Degree in Biomedical Engineering from the University of Arizona and performed post-doctoral studies in the Departments of Surgery at IU School of Medicine and Radiation Oncology at Harvard Medical School. He has extensive R&D experience as a product specialist in the medical product industry at W.L. Gore & Associates, Inc. where he supported several medical products commercialized worldwide. Currently, Dr. Gruionu is developing a computer-assisted surgical navigation and medical robotics platform while also developing a new innovation program in the Division.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/i/ilonze.jpg?h=218&w=147&rev=3f594614ecd6483689684b7530bd62db&hash=B315C555EE7E896B8D87284EE9DBC12D" style="height: 218px; width: 147px;" alt="Onyedika Ilonze, MD" />Onyedika Ilonze, MD joined the IU School of Medicine as an Assistant Professor of Clinical Medicine in the Division of Cardiology in September 2020. After residency, he trained at Wake Forest University for one year of advanced heart failure and transplant cardiology. He then proceeded to a cardiology fellowship at Virginia Tech Carilion Clinic program and then had another year of advanced heart failure and transplant cardiology with a particular focus on all aspects of pulmonary hypertension and heart failure with preserved ejection fraction. His primary clinical responsibility is in Heart Failure and Transplant Cardiology at IUH-Methodist Hospital.<br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/m/mostafa.jpg?h=218&w=194&rev=67ddb4da2d5344dfab61b3c2a8ceaf09&hash=5A42BEF1B5FAB2D58A2B3F0A1C96A6E5" style="height: 218px; width: 194px;" alt="Hassan Mostafa, MD" />Hassan Mostafa, MD is a General Cardiologist who joined Community Medicine Cardiology in July 2020 after completing his cardiology fellowship at IU School of Medicine. His main practicing location is at Saxony with outreach locations at MMP East and Tipton. Dr. Mostafa will be with Community Medicine for one year until he leaves to complete his interventional and structural fellowships in Minnesota in July 2021. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/hugo-riosmeza-md.jpg?rev=d6629235153c4bbba04ef5f9b9ba5e80&hash=BB11542919970F464BB92B761BECC85A" style=" height:218px; width:200px" alt="Hugo Rios-Meza, MD" />Hugo Rios-Meza, MD is an Interventional Cardiologist who joined Community Medicine Cardiology in July 2020 after completing his cardiology fellowship and interventional fellowship at IU School of Medicine in 2019. Dr. Rios-Meza's main location is at Saxony with an outreach location at the Primary Care Hazel Dell clinic. <br /> <br /> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/smolensky.jpg?h=194&w=200&rev=7130f9fc223340b3a704f3c10898d459&hash=4211A330450CD96891399BC3C20ADD36" style=" width:200px; height:194px;" alt="Alexander Smolensky, MD" />Alexander (Olexandr) Smolensky, MD joined the IU School of Medicine, Division of Cardiology as an Assistant Professor of Clinical Medicine in November 2020. Dr. Smolensky's primary clinical responsibility is in general Cardiology at the IU Health Adult Academic Health Center, while also participating in the IU Health Sports Cardiology Program. His research focus is on vascular disease. <br /> <br /> </p> <h1>Fellowship Match Results</h1> <p>We are excited to welcome a new group of physicians to our fellowship training program!</p> <p>Our new fellows starting July 2021:<br /> (Name, MED School, Residency/Fellowship)</p> <p>Cardiovascular Disease:</p> <ul> <li>Courtland Blunt, University of Louisville, University of Tennessee</li> <li>Patrick Fitzgerald, Southern Illinois University, Mayo Clinic</li> <li>Mark Kauth, Oakland University William Beaumont, Indiana University</li> <li>Eric Kellett, University of Toledo, The Ohio State University</li> <li>Cody McCoy, University of Tennessee, University of Texas Southwestern</li> </ul> <p>Electrophysiology:</p> <ul> <li>Mansour Almnajam, Jordan University, University of Connecticut</li> <li>Eric Robinson, Indiana University, Indiana University</li> <li>Siddharth Shah, Krishna Institute of Medical Sciences, University Medical University</li> </ul> <p>Heart Failure:</p> <ul> <li>Bhavana Siddegowda Bangalore, Kempegowda Institute of Medical Sciences</li> </ul> <p>Vascular Surgery:</p> <ul> <li>Neal Ramchandani, Indiana University, Indiana University<br /> <br /> <br /> </li> </ul> <h1>KUDOS</h1> <h3><strong>Honors and Recognitions</strong></h3> <p> <strong>Georges Ephrem, MD, MSc</strong>, was selected for the American College of Cardiology's Clinical Trials Research: Upping Your Game Program. This program is intended to ensure diversity of thought, experience, and perspective and ensure that the evidence base includes data more closely reflecting the demographics of actual cardiovascular patients. As such, as we end up performing more successful research from our institution thanks to its educational impact, we will have Hoosiers better represented in the studied patient population and therefore, the results would be more applicable to them and more likely to impact their CV health positively. <br /> <br /> November 12th was <strong>Genetic Counselor National Awareness Day</strong>, where we recognized <strong>Katie Spoonamore, MS, LCGC</strong>. Katie is part of the growing team of CV Genetic Counselors with IUSM/IUHP. She is housed in the Division of Cardiology where she sees patients with a personal or family history of inherited CV disease, and also has research and education related roles. Genetic counseling in cardiology helps families adapt to genetic implications of their disease, and it helps cardiologists extend care beyond the initial patient to the entire family - with the ultimate goal of preventing morbidity and mortality due to cardiovascular disease. Cardiovascular genetic counseling has most commonly been focused on diagnoses with known monogenic causes (genetic arrhythmias, cardiomyopathies, lipidemias, etc.). We continue to grow our programs and care for these families, while also looking forward to the future of using genetic information to help predict risk for cardiovascular disease, heart attacks, and strokes in the general population.<br /> <br /> <strong>Andrea Price, MS, CPHQ, RCIS, AACC, Director of Quality Databases at IU Health</strong>, has been selected to serve as a Chair-Elect of the Cardiovascular Team Section Leadership Council through the American College of Cardiology. Andrea's term will begin April 1, 2021, and extend for 1 year.</p> <p><strong style="font-size: 1.25rem;"> </strong><strong style="font-size: 1.25rem;">Awards</strong></p> <p><strong>Thomas Everett, PhD</strong>, was recently awarded an NIH SPARC grant. He and his co-PIs will be investigating the mechanism of vagal nerve activity on mediating the symptoms of nausea and vomiting, and if gastric electrical stimulation also affects heart rate and cardiac function.<br /> <br /> <strong>Andrew Gonzalez, MD JD MPH</strong>, was recently funded by an AHRQ/PCORI K12 Learning Health Systems mentored career development award administered through an IUSM/Regenstrief partnership. Under this grant, Dr. Gonzalez will use an artificial intelligence and computer vision algorithms to develop a platform combining clinical imaging and EMR data to gain a better understanding of limb salvage trajectories for patients with peripheral arterial disease. <br /> <br /> <br /> </p> <h3><strong>Publications</strong></h3> <p>Sudden cardiac death (SCD) results from atherosclerosis in the great majority of cases. Whether carotid intima-media thickness (C-IMT), a known marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. <strong>Takeki Suzuki, MD, PhD</strong>, found that in two biracial community-based cohorts (ARIC and CHS), that abnormal C-IMT was associated with SCD. These results from diverse populations behoove studies treating subclinical atherosclerosis to prevent SCD. Learn more in Dr. Suzuki's paper published in the Journal of the American Heart Association. <br /> <br /> Individuals with sickle cell disease, a condition that disproportionately affects black lives, suffer premature death that can be sudden. It has been uncertain to date if these sudden death could be a result of fatal ventricular tachycardia (VT) or sickle cell cardiomyopathy (SCC). Research recently published in the high impact journal, Blood, by <strong>Ankit Desai, MD</strong>, and his team of Indiana University's School of Medicine's Krannert Institute of Cardiology has discovered evidence for both in a mouse model of sickle cell disease. They further demonstrate an inflammatory basis for both VT and SCC in interleukin-18 (IL-18), as well-known inflammatory cytokine with genetic relevance in patients. His research included testing of a drug called IL-18 bp that inhibits IL-18, finding that it attenuated both VT and SCC in the sickle cell disease mouse model. Moving from mouse to humans, the team found that blood levels of IL-18 may be a novel biomarker for SCC and VT in patients with sickle cell disease. This study directly addresses a critical health disparity in the high risk and largely under-served population with sickle cell disease, and identifies a potential treatment pathway for patients at risk for sudden death. </p> <p>Check out more publications in recent months from across OneIUCV <br /> <span style="white-space: pre;"> </span><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28vascular+surgery+AND+%22Indiana+university%22%29&sort=date">Vascular Surgery</a><br /> <span style="white-space: pre;"> </span> <a href="https://pubmed.ncbi.nlm.nih.gov/?term=%28%28%222020%2F08%2F01%22%5BDate+-+Publication%5D+%3A+%222020%2F10%2F01%22%5BDate+-+Publication%5D%29%29+AND+%28cardiac+surgery+AND+%22Indiana+university%22%29&sort=date">Cardiac Surgery</a></p> <p> </p> <h1><strong>In the Media</strong></h1> <p><strong>Woman, 25, experiences heart failure after COVID-19 infection</strong>. <a rel="noopener noreferrer" href="https://www.today.com/health/covid-19-heart-damage-woman-25-suffers-heart-failure-t196609" target="_blank">Read</a> on about the important efforts that highlight the impact our OneIUCV Team can make on people's lives. <br /> <br /> <strong>BioCrossroads honors the 'Father of Echocardiography'</strong>. <a rel="noopener noreferrer" href="https://www.wishtv.com/news/local-news/biocrossroads-honors-the-father-of-echocardiography/" target="_blank">Read</a> how Harvey Feigenbaum, MD, was awarded the 2020 August M. Watanabe Life Sciences Champion of the Year Award. <br /> <br /> <strong>Man raises money for family heart scans after losing son to heart attack. </strong><a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=7kIH-eAP7dg&feature=youtu.be" target="_blank">Watch</a> this great story on Noel Dasgupta's, MD, patient. <br /> <br /> <strong>Specialists to gravely ill congenital heart patient: your heart's in the right place. </strong><a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=clqQ8FwkTtE&feature=youtu.be" target="_blank">Watch</a> how Team OneIUCV took on this case and performed a successful life saving surgery.</p> <p> </p> <h1> SGLT2 Inhibitors</h1> <p>Check out these two new Cerner auto text phrases - .SGCV and .SGHF - from <strong>Nathan Lambert, MD</strong>, as you consider use of SGLT2 inhibitors to favorably impact cardiometabolic health:</p> <p><strong>.SGHF:</strong><br /> Consider use of SGLT2 inhibitors as adjunctive therapy for patients with type 2 diabetes to reduce the risk of HF hospitalizations<br /> <br /> The following drugs have shown to reduce the outcome of HF hospitalizations in patients with diabetes (reduced HF hospitalizations appears to be as class effect, and appears to be independent of underlying CVD):</p> <ul> <li>Empagliflozin (Jardiance)</li> <li>Canagliflozin (Invokana)</li> <li>Dapagliflozin (Farxiga)</li> </ul> <p>Citations: <br /> SGLT2 inhibitors for primary and secondary prevention of cardiovascular and renal outcomes in type 2 diabetes: a systematic review and meta-analysis of cardiovascular outcome trials. <br /> Lancet.2019; 393 (10166):31. Epub 2018 Nov 10.<br /> <br /> <strong>.SGCV:</strong><br /> Consider the following SGLT inhibitors as adjunctive therapy for DM in patients with established CVD. <br /> <br /> Trials have shown a reduction in the composite endpoint of CV death, nonfatal MI and nonfatal stroke, in patients with DM and known CVD already on standard therapy.</p> <ul> <li>Empagliflozin (Jardiance)</li> <li>Canagliflozin (Ivokana)</li> </ul> <p>Citations: <br /> Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes. EMPA-REG OUTCOME Investigators<br /> N Engl J Med. 2015; 373(22):2117. Epub 2015 Sep 17.<br /> <br /> Canagliflozin and Cardiovascular and Renal Events in Type 2 Diabetes.<br /> CANVAS Program Collaborative Group<br /> N. Engl J Med. 2017; 377(7):644. Epub 2017 Jun 12.</p> <p> </p> <h1>IUPUI Paws' Pantry Holiday Giving</h1> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2021/paws-pantry.jpg?rev=5826b8e766b54c31a16e7ae7720db7d3&hash=235D7F6FAE38A4BA725BC03B6ED3A61F" style=" height:333px; width:500px" alt="Paws Pantry" /></p> <p>Do you want to give back this holiday season?</p> <p>We are still collecting food and hygiene products and making donations to Paws' Pantry through January 8.</p> <p>Ways in which you can contribute to Paws' Pantry:</p> <ul> <li>Don't have time to shop or can't bring in goods due to teleworking? Click this online donation option and choose the Paws' Pantry Support Fund</li> <li>Place donations in the orange Paws' Pantry bin in the KIC mailroom/breakroom E371 or in the Campus Center:</li> </ul> <p>Campus Center and Student Experience, Paws' Pantry<br /> 420 University Boulevard, Suite 370<br /> Indianapolis, IN 46202<br /> <a rel="noopener noreferrer" href="https://studentaffairs.iupui.edu/news/stories/2020-03-18-3-ways-help-students-paws-pantry.html" target="_blank">List of Donations Accepted<br /> </a></p> <p> </p> <p><a rel="noopener noreferrer" href="https://studentaffairs.iupui.edu/news/stories/2020-03-18-3-ways-help-students-paws-pantry.html" target="_blank"></a></p> <h3><strong>Do you have a story that reflects the strength of our statewide system for cardiovascular care?<br /> Please email <a href="mailto:OneIUCV@iu.edu">OneIUCV@iu.edu</a> so we can share with the team!</strong></h3>Mon, 21 Dec 2020 00:00:00 Z{79249BEE-4FF1-440F-B43A-8B480935C8AB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/dr-koch-answers-questions-about-prostate-cancerDr. Koch answers questions about prostate cancer<p><span>Although men may not like to talk about it, prostate cancer is the most common cancer and the second leading cause of cancer death among men in the United States, according to the National Cancer Institute. Al Roker, the Today show weatherman, recently announced he was diagnosed with prostate cancer and that he had it removed surgically, which put a spotlight on the disease.  </span></p> <p><span><a href="https://medicine.iu.edu/faculty/4930/koch-michael">Michael Koch</a>, MD, chair of the IU School of Medicine’s Department of Urology and a member of the <a href="http://cancer.iu.edu">IU Simon Comprehensive Cancer Center</a>, is a prostate cancer expert with 35 years of experience. He and a colleague were the first to develop the </span><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://medicine.iu.edu/urology/expertise/urologic-oncology/prostate-cancer/high-intensity-focused-ultrasound" target="_blank"><span>high-intensity focused ultrasound</span></a><span> (HIFU) research protocol at IU. </span><span>In 2017, he was the top honoree in the Indianapolis Business Journal’s Health Care Heroes awards program in the “</span><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.ibj.com/articles/62650-health-care-heroes-dr-michael-o-koch" target="_blank"><span>Advancements in Health Care</span></a><span>” category for his </span><span>HIFU work.</span></p> <p><span>We turned to him for some answers about prostate cancer. </span></p> <p><strong><span>Q: Al Roker is 66 years old. Does prostate cancer only affect older men?</span></strong></p> <p><span>A: The likelihood of being diagnosed with prostate cancer increases with age and to some degree depends on when primary care physicians begin screening. The average age of men diagnosed with prostate cancer currently is in the 55-65 range, but we do see men sometimes diagnosed as young as their 40s.</span></p> <p><strong><span>Q: Other than age, what else contributes to prostate cancer?</span></strong></p> <p><span>A: The causes of prostate cancer are not fully known. Certainly, age is a major risk factor. Other factors that have been proposed to increase a man’s risk of being diagnosed with prostate cancer are race (Black men are at a higher risk), obesity, and a diet rich in animal fat.</span></p> <p><strong><span>Q: What are some symptoms that should lead men to see their doctors?</span></strong></p> <p><span>A: Most men that are diagnosed with prostate cancer have no symptoms. Many of these men have concurrent non-cancerous prostate enlargement that can cause decreased urinary stream, urine hesitancy, and sometimes urine frequency. Men who are unfortunately diagnosed with very advanced prostate cancer may have pain in their bones, but this occurs in only a few percent of men, generally with very high PSA values (blood test). </span></p> <p><strong><span>Q: Does prostate cancer impact Black men differently from white men? If so, why is that?</span></strong></p> <p><span>A: The general belief is that Black men have more aggressive prostate cancers and that they do not do as well after treatment. The cause of this is not clear.</span></p> <p><strong><span>Q: Most men, at least of a certain age, have probably heard of PSA (</span></strong><strong><span>prostate-specific antigen) and digital rectal exam (DRE), two tests that look for possible signs of prostate cancer. At what age do you suggest men have one or both of these screenings? Is one better than the other?</span></strong></p> <p><span>A: The guidelines for screening men for prostate cancer are controversial and have varied somewhat over the years. Most believe that Black men and men with a strong family history of prostate cancer should begin screening earlier, generally age 40-45. Men who are not at increased risk can generally start screening around age 50. Equally important, the literature does not support screening asymptomatic men beyond the age of 70.</span></p> <p><strong><span>Q: Treatment options range from so-called “watchful waiting” to surgery to immunotherapy and more. How would you summarize all of the available options?</span></strong></p> <p><span>A: Most importantly, a large portion of men diagnosed with prostate cancer have small non-aggressive prostate cancers that do not require treatment but do require monitoring. Few of these cancers ever require intervention. </span></p> <p><span>In men with cancers that are more serious and do pose a threat to the health of the patient, some type of removal or destruction of all or part of the prostate is generally indicated which might include robotic surgery, various forms of radiation, or a variety of techniques to “cauterize” just a part of the prostate. </span></p> <p><strong><span>Q: You’ve been a pioneer in your field. What do you see on the horizon in terms of advances against prostate cancer?</span></strong></p> <p><span>A: There are several advances in the last few years, and I would break them down into three areas. First, there have been very significant advances in selecting which tumors will behave aggressively and which ones will follow a very non-aggressive course. Second, we have less invasive techniques to treat prostate cancer in some men and allowing some of those men to avoid the side effects that can occur after more aggressive treatment. Third and most excitingly, there have been very substantial advances in molecular imaging of prostate cancer allowing us to more accurately determine which patients might benefit from treatment of prostate cancer and also tailoring the aggressiveness of that treatment to that specific patient’s need.</span></p> <p><strong><span>Q: Men, in general, can be reluctant to see a doctor. That can be particularly true with this type of cancer. How do you encourage men – or the people around them that love them – to be checked out by their physicians for prostate cancer? </span></strong></p> <p><span>A: This is the toughest question. Many men tend to avoid any type of health screening whether it be general check-ups for blood pressure and diabetes or other conditions and some seem to believe that they are invincible. Many believe that they are too busy to go get a check-up. Frequently, men come in at the prompting of their spouses. Men should realize that prostate cancer has become the most common cancer diagnosed in men and the most common cause of cancer death in men. Urologists now have the tools to carefully determine who is at risk for cancer and who is not, and to customize treatment to each and every patients’ specific circumstances thereby minimizing the side effects of treatment while curing most men of their most frequent cause of cancer death.</span></p> <p><span>To learn more, visit </span><a href="https://www.cancer.gov/types/prostate"><span>https://www.cancer.gov/types/prostate</span></a><span>.</span></p>Tue, 17 Nov 2020 00:00:00 Z{06ABB7C0-217A-4D36-B456-84A224F0CC31}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/pain-and-prejudicePain and Prejudice<p>Last week, Dr. Colin Halverson, PhD, addressed ethics enthusiasts in a talk entitled, “Pain and Prejudice,” for the Fairbanks Lecture Series in Clinical Ethics. Dr. Halverson studies the clinical journeys, identities, and realities of patients diagnosed with (hypermobile) Ehlers-Danlos Syndrome, a relatively elusive and professionally understated and misunderstood disease of the connective tissue. In this IUCB blog post, I’ll introduce Dr. Halverson, and then discuss his talk. </p> <p>Dr. Colin Halverson is a Center Investigator at the IU Center for Bioethics, as well as Assistant Professor of Medicine at IU School of Medicine. Dr. Halverson received his PhD in medical and linguistic anthropology at the University of Chicago, and subsequently completed fellowships in bioethics at the University of Chicago and Vanderbilt University. His research focuses on medical genetics, patient-doctor communication, consent, and return of clinical/genetic results. </p> <p>In “Pain and Prejudice,” Dr. Halverson describes his ethnographic research, including clinical participant-observation and interviews with 21 patients suffering hypermobility-type Ehlers-Danlos Syndrome (hEDS). hEDS is an inherited disease, though with an (as of now) unknown specific genetic cause. It affects mostly females (95%), with an estimated incidence of 1/5,000. Diagnosis of this disease is tricky, because it resembles other connective tissue disorders, and can have (especially early on) nonspecific symptoms. hEDS can cause joint hypermobility, stiffness, chronic pain and fatigue, occasional cardiovascular and gastrointestinal complications, dysautonomia, osteoarthritis, and low bone density. hEDS is a debilitating illness with lifelong effects. </p> <p>Dr. Halverson refers to the clinical journey of his hEDS subjects as their ’diagnostic odyssey:’ an arduous experience that occurs over many years as patients seek diagnosis and treatment of a disease they’ve largely been left to discover on their own. The diagnostic odyssey of hEDS tends to include the following moments and/or patterns: </p> <ol type="1"> <li>The ‘always-already moment,’ wherein patients recall a history of childhood symptoms not yet recognized as debilitating or pathological. </li> <li>The ‘trigger moment,’ wherein the patient fully commits to the diagnostic odyssey.</li> <li> The ‘road of trials,’ wherein symptoms proliferate and worsen. </li> <li>Secondary effects of the disease, which affect the patient’s personal life, often necessitating the sacrifice of hobbies and relationships. </li> <li>Psychological sequelae as a result of the aforementioned life changes/losses, which are caused by an outwardly and seemingly ‘invisible disease.’ </li> <li>Clinical ignorance, as doctors tend to disbelieve patient accounts of vague symptoms; physicians can appear aloof or distrustful of their patients, which alienates them in turn. </li> <li>Self-diagnosis, wherein the patient discovers hEDS and external support systems of those who have lived with the disease; the patient can now begin coming to terms with the reality of hEDS as a disability or chronic illness. </li> <li>The ‘diagnostic apotheosis,’ wherein a patient’s self-diagnosis is vindicated by an agreeing clinical diagnosis, heralding a sense of relief. </li> </ol> <p>Though arguably easier to read, numbering these experiences as I have does a disservice to Dr. Halverson’s goal of giving a narrative pattern to the stories he collects from his participants (hopefully he’ll forgive me). Narrative is more inviting, allowing us to participate in the experiences of others. The challenges faced by hEDS patients reveal and accentuate the depths that exist between clinicians and patients, and how critical diagnostic services (or even effort), good listening, and long-term relationships can be in affirming the identities and adversities of these patients. Though the ability to take a more ‘humanistic,’ empathetic view is emphasized in medical school and clinical training, it can be largely lost in the quotidian practices of physicians who easily become strangers to patients’ experiences outside of the exam room, or who assign patients with nonspecific complaints the reputation of ‘poor historian.’ If the clinician can recall the odyssey of hEDS patients, perhaps he will be more careful in his interactions with frustrated patients, and more open to hearing nonspecific complaints with a diagnostic, or, at least, empathetic ear.</p> <p>Find Dr. Halverson's talk online, <a href="https://www.fairbankscenter.org/events/fairbanks-lecture-series-in-clinical-ethics">here</a>. </p> <p> </p>Thu, 12 Nov 2020 00:00:00 Z{CB3C625D-00FF-484F-8B3B-D0E93D0B03C1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/hpvexpertdarronbrownHPV expert Darron Brown, MD, discusses the vaccine’s dramatic impact on reducing cervical cancer<p><span>A </span><a rel="noopener noreferrer" href="https://www.cancer.gov/news-events/cancer-currents-blog/2020/hpv-vaccine-prevents-cervical-cancer-sweden-study?cid=eb_govdel" target="_blank"><span>recent, new study</span></a><span> published in the New England Journal of Medicine — which has been hailed as a “milestone” study — confirmed that widespread use of the human papillomavirus (HPV) vaccine dramatically reduces the number of women who will develop cervical cancer. We turned to </span><a rel="noopener noreferrer" href="https://medicine.iu.edu/faculty/4903/brown-darron/" target="_blank"><span>Darron Brown</span></a><span>, MD, a leading authority on HPV, for some answers about this study. Brown is a professor of medicine in the Division of Infectious Diseases and professor of microbiology and immunology at IU School of Medicine and a researcher at the IU Simon Comprehensive Cancer Center.</span></p> <p><strong><span>Do you agree that this is a milestone study? Why or why not?<br /> </span></strong><span><br /> While other studies have shown that the HPV vaccine is effective against pre-cancerous lesions, this is the first study that conclusively demonstrates that the HPV vaccine prevents invasive cervical cancer. This cancer kills nearly 400,000 women each year worldwide. While cervical screening programs have reduced the incidence of cervical cancer in this country, there are still 15,000 women who die every year from this preventable cancer. </span></p> <p><span>This study, conducted in Sweden, is a milestone in the prevention of cervical cancer. The medical records of approximately 1.7 million girls were examined who were ages 10 to 30 between the years of 2006 and 2017. Some had been vaccinated against HPV and some had not. Invasive cervical cancer developed in 557 women overall, the vast majority in those women who had never received an HPV vaccine. There was an 88 percent reduction in invasive cervical cancer in women who had received an HPV vaccine before age 17 and a 53 percent reduction among women who had received the vaccine at an older age. <br /> <br /> <strong>Are the study’s findings surprising to you? Why or why not?</strong></span></p> <p><span>The findings of the study are not surprising to me, because the HPV vaccines are highly effective in preventing infection with HPV, the virus that causes cervical cancer. In addition, we know that the HPV vaccines effectively reduce the likelihood of pre-cancerous lesions, which can develop into invasive cancers five to 20 years later. So, it makes sense that the vaccines do what they were designed to do: prevent invasive cervical cancer.<br /> <br /> <strong>What is the take-away message to the public about HPV vaccination?</strong></span></p> <p><span>Vaccines are the safest and most effective things we do as physicians. Screening programs for cervical cancer are important, but Pap smears lack sensitivity to detect all cervical cancers. In addition, HPV vaccines can prevent other malignancies in both men and women such as oropharyngeal cancer and anal cancer, for which there are no screening programs available. </span></p> <p><span>As I mentioned, the Swedish study showed that the highest reduction of invasive cancers, 88 percent, was demonstrated in the group of young women who had been vaccinated before age 17. This strongly supports the public health policy of vaccinating young boys and girls against HPV at age 11 or 12, before there is a chance of becoming infected.<br /> <br /> <strong>This study focused on females. What about males and/or the parents of boys/young males? What is the take-away message to them?</strong></span></p> <p><span>Both of my sons have been vaccinated against HPV (and my daughter as well). HPV causes most anal and oropharyngeal cancers. By 2030, more men than women will die from HPV-associated cancers in the United States. It is critical that all boys are vaccinated at age 11 or 12, the same age as for girls.  </span></p> <p><strong><span>The study pointed out the need for women in low- and middle-income countries to be vaccinated. As you mentioned in a </span></strong><a rel="noopener noreferrer" href="https://medicine.iu.edu/blogs/research-updates/hpv-vaccination" target="_blank"><strong><span>previous Q&A</span></strong></a><strong><span>, nearly 90 percent of all cervical cancer deaths occur in poor and developing countries, such as India, countries in South-East Asia and Sub-Saharan Africa. What can you tell us about your latest work in Africa?</span></strong></p> <p><span>HPV vaccines were FDA-approved in 2006, and approximately 60 percent of girls living in the United States have received the vaccine. However, while 90 percent of all cervical cancer deaths occur in women living in poor countries, few girls are vaccinated against HPV. In Kenya and Malawi, two sub-Saharan countries in which I have worked, fewer than 1 percent of girls have received an HPV vaccine. </span></p> <span>We are currently working in Kenya to develop a community-based strategy that will combine screening adult women for cervical cancer with HPV vaccination of children in the same setting. We believe this decentralized approach to cervical cancer eradication will be successful in Kenya and can be applied to other East African countries where cervical cancer is extremely common.  </span>Wed, 11 Nov 2020 00:00:00 Z{427079CB-C351-42CE-86F9-3163A815856C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/research-demonstrates-the-importance-of-studying-normal-breastDr. Marino, others demonstrate the importance of studying the “normal breast”<p style="margin-left: 0.25in;"><span>Natascia Marino, PhD, assistant research professor of medicine at IU School of Medicine and a research scientist with the Komen Tissue Bank at the IU Simon Cancer Center, is among the authors of a </span><a rel="noopener noreferrer" href="https://www.nature.com/articles/s41523-020-00191-8" target="_blank"><span>study published online in npj Breast Cancer</span></a><span>. Dr. Marino said the study demonstrates the importance of conducting research on the “normal breast” and that she and her colleagues were surprised by the role fat plays in the development of breast cancer. The study, according to Dr. Marino, provides researchers with an early clue into changes that lead to breast cancer. “For the first time, we will have a view into the earliest changes that lead to breast cancer,” she said.</span></p> <p style="margin-left: 0.25in;"><span>She answered questions about the study.</span></p> <p style="margin-left: 0.25in;"><strong><span>In your words, what is the single main purpose of this study? </span></strong></p> <p style="margin-left: 0.25in;"><span>Our main goal is to understand what causes certain women to develop cancer in their breasts versus  women who do not and how the breasts prone to cancer are different from those of healthy women.</span></p> <p style="margin-left: 0.25in;"><strong><span>What is the key finding? </span></strong></p> <p style="margin-left: 0.25in;"><span>We identified molecular alterations linked with increased processing of fat in the breast tissue of women two to six years before they had any diagnosis of breast cancer. This suggests that the breast with even a small number of cancer cells, still undetectable by current diagnostic tools, is different from a healthy breast and all the cellular components of that affected breast are working to create a surrounding favorable for cancer growth.</span></p> <p style="margin-left: 0.25in;"><strong><span>What is the significance of the finding? </span></strong></p> <p style="margin-left: 0.25in;"><span>We show the possibility to detect abnormalities in the breast associated with cancer before it is detectable by routine screening methods, like mammography. Moreover, we also suggest that the fat cells in the breast tissue may have a key role in promoting cancer by both providing energy to the cancer cells and by inhibiting the anti-cancer immune response.</span></p> <p style="margin-left: 0.25in;"><strong><span>What are the strengths of your study? </span></strong></p> <p style="margin-left: 0.25in;"><span>We are the first to look at the alterations occurring in breast tissue donated by women prior to their diagnosis of cancer and compare its features to breast tissue from healthy women. This study has been possible only because of the work of the </span><a rel="noopener noreferrer" href="http://www.komentissuebank.iu.edu/" target="_blank"><span>Susan G. Komen Tissue Bank at IU Simon Cancer Center</span></a><span> (KTB). The KTB has been collecting normal breast tissues from healthy volunteer women for the last 13 years and follows up with the donors about any change in their medical status. </span></p> <p style="margin-left: 0.25in;"><strong><span>Were you surprised by the results? </span></strong></p> <p style="margin-left: 0.25in;"><span>Yes, we didn’t expect that the fat cells, which were thought to have only a storage function, play such an important role in promoting cancer development. Further investigation is needed to understand how those fat cells are activated by either genetic or environmental factors (i.e., lifestyle, exposures to pollutions or hormones). </span></p> <p style="margin-left: 0.25in;"><strong><span>What are the implications of your findings? Are there clinical applications that can be applied in the next few years? </span></strong></p> <p style="margin-left: 0.25in;"><span>Our findings show the changes leading to cancer develop in the breast long before the cancer is detectable by routine methods. This work provides us with potential “targets” that can be modified to prevent cancer from happening. </span></p>Tue, 10 Nov 2020 00:00:00 Z{95086D68-7D2D-4DDE-AFCF-8C1AEB49FFFF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/ai-disruption-of-bioethicsAI Disruption of Bioethics<p>Last week, Dr. Eric Meslin, PhD, FCAHS, spoke to the IU Center for Bioethics on the infiltration of artificial intelligence (AI) into healthcare and its potential to wreak bioethical havoc in a presentation entitled, “How Will AI Disrupt Healthcare, and Bioethics?” In this IUCB blog post, I’ll introduce Dr. Meslin, and then discuss his talk. </p> <p>Dr. Meslin visits us from Canada, where he is President and CEO of the Council of Canadian Academies. He also currently serves as a Senior Fellow for the PHG Foundation at the University of Cambridge, Academic Affiliate at the University of Oxford, and Adjunct Professor at IU McKinney School of Law. From 2001–2016, he served as Founding Director of the IU Center for Bioethics, as well as Dean of Bioethics at the IU School of Medicine (IUSM). While at IUSM, Dr. Meslin also served as Endowed Professor of Philosophy, Professor of Medical and Molecular Genetics, and Professor of Public Health. </p> <p>Now, for Dr. Meslin’s talk. Undeniably, technology and artificial intelligence are infiltrating healthcare, creating newfangled opportunities for personal patient data analysis, clinical imaging, diagnostics, and health administration workflow. But are these innovations disrupting the health landscape, or are they predictable extensions we have the means to ethically regulate? </p> <p>To answer this question, Dr. Meslin considers Christensen’s 1997 theory of disruptive innovation, which describes the ability of small, resource-poor businesses to enter markets dominated by larger, incumbent businesses. These small businesses promote new technologies ignored or unstudied by said incumbents (who would rather spend their resources and generate guaranteed profit by bolstering existing technologies). When these new technologies offered by the smaller businesses have become mainstream, they have successfully disrupted established socioeconomic (and, by analogy or extrapolation, healthcare) systems. For a healthcare-specific definition of disruption, Dr. Meslin offers a more modest description: technological disruption occurs when a technology is seen to intersect “with an accepted trajectory of innovation, application, and integration of technology or practice into the delivery of healthcare.” It appears to me that both definitions may generate distinct answers to the question of the current level or potential of disruption of AI in healthcare, depending on the assumptions made by the asker. </p> <p>For Christensen’s definition, we must be willing to consider established healthcare delivery services an ‘incumbent business’ and patients as customers. We can consider new start-up companies (e.g. 23andMe) to have overtaken certain market niches by selling novel health-related services that classical hospital and healthcare systems do not, thereby generating capital and esteem. To me, this definition of disruption is mostly economic in nature, and presupposes that our bioethical and health infrastructure cannot compensate for the vicissitudes of market capitalism. This discussion raises interesting questions: Can we approximate healthcare as a market, and, if so, how will we ethically regulate upstarts and their services? Besides your standard FDA approval, these unique patient services are not thoroughly vetted. Furthermore, they are not allocated according to any bioethical framework. Should they be? What is the relationship between ethics and free enterprise? </p> <p>Dr. Meslin’s definition of disruption, that technology essentially outpaces its expected trajectory in the healthcare setting, assumes that our bioethical frameworks are incapable with keeping up with technological advancement, or for some reason that they will soon be unfit to do so. How can we tell if technology is outstripping our ethical framework? Dr. Meslin points to the fact that is takes 10-15 years to fully legislate and evaluate new technologies, but, these days, new technologies are outdated 5-7 years after conception. What does this mean for ethicists? Will a deluge of innovation spark ethical specialization in attempts to keep up? Would specialization fractionate and/or immobilize the current field? </p> <p>Dr. Meslin raises critical questions for us, as (bio)ethicists, to consider. We need to decide whether our work is enough to sustain contemporary innovation, and how we can maintain or regain our lead. Watch Dr. Meslin’s talk in its entirety <a href="https://www.youtube.com/watch?v=-ED8gJrxq5g&feature=youtu.be">here</a>.</p>Wed, 14 Oct 2020 00:00:00 Z{B6A41ED1-6331-4F1E-BD78-BFE4ABE59CD9}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/42-ways-to-advance-racial-equity-in-academic-medicine42 Ways to Advance Racial Equity in Academic Medicine<p><span style="background: none 0% 0% repeat scroll white; color: black;">Dr. Sotto co-authored this blog with</span><span> <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.gradyhealth.org/doctors/jada-bussey-jones/" target="_blank"><span style="color: windowtext;">Jada Bussey-Jones</span></a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://medicine.yale.edu/profile/inginia_genao/" target="_blank"><span style="color: windowtext;">Inginia Genao</span></a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.mountsinai.org/profiles/maria-e-maldonado" target="_blank"><span style="color: windowtext;">Maria Maldonado</span></a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://news.emory.edu/tags/expert/kim_manning/index.html" target="_blank"><span style="color: windowtext;">Kimberly D. Manning</span></a>, and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://uahs.arizona.edu/leadership-team/francisco-moreno-md" target="_blank"><span style="color: windowtext;">Francisco A. Moreno</span></a>. The blog was originally posted on <a rel="noopener noreferrer" href="https://www.kevinmd.com/blog/2020/09/42-ways-to-advance-racial-equity-in-academic-medicine.html" target="_blank">kevinmd.com</a> and is being re-posted here under consent of the authors.</span></p> <p><span> </span></p> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-536859905 -1073697537 9 0 511 0;} @font-face {font-family:Baskerville; panose-1:2 2 5 2 7 4 1 2 3 3; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-2147483545 33554432 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} </style> <p> </p> <p><span>Academic medicine generally encompasses a tripartite mission of research discovery, clinical innovation, and the next generation of physicians and scientists’ education.</span></p> <p><span>It is the ethics and social justice principles, practices, policies, and innovation that advance research and education in the health sciences, ultimately improving the health and well-being of all.</span></p> <p><span>This is its <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://jamanetwork.com/journals/jama/article-abstract/183685" target="_blank">socially responsible</a> mission. Yet, it seems chief diversity officers, equity practitioners, and scholars everywhere have been lifting even heavier weights within our institutions in recent times. The progress in equity, diversity, inclusion, and justice (EDIJ) within our campus environments has been hard to celebrate while we continue witnessing an overt display of systemic racism and structural violence.</span></p> <p><span>Systemic racism that has been seen throughout the experiences of minoritized groups navigating higher education: <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.jstor.org/stable/26894228" target="_blank">racism</a>, <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://psycnet.apa.org/record/2008-13166-001" target="_blank">discrimination</a>, and <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://psycnet.apa.org/record/2007-07130-001" target="_blank">(micro)aggressions</a>; cultural taxation and tokenism; bias in recruitment, promotion, and tenure; and challenges to their credibility and expertise.</span></p> <p><span>The additional systemic violence that the COVID-19 pandemic has highlighted to be pervasive of health inequities in communities of color. Being part of academic medicine also means witnessing — and at times being complicit of working in — systems that perpetuate these inequities and health disparities.</span></p> <p><span>But we are also hopeful because of the many ways our committed colleagues, students, trainees, and staff championed the combat against racism and discrimination.</span></p> <p><span>Many of us have been asked: What can I do within my academic role? Although not exhaustive, the list below offers a list of 42 actions faculty, and members of the academic community can do to advance racial equity in academic medicine, in no particular order.</span></p> <p><span>We hope you find this list helpful and that in discussions with your own institutional communities.</span></p> <p><span>1. Reflect on your own identity and privilege. What is your positionality? Positionality is the socio-political context that forms your identity in terms of race, class, gender, sexuality, and ability status (to name a few). How does your identity influence and biases your perspectives?</span></p> <p><span>2. Commit to being part of EDIJ efforts in your unit, at your institution, and your professional societies. If there are no efforts or are not sufficient, name your impression, reaction, and desired action.</span></p> <p><span>3. Engage and share the burden with faculty of color. Did you know that physicians of color care for over 50% of diverse populations and over 70% of non–English-speaking patients in the U.S. Patients from underserved populations are significantly more likely to see a physician of color. Did you know that faculty of color tend to take on more service than their counterparts? Did you know that they do most of the mentoring for minoritized students? Scholars refer to this as cultural taxation and “invisible work,” except that it is evident to those that do it.</span></p> <p><span>4. Work to ensure that “invisible work” becomes desirable contributions that are expected, quantified, and valued in the hiring, promotion, and tenure processes at your institution. Especially now, this must call for an overhaul on the way we credit and reward EDIJ work.</span></p> <p><span>5. Engage in equity-based training, such as anti-bias, anti-discrimination, and anti-racist. Seek educational development in areas of cultural competence and culturally relevant and inclusive pedagogies. Approach these with a commitment to a growth mindset. Do not fall on the trap of relabeling your efforts as anti-racism — especially if it does not challenge the status quo, institutional barriers, structures, and power.</span></p> <p><span>6. Ask what is the percentage of the school’s budget allotted to EDIJ initiatives and efforts, excluding external EDIJ-related grants. You can help advocate for more and request that it is not decreased as a result of COVID-19-related financial impact.</span></p> <p><span>7. Know what EDIJ resources are already available at your institution. Some institutions excel at inventorying and listing these resources but need accountability in identifying the gaps. Ensure your EDIJ contribution is visible.</span></p> <p><span>8. Create new and join affinity groups that include people from groups different from yours, especially those that advance equity and inclusion.</span></p> <p><span>9. Ask yourself if the representation in decision-making committees is adequately diverse, and if the decision is equitable across all diverse groups.</span></p> <p><span>10. Engage with students and trainees in ways that are holistic. Consider their backgrounds, social identities, and lived experiences in relation to fostering meaningful engagement and sense of belonging.</span></p> <p><span>11. Assist in the promotion and tenure process by helping faculty of color get promoted. Assure that mentorship and support are adequate to minimize common obstacles for the promotion of faculty of color. Help identify and remove those obstacles.</span></p> <p><span>12. Engage in promotion and tenure committees to guarantee equitable reviews of dossiers.</span></p> <p><span>13. Call for recruitment practices of faculty/staff/leadership and trainees that guarantee a diverse pool of candidates, fair processes for assessment, affirming interviews and campus visit experiences, and commitment to hire successful candidates who offer the added values of diversity. Participate and help lead in those searches.</span></p> <p><span>14. Understand different communication styles and develop skills in communication across cultures. While affirming people from other cultures, help them navigate the culture and climates at your institution.</span></p> <p><span>15. Contribute to the examination of curriculum content and experiences for cultural competence and biases. Work towards a culturally aware and socially responsible medical education and be mindful of values imparted in the “hidden curriculum.” Hidden messages perpetuate health disparities through the irrelevant addition of race, ethnicity, and gender in clinical cases.</span></p> <p><span>16. Hold executive leadership accountable for EDIJ action plans. Ask that senior diversity officials be appointed to the highest structural level at your institution (the C-suite) and participate in a structure that empowers their effectiveness. If you find yourself in this role, it is your responsibility to acquire the knowledge and expertise in equity and inclusion scholarship and strategic approaches.</span></p> <p><span>17. Acknowledge that you have biases even if you identify as an ally, an immigrant, a person of color, and even a senior diversity official. White supremacy, racism, and ethnocentrism present in many internalized ways.</span></p> <p><span>18. Take the time to learn names and how to pronounce them correctly.<br /> Individualize people by being curious about the meaning or the story behind the individual’s names. Learning to pronounce a name is about respect.</span></p> <p><span>19. Examine institutional-academic partners and health system policies and processes that perpetuate barriers to racial equity.</span></p> <p><span>20. Be uncomfortable and vulnerable. Speaking about race and/or ethnicity is not easy, but it is a must. It is OK to intervene as a bystander, be generous and humble.</span></p> <p><span>21. Learn about student activism and movements; you may not quite realize the power of students driving change.</span></p> <p><span>22. Do not opt for a path of least resistance in fear of being labeled as a “troublemaker” when it comes to issues about equity. Leverage your “friends in high places,” keep your integrity and advocate for the mission of equity.</span></p> <p><span>23. Consider the meaning of words and what they may convey depending on context: minority, politically correct, color-blind, allies, melting pot, resilience, and grit, fit, etc. It is not always what we say or means, but what people hear and how it makes them feel that influences our climate, relationships, and behaviors.</span></p> <p><span>24. Invest in much-needed diverse leadership. Build a pipeline from early on — support and sponsor pre-faculty and faculty of color.</span></p> <p><span>25. When you make a mistake while trying to promote racial equity, admit it. Name the mistake, specifically say why the mistake is a problem, and share how you plan to correct the outcome and not to repeat the error.</span></p> <p><span>26. Practice culturally competent and inclusive research. Does your research engage with marginalized communities? Can you address inequities within your research agenda?</span></p> <p><span>27. Ask about the staff of color at your institution. They deserve respect and attention to equity issues, perhaps more than often acknowledged. Staff often represents the institutional memory, the face and culture of an institution before trainees, community, and patients.</span></p> <p><span>28. Ask leaders for transparency — advocate for metrics around promotion rates, turnover, salary, and patient outcomes to assure equity across your institution. “We don’t know” is only acceptable is followed by “we will do something about it.” Evidence of inequities must trigger action-oriented interventions to resolve these issues urgently.</span></p> <p><span>29. Choose your advocacy lane. Physicians vote less often than the general public. We should at least vote. Others may do more to engage the community and legislators for true systemic and structural changes. Bring advocacy to practice, teaching, community presence, professional society, and publications.</span></p> <p><span>30. Commit to concrete ways to be a better upstander (recognizing something is wrong and doing something to correct it) and push yourself to act in real-time.</span></p> <p><span>31. Stay up to date with geopolitical and local events that affect your colleagues and learners.</span></p> <p><span>32. Avoid loose terms such as “difficult times” and “lost their lives” when describing what your Black colleagues are grieving. It is something much greater.</span></p> <p><span>33. Pour into economic improvement by adhering to supplier diversity, like ordering team lunches from Black-owned and minority-owned businesses.</span></p> <p><span>34. Show up at public events such as rallies, lectures, town-halls, etc. Your absence may be noticed more than your presence. Stay beyond the photo op and be fully engaged.</span></p> <p><span>35. Role model patient advocacy. Identify and root out policies such as segregated care and care that propagates health and healthcare disparities.</span></p> <p><span>36. Advocate for an institutional quality strategy that commits to addressing health and healthcare disparities and that provides quality data to faculty and trainees.</span></p> <p><span>37. Suggest diverse patients, families, and communities to be included in institutional committees.</span></p> <p><span>38. Engage with community members and service organizations.</span></p> <p><span>39. Speak up against injustice and discrimination! Your voice matters to peers, trainees, communities.</span></p> <p><span>40. Ensure that the medical education curriculum is culturally relevant and threads cultural humility. Center how students and trainees can learn to be providers who practice patient advocacy.</span></p> <p><span>41. Review representation in regards to the content, speakers, and consultants you invite to campus.</span></p> <p><span>42. Learn the history of the land and communities where your school of medicine is located. Recognize indigenous land with a formal acknowledgment in presentations, gatherings, media presence. Also, acknowledge the displacement of communities of color depending on where your institution is located.</span></p> <p><strong><span> </span></strong></p> <style> </style>Tue, 13 Oct 2020 00:00:00 Z{B22EBE61-9BFB-4109-8CA9-D59A4A35A707}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/genomic-medicine-key-to-treating-aggressive-breast-cancers-disproportionately-affecting-african-american-womenGenomic medicine key to treating aggressive breast cancers disproportionately affecting African American women<p>A breast cancer diagnosis will disrupt the lives of about 325,000 women in the United States this year, and more than 42,000 are expected to die from the disease in 2020. Although breast cancer affects people of all ethnicities and from all walks of life, some populations are disproportionately impacted. </p> <p>Compared to white women, the lifetime risk of developing breast cancer is slightly lower for African Americans; however, the risk of dying from the disease is higher for African American women. For years, the medical community thought these disparities could be solely attributed to socioeconomic factors, but current research tells a much more complex story. Biology and genomics are also at play. </p> <p>“We have seen for decades that African American women have lower incidence of breast cancer but a higher mortality rate. For a long time, we thought that difference could all be attributed to access to care. Several studies tried to control for socioeconomic factors, and when you do that, the differences in mortality get smaller, but they don’t completely go away,” said <a href="/faculty/4849/miller-kathy">Kathy Miller, MD</a>, Ballvé Lantero Professor of Oncology at Indiana University School of Medicine and associate director of clinical research at <a href="/sitecore/content/iu/iu-som/home/research-centers/cancer">IU Melvin and Bren Simon Comprehensive Cancer Center</a>. “The socioeconomic factors are certainly important and need to be addressed, but there are biologic factors as well.” </p> <p>According to the American Cancer Society, 40 percent of <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/cancer-facts-and-figures-for-african-americans/cancer-facts-and-figures-for-african-americans-2019-2021.pdf" target="_blank">racial variation in breast cancer subtypes</a> may be due to inherited genetic mutations. Of all ethnicities, African American women are the most likely to develop triple negative breast cancer, an often deadly form of breast cancer that is not responsive to hormone therapies and is resistant to chemotherapy. </p> <p>Miller is among several IU School of Medicine researchers studying why African American women are more likely to develop aggressive types of breast cancer and how treatments can be tailored to fight these cancers more effectively. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/20201007_hari.jpg?h=267&w=400&rev=a6abe672befb45e59e7e25a077a8bad3&hash=2DF1ED6FE6E47B43DAF10A2D7D822BD4" style="height: 267px; width: 400px;" alt="Harikrishna Nakshatri, PhD" class="float-left" />Using samples of healthy breast tissue from the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://komentissuebank.iu.edu/" target="_blank">Susan G. Komen Tissue Bank</a> at IU Simon Cancer Center, <a href="/faculty/13331/nakshatri-harikrishna">Harikrishna Nakshatri, PhD</a>, is leading a <a href="/sitecore/content/iu/iu-som/home/news/2019/06/chan-zuckerberg-initiative-picks-iu-team-for-human-cell-atlas-award">project funded by the Chan Zuckerberg Initiative</a> and t<span>he <a rel="noopener noreferrer" href="https://www.heroesfoundation.org/projects/the-catherine-peachey-fund/" target="_blank">Catherine Peachey Fund, a member of the Heroes Foundation family</a>, </span>to map the breast at the single-cell level. He’s noted several differences in breast tissue cells among women of various ethnic backgrounds. </p> <p>“We have identified a unique type of cells which is in the normal breast tissue of African American women that can be a catalyst in aggressive breast cancer development,” said Nakshatri, who is the Marian J. Morrison Professor of Breast Cancer Research at IU School of Medicine and associate director of education for the IU Simon Cancer Center. </p> <p>Another study, funded by the Department of Defense’s <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://cdmrp.army.mil/bcrp/" target="_blank">U.S. Army Breast Cancer Research Project</a>, will look at a gene mutation in women of Sub-Saharan African descent which protects them from malaria but also gives them greater risk for developing a highly aggressive form of breast cancer. </p> <p>“One question we’re trying to answer is, can we model drugs to treat breast cancers with this mutation background, tailored for women with Sub-Saharan ancestry?” Nakshatri said. </p> <p>Not all genetic differences based on ethnicity are bad news. Native Americans have alleles which protect against breast cancer, Nakshatri noted. </p> <p>“Some Latinas have inherited these Native American protective alleles,” he added. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/schneider-bryan-cs-bryancs-01-5x7/schneider-in-vb-coat-2.jpg?h=267&w=400&rev=8907d39e559147de86ddff42946019c6&hash=921C6DE51A82A6695926574E73D6A6CD" style="height: 267px; width: 400px;" alt="Bryan Schneider, MD" class="float-right" />While Nakshatri’s research focuses on identifying and understanding biologic differences in normal breast tissue, several of his IU School of Medicine and IU Simon Comprehensive Cancer Center colleagues are working to develop more effective, tailored therapies. This includes the work of <a href="/faculty/4858/schneider-bryan">Bryan Schneider, MD</a>, Vera Bradley Professor of Oncology at IU School of Medicine and founding director of the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://iuhealth.org/find-medical-services/precision-genomics" target="_blank">Indiana University Health Precision Genomics program</a>. </p> <p>“What he found was women of African descent were more likely to have severe toxicity with a commonly used chemotherapy drug, more likely to have doses reduced because of that toxicity, and more likely to have worse outcomes,” Miller reported. </p> <p>Schneider is now working to confirm his results, which show a different chemotherapy drug could be just as effective in fighting the cancer without producing severe toxicity in African American patients. </p> <p>“If that holds true, that’s huge,” Miller said. “Just by using a different drug, we can give African American women less toxicity and better outcomes.” </p> <p>Schneider, Miller and Nakshatri are all researchers with the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a>. </p> <p>When people think of cancer research, they often think of developing new drugs and therapies, but it’s equally important to study the efficacy of existing treatments and how they might be tailored to treat not only specific cancer types but also women of different ethnicities. </p> <p>“Breast cancer is a really challenging, variable disease with fascinating biology,” Miller said. “We’re trying to understand why some treatments that work so well in some women don’t seem to be as effective in other women.” </p> <p>She can see a day when scientific understanding of biologic differences could lead to differences in prevention recommendations for women of various ethnicities. “But, we’re not there yet,” Miller said. </p> <p>“For all of us, early detection is one of your best defenses,” she advised. </p> <p>In addition to following <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html" target="_blank">American Cancer Society guidelines</a> for breast cancer screening, Miller recommends lowering risk by employing basic practices of a healthy lifestyle, including eating a balanced diet, exercising, avoiding weight gain (particularly after menopause) and sleeping well.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/20190429_iusm_jacquelyn_stephens_triple-negative.jpg?h=601&w=900&rev=537e5d5fc8ba434989c7ce34738df0af&hash=BE8C1C9967D61A62A6B6682D63CD6CBD" style="height: 601px; width: 900px;" alt="a patient gets infusion at the IU Simon Cancer Center" /></p> <p>For anyone who is faced with a breast cancer diagnosis, she invites them to <a href="/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/dr-kathy-miller-discusses-clinical-trials-at-iu">consider participating in a clinical trial</a>, which may improve their personal outcome while also benefitting the medical community’s understanding and treatment of breast cancers. </p> <p>“Less than 3 percent of adults diagnosed with cancer participate in a clinical trial. But every therapy available today is the result of testing in clinical trial,” Miller said. “Clinical trials should be part of the discussion for all cancer patients.” </p> <h2>Breast Cancer Research and Resources </h2> <ul> <li>To learn more about active research in <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/research/prevention-early-detection">breast cancer prevention and early detection</a> and drug and new product development, check out the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer at IU School of Medicine website</a>.</li> <li>To learn more about how tumor biology, genomics and patterns of care affect breast cancer outcomes among Black women, see Susan G. Komen’s “<a rel="noopener noreferrer" rel="noopener noreferrer" href="https://ww5.komen.org/uploadedFiles/_Komen/Content/Special_Projects/Disparities/A Perfect Storm- FINAL 12-13-16.pdf" target="_blank">A Perfect Storm: Highlighting Breast Cancer Disparities among African-American Women.</a>” </li> <li>Important for all women: Review the American Cancer Society <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.html" target="_blank">recommendations for early detection of breast cancer</a>.</li> </ul>Fri, 09 Oct 2020 00:00:00 Z{F946706D-5CBD-4E1B-B19E-5A7B26A4C1D6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/clinical-trials-office-and-the-pandemicClinical Trials Office juggles research work, life amid a pandemic<p>For all of us now, we mark our lives—both personal and professional—as life before the pandemic and life after the pandemic began.</p> <p><span>Before the World Health Organization declared the spreading coronavirus outbreak a pandemic on March 11, the staff of the IU Simon Comprehensive Cancer Center’s </span><a href="https://www.cancer.iu.edu/research-trials/facilities/cto/index.php"><span>Clinical Trials Office</span></a><span> (CTO) was going about their important work.</span></p> <p><span>While their work has changed since then, cancer clinical trials never stopped. In fact, in the face of uncertainty, the staff has increased patient accrual over last year and streamlined some administrative tasks.</span></p> <p><span>The 100-plus staff members include data coordinators, clinical research specialists, research nurses, and others. </span></p> <p><span>“Everyone plays an important role in supporting the principal investigators who conduct oncology clinical trials,” according to Mario Contreraz, M.B.A., M.S.N., R.N., director of operations of the CTO. “We have dedicated staff who are the backbone of our research efforts.”</span></p> <p class="Default"><span>It’s no small task considering that the PIs lead hundreds of trials. </span><span>In addition to evaluating potential new prevention, diagnostic, or therapeutic approaches, these trials are often the last line of defense for patients when standard therapies have failed. The majority of these trials are only available at academic health centers and their affiliated cancer centers due to the rigorous demands of managing clinical trials and the complexity of patients’ health. </span></p> <p><span>Accrual to both therapeutic and non-therapeutic trials remained strong in the beginning of 2020. But the new year, as everyone knows, brought with it a new virus that first hit the United States on the West Coast in January. The impact of the coronavirus, renamed COVID-19 in mid-February, reached the Midwest in early March. Indiana reported its first case on March 6. </span></p> <p><span>On March 10, Contreraz held an emergency meeting with the CTO’s managers to identify essential staff who would be needed on campus. Around this time, the office was managing close to 300 trials. </span></p> <p><span>The next day, IU suspended all in-person meetings, implemented visitor restrictions, and told employees who were able to work from home to do so.</span></p> <p><span>“There was no playbook to manage a pandemic and work. Nobody knew what to expect,” Contreraz said. “For days, things changed hour by hour, day to day and week to week. The CTO staff did a tremendous job of overcoming a number of obstacles.”</span></p> <p><span>With most of the CTO staff now working from home and adjusting to their new work routines in early March</span><span>—as well as juggling personal lives amid a pandemic—the trials continued. However, not everyone could work from home. Many of the therapeutic trials meant that research nurses needed to meet with patients. </span></p> <p><span>Contreraz praised those research nurses: “</span><span>My hat goes off first to the research nurses who continued to provide the same level of quality patient care to our patients despite the pandemic.”</span></p> <p><span>On March 24, non-therapeutic trials were suspended </span><span>unless they could be conducted virtually or remotely. That allowed the CTO staff to shift their attention to the therapeutic trials.</span></p> <p><span>By the end of March, the CTO’s hard work—work being done in the very early weeks of the pandemic—led to 31 patients accruing to a clinical trial. Accrual hit a low in May, but rebounded in June and has continued its upward trajectory. By late August, the CTO managed to accrue a total of 204 patients, which is a 10-percent increase from the previous year. </span></p> <p><span>That’s impressive, considering new patient accrual decreased 30 percent in May. CTO leadership pointed to other cancer centers, which experienced accrual decreases up to 70 percent. </span></p> <p><span>“I think part of our success was really quick action by the CTO leadership in realizing that we would need to have staff working from home and we would need to adjust and develop new procedures to be able to do that,” Kathy Miller, M.D., the cancer center’s associate director of clinical research, said. “I think the key was prioritizing the work.”</span></p> <p><span>Contreraz added: </span><span>“We ensured that the staff had the tools—computer, laptops, and VPN access—to be successful at home.” </span></p> <p><span>Dr. Miller summed all of the uncertainty and the new world order perfectly in an e-mail that was sent to the CTO staff: “A huge thanks for the perseverance. Many are not ‘working from home.’ They are ‘home managing a crisis while trying to work.’ The difference might seem subtle, but it is very real.” </span></p> <p><span>During a recent interview, she elaborated on the staff’s efforts. “<span style="color: rgb(32, 32, 32);">The staff have a lot of other roles in their families and in their communities, so they are doing the same juggling act that we all are,” she said. “They have an incredible commitment to our patients and to the work the center does on behalf of our patients. And we have definitely seen that incredible commitment as they have continued to work with us. They've been incredibly flexible in how we get the work done. They've been incredibly creative in finding new ways for us to do things, some of which we've discovered work way better than the way we were doing before the pandemic.”</span></span></p> <p><span>Tim </span><span style="background: white; color: rgb(51, 51, 51);">Lautenschlaeger, M.D., medical director of the CTO, added: “The entire CTO staff has done an incredible job adapting to all the changes. Looking back, it is impressive how well the office continued to function, supporting our PIs and serving our patients. I am very proud to work with such dedicated individuals.”</span></p> <p><span style="color: rgb(32, 32, 32);">“In oncology, clinical research is not just a standard of care, it is <em><span>the</span></em> standard of care. Until every patient diagnosed with cancer is cured, this sentiment will remain. Clinical research does not happen in a vacuum, it takes a team. In these uncharted times, I join with all of our members in expressing our deepest gratitude to the staff and leadership of our CTO,” Patrick Loehrer, M.D., cancer center director, said. </span></p> <p><span>Much like elsewhere, the CTO has discovered ways to be more efficient because of the pandemic. They started </span><span style="color: rgb(32, 32, 32);">electronic signatures for patient consent forms and</span><span> e</span><span style="color: rgb(32, 32, 32);">-signatures for regulatory documents. The pandemic also has led to remote monitoring of clinical trial results. Prior to the pandemic, monitors needed to be on-site to review study data. That’s not always the case now since the data can be reviewed remotely. </span></p> <p><span style="color: rgb(32, 32, 32);">Some of the new changes are here to stay. </span></p> <p><span style="color: rgb(32, 32, 32);">“Some of the changes are things we've wanted to do for some time, but there were security concerns and regulatory concerns,” Dr. Miller said. “The Institutional Review Board and IU Health have allowed us to do some things that are much more efficient for us. Some of those will continue.”</span></p> <p><span style="color: rgb(32, 32, 32);">“We proved we can successfully work remotely to support clinical trials at the cancer center and will continue to do so,” Contreraz added. </span></p>Fri, 02 Oct 2020 00:00:00 Z{87B168F8-FE07-47CB-A72A-D23E7E16DDD2}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/free-the-vaccineFree the Vaccine<p><strong>Art, Ethics, and Access to Medicine: Creativity vs. COVID, coming to a gallery near you</strong></p> <p>You walk into your campus art gallery. In front of you, there’s a white wall with a question in large type: Between 2010 and 2016, how many new FDA-approved drugs were developed with public funding? </p> <p>Write your guess on a touch screen and wait for the correct response…. </p> <p>10%? </p> <p>It couldn’t be as high as 60%... </p> <p>You enter 25%, which seems reasonable. </p> <p>The answer appears: 100% </p> <p>In a recent study of every FDA-approved drug developed between 2010 and 2016, all of them were supported by public funding. </p> <p>But how can that be true? If innovative drugs aren’t born in pharmaceutical corporations’ private research and development labs, then how are they developed? </p> <p>The United States invests over $40 billion dollars annually in taxpayer funds from sources such as the National Institutes of Health and the Department of Defense. Most often these grants are given to University researchers doing the important preliminary work that advances basic science. When they discover something with exceptional promise, Universities then license their research findings to pharmaceutical corporations. The University receives payment from the corporation, and the corporation enjoys monopoly rights on the manufacture and distribution of the drug. </p> <p>However, there’s no requirement (yet) that public funding ensures the resulting lifesaving medications are accessible to and affordable for the public. Drug pricing policy is opaque, and takes advantage of monopolies and manipulations of patent law (from recent years you may remember Martin Shkreli, the cost of the Epi-Pen, or the rising cost of insulin). Vulnerable populations in the US often cannot afford the drugs created with their own tax dollars. </p> <p>Rather than waiting for pharmaceutical corporations to reduce their profits out of good will, Universities can right this wrong by changing their research licensing policies. </p> <p>But why are we having this conversation in an art gallery? And are we wearing face masks? We’re in a pandemic, after all! </p> <p>Exactly. In a public health crisis like the one we’re experiencing now, these questions become all the more pressing. In the past five months, the US government has pledged billions for developing tests, treatments, and vaccines for COVID-19. But what good is this investment if the medical resources it funds aren’t available to everyone? A global pandemic needs a global solution. Guaranteeing universal access to tests and treatment is crucial. And with the current death count over 900,000, from an ethical standpoint, it's simply the right thing to do. </p> <p>It’s a big challenge. And big challenges require creative solutions. </p> <p>So <a href="https://freethevaccine.org/">Free the Vaccine for COVID-19</a> launched in March of 2020. Led by <a href="https://uaem.org/">Universities Allied for Essential Medicines</a> (UAEM) and the <a href="https://c4aa.org/">Center for Artistic Activism</a> (C4AA), more than 300 university students, artists, and activists from 29 countries joined forces to make sure that COVID treatments are available to everyone, everywhere, not just those with the ability to pay. </p> <p>It’s not a conventional campaign - it’s an “advocacy innovation lab.” Experts and mentors remotely train participants in methods of creative advocacy that draw from the social and behavioral sciences, the history of art and activism, and the world of advertising and public relations. In a highly collaborative and iterative process, teams of participants experiment with how to apply those methods in different regional and institutional contexts. It’s a model for activism that’s accessible, enlivening, and fun. </p> <p>To date, the lab has produced dozens of projects. In Southern California, team members encouraged a friendly rivalry between UCLA and USC by making a set of trading cards that challenged researchers to be the first team to pledge to <a href="https://opencovidpledge.org/">openly license their COVID research</a>. Another group, inspired by Dolly Parton’s donation to support COVID research at Vanderbilt, <a href="https://www.youtube.com/watch?v=Oa09OzYgZr0">made a music video about free vaccines, set to the tune of “Jolene”</a> - and it went viral.   These and other Free the Vaccine actions invite participants to harness their own creativity and cultural resources to make meaningful change. </p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/freevaccine1.png?rev=6d47fda7a01e46e197192ce098b98489&hash=8C3C34BD468FFB587579B0976B4EE374" style=" height:477px; width:424px" alt="A collection of scientist and physician trading cards created by UCLA and USC" /><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/freevaccine2.png?rev=7c54d9c688e846e5abba1ec8c81600ab&hash=1B22784645572F3A25BD9946722C3C29" style=" height:474px; width:354px" alt="A sample trading card for a USC Professor of Molecular Microbiology and Immunology" /></p> <p>[UCLA v. USC trading cards created by Free the Vaccine for COVID-19 participants] </p> <p>As we reflect on the first 16-week round of the Free the Vaccine for COVID-19 advocacy innovation lab and prepare to launch the next 12-week season, we're taking stock of what we've accomplished and thinking of ways to invite more people into our experiment with creative activism. To achieve both of those things, <a href="https://freethevaccine.org/2020/07/29/a-free-the-vaccine-exhibit/">we're making an exhibition</a>. </p> <p>The show introduces audiences to key issues that limit access to medicine and provides robust methods anyone can use to advocate for change from anywhere, especially at this time of social distancing. It also serves as an archive for Free the Vaccine volunteers so they can reference and build on interventions past, present, and to come. </p> <p>University communities are our primary audience for the show. Why? These institutions are home to essential COVID research and development - and they have the power to help make sure that life-changing medicine reaches the people who need it most. Adopting open licenses for COVID research findings is an easy way to support an institution’s mission and social responsibility. </p> <p>We also know that university galleries are navigating their own challenges right now as they work to serve their communities while also limiting the further spread of COVID. That’s why we’re creating a virtual exhibition with optional physical components. University galleries can link to our show from their website and organize public programs that connect their audiences with current events and fresh creative work, even if gallery spaces are restricted. The interdisciplinary content of the show can bring together students, faculty, and staff across campus - from the art department to public health programs to scientific research labs. </p> <p>If it’s creativity versus COVID, we’ll be on the winning side. </p> <p>This essay was also published on the <a href="https://iahi.sitehost.iu.edu/2020/09/11/free-the-vaccine/">IUPUI Arts and Humanities Institute blog</a>.</p>Fri, 25 Sep 2020 00:00:00 Z{2A5FAB1F-08BB-4AE7-ACC8-B7622CFE43B9}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/2-students-with-interest-in-combining-cancer-research-with-patient-care-are-wright-scholarship-recipients2 students with interest in combining cancer research with patient care are Wright Scholarship recipients<p><span>Two women pursuing their medical degrees with an interest in combining cancer research with patient care have been selected as the 2020 </span><a rel="noopener noreferrer" href="http://www.cancer.iu.edu/" target="_blank"><span>IU Simon Comprehensive Cancer Center</span></a><span> William J. Wright Scholarship Fund recipients.</span></p> <p><span>Alexa Loncharich and Laura Wright (no known relation to the benefactor) earned the $8,000 scholarships for the current academic year. Each has already distinguished herself by delivering presentations at scientific meetings, earning numerous awards, taking on volunteer projects, and getting listed as an author on research published in prestigious academic journals among other accomplishments.<img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/wright-scholarship-alexa.jpg?h=267&w=400&rev=3dd645831c5a48b994d786a582cba26b&hash=A85B36FDF20EDFF19AC5A96E56AB81CF" style="height: 267px; width: 400px; float: right;" alt="Alexa Loncharich" class="float-right" /></span></p> <p><span>Loncharich, a native of Carmel, Ind., wrote in her scholarship application that she discovered her love for oncology while standing in the corner of a small conference room. The moment happened while in a pancreatic oncology clinic when she and her preceptor met with their last patient of the day. The patient, who two days earlier went to the ER, had a mass on her pancreas. It was advanced pancreatic cancer.</span></p> <p><span>“I think the poor prognosis of pancreatic cancer really inspired me to pursue research involving it,” Loncharich said. “I wanted to get involved in improving survival and treatment.”</span></p> <p><span>For her most recent research, which she completed in the lab of Michael House, M.D., she reviewed about 850 patient charts. </span></p> <p><span>“We looked at patients that had a surgery called a Whipple, which removes the head of the pancreas,” she explained. “This is often done to remove cancer in the pancreas. We wanted to determine if an early complication, biliary leak, is associated with a later complication, biliary fistula. A biliary fistula carries a high risk of additional morbidity and mortality.”</span></p> <p><span>For her most recent research, which she completed in the lab of Michael House, M.D., she reviewed about 850 patient charts. </span></p> <p><span>Their finding? Postoperative biliary fistulas—even transient, clinically insignificant fistulas—are associated with increased risk for developing a late biliary stricture that needed stents.</span></p> <p><span>The significant finding caught the Society for Surgery of the Alimentary Tract’s attention, and it was accepted for an oral presentation at the society’s 61<sup>st</sup> annual meeting. Because of the pandemic, the meeting was canceled but the findings were presented online during a webinar presented by the society. The research also was published in the Journal of Gastrointestinal Surgery.</span></p> <p><span>Also because of the pandemic, Loncharich and her fellow students were pulled off of their clinical rotations in mid-March. However, she said that allowed her more time to devote to research. In fact, she focused solely on a surgical elective for a month.</span></p> <p><span>She returned to her internal medicine sub-internship in July at the Roudebush VA Medical Center.</span></p> <p><span>The fourth-year medical student plans to apply to internal medicine residencies this fall followed by a hematology/oncology fellowship. She said she plans to continue pursuing research into her residency and beyond.</span></p> <p><span>Loncharich graduated with highest distinction from IU Bloomington with a double major in neuroscience and biology in 2017. She currently serves as a tutor at IU School of Medicine and is a member of the school’s Association of Women Surgeons Student Interest Group and the Surgery Student Interest Group. She serves as vice president of the school’s Internal Medicine Student Interest Group.</span></p> <p><span>“It is such an honor to receive this award,” she said. “I am thrilled for the recognition of my previous research and the judges’ confidence in my future research. The scholarship also allows me to devote more time on research.”</span></p> <p><strong><span>Laura Wright pursues research on cancer’s impact on musculoskeletal system</span></strong></p> <p><span>A personal interest led Wright to IU to study with Theresa Guise, M.D., widely recognized as a leader in how cancer affects bone. (Guise recently left IU for MD Anderson Cancer Center.)<img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/wright-scholarship-laura-wright.jpg?h=267&w=400&rev=dcd55bc1844e49b696b1727451b7e716&hash=ADB23FA332609687F02BE300E75F27FB" style="height: 267px; width: 400px; float: right;" alt="Laura Wright, a 2020 Wright Scholar" class="float-right" /></span></p> <p><span>Wright lost a family member to metastatic breast cancer. That death led the Portland, Ore., native to change her dissertation focus to breast cancer bone metastasis while a Ph.D. student at the University of Arizona. She earned her doctorate in physiological sciences in 2012.</span></p> <p><span>Now Dr. Wright, a third-year student at IU School of Medicine, is set to become a medical doctor in 2022.</span></p> <p><span>In the Guise lab, her research focused on the impact of cancer and cancer therapies on the musculoskeletal system. In 2016, she was promoted to an assistant research professor of medicine at IU School of Medicine. She earned funding from the Department of Defense and the American Cancer Society for her research, an impressive feat for a student.</span></p> <p><span>“A portion of my work has focused on understanding how cells inside the bone microenvironment can influence cancer growth and progression,” she said. “We’ve found that factors secreted from bone marrow can change gene expression of breast cancer cells and may contribute to its growth and ability to migrate.”</span></p> <p><span>She added: “I’ve also investigated how cells in bone are affected directly and indirectly by radiation therapy, which is often a necessary treatment for prostate and breast cancer patients. Many women experience muscle weakness and bone loss with breast cancer treatments that antagonize the estrogen receptor or block estrogen synthesis altogether, so I am currently working on a project that compares two of these drugs head-to-head in order to characterize their effects on muscle function and bone metabolism.”</span></p> <p><span>The love of combining bench research with the ability to care for patients at the bedside led her to leave the lab and to enroll in medical school two years ago. She’s currently at Riley Hospital for Children on her first clinical rotation, following the pandemic’s shutdown of in-person classes and clinicals.</span></p> <p><span>However, Wright saw a “silver lining” in the change because it gave her more time to focus on reading and writing related to her lab work before classes resumed online.  </span></p> <p><span>Still, the clinical experience makes her most happy. “It’s a joy to finally be where I set out to be: with patients,” she said. Wright also said her “number one goal is to become a well-rounded and capable clinician.”</span></p> <p><span>After medical school, Wright plans an internal medicine residency followed by a fellowship in hematology/oncology.</span></p> <p><span>Co-director of the Eskenazi Health Center West 38<sup>th</sup> St. Health Fair, Wright is a member of IU School of Medicine’s Internal Medicine Student Interest Group and the American Association for Cancer Research.</span></p> <p><span>“I was thrilled to receive the William J. Wright Scholarship because it will give me the opportunity to reconnect with the Guise Lab during my fourth year of medical school to finalize my project aimed at understanding how signals from bone marrow can impact breast cancer behavior and metastasis.”</span></p> <p style="margin-bottom: 0.0001pt;"><strong><span>William J. Wright Scholarship</span></strong></p> <p><span>Learn more about the IU Simon Comprehensive Cancer Center’s </span><a rel="noopener noreferrer" href="https://cancer.iu.edu/research-trials/funding/wright.shtml" target="_blank"><span>William J. Wright Scholarship Fund</span></a><span>.</span></p> <p> </p>Mon, 14 Sep 2020 00:00:00 Z{76C635FA-2C33-45C7-AFCB-29530371B991}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/the-art-of-palliation-in-covid19-the-ocean-that-awaits-usThe Art of Palliation in COVID19 - The Ocean that Awaits US<p><span>This blog is written by and published under permission of</span> Areeba Jawed, MD</p> <p><span> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-536859905 -1073732485 9 0 511 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:11.0pt; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:8.0pt; line-height:107%;}size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} </style> <br /> </span></p> <p><span>Over the last few weeks, I have communicated with numerous families whose loved ones were hospitalized with COVID 19 related complications as a palliative care fellow at a county hospital in Indianapolis. Due to imposed visitation restrictions, family members were unable to visit patients admitted to the hospital and we functioned as a communication arm for the ICU team. I spent hours on the phone with families breaking down the daily changes in clinical status and bridging the various pieces of medical information together to formulate a headline which was clear, concise and relayed our concerns.  I precariously walked the thin line between not depriving them of hope while preparing for an outcome which may be emotionally devastating.<br /> <br /> In the voices of these families, I heard deep sorrow, hounding fear of loss, glimmers of hope and endless gratitude for the care provided by the hospital staff. A uniform theme was one of helplessness. Children of elderly patients and parents to young adults likewise described being haunted by guilt for having to leave their loved one alone in the hospital. Spouses who had never imagined being unable to care for their partners were frustrated and grieving. I wondered about the enormity of the trust families were being asked to place in us as they often got together in virtual groups across a lifeless electronic device to hear the hum of their loved one’s breathing machine and trace the tubes and drains which seemed to run together. I worried if the picture I’d painted with my daily phone calls had prepared them for what they were about to see. Despite my yearlong training in communication skills, I continually was at a loss for words; what does one say to a wife who cannot be by the death bed of her husband of four decades? How does one comfort children of a 43-year-old, who watch their mother pass away on facetime?<br /> <br /> Practicing medicine during the pandemic defies many aspects of palliation which we value. As palliative care physicians, it’s not death we are uncomfortable with nor is death a failure of medicine in our eyes.  An integral part of what we do focuses on cherishing one’s end of life and helping bring each person’s story to that perfect ending they desire however that might look. In the COVID 19 era I, like many others, feel as though my hands are tied. I feel inadequate. I struggle with my own helplessness. I shed tears behind closed doors and in empty stairwells.<br /> <br /> Days and people begin to run into each other as each story starts with Covid 19. Now more than ever we must value the ability to stay grounded so we can take care of ourselves and that next person who needs us. We must focus on our little successes – like setting up a YouTube channel with songs in a mothers voice that her daughter listened to all day, getting a sixty year old his favorite drink before he slept into oblivion, saying aloud the “I love you” that a patient unsuccessfully mouthed to his family on FaceTime, reconnecting a zoom call every 40 minutes so family witnessed that last breath of their loved one.<br /> <br /> Nothing could have prepared us for what was asked of us in the last few weeks and the enormity of the task ahead of us is daunting to say the least.  In Khalil Gibran’s words may we all become the ocean that awaits us.<br /> <br /> “<em>The river needs to take the risk<br /> of entering the ocean<br /> because only then will fear disappear,<br /> because that’s where the river will know<br /> it’s not about disappearing into the ocean,<br /> but of becoming the ocean.”</em></span></p> <p> </p> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-536859905 -1073732485 9 0 511 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri",sans-serif; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:11.0pt; mso-ansi-font-size:11.0pt; mso-bidi-font-size:11.0pt; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;} .MsoPapDefault {mso-style-type:export-only; margin-bottom:8.0pt; line-height:107%;}size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} </style>Thu, 10 Sep 2020 00:00:00 Z{063A32F9-73A1-4DD8-8394-A296D7B2EB22}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/indiana-native-researcher-is-the-2020-vera-bradley-foundation-scholarIndiana-native researcher is the 2020 Vera Bradley Foundation Scholar<p>A researcher exploring new anticancer drugs for triple-negative breast cancer has been named the 2020 Vera Bradley Foundation Scholar. Ryan Higgins, PhD, a postdoctoral researcher in the laboratory of <a href="/faculty/41288/hao-chunhai">Chunhai “Charlie” Hao</a>, MD, PhD, is the new scholar. From Madison, Ind., Higgins is the first Vera Bradley Scholar from the Hoosier state.</p> <p>The Vera Bradley Foundation Scholars Career Development Program provides two years of research funding to a postdoctoral fellow to pursue a breast cancer research project. As the 2020 Vera Bradley Foundation Scholar, Higgins’ research project is “Development of SUMO1 Degraders as the First-in-class Drugs for Metastatic Breast Carcinoma.”</p> <p>A first-in-class drug means that the therapeutic would use a new, innovative mechanism to treat the cancer; this is the first such project for researchers at the Vera Bradley Foundation Center for Breast Cancer Research.</p> <p> “Triple negative breast cancer is termed that because it lacks hormone receptors that other breast cancers possess, therefore, you can’t target those receptors therapeutically like other cancers,” Higgins said. “Because of the lack of receptors to target, the development of triple negative breast cancer therapeutics has been a challenge.” </p> <p>Instead, Higgins will work alongside Hao to target a protein called SUMO1 (small ubiquitin-related modifier 1). Hao’s research team had previously identified the first small molecule degraders of SUMO1 protein, which has been implicated in driving breast cancer as well as many other cancers.</p> <p>Hao is co-program leader of the Experimental and Developmental Therapeutics research program at the at the <a href="http://cancer.iu.edu">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a> and a member of the Vera Bradley Foundation Center for Breast Cancer Research at IU School of Medicine.</p> <p>“Traditional therapeutics have focused on inhibiting proteins that drive cancer,” Higgins said. “Although inhibitors are proven effective therapies, drug resistance is often an unavoidable problem, therefore novel therapies are needed. Within the past five to 10 years, a new class of therapeutics called protein degraders have emerged. They work by degrading, rather than inhibiting, a protein of interest from the cell, potentially making them a more effective therapeutic than inhibitors.”</p> <p>Higgins is working now to develop a drug that functions as a SUMO1 protein degrader.</p> <p>“We have performed several drug screens and identified a compound that degrades the SUMO1 protein, and we have found that it’s very effective in treating breast cancer cell lines, specifically triple negative breast cancer cell lines,” Higgins said. </p> <p>Researchers have also shown that the compound they are developing effectively slows tumor growth in patient-derived xenografts, or mouse models developed with patient tumor cells.</p> <p>“We have modified the compound through medicinal chemistry to make it more specific to its target. This lowers toxicity and increases its ability to degrade the SUMO1 protein, which in turn kills the cancer cells while limiting affects to normal cells,” Higgins said.</p> <p>Ultimately, Higgins hopes his research will result in clinical applications for breast cancer patients.</p> <p>“I’m honored to be named this year’s Vera Bradley Scholar. I look forward to working diligently on the research proposal and trying to bring this research to a clinical trial at IU,” he said.</p> <p>Higgins earned a bachelor’s degree in biochemistry from Indiana University Southeast and a doctoral degree from Florida State University. He joined Hao’s lab in 2019. In addition to Hao, mentors for Higgins’ project are Harikrishna Nakshatri, BVSc, PhD, and Kathy D. Miller, MD.</p>Mon, 10 Aug 2020 00:00:00 Z{6F798D1E-75FA-4246-A516-D99D0B6C4B63}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/case-study-provides-insight-to-toxicity-from-chemotherapyPatient case study provides insight to toxicity from chemotherapy used for breast, colon cancers<p>When a cancer patient’s medical history was presented at a precision genomics clinic at Indiana University, her story piqued the interest of <a href="/faculty/5010/skaar-todd">Todd Skaar</a>, PhD. The woman had experienced extreme toxicity to a chemotherapy regimen widely used to treat breast and colon cancers. Her reaction to the regimen, however, resulted in a three-week hospitalization.</p> <p>That single case led Skaar and colleagues to identify a genetic marker that causes severe toxicity when patients are given standard doses of a common drug. The case report is published in <a rel="noopener noreferrer" href="https://ascopubs.org/doi/full/10.1200/PO.20.00067" target="_blank">JCO Precision Oncology</a>.</p> <p>“The overall goal of this study is to understand how to better tailor the chemotherapy regimen to individual patients,” said Skaar, the study’s senior author and a researcher and co-leader of the Cancer Prevention and Control research program at the <a href="http://cancer.iu.edu">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>, and professor of medicine at IU School of Medicine. “Some chemotherapies could be lethal in some people with a standard dose that most people can handle. We're trying to identify and predict who those people are so we can either reduce the dose or give them a different drug.”</p> <p>Using a computerized genomic data tool, Reynold Ly, Ph.D., a research fellow in Skaar’s lab, scanned the patient’s entire genome to find if there was a genetic component to explain the patient’s toxicity reaction to the chemotherapy. Among those 6.4 billion base pairs in the genome, Ly found that a variant in a gene called DPYD that likely caused the patient’s adverse reaction. The DPYD gene is needed to metabolize the chemotherapy drug called capecitabine. This variant causes the gene to be non-functional, keeping the body from processing the drug and allowing it to build up to toxic levels in the body.</p> <p>IU researchers collaborated with the <a rel="noopener noreferrer" href="https://www.mayo.edu/research/labs/dihydropyrimidine-dehydrogenase-deficiency/overview" target="_blank">Diasio laboratory</a> at Mayo Clinic that specializes in DPYD research. Mayo Clinic researchers were able to test the variant in a cell-based model to confirm what Skaar and Ly suspected—that one rare difference in the patient’s genome caused her extreme reaction and subsequent hospitalization.</p> <p>While this specific genetic variant and chemotherapy reaction is rare, researchers have unlocked another piece of the human genome to bring them one step closer to providing the best treatment to individual patients. “This specific variant is very rare, which is why it hasn’t been tested before,” Skaar said.</p> <p>“This case study gives us a little more confidence that using whole-genome sequencing can allow us to identify some of these rare variants ahead of time and avoid some of those toxicities.” Skaar also is a researcher at the Vera Bradley Foundation Center for Breast Cancer Research at IU School of Medicine.</p> <p>The patient’s whole-genome sequencing was performed through the IU Health Precision Genomics Clinic, co-directed by cancer center researchers <a href="/sitecore/service/notfound.aspx?item=web%3a%7bA0DE809C-4271-4EC6-8FBD-62DFCF55C714%7d%40en">Milan Radovich</a>, PhD, and <a href="/faculty/4858/schneider-bryan">Bryan Schneider</a>, MD, the Vera Bradley Chair in Oncology.</p> <p>Findings from this study will be implemented in genomic guidelines utilized by tumor boards across the United States to inform clinical care for patients with this specific genetic variant in DPYD.</p> <p>This research was supported by the National Institutes of Health (R35GM131812 and P30CA15083), Vera Bradley Foundation, and the <a rel="noopener noreferrer" href="https://precisionhealth.iu.edu/" target="_blank">Indiana University Grand Challenge Precision Health Initiative</a>.</p> <p>Nearly 40 Indiana University Melvin and Bren Simon Comprehensive Cancer Center research physicians and scientists and 5,000 square feet of lab space make up the <a href="https://medicine.iu.edu/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research at IU School of Medicine</a>. Named in 2018, the center celebrates The Vera Bradley Foundation for Breast Cancer’s transformational support of research at Indiana University since 1999.</p>Mon, 03 Aug 2020 00:00:00 Z{C72CD4B5-16F4-4073-BD65-127552985CAB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/historical-lessons-on-the-use-and-abuse-of-science-and-scientistsHistorical Lessons on the Use and Abuse of Science and Scientists: A Letter from Patrick J. Loehrer, Sr. M.D. to Colleagues <p>Dear colleagues,</p> <p>“One thing only I know … and that is I know nothing.” So said Socrates, one of the founders of Western philosophy, about 2,400 years ago. This was in response to hearing that the Oracle of Delphi declared there was no one who was wiser than Socrates. He tried to prove the Oracle wrong by interviewing “wise men,” but he found that unlike these so-called wise men, Socrates did not claim to know what he did not know. This was the true meaning of the Oracle’s message. Socrates frequently engaged students and citizens in Athens in philosophical discussions using questions and answers (the Socratic Method). Socrates also was an outspoken critic of the Athenian government, which eventually led to his conviction and a sentence of death by drinking hemlock. </p> <p>Persecution and defamation also have not been uncommon in science. In Renaissance times, there emerged heretical thoughts that the Earth might rotate around the sun, rather than the other way around (heliocentric theory). Nicolaus Copernicus published this theory in 1543 in his famous work <em>De Revolutionibus Orbium Coelestium</em>, which directly challenged the teachings of the Bible. Perhaps fortunately, he died shortly after its publication sparing him persecution. It did not fare as well for Galileo Galilei, who was born a couple decades after Copernicus death. Galileo was found by the Catholic church to be “vehemently suspect” of heresy for his publications supporting the Copernican heliocentric views. He was tried, convicted, and sentenced to house arrest, where he remained for the rest of his life and his offending texts were banned. <span style="background: white none repeat scroll 0% 0%; color: black;">Four centuries later, Pope John Paul II acknowledged that the Catholic church had erred in condemning Galileo. </span></p> <p style="margin-bottom: 13.5pt;">In 1847, Ignaz Semmelweis, an obstetrician in Vienna, published evidence that when doctors washed their hands before examining or treating patients the mortality rate for women in his birthing ward was greatly reduced. At the time, hygiene was not a staple of medical care. For example, it was common for medical students and doctors to examine corpses in the mor<img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/puerperal-fever-mortality-rates.png?h=245&w=405&rev=bac3c63f0ec442b69df19349ac1bb897&hash=E7EA1CEA8021352C6A1D6DE81B81989D" style="height: 245px; width: 405px; float: left;" alt="Yearly mortality rates of patients with puerperal fever" />tuary then assist women during childbirth without washing their hands in the interim. Semmelweis compared the outcomes of fatal infections and puerperal fever in the wards covered by these medical students and staff (first clinic) to a second clinic attended to by midwives who had no exposure to the cadavers. He found a striking difference (see figure). Semmelweis subsequently proposed the practice of washing hands with chlorinated lime solutions in <span style="text-decoration: underline;"><a href="https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&cad=rja&uact=8&ved=2ahUKEwjPopygwebqAhUUBs0KHcMLBRkQgAMoAHoECBYQAg&url=http%3A%2F%2Fscholar.google.com%2Fscholar_url%3Furl%3Dhttps%3A%2F%2Fpdfs.semanticscholar.org%2F2dfd%2F549b51381493916c59bc08e8dc16e4d2f733.pdf%26hl%3Den%26sa%3DX%26scisig%3DAAGBfm1FzWVuToL40MnTBRuHrHday1_BCQ%26nossl%3D1%26oi%3Dscholarr&usg=AOvVaw0d3_ovYF3OOU0a3a4v33jr" title="Etiology, Concept and Prophylaxis of Childbed Fever"><em>Etiology, Concept and Prophylaxis of Childbed Fever</em></a></span>. Despite this, the medical establishment rejected his ideas. Remember, this was well before Pasteur and Lister had discovered microbes and confirmed the role of antiseptics, so Semmelweis could offer no acceptable scientific explanation for his findings. Many of his colleagues mocked him for his suggestions and consequently Semmelweis suffered a nervous breakdown and was committed to an asylum. He died 14 days later from a gangrenous wound on his right hand after being beaten by guards. </p> <p><span>Another example of delayed scientific acceptance is the story of James Lind who was a military surgeon who served in the British Royal Navy from 1739 t0 1748. Lind conducted one of the first randomized clinical trials in medicine. In his time, scurvy was a leading cause of death among sailors, reportedly causing more deaths in the British fleet than by the hands of their French or Spanish foes with whom they were engaged in armed conflict. Scurvy is caused by vitamin C</span><span> </span><span>deficiency, but in Lind’s day, the concept of vitamins was still unknown. After two months at sea, many of his fellow shipmates on the </span><span style="text-decoration: underline;"><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC539665/" title="HMS Salisbury (1746)"><span>HMS Salisbury</span></a></span><span> were afflicted with scurvy. Lind divided 12 of these sailors into six groups of two. They all received the same diet. In addition, <span style="text-decoration: underline;">group one</span> was given a quart of cider daily, <span style="text-decoration: underline;">group two</span> 25 drops of elixir of vitriol (sulfuric acid), <span style="text-decoration: underline;">group three</span> six spoonful’s of vinegar, <span style="text-decoration: underline;">group four</span> half a pint of seawater, <span style="text-decoration: underline;">group five</span> received two oranges</span><span> </span><span>and one lemon, and <span style="text-decoration: underline;">group six</span> a spicy paste plus a drink of barley water. The treatment of <span style="text-decoration: underline;">group five</span> (oranges and lemon) stopped after six days when they ran out of fruit, but by that time one sailor was fit for duty while the other had almost recovered. In 1753, Lind published <em><span style="text-decoration: underline;"><a href="https://www.jameslindlibrary.org/lind-j-1753/">A Treatise of the Scurvy</a></span></em><span style="text-decoration: underline;">,</span> which was ignored for decades. </span></p> <p><span>Today, we are faced with a pandemic caused by a novel coronavirus, discovered just a few months ago. Like the scientists and philosophers over the last two millennia, we are struggling to understand this virus, including its treatment and prevention. We have the advantages of modern technology and the rapid exchange of knowledge that is unprecedented in our history. This still does not mean we get it all right, but we try. </span></p> <p><span>No one is trying harder than Dr. Anthony Fauci, director </span><span style="background: white none repeat scroll 0% 0%; color: black;">of the National Institute of Allergy and Infectious Diseases, who has been the public face of rational scientific reasoning during this pandemic. </span></p> <p><span style="background: white none repeat scroll 0% 0%; color: black;">Amid speculations of displeasure by the White House, the editorial board of <span style="text-decoration: underline;"><a href="https://www.usatoday.com/story/opinion/todaysdebate/2020/07/14/donald-trump-muzzling-anthony-fauci-amid-covid-hazardous-editorials-debates/5432422002/">USA Today</a></span> wrote last week, “Fauci, 79, is a national treasure. He is one of the leading authorities in his field. He combines extraordinary expertise with an exceptional ability to communicate with ordinary people. He has held his position </span><span style="text-decoration: underline;"><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.niaid.nih.gov/about/director" target="_blank"><span style="background: white none repeat scroll 0% 0%; color: black;">for 36 years</span></a></span><span style="background: white none repeat scroll 0% 0%; color: black;">, earning the admiration of multiple presidents, including George W. Bush, who </span><span style="text-decoration: underline;"><a rel="noopener noreferrer" rel="noopener noreferrer" href="https://irp.nih.gov/about-us/honors/presidential-medal-of-freedom" target="_blank"><span style="background: white none repeat scroll 0% 0%; color: black;">awarded him the Presidential Medal of Freedom</span></a></span><span style="background: white none repeat scroll 0% 0%; color: black;">.</span>”<span style="background: white none repeat scroll 0% 0%; color: black;"> Through the HIV, SARS, MERS, and Ebola crises, Dr. Fauci has led with candor and caution.  </span></p> <p><span>However, in <span style="text-decoration: underline;"><a href="https://www.usatoday.com/story/opinion/todaysdebate/2020/07/14/anthony-fauci-wrong-with-me-peter-navarro-editorials-debates/5439374002/">an opinion piece</a></span> in the same issue<em>, </em></span><span style="background: white none repeat scroll 0% 0%; color: black;">White House trade adviser Peter Navarro</span><span> painted a different view: “</span>Anthony Fauci has been wrong about everything I have interacted with him on.” Navarro went on to describe how Fauci was wrong on masks, travel bans from China, and the benefits of hydroxychloroquine and when it comes to listening to Fauci, he only does so with <span style="background: white none repeat scroll 0% 0%; color: black;">“with skepticism and caution.”</span> Also, Dan Scavino, the administration’s deputy chief of staff for communications, <span style="text-decoration: underline;"><a href="https://www.nytimes.com/2020/07/14/us/politics/fauci-scavino-cartoon-white-house.html">posted a cartoon</a></span> lampooning Fauci as an economy-destroyer. In the caption of the post, he wrote, “Sorry, Dr. Faucet! At least you know if I’m going to disagree with a colleague, such as yourself, it’s done publicly — and not cowardly, behind journalists with leaks. See you tomorrow!” Fortunately, others have come to Dr. Fauci’s defense.</p> <p>The Association of American Medical Colleges (AAMC) issued the following <span style="text-decoration: underline;"><a href="https://www.aamc.org/news-insights/press-releases/aamc-statement-support-anthony-fauci-md"><span style="text-decoration: none;">statement:</span></a></span></p> <p style="margin-left: 0.5in;">“The AAMC is extremely concerned and alarmed by efforts to discredit Anthony Fauci, M.D., our nation’s top infectious disease expert. Dr. Fauci has been an independent and outspoken voice for truth as the nation has struggled to fight the coronavirus pandemic. As we are seeing from the surge in COVID-19 cases in areas that have reopened, science and facts — not wishful thinking or politics — must guide America’s response to this pandemic. … a successful response depends on Dr. Fauci, his colleagues, and scientists throughout America’s system of medical research who are able to draw conclusions based on current observations and continuously adjust those conclusions based on continuing observations. Science is, and must be, a dynamic and evolving process.”</p> <p style="background: white none repeat scroll 0% 0%;"><span style="color: black;">And on behalf of the Infectious Disease Society of America, <a href="https://www.idsociety.org/news--publications-new/articles/2020/isda-statement-in-support-of-anthony-fauci-m.d.-fidsa/">President Thomas File wrote</a>: </span></p> <p style="background: white none repeat scroll 0% 0%; margin-left: 0.5in;"><span style="color: black;">“As 12,000 medical doctors, research scientists, and public health experts on the front lines of COVID-19, the infectious diseases community will not be silenced nor sidelined amidst a global pandemic. Reports of a campaign to discredit and diminish the role of Dr. Fauci at this perilous moment are disturbing. … This is a full-blown crisis unlike any America has ever faced and it needs to be treated as such. The only way out of this pandemic is by following the science, and developing evidence-based prevention practices and treatment protocols as new scientifically rigorous data become available. Knowledge changes over time. That is to be expected. If we have any hope of ending this crisis, all of America must support public health experts, including Dr. Fauci, and stand with science.”</span></p> <p style="background: white none repeat scroll 0% 0%; margin-top: 4.5pt;"><span style="color: black;">As scientists, we are used to being critiqued on our work. Of course, we are upset when receiving inappropriate reviews of our grant submissions or uninformed comments on our submitted papers. This current atmosphere on a national level feels much different. There are efforts to dismiss the field of science and discount sound public health practices. More disturbing is a concerted effort to disparage the messengers. Despite the advances in science, technology, and communications, we are reminded that there still remain people who persecute others that share what are inconvenient truths. It is our duty to be resilient in defense of our vocation but also admit when we are wrong, or as Socrates said, “True wisdom comes to each of us when we realize how little we understand about life, ourselves, and the world around us.”  </span></p> <p style="background: white none repeat scroll 0% 0%; margin-top: 4.5pt;"><strong><span style="color: black;">Be Safe!</span></strong></p> <p>Sincerely,</p>   <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/pat-signature.png?rev=2537331fd33e4b699d394e3b50197dfb&hash=B52AF1A92CFBF5E76BCACD5F2C40E51D" style=" height:39px; width:70px" alt="Signature of author" /> <p><a href="https://cancer.iu.edu/about/leadership/executive/loehrer.shtml">Patrick J. Loehrer, Sr., M.D.</a><br /> Distinguished Professor<br /> Associate Dean for Cancer Research<br /> Director, Indiana University Melvin and Bren Simon Comprehensive Cancer Center<br /> H.H. Gregg Professor of Oncology Professor of Medicine<br /> Indiana University School of Medicine </p> <p> </p> <style> <!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-536870145 1107305727 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman",serif; mso-fareast-font-family:"Times New Roman";} a:visited, span.MsoHyperlinkFollowed {mso-style-noshow:yes; mso-style-priority:99; color:#954F72; mso-themecolor:followedhyperlink; text-decoration:underline; text-underline:single;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-family:"Calibri",sans-serif; mso-ascii-font-family:Calibri; mso-ascii-theme-font:minor-latin; mso-fareast-font-family:Calibri; mso-fareast-theme-font:minor-latin; mso-hansi-font-family:Calibri; mso-hansi-theme-font:minor-latin; mso-bidi-font-family:"Times New Roman"; mso-bidi-theme-font:minor-bidi;}size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.WordSection1 {page:WordSection1;} </style>Fri, 24 Jul 2020 00:00:00 Z{A95C25BA-4738-4739-91CA-6EA6209E2AF4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/your-behavior-your-health-our-pandemicYour Behavior, Your Health, Our Pandemic<p>The recent COVID19 surge has triggered widespread discussion about what went wrong, who’s to blame, and what lessons we can draw about re-opening society and schools. As a bioethicist and general egghead, I am happy to talk about all these things. </p> <p>But I am writing to say that whatever you think about these issues, what really matters is what you do. In the end, what you do largely determines your health. And what the people around you do largely determines public health. </p> <p>It’s a basic truth of medicine that our health is related to what we do. Are you wearing a mask when you’re in public? Staying 6 feet away from friends when you see them? Disinfecting hands with soap or sanitizer regularly? If yes, then you will likely not get COVID19. </p> <p>No guarantees, of course. You might do everything right and still get sick, for sure. But your chance is low. </p> <p>Many people have high risk due to things they can’t change about their work (checkout clerk, daycare teacher, healthcare worker) or living situation. A tragic part of this virus is that some are forced into high risk behavior, and many are getting sick and dying because of it. It’s the grimmest reminder of the link between behavior and illness. </p> <p>Admittedly, your behavior <em>largely</em> determines your health, not<em> absolutely</em> determines it, as always in life. People at low risk, who do everything right, can get sick, and people who take all the risks in the world may stay healthy. That’s luck. But you determine how much luck you need. “The harder I work, the luckier I get,” the film producer Samuel Goldwyn said (supposedly). The more consistently we wear a mask, wash our hands, and physically distance, the less lucky we need to be. </p> <p>If you get COVID19, the risk of getting very sick or dying is higher for some people than for others. Some of the recent surge has come from young people who don’t wear masks or physically distance the way they should due at least in part to feeling invulnerable. </p> <p>This is unfortunate, for so many reasons. First, COVID19 causes severe illness and even death in at least some people with low risk. And, second, wearing masks, washing hands, and physically distancing are done to protect those around us, who might have higher risk, as much as it is for ourselves. </p> <p>Of course, there’s nothing new in saying that behavior largely determines health. What mostly determines if you get lung cancer? Basically, whether you smoke. Yes, yes, we all know someone who smoked till they were 90 and never got sick. And I had a friend who died of lung cancer even though he never smoked a day of his life (it was the rare type that isn’t linked to smoking). But your chance of getting lung cancer is (something like) 1% if you never smoked and 10-15% if you’re a smoker. </p> <p>What largely determines if you get gonorrhea, or chlamydia, or HIV? Again, your behavior: who you are having sex with, in what ways, and if you are using condoms. </p> <p>Does this mean that sick people are to blame for getting sick, if they did something that raised their risk? Well, it’s not simple, in the yes and no kind of way. There’s some responsibility, sure: As we I tell my kids, you can make good or bad choices, and you have to take responsibility for them. </p> <p>But this responsibility also has limits. Doing the right thing – what’s best for our health – requires personal traits of insight and resilience, and relies on social and economic resources. We often don’t have those traits or resources, at least at a moment, through no fault of our own. </p> <p>My patients who work two jobs and are poor are usually not going to exercise regularly. My patients with extreme anxiety and PTSD from their childhood trauma are usually going to keep smoking. Genetics and family history make drug addiction more or less common. </p> <p>Let’s put it this way: The responsibility that individuals bear for their bad health doesn’t mean that they don’t deserve sympathy and healthcare. A person with lung cancer from smoking, or heart disease from obesity and lack of exercise, deserves affordable health care and empathy as much as anybody else. Acknowledging personal responsibility does not mean assigning blame in some mean way. </p> <p>The bigger picture is that individual behaviors that determine individual health and illness eventually result in public health, or illness. Public health is just individual health times thousands and millions. Smoking and having unsafe sex gets individuals sick, which becomes an epidemic of lung cancer and sexually transmitted infections. Millions of individuals with opioid addictions add up to an opioid epidemic. </p> <p>It’s sort of like voting. You think your vote doesn’t count? Well, a winning candidate has only a whole bunch of single votes. </p> <p>In medicine, we sometimes pretend there’s a sharp distinction between individual healthcare and public health. Clinics and doctor’s offices take care of individuals, and the public health department takes care of the population. </p> <p>But, of course, the split is not so clear. Much of public health involves convincing people to do the right things for their health. And improved treatment of individuals, making them healthier one at a time, adds up to a whole population with better health. </p> <p>And doing the right thing – wearing a mask, washing your hands, and physically distancing – is the ticket to being able to go out, see friends, and play (certain) sports, without getting sick or causing a spike that kills people, overwhelms hospitals, and shuts everything down again. </p> <p>What matters is not whether the government imposes a rule requiring masks, it’s whether you wear the mask, whether or not there is a law that you should do so. </p> <p>We should not pretend this is easy. Masks, physical distancing, and cleaning our hands obsessively are new and a bit weird. Changing our own behavior is hard. Masks are sweaty, they make breathing uncomfortable (though oxygen levels are unaffected), they make us look weird and feel rude at times. Also, it’s hard to always have to remember a mask and a small bottle of hand sanitizer when you leave the house. </p> <p>Like with so many health behaviors, these will only become standard when they become a habit, something we do without thinking. Until they are habits, we have to work to remember to do them. But know that these can become habits, and can become regular. When they’re regular parts of our lives, they will be easier. </p> <p>We know what we have to do. We can do this. You can do this. We have to. </p> <p>Walk the walk. Wear the mask. </p> <p>Need more encouragement? Check out the <a href="/sitecore/content/iu/iu-som/home/blogs/bioethics/your-behavior-your-health-our-pandemic">#MaskUpHoosiers </a>campaign</p>Fri, 17 Jul 2020 00:00:00 Z{D8BF9F3A-8EFD-4C78-B1C1-E14ADA855059}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/scientists-collaborate-to-develop-a-test-to-detect-kidney-cancerIU physicians, Purdue scientists collaborate to develop a test to detect kidney cancer<p>Cancer physicians at Indiana University and scientists at Purdue University are working to develop a urine test that would enable patients to avoid an invasive, painful biopsy to detect a type of kidney cancer. </p> <p><a href="/faculty/20805/boris-ronald">Ronald S. Boris</a>, MD, a physician with the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>, treats people with various types of renal cell carcinoma, which are kidney tumors and cancers. During a two-year stint at the National Institutes of Health, he focused on hereditary kidney cancer. </p> <p>Boris, who specializes in urologic oncology surgery, wondered if a simple test—such as a urine test—could be developed that would help him and other physicians create personalized treatment plans for patients with renal tumors. </p> <p>“Could we create a test, whether it would be a urine-based test or a serum-based test, to characterize renal tumors in patients who have an isolated renal mass?” he wondered. “Instead of doing a biopsy, could we have a patient come into the office with a urine specimen, test the specimen to determine whether it’s a clear cell cancer, a papillary tumor, a low-risk tumor or a high-risk tumor that would spread in five years or 10 years?” </p> <p>Such a test would enable physicians to offer unique treatment plans for individual patients. It’s something that’s already done for patients with prostate cancer. Why couldn’t it be done for kidney cancer? </p> <p>Boris’ question could best be answered by a basic scientist, someone who devotes his or her time in a research laboratory. </p> <p>His quest led him to W. Andy Tao, PhD, of the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.purdue.edu/cancer-research/" target="_blank">Purdue Center for Cancer Research</a>. Tao, a biochemistry professor in the Purdue College of Agriculture, previously discovered a method to detect and monitor breast cancer using a simple blood test and bladder cancer using a urine test.</p> <p>Tao suggested that analyzing the proteome, or group of proteins, in urine extracellular vesicles (EVs) might help them to classify renal tumors by their aggressiveness and subtypes. Analyzing proteomes can help researchers identify cancer biomarkers. </p> <p>According to Tao, “EVs are particles naturally secreted from all types of cells. They carry important markers of the cell-like proteins, DNA and RNA cargo, and lipids, and have functions that include intercellular communication which contribute to the pathogenesis of several diseases. I like to call them the ‘Ubers’ of the cell, which transport relevant targets into other cells, and therefore, influence processes in the recipient cell.”</p> <p>They tested the idea thanks to a $40,000 grant from Indianapolis-based <a href="https://www.walther.org/">Walther Cancer Foundation Inc. </a>as part of the Walther Embedding Program. The preliminary funding led them to study about 10 tumors with different renal subtypes. Boris, associate professor of clinical urology at IU School of Medicine, said by testing and applying the EV pipeline to isolate and analyze the proteins from the vesicles in human urine, they were able to identify the subtypes of renal cell carcinoma. </p> <p>Using tumor tissue data from the National Cancer Institute’s <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://proteomics.cancer.gov/programs/cptac" target="_blank">Clinical Proteomic Tumor Analysis Consortium</a> (CPTAC), the group demonstrated significant overlap with the proteins and phosphoproteins isolated from urine EVs study tumors, suggesting that EVs may represent useful targets to develop a urine-based test for renal cell carcinoma. </p> <p>After earning a second Walther grant of $200,000, the group has been conducting experiments to test their theory using much larger sample sizes across the multiple renal tumor subtypes.</p> <p>“The Walther Cancer Foundation is pleased to see the successful collaboration between physicians and scientists at IU and Purdue as a part of the Walther Cancer Foundation Embedding Program,” Thomas W. Grein, president and CEO of the Walther Cancer Foundation, said. “The complementary talents of Drs. Boris and Tao are combining to improve patient outcomes. This is the primary goal of the program.” </p> <p>Boris plans to apply for additional grants to continue this study with the goal of offering patients more effective diagnostic testing instead of invasive biopsies and CAT scans that are currently offered. The current diagnostic tests are typically done only after a person is experiencing symptoms, a sign that the disease has already progressed. Down the road, the IU-Purdue work might lead to improved detection, diagnosis and treatment. </p> <p><strong>IU’s Boris goes to Purdue, Purdue scientists go to IU</strong></p> <p>The duo didn’t reach their findings while working separately. Boris spent time in the Tao lab, gaining hands-on experience studying proteins. Meanwhile, graduate students in Tao’s lab at Purdue—Hillary Andaluz Aguiliar and Marco Hadisurya–traveled to IU in Indianapolis to spend time in the operating room with Boris. While there, the students gained experience using the robotic surgical equipment that Boris specializes in. </p> <p>In addition, the students followed Roberto Pili, MD—a nationally recognized expert in prostate, renal and bladder cancers—in his clinic at IU, offering real-world interactions with patients. Pili, who is now at the University of Buffalo, was the IU principal investigator of this study. </p> <p>“This embedding project creates an environment in which scientists collide with clinicians, leading to an environment in which both groups think how they can best work for the benefit of the patient,” Boris said. “Ultimately, if we can characterize the tumor, its subtype and its metastatic risk, we can then integrate that knowledge into a care plan for the patient. That’s a personalized plan for the patient, which is well beyond what we can offer now.”</p> <p> </p> <p><strong>About the Walther Embedding Program</strong></p> <p>The Walther Cancer Foundation Embedding Program’s goal is to cross-train a cadre of young Indiana University and Purdue University clinicians, physical and computer scientists, and engineers. The program’s focus is on exposing junior clinical and physical scientists and engineers to each other's culture. The goal is to impact their future approach to translational science and improve patient care.</p>Fri, 10 Jul 2020 00:00:00 Z{0EB6B0B4-D436-4B22-8FD1-AAD0695F29A6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/using-virtue-ethics-to-guide-actions-during-a-pandemicUsing Virtue Ethics to Guide Actions During a Pandemic<p><span>Although countries are moving through phased reopening, the SARS-CoV-2 pandemic is not over. How can we avoid deterioration to the moral fabric of our society through social media posts that politicize the crisis and the interventions meant to prevent ongoing transmission? Virtue ethics can help us navigate through the difficult times ahead by focusing actions toward cohesion rather than division. </span></p> <p><span>Social media is a powerful and ubiquitous part of the current political and societal milieu.  Over the past few weeks, I have been noticing more posts about wearing face coverings. Some of these posts are helpful and supportive. Others are not. Several posts contained condemnation of those without a mask or face covering, comparing the non-mask wearers to anti-vaxxers. Comments including hostile back-and-forth posting of fact checking and CDC articles and arguments about scientific truths versus personal opinion dominate the screen. </span></p> <p><span>Wearing some form of face covering will be our new normal for the foreseeable future. We should all be covering our faces </span><a rel="noopener noreferrer" href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html" target="_blank"><span>when we cannot maintain a safe social distance</span></a><span>,</span><span> such as when going to the grocery store or pharmacy, while using public transportation, or on the streets in densely populated areas.  How we are reacting to this crisis and the interventions meant to fight speaks volumes about troubles in our social cohesion. Amid a pandemic when, as of the date of writing this, over 120,000 and nearing 500,000 deaths have occurred in the US and worldwide respectively due to COVID-19, we must be aware of the costs associated with </span><a rel="noopener noreferrer" href="https://doi.org/10.1076/jmep.27.2.143.2990" target="_blank"><span>politicization</span></a><span>, finger pointing, and </span><a rel="noopener noreferrer" href="http://www.otheringandbelonging.org/the-problem-of-othering/" target="_blank"><em><span>othering</span></em></a><span>. Wearing a face covering is a public health intervention that has been put in place in order to save lives. It should not be connected to any political party, religious belief, or socio-economic status. </span></p> <p><a rel="noopener noreferrer" href="https://www.academia.edu/9482392/Virtue_Ethics" target="_blank"><span>Virtue ethics</span></a><span> is a group of theories that describes how we ought to act. Rather than focusing on the rules we ought to live by, virtue ethics is grounded in the building of a good </span><a rel="noopener noreferrer" href="https://plato.stanford.edu/entries/moral-character/" target="_blank"><span>moral character</span></a><span> based on such things as benevolence, honesty, and justice. All actions that have a foundation in a just and kind character will by virtue be moral actions. In times of stress and danger, we are all challenged to regulate our emotions and respond to those around us through virtuous actions.  Vices, based on injustice, vanity, and insensitivity are often revealed, leading to morally questionable actions. </span></p> <p><span>The divide in this country will only widen if we continue to use tactics built on vices that marginalize and propagate group-based inequalities. When I </span><a rel="noopener noreferrer" href="https://medicine.iu.edu/blogs/bioethics/ethics-of-cdc-cloth-face-covering-recommendations" target="_blank"><span>previously raised concerns</span></a><span> over the morality of the CDC’s recommendations for the public to wear face coverings, it was exactly these kinds of negative consequences that worried me. The lack of transparency and failure of the CDC to effectively implement their public health recommendation has led to widespread misunderstandings of the guidelines and further erosion of trust in our already compromised public health and healthcare systems. </span></p> <p><span>Let me be perfectly clear about where I stand on these issues:</span></p> <ul style="list-style-type: disc;"> <li><strong><span>Wearing Face Coverings:</span></strong><span> Should people wear a cloth face covering when they are in a public setting <em>where social distancing is not possible</em>? <strong>Absolutely, yes.</strong> Unless you suffer from a health condition in which mask wearing is contraindicated, in which case, we are all wearing masks to protect you. </span></li> <li><strong><span>Policing Others:</span></strong><span> Is it the role of average citizens to police one another in wearing face coverings in such a setting? <strong>No.</strong> Unless that is your job (i.e. you are a security guard) you do not know others personal situations. Simply wearing a face covering yourself can deliver a strong social cue for others to follow.</span></li> <li><strong><span>Criticizing on Social Media:</span></strong><span> Will a sharply critical post on social media convince anyone to follow the CDC’s face covering recommendations? <strong>Absolutely not</strong>, and it could conversely lead to greater resistance. </span></li> <li><strong><span>Transformative Social Media:</span></strong><span> Can social media be a transformative force to promote adherence to public health interventions? <strong>Yes,</strong> moral character, and thus actions, are partly based on the social and political environment which we inhabit. A carefully worded, well-researched, and well-cited post could be designed to speak TO people who have yet to be persuaded to wear a mask rather than speaking AGAINST those people.</span></li> </ul> <p><span>When next you go out in a public setting and see the varying levels of compliance to the face covering recommendations, before rushing to post on your preferred social media platform, remember the lessons from virtue ethics. A good moral character only comes with practice, this pandemic and all the social and political fallout is our chance to practice. Acting out of compassion, generosity, and charity, even during these most difficult times, will help us to figure out how to be more virtuous human beings. Rather than judging and othering those not yet following recommendations, try instead to be charitable and understanding. You might be surprised by what you discover, and your individual actions could help, in some small way, to shift the narrative toward greater social cohesion rather than taking part in its dissolution.</span></p>Mon, 29 Jun 2020 00:00:00 Z{231162ED-E828-4A0F-A6DE-F81A33848467}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/roodman-named-an-iu-distinguished-professorNamed an IU Distinguished Professor, Roodman continues storied multiple myeloma research career<p>Progress in multiple myeloma research and improved outcomes for patients is the driving force for physician scientist <a href="/faculty/5147/roodman-g-david">G. David Roodman</a>, MD, PhD. Roodman started researching and treating multiple myeloma, a blood cancer of plasma cells within the bone marrow, in the early 1980s. </p> <p>“The patient is what drives the research,” he said. “It’s very satisfying when something works, but as I tell many of my trainees, research is 90 percent frustration, 10 percent elation, and the high is really high. That’s what keeps you going.” </p> <p>That perseverance and many discoveries along the way led to Roodman being honored earlier this year with IU’s highest academic title as a distinguished professor, an appointment reserved for the university’s most outstanding and renowned scholars and researchers. Roodman’s lab pioneered the development of long-term marrow culture techniques to study differentiation and activity of a bone cell called an osteoclast. </p> <p>Roodman’s research has focused on understanding the mechanisms underlying the bone disease associated with multiple myeloma, which occurs in about 85 percent of patients and causes devastating disease-induced fractures and bone pain and impacts survival. </p> <p>“It’s very hard to see the horrific pain associated with myeloma patients who have problems with bone disease, and trying to do something for them has always inspired me to work harder,” Roodman, a member of the <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://cancer.iu.edu" target="_blank">Indiana University Melvin and Bren Simon Comprehensive Cancer Center</a>, said. </p> <p>Taking that motivation back to the lab, Roodman has been trying to understand what causes the bone destruction process and why doesn’t the bone eventually repair on its own. </p> <p>“I’ve seen how much has happened in the field while taking care of patients and watching them improve because of the stuff we've learned,” he said. “Some of the therapies have been targeted to mechanisms that we helped identify.”</p> <p>Roodman joined IU School of Medicine as director of the Hematology/Oncology Division in the Department of Medicine in 2011. He served in that role until Jan. 1, 2020. </p> <p>Roodman’s research has been funded by more than 30 National Institutes of Health grants and supported by the Veterans Affairs Merit Review program since 1981 for myeloma research. He served as a staff physician at VA hospitals in San Antonio and Pittsburgh before retiring from the Roudebush VA Hospital in Indianapolis last fall. </p> <p>Still, Roodman is not slowing down in the lab. This spring, he was awarded a <a href="/sitecore/content/iu/iu-som/home/news/2020/05/nci-grant-for-multiple-myeloma-bone-disease-therapies">five-year $1.6 million grant</a> from the National Cancer Institute to study ways to build bone and decrease tumor growth in multiple myeloma bone disease. </p> <p>His past honors include being named a fellow by the American Association for the Advancement of Science in 2013 for his “significant contributions to research and education in cancer and bone research.” </p> <p>While Roodman has authored more than 450 peer-reviewed publications and holds six patents, he says he is most proud of the more than 80 trainees he has mentored. </p> <p>“That’s my greatest achievement,” he said. “No one reads your CV after you’re old. It’s only the people you train who continue to do well that make it all worthwhile. It’s great to see them grow into leaders in the field and continue to be superb scientists and, even more importantly, great human beings.”</p>Wed, 17 Jun 2020 00:00:00 Z{AB40C577-6063-4392-B43C-F053237ED04A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/launch-americaLaunch America<p><strong>Written by Sue Samson</strong><br /> <br /> The Kacena lab is quite familiar with launch delays, and so when last week's much-anticipated lift off of two NASA astronauts from Cape Canaveral was scrubbed due to ominous weather conditions, we could relate to the team’s disappointment with having to wait a bit longer before their efforts would speed toward the International Space Station. </p> <p>Prior to the launch attempt, local Indianapolis TV station WTHR caught up with Dr. Kacena and Zack Campbell (Marian medical student and the lab’s space geek) to share their perspectives about the historic SpaceX launch. Even though the mission was suspended, their interview aired on Wednesday evening. Check out the various links below to see how the Kacena lab was, once again, is being covered in the news! </p> <ul> <li><a href="https://www.wthr.com/article/some-hoosiers-paying-specific-attention-spacex-launch">WTHR</a> <br /> <span> </span></li> <li><a href="https://www.facebook.com/AllenCarterWTHR/videos/284001936087994/">Facebook</a><span></span></li> <li><a href="https://inscope.medicine.iu.edu/issues/2020/2020-05-28.html">InScope</a></li> </ul> <div></div>Tue, 02 Jun 2020 00:00:00 Z{D33BCAD5-BF5F-4515-BCA3-74ED673E25EC}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/ethically-violating-a-covid-closureOutlaw Tennis: Ethically Violating a COVID Closure<p>Indiana closed all tennis courts in early April, and although many reopened recently, they remain closed for now in Indianapolis. But here’s a confession: Over the last few weeks, I’ve jumped the fence numerous times at a nearby court to play singles tennis with a friend. Luckily it’s one of those courts with half-height fences along the sides, so it’s not too dangerous a climb for this middle-aged man. And I promise that we stayed 10 feet or more apart at all times. There were few others on the courts, if any, so we never violated the > 6 feet social distancing rule. </p> <p> There was some risk of infection, since we each picked up tennis balls and hit them back and forth, and we could have exchanged the virus that way. I tried to use my left hand to pick up tennis balls and my right hand to wipe sweat off my face. Anyway, the science on risk from contaminated tennis balls is still unsettled. Scientists are working instead on a vaccine or cure, which seems to be an appropriate prioritization. </p> <p> I believe that my violation of the tennis court closure was ethically defensible, even though I admit there are complexities and some open questions. I should say upfront that this is the only social distancing rule that I have violated: I make sure to leave more than 6 feet between me and anybody I encounter on the street, wear a mask to the supermarket, and wash or sanitize my hands incessantly. I am a model pandemic citizen (otherwise). </p> <p> But I felt justified jumping the tennis court fence since I knew I could play safely, without putting the health of myself, my friend, or others, at risk. The explicit reason for closing the tennis courts was that they posed a risk of virus spread, largely since people were not following social-distancing rules, standing too close together, high-fiving, etc. Although I violated the closure, I didn’t cause the dangers that the rule was meant to eliminate. </p> <p> I’ve used this rationalization for breaking rules before. In Philly, as in most other cities, bicycles are banned from sidewalks. But when I was biking back and forth to my grad school classes in West Philly, where there were few pedestrians, I generally rode on the sidewalk. If I saw someone ahead of me, I steered onto the street or pulled onto the grass, and even stopped the bike if necessary to completely defer to their right of way. But if the sidewalks were clear, I zoomed down them, flouting the rules. </p> <p> My rationale there was similar to my current tennis-court rationale: Bikes are relegated to the street to reduce pedestrian danger, and I could protect pedestrians just as well by respectful riding as by avoiding the sidewalks completely. In 6 years of doing this daily, I never hit anyone or even came close. </p> <p> I also reasoned (or rationalized?) that the danger to me, from cars on the street, was much higher than the danger to any pedestrian from my bicycle. Or to put it another way, the overall risk to public health was higher if I rode on the street (big risk to me) than if I rode on the sidewalk (small risk to me and any pedestrians). By breaking the regulation, I was advancing the goals of public health. </p> <p> Let me be clear, I am not trying to justify the behavior of my grad school friends, who swerved though pedestrians at high speed, yelling “No one moves, No one gets hurt.” I was violating the rules ethically, while they were doing so unethically. </p> <p> At the same time, I can see some chinks in my smug ethical armor. Problems arise almost immediately when you say you have good reasons to break ethical rules. I’ll tell my friend that I can’t make our lunch date since I have to work, not the truth that a better offer came along: What’s the point of hurting his feelings? Utilitarians have struggled with these type of cases for centuries. If I fraudulently sign some medical forms, I can help someone immensely, and will harm no one. The fact that this action is unethical even if it maximizes utility shakes the foundations of Act Utilitarianism. </p> <p> Perhaps lying and committing fraud for the greater good differ from my tennis court or bicycle violations since in those cases, there is lying, which is wrong in itself. In contrast, I didn’t lie to anybody when I jumped the fence or biked carefully on the sidewalk. </p> <p> On the other hand, even though my actions weren’t lies, they were violations of laws and regulations that were created by a legitimate authority for a legitimate reason. We may have good justification to break unjust laws, but there is real danger to saying that we can pick and choose which just laws to follow. What’s next, people feeling free to break the speed limit just because there’s nobody around and speeding won’t create the risks that the laws are meant to reduce? </p> <p> Well, although that was meant to be a rhetorical question, there may be an answer: we all speed, and perhaps we do so in part since we feel ethically justified when we can do it safely. </p> <p> What conclusions can we draw from this discussion? First, one should not break the rules with impunity, and one should not expect immunity. Given that I jumped the tennis court fence and biked on the sidewalk, I can’t complain if I get a ticket, and I should pay it. Second, it is ethically essential that I did these things in a way that didn’t hurt anybody. It matters that my crime was victimless. I’m not going to lose sleep over my scofflaw actions in these areas, and I’ll probably do them again. </p> <p> Finally, the key ethical question isn’t really whether to climb the tennis court fence but whether to close the courts in the first place. The government could have hired monitors to enforce social distancing on the courts, rather than just closing them down. This path would be more expensive and complex, but it would have had real benefits: encouraging physical activity, providing needed employment, and minimizing restrictions. </p> <p> By saying this, and defending my outlaw tennis behavior, I am not supporting the fringe groups who deny the need for social distancing rules, advocate a premature end to them, or flout them in dangerous ways. Social distancing is necessary to save lives and keep our health system functioning, and rules and regulations will be necessary until the virus is defeated. Breaking a rule is ethical only if it can be done in a way that supports rational social distancing, not if it puts lives at risk. </p> <p> Every community faces important questions about what to do with beaches, parks, and pools this summer. I say keep them open, if at all possible, and create policies and hire the people needed to keep them safe. Freedom is always difficult, risky, and expensive, especially in a pandemic, but it’s also essential. </p> <p> </p>Tue, 26 May 2020 00:00:00 Z{EF3B322C-801B-4D81-8054-D0BD1184BD3B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/ethics-of-cdc-cloth-face-covering-recommendationsEthics of CDC’s Cloth Face Covering Recommendations<p>The SARS-CoV-2 pandemic is placing limitations on the global supply of medical grade PPE. In a previous <a href="/sitecore/content/iu/iu-som/home/blogs/bioethics/the-ethics-of-coronavirus">blog</a>, I discussed some moral responsibilities of the public during a public health emergency. One of the points, about the appropriate use of face masks by the public, is causing a lot of confusion due to updates the <a rel="noopener noreferrer" href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html" target="_blank">CDC</a> recently made to its recommendations.</p> <p>Current <a rel="noopener noreferrer" href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html" target="_blank">CDC recommendations</a> state the public should wear a “cloth face covering in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies)”.</p> <p> Previous recommendations that asymptomatic people (i.e. the general public) <a rel="noopener noreferrer" href="https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html" target="_blank">should not wear medical masks</a> have not changed. Healthy people should not be using <a rel="noopener noreferrer" href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks" target="_blank">medical masks</a> unless they are caring for a person with (or suspected to have) COVID-19. Symptomatic people, whether diagnosed or not, should be self-isolating to avoid spreading the virus to others. </p> <p> In light of this new recommendation, the aim of this blog is to examine some ethical and practical concerns it raises. </p> <ul> <li> <strong>Rational use of resources</strong>—most importantly, the public <strong>should not be buying N95 or surgical masks</strong>. All medical grade equipment should be directed to those caring for people who are ill. Hospital administrators and medical providers are having to make difficult decisions regarding the <a href="/sitecore/content/iu/iu-som/home/blogs/bioethics/the-ethics-of-allocation">ethical allocation</a> of scare medical resources. It is obvious that when those resources include <a rel="noopener noreferrer" href="https://www.theatlantic.com/health/archive/2020/04/social-distance-ration-doctors-care/609229/" target="_blank">ventilators</a> the decisions made are a matter of life or death. More covert are the implications imposed by limitations on the supply of PPE. Hospitals are forced to consider extreme situations such as <a rel="noopener noreferrer" href="https://www.washingtonpost.com/health/2020/03/25/coronavirus-patients-do-not-resucitate/" target="_blank">universal do-not-resuscitate orders</a> for patients with COVID-19 if there is a lack of PPE to ensure protection of healthcare providers. The misuse of PPE during a pandemic can exacerbate shortages and lead to increases in mortality rates as hospitals are forced to move toward activation of triage protocols as scarcities increase.</li> <li><strong>Justice and equality</strong>—wearing homemade face coverings or handkerchiefs, when entering a grocery store or pharmacy, do not carry the same associations for everyone. Some black men, given prevalent racial stereotypes and profiling present in US society, <a rel="noopener noreferrer" href="https://www.cnn.com/2020/04/07/us/face-masks-ethnicity-coronavirus-cdc-trnd/index.html" target="_blank">have raised concerns</a> about following this recommendation. Combining these concerns with the health disparities that Black Americans already face and the disproportionate rates in which they are <a rel="noopener noreferrer" href="https://www.brookings.edu/blog/fixgov/2020/04/09/why-are-blacks-dying-at-higher-rates-from-covid-19/" target="_blank">dying from COVID-19</a>, represent ethically troublesome implications of the CDC’s recommendation.</li> <li><strong>Education</strong>—improper use of cloth face coverings can lead to increased exposure and/or a false sense of security. I have personally witnessed all of the don’ts, by both customers and grocery/pharmacy personnel, depicted in this NYT article of <a rel="noopener noreferrer" href="https://www.nytimes.com/2020/04/08/well/live/coronavirus-face-mask-mistakes.html?action=click&module=RelatedLinks&pgtype=Article" target="_blank">how NOT to wear a mask</a> during my limited outings to obtain groceries and medications. Failure to properly educate the public could be putting more people at risk who do not understand or do not have access to obtaining appropriate education regarding the donning, doffing, and washing of a cloth face covering.</li> <li><strong>Trust</strong>—implementation of recommendations that seem to counter previous advice, or the advice of other global agencies, without ensuring transparency of the change, erodes the public trust as well as the authority of that agency. Recommendations that do not have the full support of the country’s leaders sends mixed messages to the public, further reducing trust.</li> <li><strong>Wash your hands</strong>— do not let wearing a face covering give you a false sense of security. The best way to prevent the spread of this and other viruses is still proper hand hygiene. The limited protection that public wearing of a cloth face covering provides only works in combination with hand washing and social distancing.</li> </ul> <p> During this unprecedented time, recommendations by government agencies ought to follow strict ethical and practical frameworks. The nation cannot afford the spread of misinformation nor the implementation of ethically questionable recommendations. Erosion of trust, justice, and equality will have a lasting effect on our nation moving forward. </p>Thu, 16 Apr 2020 00:00:00 Z{D84E4822-17F7-41E1-B0B8-08D68AAA3E31}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/isolated-and-closer-than-everIsolated and Closer than Ever: A Lesson from Quarantine<p>Had you asked me five months ago to guess what will soon bring the world together, I may have naively told you that perhaps The Beatles (or who remain of them) are going to set off on a Summer 2020 global reunion tour. Like many, I could not have anticipated that instead of singing along to “Come Together” in the midst of large crowds of fans across the world, we would each be staying home alone, going out only with mouths and noses covered, all the while, too aware of how many feet remain between us and the nearest potential COVID carrier. </p> <p>It has been said before but it is worth saying again- we are in an unprecedented time. Each time we turn to our devices, we are bombarded with notifications of news updates, facts, figures, correspondence, executive orders, and future predictions about the worsening of our already grim state. When we use war analogies and euphemisms like “fighting COVID-19” and “on the frontline,” it is easy to feel like our closest friends and neighbors are one cough or exhalation away from crossing into enemy territory. However, in a mere matter of months when we can again leave our homes without fear, let us remember just how small the world feels right now. </p> <p>Inevitably, increasing our awareness of the true nature of our global human interdependence will also lead to an unprecedented time in bioethics. We currently use a multitude of ethical frameworks for determining the most appropriate steps in the midst of harsh circumstances. We use bioethics and public health ethics to navigate the intricacies of the human condition so that each person has a chance at flourishing. Our legislative, institutional, and personal responses in the coming months will be the guiding light for how we pave the way for future generations of communities to work together, not only in times of tragedy and national emergency, but every day. We now have a unique opportunity to reframe how we understand our obligations to our friends, colleagues, and neighbors. By the time we are able to resume our normal lives, every single person will in one way or another be affected by this pandemic but I know we will weather this intractable time of intensity and unknowns with the support of millions of hardworking, skilled clinicians, amazing technologies that allow us to see and hear our loved ones through our screens, and perhaps we will even “get by with a little help from our friends.” Cue the music.</p>Wed, 08 Apr 2020 00:00:00 Z{90089CC8-308F-422E-942B-6BAD153B27FC}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/the-ethics-of-allocationPart 1: The Ethics of Allocation<p>This blog is the first part in our series on the allocation of healthcare resources. </p> <p>The spread of COVID-19 in the United States has caused many to think more critically about the state of healthcare in the United States. While the topic of healthcare has always been a hot topic, the pandemic has brought a sense of urgency to the issue. The current national guideline of social distancing aims to decrease the distribution curve of this pandemic. Without these precautions, there is a real danger that the spread of the virus will exponentially increase. If the number of infected people increases, then there will be an inevitable strain on the healthcare system. There will not be enough equipment and workforce power to take care of all those in need of medical help. </p> <p>In such situations, difficult choices will have to be made. Some of these choices will be on the allocation of healthcare resources and deciding who will utilize these services and who won’t. This is a form of rationing, which refers to how goods and services are distributed among a population based off certain characteristics. </p> <p>These characteristics can be based on socioeconomics factors, lifestyle, health status, and other personal attributes. Rationing in healthcare may sound harsh, but it happens even in non-catastrophic situations. An example are liver transplants: due to the shortage of these organs, individuals who have a history of alcohol or drug abuse may be denied access. These organs will be prioritized for individuals who have a higher chance of survival in the future. In other words, individuals that will have a better quality of life and a higher quantity of life. Another form of rationing are healthcare systems that cater to specific populations, such as the VHA.</p> <p> The main factors of determining allocation of healthcare resources are centered on measuring the quantity and quality of life of an individual. Quantity of life refers to how long a person is projected to live based on their health status and demographic. Quality of life refers to how valuable their current and remaining life will be. Quantity of life for a population can be objectively measured, there is data on the average life span of individual groups based on race, gender, and socioeconomic status. However, even with this data, it can be difficult for any healthcare professional to estimate how long an individual will live. Determining quality of life is as troublesome, as this is a subjective measure. Without information on how an individual values life, making a judgment on quality of life becomes opinion based. For example, death can be seen for many to be the worst case scenario. However, some individuals may argue that this is not the worst fate – and that not being alive is preferable to being paralyzed or in a coma. </p> <p>However flawed these notions are, quality and quantity of life are the concepts that are used to determine allocation of resources. The next few blogs will discuss the ethics of allocation deeper.</p> <p> </p> <h2>Learn more about the Center for Bioethics.</h2>Wed, 01 Apr 2020 00:00:00 Z{C0EC2DC1-77D8-4CC9-A6E2-19FD81C22DC4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/the-ethics-of-coronavirusThe Ethics of Coronavirus<p>Hundreds of new cases of COVID-19, or coronavirus, are being reported daily as the virus continues to spread to new countries. The virus is currently spreading through the US and the first deaths have been reported in Washington State. COVID-19 has now truly reached global proportions and the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://openwho.org/channels/covid-19" target="_blank">World Health Organization</a> (WHO) is encouraging governments and the public to be prepared. </p> <p>How the world is reacting to this global emergency is raising some serious ethical questions about the responsibilities of the public as well as governments. Fortunately we are living during a time where we have tested and created effective medical and ethical frameworks to guide response to this epidemic.</p> <p>Some public obligations regarding virus containment are: </p> <ul> <li><strong>Wash your hands and get a flu shot</strong> — Read this quick <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.nytimes.com/2020/02/10/upshot/coronavirus-risk-prevention-advice.html" target="_blank">New York Times blog</a>, by IU Center for Bioethics faculty <a href="/faculty/3005/carroll-aaron">Aaron Carroll</a>, laying out the easiest ways that the public can and should act in order to prevent the spread of this and other virus.</li> <li><strong>Be informed, but do not overreact</strong> — The WHO posts <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports/" target="_blank">daily situation reports</a>, compare the numbers for yourself and keep things in perspective. Get answers to your questions from reliable sources. WHO <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.who.int/news-room/q-a-detail/q-a-coronaviruses" target="_blank">Q&A on COVID-19</a> is a good place to start and for state information visit your local state health department’s website. Here in Indiana the Indiana State Department of Health has created a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.in.gov/isdh/28470.htm" target="_blank">COVID-19 page</a> that is updated daily with relevant information. If you listen to podcasts, IU Center for Bioethics faculty Ross Silverman was on <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.podbean.com/media/share/pb-uum29-d19129" target="_blank">The Week in Health Law</a> talking about the legal and public health perspective of this outbreak.</li> <li><strong>Rational use of resources</strong> — Should you wear a mask? The ethical answer is, only when necessary and educate yourself on the <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks" target="_blank">proper use of masks</a>. People with no respiratory symptoms <strong><span style="text-decoration: underline;">should not</span></strong> be wearing medical masks. This overuse of medical equipment leads to shortages for those who really need them, medical professionals and those caring for the sick. The best way to prevent the spread of this virus is to wash your hands frequently and properly. </li> <li><strong>If you are sick, stay home</strong> — social isolation is the best way to stop the spread of this and any virus.</li> </ul> <p>Ethical issues that arise from this type of medical state of emergency are many and governments have an obligation to respond morally. Having an ethical framework ready for such a situation is crucial in order to promote, protect, and provide for the health of all residents in the community.</p> <p>Some government obligations regarding virus containment and treatment are:</p> <ul> <li><strong>Allocation of medical equipment</strong> — during times of emergency, governments have to make difficult decisions about scarce resource allocation. Having an ethical framework in place helps to ensure that it is done responsibly. This <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://scholarworks.iupui.edu/bitstream/handle/1805/1910/pandemicFluPrep_2007.pdf?sequence=1&isAllowed=y" target="_blank">technical advisory document</a>, created by the IU Center for Bioethics and the Fairbanks Center for Medical Ethics, provided an ethical framework for Indiana State Department of Health to build a <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.in.gov/isdh/files/PandemicInfluenzaPlan.pdf" target="_blank">preparation plan</a> for the event of an epidemic.</li> <li><strong><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2020/at-the-gates.jpg?h=528&w=400&rev=7f101c5d76334924a7ab3422993c8745&hash=B8FA0FB199F0127D00B863D582C12747" style="height: 528px; width: 400px;" alt=""Cleanliness" is depicted as a winged goddess with a sword and shield keeping out disease through quarantine. Image reads "Our safety depends upon official vigilance."" class="float-right" />Restriction of individual freedom</strong> — in China and elsewhere, during this outbreak, we have seen <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://twitter.com/AlexJohnLondon/status/1234676253086470145" target="_blank">quarantine restrictions</a> that are not evidence-based in effectiveness and infringe on individual liberty. <em>Cordon sanitaire</em>, the erecting of either virtual or material community-wide barriers restricting travel in and out of a geographical area, should not be used in an attempt to control the spread of disease. They disproportionately affect the most vulnerable members of society and carry heavy social costs such as erosion of public trust.</li> <li><strong>Closing state or international borders</strong> — similar to <em>Cordon sanitaire</em>, this is neither an effective nor ethical reaction from governments to quell the spread of disease. Russia has <a rel="noopener noreferrer" rel="noopener noreferrer" href="http://static.government.ru/media/files/IlvIMwJWpmCS9jzAkrsA4zqxGdAr85DA.pdf" target="_blank">restricted travel</a> between its borders with China since the end of January. These types of restriction increase risks to the most vulnerable and lead to xenophobic discriminatory acts by government and the public at large.</li> <li><strong>Ethnocentric blame of disease spreading</strong> — governments must avoid singling out certain ethnicities or religious groups. This practice has strong ties to countless <a rel="noopener noreferrer" rel="noopener noreferrer" href="https://www.fairobserver.com/region/north_america/coronavirus-outbreak-historical-context-xenophobia-official-denial-trump-administration-covid-19-news-18880/" target="_blank">historical instances of mistreatment</a> and should be avoided at all times. The virus does not care where someone was born, the color of their skin, nor the god(s) they worship.</li> </ul> <p> COVID-19 is presenting the world with a unique opportunity to prove just how far we have come from the mediaeval practices that have been used in the past. Implementation of rational, ethical, and effective measures is the only way forward. So don’t panic or blame, be prepared but don’t overreact, and if all this is just too much I implore you to remember this one thing—wash your hands.</p>Fri, 06 Mar 2020 14:00:00 Z{3ED30676-8203-43E0-BEAD-471F5570B4C0}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/facing-hard-truths-about-the-holocaust-medical-science-and-bioethicsFacing Hard Truths about the Holocaust, Medical Science, and Bioethics<p><i>From Peter H. Schwartz, MD, PhD, Director of the IU Center for Bioethics:</i></p> <p> </p> <p>This weekend and early next week, Dr. Sabine Hildebrandt will lead a series of events as the inaugural lecturer for the <i>Dr. William S. Silvers Holocaust, Genocide, and Contemporary Bioethics Lectureship</i>.   At the various events, Dr. Hildebrandt will describe how anatomists used the bodies of Nazi victims in education and research, committing many serious ethical transgressions. Anatomists even experimented on living prisoners, and two anatomists contributed to the murder of these prisoners.  The Pernkopf Atlas of Human Anatomy, which was produced during this time, was widely respected and used by anatomists and surgeons into the 1990s, when researchers uncovered the use of images of Nazi victims and close ties between the authors and the Nazi regime.</p> <p> </p> <p>Dr. Hildebrandt will describe how historians and anatomists have brought these ethical transgressions and the complicity of anatomists in Nazi Germany to light and, equally importantly, have started to systematically restore the biographies of the victims, so that they are once again known to the world by name.</p> <p> </p> <p>The discussion is painful for every human being to hear, since it reminds us of the existence of extreme human cruelty.  For people in healthcare, it is an especially painful reminder that the high ideals of medicine do immunize against base impulses.  At the time of the Nazi’s, Germany had the world’s leading centers of learning and research in medical science, but physicians and scientists collaborated with the Nazi’s in the Holocaust and other acts and programs that are now almost unthinkable.</p> <p> </p> <p>At the same time, even if it is difficult to hear and think about, this remembrance and reflection on the lowest points of modern medicine are essential for those in medicine now.  We know that we would never do what they did, but their actions and moral failures can lead each of us to recognize ways that we, and all people, can be led astray.  By reflecting on the worst that has happened, we can understand how to do better, and what moral dangers we should avoid in our own lives and professional work.  If we can face the hard truths about what they did, we may achieve a better understanding of our own limitations and possibilities.</p> <p> </p> <p>Such reflection and possible growth are a key goal of the Silvers Lectureship. By leading us to confront the Holocaust and other cases of genocide, the lectureship strives to focus healthcare workers on the morality of their actions and to ground contemporary conflicts in the lessons of history.  The Silvers Lectureship will bring a visiting scholar to campus each year to provide a lecture at IU School of Medicine and lead a community event.</p> <p> </p> <p>Dr. Hildebrandt’s visit is occurring during the International Holocaust Remembrance week, and on Eva Education Day in Indiana, for Eva Kor, a survivor of Dr. Mengele and Auschwitz, and the founder of the CANDLES Holocaust museum.</p> <p> </p> <p>There are multiple events that Dr. Hildebrandt will be leading and that people may wish to attend for Holocaust Remembrance over the next few days:</p> <p> </p> <p><b>Sunday, January 26, 10 AM – 11:30 AM:  </b><b>Community event</b><b>  </b></p> <p><b><i>Nazi Anatomy:  Restoration of the Victims’ Biographies</i></b></p> <p>Dr. Hildebrandt</p> <p>Laikin Auditorium, Jewish Community Center, 6701 Hoover Road</p> <p> </p> <p><b>Monday, January 27, 12 PM – 1 PM:  </b><b>Holocaust Remembrance Ceremony</b></p> <p><b>Campus Center Theatre, 420 University Boulevard</b></p> <p>Dee Schwartz will share her family’s story of survival during and after the Holocaust. Memorial candle lighting by community leaders and IUPUI students, faculty, and staff.  Special performance of music from Brundibar & Vedem, a 4-month project presented by Indianapolis Opera in partnership with the Indianapolis Children’s Choir and local Jewish community organizations, combining two operas related to the Terezin concentration camp, and demonstrating the power of music to save lives.</p> <p> </p> <p><b>Monday, January 27, 7 PM – 8:30 PM:  </b><b>Public Lecture</b></p> <p><b><i>Nazi Anatomy:  Restoration of the Victims’ Biographies</i></b></p> <p><b>Dr. Hildebrandt </b></p> <p><b>Campus Center Theatre, 420 University Boulevard</b></p> <p> </p> <p><b>Tuesday, January 28, 1-2:30 PM:  </b><b>Lecture and Class</b></p> <p><b><i>The Vienna Protocol:  History and Legacies of the Pernkopf Atlas</i></b></p> <p><b>Dr. Hildebrandt</b></p> <p><b>Anatomy D 501, but additional students and members of IUPUI community welcome</b></p> <p><b>R3 (Walther Hall) C203, IU School of Medicine</b></p> <p> </p> <p>Dr. Hildebrandt is Associate Professor of Pediatrics and Lecturer in Global Health and Social Medicine at Harvard Medical School.  She is an anatomy educator and conducts research on the history and ethics of anatomy, specifically the history of anatomy in National Socialist Germany.</p> <p> </p> <p>Dr. Hildebrandt’s visit has been made possible through the support of the Dr. Silvers Lectureship and the hard work and interest of multiple people and groups at the University, including:</p> <ul> <li>Jason Organ, PhD, Assistant Professor of Anatomy, Cell Biology, and Physiology, IUSM,  and Amber Comer, PhD, JD, Assistant Professor at the School of Health and Human Sciences, IUPUI, who are leading a year-long seminar on year-long seminar series on the lasting effects of the Nazi Regime on Medical Research, funded as part of the IU Consortium for the Study of Religion, Ethics, and Society;</li> <li>Jeremy Price, PhD, chair of the Jewish Faculty and Students Council and Assistant Professor of Technology, Innovation and Pedagogy in Urban Education, IUPUI;</li> <li>The IU Center for Bioethics and the Department of Anatomy, Cell Biology, and Physiology, IU School of Medicine</li> </ul> <p> </p> Thu, 23 Jan 2020 20:52:09 Z{B76CA403-4C11-48FF-9DD1-E68669AEA8E6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-mustufa-shaiekMeet the team: Mustufa Shaiek<h4>Written by Mustufa Shaiek</h4> <p>My name is Mustufa Shaikh, and I am 25 years old. I recently graduated from IUPUI in 2017.</p> <p>During my undergraduate program, I studied biology. In that time, I worked in a histology lab studying the molecular and cellular mechanisms of mechanotransduction and pharmaceutical treatments for osteoporosis and bone fractures.</p> <p>Having gained a primary understanding of bone cell biology, I want to further my knowledge in the field. In October, I joined the Kacena Lab.</p> <p>I am looking forward to understanding more of bone research, specifically in orthopaedics.</p> <p>In my free time, I am involved in activities such as indoor rock climbing, fishing and hiking. I also enjoy several genres of music and hope to learn an instrument in the near future.</p> <p>I am excited for the opportunity and hope to learn the many methods and techniques involved in studying bone. I enjoy working in research and strive to strengthen my skill set in the lab. Knowing that I am in a collaborative effort making a positive impact in the world is motivating.</p> Wed, 22 Jan 2020 09:10:10 Z{1F91EB4B-5E92-487A-B4F8-36C90F445C2D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-paulina-medinaMeet the team: Paulina Medina<h4>Written by Paulina Medina</h4> <p>Hello, everyone! My name is Paulina Medina, and I am a junior majoring in Health and Human Sciences with a minor in Biology at Indiana University-Purdue University Indianapolis.</p> <p>Aside from academics, I am involved in the Latino Student Association and Gamma Phi Omega International Sorority at IUPUI in which I enjoy helping and contributing to the Indianapolis community through event programming and volunteering.</p> <p>As a 2018-19 Life Health Sciences Internship Program (LHSI) participant in Dr. Kacena’s lab, I am very excited to learn and conduct medical research for the first time.</p> <p>Orthopedics is something that is of great interest to me, and I will have many opportunities to broaden my knowledge in bones and fractures while working on Dr. Kacena’s studies with the healing response of bone tissue. I am also looking forward to gaining basic research and lab experience while working with professional team members.</p> <p> </p> Fri, 17 Jan 2020 08:06:25 Z{890D83E4-2D8E-4E54-B08C-5505F5407E76}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-stephen-mendenhallMeet the team: Stephen Mendenhall<h4>Written by Stephen Mendenhall</h4> <p>My name is Stephen Mendenhall. I am a fifth-year neurosurgery resident interested in spine surgery.</p> <p>I joined Dr. Kacena’s lab in June 2019 for a year of research that is included in my residency training.</p> <p>During this year I will help test novel drugs to treat fracture related pain and bone regeneration.</p> Tue, 14 Jan 2020 08:03:37 Z{B56821FA-E34E-4FB6-8A98-2D919093B296}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-bianca-osunaMeet the team: Bianca Osuna<h4>Written by Bianca Osuna</h4> <p>My name is Bianca Osuna.</p> <p>I am in my junior year at IUPUI studying neuroscience and psychology and am pursuing a career in the medical field. I am a Life and Health Sciences intern this year in the Kacena Lab and have already learned so much from this experience.</p> <p>I am learning from a diverse lab team, and then I get to apply the information and skills I study in my courses to actual hands-on work in the lab.</p> <p>In the lab I can acquire and refine essential skills, such as pipetting and working with mice. I also get an inside look at how a lab functions and how team members work together daily on different research studies.</p> <p>It has been an exciting and insightful semester so far in the Kacena Lab, and I am looking forward to everything I can learn through this internship.</p> <p> </p> Fri, 10 Jan 2020 19:54:30 Z{3DCA6183-AB91-4D73-B3D1-CDD2FB58156C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/clinical-trial-for-a-rare-cancer-keeps-local-educator-former-athlete-activeClinical trial for a rare cancer keeps local educator, former athlete active<p>Demetrius “Dee” Dowler was 31 years old when he was diagnosed with thymoma, a rare cancer of the thymus gland. There is no good time to be diagnosed with cancer but 2001 was a particularly busy time for Dowler, a time when his life was full with a young family and a new career.</p> <p>Dowler, who graduated from Ben Davis High School and Indiana State University, spent his 20s playing professional baseball. He was drafted out of college by the Chicago Cubs and played for its farm team for five years before joining the Reno Blackjacks, an independent league team that played June, July, and early August. That allowed Dowler to begin his career as a math teacher at Ben Davis High School, his alma mater. That was in 1997. Less than five years later – with a young wife and an 8-year-old daughter – Dowler found himself undergoing the toughest battle of his life.</p> <p>He thought he had bronchitis because he had a cough that wouldn’t go away. His doctor recommended a chest X-ray and that revealed a mass in his chest. He was told to return in a few weeks for a second X-ray, which revealed minimal growth of the mass. His doctor said the tumor would be monitored and if the mass continued to grow, treatment would begin.</p> <p>In March of 2002, his condition had worsened. That became apparent in the classroom. “I was teaching one day and my face started drooping, my eye started drooping and my voice got slurry.” His primary care doctor referred him to a neurologist who diagnosed him with myasthenia gravis – a neuromuscular disorder frequently associated with thymoma.</p> <p>The surgery that followed included splitting his breast bone to remove the mass on his thymus, as well as parts of his lung and the sack encasing his heart, where the cancer had spread. Recovery from the surgery took several months, Dowler said. He also had three months of chemotherapy and radiation, treatments that lasted until the school year began in mid-August.</p> <p>“I remember that I was still undergoing chemotherapy for about the first two weeks of the school year because, in spite of that, I was able to have perfect attendance that year,” Dowler said. A jock at heart, physical workouts were part of his recovery plan and he persisted until he got back in shape.</p> <p>Eleven years passed with routine checkups on his chest that showed no cancer. Then, in 2013, the thymoma returned in the form of a tumor in his stomach. The mass was removed surgically and that’s when Dowler decided he needed to connect with an oncologist who specialized in his disease.</p> <p>“After my second surgery in 2013, it was recommended that I see Dr. Patrick Loehrer because he specializes in thymomas. Since the first time we met, I can tell he loves what he does and that his patients are very important to him,” said Dowler. Loehrer, who is the director of the <a href="http://www.cancer.iu.edu" target="_blank">IU Simon Cancer Center</a>, an IU Distinguished Professor, H.H. Gregg Professor of Oncology, and associate dean for cancer research at IU School of Medicine, is a thymoma expert.</p> <p>“My prognosis was that I still had cancer because the margins (from my second surgery) were not clear. We knew the cancer was going to come back,” Dowler said.</p> <p>In October 2016, there was evidence the cancer had returned. That’s when Loehrer recommended a clinical trial for Dowler.</p> <p>“The trial was based on work done years ago in the laboratory at the IU Simon Cancer Center that demonstrated by blocking a specific molecular pathway thymoma cells died,” Loehrer said. “Unfortunately, no drug was available for human consumption, but we later stumbled upon an agent in early drug development that blocked this STAT3 pathway. This demonstrates the importance of bench to bedside research. Demetrius was enrolled onto the trial, with excellent results.”</p> <p>“From October to February, I participated in the clinical study,” Dowler explained. “I took standard chemotherapy for thymoma and a pill, which was what was being studied to see if it enhanced the standard treatment. I continued working, but that was a challenge. It was tough because I was fatigued and students would come up and ask me if I was okay. I had no facial hair, no eyebrows, no head hair and I’d lost weight.”</p> <p>Since that time, all has been good. He undergoes a CT scan every six months and there is no evidence of the cancer returning.</p> <p>“Dr. Loehrer has a good eye on it,” he said. “I especially would recommend clinical research because you never know if it’s going to be an actual cure for cancer.”</p> <p>Dowler’s little 8-year-old daughter (Hunter) is now 26, and he and his wife (Holly) were blessed with a second child, a son named Jacoby, age 7. Dowler spent 17 years teaching business math, geometry, algebra and pre-calculus at Ben Davis, then he went to Brownsburg High School, where he now is in his fifth year as an assistant principal.</p> Fri, 20 Dec 2019 19:39:53 Z{428A71F2-FF7D-40CD-9821-66A732632386}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/is-your-smart-watch-watching-youIs Your Smart Watch Watching You?<p>The short answer is yes. Recently, The IU Center for Bioethics hosted a<a href="https://www.youtube.com/watch?v=DBbhoMrJ85E" target="_blank"> <strong>talk</strong></a>, given by Dr. Andrew Brightman, discussing the ethics of research involving wearable technologies. Dr. Brightman is a professor of Engineering Practice and Associate Head of the Weldon School of Biomedical Engineering at Purdue University. He spoke about the ethical quandaries often identified concerning wearable technologies. Consumer health wearables like smart watches have the ability to monitor and store data using cameras, GPS, ECG, microphone, thermometer, oximeter, and Bluetooth proximity. These consumer health wearables have the capacity to track and store a phenomenal amount of information about users. Companies producing wearable technologies argue that storing information is necessary for both the research and development of better consumer products and as a key to marketing other products that could be more beneficial to users in the future.</p> <h2><strong><u>Accuracy of Data</u></strong></h2> <p>If no one is wearing his/her smart watch 24/7/365- is it realistic to assume we can rely on the accuracy of the data collected? Moreover, does your watch ever think you are running when you are doing other activities like strumming a guitar or sautéing vegetables?</p> <p>Suppose you take your watch off to charge it. You forget about it and as it happens, your watch stays on the nightstand for the next two days all the while collecting data that could suggest your immobility. If wearable technology companies are collecting this data, who- if anyone- is responsible for interpreting it? Will they think you must have forgotten about your charging watch? Or should they be concerned that you have fallen and can’t get up? Or maybe that you have depression and are unable to get out of bed? With <a href="https://www.statista.com/topics/1556/wearable-technology/" target="_blank"><strong>526 million</strong></a> connected wearable devices worldwide, what obligation do the non-researchers from technology companies have when it comes to caring about and protecting you, the consumer?</p> <h2><strong><u>Moral Obligation</u></strong></h2> <p>Embedded in clothing and technology, health wearables provide a unique opportunity to collect data on patient health and explore early indicators for disease. Do we have a moral obligation to intervene and share data with consumers whose information is being collected and could prove useful to them and their physicians? If not, what deontological considerations must take place to ensure that third-party organizations like health insurance companies do not begin discriminating based on this kind of data? Considering the implications for the return of results by an untrained non-researcher whose collected data comes from devices not designed for research, it’s important that companies who claim to value, promote, and monitor health and wellness should do so accurately and effectively. If any company finds themselves qualified to track and store sensitive patient information, they also have an obligation to responsibly return that data to their individual consumers.</p> Mon, 18 Nov 2019 19:22:48 Z{A53108FB-61C6-460B-9C7B-AB172EC7BE3C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/moral-obligation-of-immunizations-in-pregnancy-and-beyondMoral Obligation of Immunizations in Pregnancy and Beyond<p>I would like to begin this post with a few statistics from the CDC:</p> <p><strong>Statistic #1</strong></p> <p>Pregnant women are <strong>twice as likely</strong> to be hospitalized if they contract <em>influenza</em>.</p> <p><strong>Statistic #2</strong></p> <p><strong>69%</strong> of reported <em>whooping cough deaths</em> occur in babies less than 2 month old.</p> <p><strong>Statistic #3</strong></p> <p>Only <strong>1 in 3</strong> pregnant women receive the recommended <em>influenza </em>(flu) and<em> whooping cough vaccines</em> (Tdap)</p> <p><strong><u>Ethical Dilemma</u></strong></p> <p>These are alarming statistics and they raise some interesting ethical questions. Questions such as: Do pregnant women have a <em>moral obligation</em> to get immunizations during pregnancy in order to protect the health of their unborn child? Does this obligation extend to the general public?</p> <p><strong><u>Whooping Cough</u></strong></p> <p>Since 2013, <a href="https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Update-on-Immunization-and-Pregnancy-Tetanus-Diphtheria-and-Pertussis-Vaccination" target="_blank">ACOG</a> has recommended all pregnant women receive the Tdap vaccine between 27 and 36 weeks gestation in order to maximize the maternal antibody response. These antibodies are then transmitted to the fetus and protect the newborn from acquiring pertussis, which causes whooping cough, until they are able to be vaccinated themselves after 2 months of age.</p> <p><strong><u>Influenza</u></strong></p> <p>A <a href="https://academic.oup.com/cid/article/68/9/1444/5126390" target="_blank">recent study</a> indicates that pregnant women who receive an influenza vaccine are 40% less likely to be hospitalized for influenza associated complications during pregnancy. In the same manner as the Tdap vaccine, maternal antibodies against influenza are passed to the fetus, resulting in protection from adverse peri- and neonatal outcomes. Infants cannot be vaccinated against influenza until the age of 6 months.</p> <p>Newborns, whose mothers were not vaccinated during pregnancy, become infected through contact with unvaccinated siblings, parents, and caregivers.</p> <p><strong><u>Moral Obligation</u></strong></p> <p>Given this information and those startling statistics, it seems clear to me that any adult who will be in close contact with infants and who is physically able, <u>ought</u> to receive these vaccines. The ethical question is, does this <u>ought </u>constitute a <em>moral obligation</em>?</p> <p>Has a pregnant women committed an <em>ethical wrongdoing</em> by refusing to receive vaccinations? We say that a person has a moral obligation to act in certain ways due to a relationship or agreement with another. In this case, a parent has a legal as well as moral obligation to protect the health and well-being of their child. In other circumstances, the state is legally supported by this obligation, to intervene when children are in unsafe or unhealthy situations.</p> <p>Beyond the obligation of the mother, the infant also has a <em>positive right</em> to be protected. This is where I believe we can find the answer to our <em><u>ethical dilemma</u></em>. In order for the <em>positive rights</em> of the infant to be fulfilled, something must be done for them or provided to them. Generally speaking, the obligation to provide for the positive rights of the infant falls to the parent(s).</p> <p>If parents fails to provide a safe environment for their children, it seems natural to say that they have done something morally (and legally) unacceptable. This is illustrated when states step in and remove children who are deemed to have been harmed by a parental lack of actions to protect them.</p> <p><strong><u>Conclusions</u></strong></p> <p>Similarly, I believe, a pregnant women commits an ethical wrong, when she fail to receive these immunizations that provide protective antibodies and aid in the prevention of life threatening infection in the infant.</p> <p>The question of this obligation extending to the general public is a bit more difficult to construct such a clear argument for. Although, as a society, we have some level of agreement of moral obligations between individuals, these typically fall in the realm of negative obligations, meaning that we do not interfere with others. I suppose, if I had more time and many pages, I could argue that an unvaccinated person who is infected with influenza or pertussis, has some sort of moral obligation to protect infants who cannot themselves be vaccinated. However, I am afraid that this would be weak argument.</p> <p>I prefer to conclude that rather than a <em>moral obligation</em>, healthy adults and children <u>ought</u> to receive vaccines, in order to build the herd immunity and to protect those too young or vulnerable to be vaccinated themselves.</p> <p> </p> <p><a name="_ftn1"></a><a href="#_ftnref1">[1]</a> All statistics from the CDC found at  https://www.cdc.gov/vitalsigns/maternal-vaccines/index.html photo from the CDC at https://www.cdc.gov/flu/highrisk/pregnant.htm</p> <p> </p> Wed, 13 Nov 2019 18:59:07 Z{6AC5E900-7169-4217-B06F-58E4AF785E83}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/15th-anniversary-of-miles-for-myeloma15th Anniversary of Miles for Myeloma<p>Forty-eight cyclists hit the road in October for the annual <a rel="noopener noreferrer" rel="noopener noreferrer" title="Miles for Myeloma" href="https://www.facebook.com/miles4myoma/" data-linkto="https://" data-cke-saved-href="https://www.facebook.com/miles4myoma/" target="_blank">Miles for Myeloma</a> ride. <a title="Rafat Abonour, MD," href="/faculty/4996/abonour-rafat" data-linkto="https://" data-cke-saved-href="https://medicine.iu.edu/faculty/4996/abonour-rafat">Rafat Abonour, MD,</a> leader of the <a rel="noopener noreferrer" rel="noopener noreferrer" title="PHI multiple myeloma disease research team" href="https://precisionhealth.iu.edu/areas-of-focus/disease-research-teams%20/multiple-myeloma%20.html" data-linkto="https://" data-cke-saved-href="https://precisionhealth.iu.edu/areas-of-focus/disease-research-teams%20/multiple-myeloma%20.html" target="_blank">Precision Health Initiative multiple myeloma disease research team</a>, first organized this event back in 2005 and has participated each year. Kendallville Mayor SuzAnne Handshoe proclaimed October 11 as “Miles for Myeloma 15th Anniversary Day” and gave Abonour a key to the city.</p> <p>Even though the weather conditions weren’t ideal for this year’s ride, there were 14 volunteers along the route, providing snacks and water for the cyclists. The two-day event gives patients and their loved ones a chance to raise awareness about the blood cancer and raise money for research about the rare disease. So far in 2019, the team has raised $378,702.95. <a rel="noopener noreferrer" rel="noopener noreferrer" title="Anyone can still donate through December 31, 2019." href="https://iufoundation.fundly.com/miles-for-myeloma-15th-anniversary" data-linkto="https://" data-cke-saved-href="https://iufoundation.fundly.com/miles-for-myeloma-15th-anniversary" target="_blank">Anyone can still donate through December 31, 2019.</a></p> <style type="text/css"> #gallery-1 { margin: auto; } #gallery-1 .gallery-item { float: left; margin-top: 10px; text-align: center; width: 50%; } #gallery-1 img { border: 2px solid #cfcfcf; } #gallery-1 .gallery-caption { margin-left: 0; } /* see gallery_shortcode() in wp-includes/media.php */ </style> <div id="gallery-1" class="gallery galleryid-13832 gallery-columns-2 gallery-size-vertical_large"> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="200" src="-/media/blogs/2019/miles-for-myeloma-7-300x200.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma supporters" aria-describedby="gallery-1-13839" srcset="-/media/blogs/2019/miles-for-myeloma-7.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-7-200x133.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-7-160x107.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13839"> Miles for Myeloma supporters </dd> </dl> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="183" src="-/media/blogs/2019/miles-for-myeloma-6-300x183.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma cyclists" aria-describedby="gallery-1-13838" srcset="-/media/blogs/2019/miles-for-myeloma-6.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-6-200x122.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-6-160x98.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13838"> Abonour giving speech before ride starts </dd> </dl> <br /> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="159" src="-/media/blogs/2019/miles-for-myeloma-1-300x159.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma cyclists" aria-describedby="gallery-1-13827" srcset="-/media/blogs/2019/miles-for-myeloma-1.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-1-200x106.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-1-160x85.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13827"> Miles for Myeloma cyclists </dd> </dl> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="200" src="-/media/blogs/2019/miles-for-myeloma-4-300x200.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma supporters" aria-describedby="gallery-1-13830" srcset="-/media/blogs/2019/miles-for-myeloma-4.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-4-200x133.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-4-160x107.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13830"> Miles for Myeloma supporters </dd> </dl> <br /> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="200" src="-/media/blogs/2019/miles-for-myeloma-5-300x200.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma witih Dr. Abonour" aria-describedby="gallery-1-13831" srcset="-/media/blogs/2019/miles-for-myeloma-5.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-5-200x133.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-5-160x107.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13831"> Kendallville mayor gave Abonour key to city </dd> </dl> <dl class="gallery-item"> <dt class="gallery-icon landscape"> <img width="300" height="177" src="-/media/blogs/2019/miles-for-myeloma-3-300x177.jpg" class="attachment-vertical_large size-vertical_large" alt="Miles For Myeloma cyclists" aria-describedby="gallery-1-13829" srcset="-/media/blogs/2019/miles-for-myeloma-3.jpg 300w, /-/media/blogs/2019/miles-for-myeloma-3-200x118.jpg 200w, /-/media/project/iu/blogs/2019/miles-for-myeloma-3-160x94.jpg 160w" sizes="(max-width: 300px) 100vw, 300px" /> </dt> <dd class="wp-caption-text gallery-caption" id="gallery-1-13829"> Miles for Myeloma cyclists </dd> </dl> </div> <p>The fundraising team also announced a generous $1,000,000 gift at the Miles for Myeloma dinner from a family affected by the disease, with $500,000 designated for myeloma research and another $500,000 set aside specifically for general cancer research. Since 2005, Miles for Myeloma has raised more than $5 million for research and patient care at IU.</p>Thu, 07 Nov 2019 12:47:49 Z{9BAD5B97-9E4C-44E5-9C9D-2A6BA264D58C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-hanisha-bettinaMeet the team: Hanisha Bettina<p><em>Written by Hanisha Bettina</em></p> <p>My name is Hanisha Battina and I am a sophomore at IUPUI this academic year. I am currently on the pre-medical track as a double major in biology and neuroscience along with a chemistry minor. Additionally, I am a Plater International Scholar in the IUPUI Honors College. In the future, I aspire to go to medical school and enter the medical field as a physician.</p> <p>I have joined Dr. Kacena’s lab through the Life-Health Sciences Internship (LHSI) program and this is my first time working in a research laboratory. My prior laboratory experience comes from biology and chemistry laboratory procedures and experiments carried out in an academic setting. My work in Dr. Kacena’s lab is to study bone healing in Type-II Diabetes. I am looking forward to learning from this experience and growing as a professional.</p> <p>Outside of school, I have always been passionate about music, specifically the clarinet. I have been playing the clarinet for nearly 10 years now and have served as the principal clarinetist throughout my high school career. I am also very passionate about helping others, which has driven me to serve as the Benefit Concert Chair for Jagathon this year along with volunteering at the IU Health North Hospital.</p> Wed, 06 Nov 2019 20:56:00 Z{6EEDC26C-D414-4A2B-B461-54BFEE954C68}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/iu-researcher-talks-about-close-ties-to-nobel-winnerIU researcher talks about close ties to Nobel winner<p>Indiana University School of Medicine’s <a href="/faculty/5103/ivan-mircea">Mircea Ivan</a>, MD, PhD, has a strong connection to this year’s winner of the Nobel Prize in Medicine, Dr. William Kaelin Jr. of Harvard University and Dana-Farber Cancer Institute. Dr. Ivan was a postdoctoral fellow and subsequently an instructor in Dr. Kaelin’s lab between 1998 and 2002 and first-authored the original studies on cellular oxygen sensors. Dr. Ivan’s group focuses on molecular responses to hypoxia based on noncoding RNAs and their relevance to biology. Importantly, it was Ivan’s lab in 2007 (then at Tufts Medical Center in Boston) that reported the first connection between oxygen sensing and microRNAs. We asked Dr. Ivan to answer some questions about his groundbreaking work with Dr. Kaelin and the ongoing research of his group.</p> <p><strong>Q: First off, congratulations because you’re the first author of the <a href="https://science.sciencemag.org/content/292/5516/464" target="_blank">Science journal article</a> featured as the key publication for which Dr. Kaelin was awarded the Nobel Prize. That has to be thrilling, yes?</strong></p> <p>A: Naturally, I was both elated and overwhelmed by the news. Although, if I were to be entirely rational, I should not have been very surprised as multiple predictors were already in place. For example, the original papers listed on the Nobel site as essential for this year’s awards have been cited thousands of times. Second, our medical students can already find HIF prolyl hydroxylases (HIF-PH) mentioned in their textbooks, such as Guyton’s Physiology and Harrison’s Internal Medicine. Furthermore, the trio of Kaelin, Semenza, and Ratcliffe had already collected multiple “pre Nobel awards,” such as the Lasker (2016) and the Gairdner of Canada (2010). Perhaps most significantly from a clinical standpoint, these discoveries led to important therapeutic applications.</p> <p><strong>Q: What is that research about?</strong></p> <p>In an editorial accompanying our 2001 article, Dr. Franklin Bunn emphasized that an answer to the question “How do cells sense O<sub>2</sub>?” had been sought for many decades. In short, as a postdoctoral fellow in Dr. Kaelin’s laboratory, I identified the mechanism utilized by all animal cells to “monitor” O<sub>2</sub> abundance in their surroundings. Given the central role of O<sub>2</sub> for life, it is hardly surprising that the discovery had deep implications for many basic research areas. Furthermore, during the past 18 years or so, these oxygen sensors have attracted considerable interest from a drug development angle. In 2002, I was also the first author of an article published in the journal PNAS describing molecules that bind these oxygen sensors, providing early proof-of-concept for a new class of drugs that are reaching clinical use.</p> <p><strong>Q: You and Dr. Kaelin also hold some patents together. What can you tell us about those patents?</strong></p> <p>A: Yes, we hold multiple patents together. One patent played an important role for the development of a new class of drugs termed HIF-PH inhibitors (HIF-PHI). In simple terms, by blocking the O<sub>2</sub>-sensing machinery, these molecules “turn on” genes that are typically silent in nomoxic cells. Among the 200 or so “hypoxic<em>”</em> genes, erythropoietin turns out to be particularly responsive to HIF-PHI <em>in vivo</em>, a connection with major clinical implications. The first-in-class oral agent from this class, Roxadustat (Fibrogen/AZ), was recently approved for the treatment of chronic kidney disease-associated anemia in Japan and China, with the United States and Europe anticipated in the near future. Additional inhibitors are not far behind. Based on the available literature, future clinical applications for these compounds may include chronic inflammatory disorders or ischemic conditions.</p> <p><strong>Q: How did your experience working with Dr. Kaelin influence you professionally?</strong></p> <p>A: I would compare my years at Dana-Farber to drinking water from a high-pressure hose. The discussions were intense and rigorous, during lab meetings and ad hoc. One had little choice but to become very fast and an independent thinker. During those “pre-Photoshop days,” we’d sit in front of a freshly developed blot and dissect it to the smallest details. Everything on the film had the potential to be meaningful, from subtle mobility shifts to unexpected band patterns. Bill (Kaelin) used to say, “One can never have too many controls,” which summarized the MO of his group and stayed with me ever since. I also recall the frequent interactions with young colleagues from neighboring labs, such as late afternoon brainstorming sessions around a cup of coffee with a brilliant hem-onc fellow, Ned Sharpless, the current acting commissioner of the FDA and former director of the National Cancer Institute.</p> <p><strong>Q: What research are you working on right now?</strong></p> <p>A: After becoming an independent investigator, I remained attached to the fascinating field of O<sub>2</sub> sensing, but my group developed its own niche and one of our papers has been cited almost 1,000 times. Our ongoing work focuses on molecules that are not only relevant for O<sub>2</sub>-related research, but has unexpected relevance for steroid hormone biology and inflammation studies.</p> <p> </p> Fri, 01 Nov 2019 15:57:02 Z{2807D3E1-A921-43D3-920C-AD6592043FE3}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/in-my-eyes-ushashi-dadwalIn my eyes: Ushashi Dadwal<p><em>Written by Ushashi Dadwal</em></p> <p>The Space Coast attracts many travelers to watch a rocket weighing more than 100,000 pounds and sitting on a massive amount of liquid propellant to blast out of Earth’s atmosphere. Most of these people watch a launch the old-fashioned way, by registering for a special viewing ticket with the Kennedy Space Center Visitor Complex or stopping by the side of the road to view the spectacle. However, this past summer I got to take part in a space launch with my workmates in a much more unconventional way.</p> <p>Several of the Kacena lab folks have already written about their views of the CS-02 launch from the VIP viewing area on the Kennedy Space Center campus, and about how awestruck and excited they were about watching the SpaceX rocket blast off. I share these sentiments too, however my recap is about the day before the launch, otherwise now known as SCRUB DAY.</p> <p>As you may well know, there are millions of moving parts for a launch scenario to progress. NASA and SpaceX work on very tight schedules and with so many different stakeholders, that when you factor in Mother Nature and her constantly shifting weather scenarios it seems astonishing that a rocket ever leaves the ground.</p> <p>The scrub policy is very much a reality of space launch and it doesn’t always matter that the human side of the equation has done everything needed to prepare the launch, including predicting hypothetical problems and having solutions ready. The mere threat of rain or a storm can cancel a launch attempt.</p> <p>So, back to my long-anticipated launch day.  Due to a bureaucratic mixup with the VIP tickets, we were disappointed to learn that we would need to find our own launch viewing area. So by 4 pm, our lab team consisting of myself, Rachel, six med students, and an undergraduate planted ourselves in a Kennedy Space Center parking lot to wait.</p> <p>It was still several hours until lift off and so our tailgating entertainment included an Uno tournament. All nine of us crammed into the rental minivan in the Florida summer heat to play several hotly (literally and figuratively) contested games of Uno. While some of the med students hoped that special handshakes and secret alliances would help their chances, the actual winner was the person with a very special badge!</p> <p>While we were hopeful when the skies started to clear an hour before launch, we were utterly discouraged that the launch was scrubbed with 30 seconds to liftoff due to the lingering presence of storm clouds.</p> <p>Scrub day was a roller coaster of emotions, but fortunately I had an excellent time together with my lab mates and it has made for some very fun stories.</p> Wed, 30 Oct 2019 20:49:42 Z{05637584-C58E-45CE-818C-20196E066E4F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/in-the-margins-shifting-our-view-of-health-careIn the Margins: Shifting our view of health care<h3><em>Story series begins with look at disparities in breast cancer research</em></h3> <p>Pick up any book I own, and you’ll find countless notes in the margins of nearly every page. From cursive remarks stretching the length of chapters to brackets emphasizing paragraphs that made my heart skip a beat—my books are covered in moments captured in every color of ink, scribbled and emphasized. I picked up the habit during college when something in the text left me asking questions or I felt like something was missing. Those margins always offered a space for everything to exist.</p> <p>As I brainstormed ideas to raise awareness for breast cancer this October, I began to do some research. A couple of years ago I came out as transgender<sup>1</sup>, and earlier this year I received top surgery<sup>2</sup>. With this experience, I was inspired to look at breast cancer through a new lens. I searched the web, scrolling through countless pages that focused on the disease from other institutions and hospitals.</p> <p>After a handful of clicks, I quickly noticed a severe gap in representation in breast cancer research and clinical focus when it came to transgender and non-binary<sup>3</sup> individuals. From only a handful of research papers focusing on this minority group to the lack of terminology that reflects their existence, this population of individuals within the LGBTQ+<sup>4</sup> community could barely be found when searching for breast cancer. Not seeing this representation resulted in a lot of unanswered questions:</p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/department/psychiatry/collaborativecareeducationx87182/in_the_margins_questions_v2.png?h=300&w=300&rev=31a317fa0f8b4252ac2698bd19d40241&hash=10393119B447A3F15CE3186839557F13" style="height: 300px; width: 300px;" alt="Pink image with question marks and black text scattered posing various questions like: Where do transgender and non-binary individuals exist in research? Is there any funding? What grants are available for researchers in LGBTQ+ health care? How are future physicians trained in this area of patient care? Do transgender women have a higher chance of breast cancer? How does the lack of representation in research impact LGBTQ+ individuals of color?Do LGBTQ+ physicians have leadership in implementing more LGBTQ+ focused research? After top surgery, do transgender men or non-binary individuals still need to have regular chest exams? How applicable is current data if it doesn't include trans and non-binary individuals? How are lesbian and bisexual women affected? Do hormones impact breast tissue?" class="float-left" /> <br/> <h3><span><strong>Because it’s how you say it<br /> </strong></span></h3> <p>Doors open and doors close on account of what we choose to include in the sentences we share. Breast cancer experts, like <a href="/faculty/4849/miller-kathy">Kathy Miller, MD</a>, Ballvé Lantero Professor of Oncology in the <a href="/sitecore/content/iu/iu-som/home/internal-medicine">Department of Internal Medicine</a> at Indiana University School of Medicine, are working to open more doors when it comes to how we approach breast cancer research, including how we better inform patients. When looking at the language that institutions use to describe breast cancer, female-oriented pronouns and gender binary assumptions are quite prevalent.</p> <p>In a society that absorbs so much information online, I wonder what I would have done, as a transgender man, if I hadn’t been fortunate to receive top surgery and had felt a lump on my chest. Perhaps quietly, in the dead of night, under sheets and hidden away like a secret I would have had the courage to type the word <em>breast</em> and<em> cancer</em> into Google to see what my options were. Switching perspectives, how do transgender women navigate a lifetime of journey in mere moments as they educate and inform themselves on breast health and risk factors, often with little support or guidance? I fear the lack of representation throughout the web’s countless pages on this disease could have persuaded me, and potentially others, to ignore any early signs of breast cancer, effectively impacting our health outcome.</p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/department/psychiatry/collaborativecareeducationx87182/in_the_margins_miller_quote_v2.png?h=300&w=300&rev=1fc06d645112424b98ce34ab8db23fe3&hash=64148F75D3A06A89DEECD03CCBA6DDF1" style="height: 300px; width: 300px;" alt="The transgender pride flags spans the image from top left corner to bottom right. The words "Biases and perceptions" is bold and in blue at the top with the words "put additional barriers in place for our patients to receive proper care" below in a translucent gray box." class="float-right" /> <p>“When being treated, pronouns are things that your health care providers might not always consider,” Miller said. “Part of it is still the stigma around our transgender community and how biases and perceptions put additional barriers in place for our patients to receive proper care. At <a href="/sitecore/content/iu/iu-som/home/research-centers/cancer">IU Simon Cancer Center</a>, we’re educating people about their own implicit bias and the assumptions that they make. We want to ensure that everyone is treated respectfully and with no assumptions.”<br /> <br /> </p> <h3><strong>Gap in data</strong></h3> <p>Current dialogue surrounding breast cancer often categorizes the disease into two brackets: breast cancer in women and breast cancer in men. It’s often noted that over 250,000 women and nearly 2,700 men are diagnosed with breast cancer each year. But how accurate is that data if it doesn’t include the transgender and non-binary community? How applicable are the statistics to transgender or non-binary individuals?</p> <p>Some of the biggest organizations in breast cancer research have commented as recent as 2018 that data on breast cancer risk is either limited or does not currently exist among the transgender or non-binary community. Additionally, a common response from specialists throughout medicine is that “there’s not enough data” when it comes to LGBTQ+ research. With such a lack of information and scientific data to answer individual concerns, how will this community receive the best patient care?</p> <p>Fortunately, several opportunities exist for further research focusing on LGBTQ+ individuals and breast cancer, including transgender women and their risk for hormone sensitive breast cancer and the goal for breast tissue banks storing transmasculine tissue post-top surgery. Unanswered questions offer researchers, institutes and health systems an opportunity to expand our understanding of how certain minority groups are impacted differently in breast cancer and beyond.<br /> <br /> </p> <h3><strong>It’s not just breast cancer</strong></h3> <p>While this research began with the disparities present in breast cancer for transgender and non-binary individuals, it’s clear that the gaps in health care don’t stop at breast cancer for LGBTQ+ individuals. From educating future physicians and improving insurance coverage to radiology screenings and availability in family planning—the health system is full of areas to improve its representation of an entire group of society. By doing so, not only will patients receive better treatment, but physicians and health systems will provide a foundation of difference for a community impacted by stigma and barriers.</p> <p>It’s time we fill the margins.</p> <p><em><strong>In the Margins</strong> is a series of stories at IU School of Medicine focusing on the disparities in health care for LGBTQ+ individuals.<br /> </em></p> <h6><sup>1</sup>Refers to an individual who does not identify with the gender they were assigned at birth.<br /> <sup>2</sup>A double incision mastectomy with or without nipple graft, often referred to as top surgery, is a type of gender affirmation procedure performed for many, but not all, female-to-male (FTM) transgender individuals and non-binary (NB) individuals.<br /> <sup>3</sup>An individual who does not identify exclusively as a man or woman. Some non-binary individuals identify with being both men and women while others identify outside the gender binary or somewhere in between.<br /> <sup>4</sup>Lesbian, gay, bisexual, transgender and queer/questioning. + includes other sexuality and gender identities and expressions.</h6>Wed, 30 Oct 2019 12:26:38 Z{3923AC20-0785-4C54-8093-4B5E8AE9C3B6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/navigating-your-alzheimers-risk-in-preparation-or-perilNavigating your Alzheimer’s Risk: In Preparation or Peril?<p>Six months after I received the results of my online genetics test, I opened an email informing me that the company to whom I had previously sent my DNA recently tested to determine my risk factor for Alzheimer’s disease. I reread the email—questioning myself.  What are the benefits to knowing you are at a higher risk for developing an incurable disease the symptoms of which will not begin to show until the later stages of life? To view my results, I would need to log into the website. I sat thinking to myself—do I even want to know?</p> <p>An <a rel="noopener noreferrer" href="https://www.npr.org/sections/health-shots/2019/07/12/740714662/a-genetic-test-that-reveals-alzheimers-risk-can-be-cathartic-or-distressing" target="_blank"><strong>article</strong></a> recently published by National Public Radio stated that researchers at the <strong><a rel="noopener noreferrer" href="https://alzheimerspreventioninitiative.com/" target="_blank">Banner Alzheimer’s Institute</a></strong> created the Alzheimer’s Prevention Initiative, “an international collaborative formed to launch a new era of Alzheimer’s prevention research by evaluating the most promising therapies in cognitively normal people who—based on age and genetic background—are at highest risk of developing Alzheimer’s disease symptoms as quickly as possible” (Banner Health, 2019). One of the genes capable of determining an individual’s risk factor- APOE E4- is, “…the most powerful known genetic risk factor for Alzheimer’s after age 65. APOE E4 doesn’t cause the disease, and many of those who carry it never develop Alzheimer’s. Still, about <strong>1 in 4</strong> people who carries a single copy will develop Alzheimer’s by 85. Among people who get two copies (one from each parent) up to <strong>55%</strong> will develop Alzheimer’s by age 85” (Hamilton, 2019).</p> <p>Determining how many alleles you carry and their subsequent representation of risk could set you on a path toward health and wellness that was previously unknown to you. But then again, when would you want to know your genetic risk—before or after you decide to have children? At 70 years old? At age 25? What obligation do you have to share your risk with family members, children, or grandchildren? Would you relay this potentially evocative private health information yourself, or just casually refer them to a genetic counselor during dessert at family dinner on a Sunday night? What impact could this new discovery have on shaping your everyday lifestyle choices?</p> <p>The unequal nature and privilege of becoming a beneficiary of scientific advancement, personalized health results, and healthcare as a whole, are a blog post for another time. But even if individuals did have access to their genetic risk or similar research being provided by the Banner Alzheimer’s Institute and organizations like it, they would still have a slew of tough questions to consider as they seek to both navigate and mitigate their risk factors for incurable diseases like Alzheimer’s.</p> <p>Most of the answers to the questions I asked myself the day I was presented with my results could never be found through genetic research and scientific advancement, but the Alzheimer’s Prevention Initiative provides individuals with a unique opportunity to peer into what their futures and the future of their successors may have in store.</p>Mon, 28 Oct 2019 17:05:34 Z{C8BDD070-4D1D-4996-A535-D52341D83116}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/iu-school-of-medicine-researcher-awarded-susan-g-komen-grantIU School of Medicine researcher awarded Susan G. Komen grant<p>INDIANAPOLIS — A grant from Susan G. Komen will help bolster research at Indiana University School of Medicine aimed at addressing outcome disparities in African-American patients being treated for breast cancer.</p> <p><a href="/faculty/4858/schneider-bryan">Bryan Schneider, MD</a>, is the recipient of a $250,000 Komen Breast Cancer Disparities Research Supplemental Grant, which will support his research on how genetic ancestry affects the response to breast cancer therapy in African-American women. Schneider’s work, launched as a <a href="/sitecore/content/iu/iu-som/home/news/2019/09/trial-seeks-to-reduce-neuropathy-improve-outcomes-for-black-women-with-breast-cancer">National Cancer Institute-sponsored clinical trial, EAZ171</a>, focuses on taxane-induced peripheral neuropathy (TIPN), a serious side effect which is linked to worse outcomes in patients. Neuropathy is nerve damage that can show up as weakness, numbness or throbbing pain in the fingertips and toes. It can occur during treatment and has the potential to be irreversible.</p> <p>“The goal of this study is to personalize the best type of chemotherapy for African-American women who require therapy in the curative setting for their breast cancer,” said Schneider, a professor of medicine and medical and molecular genetics and the Vera Bradley Chair of Oncology at IU School of Medicine. “We found that African-American women are markedly more likely to get neuropathy from the class of chemotherapy called taxanes when compared to Caucasian women. In this trial, we will use the genetic makeup of each patient to unravel which taxane may cause the least amount of neuropathy and result in the best quality of life, while still being effective at killing cancer cells.”</p> <p>Schneider, a physician-scientist at the Indiana University Melvin and Bren Simon Cancer Center and Vera Bradley Foundation Center for Breast Cancer Research, is also studying the information and communication needs of African-American patients. In partnership with community organizations <a rel="noopener noreferrer" href="http://redalliance.org/" target="_blank">R.E.D. Alliance</a> and Pink-4-Ever, the team will work to build a shared decision-making tool that will help patients work with their physicians to make the best treatment decisions. These studies will address the disparity of TIPN in African-American women, leading to better outcomes for these patients.</p> <p>“African-Americans are underrepresented in almost all cancer specific clinical trials across the United States,” said Schneider. “The reasons for this are multifactorial, but include a distrust derived from studies where researchers did not conduct research in an appropriate, ethical and caring way. Additionally, recruitment efforts to date have not been specific to or in collaboration with the African-American community. We are hopeful to change that trend with this trial, as this is one of the first and only trials to be conducted in the cooperative group setting with enrollment completely focused on African-American patients.”</p> <p>Schneider received this grant during Susan G. Komen’s inaugural Breast Cancer Disparities Research Summit on October 8, the only event of its kind in the United States focused on breast cancer disparities. The grants provide up to $250,000 in support over two years to bring a disparities research lens or focus to the scope of work conducted by the researcher. The goal of this grant is to better understand and address why certain populations of breast cancer patients have different outcomes, including why African-American women in the United States are 40 percent more likely to die from breast cancer than Caucasian women. The grants were made possible through the support of Genentech, a member of the Roche Group.</p> <p>The EAZ171 trial was designed and conducted by researchers in the ECOG-ACRIN Cancer Research Group with support from the National Cancer Institute, part of the National Institutes of Health. It is also supported by a Susan G. Komen for the Cure Promise Award, the Indiana University Grand Challenge Precision Health Initiative, and the Vera Bradley Foundation for Breast Cancer.</p>Fri, 25 Oct 2019 14:29:45 Z{58B6E879-42DD-40AC-A8EA-B22046F1877C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/read-all-about-it-rodent-research-publishedRead all about it: Rodent research published<p><em>Written by Sue Samson</em></p> <p>A new research paper authored by the Kacena lab about data collected during the Rodent Research spaceflight in 2017 has just been published in <em>npj Microgravity and is </em>entitled <em>Skeletal adaptation in young male mice after 4 weeks aboard the International Space Station. </em>Congratulations to everyone involved!</p> <p>To help spread the word about this study a companion blog was written, <em>Rodent Research in Space: A Scientific Journey into the Unknown</em>, and was posted to the journal’s community blogsite. It is a lighthearted look at several behind-the-scenes stories associated with this research project.</p> <p>The journal is testing a new way to measure the impact of an article, increase traffic to their journal, and reach more readers where likes, shares, and downloads are analyzed (much akin to social media campaigns).  Thus, we invite you to check out our article and blog by following the steps below.</p> <ol> <li><b>LINK </b>to the blog:<em> Rodent Research in Space: A Scientific Journey into the Unknown</em> <a href="https://npjmicrogravitycommunity.nature.com/badges/733-contributor/posts/53927-rodent-research-in-space-a-journey-to-the-unknown" target="_blank">https://npjmicrogravitycommunity.nature.com/badges/733-contributor/posts/53927-rodent-research-in-space-a-journey-to-the-unknown</a></li> <li><strong>LIKE </strong>the blog by clicking on the thumbs up icon (you will be directed to provide an email and password, but don’t worry about being added to a mailing list as this is used only for counting the number of unique likes).</li> <li>Write a <strong>COMMENT </strong>if you want to leave a message for Dr. Kacena (definitely not required!)</li> <li>Click the <strong>SHARE</strong> button if you want to share this article on your personal Facebook, Twitter, LinkedIn accounts.</li> <li>Within the blog<strong>, CLICK one of the links to go to the full research article</strong> in npj Microgravity (there is one link in the first full paragraph and then again near the bottom of the article)</li> <li><strong><u>DOWNLOAD </u></strong><u>the actual research article</u>. This is an important step because this contributes to how IMPACT SCORES are determined, which are very important to the authors.</li> <li>To share the link of the research article in your own personalized email, use this shortened link: <a href="http://em.rdcu.be/wf/click?upn=lMZy1lernSJ7apc5DgYM8asWk1HaCe2mRatYos3Q8dY-3D_8rYlohVwqsgTYJbhkexBXxdyue6dJ3zwC9dSKRp-2FMiCIybtKvbTl0aXjkJ9odLWSPIJPi-2FI8YZ9qi4BoNtSVl8KrTZUJirCEIGFuDBQH5lehiorMh9Ox-2BBhdsVyRk7q0lNpVQy9-2F4lDb37oAFPmwRk7pAWpsEZf5HUhLYZTuf0xXZ1Ro3MFNhjDULWjcQULyvnDVdZAFTWIlNz3a6EEtBX1VBkV7hNoW0e-2BSamrJF3Nzh8ki3SIfFvkuovtLQji6VnXP5zlIgG6ZaS-2BcnvAfSQ-3D-3D" target="_blank">https://rdcu.be/bRMR7</a></li> </ol> Wed, 23 Oct 2019 20:45:47 Z{F9E23FFF-ED53-4165-BB9B-31195BAD23B1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/cultural-competency-in-medical-researchCultural Competency in Medical Research<p><strong>Cultural Competency in Medical Research</strong></p> <p><strong></strong>In order to understand cultural competency, we should first come to some agreement on a definition. Unfortunately, there is no single, easy to express, definition.  It is of primary importance to realize that the scope of cultural competency is vast and its application not universal. You are not going to be able to <a rel="noopener noreferrer" href="https://www.youtube.com/watch?v=O-agfnOQSl8" target="_blank">attend a lecture</a>, read this blog post, some scholarly articles, and then declare yourself to be <em>culturally competent</em>. All of these things are, however, good starting points to understanding what cultural competency is.  Cultural competency is a journey that will be ongoing throughout your career. It is a discipline that will vary over time. Your levels of competency are influenced by your own personal situation as well as by the populations involved in your research.</p> <p>Taking all this into account, let’s begin by defining <em>cultural competency</em>. <em>Cultural competency</em> is the process with which we deliberately think about our own cultural influences and the cultural influences of those with whom we will be working. In research it is also the establishment of accommodations that respect cultural diversity and promote autonomy.</p> <p><strong>Self-reflection & Cultural Humility</strong></p> <p>This definition lacks the ability to provide a true understanding of what is necessary to become a culturally competent researcher. In order to clarify, we shall begin where every researcher should. A prerequisite to cultural competency is gaining <em>cultural humility</em>. Creating cultural humility should begin long before the onset of a research project.  Researchers begin by reflecting on their own cultural identity and reality. This allows them to honestly assess their own beliefs, practices, and implicit biases. This process of <em>self-reflection</em> is crucial in determining how our personal culture might impact the research process.</p> <p><strong>Racial Literacy</strong></p> <p>A large part this identification is for researchers to develop <em>racial literacy</em>. This begins with a recognition of the power inequalities inherent to belonging to a dominant culture. The role of researcher already places you in a higher status than  that of the volunteer subject, even if you share the same or similar culture. This introspective process requires ample amounts of humility and empathy — one cannot hope to gain a deeper understanding of how culture influences others until they are able to understand how racial, social, and cultural norms effect their own behavior. Cultural competency cannot begin without accountability for this first step by each member of a research team.</p> <p><strong>My Personal Journey</strong></p> <p>Each individual is going to have a different path to take in gaining cultural competency. My personal journey begun when I had the opportunity to live outside of the US. Embedded in a foreign culture, I often felt awkward and out of place. Personally, as a White, cisgender female, I had not previously had the opportunity to understand what it feels like to be <em>the other</em>. Living in a foreign culture helped me to understand the struggles, frustrations, and anxieties inherent to living outside of the dominate group. This experience helped to open my eyes to the privileges I had grown up with. Through self-reflection, I began to see how this privilege affected my outlook on the world.</p> <p>Returning to the US, I made a conscious effort to continue to broaden my cultural viewpoint. In the first year of my graduate studies, I volunteered to work with a professors on his research project. This project addresses the concentration of high rates of infant mortality in certain zip codes in and around Indianapolis. The communities are composed of a majority Black/African American and/or lower-income families. This professor has been a wonderful illustration of someone who practices cultural competence. He has displayed this in both the classroom and in research. He incorporates multiple strategies to support participant autonomy. His focus is to minimize the power dynamic inherent to research with vulnerable population. Beginning with the consent process, he has established a dynamic that aims to shift the power balance back toward participants. Working with him and the participants has taught me a great deal about cultural humility. I have learned from them some of the actual impacts of racism on the lives and health of real people.</p> <p><strong>Cultural Diversity & Implicit Bias</strong></p> <p>Taking advantage of further opportunities to broaden my knowledge, I participated in a course on culturally responsive teaching. This course is offered here at IUPUI by the Center for the Integration of Research, Teaching, and Learning (<a rel="noopener noreferrer" href="https://cirtl.iupui.edu/" target="_blank">CIRTL</a>). It is designed for graduate and post-doc students who will be working in classrooms. The course began by asking us to reflect critically on our own culture.  We then dove into topics that included diversity, equity, and inclusion in the classroom setting. This course helped me to challenge the way I think about <em>cultural diversity</em>. It helped me to recognize how cultural diversity relates to pedagogical practices.</p> <p>This course also allowed me to gain a better understanding of <em>implicit bias</em>. I learned how a failure to identify and address implicit biases can seep into my interactions with students. I highly encourage everyone reading this post to participate in the <a rel="noopener noreferrer" href="https://implicit.harvard.edu/implicit/takeatest.html" target="_blank">Harvard project</a> on implicit bias. Clicking through the surveys the project has posted online are quick, but very insightful. Finding out where your biases are is a key aspect to establishing culturally competent research practices.</p> <p>Unfortunately, I was witness to an illustration of a professor who lacked understanding of his own implicit biases. He did not appreciate his own privilege privilege or the history of institutionalized racism. (I will not recount the specifics here to protect individuals involved) This lack of insight contributed to actions that demeaned a student of color in a classroom setting. It was a horrifying and absolutely unacceptable depiction of how a lack of knowledge challenges cultural competency.</p> <p>The intent of this post is to highlight the importance for researchers and educators to begin their own journeys into culturally competency. Following the links provided in the text will provide some starting points. However, the responsibility lies within each individual. Begin with self-reflection. Develop cultural humility. Identify implicit biases. Find a role-model. Be a culturally competent researcher and human!</p> <p> </p>Wed, 16 Oct 2019 15:01:58 Z{BAD0B0B4-440E-40DD-A0BB-18D6ED00DBA1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-rachel-blosserFrom My Eyes: Rachel Blosser<p><em>Written by Rachel Blosser</em></p> <p>Honestly, it’s hard to believe that the launch is over. When I started working in Dr. Kacena’s lab back in January 2018, I was interested and excited to hear my lab mates talk about the spaceflight project. It was really exciting to view the whole process, from watching them run preliminary experiments, to preparing cells and everything else that went into the project.</p> <p>I thought it would be awesome to be part of the team involved in the launch; however, I was pretty new in the Kacena lab and didn’t think I’d be too involved. Things change over time, especially with personnel in an academic institution, and 12 months later I found myself as the lead lab scientist from the Kacena lab once several post-docs moved  to other positions and another lab associate retired.</p> <p>Space research requires us to discuss every little detail and to make so many preparations that it seemed like the launch date would never arrive. Knowing that we had only one chance to get the experiment right was a bit daunting, but then watching the science head to the ISS was one of the greatest things I’ve ever been part of.</p> <p>During the 18 days I spent in Florida, there never seemed to be a dull moment. Certainly, there were stressful and frustrating times, but there were far more exciting and fun times. Between all of the prelaunch preparations and making sure everything was functioning well at the lab in Indianapolis we stayed plenty busy, but we also had a lot of fun.</p> <p>In addition to experiencing the launch, a few of my favorite ways to relieve stress included the bioluminescent kayak tour, visiting Epcot, the escape room, and eating ice cream at “The Fat Donkey.” I really enjoyed working with everyone, as well as getting to know them better.</p> <p>Since arriving back home, the memories of the stressful times have faded and the important memories have stayed with me. I absolutely loved watching the launch, it truly was more than I could have imagined.</p> <p>I have told many of my friends about my experiences, and how amazing the whole thing was, but it’s impossible to truly describe how awesome it was to be a part of this. When people ask about my summer, it’s pretty cool to say “I sent bone cells to the International Space Station.”</p> Wed, 16 Oct 2019 14:38:14 Z{77727FA7-0962-4096-9D2C-1E9E67AEE442}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/becky-sobel-breast-cancer-research-fundFighting triple negative breast cancer with “I” and “U”<h4><em>Meridian, Jeff, and Autumn Sobel signing the agreement establishing the Becky Sobel Breast Cancer Research Fund on what would have been Becky’s 50<sup>th</sup> Birthday.</em></h4> <p>Beginning a lifelong friendship, Tony Chu and Jeff Sobel first met outside their freshman dorm at Syracuse University in the Fall of 1987. Moving to different regions across the country and around the world, they both served full careers in the United States Air Force. Although separated by duties, they stayed closely connected as friends. They were best men for each other’s weddings, there for each other as kids came along, and celebrated promotions and retirement together.  Jeff and his wife Becky settled in Niceville, Florida. Tony and his wife Emily wound up in Indianapolis, Indiana.</p> <p>Breast cancer became a part of Tony’s story with the loss of a family member to the disease. The experience showed him the importance of advancing breast cancer research. In time, the Chus met and became avid supporters of <a href="/faculty/4991/storniolo-anna">Anna Maria Storniolo, MD</a>, and the program she leads, the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/research/tissue-bank">Susan G. Komen Tissue Bank</a> at the IU Simon Cancer Center. The tissue bank is the only repository of healthy breast tissue in the world, and is a truly unique resource for breast cancer researchers all over the world working to determine why and how breast cancer develops.</p> <p>Breast cancer became a part of Jeff’s life when his wife Becky was diagnosed with triple negative breast cancer, a very aggressive form of the disease. When the Sobels were looking for help, the Chus turned to Storniolo. She connected them with clinical colleagues and experimental treatment trials around the country. Those connections and treatments provided Becky with time to renew her wedding vows with Jeff, celebrate with family and friends, and plan for what the future would be like for their two young daughters, Autumn and Meridian. Despite the efforts, Becky passed away in March 2017.</p> <p>The loss inspired Tony and Emily to action. They had seen what the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a> was doing to fight triple negative breast cancer and they wanted to do something to advance the research in Becky’s name.</p> <p>Together, Jeff, Tony and Emily established the Becky Sobel Breast Cancer Research Fund. It will support cutting-edge triple negative breast cancer research. To seal their commitment to support the research Jeff, surrounded by friends and family, signed the fund agreement on March 24, 2019.</p> <p>It would have been Becky’s 50<sup>th</sup> birthday.</p> <p>The creation of the Becky Sobel Breast Cancer Research Fund at Indiana University seems written in the stars. While they had no early connections to the university, the letters I and U had always played a role in Becky and Jeff’s relationship. To get around strict military rules against public displays of affection while dating, Jeff and Becky would write notes to each other using “IU” to symbolize “I Love You.” That shorthand stuck and led to an affinity for the two letters sprouting into a collection of “I” and “U” signs and special objects that decorate their house. Part of that collection was an Indiana University mug gifted to Jeff and Becky several years ago by Tony. The mug has taken on an entirely new and greater significance now. The IU mug sat beside Jeff as he used the pen from their wedding day to sign the agreement and establish the fund in his wife’s honor at Indiana University.</p> Mon, 07 Oct 2019 16:53:28 Z{AA970B5F-3D8E-4B2B-8462-D019D319F905}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-ariane-zamarioliMeet the Team: Ariane Zamarioli<p><em>Written by Ariane Zamarioli</em></p> <p>Hello everyone! My name is Ariane Zamarioli and I come from Brazil. I was a visiting assistant professor in Dr. Kacena’s lab for six months from September 2018 through February 2019.</p> <p>I first met Dr. Kacena at the ASBMR conference (the largest bone scientific meeting in the world) back in 2014. I was very excited to learn about her projects to study bone regeneration in space since I had some previous experience with fracture healing by studying different rodent models for osteoporosis (i.e. Type I diabetes, spinal cord injury). We found a way for me to contribute to Dr. Kacena’s team and we have since been remotely working together.</p> <p>I was happy to join her lab last fall and be part of her spaceflight studies for bone regeneration and therapies, which will directly benefit the astronauts and indirectly benefit a large population with limited loading to their lower body (i.e. elderly and disabled people).</p> Mon, 07 Oct 2019 16:15:18 Z{24441E91-6442-4D51-A3AC-FA8E28A547C4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-lily-blosserFrom My Eyes: Lily Blosser<p><em>Written by Lily Blosser</em></p> <p>My name is Lily Blosser, and I am 11 years old. My experience at Kennedy Space Center was truly amazing. I love being able to say, “I got to see the project that my mom worked on get launched into space!” There were tons of highlights to the trip, but I managed to skim it down to a few topics.</p> <p></p> <p>Even though most of my topics might seem silly, my feelings of gratefulness are genuine. First, I would like to talk about how exhilarating it was to see a rocket launched up as close as 3.5 miles away from the launch site. I thought waiting for it to launch was exciting too. Even though it was scrubbed the first day, I still did some fun things like trying a virtual reality simulation of the International Space Station and hearing the mission briefing.  We even wore a special badge and were given a SpaceX water bottle, T-shirt and other cool stuff.</p> <p>My second topic is that I made an awesome friend who likes the same things as me, and we bonded over stupid jokes while waiting for the launch! I really appreciate the friendships I was able to build because of the trip itself. It was a lot of fun to hang out with the rest of the IU team too! I thank everyone who helped make this awesome trip possible!</p> <p>I really enjoyed the experience at Kennedy Space Center and how educational, but also fun, it was. Kennedy Space Center has amazingly beautiful and polished buildings, and everyone there was positively pleasant! I learned about space and NASA, and got to do lots of hands-on activities.</p> <p>I loved the trip more than you could even imagine, especially when there were so many Poke Stops! The IU students were all fun to meet, and the bioluminescent kayak tour we went on put the trip over the top.</p> Thu, 26 Sep 2019 16:09:24 Z{9F39C8ED-E424-4315-9AD9-B8285BCA8D9D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-murad-nazzalMeet the Team: Murad Nazzal<p><em>Written by Murad Nazzal</em></p> <p>My name is Murad, and I am entering my freshman year at IUPUI, where I plan to major in neuroscience. I am extremely excited about this new chapter in my life and optimistic about what lies ahead.</p> <p>In high school, I always loved my science classes, especially anatomy, physiology, and chemistry. Even before high school, I was interested in the medical field, specifically orthopaedics. While I obviously have a long journey ahead of me, I would love to attend IU School of Medicine in Indianapolis.</p> <p>I joined the Kacena Lab in June of this year (2019) and have already benefited from this experience. I have learned many things about bone healing and the basics of genetics that I would not have learned otherwise. Moreover, being in the lab gives me a head start on my college biology and anatomy classes. An additional benefit is that Dr. Kacena’s research is very collaborative and places an emphasis on teamwork and communication. These skills will be helpful throughout my life, not just in school. I hope to continue working in this lab throughout my undergraduate years and beyond.</p> <p>Outside of school, I am dedicated to hitting the 1,000-pound club in the big three compound exercises before I reach 20 years old. I also enjoy boxing and football, and would like to finish a marathon under three 3.5 hours. Most of all, though, I love food. I really love food. If you get nothing else out of this intro, just know that I LOVE food.</p> <p>I really hope to make the most out of the upcoming years and continue to grow, learn and enjoy my time here. Thanks for taking the time to read this!</p> Thu, 19 Sep 2019 16:04:55 Z{96B48DED-43FE-4E65-90BD-BC2EEEB02639}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-caio-stautMeet the Team: Caio Staut<p><em>Written by Caio Staut</em></p> <p>I am Caio de Andrade Staut and am 28 years old, born in Sao Paulo, Brazil. I graduated from medical school in November 2016 from Marilia State Medical School (FAMEMA).</p> <p>After medical school, I dedicated one year to the Brazilian Army for medical services. It was a great opportunity to meet and learn from other doctors from different parts of the country.</p> <p>I moved to Indianapolis in January 2019 with my wife.</p> <p>I was in Brazil just about to finish my first year of residency in orthopedic surgery (orthopedic surgery residency in Brazil is three years long), when my wife and I got the opportunity to move to the U.S. and live a new experience in Indianapolis.</p> <p>I have been in the Kacena lab since June and it has been an amazing opportunity to learn new things and get involved with bone healing research.</p> <p>As a big sports fan, I am looking forward to watching the IUPUI Jaguars in 2019-20 season!​</p> Mon, 09 Sep 2019 15:01:32 Z{CBC2D3D5-F930-4491-B947-3F27DCB8F9C4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-zack-gundersonFrom My Eyes: Zack Gunderson<p><em>Written by Zack Gunderson</em></p> <p>One of my favorite parts of the research trip were the people working at NASA. On our days off we made little explorations around the Air Force Base and Kennedy Space Center, moving around wherever our badges would permit. Time after time when we ran into a NASA employee, whether it be in the elevator or gift shop, they would offer to give us a tour of their work area and into places where our individual clearance wouldn’t allow us. From giant pieces of space equipment, to famous launch sites, to inspiring speeches about plans for Mars, we were exposed to the culture, creativity, and vision of NASA.</p> <p>Thank you to those NASA employees that took time out of their day to show a few med students something incredibly special. I will be forever be enamored with the thought of space travel.</p> Sat, 07 Sep 2019 15:11:56 Z{80A222A6-C90B-4701-99DB-5988EA39261C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-zack-campbellFrom My Eyes: Zack Campbell<p><em>Written by Zack Campbell</em></p> <p>Reflecting on our trip to Kennedy Space Center, I have to say that it was such a unique and wonderful experience that I am forever grateful that I could be a part of it. Since we were at KSC for 18 days, picking just a few events to talk about is tough, however, a few things do stand out in my mind.</p> <p>First, working on a project of this magnitude was enlightening in so many ways. Preparing the research for launch meant that our lab got to work with people from NASA and other collaborating labs. I met such wonderful people. Plus, knowing that I physically handled and worked on this project that is now 250 miles aloft and in orbit is pretty remarkable.</p> <p>Secondarily, I am an avid follower of all things space and have watched live broadcasts of previous launches. Seeing CRS-18 launch in person was something I will never forget. The sight of the fuel burning as bright as plasma cutters followed by the sounds you can feel in your chest was a whole new experience. Trying to describe these feelings won’t do it justice.</p> <p>Third, being at KSC during the 50th anniversary of Apollo 11 was amazing good fortune. Meeting the Vice President and Astronaut Buzz Aldrin (who 50 years to <u>that day</u> was on the moon) was a great honor and made more special on the account of celebrating one of the greatest accomplishments in human history. It was humbling and fun to spend significant time at the place where the U.S. has paved the way for space exploration and where countless explorers have set foot and made history.</p> <p>At the core of all of this I am thankful to experience this with some of the finest people I have had the opportunity work with. My team members and their families made each experience into a great one</p> Thu, 05 Sep 2019 15:08:57 Z{1AFD9A5C-0DB2-4067-B3DB-1B43C06BE40C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-anthony-peruginiFrom My Eyes: Anthony Perugini<p><em>Written by Anthony Perugini</em></p> <p>What an incredible experience! From the moment we arrived at Cape Canaveral, the realization that we were working at NASA started to kick in. The other medical students and I all looked at each other in awe…what an amazing opportunity we got to be a part of.</p> <p>After a 17-plus hour car ride with five students crammed into a Honda Accord, we had finally arrived. We quickly unpacked our bags, got our badging for the Base, and met as a full team in the lab for the first time.</p> <p>We definitely made adjustments to our workflow while we were at KSC. While working at NASA, it was a “work hard—play hard” mentality, and we also needed to be flexible. Often, the timeline for the next day was fluid and we found ourselves waiting for a start time until the evening before. Some days we would pull 15-plus hours and then be rewarded with a late start the following day.  Some days we would spontaneously be called off, giving us a much needed chance to hit the beach.</p> <p>The delays in the launch schedule were disheartening, but we understood that everything MUST be perfect in order for the rocket to take off. The teams at NASA and SpaceX had to ensure that all orbital patterns were correct, and had to account for space debris (YES that is a thing!). After the first two launch dates passed due to technical issues, we eagerly waited in the Vehicle Assembly Parking Lot for the third try. This time the weather was not on our side…the countdown timer dropped to 30 seconds before being “scrubbed” to the next day.</p> <p>FINALLY, on the fourth launch day, the mission was a go. Dr. Kacena was even able to secure enough VIP passes to allow the entire IU team to be a part of SpaceX’s special viewing group. This honor got us front row seats to the amazing launch!</p> <p>This was genuinely a once-in-a-lifetime experience. My thanks go out to Dr. Kacena, the amazing team, and IUSM Department of Orthopaedics for allowing me to be a part of this incredible experience. It will be one that I will not forget!</p> Tue, 03 Sep 2019 15:08:07 Z{AAE58027-99A1-4EB0-A789-42F906310213}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/splashdownSplashdown!<p><em>Written by Sue Samson</em></p> <p>Our bone research, along with over 2,700 pounds of other science experiments, hardware and cargo, departed the ISS on August 27 and returned to the Earth with a successful and dramatic splashdown in the Pacific Ocean.</p> <p>The next part of the capsule’s journey is a two-day trip via a SpaceX recovery ship that will cover about 300 nautical miles before making port in Los Angeles. Once unloaded from the capsule, our experiment will make a pit stop at the Johnson Space Center in Houston and then be packed for shipment to the research teams at Indiana University School of Medicine in Indianapolis and to the U.S. Army in Fort Detrick in Maryland.</p> <p>We expect our samples to arrive in Indianapolis by early September and then we can begin to analyze the effects of microgravity on healing and tissue regeneration. Can’t wait!</p> Fri, 30 Aug 2019 20:00:45 Z{30C4C69B-29E9-4EEB-98B8-A7CDD06AE91A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-nikhil-tewariMeet the team: Nikhil Tewari<h4>Written by Nikhil Tewari</h4> <p>Hello!</p> <p>My name is Nikhil Tewari.</p> <p>In May 2019, I will graduate with a degree in molecular biology from Colgate University. Outside of academics, I have been a member of Colgate’s varsity track and cross country teams for the past three years.</p> <p>As a cross country and track athlete with an extensive record of bone and tendon-related injuries, I am fascinated by orthopedic research and am excited to pursue that interest in Dr. Kacena’s lab. My most recent research experience has been working as a research intern at the National Institutes of Health for the first semester of my senior year, where I explored how the TGF-beta signaling pathway affects the differentiation of brown and white adipose tissue.</p> <p>I will join Dr. Kacena’s lab for the next year to conduct orthopedic research while I take a gap year before (hopefully) going to medical school.</p> <p>I look forward to utilizing my previous research experiences with cell culture, RT-qPCR and gene sequencing to provide meaningful contributions.</p> <p>This will also be my first time conducting medical research, so I’m excited to branch my experiences in research with my interest in medicine. Furthermore, I believe that many of the skills that are required to produce high quality research such as patience, organization, and good communication are also expected from physicians, so I hope to continue to build on these qualities in myself over the next year.</p> Thu, 29 Aug 2019 08:15:59 Z{BD624516-D2D1-4E3C-8483-6955AD11D51C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-rohit-nagarajMeet the team: Rohit Nagaraj<h4>Written by Rohit Nagaraj</h4> <p>My name is Rohit Nagaraj, and I am currently a sophomore at Penn State University.</p> <p>I am in an accelerated pre-med program and will be graduating in May with a bachelor of science degree. Before I start at Sydney Kimmel Medical College at Jefferson University in Philadelphia, I will be taking a gap year to participate in orthopedic research in Dr. Kacena’s laboratory.</p> <p>My ultimate goal is to become an orthopedic surgeon, but I first want to delve further into research field to gain a more detailed understanding of what goes on behind the scenes. The opportunities that this lab will provide are numerous and will lead me one step closer to fulfilling my goals.</p> <p>I began training in the Kacena laboratory early this summer and then will work as a volunteer during my gap year after completing the MCAT.</p> <p>The work that Dr. Kacena’s lab is conducting is truly interesting to me and I cannot wait to see what I learn and accomplish while being a part of it.</p> <p>Though I have some prior research and work experience, being involved in the type of research that directly relates to my future goals is a first. Learning what goes on in designing the studies, what protocols must be followed and how teams work to produce and publish papers that aid other scientists are some of my biggest motivators.</p> <p>I look forward to getting this hands-on experience and seeing firsthand how trials are conducted!</p> Wed, 28 Aug 2019 09:00:14 Z{6EC67477-79F1-42D3-A25F-A7D44726258D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-fazal-bhattiMeet the team: Fazal Bhatti<h4>Written by Fazal Bhatti</h4> <p>“Scientific research is one of the most exciting and rewarding of occupations,” said Frederick Sanger.</p> <p>The quest for seeking answers to our questions begin in our childhood — and so did mine.</p> <p>I am Fazal Bhatti, and by the time I was in high school I knew I wanted to become a scientist.</p> <p>I describe myself as a “born biologist,” owing to my bachelor’s degree in physiology (with minors in microbiology and biochemistry) and a master’s degree in biotechnology.</p> <p>I completed my PhD in the field of molecular biology with sub-specialization in stem cell biology. My research area is orthopaedics with a focus in cartilage repair using stem cells and nanosome-mediated drug delivery during osteoarthritis.</p> <p>I joined Dr. Kacena’s lab in April to broaden my knowledge in bone and fracture healing, and I hope to find answers to poor bone healing in type-II diabetes.</p> <p>I firmly believe there is cure for every disease and we just have to put in the effort to find it. This has been my motivation to pursue a career in research and academia.</p> <p>The lab is my playground and I like to solve scientific puzzles.</p> Mon, 26 Aug 2019 09:00:43 Z{C4267404-234E-4BE5-A3CC-529726C7AF4A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-nick-digginsMeet the team: Nick Diggins<h4>Written by Nick Diggins</h4> <p>Hi, my name is Nick Diggins, and I am a first-year medical student at IUSM.</p> <p>I graduated from the University of Arizona with a bachelors of science in Mechanical Engineering, and then obtained a master’s degree in Biomedical Engineering from the University of Michigan.</p> <p>My research experience began in 2010 during undergrad years, when I worked in an orthopaedic lab at the University of Arizona and helped with scaffold facilitated cartilage tissue engineering.</p> <p>I continued in musculoskeletal research at the University of Michigan focusing on scaffold facilitated tendon tissue engineering.</p> <p>I also worked for three years at Zimmer Biomet, first as a development engineer and then later as a quality engineer.</p> <p>I am currently working with Dr. Kacena on her studies with the healing response of bone tissue. I have a great interest in orthopaedics and aspire to become an orthopaedic surgeon one day.</p> Thu, 22 Aug 2019 09:00:22 Z{E733AF4D-0EC8-41E9-9B7B-49BB7522116A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-gremah-adamMeet the team: Gremah Adam<h4>Written by Gremah Adam</h4> <p>Hello all,</p> <p>My name is Gremah Adam, an incoming first year medical student.</p> <p>Through my undergrad studies, I enjoyed learning about osteology (bone cell biology) after studying the histology of bone. From there, I endeavored to join in orthopaedic research and reached out to Dr. Melissa Kacena about working in her lab.</p> <p>I started in the Kacena Lab during the Spring of 2018 and have learned a great deal. I have been helping mainly with the bone healing experiments which use a large animal model. Specifically, we are interested in understanding how muscle injury impacts bone healing.</p> <p>Being involved in research, I have come to appreciate the importance of this aspect of science and recognize its role in improving patient care. It takes time and hard work to see results and research is certainly no exception. I look forward to seeing how our efforts change the future of orthopaedic surgery.</p> Tue, 20 Aug 2019 08:00:10 Z{035F8AE4-DAD3-473B-B1DF-324EE1371560}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/crew-proceduresCrew Procedures<p><em>Written by Melissa Kacena</em></p> <p>The second and fourth scheduled procedures were on Tuesday, July 30 and Saturday, August 3, when astronaut Tyler Nicklaus “Nick” Hague “feeds” our cells. While most of the hardware is automated, during our practice experiments completed at NASA Ames, we discovered that the volume of “fresh” media provided to the cells was inconsistent between the 10 samples and would impact our science.</p> <p>This variability would be like providing some people with one meal a day and other people with five meals per day and then studying who gained more weight. Clearly different results will be observed. We felt the best approach was for the astronauts to manually feed the cells using a syringe to deliver the same amount of media to all the cells.</p> <p>The third scheduled procedure is Friday, August 2, where the astronauts will swap out the gas tank that is providing oxygen to our cells.</p> <p>The final procedure is for the astronauts to terminate our experiment and store all of our specimens in freezers prior to packing samples back into the dragon capsule for delivery back to Earth at the end of the mission. After splashdown, the specimens will be sent to Johnson Space Center where they will be repackaged and returned to both IU and the Army for further processing and analysis.</p> Mon, 19 Aug 2019 20:43:12 Z{7A395C19-9C08-4F9C-A575-65B432264A48}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-seungyup-sunFrom My Eyes: Seungyup Sun<h4><em>Written by Seungyup Sun</em></h4> <p>On July 25, the payload from the Cell Science-02 Investigation launched into space on SpaceX’s Dragon capsule, thus concluding our work at Kennedy Space Center.</p> <p>During our time in Florida, I had an opportunity to explore the NASA base, see the actual Atlantis space shuttle at the visitor center, work with an incredible team of people and experience the relief of watching the rocket launch after numerous thunderstorms and delays.</p> <p>Truly an unforgettable experience!</p> <p> </p> Mon, 19 Aug 2019 11:50:31 Z{C589E996-BB93-40EB-B26C-7F2C58342624}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/extra-extra-space-mission-front-page-newsExtra, extra! Space mission front-page news<p>Our lab’s launch found itself above the fold this week, with an in-depth feature article published on the front page of the “Indianapolis Star.”</p> <p>Reporter Stephanie Hamilton interviewed Dr. Melissa Kacena for the story, which included details about the recent SpaceX launch, along with a look at the history and focus of the program.</p> <p>In the piece, Dr. Kacena spoke of the importance of our team’s research—tying the effects of an out-of-this-world study to everyday patients back here on Earth.</p> <p>“(The FDA-approved drug) requires gravity to help the way it works,” Kacena said in the article. “If the patient has been bedridden, or in a wheelchair, or if the patient is on crutches, you’re not getting that extra simulation that’s required.”</p> <p> </p> <p>Featured in photos that were published in print and online were Fazal Bhatti, Luke McVeigh, Nick Diggins and Deepa Kanagasabapathy.</p> <p><a href="https://www.indystar.com/story/news/health/2019/08/13/iupui-sends-mice-into-space-test-bone-drug/1868983001/" target="_blank">Read the complete story</a> on the Indy Star’s website.</p> Sat, 17 Aug 2019 19:12:40 Z{52314C5F-6E2A-479A-BE16-15B4D30BCC96}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/from-my-eyes-alex-brinkerFrom My Eyes: Alex Brinker<h4><em>Written by Alex Brinker</em></h4> <p>Participating in the research at NASA is a once-in-a-lifetime opportunity; however, I was fortunate to go twice.</p> <p>After our first mission, RR-4, I thought nothing could top the experience. I was wrong. Being able to directly participate in something so complicated, from both an engineering perspective as well as biological perspective, is so rewarding. I gained an incredible breadth of knowledge through our research as well as a tourist of Kennedy Space Center.</p> <p>During our first mission, we were shown around KSC and went on a wildlife tour. The behind the scenes tour was great, and it was hard to imagine what could top that. This time around, we went on a similar tour, but it was much more in-depth and full of interesting facts and sights.</p> <p>We were awarded a few much-needed days off, which were spent on the beach and cooling off in the water from the hot Florida sun.</p> <p>If you were to ask a close friend or family member about my previous vacations, they would all say that I am one of the most prone to having an accident. So, it seems fitting that I would have one on this trip, as well. Coming in from the ocean I hit my head which necessitated an ER visit. Fortunately, I had three other IU lab members with me for support. While I was OK and did not need substantial treatment, I am thankful they were by my side through the injury and in the lab at KSC. This is one of the many memories of our research trip that I will reflect fondly upon!</p> <p>We still have more to look forward to when the research is returned to us. But for now, the excitement of the trip still resonates within me.</p> Fri, 16 Aug 2019 08:45:18 Z{D15FC3E0-835F-4AA2-B113-FAC2B1D6D5FB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/ground-control-activitiesGround control activities<h4><em>Written by Melissa Kacena</em></h4> <p>Our Earth-based control studies are delayed by two hours so that we can mimic everything done in spaceflight. We even incorporate ground-based “astronauts” to perform the activities. These are NASA personnel who have limited familiarity with the hardware, which is more similar to the astronauts on the space station than using a professional scientist/engineer who is experienced with the hardware.</p> <p>After observing International Space Station crew operations, we can then give the ground astronauts an exact timeline so they can replicate the procedure exactly as performed in space. For example, the first media feeding on ISS took 39 minutes and the second 29 minutes. Each of these was then identically mimicked at Kennedy Space Center.</p> <p>My job is to observe both the ISS astronauts and the ground-based astronauts and provide any feedback as required. So far both sets of astronauts are doing a great job. Thank you all!</p> Wed, 14 Aug 2019 09:45:50 Z{03405378-DE58-4F4E-A8AE-2515033B4AD7}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/command-center-activitiesCommand Center Activities<h4><em>Written by Melissa Kacena</em></h4> <p>There are numerous command centers at each NASA facility. The command center at Kennedy Space Center we are using is a 20-foot by 20-foot room containing seven computer stations with two large monitors, as well as four large monitors at the front of the room.</p> <p>The photo above shows our room; pictured are our Department of Defense Space Test Program colleagues Carolynn Conley and Jim McLeroy and myself after we finished monitoring crew activities. The large screen behind on the right displays our CS-02 activities timeline as well as those of the other crew members.</p> <p>For monitoring our payload, the three of us have our own separate work stations where we can hear everything being said from all control centers communicating with the astronauts. NASA Ames personnel are communicating directly to the astronauts as they complete our tasks. There are crew procedures that were written specific to our study which the astronauts have copies of and which are read aloud step by step.</p> <p>We have video to monitor their performance, and if we see something that was missed, we communicate with the NASA Ames personnel who then communicate to the astronaut about any modifications that need to occur. This is why I was needed for these real-time decisions, as it needs to be someone familiar with all of the science activities to determine whether changes are needed.</p> <p>While the astronauts and NASA Ames personnel all did a great job, there were a few items that were identified and corrected. As with most things it is always best to have several sets of eyes on things as everyone sees things a bit differently and picks up on different things.</p> Mon, 12 Aug 2019 08:45:25 Z{AA216774-EFAE-433A-B868-2DFF1345EDBE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/transfer-of-our-payload-to-the-space-stationTransfer of our payload to the space station<h4><em>Written by Melissa Kacena</em></h4> <p>Our study has four scheduled activities which require astronaut time.</p> <p>The first occurred at the end of the astronaut “work day” when our payload was transferred from the dragon capsule into the International Space Station on Sunday, July 28.</p> <p>Initially all appeared to be OK; but within an hour the telemetry data was showing abnormal temperature readings with the temperature at the inlet port of the hardware, e.g. the temperature coming from the space station and going to our hardware.</p> <p>Unfortunately, the discrepancy was not discovered until the crew was asleep and so it could not be addressed until the next morning. Once awake, the crew tried to determine whether there was an obstruction or any other problem. Nothing was visible. They then placed the hardware into a different location (they are called locker positions) and sure enough everything was OK.</p> <p>While it is encouraging that everything appears to be resolved, we don’t know what, if anything, the impact will be on the cells. Cells, just like humans, are sensitive to temperature changes.</p> <p>Since we are examining differences in genes, proteins, metabolites, etc., all of which can change with temperature changes, we don’t know whether the overnight temperature difference will significantly impact our findings.  Clearly a lesson learned is to transfer the hardware early in the day so that this type of issue can be caught and then resolved immediately.</p> <p>While we are concerned about this observation, we are hopeful to still obtain meaningful data. Stay tuned for more information.</p> Fri, 09 Aug 2019 08:30:33 Z{97510611-397A-4235-AE4F-E73E0227BADE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/the-hard-work-has-just-begunThe hard work has just begun<h4><em>Written by Melissa Kacena</em></h4> <p>What has happened since the launch on July 25? Here is the answer: a lot!</p> <p>Immediately after the launch, our team celebrated at a local hang-out, appropriately named, “Shuttles.” We had a nice dinner where certificates were distributed and where trivia questions were answered for prizes.  Our mission patch was also distributed to team members.</p> <p>On Friday morning, the team woke up early, checked out of our hotel before 6 am and returned to Kennedy Space Center to clean up and close down the science lab. Everyone helped to complete tasks by 10 am so that the students could start the long drive back to Indianapolis. The remainder of the team at Kennedy Space Center finalized tasks and had an 11 am team meeting to see where things stand and determine how to proceed with ground control tasks.</p> <p>Although this was discussed many times in the past and previously determined that no one from IU needed to remain onsite during the mission, it became clear that someone who could make real-time decisions for the science needed to be present. This really meant that I should stay in Florida; but because I already had a 3 pm flight booked for Friday, I returned to Indianapolis for just a couple of days. This allowed me to catch up with the IU folks on Monday before returning to Cape Canaveral early Tuesday morning.</p> <p>I will remain in Florida until the crew completes the procedures on our studies and the corresponding Earth-based ground controls are finalized. Then we wait for the specimens to be shipped to IU and the Army for processing and analyzing. These activities will take significant time — about a year in total. At that time, we can prepare manuscripts for publication and prepare our data for presentation at scientific meetings.</p> <p>The rest of the team did not get a break either. They were all at work on Monday and jumped right back into the other ongoing activities. In fact, while we were gone, the students gave remote presentations for their summer research programs (which we completed posters and practiced their presentations while we were in Florida) and they are preparing for a conference in Chicago in mid-August. This is the typical busy life of academics!</p> Wed, 07 Aug 2019 10:15:01 Z{B4570956-3476-4CC7-B8C9-39DDEF102CD4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/i-am-evidence-of-what-research-can-do-and-will-doI am evidence of what research can do and will do<p>At 26, and a new mother, Nadia Miller’s dreams were typical. She wanted a big family, a career and hoped to one day travel the world. Then life—and her dreams—abruptly changed.</p> <p>“I was at that invisible stage in life. I was planning a family. I just bought a new home. My career was going well. And then, ‘You have breast cancer.’”</p> <p>Nadia was diagnosed with <a href="/expertise/precision-health-initiative/triple-negative-breast-cancer/">triple negative breast cancer</a>. She underwent a year of chemotherapy, bilateral mastectomy and tested positive for the BRCA1 gene. As a result, she came to understand something she did not have to consider before—the importance of breast cancer research.</p> <p>Now she sees how pivotal it is—not just for her, but for her daughter and women everywhere. And she’s especially grateful for the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation’s support for breast cancer research at IU School of Medicine</a>.</p> <p>“It truly impacts people’s lives— mine and those abroad,” she said. “I am evidence of what research can do and will do. It’s lifesaving and life changing.”</p> <p>Nadia’s dream these days goes far beyond herself and her family. Nadia is an advocate for marginalized women and has become a voice to empower women globally to participate in research and become active in their overall health care. She dreams of a world where a breast cancer diagnosis is simply no big deal.</p> <p>“I was really deep in thought recently about what it would be like if a breast cancer diagnosis was not any more devastating than the diagnosis of a common cold. Simple therapy or medication and back to life, family, and career. That’s my dream.”</p> Tue, 06 Aug 2019 01:35:28 Z{E2DE22C1-A7C4-40E2-A2DB-11C376C8C9FF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/pam-perry-wont-let-cancer-push-her-dreams-asidePam Perry won’t let cancer push her dreams aside<p><em>Updated October 2019<br> </em><em>In memory of Pam Perry.</em></p> <p>When <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">breast cancer</a> spreads, it often lands in bones, typically the ribs or hips. In Pam Perry’s case, it went to her skull.</p> <p>Pam was diagnosed with estrogen positive breast cancer in 2008. She had a mastectomy and reconstruction surgery, and hormone therapy. For four years, that kept the disease at bay. But in 2012, recurring headaches prompted the discovery that her breast cancer was back—and that it had spread to her skull.</p> <p>Pam was no stranger to breast cancer. Her first bout came in 1984, when her son was just four years old. She was horrified at the diagnosis—at that time, cancer was still a harbinger of inevitable doom. But surgery and radiation turned back the disease. For 24 years, she heard no more from cancer.</p> <p>In 2008, a new lump appeared in Pam’s breast. The estrogen positive diagnosis was unrelated to her first breast cancer, but it still came as a shocking surprise. So did the 2012 news that the cancer had spread to the right side of her skull. Despite everything—and through each pass at cancer—Pam has been determined not to let the disease define her. She won’t allow it to push her dreams aside.</p> <p>A wife, mother and now-retired public relations professional, Pam remains on the go. She’s traveled to France, Spain and Cuba. On the horizon are trips to Portugal and back to Spain again, and maybe even Italy and France. She’s also embracing a second act colored by art. Pam relaxes by sketching. She enjoys visits to museums and promoting her now-grown son’s fine art photography. Above all, she stays true to herself. “The breast cancer thing,” she said, “has just been in the background.”</p> Mon, 05 Aug 2019 20:16:47 Z{95F5C31C-4ADC-4B0B-BC79-98AABC35A5F8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/childhood-cancer-survivor-future-pediatric-oncology-nurseChildhood cancer survivor, future pediatric oncology nurse<p>When Tatum Parker was about to turn 6, she woke up in the night with terrible pain in her leg. Her parents took her to the emergency department, but rather than a broken leg or injury, Tatum had a large tumor on her right femur. Her pediatrician immediately recommended Riley Hospital for Children at IU Health. A few days later, Tatum had a biopsy at Riley Hospital, and doctors diagnosed her with <a href="/expertise/precision-health-initiative/childhood-sarcoma/">Ewing sarcoma</a>.</p> <p>“It was definitely scary, especially as a young kid,” Tatum remembers. “You don’t know why they’re sticking all these needles in you. You don’t understand why you have to have all these surgeries and lose your hair and be different from everybody.”</p> <p>A year of chemotherapy and major surgery followed Tatum’s diagnosis. Six inches of her femur was removed and replaced with a steel plate. She spent weeks in the hospital recovering, but a backpack she received when she was first diagnosed kept her entertained.</p> <p>“It was full to the top with games and toys, and I had a pink Gameboy, which was huge,” she remembers. “I took the bag with me every day I went to the hospital.”</p> <p>While she was in and out of Riley Hospital, Tatum noticed that there were some kids in the hospital who didn’t have many visitors or enough to play with.</p> <p>“I would share my things with them,” she says. “After I finished treatment, my family and I wanted to give back somehow. So we started making our own backpacks for every kid diagnosed with cancer at Riley.”</p> <p>When they started the project in 2008, Tatum had been cancer free for a year and half. At 8 years old, Tatum was again diagnosed with Ewing sarcoma, this time in her right lung. As she went through treatment for the second time, she also visited other kids in the hospital to give them their new backpack.</p> <p>“I was able to meet so many kids I was giving these bags to, and I got to see the impact I was making,” she remembers. Today, the Tatum Parker Project makes a backpack for every child diagnosed with cancer in Indiana. Tatum and her family fill each one with hundreds of dollars’ worth of games, toys, books, electronics and gift cards.</p> <p>Tatum has been cancer free for ten years this month. She is currently winding down her last summer before college. Soon she will move to Bloomington to attend Indiana University and study to be a pediatric oncology nurse.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2019/tatum-nurse4-360x240.jpg?h=240&w=360&rev=3e8917e22fbe485095e2abeaa0aa63ae&hash=DE85C94DC687ABDB900DB73F45E4A85A" style=" height:240px; width:360px" class="float-right" / alt="" />“I want so desperately to work with kids who are going through the same thing,” Tatum says. “I can totally put myself in their shoes. I know how to make them feel better because of the things my favorite nurses did for me. I want to be that person for other people.” She’s kept in touch with some of her nurses from Riley Hospital, who have already volunteered to help her study.</p> <p>Tatum also plans to continue giving backpacks to kids diagnosed with cancer and raising money for pediatric cancer research while she’s a nursing student at IU. She points out that only 4 percent of federal funding for cancer research goes to study pediatric cancer.</p> <p>“I know too many people who have passed away from cancers where there wasn’t enough research to know what to do to treat them,” she says. “If there was more money, we could save so many lives.”</p> <p>Tatum is even planning to participate in research as a cancer survivor. Recently at her survivor clinic she was asked if she’d be interested in joining a study to help understand how cancer treatment can effect people years or even decades later.</p> <p>Whether it’s through acts of service, fundraising for <a href="/sitecore/content/iu/iu-som/home/pediatrics/specialties/hematology-oncology/research">pediatric cancer research</a>, participating in research or her future as a nurse, for Tatum, it all comes down to giving back. “I told myself, I want to do something where I can help people. As long as you have a profession where you’re doing something to give back to people, it makes everything worth it.”</p>Mon, 05 Aug 2019 20:00:35 Z{99C3C7A1-12D1-47EA-892F-EE08ED09CE9D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/to-the-best-team-thank-youTo the best team: thank you<h4><em>Written by Melissa Kacena</em></h4> <p>With a successful launch on July 25, I want to take a moment to recap our hard work and to thank all of my team members. As with most things in life, this spaceflight study is truly a team effort.</p> <p>Our journey began in August 2012, and it won’t be finished until our data are analyzed and our manuscripts accepted for publication. The reality is it may take a couple more years after we receive our specimens, meaning this project could take a full decade to complete.</p> <p>Many people may not appreciate how long scientific research can take from initial idea conception, to obtaining funding, to completion of study, to reporting outcomes. Thus, we must celebrate the milestones and the success of the journey, not just the final outcome. Right now we are celebrating the successful launch, which is the start of our experiment.</p> <p>As mentioned before, there have been several personnel changes within our IU, Army and NASA teams over the past seven years, and we thank all past and present team members.</p> <p>Without the help of each individual, we would not have arrived at this point in our study. I would like to thank everyone on our wonderful research team: nine from IU, two from the Army, three from DOD Space Test Program and all of the NASA members for their assistance while at Kennedy Space Center.</p> <p>I also thank the members of the IU team that stayed in Indianapolis to keep our other research efforts in top shape.</p> <p>It has certainly been a busy but rewarding month. Here’s to a great team, and to what I hope will be some great long-term outcomes!</p> Mon, 05 Aug 2019 17:51:28 Z{E7B860DB-8A5E-4F20-999A-471935E384B5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bioethics/clinical-medical-ethics-planned-in-septemberClinical medical ethics conference planned in September<p>Ethical issues are ever-present in clinical communication. The 2019 IU Health Fairbanks Conference on Clinical Medical Ethics will engage with a variety of issues in clinical ethics, including the basics of ethics, communication, and critical care. This conference will be held on Friday, September 27 from 7:15 am – 4:45 pm, in Hine Hall (IP).</p> <p>The Fairbanks Center provides services in ethics for clinical care providers such as clinical ethics consultation, medical ethics education, and ethics research and community service. This event will enhance the ethics competency of everyone who practices or reflects on patient care. Register <a rel="noopener noreferrer" href="https://iu.cloud-cme.com/default.aspx?P=5&EID=41239" target="_blank">here</a>.</p> <p>The conference is also great opportunity to learn about the Fairbank Center’s ethics fellowship, a nine-month, part time fellowship for health care professionals interested in clinical ethics. In this fellowship, physicians, nurses, chaplains, and social workers will be trained in medical ethics regarding patient care.</p>Thu, 01 Aug 2019 11:30:58 Z{B554BE77-9FAE-4828-909F-5DBB2540C964}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/launch-recapLaunch recap<h4><em>Written by Melissa Kacena</em></h4> <p>As the rains diminished and skies began to clear on Thursday afternoon, the team’s spirit began to rise.</p> <p>By 4 pm, the probability for favorable launch weather was up to 50 percent, and by 5:45 pm we heard it was 100 percent a go from a weather standpoint. That was music to our ears!</p> <p>10-9-8-7 … The sun is actually shining and blue skies are all around.</p> <p>6-5-4 … Excited whispers turn into shouts ‘this is really going to happen!’</p> <p>3-2-1 … Plums of smoke surround the launch pad and the engine glows red.</p> <p>LIFTOFF … Awe, joy, pride and relief! My words can’t do it justice because this launch was such a sensory and emotional overload.</p> Tue, 30 Jul 2019 13:36:36 Z{4B28BABB-4FA8-4CFF-850C-BE5F85563A1C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/scrubbed-launch-delayed-second-attempted-scheduledScrubbed: Launch delayed, second attempt scheduled<h4>Written by Sue Samson</h4> <p>In the realm of rocket launches, not only can technical issues cause a delay, but Mother Nature comes into play, too.</p> <p>Wednesday, July 24, was a rather tumultuous weather day on the space coast with thunderstorms roaming in and out all day. According to the Air Force’s 45<sup>th</sup> Space Wing Weather Squadron, there was only a 30 percent chance of favorable weather conditions at 6:24 pm (which was the window when the International Space Station and Earth’s orbits are aligned for launch attempt).</p> <p>Unfortunately, even though the rain had stopped and skies were clearing, there were anvil and cumulus clouds in the area that could hold an electrical charge. This could trigger lightening if a rocket were to pass nearby. Thus, the launch was scrubbed — just seconds before blast off.</p> <p>The next attempt is Thursday, July 25, at 6:01 pm. However, the chance of good weather is the same as it was yesterday.</p> <p>Everyone on the Kacena Lab team will be spending their free time today working on perfecting their NO-rain dances.</p> <p> </p> <p><strong>Where to watch<br> </strong>For coverage of this second launch attempt, scheduled for 6:01 pm Thursday, follow these links:</p> <ul> <li><a href="https://www.nasa.gov/multimedia/nasatv/index.html#public" target="_blank">NASA TV</a>. This may also be available via various local cable and satellite services.</li> <li><a href="https://www.facebook.com/NASA/" target="_blank">NASA Facebook Live</a></li> <li><a href="https://www.youtube.com/watch?v=21X5lGlDOfg" target="_blank">NASA YouTube</a></li> <li><a href="https://www.space.com/17933-nasa-television-webcasts-live-space-tv.html" target="_blank">Space.com</a></li> <li><a href="https://www.rocketlaunch.live/" target="_blank">Rocket Launch Live</a></li> </ul> Thu, 25 Jul 2019 15:13:08 Z{B1C98D4D-3DA6-4C08-BA2F-6C3D619B39D0}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/where-to-watch-the-launchWhere to watch the launch<p>What’s the next best thing to personally seeing, hearing and feeling the SpaceX CRS-18 rocket launch?  Live streaming, of course.</p> <p>You can join the final countdown on July 24 (or July 25 if the first attempt doesn’t proceed) via any of these online sites. Launch is scheduled for 6:24 pm.</p> <ul> <li><a href="https://www.nasa.gov/multimedia/nasatv/index.html#public" target="_blank">NASA TV</a>. This may also be available via various local cable and satellite services. CRS-18 launch coverage begins at 5:45pm.</li> <li><a href="https://www.facebook.com/NASA/" target="_blank">NASA Facebook Live</a>, beginning at 6 pm.</li> <li><a href="https://www.youtube.com/watch?v=21X5lGlDOfg" target="_blank">NASA YouTube</a></li> <li><a href="https://www.space.com/17933-nasa-television-webcasts-live-space-tv.html" target="_blank">Space.com</a></li> <li><a href="https://www.rocketlaunch.live" target="_blank">Rocket Launch Live</a></li> </ul> Wed, 24 Jul 2019 12:48:42 Z{53343382-C8EA-4F94-98D8-053E228733DF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/escapeEscape!<h4><em>Written by Sue Samson</em></h4> <p>We know that the spaceflight research team is made up of a lot of intelligent, analytical and creative people, but can they apply those attributes outside the laboratory walls?</p> <p>Recently, the group participated in a team building activity at a Rocket Science themed Escape Room (how apropos!).</p> <p>Did they have the right stuff to solve puzzles, find hidden clues and get out of the room before time ran out? Well, according to this photo they do have what’s needed to uncover the Rocket Science secrets. And to top it off, they have a genius or two among them.  Way to go, team!</p> Wed, 24 Jul 2019 12:34:40 Z{BB06F39F-F542-401A-9227-18DAF59AFE10}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/white-glove-deliveryWhite-glove delivery<h4><em>Written by Sue Samson</em></h4> <p>Perhaps you’ve heard about “white glove delivery” for special antiques or furniture.</p> <p>Well, guess what? Recently, NASA utilized a similar service to move the spaceflight hardware that will be used in the Cell Science-02 studies from California to Florida.</p> <p>Most of NASA’s space biology research programs are conducted at Ames Research Center, which is located in the heart of Silicon Valley in California. This is also where the specialized hardware needed for our cell study was built and tested. However, this hardware is quite a distance from its final destination: the launch pad at Kennedy Space Center.</p> <p>Because of the complexity and sensitivity of the hardware, NASA uses white glove delivery services to minimize the possibility of a mission-ending jolt or snag that could materialize during transport. Not only does this type of service provide knowledgeable crews, expert packing and unpacking and specialized handling during transport, but also can monitor a multitude of parameters (vibrations, acceleration, humidity etc.) during the entire process.</p> <p>The good news is that the hardware’s 2,800-mile cross-country trek went off without a hitch and is now awaiting for us to load our cells prior to its installation onto SpaceX CRS-18. Once installed, along with 50 other scientific experiments, our cells will head toward the unique conditions found inside the International Space Station.</p> Mon, 22 Jul 2019 19:07:09 Z{B9C05826-20B0-49D2-BF61-283337523A75}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/sundays-launch-cancelledSunday’s launch cancelled — and rescheduled<h4><em>Written by Sue Samson</em></h4> <p><em>UPDATE (as of 4:30 pm Friday, July 19):  The launch has been officially pushed to July 24 or 25. We’re all hopeful that this seventh inning stretch won’t l</em><em>ast too long.</em></p> <p>EARLIER:</p> <p>Stand by everyone.</p> <p>We received word on Thursday evening that SpaceX has been working on a rocket issue for several days and confirmed that there will <strong><u>not</u> </strong>be a launch attempt on Sunday, July 21.</p> <p>So, for now, the current plan is to launch on Monday, July 22, with backup launches slated for July 24 and 25.  No other information is available at this time, and we will pass along updates as soon as they are received.</p> <p>While this is disappointing news for everyone involved, we understand this is part of spaceflight and that it’s crucial for the engineers and flight control teams to resolve issues ahead of time so that launch day will be the grand event we are waiting for.</p> Fri, 19 Jul 2019 14:10:50 Z{346C89CB-8E98-4E0D-93DF-458650D1AB16}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/helping-cancer-survivors-get-back-to-life-after-treatment-with-new-free-wellness-centerHelping cancer survivors get “back to life” after treatment with new wellness center<p>After finishing cancer treatments, many survivors do not know where to turn for guidance about their physical and mental health. The Indiana Cancer Wellness Center is a one-stop-shop for guidance about nutrition, fitness, wellness and other services that people wouldn’t be able to get at a hospital.</p> <p>Researchers at Indiana University School of Medicine and IUPUI have been working on the infrastructure of this program for the last several months. The goal is to develop personalized approaches to optimize health and wellness of cancer survivors to help them live longer, healthier lives — during and after cancer treatment. While survivors are working with the research team, they get free access to the wellness center.</p> <p>“We’re doing an amazing job at curing a lot of people with cancer,” said <a href="/faculty/6480/renbarger-jamie">Jamie Renbarger, MD, MS</a>. “Now we need to figure out better ways to help them get completely back to normalcy, or life after treatment.”</p> <p><iframe title="Indiana Cancer Wellness Center" width="500" height="281" src="https://www.youtube.com/embed/2SqUN-nR6_Q?feature=oembed" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe></p> <p>Renbarger works as a pediatric oncologist and came up with the idea for the wellness center after seeing her patients suffer from neuropathy. She was concerned when their pain affected their ability to exercise, causing effects like obesity and cardiovascular disease.</p> <p>The research team started working with cancer survivors at the wellness center in the beginning of June 2019. Cancer survivor Michael Sajdyk is about halfway through his program. He meets with a personal trainer (who is a medical student) three times a week and says he has already seen positive results.</p> <p>“Just seeing that transition, that change to where I am now, is such a motivating factor,” said Sajdyk. “You look at that and think, ‘I can’t believe I did that in six weeks.'”</p> <p>Sajdyk says he appreciates that the trainers work with the survivors as an individual, personalizing care for each person’s needs at various levels.</p> <p>“Without treating the whole person, you’re not going to help them achieve long-term goals,” said Sajdyk.</p> <p>Cancer survivors from around the state will have access to these services, housed within the <a href="https://www.indianapolishealthplex.com/" target="_blank">Indianapolis Healthplex</a>. Organizers plan to renovate a section inside the Healthplex on the third floor, adding a lobby, an exercise area and other specialized spaces for researchers to work with the survivors. Survivors will also be able to use the entire Healthplex during participation in the research program.</p> <p>“The <a href="https://indianactsi.org/" target="_blank">Indiana Clinical and Translational Sciences Institute</a> really provides the foundation that is allowing us to do the research we’re kicking off,” said Renbarger.</p> <p>Researchers say the Indiana CTSI is also helping them develop a database from across the state, which will help them compile information to better guide cancer survivors.</p> <p>Participants do not need to be patients of the IU Health system to participate in the wellness center.</p> <p>The Indiana Cancer Wellness Center is made possible through the support of IU School of Medicine, IUPUI Health and Human Sciences, Indiana Clinical and Translational Sciences Institute, IU Grand Challenge Precision Health Initiative, University of Indianapolis Department of Kinesiology, and the generosity of Joan SerVaas, CEO, Saturday Evening Post Society and Owner, Indianapolis Healthplex.</p> <p>To get more information about the Indiana Cancer Wellness Center Program, contact Tammy Sajdyk at <a href="mailto:tsajdyk@iu.edu" target="_blank" rel="noopener noreferrer">tsajdyk@iu.edu</a>  or Jamie Renbarger at <a href="mailto:jarenbar@iu.edu">jarenbar@iu.edu</a>.</p> <p>For information about the research study, call Dani Halsey at 317-948-7186 or send an email to <a href="mailto:surstudy@iupui.edu" target="_blank" rel="noopener noreferrer">surstudy@iupui.edu.</a></p> Thu, 18 Jul 2019 19:17:05 Z{8793219B-6A9B-4CE9-A3C3-4F51005A7768}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/backup-launch-dates-just-in-caseBackup launch dates – just in case<h4><em>Written by Melissa Kacena</em></h4> <p>The first launch attempt dates for SpaceX-18 remain the same. However, the second attempt launch dates have shifted by a day.  Two consecutive dates are scheduled for each launch attempt, so here is the current schedule:</p> <p>Launch attempt #1:  July 21<sup>st </sup>/ July 22<sup>nd</sup></p> <p>Launch attempt #2:  July 24<sup>th</sup> / July 25<sup>th</sup></p> Thu, 18 Jul 2019 14:45:41 Z{F49FDB3D-21C1-4B22-AE07-4E17FA00048C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/final-preparations-have-startedFinal preparations have started<h4><em>Written by Sue Samson</em></h4> <p>Now that the groundwork for the cell study has been completed, tested and re-tested, team members have now shifted their focus to the actual performance — setting up the bioreactors, hardware and cells that will go the International Space Station.</p> <p>The video clips below show some of the lab activities going on this week.</p> <div class="wp-video"><!--[if lt IE 9]><script>document.createElement('video');</script><![endif]--> <video class="wp-video-shortcode" id="video-12660-1" width="960" height="540" preload="metadata" controls="controls"><source type="video/mp4" src="http://medicine.iu.edu/blogs/wp-content/uploads/sites/23/2019/07/Kacena-4_Small.mp4?_=1"></source></video></div> <p>This video shows several Army, IU and NASA teams working together to complete steps for the bioreactor protocol. Each team consists of a ‘reader’ sitting behind the researcher executing activities in a sterile hood. Readers are responsible for clearly reciting each procedural step and then watching and confirming that the step was performed correctly. Toward the middle of this clip, you’ll see <a href="/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-ushashi-dadwal">Ushasi Dadwal</a> preparing the spaceflight bioreactors for cell loading.</p> <p> </p> <div class="wp-video"><video class="wp-video-shortcode" id="video-12660-2" width="960" height="540" preload="metadata" controls="controls"><source type="video/mp4" src="http://medicine.iu.edu/blogs/wp-content/uploads/sites/23/2019/07/Kacena-2_Small.mp4?_=2"></source></video></div> <p>This is an up-close look at <a href="/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-rachel-blosser">Rachel Blosser</a> working in the hood while flushing media through the internal and external ports of the spaceflight bioreactor.</p> <p> </p> <div class="wp-video"><video class="wp-video-shortcode" id="video-12660-3" width="960" height="540" preload="metadata" controls="controls"><source type="video/mp4" src="http://medicine.iu.edu/blogs/wp-content/uploads/sites/23/2019/07/Kacena-3_Small.mp4?_=3"></source></video></div> <p>This is a good look at the spaceflight hardware that will house the bioreactor. In this clip, you’ll see the NASA engineering team preparing the hardware for the actual integration of the bioreactor (which will occur L-35 hr, or NASA talk for 35 hours prior to launch).</p> Wed, 17 Jul 2019 20:54:29 Z{050424A6-4228-44F2-8CBB-7C241C7A072F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/high-fives-around-the-labHigh fives around the lab<h4>Written by Melissa Kacena</h4> <p>After a long but successful day of work at NASA laboratories, the Kacena Lab team acknowledged a job well done laboratory-style — you should never touch things when someone is gloved, including other hands!</p> <p><em>Pictured above are (back row, from left) Melissa Kacena, Ushasi Dadwal (front row, from left) Seungyup Sun and Rachel Blosser</em></p> Tue, 16 Jul 2019 16:44:21 Z{FE324E3A-3925-4986-A571-A29D43FA0A37}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/experiment-featured-in-videoExperiment featured in video<p>Space.com featured the Kacena Lab’s bone-therapy experiment in a YouTube video detailing what projects are headed for the International Space Station aboard SpaceX-18 on July 21.</p> <p>Space.com calls itself “the leading space news site … keeping up on the latest space science, technology and astronomy news.”</p> <p>Watch the video, here: <a href="https://www.youtube.com/watch?v=LaJRZfEK_w4&feature=youtu.be" target="_blank">https://www.youtube.com/watch?v=LaJRZfEK_w4&feature=youtu.be</a></p> Thu, 11 Jul 2019 18:37:38 Z{884D1AD8-4353-4BD3-932A-ABB30017E5C9}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/travel-arrival-at-nasaTravel, arrival at NASA<p>Bags packed, car loaded and plenty of snacks on board!</p> <p>The five team members driving to Kennedy Space Center left Indianapolis around midday Monday full of smiles and anticipation for the next couple of weeks.</p> <p>More than 15 hours later, they were joined by Dr. Kacena and the other team members who flew to Florida from Indianapolis early Tuesday.</p> <p></p> <p>Everyone caught a little shut eye and regrouped while waiting in NASA’s badging area to complete their paperwork Tuesday midday.</p> <p>Lookout for a few travel stories soon! But for now we’re all thankful everyone has arrived safely — albeit somewhat road weary.</p> Tue, 09 Jul 2019 21:46:23 Z{4B5D36F9-1F36-47A5-9D16-EE001FEFA8DB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/recap-of-our-media-dayRecap of our media day<p>The Kacena Lab was a hub of activity Monday as local TV, radio and newspaper reporters stopped by for interviews about the cell study going into space.</p> <p>First job of the day was to tidy up around the labs and then to set up several stations for scientific demonstrations.  The reporters got a chance to interview Dr. Kacena and to chat with students.</p> <p>You can follow these links to see and hear what was shared with the media. And watch for more blog updates throughout the week as our team makes its way to NASA and settles in!</p> <p> </p> <p>Media stories:<br> WFYI (Indianapolis public radio): <a href="https://bit.ly/2NJ5l0W" target="_blank">https://bit.ly/2NJ5l0W</a></p> <p>RTV6 (Indy-area ABC affiliate):<a href="https://bit.ly/2JnaG9U" target="_blank"> https://bit.ly/2JnaG9U</a></p> <p>Inside Indiana Business (local business television/radio program): <a href="https://bit.ly/2JxXnCu" target="_blank">https://bit.ly/2JxXnCu</a> and <a href="https://bit.ly/2XGb9gk" target="_blank">https://bit.ly/2XGb9gk</a></p> Tue, 09 Jul 2019 15:55:40 Z{D3A9DA34-994C-4791-B56D-3122D9244A31}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/travel-plansTravel plans<h4><em>Written by Sue Samson</em></h4> <p>The Kacena lab crew that will be participating in the research at Kennedy Space Center has been assembled and is now looking forward to the next phase of Cell Science-02 (that is the study’s official NASA name).</p> <p>For the last several months, the Indiana University scientists have been reviewing and training on Assembly, Test and Operations Procedures (ATOPs), preparing supplies for shipment to Florida and stabilizing other research projects for while they are away.</p> <p>On July 9, nine members of the Kacena Lab will move 1,035 miles south in anticipation of preparing the actual cells for launch and two weeks in orbit.  Four of the team members (Dr. Kacena, Rachel, Ushashi and Ola) will be flying into Orlando, renting a car, and then driving to Cape Canaveral to arrive in time for a mid-morning training session followed by a full day in the lab—unpacking, setting up, preparing reagents and reviewing schedules and procedures.  The other five researchers (Zach G, Alex, Sunny, Anthony and Zack C.) will be driving for 15+ hours to Kennedy Space Center to meet up with the others for training on July 9.</p> <p>Although the days in Florida leading up to the launch will be long and involved, everyone is hopeful that there will be some opportunity to relax at the team hotel, International Palms Resort, Cocoa Beach.</p> <p><em>Pictured above, from left to right are: Ola Awosanya, Rachel Blosser, Ushashi Dadwal, Zach Gunderson, Melissa Kacena, Anthony Perugini, Seungyup Sun, Zack Campbell, Alex Brinker</em></p> Fri, 05 Jul 2019 18:09:28 Z{20F1C6F0-665B-42E1-8E57-AFE27C7906D5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/happy-birthday-americaHappy Birthday, America!<p>“We hold these truths to be self-evident, that all men are created equal, that they are endowed by their creator with certain unalienable rights, that among these are life, liberty, and the pursuit of happiness.”</p> <p>The entire Kacena Lab hopes you have an enjoyable celebration of our country’s 243<sup>rd</sup> birthday!</p> Thu, 04 Jul 2019 12:00:49 Z{A792585C-F39A-4CA7-B8FC-35A70AA7DD8E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/catastrophe-avertedCatastrophe averted!<h4><em>Written by Rachel Blosser</em></h4> <p>As with many things in life, something potentially devastating seems to pop up at the most inopportune time.</p> <p>Last week while we were packing and shipping our supplies needed at Kennedy Space Center from Dr. Kacena’s lab, we received an email from our collaborators saying that the collagen required to prepare the bioreactors is on back order until July 17 — YIKES!</p> <p>Collagen is one of the critical reagents needed to culture cells, and we will need it beginning July 12.  Delivery five days later will not do us much good.</p> <p>Since research grade collagen is not something we can purchase at the local Walgreens, collaborators from IU, Army and NASA began to brainstorm the best way to handle the situation.  Several approaches were considered and some we’re discarded immediately (like scrub the research project entirely).</p> <p>Option 1: Decrease bioreactor preparation time. The protocol requires three washes for the bioreactors lasting between six and 24 hours.  Typically we wait overnight; but each wash could be shortened to six hours, allowing two washes per day rather than one wash per day. This would decrease the total bioreactor preparation time and allow us to start the prep a few days later. However, we were not eager to change the prep time if we didn’t absolutely need to.</p> <p>Option 2: Use current batch of collagen. The Kacena Lab has some collagen left over from the August 2018 <a href="/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-rachel-blosser">Experiment Verification Testing </a>and fortunately has the required amount needed. However, the next challenge was to determine the best way to get it to Kennedy Space Center, not only because this is now our sole source of collagen but also because collagen is very temperature sensitive. If we couldn’t ensure it would be maintained at 2-8 degrees at all times then it would breakdown and be unusable.</p> <p>We considered several alternatives at this point: send the collagen with the students driving to Kennedy Space Center; carry it onto the airplane with a team members that will be flying; overnight express mail in a single package to Kennedy Space Center; or split it in half and mail overnight in two separate shipments.</p> <p>We finally decided the best approach was to mail the collagen to Kennedy Space Center in two different overnight delivery packages. In case something happens to one package, we would still have a backup.</p> <p>As we get closer and closer to the launch, I am learning that hiccups like this may increase my stress level, but once we get through the challenge my sense of accomplishment grows.  I have also learned that you always need a backup plan — or two.</p> Wed, 03 Jul 2019 19:05:00 Z{22C1623D-71E7-4C03-BC17-B449D4266A93}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/the-science-of-shippingThe science of shipping<h4><em>Written by Sue Samson</em></h4> <p>Surprisingly, there is even a science aspect to getting our research materials to Florida.</p> <p>Dr. Kacena’s studies are conducted at Indiana University School of Medicine in Indianapolis, so moving all of the essentials to the laboratories in Cape Canaveral means a lot of packing, repacking, shipping, tracking and analyzing.</p> <p>In all, eight boxes of supplies, cells, serum and reagents will be packed up for overnight delivery to NASA on three different days.  Mission-critical cells and serum will be split into three different packages to minimize the risk of loss if something were to happen to the shipment, such as a delayed arrival, lost/damaged package or detrimental temperature fluctuations.</p> <p>Because the cells need to remain frozen until the scientists are ready to load them into the bioreactors at NASA, the cells will be packed into a cooler containing dry ice (which is frozen carbon dioxide).</p> <p>When packed properly, the cells will stay at -80 degrees Celsius for a few days even during the height of summer heat.</p> <p>But how do we know the cells don’t thaw a bit while in transit?  Data loggers!</p> <p>A data logger is a small electronic recorder that measures temperature over time, and a logger will be placed in every temperature-sensitive package.</p> <p>Upon arrival at Kennedy Space Center, the data from the loggers will be downloaded and analyzed to ensure the temperature remained within the proper range. Below is a data logger readout from our first cell shipment.</p> <p></p> <p>You can see the temperature drop to -80 degrees on June 27, 2019 and remain near that temperature until the next day when it was unpacked at NASA.</p> <p>This information gives us the confidence that our cells remained frozen throughout the shipping process and should be viable for the next phase of research.</p> Mon, 01 Jul 2019 18:23:12 Z{07F76D04-224A-4080-A802-96CFEEE74946}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/ballinger-earns-career-development-award-from-asco-conquer-cancer-foundationBallinger earns Career Development Award from ASCO Conquer Cancer Foundation<p><a href="/faculty/3828/ballinger-tarah">Tarah Ballinger</a>, MD, was named a recipient of the Career Development Award presented by the Conquer Cancer Foundation of the American Society of Clinical Oncology (ASCO). It was presented at the recent 2019 ASCO Annual Meeting in Chicago.</p> <p>The Career Development Award provides research funding to clinical investigators as they establish an independent research program. The Career Development grants are awarded to researchers with a focus on patient-oriented clinical or translational research. The award, supported by the Breast Cancer Research Foundation, is a three-year grant totaling $200,000 to support Ballinger’s project, “Good Vibrations: A Novel Mechanical Intervention to Understand and Preserve Musculoskeletal Health in Early Stage Breast Cancer.”</p> <p>The goal of the project, according to Ballinger, is to evaluate low intensity vibration as a means to mimic the benefits of exercise to the musculoskeletal system, and to deepen our understanding of how common breast cancer medications affect muscular and skeletal health.</p> <p>Ballinger’s mentors for the research project are Theresa Guise, MD, and <a href="/faculty/4849/miller-kathy">Kathy Miller</a>, MD.</p> <p>Ballinger previously secured funding to study the molecular mechanisms of muscle weakness in breast cancer patients and has opened a clinical trial assessing physical function and physical activity interventions to combat muscle weakness in patients.</p> <p>Her long-range plan is to continue researching the musculoskeletal complications of breast cancer and its therapies with the ultimate goal of improving the quality of life and treatment outcomes for patients.</p> <p>Ballinger is an assistant professor of clinical medicine, the Sheila D. Ward Scholar in Oncology, and a member of the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a> at IU School of Medicine, and an associate member of the <a rel="noopener noreferrer" href="https://cancer.iu.edu/research-trials/programs/prevention/index.shtml" target="_blank">Cancer Prevention and Control research program</a> at the <a rel="noopener noreferrer" href="http://www.cancer.iu.edu/" target="_blank">IU Simon Cancer Center</a>.</p>Thu, 27 Jun 2019 15:47:25 Z{E9DBFCF4-17F2-494D-B9E8-2BCD85D4296F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-luke-mcveighMeet the team: Luke McVeigh<h4><em>Written by Luke McVeigh</em></h4> <p>Hello! My name is Luke McVeigh, and I am a first-year medical student at Indiana University School of Medicine.</p> <p>I am originally from Lansing, Michigan and attended the University of Notre Dame, where I received my Bachelor of Science in Biochemistry. I joined the Kacena Lab in January 2019 and will be working in the lab full time this summer through the Indiana University Medical Student Program for Research and Scholarship.</p> <p>Research played an integral role in my education throughout my undergraduate career. I worked as a member of Dr. Robert Stahelin’s lab on the IU School of Medicine–South Bend campus during my years at Notre Dame, where we investigated the mechanism of action of Viral Matrix Protein (VP40) of the Ebola and Marburg viruses.</p> <p>I also spent a summer of research through the University of Michigan Frankel Cardiovascular Center Fellowship working in Dr. Lori Isom’s lab investigating how a specific mutation in Nav 1.6 sodium channels that causes epileptic encephalopathy affects cardiac excitability.</p> <p>I have loved my time working in the research lab as it has given me an opportunity to apply what I have learned in the classroom to real world cases and also involves critical thinking and difficult problem solving. I am excited to start a new research experience as a member of Dr. Kacena’s lab while in medical school.</p> <p>Since I have never worked with large animals before, I have enjoyed all aspects of the pig bone healing project in the Kacena lab.</p> <p>I am eager to contribute to both bone healing projects (pig and mouse) as well as investigate the effects of different analgesics on fracture healing and chronic pain state outcomes. Though I am new to the field of orthopedics, I look forward to learning and contributing to the field throughout my time in medical school and possibly beyond.</p> Wed, 26 Jun 2019 15:56:39 Z{E4D88969-6B1A-41BF-AFB2-5687C0526C92}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/pre-launch-preparationsPre-Launch preparations<h4><em>Written by Melissa Kacena</em></h4> <p>Monday, I finished a call with NASA in which we continued to work through the logistics associated with our upcoming launch.</p> <p>One of the many challenges we face will be that our team needs to begin the final spaceflight hardware loading process 40 hours prior to launch.</p> <p>Since the launch is scheduled in the evening on July 21, this means we will get a VERY EARLY start on the July 20 with a 3 am team meeting at Kennedy Space Center and then move our activities into the laboratory by 3:30 am.</p> <p>From our prior spaceflight experience, we know it will take about 45 minutes to travel from our hotel in Cocoa Beach, get through badging/security at Kennedy Space Center, park and into the building.</p> <p>Our alarm clocks will be blaring long before the sun will rise that day; however, if all goes well then we should be done by approximately 2 pm.</p> <p>Hopefully we’ll have plenty of caffeine to give us the energy boost needed for the long day. And besides, I suspect the medical students will feel right at home with a middle-of-the-night start time, as we know patient care happens at all hours of the day!</p> Tue, 25 Jun 2019 17:50:43 Z{09188B0F-57BE-4144-AFFB-3D13DAC9177F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-sue-samsonMeet the team: Sue Samson<h4><em>Written by Sue Samson</em></h4> <p>I’m Sue Samson, and I handle the administrative side of things for the Kacena lab. That makes me the behind-the-scenes person that (hopefully) keeps things running slickly.</p> <p>I’ve been with this group since the fall of 2018 and am enjoying the variety of work and the diversity of people I interact with. I’m especially looking forward to helping with the activities associated with the upcoming spaceflight and sharing some of the inside scoop with you.</p> <p>I enjoy and find inspiration in trying new things, so I guess that’s why I’ve done a bunch of things over the years, including running a small business, working for a big company, training dogs and their people, helping my kids’ sports team raise money, testing new recipes on my unsuspecting friends and family or trekking around in as many of the national parks I can get to.</p> <p>I even worked in a basic research lab for my first job right after undergrad, so I feel like I’ve gone full circle when I joined Dr. Kacena’s team.</p> <p>By the way, I love chocolate in or on most anything, so people can bribe me into doing most anything with a little chocolate—and that may be handy for people to know as we get closer to preparations for the spaceflight.</p> Thu, 20 Jun 2019 17:53:47 Z{0EA66E86-9F9B-48D5-B59A-7FB106AE587A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/launch-campaign-set-countdown-beginsLaunch campaign set, countdown begins<h4><em>Written by Melissa Kacena, PhD</em></h4> <p>Yesterday we heard from NASA what the launch campaign will be for Space-X-18 and now we are on pre-flight countdown.</p> <p>The prime launch attempt (first launch attempt) is on July 21, 2019 at 19:34 EDT.</p> <p>July 22, 2019 is the back-up launch attempt at 19:12 EDT. If the launch is unable to proceed then we stand down for a day. However, this will not be a day off for us and instead we will be working to re-load our cells so that they have minimal time on the Earth prior to launch.</p> <p>The third launch attempt is scheduled for July 24, 2019 at 18:23 EDT. If this mission doesn’t launch during the three dates, then it may be delayed until August 2, 2019 at 15:17 EDT.  The reasons: range conflicts, as the Kennedy Space Center launch facility is booked with other missions; and traffic in space – yes there are space traffic jams produced by a variety of satellites and debris in multiple orbital planes!</p> <p>Now with an official launch campaign in hand and our team’s arrival at Kennedy Space Center to prepare our experiment just three weeks away. We have booked our airline reservations and are diligently finalizing our travel plans.</p> Wed, 19 Jun 2019 16:53:34 Z{2883C732-B655-4436-A4A6-596794E916B8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/vera-bradley-donationA million dreams for breast cancer at Vera Bradley event<p>The Vera Bradley Foundation for Breast Cancer continued its two decades of support for Indiana University School of Medicine’s breast cancer research program with a donation of more than $1 million at its annual charity golf outing on June 3.</p> <p>The foundation—the charitable arm of the Fort Wayne-based handbag and accessory maker—has donated more than $32.5 million to IU School of Medicine toward a total commitment of $37.5 million.</p> <p>In recognition of that generosity, the school established the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a> at IU School of Medicine in 2018.</p> <p>“Today, I’m here to tell you that we are barreling ahead,” IU School of Medicine <a href="/sitecore/content/iu/iu-som/home/executive-leadership/dean">Dean Jay L. Hess, MD, PhD, MHSA</a>, told a crowd of several hundred people at the Vera Bradley Foundation for Breast Cancer Classic. “Over the past year, we’ve focused tremendous time and energy on one of the most aggressive types of breast cancer: triple negative breast cancer. And we are making terrific progress.”</p> <h3>Research makes possible ‘life’s simple pleasures’</h3> <p>The theme for the evening was “A Million Dreams,” based on the song from the popular movie “The Greatest Showman.” Hess, who sings in his church choir, delighted and surprised guests by joining Fort Wayne-area vocalist Rachel Smith onstage to sing the final lines of the song: <em>“A million dreams is all it’s gonna take/ A million dreams for the world we’re gonna make.”</em></p> <p>He then shared the story of <a href="https://news.iu.edu/stories/2019/05/iu/inside/22-precision-health-initiative-dramatic-triple-negative-breast-cancer-treatment-results.html" target="_blank">Jackie Stephens, a patient with triple negative breast cancer</a> who travels from South Bend to Indianapolis every week to participate in a <a href="/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/popular-arcade-game-inspiring-new-treatment-aggressive-type-breast-cancer">clinical research study</a> led by Kathy Miller, MD, and based on the research of Milan Radovich, PhD. Hess visited with Stephens in the hospital in May as she received chemotherapy.</p> <p>He said support from the Vera Bradley Foundation is helping Stephens realize her dreams.</p> <p>Thanks to the study, Stephens can visit with her granddaughter, spend time tending to her garden, and continue her near-daily visits to a nursing home for retired priests. “You see, Jackie doesn’t have a bucket list or some grand adventure she wants to go on,” Hess said. “She just wants to get up each day, enjoy life’s simple pleasures, and have more time with her family.”</p> <p>“I can’t promise what the future holds for Jackie—or for any patient—but I can promise that we don’t give up,” said Hess, who lost his own mother to breast cancer when he was in college. “We will be relentless in our pursuit of a cure. And we will get there. There will be a day when breast cancer no longer instills fear the way it did for my mother, or Jackie, or countless others like them.”</p> Thu, 13 Jun 2019 02:51:27 Z{884602EA-B9D4-49FF-AEF1-ACDB6EBB9B67}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-ushashi-dadwalMeet the team: Ushashi Dadwal<h5><em>Written by Ushashi Dadwal</em></h5> <p>Hi, everyone,</p> <p>I’m Ushashi Dadwal, a new postdoctoral appointee in Dr. Kacena’s lab.</p> <p>I received my PhD in chemical engineering from Vanderbilt University in Nashville, Tennessee. For my dissertation work, I studied how tumor cells behave on different rigidities, i.e., would certain tumor cells prefer rigid surfaces like the bone or softer tissue like breast? I used a 3D printing sacrificial mold methodology to make the rigid vs soft tissue mimics.</p> <p>I relocated to Indiana University School of Medicine for my postdoctoral work in the <a href="/sitecore/content/iu/iu-som/home/faculty-labs/sankar">research lab</a> of <a href="/faculty/23070/sankar-uma">Uma Sankar, PhD, </a>and to expand my knowledge of molecular biology.</p> <p>I just recently started in Dr. Kacena’s lab to gain experience in fracture healing within the aging population. Within two months of joining the lab, I have caught “space fever” and am excited to participate in the upcoming studies at NASA Kennedy Space Center at Orlando, Florida.</p> Wed, 12 Jun 2019 18:21:39 Z{627012A2-BB35-4003-958E-033F42BFEADD}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-alex-brinkerMeet the team: Alex Brinker<h5><em>Written by Alex Brinker</em></h5> <p>Hello, everyone!</p> <p>My name is Alex Brinker.</p> <p>I recently graduated with my Bachelors of Science in Kinesiology from IUPUI with a focus in medicine. I have been working in Dr. Kacena’s lab since my sophomore year (soon to be five years).</p> <p>Working in the lab has furthered my understanding of the complex world encompassing scientific research, as well as provided opportunities for professional and personal development.  I originally planned on obtaining my Master’s degree and becoming a research assistant, however after all of my research experiences with Dr. Kacena in both research and clinical fields, I have now decided to pursue medical school. I am studying to take the Medical College Admission Test (MCAT) in May.</p> <p>As for my work in the lab, I am deeply involved in our bone healing and muscle function studies with porcine models, assisting in staff coordination and data analyses. I also participate in our mouse research which include diabetic studies and pain studies. Moving forward I hope to stay involved in the lab and play a more integral role in the studies prior to entering medical school.</p> Mon, 10 Jun 2019 15:52:37 Z{15556A5C-9D8D-44E4-9993-C03D85E34BDA}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/team-passes-flight-readiness-reviewTeam passes Flight Readiness Review<h5><em>Written by Melissa Kacena</em></h5> <p>Yesterday, we had our Flight Readiness Review (FRR). This is a fairly formal, go/no-go review detailing the status of every aspect of our experiment from the science and the hardware to the software, the operations, the logistics and more.</p> <p>There are a few items that still need to be completed, several of which are more paperwork or quality assurance related.</p> <p>But the overall finding is that we are a go for launch!</p> Wed, 05 Jun 2019 17:41:05 Z{087597B4-CFB0-41CB-9B82-69C2174050D6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/new-launch-date-take-21New Launch Date: Take 21?<h5><em>Written by Melissa Kacena</em></h5> <p>Yesterday from 1-2 pm Eastern Standard Time, I was on a conference call with NASA where for at least for 30 minutes we discussed how the modified launch date (July 18) impacts our delivery schedule and our onsite schedule.</p> <p>Just more than an hour later, I was notified that the new official launch date is no earlier than July 21. Will this be the actual launch date? Who knows. But we will keep you posted!</p> <p>There are at least two family-related things that this new date makes easier for me.</p> <p>First, I get to enjoy the week around July 4 with my family, including watching fireworks on July 6 (originally our team was scheduled to arrive at Kennedy Space Center early on July 5).</p> <p>Second, my youngest son, for his birthday, asked to watch the Liverpool F.C. vs. Borussia Dortmund game being hosted at Notre Dame. The game is July 19, so now the rest of the family can go to the game, and my son can invite a friend to take my place while I am at Kennedy Space Center preparing for the launch. And my family can still get to Kennedy Space Center for the July 21 launch.</p> Tue, 04 Jun 2019 17:08:41 Z{52F54FC0-0E25-447A-9FC7-57AB8CE43F5C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-zach-gundersonMeet the Team: Zach Gunderson<h5><em>Written by Zach Gunderson</em></h5> <p> </p> <p>Hello everyone,</p> <p>My name is Zach Gunderson.  I am a first-year medical student at Indiana University School of Medicine. I completed my undergraduate studies in biochemistry and mathematics at Indiana University Bloomington.  It was in Bloomington while I worked as an EMT that I found my passion for serving patients and the community.</p> <p>I’ve learned a lot during my first year in medical school, and osteology and anatomy have been the most interesting for me. With my experiences in dealing with my own broken bones and my love of carpentry, orthopaedics seems like a natural fit.</p> <p>I joined Dr. Kacena’s lab the summer after my senior year of college because I wanted to work with the people who were driving advances in the field. This isn’t my first time participating in research, but I have never been more excited about it.</p> <p>From cell culture to animal surgery to bibliometric analyses, I have participated in the broad spectrum of research activities and interests that this lab provides. Dr. Kacena and the faculty we work with have also become personal mentors, helping guide my individual and professional growth as well as plan for the clinic.</p> <p>My goal is to continue working in the lab until I reach residency. I truly cannot recommend the lab and research itself enough. For anyone interested in research, go find a field you enjoy, a skill you want to learn, or a type of patient you want to help and get involved.</p> Mon, 03 Jun 2019 18:33:46 Z{A2C3FA6E-9D12-47A5-B596-3B576E7BE39E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/update-new-launch-date-new-logisticsUpdate: New launch date, new logistics<h5>Written by Melissa Kacena, PhD</h5> <p>We recently learned that the SpaceX-18 is being delayed 10 days, so our new target date is July 18, 2019.</p> <p>As you might imagine, there are a lot of changing schedules for everyone involved. We will need to modify our travel plans (we were originally leaving Indianapolis on June 26 and will now leave July 5), revise shipping strategies and develop overall timelines.</p> <p>Being in Florida and working during the week of the Fourth of July was going to be a bit tricky as it was. But now that we will be arriving immediately after the federal holiday, getting started becomes more complicated.</p> <p>Even though our team won’t begin work in the labs until Saturday, July 6, we will however need to finalize the badging process and orientation training before we can get started. That gives us just Friday, July 5, to complete all of this.</p> <p>Our crew might just have to end their Independence Day celebrations early in order to catch an early morning flight to Orlando and then head straight to KSC to get started.</p> Thu, 30 May 2019 13:23:24 Z{0031B577-3804-4873-9FBB-C875C37C296E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/memorial-day-2019Memorial Day 2019<h5><em>Written by Melissa Kacena, PhD</em></h5> <p>Monday was a U.S. federal holiday, Memorial Day. It is a day to honor those that have died while serving in the military.</p> <p>As much of our bone healing studies for our NASA mission are directly supported by the DOD, U.S. Army, and the V.A., I would like to take a moment to thank all of the brave men and women who serve, or have served, in our military to make sure we are all safe.</p> Wed, 29 May 2019 16:30:53 Z{CDF591EB-D613-4066-BBCC-F182397E7D8E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-olatundun-awosanyaMeet the team: Olatundun Awosanya<h5><em>Written by Olatundun Awosanya (pictured above)</em></h5> <p> </p> <p>Hello all, my name is Olatundun Awosanya — “Ola” for short.</p> <p>I am currently a junior at IUPUI majoring in chemistry. In my free time I enjoy hanging out with my little sisters and sitting outside on a nice day while listening to music.</p> <p>I started last fall in the Kacena lab as a Life Health Sciences intern and was unsure of my career path. I was very nervous at first; but being guided by all the amazing people in the lab helped me to gain confidence in my research ability, and that confidence has in turn translated into my everyday life.</p> <p>Now that I have been part of the beginning stages of a new study on the effects of Type-2 diabetes on bone healing and knowing that the experimental outcomes can possibly change the lives of millions, I have had a change of heart in what I want to pursue in the future.</p> <p>Because of my lab experiences and after previously going through significant life events, I now want to spend my life helping others. I hope to follow a career path in which I can help others whether it be in person or behind the scenes in a research laboratory.</p> Thu, 23 May 2019 16:58:14 Z{B2928392-E1A0-4B37-A383-795310269EFD}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/hostAlumnus and wife open home to fourth-year medical students<p>If David Cusick, MD, were so inclined, he could write an enticing listing to post on Airbnb.</p> <blockquote> <p><em>Cozy bedroom available in a mid-rise condo in the heart of Chicago’s West Loop. Travelers are only a few steps from the Windy City’s Restaurant Row and a short train ride from Millennium Park, the Museum of Contemporary Art and other attractions. Or, you can bum around by poking your head into dozens of the neighborhood’s chic boutiques. </em></p> </blockquote> <p>Instead, Cusick, a 1990 graduate of the IU School of Medicine, and his wife, Mika, chose to open their door to medical students looking for a place to drop their bags.</p> <p>The couple takes part in the <a href="/sitecore/content/iu/iu-som/home/alumni/programs-for-medical-students/help-students-travel">Help Our Students Travel (HOST) program</a>, which connects alumni with fourth-year medical students in need of housing as they venture out for residency interviews. Participating alumni offer free accommodation, meals and transportation. They also can provide vital insights to students who are looking at relocating to the area.</p> <p>The Cusicks are a prime example. While their neighborhood is undoubtedly alluring, the location is ideal for another reason: it’s equidistant–two miles, actually–from Rush University Medical Center and Northwestern Memorial Hospital. Not only can a visiting student have a comfortable bed, good food, and pleasant company, but he or she can also have a short commute to their interviews.</p> <p>This past winter, the Cusicks welcomed three visitors into their inviting home. “Now that my kids are out of the house, we have a little space,” said Cusick, who practices with a cardiology group located in the city’s western suburbs.</p> <p>Once he heard about the program, Cusick recalled his own experience three decades ago. Back then, his search was narrowly focused on the Chicago area, where his wife’s family lived. Ultimately, he matched at Northwestern University, but he knows today’s students travel farther afield to find the best training opportunities.</p> <p>“I thought this was one way we could help them get there,” he said.</p> <p>The Cusicks filled out an online application to be hosts. Students submit their own forms. An alumni relations specialist follows up to confirm availability before matching the student with the alum. The process typically takes about two weeks.</p> <p>The HOST program is also a practical way alumni can give back and help tackle the growing issue of medical student indebtedness.</p> <p>Take Brendan Knapp, for example.</p> <p>The West Lafayette native made 16 trips to take part in 17 interviews to earn a slot in internal medicine and medicine/pediatrics programs. He traveled as far west as Colorado and as far east as North Carolina. While most of his interviews took place in the Midwest, the cost of fuel, lodging and food still meant spending several thousand dollars.</p> <p>For Knapp, the appeal of HOST was obvious: keeping costs under control. Yet staying with alumni helped give him a nuanced view of the medical communities in the places he visited. In Nashville, where he interviewed at Vanderbilt University, Knapp’s host was a long-time practitioner in internal medicine and one of the few he’d met who had done both inpatient and outpatient work.</p> <p>“We had a really long discussion about that,” Knapp said. “That was something I really enjoyed. Getting that perspective on how medicine has changed was also kind of an enjoyable experience.”</p> <p>The conversations also imparted another crucial impression: While the profession has evolved over the years, each alum was still happy they chose to practice medicine.</p> <p>“Near the seventeenth interview, I started to get a little burned out,” Knapp said. “It was just nice to hear them talk about how they still enjoy what they do and what they love about it. They kind of gave me the motivation I needed.”</p> <p>The Cusicks’ approach mirrored ones used by other alumni who hosted Knapp: A warm welcome, dinner ordered in and an evening of pleasant conversation before a student turns in. “The students are always really early and off pretty early in the morning to go for their interviews,” he said.</p> <p>Often, the couple gets peppered with questions about what life is like in a sprawling metro area. What neighborhoods are affordable? Can a resident get by without a car? “We’ve had a couple who have come from smaller towns in Indiana,” Cusick said. “If they were to come to Chicago, it’s a little bit different setting. So they’re just gathering that information.”</p> <p>Ideally, the student feels well-rested and ready to tackle a stressful day ahead.</p> <p>“It’s a great way to give back,” Cusick said. “It’s not a huge time commitment at all. They really appreciate the fact someone’s opening up their home to them, and I think they get something out of it, too. It’s a great way for them to connect with other alumni.”</p> <p><em>Alumni interested in taking part in the HOST program can contact Sue Johnson, Alumni Relations Specialist. Reach her at <a href="mailto:sjohnso2@iu.edu">sjohnso2@iu.edu</a> or 317-278-2131.</em></p>Wed, 22 May 2019 13:15:04 Z{C56F7E07-C21E-4CD7-B941-3270E9C9405C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-m-k-deepaMeet the Team: M.K. Deepa<p>Hi, I’m M.K. “Deepa,” and I’m a post-doctoral appointee in Dr. Kacena’s lab at Indiana University School of Medicine.</p> <p>I have been here since January 2018 and feel privileged to work with this team. I live in the city with my family near the beautiful canal. I love living downtown and working close to IUPUI so we can enjoy all that our great city has to offer.</p> <p>In the lab, I perform a variety of duties such as isolating primary cells from mouse organs, maintaining large mouse colonies and overseeing undergraduate students. My current research is directed toward understanding the mechanism of cell interaction networks between megakaryocytes, which give rise to platelets, and osteoblasts and osteoclasts. I am particularly interested in learning how megakaryocytes regulate osteoblasts and osteoclasts during aging and in understanding mechanisms of bone healing.</p> <p>Prior to my research career at IUSM, I served as teaching faculty for more than five years with various prestigious institutions in India. I obtained my PhD while in India and focused on advanced molecular biology and genetic engineering tools to study the expression and characterization of rhPDGF-BB in plant-based system.</p> <p>I was fortunate to continue my doctoral studies at Technical University in Dresden, Germany. This international research experience peaked my interest in continuing my research abroad and led me to my postdoctoral fellowship in the United States.</p> <p>As I continue to grow as a research scientist, I hope to broaden my research exposure and present my research at venues that are challenging and intellectually stimulating in the field of Orthopaedic research. I am extremely excited to visit NASA and help my lab with the space flight studies this summer.</p> Tue, 21 May 2019 14:53:51 Z{5E6F6E5A-490E-45BF-9D16-7F12D56C6C54}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-seungyup-sunny-sunMeet the Team: Seungyup “Sunny” Sun<h5><em>Written by Seungyup “Sunny” Sun</em></h5> <p>My name is Seungyup “Sunny” Sun, and I am a first-year medical student at Indiana University School of Medicine.</p> <p>I received my undergraduate degree at the University of Notre Dame, where I majored in science-business. Originally, I planned on obtaining an MD/MBA so that I could pursue a career in hospital administration that would align both my administrative and medical interests. However, after working closely with various surgical teams in my local hospital’s surgery department, I became more interested in being a clinician and surgeon. Since then, and thanks to a great mentor, I have become interested in orthopaedic surgery.</p> <p>I joined the Kacena lab as soon as I started medical school in the fall of 2018. I previously had a research background in breast cancer cell signaling pathways, so I decided to join a lab that similarly studied the mechanisms driving bone healing.</p> <p>As a member of the lab, I assist in the surgical treatment and postoperative care of our animal models, as well as data collection. This summer, I will be able to continue my research thanks to funding from the IU Medical Student Program for Research and Scholarship.</p> <p>When I am not studying or in the lab, I enjoy cooking (especially Korean food), lifting weights, traveling, and spending time with my family, friends and girlfriend.</p> Thu, 16 May 2019 19:50:31 Z{76C2E3A3-39DA-4ECA-8636-A06ED2ECAECB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-anthony-peruginiMeet the Team: Anthony Perugini<h5><em>Written by Anthony Perugini (pictured above)</em></h5> <p>My name is Anthony Perugini, and I am a Hoosier from Fort Wayne.</p> <p>I am an OMS-1 from Marian University College of Osteopathic Medicine and started working in Dr. Kacena’s lab in early 2019.</p> <p>After the close of my collegiate football career and armed with a bachelor’s of science in biochemistry and minor in physics, I wanted to be involved in a research field that has real world applications. Dr. Kacena’s orthopaedic lab provides an incredible application to not only athletes, but also to the military men and women making sacrifices each and every day for our country.</p> <p>I have several friends and family members serving in the military, and it is a privilege to be a part of Dr. Kacena’s projects and research group. As I move forward in my career, I keep my mind open as I explore future clinical experiences, but currently am interested in a surgical specialty.</p> Mon, 13 May 2019 17:36:18 Z{010514A1-A4E6-43DD-8CE6-2A6C2A768A4F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/cancer-research/chuckstrong-fuels-cancer-research-at-iu-simon-cancer-centerChuckstrong fuels cancer research at IU Simon Cancer Center<p>Even though Chuck Pagano is now an NFL coach in another city, the lasting effects from his resilient battle with leukemia—a fight that transcended sports to inspire Hoosiers throughout the state—are still making an impact in cancer research.</p> <p>It all began shortly after Pagano, who was the head coach of the Indianapolis Colts from 2012 to 2017, publicly shared his leukemia diagnosis in 2012. The Colts immediately sprang into action and launched Chuckstrong. The initial sales of T-shirts and wristbands and other community efforts raised $486,000—all of which was designated for leukemia research and was used by the IU Simon Cancer Center to recruit a leukemia expert and to purchase laboratory equipment.</p> <p>The expert, Utpal Davé, MD, was recruited from Vanderbilt University. He works to identify genes that drive aggressive leukemias and lymphomas in order to develop more effective individualized treatments for patients.</p> <p>The laboratory equipment purchased is called a Fortessa. It allows cancer researchers to label cells in a patient blood sample with up to 16 different markers—much more than the capacity of similar machines. Labeling cells in this way allows scientists to classify them into different groups based on the markers the cells are expressing. This leads researchers to design experiments and work to determine the best treatment for an individual.</p> <hr> <p><em>Learn how research supported by the Chuckstrong initiative is giving patients access to new treatment opportunities.</em></p> <p><iframe title="2019 Chuckstrong Patient Story - IU Simon Cancer Center" width="500" height="281" src="https://www.youtube.com/embed/JMGPGzBxml0?start=6&feature=oembed" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe></p> <hr> <p><strong>Impact: New faculty recruits</strong></p> <p>From 2013 to 2017, funds from the Chuckstrong galas helped recruit 32 new cancer researchers. Their combined grants from the National Cancer Institute has increased the cancer center’s NCI funding by 47 percent in the last five years. Funding from the NCI is considered the most competitive and prestigious in the country, serving as the gold standard by which to measure research success and progress.</p> <p>The following are just a few of the recruits and their specialties:</p> <ul> <li>Nabil Adra, MD, genitourinary cancer</li> <li>Tarah Ballinger, MD, cancer survivorship</li> <li>David Boothman, PhD, lung cancer</li> <li>Jim Cleary, MD, palliative care</li> <li>Eileen Hacker, PhD, symptom management</li> <li>Shannon Hawkins, MD, endometrial and ovarian cancers</li> <li>Jaeyon Kim, PhD, ovarian cancer</li> <li>Xiongbin Lu, PhD, cancer genetics and breast cancer</li> <li>Roberto Pili, MD, prostate, renal and bladder cancers</li> <li>Xinna Zhang, PhD, breast cancer</li> </ul> <p>Another recruit, Rachel Katzenellenbogen, MD, began in September 2018 as the inaugural Chuck and Tina Pagano Scholar. The <a rel="noopener noreferrer" href="https://cancer.iu.edu/news-publications/CS_2018.shtml" target="_blank">Chuck and Tina Pagano Cancer Research Fund</a> was established in April 2018 when Colts owner Jim Irsay opened his home for a dinner for top Chuckstrong sponsors and donors. The guests, Irsay and the Paganos contributed more than $800,000 to create the fund.</p> <p><strong>Impact: New laboratory equipment</strong></p> <p>In addition to the Fortessa purchased in 2012, two analyzers have been purchased for different shared facilities. The Seahorse Analyzer helps researchers understand how cancer cells use energy differently than normal cells as they grow. The IncuCyte ZOOM is like a time-lapse camera with an attached microscope, permitting researchers to watch live images of cells as they grow. This enables researchers to better understand how certain drugs can block the formation of tumor blood vessels.</p> <p>Whether it’s a new faculty or new equipment, the IU Simon Cancer Center has become stronger because of Pagano and the Chuckstrong initiative.</p>Fri, 10 May 2019 01:32:32 Z{5932E859-F2FF-4B0A-ABD0-E739E510AAC1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-zack-campbellMeet the Team: Zack Campbell<h5><em><strong>Written by Zach Campbell (pictured above)</strong></em></h5> <p> </p> <p>Hello, my name is Zack Campbell.</p> <p>I am a first year medical student at Marian University College of Osteopathic Medicine in Indianapolis. I am a lifelong Hoosier and proud to have grown up in the Midwest.</p> <p>I completed my undergrad education at Wabash College, a small liberal arts college in rural Indiana. I majored in biology and classical studies and was on the football team. My interests are sports, and I follow the Colts and Pacers, enjoy time outdoors and anything aeronautical/space related.</p> <p>I became interested in an Orthopedics career after shadowing physicians during their surgeries and while experiencing the healing process from my teammate’s, as well as my own, sports related injuries. I really like that orthopaedics is a field that can dramatically improve the quality of people’s lives—from helping athletes get back on the field, providing wounded warriors a chance at normalcy after their sacrifices, or facilitating a neighbors’ return to their daily activities.</p> <p>Research is the foundation driving medical advancement forward and involves working with a wide variety of people. And so I am excited to be a part of this unique project in the Kacena lab, from working at the lab bench in Indy and all the way up to low Earth orbit on the International Space Station. The opportunity to work in Dr. Kacena’s lab intersects many of my passions: contributing to the betterment of medical research, taking part in furthering space exploration and teaming with others who I can learn from.</p> Thu, 09 May 2019 14:29:12 Z{8D39AB90-C3F3-453F-9630-2E309966EB76}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-rachel-blosserMeet the Team: Rachel Blosser<br/> <h5><em><strong>Written by Rachel Blosser. She is pictured above (second from right) along with several project collaborators. </strong></em></h5> <p>My name is Rachel Blosser, and have been the lab manager for Dr. Kacena’s research team since January 2018.</p> <p>I have a bachelor’s degree in biology (genetics focus) and a master’s degree in Developmental Biology, both from Ball State University in Muncie, Indiana.</p> <p>Prior to working with Dr. Kacena, I worked for more than 10 years in Dr. Susan Clare’s lab studying breast cancer, Dr. Joseph Tector’s transplant research lab, and at Eli Lilly & Co. in oncology research.</p> <p>My husband is also a biologist, and works in oncology research at Eli Lilly. We have two daughters, ages 14 and 11, so we stay very busy.</p> <p>My involvement in the spaceflight project began in June 2018 when I participated in an Experiment Verification Testing-2, or EVT-2, at NASA Ames Research Center, which is located near San Jose, California.</p> <p>The EVT is a precise way to test the written protocol and the hardware/software designed by NASA so to ensure everything is functioning and that the experiment at the International Space Station (ISS) will be successful.</p> <p>During the week at Ames, we prepared both the bioreactors and cells, just as they will be prepared the days leading up to the actual launch scheduled for July 2019. The bioreactor is a vessel where the cells will be cultured while at the space station. It is an enclosed system about the size of a dry-erase marker, with fibers inside for the cells to attach to.</p> <p>The preparation of the bioreactors and cells takes about five days, and involves injecting a series of solutions through the bioreactor to prepare the system for the cells.</p> <p>The cells are originally prepared in our lab at Indiana University, and then stored frozen. When preparing the cells, we first carefully thawed them, and then determine their viability.  At the end of the procedure, the cells are added into the bioreactors.</p> <p>The engineers then subject the bioreactors to a simulated launch. Every step we performed had to be done exactly as described in the protocol, and all of this was conducted in a sterile environment so that no contaminants are introduced. Contamination would cause the experiment to fail, so it’s extremely important to be careful.</p> <p>Since EVT-2 was not an initial test, we did not have any issues with the preparation protocol. However, after handing the bioreactors off to the engineers, a few problems surfaced with the hardware/software that have since been addressed.</p> <p>EVT is not only an interesting and exciting aspect of this entire project, is also very satisfying to see our studies getting closer and closer to the goal.</p> Tue, 07 May 2019 16:15:20 Z{CA9FE3ED-7FD8-419F-9383-627FBCDE001C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/meet-the-team-desiree-aririeriMeet the Team: Desiree Aririeri<br/> <h6><em>Written by Desiree Aririeri (pictured above)</em></h6> <p>My name is Desiree Aririeri.</p> <p>I am currently a sophomore at IUPUI, working toward a double major—a Bachelor of Arts in chemistry and a Bachelor of Science in biology.</p> <p>I started in Dr. Kacena’s lab in the fall of 2018 through the Life and Health Sciences Internship program. I am currently on a pre-med track and joined the lab to learn more about bone healing and bone health. I have been involved in studies about the regulation of adipogenesis.</p> <p>I often volunteer in hospitals and at hospice centers where many of the patients in the older population demonstrate issues regarding bone health.</p> <p>It is exciting to know that the research I am helping with could eventually lead to new treatments for bone loss diseases, such as osteoporosis, and help the people I see each day.</p> Wed, 01 May 2019 19:32:02 Z{A5D19C53-6471-41A6-AAE6-2871EC58CA78}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-back-kacena-lab-preparing-for-space-launch-in-julyWelcome back: Kacena Lab preparing for space launch in July<p><strong><em>Written by <a href="/faculty/18628/kacena-melissa">Melissa Kacena, PhD</a>, a professor in the <a href="/sitecore/content/iu/iu-som/home/orthopaedic-surgery">Department of Orthopaedic Surgery</a> at Indiana University School of Medicine.</em></strong></p> <p>It’s been a while since we posted a blog. The reason: the unpredictability of spaceflight and timing pressures.</p> <p>This journey began in August 2012 when two spaceflight experiments were planned. The first was to be a cell-based study, and the second was to be a mouse bone healing study.</p> <p>Due to problems with the cell spaceflight hardware — it was killing the cells — we delayed that experiment until the hardware was completely revamped and thus the mouse bone healing study launched first in February 2017.</p> <p>We then planned for the cell-based spaceflight study in 2018, but it was delayed due to a combination of manifesting priorities and hardware/software concerns resulting from tests we completed at NASA Ames.</p> <p>We recently learned that our study is now manifested on SpaceX-18, scheduled to launch July 8, 2019.</p> <p>There are still some hardware/software tests that need to be completed before our mission is truly a go, but everything is looking very good.</p> <p>So here we are, ready to start-up the blog again and document our exciting spaceflight research journey.</p> <p>The first thing to do is introduce you to our new team.</p> <p>As you can imagine, completing research at a university means many of the “workers” are trainees. In my case, I have a number of undergraduate students, graduate students (primarily medical students) and postdoctoral fellows working in the lab.</p> <p>By definition trainees will leave once they are trained for their new positions. Therefore, we have had a number of changes in personnel since 2012.</p> <p>Unfortunately for our spaceflight studies, two key people who had trained at NASA Ames left the lab at the end of 2018.</p> <p>Dr. Marta Alvarez retired after working in my lab for more than six years, and Dr. Kevin Maupin moved back to Michigan where his family is from.</p> <p>To fill this gap, my lab manager, Rachel Blosser, began the training process on our third NASA Ames test in 2018. Rachel will provide an account of these activities in her upcoming blog.</p> <p>And fortunately for us, Kevin will still assist with this spaceflight mission as a consultant when we go to Kennedy Space Center in June and July.</p> <p>Over the next several months our current team members will introduce themselves, and we will keep you up to date on our progress.</p> Fri, 26 Apr 2019 15:20:14 Z{D5286E38-1F50-470F-AB29-EF64F4AAD102}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/qa-with-natascia-marino-phdQ&A with Natascia Marino, PhD<p>Obesity has long been known as a risk factor for developing many diseases, including cancer. For obese women, this means an increased risk for developing breast cancer, although the reason for this increased risk has not been substantiated.</p> <p>A new study published in the journal Cancer Research provides a better understanding of the mechanisms at work with obesity to increase this risk. The study used blood samples from the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/research/tissue-bank">Komen Tissue Bank at the IU Simon Cancer Center</a>, the only known biorepository that collects, stores and provides samples for research internationally of healthy breast tissue taken from volunteer female donors. Since the bank was formed in 2007, more than 5,300 women have contributed samples of blood and breast tissue to aid in discoveries leading to a cure for the disease. Biological samples are distributed internationally and have played a part in 143 research projects resulting in 46 scientific publications. Natascia Marino, PhD, and <a href="/faculty/4991/storniolo-anna">Anna Maria Storniolo, MD</a> (executive director of the tissue bank) were among the study’s co-authors.</p> <p>We asked Dr. Marino, a research scientist at the Komen Tissue Bank, more about this study.</p> <p><strong>Q: What is noteworthy about this recent Cancer Research publication?</strong></p> <p>A:  This study provides a better understanding of why obesity can contribute to the development of breast cancer. The research shows that free fatty acids interact in an adverse way with estrogen-positive cancer cells.</p> <p><strong>Q: What happens when the estrogen-positive cancer cells come in contact with free fatty acids?</strong></p> <p>A: In our study we found that, when taken up by estrogen-receptor positive breast cancer cells, fatty acids activated pathways that increased tumor cell growth, survival and proliferation.</p> <p><strong>Q: Does the amount of free fatty acid in the blood have a greater effect on the cancer cells or the proliferation of the cells?</strong></p> <p>A: It is not just a matter of the amount but also of the type of fatty acid in the blood. Women who developed breast cancer – and women who were overweight or obese – had significantly higher blood concentrations of five free fatty acids and glycerol, which are released as byproducts when fat tissue breaks down triglycerides.</p> <p><strong>Q: Can you tell us more about the samples from the Komen Tissue Bank that were used?</strong></p> <p>A: We used two types of samples from the tissue bank: Milk-producing cells and plasma samples.</p> <p><strong>Q: What are free fatty acids and where do they come from?</strong></p> <p>A: There are several kinds of fatty acids, which are molecules that come from animal and vegetable fats and oils. They are used in everything from cooking oils to soaps and cosmetics. Free fatty acids are the byproducts of fat in adipose tissue, which is the scientific name for what many call body fat.</p> <p><strong>Q: What can be done to reduce the amount of free fatty acids in your blood?</strong></p> <p>A: Weight loss and eating more fruits and vegetables can reduce the amount of free fatty acids in the blood. A positive note from this study is that significant weight loss resulted in a significant decrease in the amount of fatty acids in the blood of the women enrolled in this clinical study.</p>Thu, 21 Mar 2019 18:23:07 Z{041293C2-4B3C-4D38-A31F-9CADA04E17C2}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/allison-maxwell-md-first-dean-of-indiana-university-school-of-medicineAllison Maxwell, MD: First dean of Indiana University School of Medicine<p><strong>By: Richard L. Schreiner, MD, Edwin L. Gresham Professor Emeritus of Pediatrics, Indiana University School of Medicine; Retired Chairman, Department of Pediatrics; Retired Physician-in-Chief, Riley Hospital for Children at IU Health</strong></p> <p>The future of Indiana University School of Medicine rested squarely on the shoulders of the Indiana University Board of Trustees naming the right leader to be first dean of the newly established medical school. The right leader was needed to put an end to contentious years of debate on how to consolidate the Hoosier State’s many medical colleges and at what university the State’s medical school should be housed.</p> <p>With Indiana University being so designated by eventual agreement in 1908 and by legislation in 1909, there was no time to waste. Building a unified IU School of Medicine faculty, creating a curriculum, and recruiting medical students needed to begin and quickly. While his name today is mentioned only briefly as dean of IU School of Medicine in its first four years, 1908-1911, that “right” leader was Allison Maxwell, MD. Here are a few things to know about the IU School of Medicine’s first dean:</p> <p>• Dr. Maxwell’s family has strong historic ties to Indiana University. His father, James Darwin Maxwell, M.D., was for many years a trustee of Indiana University; his grandfather was David H. Maxwell, M.D., who many credit as being the founder of Indiana University and who also served as president of the University’s first board of trustees. Maxwell Hall on Indiana University’s Bloomington campus is named in their honor.</p> <p>• Dr. Maxwell was dean of the State College of Physicians and Surgeons of Indianapolis until the merger in 1907 of this medical school with the Indiana Medical College and the Fort Wayne Medical College under the name of Indiana University School of Medicine. Dr. Maxwell was appointed dean of IU School of Medicine by the Indiana University Board of Trustees on June 23, 1908.</p> <p>• He led IU School of Medicine through a difficult time when financial budgets were an issue and while consolidation of the faculties of Indiana University’s and Purdue University’s Schools of Medicine was being completed. He had no budget to work with until the State Legislature appropriated one in 1909.</p> <p>• Only a year and a half into Dr. Maxwell’s tenure, Abraham Flexner, renowned American educator whose work helped reform many medical schools, paid a visit to IU School of Medicine in December 1909. In the 1910 Flexner Report, Flexner observed, “The situation in the state (was) thanks to the intelligent attitude of the university, distinctly hopeful, though it will take time to work it fully.” At the time, IU School of Medicine was among the few medical schools in the nation to receive a positive evaluation from Flexner.</p> <p>• Dr. Maxwell and John Finch Barnhill, MD, IU School of Medicine Treasurer, played prominent roles in selecting the site in 1911 for the Robert W. Long Hospital, the first teaching and research hospital to be built on the Medical Center campus. Medical campus historian, Thurman B. Rice, MD, observed that coincidentally, nearby streets were named Maxwell and Barnhill and unknowingly, both physicians had ancestors buried in the “Plague cemetery” in that same area. The site was selected and land purchased with funds allocated by the State Legislature.</p> <p>• Dr. Maxwell was an Indiana University basketball Dad. His oldest son, Leslie (“Doc”) was Indiana University’s first big-time scorer in basketball. In game four of his freshman season, he demolished Indiana University’s single-game scoring record by tallying 27 points against DePauw, a record unbroken for 35 years (1903-1938). Leslie captained the 1903-04 Indiana University squad in his sophomore year. Dr. Maxwell passed away in 1915; his younger son, Allen, was chosen to captain the Crimson basketball team in 1916.</p> <p>We owe much to the leadership of Dr. Maxwell, our first dean, who set the foundation for excellence for IU School of Medicine.</p> <p><strong><em>PHOTO:  Dr. Allison Maxwell, First Dean of the Indiana University School of Medicine. Photo courtesy of the Indiana Medical History Museum.</em></strong></p> Wed, 06 Mar 2019 22:10:06 Z{334B7A56-E7DE-481C-9155-56BFED7F2FB6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/popular-arcade-game-inspiring-new-treatment-aggressive-type-breast-cancerArcade game inspiring treatment for triple negative breast cancer<h3><span><em>National Institutes of Health funds study to test new drug combination for triple negative breast cancer</em></span></h3> <p>Think back to your days as a kid. Ever stop by an arcade?</p> <p>If you did, you almost certainly played Whac-A-Mole, the popular game in which toy rodents randomly pop up from holes, and you desperately try to thump them back into hiding with a mallet.</p> <p>For most of us, Whac-A-Mole was a fun way to pass time and maybe win some cheap arcade prizes.</p> <p>For <a href="/sitecore/service/notfound.aspx?item=web%3a%7bA0DE809C-4271-4EC6-8FBD-62DFCF55C714%7d%40en">Milan Radovich, PhD</a>, and his team, it may be the answer to helping more individuals overcome <a href="/sitecore/service/notfound.aspx?item=web%3a%7b81DCC297-5052-467B-AF2A-AC6DC4ADE464%7d%40en">triple negative breast cancer</a>—a particularly aggressive form of the disease that disproportionately affects young women and African American women.</p> <p>You see, triple negative breast cancer is smart. Researchers will detect a potential genetic culprit they believe is helping the cancer grow. But when they knock it down with a drug, another misfit pops up, allowing the cancer to continue thriving.</p> <p><em>It’s just like Whac-A-Mole</em>, thought Radovich, an assistant professor of surgery at Indiana University School of Medicine.</p> <p>But what if we could knock out the first “mole,” and predict which one would pop up next, he wondered. And what if we could block that hole, too? Would that be enough to short-circuit the game? Or, in his case, would that enable him to outsmart triple negative breast cancer and give cancer-fighting drugs a chance to do their job?</p> <p>His lab is about to find out.</p> <hr /> <p> </p> <div class="default-layout-responsive-video-container"><iframe width="500" height="281" src="https://www.youtube.com/embed/QADa1rWFtgM?feature=oembed" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe></div> <p> </p> <p><em>The newly established Vera Bradley Foundation Center for Breast Cancer Research at IU School of Medicine has set a goal of curing at least one sub-type of triple negative breast cancer. The center is uniquely positioned to make significant contributions to research related to this disease.</em> <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer"><strong><span>Learn more.</span></strong></a></p> <hr /> <h4><strong>PREDICTING THE TUMOR’S RESPONSE</strong></h4> <p>Radovich and his laboratory team spent years analyzing triple negative breast cancer tumors and comparing them to <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/research/tissue-bank">healthy, non-cancerous breast tissue</a>. Their goal was to identify precisely what had gone haywire in the cells so they could pick the best drug to attack the cancer.</p> <p>Then, they looked at how the tumors respond and adapt after being hit with that initial therapy. And they identified a second drug to circumvent this real-time adaptation. <em>In other words, they wanted to block the next hole before the mole could pop out again.</em></p> <p>“One of the most exciting parts of this research is the opportunity to treat triple negative breast cancer in a truly personalized way, by delivering therapy based on how the tumor responds to initial treatment,” lab director Jeff Solzak said.</p> <p>After promising pre-clinical results spearheaded by Solzak, the “Whac-A-Mole” theory has now moved into a first-in-human clinical trial run by IU School of Medicine oncologist <a href="/faculty/4849/miller-kathy">Kathy Miller, MD</a>. As part of the trial, patients at the <a rel="noopener noreferrer" href="https://iuhealth.org/find-locations/iu-health-simon-cancer-center" target="_blank">IU Health Simon Cancer</a> are the first in the world to receive a unique two-drug combination. This study is an important first step to test whether the drug combination is safe.</p> <p>Currently, there are no targeted therapies for triple negative breast cancer that work for the vast majority of women with the disease. Personalized therapies go after a cancer’s unique vulnerabilities, and the absence of a customized treatment is one of the reasons triple negative breast cancer is so devastating.</p> <p>“There is a huge need for better and more targeted therapies in triple negative breast cancer,” said Radovich, who is also IU Health vice president for oncology genomics and co-director of the <a rel="noopener noreferrer" href="https://iuhealth.org/find-medical-services/precision-genomics" target="_blank">IU Health Precision Genomics Program</a>. “This disease disproportionately affects young women and African American women, and it kills far too many individuals every year. I am motivated every day to develop better therapies for this disease and to benefit our patients in Indiana and across the country.”</p> <p> <img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/what-a-mole-story_09-883x480.jpg?h=480&w=883&rev=168fd628765d4dcdba60894cbd86cf65&hash=66A8F76503EF2AFE60624EC60EA57A2A" style=" height:480px; width:883px" alt="Radovich, Miller, Solzak and Hancock" /></p> <p><em>(Left to right) Milan Radovich, PhD, Kathy Miller, MD, Jeffrey Solzak and Brad Hancock are members of the IU School of Medicine team that developed and is testing a new approach to treating triple negative breast cancer.</em></p> <h4><strong>FUNDING FUELS RESEARCH</strong></h4> <p>The study got a significant boost this fall when the National Cancer Institute, part of the National Institutes of Health, awarded Radovich a two-year grant for more than $375,000.</p> <p>In addition to the NIH award, the research received early funding from the Indiana Clinical and Translational Sciences Institute, and it has been propelled by significant support from philanthropic donors, including the <a rel="noopener noreferrer" href="http://peacheyfund.org/" target="_blank">Catherine Peachey Fund</a>, a program of the <a rel="noopener noreferrer" href="http://www.heroesfoundation.org/" target="_blank">Heroes Foundation</a>; individuals who give through <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/donor-impact/100-voices-hope">100 Voices of Hope</a>, an innovative fundraising campaign that supports breast cancer research at IU School of Medicine; and several families affected by triple negative breast cancer.</p> <p>“Philanthropy is essential to move breast cancer research forward,” Radovich said. “It allows us to explore new and innovative therapies, and this current project is possible in large part due to philanthropic support. When comparing our research to a marathon, philanthropists represent those giving us vital water and encouragement to keep us going when the going gets tough. We are all in this together.”</p> <p>Radovich doesn’t just want to deliver for those who are funding his research, but for the many women affected by triple negative breast cancer. He remains hopeful that this trial will ultimately result in meaningful improvements in care.</p> <p>If it does, we can all thank a favorite arcade game for giving him some inspiration.</p> <p><em>Radovich is a member of the Vera Bradley Foundation Center for Breast Cancer Research and the Indiana University Melvin and Bren Simon Cancer Center, both of which are part of IU School of Medicine. He also is participating in the IU Precision Health Initiative, IU’s big health care solution aimed at preventing and curing diseases through a more precise understanding of the genetic, behavioral and environmental factors that influence a person’s health. Triple negative breast cancer is one of five diseases IU School of Medicine aims to cure or prevent through the IU Precision Health Initiative.</em></p> <hr /> <p><em>This research is supported by the National Cancer Institute of the National Institutes of Health under Award Number R21CA229951. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.</em></p>Mon, 22 Oct 2018 06:00:18 Z{01E01DF9-5DDC-4F3F-8A25-0C9BDA6C5A1C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/we-give-because-we-believe-in-you“We give because we believe in you”<strong>By Robert King</strong> <p>As longtime supporters of breast cancer research, Barbara Baekgaard and Patricia Miller have seen their share of reports from Indiana University School of Medicine on progress toward a cure.</p> <p>But last week’s Breast Cancer Science Social, a first of its kind event, offered the Vera Bradley co-founders, and other supporters of breast cancer research, a different kind of update – a chance to tour the labs, see where the research is being done and hear firsthand from the scientists conducting the studies.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/barbara.jpg?la=en&h=534&w=400&rev=0eab602d34714d1e816a99bdaabe8a49&hash=8682B156625F491D7B0028C9A556AD58" style="height: 534px; width: 400px;" _languageinserted="true" alt="Barbara Baekgaard" class="float-right" /></p> <p>“We know they are real people,” Miller, an IU alumna, said after the tour. “To get to be in their labs and get to hear the doctors talk about their research – it’s very personalized, and that’s very satisfying.”</p> <p>The event gave visitors a chance to leave researchers with reminders of loved ones lost to breast cancer and thanks for years added to lives because of advances in treatments. Some left pictures, some poems. Many inscribed words of encouragement on paper butterflies that the researchers can see each day as they pass through the IU School of Medicine labs. The labs were recently dedicated as the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/donor-impact/about-vera-bradley-foundation">Vera Bradley Foundation Center for Breast Cancer Research</a> in recognition of the more than $37.5 million in philanthropic support the Vera Bradley Foundation has given.</p> <p>“We give,” Baekgaard wrote on a butterfly, “because we believe in you.”</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/gadus-768x512.jpg?rev=81df3b1868f640c4ad860ebab5551b46&hash=EC796166B2EA83E665D36C3FE9244A4C" style=" height:512px; width:768px" _languageinserted="true" alt="gadus family" /></p> <p><em>Matt Gadus (L), Mike Gadus (C), Michael Gadus (R)</em></p> <p>The message on Matt Gadus’ butterfly was one he had printed on pink wristbands when his mother Mary Beth Gadus was still alive and in the midst of her 28-year fight against breast cancer. They were words he thought captured some of his mother’s best qualities.</p> <p>“Be positive. Be kind. Be selfless. Spread hope. Be MB.” The last being a reference to her initials, by which Mary Beth was known as a girl.</p> <p>Matt and his brother Michael, along with their father Mike, left butterfly messages behind. Mike’s referenced the IU School of Medicine program Mary Beth started, <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/donor-impact/100-voices-hope">100 Voices of Hope</a>, which funds research “hunches” that need support to get further exploration.</p> <p>“Thank you for all that you do. 100 Voices is 100% behind you,” Mike Gadus wrote.</p> <p>Michael Gadus said it is important to carry on his mother’s legacy and “to fuel and fund the ideas – even the crazy ones – ideally to have no idea go unfunded.”</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/rufenberger-768x525.jpg?rev=b771acf27cbe47498c9f9da84548be93&hash=1DA7500CA20DDA83C3B4E437B5A5F40E" style=" height:525px; width:768px" _languageinserted="true" alt="rufenberger" /></p> <p><em>Connie Rufenbarger</em></p> <p>Connie Rufenbarger knows what it’s like to turn a new idea to fight breast cancer into reality.</p> <p>She and <a href="/faculty/4991/storniolo-anna">Anna Maria Storniolo, MD</a>, an oncologist and professor of clinical medicine at the IU School of Medicine, co-founded the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer/research/tissue-bank">Susan G. Komen Tissue Bank</a> at the <a rel="noopener noreferrer" href="https://cancer.iu.edu/" target="_blank">IU Simon Cancer Center</a>.</p> <p>Rufenbarger posted a poem, a picture of Storniolo and a butterfly bearing the simple message: “Big Job! Big Heart!” Rufenbarger is herself a breast cancer survivor, but she tends to move quickly past her story.</p> <p>“I am an advocate and an activist,” she said. “One of the things you learn early when you are doing that is it is not about you. It’s not about me. At all. I very seldom discuss my history.”</p> <p>Her picture of Storniolo, a nationally recognized leader in oncology, is accompanied by a quote from the doctor that sums up the purpose of the healthy tissue bank: “The beauty of this is it’s a straightforward idea: to understand abnormal, you have to understand normal.”</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/spike-pin-768x576.jpg?rev=79c47579f3134a9c845039f561cc1166&hash=8918656CFC77509E2DC6B7CBC398FA2A" style=" height:576px; width:768px" _languageinserted="true" alt="spike abernathy" /></p> <p><em>Spike Abernethy</em></p> <p>Nearby, Spike Abernethy left several photographs of his own – of his family, and especially of his late wife, Anne, who fought breast cancer for 5½ years before her death in 2013.</p> <p>Anne kept a picture on her dresser of the IU researchers she knew were searching for treatments that might not save her, but could someday help other women.</p> <p>The picture gave her hope.</p> <p>One of those researchers, Milan Radovich, PhD, has kept a picture of Anne in his lab for years – a reminder of the people he’s working to save. He still has the picture. But now, he has new photographs along with a butterfly message from Spike: “Milan, Thank you. You are making a difference. Keep up the good work.”</p> <p>For IU School of Medicine Dean Jay Hess, MD, PhD, MHSA, the work going on in the cancer labs is of professional interest – and a personal one.</p> <p><img src="https://mc-42b990dd-5dae-4647-b81e-424724-cdn-endpoint.azureedge.net/-/media/blogs/2018/deanhessbutterflye15381514599731024x829.jpg?la=en&h=622&w=768&rev=9fa54cf509aa4d23a9637405cdfd01b7&hash=D6B5B7410783D8B8C04F252FC8EA5D82" style="height: 622px; width: 768px;" _languageinserted="true" / alt="" /></p> <p><em>Dean Jay Hess, MD, PhD, MHSA</em></p> <p>Hess lost his mother, Geraldine Hess, to breast cancer when he was still in college. Her suffering inspired him not only to become a doctor but to become a scientist who could transform health care.</p> <p>Addressing breast cancer research supporters during the Science Social, Hess expressed optimism about the work toward a cure being done at IU. He expressed a similar message on the butterfly he pinned to the wall of the laboratory.</p> <p>“Remembering you Mom! Miss you! We’ve come so far, and have just a bit farther to go.”</p>Fri, 28 Sep 2018 16:40:55 Z{79346242-9A4E-4335-9094-B73177BBD7F4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/iusm-resident-in-charge-of-indiana-university-bloomington-polio-quarantine-of-august-1943IUSM Resident in Charge of Indiana University Bloomington Polio Quarantine of August 1943<p><em>Army Specialized Training Program (ASTP) Soldiers in quarantine from polio on IU Bloomington campus in August 1943.  Photo courtesy Indiana University Archives.</em><br> <strong><br> By:  Richard L. Schreiner, M.D.</strong><br> <em>Chairman, Riley Hospital Historic Preservation Committee </em><br> <em>Edwin L. Gresham Professor Emeritus of Pediatrics, IUSM</em><br> <em>Retired Chairman, Department of Pediatrics, IUSM</em><br> <em>Retired Physician-in-Chief, Riley Hospital for Children at IU Health</em></p> <p>You’re in your first year out as a physician and get handed full responsibility for managing an epidemic crisis.  Would you be ready? One Indiana University School of Medicine resident was.</p> <p><strong>Dr. Margaret Ann Bassett</strong>, (MD ’42, IUSM and a member of the 1942-43 resident and intern staff of the Indiana University Medical Center), was serving as a university physician at the Student Health Center at Indiana University Bloomington.  Three hundred army men of a detachment which arrived at Indiana University Bloomington from California on August 18, 1943, were placed under quarantine the next day as a safeguard against the spread of poliomyelitis (polio).</p> <p>At that time, officials believed the two cases of polio already reported would be the only ones.</p> <p>Both Dr. Thurman B. Rice, IUSM professor of public health and then Commissioner of the State Board of Health, and Dr. Lyman.T. Meiks, (Riley Hospital’s first full-time pediatrician, 1931-51, and first full-time chairman of the IUSM Department of Pediatrics, 1951-1967), who was recognized as an authority on polio, agreed, that “there is no reason to believe the cases will spread and few if any more cases are expected.”  My best guess is that Dr. Meiks imparted his knowledge about polio to Dr. Bassett during her time as a medical student, knowledge that helped her when she needed to act quickly and decisively.</p> <p>The soldiers were transferred from California to Indiana University for specialized army training courses, according to an army statement, and both cases of infantile paralysis were discovered on the train en route to Bloomington.  One man was taken to a hospital in the West and the other removed to the I.U. Medical Center at Indianapolis.  The army said it believed both men had contracted the illness in California.</p> <p>Since Dr. Edith Boyer Schuman (IUSM MD ‘33 and first IUSM female intern, ‘33), Head of the University Health Center, was away from campus at that time, it was <strong>Dr. Margaret Ann Bassett who was handed <u>full responsibility over the infantile paralysis epidemic</u></strong>, when 15 ASTP (Army Specialized Training Program) soldiers came down with cases of polio. She had 65 soldiers under observation at the height of the epidemic and supervised checking twice daily of 400 others, successfully keeping the panic on campus under control.</p> <p>Months later, one accounting of her actions recognized that University officials and the Army not to mention several hundred ASTP cadets, will long be thankful for Dr. Margaret Ann Bassett, characterized by her colleagues as “the little dynamo with a sense of humor.”</p> <p>Dr. Bassett, an outstanding IUSM graduate and member of Alpha Omega Alpha, national medical honorary, was praised highly by Dr. Schuman.  “I know of no one,” said Dr Schuman, “who could have completely and satisfactorily managed the epidemic and controlled the panic among the men as she did.”</p> <p>Dr. Bassett completed 2 years of service as a physician at the Indiana University Health Center in Bloomington and military installations there.  She then returned to her hometown of Thorntown where her father, Dr. Clancy Bassett had practiced medicine and she did, too, for 32 years.  She also served on the staff at Witham Memorial Hospital in Lebanon.  Dr. Bassett died on January 27, 1986.</p> <p>All physicians get tested throughout their medical careers and, some, like Dr. Bassett, <em>very early</em> in their career.  All IUSM students, residents, and interns can look to her example for inspiration, knowing that when the moment comes to test what you know and can do, you can and will rise to the occasion with grace, courage, and confidence.</p> <p> </p> Mon, 23 Jul 2018 17:50:39 Z{0575AAC1-168A-4711-BBA3-E4612043E9CF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/dr-kathy-miller-discusses-clinical-trials-at-iuKathy Miller, MD, discusses clinical trials at IU<p><a href="/faculty/4849/miller-kathy">Kathy Miller, MD</a>, doesn’t just care for patients in the clinic. The physician-scientist also designs clinical trials to improve the quality and length of patients’ lives. One of the country’s leading breast clinical trial specialists, Dr. Miller, the Ballvé-Lantero Professor of Oncology at IU School of Medicine and the associate director of clinical research at the <a href="http://www.cancer.iu.edu/" target="_blank">IU Simon Cancer Center,</a> is co-chair of the National Cancer Institute’s Breast Cancer Steering Committee where she oversees clinical trials nationally. A member of the <a href="/sitecore/content/iu/iu-som/home/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a>, Dr. Miller shared her expertise about clinical trials.</p> <p><strong>What is a cancer clinical trial or clinical study?<br> </strong>Clinical trials test new treatment options. We want to ensure the safety of patient who participate in trials, so each new treatment is studied in phases. The first phase, called phase I, studies the safety of a new treatment. Phase I studies enroll only a small number of patients and follow patients closely. Once we know a treatment is safe and understand the dose and schedule, we move to phase II. Phase II trials evaluate how well a treatment works in certain patients. For example, there may be a phase II trial in patients with previously treated lung cancer and a separate phase II trial in patients with kidney cancer. The final step, phase III, compares the new treatment to the best currently available treatment.</p> <p><strong>Why are clinical trials important and why is it important that people from all ethnic groups participate?<br> </strong>Put most simply, without clinical trials we would have no new cancer therapies. No more clinical trials means accepting that the best we have to offer patients now will be the best we will ever have to offer. Laboratory and animal studies can only teach us so much and take us so far. Lots of treatments that looked promising in the lab didn’t work when tested in people. Some drugs may be metabolized differently or have different side effects based on a patient’s racial or ethnic background. If we don’t have a diverse population in the trials, we won’t recognize and understand those differences.</p> <p><strong>Who conducts clinical trials?<br> </strong>Clinical trials are conducted by academic cancer centers such as the IU Simon Cancer Center. Some large trials may be open at hundreds of centers around the country or the world, while some smaller trials may only be available at one or two centers. Some trials are sponsored by the National Institutes of Health (NIH), while some are supported by pharmaceutical companies.</p> <p><strong>Because your expertise is in breast cancer, what can you tell us about breast cancer clinical trials at IU?<br> </strong>My IU School of Medicine colleagues at the IU Simon Cancer Center conduct clinical trials across the spectrum of breast cancer – including risk and prevention, early diagnosis, and the treatment of advanced disease. A few examples, IU School of Medicine is one of 120 sites around the country conducting the TMIST trial. TMIST directly compares standard mammograms to tomosynthesis, often called 3D mammograms, in women at average risk. TMIST will enroll more than 165,000 patients and will define optimal screening for most women. In advanced disease, IU is the only site studying a two-drug combination for patients with metastatic triple negative breast cancer. Based on laboratory work at IU School of Medicine, the combination inhibits two pathways that function together to make cancers resistant to therapy.</p> <p><strong>How can I find out which clinical trials are available and enrolling patients?<br> </strong>Patients interested in clinical trials at the IU Simon Cancer Center can check online at <a href="http://cancer.iu.edu/research-trials/trials/index.shtml" target="_blank" rel="noopener noreferrer">www.cancer.iu.edu/trials</a>. Clinical trials are also available through <a href="https://hoosiercancer.org/" target="_blank">Hoosier Cancer Research Network</a>, the community clinical research arm of the IU Simon Cancer Center. The <a href="https://www.clinicaltrials.gov/" target="_blank">National Institutes of Health</a> is a good resource, too.</p> <p><strong>If I participate in a trial, will I be told of the trial’s results?<br> </strong>In most cases, yes. It is important to remember that the results of some trials may not be available for several years or more. This is especially true of trials testing new treatments to prevent recurrence in patients with early stage disease.</p> <p><strong>Will I be told if the treatment is working for me?<br> </strong>Absolutely! We all want and need to know if a treatment is working for you. Patients enrolled in clinical trials are followed closely to make sure their disease is improving or remaining under control and to avoid potentially dangerous side effects.</p> <p><strong>Do I pay to take part in a clinical trial?<br> </strong>In general, no. Treatments or evaluations that would be part of your treatment, even if you were not enrolled in the trial, are charged to you or your insurance company. However, any treatment or test that is required by the clinical trial is free to the patient. We will explain what is provided and covered by the trial as part of the informed consent process.</p> Tue, 26 Jun 2018 15:01:48 Z{0994E3EF-376F-461A-B44C-4FB8B1C22CD6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/early-breast-cancer-chemotherapy[Investigator Interview] New study finds most women with early breast cancer don’t benefit from chemotherapy<p>A major breast cancer study, recently published in the prestigious New England Journal of Medicine and announced at the world’s leading meeting for oncology professionals, caught the attention of the national news media and, naturally, women, because it found that chemotherapy does not significantly improve disease-free survival rates in some women with early stage breast cancer. <a href="http://www.cancer.iu.edu" target="_blank">IU Simon Cancer Center</a> researcher Sunil Badve, MBBS, was one of the co-authors of the study. The study’s results were announced during the 2018 annual meeting of the <a href="http://www.asco.org" target="_blank">American Society of Clinical Oncology</a> (ASCO). Dr. Badve, the Joshua Edwards Professor of Pathology and Laboratory Medicine and professor of medicine at IU School of Medicine, answered questions about this significant research.</p> <p><strong>Q: The findings of this research study, the Trial Assigning IndividuaLized Options for TReatment (TAILORx), are being hailed as great news for breast cancer patients. What is significant about the findings? </strong></p> <p><strong>Dr. Badve:</strong> The most common type of early-stage breast cancer consists of tumors that express the female hormone receptor (estrogen receptor ER). The prognosis of these women can vary dramatically depending on a variety of factors such as patient age, tumor size and lymph node positivity, meaning the cancer has spread into the adjoining lymph node(s). The current study focuses on women with ER positive (ER+), lymph node negative cancers.</p> <p>There are a number of tools that have been used to determine the prognosis of these women. Many, if not all, depend on research studies which have been validated using tumors removed decades ago. One of these assays, the 21-gene recurrence score (RS) assay, has been widely used for women with ER+, HER2-negative tumors. The assay categorizes tumors into three classes: those with low-, intermediate- and high-risk RS.</p> <p>Prior data using this assay had provided some evidence that the major benefit of chemotherapy was observed in high RS with limited benefit in low RS group. Conversely, the major benefit of endocrine therapy was observed in the low RS group. The degree of benefit for patients in the intermediate group was unclear. The TAILORx trial was designed to understand the benefit in the Intermediate (Int-RS) group.</p> <p>The trial enrolled more than 10,000 patients, of which approximately 7,000 were in the Int-RS group. These patients were randomized to chemotherapy plus endocrine therapy or endocrine therapy alone. The results of the study showed that patients receiving endocrine therapy alone had a similar disease-free and overall survival at median follow-up of nine years from the time of diagnosis. This underlines that many of these women can be spared from getting toxic chemotherapy. Additional analysis of subsets also seemed to suggest that post-menopausal women, even with slightly higher RS, could be spared from chemotherapy.</p> <p>As breast cancer in the Western world is mainly a disease of post-menopausal women, the results of this trial will mean that a large number of women with breast cancer, approximately 85,000 every year, can now safely avoid chemotherapy. This is indeed a great news for women.</p> <p><strong>Q: What are some of the side effects of chemotherapy that thousands of women will now be spared, thanks to this research?</strong></p> <p><strong>Dr. Badve:</strong> Chemotherapy is a term applied to the therapeutic use of a combination of drugs that are toxic to the cells. The goal of this type of therapy is to kill the cancer cells. However, the drugs are also toxic to normal cells. The basic hypothesis inherent to this type of therapy is that normal cells will be able to recover from the toxins but the cancer cells, because of their altered genetic structure, will not be able to recover. The toxicity of chemotherapy typically affects rapidly dividing cells. In normal individuals, the locations where these are present in large numbers are the bone marrow, gastrointestinal tract and skin. The toxicity is typically seen in the form of hair loss, diarrhea and low blood counts leading to bleeding and infections. In younger individuals, there is loss of ovarian function leading to premature menopause and infertility. Chemotherapy also affects brain function, often referred to as chemo-brain. Long-term toxicities include increased likelihood of developing blood cancers.</p> <p>Avoiding chemotherapy is therefore a big deal for our patients not only because of the changes in physical appearance, including the stigma of hair loss, but also because of these other short- and long-term side effects.</p> <p><strong>Q: What is an Oncotype DX Breast Recurrence Score test? Is it routine for this test to be administered to breast cancer patients?</strong></p> <p><strong>Dr. Badve:</strong> The diagnosis of breast cancer typically starts with the surgeon or imaging radiologists (mammographers) obtaining a needle core biopsy of the tumor. These tissues are then examined by a pathologist, such as myself, who make the diagnosis of cancer. A number of characteristics of the tumor cells are determined using a microscope and these factors are used to predict the behavior of the tumors. Advances in the last few decades have enabled analysis of genetic molecules, DNA and RNA, within the cells using several techniques. The 21-gene assay measures the RNA expression from the biopsied tissue to calculate a recurrence score. This score is a measure of the likelihood of disease-free survival in women taking endocrine therapy for five years.</p> <p><strong>Q: Were you and your colleagues surprised by the results of this study?</strong></p> <p><strong>Dr. Badve:</strong> Retrospective analysis of patient cohorts had suggested these findings to some extent. However, when one is dealing with the lives of thousands of women every year, one has to be careful and needs hard evidence to change the standard of care.</p> <p><strong>Q: Help us better understand the significance of the study’s results. How much does this change things for physicians and their patients? It basically changes the standard of care, correct?</strong></p> <p><strong>Dr. Badve:</strong> Absolutely! We have solid evidence now to avoid giving chemotherapy to a large number of women. The trial documented that women with low scores had excellent prognosis and those with intermediate scores do not obtain significant benefit from chemotherapy. This leaves a small group of high RS patients for whom chemotherapy will remain the standard of care. Subgroup analysis of TAILORx also suggested that there might be some benefit for chemotherapy for women 50 years or younger with hormone-receptor positive, HER2-negative, node-negative breast cancer and a Recurrence Score of greater than 15, however, additional studies are needed to confirm this. One would need to carefully weigh the benefits in this subgroup and individualize the use of chemotherapy for these young women.</p> Wed, 20 Jun 2018 18:11:37 Z{08111786-EDEA-4CEE-92CC-B9431446AE72}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/can-shorten-length-breast-cancer-treatmentCan the time it takes to treat breast cancer be cut dramatically?<p><span><em><strong>IU researcher testing whether chemo and radiation can be delivered concurrently<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zstrong"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zem"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zspan"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </strong></em></span></p> <p><em><strong>Just like every other year, Sandra Chapman went in for her annual mammogram in October 2016. But this time, something was different. A few days later, she got a call. Doctors had spotted a pea-sized spot and wanted to take a closer look.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </strong></em></p> <p><em><strong>In the weeks that followed, Chapman underwent additional imaging tests and a biopsy.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </strong></em></p> <div id="attachment_7403" class="wp-caption alignright"><em><strong> <p id="caption-attachment-7403" class="wp-caption-text">Sandra Chapman and her son, Quentin Taylor, a guard on the IU basketball team<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zdiv"> </p> <p>“The Monday after Thanksgiving, I was informed it was cancerous,” said Chapman, a mother of three who is an investigative reporter for WTHR in Indianapolis. “That’s how it all started. It was a total surprise. I have no family history, and I get a mammogram every year. I’m very faithful about that.”<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </p> <p>About 1 in 8 U.S. women will develop breast cancer in her lifetime. For many, the therapy needed to rid them of their disease can last as long as a year, making it hard to leave a painful chapter behind. But Chapman completed her treatment— which included a lumpectomy, chemotherapy and radiation—about five months after she was initially  diagnosed, thanks to an innovative research trial being led by an <a href="/sitecore/content/iu/iu-som/home">Indiana University School of Medicine<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za"> faculty member.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <p><a href="/sitecore/content/iu/iu-som/homefaculty/sitecore/content/iu/iu-som/home23204/sitecore/content/iu/iu-som/homezellars-rich/sitecore/content/iu/iu-som/home">Richard C. Zellars, MD<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za">, chair of the </a><a href="/sitecore/content/iu/iu-som/homedepartments/sitecore/content/iu/iu-som/homeradiation-oncology/sitecore/content/iu/iu-som/home">Department of Radiation Oncology<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za">, is experimenting with the delivery of existing therapies, with the aim of dramatically shortening the course of breast cancer treatment and reducing the likelihood of recurrence.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <p><a href="/sitecore/content/iu/iu-som/homedepartments/sitecore/content/iu/iu-som/homeradiation-oncology/sitecore/content/iu/iu-som/home">“I’ve been treating women with breast cancer for more than 20 years, and I see every day how hard the treatment is on them and their families, both physically and emotionally,” said Zellars, a member  of the </a><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">Vera Bradley Foundation Center for Breast Cancer Research<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za"> at IU School of Medicine. “I knew there had to be a way to do this better. We’ve done a lot to improve survival rates for women with breast cancer, but we have to do more to make the treatment itself more tolerable.”<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <blockquote><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home"> </a> <p><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home"><strong><span>Indiana University School of Medicine established the </span></strong></a><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">Vera Bradley Foundation Center for Breast Cancer Research<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za"> in June 2018 to develop therapies for some of the most difficult-to-treat types of breast cancer and to reduce life-altering side effects of treatment for the hundreds of thousands of women who are diagnosed with breast cancer each year. <~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zspan"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zstrong"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> <~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zblockquote"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">For certain types of cancer—such as esophageal, lung, colon and rectal— patients receive chemotherapy and radiation concurrently. The benefits  are clear: Chemotherapy helps sensitize the tumor cells to radiation, making the radiation more effective, and patients can complete their therapy more quickly.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">But that dual approach didn’t work for breast cancer. “When people tried this in the past, putting breast radiation and chemo together, patients had horrible burns, burns that were prohibitive,” Zellars said.  It turns out, the chemo doesn’t only sensitize the tumor to radiation. It also sensitizes skin, making it more likely for patients to suffer intense burns. Because treatment involves radiating the entire breast, there’s plenty of skin to scorch.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">As a result, experts all but abandoned the idea of concurrent therapy for breast cancer. That means surgery is often followed by four to six months of chemotherapy, a month off, then six weeks of radiation. “It typically takes a year,” Zellars said of  standard therapy.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">That elongated timeline continued to gnaw at Zellars, and he wasn’t quite ready to abandon the idea of offering chemo and radiation at the same time. He noticed that, in previous studies, burns tended to be worse when a larger area of the  breast was radiated. He hypothesized that radiating a smaller section of a breast might solve the problem.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">A relatively new and still experimental technique called partial breast irradiation allowed him to test his theory. Partial breast irradiation involves radiating a smaller, focused area surrounding the tumor, rather than the whole breast.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">While on faculty at Johns Hopkins University, Zellars launched two studies to investigate the simultaneous use of chemotherapy and partial breast irradiation. He expected to see a reduction in serious burn cases but was prepared for as many 20 percent of women to encounter the problem. What he found stunned him: Not a single burn, regardless of which type of chemotherapy drug he tried. And the combined treatment was also helping to manage even a difficult-to-treat  type of breast cancer known as triple negative.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">Zellars left Hopkins in 2015 to join IU School of Medicine and has continued his research in Indiana. He is now leading a multisite randomized study to compare which works better: combining chemo and radiation, or offering them consecutively. In addition to studying any side effects, Zellars will follow the women for several years to determine if one group is more likely to suffer a recurrence.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">If his original hunch holds up, Zellars may transform care for women with breast cancer—and help them get back to living their lives much more quickly. “We could take six months of chemo and radiation and shrink it down to maybe seven weeks,” he said. “That makes a huge difference.”<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <p><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">The trial is enrolling patients at IU Health Simon Cancer Center, all hospitals that are part of the Johns Hopkins Clinical Research Network, the University of Texas Health Science Center at San Antonio, and Reading Hospital and WellSpan York  Hospital, both in Pennsylvania. The Breast Cancer Research Foundation funds the trial.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></strong></p> <div id="attachment_7407" class="wp-caption alignleft"><strong><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home"> <p id="caption-attachment-7407" class="wp-caption-text">Chapman is an investigative reporter for WTHR in Indianapolis.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"><~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zdiv"> </p> </a> <p><a href="/sitecore/content/iu/iu-som/homeresearch/sitecore/content/iu/iu-som/homecenters-institutes/sitecore/content/iu/iu-som/homebreast-cancer/sitecore/content/iu/iu-som/home">Chapman learned about the trial from her oncologist, IU School of Medicine professor </a><a href="/sitecore/content/iu/iu-som/homefaculty/sitecore/content/iu/iu-som/home4849/sitecore/content/iu/iu-som/homemiller-kathy/sitecore/content/iu/iu-som/home">Kathy Miller, MD<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=za">, and decided to enroll based on promising preliminary results. She underwent her last treatment session on April 27, 2017. If she had undergone standard therapy, she would have likely remained in therapy until late August.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <p><a href="/sitecore/content/iu/iu-som/homefaculty/sitecore/content/iu/iu-som/home4849/sitecore/content/iu/iu-som/homemiller-kathy/sitecore/content/iu/iu-som/home">“I could focus on healing and getting back to myself,” she said of  the expedited treatment plan. “It’s still a process. I am still getting stronger every day and getting back to where I was before all this. The sooner you can start working toward that, the more positive it is, and perhaps it helps you emotionally to know that you’re making those strides.”<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <p><a href="/sitecore/content/iu/iu-som/homefaculty/sitecore/content/iu/iu-som/home4849/sitecore/content/iu/iu-som/homemiller-kathy/sitecore/content/iu/iu-som/home">Chapman—whose son Quentin Taylor is a guard on the IU basketball team—said she is grateful to have this kind of research available in the city where she lives, and she hopes her participation in the trial makes it possible for other women to have similar options.<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> </a></p> <p><a href="/sitecore/content/iu/iu-som/homefaculty/sitecore/content/iu/iu-som/home4849/sitecore/content/iu/iu-som/homemiller-kathy/sitecore/content/iu/iu-som/home">“It’s pretty incredible,” she said of  the research. “I’m so grateful that IU and the Simon Cancer Center have that to offer women. No one wants cancer, but if you are diagnosed, you want the best treatment available. I feel like  I was able to experience that.”<~ ink.aspx?_id="92302C6E9AFF496F9C96F9952B50ABB7&_z=zp"> <!--~--><!--~--><!--~--><!--~--><!--~--></a><!--~--><!--~--></p> </strong></div> <!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--></blockquote><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--><!--~--></strong></em></div> <!--~--><!--~--><!--~--><!--~--><!--~--><!--~-->Sat, 09 Jun 2018 15:03:50 Z{3EAB6D6C-ABEA-4272-9206-D02EB3179A50}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/vera-bradley-foundation-center-breast-cancer-research-iu-school-medicineAbout the Vera Bradley Foundation Center for Breast Cancer Research at IU School of Medicine<h6><em>The Vera Bradley Foundation for Breast Cancer Research raised more than $1 million at its 25th annual Vera Bradley Foundation for Breast Cancer Research Classic. IU School of Medicine will establish the Vera Bradley Foundation Center for Breast Cancer Research in recognition of the support to research the Foundation has provided to IU School of Medicine more than two decades.</em></h6> <p><strong>By: Karen Spataro</strong></p> <p><a href="/">Indiana University School of Medicine</a> is establishing the <a href="/research-centers/breast-cancer">Vera Bradley Foundation Center for Breast Cancer Research</a> to dramatically improve therapies for some of the most difficult-to-treat types of breast cancer.</p> <p>The following are answers to common questions about the center:</p> <p><strong>Q: Why is IU School of Medicine establishing a breast cancer research center?<br /> </strong><strong>A:</strong> Though significant strides have been made in the treatment of breast cancer, too many women still die from their disease, and others suffer life-long side effects as a result of their therapies. IU School of Medicine leaders feel confident that the school has the expertise and resources to make significant contributions to this area of medicine. By establishing a center, the school is bringing all of its talent together under one umbrella and ensuring researchers are working in a highly collaborative and coordinated fashion.</p> <p><strong>Q: Why is the research center named the Vera Bradley Foundation Center for Breast Cancer Research?<br /> </strong><strong>A:</strong> The <a href="http://www.verabradley.org/" target="_blank">Vera Bradley Foundation for Breast Cancer</a> has been a champion of breast cancer research, committing a total of $37.5 million to Indiana University School of Medicine since 1999. Naming the center in its honor recognizes the foundation’s generosity and foresight.</p> <p><strong>Q: Why will the center focus on triple negative breast cancer?<br /> </strong><strong>A:</strong> There is a real need to develop new therapies for triple negative breast cancer. Triple negative breast cancer tends to be more aggressive and spreads more rapidly than other types of breast cancer, and it disproportionately affects younger women and African American women. It also has a higher recurrence rate, and once it has returned, standard therapy is often ineffective. Put simply, women with triple negative breast cancer need better options, and IU School of Medicine aims to fill that gap.</p> <p><strong>Q: What makes triple negative breast cancer challenging to treat?<br /> </strong><strong>A:</strong> Most types of breast cancer are diagnosed and treated based on whether they have certain receptors that drive the growth of the cancer. For instance, some cancers have receptors that allow estrogen to attach to them (ER-positive), while others have progesterone receptors (PR-positive). These types of cancers can be treated with drugs that block the hormone receptors, thereby limiting cancer growth.</p> <p>Another type of breast cancer is caused when a genetic malfunction causes the body to make too many abnormal receptors called human epidermal growth factor 2 (HER2 receptors). This can cause cells to grow and divide uncontrollably. Again, there are certain drugs tailored to treat HER2-positive breast cancer.</p> <p>Triple negative breast cancer simply means that the cancer tests negative for the presence of all three known receptors: estrogen, progesterone and HER2. In other words, the cancer is diagnosed not by what causes it, but rather by what does <em><u>not</u></em> cause it. Without knowing the root cause of the cancer, researchers cannot develop targeted treatments designed to attack its unique vulnerabilities.</p> <p><strong>Q: Why does IU School of Medicine believe it can make progress against triple negative disease through the Vera Bradley Foundation Center?<br /> </strong><strong>A:</strong> A wave of scientific and technological advancements makes this the prime time to focus on this disease.</p> <p>First, genomic medicine is enabling researchers to read each tumor’s genetic blueprint, providing clues about the specific mechanisms it depends on to grow and survive. By analyzing the DNA of triple negative tumors, IU School of Medicine researchers hope to finally uncover what helps them flourish and develop precision therapies to interfere.</p> <p>In addition, physicians and scientists are learning how to train the human immune system to mount its own defense against cancer cells. While still in its infancy, immunotherapy has the potential to be the most promising new therapy in a generation. IU School of Medicine faculty researchers believe the combination of genomically guided therapies and immunotherapies will allow for some types of triple negative cancers to be cured.</p> <p><strong>Q: Does the Vera Bradley Foundation Center for Breast Cancer Research have a unique edge?<br /> </strong><strong>A:</strong> Yes. In addition to the extraordinary generosity of the Vera Bradley Foundation, Indiana University and IU School of Medicine have made monumental investments in talent and infrastructure to build a premier <a href="https://grandchallenges.iu.edu/precision-health/index.html" target="_blank">Precision Health Initiative</a>. All told, IU has committed $120 million to precision health as part of the <a href="https://grandchallenges.iu.edu/about/index.html" target="_blank">Grand Challenges</a> program.</p> <p>This funding is helping to develop critical infrastructure such as state-of-the-art genomic sequencing capabilities and a Chemical and Structural Biology Center, which will focus on drug discovery. In addition, the <a href="/research-centers/immunotherapy/">Brown Center for Immunotherapy</a> was established in 2016 with a gift from tech entrepreneur and IU School of Medicine alumnus Donald Brown. All of these resources will be leveraged by researchers in the Vera Bradley Foundation Center.</p> <p>IU School of Medicine is also <a href="/research-centers/breast-cancer/research/tissue-bank/">home to the world’s only biorepository – or bank – of healthy breast tissue</a>. The tissue is donated by selfless women without cancer who voluntarily undergo a breast biopsy. IU researchers are comparing healthy tissue from the bank to samples from women with triple negative disease and other types of breast cancer to identify differences that may contribute to the growth of the cancer.</p> <p><strong>Q: Is it really possible for IU School of Medicine and the Vera Bradley Foundation Center to cure triple negative breast cancer?<br /> </strong><strong>A:</strong> The likelihood is that triple negative breast cancer is not a single type of breast cancer, but several unique breast cancers with different genetic drivers. IU School of Medicine’s goal is to develop effective therapies for at least one subtype of what is now called triple negative breast cancer. IU researchers believe this is feasible in the foreseeable future using new therapeutic approaches such as genomically guided therapies and immunotherapies.</p> <p><strong>Q: How many researchers are members of the Vera Bradley Foundation Center?<br /> </strong><strong>A:</strong> The center includes about 30 researchers from throughout IU School of Medicine and Indiana University and is expected to grow with the recruitment of additional faculty. Center members are physicians and scientists who combine basic, translational, and clinical research skills to understand the biology underlying breast cancer and then apply that understanding to improve prevention, diagnosis and treatment.</p> <p><strong>Q: Where will the Vera Bradley Foundation Center for Breast Cancer be located?<br /> A:</strong> The main administrative home of the center will be housed within the more than 5,000 square feet of research space in Joseph E. Walther Hall on the School of Medicine’s Indianapolis campus. In addition, there will be many other laboratories distributed across several buildings that house the center’s investigators.</p>Tue, 05 Jun 2018 02:28:39 Z{3D6FCB74-670B-45D5-B0A6-E8BF1321326B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/running-bone-healingRunning and Bone Healing<h6>                                                                  <a href="http://barefootrunning.fas.harvard.edu/Fig1c.jpg" target="_blank" rel="noopener noreferrer">Image source</a></h6> <p>In my introductory post you may have noticed I included a photo of me from the Indy Mini.  In high school, I spent four years as a cross-country and track athlete and have continued my passion for running in college by designing and following my own training plan for the Indy Mini. The reason I bring this up is because of its relevance to our research into bone healing.</p> <p>Running is considered a high impact sport. Every step you take while running sends a shock through your body from the force of your body weight being hammered into the pavement. Of course, some of that force is absorbed by your muscles and other organs, but the majority of it is absorbed by the bones in your leg. After miles and miles of pounding away at your bones, it is easy to see why stress fractures are so commonly observed in runners.</p> <p>For runners who may be reading this, take relief in knowing that the stress fractures observed in us running folk are considerably smaller and manageable than the relatively traumatic bone injuries a soldier may sustain in the field, which is what our experimental drug is designed to treat. Until next time, catch me if you can!</p> <h5>Written by: Riley Gorden</h5> Tue, 08 May 2018 18:30:16 Z{C95BF767-112D-4E26-8FAA-6120586A6E3B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/returning-lab-member-aamir-tuckerReturning Lab Member Aamir Tucker<p>Hello, my name is Aamir Tucker and I am a masters student in Dr. Kacena’s lab at Indiana University School of Medicine.  I started working in the Kacena lab in May of 2014 and have had the privilege of continuously working in the lab throughout my undergraduate and graduate careers.  Over the years I have had the opportunity to fulfill a number of roles in the lab ranging from basic cell culture work to performing defect surgeries for our most recent spaceflight study in February of 2017.  In May of 2017 I was awarded the “Outstanding Research Award” in undergraduate Biology from IUPUI’s School of Science for my work on our successful spaceflight study.</p> <p>In addition to working in the lab I also work for my family’s block foundation company and oversee sidewalk snow removal operations for the greater Indianapolis area including properties such as Lucas Oil Stadium, Julia Carson Transport Center, and the length of Georgia Street during winter festivities hosted by the city of Indianapolis.  Outside of my many working roles I enjoy spending my free time outdoors mostly hiking or camping and am frequently accompanied by my Great Dane Myla during my adventures.  For my future plans, I am currently pursuing a career in medicine and am waiting for final decisions from a number of schools, as well as furthering our bone healing research through work on a number of recently started projects.  My hope is to be able to continue both my research and professional pursuits together in order to maximize my impact on the future medicine and the community at large.</p> <h5>Written by: Aamir Tucker</h5> Tue, 01 May 2018 13:59:57 Z{D7A3FABE-55FF-42BB-BF48-1953AD94A70E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-new-lab-member-venkateswaran-ganeshWelcome New Lab Member Venkateswaran Ganesh<p>It was the March of 2016 and around 0300 hours I received a mail from Purdue University, that I had been admitted to their graduate program at the Indianapolis campus. A biomedical engineering graduate program at a campus which also houses one of the finest medical schools in the country? I was thrilled. The system of education is completely different from where I come from. We are not given many choices to select from, and research opportunities were highly restricted. After my first semester, I was asked to pick a specialization and that’s when I got in touch with Dr. Stephen Trippel. Being my project mentor, he advised me to explore the opportunities that were available on campus, which lead me to Dr. Kacena’s lab here at Indiana School of Medicine.</p> <p>I have been associated with this lab since the beginning of the year, but I get a feeling that I have been an integral part of this setting already. I have picked up mice and large animal handling skills, along with an unmatchable exposure to an active research lab. Currently I am assisting in a mouse bone healing project and a porcine bone/muscle healing study. I have also begun scanning bones from the recent Rodent Research IV spaceflight study. I see myself working in a laboratory setting or pursuing a doctoral degree in next three to four years. But currently, I know that I am in right place, at the right time, with right people, doing exactly the right thing I always wanted to do. This will result in me cherishing these memories a decade later. I am glad to play a role here. Most important of all, my take away is, how meticulous planning is the key for not just a successful project but also for running an efficient work environment. Faculties, post-docs, associates, and students involved in this lab are ready to help and teach each other in all possible ways which makes me feel like home.</p> <h5>Written by: Venkateswaran Ganesh</h5> Mon, 23 Apr 2018 14:01:19 Z{469F5885-7614-4F47-B71F-7E1E818015DE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/2018-early-career-achievement-award-recipient-faruk-h-orge-md2018 Early Career Achievement Award Recipient: Faruk H. Örge, MD<p>The demand for a sliver of time from Faruk H. Örge, MD, never ends.</p> <p>There’s a full clinical load as a pediatric ophthalmologist fighting to save the sight of children facing glaucoma. There’s overseeing the fellowship program at Cleveland’s University Hospitals, which are linked to Case Western Reserve University. And, finally, there are the scores of ongoing research projects involving glaucoma, new imaging modalities, strabismus and drug delivery.</p> <p><iframe width="500" height="281" src="https://www.youtube.com/embed/vsnP2ZZNQ0M?feature=oembed" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen=""></iframe></p> <p>Yet Dr. Örge, who trained at IU School of Medicine from 1998 until 2005, retains a delicate human touch.</p> <p>“He exudes the perfect mix of intellect and approachability,” said Charline Boente, MD, MS, an assistant professor of pediatric ophthalmology at IU who was trained by Dr. Örge in Cleveland.</p> <p>“Despite his numerous projects and committees and leadership positions, he has always made me feel comfortable approaching him with any type of question—big or small.”<br> While still carrying out his training at IU, Dr. Örge left an imprint as a teacher. He helped set up a telemedicine program for continuing medical education that’s done 6,000 consultations in 110 countries.</p> <p>“As a mentor during his residency and fellowship he showed great maturity and promise,” said Derek T. Sprunger, MD, an associate clinical professor of ophthalmology at IU, who mentored Dr. Örge.” He has not disappointed since finishing training as he has built a well-founded reputation as a national and international leader in our field.”<br> Once he arrived in Cleveland a decade ago, it was only three years before he was named the director of pediatric ophthalmology and adult strabismus at University Hospitals Cleveland Medical Center Eye Institute. By 2012, he was honored with the inaugural Althans Endowed Chair and Professorship, the youngest to receive such honor in the CWRU history.</p> <p>Not only does he oversee a fellowship program, but Dr. Örge has made considerable contributions to improving the training of colleagues by serving on multiple committees for the American Association for Pediatric Ophthalmology and Strabismus and as an examiner for the American Board of Ophthalmology. He also served as Editor in Chief for the Knights Templar Eye Foundation Pediatric Ophthalmology Education Center, a comprehensive online educational source that has been used in more than 175 countries since 2015.</p> <p>Clinically, he specializes in complex cases of strabismus – misalignment of the eyes – and childhood glaucoma. Dr. Örge is a pioneer in conducting minimally invasive surgeries involving lasers to help relieve pressure inside the eye and curb the risk of blindness.</p> <p>Dr. Örge has distinguished himself locally, nationally and internationally, as well as within his academic and professional communities, said Louis B. Cantor, M.D., Jay C. and Lucile L. Kahn Professor of Glaucoma Research and Education, and Professor of Ophthalmology. “He is an excellent representative of an ambassador for the Indiana University School of Medicine.”</p> <p><strong>Dr. Örge was honored during the 71st Annual Strawberry Shortcake Luncheon on Saturday, May 19, 2018 in Indianapolis. </strong></p>Wed, 18 Apr 2018 18:41:29 Z{C86C4E49-5237-48A3-A020-23BDB4FAB14F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/2018-george-sorrells-jr-md-community-physician-award-recipient-kenneth-e-bobb-md522018 George Sorrells, Jr., MD Community Physician Award Recipient: Kenneth E. Bobb, MD’52<p><strong>By Matthew Harris</strong></p> <p>Eighteen years ago, Ruth Ann Rebber and the Jackson County United Way wanted to meet the needs of uninsured residents. The solution was simple: establish a community health clinic. Making it happen required some help.</p> <p>Rebber, who was the chapter’s director, knew the ideal person. So she dialed up Kenneth E. Bobb, MD ’52, who served as the county’s health director and had been a family physician in Seymour for over four decades.</p> <p>With his guidance and a partnership with the Community Foundation of Jackson County, the United Way was able to start up a federally-qualified health center in 2003. Four years later, the center moved into a remodeled space, and only then did Dr. Bobb, who had acted as medical director, step away.</p> <p>“His work is never-ending, supportive and always, always directed to better health for our entire community,” Rebber said.</p> <p><iframe width="500" height="281" src="https://www.youtube.com/embed/NxJxNWg-FtU?feature=oembed" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen=""></iframe></p> <p>Dr. Bobb’s commitment started in 1955 when he returned home to Seymour after a two-year stint as a medical officer for the U.S. Air Force during the Korean War. He’d been away for nine years, off earning his bachelor’s degree at IU and completing medical school before military service. He wouldn’t leave again.</p> <p>He set up his practice on South Chestnut Street, just a block away from Jackson County Hospital, now called Schneck Medical Center, where he had staff privileges until 2010. Over the next 44 years, Dr. Bobb general practice would deliver more 2,000 babies and administered anesthesia more than 10,000 times.</p> <aside class="iu-callout-box pull-right callout-normal bg-iu-cream" data-component="Callout Box"> <p>But like many primary care physicians in rural communities, Dr. Bobb’s reach wasn’t limited to his office. For 43 years, he lent his expertise as medical director to Lutheran Community Home, a non-profit organization that today provides assisted living and skilled nursing to elderly residents. In 1994, Dr. Bobb created a hospice program at Schneck, handling its operations for 16 years.</p> <p>One year later, Dr. Bobb led fundraisers for his church as well as the local Boys and Girls Club, which raised $1.8 million and $250,000 respectively. And after leaving his full-time practice in 1999, he was installed as the county’s health commissioner.</p> <p>“Not only has he done his utmost to provide the best, most professional, and most current medical care, he also does it from a heart that sees this not only as a job but as a calling in life,” said Rev. Ralph Blomenberg, who has worked closely with Dr. Bobb at Immanuel Lutheran Church. “Because of this, he has often taken time outside of office hours to be available for those who need him.”</p> <p><strong>Dr. Bobb was honored during the 71st Annual Strawberry Shortcake Luncheon on Saturday, May 19, 2018 in Indianapolis.</strong></p> </aside>Wed, 18 Apr 2018 18:38:22 Z{9049225C-EDA5-4380-85CD-C5453868CA59}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/2018-glenn-w-irwin-jr-md-distinguished-faculty-award-recipient-james-e-lingeman-md742018 Glenn W. Irwin Jr., MD Distinguished Faculty Award Recipient: James E. Lingeman, MD’74<p><strong>By Matthew Harris</strong></p> <p>Over nearly four decades, James E. Lingeman, MD’74, has achieved a feat few physicians can claim: changing how medicine is practiced in their specialty. Yet Dr. Lingeman, a professor of urology, has done exactly that since joining the faculty at Indiana University in 1980.</p> <p>“Dr. Lingeman is indisputably, the most recognized leader in the United States – and perhaps the world – in minimally-invasive surgery,” said Michael O. Koch, MD, who chairs the Department of Urology at the School of Medicine.</p> <p><iframe width="500" height="281" src="https://www.youtube.com/embed/ArB28jsZh3k?start=2&feature=oembed" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen=""></iframe></p> <p>In the early 1980s, he was the first physician in Indiana to use high-energy shock waves to break up kidney stones, a procedure that only requires patients to don a hospital gown and be placed under anesthesia for an hour. Later he was a leader in performing and teaching keyhole surgeries, where a small incision of the skin allows a surgeon to treat larger kidney stones by inserting a tube and laser fibers to break up the stone.</p> <p>Finally, in the early 2000s, Dr. Lingeman pioneered the removal of an enlarged prostate through a transurethral procedure. Using a resectoscope, a physician can trim away tissue that’s blocking urine flow, and it’s now considered the standard of care in the field. “While a difficult technique to learn he has schooled many others in this approach who have themselves become leaders in the field,” Koch said. “Top-tier institutions around the United States send their faculty to train with Jim Lingeman.”</p> <p>He also balanced innovation with teaching and research. Since 1988, Dr. Lingeman has overseen urology residents at Methodist Hospital, where’s he practiced for the bulk of his career. He has also trained 23 fellows, all of whom currently respected physicians.</p> <p>As a researcher, Dr. Lingeman has published more than 300 peer-reviewed articles and 64 book chapters. Meanwhile, his clinical interests helped him embark on a 30-year period of continuous funding from the National Institutes of Health to study the development of stones and the effectiveness of lithotripsy.</p> <p>“Dr. Lingeman is one of our finest faculty members. His dedication to science, medicine, patients, and learners is exemplary,” said Jay L. Hess, MD, PhD, MHSA, dean of the School of Medicine.</p> <p><strong>Dr. Lingeman was honored during the 71st Annual Strawberry Shortcake Luncheon on Saturday, May 19, 2018 in Indianapolis. </strong></p>Wed, 18 Apr 2018 18:34:49 Z{5294DBF8-2345-4291-98BA-7ECA37BF8C1C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/2018-distinguished-alumni-award-recipient-myron-weinberger-md632018 Distinguished Alumni Award Recipient: Myron Weinberger, MD’63<p><strong>By Matthew Harris</strong></p> <p>A common piece of advice for individuals, even those without hypertension, is to cut back on salt intake. The scientific basis for this is due to the pioneering work of Myron H. Weinberger, MD’63 who served on the IU School of Medicine faculty for over five decades. He and his colleagues, including Dr. Friedrich C. Luft and others at IU, worked in the Specialized Center of Research (SCOR) in Hypertension, one of five such centers supported by the NIH in the US. This incubator attracted scientists and fellows who pursued hypertension research throughout the world.</p> <p><iframe width="500" height="281" src="https://www.youtube.com/embed/c5afh5PoA70?feature=oembed" frameborder="0" allow="autoplay; encrypted-media" allowfullscreen=""></iframe></p> <p>Weinberger began his research career at Stanford University, after completing his Internship and Residency in Internal Medicine at IU. He was the first to identify the high doses of estrogen in birth-control pills as a cause of hypertension in women. He developed one of the first radioimmunoassays to measure renin and aldosterone in blood that enhanced research in the field of sodium metabolism. This led to many new findings of the causes and treatments of hypertension. He was also one of the first to study the newly developed classes of drugs blocking components of the renin-angiotensin-aldosterone system, as well as other new antihypertensive drugs including calcium channel and beta blockers. Six additional NIH grants investigated newer aspects of these findings leading to reduction in heart disease and stroke.</p> <p>“The cardiology division at IU has always used Myron as our authority on hypertension. He has given regular lectures on hypertension to the cardiology faculty and trainees,” said Harvey Feigenbaum, MD, Distinguished Professor of Medicine, who is widely recognized as the Father of Echocardiography. “We have literally been unable to replace him since his retirement.”</p> <p>Dr. Weinberger directed the Hypertension Research Center, published over 250 peer-reviewed scientific papers and 25 books/book chapters, while conducting a busy referral practice treating hypertensive patients from the US and Europe.</p> <p>To longtime friends and colleagues, Dr. Weinberger’s impact is even more extraordinary given the fact that he was born profoundly deaf and learned to read lips as well as books by the age of 4. In the third grade he obtained a hearing aid and embarked on a lifetime of adaptation, determined to become a physician despite repeated advice that it would not be possible.</p> <p>“This disability did not deter his august achievements, and one must conclude that his achievements are even more remarkable by way of his perseverance and dedication to overcome any handicap to achieve academic excellence,” said Robert W. Holden, M.D., Dean Emeritus of the School of Medicine.</p> <p><strong>Dr. Weinberger was honored during the 71st Annual Strawberry Shortcake Luncheon on Saturday, May 19, 2018 in Indianapolis. </strong></p>Wed, 18 Apr 2018 18:30:09 Z{F734CE88-EA2C-463E-AD65-AFEDF9EAFD64}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-new-lab-member-gremah-adamWelcome New Lab Member Gremah Adam<p>Hello all,</p> <p>My name is Gremah Adam. I am a Master of Medical Science Student at IU School of Medicine. One  goal of program is to prepare students for Medical School. It is a two-year program and I am in my second year, graduating this May. I have enjoyed my classes and found myself intrigued by osteology (bone cell biology) after studying the histology of bone. As such, I endeavored to fulfill my program’s research requirement by reaching out to Dr. Melissa Kacena about possibly working in her lab.</p> <p>I began my research with Dr. Kacena the Spring 2018 semester. Having never worked with animals in a research setting, I look forward to learning more about the ins and outs of the process. I have been brought on mainly to help with our upcoming bone healing experiments which will use a large animal model. Specifically, we are interested in understanding how muscle injury impacts bone healing. The knowledge of orthopedics is great and through it I hope to be able to contribute to the advancement of health care.</p> <p>Now having been involved in my second research lab, I have come to appreciate immensely the importance of this aspect of science and recognize its need for improving patient care. It takes time and hard work to see results and research is certainly no exception. I look forward to seeing how our efforts end up and how our research will affect the future of orthopedic research.</p> <h5>Written by Gremah Adam</h5> Thu, 12 Apr 2018 15:37:17 Z{7B31D567-9285-45F9-A627-9CC0C054AFFE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/breast-cancer-research/bryan-schneider-md-leads-way-breast-cancer-researchBryan Schneider, MD, leads the way for breast cancer research<p><strong>By: Mary Maxwell</strong></p> <p><a href="/faculty/4858/schneider-bryan">Bryan Schneider, MD</a>, explains to a shadowing medical student that his morning breast cancer clinic will be filled with chemotherapy patients – all of whom he describes as “in their 30s.” The afternoon will include “a little bit of everything, including women newly diagnosed with breast cancer.” As he categorizes his patients to plan his day, he is also acutely aware of his growing body of research that reveals just how vastly unique each tumor and each woman really is.</p> <p>As a physician-scientist, Dr. Schneider’s research is focused on deciphering the individual genomes of breast tumors and leading clinical trials that reveal why women respond so differently to the same cancer drug. In fact, he – and his colleagues at Indiana University School of Medicine – are at the forefront globally in identifying these differences and blending the information to develop breast cancer treatments of the future.</p> <p>Only nine years into his career as a faculty member at IU School of Medicine, he has received five prestigious national awards. This include recognition from the American Society of Clinical Oncology, the largest and most prestigious organization of its kind in the country, for his groundbreaking research that revealed biomarkers predicting harmful side effects of treatment. In all, he has amassed more than $7.8 million in peer-reviewed funding for his research. Today, as the Vera Bradley Investigator, he is realizing his goals of translating his discoveries from the laboratory into the clinic and revolutionizing the way breast cancer is diagnosed and treated.</p> <p>Dr. Schneider didn’t initially plan to become an oncologist, but his grandmother’s passing from caner inspired him to seek out a career that would allow him to care for cancer patients and to discover life-saving treatments.</p> <p>A home-grown Hoosier who was born in Jasper, Dr. Schneider graduates summa cum laude from the University of Evansville. He then graduated from IU School of Medicine, completing a residency in internal medicine and an extended fellowship in oncology that allowed him to concentrate time in the research laboratory. When Dr. Schneider was offered the opportunity to join the clinical care and research faculty as a member of the Indiana University Melvin and Bren Simon Cancer Center, he leapt at the chance to work with a research and care team internationally renowned for improving life expectancies for women with breast cancer.</p> <p>Dr. Schneider is one of 34 breast cancer researchers at the Vera Bradley Foundation for Breast Cancer Research Laboratories at IU School of Medicine. He collaborates with other members to identify how each breast cancer is different. Dr. Schneider is also associate director of the Indiana Institute for Personalized Medicine and is building a program in individualized therapeutics that blends billions of pieces of data to prescribe the right drug to the right patient at the right time. He and his colleagues are not only documenting which drugs are most effective at killing cancer cells, but also prescribing therapy based on the physical characteristics of patients – age, gender, ethnicity, medical history and lifestyle – that influence how a patient responds to therapy.</p> <blockquote><p>“Those of us studying pharmacogenics in the laboratory hope to develop and understanding of who will grain the greatest benefit from specific drugs in the clinic. The objective is to maximize the benefits of treatment for each patient while minimizing any potential negative side effects.” -Bryan Schneider, MD</p></blockquote> <p>Dr. Schneider knows that he is the right person in the right place at the right time. He credits his success to his fellowship mentors – Drs. George Sledge and David Flockhart – who guided his expertise in blending laboratory and patient-care expertise to understand the nature of breast cancer and develop better approaches to treatment. Best of all, Dr. Schneider didn’t have to leave his Indiana home to realize his career goals. The IU Simon Cancer Center is at the forefront of breast cancer research and treatment worldwide, and is moving ahead confidently because of the Vera Bradley Foundation support at the IU School of Medicine. In all, the foundation has generously donated $23.2 million to support breast cancer research with an additional $11.8 million pledged.</p> Thu, 05 Apr 2018 18:51:35 Z{61B14010-F4E7-4955-8A9B-D675AB47DEEB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/returning-team-member-alex-brinkerReturning Lab Member Alex Brinker<p>My name is Alex Brinker and I am currently a senior undergraduate student majoring in kinesiology with aspirations to attend medical school in the near future. I have been working in the lab since the beginning of my sophomore years (3 years in total now). I became involved in the lab’s research doing the Life Health Science Internship program (LHSI) at IUPUI which sets students up with faculty members to get them involved in research. Upon completion of the program, I decided to continue working in the lab because I enjoyed the research I was doing.</p> <p>I realized my desire to be involved in research early on in my undergraduate career as I had many friends involved in research who would tell me what they got to do, which interested me. I soon came to realize that I both enjoyed learning the “inner workings” of the human body as well as discovering new information I did not know prior. My interest in bone specifically was sparked due to many orthopaedic injuries throughout high school and college. The lab thus far has kept my interest and fueled my desire to learn more about what I am researching.</p> <h5>Written by: Alex Brinker</h5> Mon, 02 Apr 2018 08:00:16 Z{8B19C20F-ED09-44AB-A0E8-31BA22EE2DFC}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-new-lab-member-riley-gordenWelcome New Lab Member: Riley Gorden<p>Hello! My name is Riley Gorden, and I am an undergraduate biology major at IUPUI. I work in Dr. Kacena’s lab as an undergraduate researcher through my participation in the Life and Health Sciences Internship program. Even though I am only a sophomore, I am always thinking of how I can apply my current experiences to my career goal of being an emergency room physician. Dr. Kacena’s research in bone healing, especially with traumatic bone injuries, represents injuries I likely could see in an emergency room. Who knows, maybe someday I could be treating those injuries with an experimental bone healing drug tested right here in our own lab!</p> <p>Something I have found particularly insightful from my internship is seeing the process of research from start to finish. In my science courses, often the textbooks overlook the realities of experimental design, such as labeling test tubes or preparing reagents for an experiment. These overlooked things are easily done, but if not organized logically and efficiently they can break an experiment. I have learned to appreciate this aspect of the research process more and more, because science that is meticulously performed makes the entire process of data gathering, analysis, and writing for publication exponentially smoother. And that’s something every field, whether it be orthopaedic researcher or emergency room physician can appreciate.</p> <h5>Written by Riley Gorden</h5> Mon, 26 Mar 2018 08:00:16 Z{14481181-3844-41DE-948D-EE9086A12BED}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/father-wilderness-medicineThe Father of Wilderness Medicine- William Forgey, MD’75<p>By Matthew Harris</p> <p>Dr. William Forgey inched his way forward as a 65-miles-per-hour wind howled and whipped glacier snow around his face. In front of him, a pair of medical students crept along, slowly picking their way back from a camp to the physicians’ hand-built cabin in the wilds of Northern Manitoba.</p> <p>For decades, Forgey wracked his body and tested his mind by pushing into empty regions of a map. But on this day, a thought crossed his mind – a tinge of doubt in environs unforgiving to those who fall prey to worry.</p> <p>“Why am I even doing this?” Forgey wondered. “Am I trying to prove something?”</p> <p>A student peered back, his face peeking through the tightly drawn hood of his parka. He stopped, leaned in and pressed his face to Forgey’s ear.</p> <p>“Isn’t this great” he yelled.</p> <div id="attachment_6284" class="wp-caption alignleft"><p id="caption-attachment-6284" class="wp-caption-text">William Forgey, MD</p></div> <p>Now at 76 years old, Forgey’s adventures involve less risk to life and limb, but the native of Gary, Indiana, still holds an important moniker: The Father of Wilderness Medicine.</p> <p>Before he became a family practitioner, Forgey was inducted as a member of The Explorer’s Club and was known for his forays deep in the wilds of northern Saskatchewan and Manitoba. But it was at Indiana University School of Medicine, where he graduated in 1975, that he merged a passion for science with conquering the unknown.</p> <p>“When you’re in the wild, what’s the one thing you worry about? Am I OK” Forgey said. “Am I OK?” “When I was sitting in my classes, I was constantly thinking about, ‘Oh, so that’s how we’d treat this in the wilderness.”</p> <p>In the early ’70s, texts outlining medical care in remote and harsh settings – if they existed at all – were often overly technical or recommended aggressive approaches. What Forgey found, though, when his classmates peppered him with questions was a need for quick first-aid and triage techniques.</p> <p>“You don’t go into these deep wilderness areas if you’re totally worried about medical issues, but it is something to think about,” he said. “And there was nothing written about it. Nothing.”</p> <p>So, he started typing up short handouts, which he distributed to increasingly filled auditoriums as word about his background and experience filtered out.</p> <p>Growing up few would have pegged Forgey for an outdoorsman. Outside of an occasional family trip to fishing camps in northern Wisconsin, he didn’t live in nature. Like many kids his age, he wore a coonskin cap and gobbled up episodes of Davy Crockett, but he quit the Cub Scouts almost as soon as he joined. “I thought it was just doing crafts stuff in a basement,” Forgey said.</p> <p>Acquiring a suite of skills to survive in the wild didn’t occur until he graduated from IU Bloomington in 1964 with a bachelor’s degree in chemistry. Forgey enlisted in U.S. Army, training for the infantry. When he was shipped to Fort Bragg in North Carolina, local Boy Scouts drafted him as a volunteer. Impressed by the Scouts programming, Forgey took almost every adult training course offered, eventually earning his Wood Badge.</p> <p>“I just went full bore,” Forgey said.</p> <p>Between his military training, including a 30-month tour in Vietnam, and the Scouts, Forgey built an impressive array of skills. He’d put them to use after exiting the Army and going on expeditions into the Canadian Wilderness, such as a two-month long canoe trip to Fort Churchill on the Western shore of the Hudson Bay.</p> <p>Exploring the river systems in northern Canada eventually led him to a modest site on the shore of a tributary to the Churchill River. Forgey placed four cornerstones, petitioned the Canadian government for a lease and slowly built out a rough-hewn cabin from nearby black spruce trees in the clearing – a base of operations for many of his adventures.</p> <p>By the time Forgey graduated from IU School of Medicine, he’d written enough handouts on wilderness medicine that it only made sense to consolidate them. Just four years out of medical school, he published the first edition of <em>Wilderness Medicine</em> in 1978.</p> <p>On top of publishing the book, which is now in its seventh edition, Forgey hit the road to lecture at schools, outdoor clubs and REI stores, sometimes moving presentations into the parking lot to prevent overcrowding. At its peak, demand forced him to practice three days a week and travel to three different cities in as many days to make presentations.</p> <p>And that didn’t include carving out times for expeditions and adventures of his own. Today, though, the crowds have ebbed. “That’s a testament to how accepted this stuff is now,” Forgey said. “It’s just normal. The topic is so far advanced that it’s now branched out into areas like search-and-rescue. It’s taken on so many aspects. The simple stuff I was doing back then won’t pack people in.”</p> <p>So what encompasses wilderness medicine?</p> <p>An example might work best. Let’s say a hiker took a fall negotiating a steep descent on a trail. He suffered a sprain. A wilderness physician not only diagnoses the injury and splints it, but calculates risk. Can the patient slowly walk back to the trailhead? What are the complications? Will this add time? Are others in the party put at risk?</p> <p>“Normally we might say a person should call 911,” Forgey said. “But it can be a $40,000 decision if you call in a remote evacuation and put others at risk.”</p> <p>In the wild, seemingly routine injuries – sprains, blisters, mild burns – become magnified because of the elements. Often, Forgey said, exposure and hypothermia result from unplanned nights outside. Simply falling behind schedule can ultimately wind up dangerous.</p> <p>Forgey is also still pushing the evolution of the field.</p> <p>Thirty years after he first edited and sculpted the Wilderness Medical Society’s guidelines for emergency care, the protocols are solidly evidence-based and outline different standards for physicians, nurses and physicians assistants. Over the past several years, Forgey’s helped lead the drafting process of a wilderness first-aid guide for the Boy Scouts.  Additionally, Forgey teaches for IU School of Medicine where he earned the inaugural Alpha-Omega-Alpha Volunteer Clinical Faculty Award in 2000. There’s also a day job overseeing Correctional Health Indiana, which manages medical care for Lake County Jail. “I’m going all the time,” Forgey said.</p> <p>Recently, however, he was in Haiti, bumping and jostling along a rural road to ferry precious cargo. Four times a year, Forgey completes the three-hour trek into Verrettes, a rural town located in the country’s wooly interior, to deliver medicines and other supplies to a clinic run by Medical Student Missions.</p> <p>To Forgey, coordinating logistics, marshaling people and materiel is an adventure with a higher purpose. No, he’s not as athletic. Arthritis has slowed him. And he still wonders sometimes, even amid the rumbling of old engines, what he’s trying to show the world.</p> <p>“It’s still a big adventure,” he said. “It means something, and I can still crawl off that Jeep.”</p> Fri, 23 Mar 2018 13:28:05 Z{17F07D2B-4E37-4E1B-939A-6E72B17F6C19}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-new-lab-member-michael-savaglioWelcome New Lab Member: Michael Savaglio<p>Hello everyone,</p> <p>My name is Michael Savaglio. I am a first year medical student at Marian University College of Osteopathic Medicine. Prior to moving to Indianapolis I completed a Bachelor of Science in Kinesiology at Valparaiso University, as well as minors in Biology, Chemistry, and Psychology. While at Valpo I also played 4 years of tennis at the Division 1 level, staying on a fifth year as the assistant coach prior to enrolling at Marian. I originally intended to apply to physical therapy schools to further my interest in athletics, but exposure to the medical fields of Orthopaedics and PM&R gave me a change of heart to pursue my passion in a different way while becoming more well rounded in my education.</p> <p>I joined Dr. Kacena’s lab this winter to be a part of ongoing research in the field of Orthopaedics and find personal growth outside of the classroom.  This is my first time participating in research, and I have already learned a lot from the faculty, as well as from the other trainees who are members of the bone healing in space team. Currently, I am slated to assist with two projects beginning this spring that aim to find novel therapies for improving fracture healing. I look forward to witnessing first hand as all of the trials play out and learning as much as possible along the way. The field of medicine is always changing, and participating in research is an exciting way to be a part of it. For any student who might be interested in getting involved in a field they enjoy, I highly recommend it! My goal is to stay involved at IU until entering residency, and I can only imagine the experiences I will be able to look back on after four years of learning at Dr. Kacena’s lab.</p> <h5>Written by: Michael Savaglio</h5> Mon, 19 Mar 2018 12:50:23 Z{3E4FB950-C2C7-4D80-A038-10618EAA88B5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcome-new-lab-member-rachel-mannfeldWelcome New Lab Member: Rachel Mannfeld<p>Hey Everyone,</p> <p>My name is Rachel Mannfeld. I am currently a senior enrolled at IUPUI. I will graduate in May 2018 with a Bachelor of Science in Forensic & Investigative Sciences, Bachelor of Arts in Biology, and a minor in chemistry. Forensic science is considered to be application of science to the law, which I have always found fascinating. With my degrees I hope to land a job in a government crime laboratory where I will analyze biological evidence, as well as testify in court. My ultimate goal is join the FBI’s laboratory, but that’s still a while away.</p> <p>I joined Dr. Kacena’s lab at the beginning of the Fall 2017 semester as part of my capstone for my biology degree, and I will continue to work in the lab until I graduate. During my time in the lab I have actually utilized many skills that are directly applicable to forensic science. I have also learned several new skills, however. One of my main roles in the lab has been to scan the mouse calvaria bones from the previous NASA study. It has been interesting to learn about the impact of space on the calvaria bone.</p> <p>In my field of study, I have not necessarily been exposed to too much of the research aspect, so it has been a great experience to be in an Orthopaedics research lab and see all that goes into designing studies. My respect for those in research has definitely increased after seeing all the work that everyone puts in every day, and I hope to continue to learn from them as the months go on!</p> <h5>Written by: Rachel Mannfeld</h5> Mon, 12 Mar 2018 13:53:06 Z{849718B5-161A-45CF-8CDC-22A8BC0A8DFF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/kacenalabteam2018New Year, New Team Members<h6>Rows from front to back and L to R — First: Shatoria Lunsford, Alex Brinker, Melissa Kacena PhD, Nizeet Aguilar PhD, Marta Alvarez DDS, PhD.  Second: Rachel Mannfeld, Irushi Abeysekera. Third: Riley Gorden, Paul Childress PhD, Deepa Sheik Pran Babu PhD, Rachel Blosser. Fourth: Elliott Beckner, Jennifer Hatch, Kevin Maupin PhD. Fifth: Venkatateswaran Ganesh, Huseyin Arman, Aamir Tucker, Gremah Malam.</h6> <p>Entering a new academic year can sometimes feel like roaming through uncharted waters. The same can be said for entering a new semester in the Kacena Lab. Some things may be different, but what remains the same is our dedication to research and providing the highest level of training.</p> <p>All students, post docs, faculty, and staff that spend time with our lab have had a once in a lifetime opportunity to observe and learn more about bone healing and contribute in their own way to our spaceflight studies.</p> <p>As we continue our journey of <a href="/sitecore/content/iu/iu-som/home/orthopaedic-surgery/research/bone-healing-space" target="_blank" rel="noopener noreferrer"><em>Bone Healing in Space</em></a> in the Kacena Lab, some faces will change, yet some will remain the same. Please join us as we welcome our new lab members and welcome back those returning.</p> Tue, 27 Feb 2018 08:00:16 Z{68426F8E-CA45-4DAA-8223-6CD43ADD3A92}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/kacena-lab-prepares-second-spaceflight-launchKacena Lab prepares for second spaceflight launch<p>Hello everyone, welcome back to the Bone Healing in Space blog. The IU School of Medicine website recently migrated to a new platform, and our blog was rerouted to post under the general “Research Updates” category. Now that the migration is complete, the standalone “Bone Healing in Space” category has been reinstated; however, the new platform everyone to re-subscribe to the new blog listserv. Below are the instructions on how to do so:</p> <ul> <li>Visit <a href="/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space"><em>medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space</em></a></li> <li>Click on a blog post within the Bone Healing in Space category</li> <li>On the right-hand side of the text, enter your email address under “Subscribe to this Blog”</li> <li>Click the blue arrow to the right of the text field</li> </ul> <p>The new blog will provide updates about the lab’s second spaceflight, which is currently scheduled to launch on June 9, 2018. We will also provide some updates on our previous spaceflight mission and will introduce our new team members. We hope you enjoy our blog posts and follow along as we travel to NASA Ames to complete at least two sets of tests, and travel to NASA KSC to prepare our experiments for launch to the International Space Station.</p> <br/> <h5><em><strong>By: Melissa Kacena</strong></em></h5> Wed, 21 Feb 2018 17:42:53 Z{08EBD033-B508-4E6F-8C41-62ADDEECA933}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/ed-yosowitz-mdAlumnus, Ed Yosowitz, MD’67, writes unexpected tale<p><em>Dr. Ed Yosowitz was the last student seated in his medical school class and built a successful OB/GYN practice. In recent years he’s added children’s author to his resume, penning a trilogy of books to impart life lessons.</em></p> <p><strong>By Matthew Harris</strong></p> <p>Growing up, Ed Yosowitz never envisioned being an author.</p> <p>Instead, Yosowitz’s father foresaw his son running his dress shop—even if colorblindness meant his boy couldn’t tell ladies ensembles apart. Yosowitz, however, wanted to be a doctor. And the only member of the family who could spin a yarn was his mother, who settled her children each night with new plot twists to stories she conjured on the fly.</p> <p>“I couldn’t wait for her to come home and tell me the next chapter,” Yosowitz said. “She planted the seed, but I didn’t know if I had the ability.”</p> <p>Today, Yosowitz, who graduated from Indiana University School of Medicine in 1967, oversees a thriving obstetrics and gynecology practice in Houston, which isn’t bad for someone who was literally the last man admitted to his medical school class.</p> <p>Twelve years ago, though, coping with his mother’s death led him to pen a children’s book. The rest of the production process, meanwhile, just fell into place. Mickey Maurer, who owns IBJ Corp, is Yosowitz’s cousin and was willing to print the book. The illustrator? He just happened to be a renowned watercolorist—and the father to one of Yosowitz’s patients.</p> <p>And  so a trio of children’s books—Punky’s Adventures—was born. “I would never have predicted it,” Yosowitz said. “And I think my mother would have enjoyed these stories.”</p> <p>The main character, Punky, is a pumpkin from a patch in southern Indiana. Soon after harvest, he realizes his fate is to be the main ingredient in a pie. So he flees, finding refuge at an orphanage, where children accept him, and he winds up becoming a jack-o’-lantern.</p> <p>The lesson for readers is simple: You don’t have to be what other people want you to be—a theme drawn directly from Yosowitz’s life.</p> <p>Accepted to the School of Medicine, he figured expenses put it beyond his reach. After visiting with the dean of admissions, they struck a deal: Yosowitz would be placed on a waitlist, and if a slot was still open when classes started that fall, he could enroll. Fatefully, Yosowitz got the call. He didn’t have an apartment in Indianapolis and had to toss his clothes into a cardboard suitcase.</p> <p>At 17 years old, Yosowitz’s father sent him away after he refused to take over the family business. To pay for his undergraduate education at IU, Yosowitz worked odd jobs, including as a janitor at his fraternity house and another gig at Howard Johnson Inn.</p> <p>Once he arrived in Indianapolis, the dean of admissions said to Yosowitz, “I want you to know that the last guy accepted to Indiana University School of Medicine has never failed out. “Don’t be the first.”</p> <p>While the idea for Punky didn’t percolate for many years, Yosowitz quickly conceived of two more stories for the series, drawing inspiration from those around him.</p> <p>In Priscilla’s Adventure, a tale about a redheaded pumpkin who sings her way to The Metropolitan Opera, Yosowitz used his red-headed, American-Idol loving granddaughter for inspiration.  Its lesson: If you have talent, people will find you. And for Pedro’s Adventure, Yosowitz dedicated the main character to his Hispanic patients and colleagues.</p> <p> </p> <p>Typically, the writing and editing process took six months, and, accounting for illustrations, about nine months total. Making a buck wasn’t his goal, either. Instead, Yosowitz has dedicated the proceeds from the nearly 4,000 copies sold at $10 apiece to the Ronald McDonald House in Houston.</p> <p>“Each book got a little better,” Yosowitz said. “You learn from each one. I like the process of creating something. Whether you make a dollar or don’t make a dollar, it doesn’t really matter. I like the process of learning how to do it.”</p> <p>His work schedule has helped, too. Yosowitz, who is 75, stopped delivering babies 15 years ago and gave up surgical duties in 2012. Currently, he has clinic three days a week, leaving him four days a week to invent, write songs and think of new characters for his next book. It also lets him travel to Houston-area schools for reading days, spreading the tale of Punky and his lessons to 300 happy children.</p> <p>“Anytime you create something, you just want people to like it,” Yosowitz said. “When I look at those kids and see them enjoying it, that’s fulfilling.”</p> <p> </p> Tue, 23 Jan 2018 21:13:28 Z{122FFC06-7D4C-4057-AC13-A365EEB0D1A6}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/ed-dodge-mdRekindling a continental connection: Ed Dodge, MD’62<p><em>After growing up in Africa, Dr. Ed Dodge returned in recent years to teach and improve public health</em></p> <p><strong>By Matthew Harris</strong></p> <p>At first, the request sounds strange, and Dr. Ed Dodge admits as much.</p> <p>It’s not often a Zimbabwean minister working in rural Kansas calls you out of the blue. And even rarer he asks to visit your home in Florida. On the other end of the line, though, Dodge listened intently as the minister tried to explain. You see, growing up he’d admired Dodge’s father, Ralph, a Methodist bishop with the guts to stand up to the racist policies of Zimbabwe’s premier almost five decades ago.</p> <p>Not everyone is steeped in African politics, but to Dodge the request made total sense. So 15 years ago, the physician opened his doors and, along the way, revived a connection that lured him back to a continent he hadn’t set foot upon in 40 years.</p> <p>“He told me about this mission group he led,” said Dodge, a 1962 graduate of Indiana University School of Medicine. “It just sounded extraordinary.”</p> <div id="attachment_5141" class="wp-caption alignleft"><p id="caption-attachment-5141" class="wp-caption-text">Ed Dodge, MD</p></div> <p>Over the next decade, Dodge rekindled a dormant relationship with a land that he once considered his home. The occasional mission trip morphed into a teaching position for public health at Africa University—and it has been a bookend for a man whose family was on the ground long before western nonprofits arrived.</p> <p>Between 2010 and 2015, Dodge taught a semester-long public health course at Africa University—reprising a role he held in the late 1960s. Standing in front of a dozen students, the challenges he addressed in his lectures had morphed. Communicable diseases like typhoid, small pox and malaria—by and large—had been checked.</p> <p>What struck Dodge was Zimbabwe’s public health issues mirrored those he found at home. “We’re seeing the same problems with diseases we see in the United States: diabetes, high blood pressure, heart disease and stroke. That’s what’s killing a lot of Africans today.”</p> <p>Few know better than Dodge how Africa has grown up over the past century.</p> <p>To understand, you have to go back to March 1936. Ralph and Eunice Dodge stepped off a steamer in the port city of Luanda in what we today call Angola. They came with missionary zeal, and three-month old Ed in tow. For 10 of the next 14 years, the Dodge’s trained and oversaw pastors doing field work only returning to the U.S. when World War II broke out.</p> <p>But as soon as the guns stopped booming in 1945, the Dodges packed up their children and crossed the Atlantic Ocean once more. “In a way,” Dodge said, “it was like going home for me.” They spent the next three years living in a Methodist compound, but there were times when Ralph and Eunice evangelizing led them to take their children into the wild.</p> <p>In 1948, the couple was dispatched to Zimbabwe for a central Methodist conference. The only transportation: bumping across 1,800 miles of primitive road in the forerunner of a Chevy Suburban. For Dodge, who was 12, it remains an essential memory. Sitting in the backseat, he and his sister wrote essays about the landmarks they visited, spied wild game out their window and met scores of locals.</p> <p>He became even more rooted when his parents were sent north to the region near the Congolese border. “There were a few coffee plantations,” Dodge remembered. “Otherwise, it was Africa as it was a hundred years before.”</p> <p>When Dodge returned stateside to attend Taylor University in Upland, Ind., a small evangelical school that was often the first choice for missionary children, he was a man apart from his native country. “I understood other teenagers,” he said. “We both spoke perfect English. But we didn’t understand each other culturally.”</p> <p>Medicine was a means to get back to Africa, and central to Dodge’s plan when he entered IU School of Medicine. After earning his medical degree and spending two years in the U.S. Public Health Service, Dodge earned a master’s in public health from Johns Hopkins University. Then he packed up his wife, Nancy, whom he met at Taylor, and three children.</p> <p>Ethiopia beckoned.</p> <p>They arrived in 1967, but would stay just two years. Dodge loved his appointment and work on the faculty at Public Health College—a part of Haile Selassie University. Nancy, though, struggled. The privation and poor sanitary conditions she saw compounded her home sickness. “She was patient,” Dodge said. “But after two years she told me she could not spend another day in Africa.”</p> <p>Back in the United States, they eventually settled in Inverness, Florida, an hour’s drive north of Tampa. Dodge spent the bulk of his career practicing family medicine. He retired early in 1996, stepping away from medicine to care for Nancy, who had been diagnosed with ovarian cancer that had now spread to her brain. She succumbed in early 1999, but Dodge cherishes the time he had with her.</p> <p>“That was probably the best decision I ever made,” he said.</p> <div id="attachment_5139" class="wp-caption alignleft"><p id="caption-attachment-5139" class="wp-caption-text">Africa University</p></div> <p>Four years later, the minister called. On a mission trip in 2009, Dodge happened to meet the dean of the public health faculty at Africa University, who asked if Dodge might be willing to help teach. He agreed, and his background in family medicine made him well-suited for the task. Today, a major public health challenge in Africa is one it shares with America: How do you get people to make healthy lifestyle choices?</p> <p>“Traditionally, the African diets are very healthy,” he said. “They’re plant-based diets with no processed foods. Now, fast food has come and brought a tidal wave of diseases with them.”</p> <p>With the arrival of spring, Dodge took up a semester-long appointment, lecturing to a dozen or so students who set off to become change agents for public health. “I had a major impact on the lives of the students I taught,” he said. “They had a ripple effect.”</p> <p>And this coming June, his family will see up close the difference he’s been able to make. The Dodges, though, all have ties that bind them to the continent. Ed’s eldest son worked in Ethiopia for a Project Mercy. Meanwhile, his daughter and her husband will also be tagging along. Their adopted children, both of whom were born in Ethiopia, will be in tow and see their homeland for the first time in ages.</p> <p>“It’s going to be emotional,” Dodge said. “But it will be fantastic for us all to share those moments.”</p> <p></p> <p><em>When Ed Dodge was born in Salamanca, New York, nobody could have guessed the twists and turns his life would take. He spent much of his childhood in Angola, where his parents were missionaries. He suffered culture shock when he returned to America as a teenager, but went on to become a physician who worked in the United States and Africa at various stages of his career. Along the way he was a prison doctor, an emergency room physician, a public health director, a family doctor, a volunteer with Volunteer-in-Mission teams in Africa, and an adjunct professor of health.</em></p> <p>For information or to order copies of his memoir, please visit <a href="https://www.amazon.com/Ed-Dodge/e/B00HMC303I/ref=sr_tc_2_0?qid=1519831734&sr=1-2-ent" target="_blank">Ed’s author page on Amazon</a>.</p> <p> </p> Thu, 18 Jan 2018 21:46:55 Z{A0E3F058-94F6-4BC8-94DA-07F9488D6EF5}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/halting-addiction-kambiz-karimi-md81Halting Addiction: Kambiz Karimi, MD’81<p><em>The IU alumnus was one of Indiana’s first physicians to specialize in treating patients grappling with drug and alcohol problems. 30 years later, his commitment hasn’t wavered.</em></p> <p><strong>By Matthew Harris</strong></p> <p>Just an intern in 1981, Kambiz Karimi, MD, stood stunned in an emergency room.</p> <p>On its floor, a homeless man, who’d arrived on the bitterly cold night suffering frostbite on his feet, writhed in shock. Karimi looked to the resident next to him and asked what to do. What came out of his colleague’s mouth saddened him.</p> <p>“Let him die,” Karimi remembered. “He’s an alcoholic. He did this to himself.”</p> <p>For Karimi, a 1981 graduate of IU School of Medicine, it was the trigger he’d been waiting for to pursue addiction medicine. Today, he runs 365 Recovery, based in Newport Beach, California, helping patients battling substance abuse through detox, outpatient recovery and long-term treatment.</p> <p>His specialty is no longer a niche. Nor are his skills only called upon when a patient shows up in the emergency room. Instead, physicians treating addiction are vital as the U.S. wrestles with an opioid epidemic declared a national public health emergency.</p> <p>“We’re not just a last resort anymore,” Karimi said. “Doctors don’t just come to us when something’s gone really wrong.”</p> <p>And few physicians know the crippling repercussions of addiction better than Karimi.</p> <p>Born in Iran, Karimi’s family was hounded by substance abuse. His father struggled with alcoholism, unleashing violent outbursts on his wives and children. In a rage, he once smashed a broomstick on Karimi’s arm, shattering the boy’s wrist. A step-brother also succumbed to heroin’s grip, committing suicide while Karimi was in his residency.</p> <p>“It was a complete disaster,” Karimi said of his family. “I couldn’t wait to get away.”</p> <p>Studying abroad was his respite. He attended Baylor University for his undergraduate degree, taking a series of odd jobs to scrounge up enough money for tuition. Often, while working at the Ramada Inn, he hoped diners wouldn’t clear their plates before leaving. Their scraps would often be his dinner.</p> <p>After a brief return to Iran, Karimi and his wife, Susan, returned to the United States, where he attended medical school at IU School of Medicine. He specialized in internal medicine, but always with an eye toward treating addiction.</p> <p>He finally got his start after founding Indianapolis Medical Group in 1986. Two years later, he became one of the first wave of physicians to earn formal board certification in the field. At the time, though, addiction was deemed a comorbidity—a factor that contributed to death from medical issues like liver cirrhosis in an alcoholic.</p> <p>“Nobody really came in and said, “I’m drinking too much. Can you detox me?” Karimi said. “They usually came in with the medical complications from it.”</p> <p>By the middle of the 1990s, though, Karimi’s practice tilted mostly toward addiction, and he became a frequent referral from fellow internal medicine physicians and other subspecialties. The nature of treatment shifted, too. The approach became holistic, with clinicians probing patients about their family life and their mental health.</p> <p>“That was huge,” Karimi said. “If you ask me what the leading factor is in causing people to go drugs or alcohol, besides genetic predisposition, it’s childhood issues.”</p> <p>Karimi saw the first seeds of today’s crisis being sown. In the late 1990s, physicians and pain management specialists leaned on prescription painkillers as the main course of treatment. While the practice may have been defensible, those same physicians may not have known if a patient had a genetic predisposition toward addiction. The volume of pills prescribed created a black market for sales.</p> <p>“I started getting a lot of referrals from pain management and family practice doctors who realized their patients might have a problem,” Karimi said.</p> <p>A few years ago a change in the formulation of OxyContin, a powerful opioid painkiller, made it harder to crush and snort drugs. Instead, users learned how to separate Naltrexone from the drug and use a syringe to take the drug intravenously. And if they couldn’t get ahold of pills, heroin was the next step.</p> <p>The mushrooming crisis induced self-reflection among physicians, Karimi said. His peers pay closer attention now to signs that a patient may be dependent on drugs that—ideally—are a short-term solution. Increasingly, he said, pain management specialists along with primary care physicians are reaching out to consult with him about whether a patient may have a problem.</p> <p>“The whole medical community is also becoming a team and coming together to figure out who those physicians are that are overprescribing,” Karimi said.</p> <p>Six years ago, Karimi left Indiana and relocated to southern California to practice and, in 2015, started his recovery practice. The program is simple to describe: detox, a transition to a drug—Suboxone, for example—to deal with heroin withdrawal and a move to a treatment facility. If all goes well, a patient may go to a transitional living facility and get outpatient care from Karimi.</p> <p>“After that, it’s really up to them to decide whether they want to continue with sober living,” he said. “They can stay there, go to work and make progress.”</p> <p>Karimi admits the last 30 years, and his own upbringing, have numbed him when it comes to the plight of users. “I’m used to it by now,” he said. “When you see what I’ve seen, nothing shocks you.” Yet he says his experiences also allow him to speak to patients and families in a way that goes beyond clinical advice.</p> <p>“I know exactly what their families are going through,” he said. “It makes those conversations easier, and the care you can give someone so much better.”</p> Thu, 18 Jan 2018 19:39:57 Z{ED54F72E-E801-4EE2-8251-06E1544F0B43}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/pacifist-called-to-serve-in-vietnamA Pacifist Was Called to Serve in Vietnam<p><em>This year marks the 45<sup>th</sup> anniversary of the Paris Peace Accord, which ushered in the end of U.S. combat in Vietnam. An estimated 1.3 million people died as a result of the war. We spoke with three IU School of Medicine alumni who experienced the war from different perspectives.</em></p> <p><em>Second of three parts.</em></p> <p><strong>By Matthew Harris</strong></p> <p>Trudging on a mountain pass with her feet blistered because of poor footwear, Marge Nelson, MD, asked God how this fit the plan for her.</p> <p>A week earlier, North Vietnamese soldiers found her and a friend huddling in a bomb shelter in the city of Hue. The Tet offensive, launched in early 1968, had raged for days across the country, including through the ancient capital city. Scouring homes and hideouts, National Liberation Forces found the women, took them captive, and marched them into the jungle.</p> <p>Nelson had only been in the country for four months as the first physician tasked to work at a rehabilitation clinic operated by the American Friends Service Committee in the Quang Ngai Province. A devout Quaker and ardent pacifist, Nelson spent her days treating patients who had lost limbs—often to landmines—and required prosthetics.</p> <p>“I felt I had been called to do medical work,” said Nelson, a 1964 graduate of Indiana University School of Medicine.</p> <p>Now, she was despondent.</p> <p>Then she spotted a sign—a single white flower blooming along the roadside. In stilted Vietnamese, she asked a soldier the name of the flower. “Don’t eat it,” he said. “It’s poisonous.” While seemingly mundane, those brief words opened a conversation with Nelson—proof that perhaps her captors would be willing to engage in a conversation.</p> <p>“Here was an opportunity to talk to the other side and explain that I was a pacifist and that I didn’t agree with the war,” she said.</p> <p>Nelson grew up in Kokomo, Indiana and earned an undergraduate degree at Earlham College. Her goal was to pursue a career in nursing. But after a Sunday service, a physician and his wife told her she had the makings of a physician. “Can a woman do that?” she asked them.</p> <p>Yes, she could. And along the way, Nelson sought to blend faith and work. In Philadelphia, where she completed her internship and residency, a colleague connected her with the founder of the hospital ship HOPE. So Nelson spent two months off the coast of Africa, a stint that inspired her to pursue a personalized residency in overseas health.</p> <p>Just as that came to a close, the American Friends Service Committee sought her out. They were starting a hospital in Quang Ngai, located 500 miles north of Saigon but also a haven for communist forces. Would she like to go?</p> <p>“You don’t know how much this answers my prayers,” she told them.</p> <p>At 28 years old, she set off. The rehabilitation center was modest, taking up a small building at a province hospital. One side was a physical therapy center, the other was a prosthetic center, which made artificial limbs and braces as well as trained local people how to make them. “We never lacked for patients,” Nelson said, “except for Tet. Everyone wanted to go home for Tet if at all possible.”</p> <p>So Marge took off, accepting a colleague’s invitation to visit Hue, which sat only 30 miles from the Vietnamese Demilitarized Zone. Poorly defended, communist forces quickly controlled it, and it would take a month-long siege—waged after Nelson’s capture—of house-to-house fighting for U.S. and South Vietnamese forces to take it back.</p> <p>By then, the National Liberation Forces had marched Nelson and her friend deep into the jungle, where they were kept under the watchful eye of an officer named Nam. “We were given shoes, black shirts, and pants; as we had left Hue in our pajamas.  We passed our days chatting with soldiers.”</p> <p>Her captors tried to persuade her that the U.S. and South Vietnamese cause was illegitimate. To Nelson, though, the legitimacy of force mattered little. She made her position clear. “I told Nam, ‘Teach me your word for pacifist,’” Nelson remembered. “I said, “I don’t agree with war. I think all of the soldiers on all of the sides should go home.  Then we should sit down and talk to solve our differences.”</p> <p>In the middle of March 1968, it was clear the National Liberation Forces were making preparations to release Nelson and her friend. They were moved to another camp and asked to write release statements. Finally, on March 30, the women were released to a family in a village north of Hue.  They followed a path to Highway One and caught a bus back to Hue.  “It was a regular bus although there were some soldiers on the bus. None of them said anything to us.”</p> <p>Despite the ordeal, Nelson was not ready to put Vietnam behind her. Back home in America, she told the American Friends Service Committee that she hadn’t finished her two-year contract and wanted to return to Vietnam. And she did.</p> <p>“They only told me I had to go home,” Nelson said of the National Liberation Forces. “They didn’t say not to come back.”</p>Wed, 20 Dec 2017 14:59:48 Z{E2C46106-DD95-4F36-8FFE-CA6153A9EEFF}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/forced-flee-vietnamForced to Flee Vietnam, a Family Found a Home in Indiana<p><em>This year marks the 45<sup>th</sup> anniversary of the Paris Peace Accord, which ushered in the end of U.S. combat in Vietnam. An estimated 1.3 million people died as a result of the war. We spoke with three IU School of Medicine alumni who experienced the war from different perspectives.</em></p> <p><em>Last of three parts.</em></p> <p><strong>By Matthew Harris</strong></p> <p>Yung Nguyen remembers his home dropping away.</p> <p>The 7-year-old boy stared out the window of a plane as one of the last flights from Saigon rose aloft and shuttled him across an ocean. Today, Nguyen is a semiretired anesthesiologist, adopted Hoosier and president of the Indiana University School of Medicine Alumni Association. In 1975, during the final moments of the Vietnam War, he became a refugee along with his parents and four siblings.</p> <p>“We flew out that morning,” said Nguyen, a 1995 graduate of IU School of Medicine. “A few hours later it was the end of the war.”</p> <p>U.S. military forces had exited Vietnam two years earlier in 1973 on the heels of a tenuous peace agreement, but the deal fell apart just months later. Over the two years that followed, North Vietnamese forces pushed toward the capital­—now known as Ho Chi Minh City. In the spring of 1975, communist troops gathered for a finishing blow in a war that claimed 1.3 million lives.</p> <p>“I knew that was it for us,” Nguyen said.</p> <p>As a boy, though, Nguyen never felt the war burst his bubble of tranquility. If violence like the Tet offensive, Buddhist uprisings or revolts against corrupt political leaders caused strife, Nguyen says he was too young to remember. The Nguyens lived an upper-middle-class existence in Saigon. His father, a former military officer, worked for American contractors during the war. His mother ran a boutique in a nearby market. The only daily reminder of the war was a warm one: Nguyen’s grandmother, who moved from the North to resettle with the family.</p> <p>During the war’s final months, friends implored them to flee. If captured, Nguyen’s father faced almost certain execution. Meanwhile, his wife and five children would be packed off to re-education camps in the countryside. It was not until the waning days that the Nguyens decided to flee.</p> <p>“The last few hours before we left, we packed up the house,” Nguyen said. “It was whatever you could throw in your suitcase. Other families had liquidated their assets. We just came over with the clothes on our backs.”</p> <p>Even as a young boy, he knew the stakes if they stayed. “You just know you may die,” he said. “Or you may not have a house anymore. If you leave, you have a chance.”</p> <p>The family settled in Brownsburg, Indiana, then a farming community of 5,800 people in Hendricks County and home to St. Malachy Catholic Church, which sponsored their asylum application. Nguyen’s father took a job at Burger Chef, while his mother started working in the cafeteria of what was then Wishard Hospital. It was a modest reboot. Nguyen and his siblings enrolled at St. Malachy’s parochial school.</p> <p>“It was hard,” Nguyen said of parents’ assimilation process. “It was big things and little things, like not having the right ingredients to make food.”</p> <p>And in Brownsburg, the Nguyens represented a war that claimed the lives of local fathers, sons, and nephews. “We just tried to keep to ourselves,” Nguyen said. “We studied hard. We worked hard.”</p> <p>Over time, Nguyen and his family followed a familiar tale for immigrants. He went to Indiana University, where he studied chemistry, and then on to medical school. While at the IU School of Medicine, Nguyen thought he might leave Indiana for his residency. But once he settled on anesthesiology, he earned a slot at IU, which he considered one of the best residency programs in the country.</p> <p>“That’s hard to turn to down,” he said. “Indianapolis also grew up a lot, too.”</p> <p>Today, Brownsburg is a booming suburb, and his parents are respected elders in the local Vietnamese community, which now numbers close to 600. His older brother is an electrical engineer at Rolls Royce. One sister is an optometrist. Another sister is a stay-at-home mom. And the third works in human resources.</p> <p>Meanwhile, Nguyen enjoyed a successful 14-year stint at Central Indiana Orthopedic Surgery Center in Anderson and now works at Cook Medical in Bloomington, Ind.</p> <p>“I never wanted to be someone always looking for greener grass,” he said of staying in his adopted home. “I can lead the life I want to here and be the person I want to be.”<span style="font-family: BentonSans, "Helvetica Neue", Helvetica, sans-serif;"> </span></p>Wed, 20 Dec 2017 14:59:47 Z{762E17C6-CF0E-47FC-B747-52E46BADCE6F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/we-had-to-persist‘We had to persist’<p><strong>Alumnus’ memoir details service in Vietnam</strong></p> <p><em>This year marks the 45<sup>th</sup> anniversary of the Paris Peace Accord, which ushered in the end of U.S. combat in Vietnam. An estimated 1.3 million people died as a result of the war. We spoke with three IU School of Medicine alumni who experienced the war from different perspectives.</em></p> <p><em>First of three parts.</em></p> <p><strong>By Matthew Harris</strong></p> <p>When the Boeing 707 carrying him to Vietnam touched down at Tan Son Nhut Air Base, James Donadio Jr., MD, didn’t have time to deal with jet lag from his 24-hour flight.</p> <p>Instead, an Army sergeant pulled up in a jeep to greet Donadio and quickly ditched formalities. “Welcome to the war zone,” the officer said.</p> <p>The chief of medicine who met him at the 3rd Field Hospital in Saigon was equally direct. “Glad to meet you,” the chief said. “You have a patient.”</p> <p>A severely wounded soldier was slipping into kidney failure after exiting surgery. With the help of several nurses and corpsmen, Donadio hastily set up a dialysis machine to stabilize his patient. There would be no settling into his year-long stint as an Army physician. It was 1966, and the Vietnam War was ratcheting up in intensity.</p> <p>“I didn’t have time to think about where I was,” said Donadio, a 1961 graduate of Indiana University School of Medicine and an Indianapolis native. “I just knew that I was in a very strange land.”</p> <p>Donadio’s draft notice had arrived just three months before he was set to join the staff of Mayo Clinic in Minnesota as a nephrologist. He left his wife and four young children behind to supervise a newly created renal intensive care unit more than 8,000 miles away.</p> <p>Five decades later, Donadio sifted through his memories and emotions to pen “From Mayo Clinic to Vietnam: Memoirs of a Physician Serving in the War.” The memoir details his work in the renal unit, where he cared for soldiers who suffered kidney failure as a result of devastating trauma sustained in combat.</p> <p>The field of nephrology and use of dialysis were still in their infancy at the time, so there was no play book for Donadio and his colleagues to follow. When he returned to the United States, Donadio and his colleagues would publish about the management of kidney failure among military personnel in the Lancet, Annals of Internal Medicine, The Johns Hopkins Medical Journal, and other prominent journals.</p> <p>Donadio’s service in Vietnam wasn’t limited to the kidney unit. He often spent time treating soldiers fighting tropical diseases he’d only read about in textbooks: malaria, leptospirosis, typhus and dengue fever.</p> <p>Donadio’s tour, however, wasn’t entirely spent in the cocoon of the South Vietnamese capitol. In his spare time, Donadio ventured to small hamlets on the city’s outskirts, and helped care for children who’d lost their parents in the conflict at an orphanage run by Catholic nuns. He also flew north to the rugged terrain near the border region serving in forward hospitals caring for Marines who faced a steady onslaught of mortar and artillery fire.</p> <p>“You saw a lot of young men in pain,” Donadio remembered. “And those doctors were doing all they could to keep them alive in what would be primitive conditions almost anywhere else.”</p> <p>Meanwhile, life in Saigon was unsettling. In 1966, the Buddhist Uprising roiled the capital. A series of coups cycled eight leaders through the head of the government. “I had a little pit in my stomach every day,” he said.</p> <p>To pass time, Donadio would play handball at the air base, or don civilian clothes and drive into the city center with a surgeon friend to visit with and photograph the steady stream of refugees that were fleeing the war-ravaged countryside. And he looked forward to receiving reel-to-reel tapes sent by his wife twice a month so he could listen to the sound of his children saying hello. “I played those tapes over and over again,” he said.</p> <p>In the U.S., the debate about the war and whether America should be involved gained steam. For Donadio, glimpsing its toll up close left him conflicted, but not about the job he was brought across the Pacific Ocean to perform.</p> <p>“We had to persist,” he said. “We had to take care of wounded and sick young men. It was devastating: death, amputations, and surgeons fixing holes. It just drove you crazy, but you had to do it.”</p> <p><em>James V. Donadio Jr, MD, worked for 32 years as a nephrologist at the Mayo Clinic in Rochester, Minnesota, including nine years as chair of the Division of Nephrology. He served one year in Vietnam and finished his military commitment at Walter Reed Army Medical Center in Washington, D.C. For information or to order copies of his memoir, please visit www.donadiomemoirs.com.</em></p>Wed, 20 Dec 2017 14:59:43 Z{1B812915-1BAE-4DF7-93BB-E51E37BCE475}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/jimrickardsmdAlumnus takes community approach in caring for Oregonians<p><strong>By Matthew Harris</strong></p> <p>Dr. Jim Rickards’ patients were frequent flyers.</p> <p>Or at least that’s what they were called in emergency rooms around Oregon’s Yamhill County. A decade ago, Rickards, a radiologist, was getting to know his patients too well. Often, he’d see the same patients over and over again, doing imaging studies that cost thousands of dollars but seemingly having little impact.</p> <p>“What’s the value of this care or service that I’m delivering?” he thought.</p> <p>The problems confronting his patients required medical care, but their underlying causes often fell outside a physician’s scope: behavioral issues, addiction or socioeconomic stress. After practicing for just six years, Rickards, a 2002 graduate of Indiana University School of Medicine, thought there had to be a better—and more efficient way—to deliver care.</p> <p>“I couldn’t just keep my blinders on anymore,” said Rickards, who is also a native of Valparaiso, Indiana.</p> <p>Today, Rickards is the senior medical director for population health at Moda Health, an insurance company operating in Oregon and Alaska. Moving into health administration wasn’t in his plans, though. Instead, it was the outgrowth of trying to streamline care and taking part in the creation of a community care organization, which in Oregon provides coordinated services to Medicaid beneficiaries.</p> <p>It’s also a journey Rickards documented in Our Health Plan: Community Governed Healthcare that Works, which was published in August.</p> <p>“Writing the book gave me the clear understanding of how medical care fit in the broader healthcare environment,” he said. “It helped me understand how important all the other broader aspects of health care are, and showed me the importance of involving them.”</p> <p>As Rickards’ wondered about his value, Oregon, like many states, confronted a budget shortfall driven by Medicaid spending. While the federal government kicks in some funds, states are also on the hook for costs. They’re also tasked with administering the program for beneficiaries.</p> <p>While the Affordable Care Act worked its way through Congress, the state faced a $1.9 billion gap. The budget gap was likely to grow with Oregon planning on enacting a federally-backed Medicaid expansion that would increase enrollment by 400,000 residents. Meanwhile, decreasing reimbursements to hospital systems or slashing services covered for beneficiaries weren’t feasible.</p> <p>“We realized we needed to change the way we administered Medicaid benefits,” Rickards said.</p> <p>The instrument was novel: community care organizations—or CCOs.</p> <p>At the time, the state had a messy, patchwork systems of managed care entities for medical care, behavioral health and oral care. There was no coordination. Providers were confused. And the providers competed instead of collaborating.</p> <p>“There wasn’t one global budget they could use to control health care costs,” Rickards said. “There wasn’t one set of metrics everyone was looking to improve. There wasn’t a common platform for community governance.”</p> <p>At its core, a CCO streamlines the process. They’re based on geography, serving a specific set of ZIP codes. They’re set up as non-profits and operate off a global budget, which pays a set dollar amount for every beneficiary covered. Then it falls to physicians, health departments and community groups to set up a network of providers. In turn, healthcare providers hold seats on a governing board and clinical advisory panels.</p> <p>“We could take any profits it reaped and pump those back into the local community,” he said.</p> <p>Setting up the Yamhill County CCO roped in Rickards. He served on its steering community. He earned a healthcare-focused MBA to understand logistics and operations, becoming the CCO’s health strategy officer. In that role, he helped implement programs, like a teledermatology program for 25,000 patients in a mostly rural county. All the while, he split time between his practice and work.</p> <p>Over the past five years, though, management became the crux of his work. In December 2015, he was tapped as the chief medical officer, who oversees all 16 CCOs, for the Oregon Health Authority. And in July, he joined Moda, which provides administrative support for a CCO in eastern Oregon, covers state teachers and public employees and offers a plan on ACA exchange.</p> <p>In quiet moments, though, he calls upon his old skills.</p> <p>“Imaging is mostly technical,” he said. “I still do a little bit of work if there’s down time, which there isn’t very much.”</p>Tue, 19 Dec 2017 13:08:11 Z{544E440E-2728-4CBC-9CE8-1B4CBC9D5EE1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/a-prescription-for-wineA PRESCRIPTION FOR WINE: Pro tips from an IU School of Medicine alumnus-turned winemaker<p><strong>By Karen Spataro</strong></p> <p>It’s the holiday season, when we often find ourselves popping into a wine shop to grab some wine for a hostess gift or stocking up on bottles for a get-together with friends.</p> <p>But how do you decide on the perfect varietal to give your boss, or what goes best with the menu you’re planning to serve? The IU School of Medicine Alumni Association consulted with Charles Thomas, MD, a 1958 graduate of IU School of Medicine and owner of Chateau Thomas Winery in Plainfield, Indiana. He gave us a prescription to help you feel like a wine pro.</p> <p><strong>Tips for Wine Pairing</strong></p> <p>“If you’re throwing a dinner party, either the menu should command the wine, or the wine should command the menu,” Dr. Thomas said. In general, pairings should follow the sauce, not the meat. With a light sauce or no sauce, select a white wine. Red wines tend to go with red food (think steak) or red and brown sauces.</p> <p>Consider the complexity of the food and pick a varietal to match. For example, Carignans and Pinot Noirs are lighter-style red wines and go well with a light red sauce, au jus, and even some kinds of fish. Varietals like Zinfandel, Sangiovese and Barbera are medium-bodied and are ideal to serve with pasta and lighter red dishes. Cabernets, Syrahs and Malbecs are among the most complex red wines and should be paired with heavy sauces, grilled meats and Italian food.</p> <p>Dr. Thomas’ favorite pairing: an “almost rare” filet mignon enjoyed with a reserve wine he makes called Black Gold that is two-thirds Cabernet Franc and one-third Merlot. “It’s very flavorful and very elegant.”</p> <p><strong>Tips for Gifting Wine</strong></p> <p>Choosing wine is all about personal preference. It’s usually best to stay away from overly complex varietals if you don’t know the recipient’s taste. Pick something that’s neither too dry nor too sweet. Consider a Merlot, which is produced from larger grapes and therefore has fewer tannins—the element that makes wine taste dry and adds bitterness and astringency.</p> <p>But don’t worry too much. “The best thing about wine is that if you don’t like what someone gave you, you can give it to someone else, pour it for your boss, or use it to cook with,” Dr. Thomas said. “Wine should never go to waste.”</p> <p><strong>About Charles Thomas, MD</strong></p> <p>Dr. Thomas was already a practicing obstetrician and gynecologist when he first became interested in wine-making.</p> <p>It was 1970, and he was a member of the Marion County Medical Association Bowling League in Indianapolis. He had been bowling one afternoon at an alley on Keystone Avenue and was waiting for his wife to pick him up. She was running late, so he wandered across the street to a Wine Art store and left with an at-home wine-making kit.</p> <p>Within a few years, he was taking (and then teaching) wine-making classes, had started an amateur winemakers’ club, and even launched a competition at the Indiana State Fair. “It just kind of got away from me,” he recalled during a recent visit to his Chateau Thomas Winery. Soon, he found himself traveling to California while maintaining his busy OB/GYN practice to learn from the family of Robert Mondavi and other experts in the up-and-coming California wine industry.</p> <p>He opened his own winery in 1984, shipping in grapes from California, Washington state and Oregon to produce the varietals and capture the tastes he had come to appreciate.</p> <p>Dr. Thomas retired from medicine in 1995 but, at age 85, he continues to pursue his passion for wine-making. Today, Chateau Thomas Winery produces approximately 40,000 gallons of wine a year. Dr. Thomas describes his wine as a “French style, complex vinifera wine from California or Washington state grapes.” Put another way, he likes to call Chateau Thomas “Indiana’s California winery.”</p> <p>For Dr. Thomas, wine-making is a true art that starts with selecting the right grapes and requires making decisions along every step of the way that affect the taste. “It is something that is a unique combination of history, science, creative art, culinary science and chemistry,” he said. “It’s a combination of all those things. There will never be anybody who knows everything about wine.”</p> <p>Dr. Thomas has written 2 books; a cookbook, “The Chateau Thomas Table – Pairing to Perfection,” and “<a rel="noopener noreferrer" href="https://www.barnesandnoble.com/w/practical-wine-talk-charles-r-thomas-md/1115472852" target="_blank">Practical Wine Talk- A Physician Winemaker Examines Wine</a>.” Both are available at Barnes & Noble.</p>Tue, 12 Dec 2017 21:07:36 Z{06511996-4850-4F33-9D24-523B68CDDF55}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/2017-iu-school-medicine-year-review2017 IU School of Medicine Year in Review<p>Indiana University School of Medicine celebrated another banner year in 2017, making continued strides to enhance medical education and pioneer new treatments for patients in Indiana and around the world.</p> <p>Much of our success is due to the alumni who serve as volunteer faculty, mentor students and generously support the school through their giving.</p> <p>As the year comes to a close, here are just a few examples of how we are preparing healers and transforming health.</p> <p><strong>Welcoming the Class of 2021</strong></p> <p>IU School of Medicine welcomed 364 first-year students to the Class of 2021. They are now studying at all nine campuses around the state.</p> <p>Approximately 7,200 students applied – or 20 applicants for every available spot, proving IU School of Medicine has a strong reputation nationally.</p> <p>About 80 percent of students in the class hail from Indiana.</p> <p><strong>Celebrating Our Recent Graduates </strong></p> <p>In May, we graduated 331 medical students who join the ranks of IU School of Medicine alumni. They are now completing their residencies, with more than 30 percent matching in Indiana. We also sent students to other premier programs such as Massachusetts General Hospital, Mayo Clinic, Johns Hopkins, Stanford, Yale, and Duke.</p> <p>Altogether, our students matched into 20 different specialties, and about 40 percent matched into what we consider to be primary care residencies: internal medicine, pediatrics, family medicine, and meds-peds.</p> <p><strong>Adding Residency Positions</strong></p> <p>The school received permission this summer to add seven new residency positions to address Indiana’s critical need for more physicians. The positions are in obstetrics and gynecology, psychiatry, and pediatric psychiatry, and two positions each will be added in emergency medicine and family medicine.</p> <p>The Indiana Graduate Medical Education Board also voted to provide funds for IU School of Medicine to develop new residency programs in locations that do not yet offer them.</p> <p>Five spots for family medicine residents are expected to open in Lafayette beginning in July 2018 expanding to fifteen over three years. More than 60 residency positions are expected to open in Southwestern Indiana over four years beginning in 2019. The school, in a cooperative effort with various Indiana hospitals, is also studying the feasibility of establishing residency programs elsewhere in the state.</p> <p><strong>Building for the Future</strong></p> <p>A first-class medical school requires first class-facilities, and IU School of Medicine is investing in its campuses around the state. A new multi-institutional health sciences campus is under construction in downtown Evansville. The campus will be shared by health-related programs for IU School of Medicine – Evansville, IU School of Dentistry, the University of Evansville, and the University of Southern Indiana.</p> <p>In addition, construction is expected to begin in January 2018 on a new Regional Academic Health Center in Bloomington that will house Indiana University Health Bloomington inpatient and outpatient services as well as an academic facility that will be used for health sciences education and research at Indiana University. Finally, planning is also underway for a new Adult Academic Health Center in Indianapolis that is expected to include a new medical education building.</p> <p><strong>Recruiting New Leaders</strong></p> <p>IU School of Medicine continued to recruit top talent to join our faculty in 2017. Among those named to leadership positions are:</p> <p><strong><a href="/sitecore/content/iu/iu-som/home/blogs/spirit-of-medicine/meet-dr-wallach-new-executive-associate-dean-educational-affairs-institutional-improvement">Paul M. Wallach, MD</a>, Executive Associate Dean of Educational Affairs and Continuous Improvement</strong></p> <p>Wallach, a nationally recognized leader in academic medicine, will formally join the school in February 2018. He is currently vice dean for academic affairs and professor of medicine for Medical College of Georgia at Augusta University, Georgia’s only public medical school, consisting of five campuses including the main campus in Augusta. He earned his bachelor of arts degree in chemistry from Rollins College and a doctor of medicine degree from the University of South Florida Morsani College of Medicine. He completed his residency in internal medicine at the University of South Florida and a faculty fellowship in general internal medicine at the University of North Carolina at Chapel Hill.</p> <p><strong><a href="/sitecore/service/notfound.aspx?item=web%3a%7b110D659D-5F0E-4B1C-870B-259845C9BEDB%7d%40en">David K. Wallace, MD, MPH</a>, Chair of the Department of Ophthalmology and director of the Eugene and Marilyn Glick Eye Institute</strong></p> <p>Wallace joined IU School of Medicine Nov. 1 from Duke University, where he served as professor of ophthalmology and pediatrics, vice chair for clinical strategic planning, and director of clinical research for the Duke University Department of Ophthalmology. Born in Indianapolis and raised in South Bend, Dr. Wallace earned his undergraduate degree from IU and is an alumnus of IU School of Medicine’s class of 1990. He completed his residency training at Baylor College of Medicine in Houston, Texas, and he was fellowship trained in pediatric ophthalmology at IU School of Medicine.</p> <p><strong>Michael A. Weiss, MD, PhD, MBA, Chair of Department of Biochemistry and Molecular Biology</strong></p> <p>Weiss comes to IU School of Medicine from Case Western Reserve University School of Medicine, where he has been chair of biochemistry, a distinguished research professor and the Cowan-Blum professor of cancer research. In addition to his role as chair, he will serve as director of chemical biology and biotherapeutics for the Indiana University Precision Health Initiative. Dr. Weiss earned a medical degree from Harvard Medical School/MIT Program in Health Sciences & Technology. He also has an AB in physics and a PhD in biophysics from Harvard and attended Trinity College in Oxford, England, as a Harvard Sheldon Travelling Scholar. While teaching at Case Western Reserve, he took a sabbatical to study at the university’s Weatherhead School of Management, earning an MBA in 2010.</p>Tue, 12 Dec 2017 20:15:59 Z{A0E182FB-04ED-4A51-8AB1-512CA356CE37}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/alumnus-wife-open-doors-future-physiciansAlumnus and his wife open doors for future physicians<p><strong>By Matt Harris</strong></p> <p>George Sorrells spent one summer in medical school working on an assembly line bolting bumpers onto buses to help pay for his degree. Fortunately for him, he found more than a paycheck at the job. The woman who dropped his check off each week eventually became his wife.</p> <p>Soon George and Barbara Sorrells were both working to finance his medical education. During the school year, George, a member of the Indiana University School of Medicine Class of 1962, worked nights at Marion County General, now known as Eskenazi Hospital. Barbara got a job in the medical school’s purchasing office.</p> <p>George takes pride in the fact that he graduated from medical school debt free, but he knows today’s students often aren’t as fortunate. Tuition and fees for an in-state student now cost more than $38,000 a year—a price that is in line with other public medical schools but still out of reach for many Hoosiers. “It’s incomprehensible to us how medical students get by,” he said.</p> <aside class="iu-callout-box pull-right callout-normal bg-iu-cream" data-component="Callout Box"> <h2>Make a Gift</h2> <div class="body"> Are you grateful for the care of an IU faculty physician, want to support cutting-edge research, or hope to contribute to training the next generation of expert healers? Make a gift today to the area of IU School of Medicine that is most meaningful to you. </div> <div class="button-row"> <a class="button" role="button" data-style="default" href="https://www.myiu.org/one-time-gift/" target="_blank">Give Now</a> </div> </aside> <p>Today, George and Barbara live on a farm near Mitchell, Indiana. He has spent the last 55 years caring for children in Southern Indiana, where he is beloved by families and colleagues. It’s a fulfilling career that he wouldn’t trade for anything. And, through their generosity, George and Barbara are paving the way for others to pursue a similar path.</p> <p>For more than 30 years, the Sorrells have donated to scholarship funds at IU School of Medicine, and even established the endowed George and Barbara Sorrells Family Scholarship that will support students for generations to come. The Sorrells have also made arrangements to leave a lasting legacy through a planned gift. “An education is so important,” Barbara said. “It’s just our goal to help these young men and women.”</p> Tue, 05 Dec 2017 20:11:40 Z{8A15BE0E-873D-40EF-8D33-DA60E8F559C8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/patricia_keener_safe_sitterHiring a babysitter this holiday season? You may have an IU School of Medicine alumna to thank.<p><strong>By Karen Spataro</strong></p> <p>Long before the ball drops in Time’s Square this New Year’s Eve, another countdown has begun: The number of days left for parents to find a babysitter for one of the most in-demand nights of the year.</p> <p>If you’re lucky enough to book a responsible, qualified sitter, you just might have Patricia Keener, MD, to thank for it.</p> <p></p> <p>Keener, a 1968 graduate of Indiana University School of Medicine and professor emerita, is the founder of Safe Sitter®, a national program that teaches young teens the skills they need to babysit, watch younger siblings and even stay home alone. Tens of thousands of would-be sitters take the course each year, learning much-needed skills such as how to clear an obstructed airway, manage behavior problems, change a diaper, care for an injury, and handle the business-side of babysitting.</p> <p>The program was born nearly four decades ago out of a child care tragedy.</p> <p>One morning in 1980, Keener’s pager started beeping as she and a colleague from the nursing team walked into Community Hospital in Indianapolis. An 18-month-old girl was en route to the emergency room. Keener – the head of nurseries and pediatrics at Community – was being summoned to help.</p> <p>But hers was not the only pager buzzing. The nurse was simultaneously alerted to call home. The little girl being rushed to the hospital was her own.</p> <p>“Her child choked while eating breakfast,” Keener recalled. “The adult sitter didn’t know how to handle this threat to life. By the time the ambulance arrived, the toddler was beyond help. If the person caring for her had known how to relieve an obstructed airway, the child would have lived.”</p> <p>Keener resolved to do something about it. Safe Sitter® emerged.</p> <p>“All of us would say how tragic that is,” said Richard L. Schreiner, MD, who retired as chair of pediatrics at IU School of Medicine and Chief Medical Officer at Riley Hospital for Children at IU Health. “Some of us would say we should do something about it, but how many of us would actually do it, not just in our community or our city or our state, but do it all over the world, and do it in a sustainable way?”</p> <p>At first, Safe Sitter® was limited to the Indianapolis area, but the wives of medical residents who had been trained as Safe Sitter® instructors wanted to take the program with them as their husbands joined practices in other cities and states. Outposts sprung up. Keener made a presentation at the American Academy of Pediatrics, attracting the attention of pediatricians elsewhere. Then came a New York Times article and appearances on the Today show and Good Morning America.</p> <p>“The thing about Safe Sitter® is it grew whether or not I was promoting it,” she said.</p> <p>Today, the program is taught by almost 900 registered providers across the country. So this holiday season, as we raise a glass to the New Year, let’s also toast Keener for helping keep countless children safe while mom and dad are away.</p> <p>“She’s in the top 1/100th of 1 percent of people who have made a difference in the quality of life and quality of healthcare for children,” Schreiner said.</p> <p>For more information about hiring a qualified, responsible babysitter this holiday season, check out the Safe Sitter® parenting blog at <a rel="noopener noreferrer" href="https://safesitter.org/parenting-tips/" target="_blank">https://safesitter.org/parenting-tips/</a>.</p>Thu, 30 Nov 2017 13:44:59 Z{737A4039-FA50-4453-B462-49024AD03D72}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/retired-life-catching-ed-probst-md64-terry-hatch-md70Life after Medicine: Alumni pursue passions in retirement.<p><em>In the United States, more than 225,000 physicians are older than age 60 and close to winding down their careers. For many, retirement provides a chance to tackle projects and passions that have been put off during busy years in practice.</em></p> <p><em>We caught up with two Indiana University School of Medicine alumni to learn about the unique ways they have filled their days since retirement. </em></p> <p><strong>EDWARD L. PROBST, MD<br> Class of 1964<br> Retired Dermatologist/Arborist<br> Columbus, Indiana</strong></p> <p>If Ed Probst ever forgets what year he planted a stand of trees, he just thinks of his grandchildren.</p> <p>“There’s Jake’s Woods, Eve Marie’s Woods and Samira’s Woods,” Probst said. “They were planted the year they were born.”</p> <p>He paused. A grin crept across his face. “Obviously,” he said, “they always ask to see them every time they visit.”</p> <p>In the years since he stepped away from his practice, Probst has spent up to six days a week tending to more than 1,700 hardwood trees he planted on his 80-acre tract near Columbus, Indiana.</p> <p>He bought the land in the early 1970s after settling in Columbus with his wife, Patricia, but the parcel was wooly and unimproved. And the hectic pace of Probst’s dermatology practice forced him to put off clearing away dense undergrowth.</p> <p>Today, though, he can amble along a grassy path parting rows of red and white oaks, along with walnut and cherry trees—all of which are planted on a precise grid. Cultivating hardwood trees is a meticulous and exacting pursuit for a man who loathes idleness.</p> <p>“I’d be bored out of my mind if I had to sit at home all day,” he said. The tree farm allows Probst, who rose early as a child to go on milk runs before school, to blend curiosity with hard work.</p> <p>Walking the ground, Probst explains the care and devotion involved with each tree. It starts with an 80-mile roundtrip to Vallonia, Indiana, each spring to buy 200 seedlings. Each sapling is carefully placed into  into a hole and packed in with good soil</p> <p>And then he slowly nurtures the trees through their youth. Ed lugs 2.5-gallon jugs and pours water at the base of trunks to nourish roots. He wraps them in plastic tubing, protecting the brittle trunk from deer who would break them while polishing antlers. And, when they’re more mature, he stands on a hydraulic lift 30-feet off the ground to prune limbs.</p> <p>“Every tree I plant, I want it to be the best tree it can be,” he said.</p> <p>***</p> <p><strong>TERRY F. HATCH, MD<br> Class of 1970<br> Retired Gastroenterologist/Woodworker<br> Mahomet, IL</strong></p> <p>When completed, the bible chest Terry Hatch presents to his youngest son will be distinctive, with a striped-wood grain known as English tiger oak. And inside, the Rev. Nicholas Hatch will store heirlooms of faith and family: German-made tomes stretching back several generations.</p> <p>“I started it a couple of years ago,” Hatch said. “But it will be worth it.”</p> <p>Starting with a coffee table on his grandmother’s kitchen floor, Hatch has always gotten as much joy from the process of woodworking as he does from the finished product. The allure is the mastery of technique, knowledge of materials, and blending utility and beauty.</p> <p>He’s made pilgrimages to hone his craft, including three-week trips to Hartland, England, over back-to-back summers. A rural village of 3,000 people, Hartland remains an artist enclave and a time-capsule to a bygone era. England’s best potter calls the town home. It’s a place where the job “pavermaker” still exists, and where Hatch stayed in a stone manor house while taking classes in the shop of David Charlesworth, a renowned woodworker.</p> <p>He returned home with custom-made chairs for his granddaughters, the unfinished bible chest, and a kernel of wisdom: “It takes an impossibly long time to clutter the world with ugly things when doing hand woodworking,” he said with a chuckle.</p> <p>When he was still practicing, Hatch had to carve out time just to maintain an expansive collection of tools, which includes 15 planes, 70 chisels, a lathe and a band saw passed down from his father. With more time comes more projects. While still working on the bible chest, he made a butterfly house, which was installed 20 minutes away at the University of Illinois Idea Garden. He’s also become interested in woodturning and makes homemade lumber with his middle son, Gus.</p> <p>“I haven’t done as much day-by-day, month-by-month woodworking as I’d like to,” he said. “But there are always a number of ongoing projects. Each thing can take a long time to make, and they’ll get done – eventually.”</p>Mon, 27 Nov 2017 20:29:46 Z{5DB98571-8CB8-4DB7-8DB0-24E659DBCAB8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/barbarahaehnerAlumna puts her heart and soul into free clinic<p><strong>By Matthew Harris</strong></p> <p>Barbara Haehner’s early retirement only lasted two weeks. It ended 10 minutes after the nephrologist sent an e-mail to the Heart and Soul Clinic.</p> <p>On that night in late 2015, representatives from a local faith-based food pantry had spoken at her church. They also mentioned adding free medical care—a service Haehner knew would be complex. It got her thinking. What other free clinics operated in the area? So she poked around the web and fired off messages to three places she found.</p> <p>A reply popped into her inbox. Heart and Soul didn’t just need volunteers, it read. The clinic, based in Westfield, Indiana, a suburb north of Indianapolis, also needed a medical director.</p> <p>“It just sort of fell into my lap,” said Haehner, a 1989 graduate of Indiana University School of Medicine.</p> <p>Almost two years later, the clinic’s clientele has grown six-fold, tacking toward 800 patient visits this year. Appointments, available every Wednesday night and two Saturday mornings each month, are filled a month in advance. “We’re maxed out,” Barb said.</p> <p>The challenge of meeting demand is a far cry from the one she faced when she showed up her first day. Back then, her tasks weren’t glamorous. She rewrote and revised protocols. She overhauled the clinic’s credentialing system for volunteers, ensuring it qualified for its government-backed malpractice insurance. And the job of maintaining compliance with HIPAA and OSHA regulations is constant.</p> <p>“All those things weren’t necessarily in place when I first came to the clinic,” said Haehner, who spent the bulk of her career on staff at Indiana Kidney Specialists.</p> <p>At the same time, the clinic has also added services. There are two dental chairs where patients have cavities fixed or get emergency extractions done. The clinic runs a childhood vaccine program for uninsured families, and it takes referrals from local school systems. And, just recently, it acquired an RV to start a mobile clinic.</p> <p>Yet Haehner and the clinic face a constant question: Can its operations expand anymore?</p> <p>“We’d love to open another clinic another night of the week,” she said said. “But we’d have trouble with fully staffing.”</p> <p>Heart and Soul’s clientele is diverse. It serves undocumented immigrants and asylum seekers, the latter of whom can only access emergency Medicaid. The clinic’s largest block is the working poor, whose minimum-wage jobs often come without insurance or whose policies are too costly.</p> <p>Even in an upper-middle-class suburb, there are seemingly stable families whose insurance comes with high-cost deductibles. For them, out-of-pocket costs can be astronomical. For example, they may pay up to $300 for antibiotics to treat a child’s case of strep throat. “There’s need everywhere,” Haehner said.</p> <p>A majority of the clinic’s $140,000 budget is funded by seven grants and is poured into operating costs. Haehner’s new task is to find more volunteers—physicians, nurse practitioners and nurses—willing to give time to expand the clinic’s hours of operations.</p> <p>No doubt, some of her days are long. Stress taxes her. But Barb’s faith and the clinic’s growth are signs that the call she felt to give back was a divine one.</p> <p>“It was like I was supposed to do this,” she said. “They needed someone just like me. All of the pieces just fit together.”</p> <p><em>If you’d like to learn more about Heart and Soul Clinic and volunteer opportunities, please visit </em><a rel="noopener noreferrer" href="http://www.heartandsoulclinic.org" target="_blank"><em>www.heartandsoulclinic.org</em></a><em>. </em></p>Tue, 21 Nov 2017 14:24:35 Z{D50B8570-1A96-4534-9700-0027BAF5025F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/court-clinic-hes-heart-alumni-spotlight-kyle-hornsby-md09On the court or in the clinic, he’s all heart. Alumni Spotlight: Kyle Hornsby, MD’09<p><em>By <a rel="noopener noreferrer" href="http://medgifts.medicine.iu.edu/contact-us/communications/matthew-harris" target="_blank">Matthew Harris</a></em></p> <p>Strolling across the Indiana University campus, Kyle Hornsby attracted his fair share of double takes during his first year of medical school.</p> <p>At 6-foot-5, Hornsby was hard to miss. And at a basketball-obsessed school, the attention made sense. Three years earlier, Hornsby’s shooting stroke propelled the Hoosiers to the finals of the NCAA tournament. On a roster lacking traditional star power, Hornsby, who shot 47.3 percent from the 3-point that March, was emblematic of IU’s first Final Four team in a decade.</p> <p>“Now I’m just a tall doctor,” said Hornsby, a 2009 graduate of Indiana University School of Medicine who today works as a cardiologist in Bloomington.</p> <p>When he first entered IU Bloomington as an undergraduate, Hornsby’s outlook on his hardwood career was realistic. He knew the chances of a professional career – even in Europe – were slim. His plan was to earn his degree in kinesiology and enter a physical therapy program when his college days were done.</p> <p>Instead, the guard pivoted and set his sights on medicine. A decade later, the path he chose still remains surprising.</p> <p>“No one in my family is a physician,” he said. “It wasn’t established in kindergarten that I was going to do this. It was just a step-wise progression. If I had said I wanted to do this as a freshman in college, I would have no clue what that meant.”</p> <p>To prepare himself for medical school, Hornsby spent two years after earning his bachelor’s degree checking off prerequisites and studying for the MCAT. He was admitted to IU School of Medicine and donned his short white coat in August 2005. The School of Medicine has nine campuses across Indiana, and Hornsby spent his first two years in a familiar place – Bloomington – before moving to Indianapolis to complete his clinical rotations.</p> <p>He credits four years of college basketball with instilling in him time management skills and study habits that helped him thrive in his new role as medical student.</p> <p>As a player, Hornsby sat through film sessions, digested scouting reports, sweated through several hours of practice and traveled for games – a time crunch that often surpassed 20 hours per week. “I was more prepared than most,” he said of medical school’s rigors. “You learn to prioritize when playing a college sport. What are the things worthy of your attention? What are the things you can do without? The profession is still busy and still tough at times, but it’s nothing I haven’t done before.”</p> <p>Hornsby was drawn to cardiology while doing a required reading on the field between his first and second years. At the same time, John Strobel, MD, a Bloomington cardiologist, alumnus and volunteer faculty member for the School of Medicine, invited him into the electrocardiogram room to observe how he analyzes the electrical impulses of the heart.</p> <p>To Hornsby, the EKG’s readings and data were puzzle pieces for him to assemble and interpret. Even now, he admits to losing track of time when conducting exams or studying the results.</p> <p>“I was hooked,” Hornsby said. “He didn’t have to let me in the room, and I’m grateful to him for giving me those experiences when I was still a medical student trying to figure things out.”</p> <p>The mentorship of faculty and physicians like Strobel not only made medical school meaningful, but it helped position Hornsby for his successful residency in internal medicine at Duke University and a fellowship in clinical cardiac electrophysiology at the University of Michigan.</p> <p>Along the way, he had another mentor in Larry Rink, MD, a Bloomington cardiologist who has served as the Hoosiers’ team physician for nearly 40 years and ultimately sold Hornsby on a return to Indiana. “As soon as I started talking about doing cardiology during my first year of med school, he was already working on his recruitment to get me back here,” Hornsby said.</p> <p>The pitch worked. Hornsby joined Premier Healthcare in 2015, now Indiana University Health, Southern Indiana Physicians. When Hornsby shows up to work these days, Dr. Strobel is his colleague, and he has a view into Dr. Rink’s office. Hornsby has also kept ties to the Hoosier basketball program through Dr. Rink, and he’s worked alongside his mentor doing heart evaluations at the World University Games.</p> <p>“It’s a great community,” Hornsby said. “And the road has always led back here.”</p>Wed, 01 Nov 2017 13:20:07 Z{B603A286-BFB2-44AC-8601-AFB6F88DC390}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/iu-school-medicine-alum-leads-indiana-town-opioid-hiv-crisisIU School of Medicine alumnus leads Indiana town through opioid and HIV crisis<p><strong>By: Karen Spataro</strong></p> <p><em>Alumnus Will Cooke’s unrelenting commitment to his patients, as well has his many successes, have earned him national recognition by the American Academy of Family Physicians as the AAFP’s 2019 Family Physician of the Year. The award honors one outstanding American family physician who provides compassionate, comprehensive care, and serves as a role model in his or her community and to other health professionals. Dr. Cooke is the first physician from Indiana to receive this recognition.<br> </em><em><br> </em><em>In October 2017, IU School of Medicine shared Dr. Cooke’s story of leading the small Indiana community of Austin through the opioid and HIV crisis.</em></p> <hr> <p>President Donald Trump recently ordered the Department of Health and Human Services to declare the opioid epidemic a national public health emergency. But while officials in Washington debate how to best confront the crisis, one Indiana University School of Medicine alumnus has been on the front lines for years, drawing national attention as he serves a small Indiana town struggling with opioid abuse and its aftermath.</p> <p>Will Cooke, MD, noticed the drug problems soon after he arrived in Austin, Indiana.</p> <p>A 2001 graduate of IU School of Medicine, Cooke knew early on that <a href="/sitecore/content/iu/iu-som/home/terre-haute/md">he wanted to settle in a rural community</a>—one that didn’t have access to quality healthcare and where he could really make a difference in patients’ lives. He found his calling in Austin, a town of just 4,200 people about 40 miles north of Louisville, Kentucky.</p> <p>When he opened the doors of his family medicine practice in 2004, he became the sole medical provider in the community. Many residents hadn’t seen a doctor in years, and some of the health issues he encountered shocked him: fatal cases of cervical cancer that could have been prevented; tumors that had grown out of control; advanced diabetes; children who were not receiving their vaccinations.</p> <p>He also saw up close the tell-tale signs of addiction. “Right away I knew there was a significant issue with opioids, benzodiazepines and drug use in general,” Cooke said. “A lot of the patients were coming requesting a combination of benzos and opiates and muscle relaxers, and saying they had been treated a number of years with these combinations.”</p> <div> <p><iframe width="500" height="281" src="https://www.youtube.com/embed/1lVpPGtiXIQ?feature=oembed" frameborder="0" allow="accelerometer; autoplay; encrypted-media; gyroscope; picture-in-picture" allowfullscreen=""></iframe></p> </div> <p>But that was only a precursor for the problems that lie ahead.</p> <p>In 2012, a pharmaceutical company changed its formulation for Opana, a powerful opioid painkiller. Addicts had previously been taking the pills orally or by crushing and snorting them. But with the new version, the drug turned to gel when it was crushed. Instead, users started melting the drug, drawing it into a syringe, and injecting it intravenously.</p> <p>“When that happened we saw a big spike in overdose deaths,” Cooke said. “We started seeing a lot of abscesses coming through the emergency department and the clinic. We saw an increase in endocarditis, an infection of the valves of the heart from injecting bacteria into the blood stream. Then we started seeing an increase in Hepatitis C. We saw all those numbers increasing, and we knew something significant was going on in the community.”</p> <p>In December 2014, three patients tested positive for HIV at Scott Memorial Hospital. The numbers were an aberration for an area that typically saw less than a handful of HIV cases a year. By late February, the state had confirmed 26 cases. And as 2015 came to a close, the number had ballooned to 181 — the overwhelming majority of which were traced to injected opioid abuse. Austin, Indiana, was suddenly the epicenter of the largest HIV outbreak in recent U.S. history.</p> <p>Cooke, who had come to town to focus on primary care, was unexpectedly forced to become an infectious disease specialist and an expert in opioid abuse.</p> <p>“At the time there was a lot of talk about trying to get patients to HIV clinics,” Cooke said. “The closest one is down in Louisville, Kentucky. The next closest one is up in Indianapolis. There was no clinic here for the care to be provided at the time. We’d be looking at tents and buses, and to me that was unacceptable. It went against my entire concept of having this clinic here, which was to bring care to patients, not requiring patients to travel to receive care.”</p> <p>So Cooke worked with state officials to open an HIV clinic in his office. He studied everything he could, built strategic partnerships with local and national organizations, and received advanced certification in the treatment of infectious diseases.</p> <p>He estimates that he and his staff have treated more than 90 percent of patients with HIV cases in Scott County, sometimes traveling to them in a mobile unit to ensure they stay on their antiretroviral regimen.</p> <p>The results have been astounding: The number of HIV cases has held steady at around 220 for several months. Significantly, somewhere between 75 and 80 percent of those patients are considered to be in viral suppression, meaning the individual’s viral load is virtually undetectable, and the likelihood of passing HIV on to someone else is greatly reduced. In essence, the outbreak has been contained.</p> <p>Cooke has also been an innovator in addressing other consequences of the opioid epidemic, starting a clinic that allows patients in Austin to receive treatment for Hepatitis C in their own community. He is receiving training as part of Project ECHO, a program that links primary care providers with highly skilled specialists across the country through videoconferencing and other technologies. His success is prompting the state to establish similar clinics across the Indiana.</p> <p>Cooke credits his time at IU School of Medicine with providing him the foundation he needs to respond to nearly any clinical situation he encounters, including the HIV epidemic. He cited the diverse experiences IU medical students are exposed to on a campus that includes a VA hospital, a safety net hospital, a children’s hospital, and tertiary care hospital.</p> <p>“You have this unique place where you can see patients from a long spectrum from birth to grave, from poverty to wealth,” he said. “Having that broad range of experiences, that diversity from medical school, has really served me well here because wherever my practice takes me, I feel like I have at least some amount of background and foundation that I can build off of.”</p> <p>Cooke is the first to acknowledge that the opioid crisis is far from over in Austin, but he’s hopeful that the community is on the road to recovery. Beyond his role caring for patients, he is actively involved in the community and is a passionate advocate for housing for recovering drug addicts, mental health services, workforce development and other resources that he sees as vital to making inroads.</p> <p>It is only with this type of comprehensive action and coordinated response at the community level will our country win this battle, he said. Though his time in Austin has taken him down a road he had never envisioned, he has every intention of continuing the journey.</p> <p>“I have this really strong belief that a community physician’s responsibility is to respond to the needs of the community that he or she is serving in,” he said. “In Austin, the biggest need we had was to respond to the HIV outbreak, to respond to the spread of Hepatitis C, and to respond to the IV drug use that was going on. That’s why I opened my clinic: to develop a local response to the needs of my community that I serve.”</p> Tue, 31 Oct 2017 15:29:23 Z{FB9464D9-6F7A-406A-88FE-8A918D2D2697}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/alumni-pearls-wisdom-first-year-medical-studentsAlumni Pearls of Wisdom for first-year medical students<p>The IU School of Medicine Alumni Association asked its alumni to share a piece of advice, words of encouragement or a few words to live by for incoming IU medical students.  These students received a Pearl of Wisdom printed on a note card at the annual White Coat Ceremony on August 4, 2017.</p> <p>If you’d like to submit a note for next year’s ceremony or for a member of the Class of 2018 to receive at Commencement, please fill out the <a href="https://iu.co1.qualtrics.com/jfe/form/SV_3dWtqy0JVXYcQ7P" target="_blank">online form</a>.</p> <p><em><strong>Thank you to the hundreds of alumni who have shared a Pearl of Wisdom.  Below is a selection of pearls submitted for the 2017 White Coat Ceremony.</strong></em></p> <p>Make sure you have friends and interests outside medicine. As important and critical as your medical studies are, I think it is equally important to have balance and variety in your life. Therefore, take time to have fun and pursue other interests too. Study and have knowledge in other subjects. Read about and have friends not in the medical field. I think this will make you a better, more rounded person and actually a better doctor too.</p> <p><strong>David Giles, MD</strong><br> Class of 1971</p> <p>As you enter the field of medicine, you become part of a sacred trust, but this status is not limited to medicine. Your role to work to minimize the impact of disease on your patients requires great trust of you by your patients, but remember that physicians are not unique in maintaining a sacred trust. The farmer enters a sacred trust to preserve the land for use by future generations. The auto worker enters a sacred trust to produce a safe and effective product. The fast food worker enters a sacred trust to provide meals in a sanitary fashion. The single mother enters a sacred trust to do all she can to raise her children in a safe and loving environment. At the end of the day, therefore, you are not so special, because all honest work, whether or not it is remunerated, is honorable.  Keep this in mind as you work to respect ALL of your patients, whether or not at first glance they seem to be respectable.  We are all united by our humanity.</p> <p><strong>Gary Gaddis, MD, PhD</strong><br> Class of 1986</p> <p>Choose your career path in medicine based on what you love to do and not on the money you will make or the prestige you may garner.</p> <p><strong>Barry Fisher, MD</strong><br> Class of 1986</p> <p>Teachers open the door, but you must enter yourselves.<br> <em>Chinese Proverb</em></p> <p><strong>William James, MD</strong><br> Class of 1977</p> <p>Stay focused on the end goal in the tough times before clinical years.</p> <p><strong>Dan W Hibner , MD</strong><br> Class of 1961</p> <p>During your 4-8 years in learning about medicine, you will want to absorb as much information and technical skills as you can. As you know, or will know, your career will be filled with ongoing learning.  It will be a rare professor or preceptor who will not be delighted to teach you as long as you demonstrate an interest and make yourself available to many opportunities. You are being entrusted with much privileged information from your patients. Please honor that trust.  With time you will learn the very important skills of the ART of medicine. Please do not neglect that important part of caring for your patients.</p> <p><strong>William Hathaway, MD</strong><br> Class of 1967</p> <p>Dear Medical Student,</p> <p>Put on your seat belt and welcome to the adventure of a lifetime!!!  I’m grateful to be a physician every single day.  My work has taken me around the world to learn and serve patients in Africa, Asia, Europe and Latin America.  Now that you’re in the door, many hard years of study lie ahead.  Hang in there.  Inch by inch, day by day, exam by exam, you can do it!  Wishing you all the best in your career to follow.</p> <p><strong>Cynthia Haq, MD</strong><br> Class of 1983</p> <p>The doctor patient relationship goes back nearly 3,800 years to the time of Hammurabi, refined another 1,000 years later by Hippocrates.  It has survived the rise and fall of empires, the Black Death, The Crusades, The Reformation, World Wars, nuclear holocaust and all ilks of politicians and bureaucrats.  It is now in your hands to cultivate this sacred bond between the doctor and the patient.  It is in your hands to cultivate and use all forms of caregivers as the extension of that doctor-patient relationship.  It is in your hands to integrate ethics, compassion, skill, intelligence and intellectual growth to preserve and grow this great gift that we have been given by our Creator for being “human.” What you do to (for) the least of my brethren, you do unto me.  Hence, follow the golden rule and do unto others selflessly.  Go peaceful into that good night of call and retain the thought that you are there to foster the bond of the doctor patient relationship so that those that follow will foster it too.</p> <p><strong>Thomas J Fischer, MD</strong><br> Class of 1979</p> <p>Welcome to Medicine.  These next few years are a purposeful immersion in a distinct language and culture.  Take heart that is all worthwhile.  Be diligent in your study, as it builds the platform that you will stand upon for your whole career.  It is a privilege to step into the lives of your patients and be given the opportunity in some way to make their lives better.  To hold on to that privilege, you must promote healthcare safety and a caring heart.  Therefore, we have to all commit together to abide by the rules of our profession.  Promise with me to maintain habits in which you self-assess and self-correct your own and our peers’ skills and safety.  Pay attention to the two dimensions of medicine, the scientific and the humanistic, because it is through that blending that you will truly serve others and love medicine for a lifetime.</p> <p><strong>Mary Ciccarelli, MD</strong><br> Class of 1982</p> <p>Never be afraid to ask questions and to seek knowledge.  “Learning” doesn’t occur just when you “study.” The greatest lessons can happen at any time of day and in any place.  Keep your eyes open: observe—but if you don’t understand what you’re seeing—speak up!  I can guarantee you that your peers are having the same concerns.</p> <p><strong>Gregory L. Darrow, MD</strong><br> Class of 1974</p> <p>Keep an open mind and listen to your heart. Medicine is a huge field and doesn’t just include traditional bedside clinical medicine. We are entering an era of change and relative uncertainty in our profession. As much as we need great clinicians, we will need bright young minds that can influence policy. We will need thinkers. Regardless best of luck on your journey ahead.</p> <p><strong>Ryan Venis, MD</strong><br> Class of 2002</p> <p>Many years ago, my mentor was Dr. Roy Behnke. I followed him to the University of South Florida. He used to say that when a patient put their trust in you, often, their life in your hands, it is the greatest honor you could ever attain. Because of that trust, you and the patient enter into a contract. Your obligation at that point is to try to ensure that that patient gets the best care possible, sometimes by you, sometimes from your consultants. The contract has nothing to do with money, or prestige of the patient, or dictates of insurance companies or hospitals. You are honoring their trust in you. You become their advocate through the complicated and dangerous turmoil that is medicine. There are many “bottom lines” in medicine, but remember, that patient’s care is the one you take an oath for.</p> <p><strong>Kelly Chambers, MD</strong><br> Class of 1971</p> <p>Make sure to keep an open mind about your future specialty because you never know you might enjoy one you thought you never would or vice versa.  I changed my specialty choice 5 times in medical school although every one of them revolved around pediatrics.</p> <p><strong>David Stiasny, MD</strong><br> Class of 2007</p> <p>You have chosen the most influential, satisfying, and fun career out there! There is light at the end of the tunnel, and I promise that if you keep smiling and enjoying every day that you are at work, your colleagues and coworkers will flock toward you and bring you success! Keep striving to become the best!  Contact me anytime if you need some advice! Best of luck!</p> <p><strong>Eduardo Salinas, MD</strong><br> Class of 2014</p> <p>Most important is to keep balance in your life. Study hard. But I also strongly recommend having other things than medicine as priorities. Have friends that are not in med school with you. Have interests and hobbies that are not medical related. I think this approach will pay off in the long run. You will be a more rounded person. You will enjoy life more, will not burn out on medicine and actually will be a better physician.<br> <strong><br> David Giles, MD</strong><br> Class of 1971</p> <p>Congratulations!  Remember, getting in was the easy part!  Lots of hard work ahead, but since you made it this far, you can make it to the finish line.  You don’t have to be superhuman to do this.  Work hard, be diligent, be consistent, be organized, eat well, sleep, exercise.  Stay in touch with family and friends.  Life isn’t what may happen someday; it is what is happening today!  Don’t get overwhelmed.  If you need help, ask for it.</p> <p>Good luck!!</p> <p><strong>Jeffrey T. Wade, MD</strong><br> Class of 1988</p> <p>Listen carefully and always be sure to notice the color of the patient’s eyes. That’s how they know you’re paying attention to them.</p> <p><strong>Stanley Brosman, MD</strong><br> Class of 1959</p> <ol> <li>Treat the patient, not the chart. If the patient’s history, clinical presentation and history don’t make sense, compared to the test result, question the test result.</li> <li>We don’t want the treatment to be worse than the disease.</li> <li>If you are going into primary care or OB-GYN, be aware that those specialties treat 66% of all mental illness in the United States. Learn as much practical psychiatry as you can.</li> </ol> <p><strong>David K. Hilton, MD</strong><br> Class of 1987</p> <p>I urge you to enter Medical School with an open mind as to what specialty you will choose and focus on each class and rotation with interest and enthusiasm. This is what I did, and in the end chose Family Medicine and its scope and breadth and special relationship with your patients.</p> <p><strong>Robert Kurt Nicewander, MD</strong><br> Class of 1967</p> <p>Don’t decide what specialty that you want to do right away. Take time to experience everything before you make your decision. Also, get involved in as many activities as you can!</p> <p><strong>Jamie Kondis MD</strong><br> Class of 2006</p> <p>Medical School will test not only cognitive ability but determination as well.   With the right attitude, you are halfway there.</p> <p><strong>Ryan Meyer, MD</strong><br> Class of 1999</p> <p>Don’t take being a doctor too seriously. Be a human being first.</p> <p><strong>George Austin, MD</strong><br> Class of 1968</p> <p>Read, study, practice. Learn 120% more than you need to. That’s what got Dean Walter Daly, MD a successful career. Stay curious. Learn that anatomy. Learn that physiology.<br> Then when you get to the clinical years continually ask “WHY”?  Why did this disease come on when it did? Why did that one die and the other did not? Why did that molecule cause blindness, and only in some patients?  etc. etc.</p> <p><strong>Jim Ch. Hirschman, MD</strong><br> Class of 1955</p> <p>Most importantly, care about your patients and listen to them, then they will often be able to tell you what is wrong or, at least, better enable you to solve their problem.<br> If the patient knows you truly want to help them, not just use them to make a living, they will tell you the truth and help you get to the essence of their disorders. Accomplish the above instructions, and you will so enjoy your profession, you’ll never want to retire.</p> <p><strong>Ronald C. Demas, MD</strong><br> Class of 1965</p> <p>Anyone can gain the knowledge requisite to the practice of any given specialty in medicine. What makes you stand out is your ability to take direction, your desire to continually learn, and your integrity.</p> <p><strong>Morgan Barron, MD</strong><br> Class of 2014</p> <p>There is nothing more important than the subjects of our work, people. There is nothing more important than human interaction.  What a privilege is our work!</p> <p><strong>Louis Ruvolo, MD</strong><br> Class of 1966</p> <p>Just take care of patients and they will take care of you.</p> <p><strong>Paul Szotek, MD</strong><br> Class of 2002</p> <p>We frequently do our patients a disservice by making a diagnosis because we quit thinking.</p> <p><strong>Walt Beaver, MD</strong><br> Class of 1974</p> <p>The Science of Medicine is built by study, it never ends for a good physician. The Art of Medicine is built by experience, start getting all the experience you can in Medical School and continue it throughout your career.</p> <p><strong>Carl Pafford, MD</strong><br> Class of 1999</p> <p>Congrats to you, future doctor! Today’s white coat ceremony is a major accomplishment and a symbolic moment in your journey. You follow many generations of IU physicians who eagerly took this first step years ago.  Focus these next 4 years. When it gets hard, lean on each other or family or a mentor.</p> <p>Remember that everything you learn will help you become a smart, compassionate doctor. You will blink and suddenly be ready to enter residency and take care of your own patients and develop your own style.  Don’t forget that you have a unique personality and talent that you bring to the art of medicine. Keep your own health as a top priority throughout the journey. Caring and being kind to yourself will allow you to be the best physician you can be.  Don’t forget what a mentor once told me… strong mind, strong body.</p> <p><strong>Amy Dreischerf, MD</strong><br> Class of 2014</p> <p>The summer between 1st and second years of medical school I was given this wise advise that has served me well:<br> When choosing a field of specialty…ask the doctors you meet what is the least pleasant thing about that specialty.  Remember their answers.  Make sure that you pay attention to them when you choose your specialty…..You can RARELY AVOID these issues, so be sure they are not a big problem for you. Also figure out what it is that those physicians do 70% of the time…..as an obstetrician I spend 3 times as much time doing prenatal care as I do delivering babies…..for me I love providing prenatal care so that has work out well.</p> <p><strong>Rolf Loescher, MD</strong><br> Class of 1985</p> <p>Indiana University’s medical school provided me with the tools for a long and satisfying practice. Take advantage of every clinical opportunity. Your patients will teach you!<br> Best wishes for a bright future.</p> <p><strong>S Clarke Smith, MD</strong><br> Class of 1961</p> <p>Congratulations! This is a great, new adventure. There will be lots of ups and downs but you’ll make it through.  Keep your family and friends close. Make sure you take breaks and vacations. Medicine is life not just a career. You might have times of doubt but focus on the prize at the end. Don’t forget to ask for help. It’s not a sign of weakness. It’s a sign that you know yourself and you’re growing.</p> <p><strong>Sarah Delima, MD</strong><br> Class of 2008</p> <p>Be kind to everyone – your patients, your peers, others on the healthcare team, and yourself.  People won’t care how much you know, until they know how much you care. Be kind to all.</p> <p><strong>Clif Knight, MD</strong><br> Class of 1987</p> <p>Take care of yourself. Wear your white coat with pride. Always remember why you are here– the person you are helping is your first priority.</p> <p><strong>Shannon Oates, MD</strong><br> Class of 1988</p> <p>Congrats on being accepted to medical school and starting your first year! It’s such an exciting time. It is also a challenging and stretching time, although I can tell you I have never regretted my decision to pursue a career in medicine. I would encourage you to work hard, starting your first day of class. Don’t get to the end of your second year feeling that if you’d only worked harder, you could have considered more competitive specialties. Put yourself in a position where you can determine your future, instead of someone else. At the same time, know your mental and physical limits. Take an entire day off once or twice a month. Sleep in. Exercise. Seek counsel from medical students ahead of you and also from family and friends who care about you. It’s a tough journey, and it looks different for everyone. Finally (and most importantly), don’t lose sight of why you chose medicine in the first place. It will sustain you through the difficult exams, the long days on your surgery clerkships, and the long calls you will take as a resident.</p> <p><strong>Katelyn Bennett, MD</strong><br> Class of 2013</p> <p>If you are interested in research as part of your future career, connect as early as possible with someone who has successfully navigated this path in order to guide you through the process, preferably someone who has also successfully mentored others previously.</p> <p><strong>David Beversdorf, MD</strong><br> Class of 1992</p> <p>Stay focused during the 1st year of your classes with the end in mind:  you will be taking care of patients in the near future for whom the knowledge you gain in the first years of medical school may prove extremely valuable.</p> <p><strong>James E. Heubi, MD</strong><br> Class of 1973</p> <p>It is an honor and a blessing to study medicine. Enjoy the experience and the ability to use your skills to care for others.</p> <p><strong>Karen Wheeler, MD</strong><br> Class of 1990</p> <p>Simply, listen to the nurses.</p> <p><strong>Richard S. Hansell, MD</strong><br> Class of 1976</p> <p>Much of what you will learn will change within a few years. The most important thing is to view your medical education as a foundation for life-long learning!</p> <p>Edward Dodge, MD<br> Class of 1962</p> <p>If you spend time taking a thorough history the patient will tell you what is wrong with them 80-90% of the time.  Lab tests and a physical exam will confirm what you already heard.</p> <p><strong>Ed Wagoner, MD</strong><br> Class of 1963</p> <p>You will learn more medicine from your patients than from your textbooks. When you have finished an encounter with a patient, you should know the color of their eyes.</p> <p><strong>Kelly Chambers, MD</strong><br> Class of 1971</p> <p>When choosing a specialty, you should not pick solely based on what is most interesting to you.  If you are married, you should consider what your spouse desires.  If you are single and desire to have a family someday, you should consider how a particular career will affect your ability to be an excellent spouse and/or parent someday.  Try to always think several “life steps” ahead about how each specialty will affect other aspects of life.  Using your career to shape your identity may be exciting initially, but will ultimately not be fulfilling.</p> <p><strong>Daniel Fox, MD</strong><br> Class of 2012</p> <p>Spend some time each day reading and thinking about your relationships, how to improve them in family, patients, fellow workers. Take time each day to read something outside the medical field to keep in balance your awareness of the big picture in our world.  William Osler, MD is my model in medicine.  Keep growing in the Cs I discovered to be my greatest source of success and happiness: CREATIVITY….COMMUNICATIONS….CONFLICT  RESOLUTION… CONFIDENCE… COMPASSION….CAREFULNESS… CONCERN… CHOICE… CHANGE… CONTROL OVER STRESS… CONTROL OVER MONEY… CONTROL IN THE FAMILY…. COMMITMENT… CARPE DIEM!!!</p> <p><strong>Ed Hollenberg, MD</strong><br> Class of 1952</p> <p>Your medical education will be many years of personal sacrifice and challenges with the reward of a career that gives you the unique opportunity to serve all mankind every day of your life.  Your learning and education will continue the entire duration your medical career and give you the personal reward of knowing you are making the world a better place.</p> <p><strong>Robert K. Stoelting, MD</strong><br> Class of 1964</p> <p>You are about to begin a great adventure that will be filled with both personal and academic challenges.  There will be times in the first two years of school that you will question your decision to pursue this profession.  The academic work load and expectations are immense and you will think that it is impossible to learn it all.  With perseverance and hard work you will make it and the rewards are certainly well worth the efforts.</p> <p><strong>Thomas G. Slama, MD</strong><br> Class of 1973</p> <p>So many facts, figures, algorithms, oh my.  Try to not learn by rote, but seek to find out where they originated and why they have been accepted.  Then they will stick with you and give you a solid foundation to grow on.</p> <p><strong>Nicholas Timm, MD</strong><br> Class of 1975</p> <p><em><strong>If you’d like to submit a note for next year’s ceremony or for a graduating Class of 2018 medical student at Commencement, please fill out the <a href="https://iu.co1.qualtrics.com/jfe/form/SV_3dWtqy0JVXYcQ7P" target="_blank">online form</a>.</strong></em></p> Thu, 03 Aug 2017 13:53:03 Z{FD9AE85F-8556-4F29-9FEC-42247DB475CE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/dr-jerome-adams-confronts-an-hiv-crisis-and-high-infant-mortality-ratesDr. Jerome Adams confronts an HIV crisis and high infant mortality rates<p><strong><em>This interview originally appeared in the Winter 2016 issue of IU Medicine.</em></strong></p> <p>Dr. <a href="/faculty/10907/adams-jerome" target="_blank" rel="noopener noreferrer">Jerome Adams</a> had little time to settle in after Gov. Mike Pence appointed him commissioner of the Indiana Department of Health in October 2014. Within six months, an outbreak of HIV, tied to needle-sharing among users of prescription pain killers, broke out in Scott County. Meanwhile, data from the Centers for Disease Control and Prevention showed Indiana had the seventh-highest infant-mortality rate in the country, featuring a wide gap between white mothers and those who were black and Latino.</p> <p>“I stepped right into the fire,” said Adams, a 2002 graduate of the Indiana University School of Medicine.</p> <p>Ever since he was a medical student, Adams has been a proponent of applying policy and programs to impact the health of the population. During a fellowship abroad in Africa, he saw first-hand how futile it can be to treat patients long after they become ill. “If you waited, you were less successful than if you worked to keep people healthy in the first place.”</p> <p>While he enjoys his role as an anesthesiologist, he realized that for every patient he helped, there were a dozen more he couldn’t treat. “It was absolutely necessary to do more than keep plugging holes in a dike,” he said.</p> <p><strong>What facets of medicine drew you in? What was the hook?</strong></p> <p>My parents were teachers, and I always wanted a career where I interacted with people. I majored in biochemistry and planned to complete my doctorate. But I worked in a lab with a gentleman who also did rounds. When you’re meeting with a patient, you’re educating them about their disease and improving their chances of overcoming the malady they’re facing at the moment.</p> <p><strong>You’re from Maryland and were recruited by a slew of top-flight medical schools out of college. What separated IU from those institutions? </strong></p> <p>IU did a great job putting together a competitive financial aid package. That’s important. Medical students accrue large debt. It doesn’t drive choice as the sole factor, but it’s there. IU also had deep ties to Eli Lilly and Company and other stakeholders. IU isn’t just an academic center. It values community and industry input.</p> <p>Now as I travel, I see how deeply respected IU is for its clinical programs. At IU, you get so much diversity in settings and patients at the VA, Eskenazi Hospital, Riley Children’s Hospital and University Hospital.</p> <p><strong>You’re an anesthesiologist. Where do those roles intersect?</strong></p> <p>You convene people: Doctors, nurses, scrub techs, patients and their families. You bring them together to improve the health of the person having surgery. It’s the same in public health. You bring together diverse groups and convince them to be on the same team to improve health. There’s diversity, too. I may start the day with an 8-month-old patient and end with an 89-year-old patient. You’ve got to know a little bit of everything.</p> <p><strong>You split time between the operating room and keeping a state agency on track. Is there any crossover? </strong></p> <p>Working as a physician lends me credibility. I’m not ignorant to the reality of what’s going on in the real world and in our state. It’s hard for someone to question your advice on trauma care after you spent the night before on call taking care of someone in the operating room who has been shot multiple times.</p> <p>As far as public health, I’m not hesitant anymore to bring up smoking or healthy eating with a patient. My job is to be an advocate and direct them to resources.</p> <p><strong>Gov. Mike Pence has his priorities. So does the state Legislature. And there are initiatives you feel are important. What’s an example of where those interests align?</strong></p> <p>Lowering the infant mortality rate is one. We’re at 7.1 percent, one of the nation’s worst rates. We told the governor, his wife and House Speaker Brian Bosma about the obstacles we face. Karen Pence helped unveil the Labor of Love campaign, and Speaker Bosma sponsored legislation to fund pilot projects aimed at lowering that number.</p> <p>Starting a syringe-exchange program in Southern Indiana is another example. Indiana law doesn’t allow those. I explained to Gov. Pence they’re effective at halting the spread of infectious disease. We reached a consensus, and he signed an executive order for an exchange program to halt the HIV epidemic in that part of the state. I was proud he took that stance and that we could find space in the middle.</p> <p><strong>The state put forward $11 million to fund those infant-mortality programs. What objectives or projects is the department targeting?</strong></p> <p>We’ve looked at data from around the state to identify ZIP codes that are our largest contributors to infant mortality.</p> <p>We’re targeting hospitals and community groups in those areas most affected. Those projects could address prenatal care, which is a major risk factor. There are also projects for safe sleep, which is one of the best ways to prevent infant mortality in our state.</p> <p><strong>The number of new HIV cases in Southern Indiana has leveled off. Systems are in place for testing, dispensing medication, treatment and exchanging needles. What lessons did you take away?</strong></p> <p>We all need to be more aware of what goes on around us. Physicians need to grasp there’s an opioid epidemic. It’s national. And it starts with over-prescribing. It’s not just doctors, but we all need to be aware we contributed to this breakout.</p> <p>Eighty-percent of heroin users say their abuse started with prescription medications. We know the use of intravenous drugs is going up because hepatitis C rates are climbing. Indiana’s numbers have risen dramatically in the past decade.</p> <p>We’ve also got to partner. We can’t do it alone. It includes working with church-based groups, community groups and law enforcement. As physicians, we usually don’t interact with those groups, but they were critical in Scott County.</p> <p><strong>IU School of Medicine seems uniquely positioned to help. What role can it play moving forward?</strong></p> <p>We would not have been able to get this outbreak under control without the IU School of Medicine. It doesn’t just train physicians, and it doesn’t just play a role in the immediate area of its campuses.</p> <p>In Scott County, the sheriff told me, “I want IU down here.” It’s a respected institution in the eyes of citizens. It establishes credibility and helps get over trust issues. They can see, “This is Indiana University. They’re going to do the right thing. I can trust what they’re telling me.”</p> Fri, 30 Jun 2017 18:16:59 Z{FF37EC3D-AC63-4A58-8297-650C3BA1BF96}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/mary-ellen-held-hand-critical-importance-touch-medicine-m-eugene-tardy-jr-md60“Until Mary Ellen held my hand … ” The critical importance of touch in medicine by M. Eugene Tardy, Jr., MD’60<p><em>Content for the IU School of Medicine alumni blog is provided by alumni of the IU School of Medicine.  If you would like your story considered, please contact Ryan Bowman, director of alumni relations, at <a href="mailto:rsbowman@iu.edu">rsbowman@iu.edu</a> or (317) 278-2123.</em></p> <p><strong><em>This editorial was previously published in the Brazilian Journal of Otolaryngology.</em></strong></p> <p>Sitting unnoticed on my office desk, and constantly growing in height, resides a stack of letters-different sizes and shapes, in handwriting and letterheads of all descriptions, distinguished by the repetitious theme constant in them all: ‘was so very frightened when you were about to perform my surgery … until Mary Ellen held my hand.”</p> <p>In the early years of the practice of medicine I assumed these frequent testimonials were simply accolades targeted towards a splendid and unique surgical nurse, my long term partner in patient care, whose talents and caring interactions with patients in my experience are equaled by none. Quite soon, however, I came to realize that the tactile courtesies my team religiously practiced with patients – those of providing a soothing touch, a gentle grasp of the hand, even a slight hug – were not only surprisingly effective in reducing patient anxiety, but gradually came to be a major expected factor in our doctor-patient relationships.</p> <p>I still believe that most students choose to study medicine in order to experience the unique bonds that develop between patients and doctors. In this high-tech era of medicine, daily accounts are chronicled about patient annoyance and dissatisfaction with physicians who avoid eye contact, spend the majority of the patient visit recording data on an iPad, attempt to diagnose by ordering an increasing array of lab tests, and too often fail to examine, connect with, and truly “touch” the patient. My personal internist, a middle-aged relic of the Oslerian age when students gathered around the hospital bed with a mentor who reveled in the delights of the strength of a bounding pulse, seeking a palpable liver edge and deciphering a typical cardiac murmur, inevitably percusses my chest on each visit with the ”thump-thump-thump” of a practiced finger and hand. Both he and I understand the unlikelihood of revealing a chest problem undiscovered by radiographic imaging or somnography, but we mutually appreciate the touch and the valuable time it affords for further history-taking.</p> <p>In the fifth century BC, Hippocrates, the acknowledged father of medicine, wrote: “It is believed by experienced doctors that the heat which oozed out of the hand, on being applied to the sick, is highly salutary. It has often appeared, while I have been soothing my patients, as if there was a singular property in my hands to pull and draw away from the affected parts aches and diverse impurities, by laying my hand upon the place, and extending my fingers toward it. Thus it is known to some of the learned that health may be implanted in the sick by certain gestures, and by contact, as some diseases may be communicated from one to another.”</p> <p>By no means do I suggest that cure of disease derives singularly from the touch of a hand, but experience teaches that gentle touch during examination and interaction with patients yields, at the very least, emotional well-being.</p> <p>Otolaryngologists in particular are afforded the opportunity with every patient examination of the head and neck to put into practice gentle touch maneuvers. An otoscope held deftly in the tips of the fingers, parallel to the floor, provides a glimpse of the auditory canal and eardrum far more gently than when the instrument is grasped like a threatening hammer. The exploring tongue depressor, providing access to the oral cavity, serves best when a conscious effort is expended to gently deflect the tongue and lips. Indirect mirror laryn­goscopy and nasopharyngoscopy both possess the potential for discomfort if the tongue is grasped in an unduly firm manner. Patients are acutely aware of the vast difference between a rough manipulation and palpation of the neck and the deft fingertip exploration for nodes, glands and pulses. These manipulations are examination touches, as opposed to reassuring touches.</p> <p>Eye contact, listening, touching, and observation are the hallmarks of traditional medicine, and establish the vast difference between the “health care provider” and the physician.</p> <p>Touching, after all, is an effective, inexpensive, and easily-administered medication to employ in both the sick and those who simply experience foreboding in medical interactions.</p> <p>Some years ago I lost a younger brother to the ravages of metastatic cancer, despite the very finest of care by a legendary oncologist. As my brother came to the end of his courageous battle with an incurable disease, with his entire family gathered around him, his physician sat on the bed, lifted his patient into his arms, and murmured “I’m so sorry I could not have done more for you.” More than a touch, that singular gesture spoke volumes about the humanistic qualities of a caring physician.</p> <p>Patients desire, expect, and benefit from the reassuring gentle touch of their physicians. It represents a powerful tool, essential in the physician’s bag.</p> <p>And early in his or her career, may each physician discover a Mary Ellen as a valued and essential part of the medical team.</p> <p><strong>M. Eugene Tardy, Jr., MD’60<br> </strong></p> <p><strong><em><br> Share your story:</em></strong><br> <em>Content for the IU School of Medicine alumni blog is provided by alumni of the IU School of Medicine.  If you would like your story considered, please contact Ryan Bowman, director of alumni relations, at <a href="mailto:rsbowman@iu.edu">rsbowman@iu.edu</a> or (317) 278-2123.</em></p> Fri, 23 Jun 2017 14:13:31 Z{578E83FA-90F7-4552-B6C6-0CC4298C93BB}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/alumni/50-years-dinosaur-motion-richard-h-davis-m-d-f-c-c50 Years -A Dinosaur in Motion by Richard H. Davis, M.D., F.A.C.C.<p><em>Content for the IU School of Medicine alumni blog is provided by alumni of the IU School of Medicine.  If you would like your story considered, please contact Ryan Bowman, director of alumni relations, at <a href="mailto:rsbowman@iu.edu">rsbowman@iu.edu</a> or (317) 278-2123.</em></p> <p>As a young man growing up in Dayton, Ohio, searching for a profession, I was influenced by my uncle – an internist specializing in Pulmonary Medicine. He was our family doctor, available day and night.</p> <p>So, after graduation from college, I went on to Saint Louis University School of Medicine. In those days, SLU emphasized the importance of clinical medicine, ie. caring for the patient. As I think back to my days in the mid 60s I remember the doctors returning for their medical school reunions and thinking to myself- these old folks should be grateful just to be upright, having a brain, let alone practicing medicine. After graduation from SLU in 1966 (50 years ago) I was accepted for specialty training in Internal Medicine and then Cardiology at Indiana School of Medicine, Indianapolis, Indiana. I was influenced by so many great doctors, realizing the importance of my teachers and mentors. Dr. John Hickam, Director of the Department of Medicine, assembled an amazing faculty. Midway through my residency Dr. Charles Fisch, Director of the Cardiology Department, asked me to be his personal Cardiology fellow. I was overwhelmed at the generous offer, even that he knew my name. So on to Cardiology where again so many outstanding academic physicians imparted their brilliance to me. This included Dr. Harvey Fiegenbaum – Father of Echocardiography- and then Director of the Cardiac Cath Lab and so many, many others. I am sure this background of training prepared me for whatever success I had in my ensuing years of practice. In between my years of fellowship I served two years in the Air Force and still get misty on Memorial Day and July 4th. Back to I.U., I was given an opportunity to stay in academic Cardiology but really desired to practice clinical Cardiology, so on to Dayton, Ohio, for one year and then Fort Myers, Florida, where I remain to this day.</p> <p>I have been acquainted and influenced by many past presidents of the A.C.C. – Dr. Charles Fisch, Dr. Suzanne Knoebel, Dr. John Williams, Dr. Sylvan Weinberg, Dr. Richard Popp, Dr. Doug Zipes, and our present president, Dr. Richard Chazal, all of whom imparted their special and unique wisdom to me in their own ways.</p> <p>I have been grateful to so many for my career- my own doctors – yes, doctors need doctors. My internist, a fellow dinosaur who cares about his patients and is always available – you don’t need much more than that. My other doctors include my ophthalmologist, gastroenterologist, and urologist and not, as yet, a cardiologist or neurologist.</p> <p>I am grateful to my wife of 54 years who has always supported my endeavors, and who no doubt raised our family at times single-handedly – patients do get sick at night.</p> <p>I am grateful to my 3 daughters who have grown up to be ‘good people’ in spite of the times their father was not there for them. I am grateful to my grandchildren for being my grandchildren.</p> <p>I am grateful to my son in law, an interventional cardiologist practicing in another community, who educated me on STEMI, TAVR, Mitral Clip procedures, and much more. I am grateful to my present colleagues and staff for letting me practice as I desire.</p> <p>I am also very grateful to all my patients, present and past, who believed in me and in my ability to help them feel better. I have always felt the means to be a quality doctor is first of all to care about your patient. You knock on the exam room door and introduce yourself, realizing that the patient is apprehensive and anxious. You sit down, look them in the eye, and listen as the patient will more often than not convey the correct diagnosis. You offer probing questions, review past history, conduct a thorough examination, plan appropriate lab studies and arrange a follow-up visit to review your diagnosis and initial therapy.</p> <p>I do realize that medicine is changing and that change is necessary for everything. I will not review all of these, I will only add that changes are not always valuable. I believe that the practice of medicine is an amazing and unequaled profession. Where else can you truly help your fellow man?</p> <p>So, as I return for my 50th medical school reunion at Saint Louis University in October I will look at the medical students, both men and women, as it should be, and as they look at the old men, including myself, roaming the halls and classrooms of the past, I hope they will think – look at that – a dinosaur still in motion.</p> <p><strong>Richard H. Davis, M.D., F.A.C.C.</strong><br> <strong><em><br> Share your story:</em></strong><br> <em>Content for the IU School of Medicine alumni blog is provided by alumni of the IU School of Medicine.  If you would like your story considered, please contact Ryan Bowman, director of alumni relations, at <a href="mailto:rsbowman@iu.edu">rsbowman@iu.edu</a> or (317) 278-2123.</em></p> Mon, 01 May 2017 15:35:16 Z{4D63D292-44E5-45BE-88CC-EE6EAADA2238}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/bone-healing-space-whats-nextBone Healing in Space – What’s Next?<p><strong>By Emily McKnight</strong></p> <p>Orthopaedic research is no longer limited to the confinement of a traditional lab setting – it is now a part of a select group of prominent research experiments conducted 250 miles above the Earth’s surface.</p> <p><a href="/faculty/18628/kacena-melissa" target="_blank" rel="noopener noreferrer">Melissa Kacena</a>, PhD, associate professor of orthopaedic surgery at Indiana University School of Medicine, has taken bone-healing research to the outer limits and aboard the International Space Station (ISS). In partnership with NASA and the United States Department of Defense (DOD), Dr. Kacena and her team of researchers are working tirelessly to translate new discoveries in bone regeneration for osteoporosis, fracture healing and other bone disorders through the Rodent Research-IV mission.</p> <p>On Feb. 19, 2017, <a href="https://www.nasa.gov/ames/research/space-biosciences/rodent-research-4-spacex-10" target="_blank" rel="noopener noreferrer">Rodent Research-IV</a> successfully launched on the SpaceX CRS 10 spacecraft from the Kennedy Space Center in Florida. After arrival to the ISS, the astronauts then took over the care of the mice and completed studies to determine the effectiveness of a new drug, developed by Dr. Kacena, designed to enhance bone regeneration.</p> <p>So, why space?</p> <p>On Earth, bone formation typically occurs without any sort of stimulation due thanks, in large part, to gravity. Bone cells called osteoclasts are continuously breaking down the bone tissue in skeletal systems as a second group of bone cells, osteoblasts, simultaneously work to create new bone. On average, individuals “grow” a new skeleton every seven years, helping us to endure the conventional forces of Earth.</p> <p>In contrast, bone deteriorates much more rapidly in the weightlessness of space. To put it into perspective, astronauts lose approximately 1 to 3 percent of their bone density each month during spaceflight – an astounding rate compared to individuals with osteoporosis who lose approximately 1 percent of their overall bone density each year.</p> <p>“An astronaut’s body thinks it no longer needs a strong support structure because they are not bearing weight during spaceflight,” said Dr. Kacena. “Essentially, their bodies begin to rid themselves of bone without signaling osteoblasts to create more.”</p> <p>While the way bone cells respond in the two separate environments couldn’t be more different, some similarities exist. Indeed, the weightlessness of spaceflight mimics the lack of weight bearing that would occur when a doctor prescribes crutches or bedrest. This would typically be prescribed to those with severely injured limbs due to a car accident or soldiers sustaining blast injuries. This connects the dots for the importance that the efficacy of the new drug be tested in the weightlessness of space, especially in light of the fact that unlike humans, animals bear weight on their surgical limb immediately after they recover from anesthetic.</p> <p>Previous lab tests indicate that Dr. Kacena’s new drug therapy has the potential to enhance bone growth, regardless of environment. It is now time for Dr. Kacena to further prove these findings.</p> <p>On March 27, Dr. Kacena and her research team, as well as researchers with the U.S. Army, received the experimental specimens to begin analyzing the data collected through the research conducted aboard the ISS. This analysis includes the dissection of bone tissues, beginning with the most important and sensitive tissues, and moving forward. It is estimated that the data analysis phase of Rodent Research-IV will take approximately one year to complete.</p> <p>“I am hopeful that once we are through with this analysis, we will have strong evidence to support the effectiveness of this new drug,” she says. “It’ll be an exciting new therapy that can be used both here on Earth and in space, benefitting diverse population groups.”</p> <p>In addition to the intense data analysis for Rodent Research-IV, another hurdle for Kacena and her team is funding for the continuation of this research. If you would like to be a part of the longevity of this mission through the contribution of a gift, please contact Elizabeth Elkas, associate dean for development at IU School of Medicine, at 314-274-5262 or eelkas@iu.edu.</p> Wed, 19 Apr 2017 15:23:13 Z{1D97EEF0-7191-48D4-BEB3-F1D4A251173B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/ksc-team-and-updateKSC Team and Update<p>Here is a photo of the team helping at KSC. This was on our last day after all of our specimens were packed and ready for shipping. All of our ground samples have arrived at IU and at the Army for analyses. Our spaceflight samples are scheduled to arrive on Monday. After they splashed down into the ocean (you can view at <a href="https://www.youtube.com/watch?v=SqYG0VIENrs" target="_blank">https://www.youtube.com/watch?v=SqYG0VIENrs</a>), they arrive to Long Beach California and then are transported to Johnson Space Center (JSC). On Monday, March 27th, they will be hand delivered to IU and the Army. And, then we will begin to analyze the data. It will probably take about a year to collect most of the data and to analyze it. We will keep you posted with our results – but posts from hereon will likely be sporadic. The most difficult part of the mission is behind us, now we just need to do what we are good at, the science!</p> <p><span>I apologize, my assistant was out sick, so the blog that was supposed to be posted on St. Patrick’s Day was posted about a week late.</span></p> <p><span>Written by Melissa</span></p> Fri, 24 Mar 2017 21:01:00 Z{01B2D276-6515-4814-B878-433BDCB97B72}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/happy-st-patricks-day-from-cape-canveralHappy St. Patrick’s Day From Cape Canveral!<p><span>A small team has been at NASA Ames and at NASA KSC over the past 2 weeks. NASA Ames runs control center or the communications with the astronauts as they work with the rodent payloads. There was some confusion as there is a “Melissa” that was speaking to the astronauts (on the “loops”) and they wondered why the PI was speaking to them. We had to clarify there are 2 different Melissa’s involved in this mission.</span></p> <p> </p> <p><span>Rasha, the Army PI, and Jim, from the DoD Space Test Program, were stationed at NASA Ames and watched and listened to the astronauts from there. Myself, Perry and Carolynn (also from DoD Space Test Program) watched and listened from NASA KSC. The picture is of me in the Research Experiment Monitoring Area (recently renamed from Rodent Experiment Monitoring Area). This is where we were able to pull up the video of the astronauts while they were working with our payload and we could hear everything the Melissa located at NASA Ames was saying to the astronauts. She called out each step. The also had each step as a typed protocol….just like we have in the lab. I suspect my students will enjoy hearing the astronauts were literally having 20+ folks “watching over their shoulder” as I know when I go into the lab and watch the students it makes them nervous etc. So they will be happy to know even astronauts have the same treatment!</span></p> <p> </p> <p><span>Sometimes we wanted to have minor adjustments made in how the astronauts did things and we usually texted, or called, or spoke to the NASA Ames folks on the “loops” and then that information was communicated by the other Melissa to the astronauts. The astronauts did a great job and our work was completed ahead of schedule. This was good news for the ISS, as they wanted to pack up the dragon capsule early as it will be returning to Earth on March 19th ahead of schedule.</span></p> <p> </p> <p><span>Many of us took copious notes as to how long it took the astronauts to perform tasks and then we tried to mimic this precisely on Earth. I would say it usually took them 2-3 times the amount of time (at least) it would take us on Earth. In some cases maybe closer to 5 times as long. As you can imagine it is much more difficult when things float around! Overall, I was very impressed with the competence and the care the astronauts took of our payload (and to think they have sometimes as many as 100 experiments they are running at one time, lots to learn). If they get tired of their day jobs, I am sure I will have an opening in the lab and I would be happy to have them join our team at IU School of Medicine!</span></p> <p> </p> <p><span>Here is another note related to the photo.  The monitor to the left shows the astronaut timeline – how long they have scheduled for every task all day long, including eating and exercise etc – very scheduled.  The monitor on the right side shows the MSG or the Microgravity Science Glovebox. For those familiar with laboratories, we usually work in a biosafety cabinet or “hood” to protect the people and to also keep the experiment sterile or clean. This is as close to that as they get in spaceflight. It is mainly to keep the astronauts safe, it certainly is not sterile. And as you can see it is packed full of all of the supplies they will need to complete our studies. The astronaut inserts their hands through the white sleeves and then put on gloves and start working. Not the easiest way to work either!  No wonder it takes them longer to do things.</span></p> <p> </p> <p><span> </span></p> <p><span>Written by Melissa</span></p> Thu, 23 Mar 2017 20:18:00 Z{0B8CE5BF-D3F5-4033-9472-5115E9B38381}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/all-mice-successfully-made-it-to-the-international-space-stationAll Mice Successfully Made it to the International Space Station!<p>I apologize for the delay in writing an update. I have had several questions as to how the delay in Dragon docking impacted our studies etc. The answer is we don’t think it impacted it at all. NASA is very good about having room for large changes, such as delays in docking the Dragon capsule or delays in launch etc. Therefore, the spaceflight hardware is designed to support the mice for much longer periods of time than they think will be needed.</p> <p>However, with the delay came the need to change the schedule of when the astronauts perform what duties. As I have come to realize, this is a very fluid process as unexpected changes occur fairly frequently. There might be a need to fix a piece of equipment or something takes longer to complete than was originally scheduled etc.  That said, soon after the Dragon docked, all of the mice were successfully transferred to their new homes on the International Space Station. They were moved from what is called the Transporter, the hardware used to house them while they are in the Dragon, to the Habitat, the hardware which will house them during their stay on the International Space Station. The NASA vet with the assistance of remote video and the astronauts inspected all of the mice as they were being transferred. As you can imagine there are a number of regulatory requirements with sending mice into space and the mice are all very well cared for.</p> <p>Our team is back in Indiana as we patiently allow bone healing to occur over time. We will send updates as we have them, but we won’t have much to report for some time.</p> <h5>Written by: Melissa Kacena</h5> Tue, 07 Mar 2017 14:53:00 Z{8A2996CC-5358-48F1-A66B-DC05AF0FCCA9}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/successful-launch-of-rodent-research-iv-project-to-spaceSuccessful Launch of Rodent Research-IV Project to Space<p>Years of intense research, rescheduled dates and much preparation led to the successful <a href="https://www.nasa.gov/press-release/nasa-cargo-headed-to-space-station-includes-important-experiments-equipment" target="_blank">launch of SpaceX CRS 10</a> at 9:39 am EST on Sunday, Feb. 19, 2017 from the Kennedy Space Center in Cape Canaveral, Florida. The Rodent Research-IV (RR-IV) mission is a collaborative research project between the United States Army Medical Research and Materiel Command (PI, Rasha Hammamieh, PhD) and Indiana University School of Medicine (PI, Melissa Kacena, PhD, associate professor of orthopaedic surgery). Several other faculty members assisting Dr. Kacena with this project include Todd McKinley, MD; Marta Alvarez, DDS, PhD; and Liming Zhao, MD, of the Department of Orthopaedic Surgery, as well as Tien-Min Gabriel Chu, DDS, PhD of Indiana University School of Dentistry. The primary goal of this research project is to translate new discoveries in bone regeneration for osteoporosis, fracture healing and other bone disorders.</p> <p>This unique research and once-in-a-lifetime opportunity was one where Indiana University School of Medicine sent a team of 18 members down to Florida to support the preparations for launch. In addition to Dr. Kacena, the team was comprised of two additional faculty members, three postdoctoral fellow, one orthopaedic resident, five medical students, one PhD student, one staff member and four undergraduate students.  All of the team members were vitally important for the successful launch of this project aboard SpaceX CRS 10. The launch was documented in various forms of media, including television, print media and social media.  For more information about Bone Healing in Space, please visit <a href="http://go.iu.edu/1tPL" target="_blank">http://go.iu.edu/1tPL</a>.</p> Tue, 07 Mar 2017 14:48:00 Z{B1A20CC3-7339-46E7-84D0-F79E40E6DDEE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/spacex-on-snapchatSpaceX on Snapchat<p><span>One of our undergraduate students assisting with the preparation for the launch of SpaceX CRS 10 gained global attention after posting a short video on Snapchat the morning of the launch. The video was posted on Snapchat’s main page and gained over 500,000 views. </span></p> <p> </p> <p><span>As Snapchat only lists videos for 24 hours</span><span> the video is no longer up online, but for your viewing pleasure we’ve linked it here: </span><a href="http://orthopaedics.medicine.iu.edu/index.php/download_file/view/1030/560/236/236/236/" target="_blank">SpaceX_Launch-Faisal_Snapchat.mp4</a></p> Thu, 02 Mar 2017 14:32:00 Z{94CFB880-E5D7-4843-8203-953E57A9294F}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/tears-of-joyTears of Joy!<p><span>After working so hard for more than 3 y</span><span>ears, I lit</span><span>erally had tears of joy as  I saw the successful launch at 9:39a today!</span></p> <p> </p> <p><span>These photos were taken by my very supportive husband, Greg Merrell. He has had to take up so much of the slack around the house while I have been gone and working tons of hours to get this project to this point. Although we are clearly celebrating today, our work is only just beginning. We will again be at the lab at 4a tomorrow to load the ground control specimens into spaceflight hardware as they are delayed 3 days so we can see what happens in space and mimic the same thing on Earth.</span></p> <p> </p> <p><span>Off to a well deserved celebration dinner where all of those involved will finally get their mission patch and sticker as well as a great certificate that Shatoria created after getting approval from NASA which was signed by Dean Hess and the Orthopaedic Surgery Chair, L. Daniel Wurtz.</span></p> <p> </p> <p><span>Congratulations to all for a job well done! This was certainly a huge team effort and I am very thankful to each and every one of my outstanding team members!  I know they will all have great memories for years to come!</span></p> <p></p> <p></p> <p> </p> <p><span>Written by Melissa</span></p> Tue, 21 Feb 2017 19:32:00 Z{B45BA9B5-56C9-47A2-AB1D-C1AFECD975DA}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/successful-launchSuccessful Launch!<p>Rasha Hammamieh and Melissa Kacena</p> <div> <p><span>We did it!!! Successful launch!</span></p> <p> </p> <p><span>In case you missed it, you can rewatch the launch here: <a href="https://www.facebook.com/NASA/videos/10154923099676772/" target="_blank">https://www.facebook.com/NASA/videos/10154923099676772/</a></span></p> <p> </p> </div> Sun, 19 Feb 2017 15:26:00 Z{58456426-690D-46F4-86F2-8F74AF08870A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/update-on-launchUpdate on Launch<div><span>Well we were all disappointed when the launch was aborted at T-13 seconds. Immediately after the launch attempt we headed back to the lab to prepare for the launch slated for the 21st incase the launch does not occur tomorrow. It was a long day after several days of little sleep. </span></div> <div><span> </span></div> <div><span>We are keeping our fingers and toes crossed for a successful launch tomorrow!</span></div> <div><span> </span></div> <div><span>Written by Melissa</span></div> <div><span> </span></div> Sat, 18 Feb 2017 15:25:00 Z{3ECEA8AC-8E69-4556-B82A-4D526B1A4A2E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/news-updatesNews Updates!<div><span>Launch still scheduled for 10:01a, Saturday, February 18th. </span></div> <div><span> </span></div> <div><span>We continue to get some great media exposure related to our spaceflight study!  CBS4/Fox59 has interviewed Dr. Kacena and the story can be read at <a title="http://via.cbs4indy.com/WgQxC Ctrl+Click or tap to follow the link" href="http://via.cbs4indy.com/WgQxC" target="_blank">http://via.cbs4indy.com/WgQxC</a><span> </span></span></div> <div><span style="font-size: medium"><span> </span></span></div> <div><span>The largest newspaper in Colorado, the Denver Post, also ran a story about the creation of the mission patch. To read the story please go to <a href="http://www.denverpost.com/2017/02/17/nasa-patches-cu-boulder-artist-kacena-spacex/" target="_blank">http://www.denverpost.com/2017/02/17/nasa-patches-cu-boulder-artist-kacena-spacex/</a></span></div> <div><span> </span></div> <div><span>Finally, Rasha Hammamieh (my Army colleague) and I were interviewed for NASA TV Live Stream along with 5 other payloads being launched on SpaceX10. Ours starts close to minute 48.  <a href="https://www.youtube.com/watch?v=NsBDNyCtMAI" target="_blank"><span>https://www.youtube.com/watch?v=NsBDNyCtMAI</span></a></span></div> <div><span> </span></div> <div><span>Written by Melissa</span></div> Sat, 18 Feb 2017 04:00:00 Z{B8EC21DB-EE69-4F71-8817-57D8D155977D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/all-nighterAll nighter<p><span>Haven’t pulled an all nighter for a while!</span></p> <div><span>Our team worked through the night (had to arrive at 11:45p after working all day) to load the spaceflight hardware. At 7a the truck was loaded to transport the spaceflight hardware for loading in the dragon capsule. At 8:00am Rasha (Army PI) and I arrived for live taping on NASA TV. </span></div> <div></div> <div></div> <div></div> <div></div> <div></div> <div></div> <div></div> <div></div> <div><span>Written by Melissa</span></div> <p> </p> Fri, 17 Feb 2017 16:00:00 Z{CB3DA967-A6EE-46EF-BBD3-9EB57BB19059}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/more-press-on-spacex-launchMore Press on SpaceX Launch<div><span>As the team is preparing for a February 18th launch date, our project continues to get more  exposure on media outlets. </span></div> <div><span> </span></div> <div><span>The <a href="http://www.currentzionsville.com/2017/02/14/mice-on-a-mission-zionsville-researcher-sending-40-rodents-into-space-to-study-bone-healing/" target="_blank" rel="noopener noreferrer">Zionsville Current</a> released a story on the web and we even made it to the front cover this week and the <a href="http://www.dailycamera.com/cu-news/ci_30787494/cu-boulder-brother-sister-grads-forge-new-partnership" target="_blank" rel="noopener noreferrer">Daily Camera</a> of Boulder, Colorado featured a story on Dr. Melissa Kacena and her brother, artist Doug Kacena, whom designed the official SpaceX patch for the mission.</span></div> <div><span> </span></div> <div></div> Wed, 15 Feb 2017 22:17:00 Z{0B1FAF3E-1F3F-4BD8-A418-2951CDEF7A90}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/successful-static-firingSuccessful Static Firing!<p><span>Good news! Static firing tests were successful and SpaceX is working toward a February 18th launch date! </span></p> <p> </p> <p><span>Bonus picture of team members after watching Hidden Figures in theaters!</span></p> <p><span></span></p> <p><span> From L to R: Melissa Kacena,PhD, Irushi Abeysekera, Marta Alvarez,DDS,PhD, Alarbi Elhashmi</span></p> Tue, 14 Feb 2017 00:00:00 Z{157773EB-0256-4A45-9427-50EF125FDF0E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/ksc-schedule-part-2-and-update-on-static-test-firingKSC Schedule Part 2 and Update on Static Test Firing<p><span>You may have wondered what we have been doing since I wrote the last update at 1a Thursday morning.</span></p> <p> </p> <p><span><strong><span>Thursday:</span></strong> Well on Thursday most of our team members had the day off, but Paul and I had to go in to meet with the NASA vet and staff to discuss how things have gone so far and plans for future. We had a very successful meeting and I think everyone is happy with how things are progressing. After Paul and I finished with meetings about 5p, we headed up to Orlando to meet with the rest of our team members to watch the Orlando Magic basketball game – a very good game that was lost by the Magic in the final seconds.</span></p> <p> </p> <p><span><strong><span>Friday:</span></strong> Four of us had to return for mission specific duties for the entire day, but the rest of our team also had the day off. Static Test Firing was delayed.</span></p> <p> </p> <p><span><strong><span>Saturday:</span></strong> Was a “day off” for everyone – but I put it in quotes as several of us were working on manuscripts or other work related items all day. We did though make a drive to Titusville to eat at Dixie Crossroads. I remembered enjoying their food from my last time at KSC (in the late 90s) and it was still as good as I remembered! They serve free corn fritters! I had the red shrimp (only in certain seasons – and they were like eating mini lobsters). Static Test Firing was delayed.</span></p> <p> </p> <p><span><strong><span>Sunday:</span></strong> Was another “day off” for everyone – but again several of us are working on manuscripts and several emails have been sent to our colleagues about schedules for this coming week – which looks to be very busy – about 7a-7p each day Monday through Sunday. Those of us in Cocoa Beach are planning to go to the movie Hidden Figures later today, we thought that was appropriate since we are working at NASA.</span></p> <p> </p> <p><span>Also, today, Team 2 from IU arrives. We have 8 people that will be heading to our hotel from Orlando later today (a few members were up in Orlando visiting friends and family and 6 members arrive today).</span></p> <p> </p> <p><span>We are hoping that Static Test Firing will be completed today. From what I understand, it is taking longer to prepare for the testing because they are using the Space Shuttle launch pad due to the damage caused on the SpaceX launch pad with the explosion in September, and as you can imagine they are not identical. I am also under the impression that if the Static Test Firing does not occur today, then we may have another launch delay. But that is way above my pay grade. I will keep you posted as I learn more.  What I did learn is it is binary – either successful or not successful. So, if successful – we should have launch coming up soon (assuming no other reason for delay – like weather), but if not successful it is likely catastrophic, and therefore likely months of delay like what happened from the September explosion.</span></p> <p> </p> <p><span>Hopefully we will have time to get updates sent every few days but trust me the schedule is packed and at least I am exhausted after our 12 hour days.  It takes us about 40 minutes to drive each way from our hotel to the buildings we are working at – so we add 1.5 hours to each day at least with commute time.</span></p> <p> </p> <p><span>Oh, and I also learned there are absolutely no hotel rooms available in cocoa beach area this weekend or next weekend – they are all booked! One of our Army colleagues had a problem with a neighbor fighting all night and tried to move room to any hotel – had to go 10 miles further south to find a hotel in a different town.</span></p> <p> </p> <p><span>Bonus picture of the team at an Orlando Magic basketball game.</span></p> <p></p> <p><span>L to R: Liming Zhao,MD, Alarbi Elhashmi, Paul Childress,MD, Nizeet Aguilar,PhD, Irushi Abeysekera, </span></p> <p><span>Jeff Rytlewski, Marta Alvarez,DDS,PhD, Melissa Kacena,PhD</span></p> <p> </p> <p><span>Written by Melissa</span></p> <p> </p> <p> </p> Sun, 12 Feb 2017 21:28:00 Z{5A80690C-24FB-4F07-BA0B-B9E0EE6650A4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/kacena-lab-team-on-wish-tv-channel-8Kacena Lab Team on WISH TV Channel 8<p><span>This past week, WISH TV stopped by our lab while we were packing up the van for the Kennedy Space Center to chat with us about our upcoming spaceflight. You can find the full news story <a href="http://wishtv.com/2017/02/09/iu-research-team-partners-with-nasa-to-send-mice-to-space/" target="_blank"><span>here</span></a>.</span></p> <p> </p> <p><span>Also, check out more pictures that we took while gathering all of the supplies on packing day!</span></p> <p> </p> <p><span></span></p> <p><span>L to R: Irushi Abeysekera, Faisal Khan, Aamir Tucker, Nizeet Aguilar,PhD, Melissa Kacena,PhD</span></p> <p> </p> <p><span></span></p> <p><span>L to R: Mashuq Bhuiya, Jeff Rytlewski, Alarbi Elhashmi, Irushi Abeysekera</span></p> <p> </p> <p><span></span></p> <p><span>From L to R: Faisal Khan, Irushi Abeysekera, Melissa Kacena,PhD, Nizeet Aguilar,PhD</span></p> <p> </p> <p><span></span></p> <p><span>Mashuq Bhuiya</span></p> Fri, 10 Feb 2017 17:12:00 Z{4436517B-1233-4226-8953-C57B56377C16}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/update-on-launch-date-pictures-from-kscUpdate on Launch Date<p><strong>By: Melissa Kacena</strong></p> <p>It is now Thursday morning and it has been a busy 3 days for our spaceflight preparations and I only now have a few minutes of time to let you know what we have been doing and what the current plan is.</p> <p><strong>Monday:</strong> So Monday was a travel day. Four of us drove from Indianapolis to Cocoa Beach, Florida (where our hotel is located) and it was a very long drive, about 16 hours. We drove primarily to insure that our equipment and instruments needed for surgery made it safely, but we also drove to reduce expenses associated with changes of 4 airline tickets and shipping all of the equipment.  Five other team members flew in the afternoon, arrived to Orlando, rented a minivan, and drove to the hotel and went grocery shopping to stock up both the boys condo and the girls condo. We are all staying in lofts that group house people (6-8 person occupancy), again to reduce the expenses.</p> <p><strong>Tuesday: </strong>We left the hotel at 6:10 to drive to Kennedy Space Center (KSC) for badging. The badging facility is just East of the KSC Visitors Center for those familiar with the area. At badging, our group of 9 and a group of 5 Army colleagues, and 1 NASA integrator met, we all waited in two separate lines to get badges. While we successfully were badged and headed to our building by 8:30a, there were a few hiccups. My badge was only good for 2 days (as it had apparently not been properly updated from the January launch date). Another member of my team was issued a “pink” access card. All of us had to have a white badge with photo and a pink access card. Somehow his badge request did not have that on there. We then learned he would not be able to get into the required buildings without this card, so I began calling all of the people I had contact numbers for as did our NASA integrator, Carolynn. I finally was able to get ahold of someone that straightened things out and off we headed to the science building.</p> <p>At the science building we were shown to a large office space area where each of our team members were given a small cubicle to place backpacks, computers, snacks etc. There is also a conference room where we can all crowd in. If you recall from a previous blogs, Blank Slate Part 1 and Part 2, one of the many things we had to do to prepare for this mission was to create from scratch all of the work areas we required for success of this mission. From office space and equipment to the kitchen/breakroom, to the laboratory space. Now we were able to see for the first time whether we had made all of the requests we needed and whether we had purchased or shipped all of the equipment and supplies we needed to make this successful.</p> <p>After setting our things down in the office area, we were brought into the conference room where the NASA lead project manager and several other staff members from NASA were introduced to the 9 IU and 5 Army team members. At this meeting we were told that word had arrived late last night that our launch was to be delayed to February 17th. Immediately my mind started racing as to what changes needed to be made. But I could not start implementing them as we were taken off to have our safety training on NASA policy. As 2 of my team members are Green Card Holders (not yet US citizens), there was additional training as they require an escort since we are at a Federal Facility. Training ended at about 11am. Then the NASA management and I met while everyone else got to know each other and were able to get lunch. At our meeting we discussed the implications of the delay and what should then be accomplished on this first day on site. I decided we should proceed with our original schedule and set-up all of the laboratories to make sure we have all of the proper supplies/equipment.  I rationalized that if we were missing anything having the extra days will give us more time to have it shipped to KSC.</p> <p>I then quickly ate whatever snack I had packed as I did not have time to go to the food vendor and then off we went to the clean room facility. For most of us this was the first time in a clean room facility, but most of the items you wear are what we wear when we work with the mice at IU or the Army so it was fairly easy to familiarize ourselves with the procedure. We entered the facility where there is a larger cabinet containing all of the sizes of special jumpsuits that I requested for all of our team members from small to 3XL. We also collected hair nets, face masks, beard guards for those with facial hair, booties etc. Then the males and females went into separate locker rooms which are about 2.5 feet wide by 6 feet long (so only about 5 at a time can go in and change). We were advised to wear shorts and tshirts or tank tops underneath the jumpsuits as we will get hot.  Then there is a secured door with a code that allows you to enter the facility. None of us in either locker room had the code. I don’t know about the guys, but when I discovered this I tried knocking on the door, but nobody heard the knock. Fortunately there was a phone and phone list on the wall next to the door and I called every number until finally after about 5-10 minutes someone answered. I was on about the 4th to last number, so I am glad I finally reached a person that could let us out of the door….we sort of had our own “escape room” experience.  The guys were stuck too, so we opened their door from the other side and now we could all proceed with putting on sterile gloves. This was not new for the IU team as we complete surgeries on a regular basis and many of my team members are medical students where they have learned this or are orthopaedic surgeons etc. But this was new for the Army team, so it took a few extra minutes of instruction.  And then we just split up into 3 main groups and started moving tables, chairs, and equipment into proper places and unpacking all of the supplies.  There were 2-3 people from my team in each of the 3 rooms and the 3 primary NASA integrators and the 5 Army team members were divided into groups to work together to help get everything done. We had people work in the room they would later be working in so they were familiar with where everything was and how it worked. NASA staff had placed tables and larger equipment in locations we had on drafted plans we had sent previously, but once we got into the rooms we realized that in some cases things needed to be moved to allow for better access to a different piece of equipment or for the flow of the procedures etc. It took us until 7p to finalize all of the preparations, but we were happy as 3 of the 4 rooms were set-up and ready to go after the long day of work.</p> <p>After finishing work, the Army team left together and half of the IUSM team went home to eat quickly from our grocery store run and were in bed by 9:30p while the other half of us went to dinner at a tasty restaurant serving fish with one of our NASA integrators and at the restaurant we ran into another NASA staff member and she joined us for dinner. Then the remainder of us went to bed, a long, but successful first day at NASA!</p> <p><strong>Wednesday:</strong> Since we stayed late to get things done on Tuesday, we had a free morning on Wednesday and the NASA manager nicely arranged a car tour of part of the KSC facility for us. Some of the pictures from our tour will be posted on the blog. We saw the Vehicle Assembly Building (VAB) where the Space Shuttle was assembled. I learned that each stripe of the American Flag you see painted on the building is 8 feet wide – that gives you some indication of how large the building is. I also learned it is so tall, that it can create its own weather system. Clouds can form and it can rain on the building itself as a result. We also saw the crawler (literally the equipment that crawled from the VAB to the launch pad with the Space Shuttle on it) and we saw the stone path that the crawler travels. We then went to the SpaceX facility where they assemble the rocket (we were only allowed to see the outside) and the SpaceX launch pad. It is inside this building that the “Transporters” or the cages housing our spaceflight mice will be brought one day before launch to be packed into the Dragon capsule. We were also taken to the SpaceX gift shop which literally only allows 5 people into it at a time, it is a very small room with all things SpaceX. I think I spent the most money of everyone….including purchasing new clocks for the lab that say SpaceX as well as assorted t-shirts and sweatshirts for myself and as gifts, but I think every team member came out of the store with something, prices were not bad – $10 for most t-shirts and no tax!</p> <p>After our time touring we then had to go to work. As we have not worked with the Army folks we had to train everyone in their roles and we did a run through of all of the equipment and positions to make sure all the equipment worked and everyone knew what their role was and what to do. While we were in the rooms training, we were all called together where we were notified of yet another launch delay, now the launch is scheduled for Feb 18th.  The test run was successful and the day ended for everyone except for me and the NASA management team by 8p.  The IU folks all went out to dinner while the NASA management and I reworked the schedule for our preparations with the launch on the 18th.  As a result of the delays the IU and Army teams will get Thursday, Saturday and Sunday as off days. Although, my students and I are taking advantage of this time together to work on our manuscripts that are in process! We have some preparation activities on Friday and will do another test run and training on Monday with 2 new Army team members that will be joining us (this will give us more time to make sure everyone is clear on their roles and everyone is ready). We have some additional preparation activities planned for Monday as well. On Tuesday, assuming the launch is not delayed again, the remaining 9 IU team members will join us (they will arrive Monday evening), they will badge and train on Tuesday morning and then on we will do one final test run to make sure we are ready for the spaceflight mice.</p> <p>As you can imagine the constantly changing schedule is frustrating, and requires much time and flexibility, but our entire team is taking these changes in stride. Based on the success I saw in our test run, I believe we are well-prepared for our upcoming spaceflight and I believe that we have done everything we can to have a successful mission!</p> Thu, 09 Feb 2017 19:54:00 Z{75FAAFFD-EFC4-4D00-B2FD-32C4A75572EE}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/500am-departure-for-cape-canaveral5:00AM Departure for Cape Canaveral!<p><span>Day one of travel to Cape Canaveral. A few members of our team are treking it on the open road carrying supplies to Cape Canaveral. Check out their early morning picture!</span></p> <p><span>From L to R: Marta Alvarez,DDS,PhD, Liming Zhao,MD, Melissa Kacena,PhD, Irushi Abeysekera,MS</span></p>Mon, 06 Feb 2017 22:31:00 Z{F7D929C6-2FC3-4FBF-A062-50968168E3BA}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/candid-pictures-while-packingCandid Pictures while Packing<p><span>As we are preparing to leave this upcoming week for the Kennedy Space Center in Cape Canaveral, we took a few group photos. Enjoy and have a nice weekend!</span><span> </span></p> <p> <p></p> <p>Back Row[L to R]: Paul Childress,PhD, Alarbi Elhashmi, Aamir Tucker, Liming Zhao,MD, Jeff Rytlewski, Marta Alvarez,DDS,PhD</p> <p> <span>Front Row[L to R]: Irushi Abeysekera, Mashuq Bhuiya, Faisal Khan, Nizeet Aguilar,PhD, Melissa Kacena,PhD, Shatoria Lunsford</span></p> <p> <p> <p><span></span></p> <p><span>From F to B by Row[L to R]: Liming Zhao,MD, </span></p> <p><span>Aamir Tucker, Alarbi Elhasmi</span></p> <p><span>Mashuq Bhuiya, Faisal Khan</span></p> <p><span>Marta Alvarez,DDS,PhD, Jeff Rytlewski, Shatoria Lunsford</span></p> <p> <p> <p><span></span></p> <p><span>From L to R: Paul Chldress,PhD, Faisal Khan, Alarbi Elhashmi, Mashuq Bhuiya</span></p> <p><span> </span></p> Fri, 03 Feb 2017 23:58:00 Z{32FF88A7-7917-47D5-BE28-A21D8AEB5EA0}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/live-on-wthr-channel-13Live on WTHR Channel 13!<p><span>Earlier today our team was interviewed by WTHR Channel 13 about our upcoming NASA Space X Launch! We are set to be on the air during the 5o’clock news (EST). </span></p> <p> </p> <p><span>See below a few stills taken during the interview!</span></p> <p> </p> <p> </p> <p></p> <p>Paul Childress, PhD, postdoctoral fellow</p> <p> </p> <p> </p> <p></p> <p>Marta Alvarez, DDS, PhD; dentist and molecular biologist</p> <p> </p> <p> </p> <p></p> <p>Melissa Kacena, PhD; Assoc Prof of Orthopaedic Surgery, Anatomy and Cell Biology and Biomedical Engineering</p> <p>Rich Van Wyk, WTHR Channel 13 Reporter</p> <p> </p> <p> </p> <div></div> <div>Liming Zhao, MD; Visiting Assistant Professor of Clinical Orthopaedic Surgery</div> Fri, 03 Feb 2017 20:42:00 Z{462C72BE-8B91-44AC-8488-86684139CB19}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/spacex-10-patchSpaceX-10 Patch<p><strong>By: Stephen Knapp</strong></p> <p><span>If you have been following our blog you know we are very busy working to get ready for our February 14th spaceflight launch!  Although it has been a lot of work, there have certainly been some fun activities too. One is that we were able to design our spaceflight mission patch and sticker. The final product of our patch is shown in the attached image. My brother, Doug Kacena, is an artist living in Colorado (where we were both raised). I asked him if he could help us design the patch. NASA gave us some specific requirements and although I am sure the requirements limited his creativity, I think the end result is great! For those interested in learning more about the process please read the article below written by Stephen Knapp, Freelance Writer, Evergreen, Colorado.</span></p> <p><span>Although one of Colorado’s most respected abstract painters, it never occurred to Doug Kacena that his soaring talent might one day play a role in America’s space-faring history. And yet this February when SpaceX-10 thunders off the pad at Cape Canaveral and hurtles skyward toward a rendezvous with the International Space Station, it will be carrying Kacena originals and his handiwork will forever symbolize the mission’s lofty objectives.</span></p> <p><span>To fully appreciate that happy convergence of art and science, it’s best to go back a few years to when Doug and his sister, Melissa, were pursuing studies at the University of Colorado at Boulder. Doug was pre-med with a minor in fine art. Melissa was working her way toward a PhD in aerospace engineering. The Kacenas’ academic flight paths briefly crossed when they found themselves toiling side-by-side on behalf of Bioserve Space Technologies, an outfit specializing in crafting the sophisticated tools that make zero-G research possible.</span></p> <p><span>“Some of the stuff we did ended up on a half-dozen space shuttle flights, and Mir,” recalls Doug, owner of Artuvus Studios in Denver “It was really interesting, but my interest in art was stronger than my interest in molecular cellular developmental biology and I ended up going for the fine art degree.”</span></p> <p><span>But Melissa stayed her original course, more or less, earning her aerospace doctorate from CU before taking the long way to a professor’s desk at Indiana University School of Medicine. Melissa came to Indianapolis by way of Harvard Medical School and the Yale University School of Medicine, and brought with her a world-class background in orthopaedics and rehabilitation. Since her arrival at Indiana University she proposed a space-based experiment by which to test new bone-healing therapies she’s helped develop.</span></p> <p><span>“Most people don’t know that approximately 10 percent of broken bones never heal,” Melissa explains. “Bone healing is impaired in space, so if these therapies work in a weightless environment, it will be a good indication that they’ll work on Earth. It would be a very big step toward more effectively treating the IED (improvised explosive device) blast injuries that our soldiers are suffering in the Middle East.”</span></p> <p><span>Melissa’s colleagues at the US Army Medical Research and Materiel Command (USAMRMC) loved the idea, and they decided to work together to understand how bone healing occurs in spaceflight and how the different treatments work on SpaceX-10.</span></p> <p><span>For what it’s worth, Melissa’s bone therapy trial will occasion a couple of “firsts” for the American space program.</span></p> <p><span>“The maximum number of mice NASA can fly is 40, and this will be the first flight to use the maximum,” says Melissa. “It will also be the first to use male mice. Male mice haven’t been used by NASA because they’re more aggressive than females, so we had to find ways to make them, um, happier,” she smiles.</span></p> <p><span>With the nuts and bolts of the venture in place, the only thing left to do was come up with a suitable patch. Each mission, it seems, is represented by a patch signifying its specific purpose and indicating the agencies and organizations instrumental in getting it off the ground. Melissa had seen her share of patches, and wondered if maybe SpaceX-10 could do better.</span></p> <p><span>“Some of them look a little bit like clip-art,” she says. “Doug is a great artist, so I asked if he could design the patch.”</span></p> <p><span>There were no objections, although there may have been a few around the table who wondered what business an abstract artist had trying to create a rigidly representative patch. As it happens, they needn’t have worried. Doug hadn’t exactly been sitting on his hands while Melissa worked her way to Indianapolis.</span></p> <p><span>“I actually had a very formal education in art, and I have a long history in graphic design,” Doug laughs. “I’ve done hundreds of magazine ads and business logos, and the principles are the same in every kind of art.”</span></p> <p><span>And it’s not like NASA just turned him loose with the great-big box of Crayons and his own fertile imagination. Measuring just a few inches across, the official SpaceX-10 patch has to conform to some pretty specific guidelines. For starters, it must graphically depict both of the experiments on board and the space station that is their destination. Next, it has to display the acronyms of the half-dozen organizations involved, plus the mission’s formal title, Rodent Research IV. And finally, because the patch will be stitched, rather than printed, it can utilize not more than seven colors and should have limited details.</span></p> <p><span>Accepting those unyielding restrictions without hesitation, Doug applied long years of experience, a wide array of talents and an inexhaustible fountain of creativity to the task. The image he produced is an artful homage to the mission and those who animate it, and a powerful portrayal of SpaceX-10’s important scientific goals set upon the star-filled canvas of space. And if an original Kacena abstract can fetch thousands of dollars in a Denver art gallery, Doug is pleased to accept in payment for his patch a more uplifting currency.</span></p> <p><span>“I was honored even to be asked, and I’m thrilled to do it,” he says. “It’s a once in a lifetime opportunity. It’s a chance to be a little part of history.”</span></p> <p> </p> Thu, 02 Feb 2017 22:32:00 Z{E4F7877A-C266-4F54-AFEA-E335CBD61270}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/one-step-closerOne Step Closer<p><span>Today we were informed by NASA that we should continue preparations for a Feb 8th launch. We were told to </span><span>begin </span><span>shipping our mice to Kennedy Space Center and we were told that this Thursday we will be having our Flight Readiness Review. While a successful launch of SpaceX from Vandenberg is still the first step (currently scheduled</span><span> for Saturday, Jan 14</span>th<span>), each day brings us closer to our spaceflight launch!</span></p> <div> <p></p> <p><span><em> picture courtesy of Pixabay.com</em></span></p> <p> </p> <p><span>Written by Melissa Kacena</span></p> <p> </p> </div> Mon, 09 Jan 2017 21:41:00 Z{1A41D5D8-F5EB-42F0-8CA9-81C3834DBD04}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/nasas-unwritten-motoNASA’s Unwritten Moto<p><span>As a former girl scout I have heard the saying many times, “be prepared.” You have also probably heard the saying “hope for the best but plan for the worst”. I think this is NASA’s unwritten motto. While we hope that once an official launch date is provided, everything else will go according to plan, we must prepare for the worst case scenario as well.</span></p> <p><span> </span></p> <p><span>What is the best case?</span></p> <p><span> </span></p> <p><span>In the best case scenario, we arrive to Kennedy Space Center 7-10 days prior to launch. 3 days before launch, the mice undergo surgery. 1 day before launch, the mice are placed on the SpaceX Dragon. The launch occurs as scheduled or within 2 days, so that the only additional mouse surgeries required are those for our ground controls, which are delayed 3-4 days from flight so that we can mimic what occurs in spaceflight. The ground control surgeries are completed the day after launch, at which point the majority of the team members fly home.</span></p> <p><span> </span></p> <p><span></span></p> <p><span>The worst case scenario is that the launch is delayed for 8 weeks. This happened once out of the 9 SpaceX launches, thus the required scenario planning. This means we will have to have a large team in place for 9-10 weeks. As you can imagine as many of our team members are students, it is difficult for many to be away for long periods of time. We are hoping that most will be away for just over a week, and about 7 people will be away for 2 weeks. But, if there are delays we will have to rotate individuals.  Lots of preparations are occurring and schedules are being changed, on a weekly, if not daily basis as we get close to the launch date.</span></p> <div> <p> </p> <p> </p> <p><span>Written by Melissa Kacena</span></p> </div> Fri, 30 Dec 2016 17:26:00 Z{CD74727F-00E2-42A3-9F45-21521DC6EDBC}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/changing-facesChanging Faces<p> </p> <p><span></span></p> <div><strong><em> Back Row</em></strong><em> (L to R): Yinghua Cheng, MD, PhD; Liming Zhao, MD; Alarbi Elhasim, MS; Faisal Khan, undergraduate.</em></div> <div><strong><em> Front</em></strong><em> <strong>Row</strong> (L to R): Marta Alvarez, DDS, PhD; Nizeet Aguilar, PhD; Irushi Abeysekera, MS; Melissa Kacena, PhD;</em></div> <div><em>       Paul Childress, PhD; Mashuq Bhuiya, undergraduate, Jennifer Lamb, medical student, Shatoria Lunsford, support staff</em></div> <p> </p> <p><span>You have been introduced to several new team members during the blog, but unfortunately we have also had to say goodbye to several team members as well. As you can imagine, being at a university, we have a number of students join the laboratory and then complete their training and move onto the next phases of their career. We wish all of our alumni the best of luck on their journey.</span></p> <p><span>But don’t fear, as a research and teaching institution we are well poised to train the next generation of students and trainees so that we will have well qualified, highly skilled people helping complete our spaceflight studies. We continuously practice techniques and we have quality scores and each person is cross-trained in several positions. No matter when the launch occurs, we will have a great team of competent surgeons and animal handlers available to complete these important spaceflight studies!</span></p> <p> </p> <p><span> Written by Melissa Kacena  </span></p> Thu, 22 Dec 2016 19:30:00 Z{D4CAA992-0906-412E-A473-49DDEB7AFE1C}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/cruising-towards-the-futureCruising Towards the Future<p></p> <p><em>Photo courtesy of Freedigitalphotos.net</em></p> <p><em> </em></p> <p>The first form I was asked to fill out by NASA was the ERD or Experimental Requirements Document. In this form we detailed (as much as we could at the time) everything we thought would happen on Earth and in spaceflight. The NASA operations personnel, NASA scientists, and all levels of managers have been reviewing this document, asking for clarifications or changes based on astronaut time, hardware availability or any other issues. This document has been modified and updated with time and is now approved and this form will serve as the “guide” for our spaceflight experiment. I still remember I was visiting another type of mouse, as I was frantically working to finish the first draft of this form for the quick deadline, as I was going with some friends and family members on a Thanksgiving week Disney Cruise in 2013. I was working after a fun-filled day at the Disney amusement park late after our arrival in our hotel room as I had to send it off to NASA before I boarded the cruise the next day and would not have internet access. As I write this I am sensing a pattern, somehow I seem to be working near or on holiday vacations fairly often! Maybe after our successful launch now scheduled for January 28, 2017, I can finally take some extra time off during the holidays! Back to work!</p> <p> </p> <p>Written by Melissa Kacena</p> Thu, 15 Dec 2016 13:00:00 Z{B3EBEFB3-5535-4EA2-8847-77C0D1A39313}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/welcoming-our-new-support-staffWelcoming Our New Support Staff<p></p> <p>Hello everyone! I’m Shatoria, the newest member to Dr. Kacena’s laboratory team. In my role as research support assistant I am tasked with making sure that everything behind the scenes runs smoothly.</p> <p> </p> <p>Over the next few months I will be working to secure lodging and travel arrangements for the team’s trip to the Kennedy Space Center in Titusville, Florida for the planned space flight. A lot of preparation goes into making sure that everything is in order prior to the laboratory’s team departure, including making sure that we’re abiding by university and federal guidelines.</p> <p> </p> <p>Although it may sound challenging, the excitement associated with this mission makes the challenges worth it. It’s amazing to be part of such an amazing project and have the opportunity to work with amazing faculty, students, and staff.</p> <p> </p> <p>My job’s pretty cool right?! I definitely think so.</p> <p> </p> <p><span>Written by Shatoria Lunsford</span></p> <p> </p> Fri, 16 Sep 2016 16:45:00 Z{BE341D6E-ADBB-4CBC-8995-507BEBD8B977}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/spacex-explosionSpaceX Explosion<p></p> <p><em>Photo Courtesy of Duong Cong Minh’s Flickr </em></p> <p>On September 1, 2016 we received word of an explosion that occurred on the LC40 pad were SpaceX was conducting static firing testing. Even though this was not a NASA mission due to the damage on the pad it is expected that the SpaceX-10 launch date will be affected.</p> <p>We will continue to post updates regarding the launch as they funnel in and we thank you all for coming on this journey with us.</p> <p>Video footage of the explosion, courtesy of US Launch Report, can be viewed here: <a href="https://www.youtube.com/watch?v=_BgJEXQkjNQ" target="_blank">https://www.youtube.com/watch?v=_BgJEXQkjNQ</a> (explosion occurs at the 1:11 mark).</p> <p>Written by Shatoria Lunsford</p> Tue, 06 Sep 2016 14:21:00 Z{32801D5F-A697-4BE5-85BA-1177A4B53E28}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/spacex9-launchSpaceX9 Launch<p></p> <p>Photo Courtesy of SpaceX Flickr Page</p> <p>As you may have heard, early last Monday morning (7/18/16) SpaceX-9 was successfully launched.  This successful launch means that our launch date is “firm” for Veteran’s Day, November 11, 2016, barring weather or any other issues.  Since Dr. Kacena is a VA non-clinician scientist, our laboratory has DoD funding, and our spaceflight study is funded by the US Army Medical Research and Material Command, we feel this is a very fortuitous date for us, and we are very excited for the upcoming launch!  Summer has been busy, but productive, in our laboratory between preparations for the spaceflight, summer projects for medical students, and other continuing research efforts.  If you have time you can watch the launch in this video:  <a title="https://www.youtube.com/watch?v=wsBy_UeYM3E Cmd+Click or tap to follow the link" href="https://www.youtube.com/watch?v=wsBy_UeYM3E" target="_blank">https://www.youtube.com/watch?v=wsBy_UeYM3E</a></p> <p> </p> <p>Written by James Fischer</p> <p> </p> Mon, 25 Jul 2016 18:57:00 Z{03C925D0-704F-4169-B94E-67FBBE304FC4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/crazy-schedulingCrazy Scheduling<p>Have you ever tried to plan something a month or even 6 months in advance? Did everything go as planned? If you are married or have previously planned a wedding, try to think back to that planning process where 6 months or even a year in advance you were trying to plan out the entire day. Instead of just planning out a day, try planning out 6 weeks, now THAT is a real challenge!  But that is exactly what NASA wants us to try to do with our November 11th  launch date. I previously wrote about planning for everything that needs to be supplied in the office and laboratories (<a href="http://orthopaedics.medicine.iu.edu/index.php/bonehealingspace/blog/the-blank-slate-part-1/" target="_blank" rel="noopener noreferrer">The Blank Slate Part 1</a>  & <a href="http://orthopaedics.medicine.iu.edu/index.php/bonehealingspace/blog/the-blank-slate-part-2-shes-making-a-list-and-checking-it-twice-/" target="_blank" rel="noopener noreferrer">The Blank Slate Part 2</a>), what I hadn’t mentioned was the onerous task of trying to premeditate what days you will be in which buildings at what times. Yes, you read that correctly, we have to estimate what time we will arrive to which buildings. This is required as a NASA escort will have to be with us at all times. If some of our team members are in the offices, while some are in the animal facility, and others in the wet laboratories, this will require 3 separate escorts. Thus, NASA needs to understand their staffing needs to obtain budget and scheduling approvals. In my future blog, I will discuss our tentative time line and the people involved so you can better appreciate the complex scheduling and the enormous personnel-associated costs both from our end and from NASA’s end to prepare for spaceflight investigations!</p> <p> </p> <p> </p> <p>Written by Melissa Kacena</p> <p><span></span></p> <p> </p> <p><em>Image courtesy of vectorolie at FreeDigitalPhotos.net</em></p> <div><em> </em></div> Tue, 14 Jun 2016 21:47:00 Z{06FAB03B-E5CF-4671-997D-88CF300B251A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/nasa-loves-to-keep-us-on-our-toesNASA loves to keep us on our toes!<p>The launch date was set back once more to November 11th 2016. We are feeling really good about this date because it happens to fall on Veteran’s day. This might bring us a bit of luck for a more stable/secured launch date as our mission was funded by the Department of Defense to help find alternative/additional solutions for our wounded soldiers/vets.</p> <p>Veterans Day, not to be confused with the upcoming Memorial Day, celebrates the service of all U.S. military veterans, while Memorial Day honors those who <em>died</em> while in military service. Many countries around the world also celebrate November 11th as a remembrance day, marking the anniversary of the end of World War I.</p> <p>On this day, the 11th hour of the 11th day of the 11th month on 1918,  chief conflicts of World War I were formally ended. Exactly one year later, President Woodrow Wilson declared to his compatriots that this day would henceforth be celebrated as Veteran’s day, “…a day to be dedicated to the cause of world peace and to be thereafter celebrated and known as ‘Armistice Day’.”</p> <p>Years later, a veteran of World War II, Raymond Weeks, had the idea to exand Armistice Day to include all U.S. Veterans. With the support of President Dwight Eisenhower, in 1954, congress amended the bill to replace ‘Armistice’ with ‘Veterans’ and thus Veteran’s Day was recognized.</p> <p>So with respect to our brave veterans, past and present, and the upcoming holiday, thank you for your service and enjoy your Memorial Day weekend!</p> <p></p> <p> </p> <p>Written by Sandra Milescu</p> <p><em>Image courtesy of radnatt </em><em><em>and vectorolie </em></em><em>at FreeDigitalPhotos.net</em></p> Wed, 25 May 2016 19:57:00 Z{9A7AB25C-145B-4962-B41D-F38D5E7B7F1E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/getting-ready-for-kennedy-space-center-kscGetting Ready for Kennedy Space Center (KSC)<p>Everything I wrote about earlier in the blog: Getting Ready for NASA Ames Testing (<a href="http://orthopaedics.medicine.iu.edu/bonehealingspace/blog/getting-ready-for-nasa-ames-testing-a-reflection-on-the-past-in-/" target="_blank" rel="noopener noreferrer">a reflection on the past in preparation for the future </a>), we had to do to prepare for our time at KSC, plus a number of additional requirements.  We will have more extensive background checks conducted and this time I will have a foreign national in my laboratory which will require additional time and paperwork (about 6 months’ notice).</p> <p>As we were going to be in contact with material going up to the International Space Station (ISS), we were all required to have an extensive physical/health check to minimize any exposure risk to the astronauts. We have to complete another series of animal, X-ray, and laboratory safety training, both online as well as upon our arrival to KSC. For this reason, they recommend our team arrive at least 1 week in advance of the launch to pass all onsite training requirements. Furthermore, we have to complete not just 1, but 2 animal protocol application (>100 pages each); one for handling animals at KSC and one for handling animals in spaceflight. Each institution has what is termed an IACUC or Institutional Animal Care and Use Committee, which reviews and approves all animal investigations to make sure they are conducted in a humane fashion, do not duplicate what has already been done, and that the knowledge gained could not be done without using animals. Since we are interested in looking at bone regeneration we must use animals with bones, and bone regeneration with drug therapies in spaceflight, has not been done previously. All of KSC is considered 1 institution, therefore the KSC IACUC is in charge of everything done with mice at KSC (on the Earth). The ISS is considered a separate institution and the Ames IACUC is in charge of everything done with mice on the ISS. Thus, we had to complete 2 protocols with 2 sets of rules and 2 review procedures. Just before the holidays, we submitted our revised applications to KSC. Because of our extensive work on the launch simulation with Ames IACUC, we understood the NASA process much better and our initial applications required limited revisions. Just this week we received final IACUC approval.</p> <p>So we are a GO for launch!</p> <p> </p> <p></p> <p>Written by Melissa Kacena</p> <p><em>Image courtesy of alexisdc at FreeDigitalPhotos.net</em></p> Thu, 19 May 2016 20:53:00 Z{EE2FEABF-0CB1-4F8D-9A8B-9AC1E60C082B}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/better-luck-next-timeBetter luck next time<p>Save the date!</p> <p>As they say, the fifth times the charm, or do they? Once again our August launch date has been moved due to things out of our control. The date was pushed further this time to November 21, 2016, the Monday before Thanksgiving. We have been told that this was due to  2 separate 2 week blackout periods due to orbital mechanics. For those of you needing clarification, Orbital mechanics also known as astrodynamics or flight mechanics, is the study of the motions of artificial satellites and space vehicles moving under the influence of forces (out of our control) such as gravity, atmospheric drag, thrust, etc.</p> <p>The motion of these objects is usually calculated from a combination of Newton’s laws of motion and Newton’s law of universal gravitation. Orbital mechanics is a modern offshoot of celestial mechanics, which is the study of the motions of natural celestial bodies such as the moon and planets. Thus, Newton’s formulas based off celestial mechanics, which date back to the 17th century are used today in this core discipline within space mission design and control.</p> <p>The engineering applications of orbital mechanics is used by mission planners to predict the results of propulsive maneuvers and includes spacecraft trajectories, such as orbital maneuvers, reentry and landing, rendezvous computations, and lunar and interplanetary trajectories.</p> <p>I guess we’ll just have to be patient and wait for the laws of gravity to comply.</p> <p></p> <p>Written by Sandra Milescu</p> <p><em>Image Credit: NASA</em></p> Thu, 05 May 2016 16:16:00 Z{90D540F5-1467-4968-B32C-DBF830594B23}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/space-jamsSpace Jams<p>You may have noticed that our launch date keeps changing. I was originally under the impression that launch dates would only always be delayed, not moved up, primarily because there are a number of processes that take a significant amount of time which must be completed prior to launch. That is why in an earlier blog I told you about the NET date, ‘No Earlier Than’. Well in the past couple of months, our spaceflight has moved from June 2016, to August 2016, to December 2016, and now back to August 2016. When I asked why the launch was delayed from August until December I was told it was because there was too much traffic in space (Soyuz schedule etc.).  Who would have thought there would be enough activity in space to cause traffic scheduling conflicts. Almost every day I find I am learning something new.</p> <p> </p> <p></p> <p> </p> <p>Written by Melissa Kacena</p> <p><strong>Image courtesy of dan at FreeDigitalPhotos.net</strong></p> Fri, 25 Mar 2016 16:52:00 Z{72E41DAD-29E8-4826-BF12-81C4D7190C72}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/introducing-our-newest-team-member-liming-zhao-mdIntroducing our Newest Team Member: Liming Zhao, MD<p>The combined experience of 17 years of orthopaedic clinic work in China and 15 years of basic research work in the US provides me a powerful synergy towards my skeletal research.</p> <p>As a surgeon I have been engaged in treating patients with bone disorders and have conducted various operations including bone surgery.  My clinical experience gradually changed my career path towards basic research in orthopaedics.</p> <p>I have a demonstrated record of successful and productive research projects in the area of mechanotransduction of bone and joints. My research includes both in vivo animal studies and in vitro molecular and cellular works. I have used animal unloading and loading models to investigate mechanotransduction, fracture models to examine bone formation and remodeling. I have also developed genetically modified, transgenic/knockout mice.  Now I look forward to my new career opportunity by working closely with Dr. Kacena on her spaceflight bone healing studies.</p> <p> </p> <p></p> <p> </p> <p>Written by Liming Zhao</p> Fri, 11 Mar 2016 18:55:00 Z{41949BE6-629F-49B6-B5C8-192F39E61D69}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/homecoming-for-astronaut-scott-kellyHomecoming for Astronaut Scott Kelly<p>As you heard from my interviews or previous blogs, on average, astronauts lose about 1-2% of their bone mass per month in spaceflight, which is similar to what someone with osteoporosis loses in a year. What we don’t have a good sense of is whether the bone loss plateaus or continues with time. This is important to understand as a mission to Mars could take about 3 years in total length. Fortunately, with US astronaut Scott Kelly’s upcoming return to Earth (March 2nd), we should learn much more about long-term bone loss in spaceflight. Scott Kelly will have been on the International Space Station for 340 days. Interestingly, he has an identical twin, Mark Kelly, which has also been undergoing bone testing. For those not familiar, Mark Kelly is a retired astronaut. Examining the bones of these brothers will provide important information regarding spaceflight induced bone loss for physicians and scientists alike.</p> <p>To learn more about this exciting story please go to <a href="http://www.bbc.com/news/science-environment-35651665" target="_blank">http://www.bbc.com/news/science-environment-35651665</a></p> <p> </p> <p></p> <p>Written by Melissa Kacena</p> <p><em>Image Credit: NASA</em></p> Tue, 01 Mar 2016 18:50:00 Z{3B137DA3-1897-4EC7-8A97-C5B3D3E6151D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/4-minutes-of-fame4 Minutes of Fame….<p> </p> <p><span>As many of you are aware, last week was an exciting week for our laboratory, we were filmed for the local TV show, “Inside INdiana Business with Gerry Dick”.  For those of you that missed our broadcasts on Friday and Sunday, I am including the link to the interview.</span></p> <p> </p> <p><span>What you cannot learn from the video clip is that I met with reporter Barb Lewis for just a few minutes before the taping. Then, they brought us into the studio where, at 5’5”, my feet could not reach the foot bar on the tall stool, so I was awkwardly dangling on the stool. As soon as microphones were in place, the filming began, and there were no “cuts” or “second takes” etc. What you saw was the full interview from start to finish. The B-roll included shots from everyone in our laboratory that was able to make the video shoot the day before. We must have done well overall, as afterwards the producer asked if I would be willing to come back after we had our results from the spaceflight. So perhaps in 2017, I will have used 8 of my 15 minutes of fame.</span></p> <p> </p> <p><span><a href="http://www.insideindianabusiness.com/clip/12196528/iu-school-of-medicine-professors-bone-research-heading-to-internation-space-station" target="_blank">http://www.insideindianabusiness.com/clip/12196528/iu-school-of-medicine-professors-bone-research-heading-to-internation-space-station</a></span></p> <p></p> <p>Melissa Kacena and Barbara Lewis during the taping of our spaceflight bone healing segment on “Inside INdiana Business with Gerry Dick”, February 2016.</p> <p> </p> <p> </p> <p>Written by Melissa Kacena</p> Mon, 08 Feb 2016 17:18:00 Z{C49BCC30-2AE4-4091-BB01-CCFD8F4B507E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/hot-off-the-pressHot off the press!<p>We have some exciting new opportunities to spread the news to others about our research this week! I will be interviewed by business health reporter Barbara Lewis of “Inside INdiana Business with Gerry Dick”, a local news show that hosts stories on local people and businesses that are making headlines in Indiana. They will be coming to our labs to film a segment on our research and the NASA mission.</p> <p>In preparation for my interview, I learned about the art of B roll footage, which is an alternative or supplemental intercut within the main shot. In layman’s terms, while they are showing the footage of my interview, they will cut out the image of me talking and roll to a shot of other footage of the labs, where my voice will be heard in the background. This is often done in movies in the form of flashbacks.</p> <p>We here in the lab are all very excited about this media coverage and are hoping you will share in this exciting new experience with us by checking out the show and watching along with us!</p> <p>You can watch our interview scheduled to air this week on the days below:</p> <p>WFYI (PBS) 20 (and all other PBS channels): FRIDAY AT 7:30PM EST (February 5, 2016)</p> <p>WTHR (NBC) 13: SUNDAY AT 11AM EST (February 7, 2016)</p> <p>If you live in a city outside of Indianapolis, please click on the link below to see which channel may broadcast the Inside INdiana Business show with Gerry Dick in your area or to see clips of the segment online.</p> <p><a href="http://www.insideindianabusiness.com/story/29536989/on-air" target="_blank">http://www.insideindianabusiness.com/story/29536989/on-air</a></p> <p></p> <p> </p> <p>Written by Melissa Kacena</p> Tue, 02 Feb 2016 19:20:00 Z{FD6927B3-8796-44DA-976C-3C06FC5CF4D4}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/the-supportive-sideThe Supportive Side<p>Often times when people think about NASA, they see visions of the 69’ moon landing and astronauts drinking tang in large space suits; when, in fact, there is a lot more behind the scenes that goes into a space mission than most people would ever think.</p> <p>My name is Sandra Milescu, and I am the newest member of the Kacena laboratory team. I am the research support assistant, and I work on much of the backstage coordination for the upcoming mission.</p> <p>A lot of planning and preparation goes into a mission of this capacity. Supplies are ordered months ahead of time in copious quantities and often at staggering costs. For this reason, a lot of funding and donations go into helping support an undertaking this significant.</p> <p>The team will all be present at the NASA space station in Florida for the flight. Travels plans will be made for the team of close to a dozen students and faculty, and arrangements will be made for lodging and transportation for all. This may seem like a relatively simple task, but taking into account all the documents and paperwork needed for NASA clearance, it can easily turn this endeavor into quite an arduous task.</p> <p>While my position has its challenges, I can’t think of anywhere I would rather work. I am a part of something so very important and am excited to think of the wonderful possibilities our work can impact on our world.</p> <p> </p> <p>Written by Sandra Milescu</p> <p></p> Fri, 29 Jan 2016 17:27:00 Z{537C2398-2814-4927-AAF9-6099888B1A80}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/introducing-our-newest-team-memberIntroducing our newest team member<p>Hey Everyone! Happy New Year!</p> <p>My name is Austin Wininger. I am a first year medical student at the IUSM Indianapolis campus. I am from Northern California and received a B.S. in biochemistry from UCLA this past June. I am eager to begin orthopedic research in bone healing, as orthopedic surgery has always been an interest of mine. For as long as I can remember, I have been a sports fan. My favorite sport is baseball – I was even on the high school team. Once college started, I discovered my aptitude for chemistry and biology. Since I enjoy interacting with people, I thought the best way to combine my love for sports and science was to go to medical school.</p> <p>During my last year at UCLA, I began my first research experience in a gene therapy lab that targeted the arginase gene. As I progressed through this research project, I began to really understand the clinical implications of my research and how my cell-based work related to patients. Working in Dr. Kacena’s lab is the perfect opportunity for me to continue exploring research and learn new lab techniques. I hope that the next couple years of medical school and research will help me better understand the process of hypothesizing a novel medical idea and testing the clinical application of the idea in a lab.</p> <p>As I look through Dr. Kacena’s research focuses, I am interested in the cell-based work involving megakaryocyte growth factors and bone healing. The implications of this research could completely change the way surgeons repair large segmental bone defects, while eliminating the use of BMP and the associated increased risk of developing cancer.</p> <p>I am excited to have started in Kacena’s lab this month and to learn more about the orthopedic research world.</p> <p></p> <p> </p> <p>Written by Austin Wininger</p> Tue, 19 Jan 2016 17:20:00 Z{27426CE3-2B6B-409D-B007-48CAC5F835F1}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/the-blank-slate-part-2-shes-making-a-list-and-checking-it-twice-can-you-tell-i-am-working-on-this-during-the-holidaysThe Blank Slate Part 2: She’s making a list and checking it twice (can you tell I am working on this during the holidays?!?!)<p>Continuing on with the process of building the labs and offices from scratch….</p> <p>As you can imagine the excel spreadsheet we have to document all of these items is enormous. It is called the PSRD or the <strong>P</strong>ayload <strong>S</strong>upport <strong>R</strong>equirements <strong>D</strong>ocument. It is an official document that goes to NASA and is approved. It is difficult, but not impossible (I am told) to add items after the document is approved. Unfortunately, if we get down to Florida and realize we are missing items, I cannot simply go to the store and buy them.</p> <p>With the list of equipment somewhat complete, one would think we are almost done. Not so, now we need to “check it twice” and think about things like: Who will pay for which items (NASA, DOD, IU, CASIS, etc.)? Who places the orders? How, when and where to schedule the deliveries? Also, any potentially hazardous materials being delivered need to be identified so they can be handled safely (such as our x-ray machine and tissue fixative solution).</p> <p>There are three people from NASA that are primarily helping with this task, two doctoral scientists and one veterinarian technician. I am the main person from our team going over the list but have enlisted four people from my team to help check and double check the items as well as two people from the DOD and one person from Johnson Space Center. We started the list in August and have made a number of edits. I have personally spent 40+ hours working on it during the holiday break, when most people are spending time with their families (yes, the sad reality of meeting the constant deadlines – I have never worked so hard in my life as I have been working to prepare for this spaceflight mission), and yet it is still not complete.</p> <p>I have just sent a revised list with a number of questions out to all parties for comments and clarifications. I think we are finally getting close on the list and will need to get approval soon. We must have our approvals no later than early February because some items require at least 120 days to obtain prior to the mission.</p> <p></p> <p> </p> <p>Written by Melissa Kacena</p> Tue, 12 Jan 2016 17:50:00 Z{5D96D2B0-3397-4AEF-95C2-DC576BF6D28E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/the-blank-slate-part-1The Blank Slate Part 1<p><strong>The Blank Slate Part I</strong></p> <p> I am sure many of you have thought it would be great to have a blank slate to which you add whatever you want. Or perhaps you have already gone through this process when building a home or starting with an empty commercial space and filling it with your business. You need to think of everything you must add to those 4 walls, ceiling, and floor to make the space work for your particular needs. This is exactly what we are doing now with help from NASA personnel.</p> <p>When we go to Kennedy Space Center, we will need standard laboratory space (termed wet lab space), regular office space, and appropriate animal facilities. We start with these 3 areas, and we have to think of every item we will need in these empty spaces for our duration (estimated at up to 4 months, see our future blog which will describe the updated timeline).</p> <p>For the office space, these needs include how many and which brand, size and/or color we need of the following tools: phones, computers, printers, staplers, staples, hole punch, pens, pencils, pads of paper, chairs, desks, trash cans and bags</p> <p>All of these things need to be identified with a unique vendor and catalog number.</p> <p>Other questions keep popping up too. “Is there wireless? And, if so, who gets access? What security measures do we need to consider when corresponding?”</p> <p>In the wet lab, we need to have tables, adjustable height chairs, sterile hoods, chemical fume hoods, sinks, trash cans, special collection containers for different kinds of waste, lights, centrifuges, balances/scales, tubes, racks to hold tubes, special lab tape and pens to write on the lab tape, and everything else that we will need access to for preparing for the spaceflight or for collection of tissues/samples.</p> <p>We also need cages for the mice, food and water, all of the items required for surgery, all of the PPE or <strong>P</strong>ersonal <strong>P</strong>rotection <strong>E</strong>quipment that protects us from the mice and while also keeping the mice “clean” so that we don’t accidentally introduce something into spaceflight which could infect the astronauts. We will be in a clean room type facility and will be wearing “bunny suits.” We need to list the sizes of all of the personnel to ensure the proper fit of the PPE.</p> <p>We can’t forget about the astronauts either. We need to request all of the required spaceflight hardware and all the instruments the astronauts will need access to in order to complete our studies. As you can imagine this list is very long…..and as this blog is also getting very long, I thought we should continue it next week.</p> <p>Written by Melissa Kacena</p> <p> </p> <p>Image courtesy of sumetho at FreeDigitalPhotos.net</p> Fri, 08 Jan 2016 19:01:00 Z{16CA1CEF-C569-49A3-9E43-AF3AEAEBA80D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/happy-thanksgivingHappy Thanksgiving!<p></p> <p>It is that time of year when we pause to appreciate what we have – family, friends, health.</p> <p>Our unique partnership with NASA is a gift. A gift of experience and hope. Hope for cures, treatments and long-term space travel.</p> <p>I know I speak for my team as well when I say that we are very grateful for this research opportunity. And we are all grateful for you and your support. Without the support of our community, these research missions could not happen.</p> <p>So, in the spirit of the season, thank you. Thank you for your financial support. Thank you for reading our blogs. Thank you for learning about and sharing our research.</p> <p>We are thankful.</p> <p>Have a wonderful Thanksgiving!</p> <p>Melissa Kacena</p> Wed, 25 Nov 2015 15:31:00 Z{B2F102D5-AEC0-4FB8-BD36-090F2C03A605}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/famous-hoosiers-in-space-part-2Famous Hoosiers in Space: Part 2<table border="0" cellpadding="10"> <tbody> <tr> <td> <p><span>Neil Armstrong</span></p> <p> <p><span> </span></p> <p><span>Members of the Apollo 1 crew in training. Gus Grissom, Edward White, and Roger Chaffee were all killed on January 27, 1967, when a fire broke out in their capsule during testing.</span></td> <td><span>While there are 30 astronauts with Hoosier ties, I want to concentrate on two of our most noteworthy: Neil Armstrong and Gus Grissom.</span><p> <p><span>Neil Alden Armstrong, graduated from Purdue University with a degree in aeronautical engineering after serving in the U.S. Navy during the Korean War. Armstrong was the first man to walk on the moon in 1969, uttering the phrase we all know well: “That’s one small step for man, one giant leap for mankind.” As Dr. Kacena is an adjunct professor in the Biomedical Engineering department at Purdue University, we in the lab take particular pride in both our Indiana University and Purdue University-educated astronauts.</span></p> <p><span>Another famous Hoosier in space, Virgil I. “Gus” Grissom, was born and raised in Indiana. Also a graduate of Purdue, Grissom was the second American ever to go to space, and the first to travel there twice. Grissom was one of seven test pilots selected from 110 military pilots invited by the government to learn about space exploration. After passing all the physical and psychological examinations, Grissomwas selected as an astronaut for Project Mercury. Grissom flew two missions for NASA and was tragically killed in the Apollo spacecraft flash fire during a launch test at Kennedy Space Center. Today, in his hometown of Mitchell, Indiana, there is a museum in his honor that houses his old spacesuit, gloves, and helmet. Girssom received a posthumous Congressional Space Medal Honor for his work.</span></td> </tr> </tbody> </table> <p><span>Written by: Kishan</span></p> <p> </p> <p>References:</p> <p>“Astronaut Bio: Neil A. Armstrong.” <em>Astronaut Bio: Neil A. Armstrong</em>. National Aeronautics and Space Administration, 08/2012. Web. 03 June 2015.<br> “Astronaut Bio: Virgil I. Grissom.” <em>Astronaut Bio: Virgil I. Grissom</em>. National Aeronautics and Space Administration, 09/1997. Web. 03 June 2015.</p> Thu, 12 Nov 2015 13:07:00 Z{33810DAE-C113-401B-A3A5-D67E2C1ECAB8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/larc-to-the-rescueLARC to the rescue!<table border="0" cellpadding="10"> <tbody> <tr> <td align="left" valign="top"> <p> <p> </p> <p></p> <p><span><span>Kari McClimon</span> pictured left and <span>Courtney Rasbach </span>right.</span></td> <td><span><em>Today we have two special guest bloggers: Kari McClimon and Courtney Rasbach. As registered veterinary technicians here at the Indiana University School of Medicine Laboratory Animal Research Center (LARC), they provide a unique role in our spaceflight study. </em></span><p> <p><span>As background, NASA is all about triple redundancy. For example, there must be three levels of containment for any samples (so if one fails it won’t leak and cause problems, etc.). Therefore, our mice need triple animal identification. The primary means of animal identification is a microchip implanted into the mouse (similar to those in pets). We also punch their ears so we can easily and quickly identify the mice.</span></p> <p><span>Our third identification means has been a little more challenging. For some of our studies, we know the astronauts don’t care that this is mouse 36 out of 40, but they do care that the mouse is from group one, two, three or four (our four different experimental groups). They also want to be able to make that identification quickly as they only are allowed to work 6.5 hours each day. In order to quickly and easily identify these four groups of mice, we proposed to NASA that we would tattoo the mouse tail with either one, two, three or four lines.</span></p> <p><span>In past NASA experiments, tail tattooing had been done but only by the mouse vendors who were experts at tattooing and “approved” by NASA. Since we wanted to do the tattooing ourselves, we needed to show that we were proficient at the process and that the tail tattoos would be easily identifiable by astronauts.</span></p> <p><span>As I do not have a tattoo or have never tried to tattoo anything, this was certainly a new experience for me. Fortunately, our lead veterinarian and colleague at IUSM, Debra Hickman, DVM, MS, DACLAM, DACAW, introduced us to Kari and Courtney – LARC’s in-house tattoo experts. </span></p> <p><span>Before training started, Kari and Courtney advised us on the best tools to purchase as well as the best inks that would be visible on the mice – especially for the black mice. We ended up purchasing yellow, red, blue green and voodoo black ink as our most likely candidates. Once our ink and tattoo equipment arrived, “tail tattoo” training began.</span></p> <p><span>Initially, Kari and Courtney had us practice on oranges. Once we became experts on the oranges (some of my students could have a second career as tattoo artist if the medical school gig doesn’t work out – as one made a fantastic eagle design which I brought home to show my kids), we moved to testing our skills on mouse carcasses (mice that had been euthanized from other experiments). Finally, we tested our techniques on live mice who were under anesthetic for surgery. We tested all of the colors and found that voodoo black was the best ink, lasting up to six weeks.</span></p> <p><span>When we were at NASA Ames, we used our voodoo black ink and created the tattoos on the mice as we had in Indiana. Two days after surgery, we had the astronaut trainer examine our tattoos, and she approved them as easily identifiable by the astronauts. The mice were again examined 4 weeks later (the maximum time of our spaceflight study) and deemed successful.</span></p> <p><span>There is now a new mouse tail tattoo identification method that NASA would allow for not only our studies but for future investigators as well.</span></p> <p><span>So we have confirmed another critical aspect of our spaceflight mission with much thanks to both Kari and Courtney for their expert training and advice. Here are a few of their comments about their role in our success to date.</span></p> <p><span><em>“When venturing into the training role, I never imagined how greatly LARC would impact others. I knew training would play a vital role in one’s experiment such as the Kacena lab, but have learned over time, that the training has extended and reached others beyond the labs we teach at our institution.  I think highly of NASA, respect and appreciate its work in how it helps others in the general public and scientific community.”  </em>Kari McClimon </span></p> <p><span><em>“When Kari first asked me to help in teaching the Kacena lab how to tattoo their mice, I figured this would only go as far as helping the lab to keep track of their mice through a particular phase of their study; I had no idea just how far our impact would go. First off, it was great to work with the entire Kacena lab. They were very eager to learn and listened to us thoroughly through the instruction time. When training was done, it was a great feeling to walk away knowing that I just taught the lab a new skill they did not know previously. For me, it is always a great feeling to share my knowledge and help others better their skills. So, when I got the news that our training was able to impact far beyond just the lab and their immediate study it was the greatest feeling. I respect all that NASA and the Kacena lab is achieving and I am honored to be a part of an organization like LARC, which has allowed me to make a seemingly minimal yet remarkable impact in the work that is being achieved here today. I look forward to continuing to share my knowledge and skills to help better the research and impact labs or organizations for the future.”</em> Courtney Rasbach</span></td> </tr> </tbody> </table> <p><span>Written by Melissa Kacena with Kari McClimon and Courtney Rasbach</span></p> Fri, 23 Oct 2015 17:55:00 Z{A12BA8A9-6DA2-4231-AFAC-9E2292EA637D}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/launch-simulation-testingLaunch Simulation Testing<p><strong>By: Melissa Kacena</strong></p> <p>In addition to participating in the Technical Interface Meeting at NASA Ames with my DOD colleagues, we had one other very important reason for traveling to sunny California…..conducting launch simulation testing.</p> <p>As we have been developing our protocols for the spaceflight, NASA scientists raised concerns as to whether the surgical procedure could withstand the significant g-forces and vibration associated with launch. While our team, including orthopaedic surgeons, believed our surgery would withstand the launch conditions we needed to prove this to be the case.</p> <p>In addition, we decided to test two sizes of defects in the femur (2 mm and 4 mm defect). We thought the smaller defect size may be more stable than the 4 mm defect. These questions and these possibilities led to the need to conduct launch simulation testing at NASA Ames.</p> <p>NASA Ames has a vibration table and centrifuge that have been programmed to mimic the SpaceX launch conditions (in future blogs we will discuss these in more detail). We also used this opportunity to complete a “dry run” of what we will be doing at the Kennedy Space Center when we conduct our true spaceflight studies. Thus, to complete this “dry run,” I needed to fly out the whole team. There were 12 of us in total.</p> <p>Future blogs will discuss more about the great learning experience my team had as well as the successes we achieved. Without completely spoiling things……we are still on track for our Journey to Space.</p> <p> </p> <div> <hr size="1"> </div> Thu, 27 Aug 2015 13:50:00 Z{FC455131-D353-4E48-BC3E-75A3B017C421}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/space-fogSpace Fog<table border="0" cellpadding="20"> <tbody> <tr> <td></td> <td><span>Scientific and surgical procedures on Earth are difficult enough. Imagine trying to carry out a long process of fine motor tasks while you feel weightless, groggy and upside down. </span><p> <p><span>A big obstacle to translating scientific studies from Earth to outer space is planning for “space stupids,” or “space fogs.” These terms refer to the feelings of reduced cognitive ability and disorientation that astronauts often experience once they are in orbit. The effects can become severe, leading to vomiting and mood swings. </span></p> <p><span>The main cause for this condition isn’t precisely known, but it is thought that the symptoms begin with the sharp transitions in gravity before, during, and after launch. It may be possible that radiation exposure amplifies the symptoms. Once the “space fog” has set in, it is very similar to Sopite syndrome, a motion-induced drowsiness.</span></p> <p><span>Testing our novel bone-healing agent in space requires the astronauts to carry out several time-dependent interactions with mice. In the lab on Earth, we have planned for the equipment and containment the astronauts use, but we also have to try to adjust for the unique mental strains of working with space fog. The astronauts can work each day for about 6.5 hours. </span></p> <p><span>On Earth, some of the tasks for collecting data on our bone-healing agent take less than five minutes. In space, the same tasks may take the astronauts more than an hour, due to the instrumentation required and the intermittent rest needed to relieve the effects of space fog. We have to plan the timing for our experimental procedures such that neither the data nor the astronauts are put at risk.</span></p> <p><span>In addition to the clinical impacts of understanding our bone-healing agent in a microgravity environment, our study may build knowledge on working with space fog, and serve to improve future studies with rodents in space. </span></td> </tr> </tbody> </table> <p><span>Written by David</span></p> Fri, 14 Aug 2015 11:09:00 Z{2AD16503-3C2C-4B58-8E42-7847B6407F0A}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/ground-control-studies-at-nasa-ames-in-augustGround Control Studies at NASA Ames in August<p>During a space flight mission high acceleration and g-forces pose as threats to the cargo on board the spacecraft.  These forces are the most powerful during the launch and reentry of the mission.  The forces aboard the craft need to be taken into careful consideration when flying delicate material such as circuitry or in our case live mice.</p> <p>For our experiment we will be using SpaceX’s Falcon 9 rocket with the dragon capsule.  The launch consists of two stages.  Stage one involves the initial firing of the nine merlin engines situated at the base of the rocket in an 8+1 configuration.  These engines produce a staggering 1.3 million pounds of thrust at maximum power which translates into 4.5g’s, or about the same amount of force experienced by the driver of a top fuel dragster during peak acceleration.  These high forces in combination with intense vibrations from the launch present several threats to our experiments.</p> <p>The largest threat is damage to the surgical sites in the mice. Femurs in the mice that have undergone surgery on the ground are especially susceptible to damage caused by the launch.  Further damage to the sites may cause healing to be delayed and thus skew any results derived from the experiment.</p> <p>In order to better understand the risks associated with the harsh nature of a space launch, we will be conducting several ground control studies at NASA AMES testing facility the week of August 17, 2015. These studies will give us an accurate way to test the actual effects of the g-forces and vibrations on our mice and identify the best method for the space flight. The results of this testing will give us a clearer idea of what to expect during this mission and allow for fine tuning of our techniques.</p> <p> </p> Wed, 08 Jul 2015 18:49:00 Z{5FC65678-305A-4243-A185-416E48EB7CD8}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/seeking-a-better-bone-regeneration-therapySeeking a Better Bone Regeneration Therapy<p><span>There are very few tissues in the body capable of completely regenerating themselves without leaving a scar – the skeleton is one of them. However, the regenerative potential has limitations. Bone loss of more than just a couple centimeters,impacts the body to the point that regeneration cannot occur without treatment using a bone graft and/or bone-growth agents. The best bone graft is recovered from the patients themselves, but this is not possible in most cases. For instance, a soldier who has multiple sites of skeletal damage from an explosion will not have enough healthy bone available for the graft. To help the body heal without using a bone graft, bone morphogenetic proteins (BMPs) have been used. Unfortunately, these powerful agents have known side-effects; including a risk of inducing cancer and causing unwanted bone growth. </span></p> <p><span>The Kacena Lab at the Indiana University School of Medicine is trying a different tactic to help the body heal. We are stimulating a cell found throughout the body, known as a megakaryocyte (MK). These cells make platelets which are widely known for their blood clotting abilities. What is less known about platelets is that they also contain growth factors which set the stage for healing nearly all wounds, including fractures. To stimulate these MK cells we use a growth factor called thrombopoietin  (TPO). This is different than using BMPs which primarily stimulate bone forming cells; we are attempting to use TPO to stimulate the activity of MKs that will, in turn, stimulate many cell types in the body that perform many functions. Think of repairing a house after a natural disaster. BMPs focus on rebuilding the walls. But, TPO focuses on more aspects of repair such as removing damaged parts (bone pieces, dead tissue), repairing the plumbing (the blood vessels), and rebuilding the walls.</span></p> <p> </p> <p><em>written by Paul</em></p> <p> </p> <p>Carragee EJ, Hurwitz EL, Weiner BK. A critical review of recombinant human bone morphogenetic protein-2 trials in spinal surgery: emerging safety concerns and lessons learned. Spine J. 2011;11(6):471-491.<br> Carragee EJ, Chu G, Rohatgi R, et al. Cancer risk after use of recombinant bone morphogenetic protein-2 for spinal arthrodesis. J  Bone Joint Surg  Am. 2013;95(17):1537-1545.</p> Wed, 06 May 2015 16:02:00 Z{4AF13624-19E0-46AF-8339-E0A020DDD117}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/it-takes-a-village-aka-our-teamIt Takes a Village: AKA Our Team<p><span>I am sure everyone has heard the saying “It takes a village to….”. Well, that is also the case with research and especially spaceflight research. There are a number of people from multiple institutions involved – Indiana University, Department of Defense (Army), NASA and CASIS (integrate spaceflight opportunities between NASA and other institutions/companies etc), and within Indiana University, there are many faculty members, staff members and trainees that are critical to the success of our mission. </span></p> <p><span>The main faculty members working with me on this exciting project add a dynamic range of expertise to our research: Todd McKinley,MD, an orthopaedic trauma surgeon; Tien-Min “Gabriel” Chu, DDS, PhD, a dentist and tissue engineer; Stuart Warden, PT, PhD, a physical therapist; Yinghua Cheng, MD, PhD, an orthopaedic surgeon that has been working closely with me for seven years; and Marta Alvarez, DDS, PhD, a dentist and molecular biologist.</span></p> <p><span>Additionally, my lab is staffed with some amazing talent: Paul Childress, PhD, postdoctoral fellow; David Olivos, PhD, postdoctoral fellow; Evan Himes, MS, lab technician extraordinaire; Cathy Summerlot, administrative support; Aamir Tucker, undergraduate student; Jane Han, medical student; Kishan Shah, medical student; David Scofield, medical student; Jeff Rytlewski, medical student; and Jonathan Harris, MD, orthopaedic resident.</span></p> <p><span></span></p> <p><span>                               Bottom row Left to Right: David Scofield, David Olivos, Andrew Engle, Jeff Rytlewski and Jane Han<br> Middle row left to right: Cathy Summerlot, Aamir Tucker, Paul Childress, Melissa Kacena<br> Back row left to right: Evan Himes, Kishan Shah and Marta Alvarez</span></p> <p><span>Each individual brings with him/her specific skills and training which is critical in accomplishing our objectives. I want to take the opportunity to thank each of my current team members as well as my past team members for their many and varied contributions! Also, I am taking this opportunity to introduce our team as you will see their names in future blogs and possibly even meet them. Several will be joining us as we head to the NASA Ames Research Center to complete launch simulation studies and when we go to Kennedy Space Center to prepare our payloads for spaceflight. We will be blogging about those adventures as they occur, so be sure to check back in July and February for those blog posts or subscribe to our blog alerts!</span></p> <p><span>As you can see, I am fortunate this research has the support of many professionals – and just like our research, this blog “takes a village” as well.</span></p> <p> </p> <p><span><span><em>written by Melissa</em></span><br> </span></p> Mon, 04 May 2015 14:43:00 Z{E809C783-89E6-4FE2-87DC-8628DF36D72E}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/space-meets-bone-dr-kacenas-journeySpace Meets Bone – Dr. Kacena’s Journey<p></p> <p> </p> <p><span>While I am currently an associate professor of orthopaedic surgery at the IU School of Medicine, many people are surprised to hear that my education (B.S., M.S., and Ph.D.) is all in Aerospace Engineering from the University of Colorado (CU). I had a very unique opportunity as a student. I worked at BioServe Space Technologies developing spaceflight hardware for biologic applications. As an undergraduate and for my master’s degree, I studied bacterial growth in spaceflight and other gravitational environments. </span></p> <p> </p> <p><span>During my training, my doctoral advisor, Dr. Marvin Luttges, unexpectedly died from a heart attack. Soon after this tragedy,  I met Dr. William Landis (then at Harvard Medical School) at the American Society for Gravitational and Space Biology meeting. Dr. Landis (right in photo) invited me to work with him to finish up my doctoral studies by examining bone loss in spaceflight. Together with my new thesis advisor, Dr. Paul Todd, we created a new research program, and I moved to Boston to learn about bone. </span></p> <p> </p> <p><span>During my graduate studies, my experiments flew on seven Space Shuttle missions and also on Space Station MIR. You can view the manuscripts we published on spaceflight and gravitational studies on the mission website at www.orthopaedics.medicine.iu.edu/Kacena/BoneHealinginSpace. After earning my Ph.D., I continued studying bone and completed a postdoctoral fellowship at Yale University School of Medicine in Orthopaedics. </span></p> <p> </p> <p><span>Today, I am still conducting bone research and had thought my days of studying spaceflight effects on bone were over. Fortunately, what I thought of as a once in a lifetime experience is actually now a twice in a lifetime opportunity, and I could not be more excited. Spaceflight experiments are what initially made me love science, and I look forward to sharing this unique opportunity with my students in hopes that they too will fall in love with science and research.</span></p> <p><span> </span></p> <p><span><em>Photo caption: Dr. Kacena, center; her husband, Gregg Merrell – left; and Dr. Landis, right, celebrating Dr. Kacena’s thesis defense in 1999.</em></span></p> <p> </p> <p><span><em><span>written by Melissa</span><br> </em></span></p> Mon, 27 Apr 2015 16:00:00 Z{BD2074FD-8E49-460E-9F6D-E4F6CA2F9580}https://nicunest.medicine.iu.edu/sitecore/content/iu/iu-som/home/blogs/bone-healing-in-space/new-partnerships-new-opportunities-melissa-kacena-ph-dNew Partnerships, New Opportunities – Melissa Kacena, Ph.D.<p><strong>By: Melissa Kacena</strong></p> <p><span>The first question I often get asked about this project is how the IU School of MEdicine Department of Orthopaedic Surgery, NASA and the Department of Defense started collaborating on bone healing in spaceflight. My answer is usually one word, “spark.”  </span></p> <p><span>It started in August 2013, with a chance meeting at a Department of Defense conference. During one of the conference breaks, I met Dr. Rasha Hammamieh, a U.S. Army researcher. We quickly realized our mutual interest and experience with bone healing and space flight. </span></p> <p><span>Dr. Hammamieh was already working with NASA and wanted to expand her research to examine bone healing in spaceflight and apply her techniques to understand the changes in bone healing progression with the lack of weight bearing on the skeleton (think astronauts in space). I told her about my past work with NASA during my graduate studies and my current bone research, and thus the collaboration began. </span></p> <p><span>As sometimes happens in life, this chance meeting sparked an exciting new research direction in our laboratory and we invite you to come along!</span></p> Mon, 20 Apr 2015 15:57:00 Z