2008 Maryland Magazine by University of Maryland, Baltimore

university of

MARYLAND baltimore

Making An Impact Worldwide research and scholarship | 2008 f o r a l u m n i a n d f r i e n d s o f t h e m e d i c a l , l a w, d e n ta l , p h a r m a c y, n u r s i n g , g r a d uat e , s o c i a l w o r k , a n d p u b l i c h e a lt h s c h o o l s

P R E S I DE N T ’S M E S S AG E

“How wonderful it is that nobody needs to wait a single moment before starting to improve the world.” —ANNE FRANK

t the University of Maryland, Baltimore (UMB), thousands of these moments occur every day—in classrooms, clinics, labs, and conference rooms across campus, at sites throughout the state, and in places around the globe. Improving the world—or “Making An Impact Worldwide,” the theme of our newly launched $650 million capital campaign—is the promise that drives our faculty, students, researchers, and partners to excel. Our capital campaign is all about accelerating our work in the world: Whether we are providing HIV/AIDS care to patients in campus clinics or in Kenya, teaching pharmacy students in Baltimore or Shady Grove, or working for justice in Baltimore or South Africa, the work of UMB faculty, researchers, and students gives expression to our highest aspirations. In this issue of Maryland magazine, you can read about the revolution in reducing infant mortality in India, improving the lives of children in Maryland, and the dramatic advances in recovery for post-stroke patients. Included are features on the UMB BioPark, which opened its second building last year, and the Center for Health and Homeland Security, which is now training emergency responders around the country. Along with highlighting the groundbreaking research done at UMB, we feature six of our top students whose focus is in the international arena. Collaboration is what drives much of the work at UMB, and collaboration in every sense remains essential to our success. On our professional campus, state funding covers less than 20 percent of our operating budget. Quite simply, without your help, we would not be able to operate, let alone achieve the excellence in education, research, patient care, and community service that has been our hallmark for the past 200 years. Your generous contributions to our scholarship funds, endowed chairs, programs, and capital projects ensure that UMB will continue to make an impact worldwide. Tomorrow’s dentists, lawyers, physicians, nurses, pharmacists, and social workers all benefit directly from the support of our alumni and friends. Our capital campaign is about more than raising dollars for student scholarships, research funds, and new buildings. A successful capital campaign will position UMB as one of the top research universities in the world, setting the standard for interdisciplinary collaboration in critical health and social issues. I invite you to help us continue our work to transform lives with the impact we make around the world.

Sincerely,

David J. Ramsay, DM, DPhil President drramsay@umaryland.edu

university of

MARYLAND baltimore r e s e a rch and scholarship | 2 0 0 8

F EATU RE S

STU D E NT P RO F IL E S

LAW BRIGID RYAN

MEDICINE K EV IN LUNNEY

SOCIAL WORK RO SA ALVAYE RO

D E NTAL LA E LAYE SHIMELES

NURSING AMY HSIEH

PHARMACY MASAYO SATO

D E PA RTM E NTS

P RO F ILES IN GIVING

FOUND E RS WEEK AWA RD WINNERS

UNI V E RS ITY LEA D E RS HIP

RE S EA RCH & DEVELO PM E NT

UM BF ANNUAL RE PO RT

This (World) Court is in Session

Before an Emergency, CHHS Comes to the Rescue

An Infant Revolution in India

Saving Marylandâ&#x20AC;&#x2122;s Children

Dental School Researchers Lead Efforts to Eradicate Noma

New Hope for Stroke Victims

Training Nurses to Treat HIV Overseas

Collaboration is Key for New Dean

Te a m w o rk is Right Prescription for Thailand and School of Pharmacy

Treating Trauma Along the Nile

C a r rying a Global Torch at the Dental School

The UMB BioPark: A Five-Year Perspective

University of Ma ryland, Baltimore Celebrates 200 Years

UMB Launches $650 Million Capital Campaign

The bicentennial edition of Maryland magazine won a national PR News Platinum PR Award for best external publication and was recognized as an outstanding public relations effort.

COVER PHOTOGRAPH BY DAN WHIPPS ILLUSTRATION THIS PAGE BY EMERY PAJER

This (World) Cou WORLDWIDE

ROBIN CLARK

Law Reform Commission Sydney, Australia

MICHAEL VAN ALSTINE

Associate Dean and Director, International and Comparative Law Program University of Maryland School of Law Baltimore, Maryland, USA

U N I V E R S I T Y O F M A R Y L A N D, B A L T I M O R E

Court is in Session B Y LO R I R OM E R

Donating more than 100,000 hours of legal resources eve ry year, the School of Law proudly calls itself “Maryland’s largest public interest law firm.” But its outreach far exceeds the state’s borders. With a reputation for taking on important legal issues locally, regionally, and nationally, the School is expanding its take on the world—and its students are better for it.

“W

JESSICA GEORGE

Women’s Legal Centre and Legal Aid Board Cape Town, South Africa

e have a fairly large number of students who are very interested in the world outside us and want to experience it,” says William Reynolds, JD, professor at the School of Law and coordinator of the Law Reform Commission Program. Toward that end, each year 30 to 40 students live, work, and learn about public interest law in Costa Rica, England, Ireland, Switzerland, South Africa, and Australia. They return to the School from their time abroad with a new outlook and a new sense of advocacy. “They’re more confident and more experienced in the world and how the world operates,” says Diane Hoffmann, JD, MS, who helps coordinate the World Health Organization (WHO) externship program as associate dean for academic programs and director of the Law and Health Care Program. “T h e y’re viewing things from a different vantage point and learning that the United States is just one WHO member among many.” Students call the experience invaluable and in some cases career-changing. Jennifer Martin, who graduated in May 2007 and now works at the University of Maryland Center for Health and Homeland Security (CHHS), says her work in Geneva, Switzerland, for the WHO helped solidify her decision to pursue a career in the health policy field. “It was an excellent opportunity to see international diplomacy and cooperation on important public health issues,” says Martin. “The main project I worked on was an international public health law database that the WHO is putting together for its Web site.” She re s e a rched cases that deal with the right to health and public health issues. Also in Geneva working for the WHO, Irene Hui saw firsthand how policies are made on the international level during her summer at the Tobacco Free Initiative. “The best experience was attending a meeting of the Study Group on Tobacco Product Regulation in Kobe, Japan,” says Hui, a third-year law student who says she has always had an interest in health care. “It was incredible to see how the scientists inform the ambassadors on policy decisions in tobacco regulation to advance the public health and how the concerns of the different country representatives fuels f u rther research in particular areas. It was this exchange of ideas between the scientists and the regulators that was invaluable for me to see. “I always thought that problems on the international level we re different from those faced in the U.S.,” Hui adds, “but I realized that much of what those countries learned about tobacco regulation can inform policies in the U.S.” COURTING EXPANSION

Law school faculty see the expanding borders of public interest law as a logical next step. The increased focus on the public interest aspect of the international program is “a natural and necessary development for our law school because we are a public law school with a public mission,” says Michael Van Alstine, JD, MJurComp, DrJur, PHOTOGRAPHS BY ROBERT BURKE

2008

R E SE AR C H & S CH OL A R S H I P

professor and associate dean for research and faculty development. “We are committed to having our students confront, engage with, and have knowledge of, the public policy issues and the social problems that are experienced by real people in the real world, at both a national and international level.” As director of the International and Comparative Law Program, Van Alstine is responsible for the overall curriculum and its policy decisions. He credits Karen Rothenberg, JD, MPA, dean of the School, as the impetus for much of the program’s progress. “She has been directly involved in bringing about some of the programs, including the expansion of the Law Reform Commission Program,” he says. According to Van Alstine, the push to expand the public interest and public policy component of the international program really took off in 2003 when a committee was formed to review the program. He noted the law school’s extensive offerings for students to w o rk in public interest law in Baltimore, Annapolis, and Washington, D.C., and says “the natural progression of that work is that we understand we not only live in a city, a state, and a c o u n t ry, but a world as well.” Van Alstine adds: “When we started looking at our international program, top to bottom, there was something that immediately rose to the top of the agenda: the expansion of opportunities for our students to engage in public policy issues outside of the United States.” In addition to widening the students’ knowledge, it has also w o rked as a marketing tool. Martin says the WHO program is a big reason why she came to the School. She also wanted to see more of the world after her 2000-2002 stint in the Peace Corps working as a high school teacher in the Republic of Vanuatu in the South Pacific.

“I’ve always been interested in international health, and a college professor encouraged me to study international public interest law,” she says. “I knew about the program at the WHO prior to coming here, and it was one of the things that I thought was really interesting about the University of Ma ryland School of Law.” Van Alstine says the continued growth of the program will be helped substantially thanks to the establishment of the David S. Brown International Fellowship, which provides financial support for students. Baltimore real estate developer Howard Brown set up the program two years ago in memory of his father, David, class of 1933. “It’s rare among law schools to provide funding for student p a rticipation in public interest programs outside of the United States,” says Van Alstine. “Thanks to the generosity of Howard Brown and his family, we are able to provide substantial financial s u p p o rt to cover the students’ expenses.” How important was the financial support for Robin Clark, who graduated last May and spent a semester at the Law Reform Commission in Australia? “I simply wouldn’t have been able to go if it wasn’t for the fellowship,” she says. Adds Jessica George, who worked at the Women’s Legal Centre and the Legal Aid Board in South Africa in spring 2006, “It covered my airfare and housing costs for the four months I lived in Cape Town. It was certainly a critical factor in my decision to go to South Africa, and I urge any student considering the program to apply.”

JENNIFER MARTIN

IRENE HUI

Tobacco Free Initiative Geneva, Switzerland, and Kobe, Japan

U N I V E R S I T Y O F M A R Y L A N D, B A L T I M O R E

World Health Organization Geneva, Switzerland

Brown says the company his father founded, David S. Brown Enterprises, Ltd., has become known in Baltimore as one that g i ves back to the community. “I’m gratified to be able to remember my father at the institution where he received an outstanding legal education,” says Brown. “It’s important to support the work of these students as they learn about public interest law on the international stage.” Each semester, students are chosen for the fellowship based on their academic record and faculty references. When they return home, they present a re p o rthighlighting their experience. The re p o rts are published in the annual re p o rt of the David S. Brown International Fellows Program. Martin was still in Geneva when the inaugural class of Brown Fellows gave their presentation in fall 2006. She made a video that was shown at the event, in which she thanked the Brown family for its donation to the School and talked about her externship. “It was funny to return to Ma ryland in the spring and have first-year students recognize me as the woman from the video,” she says. LIFE ABROAD

C l a rk says the most surprising thing she learned during her semester at the Law Reform Commission in Australia is that “the world is watching us.” Commissions are independent organizations that analyze and make recommendations on the law. Students work in England, Australia, Ireland, and other countries comparing U.S. law to that of their host country. “I think it was about 2 a.m. Sydney time when the U.S. Supreme Court handed down its decision in Hamdan v. Rumsfeld, a landmark in the ongoing debate over the recent use of military commissions,” Clark says. “I stayed up to read the opinion, but only got through the opinion of the court. The next day, my team met with the advisory committee, which included several prominent Australian attorneys. In the reception afterw a rd, I was surprised to learn that the opinion had been read by several of those present. Luckily no one else had gotten to the dissents either! We had a wonderful discussion about the news.” During her stay in Australia, Clark developed a taste for “watching surfers, working on law reform, and eating fish and chips.” She is currently working as a law fellow for the CHHS. “I am also looking to return to Australia, after the end of my fellowship, for graduate re s e a rch on comparative anti-terrorism law,” she says. The most recent area of growth for the School of Law’s public interest law program is in Costa Rica with a partnership with the Inter-American Court of Human Rights. Students work as law c l e rks in the court that hears human rights cases from the Western Hemisphere. Sandra Goldberg, who plans to graduate in May and spent last summer in Costa Rica, was the first student to participate. Students who want to “be on the ground floor of early constitutional interpretation” also have that opportunity in South Africa, says Sherrilyn Ifill, JD, professor and coordinator of the externship. Since 1989, “even before apartheid ended,” notes Ifill, students in Maryland’s South Africa Externship Program have w o rked in public interest law organizations from Cape Town to PHOTOGRAPHS BY ROBERT BURKE

Durban, representing the poor and victims of the apartheid system of government. Since the mid-1990s when apartheid ended, externs have continued to serve in public interest law organizations, now working to ensure that the promise of democracy, equality, and civil rights enshrined in South Africa’s new constitution becomes a reality in the lives of those who continue to suffer the long-term impact of apartheid’s violently enforced system of racial segregation and subordination. Students’ work ranges from assisting with direct representation of clients at local legal aid offices to developing impact litigation and monitoring legislative developments on emerging areas of human rights law. Ifill says that students who are attracted to the program are already mature self-starters with “an intense interest in social justice.” “This is not for everybody,” says Ifill. “It’s not for the weak of h e a rt. You are going ve ry far away, you are not going to a dorm, and you are not in an academic program where you are in a classroom with a professor. You are in a job, working as a lawyer in South Africa.” For George, a semester in South Africa provided “a unique perspective on a young and struggling democracy.” “I’ve definitely learned to appreciate the laws and re l a t i ve efficiency of the U.S. legal system. I’ve also learned to appreciate living in a country where there is such opportunity for advancement. In Cape Town, I met many refugees who have fled other African nations. Many hold advanced degrees but find themselves selling handmade crafts on the streets. But they are relieved just to be living in a place with a functioning government, where there is peace,” George says. “Ab ove all, I learned that change takes time, and it’s impressive how much South Africa has accomplished in just 13 years of being a democracy,” she continues. “I learned that the most difficult challenge is not enacting legislation, but in changing attitudes at the ground level in communities across the country, in particular with regard to racial and gender discrimination.” Even though it’s been several years since her time in So u t h Africa, Erin Hahn ’02, who worked on the Legal Resources Centre’s Refugee Assistance project in Cape Town, has no pro blem recalling some of the realities about a country reborn after a p a rtheid and struggling with a tremendous surge of refugees. “I would go to the jail once a week to interv i ew any nonre s idents who had been picked up to see if they needed assistance and if they might be refugees,” says Hahn, now associate director of CHHS. “There were so many people. It became very overwhelming to deal with so many refugee cases, with so little in terms of resources and space,” she says. Hahn calls the semester a life-changing event. “The growth I experienced there, intellectually and otherwise, led to my decision to take on asylum cases here on a p ro bono basis.” Van Alstine wants even more students to have such life lessons by “carefully picking places around the world” to grow the program. “We are looking at more opportunities in Australia, and into New Zealand, India, Japan, and Turkey. The idea is to have broad diversity in terms of substance, geography, and the experience,” says Van Alstine. “We want students to understand and appreciate how law functions in societies outside the United States.”  2008

R E SE AR C H & S CH OL A R S H I P

S T U DE N T P R OF I L E

B R IG I D RYA N

S C H O O L O F L AW

From Bolivian Beehives to New Orleans Prisons, Law Student Builds a Better World BY L O RI R O M ER

rigid Ryan’s well-worn passport proudly bears the stamp of the School of Law. That is because this world traveller would not be the socially conscious advocate of the less fortunate she is today without her class work in a School committed to public service. “Over the last year,” she says, “I have become interested in criminal law because I see the growing prison population as a human rights issue.” Ryan says the School and its pro f e ssors have encouraged her work with underserved populations. Another fundamental reason for Ryan’s activism and concern for the less fortunate could be the fact that she is the daughter of civil rights lawyer Ma ry Ann Ryan, who graduated from the School of Law in 1988. “I believe that my mother dangled a spoon over my head when I was a baby and declared that I would be an attorney,” says Ryan with a laugh. A third-year student at the School, Ryan is a recipient of one of the Maryland Higher Education Commission’s inaugural William Donald Schaefer Scholarships, which provide

U N I V E R S I T Y OF M A R Y L A N D, B A LT I M O R E

support for state residents at state universities preparing for careers in public service. Her journey has taken her a long way from her hometown of Takoma Park, Md., with stops in Spain, Bolivia, Israel, South Africa, and New Orleans. Ryan, 27, was a key organizer in galvanizing dozens of law students to spend part of the January 2007 winter break working with the public defenders’ office in New Orleans. She had seen the devastation left by Hurricane Katrina firsthand, having volunteered at the office in the summer of 2006. The students interviewed defendants, many of whom had been in custody for months without access to a lawyer, and developed case files for the public defenders. Hundreds of students from law schools around the country joined the effort . Helping to rebuild New Orleans’ justice system was a natural follow-up to the years of 2002 through 2004 when Ryan worked on a beekeeping project with the Peace Corps in Presto, Bolivia. Ryan’s work and studies also have taken her to Madrid, Spain, for a semester at the University of Alcala, and a summer working as an archaeologist in Caesarea, Israel. More recently, she spent the spring semester of her second year in law school as a law clerk at the Legal Aid Board and the Legal Resources Centre in Cape Town, South Africa. “I took an interesting seminar on race and gender in South Africa, which led to my externship the next year,” says Ryan. “The course was a welcome departure from the rigid legal interpretations of other first-year courses because we looked at the law in context, rather than in a bubble.” Along with her family association with the School, Ryan came to Maryland “because of its commitment to community service and the fact that it is nearby to national policymaking organizations.” She wants to continue to work on international a n d human rights issues after graduation. “I love learning about how people around the world interpret and relate to the rule of law,” she says. 

PHOTOGRAPH BY TRACY BOYD

C E N TE R P R O F I L E

C E N T E R F OR H E A LT H A N D HOM E L A N D S EC U R I T Y

Before an Emergency, CHHS Comes to the Rescue B Y J U DY H E IG ER

CHHS law and policy analyst Joshua Easton, left, shared updates on emergency planning with Richard Hildreth when the City of Pacific mayor passed through BWI Airport last summer.

acing a catastrophic flood, City of Pacific, Washington, found higher ground with the help of the University of Ma ryland Center for Health and Homeland Security (CHHS). The training program orchestrated by CHHS arrived just in time. City of Pacific Mayor Richard Hildreth had attended a Continuity of Operations (COOP) planning course taught by Joshua Easton, JD, MA, a law and policy analyst at CHHS, at “Restoration 2006,” a conference focusing on rebuilding New Orleans after Hurricane Katrina. Following the conference, Hildreth decided to make changes to the boilerplate emergency plan his city had in place. To unify many separate plans, Hildreth completed a physical inve n t o ryof all assets, the capacity of staff and resources, and how to acquire any additional capacity needed through partnerships. Hildreth introduced a draft of the new plan to his City Council on Nov. 4, 2006. Two days later, City of Pacific experienced terrible floods and the COOP plan was activated. “If I hadn’t attended the course at Restoration 2006, I wouldn’t have realized how inadequate the emergency plan was that my city had at the time,” Hildreth says of the conference, where CHHS’ Alexandra Podolny, JD, and Catherine Napjus, JD, also served as COOP trainers. The mayor re p o rts that his city was able to strategically plan its response to the flood inside of 15 minutes because of the COOP plan. “We knew what we had, where we had it, what else was needed, and where we could go to get it,” Hildreth says. And because of COOP planning and training, 90 percent of the emergency response came from volunteers. City of Pacific is just one of the many beneficiaries of the CHHS program. Emergency planners across the country and beyond have gained direction in recent years from a program that has humble roots. In 2004, CHHS, in cooperation with

PHOTOGRAPH BY TRACY BOYD

the Ma ryland Emergency Management Agency, published a COOP manual, which details how to maintain essential s e rvices during an emergency. CHHS used it to assist Maryland Cabinet agencies and the governor’s office in writing COOP plans. The program’s effectiveness led to the award of a $1.4 million grant from the U.S. De p a rtment of Homeland Security (DHS) to CHHS in 2005 to develop a COOP curriculum and to test it in pilot programs. In 2007, the course was certified by DHS and the Federal Emergency Management Agency, who also gave CHHS an additional $650,000 grant. The purpose of the course is to provide government emergency planners with the skills to develop COOP plans for their jurisdictions and to train other state, local, and tribal personnel. Factors include delegation of authority, accessing vital records and databases, utilizing alternative facilities, and communications and training exercises. COOP planning is one of many projects for the 35-plus staff members of CHHS. They also are working on avian and pandemic flu preparedness, mass transit protection, and cyber security. A COOP plan for the Ma ryland court system also is under way. “The many requests for COOP training and the growth of the center is a tribute to the idea for CHHS, which originated with University President David Ramsay, in the wake of the terrorist attacks of Sept. 11, 2001,” says Michael Greenberger, JD, director of CHHS. On May 15, 2002, Ramsay’s vision became a reality with the official launch of CHHS. “As CHHS marks its fifth annive r s a ry, the staff continues to foster Dr. Ramsay’s original vision, searching for more opport unities to serve both governments and people in preventing and effectively responding to natural and man-made disasters,” Greenberger says.  2008

R E SE AR C H & S CH OL A R S H I P

INDIA Pinaki Panigrahi drew on a world of expertise to form his University of Maryland research team. From left: Hala Azzam (Lebanon), Gheorghe Braileanu (Romania), Olena Goddard (Ukraine), Dinesh Chandel (India), Hegang Chen (China), Pinaki Panigrahi (India), Adora Okogbule-Wonodi (Nigeria), and Judith Johnson (United States).

India

An Infant Revolution in B Y E LI Z A B E T H H E U B E CK

U N I V E R S I T Y O F M A R Y L A N D, B A L T I M O R E

PHOTOGRAPH BY ROBERT BURKE

are is the scientist who can thoughtfully approach a puzzle, solve it, and successfully apply the solution in a way that improves an entire population’s health. Rarer still is the scientist who does this in a community without a strong public health infrastructure and modern amenities. Pinaki Panigrahi, MD, PhD, associate professor of pediatrics at the University of Maryland School of Medicine’s Division of Neonatology, is one of those scientists. In 10 years, Panigrahi has addressed the high infant mortality rate (as measured in the first year of life) in India as a

major public health problem, identified its primary cause, and developed a practical solution that has reduced the infant death rate by 36 percent in targeted areas. Along the way, he has developed strong scientific collaborations in India. And it all started with a ve ry modest grant. When Panigrahi’s collaborative pediatric research with Indian scientists began in 1997, it was almost as an afterthought. The John E. Fogarty International Center for Advanced Studies in the Health Sciences, part of the National Institutes of Health (NIH), invited recipients of major grants to apply for much smaller, secondary grants of up to $30,000 for three years. The grants supported American researchers’ efforts to establish collaborations with developing countries. As a native of India who had received his medical training there, Panigrahi decided to make India the target of his grant request. He received the secondary grant, and the relationship between Panigrahi’s research team and the All India Institute of Medical Sciences, the premier medical school of India, was under way. “The grant was tiny, but that is really what started the whole thing,” Panigrahi says. Panigrahi then secured a second, much larger grant from the Global Network for Women’s and Children’s Health Re s e a rch, a public/private partnership supported by the National Institute of Child Health and Human Development (NICHD), a division of the NIH, and the Bill & Melinda Gates Foundation. These organizations allocated more than $3 million to the University of Maryland, Baltimore, while providing similar grants to seven other re s e a rch teams in the United States. The overall research objective was rather general: to conduct research that would improve maternal and children’s health in the developing world. But the grant did contain one ve ry specific caveat: Each of the eight research teams must be led by two investigators—one from an American institution and the other from an institution in a developing c o u n t ry. “T h e re was intense competition. Vi rtually eve ry major research group in the U.S. applied,” Panigrahi says. ZEROING IN ON THE CAUSE

Investigators already knew of the devastatingly high infant m o rtality rate in India. Sixty out of eve ry thousand infants die in India, compared to about seven per thousand in the U.S. They also knew that a large percentage of these deaths occur in the neonatal period, within the first 28 days of life. Just over half the neonatal deaths in India are due to sepsis, an infection produced by bacteria that, once in the bloodstream, can be fatal. Even though the statistics indicated a long-standing public 2008

R E SE AR C H & S CH OL A R S H I P

From left, a baby’s heart rate is checked in one of the 223 villages in Dr. Panigrahi’s study. Dr. Panigrahi checks records with an anganwadi worker. A pregnant mother, holding her older child, shows her 60-day follow-up card, which charts the nutrition and other data during her pregnancy.

health problem, little has been done over the last 20 years to address it. “India has a ve ry weak, or nonexistent, public health infrastructure,” Panigrahi says. Despite a glut of medical schools in India—more than 200, compared to about 115 in the U.S.—the country doesn’t have a single school of public health. The NICHD/Gates project allowed Panigrahi’s Indian research counterparts to see just how effective a well-constructed public health intervention can be. The first portion of the study relied on community-based surveillance, grassroots education, and the use of modern laboratory services to identify whether late or early sepsis was responsible for the high mortality rate among newborns. “T h e cause of early versus late sepsis infection is quite different, and unless we know when the babies are contracting infection and dying, there is no way we can propose a logical intervention,” Panigrahi says. Panigrahi chose the eastern Indian state of Orissa, where he selected 223 separate villages as the site of the community surveillance work. The painstakingly detailed job of record keeping began. Eve ry infant born in these 223 villages—about 20 eve ry year—was followed for the first 60 days of life. “Initially, I asked myself, ‘Who is going to tell me about the death rate?’ For every 10 to 25 villages, there is only one doctor who may not even stay in the rural area all the time. The government tries to keep track of infant deaths, but not in a precise way,” Panigrahi says. GRASSROOTS APPROACH TO EDUCATION

To track infants affected by sepsis, the investigators chose a grassroots-style approach. Panigrahi recruited trusted local villagers, known as anganwadi workers, to collect data. Typically, anganwadi workers educate women during pregnancy on the importance of appropriate nutrition, administer nutrients like folic acid, and provide education and nutritious meals for preschool children in their assigned villages. Offering 10

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

the anganwadi workers a small payment for their surveillance efforts, the researchers trained them to look for signs and symptoms of sepsis in infants. Investigators also encouraged the anganwadi workers to educate the village women to identify signs and symptoms of sepsis in their children. “You really have to educate the masses,” says Panigrahi. He explains that in circumstances such as these, when working primarily with women with little formal education who may not trust outsiders, finding the right people to convey the message becomes as important as the message itself. Judith Johnson, PhD, associate professor in the School of Medicine’s Department of Pathology, whose primary role was to set up and oversee the operation of U.S.-standard laboratories in several Orissa sites, says the anganwadi workers proved immensely helpful. “They used a combination of song and dance, sort of a cross between opera and a musical, to teach people about neonatal sepsis. It was ve ry effective in getting mothers interested,” Johnson says. For the surveillance portion of their work, the anganwadi workers were given a booklet describing signs and symptoms of sepsis and a newborn follow-up card to track the progress of the infants. If sepsis was detected, the anganwadi workers noted the symptoms and referred the infant to a pediatrician, providing another pivotal piece of the re s e a rch project. SOLVING THE SEPSIS PUZZLE

Prior to Panigrahi’s project, Orissa’s medical institutions did not have BACTEC blood culturing systems, which automatically and accurately detect and identify microorganisms present in the blood. “Here in the U.S., the tiniest hospital will have access to a standard pathology laboratory. In India, there are no such laboratories. It’s not part of the protocol to determine which bacteria are the root of the problem,” Panigrahi says, so the cause of an illness goes undetected or is treated inaccurately. Fortunately, the research team was able to supply the equipPHOTOGRAPHS COURTESY OF PINAKI PANIGRAHI

From left: on the street, an educational session about neonatal sepsis. Dr. Panigrahi examines a premature infant. Modern equipment was a welcome addition to this Indian lab.

ment to culture the blood samples. “For the first time in India, this community-based study on sepsis was backed by wellequipped laboratory services. Not only did it help us identify sepsis earlier, it helped us provide a guideline for treating sepsis using proper antibiotics,” says Panigrahi’s counterpart, Sailajanandan Parida, MD, FIAP, associate professor and head of the Division of Neonatology, De p a rtment of Pediatrics, at Sriram Chandra Bhanja Medical College. The combination of grassroots surveillance and modern l a b o r a t o ryequipment helped Panigrahi and his re s e a rch team conclude that late sepsis constitutes the bulk of neonatal sepsis cases in Orissa, about 94 percent. Unlike early sepsis, which d e velops within the first three days of life and is contracted either from the mother during birth or from someone assisting the delive ry process, late sepsis results from an environmentborne infection that travels via the infant’s colon through the immature stomach and into the bloodstream. “The results were extremely surprising. Everybody assumed that they weren’t using proper hygiene during deliveries,” Panigrahi says. More impressive than pinpointing the cause of infection were the lives saved because of it. “Due to Dr. Panigrahi’s study method of early identification and referral through the existing infrastructure of anganwadi w o rkers, more than 80 percent of neonatal deaths due to sepsis have been prevented in the study area. That same percentage would be reflected countrywide if implemented in a larger scale,” Parida says. After conducting the community study at two major sites in d i f f e rent parts of India and arriving at the same conclusion, Panigrahi and colleagues are confident that the results can be generalized to the entire country. MOVING BEYOND SURVEILLANCE

After determining that infants were being infected primarily with late sepsis, the team investigated low-cost, effective ways of

prevention. The group proved that by using probiotics, natural strains of ‘good’ bacteria like that of Lactobacillus acidophilus found in yo g u rt, the spread of sepsis could be prevented. “Probiotics trap bad bacteria, like a shield,” Panigrahi says. This way, the sepsis-causing bacteria cannot move beyond the intestine into the bloodstream, the point at which it becomes a death threat. Probiotics also help strengthen the gut wall and induce protective immunity. During the research team’s hospitalbased study of more than 300 infants, subjects given probiotics had better weight gain and showed signs of reduced infection. But Panigrahi’s work isn’t finished; it is just reaching deeper into the community. “We will continue to nurture these activities and expand our friendship and collaboration to more formal endeavors, such as building schools and centers of child health and public health in India,” Panigrahi says. Those who have worked with Panigrahi have no doubt that he has the vision to launch such collaborations. They have already witnessed how he forms relationships to reach re s e a rch goals. “That he was successfully able to set up this multisite study cannot be overemphasized. He got buy-in from all the players. The federal and local governments, administrators at each hospital—they were all on board,” Johnson says. Galvanizing support from Indian government officials and key professionals in the medical community will continue to be essential to Panigrahi’s goal of making public health a priority in India. Currently, he is engaged in discussions with high-ranking Indian officials about establishing an institute of public health in India. “As a resource-poor country, India needs more public health i n t e rventions,” Panigrahi says emphatically. If Panigrahi’s goal of building a public health school in India is realized, life-saving public health interventions such as those he and his Indian research partners are undertaking will become increasingly common, thereby improving the health of all of India—not just its youngest residents.  2008

RESEARCH & SCHOLARSHIP

S T U DE N T P R OF I L E

K E V I N L U N N EY

S C H O OL OF M E DI C I N E

The Whole World Is His Community BY LY D IA L E V I S B LO C H lthough he is now back in Baltimore, Kevin Lunney is still haunted by memories of the two years he spent doing research in Zimbabwe. He sees the faces of HIVpositive mothers for whom there was no antiretroviral therapy available. He remembers colleagues doggedly pursuing research, despite Zimbabwe’s political turmoil and soaring inflation. Lunney is the University of Maryland’s first MD/PhD candidate to conduct dissertation work in Zimbabwe. The third-year School of Medicine student, who completed summer rotations in Bangkok and Cairo, prefers to work overseas. “There are many medical issues that need to be addressed in resource-poor environments that are not being investigated in the U.S.,” Lunney says. For his dissertation, “Pre venting Mother to Child

A 12

U N I V E R S I T Y O F M A RY L A N D, B A LT I M OR E

Transmission of HIV Through Breastfeeding: Exclusive Breastfeeding, Mastitis, Viral Load and Early Cessation,” he analyzed blood and breast milk samples to examine HIV transmission. Resourcefulness in overseas research is crucial, Lunney says. For instance, the only way he could measure levels of sodium and potassium in breast milk was to unearth a broken flame photometer, cobble together parts to repair the machine (nobody else in the lab knew how), and run the tests himself. From 2005 to 2007, Lunney conducted research in Ha r a re and in rural areas of Zimbabwe. That re s o u rcefulness also came in handy in the clinic. On his first day at the University of Zimbabwe’s medical clinic in Ha r a re in 2006, recalls Lunney, “We saw around 30 patients in t h ree hours. About 80 percent were HIV-positive and the majority were in the end stages of AIDS.” He quickly learned to examine patients and perform basic medical procedures under the guidance of residents, as well as diagnose HIV and AIDS without the aid of lab tests. Besides conducting re s e a rch and practicing his medical skills at the university clinic, Lunney—a former Mid-Atlantic Ultra Distance champion—also was able to continue his athletic training. As a result, he placed third in the 2007 Zimbabwe National Triathlon Championships. “Zimbabwe is a great place to live while doing your research,” says Lunney. He celebrated his marriage to his wife, Jennifer, in Zimbabwe, and their two daughters were born there. Now back on campus, Lunney is concentrating on clinical studies before applying for residency. He completed his PhD work in 2007 and plans to pursue a fellowship in infectious diseases and a career in internal or pediatric medicine when he finishes his MD in 2009. Whether abroad or at home, Lunney says School of Medicine faculty provided tremendous encouragement. “T h e support I received during my academic pursuits speaks volumes about the flexibility of the MD/PhD program,” he says. He also would like to return to active duty as an officer in the U.S. Public Health Se rvice, possibly through the Centers for Disease Control and Prevention Epidemic Intelligence Se rvice. The results of his dissertation, which seem to indicate that HIV-positive mothers should breast-feed, are already among several studies shaping the World Health Organization’s policy concerning the importance of breast-feeding, even for HIV-positive mothers. Te r ry Rogers, PhD, School of Medicine professor and dire ctor of the MD/PhD program, says Lunney’s route was unusual but necessary for someone who wants to solve international health problems. “A mission of our MD/PhD program is to serve the community,” says Rogers. “For Kevin Lunney, the community is the whole world.”  PHOTOGRAPH BY ROBERT BURKE

Saving Maryland’s Children

BY SONIA EL ABD

hen the Ma ryland De p a rtment of Human Resources (DHR) was mandated by state and federal legislation to devise a system to improve child we l f a re services, it knew right where to turn. The University of Ma ryland School of Social Work, which has a 30-year relationship with DHR, was only too happy to help with several projects to improve services to children and families. “These projects will increase the safety, permanency, and well-being of children and families served by child welfare agencies throughout the state of Maryland,” says Diane DePanfilis, PhD, MSW, associate professor and associate dean for re s e a rch at the School.

2008

RESEARCH & SCHOLARSHIP

There was little doubt such an overall program was needed. Two years ago, a toddler in Randallstown suffered severe brain injuries after being violently shaken by his foster mother’s teenage daughter. Months later, a 15-year-oldBa l t i m o re girl was found starved to death in her home, imprisoned in an empty room by her court-appointed guardian. When the child we l f a re system fails children such as these, the consequences are devastating. Their experiences in the child welfare system unknowingly became a testimony for change in Maryland’s foster care system. In 2005, more than 6,000 children were abused or neglected in Ma ryland, and nearly 11,000 children lived apart from their families in out-of-home care. In 2006, the Ma ryland General Assembly passed the Child We l f a re Accountability Act, a bill designed to improve the quality of services provided to Maryland’s children. When the bill became law, DHR was required to develop a system of accountability to measure the efficiency and effectiveness of child welfare services, improve the re c ruitment and retention of child welfare workers, and develop a training and education academy to better prepare new and existing child welfare workers to handle the difficult job. With the support of Dean Richard P. Barth, PhD, MSW, faculty and staff from the School of Social Work are working with DHR to address the requirements. IMPROVING OUTCOMES

The partnership is a natural fit. “Under the leadership of Dean Barth, who has an extensive background in child welfare, it is clear that there is a commitment to working with DHR as we focus our efforts on improving outcomes for families and children in the child welfare system,” says Cathy Mols, executive director of DHR’s Social Se rvices Administration. DePanfilis is director of the Ruth H. Young Center for Families and Children, an organized research center under which the School’s child welfare-related projects are housed. She also is a nationally recognized leader in the field of child welfare, and manages the project that is developing a quality assurance system for measuring the efficiency and effectiveness of child

“

we l f a re services. Initially funded under a Ma ryland Higher Education grant of $433,000 for the first year, DePanfilis’ project is evaluating and providing technical assistance related to DHR’s process for implementing a multitier, ongoing evaluation of its child we l f a re services. “We’re helping DHR understand the degree to which they are meeting their goals, achieving their outcomes, and providing the services needed. By helping them efficiently collect and analyze administrative data, we are also helping them answer questions that will be key to the implementation of child welfare reforms,” says DePanfilis. “Turning the child welfare administrative data into information that can be used to manage and monitor child welfare programs is a daunting task,” adds Catherine Born, Ph D , MSW, research associate professor and director of the Family We l f a re Research and Training Group, which is collaborating with De Panfilis and is nationally recognized for its work with such data. “But it is a task for which our many years of similar work on welfare reform has well prepared us.” KEEPING GOOD WORKERS

Approximately 90,000 children and families are serviced by Maryland’s Social Se rvices Administration eve ry year. A 2003 U.S. Government Accounting Office (GAO) re p o rt stated that high caseloads, excessive administrative responsibilities, and inadequate training contribute to poor quality of services, caseworker burnout, and high caseworker turnover. The dire situation is compounded by low salaries and poor benefits, which hinder agencies’ ability to hire new workers and fill vacancies. But helping DHR meet its goals requires employees. Karen Hopkins, PhD, MSW, associate professor, is the principal investigator on a comprehensive study looking at retention and recruitment issues for the entire child welfare work force in Ma ryland. “There is a double-edged sword. Because child we l f a re is such a challenging and difficult field to work in, we have to find special people who are really committed to this kind of work. Finding those people is more challenging than in other areas of human service,” says Hopkins. “Because the work is so difficult, people feel that they can only do it for so long, so there

These projects will increase the safety, perm anency, and well-being of children and families served by child welfar e agencies throughout the state of Maryland. —Diane DePanfilis

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

”

“

We want to make sure the foster, kinship, and adoptive families have the knowledge, skills, and attitudes th ey need to care for —Debra Linsenmeyer the children.

”

remains a high vacancy rate. Agencies can never hire enough people to fill the vacancies when people leave, even if they continually hire new people and train them.” With a $475,000, one-year grant from DHR, Hopkins s u rveyed child welfare employees, including managers and superv isors, to collect their opinions and perspectives about their work to learn why people leave their jobs. Hopkins found several surprising results from the research, which was presented in a re p o rt to DHR in May 2007. “Most people assume Baltimore City has the most problems recruiting and retaining workers, but we found that some of the more rural areas of the state actually have the highest turnover and vacancy rates,” says Hopkins. Although low salaries and high caseloads, as mentioned in the GAO re p o rt, are often cited as reasons why workers do not stay in the child welfare field, Hopkins found that wasn’t necessarily true. “A lot of data indicates that if salary level is increased and caseloads are decreased, it doesn’t necessarily translate to higher retention. Organizational issues are important. People need to feel like they’re satisfied in their jobs and that they have the support of their supervisors.” Hopkins has proposed that the next phase of this project focus on implementing interventions based on the results of her s u rvey. TRAINING BETTER WORKERS

C a roline Long Burry, PhD, MSW, associate professor, and Debra Linsenmeyer, MSW, have been working together to d e velop the Ma ryland Child Welfare Academy. Graduate and undergraduate students in social work and new and current child welfare workers develop their knowledge and skills to provide better care for children. The academy, a partnership between DHR and the School of Social Wo rk, is funded by an 18-month, $2.4 million grant from DHR. “Prior to developing the Child We l f a re Academy, the School was already involved in training child welfare workers for DHR. De veloping the academy allowed us to elaborate on the training continuum by expanding the amount of information that

trainees and students receive upfront,” says Bu r ry. Now, along with teaching child welfare workers new practices, the trainers show workers how to apply that knowledge before they are assigned cases. “Many child welfare workers do not have degrees in social work, so they may not have the same level of knowledge and skills that individuals with social work degrees may have. So we appreciate the opportunity to support DHR’s commitment to training more people before they start work,” says Linsenmeyer, educational director for the academy. The School also developed in-service instruction for current child welfare workers to support struggling parents. For the first time, the School conducted in-service training for approved foster, kinship, and adoptive parents. “The safety of the children that DHR is responsible for relies in large part on the folks who are taking care of them,” says Linsenmeye r. “We want to make sure the foster, kinship, and adoptive families have the knowledge, skills, and attitudes they need to care for the children.” In addition, under a special project called Excellence in Child Welfare Supervision, the School is training child we l f a re w o rkers with many years of experience who want to move into supervisory and administrative roles. A $350,000 grant from the U.S. Department of Health and Human Se rvices provides tuition for these workers to earn their master’s degrees and take special courses in supervision and management. All faculty and staff at the School, working through the Ruth H. Young Center for Families and Children, are sharing information to improve their individual projects, which will eventually help them better assist DHR in meeting its goals. The ultimate goal—providing better care for Maryland’s children and families in the child we l f a re system—will be well w o rth the effort. “This continued collaboration with DHR is ve ry exciting and will improve outcomes for Maryland’s children and families,” says DePanfilis.  2008

RESEARCH & SCHOLARSHIP

S T U DE N T P R OF I L E

R O S A A LVAY E R O

SCHOOL OF SOC IAL WORK

On a Mission to Serve Latino Community BY R O N A L D H UB E

osa Alva ye ro came to New York City from El Salvador 18 years ago with a goal: to attend college to learn how to help other immigrants. Although just a teenager at the time, she understood that immigrants who move to this country “need a great deal of support to live a dignified life in the U.S.” Alvayero’s dream of college had to wait while she, like three of her 11 siblings who came to this country before her, worked to support her family in El Salvador, where wages average $5 a day. “When I came to New York, my main focus was work, and helping my parents,” she says. “After that, I was able to continue with my education.” The social work student was awarded the University’s Presidential Scholarship (created in 2004 to honor University President David J. Ramsay’s 10-year anniversary), along with the Maternal and Child Health Leadership Program Scholarship, and the William Donald Schaefer Scholarship. Alva ye ro, who works full time, plans to graduate with an MSW from the School of Social Wo rk in 2009. She has already done much toward her mission of assisting fellow Latino immigrants. While obtaining an associate’s degree in mental health from Montgomery College in Takoma Park, Md., and a bachelor’s in psychology and a graduate certificate in women’s studies from the University of Ma ryland, College Park, Alva ye ro provided interpretation for Spanish-speaking patients and their health care providers at La Clinica del Pueblo in Washington, D.C. Presently, she works as a case manager at Ma ryland Multicultural Youth Centers, where she has created a tutoring program for students who do not speak English. Alva ye ro says her studies and her real-world experiences go

U N I V E R S I T Y O F M A RY L A N D, B A LT I M OR E

hand-in-hand in her effort to help immigrants adjust to life in their new country. “If I’m working with families, the human-behavior theories that I studied have helped me understand the dynamics that the families are experiencing and some of the difficulties that may stem from them,” she says. Alvayero says her social work education is helping her learn “how to go about finding grants and resources that can support our programs.” Although many American Indians and Latino immigrants share the same problems—such as pove rty and lack of health insurance—Alvayero says the added complications of a language barrier and undocumented status often block immigrants’ access to services that could help them. “The health care clinics are overwhelmed,” Alvayero says. Although children might receive care more quickly, adults often wait “three months for ve ry, very acute problems.” Recently, Alvaye ro helped a woman obtain treatment for a swollen ankle through the Governor’s Wellmobile Program, which is administered by the School of Nursing. A victim of domestic violence, the woman had gone without treatment for months. Although Alva ye ro says she will never become accustomed to Maryland’s winter weather, she says she likes living here and plans to remain after graduation to help Spanish-speaking immigrants. And she is very pleased with how well the University has prepared her to perform that work. “In the School of Social Work, I have met wonderful and committed faculty members who have shared their knowledge and commitment to social work practice. And the Maternal and Child Health Leadership Program Scholarship that I was awarded has provided me with the opportunity to develop leadership skills to better work with the community.”  PHOTOGRAPH BY ROBERT BURKE

NIGERIA

Dental School Researchers

Lead Efforts to Eradicate Noma

B Y M A R Y S P IR O

o the Hausa ethnic group in Nigeria, the devastating affliction that eats away at the faces of so many children in its villages is known as ciwon iska—the wind disease. To re s e a rchers at the University of Ma ryland Dental School, the condition is known as noma—or c a n c rum oris—and has been called the “face of pove rt y.” When one sees how this dreaded scourge devours the faces of its young victims, it is an image that does not quickly fade. Noma typically attacks severely malnourished children under the age of 6. They suffer from the rapid spread of a gangrenous lesion, promoted by a common childhood infection such as measles, that starts inside the mouth and quickly destroys the soft and hard tissues of their cheeks, lips, gums, and jaw. If treated early with oral antiseptics and antibiotics, it is easily reversed. Without prompt medical intervention, however, seven out of 10 children afflicted die just a few weeks after the first symptoms appear. “When you see these kids—unless you don’t have a soul—it sticks in your mind,” says Cyril Enwonwu, ScD, PhD, MDS, a professor in the De p a rtment of Biomedical Sciences in the Dental School and adjunct professor in the De p a rtment of Biochemistry and Molecular Biology at the School of Medicine. He has spent much of his professional career researching the etiology and prevention of noma. A culminating honor for Enwonwu is an invitation to deliver the opening plenary lecture at the first world “Noma Day” to be held in Geneva on May 22, 2008. The event is under the patronage of Kofi Annan, former secre t a ry-general of the United Nations, in association

2008

RESEARCH & SCHOLARSHIP

In its earliest stage, noma starts as a lesion promoted by a common childhood infection such as measles.

Dr. William Falkler, pictured (left) in Nigeria, has collaborated with Dr. Enwonwu in microbiological research into the causes of noma.

with the World Health Organization (WHO), the FDI World Dental Federation, and the Winds of Hope Foundation. An expert in the field of nutritional sciences research, Enwonwu also has been honored by both Nigerian and American humanitarian groups. He works with nongovernmental organizations to develop measures to fight the global spread of noma. Since July 2006, Enwonwu has been a consultant to a private medical mission organization called the MAMA Project, Inc., based in Pennsburg, Pa. MAMA stands for Mujeres Amigas (Women Friends) Miles Ap a rt. The organization has been putting volunteer teams of physicians and civilians together for more than 20 years to address the issues of severely malnourished children. The organization’s goal is to provide the training and tools to empower local health care workers to meet urgent medical needs. The MAMA Project began in 1987 working in poor areas of Honduras and has expanded its programs toHa i t i . Wo rk in Nigeria is slated to begin in the fall of 2008. ETIOLOGY OF NOMA

Noma is endemic to rural Nigeria, but also can be found among extremely impoverished people in other parts of SubSaharan Africa, Asia, South America, and the Caribbean. Historically, noma was observed in Nazi concentration camps and more recently has been re p o rted among some AIDS patients. “My involvement with noma came about because of my interest in nutritional biochemistry and the consequences of malnutrition with regard to oral and general health,” says Enwonwu, a former director of the Nigerian Institute of Medical Research. “Noma is an end result of the complex interactions between infections, immunity, and malnutrition,” he says, “but there are many other variables.” Enwonwu first encountered noma in 1965 while doing graduate research in rural Western Nigeria. Although born and 18

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

raised in Nigeria, he grew up in an urban area far from areas of e x t reme pove rt y. He studied at the University of Bristol in England, where his textbooks defined noma as a rare, almost nonexistent, disease caused by poor diet and infections. Enwonwu’s research in nutrition and biochemistry has taken him in many directions during the last four decades. But with those unforgettable images of miserable and disfigured children fixed in his mind, he says, “At eve ry opportunity, I returned to the study of noma.” In 1993, Enwonwu came to the University of Maryland Dental School and proposed to study noma in a “more systematic way.” Funding initially came from the Nestlé Foundation in Lausanne, Switzerland, and subsequently from the John E. Fogarty International Center for the Advanced Study of the Health Sciences, a center of the National Institutes of Health. William Falkler Jr., PhD, MS, professor emeritus of microbiology in the Dental School’s De p a rtment of Biomedical Sciences, also has been actively involved in the study of noma. Falkler and Enwonwu provided expert testimony to a congressional hearing on the disease in 2002. Some of Enwonwu’s earliest re s e a rch focused on the basic biochemistry of malnutrition and its effects on physical deve lopment and metabolic parameters using animal models. He then began looking at the link between malnutrition and the s e verity of infection. He also studied how prior infection with malaria and measles impacted a child’s metabolism and his or her ability to fight subsequent infections. With Falkler, Enwonwu studied the microorganisms growing in the mouths of children from the villages where noma was found. Unlike in the mouths of normal children, anaerobic bacteria, such as Fusobacterium necrophorum and Prevotella intermedia, were prolific in the mouths of young children with noma. In vestigators subsequently determined that the bacterial contamination resulted from the practice of housing animals in the same living quarters as humans and through fecal contamination of water supplies. PHOTOGRAPHS COURTESY OF CYRIL ENWONWU

Within a matter of days, what begins as a small lesion becomes a galloping infection that destroys the soft and hard tissues of the cheeks, lips, gums, and jaw, causing severe disfigurement. If treated early enough, it is easily reversed. Without medical intervention, seven out of 10 children die within a few weeks after symptoms appear.

“

If noma is to be eliminated, national, international, g o v ernmen tal, and nong o v ernmen tal agencies will have to apply available r e s earch findings in more proactive ways.

”

—Cyril Enwonwu

After investigating the disease from a variety of angles, Enwonwu acknowledged that although severe malnutrition, often starting prenatally, is a major risk factor to noma, it is just one piece of the puzzle. The etiology of noma is complex and also includes poor oral hygiene, absence of exclusive breastfeeding in the first few months of life, unsanitary food preparation methods, living in close proximity to livestock, and prior infection with a childhood disease—all unfortunate facts of life for the poorest and most vulnerable residents of economically d e p ressed regions of the world. Location, poor public sanitation, shame, and myth also perpetuate the spread of noma, Enwonwu explains. The remote location of the villages where noma occurs hampers access to early medical interventions. Clean water is scarce in these regions. Statistically, little is known about the incidence of noma, and the general belief is that less than 10 percent of patients with the disease seek medical care, notes Enwonwu. Unable to explain the disease, villagers hold fast to a belief that noma strikes children because the mother has done something spiritually wrong. Thus noma victims are often hidden away and cases of infanticide are sometimes suspected. “We have come to a point in our research where we know enough about the causation of noma,” Enwonwu says. “Now, we must turn available scientific evidence into action by concentrating on prevention of the disease.” In order for prevention to beeffective, he emphasizes that each cause and eve ry hurdle must be addressed simultaneously. ILLUSTRATION BY ANNE ERICKSON; PHOTOGRAPH BY ROBERT BURKE

PREVENTION AND REHABILITATION

Enwonwu has been instrumental in increasing awareness and initiating action to address the noma problem. With officials of the AWD Foundation in Hanover, Germany, Enwonwu made sustained appeals to the government of Nigeria that resulted in the establishment of the 70-bed Noma Children Hospital in Sokoto, Nigeria, in 1999. Enwonwu served for four years as h o n o r a ryfounding chairman of the hospital board. The hospital is recognized by the WHO as a reference center w h e re children who survive active noma may come for plastic and reconstructive surgery performed by volunteer physicians. Hospital staff members also treat children who are suffering from other serious oral health problems. Noma is a “neglected disease,” says Enwonwu. “My team and I view its continued occurrence as a violation of the rights of the poor, particularly the innocent children who constitute the major victims. If noma is to be eliminated, national, international, governmental, and nongovernmental agencies will have to apply available research findings in more proactive ways.” That is where the expertise of the MAMA Project comes in. “They already have the structure on the ground, now they are trying to transport it to countries in Sub-Saharan Africa where conditions are not that different from Haiti or Honduras,” Enwonwu says. Priscilla Be n n e r, MD, director of the MAMA Project, visited the Dental School in December 2006. “Eradication of noma is long overdue,” Benner says. “We envision radical change, and 2008

RESEARCH & SCHOLARSHIP

to do that we will have to apply most of Dr. Enwonwu’s findings together, like a chain, in which there can be no weak link.” The MAMA Project strategies include training seminars for community health workers to recognize children at risk. The trainers also will prepare the public health workers to teach the village mothers how to care for their children and when to seek urgent help. Health workers will attempt to track confirmed cases of noma, as well as other oral lesions considered potential precursors of noma. Along with training, methods to improve nutrition are a priority, Benner says. Enwonwu’s research indicates that proper nutrition must begin with appropriate prenatal care so that children are not born immunologically predisposed to developing noma. “Malnutrition in many poor rural African communities starts in the womb,” Enwonwu says, “and that can compromise the early development of the immune system.” One of the biggest achievements of the MAMA Project to date has been the development of the “Super Cookie.” This highly nutritious and appealing treat can be baked using mostly indigenous ingredients. The Super Cookie has worked well in other locations, but Benner says applying the same strategy in Nigeria, which has poor sanitation in rural villages, may present unique challenges. Another alternative being considered is a nutrient-enriched drink, she says. But this idea “might backfire” if it discourages breast-feeding or becomes contaminated by local water sources. “We are still working on it,” Benner adds. In the meantime, there are other interventions that can be used to improve nutrition. These include encouraging mothers to breast-feed infants for longer periods, providing nutrient supplements such as vitamins A and C to adults and children, and incorporating micronutrients—trace elements such as selenium, zinc, and iodine—into the diet. To improve oral hygiene, the MAMA Project has created a simple baking powder-based dentifrice. The powder also contains the trace elements zinc, fluoride, iodine, and other essential micronutrients needed to boost immunity. Benner says trainers also will encourage the traditional practice of using chewing sticks to promote good oral hygiene. Infestation with intestinal parasites compromises the nutritional status of adults and children alike. So the MAMA

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

Project workers will administer a mass deworming program. And since getting to a doctor quickly is a problem, a village medicine chest, stocked with inexpensive and easy-to-obtain antibiotics, will be made available to trained community health care workers through the MAMA Project. Along with these direct interventions, Benner says, the entire community will need education in better hygiene practices such as boiling drinking water and washing hands. Timely immunizations against endemic childhood diseases, e.g. measles, also will be emphasized. Villagers will have to be encouraged to keep livestock away from the children’s sleeping areas and water supplies. The MAMA Project workers also will advocate for public health initiatives such as improved access to potable water in remote areas. But these are concerns that only can be dealt with by local authorities. Whatever measures are applied, Enwonwu and Benner concur that respect for the culture and traditions of the local people will have to be demonstrated at all times. “All of this has to be done carefully and gently and with cultural sensitivity,” Benner adds. WIPING OUT THE FACE OF POVERTY

As Enwonwu continues his work to guarantee the human rights of children through the elimination of preventable but neglected diseases associated with pove rty and malnutrition, noma remains at the top of his list. “All the research papers we have published are really meaningless until the day when we can get the mothers to understand and implement lifestyle measures needed to prevent occurrence of noma in their children,” says Enwonwu. And change is under way. “People are now much more conscious of the noma problem in Nigeria and in other developing countries. Oral health personnel in many of these countries are becoming ve ry active members of the primary health care team,” Enwonwu says. Benner adds that Enwonwu’s dogged dedication has been a driving force behind the winds of change for “the wind disease.” “It takes real passion to keep at it for as long as Dr. Enwonwu has,” Benner says. “When the day comes that noma is finally eradicated, he will be one of the main reasons.” 

S T U DE N T P R OF I L E

L A E L AY E S H I M E L E S

D E N TA L S C H O OL

Inspired to Make a Difference aelaye Shimeles is one of the few students at theDe n t a l School to wear a full set of braces on his teeth. But it was a friend’s mouth, not his own, that was the catalyst for Shimeles’ interest in the field of dentistry. As a young boy, Shimeles was an avid soccer player in Ethiopia when he and a teammate collided—his forehead into the jaw of a classmate. “I was a kid. I didn’t treat it as a big deal at the time, but it was serious,” says Shimeles, 27. “My injury caused an infection that required two minor head surgeries. I recovered within six months. My friend, however, ended up having his broken tooth removed and was unable to have it replaced due to a lack of dental expertise in our country.” Both the appearance and the eating habits of his childhood friend were drastically affected by his broken tooth. He also encountered frequent taunting. “My friend was left with a permanent deformity,” says Shimeles, a third-year dental student. “The fact that he couldn’t do anything about it made it all the worse. “It instilled in me the desire to educate myself in dental medicine, with the belief that I would be able to make a difference for those in need of dental care.” His inspirational beliefs have only been enhanced by his years at the Dental School. “My experience at the University of Ma ryland has been exceptional,” says Shimeles, who was attracted by the University’s proximity to his home in Washington, D.C., its large and diverse student population, and well-respected Dental School. “The curriculum during the first two years provided me with a strong base in the biological sciences and an outstanding

PHOTOGRAPH BY SOFIA SILVA

B Y G W E N N EW M A N clinical education. The new Dental School building offers high-tech clinical simulation units and facilities that greatly enhance the learning experience. “In addition, I have had the opportunity to care for a diverse patient population—pediatric, emergency, and medically compromised patients. Without a doubt, I encourage students with the desire to pursue dentistry to choose the University of Ma ryland Dental School.” Shimeles’ parents, who are both health care professionals, immigrated to Washington, D.C., in 1995 with their four children. Shimeles graduated from Cardozo High School in 1998 and received his undergraduate degree, majoring in chemical engineering, from the University of Maryland, College Park in 2003. “The fact that I went to an underprivileged high school did not limit my potential,” says Shimeles. “I realized I would have to work harder than the average high school student. And I believe that being less fortunate is not an excuse for failure.” Since his move to the United States, Shimeles has reconnected with his long-lost soccer teammate who now lives in Canada. “When we talked, the first thing he said was, ‘Guess what? I got the tooth fixed.’” Shimeles, who anticipates the removal of his own braces just prior to graduation, is now married with a 1-year-old daughter. He has many dreams—to pursue a specialty, give back to his profession, and return to Ethiopia. “I want to help people where I came from and have some positive influence and impact in dentistry. There are so many things you can do in dentistry,” says Shimeles. “It is amazing.”  2008

RESEARCH & SCHOLARSHIP

ITALY

New Hope for F R O M

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

B A L T I M O R E

Stroke Victims T

B Y BR U C E G O L D FA R B

ith the help of 200 people walking in Tuscany, Italy, Richard Macko, MD, is working toward a breakthrough for stroke victims in Baltimore. Macko is a professor of neurology and gerontology at the School of Medicine and director of the Rehabilitation Research and Development Center of Excellence in Exercise and Robotics at theBa l t i m o re Veterans Affairs Medical Center. He is challenging a universally accepted tenet of medicine that function is permanently lost when areas of the brain are destroyed by stroke. Research conducted by Macko and his colleagues, including Francesco Be n venuti, MD, in Tuscany, shows that a novel program of repetitive, aerobic, task-oriented exe rcises can not only improve physical functioning, but also help reduce cardiometabolic health risks that dispose patients to a second devastating event.

PHOTOGRAPH BY© SERGIO PITAMITZ/ZEFA/CORBIS

“What you see with stroke is an acute event followed by a brief period of rehabilitation,” says Macko, who is also academic director of the School of Medicine’s Division of Rehabilitation Medicine. The duration of post-stroke physical therapy is typically about one to three months. It is widely believed that recove ry of physical function peaks around 11 or 12 weeks after a stroke, according to Macko. Once reaching a plateau in motor and sensory function, patients usually remain the same or slowly deteriorate over time. Each year, about 750,000 Americans suffer a stroke, which results when blood to the brain is disrupted by bleeding or a clot. St a rved of oxygenated blood, brain tissue dies. The function of the affected area of the brain—memory, cognition, sensation, and movement—no longer works. About three-quarters of people who suffer a stroke are left with a neurological deficit often involving paralysis or weakness of one side of the body. Conventional rehabilitation after a stroke 2008

RESEARCH & SCHOLARSHIP

concentrates on recovering activities of daily living that make patients as independent as possible. Physical and occupational therapists work with post-stroke patients to relearn walking, getting out of bed or a chair, and activities such as eating, dressing, and grooming. Conventional rehabilitation is important, Macko says, but fails to address the underlying physical deconditioning and cardiometabolic risks that leave patients prone to another stroke. THE ‘PLASTIC’ BRAIN

Research done in recent years demonstrates that the brain is much more adaptable and “plastic” than once believed. Repeated stimulation of limbs crippled by a stroke can help the brain reorganize and establish new paths of sensation and motor function. These insights were gleaned from experiments in which animals with paralyzed rear legs were taught to walk by using a treadmill. “Many of the advances in our understanding of brain plasticity have come about in the last 10 years,” Macko says. “T h e notion of a short window of recove ry after a stroke is gone. The control of the sensory and motor system is not fixed three months after a stroke. We are not hard-wired like a telephone. With the right kind of exercise therapy, you can improve function years after a stroke.” Since the mid-1990s, Macko and a team of about 20 investigators at the University of Maryland and theBa l t i m o re VA Medical Center have collaborated with re s e a rchers at eight academic medical centers in the United States and Europe. The group conducted a series of studies in Tuscany leading to a new model of rehabilitation—Ad a p t i ve Physical Activity (APA)—

Dr. Richard Macko’s research group at UMB is collaborating with engineers at MIT in evaluating the “Anklebot.”

that combines repetitive task-oriented activities with the intensity of aerobic exe rcise to improve fitness. APA involves a series of mobility, balance, and stretching exercises designed to be done in small groups led by an exercise instructor. Sessions include walking a course marked on the floor, going from sitting in a chair to standing, shifting weight from leg to leg, half-squats, and other flexion and extension exercises. “Because many people are walking around, it creates constructive interference,” Macko says. “It requires executive function, because they’re multitasking. They’re watching other people walk at the same time. It creates social reinforcement. That’s the key to sustaining behavior—getting people out of their homes and into a group.” In the October 2005 issue of the journal Stro k e, Macko and colleagues re p o rted a study of treadmill exercise in people who have difficulty walking because of paralysis on one side of their body. Re s e a rchers sought out people well into the chronic phase of stroke recove ry, at least six months after its onset. Forty-five men and women with an average of three years post-stroke completed the study. Twenty-five participants were randomly assigned to a program of 40-minute treadmill sessions three times a week. The sessions increased in intensity and duration every two weeks, as much as could be tolerated by participants. For comparison, 20 participants were randomized to receive more conventional therapy, consisting of 35 minutes of stretching exercises and five-minute treadmill sessions that remained at a consistent low intensity for the length of the study period. After six months of therapy, significant differences were noted between the groups. Those who undertook the experimental training improved their functional mobility and also increased their aerobic fitness by six times more than those who received less intensive therapy. Macko’s group (including Larry Forrester, PhD, in the School of Medicine’s Department of Physical Therapy and Rehabilitation Science) also collaborates with robotics engineers at the Massachusetts Institute of Technology. They are evaluating an “Anklebot” to test the combination of robotics and exercise training. The robotics “impedance control system” allows for adjustments according to individual patient needs, says Macko. “APA is the ‘low-tech’ approach more easily applied in community settings. Robotics is the ‘high-tech’ promise that could enhance benefits to all patients and also help more severely disabled individuals,” he adds. TESTING THERAPY IN ITALY

Ef f o rts to translate the discoveries from the laboratory are under way in the Tuscany region of Italy, and the benefits of the discoveries are now becoming a vailable to stroke patients in Ma ryland. With the support of the National Institutes of Health and its counterpart in Italy, A PA is being tested in a pilot program developed with Benvenuti, a rehabilitation specialist for the health district that includes Tuscany. 24

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

Tuscany was chosen because APA was relatively easy to implement under Italy’s nationalized health system, and because of the interest of Benvenuti, with whom Macko has collaborated since 2003. “They took the principles of the training program and adapted them to a community program,” says Macko. APA was expanded to 200 participants in 20 community centers in Tuscany. Next on the agenda is to make exe rcise programs such as APA available to stroke patients closer to home. The need for effective therapy for stroke will become more acute as baby boomers age. By 2040, the number of people having strokes will double to 1.5 million annually. “T h a t’s going to leave us with a city the size of Baltimore filled with people with disabilities from stroke each year,” says Macko. “It’s a huge problem.” DEALING WITH DIABETES

Another huge problem in the treatment of stroke is diabetes, a disorder caused by the body’s inability to properly produce insulin to metabolize glucose for energy. Diabetes is considered a cardiovascular risk equivalent. That means a person with diabetes is as likely to have a stroke or heart attack as someone without the disease who already had one. O ver a period of months, muscle on the side of the body weakened by a stroke undergoes changes that affect glucose metabolism. “T h e re is a profound deconditioning that hinders recove ry and contributes to disability,” Macko explains. The muscle soon becomes atrophied and infiltrated with fat. Muscle bundles, normally composed of a mix of different fiber types, become dominated by “fast-twitch” fibers that are less sensitive to insulin. Measures of fitness in stroke patients tend to deteriorate quickly. “St roke patients are half as fit as able-bodied but inact i ve individuals,” says Macko. High levels of glucose in the blood are harmful to blood vessels over the long term, contributing to atherosclerosis, or hardening of the arteries. Disordered insulin and glucose metabolism eventually make arteries thicker, stiffer, and inflamed, and blood more likely to form clots. A person with diabetes has nearly three times the risk of a recurrent stroke than someone with normal blood glucose metabolism. Impaired glucose tolerance—an intermediate prediabetic state—doubles the risk of a repeat stroke. High blood glucose levels likely contribute to repeated strokes, as about a third of all stroke patients have another stroke within five ye a r s . In 2004, Macko and his colleagues conducted a study to determine the prevalence of abnormal glucose metabolism among stroke patients who were screened for exercise rehabilitation at the Baltimore VA Medical Center. The group of researchers includes his wife, Charlene HaferMacko, MD, associate professor and neuromuscular disease researcher in the School of Medicine, and Fred Ivey, PhD, an exercise physiologist who is, along with the Mackos, a member

of the Baltimore VA Geriatric Research, Education, and Clinical Center. Investigators re c ruited 216 stroke patients with hemiparesis, weakness of one side of the body. All had completed conventional inpatient and outpatient therapy, with an average of more than three years since the stroke. The researchers discovered that 77 percent of the patients had abnormal glucose metabolism. More than a third were identified as diabetic, and more than a third were found to have diabetes or impaired glucose tolerance after a blood test. The researchers’ findings were published in August 2006 by the journal Cerebrovascular Diseases. Fu rther study shows that aerobic exercise improves glucose metabolism as well as physical functioning. After six months of therapy, blood tests show that treadmill exercise can dramatically i m p rove the body’s control of glucose. People in the program had significantly better glucose tolerance test results, while no i m p rovement in glucuse tolerance was seen among controls. Glucose metabolism returned to normal for seven of 12 part i c ipants in the treadmill training group who had been diagnosed with diabetes or prediabetes during enrollment, compared to only one of 11 in the control group. The findings were re p o rted in the October 2007 Stroke and are being considered by the National Academy of Sciences as an evidence-based approach to improve health and function with e xe rcise after a stroke. The U.S. De p a rtment of Health and Human Se rvices will release new physical activity guidelines this year. “This is remarkable. You don’t usually see improvements like this,” Richard Macko says of his research team’s findings. “We need to get these developments from the university hospital lab and into the community.” IMPLEMENTING COMMUNITY TREATMENT

Toward this end, plans are under way to introduce APA in community settings in the Baltimore area. In a partnership with the Howard County Office on Aging, APA classes for stroke survivors began last fall as a pilot study in the Ellicott City and Glenwood senior centers. This is part of a larger initiative by Howard County to bring evidence-based exercise to its growing population of seniors. More than a dozen locations in Howard and Baltimore counties are under consideration, says Macko. “You don’t need a physical therapist to run these courses,” he says. “It’s an exercise class, so you can set it up for a much l ower cost.” Macko envisions an evolution in the treatment of stroke in which people are treated quickly and aggre s s i vely to minimize damage to brain tissue. Patients would then receive effective physical therapy to rehabilitate and improve activities of daily living and extended therapy with APA to maximize fitness and reduce risks. “I hope this is the beginning of a model system for stroke,” he says. “We want to empower people. This is fighting back against the disability.”  2008

RESEARCH & SCHOLARSHIP

Barbara Smith (middle row in headdress) is shown with her colleagues at the University of Zambia at Lusaka in Lusaka, Zambia.

Health care workers from Mwea Mission Hospital in Nyeri, Kenya, make home visits to promote patientsâ&#x20AC;&#x2122; adherence to HIV medications.

Keeping children free from HIV in Lusaka, Zambia

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

PHOTOGRAPHS COURTESY OF BARBARA SMITH

AFRICA

he faculty members of the University of Ma ryland School of Nursing have different specialties, areas of expertise, and professional interests. But several have united around a single goal—to empower nurses in developing countries with the skills they need to treat HIV-positive patients. Training nurses around the world to diagnose and treat patients living with the virus that causes AIDS takes time, energy, and personal commitment. The instructors bring unique vantage points from which they view the global epidemic and the nursing profession, and they have re t u rned home after experiencing incredible events that have changed their perspectives forever. NURSE EDUCATORS INTEGRAL TO UGANDA

Thomasine Guberski, PhD, RN, CRNP, was a registered nurse long before the discovery of AIDS, but like many nurses, she found herself face to face with the disease. She proactively enrolled in continuing education courses in an effort to stay current with the latest trends in care and treatment. Today, she empowers other nurses to do the same. An associate professor at the School of Nursing, Guberski is a member of a multidisciplinary team immersed in global p a rtnerships. Through international collaboration, School of Nursing faculty are helping to prepare the next generation of health care professionals in a critical arena of clinical care where the number of patients far surpasses the number of practitioners able to treat them. Guberski was tapped by the Institute of Human Virology ( I H V) in the School of Medicine for her expertise when, in

2003, IHV received the largest health care services grant in campus history (see related story on page 29). With federal funding from the President’s Emergency Plan for AIDS Relief, IHV is now in the midst of comprehensive, long-term efforts to empower health care providers in Africa, Latin America, and the Caribbean with the skills they need to care for their own. Long an international leader in AIDS research, clinical care, and prevention efforts, IHV turned to Guberski to provide the depth of real-life experience and expertise needed to spearhead and oversee training efforts directed to accomplished RNs—already bright, talented, and skilled practitioners whose own educational experiences simply did not provide a tre a tment ove rv i ew of the disease ravaging their communities. The philosophy had been: Why train nurses in HIV therapy when the developing countries had neither the financial resources nor the actual drugs needed for treatment? But when therapies became available through global funding initiatives, medical training became a critical component. As a technical advisor for the project, Guberski now spends about five months a year in Uganda and leads the development of a global nursing curriculum that will help nurses become accustomed to providing a continuity of care— treating sick populations and helping to prevent illness in the healthy ones—in addition to learning about the side effects of HIV drugs and how to monitor those taking them. “We concentrate a lot on how you run a clinic with patients now expected to come for a continuum of care, not episodic care,” she says. Collaboration is the key to the success of the team’s effort s , notes Guberski. Anthony Edozien, MD, assistant professor in the School of Medicine and IHV, is the senior technical advisor and team leader. Solomon Agbor, DRPH, specialist health care provider through IHV, promotes adherence to quality. “Without these two professionals, I could not do my job,” says Guberski. “Each colleague brings a different expertise in terms of technical assistance.” Guberski’s first visit to Uganda and to a treatment clinic was eye-opening. “When I saw the number of patients, I thought, ‘What did I get myself into?’ I had never seen so many patients in one clinic at one time. To me, it looked like thousands. It was probably between 100 and 150.” Guberski can recognize the symptoms of HIV patients suffering from opportunistic infections such as cryptococcal meningitis and quickly recommend the protocols necessary to restore health and vitality to patients. Previously the medical

2008

RESEARCH & SCHOLARSHIP

At the University of Zambia at Lusaka, health care workers enjoy the expansion of their facilities to protect nurses from occupational exposure to blood-borne pathogens.

New mothers visit an IHV-supported clinic in Uganda.

teams did not have the training, resources or experience to diagnose the condition or provide a life-saving remedy. In addition to training the local health care providers, Guberski’s team leaves behind textbooks and printed copies of the curriculum for reference. “We go to places with no electricity,” Guberski explains. “They don’t have access to the Internet or to online resources. Paper is ve ry expensive, and textbooks are a resource that most don’t have. We leave what we can.” Guberski has encountered many patients whose lives have been restored—patients who are feeling well and worry only about more commonplace illnesses. P H Y S I O LOGIST SEES RECOVERIES IN KENYA

On a recent visit to Kenya, Barbara Smith, PhD, RN, FAAN, associate dean of research at the School of Nursing, carried a snack bar inside one of her travel bags. Packed almost as an afterthought, the small amount of food proved comforting to a teen who had lost both her mother and aunt to AIDS. Living in isolation, the girl had gone several days without a meal and practically inhaled the treat. “I pulled it out, and it just disappeared,” Smith recalls of the exchange. The girl, estimated to be 15 years old, was “a head shorter than what she should have been” due to malnutrition. Smith, an exercise physiologist, has long advocated that physical activity and proper nutrition can help to prevent and minimize the risk and severity of disease. She also has deve loped a professional niche, working with special populations such as the Amish, African-American children, and HIV patients. For the last 12 years, Smith, a veteran nurse with expertise in AIDS treatment, has closely watched how food and exercise can affect the quality of life for persons living with HIV. In 2006 and 2007, Smith traveled to Kenya, where she was asked to help train nurses who for the first time have access to antiretroviral drugs (ARVs) to treat the disease. “Our motto has been, ‘Vital signs are vital,’” Smith explains. These specially trained nurses are now embracing both the day-to-day care of

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

their patients and the aggressive treatment plan. Malnutrition and the lack of food are some of the bigger obstacles to providing HIV care in a country ravaged by the disease, Smith observes, adding that medical teams in Africa refer to food as the “f o u rth ARV,” joining the three classes of antiretroviral d rugs used to treat HIV. Food is so important because HIV drugs are ineffective and cause undesirable side effects when taken on an empty stomach; many residents of Africa consider treatment options futile without access to regular meals, notes Smith. It’s just one of the many barriers Smith has observed working with medical teams also confronted with staffing shortages, lack of equipment, and overwhelming patient loads. But Smith is encouraged by the progress she sees each time she returns, including the opening of new clinics and increased numbers of health care professionals undergoing intensive training efforts. Smith says she is quick to share with her pupils and pro f e ssional colleagues that, though she might be considered “the expert,” she, too, once walked in their shoes in her professional development. “I bring a certain amount of knowledge,” Smith says to the student nurses she mentors, “but I also need your knowledge and expertise with how we apply that in Africa. We can then put our knowledge together and create something that works for Kenya. In doing so, you’ll become the experts, and we’ll become the spectators.” Smith encourages her students to adjust their treatment protocols based on evidence by scientifically gathering information from observing their patients, settings, and results. The impact can be profound. She recalls an older woman diagnosed and hospitalized with both HIV and tuberculosis. Too weak to sit upright, the patient had to be propped up by

BOTTOM PHOTOGRAPH COURTESY OF THOMASINE GUBERSKI

nurses, Smith remembers, only to see her quickly slump to the side. A few months later, Smith encountered the patient again; her condition had improved dramatically, thanks to treatment for her tuberculosis and HIV. “Her daughter called to her and this woman came running down the lane. I was envisioning the woman so weak she had to be propped up in bed, and here she was running. She had enough energy to run, to literally run.” RESEARCHER REACHES OUT IN TANZANIA

Several years ago, Keith Plowden, PhD, RN, ACRN, responded to a professional request for services and says his life was changed forever. Plowden, an associate professor and assistant dean for bacc a l a u reate studies in the School of Nursing who also teaches in the School of Medicine, specializes in urban health issues. He practices on a medical unit at the University of Maryland Medical Center and works on health care issues related to minority men, as well as factors such as drug use that put them at higher risk for HIV infection. The re s e a rcher/clinician also has extensive experience working with hard-to-reach populations and in developing culturally appropriate interventions to educate, promote consensus, raise awareness, effect change, and improve outcomes. Plowden’s work is funded through the National Institutes of Health, the U.S. Department of Defense, and the Substance Abuse and Mental Health Se rvices Administration. He traveled to Tanzania to share his insight into the AIDS epidemic and to find ways to reach that particular community with its own cultural sensitivities and specific needs. For three weeks, Pl owden visited community-based organizations and nongovernmental associations to assess, analyze, and make recommendations on what is needed to deliver and administer drugs and increase compliance and improve treatment outcomes. He quickly learned that there are huge gaps in how the two

countries approach HIV care and in what the United States can advise based on the reality of resources. “We have to be very careful when we make recommendations,” Pl owden says, “because they may be doing all they can do with what they have.” He says it is not uncommon to walk through a hospital ward where two patients share a single bed or for medical staff to be without critical resources or the drugs needed for care. “When I am in a U.S. hospital, I can pick up a phone to re p o rt my assessments and have a drug delive red instantaneously. That may not be the case there,” Plowden says. Plowden anticipated that as an African-American, he would have a connection with the culture. But he says he was surprised at the unexpected moments where he, too, learned so much. For example, despite the fact that almost eve ryone in Tanzania personally knows someone who is living with or who has died from AIDS, many have never bothered to get tested for the disease. Plowden also explained that many people know that HIV d rugs must be taken with food to work effectively and, because they can’t guarantee meals on a consistent basis, see no benefit to knowing their HIV status. In some hospitals, the patient’s family, and not the health care facility, must provide the patient’s meals. He was profoundly affected by the experience and came to the quick conclusion that, in addition to his insight as a researcher, the country needed the experience of hands-on practitioners to diagnose and treat patients based on evidence. He is now studying to become a certified nurse practitioner, a move he believes is crucial before he makes another visit. Plowden summarizes the philosophy of all the School of Nursing faculty members who are empowering nurses to work with AIDS patients in Africa. “They need practitioners to work alongside them in providing care to the patients,” he says. “I look at my contribution now in terms of responding to a humanitarian need.” 

Presidential Grant Extends IHV Work in Africa n 2003, the President’s Emergency Plan for AIDS Relief (PEPFAR) awarded the University of Maryland School of Medicine the largest health care services grant in the history of the University of Maryland, Baltimore. The $64 million grant for the School of Medicine’s Institute of Human Virology (IHV) AIDSRelief Program provides high-quality medical care, treatment, and counseling to people living with AIDS in Guyana, Haiti, Kenya, Nigeria, Rwanda, South Africa, Tanzania, Uganda, and Zambia. Robert Redfield, MD, director of clinical care and research at IHV and chief of the Division of Infectious

Diseases at the School of Medicine, directs the program, which benefited nearly 15,000 AIDS patients in its first year and is expected to reach approximately 140,000 patients within five years. In July 2007, IHV received an additional $43 million grant from PEPFAR to be used to further IHV’s AIDS Care and Treatment in Nigeria project by providing immediate care and treatment to 48,000 patients and expanding HIV testing and counseling to an additional 100,000 Nigerians. Nigeria ranks third in the world for total number of persons infected with HIV.

2008

RESEARCH & SCHOLARSHIP

S T U DE N T P R OF I L E

A MY H S I E H

S C H O O L O F N UR S I N G

Finding Support and Encouragement BY R O N A L D H UB E hen a faculty member in the School of Nursing’s PhD program placed several oranges on the desk of teaching assistant Amy Hsieh, MS, she didn’t touch them for three days. Hsieh was not sure the oranges we re for her. Now a second-year doctoral student at the University of Ma ryland, Baltimore (UMB), Hsieh obtained an undergraduate degree in nursing and began pursuing her PhD at schools in her native Taiwan—schools that she says did not provide a supportive environment for students. So finding a gift of fruit on her desk was not something she expected. But Hsieh, 49, says she soon discovered that faculty at UMB are “always concerned about students.” And that small acts of kindness are not uncommon. “They always respect, inspire, and help students,” she says. “Their teaching and patient care philosophies are so different than in my country.” It is a philosophy that Hsieh—after completing the School of Nursing’s PhD program in 2009—plans to take back to Taiwan as a teacher of nursing research and oncology nursing. Hsieh developed an interest in oncology while teaching clinical nursing in northern Taiwan. She often encountered cases of hepatic and gastrointestinal cancer, and began to ask herself, “Can we do something to prevent this kind of problem?” At age 31, Hsieh started attending the University of Delaware, where she earned a master’s degree in oncology nursing and nursing education. After graduation, Hsieh returned to Taiwan and worked for 15 years as a lecturer and clinical nurse

U N I V E R S I T Y O F M A RY L A N D, B A LT I M OR E

specialist and coordinator before enrolling in the PhD program at the National Yang-Ming University in Taipei, Taiwan, in 2003. But Hsieh was not happy at Yang-Ming. Students are not encouraged to express their true thoughts in Taiwan, Hsieh says. “Here [in the U.S.] it is free for you to speak,” she says. “And always faculty encourage you to speak. I think it is a cultural difference.” Hsieh searched the Internet for a U.S. university and was i m p ressed with the PhD curriculum at the University of Maryland’s School of Nursing. She was also pleased with the University’s support services such as the Writing Center, which offers individual instruction on the nuts and bolts of grammar, punctuation, and sentence structure, as well as on broader issues such as writing style and critical thinking. Hsieh transferred to UMB in 2006. Her re s e a rch here focuses on database analysis related to hematopoietic stem cell transplantation. Among the University faculty, Hsieh has special praise for Meg Johantgen, PhD, RN, associate professor in the School of Nursing’s Department of Organizational Systems and Adult Health. “Dr. Johantgen always encourages us: ‘You are smart . You can do it.’” While Hsieh plans to offer a supportive and caring teaching approach to her students when she returns to Taiwan, she hopes to receive something from the students as well. Teaching is a rewarding experience for both instructor and pupil, she says. “I feel teaching is learning, learning is teaching,” Hsieh says.  PHOTOGRAPH BY SOFIA SILVA

NEW DEAN

NATA L I E D. E DD I NG T ON

S C H O OL OF P H A R M AC Y

Collaboration is Key for New Dean BY J E F F R E Y R A Y M O N D nnovation comes in various sizes for Natalie D. Eddington, PhD, the new dean of the School of Pharmacy. By thinking small, really small—as in one billionth of a meter, the size of a nano—Eddington helped to create the School’s Center for Nanomedicine and Cellular Delivery (CNCD). Moving from chair of the Department of Pharmaceutical Sciences to dean of the School in July 2007, Eddington is now thinking bigger, as the School expands its education and research efforts. “Collaboration is a hallmark of the center,” Eddington says of the CNCD, which was designated as the School’s first Or g a n i zed Re s e a rch Center in Fe b ru a ry2007. With researchers both from a number of departments within the School of Pharmacy and schools at the University of Ma ryland, Baltimore (UMB), as well as several universities within the University System of Ma ryland, the center’s scientists develop methods to deliver microscopic substances into the body at the cellular level to safely transport medical treatments directly to diseased cells. As an emerging area of study, nanomedicine requires a wealth of expertise to devise possible solutions. T h e re are pharmaceutical experts to work on drug systems, engineers to develop the microscopic drug delive ry devices, and doctors to study the impact on patients. Collaboration, says Eddington, does not always come naturally. Egos have to be contained, she admits, and building trust among colleagues from different specialties can also be difficult. But, she adds, a university is the perfect place to teach people how to collaborate effectively. “A lot of the cooperative spirit,” she says, “really develops while you’re yo u n g . ” “And, today, to address any type of problem, you have to engage others who have an expertise that is unlike yours,” says Eddington, who succeeded former Dean David A. Knapp, PhD. Eddington knows the School of Pharmacy well; she earned her PhD there in 1989 and joined the faculty in 1991. She graduated summa cum laude with a BS in pharmacy from Howard University in 1982. She rose to chair of the De p a rtment of Pharmaceutical Sciences in 2003, where she pursued her re s e a rch in pharmacokinetics, the movement of drugs among the cells of the body. She was named dean following a nationwide search. Eddington wants to see the power of collaboration used more widely. She speaks of “unleashing” the talents of the faculty to improve the School’s already high ranking (it holds eighth place in the 2005 U.S.News & World Re p o rt rankings), and of putting the School into a position where it can help “transform the profession” of pharmacy. Competing more successfully for fundraising is another

PHOTOGRAPH BY ROBERT BURKE

of Eddington’s goals, along with solidifying the School’s re p u t ation for producing pharmacy industry leaders. Ultimately, the n ew dean is convinced that the same emphasis on collaboration, in areas from fundraising to instruction, will make UMB “one of the top universities in the country.” She takes over the School of Pharmacy as it expands its PharmD program to the Universities at Shady Grove, in the h e a rt of Montgomery County’s biotechnology corridor. By adding a class of 40 students each year at Shady Grove—a campus shared by eight Ma ryland universities—the School is producing more pharmacists to help meet the industry’s current shortfall. “I am delighted to have Dr. Eddington aboard as our new dean,” says University President David J. Ramsay, DM, DPhil. “The School of Pharmacy is deepening its commitment to leadership in education and research, and Dean Eddington has proven herself as a first-rate teacher, researcher, and administrator.” 

2008

RESEARCH & SCHOLARSHIP

THAILAND

Teamwork Is Right Prescription for Thailand and School of Pharmacy

BY ROBYN FIESER

early 14 years ago, along with officials from the University of Maryland School of Pharmacy, Sumon Sakolchai, PhD, was one of the architects of the international agreement that helped revolutionize the way Thailand trains pharmacists. In 2007, Sakolchai, who has risen from pharmacy dean to become president of Khon Kaen University, a central hub of education in northeast Thailand, visited the School of Pharmacy, one of the institutions his country used as an educational model. When he left after a daylong tour of the Baltimore campus in early spring 2007 that included meetings with top administrators, he took along ideas that will help shape the design of his university’s first science and industrial park. “What we have in Thailand at the moment is individual collaboration, not systematic collaboration between academia and industry,” says Sakolchai. “The University of Ma ryland, Baltimore [UMB]—with the BioPark and, in particular, the Center for Nanomedicine and Cellular De l i ve ry—is a good model for us.” As Sakolchai moves forward with plans for his own research park, he wants to engage a consultant from the University. It is just one example of the type of collaborative projects that have emerged since the School of Pharmacy and nine other U.S.

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

pharmacy schools signed a pact with Thailand on May 31, 1994, in Bangkok. Known as the U.S. Consortium for the Development of Pharmacy Education in Thailand, the international program Sakolchai helped create with the School of Pharmacy has provided numerous opportunities for students and faculty of both countries. Facing a pharmacist shortage, Thailand signed the agreement to help it move toward the PharmD model, a four-year doctorate of pharmacy that—thanks in part to early advocacy from the School—is the standard in the United States. “Thai officials we re looking to add g reater clinical emphasis to the basic science curriculum,” says Edward Moreton, PhD, professor in the School’s Department of Pharmaceutical Sciences and the consortium coordinator. “They needed clinical experience in addition to enhanced basic science— the idea being that pharmacy faculty would, when they’re done, set up re s e a rch or a clinical practice back home.” The program provides avenues for Thai students to study in U.S. partner schools to earn a PhD or a PharmD. This has helped increase the number of pharmacy faculty and pharmacy practitioners in Thailand’s health c a re system. Several schools that formerly had no graduate degree programs or clinical pharmacy programs are now establishing them with the returning faculty. The Thai government selects faculty,

Dr. Ilene Zuckerman, associate dean for research and graduate education, and Dr. Edward Moreton, School of Pharmacy professor and coordinator for the U.S. Consortium for the Development of Pharmacy Education in Thailand

Dr. Gary Smith (left) and Dr. Edward Moreton (middle) pose with faculty members during their visit to Ubon Ratchathani University in Thailand.

Below: Khon Kaen University in northeastern Thailand

Above: Khon Kaen University President Dr. Sumon Sakolchai Right: Former student Dr. Supatra Porasuphatana has continued working with Dr. Gerald Rosen in her role as assistant professor in pharmaceutical sciences at Khon Kaen University.

TOP LEFT PHOTOGRAPH BY KIRSTEN BECKERMAN; BOTTOM RIGHT PHOTOGRAPH BY ROBERT BURKE

2008

RESEARCH & SCHOLARSHIP

Dr. Rosen not only benefits me but also other Thai students who compete for scholarships, and pays their tuition and living who will become young scientists and contribute to sciences in costs in return for a commitment of two years of work in Thailand as well,” she says. Thailand after graduation for each year funded. Since returning to Thailand, Porasuphatana has been invited U.S. faculty, in turn, travel to Thai host schools to teach to lecture at the Khon Kaen School of Medicine and to write a pharmacy and graduate students, provide seminars and worktextbook on free radical detection. shops, participate in symposia, interact in collaborative research In 2004, she won funding to conduct research on the use projects, and become familiar with pharmacy education and of antioxidants in diabetes patients from the Thailand Research practice in Thailand. Fund, an award she believes she was granted in part because of Since the consortium’s inception, the School of Pharmacy her strong research background and her publications. has graduated 13 Thai faculty, and 22 faculty and students “If I can help a student go back to her country to do have completed short-term exchanges of three to four months. productive research and enhance life in that country, I’ve Four Thai students are currently enrolled in PhD programs at accomplished something,” says Rosen. the University of Ma ryland School of But the consortium also is a boon to Pharmacy, and 16 faculty and U.S. students, such as Ma s a yo Sato, a 12 students from the School have been PhD candidate inPh a r m a c e u t i c a l hosted by Thai universities in various Health Services Re s e a rch. She received capacities. a $1,500 UMB Global Health Travel Re s e a rch has become a key part of If I can help Fellowship Award to travel to Thailand the partnership, one Moreton and others last summer to research the quality and would like to expand as the consortium a student go back to appropriateness of drug therapy in approaches the signing of its second h er country to do elderly adults. (See student profile on memorandum of understanding in July page 35.) 2008. productive research Sato will build on work by PhD “The program was set up to help the candidate Jose Josue Hernandez, RPh, Thai government educate its faculty—to and en h ance life MPH; Ilene Zuckerman, PharmD, get them interested in and excited about PhD, associate dean for re s e a rch and research so that when they get back they in that country, graduate education at the School of take that experience with them, pass it I’ve accomplished Pharmacy; and Vithaya Kulsomboon, on to their students and make the PhD, MPHM, chairman, social country more productive,” says Gerald something. pharmacy department, Chulalongkorn Rosen, PhD, JD, also a professor in the University in Bangkok. Department of Pharmaceutical Sciences. —Gerald Rosen In 2006, Zuckerman and “But collaboration is always a two-way Hernandez, through the consortium, street.” taught at universities in Thailand, For example, Rosen and former instructed government regulators and student Supatra Porasuphatana, PhD, bureaucrats on drug use by the elderly, an assistant professor on the pharmaceuamong other subjects, and advised graduate students on tical sciences faculty at Khon Kaen University, have continued research opportunities. working together since her 2001 graduation. They also spent time at Chulalongkorn University As a student in the School of Pharmacy, Porasuphatana Hospital, a large, urban hospital, compiling data on the use worked with Rosen to re s e a rch the role free radicals play in of drugs by the elderly. biological systems, particularly nitric oxide—a compound Although the re s e a rch is similar to what Zuckerman and associated with activities that include neurotransmitters and He r n a n d ezwould do in the United States, Thailand provides a host immune response. unique situation. The elderly population is rapidly increasing She returns to Baltimore regularly to work in Rosen’s lab. and the government recently implemented a national health This past summer, her visit involved research on the role of plan that will not only increase access to treatment, it also will nitric oxide in fighting blood-borne pathogens, namely raise questions about the cost and effectiveness of such programs. anthrax. This current re s e a rch is supported by a grant from the When Sato visited Thailand during the summer of 2007, Middle Atlantic Regional Center of Excellence for Biodefense she discussed ways to fund and focus future research and and Emerging Infectious Diseases Re s e a rch. Even when they’re expand on the database. not working side-by-side, Rosen and Porasuphatana collaborate “The Thai consortium works in multiple ways,” on their work via e-mail, publishing papers together. The Zuckerman says. “Part of the consortium’s work has been to experience, which exposed her not only to scientific expertise train the Thai faculty. And now those faculty mentors are in like Rosen’s but also to state-of-the-art lab equipment, changed their schools of pharmacy becoming leaders of re s e a rch. In her life, says Porasuphatana. addition, they are providing our students with exciting research “I’m ve ry proud of being able to have a chance to learn and opportunities.”  practice lab work with Dr. Rosen. What I have learned from

“

”

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

S T U DE N T P R OF I L E

M A S AYO S AT O

S C H O OL OF P H A R M AC Y

Using the University of Maryland Model to Advance Pharmacy Education Overseas BY J E F F R E Y R A Y M O N D

itting in an academic office high above West Baltimore on Saratoga Street, Masayo Sato talks about life as a graduate student at the University of Ma ryland School of Pharmacy. But her story begins 7,000 miles away, in Osaka, Japan. With a degree in pharmacy from Osaka University, Sato assumed she was qualified for her job as a hospital pharmacist. But when pharmaceutical sales representatives showed her data that made the drugs they were selling look better, she bought it. Literally. Eventually, though, she realized she didn’t fully grasp the meaning of the data and might not be making the best purchasing decisions. “So many factors were involved in the numbers,” she says. Sato came to the conclusion that her pharmacy education had left her poorly equipped to analyze the data. “It’s easy for a pharmacist to read an article,” she says. “But without proper training, that pharmacist might not know the study design or basic epidemiology.” After four years at Toyonaka Municipal Hospital in Osaka, Sato realized she wanted to know more about public health, wanted to work more closely with patients, and wanted to escape the confines of her job. “I saw a limitation on what I did, and I thought that had to change.” She came to the United States and earned a master’s degree in epidemiology at the Ha rvard School of Public Health, then realized she wanted to learn more about pharmacoepidemiology—the study of drugs and their effects on large populations. With a boyfriend in Maryland, she already was familiar with the Baltimore area and was attracted to the School of Pharmacy because of its strong multidisciplinary component in the pharmaceutical health services research program. She is now in the third year of the four- to six-year PhD program. She was able to afford to pursue her doctorate by landing a

PHOTOGRAPH BY KIRSTEN BECKERMAN

job as a research assistant to Ilene Zuckerman, PharmD, Ph D , associate dean for research and graduate education. And when Sato traveled to Thailand during the summer of 2007 to study the treatment of hypertension in that country’s elderly population, she did so with the help of a $1,500 University of Ma ryland, Baltimore Global Health Travel Fellowship Award and a matching grant from the School of Pharmacy. Sato calls her global health class “great,” adding, “People who are interested in international health are ve ry enthusiastic.” But she also has interests in the care of aging people, in public s e rvice, in the pharmacy industry, and in teaching. Japan is revamping its pharmacy education system, and in March 2007 Sato returned to Osaka University to present a lecture on the School of Pharmacy’s program. “I wanted to be involved in those educational projects,” she says. Mostly, Sato says, she wants Osaka University to emulate the School ’s emphasis on practical experience. Not only does

the School get its students into clinical environments, but those students actually do much of the work of the licensed professionals. By contrast, she says, Japanese pharmacy schools leave their students with little practical experience after four years. “I think this School has a great system,” she says. By the time School of Pharmacy students graduate, she continues, “They know how to consult with patients.”  2008

RESEARCH & SCHOLARSHIP

Treating Trauma 36

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

ILLUSTRATIONS BY OLIVIER KUGLER

B Y R A N D O L P H F I LL M O RE

WHEN UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE TRAUMA RESEARCHERS ESTABLISHED A PROGRAM TO HELP THE

EGYPTIAN MINISTRY OF HEALTH AND PO P U LATION BETTER COPE WITH

RISING ACCIDENTAL DEATH AND INJURY TOLLS, THEY NEVER EXPECTED THEIR PROGRAM WOULD ALSO ADDRESS AN ACUTE NEED IN AN AREA OF THE WORLD TORN APART BY CONFLICT.

EGYPT

ccidents and injuries related to traffic and industry, or that happen in the home, are commonplace in America. With world-class trauma care at facilities like the University of Maryland R Adams Cowley Shock Trauma Center close at hand, patients expect to surv i ve an accidental i n j u ryand return to normal life. However, in other parts of the world, rates of injury, especially from motor vehicle accidents, are spiking dramatically. Trauma care in these countries is not up to U.S. standards. “Human trauma and injury is one of the world’s leading causes of death and disability,” says Jon Mark Hirshon, MD, MPH, associate professor of emergency and preventive medicine at the University of Ma ryland School of Medicine. “Children and young adults are dispro p o rtionately affected, especially young men. Road traffic accidents worldwide disable between 20 million and 50 million individuals and kill another 1 million people annually.” Statistics from the World Health Organization (W H O ) confirm this and note that these injuries occur in nations with d e veloping or emerging economies. Those who surv i ve often suffer lifelong health limitations. Because of these grim statistics, Hirshon says, many nations focus on re s e a rch in the area of injury prevention, increase their

knowledge, build an infrastructure better able to cope with trauma, and upgrade their emergency response. Egyptian researchers have a similar focus. “Vehicular and work-related accidents are at epidemic levels in Egypt,” says Thomas Strickland, MD, PhD, director of the University of Maryland, Baltimore (UMB) International Health Program and professor of epidemiology and preve n t i ve medicine at the School of Medicine. Working with public health officials in Egypt is not new to UMB clinicians and re s e a rchers, who have had a collaborative relationship with that nation for more than two decades. It s t a rted when Strickland and others began working in Cairo on an infectious disease re s e a rch program in the 1980s. Their focus then was schistosomiasis. Once rampant in Egypt along the Nile River, the debilitating disease is caused by a freshwater parasitic worm that bores into the skin, enters the bloodstream, and damages the liver or other organs. By the 1990s, Strickland and other UMB scientists and Egyptian collaborators had shifted their focus to hepatitis C, which had become Egypt’s leading cause of chronic liver disease. TACKLING INJURY PREVENTION

In May 2005, the UMB-Egyptian collaborative turned its e f f o rts toward injury prevention research. A project headed by members of the Charles McC. Mathias Jr. National Study Center for Trauma and Emergency Medical Systems (NSC) at the School of Medicine teaches injury prevention research to health professionals in Egypt. Named in honor of the former U.S. senator from Maryland and established by Congress in 1986, the NSC conducts re s e a rch related to trauma, emergency medicine, and emergency medical systems. It also acts as the re s e a rch arm of the Shock Trauma Center and the Ma ryland Institute for

Along the Nile 2008

RESEARCH & SCHOLARSHIP

Jon Mark Hirshon (far left) with some of his summer trainees and colleagues. From left: Amira Moshen, Marwa Rashad, Mohamed El Shinawi, Mohammed Farouk Taha, Maged El-Setouhy, Waleed Salah El Din, Alfred Bowles, and Maureen McCunn.

Emergency Medical Services Systems. “Our desire to help colleagues in Egypt became a reality with a grant from the John E. Fo g a rty International Center of the National Institutes of Health,” recalls Hirshon, who is board-certified in both emergency medicine and preventive medicine. “The NSC has carried out research for many years and is known for its expertise. The Fogarty Center offered us the opportunity to take that expertise overseas to help our colleagues in Egypt conduct injury prevention research.” In 2005, the Fo g a rty Center’s program for International Collaborative Trauma and In j u ry Research Training provided Hirshon and his colleagues with a five-year, $850,000 grant. “Our program was designed to help the Egyptian Ministry of Health and Population and other Egyptian health professionals increase their knowledge and understanding of human trauma and injury prevention,” explains Patricia Dischinger, PhD, professor of epidemiology and preve n t i ve medicine at the School of Medicine, an epidemiologist with the NSC, and co-principal investigator on the Fo g a rty grant. “Students completing the program apply this know ledge to help decrease the significant morbidity and mortality caused by injuries.” The grant, says Dischinger, has three aims: • to teach basic and advanced epidemiological skills to medical professionals in Egypt • to help develop the capacities and e x p e rtise for pre-hospital and emergency preparedness in the target nations • to train a cadre of emergency physicians and surgeons in state-of-the-art trauma c a re methods 38

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

SHIFTING GEARS

Plans for teaching the courses had been drawn up, but their implementation would suddenly be interrupted when world events i n t ruded. Overnight, emergency training needs were required to address trauma of another variety—the injuries caused by conflict. In fact, as Hirshon puts it, “the ink was not yet dry on the grant paperwork,” when e-mails from a physician in northern Iraq made their way to faculty in the School of Medicine. “The e-mails asked for help in coping with the human toll caused by a terrorist bomb in Erbil, Iraq.” On May 4, 2005, a suicide bomber blew himself up among a group of 300 people gathered to apply for police jobs in the Kurdish city 200 miles north of Baghdad. Sixty people we re killed and 150 were wounded. While the original grant was aimed at training professionals in injury prevention research methods, it was suddenly apparent that the need had become broader and more acute. “We immediately applied for and received from the Fogarty Center a supplemental grant to help train Iraqis in emergency preparedness and trauma response,” Dischinger explains. Thus, the need for better trauma response and emergency care, in an area of the world that Hirshon describes as a “tough neighborhood,” took a fast and different track. The Middle East has had its share of violence, mostly in terms of improvised bombs and the devastating injuries they cause. UMB researchers knew that their e f f o rts in the area needed redefining. Thanks

to the Fo g a rty grant, the project could take on new proportions. The grant helped researchers to develop three education programs. The International Emergency Preparedness and Response (IEPR) program helps health professionals prepare for and respond to disasters. The Sequential Trauma Education Programs (STEPS), developed by anesthesiologist Maureen McCunn, MD, MIPP, associate professor at the School of Medicine, i n t roduces trainees to the basics of injury care management with an emphasis on diagnostic and treatment sequences. The program is designed to be open to a variety of acute health care professionals. A third education course on injury epidemiology has been developed in collaboration with colleagues in Egypt. “Egypt is still our base of operations,” explains Hirshon. “The courses have been carried out along with the National Training Institute of the Egyptian Ministry of Health and Population and Ain Shams University.” The program is open to those with an MD or PhD and offers core training in epidemiology and biostatistics, basic knowledge of the biological and psychosocial aspects of trauma and injury prevention, injury control and trauma response, and mentor-guided research into an area in injury prevention. COMING TO JORDAN, CAIRO

The effort already has an extensive track record, starting with an inaugural IEPR training course in Amman, Jordan, presented to 23 Iraqis in October 2005. Both the IEPR and STEPS programs were presented in Egypt in May 2006 to approximately 65 Egyptian enrollees. In August 2006, 22 Iraqi physicians from the Iraqi Ministry of Health using World Bank funds attended an IEPR program in Cairo. Although the logistics of running a training program abroad occasionally caused temp o r a ry concern (visa mix-ups and canceled flights notwithstanding), Hirshon was pleased at the initial efforts. “The National Training Institute of the Egyptian Mi n i s t ry of Health and Population was an excellent location for training activity,” re p o rts Hirshon. “The right equipment was available, and personnel at the institute were responsive.” Issues such as incident command, scene management, and triage we re addressed. Specific requests from those receiving training

included instruction in stress management, communication and security, media relations, and record keeping. The trainees—physicians identified by the Iraqi Mi n i s t ry of Health—and the trainers had significant expertise in emergency preparedness, emergency medical services management, emergency medical and surgical care, and the management of mass casualties, especially in bomb injuries and weapons of mass destruction. “We found that Baghdad, because of its experience and infrastructure, was better prepared and equipped to deal with disasters than was northern Iraq,” explains Hirshon. “We also learned from some of the hurdles. The English language skills and technical knowledge varied in the students. We learned to work within the political structure and quickly found value in being flexible and culturally sensitive.” In Febru a ry and May of 2007, the IEPR and STEPS courses were repeated for Egyptian health professionals. Hirshon’s Egyptian colleague, Maged El-Setouhy, MD, PhD, a professor in the Department of Community, Environmental, and Occupational Medicine at Ain Shams University in Cairo, and a WHO consultant, was instrumental in the implementation of the program. In May 2007, six physicians came to UMB for a two-month training program in the epidemiology of injury. After weeks of w o rk in epidemiology and shock trauma, they designed a re s e a rch project and went home to implement it. Results of this effort will be presented in May at a Middle East regional conference being organized by Hirshon and El-Setouhy in collaboration with the WHO regional office. All research presented in this conference will be published in a special edition of the Eastern Mediterranean Health Journal. “Having foreign students here at UMB studying such an important topic was quite exciting,” says Hirshon. “Watching the students work through the various problems and come up with creative research projects for implementation upon their return was ve ry gratifying. “UMB is fortunate to have the NSC and the opportunity—thanks to the Fogarty Center and the Shock Trauma Center—to have an international fellowship to train medical professionals in injury prevention and response,” adds Hirshon. 

2008

“

UMB is fortunate to have an international fellowship to train medical professionals in injury prevention and response. —Jon Mark Hirshon

” RESEARCH & SCHOLARSHIP

Carrying a GlobalTorch at the Dental School WORLDWIDE B Y M Y R A A . T H OM A S

Dr. Michael Belenky directs global outreach at the Dental School.

n a world of diminishing borders, cross-cultural endeavors are bringing needed oral health care information to almost eve ry part of the globe. Maintaining professional ties, advancing collaborative research internationally, and adding a global dimension to the educational process are keys to the future of dental schools that will be “world class,” says Michael Be l e n k y, DDS, MPH, an associate professor and director of global outreach for the University of Ma ryland Dental School. Belenky coordinates ties with foreign dental schools, arranges faculty and student exchanges, and promotes collaborative efforts in research, teaching, and continuing education through the Dental School’s Global Ma ryland program. He also is a member of the School’s De p a rtment of Health Promotion and Policy, where he teaches principles of ergonomics for occupational health and serves as a general practice manager, supervising students as they treat patients in the undergraduate clinics. “Wearing two hats of responsibility allows me to maintain the professional credential of a dental educator as I enable students and faculty to carry the message of Ma ryland and contemporary dentistry around the globe,” Belenky says. The Dental School has relationships with 13 dental schools in 11 countries, including Korea, Japan, Vietnam, Thailand, Australia, Canada, Mexico, Pe ru, India, Poland, and Ireland. For more than two decades, a number of Dental School students have participated in an annual dental mission to rural areas of the Dominican Republic. “Our dental students shouldn’t be limited in their perspective. They should have global opportunities for p rofessional and cultural enrichment if they are to be leaders in meeting the 21st-century oral health needs of the community of nations. This is the reason we established the Global Maryland program,” Belenky says. The Global Ma ryland program is just one facet of the Global Outreach initiative that allowed Dental School students to serve two-week externships in Vietnam, India, Poland, Canada, and Australia in 2006-2007. “The emphasis here is learning about dental education, dental practice, and oral health in another country, and, where possible, providing essential dental care to the underserved in public health settings,” Belenky says. Each year, approximately 25 percent of the senior dental class elects to PHOTOGRAPH BY BILL MCALLEN

participate in a foreign dental externship. Postgraduate residents, faculty, and area practitioners often accompany the students abroad. “We’ve been doing this informally since 1994, but then we formalized and expanded the program,” Belenky says. “T h i s gives the student a tremendous chance to see dentistry from a different perspective and from a different part of the world— from programs that are quite advanced in developed countries to those emerging in developing countries.” Relationships also extend the other way, with theDe n t a l School playing host to foreign faculty and students. A collegial relationship with the Faculty of Dentistry of the Medical University of Lodz, Poland, dates back to the beginning of the program in 1994. About 25 percent of the Lodz professors have come to the Dental School to study the Ma ryland model of dental education and contemporary dental practice, conduct long- and shortterm re s e a rch, and attend postgraduate educational programs. Faculty members from many of the 13 partner institutions also have opted to come to Ma ryland for collaborative research endeavors. Additionally, dental students from the United Kingdom, France, Germany, Poland, Ireland, Israel, Mexico, and other nations have visited the Dental School to fulfill overseas externship requirements. As with the Ma ryland students on foreign externship, their objective is to study dental education and dental practice in other lands in preparation for their professional futures in a global community. “This broad exchange of ideas, technology, and science that is forging essential bonds between the Dental School and a number of institutions across the globe supports the School’s mission that global outreach efforts of faculty, students, and staff be mutually rew a rding,” says Christian S. Stohler, DMD, DrMe d Dent, dean of the Dental School. “Dr. Belenky is the perfect person to head up such an endeavor.” Before coming to the Dental School in 1982, Be l e n k y served more than 20 years with the U.S. Army Dental Corps before he retired as a colonel. One of his first projects at the School was the establishment of the Center for the Study of Human Pe rformance in De n t i s t ry, a unique facility dedicated to the investigation, teaching, and practice of human-centered ergonomics. “In the past, I traveled extensively with the Army, saw much of the world and its diverse cultures, and this expanded my horizons. In my Dental School career of 25 years, I was privileged to continue to travel the globe and apprise colleagues PHOTOGRAPHS COURTESY OF MICHAEL BELENKY

At left, Dental School students visiting Kyung Hee University in Seoul, South Korea, and teaching village children how to brush their teeth in Vietnam. Below, students outside a small clinic in Peru, treating patients in Mexico City, the architecturally impressive Medical University of Lodz in Poland and, bottom, a mobile dental clinic in Vietnam.

of advances in dentistry and dental education,” Belenky says. Programs such as Global Ma ryland are just one way the world’s first degree-granting dental school has taken the lead in dental education. “Thanks to Dr. Belenky and the Global Ma ryland program,” says Stohler, “Dental School students are better prepared to share their observations and knowledge with colleagues, to engage professionally within and beyond national boundaries, and to contribute to the advancements in dentistry in the global arena.”  2008

RESEARCH & SCHOLARSHIP

Dr. Claire Fraser-Liggett (second from left) directs the University’s new Institute for Genome Sciences, which will move to Building Two of the BioPark in summer 2008. Here she poses with (from left) Dr. Bruce Jarrell, vice dean for research and academic affairs at the School of Medicine; Jane Shaab, UMB’s assistant vice president for economic development; and James Hughes, UMB’s vice president for research and development.

The UMB BioPark

s faculty, staff, students, political leaders, and friends commemorated the bicentennial of the University of Maryland, Baltimore (UMB) in 2007, the University’s n ewest venture, the UMB BioPark, also reached a milestone. The biomedical research park is now in its fifth year. “When UMB launched the BioPark initiative on the west side of Baltimore in 2003, it seemed to many an unlikely project,” says James Hughes, MBA, UMB vice president for research and development and president of the UMB Health Sciences Research Park Corp. (RPC), the n o n p rofit organization set up to manage the development of the BioPark. The creation of the UMB Bi o Park was a first for the University as it expanded the campus westward across the wide, busy thoroughfare of Martin Luther King Jr. Boulevard into the neighborhood of Poppleton. Most of the land that the Bi o Park now encompasses had been 42

A five-year perspective BY J U LI E E VA N S vacant for years or was occupied by vacant commercial pro p e rties. Despite this, in the past five years UMB and RPC, working with the community and developers Townsend Capital and Wexford Science + Technology, have: • Built and maintained strong community support

• Acquired nine acres of land • Constructed two research buildings totaling 358,000 square feet and one p a rking garage with 638 spaces • Created 200 jobs • Generated $129 million in capital investment

TENANT HIGHLIGHTS

The BioPark serves as a launching point for companies that have graduated from area incubators and/or have spun out of local universities such as Alba Therapeutics Corp., which came out of UMB, and FASgen, Inc., a Johns Hopkins startup. Two other companies maintain small lab facilities in the BioPark. IRAZU BioDiscovery, LLC is the discovery arm of its Baltimore-based affiliate, Paragon Bioservices. Acidophil, LLC is an intellectual property development company founded by Red Abbey Venture Partners director Philip Goelet, PhD, and Nobel Prize-winning scientist Sydney Brenner, MD, PhD. In Building Two, a BioAccelerator has been created that will offer pre-built wet lab and office space for additional emerging companies. A no-interest, $1 million loan from the Maryland Technology Development Corp. (TEDCO) was secured to help finance this initiative.

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

PHOTOGRAPH BY ROBERT BURKE

DEVELO PM EN T MILEST ON ES

COMMUNITY DEVELOPMENT

romoting development in the surrounding community is an i m p o rtant goal as the BioPark grows. The RPC created a dedicated community fund supported by a small portion of tenant rent payments and has disbursed $58,000 in the first two years to support job training at the Poppleton Village Center and to equip science labs at the city’s newly created health sciences magnet high school near the Bi o Park, the Vivien T. Thomas Medical Arts Academy. Other initiatives include paid summer internships for Vivien Thomas students with BioPark tenants and sponsorship of qualified Poppleton residents to become lab technicians through the Bi o Technical Institute of Maryland’s intensive lab training program. Capitalizing on the success of the BioPark’s rapid growth and other nearby redevelopment projects, the City of Baltimore launched a project for 14 acres of residential redevelopment immediately north of the BioPark in p a rtnership with developer La Cité. As many as 1,600 housing units could be built for rental and purchase. MASTER PLAN

ithin the next two years, two more buildings—a new Ma ryland Forensic Center and a third commercial multitenant building—will bring this impressive undertaking to 658,000 square feet, $229 million in

capital investment, and the creation of 600 jobs. Additional buildings will open approximately eve ry 24 months according to market demand. At full build-out, the BioPark will consist of 10 research buildings totaling 1.2 million square feet and $500 million of capital investment concentrated in 10 acres. Approximately 2,500 people will work in the BioPark. As the master plan for the Bi o Park has expanded from its initial conception, so too has the importance of creating a vibrant urban center that not only advances the life sciences industry, but also encourages connections among visitors, employees, the University campus, and the surrounding residential community. This goal can be accomplished through good urban design, buildings that invite curiosity about the work within, small retail spaces that provide indoor and outdoor social interactivity, and visually appealing open space that can be enjoyed by all. The focus of the next five years will be to bring this vision into reality. “The entrepreneurial spirit at UMB has escalated—our re s e a rch base has g rown from $138 million in 1997 to $411 million in 2007. Patenting and commercialization efforts have led to the creation of startup companies and the BioPark has provided a perfect home in which they can prosper,” says David J. Ramsay, DM, DPhil, president of UMB. “I am tremendously pleased with the progress of the BioPark in its first five years.” 

MEET SOME OF THE TENANTS

• SNBL Clinical Pharmacology Center, Inc. is the largest new Japanese • •

• •

investment in Maryland in 20 years. Alba Therapeutics Corp. is the biotech company with the largest Series A venture capital round ever conducted in Baltimore. The Center of Vascular and Inflammatory Diseases, formerly the American Red Cross Holland Labs and the largest faculty recruitment in UMB history, occupies two floors of Building One. Harbor Bank, the first new bank branch in the neighborhood in two decades, provides a full range of banking services to tenants and community residents. Miles and Stockbridge P.C., a leading national law firm, located its life sciences practice in the BioPark.

2003

• Research park feasibility study completed • UMB Health Sciences Research Park Corp. incorporated as a not-for-profit • Townsend Capital selected to develop Building One • $4 million state Sunny Day Fund subsidy approved for lab fit-out 2004

• Initial 4.7 acres donated by City of Baltimore • Building One and Garage One construction started • Two private parcels acquired 2005

• UMB public safety substation opened with 16 police officers • Building One Opened: 120,000 square feet, $36 million capital investment; earned Silver Level LEED certification for environmental friendliness and achieved 35 percent Minority Business Enterprise participation, exceeding city goals • Garage One Opened: 638 parking spaces, $13 million capital investment • Wexford Science + Technology proposed development of Building Two on land it owns (801 W. Baltimore St.) 2006

• Building One 100 percent leased and occupied • Building Two construction started • New Maryland Forensic Center project awarded to BioPark • Additional acre of land in 900 block of Baltimore Street donated by City of Baltimore and private parcels acquired by BioPark 2007

• $1 million TEDCO loan approved for Building Two BioAccelerator • New Institute for Genome Sciences created • Building Two shell construction completed: 238,000 square feet, $80 million capital investment • Building Three development awarded to Wexford Science + Technology • UMB BioPark received first-ever “Emerging Park of the Year” award from the Association of University Research Parks

2008

RESEARCH & SCHOLARSHIP

University of Maryland, Baltimore C

B Y C L A RE B A N KS

n 2007, the University of Maryland, Baltimore (UMB) commemorated its bicentennial by highlighting its extraordin a ry accomplishments and its impact on local, national, and international communities. UMB was founded in 1807 by the School of Medicine and is the founding institution of the University System of Maryland. The bicentennial’s kickoff event was held at Davidge Hall in November 2006 with School of Medicine Dean E. Albert Reece, MD, PhD, MBA, vice president for medical affairs at the University of Ma ryland and John Z. and Akiko K. Bowers Distinguished Professor. It featured a “visit” from John Beale Davidge. Bicentennial events were held throughout the year and included lectures, community outreach projects, and the School of Medicine’s sponsorship of the public radio program A Prairie Home Companion, with Garrison Keillor, at the Hippodrome Theatre. Patti LaBelle, Cal Ripken Jr., and former U.S. Attorney General Janet Reno were among the speakers at the three-part “Enduring Power of Leadership” series for the public, which was also held at the Hippodrome. In April, more than 600 School of Medicine students m a rked the bicentennial by volunteering for a Student Se rvice Day, where they worked with children and parents to promote science and good health and helped build a house for Habitat for Humanity. Additionally, the School of Medicine conducted a Mini-Med School for Adults to help Baltimore-area residents improve their health and well-being. To further promote the bicentennial, the University hung banners throughout the campus and surrounding city streets. A bicentennial exhibit, including a video and timeline, was displayed in the Miller Senate Office Building in Annapolis throughout 2007. The exhibit showcased the University’s remarkable progress and many pioneering “firsts” achieved since 1807. The University’s history of excellence in education, re s e a rch, and service is the catalyst for growth that will transform lives in the next 200 years. 

U N I V E R S I T Y OF M A R Y L A N D, B A LT I M O R E

From left: President David J. Ramsay, School of Medicine Dean Emeritus Donald E. Wilson, actor Alan Wade (portraying medical school founder John Beale Davidge), and Dean E. Albert Reece sliced a cake replica of Davidge Hall at the launch of the School of Medicine’s 200th anniversary, Nov. 29, 2006, on the tented lawn of Davidge Hall. Photo: Bill Wood

Cal Ripken Jr. was a speaker at the April 26 bicentennial lecture on “The Enduring Power of Leadership” at the Hippodrome Theatre. He spoke about average people accomplishing above-average goals. Photo: Don Wright The founding medical school building, Davidge Hall, was draped with swags modeled after the University’s centennial bunting. Photo: Tracy Boyd

re Celebrates 200 Years

Bicentennial banners ringed the campus.

Entertainer Patti LaBelle was among the speakers at the Feb. 26 launch of the bicentennial lecture series at the Hippodrome Theatre. More than 900 people attended to hear scientists from the School of Medicine and other institutions talk about diabetes research and LaBelle speak about living with the disease. Photo: Bill Wood

Conducting a Mini-Med School at the Maryland Science Center (above) and at Sollers Point Technical High School (right) in April was part of the School of Medicine’s Student Service Day, where 600 medical students volunteered by teaching, cleaning, and painting schools and building a house for Habitat for Humanity. Photo above: Tom Jemski; Photo right: Don Wright

Dr. Bob Arnot, medical correspondent for NBC and CBS, moderated the three-part bicentennial lecture series, which was free and open to the public at the Hippodrome Theatre. He also spoke at the April lecture on “The Enduring Power of Leadership.” Photo: Don Wright

Legislators and visitors learned of the University’s 200-year history and accomplishments with an exhibit (below) and video in the Miller Senate Office Building in Annapolis. Photo: Tracy Boyd

The Honorable Francis X. Kelly Jr., member of the USM Board of Regents and chair of UMB’s bicentennial committee, gave the keynote address at UMB’s bicentennial-year commencement. Photo: Danielle Peterson

P R OF I L E S I N G I V I N G

HAMISH AND CHRISTY OSBORNE

Creating a Legacy in Law BY C H R IS T I N E S T U T Z amish S. Osborne, JD, was a senior policy analyst at the Social Security Administration, where he anticipated a lengthy career, when he discovered a passion for the law that would change his life. He was seated on a jury hearing a vehicular homicide case, and, as Osborne imagined himself presenting testimony and making arguments, he realized that he wanted to practice law. That was 1982. One year later he was enrolled as a full-time student at the University of Maryland School of Law. Although he was 35 years old and had a young family, he and his wife, Christy, had enough money saved so that he could d e vote his full attention to law school, t reating it like a full-time job. His experience was the impetus behind the Osbornes’ major gift to the law school, consisting of a $1 million lifetime gift and a $5 million bequest. The Osborne Scholarship Fund endowment will provide tuition assistance and stipends to students with significant professional experience, who for financial reasons might not otherwise be able to attend the School of

Law full time. “I’m hoping that eventually our scholarship fund will grow large enough to entice more world-class students to come to the University of Ma ryland,” he says, “and thereby continue to improve our outstanding student body.” Scholarship recipients are expected to p a rticipate in law school activities such as Moot Court and student law journals, fulfill leadership roles in at least one extracurricular activity, and maintain high academic standards. Bryan Saxton, a second-year law student, was selected as the first Osborne Scholar in September 2006. He is involved with five student organizations, including the Moot Court Board, and works as an admissions ambassador and peer advisor. The newest Osborne Scholar, Max Tondro, has a PhD from Cambridge University and worked most recently as a college art history professor. Osborne says that being able to attend law school full time gave him many o p p o rtunities he would not have had a s an evening student. “I really think I received a complete legal education by having the time to attend classes, part i c i-

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

S C H O OL OF L AW

pate in extracurricular activities, and work for a federal judge as an Asper Fellow. I was fortunate enough to write on the law review, and I think I got as much out of that as anything else I did in law school. My experience with the University of Ma ryland was that it was a great place to go to law school, and I had wonderful professors,” he says. After graduating in 1986, Osborne practiced corporate, tax, and real estate law, and quickly became active in the nonprofit community, eventually chairing the boards of Leadership Howard County, Inc. and the School Solutions Foundation, Inc. He also has served on, or is serv i n g on, multiple not-for-profit boards, including those of the Columbia Foundation, McDonogh School, the Mid-Shore Community Foundation, the American Military Spouse Education Foundation, and the School of Law’s Board of Visitors. “It’s the most rew a rding thing that I could ever do, I think, to be able to work with w o rthy nonprofit organizations,” he says. He retired from his Columbia, Md., law practice in 1999 to enjoy life in Vero Beach, Fla., and Easton, Md., with his wife, three children, and 10 grandchildren. Their son Matt is also a graduate of the School of Law. The Osbornes have contributed to the law school every year since 1986. “Amidst the generosity of so many of our graduates and friends, Hamish and Christy have t ruly distinguished themselves as leaders in support of the law school,” says Dean Karen H. Rothenberg, JD, MPA. “T h e i r scholarship is assisting future leaders of law and society whose accomplishments will serve as an enduring legacy for the Osbornes.” “I think the University of Maryland law school has come so far, even since I was in school,” Hamish says, “and Dean Rothenberg has just done a fabulous job in leading this effort, as is evidenced by the School of Law’s national recognition. If we want to continue that improvement and level of recognition, then the law school needs the help of its alumni and friends.”  PHOTOGRAPH BY BILL MCALLEN

unique (adj.) having no like or equal: unparalleled The University of Ma ryland, Baltimore (UMB) is unlike any other university in the world. No other campus has our precise mix of professional schools—Medicine, Law, Dental, Pharmacy, Nursing, Graduate, Social Work, and Public Health. Through the power of eight schools working as one, there is virtually no complex p roblem we cannot solve. Whether we are effecting change on the west side of Baltimore or the Western Coast of Africa, our collaborative approach makes an exponential difference in the lives of people around the world.

UMB LAUNCHES

$650 MILLION

CAPITAL CAMPAIGN Making an Impact Worldwide COLLABORATE From the bench to the bedside, UMB’s faculty and scientists are invigorated by an optimism that is changing the world. New advances bring the promise of preventing and curing intractable diseases in this generation.

“

One of the most important challenges over the next two decades will be integrating new insights from the past 10 years of genomics studies into the clinical environment to impact human health. I am extremely excited about the opportunity for multidisciplinary collaboration.

”

Claire Fraser-Liggett, PhD Director, Institute for Genome Sciences, School of Medicine

“Diverse, innovative approaches

to complex oral health issues in research, education, and patient care will ultimately change human lives. The most-needed, w o rthwhile scientific discoveries can never be fully realized without genuine commitment and deep financial support .

INNOVATE Our urban setting creates many opportunities for model partnerships, analysis of the critical problems confronting cities, and the design and testing of new approaches to urban revitalization, patient care, and other human and health services. Community involvement in all its multifaceted forms has become the hallmark of UMB’s faculty and students.

”

Christian S. Stohler, DMD, DrMedDent Dean, Dental School 2008

RESEARCH & SCHOLARSHIP

EDUCATE Our 5,600 students are an integral part of an educational culture built on the notion of solving complex societal problems. At UMB, education extends beyond the boundaries of the classroom into our surrounding community, our nation, and our world.

ADVOCATE The commitment and creativity of our faculty take shape through lifetimes devoted to improving every aspect of the human condition—both physical and social. From facilitating the release of the wrongly imprisoned to advocating against genetic discrimination in Washington, D.C., our faculty and students strive to establish policies to improve lives.

“

UMB offers an outstanding array of resources for both undergraduate and graduate students, and the excellence of its many schools offers students the opportunity to take courses across the campus and to gain the real-world experience they need to deliver quality, compassionate patient care.

” “

Patricia Gonce Morton, PhD ’89, MS ’79, RN, CRNP, FAAN Associate Dean for Academic Affairs, School of Nursing

We strive to instill a sense of responsibility and commitment in our students to do so many things—to interact with their communities, to engage in advocacy and public service, and to be skilled and responsive policymakers.

DONATE

”

“Discovering new knowledge—that

is our role—whether we apply it innovatively to the education of pharmacists, to the development of n ew drug delive ry systems through research, or to partnership in direct patient care programs. Private dollars are needed to support those initiatives.

”

Natalie D. Eddington, PhD Dean, School of Pharmacy

Ka ren H. Rothenberg, JD, MPA Dean and Marjorie Cook Professor, School of Law

“

We are deeply indebted to the Brodys for their leadership in establishing a student scholarship as the School seeks to extend support to attract and retain the many excellent and financially hard-pressed students seeking to attend the University of Ma ryland School of Social Work.

”

Richard P. Barth, PhD, MSW Dean, School of Social Work

ACCELERATE The depth of UMB’s scientific knowledge base is broadened by significant increases in research funding, which has doubled in seven years. Commercializing breakthrough therapies, diagnostics, and devices, UMB is fueling the creation of startup companies and attracting industry leaders and entrepreneurs.

Campus Center The five-story, 146,000square-foot Campus Center will bring together faculty, students, and visitors in a collaborative, shared space with conference and meeting rooms, a fitness and wellness center, swimming pool and running track, dining options, and lounge spaces.

“

The UMB BioPark is a growing community of high-growth life science companies and specialized research centers of the University of Maryland, Baltimore.

”

David J. Ra m s a y, DM, DPhil President University of Ma ryland, Baltimore

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

“

The new Campus Center will foster a greater sense of community by providing much-needed space and opportunities to synergize the great minds from UMB’s many schools. The center will bring together individuals from different academic and cultural backgrounds to achieve common goals for the greater good.

”

Jessica O’Kane, President, University Student Government Association, 2007-2008 Doctoral Student, School of Pharmacy

Leading the way in the capital campaign, clockwise from top left: Stewart Greenebaum, Richard Barth, Natalie Eddington, University President David Ramsay, Campaign Chair Francis Kelly Jr., Christian Stohler, Janet Allan, Karen Rothenberg, E. Albert Reece, Joanne Pollak, Henry Hopkins, John Patterson, John Gregory, Barbara Brody, and Edward Brody.

School Campaign Chairs & Goals SCHOOL OF MEDICINE Stewart Greenebaum Goal: $500 million SCHOOL OF LAW Henry Hopkins, LLB, and Joanne Pollak, JD Goal: $50 million DENTAL SCHOOL John Patterson, DDS, MBA Goal: $30 million SCHOOL OF PHARMACY John Gregory, DPS (Honorary) John Balch, RPh Goal: $30 million SCHOOL OF NURSING Goal: $30 million SCHOOL OF SOCIAL WORK Edward Brody and Barbara Brody, MSW Goal: $10 million

PHOTOGRAPH BY BILL MCALLEN

What You Can Do to Make an Impact

he generous contributions of people who understand our mission have made the University and its schools a world leader. As our achievements grow, so does our need to support students and faculty. New philanthropic investments will support the following initiatives: Scholarship funds for students pursuing advanced degrees in health, social work, and law who might otherwise not have access to these programs for financial reasons Endowed chairs and professorships to recruit and support top faculty in their roles as teachers, leaders, and scientists Capital funds to support the construction and maintenance of new facilities designed to enrich and expand the experience of UMB students, faculty, staff, patients, and patronsâ&#x20AC;&#x201D;the new Campus Center, the third and most advanced Health Sciences Facility, School of Pharmacy renovations, and the development of a new School of Public Health Current use or endowed funds to allow truly creative faculty and graduate students to pursue new and promising ideas, as we continue our tradition of innovation and outreach around the world No matter how you choose to support the University, venture philanthropy at UMB promises extraordinary satisfaction and results. In our third century of excellence, we will continue to offer outstanding students a dazzling array of experiences and opportunities. We hope you will partner with us as we empower them to change the world.

www.giving.umaryland.edu

2008

RESEARCH & SCHOLARSHIP

FOU N DE R S W E E K AWA R D W I N N E R S 2 0 0 7

B Y D A N IE L LE S W E E N E Y W I N N ER P H O T O G RA P H S B Y R O BE RT B UR KE

resident David Ramsay and his wife, Anne, host Founders Week each year in October to celebrate the University of Ma ryland, Baltimore’s (UMB) history and honor the achievements of its faculty, staff, students, alumni, and friends. The 2007 celebration began with a black-tie gala at the historic Hippodrome Theatre that served as the backdrop for the launch of UMB’s $650 million capital campaign. A research lecture, a breakfast honoring two entrepreneurs of the year, a student cookout, and a staff luncheon were also part of the weeklong festivities. UMB was particularly proud to announce its Teacher, Re s e a rch Lecturer, Public Se rvant, and Entrepreneurs of the Year. Photo: Jay Baker

Teacher of the Year

Robert V. Percival

nvironmental lawyer and School of Law Professor Ro b e rt V. Percival, JD, MA, has an enthusiasm for his profession—and for teaching—that inspires his students. “He has an unbridled joie de vivre that infects his students and excites them about the study and practice of law,” says Lewis Taylor, a student in the School’s Environmental Law Program and Percival’s former re s e a rch assistant. Percival, who directs the Environmental Law Program, says many factors have shaped him as an educator, factors that led to him being named Teacher of the Year. One influence was his own professors at Stanford Law School—both in what they taught him, and what they didn’t. “They taught me that there is no one correct teaching style and that there are many successful approaches,” he says. At Stanford, Percival also learned the value of a clinical law education, because Stanford—like most law schools in the 1970s—didn’t provide any. “When I established the Environmental Law Program in 1987, I made it a priority to create the Environmental Law Clinic,” Percival says. “It would teach future lawyers all the skills I had to learn by doing.” 50

Percival, the School’s Ro b e rtF. Stanton Professor of Law, also is we l l - k n own for employing nontraditional teaching methods to get students thinking about the law in different ways. In one course his students can create a short documentary film about an environmental law issue that is important to them. Recent documentaries have explored lead paint, the disappearance of the Eastern oyster, and the degradation of the Shenandoah River. K a ren Rothenberg, JD, MPA, dean of the School of Law and Marjorie Cook Professor of Law, says the assignment is challenging. “It Robert V. Percival forces students to confront the difficulty of translating complicated legal creativity it helps unleash has long-lasting and policy issues into a form the average benefits for students in their legal careers,” audience can understand,” she says. “It Rothenberg notes. also yields some ve ry powe rful films.” Perc i val believes most of his School of To showcase the students’ work, Law students are as talented as those in Percival created the Environmental Law other prominent law schools where he has Film Festival, where the best films receive taught, such as Ha rvard and Georgetown. Oscar-type awards. “Not only is the film “They just don’t know how good they f e s t i val an anticipated annual event, the are,” he says. “So I need to challenge them

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

to reach their full potential.” Taylor says that being Perc i va l’s re s e a rch assistant exposed him to many o p p o rtunities—including revising a seminal environmental law textbook and coordinating an international law conference—and credits the experience with helping him land key internships at the De p a rtment of Justice, the U.S. Senate, and the chambers of a federal court judge. Taylor is quick to stress, however, that Percival also has been a role model. “There are two things I will never forget about Bob. One is his support of his students—I have never heard him criticize a student for anything, and his door is, honestly, always open for us,” Taylor says. “Another is Bob’s incredible work ethic. I think it is a function of his love for his w o rk, and this inspires me to make sure I find work that I love, too.” Perc i val enjoys watching his students move on to satisfying law careers. “Occasionally, an excited student will bound into my office to tell me what a g reat job offer they just accepted—that they would never have pursued but for my inspiration,” Percival says. “This is p a rt of what makes teaching so rew a rding for me.”

Research Lecturer of the Year

J. Marc Simard

troke, or “brain attack,” is one of the leading causes of death and disability among Americans. A stroke occurs when a blood clot blocks the flow of blood in a vessel or artery in the brain (ischemic s t roke), or when a blood vessel in the brain bursts (hemorrhagic stroke) resulting in the death of brain cells. While strokes are somewhat preventable, few effective treatment options exist once a stroke occurs. “The only approved therapy, the clot buster tPA [tissue plasminogen activator], is given only to 10 percent of patients and

helps only some of them,” says J. Marc Simard, MD, PhD, a pro f e ssor of neurosurgery, pathology, and physiology in the School of Medicine and Research Lecturer of the Year. He, along with his re s e a rch team, is studying a potential new t reatment—a diabetes drug called glyburide, which may reduce the death of brain cells, and the swelling and hemorrhaging caused by strokes. Simard and his colleagues came to this conclusion after discovering a new ion channel—a kind of valve on the cell membrane—about six years ago. “The channel is expressed in the central nervous system J. Marc Simard only during injury or when blood flow to the brain is severely restricted, such as during ischemic were found to be ineffective in humans,” says Simard. “Glyburide seems to be the stroke,” Simard says. exception in that we already know it When the channel is open, due to works in humans.” seve rely reduced levels of adenosine Simard and his research team also have triphosphate energy inside the cell, the cells swell, burst, and die. However, studied the drug’s effects on spinal cord Simard and his team have found that gly- and traumatic brain injuries in rats and buride is highly effective in blocking the have found similar highly beneficial ion channel. “Treating rats with glyburide results. following stroke results in a dramatic If glyburide’s effect is the same in humans with spinal cord or traumatic i m p rovement in outcome,” he says. The drug seems to work the same brain injuries, Simard and his team hope way in humans. “In patients with diabetes to one day explore its use prophylactically for those at high risk of brain injury — who take these drugs and have strokes, such as football players who may experithe use of the drugs before and during ence chronic head injury, or soldiers, hospitalization has been associated with among whom traumatic brain injuries are far better outcomes,” says Howard ve ry common. “At this time, there is no Eisenberg, MD, the R.K. Thompson useful pharmacological treatment for Professor and chair of the Department these injuries,” Simard says. of Neurosurgery in the School of He emphasizes that this research is still Medicine. ve ry much in its early stages. Si m a rd is designing a clinical trial “These are ideas projected into the of glyburide in stroke patients and is future—a lot of experimental work needs cautiously optimistic. “The long history to be done to show efficacy in these appliof searching for drugs to treat stroke has cations,” he says. “From what we know, been marred by drug after drug that seemed beneficial in animal models, but however, ideas such as these are plausible.” 2008

RESEARCH & SCHOLARSHIP

FOU N DE R S W E E K AWA R D W I N N E R S 2 0 0 7 Trauma Center and director of the Program in Trauma at the School of Medicine, says Barish’s influence is evident not just on campus, but also as it lives on with his graduates. “The residency program that Bob established is considered one of the premier training programs in the country,” Scalea says. “Its graduates provide care in a wide range of settings. It is no overestimation to say that thousands of patients are alive today because of Bob Barish.” Barish reached a different kind of milestone in 2005 when he was named commander of the Maryland Robert A. Barish Defense Force, 10th Medical Regiment, a volunteer unit in support of the Maryland Public Servant of the Year National Guard. After Hurricane Katrina, the state asked the unit to deploy several hundred he stack of letters nominating Ro b e rt medical volunteers, including many from the Un i versity of Ma ryland, Baltimore A. Barish, MD, MBA, for Public campus. “More than 6,000 people were Se rvant of the Year measures half an inch thick; his many colleagues—leaders in the treated under harsh, almost primitive, conditions,” says Brig. Gen. Frederic N. campus, military, nonprofit, and health Smalkin, who chose Barish to lead the unit. care communities—agree he should be Barish does not see his medical volunrecognized for his many contributions to teerism as a personal sacrifice, but rather a Baltimore, the United States, and the benefit. “In some ways, you get more out world. of it personally than the people you help,” Barish, vice dean for clinical affairs in the School of Medicine, has been involved he says. “The bonds you form with your colleagues working together in the middle in public service most of his life. His of nowhere are hard to find elsewhere.” parents, activists themselves, instilled it in In addition, Barish is involved with him early. “We were inculcated with the Boy Scouts of America. He has raised idea of public service—of something nearly $1 million for scouts in Baltimore greater than ourselves,” Barish says. City and has advocated for programs for One of Barish’s early public service milestones was establishing the Department high-risk and special needs scouts. “These scouts get to experience things they of Emergency Medicine at the University wouldn’t otherwise,” says Barish, himself of Ma ryland Medical Center in 1985. an eagle scout. “They hike, canoe, learn “Within five years, the program was skills, and build confidence.” recognized as one of the leading sites for When asked if he encourages his medical emergency care in the nation,” says students to become public servants, Barish Mo rton Rapoport, MD, former CEO of the University of Maryland Medical System. says yes. But he doesn’t need to try ve ry Thomas Scalea, MD, FACS, physician- hard. The students are more than willing. “It’s natural for doctors to want to volunteer. in-chief at the R Adams Cowley Shock

Robert A. Barish

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

Medicine is, after all, a service industry,” Barish explains. “T h a t’s why a lot of us pursue the profession in the first place.”

Entrepreneur of the Year

G a ry David Hack

a ry David Hack, DDS, an associate professor in the De p a rtment of Endodontics, Prosthodontics and Operative Dentistry, has shown his entrepreneurial spirit since he arrived at the Dental School in 1986. Hack, who is the director of Clinical Simulation Research, developed his first invention, a tooth desensitizer, in the late 1980s. By 1995, he recalls, “It was the first patent awarded to the Dental School and has generated more than $650,000 in worldwide sales.” Hack is probably best known for his work with Leonard Litkowski, DDS, MS, and fellow Entrepreneur of the Year. Many successful partnerships develop by chance rather than design, and this one was no exception. While Hack was working on his tooth desensitizers, Litkowski was researching Bioglass, a bioactive material invented in 1969 to repair bone defects. Hack introduced Litkowski to his colleague, former University of Maryland School of Medicine neurosurgeon Walker Robinson, MD. “They both had an interest in bone regeneration—Robinson in skull defects and Len in jaw defects— and I thought they would be interested in hearing about each other’s work,” Hack recalls. But as a result of that meeting, Litkowski and Hack began working together instead. “I wondered if Bioglass would have an impact on tooth sensitivity,” Hack says. Hack and Litkowski reconfigured a sample of Bioglass to make the particle size small enough to cover the open channels between the nerve and the enamel in sensitive teeth. “We weren’t certain that the modified material would still be bioactive,” Hack says. With further modifications and testing,

a new technology and a ve ry successful collaboration were born. As a result of their work, a licensing agreement was executed between the University of Ma ryland, Baltimore (UMB) and USBiomaterials, the company that owns Bioglass, in 1996. A new company was created to market the valuable new technology under the name NovaMin. The initial patent has led to dozens more—29 of which have been issued in 24 foreign countries. Moreover, NovaMincontaining products have now generated more than $3 million in worldwide sales. Hack also has been instrumental in other discoveries. His work with Robinson has led to the discove ry of two previously unappreciated anatomic structures in the human body. The upcoming 150th annive r s a ry edition of the textbook Gray’s Anatomy will include their finding of a physical connection between the deepneck musculature and the covering of the brain. Recently, Hack submitted an invention disclosure to UMB’s Office of Research and Development for a cleft palate simulator he co-developed with William Davidson, DMD, PhD, and former chair

Gary David Hack and Leonard J. Litkowski

of the Dental School’s Department of Orthodontics. The cleft palate simulator aids in teaching dentists how to construct obturators—devices that cover the defect in the palate so patients can eat normally—and feeding plates, which enable infants with cleft palates to nurse. The cleft palate simulators were used for the first time in June 2007 during collaboration between the Dental School and Operation Smile—a nonprofit that helps people with cleft palate disorders. Cleft palates are rare in the United States but more common in Third World countries. “When Operation Smile goes on missions, parents and children are lined up for blocks begging for treatment,” says Hack. “These can be life-saving devices.”

Entrepreneur of the Year

Leonard J. Litkowski

n eve ry sense of the word, Leonard J. Litkowski, DDS, MS, is an entrepreneur. The former associate professor in the Dental School and co-director of its Center for Clinical Studies has conducted research in several arenas at the University of Maryland, Baltimore (UMB), including basic science, clinical studies for the efficacy and marketing of dental care products, and Phase I-IV clinical drug studies for the Food and Drug Administration. Litkowski also has advised several startup and established companies on the regulatory process to gain approval for d rugs and devices. “He has consistently been sought after by industry to come up with new and innovative protocols to establish the efficacy of materials and devices outside of the traditional paths for regulatory approval,” says John Gunsolley, DDS, MS, a professor in the

Department of Periodontics at Virginia Commonwealth University. Litkowski is probably best known for co-inventing NovaMin, a bioactive glass he created with his fellow Entrepreneur of the Year Ga ry David Hack, DDS. Litkowski and Hack brought the innovative, multifaceted tooth-repair technology to the marketplace in fall 2003. “Ga ry did most of the lab-related work—he is a whiz with the electron microscope—and I did most of the clinical trials,” Litkowski says. “Once the technology was to a stage where there was a pool of data worth presenting, I went on the road to present to most of the major dental corporations— Procter & Gamble, Unilever, Colgate, GlaxoSmithKline, etc.,” says Litkowski, who gave more than 20 presentations to scientific and corporate boards in a twoyear period. At that time, few resources were in place to help UMB faculty/entrepreneurs bring their technology to the marketplace. “Most inventors were on their own to identify potential companies and groups to support and develop new technologies,” Gunsolley says. “Dr. Litkowski’s determination through this time was outstanding.” So too has been NovaMin’s product evolution. Not only does it reduce tooth sensitivity, it helps strengthen teeth by combining minerals in their ionic form with human saliva to form new tooth structure. What’s more, recent research shows that toothpastes that contain NovaMin inhibit the development of cavities, especially cavities found in tooth roots, as effectively as fluoride. NovaMin Inc. is now negotiating with companies around the world—including manufacturers of most major consumer brands of toothpaste—to bring the ingredient to the $30 billion oral care marketplace. Litkowski and Hack share at least 30 U.S. and international patents for NovaMin, which has produced several hundred thousand dollars for the University and is likely to produce a substantial revenue stream for the foreseeable future. Litkowski retired from the Dental School in November 2007.  2008

RESEARCH & SCHOLARSHIP

UNIVERSITY LEADERSHIP

2008

ADMINISTRATIVE OFFICERS

ACADEMIC DEANS

David J. Ramsay, DM, DPhil President

Janet D. Allan, PhD, RN, CS, FAAN School of Nursing

T. Sue Gladhill, MSW Vice President, External Affairs

Richard P. Barth, PhD, MSW School of Social Work

James T. Hill, MPA Vice President, Administration and Finance

Natalie D. Eddington, PhD School of Pharmacy

James L. Hughes, MBA Vice President, Research and Development Peter J. Murray, PhD Vice President, Information Technology, and Chief Information Officer Malinda B. Orlin, PhD Vice President, Academic Affairs E. Albert Reece, MD, PhD, MBA Vice President, Medical Affairs

Malinda B. Orlin, PhD Graduate School E. Albert Reece, MD, PhD, MBA School of Medicine Karen H. Rothenberg, JD, MPA School of Law Christian S. Stohler, DMD, DrMedDent Dental School FACULTY, STAFF & STUDENT LEADERS

Marcelo G. Cardarelli, MD President, Faculty Senate Kenneth E. Fahnestock, MA Chair, Staff Senate Jessica Oâ&#x20AC;&#x2122;Kane President, University Student Government Association

U N I V E R S I T Y O F M A RY L A N D, B A LT I M O R E

B OARDS OF VISITORS Dental School

William H. Schneider, DDS Chair Guy D. Alexander, DDS Patricia L. Bell-McDuffie, DDS Stanley E. Block, DDS Don-N. Brotman, DDS Robert Buchanan Allan M. Dworkin, DDS Richard Goldstein Lawrence F. Halpert, DDS Ann B. Kirk, DDS Melvin F. Kushner, DDS Mary Littleton, RDH Charles P. Moore W. Gregory Wims School of Law

Paul D. Bekman Chair Alison L. Asti The Hon. Lynne A. Battaglia The Hon. Robert M. Bell The Hon. Richard D. Bennett Laura B. Black The Hon. Benjamin L. Cardin Harriet E. Cooperman The Hon. Andre M. Davis Christine A. Edwards Miriam L. Fisher PHOTOGRAPH BY J. BROUGH SCHAMP

James J. Hanks Jr. The Hon. Ellen M. Heller The Hon. Marcella A. Holland Henry H. Hopkins Alan D. Hornstein Edward F. Houff The Hon. Barbara Kerr Howe John B. Isbister Robert J. Kim Raymond G. LaPlaca Lewis Leibowitz Thomas B. Lewis Ava E. Lias-Booker Bruce S. Mendelsohn William “Hassan” Murphy III Hamish S. Osborne George F. Pappas Joanne E. Pollak Phillip A. Proger Stuart M. Salsbury Mary Katherine Scheeler Edward Manno Shumsky Hanan Y. Sibel Arnold M. Weiner Ex-officio Members Francis B. Burch Jr. and Joseph R. Hardiman, Chairmen Emeriti Karen H. Rothenberg, Dean Teresa K. LaMaster, Assistant Dean School of Medicine

Melvin Sharoky, MD Chair Peter G. Angelos, Esq. Morton D. Bogdonoff, MD Thomas S. Bozzuto Frank P. Bramble Sr. Jocelyn Cheryl Bramble Frank C. Carlucci III Michael E. Cryor William M. Davidow Jr., Esq. Sylvan Frieman, MD Ronald Geesey Gary N. Geisel Stewart Greenebaum Willard Hackerman Carolyn McGuire-Frenkil Edward Magruder Passano Jr. David S. Penn Christine D. Sarbanes Daniel E. Wagner

School of Nursing

School of Social Work

Steven S. Cohen, FACHE Chair

Stanley E. Weinstein, PhD Chair

Eric R. Baugh, MD Scott Corbett Debra B. Doyle, RN, MS, MBA Martha A. Duggan Antonella Favit-Van Pelt, MD, PhD Jack Gilden Sonya Gershowitz Goodman, MS Fran Lessans, MS Victoria C. McAndrews Katherine McCullough, RN, MS David S. Oros Marian Osterweis, PhD Beth A. Peters, MBA Judy Akila Reitz, ScD Caleb Rogovin, CRNA, MS, CCRN, CEN Alan Silverstone Julie Ann Smith Deborah Tillett, MBA William A. Zellmer, MPH (Pharm)

Jane S. Baum The Hon. James W. Campbell William T. Carpenter Jr., MD Pamela F. Corckran Erica Fry Cryor Anne P. Hahn, PhD Dorothy V. Harris Barbara L. Himmelrich The Hon. Verna L. Jones Razi F. Kosi Anne H. Lewis Jean Tucker Mann James W. Motsay Mary G. Piper Alison L. Richman Howard L. Sollins Hector L. Torres Meadow Lark Washington Susan A. Wolman

School of Pharmacy

Richard P. Penna, PharmD Chair John H. Balch, RPh David A. Blake, PhD Capt. James L. Bresette, PharmD Harold E. Chappelear, DSC, RPh, LLD (Hon.) Paul T. Cuzmanes, RPh, JD Joseph DeMino, BSP Russell B. Fair, RPh John M. Gregory, RPh, DPS (Hon.) Mark A. Levi, PD Gina McKnight-Smith, PharmD, MBA, CGP, BCPS David G. Miller, RPh Milton H. Miller Sr. Robert G. Pinco, BSP, JD Alex Taylor, BSP David R. Teckman Sally Van Doren, PharmD George C. Voxakis, PharmD Clayton L. Warrington, BSP Ellen H. Yankellow, PharmD

UNIVERSITY SYSTEM OF MARY L A N D

William E. Kirwan, PhD Chancellor Board of Regents

The University System of Maryland is governed by a Board of Regents appointed by the governor. Clifford M. Kendall, Chairman Orlan M. Johnson, Vice Chairman Patricia S. Florestano, Assistant Treasurer R. Michael Gill, Assistant Secretary Barry P. Gossett Alicia Coro Hoffman The Hon. Francis X. Kelly Jr. The Hon. Marvin Mandel The Hon. C. Thomas McMillen Robert L. Mitchell David H. Nevins A. Dwight Pettit, Esq. Robert L. Pevenstein, Treasurer James L. Shea, Secretary Thomas G. Slater, Esq. The Hon. Roger L. Richardson, Ex-officio Richard Scott, Student Regent

Ex-officio Members Alice B. Heisler, MD David Sigman, MD 2008

RESEARCH & SCHOLARSHIP

R E S E A R C H & DEV E L O P M E N T

Making Great Strides in Technology Commercialization

Ex t r amural Funding esearchers at the University of Maryland, Baltimore (UMB) attracted $411 million in s p o n s o red project awards during Fiscal Year 2007—the largest dollar volume in UMB’s history. The National Institutes of Health tightened its budget again in FY07. However, impressive growth was realized from other federal sources, including the Centers for Disease Control, organizations such as the Bill & Melinda Gates Foundation, and 150 corporations. Projects addressing global issues (HIV, bio- and nuclear t e r rorism and the prevention of disease) and regional issues (health policy, child we l f a re, and cancer caused by cigarettes) head the list of more than 1,400 awards. Overall, UMB’s research enterprise has doubled since Fiscal Year 2000.

10M

15M

20M

350M

iscal Year 2007 was a landmark year for technology commercialization at the Un i versity of Ma ryland, Baltimore (UMB). • New invention disclosures reached an all-time high of 114. • UMB’s patent portfolio currently includes 450 issued patents and more than 650 active patent applications. • New business agreements signed in FY07 exceeded those in any previous year— adding 19 licenses and 11 option agreements to an active portfolio that n ow boasts 90 agreements. • UMB’s income from license agreements topped the $1 million mark.

INFRATRAC, INC.

InfraTrac, a startup company located in the UMB BioPark, and the Un i versity signed an exclusive license agreement for UMB’s d rug authentication technology. The inve ntion utilizes near-infrared spectroscopy to develop “fingerprints” for drugs and other materials. The technology is being commercialized by InfraTrac to address the sale and distribution of counterfeit drugs. James Polli, PhD, and Stephen Hoag, PhD, of the School of Pharmacy are co-inventors of the technology. ENCORE PATH, INC.

In addition, UMB is leading Maryland institutions with the launch of a new Web page, w w w.invenioip.org, which provides a one-stop location for industry ini d e n t i f ying licensing and sponsored research opportunities. It provides access to more than 1,500 technologies from leading academic institutions in and around Maryland. Highlights of UMB’s FY07 new license agreements include:

Jill Whitall, PhD, and Sandra McCombeWaller, PhD, MS, PT, NCS, faculty members in the School of Medicine, developed a unique device for rehabilitation of stroke patients. The device takes adva ntage of repetitive bilateral arm motion to enhance and reinvigorate brain activity associated with these movements. En c o re Path, a startup company in Maryland, signed a license agreement with UMB for exclusive rights to the technology.

COUNTERVAIL CORP.

LIGOCYTE PHARMACEUTICALS, INC.

UMB entered into an exclusive license agreement with Countervail Corp. for the d e velopment and commercialization of a safe treatment for protection against organophosphates. Edson Albuquerque, MD, PhD, and Edna Pereira, PhD, of the School of Medicine, and Michael Adler, PhD, of the U.S. Army Medical Research Institute of Chemical Defense, discovered that galantamine, a chemical approved by the Food and Drug Administration for the treatment of Alzheimer’s disease, protects against short-term and long-term effects of organophosphates. Organophosphates are a class of chemicals commonly used in the production of agricultural pesticides. Since these compounds cause serious damage to the brain and nervous system, they may also be used as biological warf a re agents.

LigoCyte Pharmaceuticals, a Montana corporation, entered into an exc l u s i ve, worldwide license agreement with UMB to obtain rights to UMB patent applications related to CD103 therapeutics. CD103 is the unique alphaE-beta7 integrin that has been implicated in the activation, homing, and retention of lymphocytes that mediate inflammatory diseases affecting mucosal regions of the intestine, skin, and lungs. Patients suffering from severe inflammatory diseases such as re s p i r a t o ryinflammation, inflammatory bowel disease, Graft-versushost disease (GVHD), and organ transplant rejections may benefit from the deve l o pment of a treatment based upon the use of CD103 as a therapeutic target. The patent rights are directed to the use of CD103 for the treatment of GVHD and solid organ transplant rejection.

U N I V E R S I T Y O F M A RY L A N D, B A LT I M OR E

CHART ILLUSTRATIONS BY EMERY PAJER

University of Mary l and Baltimore Foundation, Inc. Annual Report 2007

The University of Maryland Baltimore Foundation, Inc. (UMBF) Board of Trustees is comprised of influential and committed leaders who are dedicated to advancing the goals of the University of Maryland, Baltimore (UMB). This Board provides valuable advice to UMB President David J. Ramsay on matters affecting UMB’s campus, its programs, and the community it serves. The Board promotes UMB through advocacy and by enlisting the financial support of alumni, faculty, staff, and friends. The Foundation manages and invests gifts and property for the benefit of UMB. Richard J. Himelfarb, Chairman

UMB fundraising in Fiscal Year 2007 exceeded previous records for the campus. The year-end fundraising total was $65.3 million, ahead of the $62 million goal, and nearly 8 percent ahead of last year’s total. Through fundraising and investment returns, the UMB Foundation increased current use and endowment assets (including pledges) from $115 million in FY 2006 to $143 million in FY 2007. Philanthropic support is vital to ensure the University’s continued advancement as one of the nation’s top academic health, law, and human services institutions. UMBF provides opportunities for alumni, friends, foundations, corporations, and others to support the strategic mission and goals of the University of Maryland, Baltimore. Through your gifts, you can shape the future with the support that enables the University to excel in its mission of providing excellence in education, research, public service, and patient care. (For an example of how donor dollars support the UMB mission, see page 46.) To contribute to this effort, please use the return envelope enclosed in this issue of Maryland magazine or visit http://giving.umaryland.edu. Your contributions are greatly appreciated.

Un i v ersity of Maryland Ba ltimore Foundation, Inc.

ARTWORK AND CHART ILLUSTRATIONS BY EMERY PAJER

Annual Report 2007

SUMMARY STATEMENT OF FINANCIAL POSITION June 30, 2007 and 2006

ASSETS

2007

2006

Investments Endowment Operating Total investments

$ 76,947,969 46,229,578 123,177,547

$ 52,477,238 40,653,301 93,130,539

Other assets Contributions receivable Assets held under split-interest agreements Assets due from other foundations, etc. Total other assets TOTAL ASSETS

13,882,166 3,156,335 2,745,475 19,783,976 $142,961,523

14,786,804 3,036,282 3,718,187 21,541,273 $114,671,812

LIABILITIES & NET ASSETS Liabilities Payable under split-interest agreements Other liabilities Total liabilities

$ 1,604,048 1,622,534 3,226,582

$ 1,565,533 2,820,959 4,386,492

19,048,629 56,450,160 64,236,152

14,704,811 43,742,347 51,838,162

139,734,941

110,285,320

$142,961,523

$114,671,812

Net assets Unrestricted Temporarily restricted Permanently restricted Total net assets

TOTAL LIABILITIES & NET ASSETS

To obtain a copy of the UMBF, Inc., audited financial statements, please contact Judith Blackburn, University of Maryland Baltimore Foundation, Inc., 660 West Redwood Street, Room 021, Baltimore, MD 21201. Phone 410-706-3912 or e-mail jblackburn@umaryland.edu.

Un i v ersity of Mary l and Ba ltimore Foundation, Inc.

BOARD OF TRUSTEES

Richard J. Himelfarb, Chairman Executive Vice President Stifel, Nicolaus & Co., Inc.

Joseph R. Hardiman Retired President and CEO, National Association of Securities Dealers Inc.

Janet S. Owens Community Activist and former Anne Arundel County Executive

Edward J. Brody CEO, Brody Transportation Co., Inc.

David Hillman CEO, Southern Management Corp.

Theo C. Rodgers President, A & R Development Corp.

Don-N. Brotman, DDS General Dentist

Wallace J. Hoff Retired Vice President and General Manager, Northrop Grumman Aerospace Systems Division

Donald E. Roland Retired Chairman, Vertis

Francis B. Burch, Jr. Joint CEO DLA Piper

Robert G. Sabelhaus Senior Executive Vice President and Division Director, Smith Barney

Daryl A. Chamblee Partner, Steptoe & Johnson LLP

Kempton M. Ingersol Managing Director and Senior Portfolio Manager Brown Capital Management, Inc.

Harold E. Chappelear Retired Vice Chairman UPM Pharmaceuticals, Inc.

Donald M. Kirson Retired President and CEO Kirson Medical Equipment Co.

Charles W. Cole, Jr. Chairman, Legg Mason Investment Counsel & Trust Co.

Kyle P. Legg, CFA CEO, Legg Mason Capital Management

Frederick G. Smith, DDS Vice President Sinclair Broadcast Group, Inc.

Sally Michel Baltimore City Activist and Founder of SuperKids Camp

C. William Struever Partner, CEO, and President Struever Bros. Eccles & Rouse, Inc.

Milton H. Miller, Sr. Retired Founder, Miller Corporate Real Estate

John C. Weiss, III, MBA Chairman, BioTechnical Institute of Maryland, Inc. Co-Chair, Entrepreneurship Board, University of Baltimore Merrick School of Business

Anna M. Dopkin Co-Director of U.S. Equity Research and Portfolio Manager T. Rowe Price Associates, Inc. James A. Dâ&#x20AC;&#x2122;Orta, MD Chairman, Consumer Health Services, Inc. James A. Earl, PhD President, Helena Foundation

Joseph A. Oddis Vice President Emeritus American Society of HealthSystem Pharmacists

Morton P. Fisher, Jr. Partner, Baltimore Office Ballard Spahr Andrews & Ingersoll, LLP

Thomas P. Oâ&#x20AC;&#x2122;Neill Managing Director RSM McGladrey, Inc.

Sylvan Frieman, MD Retired Physician and Volunteer Associate Professor

David S. Oros Managing Partner, Global Domain Partners, LLP

EX- O F F I CIO MEMBE RS David J. Ramsay, DM, DPhil (nonvoting) President, University of Maryland, Baltimore T. Sue Gladhill, MSW President and CEO, UMBF, Inc. Judith S. Blackburn, PhD, MBA Treasurer and CFO, UMBF, Inc. STAFF Mary A. Nichols Director, UMB Foundation Relations

Pauline Schneider, JD Partner, Orrick, Herrington & Sutcliffe LLP Alan Silverstone Consultant

Garland O. Williamson CEO and President, Information Control Systems Corp.

UNIVERSITY OF MARYLAND MAGAZINE EDITORIAL BOARD

Jeanette Balotin, MA, MPA Robert A. Barish, MD, MBA Diane DePanfilis, PhD, MSW Gail Doerr, MS Ronald Dubner, DDS, PhD James L. Hughes, MBA Teresa K. LaMaster, JD Jennifer Litchman, MA Charlene Quinn, PhD, RN Norman Tinanoff, DDS, MS Carolyn Waltz, PhD, RN, FAAN Ilene Zuckerman, PharmD, PhD EXECUTIVE EDITOR

T. Sue Gladhill, MSW MANAGING EDITOR

Paul Drehoff, MSM EDITOR

Susie Flaherty A S S I STA N T E D I TO R S

Clare Banks Ronald Hube Christian Zang ART DIRECTOR

Tracy Boyd PRODUCTION

Julie Bower Keven Waters

University of Maryland magazine is published by the Office of External Affairs for alumni and friends of the medical, law, dental, pharmacy, nursing, graduate, social work, and public health schools. Send reprint requests, address corrections, and letters to: University of Maryland Magazine Office of External Affairs University of Maryland 660 West Redwood Street, Room 021 Baltimore, MD 21201 410-706-7820 Fax: 410-706-6330 E-mail: mmagazine@umaryland.edu General information about the University and its programs can be found at www.umaryland.edu.

New Administration Building | West Lexington Street This six-story building in the 600 block of West Lexington Street is rapidly taking shape. Scheduled for completion this fall, the 108,000-square-foot building will house many of the University offices formerly located in the Lombard and 111 S. Greene St. buildings. Those buildings were demolished

to make way for a new University of Maryland Medical System facility. The Graduate School and the offices of Academic Affairs, Administration and Finance, External Affairs, and Research and Development will be among the administration buildingâ&#x20AC;&#x2122;s occupants.

NONPROFIT ORGANIZATION US POSTAGE PAID PERMIT # 1 BALTIMORE, MD 660 West Redwood Street Room 021 Baltimore, Maryland 21201-1541

ADDRESS SERVICE REQUESTED