Houston Methodist Academic Institute Annual Report 2022

Houston Methodist Academic Institute

BOARD MEMBERS

Houston Methodist Academic Institute

Judge Ewing Werlein, Jr., Sr. Chair

John F. Bookout, III, Chair

Edward R. Allen, III

David C. Baggett, Jr.

Marc L. Boom, MD

Joseph R. “Rod” Canion

David T. Chao

Stephen I. Chazen

Augustine M.K. Choi, MD

Ernest D. Cockrell, II

Martin S. Craighead

Martha S. DeBusk

W. Leslie Doggett

Antonio M. Gotto, Jr., MD, DPhil

Edward A. Jones

Evan H. Katz

Edwin H. Knight

Kevin J. Lilly

Steven S. Looke

Ransom C. Lummis

David A. Modesett

W. Benjamin Moreland

Gregory V. Nelson

Joe Bob Perkins

Mary Eliza Shaper

Suzanne H. Smith

H. Dirk Sostman, MD

Douglas E. Swanson, Jr.

David M. Underwood, Jr.

Amy Waer, MD

Joseph C. “Rusty” Walter, III

Martha S. Walton

SCIENCE IN SERVICE OF MEDICINE

Houston Methodist has served as a pillar of the Houston community since it began in 1919 as a small hospital providing medical care during the Spanish Influenza pandemic. When the COVID-19 pandemic arrived 101 years later, it provided many opportunities to appreciate the foresight of our founders, and the resilience, compassion and expertise of our health care providers and staff.

Our academic teams worked resolutely throughout the pandemic, contributing to the system-wide COVID-19 response with rapid outcomes studies and clinical trials as well as continuing to make landmark discoveries in each of our Centers of Excellence. This book shares some of the stories that embody our mission to meet the most demanding challenges faced by patients and their physicians.

In 2020, our academic community further cemented their position at the center of a global collaborative network that moves medical research from concept to clinical impact and educates healthcare professionals in the latest medical breakthroughs. This year, we partnered with Rice University to launch the Center for Translational Neural Prosthetics and Interfaces, which brings together scientists, clinicians, engineers and surgeons to solve clinical problems with neurostimulation and robotics. 2020 also saw the establishment of the Weill Cornell Graduate School doctoral program in Physiology, Biophysics & Systems Biology at Houston Methodist that builds upon our long-standing academic affiliation with Weill Cornell.

None of this work would be possible without the dedication and support of our visionary Houston Methodist Academic Institute board members, generous donors and brilliant faculty. Our work together has established Houston Methodist as a leading academic medical center, and I am honored to be a part of this journey to the future of medicine.

H. Dirk Sostman, MD, FACR

Ernest Cockrell, Jr. Presidential Distinguished Chair, Houston Methodist Emeritus Professor of Radiology, Weill Cornell Medicine

Distinguished

Member, Houston Methodist Research Institute President, Houston Methodist Academic Institute

Executive Vice President and Chief Academic Officer, Houston Methodist

2 2 0 2 Houston Methodist Academic Institute

ANNUAL METRICS RESEARCH & EDUCATION

Our Commitment to RE SE AR CH & EDUCAT ION

Houston Methodist supports our 772 faculty with a $264M annual investment in research and education and a planned investment of $300M over five years for strategic academic initiatives. In 2022, investigators also had access to more than $170M in philanthropic funds for research and education and a competitive $28.8M philanthropic fund to support translation of their most promising technologies.

$264.1M RESEARCH & EDUCATION EXPENDITURES

$170.3M PHILANTHROPIC FUNDING

$28.8M PRODUCT DEVELOPMENT

TRANSLATION & DEVELOPMENT

to bring new technologies & therapies to patients

We bring new scientific discoveries to patients as rapidly as possible through the full cycle of a cure from bench research, to prototyping and production, to clinical trials and FDA approval. Houston Methodist has a $28.8M product development fund to navigate promising technologies through this translational pipeline and facilitate a technology transfer hand off to the market for delivery of safe and effective therapies to patients.

TRANSLATIONAL RESEARCH INITIATIVE

26

$28.8M PRODUCTS IN REGULATORY PIPELINE

530

243 CLINICAL TRIALS

LICENSABLE TECHNOLOGIES

Collaboration & Leadership WORL DW IDE

Global collaboration sources the best expertise for interdisciplinary research and education. In 2022, Houston Methodist faculty mentored 1,163 trainees in residence from 78 countries and participated in 6,690 collaborations with peers from 136 countries.

Houston

6,690 COLLABORATIONS

1,360 RESEARCH PROJECTS

1,740 PEER-REVIEWED PUBLICATIONS

LEARNERS FROM 78 COUNTRIES

50 COLLABORATING U.S. STATES

136 COLLABORATING COUNTRIES

Training the NE XT GENE RAT ION

of Caregivers & Innovators

Houston Methodist faculty trained 56,260 learners in 2022. Our modern interdisciplinary GME and educational programs have access to advanced resources like the MITIESM virtual hospital and procedural skills labs that support simulation and team training.

HOUSTON METHODIST HOSPITALS & INSTITUTES

Clinical Care: 8 hospitals and 6 Centers of Excellence

Academic Institute: Research Institute and Education Institute

Affiliated with Weill Cornell Medicine

HOSPITALS

Houston Methodist Hospital

Houston Methodist Baytown Hospital

Houston Methodist Clear Lake Hospital

Houston Methodist Continuing Care Hospital

CENTERS OF EXCELLENCE

Houston Methodist Sugar Land Hospital

Houston Methodist West Hospital

Houston Methodist Willowbrook Hospital

Houston Methodist The Woodlands Hospital

Houston Methodist Dr. Mary and Ron Neal Cancer Center

Houston Methodist DeBakey Heart & Vascular Center

Houston Methodist Lynda K. and David M. Underwood Center for Digestive Disorders

Houston Methodist Neurological Institute

Houston Methodist Orthopedics & Sports Medicine

Houston Methodist J.C. Walter Jr. Transplant Center

DEPARTMENTS

Department of Anesthesiology & Critical Care

Department of Cardiology

Department of Cardiovascular Sciences

Department of Cardiovascular Surgery

Department of Medicine

Department of Nanomedicine

Stanley H. Appel Department of Neurology

Department of Neurosurgery

Department of Obstetrics and Gynecology

Department of Ophthalmology

Department of Otolaryngology

Department of Oral & Maxillofacial Surgery

Department of Orthopedic Surgery

Department of Pathology & Genomic Medicine

Department of Psychiatry and Behavioral Health

Department of Radiation Oncology

Department of Radiology

Department of Surgery

Department of Urology

CENTERS & PROGRAMS

for Cellular Therapeutics

Blanton Eye Institute

CENTERS & PROGRAMS

Center for Bioenergetics

Center for Cardiovascular Regeneration

Center for Critical Care

Center for Health & Nature

Center for Health Data Science and Analytics

Center for Human Perfomance

Center for Infectious Diseases

Center for Musculoskeletal Regeneration

Center for Neuroregeneration

Center for Nursing Research, Education and Practice

Center for Rapid Device Translation

Center for RNA Therapeutics

Center for Translational Neural Prosthetics and Interfaces

Houston Methodist Institute for Technology, Innovation & Education (MITIESM)

Immunobiology & Transplant Science Center

Immunology Center

Institute for Robotics, Imaging and Navigation

Kenneth R. Peak Brain & Pituitary Treatment Center

Nantz National Alzheimer Center

Sherrie and Alan Conover Center for Liver Disease & Transplantation

Ann Kimball and John W. Johnson Center

2.07M PATIENT ENCOUNTERS

4,923 PHYSICIANS 7 72 FACULTY 2,270 CREDENTIALED RESEARCHERS

56,260 LEARNERS

CRADLE OF TRANSLATION

A vision for integrated research, education and clinical care

CELL ENCAPSULATION

Preventing Cell Transplant Rejection

From its conception, the Houston Methodist Academic Institute intended to be different than other academic medical centers. Its driving objective is to develop treatments that can be readily adopted into patient care – using its physical connections to the hospital to source ideas for innovations. Our expertise in FDA approval pathways and access to clinical care team expertise reality-tests inventions and streamlines the process of translating laboratory research into clinical impact. page 34

page 28

RNA THERAPEUTICS

Supports National Product Development

page 14

COVID-19 SPOTLIGHTS

Social Determinants of Health

CYCLE OF TRANSLATION

Research & Education in Service of Medicine

Houston Methodist met the challenge of translation early in the design of the Research Institute building. It houses the essential services and technology that support the full cycle of development to efficiently and effectively deliver innovations to the clinic.

Translating laboratory innovations into treatments for patients is fraught with challenges. The lack of specialized translational research resources makes it extremely difficult and expensive for most institutions to turn fundamental discoveries into tangible solutions that benefit the public. Their most promising innovations perish in the “Valley of Death” before they reach the clinic. We provide support at every step of the cycle of translation from bridge funding to technical expertise with U.S. Food and Drug Administration (FDA) - approved current good manufacturing practice (cGMP) facilities, good laboratory practice (GLP) facilities and clinical trial operations. The most promising innovations have a lifeline at Houston Methodist.

HEALTH CARE DELIVERY SYSTEM

EDUCATION & ADOPTION

Throughout our system, we’re building interprofessional education programs that employ the latest strategies, including simulation, to facilitate the safe and efficient adoption of new technologies as they’re approved for clinical use. Bringing a new innovation from the completion of clinical trials to clinic adoption is very time and resource intensive, needing 10 years and $1 billion, on average.

PATIENT CARE

The cycle begins and ends with the care of patients in our hospitals and clinics. Clinicians in our hospitals care for more than 800,000 patients annually, enabling them to identify the most pressing challenges in medicine and provide excellent care.

QUALITY & OUTCOMES

A key component of leading medicine is our culture of quality, safety and innovation. As part of the system-wide goals for quality improvement and patient safety, we invest in research and education programs that maximize patient outcomes.

CLINICAL NEEDS

Clinicians and researchers form interdisciplinary teams to address their needs and clinical challenges.

DISCOVERY

DISCOVERY

Our teams of clinicians, researchers and collaborators from around the world have access to a full suite of technology to enable the discovery process.

PRECLINICAL VALIDATION

Research teams have access to dedicated Translational Research Initiative bridge funds to take the most promising discoveries into preclinical and early-phase clinical development.

CLOSING THE GAP

cGMP MANUFACTURING

The research institute is equipped with FDA cGMP-compliant facilities that produce research and clinical-grade therapeutic materials and custom radiopharmaceuticals for preclinical and first-in-human studies.

GLP PRECLINICAL VALIDATION

The GLP facilities at Houston Methodist perform risk, safety and efficacy assessment studies in compliance with current FDA guidelines in preclinical models. Adherence to GLP standards is required for safety studies in order to move to clinical trials.

CLINICAL TRIALS

CLINICAL TRIALS

Teams have access to early phase trial support (pharmacokinetics and pharmacodynamics), and outpatient clinical care and study management services, including research, nursing, regulatory submissions and budget management support for all phases of clinical trials.

Visionary Gifts of Hope

Ushering medical breakthroughs from the lab to the clinic takes many years and millions of dollars. Most promising discoveries are lost in the phase of translation called the “Valley of Death.” To help bridge the Valley of Death and to provide our most promising innovations a lifeline, Houston Methodist is drawing on the transformative power of philanthropy.

THE ANN KIMBALL AND JOHN W. JOHNSON CENTER FOR CELLULAR THERAPEUTICS

With generous support from Ann Kimball and John W. “Johnny” Johnson, Houston Methodist has entered a new era of cellular therapeutics that will expand our growing portfolio of immunotherapeutics and RNA therapeutics. Their cornerstone commitment will build a research program and production facility at Houston Methodist that will allow us to design new therapies rapidly and produce experimental therapeutics on-site. The 5,000-square-foot, state-of-the-art Current Good Manufacturing Practice (cGMP) facility is located in the Houston Methodist Outpatient Center and will open in 2021.

Stanley H. Appel, MD, the Peggy and Gary Edwards Distinguished Endowed Chair in ALS Research, Stanley H. Appel Department of Neurology, will lead a multidisciplinary team of researchers dedicated to expanding cell therapy research at Houston Methodist. His regulatory T cell therapy for amyotrophic lateral sclerosis, or ALS, is demonstrating promising results in slowing disease progression in some patients. Appel’s cell therapy for ALS will be manufactured on-site as part of the cell therapy program at the Ann Kimball and John W. Johnson Center for Cellular Therapeutics.

THE FONDREN FOOD & HEALTH ALLIANCE AND THE FONDREN INFLAMMATION COLLABORATION

The first of its kind in the Texas Medical Center, Houston and the region, the Fondren Inflammation Collaborative is creating a singular destination for patients to seek normalcy and relief from debilitating allergy, immunologic, autoimmune and gastrointestinal conditions. The program was made possible when The Fondren Foundation made a generous $15 million commitment to Houston Methodist. The entire program will be realized in the next decade, helping patients who often get passed between doctors and clinics for months or years in search of a proper diagnosis and treatment plan.

Ultimately, the Fondren Inflammation Collaborative will be extended to other disease areas impacted by inflammation, such as the heart, brain, cancer and behavioral health. The gift also will fund four endowed chairs to recruit and retain the best minds in the world, while supporting research, education and training efforts.

Fondren Foundation

The philanthropic gift strengthens and expands two Houston Methodist programs: the new Immunology Center at Houston Methodist and the Food and Health Alliance within the Lynda K. and David M. Underwood Center for Digestive Disorders. The Fondren Inflammation Collaborative will offer patients one-of-a-kind opportunities to participate in clinical trials focused on innovative treatments and therapies for inflammation-triggered conditions.

The Fondren Foundation’s vision is to close the gap in patient care by building an international destination of hope and relief for people with complex, often intertwined conditions that have underlying inflammatory triggers.

COCKRELL CENTER FOR ADVANCED THERAPEUTICS

Since 2009, the Cockrell Foundation has made a generous gift toward an endowment that supports the Cockrell Center for Advanced Therapeutics (CCAT), which opened its Phase I clinical trials unit in 2015 and continues to expand today. The CCAT and Houston Methodist have the expertise to support all phases of clinical trials, beginning with first-in-human trials. The CCAT brings together world-class medical minds and first-class facilities to study novel therapies for various medical conditions, while delivering customized and compassionate care. As part of our deep commitment to developing treatments with ready applicability to human disease, we aim to make a clinical trial available to every person who needs and wants to participate in one. All stages of clinical research operations are supported, and the experts to support all phases of clinical trials are on hand.

Houston Methodist Opens New Facility for Clinical Trials

The Houston Methodist Cockrell Center for Advanced Therapeutics supports all phases of clinical research operations. The center provides more than 7,000 square feet of dedicated space across six locations in the greater Houston area, bringing access to the latest investigational treatment options closer to study participants’ homes or workplaces.

The center conducts 24-hour pharmacodynamics and pharmacokinetics evaluations, offers early-phase and investigator-initiated trial support services, and provides a centralized clinical trials support office. The Clinical Research Phase 1 Unit caters to early-phase and proof-of-concept clinical trials as well as precision medicine-focused translational research projects.

As the COVID-19 pandemic took hold across the U.S., the center’s resources and expertise played a critical role in the historic efforts to rapidly activate and conduct clinical trials to evaluate potential therapies for COVID-19. The pandemic also underscored the need for dedicated facilities within the center to support infectious disease clinical trials that require specialized services, equipment, training and protocols. This facility is equipped to facilitate outpatient infectious diseases trials and study-mandated follow-up and data collection after discharge.

Pandemic Propels Need to Develop a Component of the Cockrell Center for Advanced Therapeutics to

Administer Clinical Trials for Infectious Diseases

Houston Methodist is fortunate to find itself in the very good position of having donors who believe in its mission and wish to provide support. One such donor is Reynolds and Reynolds, an automotive retailing company. Through a personal relationship with Ernest D. Cockrell, II, Reynolds and Reynolds gave a total of $2 million to Houston Methodist, with half of that amount earmarked for the Reynolds and Reynolds Company Infectious Disease Research Unit, a part of the Cockrell Center for Advanced Therapeutics (CCAT), that is housed in the Research Institute. The other half is earmarked for outcomes research.

The pandemic made the need to develop a component of CCAT to administer clinical trials for infectious diseases, beginning with COVID-19 patients, even more urgent. These trials require specialized facilities, equipment, training and protocols. This initiative is a component of Houston Methodist’s overall strategy to lead medicine in the prevention and treatment of infectious diseases, which ultimately will lead to the establishment of the Infectious Diseases Center of Excellence.

Beyond COVID-19, Houston Methodist will continue with clinical trials under CCAT for the Cancer Center of Excellence, Center for Outcomes Research, Pathology and Genomic Medicine and several others. The Reynolds and Reynolds Company Unit will enable us to conduct clinical research in infectious diseases, which we otherwise would be unable to participate in, for the benefit of the Houston community.

COCKRELL CENTER FOR ADVANCED THERAPEUTICS

HOUSTON METHODIST RESEARCH INSTITUTE

CCAT - TMC

CLINICAL RESEARCH PHASE 1 UNIT - TMC

REYNOLDS OUTPATIENT TRIALS CENTER

HOUSTON METHODIST SUGAR LAND HOSPITAL

HOUSTON METHODIST WEST HOSPITAL

HOUSTON METHODIST CONTINUING CARE HOSPITAL

HIGHLY INFECTIOUS DISEASE UNIT CLINICAL TRIALS CENTER

HOUSTON METHODIST PRIMARY CARE GROUP IN PEARLAND

HOUSTON METHODIST THE WOODLANDS HOSPITAL

PAULA AND JOSEPH C. “RUSTY” WALTER III

Translational Research Initiative

When Houston Methodist launched the Translational Research Initiative (TRI) in 2014, the aim was twofold: provide vital funding to promising new therapies ready to make the transition from research laboratory to clinical use and capitalize on Houston’s bold entrepreneurial spirit to lead the way toward a new model of medical innovation.

TRI exceeded expectations. Houston Methodist is now launching its third phase after securing more than $20 million for translational research projects. The first iteration of TRI, which became known as TRI I when a second initiative was created, began with a philanthropic matching fund established by Paula and Joseph C. “Rusty” Walter III.

The success of TRI I spurred TRI II, which was started through the generosity of the Jerold B. Katz Foundation.

The Katz Foundation’s $5 million challenge gift helped raise another $5 million from community visionaries.

Building on the success of TRI I and TRI II, a third initiative was established with another matching challenge gift from Paula and Rusty Walter. TRI III’s goal is to create a $10 million fund much like its predecessors, with one major difference: these funds will focus solely on neurology and translational projects, such as neurosurgery, stroke recovery or Alzheimer’s disease.

AnatomicAligner Uses State-of-the-Art Graphics to Help Presurgical Planning

Developed by James Xia, MD, PhD, professor of oral and maxillofacial surgery, and Jaime Gateno, DDS, MD, chair of the Department of Oral & Maxillofacial Surgery and professor of oral and maxillofacial surgery, AnatomicAligner, an FDA-approved software program uses information acquired from multiple imaging modalities to simulate jaw surgery. Due to the complex nature of the craniofacial skeleton, corrective surgeries require extensive presurgical planning. The use of state-of-the-art computer graphics and modeling in AnatomicAligner will help reduce unwanted surgical outcomes and procedures.

Innovative Magnetic Device Shows Promise for Treating Brain Injury

A noninvasive, portable, wireless, affordable, smartphone-compatible magnetic stimulation cap invented by Santosh Helekar, MD, PhD, associate professor of neurosurgery at Houston Methodist and Henning Voss, PhD, associate professor of physics in radiology at Weill Cornell Medical College, uses novel transcranial stimulation technology to modulate neural activity in multiple parts of the brain at the same time, leading to functional recovery following brain injury or dysfunction.

When David Chiu, MD, Elizabeth Blanton Wareing Chair in the Eddy Scurlock Stroke Center, and Helekar tested the device in a phase I/IIa clinical trial involving 30 ischemic stroke survivors with motor impairment, the cap increased neural activity near stroke-injured areas of the brain, inducing a trend toward recovery of motor function. The cap is also being tested for other applications, such as improvement of bladder control in multiple sclerosis.

The cap technology has been granted four patents by the U.S. Patent and Trademark Office so far, which have been licensed to a startup company called Seraya Medical LLC. A larger multicenter stroke trial and submission for regulatory clearance are being planned.

Before surgery, Lindsay’s bone structure was not symmetrical.

AnatomicAligner software calculated which adjustments were needed to achieve symmetry.

After two extensive surgeries, Lindsay wore braces for several weeks. With newfound confidence, she began her career at a large corporation.

JEROLD B. KATZ ACADEMY OF TRANSLATIONAL RESEARCH

A substantial commitment from the Jerold B. Katz Foundation established the Jerold B. Katz Academy of Translational Research, which aims to recruit and retain the world’s most promising transformational researchers in health care. According to Evan H. Katz, one of Jerold B. Katz’s sons and the president of the Jerold B. Katz Foundation, the gift is designed to continually seed innovation and facilitate the discovery of improved treatments and medications. A portion of this gift is intended to support the research efforts of eight investigators, of whom three have been announced.

KATZ INVESTIGATORS Katz Investigators

Nestor Esnaola, MD, MPH, MBA, FACS

Esnaola is the associate director of Cancer Control and Population Science in the Cancer Center, professor of surgery and division head of surgical oncology in the Department of Surgery. He works closely with Cancer Center Director Jenny Chang, MD, to drive efforts in the areas of cancer prevention, community outreach and engagement, cancer health disparities and population science research. He was awarded Katz Foundation funding to evaluate a patientnavigation intervention tool intended to optimize breast cancer care and address outcome disparities in minorities and underserved women. The tool will be tested in a large-scale, community-based, randomized clinical trial.

Khurram Nasir, MD, MPH

Nasir is a professor of Cardiology, chief of the Division of Cardiovascular Prevention and Wellness in the DeBakey Heart & Vascular Center and co-director of the Center for Outcomes Research. Nasir was awarded the Katz investigator endowment to support his efforts to develop a systemwide hospital resource for research in the area of cardiovascular disease prevention. This platform will harness the power of big data, innovative computation paradigms and artificial machine intelligence to integrate clinical and research data of patients with cardiovascular disease. By leveraging dashboards and digital solutions like alert systems and automatic prescriptions, Nasir aims to identify gaps in preventative care among high-risk individuals.

Trisha Roy, MD, PhD

Assistant professor of Cardiovascular Surgery, vascular surgeon-scientist and Katz investigator, Roy is researching advanced imaging options to improve procedural outcomes for peripheral arterial disease. Current imaging techniques fall short at accurately characterizing arterial lesions, which leads to a “one-size-fits-all” approach to treatment. Roy is developing a peripheral arterial magnetic resonance imaging (MRI) method for evaluating blood vessel blockages that will allow surgeons to precisely tailor surgeries and endovascular procedures to individual patients. By selecting the right treatment for the right patient, Roy hopes to reduce failure rates and make these treatments more successful.

COVID-19 Spotlights Social Determinants of Health

The arrival of the novel SARS-CoV-2 virus had a profound impact on every aspect of Houston Methodist, challenging us to quickly operationalize a new bioinformatics pipeline to better develop best practices for managing COVID-19 patients, prioritize and facilitate COVID-19 research and learn which persons are most impacted by the pandemic and why.

The Center for Outcomes Research met this challenge, devising a data repository that obtained real-time data about COVID-19 patients’ sociodemographics, diagnoses, treatments, suitability for enrollment in clinical trials and outcomes.

With CURATOR, Houston Methodist Experts Gain Deeper Insight into Real-Time COVID-19 Data Trends

The rapid global spread of the novel SARS-CoV-2 virus provided an opportunity for Houston Methodist to establish the infrastructure for a learning health-care system that further merges evidence-based medicine and practice-based evidence.

When the pandemic arrived, a cross-departmental big-data team led by Farhaan S. Vahidy, PhD, associate director of the Center for Outcomes Research, developed the COVID-19 Surveillance and Outcomes Registry, or CURATOR, to roll out processes for collecting, organizing and analyzing real-time data that’s accessible to research and clinical groups across Houston Methodist.

CURATOR has proven to be an invaluable resource for advancing research and optimizing patient care as the pandemic evolves.

Houston Methodist’s big-data infrastructure and data engineering teams proved to be highly agile and adaptable, which made it possible to establish a robust COVID-19 analytics pipeline in literally weeks. The ability to generate and implement scientific evidence was phenomenal. We consider ourselves battle tested and have confidence in our capacity to respond quickly in the midst of a global pandemic, with the majority of the teams working remotely.

– Farhaan S. Vahidy, PhD Coneway Family Centennial Endowed Directorship in Quality and Outcomes Associate Director and Associate Professor, Center for Outcomes Research Associate Professor, Neurological Institute Houston Methodist

Farhaan S. Vahidy, PhD

COVID-19 Highlights How the Virus Has Impacted People Differently, Depending on Specific Social Determinants

The increase in COVID-19 cases and scrutiny of racial inequality throughout the spring and summer of 2020 has made people more aware of underlying race and ethnic health-care disparities. Fairly early in the pandemic, most reports showed higher rates of severe COVID-19 cases and fatalities among minority racial groups across major U.S. metropolitan areas. However, Houston Methodist was one of the first to provide systematically analyzed robust insights on the racial/ethnic differences for COVID-19 infection by harnessing CURATOR.

Analysis of COVID-19 test results and sociodemographic data from across the exceptionally ethnically diverse Greater Houston area revealed that people who identified as non-Hispanic Black or of Hispanic ethnicity were almost twice as likely to test positive for COVID-19 than non-Hispanic whites. Vahidy and his colleagues identified possible mechanisms of these racial disparities within the data including lower socioeconomic status, higher comorbidity burden and residence in higher population density areas that may not permit adequate social distancing. These data were published in BMJ Open

As the pandemic evolves, emerging information on the link between COVID-19 infection and various sociodemographic factors will continue to enhance our understanding of targeted risks for contracting and preventing infectious diseases, enabling Houston Methodist to provide better care for all members of our community.

CURATOR Identifies Differences Between Those Most Impacted During the First and Second COVID-19 Surges

CURATOR’s bioinformatics repository made it possible for researchers to make evidence-based comparisons between Houston’s first COVID-19 surge from March 13 –May 15 and the second surge from May 15 – July 7, 2020, that began two weeks after the statewide phased business reopening program began. Analyzing the electronic health records of hospitalized COVID-19 patients revealed a demographic shift between the first and second COVID-19 surges.

Chief Physician Executive & Specialty Physician Group

CEO Robert Phillips MD, PhD, and Farhaan S. Vahidy, PhD, and their team revealed that patients being admitted during the second surge had shifted toward a younger, largely Hispanic and lower socioeconomic patient population who had lower rates of comorbidities, intensive care unit admissions, and in-hospital mortality than the patients seen during the first surge. These findings were published in the Journal of the American Medical Association

These findings likely reflect how the phased return to work impacted which people were becoming infected. While many people with desk jobs were able to work from home, people who work in retail, transportation and hospitality service industries, many of whom are Hispanic, interacted with the public directly. These findings provided helpful guidance for preparing and managing the next COVID-19 surge during the fall of 2020 both locally at Houston Methodist and for health systems across the country.

HOUSTON METHODIST ACADEMIC INSTITUTE

Houston Methodist Researchers Step Up and Face the Challenges of the COVID-19 Virus

When the COVID-19 pandemic arrived, although the scientific and medical communities had limited information about how to treat people infected with the novel virus, Houston Methodist was well positioned to meet the urgent need for diagnostics, treatments, vaccines and critical medical technologies.

Throughout the pandemic, our research groups continued their studies without interruption. In fact, Houston Methodist researchers submitted 32 more funding proposals during 2020 than they did the previous year. Many investigators quickly pivoted their research focus to COVID-19-related challenges by participating in more than 50 preclinical studies and clinical trials that resulted in more than 170 COVID-19-related published journal articles and 16,000 media placements.

Houston Methodist Leads the Way in Treating COVID-19 Patients with Innovative Therapies that Boost the Recovery Process

Houston Methodist was the first academic medical center in the nation to receive FDA approval to treat critically ill COVID-19 patients with convalescent plasma therapy — a plasma transfusion from a recovered individual that contains antibodies against the virus.

Although some other organizations had suboptimal results with this treatment, our patients benefited from it because we carefully analyzed and optimized our processes to select the patient populations that would be the optimal candidates. Other institutions treated broad populations much less likely to respond to Houston Methodist’s type of treatment.

In anticipation of the FDA issuing regulatory guidelines, assistant professor in the Department of Pathology and Genomic Medicine, Eric Salazar, MD, PhD, and James M. Musser, MD, PhD, Fondren Presidential Distinguished Chair, developed the therapy protocol. They were the first group in the nation to publish data demonstrating that the therapy is safe and effective. Their work rapidly resulted in five high-profile, peer-reviewed publications on convalescent plasma donors and recipients.

There is so much to be learned about this disease while it’s occurring. If an infusion of convalescent serum can help save the life of a critically ill patient, then applying the full resources of our blood bank, our expert faculty and our academic medical center is incredibly worthwhile and important to do.

”

– Marc L. Boom, MD President and Chief Executive Officer Ella Fondren and Josie Roberts Presidential Distinguished Centennial Chair Houston Methodist

Eric Salazar, MD, PhD James M. Musser, MD, PhD

Houston Methodist’s Participation in Clinical Trials for Innovative COVID-19 Treatments Has Aided Many Patients’ Recoveries

Considered the next evolution of plasma therapy, monoclonal antibody, or mAb, therapies contain synthetic versions of the proteins made by the immune system to neutralize the virus. The mAbs are designed to bind to key sites on the virus molecule to prevent it from attaching to and infecting human cells.

A team of experts at Houston Methodist, led by Salazar, began participating in the clinical trials in hospitalized patients determining the safety and effectiveness of the combination mAb therapy from Regeneron containing two neutralizing mAbs called casirivimab and imdevimab in July 2020. Current data from the Regeneron REGN-COV2 trial show that trial participants receiving the experimental therapy had a lower risk of death or need for mechanical ventilation than those in the placebo group.

Houston Methodist is also actively involved in the clinical studies investigating how well Eli Lilly’s bamlanivimab, a mAb therapy similar to Regeneron’s cocktail, safely and effectively prevents mild COVID-19 infections from becoming more serious. Clinical trial lead Howard Huang, MD, interim chief, division of pulmonary, critical care and sleep medicine, and his teams are administering a single intravenous infusion of the drug to patients who have recently received a positive COVID-19 test and show mild to moderate symptoms in the hopes of intervening before patients have a chance to develop more serious symptoms, thereby reducing COVID-19-related hospitalizations and emergency department visits. Huang and his team are also involved in similar studies of the Regeneron mAbs in patients with mild to moderate symptoms.

In November, the FDA issued an emergency use authorization for both the Regeneron and Eli Lilly therapies for treating mild to moderate COVID-19 infections in patients who are at high risk of becoming dangerously ill. The quick progression from beginning investigational clinical studies on newly developed drugs to having the ability to treat patients not involved in a study is a prime example of translational research in action.

Houston Methodist Played a Key Role in Establishing Remdesivir as a Standard of Care for Treating COVID-19

In mid-March of 2020, Houston Methodist became the only clinical trial site in Houston and the fifth site in the nation to join the two global phase III clinical trials evaluating Gilead Sciences antiviral drug Remdesivir in patients hospitalized with moderate or severe COVID-19 infections. Originally developed to treat Ebola, Remdesivir blocks the SARS-CoV-2 virus’s ability to quickly replicate throughout the body, neutralizing the deadly inflammatory cascade that leads to respiratory failure and dependence on a ventilator.

The Houston Methodist clinical study led by Katherine Perez, PharmD, assistant professor of allied health sciences, Department of Pharmacy, Department of Pathology and Genomic Medicine and Kevin Grimes, MD, assistant professor of clinical medicine, Department of Medicine, found that participants with COVID-19 responded quickly to the investigational drug and recovered more quickly than their control counterparts. The final report from the global trial leadership confirmed that Remdesivir shortens the time to recovery in adults hospitalized with COVID-19, which paved the way for Remdesivir to become the first antiviral treatment approved by the FDA for COVID-19.

Shedding Light on an Unseen Crisis: New Tools Build Health-Care Worker Resiliency

COVID-19 has brought the issue of health-care provider fatigue to the forefront of national conversation, but experts at Houston Methodist have been studying it for many years

During the initial COVID-19 surge in Houston, a team of researchers led by Faisal N. Masud, MD, Mary A. and M. Samuel Daffin, Sr. Centennial Chair in Anesthesia and Critical Care and Farzan Sasangohar, PhD, assistant professor of outcomes research, published a paper in Anesthesia & Analgesia discussing factors that contribute to provider fatigue and burnout in intensive care units (ICUs) during the pandemic. The article, which remained in Altmetric’s top 99th percentile of publications for months, was one of the first to propose specific policy recommendations for organizational readiness, resilience and disaster mitigation — many of which were already in place at Houston Methodist. Most studies investigating burnout, including the aforementioned, rely on self-reporting measures that

are inherently prone to bias. To better maintain objectivity, Sasangohar, Masud and their teams employed wearable technology to provide quantitative measurements of stress and anxiety levels in ICU workers. Participating ICU staff were observed while wearing eye-tracking glasses with a built-in camera that recorded exactly what the wearer was seeing and hearing in real time. The information collected from this device was paired with heart rate data and self-reported observations to provide a more complete picture of stress triggers and reactions.

“Nothing like this has ever been done before in an ICU setting,” said Sasangohar. “The use of wearable technology combined with artificial intelligence could set the benchmark for future research on stress and burnout.”

Faisal N. Masud, MD Farzan Sasangohar, PhD

New wearable technology developed by Faisal N. Masud, MD, and Farzan Sasangohar, PhD, provides quantitative measurements of stress and anxiety levels in ICU workers. These devices will provide objective data in self-reporting measures.

While data analyses are still ongoing, the research team is using the preliminary results to explore potential mitigation strategies, including measures to limit or eliminate environmental, task-related and technological sources of stress that contribute to burnout among ICU personnel. The next phase of this study is to utilize wearable technology to compare burnout among health-care providers in COVID-19 ICUs with those in non-COVID-19 ICUs.

Masud, who is also the medical director of critical care at Houston Methodist Hospital, has been passionate about finding transformational solutions to support the mental well-being of intensive care personnel. “The wearable technology study could provide the evidence-based solutions we need to fill the knowledge gap in health care provider stress and burnout,” he said. “COVID-19 and its far-reaching psychological implications have brought a greater sense of urgency to our work.”

Outcomes Research

Roberta Schwartz, PhD, chief innovation officer of Houston Methodist Hospital, led an observational study of patients and concluded that the use of mobile health technology (mHealth) has shown significant improvement in clinical outcomes among patients. The investigators found that patients who used mHealth technology averaged shorter hospital stays and lower post-surgical readmission rates. Breast cancer patients often gain weight during treatment, and that is a concern because obesity is a factor in the recurrence of the cancer. The Methodist Hospital Cancer Health Application, or the MOCHA app, was developed by Stephen T.C. Wong, PhD, and his informatics development team to help cancer patients make healthy lifestyle choices. A pilot study showed that 56% of enrolled patients who used the app lost an average of 3.5 pounds and that frequency of app use was positively linked with weight loss.

Breast Cancer Survivors Find a Way to Maintain Healthy Lifestyles and Lose Weight on Their Phones

Breast cancer treatment often leads to unintentional weight gain, which is concerning because obesity is associated with an increased risk of breast cancer recurrence and a higher rate of hospital readmissions.

Renee Stubbins, PhD Stephen T.C. Wong, PhD

While weight management tools are among the most frequently accessed health apps, most are not tailored to the specific needs of cancer survivors. Stephen T.C. Wong, PhD, John S. Dunn Presidential Distinguished Chair in Biomedical Engineering, and his informatics development team designed a mobile app called the Methodist Hospital Cancer Health Application, or MOCHA, to be an interactive resource that helps post-treatment cancer survivors to make healthy lifestyle choices, including weight loss.

A four-week pilot study of the MOCHA app revealed that 56% of enrolled patients lost an average of 3.5 pounds and that frequency of app use was positively linked with weight loss. The complete results are available in the journal JCO Clinical Cancer Informatics The next phase of this study will involve 12 weeks of intervention and one year of follow-up. While the app is currently accessible only to study participants, the goal is to broaden its use and focus on changing long-term behaviors to reduce health issues most common in cancer survivors.

– Renee Stubbins, PhD Assistant Clinical Member Houston Methodist

Maintaining a healthy weight is difficult enough for the average person, let alone for breast cancer survivors. With MOCHA, we can track multiple patients at once, identify those who need additional support or intervention and communicate with them via real-time messaging to help them stay motivated. This is a tremendous improvement from the typical six-month clinic visit schedule for breast cancer survivors, between which patients can lose motivation and experience weight gain.

Mobile App Improves Joint Replacement Surgery Outcomes

With close to 90% of the U.S. population having access to mobile devices, mobile health (mHealth) technology could transform how health care is delivered. Despite widespread recognition of its potential, there is limited evidence supporting the effectiveness of mHealth technology in a health care setting.

In an observational study published in the journal JMIR mHealth and uHealth, Houston Methodist investigators, led by Roberta Schwartz, PhD, chief innovation officer of Houston Methodist Hospital, show that effective use of patient-facing mHealth technology can significantly improve both clinical and patient-centered care outcomes.

The study compared the outcomes of 2,059 patients who underwent a total hip or knee replacement by orthopedic surgeons who used mHealth technology with 2,554 similar patients of nonparticipating surgeons for a year. In the mHealth group, the patients received one text or email message per day, some of which required responses while others were only informational, for 20 days before and 30 days following the joint replacement.

“In our study, we observed a significant improvement in clinical outcomes among patients who used mHealth technology,” said senior author Courtenay R. Bruce, JD, MA, associate professor of medicine. “The participating group had a significantly shorter average hospital stay and lower post-surgical hospital readmission rates compared with the nonparticipating group. In addition, the participating group also had better patient-centered care outcomes such as patient engagement, experience and satisfaction.”

According to Bruce, a more engaged patient is a better informed and more empowered patient. And this ultimately translates to improved outcomes.

We now know that mHealth technology is not only effective but significantly enhances patient outcomes. This is particularly important in the context of the rapidly evolving COVID-19 pandemic that has made mHealth services an integral part of patient care. The results of this study were so encouraging that what started as a small pilot program in a few hospital departments has rapidly expanded to include 50 different therapeutic areas, benefiting more than 300,000 patients.

– Roberta Schwartz, PhD Executive Vice President Chief Innovation Officer Houston Methodist

Roberta Schwartz, PhD Stephen Incavo, MD Courtenay R. Bruce, JD, MA

Restorative Medicine

Houston Methodist remains at the cutting edge of regenerative medicine by developing a range of medical and biotherapeutic products that help restore the functionality of impaired organs and tissues. These restorative solutions address challenges, including protecting transplanted tissues from rejection, restoring sensorimotor function in people with neuromuscular disorders and repairing broken bones.

Houston Methodist and Rice University Launch Center for Translational Neural Prosthetics and Interfaces

Neurosurgery’s history of cutting diseases out of the brain is morphing into a future in which implanting technology into the brain may help restore function, movement, cognition and memory after patients suffer strokes, spinal cord injuries and other neurological disorders. Rice University and Houston Methodist have forged a partnership to launch the Center for Translational Neural Prosthetics and Interfaces, a collaboration that brings together scientists, clinicians, engineers and surgeons to solve clinical problems with neurorobotics.

“This will be an accelerator for discovery. This center will be a human laboratory where all of us — neurosurgeons, neuroengineers, neurobiologists — can work together to solve biomedical problems in the brain and spinal cord. And it’s a collaboration that can finally offer some hope and options for the millions of people worldwide who suffer from brain diseases and injuries,” said center Co-Director Gavin W. Britz, MD, Candy and Tom Knudson Distinguished Centennial Chair in Neurosurgery at Houston Methodist.

Houston Methodist neurosurgeons, seven engineers from the Rice Neuroengineering Initiative and additional physicians and faculty from both institutions form the center’s core team. The center also plans to hire additional engineers who will have joint appointments at Houston Methodist and Rice. Key focus areas include spinal cord injury, memory and epilepsy studies, and cortical motor/sensation conditions.

“The Rice Neuroengineering Initiative was formed with this type of partnership in mind,” said center Co-Director Behnaam Aazhang, PhD, Rice’s J.S. Abercrombie Professor

of Electrical and Computer Engineering, who also directs the neuroengineering initiative. “Several core members, myself included, have existing collaborations with our colleagues at Houston Methodist in the area of neural prosthetics. The creation of the Center for Translational Neural Prosthetics and Interfaces is an exciting development toward achieving our common goals.”

The physical space for the center’s operation includes more than 25,000 square feet of Rice Neuroengineering Initiative laboratories and experimental spaces in the university’s BioScience Research Collaborative, as well as an extensive build-out underway at Houston Methodist’s West Pavilion location that’s expected to be completed late in 2021. The Houston Methodist facility will include operating rooms and a human laboratory where ongoing patient/volunteer diagnosis and assessment, device fabrication and testing and education and training opportunities are planned.

“This partnership is a perfect blend of talent,” said Rice’s Marcia O’Malley, PhD, a core member of the new center. “We will be able to design studies to test the efficacy of inventions and therapies and rely on patients and volunteers who want to help us test our ideas. The possibilities are limitless.”

Houston Methodist neurobiologist Philip J. Horner, PhD, describes the lab as “a merging of wetware with hardware,” where robotics, computers, electronic arrays and other technology — the hardware — is incorporated into the human brain or spinal cord — the wetware. The centerpiece of this working laboratory is a zero-gravity harness connected to a walking track with cameras and sensors to record feedback, brain activity and other data.

Gavin W. Britz, MD Behnaam Aazhang, PhD

Center Collaborations

Collaborations already are underway between the two institutions, which sit across Main Street from one another in the Texas Medical Center. Among them are the following:

• Houston Methodist’s Dimitry Sayenko, MD, PhD, assistant professor of neurosurgery, and O’Malley, Rice’s Thomas Michael Panos Family Professor in Mechanical Engineering, will head the first pilot project involving the merging of two technologies to restore hand function following a spinal cord injury or stroke. O’Malley will pair the upper limb exoskeleton she invented with Sayenko’s noninvasive stimulator designed to wake up the spinal cord. Together, they hope these technologies will help patients achieve a more extensive recovery — and at a faster pace.

• Britz, a neurosurgeon, and Lan Luan, PhD, Rice assistant professor of electrical and computer engineering, are collaborating on a study to measure the neurovascular response following a subarachnoid hemorrhage, a life-threatening stroke caused by bleeding just outside the brain.

NEUROSTIMULATION THERAPY

SEND SIGNAL

PROCESS & DECODE

MUSCLE CONTROL

• Britz and Center Co-Director Behnaam Aazhang, PhD, Rice’s J.S. Abercrombie Professor of Electrical and Computer Engineering, and Taiyun Chi, PhD, assistant professor of electrical and computer engineering at Rice, are collaborating on the detection of mild traumatic brain injuries (mTBI) from multimodal observations and on alleviating mTBI using neuromodulations. This project is of particular interest to the U.S. Department of Defense.

Center for Translational Neural Prosthetics & Interfaces

ROBOTICS & BRAIN COMPUTER INTERFACE

ACQUIRE SIGNAL PROCESS & DECODE

DEVICE CONTROL

Noninvasive Spinal Stimulation Enables Paralyzed People to Stand Unassisted

Regaining the ability to control a full weight-bearing standing posture without assistance from weight-supporting devices or other people is a key goal for someone who is paralyzed. Not only does this ability provide a greater level of physical independence and mobility, maintaining balance when standing is the foundation for regaining the ability to walk, including stepping with assistance from robotic devices being developed at Houston Methodist and other places.

In a well-controlled clinical study published in the Journal of Neurotrauma, people with spinal cord injuries who could not stand unassisted received noninvasive transcutaneous electrical spinal cord stimulation via electrodes placed on the spinal column three days per week for a month.

Following this treatment, all the participants could maintain an upright standing position either independently or with

minimal external assistance applied to the knees or hips, using their hands for upper-body balance as needed. The quality of their balance control improved with continued training. When the participants shifted their weight while standing, high levels of leg muscle activity emerged that depended on the amount of muscle loading.

These findings suggest that the noninvasive stimulation therapy can modulate the spinal circuitry into a physiological state that enables sensory inputs during weight-bearing to serve as a primary source of neural control to maintain externally unassisted upright posture and balance.

Sayenko recently began collaborating with Niche Biomedical to initiate a sponsored clinical trial evaluating the effects of spinal stimulation on upper limb function in individuals with spinal cord injuries. Niche Biomedical is a multidisciplinary bioelectronics medical device company focused on developing neuromodulatory technologies to address chronic conditions that have previously defied conventional medical treatment.

Dimitry Sayenko MD, PhD, assistant professor of neurosurgery, and his colleagues in the Neuromodulation & Recovery Lab are developing ways to promote mobility in people who have sustained a spinal cord injury.

Dimitry Sayenko MD, PhD

Our clinical research program focuses on central nervous system plasticity throughout the course of motor learning and regaining lost sensorimotor function. We are especially interested in exploring the strategies for regaining functionality during self-assisted standing and stepping, as well as for improving control of motor and autonomic functions.

– Dimitry Sayenko MD, PhD Assistant Professor, Neurosurgery Houston Methodist

Dissolvable Implants Enhance the Body’s Ability to Heal Broken Bones

The Houston Methodist Center for Musculoskeletal Regeneration recognizes that the human body has an incredible capacity for healing and develops biomimetic implantables to augment these processes.

Center Director and Assistant Professor of Orthopedic Surgery

Francesca Taraballi, PhD, and her colleagues have demonstrated that all regenerative processes depend on a complex dialogue among different types of cells. They have developed a collagen-based scaffold device called 3 Zonal Membrane (3ZM), which is currently in cGMP production, that enhances the structure and composition of growing bones to quickly repair complex fractures that would usually result in high infection rates, slow/incomplete healing or amputation.

Francesca Taraballi, PhD Bradley K. Weiner, MD

3ZM Steps in Healing Process

In preclinical models, 3ZM guided immune, stem and bone membrane cells that remodeled the area into functional bone. Within six weeks, the fracture healed and the implanted materials were absorbed by the body, leaving the bone strong.

The center was awarded $6 million by the U.S. Department of Defense under the leadership of Bradley Weiner, MD, professor of clinical orthopedic surgery, to complete preclinical cGMP assessment of 3ZM technology for a pre-Investigational Device Exemption regulatory consultation with the Food and Drug Administration. The center leaders have worked with industry partners and regulatory experts and policymakers to identify an accelerated path to clinical application.

3ZM Steps in Healing Process

3 Zonal Membrane (3ZM) is cut and shaped to fit the defect site and then sutured to the surrounding periosteum. The process requires only one operation and no additional growth factors. After four to six weeks, the bone is fully healed, and the 3ZM is absorbed.

Cell Encapsulation May Hold the Key to Preventing Cell Transplant Rejection

Cell transplantation is a promising option for the management of endocrine disorders such as type I diabetes and testosterone deficiency, but risk of rejection by the recipient’s immune system and the resulting life-long dependency on immunosuppressive drugs has been a major obstacle to long-term success.

In order to protect transplanted cells and improve cell viability, several research groups have tried encapsulating the cells within a capsule that acts as a physical barrier. However, issues with inadequate blood supply and oxygen permeability within the capsule have limited their ability to support the transplanted cells.

A Houston Methodist research team of nanomedicine and cell transplant experts led by Alessandro Grattoni, PhD, Frank J. and Jean Raymond Centennial Chair, and chair and professor of nanomedicine, has developed a novel encapsulation platform for transplanted cells termed neovascularized implantable cell homing and encapsulation, or NICHE, that directly addresses these limitations.

NICHE is implanted just under the skin, permitting easy access for replenishing transplanted cells or drugs when needed. The researchers utilized 3D printing technology to create the NICHE platform as it allows easy customization based on cell type and rapid, cost-effective scalability.

In a preclinical study published in Biomaterials, Grattoni and his team successfully used NICHE to transplant testosterone-producing testicular Leydig cells, offering a potential new treatment option for testosterone deficiency. The NICHE platform effectively established blood supply within the capsule and achieved sustained immunosuppressant delivery. Promisingly, the transplanted cells remained viable for the length of the study. Building upon their work with Leydig cells, the team is evaluating the efficacy of pancreatic islet cell transplantation using NICHE in preclinical diabetes models.

Alessandro Grattoni, PhD A. Osama Gaber, MD

– Alessandro Grattoni, PhD Chair and Professor of Nanomedicine, Frank J. and Jean Raymond Centennial Chair Houston Methodist

Unlike other encapsulation platforms, NICHE successfully integrates blood supply, oxygenation and localized immunosuppressant drug delivery into one device. This has significantly improved cell viability, while avoiding the adverse effects of systemic immunosupression.

“ ”

These findings are a culmination of a long history of collaboration in cellular transplantation research at Houston Methodist and should expedite the translation of cell encapsulation technology from the lab to the clinic, delivering more effective treatment options to patients with conditions like type I diabetes.

Credit: Biomaterials

Fig. 1. NICHE deployment strategy. (A) Mesenchymal Stem Cells (MSCs) hydrogel-filled NICHE is implanted in a subcutaneous pocket to stimulate vascularization. (B) Prevascularization phase, with blood vessel formation across the cell reservoir. (C) Transcutaneous loading of immunosuppressant into NICHE drug reservoir using loading and venting needles. Needles are advanced into the NICHE drug reservoir through self-sealing silicon ports. Upon drug loading, the venting needle permits flushing of the reservoir and removal of entrapped air or liquid. (D) Transcutaneous transplantation of cells into the vascularized and immunosuppressed cell reservoir using a needle connected to a cell-loaded syringe.

– A. Osama Gaber, MD, FACS, FAST John F., Jr. and Carolyn Bookout Presidential Distinguished Chair in Surgery Chair, Department of Surgery Houston Methodist

Revolutionizing the Future of Complex Valve Disease Management

Replacing a faulty aortic valve once required open-heart surgery, which can pose significant risks for patients who are older or have certain comorbidities. The advent of minimally invasive transcatheter aortic valve replacement, or TAVR, where the replacement valve is inserted via a small incision in the groin or chest, has opened much-needed treatment options for these patients.

“Momentous breakthroughs don’t happen often in medicine. TAVR is certainly one of the most exciting developments in recent times,” said Michael J. Reardon, MD, Allison Family Distinguished Chair of Cardiovascular Research in the Department of Cardiovascular Surgery. “The Houston Methodist DeBakey Heart & Vascular Center’s valve clinic team has been at the very forefront of this pioneering innovation in minimally invasive surgery, making Houston Methodist one of the most experienced TAVR sites in the nation.” Under the leadership of Reardon and his cardiology partner Lois and Carl Davis Centennial Chair Neal Kleiman, MD, the TAVR program has contributed to hundreds of publications in recent years and has played a key role in shaping this new field.

TAVR was initially approved by the U.S. Food and Drug Administration (FDA) for use in patients with an intermediate or high risk of death or major complications during open-heart surgery. In August 2019, the FDA expanded approval to low-risk patients based on outcomes from two landmark clinical trials; Reardon was the national principal investigator for one of the trials. It confirmed that TAVR was a safe and effective treatment option for low-risk patients and was associated with shorter hospital stays, improved qualityof-life scores and a significantly lower rate of all-cause mortality or disabling stroke compared to traditional surgery. The complete findings are published in The New England Journal of Medicine.

Michael J.

MD Allison Family Distinguished Chair of Cardiovascular Research Department of Cardiovascular Surgery Professor of Cardiovascular Surgery Houston Methodist

TAVR is a force of positive disruption that is completely redefining the scope of valve replacement surgery. With the expanded indication, TAVR will be a game-changer for low-risk patients who are seeking to avoid the risks and longer recovery associated with surgery.

–

Reardon,

Precision Medicine

At Houston Methodist, we develop cutting-edge medical treatments and employ advanced technology platforms and programs to translate innovations into therapies and diagnostics that can be tailored to individual patient needs.

CPRIT Funding to Drive New Discoveries in Cancer Therapeutics

Three Houston Methodist researchers have received funding from the Cancer Prevention and Research Institute of Texas (CPRIT) to address critical gaps in cancer research and therapeutics. CPRIT awarded Houston Methodist $4 million to further the RNAcore’s evolution from a research and clinical-grade RNA provider to the only academic group in the U.S. to provide integrated RNA therapeutics services that span from the conception of an idea to commercialization.

An Innovative New Tool to Enable Drug Discovery and Personalized Medicine

A High-Impact/High-Risk Award from CPRIT is facilitating the development of a novel organoid platform – a mini-brain model that mimics glioblastoma, one of the deadliest forms of brain cancer.

With a new High-Impact/High-Risk Award from CPRIT, Robert C. Krencik, PhD, assistant professor of neurosurgery, is developing a reproducible and physiologically accurate model of human glioblastoma by incorporating patientspecific glioblastoma stem cells within 3D spheres of human neural cells. This model can be utilized as a tool to screen drugs and test the effectiveness of potential treatment options for glioblastoma and other brain cancers. Using glioblastoma stem cells from individual patients will also enable a personalized approach to treatment selection.

This platform will not only serve as an important tool for drug discovery and personalized medicine, it will also enhance our understanding of cell interactions within the glioblastoma microenvironment.

– Robert C. Krencik, PhD Assistant Professor, Neurosurgery Houston Methodist

Devising a Novel Combination Treatment for Aggressive Double-hit Lymphoma

Assistant Professor of Immunotherapy in Oncology, Yulin Li, MD, PhD, received CPRIT funding to investigate the therapeutic efficacy of a new combination therapy for treating the aggressive double-hit lymphoma, or DHL cancer.

DHL simultaneously activates multiple cancer-causing oncogenes, making it very difficult to treat with frontline chemotherapy. While inactivating oncogenes with targeted therapy effectively kills tumor cells, this effect is limited by relapse and treatment resistance. In contrast, immunotherapies can provide a long-term survival benefit but are less effective with DHL because of reduced expression of the common anticancer immunotherapy, CD20. Li believes that combining the treatment approaches in a targeted therapy that suppresses oncogenes together with anti-CD20 immunotherapy holds great promise.

– Yulin Li, MD, PhD Assistant Professor of Immunotherapy in Oncology Houston Methodist

If successful, this approach may lead to a new paradigm of coupling targeted suppression of multiple oncogenes with simultaneous engagement of the immune system.

Expanding the RNAcore to Encompass the Entire Cycle of Translation

The RNAcore began as a core group for the National Heart, Lung and Blood Institute Progenitor Cell Biology Consortium, producing high-fidelity research and clinical-grade RNA, including mRNA, modified mRNA and noncoding RNA, for the support of fundamental research and clinical applications.

In 2015, the Houston Methodist RNAcore was awarded $4.8 million from the Cancer Prevention and Research Institute of Texas (CPRIT) to expand the small RNAcore supporting basic research and RNA construct development. At the time, the RNAcore was the first academic entity in Texas to generate the new class of drugs known as RNA therapeutics. The grant funded support of the development and generation of RNA therapeutics, particularly for cancer immunology.

Fast-forward six years, and RNA therapeutics are on the tip of everyone’s tongue. The development of mRNA vaccines against COVID-19 brought worldwide attention to the transformative potential of RNA-based therapeutics.

In 2020, CPRIT awarded Houston Methodist with an additional $4 million to expand the RNAcore into a state-of-the-art comprehensive RNA therapeutics facility that further enables academic and biotechnology groups to translate their ideas and innovations into therapies by providing services in

development, manufacturing, quality control and preclinical and early-stage clinical testing of RNA drugs. The RNAcore’s industry partner VGXI has licensed their manufacturing processes to scale-up for late-stage trials and commercialization. The CPRIT funding helps the RNAcore to accelerate the drug discovery process for RNA therapeutics by significantly reducing the time needed to bring potential new treatments from bench to bedside.

Under the leadership of John P. Cooke, MD, PhD, Joseph C. “Rusty” Walter and Carole Walter Looke Presidential Distinguished Chair in Cardiovascular Disease Research, and principal investigator of the CPRIT grant, the RNAcore has supported the development of several RNA-based therapies, including an mRNA vaccine for metastatic melanoma cancer treatment. Promising preclinical data showing dose-dependent antitumor activity with the vaccine led to the creation of a spin-off company focused on mRNAbased vaccine products for cancer. Daniel L. Kiss, PhD, assistant professor of cardiovascular sciences, working with the RNAcore, has generated circular RNAs to block the activity of overexpressed microRNAs in breast cancer.

There are many biotech companies and academic institutes that can quickly develop these therapies, but most lack the means to translate their product into the clinic. Researchers at Houston Methodist have built critical infrastructure to support the democratization of mRNA therapeutics. This program is a single-entry point for the development of RNA therapy candidates into transformative drugs and might be the only program of this sort in an academic center.

Though the concept of using RNA-targeting for therapeutic purposes has been around for a while, clinical potential is only just being realized, an example being the COVID-19 mRNA vaccines. With CPRIT funding, the RNAcore will help accelerate the drug discovery process for RNA therapeutics by significantly reducing the time needed to bring potential new treatments from bench to bedside.

John P. Cooke,

Joseph C.

Walter and Carole Walter Looke Presidential Distinguished Chair in Cardiovascular Disease Research Chair, Department of Cardiovascular Sciences Professor of Cardiovascular Sciences Houston Methodist

In 2020, under the leadership of John P. Cooke, MD, PhD, and principal investigator of the CPRIT grant, CPRIT awarded Houston Methodist with an additional $4 million to expand the RNAcore into a state-of-the-art comprehensive RNA therapeutics facility.

–

MD, PhD

“Rusty”

”

Siemens Healthineers and Houston Methodist

Imaging Innovation Hub Empowers Researchers to Push Boundaries

The Houston Methodist Translational Imaging Center provides clinicians and researchers across the Texas Medical Center with access to advanced, high-performance imaging equipment to create a direct translational environment for innovation. Access to such high-throughput multimodality tools in a translational research setting is seen in very few centers in the world.

Through a Siemens Healthineers and Houston Methodist multiyear consortium agreement, the Research Institute is home to one of the world’s most powerful magnetic resonance imaging (MRI) machines – the Siemens 7 Tesla (7T) MAGNETOM Terra, which is the first 7T MRI of its kind in Texas and the first 7T MRI scanner approved for clinical use in the U.S. This agreement also emphasizes an interventional imaging partnership that allows clinicians and researchers to collaborate on developing new technologies for robotic- and image-guided navigation.

The higher spatial resolution and improved contrast capabilities of the 7T MRI is being harnessed in clinical studies to more accurately localize the lesions that may be responsible for seizures in epileptic patients with focal cortical dysplasia, the most common cause of medically refractory epilepsy in children and the third most common cause of medically intractable seizures in adults. For epilepsy patients who are good candidates for surgery, equipping the surgeon with more detailed information on the lesion sites has the potential to significantly improve surgical outcomes.

Houston Methodist’s collaboration with Siemens is also enabling safer, more autonomous imaging with intracardiac echocardiography, or ICE, which allows physicians to focus their efforts and time on delivering therapy rather than dividing their attention with acquiring images. The use of robotic- and AI-assisted ICE imaging may provide simple and intuitive procedural navigation. C. Huie Lin, MD, PhD, assistant professor of cardiology, is leading an effort to introduce image-based control for semi-autonomous robotic ICE imaging and to optimize the physician-robot interface.

The 7T is also allowing physicians to better monitor patients with small cerebral aneurysms over time and tailor their course of treatment as needed. Traditionally, follow-up for such patients is conducted with computed tomography (CT) angiographic or digital subtraction angiographic

examinations. These procedures use radiation and contrast load that pose a risk of renal failure and contrast reactions apart from the risks of cumulative radiation. Although the widely available 3T clinical MRI can circumvent these undesirable effects, it has its own limitations. The 7T clinical MRI scanner may provide a good alternative as its superior spatial resolution and shortened T1 relaxation time of stationary tissue results

in superior contrast to blood than current 3T clinical MRI and thereby may prominently display the lumen of the aneurysm and the parent vessel. Experienced endovascular neurosurgeons and neuro-interventional radiologists plan to compare magnetic resonance angiographic images with clinical standard CT angiographic or digital subtraction angiographic acquisitions to determine when the 7T provides a significant advantage.

The array of advanced imaging technologies at the Research Institute Translational Imaging Center, the partnership with Siemens Healthineers and the strong interdisciplinary collaborations within our organization are all major reasons for my excitement in the opportunity to join and help lead our efforts to make imaging sciences a centerpiece of innovation. The 7T Terra whole-body MRI, in addition to our other MRI research systems, our advanced radiopharmacy GMP lab, cyclotron, PET facilities and our imaging scientists are vital building blocks that support development of a world-class translational research center.

7T MRI Brain Scan 3T MRI Brain Scan

A ribbon-cutting ceremony to celebrate the new imaging center and its capabilities was held on June 26, 2019. Leaders from Houston Methodist, Siemens and across the Texas Medical Center enjoyed tours and demonstrations of the most advanced, high-performance equipment for imaging research and innovation.

– Diego R. Martin, MD, PhD Professor and Chair, Department of Radiology Houston Methodist

Diego Martin, MD, PhD

”

Novel Monoclonal Antibody Treatment

Halts Tumor Growth in Deadly Ovarian

and Pancreatic Cancers

A research collaboration between Houston Methodist and The University of Texas MD Anderson Cancer Center has identified a promising new antibody therapy for late-stage ovarian and pancreatic cancers. Termed “silent killers,” these cancers often go undetected until it is are too late to treat.

Stephen T.C. Wong, PhD, from Houston Methodist Dr. Mary and Ron Neal Cancer Center, and Samuel Mok, PhD, from The University of Texas MD Anderson Cancer Center, are collaborating to create an antibody as a new type of immunotherapy.

For any tumor, its surrounding environment plays a crucial role in promoting growth and progression. Tumor microenvironment is composed of different types of cells and proteins, each of which influences cancer cell growth, migration and differentiation.

A group of researchers led by Stephen T.C. Wong, PhD, from Houston Methodist Dr. Mary and Ron Neal Cancer Center, and Samuel Mok, PhD, from The University of Texas MD Anderson Cancer Center, identified a protein called MFAP5, which was elevated in the tumor microenvironment of both ovarian and pancreatic cancers. They also showed that MFAP5 plays a crucial role in promoting metastasis of these cancers, stimulating blood vessel formation within the tumor and enhancing cancer cells’ resistance to chemotherapy drugs. This made MFAP5 a promising therapeutic target for treating ovarian and pancreatic cancers.

To test if blocking MFAP5 produced a desirable anticancer effect, Wong and colleagues devised a new monoclonal

antibody 130A that successfully blocked MFAP5 in preclinical models of ovarian and pancreatic cancer. Developed and patented by Wong and Mok, the antibody prevented the formation of new blood vessels within the tumor, thereby cutting off the support needed for tumor growth and proliferation. It also enhanced the bioavailability and effectiveness of other chemotherapy drugs and inhibited tumor growth as well as progression. Most importantly, treatment with the MFAP5-targeting antibody curbed tumor progression without producing noticeable toxic effects. Co-corresponding authors Wong and Mok published their findings in the journal Clinical Cancer Research

“The lack of side effects can be attributed to the fact that MFAP5 is expressed at very low levels in normal cells compared to cells in the tumor microenvironment, which makes this therapy highly targeted,” said Wong.

After demonstrating the efficacy of their monoclonal antibody in preclinical models, the team’s next step will be to design an anti-MFAP5 antibody that can be used in human studies. According to Wong, this work requires the seamless convergence of expertise across varied disciplines such as biological science, computational science and engineering, making this a truly multidisciplinary effort.

– Stephen T.C. Wong, PhD John S. Dunn Presidential Distinguished Chair in Biomedical Engineering Professor of Computer Science and Bioengineering in Oncology Cancer Center Houston Methodist

Finding an effective targeted treatment for two of the most lethal cancers is like the holy grail of cancer research. This translational discovery has raised the prospect of developing a treatment for late-stage ovarian and pancreatic cancers.

“ ”

Wong and Mok created the antibody to block the action of the MFAP5 protein, secreted by the cells that surround and support ovarian and pancreatic tumor cells.

Houston Methodist Institute for Technology, Innovation & Education (MITIESM)

Over the past decade, the Houston Methodist Institute for Technology, Innovation & Education has become one of the most advanced simulation education and clinical research facilities in the world.

At MITIE, our experts can continually refine their skills and acquire new expertise to perform at optimal levels as well as advance new innovations and develop the metrics required to define procedural competence in a hands-on simulated clinical care environment. The integrative design of the institute’s research and training spaces enables our experts to effectively collaborate within MITIE throughout the entire progression of technological or procedural

development within the research core, confirm efficacy within a simulated clinical environment and disseminate to practicing physicians within the training area and MedPresence Suite.

Under the new leadership of Alan Lumsden, MD, Walter W. Fondren III Presidential Distinguished Chair, DeBakey Heart & Vascular Center, MITIE is closely working with experts throughout the organization to further align Houston Methodist’s research and education efforts with the Centers of Excellence in a venture that will synergistically expand all of our programs.

Alan B. Lumsden, MD Randolph H. Steadman, MD

MITIE has become an incubator for innovative ideas and technological advances that offers an extensive array of resources for training, research and device development.

MITIESM Simulation Center offers a procedural and clinical environment for simulation in education and research.

The Institute for Robotics, Imaging and Navigation connects conceptualization to rapid prototyping related to robotics to transform ideas into products and processes.

The Center for Rapid Device Translation connects industry with subject matter experts in clinical and translational medicine to collaborate on preclinical device development and good laboratory practice on the path to FDA approval.

– Alan B. Lumsden, MD Walter W. Fondren III Presidential Distinguished Chair, DeBakey Heart & Vascular Center Professor and Chair, Department of Cardiovascular Surgery Houston Methodist

Surgical Technology Developed in MITIESM Gains FDA Approval

MITIE played an integral role in the development of a new device called StimSite that creatively solves an issue confronted by surgeons during the three million procedures in the U.S. annually that involve making incisions near the ureters. StimSite was devised by Albert Huang, MD, a former Houston Methodist surgical resident and research fellow and current founder and CEO of Allotrope Medical and TMCx entrepreneur in residence.

The device provides general, ob/gyn and colorectal surgeons with an elegant tool to help locate and avoid the ureters. After years of planning, prototyping and testing, Huang’s device received FDA clearance in November 2020.

When the StimSite device generates a specifically calibrated current in the lower abdomen, the famously difficult-to-locate ureters are the only structures in the vicinity containing the smooth muscle needed to respond to electrical stimulation. The rhythmic movement of the stimulated ureters makes it much quicker and easier for surgeons to locate and avoid the ureters when performing surgical procedures in the region. Huang began the clinical pilot studies on StimSite by training ob/gyn surgeons from a private practice to use the device at MITIE.

Houston Methodist is a clinical powerhouse. Aligning our education and research efforts with our Centers of Excellence allows us to share these clinical strengths. We are building relationships with collaborators and experts that create a powerful synergy as we continually expand.

Can Devices Provide A New Treatment Option for Glioblastoma?

Experts at the Houston Methodist Kenneth R. Peak Brain & Pituitary Tumor Treatment Center are developing new glioblastoma multiforme (GBM) treatment options, including an innovative technology that provides anticancer therapy through a wearable device.

GBM is the most common and aggressive form of brain cancer. After 40 years of research, median survival with aggressive treatment has only improved from 9 to 15 months and the quality of life during this time is often poor.

A team of researchers has developed a new method of generating an oscillating magnetic field (OMF) that eradicates cancer cells via a wearable device. These studies were made possible by the prior invention of a wearable miniaturized multifocal transcranial magnetic stimulator by Santosh Helekar, MD, PhD, associate professor of neurosurgery, and Henning Voss, associate professor of physics in radiology at Weill Cornell Medical College. The device uses microstimulators, called oncoscillators, that rotate strong neodymium permanent magnets-devised patterns. Helekar and his colleagues have produced selective anticancer effects in patient-derived GBM and breast cancer cells in culture without damaging cultured normal cells.

With this information, the investigators further optimized the stimulus parameters of OMF stimulation and confirmed safety and efficacy in a humanized preclinical model of GBM. They then modified the Helekar-Voss Transcranial Permanent Magnet Stimulator device to construct a wearable prototype for humans called an Oncomagnetic device along with the associated hardware, software and mobile applications.

David S. Baskin, MD Santosh Helekar, MD, PhD

– David S. Baskin, MD Kenneth R. Peak Presidential Distinguished Chair & Program Director, Neurosurgery Residency, Department of Neurosurgery Professor, Neurosurgery Houston Methodist

“ ”

On a cellular level, they demonstrated that when OMFs are applied in a defined pattern at a certain range of frequencies, they disrupt electron flows in the mitochondrial electron transport chain that drives cellular fuel production. This disruption leads to the generation of reactive oxygen species, triggering a cascade of cellular events that leads to cancer cell apoptosis. Compared with normal cells of the same tissue type, cancer cells have critically high levels of reactive oxygen species at baseline that are poised to trigger apoptosis if further increased.

Houston Methodist Hospital’s New Paula and Joseph C. “Rusty” Walter III Tower Offers the Most Advanced Treatments and Innovations Available

Houston Methodist’s Paula and Joseph C. “Rusty” Walter III Tower is home to sophisticated neurological and cardiovascular surgical suites specially designed for highly technical and minimally invasive image-guided procedures.

Through the Siemens consortium, the Walter Tower and MITIESM have been outfitted with triple hybrid surgical suites that integrate robotic-assisted technology with the most advanced computed tomography (CT), angiography and magnetic resonance imaging technology available as well as a dual CT and positron emission tomography scanner that can illuminate specific biochemical processes in order to provide precise, efficient and safe surgeries for our patients and advance our clinical research endeavors.

New Virtual Intensive Care Unit Simultaneously Improves Patient Care and Bed Capacity

The virtual ICU system has provided a great advantage to health-care providers during the COVID-19 pandemic as it reduces the amount of direct patient interaction needed, thereby limiting PPE use and potential exposure to pathogens. At the same time, the virtual ICU system increases the number of patients that can be cared for simultaneously and empowers clinical staff to provide earlier interventions.

The coronavirus pandemic has escalated a digital transformation within intensive care units (ICUs) where remote monitoring technologies enable professionals to more efficiently and safely manage their patients.

When the pandemic began, Houston Methodist accelerated the timeline for completing ongoing virtual ICU programming and construction. In March of 2020, we launched a comprehensive virtual ICU system that utilizes specifically tailored remote clinical surveillance and data analytics platforms as well as interactive video conferencing.

The virtual ICU provides continuous intensivist coverage for Houston Methodist’s 300+ ICU beds, offering additional support to bedside ICU teams. The virtual unit’s operations center is equipped with specialized software that captures and analyzes real-time clinical data to calculate each patient’s stability or risk of deterioration, allowing the team to anticipate events and act quickly. Each of the ICU rooms is equipped with a virtual alert button so that the bedside team can immediately alert the remote intensivist and nurses. The patient rooms also contain two-way audiovisual technologies for unobtrusive observation or communication between the patient, bedside team and virtual team.

Houston Methodist has also deployed tablets for healthcare providers to perform “virtual rounds” on patients.

Neuroimaging Offers New Insights into Neurodegeneration

At a time when most efforts to combat Alzheimer’s disease were focused on amyloid protein, Joseph C. Masdeu, MD, PhD, Graham Family Distinguished Chair for Neurological Sciences and director of the Nantz National Alzheimer Center at the Houston Methodist Neurological Institute found evidence that Alzheimer’s development was associated with an abnormal folded tau protein derived from the normal tau proteins that neurons use to form the white matter highways that facilitate communication among the brain’s various networks.

With the use of magnetic resonance imaging (MRI) combined with 18F-FDG, 18F-flortaucipir and 18F-AV-1451 positron emission tomography (PET), Masdeu’s group was the first to report that brain areas with abnormal tau protein deposits had decreased metabolism, a sign of low regional activity. The tau accumulations form the neurofibrillary tangles seen in Alzheimer’s disease and other neurodegenerative disorders.

These findings, published in Neurology, suggest that tau, rather than amyloid, is the critical factor in the development of neurodegenerative disorders.

Masdeu was the first to demonstrate in vivo that abnormal tau proteins spread throughout human brain networks using white matter tracts. The Journal of Nuclear Medicine study combined MRI and 18F-flortaucipir PET to study tau protein behavior in a tau-dependent progressive neurodegenerative disorder that affects the languagerelated syntactic neural network. In the study participants, tau accumulation likely began in the anterior frontal node and travelled to the spatially separate posterior temporal lobe. The arcuate fasciculus white matter tract connecting these regions was most affected near the anterior frontal node, corresponding to a loss of neurons in the anterior node.

This discovery reveals a window of opportunity for treatment, because to jump from neuron to neuron, tau appears to become extracellular – and possibly amenable to immunotherapy using antibodies that target this abnormal protein to hamper the spread, thereby preserving neural networks. Three clinical trials are underway at the Nantz National Alzheimer Center using anti-tau antibodies from Abbvie, Biogen and Eli Lilly.

Launching a Legacy of Leading Medicine

Houston Methodist is committed to building transformative education experiences at the intersections and gaps between disciplines through health science and medical education programs.

Houston Methodist is not degree-granting; rather, we forge academic partnerships that bring in measurable results today and offer greater opportunities for tomorrow.

Our residencies, fellowships, research doctoral program and continuing education programs in medicine, research, nursing and pharmacy attract more than 41,344 learners from around the world each year.

Building a Weill Cornell Graduate School of Medical Sciences Campus at Houston Methodist

The Weill Cornell Graduate School of Medical Sciences (WCGS) has expanded its PhD program to an additional campus at Houston Methodist Academic Institute, the research and education arm of Houston Methodist Hospital in the Texas Medical Center. This is a new enhancement, building upon the 16-year academic affiliation between Weill Cornell Medicine and Houston Methodist to train the next generation of physicians and scientists.

WCGS faculty at the New York campus will provide the didactic curriculum via remote learning with mentoring by WCGS faculty at the Houston campus. The thesis research will be performed at the Houston Methodist Academic Institute, under the direction of WCGS faculty located at both the Houston and NYC campuses. Graduate students and WCGS faculty based in Houston will visit New York City for program retreats and graduate school events. In turn, graduate students and faculty based in New York City can benefit from Houston-based faculty expertise and state-ofthe-art facilities and technology at the Houston Methodist Academic Institute. This collaboration will enhance the experience of students and faculty at both locations, promote scientific interactions and add diversity to the student body.

John P. Cooke, MD, PhD Barbara L. Hempstead, MD, PhD

Engineering Medicine (EnMed)

The Nation’s First Training Program at the Convergence of Medicine and Engineering

In August of 2019, Texas A&M University and Houston Methodist launched the EnMed program to instill a new generation of “physicianeers” with the skills to create innovative technological solutions that can transform patient care.

The EnMed program integrates medical education and research focused on innovation and entrepreneurship to empower future professionals with the clinical skills needed to diagnose and treat patients along with the engineering mindset to solve problems, invent new technologies and rapidly move these innovative ideas to practice inpatient care.

The EnMed program is housed in an 18-story office building acquired and renovated by Texas A&M. The building will be the focal point of the future Texas A&M Innovation Plaza, a 5-acre campus currently being constructed. The students have access to a simulation center, which occupies an entire floor, a makerspace so students can print 3D models for prototypes. Most of their didactic training will be in this building, but all wet anatomy labs happen at the Houston Methodist campus.

The 34 students who entered the EnMed program in 2020 came from a variety of educational backgrounds, including biological systems engineering, chemical engineering, material physics, mechanical engineering and mathematics. Many of these students are ready to embark on capstone projects, which are two-year mentored projects involving innovative research and technology development that directly address clinical or biomedical challenges. These projects will be conducted at Houston Methodist.

Neural Control of Organ Degeneration and Regeneration (NeuralCODR) Training Program

The NeuralCODR training program is an interdisciplinary training program at the intersection of neurophysiology and organ engineering/modeling that investigates how the central nervous system communicates with other organ systems.

The training program can be distinguished from traditional physiology or neuroscience programs by its strategic focus on the interface between regeneration/disease organ model systems and functional neuroanatomy and physiology.

NeuralCODR was conceived by Philip Horner, PhD, and a team of expert faculty from across several Texas Medical Center institutions with a rich history of research training, clinical modelling and education, including Rice University, University of Houston, The University of Texas MD Anderson Cancer Center, The University of Texas Health Science Center at Houston and Baylor College of Medicine.

The 2020 NeuralCODR Fellows

Caroline Cvetkovic, PhD

For her NeuralCODR fellowship in the lab of Robert Krencik, PhD, Cvetkovic is investigating the relationship between astrocytes and neurons in the brain. She is developing human stem-cell derived 3D neural tissue cultures to gain deeper insights into neuronal development and degeneration that could someday lead to regenerative clinical therapies.

Betsy Salazar

As a NeuralCODR fellow under the guidance of Alvaro Munoz, PhD, and Timothy Boone, MD, PhD, Salazar is investigating the impact of therapeutic drugs on functional recovery following spinal cord injury in rodent models. She is specifically interested in assessing motor function recovery using behavioral tests as well as assessing the impact that treatments have at the cellular level.

Faculty and Research Development

Houston Methodist bolsters academic productivity throughout our researchers’ careers with a full complement of individually tailored resources that includes one-on-one professional development guidance, cohorted courses and customized workshops.

Our experienced development team provides services essential to developing strategic academic priorities and securing extramural funding, including matching our experts with appropriate funding opportunities and providing planning and writing support for grant proposals, manuscripts, outcomes/big-data protocols and other academic publications.

In 2020, two new courses open to both trainees and faculty were launched via videoconferencing. The recorded sessions are currently available on the Academic Institute’s website.

A seminar series Key Elements of Clinical Research details essential elements of planning and conducting clinical research including clinical trial design, working with industry, project presentation and grantsmanship.

The Concept to Commercialization seminar lays the foundation for translating key laboratory discoveries to clinical uses that improve patient lives. It provides a practical and efficient process for researchers to bring their innovations to the market.

125 Grant applications were submitted through Academic Affairs 95 through Faculty Development and 30 through Research Development

577 Mentorships hours

Salim Allana, MD Dorothy Lewis, PhD

Graduate Medical Education

Houston Methodist provides an academic health-care environment that promotes comprehensive learning opportunities for more than 41,000 medical students and physicians each year through medical student rotations, residency and fellowship programs, MITIESM procedural skills training and continuing education courses.

Our 920 medical students work with inpatient teams and one-on-one with subspecialists during rotations in general surgery, family medicine, internal medicine, orthopedic surgery and obstetrics and gynecology. Houston Methodist has 336 residents and fellows placed within 45 programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and nine Graduate Medical Education Committee-sponsored fellowships.

On Match Day in March 2020, 60 medical students from around the world officially became incoming residents at Houston Methodist for the 2020-2021 academic year. Of the new group of residents, 32 hailed from U.S. News & World Report-ranked medical schools.

+ =

336 RESIDENTS/FELLOWS 59 GRADUATE MEDICAL EDUCATION PROGRAMS 45 ACGME ACCREDITED

14 NON-ACGME ACCREDITED

Our residents and fellows join Houston Methodist from throughout the U.S., and go on to prestigious fellowship opportunities at institutions including Mayo Clinic, Cleveland Clinic, and Massachusetts General Hospital.

Houston Methodist Academic Institute

The Houston Methodist Academic Institute oversees the Research Institute and Education Institute, including 775 faculty and 41,344 learners. The Academic Institute aligns our research and education initiatives in service to the clinical mission, providing solutions that answer the call for new technologies and skills our clinicians need for patient care.

The Houston Methodist Research Institute supports research programs and infrastructure that enable faculty across the system to bring new scientific discoveries to patients as rapidly as possible through the full cycle of a cure from conceptual bench research, to prototyping and development, to clinical trials and FDA approval. The Institute supports more than 1,470 clinical research protocols and $64.1 million in extramurally funded translational research programs.

The Houston Methodist Education Institute coordinates our primary academic affiliation with Weill Cornell Medicine and joint programs, including the EnMed engineering medicine program with Texas A&M University. The Institute also oversees continuing medical education and graduate medical education and supports more than 3,355 trainees in residence for medical, nursing, allied health and research education programs.