UAB Magazine Fall 2017 by UAB School of Medicine

A Magazine for Alumni and Friends of the School of Medicine

Volume 43 • Number 2 • Fall 2017

MISSING MEMORIES

FINDING HOPE AND RELIEF Helping patients and caregivers in the present; investigating prevention strategies for the future

LETTER FROM THE DEAN

s I write this, the feelings of excitement and promise surrounding the start of a new academic year are tempered by the scenes of devastation wrought by a series of strong hurricanes coming out of Houston, the Gulf Coast, Florida, and Puerto Rico. While the stormwaters continue to recede and the full scope of the tragedy is yet to be revealed, my thoughts and prayers are with the people impacted by these storms as they embark on the long and difficult road to recovery. At the School of Medicine, we began this academic year with renewed commitment to our missions in medical training, clinical care, and biomedical research. This issue’s cover story highlights our efforts to address one of the greatest challenges facing American families and the U.S. health care system. More than 5 million people in the U.S. are currently living with Alzheimer’s disease or another form of dementia, a number that is only expected to grow. Combined with the millions of people who provide care for those suffering from memory disorders, this issue is one that likely touches someone close to all of us. Our clinicians and researchers are working to find innovative ways to help those currently in need and develop prevention strategies to stem the tide of memory disorders diagnoses in the future. You can also read about a husband-and-wife team of neurobiology researchers whose efforts to understand how memories are formed in the brain may one day open avenues to new therapeutic strategies. In this issue, you’ll also learn about our participation in a National Science Foundation-sponsored program that helps scientists and engineers take their research from the laboratory to the marketplace; be introduced to notable figures from our school’s history for whom our Learning Communities are now named; and meet alumni who are making a difference helping veterans here in Birmingham and treating patients on a hospital ship off the coast of Africa. There is so much good happening at the School of Medicine, and we are immensely grateful for the support of our alumni and friends that buoys us in our continuing pursuit of excellence. Sincerely,

Selwyn M. Vickers, M.D., FACS Senior Vice President for Medicine and Dean James C. Lee Endowed Chair

Scenes from the White Coat Ceremony, which took place August 13. We welcomed 186 new first-year medical students and presented them with their new white coats, provided as always by our Medical Alumni Association.

COVER FEATURE

MISSING MEMORIES

How UAB programs are helping memory

disorders patients and their caregivers today, and investigating prevention strategies for the future

FEATURES

NEURAL NETWORKING

Neurobiological research shows how synapses change when new neurons are formed

SPECIAL FEATURE: THE COURSE CHARTING Visionary medical oncologist leads UAB Comprehensive Cancer Center into new era

A Magazine for Alumni and Friends of the School of Medicine Volume 43, Issue 2, Fall 2017 SCHOOL LEADERSHIP

Senior Vice President and Dean Selwyn M. Vickers, M.D., FACS Executive Vice Dean Anupam Agarwal, M.D.

DEVELOPMENT AND COMMUNITY RELATIONS

DEPARTMENTS IN BRIEF 3 Latest ranking details, expanded genetic testing, targeting glioblastoma, microbiome fingerprint, and more

CLINICAL CARE

Internal medicine resident recovers from cardiac arrest with support from peers and mentors

24 26 28

Long-funded model system advances knowledge of and care for spinal cord injuries

MEDICAL TRAINING

Newly renamed Learning Communities honor key figures from the school’s past and present

SCIENTIST TRAINING

I-Corps program teaches scientists and engineers how to be entrepreneurs

GENOMICS AND INFORMATICS

New genomics training programs foster innovation and expertise

UAB’s Informatics Institute leverages the power of big data

ALUMNI PROFILES

INVESTING IN INNOVATION

ACROSS CAMPUS

Anesthesiology alumnus Brian Barki serves aboard African hospital ship; School of Medicine alumnus Oladipo Kukoyi takes chief of staff reins at Birmingham VA Medical Center Medical Properties Trust gives $2.5 million to UAB Comprehensive Diabetes Center; endowed chair honors pioneering eye specialist and his wife; Alumni Campaign donor establishes medical scholarship to honor his parents Faculty provide care internationally to populations in crisis; pediatrics professor recognized for promoting a culture of acceptance for kids with special needs; emergency medicine instructor wins military medicine award; faculty awards and accolades; and more

FROM THE ARCHIVES

Snapshots from the history of the UAB Department of Neurology

CONNECT WITH US UABSchoolofMedicine

UABSOM

UAB.edu/medicine

Vice President for Development and Alumni Affairs Thomas I. Brannan Executive Director of Development for the School of Medicine Jackie F. Wood Comprehensive Cancer Center Lisa E. Roth Comprehensive Diabetes Center Erica L. Hollins Departments of Anesthesiology, Dermatology, and Radiology Jackie F. Wood Department of Medicine Megann B. Cain, Christian Smith, Christopher Williamson Department of Obstetrics and Gynecology Erica L. Hollins Department of Ophthalmology; Callahan Eye Hospital Morgan Quarles Departments of Neurology and Psychiatry Katherine G. Tully, Nicky Bennett Departments of Surgery and Neurosurgery Jackie F. Wood Medical Student Scholarships; Primary Care Jessica Brooks Lane Friends and Family Program Ivy Watson Cardwell Contact Information (205) 975-5659 • somdev@uab.edu

ALUMNI ASSOCIATION BOARD OF DIRECTORS President Timothy P. Hecker, M.D. ’04 President-Elect John R. Wheat, M.D. ’76 Secretary/Treasurer Rebecca R. Byrd, M.D. ’95 Immediate Past President Pink Lowe Folmar, Jr., M.D. ’72 District Representatives First - J. Donald Kirby, M.D. ’72 Second - James H. Alford, M.D. ’63 Third - George C. Smith, Sr., M.D. ’65 Fourth - Alice H. Morgan, M.D. ’82 Fifth - P. Michael Caruso, M.D. ’76 Sixth - Kirby I. Bland, M.D. ’68 Seventh - Michael A. Callahan, M.D. ’71 At Large V. Michael Bivins, M.D. ’96 Julia L. Boothe, M.D. ’02 Theodis Buggs, Jr., M.D. ’80 Alan R. Dimick, M.D. ’58 Mark H. LeQuire, M.D. ’82 Wick J. Many, M.D. ’73 Ex-Officio J. Terrell Spencer, M.D. ’68 Executive Director Meredith Burns Assistant Director Brenda Joseph Program Coordinator Beth Eddings Contact Information (205) 934-4463 • office@alabamamedicalalumni.org

UAB MEDICINE STAFF Executive Director of Communications, UAB School of Medicine Paige Dorman Managing Editor Jane Longshore Art Director Kristin Farmer Associate Editor Emily Henagan Contributing Writers Amy Bickers, Ryan Broussard, Cary Estes, Rosalind Fournier, Jeff Hansen, Katelyn Howard, Nancy Mann Jackson, Virginia GilbertLoftin, Julie Cole Miller, Tim L. Pennycuff, Adam Pope, Sarah C.P. Williams Photography Nik Layman, Dustin Massey, Steve Wood Multimedia & Graphic Design Kristin Farmer Contact Information (205) 934-0256 • somdev@uab.edu

IN BRIEF

IN BRIEF News and highlights from across the School of Medicine

RANKINGS REPORT

According to the 2017-2018 Best Hospitals ranking from U.S. News & World Report, UAB Hospital again ranks No. 1 in the state of Alabama, and 10 medical specialties rank in the top 50 in the nation:

Rheumatology Nephrology Pulmonology Urology Diabetes & Endocrinology

Gynecology Cardiology & Heart Surgery Neurology & Neurosurgery

Geriatrics Ear, Nose & Throat

EXPANDING GENETIC TESTING Recruitment for the Alabama Genomic Health Initiative (AGHI) has begun at the UAB Kirklin Clinic and the Medical Towers in Birmingham. The AGHI is one of the nation’s first statewide efforts to harness the power of genomic analysis to identify those at high risk for genetic disease. The AGHI, a partnership between UAB and HudsonAlpha Institute for Biotechnology funded by the state of Alabama, will recruit a diverse group of participants from every county in Alabama to whom it will provide genomic analysis and interpretation free of charge. “This project will result in immediate health benefits to some participants, and in the long term will help address problems of chronic disease and rising health care costs in the state,” says Bruce Korf, M.D., Ph.D., chair of the UAB Department of Genetics, chief genomics officer for UAB Medicine, and co-director of the AGHI. Prospective participants can learn more about the AGHI from patient navigators, who explain the benefits and responsibilities of participation in the program. Program administrators say public interest has been overwhelming. The majority of participants in the initiative will undergo a genotyping array test, which assesses 650,000 identified genomic biomarkers. The test will look for variants in 59 specific genes, which are known to contribute to disease for which the potential for prevention or treatment exists. They include the BRCA1 and BRCA2 genes, which are associated with a genetic risk of breast and ovarian cancers. Participants who test positive for one of the 59 genes may consent to receive that information through genetic counseling and have it shared with their primary medical providers. A second, smaller group of participants will receive whole genome sequencing in an effort to identify an underlying genetic cause for serious medical problems. Learn more at www.aghi.org.

TARGETING GLIOBLASTOMA In July, U.S. Sen. John McCain (R-AZ) was diagnosed with glioblastoma, which is a primary brain tumor with poor survival rates even after treatment with surgery, chemotherapy, and radiation. The neuro-oncology team at UAB has been developing various treatment options for patients with this devastating disease. The UAB Comprehensive Cancer Center’s NeuroOncology Program co-leader Ichiro Nakano M.D., Ph.D., (at right) teamed up with Maode Wang, M.D., of Xi’an Jiaotong University in Xi’an, China, to discover a novel molecular target, NEK2, in glioblastoma. Recently, this team developed a new chemotherapeutic candidate drug for glioblastoma. “We are currently in the process of pharmacokinetic and pharmacodynamic analyses with the newly developed drug candidate, named CMP3a, so that we can design an early-phase clinical trial for glioblastoma and other brain cancers in the near future,” the researchers said in an article published in July in The Journal of Clinical Investigation. “We are hopeful to add this drug candidate to our list of clinical trial protocols for glioblastoma in a year or two,” says Nakano.

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IN BRIEF

MICROBIOME FINGERPRINT UAB researchers have made the first direct demonstration that fecal donor microbes remained in recipients for months or even years after a transplant to treat the symptoms caused by recurrent Clostridium difficile infections, a serious and stubborn cause of diarrhea and colitis after an antibiotic treatment. ‘C. diff’ infections cost up to $4.8 billion each year in excess health care costs for acute care facilities alone. While clinicians have hypothesized that fecal microbiota transplantation (FMT) is successful because it restores missing microbial flora to the gut of a fecal transplant recipient, no one has directly shown colonization of specific microbial donor strains in recipients or what those strains are. In two patients, the UAB group showed that certain donor microbial strains persisted as long as two years after an FMT. Five other patients showed persistence of donor strains in recipients for three to six months, the longest times tested, after an FMT. To detect the fates of donor microbial strains in recipients, Ranjit Kumar, Ph.D., Elliot Lefkowitz, Ph.D., Martin Rodriguez, M.D., Casey Morrow, Ph.D., and UAB colleagues developed a method that uses detection of single nucleotide variations in microbial genomes—in combination with a new bioinformatics algorithm—to identify related microbes. “It essentially is a personalized microbiome ‘fingerprint,’” says Kumar, research scientist at UAB CCTS Informatics. This novel method may help explain why FMTs for recurrent C. diff infections succeed 90 percent of the time, more than antibiotic therapy. The method may also warn of changes in the gut microbiota that may be associated with metabolic diseases like diabetes or obesity, as well as diseases like ulcerative colitis or Parkinson’s disease.

CANCER SURVIVOR SUPPORT UAB has established a Breast Cancer Survivorship Clinic to provide specialized follow-up care for breast cancer patients based on their unique health care needs. “The UAB Breast Cancer Survivorship Clinic will provide a comprehensive approach to the care of our breast cancer survivors as they complete their treatment and are ready to turn their attention to leading a healthy and productive life,” says Smita Bhatia, M.D., MPH, professor in the UAB Department of Pediatrics and director of the UAB Institute for Cancer Outcomes and Survivorship. Bhatia’s work with cancer survivorship encompasses ongoing health care to manage treatment-related complications, monitor for cancer recurrence, detect potential late effects and additional malignancies, manage underlying chronic disease, and provide psychosocial support services to address the specialized needs of cancer survivors and their families, with the overall goal of improving health and quality of life. She is spearheading several efforts at UAB—including the Breast Cancer Survivorship Clinic—to create links among patients, clinicians, and scientists in order to foster collaborations that advance this increasingly vital facet of quality oncology care. Patients are eligible for the Breast Cancer Survivorship Clinic if they have received a diagnosis of breast cancer stages 0 to IIIC at least 12 months ago. Patients must have completed all breast cancer therapy (except hormonal therapy, which may be ongoing), with at least part of treatment provided at UAB. Eligible patients must also have no history of breast cancer spreading beyond the local breast area and/or lymph nodes and no history of breast cancer recurrence.

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UAB Medicine Fall 2017

LUNG DISEASE TRAINING This summer, UAB launched its first National Institutes of Health-funded pre-doctoral training program in lung diseases. The program, funded by an NIH T32 grant of $1.07 million over five years, will recruit and train outstanding biomedical scientists for careers in pulmonary research. “This program will capitalize on the recent growth in lung research at UAB and foster high-level training experiences to develop the next generation of outstanding lung researchers,” says Chad Steele, Ph.D., professor in the Division of Pulmonary, Allergy and Critical Care Medicine and principal investigator of the training grant. The training program will recruit three students in the first year and eventually expand to six students. It focuses on lung diseases such as asthma, cancer, COPD, cystic fibrosis, pneumonia, lung injury, and idiopathic pulmonary fibrosis. It will enlist mentors from six UAB academic departments who will study both adult and pediatric lung disease. Students will receive education, training, and mentoring via specific graduate coursework while pairing with clinical mentors along with research mentors. They will have weekly exposure to lung-specific basic, translational, and clinical research, and clinical medicine conferences.

IN BRIEF

The UAB Department of Radiation Oncology is partnering with Proton International to bring one of the most technically advanced forms of cancer-killing radiation to Alabama. Proton therapy delivers a more precise dose of radiation to a tumor and can avoid damage to healthy surrounding tissue better than conventional X-ray radiation. It is particularly effective against deep-seeded, solid tumors. Proton International, one of the world’s leading developers of proton radiation facilities, is building the UAB Proton Center on the UAB campus in downtown Birmingham. UAB physicians and staff will operate the center. There are 25 active proton therapy centers in the U.S., most affiliated with major cancer centers. Groundbreaking for the roughly $50 million project is expected to take place in early 2018, and construction and testing will take about two years before the building is clinically operational.

CRITICAL CARE EXCELLENCE This summer, UAB’s Critical Care Transport (CCT) program was reaccredited by the Commission on Accreditation of Medical Transport Systems (CAMTS) for the seventh consecutive review period. CAMTS, a peer-review organization dedicated to improving patient care and safety, surveys medical transport programs every three years. CCT, a division of the Department of Emergency Medicine, operates a Cessna Citation Bravo aircraft—a flying intensive care unit—and three specially equipped ground ambulances all capable of transporting the sickest patients requiring the most complex care. The team has carried out more than 49,200 medical transports covering 30 million miles, 46 states, and 38 countries. “The Board of Directors specifically noted that CCT is one of the few programs that has achieved full accreditation on a consistent basis with few contingencies and excellent safety culture survey results,” says Alasdair Conn, M.D., chair of the CAMTS Board of Directors. “This represents a significant achievement of the medical transport service.” The site survey results recognized specific strengths of the UAB CCT program, including purchasing quad-cab ambulances that provide a higher level of safety for crew members and developing a comprehensive scenario simulation training program for the medical teams.

PEDIATRIC RESEARCH RESOURCE UAB and Children’s of Alabama have partnered to open the Child Health Research Unit (CHRU) to enable pediatric investigators to improve the understanding of childhood diseases and bring new therapies to children. “We needed an expanded research unit because we are growing and increasing our role in new knowledge discovery to understand, prevent, and treat childhood diseases, and improve the health of the children of Alabama,” says Mitchell B. Cohen, M.D., chair of the UAB Department of Pediatrics and physician-in-chief at Children’s of Alabama. The UAB Department of Pediatrics, UAB Center for Clinical and Translational Science, and Children’s of Alabama expanded the unit to meet the growing needs of pediatric researchers by reducing barriers for researchers to conduct rigorous clinical and transitional research in childhood diseases. The 2,500-square-foot facility at Children’s includes a reception area, triage room, six exam rooms, office and conference space, workspace with monitors, a lab with a centrifuge and freezer, and a storage room. Many research teams are already using the new unit. This includes groups from neurology (working with epilepsy and Rett syndrome patients), infectious diseases (looking at efficacy of maternal RSV vaccine immunization and in utero exposure to antiretroviral medications), urology (treating urinary incontinence), nephrology (related to cardio-renal disease in kidney transplantation), pulmonary (studying cystic fibrosis and Duchene’s muscular dystrophy), and neurosurgery (looking at cerebrospinal fluid markers of post-hemorrhagic hydrocephalus). Research teams and families have all been very pleased with the convenience, functionality, and look of the new space. Photo courtesy of Children’s of Alabama

PROTON PARTNERSHIP

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IN BRIEF

Welcoming the CLASS OF 2021

186 STUDENTS 91 94

WOMEN MEN 1 NOT REPORTED

HIGHEST IN SCHOOL HISTORY

UNDERGR ADUATE INSTITUTIONS

MAJORS REPRESENTED

9 M.D./PH.D. STUDENTS 3 M.D./MPH STUDENTS 5 M.D./MBA STUDENTS

AGE R ANGE

507.9

AVER AGE MCAT

33.7

AVER AGE UNDERGR ADUATE GPA

EARLY DECISION STUDENTS

EARLY MEDICAL SCHOOL ACCEPTANCE

164 ALABAMA STUDENTS 22 OUT-OF-STATE STUDENTS 14 STATES REPRESENTED

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UAB Medicine Fall 2017

After learning that a small molecule drug improves breathing in a mouse model of the neurodevelopmental disorder Rett syndrome, UAB neurobiology professor Lucas Pozzo-Miller, Ph.D., (pictured below) wondered if he could test it on other brain functions. He has found that the brain penetrant drug LM22A-4 improves brain performance in Rett syndrome mice, specifically synaptic plasticity in the hippocampus and object location memory. LM22A-4 is mimetic of the loop domain of brain-derived neurotrophic factor, a nerve growth factor critical for the development and plasticity of brain synapses. Rett syndrome affects about one of every 10,000 females worldwide. Infants develop typically until 6-18 months of age, when symptoms of intellectual disability, autistic features, motor control and sensory perception deficits, breathing irregularities, and epilepsy start to appear. Most Rett syndrome individuals have a loss-of-function mutation in the MECP2 gene. This new finding, in collaboration with Frank Longo, M.D., of Stanford University, adds to the growing realization that neurodevelopmental disorders affecting early brain development may be amenable to treatment, even after the onset of symptoms. “Neurodevelopmental disorders with intellectual disability and autism may not need to last a lifetime,” Pozzo-Miller says. In other news, the UAB Civitan Rett Syndrome Clinic has received the Center of Excellence award from Rettsyndrome.org, a leading advocacy organization. Since 1998, Rettsyndrome.org has invested more than $41 million in Rett syndrome research. Alan Percy, M.D., director of the UAB Civitan Rett Syndrome Clinic, is an internationally renowned researcher and clinician in Rett syndrome. When at Baylor College of Medicine in the 1980s, he was one of the first physicians in the U.S. to identify the condition.

Contributing writers: Tyler Greer, Jeff Hansen, Alicia Rohan, Bob Shepard, Beena Thannickal

UNDERREPRESENTED IN MEDICINE

22-32

IMPROVING BRAIN FUNCTION IN RETT MICE

CONNECTING ONE OF A KIND HEART PROGRAMS TO ONE OF A KIND MOMENTS

CARDIOVASCULAR CONDITIONS CAN BE A SERIOUS MATTER. But being connected to the specialists and advanced heart and vascular programs at UAB can make all the difference. Our adult congenital heart disease program is the only one in Alabama that provides continuing care for patients as they move into adulthood. And we perform the most complex aortic aneurysm surgeries, as well as minimally invasive techniques not available at other centers in the state. Whatever your needs, weâ&#x20AC;&#x2122;ll give you a treatment plan that can do more than save your life. It can get you back to living it and keep you connected to what matters most.

The only program in the state with dedicated cardiologists and surgeons to treat both common and complex disease. UAB ME DICINE .ORG/CONNECTHEART

FINDING HOPE AND RELIEF Helping patients and caregivers in the present; investigating prevention strategies for the future BY CARY ESTES AND SARAH C.P. WILLIAMS

hortly after being

diagnosed with Alzheimer’s disease in 2011, singer Glen Campbell recorded a song called “Ghost on the Canvas.” The song begins with the line, “I know a place between life and death for you and me.”

An existence in limbo is a daily reality for many of the 5.5 million people in the U.S. currently living with Alzheimer’s disease or another form of dementia. It also often accurately describes the agonizing circumstances facing the more than 15 million Americans who provide care for family members and loved ones suffering from memory disorders. “It just takes over your life,” Kim Campbell, Glen Campbell’s wife of 34 years, said in an interview with The Tennessean a few months before Campbell’s death from Alzheimer’s this past August. “They are losing their identity because they can’t remember who they are, but as a caregiver you are losing your identity. You have to give up everything you are doing to take care of them.” UAB researchers are actively working to find treatments and hopefully even a cure for Alzheimer’s and other memory disorders. Until those breakthroughs occur, UAB’s School of Medicine and School of Nursing are teaming up to try to help current patients and especially caregivers deal with this fatal disease that has been referred to as “the long goodbye.” “Our focus is to try to promote the quality of life in the family as a whole,” says David Geldmacher, M.D., holder of the Warren Family Endowed Chair in Neurology and director of the UAB Division of Memory Disorders and Behavioral Neurology. “There are things we can do for the affected person—prescribe medicines and so forth—but there are also things we can do for the family members and caregivers. Since most people with dementia are cared for in the home environment, our goal is to try to optimize that family’s functioning and quality of life to the greatest extent possible.” Though Alzheimer’s is the memory disorder that receives the most attention, Geldmacher says there are a number of other diseases and conditions that can cause neurological issues that result in changes to personality and behavior similar to Alzheimer’s. These include Parkinson’s disease, frontotemporal dementia, head injuries, strokes, and even sleep disorders.

So saying ‘dementia’ is like saying ‘headache.’ It’s a generic, overall description of what we observe. But there are many causes of dementia, just like there are many causes for headaches. Dementia is the umbrella term, and specific illnesses like Alzheimer’s disease are the individual spokes.” —DAVID GELDMACHER “When we use the term dementia, we mean a change in cognition or behavior attributable to brain disease that’s severe enough to interfere with a person’s everyday activities,” Geldmacher says. “So saying ‘dementia’ is like saying ‘headache.’ It’s a generic, overall description of what we observe. But there are many causes of dementia, just like there are many causes for headaches. Dementia is the umbrella term, and specific illnesses like Alzheimer’s disease are the individual spokes.”

A Gathering Storm Regardless of how the various illnesses are categorized, the overall issue of people in this country suffering from memory disorders is a rapidly growing problem. According to a report released earlier this year by the Centers for Disease Control and Prevention, death rates from Alzheimer’s rose 55 percent from 1999 to 2014 and nearly 14 million people are expected to be afflicted with the disease in the next 20 to 25 years. “Meanwhile, we have a smaller cohort of people being left behind to take care of these older adults as they move into dementia,” Geldmacher says. “We also have difficulty attracting doctors and nurses to this field, so we have a growing shortage of specialists with an expertise in this area. Unless we come up with treatments that significantly interrupt the progression of the disease or even prevent its emergence,

David Geldmacher (left) from the School of Medicine and Rita Jablonski (right) from the School of Nursing are leading efforts to help people with memory disorders and their families cope and preserve quality of life.

the public health burden on Medicaid and Medicare and the like will be overwhelming by mid-century.” Rita Jablonski, Ph.D., CRNP, FAAN, FGSA, associate professor with the UAB School of Nursing, is even more emphatic about the problem’s severity. “The dementia crisis is here. It’s not coming; it’s here,” Jablonski says. “Almost $300 billion is expended annually because of this diagnosis, either directly through hospitalization and nursing home care costs or indirectly because family caregivers have to leave the workforce or accept lower-paying positions that enable them to offer care. And that number is only going to go up.” Since the treatment options for patients with memory disorders remain limited, the focus is increasingly turning toward helping caregivers and other family members deal with the disease. Toward that end, Geldmacher says the UAB Memory Disorders Clinic is creating a new position that he calls “a nurse navigator.” “Families often don’t know where to turn with their questions,” Geldmacher says. “We hope to provide a single focal point for families that we work with that allows them to call in and get referrals to community resources and other

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UAB Medicine Fall 2017

education as needed. We could potentially even have group educational sessions, where we can help families understand what they’re facing and the best ways of managing it.” UAB is also using a $500,000 grant from the U.S. Department of Defense (DoD) on a three-year study to see if family members can be taught caregiving strategies through online or phone instruction. The DoD is interested in studying dementia because a large number of aging and younger veterans are experiencing memory-related problems stemming from head injuries sustained during combat. Such telemedicine programs are important since many rural areas do not offer any assistance for these types of patients and their caregivers. “We know that a head injury is a risk for developing dementia later in life,” Geldmacher says. “And we know that many of the symptoms of people who have experienced repeated brain trauma—such as changes in memory, thinking, and behavior—are very similar to the symptoms that patients with Alzheimer’s disease experience. That’s why the study for both caregivers of people with Alzheimer’s disease and brain injury aims to find out their similarities and their differences. It looks to see if we can create a telemedicine caregiver coaching program that caters to both.” As part of the study, Jablonski says she spends an hour each week for a total of six weeks talking with an individual caregiver. They discuss the problems the caregiver is having

with the patient, and Jablonski offers advice on how best to solve the issues. For example, patients with Alzheimer’s disease or dementia from traumatic brain injury may resist care efforts from family members, such as taking a bath, taking medicine, practicing routine mouth care, abstaining from alcohol, or going to a medical appointment. When Jablonski and the caregiver talk again a week later, the caregiver will describe what worked well and what didn’t and Jablonski will offer fresh advice based on this feedback. “This type of interaction is mandatory for family members to become more adept at caregiving,” Jablonski says. “They know their loved one better than anybody. They can take our general strategies and then tailor them to that person’s specific behavior. “We are logical beings, and logic doesn’t work with dementia. So the way you’ve interacted with them your whole life through logic and reasoning goes out the window with dementia. In fact, a lot of the ways you used to interact with them can now cause behavior triggers that make them upset.” Jablonski says the most common behavior associated with people with memory disorders is repetition, where the person will ask the same question over and over. “Every five minutes they’ll ask what time it is,” Jablonski says. “Things like that can really wear down family caregivers.” Jablonski teaches techniques that enable caregivers to try to preempt such repetitive behaviors. If a patient continually asks about the time, she says the caregiver should put a large digital clock in the room and then ask the patient what time it is. “Beating the person to the repetitive question can sometimes move the repetitive train of thought off the track,” Jablonski says. “You can bounce them out of the loop so maybe that behavior lessens.” On the clinical side, UAB has a group of nurse practitioners who provide longitudinal ongoing care for patients and families facing dementia. Geldmacher points out UAB has the only board-certified cognitive neurologists and nurse practitioners who provide the only outpatient-focused expertise in dementia care in the state. Therefore, it makes sense the School of Medicine and the School of Nursing have formed this partnership to help caregivers navigate this strange and frightening situation. “Our doctors do a lot of diagnosis, but so much of what happens in the care of the person with dementia is nursing-oriented care, and doctors aren’t really taught that in medical school,” Geldmacher says. “Many people come in wanting to see the doctor because the doctor is going to ‘fix’ the problem. Well, unfortunately for Alzheimer’s disease we know the doctor can’t fix the problem. It’s not going away. That person is going to live with that problem for the rest of their lives. “How do you live with dementia? That’s what nursing is, the care of the person with the disease. The disease is irrelevant; it’s the person who’s the focus. A lot of people resist transitioning to the nurse practitioner when in fact that health care professional offers the right expertise. The nursing expertise in our group is every bit as important, if not more important, than the physician expertise.”

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PREVENTION & REDUCTION

ith nearly half a million new cases of

There’s a lot Alzheimer’s disease diagnosed each year in the U.S.—and aging baby boomer generation expected to push that of junk information an figure even higher—it’s clear that efforts to combat the on Alzheimer’s disease will have to do more than treat and support those who are already afflicted. For that reason, clinicians and out there. People researchers are increasingly turning their attention toward efforts for Alzheimer’s. can’t always preventive “The lesson we’re drawing from is the history of cardiovascular disease,” says Geldmacher. “In the 1950s, we didn’t know that someone had heart disease sort out what is until they had a heart attack. Then we realized there were reversible risk factors that you can treat heart disease long before a heart attack. The day may valid and what and come when we can do the same thing with Alzheimer’s by finding the illness any symptoms appear and intervening to prevent brain disease.” is snake oil. We before Geldmacher imagines a future where healthy adults undergo routine screenings as they age that look for the earliest signs of Alzheimer’s in the brain offer personalized with routine scans or tests in the same way blood tests screen for predictors of heart disease. At UAB, clinical trials involving both healthy people and those dementia, as well as basic research to uncover the molecular underpinnings attention. We with of Alzheimer’s disease, are helping bring Geldmacher’s vision to life. let them know Personalized Advice what they can do Today, screening for Alzheimer’s in healthy adults is, in most primary care limited to a short questionnaire. But for those interested in a more and inform them settings, detailed examination of their likelihood of developing Alzheimer’s, UAB runs a first-of-its-kind personalized risk clinic, a reflection of the growing influence of on how certain precision medicine. Helmed by Geldmacher, the Alzheimer’s Risk Assessment and Intervention Clinic will—for a fee—perform memory tests, collect family and carry out a patient’s baseline MRI scan to integrate into his or behaviors affect history, her personal dementia risk assessment. If the patient has a heightened risk of disease, Geldmacher advises the patient how to decrease that risk. their risk.” Alzheimer’s “There’s a lot of junk information on Alzheimer’s out there,” says —DAVID GELDMACHER

Geldmacher. “People can’t always sort out what is valid and what is snake oil. We offer personalized attention. We let them know what they can do and inform them on how certain behaviors affect their risk.” The Alzheimer’s Risk Clinic medical professionals’ advice is based on a few large studies’ results that followed healthy adults and tracked who developed Alzheimer’s disease. Studies are still needed to determine whether changing risk factors—like diet—actually alter the risk of Alzheimer’s. Additionally, research is needed to uncover new drugs that may prevent the onset of dementia in those most at risk.

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UAB Medicine Fall 2017

Strengthening Defenses

Researchers at UAB and around the country are simultaneously trying to better understand what causes Alzheimer’s at a molecular level and how those underlying changes to the brain can be stopped or reversed. Over the past couple of decades, two proteins— amyloid-beta and tau—have been implicated in the disease’s development. Both proteins are known to accumulate in the brains of people with Alzheimer’s, forming clumps known as amyloid plaques and tau neurofibrillary tangles. But when researchers autopsy the brains of healthy people—who died without ever having memory problems—they also see a significant percentage of brains with amyloid plaques and tau tangles. According to Jeremy Herskowitz, Ph.D., an assistant professor of neurology and neurobiology and the Patsy W. and Charles A. Collat Scholar of Neuroscience, “There are large numbers of individuals from between the ages of 60 and Left to right: Erik Roberson and Jeremy Herskowitz are researching ways to better understand the neurological and neurobiological mechanisms behind the development of Alzheimer’s disease. Roberson’s research is looking to answer questions about who gets Alzheimer’s and why they get it so the disease may one day be preventable. Herskowitz notes that a large number of people between the ages of 60 and 100 have Alzheimer’s pathology but no dementia, so he is trying to understand what differentiates them from those who have dementia.

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100 who have Alzheimer’s pathology but no dementia.” Herskowitz is studying what differentiates people who have amyloid-beta and tau pathology in their brains but do not develop dementia from those who have dementia. His lab recently used cutting-edge microscopy techniques to examine brains of elderly individuals who had died with and without Alzheimer’s diagnoses. They found that the synapses (connections between nerve cells) in people who avoided Alzheimer’s looked completely different—they were longer and more extensive. “Now we understand how some individuals can withstand dementia despite harboring the pathology in their brains,” he says. “We will focus on drugs to remodel the synapses in patients prone to Alzheimer’s to slow down the development of dementia.” Herskowitz is now pursuing a class of drug that may boost synapses even when amyloid and tau accumulate. “The research field is beginning to accept the idea that an Alzheimer’s therapy will attack the disease from all angles: reducing tau and amyloid, curbing neuroinflammation, and boosting synapses,” Herskowitz says. Erik Roberson, M.D., Ph.D., associate professor of neurology and neurobiology, the Patsy W. and Charles A. Collat Professor of Neuroscience, and director of the UAB Alzheimer’s Disease Center, is working on a new twist on of those approaches: attempting to disrupt the effects of tau on the brain. In healthy brain cells, tau proteins help form tracks that transport materials throughout the cells. But when tau proteins accumulate into tangles—as they do in the brains of people with Alzheimer’s—transportation goes awry, cells die, and areas of the brain become hyperexcitable.

There are a lot of principles that have emerged out of basic science, and there are wonderful cellular and animal models of Alzheimer’s. Our challenge is to bring this work forward into the human space.” —RONALD LAZAR

Above: Kristina Visscher is involved in imaging studies that seek to define and characterize a healthy aging brain. At right, left to right: Through his role as chair of the UAB McKnight Brain Institute, Ronald Lazar is working with researchers like Herskowitz and Roberson to connect UAB’s basic science and clinical strengths with the hopes of advancing breakthroughs in memory disorders research, treatment, and care.

“In mice, we can fix this hyperexcitability by knocking out their tau genes,” says Roberson. “But we can’t do that in people.” Instead, Roberson’s lab is working on developing drugs that keep tau from interacting with other proteins that, when they team up, may cause the hyperexcitability. Like Herskowitz’s plan to change synapses that could block the disease even in the face of amyloid plaques and tau tangles, Roberson is hoping that thwarting tau’s interactions may stop Alzheimer’s without changing amyloid or tau levels.

Clinical Questions Through his role at the Alzheimer’s Disease Center, Roberson is also zooming out from the molecular details of dementia to answer some broader questions about who gets Alzheimer’s and why. The center is about to start recruiting patients with and without Alzheimer’s to study how health disparities in Alabama contribute to rates of the

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UAB Medicine Fall 2017

disease. African-Americans are at a significant higher risk for Alzheimer’s, and many other risk factors for dementia—from cardiovascular disease to obesity—are present at higher than average rates in Alabama. “We really need to understand why some people have higher risks and what’s unique about them that should guide the way we approach treatment for them,” says Roberson. It is a question that is also at the heart of research being conducted at the UAB Evelyn F. McKnight Brain Institute, which welcomed Ronald Lazar, Ph.D., the Evelyn F. McKnight Endowed Chair for Learning Memory in Aging in the Department of Neurology, as its new chair this summer. “We want to take UAB’s strengths in both research and clinical medicine and build new relationships between basic scientists and clinical scientists to study age-related memory decline and cognitive decline, and discover how to create resiliency and recovery,” says Lazar. “There are a lot of principles that have emerged out of basic science, and there are wonderful cellular and animal models of Alzheimer’s. Our challenge is to bring this work forward into the human space.” The institute—one of four McKnight Brain Institutes in the country—was launched at UAB in 2004, and Lazar is already planning new initiatives that include pilot grants to facilitate interdisciplinary work. Through collaborations with the other McKnight sites, UAB associate professor of neurobiology Kristina Visscher, Ph.D., is

involved in one such interdisciplinary project that aims to define the healthy aging brain. “There are theories out there that say Alzheimer’s is an acceleration of brain aging,” explains Visscher, co-director of the Civitan International Neuroimaging Laboratory. “But the problem is that we don’t actually understand what a healthy aging brain means.” Visscher and researchers at the McKnight Institutes in Miami and Gainesville, Florida, and Tucson, Arizona, are currently recruiting 200 cognitively healthy people over age 85. The participants undergo tests and scans in three sessions that profile their cognition and brains. Tests range from timed obstacle courses to memorization challenges, and scans measure such things as the strength of connections between brain areas or the volumes of those areas. Visscher says she hopes her research reveals what healthy aging brains look like and it teaches us something about how that goes awry in Alzheimer’s. Ultimately, she and everyone else studying Alzheimer’s want to unlock the secret to growing old without losing one’s memory. “Memory is a function that everybody needs every day to have quality of life, to interact with other people, and to enjoy experiences.” says Lazar. “To study memory means we are not only trying to make the Golden Years as meaningful as possible, but we’re also trying to preserve this function that maintains civilization and society.”

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NEURAL NETWORKING

Neurobiological research shows how synapses change when new neurons are formed BY JEFF HANSEN

NE GOAL IN NEUROBIOLOGY is to understand how the flow of electrical signals through brain circuits gives rise to perception, action, thought, learning, and memories. Linda Overstreet-Wadiche, Ph.D., and Jacques Wadiche, Ph.D., associate professors in the UAB Department of Neurobiology and a wife-and-husband team, have published their latest contribution in this effort, focused on a part of the brain that helps form memories: the dentate gyrus of the hippocampus.

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FEATURE

The dentate gyrus is one of only two areas in the brain where new neurons are formed continuously in adults through a process called neurogenesis. When a new granule cell neuron is formed in the dentate gyrus, it must get “wired in” by forming synapses, or connections, in order to contribute to circuit function. Dentate granule cells are part of a circuit that receive electrical signals from the entorhinal cortex, a cortical brain region that processes sensory and spatial input from other areas of the brain. By combining this sensory and spatial information, the dentate gyrus can generate a unique memory of an experience. With this in mind, Overstreet-Wadiche and UAB colleagues posed several research questions: Since the number of neurons in the dentate gyrus increases by neurogenesis while the number of neurons in the cortex remains the same, does the brain create additional synapses from the cortical neurons to the new granule cells? Or do some cortical neurons transfer their connections from mature granule cells to the new granule cells? The answer was revealed through a series of electrophysiology, dendritic spine density, and immunohistochemistry experiments with mice that were genetically altered to produce either more new neurons or to kill off newborn neurons. Their findings support the second model—some of the cortical neurons transfer their connections from mature granule cells to the new granule cells. This opens the door to look at how this redistribution of synapses between the old and new neurons helps the dentate gyrus function. And it raises tantalizing questions: Does this redistribution disrupt existing memories? How does this redistribution relate to the beneficial effects of exercise, which is a natural way to increase neurogenesis?

This opens the door to look at how this redistribution of synapses between the old and new neurons helps the dentate gyrus function. And it raises tantalizing questions: Does this redistribution disrupt existing memories? How does this redistribution relate to the beneficial effects of exercise, which is a natural way to increase neurogenesis?

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“Over the past 10 years there has been evidence supporting a redistribution of synapses between old and new neurons, possibly by a competitive process that the new cells tend to ‘win,’” Overstreet-Wadiche says. “Our findings Linda Overstreet-Wadiche are important because they directly demonstrate that, in order for new cells to win connections, the old cells lose connections. So, the process of adult neurogenesis not only adds new cells to the network, but it Jacques Wadiche also promotes plasticity of the existing network. “It will be interesting to explore how neurogenesisinduced plasticity contributes to the function of this brain region,” she continues. “Neurogenesis is typically associated with improved acquisition of new information, but some studies have also suggested that neurogenesis promotes ‘forgetting’ of existing memories.” The researchers also unexpectedly found that the Bax gene, known for its role in cell death (apoptosis), appears to play a role in synaptic pruning in the dentate gyrus. “There is mounting evidence that the cellular machinery that controls cell death also controls the strength and number of synaptic connections,” Overstreet-Wadiche says. “The appropriate balance of synapses strengthening and weakening, collectively termed synaptic plasticity, is critical for appropriate brain function. Therefore, understanding how synaptic pruning occurs may shed light on neurodevelopmental disorders and on neurodegenerative diseases in which a synaptic pruning gone awry may contribute to pathological synapse loss.”

CHARTING THE COURSE

Visionary medical oncologist leads Comprehensive Cancer Center into new era BY EMILY HENAGAN

ichael Birrer, M.D., Ph.D.,

did not originally consider entering the field of gynecologic oncology. It was instead an obligatory appointment to serve on a board that changed the trajectory of his career. “I initially started out in 1988 as an investigator in lung cancer at the

National Cancer Institute’s Center for Cancer Research,” explains Birrer. “Since I was new faculty, I had to sit on the gynecologic oncology tumor board. It was a set of tumors I had little experience with at the time, but I enjoyed learning about everything involving these tumors. It was absolutely fascinating.” That fascination has been a constant theme throughout his almost 30-year career and has led him to his new position as director of the UAB Comprehensive Cancer Center. “What I find exciting about the role is it allows me to help a greater number of patients suffering from cancer,” says Birrer, a trailblazer in the early detection and treatment of gynecologic cancers. Birrer’s lab has a long history of determining the genomic characteristics of ovarian, cervical, and endometrial cancers,

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FEATURE

Michael Birrer, an expert in gynecologic cancers, now leads the UAB Comprehensive Cancer Center.

and using that data to form the basis for early detection assays, prevention strategies, and novel therapies. His research interests include the molecular origins of gynecologic cancers, as well as the identifications and characterization of aberrations in oncogenes and tumor suppressor genes in these cancers. Research is not the only field where Birrer excels. He has held multiple leadership positions, including as the director of Gynecologic Medical Oncology and the Gynecologic Cancer Research Program at Massachusetts General Hospital’s Gillette Center since 2008. During this time, he was also a professor of medicine at Harvard Medical School and served as the leader of the Dana Farber/Harvard Cancer Center program in gynecologic cancers. Birrer credits his hybrid research/ leadership experience for preparing him for his directorship role at the Comprehensive Cancer Center. “I have had experience in both laboratory and clinical research, but

I’ve also held leadership positions that have prepared me for my new role,” says Birrer, who succeeds retiring director Edward Partridge, M.D. Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine, couldn’t agree more. “Mike Birrer is an outstanding physician-scientist who balances a vision of transformation and leadership,” says Vickers. “He understands drivers for excellence in clinical care and has a vision for growing precision medicine in cancer care, as well as a well-established commitment to fundamental scientific discovery.” Birrer’s vision for the Comprehensive Cancer Center also incorporates expanding the reach of the center to create outpatient clinics in areas like Mississippi, western Georgia, the panhandle of Florida, and Arkansas. “These are areas where the quality and type of outstanding cancer care that UAB is known for would be established, and then populations of people in these areas who may never see a clinical trial would have access to these terrific drugs,” says Birrer, who earned his doctoral degree in microbiology and immunology and medical degree at the

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Albert Einstein College of Medicine in New York City. “It would expand the scope of the Cancer Center, but more importantly it would better cover the Deep South, where we have a lot of underserved patients.” Birrer also notes it is important to have a standalone clinical care facility for the Comprehensive Cancer Center. “UAB needs an outpatient clinic building where patients can point to it and say, ‘That is my cancer center,’” he says. “Right now we have great cancer care, but it is scattered all over the place.” Although Birrer wants to create a standalone clinical care facility for the center, he says he is extremely fortunate to take the reins of one of the first National Cancer Institute-designated comprehensive cancer centers within the U.S. that has been continuously funded for more than 40 years. “It is easy to impart a vision when you’re starting with something that is spectacular like the Comprehensive Cancer Center,” Birrer says. “UAB is a first-rate institution with a Comprehensive Cancer Center that is one of the best in the nation, and it is a great honor for me to lead such a prestigious cancer center.” Kendra Carter contributed to this article.

It is easy to impart a vision when you’re starting with something that is spectacular like the Comprehensive Cancer Center. UAB is a first-rate institution with a Comprehensive Cancer Center that is one of the best in the nation, and it is a great honor for me to lead such a prestigious cancer center.” – MICHAEL BIRRER

CLINICAL CARE

A MODEL OF PROGRESS Long-funded model system advances knowledge of and care for spinal cord injuries BY ROSALIND FOURNIER

rior to her residency in physical medicine and rehabilitation at UAB, Amie Brown (Jackson) McLain, M.D., witnessed her father suffer a spinal cord injury and become paralyzed after cancer spread into his bones. “It was very traumatic,” McLain says. “At that time I was not very knowledgeable at all about his condition, or what could or should be done. He lived several years with his paralyses. Having seen it at a certain age in my life made a profound impression on me.” Today McLain is chair of the Department of Physical Medicine and Rehabilitation, holder of the Robert B. Kyle Professorship and Chair in Rehabilitation Medicine, and director of the UAB Spinal Cord Injury (SCI) Model System. UAB’s SCI Model System is one of only 14 officially recognized systems in the country and the longest continually funded SCI model system in existence. UAB is also home to the National Spinal Cord Injury Statistical Center (NSCISC), directed by Yuying Chen, M.D., Ph.D., which supports and directs the collection, management, and analysis of the world’s largest spinal cord injury research database. Both programs are funded every five years by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). McLain describes the model system as a patient-centered program designed to follow people with SCI throughout their lives. It is a way to identify patterns in the common health problems, or secondary conditions, that this unique population faces. “We look at what’s going on to ask the

questions, Why are we Amie McLain chairs the seeing this? How can Department of Physical Medicine we get around it and and Rehabilitation, which is do something better?” home to the longest continually explains McLain. funded spinal cord injury model Much of the system in existence. progress made through the SCI model system is gradual, but there are occasional breakthroughs. McLain recalls that one patient suffering from recurring skin problems, including pressure sores, ended up having the connective tissue disorder scleroderma. That case, McLain notes, is an example of what happens all too often with SCI patients. Since skin problems are a common secondary condition associated with SCI, doctors might prematurely rule out possibilities unrelated to SCI. In other cases, patients who come in with relatively common conditions may be improperly diagnosed because their symptoms are different than those of people without SCI. The NSCISC is helping alleviate these problems by making its vast trove of data—the combined knowledge gathered from all the nation’s model systems—available to health care professionals both inside and outside the rehabilitation field. Chen says the importance of having a national statistical center is hard to overestimate when it comes to improving care for those with SCI. “Our main focus is the support of research data collection,” Chen says. “The

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CLINICAL CARE

knowledge-translation part is making it accessible to anyone who is interested in data analysis, so we have an open policy for researchers to utilize it for their research.” Chen points out that the center also collects information that can be used in SCI prevention efforts as well as treatment. Many are unaware, for instance, that growing numbers of elderly people are now sustaining spinal cord injuries from falls. “We need to be aware of that because the data can forecast trends and shape where prevention efforts should be focused,” Chen says.

A New Way of Living

Phillip Klebine has been living with tetraplegia since he was injured in a car accident in 1984. He was brought to UAB for acute trauma care and eventually transferred to Spain Rehabilitation Center, where he began to come to terms with the fact that he would never walk again. “I knew that my body wasn’t going to work for me in the same way, so my mind had to,” Klebine says. He later enrolled as a student at UAB and earned an undergraduate degree in communication and a graduate degree in counseling. He began working at UAB and eventually became director of knowledge translation in the Department of Physical Medicine and Rehabilitation. “They wanted someone who had spinal cord injury, knew about it, and could write about secondary conditions related to spinal cord injury,” he says. As someone living with SCI and working in UAB’s SCI programs, Klebine has had a uniquely close-up view of the progress that has been made in the field thanks in part to the SCI model system network. But few people with SCI know about the UAB model system, the statistical center, or how either has benefitted them. For example, conditions like urinary tract infections that are highly treatable now could lead to renal complications, kidney failure, and often death for people with SCI before advances occurred thanks in part to the model system and statistical center. In fact, most individuals with paraplegia and quadriplegia live healthy lives, adjusting far better to life after

injury than many might assume. Melissa Fendley is one of those people. Like Klebine, she suffered an SCI in a car accident in the ’80s when she was a teenager. Post-injury, she got married and had a child. She describes herself as very independent and notes her biggest health challenge was not her own but that of her husband, who was diagnosed with early-onset Alzheimer’s disease when he was 55. He passed away in January. Fendley does not complain about having a spinal cord injury, but she says she appreciates not feeling alone when she comes for follow-up visits at UAB. “It’s good to know you’re not the only one going through this, even

though we may all react to these injuries differently,” Fendley says. “It’s nice to have someone to lean on and talk to and bounce ideas off.” That attitude of collaboration and perseverance permeates through the UAB SCI program patients and health care professionals. “The one thing that most people don’t understand or don’t think about is that spinal cord injury is only one obstacle,” Klebine says. “Granted, it’s a life-changing one, but people in general are very resilient and most do very well.”

SUPPORT SYSTEM The Women’s Committee of the Spain Rehabilitation Center was formed in 1970 with a mission to improve quality of life for the center’s patients. Today, its impact can be seen throughout the center, which serves as the hub of activities for the Department of Physical Medicine and Rehabilitation (PM&R). Whether purchasing equipment, increasing public awareness of the center through charity events, or donating dozens of works of art that are displayed throughout the facility, the Women’s Committee has been Spain Rehab’s strongest and most loyal philanthropic supporter. The Women’s Committee has made numerous gifts to the facility over the decades that include a tilt table for the physical therapy department, funds to build a therapeutic pool, a wheelchair seating pressure monitor system, a diagnostic balance system, and a handicapped-accessible driver training van. These gifts are in addition to the $1 million the group raised to establish the Women’s Committee of the Spain Rehabilitation Center Endowed Chair in Rehabilitation Research. “The Women’s Committee is one of UAB’s longest-serving philanthropic groups,” says Amie McLain, M.D., chair of the PM&R department. “In their service to Spain Rehabilitation Center, they have always been patient centered. Without their help, we could not provide the enriched programs that have served so many of our patients. We are very grateful for the support of these dedicated women throughout the years.” “The Women’s Committee’s most recent purchases for the center include the Bioness Integrated Therapy System, a touch-screen tool to improve cognitive and balance training and hand-eye coordination; a bladder scanner making possible bedside evaluations; and a cryostat, an important research tool,” says Suzanne Payne, president of the Women’s Committee. “Our members are committed to supporting this vital part of the UAB system because we believe not only are the lives of the center’s patients changed as a result, but also those of patients all over the country who benefit from the center’s research.”

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CLINICAL CARE

LIFE IN RHYTHM Resident recovers from cardiac arrest with support from peers and mentors BY ADAM POPE

n November 28, 2016, Anezi Uzendu, M.D., a third-year resident in the Tinsley Harrison Internal Medicine Residency Program, was playing basketball at a local gym when he went into cardiac arrest and passed out from a loss of blood flow to the brain. A local chiropractor who happened to be in the gym came to Uzendu’s aid and performed CPR until paramedics arrived. Uzendu was shocked more than 10 times with a defibrillator, and he didn’t regain consciousness until a week later. “People don’t survive what I survived,” Uzendu says. “I didn’t know the people at the gym, but they did a great job of stabilizing me until I could get to the hospital. I know I was intubated and placed under hypothermia protocol once I was admitted.” After being taken to a nearby hospital, Uzendu was put into a medically induced coma as part of the hypothermia protocol. With no medical or family history of heart disease, he was diagnosed with ventricular fibrillation, the most serious cardiac rhythm disturbance, where his lower chambers quivered and his heart couldn’t pump blood. He says he never regained his memory from that day. “After I awoke from the medically induced coma, I was in the CCU [Cardiac Care Unit at UAB Hospital] and had memory issues,” he recalls. “I was surrounded by friends and family, and they helped me piece my life together.” Uzendu says UAB Internal Medicine Residency Program Director Lisa Willett, M.D., was instrumental in reassuring his family that he would get the best possible care. She helped get him transferred to UAB Hospital when he was deemed stable enough to transport, and he was admitted to the CCU while still in the medically induced coma. “After he was transferred to UAB and I spoke with the cardiologists, they told me he had less than a 10 percent

I was in the same CCU that I’m used to working in, and I had great nurses and doctors that I worked with all the time as a colleague now taking care of me as a patient.” – ANEZI UZENDU

Above, left to right: Former internal medicine resident Anezi Uzendu and Tinsley Harrison Internal Medicine Residency Director Lisa Willett share a special bond after Uzendu’s successful recovery from a cardiac arrest that occurred during his residency. At right: Uzendu was also supported in his recovery by his fellow residents, including Karla Williams (left) and KeAndrea Titer (right).

chance of surviving this,” says Willett. “He had complete, multisystem failure, so almost every organ in his body was not working.” “Dr. Willett was really instrumental in taking care of everything while my parents were coming from St. Louis,” Uzendu says. “She and all the chief residents came to see me at the hospital and helped me get transferred to UAB. They could tell that I really didn’t look well, and they wanted me to receive the best possible care, which was at UAB.” Uzendu, who began a cardiology fellowship at The Ohio State University this summer, was accustomed to seeing patients in the CCU, but he never imagined he would become one. “I was in the same CCU that I’m used to working in, and I had great nurses and doctors that I worked with all the time as a colleague now taking care of me as a patient.” Just six weeks after the event that left him clinging to life, Uzendu was cleared by his doctors to return to work and was back seeing patients on his normal rotation schedule. “I think one of the coolest things to come out of this experience is the love and overwhelming support that was shown to me while I was in the hospital from my family to the staff and fellow residents,” he says. “There were so many people offering help,

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CLINICAL CARE

often translates into intense bonds and long-lasting friendships. But what happens when the resident becomes the patient? Willett says seeing one of her trainees in such a seemingly hopeless state was unforgettable, but so was her relief when Uzendu began to show signs of improvement. “Someone was always with him while he was in the CCU,” she says. “You can imagine the excitement and celebration in the CCU the first time he squeezed our hand and we knew he was responding.” Uzendu says the experience has given him a unique perspective on his chosen profession. “I know that there was a lot of good that came from my illness,” he says. “I think one of the main things for me is to know how to empathize better with my patients. When you haven’t gone through it, it’s a little harder to know what patients go through. It was an important time of growth for me physically, spiritually, and career-wise.” Uzendu says when he was accepted to the Tinsley Harrison Residency Program, he expected to receive an outstanding training experience, but he left with something equally as valuable. “I knew there was collegiality at UAB, but I never knew there would be a family environment like I experienced during my time there,” he says. “When I came there, I didn’t know anyone, but I feel like I left with a whole new family.”

HONORING OUR HISTORY

whether it was covering shifts or bringing my parents food. “They also had a prayer service for me in the chapel at UAB,” Uzendu elaborates. “I later found out there were multiple prayer chains set up for me. In addition to the amazing care I received at UAB, I believe my life was saved thanks to a powerful God who answered those prayers.”

Forever Family

UAB School of Medicine residents undergo rigorous training and are prepared for practice the moment they complete their programs. Residents experience the highs and lows of practicing medicine together, and that camaraderie

The Tinsley Harrison Internal Medicine Residency Program is named for one of UAB’s most distinguished faculty leaders, Tinsley Harrison, M.D. Founding editor and editor in chief of the first five editions of Harrison’s Principles of Internal Medicine, Harrison was born in Talladega, Alabama, in 1900 to a long line of physicians. He completed his medical training at The Johns Hopkins University School of Medicine, Peter Bent Brigham Hospital in Boston, and Vanderbilt University Medical Center. He later became acting dean of the Medical College of Alabama (now UAB) and chair of the Department of Medicine in 1950. Harrison helped initiate a period of rapid growth at UAB that included recruiting nationally known physicians from the faculties of Harvard University and the Mayo Clinic, among others. This period also saw UAB rise from local to international prominence. In addition to the internal medicine residency program, the Tinsley Harrison Research Tower on UAB’s campus is named to honor the man who famously said, “No greater opportunity, responsibility, or obligation can fall to the lot of a human being than to become a physician.”

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MEDICAL EDUCATION

A LEGACY OF LEADERSHIP Newly renamed Learning Communities honor key figures from our past and present COMPILED BY KATELYN HOWARD The School of Medicine’s Learning Communities are small groups aimed at fostering interpersonal relationships among students from all four classes and between students and faculty mentors. They also offer ideal venues for group discussions on topics ranging from mindfulness and resilience to medical ethics to managing finances. This year, students were given the opportunity to rename six of the 11 Learning Communities after prominent leaders from the school’s past and present. Here you can learn more about the fascinating figures who inspired our Learning Communities.

Harrison Community Barfield-Carter Community In 1945, Melson Barfield-Carter, M.D., became the first female faculty member at the School of Medicine and the first woman to be named a department chair (of the Department of Radiology). She also was the first woman to graduate from Tulane Medical School, and she completed her residency in radiology at Massachusetts General Hospital. Barfield-Carter started the radiology residency training program and developed the School of Radiological Technology at UAB.

Tinsley Harrison, M.D., served as dean of the School of Medicine and chairman of the Department of Medicine. He helped recruit nationally known physicians from Harvard University and the Mayo Clinic, among others. His special field of interest was cardiovascular medicine as well as the pathophysiological mechanisms of disease. Harrison is best known among physicians as the founding editor and editor-in-chief of the first five editions of Harrison’s Principles of Internal Medicine.

Finley Community Wayne Finley, M.D., Ph.D., and Sara Crews Finley, M.D., became pioneers in the field of medical genetics when they co-founded the Laboratory of Medical Genetics, the first center of its kind in the Southeast, in 1962. The Finleys guided the medical genetics research, training, and service program at UAB for 35 years, providing genetics services and developing specialized diagnostic laboratories for detectable genetic disorders.

Hill Community

Hamilton Community Herschell Lee Hamilton, M.D., came to Birmingham in 1958 as its first African-American board-certified general surgeon. He was the first African-American to receive operating privileges at University Hospital. Hamilton earned his nicknames as the “Dog Bite Doctor” and the “Battle Surgeon” for his work helping injured activists during the civil rights movement.

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Longtime School of Medicine faculty member Samuel Richardson “Dick” Hill Jr., M.D., served as president of UAB from 1977 to 1986. Hill practiced internal medicine and endocrinology before coming to the Medical College of Alabama in 1954. He was appointed dean of the college in 1962 and remained there as it evolved into UAB, serving as vice president for health affairs and medical center director and director of the University of Alabama Medical Education Program. Hill recruited John Kirklin from the Mayo Clinic to chair the surgery department and Gene Bartow from UCLA to coach the university’s first basketball team.

MEDICAL EDUCATION

Hirschowitz Community Basil Hirschowitz, M.D., Ph.D., is a medical pioneer who, along with his colleagues, invented the first fiberoptic endoscope that became the standard for visualizing and treating virtually every cavity in the body. Hirschowitz dedicated his career to the study of diseases of the upper GI tract and published more than 350 papers, many related to ulcer disease. He was also a leader in clinical trials that were the forerunners to new pharmaceutical treatments in gastroenterology, paving the way for widespread use of medications known today as Pepcid, Prilosec, and Nexium.

McCallum Community

Kirklin Community In the 1950s, while at the Mayo Clinic, John Kirklin, M.D., performed the world’s first series of open heart operations using a heart-lung machine. Kirklin joined the UAB faculty in 1966 as chair of the Department of Surgery and the surgeon-in-chief for UAB Hospital. He held those positions until 1982 during which time he built one of the most prestigious cardiovascular surgical programs in the world.

Charles “Scotty” McCallum Jr., DMD, M.D., came to Alabama in 1951 to complete a residency in oral and maxillofacial surgery after earning his dental degree from Tufts College Dental School. He earned a medical degree from the Medical College of Alabama in 1957 and became dean of the School of Dentistry in 1962. He later served as vice president for health affairs and director of UAB Medical Center before becoming the third president of UAB in 1987. After stepping down as president, he was elected to two terms as mayor of Vestavia Hills beginning in 2000.

Lyons Community Champ Lyons, M.D., arrived in Birmingham in 1950 to become the first full-time chair of surgery, a position he retained until his passing in 1965. That year, Lyons became one of the first faculty members to be named a distinguished professor. His major professional contributions were in the areas of surgical infections and vascular surgery.

Oparil Community Pittman Community As the UAB School of Medicine’s longest-serving dean—19 years, from 1973 to 1992—James Pittman Jr., M.D., left an indelible mark. He was known for his ability to recruit and retain nationally and internationally renowned physicians and scientists. He is credited with restoring a four-year medical school curriculum, replacing the 35-month program that was in place when he became dean, and creating space in the academic cycle for students to pursue research and service activities.

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Suzanne Oparil, M.D., is a renowned cardiologist and a member of the prestigious National Academy of Medicine. Her research focuses on cardiovascular disease and the development of novel treatments for hypertension, including ACE inhibitors. She has also made important discoveries about mediators of pulmonary hypertension and the role of estrogen in blood vessels. She is a distinguished professor of medicine and director of the Vascular Biology and Hypertension Program at UAB.

SCIENTIST TRAINING

THE BUSINESS OF INNOVATION I-Corps program teaches scientists and engineers how to be entrepreneurs BY ROSALIND FOURNIER

realize they don’t need to go through the difficult process of getting FDA approval unless they’re certain there’s a market for the product. Lots of things have FDA approval that have never come to market.” For that reason, the I-Corps program emphasizes viability over other concerns. “We are completely technology agnostic; we can teach this entire process without knowing anything about the technology,” she explains. “This is the toughest thing for scientists to understand, because they have only been trained to talk about the technology. But we stop them and ask, ‘What’s the problem you’re trying to solve? Who cares about it, and why does that person care about it?’”

ith an estimated failure rate for business startups hovering anywhere from 50 to 90 percent, success requires Business Boot Camp plenty of inspiration, perspiration, and preparation. Robert Hergenrother, Ph.D.—a professor in The latter is what UAB is hoping to bolster through the Department of Biomedical Engineering and a new relationship with Innovation Corps (I-Corps), director of AIMTech (the Alliance for Innovative a National Science Foundation (NSF)-sponsored Medical Technology), a medical device development program designed to help scientists and engineers collaboration between Southern Research and take their research from the laboratory to the UAB—has attended I-Corps events before and was marketplace. enthusiastic about seeing the program introduced at “We used to say, ‘Okay, you’ve got a great idea. UAB. As an engineer, he says he understands it can be Now spend tons of money, build a prototype, create hard to get past the “If you build it, they will come” a business plan, and take it to market,’” says Molly mentality. Wasko, Ph.D., professor and associate dean for “You can get very caught up in how great your research, innovation, and faculty success at the UAB technology or your invention is, but you need to Collat School of Business who oversaw the I-Corps step back and listen to your potential customers,” implementation at UAB. “That system has failed.” Hergenrother explains. “Are you meeting their needs? The problem, she explains, is not a lack of passion Do they agree that what you’re proposing a solution but the opposite—innovators who are so enamored to is actually a problem?” with their ideas that they don’t stop to consider the As an I-Corps site and a member of the I-Corps value of their inventions to the market. “Our scientists South Node, UAB is now hosting entrepreneurial have been working on problems that are interesting boot camps (or cohorts), where teams workshop their to them. But what if users don’t care in the long run?” ideas, test them against hurdles they are likely to Wasko questions. Indeed, a 2014 Fortune magazine face, and assemble “Shark Tank”-style presentations poll that surveyed the founders of failed startups for feedback. UAB can recommend top teams for the found the No. 1 reason for failure is the lack of a National I-Corps program, qualifying those teams for market need for the product. grants up to $50,000. UAB is an I-Corps site and a part of the I-Corps UAB held its first cohort in June, and Hergenrother South Node, which includes The University of served as the entrepreneurial lead (or mentor) for Alabama, Georgia Institute of Technology, and the Team Slip/Stick. Their idea—which came out of a lab University of Tennessee. There are eight nodes in directed by David Brown, PT, Ph.D., FAPTA, professor the I-Corps program, which teaches scientists and engineers the steps Scientists tend to believe that all they need to do required to succeed as is get FDA approval for their idea to make a gazillion entrepreneurs. “It’s a completely dollars. I try to help them realize they don’t need to different way of thinking go through the difficult process of getting FDA for them,” Wasko says. “Scientists tend to believe approval unless they’re certain there’s a market for that all they need to do is it. Lots of things that have never come to market get FDA approval for their have FDA approval.” idea to make a gazillion dollars. I try to help them — MOLLY WASKO

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UAB Medicine Fall 2017

SCIENTIST TRAINING

and program director for the Ph.D. in Rehabilitation Science Program in the UAB School of Health Professions—is for a shoe insert designed to help people with walking disabilities avoid favoring one leg over the other. Hergenrother says the program enabled them to refine their target market tremendously. “In talking with physical therapists about their rehabilitation efforts, the target got whittled down to stroke survivors who have some sort of walking deficit rather than just anyone who has trouble walking,” Hergenrother explains. According to Wasko, this is partly because stroke survivors are more invested in avoiding the use of canes or walkers. “For them, the value proposition is how they’re perceived,” she says. “They don’t want to look feeble.”

Campuswide Impact

Beyond the cohorts, UAB is sharing the I-Corps curriculum across campus in a variety of ways. The university is offering related undergraduate and graduate courses—both new this year—as well as a master’s program in the School of Engineering with a graduate certificate in Technology Commercialization and Entrepreneurship. Beginning this fall,

UAB will also host a series of four-week, not-for-credit I-Corps sessions at Innovation Depot, a business incubation hub in downtown Birmingham. The UAB Center for Clinical and Translational Science (CCTS) is also leading a national effort to adapt I-Corps training for the translation of biomedical discoveries. Robert Kimberly, M.D., director of the CCTS, senior associate dean for Clinical and Translational Research for the School of Medicine, and holder of the Howard L. Holley Research Chair in Rheumatology, points out that the same concepts apply whether a discovery has potential commercial value or advances ideas that can improve public health. “In terms of developing the perspective that I-Corp brings, it’s a bit more concrete when you talk about engineering,” he says. “One makes a device and presumably it addresses the consumers’ needs and fixes the issues. Sometimes in the life sciences the questions and the approaches are not quite so discrete. Therefore, we initially considered if that same perspective would apply.” And Kimberly says he believes that the answer is yes. He notes it may take more work to refine the I-Corps approach as compared to the engineering and physical sciences.

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Left to right: Participants in UAB’s first I-Corps training cohort for scientists and engineers learn strategies for bringing their innovations to the marketplace; Molly Wasko of the UAB Collat School of Business is overseeing the I-Corps program at UAB.

It takes ideation, solution and development, refinement with iteration, and then application. “Sometimes folks think commercialization is the only end game, but I prefer to think of the I-Corps philosophy as helping people understand what problems they’re going to solve, what gaps in knowledge or practice they need to address, and how to help address them,” Kimberly says. “Even if one isn’t interested in ultimately having a commercialized end product, it’s about getting people to think about the next steps. And that’s very important. “Although I think doing science is its own reward, we have sponsors through the NIH and other agencies. We owe it to them, Congress, and people everywhere to do what we can to make sure we advance this research in the service of improving health.”

GENOMICS AND INFORMATICS

PURE GENE-IUS

The program also offers a variety of research opportunities to honors-level students with some of the more than 100 faculty members from over 15 departments and six schools who conduct genetics and genomics research. Through a partnership with Huntsville’s HudsonAlpha Institute for Biotechnology, UAB has also launched the BY NANCY MANN JACKSON UAB-HudsonAlpha Genomic Medicine Research Training Program. Funded by a grant from the National Institutes s precision medicine and genomics play an of Health—one of the first such grants in the country—the increasingly vital role in biomedical research and two-year program trains two postdoctoral fellows per year, for medicine, UAB has developed new programs to train a total of four trainees. The training program is geared toward the next generation of experts in the field. Along with UAB’s people from M.D., Ph.D., and M.D./Ph.D. backgrounds and existing Genetics, Genomics, and Bioinformatics Graduate focuses on genomic medicine in clinical research. Theme, a new undergraduate degree and a new postdoctoral “The overall goal is to provide training to M.D.s and Ph.D.s research fellowship complete the training pipeline, from in the application of genomic approaches in addressing undergraduate to graduate to postdoctoral training, in genetic medical problems,” Korf says. He also notes that the program’s and genomic science. approach to training recognizes the diverse backgrounds “Genomics is a relatively new and rapidly evolving area of fellows bring with them as they go through the program. medical research and practice,” says Bruce Korf, M.D., Ph.D., For example, because some participants have substantial the Wayne H. and Sara Crews Finley Chair in Medical Genetics, experience in genomics and others have little or none, the chair of the Department of Genetics, and chief genomics officer program has developed a “passport” system rather than a for UAB Medicine. “UAB is highly qualified to be a leader in one-size-fits-all curriculum. “We have identified competencies this area because of our broad and deep clinical expertise, the in genomic medicine, and we provide access to various ways of access to genomic technologies and expertise at HudsonAlpha, achieving those competencies,” Korf says. “Trainees can check and the high prevalence in our region of diseases such off the things they have mastered, either from prior training as diabetes and cancer that lend themselves to genomic or training in the program, as they gain those competencies.” approaches to develop better management strategies.” Competencies include the ability to analyze whole exome This fall, UAB launched the new undergraduate degree or whole genome data to identify variants associated with in Genetics and Genomic Science (GGS), a joint program a patient’s phenotype, or the ability to select the most between the School of Medicine’s Department of Genetics appropriate genomic tool to establish a diagnosis or formulate and the College of Arts and Sciences’ Department of Biology. a treatment plan. It is the only program of its kind in the state. Along with Korf says the program’s short-term goals include publicaGenetics faculty members Anil Challa, Ph.D., Kevin Dybvig, tions and presentations at national meetings. “The ultimate Ph.D., and Daniel Bullard, Ph.D., who also serves as assistant goal is to train people who go on to have successful careers in dean for undergraduate biomedical programs for the School genomic medicine practice and research, either in academia or of Medicine and director of the GGS degree program, collabo- industry.” rators from the Department of Biology include Chair Steven Austad, Ph.D., and Asim Bej, Ph.D., professor and co-director of the GGS degree program. “UAB is fast becoming one of the top places in the Southeast to study biomedical sciences, and adding this undergraduate degree gives us new opportunities to attract more outstanding students,” says Bullard. Faculty from both the Departments of Genetics and Biology are involved in teaching GGS students, but other departments such as Chemistry, Computer and Information Sciences, and Mathematics also contribute courses to the curriculum. In addition, new classes have been developed specifically for the program, including Genome Structure Left to right: Bruce Korf and Daniel Bullard are and Organization, Genetic Basis of Human leaders in genomics training. Disease, Personalized Genomic Medicine, and Bioinformatics.

New genomics training programs foster innovation and expertise

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UAB Medicine Fall 2017

GENOMICS AND INFORMATICS

At left: Jake Chen (left) and James Cimino (right) lead the UAB Informatics Institute.

BANKING ON DATA UAB’s Informatics Institute works to leverage the power of big data BY JANE LONGSHORE

hanks to the sequencing of the human genome and the flood of research and discovery that followed, the rate of medical knowledge has doubled every three years since about 2010. And the pace is quickening—by 2020, medical knowledge is projected to double every 73 days, making one of the chief challenges of the “genomic era” picking out relevant information from a sea of data. These developments have helped bring informatics, once a niche field, to the forefront in medicine. UAB established the Informatics Institute in 2014 and recruited James Cimino, M.D., former chief of the Laboratory for Informatics Development at the National Institutes of Health, to be its inaugural director. Last spring, Jake Chen, Ph.D., joined the institute as associate director and chief bioinformatics officer. Chen previously was founding director of the Indiana Center for Systems Biology and Personalized Medicine at Indiana University. Broadly speaking, informatics is “the art and science of organizing data about human health and disease, and making it useful for problem solving,” Cimino explains. Chen’s specialty is bioinformatics, which he says is the lynchpin of the genomic research revolution. “I like to say that bioinformatics is like a computer’s central processing unit, the brain of genomic medicine,” he says. “The whole human genome is 3.1 billion base pairs, and roughly 0.1 percent of that is the individual variation from the reference genome, but still that’s several million. It is very challenging to sift through unless you have informatics practices—computers, prior knowledge databases, experts who know what they are looking for. You can’t just collect the data and expect it to speak for itself.”

Cimino and Chen have spent the past year assembling a formidable team of informatics researchers who have been busy collaborating with UAB researchers, individually and through the UAB Center for Clinical and Translational Science. With the addition of 10 new faculty members and their teams, the Informatics Institute is prepared to address the full spectrum of clinical and biomedical informatics research needs in the School of Medicine. One of the biggest projects the institute is currently involved in is the Alabama Genomic Health Initiative, a statewide program—one of the first of its kind in the country—aimed at analyzing the genetic information of thousands of Alabamians to help prevent, diagnose, and treat disease (learn more on page 3). “The participants’ genomic data is being collected in a biobank, so it’s a lot of data to manage,” says Cimino. “We’re putting that data into an i2b2 (Informatics for Integrating Biology and the Bedside) data repository so researchers with the appropriate access can use the data to identify subjects for future studies. For example, they can search for all the people who have had a lab test that shows poor kidney function and have certain genetic markers. Since many of the subjects will be patients at UAB, the researchers can also access clinical data we may have on those subjects as part of their electronic health records. We have the breadth of all clinical data that’s in the electronic health record, and it’s alive and growing as patients come in to receive care and more data is added.” But, as Chen points out, the real transformative power of informatics does not lie solely in building the technology and collecting the data. “If you simply use IT, you can create more efficient medicine, but more intelligent medicine connects the minds of basic science researchers—what they know about biological systems—to clinicians,” he says. “Informatics can help extract that knowledge and build a knowledge base, along with new tools to help to push medicine to the next level. In my opinion, informatics is really a discovery hub.” Learn more at uab.edu/medicine/informatics.

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ALUMNI PROFILES

Left: Brian Barki is using his anesthesiology training to help some of the world’s neediest patients aboard the hospital ship Africa Mercy. Above: Barki, his wife Jamie, and their three children all live aboard the hospital ship.

HOPE FLOATS

What is it like to volunteer with Mercy Ships, and why do you do it?

Anesthesiology alumnus serves aboard African hospital ship BY JULIE COLE MILLER

rian Barki, M.D., who completed his residency with the UAB Department of Anesthesiology and Perioperative Medicine in 2010, is featured on the National Geographic Channel series “The Surgery Ship.” It details the dramatic stories that take place aboard the ship Africa Mercy, the largest civilian hospital ship in the world. Operated by international charity Mercy Ships, Africa Mercy docks in the world’s poorest areas to provide life-saving care for patients in need. Barki shared his experiences with UAB Medicine.

How did you become involved with Mercy Ships?

I heard about Mercy Ships at UAB and was drawn to the idea of a hospital ship. I had been on medical mission trips before, where the work we did was helpful but limited because of the lack of equipment, supplies, medications, etc. With Mercy Ships, we bring a first-world hospital to the people. After residency, I moved to Oklahoma and had the “perfect” life—great job, house, friends, church. I was content for a few years, but I started getting an unsettled feeling in my heart. My wife, Jamie, asked, “Why don’t we volunteer with Mercy Ships?” She was half-kidding, but that planted the seed. I first volunteered with Mercy Ships for a two-week trip to the Republic of the Congo in 2013. I returned with Jamie the next year to get her input about our family doing this. She was all for it, so I quit my job in May 2015. Jamie, our three children, and I have been with Mercy Ships since that time.

As volunteers with Mercy Ships, we do not get a salary. In fact, we have to pay monthly crew fees that cover our room and board. This is in addition to health insurance, plane tickets, etc. We do this because we know God has called us to this work. For us, any other reason to leave family, friends, a great job, and the comforts of home would have been crazy. The patients we serve are often outcasts and treated as modern-day lepers. People won’t have anything to do with them. To make matters worse, they do not have access to affordable, safe surgery. To offer these patients hope and a chance for a new beginning is fulfilling and reminds me why I became a physician. I also love that Mercy Ships continues to expand its Medical Capacity Building program. We usually stay in each country we visit for 10 months at a time, where we help renovate hospitals and train anesthesiologists, nurse anesthetists, surgeons, midwives, nurses, sterilizers, and biomedical technicians.

How did UAB influence you, and how can our readers help?

I am grateful for my time at UAB. Not only did I acquire the knowledge and skills necessary to do something like this, but I was also surrounded by tremendous people. Alumni can help by spreading the word about Mercy Ships. UAB attendings can serve with a resident, and I’d love to see more UAB alumni on board. Dr. Todd Beasley [a 2003 anesthesiology residency alumnus] has already volunteered this year. People can serve on the ship for as few as two weeks. If teaching is your passion, you can come for one week and teach training courses. Interested physicians can learn more at mercyships.org.

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UAB Medicine Fall 2017

ALUMNI PROFILES

HAIL TO THE CHIEF School of Medicine alumnus takes chief of staff reins at BVAMC BY RYAN BROUSSARD

hen Oladipo Kukoyi, M.D., M.S., traveled to Birmingham in 1995 to attend the School of Medicine, he continued the education that nearly eluded him at the University of Lagos College of Medicine in his native Nigeria. In his first year of medical school at the University of Lagos, the professors crammed a year of knowledge and classwork into three months because of the political uncertainty in the country at that time. “I wondered how I would be a doctor since my education kept getting interrupted,” recalls Kukoyi. Nearly 20 years after graduating from the School of Medicine, Kukoyi is back in Birmingham as the new chief of staff for the Birmingham VA Medical Center (BVAMC)—the same place where he trained during medical school. “The BVAMC is one of the highest-performing VA facilities and one of the highest-performing hospitals in the country,” says Kukoyi, who oversees nearly 1,000 employees who treat more than 70,000 veterans. “As a psychiatrist and primary care physician, I can’t think of any better place to practice health care in America than the VA system because everything I could want is encapsulated in our system.” Kukoyi’s experience at the VA is vast. He has been a full-time employee since 2008, with positions that range from chief of mental health for about 18 months at the Wm. Jennings Bryan Dorn VA Medical Center in Columbia, South Carolina, to chief of staff for the past two years at the Charlie Norwood VA Hospital in Augusta, Georgia. “Our mission is noble,” Kukoyi says. “I’m sure I can make more money working elsewhere, but I don’t have to search for meaning in what I do at the VA. Sometimes we as physicians underestimate the value of a noble goal, and the VA provides that.” Charles Green, M.D., FACP, the deputy chief of staff at the Augusta VA hospital, says his former colleague’s administrative knowledge of the VA medical system, interpersonal skills, ability to anticipate trends, and compassion toward veterans make Kukoyi an ideal chief of staff. “He is as genuine and committed as any veteran physician would be,” says Green. Anupam Agarwal, M.D., executive vice dean in the School of Medicine and director of the Division of Nephrology, echoes Green’s sentiments. Agarwal, who was on the selection committee that chose Kukoyi, says Kukoyi stood out from other candidates because of his passion and energy. “He clearly demonstrated leadership,” says Agarwal. “He had a can-do philosophy and was very enthusiastic about his goals.” One of Kukoyi’s goals for the BVAMC is to add doctors and health care providers in dermatology, interventional pain services, and some of the surgical services. Another project Kukoyi is working toward is reviving the family medicine

Oladipo Kukoyi has returned to Birmingham to become chief of staff for the Birmingham VA Medical Center.

residency program in Birmingham. Being a family physician, Kukoyi is interested in getting this program running, and he has had preliminary meetings with Craig Hoesley, M.D., senior associate dean of medical education at the School of Medicine, to discuss reviving the program. Hoesley says he is committed to restoring the family medicine residency program, but adds talks are in their infancy and there are many hurdles to clear before the program returns. “The family medicine training program in Birmingham has been gone for about 20 years, but there is a collaborative group of individuals looking at the feasibility of bringing that back,” he says. Kukoyi is also looking forward to possibly teaching some School of Medicine classes in the future and impacting students the way his mentors did. These include Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine, who was Kukoyi’s attending during his surgery rotation, and George Hand Jr., Ph.D., professor emeritus at UAB, who advocated for Kukoyi’s admission to the School of Medicine. Kukoyi says he is excited to return to the place where he and three of his four siblings earned their degrees. “One of the best times of my life was being roommates with two of my younger brothers while I was in medical school and they were pursuing their undergraduate degrees,” reminisces Kukoyi. “I’m happy to be back at my second home.”

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INVESTING IN INNOVATION

A BONDING EXPERIENCE ‘Easy inspiration’ sparks Medical Properties Trust $2.5 million gift to the UAB Comprehensive Diabetes Center BY EMILY HENAGAN

our Birmingham businessmen didn’t bond over a love of shared hobbies. Instead, they realized their common interest is helping eradicate a disease that affects more than 29 million Americans: diabetes. And for these men, talk wasn’t where it ended. A recent $2.5 million gift from Medical Properties Trust (MPT) to the UAB Comprehensive Diabetes Center (UCDC) that UAB School of Medicine has agreed to match is where it is beginning. MPT’s co-founders Edward Aldag Jr. and Emmett McLean didn’t need convincing from philanthropists David Silverstein and Benny LaRussa Jr. to provide the company gift to the center. “It was an easy inspiration,” says Aldag, CEO and president of the

second-largest owner of hospital beds in the U.S. with a reach that extends to five countries. “We are in the health care business, and diabetes is one of the worst and most prevalent diseases in this country. We heard what Dr. [Anath] Shalev’s team had going on, and it was an easy decision to give this gift.” Their gift will help combat an epidemic in Alabama. “We are in the buckle of the diabetes belt and are typically either the No. 1 or No. 2 in the nation in terms of our diabetes prevalence. This gift addresses an urgent need,” says Shalev, the Nancy R. and Eugene C. Gwaltney Family Endowed Chair in Juvenile Diabetes Research and the director of the UCDC. R. Steven Hamner, MPT’s chief financial officer and co-founder, agrees the gift is vital to advancing progress in the field. The three MPT leaders were also inspired to make this philanthropic donation because two valued employees have Type 1 diabetes, one of whom is Silverstein’s daughter, Sarah Silverstein. “It’s personal to us as a company,” says McLean, MPT’s executive vice president and chief operating officer. “I think our other employees didn’t realize these two have diabetes because they look so healthy, but diabetes is an indiscriminate disease. It would be wonderful if the Medical Properties Trust gift could give those living with diabetes healthier lives.”

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UAB Medicine Fall 2017

Above left: Sarah Silverstein, second from right, was an inspiration behind Medical Properties Trust’s gift to the UAB Comprehensive Diabetes Center. Also pictured, from left to right: Emmett McLean, David Silverstein, and Edward Aldag Jr. Above: Anath Shalev directs the UCDC.

Fathers on a Mission

Providing healthier lives for people with diabetes is a cause Silverstein and LaRussa have championed since their daughters, Sarah Silverstein and Chelsey LaRussa Heslop, were each diagnosed with Type 1 diabetes as children almost 20 years ago. “At the time Sarah was diagnosed, I knew very little about the disease,” admits Silverstein, a principal at Bayer

We are in the buckle of the diabetes belt and are typically either the No. 1 or No. 2 in the nation in terms of our diabetes prevalence. This gift addresses an urgent need.” — ANATH SHALEV

INVESTING IN INNOVATION

Properties Inc., who teared up while talking about his daughter’s fight. “But having a child with a life-threatening disease puts everything into perspective, and I made a commitment to Sarah that I would better understand the disease and do what I could to raise money to find a cure.” Silverstein has lived up to that promise. He and LaRussa initially raised $15 million through private donations and gifts from the Diabetes Trust Fund to establish the UAB Comprehensive Diabetes Center in 2008. “It’s important for people to understand that UAB made an institutional commitment to establish the Comprehensive Diabetes Center, and they didn’t do that randomly,” notes LaRussa, CEO of Sterling Capital Management. “Dr. Shalev and the team she has assembled are world-class, which gives the center immediate credibility. That was one of the mandates David and I had when this all started.”

A World-Class Team

Shalev is passionate about the work she and her team are doing in the field of diabetes. Their research has already shown that the common blood pressure drug verapamil completely reverses diabetes in animal models, and she says this philanthropic donation will enable more advances in the field. “This gift is really broadening the scope of our work and bringing us a major step forward,” she says. Shalev notes the gift will support two key efforts: recruiting new faculty to enhance the center’s robust interdisciplinary research and finding new, noninvasive tools and methods to measure a patient’s functional beta cell mass—an important indicator of disease stage and progression, but also of therapeutic success. “We currently have more than 250 faculty members and about an additional 170 trainees,” says Shalev. “So far, we have developed a very strong collaboration across disciplines and have expanded particularly the area of cardiovascular disease as it relates to diabetic cardiomyopathy. These funds will help increase the number of faculty even further and will allow us to expand

At the time Sarah was diagnosed, I knew very little about diabetes. But having a child with a life-threatening disease puts everything into perspective, and I made a commitment to Sarah that I would better understand the disease and do what I could to raise money to find a cure.” — DAVID SILVERSTEIN

the area of diabetes complications research into other organ systems like the kidney and eye as they relate to diabetic nephropathy and retinopathy and to ultimately improve quality of life.” The second effort involves overcoming a major hurdle in the field of diabetes treatment: finding a reliable measure of functional beta cell mass in humans. Beta cell mass regulation is critically important to understanding diabetes, which is a disease characterized by a near-absolute (Type 1) or relative (Type 2) deficiency in the number of pancreatic beta cells that produce insulin. “Currently, if we want to assess how many functional beta cells an individual has, we have to put them through a rigorous and time-consuming process with multiple blood draws over several hours and then do fancy math that only gives us an estimate of the functional beta cell mass,” says Shalev. “That is obviously not ideal. It is why we’re looking for some easily measurable biomarkers so we can better monitor natural disease progression and, even more importantly, assess the effectiveness of novel treatment approaches that target beta cell loss as the underlying cause of diabetes.”

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The End Goal

Shalev and her team at UAB, as well as Aldag, McLean, Silverstein, and LaRussa agree that everyone in the field of diabetes research is working toward one goal: curing the disease. “When we started this company in 2003, we always had the intent to give back to the communities in which we work,” says Aldag. “Birmingham is where our company is headquartered, and the opportunity for us to give back and be a part of potentially finding a cure for diabetes is truly wonderful.” They are certain UAB will play a major role in ultimately finding a cure for diabetes. “UAB is a highly regarded medical research center throughout the world, and the brightest minds in all the medical fields are right here in Birmingham,” adds LaRussa. “With the collaborative environment at UAB that can ‘crack the code’ toward finding a cure, it makes all the sense in the world to have this center here.”

For more information about giving to the UAB Comprehensive Diabetes Center, contact Erica Hollins at (205) 996-6839 or ehollins@uab.edu.

A PARTY WITH A PURPOSE Lynn and Benny LaRussa Jr. and Susan and David Silverstein recently hosted an event that kicked off a $7.5 million fundraising initiative to support the UAB Comprehensive Diabetes Center by honoring Medical Properties Trust for its generous $2.5 million lead gift. LaRussa and Silverstein hope to raise an additional $2.5 million in private donations to match the Medical Properties Trust gift, and UAB School of Medicine has agreed to invest $2.5 million in resources to support this $7.5 million fundraising initiative.

INVESTING IN INNOVATION

VISION QUEST Endowed chair honors pioneering eye specialist and his wife BY AMY BICKERS

n his 80s, Alston Callahan, M.D., went on an epic sightseeing quest. He walked across Manhattan Island. He swam the Yazoo Canal. He explored Timbuktu. For his 83rd birthday, he visited the North Pole. The following year, he traveled to the South Pole. During his long career, Callahan was dedicated to another kind of quest. He performed reconstructive eye surgery during World War II. He pioneered ophthalmologic plastic surgery and later served as the first chair of the UAB Department of Ophthalmology. In 1963, he founded the Eye Foundation Hospital, the first facility in Alabama dedicated to the care and treatment of the eye. UAB purchased the hospital in 1997, later renaming it the UAB Callahan Eye Hospital. The same year the hospital was purchased, Dr. Callahan—along with his son, Michael Callahan, M.D., Loris Rich, and Charles Kelman, M.D.—founded the Birmingham-based International Retinal Research Foundation. The IRRF is dedicated to furthering research that will someday provide a cure for blinding eye diseases such as age-related macular degeneration. Since 1998, the organization has granted more than $18 million to support scientific research into diseases of the eye. In memory of Dr. Callahan, who passed away in 2005, and his wife, Eivor, who passed away in 2002, the IRRF has committed a gift to establish the Eivor and Alston Callahan, M.D., Endowed Chair in Ophthalmology. “All of us here at the IRRF are excited to endow this chair, not only in Dr. Callahan’s honor but also in honor of his wife and trusted confidant, Eivor, who supplied the support and strength that was needed for such a lifetime of accomplishments,” says IRRF Executive Director Sandra Blackwood. “When I was growing up, the [UAB Callahan Eye Hospital] was my dad’s magnificent obsession. Our whole family life centered around the building of the hospital, which now stands as a brick-and-mortar testament to his passion,” says IRRF President Michael Callahan, M.D., a professor in the UAB Department of Ophthalmology. “I thought—and the board agreed with me—that now was the right time to make an advancement in the march to finding causes and treatments for blinding conditions by funding an endowed chair in his and my mother’s names. There’s nothing they would be more proud of.” Dr. Callahan is credited with raising more than $40 million in his lifetime toward providing eye care to those in need in Alabama. The effects of his and Mrs. Callahan’s personal philanthropy can be seen across Birmingham. They bequeathed a large collection of Asian art to the Birmingham Museum of Art, as well as funding for the museum’s annual

Eivor and Alston “Complex Vision,” (at top) a kinetic Callahan Lecture sculpture by Israeli artist Yaacov Agam, Series, which is but one of the many philanthropic focuses on Asian gifts made by Alston and Eivor Callahan (above, left to right) to UAB art. Dr. Callahan and Birmingham, a tradition that their was also the son, Michael Callahan, continues. driving force behind acquiring “Complex Vision,” a kinetic sculpture by Israeli artist Yaacov Agam that adorns the University Boulevard side of UAB Callahan Eye Hospital. “We are immensely grateful for the longtime support of the IRRF,” says Christopher Girkin, M.D., holder of the EyeSight Foundation of Alabama Endowed Chair of Ophthalmology. “Over the years, it has enabled us to fund an array of innovative research of blinding diseases. Now, the Eivor and Alston Callahan, M.D., Endowed Chair in Ophthalmology will help us attract more world-class researchers to join our nationally ranked program, and will honor the memory of Dr. and Mrs. Callahan for generations of faculty to come.” To support the Department of Ophthalmology or the UAB Callahan Eye Hospital, contact Morgan Quarles at (205) 325-8112 or nmrobinson@uabmc.edu.

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UAB Medicine Fall 2017

INVESTING IN INNOVATION

HONORING LIVES WELL-LIVED ‘Greatest Generation’ parents inspire son’s gift BY VIRGINIA GILBERT-LOFTIN

he story of Fred and Bessie Mae Chestnut is a classic tale of America’s Greatest Generation. Born in 1918 in Orrville, Alabama, as the son of a sawmill worker, Fred Chestnut grew up wherever the work took his father during the Great Depression. After graduating from high school in 1938, he began building public projects around Alabama with the Civilian Conservation Corps, a New Deal program for unemployed, unmarried men. When World War II broke out, he enlisted in the Army Air Corps, serving as a wireless radio operator in India and China for three years. When he returned home, he attended Howard College (now Samford University) on the GI Bill. At Howard, Fred met Bessie Mae McElroy of Cuba, Alabama, who shared his love of learning and deep faith. She completed a year at Southwestern Baptist Theological Seminary in Fort Worth. The couple married in 1951 Below, left to right: David Chestnut is honoring his parents, Fred and Bessie Chetsnut, by establishing a medical student scholarship in their names.

after Fred completed training at New Orleans Baptist Theological Seminary with the goal of returning to China as a missionary. By then, China had closed its border to foreign missionaries, so instead the Chestnuts served rural churches until 1957, when Fred accepted an appointment to teach Biblical studies to seminary students at Selma University, a historically black Baptist college. For the next 33 years, the Chestnuts made Selma their home. They raised two children—David, a highly regarded obstetric anesthesiologist, and Martha, now retired from global professional service company Accenture—who would give them six grandchildren. David Chestnut, M.D., is honoring his parents’ legacy—one of sharing their faith and helping the African-American community in Alabama—by creating an endowed scholarship at the UAB School of Medicine that gives preference to African-American medical students. “I wanted to honor their example,” says Chestnut, a 1978 School of Medicine alumnus, former chair of the UAB Department of Anesthesiology, and now

on the faculty of Vanderbilt University. “They were part of the Greatest Generation—humble backgrounds, a lot of hardship, and called to their work.” When her children were in junior high school, Bessie Mae taught homebound students in Selma. She later drove 100 miles per day to the University of Montevallo to earn her teaching certificate, which she used for 17 years teaching in the Selma public schools until retiring in 1988. Two years later, Fred Chestnut was diagnosed with a terminal illness. “I was on the faculty at the University of Iowa, and I came home to see him as often as possible,” Dr. Chestnut says. To pass the time, Dr. Chestnut read aloud passages from Auburn University historian Wayne Flynt’s Poor But Proud: Alabama’s Poor Whites. “My father and I both knew Wayne Flynt, another Samford graduate. His book and the time we spent together brought out stories that I had not heard before,” Dr. Chestnut recalls. “I knew he’d had to repeat the fourth grade, and I assumed he had failed, though that had never made sense to me because he was a college graduate. “I learned that back in those days, public schools could charge tuition. My father owed $4 for that year’s tuition, and he had to repeat the year because the family could not afford to pay it.” Fred Chestnut passed away in 1990, and Bessie Mae Chestnut died in 2012. In 2007, Dr. Chestnut and his wife, Janet, established the Fred and Bessie Mae Chestnut Endowed Medical Scholarship. They have made additional gifts to the fund through The Campaign for UAB and have also included it in their estate plan. “My parents taught me to give back, starting with the first 10 percent to the church,” he says. “We feel strongly about that and have passed it on to our five children. “My parents taught us to have servant hearts, and they lived that every day.” To support scholarships in the School of Medicine, contact Jessica Brooks Lane at (205) 975-4452 or jblane@uab.edu.

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UAB. He completed his residency and subspecialty training in neuroanesthesia at Mayo Clinic, where he served as a professor in the Department of Anesthesiology until 2006. Bradley Yoder, Ph.D., UAHSF Endowed Chair in Biomedical Research, has been named chair of the Department of Cell, Developmental and Integrative Biology. He will be responsible for the strategic leadership of all aspects of the department’s research and scholarly productivity, space utilization, human resource management, teaching, and Bradley Yoder compliance with School of Medicine and UAB policies. Yoder led the department in an interim capacity since January 1, 2016.

Events, announcements, and achievements in the academic life of the School of Medicine WELCOMING LEADERS David Bedwell, Ph.D., was named the chair of the Department of Biochemistry and Molecular Genetics. He has been leading the department as its interim chair since February 2016. Bedwell was elected a fellow of the American Academy of Microbiology in 2011. He serves on the editorial board of the Journal of Biological Chemistry David Bedwell and previously chaired the Molecular Genetics B and C study sections of the National Institutes of Health. He has reviewed manuscripts for more than 50 scientific publications, including Science, Cell, and Nature. Gustavo Heudebert, M.D., longtime leader of graduate medical education, was named the interim regional dean of the Montgomery Regional Medical Campus of the UAB School of Medicine. Wick Many Jr., M.D., the Virginia Loeb Weil Endowed Professor in Medical Education who has led the Montgomery Regional Campus since Gustavo Heudebert its creation in 2012, will retire from UAB in December. Heudebert became interim dean October 1. Keith A. (Tony) Jones, M.D., has been appointed UAB Medicine’s first chief physician executive and senior associate dean for clinical affairs in the School of Medicine. Jones also serves as president of the Health Services Foundation, the 1,200-member nonprofit physician practice. Jones has been the Alfred Habeeb Professor and Keith A. (Tony) Jones Chair of Anesthesiology and Perioperative Medicine for 11 years. He received a B.S. in microbiology from the University of Alabama and his medical degree from

GLOBAL HOPE This summer, Holly Richter, M.D., Ph.D., J. Marion Sims Endowed Professor of Obstetrics and Gynecology, traveled with Andy Norman, M.D., a retired physician from Vanderbilt University, and Joseph Malek, M.D., a UAB urogynecology fellow, to the Worldwide Fistula Fund’s Danja Fistula Center in Niger to perform surgeries in sub-Saharan Africa on women who have suffered obstetric fistula during childbirth. An estimated 1 million girls and women in the developing world suffer from obstetric fistula. These injuries are caused by prolonged pressure by the fetus, which cuts off blood supply to the pelvic area, typically to the bladder and/or rectum, leaving women incontinent. It can be repaired only by surgical intervention. “Obstetric fistula is a preventable and treatable childbirth injury,” says Richter, director of the UAB Division of Urogynecology and Pelvic Reconstructive Surgery in the Department of Obstetrics and Gynecology. “Treating these women, in many cases, can help them fully recover and build new lives after childbirth injuries.”

Osman Ahmad and a team of medical professionals traveled to Jordan for a medical mission trip.

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Osman Ahmad, M.D., a pediatric gastroenterology fellow, also traveled abroad to provide care to people in need. He joined a team of medical professionals for a medical mission trip, treating more than 2,700 patients at three clinics in urban refugee camps outside of Amman, Jordan. Thousands of Syrian refugees are housed in the camps, which lack the resources to provide adequate medical care.

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that has to change is the culture. We have to help them, accept them, and figure out how to meet their potentials.”

Syrian refugee children were among the patients treated by Ahmad and his colleagues.

Ahmad traveled with volunteers from the Islamic Medical Association of North America, a nonprofit organization based in the U.S., to treat refugees who had existing chronic conditions previously treated by Syrian physicians. Refugees with chronic illnesses—like diabetes, hypertension, and asthma—often struggle to find the appropriate medicine. “Of the many families I met, they were all so grateful for the care we provided them,” Ahmad says. “But I was more thankful for this opportunity to use my medical training to provide basic health care to those who need it most.”

KultureCity fulfills its mission in a variety of ways, including holding workshops at sporting venues or other businesses to teach workers ways to create a more welcoming environment. A Sensory Michele Kong Program, piloted last year in the Children’s of Alabama Emergency Department, encourages clinicians to pay special attention to children who struggle with sensory overload, perhaps by dimming the lights or offering noise-canceling headphones. The organization’s tablet:KULTURE initiative provides tablets such as Kindle Fires or iPads to families with minimally verbal or nonverbal children, which can help them make gains in communication. To learn more, visit kulturecity.org.

ADVANCING MILITARY MEDICINE

‘KULTURE’ OF ACCEPTANCE Associate Professor of Pediatrics and former Dean’s Excellence Award winner Michele Kong, M.D., is the co-founder of KultureCity, a nonprofit dedicated to creating a culture of acceptance for children and others with disabilities. Her work with KultureCity earned her the 2017 Odessa Woolfolk Community Service Award, established by UAB to recognize a faculty member who has rendered outstanding service to the Birmingham community through education, economic development, health care delivery, the arts, social services, human rights, or urban and public affairs. Kong and her husband, Julian Maha, M.D., co-founded KultureCity four years ago after their oldest son, Abram, was diagnosed with autism at age 4. Abram is minimally verbal, Kong says. Despite their medical training, the family soon found themselves isolated within their community. “When you have a special needs child, you’re constantly taking them to therapy and to hospital and doctor visits,” Kong says. “It’s hard to go out for a meal or to an event because it’s not set up for them, and the family deals with the extra burden. “Every child has great potential, and it’s up to us as parents and care providers to help them grow and fill that potential. That’s how KultureCity was born. We thought the main thing

Lt. Col. Benjamin Mitchell, M.D., the commander of an Air Force Special Operations Surgical Team operating out of UAB, was awarded the 2017 Heroes of Military Medicine Award by the Henry M. Jackson Foundation for the Advancement of Military Medicine Inc. Special Operations Surgical Teams (SOSTs) are mobile surgical specialists with advanced medical and tactics training who can deploy to austere or hostile areas to provide surgical support. UAB first became home to a SOST in 2010, allowing the team to work in the hospital’s Level 1 trauma center when not deployed overseas, which helps members hone their skills and build team cohesion. The Heroes of Military Medicine Award is given to active-duty military medical professionals, with one recipient each year from the Army, Navy, and Air Force. The award honors

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Lt. Col. Benjamin Mitchell and his team deployed in support of Operation Inherent Resolve.

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individuals who have distinguished themselves through excellence and selfless dedication to advancing military medicine and enhancing the lives and health of wounded, ill, and injured service members, veterans, and civilians. Mitchell was cited for leadership when the team was posted to an austere location in support of Operation Inherent Resolve, treating multiple patients at a field casualty collection point while undergoing a mortar attack within 250 meters. Operating out of a small concrete house with equipment from their rucksacks, the team was the first to employ a resuscitative procedure called REBOA, a technique used in cases of major bleeding from chest, abdomen, or pelvis injuries. REBOA involves stopping all blood flow temporarily while treating the most traumatic injuries. The team employed REBOA on four patients, all of whom survived. This was the first time the technique was employed by Defense Department personnel outside of a hospital setting.

SENATE SHOUT-OUT Stephen Aller, Ph.D., associate professor in the Department of Pharmacology and Toxicology, was recognized by National Institutes of Health (NIH) Director Francis Collins, M.D., for integrating cryo-electron microscopy (cryo-EM) into his research on membrane protein structure. Aller’s research was cited by Collins as an example of “the transformational power of investing in NIH basic science” at the Senate Appropriations Subcommittee hearing on June 22 discussing the Fiscal Year 2018 NIH budget. Cryo-EM allows scientists to image hundreds of thousands of individual protein molecules and reconstruct a high-resolution (atomic) structure without needing to crystalize the proteins. Image of the structure of a potential It promises to cancer-targeting toxin by cryo-EM, part of revolutionize Stephen Aller’s research. membrane protein structure determination precisely because these types of proteins are exceedingly difficult to crystallize. The technology is being used to greatly accelerate the development of drugs that could cure diseases such as cystic fibrosis. “Trained in both computer science and biology, Stephen plans to transform in fundamental ways how we design and deliver drugs for all kinds of conditions,” said Collins at the hearing.

SCHOLARLY PURSUITS Four third-year medical students from the School of Medicine’s Montgomery Regional Medical Campus presented their scholarly activity at the Student Poster Session at the Naveed Farrukh Annual Scientific Meeting of the Alabama/Mississippi Chapters of the American College of Physicians in June. The posters were selected from abstracts submitted by medical students from the UAB School of Medicine, the University of South Alabama College of Medicine, and the University of Mississippi School of Medicine. The students who presented and the titles of their posters are: Amber Dixon, “Variation in Alabama Brief Cognitive Screener Score in Amnestic and Non-Amnestic Mild Cognitive Impairment with Level of Education;” Michael Ewing, “Cholestatic Liver Failure: Multiple Myeloma in Disguise;” Naveed Farrukh, “So Much More than a Headache,” and Palee Myrex, “A Rare Abdominal Wall Mass.” Farrukh’s poster presentation was chosen as the Best Overall Student Vignette.

AT-THE-SCENE CARE The UAB School of Medicine Tuscaloosa Regional Campus and Tuscaloosa Fire and Rescue Services have partnered to provide a first-of-its-kind in Alabama program that seeks to reduce costly hospital emergency room transports of people with low-emergency conditions. The program is aimed at “low-acuity” patients who might call 911 for back or stomach pain, fever, weakness, or bleeding, which might be treatable at the scene. Under the program, nurse practitioners and social workers (and possibly psychologists) ride with fire department first responders on low-acuity calls and offer treatment at a patient’s location, eliminating the need for an ambulance ride and an ER visit. While care can be delivered at the scene, low-acuity patients have the option of being transported to the hospital if they wish. Nurse practitioners have back-up from physicians, and social workers can ensure that patients have the resources they need and connect them with primary care physicians. Psychologists can offer assistance on managing the nearly 30 percent of low-acuity calls related to mental health.

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AWARDS & ACCOLADES The para-medicine program is modeled after a similar program in Arizona, but the Arizona program does not have a university as a partner. Based on preliminary results from the Arizona program, the medical cost savings for the Tuscaloosa program could be $6 for every $1 invested, says Richard Friend, M.D., co-director of the program and chair of the Tuscaloosa Regional Campus Department of Family, Internal, and Rural Medicine.

Kondal Rao Kyanam Kabir Baig, M.D., assistant professor in the Division of Gastroenterology and Hepatology, joined the editorial board for Gastrointestinal Endoscopy, the primary journal of the American Society of Gastrointestinal Endoscopy.

The para-medicine program is funded with a legislative allocation through Alabama’s Medicaid program and uses Tuscaloosa Regional Medical Campus nurse practitioners and social workers to provide care.

Yogesh Dwivedi, M.D., Elesabeth Ridgely Shook Endowed Professor in the Department of Psychiatry and Behavioral Neurobiology, was appointed chair of the National Institutes of Health’s Pathophysiological Basis of Mental Disorders and Addictions Study Section, Center for Scientific Review.

Contributing writers: Kendra Carter, Sara Davies, Katelyn Howard, Ryan Kraemer, Jason Morris, Alicia Rohan, Bob Shepard

SIMULATION BOOT CAMP On June 27, the Huntsville Regional Medical Campus launched a new orientation component for the 20 interns in family medicine and internal medicine residencies. Roger Smalligan, M.D., MPH, professor of internal medicine and regional dean of the Huntsville campus, in conjunction with Lori Lioce, DNP, of The University of Alabama in Huntsville (UAH) School of Nursing, organized a Simulation Boot Camp to bring together faculty and trainees as an interprofessional health care team to practice dealing with real-life patient scenarios.

Do-Yeon Cho, M.D., the director of Otolaryngology Research and an assistant professor in the Department of Otolaryngology, received the American Rhinologic Society New Investigator Award.

Latesha Elopre, M.D., assistant professor in the Division of Infectious Diseases, and Gregory Payne, M.D., Ph.D., ABIM Fellow in the Tinsley Harrison Internal Medicine Residency Program, received the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program. It is the first time since 2006 a UAB faculty member has received the award, and the first time that two of the 10 national awardees are from UAB. The program works to increase the number of health professions faculty from historically disadvantaged backgrounds. Paul Gamlin, Ph.D., professor in the Department of Ophthalmology, was named chair of the Mechanisms of Sensory, Perceptual and Cognitive Processes Study Section at the Center for Scientific Review, National Institutes of Health. Louis Justement, Ph.D., professor in the Department of Microbiology, has been elected vice president of science policy at the Federation of American Societies for Experimental Biology. Vineeta Kumar, M.D., associate professor in the Division of Nephrology, won the Brewer-Heslin Award for 2017. The award, which was established by former Alabama Gov. Albert Brewer in 2015, recognizes faculty physicians who exemplify the highest ideals of professionalism.

Participants in the orientation Simulation Boot Camp at the Huntsville Regional Medical Campus.

The event took place at UAH’s new multimillion-dollar simulation center and included UAB Huntsville physician faculty and interns, UAH School of Nursing faculty and students, and PharmD faculty and students from the Auburn University Harrison School of Pharmacy. Scenarios included patients with chest pain, delirium, and shortness of breath. Interns also spent time with simulation trainers on rectal exams, pelvic exams, breast exams, and ventilator management. Participants reported that they felt better prepared to begin their new intern responsibilities and felt a real sense of teamwork and camaraderie among the various disciplines. The Simulation Boot Camp will become a regular part of new intern orientation, and increased use of simulation throughout residency training at the Huntsville Campus is being planned.

C. Seth Landefeld, M.D., professor, chair, and holder of the Spencer Chair in Medical Science Leadership in the Department of Medicine, was appointed to the American Board of Internal Medicine. Vladimir Parpura, M.D., Ph.D., professor in the Department of Neurobiology, was elected as a corresponding member of VI Section of Medical Sciences of the Slovenian Academy of Sciences and Arts. Keith Swetz, M.D., M.A., FACP, section chief and medical director of palliative care at the Birmingham VA Medical Center and associate professor in the Division of Gerontology, Geriatrics and Palliative Care at the School of Medicine, has been named editor of the Journal of Palliative Care. Tarak Vasavada, M.D., professor and regional chair of psychiatry at the School of Medicine’s Huntsville Regional Medical Campus, was elected to the American Association of Physicians of Indian Origin’s executive committee. Selwyn Vickers, M.D., FACS, senior vice president for medicine and dean of the School of Medicine, was included in Savoy magazine’s list of Top Influential Black Doctors for 2017.

FROM THE ARCHIVES

THE EVOLUTION OF EXCELLENCE Snapshots from the history of the UAB Department of Neurology COMPILED BY TIM L. PENNYCUFF IMAGES COURTESY OF UAB ARCHIVES

THE HISTORY OF THE DIVISION (now Department) of Neurology was marked by outstanding leadership, talented faculty, and remarkable growth. Here, we honor a few notable figures from the department’s first half-century.

Among the first trained neurologists in the Birmingham area, Wilmot Littlejohn, M.D., was the first director of the Division of Neurology from 1945 until 1967.

Samuel Little, M.D., directed the Division of Neurology from 1967 until 1970. He also led the Medical Center’s Electroencephalography (EEG) laboratory.

Camilo Gomez, M.D., circa 1995. Gomez was director of UAB’s Comprehensive Stroke Center from 1995 until 2003 and a longtime neurology faculty member.

James Halsey Jr., M.D., and John Whitaker, M.D., cut the ribbon for the renovated neurology facilities in Jefferson Tower, 1988. Halsey was the third and last director of the neurology division from 1970 until 1973 and was the first chair of the new Department of Neurology until 1985. Whitaker succeeded Halsey.

John Whitaker, M.D., and Shin Oh, M.D., accept a check from the Alabama Chapter of the Myasthenia Gravis Foundation, 1986. Whitaker was neurology chair from 1985 until his death in 2001, and Oh was director of the Muscular Dystrophy and Myasthenia Gravis Center from 1979 until 2000.

R. Edward Faught, M.D., and staff of the Adult Seizure Clinic mark National Epilepsy Month, 1983. Faught was the interim chair of neurology from 2001 until 2003. He was also the director of the UAB Seizure Clinic and was the founding director of the UAB Epilepsy Center.

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UAB Medicine Fall 2017

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