By Ben Boulden

Oct. 11, 2018 | Hari Eswaran, Ph.D., and his research team are working hard to see if a new generation of technology can improve on a device developed at UAMS while lowering its cost and benefitting pregnant mothers.

In 2000, Eswaran was part of the UAMS team that developed the SARA (SQUID-Array for Reproductive Assessment) device for maternal-fetal medicine research. When the SARA is used, a pregnant woman sits against a concave shield that covers her abdomen.

More than 100 sensors obtain three-dimensional data from the fetus and the uterus – without employing needles or any other invasive instruments. Advanced techniques with the SARA allowed for the simultaneous examination of cardiac and brain activities in the fetuses.

Eswaran, Ph.D., is a professor in the College of Medicine’s Department of Obstetrics and Gynecology.

“The biggest problem with SARA is its cost and maintenance,” Eswaran said. “It requires liquid helium to sustain and run. That prevents a lot of hospitals from buying a system like this, even just for research. It costs about $8,000 a month. The positions are pretty rigid. The sensors are fixed where they are and cannot be moved.”

Along with Curtis Lowery, M.D., Heather Moody, R.N., a certified research specialist, and Diana Escalona-Vargas, Ph.D., Eswaran has been working with QuSpin, a company that has developed a new type of sensor that might be a viable replacement for the original SARA. Lowery is chair of the Department of Obstetrics and Gynecology. Moody and Escalona-Vargas work in the department’s Division of Maternal-Fetal Medicine.

“The new systems that have come along in the last few years do not require any cryogenic helium to operate,” Eswaran said. “They are more flexible and we can move the sensors to be close to the heart based on what the ultrasounds show us the position of the baby is.”

Instead of more than 100 sensors, they have been able to use a grid array of 14 sensors that can be strapped to the mother’s abdomen. Where the original SARA cost almost $2 million to construct, each sensor in what Eswaran and his team are calling ‘SARA 2.0’ costs $8,000 to $10,000, a potentially huge savings.

That savings means the new technology might one day be an affordable diagnostic tool in hospitals for use with pregnant mothers. The cost of the original SARA has meant it has primarily been a research tool, one only available at UAMS and another research facility in Germany.

In late 2017, UAMS received a two-year, $275,000 grant from the National Institutes of Health to study the effectiveness of the new technology and what might be the best position for the mother to get a good signal from the device while also improving her comfort. So far, the reviews from at least one pregnant mother have been positive.

“I find it comfortable,” said Shyanne Chisum, a first-time mother and firefighter. “It eases the belly weight. It’s definitely more comfortable than the old machine, much more comfortable.”

Chisum volunteered for the study about 28 weeks into her pregnancy. When she came to UAMS recently on a September morning for her fourth round of scans, she was at 35 weeks. By volunteering, she also was able to receive 3D and 4D ultrasound imaging of her baby, something she wanted to have.

The research team also has tried using the device while the mother is leaning back in an Adirondack chair. Next, they want to try out a specially built massage table with a cut-out for the pregnant mother’s belly that will allow her to comfortably lie flat and face down while the SARA 2.0 array is strapped in place.

Eswaran said data retrieval for the fetal heart has been strong. Even though the number of sensors has been greatly reduced, the flexibility means the SARA 2.0 sensors can be moved and more precisely targeted for data gathering. Other technologies only can capture the baby’s heart rate, but the SARA can look at the activity in the fetal heart like an electrocardiogram can in an adult.

They’ve yet to examine what kind of data can be gathered in regard to fetal brain activity when compared to the original SARA, but the study will not conclude until summer 2019.

UAMS also directly contributed some funds to the study.

By Linda Haymes

David Bumpass, M.D., an orthopaedic surgeon at the University of Arkansas for Medical Sciences (UAMS), was named one of the nation’s outstanding young spine care providers by the North American Spine Society’s SpineLine magazine in its inaugural “20 Under 40” list honoring spine professionals under the age of 40.

Bumpass, 37, is featured in the September/October 2018 issue. The list, selected by the magazine’s review team, included 21 members following a tie in application scoring.

“Dr. Bumpass is an outstanding member of our department,” said C. Lowry Barnes, M.D., chair of the Department of Orthopaedic Surgery in the UAMS College of Medicine. “He excels in the clinic and operating room and in both basic and clinical research, as well as in educating and mentoring students and residents. He is already a clinical leader and was recently named co-director of the spine clinical services. We are fortunate to have him as our partner, and our state is lucky to have him here.”

Bumpass and the 20 others spotlighted this year were recognized throughout the society’s 33rd Annual Meeting in Los Angeles, Sept. 26-29 with a poster at the magazine’s booth and several tweets throughout the week. More than 3,000 spine professionals from the organization’s 8,000-plus members attended.

In addition to treating adult and pediatric patients, he serves as director of clinical research for the Orthopaedic Surgery Department.

Bumpass also collaborates with local emergency medical services in Little Rock to improve their emergency spine trauma care in the field. The joint effort has strengthened the relationship between physicians and local EMS crews and educated first responders on how physicians treat spinal injuries after patients arrive at the hospital.

“I have been able to learn more about questions and challenges the paramedics face in the field when managing spine trauma,” he said in his “20 Under 40” feature in the magazine. “Our hospital system has worked hard to streamline and improve protocols for spinal trauma management once patients hit the door, identifying delays and improving multi-team care.”

Bumpass was earlier recognized by the society in 2014 with its Young Investigator Translational Research grant for “The Role of Myeloid-Derived Suppressor Cells and T-Lymphocytes in Human Vertebral Metastasis: A Prospective Pilot Study.”

“That enabled me to complete some exciting research in the role of the immune system in facilitating spinal metastasis,” Bumpass said. The $50,000 grant went toward research that is nearly complete.

“The results suggest that there is an under-appreciated role that the immune system plays in allowing the development of metastatic cancer in bone,” Bumpass said, adding that healthy immune cells within the bone seem to be inhibited from preventing cancerous cells from spreading into the bone.

By Linda Haymes

Frits van Rhee, M.D., Ph.D., a myeloma researcher and clinician at the University of Arkansas for Medical Sciences (UAMS), was lead author on a recently published paper that for the first time establishes treatment guidelines for patients with a form of Castleman disease, a rare disorder of the lymph nodes and related tissues.

The guidelines are designed to improve outcomes in patients with a severe form of the disease called idiopathic multicentric Castleman disease (iMCD). It affects multiple lymph node areas and can cause night sweats, fevers, weight loss, anemia and in severe cases organ failure and death.

“Treatment is challenging and outcomes can be poor since no uniform treatment guidelines exist, few systematic studies have been conducted and no agreed upon response criteria have been described, according to the paper published online Sept. 4 in Blood, the journal of American Society of Hematology.
“International, Evidence-based Consensus Treatment Guidelines for Idiopathic Multicentric Castleman Disease” includes research and input from van Rhee and 41 other specialists, researchers, and clinicians from 10 countries.

“These guidelines are important because patients are at significant risk of death,” said van Rhee, director of clinical affairs of the UAMS Myeloma Center. “Until now, physicians have not agreed on the criteria for response to treatment of the disease.”

Van Rhee is regarded as an international expert on Castleman disease. He is professor of medicine and holds the Charles and Clydene Scharlau Chair for Hematologic Malignancies Research.

iMCD has been treated with a wide variety of agents, including corticosteroids and chemotherapies. But many patients, especially those with a severe form of the disease, do not benefit from some of these treatments.

The guidelines should assist physicians with selecting therapy and evaluating the response, thereby improving patient outcomes. Most recommendations were reached by consensus of the expert panel. They based the guidelines on published literature, review of treatment effectiveness in 344 cases, and expert opinion. They gathered through coordinated meetings of the Castleman Disease Collaborative Network, which van Rhee cofounded in 2012 with his patient David Fajgenbaum, M.D.

Other UAMS researchers who helped with the project are Katie Stone, director of the Myeloma Immunotherapy Lab, and Amy Greenway, research associate with the Myeloma Immunotherapy Lab. Contributors hail from across the United States and Canada, the United Kingdom, Germany, Italy, France, Japan, Hong Kong, Norway and New Zealand.

“The average oncologist may only see one patient with Castleman disease in his career,” said van Rhee. “A lot of progress has been made in the treatment of this disease and a lot of new information is available.”
An international registry for patients with Castleman disease was established in October 2016 to collect patient outcomes to increase the evidence base for selection of future therapies.

Castleman disease occurs when an abnormal overgrowth of cells occurs in the lymph system, which serves as the main part of the body’s immune system. The disease, affecting 5,000 to 6,000 patients across the nation, was identified by Benjamin Castleman, M.D., in 1954.

Van Rhee was previously the principal investigator on a worldwide trial with siltuximab, which led to the first FDA-approved treatment for multicentric Castleman disease and led to the approval of the drug by the European Medicine Agency. Earlier this year, he released a book, Castleman Disease, as part of the Hematology/Oncology Clinics of North America series of clinics review articles published bimonthly by Elsevier Inc. Van Rhee wrote the chapter, “Treatment of Idiopathic Castleman Disease” along with Green, his research associate, and Stone, his lab director.

By Susan Van Dusen

Oct. 2, 2018 | Arkansas’ children have a healthier tomorrow before them, after the University of Arkansas for Medical Sciences (UAMS) and Arkansas Children’s today signed updated research collaborative and affiliation agreements.

The agreements, which take effect Oct. 1, continue the strategic partnership of the state’s only medical university and the state’s only children’s health system.

UAMS Chancellor Cam Patterson, MD, MBA, and Arkansas Children’s President & CEO Marcy Doderer, FACHE, called the agreements “a vital step and the next milestone” in the more than 40-year relationship of the two institutions. The two describe the agreements as enhanced strategic partnerships between UAMS and Arkansas Children’s.

The institutions agreed last year to explore a closer relationship. The agreements announced today have met the due diligence and regulatory approvals of both institutions.

“The 720,000 children of Arkansas are at the center of every decision we make at Arkansas Children’s, and never more so than today,” Doderer said. “These updated agreements empower us and our strategic partner to continue blanketing the state with pediatric services aimed at improving the health of children where they live, learn and play.”

“The affiliation between our two institutions is good for Arkansas Children’s and UAMS but most importantly for children all across our state,” said Patterson. By working together, UAMS and Arkansas Children’s are able to provide better health and health care for the youngest Arkansans who are at the heart of everything we do.”

“UAMS brings a comprehensive team of physicians to Arkansas Children’s that represent all specialties across the spectrum of medicine,” said Christopher T. Westfall, MD, FACS. “Because our physicians have an academic interest in research and education, they are teaching and providing the latest treatments and techniques.”

The updated agreements aim to provide high level care to children and young adults, integrate pediatric research activities and continue to advance leading pediatric clinical care and academic programs with national recognition, attract and retain top staff, and improve operating performance.

“We look forward to empowering the faculty, researchers and staff who serve children every day to make their highest and best contribution at every point of care,” said Arkansas Children’s Executive Vice President & Chief Operating Officer Chanda Chacon, MPH, FACHE. “The people of Arkansas have come to expect the very best for their children. We are poised to continue to deliver just that.”

By Benjamin Waldrum

Seth Berney, M.D., chief of the Division of Rheumatology in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS), was invested Sept. 25 as the inaugural professor of the Eleanor A. Lipsmeyer Professorship in Rheumatology.

Berney, who also is director of the UAMS rheumatology fellowship program, has more than 20 years of experience as a researcher and teacher, for which he has received numerous awards. Since joining UAMS in 2014, he has made it his goal to develop one of the premier rheumatology training programs in the country.

“Seth Berney embodies the full spectrum of our mission at UAMS as an accomplished teacher, researcher and clinician, and that makes him an ideal choice for this professorship,” said UAMS Chancellor Cam Patterson, M.D., MBA. “It is vital that we continue the legacy of Dr. Lipsmeyer, who helped train countless rheumatologists in the state of Arkansas, and this professorship will ensure that we do just that.”

An endowed professorship is among the highest academic honors a university can bestow on a faculty member. A professorship is a $500,000 endowment established to support the educational, research and clinical activities of its holder, who will lead future innovations in medicine and health care. Those named to a professorship are among the most highly regarded scientists, physicians and professors in their fields of expertise.

“Our students and trainees, and ultimately the patients they will care for, as well as the patients who come here to UAMS, are all very fortunate to have Dr. Berney’s leadership in rheumatology,” said Christopher T. Westfall, M.D., dean of the College of Medicine. “This professorship will help to carry on the distinguished legacy of Dr. Lipsmeyer for generations to come.”

The newly established professorship honors Lipsmeyer, a physician and beloved faculty member and teacher in the Division of Rheumatology. Lipsmeyer received her medical degree from UAMS in 1962 and stayed for her residency in internal medicine. After completing her training at Yale University, she returned to UAMS in 1969, joining the faculty as assistant professor. Over the next five decades, she was promoted through the academic ranks, serving as professor until her retirement in 2015.

Lipsmeyer earned high praise from patients, being recognized repeatedly as one of Arkansas’ best rheumatologists, and was voted one of America’s Best Doctors. UAMS College of Medicine seniors awarded her the distinguished and highly coveted Red Sash Award for excellence in teaching 18 times.

Berney was presented with a commemorative medallion by Patterson and Westfall. He recognized Lipsmeyer, who was in attendance, and thanked those present.

“This award is a demonstration of the admiration and love that the UAMS community has for Dr. Lipsmeyer, and I am glad she attended this ceremony today,” Berney said. “I am honored and humbled by this endowed professorship. I will endeavor to maintain the educational, inspirational and clinical excellence that Dr. Lipsmeyer has represented.”

Under Berney, the fellowship training program has improved significantly, resulting in higher rheumatology in-service exam scores, and the Division of Rheumatology is increasing its research capabilities and attracting clinical therapeutic trials.

Berney received his medical degree from Temple University School of Medicine and completed his postgraduate training at the University of Alabama at Birmingham and New York University. He joined the faculty at Louisiana State University Health Sciences Center-Shreveport in 1995 as assistant professor of medicine, and served successively as rheumatology fellowship director, internal medicine clerkship director, director of the student musculoskeletal “Core Concepts in the Clinical Sciences” course, chair of the institution’s promotion and tenure committee, chief of the Division of Rheumatology and director of the Center of Excellence for Arthritis and Rheumatology.

Berney has served as a national council member and Southern Region president for the American Federation for Medical Research, rheumatology section editor for the Year Book of Medicine, rheumatology section lecturer for the MedStudy Internal Medicine Board Review Course, and a member of the American College of Rheumatology Research Awards & Grants Study Section B. He serves on the Alliance for Academic Internal Medicine education committee and faculty development subcommittee, and the American College of Rheumatology annual meeting committee.

Berney has received numerous teaching awards, including the American College of Rheumatology Clinician Scholar Educator Award and the Dr. Allen A. Copping Award for Excellence in Teaching Clinical Science. At Louisiana State University Health Sciences Center-Shreveport, he received multiple Clarence H. Webb Awards for Outstanding Clinical Science Instructor, and several selections as the sophomore class Arnold P. Gold Foundation White Coat Ceremony Speaker and graduation marshal. He is a member of the Alpha Omega Alpha Medical Honor Society and has been named to the Best Doctors in America every year since 2005.

By Amy Widner

Have the COBRE programs at UAMS and ACRI reached critical mass and can now benefit the entire campus research community?

Mark Smeltzer, Ph.D., certainly thinks so. There are now six active Centers of Biomedical Research Excellence (COBRE) grants from the National Institutes of Health (NIH) at UAMS and the Arkansas Children’s Research Institute (ACRI). That translates to about $11.5 million a year in research funding.

Each COBRE is built around a theme. Junior investigators working on the theme benefit from funding, mentoring, technical support, technology and an environment that encourages collaboration. Participants are more likely to obtain independent federal funding, “graduating” from the COBRE and opening a spot for the next junior researcher to benefit. Over time, an institution develops clusters of expert faculty supported by the necessary technology to be leaders in their field.

But Smeltzer — who is director of one of the more longstanding COBRE programs at UAMS, the Center for Microbial Pathogenesis and Host Inflammatory Responses — thinks the centers can do even more.

“We can integrate the efforts of each program to enhance the overall research infrastructure on our campuses,” Smeltzer said. “We can be better than the sum of our parts, but to realize that potential will require us to be proactive in promoting communication and integration across individual COBRE programs as they grow and develop.”

As a step in that direction, the COBREs took center stage at the Showcase of Medical Discoveries in September. Organized by the office of Vice Chancellor for Research Lawrence Cornett, Ph.D., and supported by UAMS College of Medicine Dean Christopher T. Westfall, M.D., the showcase is an opportunity for faculty to share their work in a social setting.

Attendees packed into the 10th floor of the Winthrop P. Rockefeller Cancer Institute for one of the most-well-attended showcases to date. They were met with posters and representatives for each COBRE and additional support programs.

The COBREs are:

• The Center for Translational Neuroscience; Edgar Garcia-Rill, Ph.D.; $22.5 million; third and final phase.
• The Center for Microbial Pathogenesis and Host Inflammatory Responses; Mark Smeltzer, Ph.D.; $21 million; Phase II.
• The Center for Studies of Host Response to Cancer Therapy; Martin Hauer-Jensen, M.D., Ph.D.; $10.5 million; Phase I.
• The Center for Childhood Obesity Prevention; Judith Weber, Ph.D.; $9.4 million; Phase I.
• The Center for Translational Pediatric Research; Alan Tackett, Ph.D.; $11.5 million; Phase I.
• The Center for Musculoskeletal Disease Research; Charles A. O’Brien, Ph.D.; $11.3 million; Phase I.

Each of the COBREs is associated with concentrations of technology known as “cores,” available to researchers whether they are associated with a COBRE or not. These include:

• Flow Cytometry Core
• DNA Sequencing Core
• Irradiation and Animal Core
• Genomics Core
• Experimental Pathology Core
• Tissue Biorepository and Procurement Service
• Brain Imaging Research Center
• Bioanalytical Core
• Digital Microscopy Core
• Ultrasound Imaging Core
• Proteomics Core
• Molecular Imaging Core
• Science Communications Core
• Genetic Models Core

“With the showcase, we hope to provide an opportunity for investigators associated with each program to become better acquainted with investigators associated with other programs and with the technical resources these collective programs have to offer,” Smeltzer said. “We hope this exposure extends beyond the programs themselves to include additional investigators at UAMS and ACRI.”

What’s more, the showcase highlighted efforts to provide resources of interest to all investigators. For example, Mary Aitken, M.D., M.P.H., and the Translational Research Institute are developing a Fundamentals in Research seminar beginning in December that will focus on issues like scientific career advancement, grant writing and management, and leadership skills building. For more information, contact Nia Indelicato at nlindelicato@uams.edu  or visit the TRI website.

“The COBRE programs at UAMS and ACRI are having exactly the impact the NIH intends for them to have to build up the environment for quality research and innovative science,” Cornett said. “It is obvious with events like the showcase that the COBREs have created many graduated investigators with independent funding of their own and many collaborative partnerships that never would have taken place. The COBREs have concentrated expertise and technology on our campus in a way that benefits everyone.”

By Amy Widner

The University of Arkansas for Medical Sciences (UAMS) has received a $1.27 million science education research grant to teach Little Rock School District students about STEM careers and cardiovascular health using handheld ultrasound devices and other interactive technology.

The five-year Science Education Partnership Award (SEPA) comes from the National Institute of General Medical Sciences, part of the National Institutes of Health.

The program is a partnership with the Little Rock School District and will include activities at both institutions. UAMS faculty will bring programs to ninth-grade physical science classes in the district. The UAMS campus will also host week-long summer camps each year of the grant, and some students will be invited back in subsequent years to deepen their engagement with science by becoming members of the camp staff.

The project’s overall aim is not only to teach individual students about science, technology, engineering and math (STEM), but to research the most effective ways to inspire students to pursue STEM careers.

“UAMS’ mission as the state’s only health sciences university expands beyond its walls and out into the community,” said Christopher T. Westfall, M.D., dean of the College of Medicine. “Educational outreach is needed in a state like Arkansas, where we are challenged by racial, ethnic and socioeconomic health disparities, as well as growing shortages of health care professionals. We must develop new and innovative methods for cultivating a larger, more diverse, and culturally competent health care workforce.”

Kevin D. Phelan, Ph.D., co-director of the Division of Clinical Anatomy in the UAMS

College of Medicine, is leading the program, which is called ArkanSONO. In the high school science classrooms, UAMS faculty will use real medical-grade handheld ultrasound devices to teach basics about the physics of sound, how ultrasounds work and how they are used in various STEM fields, including medicine, biomedical research and industry.

“It’s a novel approach that has a bit of a ‘wow’ factor with students,” Phelan said. “They get to see blood vessels expanding or contracting in real time, or see tendons moving under the skin. We all had a favorite teacher, or can think back to an exciting educational experience that sparked our interest and propelled us to our futures. We’re hoping that for some of these students, this can be that experience for them.”

Phelan conducted a pilot study in spring 2017 at four of the five high schools in the district.

“Teachers said the students were talking about it for weeks afterward,” Phelan said. “We’re excited about seeing what additional interest in STEM we can generate by having some of these students attend summer camps at UAMS, where they build on what they learn in the classroom.”

“We are grateful to UAMS for this significant investment in our students and for this tremendous partnership,” said Little Rock School District Superintendent Mike Poore. “Our students need these types of hands-on, relevant experiences to learn about STEM and associated careers. It’s clear that most of the jobs of the future will require science and math, so exposure to STEM education today will prepare our students to become the next generation of great innovators.”

During the classroom visits, students will also be able to interact with smaller versions of UAMS’ Sectra Table, a virtual dissection tool that allows students to explore human anatomy in 3D with simple gestures similar to those on a smartphone. By the end of the classroom series, the students will use the ultrasounds to conduct their own experiments, using critical thinking and the scientific process to predict how the ultrasounds will interact with common objects.

At SONOcamp, students will be able to use the ultrasounds on “standardized patients” — actors who portray patients for teaching purposes — so that they can explore the heart. They will learn about cardiovascular health, including the importance of exercise, a healthy diet and refraining from smoking.

Students will interact with role models and mentors from a variety of STEM fields as well as current UAMS students from diverse backgrounds. Participants will put what they’ve learned to the test at the SONOlympics, during which they will use many of the real-life ultrasound skills they’ve learned to solve problems and complete tasks.

Phelan is joined in administering the grant, program and accompanying research by Gregory Snead, M.D., chief of the Division of Emergency Medicine Ultrasound in the UAMS College of Medicine Department of Emergency Medicine; Billy R. Thomas, M.D., UAMS’ vice chancellor for diversity and inclusion; Noor Akhter, Ph.D., and Mohsin M. Syed, Ph.D., both assistant professors in the UAMS College of Medicine Department of Neurobiology and Developmental Sciences; and Karen Yanowitz, Ph.D., professor in the Arkansas State University Department of Psychology and Counseling.

This is the fourth time UAMS has earned the prestigious SEPA funding. Robert Burns, Ph.D., administered the UAMS Partners in Health Sciences Program from 1997-2000. It was funded for a second phase from 2000-2004. In that time, the program brought in millions in grant funding and provided outreach to Pre-K-12 teachers from across the state, giving them science curricula and high-quality teaching tools to take back to their classrooms. In addition, Teresa Kramer, Ph.D., and JoAnn Kirchner, M.D., led the Partners in Behavioral Health Science SEPA program from 2000-2005.

For more information about ArkanSONO and for ideas for using ultrasounds to teach science, find ArkanSONO on the UAMS College of Medicine Department of Neurobiology website —  or follow @ArkanSONO on Twitter.