March 2, 2020 | Incarcerated women who are new breastfeeding moms at the J. Aaron Hawkins Sr. Center in Wrightsville, Arkansas, will have access to over 200 pounds of breastfeeding supplies recently donated by Medela, a leading manufacturer of breast pumps in the United States.

The donation came about through UAMS’ partnership with the Hawkins’ Growing Together program. Growing Together was formed to support the needs of incarcerated pregnant and postpartum women in Arkansas. It includes a lactation program, prenatal education classes, and a mental health support group. Childbirth support will launch soon as part of a pilot grant provided by UAMS’ Translational Research Institute.

Marybeth Curtis, B.S.N., a nurse educator in the UAMS College of Medicine Department of Family and Preventive Medicine, saw the need for breastfeeding supplies and contacted Medela.

Medela gave hospital-grade breast pumps, storage bags, maternity and nursing shirts, lanolin, and other products to the new breastfeeding initiative. The items were donated through Hope Rises, a Little Rock non-profit that offers services to women impacted by addiction, trauma and incarceration.

Annemarie McGahagan, SPAN nutrition coordinator at UAMS, is breastfeeding coordinator for the CDC State Physical Activity and Nutrition grant that helps support Growing Together.

“When Annemarie shared with me the need for breast pumps and supplies for the Growing Together program, my first response was to reach out to Medela,” said Curtis. “I have always been amazed at their generosity. I have learned that acts of charity are waiting all around us once you make the need known.”

Melissa Zielinski, Ph.D., a clinical psychologist in the UAMS College of Medicine’s Department of Psychiatry and Behavioral Sciences, spearheads UAMS’ involvement with Growing Together.

“Gender-responsive programs like Growing Together are critical. Many people don’t realize that over 75% of incarcerated women are of childbearing age and about 4% are pregnant at intake to prison. Few prisons have specialty services available to meet incarcerated pregnant women’s needs. It will take time, but we are working toward that goal,” said Zielinski.

All pregnant women at the Hawkins Unit receive their routine pre- and postnatal care and deliver their babies at UAMS.

Other groups have joined in the Growing Together initiative: UAMS lactation specialists, the Department of Family and Preventive Medicine, doctoral-level psychology student interns from UAMS and the University of Central Arkansas who co-lead mental health support groups, retired RNs with the Presbyterian Women USA who teach prenatal classes for the women, and one volunteer who offered to sew lactation capes for the women who would like to use them when breastfeeding during visitation.

For more information, contact Zielinski at mjzielinski@uams.edu.

For the past four years, second-year medical students in the UAMS College of Medicine have called on students in the class behind them to pay it forward as they learn about blood cancers and other diseases that can make a bone marrow transplant a lifesaver.

Year after year, COM freshmen have delivered.

Sophomore Madison Caldwell organized the fourth-annual bone marrow registry drive for freshmen as first-year students completed their hematology/oncology course on Feb. 5. Her classmates Cole Howie, Emily Lorince and Elliot Taylor assisted, helping to distribute the paperwork and sterile swabs students used to collect their own saliva samples.

“Many blood disorders and blood-associated malignancies require bone marrow transplant for treatment, and sometimes bone marrow transplants can be curative for these diseases,” Caldwell explained after the drive. “However, because of our diverse gene pool, it can be difficult to find a match for a patient’s bone marrow. The more people who register to donate bone marrow, the more likely it is that these patients will be able to find a match.”

In fact, at least three UAMS medical students have gone on to donate life-saving bone marrow after registering in drives on campus or elsewhere in previous years.

“The M1s (freshmen) are best able to grasp the importance of bone marrow transplant as they learn about hematology-oncology, which is why we hold the annual registration drive for them,” she said. “I volunteered to lead this year’s drive because I discovered how important bone marrow transplants and the registry are as an M1. This is also a great way to get involved with the M1 class.”

There’s no doubt the tradition will continue. Freshman Chelsea Smith lent a hand this year and plans to lead the drive for next year’s M1s. For her, the opportunity to help future blood cancer patients is personal.

“I had acute lymphoblastic leukemia as a kid, and even though I didn’t need a bone marrow transplant, I saw the difference they made in the lives of other cancer patients,” Smith said. “Experiencing these situations firsthand is very impactful and life-changing.

“We can easily become desensitized to leukemia and lymphoma when studying these diseases academically, and I hope that registering and potentially volunteering to donate bone marrow made leukemia and lymphoma a bit more personally relevant to the med student community. I loved seeing so much participation from my class.”

More than 50 students registered during the drive, and students noted that many other classmates had actually registered at previous drives while in college or through other opportunities.

“I registered at UCA (University of Central Arkansas) four years ago,” freshman Kelley Broadbent said as she kept classmate Austin Squires company while he swabbed the inside of his cheek to collect a sample. “Like many others, I have had a personal impact with cancer, an aunt who struggled and wasn’t able to get a bone marrow transplant,” Broadbent said. “It’s important to be that person who makes a difference for someone else if you can.”

Squires agreed. “This is a chance to potentially help someone with a serious illness, and registering and donating if you match is not that big of a deal,” he said. “If you can save a life, that is pretty cool.”

The UAMS drives were coordinated through DKMS, an international nonprofit bone marrow donor center affiliated with the National Bone Marrow Donor Program.

By Yavonda Chase

TED talks focus on “ideas worth spreading.”

That philosophy was on display Feb. 7 as UAMS held its first ever TEDx talks in its Jackson T. Stephens Spine & Neurosciences Institute.

Nearly 200 people in the audience and another 100 people at simulcast locations eagerly awaited the 10 Team UAMS members who took the stage to tackle a wide variety of issues including physician burnout, mental health, abuse, the power of social media in medicine and more.

“TEDxUAMS was an amazing success, and one I hope we can replicate soon,” said Chancellor Cam Patterson, M.D., MBA. “Months of hard work went into putting on an event of this magnitude, and I want to applaud Organizational Development’s Lisa Wymer and Shelby Fray for spearheading a multi-departmental effort that included Classroom Technology, Communications & Marketing and Campus Operations.”

Wymer said she wanted to bring TEDx to UAMS “because events like these bring people together and spark collaboration and innovation.”

The 10 speakers were selected during an audition process in October. Since then, Wymer and Fray have been working with each speaker to refine their presentation.

“The topics presented by our speakers were purposely varied in subject but also deliberately personal,” said Wymer. “I hope TEDxUAMS felt like a celebration of our team — the innovators, the survivors, the ‘outside of the box’ thinkers — basically a celebration of everything that makes UAMS great.”

Kicking off the presentations was Paulette Mehta, M.D., MPH, professor of hematology and oncology, as she shared how she uses poetry to stay emotionally healthy when treating cancer patients.

She noted that just as patients experience psychological distress on their cancer journey, so do their physicians. Expressive writing helps relieve some of that distress, she said before sharing excerpts from her poetry.

Tiffany Haynes, Ph.D., an assistant professor in the Fay W. Boozman College of Public Health’s Behavior and Health Education Department, tackled the issue of mental health in the United States. She wanted to make sure the audience knew that “It’s OK to Not Be OK,” so she wore the motto emblazoned across her white T-shirt.

“Too often we look at mental health through a window instead of a mirror. We see other people’s problems but not our own,” she said. “We need mental health to become about us for a change to happen.”

Wendy Ward, Ph.D., director of interprofessional faculty development in the UAMS Office of Interprofessional Education, took the stage as a patient instead of a health care expert.

Her recent shoulder surgery reinforced her belief that team-based health care provides the best health care, she said, noting that even though she had an amazing surgical and occupational therapy team, there was something missing. Other professionals, including a clinical pharmacist to help manage her pain and a psychologist to help with her fears of never being normal again, were needed on her team for her to really have the best care possible.

She encouraged other patients to advocate for a team-based approach with their care.

“We need team-based health care because we are whole people,” she said.  “The future of health care is team-based care, and we deserve the future now.”

Closing out the morning session was Amber Booth-McCoy, senior diversity specialist in the Division of Diversity, Equity and Inclusion. Booth-McCoy welcomed the crowd to her funeral and read her obituary as she explained how she was killed by kindness and colorblindness.

“I am not just an African American woman, but being an African American woman shapes how I move through the world,” she said. “When someone tells me ’they don’t see color,’ they are devaluing my life experiences.”

She shared a story about a 7-year-old African American boy in one of UAMS’ summer camps who has already internalized fear. During preparations to celebrate the end of the camp with water balloons and water guns at a local splash pad, he asked her if she had told the police they were going to have water guns at the park.

She discussed her fear that childish pranks could result in injury or death for her 14-year-old son and his friends. She stressed that this constant fear is a very real part of her life.

“Kind and colorblind is killing millions around the world. The cure is intentional inclusivity,” she said.

After a break for lunch, Jennifer Hunt, M.D., M.Ed., chair of the Department of Pathology in the College of Medicine and the Aubrey J. Hough Endowed Professor of Pathology, tackled imposter syndrome, or self underappreciation syndrome, which affects 70% of women and 50% of men.

She confessed she has an internal mean girl, named Alice, who belittles her and tries to make her feel she isn’t worthy.

“Alice is holding women back and contributing to the gender leadership gap,” Hunt asserted.

Hunt challenged the audience to ask themselves three important questions: 1) Who is your Alice? 2) What is she keeping you from doing? and 3) What would you accomplish if you stuffed her in the trunk?

Kimberly Jones, who works with UAMS Northwest Community Health & Research, shared with the crowd the story of her childhood abuse. She warned the audience that so often we focus on the so-called “signs of abuse” that we miss other types of abuse that don’t come with bruises.

Over two years when she was a young teenager, her mother and grandfather died, her father was emotionally abusive and she was raped twice. Through all that, no one ever noticed.

“I didn’t look abused, so no one ever reached out,” she said, adding that she was so ashamed of what was happening she certainly didn’t reach out to anyone for help.

Jones was one of several speakers to receive a standing ovation for her presentation.

Erick Messias, M.D., Ph.D., M.P.H., the College of Medicine’s associate dean for Faculty Affairs, tackled physician burnout in his presentation. He recounted the death of a friend and colleague on Oct. 7, 2013, to suicide — a death in which burnout played a role.

For Messias, who is also a professor of psychiatry, meaningful work is a solution to burnout. Finding meaning in one’s work brings with it a sense of belonging and a sense of purpose, he said. It often requires reframing our internal storytelling from one that is negative (I have PTSD) to one that is redemptive (I am growing from the traumas in my life). Ultimately, finding meaning in one’s work brings with it transcendence, or a sense that you are connected to something bigger than you, he said.

Kevin Ryan, J.D., an associate professor for Health Policy and Management and associate dean for Student and Alumni Affairs in the Fay W. Boozman College of Public Health, pushed the audience a bit out of their comfort zones, challenging them to admit that “Anti-Vaxxers Love Their Children Too.”

While stressing that he is a firm believer in the benefit of vaccines to prevent disease, Ryan said the villainization of those who don’t vaccinate their children hasn’t been helpful.

“Anti-vaxxers are trying to protect the health and well-being of their children the best way they know how,” he said. “Instead of demonizing them, we need to learn how to talk to each other so that we can educate them on the benefits of vaccination.”

Joe Thompson, M.D., M.P.H., president and CEO of the Arkansas Center for Health Improvement, urged listeners to make good investments in their personal health by exercising and eating healthy foods.

“We all want to live well and die fast,” he said. “These days we are living longer, but our last decades aren’t necessarily healthy ones.”

As people age, he encouraged them to ask the important “what if” questions. He touted three steps for planning for one’s later years: 1) Create a single-page medical history that lists all of your diagnoses and medications; 2) talk about the end of life you want and create an advanced directive that reflects your wishes; and 3) make copies of that document to keep in easily accessible places and give to your friends and family.

The final presenter was Jerad Gardner, M.D., an associate professor of pathology and dermatology who has a sizable social media following. His talk “Facebook and Rare Cancer Changed My Life,” discussed how joining a rare cancer support group on Facebook changed the course of his career.

“The first time I answered a question in the group, they embraced me,” he said. “They said I was the first doctor to join the group and try to educate them.

“Knowing how much it means to those patients to better understand their disease put a fire in my soul to do more. I may be exhausted and tired, but I’m not burned out. I know my job has meaning.”

He encouraged other physicians to use social media to reach their patients and predicted that Facebook groups are going to change how rare diseases are treated.

Throughout the day, videos of earlier TED talks from around the world were shown, often expanding on themes being discussed by the UAMS speakers.

Audience members said they were wowed by the day’s presentations.

“My favorite part of the day was finding out that all of these ideas are right here at UAMS,” said Mande Corbett, coordinator for Stocked & Reddie, the UAMS food pantry. “Dr. Messias’ burnout talk really resonated with me. I find meaning in what I do, but my intensity level can get off balance. It was a good reminder for me to check myself.”

Claudia Carberry, a registered dietitian and member of the kidney transplant team, said she really appreciated the health care focus of so many of the presentations.

“Collectively, the speakers gave us ideas on how to prevent burnout, and do our jobs in a caring and compassionate way.”

The presentations are being edited, Wymer said. Once that process is completed, they will be uploaded to the TEDx YouTube channel to be curated by TEDx.

By Benjamin Waldrum

Scott Dickson, M.D., residency program director for the University of Arkansas for Medical Sciences (UAMS) Northeast Regional Campus, was invested Feb. 6 in the Arkansas Blue Cross and Blue Shield, George K. Mitchell, M.D., Endowed Chair in Primary Care.

“My words really can’t express my gratitude and my deep appreciation for this recognition today,” said Dickson. “I feel very undeserving of such a high academic honor, particularly to follow in the footsteps of such outstanding physicians as Dr. George Mitchell and Dr. Mark Jansen. I feel so very privileged to be a part of the UAMS family, and particularly to be able to work with all of the caring and compassionate members at the UAMS Northeast Regional Campus.”

Dickson, who joined UAMS in 2001, is an assistant professor in the Department of Family and Preventive Medicine in the UAMS College of Medicine. He is also chief of staff at St. Bernards Medical Center in Jonesboro.

Dickson has worked to develop clinical programs for medication reconciliation, which aims to create the most accurate list possible of all medications a patient is taking. By providing drug name, dosage, frequency and route information from the patient, physicians can compare it to their own records and ensure they provide correct medications to patient at all transition points within the hospital. This helps prevent harm from medications and remains a top safety priority for patient care.

An endowed chair is among the highest academic honors a university can bestow on a faculty member. A chair is established with gifts of at least $1 million, which are invested and the interest proceeds used to support the educational, research and clinical activities of the chair holder. Those named to a chair are among the most highly regarded scientists, physicians and professors in their fields.

“Scott Dickson exemplifies the ideal hometown physician: knowledgeable, compassionate and hard-working,” said UAMS Chancellor Cam Patterson, M.D., MBA. “He has continued a tradition of excellence in northeast Arkansas for quality primary care and built a strong residency program that is an example for the rest of the state. We are extremely proud of his contributions to patient care and education.”

“This partnership between UAMS and Arkansas Blue Cross and Blue Shield has been vibrant and extremely positive for our citizens,” said Stephanie Gardner, Pharm.D., Ed.D., UAMS senior vice chancellor for academic affairs, provost and chief strategy officer. “We’re grateful first for their investment in primary care, and we’re thankful for their longstanding support of our institution, our faculty, our students and our state.”

The chair was established with a $1 million grant to UAMS in 2015 from Arkansas Blue Cross and Blue Shield. It honors Mitchell — a UAMS graduate and Arkansas Blue Cross board member and retired president who led the health insurance company for nearly 20 years. Mitchell, who graduated with honors from the UAMS College of Medicine in 1956, was president and chief executive officer of Arkansas Blue Cross from 1975 until his 1993 retirement. Prior to joining Arkansas Blue Cross as medical director in 1968, he was a co-founder and senior partner of the Little Rock Diagnostic Clinic. He served on the Arkansas Blue Cross board for several decades.

“The establishment of this chair is a collaboration between Arkansas Blue Cross and UAMS to provide health care statewide, but also to ensure that the future of excellent primary care is secure for all Arkansans,” said Todd Holt, northeast regional executive for Arkansas Blue Cross. “We are confident that Dr. Dickson will carry on the commitment to focus on innovations in primary care.”

Founded in 1948, Arkansas Blue Cross is the largest health insurer in Arkansas. Arkansas Blue Cross and its affiliates have more than 3,000 employees. The Blue Cross Blue Shield Association is comprised of 36 independent, community-based and locally operated Blue Cross and Blue Shield Plans that collectively provide health care coverage for nearly 106 million members – one in three Americans.

The endowment calls for the chair holder to focus on innovations to meet the Triple Aim of health system reform — better patient experience, improving the health of the population and decreasing the cost of care — through the incorporation of team-based care, health promotion, health literacy and population health strategies into primary care settings. It is a UAMS-wide chair with a chair holder to be appointed on a three-year, rotating basis.

“It truly is most fitting that Dr. Dickson is receiving this chair today,” said Mark Jansen, M.D., vice president and chief medical officer for Arkansas Blue Cross, who was the inaugural chair holder before leaving UAMS. “If you have received primary medical care in northeast Arkansas in this corridor, Dr. Dickson’s prints are on that in some way, shape or form. His leadership has created a highly successful residency program for UAMS, which has the highest retention level in the state.”

“Scott Dickson is the best – if you don’t believe it, ask anyone, and they’ll agree,” said Joe Stallings, M.D., associate professor with the UAMS Department of Family and Preventive Medicine, and former residency program director at the UAMS Northeast Regional Campus. “He is the kind of doctor anyone would want.”

Mark Brown, M.D., assistant professor with the UAMS Department of Family and Preventive Medicine and medical director for the UAMS Northeast Regional Campus, was still in private practice when he met Dickson, who had just completed his first year of medical school.

“I remember being impressed by his knowledge, his maturity, his compassion and his work ethic,” Brown said. “It was clear to me that Scott was going to become the outstanding physician that he has become.”

Patterson and Gardner presented Dickson with a commemorative medallion.

Dickson thanked Mitchell and Jansen for their example, as well as Arkansas Blue Cross for its vision in creating the endowed chair to advance primary care. He singled out Stallings for inspiring him to pursue a career in academic medicine.

“I have always continued to be so grateful for his guidance, wisdom, and his friendship – and I can only hope that I can serve as that person for others in my current role as residency program director, and through the activities of this endowment,” Dickson said. “I see such opportunity to reach bright young men and women in rural communities throughout Arkansas, to hopefully encourage them to consider careers in medicine in the same way that these mentors have done for me.”

Dickson attended Arkansas State University in Jonesboro and graduated with a Bachelor of Science in zoology in 1994. He received his medical degree from UAMS in 1998 and completed his internship and residency training at UAMS Northeast Regional Campus in 2001, then joined the faculty there. He spent eight years as assistant residency director there before being named residency director in 2009. Since becoming residency director, the regional campus has graduated 71 residents, with over 80% of those remaining in northeast Arkansas.

Dickson previously was chief of the Department of Family Medicine at St. Bernards from 2007 to 2009, and served on a number of other committees including the Physician’s Health Committee, the Medical Executive Committee and the Hospital Advisory Board. In 2018, he was named president of the Arkansas Chapter of the American Academy of Family Physicians and serves on its board of directors. He has also served on the board of directors for the Jonesboro Church Health Clinic. He is a member of the Association of Family Medicine Residency Directors, the Society of Teachers of Family Medicine, the American Medical Association and the Arkansas Medical Society.

By Susan Van Dusen

To conduct biomedical research, scientists must be able to identify, analyze and compare proteins in biological samples. This complex process requires facilities – known as proteomics cores – that house the specialized equipment and highly trained staff required for such a task.

The fourth annual Proteomics Facility Staff Symposium on Jan. 29-30 at UAMS brought together 30 proteomics core directors and staff members to learn how best to operate and maintain these facilities at their institutions.

All of the participants came from IDeA (Institutional Development Award) states and Puerto Rico, all of which have been identified by the National Institutes of Health as historically receiving less grant funding for biomedical research than other states.

“The first symposium was in 2017, and it has grown each year since. By getting together on a regular basis, we can learn from each other, share our successes and ensure we all have the support and knowledge to meet the needs of our researchers,” said Alan Tackett, Ph.D., associate director for basic science in the UAMS Winthrop P. Rockefeller Cancer Institute.

Tackett also serves as co-director of the IDeA National Resource for Quantitative Proteomics, a partnership between the Arkansas INBRE (IDeA Networks of Biomedical Research Excellence) and Oklahoma INBRE.

The national resource combines the strengths of the two INBREs to guide and assist other IDeA states where core facilities may be underfunded or lack resources.

“At UAMS, our discovery phase proteomic capabilities are very strong, while Oklahoma has a state-of-the-art, targeted validation proteomics program. Together we offer expertise and access to equipment that facilities in other IDeA states may lack,” Tackett said.

Mike Kinter, Ph.D., of the University of Oklahoma Health Sciences Center, serves as co-director of the national resource with Tackett.

The INBRE program supports research in public and private four-year colleges by building research capacity and raising awareness about career opportunities in biomedical research. It is supported by the National Institutes of Health (NIH) Institutional Development Award (IDeA), which was established to broaden the geographic distribution of NIH funding for biomedical and behavioral research.

Lawrence Cornett, Ph.D., professor in the UAMS College of Medicine Department of Physiology and Biophysics, serves as principal investigator and director of Arkansas INBRE.

Symposium participants took part in breakout sessions and heard speakers on administrative topics related to operating a proteomics core and establishing a rate structure, as well as information on topics such as sample preparation and data collection. Sessions were led by UAMS faculty Sam Mackintosh, Ph.D.; Rick Edmondson, Ph.D.; and Stephanie Byrum, Ph.D.

“We covered a wide range of topics to help core directors and staff develop and maintain programs that will succeed at their universities,” said Tackett, who also serves as a professor in the UAMS College of Medicine Department of Biochemistry and Molecular Biology.

The Proteomics Core at UAMS is one of several core facilities where technology, tools and collaborative services are pooled together and made available on a pay-per-use basis to investigators both within and outside of UAMS who may not otherwise have access to them in their individual labs.

In the Proteomics Core, staff use a process known as mass spectrometry to help researchers identify proteins. The core is a one-stop-shop, where staff not only process the samples but can help researchers design experiments and analyze results.

A Discovery-Phase Proteomics Faculty and Student Workshop is scheduled for Feb. 27-28 at UAMS and will emphasize new approaches that researchers can implement in their own laboratories and how to best use the resulting data to be more competitive for extramural funding.

By Susan Van Dusen

A team led by UAMS cancer researcher Valentina Todorova, Ph.D., has demonstrated the potential to prevent chemotherapy-induced heart damage without reducing the treatment’s effectiveness.

The study titled “Dantrolene Attenuates Cardiotoxicity of Doxorubicin Without Reducing its Antitumor Efficacy in a Breast Cancer Model” was published in the February 2020 issue of the scientific journal Translational Oncology.

Todorova’s team combined the muscle relaxant dantrolene with the chemotherapy drug doxorubicin to determine if it could help prevent heart damage — also called cardiotoxicity — without reducing the drug’s cancer-fighting ability.

“Cancer treatment can cause many side effects, including heart damage. In some patients, the damage appears during or soon after treatment. In others, it occurs many years later. We are looking at new ways to prevent this damage from occurring, specifically in breast cancer patients,” said Todorova, assistant professor in the UAMS College of Medicine Department of Internal Medicine.

Doxorubicin is commonly used alone or in combination with other drugs to treat many types of cancer, including breast cancer, Hodgkin and non-Hodgkin lymphoma, bladder cancer, stomach cancer and several others.

However, due to its well-documented and unpredictable side effects, doxorubicin’s usage can be limited.

“Heart damage caused by doxorubicin begins with the first round of chemotherapy and increases in severity based on the dosage the patient receives. Typically the damage starts as cardiomyopathy, which makes it harder for the heart to pump blood. This can then lead to congestive heart failure,” Todorova said.

Her research showed, for the first time, that dantrolene, when given in addition to doxorubicin, has the potential to prevent heart damage, without decreasing doxorubicin’s cancer-fighting ability.

Dantrolene is a muscle relaxant used to treat stiffness and spasms related to conditions such as stroke, spinal cord injury or multiple sclerosis.

“No one has previously studied this combination of drugs in cancer. Our preliminary study lays the foundation for further research, both by our team and others,” Todorova said.

Next steps for Todorova include examining the most effective dosage of dantrolene, how it is best delivered, and its effect on a tumor’s response or resistance to treatment.

This research was funded in part by the Arkansas Breast Cancer Research Project (ABCRP). Established in 1997 by the Arkansas General Assembly, the ABCRP funds research efforts into the cause, cure, treatment, early detection and prevention of breast cancer.

Additional UAMS authors on the paper are Eric R. Siegel, M.S., Department of Biostatistics; Yihong Kaufmann, Ph.D., Department of Surgery; Asangi Kumarapeli, M.D., Ph.D., Department of Pathology; Jeanne Y. Wei, M.D., Ph.D., Department of Geriatrics; Issam Makhoul, M.D., Department of Internal Medicine; and V. Suzanne Klimberg, M.D., Ph.D., and Aaron Owen, both formerly of UAMS.