Despite all the centuries physicians have studied the human body, its anatomy still has secrets to reveal that can improve the treatment of patients and their health outcomes, said R. Shane Tubbs, Ph.D., professor of neurosurgery and cell biology, and director of surgical anatomy at Tulane University in New Orleans.

Tubbs spoke Oct. 11 on “Spinal Anatomy Research: Quo Vadis and Relevance to Spine Surgeons in 2019?” to dozens of residents, students and faculty as part of the Flanigan-Boop Endowed Lectureship in Spinal Neurosurgery.

Tubbs is editor of the 41^st and newly released 42^nd editions of “Gray’s Anatomy,” long considered the ‘bible’ of anatomy, as well as author of more than 30 books and over 1,500 peer-reviewed publications.

“We still know very little about spinal anatomy, no matter what someone tells you,” Tubbs said. “We’re discovering things that we never knew existed in the spine after hundreds of years of study. It’s an exciting time to be in this field.”

Tubbs said he and his research team use “reverse translational research in anatomy” to speed up the process by which research makes it from its earliest stage to a practical application for patients. The average time that takes is 17 years, he said, but his team’s approach accomplishes that in 3.2 years.

“What we do with reverse translational research is go to surgeons and ask them what problems they have encountered in the operating room and what complications they have seen with patients,” Tubbs said. “We also ask if there’s an anatomical study we can devise to address that problem and help patients in the here and now.”

Often after he and his team publish their findings, Tubbs said, their work is picked up by others around the world and other researchers expand on it.

“We’ve been doing this for 25 years, and from it we’ve developed new foams, nerve grafts and surgical procedures,” Tubbs said. “We’ve improved patient care and offered surgeons a larger tool box to use for their patients.”

For much of the lecture, Tubbs reviewed his research findings regarding the spine. Some parts of the spine have been identified and known for a long time but in many cases how they interrelate with other tissues or anatomical structures isn’t. His research even has revealed small, previously overlooked features.

Tubbs spoke earlier in the day to the neurosurgery residents about how to approach writing for academic journals and improve the chances of being accepted for publications.

People are not taught how to write in medical school, Tubbs said. He advised that as writers they should always have an idea of what publication they want to submit an article to before they even start.

“My biggest suggestion is ask yourself what mentality you want to have in writing,” he said. “You want to think like your reviewers. Are they surgeons or statisticians or something else? You want to think like them with every word you type in.”

Tubbs then took the  neurosurgical residents through an anatomical dissection examining the back of the neck and top of the spine from the shoulders to the base of the skull.

“The opportunity to have Dr. Tubbs lead a dissection for our residents is an incredible one,” said Noojan Kazemi, M.D., associate professor in the UAMS Department of Neurosurgery. “Someone of his renown is a tremendous boost to the residents for their learning and it is a real honor to host him here for the Flanigan-Boop lecture and for UAMS in general.”

Kazemi introduced Tubbs to the residents and at the annual distinguished Flanigan-Boop lecture. The lecture was part of three days of events celebrating the 50^th anniversary of the clinical training program in neurosurgery at UAMS.

J.D. Day, M.D., chair of the UAMS Department of Neurosurgery, on Oct. 10 was invested as the Robert Watson, M.D., Chair in Neurosurgery and on Oct. 12, the UAMS Neurosciences Update was held to present the latest research from faculty in neurosurgery and neurology as well as showcase the most up-to-date and minimally invasive surgical techniques performed at UAMS.

Groundbreaking research on inclined sleep products for infants by Erin Mannen, Ph.D., a baby biomechanics expert and mechanical engineer at the University of Arkansas for Medical Sciences (UAMS), was made public Wednesday as part of a U.S. Consumer Product Safety Commission investigation into their safety and related rulemaking.

“Over the course of a year-long study, we found evidence that babies age 2-6 months on average who were placed in inclined sleep products were at higher risk of suffocation in these products compared to a flat crib mattress,” Mannen said. “We found evidence that some of the deaths linked to these products occurred when babies who were placed on their backs to sleep rolled over — many for the first time — and were found dead on their stomachs.”

Mannen and a team of researchers from UAMS concluded that none of the inclined sleep products they examined as part of the study were safe for infant sleep. They further recommended that this category of products be removed from the market or that the industry rules outlining the standards for these product be significantly revised.

In detail, Mannen and her team suggested the angle of the incline on such products be no more than 10 degrees and that the lying surface be flat and rigid (rather than soft and plush-like).

Inclined sleepers are relatively new. The Consumer Product Safety Commission only began recognizing them as a product class in 2011, when they were separated from the regulations governing bassinets and cradles. They are currently defined as “a free standing product with an inclined sleep surface primarily intended and marketed to provide sleeping accommodations for an infant up to 5 months old or when the infant begins to roll over or pull up on sides, whichever comes first.” The appearance of the products varies, but they can look like hammocks or slings suspended on a frame, often with an incline of 10 to 30 degrees.

Mannen’s research became public as the Consumer Product Safety Commission considers changes to the regulations for this line of product.

Mannen and her team evaluated the products in several ways.

The researchers performed a biomechanical analysis with actual infants ranging from ages 2-6 months, comparing their muscle use and biomechanics in the products, both on their backs and on their stomachs, and at various inclines. This was compared to data on the same infants on a flat crib mattress under the same range of conditions.

They found that the babies who were placed on their stomachs in the sleepers or who rolled over had to exert many times more than the normal muscle strength to keep themselves upright and had to use muscles in a way that might be unfamiliar to them — as much as 200% more core strength than in a crib under the same conditions.

The team also conducted a review of several examples from the product class and found a wide variety of products are being marketed in this category. Many different designs and materials are in use.

They reviewed 91 incidents on a case-by-case basis, looking at police reports, caregiver interviews, autopsies and other data. They found that in many cases where an infant had been placed to sleep on their back in the sleeper and then rolled over and suffocated, the caregivers reported that they had not rolled over before and it was likely one of their first times to do so, if not the first time.

Additionally, the team monitored oxygen saturation levels of the babies over about one to two minutes in the inclined sleepers vs. a flat crib-like surface and found that even in such short time periods, there were twice as many incidents of a drop in oxygen levels in the inclined sleepers.

“We found evidence to suggest that this inclined position on a non-rigid surface may make it easier for babies to roll over, but harder for them to roll back,” Mannen said.

Co-investigators from UAMS on the study included John Carroll, M.D., pediatric pulmonologist; David B. Bumpass, M.D., pediatric spine surgeon; Brien Rabenhorst, M.D., pediatric orthopaedic surgeon; Brandi Whitaker, Ph.D., pediatric psychologist; Junsig Wang, Ph.D., biomechanics researcher; and Safeer F. Siddicky, Ph.D., biomechanics researcher.

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UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and seven institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute and Institute for Digital Health & Innovation. It is the only adult Level 1 trauma center in the state. U.S. News & World Report named UAMS Medical Center the state’s Best Hospital; ranked its ear, nose and throat program among the top 50 nationwide; and named six areas as high performing — cancer, colon cancer surgery, heart failure, hip replacement, knee replacement and lung cancer surgery. UAMS has 2,727 students, 870 medical residents and five dental residents. It is the state’s largest public employer with more than 10,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Childrens Hospital, the VA Medical Center and Baptist Health. Visit www.uams.edu or www.uamshealth.com. Find us on Facebook, Twitter, YouTube or Instagram.

By Amy Widner

Researcher Terry Harville, M.D., Ph.D., of the University of Arkansas for Medical Sciences (UAMS), has published a major study that for the first time links autism spectrum disorder to a specific genetic variation affecting the immune system.
The study, published in the Frontiers of Psychiatry, found that a genetically inherited immune type HLA-Cw7 was present in much higher numbers in people with autism as compared to the general population.

Harville and co-authors believe this HLA-Cw7 expression may cause chronic immune system activation for a subgroup of people with autism. In fact, this chronic inflammation may be affecting the brain and actually be causing the autism in these patients.

“Findings like this bring us one step closer to the future of treatment for autism: individualized medicine,” Harville said. “The more we truly understand the driving forces behind autism spectrum disorder, the better we will be able to identify and treat subgroups and individuals — to the maximum benefit for the individual patient.”

Harville, who is a professor of pathology and internal medicine at UAMS with a long career in pediatric immunology, collaborated on the study with the UAMS Department of Pediatrics, Arkansas Children’s Research Institute (ACRI), UAMS College of Public Health, National Center for Toxicological Research, and other institutions across the country.

Autism spectrum disorder includes a broad range of symptoms like challenges with social skills, repetitive behaviors, speech and nonverbal communication. It affects about 1 in 69 children in the United States.

While there is no known single cause of autism, the current consensus among the scientific community is that it is not one condition but several unique subtypes driven by both genetics and environmental factors. Scientists have long suspected the immune system may play a role for some subtypes, and a body of evidence is accumulating to support this connection.

Harville said it has been difficult to prove an immunological cause for autism, in part because the autism diagnosis is so broad. He agrees with the theory that autism is likely several different conditions, each with a unique cause. During his career as a pediatrician, Harville observed that the same treatment would have a dramatic effect for one patient with autism and little or no effect on another.

With this in mind, Harville’s study also attempted to identify other characteristics that define this subgroup of patients with the HLA-Cw7type. Harville found that — in addition to the behavioral symptoms that led to their autism diagnosis — these patients also reported higher rates of infections, allergies, food intolerances, chronic sinusitis and gastrointestinal issues compared to other patients with an autism diagnosis but without expression of the HLA-Cw7 gene.

“What emerges is a profile of symptoms that might help clinicians identify these patients as part of this subgroup,” Harville said. “Our next step will be looking at ways to perhaps manage these patients with treatments that alter immune system function or activation.”

Other variations of the HLA gene have been connected to autoimmune disorders like rheumatoid arthritis, celiac disease and ankylosing spondylitis. This led Harville to choose HLA for the focus of his autism study.

Individualized medicine, also called precision or personalized medicine, is the idea that advances in genetic testing, advanced computational abilities and other scientific tools are improving medical treatment by enabling it to be tailored to the individual.

UAMS co-authors on the study include Bobbie Rhodes-Clark, Ph.D., Department of Pathology; Sirish C. Bennuri, Marie Tippett, Shannon Rose, Ph.D., Stephen Kahler, M.D., Department of Pediatrics and ACRI; and Leanna Delhey, College of Public Health.

The study was funded by the Arkansas Biosciences Institute, the Jonty Foundation (St. Paul, Minnesota), the Autism Research Institute (San Diego), the Gupta Family Foundation (Atherton, California), the Jane Bostford Johnson Foundation (New York City), the Jager Family Foundation (Chicago) and the Phoenix Children’s Hospital Foundation (Phoenix). HLA typing was in part funded by research funds from the Department of Pathology in the UAMS College of Medicine.

Arabinda K. Choudhary, M.D., MBA, chair of the Department of Radiology in the College of Medicine at the University of Arkansas for Medical Sciences (UAMS), was invested Oct. 14 in the Ernest J. Ferris, M.D. Chair in Diagnostic Radiology.

Choudhary is an internationally recognized expert in pediatric neuroimaging and imaging related to pediatric abusive head trauma. He joined UAMS in August.

“This is a huge day for me, for our department, and possibly the single biggest achievement of my professional career,” said Choudhary. “I’m really excited for what this means for us as a department and the opportunity that we have; what it means for me, as the responsibility embedded within the Ferris Chair; what it means for UAMS with the expectations being set for our department; and for the state of Arkansas for the commitment this reflects on us to provide the best value-based care to the patients of the state.”

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.

“Today is a great day for UAMS and for the Department of Radiology,” said UAMS Chancellor Cam Patterson, M.D., MBA. “We are honored to have Dr. Choudhary continue the legacy of Dr. Ferris.”

The chair is named in honor of Ferris, who chaired the Department of Radiology for 31 years, helping bring comprehensive subspecialty training and highly specialized radiological care to Arkansas. He trained more than 350 fellows and residents at UAMS, six of whom have gone on to become department chairs at various medical schools. Ferris expanded the department to include 50 radiologists with diverse subspecialties before he stepped down as chair in 2008.

Ferris, who attended Boston University School of Medicine, held faculty positions at Harvard University and Tufts University, and served as chief of radiology at Boston University Medical Center for eight years before being recruited to UAMS in 1977.

Well-known nationally and internationally for his contributions to the field of radiology, Ferris received the American Board of Radiology’s Distinguished Service Award in 2000 and was presented with the Radiological Society of North America’s highest honor, the Gold Medal, in 2001. At UAMS, he received the Caduceus Club’s Distinguished Faculty Award in 1996 and the Dean’s Distinguished Faculty Scholar Award in 2007. College of Medicine students recognized him four times with the Red Sash Award.

“A force for good, for radiology at the local, national and international stage, Dr. Ferris’ collaborative research and clinical body of work, which is vast and extensive, has inspired many generations of radiologists, including myself,” Choudhary said. “It is a proud moment for me to be the steward of Dr. Ferris’ legacy.”

Ferris was in attendance for the ceremony, held in the Diner Learning Center at UAMS’ Little Rock campus, which served as a celebration of the department, with radiology staff, technologists, residents, alumni and faculty members participating.

James E. McDonald, M.D., who served as department chair from November 2016 until June, when he announced his retirement, was scheduled to speak but could not attend due to the imminent birth of his granddaughter. Jeannette Shorey, M.D., associate provost for faculty affairs, read from his prepared remarks.

“Arv Choudhary is very likely one of the best prepared individuals to ever lead any department at UAMS,” McDonald wrote. “He is a man who has the ability to recognize what counts, what is eternal. And, along with that, he has the intellect, skill and determination to do what needs to be done to preserve and build. He is the right leader, in the right place – this place – at exactly the right time.”

Choudhary was presented with a commemorative medallion by Patterson and Christopher T. Westfall, M.D., FACS, UAMS executive vice chancellor and dean of the College of Medicine. Choudhary thanked his wife Bhawna Jha, M.D., an assistant professor in the Department of Neurology in the College of Medicine, and their three daughters: twins Rhea and Anya, 13, and Keya, 10.

Choudhary was previously chair of pediatric radiology at Nemours/Alfred I. duPont Hospital for Children in Wilmington, Delaware, since 2013. He received his medical degree from the Medical College of Calcutta in 1994 and completed residencies in pediatrics at Princess of Wales Hospital and the University of Wales and Llandough Hospital in the U.K., followed by a residency in radiology at Cambridge University. He continued his training with fellowships in pediatric radiology and pediatric neuroradiology at Cincinnati Children’s Hospital Medical Center.

Choudhary received his MBA with a major in finance from the Wharton School at the University of Pennsylvania in 2017 and received Fellow of the American College of Healthcare Executives (FACHE) certification in 2018. He is board certified in clinical informatics, radiology, neuroradiology and pediatric radiology.

He began his career in academic medicine as director of pediatric neuroradiology at Penn State Milton S. Hershey University Medical Center in Hershey, Pennsylvania, from 2006 to 2013. He also served as associate program director of radiology in 2011-2012. He developed the pediatric neuroradiology section with increased specialization and a comprehensive teaching curriculum for fellows and residents. He worked with partnering hospitals to build relationships and provide subspecialist services. He taught medical students at Penn State and mentored numerous students, residents, fellows and junior faculty members.

Choudhary’s research has centered on diagnosis of brain and spinal trauma, as well as chronic disease and surgery involving the brain. He was the lead author on a 2018 consensus statement on abusive head trauma, the leading cause of fatal head injuries in children younger than 2. The statement, supported by 15 international pediatric and radiology organizations and published in the journal Pediatric Radiology, outlines the consensus of evidence-based medical findings on abusive head trauma to serve as a tool within the legal system. Within weeks of publication it was in the top 5% of all research ever tracked by Altmetric, and it was the third most downloaded article from Springer’s pediatric and radiology journals in 2018.

Choudhary has published extensively and lectured internationally on neuroimaging. He received the Society of Pediatric Radiology’s prestigious Walter E. Berdon award in 2016 for authoring the best clinical research paper in Pediatric Radiology in 2015. He received the David S. Hartman, M.D., Faculty Golden Apple Award for outstanding medical student teaching at Hershey Medical Center in 2010.

J.D. Day, M.D., an internationally recognized leader in skull base surgery and specialist in Gamma Knife surgery and vascular disorders of the brain and skull base at the University of Arkansas for Medical Sciences (UAMS), was invested Oct. 10 in the Robert Watson, M.D., Chair in Neurological Surgery.

“This is probably one of the most humbling days of my life,” Day said. Referring to a map showing his many stops across his medical career, he pointed to a red line that led him to UAMS. “God willing, that red stands for stop, and I will be here for the rest of my career.”

Day is chair of the Department of Neurosurgery in the UAMS College of Medicine.

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.

“I’d like to thank J.D. Day for everything that he’s done for UAMS and the people of Arkansas, and for the entire field of neurosurgery,” said UAMS Chancellor Cam Patterson, M.D., MBA. “We are grateful for what you have done and we are grateful for what you will continue to do.”

Robert C. Watson, M.D., known as the father of neurosurgery in Arkansas, was just a teenager in Mena, Arkansas, working in the local drugstore when he discovered he wanted to become a physician. Upon graduation from the UAMS College of Medicine in 1935, he had not decided which specialty he would pursue, but that changed when he cared for a young girl with a brain injury during his internship at Detroit City Hospital. He furthered his training in Brooklyn, New York, at King’s County Hospital, where his fascination with the brain grew.

In 1944, Watson became only the 108^th physician to receive accreditation from the American Board of Neurological Society. Watson returned to Arkansas to practice neurosurgery and began a 27-year volunteer career as a teacher, educating young physicians about diagnosing neurological cases.

“Dr. Watson was a pillar of the medical community and here at UAMS,” said Christopher T. Westfall, M.D., UAMS executive vice chancellor and dean of the College of Medicine. “He was truly the father of neurosurgery in Arkansas, and he had an immeasurable impact on our students, our residents, our fellows, and most importantly, to the patients they went on to serve.”

“This investiture celebrates the generosity and philanthropic spirit, and the legacy of Dr. Watson, and we are delighted to celebrate Dr. Day’s leadership and accomplishments with this chair,” he said. “Dr. Day has propelled our Department of Neurosurgery and the Neurosciences Service Line to new heights.”

Watson’s accomplishments included serving as chief of staff of Baptist Medical Center, president of both the Arkansas and Pulaski County Medical Societies, and president and founder of the Southern Neurological Society. He was a founding member and longtime chairman of the Board of Directors of the Medical Education Foundation of Arkansas. In 1980, the neurosurgeons who had joined Watson’s practice created the Robert Watson, M.D., History of Medicine Room in the UAMS Library.

“Dr. Watson truly had a remarkable career,” Day said. “He always worried about his patients like we do, and I’m sure he prayed every day, just as I do, that our patients have the best outcome possible. Some things just will never change in neurosurgery.”

Patterson and Westfall thanked the members of Watson’s family who were in attendance.

“I’ll tell you, if I ever had a neurologic or neurosurgical problem, I would fly to Arkansas, to this place, and have John as my neurosurgeon,” said James P. Chandler, M.D., vice chair of the Department of Neurological Surgery and co-director of the Lou and Jean Malnati Brain Tumor Institute of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University. “He is a neurosurgeon’s neurosurgeon. Congratulations, John – this honor is very appropriate and very well deserved.”

“We worked a lifetime together and John became a brother,” said Michael L. Levy, M.D., Ph.D., chief of pediatric neurosurgery at Rady Children’s Hospital-San Diego and the University of California, San Diego School of Medicine. “I think this honor is so appropriate for him because he is everything that this honor represents. He is everything you want in somebody to be in a leadership position, to educate those surgeons – they’re going to be practicing for decades – and to make a difference in the lives of so many people. That’s what John does.”

Day was presented with a commemorative medallion by Patterson and Westfall.

Day thanked members of his family in attendance, as well as the Watson family, and reserved special praise for members of his department, including faculty, administrators, nurses and the scrub techs in the operating room.

“While it would seem like the pinnacle of an academic physician’s career to be invested in an endowed chair, I assure you that this, for me, represents more of a rebirth and a beginning to the next phase,” Day said. “My overall goal, when I’m finished, is that if you’re in Arkansas and you have a neurosurgical problem, you know that you will be delivered the most comprehensive, cutting-edge, up-to-date care that’s available anywhere in the country. That’s my pledge to you.”

Day became chairman of the Department of Neurosurgery in 2010. He was previously an associate professor, vice chair for academic affairs, and the associate residency program director at the University of Texas Health Science Center in San Antonio, Texas.

He earned his Bachelor of Arts in chemistry from Whitman College in Walla Walla, Washington, and his medical degree from the University of Washington in Seattle, Washington. He completed his residency at the University of Southern California LAC/USC Medical Center in 1996 and followed with a research fellowship in cranial base surgery at the University of Vienna Medical School, Neurochirurgische Universitätsklinik in Vienna, Austria. During his residency, Day received the Mahaley Award for Clinical Research from the American Association of Neurological Surgeons.

Day’s clinical interests include brain tumors, cerebrovascular surgery and skull base surgery. His research efforts include refinements of minimally invasive neurosurgical techniques in brain surgery and enhancing early recovery after brain surgery. He has authored four textbooks on skull base surgery and published over 80 chapters and articles on neurosurgical topics. He is a highly sought-after lecturer on skull base surgery techniques and has lectured and served as faculty for courses on four continents.

“Unfortunately, there are currently no methods that can identify treatment response in the clinic during therapy, which causes patients – both responsive and resistant – to lose critical time when alternative approaches could be considered,” said Rajaram.

To complete his experiments, Rajaram, who spent four years at Duke University before arriving at UA in 2014, required unique cell lines to examine for potential new biomarkers and disease-resistance patterns.

Through his network of colleagues, Rajaram discovered a connection to Robert J. Griffin, Ph.D., professor and biologist in the UAMS College of Medicine Department of Radiation Oncology. After initial discussions, the two determined their mutual interest in the effects of radiation therapy and disease resistance could lead to a partnership.

Griffin’s colleague Ruud Dings, Ph.D., who joined UAMS during this time, also entered the discussion. Dings is assistant professor in the Department of Radiation Oncology and, like Griffin, uses his laboratory to create unique cell lines.

“Previously, scientists studied disease resistance patterns by comparing cell lines that were not related to each other or that had different backgrounds, resulting in potential false correlations,” said Dings.

The unique cell lines created in the UAMS labs are isogenically related, meaning they are engineered from a parental line, have the same genetic background and are exposed to repeated interventions that create acquired resistance to radiation or drugs.

With a set of unique cell lines he acquired from Dings’ lab in 2015, Rajaram continued his work on optical imaging technologies, with the goal of developing a method to predict a tumor’s sensitivity to treatment.

A paper highlighting findings related to this research was published in the April 17, 2019, issue of Cancer Research, a publication of the American Association for Cancer Research.

Out of Rajaram’s research came the development of a thin, chopstick-like probe. When touched to a tumor or surrounding tissue, light emitted from the probe refracts. The light is then captured back into the probe and collected for analysis.

With the probe ready to test in humans, Rajaram reached out to UAMS surgeon Mauricio Moreno, M.D., for input on how to apply this emerging technology to head and neck cancer.

From there, the idea for a clinical trial was born.

“The Holy Grail of head and neck oncology is the ability to accurately predict which patients will or will not respond to radiation therapy,” said Moreno, associate professor in the UAMS College of Medicine Department of Otolaryngology-Head and Neck Surgery.

Those patients whose tumors do not completely disappear following radiation therapy typically require surgery. And, as Moreno pointed out, patients who have recently undergone radiation therapy are a much higher risk of potential surgical complications.

“If there was a way for us to know upfront that a patient was not likely to respond to radiation, we could alter their treatment plan and prevent them from experiencing the toxicity of radiation therapy in the first place,” Moreno said.

Moreno and Rajaram determined that head and neck squamous cell carcinoma (HNSSC) of the larynx or tonsil was the best condition on which to focus their clinical trial for four reasons:

1) It is a common cancer, resulting in a large number of potential participants.

2) It is treated with radiation.

3) The tumor can be easily accessed noninvasively.

4) It is often caused by the human papilloma virus (HPV), which is typically sensitive to radiation therapy.

Their study, which has enrolled about five UAMS patients so far, is approved to enroll up to 90 subjects with Stage 3 or Stage 4 HNSCC, including those with tumors that are both HPV-positive and HPV-negative.

Trial participants undergo both a baseline test after diagnosis and a test during their course of radiation treatment. The test includes inserting the thin probe into the patient’s throat and touching the probe’s light to the tumor and surrounding tissue. Researchers hope that by examining the light patterns captured during both of these tests they can identify correlations related to tumor treatment response.

“It’s very investigational, but if we can identify a pattern either before or during the early phases of treatment where we see the tumor is not responding properly, that could potentially have significant clinical impact for future patients,” Moreno said.

All data collected by the probe goes back to Rajaram for analysis and is compared to the patients’ other imaging results, including CT scans, for potential correlations.

The fact that Rajaram’s NCI grant funds both the basic science and clinical trial associated with this research is uncommon, said Griffin, adding that “the clinical observations collected by Dr. Moreno will strengthen the basic science conducted by Dr. Rajaram, Dr. Dings and myself.”

Additional pre-clinical studies and technology development were conducted at Johns Hopkins University. Rajaram’s initial work to demonstrate the feasibility of this approach was supported by start-up funds from UA and the Arkansas Biosciences Institute.

Research collaborations such as this one bolster the Cancer Institute’s ongoing efforts to receive National Cancer Institute Designation.

To achieve designation, cancer centers undergo a highly competitive assessment process that demonstrates an outstanding depth and breadth of research in three areas: basic laboratory, patient/clinical and population-based. The designation brings with it many benefits, including expanded access to federal funding for researchers and improved access to clinical trials for patients.

It’s been a time of accolades for UAMS researcher Jia Liu, Ph.D., an assistant professor in the UAMS College of Medicine Department of Microbiology and Immunology.

In June 2019, she was awarded $10,000 in research funds by the River Valley Ovarian Cancer Alliance, an advocacy group based in Fort Smith, Arkansas that aims to raise awareness and promote education to fight ovarian cancer. On Friday, Sept. 27, she was honored as the Community Champion of the Year by the Arkansas Ovarian Cancer Coalition, the state advocacy organization for Arkansas.

“Ovarian cancer is the most deadly gynecological cancer. Sadly, about half of the diagnoses are in women in their early 60s,” said Shuk-Mei Ho, Ph.D., UAMS vice chancellor for research. “The five-year relative survival rate is less than 50%. We need new breakthrough treatments, such as the one being developed by Dr. Liu, to combat this cancer. UAMS as the only academic center in Arkansas is committed to research that improves cancer care in Arkansas and around the nation.”

Liu and her research team have taken a unique approach to fighting cancer, especially ovarian cancer. They are re-inventing the use of viruses that infect and kill cancer cells to create more effective treatments or even cures.

“Viruses can make us sick, but we can re-engineer them to benefit us,” Liu said. “In this case, we can use them to kill cancer cells. The virus we are studying can work on many cancer types, but we’re particularly interested in treating ovarian cancer. For four decades, long-term survival for patients with ovarian cancer remained low and we hope to be able to help to improve this result.”

The team’s work has produced one re-engineered virus that has shown promise in early testing. Liu said a patent is pending, and there is interest from a pharmaceutical company in further developing and testing the virus in clinical trials.

“While society often uses numbers of patients to measure the effect of a disease, we perhaps should look at ovarian cancer more closely. This disease is a silent killer for women and indeed impacts so many families or individuals,” Liu said. “Compared with other cancer types, improvement in diagnosis and treatment for ovarian cancer is urgently needed.

Liu said awareness of this deadly disease also needs to be raised, including awareness of its symptoms, risk factors, treatment options, care, and advocating for research that will improve diagnosis and treatment.

“We sincerely thank the generous support from the River Valley Ovarian Cancer Alliance,” Liu said. “This fund will allow us to conduct important studies and help us to establish a sustainable research program for ovarian cancer immunotherapy. I also want to thank our long-time collaborator on our work, Dr. Martin Cannon. Dr. Cannon is an internationally renowned immunologist at UAMS and a mentor for me on ovarian cancer immunotherapy. Only with his help we were able to test my viral vector on clinical specimens and showed exciting results.”

Medical school isn’t always about books and biology. Sometimes it’s about Baggo and bragging rights.

Such is the case at the Academic House Olympics, an annual event where students, faculty and their families put aside the hard work of medical school for an afternoon to have a little fun. This year’s festivities were held in Murray Park beneath a bright summerlike September sky near the banks of the Arkansas River.

The Academic Houses squared off for a house spirit competition and then broke down into smaller groups to preserve house honor at volleyball, tug of war, Baggo — even Hula-Hooping. The afternoon was interspersed with food, fun, and fellowship, and participants were encouraged to bring family members and pets so that everyone could get a better sense of each other’s lives outside of med school.

“This is all about fun,” said Haley Birth, a fourth-year student in Compton House, which won the spirit competition and was the overall top-scoring team for the Academic House Olympics. “We get to interact with our faculty mentors in a casual atmosphere, see their kids running around, and it all just makes school feel a little bit less academic and more of a social network that we can depend on.”

That feeling is by design. As freshmen, College of Medicine students are divided into one of seven Academic Houses for the duration of medical school. Each house includes students who are at various stages of their training, and each house is shepherded by faculty advisers. The small-group atmosphere facilitates mentorship from the advisers and also between the students. The Academic House system began in 2016 and the Olympics followed in 2017 to deepen those connections.

“We wanted to have an event that would welcome the freshmen medical students, a gathering that would involve family and friends, dogs, babies and really get everybody involved,” said Sara Tariq, M.D., associate dean for student affairs in the College of Medicine. “We also wanted to harness the spirit of competition from the medical students, something fun that would build a sense of comradery.”

Second-year student Olivia Speed of Ish House and her teammates spent about a week working on their phoenix-themed design. They tied for second place in the spirit competition with Tank House and Beall House.

“It’s been phenomenal,” Speed said. “It’s nice to get out of the library and actually spend a weekend having fun, relaxing and hanging out together in a non-school setting. I’ve gotten to know my advisers and the other students better — you find out pretty quick who’s competitive and who’s into trash talk!”

However, it’s not all fun and games. Many house activities focus on academic success and preparation for crucial milestone events such as national exams and the increasingly competitive National Resident Matching Program, which determines where physicians will train after graduation. The advisers and upperclassmen help younger students gear up for these challenges.

“We know that sustained professional and personal relationships between students and faculty and among peers contribute to effective learning,” Tariq said. “This is one reason about 60 medical schools across the country — about 40 percent of U.S. medical schools — have adopted academic houses or similar learning communities.”

UAMS’ seven academic houses were named by students in honor of successful UAMS alumni, iconic faculty members, prominent Arkansas physicians and other leaders (all deceased) who made their mark on Arkansas and medicine. For example, Neil Ernest Compton, M.D., graduated from UAMS in 1939, served the U.S. Naval Reserve as a medical officer, and practiced obstetrics and gynecology in northwest Arkansas for decades. Compton was a nationally lauded conservationist and was instrumental in having the Buffalo River of Arkansas designated as the first protected “national river” in the National Park System. Ish House is named for George William Stanley Ish, M.D., a Harvard-trained African American physician who cared for citizens in Little Rock from the 1920s through the 1960s and founded a sanatorium for treating tuberculosis patients.

Dozens of UAMS faculty, staff and students gathered outside the Medical Center on a mercifully cool and clear evening for a vigil by the Edith Irby Jones, M.D., chapter of the Student National Medical Association (SNMA) to honor its namesake, who died July 15.

Jones became the first African American to attend an all-white medical school in the South since Reconstruction when she was admitted to UAMS in 1948. She graduated in 1952 and went on to become the first African American resident at Baylor College of Medicine and the first female president of the National Medical Association.

“When I was younger, my grandfather gave me a picture of Edith Irby Jones because he knew I wanted to be a doctor,” said Tia’Asia James, current SNMA president, explaining the personal inspiration she takes from the example Jones set. “Having the opportunity to hold this event meant a lot to us as students, because a few of us are actually recipients of her scholarships, including me.”

“If it were not for her and what she stood for and her drive and accomplishments, many of us might not be here today,” said Maya Merriweather, SNMA vice president. “Tonight, we take a moment to celebrate who she was and what she meant to us as a doctor, mentor, friend and leader.”

Following a welcome and invocation at Bruce Fountain, under clear skies that had threatened rain all day long, James read a letter from Jones’ eldest daughter, Myra Jones Romain. It shared her mother’s struggle of losing her own mother and having to take care of a younger brother while still in medical school, beginning her career and finally establishing her practice, as well as becoming an advocate for civil rights.

Following the letter, SNMA member Paige Jones invited all participants to light candles and observe a moment of silence. Afterward, UAMS Chancellor Cam Patterson, M.D., MBA, addressed the gathering, sharing not the details of Jones’s life, but the emotions her death evoked.

“We are lucky to have been on this earth with someone who was so committed to making a difference… and grateful to Edith Irby Jones for being a groundbreaker,” he said. “We’re also sad because she’s departed us here at this moment. And I am sad that she did not accomplish her goal, that we do not have health care equity in the United States, that we are not all treated the same regardless of where we grew up, what day we pray on, what color we are or what language we speak.”

Patterson encouraged determination to carry on with Jones’ “revolution” and hope that by “committing ourselves to continuing to march forward on behalf of what really matters, that we will make her proud.”

Erick Messias, M.D., Ph.D., M.P.H., noted that in her time as a student, Jones was required to dine alone at a segregated table in the cafeteria, where the kitchen staff left her fresh flowers. “Today, the chancellor is bringing a candle to celebrate her life. This is the trajectory of life that Dr. Jones created for us,” he said.

Messias also shared the impact Jones had for the College of Medicine, transforming both its student body and its faculty.

“The door that she opened is the door through which we got incredible students, incredible residents and we have had amazing faculty members in the College of Medicine,” he said. “I am grateful to her as the associate dean of faculty affairs for giving us such an incredible group of African American faculty members who have made us proud and continue to make us proud every day.”

In closing, Brian Gittens, Ed.D., M.P.A., vice chancellor for diversity, equity and inclusion, reminded those in attendance that with all the privileges Jones’s life made possible for those who followed her comes the responsibility to provide compassionate care and to support and be kind to others.

“That’s the price of this privilege,” he said. “That’s the price I’m hoping we all are willing to pay.”

To the sounds of bingo numbers being called out, speakers on a main stage and the general murmur of conversations, several hundred seniors circulated through the Statehouse Convention Center in downtown Little Rock to participate in the Senior Expo.

Sponsored by UAMS and presented by the Arkansas Democrat-Gazette, the event pulled visitors from throughout central Arkansas and beyond.

About 243 seniors received free health screenings for blood glucose, blood pressure and heart rate as well as medication and vaccination education.

The UAMS Donald W. Reynolds Institute on Aging provided geriatricians to give free consultations throughout the day at the “Ask the Doctor” booths. UAMS Harvey & Bernice Jones Eye Institute staff performed 60 vision screenings.

As part of a panel discussion and question-and-answer session, Jeanne Wei, M.D., Ph.D., executive director of the UAMS Donald W. Reynolds Institute on Aging, and Johnathan Goree, M.D., director of Interventional Pain Management Services at UAMS, gave a presentation on “New Treatments for Managing Pain.”

Both Goree and Wei agreed someone experiencing pain, particularly in the joints and limbs, should not stay still for too long.

“I work with a physical therapist who says ‘movement is lubrication for the joints,’” Goree said. “One of the best things you can do to keep out of our offices is to keep moving. Pain makes you want to keep from moving. Pain can cause inactivity and inactivity can cause pain”

Wei provided three tips for treating acute pain:

• Applying ice to an affected area is the best because it stops nerve traffic and reduces inflammation, making it easier to recover.
• Taking over-the-counter medications like acetaminophen or ibuprofen for the first 48 hours.
• Keeping an affected arm, leg or foot above the level of your heart, so fluids can drain and reduce swelling.

“All of us know there is an epidemic of opioids and other medications that don’t really work for ongoing pain,” Wei said. “We don’t want anybody to get hurt by continuing to take those medicines long term. Research has shown that you only need between three days to seven days of a prescription of opioid medication after a surgery or procedure or injury.”

For anyone, but especially for patients older than 60, use of opioids to treat chronic pain can lead to negative side effects like nausea, constipation, respiratory changes, falls, walking difficulty and bladder issues.

Beyond just a few days of opioid use, patients should try to use mindfulness, meditation and even hypnosis to cope with the mental and emotional stress of chronic pain.

Among the UAMS services and medical specialties represented at the Expo with booths were geriatrics, orthopaedics, caregiver training, ARresearch, stroke, vascular, cancer and nutrition services.

Other presentations made by UAMS physicians included: “Retinal Diseases— Seeing into Your Senior Years,” ophthalmologist Ahmed Sallam, M.D.; “Colon Cancer Screening: Why It’s More Important Than Ever,” colorectal surgeon W. Conan Mustain, M.D.; “Protecting Our Hands and Wrists,” orthopaedic surgeon Theresa Wyrick-Glover, M.D.