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From music to medicine: MD/PhD student serves as concertmaster for high-profile charity orchestra in nation’s capital

Robin Su won an international piano competition before he had a driver’s license, has been invited to play at Carnegie Hall, and performed a violin solo at the esteemed Cleveland Orchestra.

But the greatest musical honor of the violinist and aspiring physician’s life came in August when he was selected to be concertmaster for two rare joint performances by the World Doctors Orchestra and the National Institutes of Health Philharmonia in Washington.

Robin Su, fourth-year MD/PhD candidate in the College of Medicine and Life Sciences, performed last month with the World Doctors Orchestra and the National Institutes of Health Philharmonia in Washington.

Su, a fourth-year MD/PhD candidate in The University of Toledo College of Medicine and Life Sciences, wasn’t just sitting first chair — the most important orchestra position after the conductor — he was the only student among the 70 or so doctors and researchers volunteering their time for the charity concerts.

“It is very difficult to be invited to perform with this orchestra,” Su said. “Some of the world’s finest MDs and PhDs were there together.”

Su, 25, is hoping to join their ranks.

As he worked toward a degree in violin performance at the Cleveland Institute of Music, Su was taking pre-med classes at Case Western Reserve University.

Robin Su posed for a photo with Nancia D’Alimonte, music director of the National Institutes of Health Philharmonia, in Washington.

“I was always interested in music and medicine,” he said. “As I got older and looked at the different possibilities of pursing both, I think that became more realistic.”

Su was one of just three students accepted into UT’s joint MD/PhD Program in fall 2015. His current research is focused on how microcystin, a dangerous toxin produced by algal blooms, might affect individuals with pre-existing conditions such as inflammatory bowel disease.

He is working to find biomarkers that could help clinicians diagnose microcystin-induced liver damage.

“We’re trying to be at the front end and have preventative measures and diagnostic measures to prevent it from progressing further,” Su said. “Liver disease is a progressive disease from multiple hits, and we think that microcystin definitely plays into that and accelerates that process. We’re trying to prevent that from moving forward.”

As a professional musician, Su would dedicate eight hours a day to practice. That’s been significantly scaled back as he juggles his course load and laboratory work. Even so, Su managed to cram in four hours of practice every night in the weeks prior to the August performances.

Once together in Washington, the group went through three days of grueling eight-hour rehearsals. As concertmaster, Su took on many added responsibilities, including the execution of several solo passages, acting as a liaison between the conductor and orchestra to facilitate musical communication, and serving as a leader of the entire orchestra to ensure musical unity.

That’s no small task when you’re talking about an organization in the World Doctors Orchestra that draws from a rotating cast of more than 1,200 physicians from nearly 50 countries. Combine that with integrating musicians from the NIH Philharmonia, and it’s downright challenging.

“Normal orchestras rehearse throughout the year and we only have three days,” Su said. “I think everyone was very appreciative of my strong leadership of the orchestra, and I think it played a role in bringing everything together very quickly.”

His work won high praise from Sheyna Burt, president of the World Doctors Orchestra USA. There’s a bit of a cliché, Burt said, of a hard-charging physician by day and a dedicated amateur performer by night.

“With Robin it’s different. Whatever his academic prowess might be, he is a genuinely gifted and sensitive artist,” she said. “During the first rehearsal of the World Doctors Orchestra/NIH Philharmonia collaboration, I witnessed his interpretation of the opening violin solo in Rimsky-Korsakov’s ‘Russian Easter Overture’ stop an entire orchestra in its tracks.”

Su, who is about halfway through his dual degree program, eventually wants to actively practice medicine along with conducting academic research.

And he hopes to continue playing violin, encouraged by the world-class doctors and researchers with whom he recently performed.

“It’s definitely inspirational for me, seeing that physicians can still balance their work with their musical passion,” he said.

Opioid epidemic’s impact on older adults topic of upcoming UT, BGSU seminar

The University of Toledo is partnering with Bowling Green State University’s Optimal Aging Institute, the Wood County Committee on Aging and the Area Office on Aging of Northwestern Ohio to hold a town hall discussion on how the opioid crisis is affecting older adults and what the community can do to help.

The program, called Opioid Misuse and Addiction Among Older Adults, will be held Friday, Oct. 5, from 7:15 a.m. to 1 p.m. at the Penta Career Center in Perrysburg.

Among the scheduled speakers will be Lance Robertson, assistant secretary for aging at the U.S. Department of Health and Human Services.

Opioid abuse is often seen as a problem that only affects young adults, but experts say misuse among older Americans is a real and rapidly growing concern.

“We don’t think of it as much in older adult populations, and it’s probably not as prevalent, but it certainly is a problem that exists and needs to be addressed,” said Dr. Victoria Steiner, associate professor in the UT School of Population Health and assistant director of the Center for Successful Aging.

Overdose incidents among older Americans are rising sharply. Earlier this year, the U.S. Centers for Disease Control and Prevention reported the number of emergency room visits for suspected opioid overdoses among those aged 35 to 54 increased by 37 percent. Among those 55 or older, ER visits were up by 32 percent. More than 44 percent of overdose deaths in 2016 occurred in those 45 and older, the CDC reported.

Beyond overdoses, there are other unique concerns related to prescription opioid use in older populations.

“Even if they’re not addicted, opioids can cause problems with breathing, with confusion and with falls in older adults,” Steiner said. “There’s also a risk that somebody else in the family could be diverting their medications.”

Topics to be addressed at the seminar include warning signs that older adults may be suffering from opioid addiction; examples of situations that increase the risk for abuse or addiction; evidence-based pain management in the era of the opioid crisis; and public policy and resources for health-care professionals who work with older adults and their families.

“Older adults are interfacing with so many different health-care professionals and our hope with this Oct. 5 presentation is to bring in all these providers so they receive the same prevention education messages and recognize the importance of assessing opioid use and misuse,” said Dr. Nancy Orel, executive director of research at BGSU’s Optimal Aging Institute and interim chair of the Department of Human Services.

To register for the free, public event, call the Wood County Committee on Aging at 419.353.5661 or email oai@bgsu.edu. The event does not offer continuing medical education credits.

UT faculty awarded $1.3 million in federal grants for medical research, education, technology

Faculty members at The University of Toledo were awarded $1.3 million in federal grants for projects related to opioid abuse, mental health, cancer and antimicrobial technology.

“The University of Toledo continues to advance its strong research base, this time in the two critical areas of innovative drug targets for cancer risk and also to public health and opioid crisis education,” said Congresswoman Marcy Kaptur. “The University of Toledo’s leadership in pioneering treatments and therapies for everything from heart disease to detecting a substance-use relapse has earned it the attention of granting agencies. Securing competitive federal awards is no easy task. Congratulations to UT for identifying and competing in very competitive space.”

Dr. Cheryl McCullumsmith, professor and chair of the UT Department of Psychiatry, was awarded a three-year, $449,076 grant from the Center for Substance Abuse Treatment to expand education about opioid use disorder across all disciplines within UT’s College of Medicine and Life Sciences.

“The College of Medicine and Life Sciences will equip all medical students with the knowledge and the skills they need to appropriately manage opioid treatment and confidently identify opioid use disorders, regardless of their planned specialty. We are training a generation of family medicine doctors, surgeons and internists to actively prevent and treat opioid use disorders,” McCullumsmith said.

Dr. Linda Lewandowski, dean of the UT College of Nursing and co-chair of the UT Opioid Task Force, was awarded a three-year, $371,723 grant from the Substance Abuse and Mental Health Services Administration for an interdisciplinary public health project that will provide evidenced-based mental health awareness training to UT students, faculty and staff, as well as the wider northwest Ohio community.

The training includes appropriate responses, materials on available community resources, and information about the unique mental health needs of active-duty military and veterans. The program is built with a specific emphasis on issues related to the opioid epidemic.

“With one in five Americans experiencing mental health problems in a given year, it is more likely that an individual will come across someone having an emotional or mental health crisis than someone having a heart attack. By providing ‘mental health first aid,’ we will empower our students, faculty and community to recognize mental health and substance abuse problems and respond appropriately. This type of training is especially important during this time of the pervasive opioid crisis affecting our state and the nation,” Lewandowski said.

Dr. Maria Diakonova, professor in the UT Department of Biological Sciences, was awarded a three-year, $449,667 grant from the National Institute of General Medical Sciences to focus on a protein called JAK2 as she works to identify new drug targets to reduce the risk of cancer.

“Our goal is to explain the JAK2-mediated intracellular pathways and have a better understanding of the mechanisms involved in cell proliferation, or cell division, which could provide insight into future therapeutic approaches to cancer,” Diakonova said.

Dr. Terry Bigioni, professor in the UT Department of Chemistry and Biochemistry, was awarded a $50,000 grant from the National Science Foundation to research broad-spectrum antimicrobial coatings for garments and textiles. Antimicrobial treatments are already used in medicine as anti-infective treatments and in garments and textiles for odor control. This technology could bring odor control to a wider range of products and reduce the need to launder many garments, improving garment lifespan and reducing their environmental impacts.

“We think our antimicrobial technology could bring a lot of added value to the garment and medical industries and create new manufacturing jobs right here in northwestern Ohio,” Bigioni said.

Women & Philanthropy awards two grants to College of Medicine

Women & Philanthropy, a volunteer organization that promotes The University of Toledo through grants to UT initiatives, has given 2018 grants in the amount of $69,348.44.

The first grant for $63,400 was awarded to the College of Medicine and Life Sciences to create the Women & Philanthropy Thrombosis and Hemostasis Research Center. This grant will address a significant gap in the University’s ability to assess thrombosis in human patient and rodent samples.

Scientists in the college are focusing on diseases that have significant mortality due to thrombotic complications and in projects surrounding cancer-induced thrombosis.

“The ability to find reliable diagnostic tests or markers that will accurately characterize the risk of developing a clot is vital,” Marcy McMahon, chair of Women & Philanthropy, said. “While the scientists can do certain assays associated with assessing clotting, they do not have the necessary equipment to perform platelet aggregometry and complete blood counts.”

The new equipment will have broad-ranging applications from autoimmune to metabolic disease. Investigators in multiple departments will be able to highlight the Thrombosis and Hemostasis Research Center in grant applications to organizations such as the National Institutes of Health and the National Science Foundation to help secure more research funding for investigators and The University of Toledo.

The second grant for $5,948.44 also went to the College of Medicine and Life Sciences to provide for photoscreening of infants and children at well-care visits.

The Spot Vision Screener to be utilized requires minimal patient cooperation, bypassing traditional screening methods. It will allow infants and toddlers to be screened, along with older children with significant developmental disabilities.

“This screening is important in order to reduce the risk of amblyopia, a condition that causes permanent vision impairment but is preventable if vision problems are recognized early,” McMahon said.

Women & Philanthropy at The University of Toledo was chartered in 2006 and made its first award to UT in 2008. Through this giving circle, members of diverse backgrounds and interests work collaboratively to make positive, meaningful and immediate impacts at the University.

Women & Philanthropy has given a total of 19 grants totaling $493,687.44 to The University of Toledo during the past 10 years.

Applications for 2019 grants will be available in late fall.

Additional information about Women & Philanthropy is available at
utfoundation.org/give/women-philanthropy.

UT scientists awarded nearly $1 million in federal grants to examine cell behaviors

The U.S. Department of Health and Human Services awarded nearly $1 million in federal grants to two scientists at The University of Toledo for research projects examining cell behaviors that can lead to the development of better medicines to treat cancer, cardiovascular disease and autoimmune disease.

“Once again one of our top-level Ohio universities proves that they are on the cutting edge of medical research and innovation,” said Congresswoman Marcy Kaptur. “Northern Ohio is a leader in medical research, and these funds build on that foundation of excellence. These researchers are pushing boundaries and working to develop treatments and therapies to help those suffering from chronic illness. The University of Toledo distinguishes itself by competing and winning competitive grant opportunities such as the one announced [Sept. 11]. I am pleased to be able to support their efforts to access federal research resources.”

Dr. Ajith Karunarathne, assistant professor in the UT Department of Chemistry and Biochemistry, received $441,323 from the National Institute of General Medical Sciences to examine the regulation of a crucial group of signaling pathways named G-protein and GPCRs that help the body control functions, including heart rate, and are involved in pathological processes such as cancer and heart disease.

“Knowledge from our experiments will help develop tissue- and organ-specific therapeutics for a variety of diseases, including cancer, that are less harmful to bodily functions,” Karunarathne said.

Dr. James Slama, professor in the UT Department of Medicinal and Biological Chemistry, received $461,898 from the National Institute of General Medical Sciences to identify the elusive receptor for nicotinic acid adenine dinucleotide phosphate, or NAADP, which could lead to the development of inhibitors that may be useful as anti-tumor drugs.

“This project is part of an effort to discover how cells in an organism control their behaviors, and how they can respond to changing outside conditions,” Slama said. “Calcium inside of the cell is an important controller, and a second chemical, named NAADP, is one of several substances that triggers internal calcium release. Our goal is to understand how NAADP causes this calcium release and to identify the individual steps in the process in both normal and in diseased states.”

Professor receives $2.6 million research grant to further examine link between gut bacteria and high blood pressure

A University of Toledo researcher recently received a $2.64 million grant from the National Heart, Lung and Blood Institute to continue her groundbreaking study into how the unique colonies of tiny microorganisms living in our gut can regulate blood pressure — or lead to hypertension.

High blood pressure is one of the most common ailments among American adults. According to figures from the U.S. Centers of Disease Control and Prevention, one in three adults has hypertension. And only about half of those have their condition under control.

Dr. Bina Joe has received a $2.64 million grant from the National Heart, Lung and Blood Institute for her research on hypertension and gut bacteria.

But even those who are actively controlling their hypertension are frequently just masking the problem.

“Blood pressure medicines are not curing the cause. They are attacking it after its onset,” said Dr. Bina Joe, Distinguished University Professor and chair of UT’s Department of Physiology and Pharmacology, and director of the Center for Hypertension and Precision Medicine. “If we know that there are some bacteria that shouldn’t be there and we can correct it early on, will that lead to better health as a preventative measure?”

The hope is that the grant-funded research could ultimately lead to breakthroughs that would give clinicians a way to treat or even prevent high blood pressure by manipulating those microorganisms, also known as microbiota.

Researchers have long known that our genes can predispose us to high blood pressure. But only more recently — thanks in large part to the research by Joe’s team at The University of Toledo — has the medical community begun to realize how the microorganisms living in our bodies play a role in that equation.

“A human is an ecosystem,” Joe said. “We have one host and so many microbiota. Together they influence several traits for normal health.”

The four-year grant will allow Joe’s lab and co-investigators from her department, Drs. Matam Vijay-Kumar and Ritu Chakravarti, to dig deeper into that connection in three ways:

• First, researchers will look into how an individual’s genome determines which microorganisms flourish in their guts.

• Second, researchers will look at the effects of high salt consumption on the animals’ microbiota. Salt can kill bacteria, and it’s possible, Joe said, that high salt intake can disturb the microbiota that are beneficial to maintenance of normal blood pressure.

• Third, researchers will look at epigenetics — essentially how gene function can be altered by environmental factors and diet.

Though the work is still early, Joe and her graduate student, Saroj Chakraborty, have already been granted a patent. Researchers isolated a certain chemical called beta hydroxybutyrate that increases with exercise, but decreases with salt consumption. Joe said it’s possible that exercise benefits hypertension in part because of the higher concentration of that compound.

The lab fed hypertensive rats a precursor of that molecule to see if their blood pressure decreased.

“Sure enough, it did,” Joe said. “Our idea is if there are people who cannot exercise but they’re salt-sensitive hypertensives, here could be a magic pill. You could take a bit of this chemical so you don’t have to keep running but you can control your blood pressure. That’s unpublished data coming from this work, currently in peer review.”

Some of Joe’s earlier work on microbiota and hypertension also is getting attention for its intersection with the growing worry that overuse of antibiotics is leading to an increase in drug-resistant superbugs.

Research led by her lab found that common antibiotics could lead to a spike in blood pressure for certain individuals, while other antibiotics may actually reduce blood pressure in hypertensive patients.

The reason for that discrepancy appears to be tied to how the antibiotics interact with an individual’s microbiota.

The findings, which were recently published in the journal Physiological Genomics, could lead to additional studies that hone a more individualized approach for physicians to consider when using antibiotics to treat infection.

“I think this study is hugely important for the future of prescribing antibiotics. They’re prescribed so often to hypertensive individuals, and this study shows that can have a really negative affect on their blood pressures,” said Sarah Galla, an MD/PhD candidate, who worked with Joe on the study.

“This highlights the importance of more studies that need to be done to further the field of personalized medicine, rather than just prescribing the same antibiotic to every patient.”

The University Toledo College of Nursing and ProMedica expand partnership

The University of Toledo College of Nursing and ProMedica today announced an expanded partnership to bolster nursing education and address current and future health-care industry challenges.

The planned partnership between the UT College of Nursing and ProMedica will focus on enhancing undergraduate and graduate nursing education and high-quality care while developing a clinical nursing workforce to help meet current and future health-care needs in ProMedica’s local, regional and national service areas. According to the Bureau of Labor Statistics, the United States is expecting 1.2 million job position vacancies for registered nurses by 2020.

The UT College of Nursing provides nursing education programs responsive to the changing needs of students and the health-care environment. UT’s nationally ranked master’s and Doctor of Nursing Practice Program include a range of specialties, including adult gerontology primary care, pediatrics and psychiatric mental health. UT’s Post-Baccalaureate Doctor of Nursing Practice Program was the first such program in the state to take nurses to the highest level of clinical practice and position them as leaders in the health-care field.

Through this partnership, ProMedica and UT will collaborate to develop innovative educational programs, diverse clinical experiences for students, interprofessional research collaborations and high-quality professional development programs to improve health care in our community.

Additionally, the partnership will work to advance the nursing profession and health care by supporting the development of local, state and national policies.

“Our expanded partnership with The University of Toledo College of Nursing is a natural extension of the academic affiliation between ProMedica and The University of Toledo College of Medicine and Life Sciences, and it reflects our shared commitment to developing northwest Ohio into a premier hub of medical education and clinical care,” said Randy Oostra, president and CEO of ProMedica. “This is an especially exciting time to take this partnership to the next level given our recent addition of HCR ManorCare, and the increased opportunities to educate and better prepare nurses to meet the needs of the growing senior population.”

“Strengthening the University’s partnership with ProMedica provides exciting opportunities to expand clinical training opportunities for our nursing students and to increase academic-clinical collaboration to advance nursing education, research and practice,” said Dr. Sharon L. Gaber, president of The University of Toledo. “We are proud to build on our existing Academic Affiliation to continue to advance our region as an innovative leader in education and health-care delivery. As part of this new partnership with the College of Nursing, research will be enhanced and the College of Medicine and Life Sciences, through the Academic Affiliation, is committing $1 million to collaborative research between the colleges.”

Fellows selected for MAC Leadership Program

Three UT faculty members have been named fellows to participate in the second year of the new Mid-American Conference Academic Leadership Development Program.

The program was created to identify, develop, prepare and advance faculty as leaders in the colleges and universities that are members of the Mid-American Conference. Fellows participating in the program have the opportunity to gain valuable knowledge and experience by working closely with select administrators from other colleges and universities in the MAC.

Dr. Andrew Hsu, provost and executive vice president for academic affairs, said, “Leadership development is an important part of faculty professional development and faculty success, and The University of Toledo is committed to providing these exceptional leadership opportunities for our faculty.”

Fellows for the 2018-19 academic year are:

• Dr. Cyndee Gruden, interim dean of the College of Graduate Studies, and professor of civil and environmental engineering;

• Dr. Jason Huntley, associate professor of medical microbiology and immunology; and

• Dr. Kristen Keith, associate professor of economics, assistant to the executive vice president for finance and administration/chief financial officer, and faculty associate.

Last year, two UT faculty members participated in the inaugural year of the MAC Academic Leadership Development Program: Holly Monsos, professor of theatre and associate dean of the College of Arts and Letters, and Dr. Amy Thompson, professor of public health and interim associate vice provost for faculty affairs.

All tenured faculty with experience in administrative leadership and service were eligible to apply for the MAC Academic Leadership Development Program. Candidates needed to submit a letter of support from their dean, as well as an application and curriculum vitae for consideration.

“Our fellows will participate in a development program with UT leaders to gain valuable insight and experience,” Hsu said. “In addition, they will work with administrators and peers from MAC member institutions to better understand how universities operate.”

All MAC Academic Leadership Development Program fellows will attend one three-day workshop each semester. Topics to be addressed include budgeting, conflict resolution, accreditation and accountability.

“Thanks to this program, our fellows will see firsthand the challenges and rewards of institutional service as they prepare for potential leadership positions,” Hsu said. “This is an excellent opportunity to advance academic leadership among our faculty at UT.”

Read more about the MAC Academic Leadership Development Program here.

UT psychologist wins Fulbright grant to study child abuse prevention in Netherlands

About 540 children are identified as victims of abuse or neglect each year in Lucas County.

“For every substantiated case of physical child abuse in the U.S., approximately 40 more exist that go undetected. It’s heartbreaking,” said Dr. Michele Knox, University of Toledo professor of psychology, who has dedicated her life to protecting children and educating parents with alternative methods of discipline.

Knox

She recently was awarded her second Fulbright award to visit the Netherlands to find innovative and effective ways to improve child abuse prevention in the United States.

“I am honored to receive this award. It is an opportunity to bring home new ideas and approaches because the Netherlands is among the nations with the lowest rates of child maltreatment deaths,” Knox said. “I will be learning from the people there and benefiting from their expertise, knowledge and success.”

Starting in spring 2019, Knox will spend nearly three weeks at the University of Utrecht, the largest university in the Netherlands.

“This is a big change from my last Fulbright specialist project, which was in northern Portugal,” Knox said. “I was teaching the Portuguese how to use evidence-based parenting group programs to prevent child abuse.”

The United States, Mexico and Portugal have “exceptionally” high rates of child maltreatment deaths, according to the UNICEF Innocenti Research Centre.

For 16 years, Knox has been a master trainer for the American Psychological Association’s Adults and Children Together (ACT) Raising Safe Kids Program, which trains parents and caregivers in nonviolent discipline, child development, anger management and social problem-solving skills.

While in the Netherlands, Knox plans to teach college students and professionals about the ACT program and other topics related to child abuse and well-being.

Knox teaches medical students and residents at UT. She also is a clinical psychologist who specializes in children, adolescents and trauma; child abuse prevention; and parenting.

“Spanking is often the first step in the cycle of child abuse, and it can result in aggressive behavior and delinquency in kids,” Knox said. “I teach alternative methods of discipline for positive parenting solutions, such as the use of timeouts, removal of privileges, and positive reinforcement to reward the child’s good behavior.”

Her current research addresses factors related to harsh and abusive parenting, outcomes of child maltreatment prevention programs, and the efficacy of the Child Advocacy Studies training program for medical students.

Women in STEM to host network-building event

Women in STEM at The University of Toledo is working with the Catharine S. Eberly Center for Women and the Association for Women in Science to create mentoring programs and initiatives for students.

A welcoming and network-building event will take place Monday, Aug. 20, for women pursuing a degree in science, technology, engineering or math at the University. The organization also has expanded its inclusion of those studying the medical sciences.

This free event will be held from 4 to 7 p.m. in the Libbey Hall Dining Room and provide students and faculty with a relaxed atmosphere that will allow them to establish and develop mentoring relationships to ensure their success at UT.

Women in STEM at UT also has worked with IDEAL-N, a multi-university project that is funded through the National Science Foundation ADVANCE program and facilitated by Case Western Reserve University.

IDEAL-N aims to institutionalize gender equity transformation at leading research universities by creating a learning community of academic leaders that is empowered to develop leverage knowledge, skills, resources and networks to transform university cultures and enhance diversity and inclusion.

“Organizations like these and the Association for Women in Science are a valuable source of information for women in STEMM,” said Dr. Patricia Case, associate dean for the UT College of Arts and Letters. “They provide links to education and research opportunities, as well as provide opportunities to develop relationships with other women in STEMM.”

Research has found that a male-dominated discipline can be demoralizing to women, and having a group of individuals to guide you or “have your back” can be the difference between success and exiting a career path, Case explained.

“Women account for approximately 52 percent of the population, so equality would mean that we have more representation in these fields,” Case added. “When barriers are lifted, women pursue and succeed in these degrees as much as men.”

If interested in attending the event, RSVP to Angelica Johnson at angelica.johnson2@utoledo.edu or 419.530.5146.

For questions about the event, contact Case at patricia.case@utoledo.edu.