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UT resident presents stenting research in Italy

A University of Toledo resident presented research at an international conference, showing that patients who have narrowed arteries to their kidneys are not benefiting from opening up the narrowed arteries by stenting and therefore should not have the surgery.

Mark Yu, a third-year internal medicine resident, discussed his work at the European Society of Hypertension Conference in Milan in June.

Yu was part of an international research project led by Dr. Christopher Cooper, executive vice president for clinical affairs and dean of the College of Medicine and Life Sciences, that investigated whether the use of stents helped reduce blood pressure and provided additional benefit beyond medicine. The study focused on patients with renal artery stenosis, or blockage of the arteries to the kidneys, and found stents provided no additional benefit.

Yu’s presentation was titled “Stenting of Atherosclerotic Renal Artery Stenosis Does Not Improve Clinical Outcomes in Patients Presenting With Congestive Heart Failure: An Analysis of the Cardiovascular Outcomes in Renal Atherosclerotic Lesions Trial.”

“This is a very prestigious study, and I was honored to be a part of the research led by Dr. Cooper,” Yu said. “He is an outstanding faculty member and an expert in this field of study.”

Yu said renal atherosclerotic lesions have been a challenging medical topic. Past clinical trials were criticized because they were poorly designed and executed, he added. However, Cooper’s study is the largest ever and showed convincingly evidence that stenting does not help.

“We looked at 123 patients, which is significant because the past three studies, added together, looked at 90 patients total,” Yu said. “I feel very lucky to be a part of Dr. Cooper’s group. He is leading this cutting-edge research. It was a wonderful opportunity to present this work. I am blessed.”

Cooper said the completion of the study was made possible by the excellent residents at UT.

“I am very proud of the accomplishments of our trainees,” Cooper said. “Mark did an outstanding job presenting the findings of the study. As a result of disseminating this information, it is possible that fewer patients will have to deal with the recovery and cost of inserting a stent surgically.”

UT microbiologist seeks better treatments for Lyme disease with immune response research

Singer Avril Lavigne recently talked publicly about how she was bedridden for five months due to Lyme disease and thought she “was dying” because she couldn’t eat, talk or move.

Wooten

Wooten

By studying the real-time immune response to the bacteria that causes the disease, a University of Toledo researcher is hoping to help create better treatments so that fewer people have to experience what the songstress did.

“What we are trying to figure out is what ‘tricks’ that the bacteria play so that our immune response can’t clear the infection on its own,” said Dr. Mark Wooten, UT associate professor of microbiology and immunology. “If we figure that out, we will have a better idea of what type of vaccine is needed to prevent this disease, which can be quite debilitating in some patients.”

Previously, when the bacteria was injected into mice, researchers were limited on what they could see and when. Wooten came up with the idea to make the bacteria fluorescent (glow green) so it could be studied in real-time using a high-tech multiphoton microscope.

Wooten uses special mouse strains with fluorescent immune cells, injecting them with the Lyme disease-causing bacteria called Borrelia burgdorferi, which is also fluorescent. He then uses high-powered microscopy to observe the fluorescent bacteria in the skin of the living mice to see how they interact with the different immune cells.

Initial findings show that the immune system starts to fight the bacteria, but backs down after a few days, even though large numbers of the bacteria remain. Figuring out why the immune system starts and then stops is crucial to finding a way to treat those infected by Lyme disease, the No. 1 vector-borne disease in the United States that sees an increase this time of year during tick season.

“For the first time we are seeing what the bacteria does in the mice and how the immune cells respond to them,” Wooten said. “We can see where the deficiencies are, which in return allows us to figure out how to improve the immune response in humans.”

Wooten said people getting bitten by an infected tick is a growing problem in the Midwest and Northeast because humans are increasingly living in close proximity to the animals, such as deer, that carry the bacteria.

“Not only are the numbers in the New England states continuing to rise,” he said, “but the bacteria now can be found throughout much of Ohio.”

More than 300,000 cases are believed to occur each year; however, it is estimated that only 10 percent to 20 percent of Lyme disease cases are actually reported.

“Our latest findings indicate that the bacteria can literally outrun our immune cells within the host,” Wooten said. “We figured they would get in the skin and go hide from our immune response. Actually, we are finding that they don’t hide. They continue to move for months or years, and our immune system isn’t clearing them. Why is that? That is what we hope to unravel.”

UT Health doctor named Physician of the Year by Dysautonomia International

Laura Ruszczyk could not sit upright and think for long periods of time. She was continually dizzy and had to give up her beloved road bike. She even had to retire from her job as an elementary school counselor.

Grubb

Grubb

Her dysautomomia, which was diagnosed in August 2011, was ruining the only thing she wanted out of life — normalcy.

It wasn’t until she secured an appointment with Dr. Blair Grubb at The University of Toledo Medical Center that she began to hope and think that life with an autonomic nervous system disorder was manageable.

She waited 16 months to meet the world-renowned autonomic specialist who has a wait list of more than 600 people. The distance did not matter. She drove 300 miles from Buffalo, N.Y., to Toledo.

“You hear his name, see it throughout the research on dysautomomia, and expect a giant when you finally meet him,” Ruszczyk, 51, said. “He walked into my exam room and greeted my husband and me with a warm handshake and smile. He listened, explained the autonomic nervous system to us, examined me and gave answers and hope that we would — together — find a treatment plan that gave me a better quality of life.”

Ruszczyk will get to thank Grubb for his medical efforts and well-known bedside manner when Dysautonomia International presents him with the 2015 Physician of the Year Award at its annual conference July 17-20 in Washington, D.C.

Ruszczyk nominated Grubb, specifically citing a life-changing operation to implant a Biotronik Evia pacemaker that works well for her because it responds to both heart rate and blood pressure.

“This award means a lot to me because of all the work that I have done in creating this subspecialty of medicine,” said Grubb, director of Electrophysiology Services at UTMC and Distinguished University Professor of Medicine and Pediatrics. “However, this award isn’t about me. It is about patients and changing their lives. My nurse practitioner and I do what we can for our patients. It is one day at a time with our huge waiting list. We wish we could do more.”

Dysautonomia affects the nerves that carry information from the brain and spinal cord to the heart, bladder, intestines, sweat glands, pupils and blood vessels. Symptoms can include rapid heart rate or slow heart rate, excessive fatigue, thirstiness, shortness of breath, blood pressure fluctuations and bladder problems.

Because many of the sufferers are women, Grubb said he has seen that their concerns are sometimes not taken as seriously by doctors and they are told to rest or drink more water.

Before becoming Grubb’s patient, Ruszczyk’s heart was beating only 40 to 50 beats per minute compared to a healthy rate of 60 to 100. Her heart now beats 62 beats per minute with the pacemaker.

“I can drive almost an hour now, where before I could not drive for more than five minutes,” she said. “Since the pacemaker, I can go into stores. I can shop for 20 minutes. I didn’t think I would ever bike again. I just finished a 10-mile charity ride.”

Lauren Stiles, president of the Dysautonomia International board, said Grubb was chosen from among 50 nominations. This is the second year for this award.

“This award is important because our patient community has a hard time finding doctors who understand autonomic nervous system diseases and how to treat them,” she said. “We think it is important to recognize doctors who are making a difference for these patients.”

Stiles said one of the common themes among Grubb’s patients is how much time he takes with every patient.

“He is a very special physician. He never stops learning. He is inquisitive,” she said. “He has an excellent bedside manner. He never rushes his patients. In addition to advanced research, he understands the psychology of suffering. Patient-centered medicine is a buzzword these days, but Dr. Grubb has been implementing a patient-centered practice for over 20 years, which is why his patients adore him.”

At the conference, Grubb will address the medical community when he talks about how to talk with patients who are suffering from symptoms that aren’t easily explained.

“Some physicians don’t take this area of medicine as seriously as they should,” Stiles said. “Dr. Grubb helps many of his patients feel so much better. He figures them out the best he can. Even when he can’t immediately figure it out, he says, ‘This is real and we’re going to work together to help you get your life back.’”

Ruszczyk remembers when she called Grubb in the middle of the day because she was nervous about her upcoming surgery. He got on the phone with her immediately.

“Dr. Grubb examines patients from all over the world, and he is usually behind schedule and works long into the evening to see everyone,” Ruszczyk said. “He spends as much time as necessary to see each patient in the clinic, but yet he did not rush me on the telephone.”

Dan Barbee, vice president of clinical services at UTMC, said Grubb is a testament to UTMC’s approach to putting the patient first. His waiting list is indicative of how much his expertise and compassion is valued. Patients come from Canada, Australia, Saudi Arabia, Israel and Great Britain.

“He’s regarded, literally, as the global leader in his field, and patients came from all around the world to see him here at UTMC,” he said. “We are proud that Grubb is one of our own.”

Stoepler Professor of Law and Values named

Dean Daniel J. Steinbock has named Professor Lee J. Strang the next John W. Stoepler Professor of Law and Values, effective July 1.

Strang

Strang

Strang follows Professor Susan Martyn, who became the John W. Stoepler Professor of Law and Values Emeritus following her retirement last month.

“Professor Strang’s outstanding national scholarly reputation and concern for values in his work put him squarely within the aims of this professorship,” Steinbock said. “He joins three other distinguished scholars on the College of Law faculty, Professors Geoffrey Rapp, Joseph Slater and Rebecca Zietlow, in holding one of our named professorships.”

Strang is the author of more than 20 law review publications, a constitutional law casebook, as well as several book chapters and book reviews. He has published in the fields of constitutional law and interpretation, property law, and religion and the First Amendment.

Among other scholarly projects, he is editing the second edition of his casebook for LexisNexis, writing a book titled Originalism’s Promise and Its Limits, and authoring a book on the history of Catholic legal education in the United States.

He frequently presents at scholarly conferences and participates in debates at law schools across the country. He also is regularly quoted in the media. Strang was named the college’s director of faculty research in 2014. This fall, he will be a visiting scholar at the Georgetown Center for the Constitution, where he will complete his book on originalism.

A graduate of the University of Iowa, where he was articles editor of the Iowa Law Review and a member of Order of the Coif, Strang also holds a master of law degree from Harvard Law School.

Before joining the UT College of Law faculty, Strang was a visiting professor at Michigan State University College of Law and an associate professor at Ave Maria School of Law.

Prior to teaching, Strang served as a judicial clerk for Chief Judge Alice Batchelder of the U.S. Court of Appeals for the Sixth Circuit and was an associate with Jenner & Block LLP in Chicago, where he practiced general and appellate litigation.

The professorship is named after Stoepler, the seventh dean of the College of Law. He was an alumnus and longtime faculty member before being named dean of the college in 1983. Stoepler served as interim president of the University in 1988.

The Stoepler Professorship of Law and Values is funded out of a bequest by Eugene N. Balk, a former general counsel of The Andersons Inc.

Child has asthma? Ask pediatrician to test for peanut allergy

Children with asthma should be tested for a peanut allergy or sensitivity, according to research conducted by a former resident at UT Health.

Al-Yazji

Al-Yazji

Dr. Anas Al-Yazji, who was a resident at UT Health from 2010 to 2013, co-authored a study that found children with asthma might benefit from such testing — and parents should ask for it because it isn’t routine for pediatricians to suggest it.

“Asthma is one of the most common diseases in pediatrics, while a peanut allergy or sensitivity can lead to one of the most severe allergic reactions,” he said. “It can be particularly dangerous for asthmatics if they are not prepared.”

The study, led by his mentor Dr. Robert Cohen, looked at 1,517 children who were treated for respiratory problems. Cohen, who at the time worked at Mercy Children’s Hospital in Toledo, presented May 17 at the American Thoracic Society’s international conference in Denver.

Al-Yazji combed through file after file to determine how prevalent peanut allergies were in asthmatics. The link became apparent.

“In general, asthmatics tend to have other allergies like food allergies and skin allergies,” he said. “Peanut allergies are usually more serious because sufferers can have an extreme anaphylactic reaction where they cannot breathe.”

Al-Yazji, who is a pediatrician at Family Care Partners in Jacksonville, Fla., said the study has changed the way he treats asthmatics.

“We recommend that doctors run a blood test called an ImmunoCap to see if their patients are sensitive or allergic to peanuts,” Al-Yazji said. “If they are, doctors should send them home with an EpiPen.”

He added, “It is good to see your hard work pay off. I spent a lot of time working on this. I went through every single chart.”

Physics professor receives fellowship honor

Dr. Jacques Amar, professor and associate chair of the UT Department of Physics and Astronomy in the College of Natural Sciences and Mathematics, recently was elected a Fellow of the American Physical Society.

Amar

Amar

The society fellowship is an honor signifying recognition by one’s professional peers for exceptional contributions to the field of physics. Election to fellowship is limited to fewer than half of 1 percent of American Physical Society members.

“I am honored to have been selected to receive this award. It is gratifying to know that my work has been recognized in this way,” Amar said.

Nominated by the American Physical Society Division of Computational Physics, Amar was cited “for the development and use of novel computational methods, which have advanced our fundamental understanding of a range of problems in condensed matter and statistical physics, including the kinetics of domain growth, surface roughening, crystal growth and thin-film deposition.”

Amar is a computational physicist whose research involves the use of theoretical calculations and simulations to study non-equilibrium processes such as thin-film growth and nanoparticle self-assembly on the atomic scale.

“Many of these processes are poorly understood, so it is important to obtain a fundamental understanding of the key relevant mechanisms and how they depend on experimental parameters,” Amar said. “Since this is often difficult to obtain directly from experiments, these types of calculations and simulations can be very useful.”

As part of his research, Amar uses a variety of methods, including quantum calculations and kinetic Monte Carlo and molecular dynamics simulations. He also is developing methods to carry out accelerated dynamics simulations over longer time and length scales.

Management professor to receive national health-care executives’ award for best published article

Dr. Clinton O. Longenecker, Stranahan Professor of Leadership and Organizational Excellence in The University of Toledo College of Business and Innovation, and his brother, Dr. Paul D. Longenecker, are the winners of the 2015 Edgar C. Hayhow Award from the American College of Healthcare Executives (ACHE).

Dr. Clinton Longenecker

Dr. Clinton Longenecker

They received the award for their research article, “Why Hospital Improvement Efforts Fail: A View From the Front Line,” published in the March/April 2014 issue of the Journal of Healthcare Management.

The award, to be presented during ACHE’s 58th Congress on Healthcare Leadership this week in Chicago, represents breakthrough work in health-care management.

“Working with my brother, Paul, was terrific, as he has more than 30 successful years of invaluable experience in a wide variety of health-care professions. This allowed us a unique opportunity to combine his talents with my background in leadership and change,” Longenecker said.

“This recognition was very rewarding given the changing nature of health care,” he continued. “It was great to be recognized for creating some discussion and practices around how to make changes in hospitals and health-care systems more effective and timely, and we have been receiving a lot of feedback on our work since it was published.”

Paul Longenecker is a senior instructor in the Department of Health and Sports Sciences in the School of Professional Studies at Otterbein University in Westerville, Ohio, and is a graduate of both UT’s nursing and MBA programs.

In their research study, the Longeneckers sought to help health-care leaders improve their understanding of the barriers to effective organizational change and improvement from the perspective of frontline leaders. Focus groups were conducted in four community hospitals to explore why hospital change and improvement efforts struggle and are ineffective. Analysis of the focus group data was featured in the article, as well as leadership lessons and recommendations for success based on the findings.

Paul Longenecker said, “Hospitals really need to become better at practicing the fundamentals of effective change and leadership to be able to compete in the new health-care reality.”

The American College of Healthcare Executives is an international professional society of more than 40,000 health-care executives who lead hospitals, health-care systems and other health-care organizations.

UT chosen as one of four national sites for innovation program

The University of Toledo has been selected by the National Science Foundation (NSF) as one of the first four Innovation Corps (I-Corps) sites in the country. I-Corps sites are academic institutions that engage multiple, local teams in technology transition and strengthen local innovation.

The I-Corps program prepares scientists and engineers to extend their focus beyond the laboratory and broadens the impact of select, NSF-funded basic-research projects.

Developed at Stanford University, I-Corps affords entrepreneurs the opportunity to talk to their customers much earlier in the product and business development process, enabling them to truly understand their market and determine whether or not their product is a fit.

The kickoff of the NSF I-Corps Program is Sunday, March 8, through Wednesday, March 11, in the Thomas and Elizabeth Brady Engineering Innovation Center on UT’s Main Campus. The event is part of a partnership between UT and the University of Michigan, with faculty, students and mentors from both universities participating.

“Recruiting teams for this program has been an amazing experience,” said Dr. Patricia Relue, UT professor of bioengineering. “The scientific and engineering capability at UT is diverse and rich, and the community and alumni response to our mentor recruiting efforts was very enthusiastic. The teams develop a sense of camaraderie during this training that is an important component of the program’s success.”

Eight teams with product and business ideas in the areas of bioengineering, chemistry, and manufacturing and monitoring technologies will receive education and guidance during the event.

“The main focus of this event is to educate and provide resources to these teams that enable them to talk to customers much earlier than is typical in the commercialization process, which allows them to truly understand and validate the market and their customers,” said Jessica Sattler, UT director of economic engagement and business development programs. “This can lead to a pivot in their technology or business model or complete abandonment of the idea before a lot of time and money are spent developing a technology and business for which the market has no need.”

Combining experience and guidance from established entrepreneurs with a targeted curriculum, I-Corps teaches grantees to identify valuable product opportunities that can emerge from academic research, and it offers entrepreneurship training to student participants.

NSF will work with the private sector to bring additional resources to the table, in the form of partnerships and finance, when warranted.

University leadership and representatives from the Ohio Development Services Agency, Ohio Board of Regents, Toledo Regional Chamber of Commerce, Ohio State University and Eastern Michigan University also will be present.

For more information, contact Sattler at jessica.sattler@utoledo.edu or 419.530.6164.

Chemist to talk tunes during March 4 visit

Chart-toppers and musical hits will be discussed in a presentation this week, but it won’t be coming from the music department.

Carroll

Carroll

Dr. William Carroll will give a talk, “Statistics and the Shirelles: How Physical Sciences Thinking Informs Popular Music Analytics,” as part of the Frontiers in Chemistry Lecture Series Wednesday, March 4, at 7 p.m. in Memorial Field House Room 2100.

Carroll has served as chair of the board of directors and president of the American Chemical Society. In addition, he is a Fellow of the Royal Society of Chemistry, a member of the advisory board for the Tulane School of Science and Engineering, vice president of industry issues for Occidental Chemical Corp., and adjunct professor of chemistry at Indiana University.

“To have someone of his stature coming to The University of Toledo is a huge deal,” said Dr. Jim Zubricky, UT associate lecturer in chemistry.

The talk is based on Carroll’s Popular Music and Society paper “Not So Lonely at the Top: Billboard #1s and a New Methodology for Comparing Records, 1958-1975.” He has recently expanded his database through 1980 and will compare the history of Billboard chart songs that were popular in that era, and discuss the methodology for creating the charts.

“This is some unique research that I’ve always wanted to do that I’ve never had time for until the last couple years,” Carroll said. “I always felt that there were ways of analyzing a record’s chart behavior in order to find the strongest records in a given period of time.”

Carroll explained that it’s difficult to determine the “best” records because that’s a subjective term; but you can objectively determine which had the strongest chart history. However, you first need a basis on which to compare two songs from different eras, plus you must consider the evolution of the charts themselves.

The first issue was tackled with the area under the curve approach, Carroll said. This method was developed in the 1970s by assigning a point value to each chart slot. The difference in importance between one and two on the chart is much greater than the difference between 99 and 100 — higher slots are given greater value. Using this point system, researchers can make a bar graph with a point value for each week a song is on the chart.

“The bars have the same width — one week — but different heights. So you can calculate the area of each of those rectangles simply by adding the weekly scores together and get what we call the area under the curve,” he said.

Since this method was developed, at least six more methods have been created, used and written about, Carroll said.

While many similar studies have been done on this topic, Carroll said there was one new piece of the puzzle that he contributed to the discussion: all previous studies ignored the fact that the charts changed over time.

He explained that in the mid-1960s, about 750 songs would enter the charts in a year. But in the 1970s, that decreased to only 400 songs. Each year there are only so many spaces on a chart, meaning there is a fixed amount of space occupied by songs. If you divide that space by a higher number of songs, you get a lower average score for the songs in that era.

“The score of an average song in 1967 would be significantly lower than in 1977, simply because of the denominator — the number of songs entering the charts,” he said. “So if you can’t rely on an average song having the same score, then you’re going to have trouble comparing one era to another an also determining what constitutes a really above-average song.”

What Carroll concluded was that researchers have to compare songs that were on the chart contemporaneously. Those with the highest score compared to records on the chart at the same time are ranked strongest.

However, the more important thing he wants viewers to take away from his talk is that the tools taught in chemistry class can be applied to other situations.

“The moral of the story is that for people who are science students — they go to laboratories, they think chemistry professors are just teaching you this stuff so you can do labs,” he said. “But it’s not just that. We teach you methods of visualization, of graphing, of statistics, because these are ways of dealing with data. It’s not just a chemistry experiment; it can be a popular music chart. You’ll use similar tools for any kind of data.”

Zubricky said that UT tries to instill this philosophy in chemistry students. Interdepartmental research relationships are constantly being formed between students and faculty, he said.

“Even though these are ideas we teach in chemistry classes, these can be applied to everyday problems,” Zubricky said. “The stuff that we’re talking about in general chemistry, the same kind of critical thinking skills that are applied in real-life issues. That’s one of the things I really stress in my classes.”

For more information on the free, public event, contact Zubricky at james.zubricky@utoledo.edu.

Surgeon hopes to start liver, pancreas transplant programs at UT

If you haven’t met Dr. Jorge Ortiz, you probably will; he’s going to do big things at The University of Toledo.

Ortiz

Ortiz

Ortiz, an associate professor and chief of surgical transplant who joined the faculty last year, has been doing kidney transplants and teaching residents the tools of the trade. As an expert of solid organ transplantation, Ortiz hopes to do more than just kidney transplants; he wants to start a liver and pancreas transplantation program at UT in the next two years.

“Transplant surgery is like general surgery, but the risks and benefits are much higher,” he said. “You have to know your general surgery, you have to know transplant surgery, medicine, the whole deal. You have to take care of the whole patient, not just one organ.”

On top of teaching and creating new programs, Ortiz is passionate about the effect of race on transplants. He plans to join the Minority Organ Tissue Transplant Education Program and is part of the diversity committee for the United Network for Organ Sharing (UNOS).

“I have a particular interest in helping even out disparities in health care, and also studying those disparities between ethnic and socioeconomic groups,” Ortiz said. “I want to learn and teach what are the outcome differences, if any, between groups.”

Ortiz is working with Dr. Donald White, professor and chair of the Department of Mathematics and Statistics, to decipher data from UNOS regarding race and transplant outcomes.

“We can’t have a system or a society or a culture where there are different opportunities amongst people, different outcomes amongst people,” Ortiz said. “It should all be fair. We should embrace our differences, but correct our inequalities.”

The initiative for new organ transplantation programs and the collaboration to improve transplants for everyone are just two of Ortiz’s goals. He also said he is looking forward to improving UT’s global outreach and teaching his residents.

“When you do an activity repeatedly, it’s a task, but when you do that with someone to teach them that activity, it’s more enjoyable,” Ortiz said. “I enjoy the energy that the students have — trying to get ahead, trying to improve, not just trying to get by.”