THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCES

spotlight2017 CONTENTS Letter from the Dean 1

Facts & Figures 3

Education 6

Research 14

Clinical Care 24 Supporting our Community, Fulfilling our Mission

The Spotlight presented before you is a snapshot of the past year. I hope it provides great insight into the wonderful work going on each and every day at The University of Toledo College of Medicine and Life Sciences.

Inside, you will find a glimpse of how we are supporting our community and fulfilling our three mission pillars of education, research and clinical care.

Among the highlights of this past year was growing our partnership with ProMedica. This includes expanded research and learning opportunities for our faculty and students, as well as capital investments to improve the College of Medicine facilities. A learner space for students and residents opened at Toledo Hospital and we transitioned 32 additional residents and more than 300 medical students into Toledo Children’s Hospital and Toledo Hospital.

The Academic Affiliation is making great strides toward its goal of cultivating a pipeline of exceptional medical talent. This also aligns with our new mission statement to improve health in the communities and region we serve. More than 75 percent of the new students are Ohio residents, and one-third is from northwest Ohio. Graduating students also are staying in our northwest Ohio community to pursue residencies at UT in record numbers. Of all of our accomplishments, the fact that UT students are choosing to stay in Toledo for residency will likely have the greatest impact on our medical community in the years to come.

Our students also made a difference in the community through programs like the Summer Community Health Project and CommunityCare Clinics. Our faculty and students also traveled the globe, sharing their knowledge and expertise in countries including Guatemala and Honduras.

Our surgical residency program was ranked 14th in the country by the Journal of Surgical Education when considering outcomes.

Philanthropy plays a vital role to ensure the continued advancement of medical science and our mission to improve the human condition. This report also highlights the story of the Medical Research Society, which awarded its second $50,000 grant to a faculty member leading promising research. Importantly, these grants are helping our faculty be competitive for national grant awards and creating opportunities for their trainees.

Our donors also have helped to ensure the dream of a medical education is within reach for many of our new and continuing students by providing scholarship opportunities. Our students benefit significantly from this philanthropy with more than $1.1 million in scholarships awarded last fall.

The University continues to lead in the area of research. Our faculty received more than $13 million in research grants. Studies included Alzheimer’s disease, atherosclerosis, diabetes, hypertension, the immune system, kidney disease, Lake Erie algal bloom toxins and PTSD.

As we look into 2017 and beyond, we’ll continue to pursue several major initiatives, including the ProMedica Academic Affiliation, improving residency programs to attract and retain talented students, implementing a new curriculum for our incoming class of medical students, renovating our research labs on campus and improving the student experience.

In closing, I would like to thank the faculty, staff, students, alumni, donors, supporters and trustees who have contributed to the remarkable achievements and successes in this past year. I’m looking forward to even more success in the future.

Christopher J. Cooper, MD Executive Vice President for Clinical Affairs Dean of the College of Medicine and Life Sciences

THE UNIVERSITY OF TOLEDO 1 2 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Facts & Figures List of Academic and Clinical Departments History In the 1960s, a critical shortage of doctors developed in the United States Anesthesiology due to the limited number of medical schools that existed to train them. In Cancer Biology response to this shortage, the Toledo State College of Medicine — later renamed Medical College of Ohio and, after that, Medical University of Ohio Emergency Medicine — was founded in 1964 as a freestanding, state-supported institution that Family Medicine eventually blossomed into an academic health sciences center. Internal Medicine One of 14 state universities in Ohio, The University of Toledo was established in 1872 and became a member of the state university system in 1967. UT and Medical Microbiology and the Medical University of Ohio merged in July 2006 to form an institution Immunology with a comprehensive breadth of undergraduate, graduate and professional Neurology programs matched by just 27 universities across the nation, and with the third-largest public university operating budget in the state. Neurosciences

In July 2016, the University celebrated its 10-year anniversary of the merger. Obstetrics and Gynecology

“This merger was something that was kind of ahead of its time because in Orthopaedic Surgery higher education, we’re talking about getting the best value for the resources Pathology that we spend on higher education,” said John Carey, chancellor of the Ohio Pediatrics Department of Higher Education. Physician Assistant Studies In 2015, The University of Toledo College of Medicine and Life Sciences began a 50-year academic affiliation partnership with a local health system, Physiology and Pharmacology ProMedica, to provide additional and expanded opportunities for the College. Psychiatry This includes expanded research and learning opportunities for faculty and students, as well as capital investment to improve university facilities. Radiation Oncology Radiology The University’s Economic Impact The University of Toledo’s impact to the region’s economy totals $3.3 billion, Surgery according to a 2017 comprehensive study by UT economists. Urology That is equivalent to 9.7 percent of the region’s gross, metropolitan area product.

“As the second-largest employer in northwest Ohio with an enrollment of more than 20,000 students, we are proud to be one of Toledo’s anchor institutions RESEARCH contributing as a major force to the region’s growth and development,” UT SUPPORT President Sharon L. Gaber said. “The University of Toledo continues to work hard to strengthen the community.”

96 FY16 Research Data for the College of Medicine and Life Sciences # of new awards for FY16 FY16 TOTAL EXPENSES 18,534,597.75

FEDERAL 13,854,395.12 61 STATE 468,322.85 134 225 # of principal # of active # of grant proposals investigators awards submitted and pending OTHER 4,211,879.78 for FY16

THE UNIVERSITY OF TOLEDO 3 Mission We improve health in the communities and region we serve by educating excellent clinicians and scientists, providing patient- centered and high-quality care, and producing nationally recognized research in focused areas.

The College of Medicine and Life Sciences revised its mission, vision and values in 2016 to reflect the evolving educational, clinical and research goals of the College. The revised mission accompanies an updated vision for the college, meant 346 688 to reflect the Academic Affiliation between the College of Medicine and Life GRADUATE MEDICAL STUDENTS STUDENTS Sciences and ProMedica and the ongoing effort to develop educational programs and sponsored research of national prominence. 14 Both statements reflect the College’s core values of professionalism, service, DUAL-DEGREE STUDENTS diversity, collaboration and discovery.

“We want all College of Medicine and Life Sciences employees, faculty and learners to embrace and demonstrate our common values each day,” said Dr. Christopher J. Cooper, executive vice president for clinical affairs and dean of the College of Medicine. “The revised mission and vision statements frame the MD/PHD – 9 organizational culture of the College and will influence our success in achieving MD/MBA – 1 our educational, clinical and research imperatives.” MD/JD – 2 MDDD – CERTIFICATE Students IN PATHOLOGY – 2 The College enrolled 688 medical students and 346 graduate students during the spring 2017 semester, with 14 dual degrees.

Medical Students: Class Profile The 175 medical students admitted

to the College last fall represent 54 WA ME

MT ND VT different universities or colleges, NH MN OR NY WI MA including 18 institutions in Ohio. 2 1 ID SD MI CT 17 RI More than 75 percent of the new WY PA 1 IA 2 NJ 1 NE OH MD students are Ohio residents, and IL IN 133 DE NV 1 2 3 UT WV VA DC 1 CO one-third is from northwest Ohio. KS KY 1 CA MO 1 7 All students have earned bachelor’s NC TN

OK AR SC degrees, with 60 holding master’s AZ NM GA AL and two with PhD degrees. There MS

TX LA are 95 men and 80 women. 2

FL The entering class of 2016 was filtered from 3,679 applications. AK The average, total GPA of this class is 3.64.

HI

4 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Match Results It was an exciting day for 165 graduating medical students from The University of Toledo who packed Stranahan Theater to learn where they would complete their training.

“Match Day is a thrilling milestone for a medical student,” Dr. Christopher J. Cooper, dean of the College of Medicine and Life Sciences, said. “Our students matched throughout Ohio and the nation in a very competitive environment. Our faculty and staff are proud of this class for their years of hard work and dedication to become doctors. We are honored to help launch their careers.” UT resident Ebtisam Alumin, left, and medical student Tarshree Sawyer, Of the 12 UT students who matched in northwest center, are excited to see that Avneet Singh matched in internal medicine at Ohio hospitals, nine continue to train in UT residency the University of Vermont Medical Center. Sawyer is headed to the University of North Carolina Hospitals for pediatrics. programs.

The students matched in 24 specialties, with 67, or 41 percent, in primary care fields. The top specialties for the graduating class were internal medicine, emergency medicine, family medicine and pediatrics.

Ohio was the most popular state with 52 students matching there, followed by Michigan with 18 and California with 14. Overall, students matched with programs in 31 states.

“I could’ve gone somewhere closer to home in New England, but my experience Community-based here made me want to stay,” Sophia Toraby said. “The specialty was a wonderful surprise. I had applied for both general surgery and ob/gyn. I let the national match math algorithm make the decision for me. This is a great fit.”

Not only were graduating medical students proud of their placements, faculty Clinical Basic Science Science Basic Staff Staff and staff were pleased with the spike in the number of budding doctors across 1,374 the country who will join UT’s residency programs. 290 244

Diversity The College of Medicine and Life Sciences is a community of diverse, lifelong 70 learners who embrace the value of diversity. The College seeks to create and sustain an environment in which all members remain aware of and strive to achieve their best potential when relating to patients, learners and colleagues from diverse racial, cultural and ethnic backgrounds. FACULTY

The Office of Diversity is very active in the admissions process and sits on the College of Medicine Medical School Admissions Committee.

The University of Toledo’s chapter of the Student National Medical Association (SNMA) is an organization for medical students that focuses on the needs and concerns of current students who have historically been underrepresented in medicine and come from underserved communities. The members of this organization strive to ensure that medical education has emphasis on increasing future physicians who are culturally competent and sensitive to the needs of diverse populations.

THE UNIVERSITY OF TOLEDO 5 EDUCATION

The University of Toledo College of Medicine and Life Sciences is teaching and training future physicians and world-class researchers who will lead the way to a new model of health care. Facing an aging population and an increased need for health care providers, this work is even more relevant.

By fostering new partnerships for academic excellence and expanded opportunities for clinical training and residency placement, UT is on a long-term mission to recruit top-performing students, educate them to be the best doctors, advanced practitioners and research scientists, and retain them in northwest Ohio as they build their careers.

6 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Academic Affiliation Expands Clinical Training Capacity

A learner space and conference center for students and residents opened at ProMedica Toledo Hospital and included a transition of 32 additional residents and more than 300 University of Toledo medical students. New administrative offices for the Academic Affiliation also opened in Jobst Tower on the campus of ProMedica Toledo and Toledo Children’s Hospitals. Designed to enhance clinical integration and provide offices Residents in pathology now pursue improvements in resident scores for key faculty and functions from all of their clinical rotations in blood on the annual Resident In-Service the College of Medicine and Life banking and transfusion medicine Examination in the area of blood Sciences, the 10,000-square-foot at ProMedica Toledo Hospital under banking and transfusion medicine. space includes 21 private offices, 24 the direction of Dr. Susan Shapiro. workstations and five conference This has resulted in dramatic rooms.

Surgery Residency Ranked 14th in Nation

The University of Toledo’s surgical do justice for a residency’s quality residency program was ranked when comparing surgical residency 14th in the nation when considering programs across the country. “The most important step was outcome-based measures. “This solidifies what we already know to improve the educational Published in the Journal of Surgical about UT’s surgical residency,” said Education, the research was Dr. Munier Nazzal, professor of part of the residency training.” compiled through publicly available vascular surgery and director of the data from all 218 eligible, general vascular laboratory, former director “Our residency has changed over surgery residency programs. To of the General Surgery Residency the past few years,” Nazzal said. generate an outcomes-based Program. “We offer an excellent “The most important step was to program ranking, surgery programs surgical residency program that improve the educational part of were evaluated according to results in our alumni contributing to the residency training. We shifted an average percentile that was articles, grants and clinical trials in from ‘service providers’ to ‘balanced calculated using board pass rates the surgical field.” education, research and service’ with and the prevalence of alumni This information was compared well-defined programs of research, publications. against peer nominations generated teaching and education.” The article stated that surgical through a 2014 national survey that residency programs should be valued asked 17,000 verified physicians for their outcome-based measures to rate as many as five residency and that reputation alone doesn’t programs.

THE UNIVERSITY OF TOLEDO 7 Simulation Center Focuses on Interdisciplinary Teamwork and Collaboration

The University of Toledo’s Lloyd A. Jacobs including those from the colleges of medicine and Interprofessional Immersive Simulation Center nursing, as well as paramedics from local fire and rescue continues to reflect today’s reality of medicine. Using departments and military units. The center’s technology the center’s state-of-the-art technology, UT students also can be applied in non-medical fields, including the in differing specialties are learning the importance of arts, humanities, natural sciences and engineering. interdisciplinary teamwork and collaboration. In March 2016, The University of Toledo hosted a heroin The three-story, 65,000-square-foot facility is the first overdose simulation to help fight Ohio’s heroin epidemic. in the nation to incorporate three integrated simulation In front of an audience, students training to be doctors, centers: a progressive anatomy and surgical skills center, nurses and emergency responders were put to the test an advanced clinical simulation center and a virtual with a heroin overdose simulation. immersive reality center. The real-time emergency situation — from the staged apartment to the simulated hospital room — was “We wanted everyone to experience the broadcast to a crowd of recovering heroin addicts, high-intensity process, emotions and Toledo police and fire chiefs, UT faculty and staff, and medical treatment of heroin overdose” community partners to increase education about Ohio’s heroin epidemic.

“Our graduates leave UT better equipped for their careers “We wanted everyone to experience the high-intensity due to the amplified experience they receive from the process, emotions and medical treatment of heroin Interprofessional Immersive Simulation Center,” said overdose starting inside a home,” Tia Hornish, UT clinical Dr. Christopher J. Cooper, executive vice president for simulation and education research associate, said. clinical affairs and dean of the College of Medicine and “By watching the situation unfold, we hope they feel a Life Sciences. “They are more confident in their abilities, connection to what is happening to people of all ages and which leads to higher patient confidence and safety.” walks of life in our community. As health-care providers, we need to be able to understand that the heroin Since its opening in 2014, the center has been the source epidemic is not discriminating against anyone and provide of training for approximately 2,000 learners per month, resources to help addicts.”

88 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med In an effort to improve worldwide access to quality health care, physicians from The University of Toledo in August 2016 trained Iraqi surgeons in emergency medicine.

The doctors from Kafa, Iraq, studied at UT for a month to learn the procedures and interdepartmental cooperation required to develop emergency departments in their country.

Human Donation Program Celebrates Milestone

The only academic program in graduate of the program. “It’s so the country designed to prepare rewarding to know that I’m providing individuals to coordinate and oversee comfort to families who have lost a the organ and tissue donation and loved one, and assisting in saving the “It’s the best job in the world.” transplantation process graduated its lives of other patients. Each family 100th student in August 2016. gets a piece of my heart.” programs and higher retention rates. The University of Toledo’s Master Coordinators must pull together a team We developed this program as a of Science in Biomedical Science of medical professionals, facilitate result.” Human Donation Science program medical testing and ensure laws are prepares individuals to facilitate followed while compassionately and Students enrolled in the Human the organ donation process from diplomatically communicating with the Donation Science program each beginning to end. They serve as donor’s family. receive a multidisciplinary education liaisons between the donor’s family, covering all components of organ “It’s a tough job, and organ medical staff, organ procurement donation and complete course work procurement organizations were organizations and transplant centers. in medical science, management, seeing a high level of turnover among human resources and law. They also “It’s the best job in the world,” their coordinating staff,” said Linda complete clinical training and two said Rachel Baczewski, certified Miller, assistant professor of UT’s internships prior to graduation. procurement transplant coordinator Human Donation Science program. at Life Connection of Ohio and 2013 “We wanted to see better training

THE UNIVERSITY OF TOLEDO 9 Students Run with the Dean University of Toledo College of Medicine and Life Sciences students, along with some faculty and staff, participate in a monthly “run with the dean” event on campus. The event is an opportunity for students to connect with Dr. Christopher J. Cooper, dean of the College of Medicine and Life Sciences and executive vice president for Medical Student Trades clinical affairs. Participants, including the dean, run four Baton for Stethoscope to six miles around campus to parks in the University of Toledo third-year medical student Moriah Muscaro surrounding area and back. is one of the best baton twirlers in the nation. Depending on the time, the group enjoys Her perfect figure eights, spins and illusions are a result of 17 years breakfast, lunch or dinner afterward for of continual practice, constant competition and relentless repetition. discussion and further one-on-one time

“Twirling is amazing for me, even if it is an incredible amount of with the dean. hard work, because I love to perform for people,” the 24-year-old “We have a very talented group of students said. “I love performing for an audience and getting everyone to and faculty who are committed to the smile when they leave.” emotional and physical health of our Just a week after being named College Miss Majorette of college,” Cooper said. “It is really a America in July 2015, she traded her baton for a short, white coat. great pleasure spending time with these

“In many ways, my years of baton twirling and competing can young women and men, and having the be compared to my journey of getting into medical school,” opportunity to hear their stories directly Muscaro said. “What I learned from twirling is work ethic. I from them.” have had to balance school and twirling my whole life. When I had homework and competition, I had to turn down friends and social opportunities.”

That continues to be the reality of her life as a medical school student. The aspiring pediatrician is applying many of her baton lessons to real life.

“I love the feeling of my hard work paying off, but I know that even if I work hard, I won’t always succeed,” she said. “That is good to keep in mind as I go through medical school, because while I tend to excel in math and science, I am undertaking the most vigorous academic journey of my life.”

Today, she uses baton twirling as her stress reliever and has participated in the medical student talent show.

10 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Students Benefit from Generous Support

A total of 119 scholarships worth $1.1 have become part of my personal million were awarded to University of support system. It has inspired me to The amount of financial support Toledo College of Medicine and Life think about how I can pay it forward Sciences students last fall. and serve others in the future.” available to UT students is a

One of the recipients was graduated The amount of financial support testament of generous sponsors medical student Megan Mooney, available to UT students is a and alumni. who was the recipient of the UT testament of generous sponsors and and ProMedica Better Together alumni. bearing the full weight of their Scholarship. “Our students benefit tremendously educational expenses, and can focus “Receiving this scholarship has from the generosity of our on becoming the next generation of helped me beyond words,” Mooney scholarship donors,” UT President physicians. We express our heartfelt said. “Not only has it supported me Sharon L. Gaber said. “Their financial gratitude for their continued support.” financially and educationally, I feel support means our students can like the sponsors of my scholarship continue their studies without

Scholarship Created to Honor UT Resident

that will be presented annually “Cyrus is not a ‘Hollywood’ sort of a through The University of surgeon,” Schwann had said. “He is Toledo Foundation in Chan’s not loud and boisterous. He is quietly name. The money will be given effective.” to people with the same gifts Donations had poured in from around as Chan. the world. At the time, Chan said he The UT medical community felt honored by the support. rallied for Chen during his illness. “I cannot put into words how much I Jamil called him a brilliant love them and all they have done for surgeon who helped heal many In 2016, University of Toledo surgical me,” he said. “It makes me feel special patients and teach medical students. resident Dr. Cyrus Chan passed away to know that everything I have done for one year shy of finishing his surgical “He’s not only a compassionate doctor the University and contributed to the residency at UT. with his patients,” Jamil said at the residency program has left a mark.” time. “Cyrus has won several awards Chan’s transformation from life- Chan passed away a few weeks later. for teaching. Seeing such a close saving doctor to terminal patient friend and such a good human being The money raised in Chan’s name touched his fellow surgeons with the have such a terrible condition has hit was given to students and residents unpredictability of life. home for all of us. We’re devastated.” committed to surgery and to taking Fellow residents Dr. Steve Stanek the time to educate others about the Dr. Thomas Schwann, then-interim and Dr. Tahir Jamil created a way to College of Medicine. department chair and S. Amjad ensure Chan’s legacy lives on. Hussain Endowed Professor in To support Chan’s enduring legacy, While Chan was still alive, his friends Thoracic and Cardiovascular contributions can be made to the Dr. and colleagues created an endowed Surgery, had spoken of how Cyrus Chan Endowed Scholarship scholarship for medical students honored and privileged he was to Fund or the Dr. Cyrus Chan Teaching and an endowed award for residents work with Cyrus. Award in Surgery at give2ut.utoledo.edu.

THE UNIVERSITY OF TOLEDO 11 Donor Lives up to An Evolving Admissions Daughter’s Ideal Process

Tom Litzinger is the last person Beginning with the incoming class of who would want any publicity for 2017, The University of Toledo’s College what he’s doing for the College of of Medicine and Life Sciences evolved Medicine and Life Sciences at The its admissions process. Leaders within University of Toledo. the College recognized the need for a

But he knows he can’t help a future fundamental reframing of medical school medical school student without admissions, which began in earnest this drawing attention to his cause. year. Utilizing a more rigorous interview process called multiple mini interviews or In memory of his late daughter, MMIs, Admissions was able to streamline the Litzinger donated his $100,000 life insurance policy to the College of Medicine to support the Amie interview process, seeing more applicants Litzinger MD Class of 2013 Endowed Scholarship Fund. This is in for the limited number of positions. addition to his $25,000 pledge after Amie’s death. In addition, the Office of Medical School Amie died Jan. 1, 2013, from genetic heart disease just months Admissions was structurally reorganized prior to her scheduled graduation from medical school. She and placed into the Office of Student was awarded her diploma posthumously, the only student in the Affairs, operating under the direction of Dr. history of the College of Medicine to be so recognized. Yvette Perry, assistant dean for Admissions

“Amie loved the College of Medicine,” Litzinger said. “Amie could & Strategic Enrollment. not say enough kind words about her fellow classmates, staff, faculty, administration and friends. An emphasis on competency- based curriculum “As a father, how can I not give back to the institution that provided so much for Amie? Amie loved her role at the UT Also beginning with the incoming class College of Medicine. It truly is an incredible institution that of 2017, the College of Medicine and deserves my commitment and dedication.” Life Sciences is embarking on a major curriculum change with emphasis on Litzinger, said education is expensive and he doesn’t want someone to forgo medical school because of the cost. competency-based curriculum with early clinical experience and seamless integration of foundational and clinical “As a father, how can I not give back to the sciences.

institution that provided so much for Amie?” KEY ASPECTS OF THE NEW CURRICULUM INCLUDE: • Systems-based foundational sciences “I will continue to give so we can secure any potential medical with clinical integration school student the opportunity to attend medical school,” he said. “Amie, unfortunately, will never become the caring • Greater emphasis on clinical reasoning and clinical skills in all four years physician that she desired to become. Her patients must have viable replacements to pick up where Amie left off.” • Utilization of more innovative educational methods/approaches For information about how to donate to Amie’s Fund, contact • Focus on interprofessional education, Jennifer Schaefer at 419.383.5071 or jennifer.giesige2@utoledo. patient safety and career development edu, or go to give2ut.utoledo.edu/litzinger.asp.

12 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Graduates Ready to Lead and Serve

After countless hours of studying, We respect each other and have built everything running. She was the glue hundreds of cups of coffee, and more a community of support. It’s been a that held it all together while I was than a few restless nights, students great experience.” studying. I can’t thank her enough.” graduating from The University of The path to commencement was With degree in hand, the graduates Toledo College of Medicine and Life rewarding, but challenging. are ready to make a difference in the Sciences waited in anticipation in the world by giving back. wings of the Stranahan Theater before “Medical school was definitely a receiving their diplomas. challenge. I missed family vacations Sciplin hopes to work in an and celebrations, and it was mentally outpatient clinic in an urban or “It is so rewarding to finally have draining,” said Dr. Rachael Sciplin, a underserved area, perhaps returning the title of doctor,” said Dr. Harshal doctor of medicine graduate. “My home to the Toledo region after Waghulde, who received his PhD in professors and family helped me completing her residency at the biomedical sciences at the College’s realize that the sacrifices were University of South Florida Morsani 2016 commencement ceremony. temporary, and that I would come College of Medicine in Tampa. Merris out of it better on the other side. I looks forward to making a difference had to step out of my comfort zone, in the lives of cancer patients. He and each success helped me gain will remain in Toledo for his first year confidence.” of general residency before moving to Buffalo, N.Y., to begin in radiation Waghulde is a first-generation college oncology. Waghulde will continue his student from a small town in India, but research during postdoctoral work at he said the faculty and his colleagues UT before returning to India. made Toledo feel like home. “These and all of our graduates “There were many resources here Waghulde exemplify The University of Toledo’s for me to complete research and be mission,” Waghulde was one of more than on the front lines of cutting-edge said Dr. 170 students who received doctoral science,” he said. “I am the first one Christopher degrees. in my family to go to college. I’m J. Cooper, grateful for the opportunity to pursue Graduates and their guests listened executive a career in medicine.” as retired U.S. Air Force Maj. Gen. vice Susan Desjardins delivered a For Merris, balancing medical school president commencement address centered and personal time with his wife and for clinical on the theme of public service. four young children was sometimes affairs and a challenge. He said his peers It was fitting, as leadership, Sciplin dean of the determination, focus and community were supportive and respected his College of seem to be the common threads of decision to go home after classes Medicine and Life Sciences. “They this graduating class. instead of joining them in the library are ready to become leaders and or at social events. agents of change.” “Our class is unique. Sure, we challenged each other, but it’s “My classmates and instructors In all, 254 students received degrees: not about vanity and competition,” helped me find balance. They 169 earned doctor of medicine explained Dr. Josh Merris, who encouraged me to put family first and degrees, five received doctor of received his doctorate of medicine. stay focused on the reasons I wanted philosophy degrees, 65 received “We pushed each other and learned to pursue medicine,” he said. “I credit master’s degrees, and 15 received from each other in order to get better. my wife for my success. She kept graduate certificates.

THE UNIVERSITY OF TOLEDO 13 RESEARCH For centuries, through the process of investigation and discovery, researchers have contributed to the advancement of society: Better health, longer lives, greater prosperity. The University of Toledo College of Medicine and Life Sciences continues to encourage scientific investigation among its faculty and learners by supporting promising new research and identifying new sources of seed funding. It’s through this level of discovery that our researchers are helping to ease pain, build memories and safeguard the next generation of scientists.

In 2016, UT faculty received more than $13 million in research grants. Studies included Alzheimer’s disease, atherosclerosis, diabetes, hypertension, the immune system, kidney disease, Lake Erie algal bloom toxins and PTSD.

14 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Researcher Receives $3.38 Million Grant to Study PTSD

A University of Toledo researcher years, pending oversight and review received a $3.38 million award from of annual congressionally approved the National Institute of Mental Health NIH funding levels. The NIH study in October 2016 to study the brain for section that peer-reviewed Wang’s early signs of post-traumatic stress proposal ranked it in the top 4th disorder (PTSD) after injury. percentile for “major research” among those competing for mental PTSD is increasingly recognized as a health research funding. major mental health problem, with an estimated 8 million adults suffering The research project will study from some form of the disorder as a trauma patients who agree to result of a traumatic event. be monitored for a period of a year, during which time they will Wang The competitive award is the largest be evaluated using non-invasive, grant received by the University functional magnetic resonance from the National Institute of imaging technology. This state- Mental Health and was given to of-the-art diagnostic equipment This state-of-the-art diagnostic Dr. Xin Wang, associate professor is available only at UT Medical of psychiatry, to use MRI imaging equipment is available only at Center. Study participants will be to study the early development of UT Medical Center. recruited from UTMC’s emergency PTSD in trauma victims. department, as well as emergency His study, titled “Study of Early Brain departments from the ProMedica and differentiate the PTSD development Alterations That Predict Development Mercy Health systems. of Chronic PTSD,” received $755,000 and normal recovery free of stress “This cutting-edge technology in 2016, and will total $3.38 million symptoms. We hope to identify is a safe, non-invasive and non- over a period of four-and-a-half the early changes in the brain that radioactive occur in the days following a trauma way to examine that place a patient at high risk of the brain for developing the disorder.” mechanisms Wang first developed this acute of PTSD PTSD study with civilian automobile development accident victims in 2013 with support after acute from an NIH pilot grant. His research trauma,” Wang at UT has drawn attention from said. “Patients national and international PTSD will be tracked researchers. for one year to identify possible changes in the brain that

Congresswoman Marcy Kaptur visited campus to celebrate the award. “This is a very significant development,” she said. “Dr. Wang’s research could identify and lead to new medical responses for those most likely to suffer from PTSD.”

THE UNIVERSITY OF TOLEDO 15 Team Develops and Markets Blood Clot Device

Three University of Toledo faculty would be significantly faster than all associate with the UT Office of members have developed a surgical other modes of treatment, including Technology Transfer, said. “It has tool that has the potential to save lives. competitive catheters.” been a pleasure to work with Drs. Cooper, Gupta and Elahinia, as well Dr. Mohammad Elahinia, professor The plan is for the device to extract as the various students involved of mechanical engineering, Dr. blood clots without leaving behind in the development of this device Rajesh Gupta, assistant professor smaller clots, and make the over the last few years to assist with of medicine and an interventional procedure to remove a pulmonary acquiring patent protection for the cardiologist, and Dr. Christopher J. embolism — a blockage in a lung QuickFlow PE.” Cooper, professor of medicine and artery — safe and less expensive dean of the College of Medicine and than current methods. The technology transfer team Life Sciences, created the QuickFlow also helped with the launch of An estimated 100,000 Americans die PE and say — if fully fine-tuned, Thermomorph by acquiring funding of pulmonary embolism every year, tested and FDA-approved — the through UT’s Rocket Innovations and and about 600,000 Americans suffer device would safely remove large the Ohio Third Frontier Commission, from this disease annually. which invests in entrepreneurs The QuickFlow moving new technology into the PE would work marketplace to create companies similar to a heart and jobs. catheterization. UT inventors and startup companies The idea is for have received more than $1.5 million vascular access to from the Third Frontier Technology be gained through Validation and Start-Up Fund and a vein in the groin. matching funds to support the The catheter then commercialization of research since would be threaded January 2012. UT ranks third in the to the affected site, state for the number of these awards. blood clots in the lungs in emergency and the device — situations faster than current which opens like two tiny umbrellas technology. attached by a flexible wire — would be deployed. Next, the clot would “It has been exciting to watch The device is a thin wire that be captured by closing the circular blossoms into two tiny umbrellas. the technology evolve from a covers together, then removed Elahinia, Gupta and Cooper recently through the catheter. basic idea in the laboratory launched a startup company called to the potentially life-saving UT signed an exclusive license Thermomorph to further build and agreement with Elahinia and Cooper, device it has become today,” commercialize the QuickFlow PE executive vice president for clinical with the help of UT’s technology affairs, to move the business-building transfer team. process forward. Elahinia recently participated in “Our research led us to this promising, “It has been exciting to watch the the National Science Foundation simple and effective technology, technology evolve from a basic idea Innovation Corps program to more which we believe could restore blood in the laboratory to the potentially precisely define the market need his flow within 30 to 60 minutes of the life-saving device it has become device would meet. patient’s arrival,” Elahinia said. “This today,” Mark Fox, patent technology

16 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Exploring the Connection between Kidney and Heart Diseases

Chronic kidney disease affects nearly 25 percent of the adult population in the United States. It is closely associated with cardiovascular disease and can lead to a patient requiring dialysis or kidney transplant.

Researchers at The University of Toledo are exploring the connection between the kidney and heart in an effort to understand the molecular mechanisms, which can help develop new treatments to improve Dr. Steven Haller, left, Dr. David Kennedy, center, and Dr. Jiang Tian are examining the connection patient outcomes. between the kidney and heart.

A recent study titled “Attenuation for Interdisciplinary Research, who “We are excited about these of Na/K-ATPase Mediated Oxidant discovered a new function of the findings and will further explore the Amplification With pNaKtide Na/K-ATPase during his tenure at UT. possibility to use this peptide as a Ameliorates Experimental Uremic Xie found that the Na/K-ATPase can therapeutic treatment for cardiac Cardiomyopathy” was published in mediate cell signaling, in addition to its fibrosis,” Tian said. Scientific Reports in October 2016. role in regulating the potassium and In a related UT study, Dr. Steven sodium level in each cell of the body. UT researchers, in collaboration Haller, assistant professor of with Marshall University and New The research team subsequently medicine, discovered use of the York Medical College, identified a learned that dysfunction of kidneys immunosuppressant drug Rapamycin peptide that could reduce kidney signals the body to produce steroids also helps in reducing cardiac fibrosis disease-related cardiac fibrosis in that bind to the Na/K-ATPase, but that in animal models with kidney disease. mice, which could potentially lead to a long term, “off-target” effect of this “Given that we now know Na/K-ATPase the development of new treatment causes scarring to develop in the heart. signaling initiates events that lead to options for patients diagnosed with “We discovered that these sodium- cardiac fibrosis, we can look at ways kidney disease. potassium pumps don’t just move to interrupt this sequence,” Haller “We know patients with kidney sodium and potassium around, said. “Rapamycin inhibits an enzyme disease often develop cardiac but they are multitasking proteins implicated in the progression of many fibrosis, which is a condition where that are involved in other functions, different forms of kidney disease, and their heart tissue becomes damaged as well,” said Dr. David Kennedy, we now know it also regulates a pro- and scarred,” said Dr. Jiang Tian, assistant professor of medicine fibrotic steroid, which binds the Na/K- associate professor of medicine and and co-author of the study. “It’s like ATPase and causes fibrosis.” lead co-author of the study. “Cardiac finding out your car is a spaceship The study, “Rapamycin Attenuates fibrosis was previously thought to be and you didn’t even know it.” Cardiac Fibrosis in Experimental untreatable, but this new discovery When the team introduced a peptide Uremic Cardiomyopathy by Reducing shows promise for reversing or called pNaKtide in a mouse model Marinobufagenin Levels and Inhibiting preventing the condition.” with kidney disease, the associated Downstream Pro-Fibrotic Signaling,” The research builds on pioneering cardiac fibrosis was reduced. was published in the Journal of the work by co-author Dr. Zijian Xie, American Heart Association. director of the Marshall Institute

THE UNIVERSITY OF TOLEDO 17 Research Team Focuses on the Effects of Lake Erie Algal Bloom Toxins

In the summer of 2014, the city of Toledo issued a “Do Not Drink” advisory for a half-million water customers due to the level of microcystin detected in the drinking water.

The state of Ohio awarded UT researchers a $45,000 grant, which is matched by the University, for the project to discover if a pre-existing liver disease makes a person more susceptible to damage from the toxin Dr. David Kennedy leads a research team focusing on the health effects of Lake Erie algal released by algal blooms. bloom toxins. The goal is to help inform local, state A research team in The University of problems down the road, such as the and international health organizations Toledo College of Medicine and Life liver becoming scarred and inflamed.” as they create guidelines for safe limits Sciences is taking an in-depth look at of exposure. According to the National Institutes of Lake Erie algal bloom toxins and the Health, obesity is a major risk factor UT is among eight Ohio universities impact they can have on the liver. for the development of non-alcoholic to receive a total of $1.9 million from “No one knows what safe limits are for fatty liver disease, which causes the the Ohio Department of Higher a large segment of the public,” said organ to swell with fat. Unchecked, the Education’s Harmful Algal Bloom Dr. David Kennedy, assistant professor disease can lead to liver failure and the Research Initiative. in the Division of Cardiovascular need for a transplant. Medicine. “Previous studies only “There is a large focused on healthy animals.” population of During the heart of the summer algal people who may bloom season, researchers use mice be susceptible as a model to study the impact of to the effects microcystin exposure on patients who of microcystin have the most common and often exposure, undiagnosed form of liver disease that whether it’s is tightly linked to obesity. swallowed while swimming at the “Microcystin is a toxin that specifically Cyanobacterial Index from NASA MODIS-Terra data, collected beach or through September 24, 2017. targets the liver, a vital organ that the tap should toxic needs to be healthy in order to algae once again contaminate the The Harmful Algal Bloom Research process the food you eat,” Kennedy public water supply,” said Dr. Steven Initiative, jointly managed by UT and said. “And non-alcoholic fatty liver Haller, assistant professor in UT’s Ohio State University, is funding 13 disease is the most prevalent type of Division of Cardiovascular Medicine collaborative research projects to liver disease nationally — particularly and co-leader of the project that provide solutions for the harmful algal in northwest Ohio. Whether diagnosed began in the spring. “The Toledo blooms that affect Lake Erie, Grand or undiagnosed, a third of northwest water crisis inspired us to re-evaluate Lake St. Mary’s, Buckeye Lake and Ohioans have this disease that is silent what levels we’re calling safe.” other fresh-water bodies in and at first, but predisposes you to big around Ohio.

18 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Testing a New Drug to Treat Diabetes and Increase Bone Mass

In collaboration with chemists from the Scripps Lecka-Czernik and her team at UT then tested these Research Institute, University of Toledo researchers have compounds for bone safety. discovered a compound that normalizes glucose levels “During the course of our experiments, we discovered while increasing the mass and quality of bone. that a compound called SR10171 normalizes glucose “Our data demonstrate the regulation of bone mass and levels in Type 2 diabetes, prevents associated weight energy metabolism share similar mechanisms,” said Dr. gain and increases the mass and quality of bone,” she Beata Lecka-Czernik, professor in UT’s departments of said. “Remarkably, this experimental drug also maintains Orthopaedic Surgery and Physiology and Pharmacology, its positive effect on bone in non-diabetic conditions and and a member of the faculty in the Center for Diabetes acts as an insulin sensitizer only on demand when normal and Endocrine Research. “This suggests a new glucose and insulin becomes imbalanced.” pharmacologic agent could be developed to treat both SR10171 supports bone formation by directly regulating diabetes and metabolic bone diseases.” bone cells that work together to break down, build and Targeting PPARγ, the protein in the body that regulates protect bone. energy use and bone cell differentiation and function, Dr. The results also suggest the bone remodeling properties Patrick Griffin and researchers from the Scripps Research of this compound could be used to treat osteoporosis, Institute developed a series of new insulin sensitizers. Lecka-Czernik said. “Our multidisciplinary chemical biology team at Scripps The team’s findings, “PPARG Post-Translational Florida had spent many years developing precise structure Modifications Regulate Bone Formation and Bone activity relationships around many chemical scaffolds Resorption,” was published in the August 2016 issue of that alter the shape and behavior of PPAR ,” Griffin said. γ EBioMedicine. This team science was funded in part by a “These efforts were then combined with the bone biology collaborative grant from the National Institute of Diabetes expertise of Dr. Lecka-Czernik to explore whether we have and Digestive and Kidney Diseases. compounds that maintain excellent insulin sensitization efficacy, but are positive on bone health.”

Dr. Beata Lecka-Czernik, right, posed for a photo with her team, from left, Shermel Sherman, Faiz Tausif, Amit Chougule, Lance Stechschulte, Matthew Mazur, Zachary Rotter and Ali Eltatawy.

THE UNIVERSITY OF TOLEDO 19 Looking at the Cause of Lyme Disease

A University of Toledo microbiologist mice over extended periods of time found throughout much of Ohio.” has received nearly $2 million in without harming the animal. We will More than 300,000 cases are believed federal research funds to study use these methods to continuously to occur each year; however, it is Borrelia burgdorferi, the causative monitor how the infection develops, estimated that only 10 percent to 20 agent of Lyme disease, and develop which we believe will identify the key percent of Lyme disease cases are new therapies for treating patients mechanisms that allow the bacteria to actually reported. affected by the condition. evade the host’s immune response.”

The National Institute of Health’s Data gathered from the study could National Institute of Allergy and be used to provide new targets for Lyme disease is the No. 1 Infectious Diseases awarded Dr. Lyme disease therapies. vector-borne disease in the Mark Wooten, professor of medical Lyme disease is the No. 1 vector- United States. microbiology and immunology, borne disease in the United States. $1,948,415 over five years to identify Incidence increases every year during the mechanisms that allow B. the summer tick season. “Our latest findings indicate that burgdorferi to evade immune clearance the bacteria can literally outrun in skin and other host tissues. Wooten said people getting bitten our immune cells within the host,” by an infected tick is a growing “Traditionally, it has been difficult Wooten said. “We figured they would problem in the Midwest and Northeast to study this bacterium, since it can get in the skin and go hide from our because humans are increasingly only survive within animals and not immune response. Actually, we are living in close proximity to animals, in artificial cultures,” Wooten said. finding that they don’t hide. They such as deer, that carry the bacteria. “Our group has been able to develop continue to move for months or advanced microscopy models that “Not only are the numbers in the New years, and our immune system isn’t allow us to directly observe the England states continuing to rise,” he clearing them. Why is that? That is bacteria within the skin of living said, “but the bacteria now can be what we hope to unravel.”

Lab Renamed to Honor Benefactor Laboratory is in the substantial contributions to Block Health Science help educate medical students Building. Bauer recently and support research here donated $100,000 to since the 1980s,” Wang said. the Department of “With his support, we have Neurosciences in the been growing brain MRI UT College of Medicine research at UT from scratch and Life Sciences to to a nationally recognized MRI support the research of research center. Dr. Bauer’s Dr. Xin Wang, associate new donation will help us The generosity of Dr. William professor of psychiatry. purchase new computers Bauer and his wife, Catherine, for imaging data processing Bauer is a volunteer clinical has allowed UT to expand its and devices for advanced professor of neurosciences nationally recognized research behavioral tests. The funding at UT. of the human brain. also will support talented “Dr. Bauer is a successful The William R. Bauer, MD, PhD researchers to analyze the neurologist who has made MRI Human Brain Imaging MRI images.”

20 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Seeking Answers for Hypertension

How is high blood pressure inherited? of developing hypertension, but high blood pressure can also run in the A University of Toledo researcher is family,” Kumarasamy said. “If your seeking the answer. parents or other close, blood relatives Thanks to a three-year, $231,000 grant have had high blood pressure, you are from the American Heart Association, more likely to develop it, too.” Dr. Sivarajan Kumarasamy, assistant His study explores the role a specific professor in the Department of gene called Regulated Endocrine Physiology and Pharmacology Specific Protein 18 (Resp18) plays and a member of UT’s Center for in the development of hypertension Hypertension and Personalized and kidney failure. The function of Kumarasamy Medicine, launched a new lab to this molecule is unknown, but by continue research in identifying The results of Kumarasamy’s study using a cutting-edge, genetically genetic biomarkers for hypertension could be used to diagnose or predict engineered, rat-mutant model of this and renal failure. hypertension or kidney defects. Long- gene, Kumarasamy has discovered term results of his research also could Hypertension, or high blood pressure, a novel link between Resp18 and have implications for diabetes and is a leading cause of death and hypertension. disability in the U.S. and worldwide. other medical conditions related to This new funding allows him to As many as one in three people are renal failure and hypertension. further examine the molecular hypertensive, resulting in increased mechanism connecting this gene risk for heart attack, stroke and kidney to blood pressure regulation and failure. While it can be treated with kidney disease. As many as one in three people medication, much remains to be learned about why some individuals “Preliminary results are promising are hypertensive, resulting in are more likely to develop high blood that we can identify a biomarker,” he increased risk for heart attack, pressure and kidney disease. said. “I am grateful for the excellent stroke and kidney failure. opportunity provided by my mentor, “Some lifestyle behaviors, such as salt Dr. Bina Joe, to study a piece of intake, smoking and physical inactivity, this genetic puzzle and begin my put individuals at an increased risk research career.”

THE UNIVERSITY OF TOLEDO 21 Researcher Receives Grant from Medical Research Society to Continue Alzheimer’s Disease Study

A University of Toledo researcher and leads to their death. This damage is taking a closer look at how a results in memory and cognition loss. common food additive could reverse Midi-GAGR reverses damage to brain cell damage caused by the cell network and reduces the Alzheimer’s disease. level of proteins that generate Midi-GAGR is a byproduct of low the neurofibrillary tangles, which acyl gellan gum, a commonly used allows the brain to begin repairing gelling agent in foods such as icing the building blocks and signalers, and pudding that has been shown in improving memory and cognition. lab testing to reverse the effects of “In animal lab tests, we have seen Alzheimer’s disease in mice. improvement in both behavior and Dr. Joshua Park, UT assistant in the physical structures of the

professor of neurosciences, has brain,” Park said. “There is still much Dr. Joshua Park, center, posed for a photo with received a $50,000 grant through more testing to do before we will be Marianne Ballas and Dr. Christopher Cooper, executive vice president for clinical affairs the UT Medical Research Society approved for human trials, but it should and dean of the College of Medicine and Life to continue his study and seek a move fairly quickly, as low acyl gellan Sciences, after receiving a $50,000 grant through the UT Medical Research Society. pharmaceutical company to assist in gum has already been approved for further testing. human consumption by the FDA.” progresses. It also metabolizes Alzheimer’s disease is a degenerative The Midi-GAGR treatment is slowly, which means it would be condition affecting the intracellular administered through a nasal spray, administered only once daily. network of brain cells, causing which is significant because many “We also have found the medication neurofibrillary tangles to form inside people with Alzheimer’s lose the actually crosses into the brain the cells, which inhibits their function ability to swallow as the disease to treat cells directly,” he said.

About the Society of the UT College of Medicine of their investigations and Advisory Council, chair of support it with substantive The University of Toledo Medical Women & Philanthropy at UT, data, the research is more Research Society was created and owner of Ballas Buick GMC likely to attract grant funding by the philanthropic leadership in Toledo. from other sources, enabling of northwest Ohio. The purpose investigators to more fully of the society is to create a In addition to advancing develop the research. permanent, endowed source of new treatments for chronic highly leveraged seed funding diseases and conditions, the The society meets throughout for biomedical research projects seed money provided by the the year to discuss ongoing developed at the College of Medical Research Society University research and Medicine and Life Sciences. helps researchers advance review the rising projects their projects. Once they are eligible for funding. The society was started by able to prove the ingenuity Marianne Ballas, a member

22 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Alzheimer’s Disease Study (cont.)

“This is important because most of Ballas Buick GMC and a founder Park hopes to see a medication on the medications are processed in of the UT Medical Research Society. market within the next 10 to 15 years. the circulatory system and never “We were impressed by his tenacity, “My parents are getting older, and actually make it to the brain.” and we are confident Dr. Park and his many of their friends are starting to unique research will make a difference This is the second award given by the see memory loss and early stages for patients and their families.” Medical Research Society since its of Alzheimer’s,” he said. “It is my founding in 2014. The society consists “Receiving this grant is a great hope that this research will lead to of 20 community and medical leaders honor,” Park said. “But even more treatments that will be available to with a collective interest in supporting importantly, the support from patients in my parents’ lifetime.” UT’s junior faculty research. the research society and to the UT’s Office of Technology Transfer Toledo community is motivating. It “Everyone in the room felt a personal has filed a patent for the technology, encourages me to work even harder connection to Dr. Park’s research which will provide intellectual property to find answers for Alzheimer’s because we all know someone who protection and allow Park to share his patients and their families.” has been touched by Alzheimer’s research with drug companies that disease,” said Marianne Ballas, owner could sponsor additional research. Studying the Leading Cause of Death in America

Atherosclerosis is the main cause of burden in inside the arteries. They say that coronary heart disease, the leading coronary removing or turning off the TRPC3 cause of death in western societies, heart protein may allow the macrophages and costs the U.S. more than $200 disease.” to leave the arteries, reducing billion in medical expenses and lost plaque buildup. Vazquez wages each year. said the “We have developed mouse models A University of Toledo researcher body has of atherosclerosis in which we can has received a $378,750 grant from natural ways test our hypothesis that interrupting the National Heart, Lung and Blood of clearing TRPC3 functions may lead to Vazquez Institute to study a new way to treat arteries increased mobility of the macrophage this devastating condition. of this buildup, but cells called cells,” Vazquez said. “This concept macrophages that take part in this shows promise for the development “You hear the commercials all the process can become overwhelmed of complementary pharmaceuticals time for drugs that help control as the plaque grows thicker. that could eventually be used cholesterol and blood pressure,” said in conjunction with traditional Dr. Guillermo Vazquez, associate “Specialized cells called macrophages cholesterol-lowering drugs to professor in the Department of should carry lipids out of the plaque, accelerate the reduction in plaque Physiology and Pharmacology and but they can get stuck, which then burden.” associate director of UT’s Center contributes to the buildup and further for Hypertension and Personalized reduces blood supply to the heart,” Also known as hardening of the Medicine. “These medications help Vazquez said. arteries, atherosclerosis is an manage two of the major risk factors inflammatory condition in which plaque Vazquez and his team have for atherosclerosis progression and builds up inside arteries and restricts discovered that a protein named can reduce the risk of heart attack blood flow, which can lead to reduced TRPC3, which is present in these and stroke, but it is our goal to find flow of blood through coronary arteries, macrophages, could be controlled new, complementary strategies that heart attack and stroke. to help reduce the size of the plaque could also help reduce the plaque

THE UNIVERSITY OF TOLEDO 23 CLINICAL CARE Sharing expert knowledge with students and fostering discovery and development of new treatments for chronic health conditions are key aspects of medical education. But why do we do it? For our patients. Our physicians, researchers and learners keep our patients at the heart of every lecture, every lab and every clinical experience to deliver on our mission of improving health in the communities and region we serve. Expert, patient-centered care is the product of their ongoing research and learning, and they are sharing this with patients from across the country and around the globe.

24 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med CommunityCare Clinic

The CommunityCare Clinic (CCC) is an interdisciplinary, (i.e. health promotion) in an interdisciplinary fashion, student-run organization established to deliver quality and to affect a positive change in the greater Toledo Area. health care to the underserved populations in the The CCC prides itself as being one of the few student- Toledo community. run organizations at The University of Toledo to provide The primary goal is to improve health in Toledo, while medical students with “hands-on” clinical experience. affording its volunteers the opportunity to discover As a result, it aims to enrich the educational experience societal issues, practice principles of public health for volunteers both inside and outside of the clinic.

Students Around the Globe

Faculty and students travel the direct patient-care experiences globe, sharing their knowledge in other countries. Students have and expertise in places including the opportunity to become active Guatemala and Honduras. UT members of medical teams and see students also make regular mission patients from around the world with a trips to Central America as part of wide spectrum of common and rare the UT chapter of Global Medical diseases. Brigades, the largest student-led, Global Health locations range from undergraduate, medical mission China, to Ethiopia, to Zambia. organization in the world.

The College of Medicine and Life Sciences Global Health student clerkship program offers a broad array of clerkship opportunities across the globe that foster growth of medical knowledge through

THE UNIVERSITY OF TOLEDO 25 32-year-old Woman Receives Heart Pump Implant at UTMC

“Thank God I got here when I did,” 32-year-old Stacy Rollins of Napoleon, Ohio, said during a recent checkup Her only chance of survival was a Left at the Heart and Vascular Center at The University of Ventricular Assist Device, commonly Toledo Medical Center. known as an LVAD. A month earlier, UT cardiothoracic surgeon Dr. Mark Bonnell saved her life by implanting a battery-powered Khouri said women, especially younger women, more blood pump inside her chest to take over for her failing often ignore or mistake symptoms of heart failure. heart. “This is an age where many have children,” Khouri said. “I was in pretty good shape, but I had been under a “They are so busy. They don’t have time for themselves.” lot of stress,” Rollins said. “I started to feel terrible. I couldn’t breathe at night. I couldn’t go up the stairs. I was With more women dying from heart disease than breast coughing. I thought it was pneumonia.” cancer and lung cancer combined, Rollins wants others to know she is alive and healthy today because she Turned out her heart was barely pumping. The cough responded to the subtle symptoms of heart failure and wasn’t a cold. The fatigue and breathlessness were asked for help. symptoms of heart failure, which can rapidly become fatal. “I am grateful for my doctors and my life,” Rollins said.

In Rollins’ case, she had familial idiopathic cardiomyopathy — a weakening of the heart muscle inherited with unknown cause.

Her only chance of survival was a Left Ventricular Assist Device, commonly known as an LVAD. It is a mechanical device that helps pump blood to the rest of the body.

An LVAD can serve as a bridge to a heart transplant or, in rare cases, as therapy for a patient as her heart heals. The longest a patient has lived with an LVAD is eight years and counting.

“Nationally, about 1 percent or less of these LVADs are taken out for recovery,” Bonnell said. “Here at UTMC, we have actually taken out almost 10 percent of them.”

UT Health cardiologist Dr. Samer Khouri said heart disease risk factors include a poor diet, lack of exercise and stress.

“This is what you call low-intensity stress that is continuous, unfortunately,” Khouri said. “The cause can also be genetic.”

Stacy Rollins talked with UT Health cardiothoracic surgeon Dr. Mark Bonnell during a recent checkup.

26 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med Pioneering Heart Exam Given to Gorilla

“It’s a more sensitive and more accurate test,” Khouri said. “The process takes a detailed look at the contraction of heart muscle. We can detect problems in the heart before it’s apparent in a regular echo.”

“To the best of our knowledge, the strain test has not previously been performed in great apes, and is a novel approach to measuring cardiac function in these animals,” Thomas said. “The collective efforts of the UTMC cardiac team and Toledo Zoo veterinary staff has provided us the Amy Lather, an ultrasound technician at UT Medical Center, conducted an ultrasound on Kwisha, the gorilla at the Toledo Zoo, as Dr. Qaiser Shafiq, a cardiology fellow in the University training opportunity to be on the cutting edge program, center, watched. Photo courtesy of Toledo Zoo. of great ape research.”

The largest of all primates at the “We take pride in the high-quality Khouri plans to publish the new data Toledo Zoo turned out to be the care we provide our animals here at soon and hopes to expand the work perfect patient, only hairier. the Toledo Zoo,” Jeff Sailer, Toledo to include more apes to advance Zoo executive director, said. “This knowledge about heart function. “Working with a gorilla was a scary collaboration with UTMC offered an and exciting experience,” said Dr. additional level of imaging and cardiac Samer Khouri, cardiologist, professor expertise, helping us to provide the A gorilla’s heart is almost of Medicine and associate chief of the best possible care for Kwisha.” Division of Cardiovascular Medicine. the same as a human heart — “We were in a controlled environment, Under the oversight of zoo only bigger. but Kwisha is a 470-pound, muscular veterinarians, the UT team conducted creature. He is so powerful that his a comprehensive heart exam while hand has the ability to crush all the Kwisha was under anesthesia. The “This is an important first step bones in my hand with one squeeze.” specialists gave the gorilla a clean bill for research to compare a gorilla of health with no immediate issues to human heart contraction and Several cardiologists, anesthesiologist that need to be addressed. function,” Khouri said. “Doing this Dr. Andrew Casabianca, and special analysis makes us proud. ultrasound technician Amy Lather “A gorilla’s heart is almost the same Taking care of this kind of animal from The University of Toledo Medical as a human heart — only bigger,” shows that every life on the planet Center volunteered their human Khouri said. “We followed the same deserves respect, and highlights health-care expertise for the 27-year- principles, but this checkup was how similar we are to all creatures old male western lowland gorilla. anything but routine. What’s amazing on Earth.” to me is how similar gorillas are to us “Heart disease is a global problem physically.” facing great apes,” Dr. Kirsten Thomas, Toledo Zoo associate The silverback gorilla’s screening veterinarian, said. “The UTMC team included an echocardiogram and a was brought in to provide a new strain test, which is believed to have and unique measurement of cardiac been the first strain analysis ever health in great apes.” done on an ape.

THE UNIVERSITY OF TOLEDO 27 UT Doctors Push for Multiple Arterial Coronary Bypass Grafting as a Life-saving Treatment

Cardiovascular disease, saves lives. With the current publication, they have further including atherosclerotic extended the value of multi-arterial coronary surgery, coronary artery disease, showing improved outcomes compared to coronary stents. remains a significant “Traditional, single-arterial coronary artery bypass surgery public health challenge is the ‘Chevy’ of cardiac surgery, while multi-arterial and is the No. 1 killer in coronary artery bypass surgery is the ‘Porsche’ of cardiac the developed world. surgery,” Schwann said. “By using multi-arterial coronary Coronary artery bypass artery bypass surgery, we extend patients’ lives for up to 15 surgery and stenting years post-operatively.” are the two principal Despite this compelling data, Schwann said only 10 treatment options for Schwann percent of all coronary artery disease patients in the U.S. coronary artery disease. receive more than one arterial graft during their operations, Dr. Thomas A. Schwann, S. Amjad Hussain Endowed while 70 to 80 percent of UTMC patients receive multi- Professor in Thoracic and Cardiovascular Surgery, in arterial coronary artery bypass surgery. collaboration with investigators from Mount Sinai Medical “Cardiac surgeons and cardiologists work collaboratively at Center in New York City and the American University of UTMC as part of an integrated heart team to choose the Beirut, published a paper in the Journal of the American best treatment option for our patients,” Schwann said. College of Cardiology on the effectiveness of each of these treatment options in a study involving more than 8,000 patients.

The investigators determined that coronary artery bypass surgery using multiple arteries, as opposed to the standard coronary artery bypass surgery, in which only one artery and additional vein grafts are used, is the best treatment for patients with the most complex coronary artery disease. Using multiple arteries in coronary surgery resulted in a statistically significant increase in patient survival compared “We are working with our professional societies to influence to stents that release medication. our colleagues nationally to adopt a similar strategy. One The paper concluded that multi-arterial coronary artery artery is good, but using two or more is clearly a superior bypass surgery is the optimal treatment for the most treatment strategy.” complex patients and “should be enthusiastically adopted Schwann said future investigations are needed to delve by practicing cardiac surgeons and members of a deeper into patients who benefit most from multi-arterial multidisciplinary heart team as they strive to implement coronary artery bypass graft. best evidence-based therapy.” “In conjunction with the Society of Thoracic Surgeons, we University of Toledo cardiac surgeons are on the forefront are trying to secure grant funding to study this issue on of multi-arterial coronary artery bypass surgery, and have a nationwide basis to fundamentally change the surgical published extensively with the same consistent message: treatment of coronary artery disease,” Schwann said. compared to traditional surgery, multi-arterial surgery

28 COLLEGE OF MEDICINE AND LIFE SCIENCES SPOTLIGHT // utoledo.edu/med

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