Spotlight 2017

THE UNIVERSITY OF TOLEDO COLLEGE OF MEDICINE AND LIFE SCIENCESspotlight 2017

CONTENTSLetter from the Dean 1Facts & Figures 3Education 6Research 14Clinical 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. Morethan 75 percent of the new students are Ohio residents, and one-third is from northwest Ohio. Graduating studentsalso are staying in our northwest Ohio community to pursue residencies at UT in record numbers. Of all of ouraccomplishments, the fact that UT students are choosing to stay in Toledo for residency will likely have the greatestimpact 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 Projectand CommunityCare Clinics. Our faculty and students also traveled the globe, sharing their knowledge and expertise incountries including Guatemala and Honduras.Our surgical residency program was ranked 14th in the country by the Journal of Surgical Education whenconsidering outcomes.Philanthropy plays a vital role to ensure the continued advancement of medical science and our mission to improvethe 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 becompetitive 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 andcontinuing students by providing scholarship opportunities. Our students benefit significantly from this philanthropywith 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 AcademicAffiliation, improving residency programs to attract and retain talented students, implementing a new curriculum for ourincoming 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 contributedto the remarkable achievements and successes in this past year. I’m looking forward to even more success in the future.Christopher J. Cooper, MDExecutive Vice President for Clinical AffairsDean of the College of Medicine and Life Sciences THE UNIVERSITY OF TOLEDO 1

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Facts & Figures List of Academic and Clinical Departments History Anesthesiology Cancer Biology In the 1960s, a critical shortage of doctors developed in the United States Emergency Medicine due to the limited number of medical schools that existed to train them. In Family Medicine response to this shortage, the Toledo State College of Medicine — later Internal Medicine renamed Medical College of Ohio and, after that, Medical University of Ohio Medical Microbiology and — was founded in 1964 as a freestanding, state-supported institution that Immunology eventually blossomed into an academic health sciences center. Neurology Neurosciences One of 14 state universities in Ohio, The University of Toledo was established Obstetrics and Gynecology in 1872 and became a member of the state university system in 1967. UT and Orthopaedic Surgery the Medical University of Ohio merged in July 2006 to form an institution Pathology with a comprehensive breadth of undergraduate, graduate and professional Pediatrics programs matched by just 27 universities across the nation, and with the Physician Assistant Studies third-largest public university operating budget in the state. Physiology and Pharmacology Psychiatry In July 2016, the University celebrated its 10-year anniversary of the merger. Radiation Oncology Radiology“This merger was something that was kind of ahead of its time because in Surgery higher education, we’re talking about getting the best value for the resources Urology that we spend on higher education,” said John Carey, chancellor of the Ohio Department of Higher Education. RESEARCH SUPPORT In 2015, The University of Toledo College of Medicine and Life Sciences began a 50-year academic affiliation partnership with a local health system, ProMedica, to provide additional and expanded opportunities for the College. This includes expanded research and learning opportunities for faculty and students, as well as capital investment to improve university facilities. The University’s Economic Impact The University of Toledo’s impact to the region’s economy totals $3.3 billion, according to a 2017 comprehensive study by UT economists. 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 contributing as a major force to the region’s growth and development,” UT President Sharon L. Gaber said. “The University of Toledo continues to work hard to strengthen the community.”FY16 Research Data for the College of Medicine and Life Sciences 96 FY16 TOTAL EXPENSES 18,534,597.75 # of new awards for FY16 FEDERAL 13,854,395.12 61 134 225STATE 468,322.85 # of principal # of active # of grant proposals OTHER 4,211,879.78 investigators awards submitted and pending for FY16 THE UNIVERSITY OF TOLEDO 3

Mission 346 688 We improve health in the communities and region we serve by MEDICAL G R A D U AT E STUDENTS educating excellent clinicians and scientists, providing patient- STUDENTS centered and high-quality care, and producing nationally recognized 14 research in focused areas. DUAL-DEGREE STUDENTSThe College of Medicine and Life Sciences revised its mission, vision and values MD/PHD – 9 in 2016 to reflect the evolving educational, clinical and research goals of the MD/MBA – 1 College. MD/JD – 2 MDDD – CERTIFICATEThe revised mission accompanies an updated vision for the college, meant IN PATHOLOGY – 2 to reflect the Academic Affiliation between the College of Medicine and Life Sciences and ProMedica and the ongoing effort to develop educational programs and sponsored research of national prominence. Both statements reflect the College’s core values of professionalism, service, 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 organizational culture of the College and will influence our success in achieving our educational, clinical and research imperatives.” StudentsThe College enrolled 688 medical students and 346 graduate students during the spring 2017 semester, with 14 dual degrees.Medical Students: WA MEClass Profile MT ND MN VTThe 175 medical students admitted OR SD WI NHto the College last fall represent 54 IDdifferent universities or colleges, WY NE MI NY MAincluding 18 institutions in Ohio. KS 17 2 CT RI 1More than 75 percent of the new OKstudents are Ohio residents, and IA PA NJ 1one-third is from northwest Ohio. TX MO 2 1All students have earned bachelor’s NV 2 IL IN OHdegrees, with 60 holding master’s 1 2 133 MD DEand two with PhD degrees. There CA 3are 95 men and 80 women. 7 UT WV VA 1 CO DCThe entering class of 2016 wasfiltered from 3,679 applications. KY 1The average, total GPA of this 1class is 3.64. NC TN AZ AR SC NM MS LA AL GA FL AK HI4 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Match ResultsIt was an exciting day for 165 graduating medicalstudents from The University of Toledo who packedStranahan Theater to learn where they wouldcomplete their training.“Match Day is a thrilling milestone for a medical UT resident Ebtisam Alumin, left, and medical student Tarshree Sawyer, student,” Dr. Christopher J. Cooper, dean of the center, are excited to see that Avneet Singh matched in internal medicine at College of Medicine and Life Sciences, said. “Our the University of Vermont Medical Center. Sawyer is headed to the University students matched throughout Ohio and the nation in of North Carolina Hospitals for pediatrics. 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.” Of the 12 UT students who matched in northwest Ohio hospitals, nine continue to train in UT residency programs.The students matched in 24 specialties, with 67, or 41 percent, in primary carefields. 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, followedby Michigan with 18 and California with 14. Overall, students matched withprograms in 31 states.“I could’ve gone somewhere closer to home in New England, but my experience Staff 244 here made me want to stay,” Sophia Toraby said. “The specialty was a 1,374Community-based 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.” 290Clinical Basic 70ScienceNot only were graduating medical students proud of their placements, facultyand staff were pleased with the spike in the number of budding doctors acrossthe country who will join UT’s residency programs.Diversity FACULTYThe College of Medicine and Life Sciences is a community of diverse, lifelonglearners who embrace the value of diversity. The College seeks to create andsustain an environment in which all members remain aware of and strive toachieve their best potential when relating to patients, learners and colleaguesfrom diverse racial, cultural and ethnic backgrounds.The Office of Diversity is very active in the admissions process and sits on theCollege 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 andconcerns of current students who have historically been underrepresentedin medicine and come from underserved communities. The members ofthis organization strive to ensure that medical education has emphasis onincreasing future physicians who are culturally competent and sensitive to theneeds 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 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Academic Affiliation Expands Clinical TrainingCapacityA learner space and conference Residents in pathology now pursue improvements in resident scorescenter for students and residents all of their clinical rotations in blood on the annual Resident In-Serviceopened at ProMedica Toledo banking and transfusion medicine Examination in the area of bloodHospital and included a transition at ProMedica Toledo Hospital under banking and transfusion medicine.of 32 additional residents and the direction of Dr. Susan Shapiro.more than 300 University of Toledo This has resulted in dramaticmedical students. New administrativeoffices for the Academic Affiliationalso opened in Jobst Tower onthe campus of ProMedica Toledoand Toledo Children’s Hospitals.Designed to enhance clinicalintegration and provide officesfor key faculty and functions fromthe College of Medicine and LifeSciences, the 10,000-square-footspace includes 21 private offices, 24workstations and five conferencerooms.Surgery Residency Ranked 14th in NationThe University of Toledo’s surgical do justice for a residency’s quality “The most important step wasresidency program was ranked when comparing surgical residency to improve the educational14th in the nation when considering programs across the country. part of the residency training.”outcome-based measures. “This solidifies what we already know “Our residency has changed overPublished in the Journal of Surgical about UT’s surgical residency,” said the past few years,” Nazzal said.Education, the research was Dr. Munier Nazzal, professor of “The most important step was tocompiled through publicly available vascular surgery and director of the improve the educational part ofdata from all 218 eligible, general vascular laboratory, former director the residency training. We shiftedsurgery residency programs. To of the General Surgery Residency from ‘service providers’ to ‘balancedgenerate an outcomes-based Program. “We offer an excellent education, research and service’ withprogram ranking, surgery programs surgical residency program that well-defined programs of research,were evaluated according to results in our alumni contributing to teaching and education.”an average percentile that was articles, grants and clinical trials incalculated using board pass rates the surgical field.”and the prevalence of alumnipublications. This information was compared against peer nominations generatedThe article stated that surgical through a 2014 national survey thatresidency programs should be valued asked 17,000 verified physiciansfor their outcome-based measures to rate as many as five residencyand that reputation alone doesn’t programs. THE UNIVERSITY OF TOLEDO 7

Simulation Center Focuses on InterdisciplinaryTeamwork and CollaborationThe University of Toledo’s Lloyd A. Jacobs including those from the colleges of medicine andInterprofessional Immersive Simulation Center nursing, as well as paramedics from local fire and rescuecontinues to reflect today’s reality of medicine. Using departments and military units. The center’s technologythe center’s state-of-the-art technology, UT students also can be applied in non-medical fields, including thein 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 heroinThe 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 simulationcenters: a progressive anatomy and surgical skills center, In front of an audience, students training to be doctors,an advanced clinical simulation center and a virtual nurses and emergency responders were put to the testimmersive reality center. with a heroin overdose simulation.“We wanted everyone to experience the The real-time emergency situation — from the stagedhigh-intensity process, emotions and apartment to the simulated hospital room — was medical treatment of heroin overdose” broadcast to a crowd of recovering heroin addicts, Toledo police and fire chiefs, UT faculty and staff, and“Our graduates leave UT better equipped for their careers community partners to increase education about Ohio’sdue to the amplified experience they receive from the heroin epidemic.Interprofessional Immersive Simulation Center,” saidDr. Christopher J. Cooper, executive vice president for “We wanted everyone to experience the high-intensityclinical affairs and dean of the College of Medicine and process, emotions and medical treatment of heroinLife Sciences. “They are more confident in their abilities, overdose starting inside a home,” Tia Hornish, UT clinicalwhich leads to higher patient confidence and safety.” simulation and education research associate, said. “By watching the situation unfold, we hope they feel aSince its opening in 2014, the center has been the source connection to what is happening to people of all ages andof training for approximately 2,000 learners per month, walks of life in our community. As health-care providers, we need to be able to understand that the heroin epidemic is not discriminating against anyone and provide resources to help addicts.”88 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

In an effort to improve worldwide access to quality healthcare, physicians from The University of Toledo in August2016 trained Iraqi surgeons in emergency medicine.The doctors from Kafa, Iraq, studied at UT for amonth to learn the procedures and interdepartmentalcooperation required to develop emergencydepartments in their country.Human Donation Program Celebrates MilestoneThe only academic program in graduate of the program. “It’s so “It’s the best job in the world.”the country designed to prepare rewarding to know that I’m providingindividuals to coordinate and oversee comfort to families who have lost a programs and higher retention rates.the organ and tissue donation and loved one, and assisting in saving the We developed this program as atransplantation process graduated its lives of other patients. Each family result.”100th student in August 2016. gets a piece of my heart.” Students enrolled in the HumanThe University of Toledo’s Master Coordinators must pull together a team Donation Science program each of Science in Biomedical Science of medical professionals, facilitate receive a multidisciplinary education Human Donation Science program medical testing and ensure laws are covering all components of organ prepares individuals to facilitate followed while compassionately and donation and complete course work the organ donation process from diplomatically communicating with the in medical science, management, beginning to end. They serve as donor’s family. human resources and law. They also liaisons between the donor’s family, complete clinical training and two medical staff, organ procurement “It’s a tough job, and organ internships prior to graduation. organizations and transplant centers. procurement organizations were seeing a high level of turnover among“It’s the best job in the world,” their coordinating staff,” said Linda said Rachel Baczewski, certified Miller, assistant professor of UT’s 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

Medical Student Trades Students Run with the DeanBaton for Stethoscope University of Toledo College of Medicine University of Toledo third-year medical student Moriah Muscaro and Life Sciences students, along with is one of the best baton twirlers in the nation. some faculty and staff, participate in a monthly “run with the dean” event on Her perfect figure eights, spins and illusions are a result of 17 years campus. of continual practice, constant competition and relentless repetition. The event is an opportunity for students“Twirling is amazing for me, even if it is an incredible amount of to connect with Dr. Christopher J. Cooper, hard work, because I love to perform for people,” the 24-year-old dean of the College of Medicine and Life said. “I love performing for an audience and getting everyone to Sciences and executive vice president for smile when they leave.” clinical affairs.Just a week after being named College Miss Majorette of Participants, including the dean, run four America in July 2015, she traded her baton for a short, white coat. to six miles around campus to parks in the surrounding area and back.“In many ways, my years of baton twirling and competing can be compared to my journey of getting into medical school,” Depending on the time, the group enjoys Muscaro said. “What I learned from twirling is work ethic. I breakfast, lunch or dinner afterward for have had to balance school and twirling my whole life. When I discussion and further one-on-one time had homework and competition, I had to turn down friends and with the dean. social opportunities.” “We have a very talented group of studentsThat continues to be the reality of her life as a medical school and faculty who are committed to the student. The aspiring pediatrician is applying many of her baton emotional and physical health of our lessons to real life. college,” Cooper said. “It is really a great pleasure spending time with these“I love the feeling of my hard work paying off, but I know that even young women and men, and having the if I work hard, I won’t always succeed,” she said. “That is good opportunity to hear their stories directly to keep in mind as I go through medical school, because while from them.” 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.1 0 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Students Benefit from Generous SupportA total of 119 scholarships worth $1.1 have become part of my personal The amount of financial supportmillion were awarded to University of support system. It has inspired me to available to UT students is aToledo College of Medicine and Life think about how I can pay it forward testament of generous sponsorsSciences students last fall. and serve others in the future.” and alumni. One of the recipients was graduated The amount of financial support bearing the full weight of their medical student Megan Mooney, available to UT students is a educational expenses, and can focus who was the recipient of the UT testament of generous sponsors and on becoming the next generation of and ProMedica Better Together alumni. physicians. We express our heartfelt Scholarship. gratitude for their continued support.” “Our students benefit tremendously“Receiving this scholarship has from the generosity of our helped me beyond words,” Mooney scholarship donors,” UT President said. “Not only has it supported me Sharon L. Gaber said. “Their financial financially and educationally, I feel support means our students can like the sponsors of my scholarship continue their studies withoutScholarship Created to Honor UT ResidentIn 2016, University of Toledo surgical that will be presented annually “Cyrus is not a ‘Hollywood’ sort of aresident Dr. Cyrus Chan passed away through The University of surgeon,” Schwann had said. “He isone year shy of finishing his surgical Toledo Foundation in Chan’s not loud and boisterous. He is quietlyresidency at UT. name. The money will be given effective.” to people with the same giftsChan’s transformation from life- as Chan. Donations had poured in from aroundsaving doctor to terminal patient the world. At the time, Chan said hetouched his fellow surgeons with the The UT medical community felt honored by the support.unpredictability of life. rallied for Chen during his illness. Jamil called him a brilliant “I cannot put into words how much IFellow residents Dr. Steve Stanek surgeon who helped heal many love them and all they have done forand Dr. Tahir Jamil created a way to patients and teach medical students. me,” he said. “It makes me feel specialensure Chan’s legacy lives on. to know that everything I have done for “He’s not only a compassionate doctor the University and contributed to theWhile Chan was still alive, his friends with his patients,” Jamil said at the residency program has left a mark.”and colleagues created an endowed time. “Cyrus has won several awardsscholarship for medical students for teaching. Seeing such a close Chan passed away a few weeks later.and an endowed award for residents friend and such a good human being have such a terrible condition has hit The money raised in Chan’s name home for all of us. We’re devastated.” was given to students and residents committed to surgery and to taking Dr. Thomas Schwann, then-interim the time to educate others about the department chair and S. Amjad College of Medicine. Hussain Endowed Professor in Thoracic and Cardiovascular To support Chan’s enduring legacy, Surgery, had spoken of how contributions can be made to the Dr. honored and privileged he was to Cyrus Chan Endowed Scholarship work with Cyrus. Fund or the Dr. Cyrus Chan Teaching Award in Surgery at give2ut.utoledo.edu. THE UNIVERSITY OF TOLEDO 11

Donor Lives up to An Evolving AdmissionsDaughter’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 fundamental reframing of medical school But he knows he can’t help a future admissions, which began in earnest this medical school student without year. Utilizing a more rigorous interview drawing attention to his cause. process called multiple mini interviews or MMIs, Admissions was able to streamline the In memory of his late daughter, interview process, seeing more applicants Litzinger donated his $100,000 life for the limited number of positions. insurance policy to the College of Medicine to support the Amie Litzinger MD Class of 2013 Endowed Scholarship Fund. This is in In addition, the Office of Medical School addition to his $25,000 pledge after Amie’s death. Admissions was structurally reorganized and placed into the Office of Student Amie died Jan. 1, 2013, from genetic heart disease just months Affairs, operating under the direction of Dr. prior to her scheduled graduation from medical school. She Yvette Perry, assistant dean for Admissions was awarded her diploma posthumously, the only student in the & Strategic Enrollment. history of the College of Medicine to be so recognized. An emphasis on competency-“Amie loved the College of Medicine,” Litzinger said. “Amie could based curriculum not say enough kind words about her fellow classmates, staff, faculty, administration and friends. Also beginning with the incoming class of 2017, the College of Medicine and“As a father, how can I not give back to the institution that Life Sciences is embarking on a major provided so much for Amie? Amie loved her role at the UT curriculum change with emphasis on College of Medicine. It truly is an incredible institution that competency-based curriculum with deserves my commitment and dedication.” early clinical experience and seamless integration of foundational and clinical Litzinger, said education is expensive and he doesn’t want sciences. someone to forgo medical school because of the cost. KEY ASPECTS OF THE NEW“As a father, how can I not give back to the CURRICULUM INCLUDE:institution that provided so much for Amie?” • 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 physician that she desired to become. Her patients must have and clinical skills in all four years viable replacements to pick up where Amie left off.” • Utilization of more innovative For information about how to donate to Amie’s Fund, contact educational methods/approaches Jennifer Schaefer at 419.383.5071 or jennifer.giesige2@utoledo. edu, or go to give2ut.utoledo.edu/litzinger.asp. • Focus on interprofessional education, patient safety and career development12 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // 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 ofToledo College of Medicine and Life The path to commencement was With degree in hand, the graduates Sciences waited in anticipation in the rewarding, but challenging. are ready to make a difference in the wings of the Stranahan Theater before world by giving back. receiving their diplomas. “Medical school was definitely a“It is so rewarding to finally have challenge. I missed family vacations Sciplin hopes to work in an the title of doctor,” said Dr. Harshal and celebrations, and it was mentally outpatient clinic in an urban or Waghulde, who received his PhD in draining,” said Dr. Rachael Sciplin, a underserved area, perhaps returning biomedical sciences at the College’s doctor of medicine graduate. “My home to the Toledo region after 2016 commencement ceremony. professors and family helped me completing her residency at the realize that the sacrifices were University of South Florida MorsaniWaghulde 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 Waghulde was one of more than had to step out of my comfort zone, in the lives of cancer patients. He170 students who received doctoral and each success helped me gain will remain in Toledo for his first year degrees. confidence.” of general residency before moving Graduates and their guests listened to Buffalo, N.Y., to begin in radiation as retired U.S. Air Force Maj. Gen. Waghulde is a first-generation college oncology. Waghulde will continue his Susan Desjardins delivered a student from a small town in India, but research during postdoctoral work at commencement address centered he said the faculty and his colleagues UT before returning to India. on the theme of public service. made Toledo feel like home. It was fitting, as leadership, “These and all of our graduates determination, focus and community “There were many resources here seem to be the common threads of for me to complete research and be exemplify The University of Toledo’s this graduating class. on the front lines of cutting-edge“Our class is unique. Sure, we science,” he said. “I am the first one mission,” challenged each other, but it’s in my family to go to college. I’m not about vanity and competition,” grateful for the opportunity to pursue said Dr. explained Dr. Josh Merris, who a career in medicine.” received his doctorate of medicine. Christopher“We pushed each other and learned For Merris, balancing medical school from each other in order to get better. and personal time with his wife and J. Cooper, four young children was sometimes a challenge. He said his peers executive were supportive and respected his decision to go home after classes vice instead of joining them in the library or at social events. president “My classmates and instructors for clinical helped me find balance. They encouraged me to put family first and affairs and stay focused on the reasons I wanted to pursue medicine,” he said. “I credit Sciplin dean of the my wife for my success. She kept College of Medicine and Life Sciences. “They are ready to become leaders and agents of change.” In all, 254 students received degrees: 169 earned doctor of medicine degrees, five received doctor of philosophy degrees, 65 received master’s degrees, and 15 received 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 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Researcher Receives $3.38 MillionGrant to Study PTSDA University of Toledo researcher years, pending oversight and review Wangreceived a $3.38 million award from of annual congressionally approvedthe National Institute of Mental Health NIH funding levels. The NIH study This state-of-the-art diagnosticin October 2016 to study the brain for section that peer-reviewed Wang’s equipment is available only atearly signs of post-traumatic stress proposal ranked it in the top 4th UT Medical Center.disorder (PTSD) after injury. percentile for “major research” among those competing for mental differentiate the PTSD developmentPTSD is increasingly recognized as a health research funding. and normal recovery free of stressmajor mental health problem, with an symptoms. We hope to identifyestimated 8 million adults suffering The research project will study the early changes in the brain thatfrom some form of the disorder as a trauma patients who agree to occur in the days following a traumaresult of a traumatic event. be monitored for a period of a that place a patient at high risk of year, during which time they will developing the disorder.”The competitive award is the largest be evaluated using non-invasive, Wang first developed this acutegrant received by the University functional magnetic resonance PTSD study with civilian automobilefrom the National Institute of imaging technology. This state- accident victims in 2013 with supportMental Health and was given to of-the-art diagnostic equipment from an NIH pilot grant. His researchDr. Xin Wang, associate professor is available only at UT Medical at UT has drawn attention fromof psychiatry, to use MRI imaging Center. Study participants will be national and international PTSDto study the early development of recruited from UTMC’s emergency researchers.PTSD in trauma victims. department, as well as emergency departments from the ProMedica andHis study, titled “Study of Early Brain Mercy Health systems.Alterations That Predict Developmentof Chronic PTSD,” received $755,000 “This cutting-edge technologyin 2016, and will total $3.38 million is a safe, non-invasive and non-over a period of four-and-a-half radioactive way to examine the brain for mechanisms of PTSD development after acute trauma,” Wang said. “Patients will be tracked 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 DeviceThree University of Toledo faculty would be significantly faster than all associate with the UT Office ofmembers have developed a surgical other modes of treatment, including Technology Transfer, said. “It hastool that has the potential to save lives. competitive catheters.” been a pleasure to work with Drs. Cooper, Gupta and Elahinia, as wellDr. Mohammad Elahinia, professor The plan is for the device to extract as the various students involvedof mechanical engineering, Dr. blood clots without leaving behind in the development of this deviceRajesh Gupta, assistant professor smaller clots, and make the over the last few years to assist withof medicine and an interventional procedure to remove a pulmonary acquiring patent protection for thecardiologist, and Dr. Christopher J. embolism — a blockage in a lung QuickFlow PE.”Cooper, professor of medicine and artery — safe and less expensivedean of the College of Medicine and than current methods. The technology transfer teamLife Sciences, created the QuickFlow also helped with the launch ofPE and say — if fully fine-tuned, An estimated 100,000 Americans die Thermomorph by acquiring fundingtested and FDA-approved — the of pulmonary embolism every year, through UT’s Rocket Innovations anddevice would safely remove large and about 600,000 Americans suffer the Ohio Third Frontier Commission, from this disease annually. which invests in entrepreneurs moving new technology into the blood clots in the lungs in emergency The QuickFlow marketplace to create companies situations faster than current PE would work and jobs. technology. similar to a heart catheterization. UT inventors and startup companiesThe device is a thin wire that The idea is for have received more than $1.5 million blossoms into two tiny umbrellas. vascular access to from the Third Frontier Technology be gained through Validation and Start-Up Fund and Elahinia, Gupta and Cooper recently a vein in the groin. matching funds to support the launched a startup company called The catheter then commercialization of research sinceThermomorph to further build and would be threaded January 2012. UT ranks third in the commercialize the QuickFlow PE to the affected site, state for the number of these awards. with the help of UT’s technology and the device — transfer team. which opens like two tiny umbrellas “It has been exciting to watch attached by a flexible wire — would the technology evolve from a“Our research led us to this promising, be deployed. Next, the clot would basic idea in the laboratory simple and effective technology, be captured by closing the circular to the potentially life-saving which we believe could restore blood covers together, then removed device it has become today,” flow within 30 to 60 minutes of the through the catheter. patient’s arrival,” Elahinia said. “This Elahinia recently participated in UT signed an exclusive license the National Science Foundation agreement with Elahinia and Cooper, Innovation Corps program to more executive vice president for clinical precisely define the market need his affairs, to move the business-building device would meet. process forward. “It has been exciting to watch the technology evolve from a basic idea in the laboratory to the potentially life-saving device it has become today,” Mark Fox, patent technology16 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Exploring the Connection betweenKidney and Heart DiseasesChronic kidney disease affects nearly25 percent of the adult populationin the United States. It is closelyassociated with cardiovasculardisease and can lead to a patientrequiring dialysis or kidney transplant. Researchers at The University of Dr. Steven Haller, left, Dr. David Kennedy, center, and Dr. Jiang Tian are examining the connectionToledo are exploring the connection between the kidney and heart. between the kidney and heart in an effort to understand the molecular for Interdisciplinary Research, who “We are excited about these mechanisms, which can help discovered a new function of the findings and will further explore the develop new treatments to improve Na/K-ATPase during his tenure at UT. possibility to use this peptide as a patient outcomes. Xie found that the Na/K-ATPase can therapeutic treatment for cardiac mediate cell signaling, in addition to its fibrosis,” Tian said. A recent study titled “Attenuation role in regulating the potassium and of Na/K-ATPase Mediated Oxidant sodium level in each cell of the body. In a related UT study, Dr. Steven Amplification With pNaKtide Haller, assistant professor of Ameliorates Experimental Uremic The research team subsequently medicine, discovered use of the Cardiomyopathy” was published in learned that dysfunction of kidneys immunosuppressant drug Rapamycin Scientific Reports in October 2016. signals the body to produce steroids also helps in reducing cardiac fibrosis that bind to the Na/K-ATPase, but that in animal models with kidney disease. UT researchers, in collaboration a long term, “off-target” effect of this with Marshall University and New causes scarring to develop in the heart. “Given that we now know Na/K-ATPaseYork Medical College, identified a signaling initiates events that lead to peptide that could reduce kidney “We discovered that these sodium- cardiac fibrosis, we can look at ways disease-related cardiac fibrosis in potassium pumps don’t just move to interrupt this sequence,” Haller mice, which could potentially lead to sodium and potassium around, said. “Rapamycin inhibits an enzyme the development of new treatment but they are multitasking proteins implicated in the progression of many options for patients diagnosed with that are involved in other functions, different forms of kidney disease, and kidney disease. as well,” said Dr. David Kennedy, we now know it also regulates a pro- assistant professor of medicine fibrotic steroid, which binds the Na/K-“We know patients with kidney and co-author of the study. “It’s like ATPase and causes fibrosis.” disease often develop cardiac finding out your car is a spaceship fibrosis, which is a condition where and you didn’t even know it.” The study, “Rapamycin Attenuates their heart tissue becomes damaged Cardiac Fibrosis in Experimental and scarred,” said Dr. Jiang Tian, When the team introduced a peptide Uremic Cardiomyopathy by Reducing associate professor of medicine and called pNaKtide in a mouse model Marinobufagenin Levels and Inhibiting lead co-author of the study. “Cardiac with kidney disease, the associated Downstream Pro-Fibrotic Signaling,” fibrosis was previously thought to be cardiac fibrosis was reduced. was published in the Journal of the untreatable, but this new discovery American Heart Association. shows promise for reversing or preventing the condition.”The research builds on pioneering work by co-author Dr. Zijian Xie, director of the Marshall Institute THE UNIVERSITY OF TOLEDO 17

Research Team Focuses on the Effectsof 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 toxinDr. 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 organizationsToledo 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. Lake Erie algal bloom toxins and the According to the National Institutes of impact they can have on the liver. Health, obesity is a major risk factor UT is among eight Ohio universities 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 largefocused on healthy animals.” population ofDuring the heart of the summer algal people who maybloom season, researchers use mice be susceptibleas a model to study the impact of to the effectsmicrocystin exposure on patients who of microcystinhave the most common and often exposure,undiagnosed form of liver disease that whether it’sis tightly linked to obesity. swallowed while“Microcystin is a toxin that specifically swimming at the Cyanobacterial Index from NASA MODIS-Terra data, collected targets the liver, a vital organ that beach or through September 24, 2017. needs to be healthy in order to process the food you eat,” Kennedy the tap should toxic said. “And non-alcoholic fatty liver disease is the most prevalent type of algae once again contaminate the The Harmful Algal Bloom Research liver disease nationally — particularly public water supply,” said Dr. Steven Initiative, jointly managed by UT and in northwest Ohio. Whether diagnosed Haller, assistant professor in UT’s Ohio State University, is funding 13 or undiagnosed, a third of northwest Ohioans have this disease that is silent Division of Cardiovascular Medicine collaborative research projects to at first, but predisposes you to big and co-leader of the project that provide solutions for the harmful algal began in the spring. “The Toledo blooms that affect Lake Erie, Grand water crisis inspired us to re-evaluate Lake St. Mary’s, Buckeye Lake and what levels we’re calling safe.” other fresh-water bodies in and around Ohio.18 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Testing a New Drug to Treat Diabetesand 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 while increasing the mass and quality of bone. “During the course of our experiments, we discovered 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 diabetes and metabolic bone diseases.” SR10171 supports bone formation by directly regulating bone cells that work together to break down, build andTargeting PPARγ, the protein in the body that regulates protect bone. energy use and bone cell differentiation and function, Dr. Patrick Griffin and researchers from the Scripps Research The results also suggest the bone remodeling properties Institute developed a series of new insulin sensitizers. of this compound could be used to treat osteoporosis, Lecka-Czernik said.“Our multidisciplinary chemical biology team at Scripps Florida had spent many years developing precise structure The team’s findings, “PPARG Post-Translational activity relationships around many chemical scaffolds Modifications Regulate Bone Formation and Bone that alter the shape and behavior of PPARγ,” Griffin said. Resorption,” was published in the August 2016 issue of“These efforts were then combined with the bone biology EBioMedicine. This team science was funded in part by a expertise of Dr. Lecka-Czernik to explore whether we have collaborative grant from the National Institute of Diabetes compounds that maintain excellent insulin sensitization and Digestive and Kidney Diseases. 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, 19Matthew Mazur, Zachary Rotter and Ali Eltatawy. THE UNIVERSITY OF TOLEDO

Looking at the Cause of Lyme DiseaseA 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 willfederal research funds to study use these methods to continuously More than 300,000 cases are believedBorrelia burgdorferi, the causative monitor how the infection develops, to occur each year; however, it isagent of Lyme disease, and develop which we believe will identify the key estimated that only 10 percent to 20new therapies for treating patients mechanisms that allow the bacteria to percent of Lyme disease cases areaffected by the condition. evade the host’s immune response.” actually reported.The National Institute of Health’s Data gathered from the study could Lyme disease is the No. 1National Institute of Allergy and be used to provide new targets for vector-borne disease in theInfectious Diseases awarded Dr. Lyme disease therapies. United States.Mark Wooten, professor of medicalmicrobiology and immunology, Lyme disease is the No. 1 vector- “Our latest findings indicate that$1,948,415 over five years to identify borne disease in the United States. the bacteria can literally outrunthe mechanisms that allow B. Incidence increases every year during our immune cells within the host,”burgdorferi to evade immune clearance the summer tick season. Wooten said. “We figured they wouldin skin and other host tissues. get in the skin and go hide from our Wooten said people getting bitten immune response. Actually, we are“Traditionally, it has been difficult by an infected tick is a growing finding that they don’t hide. Theyto study this bacterium, since it can problem in the Midwest and Northeast continue to move for months oronly survive within animals and not because humans are increasingly years, and our immune system isn’tin artificial cultures,” Wooten said. living in close proximity to animals, clearing them. Why is that? That is“Our group has been able to develop such as deer, that carry the bacteria. what we hope to unravel.”advanced microscopy models thatallow us to directly observe the “Not only are the numbers in the Newbacteria within the skin of living England states continuing to rise,” he said, “but the bacteria now can beLab Renamed to Honor BenefactorThe generosity of Dr. William Laboratory is in the substantial contributions toBauer and his wife, Catherine, Block Health Science help educate medical studentshas allowed UT to expand its Building. Bauer recently and support research herenationally recognized research donated $100,000 to since the 1980s,” Wang said.of the human brain. the Department of “With his support, we have Neurosciences in the been growing brain MRIThe William R. Bauer, MD, PhD UT College of Medicine research at UT from scratchMRI Human Brain Imaging 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 professor of psychiatry. purchase new computers for imaging data processing Bauer is a volunteer clinical and devices for advanced professor of neurosciences behavioral tests. The funding at UT. also will support talented researchers to analyze the “Dr. Bauer is a successful MRI images.” neurologist who has made2 0 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

Seeking Answers for HypertensionHow is high blood pressure inherited? of developing hypertension, but highA University of Toledo researcher is blood pressure can also run in the Kumarasamyseeking the answer. family,” Kumarasamy said. “If your parents or other close, blood relatives The results of Kumarasamy’s studyThanks to a three-year, $231,000 grant have had high blood pressure, you are could be used to diagnose or predictfrom the American Heart Association, more likely to develop it, too.” hypertension or kidney defects. Long-Dr. Sivarajan Kumarasamy, assistant term results of his research also couldprofessor in the Department of His study explores the role a specific have implications for diabetes andPhysiology and Pharmacology gene called Regulated Endocrine other medical conditions related toand a member of UT’s Center for Specific Protein 18 (Resp18) plays renal failure and hypertension.Hypertension and Personalized in the development of hypertensionMedicine, launched a new lab to and kidney failure. The function of As many as one in three peoplecontinue research in identifying this molecule is unknown, but by are hypertensive, resulting ingenetic biomarkers for hypertension using a cutting-edge, genetically increased risk for heart attack,and renal failure. engineered, rat-mutant model of this stroke and kidney failure. gene, Kumarasamy has discoveredHypertension, or high blood pressure, a novel link between Resp18 andis a leading cause of death and hypertension.disability in the U.S. and worldwide.As many as one in three people are This new funding allows him tohypertensive, resulting in increased further examine the molecularrisk for heart attack, stroke and kidney mechanism connecting this genefailure. While it can be treated with to blood pressure regulation andmedication, much remains to be kidney disease.learned about why some individuals “Preliminary results are promisingare more likely to develop high blood that we can identify a biomarker,” hepressure and kidney disease. said. “I am grateful for the excellent“Some lifestyle behaviors, such as salt opportunity provided by my mentor, intake, smoking and physical inactivity, Dr. Bina Joe, to study a piece of put individuals at an increased risk this genetic puzzle and begin my research career.” THE UNIVERSITY OF TOLEDO 21

Researcher Receives Grant from MedicalResearch Society to Continue Alzheimer’sDisease StudyA University of Toledo researcher and leads to their death. This damageis taking a closer look at how a results in memory and cognition loss.common food additive could reversebrain cell damage caused by Midi-GAGR reverses damage toAlzheimer’s disease. the cell network and reduces the level of proteins that generateMidi-GAGR is a byproduct of low the neurofibrillary tangles, whichacyl gellan gum, a commonly used allows the brain to begin repairinggelling 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 ofAlzheimer’s disease in mice. “In animal lab tests, we have seen Dr. Joshua Park, center, posed for a photo with improvement in both behavior and Marianne Ballas and Dr. Christopher Cooper,Dr. Joshua Park, UT assistant in the physical structures of the executive vice president for clinical affairsprofessor of neurosciences, has brain,” Park said. “There is still much and dean of the College of Medicine and Lifereceived a $50,000 grant through more testing to do before we will be Sciences, after receiving a $50,000 grantthe UT Medical Research Society approved for human trials, but it should through the UT Medical Research Society.to continue his study and seek a move fairly quickly, as low acyl gellanpharmaceutical company to assist in gum has already been approved for progresses. It also metabolizesfurther testing. human consumption by the FDA.” slowly, which means it would be administered only once daily.Alzheimer’s disease is a degenerative The Midi-GAGR treatment iscondition affecting the intracellular administered through a nasal spray, “We also have found the medicationnetwork of brain cells, causing which is significant because many actually crosses into the brainneurofibrillary tangles to form inside people with Alzheimer’s lose the to treat cells directly,” he said.the cells, which inhibits their function ability to swallow as the diseaseAbout the Society of the UT College of Medicine of their investigations and Advisory Council, chair of support it with substantiveThe University of Toledo Medical Women & Philanthropy at UT, data, the research is moreResearch Society was created and owner of Ballas Buick GMC likely to attract grant fundingby the philanthropic leadership in Toledo. from other sources, enablingof northwest Ohio. The purpose investigators to more fullyof the society is to create a In addition to advancing develop the research.permanent, endowed source of new treatments for chronichighly leveraged seed funding diseases and conditions, the The society meets throughoutfor biomedical research projects seed money provided by the the year to discuss ongoingdeveloped at the College of Medical Research Society University research andMedicine 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 ingenuityMarianne Ballas, a member2 2 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // 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, actually make it to the brain.” and we are confident Dr. Park and his “My parents are getting older, and unique research will make a difference many of their friends are starting toThis is the second award given by the for patients and their families.” see memory loss and early stages 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 Toledo community is motivating. It UT’s Office of Technology Transfer“Everyone in the room felt a personal encourages me to work even harder has filed a patent for the technology, connection to Dr. Park’s research to find answers for Alzheimer’s which will provide intellectual property because we all know someone who patients and their families.” protection and allow Park to share his 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 Deathin 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. wages each year. Vazquez “We have developed mouse models A University of Toledo researcher said the of atherosclerosis in which we can has received a $378,750 grant from test our hypothesis that interrupting the National Heart, Lung and Blood body has TRPC3 functions may lead to Institute to study a new way to treat increased mobility of the macrophage this devastating condition. natural ways cells,” Vazquez said. “This concept shows promise for the development“You hear the commercials all the Vazquez of clearing of complementary pharmaceuticals time for drugs that help control arteries that could eventually be used cholesterol and blood pressure,” said in conjunction with traditional Dr. Guillermo Vazquez, associate of this buildup, but cells called cholesterol-lowering drugs to professor in the Department of accelerate the reduction in plaque Physiology and Pharmacology and macrophages that take part in this burden.” associate director of UT’s Center for Hypertension and Personalized process can become overwhelmed Also known as hardening of the Medicine. “These medications help arteries, atherosclerosis is an manage two of the major risk factors as the plaque grows thicker. inflammatory condition in which plaque for atherosclerosis progression and builds up inside arteries and restricts can reduce the risk of heart attack “Specialized cells called macrophages blood flow, which can lead to reduced and stroke, but it is our goal to find should carry lipids out of the plaque, flow of blood through coronary arteries, new, complementary strategies that but they can get stuck, which then heart attack and stroke. could also help reduce the plaque contributes to the buildup and further reduces blood supply to the heart,” Vazquez said. Vazquez and his team have discovered that a protein named TRPC3, which is present in these macrophages, could be controlled to help reduce the size of 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.2 4 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med

CommunityCare ClinicThe 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 theToledo community. The CCC prides itself as being one of the few student- run organizations at The University of Toledo to provideThe 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 experiencesocietal issues, practice principles of public health for volunteers both inside and outside of the clinic.Students Around the GlobeFaculty and students travel the direct patient-care experiencesglobe, sharing their knowledge in other countries. Students haveand expertise in places including the opportunity to become activeGuatemala and Honduras. UT members of medical teams and seestudents also make regular mission patients from around the world with atrips to Central America as part of wide spectrum of common and rarethe UT chapter of Global Medical diseases.Brigades, the largest student-led,undergraduate, medical mission Global Health locations range fromorganization in the world. China, to Ethiopia, to Zambia.The College of Medicine and LifeSciences Global Health studentclerkship program offers a broadarray of clerkship opportunitiesacross the globe that foster growthof medical knowledge through THE UNIVERSITY OF TOLEDO 25

32-year-old Woman Receives Heart PumpImplant at UTMC“Thank God I got here when I did,” 32-year-old Stacy Her only chance of survival was a LeftRollins of Napoleon, Ohio, said during a recent checkup Ventricular Assist Device, commonlyat the Heart and Vascular Center at The University of known as an LVAD.Toledo Medical Center. Khouri said women, especially younger women, moreA month earlier, UT cardiothoracic surgeon Dr. Mark often ignore or mistake symptoms of heart failure.Bonnell saved her life by implanting a battery-poweredblood pump inside her chest to take over for her failing “This is an age where many have children,” Khouri said.heart. “They are so busy. They don’t have time for themselves.”“I was in pretty good shape, but I had been under a With more women dying from heart disease than breastlot of stress,” Rollins said. “I started to feel terrible. I cancer and lung cancer combined, Rollins wants otherscouldn’t breathe at night. I couldn’t go up the stairs. I was to know she is alive and healthy today because shecoughing. I thought it was pneumonia.” responded to the subtle symptoms of heart failure and asked for help.Turned out her heart was barely pumping. The coughwasn’t a cold. The fatigue and breathlessness were “I am grateful for my doctors and my life,” Rollins said.symptoms of heart failure, which can rapidly becomefatal.In Rollins’ case, she had familial idiopathiccardiomyopathy — a weakening of the heart muscleinherited with unknown cause.Her only chance of survival was a Left Ventricular AssistDevice, commonly known as an LVAD. It is a mechanicaldevice that helps pump blood to the rest of the body.An LVAD can serve as a bridge to a heart transplant or, inrare cases, as therapy for a patient as her heart heals. Thelongest a patient has lived with an LVAD is eight years andcounting.“Nationally, about 1 percent or less of these LVADs aretaken out for recovery,” Bonnell said. “Here at UTMC, wehave actually taken out almost 10 percent of them.”UT Health cardiologist Dr. Samer Khouri said heartdisease risk factors include a poor diet, lack of exerciseand stress.“This is what you call low-intensity stress that iscontinuous, unfortunately,” Khouri said. “The cause canalso be genetic.” Stacy Rollins talked with UT Health cardiothoracic surgeon Dr. Mark Bonnell during a recent checkup.2 6 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // 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.”Amy Lather, an ultrasound technician at UT Medical Center, conducted an ultrasound on Kwisha, “To the best of our knowledge, thethe gorilla at the Toledo Zoo, as Dr. Qaiser Shafiq, a cardiology fellow in the University training strain test has not previously beenprogram, center, watched. Photo courtesy of Toledo Zoo. 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 opportunity to be on the cutting edge of great ape research.”The largest of all primates at the “We take pride in the high-quality Khouri plans to publish the new dataToledo 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 A gorilla’s heart is almost Samer Khouri, cardiologist, professor expertise, helping us to provide the the same as a human heart — of Medicine and associate chief of the best possible care for Kwisha.” only bigger. Division of Cardiovascular Medicine.“We were in a controlled environment, Under the oversight of zoo “This is an important first step but Kwisha is a 470-pound, muscular veterinarians, the UT team conducted for research to compare a gorilla creature. He is so powerful that his a comprehensive heart exam while to human heart contraction and hand has the ability to crush all the Kwisha was under anesthesia. The function,” Khouri said. “Doing this bones in my hand with one squeeze.” specialists gave the gorilla a clean bill special analysis makes us proud. of health with no immediate issues Taking care of this kind of animal Several cardiologists, anesthesiologist that need to be addressed. shows that every life on the planet Dr. Andrew Casabianca, and deserves respect, and highlights ultrasound technician Amy Lather “A gorilla’s heart is almost the same how similar we are to all creatures from The University of Toledo Medical as a human heart — only bigger,” on Earth.” Center volunteered their human Khouri said. “We followed the same health-care expertise for the 27-year- principles, but this checkup was old male western lowland gorilla. anything but routine. What’s amazing to me is how similar gorillas are to us“Heart disease is a global problem physically.” facing great apes,” Dr. KirstenThomas, 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 CoronaryBypass 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 artery bypass surgery, we extend patients’ lives for up to 15Schwann Coronary artery bypass years post-operatively.” surgery and stenting Despite this compelling data, Schwann said only 10 are the two principal percent of all coronary artery disease patients in the U.S. treatment options for receive more than one arterial graft during their operations, coronary artery disease. while 70 to 80 percent of UTMC patients receive multi- arterial coronary artery bypass surgery.Dr. Thomas A. Schwann, S. Amjad Hussain Endowed “Cardiac surgeons and cardiologists work collaboratively atProfessor in Thoracic and Cardiovascular Surgery, in UTMC as part of an integrated heart team to choose thecollaboration with investigators from Mount Sinai Medical best treatment option for our patients,” Schwann said.Center in New York City and the American University ofBeirut, published a paper in the Journal of the American “We are working with our professional societies to influenceCollege of Cardiology on the effectiveness our colleagues nationally to adopt a similar strategy. Oneof each of these treatment options in a study artery is good, but using two or more is clearly a superiorinvolving more than 8,000 patients. treatment strategy.” Schwann said future investigations are needed to delveThe investigators determined that coronary deeper into patients who benefit most from multi-arterialartery bypass surgery using multiple arteries, coronary artery bypass graft.as opposed to the standard coronary artery “In conjunction with the Society of Thoracic Surgeons, webypass surgery, in which only one artery and are trying to secure grant funding to study this issue onadditional vein grafts are used, is the best a nationwide basis to fundamentally change the surgicaltreatment for patients with the most complex treatment of coronary artery disease,” Schwann said.coronary artery disease. Using multiple arteriesin coronary surgery resulted in a statisticallysignificant increase in patient survival comparedto stents that release medication.The paper concluded that multi-arterial coronary arterybypass surgery is the optimal treatment for the mostcomplex patients and “should be enthusiastically adoptedby practicing cardiac surgeons and members of amultidisciplinary heart team as they strive to implementbest evidence-based therapy.”University of Toledo cardiac surgeons are on the forefrontof multi-arterial coronary artery bypass surgery, and havepublished extensively with the same consistent message:compared to traditional surgery, multi-arterial surgery2 8 C O L L E G E O F M E D I C I N E A N D L I F E S C I E N C E S S P O T L I G H T // utoledo.edu/med



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