Dr. Achanta Earns Young Investigator Award

Satya Achanta, DVM, PhD, DABTDuke Anesthesiology’s Satya Achanta, DVM, PhD, DABT, has received the Young Investigator Award from the Society of Toxicology, sponsored by the Association of Scientists of Indian Origin. Each year, one award is given to applicants of Indian origin who make outstanding contributions in the field of toxicology. The applicant must have 15 years or less of experience since obtaining the highest degree at the time of application.

“It is a great honor and privilege to receive this prestigious award,” says Achanta, assistant professor in anesthesiology and member of the department’s Center for Translational Pain Medicine. “The award recognizes my significant contributions to the field of transient receptor potential (TRP) ion channels and medical countermeasures research in the last nine years.”

Achanta is a North Carolina state-licensed and a United States Department of Agriculture accredited category II veterinarian with extensive experience in directing research studies in small and large animal models. He is also a board-certified diplomate of the American Board of Toxicology. Achanta’s overall research interests are to protect the biologic barrier from chemical injuries by targeting TRP ion channels; and by activating the mediators of the resolution phase of the inflammation pathway to restore architecture and function. He has been associated with Dr. Sven-Eric Jordt’s Chemical Sensing, Pain and Inflammation Research Laboratory since 2012.

Stacey HiltonDr. Achanta Earns Young Investigator Award
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Duke Anesthesiology Ranks #4 in the Nation Among Specialties

Duke Anesthesiology Ranks #4 in the Nation Among SpecialtiesDuke University School of Medicine vaulted to No. 3 for research among 122 medical schools in the nation – tying its highest ranking in history – in the US News & World Report annual ranking of graduate programs released today. It was also ranked third in 2001.

The magazine’s research rankings are based on numerous indicators, including assessment by deans and residency directors (reputation), as well as faculty-student ratio, student admissions statistics such as MCAT, GPA and acceptance rates, and total federal research activity.

In addition to the research ranking, seven specialty programs in the School of Medicine placed in the top 10:

  • Surgery – second
  • Anesthesiology – fourth
  • Internal Medicine – fifth
  • Radiology – sixth
  • Pediatrics – seventh, tied
  • Obstetrics and Gynecology – eighth
  • Psychiatry – tenth

“These rankings recognize our outstanding faculty, staff and students and their unwavering commitment to delivering exceptional patient care, groundbreaking research and inspired teaching,” said Mary E. Klotman, MD, dean of Duke University School of Medicine. “I am especially proud and grateful to our entire School of Medicine community for never losing sight of our core missions during this most challenging year.”

For the first time this year, the magazine also published four new rankings to measure how medical schools are performing on key health care issues, including the diversity of graduates and how many newly trained physicians plan to practice primary care, establish practices in rural areas, and work in health professional shortage areas.

Among those new measures, Duke tied for 20th nationally among 118 medical schools for the diversity of its graduates. The ranking is based on two indicators: the number of underrepresented minority (URM) students enrolled in the school and the ratio of the school’s URM students to state and national numbers, both based on data from fall 2020. Public institutions’ URM enrollment were compared with its respective state URM percentage, and private institutions’ URM were compared with national figures.

“At Duke, we know that diversity is a key metric for excellence,” Klotman said. “Our diverse classes of students are here because they have demonstrated academic achievement, as well as noble character and the potential to be leaders and make a positive impact on our world.”

This past year, Duke’s School of Medicine has also placed highly in other national assessments, including: 

  • 3rd place among allopathic medical schools, by the Student Doctor Network;
  • 10th place for funding from the National Institutes of Health, by the Blue Ridge Institute for Medical Research;
  • 16th place internationally among medical schools, by QS World University Rankings.

Source: Duke University School of Medicine’s Med School Blog (Durham, NC – March 30, 2021)

Stacey HiltonDuke Anesthesiology Ranks #4 in the Nation Among Specialties
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Dr. Terrando to Study the Role of the Blood-Brain Barrier

Niccolò Terrando, BSc (hons), DIC, PhDReservoir Neuroscience, Inc, has awarded Duke Anesthesiology’s Niccolò Terrando, PhD, an $80,143 grant to study Therapies to Protect the Blood-Brain Barrier After Surgery.” The project will evaluate the efficacy of Reservoir’s experimental compounds to protect the blood-brain barrier and prevent cognitive deficits and delirium-like behavior following orthopedic surgery. Designed as a pre-clinical academic-industry collaboration, this study has the potential to advance novel, first-in-kind treatments to improve debilitating patient outcomes in postoperative neurocognitive disorders (PND) – an unmet disease area.

Surgeries, including cardiac and orthopedic, often cause neurological complications, such as post-operative delirium and cognitive decline. These outcomes can be severely debilitating and in older adults, can create risk for onset of chronic dementia. It is not yet known how delirium and PNDs develop, or how to effectively treat this complication.

The Neuroinflammation and Cognitive Outcomes Laboratory at Duke Anesthesiology, directed by Terrando, has developed models to study the pathogenesis of postoperative delirium and strategies to combat it. In particular, the investigators have focused on the role for surgery-induced systemic inflammation in causing breakdown of the blood-brain barrier (BBB), a critical interface between the periphery and the central nervous system that regulates brain homeostasis to enable proper functioning. The BBB is often impaired in aging and neurologic disorders, such as epilepsy and Alzheimer’s disease. They have described changes in the BBB following orthopedic surgery, suggesting that opening of this barrier enables immune cells (like monocytes) and molecules (like fibrinogen) to access the brain and trigger pathological disease outcomes. This vascular pathology is especially evident in the context of neurodegeneration as they have described in a recent study published in Alzheimer’s and Dementia.

“The role of the blood-brain barrier in conditions like delirium is just starting to emerge. We are thrilled for this opportunity to work with Reservoir Neuroscience to test novel therapeutics that have the potential to heal the blood-brain barrier and hopefully prevent delirium,” says Terrando, associate professor in anesthesiology.

Reservoir Neuroscience, Inc, is developing new drugs to treat BBB dysfunction. These experiments are designed to provide proof-of-concept of a novel approach to improve outcomes in a rodent model of orthopedic surgery.

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Dr. Terrando Awarded Grant to Study Delirium Therapy

Niccolò Terrando, BSc (hons), DIC, PhDExalys Therapeutics has awarded Duke Anesthesiology’s Niccolò Terrando, PhD, a $200,479 grant for his project, “Test the Efficacy of Exalys EP4 Antagonist to Prevent Neuroinflammation and Delirium in a Preclinical Model.” The project will study the efficacy and safety of Exalys’ lead Prostaglandin E2 receptor 4 (EP4) antagonist in preventing cognitive decline (inattentiveness) and associated inflammatory biomarkers in a surgical preclinical model of delirium (orthopedic fracture). Results from this study could advance the development of a new immune-drug target to combat delirium. Terrando and Dr. Ting Yang of Duke Medicine serve as co-principal investigators.

Postoperative delirium, also referred to as “acute brain failure,” is a common and serious surgical complication in older patients that can lead to increased hospital costs and poor post-discharge outcomes. The ongoing pandemic due to COVID-19 has further highlighted the multiple challenges related to treating patients with delirium, especially given the limited therapeutic options available. Despite the prevalence of delirium in multiple settings, ranging from critical illness to elective surgical procedures, there are currently no therapies to possibly prevent delirium.

Delirium is a challenging, multifactorial pathology, with several mechanisms impacting the brain functioning of vulnerable patients. The Neuroinflammation and Cognitive Outcomes Laboratory, directed by Terrando at Duke Anesthesiology, has identified a critical role of systemic inflammation in driving “acute brain failure” and causing pathologic and behavioral changes in rodent models that resemble features of human delirium.

“Inflammation truly is a double edge sword in the setting of perioperative recovery,” says Terrando, associate professor in anesthesiology. “We know many of the deleterious effects that pro-inflammatory molecules can exert on the brain. We also know that blocking these molecules can impair the recovery of postoperative patients, for example by impairing healing.” Yang and Terrando recently contributed a review in Nature Immunology discussing the role of innate immunity in driving perioperative neurocognitive disorders, such as delirium.

“We are thrilled for the opportunity provided by Exalys to test and expand the potential application of this new compound to prevent delirium,” Yang adds. Her laboratory is actively studying the role of EP4 signaling in cardiovascular disorders, including hypertension and brain inflammation.

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CAPER Unit Awarded Grant to Study New Lipid Formulation

Duke Anesthesiology’s Critical Care and Perioperative Population Health Research (CAPER) Unit

Duke Anesthesiology’s Paul Wischmeyer, MD, EDIC and the Critical Care and Perioperative Population Health Research (CAPER) Unit have been awarded a $130,000 grant for their project, titled “Impact of SMOFlipid on Clinical Outcomes Among Patients Receiving Parenteral Nutrition: An Interrupted Time Series Analysis.” The researchers will use the funding to study the effect of a newly-implemented advanced parenteral nutrition lipid on clinical outcomes versus previously used Omega-6 soy lipid.

The grant was awarded by Fresenius-Kabi Inc. Wischmeyer serves as the principal investigator of the grant; co-investigators include Drs. Vijay Krishnamoorthy, Karthik Raghunathan, Tetsu Ohnuma, Krista Haines (Duke Surgery), and Surgical Intensive Care Unit fellow, Dr. Osamudiamen Obanor.

The research team will examine the hypothesized benefits of a new IV nutrition lipid used for total parenteral nutrition (TPN) on clinical outcomes in Duke’s patients since Duke adopted the new lipid in 2017. Duke was among the first academic health centers in the nation to widely adopt the new lipid as it was only FDA approved in 2017. Wischmeyer notes that parenteral nutrition has been traditionally thought to potentially lead to increased infection risk. However, he says recent large randomized trials in Intensive Care Unit (ICU) patients in high-impact journals (New England Journal of Medicine, Lancet, JAMA) have shown there is no longer any association of TPN with infectious risk, even in ICU patients; but it is unclear what factors have reduced this risk.

One hypothesis the newly-funded study will explore is that newer lipid formulations containing fish oil, olive oil and a “healthier” fat mix reduces infection versus previously utilized Omega-6 lipids that have been used in the US for more than 40 years. This new trial will look at all Duke patients from neonates to adults who received new, healthier (SMOF) lipid formulation at Duke. And, using the unique talents of the CAPER Unit, they’ll compare similar patients from the period immediately prior to the new lipids introduction looking for differences in infection, length of stay, liver injury, and other clinical outcomes.

Results of this study are expected to provide unique insight to specific contribution of new, healthier lipid formulations to TPN safety and improved clinical outcomes. This could also lead to larger clinical trials or large health outcome database research funding opportunities to explore this question and other methods to improve outcomes with TPN.

“The US has a unique opportunity to finally utilize a safe and more optimally-balanced lipid formulation that has shown preliminary data to reduce infection, length of stay and improve clinical outcomes,” says Wischmeyer, professor of anesthesiology and associate vice chair for clinical research. “This study with our Duke Anesthesiology CAPER Unit provides a unique ‘real-world’ clinical care research opportunity to evaluate the contribution of this long-awaited new generation of lipid formulations to improve outcomes.”

Stacey HiltonCAPER Unit Awarded Grant to Study New Lipid Formulation
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Dr. Ji Named a Highly Cited Researcher

Ru-Rong Ji, PhDDuke Anesthesiology’s Ru-Rong Ji, PhD, distinguished professor of anesthesiology, has once again been named among the most “Highly Cited Researchers” in the world. Ji is one of 37 Duke faculty named to the list this year; he is one of 22 faculty from the Duke University School of Medicine.

The annual list is based on the number of highly cited papers produced over an 11-year period from January 2009 to December 2019. Citation rate, as tracked by Clarivate’s Web of Science, is an approximate measure of a study’s influence and importance. 6,127 researchers from 60 countries are recognized by the 2020 listing.

Ji was one of 54 Duke researchers who made the global list of “Highly Cited Researchers” in 2019; a list he also made in 2018. His research focuses on molecular and cellular mechanisms of chronic pain, including but not limited to mediators of inflammation and pain, neuropathic pain and cancer pain.

“This list is very dynamic from year to year,” says Ji, director of the Sensory Plasticity and Pain Research Laboratory and co-director of the Center for Translational Pain Medicine at Duke Anesthesiology. “I am very pleased that someone from anesthesiology can make the list. I am proud to represent the field, and I appreciate the strong support for my research from the department.”

The year’s most highly cited authors from the Duke University School of Medicine are: 

Robert M. Califf—Clinical Medicine
Avshalom Caspi—Psychiatry and Psychology
Jane Costello— Psychiatry and Psychology
Lesley H. Curtis—Clinical Medicine
Geraldine Dawson— Cross-Field
Pamela S. Douglas—Clinical Medicine
Charles A. Gersbach—Cross-Field
Christopher Bull Granger—Clinical Medicine
Barton F. Haynes—Immunology and Microbiology
Adrian F. Hernandez—Clinical Medicine
Ru-Rong Ji—Cross-Field
Robert J. Lefkowitz—Clinical Medicine
Sarah H. Lisanby—Cross-Field
Jason Locasale— Cross-Field
Edward A. Miao—Immunology
Terrie E. Moffitt—Psychiatry and Psychology
Kristen Newby—Clinical Medicine
Christopher B. Newgard—Cross-Field
Erik Magnus Ohman—Clinical Medicine
Manesh R. Patel—Clinical Medicine
Michael J. Pencina—Social Sciences and Clinical Medicine
Eric D. Peterson—Clinical Medicine

For a complete list of Duke faculty, see the article at Duke Research Blog.

Source: Duke Med School Blog, November 19, 2020

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