Duke AHEAD Grant Awarded

The Duke Academy for Health Professions Education and Academic Development (Duke AHEAD)  has awarded Dr. Jennie De Gagne (Duke School of Nursing) and her team of five co-investigators, including Duke Anesthesiology’s Dr. Ankeet Udani, a $5,025 grant for their project titled, “Needs Assessment of Cybercivility Learning in an Interprofessional Education.”

The goal of this study is to conduct a needs assessment to facilitate the development of interprofessional cybercivility learning modules and curriculum resources for health professions students.

Dr. Udani, assistant professor of anesthesiology and assistant director of the Duke Anesthesiology Residency Program, was awarded membership to Duke AHEAD in July of 2014. Its mission is to promote excellence in the education of health professionals by creating a community of education scholars, fostering innovation in health professions education, supporting outstanding teachers, providing faculty development programs, and facilitating quality education research.

Chris KeithDuke AHEAD Grant Awarded
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Grant Awarded to Improve Stroke Outcomes

The National Institute of Neurological Disorders and Stroke (NINDS) has awarded Wei Yang, PhD, a 5-year, $1,739,065 National Institutes of Health grant to pursue his study, titled “The Unfolded Protein Response and Neuroprotection in Stroke.”

The goal of this project is to determine the role of endoplasmic reticulum (ER) stress and the unfolded protein response (UPR) in stroke. The UPR is a pro-survival response that restores ER function impaired by stroke, and facilitates recovery of cellular protein homeostasis, which is critical to the survival of stressed cells. Understanding how UPR pathways define the fate and function of post-ischemic neurons is expected to inform the development of new therapeutic strategies to boost this pro-survival response and improve stroke outcome. To complete this study, novel UPR-selective and neuron-specific knock-out and knock-in mouse models as well as various pharmacologic tools will be used.

Dr. Yang’s mentor, Dr. Wulf Paschen, and Dr. Huaxin Sheng, both of Duke Anesthesiology, are co-investigators on this project. Significant contributors include Duke Anesthesiology’s Dr. David Warner, Dr. John Chatham (University of Alabama at Birmingham) and Christopher Glembotski (San Diego State University).

This is the second research grant awarded to Dr. Yang this year. The grant application was highly rated (third percentile) in the first submission cycle. Dr. Yang participated in the external grant review program provided by the department to gather valuable feedback on this application before submission to NIH.

Chris KeithGrant Awarded to Improve Stroke Outcomes
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Pain Researcher Awarded NIH Grant

The National Institutes of Health’s National Institute of Dental and Craniofacial Research has awarded Andrea Nackley, PhD, a $500,000, one-year grant for her project titled, “Proteins, MicroRNAs and Genes Associated with TMD and Overlapping Conditions.”

According to the Institute of Medicine, chronic pain affects 100 million Americans, causing extensive economic, social and personal costs. For some, the pain remains localized, while for others the pain spreads to affect multiple anatomic sites, suggesting a common underlying cause. In response to PA-14-244, Dr. Nackley plans to use stored biospecimens and existing data from a clinical study of 1,460 adults to determine biological (proteins, microRNAs, and gene polymorphisms), psychosocial (stress, depression, anxiety), and clinical (general health and environmental exposures) factors that contribute to localized and overlapping pain conditions. They will also use bioinformatics methods to understand how these factors interact to influence pain with the long-term goal to identify biomarkers for the diagnosis and treatment of chronic overlapping pain conditions.

Dr. Nackley is the director of The Nackley Lab, part of Duke Anesthesiology’s Center for Translational Pain Medicine. This center began in January of 2016 and represents a novel entity established to transform the way painful conditions are diagnosed and treated. This new center  further expands Duke Anesthesiology’s existing clinical and research program in innovative pain therapies by bringing together, under one umbrella, leading basic scientists, clinicians and clinical researchers who have a common core mission of unraveling the causes of painful conditions to better improve patient care.

Chris KeithPain Researcher Awarded NIH Grant
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DREAM Campaign Support Results in NIH Grant

The National Institutes of Health has awarded Dr. Sven-Eric Jordt’s Duke Anesthesiology laboratory a two-year, $384,780 grant from its National Institute of Arthritis and Musculoskeletal and Skin Diseases for their project titled, “Mechanisms of Itch in Poison Ivy-Induced Allergic Contact Dermatitis.”

This R21 grant will support highly innovative research to identify mechanisms of itch. “Conditions such as allergic contact dermatitis, atopic dermatitis and psoriasis are widespread, with patients suffering from strong untreatable itch,” says Dr. Jordt, who adds that the sensation of itch is related to the sensation of pain which is triggered by related nerve pathways. “However, itch research has clearly lagged behind pain research and there is a great need for new treatments.”

This success was made possible with support from a DREAM Innovation Grant (DIG) to Dr. Boyi Liu in Dr. Jordt’s Chemical Sensing, Pain and Inflammation Research Laboratory. This lab focuses on the mechanisms that enable humans and animals to sense touch, pain and irritation.

The DIG is part of Duke Anesthesiology’s DREAM (Developing Research Excellence in Anesthesia Management) Campaign, endowed by philanthropic gifts to the department, which supports innovative high-risk and potentially high-reward investigations to accelerate anesthesia and pain management to improve patient care. Dr. Liu recently joined the faculty of Zhejiang Chinese Medical University in Hangzhou, China, and will continue collaborating with Dr. Jordt’s group.

Chris KeithDREAM Campaign Support Results in NIH Grant
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Four Departments, One $3M Grant

The National Institutes of Health and the National Heart, Lung, and Blood Institute have awarded the chairman of Duke Anesthesiology, Dr. Joseph Mathew, and the co-principal investigator, Dr. Charles Hughes, a $3.5 million, five-year R01 award for their project titled, “Cognitive Effects of Body Temperature During Hypothermic Circulatory Arrest.”

This research endeavor in the Department of Anesthesiology will bring together the departments of Psychiatry, Cardiac Surgery, Biostatistics and Bioinformatics, as well as external academic institutions such as the University of Pennsylvania and Emory University. Co-investigators include Drs. Jeffrey Browndyke, Joern Karhausen, Yi-Ju Li, Mark Newman, and Wulf Paschen.

The use of deep hypothermia (<20°C) for cerebral protection ushered in the modern era of safe and effective operations on the heart and aorta. In large part due to advanced circulatory management strategies, surgical procedures on the proximal aorta and arch utilizing deep hypothermic circulatory arrest have steadily increased over the last decade. Despite these advances, neurologic complications remain a sobering limitation. Indeed, 7-13 percent of patients endure permanent neurologic dysfunction. In addition, postoperative cognitive decline (POCD) occurs in 36 percent of cardiac surgery patients at six weeks after surgery, and importantly, persists in 42 percent of patients up to five years after surgery and reduces quality of life. Although deep hypothermia has been the standard of care for decades in adult patients requiring circulatory arrest, moderate hypothermia is now more commonly used in many centers. However, this transition to moderate temperatures has been based entirely on observational studies that have not adequately assessed neurological or neurocognitive outcomes.

In the proposed study, the team will test their hypothesis that deep hypothermia (<20°C) during surgical circulatory arrest limits POCD and preserves brain connectivity to a greater degree than moderate hypothermia (24.1°C-28°C) and that low hypothermia (20.1°C-24°C) is non-inferior to deep hypothermia. This proposed study will be the first randomized trial to evaluate the effects of deep vs. low vs. moderate hypothermia during circulatory arrest on neurocognitive function and functional brain connectivity. Preliminary data strongly supports a detrimental effect of moderate hypothermia during circulatory arrest and this study is likely to dramatically alter practice and improve patient safety. This study will also be the first study in humans to assess the role of the small ubiquitin-like modifier conjugation pathway in protecting the brain during cardiac surgery requiring circulatory arrest. This significant study is expected to vertically advance the field of cardiac surgery by revolutionizing our understanding of the effects of hypothermia on neurologic and neurocognitive outcomes, by providing strong evidence for optimal hypothermic temperatures during surgical circulatory arrest, and by identifying new targets for therapeutic intervention to increase the resistance of organs to a transient interruption in blood supply.

Little is more devastating to a patient or the patient’s family than to have a successful operation that prolongs life, but is complicated by cognitive impairment resulting in a diminished quality of life and loss of functional independence. The long-term goal of the multidisciplinary Neurologic Outcome Research Group is to understand the mechanisms underlying neurologic and neurocognitive dysfunction after cardiac surgery, and to reduce the incidence of these devastating outcomes.

 

Chris KeithFour Departments, One $3M Grant
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