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SPRING 2014

REGENTS UNIVERSITY

REGENTS UNIVERSITY

Out of the

Blue PANTRY ITEMS POINT TO NEW TREATMENTS FOR BRAIN TRAUMA

GResearch Winter 2014

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VOL. 2

NO. 1

DISCOVERIES

IN

PROGRESS

CONTENTS GResearch is produced twice a year by the Office of the Vice President for Research, in conjunction with the Office of Communications and Marketing.

Out of the Blue

Pantry Items Point to New Treatments for Brain Trauma

2 At a Glance

PRESIDENT Dr. Ricardo Azziz

16 Tailor-Made Research Paves Way for Individualized Care

PROVOST Dr. Gretchen Caughman

20 Over There

SR. VP FOR RESEARCH Dr. Mark Hamrick SR. VP FOR COMMUNICATIONS AND MARKETING David Brond

Study Aims to Help Children Uprooted by Military Moves

20

EDITOR Christine Hurley Deriso

©2014 GEORGIA REGENTS UNIVERSITY

Research Outlines Successful Steps for Entrepreneurs

Historian Draws on Past to Create Stirring AfricanAmerican Narrative

PHOTOGRAPHER Phil Jones

Georgia Regents University does not discriminate on the basis of race, color, national origin, sex, disability, religion, age, veteran status, gender identity or expression, or sexual orientation in its programs and activities as required by Title IX of the Educational Amendments of 1972, the Americans with Disabilities Act of 1990, Section 504 of the Rehabilitation Act of 1973, Title VII of the Civil Rights Act of 1964, and other application statutes and university policies.

26 Passing ‘Go’

32 Ripple Effect

DESIGN AND PRODUCTION P.J. Hayes Design

WRITERS Toni Baker Christine Hurley Deriso Kelly Jasper

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37 Foot Soldiers

26

Study Enlists Church Members to Spread Word of Cancer Prevention

40 Advancement Update

6 37

High-Fiber Diet Fights Colon Inflammation


Dear Readers, THE SPRING 2014 edition of GResearch features of Georgia’s 2014 budget includes $64 million for such a diverse and dizzying array of research that GRU initiatives including cancer research. Also, it’s hard to know where to begin to convey the among 139 U.S. medical schools, GRU’s Medical excitement found in these pages. College of Georgia has moved into the top half in From articles covering potential new treatments federal research funding, including $43.3 million in for brain trauma to the unique struggles of military National Institutes of Health dollars. MCG also ranks children, I promise that nothing will disappoint. If I seventh nationally and first in Georgia in American do say so myself, the contents of this magazine are Heart Association funding. The GRU Colleges of downright fascinating. Dental Medicine and Nursing also rank among the In addition to showcasing excellent research, the top 70 within their respective categories, securing articles also drive home a couple of other salient nearly $1.4 million in combined funding. points. First, please note how many Our commitment is made We are thrilled students—including undergraduates—are exponentially easier and more

involved in the research unfolding on our campus. GRU’s primary mission is education, and we take pride in availing our students of multiple avenues of research participation, starting from their earliest years of higher education. Even local high school student Gerald Meixiong (the son of two of our faculty) took advantage of a research opportunity on our campus, earning national recognition and a $40,000 scholarship for a mitosis study. (See page 4.) The articles also showcase our commitment to community service. Dr. Selina Smith’s study, for instance, enlists the aid of local churches and other community organizations to train foot soldiers in the fight against colorectal cancer. (See page 37.) Likewise, our multidisciplinary study of children in military families is partnering with nearby U.S. Army installation Fort Gordon to combine resources for optimal impact. (See page 20.) GRU is truly entrenched in our community, tapping into a wellspring of local energy, ideas, enthusiasm, and expertise to advance the well-being of our citizens. You advance our mission not only as donors, but as taxpayers. We are thrilled to announce that the University System

to announce that the University System of Georgia’s 2014 budget includes

$64 million

effective when we partner with you. Every dollar of support yields a return that far outweighs your initial investment, and we thank you from the bottom of our hearts. n

for GRU initiatives including cancer research.

Dr. Mark Hamrick SENIOR VICE PRESIDENT FOR RESEARCH

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AT A GLANCE Lemonade Boost Dr. Theodore Johnson, a pediatric cancer researcher and physician, has received a $375,000 grant from the Alex’s Lemonade Stand Foundation to determine ways to block an enzyme called indoleamine 2,3-dioxygenase, or IDO. When used as part of an immunotherapy regime, he theorizes that blocking IDO will have an amplifying effect, increasing the impact of both chemotherapy and radiation therapy in children with brain cancer. While IDO is currently in clinical trials to treat lung, ovarian, and metastatic breast cancer in adults, Johnson explains that pediatric application means setting the research clock back to zero, noting that because children are still developing, their response to treatments and therapies is often very different than those of adults. Next steps include measuring tolerability and toxicity, then applying the research to other immunotherapy treatments for both adults and children. His goal: a pediatric immunology clinic at GRU. n

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A Welcomed STING A little STING could go

In 2000, at age 4, cancer patient Alexandra ‘Alex’ Scott opened a lemonade stand to help children who shared her plight. Inspired by her story, people took up the Lemonade Stand cause, donating money and often setting up their own stands. When Alex died in 2004, her foundation had raised more than $1 million. Last year, it raised $16 million and this year hopes to distribute more than $14 million in grants to researchers including Johnson.

a long way in helping treat or even avoid autoimmune diseases, researchers report. With some prompting, the protein, STING, can quell the immune response or even block its attack on healthy body components, said Dr. Andrew L. Mellor, an MCG immunologist. When MCG researchers injected into the bloodstream DNA nanoparticles (carriers to deliver drugs or genes into cells), they were the first to report that even emptyhanded, these nanoparticles could suppress immunity by prompting expression of the enzyme, IDO, in arthritic mice. Now, they have learned that the magic is in STING, which recognizes the molecule that senses the DNA, then prompts release of IDO. In fact, mice without STING had no response to the DNA nanoparticle, the researchers report. Researchers already knew there was a link between STING and immunity: the food-borne bacterium listeria releases cyclic dinucleotides

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Sound of Music

The 1998 finding at MCG that IDO creates a tolerance in a mother’s immune system to protect a developing fetus was the subject of Theodore Johnson’s (facing page) PhD thesis that year. Dr. Andrew Mellor (right), who collaborated with Dr. David Munn (left) in uncovering the groundbreaking finding, was his advisor. All three are now researchers at the GRU Cancer Center. to activate STING in cells it has infected. However, this is the first time they realized that STING can actually turn the immune system off. Mellor, the Bradley-Turner and Georgia Research Alliance Eminent Scholar in Molecular Immunogenetics at MCG, is using a $1.4 million National Institutes of Health grant to probe the best way to activate STING. n

GResearch Spring 2014

A faultily formed memory sounds like hitting random notes on a keyboard, while a proper one sounds more like a song, GRU scientists say. When the major switch for learning and memory is turned on, chatter reverberates, associations are made, and helpful memories— like how touching a hot stove results in a burn— are easily retrieved. But “in mice lacking an NMDA receptor, memory patterns are dull and dissociated. Their tones are flat, the association is poor,” said Dr. Joe Tsien, a Georgia Research Alliance Eminent Hear the recordings: Scholar in Cognitive go.gru.edu/18GOKL1 and Systems Neurobiology, go.gru.edu/1c1tWUs Co-Director of the GRU Brain & Behavior Discovery Institute and corresponding author of the study in the journal, PLOS ONE. To illustrate just how flat, Postdoctoral Fellow Hui Kuang assigned musical notes to the memory activity of each, which resulted in random noise by mice without NMDA compared to a dynamic rhythm from normal mice. The findings should help physicians better assess and treat conditions such as Alzheimer’s and schizophrenia. n

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AT A GLANCE

Brain-Muscle Breakdown

Dr. Lin Mei’s finding also shows that LRP4 is important both in forming and maintaining the neuromuscular junction—where the brain and muscle communicates.

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An antibody to a protein critical to the brain’s communication with muscles has been identified as a cause of myasthenia gravis, an autoimmune disease, which affects about 20 out of 100,000 people The finding that an antibody to LRP4 is a cause of the condition— the most common disease affecting brain-muscle interaction—helps explain why up to 10 percent of patients have classic symptoms like drooping eyelids and generalized muscle weakness, yet no obvious clues in their blood, said Dr. Lin Mei, Director of the MCG Institute of Molecular Medicine and Genetics and corresponding author of the paper in The Journal of Clinical Investigation. Mei and his colleagues first reported antibodies to LRP4 in the blood of myasthenia gravis patients in the Archives of Neurology in 2012. For the new study, they gave healthy mice LRP4 antibodies. The mice experienced classic symptoms of the disease along with clear evidence of degradation of the neuromuscular junction. The Journal of Clinical Investigation study was funded by the NIH and the Muscular Dystrophy Association. Mei is a Georgia Research Alliance Eminent Scholar in Neuroscience. n

An Early Start Gerald Meixiong, a student at Lakeside High School in Evans, Ga., placed fourth in a 2013 national research competition for his mitosis study, earning a $40,000 scholarship. Meixiong discovered a novel mechanism for efficient chromosome segregation—the process of pulling chromosomes toward opposite ends during mitosis. His finding could help identify potential treatments for cancers, which rely on unbridled cell division. The Siemens Competition in Math, Science, and Technology, sponsored by the Siemens Foundation, honors high school students’ research initiatives. Meixiong, the son of GRU faculty members Lin Mei (left) and Wen Chen Xiong, was mentored by Dr. Quansheng Du, GRU Associate Professor of Neurology. n

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Nationally Renowned

True Colors

The online graduate progrAms

GRU researchers have developed a test that will distinguish early liver cancer cells from normal cells by giving them a red-brown hue.

at the College of Nursing have been ranked 75th in national rankings by U.S. News and World Report. “For over a decade, the College of Nursing community has blended high-tech communications with pedagogy to provide quality education to nurses wherever they are,” said Dean Lucy N. Marion. “In addition to the satisfaction of serving so many nurses, the honor of being nationally ranked is like icing on the cake.” U.S. News and World Report based the rankings on factors including student engagement, faculty credentials and training, student services and technology, peer reputation, and admissions selectivity. n

For a complete list of top online graduate nursing programs, visit usnews.com/online.

GResearch Spring 2014

“There is no

definitive test for early diagnosis of liver cancer,” said Dr. Ravindra Kolhe (bottom left), Medical Director of GRU’s Georgia Esoteric, Molecular Labs LLC and lead author of the study. “Our test adds a level of comfort for making the diagnosis.” “You want to make the correct diagnosis as early in the game as you can,” Kolhe said. He collaborated with BioGenex laboratories in California to develop a probe that detects and stains a microRNA called mir21, which is found in liver cancer but not healthy liver cells. For the study, they used their probe on biopsies of 10 healthy livers and 10 cancerous livers. In every case of liver cancer, the biopsy took on the red-brown hue. They are now using the test on 200 similar cases of liver cancer. The group also is exploring this approach in other hard-to-detect early cancers, including melanoma. n

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AT A GLANCE Colon Health Scientists have more reasons for you to eat fiber, take niacin, and not abuse antibiotics. A STUDY featured on the cover of the journal, Immunity, found that mice lacking the receptor, Gpr109a, were prone to inflammation and colon cancer, said Dr. Nagendra Singh (right), MCG immunologist and a corresponding author. And when they gave niacin to mice whose healthy colonic bacteria had been wiped out by antibiotics, it helped steer immune cells in the colon into a safe, anti-inflammatory mode. Good bacteria in the colon thrive on fiber, and its digestion produces a natural activator of Gpr109a called butyrate, which was discovered years ago by Dr. Vadivel Ganapathy (left), Chairman of the Medical College of Georgia Department of Biochemistry and a corresponding study author. However, this relationship appears limited to the colon, where butyrate levels can soar in the face of a highfiber diet. Now he and Singh have shown activation of Gpr109a 6

in the colon by butyrate prompts immune cells to suppress rather than promote inflammation, a factor in conditions such as ulcerative colitis, Crohn’s,

and colorectal cancer. Next steps include clinical trials of niacin supplements in colon health. The research was funded by the National Institutes of Health. n

Dietary fiber is the component in food that your body cannot digest. High-fiber foods include lettuce, beans, nuts, fresh fruits, rice, grains, and even popcorn.

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Reproductive Health GRU HAS joined the national Cooperative Multicenter Reproductive Medicine Network designed to enable large clinical trials that target reproductive health issues. “These types of trials answer important questions about the care of infertile couples and Diamond has served allow us to offer services for more than a to the community that decade as a Principal would not otherwise Investigator of be available,” said Dr. the network, a Michael P. Diamond, component of the Chairman of the Medical National Institutes College of Georgia of Health’s Eunice Department of Obstetrics Kennedy Shriver National Institute and Gynecology. of Child Health Network participation also complements human and Human Development. studies at MCG to better understand complex reproductive issues such as delayed puberty and polycystic ovary syndrome, Diamond said. One of the first network studies he hopes to bring to MCG is evaluating the impact of multiple births on parents, siblings, and extended family. MCG receives $1.75 million as part of the base funding for the network. Additional federal funds will come to MCG for participation in individual clinical trials as part of the network. n

GResearch Spring 2014

Sodium Measure GETTING a second urine sample and blood pressure measure as patients leave the doctor’s office appears an efficient way to identify those whose bodies retain excess sodium, researchers report. “We want to prove that you can easily and efficiently identify these patients,” said Evan A. Mulloy (below left), a second-year medical student at GRU. “We want this to become a part of our routine standard of care.” Using this method, researchers found that eight of 19 adolescent boys visiting a pediatric nephrologist were sodium retainers, seven of whom were already hypertensive. The findings were presented at the American Heart Association’s High Blood Pressure Research 2013 Scientific Sessions. About 1 in 3 blacks and 1 in 5 whites retain excess sodium following stress, raising fluid retention and blood pressure, said Dr. Gregory A. Harshfield (right), a hypertension researcher who directs the Georgia Prevention Center at GRU’s Institute of Public and Preventive Health. The researchers have also determined that potassium supplementation seems to help maintain a healthier sodium level following stress. n

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Pantry Items Point to New Treatment for Brain Trauma

Out of the

Blue BY TO N I B A K E R

H

E HAS A SWEET AND MISCHIEVOUS SMILE.

It was the mischievous part that nearly killed Jesse Williford. The smile is easy enough to figure out. Jesse has spent his 24-year-old life nestled in the beauty of 100 acres in rural Lincoln County, Ga., and the love of a strong, tight family. His parents, Tamara and Wayne, brothers Stephen and Danny, along with Tamara’s mother, and Danny’s wife, Leigh, and their children, share the space with five rescue dogs and a handful of prancing horses. “I LOVE IT,” says Jesse. There is always plenty of work, fun, and together time, such as warming up a cool night with a big fire and friends at the pond, riding and tending to the horses, climbing majestic trees. Everyone has their own space on the land they were inspired to call Sunset Farms, because the ones there are so glorious. But they also have the comfort of family. Tamara is a nurse who works in Augusta. The rest of the Willifords pool their talent at an ecclectic group of businesses they own in nearby Thomson, including a car lot, pawn shop, and Mexican restaurant. The mischievous part is probably easy to figure out as well. A mother of three

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boys, Tamara rightly figured life would never be dull. Jesse certainly did his part. He got his first ticket at age 14, when he took his parents’ car for a drive. On his 17th birthday, he decided he just did not want another ticket, never mind a suspended driver’s license, so after passing a police officer going about 90 miles per hour, he ran a stop sign in excess of 100 miles per hour. When his understandably stressed passenger grabbed the wheel, unrestrained Jesse flew through the windshield. Amazingly, he was relatively unscathed and his passenger would recover as well. But Tamara says her youngest seemed even more impulsive after that.

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Jesse Williford with one of his horses on Sunset Farms in Lincolnton, Ga.

GResearch Spring 2014

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Not Looking Good MARCH 25, 2012, Jesse was unrestrained and speeding again, this time down a dirt road in his jacked-up 4Runner. He crossed a bridge, flipped his vehicle, and catapulted from the 4Runner into a tree. Falls, motor vehicle accidents, collisions, assaults, and war injuries cause more than 1.7 million traumatic brain injuries in the United States annually, according to the Centers for Disease Control and Prevention. “We see a few every week,”

“About 10 percent of the brain injuries we see are bad, like Jesse’s, another 10 percent are more moderate, and, fortunately, the vast majority are in the mild category.” –DR. COLVILLE FERDINAND

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says Dr. Colville Ferdinand, Chief of the MCG Section of Trauma and Surgical Critical Care. The traumatic brain injury stats for the region’s Level 1 Trauma Center at Georgia Regents Health System match national ones. “About 10 percent of the brain injuries we see are bad, like Jesse’s, another 10 percent are more moderate, and, fortunately, the vast majority are in the mild category.” As trauma team members rapidly and systematically assess a patient, they check for an open airway as well as adequate blood volume to reach the brain, where tissue can start dying within minutes. Any suspicion of a head injury prompts a rapid computerized tomography scan. Jesse’s did not look good. Dr. Samuel Macomson, a 1997 MCG graduate who completed a neurosurgery residency at his alma mater in 2003, was the neurosurgeon on call that Saturday, and what he saw as

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he looked at Jesse’s scan meant urgent surgery. “He was in the process of dying,” Macomson says. The major injury to his brain was complicated by extensive lung damage. The good and the bad news of trauma is that, like Jesse, many victims are young and previously healthy, so the team would persevere with the goal of giving his strong body and brain at least the opportunity to recover.

Danny Williford (right) with Jesse and mother Tamara

‘Hardheaded and Tough’ TAMARA AND WAYNE were cutting grass at their place in the North Carolina mountains, so hours passed before they learned what happened. The trauma team in Augusta promised to try to keep Jesse alive until they could get to his side, but his mother, the nurse, knew she might never see him again. Brothers Danny and Stephen, at their Lincoln County homes about an hour away, were the first to arrive at the Trauma Center. When they learned of the extreme measures required to try to save Jesse, Danny was characteristically vocal. “He’s hardheaded and tough, and I just knew if somebody is going to pull out of it, it was going to be Jesse.” Besides, he was nowhere near ready to lose his baby brother. Macomson would remove the left side of Jesse’s skull, placing it in a freezer where it would stay for seven months. He then removed a huge blood clot on the brain’s surface. Rather than the typically uniform surface with distinct crevices separating all the vital parts, Jesse’s brain was a swollen, indistinguishable mass.

GResearch Spring 2014

“He’s hardheaded and tough, and I just knew if somebody is going to pull out of it, it was going to be Jesse.” –DANNY WILLIFORD And bad stuff was going on that Macomson couldn’t see. “The skull has one main opening, so when pressure inside the head increases, it starts pushing down,” he says. The downward pressure, in turn, puts pressure on the brain stem, a sort of relay station between the body and brain that controls basic functions like consciousness and movement.

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A Resounding ‘Yes’ Balancing Act “AT THE TIME the accident happens, some brain is injured and some brain is vulnerable and, if you do the right things, you can help the vulnerable brain recover,” says Ferdinand. Removing a portion of the skull to better accommodate the swelling, called a hemicraniectomy, is one of the best tools to rescue the traumatically injured brain. Patients also need close monitoring of the pressure on their brain, diuretics to reduce fluid and susequent pressure, critical care to support the entire super-stressed body, as well as simple measures like keeping the head elevated. Still, doctors give a resounding “yes” when asked if they’d like more treatment options, noting that nearly 40 percent of patients with severe brain trauma like Jesse’s die as a result of damage that occurs after the injury, as the traumatized and swelling brain tries to heal. From his laboratory across campus, Dr. Krishnan Dhandapani, a 2003 graduate of the GRU Graduate School, is eager to hand over some better solutions. At least some of them might come from the kitchen pantry. His focus is interleukin-1, a common pro-inflammatory cytokine that aids wound-healing and repair, which he has found elevated in the cerebral spinal fluid of TBI patients who are not doing well. It’s elevated as well in TBI animal models. “Even if you just cut your finger, any kind of injury is going to get interleukin-1 beta as part of the initial immune response,” Dhandapani says. “It’s like a road flare that shoots up and calls in the immune system.” That, at least in part, is a good thing.

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IMMUNE CELLS such as macrophages move in to clear the area of debris such as dead brain cells and blood. Interleukin also activates a natural channel, called aquaporin 4, for moving water in and out of cells, presumably to provide more room for infection fighters, blood clotters, and other agents, says Dr. John Vender, Vice Chairman of MCG’s Department of Neurosurgery and a co-investigator with Dhandapani. “It’s bringing in the supplies needed to fight the injury,” Dhandapani says. However, the system, designed to ramp up exponentially,

can quickly overwhelm, affecting too much tissue and causing too much swelling in the skull. “The whole body does similar things, but not in a contained space,” says Vender, citing examples such as a sprained ankle or wrist. “Everything else can swell and stretch.”

Drs. Krishnan Dhandapani (below) and John Vender

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Dhandapani’s mentor as an undergraduate at the University of Connecticut, Dr. Bruce Goldman, always told him that the body will never intentionally harm itself. “There are good roles for inflammation and edema; I just think we have not figured them all out yet,” the neuroscientist says. It could be the Goldilocks theory of finding a balance that is “just right.” So he is also trying to figure out where interleukin-1 comes from and why it goes up. “You get this hit on the head and, a couple of hours later, interleukin 1 levels go up. What happens between the hit and when interleukin goes up?” While the uptick seems to correlate with injury progression, “we want to figure out if the interleukin we find in the cerebral spinal fluid is causing problems or whether other problems are causing interleukin to go up,” says Dhandapani, who suspects the former. “It’s all a balancing act. If interleukin is doing more harm than good at that early stage, let’s temporarily block it.”

GResearch Spring 2014

Testing shows that brilliant blue G reduces swelling and improves neurological outcome. Curcumin, the ingredient that makes the spice, turmeric, yellow, produces a similar result.

Checking the Pantry THAT’S WHERE THE pantry comes in. Brilliant blue G, a derivative, or close cousin, of the dye that makes sports drinks, M&Ms, and a lot of other products blue, appears to be a potent blocker of the receptor for interleukin 1, called P2X7. When researchers give it to a mouse model of traumatic brain injury, while it turns the mice temporarily blue, brilliant blue G reduces swelling and improves neurological outcome. When they directly block interleukin 1 production by giving curcumin, the biologically active ingredient that makes the spice, turmeric, yellow, it produces a similar result. Still, the researchers want to know more about this important connection. They have expanded the search to a hot new science field called inflammasomes, known to incite inflammation and cell death. They are still dissecting a complex series of interactions activated by a head trauma like Jesse’s in which interleukin 1 becomes uncapped and active, possibly even overactive. “It’s sitting inside all of us right now, basically ready to go,” says Dhandapani. The apparent role of the inflammasome, NLRP3, in

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helping unleash interleukin is good news, at least in part because the scientists think they already know a drug that blocks it. The diabetes drug, glyburide, is becoming known as an antagonist of another channel implicated in swelling, but is also known to directly block inflammasomes. In fact, glyburide already is being tested at the University of Maryland and Yale University, primarily in stroke patients, who also can continue to experience brain loss even days after the initial event, primarily as a result of brain swelling. Dhandapani likes this concept of repurposing, especially when, like with brilliant blue G, the drug is already known to be safe, easy to give and store, and even cheap. “It’s a tool,” he says, that appears to be working.

Full Steam Ahead THE SEARCH FOR other tools has them collaborating with MCG colleagues Joe Tsien, a neuroscientist, and Neurosurgery Chairman Cargill Alleyne, along with scientists at East China Normal University to develop even more effective, and ideally specific, analogues for curcumin. While effective in the lab, it degrades very quickly in water and can’t be given orally. They now have about three analogues that look promising. “The hope is that one of those analogues also hits and works,” Dhandapani says. Meanwhile, they are moving full steam ahead with brilliant blue G, which could be one of the first therapies to target the aftermath of TBI early and at the molecular level. With the help of two recent grants from the National Institutes of Health, they are continuing to explore its therapeutic potential up to eight hours after an injury in order to give patients like Jesse, who must travel long distances for definitive care, the opportunity for a better outcome. While nobody is calling the drugs miracle cures, the researchers suspect they can help reduce the second wave of damage that follows a severe brain injury. “What Kris is doing in the lab is trying to

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find a way to interrupt; he is blocking the process before it gets to the point where it hurts the brain tissue,” Vender says. “That is what is exciting about it.” In fact, if all continues to play out, brilliant blue G might one day be given prophylactically to high-risk groups such as soldiers and football players, Vender and Dhandapani muse. “As a societal, preventive tool, it does not make sense, but for very specific, high-risk individuals, it could make a lot of sense,” says Vender. “It’s clinically safe, people are using it, so we know that we can use it. It’s not going to cause toxicity and it’s relatively inexpensive and easy to store,” Dhandapani says. In fact, the only side effect the researchers have seen at therapeutic doses is that temporary blue hue. Back in the trauma room, the researchers also suspect interleukin-1 levels will one day help physicians recognize which patients would most benefit from a healthy dose of brilliant blue G or one of the other interventions they are pursuing.

Prolonging the Golden Hour IMPROVEMENTS IN prevention, such as better helmets, as well as lessons learned primarily from armed conflicts—such as field resuscitation, rapid transport, and the concept of the golden hour—have doubtless advanced survival rates for patients, says Vender. “What we have not been able to do is prevent that 40 percent loss of function or morbidity that is still occurring,” he says. It was about 8 p.m. when Tamara and Wayne arrived at the side of their youngest. By then, the hospital halls were flooded with dear friends from Lincoln County. But the journey was just beginning. They acknowledge many moments when they weren’t sure Jesse had been saved. But the signs would come. The day Tamara was crying by his bedside and Jesse opened his eyes and shed a few tears. The time he reached for the coin necklace she always wore. There was more than one stint of rehabilitation, GEORGIA REGENTS UNIVERSITY


“Every day is a good day to be here.” –JESSE WILLIFORD

GResearch Spring 2014

including an incredible at-home regimen Danny’s wife, Leigh, devised. “I don’t know what we would have done without Leigh,” says her proud husband, noting she quit her job as well as work on her master’s degree at Georgia Regents University to help out when Jesse finally made it back to Sunset Farms. Macomson and Ferdinand concur that Jesse’s recovery is remarkable and that his family played no small role. “This is a dramatic recovery. It just humbles you when you see that,” Ferdinand says. “You have all these numbers floating around in your head, but even so, you have something like this happen and you say: ‘Wow. You never know.’” “He is definitely the exception, not the rule,” adds Macomson. “With better treatments, hopefully a lot more people can have an outcome like Jesse had.” Because nearly two years later, Jesse is mostly back. “I remember what I was; I was pretty bad,” Jesse says with that mesmerizing smile. While a visitor might not be able to pick out who in the family had a bad head injury, Jesse acknowledges that he’s probably still recovering and may always be. His memory is a little sluggish, especially in the mornings. “We call them HIMs, head- injured moments,” he laughs. He’s working hard to regain his patience and his talent at painting and refinishing automobiles. He mostly accepts the fact that his 24-year-old brain simply has to get enough sleep and good food. He also wears his seatbelt. Life on Sunset Farms continues to look up for Jesse. “Every day is a good day to be here.” n

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Trauma Research Paves Way for Individualized Care

TailorMade B Y K E L LY J A S P E R

They call it nurses’ intuition. After more than two decades in trauma, emergency, and disaster nursing, Dr. Elizabeth G. NeSmith has it. “I GREW UP professionally in our emergency department, seeing all kinds of patients. As a nurse, you’d get a good sense that someone wouldn’t do well, but you didn’t always know why,” said NeSmith, Director of the Georgia Regents University College of Nursing PhD Program and an Associate Professor in the Department of Physiological and Technological Nursing. “Why does one patient do better than another? I thought I’d really like to be able to answer that question.” That question has been the focus of her research since 2004, when NeSmith began to study how chronic stress affects trauma outcomes, analyzing how factors such as power, discrimination, and stress affect recovery following acute, life-threatening injury.

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GResearch Spring 2014

Discoveries in Progress

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NeSmith’s study, funded by a National Institutes of Health grant, found that on average during emergency room visits, the white blood cell count in African-Americans is 14 precent lower than in Caucasians.

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Her findings—including that minorities have a different physiological response to trauma, potentially impacting recovery time and complications—could help tailor emergency room treatments for vulnerable, at-risk patients. “The inflammatory response was different for these individuals,” NeSmith said. “Research always leads to more questions. The next question was, ‘Why?’” NeSmith first began tracking racial disparities in trauma for her PhD dissertation in 2004, reviewing the charts of more than 600 intensivecare patients age 18 to 44 at Georgia Regents Medical Center. “I found that African-American trauma patients had fewer occurrences of [systemic inflammatory response syndrome],” she said. SIRS, the release of inflammatory proteins in response to injury, is a common precursor to sepsis and organ failure, and is a useful tool for nurses that can be calculated at the bedside. “You want a normal amount of inflammatory response,” said NeSmith, who sought an explanation for the minorities’ diminished inflammatory response. “Could their life experience explain this difference in the systemic inflammatory response?” she mused. “The other thing that I found out was that their baseline measures of white blood cell count were lower upon admission to the emergency department than for a similar population of Caucasians.” A National Institutes of Health grant allowed her to continue the study, taking additional blood work and learning about the lives of GR Medical Center emergency room patients who agree to participate. The findings, including an average 14 percent lower white blood cell count in African Americans than Caucasians, mirror her initial findings. “I tell [the study participants’ family members] we’re really trying

to figure out what makes one person do better or worse than another person,” NeSmith said, noting that questions include information about age, race, ethnicity, smoking, income, education, and employment. “When I say we think it might have something to do with chronic stress, they go, ‘Oh, yes, he’s had a lot of chronic stress in his life.’” NeSmith explains to them the link between stress and the immune system. “When you’re stressed, you get a cold. That’s something my patients and their families can identify with. I say, ‘If you allow us to look at these things, we think it will really give us insight into how to tailor our treatment for individuals, because we didn’t know that much before,’” she said. “They begin to tell me about the stressors in their lives. They’re partners in the research.” Most of the patients—about 70 to 80 percent—were in vehicle crashes, but the study also includes people injured in falls, shootings, stabbings, and other trauma. “No matter the mechanism, the physiological response is the same, whether it’s a gun or a car that caused the injury,” NeSmith said. “Your body gears up for that flight or fight no matter what caused the injury.” In addition to determining white blood cell counts, NeSmith and her team also measure DHEAS and telomerase activity, a hormone and an enzyme correlated with chronic stress. “We measure the response for as long as they’re in the ICU, up to 14 days,” NeSmith said. “We’ve got those nice trends of their inflammatory response that we can compare to baseline measures.” The combination of blood work and lifestyle findings creates a uniquely comprehensive picture, NeSmith said, noting that typical research in the area “doesn’t look at it from a human, sociological

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perspective that could explain differences in health outcomes when it comes to trauma. No one was looking to see if individuals come in with an immune system that was different because of things they’ve gone through in their life. That’s really what I wanted to do.” Her background, clinical colleagues, and access to other inflammation research at GRU made this university “the perfect place” to answer that question. “A neat thing about being here is the interdisciplinary work we’re able to do. Being a Level 1 trauma center means we can do really unique trauma research here,” said NeSmith, who founded and chairs the Trauma Interdisciplinary Group for Research, or TIGR. NeSmith’s latest study was co-authored with a team from across the health system, including Trauma Program Manager Regina Medeiros; Chief of Trauma Dr. Colville Ferdinand; Surgical Critical Care Fellow Dr. Steve Holsten; Georgia Prevention Center molecular geneticists Drs. Yanbin Dong and Haidong Zhu; and Medical

College of Georgia student Jay Rakkar. In retrospect, it’s not surprising to find health disparities among trauma patients, said NeSmith, noting that health disparities exist in nearly all leading causes of death. Vulnerable populations, such as those marginalized by race, ethnicity, lifestyle, or socioeconomic status are particularly affected. Still, few studies address it, even though trauma is the No. 1 killer of adults ages 15 to 44. “It takes more years of potential life than both heart disease and cancer at a cost of $574.8 million to Americans,” said NeSmith, citing Centers for Disease Control and Prevention and National Safety Council statistics. “These are young, productive people losing many, many years of their lives.” As for the implications of her research, “it’s too early to show real significance, but the trend is similar to what I’ve found. I can’t wait to analyze the rest of the data to see if that holds up,” NeSmith said. “We’re moving forward to find out what

mechanisms explain these health disparities in trauma that we really didn’t know existed before. These things are concomitantly being discovered in heart disease, in cancer, in diabetes. Inflammation is being found as the root of a lot of these other things.” She plans additional research on potential solutions to health disparities for vulnerable trauma patients. “We know Vitamin D affects immunity. Can we have early interventions with these people who are more greatly affected?” she said. “That’s the whole point of figuring this out. We could tailor our approach to people based on their need.” Tailored medicine is a national research trend. “We don’t want to continue one-size-fits-all medicine,” NeSmith said. “Once complications of trauma start happening, it’s hard to back up from that. I want to end up with something that can help us tailor our treatment of trauma patients earlier. That could save lives.” n

“We don’t want to continue one-size-fits-all medicine. Once complications of trauma start happening, it’s hard to back up from that. I want to end up with something that can help us tailor our treatment of trauma patients earlier. That could save lives.” –DR. ELIZABETH G. NESMITH

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Study Aims to Help Children Uprooted by Military Moves

Over There BY CHRISTINE HURLEY DERISO

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Military families relocate

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three times more often than civilian families; on average, every two to three years.

ikia Erickson’s most vivid memory as a child in a military family was of a near-drowning. The incident took place in Germany, and the man who pulled her from the water in the nick of time spoke no English. Erickson, Leadership Development Coordinator at the Medical College of Georgia, spoke no German. “I just remember thanking him over and over again and feeling upset that he couldn’t understand me,” she recalls. The story is perhaps more dramatic than that of most military families, but the sense of isolation Erickson describes is far from an isolated event.

FREQUENT MOVES of children in military families require constant adaptation to new languages, new cultures, new accents, new schools, new friends, or all of the above, according to Dr. Laura Wheat, Assistant Professor of Counselor Education at Georgia Regents University. “Military children experience myriad tiny little losses every day just by being part of the military culture,” she says. “It’s important to see their challenges, recognize them, then step forward to help these kids.” Several GRU faculty members have rolled up their sleeves to do just that. DR. LAURA WHEAT

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First-Hand Experience WHEAT IS the Principal Investigator of a multidisciplinary GRU project documenting the struggles of children in military families, finding common denominators, and developing strategies to help them cope. She and three colleagues are studying existing data, conducting interviews, and otherwise picking the brains of military families and those who interact with them, particularly in school settings. Wheat’s focus is on emotional and psychosocial aspects of the frequent moves associated with military life. Drs. Kathy Hogan and Misato Yamaguchi, also in the GRU College of Education, are focusing on school challenges, including curricular, cultural, and special-needs variations from one school to the next. Dr. Craig Cooper, Assistant Professor of Kinesiology and Health Science, is tackling the extracurricular part of the equation, including the participation of military children in school sports and clubs.

When College of Education Dean Cindy Chance learned that Fort Gordon— a nearby U.S. Army installation—was conducting exit interviews of families transferring out, “she challenged us to take the opportunity to work with them, find out the families’ needs, and make an impact on the children involved,” Wheat says. “We’ve taken the ball and run with it.” Wheat relished the opportunity, not only as a researcher, but as a former Air Force child herself. “I have firsthand experience,” she says. “I moved seven times before I went to college. Particularly near the end, the moves were very difficult. Kids develop their own peer groups over the years, so it’s hard to break in.”

Leaving Friends Behind ERICKSON, who like Wheat was a naturally shy child, agrees that social isolation was her biggest challenge. “I mostly coped by writing in my journal and taking long walks,” she says. Both she and Wheat cite adolescence as the toughest time to move. “It was so hard leaving my friends when we moved from Maine to Greece when I was 14,” Erickson says.

Drs. CRAIG COOPER (CLOCKWISE FROM TOP), MISATO YAMAGUCHI, AND KATHY HOGAN

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“I’d just turned 13 when we moved from Germany to South Carolina,” Wheat says. “Everybody I met had lived there all their lives and had lifelong friends. I withdrew and concentrated on studies; I made really good grades.” But she yearned for friendships, “so once I found someone I had a connection with, I kind of imitated everything about her, even down to her accent. I coped by trying my hardest to fit in, to be like the people around me. But I recall feeling really lonely until my sophomore year of high school. It took me a full two years to really feel like I belonged.”

And whereas he’d coped with frequent moves in early childhood by being the class clown, by high school, “unfortunately, I became aggressive,” he recalls. “If someone even looked at me the wrong way, it escalated very quickly. I wanted to show them I was tough so they wouldn’t mess with me.” Says Hogan, “I’m particularly interested in behavior concerns identified by teachers, parents, and the students themselves— how these behaviors are being addressed, how many military children have been identified as special education due to behavior, and what types of support systems are being

implemented to deal with their behavior concerns.” Although Jones’ family was supportive, he remembers his mother was so overwhelmed as the sole caregiver of three children with a husband fighting in the Vietnam War that he was largely left to his own devices to deal with his struggles. “It was a different generation,” he says. “Parents weren’t as involved in their children’s lives when I was growing up. We were expected to man up and make the best of it. It was just the way we lived.”

‘We’ve Got to Do This All Over Again’ GRU SENIOR Photographer Phil Jones, whose father was in the Air Force, was in three different schools in 10th grade. “It destroyed me,” he says simply. “You somehow have to integrate into all the cliques, and then it would be time to say, ‘Oh my gosh, we’ve got to do this all over again.’”

“Moving and packing was probably the hardest part every time. There were always farewell parties and tears,” says Tracy Ciampaglio, whose two sons weathered a dozen-plus moves during husband Tim’s Coast Guard career. Even more challenging than the social and emotional ramifications, she notes, were the scholastic ones. “Sometimes my kids took classes over again, or studied a book they’d already read elsewhere,” she says. GResearch Spring 2014

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Struggling Academically ERICKSON recalls that she had to be home-schooled to avoid graduating late from high school because some of her credits didn’t transfer from one school system to another. “Academically,” says Jones, “the moves really hurt me. My grades absolutely suffered. I really struggled.” Wheat is particularly interested in this facet of the GRU study, recalling, “I ended up in a random study hall that was miserable because the curriculum from one school to the next was so vastly different. A major reason that this research is important to me is because I went through it personally.” Her colleague, Cooper, is also drawing on personal experience as he studies the struggles of military kids concerning extracurricular activities. “I played football growing up and know how important that part of life was to me,” he says.

Getting Benched RESEARCH data to date, he notes, indicate that military children at all skill levels struggle to participate in sports and clubs. “What if a kid is a high-level soccer player and moves to a place that doesn’t have a soccer program?” he posits. “Or what if a coach doesn’t want to deal with a new kid because he doesn’t want to disrupt the team’s chemistry, or because he doesn’t want to sit out a player who’s already been paying his dues for a number of years? “Higher-level kids with scholarship potential deserve a chance to succeed,” Cooper says. “And what about kids with lower-level skills who just like the outlet and social interaction and camaraderie of school sports? Sports can help kids integrate into new environments and feel less isolated, so we need to optimize their ability to participate.”

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School clubs can also feel offlimits to military kids, Cooper says, “particularly the more popularitybased clubs, which can be difficult to make inroads in.” Recalls Jones, “I never participated in extracurriculars in school. It was just another hoop I’d have to jump through. You knew everything was temporary, so you didn’t really commit that way. Extracurriculars were just extraneous.” Indeed, extracurricular activities were a major factor in Tracy Ciampaglio’s husband’s decision to retire from active duty once their sons, Ethan and Christian, were in high school. “Ethan had to have three years of journalism classes in order to be considered for the yearbook editor,” she says. “He was eventually chosen as Editor in Chief. Never would that have happened if we’d moved. And Christian worked through the tennis ranks and eventually ranked third on the varsity team. Compare that to the daughter of [my active-duty friend], who was not chosen for varsity even though she was clearly better than others, because it was known she was moving the following year. Why put effort into a kid who’s leaving, right?”

Exploring Volcanoes

Jennifer Buer, whose husband has been in the U.S. Marines for 24 years, has gone to considerable lengths to help her four children adjust from one move to another. “We’ve always used Catholic schools, and that helps with the transitions—same atmosphere, same culture,” she says. “Plus, the curricula are pretty close.” The most difficult adjustment, she says, was moving from a Marine base to a house on a large piece of land. “The kids felt really isolated,” she says.

IF THESE stories sound like Debbie Downer on steroids, the researchers stress that they are probing the bad and the good aspects of a military childhood in accentuating the positive while ameliorating the negative. And the good abounds. Even the families with heartbreaking stories of adjustment cite advantages of military life that would make the average civilian salivate. “We just got back from a treedecorating service on the base and watched the Blue Angels practicing. There are so many neat opportunities in this world,” says Jennifer Buer.

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“Plus, military kids are very comfortable around both children and adults; they get very good at making connections.” Jones concurs that he wouldn’t have changed many aspects of his childhood for the world. “I climbed on cliffs and explored volcanoes on an island in Portugal,” he says. “We saw the world and had great vacations. I would not have opted for a different life.”

‘We Felt So Safe’ AND ALTHOUGH he endured the hard knocks of peers, he adds that he felt extraordinarily safe in the military community. “I must have been 11 before I knew there was such a thing as assault against children. That was unheard of. I had no comprehension of people hurting children because we were so well-protected on bases. We all looked out for each other. It truly was like being raised by a village. We felt so safe.” Ciampaglio agrees. “The biggest thing that gets a military family through a remote duty

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station is the military family of friends and neighbors,” she says. “Everyone becomes your support system. Women get together with everyone else’s kids and help out in any way the can—dinners, girls’ nights out, taking other people’s kids for overnighters if the mom is sick— things like that. The kids feel that sense of family and don’t feel alone at all.” Wheat is excited to build on these assets, which she knows well from her own experience. “I grew up with a really great appreciation for diversity,” she says. “I lived all over the world and interacted with all kinds of people. I think for my family, military life is sort of a point of pride. Whereas before being different was a bad thing, now it’s a good thing. We got to have a privileged experience that many of our peers did not.”

Collective Wisdom AS SHE and her colleagues compile data from military families, they hope to incorporate the collective wisdom into an online training series or handbook for parents, educators, coaches, counselors, the military community, and others involved in the lives of military children. That wisdom, she’s finding, is extensive. For instance, Buer advises military parents to “pick the school first when you’re moving with children. Focus on the neighborhood and the school more than anything else. Plus, take advantage of social media to help kids stay connected with former friends.” Counsels Ciampaglio, “I highly recommend using the military’s

Office of Morale, Welfare, and Recreation. They will guide a spouse to the right office to find job assistance, or guide you with your vacation travel. They offer outdoor recreation, libraries, youth centers, golf courses, and more, depending on the duty station.”* Cooper notes that “information-sharing is important. We’re hoping our materials will facilitate that kind of support. We’re just trying to come up with some answers—suggestions and guidelines that could be used here and elsewhere to help families cope and adapt better to their moves.” The need, the researchers agree, is extensive. “While there is some literature that introduces support programs and practical implementation ideas,” Yamaguchi says, “there are relatively limited numbers of empirical studies based on students’ voices and insider perspective.” She and her colleagues are eager to contribute to research that fills that gap. Says Wheat, “I think we’re going to find a wide variation in coping mechanisms. So far, what we see is that military kids in some ways are just like other kids. The ones prone to acting out are going to act out, and the ones prone to withdraw will withdraw. If a non-deployed parent copes well, the kids tend to cope well, too. The parents play a big role in how their children adjust.” Ciampaglio couldn’t agree more. “You can look at your situation and complain about it,” she says, “or you can say, ‘Here we go again!’ and head out to another adventure.” n

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Research Outlines Successful Steps for Entrepreneurs

Passing

‘Go’ BY CHRISTINE HURLEY DERISO

AT FIRST GLANCE, DR. STEPHEN HSU’S PAST

might seem the antithesis of the ideal backdrop for successful entrepreneurship. HSU, PROFESSOR of Oral Biology in the Georgia Regents University College of Dental Medicine, was 11 in 1966 when his idyllic childhood in Beijing, China came to a brutal and abrupt end. His high-achieving family was among the tens of thousands targeted by Mao Zedong during China’s Cultural Revolution, a 10-year experiment in creating an egalitarian society by uplifting the poor and stripping the affluent of their wealth. Hsu was wrenched from his family to an isolated mountain, forced to farm the land and create food and lodging with the youths who shared his fate. The youths worked 18-hour days, building a dam, raising pigs, and growing rice, vegetables, and tea plants. Hsu recalls standing waist-deep in a rice paddy with sweat pouring from his brow and leeches digging into his flesh. Years passed, with every day steeped in the same misery as the day before.

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Digging Deep SO HOW IS IT possible that Hsu today is a world-renowned researcher and strikingly successful entrepreneur? Because despite the depredations of his childhood, a GRU marketing expert notes that Hsu possesses the innate qualities that paved his way to success. “Successful entrepreneurs are creative and innovative,” says Dr. Anthony Robinson, Assistant Professor of Marketing, whose extensive research has uncovered a treasure trove of secrets to startup business success. “They’re problem-solvers, often due to necessity or the desire to pursue opportunities.” Indeed, his assessment suggests that Hsu’s privations, as tragic as they were, might have actually accelerated his progress, forcing him to dig into the deepest reserves of his resilience, perseverance, and determination. Hsu was a young adult when the Cultural Revolution sputtered to its demise in 1976. He was penniless, but freed from forced labor on the farm. All he cared about was reuniting with his family and somehow cobbling together the education that had been denied him all those years.

‘I Wasn’t About to Blow It’

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HIS FAMILY used most of their resources to buy textbooks so he could study for the college entrance examination. But “despite my dedication,” he writes in his book, “Green Tea and Beyond”, “I’d lost so much ground over the years that the effort sometimes seemed futile. I knew nothing about math or science. Chemistry was as foreign as an unfamiliar language. But I remembered how to read and write. That was my springboard. If I could read, I could learn. And I had no higher priority. I’d never felt so driven in my life. My chance, miraculously, had materialized, and I wasn’t about to blow it.”

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“People who are passionate perceive their work differently. They’re willing to do more and put forth more effort.” –DR. ANTHONY ROBINSON (LEFT)

With nothing to lose, and with nowhere to go but up, Robinson notes that Hsu was primed to take the leaps of faith necessary to build something from nothing. “Entrepreneurs are comfortable with risk and ambiguity,” says Robinson, who recently published a paper in Digital Knowledge at Babson establishing a strong relationship between how potential entrepreneurs perceive risks and their decisions to start new ventures. “They perceive risk differently. For instance, imagine we’re

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standing on a cliff and have to jump four feet. If I jump four feet all the time, I don’t perceive that as a risk.” Hsu’s youth was so replete with challenges—with four-foot jumps, as it were—that he was undaunted by the risks of an uncertain future. And his hardships had honed another essential element: passion. “Passion matters,” Robinson says. “People who are passionate perceive their work differently. They’re willing to do more and put forth more effort. Also, it’s much easier to enlist the help of people who own important resources like talent, money, and facilities when that passion runs deep.” It would be hard to overstate Hsu’s passion or the amount of effort he was willing to

Pass G

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expend. After earning a degree in biochemistry from Wuhan University, he moved to the United States, studying English as a second language and earning a master’s degree from Montclair State University in New Jersey while working two jobs to support himself. By the time he enrolled in the University of Cincinnati School of Medicine in 1985, his academic record was rewarded with a scholarship. He earned a PhD in cell biology in 1991.

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Team Spirit ONCE HSU had completed his education, more attributes crucial to entrepreneurial success kicked in. For instance, Robinson notes that collaboration is critical. “Entrepreneurship really is an entrepreneurial team,” he says. “You have to collaborate. That’s when the chance of success goes up exponentially.” Hsu, whose innate people skills were enhanced as his empathy grew rather than diminished amid his suffering, agrees. “Collaboration is absolutely the most important factor to succeed,” he says simply. “It’s important not only to collaborate with others, but to think about others in order to create a winwin situation for everyone.” Says Robinson, who helped develop an MBA/MD option at GRU, “Doctors, for instance, are very proficient in medicine but may not have good business skills. They may not realize the necessity of spending $3 in marketing for every dollar they spend in technical costs when launching a startup. Having a great idea is necessary but not sufficient; you need people around you who can compensate for the areas in which you lack expertise. Teamwork also provides emotional support. Most businesses fail. It’s much easier to emotionally survive the downs if people are around you who understand.” Another vital component of success? Opportunity. “The key for the entrepreneur is in correctly identifying an opportunity based on creatively solving a problem,” says Robinson, whose research shows that perceiving an opportunity increases the chances of launching a startup.

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Full Circle FOR INSTANCE, Hsu was deprived of an education while farming on a cold mountain in China, but he learned a lot about the crops he grew, particularly tea plants. He turned that chance expertise into opportunity, devoting his career to studying the healing properties of green tea. He started a business, Camellix, LLC, to bring green tea technology-derived products to the marketplace. The company was among the first businesses hatched by GRU’s Life Sciences Business Development Center, which provides support services and a physical space to grow and mature fledgling biomedical companies. “Today,” Hsu writes in his book, “my life has come full circle. Instead of growing tea plants in a labor camp, I’m working in a laboratory studying their amazing healing properties. The symbolism isn’t lost on me: In the midst of my despair on that wretched mountain, I was surrounded by a wellspring of hope and vitality, growth, and abundance. I was immersed in the plant that I would come to find more fascinating than any other on earth.” Hsu also proved to be an incredibly quick study—for instance, adapting readily to a new culture when he moved to the United States. “Culture is crucial. For instance, the East is more community-oriented, the West more individualistic, which lends itself to entrepreneurship,” says Robinson, whose recent study shows that entrepreneurship occurs differently in different regions of the world based on cultural differences. “Not only are risks and opportunities

perceived differently based on culture, but how people act on that perception may be different regarding a startup.”

Capitalizing on Capitalism HSU ALSO capitalized on—well, capitalism. Says Robinson, “Centrally governed countries have more entrepreneurs than other countries, and their entrepreneurialism tends to be more opportunity-based than necessity-based. They have more resources, more infrastructure, and more policies in place to encourage entrepreneurialism. It’s called environmental munificence—resources within an environment to support your business. It can really make a big difference in startup activity.” GEORGIA REGENTS UNIVERSITY


Calculated Risks For more information about Camellix LLC, whose products target conditions including dry mouth, dandruff, thinning hair, and cold sores, visit camellix.com. For more information about the GRU Life Sciences Business Development Center, visit gru.edu/oic/.

But even within an industrialized, centrally governed country, differences and opportunities can vary from one region to another. For instance, “in Atlanta, you’ll find a much more resource-rich environment than in, say, Savannah, even though Savannah is doing very well,” Robinson says. “You need human resources—people—as well as technical expertise, business expertise, and money. You get the money through angel investors or venture capital groups. Some communities don’t have those resources. Having them makes it easier.” Hsu notes that areas such as North Carolina’s Research Triangle and California’s Silicon Valley have far outpaced other areas of the country, but that Augusta is nipping at their heels. “The key is to create a resource-rich environment by locating the resource and being willing to put extra effort to build a startup,” he says. Robinson concurs, adding, “There are things Augusta can do really, really well, and potentially better if we have a more focused, strategic view. Clearly, medicine is an area where we can be extremely competitive. Other areas include energy and cybersecurity, capitalizing on resources such as the Savannah River Site and [U.S. Army installation] Fort Gordon. Imagine combining those strengths. That’s when things get really interesting. The area should focus its efforts without trying to be all things to all people, but it should leverage its assets. Think of Honda: The company started out making great motors, then turned that skill into making great cars, all-terrain vehicles, motorcycles, lawn mowers . . . they turned that strategic advantage into something that could be leveraged in multiple ways.”

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SUCH SYNERGY, he insists, will not only bring great minds to Augusta, but will retain the great minds that are already here. “Our brightest minds want to stay here,” he says. “They just need a reason to stay. Coalescing our efforts around our strongest strategic assets provides a competitive advantage with existing resources. Perhaps equally important is that medicine, energy, and cybersecurity are of significant interest to our nation, creating opportunities for our community.” Robinson adds that cultural influences rear their heads in different parts of the country as well. “Failing in Silicon Valley is very different than failing in Augusta,” he says. “Failing here is not tolerated as much, isn’t considered the norm. But in Silicon Valley, failing is a rite of passage. Most potential entrepreneurs do not pursue their innovative ideas based on a fear of trying and subsequently failing. My research suggests that entrepreneurs fear not being innovative more than they fear the risk of failure.” Hsu considers himself a prime example of that thesis, but notes that his risk-taking spirit is tempered with circumspection. “I agree with taking risks, but they must be calculated risks,” he says. “It is always good to be well-prepared and have a plan B before any major advance.” So if Hsu is exhibit A of how to start a business, the next obvious question is how to replicate his success. Is entrepreneurialism teachable? “You can absolutely learn these concepts,” Robinson says. “But applying and executing them is very different. We can all learn how to play soccer, but some people are just better than others. Yes, you can learn the what, but being effective in the implementation is different. The how is very different.” Robinson devotes his career not only to researching entrepreneurialism to ensure a constant flow of new information into the arena, but of teaching those concepts in the classroom. “I teach an entrepreneurism class to MBA students and have successful business people from the community come share ideas,” he says. One of my students said it was the best MBA class he’d ever taken.” Robinson just wishes he could bottle the passion of entrepreneurs like Hsu. Says Hsu, “If you love what you are doing and believe it will help many others, that becomes part of your life rather than a job.” n

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Historian Draws on Past to Create Stirring Narrative

Ripple Effect BY CHRISTINE HURLEY DERISO

I

T IS THE RIPPLE EFFECT THAT MOST INEXORABLY pulls Dr. Perzavia Praylow back to the past. Praylow, whose research of leadership in traditionally black colleges and universities keeps presenting intriguing new detours and byways, is fascinated by the effects of 150-year-old decisions on the present.

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“I WANT MY students to critically challenge the American narrative they’ve been taught,” says Praylow, Assistant Professor of History. “I see lightbulb moments when they realize history isn’t just for history’s sake—that we can use the past to get perspective about the future.” And perspective, she notes, can change everything. For instance, the two most arguably influential players

in African-American education in the United States—Booker T. Washington and W.E.B. Dubois—had vastly different perspectives. Washington, a former slave from the South, felt strongly about cultivating good will among majority-whites when he founded Tuskegee Normal and Industrial Institute (now Tuskegee University) in 1881. He wanted to teach former GEORGIA REGENTS UNIVERSITY


“We’ve lived almost as long as a nation as an enslaved people than as a free one. It’s vital that we know our history and celebrate our successes.” –DR. PERZAVIA PRAYLOW (LEFT)

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slaves useful and marketable trades, assuming that such modest goals would not only ensure economic stability for their families but be palatable enough to whites to enhance their chances of success, which they could build on from one generation to the next. DuBois—born in 1868 and raised in a relatively tolerant and integrated Massachusetts community—had higher aspirations for his fellow AfricanAmericans. A graduate of Fisk University—a historically black institution in Nashville that Praylow studied in depth for her dissertation—counseled cultivating the “talented tenth”—people he considered intellectuals who could establish African-American footholds in society’s most prestigious professions. DuBois, a founder of the National Association for the Advancement of Colored People, argued that Washington’s incremental approach to equality inadvertently laid the groundwork for the Supreme Court’s 1896 Plessy vs. Ferguson “separate but equal” ruling that unleashed decades of Jim Crow-era oppression.

The Bridge to Independence YET DESPITE their differences, Washington and DuBois agreed that “education was the bridge from slavery to independence,” Praylow says. And even the institutions that espoused DuBois’ position were generally led and financed by whites. His alma mater, Fisk, for example, didn’t seat its first AfricanAmerican President—Dr. Charles Spurgeon Johnson—until 1946. Decades would pass before most historically black colleges and universities followed suit, including Augusta’s own Paine College, which seated its first African-American President, Dr. Lucius H. Pitts, in 1971.

“A certain level of paternalism characterized the era,” Praylow says. “You can’t divorce the history of these colleges from the Jim Crow realities, and by the 1920s, African-Americans were protesting the ways their schools were structured. They argued that black colleges needed to become black.” The ensuing rebellions eventually culminated in the Civil Rights Movement. “The black students in some ways had become radicalized [by espousing changes in higher education], and they pushed their administrators to become engaged in the Civil Rights Movement,” Praylow says.

To help ensure that her students appreciate the treasure trove at their fingertips, Praylow spent several weeks last summer mentoring three of them in GRU’s Center for Undergraduate Research. Each completed a research project on the history of African-American life in Augusta. 34

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“You can’t divorce the history of these colleges from the Jim Crow realities, and by the 1920s, AfricanAmericans were protesting the ways their schools were structured. They argued that black colleges needed to become black.”–DR. PERZAVIA PRAYLOW Treasure Trove PRAYLOW, who spent the month of July as a National Endowment for the Humanities Fellow at the Harvard University DuBois Institute, has uncovered numerous related threads in the course of her research. For instance, Praylow, who recently moved from New Jersey to Augusta, has found a wellspring of cultural

In 1889, Wells-Barnett, a former Fisk student, founded Free Speech and Headlight, an anti-segregationist newspaper based in Memphis.

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data in her new hometown. She has pored through the archives of local churches, schools, museums, newspapers, and administrative documents to glean insight into African-American history. “I have been inspired by the rich diversity of institutions in the South regarding the AfricanAmerican experience,” she says. African-American churches, for instance, have played a pivotal role in the support and advancement of its parishioners through the years and often have veritable goldmines of data. For instance, Augusta’s Springfield Baptist Church dates back to 1801 and houses a museum to preserve both its own history and that of the surrounding community. Likewise, history virtually oozes through the pores of Augusta’s 128-year-old Tabernacle Baptist Church (pictured on page 32), from its base as the city’s Civil Rights Movement to its stunning Italian Renaissanceinspired architecture. And Praylow didn’t even have to leave campus to uncover one of her most exciting finds: the Summerville Campus’s collection of the now-defunct Pilgrim Health and Life Insurance Company, founded in 1898 in Augusta as Georgia’s first insurance provider for African-Americans.

Conveying a Narrative THE STUDENTS’ experiences not only enriched their knowledge bases, but added to the growing repository of information Praylow is amassing. The students in Praylow’s college courses are contributing as well. For instance, Alyssa Lloyd, a history major in Praylow’s fall 2013 research seminar, “The Black Freedom Movement Since Reconstruction,” uncovered a thread extending from Memphis to rural Georgia. “Walton County (north of Atlanta) had a huge Klan population during Reconstruction,” Lloyd says, referencing the infamous white supremacist movement, the Ku Klux Klan. The ensuing lynchings of AfricanAmericans attracted nationwide attention, including that of Ida B. Wells-Barnett. Lloyd learned that WellsBarnett—herself a former Fisk student who in 1889 founded Free Speech and Headlight, an anti-segregationist newspaper based in Memphis—meticulously publicized lynchings throughout the South. The publicity not only gave African-Americans a sounding board for the travesty, but heightened the country’s awareness of the issue and laid the groundwork for reform.

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‘She Wasn’t Afraid’

Transformational Impact

“EVEN AFTER slavery,” Lloyd says, “AfricanAmericans would be moving through these counties and just come up missing. The police were often involved, so there was no help. [Wells-Barnett] was a woman and wasn’t afraid to speak out and say this was wrong. She wasn’t afraid, even though it was so dangerous to be black in the wrong place at that time.” The research experience, Lloyd says, immeasurably broadened her understanding of her forebears. Her enlightenment has continued as a student this year in Praylow’s Black Freedom Movement class. “The class analyzes the pivotal players in the black freedom movement and who inspired them. It’s like creating a web of key people in the black history movement that I didn’t even know existed until I took the class,” says Lloyd. “Dr. Praylow’s passion for African-American history and history in general really comes out when she’s teaching. She takes it all the way from reconstruction to contemporary issues, which I love. A lot of times, history classes get stuck in their subject matter, but Dr. Praylow makes us think about the subject matter in today’s world, which I really enjoy.” Zack Hollis, a participant in Praylow’s Center for Undergraduate Research project, concurs. “She’s a very, very unique professor. There was more thought discussion in her class than any other course I’ve taken.”

PRAYLOW is gratified her students have relished the experience, both as learners in the classroom and as creators of new knowledge in the research setting. “I consider my classroom a ‘moment’ to convey a narrative and a sense of diversity that my students, most of whom aren’t history majors, will carry with them throughout their educations, whatever field they’re pursuing, and throughout their lives,” she says. “I’m excited about the opportunity to expand perspectives in the classroom.” Praylow insists that she has learned as much as she has taught, if not more, and is thrilled to have entered GRU on the ground floor. “I’ve become a better historian since I’ve been here, and a better scholar. It’s one thing to know about the Emancipation Proclamation, for instance, but another to be in an environment where its meaning—more than 150 years after its passage—that citizenship and equality are two sides of the same coin continues to inform how we co-exist as a society.” She hopes to oversee an oral history project and make ongoing contributions to GRU’s commitment to diversity. Teaching in a university both teeming with potential as a nascent institution while steeped in decades of tradition creates a once-in-a-lifetime opportunity for the entire GRU community, she says, noting, “I’m very interested in the transformational impact faculty can have on students.” n

African-American Milestones The year 2013 marked not one, but two milestones in the history of the nation’s African-American experience: the 150th anniversary of President Abraham Lincoln’s signing of the Emancipation Proclamation and the 50th anniversary of Dr. Martin Luther King Jr.’s Civil Rights March on Washington. “We’ve lived almost as long as a nation as an enslaved people than as a free one,” Dr. Perzavia Praylow notes. “It’s vital that we know our history and celebrate our successes.”

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Study Enlists Church Members to Spread Word of Cancer Prevention

Foot Soldiers BY CHRISTINE HURLEY DERISO

I

t’s one o’clock on a sunny Thursday afternoon,

They exchange genial chitchat while eating their and a couple dozen parishioners of Mt. Enon lunch, then get down to business. Dr. Selina Smith, Baptist Church in Evans, Ga., file into the Director of the GRU Institute of church. Public and Preventive Health and Curtis G. Hames Professor, They greet each other with hugs and asks the attendees to stand up and give themselves a hug. help themselves to a lunch buffet. The pastor, John W. Smiling bashfully, they stand Harmon, offers warm handshakes and buoyant smiles. up and crisscross their arms around their waists. As they complete the exercise, Smith tells them, “We don’t talk about your weight; DR. SELINA SMITH CHATS WITH MT. ENON PARISHIONERS we talk about your waist,” noting that their impromptu hug is a good indication of abdominal weight. Those whose hands can’t reach their sides have excess weight around the abdomen, a chief risk factor for a host of health problems, including colorectal cancer.

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37


Smith wants them to know not only for their own sakes, but for the sakes of the people they will soon be counseling. These parishioners are the latest foot soldiers in a nationwide battle to fight colorectal cancer, which kills approximately 50,000 Americans a year—a disproportionate amount of whom are African-Americans. When Smith joined the faculty last year, she brought to GRU her participation in a $2.5 million National Cancer Institute community-based participatory research study helping determine whether outreach increases colonoscopy in the African-American community. The project enlists the help of the National Black Leadership Initiative on Cancer, a volunteer organization that helps educate communities about cancer and provides information on prevention and early diagnosis to improve survival rates. The project, called the Education Program to Increase Colorectal Cancer Screening, has formed 17

community-based coalitions nationwide, enlisting volunteers chiefly through African-American churches to spread the word of cancer awareness to friends, acquaintances, and family members. The goal is to increase colorectal screenings nationwide, using volunteers to spread the word to approximately 7,200 AfricanAmericans. About 1,300 have been reached thus far. The study is gauging whether the outreach is effective in prompting people to get screened. When Smith came to GRU from Morehouse School of Medicine last year, she brought her grant with her and jumped at the chance to establish coalition number 18 in the Augusta area. “This is my new home,” she says. “I’m concerned about my community. I’ve been involved in this initiative since the early 1990s, and I’m really excited to establish this new coalition in the area. One of the strongest partners you can have is a church, and historically, AfricanAmerican churches are involved in every aspect of the community. If you’re trying to reach the community, this is where you start.” When Smith and Program Director Joyce Sheets approached the Rev. Harmon about enlisting volunteers in his church, they found the most enthusiastic of partners. “Mt. Enon is known as Holy Ghost Headquarters,” Harmon says with his characteristic broad smile. “We would rather grow in faith and fellowship than members.” Throughout its 144-year history, the church has served not only its members’ spiritual needs, but its educational, vocational, and health needs as well. Its extensive outreach programs

Americans are advised to have their first colonoscopy—the primary diagnostic tool for colorectal cancer—at age 50, but only about 60 percent comply. That number drops below 50 percent in the AfricanAmerican community. 38

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“Our church is known not by its seating capacity, but by its sending capacity—how many people we can send out to serve others. It’s hard to talk to people about the word of God when they’re hurting, so if they’re hurting in any way—including physically—we try to meet their needs.” –PASTOR JOHN W. HARMON

serve not only its approximately 125 parishioners, but any other community members who might benefit. “Our church is known not by its seating capacity, but by its sending capacity—how many people we can send out to serve others,” Harmon says. “It’s hard to talk to people about word of God when they’re hurting, so if they’re hurting in any way—including physically—we try to meet their needs.” Sheets was well aware of Harmon’s commitment to the community and recommended him as a resource when Smith, who is also a minister, brought her grant to GRU. “I’ve always been involved in health,” Harmon says. “We want to empower the community both spiritually and in other ways, including keeping them as healthy as possible. We’re not a big church in numbers, but we take care of our people.” He of course is on hand as Smith and Sheets host a luncheon for potential volunteers—people Harmon helped recruit during a recent sermon. As Smith greets the group, she encourages them to help people push past their squeamishness regarding colonoscopies. “When I grew up,” she tells them, “people didn’t talk about cancer. We’re much more comGResearch Spring 2014

fortable talking about it now because we’re surviving it now. And the way we survive is by finding it early. Knowledge is power.” When one volunteer tells her that people will balk at the preparation process (drinking a substance that clears the bowel), she encourages him to remind people that they also do other things they aren’t particularly thrilled about—such as paying taxes—to avoid consequences that they’ll really hate. Colonoscopy, including the prep, she stresses, is a breeze compared to late-stage cancer treatment. Besides, she says, colonoscopy often performs double duty by ridding the colon of polyps that, left untreated, could set the stage for cancer. Smith also stresses the importance of the fecal occult blood test and flexible sigmoidoscopy as screening tools. The volunteers are also urged to spread the word of healthy lifestyles in general. They should counsel eating healthy diets with lots of fiber; incorporating exercise into one’s daily routines, such as parking farther than normal from the grocery store; and drinking lots of water. “You should also know your history—both your personal health history and your family health history,” Smith says,

noting that risk factors for colorectal cancer include family histories, age, and obesity. “If you have a hard time hugging yourself,” she tells the volunteers, “I’m talking to you.” The good news, she says, is that healthy lifestyles reduce the risk not only of colorectal cancer, but of scores of other conditions, including hypertension, heart disease, and diabetes. The volunteers giggle through one more piece of information they’re asked to share with community members: paying attention to their bowel movements, which should be firm and regular. The volunteers who choose to sign on will return for three hour-long Education Program to Increase Colorectal Cancer Screening education sessions. “We’re asking you to plant a seed,” Smith tells them. “Screening saves lives.” Once the volunteers begin spreading the word, the researchers will disseminate surveys and other tools to determine whether their advice increases the rate of colonoscopy, in which case the program can be expanded and perhaps applied to other health matters. “We’re trying to see if the education works,” Smith says. “If people act on what they’ve learned, it’s working.” n

39


ADVANCEMENT Update BY SUSAN BARCUS Senior Vice President for Advancement

THE COMMUNITY FOUNDATION for the CSRA recently announced a $6 million commitment from the Masters Tournament to support our Cancer Center, a huge step forward in our efforts to build the state’s second National Cancer Institute-designated cancer center right here in Augusta. The funds from the Masters Tournament will also help us establish a children’s camp in collaboration with the Family Y of Augusta for children with cancer, diabetes, joint disorders, heart conditions, and other debilitating diseases and conditions. A gift of this size from a partner that enjoys international recognition says much about the importance of the work underway at the university. Billy Payne, Chairman of the Augusta National Golf Club and Masters Tournament, said he and his colleagues see the “cancer facility and children’s camp as a way to help transform lives and serve the entire city, state, and region for many years to come.” We couldn’t agree more.   I cannot overstate the importance of the role of private philanthropy – and the role of partnerships – in creating a robust future for our organization. We have been working with our colleagues at the Community Foundation and the Augusta National on this gift for some time. This is a great example of collaborating with our partners to accomplish a blended goal. It also speaks to the fundraising truth that big ideas attract big gifts.   Consider this donation and other transformative gifts we have recently received: n $8 million from the Robert W. Woodruff Foundation to fund the Simulation Center in the Education Commons n $10 million from the late Dr. Harold Harrison and his wife, Sue, to name the Education Commons n $66 million from the Harrison estate to fund scholarships and endowed chairs in the Medical College of Georgia Clearly, the university and our many internal partners are worthy of significant support. We’re doing a good job telling our story, enhancing understanding among our alumni, donors, and friends of how their commitment to their community and their state can be satisfied by investing in GRU . . . in our colleges, our faculty and students, our health system, our physical infrastructure.   We are immeasurably grateful to our friends at The Community Foundation for the CSRA and the Augusta National. n 40

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CADMIUM CANTADA by Michael Fowler GRU Cancer Center Healing Art Fowler, an advertising design graduate of Harding University in Searcy, Ark., holds a Master of Fine Arts degree in painting and drawing from the University of Nebraska and a Doctorate of Education from the University of Memphis. His work has been exhibited across the Southeast and is housed in many corporate collections. He holds the Mary Durban Toole Chair of Art and teaches design and computer graphics as Associate Professor at the University of South Carolina–Aiken.

GResearch Spring 2014


Office of the Senior Vice President for Research CJ3317 1120 15th Street Augusta, Georgia 30912

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Innovation is In

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Hundreds of thought leaders gathered in Augusta Sept. 17-18 for GRU’s Innovation Summit 2013, a free conference offering strategies, trends, and practical advice to propel an organization to the next level of success. The 2014 summit, “Building the Innovation Ecosystem,” will be held Oct. 7 at Augusta’s Kroc Center. For more information, contact: Chris McKinney, Office of Innovation Commercialization Christopher.McKinney@gru.edu 706-721-4062.

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