College of Medicine Magazine | Spring 2021

New Patient Tower Opens [ Fa l l / Wi n t e r 2020 ]

OU MEDICINE

As we enter 2021, it continues to be an unprecedented time for the OU College of Medicine during the COVID-19 pandemic. However, these past several months have also featured great strides and accomplishments. This issue of the magazine offers an in-depth look at our activities.

COVID-19 has, of course, changed the way we educate our students and care for our patients. After pausing their in-person clinical clerkships for a period of time in the spring, our medical students returned to their rotations by summer. Many of our faculty members, particularly in the Department of Pathology, undertook the herculean effort of deploying several tests for COVID-19. They also created a new test, in collaboration with colleagues at the Oklahoma Medical Research Foundation, that avoids many of the supply chain issues that have plagued other laboratories. This magazine also features stories about some of our research efforts surrounding COVID-19, as well as a program to train nursing home personnel to keep their residents safe and engaged during the pandemic. That effort utilizes our extensive network of relationships with healthcare providers across rural Oklahoma.

Our healthcare enterprise as a whole has made major strides over the past several months. The OU College of Medicine, like all colleges within the OU Health Sciences Center, is working closer than ever with our hospital partner, OU Medicine, Inc. In the fall, our enterprise announced the new brand identity OU Health, which represents the combined efforts of OU Medicine, Inc., and the OU Health Sciences Center. The identity came after months of analysis and extensive feedback from Oklahomans across the state, whose needs encompass medicine and many other healthcare services.

Dean’s Message

In the fall, we opened the new patient tower at the OU Health University of Oklahoma Medical Center. The North Tower, as it is called, is connected to the existing hospital on the southeast corner of 13th Street and Lincoln. It features 144 additional beds, 32 operating rooms, and was also designed with our educational mission in mind, featuring simulation rooms and additional meeting space for our students and residents.

In this issue of the magazine, we’ll also tell you about many other successes – the first patient at Oklahoma Children’s Hospital OU Health to be treated with CAR-T, an immune therapy that is changing the way we treat blood cancers; our faculty members’ participation in an international clinical trial that led to a new drug for metastatic prostate cancer; and a record-breaking year for research grants, both for the college as a whole and for several individual departments.

This is a unique time in our history to be in academic medicine. The COVID-19 pandemic has been challenging, and often fatiguing, for our dedicated healthcare providers as they use all the tools at their disposal to help patients who are fighting for their lives.

Our students and residents face unforeseen hurdles to training and preparing for their future. But everyone who is part of the OU College of Medicine, indeed our entire academic healthcare system, has risen to the occasion day after day. I am proud to serve with them as we work toward improving the health and well-being of all Oklahomans.

John P. Zubialde, M.D. Executive Dean, OU College of Medicine

contents MEDICINE

University of Oklahoma College of Medicine

TABLE OF CONTENTS 7. Mike Samis Passes Away The OU Health community mourns the passing of civic leader and philanthropist

Senior Vice President and Provost, OU Health Sciences Center Jason Sanders, M.D., MBA

Mike Samis.

Executive Dean, College of Medicine John Zubialde, M.D.

the OU College of Medicine is planning to create a mobile health education

Executive Editor Jon Brightbill Associate Dean for Executive Affairs Assistant Vice President of Development, OU Health Sciences Center Stacey Maxon Editor/Feature Writer April Wilkerson Medicine is published twice a year by the OU College of Medicine. For more information or to submit news for the Class Notes section, contact: April Wilkerson, Editor april.wilkerson@oumedicine.com

9. Mobile Classroom Planned With a grant from the U.S. Health Resources and Services Administration, classroom inside a large, customized recreational vehicle.

14. COVID-19 Testing Faculty members in the Department of Pathology led a team that quickly deployed several tests for COVID-19 as the virus began spreading across Oklahoma.

16. Addressing Problematic Sexual Behavior OU College of Medicine faculty members are national leaders in the treatment and research of problematic sexual behavior in youth. A new federal grant is allowing them to work with the U.S. Department of Defense on the issue.

24. NAFLD in Children Harold Hamm Diabetes Center researchers are studying the role of the microbiome in the onset of non-alcoholic fatty liver disease in children.

27. New Prostate Cancer Drug Stephenson Cancer Center took part in an international clinical trial that proved the effectiveness of an oral medication for prostate cancer, the first treatment advance for that disease in many years.

32. Food as Medicine

Medicine is online at www.oumedicine.com/magazine

The OU Health Sciences Center received a federal grant to test a food as

The University of Oklahoma, in compliance with all applicable federal and state laws and regulations does not discriminate on the basis of race, color, national origin, sex, sexual orientation, genetic information, gender identity, gender expression, age, religion, disability, political beliefs or status as a veteran in any of its policies, practices or procedures. This includes, but is not limited to: admissions, employment, financial aid and educational services.

34. Preserving Limbs

Inquiries regarding non-discrimination policies may be directed to: Bobby J. Mason, University Equal Opportunity Officer and Title IX Coordinator, 405-325-3546, BJM@ou.edu, or visit ou.edu/eoo.html.

the event in 2022.

Copies of this magazine were printed at no cost to the taxpayers of the State of Oklahoma. © 2020 University of Oklahoma

COVER PHOTO:

The new North Tower of the University of Oklahoma Medical Center has opened, providing 144 additional beds and 32 new operating rooms, as well as a design that incorporates educational needs.

medicine intervention for people living with HIV and AIDS.

An OU Health vascular surgery team and podiatrist in Tulsa have launched efforts to reduce the number of major amputations due to complications from diabetes and peripheral artery disease.

36. Evening of Excellence Because of COVID-19, the Evening of Excellence gala was not held in January 2021. However, the OU College of Medicine Alumni Association hopes to hold

37. Alumni News OU College of Medicine alumni did not gather for their reunion in 2020 because of the COVID-19 pandemic. However, activities are tentatively scheduled for fall 2021.

The OU College of Medicine Alumni Association is on Facebook.

Like us at www.facebook.com/oucomalumni

VITAL SIG NS

OU Medicine and OU Health Sciences Center Announce New, Unified Brand Oklahoma’s comprehensive academic health system is now known as OU Health. The new brand identity represents the combined efforts of OU Medicine and the University of Oklahoma Health Sciences Center and reflects a focus and commitment to improving the health of all Oklahomans.

The brand identity OU Health comes after months of gathering extensive feedback and insight from existing patients and Oklahomans across the state, whose needs encompass medicine and many other healthcare services that lead to good health.

“This unified brand identity for our state’s only flagship comprehensive academic health system is emblematic of the University of Oklahoma’s core purpose — to change lives,” said OU President Joseph Harroz Jr. “It’s here at OU Health – an idea decades in the making – where we bring life-changing, unparalleled care to all Oklahomans.

Today marks a major milestone in our ongoing work to transform healthcare in Oklahoma through education, research and clinical care.”

OU Health will continue expanding the full breadth of services across the enterprise statewide, from primary care to specialty care. Hospital names, clinic names, centers and faculty practices within OU Health Sciences Center and OU Medicine will now be a part of the OU Health brand family.

4

The transition of the brand will take place over many months, and it will simplify the public’s ability to interact with the academic health system and find necessary healthcare services.

“Our combined effort under the brand of OU Health speaks to our momentum as a comprehensive academic healthcare enterprise,” said Chuck Spicer, FACHE, President and CEO of OU Medicine, Inc. “Our patients come to us because of the future they want for themselves and their families. Our mission is to provide the healthcare that gives them that fullness of life.”

The new brand of OU Health is accompanied by a newly designed, patient-centric website – www.OUHealth.com – to carry the enterprise into a future of innovative healthcare delivery. The website is designed for easy access, usability and quick navigation. OU Health’s doctors, health services, and clinic and hospital locations are available on the site along with healthcare news and information.

With the master brand of OU Health, a new logo symbolizes the broad range of services that are important for health.

Patients can expect the same high-quality care under the brand refresh: Oklahoma Children’s Hospital OU Health is the new name for the state’s only freestanding children’s hospital and 24/7

[ Fa l l / Wi n t e r 2 0 2 0 ]

VITAL SIG NS

pediatric emergency department. The name was designed after extensive research of freestanding children’s hospitals nationally, along with contributions from Oklahomans and patients’ families.

OU Health Stephenson Cancer Center, the state’s only National Cancer Institute-Designed Cancer Center, and the OU Health Harold Hamm Diabetes Center, will retain their legacy names derived from generous philanthropic support.

The adult hospital will officially be known as OU Health University of Oklahoma Medical Center to reflect its status as the flagship academic medical center for Oklahoma, and a Top 100 hospital nationally. OU Health Edmond Medical Center is the name of the Edmond hospital to reflect its over 70-year commitment to the Edmond community.

The faculty practices of the OU Health Sciences Center will reflect the depth of healthcare expertise and services, including OU Health Dentistry, OU Health Pharmacy and OU Health Physicians in both Oklahoma City and Tulsa.

The brand identity of OU Health signifies a closer partnership with the OU Health Sciences Center – one of only three academic health centers in the nation with seven health profession colleges – and its campuses in Oklahoma City and Tulsa. The OU Health Sciences Center is training Oklahoma’s future health professionals –3,200 students and 850 residents across the Colleges of Medicine, Nursing, Pharmacy, Allied Health, Dentistry, Public Health and the research disciplines of the Graduate College. Colleges will maintain their University of Oklahoma Health Sciences Center academic brands with a co-branding tie-in to signify their collaboration with OU Health.

“We are extremely proud to unify our brand to be reflective of who we are,” said Jason Sanders, M.D., MBA, Senior Vice President and Provost of OU Health Sciences Center. “Our faculty members are national leaders and comprise the largest group of health specialists in Oklahoma, and our researchers work closely with them to bring their discoveries to the patient’s bedside and to the community. Students and residents are training within the vision and values of our enterprise – providing expertise, advanced technology and compassionate care to ensure each patient is the focus of every decision we make.”

OU Health strives to offer high-value, accessible care, and invests in strategies to serve people across the state and region. OU Health is not just about treating patients’ illnesses and injuries, but it is a commitment to achieving the health that allows them to live their best lives.

“We spent time asking Oklahomans about healthcare and about their understanding of us,” said Jennifer Schultz, Senior Vice President of Marketing and Communications. “We quickly learned that we needed to streamline our brand and simplify the ways in which you can find information about us. At OU Health, we believe that healthcare is about the needs of our patients and how our interactions with them can lead to the health and well-being they seek. The OU Health brand and website are reflective of who we are and who we serve and is aimed at providing the entry point to fulfill the healthcare needs of Oklahomans.”

Faculty, staff and students kneel during the White Coats for Black Lives event this summer.

Campuses Join White Coats for Black Lives Movement On June 5, the unforgiving heat of an Oklahoma summer day did not deter nearly 450 people from the OU Health Sciences Center, OU Medicine and OU-Tulsa from gathering in solidarity with the national White Coats for Black Lives effort, which supports the Black Lives Matter movement and rejects racism in all its forms.

Each campus hosted its own event and heard from several speakers before kneeling for eight minutes and 46 seconds, the amount of time a Minneapolis police offer pressed his knee on George Floyd’s neck until he died.

“As healers and teachers and educators, we have an obligation to address social inequalities,” said Robert Salinas, M.D., Assistant Dean for Diversity, Inclusion and Community Engagement at the OU College of Medicine.

“We cannot remain silent. We must speak for those who have no voice and rise for those who cannot stand.”

Medical student Ariana Baker said, “Let this not be the last time that you think about these injustices and the racism that’s still plaguing our country.”

As members of an academic healthcare system, providers, staff and students were reminded of their responsibility to speak out against healthcare inequalities.

“We are the physicians who are operating on people who are hurt,” said medical student Garret Eaker. “We are the social workers repairing broken families. We are the counselors who are healing the minds of the children who grew up without a father. We’re the people here trying to make this better.

So this is in our wheelhouse, this is within our grasp. We can make changes, we can push for changes, and we can keep fighting the good fight.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

5

VITAL SIG NS

Morris Gessouroun, M.D., chair of the Department of Pediatrics for the OU College of Medicine, speaks virtually during a Schwartz Rounds presentation.

Oklahoma Children’s Hospital Launches Schwartz Rounds for Provider Well-Being Oklahoma Children’s Hospital OU Health is the first facility in the Oklahoma City area to incorporate Schwartz Rounds, a program to support staff members who may deal with stressful and emotional situations throughout their workday.

Schwartz Rounds are a multidisciplinary forum where caregivers discuss difficult emotional and social issues that arise in caring for patients. The program’s mission is to promote compassionate healthcare and strengthen the relationship between patients and caregivers.

“The healthcare environment offers both unique challenges and privileges for caregivers,” said Deborah Browning, chief nursing officer at Oklahoma Children’s Hospital. “Schwartz Rounds is a comprehensive system of caregiver support that preserves and protects the human connection in healthcare.”

Care team members from all areas of the hospital are invited to participate, including nurses, dietitians, physicians, housekeepers, chaplains and others. Each session features a different health topic that care team members encounter through their work in a pediatric environment. Thus far, topics have included Coping with COVID-19, Being Black in Healthcare, and Dealing with Difficult Families.

6

A panel of presenters shares perspectives and experiences, and participants are encouraged to engage with the panel and share their own experiences. The purpose is for staff to talk about how they feel, rather than something that specifically happened, and to do so in a safe, comfortable environment where they can learn from and support each other.

Schwartz Rounds were created by the Schwartz Center for Compassionate Healthcare based at Massachusetts General Hospital in Boston. The center was named after Ken Schwartz, a healthcare attorney who died of lung cancer in 1995 at the age of 40. During his illness, he wrote an article for Boston Globe Magazine describing a group of caregivers who attended to his medical and emotional needs, “making the unbearable bearable.”

The Association of American Medical Colleges conducted a survey of Schwartz Rounds participants and found that 87% of respondents reported the rounds led to new ideas and strategies for challenging patient situations and increased their compassion.

[ Fa l l / Wi n t e r 2 0 2 0 ]

VITAL SIG NS

by Hospital Corporation of America (HCA) in the former OU Medical System.

“Mike was a remarkable figure and leader in our state.

His life, lost too soon, leaves a legacy that will benefit generations of Oklahomans,” said University of Oklahoma President Joseph Harroz Jr. “Thanks in large part to his leadership and wisdom, the future of healthcare in our state is a bright one. His twenty-seven years of volunteer leadership profoundly impacted the University of Oklahoma Health Sciences Center and the many lives it improves. I’m thankful for his life of service, his friendship, and to have had the opportunity to work alongside him.”

Built in 2012, Samis Family Education Center, adjacent to Oklahoma Children’s Hospital OU Health, was named to acknowledge the numerous and significant contributions of its namesake throughout a career dedicated to advancing initiatives that improve quality in healthcare and in medical education.

Mike Samis signs the beam during the topping-out ceremony for the North Tower of OU Health University of Oklahoma Medical Center.

OU Health Community Mourns Passing of Civic Leader and Philanthropist Mike Samis After a lengthy illness, Mike Samis, 67, entrepreneur, civic leader and philanthropist, passed away Oct 22. He is survived by his wife, Karen, their two daughters and five grandchildren.

Gov. Kevin Stitt said, “The State of Oklahoma has lost a great advocate and public servant in Mike Samis. The successes he knew in business are a testament to his keen knowledge of the corporate world, his ability to collaborate and to rally diverse interests for a shared purpose. Mike Samis lived his life to make Oklahoma a better place to live, work, dream and achieve. His absence will be felt deeply across our state.”

Samis, a native Oklahoman, was chairman of the board of OU Medicine, Inc., a 501(c)3 Oklahoma non-profit corporation formed in 2017. He was instrumental in negotiation efforts that ultimately resulted in the acquisition of interests held

“The Samis Center holds a place of prominence at the heart of the OU Health Center, not only as a structural presence, but for the vital educational functions it serves. That it bears the Samis name is fitting, then and now,” said G. Rainey Williams Jr., chair, University Hospitals Authority and Trust. He spoke of his personal esteem for Samis, his predecessor and former trust board member. “Mike was driven to see Oklahomans live better lives through improved access to excellent healthcare.

His dedication to that goal was evident in his focused interest in healthcare administration, public health policy and healthcare delivery. It is impossible to overstate all the ways in which his influence continues to elevate improved quality of life for Oklahomans throughout the state.”

Samis earned a bachelor’s degree in finance from the University of Oklahoma, Norman, and completed a master’s degree in business administration from Southern Methodist University, Dallas. As the initial chair of the University Hospitals Authority and Trust, appointed by Gov. David Walters in 1993, Samis led the negotiating team that structured the 1993 agreement with HCA to jointly operate the state’s academic medical center in Oklahoma City and the HCA facility then known as Presbyterian Hospital. Under that historic OU Medical Systems (OUMS) agreement, medical education remained intact on the Oklahoma City campus, and capacity to provide care to the underserved was preserved and expanded. Further, the agreement helped ensure that ongoing research programs conducted through the OU College of Medicine were sustained. In 2000, Samis was elected chair of OUMS, serving continuously until OU Medicine, Inc. became operational on February 1, 2018.

Samis was vice president of Hiawatha Oil Company, a large independent oil and gas exploration and production company in Oklahoma City. He later became president, CEO and chairman of the board of Macklanburg-Duncan Company (M-D), and CEO and chairman of the board of its successor company, M-D Building Products, Inc. Under his leadership, M-D became one of the 25 largest suppliers to the hardware and home center industry with sales exceeding $250,000,000.

[ Fa l l / Wi n t e r 2 0 2 0 ]

7

VITAL SIG NS

Among many business and civic leadership roles, Samis served as a director of BancFirst, a publicly traded commercial bank, was a member of the board of the Dean McGee Eye Institute, and chaired the University of Oklahoma Foundation.

Samis received the 2002 Alumni Achievement Award from Casady School and was honored in 2010 as the recipient of the school’s Distinguished Graduate Award. The University of Oklahoma presented Samis with its Regents’ Alumni Award in 2007 and an honorary doctorate in 2010.

Isaac Rutel, Ph.D., Department of Radiological Sciences, Oklahoma City campus, faculty membership R. Michael Siatkowski, M.D., Department of Ophthalmology, Oklahoma City campus, faculty membership

Several faculty members also were honored with Dewayne Andrews Excellence in Teaching awards in the areas of preclinical, clinical, graduate medical education and physician assistant education.

“Mike was a more than a highly regarded and valued colleague. He was also a trusted friend and mentor whose insights and leadership had profound impact,” said Chuck Spicer, FACHE, President and CEO of OU Medicine, Inc. “The void created by his death is immeasurable. He was a man who challenged us to be better and helped us find the best within ourselves.”

Preclinical Awards:

Jason Sanders, M.D., MBA, Senior Vice President and Provost of OU Health Sciences Center and Vice Chair of OU Medicine, Inc. Board of Directors, said, “Mike Samis had tremendous resolve to lead OU Medicine through milestone after milestone. Due to Mike’s years of tireless effort, in 2018 OU Medicine became a locally owned and operated health system. Mike’s vision centered on the patient, and he fought to expand OU Health’s essential clinical programs for all Oklahomans. He likewise championed medical education for tomorrow’s caregivers. Among his many legacies is a lifetime of reaching new heights for healthcare in Oklahoma, and challenging each of us to do the same.”

•

•

•

•

Academy of Teaching Scholars Inducts New Members, Honors Faculty Medical educators were celebrated during the Academy of Teaching Scholars Education Week this fall at the OU College of Medicine.

The ATS was created in 2012 by former Executive Dean M. Dewayne Andrews, M.D., as a means to foster, recognize, celebrate and encourage excellence in teaching and scholarly pursuits.

This year’s inductees into ATS are:

•

•

•

8

•

•

Catherine Heith, M.D., Department of Pediatrics, Oklahoma City campus, associate membership Edgar LeClaire, M.D., Department of Obstetrics and Gynecology, Oklahoma City campus, associate membership Catherine Hunter, M.D., Department of Surgery, Oklahoma City campus, faculty membership

•

•

Mohiuddin Ahmad, Ph.D., Department of Cell Biology, Oklahoma City campus Kent Teague, Ph.D., Integrative Immunology Center, Tulsa campus

Clinical Awards: Afia Sadiq, M.D., Department of Psychiatry and Behavioral Sciences, Oklahoma City campus Bryan Billings, M.D., Department of Family and Preventive Medicine, Oklahoma City campus Blake Lesselroth, M.D., Department of Medical Informatics, Tulsa campus Shashank Shettar, M.D., Department of Anesthesiology, Oklahoma City campus

Graduate Medical Education Awards:

•

•

•

•

•

Kristina Booth, M.D., Department of Surgery, Oklahoma City campus Brian Lich, M.D., Department of Internal Medicine, Oklahoma City campus James O’Brien, M.D., Department of Ophthalmology, Oklahoma City campus Amy E. Lee, M.D., Department of Pediatrics, Oklahoma City campus Gwendolyn Neel, M.D., Department of Obstetrics and Gynecology, Oklahoma City campus

PA Faculty Awards:

• Mark Perdue, MHS, PA-C, Tulsa campus • Jennifer Boyett, MHS, PA-C, Oklahoma City campus

Several grants for health education research were also presented. Recipients are:

•

•

•

•

•

•

•

Zain Ul Abideen Asad, M.D., Department of Internal Medicine, Oklahoma City campus Sarah Beth Bell, Ph.D., Research Development, Tulsa campus Monica Henning, M.D., Department of Obstetrics and Gynecology, Tulsa campus Monique Naifeh, M.D., MPH, Department of Pediatrics, Oklahoma City campus Erin Hawks, Ph.D., HSP, Department of Psychiatry and Behavioral Sciences, Oklahoma City campus Kristina Booth, M.D., Department of Surgery, Oklahoma City campus Catherine Heith, M.D., Department of Pediatrics, Oklahoma City campus

[ Fa l l / Wi n t e r 2 0 2 0 ]

MEDICAL EDUCATION

With a new federal grant, the College of Medicine is expanding its efforts to promote diversity on campus.

OU College of Medicine Plans Mobile Classroom to Promote Diversity in Health Professions A large recreational vehicle, customized as a health education classroom on wheels, is among new projects the University of Oklahoma College of Medicine plans with a $2.8 million grant from the U.S. Health Resources and Services Administration.

The grant is a one-year supplement that augments an initial $4.7 million award to the OU College of Medicine in 2019.

The aim of the grant is to recruit, retain and admit students from rural, tribal and medically underserved areas, and to expand the primary care experience among current medical students. Data shows that students from those groups who attend medical school and residency in Oklahoma are more likely to return to their communities to practice medicine.

“Of Oklahoma’s 77 counties, 76 have a shortage of primary care physicians, and the need is particularly great in rural areas, underserved communities and tribes. The ultimate goal of this grant is to reduce healthcare disparities among Oklahomans and raise the health of the state,” said Steven

Crawford, M.D., Senior Associate Dean of the College of Medicine and director of the Office of Healthcare Innovation and Policy. Crawford is leading the grant with James Herman, M.D., Dean of the OU-TU School of Community Medicine on the Tulsa campus.

The mobile classroom will allow the OU College of Medicine to introduce young people across Oklahoma to careers in health and to give them hands-on experience with activities like suturing, using a stethoscope or a microscope.

The classroom will be geared especially toward smaller communities with fewer resources. Students from those areas may have the interest and skills to enter a health profession, but lack opportunities to pursue it, said Robert Salinas, M.D., Assistant Dean for Diversity in the College of Medicine and a faculty lead for the grant.

“This mobile classroom will be a major asset in our outreach and in building long-term relationships with young people,”

[ Fa l l / Wi n t e r 2 0 2 0 ]

9

MEDICAL EDUCATION

Salinas said. “This is not a one-year event, but is part of our efforts to build a pathway to medical school in which we mentor them over several years.”

Current students from all seven colleges at the OU Health Sciences Center, as well as the Anne and Henry Zarrow School of Social Work on OU’s Norman campus, will accompany the mobile classroom on trips around the state as part of their training to care for patients as an interprofessional team. They will not only introduce their chosen disciplines to the young people they encounter, but also see first-hand the challenges of life in underserved areas, where there are numerous barriers to good health.

The grant supplement also will allow the OU College of Medicine to launch the Medical School Readiness Program, an opportunity for students to be mentored as they prepare for the Medical College Admission Test, take part in mock interviews and job shadowing. This program is geared toward highly motivated students who traditionally have lacked resources, because of time or money, to prepare for medical school.

The OU-TU School of Community Medicine, the college’s branch campus in Tulsa, is expanding several parts of its curriculum designed to help students better understand the importance of primary care. A course on medical informatics will give students a deeper dive into telemedicine and using the electronic health record to analyze trends among patient populations. Two other courses, Lifestyle Medicine and Health Promotion I and II, have already been added to the curriculum to further educate students about the roles of food and exercise in promoting better health for their patients.

This year, students will spend more time on culinary medicine, learning from a chef how to make healthy foods appropriate for specific medical conditions, like diabetes. They will then teach those skills during visits to high schools in the Tulsa area.

“Our medical students will teach culinary medicine concepts and healthy food options to high school students,” said Frances Wen, Ph.D., Professor of Family and Community Medicine on the Tulsa campus and a primary faculty participant on the grant. “They will also talk about what it’s like to be in medical school. It has a powerful impact on high school students, who are not too much younger than they are, to see someone like them who is becoming a physician.”

The College of Medicine’s outreach and recruitment efforts are already starting to pay off, Salinas said. Several students who have been mentored over the past year are entering medical school or are preparing to apply.

“These efforts are relationship-centered, and to be successful, we need to work with students over a long period of time to help them overcome barriers to attending medical school or another health profession college,” Salinas said.

“Studies show that health outcomes improve with a more diverse workforce,” he added. “A person’s ZIP code should not determine their health status, and we hope this initiative can begin to improve the health and quality of life of Oklahomans.”

10

Medical student Amy Parker calls patients to inform them of changes being made in response to the COVID-19 pandemic.

Medical Education Adapts to Pandemic When the COVID-19 pandemic came to Oklahoma, it caused immediate changes in how future doctors learn.

Administrators and students felt anxiety at first, but they learned to adapt – and some of the changes may be here to stay.

In late March, following national guidance, the OU College of Medicine removed undergraduate medical students from clinical settings to conserve PPE and limit exposure to the novel coronavirus.

Associate Dean for Student Affairs Mark Fergeson, M.D., said some students disagreed with the disruption.

“Some were upset by changes, because they wanted to be on the front lines helping people. They were very concerned about patients,” he said. “But they also didn’t want to catch the virus or put others at risk.”

Yashna Naidu, who was a third-year medical student when the crisis struck, said she felt uncertain when her rotations were disrupted and lectures went virtual.

“It was quite a big change,” she said. “I usually wake up excited to go to the hospital and to experience a sense of community. Despite the major shift in our daily activities, everyone helped make it as normal as possible.”

Administrators adjusted the traditional schedule so learning could continue online, then returned to an in-person model for clinical experiences as soon as it was safe to do so, Fergeson said.

“For two months, our students focused on at-home work and lectures. But by late May, students returned to clinical education,” he said. “About one-third of students lost their two-week summer break, but everyone was back on schedule to prepare for the start of the academic year in July.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

MEDICAL EDUCATION

“The education is now really very similar to how it’s always been,” he said. “The main difference is undergraduate medical students do not see patients who are COVID-positive or patients under investigation. Otherwise, we are back on track with PPE and social distancing measures in place, and some lectures being given online.”

In fact, Fergeson said some aspects of the undergraduate medical experience may have improved, such as how the Human Structures course is taught.

When other schools were shifting to an all-simulation model, the OU College of Medicine instead decreased group size from four students to two and implemented social distancing precautions. One student would read while the other examined a body. Each student gained more hands-on time.

“Our primary goal from the beginning was to keep students and patients safe. Our secondary goal was to recognize it was not an option to let education quality drop,” Fergeson said. “It took hundreds of hours of planning by the COVID-19 Medical Education Response team, and I’m confident we did a good job getting students the experiences they needed.”

The situation was similar for graduate medical residents and fellows.

Associate Dean for Graduate Medical Education Elisa Crouse, M.D., said the challenges were different because of the requirements to complete clinical experiences during a certain period of time. The timeline became especially tight because of isolations and changes in care brought on by the crisis.

As with undergraduate medical students, the college found educational activities to help fulfill requirements, such as readings and research. No trainee was required to extend their training, though the college was prepared to do so.

Crouse said one negative change was eliminating travel to medical conferences. But a handful of organizations moved their conferences online, and virtual tools were used for didactics and other activities.

This actually created new learning opportunities. Some national subspecialities rolled out free virtual didactics.

Crouse said this may provide a new model for the future: standardized programs across the country.

However, virtual meetings can never entirely replace face-toface meetings, especially when it comes to recruiting students into graduate medical education programs.

“Virtual recruitment is a tough environment that is new to medicine. At OU, it’s especially difficult to overcome perceptions about the city and the school without being able to bring people in,” she said. “But it’s probably good for us to learn, and virtual recruitment helps cut down on costs of travel and meals.”

Away rotations also evolved for medical students. Naidu completed an away rotation in pediatrics at Northwestern University without ever leaving Oklahoma City. Despite not being there in person, she got a strong sense of the program, including its dedication to talking about societal issues such as implicit bias.

Patrick Browne was one of several medical students who helped contact patients with upcoming appointments to let them know of changes due to COVID-19.

The biggest losses, Crouse said, are related to the emotional side of medicine.

“Residency is a hard thing, and it helps when people have the opportunity to sit down together and share both good and bad experiences. In these times, residents just can’t get together and, without that, a portion of their support system is gone,” she said. “Humans are social, and connectedness is important.

Physicians are taught to touch, but now some residents are hesitant about exams and rethinking even shaking hands with patients. It’s difficult.”

Fergeson saw a similar problem for undergraduate medical students, who must learn to take patient histories and physicals. To limit social contact, OU had to go back to how training was done in the past — students practice on each other, rather than on simulated patients.

Medical students also use a large, state-of-the-art simulation lab that allows them to practice a wide variety of procedures.

Still, some appreciate the old ways.

“Our time back in the hospital has been refreshing,” Naidu said.

[ Fa l l / Wi n t e r 2 0 2 0 ]

11

PATIENT CARE

The new North Tower of the University of Oklahoma Medical Center opened in late 2020.

University of Oklahoma Medical Center Opens North Tower to Patients The new patient tower at OU Health University of Oklahoma Medical Center has opened its doors, providing patients with the most advanced treatments and technology in a space designed for healing and comfort.

The eight-story North Tower, which provides 144 additional beds and 32 new operating rooms, is the largest hospital expansion project in Oklahoma history and one of the largest in the nation. The new facility reflects the ongoing transformation of Oklahoma’s flagship comprehensive academic health system and its mission to provide services that Oklahomans need to achieve health.

“The opening of the North Tower is an exciting milestone for OU Health and for all of Oklahoma,” said Kris Gose, R.N., President of the University of Oklahoma Medical Center.

“This new tower will optimize our ability to provide care at all levels, from trauma services to every type of surgical and medical expertise, in an environment that supports patients and their families.”

The tower is connected to the existing hospital on its north

12

side, on the southeast corner of 13th Street and Lincoln.

Groundbreaking was in 2017, and its opening is the culmination of a vision that began more than 10 years ago, said Chuck Spicer, FACHE, President and CEO of OU Medicine, Inc. Its completion also follows the announcement of OU Health as the new, unified brand identity to represent the combined efforts of OU Medicine and the University of Oklahoma Health Sciences Center.

“Oklahomans can be proud of this facility because this is not just another hospital expansion, but an advancement in the way healthcare is delivered,” Spicer said. “Healthcare is a team effort that begins with our patients, surrounded by an interdisciplinary team of providers working together to deliver the best care.”

The tower brings 450,000 additional square feet and a new medical Intensive Care Unit. Another floor is dedicated to hematology-oncology, bone marrow transplant and stem cell therapy, where OU Health Stephenson Cancer Center patients will receive treatments offered nowhere else in the state, including CAR-T, an immune therapy that harnesses

[ Fa l l / Wi n t e r 2 0 2 0 ]

PATIENT CARE

the body’s own immune cells to recognize and eliminate cancer cells.

As home to Oklahoma’s only Level 1 Trauma Center, the University of Oklahoma Medical Center provides in-house expertise to treat the most traumatic and complex injuries.

The North Tower increases the capacity and technology to care for those with the most severe injuries.

“The advantage of building a new hospital facility is that it is designed for the modern practice of healthcare,” said orthopedic and trauma surgeon David Teague, M.D., OU Physicians Director of Adult Services, Perioperative Surgical Director at University of Oklahoma Medical Center and chair of the Department of Orthopedic Surgery and Rehabilitation at the OU College of Medicine. “The operating rooms were created for today’s surgical teams and to accommodate the most advanced technology. We care for more patients with complex conditions than anyone else in the state, and this new facility will play a major role in attracting national leading specialists to practice at OU Health.”

More noticeable to patients are the oversized rooms with extra space for families. All patient rooms have floor-to-ceiling windows that let in natural light, and because all rooms are on an outside wall, patients and families will have views of downtown Oklahoma City, the State Capitol and the OU Health Center campus. Nature was introduced in various ways, including natural elements in the design, a healing garden on the fourth floor and a courtyard garden on the first floor. The design of the North Tower, created by architecture firm Perkins & Will, is inspired by the Gloss Mountains northwest of Oklahoma City, a series of mesas and buttes where gypsum sparkles on the slopes.

“Hospitalization is a significant life event for most patients, and their support network of family and friends is key to their healing,” Gose said. “The new tower offers spacious rooms and amenities that maximize comfort, communication and rest. Because nature is a vital part of the human condition, the natural elements in the design, as well as the large windows, connect patients to the outdoors.”

The large patient rooms are also key because today’s patient care is increasingly delivered by interdisciplinary teams. In addition to doctors and nurses, patients may see other healthcare providers from the specialties of pharmacy, physical therapy, nutritional sciences or social work.

OU Health combines the resources and efforts of OU Health Sciences Center and OU Medicine to train the next generation of health professionals and researchers in Oklahoma City and Tulsa. The design of the North Tower incorporates the educational mission of the health system, with additional meeting space for students and residents, as well as simulation rooms where trainees can practice procedures using advanced technology.

“The new tower enables us not only to deliver exceptional care to more Oklahomans, but also to train the students and residents who will be the healthcare leaders of tomorrow,” said Jason Sanders, M.D., MBA, Senior Vice President and

Oversized rooms with floor-to-ceiling windows are featured in the new North Tower.

Provost of the OU Health Sciences Center. “The patient care at OU Health is distinguished by the research that takes place across our academic health system, and through the clinical trials that provide patients with the most advanced treatments and diagnostics in Oklahoma.”

The opening of the North Tower at University of Oklahoma Medical Center comes nearly three years after OU Medicine, Inc. became a locally owned, nonprofit academic healthcare system, paving the way for additional collaboration, partnership and innovation with OU Health Sciences Center.

As OU Health continues to grow, it will also drive economic growth in Oklahoma, Spicer said, with the hiring of additional healthcare providers and support staff.

“We have seen tremendous growth across our campus -achievements that have been possible because of our collaboration between the University Hospitals Authority and Trust, OU Health Sciences Center and OU Medicine.

We are fortunate to have physician leaders, administrators, nurses and the entire team ready to carry the vision of OU Health into the future,” Spicer said. “Everyone has stepped up to meet the challenges posed this year by the COVID-19 pandemic, including the acceleration of two floors of the tower to care for patients fighting the virus. Even during this difficult year, the opening of the North Tower serves as an inspiration for all of us and a symbol of our commitment to the people of Oklahoma.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

13

PATIENT CARE

All Hands on Deck to Meet Testing Demand for COVID-19 As COVID-19 began spreading across the United States, clinical laboratory personnel accelerated efforts to help diagnose the disease. The OU Medicine Laboratory met the challenge by quickly deploying several tests for the virus.

Patient specimens at OU Medicine are placed on one of six different platforms depending on how rapidly results are needed, said Cindy McCloskey, M.D., director of Clinical Microbiology and Virology Laboratories and associate professor in the Department of Pathology. Patients in the emergency department, for example, need to be tested promptly if they are going to be admitted to the hospital. All patients having surgeries or outpatient procedures must be tested as well. The OU Medicine Laboratory also provides COVID-19 testing for the community from samples gathered at “swab pods” in Oklahoma City and Tulsa.

Having several testing options allows the OU Medicine Laboratory to operate 24/7 and process more than 1,000 specimens each day, with results typically available in less than 24 hours and as little as two hours for the most critical patients. Quick turnaround is important for a variety of reasons: so that a person can immediately quarantine if the test is positive; be admitted to a COVID-only section of the hospital; or return to work after recovering from the virus, among others.

Being able to conduct 1,000 or more COVID-19 tests daily, along with regular hospital testing for other illnesses, is an achievement. To put it in perspective, the OU Medicine Laboratory previously conducted 650 respiratory virus tests per week during a busy flu season, McCloskey said.

“I’m proud that we’ve been able to ramp up testing to meet demand, turn around test results quickly, and not have a backlog,” she said.

The laboratory also created a new test that avoids many of the supply chain issues that have plagued other laboratories.

Through an innovative partnership, OU Medicine, its academic partner, the University of Oklahoma Health Sciences Center, and a neighboring institution, the Oklahoma Medical Research Foundation, created the Oklahoma COVID-19 polymerase chain reaction (PCR) test, a new approach to analyzing specimens.

“The spirit to combat COVID-19 has been very high,” said Michael Talbert, M.D., Chief of Pathology Services for OU Medicine and chair of the Department of Pathology.

“Because of our collaboration, we developed a new test in about two months that otherwise would have taken a year.

Everyone contributed their expertise, while also making other COVID tests operational and continuing our routine care for patients in OU Medicine hospitals and clinics.”

The idea to create a new test for COVID-19 originated

14

Michael Talbert, M.D., left, and Gregory Blakey, M.D., visit in the OU Medicine Laboratory.

with Joel Guthridge, Ph.D., a researcher at the Oklahoma Medical Research Foundation and adjunct faculty member in the Department of Pathology. Guthridge and his team contributed their experience with the company Fluidigm, which specializes in microfluidics, or the use of a tiny amount of chemicals to test patient samples. Because different chemicals are used in the Fluidigm testing instrument, and because such a small amount is necessary, the OU Medicine Laboratory doesn’t have to compete for chemical supplies with this particular test, Talbert said.

The Oklahoma COVID-19 PCR assay can analyze 186 patient specimens at once, and, using microfluidics, each test is performed five times to ensure accuracy. Because the process is highly complex, the equipment was retrofitted with robotics, which saves time and avoids human injuries due to repetitive motions.

The traditional season of colds, influenza and respiratory syncytial virus (RSV) has arrived, which may further increase demand for lab testing. The OU Medicine Laboratory is preparing even more options, including testing for COVID-19, flu and RSV from the same patient specimen instead of three different samples, said Gregory Blakey, M.D., Vice Chief of Pathology Services and Associate Professor in the Department of Pathology.

OU Medicine is also pursuing a test for COVID-19 using saliva, instead of the nasal swabs that have been used to date, Blakey said. Developed at the Yale School of Public Health, the test provides even faster results.

“This simple test, called SalivaDirect, will increase our capacity so we can help detect more cases and drive the infection rate down,” he said.

[ Fa l l / Wi n t e r 2 0 2 0 ]

PATIENT CARE

First Oklahoma Children’s Hospital Patient Treated With CAR-T Therapy Receives New Hope in Battle Against Leukemia This spring, five years after his diagnosis with acute lymphoblastic leukemia, Ryan VanZandt experienced his second relapse, the type of bad news that typically would mean his treatment options had run their course. However, the return of his cancer coincided with the arrival of a new immune therapy at Oklahoma Children’s Hospital OU Health, which is giving new hope to VanZandt and patients like him.

This year, VanZandt became the first patient at Oklahoma Children’s Hospital to receive CAR-T, a new treatment for blood cancers in which a patient’s own immune cells are genetically modified to recognize and attack cancer cells.

Since receiving CAR-T, VanZandt has been in remission and able to spend Thanksgiving and Christmas at home with his family after being hospitalized during the holidays several times over the past five years.

“This revolutionary new treatment successfully eliminated VanZandt’s leukemia, and it did so by attacking only the cancer cells, not the normal cells in his body,” said Rikin K. Shah, M.D., interim director of pediatric transplantation and cellular therapy at the Jimmy Everest Center at Oklahoma Children’s Hospital. “This treatment is changing the landscape of pediatric cancer treatment because it is giving an opportunity for survival for those patients who had run out of treatment options.”

CAR-T stands for chimeric antigen receptor T-cell therapy.

Patients being treated with CAR-T first have their blood collected in a process similar to a typical blood donation.

White blood cells (which include T cells) are filtered out and sent to a company that inserts the gene for a chimeric antigen receptor into the T cells, which binds to cancer cells and activates the T cells. This process allows the newly engineered T cells to recognize and attack cancer with remarkable efficiency. Once the CAR-T cells are generated, they are shipped back to the hospital and given to the patient through an IV, much like a blood transfusion.

VanZandt’s long journey with acute lymphoblastic leukemia, or ALL, began in August 2015. A typical teenager and a high school athlete in Duncan, VanZandt was running on a freshly mowed track during cross-country practice when he became exhausted and couldn’t finish his lap. In the days ahead, he became increasingly tired and sleepy and quit hanging out with his friends. He even lost interest in playing games on his Xbox, one of his favorite things to do.

Ryan VanZandt of Durant is pictured at Oklahoma Children’s Hospital, where he became the first patient to receive CAR-T therapy to treat his leukemia.

After his diagnosis with ALL, VanZandt received chemotherapy at Oklahoma Children’s Hospital for nearly three-and-a-half years, a standard length of treatment to ensure the cancer doesn’t return. VanZandt faced complications during that time, including serious bouts with pancreatitis, but at the end of his chemotherapy, in January 2019, he was declared cancer-free.

“I was feeling pretty good,” VanZandt said. “I rang the bell at the hospital,” a tradition for patients who are free of cancer.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

15

PATIENT CARE

But the good news was short-lived. Four months later, in May 2019, VanZandt’s leukemia returned in his spinal fluid.

He started back on chemotherapy, and again the cancer cells were eliminated. He stayed on a chemotherapy regimen, but a year later, he had a second relapse, this time in his bone marrow and his spinal fluid. That’s when his doctors decided he was a candidate for the new option of CAR-T. “The success rate of treating acute lymphoblastic leukemia with chemotherapy in young people is usually very high.

The problem is that when patients have a recurrence, the outcomes are dismal,” Shah said. “That’s why CAR-T is so important – because it allows us to help patients whose cancer would otherwise be deemed incurable. And Ryan was able to have CAR-T therapy in Oklahoma instead of going out of state, which would bring an additional burden of travel and finding housing for a month.”

Although CAR-T therapy has cleared his body of cancerous cells, VanZandt’s treatment for ALL is not quite over. Next year, he will have a bone marrow transplant from his sister Savannah, who is a perfect match for the donation of a brand-new immune system. However, the transplant would not be possible without VanZandt first receiving CAR-T. “Patients are not eligible for bone marrow transplants when they still have leukemia cells, and because Ryan had relapsed, he still had cancerous cells,” Shah said. “CAR-T therapy allowed us to put his leukemia into remission so that he will be able to have the transplant.”

As CAR-T continues to be studied, it will likely help patients at several different stages of their treatment, Shah said.

For some patients, it will serve as the final treatment and the CAR-T cells will stay vigilant in the body in an effort to eliminate any new cancerous cells. It also may move up earlier in the treatment process, or be used to treat patients whose bone marrow transplants fail.

“This type of immune therapy is going to change the way we treat cancer in the next five years because we are harnessing the patient’s own immune cells to fight cancer,” Shah said.

VanZandt’s mother, Bylynn VanZandt, read online about CAR-T before it was approved for use in the United States.

Like any mother, she was nervous about her son receiving a new treatment, she said, but the timing was a godsend.

“We were down to some of the last options, so we decided to do it,” she said. “It was clear that it would make the transplant possible for him.”

VanZandt’s five years with leukemia have not been easy, his mother said, but their faith, family, friends and church family have supported them in numerous ways. VanZandt graduated from Durant High School and has taken classes at Southeastern Oklahoma State University as his health has allowed; he is majoring in business and envisions a career in banking.

“It’s definitely been a long journey,” VanZandt said. “All my friends and family have kept my spirits up. I do my best to look on the brighter side of things. This has given me a new perspective on life, especially to value the people who have cared for and supported me.”

16

Jane Silovsky, Ph.D.

OU College of Medicine Partners With U.S. Department of Defense to Address Problematic Sexual Behavior in Youth When young people act out sexually in ways that are harmful to others or themselves, the stigma surrounding the issue can be paralyzing for everyone affected. However, data shows that treatment for problematic sexual behavior in youth is highly effective. Faculty members at the University of Oklahoma Health Sciences Center are among the nation’s leaders on this topic, and they recently received a federal grant to assist the U.S. Department of Defense in addressing problematic sexual behavior of youth in the military.

The National Center on the Sexual Behavior of Youth (NCSBY) is housed within the OU College of Medicine, Department of Pediatrics. Its personnel have been trailblazers in the research and treatment of problematic sexual behavior of youth, and in training parents, caregivers, healthcare providers and others around the world to prevent and respond to incidents.

NCSBY’s new work is funded by the Office of Juvenile Justice and Delinquency Prevention, a component of the U.S. Department of Justice. NCSBY is assisting the U.S. Department of Defense in developing training materials and resources to address the issue of youth problematic sexual behavior in all branches of the military.

“This is an issue that communities and people worldwide struggle to address,” said clinical child psychologist Jane Silovsky, Ph.D., director of NCSBY. “But the Department of

[ Fa l l / Wi n t e r 2 0 2 0 ]

PATIENT CARE

Defense has done a remarkable job of understanding the science about the appropriate response to the children with behavior problems, as well as their caregivers and the children who are impacted.”

In many cases, problematic sexual behavior in youth involves one young person harming another young person, Silovsky said. Studies show the behavior peaks between the ages of 12 and 14, and that young people rarely act out on strangers; most of the time, they’re acting out on siblings, cousins, schoolmates and others within their social networks.

Exposure to violence is a major risk factor, whether it’s domestic violence, physical abuse, harsh parenting practices, or community violence. Exposure to sexualized media is another risk factor; young people can access pornography on any device, despite the best efforts of their caregivers, Silovsky said. In addition, there are individual risks, such as a child having developmental disabilities, being on the autism spectrum and having impulse disorders.

“These risk factors can impact children’s emotional regulation skills, impulse control skills, and their understanding of the rules and how you treat others,” Silovsky said. “A common myth is that all youth with problematic sexual behavior are being sexually abused themselves. While sexual abuse is a risk factor and a concern, many kids with problematic sexual behavior have not been sexually abused.”

Nor are children with problematic sexual behavior the same as adults who have illegal behaviors or adults with pedophilia who have inappropriate arousal toward children, Silovsky said, and treating them as adults does more harm than good.

Rather, the approach involves cognitive behavioral therapy, in which children and caregivers alike build new skills, protective and resilience factors, and learn to manage their emotions.

The treatment involves group therapy – the youth in one group, parents/caregivers in another, with time during each session when they’re all together.

The good news is that when children and families are connected to evidence-based treatment, the recidivism rate is less than 2%, said licensed clinical psychologist Jennifer Shields, Ph.D., whose expertise with NCSBY is family engagement. With appropriate treatment, supervision and monitoring, most youth with problematic sexual behavior can be maintained in their homes or community environments rather than inpatient care, she said.

“That’s what gives me hope as a provider – we have empirical evidence that this treatment works for kids,” Shields said. “Caregiver involvement is critical to the outcomes. We help parents and caregivers learn better strategies to supervise and guide their children, build healthy relationship skills, and immediately address anything problematic in a way that helps kids learn from the experience and develop better behaviors.”

NCSBY is working with the military’s Family Advocacy Program to develop training materials that their multidisciplinary team of providers will use to address problematic sexual behavior. In addition to treatment protocols, the training includes a preventive focus in which

Jennifer Shields, Ph.D.

daycare and school personnel are trained to recognize potential problems, Silovsky said.

NCSBY also has a Parent Partnership Board comprised of parents whose families have finished treatment programs and want to support other families who are in the same situation.

They developed a guide that supports parents as they talk to their children about sexual behavior.

“As health providers, we can support families and tell them there is hope, but it’s entirely different when families with a shared experience get together,” Shields said. “Parents come in feeling guilty and judged, but they have a space where they can talk with each other, which also helps to promote healing.”

NCSBY’s training and technical team expertise was built from over 30 years of research and clinical care for preschool and school-age children and adolescents with problematic sexual behavior and their caregivers at OU Child Study Center. For more information about the work of NCSBY, visit www.ncsby.org.

Training and Technical Assistance activities are made possible in part by grant 2016-MU-MU-K053 and 2019-MCFX-K022 awarded by the Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, U.S. Department of Justice. The opinions, findings, and conclusions or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect those of the Department of Justice.

[ Fa l l / Wi n t e r 2 0 2 0 ]

17

PATIENT CARE

Healthcare providers at the OU Health Sciences Center are training nursing home providers across Oklahoma on COVID-19 safety and resident engagement.

OU Health Sciences Center Training Nursing Home Providers on COVID-19 Safety Geriatrics, infectious disease, nursing and public health experts at the University of Oklahoma Health Sciences Center are offering training to nursing home providers across Oklahoma on how to best keep their residents safe and engaged as the COVID-19 pandemic continues.

In Oklahoma, 40% of all deaths due to COVID-19 are among nursing home residents, yet they account for less than 1% of the state’s population. At the same time, there is a rise in infections among people ages 18 to 35, which tends to be the age of nursing home staff, who may unknowingly bring the virus into the facility. Those factors underscore the necessity of training and creating best practices concerning COVID-19, said Lee Jennings, M.D., associate professor and Section Chief of Geriatrics in the Department of Internal Medicine, OU College of Medicine.

18

“Older adults who live in nursing homes tend to be frail and in poor health, which puts them at much higher risk for bad outcomes or death if they contract COVID-19,” Jennings said.

“We want to train and support nursing home providers so they can prevent COVID-19 infections and be prepared to care for residents who do become infected. Nursing homes also need to be prepared to respond to changing regulations and have best practices around personal protective equipment, and screening and testing staff members, among other considerations.”

The OU Health Sciences Center is uniquely positioned to offer this training because it has existing relationships with nursing homes through the Oklahoma Dementia Care Network. The value of these partnerships is evident as the COVID-19 training launches, Jennings said.

[ Fa l l / Wi n t e r 2 0 2 0 ]

PATIENT CARE

underserved and remote areas to become experts in subspecialty care.

The training, which is being offered to all Oklahoma nursing homes, consists of a 16-week boot camp for managing COVID-19 and related quality improvement steps, plus weekly “office hours” for a year. All sessions will be conducted virtually on Zoom. Each participating nursing home receives up to $6,000 to use as they need, Jennings said.

In addition to specialists from the OU Health Sciences Center, national quality improvement experts from the Institute for Healthcare Improvement will take part in each session. Other collaborators include the Oklahoma State Department of Health, the Oklahoma Foundation for Medical Quality, and Telligen, the quality improvement organization designated for Oklahoma by the U.S. Centers for Medicare & Medicaid Services. In addition to training and mentoring nursing home providers on issues specific to the virus, the sessions will address social isolation and continuing mobility for residents during the pandemic, Jennings said.

“While it has been necessary for nursing homes to limit visitation, that has been really hard on residents and families.

There are spouses who have spent every day of their adult lives together and now can’t see one another. The toll it is taking is heartbreaking. There are similar situations with their children, grandchildren and other family members,” she said.

“We want to promote guidelines for visitation when that becomes possible, perhaps visiting outside with family members wearing personal protective equipment. For now, we can use technology for virtual visits, and we need to make sure everyone involved knows how to best do that.”

Nursing home staff should also help residents and families talk about their loved one’s wishes should they become infected and very sick with COVID-19, Jennings said. “Best practices for advance care planning are important,” she said. “It’s vital that nursing home staff know what your loved one would want in that situation – do they want to go to the hospital, and what are their wishes for treatment if they do go the hospital? The impact of COVID-19 has pushed those conversations to the forefront in nursing homes, and we can help.”

After COVID-19 training is finished, the same network will be helpful for nursing homes going forward as other issues develop, such as making COVID-19 vaccines available, or additional topics that are especially relevant to nursing homes, Jennings said.

Lee Jennings, M.D.

The training is funded by the federal Agency for Healthcare Research and Quality through a program called Project ECHO (Extension for Community Healthcare Outcomes). Based at the University of New Mexico, Project ECHO is a national model that allows partners like the OU Health Sciences Center to access the most current medical information and best practices for nursing home providers during COVID-19. Project ECHO addresses many other health issues by partnering with academic medical centers to train primary care physicians in

“This new network is a nice opportunity to provide nursing homes with the latest information and quality improvement tools on an ongoing basis,” she said. “It’s also a valuable tool for nursing home providers to reach out to their peers in other facilities and ask them what does and doesn’t work. No one knows better what the challenges are than the people who work in nursing homes. Ultimately, we all want to take the very best care of older adults that we can.”

Nursing homes can sign up to participate by emailing okdcn-echo@ouhsc.edu, calling (405) 271-8166 or visiting dcn.ouhsc.edu.

[ Fa l l / Wi n t e r 2 0 2 0 ]

19

RESE ARCH

A research project is determining the prevalence of COVID-19 among healthcare workers and whether a positive test can protect against future reinfections.

COVID-19 Antibodies Examined in Healthcare Workers OU Medicine, OU Health Sciences Center and Oklahoma Blood Institute are collaborating on a project to determine the prevalence of Oklahoma healthcare workers who have previously been infected with the COVID-19 virus. In addition, the antibodies of those who test positive for previous infection will be analyzed for their ability to protect against future COVID-19 infection.

The Oklahoma Blood Institute is testing through its existing partnerships with healthcare facilities across Oklahoma.

Through mobile blood drives around the state or at OBI donor facilities, healthcare workers can be tested for COVID-19 antibodies while donating much-needed blood for Oklahoma’s

20

supply. If their tests show a previous infection, they have the option of donating their plasma to be used as convalescent plasma treatment in seriously ill patients with COVID-19.

In addition, COVID-19 antibody tests are offered on the campus of the OU Health Sciences Center to all employees of OU Medicine, OU Health Physicians and OU Health Sciences Center, whether or not they work in a clinical setting.

In total, the study aims to test 8,000 workers at healthcare facilities in Oklahoma. Altogether, the test results should provide insight into how the state’s healthcare population has been affected.

[ Fa l l / Wi n t e r 2 0 2 0 ]

RESE ARCH

“The virus has had a disproportionate impact on healthcare workers around the world,” said Tim VanWagoner, Ph.D., deputy director of the Oklahoma Clinical and Translational Science Institute, a campus initiative that is spearheading the project. “It makes sense for us to focus these early serological studies to better understand the prevalence of COVID-19 antibodies among healthcare workers. Because a high number of individuals are asymptomatic after infection, many people are very interested in knowing whether they may have been previously exposed and might have some protection against future infections.”

OU Medicine’s high-complexity laboratory will test the samples provided by OBI and others from OU employees.

However, some tests will be administered using lowercomplexity devices that can be used to provide rapid results in a variety of settings. The results will be compared and verified to determine whether they are as accurate as laboratory testing, VanWagoner said.

Researchers at the OU Health Sciences Center will lead investigations into the antibodies of those who were previously infected. The studies will focus on whether the antibodies have the ability to block the virus from infecting cells and, if so, the amount of antibodies needed to do so, said OU Health Sciences Center virologist James Papin, Ph.D. “We are interested in whether antibodies made by previously infected individuals have the ability to neutralize the virus,” Papin said. “While we have some evidence that individuals who have recovered from COVID-19 possess antibodies that can protect from re-infection, what we do not know is how long those antibodies persist or if antibodies produced during asymptomatic infection can protect against re-infection. As part of the testing, we will determine the highest dilution of antibodies that can block the virus from infecting cells, as a higher dilution indicates a stronger response and thus greater chance of protection from re-infection.”

The OU Health Sciences Center is qualified to conduct these tests because of its Biosafety Level 3 Laboratory, a requirement for working with live SARS-CoV-2, the virus that causes COVID-19, Papin said. The facility includes multiple safety protocols, including extensive personal protective equipment and clean airflow that is HEPA-filtered and not re-circulated.

After this round of testing and research, the project will broaden into community settings for non-healthcare workers, which will be particularly important if infection rates continue to rise, VanWagoner said.

Because of its longstanding collaborations with Oklahoma healthcare facilities, OBI is well-positioned to gather samples from a cross-section of the state.

“OBI is excited to team with OU’s scientists to understand the impact of COVID-19 on the frontline heroes who have been caring for patients throughout the pandemic,” said John Armitage, M.D., president and CEO of Oklahoma Blood Institute. “We owe these great healthcare workers not only our respect and admiration, but our best efforts and research to protect them.”

Researchers are investigating whether COVID-19 antibodies protect against future reinfection.

Three Departments Rank in Top 20 for NIH Funding Three departments in the OU College of Medicine -Obstetrics and Gynecology, Family and Preventive Medicine, and Ophthalmology -- have ranked in the top 20 medical school departments in the United States for research funding from the National Institutes of Health in federal fiscal year 2019. The rankings are compiled by the Blue Ridge Institute for Medical Research, considered the gold standard for medical school research metrics.

The Department of Obstetrics and Gynecology, which conducts a broad range of research across its seven sections, ranked No. 8 among its peer departments with $5.7 million in NIH grants. In the Section of General Obstetrics and Gynecology, researchers are studying the effects of iron deficiency in women who have gone through menopause. In the Section of Maternal-Fetal Medicine, researchers are investigating whether the Zika virus can be passed from mother to baby if the female becomes pregnant by a male infected with Zika.

[ Fa l l / Wi n t e r 2 0 2 0 ]

21

RESE ARCH

Research in the Section of Reproductive Endocrinology and Infertility includes an exploration of the mechanism of newborn obesity in obese mothers, as well as a project that is investigating whether there are health risks associated with frozen embryo transfers in which a woman’s uterus is prepared for implantation with estrogen and progesterone compared to transferring an embryo in a woman’s natural cycle.

Another grant focuses on cancer survivorship, specifically facilitating communication between the patient’s oncologist and primary care physician once active cancer treatment is complete. Communication barriers remain among medical disciplines that traditionally do not work together, and too often the patient is caught in the middle and feels overwhelmed at having to navigate both areas of healthcare, Nagykaldi said.

Led by faculty members in the Section of Gynecologic Oncology, Stephenson Cancer Center is advancing patient treatments in gynecologic cancers through multiple NIH grants. Stephenson Cancer Center also has major NIH grants across other clinical areas, conducts clinical trials for experimental therapies and cancer prevention, and leads in dissemination and implementation research. It is now a Lead Academic Participating Site for the National Cancer Institute’s National Clinical Trials Network and is currently No. 1 in the nation for enrolling patients to those trials.

“We also need to better understand the most effective content of a survivorship plan so that a primary care physician can resume monitoring the patient, but still communicate with the oncologist,” he said. “The treatment of chronic conditions like heart disease or diabetes, for example, should be viewed in a new light following cancer treatment.”

“Our mission as an academic medical center is not just offering the standard of care to our patients, it’s defining the next standard of care,” said Karl Hansen, M.D., Ph.D., chair of the Department of Obstetrics and Gynecology. “Our research and teaching missions are an important element of continuously improving our patient care now and in the future.”

The Department of Family and Preventive Medicine is ranked No. 11 in the nation with $2.2 million in NIH funding, which is especially notable given that family medicine departments typically receive less funding from the NIH and more from other agencies, such as the Agency for Healthcare Research and Quality. The department is also a leader in funding from those other agencies, said Director of Research Zsolt Nagykaldi, Ph.D. Research projects in the Department of Family and Preventive Medicine often include collaborators in the community, as well as researchers from other disciplines of medicine and from other colleges at the OU Health Sciences Center. Three current NIH-funded projects address cancer by assessing and improving the processes involved in a patient’s screening and treatment. In a partnership with the Choctaw Nation, researchers are designing and testing a new care delivery process to improve the rate of lung cancer screening using low-dose computed tomography (CT).

In this type of community-engaged research, members of the Choctaw Nation are deeply involved in the design and creation of the intervention, in addition to their patients benefiting from an improved care delivery system.

Another grant involves collaborations with several tribal nations across Oklahoma and the United States, all working to improve the rate of colorectal cancer screening and follow-up care. Screening rates in tribal nations are lower than rates in the general population, and there are challenges to follow-up care. If a polyp or malignancy is discovered during a colonoscopy in a tribal health system, for example, patients face hurdles related to the referral process or because the next stage of treatment would require travel to another community.

22

The Department of Ophthalmology, which is housed within Dean McGee Eye Institute, ranked No. 19 in NIH funding with $6.4 million. Most researchers in the department have one or more grants from the National Eye Institute, and several grants also support training for early-career investigators and acquiring state-of-the-art equipment.

Researchers bring deep expertise to their investigations of the mechanisms that underpin blinding diseases. One researcher focuses on autoimmune uveitis, and his grant supports the generation of a novel line of genetically altered mice whose ocular cells can be easily visualized and tracked.

This will allow him to better understand the dynamics of the immune response during autoimmune uveitis and develop therapeutics for that disease.

Another researcher studies how the cells of the retina communicate with one another, which is fundamentally important for the regulation of their functions. The insulin-like growth factor 1 receptor is a key factor in several cellular functions of rod and cone photoreceptors, cells whose functionality is critical for vision.

The body’s immune response to viral infections of the central nervous system is another well-funded area of ophthalmology research. Currently, researchers are focusing on the genesis of lymphatic and blood vessels into the cornea during herpes simplex viral infection, as well as identifying mediators that drive these events. These mediators can be inhibited with novel therapeutics, which may prevent recurrence and preserve vision.

The Department of Ophthalmology has a P30 Core Grant for Vision Research, which supports training, expertise and equipment for 24 vision research labs at the OU Health Sciences Center and the Oklahoma Medical Research Foundation.

“This core support has undoubtedly been a driving factor in recruiting new vision researchers to the OU Health Sciences Center and new non-vision researchers to vision science,” said Michelle Callegan, Ph.D., director of Vision Research and director of the core grant. “It also has kept OUHSC at the forefront of vision research and vision as one of the most highly funded groups on our campus.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

RESE ARCH

Researchers and physicians review literature to highlight the role of CT in COVID-19 treatment.

Research Collaboration Sheds Light on CT for COVID-19 Treatment Because COVID-19 is a brand-new virus, physicians did not have an established protocol for treating patients as the pandemic began to spread. However, a collaboration between researchers and physicians at the University of Oklahoma and OU Health provides a better understanding of how computed tomography imaging can guide the current and future treatment of COVID-19.

Medical imaging researchers in the Gallogly College of Engineering on the OU Norman campus partnered with

a radiologist at OU Health to publish a review article in the journal Experimental Biology and Medicine about CT’s role in determining the severity of the disease and guiding a patient’s course of treatment. OU’s new journal article compiles evidence about CT use among healthcare providers around the world.

“One of our research focuses is X-ray imaging,” said the article’s author, Hong Liu, Ph.D., a professor in the School of Electrical and Computer Engineering. “Through this review

[ Fa l l / Wi n t e r 2 0 2 0 ]

23

RESE ARCH

article, we sought to provide an understanding of the role of CT so that researchers can develop new and better imaging technologies for COVID-19.”

An interdisciplinary approach was important for this study.

Liu, along with colleagues Molly Wong, Ph.D., and Yuhua Li, Ph.D., paired their imaging expertise with OU Health radiologist Theresa Thai, M.D., who provided medical knowledge and experience reading CTs. Their study shows the general patterns of COVID-19 infection. Early hallmarks of the disease are the development of ground-glass opacities, which are hazy shapes in otherwise healthy lungs, Thai said. Middle stages of the infection are characterized by “crazy paving,” a continued spread of densities that mimic disorganized paving stones, and later stages see an increased consolidation of those patterns.

Although these CT findings can be found in other lung conditions, studies of COVID-19 generally concur that the disease follows this trajectory.

“For physicians, CT scans can help determine which patients need to be hospitalized as opposed to those who can stay at home and recuperate,” Thai said. “And among patients who are hospitalized, CT helps determine which need to be in the ICU as opposed to a regular hospital floor.”

The OU study will also serve as a road map for medical imaging researchers across the world as they use their expertise to improve imaging technology for patients with COVID-19. The next frontier is artificial intelligence, in which the computer identifies areas of concern that the radiologist can further examine and confirm, Thai said.

“The potential for pattern recognition in imaging is exciting,” Thai said. “The goal is for the computer to highlight suspicious areas so that radiologists can spend their time on those areas as opposed to findings that are more incidental.”

Liu’s laboratory focuses on cancer imaging, but in response to OU’s call for research on COVID-19, he and his colleagues are closely monitoring the disease to see if they can further contribute through their expertise in engineering sciences.

Liu said interdisciplinary research is a core component of the university’s research programs.

“Interdisciplinary collaborations are important to make advances in healthcare,” Liu said. “As engineers in medical imaging, we can develop new technologies, but until we work closely with clinicians, talking with them and understanding their needs, those instruments will otherwise be useless tools. However, as we have close collaborations between engineering and clinical services, those tools can become useful to clinical practice and can save lives.”

Thai emphasizes the same benefit of partnerships that move discoveries from the “research bench to the patient bedside.”

“We are working toward the same outcome, just from different vantage points,” Thai said. “As physicians, we can’t do what we do without researchers developing their technologies, and they need our perspective about where they should focus their research so that it benefits patients. We have the same overall goal of helping patients.”

24

Jed Friedman, Ph.D., is an active researcher and director of Harold Hamm Diabetes Center.

Harold Hamm Diabetes Center Researchers Earn Grant to Study Liver Disease in Children More than 30% of children who are obese will eventually be diagnosed with non-alcoholic fatty liver disease, or NAFLD, a silently progressing condition that sometimes isn’t discovered until a child’s liver is stiffened with fibrosis.

Children born to obese mothers face a higher risk of developing NAFLD, but the exact reasons why remain unknown. Three researchers at OU Health Harold Hamm Diabetes Center have been awarded a $2.3 million grant from the National Institutes of Health to investigate the role of the microbiome – the millions of bacteria in a person’s gut – and how the microbes passed from mother to child contribute to the onset of NAFLD. The researchers are also testing a nutritional compound for its potential to counter negative changes in the microbiome, thereby lowering the risk for NAFLD. Babies receive their first microbes from their mothers as they travel through the birth canal, breast feed, and have skin-to-skin contact. The microbiome plays a major role in how the immune system develops, beginning soon after birth.

By age 3, a child’s microbiome is established, but things that disrupt its development in the first 1,000 days can alter the infant’s early immune system with significant consequences in later life. A primary suspect in that disruption is what the mother eats during pregnancy.

[ Fa l l / Wi n t e r 2 0 2 0 ]

RESE ARCH

“A mother’s diet that causes her to be overweight will be transmitted to the infant in several ways. Knowing what those microbes are and figuring out how they disrupt the child’s immune system is the focus of this study,” said Jed Friedman, Ph.D., director of Harold Hamm Diabetes Center and a principal investigator on the grant.

Friedman’s past research in this area helped him attract the new federal grant. In his previous study, he took stool samples from 2-week-old infants who were born to obese mothers.

Those samples, which contain the microbiome, were placed into mice that had no microbes of their own. The mice became obese and experienced a change in their immune systems.

“That prompted us to start thinking about what these microbes are and what they’re doing,” Friedman said.

“They’re coming from the mother in some way, but they’re leaking out of the infants’ microbiomes and changing their immune systems and making them gain weight. There’s a super-highway from the gut to your liver. So anything that leaks out of the gut travels straight to the liver. Your liver is a prime target for these microbes.”

Friedman’s current study will go a step further to determine how much of an infant’s microbiome disruption can be attributed to a mother’s diet during pregnancy vs. what the baby takes in during breastfeeding. Mice born to an obese mother will be placed with healthy-weight mice to breastfeed, and their immune system development will be monitored, he said.

The human microbiome is sometimes called the “undiscovered community within,” Friedman said, because it is 10 times the size of the human genome and extremely complicated because of how microbes act and communicate with each other. But for all its complexities, researchers have discovered ways to create a healthier microbiome, such as using probiotics in children who have immune conditions like allergies, he said.

Part of this study will test the nutritional compound pyrroloquinoline quinone, or PQQ, for its ability to improve the microbiome. PQQ is an antioxidant found in green, leafy vegetables and, among other things, human breast milk, Friedman said. In the study, his team will investigate whether PQQ can counteract the microbial factors that lead to NAFLD. “About 50% of women of reproductive age in the United States are overweight or obese, and of the 30% of obese children who are diagnosed with NAFLD, about 20% will have advanced disease by the time it is discovered,” Friedman said.

“The diagnosis represents a lifelong struggle, and there are no treatments except major lifestyle changes. That’s why we want to catch it before it starts.”

Friedman’s co-principal investigators on the grant are Karen Jonscher, Ph.D., who brings expertise with PQQ, and Kenneth Jones, Ph.D., who contributes a wealth of experience in laboratory testing, including single-cell RNA sequencing to capture images of the liver and its many cell types.

Beverley Greenwood-Van Meerveld, Ph.D., received a new federal grant to investigate IBS.

OU College of Medicine Researcher Earns Federal Grant to Study StressInduced Irritable Bowel Syndrome Anyone who suffers from irritable bowel syndrome can testify to its signature trait: It gets worse during times of stress.

[ Fa l l / Wi n t e r 2 0 2 0 ]

25

RESE ARCH

However, women with irritable bowel syndrome appear to have more severe abdominal pain than men when they’re under stress. An OU College of Medicine researcher is moving closer to understanding why, and the National Institutes of Health recently validated the promise of her work with a $1.3 million grant.

Beverley Greenwood-Van Meerveld, Ph.D., a professor in the Department of Physiology and a Senior Veterans Administration Career Scientist, has devoted much of her research career to the connection between emotional stress and gastrointestinal problems. Each discovery has served as a stepping stone to another, more specific research project, such as her current work, which seeks to identify mechanisms in the brain that make women with irritable bowel syndrome more susceptible to abdominal pain than men when under stress.

“IBS is a difficult condition because along with abnormal bowel habits, people have abdominal pain, often in conjunction with anxiety and depression,” she said. “People feel miserable and there’s nothing that can really treat the pain. While it’s not a disease that will lead to death, it affects quality of life and leads to lost work days. The financial burden to society is huge, and it’s one of the most common disorders that influence women’s work productivity.

“The research question we are asking now is, why are females more vulnerable to abdominal pain? Our hypothesis is that there is an epigenetic change in specific brain nuclei in females,” she said. “Once we know that, we can potentially direct therapies to treat stress-induced pain. Because we have both male and female research models, we can compare and look for molecular mechanisms of coping vs. vulnerability.”

Greenwood-Van Meerveld’s previous research has built the foundation for her current project. Thus far, her research has demonstrated that males with IBS who are exposed to chronic stress as adults experience increased abdominal pain.

Females in the same scenario experience even greater pain.

In addition, she studies different types of stress and how they affect both males and females with IBS. Her previous research has demonstrated that when exposed to early-life stress that was predictable, both males and females coped well when they encountered stress again in adulthood.

However, when the early-life stress was unpredictable, females were far more likely to have pain when they experienced stress again as adults, while males remained resilient.

Her current project, which seeks to identify and compare the mechanisms of stress-induced pain between males and females, is a step closer to potentially devising a solution.

“We know that early-life stress is a risk factor for the development of irritable bowel syndrome later in life,” Greenwood-Van Meerveld said. “But, because research has traditionally used male research models, we need a better understanding of the connection between the brain and the gastrointestinal tract in women.”

26

Amy Cohn, Ph.D.

Tobacco Regulatory Science Researcher Earns Grant to Study Role of Menthol in Smoking Habits In 2009, the Food and Drug Administration banned numerous cigarette flavors, from chocolate to cherry to cinnamon, in an effort to decrease their attractiveness to young people. But it did not ban menthol flavoring. Now, the FDA is considering whether to ban the minty flavor, and a researcher at OU Health Stephenson Cancer Center is conducting a study that will help inform that decision.

Tobacco regulatory science researcher Amy Cohn, Ph.D., received a $1.3 million grant from the National Institutes of Health and the FDA Center for Tobacco Products for her study, which will investigate the role of menthol flavoring in smoking habits among young adults. The study will build

[ Fa l l / Wi n t e r 2 0 2 0 ]

RESE ARCH

upon on existing research as the FDA gathers evidence for its proposal to ban menthol flavoring in cigarettes.

“A lot of young people who initiate tobacco use with a cigarette do so with menthol, and one of the hypotheses for this is that the minty, cool sensation of menthol masks the harshness of inhaled cigarette smoke,” said Cohn, who is part of the Tobacco Settlement Endowment Trust Health Promotion Research Center at Stephenson Cancer Center.

“Young people who had their first cigarette with menthol flavoring reported a more positive smoking experience compared to young people who didn’t smoke menthol as their first cigarette. That’s important because an initial positive experience is linked to ongoing use of tobacco products.”

Cohn’s study will also help the FDA in another move it is contemplating: bringing very low-nicotine cigarettes to the market with the aim of helping people reduce and ultimately quit smoking. Low-nicotine cigarettes have approximately 0.4 milligrams of nicotine compared to the average cigarette, which contains 10 milligrams of nicotine. While previous studies have shown that low-nicotine cigarettes help people stop smoking, Cohn will specifically investigate whether menthol flavoring in low-nicotine cigarettes contributes to that reduction in smoking, or if it has the opposite effect and entices people to continue smoking.

Cohn uses three primary methods to measure the appeal of different types of cigarettes. In her laboratory, she can analyze smoking behavior, which is a proxy for the influence of a particular tobacco product. She can measure how many puffs people take, the interval between puffs, the volume of the puff and the draw of the puff. Another method involves giving study participants cigarettes, both menthol and regular, to take home and smoke as they wish for a week. They will be surveyed to gather information about how satisfying each type was in comparison to the other, and whether they choose to use other tobacco products instead, as a potential negative unintended consequence of bringing low-nicotine cigarettes to the market.

Study participants also will take part in an “experimental tobacco marketplace,” similar to any online shopping experience, in which they shop online according to the availability of various tobacco products, including low-nicotine options. Researchers will manipulate the types of tobacco products available in the marketplace to determine what young people choose to buy when menthol is and is not available in cigarettes and other combustible tobacco products. The marketplace serves as a simulation of tobacco policies, allowing researchers to see how people react to policies before they actually go into effect.

“Menthol cigarettes are disproportionately used by several at-risk populations, including African Americans, young people, Hispanics and women,” Cohn said. “There are a lot of hypotheses that a ban on menthol would reduce the public health impact of cigarette smoking, which we know is a very strong risk factor for cancer and other diseases. Our research will help the FDA make decisions in its regulatory efforts.”

Michael Cookson, M.D.

Stephenson Cancer Center Part of Trial Resulting in New Treatment for Metastatic Prostate Cancer OU Health Stephenson Cancer Center took part in an international clinical trial that proved the effectiveness of an oral medication for metastatic prostate cancer, the first treatment advance for that disease in many years.

Results of the trial, which studied oral drug relugolix, were published in the prestigious New England Journal of Medicine.

One of the lead authors is Michael Cookson, M.D.,

[ Fa l l / Wi n t e r 2 0 2 0 ]

27

RESE ARCH

Stephenson Cancer Center urologic oncologist and chair of the Department of Urology in the OU College of Medicine.

The mainstay of treatment for metastatic prostate cancer is androgen deprivation therapy, also called hormonal therapy, in which a man’s testosterone level is lowered in order to put cancer cells into a state of remission. For many years, the therapy has been available only in the form of an injection, which sends a signal to the brain to shut down the production of testosterone. The new trial studying relugolix showed the same ability to lower testosterone, perhaps even better, as well as a decrease in several side effects that occurred with the injection.

“Prostate cancer is the second-leading cause of cancer deaths among men,” Cookson said. “This study is exciting because it is the first trial to demonstrate that men can take a pill instead of having to go to the doctor’s office for shots, and the cancer control is just as effective. But there were several additional findings that are also positive.”

One of the trial’s bonus findings centers around how a man’s testosterone is lowered, Cookson said. Injections work by stimulating the pituitary gland so that there is initially a slight overproduction of testosterone before it starts to lower.

That “flare” of testosterone after the injection delays the effectiveness of the therapy. However, relugolix is able to tell the brain to stop producing testosterone immediately without a flare.

“In addition, because the pills directly send the message to stop testosterone production, they lowered the testosterone level faster than injections do, and kept it lower over the duration of the study,” Cookson said. “And perhaps even more interesting is that once men stopped taking the pill, their testosterone levels rebounded fairly quickly, whereas men who received injections can take up to a year to go back to their normal testosterone levels.”

Another important finding of the trial was a decrease in cardiovascular side effects in men who received the oral drug vs. the injection. While cardiovascular side effects were not eliminated in men who took the pill, they were significantly lowered, Cookson said.

Stephenson Cancer Center was one of many centers around the world that collectively enrolled more than 900 men to the trial. The patients were randomized to receive either the injection or the oral drug, then their health was monitored for 48 weeks. The next, and final, step is to seek approval from the Food and Drug Administration to offer relugolix to patients with metastatic prostate cancer.

Because Stephenson is a National Cancer Institute-Designated Cancer Center and one of the nation’s top enrollers in NCI clinical trials, it treats many men with metastatic prostate cancer, Cookson said.

“This clinical trial is part of our portfolio for men with this disease,” he said. “Our prostate cancer program is unique because it is truly multidisciplinary, offering the most advanced medical, surgical and radiation therapy treatments with access to clinical trials, all at the same center.”

28

Jimmy Ballard, Ph.D., chair of the Department of Microbiology and Immunology, leads an $11 million grant in microbial pathogenesis and immunity. The award is part of the campus’s record year for research funding.

OU Health Sciences Center Earns Record High in Federal, State Grants The University of Oklahoma Health Sciences Center earned a record high $190 million in federal and state awards during state fiscal year 2020, a milestone that advances research and other strategies to improve health and well-being among Oklahomans.

The majority of the grants were awarded to researchers at the OU College of Medicine. The total includes $86.3 million from the National Institutes of Health (NIH), considered the gold standard in research funding. The OU Health Sciences

[ Fa l l / Wi n t e r 2 0 2 0 ]

Center brings the most NIH funding to Oklahoma through its national centers of excellence, and the total for fiscal year 2020 represents growth of 40% over the previous year. That growth is a testament to the innovative work taking place across all seven colleges on campus, said Vice President for Research James Tomasek, Ph.D. “Research is a primary mission of the OU Health Sciences Center, with the aim of advancing knowledge and improving the health of the state,” Tomasek said. “As the academic and research partner of OU Medicine, the state’s comprehensive healthcare system, a critical component of our strategic plan is to make research discoveries that lead to new methods of preventing, diagnosing and treating disease.”

Two of the OU College of Medicine’s key research areas, cancer and neuroscience/vision, saw a significant increase in grants in fiscal year 2020. The National Cancer Institute (NCI) and the National Eye Institute (NEI), two major NIH Institutes, awarded $16.1 million and $10.9 million, respectively, to the OU Health Sciences Center. That represents an increase of 26% percent from the NCI and 62% from NEI over the previous fiscal year. Those grants are used for projects ranging from laboratory science to clinical trials, ultimately improving patient care and outcomes at Stephenson Cancer Center and Dean McGee Eye Institute.

The OU College of Medicine also received $8.3 million from the National Institute of Diabetes and Digestive and Kidney Diseases, an increase of 221% over the previous fiscal year.

Much of that research furthers the understanding and treatment of Type 1 and Type 2 diabetes in children and adults at OU Health Harold Hamm Diabetes Center, advancing the search for a cure.

One of the largest NIH grants over the past year was a five-year, $11 million award to create the Oklahoma Center for Microbial Pathogenesis and Immunity, a hub for research into many types of infections and the immune system response, which is critical in facing COVID-19 and other emerging pathogens. This Centers of Biomedical Research Excellence (CoBRE) grant establishes multidisciplinary research in Oklahoma and enables talented researchers to compete for additional federal awards.

“This grant is an exciting opportunity because it will allow us to advance our research through collaborations with scientists in other disciplines and other universities,” said Jimmy Ballard, Ph.D., chair of the Department of Microbiology and Immunology in the OU College of Medicine. “But the grant is also significant because a major component of the program is mentoring junior researchers. They will contribute to better patient treatment with their projects, while building their careers and attracting additional grant funding that helps to drive Oklahoma’s economic growth.”

Many NIH grants earned by researchers at the OU Health Sciences Center are made possible by an important local nonprofit organization – the Presbyterian Health Foundation (PHF). Each year, PHF awards millions in grants, which researchers use to further their investigations or purchase crucial equipment they would otherwise be unable to acquire.

“Research is a primary mission of the OU Health Sciences Center, with the aim of advancing knowledge and improving the health of the state.”

“Our partnership with PHF is indicative of the importance of local funding to the process of research,” Tomasek said. “Because of the generosity of entities like PHF, our researchers are able to enhance their investigations and make discoveries that then attract the attention of federal funding sources like the NIH.” Overall, federal funds awarded to the OU Health Sciences Center increased by 43% over the previous fiscal year. Grants from the U.S. Health Resources and Services Administration (HRSA) were second behind the NIH in federal awards to the OU Health Sciences Center. In fiscal year 2020, HRSA awarded several multimillion-dollar grants, including one for suicide prevention strategies in Native American and other communities, and another to increase the number of primary care physicians in Oklahoma, particularly in rural, tribal and medically underserved areas.

The majority of OU Health Sciences Center research is conducted on the Oklahoma City campus, with a focus on community health research at the Tulsa campus, and expanding research collaborations across the state. As Oklahoma’s only comprehensive academic health center, the OU Health Sciences Center contributes to innovative patient care that is not available anywhere else in Oklahoma.

“Thanks to the expertise and determination of our researchers, combined with the support of our donors and clinical enterprise, the OU Health Sciences Center has achieved the highest level of NIH funding ever seen in Oklahoma,” said Senior Vice President and Provost Jason Sanders, M.D., MBA. “Through our partnership with the OU Medicine health system, research growth will reach even higher levels across our comprehensive centers of excellence.

Our physicians and teams of highly skilled healthcare professionals bring research from the bench to the bedside to the community, giving Oklahomans and our state new options, and new hopes. Our distinctive research assets also accelerate Oklahoma’s economy through private sector investments in new technologies and treatments.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

29

RESE ARCH

A $38 million grant has been awarded to the OU Health Sciences Center for suicide prevention efforts.

Pediatrics Faculty Members Lead Major Suicide Prevention Grant The University of Oklahoma Health Sciences Center has been awarded a five-year, $38 million grant to lead and expand a national program dedicated to suicide prevention. The grant will be led by Dolores Subia BigFoot, Ph.D., a professor in the OU College of Medicine and a longtime researcher and organizer of suicide prevention efforts.

Suicide prevention has always been a priority in the mental health community, but the new grant is especially timely as the nation faces increased stressors because of the COVID-19 pandemic and its economic toll, as well as racial injustice and inequality.

30

“We’re coming into this at a very important time,” BigFoot said.

“We’re in a new era in which the suicide risk may increase. We want to increase our resources and grow a network of safety for people at risk of suicide.”

During the five-year grant period, BigFoot and her team will be furthering the work of the Suicide Prevention Resource Center, an organization funded by the U.S. Substance Abuse and Mental Health Services Administration. More than 48,000 people in America died by suicide in 2018, according to the Centers for Disease Control and Prevention, and from 1999 through 2018, the suicide rate increased 35%. Suicide is complex and requires a multifaceted approach, but it is

[ Fa l l / Wi n t e r 2 0 2 0 ]

RESE ARCH

preventable, BigFoot said. Education, evidence-based prevention strategies and public awareness are among the tools to help people who are considering taking their own lives.

Among those at higher risk of suicide are people living in domestic violence situations, those who face poverty and persistent inequality in life, people who are elderly and people who live in rural communities. The LGBTQ+ community faces a higher risk, as do ethnic minorities such as American Indians and Alaskan Natives. First responders face an increased risk after working during major events like the Oklahoma City bombing and the terrorism of Sept. 11, 2001. And risk can be compounded by substance misuse or existing mental health conditions.

“By combining her medical knowledge and deep understanding of Native culture, Dr. Dee BigFoot has expertly developed culturally responsive treatments to better serve Indigenous populations, who unfortunately face significant inequities in healthcare, including proper mental health support,” said OU President Joseph Harroz Jr. “This transformative grant will amplify the scope of her important work across tribes and other vulnerable groups, literally saving lives and preserving communities and cultures.”

Suicide is rarely something that people think about in the moment and complete, BigFoot said. “Suicide may be an individual act, but it is the final act of something that has led to that point,” she said. “We need to continue to understand the dynamics that come into play – trauma, substance misuse, mental illness, family conditions. People have such a burden of mental anguish that they perceive suicide as being the only way to stop the pain. We need to understand that everyone who is suicidal is struggling with something on a regular basis.

It’s not there one day and gone tomorrow.”

BigFoot plans to address workforce development – training people in settings where they have regular opportunities to talk about suicide risk, such as clinics, hospitals, schools and colleges, and making suicide screening part of standard practice. People must become comfortable with asking someone if they’re thinking about harming themselves, and overcoming the myth that talking about suicide increases the chance that someone will carry it out, she said.

Suicide prevention also includes a specific focus on children, who are not immune from thinking about suicide as young as 4 or 5 years old, BigFoot said. Children may not be capable of carrying out suicide at a young age, but if they continue having thoughts of suicide as they get older, they are increasingly capable of completing the act. Prevention entails helping parents and intervening when children are facing neglect or harm.

Young people are also an asset when talking about suicide prevention, said Beverly Funderburk, Ph.D., an OU College of Medicine professor who is co-leading the research with BigFoot.

“An important part of this effort is to incorporate the knowledge and voice of at-risk young people and have them be part of the solution,” Funderburk said. “For young people,

Dolores Subia BigFoot, Ph.D.

it’s often much easier to talk about suicide risk when they hear about it from their peers.”

As an academic health system, the OU Health Sciences Center is well-positioned to apply the resources made possible by this grant. Funderburk said. Both she and BigFoot are faculty members in the Center on Child Abuse and Neglect, a program within the College of Medicine’s Department of Pediatrics, Section of Developmental and Behavioral Pediatrics. BigFoot also directs the Indian Country Child Trauma Center. Together with their colleagues, they have a long history of clinical work, research, developing programs and training workforce. Along with partners across Oklahoma and the nation, they will use the grant to further the work of the Suicide Prevention Resource Center.

“Partnerships are a critical component of this program,” Funderburk said. “The grant allows us to bring our expertise and foundation in this area and collaborate with many partners across the nation, each of us bringing different strengths. Suicide absolutely can be prevented, and we want to address it as the public health concern that it is.”

Major partners on the grant include the American Psychiatric Association; Columbia University; the Education Development Center; Vibrant Emotional Health/National Suicide Prevention Lifeline; and the Southwest Prevention Center at University of Oklahoma Outreach.

[ Fa l l / Wi n t e r 2 0 2 0 ]

31

OU -TU SCHOOL OF COMMUNIT Y MEDICINE

Casey Bakhsh, LCSW, director of programs for Tulsa CARES, places items in the agency’s food pantry. Tulsa CARES, which delivers social services to people with HIV/AIDS, is the community partner for a new OU Health Sciences Center grant.

Tulsa Researcher Receives Federal Grant to Study Food as Medicine Intervention for People With HIV In the healthcare profession, food is increasingly seen as medicine – a healthy diet can lessen the severity of disease and prevent additional chronic conditions from complicating a person’s health. A new federal grant awarded to the University of Oklahoma Health Sciences Center will be used to study how food can best be used to improve the health of Oklahomans living with HIV.

long before you see elevations in blood glucose. That’s why we’re focusing on insulin resistance for this study – so that we can identify food as medicine strategies for intervening sooner. But the intervention we ultimately develop will benefit people regardless of where they are on that spectrum, from showing initial signs of insulin resistance to having Type 2 diabetes or other related conditions.”

Studying the effects of healthy diets in people with HIV is important for many reasons, said Marianna Wetherill, Ph.D., who is leading the grant for the OU Health Sciences Center on its Tulsa campus. About 21% of people with HIV may have insulin resistance, which contributes to numerous chronic conditions, including diabetes, renal insufficiency and liver disease; the prevalence is even higher among those with limited financial resources. In addition, some of the antiretroviral medications taken by people with HIV are associated with insulin resistance, she said. Another factor is that anywhere from 24% to 50% of people with HIV are considered food insecure, meaning they don’t have reliable access to affordable, nutritious food.

The study is being funded by a $2.4 million grant from the National Institutes of Health. The program created by the grant is called NOURISH-OK – Nutrition to Optimize, Understand, and Restore Insulin Sensitivity in Oklahoma.

It is an example of community-based participatory research, meaning it is heavily driven by a community partner, in this case Tulsa CARES. For 30 years, the agency has delivered social services to people affected by HIV/AIDS and created opportunities for healthy living. The comprehensive approach addresses unmet needs under one roof, including care coordination, housing, mental health and nutrition.

“There are many risk factors with HIV that may contribute to insulin resistance,” Wetherill said. “Insulin resistance develops

32

Licensed clinical social worker Casey Bakhsh, director of programs for Tulsa CARES, is leading the study for the agency, which has long-term relationships and strong rapport with its clients. Over the past three decades, medication has vastly

[ Fa l l / Wi n t e r 2 0 2 0 ]

OU -TU SCHOOL OF COMMUNIT Y MEDICINE TULSA

improved for people living with HIV to the point that they can expect to live just as long as anyone without the condition, Bakhsh said. However, those advancements have come with a caveat, which the NOURISH-OK study is also addressing.

“When HIV was a major epidemic in the 1980s and 1990s, we were encouraging people to eat a high-calorie, high-fat diet because they were dying from HIV wasting,” Bakhsh said. “The message was, ‘You don’t need to lose weight and, ideally, we want you to be overweight so that if you get sicker, you’ll have some reserve.’ We addressed the issues we had at the time because we didn’t realize that people were going to age. So we unknowingly promoted an unhealthy diet that is leading to other chronic conditions, and that messaging has remained ingrained in the HIV community.”

The NOURISH-OK study will begin with data collection – surveying HIV-positive clients from Tulsa CARES and other agencies in northeastern Oklahoma. The information gathered will be robust: Participants will be interviewed about their food security status and their diet, as well as other factors that may affect insulin resistance, including adverse childhood experiences, tobacco use, stress and sleep quality. Other objective measures will include body composition to measure body fat, lean muscle mass and hydration, as well as blood work to measure chronic inflammation. A metric called the Dietary Inflammatory Index, which has been shown to predict insulin resistance, will be used to create a dietary score for each person. The study also will analyze samples from participants’ gut microbiome, where bacteria changes shed light on the connection between food and insulin resistance.

“There are many behavioral risk factors for insulin resistance, and we suspect that food insecurity will directly and indirectly influence these risk factors,” Wetherill said. “We’re taking the most holistic approach that we can, knowing that this is a food as medicine study, but if we need to provide wraparound services too, that will be part of our NOURISH-OK intervention.”

Rather than telling participants to follow an anti-inflammatory diet, the research team will use its findings to customize intervention foods with the specific goal of lowering (improving) the study population’s Dietary Inflammatory Index score. Then, boxes of food will be delivered to study participants, who will also learn skills about how to cook the foods in a way they enjoy and will be sustainable over time.

Researchers will evaluate the effectiveness of the intervention by assessing participants to determine whether changes in food security and diet can be linked to shifts in microbiome, inflammatory markers and insulin resistance.

Tulsa CARES will also play an important role in sustaining the food intervention through its in-house food pantry and farmer’s markets that serve hundreds of people each year.

“This is an innovative opportunity for us because we’ll not only be contributing to the data about food for people with HIV, but we’ll be able to stock those foods in our pantry after the study is over,” Bakhsh said. “Whether our clients come to us on a long-term basis or for emergency food assistance, we will have confidence that the food has health benefits.”

Marianna Wetherill, Ph.D.

Food as medicine is a growing part of the educational programs and health services at the OU-Tulsa campus.

Wetherill, who is also a registered and licensed dietitian, co-leads the Culinary Medicine Program in which medical and physician assistant students learn the importance of good nutrition, both for themselves and the patients they will treat. Because of the interdisciplinary nature of her work, Wetherill holds faculty appointments in the OU-TU School of Community Medicine, the OU Hudson College of Public Health, the OU College of Allied Health, and the OU School of Social Work. Bakhsh, who earned her social work degree from OU, also serves as a field instructor for social work students.

“OU and Tulsa CARES already had a strong relationship, and we’re excited to work together on a project that will benefit the HIV community,” Wetherill said. “Because healthy food is often perceived as being more expensive than less-nutritious food, those who are marginalized in society are often excluded from the concept of food as medicine.

This grant is about changing that.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

33

OU -TU SCHOOL OF COMMUNIT Y MEDICINE TULSA

The vascular surgery team on the Tulsa campus, including Kelly Kempe, M.D., is increasing their efforts to decrease major amputations in Oklahoma.

Tulsa Launches Limb Preservation Clinic and Study to Decrease Amputations An OU Health vascular surgery team and a podiatrist in Tulsa have launched efforts to reduce the number of major amputations due to complications from diabetes and peripheral artery disease.

Oklahomans experience high rates of diabetes and peripheral artery disease, which are the primary non-traumatic contributors to leg amputation, said Kelly Kempe, M.D., whose work as a vascular surgeon is to help patients achieve the blood flow necessary to avoid an amputation.

Kempe, her vascular surgery partners and her new colleague, podiatrist Todd Hasenstein, DPM, are beginning a Limb Preservation Clinic in Tulsa. In addition, Kempe is collaborating with primary care physicians across Oklahoma to monitor patients who are at risk for amputation.

34

“Throughout the mid-South and South, there is a disproportionately high rate of major amputations,” Kempe said. “Too many people come to me with non-salvageable limbs, which means they have end-stage disease and there’s nothing I can do to help them avoid an amputation. But it doesn’t have to be this way. There is a lot we can do to screen and monitor patients who are at high risk for an amputation.”

Both diabetes and peripheral artery disease, by themselves or in combination, can lead to amputation. With diabetes, people can lose sensation in their feet, which puts them at risk for open wounds they don’t know they have, Kempe said. People without sensation in their feet also get calluses and pressure points that can turn into open wounds, allowing bacteria to enter and cause infection.

[ Fa l l / Wi n t e r 2 0 2 0 ]

OU -TU SCHOOL OF COMMUNIT Y MEDICINE TULSA

“Primary care physicians are on the front lines for patients with these longstanding diseases that can lead to a dramatic change in their overall health.”

If a patient must have a toe amputation, that puts them at much higher risk of a major amputation, which is defined as the leg, above or below the knee. “That’s why we recommend that people look at the bottom of their feet every day,” Kempe said. “If they’re unable to do that themselves, they can ask a family member or friend to check, or they can place a mirror at a 45-degree angle so they can see their feet.”

In peripheral artery disease – the same condition that causes heart attacks and strokes – the arteries to the legs become narrow or blocked. The more extensive the blockage, the less blood flow to the leg and foot. Patients with this disease also need to check their feet, Kempe said.

Much of the medical care for people with diabetes or peripheral artery disease is provided by primary care physicians across Oklahoma. That’s why Kempe is conducting a study that she hopes will shed light on how best practices may need to change for more effective monitoring of patients at risk. With grant funding from the Society for Vascular Surgery Foundation, she is surveying and interviewing primary care physicians around the state. She is conducting her work through the Oklahoma Primary Healthcare Improvement Cooperative (OPHIC), a program at the OU Health Sciences Center that disseminates evidence-based practices to primary care providers.

“Primary care physicians are on the front lines for patients with these longstanding diseases that can lead to a dramatic change in their overall health,” she said. “We want to get a feel for what barriers physicians face, and what helps them when their patients have at-risk limbs. We also need to know if they have trouble accessing specialty care. Based on what we learn, we want to make a difference for these patients, both in terms of prevention and if they have an urgent need.”

The new Limb Preservation Clinic is also a major step forward in preventing amputation. In addition to Kempe and her partners’ expertise in the vascular system, Hasenstein’s skills as a podiatrist are equally important for patients.

“Podiatrists look at different things than I do, such as foot deformities and calluses,” Kempe said. “For example, if a patient has a toe amputation, the podiatrist will know if there needs to be a tendon release. Then it’s my job to make sure the patient’s blood flow is as good as possible.”

Over time, the Limb Preservation Clinic plans to add more specialties to the clinic, including diabetes management and medication management.

Tulsa Physicians Publish Paper on Gap in Psychiatric Care for Children, Adolescents Four physicians with OU Health Physicians Tulsa have co-written a paper about often-untreated psychiatric disorders in children, published in the Journal of the Oklahoma State Medical Association.

The publication, Increasing Access to Child Psychiatrists for the Youth of Oklahoma through Outpatient Pediatric Psychiatry Consultation, cites the prevalence of psychiatric illnesses in children and adolescents and the shortage of specialists who provide pediatric psychiatric care.

Authors are OU-TU School of Community Medicine faculty members Andrew Liew, M.D., Assistant Professor of Child Psychiatry and Director of Medical Student Education, and George Kaiser Family Foundation Professorship in Community Medicine; and Heath Mueller, M.D., Assistant Professor and Oxley Foundation Chair in Child and Adolescent Psychiatry.

The collaboration included April Bowling, M.D., Medical Director of Pediatrics, OU Health Physicians Tulsa; and Hilary Redemann, D.O., Fellow, Child and Adolescent Psychiatry Program.

“Our research found 66 child and adolescent psychiatrists in Oklahoma currently serve nearly a million youth in the state under the age of 18,” Redemann said. “The impact is that prevalent conditions, including attention deficit hyperactivity disorder, depression and anxiety disorders, are not being treated at all in some cases or, at best, not being treated as effectively as they should.”

Based on a model of care developed at the University of Florida College of Medicine, members of child and adolescent psychiatry faculty at OU Health Physicians Tulsa saw opportunities to increase access to care through more direct collaboration with pediatricians at the OU Schusterman Pediatric Clinic. A natural partnership emerged in which pediatricians with OU Health Physicians Tulsa referred patients needing psychiatric evaluation and care to Schusterman Pediatric Clinic.

Given the stigma that may follow patients and families seeking psychiatric care, the familiarity of a traditional pediatric clinical setting is preferred by many. One of the goals of the clinic is to facilitate training in the management of psychiatric issues.

Pediatricians welcome opportunities to broaden their depth of expertise that enables them to provide more comprehensive and psychiatric-specific care.

“We see great promise in this model of collaborative pediatric/psychiatry care,” Redemann said. “In the face of such overwhelming need, we look at every innovation in care delivery as a part of the solution.”

[ Fa l l / Wi n t e r 2 0 2 0 ]

35

ALUMNI

Ryan Brown, M.D., was honored by Students Today, Alumni Tomorrow.

STAT Honors Pediatrics Faculty Member Each year, OU College of Medicine students who are members of STAT (Students Today, Alumni Tomorrow) choose a faculty member to honor during the annual Alumni Awards Program and Reception. Although COVID-19 led to the cancellation of the 2020 event, students still chose an award recipient: Ryan Brown, M.D., associate professor in the Department of Pediatrics and medical director of the Child Protection Team.

STAT Awards are presented to any alumnus who works as full-time, part-time or volunteer faculty at the OU College of Medicine, or to an alumnus who is a community practitioner involved in medical student education in some way. Recipients must fulfill two criteria: • An alumni physician who constantly acts as a role model for compassionate, sensitive and energetic patient care.

• An alumni physician who has demonstrated dedication to guidance, mentoring and stewardship of medical students’ careers.

In recognizing Brown, his students said: • “His passion for advocacy for child abuse and neglect is easily demonstrated as he speaks to students about the field. Dr. Brown is also a mentor. His constant encouragement gives students the confidence to pursue whatever goals they have.”

• “Dr. Brown is a thoughtful, confident physician who goes above and beyond to teach his students well.

He has taught me the importance of treating the whole patient. I hope to show my future patients the same level of respect, kindness and attention as does Dr. Brown.”

36

• “Even though Dr. Brown does not directly teach a course until fourth year, he makes a huge impact on his students in the little time he can spend with them.

He has a palpable passion for educating students about some of the darkest aspects of medicine. He engages with each student in a way where students genuinely feel that he cares about them. He is an advocate for his patients and for his students.”

Evening of Excellence to Resume in 2022 Because of COVID-19, the 2021 Evening of Excellence gala, normally held each January, has been canceled. However, the OU College of Medicine Alumni Association, which hosts the event, plans for the event to return in 2022.

Evening of Excellence, which has been held for 36 years, raises funds for researchers in the College of Medicine. The Alumni Association awards grants each year, mostly in the form of seed grants to early career researchers. The grants allow them to grow their research and gather data that they will then use to apply for larger federal grants.

Since Evening of Excellence began, it has raised $5.7 million, and the Alumni Association has awarded $3.6 million in research grants. For more information about the event, or to donate toward research, visit. medicine.ouhsc. edu/eoe.

[ Fa l l / Wi n t e r 2 0 2 0 ]

ALUMNI

Alumni Day 2020 Canceled; Celebration Planned for Fall 2021 Because of the COVID-19 pandemic, 2020 Alumni Reunion Day activities, originally scheduled for spring, were canceled.

However, the OU College of Medicine Alumni Association plans to combine both 2020 and 2021 activities during an event to be scheduled in fall 2021. An announcement will be made later as to whether activities will be held.

Both 2020 and 2021 class reunion celebrations will be celebrated. The 2020 reunions are those classes whose graduation year ends in a 5 or 0. The 2021 reunion years will end in a 6 and 1.

In addition, Alumni Day honorees from both 2020 and 2021 will be recognized next year. Nominations for the 2021 award winners are now being accepted and can be submitted by filling out the form at https://medicine.ouhsc.edu/Alumni-Friends/Alumni-Association/Alumni-Awards.

Robert N. Cooke, M.D.

The 2020 honorees are:

•

•

•

•

•

Robert N. Cooke, M.D., Class of 1980 – Physician of the Year Award in Private Practice Woody Jenkins, M.D., Class of 1990 – Physician of the Year Award in Private Practice Bonnie Miller, M.D., Class of 1980 – Physician of the Year in Academic Medicine Award George Thompson, M.D., Class of 1970 – Physician of the Year in Academic Medicine Award Hanna Saadah, M.D. – Friend of Medicine Award

Robert N. Cooke, M.D. Before he started medical school, Cooke attended law school for two years at Oklahoma City University. After earning his medical degree, he completed his general surgery residency at the OU Health Sciences Center. He was in private surgery practice in Oklahoma City from 1985 until 2017 and was affiliated with several hospitals, primarily Integris Baptist Medical Center.

Woody Jenkins, M.D.

Cooke is a member of the American College of Surgeons and served one year as president of the Oklahoma chapter of the American College of Surgeons. He is a member of the Oklahoma County Medical Society, serving on the board of directors for several years, and he is a member of the Oklahoma State Medical Association.

In 2013, he received the Gordon H. Deckert Community Service Award from the Oklahoma State Medical Association, an honor presented to physicians who make significant contributions to the medical community and demonstrate an ability to improve the overall health and well-being of Oklahomans.

Bonnie Miller, M.D. [ Fa l l / Wi n t e r 2 0 2 0 ]

37

ALUMNI

Bonnie Miller, M.D. Miller serves as Vice President for Educational Affairs and Professor of Medical Education and Administration at Vanderbilt University Medical Center. In her role, she promotes innovative approaches to continuing professional development and serves as an advisor for medical education.

George Thompson, M.D.

Previously, she served in several roles with the dean’s office at Vanderbilt University School of Medicine for 20 years.

During that time, she oversaw all programs related to physician education, from the medical school admissions process to continuing professional development, among other duties. With academic interests in the moral and professional development of physicians, curriculum change, and continuous learning in medicine, she is recognized as a senior leader in medical education.

Hanna Saadah, M.D.

Miller completed her post-graduate training in general surgery at Vanderbilt University Affiliated Hospitals, followed by a fellowship in hepato-biliary disease at the Virginia Mason Clinic in Seattle. She then returned to Nashville and eventually focused her clinical interests on patients with breast cancer.

George Thompson, M.D.

During Alumni Reunion Day, graduates typically return to campus for tours and lectures. Those activities were canceled during the COVID-19 pandemic, but organizers plan for them to return.

Woody G. Jenkins, M.D. After earning his medical degree, Jenkins continued his education at the OU Health Sciences Center with his internship and residency in internal medicine. From 1993 to 2013, he practiced at Warren Clinic in Stillwater, a division of the Saint Francis Health System. Since 2013, he has practiced at the Stillwater Medical Physicians Clinic, a division of Stillwater Medical Center.

Jenkins has served in several leadership roles at Stillwater Medical Center, including Chief of Medicine and Chief of Staff. He has been active with the Oklahoma State Medical Association, currently serving as co-chair of the OSMA Rural Section. He previously served as president of OSMA and chairman of its board of trustees. He currently serves as president of the Payne-Pawnee-Noble County Medical Society.

He has received several honors, including the Ed Calhoon, M.D. Leadership in Medicine Award from the Oklahoma State Medical Association, in recognition of his distinguished leadership and service to organized medicine. He was also awarded the Tim K. Smalley Leadership Award by the medical staff of Stillwater Medical Center for his outstanding leadership, professionalism, clinical expertise, friendship and mentorship.

38

Thompson currently serves as interim chief medical officer for Shriners Hospitals for Children. He is past director of Pediatric Orthopedics at Rainbow Babies and Children’s Hospital, University Hospitals Cleveland Medical Center, and Professor Emeritus of Orthopedic Surgery and Pediatrics at Case Western Reserve University in Cleveland, Ohio. He retired from surgical practice in January 2019 after spending his entire academic career in Cleveland.

He completed a surgical internship and orthopedic surgery residency at the University of California Los Angeles Medical Center. Following residency, he did a fellowship in pediatric orthopedic surgery at the Hospital for Sick Children in Toronto, Ontario, Canada. He was a major in the U.S. Air Force Medical Corps, performing general and orthopedic surgery from 1972-1974.

During his career, Thompson served as president of six orthopedic societies and organizations, and he was an author on more than 200 publications.

Hanna Saadah, M.D. Saadah earned his medical degree from the American University of Beirut and completed a residency in internal medicine and a fellowship in infectious diseases at the OU Health Sciences Center.

He joined the faculty of the OU College of Medicine in 1975 and initiated the Adolescent Medicine Program. He served as director of the program for two years and continues to serve as a volunteer faculty member. He practiced internal medicine at Mercy Hospital and is currently Emeritus Clinical Professor of Medicine in the OU College of Medicine.

Saadah is active in the Open Arms Clinic and the Good Shepherd Clinic in Oklahoma City, as well as his hometown’s free clinic in Lebanon.

[ Fa l l / Wi n t e r 2 0 2 0 ]

ALUMNI

Douglas Voth, M.D.

Former Dean Honored With Regents’ Award Former OU College of Medicine Executive Dean Douglas Voth, M.D., has been honored with a 2020 Regents’ Alumni Award from the University of Oklahoma.

of the College of Medicine, a position he held until 1996.

Regents’ Alumni Awards honor individuals, either alumni or friends of the university, who have generously given their time and services to OU. Recipients receive a plaque and have their names added to a permanent plaque in the Oklahoma Memorial Union on OU’s Norman campus.

On leave from the OU College of Medicine until 2001, he was Professor of Medicine and Dean at the United Arab Emirates University. He returned as Professor of Medicine at the OU College of Medicine in 2001, first serving as a director of the Office of Alumni and Development for the OU Health Sciences Center. In 2002, he was named Dean of the OU College of Pharmacy, a position he held until 2007.

Voth earned his medical degree from the University of Kansas School of Medicine, followed by a residency in internal medicine at Kansas University Medical Center. He undertook a three-year fellowship in infectious diseases at State University of New York, which was sponsored by the Centers for Disease Control and then the National Institutes of Health.

Since that time, he has been active in numerous programs and initiatives across the OU Health Sciences Center, notably interdisciplinary education, which involves students from all seven colleges, as well as the Anne and Henry Zarrow School of Social Work on the OU Norman campus. He has also been extensively involved with the Stewart Wolf Society.

He served as Professor and Chair of Medicine for 10 years on the Wichita campus for the KU School of Medicine, and arrived as Professor of Medicine at the OU College of Medicine in 1987. He was Professor and Acting Chair of the Department of Neurology in 1990, and in 1992 he was named Executive Dean

In 2005, he was honored with the Delp Award of Clinical Excellence by the Kansas Chapter of the American College of Physicians. In 2012, he was inducted into the Oklahoma Higher Education Hall of Fame. He has emeritus titles from OU including Dean, Regents’ Professor, and Professor of Medicine.

[ Fa l l / Wi n t e r 2 0 2 0 ]

39

University of Oklahoma College of Medicine P.O. Box 26901 Oklahoma City, OK 73126-0901

Faculty members, staff kneel for eight minutes and 46 seconds during the White Coats for Black LIves event.