Irene Davis, PhD, PT, FACSM, FAPTA, FASB, professor in the USF Health School of Physical Therapy and Rehabilitation Sciences, is trying to understand the intricate relationship between lower extremity mechanics and overuse injuries in runners. With a focus on transforming the way runners experience pain and preventing injury, Dr. Davis and her team are researching gait retraining for injury prevention. 

Subject crossing the force plate at a constant velocity to test the three-dimensional components of force being produced on their joints.

At the heart of their research is a force plate used at the center of an elongated runway. This allows individuals to simulate a complete running cycle, starting from acceleration, and crossing the force plate at a consistent velocity. The force plate captures not only vertical forces but also forces in all three dimensions, offering a clearer picture of the intricate nature of the forces exerted when landing. This three-dimensional analysis provides a comprehensive understanding of how alignment and mechanics contribute to the risk of injury.

Reflective markers attached to a subject’s body which supply data with a multi-dimensional perspective on joint movement. Essential for understanding the mechanics involved in running.

To access this data, the research team attaches reflective markers to the subjects’ bodies, which are then tracked by multiple cameras. These complex algorithms decipher the markers’ movements, enabling the researchers to see the angles at the ankle, knee, and hip joints. This approach supplies a multi-dimensional perspective on joint movement, essential for understanding the mechanics involved in running.

The integration of force plate data and marker tracking empowers the team to calculate joint loads and torques, giving a complete picture of the forces experienced by various joints during a runner’s gait cycle. This holistic approach enables Dr. Davis and her team to identify problematic mechanics and design interventions that could alleviate pain and reduce the risk of injury. 

By applying their findings, her team is pioneering an innovative approach to runner rehabilitation. Through a series of sessions involving real-time feedback and targeted practice, the research team has started receiving results. A notable example is a study focused on addressing knee pain, in which participants underwent a tailored gait retraining program. Participants experienced improvements in their alignment and mechanics, easing the persistent pain that they have dealt with for years. 

This groundbreaking research challenges the traditional notion that gait patterns are fixed and unalterable. By bridging the gap between scientific understanding and medical practice, Dr. Davis and her team have proven that gait retraining is not only possible but also effective in alleviating pain and preventing future injuries. The success of their interventions underscores the transformative potential of multidimensional biomechanical analysis in sports medicine. 

The researcher is analyzing data provided by the force plate.

In a field where innovation meets application, Dr. Davis and her team are revolutionizing the way we think about running mechanics and their impact on injuries. This has not only raised awareness but also instilled hope for countless runners who want to run free of pain. Dr. Davis hopes that science and medicine can work hand in hand to reshape runners’ lives.

“We hope our clinic and our research will offer injured runners a solution so they are able to continue to run pain-free,” Dr. Davis said. “We really have pioneered this idea of retraining gait patterns.”  

Story, photos, and video by Ryan Rossy.

The USF Health School of Physical Therapy and Rehabilitation Sciences (SPTRS) is taking strides to expand its research efforts and contribute significantly to the improvement of patient care and the advancement in the movement sciences, particularly in physical therapy and athletic training. With a vision to make lives better, the school is focused on internal and external collaborations, securing grants, and conducting research that addresses critical questions using scientific methods. 

Guided and supported by the school’s leadership, SPTRS faculty are committed to increasing their research footprint by attracting new faculty members, obtaining additional grants, and generating research with widespread implications. They aim to create a significant impact on patients, their families, and society, said Dave Russ, PT, PhD, associate professor and assistant director of research at SPTRS.

“Our primary goal is to produce research that goes beyond mere accreditation requirements,” Dr. Russ said. “We aspire to explore real questions and apply strong scientific methods to address them.” 

USF Health’s strategic location in the growing Tampa Bay region plays a pivotal role in SPTRS research pursuits. The area’s diverse population mirrors that of the entire United States. This provides a unique opportunity to collaborate with clinical partners, local hospitals, and the community, which enables the school to produce research findings that are generalizable and applicable to the broader U.S. population. 

“Our presence in Tampa Bay allows us to work closely with our clinical partners and the community to tackle diverse research topics,” said Doug Haladay, PT, DPT, PhD, MHS, professor and director of the USF Health School of Physical Therapy and Rehabilitation Sciences and associate dean of the USF Health Morsani College of Medicine. “Despite the variations in subject matter, we share one common vision… to make lives better.” 

The research produced by SPTRS faculty benefits patients directly and contributes to the advancement of the physical therapy and athletic training professions. Not only does their research advance the professions, but they are able to bring that research into the classroom for their students to ensure they are being taught contemporary practices and evidence. The school prides itself on its ability to have a collaborative environment, where interdisciplinary partnerships with different departments and colleges strengthen potential research projects and grant applications. The athletic training faculty have a strong partnership with USF Health Sports Medicine and Athletics and are continually working to share research findings and collaborate on best practices to support our USF athletes and teams.

Furthermore, the school is proud of its ability to secure research funding from many sources, ranging from local foundations to nationally funded initiatives, including the prestigious National Institutes of Health (NIH) and the Department of Defense (DOD). This diversified funding approach enables researchers to explore a wide array of topics and pursue programmatic research that can drive significant improvements in patient outcomes.

Research milestones at USF Health School of Physical Therapy and Rehabilitation Sciences: 

• Growth in Peer-Reviewed Publications: Over the last three years, the USF Health School of Physical Therapy and Rehabilitation Sciences has experienced a substantial 76% increase in peer-reviewed publications.
   
• Engagement in Professional Presentations: The school’s faculty members actively participate in more than 32 professional presentations annually, sharing their research findings with the wider academic and healthcare communities both nationally and internationally.
   

• Surging Research Expenditures: The school has experienced an impressive 33% increase in research expenditures from 2019 to 2023.
   
• Funding from DOD and NIH: Several projects have been awarded funding from esteemed organizations such as the Department of Defense (DOD) and the National Institutes of Health (NIH).  

As the USF Health School of Physical Therapy and Rehabilitation Sciences continues to expand its research endeavors, its focus on producing impactful, evidence-based research continues to contribute to the betterment of society striving for its vision of making lives better.

Story, photos, and video by Ryan Rossy.

People on cisplatin-based chemotherapy often suffer an unexpected side effect that can significantly compromise their quality of life, but new data could help improve their recovery, according to a study by USF Health researchers.

During treatment with this highly ototoxic drug, many patients experience hearing loss or tinnitus, but more specific input has been needed to address their needs, the Tampa-based team notes in the Journal of Clinical Oncology.

“The average person should care about this because lots of people who have cancer are on cisplatin,’’ said Victoria Sanchez, Au.D., Ph.D., the study’s lead author and assistant professor and chief of the Audiology Section in the Department of Otolaryngology at the USF Health Morsani College of Medicine. “Millions of people who are getting this medication can be affected with hearing loss.’’

Victoria Sanchez, Au.D., Ph.D.

Although previous studies have been published on the ototoxicity of cisplatin, patient-reported functional impairment had not been comprehensively evaluated. In the new study, USF Health researchers based their findings on feedback from patients who are or were on cisplatin.

This information could help doctors better predict side effects and improve treatment, said co-author Robert Frisina, Ph.D., a Distinguished University Professor and director of the USF Global Center for Hearing and Speech Research.

“Cisplatin also is used in childhood cancers, so you can imagine the impact this can have on their lives,’’ Dr. Frisina said. “Families would be interested in this research because these young adults and children would have to live with hearing loss and tinnitus for many years or for the rest of their lives … But we can’t treat this unless we understand all the mechanisms. Our hope is to one day prevent it altogether.’’

Specifically, testicular cancer survivors who were given cisplatin completed validated responses, including the Hearing Handicap Inventory for Adults and Tinnitus Primary Function Questionnaire. Associations between hearing loss or tinnitus and five pre-specified adverse health outcomes – cognitive dysfunction, fatigue, depression, anxiety, and overall health – were then evaluated.

The researchers concluded that one in three patients described “clinically significant functional impairment,’’ and that follow-up should include routine assessment and possible treatments for hearing loss and tinnitus by an audiologist.

“This is one of first reports where we included patient response,’’ Dr. Sanchez said, adding that hearing

Robert Frisina, Ph.D

health also is directly related to brain health.

However, many patients who suffer cisplatin-related hearing loss seldom change their behavior, even though hearing loss is the single largest modifiable risk factor for cognitive decline and dementia in the general population, the researchers said.

“Less than 10 percent of the people affected reported using hearing aids,’’ Dr. Sanchez said. “There are a lot of barriers to this, such as access and cost. And there’s the stigma some people have about wearing a hearing aid.’’

Cisplatin is used to manage and treat solid tumors and hematologic malignancies. While highly toxic, it is one of the most common chemotherapeutic agents used to treat cancer, either as a single-agent or combination therapy. Because of its success rate, it’s the preferred drug for testicular cancers, in addition to cancers of the bladder and ovaries.

But a drawback of such platinum-based drugs is the damage they can do to hearing. Cisplatin can leave between 40 to 80 percent of adults – and at least 50 percent of children – with “significant permanent hearing loss,’’ according to the National Institutes of Health.

Researchers aren’t certain on precisely why cisplatin invades the inner ear, while other organs in the body eliminate it within days or weeks. They do know that once in the ear, it usually does irreversible damage.

“Cisplatin is given to eliminate the cancer tumor, but for reasons not completely understood it goes into the inner ear and kills cells in the cochlea and does it through several mechanisms, such as inflammation, programmed cell death, or overproduction of reactive oxygen species (ROS),’’ Dr. Frisina said.

“It can kill hearing cells and they don’t grow back … So, one implication of our paper is people who have cancer-related hearing loss and tinnitus should seek treatment.’’

— By Kurt Loft for USF Health News 

A unique scientific collaboration that could offer an innovative potential treatment for atrial fibrillation has blossomed within USF Health, thanks to a chance encounter in a hallway, a plain green chalkboard and a most surprising star: the European honeybee.

It represents a convergence of two distinctly different medical mindsets – pharmacology and immunology – and a blend of high-tech bio-engineering with an old-school writing surface. And then there’s the bee, which has pollinated the process in an exciting and novel way.

The result is a newly published paper in the Proceedings of the National Academy of Sciences that details efforts to develop a non-invasive treatment for atrial fibrillation (also referred to as AFIB or AF) by blocking a potassium channel that can go rogue within the heart, leading to a dangerous, irregular and fast rhythm in the atria, the heart’s upper chambers, increasing the risk of blood clots that can travel to the brain and cause a stroke.

The material to create this blocker  is a small peptide that has been successfully tested in mice and sheep.

“This peptide was originally isolated in the past from the European honeybee’s venom,” said Sami Noujaim, Ph.D., associate professor in Molecular Pharmacy & Physiology and senior author of the eight-person study that includes lead investigator Bojjibabu Chidipi, Ph.D., a researcher in the USF Health Morsani College of Medicine. “We have demonstrated in tests on small animals that it can block this rogue potassium channel. And by blocking this channel, it was able to eliminate atrial fibrillation.”

That research might well have never progressed to this point had it not been for a pair of fortuitously situated offices. Co-author Michael Teng, Ph.D., an associate professor in the Division of Allergy and Immunology in the College of Medicine, works in an office adjacent to the one occupied by Dr. Noujaim – in spite of their divergent fields.

Micheal Teng, PhD, (left) and Sami Noujaim, PhD, have collaborated to study whether a bioengineered peptibody could help treat atrial fibrillation.

“I work in viruses, a completely different area than Sami’s,” said Dr. Teng. “But there’s this green chalkboard hanging on the wall outside our offices – I can see it right now from my desk, in fact. You’d think, ‘Let’s take it down, nobody uses chalkboards anymore.’ But Sami loves this chalkboard. So, we’re neighbors and we talk to each other. And one day, prior to the pandemic, he was trying to figure out a problem.”

Here’s how Dr. Noujaim remembers it unfolding: “I was at the board with Bojji and other members of the lab. We drew the potassium channel on the board. And I was telling them that the drugs currently available for AF are small molecules and have side effects. What if we’re able to actually design our own blocker? And instead of that blocker being a small molecule, what if it was a protein? Because we can design and generate proteins.”

At that moment, Dr. Teng was passing by the group in the hallway en route to his office.

“I go, ‘Hey Mike, I know that in immunology there are ways people have been engineering proteins – can we do this here?’ “ Dr. Noujaim recalled. “Mike said, ‘Absolutely,’ and that’s where things took off.”

Electrical activity is generated by the heart via ion channels of sodium and potassium. They work like resistors and can conduct current. Atrial fibrillation occurs, in part, when a specific type of potassium channel in the heart goes out of whack, and starts passing potassium when it should not.

Bojjibabu Chidipi, PhD, (left) talks with Sami Noujaim, PhD, about how a bioengineered peptibody could help treat atrial fibrillation.

“This is where the problem occurs,” Dr. Chidipi said. “Instead of contracting and emptying the blood vessels into the ventricles, and the ventricles contracting and ejecting blood into the circulation, these atria cannot contract because of the atrial fibrillation caused by the rogue potassium current. They just sit there and quiver.”

“When that happens, they cannot completely empty the blood,” Dr. Noujaim added. “And blood does not like to stay stagnant. So there’s a high probability of forming a clot in the atrial chamber. At some point that clot can launch into the circulation and reach the brain, causing a stroke.”

One common form of treatment is to put a person with AFIB on blood thinners.  Pharmaceuticals are also utilized to restore normal sinus rhythm of the heart. A more invasive step is called ablation, a procedure in which the trouble spots in the atria are located and corrected via catheters inserted through the groin and advanced to the atria.

“The problem is that there is a high chance the AF will return at some point,” Dr. Noujaim said. “Another alternative is medication. But the problems with the existing medications are two-fold: One, they are not very effective, and two, they may cause other types of arrhythmia. And that is where we came in. We asked ourselves, ‘What would be the best way to restore the normal sinus rhythm with a pharmaceutical, without having other side effects on the heart?’”

Several members of Dr. Sami Noujaim’s team collaborated on the peptibody research. Pictured (l-r) are Bojjibabu Chidipi, PhD, Dr. Noujaim, Obada Abou-Assali, MS, and Mengmeng Chang, MD, PhD.

Now back to the green chalkboard. The challenge was that the very small peptide, called tertiapin, comprised of 21 amino acids from honeybee venom, doesn’t last long enough to be effective as a blocking agent. It is very short-lived when exposed to air. That led previously to the creation of a synthetic oxidation-resistant version called tertiapinQ. This is what Dr. Noujaim and his team would rely upon in their testing.

But there was still a problem with these peptides breaking down too quickly in the body, whether injected or taken as a pill. So they wondered: Could this peptide be fused with an antibody fragment and give it longer-lasting life to combat AFIB?

“We talked it through and drew on the board for about 15-20 minutes,” Dr. Teng said. “And we came up with this idea of attaching that little peptide onto the stem of an antibody.”

The stem could be hooked onto the peptide, forming a “peptibody.” That concept has been utilized before, but not for treating atrial fibrillation. With this new peptibody AFIB application, a drug could remain in the bloodstream for longer periods of time without breaking down.

“That way you will have a sustained effect of the therapeutics,” Dr. Noujaim said. “Now we have a formulation that does not need to be administered daily– it could be every week or every month. We’re excited to have received a patent for this as well as a nice grant from the National Institutes of Health.”

“So far, there are two peptibodies approved by the FDA and available in the market to treat low blood platelet counts, and for glucose control in type 2 diabetes” Dr. Chidipi added. “We are the first to demonstrate that bioengineered peptibodies could potentially treat cardiac arrhythmia.”

Meanwhile, new collaborators are on board at a cardiovascular center in Spain to work with USF Health in testing it further..

It took collaboration with a bee and a board at USF Health to make it all possible.

— Story by Dave Scheiber for USF Health News; photos by Allison Long, USF Health News.

This year’s USF Health Research Day set new records as more participants than ever filled the USF Tampa campus Marshall Student Center on March 3 to showcase the best of their scientific work.

The 33^rd USF Health Research Day included 457 research poster presentations by students, postdocs, residents, faculty, and staff across all health disciplines. Research Day is the largest research-oriented event of its kind at USF and remains the largest celebration of health sciences research collaboration across all four USF Health colleges (medicine, nursing, public health and pharmacy) as well as with colleagues in other USF colleges, including social work and engineering.

From left, Dr. Charles Lockwood, Dr. Kim Orth, Rhea Law, and Dr. Steve Liggett.

Research Day kicked off with the Annual Roy H. Behnke, MD, Distinguished Lectureship featuring speaker Kim Orth, PhD, professor of Molecular Biology and Biochemistry at University of Texas Southwestern Medical Center and an investigator at the Howard Hughes Medical Institute, at UT Southwestern Medical Center.

Dr. Orth’s presentation was titled “Black Spot, Black Death, Black Pearl: Tales of Bacterial Effectors” – click here for more about Dr. Orth and her work.

Dr. Kim Orth.

* * *

Tampa General Hospital, the primary teaching hospital for USF Health Morsani College of Medicine, was the presenting sponsor for USF Health Research Day 2023.

Following Dr. Orth’s presentation was the judging of work. Judges reviewed the posters that lined the Marshall Center Ballroom, asking the students for more detail and clarifications about their research projects. Presentations ranged from pilot, preliminary, empirical and case studies to system reviews and reviews of literature or charts.

Following the 13^th Annual Joseph Krzanowski Invited Oral Presenters by select students representing medicine, nursing, public health, and pharmacy, Research Day culminated with an Awards Ceremony in the Oval Theatre announcing the winners in 29 competitive categories – including 18 monetary awards totaling $8,600.

* * *

For the list of Research Day 2023 award winners, click here.

For the list of Research Day judges and sponsors, click here.

More photos

Photos by Freddie Coleman, video by Allison Long, USF Health Communications

Kim Orth, PhD, paused in mid-Zoom to reach for a plaque behind her that contains words to live – and practice science – by.

The distinguished biochemist and microbiologist from the University of Texas Southwestern Medical Center earned the award in 2003 from the Beckman Institute as a junior investigator and assistant professor. And it contains a quote from late chemist and inventor Dr. Arnold O. Beckman that she embraces to this day.

“It reads, ‘Everything in moderation, including moderation itself,’ ” said Dr. Orth, the keynote speaker Friday at USF Health Research Day. “You really need to have a balance.”

That philosophy has served the heralded professor of microbiology and biochemistry well in her career. As an Investigator for the Howard Hughes Medical Institute. Dr. Orth runs the Orth Lab, is a W.W. Caruth Jr. Scholar in Biomedical Research and holds the Earl A. Forsythe Chair in Biomedical Science. Her many honors over the past 20 years include a place on the Celebrating Women Wall at the UT Southwestern Medical Center (2022), being named an American Society of Microbiology Distinguished Lecturer (2021-23), and a Merck Award in 2018. In 2020, Dr. Orth also was elected as a member of the National Academy of Sciences, one of the highest honors that a scientist can receive.

But early on, Dr. Orth learned about the need for moderation, and balance, the hard way when she began graduate school at UCLA. She was equipped with a Bachelor of Science degree in biochemistry from Texas A&M and big dreams to chart her own path – much to the consternation of her family back home in the Lone Star State.

Unfortunately, she found herself unprepared for the culture shock of life in Los Angeles, and despite her success in labs working with fruit flies, Dr. Orth pushed herself past her limits. Wanting to enhance her graduate-student income, she took a second job working the night shift in a dorm. In short order, she found herself mentally and physically burned out – and dropping out of school altogether.

She returned home and went to work as a secretary for her father, who had not been keen on his daughter’s scientific pursuits – as she chronicled in a 2018 personal essay about her life and career challenges in the Journal of Biological Chemistry.  It is a story she tells to give inspiration – and hope – to young scientists.

“When I went to graduate school at UCLA, I didn’t have any tools,” she explained during a recent interview. “I didn’t know you were supposed to sleep so many hours a night, and nobody was telling me these kinds of things – like ‘Make sure you eat and exercise and get your sleep.’ So you go out there gung ho and don’t have any of these checks and balances in your brain. At the time, there was no Internet. And there wasn’t anybody telling me, ‘You need to be responsible and do these things.’ ”

Of course, Dr. Orth eventually found success by striking a healthy balance and not entirely allowing moderation to guide her at all times. While learning to take better her of herself, she re-set her sights and pushed hard to excel, leaving her secretary job to work as a Howard Hughes Medical Institute technician with a solid salary at the Protein Chemistry Core, UT Southwestern Medical Center.

It was the first step in what became a prestigious lab career, which saw her earn a PhD, marry a loving and supportive fellow scientist, Ron Taussig, complete four post-doctoral research projects while becoming pregnant and giving birth to the couple’s two children, and learning how to balance science and motherhood.

As she wrote in her essay, “I fortunately had the opportunity to spend time with other women scientists, some of them moms, during a once-a-month ‘ladies’ lunch. This was not only a very valuable ‘tool’ for my sanity, but I learned about many practical tools that helped to make ‘things’ work. Throughout my career, I continue to interact with other female colleagues on regular bases for many of these same practical reasons. All in all, my scientific productivity did not suffer as a working mom, but my efficiency did increase.”

There is far more to Dr. Orth’s story and fascinating research. But one example of that research offers a window onto the balance theme.

“I’m a biochemist by training and so I basically try to understand how, at the molecular level, bacterial pathogens are talking to our host cells and basically manipulating them,” she explained. “But what happened was we uncovered a new way for molecules to manipulate each other. We realized that a particular enzyme wasn’t only found in bacteria but also animals.”

Wondering what effect it had in animals, Dr. Orth and her colleagues studied the enzyme in flies. What they learned was that the cells one has for a lifetime are forced to recover after undergoing stress. “We found that if we got rid of a gene in flies, their eyes could not recover normally,” she said.

Next they experimented on mice. Removing the gene made it impossible for them to recover from stress.

“So we’ve uncovered this mechanism that’s like a rheostat,” she said. “It allows us to deal with daily stresses all the time. These cells that we use our whole live in our brain, our eyes, our heart muscles, whatever, they have to have the resilience to handle the daily stresses and then recover.

“If you don’t have this ‘rheostat’ mechanism, it appears that you can’t recover as well. What I can tell you is that when the cells in your body get hyper-stressed, they shut everything down. And to recover, they have to rebuild all of those things that were there before. This mechanism allows you to have a buffer, so everything isn’t shut down.”

That would take a toll on a body over a lifetime. It’s another reminder that moderation and balance are far preferable – even when it comes to cells.

Dr. Kim Orth, Professor of Molecular Biology and Biochemistry at UT Southwestern Medical Center, will deliver the Roy H. Behnke Keynote Address at #USFHealth Research Day on Friday, March 3 at 9:00 a.m. in the USF Marshall Student Center Student Oval Theater.

— By Dave Scheiber for USF Health News 

By Charles J. Lockwood, MD, MHCM
Executive Vice President, USF Health
Dean, USF Health Morsani College of Medicine

I hope you all had a peaceful and relaxing holiday break and enjoyed time with your family and friends. I also hope we are all ready to embark on a new year energized and ready to tackle educational challenges, make scientific discoveries, and continue to offer the best health care and public health leadership in Florida.

As we go forward at USF Health as health science colleges, we do so with a common spirit: one in which we are passionate about scientific inquiry and an unwavering pursuit of truth. At their heart, this is what great universities do, and it’s a charge that we should take very seriously.

Unfortunately, attacking truth has become quite fashionable of late. Disseminating misinformation, spreading baseless conspiracy theories, and drawing anti-scientific conclusions from anecdotes – sometimes sincerely, but often to expediently score political points — has become numbingly routine. Conversely, we see an equally harmful effort to suppress uncomfortable dialogue, to cancel civil discourse, and to self-righteously refuse to acknowledge different perspectives. We frequently see this as a tendency to censure or silence those who may not conform to the latest fad in virtue signaling.

However, the pursuit of truth demands skepticism, curiosity, objective assembly of facts, generation of hypotheses and their rigorous debate. For half a millennium, nowhere has this formula for human progress been more effectively and consistently practiced than in universities. Since modern universities should be the sentinels of truth, it falls to them to combat the twin threats of disinformation and censorship. Peter Salovey, president of Yale University, made this point in an address to students this fall, saying:

“For our part, colleges and universities must combat the spread of misinformation, propaganda, and conjured conspiracy theories first by supporting faculty; they generate scientific data and scholarly insight. Faculty must be free to disseminate knowledge and teach you to think critically about ideas and their sources. …But to do so effectively, our institutions of higher education—faculty and students—must be open to engaging with diverse ideas, whether conventional or unconventional, of the left or of the right.”  

Ben Sasse, the new president of the University of Florida, also underscored the importance of civil discourse and debate when he addressed the Florida Board of Governors during the Trustee Summit held here at USF Health in November, saying:

“At a university, we enter in, in a way and with a posture that is humble enough to say, ‘We’re here to have dialogue with people who don’t always share our beliefs and we don’t share their beliefs,’ and that’s not a bad thing, that’s a good thing – that we don’t all have the same starting assumptions and ultimate conclusions… We are here at a place like this – at our institutions, precisely to argue and debate.”

That is why we must vigorously resist the idea that students should be sheltered from ideas with which they disagree. As Greg Lukianoff and Jonathan Haidt write in The Coddling of the American Mind:

“The notion that a university should protect all of its students from ideas that some of them find offensive is a repudiation of the legacy of Socrates, who described himself as the ‘gadfly’ of the Athenian people. He thought it was his job to sting, to disturb, to question, and thereby to provoke his fellow Athenians to think through their current beliefs, and change the ones they could not defend.”  

For our USF Health colleges, the pursuit of truth is even more important – because when we act on misinformation or suppress critical data, patients can die. The truths we seek directly impact people’s lives and health. For us the stakes could not be higher. So we must pursue truth with determination and rigor, through an empirical, logical and deeply rational interrogation of data. This is the very foundation for evidence-based clinical care and effective public health policy.

I’m happy to say that we have a rich history of this kind of inquiry at USF Health. This is reflected in our record-breaking rise in research rankings and our annual celebration of trainee scientific inquiry at Research Day. But it is also found in our matchless record of high-quality patient care and trusted public health leadership during the pandemic. It is in this spirit, that I welcome all of you back for another semester of growth and exploration – and hope that continuing the pursuit of truth will be our most noble New Year’s resolution.

It is a part of the heart that most people have never pondered, let alone heard of, in their lives. But the left atrial appendage – a physical trait that all humans share – is worth knowing about because it is involved in the vast majority of strokes. Now, a prestigious new grant obtained by a team from the USF Health Morsani College of Medicine and Tampa General Hospital could significantly enhance preventive treatments.

Thanks to the innovative work of Dr. Hiram Bezerra, professor at the USF Health Morsani College of Medicine and director of the TGH Interventional Cardiology Center of Excellence, the $460,000 grant could lead to key improvements of an existing procedure to block the opening to the left atrial appendage (LAA) in certain patients who are at high risk for stroke. And it ultimately could deliver safer, faster, and more effective results for patients.

This marks the first time a National Institutes of Health R01 grant – designed to support advanced, hypothesis-driven research projects with strong preliminary data – has been awarded to USF Health’s Division of Cardiology Sciences in the Morsani College of Medicine.

“I think this is reflective of the journey we are on to become a national presence in the forefront of cardiology,” said Dr. Guilherme Oliveira, chief of the division and Ed C. Wright Professor and Chair of Cardiovascular Research, as well as co-director of the USF Heart Institute for Research. Dr. Oliveira also is vice president and chief of the Tampa General Hospital Heart & Vascular Institute.

“This has never been done here before – the ability to get an R01 grant for our division that basically is developing a new technology – with potential clinical applications going all the way from basic pre-clinical engineering of an innovation and taking it all the way to the bedside,” said Dr. Oliveira. “And I think it’s very telling of where we are with the type of talent we’ve been able to attract to USF and Tampa General.”

In this case, the grant, three years in the works, will allow Dr. Bezerra and his team to produce a better, more streamlined approach for dealing with the left atrial appendage – an area in the heart’s left atrium akin to a little pocket. While the structure may help lower pressure in the atrium, it also is possible for blood to pool there in patients with atrial fibrillation, a type of irregular heartbeat, and raises the risk of a clot that could travel to the brain.

“The actual magical aspect of it, and what we are trying to achieve, is a therapy that is offered for stroke prevention,” said Dr. Bezerra. “More than 90 percent of strokes originate from the left atrial appendage chamber. And by occluding the left atrial appendage, you will prevent a stroke in a population prone to have one – the atrial fibrillation, or AFib, population.”

Those suffering from AFib experience an array of symptoms that include an irregular heartbeat, a racing heart, shortness of breath, fatigue and chest pain. People with the condition are some five times more likely to suffer a stroke than those without it – with some 12 million in the U.S. estimated to have AFib by 2030.

“The patients we are targeting have AFib and for some reasons are not a good candidate for the standard preventive therapy of blood thinners,” Dr. Bezerra added. “The next treatment in line is occluding the left atrial appendage. And we are talking about hundreds of thousands of patients in the United States.”

The primary device in the U.S. used to block the left atrial appendage is called the Watchman, manufactured by Boston Scientific, with some doctors employing the Amplatzer Amulet heart device from Abbott. In the current protocol, a patient typically receives a transesophageal echocardiogram two weeks ahead of the procedure to examine the structure and functioning of the heart and evaluate the size of the appendage.

This allows doctors to plan the procedure and select the device. Patients commonly receive general anesthesia for the procedure, which again involves a transesophageal echocardiogram as a real-time guide. In most cases, patients return home the next day.

“But we are pushing to implement a workflow that is less resource intense, and that we believe is actually safer to do,” Bezerra said.

The grant proposed that patients will not have to undergo general anesthesia for the procedure, and a single cardiac MRI would be employed, allowing a patient to just come in once and not have to undergo a separate pre-imaging appointment. The scanner on the day of the procedure would perform the sizing to determine the best device to use. And it would also allow for improved visibility in real-time guidance during the procedure – providing live, higher-resolution images than the current method affords.

“It will all be done with a single modality,” Dr. Bezerra explained. “In addition, the patient is awake. There is no additional cost of the intracardiac echo, or the inconvenience of general anesthesia. And it increases the chances of a patient to go home the same day.”

Dr. Bezerra wrote the grant to be tied specifically to the Watchman because it is more frequently used. But ultimately, replicating the procedure on a different device would not be difficult to achieve. The grant includes a pre-clinical stage at Cleveland’s Case Western University followed by a clinical phase at USF Health and Tampa General. He estimates that it could be available for use on USF Health patients at TGH in three years.

“The plan is for me now to make a few trips to Cleveland, when it’s time for the animal experiments and to help facilitate that,” Dr. Bezerra said. “The next step will be testing for MRI compatibility and starting basic engineering work. A lot of bench and pre-clinical work still needs to take place before we can offer it to patients.”

Dr. Oliveira put it in perspective: “This is the holy grail of grants – where you go, as I said, from a bench concept and have a grant that will support the development of that product all the way to the bedside. It is not easy to do outside of the industry.”

The research also will be a natural fit for work that other physicians, such as Dr. Bibhu Mohanty, already are doing at USF and TGH to advance stroke care, Dr. Bezerra said. Dr. Mohanty, an associate professor in Internal Medicine at the College of Medicine, is an interventional cardiology specialist.

“This grant will complement our very active multidisciplinary neurocardiac program led by Dr. Mohanty in close collaboration with Neurology and Electrophysiology,” Dr. Bezerra said. “With the addition of this translation grant, USF/TGH will continue to be on the very cutting edge of stroke prevention.”

Story by Dave Scheiber for USF Health News.

USF Connect – Student Innovation Incubator Orientation.

Two students in the USF Health Taneja College of Pharmacy (TCOP) launched a company that may have the newest innovation in diagnosing Alzheimer’s disease, and their work opened the way for acceptance to USF Connect, the university’s premier technology and design incubator.  

TCOP pharmaceutical doctoral students Siegrid Pregartner and Laura Borgerding founded Janus AI (Artificial Intelligence), which designed a tool that aims to aid in the early detection of Alzheimer’s using AI technology.

The goal of their company is to give patients with Alzheimer’s disease the opportunity to take control of their lives and make the best healthcare decisions they can before the disease progresses too far.

“There are treatments coming out every single month for Alzheimer’s disease and the amount of money for research increases every single year but, we still do not have a way to know who does and who does not have the disease before symptom onset. Our tool will be able to diagnose patients for when more effective treatments come out to give people extra years to their lives when they are comfortable and in control,” said Pregartner.

USF Connect – The Business Incubator Program.

Recently, their health care startup company won first place and $15,000 at the Florida Blue Health Innovative Challenge, and has been accepted into USF Connects cohort.

“Winning the challenge will not only help us to develop our business but, also it made us realize that this could be a genuine business that could change lives,” Pregartner said.

Students who join a cohort through the USF Connect Incubator will be able to gain access to an abundance of resources such as business experts, legal, and investors. That will assist them in growing their business, concept, and product.

“USF Connect is going to help build a cohesive model and connect us with mentors that will help us with the implementation of our prototype and how to move forward as a business,” Borgerding said.

By utilizing their artificial intelligence tool, they could also contribute to further research and prove that certain drugs have a preventative effect on Alzheimer’s.

“Having the dean and our professors support us from the start at The USF Health Taneja College of Pharmacy, has been more than them just doing their job… that is them caring about our future and I think that has been the most important factor in our success,” Borgerding said.

(Left to right): Siegrid Pregartner and Laura Borgerding

Story and photos by Ryan Rossy, USF Health Communications and Marketing 

After more than a decade interviewing and admitting students based on their levels of emotional intelligence, Joann Farrell Quinn, PhD, MBA, has learned that many times the best students are those who show a high level of interest in developing stronger emotional intelligence.

Before the official first day for newest class of medical students, the USF Health Morsani College of Medicine hosts a one-week orientation for students in the program called  SELECT (Scholarly Excellence, Leadership Experiences, Collaborative Training).  SELECT students are admitted based on intellectual perspective, empathy, creativity, and passion to drive change in healthcare.  This group will spend their first two-years in Tampa, and finish medical school, professional development and leadership training at Lehigh Valley Health Network in Allentown, Penn.

Dr. Quinn, associate professor in the Morsani College of Medicine and director of the SELECT Competency Assessment, has been part of the program since 2015 and has interviewed more than 60 students eager to take a coveted seat in an incoming class for USF Health’s medical school. The SELECT program prepares students to be physician leaders who can accelerate change in health care.  The program was built on the principle that students with high emotional intelligence are more likely to develop the skills needed to transform health care and improve the health of communities.   Such students tend to be more engaging, compassionate physicians who will connect deeply with their patients and their families and be more effective as team members and team leaders.

Joann Farrell Quinn, PhD, MBA, USF Health Morsani College of Medicine associate professor and director of the SELECT Competency Assessment.

Dr. Quinn is a nationally recognized expert in emotional intelligence and her team at MCOM uses a common assessment tool developed by Daniel Goleman, world-renowned journalist, psychiatrist and author, to measure the emotional intelligence of candidates.  She said the school uses this model because candidates are evaluated on whether they believe in what they do or say.

Emotional intelligence includes everything outside of cognitive intelligence. Cognitive intelligence is knowledge developed from existing information.   Emotional intelligence refers to a person’s ability to manage their own emotions and understands the emotions of others.  According to Dr. Quinn, strong emotionally intelligent people will be more successful in leadership roles.

“Effective leaders can’t only develop professionally; they must also develop personally,” Dr. Quinn said.  “Leadership is truly a framework of your own social and emotional competencies.  You’re only as good as your understanding of what’s happening with yourself and others, your ability to manage yourself and your relationships.”

During the interview process for the SELECT program, prospective students are essentially asked to describe two scenarios: A time when they felt effective as a team member or leader, and a time when they didn’t.  This gives evaluators the opportunity to hear about what they said and did in various situations, often alluding to their competencies.   She understands that students come from a wide array of backgrounds and experiences.  However, she doesn’t whole-heartedly believe the best students are the ones who already display a high level of emotional intelligence.  She believes some of the best students are those who show a high level of interest in developing stronger emotional intelligence.

No other allopathic medical school in the country has a program like USF Health’s SELECT program. About 24 schools have leadership education and development training for medical students, Quinn explained.  Medical school curriculum leaders at MCOM collaborate regularly with other colleges to share ideas and best practices on how to deliver effective leadership development across all four years of medical school.  The goal is to continue to train and graduate more doctors with strong academic, social, and emotional competencies to drive change in the country’s health care system.

“This is a small number of schools and there’s a lot of work that still needs to be done,” she said. “We haven’t really explored what ‘leadership’ truly is as it pertains to physicians in leadership roles.  Leaders of medical schools must buy in to the concept of physician leadership training if we’re going affect positive change in the health care system.”

Photos below are from Prologue 2 and Summer Immersion. Prologue 2 is part of an orientation for first-year SELECT students.  Summer Immersion allows students to create an individualized learning experience that focuses on an area of the student’s interest and builds upon he basic principles of safety, quality, patient-centered care, and leadership.  The course takes place between the first and second year in Tampa, Lehigh Valley, other places in the country or internationally.  The experience results in a scholarly product that is shared with peers and faculty upon return to campus.  First-year medical students listened and learned from second-year students and they presented their scholarly work and spoke about their experience with SELECT.