School of Medicine Newsletter

Volume 4

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May 2012

Celebrating (and Connecting) Us

There was a time when the place was smaller, the pace was slower, and it was easier to connect with colleagues across the School of Medicine. When there was more opportunity to interact with people from other departments, to hear about their interests and to share ideas.  But we’ve grown to be a very large faculty – 25% bigger now than we were when I arrived at Duke almost five years ago. And it feels like everyone is very busy, all the time.
 
Our recent Clinical Science Day was an opportunity to bring together faculty and trainees from many departments, to share exciting science and, importantly, to celebrate us. As you will read, the breadth and quality of the talks and posters was extremely impressive. It was exciting to see new collaborations form on the spot, and to find unexpected links between seemingly disparate research efforts. We have a community of extraordinary people, and academic assets that very few institutions can match. Being reminded of that was well worth a Saturday morning. 
 
We will celebrate us again at the beginning of May, when we gather for our Annual Faculty Dinner. This has become a wonderful occasion to catch up with colleagues and to formally honor outstanding teachers and mentors with special awards. I hope to see you there. 
 
With warm wishes,
Nancy

First Clinical Science Day Is Forum for Collaboration

Attendees at Duke University School of Medicine’s inaugural Clinical Science Day 2012 enjoyed a rare opportunity to receive continuing medical education credit while learning about the vast array of clinical research going on across the medical campus. They also saw, firsthand, the potential such a forum presents for future interdisciplinary collaborations.

“This was about creating synergism across departments and across investigators,” explained Theodore Pappas, M.D., Vice Dean for Medical Affairs, and co-moderator of the March 3 event. “We hope people can learn from one another and possibly develop projects that would not have been created otherwise.”
 
According to Dean Nancy C. Andrews, M.D., Ph.D., “We need opportunities like Clinical Science Day because they invite us out of our labs and clinics to discover what is going on across this diverse, academic medical center. The collaborations that have resulted from Basic Science Day prove these events serve an important purpose.”
 
Department chairs, vice chairs of research, and professors representing each of the School’s 13 clinical departments offered synopses of their work and recent achievements. The presentations were often followed by short, engaging Q&A sessions.
 
“I liked the dialogue,” said Mark Stacy, M.D., Vice Chair for Clinical Research, who co-moderated the event with Pappas. “I liked that we talked about research and accomplishments. So often we don’t talk about accomplishments; we talk about process. My job is to make the process work better but it’s fun to see the validation of the work we do.”
 
Residents and fellows competed in a poster contest, which participants, like psychiatry resident Thadeus Koontz, M.D., described as a beneficial experience. “I received excellent suggestions for new applications of our deep sequencing and pathogen detection bioinformatic pipeline. I was also approached by a gentleman interested in collaborating with us on bioinformatics for which we have a desperate need.”
 
The posters were judged by Pappas, Stacy, Robert Harrington, M.D., Director of the Duke Clinical Research Institute and Mark Dewhirst, D.V.M., Ph.D., Associate Dean for Faculty Mentoring. The winner of the best poster was neurosurgery resident Shahid Nimjee, M.D.
 
Poster runners up were medicine residents Callie Coombs, M.D. and Ann Marie Navar-Boggan, M.D. 
 
Shannon O’Connor, a third year M.D./Ph.D. student, said she enjoyed viewing the posters, as well as the chance to be re-exposed to the clinical side of medicine. “I appreciated hearing people exchange ideas between departments, and learn about new ways people can help each other.”
 
Koontz agreed. “The cross pollination of ideas was wonderful, but I truly appreciate that those of us passionate about research are able to share our passion more broadly, and be recognized by the Duke community. To me, this culture of curiosity and continuous improvement of the clinical sciences is what sets Duke apart.”

Duke Research Named Twice Among Top 10 Clinical Research

 Two members of the Duke School of Medicine faculty were selected to receive the inaugural Clinical Research Forum Top 10 Research Achievement Awards. 

The projects spearheaded by Christopher Granger, M.D., professor of medicine in the division of cardiology, and Vance Fowler, M.D., associate professor of medicine in the division of infectious disease, were considered by the nonprofit organization to be among the best and most compelling examples of scientific innovation that can benefit human health and welfare. They were sited for their extensive collaboration, and viewed as remarkable for their bold approaches, innovation and potential for alleviating human suffering.
 
Granger was the lead author of a paper published in The New England Journal of Medicine, which compared a new anticoagulant drug called apixaban to the standard drug, warfarin, used in patients with atrial fibrillation, which affects more than 2.6 million Americans. “These are important findings because they show that, when compared to warfarin, a very effective treatment to prevent stroke, apixaban resulted in an additional 21 percent relative reduction in stroke or systemic embolism. There is an enormous unmet need for treatment of patients at risk for stroke associated with atrial fibrillation,” he added. “Only about half of patients who should be treated are being treated. The disparity exists because warfarin treatment has several limitations.”
 
Fowler’s research suggests that some patients develop a potentially deadly blood infection from their implanted cardiac devices because bacterial cells in their bodies have gene mutations that allow them to stick to the devices. "I would expect the findings would be relevant for most implanted devices. Getting to the fundamental answers of common, serious infections that plague our patients is why I stay in research," he added. "Now a basis for working on prevention strategies." Fowler’s study was published in the Proceedings of the National Academy of Sciences Early Edition.

Seamless IT Vision Integrates School's Three Missions

Creating a seamless, information technology (IT) infrastructure that integrates research, clinical care and education is an important goal for the School of Medicine. While many avenues to reach that goal are being explored, the transformation to a more sophisticated IT platform has definitely begun.  

The new Maestro Care Electronic Health Record (EHR), which will first go live in ambulatory clinics in July and be system-wide by 2014, will enhance the management of patient care and clinical research, says Jeff Ferranti, M.D.,M.S., Duke Medicine’s chief medical information officer. 
 
“By housing clinical data in a unified, seamless EHR, we will be able to identify eligible patients for research studies, better manage patient cohorts, and enhance clinical registries.” Ideally, Ferranti says the EHR should interface with the clinical trials management system and with the eIRB. A research advisory committee, comprising all the major clinical research stakeholders, is helping to guide and inform the process.
 
The new EHR system will also positively impact medical education, Ferranti says. Training environments may be created in which “students and learners can use the EHR to manage simulated patients and medications throughout the education continuum.”
 
One of the most important parts of an integrated IT infrastructure involves the creation of a standardized shared service environment that manages data storage, tracks data provenance, and provides centralized services.  “Right now there is little continuity,” Ferranti says. “We need enterprise scaled solutions for biobanking, LIMS, e-research and the storage of research information that promotes research integrity. We are looking into several viable options.”
 
Ferranti says the door remains open for the School of Medicine to be as innovative as possible while investigating the best possible IT path for the future. “We know having a usable and integrated IT solution is important. We know we want it to be a service-oriented structure that protects academic exploration and innovation. Ultimately, we want to provide the IT tools and core services that meet the needs of our faculty, students and researchers.”
 
For more information on Maestro Care visit maestro.duke.edu.

Duke Viral Vector Core Offers Customized Services

It’s been more than 40 years since the process of delivering genetic material with the use of a virus was first developed. Today, demand is at an all time high. With the Duke Viral Vector Core now fully operational on campus, Duke scientists can easily access viral vectors for their research.

 Viral vectors are powerful tools with broad applications in basic science. They can ensure gene delivery into nearly 100 percent of cells without affecting the cell viability. They allow the introduction of constructs into cells that are not otherwise amenable to the introduction of DNA. Some viruses integrate into the cell genome, which facilitates long-term, stable expression. These advantages can be applied in vitro as well as in vivo. 
 
Viral vectors can deliver fluorescent markers to cells, effector genes, or interfering RNA to knock-down gene expression. They can express proteins that allow control over the electrical activity of nerve cells. They can also be used in animals as a facile and inexpensive approach for transgenesis. For example, viral vectors are used in work with primates and songbirds because they are the only way to introduce and express transgenes in cells of interest in these animal models.
 
Experts in molecular biology at the Duke Viral Vector Core have centralized the process of producing and distributing viral vectors including lentivirus, retrovirus, AAV and rabies. The facility works with basic scientists across diverse fields of study including systems neuroscience, stem cell biology, metabolism, ageing and cancer biology. However, they say many Duke researchers remain unaware of the scope of their services.
 
“Anybody doing biological research can benefit from these tools,” says Ute Hochgeschwender, M.D., director of the Duke Viral Vector Core. “If they have the capacity to create these tools in their lab, we can save them time and money by providing consistent viruses because we produce them on a regular basis. If they don’t have the capacity to produce the viruses, we can produce them in house. And we customize our services, which the bigger companies can’t provide.”
 
That personal touch is what sets the Duke Viral Vector Core apart from its peers at other academic medical centers. “Many investigators have an idea of what they would like to do with viral vectors, but might not know exactly how to get started,” says Marguerita Klein, a research analyst who has been generating viral tools over the last eight years. “We provide consulting for labs that don’t know how to begin using molecular tools. We custom create such tools for them from the DNA through the virus.” 
 
The Duke Viral Vector Core services are available to all Duke researchers and outside investigators. For more information, contact Marguerita Klein by email orcall  919-684-0044. Or visit the lab’s website at sites.duke.edu/dvcc

Five Duke University Faculty Members Selected as AAAS Fellows

The following Duke University School of Medicine faculty members have been chosen for the distinct honor of fellow of the American Association for the Advancement of Science (AAAS): 

  • Richard Brennan, Ph.D., Chair of the Duke Department of Biochemistry
  • Bryan Cullen, Ph.D., Professor of Molecular Genetics and Microbiology
  • Mariano Garcia-Blanco, M.D., Ph.D., Professor of Medicine and Professor of Molecular Genetics and Microbiology
  • Sue Jinks-Robertson, Ph.D., Professor of Molecular Genetics and Microbiology
  • Donald McDonnell, Ph.D., Glaxo-Wellcome Professor of Molecular and Cellular Biology and Chair of the Duke Department of Pharmacology and Cancer Biology 

Awards and Honors

The American Society for Clinical Investigation welcomes three new members:

  • John W. Hollingsworth, M.D., Associate Professor of Medicine, Division of Pulmonary, Allergy, and Critical Care Medicine, Assistant Professor, Department of Immunology.  
  • Adrian Felipe Hernandez, M.D., M.H.S., Associate Professor of Medicine, Division of Cardiology,
  • Scott Michael Palmer, M.D., M.H.S. - Associate Professor of Medicine, Division of Pulmonary, Allergy and Critical Care Medicine. 
Nicholas Katsanis , Ph.D., a professor in the departments of Cell Biology and Pediatrics, has been awarded the 2012 E. Mead Johnson Award from the Society for Pediatric Research. This prestigious award honors clinical and laboratory pediatric research achievements. Katsanis’ work focuses on the Bardet-Biedl Syndrome (BBS), a complex genetic disease with autism-like symptoms, cognitive defects and depression. Katsanis is an expert in using BBS genetic mutations and proteins to learn more about other diseases. His lab is developing animal models to understand how an individual’s genome can influence the clinical presentation of this and other genetic diseases. BBS is now a model for oligogenic disease, a category between classical monogenic and complex traits.
 
Christopher O’Connor, M.D., professor of medicine and acting director of the Duke Heart Center, has been selected by the American College of Cardiology’s Publications Committee as the founding editor of a new scientific journal, JACC Heart Failure.
 
Marvin Swartz, M.D., is the recipient of the 2012 American Psychiatric Association (APA) Senior Scholar Award, which recognizes singular or sustained research accomplishments by a researcher beyond early career status which have made an important contribution to the field of mental health services research.  Dr. Swartz was recently appointed to the role of Director DUHS Behavioral Health Services. He will represent DUHS he interfaces with local, state, regional and national leaders in behavioral health policy and provide guidance to health system leadership.
 
Jan Gwyer, professor and vice chief of education in the doctor of physical therapy division, has been selected as a Catherine Worthingham Fellow of the American Physical Therapy Association.

News and Notes

 The 2012 Schools of Medicine and Nursing Spring Faculty Meeting will be held Wednesday, May 2, 5:00-8:00 pm at the Sarah P. Duke Gardens Doris Duke Center. This event is a chance to reflect on the past academic year, remember colleagues, and present awards. All SoM and SoN faculty are welcome and encouraged to attend.

Registration is required and is available online at http://facdev.medschool.duke.edu. Contact the Office for Faculty Development with questions (684-4139).