UW Medicine Insight: June 6, 2016

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IN THIS ISSUE:

RESEARCH: Understanding how a body divides into 40 trillion cells
CLINICAL: UWMC ready to deploy smallest pacemaker ever 
EDUCATION: The little-known UW-Madigan partnership in pediatrics
PEOPLE: Beth Buffalo unlocking mysteries of Alzheimer's with video games
WWAMI: Washington's healthcare shortage receives new focus
AWARDS: UW Neighborhood Clinics receive Award of Excellence
EVENTS: Seattle PrideFest and Pride Parade
In the News: Stories involving UW Health Sciences

and much more...

A biweekly newsletter focused on issues related to the UW Medicine system.


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Dear Colleagues,

On May 27, 200 graduating seniors participated in the 2016 Investiture of Doctoral Hoods and the Physician's Oath Ceremony at Benaroya Hall marking achievement of the M.D. degree. Among this year's 202 graduates, 129 are from Washington, including 35 from Eastern Washington (Pullman and Spokane), 17 from Wyoming, 19 from Alaska, 20 from Montana and 17 from Idaho. 

The speaker chosen by the 2016 graduating class was Doug Paauw, UW professor of medicine in the Division of General Internal Medicine and one of our best-known and most-beloved educators. I have known Doug since he was a resident, and he is an outstanding example for all teachers of modeling compassionate, high-quality care. Doug reminded the graduates, "The most important education you have received though is how you think, how you organize information, with both your brain and your heart - how you will care, truly care  about your patients. Always be curious, always be compassionate. These skills are eternal."

He went on to describe in more detail the graduates' need for "the three C's" -  Curiosity ("The great doctor always wonders why? What lies under the surface?"), Compassion ("The more we care, the better our patients will be.") and Courage ("Be courageous to speak up, to help guide the changes that will occur, and be courageous to stand up for the values you believe.") I would like to thank Doug for remarks that resonate with all of us, whether graduates or seasoned physicians, and for his exceptional work with our students and residents.  

In addition to the granting of the M.D. degree, a number of awards were given to students and faculty members as voted by the graduating class. Four faculty were honored by the students with the Distinguished Teacher Award. Dave Conley, who teaches anatomy in Spokane, received the award for basic science teaching. Ron Loge, who lives, practices and teaches in Dillon, Montana, received the award for WWAMI teachers. Basak Coruh,  UW assistant professor of medicine in the Division of Pulmonary & Critical Care Medicine and director of the school's Objective Structured Clinical Examination program, received the clinical teaching award. That award also went to Jamie Shandro, UW associate professor of emergency medicine.  

The Margaret S. Anderson Award, which recognizes a staff member with exceptional concern and support for students this year, was awarded to Tara Gates, assistant registrar in Academic Affairs. The Ellen Griep Award, which honors a graduate who has provided inspiration to classmates, staff and faculty by managing both academic demands and continued endeavors in other aspects of life, went to Chad Ulrich.   

Congratulations as well to the students who received other School of Medicine and departmental awards and to the following students who graduated with high honors: Andrea Rea, Michael "Mitch" Tan and Chad Ulrich. To all awardees, these honors are a strong indication of the excellence and compassion you bring to your work. Thank you. And thank you to all graduating students and to the faculty and staff who have contributed to their education. It is an honor to work with each of you!

Sincerely,

  

Paul G. Ramsey, M.D.
CEO, UW Medicine
Executive Vice President for Medical Affairs and
Dean of the School of Medicine,
University of Washington


Jay Shendure, UW professor of genome sciences, has been working on a technique to map cell lineages for 16 years. (Image courtesy of the Howard Hughes Medical Institute.)
Jay Shendure

Understanding how a body divides into 40 trillion cells 

 

Jay Shendure, UW  professor of genome sciences, is the lead researcher on a study published in Science showing how to map cell lineages in larger animals using a gene editing technique called CRISPR. The work is being hailed as a breakthrough in understanding how the trillions of complex cells in a body are descended from a single egg. "It has the potential to provide profound insights into how normal, diseased or damaged tissues are constructed and maintained," a UK biologist told the BBC.
 

The human body has around 40 trillion cells, each with a highly specialized function. Yet each can trace its history back to the same starting point  a fertilized egg. Read more in The Atlantic and the BBC.
 

Wearable artificial kidney shows promise 

With some technical modifications, a wearable artificial kidney device could emerge as a less restrictive alternative dialysis technology, according to results from an exploratory clinical trial. The findings were published June 2 in JCI Insight, a peer-reviewed medical journal of clinical investigations. The prototype trial was performed with seven patients at UW Medical Center in autumn 2015.

The senior researchers on the non-randomized trial were Jonathan Himmelfarb, UW professor of medicine (nephrology) and director of the UW Kidney Research Institute, and Larry Kessler, UW professor of health services. Read more on HSNewsBeat. View coverage on KING 5.

UW's work on the Zika virus 

As part of U.S. Sen. Patty Murray's (D-WA) May 20 trip to Harborview Medical Center championing a bipartisan Senate bill to provide $1.1 billion in emergency funding for the Zika virus, her office wanted to know what was being done in Seattle. The UW Department of Global Health surveyed faculty and learned of more than a dozen projects underway.


Q-13 Fox features the Zika work being conducted by a team of eight UW researchers in the Michael Gale lab.


Other research news:


The old and the new: A conventional pacemaker, left, and the Medtronic Micra displayed by UW electrophysiologists Jordan Prutkin and Kristen Patton.(Photo by Brian Donohue/UW Medicine.)
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UWMC ready to deploy smallest pacemaker ever

 

The world's smallest pacemaker will debut soon at UW Medical Center - one of two Washington state hospitals that will offer the device for the next several months.  About as tall and wide as a AAA battery, the device, called Micra, is threaded up through the femoral vein to the heart, where it is attached to the right ventricle to deliver impulses when a patient's heartbeat is too slow. The Micra's battery is projected to last 10 to 14 years, depending on how much pacing a patient requires. 


Jordan Prutkin and Kristen Patton, cardiac electrophysiologists with the UW Medicine Regional Heart Center, received final training in May from representatives of Medtronic, the manufacturer of the device. Read more on HSNewsBeat.

 

Bariatric surgery helps with diabetes

 

David E. Cummings, UW professor of medicine (metabolism, endocrinology and nutrition), is senior author of guidelines stating that weight-loss surgery should become a more routine treatment option for diabetes, even for some patients who are mildly obese.

 

The recommendations released May 24 were endorsed by the American Diabetes Association, the International Diabetes Federation and 43 other health groups, and published in the journal Diabetes Care. "We do not claim that surgery should be the first-line therapy," cautioned Cummings. "But as standard care often isn't enough, it's time for something new." Read more in The New York Times.

 

In related news, a UW-led study found that a peptide injected into the brains of diabetic mice and rats has been shown to produce sustained Type 2 diabetes remission. The results were reported in the journal Nature Medicine. Michael Schwartz, UW professor of medicine (metabolism, endocrinology and nutrition) and director of the UW Diabetes and Obesity Center of Excellence, led the study team. Read more in The Los Angeles Times and on  HSNewsBeat

 

Other clinical news:

  • Most Americans aware of Zika threat, but gaps in knowledge remain, Health, May 31, 2016
    Americans are becoming more informed about the Zika virus, but there are still some large gaps in their knowledge of the mosquito-borne illness that can cause devastating birth defects. Jeffrey Duchin, UW professor of medicine (allergy and infectious diseases) and health officer with Seattle & King County Public Health, is quoted.
  • 150 experts say Olympics must be moved or postponed because of Zika, Washington Post, May 27, 2016
    More than 100 prominent physicians, bioethicists and scientists from around the world posted a letter urging WHO Director-General Margaret Chan to exert pressure on Olympic authorities to move or postpone the Brazil Olympics. Benjamin Wilfond, UW professor of pediatrics, and Seema K. Shah, UW associate professor of pediatrics, are among them.
  • A first in U.S.: Patient infected with bacteria resistant to last-resort antibiotic, Seattle Times, May 26, 2016
    The case raises the specter of superbugs that could cause untreatable infections, because the bacteria can easily transmit their resistance to other germs that are already resistant to additional antibiotics. John Lynch, UW associate professor of medicine (allergy and infectious diseases), is quoted.
  • Want to sell an anti-aging pill with no human testing? Make it a supplement, BuzzFeed, May 26, 2016
    Elysium Health claims to have hit the jackpot in the search for an anti-aging pill. But researchers are divided over the safest way to deliver such products to consumers. Matt Kaeberlein, UW professor of pathology, is quoted.
  • Scientists are closer than ever to creating the 'Fountain of Youth'New York Post, May 24, 2016
    What if there existed a drug that staved off all the inevitable pitfalls of aging: cancer, Alzheimer's, heart attacks and more? As dubious as it sounds, a group of scientists from the UW believe such a wonder pill may not be far off. Matt Kaeberlein, UW assistant professor of pathology, is quoted.
  • The latest treatment for depression: Heat lamps? BuzzFeed, May 20, 2016
    A new study finds that "hyperthermia" could be helpful in treating depression. It's a century-old idea, but bigger trials are needed before it sees widespread use. David Avery, UW professor emeritus of psychiatry, is quoted.
  • Do women need periods?, NPR, May 20, 2016
    Six years of your life. 2,190 days. That's about how long the average woman will spend having her periods. For some women, that's too many days, too many periods. Elizabeth Micks, UW assistant professor of obstetrics and gynecology, is featured.
  • Opioid prescriptions drop for first time in two decades, New York Times, May 20, 2016
    After years of relentless growth, the number of opioid prescriptions in the United States is finally falling, the first sustained drop since OxyContin hit the market in 1996. Bruce Psaty, UW professor of medicine (general internal medicine) and epidemiology, is quoted.

Meghan Behrmann, a UW developmental-behavioral pediatrics fellow with a young patient at Madigan Army Medical Center. (Photo by Emily Rasinski/UW Medicine.)
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The UW-Madigan partnership

A little-known partnership between UW and Madigan Army Medical Center brings together fellows from both institutions to train as developmental behavioral pediatricians. Fellows from UW and Madigan rotate to Madigan, Seattle Children's and the UW Center of Human Development and Disability (CHDD). 

Beth Ellen Davis, director of the clinical training unit at the CHDD, came up through the military and has been on both sides of the affiliation - first in the Army and now at UW. "This is a perfect partnership," she said. "These fellows leave with a great education. They are ready to take on whatever it is they will need to take on, regardless of whether it's on the military or civilian side."

Though developmental pediatricians are in high demand, the numbers of physicians in the subspecialty are few. Nationally, just around 30 complete their training each year. On average Madigan and UW bring three new fellows into this specialty each year. This means that the fellows rotating at UW and Madigan represent about 10 percent of the total developmental behavioral pediatrics fellows training in the country. Read more on HSNewsBeat

Med student for a day

On April 26, 40 Washington state legislators, legislative staff and Congressional staff members spent the day at the UW School of Medicine learning what it's like to be a medical student. From taking basic science classes in the anatomy lab to performing procedures in simulation classrooms, policymakers got a firsthand look at the day-to-day life of aspiring physicians. For photos of the event, see the UW Medicine Facebook page.

Other education stories:

  • Opinion | Coming out again, 10 years later, Huffington Post, May 26, 2016
    "UW School of Medicine is one of the few medical institutions in the country not only progressive enough to have a dedicated course on transgender health, but also to have accepted at least one transgender student," writes Rachel Jackson, a UW medical student.

A third-year UW medical student consulting with a geriatric patient at a clinic in Libby, Montana. (Photo by Clare McLean/UW Medicine.)

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Washington's healthcare shortage receives new focus

Crosscut takes a look at efforts to get more doctors to work in underserved rural areas of the state, but the question is whether or not medical students trained in Eastern Washington will want to stay there to practice after graduation.

Dean Larsen, CEO of the Spokane County Medical Society, and Suzanne Allen, vice dean for Academic, Rural and Regional Affairs at the UW School of Medicine, emphasized that most medical students end up working where they received their training. 

"We keep a lot of our students in the area; over half of our students stay in Washington," Allen said. "The more time you spend in one location training, the more likely you'll stay there."

Allen and Larsen also agreed on the missing key factor for retaining even more students: residency programs. Most residencies are outside of the state or in Western Washington, not Eastern. 

"Medical education is only the beginning point," Larsen emphasized. "If we train [doctors] here and we don't have graduate medical education, and we ship them out to the Midwest or the East Coast, it's going to be a hard sell to draw them back." Read more on Crosscut.

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Beth Buffalo, UW associate professor of physiology and biophysics, is testing monkeys for memory function using video games. (Photo by Genevieve Wanucha/UW Medicine.)
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Beth Buffalo unlocking mysteries of Alzheimer's through video games

Beth Buffalo, UW associate professor in physiology and biophysics, designed video games for non-human primates to better understand their ability to do a memory task. 

"In order to understand what might be missing or impaired in human patients with Alzheimer's disease, we need to understand how their memory system works at a deep level," said Buffalo. 

Her team has found several biological markers of memory formation in the brain - distinct patterns of neuron firing and eye movements that predict a monkey's success or failure in a memory task. 

Aligned with the UW Alzheimer's Disease Research Center, Buffalo's goal is to translate these cognitive biomarkers into ways to identify signs of memory loss in people, even when there are no noticeable symptoms -  a development that could lead to earlier diagnoses and a window for intervention. Read the full story on the UW Medicine Memory & Brain Wellness Center website. The story also appeared in the King County Medical Society Bulletin (May/June 2016).

In related news, see the Q&A with Dirk Keene, leader of the UW Alzheimer's Disease Research Center Neuropathology Core.

UW Neighborhood Smokey Point Clinic. (Photo by Clare McLean/UW Medicine.)
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UW Neighborhood Clinics receive Award of Excellence 

The UW Neighborhood Clinics recently received a Washington Award of Excellence in Healthcare Quality from Qualis Health for their Behavioral Health Integration Program (BHIP)

BHIP is a team-based, collaborative care approach designed to improve the outcomes of anxiety and depression management in primary care. UW Medicine psychiatrists work as clinic-based psychiatric consultants who are responsible for supporting mental healthcare provided by primary care providers and care managers as well as providing direct patient consultations. More than 70 percent of patients with depression and 65 percent of patients with anxiety enrolled in BHIP have shown a 50 percent improvement in symptoms following a minimum of 10 weeks of treatment.

The UW Neighborhood Clinics was one of five healthcare organizations across the state of Washington recognized for their achievements in improving healthcare quality and outcomes including better healthcare for individuals, better health for populations and reduced costs through improvement. 

Qualis Health, based in Seattle, is one of the nation's leading population health management organizations. UW Neighborhood Clinics Medical Director Peter McGough and Jay Wellington, UW Neighborhood Clinics manager of social work, accepted the award. For more information, see the Qualis Health website.

3 UW research teams receive innovation awards from ITHS 

The UW Institute of Translational Health Sciences awarded three one-year $50,000 Collaboration Innovation Awards to UW research teams. The winning proposals represent either a new project or new research direction for the principal investigator and will provide research teams with the preliminary data needed to seek outside funding.

Awardees:

  • PI: Deok-Ho Kim, UW assistant professor in bioengineering. Co-PI: Charles Murry, UW professor in pathology. (Helping stem cell-based therapies in damaged hearts).
  • PI: Suzanne Dintzis, UW associate professor in pathology. Co-PI: Jonathan Liu, UW assistant professor in mechanical engineering. (Improving measurement of biomarkers in breast cancer).
  • PI: Chistoph P. Hofstetter, UW assistant professor in neurological surgery. Co-PI: Buddy Ratner, UW professor in bioengineering (Helping promote neuronal regeneration after spinal cord injuries). For more on the awards, see the ITHS website.

  • Seattle Pride Parade and PrideFest 2016, June 26, 2016
    Seattle's PrideFest and Pride Parade is the premier, annual event focused around our local lesbian, gay, bisexual and transgender (LGBT) community. You do not need to be a member of the LGBT community to participate, all are welcome! If you are interested in volunteering at the UW Medicine PrideFest booth or marching in either parade, please register as a volunteer by completing the Catalyst form no later than June 17, 2016. 

    Also, during Pride Week (through July 1), all UW Medicine hospitals will be flying Pride flags. Please join us at your entity's flag raising on Monday, June 20. More details will be provided early next month. If you have any questions, please feel free to submit them to uwmpride@uw.edu.
     
  • Cancer Moonshot Summit, Fred Hutch, June 29, 2016 (12-4 p.m.)
    Vice President Joseph Biden is convening a Cancer Moonshot Summit, including conversations in communities across the United States. These summits will be the first time that individuals and organizations representing the entire cancer community and beyond will all convene under the national charge to double the rate of progress toward a cure.

Other articles that mainly involve UW Health Science faculty staff, students and trainees.

  • UW-led study pinpoints how air pollution harms your heartSeattle Times, May 24, 2016
    Joel Kaufman, UW professor in environmental & occupational health sciences (public health), medicine (general internal medicine), and epidemiology (public health), led a 10-year study of 6,000 people in six cities that found air pollution accelerates deposits of calcium in heart arteries, a known cause of heart attack and stroke. ( Grist, KOMO 4, KIRO 7, Q13 FOX also covered this story.)
  • Low-income children receive sub-par care for brain injuries, study says, UPI, May 23, 2016
    Low-income, Spanish-speaking children generally receive sub-par care after traumatic brain injuries, according to a study published in the American Journal of Physical Medicine & Rehabilitation. Megan Moore, UW assistant professor of social work and a core faculty member at the UW Harborview Injury and Prevention Center, is the lead author.
  • Designed in Seattle, this $1 cup could save millions of babiesSeattle Times, May 23, 2016
    A simple invention for breastfeeding called the NIFTY cup, for Neonatal Intuitive Feeding Technology, could help many newborns all over the world. The invention is a collaborative project between UW, PATH and Seattle Children's. Key contributors at UW include Christy McKinney, UW clinical assistant professor in oral health sciences, and Michael Cunningham, UW professor of pediatrics and director of the Craniofacial Center at Seattle Children's. (KIRO 7 and  Huffington Post also covered this story.) 
     
    Note: McKinney, the visionary behind the device, was featured by the Institute of Translational Health Sciences, who supported her work as a KL2 Scholar. Read more. 
    And in an editorial, The Seattle Times (June 1, 2016) calls the NIFTY cup "Nobel-worthy." Read more.

    If you would like to offer feedback, please write Bobbi Nodell, the editor of 
    UW Medicine Insight, at bnodell@uw.edu. To subscribe, go to our landing page.
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