New funding targets HIV, malaria

Rama Amara and Eric Hunter are co-PIs on a new NIH grant targeting HIV/AIDS.

Two new major awards, one a five-year $35.6 million NIH grant and the other a $6.4 million DARPA contract, both rely heavily on resources of Yerkes Primate Center.

The Emory-led Consortium for Innovative AIDS Research in Nonhuman Primates (CIAR-NHP) received an NIH grant to develop new strategies against HIV/AIDS. CIAR researchers, led by co-principal investigators Rama Amara and Eric Hunter, aim to develop advanced vaccines that provide sustained protection from retroviral infection and to refine existing approaches to eliminate HIV from latent reservoirs in people who are already infected. They will focus their work on SIV and SIV/HIV hybrid viruses.

Scientists already know that use of a particular immune-stimulating agent can enhance vaccine protection; they also know that use of another agent can decrease viral levels for an extended time after discontinuation of antiretroviral therapy. The team has a plan for combining these different pieces of the puzzle to fill gaps in current knowledge.

CIAR includes Emory scientists from Yerkes, Emory Vaccine Center, pathology, microbiology, pediatrics, and biostatistics as well as investigators from around the country. In addition to Hunter, three other members of the Emory team, Rafi Ahmed, Max Cooper, and Guido Silvestri, are Georgia Research Alliance Eminent Scholars. Read more.

The DARPA contract involves more than 40 researchers at Emory, UGA, and Georgia Tech, along with national and international collaborators, to investigate mechanisms behind "resilience" following malaria infection.

Co-PIs Mary Galinski and Rabindra Tirouvanziam

"Resilience in some people and in some non-human primates allows them to avoid adverse outcomes, so that malaria infection is not incapacitating," says Mary Galinski, project PI. "Our goals are to identify host features associated with resilience and develop interventions to enhance that resilience." Co-PIs include Emory cystic fibrosis researcher Rabindra Tirouvanziam and Juan Gutierrez from UGA.

The project focuses on Plasmodium knowlesi, which can infect both humans and non-human primates. P. knowlesi causes mild chronic infections in some monkeys, such as long-tailed and pig-tailed macaques, but severe, virulent infections in other monkeys, such as rhesus macaques.

The team will generate large datasets on characteristics of P. knowlesi infection in the two types of non-human primates and in humans. They will use surgically implanted telemetry devices to gather continuous real-time physiological data from the two types of monkeys, before and during infection, and they will investigate correlates of the physiological data to detect signatures of onset of severe disease.

The project draws on a wide range of expertise, including infectious diseases, systems biology, physiology, pathology, immunology, genomics, bioinformatics, pediatrics, cardiology, pulmonology, biomedical engineering, and mathematics. The project also builds on the scientific infrastructure, leadership, and expertise of MaHPIC, an NIH-supported malaria systems biology partnership between Emory, UGA, Georgia Tech, and the CDC Foundation. Read more.

5,000 bone marrow transplants and counting

Flags on the lawn of the medical school building each represent one of 5,000 BMTs performed here since 1979. L to R: Physicians Amelia Langston and Ned Waller with 5,000th patient Glenn Pontoo, who had an autologous stem cell transplant on June 20 for multiple myeloma.

The nurses in Winship Cancer Institute's bone marrow and stem cell transplant (BMT) unit know how to whoop it up. On Kentucky Derby day, they don fancy hats and serve food and alcohol-free mint juleps to patients. Come football season, they tailgate and decorate the doors of patients' rooms with their favorite team colors. Once, on a whim, a nurse put tacks on her shoes and tap-danced down the hall. During the Summer Olympics in London, staff and patients competed in their own version of the games.

And then there's the "Birthday Song," written by two BMT nurses to celebrate "Day Zero," when a patient has a transplant.

Mitzi Smiley and Emily Bracewell

"We go in with tambourines and other musical instruments and sing it to the patients," says Emily Bracewell, BMT unit nursing director. "We put balloons on the patient's door. When you walk down the hall and see all the balloons, you know these patients had transplants recently. That's their new birthday."

There have been many new birthdays since the first bone marrow transplant at Emory in 1979. In the beginning, doctors performed one or two transplants a year. Today, more than 430 patients undergo bone marrow and stem cell transplants annually. By June 20, the total tally had reached 5,000, each one symbolized by a white flag planted by Winship staff and former patients on the lawn in front of the School of Medicine building.

Emory's BMT program is the oldest and largest in Georgia and one of the top 10 nationally in volume. Its physicians have transplanted patients with leukemia, lymphoma, multiple myeloma, myelodysplastic syndrome, myelofibrosis, aplastic anemia, and sickle cell anemia. During the program's infancy, patients were isolated for up to two months at a time. Graft-versus-host disease was a major worry. There were no drug pumps. Nurses mixed chemotherapy drugs and hung as many as 50 antibiotic IVs, each with a new piece of tubing, per shift. Charting was done by hand. The rounding team consisted of a doctor and a nurse.

Today, approximately 70 physicians, nurses and nurse practitioners, pharmacists, social workers, discharge planners, and others work in tandem to care for patients, physically and emotionally. Nursing care is considered a hallmark of the BMT program. A third of its nurses have been with the unit for 15 to 20-plus years.

"When I hire new people, I tell them, 'you either love oncology or you don't. There's no middle ground,' " says Bracewell, a 37-year unit veteran. "You have a passion for oncology, and that's what makes you stay."

Mitzi Smiley joined the hematology unit at the urging of her sister, an Emory pharmacist. That was 35 years ago.

 "Our medical team is great to work with, and it has a lot to do with the way nurses practice here," says Smiley, BMT unit charge nurse. "You have a lot of autonomy. Our physicians love to teach. When we're rounding, the physicians are happy to answer questions to explain any kind of situation. So the nurse feels like a very important part of the team on our floor. There's a lot of satisfaction in that."

Nursing care often ranks high on the list when it comes to patient satisfaction scores, Bracewell notes. Because nurses spend up to 12 hours a day with patients and families, they know when a morale booster is needed. After patients are discharged, they often come back to visit. One of them returns each Christmas with a small gift for every patient. His BMT was 15 years ago.

 "Our patients love us," says Bracewell. "They don't want to go anywhere else. If they have to be readmitted, they want to come to their unit and their home. That's special."—Pam Auchmutey

New pedestrian bridge, lane access, streetscape update

The new EUH bridge will span more than 130 feet, with two levels, each about 15 feet tall. View larger image.

A new two-tier pedestrian bridge connecting the new hospital wing with the current Emory University Hospital building is slated to be constructed on site next month, with significant impact on traffic on the section of Clifton Road between Gambrell Drive and Uppergate Drive. Following are projected dates to help you plan your travels along this route. Please note that these dates are subject to change, depending on weather or other factors.

Once the new bridge is operational next spring, the current bridge will be torn down. View larger image.

July 15-17: Over the weekend, the two outer (curbside) lanes in front of EUH in each direction will be restricted to allow delivery of the steel columns that will support the bridge. Travel on Clifton Road in both directions will be limited to the two inner lanes. Access to the hospital or clinics will not be impeded by this work.

July 18-22: During this week, the three center lanes will be restricted to allow bridge construction, which will take place on site in the middle of Clifton Road. (Onsite construction is necessary because the bridge, which will weigh approximately 150,000 pounds, cannot be moved very far once it is built.) Cars will continue to have access to Clifton Road in both directions but will be limited to one outer lane in each direction. Police officers at main intersections will direct traffic to help maintain traffic flow.

July 22-24: Over the weekend, the bridge will be raised, resulting in restricted access along Clifton Road from Gambrell Drive to Uppergate Drive. EUH valet and patient discharge operations will be relocated to Emory Clinic A valet and will be staffed with additional transporters to assist in patient/visitor movement to and from EUH during this time period. Only Emergency Department drop-offs and ambulances will be allowed onto Clifton Road in front of EUH and the surrounding areas. Access to the parking decks and buildings will be from the roads behind Emory Clinic.

August - late fall: Additional work on the bridge during this time may necessitate some restricted access (e.g., a lane closure), but you will be able to travel on Clifton Road.

Right lane of traffic is headed north, with bike lane on the east side. View larger image.

Clifton Streetscape update on bike lanes, tree canopy: A bike lane will be added on the east side of Clifton Road. On the west side of Clifton Road, between Eagle Row and Woodruff Circle, a bike path will be added outside of the roadway on Emory property to allow bicyclists to connect with Emory University Hospital, other health sciences facilities, and the existing university bike path network. Also, a 'sharrow' (shared bike-vehicular lane) will extend through the work zone on the west side of Clifton Road, where a bike lane was not feasible due to space constraints and physical infrastructure.

Removal of 30 trees during the streetscape project will be offset by planting of 107 trees, a number that includes trees both along the sides of the road and in new medians. The tree removal and replanting complies with Emory's No Net Loss of Forest Canopy policy, which since 1999 requires that any time a tree is removed, a sufficient number of trees must be planted in order to maintain or exceed the original forest canopy.

For questions about the bridge, please email communications@emoryhealthcare.org.

For questions about the Clifton Streetscape project, please visit cliftonstreetscape.com.

Yerkes base grant provides foundation for discovery

Jonathan S. Lewin

Yerkes National Primate Research Center is one of only seven such centers in the United States, and it consistently leads the other six in sponsored research funding. The foundation on which its research breakthroughs (such as those described at left) are built is a rigorous and competitive P51 base grant. The grant primarily covers essential operating costs for facilities and animal care and funds about 22% of the center's total operating costs. Yerkes has continuously earned this grant funding for 55 years and was recently approved for five additional years at a rate of more than $10.5 million per year.

The continued success of the renewal process represents a herculean effort on the part of Yerkes Director Dr. Paul Johnson and his entire team. The most recent application had 31 components, was more than 2,200 pages long, and earned an outstanding score of 21.

Congratulations to everyone at Yerkes who played a part in securing this crucial foundational funding, which makes so much discovery possible.

Please direct questions and comments to evphafeedback@emory.edu.

In brief

NIH grant for "citizen science"

Winship researchers Adam Marcus and Theresa Gillespie received a five-year, $1.2 million NIH Science Education Partnership Award to create the Center for Advancing Health and Diversity through Citizen Science. Targeting the entire state of Georgia, the grant will focus efforts on urban and rural students who are under-represented in science, engineering, technology, and math, including girls and minorities. Read more.

Discovery engine for cancer drugs

Emory's Chemical Biology Discovery Center, led by Haian Fu, has been selected as a Specialized Center in the Chemical Biology Consortium, the discovery engine for the NCI Experimental Therapeutics (NExT) Program aimed at accelerating discovery of new cancer drugs. Read more.

FDA approves new imaging probe

Mark Goodman

A PET imaging agent for diagnosing recurrent prostate cancer, 18F-fluciclovine, received FDA approval last month. The agent was developed by Mark Goodman and Timothy Shoup, the latter now at Massachusetts General. Read more.

Team to train first responders

Alex Isakov, Kate Moore, Kathy Miner

Emergency Medicine in the medical school received a federally sponsored grant to train first responders and other workers in protection against the spread of infectious disease. The multidisciplinary training team includes Alex Isakov (CEPAR executive director), Kate Moore (nursing), and Kathy Miner (public health). Read more.

Bacterial persistence

Christine Dunham (biochemistry) received a $500,000 grant from Burroughs Wellcome to investigate how some bacteria withstand antibiotic treatment. Read more.

Religious holidays

The Woodruff Health Sciences Center has more than 24,000 employees, representing a wide range of ethnicities, cultures, and religions, observance of which is an important expression of diversity within the WHSC. Please see the 2016 list of religious holidays if you're interested in learning more about the holidays your colleagues may be observing.

New ECMO transport

Emory Healthcare has a new specialized ambulance to transport adults requiring ECMO life support. Read more.

Erratum

Last month, in an award announcement, this newsletter incorrectly identified Wendy Armstrong as "former" director of the Ponce Infectious Disease Clinic at Grady. She is very much still the director of this clinic. The "former" adjective, intended for another awardee's title, was misplaced.

Notable

Richard Compans (microbiology) received the Georgia Research Alliance Catalyst Award and the dean's Distinguished Faculty Award. Read more.

Jenny Foster (above) is one of five nursing faculty who will be inducted as American Academy of Nursing fellows in October. The others include Sharron Close, Suzanne Staebler, Kathryn Wood, and Kate Yeager. Read more.

Renee Read (pharmacology) received a $50,000 grant from Rally for Research for her research on pediatric brain cancer therapies. Read more.

Patrick Sullivan (epidemiology, public health) was appointed to the Presidential Advisory Council on HIV/AIDS. Read more.

Researcher Vin Tangpricha received an Outstanding Service Award from the American Association of Clinical Endocrinologists for work with the transgender community. Read more.

Yerkes researcher Lary Walker received the Humboldt Research Award and has been invited to spend up to one year collaborating with colleagues at a research institution in Germany. Read more.

Events

Oct. 1: Sixth Annual Winship Win the Fight Walk/Run. 8:30 a.m., McDonough Field. Atlanta Braves Vice Chairman John Schuerholz will serve as grand marshal. Register.