In this November-December issue of The TRIbune, we highlight the TRI Community Partner Celebration, which honors community partners who play key roles in helping UAMS advance research and improve health, especially for rural and underserved communities. 

The celebration on Dec. 6 was a great success, with more than 80 attendees from across Arkansas.

The TRIbune also features Jure Baloh, Ph.D., who received National Institutes of Health funding to support his work related to addiction treatment. He is a 2022 graduate of the TRI KL2 (now K12) Mentored Research Career Development Program and an assistant professor in the Fay W. Boozman College of Public Health.

We also highlight the three new Implementation Science Scholars: Paige Beck, M.D., Ph.D., Tisha Deen, Ph.D., and Saritha Ranabothu, M.D.

In addition, we note the recent meetings of our UM1 and K12 External Advisory Boards. In its report following the November meeting, the UM1 EAB described TRI as a “gem activity” at UAMS.  

Read The TRIbune.

Gail Runnells, RN, a clinical research nurse manager at the UAMS Translational Research Institute, recently received the 2024 Bonny Hope Wallace Award for her outstanding work as a research coordinator, mentor and manager.

The Bonny Hope Wallace Award goes to a UAMS certified research specialist selected by their peers. Wallace worked in research at UAMS for more than 30 years before her death in 2004. The award in her name was presented at the conclusion of the Dec. 11 Certified Research Specialist (CRS) Awards Ceremony, sponsored by the UAMS Office of Research Compliance.

Runnells, who joined the Translational Research Institute in 2017, was nominated by her colleagues.

Her passion for research and work ethic are an inspiration to those who work with Runnells, said Anja Rassmann, BSN, RN, CCRP, a clinical research nurse manager at the Translational Research Institute.

“Gail truly embodies what it means to be an outstanding clinical research professional,” Rassmann said. “She has a true passion for research and our research patients. She displays respect, integrity and professionalism in all aspects of the clinical trial.”

Rory McCoy, BSN, RN, CRS, a clinical research coordinator at the Translational Research Institute, said Runnells’ mentorship has had a profound impact on him.

“Gail’s unwavering support and mentorship have shaped my pursuit of knowledge and inspired my dedication to research,” McCoy said.

Erin Hatcher, a clinical research coordinator, also praised Runnells’ dedication to research participants as well as her less experienced colleagues.

“She always ensures that the participants understand the research process and that they feel comfortable and cared for during the process,” Hatcher said. “She takes on several studies and yet always is available to mentor and teach others. She is patient, nurturing and supportive when teaching others.”

Among Runnells’ significant contributions was her vital role recruiting participants for the breast cancer research project known as “Spit for the Cure.” The groundbreaking initiative, launched in 2007, recruited nearly 26,000 women from all 75 Arkansas counties to participate in breast cancer research through DNA collection. Gail’s recruiting efforts helped establish the robust cohort of volunteers, which continues to impact cancer research today.

“Receiving the Bonny Hope Wallace Award is truly an honor,” Runnells said. “Bonny set a high standard for research professionalism and integrity, and I’m humbled to be recognized in her name. I share this award with my incredible colleagues and mentors, who inspire and support me every day. Most of all, I’m grateful for the research participants who trust us with their care and make our work possible.”

Wallace was an instructor in surgery and laboratory director for surgical research at the Department of Surgery at UAMS as well as clinical coordinator of research at the Arkansas Children’s Hospital (ACH) Burn Unit. She was instrumental in pioneering ACH’s Burn Unit. Her efforts were focused on cutting-edge research to promote women’s health. She is remembered for her respectful treatment of research participants and her commitment to research integrity.

The Ninth Annual Translational Research Institute Community Partner Celebration on Dec. 6 brought attendees from across Arkansas to recognize the pivotal role of community partnerships in advancing research and improving health.

Organized by the institute’s Community Engagement Core, the event at the Mosaic Templars Cultural Center in Little Rock drew more than 80 attendees representing community and academic partnerships to address critical health challenges in Arkansas.

Laura James, M.D., institute director, recognized attendees for their dedication to helping UAMS improve health through research.

“I want to thank everybody for all of your contributions throughout the year to help us be successful as an institution,” said James, also associate vice chancellor for Clinical and Translational Research.

James and Tiffany Haynes, Ph.D., director of the Community Engagement Core, presented awards in five categories. The 2024 awardees are:

Research Partner of the Year: Olly Neal Community Health Center

The Olly Neal Community Health Center, based in Marianna, Arkansas, was celebrated for its work in the Mississippi Delta, one of the state’s most underserved regions. Cassandra Franklin and LaFay Broadway accepted the award on behalf of the center for their successful efforts recruiting Type 2 diabetes participants for the research project “Home Food Delivery for Diabetes Management in Patients of Rural Clinics.”

Franklin said the award is “amazing,” and she has been gratified to see the impact of her work.

“It’s been wonderful to meet the patients who need this service and to see their health improve through education and food delivery boxes,” Franklin said.

UAMS’ Kelsey Bounds, assistant director of research at the Institute for Community Health Innovation, which oversees the National Institutes of Health-funded study, nominated the center for the award.

“The work they do in the Delta and in Lee County is just outstanding,” Bounds said. “Their reach in the rural communities of the Delta is exemplary of how we should be working with our neighbors.”

Chancellor’s Community Engaged Research Partner of the Year: Boys, Girls, Adult Community Development Center

The Boys, Girls, Adult Community Development Center in Marvell was honored for its partnership with Tiffany Miles, Ph.D., an instructor in the UAMS College of Medicine Department of Pediatrics. Together, they are tackling obesity and diabetes prevention through a community-led research project developed during training in the Translational Research Institute’s yearlong Community-Based Participatory Research (CBPR) Scholars Program.

Miles and the center received a $25,000 pilot grant to support their project to develop a community-led obesity intervention program and to develop ideas for sustaining the intervention.

“We have been a partner of UAMS for a long time and it’s a great honor,” said Beatrice Shelby, the center’s executive director. “UAMS values our partnership, and we just really enjoy working with them. We’re so fortunate to be working with Dr. Tiffany Miles because she is so committed to our project and our goals.”

The research team will assess the community’s perceptions of obesity, maternal health, maternal nutrition and nutrition in general, as well as get the community’s input about potential interventions.

Miles said she has been impressed by the center’s commitment to its community and to the project.

“I’ve been in communication with them for about a year and a half, and they were proactive from the start in pursuing this project,” Miles said. “It’s been beautiful building that relationship.”

1. Kate Stewart Community Engaged Researcher of the Year: Taren Massey-Swindle, Ph.D.

Taren Massey-Swindle, Ph.D., is an associate professor in the College of Medicine departments of Pediatrics and Family and Preventive Medicine. She has built strong partnerships with diverse communities across Arkansas and secured multiple national grants to help improve feeding practices in early childhood care and education settings.

“I couldn’t have received this award without incredible community partners and the dedication that they have every day to doing good work for child health. It’s because of those partnerships that I’m able to do community engaged research,” said Massey-Swindle.

Community Engaged Student/Trainee of the Year: Rachel Hale

Rachel Hale is a Ph.D. student in the UAMS Fay W. Boozman College of Public Health in the college’s Health Promotion and Prevention Research program. She is an instructor and co-director of the Climate, Rural, and Global Health Master of Public Health program. Her award stems in part from her research project “Climate Change and Health Risk Perceptions of Arkansas Small Farmers through the Application of the Health Belief Model.” Hale secured a pilot grant to support her project, and she has demonstrated to her peers and students that community is always at the forefront of her work.

Community Engaged Research Staff Member of the Year: Ason Mohammed

Ason Mohammed is a senior data analyst at the Institute for Community Health Innovation.

He was recognized for his exemplary work on the research project “Comparative Evaluation of Telehealth Multi-Component Optimal Model of Postpartum Care among Rural, Low-Income and Diverse Women.” Mohammed manages databases and performs data analysis for multiple community-based participatory research projects, providing invaluable support to the institute’s research staff and principal investigators. His technical expertise and attention to detail have greatly improved all of the institute’s research projects in his time at UAMS.

Naomi L. Cottoms Community Advisory Board of the Year: Barber Shop Talk Steering Committee

With a new name this year, the award honors the memory of Naomi Cottoms, who died March 5. She was executive director of the Tri-County Rural Health Network, based in Helena-West Helena, and a longtime UAMS community partner. Cottoms was well known for her passionate work on behalf of underserved communities in the Delta.

The Barber Shop Talk Steering Committee is providing guidance on the research project “Barbershop Talk: Reducing Excessive Alcohol Use among Black Men.” The project focuses on reducing unhealthy drinking habits by bringing treatment to a more accessible location for Black men. The steering committee helped shape the research project prior to its implementation and has been instrumental in the positive progress of the study.

The celebration included a keynote address by UAMS’ Nakita Lovelady, Ph.D., MPH, and Joyce Raynor, who leads the Center for Healing Hearts & Spirits. They discussed their NIH-funded

hospital-based violence intervention program, UAMS Project Heal. Lovelady is a recent graduate of TRI’s KL2 Mentored Research Career Development Award program, and she is an assistant professor in the Fay W. Boozman College of Public Health. Their successful partnership led to Raynor winning the 2023 Chancellor’s Community Engaged Research Partner of the Year, and Lovelady winning the 2023 M. Kate Stewart Community Engaged Researcher of the Year.

UAMS Chancellor Cam Patterson, M.D., MBA, told the audience that their dedication embodies what UAMS is striving to achieve: a healthier, more equitable future for everyone in Arkansas.

“It’s only through partnerships like these that we can move the needle on health outcomes, particularly in the rural and underserved communities that need it most,” he said.

Jure Baloh, Ph.D., MHA, a 2022 graduate of the UAMS Translational Research Institute’s (TRI) KL2 Mentored Research Career Development Scholar Award Program, is using a recent National Institutes of Health (NIH) grant to support his work related to addiction treatment.

Baloh, an assistant professor in the UAMS Fay W. Boozman College of Public Health’s Department of Health Policy and Management, is developing and piloting a supervision strategy to support management and staff of addiction treatment programs.

The project is funded by a three-year, $657,103 R34 grant from the NIH National Institute on Drug Abuse. Baloh said there is a straight line from his KL2 (now K12) award to the R34.

“My KL2 experience was foundational for the success of my NIH application,” he said. “The mentorship, training, preliminary research and protected time over those two years allowed me to focus on this project and develop a truly competitive application.”

The study will provide the foundation for a future large-scale test of the supervision strategy.

“We’re trying to develop a system for addiction treatment facility supervisors to help support their counselors,” Baloh said. “That way, supervisors and staff can feel empowered and have the tools to help them do their jobs well. We think this approach can also help reduce the rates of burnout. We want to solve those issues.”

Previous studies suggest that treatment facility jobs can be highly demanding with low pay and long hours. That results in low morale and staff shortages, ultimately undermining the quality of services. The level of assistance a program can provide factors heavily into a person’s ability to recover from a substance use disorder, Baloh added.

“People receiving treatment need ongoing support from an attentive workforce to lead them,” he said. “Quality services are a key component to a successful recovery.

“Therefore, this study is focusing on the counselors, not so much the treatment. We’re focused on people having access to high quality treatment, to help them recover.”

This planning study will also emphasize the need for an increase in the use of evidence-based practices that provide support for the staff and supervisors.

“We’re trying out some components to see if we can do this at different levels,” Baloh said. “We’ll survey and interview supervisors and counselors to get an idea if they like the intervention, if it’s helpful, if it’s not too burdensome. If we’re successful in doing all that, they should be better supported to provide evidence-based treatments.”

In the U.S., addiction to opioids, methamphetamines and alcohol harm almost 50 million people annually. For supervisors of substance abuse centers to properly support counselors, they need evidence-based supervision strategies. According to Baloh, it’s common for supervisors of the programs to receive limited support.

That’s a major reason why developing and refining a supervision strategy and piloting it in treatment programs is important.

“The study is a small piece in a larger picture to improving the issues that the workforce experiences, which can help ensure access to high quality treatment,” Baloh said. “This study will provide information to inform planning and design of a future study to assess the effectiveness of the new supervision strategy in a large sample of substance use disorder programs.”

Assisting programs with methods for upgrading team morale and reducing turnover is important for Arkansans.

“The individuals working in the treatment field are our neighbors, family members, church members and friends,” Baloh said. “We hope that what we learn from this study — and future studies — is that we’ll be able to show that supervision strategies can support the workforce and increase the quality of care provided.”

“If the workforce does not receive good support, they’re unlikely to do quality work,” he said. “It’s an immediate problem to address.”

The information can also help future health professionals create methods to help supervisors and staff at other types of facilities.

“If it all proves effective, perhaps it’s something we can teach in our college’s Master of Health Administration program or other leadership trainings,” he said.

TRI is funded by the National Center for Advancing Translational Sciences of the NIH, Clinical and Translational Science Award numbers UM1 TR004909, K12 TR004924, and T32 TR004918.

Children who grow up in Arkansas have a harder time with asthma than their peers elsewhere, and a scientist at Arkansas Children’s Research Institute (ACRI) and the University of Arkansas for Medical Sciences (UAMS) hopes to discover why.

Akilah Jefferson, M.D., an early career researcher at ACRI, will use a $662,000 four-year award from the National Institutes of Health (NIH) to explore why asthma is uniquely troublesome for Arkansas children. Jefferson, a recent graduate of the UAMS Translational Research Institute’s two-year KL2 (now K12) Mentored Research Career Development Award Program, is also an assistant professor in the College of Medicine Department of Pediatrics in the Division of Allergy and Immunology. She treats children with allergies and immune conditions at Arkansas Children’s Hospital (ACH) and Arkansas Children’s Northwest (ACNW).

Asthma is among the most common childhood conditions and can be especially daunting for children in underresourced and rural areas. In Arkansas, children living in rural communities often face higher rates of asthma, especially those from minority backgrounds or low-income families. They are also much more likely to have complications from asthma that put their lives at risk.

Jefferson and her research team will explore factors like a child’s home environment, access to health care and the quality of care they receive. They will also examine how different communities and healthcare providers might contribute to these disparities.

“A child’s zip code should have nothing to do with how easy it is for them to breathe. Arkansas children need our help to determine why asthma is so challenging in our state and to create new ways to help them,” Jefferson said. “Our goal is to ensure that every child, regardless of where they live, has the chance to breathe easy and thrive.”

By learning more about these factors, Jefferson hopes to develop targeted interventions that can improve asthma outcomes for children in rural Arkansas. This could include providing better education about asthma management, increasing access to healthcare, or addressing environmental factors that can trigger asthma attacks.

The funds are awarded through NIH’s Mentored Patient-Oriented Research Career Development (K23) program, designed to provide protected time for clinically trained researchers to receive intensive, supervised research training in biomedical research. The award supports a period of supervised research and research career development to prepare the candidate to successfully seek an NIH R01 or equivalent major research grant by the end of the award period. Tamara Perry, M.D., chief of Allergy and Immunology at Arkansas Children’s and a professor of Pediatrics in the UAMS College of Medicine, serves as Jefferson’s mentor on the project.

This work was supported by the UAMS Translational Research Institute, which is funded by the National Center for Advancing Translational Sciences at the National Institutes of Health, grant award Kl2 TR003108.

The UAMS Translational Research Institute (TRI) recently welcomed three UAMS faculty members to its leadership team, with Jason E. Farrar, M.D., Melody Greer, Ph.D., and Tuhin Virmani, M.D., Ph.D., providing oversight of key programs and serving on the TRI Leadership Council.

Farrar is co-director and a multiple principal investigator of the K12 Mentored Research Career Development Award Program, joining co-directors/MPIs John Arthur, M.D., Ph.D., and Mario Schootman, Ph.D. Farrar is an associate professor of pediatric hematology/oncology and director of the Arkansas Children’s Research Institute Genomic Core Laboratory. He is also co-director of the Arkansas Children’s Hospital Leukemia and Lymphoma Program.

Greer is co-director of the T32 Health Sciences Innovation and Entrepreneurship (HSIE) Training Program for postdoctoral fellows, joining co-director/principal investigator John Imig, Ph.D. Greer is an assistant professor in the College of Medicine Department of Biomedical Informatics and a graduate of the HSIE program.

Virmani is co-director of Translational Workforce Development, joining Schootman. Virmani will also lead new initiatives in clinical trials education through the Clinical Trials Learning Collaborative, scheduled to launch in 2025. He is an associate professor in the College of Medicine Departments of Neurology and Biomedical Informatics. He is also vice chair for Education and chief of the Neurodegenerative Disorders Division in the Department of Neurology. In addition, he is director of the Mission MSA Center of Excellence, the Huntington’s Disease Society of America’s Center of Excellence, and co-director of CurePSP Center of Care.

TRI Director Laura James, M.D., said she is excited to have them on the team.

“Each of these faculty leaders brings unique experience and expertise to TRI,” she said. “They are each committed to helping our programs thrive, and I am thrilled that they are here.”

As Dewey Hickey took apart and reassembled a bait casting reel using an experimental prosthetic hand system, he marveled at the revolutionary technology that made it possible.

“It amazes me,” said Hickey, who in January 2023 became the first Arkansan and only the second person in the world to receive the device, which restored his sense of touch and grip force. “This has even enhanced the science fiction buff in me.”

A retired pastor, Hickey, 85, said he was skeptical when he first heard about the innovative device, which is part of a research collaboration between the system’s inventors at the Institute for Integrative and Innovative Research (I³R) at the University of Arkansas at Fayetteville and the University of Arkansas for Medical Sciences (UAMS).

“I told them upfront I didn’t think it was going to work on me because I haven’t had use of my hand for 75 years,” said Hickey, whose amputation stemmed from a bicycle accident when he was 10.

Before agreeing to receive the experimental prosthesis, he met with the I³R inventors and then the UAMS surgery team, led by neurosurgeon Erika Petersen, M.D.

In his first meeting with the I³R team, James Abbas, Ph.D., who co-leads the team, gripped his left arm above the amputation and asked Hickey to move his nonexistent thumb. He hesitated, telling Abbas that it seemed impossible, but Abbas encouraged him to try his right thumb first, then to think about having a left thumb. Hickey focused on the muscles that would have moved the thumb, then did the same to make a fist.

“I feel it,” he recalled Abbas telling him. “You’ve got everything we need to work with.”

Abbas, who has a joint appointment with UAMS in the College of Medicine Department of Neurosurgery, led the discussions that brought the team of UAMS surgeons, Snell Prosthetics and Orthotics and health technology companies together with I³R’s Adaptive Neural Systems Group (ANS). The UAMS Translational Research Institute also facilitated collaboration on the study.

Next, Hickey met with Petersen, director of the Section of Functional and Restorative Neurosurgery in the College of Medicine Department of Neurosurgery who has a courtesy appointment with I³R, and UAMS orthopaedic hand and nerve specialists John Bracey, M.D., and Mark Tait, M.D., both in the Department of Orthopaedic Surgery.

“Dr. Petersen is who I primarily spoke with, and she is very personable,” he said. “I met with them for over an hour, and finally Dr. Petersen turned to Dr. Abbas and said, ‘Look, I know this man’s about to be 84 years old, but his body is not, and his mind is certainly not.’”

The December meeting concluded with Hickey agreeing to the Jan. 9, 2023, surgery, with hopes that his participation will someday help soldiers and others who have lost limbs.

“By that time, they had given me a complete understanding of what the program was about, and I said, ‘Yes, I’m willing to do the research — whatever you want me to do,’” he said.

The ongoing clinical trial is titled, “Neural Enabled Prosthesis for Upper Limb Amputees,” and has been approved as an investigational device by the Food and Drug Administration. The project is supported by the U.S. Department of Defense, National Institute of Biomedical Imaging and Bioengineering of the National Institutes of Health, and the UAMS Translational Research Institute.

‘A promise of what’s to come’

The UAMS surgeons used their complementary expertise to implant electrodes and other components that are part of the device, and which enable communication from the prosthetic hand system to the brain through the arm’s median and ulnar nerves.

Bracey and Tait had the delicate task of implanting the thinner-than-human-hair filament wires into Hickey’s nerves.

Petersen, whose expertise is helping expand the use of new and evolving technologies that can alter a patient’s nerve activity, known as neuromodulation, ensured that the neurostimulator portion of the device was placed appropriately in Hickey’s arm.

Petersen’s leadership of clinical trials testing implantable electrical devices since 2015 has produced profound outcomes for patients with intractable pain and movement disorders. She continues to lead studies of potential new procedures for Parkinson’s disease, chronic migraines, stroke and spinal cord injuries.

The prosthesis technology, Petersen said, significantly advances the ability to harness the power of the human nervous system.

“Mr. Hickey’s case is an exciting promise of what’s to come for people with amputations around the globe,” she said.

The neurostimulator in Hickey’s upper arm receives commands from the prosthesis-mounted components and produces electrical pulses that get conveyed to his nervous system, enabling the sense of touch. During his surgery, the I³R team observed and occasionally consulted with the surgeons.

Bracey and Tait work with many individuals with amputated limbs, and they have dreamed about such a breakthrough.

“The idea of enabling someone to feel with their prosthesis is pretty meaningful, and we’re excited to be part of this groundbreaking project with the I³R team,” Tait said.

A Eureka Moment

Only about a week out of surgery, Hickey began working with the I³R team two days a week in Fayetteville. During his three-hour sessions, the team helped him acclimate to the device and fine-tuned its settings as he worked on activating and recognizing the sensations in his long-latent nerves.

About 12 weeks post-surgery, Hickey had a eureka moment as he was watching television with his wife. His prosthesis was off, and he began to recognize the phantom sensations of his missing fingers.

“I was sitting there, and I said, ‘Oh my gosh, that’s my index finger; that’s my middle finger; that’s my ring finger; that’s my little finger.’ I identified my fingers for the first time. They have never been there before, well, since I was 10 years old.”

“Now, when I shake hands with somebody, I really can feel their hand with the prosthesis,” he said.

Throughout the intensive sessions with the I³R team, Hickey said he developed a bond with Abbas, Ranu Jung, Ph.D., who co-leads the program, and others on the team.

“They are just some of the most compassionate people I’ve ever been around,” he said. “You get the sense they really care.”

The clinical trial is open and recruiting participants with amputations below the elbow. Visit ans.uark.edu to learn more. For questions about the study, contact anslab@uark.edu or 479-718-2390.

This research is supported by the U.S. National Institute of Biomedical Imaging and Bioengineering (NIBIB; R01 EB023261) and U.S. Army Joint Warfighter Medical Research Program (W81WXH1910839). Abbas and Jung are the principal investigators.

The Translational Research Institute is supported by a Clinical and Translational Science Award from the NIH National Center for Advancing Translational Sciences (grant UM1 TR004909).

The Consortium of Rural States (CORES) Research Collaborative, which includes UAMS, recently released its multi-institutional pilot award Request for Applications (RFA), with up to $25,000 available per award per participating institution.

All UAMS-affiliated faculty are invited to apply, including those based at Arkansas Children’s Research Institute and the Central Arkansas Veterans Healthcare System.

Letters of intent are due Jan. 8, 2025, and invited full applications are due March 3, 2025.

The multi-institutional pilot awards involve eight institutions with Clinical and Translational Science Awards (CTSA). In addition to UAMS, the consortium includes Dartmouth SYNERGY Clinical and Translational Science Institute at Dartmouth College; Penn State Clinical and Translational Science Institute at Penn State University; the Clinical & Translational Science Center at University of New Mexico Health Sciences; Frontiers Clinical and Translational Science Institute at the University of Kansas; University of Kentucky Center for Clinical and Translational Science; The Institute for Clinical and Translational Science at the University of Iowa; and the Clinical and Translational Science Institute at the University of Utah Health.

The RFA requires the participation of at least two CORES institutions on each pilot application.

Funding emphasis for this RFA will be given to proposals that address one of the following: Climate change and environmental health; health equity for underrepresented populations; rural health; and maternal health.

Read the Request for Applications.

If you have any questions, please contact Hailey Rogers, HRogers@uams.edu. 

Unplanned life events sidelined UAMS researcher Chenghui Li, Ph.D., for two years, but since returning in 2020 she has authored or co-authored 33 published papers, thanks largely to a National Center for Advancing Translational Sciences (NCATS) re-entry grant.

The NCATS re-entry grants, also known as the Clinical and Translational Science Award (CTSA) Program Diversity, Re-training, Re-integration, and Re-entry Supplement, support researchers trying to resume their careers after time away.

Li received the two-year $221,000 grant to support her research into if and why many breast cancer patients in Arkansas are not receiving or adhering to a potentially life-saving hormone treatment known as endocrine therapy.

“I am very thankful for the NCATS supplement. It really helped me restart my career,” said Li, an associate professor in the College of Pharmacy Division of Pharmaceutical Evaluation and Policy, and a member of the UAMS Winthrop P. Rockefeller Cancer Institute’s Cancer Prevention and Population Services program.

Li applied for the grant with support from UAMS Translational Research Institute (TRI) Director Laura James, M.D., and her mentor, Laura Hutchins, M.D., professor emerita.

“Dr. Hutchins and I saw Dr. Li as an ideal candidate for the NCATS re-entry award, and she has exceeded our expectations,” James said. “Her remarkable talent and dedication have not only advanced her research but have also contributed meaningfully to her field. Dr. Li has a promising future, and we are excited to see the far-reaching impact of her work.”

TRI is funded by a CTSA (UM1 TR004909) from NCATS, a program of the National Institutes of Health.

Of Li’s 33 published papers, 22 cite NCATS and TRI support. Of those, she was lead author on six papers and corresponding or senior author on 12.

Her research has involved use the Arkansas All Payer Claims Database and Arkansas Cancer Registry database to assess the disparity of endocrine therapy use for Arkansas women with stage 0-3 estrogen responsive tumors. Patients and providers were also interviewed to determine barriers to endocrine therapy.

According to 2022 estimates, breast cancer mortality in Arkansas exceeds the national average (20.6 deaths per 100,000 compared to 18.8 nationally), especially among Black women, at 27.7 deaths per 100,000 compared to 21.0 for white women.

In her July publication in the journal Clinical Breast Cancer, Li concluded that, within the first year of diagnoses, there was no difference between Black and white women in either initiating endocrine therapy or adherence to treatment. Black women were less likely than white women to discontinue their endocrine therapy within five years of initiation after adjusting for patient sociodemographic and tumor characteristics.

This is a somewhat surprising result, Li said, based on some previous studies. One possible explanation could be that this retrospective study included women who were diagnosed from 2013-2017, and most previous studies of racial disparities in endocrine therapy treatment used data before 2010. Generic, less expensive options for aromatase inhibitors, a type of endocrine therapy to treat breast cancer, became available in 2010.

Li said her study provided a more comprehensive assessment than previous studies. By using the Arkansas All-Payer Claims Database, she was able to access insurance claims from Medicare, Medicaid, commercial plans and state employee plans, covering approximately 80% of Arkansans.

The fact that Black women have a higher mortality rate is likely due to having later diagnoses of their cancers than white women, Li said, noting that her study focused on stages 0-3 for which endocrine therapy are commonly prescribed.

“Black patients are still more likely to be diagnosed at a higher cancer stage, with larger tumors, and higher grades, all of which could increase the risk of mortality,” she said.

Another potential contributor to this finding could be that Arkansas expanded Medicaid through private option in 2014 under the provision of the Affordable Care Act (ACA), which may have increased access to this treatment and reduced cost-sharing of minority patients.

Li also received a $220,000 American Cancer Society grant in 2023, which is supporting her assessment of racial disparities in endocrine therapy use after the ACA, which was enacted in 2010 but fully implemented in 2014.

Greater access to health insurance through the ACA, along with price reductions for aromatase inhibitors, may have increased breast cancer patients’ use of the life-saving treatments, she said.

A successful effort at UAMS to reduce the amount of blood taken for lab tests from premature infants has been published in the journal Pediatrics.

The project was led by Megha Sharma, M.D., a neonatologist and associate professor in the College of Medicine Department of Pediatrics. Her work was conducted in the UAMS Neonatal Intensive Care Unit (NICU) over two years as part of the UAMS Translational Research Institute’s Implementation Science Scholars Program. Her paper, “Reducing Iatrogenic Blood Losses in Premature Infants,” was published in September.

Research has shown that blood loss from repetitive lab testing is a significant contributor to anemia in very low birth weight infants (less than 3.3 pounds). The blood lost from lab tests in the first few weeks of life often equals or exceeds the amount of an infant’s total blood volume, which is only 2-3 ounces. It can lead to a range of poor health outcomes.

“I was excited to see that we were able to achieve an 18% reduction in lab tests and blood loss,” Sharma said. “It has the potential over time to reduce the number of blood transfusions and the risk of anemia for our preterm babies.”

A key implementation strategy was revising automated patient care instructions in the electronic health record known as order sets that are used by NICU doctors.

“We had to take some of those defaults out of the computer-generated order sets so that our NICU physicians would be empowered to consider whether a blood test is actually needed,” Sharma said.

Helping physicians find the right balance of testing for such infants also involved resident education and an awareness campaign for all NICU care providers. Sharma used a travel-size 2-ounce bottle of hand sanitizer to demonstrate just how little blood the infants have available to give.

“An important aspect of this project was seeking qualitative input from physicians to thoroughly assess the NICU’s practices and culture so that we could tailor the interventions and deploy the most effective implementation strategies possible,” she said.

Resident physicians who rotate through the NICU monthly received laminated pocket cards stating the amount of blood needed for the 15 common lab tests in the NICU as well as the charges for those tests. This information also was provided in the electronic health record when entering lab orders.

Other implementation tactics included requiring documentation of the amount of blood drawn from each infant.

The project involved 354 infants and resulted in an 18.5% reduction in lab tests in the first three postnatal weeks, a 17% decrease in blood taken, and a $290,328 reduction in lab charges.

“There were fewer painful blood draw procedures and fewer invasive (central line) catheters placed as a result of this initiative,” Sharma said. The reduction in lab tests ordered also had no adverse health effects for the infants during the implementation science project.

In addition to her excitement about these results, Sharma said the implementation science project demonstrated how improvements can be made in other areas of a hospital.

“This work is generalizable,” she said. “Our methods can be adopted to reduce other unnecessary and wasteful practices, especially in an ICU setting. It involves modifying our way of thinking and embracing ‘less is more’ such that it is more respectful not only of patients but also of our economic and environmental resources.

The Implementation Science Scholars Program, led by Geoffrey Curran, Ph.D., made her project possible.

“I had identified a need for de-adopting a nonevidence-based practice, which is always a challenge. The Implementation Science program gave me a scientific and systematic way to approach it,” she said. “Dr. Curran was always present whenever I ran into barriers or needed help, and he and Dr. Sara Landes [Ph.D.] were instrumental in the success of this project. I am grateful for our biostatistician, the late Trey Spencer, for his incredible work in analyzing the effects of our interventions so we could disseminate our results to a wide community of physicians and researchers.”

Sharma said the knowledge gained in the Implementation Science program, which began in 2020, has informed her work as a student in the Clinical and Translational Science Master of Science program, supported by the Translational Research Institute, and as a current scholar in the institute’s K12 Mentored Research Career Development Program. The K12 program offers two years of translational research training, salary support and seed funding for a research project.

TRI is supported by the National Center for Advancing Translational Sciences at the National Institutes of Health, Clinical and Translational Science Award UM1 TR004909.