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 Tuesday, Jan. 21, 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.

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 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 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.

Li also received a $220,000 American Cancer Society grant in 2023, which is supporting her assessment of patient challenges 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.

In the October issue of The TRIbune, we feature one of TRI’s biggest co-sponsored events of the year, Research Expo 2024, coupled this year with the UAMS Division of Research and Innovation New Research Faculty Orientation. 

We also announce three new faculty leaders for TRI: Jason E. Farrar, M.D., Melody Greer, Ph.D., and Tuhin Virmani, M.D., Ph.D.

This issue also includes a story about Megha Sharma, M.D., whose project in TRI’s Implementation Science Scholars Program was published in the journal Pediatrics.

A story about ARresearch reveals what a rich resource it has become with nearly 11,000 registrants available to help UAMS-affiliated investigators reach their participant enrollment goals.

Read The TRIbune.

As a new faculty member at UAMS, Kristen Muller, Ph.D., said attending Research Expo 2024 and the New Research Faculty Orientation was a perfect way to start the year as a researcher.

“Being brand new, it’s really helpful learning all about the university, the processes, and putting faces with names,” said Muller, an assistant professor in the College of Health Professions Department of Audiology and Speech Pathology. “I’ve poked around the website a bit looking at the resources that UAMS has, but actually having it all laid out here and getting to meet the people and hear from them what they do and what’s available here is really helpful.”

Muller, who is conducting research in the autism community, said she was especially pleased to visit with the Translational Research Institute’s (TRI) community engagement team as well as the UAMS Division of Research and Innovation’s Office of Sponsored Programs Administrative Network (OSPAN) and the Science Communication Group.

This year’s Research Expo on Sept. 12, which drew 117 attendees, was linked for the first time with the UAMS Research & Innovation New Research Faculty Orientation at the Reynolds Institute on Aging Building.

During the orientation, which preceded the expo, TRI Director Laura James, M.D., thanked Dan Voth, Ph.D., vice chancellor for Research and Innovation, for combining the two annual events.

“I like this format, and I hope you’ll let us come back and do it again,” she said. “This is a great way to acquaint people with all the many wonderful resources that we have here at UAMS.”

Voth thanked his department leaders after they each gave brief presentations and emphasized to researchers in the audience that his division’s primary purpose is to help researchers.

“Science is hard, and you’re pursuing all this cool research, so we want to make it as easy on the administrative side as possible,” Voth said. “That’s our entire goal.”

The Research Expo included more than 40 tables and more than 50 research services available at UAMS, Arkansas Children’s Research Institute (ACRI) and the Central Arkansas Veterans Healthcare System.

Lisa Brents, Ph.D., underscored the value of the expo for all researchers, including those who are more seasoned.

“Even for investigators like me who are not new to UAMS, the expo is a great way to get a refresher on many of the infrastructural resources UAMS offers to support and enrich research,” said Brents, an assistant professor in the College of Medicine Department of Pharmacology and Toxicology. “It’s also a great opportunity to learn about changes and to interact in person with colleagues I haven’t seen in a while.”

Alexa Escapita, Ph.D., a postdoctoral fellow, was pleased that the Research Expo was the catalyst for meeting a potential collaborator.

“It was nice to meet a fellow postdoc who does research in kind of the same field, so we connected and we’re going to reach out for collaboration,” said Escapita, who is in the College of Medicine Department of Obstetrics and Gynecology.

Jasmine Stewart, M.S., a fourth-year medical student who is spending the year as part of a UAMS research team, said the expo will give her a leg up. 

“There’s a lot that I’m not familiar with, so the fact that this exists is extremely helpful,” said Stewart, a research associate at the College of Medicine Center for Hearing Health Equity.  “When I have writing assignments, or manuscripts to review, or data to analyze, instead of going to Google or Chat GPT to look up how to do something, now I’ve made contact here and I can shoot them a quick Teams message or send them an email.”

Lexus Brettell, a third-year occupational therapy doctoral candidate based at the UAMS Northwest Regional Campus, said she was impressed by the number of available resources.

“We came down from Northwest Arkansas today just to be part of this,” she said. “There are so many resources here that I didn’t know were available. There’s a lot of opportunity for funding, and funding that’s matched with mentorship. I found myself picking up so many cards, thinking that my peers or my research primary investigator may need them someday.”

Ripa Jamal, Ph.D., said she was amazed by the many resources and services offered at the expo.

“It was indeed a wonderful cross-platform for greeting and meeting with resourceful researchers and opportunities,” said Jamal, a postdoctoral fellow in the Section of Pediatric Nephrology in the College of Medicine Department of Pediatrics. “This platform gave us a chance to meet collaborators with the same interests. What stood out most for me was how involved I felt with everyone who attended. It was time well spent.”

Jamal also won a UAMS-branded cutting board during the door prize drawings, which she said was a “nice touch.” 

“Sometimes small tokens like that can serve as a pleasant reminder of the positive experiences and connections made at such events. I am looking forward to attending similar events in the near future.”

In this issue of The TRIbune, we highlight the recent Advancing Arkansas Lifespan Research Conference, which featured Neal Halfon, M.D., as the keynote speaker. The day-long event also included a diverse range of topics presented by eight UAMS-affiliated researchers, including those from Arkansas Children’s Research Institute and the Central Arkansas Veterans Healthcare System.

This issue also includes a story about TRI’s Community Engagement Core, which has joined a multisite study funded by the Patient-Centered Outcomes Research Institute (PCORI). The collaboration involves seven other community engagement teams across the U.S. with the aim of promoting and strengthening institutional support for community-based research and patient/community leadership in research.

In addition, we recognize our Summer Writing Challenge winners and highlight our K12 Mentored Research Career Development Scholars Program, which has two upcoming information sessions ahead of its letter of application deadline.

Read The TRIbune.   

The University of Arkansas for Medical Sciences (UAMS) will receive up to $2.4 million over the next four years to test prevention strategies for reducing high rates of maternal and infant deaths in the Arkansas Delta.

The grant from the U.S. Department of Health and Human Services (HHS) will fund a combination of education, training, outreach and preventive health services focusing on Helena-West Helena, Lake Village and Pine Bluff. The initial $599,887 grant is for one year and must be renewed each year.

The collaborative effort led by BioVentures LLC at UAMS includes key partnerships with the UAMS Institute for Digital Health & Innovation and the UAMS Division for Academic Pathways and Workforce Partnerships.

“This is a big team effort, and the HHS grant will help us address one of the most significant, preventable health issues in our state,” said UAMS’ Stefanie Kennon-McGill, Ph.D., the grant’s principal investigator and project director, as well as senior program manager for BioVentures, which is the project’s operations manager.

Kennon-McGill noted that while BioVentures primarily helps UAMS researchers commercialize their discoveries, its role has expanded in recent years to find other innovative ways to improve the health of Arkansans.

As of March, Arkansas had the highest maternal mortality rate in the United States, at 8.6 deaths per 100,000 live births, compared to the national average of 5.4. Arkansas also has the third highest infant mortality rate in the United States, with 7.67 infant deaths per 1,000 live births, based on 2022 data.

“Our goal with this grant is to test innovative, sustainable strategies to prevent maternal and infant deaths in the Delta region,” Kennon-McGill said.

Called the Delta Maternal Outreach and Transformational Health Education Resource (Delta MOTHER) project, it will establish and track community-level health initiatives. The primary activities supported by the grant will include:

• Holding health screenings and conducting educational outreach at existing community events in Helena-West Helena, Lake Village and Pine Bluff.
• Providing four interactive educational presentations for local health care providers each year covering evidence-based, best practices in maternal and infant care.
• Engaging five college students per year who will identify community needs and work with the BioVentures team to develop their ideas for sustainable solutions and gain entrepreneurial skills and training.

The UAMS Institute for Digital Health & Innovation and its High-Risk Pregnancy Program will offer the Delta MOTHER project clinical expertise, partnership connectivity and fiscal management. Its contributions also include access to its three grant-funded satellite digital health resource centers at Lake Village, Helena-West Helena and Pine Bluff.

The Division for Academic Pathways and Workforce Partnerships will engage college students through its SUPER Program, providing opportunities for undergraduates to conduct community-based research, focusing on health challenges that affect populations with limited access to medical care.

Other key partners on the grant are the Jefferson Regional Medical Center School of Nursing in Pine Bluff, the Arkansas Rural Health Partnership in Lake Village, and UAMS East Regional Campus in Helena-West Helena.

Kennon-McGill is a 2021 graduate of the TRI KL2 (now K12) Mentored Research Career Development Scholars Program. TRI is supported by the National Center for Advancing Translational Sciences of the National Institutes of Health, grant UM1TR004909.

University of Arkansas for Medical Sciences (UAMS) researcher Taren Massey-Swindle, Ph.D., and a Louisiana Tech University collaborator have secured a $3 million grant from the National Institutes of Health (NIH) to address feeding practices at 80 early childhood care and education sites in Arkansas and Louisiana.

Massey-Swindle and Julie Rutledge, Ph.D., from Louisiana Tech University in Ruston, found in prior studies that early childhood care and education settings frequently use inappropriate feeding practices such as hurrying children and encouraging them to eat more. Such practices contribute to eating less healthy foods, overeating and long-term food rejections.

A big part of the five-year, $3,043,419 grant from the NIH National Institute of Diabetes and Digestive and Kidney Diseases is its “de-implementation” plans for eliminating inappropriate feeding practices. 

While early childhood teachers and caregivers may mean well, their words and actions can undermine long-term healthy eating habits, Massey-Swindle and Rutledge said.

“We have no negative judgment for these teachers,” said Massey-Swindle, a former early-childhood educator and now associate professor in the College of Medicine departments of Pediatrics and Family and Preventive Medicine. “When I was a child care provider myself, I told children to clean their plates and make a happy plate. I had no training in how to support children around positive feeding practices at mealtime.”

The issue is significant, she said, because children will eat more than 500 meals a year with the adults in their early care and education classrooms.

“It’s really an opportunity to support those adults in this setting with training that they otherwise don’t get,” Massey-Swindle said.

The 80 sites are in the Little Rock and Russellville areas in Arkansas and in Ruston and New Orleans areas in Louisiana.

By the end of the five-year study, the researchers expect to have determined the effectiveness of a package of strategies that can be applied and tailored for early care and education settings across the United States. They also expect that by removing inappropriate feeding practices, their results will show a positive impact on children’s dietary behaviors. They will track children’s willingness to try different foods, fear of new foods, and how many fruits and vegetables they eat.

“Finding ways to impact the health of children in our communities is really my passion,” said Massey-Swindle, who recently became director of the Arkansas Children’s Research Institute (ACRI) Link, a core of services focusing on community-engaged dissemination and implementation science. “From a scientific perspective, we’re going to be answering some really compelling questions about whether de-implementation effects can be sustained over time.”

To help secure the NIH award, Massey-Swindle used a pilot grant from the UAMS Translational Research Institute to get preliminary data on the effectiveness of a virtual communication approach to reducing inappropriate feeding practices. Rutledge also received pilot funding from the Lincoln Health Foundation in Louisiana to test in-person approaches to reducing inappropriate feeding practices. Ultimately, they developed an effective hybrid model using in-person and virtual approaches.

“We really work hard to get robust preliminary data to support our R01-level NIH applications,” Massey-Swindle said. “Without funding like the Translational Research Institute provides, there’s no way for researchers to do that. I think it strengthened our application a great deal.”

She is also a graduate of the Translational Research Institute’s KL2 (now K12) Mentored Research Career Development Scholars Program, which provides two years of mentored research support, salary support and seed funding.

In addition, Massey-Swindle said the Arkansas Children’s Nutrition Center (ACNC) provided funding and support for her to attend an intensive grant development workshop with one-on-one writing, coaching and detailed feedback that helped her submit a competitive grant application. The ACNC is supported by Arkansas Children’s, UAMS and the USDA Agricultural Research Service.

The Translational Research Institute is supported by the NIH National Center for Advancing Translational Sciences, Clinical and Translational Science Award #UM1 TR004909.