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February 7, 2014
Table of contents
UW Medicine’s success is built upon many individual contributions
Thank you to the many individuals who attended my annual address yesterday, either in Hogness Auditorium or by video link at another UW Medicine site. If you were unable to attend and would like to hear my comments, a video of the address is on the UW Medicine home page.
A major point of my annual talk is to thank every member of our community for your outstanding work and active commitment to UW Medicine. I greatly appreciate your many contributions to our mission of improving the health of the public. You truly are at the core of UW Medicine’s progress and success!
Our faculty, staff, students and trainees at UW Medicine’s hospitals and clinics offer different levels of service—some offer primary care, some secondary care, some tertiary and quaternary care and some a combination. Similarly, faculty and staff activities in support of our mission of improving health—teaching, research and patient care—are diverse and complementary. The diversity and excellence of our services and activities are key strengths of UW Medicine.
The individuals who choose to work at UW Medicine are vital to our success in our clinical, teaching and research activities. I would like to highlight the services of one individual, Janell Douglas, grants review manager for the School of Medicine. Janell has worked at the University of Washington for 40 years, including a number of years in the Department of Bioengineering. For the past 16 years, Janell has led the research grant review process for the School of Medicine in the Office of Research and Graduate Education. During the time that Janell has reviewed grants for the School, research awards to University of Washington-based faculty have totaled nearly $7.5 billion. The dollar value of her service is much higher, however, since awards to UW Medicine faculty and affiliated investigators based at other research institutions are not included in that figure.
From 1998 when she began her manager role to the end of 2013, the annual volume of grant proposals involving School of Medicine faculty doubled from 2,200 to nearly 4,400. Janell has personally reviewed 32,000 grants, contracts and research agreements. With help from her capable staff, a total of 54,000 grants were reviewed during her 16 years of leadership.
Janell is helpful, cheerful, careful, knowledgeable and committed. In 16 years, her supervisor Kathy Bracy estimates that Janell has been offline and unavailable to monitor grant routing fewer than 20 days. In performing these reviews, Janell has been an invaluable resource for training throughout the UW community.
I would like to thank Janell for her wonderful work—that continues to this day. Forty years of outstanding service at one institution is a remarkable legacy. Janell Douglas and many others—faculty, staff, students and trainees at all levels and in a variety of positions and locations—make UW Medicine a truly inspiring place to work.
Paul G. Ramsey, M.D.
A substantial fraction of the Neanderthal genome persists in modern human populations. A new approach applied to analyzing whole-genome sequencing data from 665 people from Europe and East Asia shows that more than 20 percent of the Neanderthal genome survives in the DNA of this contemporary group, whose genetic information is part of the 1,000 Genomes Project.
Previous research proposes that someone of non-African descent may have inherited approximately 1 percent to 3 percent of his or her genome from Neanderthal ancestors. These archaic DNA sequences can vary from one person to another and were aggregated in the present study to determine the extent of the Neanderthal genome remaining in the study group as a whole. The findings are a start to identifying the location of specific pieces of Neanderthal DNA in modern humans and a beginning to creating a collection of Neanderthal lineages surviving in present-day human populations.
University of Washington scientists Benjamin Vernot and Joshua M. Akey, both population geneticists from the Department of Genome Sciences, report their results Jan. 29 in Science Express. Vernot is a graduate student and Akey is an associate professor. Their paper is titled, “Resurrecting Surviving Neanderthal Lineages from Modern Human Genomes.”
To check the accuracy of their approach, Vernot ran their analysis before comparing the suspected Neanderthal sequences they found in modern humans to the recently mapped Neanderthal genome obtained from DNA recovered from bone. This genome came from the paleogenetics laboratory of Svante Paabo of the Max Planck Institute for Evolutionary Anthropology in Germany.
“We wanted to know how well our predictions matched the Neanderthal reference genome,” Akey said. “The analysis showed that, after more refinement of these methods, scientists might not need a reference genome from an archaic species to do this type of study.”
The results suggest that significant amounts of population-level DNA sequences might be obtained from extinct groups even in the absence of fossilized remains, because these ancient sequences might have been inherited by other individuals from whom scientists can gather genomic data, according to Akey. Therein lies the potential to discover and characterize previously unknown archaic humans that bred with early humans.
“In the future, I think scientists will be able to identify DNA from other extinct hominin, just by analyzing modern human genomes,” Vernot said.
Serious risks are associated with continuing game play immediately after incurring a concussion, yet University of Washington researchers found that many young female soccer players do just that.
John O’Kane, UW professor of orthopaedics and sports medicine, and Melissa Schiff, professor of epidemiology and director of education at the Harborview Injury Prevention and Research Center, had parents make weekly online reports about any concussion symptoms their daughters experienced. They determined that a majority of players stayed on the field after experiencing concussion symptoms, and half never sought medical care.
The findings are reported Jan. 20 in JAMA Pediatrics. The study was supported by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases. “Unlike a sprained ankle, concussion symptoms like a headache or dizziness often don’t physically prevent an athlete from continuing play, even though they’re putting themselves at risk by doing so,” O’Kane said.
Part of the problem may be that many concussed players don’t recognize symptoms. Concentration problems, headache, and dizziness were the most commonly reported symptoms in the study. More obvious symptoms, such as loss of consciousness, were least common.
Playing through concussion makes people more vulnerable to getting hit again, and having longer and more severe symptoms. A second blow can cause a rare condition known as second-impact syndrome, which can result in severe injury or death. Second-impact syndrome typically occurs in people under 20, O’Kane said.
O'Kane and Schiff found a higher rate of concussion among middle school soccer players than has been reported among high school and college soccer players.
“Young athletes who get a concussion tend to underreport or minimize it because they don’t want to be taken out of play,” Schiff said. “Unless they tell their coach about it, coaches often aren’t aware of what happened.”
Schiff and O’Kane emphasized the crucial role education plays in preventing concussed players from returning to the game and reinjuring themselves.
UW Medicine’s top research awards have been listed for October through December 2013. The list draws from all awards, including those for new projects and for an additional installment to an existing project. Awards granted during January through March 2013, April through June 2013, and July through September 2013 are also available online.
On Jan. 14, patient Dave Skelton received a donor kidney, transplanted by surgeon Stephen Rayhill, UW professor of surgery. UW Medicine media representatives Elizabeth Hunter and Kim Blakeley live-tweeted updates before, during and after the three-hour procedure—encapsulated in a Storify file. Read the full story at UW Medicine Storify.
Carlos Pellegrini, the Henry N. Harkins Professor and Chair of the Department of Surgery at the UW and president of the American College of Surgeons (ACS), has been elected an Honorary Fellow of The Royal College of Surgeons of England (RCS). The award, one of the RCS’s highest honors, recognizes Pellegrini’s contributions to surgery. He will be formally admitted to the Honorary Fellowship on July 8, 2014 in London.
Pellegrini is a world leader in the field of minimally invasive gastro-intestinal surgery and a pioneer in the use of videoendoscopy for the surgical treatment of gastroesophageal reflux disease. He developed the initial techniques for the minimally invasive treatment of esophageal motility disorders.
The Royal College of Surgeons of England, established in 1800, is a professional membership organization and registered charity. The College’s mission is to advance surgical standards and improve patient care. The College supports 20,000 members in the United Kingdom and internationally by providing education and training, developing policy and guidance, and carrying out projects to improve surgical care.
In October, Pellegrini was installed as the 94th president of the American College of Surgeons (ACS) during the 2013 Clinical Congress in Washington, DC.
Pellegrini has been chair of the Department of Surgery since 1993; in 1996, he became the UW’s first Henry N. Harkins Professor and Chair in recognition of his role in strengthening the department’s clinical, teaching and research programs. He is credited with the development of UW’s Center for Videoendoscopic Surgery, the Center for Esophageal and Gastric Surgery, and the Institute for Simulation and Interprofessional Studies (ISIS). He is a long-time member of the UW Medicine’s highest decision-making bodies and chairs many committees that oversee a range of topics, including continuous professional improvement, diversity, executive search committees, and oversight of multidisciplinary practices.
In addition to the ACS presidency, Pellegrini’s ACS involvement includes serving on the Steering Committee on Simulation-Based Surgical Education, the Task Force on the Resident 80-Hour Work Week, and the Health Policy and Advocacy Group.
The American College of Surgeons, a scientific and educational organization of surgeons, was founded in 1913 to raise the standards of surgical practice and improve the quality of care for surgical patients through ethical and competent practice of surgery and advocacy for surgical patients. The ACS has more than 79,000 members and is the largest organization of surgeons in the world.
Read more about Carlos Pellegrini’s installment as ACS president online.
UW Medicine students and faculty presented their research at a major western conference held in Carmel, Calif., in January; many were recognized for contributions. Sixty-nine UW School of Medicine students were among the 298 participants at the annual meeting of the Western Student Medical Research Forum (WSMRF) Jan. 23-26. The annual conference is held in conjunction with the Western Section American Federation for Medical Research (WAFMR), Western Society for Pediatric Research (WSPR), Western Association of Physicians (WAP), and the Western Society for Clinical Investigation (WSCI).
The second- and third-year medical students showed posters and gave oral presentations to students and faculty from 20 western medical schools and programs from across the United States and Canada. The majority of the presentations were on projects the students designed and implemented as part of their Independent Investigative Inquiry (III) research requirement.
WSPR Subspecialty Award Winner: Matthew Perez (2nd-year student), Analyzing the Clinical Indications When Testing for Lynch Syndrome Using Next Generation Sequencing
WSPR Abbott Nutrition Lowell Glasgow Student Research Award: Amanda Valdez (2nd year)
WAFMR/WAP Subspecialty Award Winners: David Roach (3rd year), Whole Genome Sequencing of 366 Clinical E. Coli Isolates Compares Genotype with Phenotype and Shows the Molecular Epidemiology Among Strains; Alexander Salter (2nd year), Combinatorial Antigen Recognition by Engineered T Cells; and Spencer Schulte (2nd year), Diuretic Management of Patients with Stage 3 and 4 Chronic Kidney Disease.
Four students from the UW School of Medicine were honored for best oral presentations. The presentations were rated by WSMRF student representatives on PowerPoint quality, clarity, style of delivery and response to questions.
Best oral presentations: Nicole Duggan (2nd year) received the Klea Bertakis Award for Dissecting the Effect of Novel Basal Ganglia-Prefrontal Cortical Projections in Schizophrenic Pathophysiology; Steven Levitte (3rd year) received the Dionesia P. Bertakis Award for SNAPC1 Mediates Susceptibility to Mycobacterial Infection in Zebrafish; Andrew Maertens (2nd year) received Gale Hansen Starich Award for Comparative Radiation Exposure Using Standard Fluoroscopy versus Cone Beam CT for Posterior Instrumented Fusion in Adolescent Idiopathic Scoliosis; and Max Dougherty (2nd year) received the David Lupan Award for Transcript Characterization o the Human-Specific Neural Gene HYDIN2.
WSCI Travel Award: Lori Cooper, senior fellow in the Division of Metabolism, Endocrinology and Nutrition
UW faculty were also honored at the meetings.
Of 11 new WSCI members, six were UW Medicine faculty: Brad Anawalt, professor of medicine and vice chair of the Department of Medicine; Ann O’Hare, associate professor of medicine in the Division of Nephrology; Hyang Kim, assistant professor of medicine in the Division of Allergy and Infectious Diseases; Josh Thaler, assistant professor of medicine in the Division of Metabolism, Endocrinology and Nutrition; Ian de Boer, associate professor of medicine in the Division of Nephrology; and Ellen Schur, assistant professor of medicine in the Division of General Internal Medicine.
Fred Buckner, associate professor of medicine in the Division of Allergy and Infectious Diseases, became WSCI president-elect.
Anna Wald, professor of medicine, epidemiology and laboratory medicine, was the WSCI Outstanding Investigator. Her lecture was titled Sex, Shedding and Suppression The HSV Story.
Mary-Claire King, professor of medicine and genome sciences, gave the WAP Distinguished Lectureship, titled Tools of Genomic Medicine of Use to the Physician in Practice.
Three faculty presented State-of-the-Art lectures: Gregory Roth, acting assistant professor of medicine in the Division of Cardiology, gave the Health Outcomes Research State-of-the-Art talk, Measuring the Global Burden of Disease and Disability. David S. Owens, assistant professor of medicine in the Division of Cardiology, gave the Cardiovascular State-of-the-Art talk, Calcific Aortic Stenosis: A Disease Comes of Age. Rebecca Prince Petersen, assistant professor of surgery, gave the Surgery State-of-the-Art talk, Update on Hernia Repair.
While not quite matching the nervous energy and delighted relief of Superbowl Sunday’s Seahawks victory, curriculum renewal still generated considerable interest and enthusiasm as it took center stage on Friday, January 31. In a well-attended public forum in Turner Auditorium, 12 of 13 full proposals submitted through a Request for Proposals (RFP) process were vetted. Tom Montine, committee chair and chair of the Department of Pathology, hosted the event and introduced presenters.
About 100 faculty, staff and students were on hand to hear the presenters discuss their ideas for integrating the overall structure of the scientific foundations phase of the medical student curriculum. Many more tuned in online from throughout the WWAMI region or later viewed the session video-recording.
The RFP was issued in late 2013 by the Foundations Phase Committee of curriculum renewal to elicit possible structural models for the scientific foundations section of the curriculum.
Keiran Warner, a second-year medical student, opened the forum with a proposal generated by a group of students. “The UW is known as an institution able to make big, radical changes,” said Warner in introducing the students’ proposal for an integrated patient-centered curriculum. He cited the WWAMI program and the Colleges program as two examples.
About another proposal generated and presented by students, first-year medical student and co-proposer Ryan Smith later said: “I’m interested in changing the face of medicine and I want to start a small effort at UW.”
In addition to medical students, proposals came from faculty, staff and residents. As many as 150 people participated in preparing all the proposals. Four full proposals came from faculty and students at WWAMI sites. Tim Robinson, interim assistant dean for first year at WWAMI Wyoming, was present via videolink from the University of Wyoming in Laramie to describe his ideas for integrating the curriculum and field questions. Larry Kirvin, assistant clinical dean for WWAMI Wyoming, was streamed in from Buffalo, WY to present his proposal.
Second-year medical student Lauren Benson traveled to Seattle from Spokane to present a proposal based on student and faculty experiences at the WWAMI Spokane second-year pilot site. Jane Shelby, assistant first-year dean for WWAMI Alaska, along with colleagues Bob Furilla and Cindy Knall, traveled from Anchorage to present their proposal for an integrated curriculum.
Warm applause followed every proposal and a five-minute question and discussion followed each presentation. After the three-hour session, audience members and participants convened to Turner Conference Hall for a reception where posters were displayed outlining additional proposals submitted for individual courses, themes or a segment of the curriculum. Both poster presenters and earlier presenters mingled with audience members to answer questions and discuss the posters and session. Twenty-two course, theme or segment proposals were submitted. These will be carefully considered further in the appropriate committee settings for incorporation into the curriculum.
At the poster session reception, Keiran Warner was asked why students would take time out of medical school to create ideas that won’t be adopted until after they graduate. He responded, “This school means a lot to me. This is an opportunity I couldn’t pass up.”
Sherilyn Smith, professor of pediatrics and a member of the Curriculum Renewal Steering Committee, was able to attend part of the Friday session. She later commented, “This entire experience has made me very proud to be part of the faculty and grateful to be part of the process to create the new curriculum for UW Medicine.”
The day after the public forum, the full Foundations Phase Committee met to consider the 13 full proposals. The process to review proposals in the all-day Saturday retreat, led by Tom Montine, was patterned closely after National Institutes of Health study section procedures. Each proposal had been carefully reviewed and assessed on pre-established criteria by three committee members prior to the retreat. All the proposals were ranked and the strengths and weaknesses of each discussed at the retreat by the entire committee, followed by post-discussion re-ranking. Committee members who participated in preparing a full proposal were recused from the rankings and discussion. Comments and assessments were considered carefully from non-committee members who had weighed in on a Catalyst website during a public comment period.
The final proposal may be based on one proposal or a blend of different proposals. The Foundations Phase Committee will submit its recommendations to the Curriculum Renewal Steering Committee in mid-February. Further discussion of the recommendations from all committees addressing curriculum renewal (Foundations Phase Committee, Patient Care Committee, Intersessions, Transitions and Scholarship Committee, Evaluation Committee, and Governance Committee) will occur among the Curriculum Renewal Steering Committee and UW School of Medicine leadership over the subsequent month. In addition, public comments on the recommendations will be elicited broadly through town hall meetings in March open to all.
Once a structure is decided upon for the Foundations Phase and other aspects of the curriculum, development of content will commence. The goal is to begin the new curriculum in fall 2015.
All 13 full proposals and 22 theme, class and segment proposals, as well as a video of the three-hour Friday presentation session, can be viewed online (UW NetID required to access). Please contact Michael Ryan, associate dean for curriculum, at firstname.lastname@example.org with questions.
WWAMI is recognized nationally and internationally as a model program for training physicians and other health professionals for rural areas. This philosophy was embraced by Jefferson Memorial Healthcare in Port Townsend, Wash., a small community located on the northeast tip of the Olympic Peninsula. Port Townsend is one of five designated Targeted Rural and Underserved Track (TRUST) sites in the Western Washington WWAMI region. Under the leadership of Molly Hong of Jefferson Healthcare Primary Care, Port Townsend is in its fourth year participating in the TRUST program.
After completing medical school at Brown University in Providence, R.I., Hong moved to the Pacific Northwest to complete her family medicine residency at Oregon Health & Science University in Portland, and an OB/GYN fellowship at Tacoma General Hospital in Tacoma, Wash. “It was during my rural rotations…that confirmed in my mind the need for family docs in rural settings and the fact that family docs in rural settings have more fun,” Hong says.
Hong says she loves working with students, keeping up with academic medicine and staying on top of the medical literature. She explains that having medical students, “offers a breath of fresh, positive air to me, my staff and my patients.” Hong shares her enthusiasm for teaching medical students with her colleagues Rachel Bickling, Joe Mattern, Todd Carlson, and Molly Parker, at Jefferson Healthcare Primary Care.
This academic year, Jefferson Memorial Hospital became a teaching site for third-year medical students on the internal medicine clerkship under the leadership of Gemma O’Keeffe. O’Keeffe was a Peace Corps volunteer in the Dominican Republic prior to attending medical school at the UW.
During medical school, O’Keeffe met and married fellow physician, Chris Giedt. The couple completed internal medicine residencies at the University of California at Davis and joined the Jefferson Memorial Healthcare system in 2010. O’Keeffe teaches outpatient internal medicine with the help of her colleagues Sarah Schmidt, Steve Butterfield, Carrie Day, Tracie Harris, Chris Giedt, Judy Gaynes, Karen Forbes, and Matt Crowell. Giedt and his colleagues teach inpatient medicine.
During the 2014-2015 academic year, 11 medical students—eight students doing an internal medicine rotation and three TRUST students—will learn the art of medicine through the committed faculty members at Jefferson Memorial Healthcare.
Corrections to Online News, Jan. 24, 2014
School of Medicine announces new endowed faculty appointments: Howard Chansky, UW professor, Department of Orthopaedics and Sports Medicine, is the first holder of one of the Hansjörg Wyss Endowed Chairs for the Advancement of Hip and Pelvis Surgery. Chanksy is one of three Hansjörg Wyss Endowed Chairs; the remaining chairs will be named in the future.
Sleep apnea higher among men than women: The photo caption in the email version of the Jan. 24 Online News misidentified Nathaniel Watson as Hunter Wessels.
The following events may be of interest to the UW Medicine community:
Fred Hutch Science for Life, Feb. 13 & Feb. 27
The “Science for Life” lecture series offers the public an opportunity to interact with world-class researchers in a fun and informal atmosphere, 7 to 8:30 p.m., Thursday, Feb. 13 and Feb. 27, Fred Hutchinson Cancer Research Center, Thomas Building, Pelton Auditorium, 1100 Fairview Ave. N. , Seattle.
Feb. 13, Getting to the root of the problem: Eliminating the gene behind inherited diseases
To find out more or to register, visit the Science for Life website or contact Mary Hazen at email@example.com or 206.667.1226 for more information.
UW School of Medicine alumni awards nominations open until Feb. 21
UW School of Medicine alumni, faculty, staff and other professional colleagues are invited to nominate alumni for a series of awards, including the Distinguished Alumnus Award, to be presented at the Reunion Weekend, June 6-7. Anyone who has received an M.D. from or completed a residency program or fellowship at the UW School of Medicine is eligible. Nominations are due by Feb. 21, 2014. Nominations can be submitted online or by email at firstname.lastname@example.org. For more information, please call 206.685.1875.
Science in Medicine Lecture, Feb. 24
More Than Meets the Eye: New Retinal Photoreceptors, and the Promise of Vision Restoration, 12 to 1 p.m., Monday, Feb. 24, Health Sciences Bldg., K-069 (Fialkow Biomedical Sciences Research Pavilion). Russell Van Gelder, the Boyd K. Bucey Memorial Chair, professor, and chair of Department of Ophthalmology, will give the lecture. Van Gelder has been at the forefront of research in non-visual ocular photoreception and molecular diagnostics of ocular inflammatory disease. He is president-elect of the American Academy of Ophthalmology, associate editor of Investigative Ophthalmology and Visual Sciences, and a member of the editorial board of the journal Ophthalmology. Lectures are open to all faculty, staff and students. No registration required.
Microsoft-UW Workshop on Technology Enriched Instruction offered Feb. 25
Learn to Use Technology in Teaching: A Microsoft-UW Workshop on Technology Enriched Instruction, 8 a.m. to 5 p.m., Tuesday, Feb. 25, in the Husky Union Building (HUB), Room 250, UW Seattle campus. The session incorporates participatory and inquiry-based learning, allowing faculty to actively experience a range of technology tools and resources and research-based approaches to use in teaching. This activity has been approved for AMA PRA Category 1 Credit™. Sign up for the workshop online. Contact Stephanie Habben at email@example.com for information.
11th Annual Western Regional International Health Conference (WRIHC), April 4-6
Uncensored: Gender, Sexuality & Social Movements in Global Health, April 4-6, 2014, University of Washington, Seattle. Conference will cover social and political movements, diverse sexualities and sexual health, gender-based violence, reproductive rights, global discrimination against LGBTQ community, income inequality, and universal access to healthcare. Keynote speaker will be Stella Nyanzi, Ph.D., of the Makerere Institute of Social Research at Makerere University in Kampala, Uganda. Her research covers the politicization of sexuality in contemporary Uganda. The conference is sponsored by the UW, the WRIHC, UW chapter of GlobeMed and the UW Department of Global Health. Register here. For more information, visit the Western Regional International Health Conference website or contact firstname.lastname@example.org
Paws-on Science recruiting researchers for April 4-6 Husky Weekend event
Paws-on Science: Husky Weekend at the Pacific Science Center is recruiting researchers to take part in its annual community outreach event, April 4-6. Paws-on Science, a partnership between the UW and Pacific Science Center (PSC), introduces families and the community to innovative research underway at the UW in a fun and accessible way. During the past four years, more than 1,100 UW scientists have shared their work through hands-on activities with nearly 47,000 adults and children. Scientists who are interested in taking part in the 2014 Paws-on Science, should register by Feb. 14. For more information, contact McCayla Butler at email@example.com or 206.543.1867.
Continuing Medical Education
Visit Continuing Medical Education for information on upcoming classes.
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