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Research Update

August 2018

Engaging Teens through Smartphones to Improve Their Health 

Dr. Tamara Perry is studying the use of smartphones to improving the care of teens with asthma.

Teens with asthma have an increased risk of adverse health outcomes related to asthma. In addition, this age group is traditionally difficult to engage in self-management for chronic illnesses. More than 90% of US teens have access to a smartphone, and smartphones are the preferred method of communication for teens. NIH has awarded Dr. Tamara Perry a $3.1 million, 5-year R01 research grant to assess the effectiveness of a smartphone application in improving medical self-management and reducing asthma-related illness among teens.

“Teens use their smartphones for virtually everything. Smartphones can provide teens with access to health information at their fingertips,” said Dr. Perry, Associate Professor of Pediatrics and Medical Director of ACH Telemedicine, “A smartphone app for asthma would give disease-specific health information to teens with asthma and could potentially allow them to become more involved and proactive in the management of their own healthcare.”

The study, “Implementing a Guidelines-Based M-Health Intervention for High Risk Asthma Patients,” will involve over 400 adolescent asthma patients, recruited primarily from ACH’s Adolescent, General Pediatric Clinic, and Circle of Friends Clinics. Two groups of the teens will have a mobile asthma action plan, a smartphone application that provides real-time, personalized feedback, asthma education, and data logging/tracking capabilities; for one of the two groups, data from the application will be shared with the patient’s primary care physician. A third group will have a mobile application that provides daily non-asthma-related health reminders. The teens will use the application for 12 months.

“Teens are more likely to downplay the impact of asthma on their day-to-day activities at doctor’s appointments, which can typically be up to 6 months apart. The application provides an opportunity to collect real-time data and feedback on how well the participants are controlling their asthma between healthcare visits,” said Dr. Perry. In addition to examining the impact of the application on participants’ asthma self-management skills, the study will also allow Dr. Perry and her team to measure the impact of sharing health data derived from the application with participants’ PCPs on asthma management and outcomes.

Dr. Perry pilot tested the mobile asthma action plan concept previously. Through funding from the UAMS Translational Research Institute, she confirmed that teens would engage in using a mobile application for asthma management. Additional support from the TRI included convening a community advisory board of teens and their parents to assist Dr. Perry and her team in fine-tuning features of the mobile app and the design of future studies utilizing smartphone applications for asthma. Dr. Perry also received Arkansas Biosciences Institute funds through ACRI to revise the application and study the mobile asthma action plan further by comparing utilization of the smartphone application to traditional written asthma instructions.

“Hundreds of health-related mobile applications are currently available, but very little research has been done to ensure the safety and efficacy of the majority of them. As healthcare providers and researchers, we have an obligation to design responsible technology-based solutions that improve health outcomes, noted Dr. Perry, “Support provided by the NIH will allow us to conduct a rigorous clinical trial to study the efficacy of a smartphone application designed by a collaborative team of teens with asthma, researchers, and clinicians.”

“Improving the care of teens with asthma requires not only innovations in treatment but also in ‘connectivity’ between the provider and patient. You must encounter the teenager where they live and through a medium that is interesting and appeals to them,” said ACRI President Dr. Greg Kearns, “Through her new grant from the National Institutes of Health, Dr. Perry will produce and demonstrate novel methods to improve the care of teens with asthma by using mobile health applications that will be both innovative and appealing to the patients.”

This year’s Summer Science Program provided 24 outstanding students the experience of the clinical and the research aspects of a career in academic medicine.

Summer Science Program 2018

This summer, the UAMS Department of Pediatrics/ACRI Summer Science Program provided 24 outstanding students the experience of a career in academic medicine—in both the clinical and the research aspects. These students spent June and July shadowing physicians, attending rounds and clinics, and touring different hospital units, as well as participating in mentored research projects involving children’s health. Faculty from various pediatric subspecialties taught basic science and clinical research techniques and helped the students gain exposure to clinical medicine. In addition, the Summer Science Program hosted a twice-a-week lecture series focusing on various aspects of academic medicine, graduate school, medical school, residency, research, and clinical medicine for its participants. 

Summer Science Program Awards

Anna-Claire Pilkington (left) and Julienne Daniel (right), pictured with Summer Science Program Coordinator Jenny Kubacak, received awards for their outstanding presentations at the end of the presentation week.

At the end of the Summer Science Program, each student gave a scientific presentation on his or her mentored research project. ACRI presents two awards for outstanding presentations by the students.

This year among college students, Anna-Claire Pilkington, a junior at Texas Christian University who was mentored by Dr. Umesh D. Wankhade, Developmental Nutrition was awarded first place for the Most Outstanding Presentation, “Maternal Obesity Affects Offspring Brown Adipose Tissue Transcriptome,” and she received a $500 prize. Second place was won by Julienne Daniel, a senior at the University of Arkansas, who was mentored by Dr. Keshari Thakali, Developmental Nutrition, for her presentation “The Effect of High Fat Diet on Mitochondrial Function in Perivascular Adipose Tissue (PVAT).” She received a $250 prize. The awards for the most outstanding presentations by college students were sponsored by ACRI. 

Featured Student:  Dillon Wester – Ouachita Baptist University

Dillon Wester observed the activity of chemoresistant-promoting protein expressed in pancreatic cancer.

This summer, Dillon Wester had a hands-on laboratory experience that boosted his academic and career goals. Dillon, a senior biology major at Ouachita Baptist University, worked in the laboratory of Dr. Marie Burdine at the Center for Translational Pediatric Research (P20GM121293) where he also conducted an independent research project.

Dillon observed the activity of ATAD2, a protein highly expressed in pancreatic cancer and that promotes chemoresistance, by using standard laboratory procedures. His results allowed him to locate where the protein was binding to DNA in cancer cells he grew and maintained in cultures in the laboratory. Establishing the site of binding can lead to creating inhibitors to block the cancer-promoting activity of ATAD2. Important steps to developing improved chemotherapy.

Conducting his project with Dr. Burdine’s guidance provided Dillon, from Mesquite, Texas, with an experience beyond that of his academic laboratory. “I learned how these instruments and techniques work,” Dillon said, “It was more than ‘do this’ and ‘pour this.’”

Dillon’s mentor, Dr. Burdine of the Division of Surgical Research, noted, “Opportunities like the Summer Science Program give students access to the world of science.” She wanted Dillon to understand how important research is and how much hard work is involved, but to have a love for it. Dr. Burdine noted that Dillon’s independence and focus were traits that aided in his success.

The Summer Science Program experience did reinforce the importance of medical research for Dillon. “Without research there are no advances in medicine,” he said, “It is crucial in discovering new concepts and curing disease.” It has also influenced his post-graduate goals. He is planning to focus on pediatrics in medical school (he is targeting Baylor University and University of Texas Southwestern). Dillon now is contemplating an MD/PhD program to strengthen his interest in medical research.

Julienne Daniel assessed the effect of obesity on
mitochondrial respiration.

Featured Student:  Julienne Daniel – University of Arkansas

University of Arkansas Senior Julienne Daniel plans to attend medical school and to specialize in cardiology. She pointed to shadowing cardiovascular surgeons as a highlight of her Summer Science Program experience. “I saw how the team worked together and merged two surgical procedures to help a patient,” Julienne noted. Observing the surgical team conduct this novel surgery in the operating room only made the experience more exciting and memorable.

In addition to time in the clinic, Julienne worked in the laboratory of Dr. Keshari Thakali at the Arkansas Children’s Nutrition Center. Julienne’s independent research project assessed the effect of obesity on mitochondrial respiration, a function in cells needed to convert nutrients into energy, in mice. Her data suggested that high fat diet-induced obesity reduced mitochondrial function in perivascular adipose tissue, a fat deposit surrounding blood vessels. This reduced mitochondrial function may be an important factor driving cardiovascular changes associated with obesity.

“The program has helped me respect and appreciate what research does for medicine on the whole,” said Julienne, a biology major from Little Rock. Her involvement in the Summer Science Program reaffirmed her decision to study medicine and to consider also earning a PhD concurrently. Julienne is considering medical programs at the University of Alabama, the University of Arizona, the University of Oklahoma, and UAMS.  Dr. Thakali of the Section of Developmental Nutrition stated, “It’s important for students to understand the process of how research leads to advancements in medicine.” Dr. Thakali noted that Julienne’s demonstration of intelligence, diligence, and inquisitiveness indicated she would be successful this summer and in the future.

About the Summer Science Program

Dr. Robert Fiser, Chairman of the Department of Pediatrics (1975 to 1994), created the Summer Science Program in 1989 to encourage Arkansas college students to pursue careers in medicine and science. Initially, a few college students worked in various research laboratories in the department. Throughout the history of this program, it has been funded using seed money from drug companies, then private companies and a pediatric clinic, and currently through the UAMS Department of Pediatrics, Arkansas Children’s Research Institute, and the Stella Boyle Smith Trust (which sponsors two Stella Boyle Smith Summer Scholars from Episcopal Collegiate School)—testimony to the broad range of research and clinical support for this program.

Jenny Kubacak is the Coordinator of the Summer Science Program. Since 1992, approximately 300 students and over 100 pediatric research faculty members have participated in the program. This year, the program selected its participants from more than 120 applications and received the support of 24 faculty members serving as mentors. The Summer Science Program has an application deadline of February 28, 2019, for next year’s participants.

Going to Bat for Clinical Research

High-quality clinical research increases our knowledge to improve the diagnosis, treatment, and prevention of pediatric diseases and disorders. Our pediatric clinical researchers conduct studies, with consenting patients, and perhaps their families, to answer specific questions about new biomedical and behavioral interventions, such as drugs, treatments, and devices, or new ways to use known interventions. Their goal is to assure that medicines, vaccines, and treatments are safe and effective ways to prevent illness or to help children get well and feel better.

These studies, often known as clinical trials also require the participation of children and families. To recruit children and families for clinical trials, the clinical trials staff at ACRI use social media, print and broadcast advertising, and public events. A promotional event that has been successful in recent years to boost recruitment of clinical research participants and awareness of pediatric clinical research has been meeting families at Arkansas Travelers baseball games.

Building on seven successful seasons with the Travelers, ACRI is also teaming with the Northwest Arkansas Naturals in Springdale to champion pediatric clinical research. Beginning this summer, Brandi Poe, Clinical Research Recruiting Coordinator, is now registering interested families in Northwest Arkansas for the clinical trials database and inviting them to subscribe to ACRI’s text service.

Brandi has scheduled four Naturals games in Springdale to meet with young families to discuss the importance of pediatric clinical research. Many families were unaware of research at Arkansas Children’s. A common misunderstanding about clinical studies is that they are only for sick children. Through these events, Brandi can inform parents that many clinical trials also require healthy kids and address other questions about clinical trials. Families leave with more insight into research and its importance. Many choose to be involved and join the research registry and subscribe to ACRI’s text alerts.

Behind the ACRI booth on the concourse of Arvest Field, the newly opened ACH-Northwest stands impressively beyond the outfield fence. With this magnificent backdrop, Brandi provides ACRI promotional items, such as drawstring backpacks, stress balls, plastic tumblers, and ink pens. She has had lines of people in Springdale, often running out of items to give away. “Going to this ballpark has been another great opportunity to message the community about Arkansas Children’s Research Institute. From our participation there, we have actively engaged the community via our texting service and enrollment in our participant database.” Brandi said, “We look forward to staying involved in the near future with both the Arkansas Travelers and the Northwest Arkansas Naturals.”

Find Out About Opportunities to Volunteer for Research

Arkansas Children's needs volunteers for clinical research. You can learn about currently enrolling studies at our Clinical Trials webpage. If you wish for us to contact you about research studies when they are enrolling, join our Research Registry at https://secure.archildrens.org/ResearchContacts/. Additionally, we share research opportunities using text alerts. Instructions on receiving our text alerts is here. By providing us with your information, you are agreeing to be contacted about research, and joining is completely voluntary.

Researcher Spotlight: Nirmala Parajuli, PhD

Nirmala Parajuli is an Assistant Professor in the Pharmacology & Toxicology Department of UAMS and a Junior Investigator of the Center for Translational Pediatric Research (P20GM121293) at ACRI. Her focus is on pediatric kidney transplant research. In most cases of pediatric kidney failure, young patients require donor kidneys for transplantation to improve quality of life. However, the shortage of donor kidneys for transplantation and the lower survival rate of transplanted kidneys complicate the health condition of these patients. Dr. Parajuli’s laboratory focuses on the clinically relevant topic of kidney cold storage and transplantation.

Dr. Parajuli arrived at the Center for Translational Pediatric Research earlier this year. Her laboratory focuses on identifying novel cold storage-related pathways that contribute for poor transplant outcome. Dr. Parajuli is also testing new drugs to include in cold preservation solution. Her results will provide a scientific basis for developing new therapies designed to improve the viability of donor kidneys after cold storage and transplantation with the aim to reduce the mortality of pediatric patients with kidney failure.

Within the Center for Translational Pediatric Research, Dr. Parajuli is collaborating with Program Director Dr. Alan Tackett to identify proteins that are altered during pediatric kidney cold storage plus transplantation. With Dr. Lee Ann MacMillan-Crow the Pharmacology & Toxicology Department, she is studying the contribution of injured mitochondria on renal damage during cold storage and after transplantation. Dr. Parajuli’s collaboration with Dr. Karl Boehme, Department of Microbiology and Immunology, aims to develop molecular tools to decipher mechanisms of kidney damage following cold storage plus transplantation.

In addition, to the support from the COBRE, Dr. Parajuli has funding from a Scientist Development Grant from the American Heart Association and start-up funds from the ACRI/Arkansas Biosciences Institute.

In regards to research Dr. Parajuli said, “Getting involved in research needs a lot of patience, persistence and perseverance, which ultimately will lead to unveil key scientific questions that we are asking…I worked hard and believed in myself and got this opportunity to launch my independent research career at ACRI.”

President's Choice Publications

The following articles were selected as this month's feature publications.

  • Chintapalli SV, Anishkin A, Adams SH.  Exploring the entry route of palmitic acid and palmitoylcarnitine into myoglobin.  Archives of Biochemistry and Biophysics. 2018 Aug 6. pii: S0003-9861(18)30364-3.

  • Chehade M, Jones SM, Pesek RD, Burks AW, Vickery BP, Wood RA, et al.  Phenotypic characterization of eosinophilic esophagitis in a large multi-center patient population from the Consortium for food Allergy Research. J Allergy Clin Immunol Pract. 2018 Jul 31. pii: S2213-2198(18)30462-8.

Recent Grant Activity

Extramural Grant Awards

PI Agency Project Title Project Period Total Funding
Tamara Perry NIH Implementing a Guidelines-Based M-Health Intervention for High Risk Asthma Patient 7/2018-5/2023 $3,130,833

Intramural Grant Awards 

PI Agency Project Title Project Period Total Funding
David Douglass ACRI Plasma biomarkers in anthracycline cardiotoxicity 6/2018-5/2020 $15,000
Ashley Lynch ACRI Prospective Crossover Comparison of Tidal Volume Delivery During Nasal Intermittent Positive Pressure Ventilation in Preterm Infants: Infant Cannula vs. Nasal Continuous Positive Airway Pressure Prongs 6/2018-5/2020 $15,000
Clark Sims ACRI A dietary intervention to modify breast milk content in obese lactating women 6/2018-5/2020 $14,924
Aaron Storey ACRI Etiological study of pediatric septic arthritis cases in the Arkansas region using mass spectrometry 6/2018-5/2020 $15,000

Grant Submissions

PI Agency Project Title Project Period Total Funding
Sarah Blossom NIH Epigenetic modulation of CD4+ T cell differentiation and autoimmunity by trichloroethylene 4/2019-3/2024 $1,985,633
Jin-Ran Chen NIH GPR109A regulates osteoclastogenesis and bone resorption in mice 4/2019-3/2024 $3,582,967
Stepan Melnyk NIH Development of Metabolic Subtypes within the Autism Spectrum Disorder 4/2019-3/2021 $418,707
Gresham Richter NSF/U of Arkansas NTVA: Non-contact Tissue Vascularization Assessment 1/2019-12/2019 $21,269

Clinical Trial Activity

PI Sponsor Project Project Period Total Funding
David Bumpass Scoliosis Foundation Scoliosis QoL 7/2018-12/2020 $3,000
Stacie Jones Sanofi Peanut Allergy 7/2018 - 6/2019 $111,225

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ACRI Researcher-Specific Announcements

Announcements that are specific to ACRI/ACH Campus Researchers may be found at the Weekly Research Update page: http://compoint/ACRI/default.aspx.