A Bridge to the Future: Cultivating Academic Leadership Today for Better Communities Tomorrow

The purpose of this project is to develop a plan for expanding and funding the Grace E. Harris Leadership Institute (GEHLI). Currently, teams of leadership scholars selected from Virginia Commonwealth University (VCU) develop projects relating to the academic community in addition to studying the dynamics of effective leadership. Consistent with VCU\u27s vision of partnering with and service to metropolitan Richmond, we propose that future teams of leadership scholars develop outreach projects that involve and benefit the local community. The training in which scholars would participate would include learning about the Richmond community, its needs and goals, as well as the dynamics of leadership. Project teams would collaborate with community groups or leaders, thereby strengthening the bonds between VCU and the community, and providing public service, in accordance with VCU\u27s mission. Projects might include education, outreach, fundraising, mentoring, or research that would benefit Richmond and provide scholars with opportunities to network with local leaders. Financial and philanthropic resources will be investigated and a list of potential funding organizations will be generated

Mind Your Meds: Safe Opioid Disposal Awareness

Driven by the effects of the opioid epidemic on friends, family members, students, and patients, members of the 2019 GEHLI Team “Mission Possible” are dedicated to bolstering educational awareness of safe leftover opioid disposal methods to decrease the supply of opioids in our community. On average, over 2/3 of opioid prescription medications are leftover and lead to later misuse or abuse (JAMA Survey). Despite a decrease in prescription writing for pain medication over the years, the mortality rate from overdose, and the rate of infants born to mothers with opioid abuse continues to steadily increase in Virginia (VDH). Team Mission Possible seeks to promote awareness of both the need and resources available for safe opioid disposal by educating prescribers in the VCU Health system and spreading knowledge to VCU patients, students, faculty, staff, and members of the surrounding community through: educational events on the Monroe Park and Medical campuses; teaming up with Miss Virginia’s “Mind your Meds campaign”; live Facebook interviews; and educational flyers

Economic and Humanistic Burden of Triple-Negative Breast Cancer: A Systematic Literature Review

Triple-Negative Breast Cancer; Economic burdenCáncer de mama triple negativo; Carga económicaCàncer de mama triple negatiu; Càrrega econòmicaBackground Triple-negative breast cancer (TNBC) accounts for 10–20% of all breast cancers (BCs). It is more commonly diagnosed in younger women and often has a less favorable prognosis compared with other BC subtypes. Objective The objective of this study was to provide a literature-based extensive overview of the economic and humanistic burden of TNBC to assist medical decisions for healthcare payers, providers, and patients. Methods A systematic literature review was performed using multiple databases, including EMBASE, MEDLINE, Econlit, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, from database inception to 16 May 2021. In addition, a targeted search was performed in the Northern Light Life Sciences Conference Abstracts database from 2016 through June 2021. The bibliographies of included articles were reviewed to identify other potentially relevant publications. Quality assessment of the included studies was conducted. Results The review identified 19 studies assessing the economic burden and 10 studies assessing the humanistic burden of TNBC. Studies varied widely in study design, settings, patient populations, and time horizons. The estimates of mean per-patient annual direct medical costs ranged from around $20,000 to over$100,000 in stage I–III TNBC and from $100,000 to$300,000 in stage IV TNBC. Healthcare costs and resource utilization increased significantly with disease recurrence, progression, and increased cancer stage or line of therapy. Compared with the costs of systemic anticancer therapy, cancer management costs comprised a larger portion of total direct costs. The estimates of indirect costs due to productivity loss ranged from $207 to$1573 per patient per month (all costs presented above were adjusted to 2021 US dollars). Cancer recurrence led to significantly reduced productivity and greater rates of leaving the workforce. A rapid deterioration of health utility associated with disease progression was observed in TNBC patients. Treatment with pembrolizumab or talazoparib showed significantly greater improvements in health-related quality of life (HRQoL) compared with chemotherapy, as measured by EORTC QLQ-C30, QLQ-BR23, and FACT-B. Conclusion TNBC is associated with a substantial economic burden on healthcare systems and societies and considerably reduced productivity and HRQoL for patients. This study synthesized the published literature on the economic and humanistic burden of TNBC and highlighted the need for continued research due to the rapidly changing landscape of TNBC care

The Atacama Cosmology Telescope: The polarization-sensitive ACTPol instrument

The Atacama Cosmology Telescope (ACT) is designed to make high angular resolution measurements of anisotropies in the Cosmic Microwave Background (CMB) at millimeter wavelengths. We describe ACTPol, an upgraded receiver for ACT, which uses feedhorn-coupled, polarization-sensitive detector arrays, a 3 degree field of view, 100 mK cryogenics with continuous cooling, and meta material anti-reflection coatings. ACTPol comprises three arrays with separate cryogenic optics: two arrays at a central frequency of 148 GHz and one array operating simultaneously at both 97 GHz and 148 GHz. The combined instrument sensitivity, angular resolution, and sky coverage are optimized for measuring angular power spectra, clusters via the thermal Sunyaev-Zel'dovich and kinetic Sunyaev-Zel'dovich signals, and CMB lensing due to large scale structure. The receiver was commissioned with its first 148 GHz array in 2013, observed with both 148 GHz arrays in 2014, and has recently completed its first full season of operations with the full suite of three arrays. This paper provides an overview of the design and initial performance of the receiver and related systems

ACTPol: On-Sky Performance and Characterization

ACTPol is the polarization-sensitive receiver on the Atacama Cosmology Telescope. ACTPol enables sensitive millimeter wavelength measurements of the temperature and polarization anisotropies of the Cosmic Microwave Background (CMB) at arcminute angular scales. These measurements are designed to explore the process of cosmic structure formation, constrain or determine the sum of the neutrino masses, probe dark energy, and provide a foundation for a host of other cosmological tests. We present an overview of the first season of ACTPol observations focusing on the optimization and calibration of the first detector array as well as detailing the on-sky performance

Increasing Compliance with Mass Drug Administration Programs for Lymphatic Filariasis in India through Education and Lymphedema Management Programs

Global elimination of lymphatic filariasis requires giving drugs at least annually to populations who live at risk of becoming infected with the parasite. At least 80% of people at risk need to take the drugs annually for 5 or more years to stop transmission of the infection. People suffering from the long-term effects of infection, such as swollen legs, benefit from programs that teach self-care of their affected limbs. In this study, we assessed the impact of an educational campaign that, after addressing previously identified predictors of compliance, significantly improved drug compliance. The specific factors improving compliance included knowing about the drug distribution in advance, knowing that everyone is at risk for acquiring the infection, knowing that the drug distribution was for lymphatic filariasis prevention, and knowing at least one component of leg care. We also found that areas with programs to assist people with swollen legs had greater increases in compliance. This research provides evidence that program evaluation can be used to improve drug compliance. In addition, our work shows for the first time that programs to benefit people with swollen legs caused by lymphatic filariasis also increase the participation of people without disease in drug treatment programs

Gene therapy for Wiskott-Aldrich syndrome in a severely affected adult

Until recently, hematopoietic stem cell transplantation was the only curative option for Wiskott-Aldrich syndrome (WAS). The first attempts at gene therapy for WAS using a \u3d2-retroviral vector improved immunological parameters substantially but were complicated by acute leukemia as a result of insertional mutagenesis in a high proportion of patients. More recently, treatment of children with a state-of-the-art self-inactivating lentiviral vector (LV-w1.6 WASp) has resulted in significant clinical benefit without inducing selection of clones harboring integrations near oncogenes. Here, we describe a case of a presplenectomized 30-year-old patient with severe WAS manifesting as cutaneous vasculitis, inflammatory arthropathy, intermittent polyclonal lymphoproliferation, and significant chronic kidney disease and requiring long-term immunosuppressive treatment. Following reduced-intensity conditioning, there was rapid engraftment and expansion of a polyclonal pool of transgene-positive functional T cells and sustained gene marking in myeloid and B-cell lineages up to 20 months of observation. The patient was able to discontinue immunosuppression and exogenous immunoglobulin support, with improvement in vasculitic disease and proin-flammatory markers. Autologous gene therapy using a lentiviral vector is a viable strategy for adult WAS patients with severe chronic disease complications and for whom an allogeneic procedure could present an unacceptable risk. This trial was registered at www.clinicaltrials.gov as #NCT01347242

Common and low Frequency variants in MERTK are independently associated with multiple sclerosis susceptibility with discordant association dependent upon HLA-DRB1*15:01 status

Multiple Sclerosis (MS) is a chronic inflammatory demyelinating disease of the central nervous system. The risk of developing MS is strongly influenced by genetic predisposition, and over 100 loci have been established as associated with susceptibility. However, the biologically relevant variants underlying disease risk have not been defined for the vast majority of these loci, limiting the power of these genetic studies to define new avenues of research for the development of MS therapeutics. It is therefore crucial that candidate MS susceptibility loci are carefully investigated to identify the biological mechanism linking genetic polymorphism at a given gene to the increased chance of developing MS. MERTK has been established as an MS susceptibility gene and is part of a family of receptor tyrosine kinases known to be involved in the pathogenesis of demyelinating disease. In this study we have refined the association of MERTK with MS risk to independent signals from both common and low frequency variants. One of the associated variants was also found to be linked with increased expression of MERTK in monocytes and higher expression of MERTK was associated with either increased or decreased risk of developing MS, dependent upon HLA-DRB1*15:01 status. This discordant association potentially extended beyond MS susceptibility to alterations in disease course in established MS. This study provides clear evidence that distinct polymorphisms within MERTK are associated with MS susceptibility, one of which has the potential to alter MERTK transcription, which in turn can alter both susceptibility and disease course in MS patients