Several MetroHealth physicians and researchers have been awarded nearly $14 million in research grants for groundbreaking studies.

The awards are from various institutes and agencies, including the National Institutes of Health, the Health Resources and Services Administration, and The Agency for Healthcare Research and Quality. The projects range from examining organ and tissue donation rates in a primary care setting to electrical stimulation for shoulder pain.

The following projects and researchers were awarded grants:

	Scholarships and Systems to Improve the Care of the Underserved James Campbell, MD (Health Resources and Services Administration: $1.08 million.) This grant will be used to create a faculty development program to optimize faculty productivity and patient outcomes in a safety net health system. The project will involve family medicine, geriatrics and dentistry. Faculty will serve as role models for trainees by encouraging careers in caring for the underserved. The project also will focus on challenges of primary care such as health disparities, academic productivity within a safety net system, teaching skills, improving quality of care and cross discipline education in systems-based care.
	Two Stage Electrical Stimulation for Hemiplegic Shoulder Pain John Chae, MD (National Institutes of Health-National Institute of Child Health and Human Development: $413,191) Shoulder pain following stroke is a major rehabilitation problem affecting approximately 60% of moderate to severely impaired stroke survivors. The investigative team has already demonstrated the therapeutic effects of percutaneous (performed through the skin) intramuscular electrical stimulation (ES) in treating post-stroke shoulder pain for individuals enrolled within 18 months of having a stroke. Participants who enrolled after the 18-month period also experienced significant pain reduction toward the end of treatment, but the therapeutic benefits didn't persist long term. This population may benefit from a fully implanted ES system, so a feasibility trial is proposed to research the benefits from a two-stage implanted ES system.
	Improving Outcomes for Individuals with Serious Mental Illness and Diabetes Neal Dawson, MD, and Martha Sajatovic (National Institutes of Health-National Institute of Mental Health: $3.04 million) Individuals with serious mental illnesses (SMI) such as schizophrenia and bipolar disorder commonly have co-morbid medical illnesses such as diabetes. Medical comorbidity in SMI populations complicates psychiatric and medical health outcomes and is a contributor to increased mortality among these patients. SMI and diabetes are both major public health issues, but there are currently few effective treatment models for patients with both conditions. This project will use a randomized, controlled trial to study a psychosocial intervention called Targeted Training in Mental Illness Management, which is intended to improve mental health symptoms, functioning and quality of life, along with diabetes outcomes. The intervention is designed to overcome barriers to the complex problem of co-management of SMI and medical conditions. Nurse educators will work with peer educators to lead intervention sessions in order to facilitate communication, boost self-intervention and model behavioral changes.
	Social and Behavioral Interventions to Increase Organ and Tissue Donations J. Daryl Thornton, MD, MPH (Health Resources and Services Administration: $1.17 million) The number of people on the national organ waiting list continues to increase, while the number of donated organs has failed to keep pace. There are some portions of northeast Ohio where the donation rate is only 32%. Research indicates a positive correlation between discussing organ donation with a primary care physician and signing a donor card. However, these discussions are rare. The research team proposes working with patients and physicians to encourage them to have discussions regarding donation.
	Below Injury Control Sources for Upper Extremity Neuroprosthetics in Spinal Cord Kevin Kilgore, PhD (National Institutes of Health: $1.03 million) Individuals with cervical level spinal cord injury (SCI) can achieve significant functional gains - including the ability to be more independent when it comes to activities such as eating, personal hygiene and office tasks - by using an implanted upper extremity neuroprosthesis (an electronic and/or mechanical device that connects with the nervous system). Dr. Kilgore's research team has discovered that most individuals who have been classified as having a "motor complete" cervical level SCI retain some voluntary control over their lower leg muscles. The team hypothesizes that further significant increases in functional outcomes can be obtained by expanding the alternatives for control of implanted neuroprosthetics. They plan to screen and develop training methods for a cohort of motor complete cervical level SCI individuals and research advances related to "below injury control sources."
	The Biology of Genetic Varients in Human Kidney Disease John O'Toole, MD (National Institutes of Health: $1.18 million) The team has identified mutations in the gene XPNPEP3 in families with a progressive, hereditary kidney disease similar to nephronophthisis, the most common genetic cause of end-stage renal disease in children and adolescents. The research team has already shown that XPNPEP3 localizes to the mitochondria (self-replicating organelles that play an important role in generating energy for cells). Their overall hypothesis is that the loss of XPNPEP3 function increases the breakdown of mitochondrial proteins, reducing them to peptide fragments. This process sets off a chain reaction that ultimately leads to the cyst formation and kidney failure that is observed in individuals with nephronophthisis. For the project, they will test this hypothesis using genetic models to examine XPNPEP3's role in the progression of kidney disease.
	An Open-Source Public Domain Health Risk Assessment for Use in Primary Care Joseph Sudano, PhD (Agency for Healthcare Research and Quality: $1.95 million) Statistics indicate that more than half of all deaths before age 65 can be attributed to lifestyle factors. If these numbers are going to be reduced, it is necessary to understand aspects that are potentially under an individual's control, as well as factors that may be influenced by social, medical or pharmacological interventions. The health risk appraisal (HRA) can be an important tool in assessing the impact of these precursors. For this project, the research team will work to re-engineer a free, technologically advanced HRA tool that can be used in diverse primary care clinical settings. Part of the project would include updating current mortality risk algorithms, creating new ones for chronic diseases, and updating patient and provider reports to provide estimates and recommendations.
	Automatic Control of Standing Balance with Functional Neuromuscular Stimulation Ron Triolo, PhD (National Institutes of Health: $2.4 million) This project will develop new control systems to restore standing and to enhance the postural stability of individuals paralyzed by spinal cord injuries (SCI). The research team will design systems that provide the ability to stand, alter standing posture and maintain balance by automatically adjusting stimulation to the paralyzed muscles. These systems will be enhanced and evaluated experimentally in several volunteers who have spinal cord injuries. The overall goal is to develop a comprehensive balance control system that extends capabilities and improves safety for all currently available standing neuroprostheses.
	EphA2 Kinase in Prostate Cancer Bingcheng Wang, PhD (National Institutes of Health: $1.62 million) An estimated 240,890 new cases of prostate cancer will be diagnosed this year in the United States, and approximately 33,720 men will die from the disease. Prostate cancer is a complex disease: while the majority of patients have a benign form and can go on to live long lives, others have an acute form that is aggressive, resulting in a short time period between diagnosis and death. This research project will study the more aggressive form, which is often metastatic (spreads from the place where it first started to another place in the body). For the past 14 years, the research team has been studying a molecule, EphA2, and they've discovered that EphA2 contributes to the metastasis of prostate cancer. They will study how this molecule drives the metastatic progression of prostate cancer by researching human tissues and mouse models in order to potentially develop a new drug that targets EphA2.

Learn more about research at MetroHealth.