INDIANAPOLIS — Two Indiana University-Purdue University Indianapolis researchers were named recipients of the 2016 Research Frontiers Trailblazer Award during the IUPUI Research Day earlier this month.

Established in 2010, the Research Frontiers Trailblazer Award recognizes outstanding IUPUI researchers who are showing great promise in becoming nationally and internationally known for their accomplishments in advancing the frontiers of knowledge.

Specifically, the award is for outstanding accomplishments in research and creative activity by an associate professor within the first three years of promotion or appointment in the given rank.

This year's Trailblazer Award recipients are:

Dr. Carmella Evans-Molina, associate professor, Department of Medicine, Indiana University School of Medicine

Carmella Evans-Molina is associate director of development of the Center for Diabetes and Metabolic Diseases, one of only 16 NIH-funded Diabetes Research Centers in the U.S. Her research focus is islet dysfunction in diabetes. At the IU School of Medicine, Evans-Molina holds two major NIH grants as a principal investigator; a VA Merit Award; and a major grant from JDRF, the leading global organization funding Type 1 diabetes research. She has published more than 40 papers in the highest-quality journals.

The combined syndromes of Type 1 and Type 2 diabetes mellitus affect nearly 387 million people worldwide. If current trends continue, 1 out of every 3 persons born in the U.S. after 2000 will develop diabetes during his or her lifetime.

"As a physician-scientist and endocrinologist at the IU School of Medicine, I am committed to reversing these trends and improving the health of those affected by diabetes through basic, translational and clinical research," Evans-Molina said.

"Carmella is a rising superstar, an academic leader and a role model for young trainees. She is actively publishing, gathering exciting data, writing successful grants, and training students and postdoctoral fellows," said Dr. Anantha Shekhar, Indiana University associate vice president for clinical affairs, in a letter of recommendation. "She represents IUSM and IUPUI on the national and international levels. Carmella is diligent, methodical and careful, but importantly, she is personable. I have no doubt that she will rise to hold significant leadership positions within academic medicine."

"Carmella's research has provided novel insights into the common pathways leading to beta cycle dysfunction in Type 1 and 2 diabetes. She pioneered the concept that dysregulation of calcium homeostasis contributes to beta cell dysfunction in both disorders," said Dr. Stephen R. Hammes, of University of Rochester Medical Center School of Medicine and Dentistry, in a letter of recommendation. "Her work is basic, translational, elegant and unique."

Evans-Molina holds a bachelor's degree in pharmacy from West Virginia University and an M.D. degree from Marshall University School of Medicine.

Gavriil Tsechpenakis, associate professor, Department of Computer and Information Science, School of Science at IUPUI

"Dr. Tsechpenakis is an energetic, visionary and hardworking researcher. His expertise is in computer vision, biomedical imaging and computational biology," Simon Rhodes, dean of the School of Science and professor of biology, said in a letter of recommendation.

The human brain has an amazing capacity to functionally recover from strokes that damage local neuronal circuitries, but little is known about the principles of such a highly adaptive system, according to Rhodes. Recent advances in imaging and computational technologies allow for visualizing and processing the small insect brain in its entirety; scientists most often use the Drosophia melanogaster, or fruit fly, for such studies.

"Using data acquired with state-of-the-art imaging techniques at two Drosophila neuroscience laboratories, Dr. Tsechpenakis seeks to pattern the detailed morphology and dynamics of individual neurons during development, and reconstruct neuronal circuits and model their changes during brain development," Rhodes said.

Tsechpenakis received a $573,000 NSF CAREER Award for his "Modeling the Structure and Dynamics of Neuronal Circuits in the Drosophila larvae using Image Analytics" project.

Tsechpenakis' research focus on the bottom-up reconstruction of a model brain is "an impressive line of research," said UCLA computer science professor Demetri Terzopoulos. "It goes beyond the application of computer vision methods; it requires knowledge of basic neuroscience and a deep understanding of the biological problem, the data and data-acquisition issues. In this domain, [Tsechpenakis] is already considered a pioneer."

"Given Dr. Gavriil Tsechpenakis' scientific curiosity, creativity, critical thinking, research drive, strong work ethic and technical skills as a computer scientist, I am confident that he will continue to have a fruitful academic career at IUPUI, continuing to produce trailblazing research achievements that promise to bring international recognition to your university," Terzopoulos said in a letter of recommendation.

The IUPUI professor earned his undergraduate and doctoral degrees in electrical and computer engineering from the National Technical University of Athens, Greece.

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INDIANAPOLIS –The fourth annual Chuckstrong Tailgate Gala set a record Thursday night with nearly $1.2 million netted for cancer research at the Indiana University Melvin and Bren Simon Cancer Center.

Hosted by the Indianapolis Colts and head coach Chuck Pagano at the Indiana Farm Bureau Football Center, the tailgate gala raised the funds through corporate sponsorships, live and silent auctions, and the annual Chuckstrong Giving Challenge. The total includes $250,000 that was given by the Jim Irsay family and $50,000 from the coach and his wife, Tina.

The record-setting amount also included $30,000 that was generated by 25 people who paid $1,200 each for the thrilling chance to catch a touchdown pass from quarterback Andrew Luck.

Peggy Throgmartin was one of those to successfully catch a pass from Luck.

"I finally got up the nerve to try it," Throgmartin said. "I love the fact that everybody can gather together and play a little football and have fun. It goes to a good cause. It's well worth every dime."

The event brought together more than 500 guests, nearly all of the Colts players, the Colts coaching staff, and the Colts cheerleaders. The guests participated in activities such as a 40-yard dash, punt returns, and tackling stations on the Colts practice field before they turned their attention to raising money for cancer research.

Coach Pagano, who was diagnosed with acute promyelocytic leukemia nearly four years ago, asked the crowd to contribute to fight the "monster" — cancer.

"There's a monster out there, and it's terrorizing everyone," Pagano told the crowd. "Cancer does not discriminate. It's touched everybody in this room. What I'm asking tonight is that we all come together. I'm asking that we all form a powerful army tonight. I'm asking you to give tonight so that the doctors, the researchers, and the scientists that are here tonight and the other 200 at the IU Simon Cancer Center can do their jobs."

Funds from the tailgate gala are used to support cancer research projects that translate laboratory discoveries into improved treatment options for patients. Research leads to advancements to find better ways to prevent, detect, and treat cancer.

"We're so grateful for Coach Pagano, the Indianapolis Colts, and the community for making the tailgate gala such a success each year," Patrick Loehrer, M.D., director of the IU Simon Cancer Center, said. "Equally important, we are thrilled that the tailgate gala gives us the opportunity to tout the importance of cancer research and its impact on patient care. Without research, we wouldn't be able to make strides against cancer."

In all, the Chuckstrong initiative has raised $3.7 million for cancer research at IU.

Top-level "touchdown" sponsors for the event were Anthem Blue Cross and Blue Shield, DairyChem, the Efroymson Family Fund, Huntington Bank, Lilly Oncology, Sol and Kay Raso, the Throgmartin family, the IU Simon Cancer Center, the IU School of Medicine, and Indiana Knitwear.

The IU Simon Cancer Center is one of only 69 National Cancer Institute-designated cancer centers in the nation. NCI-designated cancer centers are recognized for meeting rigorous criteria for world-class, state-of-the-art programs in multidisciplinary cancer research. NCI-designated cancer centers put significant resources into developing research programs, faculty, and facilities that will lead to better approaches to prevention, diagnosis, and treatment of cancer.

Chuckstrong history

The Chuckstrong initiative has raised $3.7 million for cancer research at IU.

2012: The Colts first launched the Chuckstrong initiative, which raised $485,000 through the sales of Chuckstrong T-shirts and wrist bands, following the announcement that Coach Pagano was diagnosed with leukemia.

2013: The inaugural tailgate gala raised $650,322.

2014: Tailgate gala raised $661,427.

2015: Tailgate gala raised $720,000.

2016: Tailgate gala raised nearly $1.2 million.

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INDIANAPOLIS — Machine learning has come of age in public health reporting according to researchers from the Regenstrief Institute and Indiana University School of Informatics and Computing at Indiana University-Purdue University Indianapolis. They have found that existing algorithms and open source machine learning tools were as good as, or better than, human reviewers in detecting cancer cases using data from free-text pathology reports. The computerized approach was also faster and less resource intensive in comparison to human counterparts.

Every state in the United States requires cancer cases to be reported to statewide cancer registries for disease tracking, identification of at-risk populations, and recognition of unusual trends or clusters. Typically, however, busy health care providers submit cancer reports to equally busy public health departments months into the course of a patient's treatment rather than at the time of initial diagnosis.

This information can be difficult for health officials to interpret, which can further delay health department action, when action is needed. The Regenstrief Institute and IU researchers have demonstrated that machine learning can greatly facilitate the process, by automatically and quickly extracting crucial meaning from plaintext, also known as free-text, pathology reports, and using them for decision-making.

"Towards Better Public Health Reporting Using Existing Off the Shelf Approaches: A Comparison of Alternative Cancer Detection Approaches Using Plaintext Medical Data and Non-dictionary Based Feature Selection" is published in the April 2016 issue of the Journal of Biomedical Informatics.

"We think that its no longer necessary for humans to spend time reviewing text reports to determine if cancer is present or not," said study senior author Shaun Grannis, M.D., M.S., interim director of the Regenstrief Center of Biomedical Informatics. "We have come to the point in time that technology can handle this. A human's time is better spent helping other humans by providing them with better clinical care."

"A lot of the work that we will be doing in informatics in the next few years will be focused on how we can benefit from machine learning and artificial intelligence. Everything — physician practices, health care systems, health information exchanges, insurers, as well as public health departments — are awash in oceans of data. How can we hope to make sense of this deluge of data? Humans can't do it — but computers can."

Dr. Grannis, a Regenstrief Institute investigator and an associate professor of family medicine at the IU School of Medicine, is the architect of the Regenstrief syndromic surveillance detector for communicable diseases and led the technical implementation of Indiana’s Public Health Emergency Surveillance System – one of the nation’s largest. Studies over the past decade have shown that this system detects outbreaks of communicable diseases seven to nine days earlier and finds four times as many cases as human reporting while providing more complete data.

"What's also interesting is that our efforts show significant potential for use in underserved nations, where a majority of clinical data is collected in the form of unstructured free text," said study first author Suranga N. Kasthurirathne, a doctoral student at School of Informatics and Computing at IUPUI. "Also, in addition to cancer detection, our approach can be adopted for a wide range of other conditions as well."

The researchers sampled 7,000 free-text pathology reports from over 30 hospitals that participate in the Indiana Health Information Exchange and used open source tools, classification algorithms, and varying feature selection approaches to predict if a report was positive or negative for cancer. The results indicated that a fully automated review yielded results similar or better than those of trained human reviewers, saving both time and money.

"Machine learning can now support ideas and concepts that we have been aware of for decades, such as a basic understanding of medical terms," said Dr. Grannis. "We found that artificial intelligence was as least as accurate as humans in identifying cancer cases from free-text clinical data. For example the computer ‘learned’ that the word 'sheet' or 'sheets' signified cancer as ‘sheet’ or ‘sheets of cells’ are used in pathology reports to indicate malignancy.

"This is not an advance in ideas, it's a major infrastructure advance — we have the technology, we have the data, we have the software from which we saw accurate, rapid review of vast amounts of data without human oversight or supervision."

The study was conducted with support from the Centers for Disease Control and Prevention.

In addition to Dr. Grannis and Mr. Kasthurirathne, co-authors of the study are Regenstrief Institute investigator Brian E. Dixon, MPA, Ph.D. and Huiping Xu, Ph.D., of the IU Fairbanks School of Public Health; former Regenstrief fellow Judy Gichoya, M.D. and Regenstrief investigator Burke Mamlin, M.D. of the IU School of Medicine and Yuni Xia, Ph.D. of the School of Science at IUPUI.

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INDIANAPOLIS — A new study from the Indiana University Center for Aging Research and the Regenstrief Institute has found that almost half of all long-stay nursing home residents experience at least one transfer to an Emergency Department over the course of a year regardless of their cognitive status. While a high percentage of long-stay nursing home residents were sent to the ED, only about a third of these individuals were subsequently admitted to the hospital.

The study determined that while dementia severity was not associated either with likelihood of transfer to the ED or with having that transfer result in a hospitalization; age, race, two or more chronic diseases, number of hospitalizations in the year prior to study entry, and "Do Not Resuscitate" status all influenced the time to first ED visit.

Participants in the study were 4,491 long-stay (90 or more consecutive days) nursing home residents age 65 and above. Average time from entry into a long-term nursing facility to first ED visit for those with advanced stage dementia was 258 days; 250 days for individuals with early to moderate cognitive impairment and 202 days for those with no dementia.

"Transferring to an ED is stressful for most people, but it is especially difficult for cognitively impaired older adults from nursing homes who may not understand what is happening to them," said IU Center for Aging Research and Regenstrief Institute investigator Michael LaMantia, M.D., MPH, first author of the study. "We — physicians, nursing home staff and all who are concerned with older adults who live in long-term care facilities — should be thinking about why individuals with advanced dementia, for whom comfort-oriented care is often more in line with preferences indicated by family members, have ED utilization patterns similar to those patients with early to moderate dementia and even those with no dementia.”

Among nursing home residents sent to the ED, persons with advanced stage dementia were significantly more likely than persons with early to moderate stage or no dementia to receive a diagnosis of a urinary tract infection, a condition potentially treatable in the nursing home.

"Patterns of Emergency Department Use Among Long-Stay Nursing Home Residents with Differing Levels of Dementia Severity" appears online in advance of print publication in JAMDA, the official journal of the Society for Post-Acute and Long-term Care Medicine.

The researchers encourage nursing home providers to employ the findings of the new study to develop strategies that meet their residents’ care goals and avoids unnecessary transfers from the nursing home to the ED, which in addition to being stressful for the individual are costly to the health care system.

“Identifying unnecessary transfers of nursing home patients to the hospital continues to be a high priority for policymakers, researchers and clinicians," said IU Center for Aging Research and Regenstrief Institute investigator Kathleen Unroe, M.D., MHA, senior author of the study. "We need to deliver patient-centered and directed care in the most appropriate setting. This study describes high rates of transfers to the hospital in a frail population; more work needs to be done to understand which of these transfers can be avoided.”

"As dementia is a progressive illness that affects patients’ cognition, functional abilities, and health care utilization, it is not surprising to find that our subjects with advanced dementia were older, more functionally impaired, and more likely to have visited the ED in the previous year than patients with less severe or no cognitive impairment," the authors write. "The fact that long-stay residents with advanced dementia had less comorbidity [serious medical conditions not directly related to dementia] than subjects with early to moderate stage dementia was unexpected and may suggest that long-stay nursing home residents with advanced dementia are “survivors” who are healthy enough to have lived long enough to develop advanced dementia."

This work was funded by grants from the Regenstrief Institute and the National Institute on Aging (5K23 AG043498 and 5K23 AG048323).

Authors, in addition to Drs. LaMantia and Unroe, are Kathleen A. Lane, M.S., and Frank Messina, M.D., of IU School of Medicine; Wanzhu Tu, Ph.D., and Jennifer L. Carnahan, M.D., MPH, of the Regenstrief Institute, IU Center for Aging Research, and IU School of Medicine.

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