Sept. 4, 2019, marks an important date in advancing health care in Colorado.
UCHealth announced a significant investment that will bolster behavioral health care for patients across the state. With an infusion of $100 million and an additional $25 million in matching funds, UCHealth will ensure that behavioral health therapists and psychiatrists are an integral part of the patient care experience. By building out its intensive outpatient, preventive and telehealth services, the health system will be able to better serve more individuals in Colorado, the Rocky Mountain region and beyond.
“Together with our clinical partners, we will accelerate the pace of change in behavioral health care, and bring high-quality, integrated care to more of the millions of patients cared for each year.” – Don Elliman, Chancellor of CU Anschutz
“Our faculty have the expertise and resources to make a transformative impact on people’s lives,” said CU Anschutz Chancellor Don Elliman. “Together with our clinical partners, we will accelerate the pace of change in behavioral health care, and bring high-quality, integrated care to more of the millions of patients cared for each year.”
Dr. Neill Epperson, professor and chair of the Department of Psychiatry at the CU School of Medicine, said 20% to 40% of primary care patients have a behavioral health need.
“Attending to our patients’ behavioral health needs in a timely manner is critical to their overall health and well-being. This comprehensive approach to mental health and substance abuse treatment has the potential to improve the lives of hundreds of thousands of Coloradans,” Dr. Epperson said. “By embedding services within primary care locations, we can treat these needs in a cost-efficient manner while still providing an expert psychiatrist for patients who need a specialist.”
In contrast to the science fiction portrayal of evil computers plotting to overthrow humankind, artificial intelligence (AI) in fact seems poised to help improve human health in a multitude of ways, including flagging suspicious moles for dermatologist follow-up, monitoring blood volume in military field personnel and tracking flu outbreaks via Twitter.
The Colorado Clinical and Translational Science Institute (CCTSI) recently held the 7th annual CU-CSU Summit on the topic of “AI and Machine Learning in Biomedical Research”, with over 150 researchers, clinicians and student attendees from all three CU campuses and CSU.
Ronald Sokol, MD, CCTSI director, said, “The purpose of the CCTSI is to accelerate and catalyze translating discoveries into better patient care and population health by bringing together expertise from all our partners.” Rather than individual campuses operating in silos, the annual Summit brings together clinicians, basic and clinical researchers, post-doctoral fellows, mathematicians and others to highlight ongoing research excellence, establish collaborations and increase interconnectivity of the four campuses.
This year’s conference on AI hit capacity for registration, including attendance by more mathematicians and with more poster submissions than the preceding six events. “The topic of AI in research is everywhere. No one knows exactly what is going to happen,” Sokol said, referencing the many privacy and ethics concerns about AI use in research. “I’m here to learn too – I’m not sure I understand it all.”
Living up to the ‘hype’
Lawrence Hunter, director of the Computational Bioscience program at CU Anschutz, framed AI as having the potential to change the way people practice medicine. “There’s a lot of hype, so we need to be careful how we talk about it,” Hunter said.
What, specifically, is AI doing for biomedical research in Colorado? Michael Paul, PhD, assistant professor of Information Science from CU Boulder, uses social monitoring through sites like Twitter and Google to track and predict public health, including yearly flu rates and Zika virus outbreaks. The Centers for Disease Control (CDC) is typically considered the gold standard for public health information, but Paul points out that CDC data is always at least two weeks behind. In contrast, Google Trends provides a daily population snapshot: as a fictional example, ‘1 million people in Colorado searched for ‘flu symptoms on September 15, 2019’.
Social media sources like Twitter can be mined for tweets containing terms like ‘flu’ within a specific geographic area or demographic group of interest. Using Twitter, researchers can distinguish between “I have the flu” vs. “I hope I don’t get the flu”, whereas Google data cannot make this distinction.
Steve Moulton, MD, trauma surgeon, director of Trauma and Burn Services at Children’s Hospital Colorado and CU School of Medicine and co-founder of Flashback Technologies, Inc, used a machine learning system originally designed to help robots navigate unfamiliar terrain in outdoor, unstructured environments to create a new patented handheld medical device called the CipherOx, which was granted FDA clearance in 2018.
The CipherOx, developed in partnership with the Defense Advanced Research Projects Agency (DARPA) from the United States Department of Defense, monitors heart rate and oxygen saturation and estimates blood volume through a new AI-calculated number called the compensatory reserve index (CRI), which indicates how close a patient is to going into shock due to blood loss or dehydration. While designed to be used in military field operations, the CipherOx can also be used to monitor patients en route to the hospital and postpartum women. Of note, Moulton’s pilot studies were funded by the CCTSI.
AI use in machine learning can be broken into three broad categories: supervised, unsupervised and reinforcement learning. In supervised learning, AI systems learn by being trained to make decisions. For example, in 2016 Google developed an AI-based tool to help ophthalmologists identify patients at risk for a diabetes complication known as diabetic retinopathy that can result in blindness. The Google algorithm learned from a set of images diagnosed by board-certified ophthalmologists and built a set of criteria for making yes vs. no decisions.
In unsupervised learning, AI relies on probabilities to evaluate complex datasets; predictive text on your cellphone is an example of this. In biomedical research, an example of unsupervised learning is using AI to analyze drug labels to find common safety concerns among drugs that treat similar conditions.
Finally, reinforcement learning, like Google’s AlphaZero, the world’s best machine chess player, allows AI to try a lot of options to maximize reward while minimizing a penalty. In reinforcement learning, an AI program can fully explore a hypothetical space without causing trouble. Reinforcement learning in biomedical research can be useful when AI is given a narrow range of choices, for example, predicting best patient response within a narrow range of possible drug doses.
Human mistakes vs. AI mistakes
According to Lawrence Hunter from CU Anschutz, a major problem with AI in healthcare is not proving how good AI is, but paying attention to where it fails. “With 92% correct AI, that gives us confidence that the system is accurate, but we have to be really careful about the other 8% because the kinds of errors AI makes are different (and can be more severe) than the kinds of errors humans make,” he said.
Matt DeCamp, associate professor with the Center for Bioethics and Humanities from CU Anschutz, gave an example of this phenomenon: when AI was used to classify pictures, a picture of a dragonfly was alternatively identified as a skunk, sea lion, banana and mitten. “Some mistakes are easily detected (dragonfly doesn’t equal sea lion),” DeCamp said, “but other mistakes closer to the realm of reasonable may challenge how risks are evaluated by Institutional Review Boards (IRB),” the panels of scientists and clinicians responsible for evaluating patient risks in clinical trials.
THE AI LANDSCAPE
Matt DeCamp, associate professor with the Center for Bioethics and Humanities from CU Anschutz, framed the AI landscape:
Up to $6 billion anticipated for AI investment into biomedical research by 2021
At least 14 recent AI-related FDA approvals in past two years, mostly in imaging, ophthalmology and pathology
55 active or pending clinical trials using the term “deep learning”
141 startup biotech companies using AI
Insurance companies actively using AI to review records and optimize care for chronic conditions
In examples like Google’s system for helping ophthalmologists catch patients at risk of blindness, AI has been heralded as increasing patient access, particularly in rural areas and for patients with limited mobility, and decreasing costs for providers and hospitals. While potential for using AI to improve human health is high, DeCamp echoed Hunter’s comments and cautioned against automatic acceptance of AI superiority. “It’s possible that an AI system could be better on average, but remember that being better on average can obscure systematic biases for different subpopulations. And that is an issue of justice.”
Challenges and concerns
Some issues relative to AI use in biomedical research involve patient privacy. For example, a lawsuit made headlines this summer when a patient at the University of Chicago claimed that his privacy was violated in breach of contract and consumer protection law as a result of data sharing between the university and Google. Michael Paul from CU Boulder said that recent studies regarding use of recreational drug brings up obvious concerns about how to balance public health research with privacy, since Twitter exists in a public space.
Truly informed consent is also an ethical concern, given the ‘black box’ nature of AI algorithms. DeCamp from CU Anschutz clarified, “Black box, meaning that the algorithmic workings are not only unknown, but may be in principle unknowable.”
Just because we can, should we?
Matt DeCamp said that as an ethicist, AI raises big questions. “What is an appropriate use of AI in the first place? Just because we can, does that mean we should? For example, there’s interest in developing robot caregivers. Should we? Would computer-generated poetry be ‘real’ poetry?” Patients may fear further de-personalization of health care in a system that can already seem impersonal at times.
Long-lasting effects of AI are even more uncertain. Will AI change the way we think or act toward each other? DeCamp highlighted research from sociologist Sherry Turkle, PhD, from the Massachusetts Institute of Technology that validates this possibility. In summary of Turkle’s research, DeCamp said, “Computers don’t just change what we do, but also what we think.”
Guest contributor: Shawna Matthews, a CU Anschutz postdoc
Parkinson’s disease is a neurodegenerative disease that affects 15,000 Coloradans. From feeling fatigued, depressed and anxious, to experiencing uncontrollable muscle spasms and tremors, symptoms can interrupt every aspect of daily life. Maureen Leehey, MD, has worked with Parkinson’s patients for over 30 years and is looking to the booming world of cannabis for a potential treatment.
‘Let’s do the research’
Leehey, a neurology professor and director of the Movement Disorders Division in the CU School of Medicine, believes cannbidiol, most commonly known as CBD, may provide some relief for patients. CBD is a chemical component of cannabis that has anti-inflammatory properties and does not produce the high associated with marijuana.
“There is a lot of literature that suggests CBD might slow down Parkinson’s disease,” she explained. “This research is in basic science and in animal studies. We really wanted to look at how it could potentially benefit our patients. So we thought let’s do the research.”
‘Jumping through regulatory hoops’
Studying cannabis in a rigorous, scientific manner is incredibly difficult. Due to its schedule I rating from the Drug Enforcement Administration (DEA), a prospective researcher must navigate a complicated regulatory pathway to administer it to study participants. However, this didn’t stop Leehey.
“Once marijuana became legalized recreationally in Colorado, our patients started asking about how it could help them,” she said. “There was a lot of interest, and we wanted to look at how we could help our patients make informed decisions about it.”
After almost two years of attaining compliance to a seemingly endless amount of governing bodies, Leehey’s tenacity paid off.
“We were fortunate in that CU Anschutz provided us with the resources we needed to overcome obstacles and really make this study possible,” she said. A special ventilated room was created for the study participants to consume the marijuana-type study drugs on site, and a storage site for these products was bolted to the ground under the protection of a dual-key lock.
Following regulatory approval, Leehey then received the funds from a grant from the Colorado Department of Public Health and Environment (CDPHE) to start her study.
‘Less irritability and improved nighttime sleep’
Leehey was finally set to administer and monitor the effects of a CBD pharmaceutical on Parkinson’s patients. Thirteen patients entered the study and each was given approximately 400 mg of CBD to start; dosing was increased as appropriate.
Overall, the participants reported they felt less irritable and that they were sleeping better, Leehey said. They even saw that some of their motor symptoms, including stiffness and slowness, improved.
Although the participants experienced some mild side effects, the benefits were clear. These results, along with more anecdotal evidence from her patients outside of the study, encouraged Leehey to run another study. This time, she wants to look at the potential benefits of a small amount of THC combined with CBD in patients with Parkinson’s. She is actively recruiting for this study.
‘Support for other researchers interested in cannabis’
Leehey wants other researchers at CU Anschutz who are interested in cannabis to have support in their endeavors.
“CDPHE gave out a few grants for cannabis research,” she said. “We came together and navigated this research path.”
The awardees have since created a group called the Colorado Cannabis Research Consortium, the C2RC.
“Anyone who is really into cannabis research can be a part of this group,” said Leehey. “A lot of researchers get started and then run into problems. We have been there. We want to use this experience to mentor others and really get this research going.”
If you are interested in participating in Leehey’s study, please contact Ying Liu at 303-724-8288 or ying.3.liu@CUAnschutz.edu.
If you are interested in joining the Colorado Cannabis Research Consortium (C2RC), please contact Kirk Hohsfield at kirk.hohsfield@CUAnschutz.edu.
While nearly 35,000 people at work at CU, only 4,500 are connected on LinkedIn. For the best LinkedIn Learning experience, Employee Services recommends faculty, staff, and students create a personal LinkedIn profile.
Here are the top three reasons employees should open a LinkedIn profile:
Faculty and staff have the option to connect their personal profile to LinkedIn Learning. By doing so, they’ll get video, course and training recommendations based on job title, personal interests, professional growth and career goals.
In addition, supervisors will be able to shares collections of assets to supplement employee growth. According to LinkedIn, 56% of employees say they would spend more time learning if their manager suggested a course to improve skills.
Build an online resume
A LinkedIn profile acts as a personal online resume, a great way to share professional accomplishments. Whether someone recently received a promotion or became certified in Project Management, these career growth milestones can be included in their LinkedIn profile.
When an employee finishes a course in CU LinkedIn Learning, a badge will be awarded and can be displayed on their profile.
Connect with colleagues and build your network
Networking strategies have changed, thanks to LinkedIn. Similar to other social media networks, employees can connect with former classmates, coworkers and supervisors to build an ever-growing professional network. With their connections, users can share their personal career accomplishments and latest industry news.
Visit our webpage to learn more about the update and create a profile.
During her 22 years as associate dean of Clinical and Community Affairs, Professor Amy Barton spearheaded the creation of the University of Colorado College of Nursing’s clinical enterprise. The string of health centers target everyone from CU Anschutz Medical Campus students to the Denver area’s most at-risk populations.
Barton also earned numerous prestigious appointments and awards, wrote a long list of scholarly articles and books and netted the university $8.5 million in grants during that time.
It appears she listened to her parents.
Fate and upbringing guide Barton to CU
“My parents were very involved in the community, and I grew up with the ethic that to whom much is given much is expected,” said Barton, PhD, RN, FAAN, one of five children in her family. “My parents also worked hard to send us all through college. Education was very important to them,” said Barton, a native of Toledo, Ohio.
Barton, also the Daniel and Janet Mordecai Endowed Chair in Rural Health Nursing, will step down from her administrative post on Sept. 1. She will remain with CU Nursing in her professorship and endowed chair roles.
“One of the hallmarks of success to this is that our providers focus on the needs of their particular communities and figure out how to create and deliver those services.” – Amy Barton
Along with her parents, CU Nursing can thank Barton’s husband for her contributions.
“It provides a real balance between the academic world and the practice world,” Barton said of the position, which CU Nursing Professor Rosario Medina, PhD, FAANP, FNP-BC, ACNP, CNS, will take over. “I have always enjoyed working on projects that impacted patients and made a difference in people’s lives,” Barton said.
Barton’s passion to influence people’s health resulted in:
The Campus Health Center at CU Anschutz. Designed for providing faculty, staff and students with convenient health care, the on-campus clinic offers everything from flu shots and prescription refills to pregnancy tests and behavioral health counseling.
Sheridan Health Services. With two facilities (one focused on family and the other on youth), Sheridan Health Services provides targeted medical and behavioral care in areas with high at-risk populations. A 501(c)(3) federally qualified health center, the clinics are led by CU Nursing faculty who strive for equality in health care.
Belleview Point Clinic. This clinic in southeast Aurora focuses on providing integrated health care emphasizing wellness and prevention with its advanced practice nursing.
The Center for Midwifery. With a number of private practice clinics in the area, this center provides holistic health care through the pregnancy journey. Its branch in Longmont, which serves Weld and Boulder counties, will move to one central Longmont location on Sept. 3.
“I think that we’ve created a successful, sustainable practice here,” Barton said. “One of the hallmarks of success to this is that our providers focus on the needs of their particular communities and figure out how to create and deliver those services.”
Barton does not own the clinical and community enterprise success, saying it took a concerted effort. “It’s about bringing people with different expertise to the table,” she said of her achievements. “It’s recognizing that I don’t have all the answers and knowing how to find them.”
End of one job, new beginning for another
While her move marks a big shift for CU Nursing, Barton’s contributions will continue. Her far-reaching success to the rural corners of the state with the generous donations from the Daniel and Janet Mordecai Foundation are making a big difference in people’s lives.
“Because of you (the foundation), we are able to build and strengthen the rural nursing workforce across the state, bringing care to rural communities where people need it most,” Barton wrote in the foundation’s 2019 Impact Report.
Barton said she will miss the associate dean role. “What I will miss most is working with these amazing people that we have on our team. Our providers are so passionate about the work that they do and really bring their full selves to that work with their patients on a daily basis,” she said.
Yet, Barton remains confident about the future of the enterprise with its many “amazing leaders” and knows the time is right. “I think we are at a point now where the program could benefit from the vision of a new leader,” Barton said. “I’ve taken the train far enough.”
There’s extra excitement at the Fitzsimons Innovation Community this week, thanks to a major honor for April Giles.
The Denver Business Journal named her the winner of the prestigious Outstanding Women in Business Award in the technology and telecom category. Giles leads the strategy and growth initiatives as vice president of business development.
The Fitzsimons Innovation Community team celebrated with Giles when The Denver Business Journal announced her win during a special cocktail reception on Aug. 21. She was honored along with 35 other winners and finalists.
The highly regarded awards program recognizes women from the Denver metro area for their innovation, entrepreneurship, professional accomplishment and community leadership.
“I’m deeply honored for the recognition by the Outstanding Women in Business Awards program,” Giles said. “The Denver Business Journal brought an amazing group of leaders together to celebrate the metro area’s diverse and dynamic business community. It was a privilege to represent Fitzsimons Innovation Community and our visionary organizations.”
Steve VanNurden, President and CEO of Fitzsimons Innovation Community, said: “Our team and the entire Fitzsimons Innovation Community congratulates April for this well-deserved honor. We’re pleased the Denver Business Journal recognized April’s work to support the growth of bioscience in Colorado.”
Giles joined the Fitzsimons Innovation Community team in October of 2019 after leading the Colorado BioScience Association as President and CEO for seven years.
Getting ready to catch a morning flight to Chicago in February 2018, Emily Daniels felt a strange tightness in her chest. She noticed a shortness of breath. Taking her mother’s advice, she called her obstetrician who said she should go to the ER.
She remembers thinking, “Emergency room … is that really necessary?” Nonetheless, Emily went to an ER near her home in Lakewood and re-booked for a 5 p.m. flight, thinking she’d still make her business trip. After an initial test, doctors advised a CT scan, which revealed two blood clots in Emily’s lungs and a mass in the bottom of her right lung.
“Cancer didn’t even register in my mind,” she said. “What could that (mass) be? I’m young, healthy, no history of disease, never smoked.”
The doctor said it could be lymphoma, a virus or lung cancer and said she should remain in the hospital. Adding to the urgency: Emily was 33 weeks pregnant with her second child.
‘Fight for our kids’
A subsequent biopsy confirmed the mass was cancerous and additional scans showed cancer in Emily’s bones and right adrenal gland. Stage IV lung cancer.
“Initially, it was shocking, devastating,” she said. “But we (along with her husband Brian) also knew we couldn’t wallow in our sadness. We had a 3 ½-year-old girl (Paige) and a baby on the way, so we were going to fight for our kids.”
Emily stayed in the hospital and delivered her baby, Brady, but her diagnosis precluded the new-mother things, like nursing and a quick release from the hospital, she enjoyed with Paige. What should have been a celebratory time felt overshadowed by a startling and grim diagnosis.
She remembers the trip home from the hospital with Brian – Paige was at home with Emily’s parents – where “we pulled over on the side of the road and broke down.”
Pivotal decision for personalized care
Brian Daniels, a former football standout at the University of Colorado, consulted a handful orthopedic doctors he knew from his playing days. Their advice: Get an appointment with Ross Camidge, MD, PhD, professor and director of thoracic oncology, at the CU Anschutz Medical Campus. “He’s one of the best in the world with this targeted therapy,” Emily said. “It was a no-brainer … this is where I needed to do my treatment.”
The decision has proven to be pivotal, as Camidge, in collaboration with Robert Doebele, MD, PhD, associate professor of medicine, CU School of Medicine, eventually devised a completely novel and personalized treatment that has, for more than eight months, stopped the spread of Emily’s cancer.
However, before making this major discovery, which will be presented at next week’s World Conference on Lung Cancer in Barcelona, Emily’s medical team worked through their clinical bag of tricks in a very short time. In the ensuing battle, it was readily apparent that Emily’s cancer did not play by the normal rules.
In basic terms, the cancer battle comes down to exposure and attack: identifying the genetic pathways that enable cancer to grow, and developing therapies that inhibit those pathways.
BREAKTHROUGH ON WORLD STAGE
Camidge and Doebele are co-authors on the report about the living-cell line that gave doctors insight into Emily Daniels’ cancer and resulted in her novel, personalized treatment regimen that will be presented at the World Conference on Lung Cancer in early September.
Soon after Emily was first seen in the lung cancer multi-disciplinary clinic at the CU Cancer Center Camidge quickly discovered that she had ALK-positive non-small cell lung cancer. Over a decade ago, Camidge was on the clinical-trial forefront that developed the first treatment for lung cancers driven by acquired changes in the anaplastic lymphoma kinase (ALK) gene, causing the cells to grow abnormally fast and aggressively.
A few years later, the initial drug was replaced by more effective ones; Camidge co-led an international trial in 2017 that established alectinib as the initial go-to therapy for this sub-type of lung cancer.
In late-February 2018, Emily started on alectinib and initially responded well to the four pills taken in the morning and four more in the evening. But in just a couple months, her cancer was progressing again.
Another biopsy, tested with the CU Colorado Molecular Correlates Laboratory’s cutting-edge assays, did not show any identifiable reason for the cancer’s resistance. Camidge tried another ALK inhibitor, brigatinib – a drug he also helped develop and one that showed great promise for longer-duration disease control.
However, within a month, Emily’s cancer was progressing again.
Living cells are key to breakthrough
In June 2018, the addition of a specific chemotherapy regimen, identified by Camidge in 2011 as being particularly effective in ALK-positive lung cancer, helped stop her cancer – but only for 3 ½ months. The team then applied another CU-developed treatment strategy: weeding the garden – or radiotherapy treatment of “oligo-progression” as Camidge’s team coined it – whereby they kept Emily on her drug treatments while treating individual spots of cancer with highly focused radiation.
However, nothing completely slowed the cancer. “My colleague Dr. Bob Doebele had this idea that not everything driving resistance in a cancer cell can be found just by looking with the already-established tests,” Camidge said.
Doebele knew there were only a certain number of interrogations that could be done on the kind of preserved pieces of tissue from biopsies like the one sent to the Colorado Molecular Correlates lab. So when the biopsy of Emily’s cancer was taken, as part of a CU research protocol, some of her cancer was sent directly to Doebele’s lab to see if live cancer cells could be grown from it.
“When Bob grows it and it’s living, he can poke it and see which signaling pathways go up and down,” Camidge said. “He was able to deduce that Emily’s cancer had become dependent on another signaling pathway, separate from the ALK side of things.”
That pathway is called MET, and it essentially acts as a second driver of Emily’s cancer.
‘Responded like a dream’
Importantly, all of the known ways of activating MET, the methods doctors test for it in preserved cancer tissue, showed normal results. The key difference were the living cells.
“Entirely because Dr. Doebele was able to grow the cells in a lab, we were able to say for the first time to a patient, ‘Look, your cancer cells have tons of MET signaling going on,’” Camidge said. “In the living cell lines, if we put on a MET inhibitor as well as an ALK inhibitor, they get really unhappy.
“Emily is technically the only patient I know of that has this exact mechanism resistance,” he said.
‘I just have to have hope and believe that the doctors are going to keep coming up with new things.’ – Emily Daniels
Based on Doebele’s data, which will be highlighted at the Barcelona conference, Camidge added crizotinib, a licensed drug designed for other purposes but which can function as a MET inhibitor, to Emily’s treatment.
What has been her response to this targeted-therapy regimen — one that’s been applied to a handful of patients, if that, in the world? Emily started the regimen last December and “she has responded like a dream,” Camidge said.
Emily, 33, is enjoying every day with her children, watching Paige head off to kindergarten and hearing Brady utter his first words. In August, she and Brian took a long-planned trip to the French Alps and coastal Italy. Every chance Emily gets, she logs a several-mile run, does yoga or lifts weights.
She has also become an advocate for other people battling the disease. She and Brian organized a golf tournament – Links for Lungs – which tees off again on Sept. 11. Last year’s debut tournament raised over $130,000 for the Lung Cancer of Colorado Fund.
“It’s important for me to be an advocate for research and be the face of lung cancer,” she said. “This can happen to anyone – it’s not just smokers and older people.”
‘Truly cutting edge’
Emily said she need not look beyond the CU Anschutz Medical Campus and UCHealth University Hospital for her care. “The research is truly cutting edge,” she said. “They’re doing things at the hospital that they’re not doing at other places. The research that Dr. Doebele and Dr. Camidge are doing truly saved my life and gives me unique treatment options.”
‘Here we are at the cutting edge again. Our whole team lives there and we’re comfortable with it.’ – Dr. Ross Camidge
Camidge is impressed by the way Emily has turned her disease into a positive as she reaches out to other lung cancer patients. “Even though she’s hit many bumps in the road, her attitude is kind of like, ‘Yeah, it’s just another one,’” he said. “So she’s actually much more inspiring to them – not necessarily because things have gone well, but because she’s dug in there… It’s like, she can really say to other lung cancer patients, ‘We’ve been through it, and I know what you’re going through.’”
Emily knows she’ll never be completely cancer free; she has to stay on treatment to control the disease. The important thing is to keep moving forward. “I just have to have hope and believe that the doctors are going to keep coming up with new things,” she said. “I want see Paige go to kindergarten, and Brady grow up and play football and do all the things a parent wants to do with their kids.”
Camidge said all indications show that the combination therapy is working in Emily’s case, but they must remain vigilant.
The next move is to develop a clinical trial with a MET inhibitor that is better at getting into the brain than crizotinib. “The brain is known to be a problem area for crizotinib to reach,” he said. “So we are not waiting to react; we are working on developing the next generation of MET-ALK combinations for Emily and anyone else who needs them.”
The research into cancer’s vulnerabilities, to ideally overcome the disease, grows ever stronger, thanks to the fundraising efforts of people like the Daniels and the novel clinical trials taking place at academic medical centers such as CU Anschutz.
“Here we are at the cutting edge again,” Camidge said. “But that’s OK. Our whole team lives there and we’re comfortable with it.”
In 2017, Colorado had the tenth highest rate of suicide in the nation and approximately half of the suicides happened with firearms. When adolescents die by firearm suicide, over 80 percent use a gun belonging to a family member.
“Suicide is a major public health problem in Colorado and when someone is at risk of suicide, the safest option is to store guns away from their home temporarily,” said Sara Brandspigel, MPH, assistant director, Program for Injury Prevention, Education and Research at the Colorado School of Public Health. “Our goal with creating this resource is to improve community safety and prevent suicide by reducing the time it takes for people to find and reach out to local storage options, which is a challenging landscape to navigate.”
Partnership with Law Enforcement and Gun Shops
CU Anschutz faculty identified 15 law enforcement agencies and 47 gun shop owners around the state that currently offer out-of-home storage options, and they will continue to add new storage locations to the map. The storage map lists contact information to streamline the process of identifying storage options.
“Navigating the ever-changing legal landscape and looking for reasonable options for storage in a time of crisis can add a lot of stress to an already stressful situation,” said Jacquelyn Clark, owner of Bristlecone Shooting, Training & Retail Center. “We have room at our facility to house a moderate number of firearms just for storage purposes and are committed to being good community partners. It makes sense to offer our facility as a resource to families who may need temporary storage at an affordable rate.”
The online resource can also be used for a number of temporary firearm storage reasons, such as when traveling out of state, hosting visitors, selling a home, etc.
“Participation in the Colorado Gun Storage Map is another means of helping our community members, which can be accomplished so easily,” said Mark Heminghous, chief of police, Dillon Police Department. “We want to be able to offer people the ability to have some time away from their firearms if they need it. We hope people will take us up on the offer before they experience a crisis.”
Opening doors, turning on lights, helping remove socks and shoes – for the talented service dogs in training from the non-profit Warrior Canine Connection (WCC), these skills are just the tip of the 80-command iceberg that dogs master to assist the visible and invisible injuries of their veteran partners.
For veterans dealing with the symptoms of traumatic brain injuries (TBI), the invisible wounds of war can worsen feelings of isolation and being disconnected from friends and family. Here at CU Anschutz, the Marcus Institute for Brain Health (MIBH) on campus has a new partnership with the WCC, a national nonprofit where veterans training service dogs for other veterans aims to heal those wounds.
Training dogs, training people
Currently, five special dogs on campus work with veterans, retired elite athletes and adult civilians who are receiving treatment for mild to moderate TBI at the MIBH. Importantly, the MIBH philosophy is that discharge status should not be a barrier to receiving treatment for veterans.
‘Veterans can be reluctant to focus on themselves, so helping train service dogs for others is a way for them to indirectly work on their own goals.’ – Ann Spader
After a one-week assessment, patients embark on a three-week outpatient program that includes working with professional dog trainers to help train service dogs for other veterans with disabilities. Why is it important that veterans train service dogs for other veterans? Ann Spader, service dog training instructor for WCC, said, “Veterans can be reluctant to focus on themselves, so helping train service dogs for others is a way for them to indirectly work on their own goals.”
Like many person-to-person interactions, training dogs can require significant patience. As they learn to train, patients are required to work on skills like frustration tolerance, expressing positivity, praising and rewarding good behavior and holding focus on the dog instead of turning inward on themselves.
The canine cast
The first eight weeks of life for all of WCC’s dogs can be watched with the live Puppy Cam.
Because service dogs spend their lives working on behalf of their partners, golden and Labrador retrievers are purpose-bred in the WCC headquarters in Maryland to maximize traits of health, temperament and longevity.
Here in Colorado, five dogs are currently in training: two yellow labs named Joseph and Sully; a black lab named Nate; and two golden retrievers named Candace and Poyner. Dogs are named in honor of military servicemen and women who have made outstanding contributions and sacrifices for their country. The CU Anschutz dogs join approximately 70 other service dogs being trained in facilities nation-wide.
Each dog works with up to 60 veterans during their two-year training. Much of this training is focused on mobility commands which include helping with balance support and learning to pull wheelchairs for short distances in case of emergency. WCC dogs also identify and interrupt physical stress cues such as a bouncing leg by nudging a partner’s hand or jumping into their lap to decrease anxiety and stress and provide physical grounding. As service dogs accompany their partners in their daily lives, dogs even learn to control their need for bathroom breaks, fittingly designated as the “Better hurry!” command.
During the two years of training, volunteers from CU Anschutz known as ‘Puppy Parents’ help to reinforce the training and socialization during the dogs’ off duty hours. After completing the two years of training, dogs are matched with a veteran in a manner consistent with their own personalities. The pair undergoes an intensive two-week program designed to familiarize both dog and human to the details of their new partnership. The partnership created is celebrated at a graduation ceremony attended by each dog’s namesake or their family and the dogs are transferred into the care and service of their lifelong partners.
Love hormone, unleashed
Why are dogs so skilled at healing emotional wounds? A 2015 study in the journal Science provided some clues: mutual gazing was shown to increase blood levels of oxytocin, the love hormone, in both humans and dogs. This can promote attachment and bonding between dogs and owners. Other studies have shown that petting a dog can lower blood pressure and slow heart rate. Also, dogs are also great listeners; patients have told Spader that talking to the dogs is easier than talking to people, because they don’t feel like they’re being judged.
Service dogs vs. ‘dogs who want to be served’
Not every dog is meant to be a service dog, Spader said. “Instead of being born to serve, some dogs want to be served,” she laughed. Dogs that are too social or attention-loving to maintain the necessary level of focus on their partner choose a different career path since being a service dog is not the only option for these talented canines. For example, some dogs provide comfort as therapy dogs at veterans’ care facilities, hospitals, and court rooms. Other dogs serve as military family support dogs, where they help heal the rifts within families.
How to get involved
WCC is supported entirely through grants and donations. With the two years of intensive training and care, each dog is estimated to be worth $35,000. Yet, the dog is provided to a veteran at no cost.
When it comes to veterans helping other veterans, Spader said that WCC’s mission-based trauma recovery model relies on the warrior ethos; leave no man behind. She added, “It’s a no-fail mission. The dogs have to be trained, they need to be socialized, because they have such important work to do.”
Guest contributor: Shawna Matthews, a CU Anschutz postdoc
Beginning Monday, Nov. 25, InfoEd will look and feel differently to what you are used to. While the functional changes are minimal, there are some new features that may change the way you search the Conflict of Interest (COI), Human Subjects (HS), Proposal Development (PD) and Proposal Tracking (PT) modules.
What is changing?
InfoEd is being upgraded several versions to the most current version – 812.01. With this upgrade, you will primarily see aesthetic changes in color, look and feel. The functionality you are used to will not change significantly.
The most important changes you will see with the upgrade are as follows:
The new Enable landing page includes Widgets;
Flyouts with extended navigation functionality were added;
The search function has changed to selection of preferred parameters;
Changes to the titles of certain fields to allow searching across modules (e.g. “Proposal number” or “Certification number” will be shown as “Record Number”);
The “adding personnel” functionality uses progressive text instead of alpha split; and
For COI, you can now submit your disclosure with fewer clicks.
Why are we upgrading?
We are implementing the upgrade for the following reasons:
We are currently several versions behind in InfoEd, meaning that we can’t receive patches, upgrades or enhancements to the software;
Version 812.01 includes enhancements we need, and lays the foundation to keep current and to accept desired features; and
We are not using the InfoEd to its fullest potential today and this upgrade will allow us to do so.
The Regulatory Compliance Office, Office of Grants and Contracts and The Office of Information Technology are partnering to bring this upgrade to you. There will be many opportunities to engage with these departments to learn more about the upgrade, the changes and to provide feedback. Keep an eye out for town halls, newsletter articles, training opportunities and more in the coming months.
Have questions about the InfoEd 812.01 upgrade project? Please reach out to firstname.lastname@example.org