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Research roundup: Recent grants and publications for Emory faculty and staff
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As an academic research institution, Emory’s faculty and staff conduct studies across every discipline, from the sciences to the humanities. Here’s a sample of recent grant awards and the work they will support, plus highlights from some published research findings.

To read more about ongoing research at Emory, visit the eScience Commons blog (for natural and social sciences) and the Lab Land blog (for health sciences).

Grants highlighted:



Publications highlighted:




Grants

Expanding smoke-free homes intervention for rural families

A five-year, nearly $5 million National Cancer Institute R01 grant to public health behavior specialist Michelle Kegler will expand her smoke-free homes intervention to rural Native American households, with the goal of reducing second-hand smoke and related cancer disparities. The research builds on an established partnership between the Emory Prevention Research Center and members of the CDC-funded National Native Network to evaluate and adapt a smoke-free homes intervention.

The original intervention was evaluated through a series of studies, from efficacy to effectiveness to dissemination, and is listed on NCI’s Evidence-Based Cancer Control Programs website


Challenge Award funds new prostate cancer study at Winship

Radiation oncologist Sagar Patel and co-principal investigators Brian Olson and Anant Mandawat have received a two-year, $750,000 Prostate Cancer Foundation-Pfizer-Myovant Challenge Award for a new clinical trial studying the effect of androgen deprivation therapy on the heart. The goal of the trial, which will open at Winship Cancer Institute of Emory University, is to optimize treatment selection for men with prostate cancer and reduce treatment-related cardiovascular side effects.


Donaldson Charitable Trust supports brain tumor, CAR-T research

Two research teams from Winship Cancer Institute were awarded pilot grants from the Donaldson Charitable Trust Research Synergy Fund, a funding mechanism offered jointly by Winship, the Aflac Cancer and Blood Disorders Center of Children's Healthcare of Atlanta, and the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory.

The recipients for 2022 are Kimberly Hoang and Jaydev Desai for “Real-time Characterization of Malignant Brain Tumors with Microelectromechanical Systems (MEMS)” and Gabe Kwong and Madhav Dhodapkar for “In Situ Programming of Virus-Specific T cells for CAR-T Cell Therapy.” Each one-year grant of $125,000 is funded in part by contributions from the Oliver S. and Jennie R. Donaldson Charitable Trust. Learn more here


Blanton awarded stroke rehab grant

The Foundation for Physical Therapy Research has awarded the 2021 Paris Patla Physical Therapy Research Grant to physical therapist Sarah Blanton for her work on a telehealth program for stroke rehabilitation. Blanton is associate professor of rehabilitation medicine.

The funds ($100,000) will support the study titled “Evaluation of a Care Partner-Integrated Telehealth Gait Rehabilitation Program for Persons with Stroke.” The study arises from the preliminary work from Blanton’s NIH-funded K23 project, which evaluated the feasibility of a web-based, family-focused upper extremity intervention for persons with stroke and their care partners.

Building upon the insights gained and promising results from engagement of the care partner in upper extremity rehabilitation, the current research seeks to broaden the scope of our intervention and optimize post-stroke outcomes by pairing CARE-CITE with home-based gait and functional mobility training (CARE-CITE-Gait). Partnering with co-investigator Trisha Kesar’s expertise with measuring and treating post-stroke walking deficits, the proposed work will, for the first time, test CARE-CITE-Gait to determine its effects on functional mobility, physical activity, quality of life and psychosocial outcomes in stroke survivors and their care partners.


Low dose naltrexone to be studied for chronic neuropathic pain

Emory pain specialist Anne Marie McKenzie-Brown has received a $50,000 grant from Cures Within Reach to study low dose naltrexone for the treatment of chronic neuropathic pain in patients living with HIV infection. The grant includes supplementary funds for community engagement.

Naltrexone is a long-acting opioid antagonist that has been repurposed for the treatment of chronic pain at low doses, and systematic research is necessary on best practices for its use. Cures Within Reach is a disease-agnostic organization dedicated to repurposing approved and available drugs, devices, nutraceuticals and diagnostics.

McKenzie-Brown is director of Division of Pain Medicine and associate professor in Emory University School of Medicine’s Department of Anesthesiology.



Publications

Nurse burnout study continues to attract attention 

Pre-pandemic findings from a team of Emory University investigators have contributed to the understanding of why nurses, the largest proportion of the country’s health care workforce, may leave or at least consider leaving their job. With increasing demands placed on frontline nurses during the coronavirus disease pandemic, these findings suggest an urgent need for solutions to address burnout among nurses.

The JAMA Network Open paper Prevalence of and Factors Associated With Nurse Burnout in the U.S. received extensive media coverage and received honorable mention for the 2022 Society of Teachers of Family Medicine Research Paper of the Year.

This secondary analysis of cross-sectional survey data from more than 3.9 million U.S. registered nurses found that among nurses who reported leaving their current employment (9.5 percent of sample), 31.5 percent reported leaving because of burnout in 2018. The hospital setting and working more than 20 hours per week were associated with greater odds of burnout. These findings suggest that burnout is a significant problem among U.S. nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift.

Senior author was Mo Ali, vice chair for research in the Department of Family and Preventive Medicine and professor of global health and epidemiology in the Rollins School of Public Health. Co-authors included School of Nursing faculty member Jeannie Cimiotti; Division of Family Medicine faculty Megha Shah, Neena Ghose and Miranda Moore; and family medicine resident Nikhila Gandrakota. Cimiotti's research on nursing staff resources and hospital infection-related outcomes is currently supported by the Agency for Healthcare Research and Quality.

Studying the role of certainty and dogmatism in political beliefs 

Individuals with extremist views — whether they identify with the far left or the far right — are about five times more likely than others to be absolutely, 100% certain that their political views are correct, a study by Emory psychologists finds. Social Psychological and Personality Science published the research by Thomas Costello and Shauna Bowes, both Emory PhD candidates in psychology. 

They surveyed 2,900 people about how certain they were of their political beliefs, on a scale of 0 to 100%. Four in 10 participants who self-identified as extremely left wing or extremely right wing were 100% certain of their political beliefs. However, only about one in 10 participants with the slightly less polarized views, or “very” left or right wing, were 100% certain, which was similar to the ratio of people who self-identified as politically neutral. 

The researchers also assessed the participants’ dogmatism as a cognitive style, or how closely people hold their major beliefs in general. While extremists at both ends of the political spectrum were more dogmatic and certain about their beliefs, the most dogmatic of all were the extreme social conservatives. The opposite pattern was found on the left of the spectrum, with the sharpest increase in dogmatism seen in economic liberals. 

The findings are part of a larger body of work by the psychologists to explore the cognitive architecture underlying extremist, unjustifiably certain views and for possible ways to bridge the gaps in understanding. 


Window system allows for long-term studies of brain activity

Bilal Haider in the Wallace H. Coulter Department of Biomedical Engineering has created a new kind of window that allows for longer-term monitoring and data recording of mouse brain activity.

Haider is studying how multiple areas of the brain work together for visual perception. To get a clear image of the brain’s visual network, Haider’s lab uses an established technique called blood flow imaging, which tracks oxygen in the blood, measuring the active and inactive areas of a mouse brain while the animal views visual stimuli. To capture a strong blood flow signal, researchers typically create a cranial window by thinning the skull or removing a piece of it altogether. These procedures can diminish stability in the awake, pulsing brain — detrimental conditions for delicate electrophysiological measurements made in the same visual areas after imaging.

In Scientific Reports, Haider’s team presented a new kind of cranial window they created using a tiny piece of glass and a surgical glue called Vetbond that contains the same compound as Krazy Glue. The glue creates a transparent barrier that allows all the underlying physiological processes to continue but leaving a clear view of brain for imaging. Read more here.


Targeting galectin-9 in obesity-related chemoresistance

Researchers studying the impact of obesity on leukemia have identified galectin-9 as an important immunotherapeutic target to overcome obesity-induced chemoresistance, publishing their findings in Nature Communications. Curtis J. Henry, assistant professor of pediatrics and an investigator with the Aflac Cancer and Blood Disorders Center and Winship Cancer Institute of Emory University, is the study’s senior author.

Galectin-9 is a protein expressed on the surface of leukemia cells that promotes chemoresistance, and adipocytes secrete factors that promote greater levels of galectin-9. Antibody-mediated targeting of galectin-9 can significantly extend the survival of obese but not lean mice with aggressive B-acute lymphoblastic leukemia, the authors report.


Promoting improved outcomes for vulnerable patients during COVID-19

COVID-19 disrupted access to critical health care and resources for many people, especially affecting patients at safety-net hospitals who rely on regular care for multiple complex conditions.

Led by Tracey Henry and Maura George, Emory faculty in the Division of General Internal Medicine, medical and physician assistant students from Emory and Morehouse partnered with Grady Health System to perform telephone outreach to thousands of patients at highest risk of poor outcomes from COVID-19. 

This proactive, novel initiative identified substantial clinical and social need among patients at highest risk for poor outcomes and filled a pressing health system gap exacerbated by COVID-19. Simultaneously, interprofessional students gained applied exposure to health systems sciences. This program can serve as a model for rapid, cost-effective, high-yield outreach to promote patient health at home both during and beyond the pandemic, the authors write.

The results were published in the Journal of General Internal Medicine.


Elusive function of ribosome modification brought to light

Emory researchers have established the function of 2’-O-methylation, a chemical modification of ribosomes, the cell’s factories for protein synthesis. 2’-O-methylation is present on ribosomes in all forms of life but its function has been poorly understood.

Scientists led by assistant professors of biochemistry Sohail Khoshnevis and Homa Ghalei found that under certain conditions, yeast cells produce ribosomes with reduced 2’-O-methylation, which allowed them to analyze ribosomes lacking the modification. Those ribosomes displayed reduced fidelity of protein synthesis, including frameshifting and initial codon selection. Collectively, the results suggest that a major role of 2′-O-methylation of ribosomes is to support faithful initiation of protein synthesis.

The results were published in Proceedings of the National Academy of Sciences


Biosensors for quick assessment of cancer treatment

Immune checkpoint blockade (ICB) inhibitors have become a frontline therapy for a broad range of cancers, but less than 25% of patients benefit from these drugs — and sometimes only temporarily. A team led by Gabe Kwong in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory describe in Nature Biomedical Engineering a system of synthetic biosensors they designed to help.

The biosensors can be detected via a noninvasive urinalysis, telling the patient and doctor quickly if ICB therapy is working. The aim is to provide reliable, early information to help oncologists decide if a patient should stay the course or try alternative therapies. The molecules also can flag when patients develop resistance and stop responding to the treatment.

The sensors are attached to the ICB drug that makes its way toward the tumor environment after injection. When they reach their destination, the sensors are activated by proteases produced by both T cells and tumor cells, which triggers the release of signaling fluorescent reporters that are designed to concentrate into urine.


Faculty contribute to new book on ocular telehealth

Two Emory Eye Center faculty contributed to “Ocular Telehealth: A Practical Guide,” published recently by Elsevier.

Ophthalmologist April Maa, clinical director of Technology-based Eye Care Services at the Atlanta Veterans Affairs Medical Center, was the book’s editor and contributed heavily to several chapters. Ophthalmologist Alexa Lu also wrote or contributed to several chapters.


Calling for more comprehensive studies of diabetes-long COVID connection

Emory researchers have called for large-scale epidemiological studies with multi-ethnic populations from varied socioeconomic backgrounds as well as mechanistic studies to further investigate the connection between type 2 diabetes and long COVID.

In a commentary published by The Lancet Diabetes and Endocrinology, researchers K.M. Venkat Narayan and Lisa Staimez noted that recent studies have suggested COVID-19 could increase the risk of type 2 diabetes. They pointed to a new study published in The Lancet that found COVID-19 survivors exhibited an increased risk for and incidence of diabetes a year later although what triggers this has yet to be determined.

Narayan and Staimez said that given the study results, it is imperative that researchers use a comprehensive approach to investigate some of the critical questions raised about the connection between diabetes and COVID-19. This could include, the authors said, expanding the population to include a more varied demographic; measuring factors that may have some bearing on long-term COVID-19 complications such as disease severity and viral load; and standardizing approaches to measuring exposure to SARS-CoV-2 infection and diabetes. They also urged researchers to look into the mechanisms that might help explain the link between the viral infection and diabetes.

The authors noted that the long-term implications of SARS-CoV-2 infection increasing diabetes risk are profound, and could lead to unprecedented numbers of diabetes cases worldwide and increase the death and disability toll of the chronic disease.

If COVID-19 is indeed a risk factor for diabetes in the post-acute phase of infection, screening and management of dysglycemia  should be an integral part of clinical guidelines for COVID-19 diagnosis and follow-up, Narayan and Staimez say.


Multiple myeloma impairs COVID-19 vaccine immune response

Patients with B-cell malignancies, including multiple myeloma, are at increased risk of COVID-19-related mortality and exhibit variable serologic response to the vaccine. Investigators from Winship Cancer Institute of Emory University found that although more than 80% of patients with multiple myeloma mount some response to current COVID-19 vaccines, many of these patients lack detectable vaccine-induced neutralizing antibodies that are critical for protective immunity.

Serum samples from 238 patients with multiple myeloma were analyzed for neutralizing activity against SARS-CoV-2, with 33% of patients lacking anti-spike antibodies with detectable neutralizing activity. Patients receiving Moderna’s mRNA1273 vaccine achieved significantly greater induction of neutralizing activity compared with those receiving Pfizer/BioNTech.

Ajay K. Nooka and Uma Shanmugasundaram are co-first authors, and Madhav V. Dhodapkar is senior author of the original report published in the Journal of Clinical Oncology. Dhodapkar is director of the Winship Center for Cancer Immunology and a Georgia Research Alliance Eminent Scholar. Nooka is an oncologist with Winship and Shanmugasundaram is with the department of hematology/medical oncology.


MIS-C cardiac imaging follow-up results reassuring

A group of 51 children hospitalized for cardiac manifestations of MIS-C (multisystem inflammatory syndrome in children) mostly did not display cardiac abnormalities on magnetic resonance imaging follow up 3-5 months later. The findings, which the authors call “rapid improvement” and “reassuring,” were published in the Journal of Pediatrics.

Clinicians led by Children’s Healthcare of Atlanta pediatric cardiologist Matthew Oster have been seeing the largest number of children with MIS-C, a severe complication following COVID-19 infection, in the United States. Emory pediatric cardiology fellow Matthew Dove was the first author.

The 51 children, average age 11, were examined between July 2020 and May 2021 at Children’s Healthcare of Atlanta. None of the patients showed evidence of acute myocarditis on follow up 3-5 months later, a contrast with previous studies on acute viral myocarditis. However, two patients were observed to have signs of myocardial fibrosis, and a few had other signs of residual cardiac problems (valve regurgitation and coronary artery dilation).

Oster was also lead author on a January 2022 JAMA report on COVID-19 vaccine-associated myocarditis cases, mainly in adolescent males.


Very high HDL levels increase cardiovascular risk

Very high levels of HDL cholesterol carry an increased risk of cardiovascular and all-cause mortality, according to Emory cardiology researchers using data from the UK Biobank. The results were published in American Journal of Cardiology.

HDL (high-density lipoprotein) cholesterol is conventionally described as “good” cholesterol because it helps remove other forms of cholesterol from the body. Most studies of heart disease indicate that HDL-C levels above 40 milligrams per 100 milliliters of blood are generally protective against cardiovascular disease.

However, HDL-C at or above 80 milligrams per 100 milliliters (present in about 2% of men) confers increased risk. The increase is about two-fold, after adjusting for other factors, Emory cardiologist Arshed Quyyumi and colleagues found. The findings may partly explain the lack of benefit seen in clinical trials of medications designed to increase HDL cholesterol, such as dalcetrapib and torcetrapib.

About 11% of women have levels of 80 mg/100 ml or above; women with HDL levels above 100 mg/100 ml also appear to be at higher risk. The study looked at more than 410,000 people without coronary artery disease enrolled in the UK Biobank — a much larger number than previous studies. UK Biobank enrollment is predominantly white and older than 50.

The co-first authors are former Rollins School of Public Health graduate student Chang Liu and cardiology research fellow Devinder Dhindsa. Quyyumi is director of Emory Clinical Cardiovascular Research Institute and Bruce Logue Chair for Cardiovascular Research.


AI used to quantify key characteristic in lungs of COVID-19 patients

Researchers from Emory University and the University of Southern California recently found that artificial intelligence (AI) could better help detect and quantify a key feature in the lungs of COVID-19 patients, which may allow for a more efficient diagnosis as well as help assess the severity of disease — which could then inform more appropriate interventions.

Researchers, who published their findings in PLOS One, noted that one of the hallmark characteristics of SARS-CoV-2 infection is a hazy gray density on computed tomography (CT) scans of lungs called ground-glass opacity (GGO). The investigators used an AI-driven approach to detect and quantify GGOs in more than 1,000 CT lung scans of COVID-19 patients. Their algorithm detected GGOs with great accuracy and provided more defined patterns to help delineate those of COVID-19 from other lung diseases.

The research was led by Monjoy Saha, former research scientist at Emory, under the supervision of Ashish Sharma, associate professor in Emory's Department of Biomedical Informatics, and Rajiv K. Kalia, professor of physics and material science at the University of Southern California. Emory's Sagar B. Amin, an assistant professor in the Department of Radiology and Imaging Sciences, contributed to the clinical aspects of the study. 

The study results could provide radiologists and clinicians with a valuable set of tools when interpreting CT lung scans of COVID-19 patients. Implementation would be particularly useful in under-resourced countries where the number of COVID-19 cases has in the past outstripped available resources creating delays or even breakdowns in patient care.


‘Non-place’ brain cells play a crucial role in navigation

A new paper from biomedical engineer Annabelle Singer in the Proceedings of the National Academy of Sciences explains how a group of cells in the brain called non-place cells plays a vital role in navigation, separating a real goal from something that looks like the goal. The study described for the first time how they work in tandem with neurons in the brain’s hippocampus called place cells that help us understand where we are in space.

Singer is an assistant professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory. Her team was comparing healthy mice and mice with Alzheimer’s disease pathology as they navigated a tiny virtual-reality maze in search of a treat. They were studying the electrical oscillations in the brain when they found the non-place cells were out of sync with those signals in Alzheimer’s mouse models and also in healthy mice who failed to reach the right spot in the maze to receive a treat. That prompted the researchers keep digging to understand what the non-place cells were doing. Learn more here.


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