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COMMUNITY HEALTH PARTNERSHIP Report 2018

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Table of Contents 4 Aha Moment—Webster dictionary defines an “aha moment’

as “a moment of sudden realization, inspiration, insight, recognition, or comprehension.”

6 Social Determinants of Health—Social determinants have a major impact on health outcomes—especially in the vulnerable and remote communities like the Upper Peninsula of Michigan.

8 Kevin Trewartha—Mind and Body approach to Alzheimer’s 12 Megan Frost –researcher, mentor, and entrepreneur Megan

Frost and Caroline Gwaltney partner to engineer smart wound dressings that have the potential to solve a significant health problem.

16 Jeremy Goldman—A research team at Michigan Tech is creating bioabsorbable stents with zinc and zinc alloys that could prove safer than current stent materials.

18 Marina Tanasova—GLUT5 is not just another tool to image cancer. This probe is a two-for-one: detect cancer and distinguish one type from another. Together, they develop a cancer fingerprint.

20 Mindfulness—A student-led study reveals meditation could help anxiety and cardiovascular health.

22 Community Health and Wellness—Three professorships, three approaches to community health and wellness.

26 Portage Health Foundation—Making a Difference through scholarships.

28 Health and Student Wellness Advocates (HOSA)—In order for programming to be effective, the need, tone, and purpose must be student driven.

30 Ripple Effect—Increasing opportunities for paid health research experiences for undergraduate and graduate students.

34 Abby Sutherland—An interview with Songer Research Recipient and Portage Health Foundation scholar.

36 Ian Greenlund—Sitting is the new smoking. 38 Kelly Kamm—Vision screening using smartphone app. 40 David Rosen—Portage Health Foundation Graduate

Assistantship investigates uncertainties in a novel medical imaging modality.

42 An upward trajectory—$1 of NIH funding puts $2.1 into the local economy.

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Webster’s Dictionary de� nes an “aha moment” as ‘a moment of sudden realization, inspiration, insight, recognition, or comprehension.’ While I’m slightly embarrassed to acknowledge that it took me three years to have my true aha moment with this partnership, I want to share that vulnerability with you—because if we don’t make ourselves vulnerable, we cannot grow.

In many ways, our community was humbled by the tragic Father’s Day � ood. I happened to be traveling for a conference and missed the actual � ood and immediate days of the a� ermath. Like anyone from our community who was away for that period, my wife and I followed the progress via social media—and we were inspired by the stories and pictures of individuals and groups rallying to help one another. It was truly inspiring, and I began to think di� erently about our community.

� is is not to suggest that I didn’t always care about our community—because I’ve lived and breathed in this community as a college student, a local high school teacher, a coach, and a professor for over 20 years—intersecting with a wide swath of individuals and engaging in a number of community events and outreach. But as I saw the devastation from the Father’s Day � ood—and learned more about the strained � scal and health conditions so many in our community are plagued with—I challenged myself in my current leadership role to not simply donate to the various fundraisers and move on, but to use my position to seek fundamental change.

At about the same time, the Western UP Health Department was � nishing up their Community Health Needs Assessment report, and beginning to disseminate the results. I was aware of this e� ort because I helped facilitate and support the involvement of Michigan Technological University through a dynamic and exciting faculty member with Kelly Kamm (featured in this report). Moreover, we had included an older version of the Western UP Health Department’s report when we proposed our partnership to the Portage Health Foundation (PHF) in 2015. So it shouldn’t have surprised anyone when we (Michigan Tech) got involved; no, that was a “grant objective” from the start—one of many we needed to “check o� ” to demonstrate progress.

� e aha moment came when this simple grant “objective” shi� ed from an objective to something very real, and something I realized we (Michigan Tech) have a huge role to play. As a primary contributor to the economic and intellectual ecosystem of our region, it is incomprehensible if Michigan Tech isn’t more involved in addressing the social determinants of health through our research, education, technology development, outreach, and innovation.

� is was always the “part” of the plan—but in the last year it has emerged as a centerpiece—and I couldn’t be more thrilled about this fundamental shi� .

Flood photo by Adam Johnson | brockit inc.

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Accordingly, you will see an intentional e� ort on our part to con-nect to the Community Health Needs Assessment report in the stories highlighted throughout this annual report. � e faculty and students of Michigan Tech are doing so many great things related to health research, education, and leadership—and you can feel the grounds shi� ing around the importance of this with respect to social determinants of health, social mobility of our students and community, and a genuine desire to be part of a solution.

A little over three years ago when we pitched this partnership, we included the following quote from Henry Ford in the presentation summary: “Coming together is the beginning. Keeping together is progress. Working together is success.” Leveraging the assets of Michigan Tech and PHF, and establishing this partnership was clearly the beginning.

Over the past three years, we’ve been “keeping together” and making progress. I can’t help but think that while we still have lots of work ahead of us, we are approaching that third and ultimate phase of “working together”—and meaningful change is beginning to take shape as a result. We look forward to continuing to advance this community health mission, which we’ve come to embrace as not just the PHF mission, but a fundamental value at Michigan Tech.

-Jason Carter

Jason R. Carter, PhDAssociate Vice President for Research DevelopmentPrincipal Investigator for the Michigan Tech-Portage Health Foundation Partnership for Health

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In the following pages, several stories will focus on how the partnership between the Portage Health Foundation (PHF) and Michigan Tech is signifi cantly impacting social determinants of health in our local and regional communities.

Social determinants have a major impact on health outcomes—especially in vulnerable and remote communities like the Upper Peninsula of Michigan. Income, level of education, and age all play a role in prevention and treatment of disease. Recognizing this, Michigan Tech partnered with the Upper Peninsula health departments and other agencies to release the fi rst-of-its-kind Community Health Needs Assessment (CHNA).

The Western Upper Peninsula Health Department (WUPHD) reports that the CHNA is the culmination of an 18-month project led by local health departments in collaboration with hospitals, behavioral health agencies and health foundations. It includes data on health across the lifespan, access to care, community issues like drug abuse, and results from an extensive health survey conducted last August.

Kelly Kamm, a faculty member in Michigan Tech’s Department of Kinesiology and Integrative Physiology (KIP), was contacted by the WUPHD to conduct the analysis of the Regional Adult Health Survey. “The health department designed and conducted the survey, and I was brought in to do the analysis of the data,” Kamm says. “I also contributed to writing the text in some of the chapters where the data is interpreted.”

Kamm says the survey was important on a couple of levels. “This is an example of how we at Tech can partner in our community to provide expertise to local and regional programs or initiatives. Then, there’s the importance of the project itself.”

Kate Beer, WUPHD health offi cer, says, “Community health needs assessment and health improvement planning are core functions of public

SOCIAL DETERMINANTS OF HEALTHhealth. The fi nding in this report will help healthcare providers and communities address the health needs of people across the region.”

Kamm says the information in the report will be useful to individuals as well as the institutions who compiled the report. The 350-page report covers all 15 UP counties and is available online. It provides a wealth of information on the health status of the UP’s 310,000 residents.

“Nearly 5,000 people responded to the Adult Health Survey and it is important for everyone to have the opportunity to see how that data is summarized and placed in the context of improving health in our region.”

Upper Peninsula Community Health Needs

Assessment 2018

Reporting on the Health Status of

Michigan’s Upper Peninsula Residents

Second Edition

*Data from the UP Community Health Needs Assessment is cited throughout PHF Community Report.

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MOTIVATINGTEAMS

1 in 9 UP adults is diagnosed

with diabetes

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Trewartha hopes to add motor learning tests to the suite of neurological and cognitive screenings for Alzheimer’s.

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Kevin TrewarthaMIND and BODYAPPROACH TO ALZHEIMER’S

*Over 77 percent UP Community Health Needs Assessment adult survey participants identified lack of programs for people with Alzheimer’s Disease or dementia as important.

Here’s how one Michigan Tech researcher is trying to address that.

While many think of the progression of Alzheimer’s mostly as a cognitive process, the mind and body are inherently linked. PHF funded early-career researcher Kevin Trewartha explains the mind-body connection:

“�ere is an intimate link between motor behav-ior and cognitive function, especially as we get older,” Trewartha says, explaining that when a person starts a physical task they’ve never done before, speci�c parts of their brain kick in. “�at early part of learning a novel skill is where cognitive abilities are particularly important.”

The challenge in studying Alzheimer’s is that the symptoms doctors examine and use to diagnosis patients focus on cognitive abilities and neurological functioning. Trewartha and his collaborators at UP Health System Portage have found changes in motor skills as well. But what comes first—cognitive decline or declines in motor behavior?

L’Anse native and PHF Undergraduate Research Intern Program (URIP) recipient, Allie Waara, works with Trewartha. Along with a rare opportunity to conduct hands-on Alzheimer’s research with a faculty mentor, Allie is charting a course of social/economic mobility for her high school peers—who reside in community where only

*13.1 percent of the population has a bachelor’s degree or higher.

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“You can see differences in motor behavior and motor performance that are indicative of cognitive decline and aging, which is true even in individuals who we would say are normal with cognitive and neurological tests,” he says. “If we can identify the subtle differences between people who do have Alzheimer’s, people who have mild cognitive impairment, and people who are just healthy older adults, then hopefully that will allow us to demonstrate that it’s important to add these tests to the current diagnostic procedures that are used in the clinic.”

To help with the screenings, Trewartha and his team need a robot. Specifically, a Kinarm End-Point Lab that looks like a seated voting booth with handles. When a participant sits down and holds onto the handles, a virtual reality display of objects appears in front of them. By shifting the handles they can try to reach for the objects. In a test called a force field adaptation task, the robot pushes back against the participant’s hands and they have to relearn how to change the pressure of their grip to reach the objects.

In another test, called a visuomotor rotation, a cursor representing the participant’s hand moves off in a different direction than expected. When reaching to the right, the cursor might move left instead. Again, the participant needs to adjust and relearn how to move their hand when the visual feedback veers off. The two tests engage slightly different cognitive abilities.“The benefit is that they’re tasks you would never do in real life; we’re taking a task that is completely novel so that we can truly assess that early stage of how people

approach learning a new skill,” Trewartha says. “We can measure performance over time—from trial to trial—to measure how people learn from the errors they produce.”

The team plans to work with UP Health System-Portage to recruit about 100 participants, focusing on three groups: patients diagnosed with Alzheimer’s, patients with mild cognitive impairment—a high risk factor for Alzheimer’s—and healthy older adults. The study participants will complete one of the two tests, then follow up and repeat it 24 hours later to gauge their memory and skill retention.

While the tasks themselves are as simple as reaching for an object, programming the Kinarm robot and recruiting participants is more complex. What will be even trickier—and more important, Trewartha says—is establishing tests for use in clinical practice.

“If we can show that this is successful in terms of the diagnostic approach, then we need to develop a test that is easily administered by clinicians. The force field task can’t be—people won’t likely have the equipment, it’s expensive, it’s technically complicated,” he says. “What’s nice about visuomotor rotation, is that you can design one for a smartphone or tablet.”

Perhaps one day, worried patients and their loved ones won’t have to wait until they feel their memory slipping. Screening early for Alzheimer’s could be as simple as a phone game—a tech-enhanced window into the subtle influences between mind and body.

SHARING THE SPIRIT:

SHARING THE SPIRIT:

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SHARING THE SPIRIT:

SHARING THE SPIRIT:

Handles on the robot provide feedback to participants, challenging them to learn a different way to move a virtual reality cursor on a screen in front of them.

Lines on the screen show the participant’s movement, which will help Trewartha’s team determine how quickly they learn a new motor skill.

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PHF Mid-Career Research Excellence Funds provided Megan Frost an opportunity to pursue funding from the National Institutes of Health.

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Megan Frost and Caroline Gwaltney are partnering up to engineer smart wound dressings that would solve a significant health problem.

Diabetes Mellitus is a metabolic disorder that effects 29.1 million Americans. This disease and its complications created $245 billion in health care costs in the US in 2012. It is estimated that approximately 15 percent of those suffering from diabetes will also suffer from chronic foot ulcers that develop as a result of the so called “pathogenic triad of neuropathy, ischemia, and trauma.”

Additionally, infections in these open wounds further complicates this classical triad and makes treatment of foot ulcers even more challenging. Chronic foot ulcers result in open wounds that do not heal for more then 128 days, and in fact grow in size over time, thereby causing increased morbidity and mortality for those afflicted with these wounds.

Frost’s laboratory is systematically investigating cellular responses of macrophages, fibroblasts, and keratinocytes to nitric oxide delivered with temporal and spatial control. Dysfunction in the regulation of these cell populations has been shown to be an underlying cause of diabetic ulcers. Understanding how these cells respond to precisely delivered doses and durations of nitric oxide will allow engineering of smart wound dressings.

The goal is to move wound healing through inflammation and into the migration and proliferation stages to lead to complete wound resolution in 21 days.

MEGAN FROSTis interim department chair of the Department of Kinesiology and Integrative Physiology and professor in biomedical engineering at Michigan Tech.

CAROLINE GWALTNEYis assistant professor and regional clinical coordinator in Central Michigan University’s Doctorate of Physical Therapy program extension at Michigan Tech.

Megan FrostWound healing PARTNERSHIP

*Regional diabetes prevalence is about 11 percent, a rate expected to rise given the dramatic increase in obesity in recent years. Rates of chronic disease are disparate by educational attainment; for instance, 22.3 percent of the lowest educated group had diabetes, vs. just 5.3 percent for the highly educated group.

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In Megan Frost’s polymeric biomaterials lab, undergraduate and graduate students alike have a chance to learn about the world of biomedical engineering research. Frost says her approach to hiring student researchers is to open the door to anyone who wants to learn.

“Tissue engineering sounds so elegant and exciting,” she says. “To actually do tissue engineering, it means hundreds of hours in the lab changing solutions. There are so many aspects of engineering people are not exposed to until they’re doing it. How do they know they’ll like it or dislike it until they’re exposed to it?”

Frost believes students have a better chance of finding their calling if they have the chance to explore and learn in a mentored environment. She takes students as young as incoming first years with the stipulation that even if the student discovers the work is not for them, they must finish out the semester. Frost says she’s had more than 60 undergraduates work in her lab and can recall only two negative experiences.

“We can’t teach enthusiasm and natural curiosity. Getting involved in research is a great motivator,” Frost says. She notes that giving students a sense of ownership of the work, and the knowledge that they are working on real problems, imbues their educational experience with greater meaning.

Genevieve Romanowicz, who graduated from Michigan Tech in 2012 with a Bachelor of Science in Biomedical Engineering, is now pursuing her Doctorate of Dental Surgery (DDS) and a PhD at the University of Michigan. She is one of two students accepted annually into the DDS/PhD program.

Romanowicz also learned how to be a mentor.

“Dr. Frost emanates a joy and passion for research. She would be whistling and singing as she was showing me how to synthesize some chemicals,” Romanowicz recounts. “Now I have to be the one whistling at the bench. I also try to mimic Dr. Frost in much of her mentoring style when I work with undergraduate students because I know she really helped to shape my view of research and my success so far.”

IDEAL PLACE TO LIVE

Inspiring HEALTH TALENT

Frost’s research looks for ways to amplify the body’s natural response. When done, it can heal without relying on an antibiotic.

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Megan Frost first began thinking about starting a company after she suffered from a serious infection following oral surgery in 2011. Treatment for the infection required her to use what is called a PICC line for 40 days.

PICC is an acronym for peripherally inserted central catheter, a thin, soft tube inserted in a vein that carries blood to the heart. The problem is that PICC lines are themselves hosts to serious infections. Frost was cleaning the site daily and changing the bandage and thinking about how unsanitary, dangerous, and in need of improvement it all was. Her solution?

Figure out a way to infuse polymers with nitric oxide, a free radical gas which has antimicrobial properties and is benign in the human body. Strips of the infused polymers would serve as bandages and wound dressings.

“It’s analogous to the way bleach kills bacteria, but much gentler,” she says.

Frost teamed up with health care entrepreneur, Jeff Millin, to bring to market Sentry Wound Dressing, a product designed to prevent infection and reduce the need for some post-acute care, including home health.

Their four-employee business, FM Wound Care, LLC, is awaiting US Food and Drug Administration approval on a nitric-oxide-infused, self-sterilizing wound dressing designed to kill bacteria following surgery. The post-op bandage could potentially reduce the need for some care performed by home health care providers, and lower overall wound care costs.

The Sentry product helps cut infection risks by steadily releasing nitric oxide, which the body produces naturally to help fight bacteria.

The product only works on surface wounds, not deep ones. Along with the health and time-saving benefits, there is a cost savings due to fewer dressing applications. Millin estimates that the total cost of changing a wound dressing is around $100, when considering the cost of the product, medical professional, and any related treatment.

Aspiring ENTREPRENEUR

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Researchers at Michigan Tech are creating bioabsorbable stents with zinc and zinc alloys that could prove safer than current stent materials.

Building better metallic stents to support weakened arteries has been the work of several years and the focus of a flurry of publications from Michigan Tech researchers and their collaborators.

Stents are small mesh tubes used to treat narrowed or weakened arteries. Arteries are blood vessels that carry blood away from the heart to other parts of the body. When arteries are blocked or damaged, stents are often used to reopen them. Even though stents can be lifesavers for many, over time the kind of materials the stents are made from can cause other problems to arise, including chronic inflammation, late-stage formation of a blood

clot inside a blood vessel, obstruction of blood flow through the circulatory system, and perforation or damage to local cells.

Bodily fluids are extremely corrosive to metallic surfaces; corrosion has traditionally been viewed as one of the major problems for the widely used inert stent metals since the corroded products can cause infections, local pain, swelling, and loosening of the implants. However, advances in biodegradable stent materials whose purpose is to dissolve and be absorbed in the body, could address problems related to the permanent presence of traditional stent metals. Manufacturing stents that are biodegradable could revolutionize the way people are treated for clogged arteries, prolonging lives and limiting the need for risky open-heart surgery.

Reaching solutions has been a collaborative effort by scientists in various departments and fields of expertise, including Jeremy Goldman, Patrick K. Bowen, Jaroslaw Drelich, Sean P. Hopkins, Emily R. Shearier, Elisha J. Earley, Roger J. Guillory, Amani A. Gillette, Eli Aghion, and Martin Bocks, among others. They have relentlessly pushed the boundaries of stent development using zinc.

Jeremy Goldman A SHORT STINT AS A STENT

The researchers hope to solve a tricky issue in stent construction: The stent itself begins to create more problems than it solves.

Jeremy Goldman and his team collaborators have received funding from various organizations and institutions including: PHF Mid-Career Research Excellence Funding; NIH National Heart, Lung, and Blood Institute; and NIH National Institute of Biomedical Imaging and Bioengineering.

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* 9.6 percent of UP adults were diagnosed with heart disease at one time, 5.8 percent

have had a heart attack. 3.2 percent a stroke.

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The 2018 UP Community Health Needs Assessment report calls for finding methods for rural healthcare providers to increase cancer prevention and early detection. Enter the potential of the GLUT5 Fluorescent Probe.

GLUT5 is not just another tool to image cancer. The probe is a two-for-one: detect cancer and distinguish one type from another. Together, they develop a cancer fingerprint.

Determining the presence of cancer, as well as its type and malignancy, is a stressful process for patients that can take up to two weeks to get a diagnosis. With a new bit of technology—a sugar-transporting biosensor—researchers at Michigan Tech hope to reduce that timeframe down to minutes.

Portage Health Foundation funded researcher, Marina Tanasova, assistant professor of chemistry, and Smitha Rao, assistant professor of biomedical engineering, turned a 10-minute office meeting into a two-year collaboration built on a tiny fluorescent probe that seeks out the fructose transporter named GLUT5.

Cells need carbohydrates; facilitative glucose transporters (GLUTs) bring nutrients in and out of cells. When metabolic swings kick in—say, from cancer development—the overall make-up

of GLUTs change so that more or less GLUTs are active. Fructose transporters like GLUT5 are of particular interest because of the direct connection between fructose uptake and cancer development, which also changes as cancer progresses and becomes malignant.

“We came closer to a basic screening of cells’ GLUT composition—one that both detects cancer and distinguishes type,” Tanasova says, adding that while the concept is elegant, developing the technology is not easy. “From basic science to application, there is a lot of transformation that has to happen.”

By better understanding the science behind sugar transporters, the team is more equipped to build technology that captures an accurate and precise GLUT fingerprint of cancerous cells.

“This probe is like a Swiss army knife,” Rao says, explaining that cancer detection is not the only use for the probe. “The more we learn about cancer through these probes, the more opportunities we have to apply them—which means more chances to treat different cancers, hopefully cure them, and at least prevent their spread and maximize drug delivery.”

What makes the probe so versatile is its ability to not only seek out and highlight cancer cells, but

Marina Tanasova GLUT5 FLUORESCENT PROBE CANCER CELL FINGERPRINTS

also to reveal the metabolic nuances of different stages of cancer development. While cancer generally gobbles up fructose, the GLUT5 and metabolic activity of nonmalignant, pre-malignant and malignant breast cancer cells do vary, which is what Rao, Tanasova, and their team explored in a recent study. They found that ManCou probes allow for parallel analysis and quantification of GLUT5 and metabolic activity of cells just after a 10-minute incubation period. The notable differences in fluorescence intensity observed between normal cells and cancer cells, as well as different cancer types, provide important points of differentiation between different cell types and make these probes promising tools for cancer detection and diagnostics.

The research is still early on, but Tanasova and Rao have a clear vision for the project’s next steps. Funding from the Portage Health Foundation helps move their research one step closer to creating the future of point-of-care cancer detection devices.

*Cancer and heart disease account for about half

of all UP deaths.

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Chemistry researcher, Professor Marina Tanasova, used PHF SEED funding to advance her research and position her to be more competitive for external funding.

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In a student-led study, one hour of mindfulness meditation was shown to reduce anxiety and some cardiovascular risk markers.

It sounds like a late-night commercial: In just one hour you can reduce your anxiety levels and some heart health risk factors. But a study with 14 participants shows preliminary data that even a single session of meditation can have cardiovascular and psychological benefits for adults with mild to moderate anxiety.

The research team, which included John Durocher, professor in biological sciences, Hannah Marti, a recent Michigan Tech graduate and PHF research intern, Brigitte Morin, lecturer in biological science, and Travis Wakeham, laboratory supervisor, found the following results from their study:

60 minutes after meditating, the 14 study participants showed lower resting heart rates and reduction in aortic pulsatile load—the amount of change in blood pressure between diastole and systole of each heartbeat multiplied by heart rate. Additionally, shortly after meditating, and even one week later, the group reported anxiety levels were lower than pre-meditation levels.

“Even a single hour of meditation appears to reduce anxiety and some of the markers for cardiovascular risk,” Durocher says.

While it’s well-documented that meditation over the course of several weeks reduces anxiety, there have been few comprehensive research studies on the benefits of a single meditation session. Durocher’s team wanted to understand the effect of acute mindfulness on cognition and the cardiovascular system to improve how anti-anxiety therapies and interventions are designed.

The study hinged on a research design proposed by recent graduate Hannah Marti ’17. Marti, who graduated with a bachelor’s degree in biomedical engineering, is now attending medical school at the Medical College of Wisconsin—and is continuing her research and community outreach related to meditation.

Marti designed the mindfulness study to include three sessions: 1) An orientation session during which researchers measured anxiety using the Beck Anxiety Inventory (BAI) and conducted cardiovascular testing by measuring heart rate variability, resting blood pressure, and pulse wave analysis; 2) A meditation session that included repetition of the cardiovascular testing plus the mindfulness meditation—20 minutes introductory meditation, 30 minutes body scan, and 10 minutes self-guided meditation—repeating cardiovascular measurements immediately following meditation and 60 minutes after;

A STUDENT-LED STUDY: Pathway to Success MEDITATION COULD HELP ANXIETY AND CARDIOVASCULAR HEALTH

3) A post-meditation anxiety test one week later.During a body scan, the participant is asked to focus intensely on one part of the body at a time, beginning with the toes. By focusing on individual parts of the body, a person can train his or her mind to pivot from detailed attention to a wider awareness from one moment to the next.

The single session mindfulness meditation study is an excellent example of the emphasis on student participation in research at Michigan Tech.

“In Michigan Tech’s health science research programs, I want our students to get hands-on experience that they can carry into their futures, gaining experiences to advance their educational careers or their professional careers,” Durocher says. “When they go for an interview, they have something real to talk about, there’s substance.”

Marti says this has been her experience.

“I had so much to talk about in my medical school interviews,” she says. “I didn’t have to say ‘I just helped the professor do this,’ because with Dr. Durocher’s help, I was able to do most of the research myself.”

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A STUDENT-LED STUDY: Pathway to Success MEDITATION COULD HELP ANXIETY AND CARDIOVASCULAR HEALTH

* 40 percent of surveyed adults are told they had high blood pressure.

More than 80 percent of those adults also reported taking medication for the condition.

Adults with less than a high school degree were more likely to report they had high blood pressure and more likely to be taking medication if they had high blood pressure than adults with a college degree.

The study is also an excellent example of how internal “early-career” funding leads to externally funded research programs. John Durocher is a recipient of a $465,854 research and development grant from the US Department of Health and Human Services—National Institutes of Health. Jason Carter (KIP) and Min Wang (Math) are Co-PIs on the project "Mindfulness and Neural Cardiovascular Control in Humans."

“We know a little bit about mindfulness and blood pressure, but very little about blood pressure patterns or the mechanisms for how mindfulness may reduce blood pressure,” Durocher says.

The NIH grant is a three-year project that utilizes an eight-week mindfulness meditation intervention for 60 participants—30 of whom will serve as a control group.

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Imagine Blizzard fractures his tibia snowboarding Ripley. The doctors put his leg in a cast and recommend, in a few weeks or months, physical therapy to help healing. But what if there were a technology that could shave a few weeks off Blizzard’s PT time so he could get back on the slopes faster?

Keat Ghee Ong, PHF Professor of Technological Innovations in Health, is using his professorship funds to do just that with “smart” implantable devices and cell therapy, two lines of research at the cutting edge of biomedical engineering.

Imagine analyzing big data sets to better identify, treat, or mitigate disease and illness in the Upper Peninsula. Collaborating with Upper Peninsula Health Plan, Qiuying Sha, PHF Professor of Population Health, is using her funds to do just that.

William Cooke, PHF Professor of Preventative and Community Health, used his funds to recruit PhD student, Josh Gonzalez (pictured right). One of their research projects investigates the potential cardiovascular risks of the newest generation of e-cigarettes.

Let’s Make a Difference COMMUNITY HEALTH

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* 8.9 percent of UP adults age 18-39, and 10.5 percent of all men, used smokeless tobacco (chew), and 6.8 percent used e-cigarettes.

* Smokeless tobacco and e-cigarette use decreased with age, income, and education.

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“Education is the premise for positive long-term change in any community. It is an engine of social mobility, it is inspiration for making a meaningful difference, and it is authentic experiences that refine talent and define leaders.”

— JODI LEHMAN,DIRECTOR, FOUNDATION RELATIONS AND SPECIAL PROJECTS

PHFMAKING A DIFFERENCE SCHOLARS

A Michigan Tech education is anengine of social mobility, helping

low-income students, who make up over

26 percent of our undergraduate

population, rise from the lowestquintile of family income to the

highest quintile in less than 20 years(by the time they are mid-way

through their careers).

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PHFMAKING A DIFFERENCE SCHOLARS

“I’ve learned how to form meaningful relationships with others, and to feel beautiful on the inside.” –COREY MILLER

During Corey’s first year at Michigan Tech, she had a vision for a Music and Memory program that is now in full implementation at Portage Pointe.

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CHALLENGING|DEDICATION“This past year I was enrolled in and completed the Emergency Medical Technician (EMT) class that Michigan Tech offers. It was 100 percent volunteer, and included weekly classes and clinical experience in both the emergency room and the ambulance. Starting this summer, I will be volunteering as an EMT with Michigan Tech and giving back to the community. “

-ELISHA HOULE, Dollar BayMedical Laboratory Sciences

CATALYST|PASSIONThe scholarship gets me out of my comfort zone. This past semester, I became involved with SPartners for Health, which is a health and nutrition intervention program. I was selected to be student coordinator, which allowed me to gain confidence in my leadership abilities and allowed me to work in a team environment. Initially, I was hesitant to apply for the student coordinator position, but once I learned that I was chosen for the job, I knew this experience would be one I would never forget. Getting involved in the community and acting as a catalyst for healthy change is something we can’t learn from a book or a lecture. The opportunities I have been given for service-based learning have proven themselves invaluable.

-JANA HENDRICKSON, CalumetExercise Science

TEAMWORK|RESPONSIBLE

The PHF Scholarship has allowed me to pursue a degree in computer engineering, fulfilling my technical aspirations, while also being connected to my health related interest of imaging. The Music and Memory program has given me a look into a part of healthcare that I wasn’t initially interested in, but it has instilled an interest into Alzheimer’s and dementia research.

-PETER ALGER, HoughtonComputer Engineering

EAGER|STIMULATE“This scholarship has not only supported me financially, but has also allowed me to inform my mentors and professors publicly about what my goals are for my educational and professional life. My hard work for this scholarship continues to open doors for opportunities presented to me by staff and faculty in the KIP department. One awesome experience was presenting at a KIP seminar about my work with outreach within the department. Our poster was entered into the Michigan Physiology Society Conference that was held at Michigan Tech last June.

I have submerged myself in the community by working with elementary students through programs like SPartners for Health and PhUn Week. I was able to further my understanding of health and wellness concepts while teaching students the importance of staying active and making good diet choices.

-ALEXA DESTRAMPE, Lake LindenExercise Science

WHAT DOES THE PORTAGE HEALTH FOUNDATION SCHOLARSHIP mean to you?

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WHAT DOES THE PORTAGE HEALTH FOUNDATION SCHOLARSHIP mean to you?

* About one-in-six UP adults reported general health status that was only fair or poor. The rates for fair-to-poor health were much higher with lower education and lower household income.

About 40 percent of adults in either the lowest education or lowest income level reported a depressive disorder, but only 20 percent of adults in the highest education or highest income level reported a depressive disorder.

Nearly 1/4 of adults in the UP are on medication to help with mood, emotions, or mental health. Medication use decreases as education level increases, but the same trend is not seen with counseling.

WHY Scholarships?Obesity was significantly different by education; while only 20 percent of adults who did not finish high school were not obese or overweight, 40 percent of adults with a college degree reported normal weight.

Nearly 30 percent of adults who did not finish high school reported no leisure-time physical activity, but only 4 percent of those with a college degree reported no activity.

Less than 3 percent of adults with a college degree reported chronic pulmonary disease; the rate among adults with less than a high school degree was nearly seven times higher at about 19percent.

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HEALTH AND STUDENT WELLNESS ADVOCATES (HOSA)

This year I participated in the SPartners for Health program as a Student Mentor. Through this program I went into Hancock Elementary, teaching and helping lead lessons on health and nutrition for their fifth grade classes, as well as mentored the students through an online portal. This experience reassured me of my passion for working with others, particularly educating others about their health.

-ADISON COOK

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“In order for the programming to be effective, the need, tone, and purpose must be student driven. The Health and Student Wellness Advocate (HOSA) student group helps make this happen.”

—WHITNEY BOROSKI,COORDINATOR, STUDENT HEALTH AND WELLNESS

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MAKING A DIFFERENCEDR. MATTHEW AND LAURA SONGER

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Through our partnership with the Portage Health Foundation, health education and research at Michigan Tech has become visible. As a result, other generous donors are coming to the table to support what they know is an impactful gift of giving.

Dr. Matthew Songer has distinguished himself as both an orthopedic spine surgeon and an entrepreneur. Songer earned a bachelor’s degree in biological sciences from Michigan Tech in 1979; a doctor of medicine from the University of Illinois, Chicago in 1983, where he also completed his orthopedic residency in 1988; and a spinal surgery fellowship at Northwestern University in 1989. In 2006, Songer received a Master’s of Business Administration from Northwestern University. He is an adjunct professor at Michigan Tech and a clinical assistant professor at Michigan State University’s College of Human Medicine. His wife, Laura Songer, is also an alum of Michigan Tech. She graduated with a degree in biological sciences in 1980.

Songer founded Pioneer Surgical Technology in 1992. The firm, which received a Cool UP business award from the governor in 2004, is a leading developer and manufacturer of surgical instrumentation and spinal and orthopedic implants. The firm is working on tissue

engineering to repair or regenerate diseased or damaged tissue.

Pioneer Surgical is expanding globally and has more than 200 employees. The firm has received numerous patents, including one it shares with Michigan Tech for a device to help reconstruct the spinal column.

Recipients of the Songer Research Award Competition had an opportunity to talk with Matthew and Laura Songer. Rupsa, a graduate student in biological sciences, shared her experience in working with her advisor Ebenezer Tumban to develop a safe, highly immunogenic, long-lasting, bacteriophage VLP-based chikungunya virus vaccine. Jeremy Bigalke, who was advised by Jenny Shan in kinesiology and integrative physiology, discussed their work with orexin control of arginine vasopressin in DOCA-saly-hypertension. From chemistry, Gilliane Kenyon, an undergraduate researcher of Marina Tanasova, talked about her experience analyzing the impact of DNA minor groove alkylation on DNA replication and transcription.

The Songers were motivated by the desire to allow Tech’s current students to experience the excitement they remembered when they conducted research as students 35 years ago.

RIPPLE EFFECT: Paid Student Research

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MAKING A DIFFERENCE

JEREMY BIGALKEKinesiology and Integrative PhysiologyMy current research is focused on the pathogenesis of salt sensitive hypertension. We are trying to elucidate an underlying mechanism specifically through hypothalamic projections. I hope to use this research to better understand the molecular mechanism of neural control of cardiovascular function, so that I can apply it to the human system during my PhD. I think the translation from molecular to human levels is essential in finding any sort of potential countermeasures for cardiovascular dysfunction.

“I am glad my research can potentially save millions of lives and reduce medical costs! It was my �rst attempt in writing a research grant and it makes me elated.” -RUPSA BASU

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RUPSA BASUBiological SciencesChikungunya virus (CHIKV) infection is raising concerns around the globe by causing rashes, fever, and joint pains, which are debilitating. Currently there are no licensed vaccines available against CHIKV. My aim is to develop a safe, economic and stable vaccine against CHIKV by using bacteriophage virus-like particle based platform. I have already identified and evaluated the antibody responses of my candidate vaccine and have found it to be immunogenic. The sera collected after immunizing mice with our candidate vaccine has also shown good reactivity with the live CHIKV SL15649 (Sri Lankan strain), as well as neutralization responses (at low titers) in-vitro, i.e., the sera were able to neutralize the virus infection once treated to the live CHIKV SL15649strain infected African green monkey kidney cells. My further strategy would be to evaluate the protection response of the candidate vaccine in virus infected mice.

GILLIANE KENYONChemistryDNA alkylation is a mainstay of chemotherapy and alkylation at the minor drove of DNA has received much attention in drug development. The mutagenic outcomes of minor groove alkylation are, however, not well understood. The Tanasova group has recently developed a synthetic approach to obtain a library of adenine analogs that carry a modification at the N3 (minor groove). Within the Songer Award, we assessed the outcomes of DNA minor grove alkylation with N3-modified probes and found that some modification inhibited DNA synthesis, while others promoted gene mutation. Further structure-activity studies are underway to dissect the features allowing for complete inhibition of DNA synthesis—an outcome sought for the development of DNA alkylating drugs.

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What is your involvement in Dr. Elmer’s lab? I have been involved in Dr. Elmer’s lab since my fi rst year on campus. I have helped our lab with outreach events, such as, PhUn Week, Physiology Friday, and National Biomechanics Day, which all involve putting together physiology/exercise focused projects and presenting them to students from local elementary, middle, and high schools.

Most of my community service projects have stemmed from my outreach involvement. I worked with a team from Dr. Elmer’s lab to put together a project about rotational inertia that we presented to a high school physics class. Also in my second year, I led a group of high school seniors on a tour of the KIP department for National Biomechanics Day. My involvement in HOSA has largely been working with the other three initial offi cers to establish the chapter and lay the foundation for the future of the organization. I’ve also helped out other members of the lab by helping with data collection and pilot testing for other studies. This year, as a senior, I’m in charge of my own project!

What is your research aim? Identify an equation that will use a person’s age to estimate what their maximal heart rate would be if they were doing strictly upper-body exercise. To do this, we are going to have our subjects complete a maximal effort graded exercise test on an arm bike; essentially we have them arm bike while the diffi culty increases with time until they cannot go any more.

An interview with Songer Research Recipient and Portage Health Foundation Scholar ABBY SUTHERLAND by Hannah Cunningham

“This scholarship was a huge factor in my decision to come to Michigan Tech. Had I not

come to Michigan Tech, I would have missed out on all of the

incredible opportunities that I have had here. I am extremely grateful for the Portage Health Foundation’s role in making it

all possible.”

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An interview with Songer Research Recipient and Portage Health Foundation Scholar ABBY SUTHERLAND by Hannah Cunningham

By reaching their maximal effort, they will have reached their maximal heart rate, which we can then plot on a graph against their age. From this scatter-plot of data, we can figure out the age-predicted maximum heart rate equation. We will be testing males and females ranging from 18-80 years of age, and right now are in the process of dialing in on the protocols we will be using: one for young males, young females, older males, and older females. This type of study has never been done before with this wide of an age range, so figuring out the best protocols to use is critical.

What are your goals? My long-term goal is to be a physical therapist specializing in sports medicine. I would love to work with athletes coming back from significant injuries, because my experience as that athlete in high school is what got me into this field and created so many amazing opportunities for me. As far as short-term goals, I’ve already checked one off by getting accepted to CMU’s physical therapy program. My goals for the near future include successfully obtaining my degree from Michigan Tech and beginning my “home stretch” of schooling this May.

How has being a PHF scholar helped you? Being a PHF scholar has helped me in more ways than I ever thought it would when I was first awarded the scholarship. Getting to collaborate and work with an outstanding group of local students, learning and developing professional skills through outreach events, conducting my own research study as an undergraduate student, and gaining knowledge and skills that will prepare me specifically for a career as a clinician are all things I’ve been able to experience in my time at Michigan Tech.

Much of what I have learned are things I will carry with me into my career. They are the type of things that are impossible to learn in a classroom.

Something interesting about yourself?I have been set on being a physical therapist since the eleventh grade. I came in knowing exactly what I want to do! The only thing I’ve changed my mind about was doing research as an undergrad. I didn’t really have any interest in doing research at all until I started helping out in Dr. Elmer’s lab.

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In 2011, I took a bus trip to Michigan Tech with my high school. I fell in love with the area and campus right away. I got my undergrad in biological sciences from Tech in 2016. Now I’m working on my master’s degree in the same major. After I finish, I’ll work toward a PhD in integrative physiology. Will I officially be a Yooper after nine years in the UP? My dad is an alumnus, too.

Transitioning from undergraduate to grad school was difficult at first. A lot of things demanded my time. Classes. Labs I teach. Studies for my thesis.

Ever heard the phrase, “Sitting is the new smoking”? My thesis is on the standing desk study. We’re looking to see if there’s a cardiovascular effect of standing versus sitting at a desk during the workday. Researchers all over the world are discovering that a sedentary lifestyle alters your body physiologically.

Doing nothing is hurting you.

Healthy people have elastic arteries, expanding and recoiling with changes in blood pressure,

when your heart is beating and relaxing. Our arteries become stiffer with age—sometimes leading to hypertension and other cardiovascular diseases. Your arteries can stay more elastic by doing aerobic exercise like walking and running—so your artery health isn’t doomed.

We classify participants into four groups: high-fit standing, low-fit standing, low-fit seated, and high-fit seated. We are using pulse-wave velocity, the gold standard of arterial health assessment. When your pulse-wave velocity is lower, your arteries are more elastic and considered healthier. We also screen blood pressure, like in the doctor’s office, and aerobic fitness level by walking on a treadmill for a mile—as fast as possible.

We achieved our target sample of 48 people. I defended my thesis using the final results. I plan to pursue a postdoctoral research position and eventually a faculty position at a university.

Sitting is the New Smoking:IAN GREENLUND

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Early identification of vision problems can increase the possibility that the impairment can be corrected or treated. But many older individuals have difficulty getting the recommended annual vision screening, possibly because of factors such as limited mobility, financial resources, and transportation.

Kelly Kamm, a professor of kinesiology and integrative physiology, alongside students Alexa Destrampe and Bella Nutini, tested a smartphone-based app that screens visual acuity (how well can you read shapes at a distance) at the Health and Safety Fair sponsored by UP Health Systems-Poratge. Their goal: To find out if the app would be acceptable to the community and if students could effectively administer the test.

Bella and Alexa, both exercise science students and Portage Health Foundation scholars, successfully provided the screening test to about 50 community members. The majority of respondents indicated they felt the test was acceptable.

The app is not a diagnostic tool but works as a basic screening test, akin to a blood-pressure machine at a pharmacy.

Kelly Kamm VISION SCREENINGUSING SMARTPHONE APP

During the screening, only one letter is used —a capital E. The person being tested points to indicate which one of four directions the letter is facing, which the researcher then records in the app. The letter gradually grows smaller until the point where the person begins to answer incorrectly or say they don’t know.

For the research team, the important data wasn’t the tests, but the questionnaires people filled out afterward. Those answers—whether they felt comfortable, whether they would let a researcher visit them for a home test—will go into their application for a National Institute of Health grant for a larger study.

The benefit is the screening can be done in health care settings, schools, or at home. Vision screening in a community or home setting that successfully encourages individuals to seek treatment and does not require medically trained professionals, could increase access to vision care and reduce the health effects of visual impairment.

“It really impacts the whole rest of your life if you can’t see well. As someone who has worn glasses since kindergarten, I understand the value of good vision,” says Kamm.

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David Rosen, a PhD student in biomedical engineering, investigates uncertainties in a novel medical imaging modality called ultrasonic elastography (USE). USE uses tissue elasticity as a source of contrast. Because pathological evolution of many diseases (e.g. cancer, liver fibrosis, vascular plaque) alter the elasticity of biological tissues, USE is becoming a cost-effective and potentially impactful technology. However, uncertainty related to USE in the clinical workflow prevents it from reaching its full potential. David’s research investigates the role that the complex material mechanics of soft tissues (i.e. viscoelasticity, heterogeneity, and nonlinearity) play in producing uncertainty in USE measurements.

Currently, his graduate research is nearing completion. Early in the semester, he submitted a manuscript for his work on the role of elastic nonlinearity in USE measurements of tissue-mimicking phantom materials. Right now this manuscript is under review. Lately, he has been finalizing data in preparation of an additional manuscript. In this manuscript, he draws from previous work to complete an analysis of uncertainty in USE by considering imaging physics (i.e. heterogeneity, viscoelasticity, etc.). Using this approach allows him to delineate which properties contribute most significantly to USE measurements, and thereby arrive at a better understanding of their rule in the uncertainty of USE measurement and imaging. Along with these efforts, David is also writing his dissertation, which he anticipates defending early next semester.

After completing his degree, David intends to pursue a postdoctoral position in a medical imaging laboratory that is developing the USE technology or similar technologies. The funding he has received through the Portage Health Foundation has been instrumental in providing him time necessary to focus on completing his research and preparing relevant manuscripts for publication. It is research and publication experiences, like the ones the Portage Health Foundation funding help to support, that position David well for a postdoctoral position.

PHF GRADUATE ASSISTANTSHIPDAVID ROSEN by Hannah Cunningham

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The funding David received through

the Portage Health Foundation has

been instrumental in providing him time

necessary to focus on completing his research and preparing relevant

manuscripts forpublication.

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$1 of NIH funding puts $2.1 into the local economyAccessed on 2015, January 14 from

www.nih.gov/about/impact/economy.htm

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Michigan Tech currently has 17 active NIH research awards from a number of Institutes and Centers whose mission is focused on areas that are relevant to the social determinants of health in our region:

As depicted to the left, Michigan Tech has tripled its NIH research expenditures over the past five years.

• National Institute of General Medical Sciences (five grants)

• National Heart, Lung and Blood Institute (three grants)

• National Biomedical Imaging and Bioengineering (three grants)

• National Cancer Institute• National Institute of Diabetes and Digestive and Kidney Diseases• National Institute on Alcohol Abuse and Alcoholism• National Institute on Aging• National Human Genome Research Institute• National Dental and Craniofacial Research

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Shown here are Kelly Kamm, Megan Frost, and Kate Beer. Their work is one of many examples of bridging efforts to advance a micropolitan community of health and wellness.

Photo credit: Mark Riutta Defi nedVisuals.com

Houghton/Hancock and the surrounding four-county area are on a sustainable path to becoming a “micropolitan” area—an economic center that is remote, not rural, and has many core characteristics of a bigger city. This includesexemplary schools, thriving businesses, and perhaps most importantly, high-caliber talentdelivering ideas and goods to society.

Micropolitan Community OF HEALTH AND WELLNESS