Annabelle Fonseca, MD, MHS
University of South Alabama
Assistant Professor, Department of Surgery

Project Title: Patient and Stakeholder Reported Perspectives on Barriers in Access to Oncological Care in Pancreatic Cancer

Research Impact: Disparities in access to pancreatic and other foregut cancer care are well documented. A large percentage of patients with resectable pancreatic and other cancers do not receive potentially curative surgical resection. We know that sociodemographic factors predict unequal access to cancer care, however we have not as yet identified all the modifiable barriers that prevent equitable access at the patient-, provider- and systems-levels. Identifying and understanding the scope of these barriers will allow us to identify and develop potential targets for intervention that can help mitigate disparities in access to care. My long-term research objective is to design, implement and study system-level interventions to improve the delivery of cancer care such that it is more equitable and just.

How do you plan to leverage this time with the CCTS? The CCTS Pilot Program Award affords me both some protected time and grant funding that will allow me to obtain pilot data on barriers in access to curative-intent surgical resection in patients with potentially resectable pancreatic cancer. I plan to use this time to identify patient, caregiver and other stakeholder perceived barriers, and identify the underlying modifiable barriers from a patient-centric and systems perspective. Identifying the underlying modifiable barriers to receipt of curative-intent surgery is the important first step that will allow us to develop targeted interventions for at-risk patients. I plan to use this data to apply for a mentored career development award.

What interested you about this funding opportunity? My research focus shifted to health services research with a focus on disparities in access to cancer care, largely due to my clinical experience here at the University of South Alabama. Our hospital is a safety-net hospital and tertiary referral center, and a large percentage of my patients have significant barriers impacting their access to care. Seeing this, and wanting to do something about it, is what resulted in the switch in my research focus. I first got involved in the CCTS when I applied to the Health Disparities Research Education Program at the Minority Health and Health Disparities Research Center. While there, I became aware of the CCTS pilot funding opportunity. I am in the process of applying for a career development award, and thought that this Pilot grant program would allow me to obtain pilot data to help with my CDA.

What is your favorite thing about your career? It would be hard to pick the one thing I like the most about being a surgical oncologist. As a HPB and foregut focused surgical oncologist, I value the long-term relationship I am able to establish with my patients, most of whom I am meeting for the first time at what is probably the worst times of their lives. Helping them navigate that period in a manner that best serves their needs and goals of care, while potentially providing meaningful and impactful surgical care is a privilege.

Byron Lai, PhD, MS
University of Alabama at Birmingham
Assistant Professor, Department of Pediatrics, Division of Pediatric Rehabilitation Medicine

Project Title: Testing the feasibility, validity, and reliability of a replicable tele-monitored physical fitness battery that is inclusive of early adults with and without physical disabilities

Research Impact: Requiring individuals to travel for exercise-related laboratory measurements is the number one factor preventing enrollment in exercise trials and, therefore ultimately, the ability to confirm benefits of novel exercise treatments. We are working on removing the travel requirement from trials. Specific to the CCTS Pilot, we aim to test the validity and reliability of teleassessment fitness battery, which we expect will inform how to increase the accessibility of exercise trials particularly among those with disabilities, who are typically excluded from participation despite the benefits that exercise provides.

What interested you about this funding opportunity? The CCTS, in partnership with Auburn University, held a Telehealth-related Lightning Session. Through the session, we met Dr. Danielle Wadsworth, Associate Professor of Kinesiology at Auburn University, who has shared vision of increasing participation in exercise trials. Importantly, Dr. Wadsworth has access to study populations that are also highly complementary to those we can access. Combining our study populations ultimately enables the development of a highly inclusive framework from which to build exercise trials and treatments. Since the CCTS Partner Network was developed to enable cross-institutional collaboration, applying to its Pilot Program was the natural next-step to support our collaborative effort.

What would you like to share about applying for a CCTS Pilot? The application through notice of award period was extremely helpful to me as a junior research faculty member. As part of the application process, the CCTS connected us with a panel of scientifically-aligned, senior investigators. I believe the panel’s feedback tipped the scales towards the proposal being awarded. The CCTS also assisted in navigation of many administrative processes during the ‘Just In Time’ period, which are difficult to navigate independently.

What keeps you motivated? Compared to many other fields of research, exercise-focused disability research includes fewer scientists with fewer funding opportunities, creating some unique challenges. A good friend once asked me an ever-motivating question, “If you don’t push for funding to advance the field, who will?” Helping people with disabilities through therapeutic exercise has and always will be the primary motivating factor that keeps me pursing research.

Chad Rose, PhD
Auburn University
Assistant Professor, Department of Mechanical Engineering
Director of the Wearable and Bio-Robotics Laboratory (WeBR Lab)

Project Title: A Novel Non-Pharmacological Treatment of Diabetic Neuropathy

Research Impact: Diabetic Peripheral Neuropathy (DPN) is the most common complication of diabetes. DPN is a vicious cycle where burning, tingling, numbness and chronic pain in the feet reduces physical activity, which reduces blood flow, worsening DPN symptoms, effectively increasing risk of falls, injuries and amputations. Traditional drug therapies for DPN provide symptomatic relief whereas non-pharmaceutical interventions provide an opportunity to impact the underlying causes of neuropathies. However, there is a dearth in the development of non-pharmacological interventions for DPN and associated clinical studies. Our goal is to develop a non-pharmacological intervention to manage DPN using heat, pressure and vibration. This study aims to establish the feasibility and safety of the approach as quantified by biomechanical and sensory-perception changes, such as walking and foot sensitivity. We anticipate that the hardware, software and data collected as part of this pilot study will inform the development and adoption of non-pharmaceutical interventions for diabetic neuropathy and related health conditions.

What interested you about this funding opportunity? The School of Engineering at Auburn University promoted the CCTS Pilot Program via flyers and digital communications. The program promoted providing resources and mentorship for early career scholars interested in NIH programs, which caught my eye as an engineer focused on biomechanics. Additionally, the program provides support to garner preliminary results, which are very much a requisite when competing for future extramural, particularly NIH, support.

How do you plan to leverage this time with the CCTS? The CCTS Pilot Program is undoubtedly accelerating the transition of this project from being a good idea towards measurable progress and outcomes. Beyond the CCTS Pilot Program, I anticipate additional CCTS resources, both formal (e.g. Nascent Project Panels and BERD) and informal (networking), as instrumental towards acquiring the support needed to move engineering concepts into clinical application.

What is your favorite thing about your career? As an Assistant Professor in a Department of Mechanical Engineering, I find “wearing many hats” an absolute privilege. I’m afforded the opportunity to work with a wide range of investigators, invest in my own continued learning, advise student researchers, lecture, pitch ideas and draft team-based proposals. Each of these responsibilities intertwine and contribute to my favorite activity – developing robotic solutions to improve individuals’ quality of life.

Henry Zelada Castro, MD
University of Alabama at Birmingham
Assistant Professor, Department of Medicine, Division of Endocrinology, Diabetes and Metabolism

Project Title: Continuous Glucose Monitoring (CGM) in Kidney-Transplanted Adults

Research Impact: My long term goal is to improve solid organ transplant outcomes through improved diabetes management. Post-transplant diabetes, which may exists prior to or as a result of post-transplant care routines, is associated with increased risk of post-transplant organ rejection, infection, and in some cases, early mortality. One approach towards improving diabetes management is the use of continuous glucose monitoring (CGM). However, studies related to CGM utilization in the post-transplant population and related outcomes are lacking. Through this pilot study, we aim to assess the feasibility and acceptance of CGMs in adult, post-kidney transplant patients with diabetes and improvement of glycemic- and transplant-related outcomes. The proposed work is foundational towards determining the acceptability and clinical utility of CGM usage, effect on kidney transplant outcomes and expansion of access to CGMs in the solid-organ transplant population.

How do you plan to leverage this time with the CCTS? CCTS has many resources for young investigators, several of which I’ve leveraged as part of implementing this study. I also plan to work closely with a diabetes-focused clinical epidemiologist and biostatistician to garner feedback about how to effectively capture information as part of this pilot so it may be leveraged as part of future studies.

What keeps you motivated? I am an adult endocrinologist with a passion for improving diabetes care, specifically atypical and post-transplantation forms of diabetes. I strongly believe expanded access to diabetes care technologies can improve diabetes outcomes at a population-level. In order to systematically assess this belief and realize the potential impact, I’m interested in driving forward studies assessing glycemic control and related health outcomes of diabetes-related technologies across clinical settings.

Jaimie Roper, PhD
Auburn University
Assistant Professor, Department of Kinesiology
Director of the Locomotor and Movement Control Laboratory

Project Title: Investigating Gait and Balance in Essential Tremor

Research Impact: The maintenance of gait and balance is a critical factor for people with Essential Tremor to function independently and during activities of daily living. People with Essential Tremor are at a higher risk for gait impairment, falls, and mortality compared to age-matched controls. Negative outcomes due to falling consist of major or minor injury, including death. Fortunately, mobility performance linked to falls arises from a combination of modifiable and predisposing features such as slow gait speed and impairments in balance and functional strength. While Essential Tremor may be the primary contributor to gait and balance impairments, it is unclear whether additional complications associated with aging might also affect mobility. According to the Center for Disease Control and Prevention, approximately 85% of older adults have at least one chronic health condition, and 60% have at least two chronic conditions (comorbidities). Therefore, gait and balance impairments in Essential Tremor may be further exacerbated when occurring concurrently with an age-related comorbidity. This pilot study aims to develop successful recruitment and study strategies, and estimate associations of comorbidity severity and function, gait, balance performance and falls. These activities represent foundational steps towards designing future observational and interventional clinical studies aiming to improve health outcomes in individuals with Essential Tremor.

What interested you about this funding opportunity? The CCTS Digest alerted me to the CCTS Pilot Program. What caught my eye was inclusion of the a panel as part of the application process as a means to help investigators plan and acquire preliminary data that inform the development of larger-scale studies, which aligns with my interest in improving health outcomes in older adults with Essential Tremor.

How do you plan to leverage this time with the CCTS? Over the course of the award period, the CCTS coordinates project team meetings. I look forward these meetings, where interactions with study team members will help shape current and future project plans. The CCTS Pilot Award provides me with protected time to assess recruitment strategies, and estimate comorbidities among individuals with Essential Tremor.

What is your favorite thing about your career? Beyond working with older adults with movement disorders, I also value working with trainees. Investment of my time in phenomenal, future stakeholders that will have to address upcoming healthcare system challenges is a privilege.

Mohamed Shaban, PhD, MS, MS
University of South Alabama
Assistant Professor, Department of Electrical and Computer Engineering
Director of the Biomedical Artificial Intelligence Group

Project Title: Artificial Intelligence for Identification of Mild Cognitive Impairment Biomarkers in Parkinson's Disease

Research Impact: Parkinson’s Disease (PD) is a complex neurodegenerative disease that is challenging for physicians and specialists to diagnose and grade. Observation of motor system abnormalities is the current means of clinical diagnosis despite being subjective and prone to human error. Progression of the disease to mild cognitive impairment (MCI) and dementia has been associated with disease morbidity, significant burden on caregivers, social and working impairment, placement at long-term care facilities, and mortality. There are currently no established biomarkers or effective treatments for cognitive impairment, but earlier identification of impairment may allow earlier intervention. This study focuses on developing precise machine and deep learning (MDL) techniques with the goal of improving detection of PD-related cognitive dysfunction from sleep Electroencephalography (EEG) recordings beyond that achieved by conventional spectral analyses. Further, this project aims at interpreting the high-level features identified by the proposed MDL frameworks to provide mechanistic insights and granular information of MCI in sleep EEG. Improving PD-related cognitive dysfunction detection is foundational towards enabling earlier interventions for patients with MCI, reduce healthcare costs and increase diagnostic reliability needed to execute informative clinical trials.

What interested you about this funding opportunity? In searching for NIH funding programs that target early-career investigators, I identified the CCTS Pilot Program. The program provides investigators with resources to bolster their application and research plans. Moreover, the program’s mission to address health disparities affecting the Deep South aligns with my research interests as evidence is growing of health disparities in Parkinson’s Disease in our region.

How do you plan to leverage this time with the CCTS? The dataset that will be utilized to execute the work is a huge sleep EEG dataset collected at UAB from Parkinson’s Disease patients with Mild Cognitive Impairment, which will be harnessed to develop EEG signal analysis in transform domains and integration of Artificial Intelligence (AI) techniques. Collaboration with UAB-based investigators, deployment of the AI framework and other potential applications will be fostered through CCTS facilitated team meetings.

What is your favorite thing about your career? The ability to do research and introduce innovative solutions to address the complex challenges related to medical imaging, digital pathology and electroencephalography.