Uganda-South Korea-Michigan partnership to develop complementary and integrative health interventions
UM Lead: Cheong-Hee Chang, PhD, Microbiology and Immunology
Partners: Patrick Ogwang, Pharmacology, Mbarara University of Science and Technology; Eui-Cheol Shin, Endowed Professor, Graduate School of Medical Science and Engineering, Korea Advanced Institute of Science and Technology, South Korea; Youngmin Kang, Professor, Korea Institute of Oriental Medicine, South Korea; Mi Houn Park, Senior Scientist, Erom company, South Korea
Dr. Chang has ongoing collaborations in Uganda at Mbarara University of Science and Technology (MUST), where the University of Michigan is a prominent partner in a World Bank-funded project that aims to help Ugandan researchers study and commercialize new drugs developed from traditional remedies. An ongoing project between Chang’s lab and MUST researcher Patrick Ogwang exploring the efficacy and function of a medicinal plant Artemisia in the treatment of malaria has shown promise. Researchers in South Korea, a country with a rich history of traditional medicine dating back thousands of years, have independently been conducting similar work in Uganda. A new triangular partnership between U-M, MUST, and experts in South Korea could accelerate discovery.
Establishing an Ophthalmic Assistant/Ophthalmic Technician Training Program in Ethiopia
UM Lead: Christine Nelson, MD, Kellogg Eye Center
Partners: Dereje Hayilu, OD, Med, St. Paul’s Hospital Millennium Medical College
In 2015, the Kellogg Eye Center helped establish a residency training program in ophthalmology St. Paul’s Hospital Millennium Medical Center (SPHMMC) in Addis Ababa, with University of Michigan faculty committing to serve as faculty mentors. The program celebrated its first graduates in the summer of 2019. It has now become apparent that, to assure maximum efficiency and effectiveness in patient care, our joint training efforts must be expanded. We propose to launch a new program to train certified ophthalmic assistants, ophthalmic surgical assistants, and ophthalmic technicians, who will relieve physicians and nurses of the unnecessary administrative and technical burdens that are currently stealing their time, diverting their energy, and limiting their ability to provide one-on-one patient care.
Bystander training in Sierra Leone
UM Leads: Krishnan Raghavendran, MD, Surgery and Peter Delaney, UMMS student
Partners: LFR International and multiple organizations and agencies in Sierra Leone, including: Sierra Leone Red Cross Society (SLRCS); University of Makeni; Holy Spirit Hospital; the Agency for Rural Community Transformation
UMMS student Peter Delaney is the founder of the LFI International, an NGO which has successfully worked to train citizens including moto-taxi drivers to be first responders to effectively address trauma injuries in Uganda, Chad, and Guatemala. LFI International’s newest – and largest – project to date involves scaling up its training model across Sierra Leone with government support. Trauma surgeon Krishnan Raghavendran is head of Michigan Medicine Center for Global Surgery and has an extensive international collaborative research network. Together, the partners expect to jump-start an active partnership between the Sierra Leone coalition and the University of Michigan in furthering a coordinated trauma care program for the people of Sierra Leone. This partnership presents an opportunity to develop a prehospital emergency care model that could be replicated across Sub-Saharan Africa, where more than one billion people who are living without emergency medical coverage.
Establishing a screening program for autism in Ethiopia
UM Lead: Mohammad Ghaziuddin, MD, Psychiatry
Partner: Enque Deresse, MD, Head of Psychiatry, St. Paul’s Hospital Millennium Medical College
Although autism is a global disorder with a prevalence of at least 1% in most developed countries, its diagnosis is often missed in resource-challenged countries such as Ethiopia. The proposed study will explore the feasibility of establishing a screening program and a database for autism and related disorders at the St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. In a population of almost 100 million, more than half of which are children, Ethiopia has only 46 psychiatrists including one trained child psychiatrist. As a result, access to experts in the field of developmental disorders is extremely limited. With partners in the department of psychiatry at the St Paul's Hospital Millennium Medical College in Addis Ababa, we will train medical and paramedical staff to screen for autism; set up a brief diagnostic protocol; form a local team of experts; and establish a database of 100 patients, who will be follow-up at regular intervals.
A novel approach to correlate neuronal cohorts activated during innate behaviors
UM lead: Dawen Cai, PhD, Assistant Professor Cell & Developmental Biology
Partner: Xiao-Hong Xu, PhD, Institute of Neuroscience (ION), Chinese Academy of Sciences, Shanghai
Dr. Cai’s lab has developed new imaging technology capable of depicting the molecular connectivity and functional heterogeneity of neurons in mouse and drosophila brains. His research partner, Xiao-Hong Xu, at Shanghai’s Institute of Neuroscience, is an expert in developing mouse models to study innate sexual and parenting behaviors. Through joint research, the team plans to devise novel experiments to image brain activity during innate behaviors at the individual neuronal level. Precisely defining the circuitry characteristics of innate behaviors will ultimately help researchers understand how the nervous system is wired to govern more complex behaviors.
HLA-B27 and its linkage to ankylosing spondylitis
UM Lead: Malini Raghavan, Microbiology and Immunology
Partner: Vir Singh Negi, Department of Clinical Immunology, Jawaharlal Institute of Postgraduate Medical Education and Research, India
The very strong linkage of certain HLA-B*27 variants to the occurrence of ankylosing spondylitis, a form of spinal arthritis, was defined some decades ago among Caucasians, yet the molecular mechanisms underlying this association remain unknown. The peptide-binding characteristics of HLA-B*27 variants could underlie some of the known disease associations. Alternatively, intrinsic features of HLA-B folding, assembly and stability could underlie the strong disease associations. These models require further investigations. It is also important to understand whether there are distinct HLA associations with ankylosing spondylitis in non-Caucasian individuals, and if so, what such associations are. These studies will be undertaken in collaboration with the Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), in Puducherry, India, a medical school with clinician scientist faculty who have a relevant patient cohort and significant interest in building HLA-B*27-related research for graduate student training. The goal of this project is to expand this HLA-B research in new disease-related directions, in this case towards the understanding of HLA-B*27-linked ankylosing spondylitis pathogenesis.
Ghana-Michigan Partnership on HIV Research
UM Leads: Alice Telesnitsky, PhD, Microbiology and Immunology; Akira Ono, PhD, Microbiology and Immunology
Partner: Osbourne Quaye, PhD, Dept. of Biochemistry, University of Ghana/West African Center for Cell Biology of Infectious Pathogens
Epidemiological studies have shown that the major circulating subtypes of HIV differ by geography. Circulating strains of HIV can be classified into four groups, M (the “major group, representing the majority of the global epidemic), N, O and P (which are rarer and represent less than 20% of the epidemic). Within group M, there are several distinct subtypes, A-K, and hybrid forms, termed “circulating recombinant forms (CRFs)” and “unique recombinant forms (URFs)”. Studies have shown differences in the virus subtype with regard to transmission, entry receptor usage and disease progression rates. The most common subtype in the Western Europe and the United states, subtype B, represents less than 15% of the global epidemic. Despite this, most molecular biology research efforts have utilized subtype B viral strains, and there have been limited research efforts focused on non-B subtypes. It is our hope that this research and the University of Michigan will expand our understanding of the non-B HIV subtypes as we move towards a cure.
Toward the Practice of Precision Medicine: Identification and Validation of Biomarker Assays for Clinical Management of Cancer
UM Lead: Xiaoju Wang, PhD, Pathology
Partner: Fang Guo, PhD, Shanghai Jiao Tong University, China
Joint research will mainly focus on exploring the genetic alteration in cancers, such as gastric, nasopharyngeal cancers, to identify novel biomarkers for diagnosis, prognosis, treatment prediction and therapeutics. The research utilizes human gastric/nasopharyngeal cancer cell lines, tissue and blood samples, and there is relative limited access to these specimens at UM (or even nationwide) due to the low prevalence of those cancer patients in western countries. However, gastric cancer is the second leading cause of cancer death in China. Dr. Guo has access to more than 20,000 patient samples (along with their associated detailed clinical information) in China and is interested in sharing this sample data to accelerate discovery as well as establishing potential bilateral student/trainee exchanges between Shanghai Jiao Tong University and U-M.
Pediatric Ophthalmology Fellowship Training Program in Ghana
UM lead: Grace Wang, MD, PhD, Ophthalmology
Partner: Colleagues at the Ghana College of Physicians and Surgeons
There is a dire need for pediatric ophthalmologic care in Ghana, where currently only a handful of pediatric ophthalmologists are available to serve the entire country’s pediatric population. Many children in Ghana are going blind or becoming severely visually impaired from treatable eye diseases. This severe lack in access to care is in part due to having no fellowship training program to expand the number of pediatric ophthalmology subspecialists. The University of Michigan Kellogg Eye Center has ample experience in helping to establish training programs on site in developing countries. We propose to establish a fellowship-level pediatric ophthalmology training program at a well-established teaching institution, the Ghana College of Physicians and Surgeons, to train subspecialists locally who can help relieve the burden of pediatric ophthalmic diseases in Ghana and surrounding regions.
Edible Insects to Address Food Insecurity at Maternity Waiting Homes in Liberia
UM Leads: Jody Lori, PhD, School of Nursing (with Sarah Rominski, PhD, Ob-Gyn, and Cheryl Moyer, PhD, Ob-Gyn and Learning Health Sciences)
Partners: Dr. Jacob Anakware, University of Energy & Natural Resources, Ghana
Malnutrition has been identified as the greatest risk factor for illness and death for women and children in sub-Saharan Africa where, despite efforts to improve foods security, approximately one person in every four is undernourished. We propose exploring a partnership with Dr. Jacob Anakware and AnePaare Farm to cultivate edible insects which are already consumed by the population in Liberia as a source of staples and protein. We anticipate this public/private partnership will lead to the cultivation of edible insects to improve the nutrition and help combat the food insecurity currently faced by women awaiting delivery at the maternity waiting homes (MWHs) in Liberia. We also believe this partnership has the potential to scale up and serve as an incoming generating activity to support the long-term sustainability of the MWHs as cultivated palm weevils can be sold for a profit to the general population. This program has the potential to significantly improve food security for women and children in rural Liberia and contribute to the sustainability of the maternity waiting homes.
Radiation Oncology Partnership between University of Michigan and Komfo Anokye Teaching Hospital in Kumasi, Ghana
UM Lead: Laila Gharzai, MD, Radiation Oncology (with Shruti Jolly, MD, Radiation Oncology)
Partners: Dr. Ernest Baawuah Osei-Bonsu, KATH
The Department of Radiation Oncology wishes to build a long-lasting and mutually beneficial partnership with the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana. With the increased incidence of various cancers within Ghana, there has been a concomitant increase in the use of radiotherapy to treat malignancies. This gives the University of Michigan the opportunity to leverage its longstanding expertise in the field of radiation oncology to benefit a nascent and growing department in Ghana. The initial phase of relationship-building at KATH will focus on gynecological malignancies, with plans to extend more broadly to human papilloma virus (HPV) related malignancies. Relationship-building efforts will lay the foundation for further work in medical education, medical physics, capacity building and improvement in patient care, as well as research into the reduction of health disparities.
Taiwan Partnership - Michigan Medicine International Emergency Medicine Research Network
UM Lead: Prashant Mahajan, MD, MPH, MBA, Emergency Medicine
Partners: Dr. Jacob Ping, Chang Gung Memorial Hospital, Taiwan
Efforts will focus on including Taiwan as a pilot site for the Michigan Medicine International Emergency Medicine Research Network. A newly launched global health project in Emergency Medicine, the international network ultimately seeks lay the groundwork for interventional studies in location-relevant epidemiology and high-stakes illness (e.g., trauma, sepsis, cardiovascular events) across partner sites. The initial pilot, now to include Chang Gung Memorial as well as partner institutions in Ghana, Brazil, India, and China, is to demonstrate feasibility in conducting simultaneous prospective studies in the acute care setting across these partner institutions to determine the epidemiology of acutely ill and injured patients.
Partnerships in Human Genetics in West Africa
UM Lead: Thomas Glover, PhD, Human Genetics and Pathology
Partner: Colleagues at the University of Ghana School of Medicine
While there are limited educational or research opportunities for advanced genetics in Ghana, there is rapidly growing interest in the field. Support will help Dr. Glover visit the University of Ghana Medical School for three weeks as part of an upcoming sabbatical to present a series of lectures and to meet and consult with students, faculty and clinicians interested in genetic disease. The major goals of this visit are to explore and expand on educational, diagnostics and research opportunities in Human Genetics in West Africa, and develop new collaborative partnerships.
Antivascular Photo-mediated Ultrasound Therapy
UM Lead: Xuedang Wang, PhD, Biomedical Engineering
Partner: Quinghuai Liu, Nanjing Medical University, China
The partners plan bilateral exchange and training between the institutions, laying the groundwork for joint research to test a new non-invasive therapy technology recently invented at UM, called photo-mediated ultrasound therapy, that could be useful for treating neovascular retinal diseases such as age-related macular degeneration and diabetic retinopathy. Dr. Liu and his team in China have extensive experience with translational research of retinal diseases and plan to help with clinical trials once the partnership, training, and systems are in place.
FMUSP-UMMS Partnership in Emergency Critical Care
UM Lead: Robert Neumar, Emergency Medicine
Partner: Aluisio Segurado at the University of Sao Paulo in Brazil
As part of a growing partnership, colleagues at the University of Sao Paulo and UMMS Emergency Medicine leaders are planning their first collaborative projects to focus on diagnosing, monitoring, and treating severe sepsis and septic shock. A small team from Sao Paulo will plan to visit UMMS later this year to identify opportunities for specific collaborative research projects. Likely areas include clinical testing of new non-invasive hemodynamic monitoring techniques in patients with septic shock, and evaluation of nanorod PCR technology for early diagnosis of bacteremia and antibiotic resistance.
Introduction of the MiGene Family History Application in Ghana
UM lead: Shane Quinonez, Department of Pediatrics
Partner: Charlotte Osafo, of The University of Ghana
Dr. Quinonez will help colleagues at the University of Ghana adopt a mobile app tool that assists physicians and other health workers in collecting patients’ personal and family histories. Already in use in Ethiopia, The MiGene Family History Application queries patients on common birth defects and genetic diseases, and provides personalized genetic counseling information. An updated version of the app will be expanded to include adult-onset non-communicable diseases like cancer, chronic kidney disease, diabetes, etc. Dr. Quinonez plans multiple visits to Ghana later this year to pilot, validate and train colleagues on the app.
Multi-Generational Mental Health Curriculum: An Authentic Global Academic Engagement to Build Workforce Capacity and Improve Treatment for Children and Elders with Mental Illness in Rural Ghana
UM Leads: Dr. Michelle Riba, Department of Psychiatry; Dr. Gregory Dalack, Department of Psychiatry
Partners: Dr. Gordon Donnir, Komfo Anokye Teaching Hospital, Kumasi, Ghana ; and Dr. Sammy Ohene, University of Ghana Medical School, Accra, Ghana
As of 2016, Ghana, a nation of nearly 30 million, has only 11 practicing psychiatrists. Only about 1% of the estimated 2.8 million Ghanaians with mental disorders actually receive treatment. Dr. Riba and Dr. Dalack are teaming up with colleagues at two Ghanaian medical schools to explore long-term curriculum building to increase workforce capacity in this area. Initial work will focus on improving mental health treatment for children and elders in rural Ghana. In addition to face-to-face meetings for the partners, the team hopes to launch faculty/resident exchanges this fall.
Exploring the Acceptability and Feasibility of Group-Based Postnatal Care in Rural Uganda
UM Lead: Cheryl Moyer, Learning Health Sciences & OB-GYN
Partners: Peter Waiswa and Elizaeth Nansubuga, Makerere University, Uganda
While many countries in Sub-Saharan Africa have made strides to improve antenatal and delivery care for mothers and their unborn babies, post-natal care has not kept pace. In Uganda, two thirds of mothers do not receive any post-natal care. Dr. Moyer and her partners plan to explore – and seek NIH funding for – the development of a group-based post-natal care program from an existing pre-natal care model in Uganda’s Rakai District.
Collaborative Biomedical Ontology Research and Software Development to Support Standardized and Integrative Big Data Analysis and Precision Medicine
UM Lead: Oliver He, Unit for Laboratory Animal Medicine
Partners: Heng Wang, Biologic Medicine Information Center in China, Chinese Academy of Medical Sciences, Beijing
Dr. He is a leading authority on Informatics Ontologies, which are taxonomy-based models that help computers define the domains, terms and relationships necessary for massive-scale data searches, computations, and comparisons. A prior guest of the Biologic Medicine Information Center of China (BMICC) for presentations and short-term consulting, Dr. He plans to expand collaborations at BMICC this summer during a three-month sabbatical. In that time, he will help finish an ontological systems installation and set-up; help train the staff in the latest ontology methods; and begin to apply these tools to some of the electronic health record data that BMICC has access to.
Addressing gender-based violence in Ghana
UM leads: Sarah Rominski, Senior Research Associate; & Michelle Munro-Kramer, Assistant Professor School of Nursing
Sexual violence among university students is an issue around the world. In a recent survey of students at the University of Cape Coast (UCC), in Ghana, more than a third of women and nearly a fifth of men reported experiencing being forced or coerced into sexual intercourse. Drs. Rominski and Munro-Kramer, partnering with UCC colleagues, are adapting a sexual violence prevention program for undergraduate students developed by UM. The adaptation will make the program culturally and contextually appropriate for UCC. The project involves testing both the content and delivery mechanism to optimize the program,as well as training local facilitators to administer it to incoming first-year students.
Epigenetic regulation in pancreatic cancer development
UM lead: Jiaqi Shi, Department of Pathology Assistant Professor
Recent population-based studies show that the prevalence of pancreatic cancer in China is on the rise. Dr. Shi and her collaborator at China Medical University wish to identify novel biomarkers for diagnosis, prognosis, therapeutic prediction, and therapeutic targets for pancreatic cancer. In addition, both hope to establish a program to foster scholar, student and resident exchange between China Medical University and Dr. Shi’s UM lab.
Improving pediatric epilepsy care in Ethiopia
UM lead: Erin M. Fedak Romanowski, Pediatric Neurology Clinical Assistant Professor
On no other continent is epilepsy more prevalent than in Africa, and yet the number of anti-seizure medications available is limited in most African countries. Diet-based therapy can be effective when medications don’t work or aren’t readily available. Dr. Fedak Romanowski is already working with partners at St. Paul’s Hospital Millennium Medical College on a pilot program using dietary therapy to treat Ethiopian children suffering from epilepsy. This additional funding will support UM dieticians traveling to Ethiopia to partner with counterparts at St. Paul’s Hospital on culturally appropriate dietary-treatment menus and patient education, as well support Dr. Fedak-Romanowski’s colleague from St. Paul to visit UMHS for a pediatric neurology observership.
Harmonized assessment of age-related weakness, disability and diabetes risk: The Chinese Health and Retirement Longitudinal Study (CHARLS).
UM lead: Mark D. Peterson, Phd, MS, FACSM, Assistant Professor, Physical Medicine & Rehabilitation
Diabetes, a leading cause of disability and early mortality, is estimated to affect over 400 million adults globally. In 2015, diabetes-related healthcare expenditures were highest in the U.S. and China, where costs exceeded a combined $320 billion International Dollars. There is also a high prevalence of pre-diabetes, undiagnosed diabetes, and poor cardiovascular health in both countries, and the burden tends to be exaggerated among mid-life (50-64 years) and older (65-plus) adults. The expansion of the aging population combined with decreasing mortality has led to a diversification of cardiometabolic disease morbidity, including increased prevalence of aging-related mobility impairments and a substantial reduction in the number of nondisabled years. The purpose of this collaboration will be to leverage the Health and Retirement Study (HRS) and the Chinese Health and Retirement Longitudinal Study (CHARLS) to explore and compare the burden of age-related frailty/disability and diabetes in U.S. and China.
Expanding collaboration on genetic analysis of neurodevelopmental disorders in India
UM lead: Stephanie Bielas, Department of Human Genetics Assistant Professor
One recent study found that almost 15 percent of children ages 2-9 in India had one or more neurodevelopmental disorders, far outpacing rates observed in the U.S. and in Europe. Defining genetic causes of inherited conditions is the first step to prevention. Dr. Bielas plans to expand a current Whole Exome Sequencing project underway with partners at Manipal University, bringing in new collaborators at other Indian institutions, including the All India Institute of Medical Sciences and the Sanjay Gandhi Post Institute of Medical Sciences. Plans also call for supporting more genetic counseling services.