Year in review: CTSI reflections on 2020

The COVID-19 pandemic has demonstrated the vital role biostatistical and epidemiological methods have in the health sciences. It also has exposed a number of new methodological problems for which innovative solutions are lacking. BERD core scientists have continued to lend their expertise to research efforts such as treatment development, diagnostic test development, testing strategies, prevalence prediction, and identification of risk factors of infection in order to help guide public health policy. We recently implemented a successful SUNY-wide “Research Bootcamp” web series aimed to provide faculty researchers with the study design and analysis skills required for high-level research in scientific areas including those relevant to the pandemic response.

The Center for Biomedical Imaging (CBI) identified and recruited a PhD student, Alexander Bartnik, under the supervision of CBI Director of Computational Analysis Michael G. Dwyer, III, PhD, Associate Professor of Neurology and Biomedical Informatics, Department of Neurology, Jacobs School. Alexander has begun preliminary work on implementation of the XNAT neuroinformatics platform, which is an open source imaging informatics platform developed by NIH. Initial work focused on development of key imaging and analysis ontologies, to facilitate automated connection of incoming scan types with appropriate methods of image analyses in a manner that standardizes the multitude of data and formats used across the national CTSA consortium. This has the additional benefit of ensuring consistency in communication and facilitates the sharing of data. As an initial proof-of-concept, the DeepGRAI thalamic artificial intelligence (AI) volumetry tool developed in part based on CTSI pilot grant funding to Dwyer, has been incorporated into the XNAT platform in order to facilitate fully automated thalamic volumetry via a simple PACS relay that can be easily integrated with clinical scanning protocols.

The global pandemic is having a devastating impact on our nation and the world, in addition to our university and our community, particularly in underserved communities. Our CTSI supports innovative clinical and translational research broadly and our priority is to perform research to reduce health disparities and improve the health of our community and the nation. In view of these high-level goals, the CTSI has adapted our activities and taken a leadership role at our university to guide and support clinical and translational research during the pandemic. This includes partnerships with the underserved underrepresented minority communities to mitigate the devastating impact of the pandemic, especially on African American communities on the East Side of Buffalo. The CTSI played a key role in providing support to faculty and their teams to perform research specifically on SARS-CoV-2 and COVID-19.

I am so pleased that we have launched our community newsletter, Buffalo Research News. The newsletter was developed with input from the community, for the community. This provides a way to connect community members with our community partners, research studies, CTSI activities, and research results. Disseminated every other month, it is a consistent way to communicate with Western New Yorkers. We also launched a number of other new initiatives, including Community Engagement Seed Grants to facilitate university-community partnerships and Community Engagement Studios to link research teams with community members for the purpose of improving clinical trial design and conduct.

The year 2020 was the beginning of a new funding cycle for the UB CTSI and the evaluation of its long-term impacts. The Evaluation and Continuous Improvement team has conducted literature reviews of learning organizations and learning health systems, two of five long-term impacts for the CTSI. The team has also created preliminary quantitative metrics and standardized measurement instruments for measuring learning organizations and learning health systems.

“Rising to the challenge” is how I would describe the best of this year. I have seen my colleagues come together to protect our community and to work harder and more diligently in support of others. Examples that we have been involved with include creating and donating 3D printed masks after gaining FDA emergency use authorization. We worked on tracking and predicting the pandemic using new models of COVID-19 spread, taking into account our public health measures. We worked to build local, regional and national COVID-19 research data warehouses to empower a better understanding of the pandemic. This, I believe, will lead to a new national public health infrastructure in support of the biosurveillance needed to protect our present and future population health.

In March 2020, the COVID-19 pandemic arrived in Western New York. As part of a region-wide response, the University at Buffalo was asked to lead the analytics and modeling efforts. Two workgroups were rapidly formed, both chaired by me, which included a regional analytics workgroup and a UB modeling workgroup. The regional workgroup had representation from multiple entities across WNY, including health systems, payers, health information exchange providers, UB, Cerner (the EHR vendor for Kaleida Health), and others. The modeling workgroup helped inform the regional response to COVID-19 by providing insights to the Erie County Department of Health and hospital leaders from all Erie County health systems.

I would like to highlight two research projects that were awarded Pilot Studies funding in 2019-20. Jason Muhitch, PhD, Assistant Professor of Oncology, Department of Immunology, Roswell Park (who is a CTSI K Program Scholar Alumnus), and his team found that radiation to renal tumors initiates a relatively short-lived expansion of tumor-resident T cell clones. The translational significance of this work relates to identification of a window of tumor-resident T cell expansion following radiation that may be leveraged for the rational design of immunotherapy. Based on this work, Dr. Muhitch was awarded a Kidney Cancer Research Program Idea Development Award from the Department of Defense office of the Congressionally Medical Research Programs. (The findings of this study are published here.)

John J. Leddy, MD, Clinical Professor, Department of Orthopaedics, Jacobs School, and his team conducted a randomized controlled trial (RCT) of exercise treatment of 103 adolescents with a recent concussion. In Dr. Leddy’s study, those assigned to aerobic exercise (rather than the standard practice of prolonged rest) recovered significantly faster (13 days) than those assigned to placebo-like stretching (17 days). This is the first RCT to show that aerobic exercise treatment prescribed to adolescents with concussion symptoms during the first week after injury speeds recovery and may reduce the incidence of delayed recovery. These results have been widely disseminated in scientific articles, national and international presentations/webinars, and importantly the development of national and international concussion guidelines.

As I reflect on what we’ve accomplished over the past year, I am happy we have further disseminated “Sofia Learns About Research” through our partnership with Explore & More — The Ralph C. Wilson, Jr. Children’s Museum in downtown Buffalo, and that we have expanded our collaboration with community organizations to engage underrepresented populations in research. All this could not have been possible without the contributions of many CTSI staff members who are always ready to help, both on the administrative side as well as with everyday tasks, in any way necessary to accomplish our goals. I want to express my gratitude to all of them. I feel a sense of pride for being part of such a collegial team.

I will forever remember 2020 as the year of reflection. In the midst of the international pandemic, global uncertainty and anxiety, cancelled plans, conferences and vacations provided us with plenty of time to pause our overbooked lives and reflect on how we live. In the face of the national public health crisis, I realized that my perception of the importance of my research has shifted. I can no longer get excited about projects that may be fundable but lack potential for population impact, implementation and dissemination. When it comes to teamwork, before the pandemic most researchers were fairly comfortable in their ability to work in face-to-face teams and had plenty of spontaneous “around the cooler” discussions to keep communication among team members going. Maintaining effective teamwork via Zoom requires special skills, planning and creativity. I am confident that those teams that invested time in figuring out strategies to maintain their team culture while working remotely (like most UB CTSI cores), will come out of the pandemic stronger and more efficient than before. I personally enjoyed enormously watching my colleagues and students on Zoom surrounded by their family pictures, affectionate pets and demanding children. This experience also renewed my appreciation for work-life balance that allows people to stay grounded and productive under the most unprecedented circumstances. I have reflected enough … and now I am ready to move on to a new and improved 2021!

A year like no other, marked by an overwhelming toll in human life, sadness, loneliness, grief and swift changes in the ability to complete our work. Nevertheless, we have witnessed incredible scientific accomplishments worldwide, as well as in our ability to discover new platforms to complete our research, teach, and educate, moving to a more productive and technologically efficient landscape.  When the COVID-19 pandemic sent us to work from home, our CTSI Workforce Development team swiftly adapted, moving the ongoing face-to-face Core Competency workshop series to online delivery. This change, a long-term plan in our future to-do list, happened literally overnight with unexpected positive results. Learners favored the new platform that increased attendance and focus, and provided an efficient model for distance learning. When the pandemic is over, our educational and research programs will be strengthened by what we learned during a period devastated by the COVID-19 disease.