After careful peer review of 29 applications submitted in April 2018, we are pleased to announce the five Round 2 Northern New England Clinical & Translational Research Network pilot project award winners:
Jessica Heath (UVM)
Targeting Cell Adhesion in CALM-AF-10 Leukemias
Leukemias are the most common childhood cancers. Some leukemias are characterized by particular genetic mutations, such as the CALM-AF10 gene fusion. These leukemias are harder to treat, and the way in which the CALM-AF10 mutation causes leukemia is incompletely understood. We have identified that the CALM- AF10 protein changes the way leukemia cells interact (adhere) with each other. It is known that cell adhesion plays a role in leukemia development and resistance to chemotherapy. There are drugs already available to interfere with cell adhesion, and we will test these in combination with chemotherapy in CALM-AF10 leukemia cells. Leukemia patients who live in rural locations, such as Northern New England, may have particular difficulty completing intensive chemotherapy regimens that require very frequent travel to and from the clinic. It would be especially beneficial to these populations to further the development of effective oral medications, or intravenous medicines that can be given less frequently. This proposal will prioritize the study of such medicines in leukemia. Furthermore, some of these drugs are already in use in other disease processes, which will facilitate translating what we find at the bench directly to the patient’s bedside.
Michael LaMantia (UVM)
Feasibility and Preliminary Effectiveness of a Community Health Worker-Delivered Intervention to Slow Progression of Functional Decline among At-Risk Rural Older Adults
The populations of Vermont, New Hampshire, and Maine are among the oldest in the nation. We need to provide services for seniors who are at risk of losing their independence, particularly in rural areas of our three states. Our project will train community health workers to assist rural older adults who have early signs of memory loss, depression, and difficulty with mobility. We hope to improve the health and well-being of rural older adults and help them remain independent in the community.
Kinna Thakarar (MMC)
Rural Harm Reduction Access and Regional Trends ("Rural HeART")
There are particular concerns about high-risk persons who inject drugs (PWID) in rural areas such as northern New England where geographic dispersion, poor public transportation, and limited public health infrastructure constrain the delivery of effective preventive and treatment services. A better understanding of the epidemiology and service accessibility to harm reduction services for patients with infectious complications related to injection drug use (IDU) is crucial to develop community response models and public health best practices to reach PWIDs in these rural communities.
In this proposal, among patients hospitalized in Maine with IDU-associated infections, we plan to assess patient knowledge of safe injection techniques and access to harm reduction services such as syringe services programs (SSPs), medication for addiction treatment, vaccinations and naloxone rescue kits. We will identify factors predicting SSP uptake, as well as uptake of other harm reduction services.
Katherine Motyl (MMC)
Direct and Indirect Mechanisms of Opioid-Induced Bone Loss
Patients with opioid addiction have more fractures and impaired fracture healing, but how this occurs remains unclear. We will identify mechanisms of opioid-induced bone loss using a collaborative team of basic and clinical scientists and state of the art technologies available to us in Northern New England. This knowledge will help physicians design better fracture treatment and prevention strategies that will be tailored to this specific population.
Teresa May (MMC)
An Atlas of Rural and Urban Variation in Cardiac Arrest Processes of Care and Outcomes in Northern New England: Toward Improved Outcomes After Rural Cardiac Arrest
Cardiac arrest is the 3rd leading cause of death in North America, and great variation is known to exist in survival rates between centers and regions, nationally. Maine and Northern New England are characterized by a large rural population and small non-rural centers; conversely most resources for treating cardiac arrest are concentrated in urban areas. We hope to study variations in epidemiology of cardiac arrest, provision of services, and outcomes broken down by county throughout Northern New England, in an effort to better understand how geographic barriers to care and variation in practices affect the outcomes of cardiac arrest patients throughout our region. This improved understanding will then become the basis for quality improvement work, and affords an opportunity for improved clinical outcomes throughout our healthcare system and region.