Research Education Component / RL5 Program (REC/RL5) The Pepper Center at UTMB
The UTMB Research Education Component (REC) has been recruiting scholars and providing them with the skills and research experience necessary to become independent investigators and future leaders and mentors in aging research for the past sixteen years. The REC career development program is based on a model of mentor-driven research training that occurs in the context of a multidisciplinary team.
The goal of the REC is to increase the number of rigorously trained, extramurally competitive, and scientifically competent scholars who will conduct translational investigations in aging, lead multidisciplinary research teams, and eventually mentor the next generation of investigators in aging research.
Since 2000, we have supported twenty-two REC scholars with OAIC funds. They have become directors of geriatrics divisions at academic health science centers (M. Raji), received NIH (S. Ajala-Torred, S. Al Snih, E. Børsheim, M. Drummond, H. Dryer, W. Durham, L. Killewich, M. Moore, G. Ostir, D. Paddon Jones, K. Peek, G. Sharma, and E. Volpi) and DOD (M. Kinsky) funding, have been promoted to full professor (L. Killewich, M. Moore, G. Ostir, D. Paddon-Jones, K. Peek, M. Raji, G. Sharma, and E. Volpi), and are making important research contributions at other universities across the nation (E. Ajala-Torres, E. Børsheim, H. Dryer, J. Dickinson, M. Drummond, K. Timmerman).
The REC engages early stage investigators in a mentored research experience to support development of externally funded research. Scholars will work with a primary mentor and members of a research team to create and execute an individual development plan that includes training activities, research projects, funding initiatives, and publications. Scholars will participate in a series of seminars and workshops focused on preparing external grant applications.
The introduction of the RL5 program as an important component represents a substantial expansion of the career development component of the OAIC. The RL5 program's associated requirements allow us to operationalize our team-based mentor-driven training in more detail. Each REC scholar must now devote 50% effort to research during the period of OAIC support. Scholars may be supported for a period of up to three years on OAIC/REC funds at this level of effort. Modifications in scholar recruitment and the selection process have been made to address the requirements of the RL5 program.
The REC Program addresses the following objectives:
- Objective 1:
Identify, recruit and select qualified scholars who are beginning their academic/scientific careers in aging and demonstrate the potential for multidisciplinary translational research.
- Objective 2:
Create Individualized Career Development Plans for each scholar that identify a lead mentor and mentoring team with defined roles, and document expected milestones of research progress including publications, presentations, and submission of grant proposals, and training in the scientific integrity and the responsible conduct of aging related research.
- Objective 3:
Develop and implement a high quality program of education and training activities integrated with mentoring experiences that provide REC scholars with the skills necessary to establish productive scientific careers.
The UTMB Pepper OAIC provides a vigorous program in which all REC scholars participate. This program includes the following training and career development activities:
- Monthly Pepper Investigators seminars
- Weekly Translational Research in Aging and Metabolism (TRAM) meetings
- Activities held in collaboration with the Institute for Translational Sciences (ITS) as part the ITS Career Development Program, including the Translational Scholars and the Translational Research Scholars Program (TRSP), a biweekly series of 1-hour seminars held every other Thursday focusing on topics in career development presented by UTMB campus faculty and senior investigators as well as external special invited speakers
- Addition of 3 new REC Scholars this cycle: Christopher Fry, PhD, Addie Middleton, PhD, DPT & Monique Pappadis, PhD.
- Blending of activities associated with the Rehabilitation Research Career Development Program (RRCD) designed to educate and train future rehabilitation scientists and encourage development through RL5 awards
- Continued partnerships with RL5 training programs and Institute for Translational Science to support scholars (e.g., Elizabeth Lyons, PhD)
- Continue to explore opportunities to recruit clinician investigators (MSTAR, presentations and meetings with clinical chairs and division directors)
- REC mentors participate in activities of the UTMB Academy of Research Mentors
- Collaborate in education and training activities with AHRQ R24 grant on Patient-Centered Outcomes Research in the Elderly
|Rachel Deer, PhD||UTMB Division of Rehabilitation Sciences||Validating a Screening Tool for Sarcopenia Using a Model for BIA Analysis|
|Ted Graber, PhD||UTMB Division of Rehabilitation Sciences||Aging Skeletal Muscle and Sarcopenia in the Murine Model|
The RL5 Career Development Application is now closed.
- Deadline: July 29, 2016
- Candidates: Early stage research investigators with doctoral degrees and a full-time UTMB appointment (i.e. junior faculty and fellows)
- Funding: Up to 3 years or until scholar secures independent funding
- Download: RL5 Application Call to Action (pdf)
REC Scholars Program
Over 70% of our scholars have achieved scientific independence by receiving external funding for research.
Current Scholars - Phase 1
Dr. Deer’s research focuses on improving healthcare outcomes of older adults with pragmatic and effective interventions. She recently completed a pre-pilot clinical trial (PACE) examining the feasibility and effect size of targeted nutritional, exercise, and pharmacological interventions to accelerate recovery of strength and physical function in geriatric patients after hospitalization. Her ongoing follow-up clinical trial (GRAMS) examines the efficacy of two promising new treatment strategies identified in the pre-pilot study: testosterone and whey protein. The primary outcome of this Phase I double-blind placebo controlled randomized clinical trial is the recovery of physical function as measured by the Short Physical Performance Battery. Secondary outcomes of interest are changes in lean mass, muscle strength, and hospital readmissions.
A key feature in developing intervention programs is to accurately classify individuals at high risk – so that treatments can be specifically delivered to those who will most benefit. Thus, Dr. Deer is currently working on an additional project (MASS) examining screening tools for malnutrition and sarcopenia in hospitalized older patients. She recently began collaborating with key stake-holders to implement better malnutrition screening tools into UTMB hospital workflows as a part of all geriatric patient’s intake questionnaires. Dr. Deer is also working to develop a prediction model of sarcopenia that will use provider-friendly measurements and can be easily implemented in a hospital or clinic setting to identify patients at risk for sarcopenia.
Research Project Description: The Hispanic Alzheimer's Risk Reduction Trial (HARRT) is an intervention meant to educate Hispanic adults about Alzheimer's disease and the benefits of engaging in a healthy lifestyle for cognitive health. The primary outcomes of interest are changes in knowledge about Alzheimer's disease, health behaviors (diet, physical activity), and social engagement. Five participants completed the first four-week session in February and we are in the process of analyzing pre- and post-assessment data. We are also making arrangements for future sessions.
Dr. Downer has also been using data from the Hispanic Established Populations for the Epidemiologic Study of the Elderly (H-EPESE) to study the relationship between physical limitations and cognitive impairment. Initial findings from this research indicate that cognitive impairment is an important risk factor for frailty and mortality among older pre-frail Mexican Americans. This work has also produced preliminary evidence that despite increases in chronic health conditions, Mexican Americans aged 77 and older in 2005-06 have lower odds for frailty compared to Mexican Americans 77 and older in 1995-96. Finally, Dr. Downer is in the early stages of using H-EPESE data to examine the proportion of dementia cases that may be attributable to limitations in physical functioning and the potential impact that reducing the prevalence of physical limitations may have on preventing dementia.
To date, Dr. Hreha’s research has centered on post-stroke neurological vision impairments and spatial neglect deficits. Her past research has included improving outcome measurement tools and testing interventions in underserved populations and using different research methods. Now serving as a co-investigator of the Stroke Implementation Science Multidisciplinary Translational Team (MTT), she will expand her research to study age related vision conditions, such as macular degeneration and glaucoma. Visual impairment, neurological or age related, can negatively affect quality of life and functional independence as well as increase individuals’ risk for falls, depression, and medical costs. Those living in the community with visual impairment are encouraged to monitor their eye health, participate in rehabilitative treatments, learn strategies for continued safety, and follow eye medication regimes. There are effective vision self-management programs however; these empirical studies have been conducted on well elderly. Stroke survivors may have unique needs that cannot be adequately addressed with the current programs. The implementation of a stroke specific vision self-management program for community dwelling stroke survivors, living with visual impairment is essential. Dr. Hreha and the MTT research team plan to determine the feasibility of stroke specific self-management programs using a randomized controlled trial in community-dwelling participants.
Dr. Hreha will also utilize secondary analysis of Medicare claims data as a second line of research. She will focus her current investigations among Medicare beneficiaries who have experienced a stroke. Dr. Hreha is interested in determining prevalence and variation of vision impairments across post-acute Medicare beneficiaries. Lastly, she intends to explore health disparities among this cohort across the United States to look for regional trends.
Dr. Hreha's Mentor: Kenneth J. Ottenbacher, PhD, OTR
Research Project Description: Dr. Pappadis' project involves conducting qualitative analyses of interviews of English- and Spanish-speaking older women regarding their decision-making process regarding breast cancer screening, perceptions of over diagnosis and over treatment, and opinions regarding a decision support tool developed for older women. In addition, this project involves analyzing physician interviews regarding their perspectives on breast cancer screening in older women and the use of a decision support tool in supporting the decision-making process.
Dr. Pappadis and her project team are also conducting a systematic review on harms of breast cancer screening in older women. This group of work will identify ways to improve the decision-making process for older women, support communication with their physicians, and provide evidence regarding harms of breast cancer screening so that older women can make informed decisions about screening after age 70.
Research Project Description: Dr. Samper-Ternent is a Clinician Scientist with a unique background in both patient care and research. Both his clinical and research activities focus on improving care and quality of life of older adults. He uses a multidisciplinary approach to analyze health disparities in different countries in Latin American and Hispanic adults in the United States. Dr. Samper-Ternent was recently hired as an Assistant Professor and was accepted as an REC Pepper Scholar at the University of Texas Medical Branch (UTMB). As an OAIC REC Scholar, he will focus on two main areas of research: 1) Functional and cognitive decline of community dwelling older adults from different ethnic groups; 2) Analyzing the effect of multimorbidity on sarcopenia progression.
For the first area, Dr. Samper-Ternent is analyzing rates of ADRD by race/ethnicity, and identifying patient-caregiver dyads. He is also studying how different characteristics of individuals with ADRD and their caregivers determine how the patient-caregiver dyad works and if functional and cognitive decline are affected by how the dyads work. He will then estimate the impact of these differences on changes in quality of life, use of resources and hospital admissions over time for the dyads. For the second area, he and his colleagues are conducting a trial analyzing the effect of diabetes on sensitivity of muscle amino acid transportation to dietary amino acid supplementation. Additionally, they want to determine the effect of exercise on the sensitivity of muscle amino acid transportation in chronic sarcopenia of individuals with diabetes.
Current Scholars - Phase 2
Dr. Al Snih came to UTMB in 1998 and is Assistant Professor in the Division of Rehabilitation Sciences and Fellow at the Sealy Center on Aging. She received her degree in Medicine at the Universidad Central de Venezuela, "Luis Razetti" School of Medicine (1986) in Caracas-Venezuela. She received further training at the University Hospital of Caracas, where she completed her Internal Medicine residency in 1991 and her fellowship in Rheumatology in 1993. Then she served as faculty in the Rheumatology division taking care of patients, training rheumatology fellows, and conducting clinical research from 1994 to 1998. Upon her arrival in the United States, she completed her Master of Science degree in August 2001, in the Department of Preventive Medicine and Community Health at UTMB; then she completed her PhD in health services research, with special focus in the health of the older adult Hispanics in May 2005.
She has published over 60 articles in top peer-review journals. Her work has been widely cited by researchers at the national and international levels in a number of prestigious journals. She serves on the editorial boards of the Journal of Aging Health and the Open Geriatric Medicine Journal.
Dr. Al Snih's current research interests related to the OAIC are obesity, frailty, disability, CVD, and diabetes in older Mexican Americans.
Dr. Fry's research focuses on elucidating the mechanisms that regulate skeletal muscle hypertrophy to establish interventions to maintain skeletal muscle mass and strength during conditions of muscle wasting. His graduate research at UTMB under the mentorship of Blake Rasmussen, PhD involved the use of human subjects in a clinical setting. These graduate studies explored the regulation of skeletal muscle protein anabolism/catabolism from muscle biopsies utilizing immunoblotting, quantitative real time PCR and stable isotopic tracer methodologies for the quantification of protein synthesis and degradation. Dr. Fry plans to utilize cell culture and transgenic animal models to better characterize the regulation of skeletal muscle growth and explore the role of satellite cells, or muscle stem cells, in skeletal muscle plasticity and fibrosis. Following his postdoctoral fellowship at the University of Kentucky, he was recruited back to UTMB to continue his work on muscle stem cells in aging.
Dr. Fry's Mentor: Dr. Blake Rasmussen
Elizabeth Jaramillo, MD
Dr. Jaramillo received her medical education and Doctorate of Medicine from UTMB in 2009. She graduated from the Internal Medicine Residency Program at UTMB (2012). Dr. Jaramillo completed her clinical training at UTMB in 2013 as a Fellow in Geriatrics. She is now an Instructor at UTMB in the Geriatrics Department. She is currently working on a Master's degree in Clinical Science.
Along with being an REC scholar, Dr. Jaramillo is a trainee on the CERCIT grant at the Sealy Center on Aging at UTMB. She has had several publications in the past year. Her research centers around Prostate Specific Antigen (PSA) screening in the elderly, including its use and overuse and variation in PSA test ordering at the Primary Care Provider level.
Dr. Jaramillo's research interests include Health Outcomes Research, Health Disparities Research, and Comparative Effectiveness Research.
Dr. Jaramillo's Mentor: Dr. James Goodwin
Dr. Lyons came to UTMB in 2011 and is an Assistant Professor in the Institute for Translational Sciences. She received a BA in English and Psychology from the University of Texas at Austin (2002) and a Master of Public Health (2005) and PhD (2010) in Health Behavior & Health Education from the University of North Carolina at Chapel Hill. After obtaining her PhD, she completed a postdoctoral fellowship at the Interdisciplinary Obesity Center at UNC before coming to UTMB.
Dr. Lyons' career goal is to become an independent researcher and leader in the area of physical activity interventions for cancer survivors. Health topics of most interest to her are obesity, physical activity, chronic disease, women's health, and aging. Her research is focused on the use of technology for health promotion and cancer control. Dr. Lyons is currently working on developing translational interventions in post menopausal breast cancer survivors for promotion of physical activity using video games.
Current - Associate Scholars
Click name to email an individual scholar.
Michael Borack, MS
Rehabilitation Sciences (Mechanisms of muscle growth and loss)
Tony Chao, MS
Shriners (Fat metabolism)
Rachel Deer, PhD
Sealy Center on Aging (Functional recovery following hospitalization)
Edgar Dillon, PhD
Internal Medicine (Quality of life during chemotherapy in recurrent cancer)
Ted Graber, PhD
Rehabilitation Sciences (Muscle metabolism and nutrition)
Shilpa Krishnan, PhD
Emily Lantz, PhD
Rehabilitation Sciences (Muscle metabolism and nutrition)
Hemalkumar B. Mehta, PhD
Craig Porter, PhD
Rehabilitation Sciences (Muscle metabolism and burns)
Paul Reidy, PhD
Rehabilitation Sciences (Muscle metabolism in exercise)
Manish Saraf, PhD
Surgery (Fat metabolism and burns)
Maria Swartz, PhD
Srinivas Teppala, PhD
Click name to visit an individual scholar bio.
Jose Barral, MD, PhD
Professor and Vice Chair for Operations, Dept. of Neuroscience, Cell Biology & Anatomy
Associate Dean for Academic Affairs, Graduate School of Biomedical Sciences
Steve Fisher, PhD, PT, GCS
Associate Professor, Department of Physical Therapy
Michael Kinsky, MD
Professor, Department of Anesthesiology
Douglas Paddon-Jones, PhD
Professor, Department of Nutrition and Metabolism
Gulshan Sharma, MD
Professor, Department of Internal Medicine
Vice President, Chief Medical & Clinical Innovation Officer;
Director, Division of Pulmonary Critical Care & Sleep Medicine;
Sealy and Smith Distinguished Chair in Internal Medicine
Elisabet Børsheim, PhD
Associate Professor, College of Medicine, Department of Pediatrics
University of Arkansas for Medical Sciences
Jared Dickinson, PhD
Assistant Professor, School of Nutrition and Health Promotion, Exercise & Wellness
Arizona State University
Hans Dreyer, PhD, PT
Associate Professor, Department of Human Physiology
University of Oregon
Micah Drummond, PhD
Associate Professor, Physical Therapy & Athletic Training
University of Utah
Kyle Timmerman, PhD
Associate Professor, Department of Kinesiology & Health
The UTMB Pepper OAIC provides a vigorous program for REC scholars. This program includes regular participation in multiple training and career development activities including:
- Attending monthly Pepper Investigators seminars,
- Attending weekly Translational Research on Aging and Metabolism (TRAM) meetings
- Activities held in collaboration with the Institute for Translational Sciences (ITS) as part the ITS Career Development Program. This includes the Translational Scholars and the Translational Research Scholars Program (TRSP), a biweekly series of 1-hour seminars held every other Thursday focusing on Topics in career development presented by UTMB campus faculty and senior investigators as well as external special invited speakers,
- Blending of activities associated with the Rehabilitation Research Career Development (RRCD) Program designed to educate and train future rehabilitation scientists and encourage development through RL5 awards.
Validating a Screening Tool for Sarcopenia Using a Model for BIA Analysis
PI: Rachel Deer, PhD
Sarcopenia is now a billable ICD-10 geriatric condition characterized by low appendicular skeletal muscle mass (ASMM) and low function. There is an increasing need of portable, provider-friendly, cost-effective methods for the estimation of ASMM. Thus, the overall goal of this project is to create and validate a regression model for obtaining ASMM from Bio Impedance Analysis (BIA) measurements using DXA as the reference. We recently developed and validated an ASMM prediction model in a population of acutely ill older adults. This present study will utilize secondary data analysis using publically available data sets to develop and validate a more generalizable model to estimate ASMM in a larger sample of older adults. Once validated with a larger sample, this equation could be used as a screening tool for sarcopenia in a clinic or hospital setting. Those identified to have low ASMM could then undergo further functional testing for diagnosis and treatment for sarcopenia.
Aging Skeletal Muscle and Sarcopenia in the Murine Model
PI: Ted Graber, PhD
The age-associated loss of muscle mass and strength (sarcopenia) leads to frailty, loss of independence, poor prognoses after clinical procedure, and quality of life degradation. Neither sarcopenia nor frailty are curable, and we have incomplete understanding of their etiology. Comorbidities may increase the risk/severity, with examples being Congestive Obstructive Pulmonary Disease (COPD) cachexia, malnutrition, and diabetes. Loss of muscle mass, the main metabolic engine of the body, can lead to impaired glucose tolerance, contributing to development of metabolic syndrome. As muscle stem cells (satellite cells) are necessary for muscle repair and have reduced proliferative capacity with age, capacity for rehabilitation of injury in older adults may be compromised leading to lowered activity rates, exacerbating the onset of frailty/sarcopenia. For older adults to remain independent longer, and to improve their healthspan, there must be a retention of neuromuscular aptitude, strength, and muscle mass. This proposal is to investigate both the cause of and potential interventions for sarcopenia, frailty, age-related metabolic dysfunction and satellite cell impairment utilizing a basic science approach in animal models, with translation to clinical applications to follow; by first establishing an aging mouse muscle research group with a singular initial goal divided into four sub-aims.