On Feb. 15, 2023, stakeholders from across UAB, UAB Medicine, and outside partners gathered at the UAB Alumni House for a Strategic Research Retreat. The event featured presentations from the task force leaders of the four Research Focus Areas that the Heersink School of Medicine announced in September 2022: Disruptive Technology Empowering Precision Health (D-TECH), Infection, Inflammation, Immunity and Immunotherapy (I-4ward), Brain Health and Disease Across the Lifespan, and Health Equity.
The presentations detailed tangible goals for the next 12-18 months, along with mid- and long-term goals for each focus area. Following the presentations, attendees participated in breakout groups to discuss four questions based on the task forces’ recommendations as a means to provide guidance to the Heersink School of Medicine on implementation:
- What does the next generation Core look like?
- What does a big data/Artificial Intelligence (AI) proficient research institution look like?
- What are we not doing to attract and retain scientific talent in staff, trainees, and faculty?
- How do we engage the UAB Health System to enhance research in each area and impact care where appropriate?
We spoke with the theme leads about the main Research Retreat takeaways and the next steps for implementation.
Disruptive Technology Empowering Precision Health (D-TECH)
Advances in “omics” coupled with the innovative progress in digital technology, computational health, and data science are reshaping health care delivery beyond our imagination. The impact of these disruptive technologies (D-TECH) will span the entire spectrum of health care, from wellness and prevention to precision screening, diagnostics, and therapeutics, and the ultimate goal of delivering the most effective and efficient value-based health care.
Led by George Netto, M.D., Robert and Ruth Anderson Endowed Chair in the Department of Pathology, the D-TECH theme calls for investing in critical technologies and expertise in artificial intelligence (AI), data science, and spatial and single cell omics for all aspects of research in precision health.
According to Netto, D-TECH is “not just a theme; it's really building for the future of the institution, both in the clinical and research realms.” He says the theme is unique in that it intersects with and supports the three other themes. “D-TECH is an infrastructure theme, where the other three themes will be using some of the investments in people and technologies and equipment that this theme will require. You can look at it as underpinning the other themes, but also it has its own potential for exploration and research in data science and computational health.”
Building out AI capacity is a central pillar of the D-TECH theme. “AI is going to be critical to the advancement of precision health,” says Netto. “It is going to require a lot of investment in talent and personnel who are in very high demand and short supply right now. As a leading academic medical institution, we have an advantage in that we can train the next generation of experts in our university; the key will be to offer them a track that will encourage them to stay in Birmingham.”
Acquiring the technology is just one requirement; facilitating broad access to it is equally important. “Part of the investment in this theme should also be around developing service lines for AI and data services that can be a resource to all departments and disciplines at UAB,” Netto says. “It is critical for such investments in a service line or Core to be aligned and integrated with existing departmental resources and the new Department of Biomedical Informatics and Data Science.”
Improving UAB’s data analytics capacity is another priority for the D-TECH theme. “We have a treasure trove of patient information in our EMR [electronic medical record], but the problem is it is not easy to access. Many investigators struggle with how long it takes to gather the data and how fragmented the data are. So, if we can bring in the expertise and invest in developing the framework and how we collect these data, we will be sitting on a goldmine of health care data that can be readily tapped into by our researchers.”
But, according to Netto, the fundamental first step is getting the right people in place. “The first step is people, people, people,” he says. “That means faculty and personnel—engineers, data analysts, people that we can attract here and keep here.”
Infection, Inflammation, Immunity and Immunotherapy (I-4ward)
Led by Frances Lund, Ph.D., professor in the Department of Microbiology and director of the Immunology Institute, I-4ward focuses on microbes that promote health and cause disease, acute and chronic inflammatory-mediated diseases, the immune system, and immune-targeted medicines and therapies.
According to Lund, “This year, I-4ward is prioritizing access to technologies that are needed to for single cell imaging in all its various formats. One of those is the single cell spatial proteomics instrument, the COMETTM, which has been purchased and is being housed in the Flow Cytometry and Single Cell Core Facility.
“We also want to purchase the Xenium single cell spatial transcriptomics instrument. We're going to apply for an HSF-GEF grant and hopefully we will find partners to provide matching funds for this application. If we want to keep up with the NIH prioritization of research that encompasses single cell assays, we need to have access to these analytic platforms.”
Additionally, appropriately trained personnel are a significant initial priority. “Another need we have is called the Single Cell Analytic Core, or SCAC. As we apply different single cell technologies to our research questions, we end up with very large single cell data sets and many of our researchers do not currently have the expertise to analyze these types of data. We need to educate our scientists and trainees to use different types of single cell analytic software programs, and to help them assemble their data in a format that allows them to compare their experimental data with other published datasets. Our goal is to hire scientists with expertise in single cell analytic programs and embed them in one of the existing informatic Cores so these individuals can help our scientists get the most out of their datasets.”
Looking beyond the initial implementation needs, Lund hopes to make EMR data more accessible and useful for research. “In year two, we want to enhance our ability to collect de-identified data from the EMR and provide it to researchers who have an IRB-approved research project,” she says. “We are building a data dictionary that defines the medical terms that describe the information in the EMR. Within the Immunology Institute, we've started building the dictionary by defining medical terms that are important for immunologically focused questions, but we would like to expand to make it more broadly applicable to everybody in I-4ward, whose research interests span not just immunology, but infectious diseases, chronic inflammatory diseases, and more.”
The I-4ward task force’s longer-range plans focus on staffing recruitment and retention. “Our aspirational goals in years three to five include making some of the other types of next-generation scientific assays more user-friendly and ensuring that we have access to cutting-edge technology. We also need to recruit and retain highly trained Core staff who will be responsible for operating the equipment and teaching researchers how to analyze their datasets. Most importantly, we need to provide sustainable and rewarding career paths for these individuals who have unique and valuable skill sets, so we don't lose them to industry or peer institutions.”
Brain Health and Disease Across the Lifespan
Led by Jeremy Day, Ph.D., associate professor in the Department of Neurobiology and director of the Comprehensive Neuroscience Center, this focus area will transform our understanding of brain development, aging, and health, and leverage knowledge to improve treatments for brain diseases.
Day says adding new voices to the theme’s task force was an unexpected outcome of the Research Retreat. “One of the things that came out of the retreat was we identified new faculty to join our task force: Dr. Brian Samuels [interim chair of the Department of Ophthalmology and Visual Sciences] and Dr. Robert Brunner [professor and vice-chair of the Department of Physical Medicine and Rehabilitation]—both will help us in areas that were missing from the initial task force,” he says.
As with other research themes, personnel and workforce is one of the top priorities of the Brain Health task force. “We recognize the need to add additional trainees in neuroscience at the graduate and the post-doctoral levels,” Day says. “We modeled a program that we call PRINS, Postdoctoral Research in Neurosciences, which would allow us to recruit at the forefront nationally by offering higher stipends, career development, training workshops, and funds for travel to conferences.”
Expanding data science is another key need, Day says. “Our proposal is to hire additional data scientists into our existing Biological Data Sciences Core structure that could facilitate implementation of AI/machine learning types of approaches in the neurosciences.”
The Brain Health theme also hopes to address gaps in Core facilities and capabilities. “We are missing the kind of breadth that we need to really excel in the area of induced pluripotent stem cell models, which you can use
to create neurons in a dish that have a patient's genome,” Day says. “We would like to support a core facility that can supplement our expertise in this area and maintain a repository of cell lines from patients with various disease states, which will allow researchers to add this technique to grant submissions and will facilitate taking that to the next level.”
Day says investments in equipment and technology will be critical to enhancing the theme’s research impact. “Sequencing and single cell multiomic profiling are powerful approaches where you can get information from various brain structures on not just what cell types are present, but also how they're changing across different disease states. And with single cell resolution you can actually drill down on what's changing in a specific small cell population and develop strategies to target that in a structured way. We would love to invest in equipment and infrastructure that make this possible, and that provides a spatial domain. So, you can look at not just which genes are affected in a disease state, but where they exist in the context of an entire brain section.”
Collecting and working with the data provided by these types of technology investments will require significant computational muscle, Day says. “A final thing we have proposed within the equipment infrastructure domain was the potential to have a UAB brain supercomputer, which neuroscientists in this focus area would have priority access to. This would allow us to plug into existing pipelines and our high-performance computing structure with reduced wait times and accelerated processing power.”
Health Equity
The Health Equity task force is led by Michael Mugavero, M.D., professor of Medicine in the Division of Infectious Diseases, director of the Center for Outcomes Effectiveness Research and Education, and co-director of the Center for AIDS Research and the Center for Clinical and Translational Science. Health Equity ensures access to quality, affordable health care and the opportunity for a healthy life for all people, including race, ethnicity, gender identity, sexual orientation, ability, age, socioeconomic status, and geographic location. The task force includes representation from the four subsections within the Health Equity theme: Sexual and Gender Minority Health, Women’s Health Across the Lifespan, Global and Rural Health, and Health System and Outcomes Research to Address Chronic Diseases and Health Equity.
According to Mugavero, “We got a clear message that there is an abundance of interests, expertise, and resources on campus, but things are somewhat fragmented. So, the immediate next steps, and the lowest hanging fruit, is bringing people doing this work around the table to share what they're doing, where their strengths are, who their collaborators are, and what resources, core facilities, and services they are accessing, so we can fully maximize the resources we currently have. Then we can look at what's missing, where we need to invest, and decide if there are essential services or functions that we can do through this focus area in a centralized way or in partnership with an existing center, institute, or research program.”
Toward that end, the Health Equity task force has assembled a Collaborative Health Equity Council, as well as a smaller executive committee within the council. “We needed a guiding group and want it to be as inclusive and representative as possible, where everyone has an equal seat around the table and brings unique perspectives from across the Heersink School of Medicine, UAB, and UAB Health System,” says Mugavero.
Mugavero asserts that the real test of their theme’s priorities and investments will be if they produce improvements in health outcomes. “At the retreat, we said very clearly that the ultimate goal of this theme is, in five to seven to ten years, have we moved the needle in health indicators and rankings. So, some of the key areas of science are going to have to be intervention development and implementation science—learning how to take the things that we know work and making it accessible to people where they live, when they need it, and how they want it delivered.”
“There are going to be shared multilevel drivers impacting things like maternal child health, hypertension, or diabetes,” he continues. “So where we know that an intervention has worked in one population or group or setting, let's make sure we're sharing that knowledge so others might apply it to their area.”
In terms of the technology needs Health Equity has identified, Mugavero says, “that can be as simple as making the EMR technology in the Health System more of a tool and a resource, to different software programs that help us study and measure social determinants of health, to things that are more sophisticated, like machine learning and natural language processing, with the emergence and prominence of AI.”
It is anticipated that resources from multiple themes will be pooled to fulfill overlapping needs, and that experience implementing new initiatives and programs in one theme can help other themes achieve similar goals.
This Strategic Research Initiative in the Heersink School of Medicine, led by Tika Benveniste, Ph.D., senior vice dean, encouraged all Heersink School of Medicine faculty to participate and was truly a collaborative effort between the School of Medicine, other schools at UAB, and entities such as Southern Research.
“These four themes build on strengths within the Heersink School of Medicine and will set the framework for building infrastructure, technological advancements, biomedical workforce development, faculty recruitment, and engagement with the UAB Health System. We envision much collaboration between the four themes, which will lead to new academic pursuits, collaborative grants, mentorship opportunities, and the advancement of knowledge. The next steps are implementing both short- and long-term goals of the themes, which will position the Heersink School of Medicine for tremendous growth in the next five to seven years.”