There's a growing need for physician-scientists who can see from both sides of the table. Miguel Tovar/University of Houston

Physician-scientists are a group of specialized researchers at the intersection of medicine and technology. Earning both medical degrees and Ph.D.s, they offer a perspective beyond the scope of clinical practice.

Three such researchers discussed how they make the connections between discovery and patient care.

Why a dual education matters

Shaun Xiaoliu Zhang, director of the Center for Nuclear Receptors and Cell Signaling at the University of Houston and M.D. Anderson professor of biology and biochemistry, knows exactly what the clinical demands are.

"I can see from the M.D. perspective, but at the same time I have a Ph.D. — I know how to design research properly," he says. "In the clinic, you're faced with reality that a patient is struggling but you don't have the tools to treat those patients. If you engage in research you can create a tool."

Zhang says clinicians know the need but may struggle to design a solution. A Ph.D., on the other hand, may only know basic research.

Renowned hormone researcher Jan-Åke Gustafsson, Robert A. Welch professor of biology and biochemistry and founding director of the Center for Nuclear Receptors and Cell Signaling, agrees.

"The dual education makes it possible for you to see which diseases are in need of more research, drugs and so on," he says.

Physician-scientists are the driving force behind many advances of modern medicine.

"The way I look at it is, practicing medicine is relatively easy but coming up with the next diagnostic device or the next treatment for a disease is way more difficult, way more challenging," says Chandra Mohan, Hugh Roy and Lillie Cranz Cullen Endowed professor of biomedical engineering at UH.

"You see patients with certain diseases, and you know there's a dire need for better diagnostics, earlier treatment, earlier diagnosis with fewer side effects," he says.

While researchers spend time primarily in the laboratory and clinical practitioners interact with patients, they both want to make an impact.

"We have made some discoveries which have led to the development of new drugs and better understanding of certain diseases," says Gustafsson. "There's a great satisfaction that it may help people to get healthy."

Traditional research brings value to a university

The synergy of this dual education makes these investigators valuable not only to academia, but also to medical science.

"I can't imagine doing translational research without medical training," Zhang says. "If you have this part without the other, you don't know where to go. With medical training, you know exactly which direction to go."

Mohan echos that assessment.

"When you start doing research there are so many questions you can answer," he says. "Sometimes there are questions which are just too basic. They're too far removed from how it will impact a patient's life. So what are the most important questions? I think questions that really make a difference in the patient's life are the most important."

Zhang notes that the National Institutes of Health has switched its funding philosophy — once focused on basic science, it now is more interested in translational research, with a direct relationship to patient health.

As physician-scientists, these "translators" of medical research are able to bridge the chasm.

Amr Elnashai, vice president/vice chancellor of research and technology transfer at UH, says physician-scientists play an important role.

"The increasing importance of deploying technology in medicine renders it essential for a progressive research university to hire medical Ph.D. holders who are in an ideal position to bridge the gap between engineering and science on the one hand, and the broad field of medicine on the other," he says.

Research groups that bring both fields together not only have a much higher probability of impacting lives by adopting the latest technology in medical applications, he adds, but they also give interdisciplinary teams greater access to specific funding pursue such solutions.

In that sense, says Elnashai, medical Ph.D. researchers play an important part of the future research university.

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This article originally appeared on the University of Houston's The Big Idea.

Nitiya Spearman is the internal communications coordinator for the UH Division of Research.

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Houston doctor wins NIH grant to test virtual reality for ICU delirium

Virtual healing

Think of it like a reverse version of The Matrix. A person wakes up in a hospital bed and gets plugged into a virtual reality game world in order to heal.

While it may sound far-fetched, Dr. Hina Faisal, a Houston Methodist critical care specialist in the Department of Surgery, was recently awarded a $242,000 grant from the National Institute of Health to test the effects of VR games on patients coming out of major surgery in the intensive care unit (ICU).

The five-year study will focus on older patients using mental stimulation techniques to reduce incidences of delirium. The award comes courtesy of the National Institute on Aging K76 Paul B. Beeson Emerging Leaders Career Development Award in Aging.

“As the population of older adults continues to grow, the need for effective, scalable interventions to prevent postoperative complications like delirium is more important than ever,” Faisal said in a news release.

ICU delirium is a serious condition that can lead to major complications and even death. Roughly 87 percent of patients who undergo major surgery involving intubation will experience some form of delirium coming out of anesthesia. Causes can range from infection to drug reactions. While many cases are mild, prolonged ICU delirium may prevent a patient from following medical advice or even cause them to hurt themselves.

Using VR games to treat delirium is a rapidly emerging and exciting branch of medicine. Studies show that VR games can help promote mental activity, memory and cognitive function. However, the full benefits are currently unknown as studies have been hampered by small patient populations.

Faisal believes that half of all ICU delirium cases are preventable through VR treatment. Currently, a general lack of knowledge and resources has been holding back the advancement of the treatment.

Hopefully, the work of Faisal in one of the busiest medical cities in the world can alleviate that problem as she spends the next half-decade plugging patients into games to aid in their healing.

Houston scientists develop breakthrough AI-driven process to design, decode genetic circuits

biotech breakthrough

Researchers at Rice University have developed an innovative process that uses artificial intelligence to better understand complex genetic circuits.

A study, published in the journal Nature, shows how the new technique, known as “Combining Long- and Short-range Sequencing to Investigate Genetic Complexity,” or CLASSIC, can generate and test millions of DNA designs at the same time, which, according to Rice.

The work was led by Rice’s Caleb Bashor, deputy director for the Rice Synthetic Biology Institute and member of the Ken Kennedy Institute. Bashor has been working with Kshitij Rai and Ronan O’Connell, co-first authors on the study, on the CLASSIC for over four years, according to a news release.

“Our work is the first demonstration that you can use AI for designing these circuits,” Bashor said in the release.

Genetic circuits program cells to perform specific functions. Finding the circuit that matches a desired function or performance "can be like looking for a needle in a haystack," Bashor explained. This work looked to find a solution to this long-standing challenge in synthetic biology.

First, the team developed a library of proof-of-concept genetic circuits. It then pooled the circuits and inserted them into human cells. Next, they used long-read and short-read DNA sequencing to create "a master map" that linked each circuit to how it performed.

The data was then used to train AI and machine learning models to analyze circuits and make accurate predictions for how untested circuits might perform.

“We end up with measurements for a lot of the possible designs but not all of them, and that is where building the (machine learning) model comes in,” O’Connell explained in the release. “We use the data to train a model that can understand this landscape and predict things we were not able to generate data on.”

Ultimately, the researchers believe the circuit characterization and AI-driven understanding can speed up synthetic biology, lead to faster development of biotechnology and potentially support more cell-based therapy breakthroughs by shedding new light on how gene circuits behave, according to Rice.

“We think AI/ML-driven design is the future of synthetic biology,” Bashor added in the release. “As we collect more data using CLASSIC, we can train more complex models to make predictions for how to design even more sophisticated and useful cellular biotechnology.”

The team at Rice also worked with Pankaj Mehta’s group in the department of physics at Boston University and Todd Treangen’s group in Rice’s computer science department. Research was supported by the National Institutes of Health, Office of Naval Research, the Robert J. Kleberg Jr. and Helen C. Kleberg Foundation, the American Heart Association, National Library of Medicine, the National Science Foundation, Rice’s Ken Kennedy Institute and the Rice Institute of Synthetic Biology.

James Collins, a biomedical engineer at MIT who helped establish synthetic biology as a field, added that CLASSIC is a new, defining milestone.

“Twenty-five years ago, those early circuits showed that we could program living cells, but they were built one at a time, each requiring months of tuning,” said Collins, who was one of the inventors of the toggle switch. “Bashor and colleagues have now delivered a transformative leap: CLASSIC brings high-throughput engineering to gene circuit design, allowing exploration of combinatorial spaces that were previously out of reach. Their platform doesn’t just accelerate the design-build-test-learn cycle; it redefines its scale, marking a new era of data-driven synthetic biology.”