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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Rice University lands $18M to revolutionize lymphatic disease detection

fresh funding

An arm of the U.S. Department of Health and Human Services has awarded $18 million to scientists at Rice University for research that has the potential to revolutionize how lymphatic diseases are detected and help increase survivability.

The lymphatic system is the network of vessels all over the body that help eliminate waste, absorb fat and maintain fluid balance. Diseases in this system are often difficult to detect early due to the small size of the vessels and the invasiveness of biopsy testing. Though survival rates of lymph disease have skyrocketed in the United States over the last five years, it still claims around 200,000 people in the country annually.

Early detection of complex lymphatic anomalies (CLAs) and lymphedema is essential in increasing successful treatment rates. That’s where Rice University’s SynthX Center, directed by Han Xiao and Lei Li, an assistant professor of electrical and computer engineering, comes in.

Aided by researchers from Texas Children’s Hospital, Baylor College of Medicine, the University of Texas at Dallas and the University of Texas Southwestern Medical Center, the center is pioneering two technologies: the Visual Imaging System for Tracing and Analyzing Lymphatics with Photoacoustics (VISTA-LYMPH) and Digital Plasmonic Nanobubble Detection for Protein (DIAMOND-P).

Simply put, VISTA-LYMPH uses photoacoustic tomography (PAT), a combination of light and sound, to more accurately map the tiny vessels of the lymphatic system. The process is more effective than diagnostic tools that use only light or sound, independent of one another. The research award is through the Advanced Research Projects Agency for Health (ARPA-H) Lymphatic Imaging, Genomics and pHenotyping Technologies (LIGHT) program, part of the U.S. HHS, which saw the potential of VISTA-LYMPH in animal tests that produced finely detailed diagnostic maps.

“Thanks to ARPA-H’s award, we will build the most advanced PAT system to image the body’s lymphatic network with unprecedented resolution and speed, enabling earlier and more accurate diagnosis,” Li said in a news release.

Meanwhile, DIAMOND-P could replace the older, less exact immunoassay. It uses laser-heated vapors of plasmonic nanoparticles to detect viruses without having to separate or amplify, and at room temperature, greatly simplifying the process. This is an important part of greater diagnosis because even with VISTA-LYMPH’s greater imaging accuracy, many lymphatic diseases still do not appear. Detecting biological markers is still necessary.

According to Rice, the efforts will help address lymphatic disorders, including Gorham-Stout disease, kaposiform lymphangiomatosis and generalized lymphatic anomaly. They also could help manage conditions associated with lymphatic dysfunction, including cancer metastasis, cardiovascular disease and neurodegeneration.

“By validating VISTA-LYMPH and DIAMOND-P in both preclinical and clinical settings, the team aims to establish a comprehensive diagnostic pipeline for lymphatic diseases and potentially beyond,” Xiao added in the release.

The ARPA-H award funds the project for up to five years.

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.