November

Research that benefits Indiana, the nation and the world, and an important historical remembrance

Dear Friend of IU:

As the state's flagship university, a national and global leader in research and innovation, and the home to numerous internationally recognized scholars, Indiana University continues to produce research and scholarship that have enhanced the day-to-day lives of Hoosiers in profound ways.

Throughout its nearly 200-year history, IU has helped fuel an engine of prosperity for Indiana and the nation, led the state's international engagement, sparked discoveries that have helped solve large-scale problems, improved the health and wellness of Indiana communities, and illuminated the boundless possibilities of human imagination and creativity.

Like other leading research universities around the country, we have also positioned ourselves to have a major impact on society's most critical challenges — challenges that require expertise drawn from across a full range of the humanities, social sciences and natural sciences. Indeed, in recent years IU has made strategic and bold investments in collaborative research focused on solving large-scale problems — the "grand challenges" of our time. These challenges are daunting. Consider the challenges of addressing environmental degradation and restoration; expanding our renewable energy; creating and administering medical treatments tailored to the unique physical and environmental needs of individuals; ensuring a supply of safe foods and fresh water; finding cures for diseases such as cancer; and understanding and preventing infectious diseases such as the Zika virus and Lyme disease.

Through the Grand Challenges program, designed to engage IU's leading research expertise in collaboration with industry, government, nonprofit and community partners, IU is doing the hard work of providing the people, ideas and discoveries that will help us meet and overcome these challenges.

As we rapidly approach the IU Bicentennial, now just 229 days away, the program reflects the university's commitment to redoubling its efforts to find and implement solutions that will improve the quality of life for the residents of the state of Indiana who have helped support IU for nearly 200 years.

In this update, I would like to describe for you some of the extraordinary and inspiring progress we are making through our Grand Challenges initiatives and how we continue to fully harness the power of IU faculty, staff and students — in collaboration with external partners across the state — to address the big issues impacting our state, nation and world.

At the conclusion of this letter, I will also share how IU is commemorating a seminal time in our nation's and the world's history: the 100th anniversary of the end of the First World War, which has had a lasting legacy on the mission, values and vision of the university from which the Grand Challenges and other major IU engagement efforts continue to arise.

Continuing IU's legacy of biomedical breakthroughs: The Precision Health Initiative

Established in 2016 with a $120 million investment, the Precision Health Initiative — which builds on IU's legacy of biomedical breakthroughs, such as the invention of echocardiography and the cure for testicular cancer — has the dramatic goal of curing at least one cancer and one childhood disease, as well as finding ways to prevent one chronic illness and one neurodegenerative disease. The initiative is led by Dr. Anantha Shekhar, IU associate vice president for clinical affairs and executive associate dean for research at the IU School of Medicine.

Mary Estrada, 62, right, with her physician, Dr. Liana G. Apostolova of the IU School of Medicine. Estrada, who lost her mother to Alzheimer’s disease, was recently diagnosed with early onset Alzheimer’s disease. Photo provided by IU School of Medicine

Recently, we announced that more than 30 new research faculty from throughout the country have joined the PHI team, which now possesses some of the most advanced research and clinical capabilities in the Midwest and has trained its energy and expertise on several major objectives, including:

  • Developing new approaches for treating triple negative breast cancer and multiple myeloma that will cure more of these patients.
  • Curing more children with pediatric sarcoma, a particularly deadly cancer found in tissues such as tendons, bones and muscle.
  • Preventing the onset and progression of Type 2 diabetes by discovering what biological factors trigger the disease and tailoring treatments to individuals.
  • Slowing the progression of Alzheimer's disease by researching the role of the immune system and developing new immunotherapies.

In September, we shared that a promising therapy for the treatment of cancer has now come to Indiana, thanks to the work of scientists who are part of PHI. CAR T-cell therapy harnesses the disease-fighting power of a patient's own immune T cells by taking them out of the patient's blood, changing them in a laboratory and then infusing them back into the patient's body to attack cancer cells. The therapy was recently administered for the first time in Indiana to a lymphoma patient at IU Health, and pediatric patients will soon be able to receive the therapy at Riley Hospital for Children at IU Health.

Researchers affiliated with PHI continue to examine how the body's own immune system may affect the underlying biology associated with cognitive decline, the primary symptom of Alzheimer's disease. The team is planning to establish new immune biomarkers associated with Alzheimer's that together, with existing Alzheimer's biomarkers, will better predict onset and progression of the disease.

In related news, last month IU School of Medicine scientists received the university's largest single grant from the National Institutes of Health to lead a five-year national research study of early-onset Alzheimer's disease. We are pleased that IU School of Medicine neurologist and neuroscientist Dr. Liana Apostolova will lead this extremely important national study of Alzheimer's disease in younger individuals, a subset of patients for whom the diagnosis is especially devastating. We are also grateful to Lilly Endowment Inc., whose original grant to support IU's Physician Scientist Initiative made it possible to recruit Dr. Apostolova, a most prolific researcher, to the university in 2015.

Finally, a team of IU social scientists, led by Distinguished Professor of Sociology Bernice Pescosolido, has begun an effort to canvass rural Indiana to collect information and DNA samples from 2,000 residents of all backgrounds. This data will help researchers understand how genetic, behavioral and environmental factors influence a person's health.

All of this represents enormous progress — in a relatively short period of time — that is already having an impact on the type of care we are providing Hoosier patients. PHI is helping to ensure that our state's residents can stay close to home to receive cutting-edge, personalized care and participate in health studies and clinical trials that will be critical to our ongoing ability to, as Dr. Shekhar says, "provide the right treatment for the right patient at the right time — right here in Indiana."

Prepared for Environmental Change

The second project funded through IU's Grand Challenges program, Prepared for Environmental Change, continues to progress in helping our communities track and prepare for environmental changes in order to sustain economic opportunities and protect public health.

Announced last year, and supported by a $55 million university investment, the Prepared for Environmental Change initiative focuses on helping Hoosier communities better anticipate the implications of and adapt to changes in extreme weather, migratory patterns and the related spread of infectious diseases.

Environmental change affects natural habitats, human and animal migration, crop yield, demand for natural resources, disaster resilience, disease vectors, and animal and insect populations.    Photo by James Brosher, Indiana University

Shorter, less intense winters have contributed to a four-fold increase in documented cases of Lyme disease since 2001. And sustained warmer temperatures may jeopardize the nearly $6 billion generated annually by corn and soybean production. Nationally, the intensity and duration of tropical storms and hurricanes make the 2018 hurricane season the most powerful ever recorded.

Whatever the effects of environmental change, we know they are complex and interrelated and that they challenge the ability of industries, governments and communities to adapt. We know the change extends far beyond weather to include shifts in natural habitats, human and animal migration, crop yield, demand for natural resources, disaster resilience, disease vectors, and animal and insect populations. And we know that the failure to understand, predict and adapt to environmental change could threaten the vitality of Hoosier businesses, agriculture, jobs and physical well-being.

Under the leadership of Distinguished Professor Ellen Ketterson of the Department of Biology in IU Bloomington's College of Arts and Sciences, IU's Prepared for Environmental Change initiative has been making considerable progress in ensuring Hoosiers' recognition of and readiness to address a wide variety of environmental changes.

To this end, funded by the Grand Challenges program, IU established the Environmental Resilience Institute. ERI is facilitating collaborations between scientists, local officials, businesses, nonprofits and community leaders to better understand existing changes and develop accurate predictions, feasible solutions and effective communications.

To help inform its important work, ERI has recruited 12 new research fellows. Collectively, this group of scientists, social scientists, artists, historians and business and legal experts will pursue projects addressing a wide range of environmental change issues.

The group includes sociologist Matt Houser, who will explore how farming practices are affected by changing social, economic and ecological circumstances, and how to communicate with farmers about climate change in ways that reduce skepticism and promote change. Another fellow, environmental scientist Tara Smiley, will study how species respond to environmental change, including the key roles migrating birds play in ecosystems, dispersing seeds, transporting diseases, controlling pest populations and pollinating flowers of certain plant species.

This summer, ERI researchers also launched the Environmental Resilience Institute Toolkit. ERIT is a publicly accessible, interactive digital toolkit that offers communities access to information on such environmental issues as flooding and energy-efficient streetlights, including case studies, recommendations and suggestions for funding sources where available. Based on the Environmental Protection Agency's Climate Change Adaptation Resource Center, also known as ARC-X, it is specifically tailored to the needs of communities in Indiana and surrounding Midwestern states. (Watch this short video to learn more about ERIT.)

Additionally, a monthly, free webinar series aims to support local government officials and staff  as they prepare their communities for higher average temperatures year-round, increased precipitation during spring and winter, and all of the impacts that occur as a result. ERI hosts this series in partnership with Accelerate Indiana Municipalities and the Association of Indiana Counties.

ERI researchers are also leading Project Vector Shield, working on an early warning system to map the presence of insects that spread human diseases, such as the Zika virus and Lyme disease, and gathering data that will be available on the ERI website. They are also engaging with Hoosier communities to understand how green infrastructure promotes resilience, such as the installation of vegetation to manage storm water. ERI is part of the Urban Green Infrastructure Analysis Project, which helps local communities with flood protection, cleaner air, cleaner water, increased biodiversity and urban heat management. Flooding is already increasing in Indiana, and this project will provide a replicable model to help communities understand, alleviate and manage water inundations.

In Indianapolis, ERI is partnering with Keep Indianapolis Beautiful to conduct research on areas where invasive plant species are removed. Through the Greening the Pleasant Run Waterway project, ERI researchers are studying 30 urban greenspace locations. The work will inform recommendations for reducing the impact of human expansion on wildlife. It also includes an analysis of how the reintroduction of native plants in urban areas affects the health of migrating birds, which has a ripple effect on the well-being of entire ecosystems.

As with all of IU's Grand Challenges, there is more to this prolific work than I can possibly cover here. To read more than the aforementioned highlights, please visit the ERI website.

Responding to the Addictions Crisis

Through our third Grand Challenge initiative, Responding to the Addictions Crisis, IU faculty members continue to work in partnership with state government, local communities and health care providers statewide to combat the pervasive and grave substance abuse crisis in Indiana and the U.S.

Opioid addiction is a major public health crisis that is taking an increasingly severe toll on the health of far too many Hoosiers and devastating communities throughout our state. Indiana is one of four states where the fatal drug overdose rate has more than quadrupled since 1999. Hoosiers are now more likely to die from a drug overdose than a car accident. Economic damages resulting from the opioid epidemic are expected to eclipse $4 billion in Indiana this year, including costs for products and services used to fight the epidemic, lost work productivity and emergency responses.

Naloxone samples are handed out at the IU Responding to the Addictions Crisis Grand Challenge naloxone training held at Hine Hall at IUPUI.   Photo by Liz Kaye, Indiana University

The situation has become so severe nationally that it is expected to result in a decrease in the average life expectancy of Americans — something usually only associated with countries ravaged by war and famine.

Announced alongside Indiana Gov. Eric Holcomb in fall 2017, IU's $50 million initiative is the nation's largest and most comprehensive state-based response to the opioid addiction crisis, and the largest anywhere led by a university. The hallmark of IU's Grand Challenges program, this initiative engages a broad array of our world-class faculty, as well as IU's business, nonprofit and government partners. The goals are to implement a comprehensive plan to reduce deaths from addiction, ease the burden of drug addiction on Hoosier communities, expand education and training on this issue, and improve health and economic outcomes.

In the first phase of the initiative, IU's interdisciplinary team of researchers, led by IU School of Nursing Dean Robin Newhouse, launched a collaborative action plan to halt the addictions epidemic. Partnering with hospital systems, public health departments, health care research institutes and other organizations, they centered their efforts on:

  • Creating and implementing new approaches to treating addiction and supporting recovery.
  • Equipping current and future professionals to better assist those struggling with addiction.
  • Sharing legal and policy best practices developed in response to the opioid epidemic.
  • Conducting research to uncover the biological and environmental forces that drive substance abuse disorders.
  • Ensuring robust and commonly accessible data that helps inform community leaders, health professionals and policy makers around the state about what is driving the epidemic and where it is headed.

Earlier this year, IU researchers offered local, state and federal governments an array of strategies for mitigating the opioid addictions crisis. They shared these recommendations directly with members of the Indiana congressional delegation, as well as during live testimony in front of the U.S. Senate Special Committee on Aging. These strategies centered on prioritizing harm reduction, such as increasing the availability of the overdose reversal drug naloxone and understanding the role of syringe exchange programs in public health crises. They also focused on removing legal impediments that hold up effective responses and investing in more and better evidence-based treatment services, including counseling and safe housing services.

This fall, across Indianapolis, members of the public were trained to save lives by administering naloxone. Partnering with IU Health, the Indianapolis Public Library, Overdose Lifeline Inc. and the Indiana Family and Social Services Administration, trainings were held concurrently on the IUPUI campus and at four Indianapolis Public Library branches.

Additionally, building on an existing program within the IU School of Medicine, the innovative CARE Plus pilot program was launched to train community health workers in screening, brief intervention, referral to treatment, and hiring and training peer addiction recovery coaches. The goal is to enable opiate-addicted parents to receive substance abuse and mental health treatment while caring for their children. Working with partners at Eskenazi Health, CARE Plus has already trained five community health workers to provide SBIRT as well as adding CARE addiction recovery coaches to expand support and referral to treatment for pregnant women, new mothers and fathers at risk for substance use disorder.

Rates of Indiana youth substance use are higher than the national average. The addictions Grand Challenge has established a project led by Professor Tamika Zapolski to combat adolescent drug use via school-based programming. The goal is to provide youth with healthy coping and stress-management skills to prevent future substance use. Already working with about 40 students in groups at two schools, Ben Davis Ninth Grade Center and Ben Davis University High School — the teams plan to add new groups at North Central High School in 2019. In addition, the team is gathering data from qualitative interviews with students and school staff to further inform continued efforts.

Breaking the cycle of this epidemic will take more than training existing practitioners on the front lines. IU is improving training for future health professionals to reduce and prevent addiction. Leveraging interprofessional training, the goal is to increase the number of IU health science graduates entering the workforce prepared to address opioid abuse syndrome and overdose.

We also need to know much more about the who, what, where, when and why of the opioid crisis gripping our state. Robust and commonly accessible data and information are essential to fully understanding, addressing and monitoring the nature and extent of the crisis. The Indiana Addictions Data Commons, created by the addictions Grand Challenge, will integrate electronic health records, crime statistics, socioeconomic status, dental data and local/state public health data into a new standardized and common data resource that will more efficiently and effectively support the work of researchers, clinicians, health professionals and others.

Finally, last week the university announced 15 impressive new projects that were awarded funding in phase two of the Responding to the Addictions Crisis Grand Challenges initiative. These projects include an assessment of the impact of opioid addictions on the labor market, examinations of stigma and a study of how a more effective version of naloxone might be created.

IU is certainly not immune to the addictions crisis. It affects IU faculty, staff, students and alumni, as well as their families, friends and neighbors. People are dying. This is why we are bringing to bear the acumen of IU's incredible academic leaders and practitioners to help address and mitigate this destructive and deadly public health crisis.

A final word: IU and World War I

Just over 100 years ago in 1918, the guns fell silent all over the world, signaling the end to one of the most devastating wars in human history. An estimated 40 million soldiers and civilians either lost their lives or were wounded in the First World War, which has been justifiably called one of the 20th century's greatest catastrophes.

A World War I Armistice parade in front of Maxwell Hall on the IU Bloomington campus on Nov. 11, 1918. Photo provided by IU Archives

Four great empires collapsed, with geopolitical consequences that endure to this day, while the lone remaining empire found itself exhausted and depleted. A world weakened by the harsh privations of war was soon swept and devastated by an outbreak of deadly influenza that killed over 50 million. And the First World War was but the precursor to the even more deadly Second World War that killed around 80 million soldiers and civilians around the world and brought the world the unspeakable horrors of genocide on an industrial scale.

Over the rest of this academic year, IU will commemorate the centennial of the end of the First World War and give expression to the events and experiences that fundamentally transformed the world and altered the course of our university. Indeed, IU's involvement with the war and the world at large resulted in the university's becoming more civically involved and globally engaged and, in many ways, cementing the modern-day missions of the institution that are reflected in the Grand Challenges and other major university initiatives.

Please visit this special website to learn more about IU's involvement in World War I and the plans we have to commemorate this major anniversary. I hope you will take part in the many activities and events we have planned, remembering those who gave the ultimate sacrifice during World War I and reflecting upon the role their legacy has played in IU's ongoing pursuit of excellence in our mission to serve people in Indiana and beyond through higher education.

With thanks for your continued support and all that you do on behalf of IU,

Michael A. McRobbie

President

Indiana University