Focus Area: Research

In Wisconsin, 750,000 people live with diabetes, and 25 percent of those individuals will develop a diabetic foot ulcer (DFU), a common complication of diabetes, in their lifetime. DFUs can remain open for a long time, and it can be difficult to predict which of these wounds will respond to treatment and heal or require amputation. Wound tissue supports the colonization of a diverse community of microbes referred to as a microbiome. The microbiome in the wound tissue is thought to sustain inflammation which impairs healing and tissue repair. There is a critical, unmet need to develop methods that predict if diabetic wounds will heal in response to treatment, or if they will remain open and healing will be stalled due to a complex microbiome. In this study, researchers hypothesized that the wound microbiome interacts with host healing pathways and genes that control tissue repair. Ultimately, they found that anaerobic bacteria species, which can survive and grow with no oxygen, are more abundant and transcriptionally active in the microbiome of persistent and amputated wounds. Therefore, anaerobic bacteria may serve as a predictive biomarker of wound healing. The research team has received a $26,000 Wisconsin Alumni Research Foundation (WARF) Technology Accelerator Grant and a $2 million NIH grant to expand their work.

Antibiotic resistance makes drugs less effective at treating infections, which can be very dangerous. This study explored the role that dietary fiber intake and the diversity of microorganisms in the gut may play in reducing the risk of colonization by multidrug resistant organisms (MDROs). The study found higher rates of MDRO colonization in older, low-income, and urban-living individuals and that increased dietary fiber intake may be associated with slightly lower rates of MDRO gut colonization. Further study using leveraged grant funding in underway.

In Wisconsin, people of Hmong ancestry are infected by a particular fungal lung disease at rates up to 100 times higher than people of European ancestry, a concerning public health disparity. The researchers identified the genetic basis for susceptibility to the fungal infection in people of Hmong ancestry, providing new opportunities for treatment and education.

This project aimed to genetically characterize SARS-CoV-2 in Wisconsin to estimate infection parameters and evaluate the effectiveness of interventions. In March 2020, little was known regarding the true extent of SARS-CoV-2 transmission in Wisconsin. Researchers used genomic surveillance, tracking of different SARS-CoV-2 strains through space and time, to inform decisions on public health measures and aid the transition between mitigation and containment strategies. Preparing the genetic epidemiology infrastructure was crucial for tracking the local SARS-CoV-2 epidemic through 2020. The project was successful in understanding and tracking SARS-CoV-2 transmission in Wisconsin. The team utilized genomic surveillance to identify patterns in SARS-CoV-2 transmission and sequenced over 5,000 viral genomes. The establishment of a sequencing program played a vital role during the emergence of the Delta variant, contributing to its early detection in Wisconsin. This project was also one of the first to show that vaccinated people who became infected with Delta variants could transmit the virus to others. Results from this project established a vigorous new research program that attracted significant extramural support, including three new CDC-funded projects using SARS-CoV-2 genome sequences to reveal patterns in virus transmission and evolution.

SARS-CoV-2, the virus that causes COVID-19, genetically changes across populations at a predictable rate of one mutation approximately every 15 days. Understanding the transmission of COVID-19 in healthcare facilities, which are at the core of the pandemic in Wisconsin, is crucial to help resolve the directionality and source of infection. In order to understand if healthcare workers are becoming infected through patient contact, the research team used information such as viral lineage and consensus sequence provided by Oxford Nanopore Technology. The researchers had an initial goal of sequencing ten transmission clusters per month from UW Hospitals and Clinics. They far surpassed this goal and have investigated 55 transmission clusters involving over 400 individuals. After identifying likely and unlikely sources of infection in healthcare workers (HCW) and comparing patient sequences to local outbreaks, they found little evidence for widespread transmission, suggesting that HCWs are most likely to become infected with SARS-CoV-2 in the community.

Most older women in Wisconsin experience incontinence, which impacts quality of life, but they may not seek care due to stigma. The “Mind over Matter: Healthy Bowels, Healthy Bladder (MOM)” workshop teaches women skills to improve symptoms without a medical professional. Participants in the MOM workshop reported significant improvement in both bladder and bowel symptoms. Since the trial, more than a dozen additional MOM workshops have taken place and more widespread workshops and trainings are planned for 2020, in partnership with the Wisconsin Institute for Healthy Aging (www.wihealthyaging.org).

The overarching goal of this project was to disseminate accurate and up-to-date information on COVID-19 to Black, Latinx and Native American communities in Wisconsin through trusted community influencers. The project team, including a media specialist and community influencers, created and shared over 400 accurate and accessible posts with the Black, Latinx, and Native American communities in Wisconsin. Additionally, social media connections were made with 14 additional community networks between the three target communities.

The COVID-19 pandemic highlighted the need for detailed and timely information in making public health and operational decisions. This project aimed to develop an advanced COVID-19 syndromic surveillance system using electronic health records (EHR) and predictive analytics to provide just-in-time training for health care providers. Researchers successfully developed data pipelines from UW Health emergency department (ED) EHR data and validated them at Marshfield Clinic. Analysis of the data revealed an increase in acute respiratory infection (ARI) cases during the COVID-era, and predictive models performed well in predicting ARI arrivals and boarders ​(patients admitted to the hospital who remained in the ED for a minimum or four hours after admission). The Wisconsin Real-time Emergency Department Surveillance and Responsive Training (WIRED-RT) COVID-19 Simulation Curriculum Toolkit was developed to help health care teams prepare for surges in cases, focusing on key care scenarios.

The Medical College of Wisconsin (MCW) and the UW School of Medicine and Public Health are partnering on an initiative to improve health equity in Wisconsin. MCW’s Advancing a Healthier Wisconsin Endowment (AHW) and the UW’s Wisconsin Partnership Program (WPP), statewide health funders based at Wisconsin’s two medical schools, have announced a joint three-year, $3 million grant to launch an expansive new statewide partnership that will study, measure and recommend solutions for health inequities across the state of Wisconsin.

This project, led by Dr. Yun Liang, aimed to understand how factors like diet and biological differences between men and women influence autoimmune diseases. Autoimmune diseases like lupus are much more common in women, while men are more often affected by infections and cancer. These sex differences in immune response are not well understood, partly because women have historically been underrepresented in medical research. One promising area of research focuses on a molecule called VGLL3, which is found at higher levels in women and is linked to autoimmunity. The project made significant strides in understanding how VGLL3 contributes to lupus inflammation. High levels of VGLL3 were found to increase the activity of specific lupus-related genes, and high levels of another molecule, called IL17C, suggest a link between VGLL3 and IL17C in driving inflammation in lupus. The study revealed a complex interplay between VGLL3 and immune regulation pathways, especially under conditions of stress. Overall, these findings offer valuable insights into potential therapeutic approaches for lupus.