The AAST Research and Education Fund is funding three scholarships for 2023-2024. The scholarship recipients will receive their scholarship plaque at the 82nd Annual Meeting of AAST & Clinical Congress of Acute Care Surgery in Anaheim, CA, and will present their research findings at the 83rd Annual Meeting of AAST & Clinical Congress of Acute Care Surgery in Las Vegas, NV
Julia Coleman, MD
Ohio State University
"The Interaction of Estradiol and Platelet Biology: A Mechanistic Exploration of Sex Dimorphisms in Coagulation and Implications for Transfusion Medicine"
Sex dimorphisms in coagulation are well-established, with females demonstrating a relative hypercoagulability. This procoagulant profile persists following severe injury, with the female sex conferring a survival benefit in the setting of trauma-induced coagulopathy. The mechanism underlying this population-level observation has yet to be elucidated. My group has previously described sex-specific platelet activation potentials that can be manipulated with estradiol treatment. The goal of this project is to determine the mechanism for sex dimorphisms in platelet biology, specifically estrogen-mediated enhancement of platelet receptor expression and signaling through nongenomic and genomic effects. My central hypothesis is that the prohemostatic platelet biology sexual dimorphism is dependent upon estradiol-mediated expression of key platelet receptors resulting in hyperresponsive signaling and hyperreactivity. My specific aims include 1) identify sex dimorphisms in platelet receptor biology in response to agonists released after traumatic injury and 2) identify the timeline of sex dimorphisms in platelet receptor biology and the nongenomic effects of estradiol across the shelf life of stored platelets. The methodology will include 1) assessing sex dimorphisms in baseline platelet receptor density, following by platelet function tests after stimulating platelets with proteins released after trauma which downstream signaling converge on calcium and then 2) assessing this same functionality across the shelf life of a stored platelets natively, after addition of estradiol, and then with addition of an estradiol-estradiol inhibitor complex. The crux of this experimental design is based on the importance of recognizing sex as a biological variable in experimental design and personalized therapeutics. The results from this work have implications for sex-specific transfusion medicine and the role of estradiol as a therapeutic adjunct in resuscitation of trauma-induced coagulopathy, which remains a leading cause of mortality in trauma patients.
Anaar Siletz, MD
University of Southern California
"Whole Transcriptome Dynamics In Neutrophils After Blunt Trauma"
Marissa Boeck, MD, MPH
Zuckerberg San Francisco General Hospital/UCSF
"Identifying and Addressing Unmet Needs of Injury Survivors at a Safety Net Hospital in San Francisco"
Injury remains a significant cause of morbidity and mortality in the United States. Major advances in trauma systems and care have led to meaningful in-hospital mortality reductions. Yet, for the 95% of patients who survive their initial injuries, mortality and morbidity post-hospital discharge are not well understood, as patients are not routinely followed after their index hospitalization. The social determinants of health, both individual and community-level, account for up to 80% of healthcare outcomes, but many remain unmeasured and unaddressed for injured patients. The overall objective of this proposal is to co-design a human-centered injury survivorship pathway at a safety-net hospital in San Francisco using culturally competent navigators to meet the diverse post-discharge medical and social needs of injury survivors. The project will use human-centered design methodology, which embraces community engagement to solve complex problems by turning to the people who face these problems every day to collaboratively brainstorm and innovate. We will first identify unmet medical and social needs through qualitative methods with injury survivors, their caregivers, and trauma care stakeholders. Using this information plus evidence from the literature we will co-design and iteratively refine a human-centered injury survivorship pathway for future implementation, refinement, and evaluation. The resultant pathway will be adaptable to different settings and has the potential to impact population health through recognizing and addressing costly, chronic sequelae of injuries before they manifest, ideally preventing severe disability.
Letitia Bible, MD
University of Florida
"Can the Gut Save the Brain? An Investigation of Microbiome on the Recovery from Traumatic Brain Injury"
The intestinal microbiome is involved in bidirectional communication with the brain and undergoes significant changes following traumatic brain injury (TBI) as well as following stress. The dysbiosis following stress can induce changes in learning, memory, and behavior. Following TBI many patients require an intensive care unit level of care where they are exposed to the daily stress of circadian rhythm disruption, invasive procedures, and frequent traveling for imaging and procedures. The objective of the proposed research is to investigate the influence of stress and dysbiosis on recovery from TBI. The central hypothesis of this project is that following TBI, dysbiosis is associated with worse functional outcomes mediated by a biofeedback loop of chronic stress with increased circulation of catecholamines, which can be ameliorated by the use of sympatholytics. This will be investigated using a preclinical model of TBI and chronic stress.