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insider
insiderWednesday, March 26, 2014
St. Jude
A l s o i n t h i s i s s u e
A biweekly internal publication for St. Jude employees
6 Celebrating nurses
The hospital recognizes certified nurses.
2 On the Horizon
Pam Dotson, RN, discusses why hand-washing is important to patient care.
1 L.I.F.T. presentation
Swimmer Diana Nyad shares her story of inspiration and hope.
7 Grizzly visit Memphis Grizzly
Marc Gasol visits with patients and families.
Please recycle after reading.
insider is published for employees of St. Jude Chil-
dren’s Research Hospital biweekly by the Communications
department. Any use of these stories by other parties or for
other purposes requires authorization by hospital Communi-
cations. Email story ideas to insider@stjude.org, or contact
Mike O’Kelly, 595-4047. Submissions such as achieve-
ments, births, in memoriam and wedding announcements
are welcomed. Communications reserves the right to edit or
hold any submissions. If you prefer to obtain St. Jude In-
sider online, visit http://home.stjude.org/communications/
Pages/stjude-insider.aspx . To change the number of paper
copies your department receives, email insider@stjude.org.
Photography and design by the department of Biomedical
Communications. The mission of St. Jude is to advance
cures, and means of prevention, for pediatric catastrophic
diseases through research and treatment. St. Jude is an Equal
Opportunity Employer.
A possible new ‘off’ switch for a pathway that can lead to cancer
A St. Jude biochemist and a structural
biologist recently reported progress
in efforts to design a new ‘off’ switch for
a developmentally important signaling
pathway that can also drive certain cancers,
including the pediatric brain tumor
medulloblastoma.
Their work focused on a signaling
protein called smoothened. Smoothened
sits on the cell surface and, given the right
stimulus, can switch on the hedgehog
pathway. The pathway controls a variety
of cell functions and is essential for early
growth and development. Inappropriately
activated later in life, however, the
hedgehog pathway can lead to cancer.
Smoothened is already targeted
by the drug vismodegib for treatment
of advanced basal cell carcinoma, the
most common skin cancer. The efficacy
of vismodegib is also being studied in
a Phase II clinical trial for treatment of
certain medulloblastoma patients. Amar Gajjar, MD, Oncology, is principal
investigator of that national study.
The latest research details how
another drug cripples the pathway
by targeting a different part of the
smoothened protein.
Stacey Ogden, PhD, Biochemistry,
and Jie Zheng, PhD, Structural
Biology, directed the work, which was
published recently in the journal Nature
Communications. The results close an
important gap in determining the structure
of smoothened. The findings also led
investigators to propose a new model of
how smoothened regulates the hedgehog
pathway.
“We have identified a new direction
for drug development against the
hedgehog pathway,” Zheng said. That is
important because some tumors develop
resistance to vismodegib.
The scientists used a technology
called nuclear magnetic resonance to
determine the structure of a part of the
smoothened protein called the cysteine
rich domain (CRD). The CRD extends
outside the cell surface and is required for
smoothened to function normally. Until
now, however, the CRD’s structure was
unknown.
“Understanding how a protein works
is often hard without a picture, and until
now we didn’t have the whole picture of
smoothened. This marks a significant step
in understanding how smoothened works,”
Ogden said.
Researchers showed that the anti-
inflammatory drug binds to both human and
fly CRDs. The fly is a widely used model of
hedgehog signaling in humans. In the fruit
fly Drosophila melanogaster, budesonide
was associated with as much as a 40
percent reduction in the activity of genes
regulated by the hedgehog pathway.
Investigators are now screening other
approved drugs for any that do an even
better job of silencing hedgehog signaling
by binding the CRD. “Knowing the
structure, we can also carry out structure-
based drug design to target smoothened,”
Zheng said. “That study is currently
underway.”
Added Ogden: “This could lead to new
options for patients who develop resistance
to the current smoothened inhibitor or the
possibility of combination therapies with
smoothened inhibitors in the future.”
Meanwhile, the search for the molecule
Researchers recently reported progress in efforts to design a new “off” switch for an important
signaling pathway that can drive certain cancers. Stacey Ogden, PhD, Biochemistry (at left), and
Jie Zheng, PhD, Structural Biology (at right), directed the work, which was published recently in
Nature Communications. Rajashree Rana, Structural Biology (center), is the study’s first author.
that normally binds with and activates the
smoothened CRD continues. Researchers
in this study propose this unknown
molecule serves as the bridge that brings
different parts of smoothened together,
altering the protein’s shape and serving
as the on switch for hedgehog signaling.
The study’s first author is Rajashree
Rana, Structural Biology. The other
authors are Ho-Jin Lee, PhD, Ju Bao, PhD, Grace Royappa, PhD, and
Cristina Guibao, all of Structural
Biology; Suresh Marada, PhD,
Biochemistry, and Candace Carroll, formerly of St. Jude.
continued on back cover
Switchcontinued from front cover
insider
insiderWednesday, March 26, 2014
St. Jude
A l s o i n t h i s i s s u e
A biweekly internal publication for St. Jude employees
6 Celebrating nurses
The hospital recognizes certified nurses.
2 On the Horizon
Pam Dotson, RN, discusses why hand-washing is important to patient care.
1 L.I.F.T. presentation
Swimmer Diana Nyad shares her story of inspiration and hope.
7 Grizzly visit Memphis Grizzly
Marc Gasol visits with patients and families.
Please recycle after reading.
insider is published for employees of St. Jude Chil-
dren’s Research Hospital biweekly by the Communications
department. Any use of these stories by other parties or for
other purposes requires authorization by hospital Communi-
cations. Email story ideas to insider@stjude.org, or contact
Mike O’Kelly, 595-4047. Submissions such as achieve-
ments, births, in memoriam and wedding announcements
are welcomed. Communications reserves the right to edit or
hold any submissions. If you prefer to obtain St. Jude In-
sider online, visit http://home.stjude.org/communications/
Pages/stjude-insider.aspx . To change the number of paper
copies your department receives, email insider@stjude.org.
Photography and design by the department of Biomedical
Communications. The mission of St. Jude is to advance
cures, and means of prevention, for pediatric catastrophic
diseases through research and treatment. St. Jude is an Equal
Opportunity Employer.
A possible new ‘off’ switch for a pathway that can lead to cancer
A St. Jude biochemist and a structural
biologist recently reported progress
in efforts to design a new ‘off’ switch for
a developmentally important signaling
pathway that can also drive certain cancers,
including the pediatric brain tumor
medulloblastoma.
Their work focused on a signaling
protein called smoothened. Smoothened
sits on the cell surface and, given the right
stimulus, can switch on the hedgehog
pathway. The pathway controls a variety
of cell functions and is essential for early
growth and development. Inappropriately
activated later in life, however, the
hedgehog pathway can lead to cancer.
Smoothened is already targeted
by the drug vismodegib for treatment
of advanced basal cell carcinoma, the
most common skin cancer. The efficacy
of vismodegib is also being studied in
a Phase II clinical trial for treatment of
certain medulloblastoma patients. Amar Gajjar, MD, Oncology, is principal
investigator of that national study.
The latest research details how
another drug cripples the pathway
by targeting a different part of the
smoothened protein.
Stacey Ogden, PhD, Biochemistry,
and Jie Zheng, PhD, Structural
Biology, directed the work, which was
published recently in the journal Nature
Communications. The results close an
important gap in determining the structure
of smoothened. The findings also led
investigators to propose a new model of
how smoothened regulates the hedgehog
pathway.
“We have identified a new direction
for drug development against the
hedgehog pathway,” Zheng said. That is
important because some tumors develop
resistance to vismodegib.
The scientists used a technology
called nuclear magnetic resonance to
determine the structure of a part of the
smoothened protein called the cysteine
rich domain (CRD). The CRD extends
outside the cell surface and is required for
smoothened to function normally. Until
now, however, the CRD’s structure was
unknown.
“Understanding how a protein works
is often hard without a picture, and until
now we didn’t have the whole picture of
smoothened. This marks a significant step
in understanding how smoothened works,”
Ogden said.
Researchers showed that the anti-
inflammatory drug binds to both human and
fly CRDs. The fly is a widely used model of
hedgehog signaling in humans. In the fruit
fly Drosophila melanogaster, budesonide
was associated with as much as a 40
percent reduction in the activity of genes
regulated by the hedgehog pathway.
Investigators are now screening other
approved drugs for any that do an even
better job of silencing hedgehog signaling
by binding the CRD. “Knowing the
structure, we can also carry out structure-
based drug design to target smoothened,”
Zheng said. “That study is currently
underway.”
Added Ogden: “This could lead to new
options for patients who develop resistance
to the current smoothened inhibitor or the
possibility of combination therapies with
smoothened inhibitors in the future.”
Meanwhile, the search for the molecule
Researchers recently reported progress in efforts to design a new “off” switch for an important
signaling pathway that can drive certain cancers. Stacey Ogden, PhD, Biochemistry (at left), and
Jie Zheng, PhD, Structural Biology (at right), directed the work, which was published recently in
Nature Communications. Rajashree Rana, Structural Biology (center), is the study’s first author.
that normally binds with and activates the
smoothened CRD continues. Researchers
in this study propose this unknown
molecule serves as the bridge that brings
different parts of smoothened together,
altering the protein’s shape and serving
as the on switch for hedgehog signaling.
The study’s first author is Rajashree
Rana, Structural Biology. The other
authors are Ho-Jin Lee, PhD, Ju Bao, PhD, Grace Royappa, PhD, and
Cristina Guibao, all of Structural
Biology; Suresh Marada, PhD,
Biochemistry, and Candace Carroll, formerly of St. Jude.
home.stjude.org/insider Wednesday, March 26, 2014 insider
1
L.I.F.T. presentation: Nyad shares story of inspirational swim from Cuba to Florida
World-class swimmer Diana Nyad shared her inspirational
story of persistence, age-defying feats and goal-setting with
employees March 6 as part of the L.I.F.T. (Learning. Inspiration. Focus.
Transformation.) presentation in the St. Jude Auditorium.
Nyad, 64, made history last September when she successfully swam
from Havana, Cuba, to Key West, Florida, becoming the first person ever
to do so without a shark cage. The 100-mile journey was rife with potential
obstacles—predatory sharks, deadly jellyfish, severe thunderstorms
and strong ocean currents that could push her off course if not carefully
calculated.
Her swim was not a solitary effort. Nyad credited a team of 44
experts—swimmers, physicians, oceanographers, marine biologists, sports
scientists and navigators—for helping her complete the 53-hour journey.
“We should never, ever give up. You are never too old to chase your
dreams,” Nyad told reporters just minutes after she reached the shores of
Key West.
Nyad had attempted the swim four previous times unsuccessfully,
beginning in 1978 at the age of 29. In her mid-20s, she was introduced to
the extreme sport of marathon swimming and traversed the waters of Lake
Ontario and the perimeter of the island of Manhattan.
After swimming competitively since age 7 and nearly qualifying for
the Olympics in 1968, Nyad retired from swimming at age 30. At the
time, she said she would never swim another stroke. Nyad then began a
successful career in sports journalism, working for ABC Sports, National
Public Radio and authoring three books.
But at age 60, she again set her sights on the swim from Cuba to
Florida. She came up short in two attempts in 2011 and once in 2012,
veering off course due to the powerful currents of the Gulf Stream.
After Nyad’s fourth attempt, members of the marathon swimming
community were declaring the swim impossible. They were joined in
this claim by sports scientists, sports psychologists and journalists. Even
members of Nyad’s team were unsure if she should pursue a fifth attempt.
“I was filled with trepidation, and it was going to be tough not to make
it again,” Nyad said. “I said, ‘I’d rather not make it again than to be at home
wondering if we ever would have made it.’ I wanted to be the bold one.”
Nyad, who is a contestant on the current season of Dancing with the
Stars, said since jumping back in the water at age 60, she now tries to
live each day to the fullest and revealed why she was so passionate about
marathon swimming and reaching her goals.
“It’s like a microcosm of life. You have lows, and you have highs,”
Nyad said. “You’ve got to believe that if you are in a low, that you have the
will to find your way through it.”
Diana Nyad speaks to St. Jude employees as part of the L.I.F.T. (Learning. Inspiration. Focus. Transformation.) presentation this month. Nyad discussed her early career
as an Olympic hopeful and how she became involved in marathon swimming. Last fall, Nyad became the first person to successfully swim from Cuba to Florida without
the aid of a shark cage.
insiderSt. Jude
Wednesday, March 26, 2014A biweekly internal publication for St. Jude employees
insider Wednesday, March 26, 2014 home.stjude.org/insider 2
with St. Jude Leadership — Pam Dotson, RNon the horizon
W e’ve all been taught the importance of washing our hands
since childhood, but do we understand how important
hand-washing really is, especially for the safety of our patients?
Consider this: The Centers for Disease Control and
Prevention (CDC) has estimated that roughly 1.7 million
hospital-associated infections cause or contribute to 99,000
deaths each year. That is a staggering number, and a frightening
risk to anyone who goes into a hospital for care. So what’s the
connection to hand-washing? The simple act of washing your
hands is the single most important step to preventing a hospital-associated
infection.
Our patients are at high risk for infection due to the nature of their
primary diseases. In addition, because they spend so much of their time
inside the hospital setting, whether outpatient or inpatient, they have an even
higher risk. We have to make sure we do all we can to protect our patients.
Hand contact is the most frequent and effective means for transmitting
organisms from one person to another.
To properly prevent transmission of diseases, employees should wash
their hands according to the guidelines below:
1. When beginning your work day.
2. When the hands are obviously soiled (soap and water only).
3. Immediately before and after contact with a patient.
4. When leaving an isolation area or after handling articles from an
isolation area.
5. Before wearing gloves and after removing gloves.
6. After personal use of the toilet (soap and water).
7. After blowing or wiping the nose.
8. Before handling or preparing food.
9. Before eating.
10. On completion of duty.
Do you wash your hands correctly? A recent Michigan State University
study revealed that only 5 percent of people studied washed their hands
correctly. The CDC recommends that you wash your hands vigorously with
soap for 15 to 20 seconds. On average, people washed their hands for about
six seconds. Shocking findings from the study showed that 33
percent of people did not use soap, and 10 percent did not wash
their hands at all.
Every St. Jude employee must take the proper precautions
to prevent exposing our patients to potentially life-threatening
infections. You may be reading this and thinking it doesn’t
apply to you because you don’t care directly for patients, but
here’s another fact to consider: 50 percent of foodborne illness
outbreaks are linked to lack of or improper hand-washing.
Many viruses and bacteria can live several hours on hard surfaces like
cafeteria tables, telephone receivers and computer keyboards. Listed below
are the suggested methods for washing your hands with soap and water and
with an alcohol-based gel. Preventing infection is important to all of us, and
hand-washing is the key. Please do it correctly and frequently.
When washing hands with soap and water:• Wet hands with water
• Apply enough soap necessary to cover all surfaces
• Vigorously perform rotational hand rubbing for at least 15 seconds on
both the palms and back of hand, interlace and interlock fingers to
cover all surfaces
• Rinse hands with water and dry thoroughly with a single-use towels
When using an alcohol-based hand gel:• Apply a dispensed amount of alcohol gel (5 grams)
• Spread thoroughly to cover all surfaces of the hands
• Rub hands until dry; do not dry with towels
Pam Dotson, RN
Senior Vice President and Chief Nursing Officer
Xinwei Cao, PhD,
Developmental
Neurobiology, is the
principal investigator
of a $1,914,065 grant
from the National
Institute of Neurological
Diseases and Stroke of
the National Institutes of
Health titled “Function
and Regulation of Hippo
Pathway Effectors
YAP/TAZ During Brain
Development.” The
grant is funded from
2014 to 2019.
Hongbo Chi, PhD,
Immunology, is the
principal investigator
of a $1,968,750 grant
from the National
Institute of Allergy and
Infectious Diseases of
the National Institutes of
Health titled “Metabolic
Checkpoint in TH17
Cell Differentiation.”
The grant is funded
from 2014 to 2019.
Wilson Clements,
PhD, Hematology, is the
principal investigator
of a $150,000 grant
from the March of
Dimes Birth Defects
Foundation titled “ID of
Novel Somite-derived
Hematopoietic Stem Cell
Specification Signals.”
The grant is funded
from 2014 to 2016.
Patricia Flynn, MD,
Infectious Diseases, is
the principal investigator
of a $3,247,748 grant
from the National
Institute of Allergy and
Infectious Diseases of
the National Institutes of
Health titled “HIV CURE
CTU.” The grant is funded
from 2013 to 2020.
Aditya Gaur, MD,
Infectious Diseases, is
the principal investigator
of a $141,174 grant from
Gilead Sciences Inc. titled
“Gilead GS 216-0128.”
The grant is funded
from 2013 to 2019.
Douglas Green, PhD,
Immunology chair, is the
principal investigator
of a $2,143,750, grant
from the National
Institute of Allergy and
Infectious Diseases of
the National Institutes
of Health titled “LC3-
Associated Phagocytosis
Resubmission.” The
grant is funded from
2013 to 2018.
Hans Haecker, MD, PhD,
Infectious Diseases, is
the principal investigator
of a $300,000 grant
from the Lupus Research
Institute titled “Innate
Immune Mechanisms
Controlling Inflammation
in Systemic Lupus
Erythematosus.” The
grant is funded from
2014 to 2017.
Scott Howard, MD,
International Outreach, is
the principal investigator
of a $250,000 grant
from World Child Cancer
titled “Alliance for
Outcome Evaluation
in Central America.”
The grant is funded
from 2013 to 2018.
Hiroto Inaba, MD,
PhD, Oncology, is the
principal investigator
of a $100,000 grant
from Cookies for Kids’
Cancer titled “Genetic
Characterization and
Therapeutic Targeting
of Pediatric MPAL.”
The grant is funded
from 2014 to 2015.
Wanda Layman,
PhD, Developmental
Neurobiology, is the
principal investigator of
a $161,802 grant from
the National Institute
on Deafness and
Other Communication
Disorders of the National
Institutes of Health titled
“Epigenetic Regulation
in the Postnatal
Mammalian Inner Ear.”
The grant is funded
from 2014 to 2016.
Wing-Hang Leung,
MD, PhD, Bone Marrow
Transplantation and
Cellular Therapy chair, is
the principal investigator
of a $450,000 grant
from the Cure Childhood
Cancer Foundation
titled “Hematopoietic
Cell Trans and NK Cell
Therapy Neuroblastoma.”
The grant is funded
from 2014 to 2016.
Charles Mullighan,
MBBS (Hons), MSc,
MD, Pathology, is the
principal investigator
of a $2.1 million grant
from the National
Cancer Institute of the
National Institutes of
Health titled “Verification,
Validation and Discovery
of Findings in TARGET’s
Acute Lymphoblastic
Leukemia.” The
grant is funded from
2013 to 2014.
Peter Murray, PhD,
Infectious Diseases, is
the principal investigator
of a $100,000 grant
from Alex’s Lemonade
Stand Foundation
titled “Inflammatory
Signaling in the Tumor
Microenvironment.”
The grant is funded
from 2013 to 2014.
Ching-Hon Pui, MD,
Oncology chair, is the
principal investigator
of a $188,912 grant
from Give2Asia titled
“St. Jude IOP China
Program.” The grant is
funded through 2014.
Mary Relling, PharmD,
Pharmaceutical Sciences
chair, is the principal
investigator of an
$863,936 grant from
the National Cancer
Institute of the National
Institutes of Health
titled “Comprehensive
Approach to Improve
Medication Adherence
in Pediatric Leukemia.”
The grant is funded
from 2014 to 2018.
Jian Zuo, PhD,
Developmental
Neurobiology, is the
principal investigator of
a $100,260 grant from
Quark Pharmaceuticals
titled “Notch shRNAs
in Hearing Restoration
in Mice.” The grant is
funded through 2014.
Major new grant awardsThe following major new grants were awarded to St. Jude between December 1, 2013, and February 28, 2014.
home.stjude.org/insider Wednesday, March 26, 2014 insider
3
Research Matters…The importance of communication and documentation in research
Communication between
investigators and research participants
is essential to ensure participant
understanding of the risks and potential
benefits of the research, to distinguish
standard of care procedures and
treatments from those that are for
research purposes only, and to prevent
misunderstandings regarding the
intent of the research. Communication
failures and lack of teamwork are
common causes of medical mishaps and
inadvertent patient harm.
Everyone has heard these
statements: “If it isn’t written, it doesn’t
exist,” and “If it isn’t documented,
it didn’t happen.” These statements
also apply to research conduct.
Documentation is necessary to protect
the research participant, the integrity of
the research data and the researchers.
Effective communication, teamwork
and accurate documentation support the
fundamental principle of protecting the
subject’s rights, safety and well-being.
Documentation is necessary to meet
both legal and regulatory requirements,
to show and prove what work has been
done, to show what activities have
occurred, what information has been
shared or discussed, and what decisions
have been made. Documentation is
essential to recreate the history and
events of the patient while participating
in the research and when re-visiting the
research activity. The best proactive
step against a professional negligence
claim is thorough, precise and timely
documentation.
Key attributes for good
documentation were first described
by the Food and Drug Administration
(FDA) in the form of ALCOA-
attributable, legible, contemporaneous,
original and accurate. These are
also adapted by the World Health
Organization.
The second most commonly cited
deficiency in FDA inspections of
clinical investigator sites is inadequate/
inaccurate case histories as defined
in FDA 21 CFR 312.62(b) (b) and
FDA 21 CFR 812.140(a)(3). There are
many methods for documentation, as
no one size fits all. However, there are
basic elements, which are described
in “Guidance for Industry E6 Good
Clinical Practice: Consolidated
Guidance” located fda.gov/downloads/
Drugs/Guidances/ucm073122.pdf.
This information is provided as part
of the hospital’s efforts to continually
enhance the protection of research
participants and to assist researchers
in conducting and documenting their
research to the highest standards.
New SOP info for “Unblinding St. Jude Initiated Trials”
The new Central Protocol and Data
Monitoring Office (CPDMO) Standard
Operating Procedure can be found on
the CTA Policies and Procedures/SOPs
page at home.stjude.org/clinical-trials-
administration/Policies/sop-36.pdf.
New process map for Limited English Proficiency procedures
There is a new process map
detailing the procedures for consenting
Limited English Proficiency parents
and participants to research or clinical
procedures. The map is available
at home.stjude.org/clinical-trials-
administration/Documents/guidance-
obtaining-documenting-lep-consent.pdf.
The research portion of the process
map will be provided to study teams
when they request a short-form consent
through CPDMO.
Revised policy posted The revision for policy 30.004
“Procedure for Single Patient Expanded
Access Use of an Investigational
Drug/Biologic or Unapproved Device
(Including Emergency Use)” has been
posted to the intranet’s policy and
procedures page.
CITI certification completion reports
Did you know? Collaborative
Institutional Training Initiative Human
Subject’s Protection training completion
reports can be printed off at any time by
registered users.
To print a completion report, log
in to citiprogram.org and you will be
directed to your Main Menu page.
Select “PRINT REPORT” located
to the side of each completed course in
the menu grid. For more information,
email the Office of Clinical Research
Education at CREOFFICE@stjude.org
or call 595-4773 or 595-3938.
Upcoming SoCRA examThe spring examination for the
Society of Clinical Research Associates
is scheduled for Friday, May 16.
Researchers discover immune signature that predicts poor outcome in influenza patients
St. Jude scientists have identified
a signature immune response that
might help doctors identify which
newly diagnosed influenza patients
are most likely to develop severe
symptoms and suffer poor outcomes.
The findings also help explain why
infants and toddlers are at elevated risk
for flu complications. The research was
published recently in the American
Journal of Respiratory and Critical
Care Medicine.
The discovery came after
investigators tracked flu infections
for 28 days in 84 individuals with
community-acquired influenza. This
report focused on the 2009–2010 and
2010–2011 flu seasons. Participants
were recruited by collaborators at
Le Bonheur Children’s Medical Center.
Researchers found that patients
with elevated levels of three particular
immune system regulators, or cytokines,
early in the infection were more likely
to develop severe flu symptoms and to
be hospitalized than patients with lower
levels of the same regulators. Study
participants ranged in age from 3 weeks
to 71 years old.
The cytokine levels early in
the infection predicted flu-related
complications regardless of patient
age, flu strain, the ability of the virus to
replicate or other factors. The cytokines
involved—MCP-3, interferon alpha 2
and interleukin 10—help to regulate
inflammation driven by the innate
immune response. The innate immune
system serves as the frontline of the
body’s defense against flu.
“Patients in this study could
handle the flu virus and clear it from
their lungs in a week to 10 days. The
problem for patients with this immune
signature is likely the inflammatory
environment in their airways created by
the innate immune system in response
to the virus,” said corresponding author
Paul Thomas, PhD, Immunology.
“Clinically, we need to explore targeted
therapies to address this problem
separately from efforts to clear the
virus.”
Flu remains a leading cause of
illness and death worldwide. Nineteen
patients in this study were hospitalized,
including four who were admitted to an
intensive care unit.
For this study, researchers tracked
both the flu infection and the resulting
immune response through blood, nasal
swabs and nasal wash samples collected
from patients with laboratory-confirmed
flu. Along with measuring levels
of flu virus in the nose and sinuses,
researchers measured 42 cytokines
and antibodies against circulating
flu viruses. Similar sampling was
conducted on 126 volunteers recruited
from the households of flu patients.
The testing showed children
and adults were equally successful
at eliminating the virus regardless of
the subtype. “Previous studies using
different measures reported that
children mounted a weaker immune
response,” said first author Christine
Oshansky, PhD, a St. Jude postdoctoral
fellow. In this study, the hyperactive
immune response diminished with age,
but Thomas said it may help explain
why toddlers and infants are more likely
to develop severe flu symptoms.
The other St. Jude authors are
Sook-San Wong, PhD, Trushar Jeevan, Miguela Caniza, MD, and
Richard Webby, PhD, all of Infectious
Diseases, and David Wang, formerly of
St. Jude.
Christine Oshansky, PhD
Immunology
Paul Thomas, PhD
Immunology
insider Wednesday, March 26, 2014 home.stjude.org/insider 4
The 17th annual Bettye Arnold Seminar will provide ways for
employees to keep their cool in difficult situations and how to address issues
with creative solutions.
Offered by the Patient Care Services Professional Excellence Council,
the half-day seminar is scheduled for Tuesday, April 1, in the St. Jude
Auditorium, and will feature author and humorist Christine Cashen speaking
on the topic “Why Can’t Everyone Just Get Along?”
Cashen is the author of The Good Stuff: Quips and Tips on Life, Love,
Work and Happiness, which was named motivational book of the year by the
Next Generation Indie Book Awards.
The seminar is targeted at staff members who have direct patient care,
but all employees are welcome to register for either the morning or afternoon
session. The cost is $20 for students and St. Jude and affiliate employees and
$40 for others.
To learn more about the event or to register, visit www.stjude.org/
bettyearnold, or contact Michael Hans, RN, Nursing Education, 595-5283.
Find out more about St. Jude Toastmasters
The St. Jude Toastmasters Club is open to all St. Jude, Children’s
GMP, LLC, and ALSAC employees who are looking to improve their
public speaking and leadership skills.
The club offers staff members an opportunity to become exposed to
public speaking in a warm, friendly and nurturing environment as they
develop and improve their communication skills in front of an audience.
The Toastmaster journey is traveled on your own path, at your own
speed—regardless of your current public speaking skills. Fellowship and
friendships grow out of the weekly meetings, which are held
each Thursday at 11 a.m. in the IRC, Room E-1004.
For more information on the St. Jude Toastmasters Club,
visit their next meeting or contact Maricarmen Windisch,
Professional Services Office, 595-4202.
The first ether anesthetic for surgery was administered March 30, 1842, by Crawford Long, MD, of Jefferson, Georgia. Long delivered the anesthesia and then operated to remove a tumor from a patient’s neck. Later, the patient said that he felt nothing during the surgery and wasn’t aware the surgery was over until he awoke.
That date, March 30, is now celebrated each year as Doctors’ Day. The first observance of Doctors’ Day was March 30, 1933, in Winder, Georgia, when Eudora Almond, the wife of physician Charles Almond, decided to
Celebrate Doctors’ Day with a cool treat
More about Bettye Arnold
The Bettye Arnold Nursing Seminar is an annual educational event open to all hospital employees. Each year an outside speaker is invited to do a presentation that is timely and meaningful for everyone.
Bettye Arnold was a registered nurse at St. Jude for 30 years. She practiced in a variety of RN roles, and she was honored in 1991 as Employee of the Year. Arnold died in July 1994.
During her tenure at St. Jude, Arnold was continually impressed by the family involvement, as parents were actively involved with their children’s care. Arnold once learned from a young patient that “you don’t have to live a long life to live life to its fullest.” Arnold served in several roles in both ambulatory and inpatient care areas. Her last role was as a clinical research nurse coordinator.
Regardless of the department she served in, Arnold’s colleagues always praised her selflessness, dependability, caring attitude and professionalism.
Upcoming Bettye Arnold Seminar focuses on keeping your cool
set aside a day to honor doctors. This first observance included the mailing of greeting cards and placing flowers on graves of deceased doctors.
A resolution commemorating Doctors’ Day was adopted March 30, 1958, by the United States House of Representatives. In 1990, legislation was introduced in the House and Senate to establish a national Doctors’ Day. Following overwhelming approval by the Senate and the House, on October 30, 1990, President George Bush signed S.J. RES. No. 366 (which became Public Law 101-473) designating March 30, 1991, as the first National Doctors’ Day.
Employees are invited to attend an ice cream party during this year’s Doctors’ Day celebration Thursday, March 27, from 2 to 4 p.m. in front of Kay Kafe. Stop by the event any time for a cool treat as the hospital shows its appreciation for the work done by St. Jude physicians.
Did you know?
It pays to work with Technology Licensing
Did you know that disclosing your new ideas to the Office of
Technology Licensing (OTL) can pay off for you as well as St. Jude?
To encourage disclosure and comply with federal regulations,
St. Jude shares about one-third of the net license income generated
from inventions made here with individual inventors. Last year the
inventors’ portion of license income totaled more than $1 million
shared among 75 individuals. The remaining license income retained
by St. Jude is used to further the research mission.
While there is no guarantee that your idea will be pursued and
developed into a successful product, the only way to know is to contact
the OTL. Any employee can fill out and submit the disclosure form on
the OTL intranet site at home.stjude.org/ technology-licensing/Pages/
forms.aspx to have an idea considered for patenting and licensing.
OTL can also meet with you if you are unsure the idea qualifies as an
invention or if you need help with the form.
If you are interested in learning about some of the past inventions
that have been developed into products and contributed to the
institution’s licensing success, click the “Success Stories” link at
stjude.org/technology-licensing. These stories may help you envision
what is possible when you work with the OTL to turn your idea into a
product that can benefit the public and perhaps St. Jude patients.
home.stjude.org/insider Wednesday, March 26, 2014 insider
5
All nurses and nursing staff members may nominate a nursing staff colleague for the 2014 Nursing Peer Excellence Awards. The awards recognize outstanding nurses, nursing care assistants, patient care associates, patient representatives and utility aids for their contributions to the hospital, their colleagues and to patients and families. With nurses working in a variety of areas at St. Jude, keep in mind that anyone with an RN or LPN degree is eligible for nomination.
The awards will be presented during Nursing Care Team Week, May 10 through 16. Nominees will also be considered for the 2015 edition of the Memphis area’s annual Celebrate Nursing Awards, at the nominator’s discretion.
To nominate a nursing staff colleague, complete the form provided in St. Jude Today by Friday, March 28, at 5 p.m. For more information, contact Angela Alexander, 595-3531.
Getting social with SharePoint 2013Have you tried the new social
features of SharePoint 2013 yet, or
are you a little intimidated by those
hashtags (#), at symbols (@) and
followers? These new social tools can
help you collaborate and connect to
enhance your productivity.
If you’re unsure of where to
get started or maybe a little timid,
Information Sciences recommends
that you first visit the SharePoint 2013
Help Center located on the St. Jude
Intranet. A link to the Help Center is
provided in the footer on every page of
the intranet.
There you’ll learn where to get
started through the enhanced My
Site social capabilities: Newsfeed,
SkyDrive, Sites, About Me, Blog,
Apps and Tasks. When you click any
of these links for the first time, you
will be prompted to “Get the most out
of SharePoint” by getting social. Click
OK, and within a few minutes, your
My Site will be ready to use.
For information on the proper way
to use social media at St. Jude, read
the Social Media policy located under
Institutional Policies on the intranet.
SITESThe Sites tab lets you see all the
sites you currently follow and also
suggests sites you may be interested in
following. Sites you can follow include
specific sites on the intranet or in
Workspaces. Think of these as personal
bookmarks for sites that you work with
or visit the most. You can start or stop
following a site at any time.
FOLLOWKeep tabs on important
Workspaces documents, view updates
to a project you are working on,
or track the activities of your team
members all using the Follow feature.
You will receive these updates in your
Newsfeed.
NEWSFEEDNewsfeed serves as a central
location for updates about all of the
people, sites, documents, hashtags and
conversations you are following.
#TAGWhen posting to a Newsfeed,
add #Tags to your posts both to make
them easier to locate in the future,
and to ensure they are seen by others
searching for or following that tag.
(Example: #SharepointTip)
BLOGEveryone has the ability to create
a Blog within their My Site area.
You can share thoughts, pictures,
videos and links to other sites from
your blog. You can edit or delete your
blog postings. Blog postings can be
categorized and archived.
People who are following your
blog have the ability to write a
comment, like or email a link to your
blog.
Everyone in the institution can see
your blog posting, but only those who
are following you will receive an email
alert when you create a new post.
SHAREDo you need to collaborate on a
document? Share allows you to give
someone permission to view or edit
a document that is stored in your
SkyDrive. Using the Share button, you
can enter names and email addresses
to issue invitations to other users at
St. Jude. You can include a personal
message along with the invitation.
Need to share documents,
calendars, tasks and conversations with
a group?
Email sharepointadministrators@
stjude.org about having a SharePoint
site built for the team.
TASKSSee all your assignments in one
place with the Task roll-up on the
My Tasks screen. To get there, go to
your Newsfeed and click the Tasks
link on the left side of the page. If
you are assigned a task in any of your
Workspace sites, you can see the entire
combined list here.
You can mark tasks as Important
and Upcoming, view on a Timeline,
see which tasks are Active or
Completed, find a task using Search, or
add new tasks. Only you can see your
task roll-up.
SKYDRIVESkyDrive is your personal
document library. You can create,
upload and store files for private access
or share with others. Documents
remain private until you allow access
to others by using the Share function.
SkyDrive offers version control and
is best used for temporary storage of
documents that require collaboration
with others.
You can also sync documents
between SharePoint 2013 and your
local workstation. Work on your
document offline and then synchronize
when you are online again. The Sync
function only works on St. Jude-issued
Windows-based devices. For the best
Sync experience, call the Help Desk,
595-2000, for installation of the
SkyDrive Pro Client. SkyDrive Pro
Client provides quick access to your
synced documents through Windows
Explorer.
You and the people you have
shared with can see the documents you
have posted to SkyDrive.
CONVERSATIONSConversations include those
conversations you start from
your Newsfeed page, replies to
conversations you are following,
postings that contain #Tags you are
following or postings that mention you,
whether you are following the person
or not.
Everyone in the institution can
see postings from a conversation
you start. If you would like to be
able to have private conversations
with specific groups, email
sharepointadministrators@stjude.
org. Your Newsfeed is filtered to show
conversations from people you are
following.
LIKEYou can Like comments and reply
to comments in Conversations and
Blogs. You can Unlike at any time.
On your Newsfeed page, you can
click the ellipsis to the right of the
Mentions link, then select Likes to see
items you previously liked.
MENTIONIf you want to draw attention
to someone in your organization in
a Newsfeed post, you can mention
them by typing an @ symbol and
then picking a person’s name from
the People Directory. The person
mentioned and everyone who follows
you will see the mention.
SEARCHOn sites filled with data, updates
and documents, Search is your key to
finding information quickly. Whether
it’s a document or a link posted by a
colleague, Search helps you find it fast.
You can choose to search Everything,
People, Conversations, and This Site.
This Site includes the site you are
currently on and every sub-site below
it. You can also search the content on
your U:// drive.
See the Help Center for more
information and keep an eye on the
FAQs page for tips and tricks to
customize your SharePoint experience.
Want to learn more about the
many ways you can use SharePoint to
help your team work more efficiently?
Sign up for a SharePoint class in
LearnCenter.
Make a Peer Excellence Award nomination
insider Wednesday, March 26, 2014 home.stjude.org/insider 6
NEWS ROUNDUP
Celebrating certified nursesThe St. Jude Professional Excellence Council honored the work of certified
nurses at an event at the ABC Wall on Certified Nurses Day, March 19. Certified
nurses received treats and newly certified nurses received T-shirts. Pictured (from
left): patient schedulers Kristy Rodgers, MeLissa Clayton and Amy Wade, all
of Nursing Administration.
A musical dayALSAC recently hosted country musician and
actress Jana Kramer, who took a break from
her tour to visit with patients and families.
During the visit, Kramer played games,
participated in a puppet show and sang
songs. Pictured, Kramer shares a moment
with Bailey Parker.
Schwartz Center RoundsThe inaugural session of Schwartz Center
Rounds at St. Jude featured the topic
“What Keeps You Up at Night?” The rounds
program is a multidisciplinary forum where
caregivers gather to discuss emotional and
social issues that arise in caring for patients.
The forum’s panelists included (from left):
Guillermo Umbria, Interpreter Services; Ray
Morrison, MD, Critical Care chief; Valerie
Groben, Oncology; and Ross Goshorn, MD,
Oncology.
Joining the funMembers of the boy band Mindless Behavior visit with patients and siblings
at Target House. The band members performed their songs and were joined in
the fun by some of their fans. Pictured, Gabriel Toma (at right) performs with
Chresanto August, also known as Roc Royal (at left), and Jacob Emmanuel
Perez, also known as Princeton (center). ALSAC hosted the event.
home.stjude.org/insider Wednesday, March 26, 2014 insider
7
As you read the
St. Jude Insider, let us
know how we can help
tell your stories. Forward
your feedback, comments
or questions to
insider@stjude.org.
Please recycle after reading.
insiderMonday, January 23, 2012
St. Jude
A l s o i n t h i s i s s u e
2 On the Horizon Mike Canarios writes
about the roll-out of a new online effort
reporting system.
3 Great Places to Work
St. Jude again makes
the list of FORTUNE’s
Top 100 Companies to
Work For.
A biweekly internal publication for St. Jude employees
insider is a publication intended for employees of
St. Jude Children’s Research Hospital. It is published bi-
weekly by the Communications department. Any use of
these stories by other parties or for other purposes requires
authorization by hospital Communications. E-mail story ideas
to insider@stjude.org, or contact Mike O’Kelly, 595-4047.
Submissions such as achievements, births, in memoriam and
wedding announcements are welcomed. Communications re-
serves the right to edit or hold any submissions. If you prefer
to obtain St. Jude Insider online, visit http://home.web.stjude.
org/pr/stjudeinsider.shtml. To change the number of paper
copies your department receives, e-mail insider@stjude.org.
Photography and design by the department of Biomedical
Communications. The mission of St. Jude is to advance cures,
and means of prevention, for pediatric catastrophic diseases
through research and treatment. St. Jude is an Equal Oppor-
tunity Employer. cont’d on back cover
cont’d on page 3
1 Honoring Danny Thomas
Founder Danny
Thomas is honored with postage stamp,
birthday celebrations.
The new studies include research on retinoblastoma, with Michael Dyer,
PhD, Developmental Neurobiology, as the
corresponding author, and a finding in early
T-cell precursor ALL that features Charles
Mullighan, MD, PhD, Pathology, as the
corresponding author.
Gene identified as new retinoblastoma target
“The dogma has been that once RB1
is mutated, the genome of the affected cell
becomes unstable and mutations quickly
develop in the pathways that are essential
for cancer progression,” said Michael
Dyer, PhD, Developmental Neurobiology.
When sequencing the complete
normal and cancer genomes of four
St. Jude patients with retinoblastoma,
researchers found that the tumors
contained very few alterations. The
human genome is the complete set of
instructions needed to assemble and
sustain an individual. The findings prompted Dyer to
integrate the whole-genome sequencing
results with additional tests that looked at
differences in the patterns of gene activity
in tumor and normal tissue. “To our surprise and excitement,
what we found was that instead of cancer
genes having genetic mutations, they were
being epigenetically regulated differently
than normal cells,” Dyer said.
The affected genes included SYK.
When researchers checked SYK protein
levels in normal and retinoblastoma
tissue, they found high levels of the
protein just in tumor samples.
Drugs targeting the SYK protein are
already in clinical trials in adults with
other diseases. This study suggests one
of the drugs might be effective against
retinoblastoma. Researchers are working
Project sheds new light on ETP-ALLR esearchers have discovered that a
subtype of leukemia characterized by
a poor prognosis is fueled by mutations in
pathways distinctly different from a seem-
ingly similar leukemia associated with a
much better outcome. The findings from
the St. Jude Children’s Research Hospital
– Washington University Pediatric Cancer
Genome Project (PCGP) highlight a
N ew findings from the St. Jude
Children’s Research Hospital –
Washington University Pediatric Cancer
Genome Project (PCGP) have helped
identify the mechanism that makes the
childhood eye tumor retinoblastoma so
aggressive. The discovery explains why the
tumor develops rapidly while other cancers
can take years or even decades to form.
The finding also led investigators to a
new treatment target and possible therapy
for the rare childhood tumor. The study
appeared in the January 11 advance online
edition of Nature.Researchers have known for decades
that loss of a tumor suppressor gene named
RB1 launches retinoblastoma during
fetal development. But other steps in the
rapid transformation from a normal to a
malignant tumor cell were unknown.
New evidence suggests that epigenetic
factors, including reversible chemical
changes that influence how genes are
switched on and off, are altered when RB1
is mutated.
Pediatric Cancer Genome Project
studies provide new insights
Pediatric Cancer Genomecont’d from front cover
Gene ident i f ied
Michael Dyer, PhD,Developmental Neurobiology
toward a Phase I trial of one drug in
retinoblastoma patients.The first authors are Jinghui Zhang,
PhD, Computational Biology; Claudia
Benavente, PhD, Justina McEvoy,
PhD, and Jacqueline Flores-Otero,
PhD, all postdoctoral fellows in Dyer’s
laboratory. The corresponding authors are
Dyer, James Downing, MD, scientific
director, and Richard Wilson, PhD,
Washington University in St. Louis.
The other authors are Xiang Chen, PhD,
Gang Wu, PhD, and Michael Rusch,
all of Computational Biology; Matthew
Wilson, MD, adjunct St. Jude faculty;
Jianmin Wang, PhD, Jing Ma, PhD,
David Zhao, Suraj Mukatira, PhD,
and Pankaj Gupta, all of Information
Sciences; Rachel Brennan, MD,
Oncology; John Easton, PhD, Pediatric
Cancer Genome Project; Sheila
Shurtleff, PhD, Charles Mullighan,
MD, PhD, and Armita Bahrami, MD,
all of Pathology, Stanley Pounds,
PhD, Biostatistics; Geoff Neale, PhD,
Hartwell Center; Clayton Naeve, PhD,
chief information officer; David Ellison,
MD, PhD, Pathology chair; and Anatoly
Ulyanov, PhD, formerly of St. Jude.
6 Sweet music
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Have we heard from YOU?
AchievementsSt. Jude has received a rating of Full Accreditation from the Association for the
Accreditation of Human Research Protection Programs Inc. (AAHRPP).
Teddy Huerta, Rhodes College student in the laboratory of Stacey Schultz-Cherry, PhD, Infectious Diseases, received the American Society for Microbiology
(ASM) Capstone Award to present his research at the annual ASM meeting in
Boston in May. His presentation is titled “The H5 Hemagglutinin Protein Confers
the Ability of Highly Pathogenic H5N1 Influenza Viruses to Replicate Productively
in Macrophages.”
The Memphis Academy of Nutrition and Dietetics selected Karen Smith,
Clinical Nutrition, as the Outstanding Dietetic Educator for the Memphis Academy
of Nutrition and Dietetics for 2014. In addition, Jennifer Presson, Food Services,
was named the Outstanding Dietetic Technician and student Perrin Tamblin,
Clinical Nutrition, was named Tennessee’s Outstanding Dietetic Graduate Student.
Ranjit Thirumaran, PhD, Pharmaceutical Sciences, was one of five finalists
in the professional category for the NRI (Non-Resident of India) of the Year
from the United States. The award is for achievers who have made their mark
internationally.
Welcome St. Jude baby
Congratulations to Jennifer Pauley, PharmD, Pharmacy, and Shawn Beyer
on the birth of their son, Hudson Andrew, March 7.
e-St. Jude Insider poll question results
Do you count calories throughout the day?
I never do. I don’t think twice about counting calories.
41.8%I have a general idea of how many calories I take in daily.
26.9%I monitor my calories from time to time.
22.3%I keep track of the calories in everything I eat.
9%
Hoop DreamsMemphis Grizzlies center Marc Gasol (pictured
with patients) visits St. Jude this month to
celebrate the success of Hoops for St. Jude
Week. During the visit coordinated by ALSAC,
Gasol visited with patients and families in the
Kay Kafe and then helped distribute popcorn
to employees and family members at a special
celebratory party at the ABC Wall. Each year,
the NBA dedicates a week to the hospital,
encouraging fans and players to get involved
in helping save the lives of children with cancer
and other life-threatening diseases.
Recommended