K Scholar, Alexandra Sims, MD, MPH, FAAP in the Division of General and Community Pediatrics, Cincinnati Children’s Hospital was recently named one of the National Minority Quality Forum’s (NMQF) 2022 40 Under 40 Leaders in Minority Health. These young leaders are working to eliminate health inequities and improve outcomes across the country and are considered to be leading the charge to better patient outcomes and building sustainable healthy communities.

Dr. Arun Jose (photo courtesy of University of Cincinnati College of Medicine)

CCTST K Scholar, Arun Jose, MD, MS, Director of Pulmonary Hypertension, Cincinnati VA Medical Center, Assistant Professor, University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, published an article on a pilot study focusing on unique gut microbiota in pulmonary arterial hypertension (PAH) in the Journal of Pulmonary Circulation on February 11, 2022.

Pulmonary Arterial Hypertension (PAH) is a progressive, ultimately fatal cardiopulmonary disease associated with a number of physiologic changes, which is believed to result in imbalances in the intestinal microbiota. To date, comprehensive investigational analysis of the intestinal microbiota in human subjects is still limited. To address this, Dr. Jose and his team performed a pilot study of the intestinal microbiome in 20 PAH and 20 non-PAH healthy control subjects, recruited from a single center, with each PAH subject recruited simultaneously with a cohabitating non-PAH control subject. Shotgun metagenomic sequencing was used to analyze the microbiome profiles. There were no differences between PAH and non-PAH subjects across several measures of microbial abundance and diversity (Alpha Diversity, Beta Diversity, F/B ratio). The relative abundance of Lachnospiraceae bacterium GAM79 was lower in PAH stool samples as compared to non-PAH control subject’ stool. There was no strong or reproducible association between PAH disease severity and global microbial abundance, but several bacterial species (a relative abundance of Anaerostipes Rhamnosivorans and a relative deficiency of Amedibacterium Intestinale, Ruminococcus bicirculans, and Ruminococcus albus species were associated with disease severity (most proximal right heart catheterization hemodynamics and six minute walk test distance) in PAH subjects. Our results support further investigation into the presence, significance, and potential physiologic effects of a PAH-specific intestinal microbiome.

Publication link: A unique gut microbiota signature in pulmonary arterial hypertension (PAH): a pilot study - Jose - - Pulmonary Circulation - Wiley Online Library

Dr. Shuchi Gulati (photo courtesy of University of Cincinnati College of Medicine)

K Scholar, Shuchi Gulati, MD, Division of Hematology and Oncology at the University of Cincinnati will be presenting her research as a poster and an oral presentation at the upcoming American Society of Clinical Oncology (ASCO)’s Genitourinary Cancers Symposium in San Francisco, in February 2022. The poster entitled “Complimentary transcriptomic-metallomic analysis identifies risk of relapse for clear-cell renal cell carcinoma (ccRCC) patients” highlights the work she has done over the last year as a KL2 scholar, where her team identifies transcriptomic signatures and complimentary metallomic biomarkers to identify patients at risk of relapse after surgery. This work will expand further into identifying a biomarker of poor prognosis in kidney cancer, a space where biomarkers are currently non-existent; thus further lending opportunities to identify therapeutic targets as a next step.

In addition, as part of the Precision Oncology Alliance within CARIS Life Sciences, Dr. Gulati’s team will be presenting an oral presentation entitled “Molecular alterations across sites of metastasis in patients with renal cell carcinoma (RCC)”. This work is based on identifying unique transcriptomic and genomic signatures at various sites of metastasis in kidney cancer. She is one of the lead authors on this abstract and through this work will continue her effort to identify biomarkers in kidney cancer, the focus of her KL2 work.

Dr. Arun Jose (photo courtesy of University of Cincinnati College of Medicine)

CCTST K Scholar, Arun Jose, MD, MS, Director of Pulmonary Hypertension, Cincinnati VA Medical Center, Assistant Professor, University of Cincinnati Division of Pulmonary, Critical Care, and Sleep Medicine, published review article on the management of Portopulmonary Hypertension in the Journal of Liver Transplantation on January 19, 2022.

Dr. Jose explains that portopulmonary Hypertension (PoPH) is a rare type of disease affecting the blood vessels connecting the heart to the lungs, that occurs exclusively in people with underlying liver disease. Until recently, much was unclear regarding the best treatment options for these high-risk patients, how PoPH is related to other pulmonary vascular diseases unique to liver disease, and how liver transplantation affects PoPH. This timely review article addresses several of these questions, incorporating recently published scientific research to provide a comprehensive update on the current management of this complex, multi-organ disease.

To read the publication, click here.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

Dr. Silvi Shah (photo courtesy of University of Cincinnati College of Medicine)

Women who receive a kidney transplant have low rates of contraceptive use, according to new research from the College of Medicine. The study, published in the Journal of Nephrology, finds an overall contraceptive use rate of 9.5% among women with kidney transplant in the United States.

“Although kidney failure adversely impacts fertility, there is a return of reproductive function following a kidney transplant, and conception is common. History of kidney transplant increases the risk of adverse pregnancy outcomes, including pre-eclampsia, gestational hypertension, low birth weight babies and preterm births,” says Silvi Shah, MD, associate professor in the Division of Nephrology and Hypertension, Department of Internal Medicine, and lead author of the study. “Unplanned pregnancies occur in women with kidney transplant. It is of paramount importance that pregnancies in this high-risk population are planned and underlines the importance of counseling women about family planning and the impact of pregnancy on kidney transplant, and the impact of kidney transplant on maternal and fetal outcomes.”

The study evaluated 13,150 women of childbearing age for each calendar year women with kidney transplantation between Jan. 1, 2005 and Dec. 31, 2013, who were aged 15 to 44 years with Medicare as the primary payer and linked data from the United Network for Organ Sharing, for up to three entire years after the date of transplantation. Overall, the rate of contraceptive use was 9.5%. The mean age at study entry was 29±7 years for women with any contraceptive use. The contraceptive use was highest among women aged 15 to 24 years (14.6%) and lowest among women aged 40 to 44 years (4.1%). The study showed that younger age, Native American and black race/ethnicity, and glomerular filtration rate < 60 ml/min/1.73 m2 were associated with a higher likelihood of contraceptive use and second- and third-year post-transplant were associated with a lower likelihood of contraceptive use. Interestingly, the socioeconomic status and donor type did not impact the likelihood of contraceptive use. 

Shah says the study is unique in that it addresses a comprehensive group of all women with a history of kidney transplants of all racial and ethnic groups in the United States to better understand the incidence of contraceptive use and factors associated with it. The study further took into account patients with complete Medicare coverage, thus avoiding the potential shortfalls of registries dependent on voluntary reporting or patient recall. This study shows for the first time that contraceptive rates in women with kidney transplant remain low in the United States. 

“We were not able to account for use of natural methods or use of condoms by men in our study, which remains a limitation. However, our results highlight that contraceptive use among women with kidney transplants is low,” says Shah. “The low rate of contraceptive use among women with kidney transplants may be attributed to lack of awareness about return of fertility and inadequate counseling regarding contraception to prevent unplanned pregnancies. Therefore, we need to include contraceptive counselling for women with kidney transplants in routine clinical care. Additionally, the present study emphasizes the importance of formulating policies that promote awareness of reproductive health and contraception among women with kidney transplants.”

Assisting her in the research were Annette Christianson, research associate, Department of Environmental Health, Shalini Bumb, MD, assistant professor, Division of Nephrology and Hypertension, and Prasoon Verma, MD, assistant professor, Department of Pediatrics. Shah is supported by the National Institutes of Health K23 career development award, under award number 1K23HL151816-01A1 and intramural funds.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

Dr. Arun Jose (photo courtesy of University of Cincinnati College of Medicine)

K Scholar Arun Jose, MD, MS, in the Division of Pulmonary, Critical Care and Sleep Medicine at the University of Cincinnati recently had an article accepted in Respiratory Medicine titled "Predictors of outcomes following liver transplant in hepatopulmonary syndrome: An OPTN database analysis". Hepatopulmonary Syndrome (HPS) is a type of lung disease affecting those with underlying liver disease, and can increase the risks associated with liver transplantation. His team studied national transplant records from the UNOS/OPTN database, clarifying the relationship between HPS disease severity and outcomes following liver transplant. This work will help identify high-risk HPS patients who may require additional resources to successfully undergo lifesaving liver transplantation, and sheds further light on the relationship between lung disease and liver disease, the focus of Dr. Jose's KL2 work.

Publication link: https://pubmed.ncbi.nlm.nih.gov/34784562/

CCTST K Scholar, Natalja Stanski, MD, Division of Critical Care Medicine at Cincinnati Children’s Hospital, was selected to be junior faculty at the Pediatric Acute Disease (Dialysis) Quality Initiative (pADQI) meeting held on November 11 – 14, 2021. This will be an international expert consensus meeting focused on drafting summary guidelines for pediatric AKI management and research. To learn more about the pADQI meeting, click here.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar Graduate, Moises Huaman, MD.

Moises Huaman, MD, associate professor in the Department of Internal Medicine, Division of Infectious Diseases, University of Cincinnati and 2020 KL2 Program Graduate, will be one of three researchers for a virtual panel discussion “A Conversation with Latinx Researchers,” from 2:00-3:00p.m. on Thursday, October 14, 2021.  Register for “A Conversation with Latinx Researchers”. 

The webinar will be hosted by the New Investigators Working Group and the Latinx Caucus of the Legacy Project in observance of the National Latinx HIV/AIDS Awareness Day (Oct. 15). Featuring Latinx researchers working in academia and conducting HIV research in the United States and Canada, participants will learn about the professional trajectory and career path of investigators from the United States, Venezuela and Peru.

In addition to Dr. Huaman, panelists include Brandon Brown, PhD, associate professor in the Department of Social Medicine, Population and Public Health, University of California, Riverside School of Medicine, and Amaya Perez-Brumer, PhD, assistant professor in the Division of Social and Behavioral Health Science, University of Toronto.

Dr. Huaman also serves as medical director for the Hamilton County Tuberculosis Control Program and has experience conducting tuberculosis and HIV studies locally and internationally. His research focuses on the interplay between tuberculosis, HIV and cardio-metabolic diseases. He is a former Scholar of the AIDS Clinical Trials Group (ACTG) Minority HIV Investigator Mentoring Program and CTSA KL2 Program.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar Graduate, Moises Huaman, MD.

Our KL2 Research Scholars Program recently published a manuscript on the development, implementation, and short-term outcomes of the KL2 Visiting Scholars Program that exists between the Clinical and Translational Science Award hubs at the University of Cincinnati, University of Kentucky, and the University of Indiana. 

The KL2 Visiting Scholars Program was developed to promote collaborative cross-CTSA training, leverage academic strengths at host CTSAs, and support the career development of participating scholars through experiential training and the development of new partnerships.  Since 2016, 12 scholars have completed the program, with 6 scheduled to complete it in 2021.  Post-visit surveys (n = 12) indicate that all scholars reported the program was valuable to career development, 11 reported benefit for research development, and 11 reported expansion of collaborative networks. Outcomes surveys (n = 11) revealed subsequent scholar interaction with host institution faculty for 10 scholars, 2 collaborative grant submissions (1 funded), 2 planned grant submissions, 1 published collaborative manuscript, and 3 planned manuscript/abstract submissions.  The Visiting Scholars Program is a cost- and time-efficient program that leverages the academic strengths of CTSAs. The program also enhanced KL2 scholar training by expanding their professional portfolio, promoting research development, and expanding collaborative networks. 

Reference: Journal of Clinical and Translational Science. 2020. 5(1):e67. Visiting Scholars Program to enhance career development among early-career KL2 investigators in Clinical and Translational Science: Implications from a quality improvement assessment. Sheri L Robb, Thomas H Kelly, Victoria L King, Jason T Blackard, Patricia C McGuire

Dr. Arun Jose (photo courtesy of University of Cincinnati College of Medicine)

CCTST KL2 Scholar, Arun Jose, MD, MS, Division of Pulmonary, Critical Care, Sleep Medicine, University of Cincinnati, recently published research on Portopulmonary hypertension (PoPH) from his KL2 Project in the journal, Liver Transplant.  (PoPH) is a type of cardiovascular disease that affects the blood vessels connecting the heart to the lungs in people with underlying liver disease, and can complicate a potentially lifesaving liver transplantation procedure. To investigate the association between PoPH and outcomes following transplantation, Dr. Jose and colleagues studied liver transplantation records from over 62,000 patients through the national United States UNOS/OPTN database. He found that the severity of PoPH predicted death after liver transplantation, at a much lower level than expected, and that PoPH was associated with an increased risk of graft failure following transplant. The new questions raised by this work regarding the complex interplay between PoPH disease severity and liver transplantation, and the underlying mechanisms and biomarkers that drive PoPH disease pathogenesis, are the current focus of Dr. Jose's KL2 work. 

Publication link: https://pubmed.ncbi.nlm.nih.gov/33964116/
Editorial by some experts in the field: https://pubmed.ncbi.nlm.nih.gov/34392597/

CCTST KL2 Research Scholars Career Development Program - Accepting Letters of Intent (LOI) July 1 - August 31, 2021

The objective of the KL2 Scholars Program is to successfully train diverse, multidisciplinary junior faculty members to:

• Conduct innovative, team-based, community-engaged clinical and translational research

• Develop sustainable careers in clinical and translational research

• Disseminate and implement research findings that improve health outcomes and reduce disparities

The KL2 program generally provides 75% salary support plus additional funds for research-related expenses for up to 2 consecutive years and during the award period, Scholars are expected to pursue their own K or similar individual career development awards, or R grants. For the RFA and additional details, click here.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Shuchi Gulati, MD.

Dr. Shuchi Gulati (photo courtesy of University of Cincinnati College of Medicine)

Shuchi Gulati, MD, assistant professor in the Department of Internal Medicine, Division of Hematology Oncology, has received the ASCO Career Development Award supported by the Conquer Cancer Foundation and the Brandon C. Gromada Head and Neck Cancer Foundation.

The three-year grant totaling $200,000 will fund Gulati’s study “Combining Anti-PD1 and Cesium-131 Intraoperative Brachytherapy with Salvage Surgery to Enhance Immunogenicity and Improve Local Control in Head and Neck Cancer.” This phase-1b/2 clinical trial will allow Gulati to capitalize on synergy between radiation therapy and immunotherapy to improve outcomes in patients with locally recurrent head and neck cancer and who have dismal prognosis when treated with surgery alone, which is the current standard of care.

The Career Development Award funds clinical investigators who have received their initial faculty appointment and are working to establish an independent, patient-focused, clinical cancer research program. Conquer Cancer, an affiliate organization to the American Society of Clinical Oncology, announced the awards May 28 at the 2021 ASCO Annual Meeting.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

Dr. Silvi Shah (photo courtesy of University of Cincinnati College of Medicine)

Silvi Shah, MD, an assistant professor in the Department of Internal Medicine, Division of Nephrology and Hypertension, has been awarded a K23 National Institutes of Health (NIH) career development grant.

The grant, “Sex Disparities in Cardiovascular Disease and Optimal Coronary Revascularization in Dialysis Patients,” will fund research allowing her to examine the sex differences in ischemic and non-ischemic cardiovascular events, coronary revascularization strategies and clinical outcomes in dialysis patients.

Shah is a clinician-scientist with expertise in clinical outcome research. Her research program focus lies at the intersection of women’s health, cardiovascular health and kidney disease. She has been a recipient of a Center for Clinical and Translational Science Training KL2 award.

Shah leads the American Society of Nephrology’s Women’s Health and Research in Nephrology community and is an executive member of the American Society of Transplantation’s Women’s Health Community of Practice. Shah is an associate editor for the journal Advances in Chronic Kidney Disease and is a peer reviewer for the American Journal of Kidney Disease and the Annals of Internal Medicine. She is a committee member of the American Heart Association’s Kidney in Cardiovascular Disease Committee and a fellow of the American Society of Nephrology, the American Society of Transplantation, the National Kidney Foundation and the American College of Physicians.

Moises Huaman, MD, MSc, Assistant Professor, Department of Internal Medicine, University of Cincinnati and 2020 CCTST KL2 Career Development Program Graduate, is first author on the recent publication, Latent Tuberculosis Infection and Subclinical Coronary Atherosclerosis in Peru and Uganda, published in Clinical Infectious Diseases.

The paper’s summary explains that the authors found that latent tuberculosis infection was independently associated with subclinical obstructive coronary artery disease in Peru and Uganda. The data indicates that latent tuberculosis infection is a non-traditional correlate of atherosclerotic cardiovascular disease risk.  The publication includes data from Dr. Huaman’s CCTST KL2 project.

Click here to read the publication.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

Research finds low rates of contraceptive use in women with kidney failure

Women with kidney failure have low rates of contraceptive use, according to a study by Silvi Shah, MD, assistant professor in the Department of Internal Medicine, Division of Nephrology and Hypertension. The study, published in the journal Kidney Medicine, finds an overall contraceptive use rate of 5.3% among women with kidney failure undergoing dialysis in the United States.

“Although end-stage kidney disease adversely impacts fertility, conception is common among women on dialysis. Kidney failure increases the risk of adverse pregnancy outcomes, including pre-eclampsia, fetal growth restriction and preterm babies,” says Shah, the lead author of the study. “Unplanned pregnancies occur in women with kidney disease. It is of paramount importance that pregnancies in this high-risk population are planned and gives us the opportunity to counsel women about family planning and the impact of pregnancy on kidney disease, and the impact of kidney disease on maternal and fetal outcomes.”

Shah says the study is unique in that it addresses a comprehensive group of women undergoing dialysis of all racial and ethnic groups in the United States from 2005 to 2014 to better understand the incidence of contraceptive use and factors associated with it. This research shows for the first time that contraceptive usage rates in women with kidney failure who are undergoing dialysis remains very low in the United States.

“The results highlight that contraceptive use among women with kidney failure is extremely low which may account for higher rates of unintentional pregnancies in this high-risk population,” Shah says. “We need to include contraceptive counselling for women of child-bearing age in routine clinical care. Additionally, the present study emphasizes the importance of formulating policies that promote awareness of reproductive health and contraception among women with kidney failure.”

Co-authors are Annette Christianson and Karthikeyan Meganathan, research associates, Department of Environmental and Public Health Sciences; Charuhas Thakar, MD, professor, division director and Robert G. Luke, MD Endowed Chair in Nephrology, and Samantha Kramer, senior clinical research professional, Division of Nephrology and Hypertension; and Anthony Leonard, PhD, associate professor, Department of Family and Community Medicine.

Shah is supported by a career development award from the Center for Clinical and Translational Science and Training, a Dialysis Clinic Inc. grant and intramural funds.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

K Scholar, Silvi Shah, MD, Assistant Professor, Department of Internal Medicine, Division of Nephrology and Hypertension, UC, was invited to present during the American Society of Nephrology Kidney Week Virtual Conference.

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Dr. Shah presented, “The Time is Now: Pregnancy on Dialysis” on October 24, 2020. Her presentation was part of the session “When Timing is of the Essence: Pregnancy in ESRD Versus Transplantation.” Dr. Shah’s presentation is available online (for members only).

Story released by the University of Cincinnati Dean’s List Weekly Newsletter and UC News. Story features CCTST K Scholar Graduate, Stephanie Merhar, MD.

College of Medicine forms Center for Addiction Research

An estimated 23 million adults in the United States have struggled with unhealthy drug use, according to the National Institutes of Health.

“Addiction is a chronic, recurring medical disorder but many suffering from addiction continue to be stigmatized,” says Theresa Winhusen, PhD, the Donald C. Harrison Endowed Chair in Medicine and vice chair for addiction sciences in the Department of Psychiatry and Behavioral Neurosciences. “Research to better understand the causes and consequences of substance use and addiction and to improve treatment outcomes for those struggling with addiction is needed.”

To help meet this need, the College of Medicine has established the Center for Addiction Research (CAR) to expand the university’s scope as a national leader in addiction science.

“As part of the center, our investigators will continue their important research on opioid, stimulant, cannabis, tobacco and alcohol use disorders,” says Winhusen, who is director of the center. “These researchers are leaders in their fields. The center will support cross-disciplinary collaborations to accelerate scientific progress.”

Winhusen says the center will focus on three areas of addiction research: treatment development and testing, perinatal addiction and developmental consequences and population health and health services. These “cores” will be led by Andrew Norman, PhD, professor in the Department of Pharmacology and Systems Physiology; Stephanie Merhar, MD, research associate professor in the Department of Pediatrics and a physician at Cincinnati Children’s; and Michael Lyons, MD, associate professor in the Department of Emergency Medicine.

“The talents of these leaders will help us establish collaborative relationships within these three areas of investigation—not only across UC departments, colleges and centers, including those at Cincinnati Children’s, but also with community and governmental partners, other academic institutions and industry,” she says.

The center includes 27 faculty members who have all been involved in addiction research and have addiction-related publications in peer-reviewed journals. Currently, CAR investigators have over $22 million in research support from both federal and private sources, but Winhusen hopes that the collaborative nature of the center will lead to additional funding and the creation of a pilot funding mechanism to help researchers get the ball rolling on innovative studies.

Read more about the Center for Addiction Research

Story released by the University of Cincinnati Dean’s List Weekly Newsletter and UC News. Story features CCTST K Scholar Graduate, Stephanie Merhar, MD.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar Graduate, Moises Huaman, MD.

Dr. Moises Huaman (photo courtesy of University of Cincinnati College of Medicine)

Moises Huaman, MD, assistant professor in the Department of Internal Medicine, Division of Infectious Diseases at University of Cincinnati, is serving as chair of a plenary session at the CHEST Annual Meeting 2020 in October. Huaman will chair a session on “Tuberculosis: New Challenges and New Therapies in the Era of Drug Resistance.” He also will make a presentation titled “Modern Strategies for Tuberculosis Prevention.”

The CHEST Annual Meeting 2020, sponsored and organized by the American College of Chest Physicians, will be a virtual meeting with live and recorded presentations from Oct. 18 to 21. 

Huaman is a graduate of the KL2 Research Scholars Program at the University of Cincinnati and Cincinnati Children’s. He is currently the local co-principal investigator for the National Institutes of Health-funded AIDS Clinical Trials Group (ACTG) Cincinnati Research Site and serves as investigator member in the ACTG Tuberculosis Transformative Science Group. Huaman also serves as local principal investigator for Johns Hopkins University-led clinical trials investigating the use of convalescent plasma for prevention and early treatment of patients with COVID-19.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar Graduate, Moises Huaman, MD.

Congratulations to K Scholar Graduate, Yoonjee Park, PhD, Assistant Professor, College of Engineering and Applied Science, University of Cincinnati, who recently received a Lois Hagelberger Huebner Young Investigator Award from Ohio Lions Eye Research Foundation. Dr. Park’s proposal is titled, “Dose-Controlled Co-Delivery Implant For Chronic AMD Treatment”. The award is $214,000 (direct cost) for two years.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.

Dr. Silvi Shah (photo courtesy of University of Cincinnati College of Medicine)

Silvi Shah, MD, Assistant Professor, Department of Internal Medicine, Division of Nephrology and Hypertension at University of Cincinnati, will be the primary speaker during an upcoming webinar by the International Society of Nephrology (ISN). The event is titled “Women’s Health in Kidney Disease” and will be held at 11 a.m., Thursday, Sept. 10.

The program will cover sexual dysfunction and fertility in kidney disease, pregnancy risk assessment and counseling and management of hypertension and immunosuppression in a pregnant patient with kidney disease.

Register for the ISN webinar.

Story released by the University of Cincinnati Dean’s List Weekly Newsletter. Story features CCTST K Scholar, Silvi Shah, MD.