The day Howard Gendelman, M.D., announced that his University of Nebraska Medical Center team, in partnership with Temple University, had successfully eliminated HIV in a living animal was a long time coming after decades of research.

A Critical Step Toward Eliminating HIV

UNMC and Temple University researchers collaborate on first-time achievement

The day Howard Gendelman, M.D., announced that his University of Nebraska Medical Center team, in partnership with Temple University, had successfully eliminated HIV in a living animal was a long time coming after decades of research.

That moment seemed infinitely far off from when he was racing his station wagon on a Sunday morning to UNMC to transport a terminally ill patient. That was in the early 1990s, when HIV and AIDS were poorly understood and highly stigmatized. But when Gendelman, the Margaret R. Larson Professor of Infectious Diseases and Internal Medicine at UNMC, was called on to see her, the patient was in ICU with a high fever and showing signs of severe dementia. No one knew what was wrong with her. But after an examination, Gendelman quickly understood she was in the terminal stages of AIDS, an illness that would soon become a worldwide epidemic. 

Gendelman knew the patient had only one chance: Promising new drugs had to be administered immediately. The medicine worked quickly. Within a week or two, the patient had regained consciousness and was almost back to her normal self — talking, walking and interacting with her family. It was one of the first complete reversals of AIDS dementia. 

That patient’s recovery was likely one of the few moments when emotion proved contagious in Gendelman’s career as a physician-scientist at Albert Einstein College of Medicine, Johns Hopkins, the National Institutes of Health, the Walter Reed Army Medical Center and, for the past 27 years, UNMC.

As the patient later described in a book edited by Gendelman: He was “like a kid in a candy store.” He paraded his colleagues in to see me and called me “medical history in the making.” She recalled him saying, “It’s moments like these that make me so proud to be a doctor,” and then turning to his colleagues and saying, “It’s time to find a cure!”

That was more than 20 years ago. Since then, AIDS has ravaged communities and claimed an estimated 35 million lives. Today, it is somewhat contained by antiretroviral drugs that suppress the virus. New infections have fallen 39% from the epidemic’s peak in the late 1990s — a major win in the worldwide battle against the disease. Antiretroviral drugs allow AIDS victims to live seminormal lives — but not everyone can afford or access these lifesaving medicines. In 2016, the Joint United Nations Programme on HIV/AIDS announced that for the first time, more than half of the world’s population living with HIV was receiving antiretroviral drugs. But that still leaves roughly 16 million people living with the disease and not receiving treatment.

Few thought that HIV could be eliminated. But, today, things are no longer as they were.

Then came the day that Gendelman announced a breakthrough in the painfully long search for a cure. On July 2, 2019, Gendelman, Prasanta Dash, Ph.D., Benson Edagwa, Ph.D., and other UNMC and Temple University researchers announced they had eliminated HIV, the cause of AIDS, for the first time in a live animal.

The team used a cutting-edge therapeutic strategy, known as long-acting, slow-effective release antiretroviral therapy (LASER ART) in combination with CRISPR, a revolutionary gene-editing therapy, to eliminate the virus in a mouse model of human disease. The model used mice with a human immune system developed, in large measure, by UNMC scientists Larisa Poluektova, M.D., Ph.D., and Santhi Gorantla, Ph.D

“Few thought that HIV could be eliminated,” Gendelman said. “But, today, things are no longer as they were.”

The announcement was a watershed moment in the history of HIV and AIDS. But, for Gendelman, it was not a moment of fulfillment. It was more like a step forward in a marathon still in progress. For him, the moment was about the slow-plodding work of scientific discovery. It was about the curiosity that first brought him into the world of scientific research. It was about the days and nights spent mulling over problems — because the workday of a scientist never really ends. It was about the behind-the-scenes legwork — writing grants, filing financial papers, setting up laboratories. It was about the slow, complicated work that — despite the magnitude of this breakthrough — is far from over.

“When you make a discovery, it’s about incremental steps,” Gendelman said. “It’s a process and far from a single destination. You must love the journey of science … the day-to-day operations, the good, the bad, the difficult obstacles. It is all about overcoming the odds and keeping focused on the quest.”

When that quest resulted in the elimination of a virus that has confounded doctors and scientists for years, Gendelman said the first thing he thought was, “Could this be a mistake?”

“Something happened. It may not be accurate. … We must be sure,” he said. “It must be reproduced, and we must search for all controls and all possibilities to any uncertainty.”

So the team tested it again. And again. And again — until they could say with near certainty that the virus had been, to the best of their abilities and knowledge, eliminated. 

The discovery was published in the prestigious scientific journal Nature and picked up by media outlets around the world.

“This achievement could not have been possible without an extraordinary team effort that included virologists, immunologists, molecular biologists, pharmacologists and pharmaceutical experts,” Gendelman wrote in the press release. “Only by pooling our resources together were we able to make this groundbreaking discovery.”

It would also not have been possible without the infrastructure that UNMC has built over decades, supported by a community that believes in the medical center’s mission ­and believes that breakthroughs of worldwide significance can happen in a midsize, Midwestern city when it is empowered to think big. 

But the breakthrough is really just the first step. Delivering it to the people who need it in the form of compliance-approved, effective, safe and lifesaving medicine is Gendelman’s next hurdle. It’s a complex and lengthy process that necessitates layers of testing, and highly specialized procedures and staff who can navigate the delicate process of human trials.

Typically, a powerful industry partner, such as a large drug company, steps in to help. But that can slow the process down significantly, and Gendelman hopes to move more quickly by producing the medicine in-house at the newly created Nebraska Nanomedicine Production Plant. Fully staffed, this facility will provide the specialized space required to produce FDA-compliant medicine — independently, rapidly and right here in Nebraska.

It will still be slow-plodding work, with highs and lows, hurdles and breakthroughs. But Gendelman doesn’t want to wait a moment longer than he has to, not when a cure is potentially within reach. The work is evolving rapidly and needs to be in the hands of those who need it. Gendelman can imagine the satisfaction in their recoveries — and looks forward to being able to take a breath, step back and appreciate what can be achieved, knowing Nebraska is at the center of all of it.

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Parker Witthuhn came to the University of Nebraska at Kearney to study history and political science. But more than that, the Story City, Iowa, native came to wrestle for the Lopers.

Taking History to the Mat

A UNK student’s migration from wrestling to research

Parker Witthuhn came to the University of Nebraska at Kearney to study history and political science. But more than that, the Story City, Iowa, native came to wrestle for the Lopers.

“Wrestling and being on a team is in my blood,” he said.

That made suffering a career-ending injury, fracturing his L5 vertebra and undergoing surgery in 2017, very difficult. Witthuhn struggled with the loss of his ability to compete on the mat and suddenly having “way more time on my hands,” he said.

His UNK wrestling coaches suggested this was “an opportunity to push myself academically, and that I should throw myself into my schoolwork to see what I could accomplish,” Witthuhn said.

He explained his passion for learning spans many fields, but his interest is piqued most when studying history and political science.

“I love diving into topics and finding similarities to things going on in the world today or finding roots and causes of current events,” he said. “Finding obscure facts and being able to trace the fallout from those events all the way up to today — that’s super fun.”

Witthuhn sought guidance from his teacher and mentor, Jeff Wells, Ph.D., of the history department in UNK’s College of Arts & Sciences. Aware of Witthuhn’s passion for history, Jeff encouraged him to get involved in UNK’s undergraduate research program.

“I hadn’t considered my writing good enough for publication until then and never really considered doing research until Dr. Wells showed me all the opportunities,” Witthuhn said.

Undergraduate research is highly supported and encouraged at UNK, according to Charles Bicak, Ph.D., senior vice chancellor for academic and student affairs.

“We have a strong emphasis on students doing independent scholarly work,” he said. “It’s a distinguishing part of the UNK experience.”

Matthew Bice, Ph.D., director of undergraduate research and associate dean of graduate studies, echoed these comments, saying research projects are student-driven, allowing a project to capture the interest of the student.

“The undergraduate research experience provides transferable skills that transition into all aspects of life, making it a lifelong experience,” he said.

Under Bice’s direction, students present their research and scholarly work at UNK Undergraduate Student Research Day each spring. Wells and Bice both encouraged Witthuhn to consider a history-writing project to present.

Parker arrived at UNK with a love for competition. He was accustomed to winning as an athlete, but his injury deprived him of those opportunities. His participation in the Undergraduate Research Fellowship program allowed him to showcase his academic talents, and winning this award affirmed for him his potential to accomplish great things beyond sports.

Bicak was walking through the UNK union one day when he began talking with UNK alumna Carolyn Snyder, Ph.D. He enthusiastically told her about the campus’s annual day of student research presentations, which piqued her interest.

“During my career as a professor and librarian, I wrote a number of articles and a book related to libraries,” she said. “As I progressed, it was important to do research and writing. That importance is still present as students pursue careers, but even more so in today’s world of shortened words, sentences and text messages.”

Already familiar with giving back to UNK – Snyder had established an endowed scholarship fund to benefit student library workers in honor of her mother, who also graduated from UNK — she decided to create the Wagner Family Writing Awards, which are given annually at the UNK Undergraduate Student Research Day, through a gift to the University of Nebraska Foundation.

“Naming the award after our Wagner family was very special to me” Snyder said. “My nephew Luke Wagner has joined me in the awarding of funds. I am so proud that it’s a family legacy that will continue through our scholarships and awards.”

The Wagner Family Writing Awards provide a total of $1,000 per year to students who place first, earning $750, and second, earning $250.

The award draws many applicants, “which sends a signal that students see the importance of research and writing,” Snyder said.

What started out as a project I was encouraged to do became a passion that I pursued with earnest.

While he was still some time away from writing his paper for Undergraduate Student Research Day, Witthuhn had begun to get a feel for what he wanted to research.

“I have always found World War I fascinating,” he said. “2018 marked the 100-year anniversary of the end of WWI, and there hadn’t been much research done on the students and staff that served from Kearney State Normal School. I decided this would be a really great topic that was relevant.”

Witthuhn began research for “WWI: Soldiers of Kearney State Normal School” with the assistance of Laurinda Weisse, archivist and assistant professor at C.T. Ryan Library, who helped him unearth documents.

“There were war letters from the students who served, newspaper articles from the Antelope student newspaper and Kearney Hub during the war, and primary documents for the project,” Witthuhn said. “I’d already be deeply engrossed in an interesting war letter or article, and Ms. Weisse would come rushing in saying she found something else new that I should see.

“These documents, including mud- and blood-soaked letters, hadn’t been written about or analyzed fully yet, were so intriguing. I was hooked and loved doing the research in the archives.”

Witthuhn’s dream job is to be a historian and to teach and research at a university, in large part after working with Weisse in the UNK archives. Weisse says that’s the best part of her job.

“Discovering, seeing, reading and even feeling primary source documents — there’s a lot of power in that,” she said. “I love my opportunities to work with departments and students and make our history come alive.”

Weisse helped Witthuhn connect his life as a UNK student to those here 100 years ago. “Making connections for people through history helps tell their own story,” Weisse said.

Witthuhn explained how he grew emotionally, connecting to the Kearney Normal School soldiers and their stories.

“It’s hard to imagine that students my age were leaving our campus to go to war. One soldier in particular, Clarence Olsen, became very real to me,” he said. “Clarence’s brother, Henry, was also a student at Kearney Normal but was not sent to fight. Henry received many letters from Clarence while he fought in France during the final phase of the Meuse-Argonne Offensive.”

Witthuhn details in his research paper how Clarence Olsen, hours after penning a letter to Henry on Oct. 28, 1918, was hit by an exploding artillery shell and a gas grenade while going over his trench to advance toward the German line. The incident shattered Olsen’s legs, and the gas infected his wounds and caused partial paralysis in his arms.

“Clarence’s injuries caused both of his legs to be amputated in the field evacuation hospital before he was moved to Base Hospital No. 49,” Witthuhn said. “That hospital was actually nicknamed ‘Nebraska’s Hospital’ because it was created and staffed by members of the University of Nebraska’s Medical College at Omaha.

“The interesting and intriguing facts just kept coming. What started out as a project I was encouraged to do became a passion that I pursued with earnest.”

Witthuhn completed his research and paper, submitted his final copy for consideration for the Wagner Family Writing Awards, and then presented it last spring at UNK Undergraduate Student Research Day.

“It was an amazing opportunity and one that helped me grow incredibly as a researcher and writer,” he said. “While at the awards ceremony, the winners of the Wagner Family Writing Awards were being announced. I noted to myself how great that $250 second-place prize money would be. Little did I know my name would be announced as the winner of the award and a cash prize of $750.”

Snyder had the opportunity to read Witthuhn’s paper and was impressed.

“He had such a well-researched and captivating paper,” she said. “From utilizing the archives and library, to solid writing — it is what this award is all about.”

Witthuhn acknowledged that his experience opened his mind to his potential for creating scholarly writing and conducting research.

“The history department, the archivist, Carolyn Wagner Snyder — so many contributed to my growth and accomplishment,” he said.

And further, the award money paid for his books for the upcoming semester. “For that and more, I am really grateful,” Witthuhn said.

Witthuhn’s paper may be found at openspaces.unk.edu/undergraduate-research-journal/vol23/iss1/12/

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Commission tackles one of most complex, pressing issues facing Nebraska

High Stakes for the State's Youngest Citizens

Commission tackles one of most complex, pressing issues facing Nebraska

Sara Renken has never wanted to do anything else. She’s a third-grade teacher at Eagle Elementary School in Eagle, Nebraska. “I’ve always had a natural connection with kids,” she said. “I knew I made the right choice a few years into my career. It just felt right.”

Renken said she loves her job mostly because of the relationships she builds with kids and their families in this small village of about 1,000 people in Cass County.

Renken said teaching kids feels like a calling. But she also has challenging days and ongoing battles.

Not enough time and increasingly high expectations from federal and state governments are her No. 1 issues.

“You have little human beings that walk through your door,” she said. “They’re not just a number, they’re a person.

… We do so much more than just trying to get them to learn words, science, math. My job is to help them grow up, to help them be the best that they can be.”

Early childhood educators are crucial to young children’s learning and development. Yet, these teachers are the most likely to leave their professions.

Renken is one of the lucky ones. She teaches in a public school system and has never considered leaving her profession. Many early childhood educators, however, teach at private child care centers or preschools that don’t have the resources to pay staff sufficiently or provide benefits, such as health insurance or retirement savings. In fact, many early childhood teachers barely scrape by.

The median salary for child care workers in Nebraska was $22,870 in 2015, according to information shared by the Buffett Early Childhood Institute at the University of Nebraska. That’s half of the median salary for public school teachers and below the federal poverty line for a family of three.

Not surprisingly, there is high turnover within the field — up to 26 percent annually in licensed child care settings — and a critical shortage of quality educators. A 2016 Kids Count report said that roughly 84% of Nebraska counties with child care centers report being unable to meet demand.

Frequent teacher turnover and inconsistent care, especially in the early, formative years, can have devastating effects on children and the learning process. But for the past three years, the Nebraska Early Childhood Workforce Commission, which Renken serves on and was convened by the Buffett Institute, has been working to tackle the most complex and pressing challenges facing Nebraska today — expanding and strengthening the state’s early childhood workforce to meet children’s needs throughout the first eight years of life.

Susan Sarver, director of workforce planning and development at the Buffett Institute, said there are many factors that keep early childhood teachers from earning enough to stay in their positions. One is perception. Not that long ago, the role of child care providers was viewed as relatively passive, but now science has caught up to what many knew intuitively. Those early years are crucial in a child’s development.

According to information on the Buffett Institute’s website, nearly 90% of the brain’s growth happens during the first five years of a child’s life. More than 1 million new neural connections are formed every second. These are the connections that build brain architecture — the foundation upon which all later learning, behavior and health depend. 

Children who do not receive high-quality education in their early years are far more likely to drop out of school later on, be placed in special education and not go to college — and even 70% more likely to be arrested for a violent crime. The stakes are high.

“We know now from science that birth through third grade is a unique developmental period,” said Sarver. “That infant or toddler teacher needs to be just as competent as a teacher for older students. Their needs are just different. We know better now, so we’re trying to be better.” 

Another problem is cost. The younger the children, the more teachers are needed per student. At child care centers and private preschools, Sarver said those costs eat up as much as 80 percent of the budget.

“Home-based providers often say they would like to raise their rates, but they know they can’t,” she said. “Parents are stretched. They can’t pay any more. The cost of putting an infant in child care costs more than college tuition.”

Consistent standards for teacher training also present a challenge. “It’s kind of a historical artifact,” Sarver said. “They began as two different systems. K-12 has a very clear path. 0-5 started a little differently.” Unlike for teachers of older students, there are no set requirements for early childhood educators, and requiring advanced degrees across the board is not necessarily the answer.

Determining the best way forward is a monumental task. But the commission formed by the Buffett Institute brought together about 40 people from diverse backgrounds in the public and private sectors to tackle it.

“It’s the unusual suspects,” Sarver said. “The department of labor, the chamber of commerce … it’s a unique collaboration.”

All those groups, along with the departments of education and health and human services — two divisions that exist in silos in many states, hold pieces of the puzzle. The hope is the more they collaborate, the more the big picture will come into view. Sarver said people across the early childhood spectrum are committed to moving forward together. They’re invested, she said, and, importantly, they get along.

“Nebraska nice really comes through,” she said. “It’s a small enough group that we’re able to tackle the hardest questions.”

The commission published a report in late January that details the challenges Nebraska faces and makes recommendations on how to address them. Sarver said she expects the University of Nebraska system to play an important role as the state moves forward in implementing the commission’s recommendations, given the research, knowledge and competencies that are housed there and that are required to make the changes that are needed. Many others will also be involved, including state and local governments, the early childhood community, K-12 education, businesses and private philanthropy.

“This is not a unique problem,” Sarver said. “We see this everywhere. The advantage we have in Nebraska is there are a lot of really good things going on in the state. We want to build on those strengths.”

Renken said she hopes the commission can raise awareness and help people understand the value of her profession.

“When the public knows the need and the value for good, quality care for our young kids, that’s when we’re going to see change,” she said. “One voice can be heard. But a lot of voices can start to make a difference. We’re still growing — but we’re becoming a little more vocal, a little louder.”

The Buffett Early Childhood Institute was created in 2011 and emerged from the shared vision of the University of Nebraska leadership and Susie Buffett, a longtime philanthropist and champion of early childhood education and development. More information about the institute and the Nebraska Early Childhood Commission report can be found at earlyyearsmatter.org/workforce.

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