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Two Duke University Medical Center Researchers Receive Presidential Early Career Award

Two Duke University Medical Center Researchers Receive Presidential Early Career Award
Two Duke University Medical Center Researchers Receive Presidential Early Career Award


Duke Health News Duke Health News

DURHAM – John Klingensmith, Ph.D., an assistant professor of cell biology, and James A. Tulsky, M.D., associate professor of medicine, at Duke University Medical Center are two of 60 U.S. scientists and engineers who will be awarded the 2001 Presidential Early Career Award for Scientists and Engineers (PECASE) by President Bush.

Klingensmith is receiving the award for basic research in developmental biology that is contributing to the understanding of birth defects, primarily craniofacial defects. His work could lead to gene testing and therapy to prevent birth defects or possibly to new treatments for birth defects.

Tulsky's research focuses on physician-patient communication and the care of dying patients. He was nominated by the Department of Veteran Affairs for his research that explores the quality of life at the end of life. The research, funded by two grants from the VA totaling $550,000, is designed to define the attributes of a "good" death -- one that eases the transition for the patient -- and to create a method to measure the quality of life for dying patients.

Other Duke University award recipients include Michael C. Fitzgerald, Ph.D., assistant professor of chemistry; and Steven A. Cummer, Ph.D., assistant professor of engineering. Both were nominated by the National Science Foundation.

The award ceremony will take place on July 12 in the Eisenhower Executive Office Building after a private White House tour. President Bush will address the awardees at the ceremony.

The PECASE awards were established by President Clinton in February 1996 to recognize the achievements and significance of research by scientists and engineers early in their careers. The award is the highest honor bestowed by the U.S. government on scientists and engineers who "show exceptional potential for leadership at the frontiers of knowledge."

There are eight nominating agencies, among them the National Institutes of Health, which nominated Klingensmith. He was nominated by Rochelle K. Small, director of the Developmental Biology and Mammalian Genetics Program of the National Institute of Dental and Craniofacial Research of the NIH.

Wrote Small in her nomination, "Dr. Klingensmith is a highly productive new investigator whose accomplishments in the field of developmental biology have already had a major impact. His research findings have significantly moved the field ahead by revealing unsuspected features of mouse development that have major implications for understanding the causes of craniofacial and neural tube malformations. Because the majority of serious human birth defects involve the head or neural tube, his work will have high societal value,"

Klingensmith is a developmental geneticist who specializes in research on the development of craniofacial and neural tube birth defects during gestation. His research in mice has led to the identification of two genes, called Chordin and Noggin, that play a critical role in craniofacial development.

The PECASE award is being given for his work on molecular pathways that regulate
development of craniofacial structures. The award stems from a grant that focuses on Chordin and Noggin, which are known to regulate Bone Morphogenetic Proteins (BMPs). BMPs are a family of protein signals that have potent effects on craniofacial development. BMP2 and BMP4 are thought to be particularly important in the growth of the brain, skull, pituitary gland, teeth and face. Scientists had previously never before made the connection between BMP regulation and neural tube defects.

"Our primary goal is to understand the mechanisms of human birth defects. In our work on BMP signaling, I think we've made an important contribution toward explaining the mechanism of how birth defects of the head and face occur," Klingensmith said. "Very little is known about the molecular and genetic mechanisms that underlie these birth defects, or for that matter, normal craniofacial development. Much of our research is designed to reveal the key steps in head formation, and to elucidate the molecular basis of craniofacial birth defects.

"One in 50 births has a significant birth defect, a third of which involve the head and face. Those that are not lethal in infancy result in considerable physical and psychological suffering," Klingensmith said.

Klingensmith pursued his graduate studies at Harvard Medical School and Stanford University before completing postdoctoral work at Mount Sinai Hospital in Toronto. He has been with Duke University Medical Center since 1998.

Tulsky is a general internist at the Durham VA Medical Center, where he directs the Program on the Medical Encounter and Palliative Care. He holds a joint appointment as an associate professor of medicine at the Duke University Medical Center, where he is a physician in ambulatory care and associate director of the Duke Institute on Care at the End of Life.

In his research, Tulsky and colleagues identified six possible interventions designed to improve quality of life at the end of life -- pain and symptom management, clear decision making, preparation for death, completion, contributing to others and affirmation of the whole person.

Tulsky's research has shown there is no one definition of "a good death" and that wide disagreement exists about the importance of such issues as dying at home and the use of life-sustaining treatments, Tulsky said. His research contributes to efforts to improve the measurement of quality of care at the end of life and to design interventions that will best meet the needs of dying patients.

Tulsky has been with Duke and the Durham VA Medical Center since 1993. Prior to arriving at Duke, he received his internal medicine training at the University of California, San Francisco, where he was also chief medical resident and a Robert Wood Johnson Clinical Scholar.

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