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17
2017

Timely scholarship gives nontraditional student the help he needs to return to the classroom

Kenneth Guinn first experienced the fast-paced, high-stakes environment of the emergency room as a volunteer at a hospital near his undergraduate university.

This story first appeared in Impact, VCU’s award-winning publication that shows how philanthropy changes the lives of students and faculty on campus.This story first appeared in Impact, VCU’s award-winning publication that shows how philanthropy changes the lives of students and faculty on campus.

“I loved the energy,” he says, “and the sense of urgency knowing that patients needed immediate help.”

After those experiences, Guinn knew he wanted to go to medical school. What he didn’t know yet was that his journey to the Virginia Commonwealth University School of Medicine would involve a few unexpected diversions.

“I just always assumed I would go right into medical school after earning my bachelor’s degree,” he says. “I never even considered another path to that goal.”

But as Guinn neared the end of his undergraduate education, something else occurred to him: a feeling that it was his duty to serve his country. Instead of applying to medical school, he joined the Navy.

“When you’re enlisted, you’re pretty low on the totem pole, so respect and humility go a long way,” says Guinn, who completed a four-year enlistment before being discharged honorably. “I learned a lot about character during my time in the military, which I believe will be useful in my future medical career.”

Guinn was finally ready to take everything he’d learned and get back to work pursuing his original dream of a medical degree. He was accepted into the VCU School of Medicine in 2015. But after years away from the classroom, he faced the challenges of not only returning to school as a nontraditional student but also affording an expensive medical degree.

Relief came via the Stephen C. and Marie F. Cenedella Endowed Scholarship, a renewable award that Guinn has received both of his years at VCU.

“When you think about the costs – tuition, books, even living expenses – it all adds up,” Guinn says. He also receives help through military benefits and says every bit helps. “The financial benefit of the scholarship has been great, but it’s also a confidence-booster. It means a lot when someone shows that they support you and believe in your success.”

Awarded annually to students in the VCU School of Medicine based on both merit and need, the Cenedella Scholarship was established with a gift of $125,000 from Stephen C. Cenedella, M’68, and his late wife, Marie, and 1967 alumna of the School of Allied Health, in December 2005.

Stephen Cenedella and his late wife, Marie, pictured in 2006.Stephen Cenedella and his late wife, Marie, pictured in 2006.

Cenedella still talks with gratitude about the scholarship he received during his time on the MCV Campus. By the end of his third year in medical school, he had accumulated 14 student loans. The scholarship he received covered the full tuition cost for his final year.

“I’ll never forget how relieved I felt to have that last year paid for,” Cenedella says. “I always knew I wanted to pay it forward.”

Cenedella hopes his support will help medical students pursue their passion without being discouraged by the financial burden.

“My advice for them is to follow their heart and never forget why they wanted to become doctors: to help others,” says Cenedella, who has seen more than 200,000 patients since his career in family medicine began in 1972.

In November 2016, Cenedella made arrangements to give an additional $100,000 to the scholarship fund through his individual retirement account. With this additional gift Cenedella is contributing to the School of Medicine’s 1838 Campaign, which aims to recruit and reward top students and to reduce student debt.

Planned giving via an IRA charitable rollover

The federal government made permanent a tax law that makes it more appealing for some donors to use IRA funds to support VCU.

IRA owners older than 70 1/2 are required to begin taking annual minimum distributions. Recent legislation allows these individuals to make a distribution of up to $100,000 from their IRA directly to an eligible charitable organization, tax-free. This can satisy the required minimum distribution amount from their income, resulting in lower taxable income regardless of whether they itemize deductions.

Peter F. Buckley, M.D., dean of the VCU School of Medicine, says the campaign is a way to level the playing field for all students. When the Liaison Committee on Medical Education, the accrediting body for medical schools in the U.S., visited VCU last year, they gave the School of Medicine high marks and a full eight-year re-accreditation. In their review, they paid special attention to the level of educational debt students carry, which is an issue nationwide.

“The accreditors were glad to see that we’ve launched the 1838 Scholarship Campaign to build an endowment that’s on par with our peer schools,” Buckley says. “Combined with tightly limiting tuition increases, it’s our approach to helping talented and compassionate students fulfill their dream of becoming physicians – regardless of their families’ financial resources. We’re enormously grateful to Dr. Cenedella for his partnership in that goal.”

Guinn is on track to graduate from the School of Medicine in 2019. He has maintained his passion for emergency care and still experiences the same rush of adrenaline that inspired him to pursue it as a career.

In a letter of thanks to Cenedella, Guinn explained that although his path to medicine was not as direct as he’d imagined, he believed his experience would help make him a better doctor.

“While I have not taken the traditional path to medicine, I have learned and grown so much more through my alternative route,” he wrote. “I plan to remain a creative, outside-the-box thinker who is not afraid to take the road less traveled.”

By Brelyn Powell

03
2017

Alumni star M’99 Eduardo Rodriguez inspires the next generation

It was front-page news out of NYU Langone Health in August 2015. In a 26-hour operation, the face of a 26-year-old bike mechanic who was declared brain-dead after a cycling crash was transplanted onto a 41-year-old former firefighter who was severely burned in the line of duty.

Eduardo D. Rodriguez, M'99 (center) with the Class of 2019's Diana Otoya and the Class of 2020's Frank Soto at the 2017 Alumni Stars Ceremony.

Eduardo D. Rodriguez, M’99 (center) with the Class of 2019’s Diana Otoya and the Class of 2020’s Frank Soto at the 2017 Alumni Stars Ceremony. Photo credit: Jay Paul.

Leading the team that performed the most extensive facial transplant ever was M’99 Eduardo D. Rodriguez, M.D., D.D.S., the Helen L. Kimmel Professor of Reconstructive Plastic Surgery and chair of the Hansjörg Wyss Department of Plastic Surgery at NYU Langone. The painstakingly delicate surgery was a resounding success.

Becoming a leader in facial transplantation, Rodriguez says, wasn’t an anticipated career goal.

“However, I’ve always had an interest in finding solutions to difficult problems, and this pursuit has led me to the position in which I currently reside,” he says.

Rodriguez recently returned to Richmond to be honored at the 2017 Alumni Stars ceremony, a biennial event that celebrates alumni from across the university’s academic units for their extraordinary personal and professional achievements. During the event, Rodriguez met the Class of 2019’s Diana Otoya, who says she was encouraged by Rodriguez’s non-traditional path to medical school.

“I confessed to him I didn’t really know what I wanted to do yet,” Otoya says. “He made me feel comforted by his own story about starting in dentistry before even thinking about medical school. He gave me reassurance that there is no path that is set in stone and that our careers are fluid.”

Rodriguez and his team at NYU Langone are planning for future reconstructive procedures while expanding the face transplant program’s clinical, research and education/training efforts.

“Clinical efforts will focus on patient selection and achieving the most optimal aesthetic and functional results,” he says. “Research efforts are focused on improving immune surveillance and designing patient-specific targeted immune therapies to lessen drug toxicity without increasing risk of transplant rejection.”

Peter F. Buckley, M.D., dean of the VCU School of Medicine, praised Rodriguez’s work. “He brings hope to patients in the most difficult of circumstances and I have no doubt he will continue to transform countless lives,” Buckley says. “I’m proud to see him receive this alumni honor and grateful we can call him one of our own.”

Rodriguez, the son of Cuban immigrants, was born and raised in Miami. His road to VCU began with undergraduate education at the University of Florida followed by a dental degree from NYU College of Dentistry. He completed a residency in oral and maxillofacial surgery at Montefiore Medical Center/Albert Einstein College of Medicine before enrolling at VCU, where he earned his medical degree in 1999.

“I was fortunate to have been part of a newly designed education curriculum there and certainly received the best medical education at VCU,” he says.

In addition to pioneering clinical achievements, Rodriguez has written more than 130 articles and 21 book chapters. He is a member of numerous national and international professional societies, and he was the Dawson Theogaraj visiting professor in plastic surgery on VCU’s MCV Campus in 2016.

Rodriguez is quick to share credit for his accomplishments and accolades.

“I am lucky to have been mentored by remarkable individuals, and along the way, I have worked hard but have enjoyed every moment,” he says. “I have learned from the most challenging moments, and that is why one must always look forward and never give up.”

By Polly Roberts

23
2017

Hepatologist Arun Sanyal Honored as 2017 Distinguished Scientific Achievement Award Winner Recipient

Housestaff alumnus Arun Sanyal, M.D., now on faculty with the medical school, received the 2017 Distinguished Scientific Achievement Award from the American Liver Foundation.

Housestaff alumnus Arun Sanyal, M.D., now on faculty with the medical school, received the 2017 Distinguished Scientific Achievement Award from the American Liver Foundation.

Arun J. Sanyal, M.D., has been honored by the American Liver Foundation with its 2017 Distinguished Scientific Achievement Award. The award was presented on Oct. 23 at an ALF reception in Washington, D.C.

Continuously funded by the National Institutes of Health for more than 25 years, his research has spanned the spectrum of translational science from basic discovery to first-in-humans and advanced phase clinical trials as well as regulatory aspects of drug development.

“Dr. Sanyal’s record of achievement is remarkable both for its longevity and also for its scope,” says Peter F. Buckley, M.D., dean of the VCU School of Medicine. “I am proud to see him receive this latest honor, which is an endorsement of the translational value that his work carries for patients with liver disease – both now and into the future.”

Sanyal’s work has focused on end stage liver disease and nonalcoholic steatohepatitis for over 20 years. More recently, he has led several efforts in the National Institute on Alcohol Abuse and Alcoholism-funded TREAT consortium that is investigating the pathophysiology and management of alcoholic hepatitis. He recently established the Liver Forum, which provides a neutral platform for the U.S. Food & Drug Administration, the European Medicines Agency and other stakeholders in fatty liver disorders to work collaboratively on the regulatory science required to accelerate drug development in liver disease.

Internationally recognized for his contributions to the understanding of the science and clinical implications of non-alcoholic liver disease, he has created a proprietary mouse strain to test potential therapeutics to treat the disease, which has become a leading cause of liver-related mortality.

Sanyal is a professor of internal medicine, physiology and pathology at VCU School of Medicine and completed his gastroenterology and hepatology fellowship training on VCU’s MCV Campus in 1990.

The American Liver Foundation was created in 1976 by the American Association for the Study of Liver Disease to facilitate, advocate and promote education, support and research for the prevention, treatment and cure of liver disease.

16
2017

Through your eyes

Tom Eichler, M’87, H’92, auditioned for the play “Music Man” on a lark.

By the end of his first performance, there was no turning back.

“I remember delivering my lines and the audience roared,” he says. “I was thinking, ‘Hey, I’m funny!’ I was hooked.”

This story first appeared in the fall 2017 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

Tom Eichler, M’87, H’92, as the character of Andrew Carnes in a production of “Oklahoma!”

Tom Eichler, M’87, H’92, as the character of Andrew Carnes in a production of “Oklahoma!”

Since that first performance with St. Michael Theatre Group in 2007, Eichler has appeared in several other theatrical productions around the Richmond, Virginia, area. He’s taken on a wide variety of roles, including Kris Kringle in “Miracle On 34th Street” and Andrew Carnes in “Oklahoma!”

“People think you just go out there and say a few lines and make a few faces,” says Eichler, who has also appeared in five radio productions. “But it’s so much more than that. It requires a lot of discipline. You really have to think on your feet. It’s the same with medicine. Every patient is different and you have to respond to that.”

Eichler, a radiation oncologist with Virginia Radiation Oncology Associates, sees other parallels between acting and medicine. Both, for example, are pressure-packed.

“Every patient expects you to be on your game every day,” Eichler says. “On stage, the actors around you expect you to be at your best as well. Obviously, the stakes are higher with medicine. But in theater, no one wants to be the one who forgets a line. No one wants to lay an egg on stage.”

A graduate of the University of Notre Dame with a degree in American Studies, Eichler worked as an orderly before taking pre-med classes at Le Moyne College. After failing to gain admission to medical school, he accepted a friend’s offer to serve as the stage manager for First Street Theater in Dayton, Ohio. He later relocated to Northern Virginia with his future wife, Alison, and worked at the Folger Theatre as the box office manager.

One night, his parents and future in-laws joined him for dinner.

“I got up to use the restroom, and when I returned they had decided I was going to be a cardiologist,” Eichler says. “It got me thinking.”

He applied again to medical school and this time was accepted to Virginia Commonwealth University.

“I just love the whole process of medicine,” he says. “Being responsible for helping people, along with the rigor and discipline involved, really excites me.”

Despite working 12-hour days and serving on the board of directors for the American Society for Radiation Oncology, Eichler continues to carve out time for theater. Sometimes he works with his wife who serves as costume mistress and producer for several Richmond-area theater companies.

“Everyone has something they do that provides a release,” he says. “It might be riding a motorcycle or mountain climbing. For me, it’s theater.”

Eichler, who plans to retire from his practice later this year, hopes to continue acting for years to come.

“Usually I’m the oldest person at auditions,” the 65-year-old says. “And that’s OK. I have a lot of life experiences that I can pull from. You may be called upon to play a happy role or a sad one. I can get there by remembering the best day of my life or the worst day. I get such a rush from standing on stage and hearing the applause from the crowd. Everyone wants to be loved.”

By Janet Showalter

 

16
2017

Alumni spotlight: Cynthia Morton

Cynthia Morton, PhD’82 (HGEN), has been interested in genetics since eighth grade when she needed a topic for a term paper. One of Morton’s former teachers suggested focusing on twins. Morton delved deep, and she has been hooked ever since.

This story first appeared in the fall 2017 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

Cynthia Morton with her mentor Walter Nance, M.D., Ph.D., at her American Society of Human Genetics presidential address in 2014.

Cynthia Morton with her mentor Walter Nance, M.D., Ph.D., at her American Society of Human Genetics presidential address in 2014.

Today Morton is a professor of OB-GYN and reproductive biology and of pathology at Harvard Medical School and director of cytogenetics at Brigham and Women’s Hospital. A past president of the American Society of Human Genetics, her research aims to uncover the genetic causes of hearing loss and uterine tumors. She also is drawing on her training in cytogenetics, a field that looks at chromosomal rearrangements, to hunt for genes associated with human development.

Morton earned her Ph.D. in human genetics on the MCV Campus in 1982. There she became the protégé of Walter Nance, M.D., Ph.D., longtime chair of the Department of Genetics and a past president of the American Society for Human Genetics. “She was one of my best students,” he says. Even after Morton graduated, Nance continued her education by teaching her about applied probability in the annual poker game he organized.

In her 35-year career, Morton has received many accolades. She served as editor of the American Journal of Human Genetics, chair of the Board of Regents of the National Library of Medicine and in 2015 was elected a fellow of the American Association for the Advancement of Science.

Morton and her colleagues are on the cusp of launching a project called SEQaBOO (it rhymes with ‘peekaboo’ and is shorthand for SEQuencing a Baby for Optimal Outcome), which aims to sequence the whole genomes of approximately 400 newborns who do not pass newborn hearing screening. “We want to be able to identify new genes involved in hearing loss and also potentially mutations that have been difficult to detect by alternative methodologies.” she says, such as chromosomal structural rearrangements.

The hope is that once more therapies become available, physicians will be able to tailor interventions for different kinds of deafness. Eventually they might even be able to correct hearing loss by gene editing or gene therapy.

But this information can be valuable today, too, Morton says. For example, researchers know that children who have a mutation in one particular gene, called GJB2, tend to respond well to cochlear implants. And children with a mutation in another gene may not do well with hearing aids. In fact, these devices may even make the problem worse.

Some 150 genes have been implicated in deafness, but Morton expects that number will more than double. “This is the tip of the iceberg,” she says.

16
2017

Medicine gets personal

Nearly two decades ago, researchers decoded the human genome. Ever since, they’ve been trying to use that code to transform the practice of medicine.

Long flights make her feet swell. Cynthia Morton, PhD’82 (HGEN), has known this for years and wears compression stockings when she flies. But it wasn’t until Morton had her genotyping done that she realized her genetic makeup puts her at an increased risk of developing clots in her veins. The condition can be deadly. She recently used the knowledge as a bargaining chip. Last year, she was invited to give a talk in Europe. She told the organizers about her test results, and asked for a business class seat with more space to stretch her legs. And she got it. Now in a course she teaches she includes a few slides titled, “How I used my genome to get a business class ticket.”

This story first appeared in the fall 2017 issue of the medical school’s alumni magazine, 12th & Marshall. You can flip through the whole issue online.

Nearly two decades ago, researchers decoded the human genome. Ever since, they’ve been trying to use that code to transform the practice of medicine.

But the value of genetic sequencing goes far beyond getting more legroom. The hope is that one day medical decisions will be based not just on lab tests and family history, but on the unique suite of variations found within our DNA. This idea, once called personalized medicine and now commonly referred to as precision medicine, has been around for more than a decade. But only in recent years has precision medicine become part of clinical practice.

LISTENING TO THE GENOME
The human genome contains more than three billion base pairs. It would take a competent typist working around the clock more than half a century to type out the entire code. When Morton was on the MCV Campus as a graduate student in the late 1970s, she and her colleagues could only manage to sequence chunks about 200 letters long. “At that point, sequencing the entire human genome was a pretty far-fetched idea,” says Morton, now a professor of OB-GYN and reproductive biology and of pathology at Harvard Medical School. (Read more about Morton’s career here.)

Today technological advances have made this far-fetched idea reality. But the promise of precision medicine has yet to be realized in many fields. “The technology often exceeds our understanding of the information we’re getting back,” says Gerald Feldman, PhD’82 (HGEN), M’84. He is the immediate past president of the American College of Medical Genetics and Genomics, and professor of molecular medicine and genetics, pediatrics and pathology at Wayne State University School of Medicine. Although scientists can now access the entire sequence of any individual, the health information locked within that sequence has been difficult to parse. Biologist Eric Lander, who helped lead the Human Genome Project, offered this famous quip: “Genome: Bought the book; hard to read.”

Still, researchers are making steady headway. Morton is working to decipher the pages related to deafness. More than half of all congenital deafness is genetic, but most children never know the particular alterations responsible for their hearing loss. Morton, however, believes that information is crucial, and will become even more so in the coming decades. “It’s really important to know the etiology and to know it early,” she says.

In 2006, she and her mentor, VCU’s founding Department of Human Genetics Chair Walter Nance, M.D., Ph.D., co-authored a paper that argued for more genetic evaluation of infants with hearing loss. At the time, their vision seemed like an “audacious dream,” Morton says. But the advent of next generation sequencing has made that dream feasible.

PRECISION MEDICINE IN THE CLINIC

Nearly two decades ago, researchers decoded the human genome. Ever since, they’ve been trying to use that code to transform the practice of medicine.

In oncology, precision medicine has already become part of clinical practice. Doctors typically order genetic testing for patients with melanoma and some leukemias as well as breast, lung, colon and rectal cancers. The goal is to identify mutations within the tumor that might be driving the cancer. The results help oncologists select therapies that target those pathways. “It’s a really exciting time to be in cancer medicine,” says Charles Clevenger, M.D., Ph.D., chair of VCU’s Pathology Department and holder of the Carolyn Wingate Hyde Endowed Chair of Cancer Research.

Clevenger is impressed at the strides that have been made in treating metastatic melanoma, once considered one of the most difficult cancers to treat. Since 2011, five new targeted therapies have been approved for melanoma patients who have a handful of mutations in the BRAF gene, and more are on the way. “There are some real cures occurring now that five years ago would have been a death sentence,” Clevenger says.

One major advantage of targeted medicines is that they tend to be less toxic. In the 1980s and ’90s oncologists would “take the biggest and baddest drugs and give them to the patient almost irrespective of the particular type of cancer they had,” says Raymond Lewandowski, M.D., a professor in the Department of Human and Molecular Genetics at VCU. Now oncologists can tailor treatment and potentially use drugs with fewer side effects.

Lewandowski is particularly excited about the promise of a new, even more personalized therapy for cancer called CAR-T. The procedure begins with extraction of a patient’s T-cells from the blood. These cells are then engineered in the lab to recognize specific markers on the patient’s cancer cells and expanded to form a cancer-fighting army. Researchers then re-infuse the cells back into the patient. There, “they go hunting,” seeking out and destroying all cancer cells, Lewandowski says.

“The trials have been very exciting and, to a large extent, very successful,” he adds. So successful, in fact, that the Food and Drug Administration approved CAR-T in August. “These cells have the really unique ability to hunt out all of those little, bitty metastatic cells and find them wherever they’re hiding and wipe them out,” he says. “That type of treatment is going to revolutionize cancer treatment for many, many patients.”

Targeted treatments are helping people with heritable genetic disorders as well, Feldman says. In 2012, the FDA approved the first targeted therapy for cystic fibrosis. A second targeted drug became available in 2015. Rather than just addressing the symptoms of cystic fibrosis, these medicines help correct the function of defective proteins in people with specific mutations in the cystic fibrosis gene.

Feldman expects to see many more such drugs approved in the coming years for a whole host of heritable diseases. Although these diseases tend to affect relatively small numbers of people, “if you can extrapolate that to more common diseases that have
some underlying genetic influences, like heart disease or hypertension, there may be opportunities for that type of treatment as well,” he says (read more about Feldman’s career here).

DIY DNA
Some people, like Morton, are taking genetic testing into their own hands. A handful of companies in the U.S. offer direct-to-consumer genetic tests. With just a single sample of saliva, these companies provide information about health and disease risk. Perhaps the most well-known company, 23andMe, offers consumers information about their risk of a handful of diseases and whether they carry harmful mutations that could be passed on to their children. The company also provides information about wellness — for example, whether your genes predispose you to being overweight.

Morton enjoyed getting her test results. And she found the data useful. For example, the test showed she was a fast metabolizer of caffeine, so she stopped drinking decaf.

But other geneticists worry that these direct-to-consumer tests can be confusing and misleading for non-experts. Lewandowski says that companies often don’t provide enough support to consumers. “They send the patient a 15- or 20-page report, and tell them, ‘go to your doctor to have them explain what these mean,’” he says. But primary care physicians might not know how to interpret this information either.

Lewandowski also worries that such tests could give people a false sense of security. People who test negative for genetic variants associated with a given disorder assume that they have no risk, but in some cases the testing companies only look at a few risk variants. The Centers for Disease Control warns that direct-to-consumer genomic testing has little clinical utility and offers little to no health benefits. The agency advises consumers to “think before they spit.”

Feldman echoes that advice. “There are lots of things I think a consumer needs to think about before even having the testing done,” he says, including what kind of tests are being performed, how those tests will be interpreted and what will happen to the DNA sample after testing is complete. “Has the patient signed a consent form that allows that sample to be used for other purposes, or is that DNA to be destroyed after the test?” he asks. “One needs to be careful.”

The deeper geneticists peer into the genome, the more ethical conundrums arise. Parents often bring their sick children to geneticists like Lewandowski in the hope that he can discover the cause of their children’s illnesses. By sequencing all the genes in the genomes of both the child and the parents, he can often pinpoint the rare mutation that is to blame. But such extensive sequencing efforts may turn up other potential genetic risks too — some of them serious. “The parents or patients have to decide whether they want that information or not,” Lewandowski says. The choice isn’t easy, but most people choose to be informed. Knowledge, of course, is power. But it can also be a burden.

By Cassandra Willyard

6 TIPS FOR DIRECT-TO-CONSUMER TESTING

ONE Know what you’re getting. The companies that offer genetic testing aren’t sequencing your genome, or even your genes. They’re only looking at specific spots where variation typically occurs. Genetic variants can provide clues to your ancestry and insight into your risk of developing certain diseases, but the information they provide is limited.

TWO
Make sure you understand what will happen to your data. Will it be used for research? Will it be shared with pharmaceutical companies? What strategy will the testing company use to protect your privacy?

THREE
The test might tell you that you have variants associated with a certain disease, but not everyone with those variants will go on to develop that disease. Conversely, people without those risk variants can still develop that disease, too. The test doesn’t cover all variants.

FOUR
Your test results alone are not enough to guide medical decisions. And in some cases the results might not be all that meaningful. For example, the report might tell you that the average risk for a given disorder is 1 in 1,000, and your risk is 1 in 500. There isn’t much you can do with that information.

FIVE
Other results, however, might help guide your medical care. If you know that you have an increased risk for developing a certain disease, your doctor might be able to recommend lifestyle changes or prescribe medications.

SIX
The test might reveal information you weren’t expecting. Perhaps you’re a carrier for a variant associated with cystic fibrosis. If there’s something on the report that worries you, your best bet is to talk to a board-certified clinical geneticist or a board-certified genetic counselor.

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Updated: 04/29/2016