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The Association Between Sleep Problems, Sleep Medication Use, And Falls In Community-Dwelling Older Adults: Results From The Health And Retirement Study 2010, Yaena Min, Pramit A. Nadpara, Patricia W. Slattum

Pharmacotherapy and Outcomes Science Publications

Background. Very few studies have assessed the impact of poor sleep and sleep medication use on the risk of falls among community-dwelling older adults. The objective of this study was to evaluate the association between sleep problems, sleep medication use, and falls in community-dwelling older adults. Methods. The study population comprised a nationally representative sample of noninstitutionalized older adults participating in the 2010 Health and Retirement Study. Proportion of adults reporting sleep problems, sleep medication use, and fall was calculated. Multiple logistic regression models were constructed to examine the impact of sleep problems and sleep medication use on …

Major Depression As A Complex Dynamic System, Angélique O. J. Cramer, Claudia D. Van Borkulo, Erik J. Giltay, Han L. J. Van Der Maas, Kenneth S. Kendler, Marten Scheffer, Denny Borsboom

Psychiatry Publications

In this paper, we characterize major depression (MD) as a complex dynamic system in which symptoms (e.g., insomnia and fatigue) are directly connected to one another in a network structure. We hypothesize that individuals can be characterized by their own network with unique architecture and resulting dynamics. With respect to architecture, we show that individuals vulnerable to developing MD are those with strong connections between symptoms: e.g., only one night of poor sleep suffices to make a particular person feel tired. Such vulnerable networks, when pushed by forces external to the system such as stress, are more likely to end …

African-American Patients With Cancer Talking About Clinical Trials (Tact) With Oncologists During Consultations: Evaluating The Efficacy Of Tailored Health Messages In A Randomised Controlled Trial—The Tact Study Protocol, R F. Brown, R Davis, M Wilson Genderson, S Grant, D Cadet, M Lessard, J Alpert, J Ward, G Ginder

Health Behavior and Policy Publications

Introduction Low rates of accrual of African-American (AA) patients with cancer to therapeutic clinical trials (CTs) represent a serious and modifiable racial disparity in healthcare that impedes the development of promising cancer therapies. Suboptimal physician–patient consultation communication is a barrier to the accrual of patients with cancer of any race, but communication difficulties are compounded with AA patients. Providing tailored health messages (THM) to AA patients and their physician about CTs has the potential to improve communication, lower barriers to accrual and ameliorate health disparities.

Objective (1) Demonstrate the efficacy of THM to increase patient activation as measured by direct …

News Stories Of Intimate Partner Violence: An Experimental Examination Of Participant Sex, Perpetrator Sex, And Violence Severity On Seriousness, Sympathy, And Punishment Preferences, Matthew W. Savage, Jennifer A. Scarduzio, Kate Lockwood Harris, Kellie E. Carlyle, Sarah E. Sheff

Health Behavior and Policy Publications

This study experimentally examines the effects of participant sex, perpetrator sex, and severity of violence on perceptions of intimate partner violence (IPV) seriousness, sympathy toward the victim, and punishment preferences for the perpetrator. Participants (N = 449) were randomly assigned to a condition, exposed to a composite news story, and then completed a survey. Ratings of seriousness of IPV for stories with male perpetrators were significantly higher than ratings of seriousness for stories with female perpetrators. Men had significantly higher sympathy for female victims in any condition than for male victims in the weak or strong severity of violence …

Substance Use And Depression Symptomatology: Measurement Invariance Of The Beck Depression Inventory (Bdi-Ii) Among Non-Users And Frequent-Users Of Alcohol, Nicotine And Cannabis, Ashlee A. Moore, Michael C. Neale, Judy L. Silberg, Brad Verhulst

Psychiatry Publications

Depression is a highly heterogeneous condition, and identifying how symptoms present in various groups may greatly increase our understanding of its etiology. Importantly, Major Depressive Disorder is strongly linked with Substance Use Disorders, which may ameliorate or exacerbate specific depression symptoms. It is therefore quite plausible that depression may present with different symptom profiles depending on an individual’s substance use status. Given these observations, it is important to examine the underlying construct of depression in groups of substance users compared to non-users. In this study we use a non-clinical sample to examine the measurement structure of the Beck Depression Inventory …

Family-Centered Rounds And Medical Student Performance On The Nbme Pediatrics Subject (Shelf) Examination: A Retrospective Cohort Study, Tiffany N. Kimbrough, Victor Heh, N. Romesh Wijesooriya, Michael S. Ryan

Pediatrics Publications

Objective

To determine the association between family-centered rounds (FCR) and medical student knowledge acquisition as assessed by the National Board of Medical Examiners (NBME) pediatric subject (shelf) exam.

Methods

A retrospective cohort study was conducted of third-year medical students who graduated from Virginia Commonwealth University School of Medicine between 2009 and 2014. This timeframe represented the transition from ‘traditional’ rounds to FCR on the pediatric inpatient unit. Data collected included demographics, United States Medical Licensing Examination (USMLE) Step 1 and 2 scores, and NBME subject examinations in pediatrics (PSE), medicine (MSE), and surgery (SSE).

Results

Eight hundred and sixteen participants …

Underuse And Potential Detrimental Effect Of Radiotherapy In The Management Of Ureteral Cancer, Reza Nabavizadeh, Mashya Abbassi, Emma C. Fields Md

MD Student Summer Research Fellowship Program Posters

Ureteral cancer is extremely rare, with only 3530 cases predicted in 2016. Therefore, published studies on ureteral cancers are limited to single-institution retrospective studies, which have not elucidated a clear recommendation on the best treatment modality. Large cancer databases such as the Surveillance, Epidemiology, and End Results program (SEER) are ideal for providing data for these rare cancers. Epidemiological studies using the SEER database with large sample sizes (13,800) found rising incidence of ureteral cancer over the past 30 years with worsened outcomes in older patients, males, and patients with regional/distant spread. However, to date, these studies have not used …

Rnaseq Analyses Identify Tumor Necrosis Factor-Mediated Inflammation As A Major Abnormality In Als Spinal Cord, David G. Brohawn, Laura C. O'Brien, James P. Bennett Jr.

Physiology and Biophysics Publications

ALS is a rapidly progressive, devastating neurodegenerative illness of adults that produces disabling weakness and spasticity arising from death of lower and upper motor neurons. No meaningful therapies exist to slow ALS progression, and molecular insights into pathogenesis and progression are sorely needed. In that context, we used high-depth, next generation RNA sequencing (RNAseq, Illumina) to define gene network abnormalities in RNA samples depleted of rRNA and isolated from cervical spinal cord sections of 7 ALS and 8 CTL samples. We aligned >50 million 2X150 bp paired-end sequences/sample to the hg19 human genome and applied three different algorithms (Cuffdiff2, DEseq2, …

Donor Ifnl4 Genotype Is Associated With Early Post-Transplant Fibrosis In Recipients With Hepatitis C, Taylor Aiken, Ari Garber, Dawn Thomas, Nicole Hamon, Rocio Lopez, Rajesh Konjeti, Arthur Mccullough, Nizar Zein, John Fung, Medhat Askar, Binu V. John

Internal Medicine Publications

Background and Aims

Early post-transplant hepatic fibrosis is associated with poor outcomes and may be influenced by donor/recipient genetic factors. The rs368234815 IFNL4 polymorphism is related to the previously described IL28B polymorphism, which predicts etiology-independent hepatic fibrosis. The aim of this study was to identify the impact of donor and/or recipient IFNL4 genotype on early fibrosis among patients transplanted for hepatitis C (HCV).

Methods

Clinical data were collected for 302 consecutive patients transplanted for HCV. 116 patients who had available liver biopsies and donor/recipient DNA were included. 28% of these patients with stage 2 fibrosis or greater were compared to …

Burden And Depression Among Caregivers Of Visually Impaired Patients In A Canadian Population, Zainab Khan, Puneet S. Braich, Karim Rahim, Jaspreet S. Rayat, Lin Xing, Munir Iqbal, Karim Mohamed Mohamed, Sanjay Sharma, David Almeida

Ophthalmology Publications

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at …

Burden And Depression Among Caregivers Of Visually Impaired Patients In A Canadian Population, Zainab Khan, Puneet S. Braich, Karim Rahim, Jaspreet S. Rayat, Lin Xing, Munir Iqbal, Karim Mohamed, Sanjay Sharma, David Almeida

Ophthalmology Publications

Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression …

Methods For Evaluating Respondent Attrition In Web-Based Surveys, Camille J. Hochheimer, Roy T. Sabo, Alex H. Krist, Teresa Day, John Cyrus, Steven H. Woolf

Biostatistics Publications

Background: Electronic surveys are convenient, cost effective, and increasingly popular tools for collecting information. While the online platform allows researchers to recruit and enroll more participants, there is an increased risk of participant dropout in Web-based research. Often, these dropout trends are simply reported, adjusted for, or ignored altogether.

Objective: To propose a conceptual framework that analyzes respondent attrition and demonstrates the utility of these methods with existing survey data.

Methods: First, we suggest visualization of attrition trends using bar charts and survival curves. Next, we propose a generalized linear mixed model (GLMM) to detect or confirm …

Speaking Up: Using Ostes To Understand How Medical Students Address Professionalism Lapses, Constance R. Tucker, Beth A. Choby, Andrew Moore, Robert Scott Parker Ii, Benjamin R. Zambetti, Sarah Naids, Jillian Scott, Jennifer Loome, Sierra Gaffney

Publications from the Office of the Dean

Background: Objective-structured teaching encounters (OSTEs) are used across many disciplines to assess teaching ability. The OSTE detailed in this paper assesses 191 fourth-year medical students’ (M4) ability to identify and address lapses in professionalism based on Association of American Medical Colleges’ professionalism competencies. The research questions addressed are:

• How frequently do M4s address professionalism lapses observed during an OSTE?
• What factors influence whether M4s provide feedback when they observe professionalism lapses in an OSTE?

Methods: Standardized patients (SPs) and standardized learners (SLs) were recruited and trained to participate in a standardized encounter with specific cognitive, social, and behavioral …

Dna Methylation Of Regulatory Regions Of Imprinted Genes At Birth And Its Relation To Infant Temperament, Bernard F. Fuemmeler, Chien-Ti Lee, Adelheid Soubry, Edwin S. Iversen, Zhiqing Huang, Amy P. Murtha, Joellen M. Schildkraut, Randy L. Jirtle, Susan K. Murphy, Cathrine Hoyo

Health Behavior and Policy Publications

Background: DNA methylation of the differentially methylated regions (DMRs) of imprinted genes is relevant to neurodevelopment.

Methods: DNA methylation status of the DMRs of nine imprinted genes in umbilical cord blood leukocytes was analyzed in relation to infant behaviors and temperament (n = 158).

Results: MEG3 DMR levels were positively associated with internalizing (β = 0.15, P = 0.044) and surgency (β = 0.19, P = 0.018) behaviors, after adjusting for birth weight, gender, gestational age at birth, maternal age at delivery, race/ethnicity, education level, smoking status, parity, and a history of anxiety or depression. Higher methylation levels at the …

Rnaseq Analyses Identify Tumor Necrosis Factor-Mediated Inflammation As A Major Abnormality In Als Spinal Cord, David G. Brohawn, Laura C. O'Brien, James P. Bennett

Human and Molecular Genetics Publications

ALS is a rapidly progressive, devastating neurodegenerative illness of adults that produces disabling weakness and spasticity arising from death of lower and upper motor neurons. No meaningful therapies exist to slow ALS progression, and molecular insights into pathogenesis and progression are sorely needed. In that context, we used high-depth, next generation RNA sequencing (RNAseq, Illumina) to define gene network abnormalities in RNA samples depleted of rRNA and isolated from cervical spinal cord sections of 7 ALS and 8 CTL samples. We aligned >50 million 2X150 bp paired-end sequences/sample to the hg19 human genome and applied three different algorithms (Cuffdiff2 …

Loneliness, Depression, And Inflammation: Evidence From The Multi-Ethnic Study Of Atherosclerosis, Briana Mezuk, Moon Choi, Amy S. Desantis, Stephen R. Rapp, Ana V. Diez Roux, Teresa Seeman

Family Medicine and Population Health Publications

Objective

Both objective and subjective aspects of social isolation have been associated with alterations in immune markers relevant to multiple chronic diseases among older adults. However, these associations may be confounded by health status, and it is unclear whether these social factors are associated with immune functioning among relatively healthy adults. The goal of this study was to examine the associations between perceived loneliness and circulating levels of inflammatory markers among a diverse sample of adults.

Methods

Data come from a subset of the Multi-Ethnic Study of Atherosclerosis (n = 441). Loneliness was measured by three items derived from the …

Sex And Gender In Medical Education, And Proceedings From The 2015 Sex And Gender Education Summit, Eliza L. Chin, Marley Hoggatt, Alyson J. Mcgregor, Mary K. Rojek, Kimberly Templeton, Robert Casanova, Wendy S. Klein, Virginia M. Miller, Marjorie Jenkins

Family Medicine and Population Health Publications

The Sex and Gender Medical Education Summit: a roadmap for curricular innovation was a collaborative initiative of the American Medical Women's Association, Laura W. Bush Institute for Women’s Health, Mayo Clinic, and Society for Women's Health Research (www.sgbmeducationsummit.com). It was held on October 18–19, 2015 to provide a unique venue for collaboration among nationally and internationally renowned experts in developing a roadmap for the incorporation of sex and gender based concepts into medical education curricula. The Summit engaged 148 in-person attendees for the 1 1/2-day program. Pre- and post-Summit surveys assessed the impact of the Summit, and workshop discussions provided …

The Prostaglandin E2-Ep3 Receptor Axis Regulates Anaplasma Phagocytophilum-Mediated Nlrc4 Inflammasome Activation, Xiaowei Wang, Dana K. Shaw, Holly L. Hammond, Fayyaz S. Sutterwala, Manira Rayamajhi, Kari Ann Shirey, Darren J. Perkins, Joseph V. Bonventre, Thangam S. Velayutham, Sean M. Evans, Kyle G. Rodino, Lauren Viebrock, Karen M. Scanlon, Nicholas H. Carbonetti, Jason A. Carlyon, Edward A. Miao, Jere W. Mcbride, Michail Kotsyfakis, Joao H. F. Pedra

Microbiology and Immunology Publications

Rickettsial agents are sensed by pattern recognition receptors but lack pathogen-associated molecular patterns commonly observed in facultative intracellular bacteria. Due to these molecular features, the order Rickettsiales can be used to uncover broader principles of bacterial immunity. Here, we used the bacterium Anaplasma phagocytophilum, the agent of human granulocytic anaplasmosis, to reveal a novel microbial surveillance system. Mechanistically, we discovered that upon A. phagocytophilum infection, cytosolic phospholipase A2 cleaves arachidonic acid from phospholipids, which is converted to the eicosanoid prostaglandin E2 (PGE2) via cyclooxygenase 2 (COX2) and the membrane associated prostaglandin E synthase-1 (mPGES-1). PGE2-EP3 receptor signaling leads …

Social Determinants Of Participation In A Home Visitation Fluoride Varnish Program, James E. Puryear, Tegwyn Brickhouse, Caroline Carrico

Theses and Dissertations

Purpose: The purpose of this study is to examine the social determinants of CHIP (Child Health Investment Partnership) of Roanoke Valley children who participated in the preventive oral health program compared to those who did not.

Methods: This is a retrospective cohort study of children (n=2,425) enrolled in CHIP of Roanoke Valley from September 2008-September 2014. Bivariate analysis and multivariable logistic regression models were used to compare age, gender, race, locality, parents’ education level, age at enrollment, and length of enrollment for oral health program participants versus those who did not participate.

Results: Children who were Hispanic …

Virginia Dental Journal (Vol. 93, No. 4, 2016)

Virginia Dental Journal

No abstract provided.

Examining The Psychological Adjustments Of Neurotypical Siblings Of Individuals With Autism Spectrum Disorder (Asd) And Determining The Efficiency Of Support Groups, Swathi Deo Sambatha

Undergraduate Research Posters

Neurotypical siblings of individuals with behavioral disorders are reported to have complex, complicated psychological adjustments that vary significantly due to a multitude of sociodemographic factors. In addition, these children are at risk of mental health disorders and negative psychological symptoms. Support groups or extensive social support are known to increase intra-communication and create better sibling dynamics between the neurotypical and autistic siblings. This paper investigates such complications to the psychological adjustment of neurotypical siblings of individuals with autism spectrum disorder (ASD) and determines the implications of the utilization of support groups/social support. The analyzed trends and reportings of multiple studies …

Investigating The Effects Of Racial Residential Segregation, Area-Level Socioeconomic Status And Physician Composition On Colorectal Cancer Screening, Qin Shen

Theses and Dissertations

Background: The current adherence to colorectal cancer screening (CRCS) guidelines is suboptimal. How neighborhood characteristics, e.g., racial residential segregation (RRS), area-level socioeconomic status (SES) and physician composition, affect CRCS adherence are not fully understood. We assessed associations between facility proximity to RRS areas, area-level SES, physician composition, and CRCS adherence.

Methods: Data sources included 2013 Minnesota Community Measurement, 2009-2013 American Community Survey, 2012 U.S. and 2012-2013 Washington State Behavioral Risk Factor Surveillance System data, and 2013-2014 Area Health Resource File. Logistic regressions and weighted multilevel logistic regressions were used to assess the association between facility proximity to RRS areas and …

Testing A Low-Intensity And Accessible Cognitive Behavioral Therapy For Insomnia (Cbt-I) Intervention In Individuals Newly Diagnosed With Cancer, Amma Agyemang

Theses and Dissertations

Insomnia is defined as difficulty initiating or maintaining sleep, or nonrestorative sleep that lasts for at least one month and is accompanied by significant impairment in daytime functioning including fatigue, irritability, and/or difficulty concentrating. It is one of the most common complaints reported by individuals with cancer, especially around the time of cancer diagnosis and treatment. Yet it is often unrecognized and untreated, leading to adverse health consequences and increased healthcare costs. Cognitive Behavioral Therapy for Insomnia (CBT-I) has been recommended as the gold standard for treating insomnia among individuals with cancer. Multiple studies have tested and proven the efficacy …

Stall Seat Journal As A Social Norms Intervention For Risky Drinking Among College Students, Zackaria I. Niazi, Mariam Alshagra, Rhianna G. Ericson, Jinni Su Ph.D., Linda C. Hancock Ph.D.

Undergraduate Research Posters

Alcohol use is prevalent among college students and many participate in risky drinking behaviors over the course of their college careers, leading to negative consequences. The social norms theory posits that individuals behave based on their perceptions of peer behavior. Overestimation of peers’ problem behavior is associated with increase in their own problem behavior. The Stall Seat Journal (SSJ), developed by the Wellness Resource Center, is used in part to help correct common misperceptions, including those related to peer alcohol use. Our study aimed to see if Stall Seat Journal readership was associated with perception of peer alcohol use among …

Perception Of Profile Appearance As Judged By Peers Using 3d Video Imaging, Megan G. Schuler

Theses and Dissertations

The purpose of this study was to investigate the social perceptions of subjects with differing lip position and facial convexity in three dimensions. A 3dMD camera (3dMD, Atlanta, GA) was used to capture 3D images of 9 subjects’ faces. The images were altered to have ideal lip position and ideal convexity, ideal lip position and Class II convexity, Class II lip position and ideal convexity, and Class II lip position and Class II convexity. 400 laypersons rated their perceptions of the subjects’ athletic ability, popularity, leadership, and intelligence on a VAS scale. Subjects with ideal lip position relative to the …

Using Semiphysiologically-Based Pharmacokinetic (Semi-Pbpk) Modeling To Explore The Impact Of Differences Between The Intravenous (Iv) And Oral (Po) Route Of Administration On The Magnitude And Time Course Of Cyp3a-Mediated Metabolic Drug-Drug Interactions (Ddi) Using Midazolam (Mdz) As Prototypical Substrate And Fluconazole (Flz) And Erythromycin (Ery) As Prototypical Inhibitors, Mengyao Li

Theses and Dissertations

The purpose of the project was to investigate the impact of IV and PO routes difference for MDZ, a prototypical CYP3A substrate, and two CYP3A inhibitors (CYP3AI) -FLZ and ERY-, on the magnitude and time course of their inhibitory metabolic DDI.

Individual semi-PBPK models for MDZ, FLZ and ERY were developed and validated separately, using pharmacokinetic (PK) parameters from clinical/in-vitro studies and published physiological parameters. Subsequently, DDI sub-models between MDZ and CYP3AIs incorporated non-competitive and mechanism-based inhibition (MBI) for FLZ and ERY, respectively, on hepatic and gut wall (GW) CYP3A metabolism of MDZ, using available in-vitro/in-vivo information. Model-simulated MDZ …

Characterization And Economic Burden Associated With Pediatric Opioid Exposures And Poisonings, Anisha M. Patel

Theses and Dissertations

Introduction

The main objectives of this study were: 1) to examine the prevalence and characteristics of opioid exposures, 2) to estimate the economic costs associated with opioid poisonings, and 3) to examine the characteristics associated with opioid poisoning-related health care resource use (HCRU) and costs in children.

Methods

Data from the National Poison Data System from January 1, 2010 to December 31, 2014 were utilized to examine the prevalence and characteristics of opioid exposures and poisonings in children <18 years. Economic costs were estimated using the 2012 Nationwide Emergency Department Sample, Kids’ Inpatient Database, Multiple Cause-of-Death file and other published sources, applying a societal perspective. Direct costs included costs associated with ED visits, hospitalizations and ambulance transports. Indirect cost included productivity costs due to caregivers’ absenteeism and premature mortality among children.

Results

There were a total of 83,418 pediatric opioid exposures and nearly half of them resulted in poisoning. The epidemiology of opioid …

The Effect Of Pre-Deployment Physiology As A Predictor Of Post-Traumatic Stress Disorder Among A Sample Of United States Army National Guard And Reserve Soldiers, David J. Rothman

Theses and Dissertations

Potential risk factors for development of Post-Traumatic Stress Disorder (PTSD) are still unclear. One potential risk factor for the development of PTSD is an individual’s cardiovascular reactivity and recovery in response to stressor tasks. The current study was conducted with 763 Army National Guard and Army Reserve soldiers. Participants completed a stressful induction along with self-report measures prior to deployment. Post-deployment, self-report measures were completed to assess PTSD symptomatology and experiences related to deployment and combat. Multiple regression was used to determine the ability of blood pressure response to stress to predict PTSD symptoms immediately and one-year after return from …

Analysis Of Radiographic Changes Associated With The Periradicular Diagnosis Of Symptomatic Apical Periodontitis, Preeti Batra

Theses and Dissertations

Symptomatic apical periodontitis (SAP) is indicative of inflammation of the periodontal ligament. It may or may not be accompanied by radiographic changes and may occur with vital or necrotic pulpal diagnosis. Purpose of this study was to analyze clinical and radiographic presentations of SAP in a retrospective electronic dental chart and digital radiograph review utilizing the endodontic diagnostic template note of predoctoral dental school patients presenting with SAP. The aim was to determine prevalence of periapical radiolucencies (PARLs) in SAP, association of SAP to pulpal diagnosis, and define associated radiographic changes. Most prevalent pulpal diagnosis with SAP was symptomatic irreversible …

The Relationship Between Exercise And Depression And Anxiety In College Students, Joshua Frank, Dr. Amy Adkins, Nathan Thomas, Dr. Danielle Dick

Undergraduate Research Posters

The literature shows an inverse association between exercise and mental disorders. The aim of this study is to further elaborate on this association with regards to exercise and its relationship with anxiety and depression in a college sample. The subject group focused on seniors in the Spit for Science data set which incorporated a total of 821 students. Physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) to estimate the overall metabolic equivalents (MET’s) each student spent in walking, moderate, or vigorous activity levels in the previous week. Sum scores were used to measure depression and anxiety. Overall,the …