Medicine and Health Sciences Commons^™

Fitting A Square Peg Into A Round Hole: Perceptions Of Appalachian Physicians On The Incorporation Of Chronic Disease Prevention Into Their Practice, Lauri Andress, Danny Scalise, Jessica G. Wright, Stephanie E. Moore

Faculty & Staff Scholarship

This study used a focus group in August 2017 (n = 9) to explore the perceptions of rural physicians to a state request to incorporate diabetes prevention screening into their West Virginia medical practice. Analysis of the data revealed that the participants did not think private physicians were equipped to incorporate diabetes prevention programming into their practice. Three categories emerged from the data analysis to explain the reasoning of the health practitioners on the incorporation of pre-diabetes screening and management into their practice.

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The practice of medicine

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Prevention is a mismatch

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Social determinants of health

In the …

An Electronic Health Record Data-Driven Model For Identifying Older Adults At Risk Of Unintentional Falls, Adam Baus, Jeffrey Coben, Keith Zullig, Cecil Pollard, Charles Mullett, Henry Taylor, Jill Cochran, Traci Jarrett, Dustin Long

Clinical and Translational Science Institute

Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically …

Constructing Tailored Parental Monitoring Strategy Profiles To Predict Adolescent Disclosure And Risk Involvement, Lesley A. Cottrell, Christa A. Lilly, Aaron Metzger, Scott A. Cottrell, Andrew D. Epperly, Carrie Rishel, Bo Wang, Bonita F. Stanton

Clinical and Translational Science Institute

No abstract provided.

Inhibition Of Vegf And Angiopoietin-2 To Reduce Brain Metastases Of Breast Cancer Burden, Kaci A. Bohn, Chris E. Adkins, Mohamed I. Nounou, Paul R. Lockman

Clinical and Translational Science Institute

For metastases in the central nervous system, angiogenesis enhances metastatic potential and promotes progression. Primary factors which drive vessel growth are vascular endothelial growth factor (VEGF) and angiopoietin-2. Preclinical models show inhibition of either factor reduces metastases spread and inhibits growth. This work sets out to answer two questions in a preclinical mouse model. First, whether the combined inhibition of VEGF and angiopoietin-2, reduces passive permeability and limits drug uptake into brain metastases; and second, whether this inhibition reduces metastases burden in brain. We observed combinatorial inhibition of VEGF and angiopoietin-2, decreased (p < 0.05) angiogenesis and vascular branching in an aortic ring assay and decreased (p < 0.05) endothelial wound closure times. Using a brain metastases of breast cancer model (induced by intracardiac injections of brain seeking MDA-MB-231Br cells or 4T1Br cells), we observed, similar to VEGF, angiopoetin-2 expression correlates to increased angiogenesis (p < 0.05) and increased lesion permeability. To determine efficacy, animals were administered bevacizumab plus L1-10 (angiopoietin inhibitor) twice per week until neurological symptoms developed. Lesion permeability significantly decreased by ∼50% (p < 0.05) compared to untreated lesions, but remained ∼25% greater (p < 0.0%) than brain. In subsequent experiments, animals were administered similar regimens but sacrificed on day 32. The number of metastatic lesions developed was significantly (p < 0.001) reduced in the bevacizumab group (56%) and combination group (86%). Lesions’ size was reduced in bevacizumab treated lesions (∼67%) and bevacizumab and L1-10 treated lesions (∼78%) developing area < 0.5 mm2. In summary, combinatorial inhibition of VEGF and angiopoietin reduces lesion permeability and brain metastatic burden.