Translational Medical Research Commons^™

Developing A Community-Based Screening And Referral Mechanism For Atrial Fibrillation In Low Resource Settings: “Smartphone Monitoring For Atrial Fibrillation In Real-Time – India (Smart-India)”, Apurv Soni, Nisha Fahey, Harshil Patel, Kandarp Talati, Anna Handorf, John A. Bostrom, Shyamsundar Raihatha, Ravi Shah, Sunil Karna, Robert J. Goldberg, Jeroan J. Allison, Ki Chon, Somashekhar M. Nimbalkar, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation (AF), the world’s most common arrhythmia, often goes undetected and untreated in low-resource communities, including India. Moreover, AF is an important risk factor for stroke, which plagues an estimated 1.6 million Indians annually. As such, early detection of AF and management of high-risk patients is critically important to decrease stroke burden in individuals with AF.

OBJECTIVE: The objectives of this study are to evaluate the age- and sex-stratified epidemiology of AF in Anand District, Gujarat India; characterize the profile of individuals who are diagnosed with AF; and determine the performance of two mobile technologies for community-based AF …

High Burden Of Unrecognized Atrial Fibrillation In Rural India: An Innovative Community-Based Cross-Sectional Screening Program, Apurv Soni, Allison Earon, Anna Handorf, Nisha Fahey, Kandarp Talati, John Bostrom, Ki Chon, Craig Napolitano, Michael S. Chin, John Stephen Sullivan, Shyamsundar Raithatha, Robert J. Goldberg, Somashekhar Nimbalkar, Jeroan J. Allison, Sunil Thanvi, David D. Mcmanus

Apurv Soni

BACKGROUND: Atrial fibrillation, the world's most common arrhythmia, is a leading risk factor for stroke, a disease striking nearly 1.6 million Indians annually. Early detection and management of atrial fibrillation is a promising opportunity to prevent stroke but widespread screening programs in limited resource settings using conventional methods is difficult and costly.

OBJECTIVE: The objective of this study is to screen people for atrial fibrillation in rural western India using a US Food and Drug Administration-approved single-lead electrocardiography device, Alivecor.

METHODS: Residents from 6 villages in Anand District, Gujarat, India, comprised the base population. After obtaining informed consent, a team …

Education Mitigates The Relationship Of Stress And Mental Disorders Among Rural Indian Women, Nisha Fahey, Apurv Soni, Jeroan J. Allison, Jagdish Vankar, Anusha Prabhakaran, Tiffany A. Moore Simas, Nancy Byatt, Ajay Phatak, Eileen O'Keefe, Somashekhar Nimbalkar

Apurv Soni

BACKGROUND: Common mental disorders (CMD) are a constellation of mental health conditions that include depression, anxiety, and other related nonpsychotic affective disorders. Qualitative explanatory models of mental health among reproductive-aged women in India reveal that distress is strongly associated with CMD. The relationship of perceived stress and CMD might be attenuated or exacerbated based on an individual's sociodemographic characteristics.

OBJECTIVES: To screen for Common Mental Disorders (CMD) among reproductive-aged women from rural western India and explore how the relationship between perceived stress and CMD screening status varies by sociodemographic characteristics.

METHODS: Cross-sectional survey of 700 women from rural Gujarat, India. …

Health Promotion Practice And The Road Ahead: Addressing Enduring Gaps And Encouraging Greater Practice-To-Research Translation, Amanda Birnbaum, Mark D. Rivera

Amanda Birnbaum

A decade ago, Lancaster and Roe described four critical gaps (i.e., communications, accessibility, credibility, and expectations) between research and practice in health education and health promotion that formed the framework for this department. Despite considerable attention and some progress, these gaps persist and are barriers to interaction and translation between health promotion and health education research and practice. Looking to the next several years as the new Associate Editors for this department, we renew the department’s commitment toward addressing these enduring gaps around which we frame new questions and invite continued dialogue.

The Fertility Problem Inventory And Infertility-Related Stress: A Case Study, Staci L. Born, Jennifer J. Preston

Staci Born

More than seven million people of childbearing age in the United States experience infertility. Oftentimes, for women, the experience of infertility is stressful. The Fertility Problem Inventory (FPI) has been used to quantitatively measure women’s experience of infertility-related stress. However, the construct of infertility-related stress is poorly described in existing literature. The purpose of this case study was to understand how women experience the FPI as a measure of infertility-related stress. To address this issue, women who were undergoing infertility treatment completed the FPI and participated in unstructured interviews. Archival documents were also retrieved to corroborate findings and satisfy saturation. …

Defining Patient-Oriented Research For The Average Person (And Potential Research Partner), Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this introduction to the first issue of 2019, the editor-in-chief of Journal of Patient-Centered Research and Reviews offers additional context to the findings of Kaur and Pluye (p. 7), who methodically formalized an operational definition of patient-oriented research for the purposes of searching bibliographic databases. A possible succinct, lay definition of patient-oriented research for the average “person on the street” is proposed.

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Hepatic Changes Associated With Chronic Alcohol Exposure In An Alpha-1 Antitrypsin Piz Mouse Model, Zhuoyao Lyu, Alisha M. Gruntman, Brian O'Sullivan-Murphy, Christian Mueller, Terence R. Flotte

Christian Mueller

The PiZ mutation in the alpha-1 antitrypsin (AAT) gene causes the PiZ mutant protein to be sequestered in the endoplasmic reticulum of hepatocytes, causing significant liver pathology in ~10% of PiZZ homozygous AAT disease patients. Current transgenic mouse models of the disease include the liver-specific over-expression of mutant PiZ protein. However, these animal models do not efficiently recapitulate the liver damage found in PiZZ homozygous patients. Since only a small percentage of patients develop liver disease and it is not reproducible in animal models of AATD, it suggests that there are other factors that participate in disease pathogenesis. Here, we …

Evolution Of The Alpha-1 Antitrypsin Muscle Gene Therapy: Translation From Clinical Trial To Benchtop And Back Again, Alisha M. Gruntman, Gwladys Gernoux, Gensheng Wang, Janet Benson, Jeff Chulay, Dave Knop, Christian Mueller, Terence R. Flotte

Christian Mueller

Alpha-one antitrypsin (AAT) deficiency is a genetic disease affecting the lungs due to inadequate anti-protease activity in the pulmonary interstitium. On-going human trials use intra-muscular delivery of adeno-associated virus (rAAV1), allowing expressing myofibers to secrete normal (M)AAT protein. In the Phase IIa trial, patients in the highest dose cohort (6x1012vg/kg) were given 100 intra-muscular (IM) injections of undiluted vector, with serum AAT levels still substantially below target levels. Previous work has shown that delivering rAAV vector to the musculature via limb perfusion leads to widespread gene expression in myofibers. We hypothesize that widespread delivery would result in an overall increase …

Pain And Pharmacologic Pain Management In Long-Stay Nursing Home Residents, Jacob N. Hunnicutt, Christine M. Ulbricht, Jennifer Tjia, Kate L. Lapane

Jennifer Tjia

Prior studies estimate that >40% of long-stay nursing home (NH) residents experience persistent pain, with 20% of residents in pain receiving no analgesics. Strengthened NH surveyor guidance and improved pain measures on the Minimum Data Set (MDS) 3.0 were introduced in March 2009 and October 2010, respectively. This study aimed to provide estimates after these important initiatives of: 1) prevalence and correlates of persistent pain; and 2) prevalence and correlates of untreated or undertreated persistent pain. We identified 1,387,405 long-stay residents in United States NHs between 2011-2012 with 2 MDS assessments 90 days apart. Pain was categorized as persistent (pain …

Taking Flight To Disseminate Translational Research: A Partnership Between The Umass Center For Clinical And Translational Science And The Library’S Institutional Repository, Lisa A. Palmer, Sally A. Gore

Lisa A. Palmer

eScholarship@UMMS is the University of Massachusetts Medical School’s open access digital archive of research and scholarship, managed by the Lamar Soutter Library. The Library began collaborating with the UMass Center for Clinical and Translational Science (UMCCTS) in 2011. eScholarship@UMMS facilitates knowledge and resource sharing of the UMCCTS by collecting and organizing its research products, including Research Retreat posters and presentations, Community Engagement Symposia products, the UMCCTS Newsletter, the UMCCTS Seminar Series, and publications that are the result of UMCCTS-supported research. eScholarship@UMMS provides long-term stable URLs for access to content, which are highly discoverable in Google and other search engines, maximizing …

Recruitment Of Young Adult African American Women In Health Research: Best Practices And Lessons Learned, Sarah M. Camhi, Laura L. Hayman

Laura L. Hayman

As part of the breakout session entitled "Creating Crucial Connections: Lessons Learned from Engaging Diverse Communities in Research," this presentation discusses engaging young adult African American women in community-engaged research and the steps taken to develop critical partnerships which provided the foundation for conducting relevant research in the community.

Developing Hyperpolarized Silicon Particles For In Vivo Mri Targeting Of Ovarian Cancer, Nicholas Whiting, Jingzhe Hu, Niki M. Zacharias, Ganesh L. R. Lokesh, David E. Volk, David G. Menter, Rajesha Rupaimoole, Rebecca Previs, Anil K. Sood, Pratip Bhattacharya

Nicholas Whiting

Magnitude Of And Prognostic Factors Associated With 1-Year Mortality After Hospital Discharge For Acute Decompensated Heart Failure Based On Ejection Fraction Findings, Andrew H. Coles, Mayra Tisminetzky, Jorge L. Yarzebski, Darleen M. Lessard, Joel M. Gore, Chad E. Darling, Robert J. Goldberg

Jorge L. Yarzebski

BACKGROUND: Limited data exist about the magnitude of and the factors associated with prognosis within 1 year for patients discharged from the hospital after acute decompensated heart failure. Data are particularly limited from the more generalizable perspective of a population-based investigation and should be further stratified according to currently recommended ejection fraction (EF) findings.

METHODS AND RESULTS: The hospital medical records of residents of the Worcester, Massachusetts, metropolitan area who were discharged after acute decompensated heart failure from all 11 medical centers in central Massachusetts during 1995, 2000, 2002, 2004, and 2006 were reviewed. The average age of the 4025 …

Attitudes Toward Substance Abuse Clients: An Empirical Study Of Clinical Psychology Trainees, Chandra Mundon, Melissa Anderson, Lisa Najavits

Melissa L. Anderson

Despite the high prevalence of substance use disorder (SUD) and its frequent comorbidity with mental illness, individuals with SUD are less likely to receive effective SUD treatment from mental health practitioners than SUD counselors. Limited competence and interest in treating this clinical population are likely influenced by a lack of formal training in SUD treatment. Using a factorial survey-vignette design that included three clinical vignettes and a supplementary survey instrument, we investigated whether clinical psychology doctoral students differ in their level of negative emotional reactions toward clients with SUD versus major depressive disorder (MDD); whether they differ in their attributions …

Interrogating Metabolism In Brain Cancer, Travis Salzillo, Jingzhe Hu, Linda Nguyen, Nicholas Whiting, Jaehyuk Lee, Joseph Weygand, Prasanta Dutta, Shivanand Pudakalakatti, Niki Zacharias Millward, Seth Gammon, Frederick F. Lang, Amy B. Heimberger, Pratip Bhattacharya

Nicholas Whiting

Displacement Across A Fracture Gap With Axial Loading Of Far Cortical Locking Constructs, Peter Wagner, Dennis Murphy, Kristen Billiar, Judith Siegel, John Wixted

Kristen L. Billiar

Purpose: Far cortical locking has been proposed for reducing stiffness and promoting greater dynamic stability in locked plating constructs. Prior studies have shown reduced stiffness with axial loading of these constructs, leading to a theoretical increase in inter-fragmentary motion and secondary bone healing. The purpose of this study was to examine strain across a fracture gap using far cortical locking constructs in a biomechanical model of distal femoral fractures.

Methods: Fourth generation sawbones were cut transversely along the distal diaphysis and plated with distal femoral buttress plates and cortical locking screws. Far cortical locking (FCL) specimens were predrilled in the …

Characterizing The Performance And Behaviors Of Runners Using Twitter, Qian He, Emmanuel Agu, Diane Strong, Bengisu Tulu, Peder Pedersen

Emmanuel O. Agu

Running is a popular physical activity that improves physical and mental wellbeing. Unfortunately, up-to- date information about runners’ performance and psychological wellbeing is limited. Many questions remain unanswered, such as how far and how fast runners typically run, their preferred running times and frequencies, how long new runners persist before dropping out, and what factors cause runners to quit. Without hard data, establishing patterns of runner behavior and mitigating the challenges they face are difficult. Collecting data manually from large numbers of runners for research studies is costly and time consuming. Emerging Social Networking Services (SNS) and fitness tracking devices …

Getting To The Root Of Bacterial Hairs: What Is “S”?, Rebecca Gaddis, Samantha O'Conner, Evan Anderson, Terri Camesano, Nancy Burnham

Nancy A. Burnham

An atomic force microscope (AFM) was used to measure the steric forces of lipopolysaccharides (LPS) on the biofilm-forming bacteria, Pseudomonas aeruginosa. It is well known that LPS play a vital role in biofilm formation. These forces were characterized with a modified version of the Alexander and de Gennes (AdG) model for polymers, which is a function of equilibrium brush length, L, probe radius, R, temperature, T, separation distance, D, and an indefinite density variable, s. This last parameter was originally distinguished by de Gennes as the root spacing or mesh spacing depending upon the type of polymer adhesion; however since …

Detection Of Diabetic Foot Ulcers Using Svm Based Classification, Lei Wang, Peder Pedersen, Diane Strong, Bengisu Tulu, Emmanuel Agu, Qian He, Ronald Ignotz, Raymond Dunn, David Harlan, Sherry Pagoto

Emmanuel O. Agu

Diabetic foot ulcers represent a significant health issue, for both patients’ quality of life and healthcare system costs. Currently, wound care is mainly based on visual assessment of wound size, which suffers from lack of accuracy and consistency. Hence, a more quantitative and computer-based method is needed. Supervised machine learning based object recognition is an attractive option, using training sample images with boundaries labeled by experienced clinicians. We use forty sample images collected from the UMASS Wound Clinic by tracking 8 subjects over 6 months with a smartphone camera. To maintain a consistent imaging environment and facilitate the capture process …

A Context-Aware Activity Recommendation Smartphone Application To Mitigate Sedentary Lifestyles, Qian He, Emmanuel Agu

Emmanuel O. Agu

A sedentary lifestyle involves irregular or no physical activity. In this kind of lifestyle, people’s activities do not increase their energy expenditure substantially above resting levels. Long periods of sitting, lying, watching television, playing video games, and using the computer are typical examples. Energy expenditures at 1.0-1.5 Metabolic Equivalent Units (METs) are considered sedentary behaviors. A recent study of sedentary lifestyles found that the length of sedentary times is associated with an increased risk of diabetes, cardiovascular disease, and cardiovascular and all-cause mortality. In this study, we developed a smartphone application called “On11”, which continuously tracks and informs the user …

Evening Snacking In Relation To Self-Reported Declines In Sleep Quality During Pregnancy: Preliminary Results From The Decision-Making, Eating, And Weight Gain During Pregnancy (Dew) Study, Wendy Mccallum, Bradley M. Appelhans, Tiffany A. Moore Simas, Rui Sherry Xiao, Shums Alikhan, Isabelle C. Pierre-Louis, Barbara C. Olendzki, Sherry L. Pagoto, Molly E. Waring

Tiffany A. Moore Simas

Background: Poor sleep in non-pregnant adults has been associated with increased evening snacking, which may contribute to weight gain. Sleep disturbances are common during pregnancy.

Objective: To examine the association between changes in sleep quality from pre-pregnancy and evening snacking.

Methods: In an ongoing prospective cohort study, pregnant women were recruited from UMMHC obstetric practices and the community. Participants are 18+ years, with singleton gestation <36 >weeks, pre-pregnancy BMI 18.5-40 kg/m2, English-speaking, and with plans to deliver at UMMHC. Participants were asked “compared to the three months before you became pregnant, how is your sleep quality now?”; we combined responses of …

Perceiving One's Heart Condition To Be Cured Following Hospitalization For Acute Coronary Syndromes: Implications For Patient-Provider Communication, Molly Waring, David Mcmanus, Stephenie Lemon, Joel Gore, Milena Anatchkova, Richard Mcmanus, Arlene Ash, Robert Goldberg, Catarina Kiefe, Jane Saczynski

Richard H. McManus

OBJECTIVE: We examined the proportion of patients perceiving their heart condition to be cured following hospitalization for ACS and identified characteristics associated with these perceptions.

METHODS: We conducted a prospective cohort study of adults hospitalized with ACS (N=396). Patient interviews during hospitalization and one week post-discharge provided demographic and psychosocial characteristics. Medical records provided clinical characteristics. At one week, patients who rated "My heart condition is cured" as "definitely true" or "mostly true" were considered to perceive their heart condition cured.

RESULTS: Participants were aged 60.7 (SD:11.0) years, 26.5% female, and 89.0% non-Hispanic white; 16.7% had unstable angina, 59.6% NSTEMI, …

Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions, Ahmad Nusair, Md, Balwinder Singh, Md, Ms., Shifang Ding, Md, Phd., Ognjen Gajic, Md, Guangxi Li, Md

Ahmad R. Nusair, M.D.

Objective There is no widely accepted standard definition for Ventilator Associated Pneumonia (VAP). The reliability of the current definitions in use remains controversial. Our objective was to assess the reliability of six commonly used VAP definitions: The Loose, The Rigorous, The Modified Clinical Pulmonary Infection Score (CPIS), The Canadian Critical Care Trials Group (CCCTG), The International Sepsis Forum Consensus (ISFC) and The Center for Disease Control and Prevention (CDC). Design We examined the electronic health records of all the consecutively admitted adult patients at our institution who received invasive mechanical ventilation (IMV) for ≥ 48 hours, from January 2006 through …

Interrater Variability In Identifying Ventilator Associated Pneumonia Using Six Different Definitions#11;, Ahmad Nusair, Balwinder Singh, Ognjen Gajic, Guangxi Li

Ahmad R. Nusair, M.D.

There is no widely accepted standard definition for Ventilator Associated Pneumonia (VAP). The reliability of the current definitions in use remains controversial. Our objective was to assess the reliability of six commonly used VAP definitions: The Loose, The Rigorous, The Modified Clinical Pulmonary Infection Score (CPIS), The Canadian Critical Care Trials Group (CCCTG), The International Sepsis Forum Consensus (ISFC) and The Center for Disease Control and Prevention (CDC).

Working Therapeutically With Deaf People Recovering From Trauma And Addiction, Melissa Anderson, Neil Glickman, Lisa Mistler, Marco Gonzalez

Melissa L. Anderson

OBJECTIVE: This article reviews what is known about behavioral health treatment of deaf persons with comorbid trauma and addiction.

METHOD: We discuss how to work therapeutically with deaf people with comorbid trauma and addiction, both through a review of the literature and through clinical observations of the authors. The article also includes the personal stories of two people-a Deaf peer specialist and a hearing psychiatrist-who share their humbling stories about the recovery process for deaf people and the challenges of learning to become an effective Deaf mental health care provider.

FINDINGS: Deaf people report higher rates of mental health problems …

Plasma Micrornas Are Associated With Atrial Fibrillation (The Mirhythm Study) And Change After Catheter-Ablation, David D. Mcmanus, Kahraman Tanriverdi, Honghuang Lin, Nada Esa, Menhel Kinno, Rosalind Lee, Divakar Mandapati, Stanley Tam, Patrick T. Ellinor, John F. Keaney, Emelia J. Benjamin, Victor R. Ambros, Jane E. Freedman

Victor R. Ambros

Background: Atrial fibrillation (AF) is the most common dysrhythmia in the U.S. and Europe. Few biomarkers exist to identify individuals at risk for AF. Cardiac microRNAs (miRNAs) have been implicated in susceptibility to AF and are detectable in the circulation. Nevertheless, data are limited on how circulating levels of miRNAs relate to AF or change over time after catheter- ablation. Methods: In 211 miRhythm participants (112 with paroxysmal or persistent AF; 99 without AF), we quantified plasma expression of 86 miRNAs associated with cardiac remodeling or disease by high-throughput quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). We used qRT-PCR to examine …