Medicine and Health Sciences Commons^™

Clinical Reconciliation Of Patient Social Context And Implementation Of Preventive Care Guidelines, April Williams

Graduate Research Posters

Background

Preventive care practice guidelines are disseminated regularly through federal and scientific groups as a way of promoting best practices and evidence-based health promotion. Yet rates of their implementation are historically low and complex, with cited barriers including limits on physicians’ time, knowledge or attitudes; and external factors related to the guideline itself, the clinical environment, or patient factors. The objective of this qualitative research is to understand how primary care clinicians and staff reconcile perceived patient-level factors and implementation of preventive care guidelines.

Methods

Key informant interviews (n=23) with 14 clinicians and 9 office managers from 14 primary care …

Determining The Impact Of Increased Physical Activity On Improving Sleep Quality In Young Adults, Ashley Darling, Alex Chiu, Eric Henderson, Aaron Autler, Jennifer Weggen, Kevin Decker, Ryan Garten

Graduate Research Posters

Determining the Impact of Increased Physical Activity on Improving Sleep Quality in Young Adults

Disturbed sleep, defined as any alteration to normal sleep patterns, has been linked to poor cardiovascular health and an increase in cardiovascular disease (CVD) risk. These negative sleep patterns are highly prevalent with 35% to 41% of individuals in the United States reported some form of disturbed sleep. Although high amounts of physical activity (PA) are often associated with high sleep quality, little is known about PA’s effectiveness to improve different aspects of sleep (e.g. duration vs quality) and the mechanisms to which it can improve …

The Effects Of A High Fat Meal On Blood Flow Regulation During Arm Exercise, Alexander Chiu, Lauren Pederson, Jeremy O. Via, Natalie J. Bohmke, Jacob Richardson, Aaron Autler, Hunter Reed, Eric Henderson, R. Lee Franco, Ryan S. Garten

Graduate Research Posters

A diet high in saturated fats results in endothelial dysfunction and can lead to atherosclerosis, a precursor to cardiovascular disease. Exercise training is a potent stimulus though to mitigate the negative effects of a high saturated fat diet; however, it is unclear how high-saturated fat meal (HSFM) consumption impacts blood flow regulation during a single exercise session.

PURPOSE: This study sought to examine the impact of a single HSFM on peripheral vascular function during an acute upper limb exercise bout.

METHODS: Ten young healthy individuals completed two sessions of progressive handgrip exercise. Subjects either consumed a HSFM (0.84 g of …

Dyrk1a And The Cell Cycle, Holly Byers, Larisa Litovchick, Md, Phd

Graduate Research Posters

The ability to halt the cell cycle is critical for cells to maintain tissue and organ size, to suppress tumors and abnormal growth, and exists as a helpful mechanism to pause the cell cycle for DNA repair. DYRK1A is (dual specificity tyrosine-(Y)-phosphorylation regulated kinase 1A) a human gene found on the long (q) arm of chromosome 21, which is known to be involved with nervous system development, cell growth and division, and neuronal differentiation. In glioblastoma cells grown in vitro (T98G cell line), there are three copies of DYRK1A, which have dosage- dependent effects on the cell, including association with …

The Future Of Returning Genetic Test Results For Psychiatric Conditions, Morgan Driver, Sally Kuo, Danielle Dick

Graduate Research Posters

Background: Genome-wide association studies are rapidly advancing our understanding of the genetic architecture of complex psychiatric conditions. In order to use findings from these studies for enhanced clinical prediction, we need to gain a better understanding of the issues surrounding the return of complex genetic results.

Methods: We review the current literature on genetic literacy in the population, the public’s interest in receiving genetic test results for psychiatric conditions, how individuals react to and interpret their genetic results for psychiatric conditions, and gaps in our knowledge that will be critical to address before returning genetic results for psychiatric conditions.

Results: …

Prevalence Of Mental Health Disorder Symptoms And Rates Of Help-Seeking Among University-Enrolled, Black Men, Kofoworola D. A. Williams, Amy Adkins, Sally I-Chun Kuo, Jessica G. Larose, Shawn O. Utsey, Jeanine P. D. Guidry, Danielle Dick, Spit For Science Working Group, Kellie E. Carlyle

Graduate Research Posters

Background. Black men in college represent a subgroup of emerging adults who are at increased risk of developing mental health disorders (MHDs), such as anxiety and depression. Such risk has been attributed to disproportionate experiences with everyday racial discrimination and high levels of psychological distress. Despite being at higher risk, university-enrolled, Black men are not utilizing mental health or health resources at optimal rates. The current evidence base describing prevalence of MHDs and health services utilization among Black men in college is limited. The present study addresses this by examining mental health prevalence among university-enrolled, Black men and their rates …

Local Lung Targeting Of Tumor Associated Macrophages Combined With Cytoreductive Therapy Decrease Tumor Burden In A Secondary Lung Cancer Model, Sulaiman Alhudaithi, Hanming Zhang, Rashed Almuqbil, Wei Du, Fatemah Sunbul, Paula Bos, Sandro Da Rocha

Graduate Research Posters

Backgrounds. The efficacy of a locally administered small molecule colony stimulating factor 1 receptor inhibitor (CSF-1Ri), PLX3397, alone or in combination with cytoreductive therapy (paclitaxel) in reducing the tumor burden of an in vivo model of secondary lung cancer was investigated in this work. Local administration of immunotherapy to the lungs may enhance lung biodistribution of such therapies and reduce potential unwanted off-target toxicity. In addition, combination of such therapy with low dose standard of care chemotherapy may offer improved anti-tumor effects.

Methods. Murine breast cancer cells (4T1, known to be highly metastasized to the lungs) were transduced to …

Guadecitabine, In Combination With Cyclophosphamide, Promotes Anti- Cancer Immunity In Balb/C Mice Bearing 4t1 Mouse Mammary Carcinoma, Carmen Camarena, Timothy M. Smith, Rebecca K. Martin Phd, Harry D. Bear Md

Graduate Research Posters

Background: The extremely high mortality rate of patients diagnosed with triple negative breast cancer makes it one of the deadliest forms of cancer. Due to the heterogenous nature of tumors, complete clearance is not achieved and clonal selection occurs resulting in tumor cells evading the immune system. I aim to design a therapeutic intervention that is able to elicit an effective immune response against the tumor and instill immunological memory to eradicate primary and metastatic lesions. I hypothesize that the combination of Guad and Cyp will synergize and promote anticancer immunity via increased expression of neo-tumor antigens and depletion of …

Molecular Predictors Of Anakinra Treatment Success In Heart Failure Patients With Reduced Ejection Fraction, Joshua Morriss, Daniel Contaifer Jr, Leo F. Buckley, George Wohlford, Monther Alsultan, Suad Alshammari, Asanga D. Ranasinghe, Salvatore Carbone, Justin M. Canada, Cory Trankle, Elvin T. Price, Antonio Abbate, Benjamin W. Van Tassell, Dayanjan S. Wijesinghe

Graduate Research Posters

Background. Kineret (Anakinra) is an interleukin-1 antagonist that is under investigation for its novel clinical application treating patients that have heart failure with reduced (<50%) ejection fraction (HFrEF). A prior study from our group indicated that Anakinra may restore heart function by addressing dysregulations in HFrEF metabolic pathways. Herein, we attempt to elicit Anakinra’s effects on both metabolome and lipidome.

Methods. Lipids and metabolites that had previously been quantified by mass spectrometry (MS) from patients (n=49) who had ≥2 mg/L of high-sensitivity C-reactive protein (hs-CRP) were mTIC normalized and transformed. We conducted a stepwise Linear Discriminant Analysis (r- LDA) to test Anakinra (2 and 12 weeks) vs placebo for separation from combined baseline. Metabolic pathway analysis was performed with Fisher’s exact test algorithm for detection of over-represented and enriched analytes. Univariate analysis (one tailed t-test …

Effects Of Dietary Sodium Intake On Blood Flow Regulation During Exercise In Salt Resistant Individuals, Kevin P. Decker, Morgan T. Kimmel, Hunter L. Reed, Alex H. Chiu, Austin C. Hogwood, Jennifer B. Weggen, Ashley M. Darling, Ryan S. Garten

Graduate Research Posters

PURPOSE: Dietary sodium intake guidelines is ≤2,300 mg/day, yet is exceeded by 90% of Americans. This study examined the impact of a high sodium diet on blood flow regulation during exercise. METHODS: Six males (25 ± 2 years) consumed dietary sodium intake guidelines for two weeks, with one week salt-capsule supplemented (HS: 6,900 mg/day of sodium) and the other week placebo-capsule supplemented (LS: 2,300 mg/day of sodium). At the end of each week, peripheral hemodynamic measurements [blood flow (BF), shear rate (SR), and flow mediated dilation (FMD)/SR)] of the brachial and superficial femoral artery were taken during handgrip (HG) and …

“How Am I Supposed To Feel?”: Social Support And Black Mothers’ Infant Feeding Decisions, Hannah M. Ming, Cecilia Barbosa

Graduate Research Posters

Background: Many of the adverse health outcomes that breastfeeding protects against disparately affect black mothers and children; however, black mothers are the least likely racial group in the U.S. to breastfeed. Black mothers have indicated that breastfeeding barriers include a lack of social support. Qualitative studies examining such breastfeeding barriers often focus on women who have unsuccessfully breastfed and fail to define the experiences of women who have successfully breastfed. This study aims to identify the impacts of social support on the infant feeding decisions of black women with varying levels of breastfeeding success.

Methods: Twenty-five black women were interviewed …

Vascular Dysfunction And Posttraumatic Stress Disorder: Examining The Role Of Oxidative Stress And Sympathetic Activity, Jennifer Weggen, Aaron Autler, Gina Tuzzolo, Austin C. Hogwood, Ashley M. Darling, Kevin P. Decker, Ryan S. Garten

Graduate Research Posters

Purpose: The physiological manifestations of posttraumatic stress disorder (PTSD) have been associated with an increase in risk of cardiovascular disease (CVD) independent of negative lifestyle factors. The goal of the study was to better elucidate the mechanisms behind the increased CVD risk by examining peripheral vascular function, a precursor to CVD. Moreover, this study sought to determine the role of oxidative stress and sympathetic nervous system (SNS) activity in PTSD-induced vascular dysfunction.

Methods: Sixteen individuals with PTSD (10 women, 6 men; age 24 ± 4 years), and twenty-four healthy controls (CTRL; 15 women, 9 men, 24 ± 4 years), participated …

An Examination Of Virginia Wic Staff’S Attitudes And Knowledge Towards The Brush, Book, Bed Oral Health Program, Tia Jackson, Tegwyn H. Brickhouse, Lizbeth Snead, Natalie Pennywell

Graduate Research Posters

Introduction: Families who are low income and have low oral health literacy tend to have poor oral health. The Brush, Book, Bed (BBB) program helps caregivers establish a consistent night routine for their children that includes brushing teeth, reading, and an age-appropriate bedtime. BBB has been shown to increase oral hygiene behaviors and therefore oral health outcomes. Studies have shown that children who participate in Women, Infants, and Children, (WIC) programs are more likely to access dental services. This study examined local Richmond, Virginia (VA) WIC staff on their current oral health knowledge and views on implementing BBB.

Methods: A …

A Pre-Transplant Blood-Based Lipid Signature For Prediction Of Antibody-Mediated Rejection In Kidney Transplant Patients, Monther Al Sultan, Daniel Contaifer Jr., Joshua Morriss, Suad Alshammari, Jeffrey Stern, Sindhura Bobba, Pamela Kimball, Anne King, Dhiren Kumar, Marlon Levy, Gaurav Gupta, Dayanjan Wijesinghe

Graduate Research Posters

Purpose. The aim of this study is to demonstrate the potential of the pre-transplant lipidome to predict post-transplant antibody-mediated rejection (AMR) in kidney transplant patients.

Methods. Patients were selected from a prospective observational cohort of a single-center adult kidney transplant center in the United States. The study included 16 kidney transplant patients who develop AMR within 2 years post-transplant and 29 stable control (SC) kidney transplant patients who did not develop AMR at any time within the post-transplant follow up. Selection of group differences on the day of transplant was determined by t-test analysis. Stepwise forward method was used to …

Perceptions Of Using Smart Speaker Technology For Improving The Health And Wellness Of Older Adults Living In A Low-Income Community, Brooke Saba Mcdowell, Jane Chung, Johnathan Bennett

Graduate Research Posters

There is a growing interest in the usage of smart speakers in various settings with older adults for improved quality of life and health. Residents who live within a low-income housing development may benefit from the use of smart speaker technology for creating a more engaging and healthier lifestyle. Because technology acceptance is critical; this study aims to examine smart speaker acceptance among low-income senior housing residents. A cross-sectional survey (n=46) was conducted to assess smart speaker acceptance, perceived usefulness, perceived ease, and privacy concerns. Individuals were recruited through varying methodologies, including group information sessions, sign-up sheets, word of mouth, …

Dendrimer Conjugation Enhances Tumor Penetration And Cell Kill Of Doxorubicin In 3d Coculture Lung Cancer Models, Rashed Almuqbil, Rodrigo S. Heyder, Elizabeth R. Bielski, Mikhail Durymanov, Joshua J. Reineke, Sandro R. P. Da Rocha

Graduate Research Posters

Background: Doxorubicin (DOX) is a potent chemotherapeutic widely used for solid tumors (1). Despite high efficacy in 2D cell culture, DOX efficacy does not translate to in vivo lung cancer models (2). Major side effects such as cardiotoxicity may be alleviated with nano-based drug delivery systems (nanoDDS). However, tumor penetration of DOX and DOX-nanoDDS is largely unknown and is an additional barrier to effective clinical therapy (3). Here we describe a nanoDDS capable of enhancing the penetration of DOX.

Methods: DOX was conjugated to generation 4 poly(amido-amine) dendrimers through (GFLG) tumor- liable bond. G4SA-GFLG-DOX was synthesized/characterized. spheroids were formed of …

Investigating The Role Of Aeg-1 In Mouse Models Of Pain, Bryan Mckiver, Wisam Toma, Deniz Bagdas, Devanand Sarkar, M. Imad. Damaj

Graduate Research Posters

Background: Astrocyte Elevated Gene 1 (AEG-1) is a multifunctional protein shown to be a regulator of transcription and multiple intracellular signaling pathways. The role of AEG-1 in cellular inflammation appears to be primarily facilitated by its direct interaction with the transcription factor NFκB, transcriptional regulator of inflammatory cytokines. May be have a potential role in models of pain, particularly chronic inflammatory and chemotherapy induced peripheral neuropathy (CIPN). Methods: C57BL6/J male and female mice, 8-14 weeks old. AEG-1 wild type (WT) and global knockout (KO) male and female mice, 8-14 weeks old. Chronic Inflammatory Pain induced via i.pl. injection of 50% …

Development Of An R Script For Simple Lipidomic And Metabolomic Data Analysis, Suad Alshammari, Joshua M. Morriss, Daniel Contaifer, Dayanjan S. Wijesinghe, Monther Alsultan

Graduate Research Posters

Background: Metabolomic and lipidomic studies generate vast quantities of data that are often analysed in a closed software environment with little to no access to the underlying algorithms. As a result, data processed via different software pipelines yield different results thus leading to a widespread problem of low reproducibility within these fields. To address this problem, we are developing LipidAnalyst; an R based lipidomics software pipeline. As a part of this project, we are creating a simple statistical analysis and graphing module in R to generate accurate, reproducible, high-resolution figures.

Methods: R scripts were developed under version 3.5.3 with the …

Paroxetine Is Pro-Inflammatory In Human Brain Microvascular Endothelial Cells, Syeda Hashimi, Sulay Patel, Omar Hassan, Bukola Odeniyi

Graduate Research Posters

BACKGROUND: Paroxetine is an antidepressant that is widely used. However, Paroxetine possesses anticholinergic properties which may contribute to cognitive decline in older adults. Surprisingly, the mechanisms of the cognitive decline of anticholinergic drugs in older adults remains elusive. A hypothesis is that a loss of cholinergic signaling is pro-inflammatory in the brain. We designed experiments to determine if Paroxetine is pro-inflammatory in Normal Human Brain Microvascular Endothelial Cells (NHBMECs).

METHOD: NHBMECs were grown at 5% CO2, 37C and 95% relative humidity until 90% confluent. NHBMECs were treated with the RNA free water as control, Paroxetine as 1.67x 10 4 mM/mol, …

Impact Of Diet On Colorectal Cancer, Ashley Rosenberg Md, Mirinda Gromley Msph, Nicole Weighard Md, Juan Lu J Phd Mph Md

Graduate Research Posters

Background

Colorectal cancer (CRC) is the third most common cancer diagnosed worldwide. Modifiable risk factors such as diet have been linked to the development of CRC but results of previous research have been inconsistent. We utilized the National Health and Nutrition Examination Survey (NHANES) to determine whether the consumption of dietary variables contributed to increased diagnosis of colorectal cancer.

Methods

Participants from NHANES 2015-2016 database aged 16 years or older, with available two-day dietary and CRC information were included. Study exposure included dietary consumptions (salt, cholesterol, sugar, fat, and carbohydrates); the outcome was self-reported CRC. Descriptive analysis was performed with …

Centering High Risk Pregnancies Interprofessionaly (Chrpi) To Reduce Racial Disparities In Pregnancy Outcomes, Dongjin Suh B.S., Dhruv Srinivasachar B.S., Wintwar Phyo B.S., Asma Khan B.S., Sarah H. Milton, M.D.

Graduate Research Posters

Background:

Despite the steady rise in use of prenatal care, significant racial disparities exist in pregnancy-related outcomes. This calls for innovative prenatal care to improve pregnancy outcomes in racial minorities. CHRPI is an innovative prenatal care model designed to address risk factors and manageable conditions particularly prevalent in African Americans that threaten their course of pregnancy.

Methods:

CHRPI is an outpatient model (Fig. 1) that will accept pregnant moms with risk-factors outlined by the ACOG. They are initially evaluated by a Maternal Fetal Medicine physician where management is outlined. Then, patients are placed in groups of 4 according to their …

Differences In Treatment For Substance Use Disorders By Insurance Status: Self-Help Only Versus Outpatient Medical Treatment, Huyen Pham, Lauryn Walker Phd Rn, Andrew J. Barnes Phd, Peter Cunningham Phd

Graduate Research Posters

Background: The role of insurance on substance use disorders (SUD) treatment utilization generally is poorly understood and still less is known on how insurance status relates to the use of evidence-based treatment (i.e., medicalization approach) compared to other treatments, like single self-help groups, where the research on effectiveness is less supportive. This study examines associations between health insurance and any SUD treatment utilization as well as use of single self- help versus medicalization approach.

Methods: A cross-sectional study design was used. Data were from the 2015-2017, public use National Surveys on Drug Use and Health (NSDUH). Adjusted logistic regressions were …

Addressing Minority Health Disparities In Richmond: Results From A Health Needs Assessment Of A Southside Community, Nixon Arauz, Ma, Shanteney Jackson, Ma, Robert A. Blanco, Mph

Graduate Research Posters

Background:

Evidence shows the effectiveness of integrating community health workers (CHWs) into care models serving high-risk patients to reduce emergency department (ED) use, increase primary care use, and address adverse social determinants of health (SDH). The Southwood Resource Center, part of a network of clinics established by Richmond City Health Department, utilizes CHWs to address disparities affecting underserved populations through primary care referrals and additional resource linkages. Local student-volunteers in partnership with CHWs conducted a community needs assessment to identify patient resource gaps, aid in design and implementation of SDH interventions, and examine the relationship between chronic disease management and …

Six Weeks Of Resveratrol Improves Cardiovascular Health In Patients With Copd, Rebekah Lavender, Kolton Cobb, Kendall Goldman, Paula Rodriguez-Miguelez Phd

Graduate Research Posters

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. One-third of people diagnosed with COPD die of cardiovascular (CV) complications as opposed to pulmonary. Despite these odds, there are no therapies that mitigate this important health issue. Resveratrol, a naturally occurring antioxidant, improves CV health in other populations. However, there is currently no literature on resveratrol in patients with COPD. The purpose of this pilot study was to test if six weeks of resveratrol supplementation could improve CV health in patients with COPD. METHODS: A randomized, double-blind, pilot trial was completed in 8 patients with …

Offering The Choice Of Self-Administered Oral Hiv Testing (Chivst) Among Long-Distance Truck Drivers In Kenya: A Trial-Based Cost-Effectiveness Analysis, Deo Mujwara, April D. Kimmel

Graduate Research Posters

Background: Long distance truck drivers (LDTD) are a high-HIV-risk population facing unique healthcare barriers due to continuous travel and irregular schedules, and may require targeted, resource-intensive strategies for HIV-test uptake. We conducted a trial-based cost-effectiveness of CHIVST among LDTD in Kenya.

Methods: Effectiveness data came from a randomized-controlled trial of CHIVST (n=150) versus provider-administered testing (n=155). Economic cost data came from the literature and reflected a societal perspective. Generalized Poisson and linear-gamma regression models estimated the effectiveness (relative-risk) and incremental costs (2017 I$), respectively, with incremental effectiveness calculated as the reciprocal of the absolute risk difference and reported as the …

Richmond City Health District (Rchd), Bon Secours Richmond City Hospital (Rch), And Virginia Commonwealth Universities (Vcu) Department Of Health Behavior Policy (Hbp): Partnering With Community Health Workers (Chw) To Improve Community Health Outcomes And Reduce Emergency Department (Ed) Use, Anita M. Kumar, Mph, Stephanie Toney, Rn Bsn, Tamera Langhorne, Mba Chw, Bassan Dahman, Ph.D.

Graduate Research Posters

Background: Frequent ED users (5%) are sicker, poorer, not satisfied with the health system and cost 20% of total ED charges.

Objective: A pilot study of feasibility of partnering with CHW to improve health knowledge and outcomes and reduce ED use in low income community.

Methods: RCH ED utilizers were randomized to intervention and control groups. CHW contacted intervention group within 10 days of ED visit, surveyed about access to care, healthy living, and knowledge about chronic disease, and offered education, referrals to insurance and social and economic support. ED utilization and cost were recorded for all patients for 6 …