Health Sciences – Page 14 – UROP Spring Symposium 2021

Health Sciences

SIMPL User Engagement

This study aims to assess the impact of sending a list of the 5 most active faculty and residents to programs on the program’s engagement with a trainee operative performance assessment mobile application known as SIMPL. SIMPL is a mobile app that allows trainees to request evaluations of their operative performance and also supports supervising attendings submitting evaluations independent of the trainee. Because the evaluation process is dependent on a person going into SIMPL and submitting the evaluation, engagement with the application has been historically low. General surgery programs were randomly assigned to two cohorts of the intervention arm of the study. The A cohort were sent their top 5 list weekly and the other B cohort recieved it bi-weekly. Each program was emailed a slide of the top 5 faculty & resident users for the designated time period according to the cohort to which the program has been assigned. Faculty and trainee engagement data were recorded for the designated time period and will be used to create the “top 5” slides. A third cohort, Cohort C, where no action was taken was identified and engagement data tracked. An analysis of the engagement data among the three cohorts will be conducted to determine what if any impact sending a leadership board has on user engagement with the SIMPL application. If engagement was improved by sending a leadership board, an effort to automate the manual task of sending a leadership board will begin. This information can also be helpful to improve engagement with other medical education applications.

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Effects of Chinese-English Bilingualism on English literacy development

Words in a language are generally represented by sound, meaning, and print. Learning to read words often involves building interconnections among the three components. Thus, sound and meaning-based language skills become essential precursors of children’s word reading competency. In particular, phonological awareness, or the ability to break down words and distinguish them into smaller units of sounds, morpheme, is a critical skill and foundation for later literacy development. Morphological components refer to the words created from sounds; it’s the system for word construction. Morphological awareness is especially important for word reading and comprehension skills. Languages like Spanish or English are phonologically transparent because they map letters directly to individual phonemes. In comparison, Chinese is a morphologically transparent language that maps characters to meaning units, morphemes. This study aimed to examine whether being bilingual in Chinese and English would affect children’s morphological awareness when reading in English due to bilingual transfer. We hypothesized that bilingual children may show a strong sound-to-meaning association compared to monolingual children. Standardized language behavioral tasks were conducted to bilingual and monolingual children between age 5 to 10 to assess their reading comprehension and syntactic abilities in both English and Chinese. The findings of this research might indicate that bilingualism experience alters how bilingual children learn to read compared to monolingual children, despite the fact that some bilinguals are equally proficient in both languages. Findings might also inform theories of bilingualism and literacy instruction practices on linguistically diverse children.

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A National Study of Barriers and Facilitators of Expedited Partner Therapy Use in Emergency Departments: A Qualitative Study

Background: Emergency Departments (ED) are the primary source of healthcare for many patients diagnosed with sexually transmitted infections (STIs). Expedited partner therapy (EPT), treating the partner(s) of patients with STIs without an exam, is an evidence-based practice for individuals who might not otherwise seek care. Methods: We conducted semi-structured, open-ended interviews with ED medical directors and key medical personnel within different institutions. Participant enrollment continued until thematic saturation was reached. Our interview guide and initial coding were informed by the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded, transcribed, and iteratively coded, and qualitative thematic analysis was used to identify themes and subthemes by consensus. Results: We interviewed 12 medical directors and key informants, including a resident, follow-up nurse, program director, 2 pharmacists, and a physician champion. Some of the primary barriers to EPT were legal liability, lack of a specific implementation process, and the stigma surrounding sexual health. Facilitators of EPT included a clear delineation of task-sharing responsibilities for prescribing EPT, efficient electronic medical record prescribing, and leadership engagement. Many participants acknowledged the ED’s potential role in improving sexual health especially for marginalized populations and expressed a desire to use this practice if it was streamlined and did not affect departmental flow. Conclusions: The non-traditional processes involved in EPT present many challenges for adoption in the ED. Understanding these barriers and facilitators will assist in designing strategies for the implementation of EPT.

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COVID-19-assocaited Kidney Disease Analysis using Ontology and Bioinformatics

Kidney diseases pose a major threat to human health. Human acute kidney injury (AKI) is a sudden and temporary loss of kidney function. This project examines the relation between AKI and COVID-19 in patients under different conditions. Using International Classification of Diseases (ICD) codes, the project aims to better understand COVID-19 on patients under different conditions. In the study, we are given the ICD and UBERON codes (Uber-anatomy ontology) in which we have to decode them and know the conditions associated with the ICD code to then transfer the term label and the information associated with it to an Ontology tree on the Protege application. The ICO Ontology (ICDO) codes are decoded on a Google Sheet and then transferred to the Protege application. When inputting the terms into the ontology on Protege, each group has a Parent Code which then produces the sub groups where they have the same first two numbers of the ICDO code to represent them being in the same group. This makes them easier to identify and input the information where it belongs within the Entities on Protege. The data from the Consortium for Clinical Characterization of COVID-19 by EHR (4CE) were used for our ontology modeling and analysis. Kidney related data were analyzed. Over 200 ICD codes were transferred and ontologized to the ICDO. Our study found COVID-19 targeted to diferent kideny parts. This project established a new ontology-based bioinformatics pipeline to systematically study COVID-19 related kidney disease data, supporting our better understanding of COVID-19 pathogenesis.

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Colorectal Cancer: Rise in Early Onset, Detection Methods, and Aftermath Due to Covid-19

Background: Colorectal cancer (CRC) is one of the most frequently diagnosed cancers in the United States and has taken thousands of lives annually. One of the key methods in decreasing death rates of those with colorectal cancer is early detection by way of several different screening methods. However, early onset of the disease is a more recent concern that is revealing a dangerous trend. Due to Covid-19, many screening methods and tests have been put on hold as most doctors need to put their effort towards the influx of Covid-19 patients. Purpose: The purpose of the review is to examine the emerging trends in colorectal cancer, specifically young onset, and the different types of screening methods available at the present time (and potential ones for the future). Also, the purpose is to analyze how the pandemic has impacted CRC screening tests and treatments, as well as longer term CRC patient outcomes.

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Colorectal Cancer: Rise in early onset, screening and impact of Covid-19 pandemic

Background: Colorectal cancer is one of the most frequently diagnosed cancers in the United States and has taken thousands of lives annually. One of the key methods in decreasing the death rates associated with colorectal cancer is early detection by way of several different screening methods. Due to Covid-19, many screening methods and tests have been put on hold as many doctors need to put their effort towards the influx of Covid-19 patients. Methods: This review was conducted by a thorough search of peer-reviewed journals from medical databases, as well as articles from other reputable sources. Keywords used included colorectal cancer, incidence, detection, screening method, colon, and Covid-19. Results: There are both advantages and limitations to all CRC screening methods. Unfortunately, administering these screenings has become difficult due to the pandemic. Not only have there been missed and delayed screening procedures, but there have been delayed surgeries, misdiagnoses, and likely missed diagnoses altogether. Consequently, it is predicted that there will be thousands of excess CRC-related deaths within the next decade. Conclusion: Delays in screening methods due to the pandemic are predicted to cost thousands of lives in the future as cancer is harder to control with late detection. With the strain Covid is putting on the healthcare system, many CRC patients have had to forgo not only screening tests but other treatments, including surgeries. The effects of Covid-19 are catastrophic and will continue to unfold over the next several years.

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Schwann cell-derived signals on skeletal muscle growth

Schwann cells play a pivotal role in the maintenance and regeneration of axons in the peripheral nervous system by directly communicating with motor neurons. Under conditions of acute oxidative stress, Schwann cells produce cytokines and neurotrophins to communicate with immune and nerve cells to orchestrate the nerve repair process. However, less is known about the direct communication that occurs between schwann cells and myofibers. In an in vitro setting, the communication between schwann cells and myofibers, as well as the effects of oxidative stress on myogenesis were investigated. Schwann cells were activated with hydrogen peroxide to induce growth factor and cytokine expression. Conditioned media from both activated and non-activated Schwann cells were then added to skeletal muscle progenitors cells (C2C12) to assess the effects of treatment on myogenesis. We hypothesized that the C2C12 cells receiving the conditioned media derived from activated Schwann cells would display larger myotubes than C2C12 cells that were treated with non-activated conditioned media and non-treated controls. Images were taken with a fluorescent microscope six days after treatment and the results showed that myotube diameter was not significantly different between the three groups. More experimentation and analyses are needed to fully understand the communication between Schwann cells and myofibers, especially in conditions of elevated oxidative stress such as aging. Further analysis of such data and gaining a thorough understanding of the relationship between these cells can be vital in the discovery and implementation of new treatment methods for neuromuscular diseases.

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Whole Health Evaluation for Veterans

Holistic forms of healthcare treatment are becoming increasingly important. Many research studies have been conducted on holistic treatment options for veterans, demonstrating their value and encouraging implementation. The federally funded Veterans Affairs (VA) Healthcare System, also the largest healthcare system in the USA, employs “Whole Health”, a holistic system of care, involving a diverse array of modalities, including yoga, acupuncture, meditation, tai chi, massage therapy, and more. This research seeks to evaluate the understanding, awareness, and treatment outcomes of Whole Health by those at VA, including employees, patients, relatives, and volunteers. A quantitative and qualitative Qualtrics survey was given to those at the Ann Arbor VA Healthcare System to analyze such by having participants rank themselves in categories like mental health, emotional health, spiritual health, and more. Survey-takers also identified which Whole Health modalities they have participated in. Currently, the research is ongoing. At the time of publication of this abstract, the data has been collected and preliminary analysis is in process. Specific, detailed, and final results will be available at the time of the Symposium presentation. Our team expects that the resulting data from the survey will indicate a strong understanding of the VA Whole Health system and its benefits. We anticipate that those who have utilized the offered VA modalities will report a greater health than those who haven’t. These results will demonstrate the value and relevance of holistic healthcare, specifically when treating veterans. In turn, our results will support the initiative to implement holistic medical treatment in more hospitals/healthcare systems worldwide and contribute to the academic discourse about the benefits of holistic healthcare.

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Whole Health Educational Evaluation for Veterans and VA Staff

“Whole Health Educational Resource Development and Evaluation for Veterans and VA Staff” A study was undertaken with the purpose of evaluating and identifying resource effectiveness in veterans or VA staff related to Whole Health usage. The federal government has taken interest in determining if Whole Health is a more effective healthcare care technique that can treat serious mental and physical conditions that can occur as a result of military engagement or treatment of military members. Review of Passport to Whole Health 3rd Edition 2018, videos on the VA Administration website, and mentor guidance helped prepare the development of a survey to be distributed. This survey is yet to be distributed to veteran and VA participants through online and physical means. Online through qualtrics and by hand for physical copies with the means of spreading the word through the VA Ann Arbor Healthcare System in Ann Arbor, MI. We are yet to determine the findings, but we expect to be able to determine pain points associated with the treatment and effective modalities as well. Based on these results we are to address and analyze the data to report our findings on Whole Health resources.

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Suppressing heterotopic ossification and fibrodysplasia ossificans progressiva in mouse models through targeting BMP type 1 receptor kinases

Fibrodysplasia Ossificans Progressiva (FOP) is a rare genetic condition distinguished by the development of bone in soft tissue, known as heterotopic ossification (HO). FOP is a gain-of-function mutation, causing substitution of an arginine by histidine (R206H) within BMP type 1 receptor ACVR1 protein. This disorder severely impacts an individual’s life, as it leads to body malformations and disabilities. While the exact mechanism of HO progression is still unclear, studies have found that HO development is accompanied with an increase of BMP-SMAD signaling and inflammation. In this research project, we aim to discover methods to decrease HO in FOP mouse models, by attempting to decrease BMP signaling. ACVR1, BMPR1a, and BMPR1b are BMP type 1 receptors. Our previous studies showed that BMP-SMAD dependent signaling is decreased by the knockout of BMPR1a or ACVR1 in specific tissues. By deleting one and/or multiple of these receptors, we predict that it will decrease BMP signaling, ultimately suppressing HO. We use the constitutively active ACVR1 model (caACVR1-Q207D), which develops massive HO within two weeks after activation of BMP signaling with tissue injury. But our study showed our anticipation was wrong. We found that the HO was not inhibited in ACVR1-Q207D mouse model by knocking out BMP type 1 receptors. Additionally, the BMP-SMAD dependent signaling pathway was not inhibited by knocking out BMP type 1 receptors in the HO mouse models. Due to the fact that the outcomes of this project did not support our initial hypothesis, we need to analyze other ways to decrease BMP signaling to suppress HO formation. This research hopes to bring us closer to finding the first effective treatment for FOP/HO, helping the individuals whose lives are permanently impacted by this genetic disease.

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