Health Sciences – Page 7 – UROP Spring Symposium 2021

Health Sciences

Making Learning Visible in the Clinical Team-based Simulations

In the medical field, the technique of “breaking bad news” is incredibly important for future doctors and social workers to practice and receive meaningful feedback on. Our research team transcribed, analyzed, and interpreted over 150 medical simulation videos to analyze body language, tone of voice, and responses to see how students reacted to feedback from debriefers. A methodology was employed for multimodal sentiment analysis, which consists of gathering sentiments from available simulation videos by extracting audio, visual, and textual data features as sources of information. Then, this information can be used to predict and analyze a trainee’s emotional states when receiving feedback. As this study is still in process, conclusive findings cannot be stated but thus far the findings show a range of different reactions to the feedback ranging from negative deactivating to positive activating. Overall, the goal is to optimize the feedback given in order to fully prepare future medical professionals for the critical task of delivering bad news. This research is valuable to the future of medical education, as analyzing the quality of feedback given can help to optimize these patient simulations and better prepare medical students for real-life situations.

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Making Learning Visible in the Clinical Team-based Simulations

In the medical field, the concept of “breaking bad news” is incredibly important for future doctors and social workers to practice and receive meaningful feedback on. The moment a medical professional tells a family member bad news, that instance stays with the patient’s family for the rest of their life. Our team transcribed, analyzed, and interpreted over 150 medical simulation videos to analyze body language, tone of voice, and responses to see how they reacted to feedback from debriefers. Our goal is to optimize the feedback given in order to fully prepare future medical professionals for this critical task. This study was conducted on a sample of over 150 fifteen-minute videos of medical students debriefing with supervisors about their breaking bad news patient simulation.

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Making Learning Visible in the Clinical Team-based Simulations

In the medical field, the concept of “breaking bad news” is incredibly important for future doctors and social workers to practice and receive meaningful feedback on. The moment a medical professional tells a family member bad news, that instance stays with the patient’s family for the rest of their life. Our team transcribed, analyzed, and interpreted over 150 medical simulation videos to analyze body language, tone of voice, and responses to see how they reacted to feedback from debriefers. Our goal is to optimize the feedback given in order to fully prepare future medical professionals for this critical task. This study was conducted on a sample of over 150 fifteen-minute long videos of medical and social work students debriefing with supervisors about their breaking bad news standardized patient simulation.

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Neutrophil depletion’s effect on lung cancer

Lung cancer remains the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) making up 85% of lung cancers. NSCLC is comprised of adenocarcinomas and lung squamous cell carcinoma and develops primarily in individuals over the age of 55 who regularly smoke. Current research on the tumor microenvironment revealed that neutrophils, a type of white blood cell responsible for fighting infections, actually aids tumor progression by allowing the creation of chemotaxis that promote tumor metastasis. Additionally, current immunotherapies are only 30% effective. This study looks specifically at how neutrophils affect the tumor microenvironment (TME). We hypothesized that if neutrophils depleted in mice with adenocarcinoma they would decrease in tumor burden, as the chemotaxis transport mechanism for cancer cells would be gone. We have established a murine model of lung cancer, wherein expression of oncogenic Kras and p53 can be controlled genetically, allowing activation of oncogenic Kras to initiate tumor growth, tumor eradication upon Kras depletion and re-activation as a means to model relapse, and p53 speeds up tumor progression. Control mice were used alongside our cancer inducible mice, to test the effects of neutrophil depletion. Half of the mice were given the antibody IgG that has no effect on neutrophil depletion while GR-1, a neutrophil depleted antibody was given to the other half. After 4-week treatment, we took lung tissue; paraffin embedded it and stained it with HE. Tumors were counted and the subsequent analysis revealed 1) Mice with both Kras and p53 on have more tumors than those with just Kras on 2) Neutrophil depletion resulted in lower tumor counts for mice. In summary, neutrophils play likely a tumor-promoting role in lung cancer. Depletion of neutrophils by antibodies resulted in a decrease in tumor burden suggesting new treatment option for lung cancer patients by modulating TME.

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Quantifying Gene Regulation in HNSCC

My project focuses on developing precision medicine for head and neck squamous cell carcinoma (HNSCC). Many HNSCC tumors are caused by human papilloma virus (HPV) infection. E7, an HPV protein, has proven to occasionally change the expression of certain genes in HPV positive tumors. My project aims to analyze RNA expression patterns to determine what triggers HPV-mediated gene regulation. We collect RNA from patient-derived cell lines and generate a complimentary DNA (cDNA) sample. We then use the process of qPCR to replicate the cDNA and measure the CT value. This value quantifies RNA expression where a low CT value implies higher amounts of RNA in the original sample meaning increased transcription of our gene of interest. Finally, we will use a script written in R Code to create a summary table of qPCR data along with a graph of CT values. We have already generated, and verified using qPCR, cell lines that express HPV genes. We expect that the expression of the HPV E7 gene will decrease the expression of the HLAA, HLAB, and HLAC genes, all of which are needed for an antiviral and anti-tumor immune response. By measuring the effect HPV genes have on the transcription of immune response genes, we will be able to understand the mechanism by which HPV evades the immune system. As of now, treatments for HNSCC are similar to those for the majority of cancer types. This research will help develop treatment tailored to HNSCC which can hopefully improve recovery for afflicted patients.

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Whole Health Evaluation for Veterans and VA Staff

Whole Health is a care model developed by VA clinics and hospitals in an effort to integrate complementary medicine, prevention, and the uniqueness of each patient to provide healthcare that ultimately focuses on what matters to the patient, rather than what is the matter with them. Such a care model is crucial in the U.S where healthcare often focuses merely on treatment, rather than prevention, and preventable deaths are estimated to make up 20-40% of total deaths caused by the top five causes of mortality. This study aims to expand on the current body of research that evaluates the efficacy of Whole Health, by garnering feedback about various aspects of health and how the program has come about addressing them. The research is conducted through a questionnaire created on the Qualtrics platform, which will be electronically and potentially physically distributed to veterans, caregivers, and staff. Data from the questionnaire will be inputted into an Excel spreadsheet to be later processed and analyzed using SPSS, a quantitative and qualitative statistical analysis software. Previous studies on Whole Health have indicated an improvement in social engagement, physical wellbeing, and perceived stress for patients enrolled in the program. So while results are currently pending, we expect our data to also suggest Whole Health’s adequate provision of care at least within the aspects of wellbeing mentioned above. Analysis of pending results will provide valuable insight for evaluating and potentially informing future changes to the program to better reflect its mission.

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Evaluating how anesthesia trainees identify and treat malignant hyperthermia in the team-based simulation training with Epistemic Network Analysis

Technological advances in society have given the opportunity to modify and refine the education and experiences that occur within medical schools and the training provided to healthcare professionals. Clinical simulations provide team-based training to students and healthcare providers in ways that they otherwise may not receive through lectures and real-life settings. This study aims to analyze team communication during team-based training simulations on malignant hyperthermia (MH). The simulations were made available for analysis and evaluation through about 25 video recordings that were collected by the Clinical Simulation Center at the University of Michigan. MH is a rare but severe reaction to certain anesthetic drugs which requires the teams to work together to identify the symptoms (increasing end-tidal carbon dioxide, heart rate muscle rigidity, and temperature), properly treat the patient, and recognize the patient’s response to appropriate and inappropriate management interventions. The videos consist of different teams doing the same training on MH which may give insight as to why some teams are more successful than others. The analysis will also focus on how trainees allocate tasks efficiently within a group and develop individual/team skills in treating MH. The ability to automate computer assessments will also be evaluated to identify technical and nontechnical skills in team-based simulation training while treating MH. With improved training in a simulation environment, healthcare professionals will be able to improve their ability to work together in real environments where patient lives may be at risk.

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Dysfunction of insulin producing pancreatic beta cells – The Central Problem in Diabetes

Syed Mustafa Pronouns: He/Him Research Mentor(s): Mehboob Hussain, Professor Research Mentor School/College/Department: Internal Medicine, Metabolism, Endocrinology, Diabetes, Michigan Medicine Presentation Date: Thursday, April 22, 2021 Session: Session 5 (3pm-3:50pm) Breakout Room: Room 12 Presenter: 2 Event Link Abstract Authors: Syed Mustafa Research Method: Laboratory Research with Animals

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Overuse of Helicopter Transportation for Burn Patients

Far too many burn patients are experiencing additional suffering through the use of unnecessary helicopter transportation to specialized burn facilities. This study looks at gathered burn patient data in the state of Michigan and looks at the factors related to helicopter transport of certain patients. Inappropriate helicopter burn patient transport to specialized burn centers is often costly, excessive, and traumatic for patients- particularly those who only have minimal burns. However, it is clear that the burn centers are benefiting from this excessive transport, as it does help certain burn units meet their patient quotas and remain in business. We are examining current burn education, telemedicine opportunities, faulty and discriminatory practices, and other factors, to determine if these areas are in need of improvement. Overall, we aim to help transform medical practice and reduce unnecessary helicopter transport of burn patients. These findings may be generalized to burn care providers everywhere, even beginning with reforms in schooling. In advocating for the patient, our team of health science-minded professionals aims to provide quality patient and family-centered care for burn patients everywhere, without additional healthcare costs.

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Scoping review on the impact of type 2 diabetes self management programs in Asian-Americans

Type 2 diabetes (T2D) is among the top reasons for deaths in Asian-Americans (AA). Although AA consists of people from more than 20 countries, existing T2D research often masks the differences. According to the Office of Minority Health (2019), about 11.5% of AA adults have T2D, compared to 8% of White Americans. The data also suggests that the rate of T2D in AA adults increased from 8.7% in 2017 to 11.5% in 2018. As Asian-Americans face challenges in healthcare, including linguistic, cultural, and literacy barriers, it is essential to research existing diabetes self-management programs (DSMPs), as many studies aggregate Asian Americans as a monolith group and disregard Asian-American subgroups’ heterogeneity. A scoping review is vital to establish foundational knowledge for DSMPs focused on AA. This scoping review defines DSMPs as managing an individual’s condition through self-care, problem-solving & decision making, resource utilization, and symptom, family, medical, or emotional management. We searched six different databases for relevant articles with no date range. The initial citation lists from all databases by keyword search yielded 2581 results. After screening for titles and abstracts, 311 articles were included in the full-text screening. Articles were excluded if they were non-primary research studies, did not focus on T2D or AA adults, and did not include DSMPs. After screening the full-text articles, 31 articles were included in the final analysis. DistillerSR was used to screen and extract data, including method, intervention duration, participant setting and demographics, theoretical framework, number and details of DSMP intervention groups, and results. We hypothesized that there is a higher need to focus on minority subgroup research. There is a need to tailor DSMPs to address the barriers that AA face in healthcare so that distinct cultural, linguistic, ethnic needs and preferences are met. Improved understanding of existing research may enhance future development of DSMPs for Asian-Americans and its subgroups.

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