Program - UCLA.edu
Eleventh Annual Senior Scholarship Day & Charles R. Drew University of Medicine and Science Thursday, March 19, 2015 Covel Commons, Grand Horizon Room Northwest Auditorium Conference Moderator: Margaret L. Stuber, MD Assistant Dean of Student Affairs for Career Development and Well-Being Vice Chair for Education in Psychiatry Daniel X. Freedman Professor, Psychiatry and Biobehavioral Sciences David Geffen School of Medicine at UCLA Table of Contents Schedule ............................................................................................................................ 2 Concurrent Poster Session Schedule ............................................................................ 3 BASIC SCIENCE OF MEDICINE..............................................................................................3 CARDIOLOGY ……………………….................................................................................................3 DIABETES, WEIGHT-LOSS and GI I…………...........................................................................4 DIABETES, WEIGHT-LOSS and GI II....………..........................................................................4 EDUCATION I.............................................................................................................................4 EDUCATION II………..................................................................................................................5 EMERGENCY MEDICINE…….....................................................................................................5 GLOBAL HEALTH……………………………………………………………………………………….6 HEALTH CARE DELIVERY…......................................................................................................6 HEALTHCARE POLICY...............................................................................................................6 HEMATOLOGY………………………………………………………………………………………….7 INFECTIOUS DISEASE..............................................................................................................7 NEUROLOGY.............................................................................................................................7 OB-GYN ………………................................................................................................................8 OB-GYN…………………………………………………………………………………………………..8 ONCOLOGY I .............................................................................................................................8 OPHTHALMOLOGY ...................................................................................................................9 ORTHOPEDICS I …………………................................................................................................9 ORTHOPEDICS II.......................................................................................................................9 PEDIATRICS I........................................................................................................................... 10 PEDIATRICS II.............................................................................................................................10 PSYCHIATRY............................................................................................................................ 10 PUBLIC HEALTH I: ................................................................................................................... 11 PUBLIC HEALTH II: ……........................................................................................................... .11 THORACIC & VASCULAR SURGERY........................................................................................11 UROLOGY...................................................................................................................................11 ANNOUNCEMENT……………………………………………………………………………………...12 Oral Plenary Session Schedule ....................................................................................... 13 Sudeep Banerjee: A Computed Tomography Radiogenomic Biomarker Predicts Microvascular Invasion and Clinical Outcomes in Hepatocellular Carcinoma…………………………………………………..…..14 Brittany J. Dixon: Does behavioral health integration and recognition as a patient-centered medical home improve delivery of care within the safety net system?............................................................ 14 Victoria Ho: Post-transcriptional gene regulation in mature neurons…………………… ....... 15 Lydia N. Lo: Hypoglycemia: A Rare Cause of Pediatric Seizures in Pre-Hospital Care ……………...15 Alicia Morehead-Gee: Factors Contributing to Depression among HIV-Positive and HIV-Negative Latino and African-Americans Residing in South Los Angeles......................................... 16 Schedule 8:30 – 9:00 am Check-In & Breakfast Covel Commons, Grand Horizon Room, 2nd level 9:00 – 9:30 am Poster Set-Up & Viewing 9:30 – 11:00 am Concurrent Poster Sessions 11:15 – 12:15 pm Oral Plenary Session Covel Commons, Grand Horizon Room, 2nd level Northwest Auditorium 12:15 – 12:30 pm Students travel back to remove posters no later than 12:30 pm 2 Concurrent Poster Session Schedule Covel Commons-Grand Horizon Room BASIC SCIENCE OF MEDICINE Moderator: Sally Krasne, PhD Poster Student 1 Chan, Eric 2 Hu, Shirley 3 Istrin, Joshua 4 Minkovsky, Alissa 5 Knowles, Scott 6 Scapa, Jason Topic Evaluation of Epithelial Changes in Limbal Stem Cell Deficiency Using in Vivo Confocal Microscopy Investigation of putative IRES structures in truncated p110 ERBB2 Sex differences in the relationship between trait resiliency and the intrinsic connectivity of the salience and default mode networks A High-throughput Screen of X Chromosome Inactivation Identifies a Novel Drug Combination to Enhance Silenced Gene Reactivation by 5-aza-2’-dC PSCA Minibody for immunoPET Imaging of Prostate and Pancreatic Cancer Investigating the Role of Macrophage Recruitment in Benign Prostatic Hyperplasia CARDIOLOGY Moderator: Gary Satou, MD 7 Amble, Catherine Predictive factors of 30-day readmissions for heart failure patients: site comparison 8 Brugger, Michelle The Obesity Paradox in Heart Failure: Associations of Body Fat Mass and Lean Body Mass with Increased Survival 9 Kern, Tyler Effect of care transition interventions on different heart failure patient subgroups, defined by underlying etiology: Are there identifiable subgroups more likely to benefit? 10 Rostomian, Ara 100% Statin Compliance 11 Choi, Young The incidence of pulmonary hypertension in psoriasis 3 Concurrent Poster Sessions - continued Covel Commons-Grand Horizon Room DIABETES, WEIGHT-LOSS, and GI- I Poster Moderator: Greg Brent, MD Student Topic Arroyo, Jeffrey Are there gaps in self-reported and objectively measured physical activity in U.S. adult diabetic patients: A racial comparison 12 Colonoscopy Mobile App Pilot Study 13 Chang, Jiwoon 14 Park, Sarah The Workup of Cushing's Syndrome: Illustrated through a Case of Ectopic ACTH-Dependent Hypercortisolism Surapaneni, Nirmala Diabetic muscle infarction Vu, Kim Primary Sleeve Gastrectomy Compared to Sleeve Gastrectomy as Revisional Surgery: Weight Loss and Complications at Intermediate Follow-up 15 16 DIABETES, WEIGHT-LOSS, and GI- II Moderator: Angela Leung, MD 17 Ali, Saima A New Digital Histopathology Approach for Quantifying Liver Fibrosis in Patients with Nonalcoholic Steatohepatitis 18 Andre, Mark Diabetes Intervention in a Homeless Population 19 Lee, Heajung Ten Years at a Large Liver Transplant Center: Routine, Non-Invasive Serologies are Predictive of Significant Fibrosis in Hepatitis C Patients Following Liver Transplantation 20 Lentz, Jacob A New Digital Histopathology Approach for Quantifying Liver Fibrosis in Patients with Viral Hepatitis C 21 Ngaou, Huy Diabetic Retinal Screening Rates at the Venice Family Clinic EDUCATION I Moderator: Anju Relan, PhD 22 Cuk, Natasha Working to reduce adverse events in patients that are "handed off" 23 Guzman, Carlos Extending Anatomical Didactics for the medical student beyond the first year: do long term career goals matter for the Drew cohort? 24 Harrison, David Utility and efficacy of a peer-based anatomy tutoring program for first-year medical students: updated data from the 2013-2014 academic year 25 Lam, Helen Developing an Online Antibiotics Educational Module for Medical Students 26 Quant, Cara Survey of Medical Students and Medical Professionals on the Use of Information Technology in the Practice of Medicine 27 Smith, Jeremy Publication of Results of Abstracts Presented at Simulation Conferences 28 Taon, Matthew Czar Randomized controlled study to evaluate whether the use of Google Glass wearable technology can improve medical student and resident stimulation-based training in Ultrasound-Guided Anesthesia 4 Concurrent Poster Sessions - continued Covel Commons-Grand Horizon Room EDUCATION II Poster 29 Student Baustista, Alejandra Moderator: Sarika Thakur, Ed.D. Topic Interventions for Depression in Medical Students: A Review of the Literature 30 Chung, Melody A student-driven initiative to identify and address medical student mistreatment on clinical clerkships 31 Croymans, Daniel UCLA Wellbeing Initiative by Student Engagement (U-WISE) Project: Evaluating the Wellbeing of the UCLA DGSOM Student Body 32 Cun, Tony Trends in Increasing Clinical Time in Medical School Curricula 33 Hoang, Alexander 4th Year-itis 34 Larsen, Tyler A comparison of simulation-based education and problem-based learning in pre-clinical medical undergraduates 35 Laufer, Danielle 36 Magbegor, Wemo Effectiveness of hemodynamics simulator in teaching medical students about the treatment of shock compared to traditional didactic methods Does the medical school curriculum prepare students to effectively cope with the clinical years of medical school EMERGENCY MEDICINE Moderator: Michelle Zeidler, M.D. 37 Azukawa, Hiroko Bandage Contact Lenses to Decrease Pain and Improve Healing in Emergency Department Subjects Presenting with Corneal Abrasions 38 Haeffele, Cathryn Ultrasound Measurement of the Inferior Vena Cava to Evaluate Volume Status in Patients Requiring Fluid Resuscitation in Limited-Resource Settings 39 Salah, Ramy Outcomes of a Protocol for Early Evaluation of Shock using Bedside Ultrasound at UCLA: The RUSH Protocol 40 Smogorzewski, Jan Lichen Amyloidosis in an Atypical Location 41 Wolday, Feven Spontaneous Atraumatic Splenic Rupture in a Alcoholic Male Patient: A Case Report 42 Yee, Lisa The RUSH exam: Rapid Ultrasound in SHock in the evaluation of MICU patients 43 Yu, Chuck Goldsheet QI ED 44 Zhu, Lisa RUSH (Rapid Ultrasound in SHock) Trial 5 Concurrent Poster Session - continued Covel Commons-Grand Horizon Room GLOBAL HEALTH Moderator: Thomas Coates, Ph.D. Topic Poster 45 Student Cambou, Mary 46 Foulad, David Hypertension Prevalence in Rural Haiti 47 Goldstein, Max Dean Recurring Fevers: Malaria and the Quinine Trade in the Early Americas 48 Park, Hayoung Recent syphilis infection among high-risk men who have sex with men (MSM) in Lima, Peru 49 Zorian, Aline A descriptive analysis of disease burden encountered during a two-week student global health experience in urban and rural Haiti Anal Human Papillomavirus (HPV) Prevalences and Factors Associated with Abnormal Anal Cytology in HIV-Infected Women in an Urban Cohort from Rio de Janeiro, Brazil HEALTHCARE DELIVERY Moderator: Shahrzad Bazargan-Hejazi, Ph.D. 50 Goldstein, Zachary 51 Henderson, Geoffrey Increasing Health Literary in the Geriatric Population: A Program at Vintage Westwood Horizons, an Independent Senior Living Facility 52 53 Mendez-Kohlieber, Cynthia Riveros, Toni A Retrospective Study of the Impact of Group Visits with Peer-to-Peer Support for Patients with Diabetes TeamSTEPPS: Supporting Leadership and Communication at Harbor-UCLA 54 Solorio, Veronica Reducing Avoidable Admissions in a Brooklyn Hospital 55 Thang, Christine Improving the Process for Obtaining Hospital Discharge Follow-up Appointments 56 Zhang, Lujia A Systematic Literature Review of Appointment Reminder Systems Is There Adequate Communication Between the Primary and Dermatology Consult Team? HEALTHCARE POLICY 57 Clarke, Lenorre 58 Gonzalez, Erik 59 Kalsi, Sangeeta 60 Lunderville, Chantal McIntosh, Adam Moderator: Gerardo Moreno, M.D. Reducing Consumption of Sugar-Sweetened Beverages in Los Angeles County The Affordable Care Act and Colorectal Cancer Screening at a Federally Qualified Health Center Assessing the Potential for Implementation and Spread of Interdisciplinary Primary Care for Older Adults Using Policy to Address Obesity in Los Angeles County: The Case of Sugar Sweetened Beverages (SSB) Choosing Primary Care: A View from System Dynamics 61 Sanaiha, Yas 62 Rates of diverting ileostomy in patients undergoing Low Anterior Resection for Colorectal Cancer at Olive View Medical Center 6 Concurrent Poster Session – continued Covel Commons-Grand Horizon Room HEMATOLOGY Poster Student Moderator: Jason Napolitano, MD Topic 63 Kita, Ashley Solute Flux as a Quantitative Permeability Measure in a Stem Cell Derived Laryngeal Mucosal Replacement 64 Blum, Steven TCR use and cytokine response in PD-1 blockade 65 Kohn, Lisa Human Lymphoid Development in the Absence of Common ?-Chain Receptor Signaling 66 Nobori, Alex Comparison of automated solid phase and manual tube DAT testing for detection of clinically significant immune mediated hemolysis 67 Silva, Oscar Acute Dlg1 knockout prevents optimal T cell activation, effector function and differentiation in CD8+ T cells 68 Strength, Kristen Assessment of length of hospitalization and hospital readmission among patients at risk for sepsis in the postoperative setting 69 Zhao, Jimmy Conversion of danger signals into cytokine signals by hematopoietic stem and progenitor cells for regulation of stress-induced hematopoiesis INFECTIOUS DISEASE Moderator: Timothy F. Brewer, MD, MPH 70 Baweja, Abinav Oral Thrush? Not So Much. 71 Bechtold, Hannah Streptococcus salivarius: An unusual but important cause of bacterial meningitis 72 Ferguson, Jessica Increases in Life Expectancy in the Elderly by Treating Chronic Hepatitis C Infection 73 Isnasious, Sandra West Nile Encephalitis Case Presentation 74 Jankovic, Ivana 75 Pena, Jonathan Dell Cat Bugs vs. Brain Cancer: The Diagnostic Difficulties of Distinguishing Between Toxoplasma Encephalitis and Primary CNS Lymphoma in an AIDS Patient lmonary Hyalinizing Granuloma in a Veteran with Latent Tuberculosis and Agent Orange Exposure 76 Tong, Lana Viral infections in acute graft-versus-host disease: A review of diagnostic and therapeutic approaches 77 Zhang, Alice West Nile Encephalitis Presenting with Opsoclonus NEUROLOGY Poster 78 Student Cheok, Stephanie Moderator: Shaun A. Hussain, M.D.,MS Topic Basis of Management of Tethered Cord in Spinal Lipomas 79 Cross, Kathryn Shared neural systems for observing and performing actions: functional connectivity & implications for neurorehabilitation 80 Hazboun, Michael Case Report: Refractory status epilepticus as a presentation of PRES in a pediatric liver transplant patient 81 O’Donnell, Kelley Axon degeneration and PGC-1alpha-mediated protection in alpha-synuclein toxicity 82 Sozmen, Elif Collateral Advantage: Complete Reversal of Clinical Deficits in Acute Ischemic Stroke due to Bilateral Middle Cerebral Artery Occlusion 7 Concurrent Poster Session - continued Covel Commons-Grand Horizon OB-GYN I Moderator: Tony Kuo, M.D. 83 Cham, Stephanie Severe anemia in the post-partum patient – Mom or Baby to blame? 84 Echevarria, Dina Intra Aortic Balloon Occlusion during Cesarean Hysterectomy for Placenta Increta 85 Huang, Katherine Pregnancy-related mobile application usage: A Cross Sectional Study 86 Rose, Kelsey Impact of an Educational Video Intervention on Perceived IUD Knowledge 87 Shull, Hannah Prevalence of curable sexually transmitted infections in pregnant women in low- and middleincome countries: A systematic review OB-GYN II Moderator: Ed Ha, M.D. 88 Getachew, Ruth Active Versus Expectant Management of Intrahepatic Cholestasis of Pregnancy: A Systematic Review 89 Maykin, Melanie Validation of the Prediction Model for Success of Vaginal Birth After Cesarean Delivery in Patients Delivering at Ronald Reagan UCLA Medical Center 90 Medina, Wendy Timeliness of abnormal screening mammography follow-up at Venice Family Clinic 91 Perkins, Colby Transvaginal Mesh Litigation Trends: An Analysis of Cases 92 Strong, Barbara Epidemiology and Etiology of Intrahepatic Cholestasis of Pregnancy ONCOLOGY Moderator: Mitchell Kamrava, M.D. 93 Gibson, Amanda Evaluation of Response to Progestin Treatment in Lynch Syndrome Patients with Complex Atypical Hyperplasia and/or Well differentiated Endometrial Carcinoma 94 Hobbs, Evthokia New Directions in the Neoadjuvant Treatment of HER2+ Breast Cancer New Directions in the Neoadjuvant Treatment of HER2+ Breast Cancer 95 Higgins, Shauna Calciphylaxis and Hypotension: Report of a Case and Review of the Literature 96 Kwon, Daniel Physician-Reported Barriers to Referring Cancer Patients to Specialists: Prevalence, Factors, and Association With Career Satisfaction 97 Norberg, Adam Carcinoma Erysipeloides: Recurrent Metastatic Breast Carcinoma Mimicking Infectious Dermatitis 98 Spasic, Marko Stereotactic Radiation for the Treatment of Vestibular Schwannoma: Tumor Control and Hearing Preservation 99 Yaghoubian, Alan Adoptive Transfer Immunotherapy Targeting NY-ESO-1 for Treatment of Glioblastoma 8 Concurrent Poster Session - continued Covel Commons-Grand Horizon Room OPHTHALMOLOGY Moderator: Lynn Gordon, M.D., PhD 100 Ashraf, Davin Longitudinal Cohort Study of Patients with Birdshot Chorioretinopathy: Quality of Life During 5 Years of Follow-up 101 Chen, Andrew Models of Glaucomatous Visual Field Loss 102 Fors, Darron Severe Choroidal Hemorrhage Outcomes and the Effect of Early Intervention Facilitated by Tissue Plasminogen Activator 103 Garg, Elisha Intravitreal Anti-VEGF for Radiation Retinopathy Following Iodine-125 Brachytherapy for the Treatment of Choroidal Melanoma 104 Gupta, Kishan Ocular Melanoma GEP Class does not Predict Tumor Height Regression Speed after Brachytherapy 105 Lee, Patrick Effects of visual noise on binocular summation in strabismic patients without amblyopia 106 Roberts, Kristofer Quantitative Multiparametric MRI in Uveal Melanoma ORTHOPEDICS I Moderator: Jonathan R. Hiatt, MD 107 Awad, Taysir Twenty-eight year hip survivorship and outcomes of patients treated with a periacetabular osteotomy for acetabular dysplasia 108 Balcescu, Cristian Early Results of a Modular Cementless Tibial Component for Total Knee Arthroplasty 109 Burke, Zach The Role of Chairman and Research Director in Influencing Scholarly Productivity and Research Funding in Academic Orthopaedic Surgery 110 Kadri, Omar Twenty-eight year hip survivorship and outcomes of patients treated with a periacetabular osteotomy for acetabular dysplasia 111 Natsuhara, Kyle What Is the Frequency of Vascular Injury After Knee Dislocation? ORTHOPEDICS II Moderator: Isaac Yang, M.D. 112 Chen, James Implant Cost Awareness of Analogous Intramedullary and Plate Devices among Orthopedic Surgeons and Residents in a Public University Hospital 113 Elsissy, Joseph Wear patterns of hip resurfacing arthroplasty retrievals demonstrate impingement and subluxation are common 114 Nassiri, Nima Arthroscopic versus Open Surgical Repair of Anterior Shoulder Instability in Overhead Athletes 115 Rugg, Caitlin The Impact of Prior Upper Extremity Surgery on Orthopaedic Injury and Surgery in Collegiate Athletes 116 Takamura, Karren Highly Cross-Linked Polyethylene in Hip Resurfacing Arthroplasty: Long Term Follow-up 9 Concurrent Poster Session - continued Covel Commons-Grand Horizon Room PEDIATRICS I Moderator: Rebecca Dudovitz, M.D. 117 Carballo, Nancy Effects of Alcohol on U.S. Adolescent Sleep Patterns: A Systematic Review 118 Cui, Li Sensitivity of Plain Radiography for Pediatric Cervical Spine Injury 119 Garg, Dave Effect of Intravenous Acetaminophen on Pediatric Tonsillectomy and Adenoidectomy Narcotic Requirements 120 Furukawa, Daisuke Analysis of Associated Symptoms and Clinician Awareness of Sleep Disturbance in SportsRelated Concussion in Children 121 Oh, Taemin Maximum Safe Surgical Resection Provides Best Clinical Outcomes for Intramedullary Astrocytomas in Pediatric Patients 122 Shah, Shaishav Effect of Intraoperative Acetaminophen on Pediatric Tonsillectomy Post-operative Recovery Time and Pain PEDIATRICS I Moderator: Jennifer Sucre, M.D. 123 Diep, Thuan Comparing peer and adult social networks inside and out of school in bullying for inner-city adolescents 124 McCoy, Kelsi Evaluation of School Based Wellness Centers 125 Moss, Tanesha Low-Income Parents' Views on a New Model for well Child care redesign 126 Ramirez, Carmen Pediatric stroke: A case report of Antiphospholipid Antibody Syndrome induced stroke as a manifestation of newly diagnosed SLE 127 Russell, Christine The Necessity of an Interdisciplinary Curriculum for Inner City Teens: Evaluating Athletics, Music Education Programs and Health Utilization 128 Snider, Samantha School-Sponsored Activities & Their Relation to Marijuana Use Among Los Angeles Latino Teens PSYCHIATRY 129 Alexander-Bloch, Aaron 130 Ben-Ghaly, Lubabah 131 Eng, Kevin 132 Kho, Christine 133 Lee, Eun Kyung 134 Masukawa, Kristin 135 Rodriguez, Johana Moderator: Erica Nurmi, M.D., PhD Functional and structural MRI of brain networks in typical development and childhood-onset schizophrenia Neuroleptic Malignant Syndrome: Case Report and Review of Current Treatments Knowledge of dementia community resources and stigma among Chinese American immigrants Breast and Colorectal Cancer Screening in the Mentally Ill: Results from the 2009 California Health Interview Survey Assessment of mental health need in Korean youth population and stigma within the community as assessed by Korean Youth Pastors. Older Adults Visit Online Sites for Screening and Brief Intervention for Unhealthy Alcohol Use Mental Health Literacy about Depression and Anxiety among Low-income Latino Women: The Effects of Integrating a Sustainable Multi-component Prevention Program in a Community Setting 10 Concurrent Poster Session - continued Covel Commons-Grand Horizon Room PUBLIC HEALTH I Moderator: Daphne Calmes, M.D., 136 Chen, Katherine 137 Li, Eric 138 Espinoza-Setchko, Bo The Role of Network Adequacy and Essential Community Providers in Delivering Care to Underserved Populations: A South Los Angeles Study 139 Nafiz, Rayek SBIRT Implementation at UCLA IMS Clinic 140 Mangubat, Michael Role of acculturation in determining pre-operative anesthesia-related concerns Urban agriculture: potential response of a resourceful community to living in a “food desert” Perceptions of the ACA in the homeless population PUBLIC HEALTH II Moderator: Lawrence ‘Hy’ Doyle, Ed.D. 141 Gonzalez, Karla Ideas and Opinions of Older Latinos On Aggressive Treatments 142 Khalili, Josh Identifying LGBT-Competent Physicians Nationally: A Follow-up Study 143 Padilla, Guillermo 144 Sunjaya, Dharma The Affordable Care Act and Colorectal Cancer Screening at a Federally Qualified Health Center Factors Affecting Diabetes Mellitus Care in the United States 145 Weintraub, Gil Allergic Contact Dermatitis Database Review THORACIC AND VASCULARY SURGERY Moderator: Chris DeVirgilio, M.D. 146 Abdulla, Amer Outcomes of Surgery for Primary Hyperparathyroidism: Analysis of 17,082 Cases 147 Khoo, Teresa Massive Pulmonary Embolism 148 Klausner, Jill The Contemporary Management of Renal Artery Aneurysms 149 Lancaster, Elizabeth Long Term Outcomes of Abdominal Aortic Aneurysm Repair in the Veteran Population 150 Maciel, James Predictors of Mortality in Patients with Penetrating Injuries of the Inferior Vena Cava Surviving to the Operating Room 151 Nguyen, Virginia Symptomatic Common Femoral Artery Elongation and Kinking in a Cyclist 152 Tse, Brian Comparing levels of glucose using an insulin infusion protocol vs. conventional intraoperative glucose management during cardiac surgery with cardiopulmonary bypass 153 Tse, Justin Removing vocal fold epithelium impairs vibration in an excised larynx model UROLOGY Moderator: Gerald Lipshutz, M.D. 154 Elbuluk, Osama Correlating ADC with Prostate Cancer Aggressiveness using 3T Multiparametric-MRI 155 Greenburg, Scott Literature Review and Case Report: Pemphigoid as a Rare Urologic Paraneoplastic Presentation 156 Moradzadeh, Ariel Review of studies and review papers related to Tadalafil daily use for the treatment of Erectile dysfunction, with or without LUTS, from 2011 to current 157 Shkolyar, Eugene 158 159 Slupski, Victor Zaki, Michael Comparison of Multi-Parametric MRI Performance for Cancer Detection Between the Central and Peripheral Prostate Testicular tumor presenting with massive deep venous thrombosis Unusual Presentation of Metastatic Prostate Carcinoma as Neck Mass 11 Charles R. Drew University of Medicine and Science CDU/UCLA Medical Education Program The Medical Student Research Thesis Program (MSRTP) Presents The Class of 2015 Medical Student Research Colloquium Current Research in Health Disparities Wednesday, March 25, 2015 8:30 AM to 4:30 PM Registration begins at 7:30 a.m. Keck Auditorium Charles R. Drew University of Medicine and Science 1731 East 120th Street Shahrzad Bazargan-Hejazi, PhD shahrzadbazargan@cdrewu.edu Stacey Teruya, EdD, MS staceyteruya@cdrewu.edu 12 Northwest Auditorium 11:15 am – 12:15 pm Student presentations are 7 minutes in length followed by a 4 minute question and answer period Speaker Order Student Moderator: Alison A. Moore, MD Mentor Presentation Michael Kuo, M.D. A Computed Tomography Radiogenomic Biomarker Predicts Microvascular Invasion and Clinical Outcomes in Hepatocellular Carcinoma Dixon, Brittany J. Nadereh Pourat, M.D. Does behavioral health integration and recognition as a patientcentered medical home improve delivery of care within the safety net system? 3 Ho, Victoria Kelsey Martin, M.D. Post-transcriptional gene regulation in mature neurons 4 Lo, Lydia N. Andrea Rapkin, M.D. 5 Morehead-Gee, Alicia Cynthia Davis, MPH 1 Banerjee, Sudeep 2 Impact of Vulvodynia on Sexual Function: Data from a Nationwide Registry Factors Contributing to Depression among HIV-Positive and HIVNegative Latinos and African-Americans Residing in South Los Angeles 13 Oral Presentation Abstracts Sudeep Banerjee: Case Study: A Computed Tomography Radiogenomic Biomarker Predicts Microvascular Invasion and Clinical Outcomes in Hepatocellular Carcinoma Introduction: Microvascular invasion (MVI) in hepatocellular carcinoma (HCC) is an independent predictor of poor outcomes following surgical resection or liver transplantation (LT); however, MVI currently cannot be adequately determined preoperatively. Radiogenomic venous invasion (RVI) is a contrast-enhanced computed tomography (CECT) biomarker of MVI derived from a 91-gene HCC "venous invasion" gene expression signature. Methods: Preoperative CECTs of 157 HCC patients who underwent surgical resection (N = 72) or LT (N = 85) between 2000 and 2009 at 3 institutions were evaluated for the presence or absence of RVI. RVI was assessed for its ability to predict MVI and outcomes. Interobserver agreement for scoring RVI was substantial among 5 radiologists (k=0.705, P<0.001). Results: The diagnostic accuracy, sensitivity and specificity of RVI in predicting MVI were 89%, 76% and 94%, respectively. Positive RVI score was associated with lower overall survival than negative RVI score in the overall cohort (P<0.001; 48 vs. >147 months), AJCC-TNM stage II (P<0.001, 34 vs. >147 months), and in LT patients within Milan criteria (P<0.001; 69 vs. >147 months). Positive RVI score also portended lower recurrence-free survival at 3years versus negative RVI score (P=0.001; 27% vs. 62%). Conclusion: RVI is a noninvasive radiogenomic biomarker that accurately predicts histologic MVI in HCC surgical candidates. Its presence on preoperative CECT is associated with early disease recurrence and poor overall survival and may be useful for identifying patients less likely to derive a durable benefit from surgical treatment. Brittany J. Dixon: Does behavioral health integration and recognition as a patient-centered medical home improve delivery of care within the safety net system? Objective: Adoption of patient-centered medical home (PCMH) recognition and behavioral health integration among community clinics has accelerated since the implementation of the Affordable Care Act (ACA). The ACA aims to improve patients’ health and the quality of care delivered while simultaneously decreasing costs. This study examines the effect of PCMH recognition and behavioral health integration on service use of enrollees in the Low Income Health Program (LIHP), which was established by a Medicaid 1115 waiver and implemented over seven quarters (January 2011 - December 2013) in 53 California counties. Methods: PCMH recognized community clinics that employed behavioral health (BH) care providers and provided publicly available LIHP data were selected. LIPH enrollees (total N=48,666 in 37 clinics; had BH diagnosis N=16,847) were selected from 41 counties. Random effects Poisson was utilized to examine change over time in service use, which included evaluation and management visits (E&M), emergency room visits, and hospitalizations. Results: The adjusted rate of E&M visits (1.3 to 0.9), ER visits (0.19 to 0.15), and hospitalizations (0.09 to 0.04) decreased for PCMH enrollees during this time. Enrollees with BH diagnosis in PCMH clinics with BH employees experienced the highest drop in adjusted E&M visit rates (1.59 to 1.24 visits/person). Those with PCMH, but no BH employees experienced decreased utilization, but it was less steep. Clinics without PCMH, but with BH employees had the least steep drop in the rates of E&M visits. Conclusions: PCMH recognition significantly reduced the rates of E&M visits, emergency room visits, and hospitalizations during this time period. BH integration decreased E&M visits, but did not have an independent impact from PCMH on emergency visits or hospitalizations. Implications for Policy: PCMH recognition and BH integration may promote cost savings through decreased utilization. BH integration and PCMH recognition appear to directly benefit Medicaid programs. 14 Victoria Ho: Post-transcriptional gene regulation in mature neurons Introduction: Neurons are highly-polarized cells with processes that span great distances and many independent subcompartments. Despite their challenging morphology, neurons are able to respond to external stimuli in a local or cell-wide manner. They are also able to form stable connections with other neurons, while remaining plastic and adaptable to change. To meet these demands, neurons use complex, post-transcriptional mechanisms to regulate gene expression. Two approaches were taken to study these mechanisms. Methods: First, a cell biological approach was used to study a specific interaction between the microRNA, miR124, and GluA2 mRNA in dissociated hippocampal neurons. Using biochemical fractionation, fluorescence in situ hybridization, immunoblotting, and immunocytochemistry, we found that miR-124 is dendritically-localized while GluA2 mRNA is somatically-restricted. Both RNAs are present in the cell body, where they interact to downregulate GluA2 proteins in the soma by ~30 %. Synaptic GluA2 protein was not affected by this manipulation, suggesting that post-translational regulatory mechanisms (e.g. trafficking) are in place to maintain appropriate concentrations of GluA2 at the synapse. Methods: Second, a high-throughput sequencing approach was taken to identify general mechanisms of gene regulation during chemical long-term potentiation (chemLTP) in acute hippocampal slices, as well as to screen for interesting candidates for further investigation. RNA was extracted from chemLTP-treated and control slices, and changes in steady-state RNA levels were determined. Results: This study is ongoing but so far, preliminary results suggest that non-neuronal cells may play an important role in the strengthening of neuronal connections. Future analysis will focus on 3’ untranslated regions, which determine the post-transcriptional fate of genes. Conclusion: The two approaches provide different levels of information on the regulation of gene expression in neurons and yield unexpected findings. Together, they illustrate the complexity of regulatory mechanisms in neurons, and that there is much we have left to understand. Lydia N. Lo: Impact of Vulvodynia on Sexual Function: Data from a Nationwide Registry Background: Vulvodynia is a poorly-understood chronic pain disorder of unknown etiology. The National Vulvodynia Registry is a multi-site, national registry of more than 200 patients with vulvodynia that contains clinical examination data, as well as questionnaire data on a variety of other aspects, including medical comorbidities and quality of life. One of the interesting findings form this database is how vulvar pain correlates with sexual functioning. Methods: Cleaned data was analyzed using STATA. The outcomes of interest are two clinical pain scores summarizing pain in the mucosa of the vestibule and also pain with muscle activation in the vulva. Sexual function was assessed using the Female Sexual Function Index (FSFI) and other quality of life questions. Results: Both mucosal and muscle pain scores had strong correlations with factors associated with components of sexual activity. For instance, both mucosal and muscle pain is negatively correlated with arousal (frequency of, level of, confidence with, and satisfaction with) and orgasm (frequency of, difficulty of achieving, and satisfaction with ability to achieve), and negatively correlated with overall satisfaction with sex life. However, there were no significant correlations between mucosal and muscle pain scores and factors outside of sexual activity itself that addressed more broadly the patient’s relationship with her partner. We found no relationship between pain and frequency of intercourse, whether or not vulvodynia affected the patient’s relationship with her partner, the degree of support the patient received from her partner post-diagnosis, or the level of intimacy between the patient and her partner. Conclusion: This information suggests that, while vulvodynia negatively affects sexual activity, it has much less of an impact on a patient’s relationship with her partner. More information is needed on how women cope with increased difficulty with sex while maintaining relationships. 15 Alicia Morehead-Gee: Factors Contributing to Depression among HIV-Positive and HIV-Negative Latinos and African-Americans Residing in South Los Angeles Background: The prevalence of depression among HIV-positive individuals is twice that of HIV-negative individuals. Few studies have investigated risk factors for depression among HIV-positive and HIV-negative Latinos and African-Americans. Objective: To compare depression prevalence among HIV-positive and HIV-negative Latinos and AfricanAmericans in South Los Angeles and examine how alcohol abuse, childhood sexual abuse (CSA), and HIV/AIDS knowledge influence depression status. Methods: Cross-sectional data were collected over two years. Subjects were recruited at community outreach sites and HIV/AIDS Primary Care Clinics. Preliminary analysis of depression by demographics, HIV status, alcohol abuse, CSA, and HIV/AIDS knowledge was done using SPSS 22. Results: Of the 168 participants, 61% were Latino, 35% were African-American, 54% were male, 63% had an income under $10,000/year, 53% were depressed, 69% had experienced CSA, 55% screened positive for alcohol abuse, and 12% were HIV-positive. There was no significant difference in depression between HIV-positive (74%) and HIV-negative (51%) participants (p>0.05). Depression was significantly higher in males, Latinos, participants with income under $10,000, those with history of CSA, and those who abused alcohol (p<0.05) compared to the other groups. Compared to HIV-positive participants, a significantly higher percentage of HIV-negative participants incorrectly stated that HIV is transmitted through saliva and that oil-based lubricants do not make condoms more likely to break (p<0.05). Logistic regression analysis showed that those with history of CSA (Odds Ratio [OR]=8.4, 95% Confidence Interval [CI]=1.4-50.9) and alcohol abuse (OR=5.6, 95% CI=1.2-26.8) were more likely to be depressed relative to the other groups. Conclusion: No difference was found in depression prevalence between HIV-positive and HIV-negative participants. Depression was significantly associated with CSA and alcohol abuse, indicating the need for increased depression screening among individuals with these risk factors. There was decreased knowledge about HIV transmission among HIV-negative participants, showing that increased HIV-related education is needed in this population. 16
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