IUPUI Research Day 2013
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A program book describing the Research Day 2013 events and posters is available from: http://hdl.handle.net/1805/4914.
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Item Paced Respiration for Vasomotor and Other Menopausal Symptoms: A Randomized, Controlled Trial(Office of the Vice Chancellor for Research, 2013-04-05) Carpenter, Janet S.; Burns, Debra S.; Wu, Jingwei; Otte, Julie L.; Yu, MenggangBackground: Paced respiration has been internationally recommended for vasomotor symptoms (e.g., hot flashes, night sweats) despite limited empirical evidence. Objective: To evaluate efficacy of a paced respiration intervention against breathing control and usual care control for vasomotor and other menopausal symptoms. Design: A 16-week, 3-group, partially blinded, controlled trial with 2:2:1 randomization and stratification by group (breast cancer, no cancer) was conducted in a Midwestern city and surrounding area. Participants: 218 randomized women (96 breast cancer survivors, 122 menopausal women without cancer) were recruited through community mailings and registries (29% minority). Interventions: Training, home practice support, and instructions to use the breathing at the time of each hot flash were delivered via compact disc with printed booklet (paced respiration intervention) or digital videodisc with printed booklet (fast shallow breathing control). Usual care control received a letter regarding group assignment. Main Measures: Outcomes included hot flash frequency, severity, and bother (primary), hot flash interference in daily life, perceived control over hot flashes, and mood and sleep disturbances (secondary). Intervention performance, adherence, and adverse events were assessed. Key Results: There were no significant group differences for primary outcomes at 8- or 16-weeks post-randomization. Most intervention participants did not achieve 50% reduction in vasomotor symptoms despite demonstrated ability to correctly do paced respiration and daily practice. Statistically significant differences in secondary outcomes at 8- and 16-weeks were small, not likely to be clinically relevant, and as likely to favor intervention as breathing control. Conclusions: Paced respiration is unlikely to provide clinical benefit for vasomotor or other menopausal symptoms in breast cancer survivors or menopausal women without cancer.Item Surgical Model of Menopause Symptoms: GABA’S Role in Anxiety and Hot Flashes(Office of the Vice Chancellor for Research, 2013-04-05) Frink, AnnaMenopause is the permanent cessation of the primary functions of the human ovaries: the ripening and release of the ova, and the release of hormones that create the uterine lining. The transition from a reproductive to non-reproductive state is a result of a reduction in sex hormone production by the ovarian follicular cells due to their degeneration. For some women, the accompanying signs of and effects that can occur during the menopause transition years can significantly disrupt their daily activities and sense of well-being; symptoms include vasomotor instability (hot flashes and night sweats), anxiety, and sleep disruption. Unfortunately, animal modeling to understand these symptoms, particularly “hot flashes” has been limited and lacks predictive and construct validity. We have developed a novel model of “hot flashes” by injecting a 3 mg/kg (intraperitoneal administration) dose of the anxiogenic drug FG-7142 (a partial inverse agonist at the benzodiazepine site on the GABAA receptor) following bilateral ovariectomy. Previous work in our lab has determined that this injection elicits a rapid, 9° Celsius increase in tail skin temperature (the indicator of the “hot flash” response in a rat) in ovariectomized rats but not in sham-operated control rats. However, the neural sites that mediate this response are unknown. We hypothesized that there are significant differences in either the anatomical sites involved in the “hot flash” response in ovariectomized rats or the extent of activation of the same neural sites. To test this hypothesis, female rats were either bilaterally ovariectomized or sham-ovariectomized; following recovery, rats were given a 3 mg/kg dose of FG-7142 or vehicle and perfused 90 min later. Tissue was processed and stained for the immediate early gene product c-fos. It was determined that the ovariectomized rats had a hyperactive response in the hypothalamic brain region associated with anxiety and thermoregulation (i.e., dorsal medial hypothalamus).Item Wnt Signaling in Zebrafish Fin Regeneration: Chemical Biology Using GSK3b Inhibitors(Office of the Vice Chancellor for Research, 2013-04-05) Curtis, Courtney; Sarmah, Swapnalee; Collins, Kayla; Chu, Shaoyou; Sato, Mas; Sanchez-Felix, Manuel; Marrs, James A.Bone growth can be impaired due to disease, such as osteoporosis, and Wnt signaling pathways regulate bone growth. The parathyroid hormone (PTH) is therapeutic for anabolic bone growth (bone building), which activates Wnt signaling, leading to bone growth. GSK3b (glycogen synthetase kinase 3 beta) protein inhibitors activate Wnt signaling, including in bone growth models. Our study utilized a zebrafish model system to study Wnt activated fin regeneration and bone growth. Wnt signaling is the first genetically identified step in fin regeneration, and bony rays are the main differentiated cell type in fins. Thus, zebrafish fin regeneration may be a useful model to study Wnt signaling mediated bone growth. Fin regeneration experiments were conducted using various concentrations of GSK3b inhibitor compound for different treatment periods and regenerative outgrowth was measured at 4 and 7 days post amputation. Experiments revealed continuous low concentration (5-6 nM) treatment to be most effective at increasing regeneration. Higher concentrations inhibited fin growth, perhaps by excessive stimulation of differentiation programs. In situ hybridization experiments were performed to examine effects of Gsk3b inhibitor on Wnt responsive gene expression. Initial experiments show temporal and spatial changes on individual gene markers following GSK3b inhibitor treatment. Additionally, confocal microscopy and immunofluorescence labeling data indicated that the Wnt signaling intracellular signal transducer, betacatenin, accumulates throughout Gsk3b inhibitor treated tissues. Finally, experiments are underway to quantify phosphohistone-3 staining in regenerating tissue to measure effects of Gsk3b inhibitor on cell proliferation. Together, these data indicate that bone growth in zebrafish fin regeneration is improved by activating Wnt signaling. Zebrafish Wnt signaling experiments provide good model to study bone growth and bone repair mechanisms, and may provide an efficient drug discovery platform.Item Indiana Center for Intercultural Communication: Translating Health Discourse Research into Action(Office of the Vice Chancellor for Research, 2013-04-05) Connor, UllaThe Indiana Center for Intercultural Communication (ICIC) is a university-based research and service organization created to enhance links between the city of Indianapolis, the state of Indiana, and cultures/nations throughout the world. ICIC conducts internationally recognized research on language and intercultural communication and applies its expertise to benefit the wider community. The Center also offers group training programs and individualized tutoring in language for specific purposes and intercultural communication to students, faculty, medical residents, postdoctoral researchers, and business professionals in the community as well as international language educators. ICIC’s research focuses on health discourse from the perspective of intercultural rhetoric. The Center’s strong linguistic background provides a unique multimodal approach to the study of factors and forms of interaction and communication that impact medication adherence, risk comprehension, and patient disease management and decision-making. In keeping with the Signature Center Initiative mandate to conduct research that translates into practice, the results of ICIC’s research translate into action in the form of training to healthcare providers and guidelines for patient-tailored language and communication strategies. This poster features results from recent ICIC research projects, among them a study of linguistic indicators related to diabetes patient self-management and an intercultural analysis of sources of medical information in Spanish-speaking diabetes patients. Also featured are ongoing and future projects: a psychosociolinguistic study of patient voices to be applied to the development of patient-tailored messaging and the health-literacy oriented redesign of the Walther Cancer Center information portal for patients.Item Carbon Dioxide Challenge and Hot Flashes(Office of the Vice Chancellor for Research, 2013-04-05) Dorsey, Sarah E.; Carpenter, Janet S.Little is known about the pathophysiology of menopausal hot flashes, although there appear to be many similarities between hot flashes and panic attacks. While hot flashes occur at random and are difficult to study, there is a method of testing panic attacks. A Carbon Dioxide (CO2) Challenge is a validated method that has been used to induce panic attacks in a laboratory setting. The aim of this study is to test whether a CO2 Challenge using inhalations of 20% and 35% CO2 can provoke a hot flash in menopausal women. We hypothesize that women who have many hot flashes each day (4+) will have a hot flash when exposed to the increased concentration of CO2 using this challenge. Six healthy women attended a study session lasting ninety minutes. In this placebo controlled, cross-over study, women inhale room air, 20% CO2 for 40 seconds, rest for 15 minutes, and 35% CO2 using a double-breath vital capacity inhalation. Anxiety was measured on a numeric rating scale (NRS) and a State Trait Anxiety Inventory (STAI). Most participants have reported a hot flash within minutes of the CO2Challenge. There have been no significant changes in anxiety during the study. Findings provide evidence of the proposed link between hot flashes and panic.Item Increased Ischemic Cardiac Deaths in Central Indiana in Summer Months Compared to Winter Months(Office of the Vice Chancellor for Research, 2013-04-05) Cook, Shannon; Lloyd, Frank, Jr.; Ballew, Alfie; Sandusky, George E.Cardiovascular diseases have been the leading cause of death in the United States for several decades. Despite sustained declines in the mortality rates from these diseases, the magnitude of the disease is still staggering. One large recent study, using data on hundreds of heart attacks documented in the National Registry of Myocardial Infarction, found that 53 percent more cases in winter than in summer. The primary culprit, many believe, is temperature. Cold weather narrows coronary arteries and raises blood pressure, stressing the heart. Physical strain and ruptured plaques caused by shoveling snow are also commonly cited. But in a recent study, two researchers, found that the risk increases even in warm climates. Analyzing death certificates in seven regions with different climates, Los Angeles, Texas, Arizona, Pennsylvania, Massachusetts and others found that cardiovascular deaths rose up to 36 percent between summer and winter, regardless of climate and temperatures In this study we evaluated the incidence of ischemic cardiomyopathy in the Central Indiana area in the winter months compared to the summer months for the years 1998 to 2002. Approximately 5325 deaths were seen in the Marion County Morgue in central Indiana in this time period. There were 609 ischemic cardiac deaths seen in the summer (March 15th through October 15th) compared to 434 ischemic cardiac deaths seen in the winter (October 15th through March 15th). The deaths by years in the summer were 129, 131, 92, 127, and 130 and in the winter were 95, 96, 90, 96, and 57 respectively. In conclusion, this study was consistent with the outcome as the previous study done in multiple northern and southern cities in the country.Item The Effect of Body Mass Index on Blood Pressure Varies by Race among Children(Office of the Vice Chancellor for Research, 2013-04-05) Li, Zhuokai; Eckert, George; Tu, Wanzhu; Gupta, Sandeep; Carroll, Aaron; Pratt, J. Howard; Hannon, Tamara S.The effect of adiposity on blood pressure (BP) intensifies as children become obese, and black children tend to have greater body mass index (BMI) and higher BP than age-matched white children. But few studies have compared the magnitude of the effect of BMI on BP in obese black and white children. We used a novel analytic technique to examine the influence of age and BMI on BP in children seen at a hospital-based obesity clinic. The study sample included 821 overweight and obese children (age and sex adjusted BMI% ranged from 87% to 100%; 306 males, 515 females, 362 blacks, and 459 whites). The mean age of the study subjects was 11.72 ± 3.48 years, the mean BMI was 36.22 ± 8.51 kg/m2, and the mean systolic and diastolic BP were 109.36 ± 16.10 and 69.99 ± 10.48 mmHg, respectively. In comparison, blacks and whites were similar in age (11.89 vs 11.58; p=0.197); while black patients had higher BMI (37.32 vs 35.34 kg/m2; p=0.0010), and higher systolic BP% than whites (58.71 vs 50.72 mmHg; p=0.00062). Semiparametric regression models showed that while age and BMI were significantly associated with systolic BP% in both race groups, black children had significantly higher BP% values as compared with white children of the same age and BMI (Fig 1 (a) and (b)). Although BP% values have taken into account the effect of age, there continued to be a significant effect of age on BP% in black children. In conclusion, among children referred for treatment of obesity, black children are at a significantly greater risk for having elevated BP as compared with their white peers of similar age and severity of obesity. Further research is needed to better understand this population-specific intensification of the adiposity effect on BP in obese black children.Item Organizational and Faculty Determinants Associated with Health Information Technology Adoption in DNP Programs: A Descriptive Study(Office of the Vice Chancellor for Research, 2013-04-05) Fulton, Cathy R.Background: Informatics is a key component of graduate nursing education and an accreditation requirement, yet little is documented about the barriers to implementing informatics in Doctor of Nursing Practice curricula. Purpose: The purpose of this descriptive study was to explore: 1) the degree to which the accreditation standard and informatics guidelines have been met across programs; 2) the outcome of the Technology Informatics Guiding Educational Reform Initiative Foundation’s Phase II goals and recommendations as they relate to the Education and Faculty Development Collaborative; 3) the faculty and organizational determinants that lead to actions characteristic of Doctorate of Nursing Practice programs that are required by American Association of Colleges of Nursing to implement Essential IV into their curricula. Method: A survey was sent electronically to 138 Doctor of Nursing Practice program directors as identified on the American Association of Colleges of Nursing website with an 84% response rate. Results: Major findings include a lack of informatics’ certified and/or prepared faculty and a lack of awareness of informatics curricular guidelines. Conclusions: Recommendations for deans and DNP program directors include encouraging interested faculty members to pursue informatics education, using established national informatics curricular competencies, and partnering with educational institutions which do have nursing informatics certified or master’s prepared faculty to improve the development of informatics/health information technology curricula.Item Barriers, Facilitators, and Suggestive HIV Interventions for Women: Preliminary Data from a Secondary Analysis(Office of the Vice Chancellor for Research, 2013-04-05) Schmitt, Herman C.; Burrage, JoeThe Centers for Disease Control and Prevention report that women account for almost ten thousand of those newly diagnosed with HIV annually. Within this group, Latina, non-Latina white and non-Latina black women are particularly affected. The purpose of this secondary analysis was to analyze existing de-identified data for barriers and facilitators for HIV testing and willingness to participate in a vaccine if available. The data were 30 de-identified transcripts of one hour interviews obtained from three groups of women (10 Latinas, 10 non-Latina white, and 10 non- Latina black) during the initial phase of a parent study, “HIV Testing and Women’s Attitudes on HIV Vaccine Trials”: G. Zimet, PI. A semi-structured interview guide had been used to guide the interviews. This sub analysis was conducted with removal of ethnic classification to reduce bias during qualitative review. Three predominant categories of fear, time, and cost emerged from all interviews regardless of ethnicity. Less prominent categories of gender, education, trust, motherhood, discrimination, loss of integrity, invincibility, safety, age, testing accuracy, confidentiality, indifference, pride, lifestyle, divine justice, and stress varied among the three groups. These categories will provide the basis for further analysis to determine subthemes and themes, and if there are themes unique to any of the three groups.Item Exercise Completed When Young Provides Lifelong Benefit to Cortical Bone Structure and Estimated Strength(Office of the Vice Chancellor for Research, 2013-04-05) Warden, Stuart J.; Roosa, Sara Mantila; Hurd, Andrea L.; Fuchs, Robyn K.Exercise induces greatest bone gains during growth, yet reduced bone strength is an age-related phenomenon. This raises the question of whether exercise-induced bone changes when young persist into adulthood. The current studies used Major/Minor League Baseball (MLB/MiLB) players to explore whether exercise-induced gains in humeral bone structure and strength accrued when young persist lifelong. MLB/MiLB players are a unique model as the unilateral upper extremity loading associated with throwing enables the contralateral side to serve as an internal control site and former MLB/MiLB players were consistently exposed to extreme loading reducing secular variations in exercise levels between generations. Dominant-to-nondominant (D-to-ND) differences in humeral cross-sectional properties in MLB/MiLB players were normalized to matched controls to correct for side-to-side differences due to elevated habitual loading associated with arm dominance. Exercise when young induced significant skeletal benefits, with active MLB/MiLB players having nearly double the estimated ability to resist torsion (polar moment of inertia, IP) in the humerus of their dominant arm. The cortical bone mass and area benefits of exercise observed in active MLB/MiLB players were lost in former MLB players following 40-49 years of detraining as a result of elevated medullary expansion and endocortical trabecularization. However, 42% of the total bone area benefit persisted following 50+ years of detraining and contributed to the maintenance of 24% of the benefit on IP. In MLB players who continued to exercise during aging, medullary expansion and endocortical trabecularization were reduced and there was maintenance of the cortical bone mass and area benefits of exercise. These cumulative data indicate: 1) the extreme plasticity of the growing skeleton to exercise; 2) that exercise when young has lifelong benefits on cortical bone size and estimated strength, but not bone mass, and; 3) exercise continued during aging maintains the bone mass benefits of exercise.