Abstracts (Missouri Regional Life Sciences Summit 2010)
Permanent URI for this collection
This collection contains the abstracts for the three types of sessions of the Missouri Regional Life Sciences Summit 2010: posters; presentations; plenary speakers. Please enter text in the search box above or click on one of the browse options to explore this collection.
Browse
Recent Submissions
Item Novel Nanostructured Organosilicate Nanoparticle Coatings for Chem-Bio Sensing [abstract](2010-03) Korampally, Venumadhav, 1972-; Darr, Charles Matthew, 1984-; Polo-Parada, Luis; Gangopadhyay, Keshab; Gangopadhyay, Shubhra; Grant, Sheila Ann; Sobel, Annette; Singh, Balram; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)We present novel nanostructured organosilicate particulate based films and demonstrate that these materials have a great potential for chemical-biological sensor development. With unprecedented high surface areas (> 1400 m2/g) and optical transparency together with its easy surface functionalization, these materials can be readily interfaced with existing immunoassays for the rapid and trace detection of both chemical and biological warfare agents. The ultra high surface area associated with these films stems from its unique nanostructure consisting of nanoparticles (2-5nm) in a “raspberry” structure in combination with interconnected nanopores (3-10nm). This unique nanostructure has been exploited to immobilize high areal density of sensor probes to improve the sensing performance. Two orders of magnitude increase in binding density was achieved when fluorescently tagged protein A molecules were immobilized upon these surfaces compared to flat substrates (glass and Silicon). Our on-going work applies these materials to develop platforms for multiplexed sensitive detection of biological and chemical agents at point of care for both army and civilian use.Item Temporal trends in the management of severe hyperglycemia among patients hospitalized with acute myocardial infarction [abstract](2010) Venkitachalam, Lakshmi; Gosch, Kensey L.; Lipska, Kasia; Inzucchi, Silvio E.; Goyal, Abhinav; Spertus, John A.; Masoudi, Frederick A.; Jones, Phillip G.; Kosiborod, Mikhail; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)Background: Elevated blood glucose (BG) is associated with an adverse prognosis in acute myocardial infarction (AMI) patients. While guidelines recommend insulin therapy to lower markedly elevated BG in AMI patients, it is unknown whether these recommendations have impacted BG management over time. Methods: We studied 39,775 AMI patients hospitalized from 2000 to 2008 in 55 US medical centers contributing to Health Facts, a national database with extensive data on in-hospital BG and insulin use. Using all available BG measures during the hospital stay, we restricted our analysis to patients with a mean BG ≥200mg/dl and examined temporal trends in insulin use with hierarchical logistic regression models. Results: Overall, 4330 patients (11% of the entire cohort) had mean hospitalization BG ≥ 200 mg/dL and this proportion decreased from 2000 to 2008 (12% to 8%, p for trend<0.001); 75% of these patients had diabetes. In total, 61% of AMI patients with mean BG ≥ 200 received any insulin and only 16% received intravenous (IV) insulin during hospitalization. Hierarchical multivariable models showed an increased likelihood of insulin use over time (Figure). However, about one in three patients continued to receive no treatment for markedly elevated BG. Conclusions: Despite some improvement over time, insulin treatment rates among hospitalized AMI patients with severe, sustained hyperglycemia remain low. These findings likely reflect continuing uncertainty regarding optimal BG management during AMI.Item Small Business Support for Youth Physical Activity Opportunities(2010-03) Suminski, Richard R.; Tota, Tonya; Dinius, David; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)Background: Increasing the number of youth physical activity opportunities (YPAO) (e.g., programs) may be a promising approach for encouraging physically active lifestyles among youth. To do this effectively, we need information on YPAO support systems (e.g., types [financial, in-kind]). Objective: To construct a comprehensive description of YPAO support systems with a focus on the involvement of small businesses. Methods: The first aim was to obtain detailed information about YPAO available to the public including their characteristics (e.g., amenities), operating costs, and the sources of support for the operating costs. The second aim was to describe characteristics related to supporting YPAO. Data from four minority (>70% minority) and four non-minority (<10% minority), inner-city Kansas City neighborhoods was obtained over an eight-month period using quantitative (e.g., surveys, community tours) and qualitative (e.g., key informants) data collection methods. Results: Of the 55 small businesses surveyed, those whose owner was middle-aged (40-50 y), white, with a sports background, and children between 5 and 16 years old were more likely to support YPAO. Only 33% of the business owners surveyed supported YPAO and less than 1% did this to advertise their business. Although YPAO support levels were low, all owners (supporters and non-supporters of YPAO) believed small businesses should support YPAO and how such support can make a difference in the neighborhood. Three main themes emerged regarding the culture of support. First, business owners were more apt to offer support for YPAO if family and friends were involved. Second, business owners tended to be aware of and offer support for broad initiatives focused on neighborhood improvements but experienced barriers to specifically supporting YPAO. For example, information about YPAO needing support was not readily available and few organizations soliciting support for neighborhood initiatives allowed for specific initiatives (e.g., YPAO) to be selected. Third, prominent stakeholders within a neighborhood heavily influenced the culture of giving which suggests they could be used to champion support for YPAO from small businesses. Several barriers to supporting YPAO by small businesses were identified. Small business owners did not track how their support was used and therefore did not receive feedback on the impact of their support. Credit was seldom given to small businesses for their support negating possible returns on their investments (e.g., positive exposure leading to increased business). Owners had little knowledge of who needed help and why they needed help within the neighborhood where their business was located, thus they did not know who or what cause to support. Some owners were not willing to give support because they did not trust the population of the neighborhood where their business was located and did not believe the support would be used for legitimate purposes. This was particularly true for non-minority business owners with a business in a minority neighborhood. Conclusions: Characteristics of small business owners, cultural trends regarding support, and the existence of modifiable barriers to support were identified that may help in the formulation of partnerships to promote youth physical activity.Item Dangerous Drug Reactions on the S&A iPhone App [abstract](2010) Hagerty, Jason; Krumm, John W.; McKinnon, Thomas A.; Stoecker, William V.; Stricklin, Sherea; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)The S&A drug database for handhelds, sold to dermatologists for 8 years, was uploaded as a new iPhone application (app), February 2010. Our program notes all warnings at the several FDA levels: boxed warnings, bold warnings, warnings, and adverse effects, reflecting greater interest in drug warnings by all parties, including consumers, regulators, industry. The FDA has a program called MedWatch, which collects reports of adverse drug reactions, including serious and fatal reactions. In 2007, The Institute for Safe Medical Practices (ISMP) published a list of the fifteen drugs most often reported as primary suspects for serious and fatal reactions in the FDA's MedWatch program for the eight years ending in December, 2005. Our iPhone app now notes all drugs which made this list. Using knowledge gained working with the ISMP during summer, 2009, S&A researchers, including 2 S&T seniors, are working with MedWatch data to revise and update the old fatal drug list. The new information will be placed on the S&A website and the iPhone app during Spring, 2010. The quarterly data will allow consumers to see how the fatality rates for different drugs are changing. In addition, the changes will allow S&A to look for a signal for specific reactions. The proportional reporting ratio (PRR) was used to search the MedWatch data from 2004-2008 and discover that ciprofloxacin was the leading primary suspect drug in deaths in elderly patients from severe skin reactions during the period 2004-2008.Item INFORMER and Potassium Values: A system to enhance detection, notification, and action upon a threat to patient safety in the emergency department [abstract](2010) Gaddis, Gary; Garg, Uttam; Sharma, Mukut; Kumar, Vijay; University of Missouri (System); Missouri Life Sciences Summit (2010: University of Missouri--Kansas City)Background: Quick remediation should occur after critically abnormal potassium levels are detected by the medical laboratory in blood from emergency department (ED) patients. Critical potassium levels can be elevated (“HyperK+“) or decreased (“HypoK+“). HyperK+ and HypoK+ can both lead to avoidable patient harm by causing heart rhythm problems, which can be harmful or lethal. Also, Continuous Quality Improvement (CQI) could be enhanced by the creation of an electronic “audit trail” to track these remediations, which involve detection, notification, action-upon, and documentation steps (D1-N-A-D2). HyperK+ and HypoK+ are a logical first target to ameliorate inefficiencies of D1-N-A-D2, because of the frequency of occurrence of these problems in the ED, because the appropriate rapid ED response is clear, and because failures of D1-N-A-D2. can hurt or kill patients. Hypothesis: An automated D1-N-A-D2, plus audit path, can be created, then merged with a to-be-created standing ED order set, to hasten the treatment of HyperK+ and HypoK+. Methods: (1) A standing order set will be adopted, to permit nurses to administer appropriate treatments to patients with either HyperK+ or HypoK+, without prior physician notification. Oral or intravenous potassium, as appropriate, will remediate HypoK+, Administration of insulin plus glucose, calcium, sodium bicarbonate, and sodium polystyrene resin will ameliorate HyperK+. Order sets will be created after input from physician and nursing personnel. (Re-obtaining of blood from patients in whom HyperK+ is thought to be a false positive result, due to hemolysis of the blood sample, will be permitted). (2) “Electronic loop”: Engineers will create an electronic pathway to enable the rapid electronic notification of appropriate medical personnel, after critical HyperK+ or HypoK+ have been detected. This will enable and drive nurses to action. Actions can be electronically audited via review of digital PyxisTM medication administration machine records, matching medication withdrawals for specific patients to specific incidences of HyperK+ and HypoK+. Time to nurse action will be documented. Data during implementation of D1-N-A-D2 will be compared to prior historical control data, to determine whether the newly created process delivers appropriate care more quickly to patients with critically abnormal K+ values. (In addition, it is anticipated that electronic review of laboratory data for the historical controls will reveal total system failures for some patients; some patients with HyperK+ and/or HypoK+ might not have been treated at all for their potassium abnormality during their time in the ED.) Results: Time to treatment for HyperK+ and HypoK+ patients, and % of patients with HyperK+ and HypoK+ who represent total system failures, before vs. after implementation of the pervasive computing protocol, will be determined. Conclusion: It is anticipated that a pervasive computing environment can be created to facilitate implementation of a standing medication order set, to enable more rapid D1-N-A-D2 after critical values of HyperK+ or HypoK+ are detected in the blood of emergency department patients. Also, this environment will decrease the failure-to-treat rate for critical HyperK+ and HypoK+.