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Publication Quality improvement approach to improve assessment of and responsiveness to food insecurity(Oklahoma State University Center for Health Services, 2020-02-28) Nguyen, Hong; Fugate, ColonyBackground: Access to nutritious food is essential to foster optimal health and development in children. Thus, the American Academy of Pediatrics recommends pediatricians routinely screen for food insecurity (FI). Previous initiatives within the OSU Pediatric Clinic sought to improve FI screening and intervention with varying degrees of success. Notably, rates of FI varied widely as studies used different validated screening tools and methods of assessment. The purpose of this project was to refine workflow, using a multistep quality improvement process, to more accurately assess for and appropriately respond to FI.Publication Analysis of publication trends in orthopedic residents in relations to academic achievement post-graduation(Oklahoma State University Center for Health Services, 2020-02-28) Carr, Marvin; Anderson, J. Michael; Hobbs, James; Walters, Corbin; Johnson, Austin L.; Vassar, MattBackground: Continuing Medical Education (CME) is an essential component of physician's careers. For many years the Accreditation Council for Graduate Medical Education (ACGME) has required residency programs to promote scholarly activity to obtain and retain accreditation. Many programs interpret this to mean promoting research amongst their members. Encouraging students to publish during residency is believed to promote research throughout their careers, but little information has been collected and analyzed to verify this assumption. This study was undertaken to determine if publishing in peer reviewed journals during orthopedic residencies was an indicator of continued academic achievement post-graduation.Publication Effect of voluntary exercise on weight gain and associated neuroimmune signaling in ovariectomized rats(Oklahoma State University Center for Health Services, 2020-02-28) Wu, D.; Rivera, S.; Buck, D.; Davis, R.; Curtis, K.Obesity is a multifaceted disease that poses a health care challenge, affecting ~40% of adults in the United States. It is associated with a range of co-morbidities and exorbitant medical costs. Obesity as a disease disproportionately affects different ethnic groups, as well as individuals of different socioeconomic status. However, the disparity between sexes is particularly concerning. 45% of women are obese compared to only 38% in men. Given this disparity, there is still surprisingly little literature on female obesity, even in animal models. It is known that ovarian hormones influence body weight, and that ovariectomized (OVX) rats rapidly gain weight. Additionally, it was noted in our previous study that this post-OVX weight gain is associated with regionally specific changes in neuroimmune signals in the CNS, particularly in areas involved in body weight regulation and feeding control, such as the arcuate nucleus (ARC), paraventricular nucleus (PVN), and the dorsal vagal complex (DVC). Obesity management is an issue as well. Due to its multifaceted nature, obesity is difficult to control. The most common recommendations for obese individuals are still dieting and exercise. In this study, we investigated the impact of exercise on weight gain along with the associated changes in neuroimmune signals focusing on Interleukin-6 (IL6), Monocyte Chemoattractant Protein (MCP-1), Toll-like Receptor 4 (TLR4), and Glial Fibrillary Acidic Protein (GFAP) due to their involvement in innate immune activation, which is associated with obesity.Publication Public awareness of health issues after the Surgeon General tweets(Oklahoma State University Center for Health Services, 2020-02-28) Young, Ryan; Roddy, Kevin; Torgerson, Trevor; Keener, Ashley; Vassar, MattHealth information distributed on social media may benefit public health by aiding in disease management and increasing awareness, however, not all information disseminated on social media is reliable. Therefore, a need exists for credible, evidence-based information that is accessible by the public. In the United States, the Surgeon General serves as the highest public health official and could serve as a solution to this need. In our study, we used Google Trends to evaluate the search interest of topics related to tweets sent out by the Surgeon General. We then used an autoregressive integrated moving algorithm to determine whether the tweets were associated with search volumes that were greater than the expected search volumes without the tweet. Thirteen tweets were analyzed and a significant positive mean search interest was found for only 2 tweets. One of the significant tweets had a mean search interest increase of 7.50% (95% CI, 0.8 - 14.2), which was a tweet the Surgeon General retweeted from another account. Given the public's limited engagement with the Surgeon General's current Twitter account, strategies to increase the number of followers is greatly needed if the Surgeon General is to make effective use of these outlets. One viable solution to the Surgeon General reaching a greater audience may be through celebrity partnerships.Publication Publication trends among anesthesiology graduates and its relationship with future academic success(Oklahoma State University Center for Health Services, 2020-02-28) Walters, Corbin; Anderson, J. Michael; Ferrell, Sydney; Kee, Micah; Johnson, Austin L.; Vassar, MattPurpose: Research during medical training is widely considered to be an integral component of residency and fellowship match success, with many residency programs encouraging residents to engage in scholastic activities, such as serving as authors on peer-reviewed publications. However, the degree to which these scholarly practices continue beyond residency is unknown. Here, we investigate publication trends among graduates of anesthesiology residency programs as part of a larger initiative to examine publication trends and academic achievement across medical specialties.Publication Publication and research trends among neurological residents(Oklahoma State University Center for Health Services, 2020-02-28) Wright, Bryan; Claassen, Analise; Faulkner, Jantzen; Fladie, Ian; Johnson, Austin L.; Vassar, MattResearch is a critical aspect of residency training, but many programs lack a robust research component in their curriculum. Research publications are one way that physicians can advance their career in academic medicine, and the number of publications is often used as a criterion for determining suitable fellowship applicants. In this study, we evaluate the relationship between publications during and after residency in the field of neurology as well as analyze the relationship between number of publications and characteristics such as gender and career path. We randomly selected 50 ACGME Neurology residency programs from across the United States and recorded the number of publications, h-index, gender, fellowship choice, and career path for each graduate between 2013-2015. Each publication was sorted into time frames before residency, during residency, and after residency. The study included a total of 379 neurology residents from 25 different residency programs. Residents who pursued academic medicine had a significantly higher mean total publications (M = 10.1, SD 16.4) than those who pursued private practice (M = 4.2, SD 9.0) (t377 =-4.5, p <0.000). The mean total publications for male residents (M = 8.6, SD 16.5) was significantly higher than female residents (M = 4.1, SD 5.6) (t377 =-3.6, p <0.0002). Pearson correlation also revealed a correlation between publications during residency and publications after residency, with a Pearson product moment correlation of 0.61. The positive correlation between number of publications during residency and publications after residency, demonstrates the importance of implementing strong research principles and practice in a residency's curriculum. We also report a higher number of mean total publications by those who pursued academic medicine than those who pursued private practice. In addition, the results show an underrepresentation of females in neurology research, indicating a need to encourage more females to engage in neurology research and possibly STEM fields in general at an earlier stage in their educational career.Publication Chronic appendicular abscess presenting as a complex adnexal mass: A case report(Oklahoma State University Center for Health Services, 2020-02-28) Wright, Micah R.; Abernathy, Kent; Street, Darren; Frye, Lance; Po, WilliamBackground: The authors present an unusual presentation of a chronic appendicular abscess. A 57-year-old presented to the emergency department with acute on chronic abdominal pain, worsening abdominal distention and decreased appetite. Abdominal imaging revealed the presence of a multi-septated cystic right adnexal mass concerning for metastatic ovarian carcinoma. Intra-operatively the diagnosis of a likely chronic ruptured appendix at the base of the colon was confirmed. In postmenopausal women the majority of adnexal masses are benign neoplasms, however, the risk of malignancy is much greater than in premenopausal women. Postmenopausal women with clinical symptoms and findings on diagnostic imaging suggestive of malignancy warrant expedited management. While imaging and biomarkers help to give insight into origin of masses and can aid in determining treatment, diagnostic operations may be ultimately required to achieve final diagnosis and direct further management.Publication Can self-efficacy predict first year medical students' academic success?(Oklahoma State University Center for Health Services, 2020-02-28) Volberding, Jennifer L.; Madrak, Emily; Baker, Jana N.Background: Self-efficacy (SE), the ability for an individual to believe in their own capabilities, has been connected to an individual's ability to succeed, deal with resistance and failures, and cope with challenges, all skills that are essential for competent physicians. SE has been found to have a positive impact on college student academic performance, but has not been evaluated in medical students. The purpose of this study was to measure first year medical students' SE and to determine what characteristics impacted their academic success in their first semester of medical school.Publication Muskogee Opiate Response Coalition(Oklahoma State University Center for Health Services, 2020-02-28) Burkeen, Jennifer; McCance, Dallas; Croff, JuliePublication Probiotic protocol: Prevention of hospital acquired Clostridium difficile associated diarrhea(Oklahoma State University Center for Health Services, 2020-02-28) Vardeman, D.; Garibay, Meagan; McFarland, N.; Flournoy, P.; Greuel, K.; Bernard, M.Publication Impact of social defeat on NF-KB p-65 activation in liver: A study in C57BL/6J male mice(Oklahoma State University Center for Health Services, 2020-02-28) Vaithianathan, Nadesh; McCracken, K.; Daniel, B.; Davis, R.An increase in mood and anxiety disorders causes a demand to invent new medications and treatment strategies to reduce neuroinflammation in the brain and liver. The drug of interest, B-funaltrexamine (B-FNA) has shown to reduce jauntiness behavior in mice from a previous experiment. We currently are determining if Social Stress increases when a different strain or the same strain of mouse is introduced into the community of mice. This project, Repeated Social Defeat (RSD) has 2 test groups, Single Bout of Social Defeat and RSD to analyze different stress levels through NF-kB p65 Activation levels. This activation level was determined by using Western Blot Analysis. The Results of this experiment showed that the community of mice had increased stress levels regardless of the strain of mice. This experiment will be a footstep for the upcoming implementation of B-FNA as a therapeutic drug.Publication Posterolateral hip muscle strengthening in decreasing symptoms of patellofemoral pain syndrome: A critically appraised topic(Oklahoma State University Center for Health Services, 2020-02-28) Van Boskerck, Kristi; Dopson, Daniel; Warren, AricContext: Patellofemoral pain (PFP) is an idiopathic condition characterized by aching pain in the peripatellar area, which is exacerbated by physical activities, such as climbing stairs, squatting, jumping, running, and prolonged sitting. PFP can often be managed by corrective exercise treatment that emphasizes strengthening of thigh and hip musculature, correction of malalignment of the lower extremity, and improvement of patellar incongruence. Evidence is inconclusive whether strengthening of the thigh or hip musculature is more beneficial in the treatment of PFP.Publication Cloning, sequencing, and identification of Phage 16, an unknown salmonella or EHEC (enterohemorrhagic E. coli) bacteriophage(Oklahoma State University Center for Health Services, 2020-02-28) Tyagi, Shrea; Nambiar, Nayna; Reddig, B. J.; Litt, P.; Jaroni, D.; Blewett, E. L.Bacteriophage are viruses that infect, replicate and kill bacteria. Salmonella and EHEC food poisoning are caused by Salmonella and E. coli bacteria. Bacteriophage can be used to prevent food poisoning by application to food products or processing machinery. Bacteriophage P16 specifically infects Salmonella and E. coli bacteria. We cloned fragments of the P16 genome, sequence the DNA and used bioinformatics to identify P16. Phage P16 is a Salmonella phage similar to Stitch. A phylogenetic tree inferring relationships of P16 and other bacteriophage was created.Publication Isolation of halophilic bacterium from Makai Deep Pure Sea Salt(Oklahoma State University Center for Health Services, 2020-02-28) Truitt, Chelsea; Deole, RatnakarPublication "Michael Douglas" effect(Oklahoma State University Center for Health Services, 2020-02-28) Torgerson, Trevor; Johnson, Austin L.; Cooper, Craig; Khojasteh, Jam; Hamilton, Tom; Vassar, MattBackground: In June 2013, celebrity actor Michael Douglas announced that he had received a diagnosis of throat cancer, which he attributed to the human papillomavirus (HPV). HPV is the most common sexually transmitted disease, however the HPV vaccination rates are lower than other vaccines. Given the health disclosure of Michael Douglas's cancer, we queried whether this event had an effect on public awareness for HPV-related head and neck cancers (HNCs) or its prevention.Publication Anavip interaction with western pygmy rattlesnake venom: In vitro assessment of reactivity using SE-HPLC(Oklahoma State University Center for Health Services, 2020-02-28) Tanner, D. A.; Shults, C. A.; Sanny, C. G.Background: Every year there are a large number of venomous snake bites that occur around the world and especially in tropical areas. This is a problem that is faced worldwide with the World Health Organization classifying venomous snake bites as one of their highest priority neglected tropical diseases. One of the reasons for this classification is the short supply of antivenom compared to the number of snake envenomations that occurs each year. The standard of care for snake envenomation is administration of antivenom. Many antivenoms are polyvalent in that they are produced using venoms from multiple species of snakes. These polyvalent antivenoms can treat envenomation from the snake venoms that are used in the production, but also show cross-reactivity against snake venoms that share similar components. Determining the cross reactivities of antivenoms could help improve the quality of treatment, and provide a better understanding of venom-antivenom binding. Until recently there has only been one antivenom available for treatment of North American Crotaline envenomation. With the introduction of an F(ab')2 antivenom (Anavip) into the United States, we look at the cross-reactivity of the western pygmy rattlesnake, Sistrurus miliarius streckeri, against Anavip.Publication Massive transfusion protocol optimization(Oklahoma State University Center for Health Services, 2020-02-28) Smith, M.; Briggs, J.; Coker, R.; Blankenship, D.; Schiesel, M.; Cannon, M.; Murray, K.; Pritchett, J.Hemorrhage is the leading cause of mortality in trauma, accounting for up to 80% of intraoperative trauma mortalities and nearly half of the deaths that occur within 24 hours of traumatic injury. The timely and appropriate administration of blood products in hemorrhage control is paramount to adequate resuscitation efforts. Given the need for rapid delivery of products, appropriate product infusion ratios, and adjunctive therapies for control of hemorrhage and anticoagulation reversal, it is essential that facilities have and maintain a Massive Transfusion Protocol. The goal of this project was to create a Massive Transfusion Protocol for our facility that incorporated current literature, involved buy-in from all involved departments, and optimized blood product ordering and delivery in the emergency setting. To this end, a literature search was performed, and a protocol was drafted which focused on single entry point ordering, and automated product delivery until massive transfusion was halted. Elective orders were also incorporated for easy requesting of coagulation reversal agents and pro-clotting factors. The final draft of the protocol was submitted to the hospital transfusion committee for approval and then incorporated into an EHR order set. Staff training was performed in all involved departments before deployment. Outcome measurement is ongoing but it is anticipated that this updated protocol will decrease time between disposition of major bleed and arrival of blood products at the bedside. It is also expected that this protocol will decrease the amount of crystalloid products given to major bleeding patients by increasing efficiency of blood product delivery.Publication Assessment of transparent and reproducible research practices in the psychiatry literature(Oklahoma State University Center for Health Services, 2020-02-28) Sherry, Caroline E.; Pollard, Jonathan Z.; Tritz, Daniel; Carr, Branden K.; Pierce, Aaron; Vassar, MattObjective: Reproducibility is a cornerstone of scientific advancement; however, many published works may lack the core components needed for study reproducibility. In this study, we evaluate the state of transparency and reproducibility in the field of Psychiatry using specific indicators as proxies for these practices.Publication Gratitude in medical students and other markers of well-being(Oklahoma State University Center for Health Services, 2020-02-28) Stevens, Vivian M.; Ford, Alicia; Keener, Ashley; Hall, SarahPublication Inappropriate prophylactic use of antibiotics in gynecologic surgeries in an inner city hospital(Oklahoma State University Center for Health Services, 2020-02-28) Boyd, Jacquelyn; Kniech, KristinAs antibiotic resistance is an increasing healthcare issue, promotion of antibiotic stewardship within hospitals has led to research into their proper use. The American College of Obstetricians and Gynecologists (ACOG) has specific recommendations for antimicrobial prophylaxis prior to gynecologic procedures. We hypothesized that patients in an inner-city hospital in Oklahoma City, Oklahoma undergoing gynecologic procedures were receiving prophylactic antibiotics that were not necessarily indicated for their surgery. A retrospective chart review was performed from July, 2017 to June, 2018. 314 surgeries were performed in this time and 169 cases met inclusion criteria as gynecologic procedures with no indication for antimicrobial prophylaxis. Of the 169 included cases, 98 (57.99%) revealed antibiotics were inappropriately given, which was statistically significant (p <0.5). The most common procedure in which misuse was noted were laparoscopic procedures without entry into the bowel or vagina, composing 61.2% of cases. Cefazolin was the most frequently used and was given in 84.7% of the cases. These results reflect the overuse of antibiotics for surgical prophylaxis, which contributes to increasing antibiotic resistance in women undergoing elective gynecologic procedures. Overall, this is hindering the progressive movement towards promotion of antibiotic stewardship. We hope that these study results will limit the misuse of antibiotics in a hospital setting, and specifically in surgical specialties.