Emily Houston, PhD candidate in CTS obtains new grant funding

Congratulations to Emily Houston, PhD Candidate in CTS, on receiving notice of funding from Neurocrine Biosciences! Emily will serve as PI of the $128,000 grant for her project, Evaluating a Telemedicine Neurological Consult Program for Drug-Induced Movement Disorders (DIMD) using the RE-AIM Framework. James Boyd, MD from Neurology is serving as Emily’s research mentor and Amanda Kennedy, Pharm. D. is her CTS academic advisor.  Congratulations Emily. Well deserved!

New article by Maria Ramos-Nino

Our colleague, Maria E. Ramos-Nino, PhD from the Department of Microbiology, Immunology and Pharmacology at St. George's University, Grenada and the Department of Pathology and Laboratory Medicine at UVM, just published another study from the Vermont Diabetes Information System.

Ramos-Nino ME, MacLean CD, Littenberg B. Association between Obstructive Lung Disease and Cardiovascular Disease: Results from the Vermont Diabetes Information System. Journal of Respiration. 2021; 1(3):165-172. https://doi.org/10.3390/jor1030016

The association between obstructive lung disease and cardiovascular disease (CVD) has been suggested previously, but few studies have looked at this association in a diabetic cohort, a population highly susceptible to both comorbidities. A total of 1003 subjects in community practice settings were interviewed at home at the time of enrolment into the Vermont Diabetes Information System, a clinical decision support program. Patients self-reported their personal and clinical characteristics, including any obstructive lung disease. Laboratory data were obtained directly from the clinical laboratory. We performed a cross-sectional analysis of the interviewed subjects to assess a possible association between obstructive lung disease and CVD. In a multivariate logistic regression model, obstructive lung disease was significantly associated with CVD, even after correcting for potential confounders, including gender, obesity, low income, cigarette smoking, alcohol problems, and high comorbidity (odds ratio = 1.96; 95% confidence interval 1.37–2.81; p < 0.01). All components of CVD, including coronary artery disease (CAD), congestive heart failure (CHF), peripheral vascular disease (PVD), and cerebrovascular accidents (CVA), were also significantly associated with obstructive lung disease. These data suggest an association between obstructive lung disease and CVD in patients with diabetes. Future studies are needed to identify the mechanism supporting this association.

 

Clinical Research Oriented Workshop (CROW) Meeting: June 17, 2021

 

Present:   Claudia Abbiati, Justine Dee, Juvena Hitt, Ben Littenberg, Liliane Savard, Adam Sprouse-Blum, Connie van Eeghen (7)

 1.                   Warm Up: all here…

2.                   Claudia’s research question about motor anomalies for people with autism:

a.       Overview of RQ

b.       Challenges

                                                   i.      Many variables: finger, larynx, lips

c.       Strengths

                                                   i.      Clearly stated question: pair wise testing

1.       Omnibus test: a test that looks for many outcomes at the same time with a p value that indicates if something, rather than a particular thing, is the variable that matters.  ANOVA is one of those tests: the F statistic and p value tell you that one group was different from the others. Test with p = .05 and a relatively small sample size

2.       Handy if there’s a big p value: you’re done

3.       Troublesome if there’s a small p value: what to do next?

d.       Options

                                                   i.      Create three hypotheses and test each independently, e.g. finger vs. larynx; larynx vs. lips; lips vs. finger

1.       Power for less than .05 to correct for multiple comparisons

a.       .05/3 = .0167

b.       Will need more subjects

e.       Study plan:

                                                   i.      40 subjects, 20 in each arm

                                                 ii.      Re-evaluate the power depending on effect size and variance or SD

f.        Interaction of variables leads to even more complexity in testing for outcomes

                                                   i.      This may not be a hypothesis test question; it may be a descriptive question

                                                 ii.      Based on prior literature, theory of mechanisms, the one hypothesis is… e.g. maximization of vocalization, with a list of secondary hypotheses

                                               iii.      OK to say that the final hypothesis is not determined and that preliminary work (a PILOT) will set that stage

g.       Manage the portfolio of ideas: do what is essential for the academic program, as well as what is essential for funded work.

3.                   Next week:  Jen will let us know; include Claudia

 

Congratulations to Levi Bonnell, MPH, CTS Doctoral Candidate. He led a team of investigators using data from Integrating Behavioral Health in Primary Care to assess the impact of housing, food and financial insecurities on functional capacity. The abstract is now on the web site of the Journal of the American Board of Family Medicine; the full article is slated for release on July 15. 

The Relationship Between Social Determinants of Health and Functional Capacity in Adult Primary Care Patients With Multiple Chronic Conditions

Levi N. Bonnell; Abigail M. Crocker; Kathleen Kemp; Benjamin Littenberg​ 

Purpose: Social determinants of health (SDH) including insecure access to food, housing, and financial resources are critical threats to overall health. We sought to examine this relationship among adult primary care patients with multiple chronic conditions. Methods:  We obtained cross-sectional data on 2,763 adults with chronic medical (heart disease, diabetes, lung disease, or arthritis) and behavioral (mood disorder, insomnia, substance abuse, chronic pain, or irritable bowel syndrome) conditions or greater than two chronic medical conditions from a survey of participants in Integrating Behavioral Health and Primary Care, a multi-center randomized trial. Results: The prevalence of one or more insecurities was reported in 29% of participants, including food (13%), housing (3%), or financial (25%). Functional capacity ranged from 2.74 to 9.89 METs (median 6.05). The distribution of functional capacity was significantly lower for those with any one or more SDH than for those without (-0.88 METs (95% Confidence Interval (CI) -1.04, -0.72; P<0.001). After adjusting for age, marital status, income, and neighborhood social deprivation, the presence of one or more SDH resulted in a reduction of -0.77 METs (95% CI: -0.94, -0.61). Further, each insecurity independently affected the functional capacity in multivariable analysis (Food: -0.61 METs (95% CI: -0.82, -0.39), Housing: -0.58 METs (95% CI: -0.96, -0.20), Financial insecurity: -0.74 METs (95% CI: -0.91, -0.57), (all P<0.005)). Conclusions: Among primary care patients with chronic conditions, SDH are associated with poorer functional capacity, independent of other social and demographic factors. Primary Care offers a promising, if underused, opportunity to intervene in SDH. There is a need for future studies to explore the role of screening and intervention by primary care providers to mitigate or prevent SDH. 

https://www.jabfm.org/content/relationship-between-social-determinants-health-and-functional-capacity-adult-primary-care

 

 

Update your Biosketch by 1/25/22!

NIH updated the Biosketch and Other Support Page formats.

See here: https://grants.nih.gov/grants/guide/notice-files/NOT-OD-21-073.html

The key difference for the Biosketch is "Section D Research Support" has been removed, but you can still discuss ongoing and completed research in Section A.

The new formats are already in affect, but grants are not at risk for for being withdrawn due to non-compliance until 1/25/22.

Also...NCBI has a tool to format your Biosketch called SciENcv here: https://www.ncbi.nlm.nih.gov/sciencv/

Congrats to CTS student, Dr. Adrianzen-Herrera

 Diego Adrianzen-Herrera, M.D., assistant professor in the Division of Hematology/Oncology, has received a grant from Northern New England Clinical Oncology Society. Titled “Identifying factors associated with cardiovascular disease in MDS. An analysis of the Seer-Medicare database,” the research seeks to determine the sociodemographic and patient-specific clinical risk factors associated with increased risk of CVD and cardiovascular mortality in patients with myelodysplastic syndromes.

Clinical Research Oriented Workshop (CROW) Meeting: June 3, 2021

 

Present:   Levi Bonnell, Justine Dee, Nancy Gell, Ben Littenberg, Charlie MacLean, Jen Oshita, Liliane Savard, Adam Sprouse-Blum, Connie van Eeghen (9)

1.                   Warm Up: (the recorder was late…)

2.                   Adam’s Biosketch for his K award:

a.       The goal is to present oneself as the researcher who has already done this kind of work and is sure to deliver

b.       Biosketches are revised with each submission

c.       Department of Medicine has a great resource in Gretchen Argraves

d.       Personal Statement

                                                   i.      First person singular is correct

                                                 ii.      Sales message: the K award is an investment to create a long term researcher with ongoing returns to the field of knowledge and the benefits to patients/society. Communicate the “I” in FINER – what is the life-long passion about?  Have made many efforts in this direction and need the award to take the next step to complete this preparation process.  Make it a story arch that ends in the elevator speech.

                                               iii.      Rephrase weaknesses to gaps and be consistent; indicate what is needed to become an R01 ready scientist

                                               iv.      Center on the dissertation as part of the story; it’s not a side issue.  How does what the dissertation study is focusing on fit into the long term trajectory of the plan, with the skills that it brings. “The PhD program taught me these skills which resulted in these accomplishments….  And I will build on them by…”

e.       Contributions to Science section:

                                                   i.      Should tell the story that supports the I in FINER

                                                 ii.      Good to present as a progression that connects across the story arch

                                               iii.      Some of the contributions can be in terms of collaborations with other peers to help their work and to learn about science

                                               iv.      Group by “treatment” and “etiology” – rebinning works

                                                 v.      Remember to include in the proposal, the plan to move from novice to mastery, leveraging the LCOM resources

f.        Sharing the document with line numbers is great for CROW; remember to remove for submission

3.                   Next week:  Jen may take the slot or will prompt for other volunteers