Senior Scientific Session Abstract Book - Pritzker School of Medicine

67 th Annual 

Senior Scientific Session 

Abstract Book 

d 

May 16, 2013

67 th Annual 

Senior Scientific Session 

Abstract Book 

Thursday, May 16, 2013 

1 PM - 6:30 PM 

Biological Sciences Learning Center 

Room 115 & Lobby 

John Alverdy, MD 

Department of Surgery 

2013 Session Chair 

Vineet Arora, MD, MAPP 

Assistant Dean for Scholarship & Discovery 

Associate Professor of Medicine 

d 

2013 Presentation Judges 

Kristen Knutson, PhD 

Department of Medicine 

Arshiya Baig, MD, MPH 


Matthew Brady, PhD 


Marshall Chin, MD, MPH 


Ronald Cohen, MD 


Andrew Davis, MD, MPH 


Harriet deWit, PhD 

Department of Psychiatry & Behavioral Neuroscience 

Peggy Mason, PhD 

Department of Neurobiology 

Mark Musch, PhD 


Funmi Olopade, MD 


Sola Olopade, MD, MPH 

Department of Family Medicine 

Tipu Puri, MD, PhD 


Lainie Ross, MD, PhD 

Department of Pediatrics 

Elbert Huang, MD, MPH 


Scott Hunter, PhD 

Department of Psychiatry & Behavioral Neuroscience 

Department of Pediatrics 

Stephen Small, MD 

Department of Anesthesia & Critical Care 

1

1 PM Holly J. Humphrey, MD 

Dean for Medical Education 

Welcome & Opening Remarks 

Biological Sciences Learning Center Room 115 


Assistant Dean for Scholarship & Discovery 

Associate Professor of Medicine 

Oral Presentations 

Abstracts Located on Pages 13-22 

1:15 PM Nikita Alexiades: Maciej Lesniak, MD, MHCM 

Evaluation of VEGFR2 Signaling and MMP14 Activity in Human Neural Stem 

Cell Glioma Tropism 

1:30 PM Kiran Kumar: Ralph Weichselbaum, MD 

Cytosolic DNA Sensors Regulate IR Induced Interferon Killing of Tumor Cells 

1:45 PM Marcia Faustin: Dana Suskind, MD 

A Randomized Controlled Pilot of a Novel Parent-Directed Language Intervention in Children of Low 

SES: The Thirty Million Words Project 

2:00 PM Gabrielle Schaefer: Vineet Arora, MD, MAPP 

Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: 

Medical Urban Legend? 

2:15 PM Rachel Stork: Jeffrey Frank, MD 

Simulation: A Novel Modality for Improving Physician Knowledge and Confidence with 

Recombinant Tissue-Type Plasminogen Activator for Acute Ischemic Stroke 

2:30 PM BREAK 

2:45 PM Benjamin Ferguson, PhD: Ravi Salgia, MD, PhD 

The EphB4 Receptor Tyrosine Kinase Promotes Lung Cancer Growth: 

A Potential Novel Therapeutic Target 

3:00 PM William Zeiger, PhD: Gopal Thinakaran, PhD 

Ca2+ Influx through Store-Operated Calcium Channels Reduces Alzheimer’s 

Disease Aβ Secretion 

3:15 PM Kelly Ledbetter: David H. Song, MD, MBA 

Thoracodorsal Artery Perforator and Muscle Sparing Latissimus Dorsi Flaps in Breast Reconstruction 

after Radiation Therapy 

3:30 PM Tarak Trivedi: Benjamin Lopman, PhD 

Hospitalizations and Mortality Associated with Norovirus Outbreaks in Nursing Homes, 2009-2010 

3:45 PM Joyce Woo: David Glick, MD 

Competition and Quality in Procedural Health Care 

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Poster Presentations 

Biological Sciences Learning Center Lobby 

Abstracts Located on Pages 25-53 

4:15 PM 

Rajiv Agarwal 

Brittany Betham 

Clifton Brock 

Valerie Chen 

Tharian Cherian 

Kevin Choo 

Michael Combs 

Amanda Gawin 

Elizabeth Greenstein 

Atul Kapila 

Yelena Koldobskaya, PhD 

Samuel Lee 

Patrick Mann 

Rebecca Miller 

Shamsideen Musa, MS 

Michael Putman 

Katie Raffel 

Paul Riordan 

Jasmine Swaniker 

Sarah Todd, MAT 

Anne Toledo 

Joseph Triggs, PhD 

William Uffmann 

Joshua Williams 

Wenlu Xiong 

Babatunde Yerokun 

Jordan Yoder 

Matthew Zegarek 

Presentation Judging 

5:45 PM 

ORAL 

Catherine Dobson Prize 

For the best oral presentation given by a student in the area of scientific investigation 

in clinical or social sciences 

Leon O. Jacobson Basic Science Prize (MD/PhD students) 

Granted to the MD/PhD student whose basic science research is judged to be the most 

meritorious from among session participants 

Leon O. Jacobson Prize (non-PhD students) 

For the best oral presentation given by a non-PhD student in the area of the basic biological sciences 

Medical and Biological Sciences Alumni Association Prize 

For the best presentation made by a student in the area of Applied Scholarship (Global Health, 

Community Health, Medical Education or Quality & Safety) 

POSTER 

Award for Best Poster Describing Applied Scholarship 

Award for Best Poster Describing Basic Scientific Investigation 

Award for Best Poster Describing Scientific Investigation in Clinical or Social Sciences 

ORAL OR POSTER 

Franklin McLean Medical Student Research Award 

Granted to the non-PhD student who has performed the most meritorious research 

in the medical field 

6:15 PM Vineet Arora, MD, MAPP 

Closing Remarks & Award Presentations 

2013 Senior Scientific Session Organized by Pritzker School of Medicine Faculty and Staff: 

Vineet Arora, MD, MAPP, Assistant Dean for Scholarship and Discovery, Associate Professor of Medicine 

Kate Blythe, Director of Student Programs 

Candi Gard, Student Programs Administrator 

Jo Beaudreau, Student Programs Administrator 

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Numbers are Associated with Abstract Page Number. Abstracts are in Order of Presentations. 

13……...Nikita Alexiades: Maciej Lesniak, MD, MHCM 

Evaluation of VEGFR2 Signaling and MMP14 Activity in Human Neural Stem 

Cell Glioma Tropism 

14.……..Kiran Kumar: Ralph Weichselbaum, MD 

Cytosolic DNA Sensors Regulate IR Induced Interferon Killing of Tumor Cells 

15……..Marcia Faustin: Dana Suskind, MD 

A Randomized Controlled Pilot of a Novel Parent-Directed Language Intervention in Children of Low 

SES: The Thirty Million Words Project 

16……..Gabrielle Schaefer: Vineet Arora, MD, MAPP 

Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: 

Medical Urban Legend? 

17……..Rachel Stork: Jeffrey Frank, MD 

Simulation: A Novel Modality for Improving Physician Knowledge and Confidence with 

Recombinant Tissue-Type Plasminogen Activator for Acute Ischemic Stroke 

18……...Benjamin Ferguson, PhD: Ravi Salgia, MD, PhD 

The EphB4 Receptor Tyrosine Kinase Promotes Lung Cancer Growth: A Potential Novel Therapeutic Target 

19….…..William Zeiger, PhD: Gopal Thinakaran, PhD 

Ca2+ Influx through Store-Operated Calcium Channels Reduces Alzheimer’s 

Disease Aβ Secretion 

20…….. Kelly Ledbetter: David H. Song, MD, MBA 

Thoracodorsal Artery Perforator and Muscle Sparing Latissimus Dorsi Flaps in Breast Reconstruction 

after Radiation Therapy 

21….….Tarak Trivedi: Benjamin Lopman, PhD 

Hospitalizations and Mortality Associated with Norovirus Outbreaks in Nursing Homes, 2009-2010 

22……...Joyce Woo: David Glick, MD 


4 Oral Presentation Abstracts

APPLIED SCHOLARSHIP 


Numbers are Associated with both Abstract Page Number & Poster Number 

25……..Kevin Choo: Jeanne M. Farnan, MD, MHPE 

How Do Supervising Physicians Decide to Entrust Residents with Unsupervised Tasks? 

26……..Amanda Gawin: Deborah Burnet, MD, MA 

Development of Text Message Intervention to Engage Parents in Youth After-School Nutrition and 

Exercise Program 

27……..Elizabeth Greenstein: Jeanne M. Farnan, MD, MHPE 

Interruptions During Resident Handoffs on Labor and Delivery: A Mixed-Methods Multi-Site Study 

28……..Patrick Mann: Aliya Husain, MD 

Updating the Virtual Pathology of Clinical Pathophysiology and Therapeutics 

29……..Rebecca Miller: Debra Stulberg, MD, MA 

Sex(Ed) is Fun: Design, Implementation and Analysis of a Sexual Education Curriculum 

for Middle School Students 

30……..Katie Raffel: Monica Peek, MD 

Food Rx: Integrating Clinic and Community Resources to Improve Dietary Management of Diabetes 

29……..Sarah Todd, MAT: Debra Stulberg, MD, MA 

Sex(Ed) is Fun: Design, Implementation and Analysis of a Sexual Education Curriculum 

for Middle School Students 

31……..Anne Toledo: Brian Callender, MD 

Attitudes of Chilean Primary Care Providers Toward Chilean Public Primary Care 

32……..William Uffmann: Christopher Straus, MD 

Streamlining the Medical Imaging Anatomy Curriculum: Introducing Image Interpretation 

with ‘Core’ Images and Narrated Screencasts 

33……..Wenlu Xiong: Aisha Sethi, MD 

Global Health Experiences and Their Influence on Medical Specialty Choice and Career Path 

34……..Matthew Zegarek: Shalini Reddy, MD 

Can I Get Some Feedback?: Student Descriptions of Facilitators and Barriers to Formative Feedback 

BASIC SCIENTIFIC INVESTIGATION 

36……..Clifton Brock: Suzanne Conzen, MD 

Glucocorticoid Mediated Gene Expression is Associated with Decreased Insulin Sensitivity 

in Human Sub-Cutaneous Abdominal Fat 

37……..Tharian Cherian:Timothy Niewold, MD 

IRF5 Systemic Lupus Erythematosus Risk Haplotype is Associated with Serologic Autoimmunity and 

Progression to Clinical Autoimmunity in Mothers of Children with Neonatal Lupus 

38……..Yelena Koldobskaya, PhD: Joseph A. Piccirilli, MS, PhD 

A Portable RNA Sequence Whose Recognition by a Synthetic Antibody Facilitates Structural 

Determination 

Poster Presentation Abstracts 

5

39……..Samuel Lee: Edwin Munro, PhD 

Dynamic Interactions Among CDC42, PAR-6/PKC-3 and LGL Can Maintain Cell Polarity in Early 

Embryos of the Nematode Worm C. elegans 

40……..Shamsideen Musa, MS: Rick Kittles, PhD 

Uncovering the Mechanism of Vitamin D and NSAID Combination Therapy in Prostate Cancer 

41……..Joseph Triggs, PhD: Harinder Singh, PhD 

The Genomic Interplay of Key Lineage Determinants During B Cell Fate Determination 

42……..Joshua Williams: Stephen Meredith, MD, PhD 

Chaotic Aggregation of Truncated Amyloid Beta Peptides 

43……..Babatunde Yerokun: Elizabeth McNally, MD 

Abcc9 is Required for the Transition to Oxidative Metabolism in the Newborn Heart 

SCIENTIFIC INVESTIGATION IN CLINICAL OR SOCIAL SCIENCES 

45……..Rajiv Agarwal: Hongtao Liu, MD, PhD 

Predicting Allogeneic Stem Cell Transplant Outcomes in Patients with High Risk AML & MDS: 

A Retrospective Analysis of Pre-Transplantation Variables 

46……..Brittany Betham: Melissa Gilliam, MD, MPH 

Impact of a Revised Appointment Scheduling Script on IUD Service Delivery in 

Three Title X Family Planning Clinics 

47……..Valerie Chen: H.Barrett Fromme, MD, MHPE & Susan Ksiazek, MD 

Comparison of Illuminated Dilated Pinhole, Laser Inferometer, and Potential Acuity Meter in Predicting 

Postoperative Visual Acuity after Cataract Surgery 

48……..Michael Combs: Farr A. Curlin, MD 

Substituted Judgment in Principle and Practice: A National Physician Survey 

49……..Atul Kapila: Sangeeta Bhorade, MD 

Inter‐Observer Variability Regarding the Diagnosis of Bronchiolitis Obliterans Syndrome 

50……..Michael Putman: Farr A. Curlin, MD 

Intentional Sedation to Unconsciousness at the End of Life: Findings From a National Physician Survey 

51……..Paul Riordan: Gregory Ruhnke, MD, MS, MPH 

The Impact of Adverse Economic Conditions on Healthcare Demand 

52……..Jasmine Swaniker: David Glick, MD 

Infection Control for Anesthesia Providers: A Literature Review and Research Proposal 

53……..Jordan Yoder: Vineet Arora, MD, MAPP 

Are All Vital Signs “Vital”? A Prospective Study of Nighttime Vital Sign Frequency and 

Risk of Clinical Deterioration 

6 Poster Presentation Abstracts

Presentation Notes

LEON ORRIS JACOBSON 

December 16, 1911 – September 20, 1992 

The annual Senior Scientific Session was founded by Dr. Leon Jacobson in 1946 to showcase the caliber of Pritzker 

graduates and the quality of their education. The Session provides fourth-year students with the opportunity to 

showcase their research through oral and poster presentations. 

As a young resident at the University of Chicago hospital in 1942, Dr. Jacobson was summoned from a patient’s bedside 

and told he was being put in charge of protecting the health of the staff of the secret Manhattan Project. He was 

later credited with laying the groundwork for bone marrow transplantation and initiating the search for the hormone 

erythropoietin, which regulates red blood cell production in mammals. Erythropoietin is now the basis for a drug that 

treats chemotherapy-induced anemia in some cancer patients. 

He was chosen because he had done research on the biological effects of radiation, and was one of the first doctors to 

treat blood disorders with radioactive phosphorus. By the conclusion of the project in 1945 Dr. Jacobson and his staff 

had produced several medical advances, including testing the first forms of chemotherapy to fight cancer. 

Professor Jacobson, a native of Sims, North Dakota, received a Bachelor of Science degree from North Dakota State 

University in 1935 and his medical degree from the University of Chicago in 1939. 

He was an authority on the study and clinical use of radiation in medicine and on diseases of the blood. His professional 

career, spent entirely at the University of Chicago, included serving as director of the Argonne Cancer Research Hospital 

and as dean of the division of biological sciences. 

Dr. Leon Jacobson passed in 1992. His first wife, Elizabeth L. Benton, died in 1983. Dr. Jacobson, who lived in Chicago, 

is survived by his second wife, Elise; a son, Eric P. Jacobson; a daughter, Judith A. Boniker, and six grandchildren. 

8 History

2012-2013 Calvin Fentress Fellowship Recipients 

Rajiv Agarwal 

Mentor: Hongtao Liu, MD, PhD 


Mentor: Timothy Niewold, MD 

Michael Combs 

Mentor: Farr A. Curlin, MD 

Kiran Kumar 

Mentor: Ralph Weichselbaum, MD 

Samuel Lee 

Mentor: Edwin Munro, PhD 

Tarak Trivedi 

Mentor: Benjamin Lopman, PhD 


Mentor: Stephen Meredith, MD, PhD 

Joyce Woo 

Mentor: David Glick, MD 

Jordan Yoder 

Mentor: dVineet Arora, MD, MAPP 

2012-2013 John D. Arnold, MD 

Scientific Research Prize Recipients 

Nikita Alexiades 

Mentor: Maciej Lesniak, MD 

Clifton Brock 

Mentor: Suzanne Conzen, MD 


Mentor: David Glick, MD 

Awards 

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2012-2013 JOHN D. ARNOLD, MD 

MENTOR AWARD RECIPIENTS 

In 2012, a grateful alumnus, Dr. Charles Pak, established the John D. Arnold, MD Scientific Research Prize in 

recognition of the impact his mentor had on his education and future research career. The Arnold Scientific Research 

Prize recognizes students whose research accomplishments as medical students are based on ongoing, sustained work 

with a single faculty mentor. The goal of the Arnold Scientific Research Prize is to provide support for the continuation 

of the mentoring relationship and collaborative research during the fourth year of medical school. As part of the 

application, students were asked to comment on the contributions their mentors had made on their professional growth 

and development, and the mentors of the selected students are also honored with the 2012-2013 John D. Arnold, MD 

Mentor Award for sustained excellence in mentoring medical students. 

The inaugural John D. Arnold, MD Mentor Awards are bestowed upon: 

Suzanne Conzen, MD 

Dr. Conzen is an expert in the diagnosis and treatment of breast cancer. She has a special clinical interest in the 

multidisciplinary care of locally advanced breast cancers, which may require chemotherapy and radiation therapy prior 

to surgical resection. Dr. Conzen’s research laboratory uses a combination of molecular biology and large-scale genomic 

techniques to identify new targets for the effective therapy of breast cancer. Her work led to the recognition of a role for 

glucocorticoid receptor signaling in breast cancer biology. 

Dr. Conzen received the John D. Arnold MD Mentor Award for her work with fourth year student Clifton Brock. In 

commenting on Dr. Conzen’s contributions to his professional growth and development, he wrote: 

“With Dr. Conzen’s help, I was able to learn cutting edge techniques in bioinformatics, attend national 

conferences in endocrinology, and acquire my own funding from HHMI. None of this would have 

been possible without her ongoing support. While a medical education obviously requires scientific 

literacy, the vast majority of my skill in generating scientific hypotheses and performing experiments was 

developed in Dr. Conzen’s laboratory. In short, she has provided a foundation for a career as a physicianscientist.” 

Suzanne Conzen, MD 

Professor of Medicine, Section of Hematology-Oncology 

10 Awards

David Glick, MD 

Associate Professor of Anesthesia 

and Critical Care 

David Glick, MD 

Dr. Glick’s academic interests include a focus on anesthesia and the 

autonomic nervous system, intraoperative awareness under anesthesia, 

and structural issues related to the practice of anesthesia, including 

quality metrics in anesthesia and surgery and economic optimization 

of the operating room. Dr. Glick is a devoted teacher, who serves as 

the track leader in the Scientific Investigation – Clinical Sciences track 

for the Scholarship and Discovery curriculum at the Pritzker School of 

Medicine. 

Dr. Glick received the John D. Arnold MD Mentor Award for his work 

with fourth year student Jasmine Swaniker. In commenting on Dr. 

Glick’s sustained excellence as a mentor, she wrote: 

“I wanted to find a mentor with a great deal of research experience as 

well as a reputation for being a great teacher and source of support 

for medical students. In speaking with previous students who’d done 

research with Dr. Glick, I was struck by the overwhelmingly positive 

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experiences they had and knew that working with him would be a great learning experience. I was certainly not 

disappointed….Furthermore, it is due in no small part to the time I’ve spent in his lab that I’ve chosen to pursue 

Anesthesiology as my specialty.” 

Maciej Lesniak, MD 

Dr. Lesniak is director of neurosurgical oncology and neuro-oncology 

research in the University of Chicago Brain Tumor Center. This 

multidisciplinary physician team provides a comprehensive approach 

to brain tumor care, and offers the newest, most innovative therapies. 

The Brain Tumor Center actively participates in clinical trials sponsored 

by the National Institutes of Health (NIH). Dr. Lesniak’s research 

interests include gene therapy, stem cell therapy, immunotherapy and 

nanotechnology. 

Dr. Lesniak received the John D. Arnold, MD Mentor Award for his 

work with fourth year student Nikita Alexiades, who described her 

interactions with Dr. Lesniak over the course of the last few years as 

follows: 

Maciej Lesniak, MD 

Professor of Surgery and Neurology 

“Dr. Lesniak has been an amazing mentor thus far, both in guiding my development as a physician 

scientist and in guiding my path into the field of neurosurgery. He has been and continues to be extremely 

involved in my career development and has opened many doors for me into my desired field. He has been 

an outstanding professional role model, and I am certain that his role in my career will continue well 

beyond my graduation from Pritzker.” 

Awards 

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12 Oral Presentation Abstracts 


In Presentation Order

Evaluation of VEGFR2 Signaling and MMP14 Activity in 

Human Neural Stem Cell Glioma Tropism 


MENTOR: Maciej Lesniak, MD, MHCM, Department of Surgery, Section of Neurological Surgery 

CO-AUTHORS: Atique U. Ahmed, PhD, Alex Tobias, BA, Chung Kwon Kim, PhD 

BACKGROUND: Despite aggressive research efforts the prognosis for patients diagnosed with malignant glioma 

remains dismal. Optimal accepted treatment combining surgical resection, chemotherapy and radiotherapy continues 

to afford a median survival of little over one year. Neural stem cells possessing inherent tumor tropism offer a platform 

for the targeted delivery of diverse therapeutic agents including oncolytic viruses, chemotherapeutic drugs and custom 

built antibodies to diffusely distributed tumor burden. Despite the effectiveness of this approach, NSC migration 

remains consistently incomplete with only 20‐25% of cells migrating to the tumor burden. Numerous signaling 

molecules and membrane bound proteins have been implicated in NSC migration. The identification of such molecules 

and their augmentation may serve to enhance migration and increase clinical efficacy. 

METHODS: Migratory and non migratory subpopulations were isolated using Transwell migration chambers and 

levels of VEGFR2 and Nestin expression were measured using qRTPCR and FACS. Immunofluoresence was employed 

to evaluate VEGFR2 protein expression and localization in both in vitro and in vivo tumor models. A custom built PCR 

array was conducted to identify target molecules unpregulated following NSC exposure to growth factors previously 

shown to enhance migration. Western blots were used to study the VEGFR2 signaling cascade and MMP14 expression 

following dose and time dependent exposure to VEGFA. An shRNA knockdown of MMP14 using a lentiviral vector 

was executed and functional assays of NSC glioma tropism were conducted. 

RESULTS: Migratory NSCs were found to express significantly greater levels of VEGFR2 mRNA (4x, p

Cytosolic DNA Sensors Regulate IR-Induced Interferon Killing of Tumor Cells 

Kiran Kumar 

MENTOR: Ralph Weichselbaum, MD, Department of Radiation and Cellular Oncology 

CO-AUTHORS: Akash Parekh, MS2, Ryan Widau, PhD, Nikolai Khodarev, PhD 

BACKGROUND: Ionizing radiation (IR) induces interferon (IFN) production in tumor cells both in vitro and in 

vivo, which play a role in IR-induced cytotoxicity. This project aims to further understand the connection between 

IR and IFN production. Specifically, we hypothesize that radiation-induced DNA damage is recognized by cytosolic 

sensors of DNA, which signal downstream through proteins like STING to activate the IFN production pathways. 

METHODS: Cell cultures were maintained using standard protocols. IR was delivered using a Phillips orthovoltage 

X-ray generator. IFN-b response was measured using qRT-PCR. shRNA was used to create stable knockdowns of 

STING in SCC61 head and neck cancer cell line (knockdowns verified with Western blots and PCR). Clonogenic 

assays were done to measure cell survival and radio-resistance and –sensitivity. Immunofluorescence (IF) was used with 

HSV as a positive control to visualize STING relocation to Golgi after IR. C57BL/6 mice livers were treated with 20 

Gy IR and one day later, harvested. DNA is then extracted from the cytosolic portion of cells by using the detergent 

Digitonin to lyse the plasma membrane only. 

RESULTS: We irradiated 11 different cancer cell lines in vitro, and measured IFN-b response on Day 3 post-IR. We 

found that the cell lines that expressed the highest levels of STING had the highest fold induction (>50) of IFN-b. 

Knockdown of STING reduced IFN-b induction by 75% (p

A Randomized Controlled Pilot of a Novel Parent-Directed Language Intervention 

in Children of Low SES: The Thirty Million Words Project 

Marcia Faustin 

MENTOR: Dana Suskind, MD, Department of Surgery, Section of Otolaryngology 

CO-AUTHORS: Kristen Leffel, BS, Shannon Sapolich, BA, Elizabeth Suskind, BA 

BACKGROUND: The Thirty Million Words Project (TMW) is a parent‐directed intervention aimed at increasing 

the educational potential of children of low socioeconomic status (SES). A Hart and Risely study demonstrated that 

children of lower SES heard thirty million fewer words than children of greater affluence by age three. Low‐SES 

mothers have consistently been found to talk less, use a smaller vocabulary, be more directive, and ask fewer questions 

of their children than higher SES mothers. Subsequently, these low‐SES children enter school with much smaller 

vocabularies, become weaker readers, and set out on trajectories for lower ultimate educational attainment. However, 

research has found that child‐directed speech is mediated by parental knowledge of child development. Therefore, we 

hypothesize that parental linguistic input can be increased by increasing parental knowledge of child development and 

giving parents quantitative linguistic feedback, measured by adult word count and conversational turn count. 

METHODS: This was a randomized, controlled study trial completed on Chicago’s South side. Twenty‐six families 

completed the study and were randomly assigned to either the treatment or control group. Inclusion criteria included 

parents of children age 18‐36 months with government medical insurance and parent education level at or below a 

college degree. Exclusion criteria included children receiving early intervention or parents unable to commit to the 

length of the study. 

A 30‐item TMW Knowledge Questionnaire was administered pre‐ and post‐intervention to assess parental knowledge 

of a variety of child language development topics. The Language Environment Analysis System (LENA) was used to 

record and analyze the child’s language environment, focusing on: adult word count (AWC) and conversational turn 

counts (CTC). Fourteen LENA recordings were completed over a 24‐week period: three pre‐intervention baseline 

recordings, eight weekly recordings, and three monthly post‐intervention follow up recordings. The Home Visitor 

made home visits for the eight weekly recordings to discuss the parent’s LENA feedback reports and strategies for 

improving their child’s language environment. 

RESULTS: The treatment and control groups were comparable in regards to baseline measurements of mean AWC 

= 711 wordsper‐ hour, SD = 332 and mean CTC = 26 turns‐per‐hour, SD = 14. Post‐intervention, the treatment 

group showed statistically significant changes in all the variables tested. The TMW Knowledge Questionnaire showed a 

significant postintervention increase, p < .05. AWC had a significant increase, mean difference = +146 words‐per‐hour, 

t = 2.64, p

Financial Responsibility of Hospitalized Patients 

Who Left Against Medical Advice: Medical Urban Legend? 

Gabrielle Schaefer 

MENTOR: Vineet Arora, MD, MAPP, Department of Medicine, Section of General Internal Medicine 

CO-AUTHORS: John Schumann, MD, Heidi Matus, MD, Keith Sauter, Ben Vekhter, PhD, 

David Meltzer, MD, PhD 

BACKGROUND: When patients leave against medical advice (AMA) health care providers often tell them that 

insurance will not pay for the care they have received. To clarify whether or not third party payers actually deny 

payment to the hospital in these circumstances we studied the bills of patients who had left against medical advice. In 

addition, we created and educational intervention to address these myths. 

DESCRIPTION OF PROGRAM/INNOVATION: We audited billing records of patients who left AMA at UCMC 

and surveyed attending and resident physicians about their beliefs about whether insurance pays when someone leaves 

AMA. Review of 10 years of billing data showed that none of the patients who left AMA (N=526) were denied 

payment because they left AMA. Despite this 68% of residents and 45% of attendings believed that insurance would 

deny payment if a patient left AMA. Sources of this misconception were the AMA form, as well as rumor and other 

residents. Review of the AMA forms from Chicago hospitals (N=17) showed our hospital was an outlier in including 

this language on the form. 

We developed an educational video for physicians that included a scenario of a patient leaving against medical and 

advice about how to negotiate with patients based on literature review and the findings of our study. We housed this 

video on a website that contained additional information about the subject and links to reference articles. We then used 

social media (Facebook, Twitter) to disseminate our findings. As another part of our QI project, we worked with our 

hospital’s Medical Legal and Risk Management departments to update the language in the AMA form to remove any 

statements about financial responsibility. 

EVALUATION OF PROGRAM/INNOVATION: In an annual survey of internal Medicine attendings at UCMC, 

we examined the effect of education on the degree to which they believed insurance does not pay when a patient leaves 

AMA and how often they inform patients of this. The response rates for the attending physician survey were 56% 

in 2010, 60% in 2011, 54% in 2012. Initially 45% of attendings responded they agreed or strongly agreed with the 

statement “when a patient leaves the hospital against medical advice, insurance companies do not pay for the patient’s 

hospitalization”. In the two years since our intervention, there has been a sustained downward trend in that belief from 

45% to 28% and then 21% (trend test p value = 0.043). Before the intervention, 51% of attendings responded that 

they often or always informed patients that they may be held financially responsible if the leave AMA. In the years since 

that has decreased to 36% and then 33%. 

CONCLUSION: Despite the belief that patients are forced to pay the bill when they leave AMA, we found no 

evidence of this practice. With education, UCMC physicians were less likely to report patients are held financially 

responsible for leaving AMA. We plan to continue our efforts to make sure all our physicians are informed of the truth 

about this issue to prevent them from misinforming patients. 

IRB/IACUC: ExemptTrack: Quality and Safety 

Submitted for: MS4 S&D Work 

Acknowledgements/Disclosures: Grant Funding: AHRQ CERT Grant 1U18HS016967-01 and NIA T35 Grant 5T35AG029795-02. 

Disclosures: David O. Meltzer reports a consultancy position at the Congress and Budget Office and grants from the NIH, RWJ, and 

AHRQ. Vineet Arora reports grants from the NIA, AHRQ, ACGME, and the ABIM Foundation. 


Simulation: A Novel Modality for Improving Physician Knowledge and Confidence 

with Recombinant Tissue-Type Plasminogen Activator for Acute Ischemic Stroke 

Rachel Stork 

MENTOR: Jeffrey Frank, MD, Department of Neurology, Section of Neurocritical Care 

CO-AUTHORS: Morris Kharasch, MD, Ernest Wang, MD, Pam Aitchison, RN, Fernando Goldenberg, MD, 

Cedric McKoy, APN 

BACKGROUND: Intravenous recombinant tissue-type plasminogen activator (Alteplase) is the only FDA approved 

non-invasive medical treatment for restoring brain perfusion in acute ischemic stroke (AIS) patients, however many 

neurology residents will graduate with little or no experience in its use. Alteplase for AIS is underutilized, in part, due 

to lack of physician experience and training. Inappropriate use of Alteplase leads to more frequent, potentially deadly 

complications. Simulation is an ideal educational modality for increasing physician knowledge, skill, and xperience 

with the management of AIS without risk to patients. 

DESCRIPTION OF PROGRAM/INNOVATION: 23 physicians (13 neurology, 10 emergency medicine) were 

interviewed to identify and prioritize learning objectives for AIS management with respect to intravenous rtPA use. 

A comprehensive curriculum consisting of case discussions, a standardized patient encounter, and both high and low 

fidelity simulated patient scenarios were designed around these objectives in the format of a half-day acute stroke 

simulation workshop (ASSW). A pilot workshop was used to refine the curriculum. Entrance and exit surveys were 

administered to measure changes in knowledge, skills, and attitudes. The use of Alteplase for AIS was tracked before 

and after the intervention. 

EVALUATION OF PROGRAM/INNOVATION: To date, 17 neurology and emergency medicine residents have 

completed the workshop. All trainees reported significantly increased confidence in AIS patient selection and management 

with Alteplase, including its potential complications. The percent of AIS patients who received interventions doubled 

after resident participation in simulation, going from 6.75% in the 26 months before the first simulation workshop 

to 13.82% in the 13 months following the third simulation workshop, with no complications or protocol violations. 

CONCLUSION: Medical simulation is an effective educational modality for the training of physicians in management 

of AIS and shows great promise to favorably impact physician practice and AIS patient outcome. 

Track: Medical EducationSubmitted for: MS1 Spring Elective, SRP, MS2 S&D Block, MS4 S&D Work 

Acknowledgements/Disclosures: None. 

Oral Presentation Abstracts 

17

The EphB4 Receptor Tyrosine Kinase Promotes Lung Cancer Growth: 

A Potential Novel Therapeutic Target 

Benjamin Ferguson, PhD 

MENTOR: Ravi Salgia, MD, PhD, Department of Medicine, Section of Hematology/Oncology 

CO-AUTHORS: Ren Liu, PhD, Cleo E. Rolle, PhD, Yi-Hung Carol Tan, PhD, Valery Krasnoperov, PhD, 

Maria S. Tretiakova, MD, PhD, Gustavo M. Cervantes, MD, Robyn D. Hseu, Theodore Karrison, PhD, 

Mark K. Ferguson, MD, Aliya N. Husain, MD, Leonardo Faoro, MD, Parkash S. Gill, MD 

BACKGROUND: Despite progress in locoregional and systemic therapies, patient survival from lung cancer remains 

a challenge. Receptor tyrosine kinases are frequently implicated in lung cancer pathogenesis, and some tyrosine kinase 

inhibition strategies have been effective clinically. The EphB4 receptor tyrosine kinase has recently emerged as a potential 

target in several other cancers. 

METHODS: We sought to systematically study the role of EphB4 in lung cancer through analysis of protein expression 

and gene copy number aberration in tumor tissues; modulation of protein expression and effects on cell viability, 

growth, and motility; and inhibition of protein function in xenograft mouse models. 

RESULTS: We demonstrate that EphB4 is overexpressed 3-fold in lung tumors compared to paired normal tissues and 

frequently exhibits gene copy number increases in lung cancer. We also show that overexpression of EphB4 promotes 

cellular proliferation, colony formation, and motility, while EphB4 inhibition reduces cellular viability in vitro, halts 

the growth of established tumors in mouse xenograft models, and causes near-complete regression of established tumors 

when used in combination with paclitaxel. 

CONCLUSION: Taken together, these data suggest an important role for EphB4 as a potential novel therapeutic 

target in lung cancer. Clinical trials investigating the efficacy of anti-EphB4 therapies as well as combination therapy 

involving EphB4 inhibition may be warranted. 

Acknowledgements/Disclosures: NIH/NICHD T32HD009007 (BDF), NIH/NCI (RS), Janice Lamb McArdle Cancer Research 

Foundation (RS). PSG is the co-founder and director of Vasgene Therapeutics, Inc. VK is an employee of Vasgene Therapeutics, Inc. 


Ca2+ Influx through Store-Operated Calcium Channels 

Reduces Alzheimer’s Disease Aβ Secretion 

William Zeiger, PhD 

MENTOR: Gopal Thinakaran, PhD, Department of Neurobiology 

CO-AUTHORS: Kulandaivelu S. Vetrivel, PhD 

BACKGROUND: Alzheimer’s disease (AD), the leading cause of dementia in the United States, is characterized by the 

accumulation of amyloid beta (Aβ)-containing senile plaques in the brains of affected patients. While Aβ is considered to 

play a central role in the pathogenesis of AD, recent work has implicated other mechanisms as potentially important in 

the development and progression of the disease. Specifically, several lines of evidence point to the dysregulation of Ca2+ 

homeostasis as underlying aspects of AD pathogenesis. These include studies showing alterations in expression of Ca2+ 

handling proteins and Ca2+-dependent enzymes in the brains of affected AD patients. Other work has demonstrated 

direct roles for Aβ peptides and the familial-AD linked genes presenilin 1 (PS1) and amyloid precursor protein (APP) 

in the regulation of Ca2+ homeostasis. While these studies support the hypothesis that disruption of Ca2+ homeostasis 

contributes to AD, it has been difficult to disentangle the effects of FAD-linked genes on Aβ production from their 

effects on Ca2+ homeostasis. 

METHODS: To directly investigate the effects of alterations in Ca2+ homeostasis on APP processing, we developed 

a genetic system in which cellular Ca2+ homeostasis could be directly manipulated. Specifically, we overexpressed 

the molecular components of the store-operated Ca2+ entry (SOCE) pathway, STIM1 and Orai1, in cells expressing 

APP. We then characterized the changes in constitutive and store-depletion induced Ca2+ entry in these cells and 

investigated the effects of these changes on APP processing using metabolic labeling and Aβ ELISA. 

RESULTS: We found that overexpression of STIM1 and Orai1 produced dramatic effects on both store-operated and 

constitutive Ca2+ entry. These changes in Ca2+ homeostasis led to striking alterations in APP processing. Specifically, 

elevations in [Ca2+]i levels reduced amyloidogenic processing of APP and resulted in dramatic reductions in the 

secretion of Aβ. 

CONCLUSION: Our results suggest a reciprocal relationship between cellular Ca2+ homeostasis and Aβ production 

and demonstrate that disruptions in Ca2+ homeostasis may influence AD pathogenesis directly through the modulation 

of Aβ production. 

Acknowledgements/Disclosures: This work was supported, in whole or in part, by National Institutes of Health Grants AG021495 and 

AG019070 (to G. T.) and NRSA award NS065660 (to W.Z.). This work was also supported by grants from the Alzheimer’s Association 

(to G. T. and to K. S. V). 

Oral Presentation Abstracts 

19

Thoracodorsal Artery Perforator and Muscle Sparing Latissimus Dorsi 

Flaps in Breast Reconstruction after Radiation Therapy 

Kelly Ledbetter 

MENTOR: David H. Song, MD, MBA, Department of Surgery, Section of Plastic and Reconstructive Surgery 

CO-AUTHORS: Jonathan Bank, MD 

BACKGROUND: After mastectomy, patients often have breast reconstruction with tissue expanders or implants. If 

they had prior implant failure or radiation therapy they may also have one of three pedicle flaps to provide additional 

soft tissue coverage: a thoracodorsal artery perforator (TDAP) flap, a muscle-sparing latissimus dorsi (MSLD) flap, or 

a latissimus dorsi (LD) flap. More technically demanding, TDAP and MSLD flaps spare most of the latissimus dorsi 

muscle and may have better functional outcomes and fewer donor site complications. Though studies have found that 

preoperative chest wall irradiation increases the complication rate of tissue expander/implant reconstruction, the effect 

of radiation on TDAP and MSLD flaps remains unclear. The goal of this study is to evaluate the long-term outcomes of 

patients with and without preoperative radiotherapy who subsequently had TDAP, MSLD, or LD flap reconstruction 

with expanders or implants. 

METHODS: A retrospective analysis of a prospectively maintained database was performed to identify patients who 

received a TDAP, MSLD, or LD flap plus a tissue expander or implant between 2005 and 2012 by a single surgeon. 

During the operation an algorithm was used to determine the suitability of the TDAP, MSLD, or LD flap. If a sizable 

pulsatile perforator was identified, a TDAP flap or MSLD type 1 flap was selected and < 2cm of LD muscle was sacrificed. 

If the signal was not pulsatile and lacked large perforators, an MSLD type 2 flap was performed (< 5cm LD muscle). 

Lastly, a standard LD flap was performed in the event that additional muscle was needed. Information regarding the 

patients’ primary diagnosis, radiation history, prior breast reconstructions, and complications was collected. Statistical 

analysis using the student t-test or fisher’s exact test was performed using p

Hospitalizations and Mortality Associated With 

Norovirus Outbreaks in Nursing Homes, 2009-2010 

Tarak Trivedi 

MENTOR: Benjamin Lopman, PhD, Centers for Disease Control and Prevention 

CO-AUTHORS: Traci DeSalvo, MPH, Lore Lee, MPH, Aimee Palumbo, MPH 

BACKGROUND: Norovirus outbreaks are common among vulnerable, elderly populations in US nursing homes. 

To assess whether all-cause hospitalization and mortality rates are increased during norovirus outbreak vs nonoutbreak 

periods in nursing homes, and to identify factors associated with increased risk. 

METHODS: We conducted a retrospective cohort study of Medicare-certified nursing homes in Oregon, Wisconsin, 

and Pennsylvania that reported at least 1 confirmed or suspected norovirus outbreak to the Centers for Disease Control 

and Prevention’s National Outbreak Reporting System (NORS), January 2009 to December 2010. Deaths and 

hospitalizations occurring among residents of these nursing homes were identified through the Medicare Minimum Data 

Set (MDS). We measured rates of all-cause hospitalization and mortality during outbreak compared with nonoutbreak 

periods were estimated using a random-effects Poisson regression model controlling for background seasonality in both 

outcomes. 

RESULTS: The cohort consisted of 308 nursing homes that reported 407 norovirus outbreaks to NORS. Per MDS, 

67 730 hospitalizations and 26 055 deaths occurred in these homes during the 2-year study. Hospitalization rates 

were 124.0 (95% CI, 119.4-129.1) vs 109.5 (95% CI, 108.6-110.3) hospitalizations per nursing home−year during 

outbreak vs nonoutbreak periods, yielding a seasonally adjusted rate ratio (RR) of 1.09 (95% CI, 1.05-1.14). Similarly, 

mortality rates were 53.7 (95% CI, 50.6-57.0) vs 41.9 (95% CI, 41.4-42.4) deaths per nursing home−year in outbreak 

vs nonoutbreak periods (seasonally adjusted RR, 1.11; 95% CI, 1.05-1.18). The increases in hospitalizations and 

mortality were concentrated in the first 2 weeks (week 0 and 1) and the initial week (week 0) of the outbreak, respectively. 

Homes with lower daily registered nurse (RN) hours per resident (


Joyce Woo 

MENTOR: David Glick, MD, Department of Anesthesia and Critical Care 

CO-AUTHORS: Kristen Wroblewski, MS, Ben Dauber, Avery Tung, MD 

BACKGROUND: In light of unsustainable health care costs, there has been a great movement to focus spending from 

a cost‐centric to value‐centric view, and with that a better understanding of quality is essential. Proposals to increase 

competition among hospitals have been advocated to improve quality, especially with the implementation of publicly 

reported quality measures. Yet it is unclear the degree to which hospitals compete on quality, and the current literature 

employ different definitions of competition. We hypothesize that hospitals in more competitive environments would be 

more likely to compete on the basis of quality. To test our hypothesis, we studied the relationship between competition 

and quality in hospitals providing cardiac care, and further compared our results using the two most widely used 

geographic statistics used to define competition: fixed radius and Metropolitan Statistical Area (MSA). 

METHODS: We examined hospitals performing heart valve surgery (HVS) and delivering acute myocardial infarction 

care (AMI) in the Hospital Compare database. We defined competition either as (1) the number of hospitals managing 

the same diagnosis within a 20‐mile fixed radius, or (2) the number of hospitals managing the same diagnoses within 

the same MSA. For each hospital that managed the diagnosis in question, we correlated competition with performance 

on quality metrics as defined by the Centers for Medicare and Medicaid services (CMS), mortality, patient volume, and 

Medicare per‐patient costs. All statistical analyses were performed using Stata Version 11 (Stata Corp., College Station, 

TX). 

RESULTS: 653 hospitals met inclusion criteria for HVS, and 1,898 for AMI. Hospitals facing more competition did 

not demonstrate better performance in CMS quality metrics for either diagnosis. This was evident for both measures 

of competition. For both diagnoses, competition correlated positively with costs: partial correlation coefficients = 

0.40 (p


Applied Scholarship............................25 

Basic Scientific Investigation...............36 

Scientific Investigation in 

Clinical or Social Sciences...................45 


23

24 Poster Presentation Abstracts 

Applied Scholarship

How Do Supervising Physicians Decide to Entrust 

Residents with Unsupervised Tasks? 

Kevin Choo 

MENTOR: Jeanne M. Farnan, MD, MHPE, Department of Medicine, Section of Hospital Medicine 

CO-AUTHORS: Vineet Arora, MD, MAPP, Paul Barach, MD, MPH, Julie K. Johnson, MSPH, PhD 

BACKGROUND: Medical educators struggle to find meaningful ways to evaluate trainees’ preparedness to 

independently perform tasks. The aim of this study was to identify factors and to develop a conceptual framework to 

determine how attending and resident perceptions of trust relate to clinical decision-making and patient care. 

METHODS: Internal medicine residents and attending physicians at an academic medical center were interviewed 

between January and November 2006. Participants were asked to describe, using the Critical Incident Technique, 

important entrustment decisions made during their clinical rotations. A deductive qualitative analysis using the 

Entrustable Professional Activities (EPA) framework was used. Inter-rater reliability was calculated using a generalized 

kappa-statistic (k). 

RESULTS: Eighty four percent (42/50) of residents and 80% (40/50) of attending physicians participated. Analysis 

yielded 535 discrete mentions of trust factors. The domains of trust described included: trainee factors (e.g., confidence, 

specialty plans); supervisor factors (e.g., approachability, clinical expertise); task factors (e.g., situational characteristics); 

and systems factors (e.g., workload, duty hours). The kappa (k) between the two raters was 0.84. 

CONCLUSION: The development of trust is multi-factorial and consists of factors driven by the supervisor, trainee, 

task, and environment. Trust is often determined by subjective conclusions drawn from direct trainee observation. 

Attendings and residents reported team dynamics played a large role in influencing trust. Attendings noted trainee 

absences, even those to comply with regulation, had a negative effect on entrustment decisions. Future studies are 

needed to address correlations with patient outcomes, and tools to objectively make entrustment decisions regarding 

preparedness for independent practice. 

IRB/IACUC: TBDTrack: Medical EducationSubmitted for: MS2 S&D Block 



25

Development of Text Message Intervention to Engage Parents in Youth After-School 

Nutrition and Exercise Program 

Amanda Gawin 

MENTOR: Deborah Burnet, MD, MA, Departments of Medicine, General Internal Medicine and Pediatrics 

CO-AUTHORS: Michael T. Quinn, PhD, Althera M. Steenes, Marla C. Solomon RD, CDE, Shantanu Nundy, MD, 

Lori McClinton-Powell, BA, F. Kwieku Embil, MA 

BACKGROUND: Obesity and its consequences are on the rise among children, especially minority youth. Power 

Up is a weekly healthy nutrition and exercise after‐school program for 2nd – 5th graders in south‐side Chicago Public 

Schools. Power Up was successfully pilot tested in 2009 with promising results; however engaging the parents of the 

Power Up children was a challenge. 

Text messaging has been used effectively for a number of behavior change and health interventions. Additionally, given 

that cell phones have been shown to be virtually universal in American homes, text messaging potentially presents a 

prime delivery channel for interventions targeting traditionally hard‐to‐reach populations. Using a text message system 

to engage the parents of Power Up children has the potential to enhance the impact of the Power Up intervention. 

DESCRIPTION OF PROGRAM/INNOVATION: First, a literature review was performed to learn about previous 

text messaging interventions. In total, 15 studies published after 2004 were reviewed. The search engine was PubMed 

with search terms “SMS”/”Short Messaging Service” and “text message/messaging”. The literature review revealed that 

most studies reported improved outcomes with text messaging interventions, and participants were typically satisfied 

with the intervention. Personally tailored and interactive messages were the most effective. Text frequency was optimal 

when it reflected the expected frequency of the targeted behavior, and response rates tended to decrease over time. 

Next, a collection of messages intending to engage Power Up parents as their children participated in the Power Up 

curriculum was created. First, five text message categories were described using findings from the literature review: 

1) Informational: shared information learned in Power Up session, 2) Importance: explained importance of session 

content, 3) Motivational: encouraged a family activity related to session content, 4) Reminders: reminder to complete 

homework, 5) Monitoring/feedback: posed a question. Then, the categories were integrated with the Power Up 

curriculum to create text messages that corresponded with each session. 

EVALUATION OF PROGRAM/INNOVATION: In 2012, Power Up with the text messaging component was 

pilot tested for one month to assess the feasibility of such an intervention with the Power Up parent population. The 

study design was a Pre‐Post survey with follow‐up interviews. Study subjects were 10 Power Up parents, all of whom 

were African American and low‐income. At baseline, 100% of the parents used text messaging, and 100% reported 

feeling comfort using text messages. The mean response rate to text messages was 32% (range: 0% ‐ 73%). Follow‐up 

interviews showed that participants found the intervention to be “easy to use”, “helpful”, and “engaging”. 

CONCLUSION: AA review of the literature revealed that text messaging interventions can be effective at invoking 

behavior change. Text message types can be organized into five categories: informational, importance, motivational, 

reminders, and monitoring/feedback. Finally, the 2012 pilot demonstrated that a text message system aimed to engage 

parents is feasible with the Power Up population. 

IRB/IACUC: 16364B 

Track: Community HealthSubmitted for: MS2 S&D Block, MS4 S&D Work 

Acknowledgements/Disclosures: Supported by University of Chicago CTSA UL1 RR0244999, NIDDK Diabetes Research, and Training 

Center P60 DK20595. 


Interruptions During Resident Handoffs on Labor and Delivery: 

A Mixed-Methods Multi-Site Study 


MENTOR: Jeanne M. Farnan, MD, MHPE, Department of Medicine, Section of Hospital Medicine 

CO-AUTHORS: Adrianne V. Dade, MD, Vineet Arora, MD, MAPP 

BACKGROUND: The transfer of care of patients, or handoff, between trainees represents a potential threat to patient 

safety. This transfer of professional responsibility has the potential for miscommunication, and published research 

shows frequent interruptions. There is little literature regarding handoffs in Obstetrics and Gynecology, particularly on 

the interruption-prone Labor and Delivery floor. 

METHODS: All 27 OB/GYN residents from a single residency program rotating on all OB/GYN services at two 

hospitals (University of Chicago Medicine and NorthShore Evanston Hospital) from January-March 2013 consented 

and participated. Direct observations of AM and PM handoffs were performed with tallies of interruptions. A paperbased 

survey was administered to all OB/GYN residents regarding the frequency, disruptiveness, and preventability 

of different interruptions. A focus group was held with 10 of 27 OB/GYN residents regarding their experience with 

missed information secondary to interruptions during handoffs. 

Descriptive statistics were performed on the direct observation and survey data. Pairwise correlations were performed 

on direct observations versus time of day. Qualitative analysis was performed by two authors (EG,JF), and any 

disagreements were settled by consensus. 

RESULTS: Twenty total handoffs were observed at both UChicago and NorthShore. People entered the handoff area 

in 85% of handoffs (mean = 6.5 times), other teams had conversations in the handoff area in 75% of handoffs (mean = 

4.2 times), two separate conversations occurred within the handoff in 73% of handoffs (mean = 3.1 times), phone calls 

among the handoff team or other teams in the same room occurred in 55% and 45% of handoffs, respectively (mean= 

2.2 times total). 

Pairwise correlations show a statistically significant strong correlation between evening handoffs and all pagers in the 

room going off (R= 0.7203, p=0.003) as well as other teams not involved in the handoff having conversations amongst 

themselves or on the phone in the same workspace (R=0.6834, p=0.009). 

Qualitative analysis of the focus group elicited many themes. 

1) Evening handoffs to night float are less formal. (n=5) 

2) The lack of defined roles contributes to missed information. (n=3) 

3) The contribution of physical workspace to disruptions. (e.g. phones) (n=11) 

4) Adverse events occur, e.g. missed or delayed tubal ligations due to inadequate handoffs. (n=7) 

CONCLUSION: Structural workplace issues, particularly handing off at the phones they work at during shift makes 

residents available to be contacted for non-emergent issues during handoffs. Work should be aimed towards fixing 

preventable systems issues which are interrupting handoffs. 

Side conversations are frequent, by both observation and resident report. Residents rated side conversations both 

among the most disruptive and the most preventable. Cultural changes should be enacted to allow for a less interrupted 

handoff. 

Evening handoffs, per the direct observations and the focus group participants, are more frequently interrupted. As 

night float residents do not know patients as well as the primary services, patients may be put at extra risk from both 

the lesser amount of knowledge of night float and a suboptimal handoff. 

IRB/IACUC: 12-2300 

Track: Medical EducationSubmitted for: MS4 S&D Work 


Poster Presentation Abstracts 27

Updating the Virtual Pathology of Clinical Pathophysiology and Therapeutics 

MENTOR: Aliya Husain, MD, Department of Pathology 

CO-AUTHORS: Scott Stern, MD, Peter Pytel, MD 


Patrick Mann 

BACKGROUND: For over 40 years, the Pritzker School of Medicine has offered second year medical students an 

integrated clinical and pathology course spanning the breadth of medicine. Started in 1972 by Drs. Seymour Glagov 

(Department of Pathology) and John E. Ultmann (Department of Medicine), the course has grown from 12‐weeks, 

lecture only, focusing primarily on pathology with clinical correlations to a robust, 17‐week, multi‐modality lecture and 

lab course that introduces students to the world of clinical pathophysiology and its therapeutic interventions. 

Just as the length and scope of the course has not remained static, its approach to teaching has also evolved to match 

technological advances seen over the past 40 years. Lectures once taught with chalkboards are now projected, recorded, 

and disseminated to students via the internet. The sound of scratching pencils has been replaced by the clacking of 

laptop keyboards. Lab books have migrated from paper to CDs to a static website to an interactive, multimedia enabled 

site that gives students a shared and universal learning experience. Most importantly to this project, students no longer 

review disparate glass pathology slides using microscopes; instead, they have been unchained from their microscopes 

and are provided high quality, uniform, virtual microscope slides accessible via the internet. 

METHODS: The primary goals of this project were three‐fold: 1) to update the image quality of the pathology 

portions of the course cases, including the virtual slides and static images (gross and microscopic); 2) to develop of a 

Socratic approach for training students to recognize common pathology; and 3) redesign the pathology‐based questions 

in the cases to better solidify students’ understanding of pathogenesis. 

To evaluate the success of these initiatives, a retrospective analysis of test scores and course evaluations (including the 

comment sections) will be used in order to address the effectiveness of the above improvements and seek to identify new 

directions to take this continually evolving course. 

RESULTS: 

1) Microscopic images within the cases were evaluated, with the majority of these images replaced. The replacement 

images now only highlight, but do not identify, the pathology discussed in the case, with answers provided to the 

students following the lab. 

2) Gross pathology images were evaluated and replaced as needed. 

3) Twenty-five new virtual pathology slides were added, most replacing older, poor quality slides. The addition of 

normal histology correlations to the cases is ongoing. 

4) Questions related to the pathology portion of the cases are under continuous improvement, with one section 

(pulmonary) completely updated and others close to completion. For instance, one word answers of “yes” or “no” were 

augmented to provide explanations of the affirmation or negation. 

CONCLUSION: Anecdotal reviews of the project indicate that the new slides, images, and questions significantly 

improve the laboratory experience for both instructors and students. However, given those taking CPP&T in 2012‐2013 

only saw improvements to the Pulmonary, Obstetrics/ Gynecology, and Dermatology sections, we could not perform a 

more quantitative analysis comparing their evaluations to prior years’ evaluations. 

Current suggestions for improvement include: adding annotated images to help supplement the existing, unlabeled 

still images, adding extra normal histology slides for reference, and restructuring the flow of cases to put the pathology 

images and questions into closer context with each cases’ clinical aspects. 

Following these updates, a retrospective analysis of test scores and course evaluations will address the effectiveness of 

these improvements and seek to identify new directions to take this continually evolving course. 

RB/IACUC: TBD - n/aTrack: Medical EducationSubmitted for: MS2 S&D Block, MS4 S&D Work 

Acknowledgements/Disclosures: None.

Sex(Ed) is Fun: Design, Implementation and Analysis of a Sexual Education 

Curriculum for Middle School Students 

Rebecca Miller & Sarah Todd, MAT 

MENTOR: Debra Stulberg, MD, MA, Department of Family Medicine 

BACKGROUND: In the United States, 46% of students in grades 9‐12 report having had sexual intercourse with at least 

one person, and nearly 6% of high school students report that their sexual debut was prior to the age of 13. It is estimated 

that American teens between the ages of 15‐19 acquire 50% of new sexually transmitted infections, and the United States 

continues to have one of the highest teen pregnancy rates in the developed world. In addition, data suggests that more than 

one third of U.S. teens do not receive any formal education about contraception prior to their sexual debut. Despite these 

statistics, sexual education in schools remains a hotly debated optic. Currently, mandates about sexual health education vary 

widely by state: some states require an emphasis on abstinence, some require HIV education only, and few require instruction 

about contraception. It has been demonstrated repeatedly that effective sexual education programs educate teens about both 

abstinence and safer sex practices. Studies show that abstinence‐only programs may actually deter contraceptive use among 

sexually active teens, increasing their risk of STIs and unintended pregnancy. It is often argued that the most effective sexual 

health programs for teens are multi‐disciplinary, involving the efforts of schools, parents, community leaders, and health care 

providers. In this intervention, a comprehensive sexual education program for middle school students was born out of close 

collaboration between educators and medical students. 

DESCRIPTION OF PROGRAM/INNOVATION: Three fourth year medical students from the University of Chicago 

partnered with a local public charter school, Gary Comer College Prep Middle School. Teachers from the middle school 

identified the need for sexual health education lessons for their seventh grade students. The medical students agreed to 

research, design and implement a sexual health curriculum for their students. Goals and objectives were written based 

on existing sexual health curricula and teacher/administrator concerns. Six one‐hour lessons were planned, addressing the 

following topics: reproductive anatomy, puberty, contraception, STI prevention, hygiene, and healthy communication. The 

six lessons were taught at Gary Comer Middle School over the course of three months. A core group of six medical students 

completed the teaching, which occurred in two single‐gender classrooms, each with 25 seventh grade students. Sessions were 

objective‐driven and interactive. 

EVALUATION OF PROGRAM/INNOVATION: On the first day of the intervention, students were given a pre‐test to 

assess their baseline knowledge. To evaluate the program’s efficacy, a post‐test was given on the last day of the intervention. 

The tests assessed both specific content knowledge and the students’ perception of their mastery of the material. Unique 

anonymous identifiers allowed preand post‐test data comparison. 

Initially, both groups of students demonstrated relatively low knowledge levels. Both male and female students initially 

overestimated their mastery of different sexual health topics. Both male and female students demonstrated improved 

knowledge after the intervention. Both groups of students also perceived that their knowledge of sexual health topics had 

improved. 

For the male students, pre‐test mastery of the objectives ranged from 3%‐33%, while post‐test mastery of the objectives ranged 

from 20%‐70%. The boys scored 8.23 (SD=5.13) points higher on the post‐test than the pre‐test, which was statistically 

significant according to a paired t‐test, t(21)=7.51, p


Food Rx: Integrating Clinic and Community 

Resources to Improve Dietary Management of Diabetes 

Katie Raffel 

MENTOR: Monica Peek, MD, Department of Medicine, Section of General Internal Medicine 

CO-AUTHORS: Anne Goddu, MSc, Tonya Roberson, DT, BA, Marshall Chin, MD, MPH, Rachel Stork 

BACKGROUND: For low-income minorities with diabetes, barriers often exist to healthy eating, including limited 

access to healthy food in their community, lack of knowledge about dietary recommendations, and lack of physician 

support/recommendations. The integration of community resources into the clinic setting may be an effective way to 

address these barriers. Our aim was to create a program that leveraged the power of physician recommendation, reduced 

financial barriers to healthy food, increased patient awareness about community resources for healthy food within the 

city’s ‘food deserts,’ and provided patient education resources within the clinic setting. 

DESCRIPTION OF PROGRAM/INNOVATION: Food Rx was collaboratively designed by Improving Diabetes 

Care and Outcomes of the South Side of Chicago, Walgreens and the 61st Farmers Market. The Food Rx has four 

components: a dietary prescription, low-literacy nutrition education handout, map of participating locations, and 

coupon/voucher for healthy food. During visits with diabetic patients, providers screened patients for food insecurity; 

if a need were found, the provider could then prescribe a diet (low-carbohydrate, low-fat, low-sodium, and/or high 

fiber) using the Food Rx. Patients could then redeem the Food Rx coupon at the local farmers market or the nine 

participating Walgreens stores expanded to sell healthy food. 

Six sites including four federally qualified health centers, one academic primary care clinic and one academic 

endocrinology clinic participated in the Food Rx program; patients at each site were predominantly African-Americans 

with poorly-controlled diabetes. 

EVALUATION OF PROGRAM/INNOVATION: We are evaluating Food Rx utilization among recipients via deidentified 

coupon redemption data provided by our retail partners. Further, through a series of focus groups and 

one-on-one interviews with Food Rx recipients, we plan to qualitatively explore the impact of Food Rx on patient’s 

understanding of dietary recommendations, perceptions of their community’s food resources and the barriers/facilitators 

to Rx utilization. 

CONCLUSION: We have found that providers and patients are enthusiastic about the Food Rx program. Providers 

report feeling empowered to provide comprehensive diabetes care, and patients report that the educational handouts 

and coupons are helpful. However, there were both provider and patient barriers to the initial Food Rx implementation. 

Despite provider training, utilization of the prescriptions was impeded by time constraints and oversight. In order to 

adapt the Food Rx program to the clinic workflow, non-physician staff (e.g. nutritionists, medical assistants) with more 

time and familiarity with the community became champions of the program. Further, despite the selection of Walgreens 

stores near clinic sites, patients often preferred to shop at Walgreens stores closer to home, many of which were not 

participating locations. Patients also believed that the higher prices at Walgreens would offset the value of the voucher. 

To address these concerns, we have included 2 new Walgreens sites frequented by clinic patients and performed a cost 

comparison between the Walgreens sites and local low-cost grocers. No significant difference in cost was found. 

Food Rx has demonstrated that it is feasible to implement a program integrating community nutrition resources into 

a variety of medical settings. The collaborative nature of program development allowed the intervention and study to 

meet the demands of all stakeholders: safety-net clinics, an academic medical center, a national corporation and a local 

non-profit. 

IRB/IACUC: TBD- Left BlankTrack: Community HealthSubmitted for: MS4 S&D Work 

Acknowledgements/Disclosures: This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) (Grant No. R18DK083946), the Chicago Center 

for Diabetes Translation Research (Grant No. P30 DK092949), the Diabetes Research and Training Center (Grant No. P60 DK20595), and the Alliance to Reduce Disparities in Diabetes of the 

Merck Company Foundation. Marshall Chin is supported by an NIDDK Midcareer Investigator Award in Patient-Oriented Research (Grant No. K24 DK071933).

Attitudes of Chilean Primary Care Providers Toward Chilean Public Primary Care 

Anne Toledo 

MENTOR: Brian Callender, MD, Department of Medicine, Section of Hospital Medicine 

CO-AUTHORS: Gavin Hougham, PhD 

BACKGROUND: This study is a survey assessing Chilean providers’ attitudes toward recent health care reform and its 

effects on delivery of primary care in the public health sector. 

With the exception of military personnel, the Chilean population is served by a dual public and private health system 

(Vargas, 2008). The system is funded by an income tax of 7% on all Chilean citizens above a minimum income level. 

A prioritized system of public services (Guarantias Explicitas de Salud, GES; to guarantee coverage by disease type, age 

group) began implementation in 2005 within an already existing public system. 

The plan’s four guarantees are: Access, guaranteeing healthcare to the uninsured; Opportunity, guaranteeing timely 

access; Quality of treatment and Financial Protection from more than 20% of the cost of treatment (Borzutsky, 2008). 

The plan originally included 56 medical conditions which together comprised 80% of Chile’s disease burden at the time 

(Borzutsky, 2008). Since the implementation of GES from 2005‐2007, Chileans’ access to health care has improved 

and Chile is now viewed as having one of the strongest health systems in Latin America (Bitrán, 2010). Despite national 

surveys tracking improved treatment of illnesses, as far as we know there is comparatively less investigative information 

about health professionals’ continued reception of the plan in their daily work (Ministerio de Salud, 2011). 

The goal of this research is to use our survey data to better understand the opinions of primary care providers working 

in the public health system as they are most directly involved in administering care within the reformed system. 

DESCRIPTION OF PROGRAM/INNOVATION: Anonymous, four question open‐ended survey, consented in 

person by research staff. Surveys transcribed, translated from Spanish to English then analyzed with standard qualitative 

analysis techniques. Themes sorted by larger domains and divided into more/less prevalent by number of occurrences 

relative to median (5< responses). 

EVALUATION OF PROGRAM/INNOVATION: The following domains are those represented by 5< survey 

responses; findings are presented in aggregate from entire survey rather than by question given limited sample size and 

overlapping themes: Quality, Streamlining, Expanded Access, Utilitarianism, System Overload, Work Culture, Work 

Challenges. 

CONCLUSION: Majority of respondents stated that government constructed medical guidelines did not negatively 

affect their clinical reasoning. They cited clear infrastructure, care goals and evidence based guides as GES‐related 

sources of patient access improvements. In tension with improvements in access appears an omnipresent sense of 

utilitarianism, with prioritization focusing on most good for most people yet leaving certain illnesses and age groups 

vulnerable. Many providers feel motivated by leading multidisciplinary teams and sense of duty to the under‐served yet 

simultaneously cite frustration with a perceived lack of societal support, both economically and morally. 

IRB/IACUC: TBA - Left BlankTrack: Global HealthSubmitted for: MS1 Spring Elective, MS2 S&D Block, MS4 S&D Work, Innovation 

Award, Other (Global Health Fellowship) 

Acknowledgements/Disclosures: Keith Edson Fellowship, Innovation Funding, Global Health Fellowship. Additional support provided 

by: Eduardo Costa, Patricia Larraín, Nell Thompson, Valentina Osses, Jeanne Farnan, Jose Iriarte. 


31

Streamlining the Medical Imaging Anatomy Curriculum: Introducing Image 

Interpretation with ‘Core’ Images and Narrated Screencasts 


MENTOR: Christopher Straus, MD, Department of Radiology 

CO-AUTHORS: Kelly Ledbetter, BA, MS4, Andrew Phillips, MD, Steven Eilers, BA, MS3 

BACKGROUND: Many educators accept the value of incorporating medical imaging curriculum into first year anatomy 

courses. Doing so provides a key opportunity to refine, solidify, and test newly acquired anatomical knowledge. Despite the 

increasing popularity of medical images as anatomy teaching tools, there is no standard or ‘core’ set of images nor a tried 

and true means of implementation and integration into the traditionally rigorous anatomy curriculum. As the incorporation 

of medical imaging into medical school anatomy curriculum becomes more common, important questions arise as to how 

best package and deliver an integrated imaging curriculum in a successful, time-sensitive, and independent learning module 

preferred by today’s students. The ultimate educational goal is to provide long term retention of anatomical knowledge 

while simultaneously introducing the primary means in which each future physician will clinically evaluate anatomy. With 

anatomy being sufficiently challenging in its own right, the approach to medical imaging must be at an introductory level 

and every effort should be made to avoid overwhelming students with extraneous material. The key challenge is to develop 

a portable, digital learning platform that allows students to acquire and refine image interpretation skills on a concise set of 

medical images carefully chosen to illustrate integrated learning objectives tested in the classroom and anatomy lab. 

DESCRIPTION OF PROGRAM/INNOVATION: The authors created a streamlined survey of normal radiographic 

anatomy by building easily accessible “core” files of hand chosen, digital medical images that demonstrate basic regional 

anatomy. Images from multiple modalities were chosen to illustrate key structures and clinically pertinent anatomical 

relationships wherever possible. Common structures were labeled with arrows and key structures were highlighted with 

transparent colored overlays superimposed upon the image to make them more readily identifiable. As the course progressed 

through regional anatomy, successive files progressed from simple plain films to more complex serial imaging requiring 

improved image understanding. Initial files emphasized image orientation, production, and skills needed for the later, more 

advanced imaging modalities. The authors then created screencast recordings of each “core” file providing powerful, selfpaced, 

portable, and independent teaching tools to practice image interpretation. These audio-visual files captured the 

narrative and mouse inputs of a course instructor discussing and deconstructing selected images within each core file. 

With each file representing an independent lesson in skill building, focus was placed on pivotal image information and 

accompanying logic required for structure identification. Serial narrative reinforcement within each module cues the learner 

to follow along, first developing and then solidifying their skills. Computer-displayed video formatting within each module 

allows the student to stop, start, replay, speed up, or slow down the modules providing individually paced learning. To 

evaluate the curriculum, Ninety first year medical students in the Human Body Course at the Pritzker School of Medicine 

were given web access to the “Core” images and screencast videos as an optional educational resource. Student performance 

in the course was assessed using three examinations per course module: a written anatomy examination, a free response 

cadaver lab practical, and a twenty question free response radiology practical exam. All images used in the Radiology exam 

were previously unseen by students. Surveys given at three points in the course collected the students’ opinions about the 

effectiveness and usage of the course’s teaching tools. 

EVALUATION OF PROGRAM/INNOVATION: Preliminary results include data from 85 of 90 (94%) first year medical 

students over the first three modules of a six-module course. Students who utilized the recordings did not have significantly 

higher test scores. As the course progressed, more students watched the video recordings (43%, 58%, and 60% for modules 

1-3 respectively). Additionally, students identified using the recordings as their principle radiology material (33%, 32%, and 

37%) as opposed to a supplement, an equivalent radiology material, or a material not used. Preliminary qualitative survey 

results indicate that the videos were well liked and used as the primary means of learning radiology material. Exam data 

indicate this method is equivalent to other radiology education methods and is an effective independent learning tool. 

CONCLUSION: Our study provides evidence that a well-designed independent learning tool is preferred by students 

and provides a unique means of teaching image interpretation skills and key educational objectives. It is these skills that 

are neither inherent nor addressed in more traditional, time-compressed curricula. These streamlined materials are at least 

an equally effective means of medical imaging instruction and further tailor individual learning into a time-compressed 

curriculum addressing the needs of students. 

IRB/IACUC: 15817ETrack: Medical EducationSubmitted for: MS4 S&D Work 



Global Health Experiences and Their Influence on 

Medical Specialty Choice and Career Path 

Wenlu Xiong 

MENTOR: Aisha Sethi, MD, Department of Medicine, Section of Dermatology 

BACKGROUND: Global health has become increasingly popular amongst students and trainees in colleges, medical 

schools, and residencies. The world has become more globally connected as technologies in travel and trade have 

improved, placing people in contact with all parts of the world. Tropical diseases only found abroad can be witnessed 

in travelers returning to the U.S., and patients of various cultural and ethnic backgrounds can be a part of any doctor’s 

practice. Therefore, global health should be considered in any medical training program. Currently, many colleges, 

medical schools, and residencies do provide students with global health opportunities. However, the future outcomes 

of these experiences have not been well‐studied and, therefore, are not entirely known. 

METHODS: A confidential, structured online survey was developed using Google Forms and distributed to 90 

Internal Medicine, Pediatrics, Med‐Peds, and Dermatology residency programs throughout the U.S. Senior residents 

were surveyed about their global health experience in the past, if any, how these experiences may have influenced 

their plans for the future, and reasons for not participating in global health. We obtained 142 survey respondents and 

analyzed the data with Stata. 

RESULTS: When asked why respondents did not participate in global health at each educational level, the vast majority 

cited lack of opportunity, opportunities that they were not interested in, or conflicts with time and/or money, and not 

lack of interest in global health. When asked whether institutions at each educational level should provide global health 

opportunities, a large percentage marked that they should regardless of the respondents’ global health experience level. 

Residents with global health experience were more likely to report considering a public health degree and expecting to 

go into global health in the future than residents with no global health experience. Residents without global health 

experience expected a career in private practice more often than those with global health experience although the groups 

did not significantly differ in plans to do academic medicine in the future. 

CONCLUSION: Therefore, institutions should provide their students with global health opportunities or increase 

awareness of their programs to further develop interest in the medical field and possibly influence career choices in the 

future. 

IRB/IACUC: n/a, Exempt Category 45 CFR 46.101(b)(2)Track: Global HealthSubmitted for: MS2 S&D Block, MS4 S&D Work 



33

Can I Get Some Feedback?: 

Student Descriptions of Facilitators and Barriers to Formative Feedback 


MENTOR: Shalini Reddy, MD, Department of Medicine, Section of Hospital Medicine 

CO-AUTHORS: H. Barrett Fromme, MD, MHPE, Michael S. Ryan, MD, Sarah-Anne Schumann, MD 

BACKGROUND: Quality formative feedback supports the development of medical students (MS) into competent 

professionals. Studies demonstrate that student satisfaction with feedback frequency and quality is low. This qualitative 

study examines the student perspective on facilitators and barriers to feedback. 

METHODS: Third‐year MS and second‐year physician assistant students (PA‐S) from three geographically diverse 

medical schools were recruited to participate in focus groups in 2012. Open‐ended questions prompted students to 

describe their experiences with feedback and discuss facilitators and barriers. Focus group transcripts were analyzed for 

themes and sub‐themes using the constant comparative method. 

RESULTS: A total of 25 MS and four PA‐S participated at the three sites, with an average focus group size of ten. 

Barriers to feedback initiation include learner intimidation, lack of time, and teacher discomfort with giving negative 

feedback. Barriers to students interpreting feedback as effective include lacking a strong student‐teacher relationship, 

considering the feedback to be poorly timed, and having a performance rather than a learning goal orientation. 

Facilitators of effective feedback include teacher and learner behaviors such as specificity, purposefulness, exhibiting 

a positive attitude, using feedback tools, and learner self‐reflection. Based on the themes that emerged, a conceptual 

framework centered on a “feedback event” was created, grouping factors that affect feedback initiation, content, learner 

interpretation, and follow‐through. 

CONCLUSION: This conceptual framework can inform the development of curricular interventions to mitigate 

barriers and enhance facilitators to feedback. Further curricular interventions to promote a learning goal orientation of 

students and to provide time to develop stronger student‐teacher relationships can address negative student emotions 

and interpretations of feedback events. 

IRB/IACUC: Exempt 

Track: Medical EducationSubmitted for: MS4 S&D Work 

Acknowledgements/Disclosures: Supported by a grant from the Institute of Medicine as a Profession and the Josiah Macy Jr. Foundation. 


Basic Scientific Investigation 


35

Glucocorticoid Mediated Gene Expression is Associated with 

Decreased Insulin Sensitivity in Human Sub-Cutaneous Abdominal Fat 

Clifton Brock 

MENTOR: Suzanne Conzen, MD, Department of Medicine, Section of Hematology/Oncology 

CO-AUTHORS: Paul Volden, Julie Park, MD, Maxwell Skor 

BACKGROUND: The glucocorticoid receptor (GR) is ubiquitously expressed in adipose tissue and known to be 

involved in several normal adipocyte functions as well as the pathogenesis of metabolic syndrome, diabetes, and 

hypertension. Despite this, few studies have been performed in primary human adipose tissue. Based on the time 

course of glucocorticoid treatment required to decrease insulin sensitivity in primary adipose tissue, we hypothesized 

that the ligand-activated GR may alter insulin signaling through direct transcriptional regulation of key genes involved 

in insulin signaling. 

METHODS: GR activation was shown to decrease insulin-mediated activation of AKT in primary subcutaneous 

adipose tissue. We therefore performed anti-GR chromatin immunoprecipitation (ChIP) coupled with high throughput 

sequencing (ChIP-seq) in primary subcutaneous adipocytes +/- dexamethasone treatment to determine GR chromatin 

binding regions and compared this GR cistrome with early (four hr) glucocorticoid-mediated gene expression. 

RESULTS: We found that several genes encoding proteins known to regulate insulin signaling were likely direct 

transcriptional targets of the GR. For example, following GR activation PIK3R1 (p85) and MTORC inhibitors 

DEPTOR and SESN1 were upregulated, while PIK3R5 (p101) expression was repressed, consistent with glucocorticoidmediated 

insulin resistance occurring via decreased PI3K and MTORC2 signaling to AKT. In addition, GR activation 

was associated with the direct regulation of genes associated with inflammation and lipolysis. 

CONCLUSION: We show for the first time in human primary subcutaneous adipose tissue that the GR directly 

regulates a subset of genes encoding proteins that modulate insulin signaling and inflammation. Because an unwanted 

side-effect of currently employed glucocorticoids is insulin resistance, understanding those genes GR regulates is 

predicted to be useful in screening novel GR modulators that lack these unwanted side effects and yet retain antiinflammatory 

activity. 

Acknowledgements/Disclosures: Howard Hughes Medical Institute (HHMI) Medical Fellows Scholarship, The University of Chicago 

John D. Arnold, MD Scientific Research Prize Recipient. 


IRF5 Systemic Lupus Erythematosus Risk Haplotype is Associated with 

Serologic Autoimmunity and Progression to Clinical Autoimmunity in 

Mothers of Children with Neonatal Lupus 


MENTOR: Timothy Niewold, MD, Department of Medicine, Section of Rheumatology 

CO-AUTHORS: Silvia N. Kariuki, BA, Beverly S. Franek, BS, Jill P. Buyon, MD, Robert M. Clancy, PhD 

BACKGROUND: Neonatal lupus (NL) is caused by the passage of maternal antibodies across the placenta, with tissue 

deposition and inflammation in the fetus. Mothers of NL patients may have a variety of diagnoses such as systemic 

lupus erythematosus (SLE), sjogren’s syndrome (SS), undifferentiated autoimmune disease (UAS) and asymptomatic. 

Variation in the interferon regulatory factor 5 (IRF5) gene has been associated with risk of developing SLE, and this 

association is largely dependent upon the presence of anti-Ro autoantibodies. This study was undertaken to determine 

if the IRF5 genotype is associated with anti-Ro antibodies, maternal diagnosis, and/or progression of autoimmunity in 

mothers of children with NL. 

METHODS: Genotyping of haplotype-tagging polymorphisms in IRF5 was performed in 93 subjects of European 

ancestry who were recruited to the Research Registry for Neonatal Lupus. Seventeen of these subjects were healthy/ 

asymptomatic, 30 had been diagnosed with SLE, 22 had been diagnosed with SS, and 24 had been diagnosed with 

UAS. All subjects had high-titer anti-Ro autoantibodies and had a child with NL. Allele frequencies in subjects were 

compared to those in non-autoimmune controls at the IRF5 locus. 

RESULTS: The SLE risk haplotype of IRF5 was enriched in all anti-Ro-positive subjects except in those with SS (odds 

ratio [OR] 2.55, P = 8.8 × 10(-4) ). The SLE risk haplotype was even enriched in asymptomatic individuals with anti-Ro 

antibodies (OR 2.69, P = 0.019). The same haplotype was more prevalent in subjects who were initially asymptomatic 

but developed symptomatic SLE during follow up (OR 5.83, P = 0.0024). Interestingly, SS was associated with 2 minor 

IRF5 haplotypes, and these same haplotypes were decreased in frequency in mothers with SLE and those with UAS. 

CONCLUSION: The IRF5 SLE risk haplotype was associated with anti-Ro antibody positivity in asymptomatic 

individuals, as well as with progression to SLE in asymptomatic anti-Ro-positive individuals. SS in mothers of children 

with NL was associated with different IRF5 haplotypes. These data suggest that IRF5 haplotypes are associated with 

both auto-antibody formation and progression to autoimmune disease in patients with serologic autoimmunity. 

IRB/IACUC: TBDTrack: Basic SciencesSubmitted for: MS4 S&D Work, Fentress 

Acknowledgements/Disclosures: Dr. Niewold’s work was supported by the NIH (grants R01-AR-060861, K08-AI-083790, and 

P30-DK-42086, National Institute of Allergy and Infectious Diseases Clinical Research Loan Repayment AI-071651, Clinical and 

Translational Science Award [CTSA] Core Subsidy Grant, and CTSA Pilot Grant UL1-RR-024999), The University of Chicago Calvin 

Fentress Fellowship Recipient. 


37

A Portable RNA Sequence Whose Recognition by a 

Synthetic Antibody Facilitates Structural Determination 


MENTOR: Joseph A. Piccirilli, PhD, Department of Chemistry 

CO-AUTHORS: Erica M. Duguid, PhD, David M. Shechner, PhD, Nikolai B. Suslov 

BACKGROUND: RNA crystallization and phasing represent major bottlenecks in RNA structure determination. 

Seeking to exploit antibody fragments as RNA crystallization chaperones, we used an arginine-enriched synthetic 

antibody fragment (Fab) library displayed on phage to obtain specific Fabs that bound the class I ligase ribozyme. 

METHODS: Phage display was used to select synthetic Fab fragments that bound the class I ligase RNA. Crystal 

screening was performed using pre-formulated Hampton Research crystallization screen reagents. X-ray diffraction was 

performed at the Advanced Photon Source Sector 21, and initial phases for the Fab-class I ligase crystal structure at 3.1 

Å resolution were obtained by molecular replacement. 

RESULTS: We used phage display to select synthetic Fab fragments that bound the class I ligase RNA with micromolar 

affinities, and then used error-prone PCR to improve Fab-ligase binding 10-fold. We then used molecular replacement 

with Fab coordinates to solve the structure of a Fab–ligase complex at 3.1-Å resolution, revealing the ribozyme 

architecture and the chaperone’s role in RNA recognition and crystal contacts. The Fab-RNA epitope resides in the 

GAAACAC sequence that caps the P5 helix of the ligase. This sequence retains high-affinity Fab binding within the 

context of other structured RNAs. 

CONCLUSION: The Fab-GAAACAC epitope provides a new RNA crystallization chaperone system that easily can be 

screened in parallel to the U1A RNA-binding protein, with the advantages of a smaller loop and Fabs′ high molecular 

weight, large surface area and phasing power. 

Acknowledgements/Disclosures: This work was funded by Howard Hughes Medical Institute (J.A.P.), US National Institute of General 

Medical Sciences Medical Scientist National Research Service Award no. 5 T32 GM07281 (Y.K.) and US National Institutes of Health 

grants R01-GM72688 and U54-GM74946 (to S.K. and A.A.K.) and R01-GM61835 (to D.P.B.). Use of the Advanced Photon Source 

was supported by the US Department of Energy, Office of Science, Office of Basic Energy Sciences, under contract no. DEAC02- 

06CH11357. Use of the LS-CAT Sector 21 was supported by the Michigan Economic Development Corporation and the Michigan 

Technology Tri-Corridor for the support of this research program (grant 085P1000817). 


Dynamic Interactions Among CDC42, PAR-6/PKC-3 and LGL Can Maintain Cell 

Polarity in Early Embryos of the Nematode Worm C. elegans. 

Samuel Lee 

MENTOR: Edwin Munro, PhD, Department of Cell Biology and Molecular Genetics 

BACKGROUND: Maintaining cell polarity is fundamental for cell structures and their specialized functions. Genetic 

and biochemical studies have defined a core set of highly conserved regulatory molecules that are asymmetrically 

localized in the Caenorhabditis elegans embryo cells and that interact dynamically to maintain polarity. These 

include the posterior cytoskeletal protein LGL, the anterior GTPase CDC42, the adaptor protein PAR-6 and the 

serine threonine kinase PKC-3. Previous studies suggest that a system of cross-regulatory interactions among PAR-6/ 

PKC-3, LGL and CDC42 is essential for the maintenance of complementary domains enriched in anterior CDC42/ 

PAR-6/PKC-3 and posterior LGL. Hoege et al. recently proposed that the binding of PAR-6/PKC-3 to LGL leads 

phosphorylation of LGL, resulting in destabilization of cortical binding of LGL, which in turn causes dissociation 

of an LGL-phosphorylated/PAR-6/PKC-3 complex from the cortex. They proposed that this interaction results in 

stochiometrically balanced “mutual elimination” of PAR-6/PKC-3 and LGL from the cortex, and that this could 

mediate the dynamic maintenance of the boundary between the anterior PAR-rich and posterior LGL-rich domains. 

However, while existing data support the mutual elimination model, it remains unclear whether this mechanism is in 

fact sufficient to dynamically sustain the polarized protein distributions. 

METHODS: We modeled a two-dimensional cross section of the embryo cell with a single cytoplasmic compartment 

and the cortex represented by a collection of discrete compartments surrounding the cytoplasm. We converted known/ 

hypothesized molecular interactions into a system of biochemical kinetic equations that governs how the densities of 

elements in each compartment evolve over time due to local interactions and flux between compartments. Then we 

asked whether and under what conditions these interactions could explain the stable maintenance of complementary 

anterior and posterior domains. 

RESULTS: We show that the mutual elimination mechanism cannot explain absolute stable maintenance of polarity 

under any conditions – the system always tends towards a single spatially uniform steady state. Furthermore, even 

the two-step mutual elimination mechanism (CDC42 initially binds to the cortex and recruits PAR-6/PKC-3. Then 

PAR-6/PKC-3 is transferred to LGL and phosphorylates LGL), the absolute stable polarity cannot be maintained. 

Here, we propose an alternative mechanism that maintains polarity for an indefinite amount of time. In addition to 

the two-step mutual elimination mechanism, CDC42/PAR-6/PKC-3 directly phosphorylates LGL thus dissociating 

LGL from the cortex, and a posterior protein (e.g. PAR-2 through CHIN-1) inhibits CDC42 from associating with the 

cortex. Essentially, this biologically plausible “cross-inhibition” mechanism is a variant of a simple theoretical two-step 

cortical recruitment of an anterior protein where the posterior protein inhibits both recruitment steps, and the anterior 

protein promotes the cortical dissociation of the posterior protein. These proposed mechanisms are the first systems of 

interactions which can dynamically maintain polarity with only a set of unimolecular and bimolecular kinetic laws and 

without using any non-linear relationships in the system. 

CONCLUSION: We show that both the one-step and two-step mutual elimination mechanisms are insufficient to 

sustain the polarized distributions of CDC42, PAR-6/PKC-3, and LGL in the C. elegans embryo. The proposed crossinhibition 

mechanisms are the biologically and kinetically plausible mechanism that can sufficiently maintain cell 

polarity. 

IRB/IACUC: TBD - Left Blank 

Track: Basic SciencesSubmitted for: MS1 Spring Elective, SRP, MS2 S&D Block, MS4 S&D Work, Fentress 

Acknowledgements/Disclosures: NIH, The University of Chicago Calvin Fentress Fellowship Recipient. 


39

Uncovering the Mechanism of Vitamin D and 

NSAID Combination Therapy in Prostate Cancer 


MENTOR: Rick Kittles, PhD, Department of Genetics, University of Illinois at Chicago 

BACKGROUND: Prostate cancer arises from complex interactions of environmental and genetic factors and is the 

second leading cause of cancer death in American men behind lung cancer. The leading risk factors for developing 

prostate cancer include age, family history, and ancestry. A interesting potential environmental factor that may lead to 

increased risk of prostate cancer is vitamin D deficiency. Vitamin D has both anti-proliferative and anti-inflammatory 

effects on prostate cells and may be an important therapeutic in the treatment of prostate cancer. Recently the active 

metabolite of vitamin D, calcitriol (1,25(OH)2D3), has been found to influence multiple steps in the prostaglandin 

(PG) synthesis pathway. 

Furthermore, when calcitriol is combined with non-steroidal anti-inflammatory drug (NSAID) therapy, a synergistic 

antiproliferative effect is observed in prostate cancer cell lines. Despite this, the mechanism of vitamin D mediated antiinflammatory 

activity in combination with NSAIDs is poorly characterized in the prostate cancer setting. Expression 

profiling of prostate cancer cells have demonstrated that thousands of genes are differentially expressed when comparing 

non-selective to selective COX-2 inhibitors and low dose to high dose NSAIDs. We hypothesize that this synergistic 

effect occurs by targeting COX-2 independent mechanisms in addition to COX-2 mediated inflammation. 

METHODS: Prostate cancer cell lines MDA-Pca-2b and DU 145 will be grown in culture with manufacturer 

recommend media in an incubator containing 5% CO2. Cells will be obtained from current lab frozen stock. NS-398 

will be used as the COX-2 selective NSAID and ibuprofen will be used as the COX-1 and COX-2 nonselective NSAID. 

NSAIDs will be ordered from Cayman Chemical Company in Ann Arbor, MI[9]. Cells will be treated with NS-398 

(1-100 µM) and ibuprofen (5-100 µM) in combination with calcitriol (50nM) for 24 hours. 

Western Blots: Western Blots will be performed in all cell lines to confirm the COX-2 and VDR status of each cell line. 

RESULTS: 

1) High dose ibuprofen decreases AR and VDR expression in addition to COX-2 in MDA-Pca 2b cells. 

2) MDA-Pca-2b cells express COX-2. 

3) DU-145 cells do not show a similar decrease in VDR expression in response to high dose ibuprofen treatment 

CONCLUSION: Preliminary data indicates COX-2 pathway dependent and independent changes in expression occur 

after combination therapy. This can lead to the identification of new therapeutic targets for prostate cancer treatment. 



The Genomic Interplay of Key Lineage Determinants 

During B Cell Fate Determination 


MENTOR: Harinder Singh, PhD, Department of Molecular Genetics and Cell Biology 

CO-AUTHORS: Chauncey J. Spooner, PhD 

BACKGROUND: Hematopoiesis is an ideal system to investigate the molecular underpinnings of cell fate choice due to 

the ease with which developmental intermediates can be isolated and analyzed both in vitro and in vivo. Hematopoietic 

stem cells differentiate into all the cells that constitute the blood and immune systems. This process is coordinated by 

the unique combinatorial set of transcriptional regulators that control gene expression, in part, by altering the proximal 

and distal epigenetic landscape to shape the identity of a particular cell fate. During B lymphopoiesis, the transcription 

factors PU.1, Ebf1 and Pax5 are all required for proper development. The loss of any one of these factors results in 

a failure of B cell developmental progression and mutations in these factors have been implicated in several human 

malignancies. However, an in depth understanding of how these transcriptional regulators coordinate the B cell fate is 

not fully understood. 

METHODS: Using mouse primary bone marrow progenitors, we performed chromatin immunoprecipitation 

followed by massively parallel sequencing (ChIPseq) to identify where transcriptional regulators (Ebf1, PU.1 and Pax5) 

and histone modifications (monomethylation of histone H3 on lysine 4 [H3K4me1]) were present throughout the 

genome during B cell specification and commitment. These data were integrated with microarray gene expression 

profiles of cellular states prior to and subsequent B cell commitment. All sequencing data were analyzed using the 

Illumina sequencing pipeline and QuEST (quantitative enrichment of sequence tags). An in-depth analysis of the 

spatial regulation of the immunoglobulin (Igh) locus during B cell fate commitment was carried out via fluorescence 

in situ hybridization (FISH). 

RESULTS: Ebf1 targets B-lineage genes, including the Igh locus, for activation, in part, by regulating H3K4me1, a 

histone mark enriched at enhancer elements. Notably, Ebf1 induces release of Igh alleles from the nuclear lamina, a 

process that precedes Igh recombination. Our data suggest that this regulation may be due to alterations in chromatin 

structure at the Igh locus induced by Ebf1 binding. Furthermore, the Ebf1 binding landscape undergoes expansion in 

a Pax5-dependent manner as cells transit from a specified to a committed state. De novo motif analysis of Ebf1 target 

sequences in Ebf1-regulated genes reveals presumptive sites for Pax5 and PU.1. ChIPseq analysis of Pax-5 and PU.1 

identifies a class of sequences in functionally important B cell genes that are bound by all three factors. 

CONCLUSION: Although PU.1, Ebf1 and Pax5 have been shown to act in a hierarchical manner in B cell fate 

determination, our molecular and genetic analyses demonstrate that downstream components in the gene regulatory 

network feedback to substantially modify the genomic targeting and functioning of upstream counterparts. Furthermore, 

Ebf1 targets the Igh locus and is required for release from its association with the nuclear lamina, a process necessary for 

proper Igh recombination. Ours is the first study to demonstrate such a function for a transcription factor. 

Acknowledgements/Disclosures: HHMI, NIH P50 GM081892-01A1 & Chicago Biomedical Consortium. 


41

Chaotic Aggregation of Truncated Amyloid Beta Peptides 


MENTOR: Stephen Meredith, MD, PhD, Departments of Pathology and Biochemistry and Molecular Biology 

CO-AUTHORS: Laura Luther, MS, Andrew Hawk, PhD, Joseph Sachleben, PhD 

BACKGROUND: Aggregation of monomeric Amyloid Beta (Aβ) peptides (mostly Aβ1-40 and Aβ1-42) into 

neurotoxic soluble oligomers and insoluble fibrils is believed to be essential to the pathogenesis of Alzheimer’s Disease. 

Yet, the mechanism by which monomeric Aβ undergoes aggregation is poorly understood; two possibilities have been 

suggested. One hypothesis proposes that a central domain, possibly Aβ21-30, folds autonomously, thereby apposing 

hydrophobic residues within Aβ that interact to induce the formation of β-sheet, oligomers and fibrils. An alternative 

hypothesis suggests that an ordered folding process is unlikely; rather, hydrophobic residues within Aβ collapse upon 

one another in a chaotic fashion, forming polymorphic associations that favor β-sheet formation then oligomer and 

fibril formation. 

METHODS: In order to compare these hypotheses, we synthesized three internal fragments of Aβ of varying length 

(Aβ21-30, Aβ16-34 and Aβ13-38); the longer fragments contained more hydrophobic residues on either side of the 

central domain. In addition, we synthesized cyclic Aβ21-30, cyclic Aβ 16-34, and Aβ21-30 and Aβ16-34 extended 

at their N-termini by a Cystine residue. The Cys-containing or cyclic peptides, we hypothesized, might stabilize any 

interactions between side chains in Aβ21-30 through an entropic effect, making them more manifest by structural 

techniques, including Circular Dichroism (CD), Size Exclusion Chromatography (SEC), and two-dimensional Nuclear 

Magnetic Resonance (NMR) Spectroscopy. 

RESULTS: Aβ21-30, in addition to its Cys-modified and cyclic variants, was strictly monomeric and unstructured 

by CD, SEC, NMR, and analytical ultracentrifugation. Conversely, Aβ16-34 and Aβ13-38 formed oligomers, slowly 

fibrillized, and had strong β-turn and weak β-sheet signals (Aβ13-38 > Aβ16-34). Individual NMR spectra of Aβ16- 

34 were polymorphic and strongly dependent on temperature and pH. Sequential NMR spectra of fibrillizing samples 

of Aβ16-34 demonstrated variable signal decay and a faster rate of decay at certain hydrophobic residues near the 

N-terminus of the peptide. Adding a Cys residue to Aβ16-34 accelerated fibril formation, increased the rates of signal 

decay, and increased the consistency of decay rates within and between experiments. Finally, Cys-Aβ16-34 > Aβ13-38 

> Aβ16-34 were able to seed fibrillization of monomeric Aβ. 

CONCLUSION: We find no evidence that Aβ21-30 constitutes an autonomously folding core domain or has the 

ability to promote oligomerization or fibrillization of Aβ monomers. Conversely, Aβ fragments extended by hydrophobic 

residues possess a β-turn like structure, aggregate into soluble oligomers and fibrils, and seed fibrillization of monomeric 

Aβ. Furthermore, the addition of an N-terminal Cys residue favors interactions between sidechain residues known to 

interact in Aβ fibrils and orders the aggregation process. Lastly, differences in chemical shifts and signal decay rates for 

sequential NMR spectra of fibrillizing Aβ16-34 and Cys-Aβ16-34 indicate that Aβ fails to adopt a single structure 

during aggregation. Rather, hydrophobic effects lead to the formation of polymorphic aggregated species (i.e. oligomers 

and fibrils) that have greater heterogeneity than any normally folded protein. That is, the defining feature of Aβ – 

and perhaps of any amyloid – is its incompetence to assume a unique three-dimensional structure beyond the most 

rudimentary architectures, e.g. the presence of β-sheets. 

Acknowledgements/Disclosures: Laura Luther & Joshua Williams contributed equally to this project. We acknowledge the National 

Institutes of Health (NIH) Grant NS042852 to S.C.M, The University of Chicago Calvin Fentress Fellowship Recipient. 


Abcc9 is Required for the Transition to Oxidative 

Metabolism in the Newborn Heart 


MENTOR: Elizabeth McNally, MD, Department of Medicine, Section of Cardiology 

CO-AUTHORS: John P. Fahrenbach, Douglas Stoller, Gene Kim, Nitin Aggarwal, Judy U. Earley, Michele Hadhazy, 

Nian-Qing Shi, Jonathan Makielski 

BACKGROUND: At birth the newborn heart adapts by shifting from a fetal glycolytic metabolism to a mitochondrial 

oxidative metabolism, and the regulation of this transition is not well understood. With the shift to oxidative 

metabolism, the maturing heart generates more ATP. Abcc9, an ATP binding cassette family member, is highly 

expressed in the developing heart consistent with a role in this transition to oxidative metabolism. Abcc9 encodes a 

membrane-associated sulfonylurea receptor that partners with a potassium channel to become the major potassium 

sensitive ATP channel in the heart. Abcc9 also encodes a smaller protein enriched in the mitochondria. 

METHODS: We now deleted exon 5 of Abcc9 to ablate expression of both plasma membrane and mitochondriaassociated 

proteins. 

RESULTS: In the absence of Abcc9, the myocardium failed to acquire normal mature metabolism and caused neonatal 

cardiomyopathy. Unlike normal cardiomyocytes, mitochondria from Ex5 cardiomyocytes were unresponsive to the 

KATP agonist diazoxide, consistent with loss of mitochondrial KATP activity. When exposed to hydrogen peroxide to 

induce cell stress, Ex5 neonatal cardiomyocytes displayed a rapid collapse of mitochondria membrane potential, distinct 

from normal cardiomyocytes. Ex5 cardiomyocytes had reduced fatty acid oxidation and reduced oxygen consumption, 

and morphologically, Ex5 cardiac mitochondria exhibited an immature pattern with reduced cross sectional area and 

inter-mitochondrial contacts. 

CONCLUSION: In the absence of Abcc9 the newborn heart fails to transition normally from fetal to mature 

myocardial metabolism. 

IRB/IACUC: 70950; 70783 

Track: Basic ScienceSubmitted for: MS1 Spring Elective, SRP, MS2 S&D Block, MS4 S&D Work 



43

Scientific Investigation 

in 

Clinical or Social Sciences 


Predicting Allogeneic Stem Cell Transplant Outcomes in Patients with 

High Risk AML & MDS: A Retrospective Analysis of Pre-Transplantation Variables 

Rajiv Agarwal 

MENTOR: Hongtao Liu, MD, PhD, Department of Medicine, Section of Hematology/Oncology 

CO-AUTHORS: Andrew Artz, MD 

BACKGROUND: Allogeneic hematopoietic stem cell transplantation (HCT) is the only treatment option with the 

potential for long term disease remission for patients with relapsed and/or refractory AML and MDS. Response to 

HCT is dependent on a number of variables. Identifying pre‐transplantation variables may be used to predict clinical 

outcomes. 

METHODS: We performed a retrospective analysis to examine pre‐HCT variables for patients with high risk AML or 

MDS who underwent reduced intensity conditioning (RIC) for T‐cell depleted HCT from 2002‐2012. Our primary 

objective was to critically assess which variables may serve as prognostic factors that predispose patients to better or 

worse clinical outcomes. Inclusion criteria for our study included adult patients: (a) who received RIC, (b) undergoing 

first allogeneic HCT without previous HCT, (c) with high risk disease status, and (d) who are not in remission at time 

of HCT. Based on previous studies, pre‐HCT variables considered for analysis include: C‐reactive protein, number of 

courses of induction chemotherapy, number of previous relapses, time of relapse after induction therapy, age at relapse 

post induction therapy, presence of molecular FLT‐ITD mutations, bone marrow blast percentage at HCT, neutrophil 

nadir, cytogenetic profiles, and ECOG performance status. Using univariate and multivariate analysis, we aim to show 

how different pre‐HCT variables correlate with post‐HCT outcomes: namely, incidence of graft versus host disease, 

progression free survival, and overall survival. 

RESULTS: 127 patients were evaluable based on inclusion criteria; 96 AML (disease status: 60 PIF/Refractory, 36 

relapse), 31 MDS (disease status: 12 RAEB‐1, 10 RAEB‐2, 5 CMML, 4 active disease/progressing); median age was 

56 years (range 18‐71); sex: 78 M, 49 F. 18 patients had low risk, 52 had intermediate risk, and 49 had high risk 

cytogenetic profiles at diagnosis. 8 patients had an inadequate sample or did not have cytogenetic analysis. Of the 

36 patients who relapsed prior to HCT, only 3 patients relapsed after > 12mo of induction and 14 patients relapsed 

between 6 and 12 mo, but 19 patients relapsed after < 6mo of induction; median age at first relapse was 53 years (range 

25‐68); 31 patients had only 1 relapse while 5 patients had multiple relapses. 9 of 60 patients evaluated showed a 

FLT3 ITD mutation. 32 of 45 evaluable patients had high C‐reactive protein levels at study entry (>5mg/L). Nearly all 

patients had ECOG performance status of 0 to 1. 

2 patients did not have pre‐HCT induction chemotherapy, 46 patients had one, 47 patients had two, and 32 patients 

had three or more courses; 79 patients had pre‐HCT BM blast percentage < 10%, 16 had between 10‐20%, 31 had 

> 20%; 70 patients had pre‐HCT BMcellularity < 20%, 56 had > 20%; One pt’s pre‐HCT BM was inadequate for 

analysis. Graft sources included: 108 PBSC (64 matched related, 44 matched unrelated), and 19 haploidentical PBSC 

plus a cord blood unit. We are currently in the process of examining post‐transplant outcomes: GVHD, progression 

free survival, and overall survival, and conducting univariate and multivariate analysis on pre‐HCT variables. 

CONCLUSION: We expect that with further statistical analysis of our results, we can identify which variables predict 

favorable or unfavorable clinical outcomes prior to HCT. This provides us with the potential to optimize therapeutic 

strategies and identify subgroups of high‐risk patients with AML or MDS who are more likely to benefit from HCT. 

By detecting the prognostic factors that correlate with post‐HCT outcomes, we advance our understanding of how 

patients with hematologic malignancies vary in their response to HCT. 

RB/IACUC: 12335BTrack: Clinical SciencesSubmitted for: MS4 S&D Work, Fentress 

Acknowledgements/Disclosures: The University of Chicago Calvin Fentress Fellowship Recipient. 


45

Impact of a Revised Appointment Scheduling Script on IUD Service 

Delivery in Three Title X Family Planning Clinics 


MENTOR: Melissa Gilliam, MD, MPH, Department of Obstetrics and Gynecology, Section of Family Planning 

CO-AUTHORS: Stephanie Mistretta, MA, Summer Martins, MPH, Jane Holl, MD, MPH 

BACKGROUND: Women ages 15-25 are at high risk of unintended pregnancy yet have the lowest rates of intrauterine 

device (IUD) use. There is a paucity of research about how failures of in the system of IUD delivery may be contributing 

to this low rate of uptake. We used Failure Modes Effects and Criticality Analysis (FMECA), a well-established risk 

assessment and safety technique derived from industries outside of healthcare, to systematically evaluate IUD service 

delivery to young women in three Chicago Title X clinics. The FMECA is a multidisciplinary process, for which, in our 

study, the steps of obtaining an IUD were delineated and ways in which the delivery system fails (failure modes) were 

identified. The consequences of these failures were then identified and assessed for severity, frequency of occurrence, and 

potential safeguards already in place. Based on this assessment, a “criticality score” (level of risk) was assigned to each 

failure mode, and the highest risk failure modes were selected for possible intervention. We identified three “high risk” 

areas preventing IUD insertion: unprotected sex prior to the appointment, lack of understanding of clinic policies, and 

missed appointments. 

METHODS: We revised the call center’s script for IUD appointment scheduling to address the failures identified 

during the FMECA. We piloted the new script over a one-month period in November 2012 and assessed its impact on 

rates of appointment attendance, IUD eligibility (i.e. adherence to unprotected sex instructions), and completed IUD 

insertions using a pre/post study design with 3-week blocks of data collection before and after the intervention (n=99 

appointments). 

RESULTS: The revised script decreased no-show rates for appointments overall (40.4% vs. 23.8%, p=0.08), with 

significant differences for patients < age 25 (n=51; 46.9% vs. 15.8%, p=0.04). Among patients who attended their 

appointment, there were no pre/post differences in the proportions of IUD-eligible patients (97.1% vs. 90.3%, NS) or 

completed insertions (79.4% vs. 78.1%, NS). 

CONCLUSION: Use of a standardized scheduling script that emphasizes clinical and administrative policies for IUD 

visits may positively impact appointment outcomes. This simple, scalable intervention can increase the efficient use of 

clinic resources, thereby improving IUD service delivery and administrative outcomes. 

IRB/IACUC: 10-508-BTrack: Clinical SciencesSubmitted for: MS4 S&D Work 

Acknowledgements/Disclosures: Department of Health and Human Services: Office of Secretary, Office of Public Health and Science, 

Office of Population Affairs. 


Comparison of Illuminated Dilated Pinhole, Laser Inferometer, and Potential Acuity 

Meter in Predicting Postoperative Visual Acuity after Cataract Surgery 

Valerie Chen 

MENTOR: H. Barrett Fromme, MD, MHPE, Department of Pediatrics & 

Susan Ksiazek, MD, Department of Surgery, Section of Ophthalmology and Visual Science 

CO-AUTHORS: Janice M. McMahon, OD, Rominder S. Momi, MD, Joshua K. Fernandes, MD 

BACKGROUND: The majority of people begin to develop age‐related cataracts by their 40s‐50s. At age 60, most 

cataracts begin to steal vision. It is difficult to determine how much of the decreased vision is due to the cataract in 

patients with coexisting ocular comorbidities (e.g. retinal or neural disease). 

Potential vision tests (e.g. Dilated Pinhole, Laser Inferometer, Potential Acuity Meter) have been developed to help 

predict visual acuity after uncomplicated cataract surgery. These tests offer the patient more complete information in 

weighing the risks, benefits, and risks and benefits of undergoing the operation. 

METHODS: This prospective study evaluated 58 eyes in 48 patients undergoing cataract surgery between May 2011 

and January 2013. Pre‐operative measurements included pre‐operative best‐corrected visual acuity (BCVA), Illuminated 

Dilated Pinhole (DPH), Potential Acuity Meter (PAM), and Laser Inferometer (LI). One month post‐operative BCVA 

was used at the outcome measure to evaluate the accuracy of the potential vision tests. For data analysis, eyes were 

categorized based on pre‐operative BCVA: Group 1 ‐ LogMar 0.30 to 0.48 (equivalent to 20/40 to 20/60) (n=28), 

Group 2 ‐ LogMar 0.50 to 0.70 (equivalent to 20/63 to 20/100) (n=12), and Group 3 ‐ LogMar 0.72 to 1.3 (equivalent 

to 20/125 to 20/400) (n=18). Percent accuracy of prediction within LogMar 0.2 (equivalent to 2 lines on the Snellen 

chart), mean LogMar inaccuracy between predicted and post‐operative visual acuity, and paired t‐tests were then 

calculated. 

RESULTS: DPH predicted visual outcomes within LogMar 0.2 (equivalent to 2 lines on the Snellen chart) in 50%, 

50%, and 33% for Group 1, Group 2, and Group 3, respectively. LI predictions within LogMar 0.2 for the same groups 

were 39%, 33%, and 50%. Similarly, PAM predictions within LogMar 0.2 were 36%, 42%, and 28%, respectively. 

Mean LogMar inaccuracy with DPH was 0.22 (±0.19), 0.18 (±0.25), 0.30 (±0.43), and 0.23 (±0.30) for Group 1, 

Group 2, Group 3, and Overall, respectively. Mean LogMar Inaccuracy with LI was 0.29 (±0.26), 0.21 (±0.38), 0.26 

(±0.40), and 0.25 (±0.35) for the same groups. Mean LogMar Inaccuracy with PAM was 0.35 (±0.34), 0.32 (±0.45), 

0.38 (±0.31), and 0.35 (±0.37), respectively. Paired t‐tests revealed no significant statistical differences between any of 

the 3 potential vision tests’ ability to predict visual outcomes both overall and after pre‐operative BCVA classification. 

CONCLUSION: The Dilated Pinhole test is a simple, inexpensive method that may be useful in predicting visual 

acuity after cataract surgery. It is comparable to Potential Acuity Meter and Laser Inferometer. 

IRB/IACUC: TBDTrack: Clinical SciencesSubmitted for: MS4 S&D Work 



47

Substituted Judgment in Principle and Practice: 

A National Physician Survey 

Michael Combs 

MENTOR: Farr A. Curlin, MD, Department of Medicine, Section of General Internal Medicine & 

MacLean Center for Clinical Ethics 

CO-AUTHORS: Kenneth A. Rasinski, PhD, John D. Yoon, MD 

BACKGROUND: The conventional framework for surrogate decision‐making prioritizes substituted judgments over 

judgments about what is in the patient’s best interest, but it is unknown to what extent physicians endorse substituted 

judgments in principle or accommodate them in practice. 

METHODS: We surveyed a stratified, random sample of 2016 U.S. physicians by mail. Primary outcome measures 

were agreement with two in‐principle statements about substituted judgment and, following an experimental vignette 

that varied the basis used by a patient’s surrogate to refuse life‐saving treatment, responses indicating how appropriate 

it would be to overrule the surrogate’s decision. 

RESULTS: Our response rate was 62% (1156/1875). Most physicians (78%) agreed that surrogate decision makers 

should base their decisions on substituted judgment rather than on what they believe is in the patient’s best interest 

when the two values are in conflict. Yet, a significant minority of physicians (40%) agreed with a statement expressing 

the opposite. In the experimental vignette, physicians were much more likely to oppose overruling a surrogate’s refusal 

of life‐sustaining medical treatment when that refusal was based on substituted judgment, compared to when the 

refusal was based on the patient’s best interest (50% vs. 20%; OR 4.2, 95% CI 2.7 to 6.3). Contrary to our hypothesis, 

responses to the inprinciple statements about substituted judgment were not consistently associated with responses to 

the experimental vignette. 

CONCLUSION: U.S. physicians largely agree, in principle, that surrogates should prioritize what the patient would 

have wanted over what they believe is in the patient’s best interest, although many physicians are ambivalent in cases 

in which the two norms conflict. Even physicians who reject the principle of substituted judgment tend to treat 

substituted judgment as the preferred norm for surrogate decision‐making when responding to a clinical vignette. 

IRB/IACUC: TBD 

Track: Social SciencesSubmitted for: MS2 S&D Block, MS4 S&D Work, Fentress 

Acknowledgements/Disclosures: This study was supported by a grant from the John Templeton Foundation, and The University of 

Chicago Calvin Fentress Fellowship supported my involvement. 


Inter-Observer Variability Regarding the Diagnosis 

of Bronchiolitis Obliterans Syndrome 

Atul Kapila 

MENTOR: Sangeeta Bhorade, MD, Department of Medicine, Section of Pulmonary and Critical Care 

CO-AUTHORS: Jerry Krishnan, MD, PhD 

BACKGROUND: Bronchiolitis obliterans syndrome (BOS), or chronic rejection, is the major limitation affecting 

long‐term survival in the lung transplant population. The current criteria used by clinicians in identifying BOS onset 

and severity is based on values of forced expiratory volume in 1 second (FEV1) obtained from pulmonary function 

testing. To our knowledge, no studies have formally evaluated the reliability or concordance of this definition. The 

purpose of this study is to determine a concordance rate among lung transplant experts, identify potential difficulties 

with the criteria, and discuss possible improvements. 

METHODS: Spirometric data from 181 patients enrolled in the AIRSAC trial were analyzed by 3 reviewers for the 

development of BOS. From the 35 discordant cases identified, 5 were selected, summarized with relevant clinical 

information, and formatted into a survey. The survey was sent to lung transplant experts around the world, and the 

results were analyzed for concordance. 

RESULTS: Eighty‐seven (47%) of the individuals who received the survey responded. Ninety‐five percent were 

pulmonologists with a mean of 12.2 years of experience in lung transplantation. The majority agreed with and felt 

confident in their ability to use the FEV1 criteria for BOS. An average discordance of almost 30% was observed over 

the five clinical scenarios. An average of 46% agreement regarding the time of BOS onset was noted among those who 

agreed upon the presence (or absence) of BOS. 

CONCLUSION: At least in a subset of patients, substantial discordance among clinicians exists in diagnosing BOS 

when using current guidelines based primarily on FEV1 values. This indicates that the definition likely needs further 

refinement to increase the reliability in identifying patients who have developed or are at risk for developing BOS. 

IRB/IACUC: 11-081Track: Clinical SciencesSubmitted for: MS2 S&D Block, MS4 S&D Work 

Acknowledgements/Disclosures: We would like to acknowledge the AIRSAC Investigators, The AIRSAC study was funded by Astellas 

Pharma, Inc. 


49

Intentional Sedation to Unconsciousness at the End of Life: 

Findings From a National Physician Survey 


MENTOR: Farr A. Curlin, MD, Department of Medicine, Section of General Internal Medicine & 

MacLean Center for Clinical Ethics 

CO-AUTHORS: John D. Yoon, MD, Kenneth A. Rasinski, PhD 

BACKGROUND: The terms “palliative sedation’’ and “terminal sedation’’ have been used to refer to both proportionate 

palliative sedation, in which unconsciousness is a foreseen but an unintended side effect, and palliative sedation to 

unconsciousness, in which physicians aim to make their patients unconscious until death. It has not been clear to what 

extent palliative sedation to unconsciousness is accepted and practiced by U.S. physicians. 

METHODS: In 2010, a survey was mailed to 2016 practicing U.S. physicians. Criterion measures included selfreported 

practice of palliative sedation to unconsciousness until death and physician endorsement of such sedation for 

a hypothetical patient with existential suffering at the end of life. 

RESULTS: Of the 1880 eligible physicians, 1156 responded to the survey (62%). One in ten (141/1156) physicians 

had sedated a patient in the previous 12 months with the specific intention of making the patient unconscious until 

death, and two of three physicians opposed sedation to unconsciousness for existential suffering, both in principle 

(68%, n=773) and in the case of a hypothetical dying patient (72%, n 1=831). Eighty-five percent (n=973) of physicians 

agreed that unconsciousness is an acceptable side effect of palliative sedation but should not be directly intended. 

CONCLUSION: Although there is a widespread support among U.S. physicians for proportionate palliative sedation, 

intentionally sedating dying patients to unconsciousness until death is neither the norm in clinical practice nor broadly 

supported for the treatment of primarily existential suffering. 

IRB/IACUC: TBA - Left Blank, No Human Research conductedTrack: Social SciencesSubmitted for: MS2 S&D Block, MS4 S&D 

Work 

Acknowledgements/Disclosures: This study was supported by a grant from the John Templeton Foundation. 


The Impact of Adverse Economic Conditions on Healthcare Demand 

Paul Riordan 

MENTOR: Gregory W. Ruhnke, MD, MS, MPH, Department of Medicine, Section of Hospital Medicine 

CO-AUTHORS: David O. Meltzer, MD, PhD, Christopher S. Lyttle 

BACKGROUND: Media reports have suggested that the demand for health care is resistant to market fluctuations, 

particularly for patients with health insurance, whose out-of-pocket payments compromise only a small proportion 

of total costs. To determine if the recent recession affected health care utilization, we examined the effects of variation 

in income and housing prices on the likelihood that patients with osteoarthritis of the knee would undergo knee 

replacement. We hypothesized that higher income and housing prices, before and after the recession, would be associated 

with an increased likelihood of knee replacement. 

METHODS: Claims data were extracted from the 2005-2010 MarketScan commercial claims and Medicare 

supplemental databases from a convenience sample of 20 metropolitan statistical areas (MSAs) for which detailed 

income and housing price information were available. These claims were linked to county-level percent change scores 

for annual per capita personal income and to MSA-level percent change scores for monthly Case-Shiller housing 

indices. Additionally, the claims were linked to 2008 area resource file data on the county-level density of orthopedic 

surgeons and total number hospital beds. The cohort was defined by patients with any claim for osteoarthritis of 

the knee who were continuously enrolled for four years. Using the Elixhauser Comorbidity Software, comorbidity 

indicator variables for 29 conditions were defined based on all outpatient and inpatient claims one year prior to the 

first osteoarthritis diagnosis. A fixed effects hazard model was constructed with the economic indicators entered as 

time-dependent covariates and other characteristics (orthopedic surgeon density, total hospital bed density, age, sex, 

comorbidities) as time-independent covariates. 

RESULTS: The cohort consisted of 202,932 patients with osteoarthritis of the knee, of whom 23,397 (11.53%) had a 

knee replacement for osteoarthritis. A 1% increase in income predicted a 3.9% greater likelihood of knee replacement 

(Hazard Ratio [HR]: 1.039 [95% Confidence Interval [CI] 1.036-1.042]), and a 1% increase in the CaseShiller Index 

predicted a 3.3% greater likelihood of knee replacement (HR: 1.033 [95% CI 1.024-1.042]). Greater density of 

orthopedic surgeons and hospital beds did not predict a greater likelihood of knee replacement, [compared to the 

lowest quartile; orthopedic surgeon density highest quartile 1.040 (0.965-1.121); total hospital bed density highest 

quartile 1.036 (0.964-1.113)]. 

CONCLUSION: Improved macroeconomic conditions are associated with increased demand for elective health care 

among a cohort of insured patients. Increased housing prices and per capita income both predicted a increased likelihood 

of knee replacement among patients with osteoarthritis, suggesting that elective procedures may be postponed during 

a recession. 



51

Infection Control for Anesthesia Providers: 

A Literature Review and Research Proposal 


MENTOR: David Glick, MD, Department of Anesthesia and Critical Care 

BACKGROUND: Iatrogenic post‐operative infections remain a significant healthcare system and patient burden 

despite advances in aseptic technique. While past research has focused on surgical site infections, recent contamination 

outbreaks involving propofol and hepatitis virus transmission suggest the anesthesia provider plays a large role in 

maintaining intraoperative sterility. These recent breeches in aseptic technique have helped improve education about 

the dangerous practice of reusing a syringe or medication vial on more than one patient. However, many other sources 

of bacterial transmission remain overlooked. 

The goal of this investigation is to a. compare and contrast intraoperative infection control guidelines for anesthesia 

providers in order to identify gaps and/or inconsistencies in policy recommendations b. review recent literature on 

potential sources of intraoperative infection transmission c. propose a novel investigation of syringe contamination 

based on insufficiencies in current guidelines and recent data. 

METHODS: The injection practice guidelines for the following major administrative organizations were reviewed and 

compared: Center for Disease Control (CDC), American Society of Anesthesiology (ASA), United States Pharamacopeia 

(USP), and the American Association of Nurse Anesthetists (AANA). Additionally, a literature review was performed 

using PubMed and the search terms “intraoperative contamination.” Only studies from the last 10 years were included. 

The following studies were excluded a. those lacking microbiological confirmation of contamination b. case reports c. 

those involving pre‐filled syringes not prepared directly by a healthcare provider d. those regarding contamination of 

propofol syringes (given its intrinsic bacterial growth‐promoting properties and distinct administration regulations) e. 

those involving single syringe use on multiple patients. A total of 9 studies were reviewed. 

RESULTS: While there was concordance among all administrative organizations regarding the re‐use of syringes on 

multiple patients and the preference for single‐use vials over multi‐use vials there were inconsistent findings on handwashing 

guidelines, re‐use of syringes for the same patient, and appropriate use of single‐use vials. A review of recent 

investigations on intraoperative contamination shows that the patient, the provider, and the environment are the 

most important contributors to IV access contamination. Noted contamination rates ranged from 13‐32%. Anesthesia 

workplace decontamination and provider hand hygiene improvements are the most promising avenues for reducing 

infectious transmission. 

CONCLUSION: This review suggests that intraoperative infection control guidelines for anesthesia providers should 

be revised to include a. intraoperative hand‐washing protocols b. directions regarding the re‐use of syringe on the same 

patient c. the appropriate timing and use of single‐use vials. Additionally, a review of recent literature suggests that 

the patient, the environment, and the provider all significantly contribute to intraoperative contamination. Improved 

anesthesia workspace decontamination and provider hand hygiene are promising points of intervention. These findings 

suggest that a novel investigation examining the correlation between syringe re‐use during extended surgical cases and 

internal syringe contamination is warranted to guide future infection control policies. 

IRB/IACUC: 12-1952Track: Clinical SciencesSubmitted for: MS4 S&D Work 

Acknowledgements/Disclosures: The University of Chicago John D. Arnold, MD Scientific Research Prize Recipient. 


Are All Vital Signs “Vital”? A Prospective Study of Nighttime 

Vital Sign Frequency and Risk of Clinical Deterioration 

Jordan Yoder 

MENTOR: Vineet Arora, MD, MAPP, Department of Medicine, Section of General Internal Medicine 

CO-AUTHORS: Trevor C. Yuen, Matthew M. Churpek, MD, MPH, Dana P. Edelson, MD, MS 

BACKGROUND: Sleep disruptions are prevalent among ward patients and are associated with a number of negative 

health outcomes, including elevated blood pressures and delirium. Overnight vital signs are an especially bothersome 

disruptor and can deplete crucial health care resources. While vital sign checks every four hours are often routine, there 

are limited data to support this level of monitoring for all ward patients. The Modified Early Warning Score (MEWS) 

has been used to identify high-risk patients for Rapid Response Team interventions. This study investigated whether 

evening MEWS could identify low risk patients who could forgo overnight vital signs. 

METHODS: We conducted a prospective cohort study of consecutive adult, inpatients at an academic institution 

between November 2008 and January 2011. All vital signs were extracted from the electronic medical record (EPIC, 

Verona, WI), and a MEWS was calculated for each set taken on the general floors, with median-value imputation used 

for incomplete sets. The MEWS most closely preceding 11pm each evening was used to stratify patients. The number of 

nighttime (11pm - 6am) disruptions for vital signs and adverse events (AE), defined as ICU transfers or cardiac arrests 

in the next 24 hours (11pm - 11pm), were compared across all MEWS. 

RESULTS: A total of 54,096 patients were included in the study, accounting for 182,828 patient-days on the wards 

and 1,699 AEs. The median evening MEWS score was 2 (IQR 1-2). The AE rate increased with increasing evening 

MEWS from a rate of 5.0 per 1000 patient days (when the MEWS was 0 or 1) to 157.3 (when the MEWS was greater 

than 6), p=0.003 for trend. However, the frequency of vital sign disruptions was unchanged, with a median of 2 vital 

sign checks per patient per night and at least one disruption for vitals 99% of the nights, regardless of MEWS category. 

Almost half of all nighttime vital sign disruptions (48%) occurred in patients with a MEWS of 0 or 1. 

CONCLUSION: Overnight vital signs are frequently collected in ward patients regardless of the patient’s risk of clinical 

deterioration. The MEWS identified a subset of patients who had significantly fewer adverse events, but had overnight 

vital signs taken at a similar rate as high-risk patients. This suggests nighttime frequency of vital signs for low risk 

medical inpatients could be reduced, potentially improving patient sleep without forsaking safety. A tailored approach 

would also enable reallocation of resources to monitoring higher risk patients more frequently. Further prospective 

study of the safety and benefit of personalized vital sign collection is warranted. 

IRB/IACUC: TBD - Left BlankTrack: Social SciencesSubmitted for: MS4 S&D Work, Fentress 

Acknowledgements/Disclosures: This research was funded in part by an institutional Clinical and Translational Science Award grant 

(UL1 RR024999). Dr. Edelson is supported by a career development award from the National Heart, Lung, and Blood Institute (K23 

HL097157-01) and has received research support from Philips Healthcare (Andover, MA) and Laerdal Medical (Wappingers Falls, NY), 

and has ownership interest in Quant HC (Chicago, IL), which is developing products for risk stratification of hospitalized patients. Dr. 

Churpek is supported by a National Institutes of Health grant (T32 HL 07605). Dr. Arora is supported by the National Institutes on 

Aging K23AG033763-04 and Jordan Yoder is supported by the Fentress Award from the Pritzker School of Medicine. The University of 

Chicago Calvin Fentress Fellowship Recipient. 


53

Presentation Notes

Scholarship d& Discovery Leadership 


Rachel Wolfson, MD 

Sujata Mehta, MA 

Scholarship & Discovery Tracks 

Applied Scholarship 

Community Health 

Deborah Burnet, MD, MAPP 

Kohar Jones, MD 

Global Health 

Brian Callender, MD, MPH 

John Schneider, MD 

Medical Education 

Jeanne Farnan, MD, MHPE 

H. Barrett Fromme, MD, MHPE 

Quality & Safety 

Julie Oyler, MD 

Lisa Vinci, MD, MS 

Basic Scientific Investigation 

David Boone, PhD 

Erika Claud, MD 

Scientific Investigation in Clinical or Social Sciences 

David Glick, MD (Clinical Research) 

Gavin Hougham, PhD (Social Sciences) 

V. Leo Towle, PhD (Clinical Research)

The annual Senior Scientific Session was founded in 1946 by Dr. Leon Jacobson to provide fourth 

d 

year medical students with a forum to present their research. Each year over 1/3 of the graduating class 

participate in this event. Student presentations and posters are judged by a panel of faculty members. 

2013 Panel of Faculty Judges: 

John Alverdy, MD 

Arshiya Baig, MD, MPH 

Matthew Brady, PhD 

Marshall Chin, MD, MPH 

Ronald Cohen, MD 

Andrew Davis, MD, MPH 

Harriet deWit, PhD 

Elbert Huang, MD, MPH 

dScott Hunter, PhD 

Oral Presentations By: 


Marcia Faustin 

Benjamin Ferguson, PhD 

Kiran Kumar 

Kelly Ledbetter 

d 

Kristen Knutson, PhD 

Peggy Mason, PhD 

Mark Musch, PhD 

Funmi Olopade, MD 

Sola Olopade, MD, MPH 

Tipu Puri, MD, PhD 

Lainie Ross, MD, PhD 

Stephen Small, MD 

Gabrielle Schaefer 

Rachel Stork 

Tarak Trivedi 

Joyce Woo 

William Zeiger, PhD 

Rajiv Agarwal 


Clifton Brock 

Valerie Chen 


Kevin Choo 

Michael Combs 

Amanda Gawin 


Poster Presentations By: 

Atul Kapila 


Samuel Lee 

Patrick Mann 

Rebecca Miller 



Katie Raffel 

Paul Riordan 


Sarah Todd, MAT 

Anne Toledo 




Wenlu Xiong 


Jordan Yoder 


At the University of Chicago, in an atmosphere of 

interdisciplinary scholarship and discovery, the Pritzker 

School of Medicine is dedicated to inspiring diverse students 

of exceptional promise to become leaders and innovators in 

science and medicine for the betterment of humanity. 

Front Cover: Images from the 2012 Senior Scientic Session

Senior Scientific Session Abstract Book - Pritzker School of Medicine

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