2018 Pilot Grant Recipients

Priscila Rodrigues Armijo, MD

Assistant Professor
Department of Surgery
University of Nebraska Medical Center

Project: Use of i2B2 to Examine General Surgery Outcomes in Rural and Urban Patient Populations: a Big Data Analysis (Poster Download)

Access to primary care physicians and the cost of care continue to be problematic in Nebraska, especially in rural areas of the state. The purpose of this study is to examine clinical and surgical outcomes in rural and urban patient populations using the Informatics for Integrating Biology & the Bedside (i2B2) platform to query data from our hospital electronic health record. Our hypothesis is that social disparities will exist between patients originating from rural and urban locations, despite receiving care in the same academic hospital, and that rural patients will have lower rates of follow-up and compliance. This study will be one of the first uses of Informatics of the i2B2 platform in the context of surgical outcomes with our hospital electronic health record, and will explore the feasibility of using this large database with long-term clinical and surgical outcomes. Information from this study will provide experience and background in order to springboard our study methodology to other medical institutions in the Great Plains Collaborative Network.

Angela AuBuchon, PhD

Director, Working Memory and Language Laboratory
Center for Childhood Deafness, Language and Learning Research
Boys Town National Research Hospital

Project: Testing the Validity of a new measure of rehearsal (Poster Download)

Commonly, adults “hear” inside their heads as they read. Adults also often use this internal speech to improve memory or regulate behavior. We know much less about how and when children use internal speech to remember and learn, although we suspect many children with learning disorders and behavior problems do not use internal speech well. The goal of this project is to test a new tool to measure children’s internal speech while they are trying to remember things. Surface electromyography (sEMG) uses electrodes that adhere to the skin like stickers and measure the electrical activity of neurons communicating with muscles—even when the muscle movement isn’t big enough to see. Once we can measure internal speech in a simple task—like short-term remembering, we can use this technique to examine children’s internal speech in more complicated tasks like reading and long-term learning. Then we can determine when internal speech is useful for children and test interventions that teach children to use internal speech in these situations.

Shannon Bartelt-Hunt, PhD

Professor
Associate Dean for Professional Development, Office of Graduate Studies
University of Nebraska-Lincoln

Project: Well Water, Farm Families and Better Health (Poster Download)

Rural communities face a variety of health disparities, one of which is their reliance on private wells for water. There are no regulations requiring water quality testing for private groundwater wells in Nebraska. A recent State of Nebraska report found that potentially 80% of private water supply wells may exceed the drinking water standard for nitrate. In this project, we will engage citizen scientists to monitor ground and surface water quality for nitrate across Eastern Nebraska. When nitrate contamination is identified in private water supply wells, we will follow up with analytical testing of the water quality and provide informational resources to farm families about how to treat their water. In addition to improving drinking water quality for farm families, this project will engage citizens and provide science-based education and resources enabling them to be more aware of their environment and the need for healthy water supplies.

Pi-Wan Cheng, PhD

Professor
Department of Biochemistry and Molecular Biology
University of Nebraska Medical Center

Project: Identification of aggressive prostate cancer based on high mannose N-glycans on PSA (Poster Download)

Prostate cancer ranks first in incidence and third in death for men with cancer in North America. Serum level of prostate specific antigen (PSA) has been used to screen for prostate cancer. But, this test shows poor specificity for clinically significant prostate cancer which leads to under-diagnosis of high-grade prostate cancer in patients with PSA level in the normal range and over-diagnosis of indolent prostate cancer in patients with PSA level outside the normal range. The inability to distinguish indolent from aggressive prostate cancer has resulted in over-treatment of many indolent prostate cancer, thus causing unnecessary treatment side effects in these patients and casting doubt on the usefulness of this test for screening purposes. There is a pressing need to develop a test that can distinguish indolent from aggressive prostate cancer to facilitate treatment decision, i.e. active surveillance for indolent cancer and immediate treatment for aggressive, but localized, prostate cancer. The goal of the proposed study is to develop a modified PSA test to distinguish indolent and aggressive prostate cancer based on concentrations of PSA decorated with high mannose (Man) N-glycans in urine and/or serum.

Arielle Deutsch, PhD

Assistant Professor
Department of Pediatrics
University of South Dakota Sanford School of Medicine

Project: Community-based understanding links between IPV and alcohol for American Indian women (Poster Download)

Although 100% preventable, fetal alcohol spectrum disorders are among the most common birth defects in the US – in part due to the average 10% of women who drink while pregnant. Research indicates that alcohol-exposed pregnancy may be predicted in part by a syndemic association between intimate partner violence, alcohol misuse, and unintended pregnancy. However, current interventions ignore the role of intimate partner violence in alcohol-exposed pregnancy, and other alcohol exposed pregnancy predictors. Given high rates of intimate partner violence in some American Indian communities, such interventions may be beneficial. The current project utilizes community-based participatory research and tribally based research approaches as innovative ways to better assess risk and facilitate development of interventions that target the cycle of alcohol misuse and intimate partner violence as a systemic etiology of alcohol-exposed pregnancy. To achieve this goal, we plan to develop community-based operational definitions of intimate partner violence, substance misuse, as well as assess community understandings of current needs for addressing these issues. Our community partner is a domestic violence shelter in a Northern Plains American Indian reservation.

Kyle Hackney, PhD

Assistant Professor
Health, Nutrition & Exercise Sciences
North Dakota State University

Project: Effects of eight weeks of concurrent exercise training and time-restricted feeding (16/8) on body composition, muscle endurance, metabolism, cardiovascular risk factors, and dietary intake in overweight, sedentary males and females (Poster Download)

New diet and exercise intervention techniques are required to help fight the overweight/obesity epidemic in the United States. Time-restricted feeding is an increasingly popular dietary approach because it does not require a restriction on energy intake (amount of food consumed). Instead, time-restricted feeding reduces the time window of energy consumption (example: 12:00pm-8:00pm) which facilitates a 16 hour fasting period (half of which an individuals may be sleeping). The purpose of this study is to (1) determine whether time-restricted feeding is an effective dietary strategy for reducing fat mass while preserving fat-free mass in combination with aerobic and resistance training. We will also evaluate changes in health-related biomarkers and hormone profiles.

Keyonna King, DrPH, MA

Assistant Professor
Department of Health, Promotion, Social & Behavioral Health
Center for Reducing Health Disparities
University of Nebraska Medical Center

Project: Get Your Mind Right: Feasibility of a mental health intervention for African American fathers in North Omaha (Poster Download)

The mental health treatments available for parents focused on prevention and treatment of mothers or families, but rarely was there a focus on fathers. Our proposed idea will use an existing parenting program for fathers to provide a mental health treatment for African American fathers with the intent of creating an effective treatment to screen, diagnosis, increase access to mental health services, and provide mental health treatment. The Fathers for a Lifetime (FFL) program, a 12-week educational program, is part of the Omaha Healthy Start (OHS) initiative. We will recruit African American men who live within the federally mandated areas of the OHS initiative. We will implement individual and group mental health treatment techniques. In addition, the men will receive three one-on-one therapy sessions with a Charles Drew Licensed Mental Health Professional (LIMHP) that will be completed by the end of the FFL program. By improving fathers’ mental health, we can expect to see improvement in daily functioning, parent-parent interactions, parent-child interactions, increase confidence in parenting skills, and a decrease in parental stress.

Kaylah Lalonde, PhD

Director, Audiovisual Speech Processing Laboratory
Center for Childhood Deafness, Language and Learning Research
Boys Town National Research Hospital

Project: Effects of Hearing Aid Compression on Temporal Cues in Audiovisual Speech (Poster Download)

Even when using hearing aids, many people with hearing loss have difficulty understanding speech in noisy environments. To help offset this difficulty, they often watch talker’s lips. The talker’s mouth movements provide information about timing cues in auditory speech. Unfortunately, the processing algorithms used in hearing aids distort the sound’s natural timing cues. This distortion means that mouth movements might not match the timing cues in the speech sounds. Therefore, hearing aid processing may decrease the benefit derived from watching the talker’s lips. The goal of this project is to investigate the impact of a certain hearing aid processing feature (called wide dynamic range compression) on the benefit derived from watching the talker’s lips. We expect that this hearing aid processing feature will decrease the match between auditory speech and the visual mouth movements that created it. If so, we expect that watching the talker’s mouth will be less useful for speech processed with this hearing aid feature. We propose to do two kinds of tests to figure out how much the hearing aid processing feature causes mismatches in the auditory and visual timing cues and which mismatches affect our ability to benefit from the visual mouth movement cues. First, we will use a computer to process speech so that it sounds like it is going through a hearing aid and to identify auditory-visual mismatches. Second, we will test normal hearing listeners to see how the processed speech affects their ability to use the visual mouth movement cues. This study will improve our understanding of how a widely used hearing aid processing feature affects auditory-visual speech perception. This line of research will help audiologists to decide which hearing aid settings will best optimize face-to-face speech communication in noisy environments.

Maital Neta, PhD

Assistant Professor
Department of Psychology
University of Nebraska-Lincoln

Project: Brain Connectivity for Prediction of Lesion Site in Sports-Related Concussion (Poster Download)

Each year, thousands of adolescents and young adults experience sports-related concussion (SRC), a form of mild traumatic brain injury. The lack of a reliable biological signature or marker of the injury has hampered progress in identification, management and treatment of this injury. Although a mild injury by definition, the consequences can be profound if not identified and managed properly. Thus, there is critical need to identify reliable biomarkers of injury that afford better understanding of injury severity, with the goal of promoting better outcomes. Magnetic resonance imaging (MRI) has begun to show promise for detecting these brain changes. In this project, we will complete pre-season baseline MRI of all rostered football players. Subsequently, those who sustain concussion will be invited for follow-up testing post-injury and again at recovery. This work will implement a novel analytic approach to MRI that examines both the structure and function of brain networks, in order to triangulate on brain areas impacted by the injury. In other words, this approach considers the information flow between brain regions, and how differences in brain circuitry and location of injury predict outcome. These sophisticated techniques are expected to, for the first time, draw a link between these mechanisms and differences in clinical outcome.

Timothy Nelson, PhD

Assistant Professor
Department of Psychology
University of Nebraska-Lincoln

Project: Developing executive control, obesity risk, and behavioral health problems: A pilot fMRI study (Poster Download)

Obesity and behavioral health problems are among the most prevalent and costly conditions in the United States today, with each posing critical challenges for the health and productivity of the nation. Deficits in executive control (EC), a critical set of cognitive abilities for directing attention and behavior, have been proposed as modifiable contributors to both obesity risk and behavioral health problems; however, the role of EC deficits in the development of these problems is not well-understood. There is a critical need for studies that elucidate the EC-obesity and EC-behavioral health relationships within rigorous studies incorporating brain imaging techniques to explore connections between brain and behavior. The current study will explore these connections among young adults ages 18-19, including undergraduate students and individuals who have participated in a long-term longitudinal study. Participants will complete two tasks in the MRI scanner at the University of Nebraska-Lincoln, including one task that involves reducing appetitive response to appealing food images and another task that involves reducing emotional response to negative images. Resting state MRI data will also be collected. The data collected will facilitate analyses exploring associations between brain responses, EC, and clinical outcomes.

Shireen Rajaram, PhD

Assistant Professor
Department of Health Promotion
University of Nebraska Medical Center

Project: Planning Summit -- Feasibility of Training/Education of Tattoo Artist in Sex Trafficking Prevention (Poster Download)

Women who are sex trafficked within the U.S., often are made to have tattoos such as bar codes, a dollar sign or the name of the trafficker – the person who is selling them for sex. Tattoo artists may routinely encounter a sex trafficking survivor while she is being trafficked. As front-line professionals, they are in a unique position to detect, identify, and report of any abuse, including sex trafficking. The aim of this community based participatory pilot project is to engage the tattoo artist community in Nebraska to determine the feasibility of training/education on prevention of sex trafficking including the content and preferred mode of training on sex trafficking.

Alicia Schiller, PhD

Assistant Professor
Department of Anesthesiology
Director of Combat Casualty Medicine
University of Nebraska Medical Center

Project: Development of Real-time Clinical Data Visualization Tools through User-Centered Software Design (Poster Download)

Shock accounts for 10% of all ICU admissions, 20-30% of hospital deaths, and 15.4 billion in annual health care costs. Patients suffering from life-threatening conditions can progress quickly from a physiological state of compensation to overt clinical shock with only minor changes in traditional vital signs. Consequently, identifying and predicting through these stages is paramount for optimal clinical intervention. Current medical monitoring technologies focus on mean, time-averaged values that are only visualized for short periods of time (seconds/minutes), hindering trend identification and prediction. Visualization of longer segments of clinical data is touted as a viable solution to this problem. This study will explore a novel data visualization model developed from real-time ICU patient information, with input from ICU healthcare professionals to guide our agile/user-centered software design process.


Co-PI’s : Martina Clarke, PhD Cardiology, University of Nebraska Medical Center; Kate Cooper, PhD and Ann Fruhling, PhD, Information Science and Technology, University of Nebraska Omaha

Myra Schmaderer, PhD, MSN, RN

Assistant Professor
College of Nursing
University of Nebraska Medical Center

Project: Self-Management Intervention Using Mobile Health for the Multimorbid (Poster Download)

Multimorbidity (2 or more chronic illnesses) affects over one in four Americans. Self-managing multimorbidity is complex and challenging. This study evaluates the impact of two mobile health self-management interventions (m-Health and mHealth plus virtual visits with a nurse practitioner and community health worker team) using an app on a mobile device compared to usual care. This telehealth intervention addresses a specific priority area for the IDeA-CTR by evaluating new technologies and models to improve health care access to multimorbid individuals in the community. We will evaluate these intervention procedures as well as examine the impact of these interventions compared to standard care on adherence to disease specific lifestyle behaviors, health related quality of life, patient-reported health status, symptom status and healthcare utilization.

Jamie Scholl-Bushman, MS

Researcher, Center for Brain and Behavioral Research (CBBRe)
Basic Biomedical Sciences
University of South Dakota

Project: Gut Microbiota and Immune Markers in Psychological Health (Poster Download)

There has been a growing emphasis on the relationship between gut microbiota and the immune system, and deviations have been shown to directly influence responses that potentially affect mental health outcomes. A direct association between behavior profiles such as anxiety and depression, the composition of the gut microbiota, basal levels of CRP and cytokines, cortisol and genetic predisposition has been proposed, and this research will focus on identifying the relationships between these factors. By collecting measures of depression, anxiety, and immune function and combining survey and laboratory results, we will be able to further explore alternative relationships as they arise, and adjust the hypothesized relationships in order to retest the data. Understanding these relationships will help to determine direct future research in assessing causal direction between all of these factors that can promote mental well-being, and could in the future be used as biomarkers for vulnerability to mental illness, and even help re-think how we treat mental health disorders.


Co-PI’s : Gina Forster, PhD, Basic Biomedical Sciences, University of South Dakota

Gary Schwartz, PhD, MPH, PhD

Chair, Population Health
School of Medicine & Health Sciences
University of North Dakota

Project: Identifying Women at High Risk for Ovarian Cancer Using Routine Lab Results (Poster Download)

The high fatality of ovarian cancer is due to its late stage at diagnosis. At diagnosis, women with malignant ovarian tumors have significantly higher serum calcium and lower albumin than women with benign tumors (Kelly et al, Cancer Epidem Biomark Prev 2015,24:1593). Because these differences likely develop gradually, changing calcium and albumin levels over time may detect ovarian cancer earlier. We will conduct a case-control study comparing serum calcium and albumin levels over 2-3 years. We hypothesize that relative to controls without ovarian cancer, women with ovarian cancer will show significant increases in serum calcium and decreases in serum albumin.

Lynette Smith, PhD

Assistant Professor
Department of Biostatistics
University of Nebraska Medical Center

Project: Time to Event Prediction Based on Risk Calculation from Longitudinal Biomarkers using Bayesian Hierarchical Changepoint Mixture Models (Poster Download)

Pancreatic cancer (PC) is an extremely aggressive malignancy with 5-year overall survival rate of <8%. While identification of patients at a resectable stage results in increased patient survival, PC patients are often diagnosed at late stages due to the asymptomatic nature of PC. Biomarkers are needed that can be used to screen individuals for PC during the asymptomatic period in order to detect disease and predict survival rate. Longitudinally measured biomarkers can show a variety of trends over time. Most control subjects show little to no change in biomarkers, but cancer patients with progressive disease could reflect either no change or rapid changes in biomarkers prior to diagnosis of cancer or prior to death from the disease. Hence, the rate of change in biomarker levels, in combination with the absolute level of the biomarker, could better predict presence/progression of disease and patient survival. The aim of this project is to develop methodology for a Bayesian changepoint mixture model could be used to effectively predict patient survival or time to recurrence.

Raluca Simons, PhD

Assistant Professor
Department of Psychology
University of South Dakota

Project: An Experience Sampling Study of Sleep, PTSD, and Alcohol (Poster Download)

In this study, we test the effectiveness of a readily accessible sleep intervention to reduce sleep disturbance, PTSD, and alcohol use among rural veterans. We also try to understand temporal associations between sleep, posttraumatic stress disorder and alcohol misuse (i.e., are sleep difficulties a consequence of PTSD/alcohol misuse OR are sleep difficulties precursors that exacerbate PTSD/alcohol misuse?). Addressing these issues is crucial because sleep difficulties have been shown to be highly resistant to traditional treatment modalities for PTSD and sleep impairment is a risk for alcohol relapse and worsening symptoms in mental health diagnoses.

Saraswathi Viswanathan, PhD

Assistant Professor
Department of Cellular & Integrative Physiology
University of Nebraska Medical Center

Project: Assessing the Link between TP-R and Obesity-associated Insulin

The overall focus of our laboratory is to determine the role of obesity in modulating the pathogenesis of type 2 diabetes and cardiovascular disease. Obesity is a growing worldwide concern, and the mechanisms by which it leads to other metabolic disorders such as insulin resistance, dyslipidemia, and non-alcoholic fatty liver disease are still unclear. Adipose tissue (AT) is a storage reservoir for excess energy in the form of triglycerides (TGs). In addition to storing TGs, AT secretes several factors called adipokines into the plasma which, in turn, regulate glucose and lipid metabolism. It is becoming clear that AT-inflammation impairs the storage and secretory functions of AT thereby leading to other metabolic disorders. While arachidonic acid-derived eicosanoid metabolites regulate several physiological and pathological processes, their role in modulating inflammation as it relates to metabolic syndrome is not clear. In the current translational project, we collaborate with Drs. Cyrus Desouza and Corrigan McBride, to determine the potential of AT thromboxane-prostanoid receptor (TP-R), an eicosanoid receptor, as a biomarker and/or a therapeutic target for obesity-associated metabolic disorders, in particular, insulin resistance.

Don Warne, MD, MPH

Director, Indians into Medicine
University of North Dakota

Project: Targeting Avoidable Admissions and Non-Emergent ED Visits within Rural and Urban Populations

Within the framework of alternative payment models, provider systems within the state of North Dakota are working in partnership with the state's major insurance companies and programs to better achieve the Institute for Healthcare Improvement (IHl)'s Triple Aim: improving population health, providing high quality care, and reducing costs. We will be developing an algorithm to identify patients in need of coordinated primary care, mental/behavioral health and pharmacy services, for patients using (high cost) preventable emergent services. This project will facilitate targeted efforts within regional provider systems to improve levels of health literacy and patient engagement within this high risk population. Rural areas have higher rates of uninsured, low-income, Medicaid and elderly Medicare beneficiaries and are more likely to be facing shortages of primary care providers than urban areas. Primarily due to barriers to accessing care, rural residents have a greater potential to use the emergency room for non-emergent purposes and have higher rates of potentially preventable hospitalizations. Identifying high risk populations such as rural and Medicaid populations will unveil significant opportunities to improve quality and lower costs.

David Warren, PhD

Assistant Professor
Department of Neurological Sciences
University of Nebraska Medical Center

Project: Targeted transcranial magnetic stimulation to improve hippocampal-dependent declarative memory abilities (Poster Download)

Memory is critical for us to function independently and to maintain our sense of identity, but memory abilities can decline due to age or disease. In our research project, we will test whether a clinically-significant decline in memory — called amnestic mild cognitive impairment (aMCI) — can be treated using a form of non-invasive brain stimulation called transcranial magnetic stimulation (TMS). We will measure brain structure, brain function, and memory ability before and after a one-week course of TMS, and based on prior work with healthy young adults we predict improvements in memory abilities. If our predictions are correct, we will work to apply our methods to treat memory impairment in other patient groups.

Christopher Wichman, PhD

Assistant Professor
Department of Biostatistics
University of Nebraska Medical Center

Project: Are Linear Models Sufficient for Analyzing Adolescent BMI z-scores: a comparison of methods for right skewed data

Childhood obesity is currently considered one of the most serious public health problems. The states included in the Great Plains IDeA-CTR Network (NE, ND, SD and KS) are estimated to have one of the highest national percentiles of 2-19 year olds classified as overweight or obese. My research looks at the most appropriate ways of analyzing Body Mass Index (BMI) z-score data. BMI z-scores are measures of relative weight adjusted for child age and sex. Due to inclusion criteria in a number of comparative studies that require participants to have a minimum BMI percentile of 85%, the data tends to be skewed right. This calls into question whether the appropriate models are being used for these measurements. Success of this pilot will provide a more precise representation of BMI z-score data.

Jon Youn, PhD

Professor
College of Information Science & Technology
University of Nebraska Omaha

Project: Development of a Wearable Intelligent System for Elderly (WISE) with fall risk

Clinical studies show that more than one-third of adults aged 65 years and older fall each year. Of those who fall, 20 to 30 percent suffer moderate to severe injuries that reduce mobility and independence, increase the risk of premature death, and result in increased health care costs. There is an urgent need to develop assistive technologies for preventing falls and enable the elderly to maintain the highest level of functioning possible for independent living. Therefore, in the study, we will develop an innovative and comprehensive mobility monitoring system, called Wearable Intelligent System for Elderly (WISE), with efficient data gathering and intelligent gait analysis methods for predicting mobility issues and falls to provide a clinically useful, at-home solution to monitor the elderly to ensure their safety and well-being.

Chi Zhang, PhD

Associate Professor
Biological Sciences
University of Nebraska-Lincoln

Project: Predictive modeling and visual analytics of radiotherapy on pancreatic cancer treatment, diagnosis, and prognosis

Ductal pancreatic adenocarcinoma is the fourth most common cause of death due to cancer in the United States. Although some new front-line chemotherapy/radiotherapy regimens have modified the landscape of therapy for pancreatic cancer, such as Stereotactic Body RadioTherapy (SBRT), there remain several problems, such as not every patient responds to all therapies and treatment. In this project, by applying the latest technology and methods in artificial intelligence, visualization, and computational systems biology to clinical images and data, we propose a mathematic model on pancreatic tumor growth and shrinkage to predict tumor response underwent SBRT and utilize deep-learning method for auto-segmentation. If successful, these models and methods can have direct clinical impacts on pancreatic cancer radiotherapy, such as to facilitate clinical decision making, so that the patients could receive the most effective treatments with the least toxicity.