Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine


Collaboration Roundtable

February 2, 2009


POSTER ABSTRACTS


Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine


Hemoglobin, nutrition, inflammation and the environment: at the crossroads of global health. Thomas Adamkiewicz, Jacqueline Hibbert, Beatrice E Gee, Adel Driss, Kwaku Asare, Jonathan Stiles Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Morehouse School of Medicine - Postdoctoral Training in Genomics and Hemoglobinopathies Program (MTGHP). Hemoglobinopathies affect disproportionately minorities in the US and significant portions of the global population, mostly residing in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine countries with low incomes. The MTGHP, funded by NIH/Fogarty, recruits and trains postdoctoral fellows from underrepresented US minority populations, particularly those affected by hemoglobinopathies over a period of two-three years Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. MTGHP includes international (University of Ghana; Sickle Cell Trust, Jamaica) and local collaborators (Emory and Medical College of Georgia). Members of the MTGHP group conduct laboratory, clinical and population-based studies that examine interactions between Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Sickle Cell Disease (SCD) and nutrition, inflammation, vascular biology, susceptibility to infection and possible therapeutic interventions. Recent studies examined the relationship of resting energy expenditure with inflammation in patients with Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine SCD,[1] allocation of the increased metabolic demand,[2] as well effect of high protein diet on the inflammatory response in SCD mouse models.[3] Determinants of vascular injury are being elucidated, with demonstration, for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the first time, of the enhanced vasculogenic potential at steady-state in patients with SCD.[4] These may serve as markers of disease severity. Population based studies examined the nature of increased susceptibility to pathogens Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, methods of prevention,[5] and their possible global impact. In addition to the effect of nutrition,[1-3] other therapeutic modalities explored include stem cell translation modalities,[6] and interaction between chronic transfusion iron overload Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine toxicity, inflammation and hemolysis.[7] With the participation of fellows, the program is currently laying the groundwork for SCD population based screening to determine reliable markers of disease severity in the context of complex Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and diverse environments, including hitherto seldom examined populations (Tunisia) as well as in Ghana. In summary, the aim of this program is to cultivate outstanding researchers who will strive to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine improve care of individuals both burdened by hemoglobinopathies and resource disparities, while exploring critical, but neglected interactions of human biology that possibly affect large segments of the global population. 1. Hibbert, Hsu, Bhathena, et al Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Proinflammatory cytokines and the hypermetabolism of children with SCD. Experimental Biology & Medicine 2005 2. Hibbert, Creary, Gee, Buchanan, Quarshie, Hsu. Erythropoiesis and myocardial energy requirements contribute to the hypermetabolism of childhood Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine SCD. Journal of Pediatric Gastroenterology & Nutrition 2006 3. Archer, Stiles, Newman, et al. C-reactive protein and interleukin-6 are decreased in transgenic sickle cell mice fed a high protein diet. Journal of Nutrition 2008 4. Gee Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine BE, Manlove-Simmons JM, Huang Y, Wilson N, Stiles J, Ofori-Acquah S. Dominant Role for SDF-1 in the Vasculo-Angiogenesis Phenotype in Children with SCD. ASH/Blood 2008 5. Adamkiewicz, Silk, Howgate, et al Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Effectiveness of the 7-valent pneumococcal conjugate vaccine in children with SCD in the first decade of life. Pediatrics 2008 6. Adamkiewicz, Szabolcs, Haight, et al. Unrelated cord blood transplantation in children with SCD: review of four Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-center experience. Pediatric Transplantation 2007 7. Adamkiewicz, Abboud, Paley, et al. Iron Overload in Children with SCD on Prophylactic Chronic Transfusion. Submitted 2009


Submitted by: Holly Avey, Georgia State University, Georgia Health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Policy Center


Georgia Health Policy Center: Founded in 1995 and housed within the Andrew Young School of Policy Studies, the Georgia Health Policy Center is focused on providing the best possible quality of research Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and information. Competencies: Core competencies include: knowledge creation and management; consensus building; grants management; health systems change; and knowledge transfer. Because of these core competencies, our staff has extensive experience, skills and knowledge Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in conducting evidence-based research and program evaluation, convening and engaging diverse stakeholders, empowering local communities, providing targeted technical assistance and strategic support, and disseminating research and best practices information through briefs Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, reports, and publications. Our Work: The Center provides evidence-based research, program development and policy guidance on local, state and national levels to improve health status at the community level. Projects Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine have focused on: • Public and private insurance coverage • Long-term care and end-of-life care improvement • Children’s health and well-being • Rural and community health system development • Social determinants of health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Research Initiatives: Strengthening Public Health Infrastructure through Public Health Institutes - examine the overall capacity of existing Public Health Institutes (PHIs), assess the potential for mature PHIs to provide technical assistance to emerging institutes Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, and explore the contextual conditions in states without statewide PHIs. Collaborators: Centers for Disease Control and Prevention, National Network of Public Health Institutes PeachCare for Kids Evaluation - conduct the annual evaluation of Georgia Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine's health insurance program to serve low-income children. Collaborator: Georgia Department of Community Health Cancer Regional Programs of Excellence Evaluation - assess the cancer control planning work carried out by Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine nine grantees seeking designation by the Coalition as Regional Programs of Excellence. Collaborator: Georgia Cancer Coalition Program Efforts: HRSA National Technical Assistance – provide technical assistance to 198 community network and outreach grantees Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in 49 states. Collaborator: Health Resources and Services Administration’s Office of Rural Health Policy Building Strong Families - help couples strengthen their relationship, achieve a healthy marriage if that is the path they choose, and thus Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine enhance child and family well-being. Collaborators: Annie E. Casey Foundation, Association for Child and Family Services Policy Initiatives: Finding the Voice of Public Health in the National Health Reform Dialogue Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine - explore ways that public health issues might become part of the reform debate. Extensive research, interviews and фокус groups, and convenings throughout the country resulted in a model that engages stakeholders at Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine every level as instruments of reform. Collaborator: Centers for Disease Control and Prevention Legislative Education Initiative –developed the Legislative Health Policy Certificate Program, a comprehensive, policy-relevant, educational initiative to improve health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine policy decision making capacity. A system dynamics model for childhood obesity was developed to enable more rigorous discussions of policy alternatives. Collaborator: Robert W. Woodruff Foundation Partners and Collaborations: We Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine recognize the evolving nature of our work and experiences. We learn from our clients, our communities, and partners. We actively seek partners to further the Center’s mission of improving health status. We are Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine open to new ideas, approaches and partnerships and want our work to reflect our emergent knowledge and experiences.


Submitted by: Bernard Beall, CDC


This is perhaps a non-conventional approach, but Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine if allowed, our poster will probably simply consist of a panel of recently published and submitted abstracts from the CDC Division of Bacterial Diseases Streptococcus Lab. We feel that this would probably be the most Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine convenient and efficient way convey our current research interests.


Submitted by: Elizabeth Buffalo, Emory University School of Medicine


HIPPOCAMPAL ACTIVITY REFLECTS RECOGNITION MEMORY ON A TRIAL-BY-TRIAL BASIS M. J. JUTRAS1,2, P Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. FRIES3, E. A. BUFFALO2,4 1Neurosci. Program, Emory University, Atlanta, GA; 2Yerkes National Primate Research Center, Atlanta, GA; 3FC Donders Center For Cognitive Neuroimaging, Nijmegen, Netherlands; 4Department of Neurology, Emory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine University School of Medicine, Atlanta, GA Recognition memory depends on the integrity of the medial temporal lobe (MTL). Although previous neurophysiological studies have reported recognition memory signals in the monkey MTL, it has Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine been difficult to examine whether these signals correlate with performance because monkeys are typically overtrained to perform at high levels, resulting in very few error trials. To address this issue, hippocampal spikes Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and local field potentials (LFPs) were recorded from multiple electrodes in two monkeys performing the Visual Preferential Looking Task (VPLT). This task relies on the monkey’s innate preference for novelty, and therefore requires Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine no specific training. Additionally, this task elicits variations in performance that allow for an examination of the relationship between trial-to-trial fluctuations in recognition memory and neuronal activity. Out of 131 single Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine units, 100 (76%) responded significantly to stimulus presentation, and the firing rate of 31% of these neurons was significantly modulated by stimulus novelty. Importantly, this modulation was positively correlated with trial-to-trial variations in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine performance, such that increased neuronal responses to novelty predicted better memory performance (median correlation coefficient = .40, p<.001). We also examined phase synchrony in the gamma-frequency band, which has previously been Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine associated with successful memory performance (Fell et al., 2001). Across trials in a session, we found a significant positive correlation between gamma-band spike-field synchrony during encoding and subsequent memory performance (median Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine correlation coefficient = .25, p<.001). Taken together, these results provide direct evidence linking hippocampal activity with recognition memory performance on a trial-by-trial basis.


Submitted by: George Carlone and Sandra Steiner, CDC


Research Interests and Capabilities in the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Immunology Laboratories George Carlone, Sandra Steiner, Jacquelyn Sampson, Gowrisankar Rajam, Cheryl Elie, and Edwin Ades Immunology Laboratories, Meningitis and Vaccine Preventable Diseases Branch, Division of Bacterial Diseases, NCIRD Abstract Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine: The Immunology Laboratories, (1) Integrates laboratory and epidemiologic approaches to enhance the diagnosis and surveillance of agents causing respiratory, meningococcal and other priority bacterial infections, (2) Develops, evaluates, implements, and improves serologic, immunologic and molecular biologic methods Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, techniques and strategies, (3) Develops and evaluates vaccines and vaccine candidates that protect against priority bacterial diseases, (4) Conducts, participates, and collaborate in vaccine clinical trials, (5) Develops, standardizes and validates correlates Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of protection and applies to the evaluation of new and developed priority bacterial agents, (6) Develops new diagnostic reagents and methods including the development, maintenance and evaluation of hybridomas, (7) Develops and evaluates immunizing agents Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and studies the role of immunologic mechanisms in disease processes, (8), Operates and maintains a research laboratory at the Good laboratory Practice (GLP) compliance level in support of vaccine clinical trials, (9) Maintains the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine World Health Organization Collaborating Center for Research and Reagents for Human Immunoglobulin Subclasses, and (10) Supports global access to vaccines by providing reference materials, standardized protocols training, and consultative support to other government agencies, international Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine collaborators including domestic and international reference laboratories, vaccine manufactures, academic institutions, The World Health Organization, and the Pan American Health Organization.


Submitted by: Corinne Crammer, American Cancer Society


Cancer Survivors’ Spiritual Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Well-Being and Use of Mind-Body Complementary Therapies: The Effects of Race and Gender Corinne Crammer PhD, MDiv, MM; Kevin Stein, PhD; Chiewkwei Kaw, MS; George Fitchett,DMin; Youngmee Kim, PhD; and Cristina Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Stephens, PhD PURPOSE: Little is known about the relation between cancer survivors’ spirituality and their use of complementary therapies, specifically, mind-body methods (MBM). We examined this association and explored the effects Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of race and gender on this association. METHODS: We analyzed data from 3,903 cancer survivors who completed the American Cancer Society’s Study of Cancer Survivors-I, a population-based, longitudinal Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine study of quality of life. Participants completed this survey approximately 1.25 years after diagnosis. Three aspects of spirituality – Meaning, Peace, and Faith – were assessed using the FACIT-Sp. Mind-body methods (MBM) were Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine divided into spiritual/religious (MBM-S) and non-spiritual/religious (MBM-NS). The race by gender moderating effects were tested for four groups: Black Male (BM), White Male (WM), Black Female (BF Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine), and White Female (WF). Demographics, cancer severity, and health status served as covariates. RESULTS: Generalized linear model revealed that survivors who were younger, more educated, had more severe cancer, or poorer Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine general health were more likely to use MBM. Meaning and Faith were positively associated with overall MBM use, whereas Peace was negatively associated. Meaning was significantly related for BM (OR=1.287) and WF (OR Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine=1.057); Faith, for BM (OR=1.247), WM (OR=1.221), and WF (OR=1.255); and Peace was negatively associated for Whites only (WM, OR=0.916; WF, OR=0.931). For MBM-NS use, Meaning was positively related for females (BF Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, OR=1.250; WF, OR=1.051), and Faith, for Whites (WM, OR=1.065; WF, OR=1.052). For MBM-S use, Meaning was positively related for BM only (OR=1.338), whereas Faith was strongly and positively associated for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine all gender-racial groups. Peace was negatively associated with MBM-S for Whites only (MW, OR=0.852; FW, OR=0.882). The p-values for all reported ORs were <0.05. CONCLUSIONS: Spiritual well-being is associated both positively Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and negatively with the use of MBM. Associations differ based on gender and race. RESEARCH IMPLICATIONS: Causality between variables and the mechanism for differential effects of race and gender on the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine spirituality and MBM use should be further explored. CLINICAL IMPLICATIONS: Survivors’ spirituality impacts the likelihood of their use of MBM. White survivors using spiritual MBMs may be experiencing low levels of spiritual Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine peace, but this association was not found for Black survivors. ACKNOWLEDGEMENT OF FUNDING: ACS intramural.


Submitted by: Edward Timothy Davies, Dept. of Biochemistry, University of Georgia


The Bioexpression and Fermentation Facility is a molecular biology Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, protein and biomass production facility offering services and training to the University of Georgia research community, academic researchers, and private industry. The BFF provides custom services in molecular biology Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine; vaccine development; antibody and protein expression and purification; process development; and production of biological materials and metabolites, from laboratory to pilot-scale. The BFF comprises the BioXpress laboratory, providing molecular biology, small scale protein Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine expression and purification services; the Fermentation Research Facility, which is equipped with 23 bioreactors ranging from 1L to 800L and is designed to cover aspects of the biomanufacturing from process development Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine through scale up and production; the Protein Purification Laboratory, which conducts large scale protein purification process development and production; and the BSL3 Cell Culture Laboratory which is designed for the production of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine proteins using mammalian cells in a high quality high containment setting. Our mission is to provide researchers with state of the art instrumentation and expertise to accelerate research from gene identification through Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine process development, scale-up, and manufacturing. Our services include confidential fee-for-service research tailored to your exact research needs, utilization of BioXpress equipment by your research personnel, and training in our academic Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine laboratory setting.


Submitted by: Gene Demchuk, ATSDR, CDC


Computational Toxicology in Public Health: the Present and the Future The Agency for Toxic Substances and Disease Registry (ATSDR) Computational Toxicology and Method Development Laboratory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine implements the full range of methods in support of ATSDR mission to protect human populations from exposure to environmental contaminants. These include benchmark dose, chemical-specific adjustment factor, physiologically-based pharmacokinetic/pharmacodynamic, quantitative structure Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-activity relationship, genetic-susceptibility- and meta-analysis modeling, and modeling the toxicity of chemical mixtures. Computational toxicology methods are used as an integrated systematic approach in the development of ATSDR Minimal Risk Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Levels to be used as health guidance values to protect populations exposed to toxic chemicals at hazardous waste sites. These methods are also used in the development of ATSDR Toxicological Profiles Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, to support environmental health consultations and prioritization of environmental chemical hazards, when experimental information is insufficient, and to improve study design, when filling the priority data needs as mandated by the Congress Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Also, the Laboratory is engaged in the development of response strategies to new emerging chemical threats, such as toxicology of nano-materials, and emerging techniques in the area of hazard Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine identification and risk assessment, including characterization of personalized biomarkers, personalized and population genomics, and immunotoxicology.


Submitted by: Andrew Dent and Stephanie Foster, Geospatial Research, Analysis and Services Program, CDC


Background: The Geospatial Research, Analysis, and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Services Program (ATSDR/CDC) provides expert advice and assistance with the application of geospatial science and spatial analysis tools. GRASP scientists utilize US Census data, health outcome data, and environmental data to evaluate Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine geospatial relationships between health outcomes and risk factors. Highlighted Projects: > Avian Influenza Surveillance Collaborators: NCZVED GRASP is tracking animal H5N1 cases compiled from the Office International des Epizooties (OIE) and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine other reports for DEOC briefings to senior leadership. >Population Vulnerability Index (PVI) Collaborators: NCEH/ATSDR, Office of Terrorism Preparedness and Emergency Response PVI is designed to assess the vulnerability of populations Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine to all-hazard events based on a combination of economic, household, transportation, and language Census attributes. >Patna, India Hospital Service Area Assessment Collaborators: NCIRD, Global Immunization Division GRASP is estimating population Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine within hospital service areas of Patna, India to enable the efficient distribution of health services. >Modular Photographic Observational Device (ModPOD) Collaborators: NCEH/DEEHS/International Emergency and Refugee Health Branch, Georgia Tech Research Institute Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine GRASP/GTRI developed the ModPOD, a low-cost, high resolution imaging device that produces georeferenced images for rapid assessment of complex humanitarian emergencies. >Barriers to Mammography Clinic Access in Metropolitan Atlanta Collaborators: NCCDPHP/Division Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of Cancer Prevention and Control, Susan G. Komen For the Cure GRASP is using MARTA route data to evaluate time and distance barriers confronting disadvantaged populations attempting to access mammography screening facilities Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in metropolitan Atlanta. >Emergency Preparedness and Response Collaborators: Director’s Emergency Operations Center GRASP provides maps and consulting on the use of geospatial data to respond to public health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine emergencies. >Systems Integration and Applications Collaborators: Multiple GRASP develops and/or supports web/desktop applications that facilitate the investigation and analysis of disease dispersion, environmental exposure, and health care access. Conclusion: With expertise in demographic Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine analyses, medical geography, epidemiology, exposure assessment, contaminant modeling, and emergency preparedness/response GRASP is poised to engage in new collaborative ventures that integrate a geospatial component into public health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine research.


Submitted by: Duc Do, Mercer University


Novel Nanotechnology Platform for Oral Delivery of Vaccines

Martin J. D’Souza, Tuhin Bhowmik, Bernadette D’Souza, Neil J. Patel, Naser M. Uddin, Prathap Nagaraja Shastri, Lipika Chablani, Archana Akalkotkar Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, Duc Do, Suprita Tawde

Mercer University, Nanotechnology, Cancer & Vaccine Laboratory, Atlanta, GA 30341


We, at the Nanotechnology, Cancer and Vaccine Laboratory at Mercer University, Atlanta, have developed a platform technology using nanospheres and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine microspheres to deliver vaccines by the oral route of administration, specifically in the form of a capsule containing the bead-like encapsulated vaccine antigens. This formulation technology enables us to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine prepare microspheres and nanospheres containing biologically active compounds, such as vaccine antigens and protein drugs, without loss of their biological activity during the formulation process. We can also encapsulate multiple antigens, targeting Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine agents and drugs in a single particle. Using our novel method, the vaccine prepared exists in a dry stable form. These bead-like particles containing the antigen can be administered either orally Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine or systemically. When administered orally, these spheres have an enteric coating to protect from the acidic environment of the stomach. The enteric coating dissolves in the basic environment of the intestine and the vaccine is Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine targeted to the Peyer’s patches and the general mucosal immune system. Since these particles are particulate in nature, ranging between 0.05-2.0 microns in size, they are taken up by phagocytic antigen presenting Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine cells (APC's), such as M cells and macrophages in the Peyer's patches of the intestines, and the antigen is presented to the lymphocytes, which are responsible for antibody Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine production. Since these nanospheres/microspheres release the antigen (payload) intracellularly into the APC's, a higher antibody response to the encapsulated antigen is obtained. Of particular interest in this formulation is Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the fact that the microspheres release the antigen in a slow and sustained manner over a prolonged time period, resulting in strong mucosal and systemic immunity after oral administration, without the need for adjuvants. Since Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine no needles are required, this method of vaccine delivery is inexpensive and suitable for the developing world as well as for the developed world. Preliminary studies conducted in our Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine laboratory with TB, typhoid, melanoma, and hepatitis B vaccine antigens suggest that this delivery system is highly suitable for antigens to be used for protective immunity. This method of vaccine delivery enables us to address Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine a wide spectrum of vaccines for prophylactic and therapeutic use. Melanoma tumors are widespread in the southeastern United States. We have been working on the “Evaluation of an oral Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine encapsulated melanoma tumor vaccine” as a collaborative research project, funded by the Georgia Research Alliance, with Dr. Periasamy Selvaraj from Emory University. We are currently also working on another grant funded by the Georgia Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Research Alliance in collaboration with Dr Sang-Moo Kang from Emory University on the “Formulation and testing of oral nano-encapsulated influenza vaccines”. We have also just received a grant from the Georgia Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Cancer Coalition for “Nanosphere based targeted oral vaccines for breast cancer”. We hope to obtain some encouraging results specifically in terms of generating a strong immune response after oral Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine vaccination.


Submitted by: Anne Fitzpatrick, Emory University


Severe asthma in children is a complex disorder characterized by ongoing symptoms and extreme morbidity despite aggressive treatment with high-dose inhaled and oral corticosteroids. Although Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the pathophysiology of severe asthma is complex and not well understood, symptoms are thought to result from persistent airway inflammation and oxidant stress, with respiratory infection as a major trigger. Once infected, asthmatics have more Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine severe lower respiratory tract infections with greater symptom persistence. The underlying biological mechanisms responsible for this aberrant response to respiratory infection in asthmatic children are unclear. Through clinical and translational research Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine studies, my research program is focused on the cellular and biochemical derangements in the lung that are associated with severe asthma in children. We have previously demonstrated unique differences in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the airway environment of children with severe asthma characterized by increased reactive oxygen species formation, lipid peroxidation, and loss of the protective antioxidant, glutathione (GSH). We have further shown impairment of alveolar macrophage (AM Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) function in children with severe asthma evidenced by decreased phagocytosis of pathogenic bacteria and increased AM apoptosis which are restored by GSH treatment. These data suggest that oxidant stress and GSH depletion may Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine regulate the response to respiratory infection in children with severe asthma. While the broad, long-term goal of this research is to better understand the molecular mechanisms associated with respiratory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine infection, airway symptoms and AM dysfunction in children with severe asthma, we also hope to utilize these data to develop novel antioxidant therapies to improve airway innate immune defenses in this population Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine.


Submitted by: Stephanie Foster and Andrew Dent, Geospatial Research, Analysis and Services Program, CDC


^ See poster abstract listed previously for Andrew Dent


Submitted by: Eric Gilbert, Georgia State University


Constructing Polymicrobial Biofilms with Defined Cell Compositions Bryan Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Stubblefield, Kristen Howery, Wendy Cardenas and Eric Gilbert Biology Department, Georgia State University, Atlanta, GA 30303 Multiple antibiotic resistant biofilms may potentially develop from bacteria that benefit one another via complementary Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine antibiotic detoxification. We determined that two strains of Escherichia coli could establish a biofilm by simultaneously inactivating inhibitory concentrations of ampicillin (Amp) and spectinomycin (Spt). An asymmetry existed in the detoxification Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine efficiency of the two strains; thus we predicted that varying their ratios at the substratum would influence the ability of a biofilm to form. To test this hypothesis, the areal cell density of each Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine strain at the onset of biofilm formation must be controlled. To accomplish this, we recirculated cells suspended in 50 mM phosphate buffer for up to 4 h through parallel plate flow cells and enumerated Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine cells attached to the substratum by confocal microscopy. Amp-resistant cells were labeled with green fluorescent protein and were visually distinct from red-stained Spt-resistant cells. A linear relationship was observed between Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the cell density of the recirculated suspension and the areal density for each strain alone. Following the reproducible attachment of the initial population, the second strain of cells could Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine be linearly introduced into the flowcell, forming a monolayer at the biofilm substratum with defined cell composition. We will use this approach to investigate the effect of substratum cell composition on the development of mature Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine polymicrobial biofilms.


Submitted by: Jason Goldstein, Centers for Disease Control, Division Scientific Resources/NCPDCID


The Biologics Branch within the Division of Scientific Resources provides the CDC Laboratories with expertise devoted to Quality System Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Essentials (QSE) and current Good Manufacturing Practices (cGMP) in development, production, and distribution services. In addition to a large variety of services and products (cell lines, commercial/custom buffers and growth media Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine), the Branch provides reagents that are customized to infectious organisms and agents. These include 1) biologics inventory management and distribution services, 2) pilot-scale reagent and in-vitro diagnostic device production Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, and 3) the development and manufacturing of novel gene products, protein reagents and diagnostic assays. We provide a custom service for the development of novel polyclonal and monoclonal antibodies through our Hybridoma Facility. The Protein Science Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Team provides and characterizes antigen preparations for selective immunizations as well as screening for selection of clones. Our expertise is focused in the affinity purification and biochemical characterization of immunoglobulin classes Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine from mouse, rabbit, goat and human sources. Within the Laboratories for Gene Expression, Protein Production and Analytical Biochemistry, we фокус on recombinant antigen and protein projects through various prokaryotic and eukaryotic expression systems Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. We employ new and classical biochemical methods for the isolation, purification and characterization of antibodies, recombinant proteins and native antigens. Our biochemical analysis elucidates protein structure and functionality, post-translational processing Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, and macro-molecular complexes. We maintain a Biosafety Level 3 Laboratory with clinical, diagnostic, training, research and production capabilities where work is performed on microorganisms that may cause serious or potentially lethal Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine disease. The Quality Assurance Program within DSR has developed and implemented Quality Manufacturing Systems for the production of biological reagents and in-vitro diagnostics. Under the Program’s guidance our laboratories ensure the highest Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine quality services and reagents for our collaborators and clients.


Submitted by: Gerardo Gutierrez-Sanchez, University of Georgia


The molecular mechanisms that determine survival, differentiation and movement in multicellular organisms Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine are dependent on interactions with the extracellular matrix (ECM). Cells in tissues are structurally and functionally integrated with their surrounding ECM via numerous dynamic connections. This matrix is composed of a variety Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of macromolecules that are secreted locally and assembled into an organized meshwork in close association with the surface of the cell that produced them. Two main classes of extracellular macromolecules make up Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the matrix: (1) polysaccharide chains of the class called glycosaminoglycans (GAGs), which are usually found covalently linked to protein in the form of proteoglycans, and (2) fibrous proteins, including collagen, elastin, fibronectin, and laminin, which have both Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine structural and adhesive functions. The most common GAG structures are chondroitin sulfate (CS), dermatan sulfate (DS), heparan sulfate (HS), keratan sulfate (KS), hyaluronic acid (HA), and heparin. A major Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine function of cell surface proteoglycans is in cell adhesion and migration, dynamic processes that are mediated through interactions between the proteoglycans GAG chains and extracellular matrix components, such as laminin, collagen, and fibronectin. Proteoglycans Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine also occur as integral components of basement. Substantial evidence has accumulated over the last decades, indicating that GAG chains can impact cancer progression either positively or negatively. GAG chains, through binding Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and regulation of a formidable number of ligands, are important mediators of tumor cell and normal cell behaviors such as proliferation, differentiation, migration and adhesion. Therefore, many researchers are interested in this class Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of carbohydrates because of their roles in various cell surface phenomena such as cell– cell interactions, cell adhesion, and tumor metastasis. To elucidate these phenomena, it is essential to identify Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the biological molecules that recognize these carbohydrates and characterize quantitatively the interaction between the carbohydrates and their recognition molecules. To do so requires immobilization of carbohydrates, often on microtiter plates. We believe that immobilization on Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine SPR chips provides a route to a much more quantitative of GAG-receptor interactions. The importance of the chemistry chosen to immobilize heparin to perform protein binding experiments using SPR has Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine been previously demonstrated (Osmond et al., 2002). Results suggest that immobilizing heparin to a surface via multiple intrachain modifications of the heparin molecule can affect the binding of particular heparin-binding Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine proteins. In our laboratory we have developed an appropriate method by which the pectin or GAG is biotinylated through the reducing end and bound to the surface of the SPR chip. This provides Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine a surface with a relatively “native” presentation of the GAG chains. Using this approach, we have successfully biotinylated different types of GAGs for conjugation to SPR chips. We present some examples of the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine use of SPR technology and this GAG immobilization chemistry to study protein-GAG interactions.


Submitted by: Brantley Herrin, Emory University


The jawless vertebrates, lamprey and hagfish, possess a second type of adaptive Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine immunity that utilizes variable lymphocyte receptors (VLRs) composed of leucine-rich repeat (LRR) modules for antigen recognition, rather than immunoglobulin-based receptors. In the germ-line configuration, the two VLR genes (VLR-A and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine VLR-B) contain only invariant N-terminal and C-terminal sequences separated by a non-coding intervening sequence, however, they are flanked by hundreds of LRR gene segments. During lymphocyte development Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, the LRR gene segments are randomly and sequentially copied into the incomplete VLR gene to assemble a potential repertoire of >10^14 distinct antigen receptors. Immunization with particulate antigens induces VLR-B+ lymphocytes to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine divide and differentiate into plasmacytes that secrete multivalent VLR-B ‘antibodies’ composed of 8 – 10 disulfide-linked uniform subunits. Antigen-specific VLR-B clones are isolated by screening the tissue culture supernatants of HEK Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-293T cells transfected with VLR-B cDNA library plasmids for antigen binding. Monoclonal VLR-B antibodies can distinguish between antigens with 90% sequence identity and retain antigen binding capability after exposure to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine extremes of temperature and pH. Sequence analysis, mutagenesis, and crystal structure analysis have demonstrated that the antigen-binding site resides in the beta-sheets of the LRR subunits and a loop Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine contributed by the LRR-CT region. The specificity, avidity, and stability of these unusual LRR-based monoclonal antibodies suggest they will have many biomedical uses.


Submitted by: Robert (Jeff) Hogan, University of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Georgia


Significance of caveolin 1 and clathrin in SARS coronavirus replication T. Jelesijevic1, E.W. Uhl1 and R.J. Hogan2. 1Department of Pathology, 2Department of Radiology and Anatomy, University of Georgia Athens, Georgia Severe Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine acute respiratory syndrome (SARS) is characterized by influenza-like symptoms and severe disease of the lower respiratory tract. It is caused by a positive-sense, single-stranded RNA virus (SARS coronavirus Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, SARS-CoV). SARS-CoV replication cycle is highly complex, and the mechanism(s) of pathogenesis remain unclear. With this in mind, we employed an RNA interference (RNAi) based approach to investigate which cellular proteins are Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine involved in successful viral replication. The gene silencing was based on activation of polyprotein complex Ribonuclease Inducing Silencing Complex (RISC) with double stranded small interfering RNAs (siRNAs). The RISC, guided by Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine sense/antisense sequences of siRNAs, bind and cleave cellular mRNAs and results in decreased translation of targeted cellular genes. Using siRNAs targeting 125 membrane trafficking and 50 nuclear receptor genes, we performed a Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine set of experiments in vitro using Vero E6 cells and 3 different strains of SARS-CoV. Our initial results identified several cellular genes that may be important for viral replication. Among the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine genes identified, caveolin1 and clathrin appeared to be critical in the virus life cycle. When transfected with both caveolin1 and clathrin siRNAs, between 60% - 80% of Vero cells survived while the survival rate for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine infected, non-siRNA treated cells was from 10- 20%. Ongoing studies are aimed at investigating whether failure of SARS-CoV replication is at the point of entry or during the final stages of viral assembly and release Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine.


Submitted by: Baoming Jiang, CDC


Rotavirus is the most common cause of severe dehydrating diarrhea in young children and is responsible for over 500,000 deaths per annum. The two newly licensed live oral Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine vaccines (LOV), RotaTeq® and Rotarix®, have been demonstrated effective against severe rotavirus diarrhea among children in developed and mid income countries. However, the efficacy of neither vaccine has been demonstrated among children Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in resource-poor countries where a vaccine is needed most. Preliminary results of the ongoing immunogenicity and efficacy trials of the two vaccines in Asia and Africa have raised concern Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine that either vaccine may not provide adequate protection in these settings. In addition, safety of these vaccines (e.g., intussusception and pneumonia) remains a concern as well. We have pursued inactivated rotavirus vaccine (IRV Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) as a backup strategy for LOVs. IRVs have several potential advantages. They are more uniformly reliable than oral vaccines when used in different settings. They would be less costly to test since Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine intussusception is not an issue. They could be combined with other parenteral EPI vaccines and more easily delivered to children throughout the world. Finally, they do not replicate so their efficacy Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine should be free of interference from maternal antibody in the gut, a problem that may inhibit the take of LOVs. We have conducted studies in monkeys and children and demonstrated that serum IgG is Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine either an effector or a proxy against rotavirus infection and disease. These studies have established proof of principle for the protective role of serum antibody. We have developed human Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine rotavirus vaccine pre-seed strains with specificity to major serotypes and demonstrated robust growth in cell culture and high yields. We have developed a novel, safe and robust method that effectively inactivates rotavirus but Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine maintains the integrity of virus particles. Our IRV when formulated with adjuvant aluminum and administered intramuscularly induces a strong serum antibody response in mice and macaques and protects against oral Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine challenge in gnotobiotic piglets. Currently we are looking for a jointly collaborative effort to examine and compare the immunogenicity and protective efficacy of intramuscularly and subcutaneously administered IRV in animal models.


Submitted by: Alison Kelly Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, CDC/Coordinating Office for Global Health


CDC is currently developing a global health research agenda to complement and support its global health strategic plan. Input is being sought on high-priority, high-impact Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine research questions which are evidence-based, cross-cutting, relevant, unique, scientifically feasible, and actionable. Categories of research under development include: intervention scale-up, maternal and newborn health, global public health capacity development Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, policy change, surveillance system enhancement, social determinants of health, technology development, epidemiologic and etiologic. Participants in this poster session will have an opportunity to review CDC's work to date Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine on the development of its global health research agenda and provide input to further develop and refine the agenda.


Submitted by: Kim Klonowski, University of Georgia


An effective long-term vaccine against influenza Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine virus has not yet been achieved. One problem contributing to the ineffectiveness of flu vaccines is the deterioration of memory CD8 T cells from the lung airways early after infection. While Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine a secondary pool of memory cells continue to be recruited to the site, these cells represent inferior replacements. IL-15 is a cytokine important for the maintenance of CD8 memory cells and in other systems Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine can induce lymphocyte migration. We believe that deficiencies in the levels of IL-15 or the types of cells recruited by IL-15 is responsible for the lack of protection in the airways. Our Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine studies using IL-15-/- mice demonstrate that IL-15 is important for maintenance of flu-specific memory CD8 T cells in distinct locales. In vitro migration studies suggest that IL-15 may be important Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine for migration of CD8 T cells. RT-PCR studies also confirm that IL-15 is differentially regulated after flu infection. Together these data suggest a role for IL-15 in controlling multiple aspects of memory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine CD8 T cell responses to flu infection. (NIH grant AI077038 (KDK)).


Submitted by: Zsuzsanna Kuklenyik, CDC/NCEH Division of Laboratory Science


On-line coupling of a microfluidic enzyme reactor with Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine reverse phase chromatography and mass spectrometry detection for quantitative measurement of protein toxins Zsuzsanna Kuklenyik,a Shyam Aravamudhan,b Anne E. Boyer,a Paul Joseph,b and John R. Barra Centers for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Disease Control and Prevention, Division of Laboratory Sciences Georgia Institute of Technology, Micro Electronics Research Center Atlanta, GA The enhanced sensitivity and speed is a well established inherent feature of miniaturized sample preparation platforms Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine because of increased specific interface, reduced diffusion distance and reduced diffusion time. These inherent features can be exploited for “micro total analysis systems” or “laboratories-on-chips” where all components of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine sample analysis, analyte purification, liquid handling, analyte detection, and data analysis can be performed in an integrated and automated fashion on microfabricated chips. The purpose of this on-going project is Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the development of an integrated microfluidic platform that is capable of performing sensitive and specific enzymatic assays for detection of protein toxins. The platform is designed to capture the protein toxins using Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine antibodies cross linked to magnetic beads. The magnetic beads are loaded into chambers containing NiFe micro strips. The alignment of the beads inside the channels along the NiFe strips prevents clogging and high back pressure Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, avoiding a major drawback of packed bed microfluidic reactors. At the current proof-of-concept stage, the microfluidic reactor was connected in-line with a liquid chromatography-tandem mass spectrometry (HPLC Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-MS/MS) analysis system, where the enzyme reaction products are continuously collected on a HPLC column. Following the enzyme reaction, the products are automatically eluted from the HPLC column and detected Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine by MS/MS. This project is collaboration between the Microelectronics Research Center at Georgia Institute of Technology where the fabrication work was performed, and the Division of Laboratory Sciences at National Center for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Environmental Health where the prototypes were tested for measurement of anthrax lethal factor.


Submitted by: Amrita Kumar, Emory University School of Medicine


Commensal enteric bacteria, which can also be used as probiotics Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, positively affect epithelial barrier integrity after injury. Restoration of epithelial barrier functions following injury requires epithelial cell migration also referred to as restitution. Cell migration in turn is dependent on dynamic Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine turnover of focal cell-matrix adhesions (FACs). The mechanisms by which commensal bacteria regulate cell migration after injury are however not understood. Thus, our objective was to define such mechanism(s). We Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine show that in vitro interaction of cultured model epithelia with the commensal bacterial strain Lactobacillus rhamnosus, resulted in significant increase in cell adhesion, spreading and wound closure. This was associated with phosphorylation Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine/activation of key FAC proteins, focal adhesion kinase (FAK) and paxillin within 5 minutes of bacterial contact. Furthermore, bacterial colonization of cultured epithelial cells resulted in rapid and reversible generation of reactive oxygen species (ROS), that Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine mediated oxidative inactivation of a FAK phosphatase, PTEN, thus inducing sustained FAK activation. These observations demonstrate that commensal/probiotic bacteria modulate epithelial barrier recovery by stimulating ROS production that consequently modulates Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the phosphorylation of FAK.


Submitted by: Anh Le, Emory University


BIOMARKERS OF CARDIOVASCULAR DISEASE Ngoc-Anh Le, PhD Associate Professor of Medicine Director, Emory Lipid Research Laboratory Emory University and Atlanta VAMC The Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine research interest of our group in biochemical markers of cardiovascular disease. In addition to original research, our laboratory has the capacity to provide core laboratory services for other investigators as well as Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine multicenter trials. We provide basic lipid/apolipoprotein measurements including lipoprotein subclasses by NMR as well as specialized assays of inflammatory markers (hsCRP, Lp-PLA2, TNF, IL6, IL10, etc…), and of lipoprotein-associated oxidation Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (oxLDL, TBARS, nitrotyrosine-modified proteins, oxidative susceptibility of isolated lipoproteins). In addition to working with human plasma, our laboratory can also support lipid/lipoprotein research in animals. Using a semi-automatic FPLC Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine system we can isolate individual subclasses of lipoproteins for composition analysis from as little as 200 l of whole plasma. We are currently supporting research in patients with CAD, diabetes mellitus Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, obesity, NAFLD, CKD, stroke, and HIV. In our research, we are фокус on meal-induced changes in oxidative stress in humans. Using a number of different assays we have reported in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine vivo evidence for the direct generation of oxidatively modified epitopes in the plasma of patients with documented CAD following the consumption of a standardized fat-containing meal. We have subsequently demonstrated that this response Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine is specific for the highly oxidizable polyunsaturated fatty acids and could not be demonstrated with meal enriched in saturated or monounsaturated fatty acids. We are currently evaluating interventions that may modulate meal Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-induced oxidative stress in humans.


Submitted by: Keri Lubell, CDC


Background: CDC’s risk communication strategy for public health emergencies is developed by CDC’s Emergency Communication System (ECS) as health threats are emerging Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and/or emergency response is required. ECS strategy is based on communication science and rapid assessment of public knowledge, attitudes, and behaviors (KABs) related to both the nature of the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine emergency and the particular health threat. Assessing public concerns and beliefs about the threat is critical to development of an effective communication response. During emergency health threats, ECS’ Research Team conducts daily scans of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine traditional news media stories (print, internet, and television), blogs, and public inquiries to CDC INFO (phone calls and e-mails). Based on our analysis of these materials, we identify key news themes Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine that may affect public perceptions of the emergency and influence adherence to public health recommendations. We also highlight critical information gaps, points of possible confusion or misinformation, pressing public Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine information needs, and potentially important issues likely to emerge in coming days. A daily report summarizing this assessment is used by ECS leadership as the foundation for CDC’s emergency communication strategy Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine development. Process: The poster presents 1) the overall data collection approach we use to identify relevant news stories from multiple media outlets in each 24-hour cycle, 2) how we tailor the process to фокус Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine more on local outlets where affected groups are most likely to look for credible information and health guidance, 3) how we conduct a systematic “content analysis” to generate the findings summarized in the daily Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine report, and 4) examples from recent events and activations. Conclusion: The rapid and ongoing nature of the assessments compiled in the daily report helps ensure that agency messaging is responsive to the public’s Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine information needs as the situation evolves. It thereby enhances ECS’ ability to create effective emergency communication messages that can influence public beliefs, attitudes and knowledge related to health threats.


Submitted Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine by: Marguerite Madden, University of Georgia


GIS and Remote Sensing for Infectious Disease Studies Marguerite Madden, Thomas Jordan, Janna Masour Center for Remote Sensing and Mapping Science (CRMS) Department of Geography, UGA and Joseph Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Corn, David Stallknecht Southeastern Cooperative Wildlife Disease Study College of Veterinary Medicine, UGA The University of Georgia’s (UGA) Center for Remote Sensing and Mapping Science (CRMS) has worked cooperatively with Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the UGA Southeastern Cooperative Wildlife Disease Study (SCWDS) on a number of projects involving the use of remote sensing, geographic information systems (GIS) and Global Positioning System (GPS) technologies in support Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of wildlife infectious disease studies. All projects involve the visualization of disease occurrences or landscape analysis including vegetation mapping, 3D terrain analysis and landuse change to assess environmental factors influencing disease outbreaks. Specific examples include Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine: • Mapping distributions of exotic ticks known to be the vectors of diseases to animals and humans; • Assessing U.S. feral swine distributions and spatial coincidence with domestic swine populations Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine; • Spatial patterns of wildlife associated with dairy farms for Johne’s Disease in Georgia and Wisconsin; • Deriving spatial data sets for logistic regression linking West Nile virus live bird surveillance in Georgia to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine environmental and climatic variables; and • Spatio-temporal analysis and modeling of a 20-year database of nation-wide county surveys on reports on hemorrhagic disease in white-tailed deer (Odocoileus virginianus). Our current Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine cooperative effort involves the development and implementation of a web-based mapping interface that allows state and regional wildlife experts to access and edit a map of U.S. feral swine Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine distributions. Procedures were developed for wildlife managers to view the map of feral swine populations superimposed on satellite image data in Гугл Maps. The images provide a geographic reference for uses to add new Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine populations, delete areas where feral swine have been removed and change map lines to reflect current swine distributions. The edited feral swine map is submitted to SCWDS for review and quality control checking Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine via a password protected web site. As soon as the quality control is complete, the up-to-date map is quickly posted back to the website. The intent of this Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine project is to provide local experts with easy-to-use geospatial tools to continually revise feral swine maps and assist farmers who must take precautionary measures to prevent the spread of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine infectious diseases from feral swine to their domestic stock.


Submitted by Michael McNeil, CDC


Title: The Vaccine Analytic Unit (VAU): A Collaborative Vaccine Safety Research Infrastructure Using the Defense Medical Surveillance System (DMSS Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) Michael M. McNeil MD MPH1, Susan K. Duderstadt MD MPH1,2, Theresa M. Real PhD1,2, 1Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, 2Logistics Health Incorporated Abstract Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Background: The VAU is a collaboration between CDC, DoD and FDA to assess unusual, longer term anthrax vaccine adverse events utilizing the DMSS. The VAU is a critical component of the CDC Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine’s Anthrax Vaccine Safety and Efficacy Research Program. Attributes: The DMSS is an active surveillance system administered by the DoD to integrate data from miltary treatment facilities, vaccination centers Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, and military personnel offices worldwide. Inpatient and outpatient diagnosis data are coded using ICD-9-CM codes. The DMSS is a valuable resource for investigating vaccine adverse events. The DoD also maintains a Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine serum repository, which holds great potential for the assessment of specific identified adverse events for biologic plausibility and possible causative mechanisms. Population: All U.S. active duty and reservist service personnel. Project Description: The Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine VAU’s research agenda was established with input from the NVAC. Completed research activities include quality assessments of immunization data in DMSS, database hypothesis testing studies (optic neuritis, concurrent vaccinations Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, type 1 diabetes mellitus, and atrial fibrillation), and a pilot hypothesis generation/data mining study to evaluate a possible association of concurrent vaccinations and military hospitalizations. Ongoing and planned activities include hypothesis testing studies with medical Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine chart diagnostic validation (Stevens Johnson syndrome, diffuse connective tissue diseases), database studies (unintentional injuries, autoimmune thyroid disease), data mining studies including an evaluation of Rapid Cycle Analysis for vaccine adverse event Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine monitoring in DMSS, and a seroepidemiologic study of vaccine-associated Guillain Barré syndrome. Current Status: The VAU has increased understanding of the safety profile of anthrax vaccine and complements other post Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-marketing vaccine safety systems (Vaccine Adverse Event Reporting System and the Vaccine Safety Datalink). Importantly, the VAU provides a platform for the conduct of timely investigations of vaccines administered in the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine DoD population which have critical implications for “civilian” public health.


Submitted by: Ross Molinaro, Emory University


We have developed and validated a novel liquid chromatography-tandem mass spectrometry (LC-MS/MS) method for the identification Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and quantitation of iothalamate in biological samples to better assess renal function by calculating glomerular filtration rate (GFR). Current methods using iothalamate to calculate GFR have long run times and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine lack the analytical sensitivity allowing a reduced iothalamate dosage. After the addition of iohexol as the internal standard, iothalamate is isolated from plasma by methanol extraction and urine by quick-spin filtration. Gradient chromatographic Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine separations were performed on a reversed-phase dC18 column using an ammonium acetate/formic acid mobile phase. Iothalamate demonstrated a reproducible elution time of 0.8 minutes while iohexol, the more non-polar compound Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, consistently eluted from the column at 0.9 minutes. Both iothalamate and iohexol were monitored in the multiple-reaction monitoring (MRM) mode (Waters Quattro Micro) using the hydrogen adduct mass transitions. Primary Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (614.5>360.5, iothalamate; 821.6>652.3, iohexol) and secondary (614.5>486.5, iothalamate; 821.6>730, iohexol) ion ratios were calculated as an additional check of compound specificity. This method requires only a 3 minute run-time per sample. The iothalamate standard curve for plasma and urine Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine displayed a wide measuring range with linearity up to 600 µg/mL and a limit of quantitation at 18.75 ng/mL. Acceptable precision (CVs ≤ 9.3 %) was demonstrated by both within-run and between Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-run experiments using drug-free plasma and urine spiked with known low, medium, and high concentrations of iothalamate. Ion suppression was tested by sample addition and infusion assays. Recovery from plasma and urine Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine samples ranged from 93.6% to 104.1%. Accuracy was assessed using 50 urine and plasma samples tested by LC-MS/MS and an accepted capillary electrophoresis (CE) assay. The equations of the linear regression lines Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine were; UrineLC/MS/MS = 0.959×UrineCE – 1.351, (r = 0.98, SY/X = 11.2); PlasmaLC/MS/MS = 1.064×PlasmaCE – 0.317, (r = 0.89, SY/X = 0.94); GFRLC/MS/MS = 1.005×GFRCE – 5.264, (r = 0.92, SY/X = 10.3). GFR was calculated using the patient’s urine flow rate and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine plasma and urine iothalamate values. We have developed and validated a fast, accurate LC-MS/MS assay to calculate GFR in patients that can serve to determine renal efficiency in potential Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine kidney donors. In addition, the sensitivity of this assay holds promise for allowing a smaller dose of iothalamate to be administered to patients thereby reducing the chances of iothalamate hypersensitivity.


Submitted by Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine: Teresa Morrison, CDC


Asthma Prevalence by Urban-Rural Status — United States, 2005 Teresa A. Morrison, D. Callahan, J. Moorman, C. Bailey Background: Approximately 20 million persons in the United States have asthma. Identifying populations Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine with high asthma prevalence focuses resources to reduce disease burden. Although geographically narrow studies suggest that asthma prevalence is higher in urban versus rural areas, a multi-state urban-rural comparison has not Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine been done. We analyzed data from a national survey to determine prevalence by urban-rural status. Methods: We linked the 2005 Behavioral Risk Factor Surveillance System (BRFSS) to Urban Influence Codes (UIC Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) from the U.S. Department of Agriculture. BRFSS is an annual state-based telephone survey that uses a disproportionate stratified sampling plan to collect health data from non-institutionalized adults. In 2005, all 50 states asked about Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine asthma. UICs categorize counties based on population size and adjacency to metropolitan areas. We classified these UIC categories into four groups (metropolitan, adjacent-metropolitan, micropolitan, and remote) to define Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine urban-rural status. By using SUDAAN, we calculated weighted estimates for complex sample design and multivariate logistic regression to generate adjusted odds ratios (ORs) for the association between current asthma and urban-rural status while Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine controlling for sociodemographic and health behaviors. Results: Overall asthma prevalence was 7.9% (95%CI=7.73–8.08). Although asthma prevalence was highest among micropolitan residents (8.6%; 95%CI=7.84–9.36) and lowest among metropolitan residents (7.8%; 95%CI=7.65–8.05), prevalence across urban-rural Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine categories was not statistically different (p<0.28). After we adjusted for sociodemographic and health behaviors, adjacent metropolitan (OR=0.91; 95%CI=0.85–0.97) and remote (OR=0.87; 95%CI=0.78–0.98) residents were less likely to report current asthma compared to metropolitan Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine residents. Conclusions: Current asthma prevalence is as high in rural areas as in urban areas. Characteristics unique to residence impact disease burden. Allocating resources to address these environmental influences may Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine reduce asthma prevalence.


Submitted by: Mary Ohmer, Georgia State University


Title: Building Community Capacity to Prevent Violence: Findings from a Pilot Project to Facilitate Collective Efficacy among Residents (Ohmer, M., Warner, B., & Beck Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, E.) Research demonstrates that collective efficacy, including social cohesion/trust and the willingness of neighbors to intervene in neighborhood problems and inappropriate behaviors, is associated with lower levels of community crime and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine violence (Morenoff, Sampson, & Raudenbush, 2001; Sampson, Raudenbush, & Earls, 1997). This poster presents findings from a training project designed to facilitate collective efficacy and informal social control among residents. The program taught residents skills to directly intervene Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in inappropriate neighborhood behaviors in a respectful and supportive manner, using the principles of restorative justice; and taught residents consensus organizing strategies for building trusting relationships with other residents and external Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine stakeholders, thus enhancing social cohesion/capital; and helping residents identify and establish community norms supporting prosocial behavior and mutual trust. The program took place in Thomasville Heights, a low-income neighborhood in Atlanta Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, and consisted of six 90 minute sessions involving a combination of lecture, discussion, role plays and homework. Sixteen participants were recruited who were active in their community and/or were interested Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in gaining skills in community violence prevention. Data were collected using quantitative and qualitative methods, including a pre- and post training survey. Participants’ average length of neighborhood residency was 6.5 years; most were African American Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (93%) and female (69%). Half completed high school/GED, 38% some college, and 12% a college and/or graduate degree. Only 25% were employed full-time, and the rest were retired or disabled (19%), and unemployed or Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine full-time students (13%). Most participants also had low-incomes (65% earned less than $20,000/year). The survey asked participants about their attitudes toward intervening (@=.81), likelihood of and confidence in intervening in a variety of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine hypothetical situations, and what they were most likely to do when they intervened. Results were analyzed quantitatively using paired samples t-tests, and qualitatively according to themes. One way significance tests were conducted, as Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine it was hypothesized that the training would improve participants’ attitudes towards intervening and increase participants’ likelihood of intervening and confidence in intervening. The t-test (N=15) demonstrated that the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine mean scores regarding participants’ attitudes about intervening (p<.05) and their likelihood to intervene (p<.05) increased significantly from pre- to post-test; however, their mean scores regarding their confidence in intervening did not increase significantly Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (p=.29; p=.17). Participants who stated that they were “very likely” or “likely” to intervene in two of the hypothetical situations (a couple fighting, a neighbor having loud parties) were asked what they were most Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine likely to do when they intervened. The results demonstrated that over half to most participants stated they would use only indirect intervention strategies (e.g., calling the police or 911) prior Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine to the training; while afterwards most would use direct intervention (e.g., non-threatening strategies such as talking to the individuals) or a combination of direct and indirect intervention strategies. The results Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of this study contribute demonstrate the importance of facilitating collective efficacy and informal social control among residents as a strategy for building community capacity to prevent violence.


Submitted by: Chima Ohuabunwo, Grady Health System Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Health Outcomes Center & Department of Medicine, MSM


ABSTRACT Title: Evaluating Telemetry Utilization in a Large Inner-city Academic Medical Center Background: Cardiac telemetry is costly and requires continuous human surveillance. Following its Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine increasing use in non-critical care settings, the American College of Cardiology (ACC) published guidelines for in-hospital cardiac monitoring. Our institution and others adopted telemetry policies based on these criteria Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Objective: Evaluate the appropriateness and outcomes of telemetry admissions, characterize the arrhythmias detected, and determine the use of cardiology consultations based on telemetry event as a surrogate for influence of telemetry findings on Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine physician practice. Design and Setting: Medical records of all new telemetry admissions at the Grady Health System (GHS), a large inner-city academic medical center during a two-month period were Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine prospectively studied for their entire telemetry stay. Two authors classified the patients using the ACC criteria and the GHS telemetry policy. Measurements and Statistical Methods: The appropriateness of telemetry admission based on the GHS telemetry Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine policy and ACC classes I and II were determined along with other telemetry process and outcome measures. The degree of agreement between the ACC guideline and our institution’s Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine telemetry policy was computed as the kappa coefficient. Chi Square, or Fisher exact test compared categorical group parameters. Variation in telemetry LOS between groups was compared using the Mann-Whitney and the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Kruskal Wallis non-parametric tests. Multiple regression analysis was done to ascertain predictors of telemetry LOS. Results Of the 120 patients, 58.3%, 23.3% and 18.3% were in ACC class1, II, and III respectively. The appropriate admissions rate was 81.6% per Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine ACC criteria and 83% per the GHS telemetry policy. The degree of agreement or the interrater reliability between the ACC classification and our institution’s policy was 0.89 (Kappa coefficient). The overall Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine incidence of telemetry events was 32.3% with 5.8% being major and 27.5% minor events or arrhythmias. No major events occurred among the inappropriate admissions. Telemetry LOS was longer among the major than minor events group Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (7.8 versus 3.4 days, p=0.01). Type of telemetry event was a predictor of LOS (p=0.0001). The occurrence of major telemetry event was associated with cardiology consultation (p = 0.03). Conclusions: There was greater than 80% appropriate Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine telemetry utilization and compliance with ACC guidelines at this site but opportunity for improvement remains. Agreement between ACC and GHS telemetry guidelines was very good. The low incidence of major telemetry events might question the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine effectiveness of current ACC criteria. Institutional measures alongside ACC guidelines are necessary for appropriate telemetry utilization


Submitted by: Michael Powell, Morehouse School of Medicine


Our lab group is involved in research to investigate the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine role of Nef in the pathogenesis of AIDS. We have found that Nef is secreted from infected cells in vesicular form and is present in patient plasma. Vesicular Nef Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine can interact with uninfected T cells and induce apoptosis. Therefore, secreted Nef vesicles may play a key role in T cell depletion and dysregulation of the immune system.


Submitted by: Mark Prausnitz, Georgia Tech Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine


Seasonal influenza causes up to 1.5 million deaths worldwide each year. Pandemic influenza killed up to 50 million people during the three pandemics of the last century. Our ability to deal with a future pandemic Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine is limited in large part by inadequate methods to rapidly vaccinate against new threats. Hypodermic injection of vaccine by medical personnel is extremely time consuming, as seen during the prolonged Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and inefficient annual influenza vaccination campaigns. To expedite mass vaccination, this project seeks to develop microneedle-based vaccine patches that can be self-administered; do not produce sharp, biohazardous waste; and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine are low cost. Such patches could be rapidly distributed through pharmacies, fire stations or even the U.S. mail. Because microneedle patches target delivery to skin’s dendritic cells, stronger mucosal and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine cellular immune responses can be achieved. To accomplish these goals, this project has two Specific Aims. Aim 1 seeks to design and characterize microneedle systems to deliver influenza vaccines to skin. Novel microfabrication techniques are being Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine developed to make microneedles that easily insert into skin to rapidly deliver vaccine to targeted depths. Microneedle designs are studied using cadaver skin, living human skin explants, and human subjects Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine to determine microneedle mechanical properties; stability during processing and storage; controlled dose targeting and kinetics of vaccine delivery; and safety. These studies are producing microneedles designed to meet the needs of mass immunization against Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine pandemic influenza. Aim 2 seeks to evaluate the efficacy of influenza vaccines delivered using microneedles and determine the role of antigen presenting cells in immune activation. Virus-like particles, purified Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine protein, and DNA vaccines against the H5 influenza strain are being delivered using microneedles to mice and hairless guinea pigs. Microneedle design and vaccination protocol are being optimized based on measuring humoral immune responses Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, cellular immune responses, memory B cell repertoire, and protection against virus challenge. Cellular pathways to immunity are evaluated by identifying the role of dendritic and other antigen-presenting cells in immune activation.


Submitted Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine by: Mary Reynolds, CDC, Poxvirus and Rabies Branch


Monkeypox: Applying Lessons Learned from Disease-specific Control Strategies to Overall Capacity Building Goals ABSTRACT: In the era immediately following smallpox eradication, relatively little research Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine was performed to address basic issues relating to the pathogenesis and treatment of orthopoxvirus infections, including monkeypox, smallpox and vaccinia. It is only during the last decade—and principally Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine as a consequence of bioterrorism concerns—that modern technologies have been applied to the development of rapid diagnostic assays, drugs and vaccines. Many of these technologies and medical advancements were conceived to combat smallpox but Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine have likely additional utility in the context of extant, naturally-occurring orthopoxvirus infections of humans. Nevertheless, significant barriers exist to adapting and delivering new technologies to resource poor settings and communities Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in need. The public health infrastructure, vital for identification and prevention of orthopoxvirus-associated diseases such as monkeypox, has experienced declines in many parts of Africa, while at the same time smallpox Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine vaccine-derived population-level immunity has eroded. Consequently, monkeypox, which is endemic to West Africa and the Congo Basin, may go unrecognized and undiagnosed while yet increasing in prevalence. This backdrop provides little Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine opportunity to leverage newly developed technologies (vaccines, diagnostics, drugs etc.) that could have a positive impact on disease prevention. During the past five years, we, and others, have investigated Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine several outbreaks of febrile rash illness suspected to be monkeypox in countries of the Congo basin; a serosurvey performed in the Republic of the Congo (RoC) in 2006 revealed evidence of recent foci of orthopoxvirus Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine infections in several remote communities. To assist in strengthening recognition and prevention of monkeypox, we have initiated a multidisciplinary collaboration with representatives from the Ministries of Health, Research, and Natural Resources in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine RoC to enhance local diagnostic laboratory and outbreak investigation capacity (including promotion of ecologic and human disease surveillance). Difficulties encountered have included physical and supply-chain barriers which have impeded laboratory technology Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine transfer, capacity deficits for scientific and ethical review of research protocols, and ineffective channels for communication with remote healthcare personnel, as well as among various partner agencies. Various strategies have been developed to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine deal with these issues, including increasing the number of partner face-to-face visits, and additional outreach to other agencies and organizations with appropriate expertise. This has for example led Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine to the development of video based educational materials for health care workers designed to foster enhanced integration of clinical, epidemiologic and laboratory-based disease surveillance. We anticipate that partners are likely to benefit from Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine this integrated approach, as it will ultimately promote use of systematic methodologies for disease identification and reduction, and will provide new opportunities to engage in useful and appropriate public health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine actions and clinical trial research.


Submitted by: John Rose, University of Georgia


Structural studies of the hepatitis B virus surface protein (HBsAg) aimed at developing next generation vaccines: a progress report

John P. Rose Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine1, Quentin Florence1, Hao Xu1, Jonny Yokosawa2, James Lara2 and Yury Khudyakov2, 1Department of Biochemistry and Molecular Biology, University of Georgia, Athens, GA 30602 and 2Epidemiology & Bioinformatics, Laboratory, Division of Viral Hepatitis, Centers for Disease Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Control and Prevention, Atlanta, GA 30333.


The purpose of this study is to derive a 3-dimensional structure by X-ray diffraction of the HBsAg protein, which is the antigenic component of the currently Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine licensed vaccine for hepatitis B virus (HBV). Despite its worldwide usage and its application as a carrier for epitope presentation, the tertiary structure of this important protein is still Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine unknown. This lack of information has impeded the development of bivalent vaccines where HBsAg is used as a carrier for foreign antigenic epitopes. Additionally, the lack of this conformational information does not Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine allow for understanding the effects of mutations, especially polymerase drug-resistance mutations in the region of the HBV genome overlapping with the HBsAg open reading frame, on antigenic properties of the HBsAg major neutralizing Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine antigenic epitope. The first step in the X-ray structure determination process is the production of crystals of the protein under study. Initial crystallization trials on the HBsAg protein provided by the CDC Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine have produced some promising hits. Results from the initial crystallization screen together with plans on crystal optimization will be presented. Work supported by a GRA/CDC Collaboration Planning Grant GRA.VAC09.G Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine.


Submitted by: Rebecca Rosen, Emory University/Yerkes National Primate Research Center


Aβ multimers are structurally distinct in Alzheimer’s disease and aged nonhuman primate brain R.F. Rosen1, A. S. Farberg1, B.J Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine. Ciliax2,3, J.J. Lah2,3, M. Gearing2,3, J. Dooyema1, H. LeVine III4, J. A. Ghiso5, T.M. Pruess6,7, L.C. Walker3,6 1Graduate Program in Neuroscience, 2Ctr for Neurodegenerative Disease, Emory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Univ, Atlanta, GA, 3Dept Neurology, Emory Univ, Atlanta, GA 4Sanders-Brown Ctr on Aging, Dept Biochemistry, Univ Kentucky, Lexington, KY, 5Dept Path and Psych, NYU Med Center, New York, NY, 6Yerkes Natl Primate Research Ctr Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, 7Dept Path and Lab Med, Emory Univ, Atlanta, GA Aβ is a rapidly self-aggregating peptide that accumulates with age in both human and nonhuman primate brain. According to the amyloid Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine hypothesis, the aberrant multimerization of Aβ is an upstream effector in Alzheimer’s disease (AD) neurodegeneration. The Aβ peptide sequence is identical in humans and nonhuman primates. However, full spectrum AD has never Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine been seen in an aged nonhuman primate. Because of their close biological relationship to humans, nonhuman primates are a unique model of nonpathologic Aβ accumulation. Clarifying the factors that govern Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the initiation and toxicity of Aβ aggregation in vivo could yield important clues to the uniquely human susceptibility to AD. To this end, we have extensively characterized cerebral Aβ populations in AD Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, aged chimpanzees, rhesus macaques, and squirrel monkeys. Using immunohistochemistry, ELISA, immunoprecipitation/ MALDI-TOF MS, Western Blot and in vivo Aβ-seeding assays, we found that Aβ populations are quantitatively and qualitatively similar in AD Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and nonhuman primate brain. To explain the pathological differences between humans and other primates, we hypothesized that higher-order structural features distinguish toxic Aβ in AD brain from the relatively benign Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Aβ in nonhuman primates. Recent reports show that Pittsburgh Compound B (PIB), a radioligand used for in vivo PET imaging of amyloid, binds with high affinity and stoichiometry to AD brain Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine but with low stoichiometry to synthetic Aβ and to the Aβ deposits in transgenic mouse brain. We measured the binding of 3H-PIB to cortical homogenates from AD and nonhuman primate cases, all Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of which had been characterized for total soluble and insoluble Aβ levels. We found that 3H-PIB binds with low stoichiometry to Aβ in nonhuman primate cortical homogenates, even in cases with Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine levels of Aβ equal to those in AD. These data suggest that cerebral β-amyloid deposits in aged nonhuman primates, which naturally develop cerebral β-amyloidosis over the course of many years, are structurally distinct Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine from those in humans with AD, and that high-affinity PIB binding may be relatively selective for pathogenic Aβ in the AD brain. Supported by NIH RR-00165, P01AG026423, P50AG025688, Emory Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine URC and a UK Faculty Research Support Grant.


Submitted by: Don Rubin, University of Georgia


The Southern Center for Communication, Poverty, and Health is a CDC-sponsored center for excellence in health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine marketing and communication. This center encompasses four major research studies as well as a public health workforce training unit, all focused on reducing health disparities through effective communication. One study Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine examined lay understanding of genetics and disease and ways to reduce the resultant fatalism that can impede health behaviors. A second study examined resistance of minority youth to anti-smoking ads. People Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in poverty must often juggle multiple health risks. A third study examines the calculus people use to allocate concern and resources in dealing with those simultaneous demands. The fourth major study Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine considered how many health recommendations can be optimally bundled in a single message, in this case in the context of prenatal health. Evidence-based lessons learned from these research projects include the following Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine: (1) evoke empathy, (2) employ metaphors to render complex relations comprehensible, (3) thoroughly pretest messages with target audiences, (4) never mention genetic predisposition in isolation from behavioral determinants of disease, and (5) increase individual feelings of control over Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine risks. Workforce training resources created include guidance on establishing liaison with Latino communities, strategies for pandemic flu planning with African American faith-based communities, and modules on working with the media Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and the public to be infused in MPH core classes.


Submitted by: Kaori Sakamoto, UGA


My research focuses on the host immune responses and pathology elicited by mycobacterial cell wall lipids in tuberculosis. Mycobacterial lipids Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine are constantly produced and shed from phagocytosed bacilli, trafficking throughout the host cell and released in exosomes, making these lipids strong candidates for mediators of immunomodulation. We find that Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine the mycobacterial lipid trehalose dimycolate (TDM) induces moderate cytokine responses, granulomagenesis, cachexia, and coagulopathies, while also inhibiting phagosome maturation. TDM synthesis is also upregulated in Mycobacterium tuberculosis after phagocytosis by macrophages. TDM Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine in turn stimulates the up- and down-regulation of numerous macrophage genes involved in the immune response and tissue remodeling. A new research front is the investigation of the immunostimulatory properties of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Mycobacterium avium paratuberculosis lipids, which may play a role in other granulomatous diseases, such as Johne’s or Crohn’s disease. My laboratory uses molecular, biochemical, cell biological, immunological, and histological methods to study the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine mechanisms by which mycobacterial lipids stimulate or inhibit the host immune response. We are also pursuing ways in which these lipids could be utilized prophylactically or therapeutically in the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine treatment of granulomatous diseases. The purpose of this poster is to present the techniques and analyses that my laboratory and collaborators can/will be capable of performing.


Submitted by: Kasumu Salawu, CDC-COTPER-DSNS Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine-PPB


[Demonstration on Laptop] Minimum Entropy Measure for Interobserver Agreement in Diagnosing Disease It is necessary to divide people in a population into one group that has a disease and another that does Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine not, in order to understand how the disease develops and is transmitted. That initiates a search for appropriate and effective health care both in the clinical setting and in the public health Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine arena where secondary prevention programs require early disease detection and intervention. As such, the quality – validity and reliability -- of diagnostic and screening tests is critical. The Kappa statistic is the most popular measure Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of interobserver percent agreement reported in medical literature. However, the debate continues as to the strength and biases of the method and several modifications have been proposed. In this paper Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, we borrow Shannon’s Uncertainty Function from the field of Information Theory to join the debate and improve on a limitation of Kappa.


Submitted by: Michael Schwartz, CDC


Autism Spectrum Disorder (ASD Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) is thought to result from gene-environment interactions. Despite research progress in identifying candidate genes associated with ASD, no clear causative marker has been found, and as a result no directed search for Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine a likely environmental trigger can be undertaken. We propose a novel computation approach to attempt to answer both questions at once. The purpose of our research is to develop a high-throughput Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine computational toxicology methodology to screen for both the implicated gene variants and suspected environmental toxicants for further study using complementary laboratory screening of select candidate chemical-agent / genetic-variant combinations in the toxicology Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine laboratory and through directed genetic association studies using biosample sets from ASD cohorts. The end result will be a high-throughput computational protocol which is available for screening of a wide range of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine neurodevelopmental and other disorders which have an implied gene-environmental basis. The method could be available for screening of a large number of gene and/or variant protein structures against Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine an exhaustive database of toxicants when the causative mutation(s) are not known for a disease. High-Throughput Molecular Modeling (Docking) of ASD candidate gene products with common hazardous environmental agents will provide Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine valuable and novel information concerning candidate genes and the potential environmental ligands implicated in disease pathogenesis. Identification of putative gene SNP variant(s) in ASD will facilitate rapid, directed genetic association studies Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine of currently available databases of biosamples from known cohorts to validate the association of the SNP variant with the clinical phenotype. This would greatly reduce or obviate the need for large and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine costly Genome Wide Association Studies (GWAS). In addition to identification of a genetic marker associated with ASD, the environmental chemicals identified as scoring highly using our methodology could highlight those biologically Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine plausible (based on biological target interaction) environmental triggers potentially responsible for the development or manifestation of the phenotype. Our research targets both genes and environmental agents; both treated as a unique pair of myriad Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine possible combinations. Solution of combinatorial HTS problems of this kind is impractical using methods of traditional epidemiology. Thus, the current proposal provides an opportunity for the rapid identification of testable Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine gene variant-chemical pairings implicated in a disease and an opportunity for Public Health Genomics to expand beyond the confines of conventional population studies with size-limited statistical power.


Submitted by: Stuart Shapira, NCBDDD Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine / CDC


Effects of Stage of Reproduction, Nutrient Status, and Genes on Serum Homocysteine in Reproductive Age Women S.K. Shapira(1), A. Yesupriya(2), J. Robitaille(1), R. Fisk Green(1), H.C. Hamner Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine(1), J.E. Kimmons(3), and K.S. Crider(1) (1) NCBDDD, CDC, Atlanta, GA; (2) NOPHG, CDC, Atlanta, GA; (3) NCCDPHP, CDC, Atlanta, GA Elevated serum homocysteine (Hcy) has been associated with adverse pregnancy outcomes, such as preterm birth Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, stillbirth, and low birth weight, as well as with cardiovascular disease and stroke. To evaluate genetic and environmental factors affecting Hcy, our study utilized survey data of 2,012 reproductive age women Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine (17-44 years) from the NHANES III DNA Bank (1991-94). Associations between genetic variants (MTHFR 1298A-C, 677C-T, and 116C-T, MTRR 66A-G, and CBS 844ins68) and Hcy were tested using linear regression models Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine that adjusted for demographic, reproductive, dietary, and environmental factors. To examine possible effect modification, models were stratified by race/ethnicity, reproductive stage in relation to pregnancy (never, currently, ≤2 years, >2 years), and total folate Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine intake (“low” vs. “adequate,” accounting for both folic acid from vitamins and food folate). Significant associations with mean Hcy were detected only for MTHFR 677C-T. Mean Hcy among TT Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine women was higher compared with CC women (9.5 vs.7.1 μmol/L, p<0.001). When stratified by total folate intake, TT women with “low” intake had higher mean Hcy, compared with CC women (16.7 vs. 7.6 μmol/L, p<0.001), while TT and Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine CC women with “adequate” intake had similar mean Hcy (7.1 vs. 6.8 μmol/L, p=0.44). Mean Hcy differed by genotype (TT vs. CC) for whites (17.9 vs. 7.7 μmol/L, p=0.003) and Mexican Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Americans (8.8 vs. 6.5 μmol/L, p=0.006) with “low” total folate intake, although the difference was smaller for the latter. Models could not be stratified for blacks because of the low TT prevalence. A similar genotype Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine effect was seen for women with “low” total folate intake in all reproductive stages except currently pregnant, where TT women had lower mean Hcy compared with CC women (4.9 vs. 7.0 μmol Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine/L, p=0.003). These results suggest that the effect of total folate intake on the association between MTHFR 677C-T and Hcy is modulated by stage of reproduction and race/ethnicity. Therefore, adequate Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine total folate intake appears to be important for reproductive age women, particularly those with the MTHFR 677TT genotype.


Submitted by: Minoru Shinohara, Georgia Institute of Technology


Impaired fine motor skills with heightened sympathetic nerve activity Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Minoru Shinohara (School of Applied Physiology, Georgia Institute of Technology) Manual dexterity is compromised in hypertensive individuals, heart transplant candidates, diabetics, the unaffected хэнд in stroke patients, and even healthy Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine older adults. The impairment of manual dexterity in these individuals may precede a decrease in their quality of life and capacity for independent living. High levels of sympathetic nerve activity are observed in Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine individuals with a variety of cardiovascular diseases including those listed above. It is possible therefore that an increase in sympathetic nerve activity is associated with impaired manual dexterity exhibited by the individuals Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine described above. The purpose of the study was to test if heightened muscle sympathetic nerve activity increases fluctuations in motor output of a хэнд muscle in humans. Muscle sympathetic nerve activity was Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine increased by applying lower body negative pressure (LBNP) while subjects performed low force isometric and anisometric contractions involving abduction of the index finger (5% of maximal force). The coefficient of variation of Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine force during the isometric contraction increased with the application of LBNP. The standard deviation of acceleration during the eccentric contraction increased. There was no change in the standard deviation of acceleration during the Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine concentric contraction. Discharge rate variability of motor units in the first dorsal interosseus muscle tended to increase with an increase in LBNP. The results indicate that heightened sympathetic nerve activity increases Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine fluctuations in motor output during low force contractions, leading to impaired fine motor skills.


Submitted by: Sarah Spencer, Georgia State University


Microchip for Detection of Pathogenic RNA Detection of cellular messenger RNA is a Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine useful diagnostic strategy for the detection of bacterial pathogens. A rapid and sensitive method for “on site” detection of specific pathogens would be of great use for a number of fields. For example, simple Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine and inexpensive method for the detection of Bacillus anthraces in train stations and airports is a useful system for national security. Rapid detection of pathogenic E. coli strains in food Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine production would also be of great benefit in ensuring the safety and quality of our food supply. Here we present a method for the rapid detection of cellular mRNA. This system is Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine based on the 3’-labeling approach in which targeted RNA is simultaneously extended and labeled with the use of biotin labeled-dNTPs and DNA polymerase on an immobilized nucleic acid-base probe. The Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine biotin is subsequently converted to an enzymatic label, which produces a detectable chemiluminescent reaction in the presence of the enzymatic substrate. Detection time of this system is very short (approximately 30 minutes Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine) because there is no need for amplification by PCR, transcription, or fluorophore labeling. Furthermore, we have demonstrated detection sensitivity in the low femtomole range. This novel technology has been successfully demonstrated by Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine selective detection of lac Z mRNA in a total RNA sample.


Submitted by: Jason Stein, Section of Hospital Medicine, Emory University School of Medicine


Automated, Real-Time Relay of Actionable Performance Data to Nursing Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Units: A Transferable Quality Improvement Strategy Jason Stein MD1, Bryce Gartland MD1, Laura Phillips2, Bruce Douglas2, Dee Cantrell2 1 Section of Hospital Medicine, Department of Medicine, Emory University School of Medicine 2 Emory Healthcare Information Services Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine Background: Hospitals still have no readily transferable strategy to deliver optimal care consistently. Moreover, the regular data flow necessary to track and drive better performance is typically not available. Pilot Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine work from our hospital medicine program suggests that daily relay of potential quality outliers enables front line staff to address oversights as they occur. Timely, actionable data relayed to the front Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine line has significant value. Its acquisition represents a de facto performance tracking system, the strategy could apply to multiple hospital quality metrics, and could be transferred throughout a hospital or system if automated. Purpose: To Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine examine the effect of automated, real-time relay of actionable performance data in nursing units across 5 separate Emory hospital facilities, hospitalists and health information specialists designed and developed a prototype aimed Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine at improving the prevalence of venous thromboembolism (VTE) prophylaxis. Description: Features of the prototype were designed to overcome common quality improvement obstacles, accommodate clinical work flow, and positively influence provider behavior (Figure Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine). To remove the necessity for manual acquisition of outlier data, we created an automated program to query our hospital system’s electronic clinical database. To ensure real-time, geographic relevance of the information Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine, the program runs every hour and presents the data by nursing unit. To make it readily accessible and useful to front line care givers, the data output is relayed Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine to an aesthetically pleasing dashboard display that care team members can launch from any computer terminal. To emphasize actionable data while offering positive feedback, potential quality outliers are highlighted in red, but Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine become green within an hour of being addressed. To leverage other drivers of behavior, performance for every nursing unit is мейд fully transparent to all users across our hospital system. The prototype was introduced to Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine over 40 nursing units in 5 separate Emory hospital facilities within a 3 week period. Conclusions: Automated, real-time relay of actionable performance data appears to be viable and transferable throughout a hospital Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine system. As a strategy, it holds promise for improving the reliability and sustainability of quality hospital care. More research and development is needed to understand features of effective implementation and measure its Submitted by: Thomas Adamkiewicz, Morehouse School of Medicine impact on clinical, cost, and service outcomes.


Submitted by: Sandra Steiner and George Carlone, CDC



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