Central Virginia Research Articles

MSOR10 Presentation Time: 8:45 AM: Barriers to Brachytherapy for Locally Advanced Cervical Cancer in Central Virginia

MSOR10 Presentation Time: 8:45 AM: Barriers to Brachytherapy for Locally Advanced Cervical Cancer in Central Virginia

Validation of the Adult Eating Behavior Questionnaire (AEBQ) in a young adult Black sample in the U.S.: Evaluating the psychometric properties and associations with BMI

The Adult Eating Behavior Questionnaire (AEBQ) is an instrument developed in the UK and used to examine appetitive traits in adults. The AEBQ is divided into four Food Approach subscales, namely; Enjoyment of Food, Emotional Overeating, Food Responsiveness and Hunger, and four Food Avoidance subscales, namely; Emotional Undereating, Food Fussiness, Slowness in Eating, and Satiety Responsiveness. The instrument has been validated in a number of countries. However, there is limited evidence to show the validation of the AEBQ in predominantly Black populations. The aim of this cross-sectional study was to validate the AEBQ in a Black young adult sample in the U.S.A. Participants (n = 229) consisted of young adults with an average age (20.97 ± 4.31) attending a Central Virginia Historically Black University. Reliability Analysis and Confirmatory Factor Analysis (CFA) were conducted. Correlations, as well as multivariate multiple linear regression models were estimated. Food Avoidance subscales demonstrated more internal consistency than the Food Approach subscales. The CFA results indicated a 7-factor model in which the Hunger subscale was eliminated to fit the data better overall. The Food Approach subscales demonstrated more convergent validity than the Food Avoidance subscales. BMI significantly predicted both Emotion Overeating and Emotional Undereating, as well as Food Fussiness. Moreover, both sex and age significantly predicted Emotional Undereating, Food Responsiveness and Hunger. Further, sex significantly predicted Emotional Overeating and Satiety Responsiveness. Lastly, depression predicted Emotional Undereating. In conclusion, this study provided some evidence to support the use of the AEBQ as a reliable and valid measure of adult eating behavior.

Mammalian Meat Allergy and IgE to Alpha-Gal in Central Virginia: Findings From a COVID-19 Vaccine and Patient Cohort

IgE to galactose-alpha-1,3-galactose (alpha-gal) is linked to tick bites and an important cause of anaphylaxis and urticarial reactions to mammalian meat. The alpha-gal syndrome (AGS) is recognized as being common in the southeastern United States. However, prevalence studies are lacking and open questions remain about risk factors and clinical presentation of alpha-gal sensitization. Here we characterized the prevalence as well as the presentation and risk factors of AGS and alpha-gal IgE sensitization in adults in central Virginia recruited without regard to the history of allergic disease. Adults in central Virginia, primarily University of Virginia Health employees, were recruited as part of a COVID-19 vaccine study. Subjects provided at least one blood sample and answered questionnaires about medical and dietary history. We used ImmunoCAP for IgE assays and assessed the ABO blood group by reverse typing using stored serum. We also investigated biobanked serum from COVID-19 patients. Median age of the 267 enrollees was 42 years, 76% were female, and 43 (16%) were sensitized to alpha-gal (cutoff of 0.1 IU/mL), of which mammalian meat allergy was reported by seven (2.6%). Sensitized subjects (1) were older, (2) had higher total IgE levels but a similar frequency of IgE to common respiratory allergens, and (3) were more likely to report tick bites than were nonsensitized subjects. Among those who were sensitized, alpha-gal IgE levels were higher among meat-allergic than nonallergic subjects (geometric mean, 9.0 vs 0.5 IU/mL; P< .001). Mammalian meat and dairy consumption was common in individuals with low-level sensitization. In central Virginia, AGS is a dominant cause ofadult food allergy with a prevalence approaching or exceeding2%.

The role of new green construction in neighborhood change and gentrification

Recent research has highlighted the potential for green certification to contribute to gentrification in urban areas. This occurs as the adoption of a reductionist sustainability planning language can turn green-certified houses into luxury goods that attract primarily White, college-educated, and pro-environmental households, who may replace existing long-term residents, particularly lower-income residents and racial minorities, in core urban areas. This study aims to assess the extent to which the supply of green-certified units affects neighborhood change and gentrification. Using housing market transaction data from Central Virginia’s Multiple Listing Service and socioeconomic data from the U.S. Census Bureau, we employ a difference-in-differences approach to analyze the differential effect of new construction of market-rate, EarthCraft-certified units in Richmond Metro Area. Our results show that neighborhoods with new green-certified units experience statistically significant increases in population growth, new construction, and house prices. We observe trends that suggest potential negative impacts on minorities. However, these observed trends have not reached statistical significance. Our study provides evidence that green housing can contribute to the conditions that make residential zones ripe for gentrification, thus, highlighting the need to balance the benefits of green certification with the potential negative impacts on disadvantaged groups.

Examining Antimicrobial Resistance in Escherichia coli: A Case Study in Central Virginia's Environment.

While environmental factors may contribute to antimicrobial resistance (AMR) in bacteria, many aspects of environmental antibiotic pollution and resistance remain unknown. Furthermore, the level of AMR in Escherichia coli is considered a reliable indicator of the selection pressure exerted by antimicrobial use in the environment. This study aimed to assess AMR variance in E. coli isolated from diverse environmental samples, such as animal feces and water from wastewater treatment plants (WWTPs) and drainage areas of different land use systems in Central Virginia. In total, 450 E. coli isolates obtained between August 2020 and February 2021 were subjected to susceptibility testing against 12 antimicrobial agents approved for clinical use by the U.S. Food and Drug Administration. Approximately 87.8% of the tested isolates were resistant to at least one antimicrobial agent, with 3.1% showing multi-drug resistance. Streptomycin resistance was the most common (73.1%), while susceptibility to chloramphenicol was the highest (97.6%). One isolate obtained from WWTPs exhibited resistance to seven antimicrobials. AMR prevalence was the highest in WWTP isolates, followed by isolates from drainage areas, wild avians, and livestock. Among livestock, horses had the highest AMR prevalence, while cattle had the lowest. No significant AMR difference was found across land use systems. This study identifies potential AMR hotspots, emphasizing the environmental risk for antimicrobial resistant E. coli. The findings will aid policymakers and researchers, highlighting knowledge gaps in AMR-environment links. This nationally relevant research offers a scalable AMR model for understanding E. coli ecology. Further large-scale research is crucial to confirm the environmental impacts on AMR prevalence in bacteria.

Earthquake Rupture Forecast Model Construction for the 2023 U.S. 50-State National Seismic Hazard Model Update: Central and Eastern U.S. Fault-Based Source Model

Abstract As part of the U.S. Geological Survey’s 2023 50-State National Seismic Hazard Model (NSHM), we make modest revisions and additions to the central and eastern U.S. (CEUS) fault-based seismic source model that result in locally substantial hazard changes. The CEUS fault-based source model was last updated as part of the 2014 NSHM and considered new information from the Seismic Source Characterization for Nuclear Facilities (CEUS-SSCn) Project. Since then, new geologic investigations have led to revised fault and fault-zone inputs, and the release of databases of fault-based sources in the CEUS. We have reviewed these databases and made minor revisions to six of the current fault-based sources in the NSHM, as well as added five new fault-based sources. Implementation of these sources follows the current NSHM methodology for CEUS fault-based sources, as well as the incorporation of a new magnitude–area relationship and updated maximum magnitude and recurrence rate estimates following the methods used by the CEUS-SSCn Project. Seismic hazard sensitivity calculations show some substantial local changes in hazard (−0.4g to 1.1g) due to some of these revisions and additions, especially from the addition of the central Virginia, Joiner ridge, and Saline River sources and revisions made to the Meers and New Madrid sources.

Examining the Seventeenth-Century Copper Trade: An Analysis of Smelted Copper from Sites in Virginia and North Carolina

AbstractWhen the colonists who made up the Virginia Company of London established James Fort on the banks of the James River in 1607, they brought with them sheets of scrap copper. Based in large part on the experience of the earlier Roanoke Colony, the English knew that copper was a highly prized material among Native peoples of the Chesapeake, and they brought it with them as a trade item. Artifacts made from European smelted copper (impure copper and copper alloy) have been found at contact period sites (ca. AD 1607–1680) throughout Virginia, and James Fort has long been hypothesized to be the primary distribution point for that material. To test this hypothesis, we analyzed the elemental composition of a sample of smelted copper artifacts from James Fort (1607–ca. 1625), as well as samples of copper artifacts from five Native sites in central Virginia. We also analyzed a sample of copper artifacts from another well-known European fort site—Fort San Juan (1567–1568) in North Carolina. The results suggest that although a portion of the smelted copper that circulated through Native networks in Virginia came from James Fort, the rest of it possibly came from English, French, or Dutch distribution points to the northeast.

Implementation of a Colorectal Surgical Site Infection Prevention Bundle and Checklist: A Quality Improvement Project.

After noting an elevated surgical site infection rate in 2019 associated with colorectal surgeries, leaders at two Central Virginia health system hospitals convened an interdisciplinary team to audit current practices and research infection prevention strategies. After identifying a lack of standardization in care processes for colorectal surgery patients and reviewing the literature on colorectal bundles, the team created a bundle focusing on the use of antibiotics, chlorhexidine gluconate wipes or baths, separate closing instrument trays, nasal decolonization, bowel preparation, and maintaining patient normothermia. After synthesis and stakeholder input, the team implemented the colorectal bundle along with a checklist for all users to complete to ensure compliance and standardization of practice and for auditing purposes. Implementation results were positive: the total number of colorectal infections decreased from nine in 2020 to three in 2021. Education was critical to securing staff member engagement for successful implementation of and compliance with the bundle.

Exploring Experiences of Pain Management Among Family Caregivers of Community-Dwelling Older Adults With Dementia.

Pain is often underreported and under-treated in older adults with dementia. The role of family caregivers (FCGs) in managing pain for their loved ones with dementia living in community has been significantly burdensome. Surprisingly, research has not delved into the experiences of FCGs' concerning pain management in this context. A qualitative descriptive study was conducted to gain a deep understanding of FCGs' experiences in managing pain for their loved ones. Family caregivers participated in semi-structured face-to-face or telephone interviews. Inclusion criterion included being an adult providing care to community-dwelling older adults with dementia. Recruitment stopped upon reaching thematic saturation. Basic demographic characteristics was also collected. Constant comparison analytic method was employed. The study included 25 FCGs in central Virginia, spanning ages from 29 to 95. Participants were predominantly white, female, married, and had a minimum high school education. Most of them were adult children (52%) or the spouses (28%) of the care recipients. Four thematic categories emerged around exploring FCGs' pain management experiences: (1) Values; (2) Barriers; (3) Support; and (4) Adaptation. Each theme included sub-themes. Family caregivers follow their values to make decisions in pain management. Barriers existed for effective pain management. Adaptation and support from professional or formal caregivers greatly improved FCGs' perception of their competence in pain management. The finding underscores the need for further research and the development of interventions aimed at enhancing FCGs' perception of self-efficacy in this crucial aspect of caregiving.

Load-Out and Hauling Cost Increase with Increasing Feedstock Production Area

The impact of average delivered feedstock cost on the overall financial viability of biorefineries is the focus of this study, and it is explored by modeling the efficient delivery of round bales of herbaceous biomass to a hypothetical biorefinery in the Piedmont, a physiographic region across five states in the Southeastern USA. The complete database (nominal 150,000 Mg/y biorefinery capacity) had 199 satellite storage locations (SSLs) within a 50-km radius of Gretna, a town in South Central Virginia USA, chosen as the biorefinery location. Two additional databases, nominal 50,000 Mg/y (29.1-km radius, 71 SSLs) and nominal 100,000 Mg/y (40-km radius, 133 SSLs) were created, and delivery was simulated for a 24/7 operation, 48 wk/y. The biorefinery capacities were 15.5, 31.1, and 47.3 bales/h for the 50,000, 100,000, and 150,000 Mg/y databases, respectively. Three load-outs operated simultaneously to supply the 15.5 bale/h biorefinery, six for the 31.1 bale/h biorefinery, and nine for the 47.3 bale/h biorefinery. The required truck fleet was three, six, and nine trucks, respectively. The cost for load-out and delivery was 11.63 USD/Mg for the 50,000 Mg/y biorefinery. It increased to 12.46 and 12.99 USD/Mg as the biorefinery capacity doubled to 100,000 Mg/y and tripled to 150,000 Mg/y. Most of the cost increase was due to an increase in truck cost as haul distance increased with the radius of the feedstock supply area. There was a small increase in load-out cost due to an increased cost for travel to support the load-out operations. The less-than-expected increase in average hauling cost for the increase in feedstock production area highlights the influence of efficient scheduling achieved with central control of the truck fleet.

Optimization of herbaceous feedstock delivery to a network of supply depots for a biorefinery in the Piedmont, USA

AbstractThe southeastern USA has the potential to be a significant producer of bio‐based products; however, research is still needed to demonstrate the most cost‐effective feedstock delivery system for this region. A logistic system that has shown promise is one utilizing a network of supply depots. This study calculated the cost to produce a stream of size‐reduced herbaceous biomass (i.e., switchgrass) for five theoretical depots in the Piedmont province. Three depots were located in south central Virginia and two in north central North Carolina. A logistics system with a 20‐bale handling unit was used for load‐out operations at 199 theoretical satellite storage locations (SSLs) within a 48 km radius of each depot location. The distribution of potential production fields and the transportation distance from SSLs to the depots were determined with spatial and network analyses. Based on an analysis of potential land cover available for feedstock production, the annual capacity per depot ranged from 80 839 to 170 830 Mg, resulting in a total annual capacity of 555 195 Mg for all five depots. Cost to deliver feedstock for 24/7 operation, 48 weeks per year ranged from 46.03 to 62.86 USD Mg−1 annual capacity. At the low end, these costs were: SSL operation (22%), truck (29%), receiving facility (26%), and debaling‐size‐reduction (23%). The principle economy‐of‐scale factors were the receiving facility and debaling‐size‐reduction costs. To minimize per‐Mg cost, depot capacity should be chosen such that equipment can be operated as close to 80% of design capacity as possible.

A retrospective review of α-gal syndrome complicating the management of suspected pancreatic exocrine insufficiency in one gastroenterology clinic in central Virginia

The galactose-α-1,3-galactose (α-gal) mammalian meat allergy, α-gal syndrome, often includes diarrhea, abdominal pain, and other gastrointestinal (GI) symptoms. Pancreatic exocrine insufficiency causes similar symptoms. The pancreatic replacement enzymes, referred to here as pancreatic enzymes, used to treat pancreatic insufficiency are porcine products and contain α-gal. Patients with pancreatic insufficiency who also have α-gal syndrome may be intolerant of mammalian products in their diet and of α-gal in pancreatic enzymes. In this article, we describe 40 patients from one GI clinic in central Virginia with suspected pancreatic insufficiency and increased α-gal immunoglobulin E (IgE) levels. Over 50% of these patients had some clinical improvement when mammalian products were removed from the diet. Most patients could tolerate pancreatic enzymes; 10% could not tolerate them due to suspected allergy symptoms, but none developed anaphylaxis. Understanding that α-gal syndrome can be superimposed on pancreatic exocrine insufficiency and exacerbate symptoms, and that treatment with pancreatic enzymes may increase GI and/or allergy symptoms in this group, will lead to improved medical management of this complex patient population.

Microbiological Survey and Antimicrobial Resistance of Foodborne Bacteria in Select Meat Products and Ethnic Food Products Procured from Food Desert Retail Outlets in Central Virginia, USA.

In food desert areas, low-income households without convenient transportation often shop at small, independently owned corner markets and convenience stores (SIOMs). Studies indicate a higher potential for reduced product quality and safety of foods sold at SIOMs, with more critical and non-critical code violations in the region. This study aimed to assess the difference in market scale on the microbiological quality in select food products procured from food deserts in Central Virginia. A total of 326 samples consisting of meat products (i.e., ground beef, chicken, and sausage), ethnic food products (i.e., ox tail, stock fish bite, egusi ground, and saffron powder), and food packaging surfaces procured from ten registered SIOMs and nine large chain supermarkets (LCSMs) between August 2018 and March 2020 were evaluated. Higher levels of aerobic mesophile and coliform counts were found in SIOMs-acquired samples than in LCSMs-acquired samples, as demonstrated by the lower food safety compliance rate of SIOMs. Regardless of SIOMs or LCSMs, Campylobacter, E. coli, Listeria, and Salmonella were detected in 3.6%, 20.9%, 5.5%, and 2.7% of samples, respectively. The majorities of Campylobacter (75%, 6/8) and Salmonella (83.3%, 5/6) detected were from SIOMs-acquired samples including ethnic food products. Among the tested antimicrobials, AMP (100%) and TOB (100%) showed the highest frequency of resistance among Campylobacter, TCY (69.9%) among E. coli, NAL (100%) among Listeria, and TCY (50%) among Salmonella, respectively. The prevalence of multi-drug resistance (MDR) and non-susceptibility in Campylobacter and non-susceptibility in Listeria isolated from SIOMs-acquired food products were lower than those isolated from LCSMs-acquired samples. A higher price of the same brand name commodity sold at SIOMs than those sold at LCSMs was also observed, indicating an increased financial burden to economically challenged residents in food desert areas, in addition to food safety concerns. Elaborated and in-depth research on a larger-scale sample size with a greater diversity of products is needed to determine and intervene in the cause(s) of the observed differences in the prevalence of the pathogens and AMR profiles.

Thursday at Miller's

At seventy-three years old, jazz trumpeter/composer/bandleader John D’earth remains a vortex of swirling energy: gigging constantly, ceaselessly composing, and tirelessly teaching. An iconic musician with a world-class reputation, D’earth is a gifted post-bop trumpeter with a fat sound, a dense knowledge of harmony, and a virtuosic sense of rhythm. D’earth is the type of player that would demand attention in any major metropolitan jazz scene, but within the small confines of the Charlottesville, Virginia jazz community, D’earth is a pillar of influence. Simply put, D’earth is the heart and soul of the central Virginia jazz milieu. Beyond his skills as a performer, D’earth is a revered teacher and mentor. As the Director of Jazz Performance at the University of Virginia, D’earth has certainly helped hundreds of promising young musicians navigate the vicissitudes of institutional learning. But it is D’earth’s work as a teacher outside the academy that will ultimately cement his legacy. D’earth has been leading a Thursday night weekly gig at Miller’s, a beloved tavern in downtown Charlottesville, for over thirty years. Miller’s on Thursdays is a laboratory—a musical workshop—where D’earth holds forth with both his students and his colleagues. On the Miller’s bandstand, D’earth puts professionals next to amateurs, beginners alongside experts. Everyone solos, all players add to the collective musical interplay, and each musician has a voice within the group. This project engages D’earth in a series of interviews exploring his holistic approach to jazz pedagogy. Beyond interrogating D’earth’s specific teaching system(s), I inquire into his views about both the pitfalls and advantages of jazz in the academy, how improvisation can build social, political, and economic alliances, and the ways in which music can act as both a form of resistance and a strategy for survival in neoliberal times. At the forefront of my agenda is a discussion on how the jazz ecology of Charlottesville was affected by the events of August 12, 2017, when a misguided “Unite the Right” rally ended in the tragic death of Heather Heyer, bringing political upheaval and racial turmoil to the city of Charlottesville. Finally, I dissect the Miller’s phenomenon with D’earth, attempting to explain how this particular location has operated as both a performance environment and important pedagogical space for such a remarkably long time and yielded such a wealth of creativity and access to musical insight.

The Challenges and Rewards of Working With Veterans.

Derenda Lovelace, RN, MSN, CMGT-BC, spent 25 years as a case management leader in the DoD and VA health care systems retiring from Federal service in January 2019. She is an active Central Virginia Chapter and National CMSA member currently serving as Chair for the National Awards Committee. She works as a Geriatric Care Manager for GeroPartners LLC in Midlothian, VA, as well as volunteers for the Chesterfield Council on Aging, American Legion Post 186 and the RICVAMC. Address correspondence to Derenda Lovelace, RN, MSN, CMGT-BC, GeroPartners LLC, 1 Park West Cir, Ste 102, Midlothian, VA 23114 ([email protected]). The author reports no conflicts of interest.

Characterizing the Digital Divide in the Latinx Community of Central Virginia

Historically, Latinx communities in the United States (US) have had some of the lowest levels of internet access and use in comparison to other minority groups. In order to develop a better understanding of how the digital divide impacts the Latinx community of Central Virginia, we conducted a telephone survey of 39 Latinx participants. Survey questions were related to both technology access and technology use. We found that older participants were significantly less likely to have home internet connection than younger participants and significantly less likely to use email. In addition to providing insight on technology-related needs of the Latinx community of Central Virginia, we hope our research may serve as a foundation for advocacy efforts to increase technology access as well as technology education resources for Latinx communities nationwide.

86 A summer research experience to encourage URM students’ participation in health sciences research

OBJECTIVES/GOALS: To increase the diversity of the health sciences research workforce, students from a variety of backgrounds must have the opportunity to participate in hands-on research experiences that highlight translating science to treating human disease. We developed a mentored translational research program for students from VCU and central Virginia HBCUs. METHODS/STUDY POPULATION: The Wright Regional Center for Clinical and Translational Science collaborated with the existing VCU Honors’ Summer Undergraduate Research Program (HSURP) to expand their summer research experience to URM students from our partner HBCUs. For 10 weeks, students worked with faculty mentors to learn research techniques and engage in research projects. Students also participated in career development sessions like developing a CV and choosing graduate programs, and at the end of HSURP, they shared formal presentations of their research with peers and mentors. HSURP students were provided housing and a stipend, and mentors were provided a stipend. A post-program assessment gathered feedback on research and personal skills gained, the program’s influence on their career goals, and overall experiences with HSURP. RESULTS/ANTICIPATED RESULTS: Nine students, 7 from VCU and 2 from Virginia State University participated in HSURP. Students were rising sophomores, juniors, and seniors, and 5 had previous research experience. Students worked on projects ranging from basic to social behavioral, community-placed research. All students rated the program as good or excellent. Post-program assessments showed all students believed they had a better understanding of ethical responsibilities of researchers, relevance of community-engaged and clinical/translational research, and interpreting journal articles after participating in the program. Four students reported they plan to continue working on their research projects during the academic year, and all students strongly agreed or agreed that HSURP prepared them for graduate or professional schools. DISCUSSION/SIGNIFICANCE: A program that combines hands-on research training and career development opportunities provides a robust research foundation for URM students, which can increase their participation in the translational science workforce. Future program development will include preprogram training modules to better prepare students for research experiences.

Featured Poet Kiki Petrosino: “The Red Earth of Terra”

Featured Poet Kiki Petrosino: “The Red Earth of Terra”

The American Journal of Gastroenterology: Reflections on 2022 and the Road Ahead

1University of North Carolina, School of Medicine, Chapel Hill, North Carolina, USA; 2Virginia Commonwealth University School of Medicine and Central Virginia Veterans Healthcare System, Richmond, Virginia, USA.

Fruit flies in central Virginia: Capstone research projects at a community college and partnership with a university genomics lab

Fruit flies in central Virginia: Capstone research projects at a community college and partnership with a university genomics lab