Virginia School Research Articles

MP54-20 IDENTIFYING AN OVERACTIVE BLADDER PHENOTYPE WITH AUDIO VISUAL INTERVENTION IN AN ORAL HYDRATION STUDY

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology (MP54)1 Apr 2020MP54-20 IDENTIFYING AN OVERACTIVE BLADDER PHENOTYPE WITH AUDIO VISUAL INTERVENTION IN AN ORAL HYDRATION STUDY Urmila Sivagnanalingam*, Priscilla Koirala, Kaitlyn Maddra, Rui Li, Kyla Egenberger, Syndey Roberts, Natalie Swavely, Samuel Weprin, Adam Klausner, and John Speich Urmila Sivagnanalingam*Urmila Sivagnanalingam* More articles by this author , Priscilla KoiralaPriscilla Koirala More articles by this author , Kaitlyn MaddraKaitlyn Maddra More articles by this author , Rui LiRui Li More articles by this author , Kyla EgenbergerKyla Egenberger More articles by this author , Syndey RobertsSyndey Roberts More articles by this author , Natalie SwavelyNatalie Swavely More articles by this author , Samuel WeprinSamuel Weprin More articles by this author , Adam KlausnerAdam Klausner More articles by this author , and John SpeichJohn Speich More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000916.020AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Limited studies have been conducted to investigate the effect of environmental stimuli on patient sensation changes in urinary urgency. In this study we quantified percent-sensation changes with an audio-visual intervention to assess any differences between normal and overact bladders during in a non-invasive oral hydration study. METHODS: All recruited participants completed an ICIq-OAB survey and were divided into healthy and OAB groups based on responses to the urgency question (5a ≤1a or ≥2). An additional survey was completed by participants asking if 1) the sound or sight of running water, 2) being stressed or anxious and 3) cold weather made them feel more likely to rush to the toilet to urinate. In the study, participants drank 2L Gatorade G2® during fill 1 and water during fills 2 and 3 while concurrently using a tablet-based sensation meter to record real-time bladder sensation on a 0%-100% scale. When participants reached 50% sensation in fill 3, participants were instructed to remain completely silent for 90-seconds (as a control period) and then to watch a 3-minute video showing scenes of waterfalls, flushing toilets, running water, water fountains, etc. The % sensation change from the end of the control period to the end of the video was calculated for both healthy and OAB participants. Firth logistic regression analysis was performed to assess statistical difference and odds ratio between the groups. RESULTS: Data analysis was performed on 30 participants (19 healthy, 11 OAB). Percent sensation during the audio-visual intervention increased by ≥30% in 4/11 OAB and 0/19 in healthy participants. A ≥30% increase in sensation was significantly associated with OAB participants (p<0.01, odds ratio=7.183). Survey responses were categorized as low (0-1) or high (2-4), and the odds ratio for OAB participants exhibiting high responses were significant (p<0.02) for the water (8.4), stress (21.3) and cold (9.3) triggers. CONCLUSIONS: The results from this study suggest that OAB participants may have a heightened sensation to urinate with audio-visual stimuli compared to healthy subjects. The survey further validates that environmental stimuli such as water, cold or stress increase urinary urgency in OAB compared to healthy participants. The findings may be used to help identify a behavioral-based OAB phenotype using a non-invasive approach. Further research is needed to understand the effect of environmental triggers on bladder sensation in OAB. Source of Funding: NIH grant R01DK101719, NSF REU award 1852116, and the Virginia Commonwealth University Presidential Research Quest Fund and School of Medicine Summer Research Fellowship Program. © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e799-e800 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Urmila Sivagnanalingam* More articles by this author Priscilla Koirala More articles by this author Kaitlyn Maddra More articles by this author Rui Li More articles by this author Kyla Egenberger More articles by this author Syndey Roberts More articles by this author Natalie Swavely More articles by this author Samuel Weprin More articles by this author Adam Klausner More articles by this author John Speich More articles by this author Expand All Advertisement PDF downloadLoading ...

3D‐printing of Stem Cells and Stromal Cells to Prime for Vascularization and Regeneration

Implanted engineered constructs intended for regenerating tissues face the immediate challenge of recruiting a microvasculature for the delivery of oxygen and nutrients, the trafficking of immune cells, and the regulation of interstitial fluid. The microcirculation is a hierarchical network of interconnected vessels that achieves this diverse range of functionality through its different components: arterioles, capillaries, and venules. The lumenized and branched structure of the microcirculation requires proper positioning of different cell types ‐‐ endothelial cells with an abluminal coating of pericytes and vascular smooth muscle cells ‐‐ and the establishment of a basement membrane between them. Spatially and temporally‐regulated molecular cues drive the cell‐to‐cell interactions that coordinate the assembly of these complex networks. Our lab combines computational modeling with 3D‐bioprinting to understand how microvessels assemble in vivo and to design and pattern them in vitro. We identified a sub‐population of cells in the stromal vascular fraction of adipose tissue that is capable of supporting capillaries and neo‐capillaries, much like native pericytes. We have developed techniques to exploit their use in murine models of diabetes, where angiogenesis is dysregulated and wound healing is delayed. Applications of our approach also include skeletal muscle regeneration and pancreatic islet re‐implantation.Support or Funding InformationUniversity of Virginia Center for Advanced Biomanufacturing University of Virginia School of Medicine Pinn Scholars

ATA2020 Session Summaries (Abstracts)

ATA2020 Session Summaries (Abstracts)

The Fatal Deceit of Public Policy: Can Austrian and Public Choice Economics Complement each other?

The Fatal Deceit of Public Policy: Can Austrian and Public Choice Economics Complement each other?

The anti-discriminatory tradition in Virginia school public choice theory

This paper investigates the historical relationship between the emergence of public choice theory in the 1960s and the problem of racial discrimination. Drawing upon archival research, I argue that foundational public choice scholars brought together four distinct strains of anti-discriminatory theory to grapple with the challenges posed by segregationist public policy instruments during the Civil Rights era. They include (1) the treatment of racial discrimination as regulatory capture, which is typified in the work of Frank Knight and W. H. Hutt; (2) the treatment of discrimination as an efficiency problem, building upon the closely related Chicago school insights of Gary Becker and Milton Friedman; (3) the treatment of discrimination as a constitutional problem, as seen in extensions of the framework of James M. Buchanan and Gordon Tullock; and (4) historical analysis of discriminatory institutions, also as seen in the work of Tullock. Together, the four components provided the basis of a comprehensive economic critique of discrimination that has since been neglected in the literature on the history of economic thought, and that offers far-reaching insights into the academic literature on race and the continued problem of discriminatory institutions.

Middle School Children With Attention-Deficit/Hyperactivity Disorder Have a Greater Concussion History.

Examine lifetime history of concussions in middle school student athletes who have attention-deficit/hyperactivity disorder (ADHD). Cross-sectional study. Nine middle schools in Virginia, USA. A sample of 1037 middle school students (ages 11-14 years, M = 12.6, SD = 0.93; 45.8% girls) underwent baseline/preseason assessments during the 2017 to 2018 academic year and self-reported their health history, including whether or not they had been diagnosed with ADHD. Athletes were divided into 2 groups, those with ADHD (n = 71; 6.8%) and control subjects (n = 966). Self-reported diagnosis of ADHD and self-identified sex. Self-reported concussion history. In the total sample, boys were more likely to report a previous history of concussion than girls [χ2(1) = 10.81, P = 0.001; odds ratio (OR) = 1.92; 95% confidence interval (CI), 1.30-2.85]. The rate of previous concussion in children with ADHD (23.9%) was twice the rate of previous concussion among children without ADHD (11.4%) [χ2(1) = 9.70, P = 0.002; OR = 2.45; 95% CI, 1.37-4.38]. Approximately 1 in 4 boys with ADHD (24.5%) and 1 in 5 girls with ADHD (22.2%) reported having sustained one or more previous concussions. Attention-deficit/hyperactivity disorder is associated with a greater prevalence of previous concussion in middle school children. Further research is needed to understand the risk of sustaining concussion for young athletes with ADHD, as well as short- and long-term outcomes of concussion among young athletes with ADHD.

Histological Subtypes and Response to PD-1/PD-L1 Blockade in Advanced Urothelial Cancer: A Retrospective Study.

Urinary tract cancer can be pure urothelial carcinoma, pure nonurothelial carcinoma or variant urothelial carcinoma (defined here as mixed urothelial carcinoma). Little is known regarding outcomes for patients with variant urothelial carcinoma receiving immune checkpoint inhibitors. We hypothesized that variant urothelial carcinoma does not compromise immune checkpoint inhibitor efficacy in patients with advanced urothelial carcinoma. We performed a retrospective cohort study across 18 institutions. Demographic, clinicopathological, treatment and outcomes data were collected for patients with advanced urothelial carcinoma who received immune checkpoint inhibitors. Patients were divided into pure vs variant urothelial carcinoma subgroups, with variant urothelial carcinoma further divided by type of variant (ie squamous, neuroendocrine etc). We compared overall response rate using univariate and multivariate logistic regression and progression-free survival and overall survival using Kaplan-Meier and univariate and multivariate Cox proportional hazards. Overall 519 patients were identified, with 395, 406 and 403 included in overall response rate, overall survival and progression-free survival analyses, respectively. Overall response rate to immune checkpoint inhibitors between patients with pure vs variant urothelial carcinoma was comparable (28% vs 29%, p=0.90) without significant differences for individual subtypes vs pure urothelial carcinoma. Median overall survival for patients with pure urothelial carcinoma was 11.0 months vs 10.1 months for variant urothelial carcinoma (p=0.60), but only 4.6 months for patients with neuroendocrine features (9 patients, HR 2.75, 95% CI 1.40-5.40 vs pure urothelial carcinoma, p=0.003). Median progression-free survival was 4.1 months for pure vs 5.2 months for variant urothelial carcinoma (p=0.43) and 3.7 months for neuroendocrine features (HR 1.87, 95% CI 0.92-3.79 vs pure urothelial carcinoma, p=0.09). Overall response rate to immune checkpoint inhibitors was comparable across histological types. However, overall survival was worse for patients with tumors containing neuroendocrine features. Variant urothelial carcinoma should not exclude patients from receiving immune checkpoint inhibitors.

Self-Portrait with Statue of a Hawk, and: Self-Portrait as Ornament

Self-Portrait with Statue of a Hawk, and: Self-Portrait as Ornament Annie Kim (bio) Self-Portrait with Statue of a Hawk Some days I stare into the mirror like a movie character. I could talk to my reflection, but what to say? I use a wand to paint two midnight lines across my eyelids. If the wand shakes, I get two Rorschachs. Don't think, I think.There are reasons why a lake might freeze: hardheartedness, a desire to reflect, boredom. Reasons why the hawk perched on the roof of that crumbling brownstone never moves. In the landscapes of Hendrick Avercamp the lake is always frozen. Unclear, though, whether the villagers skating across the lake with their baskets and their plumy cloaks are having the time of their lives because now they can go wherever they want or because now they realize how the end of the world will look: cold but sunny.Some days I prefer leafless trees. They're like those ancient women who stand around in the gym locker room, buck naked, skin steaming a little after a shower, toes soft—ever so slightly taloned—gripping their snowy patch of towel. [End Page 100] Self-Portrait as Ornament Say you were a sink. Say you had a pedestal. And your walls, high and lovely, were engineered to release the water that came tumbling down each day into your drain. What is a mouth, anyway? Though you remember how to pray. How you sat with that blond boy, holding hands beneath a tree, asking Heavenly Father to pierce the hearts of your unbelieving friends. Now you watch the squirrels leap from branch to branch and listen to the wind tossing supple golden leaves of the oak from where you stand, affixed to drywall. Your dream? No longer whisking off your daily damages through pipes, those switchboard circuits, no longer being sturdy, worthy, useful—just an ornament. But how would you endure those vapid hours simply crouched in your sunlit corner, wordlessly absorbing space? [End Page 101] Annie Kim Annie Kim is a poet, ex-lawyer, and violinist. Her books are Eros, Unbroken (2020), winner of the 2019 Washington Prize, and Into the Cyclorama, winner of the Michael Waters Poetry Prize (2016), a finalist for the Foreword INDIES Best Poetry Book of the Year. Kim's poems have appeared in journals such as Beloit Poetry Journal, The Cincinnati Review, Four Way Review, The Kenyon Review, Narrative, and Plume. A graduate of Warren Wilson College's MFA Program for Writers and the recipient of fellowships from the Virginia Center for Creative Arts and Hambidge Center, Kim works at the University of Virginia School of Law as the Assistant Dean for Public Service, where she teaches in the Program for Law and Public Service. Copyright © 2020 Pleiades and Pleiades Press

The Virginia Journal of International Law (A)

Established in 1959, the Virginia Journal of International Law (VJIL) was a student-edited law review at the University of Virginia School of Law. It was among the world's most influential international law journals, and pieces published in the journal had been cited by the Supreme Court of the United States and the International Court of Justice, among many other highly prestigious courts. Despite this, it faced numerous operational challenges, including long publication lead times, missed publication dates, and financial uncertainty. The case allows students to practice problem solving through the A3 thinking process. Supplemental videos discuss aspects of the case in detail and support case discussion. Excerpt UVA-OM-1640 Jul. 31, 2020 The Virginia Journal of International Law (A) This is a [freaking] mutiny…how the hell did it get like this? —Incoming Editor-in-Chief, Virginia Journal of International Law, Volume 60 Established in 1959, the Virginia Journal of International Law (VJIL) was a student-edited law review at the University of Virginia School of Law. It was among the world's most influential international law journals, and pieces published in the journal had been cited by the Supreme Court of the United States and the International Court of Justice, among many other highly prestigious courts. VJIL covered a wide range of topics within international law, including international commercial law, international litigation and arbitration, international humanitarian and human rights, and comparative law. The journal expected to publish three editions annually, comprising one volume. Each issue contained approximately four pieces, which could be articles, notes, or essays. VJIL had hundreds of universities and agencies as subscribers that paid annual subscription fees for the three editions in each volume. The journal had the goals of being profitable and being a highly citable and prestigious law review to which scholars and judges looked when writing commentary and making decisions about the future of international law. . . .

164: PREDICTIVE VALUE OF SOMATIC REGIONAL OXYGEN SATURATION IN NEONATES FOLLOWING CARDIAC SURGERY

1University of Virginia School of Medicine, Charlottesville, VA 2Johns Hopkins Medical Institutions, Baltimore, MD

Experts Meetings on Biodiversity beyond National Jurisdiction

This article summarizes and discusses the main issues addressed at two events hosted at the World Maritime University–Sasakawa Global Ocean Institute in Malmö, Sweden in the first half of 2019. The first event was the International Workshop on bbnj: Toward Development of a Balanced, Effective and Universal International Agreement on 7 February, co-sponsored by the Ministry of Foreign Affairs Japan, and the second event was the 43rd colp Annual Conference on Biodiversity Beyond National Jurisdiction: Intractable Challenges &amp; Potential Solutions co-hosted with the Center for Oceans Law and Policy (colp), University of Virginia School of Law and The Nippon Foundation. The two events covered topics including marine genetic resources – access and benefit sharing, area-based management tools including marine protected areas, environmental impact assessments, capacity building and transfer of technology, cross-cutting issues, and Arctic concerns.

Medical emergencies in flight: Are doctors prepared to improvise?

Medical emergencies in flight: Are doctors prepared to improvise?

Moving Toward Summative Competency Assessment to Individualize the Postclerkship Phase.

In the move toward competency-based medical education, leaders have called for standardization of learning outcomes and individualization of the learning process. Significant progress has been made in establishing defined expectations for the knowledge, skills, attitudes, and behaviors required for successful transition to residency training, but individualization of educational processes to assist learners in reaching these competencies has been predominantly conceptual to date. The traditional time-based structure of medical education has posed a challenge to individualization within the curriculum and has led to more attention on innovations that facilitate transition from medical school to residency. However, a shift of focus to the clerkship-to-postclerkship transition point in the undergraduate curriculum provides an opportunity to determine how longitudinal competency-based assessments can be used to facilitate intentional and individualized structuring of the long-debated fourth year.This Perspective demonstrates how 2 institutions-the University of Virginia School of Medicine and the University of Michigan Medical School-are using competency assessments and applying standardized outcomes in decisions about individualization of the postclerkship learning process. One institution assesses Core Entrustable Professional Activities for Entering Residency, whereas the other has incorporated Accreditation Council for Graduate Medical Education core competencies and student career interests to determine degrees of flexibility in the postclerkship phase. Individualization in addition to continued assessment of performance presents an opportunity for intentional use of curriculum time to develop each student to be competently prepared for the transition to residency.

The Pediatrician's Role in Eliminating Racial and Ethnic Disparities in Sleep-Related Infant Deaths.

* Abbreviation: PRAMS — : Pregnancy Risk Assessment Monitoring System The infant mortality rate in the United States ranks 33rd among countries belonging to the Organization for Economic Cooperation and Development,1 and there are persistent racial and ethnic disparities, with non-Hispanic black infants dying at a rate 2 to 3 times that of non-Hispanic white infants.2 In this issue of Pediatrics , Hirai et al3 provide insight into racial and ethnic differences in infant sleep practices that have important implications for racial and ethnic disparities for sleep-related infant deaths, including sudden infant death syndrome and accidental suffocation and strangulation in bed, which are the third leading cause of infant mortality in the United States. Hirai et al3 leveraged recently added questions to the Centers for Disease Control and Prevention’s Pregnancy Risk Assessment Monitoring System (PRAMS) to examine differences in sleep position, items in the sleep environment, bed-sharing, and room-sharing by race and ethnicity. Forty-seven states currently partner with the Centers for Disease Control and Prevention to administer the PRAMS survey to a randomly selected subpopulation of women in their state who have recently delivered. PRAMS previously only … Address correspondence to Rachel Y. Moon, MD, Department of Pediatrics, University of Virginia School of Medicine, PO Box 800386, Charlottesville, VA 22908. E-mail: rymoon{at}virginia.edu

Deregulation of European Telecommunications: The Role of Private Interests

The large-scale reformation of various economic industries, which took place in developed countries at the end of the last century, is very oft en perceived as “liberalization” or “deregulation”. Meanwhile, there are robust reasons to argue that this terminology does not fit correctly the nature of the real transformation. Moreover, the newly formed system is often described in modern literature in such terms as “managed competition” or “regulatory capitalism”, and this system highly relies on various forms of government interventions in the market process, which makes the environment incompatible with the proclaimed values of neoliberalism. The analysis of the actual processes from the point of view of private interest theories of regulation allows one to conclude that the real objectives of the new regulatory environment were rather the suppression of market mechanisms and the curbing of the creative destruction process, than the development of market institutions as was proclaimed in the official documents. Moreover, it is important to take into account that the scientifi c discussion also off ered an alternative to the chosen methods. It could be based on the views of the Austrian school of economics, which understands competition in a diff erent manner than the neoclassical mainstream does. However, this alternative was widely ignored by the reformers. This study focuses on the European telecommunications sector. The history of its reformation allows one to see in details how, under the guise of market liberalization, the reforms created a new regulatory regime that was aimed at restriction of market forces. Th e research uses the approaches of the Austrian school, as well as those of the Virginia school of political economy which formed the main postulates of public choice theory, according to which government interventions are mainly explained by private interests of powerful actors.

First person – Robert Bloodgood and Roger Sloboda

ABSTRACT First Person is a series of interviews with the authors of a selection of papers published in Journal of Cell Science. Here, established researchers Robert Bloodgood and Roger Sloboda, authors on ‘The Chlamydomonas flagellar membrane glycoprotein FMG-1B is necessary for expression of force at the flagellar surface’, published in JCS, talk about their paper and career. Robert is a Professor at Department of Cell Biology, University of Virginia School of Medicine, VA, and Roger is a Professor at Department of Biological Sciences, Life Science Center, Dartmouth College, NH. They are interested in understanding the mechanism of an unusual form of cell motility, flagellar-dependent whole-cell gliding in the bi-flagellate green alga Chlamydomonas.

Middle School Children with Attention-Deficit/Hyperactivity Disorder Have a Greater Concussion History

Abstract Purpose Examine lifetime history of concussions in middle school student athletes who have attention-deficit/hyperactivity disorder (ADHD). Methods A sample of 1,037 students from nine middle schools in Virginia, USA (ages 11 to 14, M=12.6, SD=0.93; 45.8% girls) underwent baseline/pre-season assessments during the 2017-2018 academic year and self-reported their health history, including whether or not they had been diagnosed with ADHD and their concussion history. Athletes were divided into two groups, those with ADHD (n=71; 6.8%) and control subjects (n=966). Chi-Square tests were conducted to compare the number of prior concussions in students with and without ADHD. Results In the total sample, boys were more likely to report a prior history of concussion than girls [χ2(1) =10.81, p=.001; OR=1.92; 95% CI=1.30-2.85]. The frequency of prior concussion in children with ADHD (23.9%) was twice the frequency of prior concussion among children without ADHD (11.4%) [χ2(1)=9.70, p=.002; OR=2.45; 95% CI=1.37-4.38]. Approximately one in four boys with ADHD (24.5%) and one in five girls with ADHD (22.2%) reported having sustained one or more prior concussions. Conclusion ADHD is associated with a greater prevalence of prior concussion in middle school children. Further research is needed to understand the risk of sustaining concussion for young athletes with ADHD, as well as short- and long-term outcomes of concussion among young athletes with ADHD.

WVSOM Anatomy Lab Tour Program: An Osteopathic Medicine Pipeline With Student Teaching Opportunities.

In spring 2013, the West Virginia School of Osteopathic Medicine (WVSOM) reformatted its Anatomy Lab Tour Program to include interactive stations in the gross anatomy laboratory. The design of the outreach program introduces high school and allied health learners to osteopathic medicine while working through anatomy laboratory stations and how the tenets of osteopathic medicine relate to a person's overall health and wellness. Throughout the history of the program, first- and second-year osteopathic medical students at WVSOM have helped teach visiting learners in the laboratory experience. The new program design allows more time for one-on-one time between the student teachers and the learners. Exit surveys have reported that the current program design creates a synergistic learning environment in which both the learners and student teachers benefit through the encounter. The authors present this case study of the WVSOM Anatomy Lab Tour Program to establish a baseline for the collection of information gained through participant surveys to assess the impact of the program on learners and student teachers.

A data envelopment analysis of West Virginia school districts

West Virginia schools are consistently below the national average on the National Assessment of Educational Progress. Using Data Envelopment Analysis, we estimate the technical efficiency of West Virginia school districts. We find less variation in technical efficiency in West Virginia than in similar studies conducted in other states. This appears to be because of state policy imposing homogeneity of input usage. Due to the limited variation in technical efficiency across districts, we cannot analyze how non-school inputs such as socioeconomic factors affect technical efficiency across districts. Summary statistics organized by county economic status, however, suggest that socioeconomic status plays a role. Our results highlight an important limitation of DEA analysis on schools.

Behavioral economics and the Virginia school of political economy: overlaps and complementarities

A variety of complementarities and overlaps exist between the psychological strand of behavioral economics and the subjectivist strand of Virginia Political Economy. This paper provides an overview of those commonalities and places them in a common information processing framework. The framework can account for systematic mistakes, framing effects, subjectivity, individual variety, and several issues in constitutional political economy. It also reveals many commonalities between these two quite different approaches to human behavior.