Southern Illinois University Research Articles

Social Accountability at Southern Illinois University School of Medicine: A Focus on Admission Policy

Given the increasing health disparities across regions and populations, social accountability is not an option but an obligation for health professions schools, including medical schools. In this short communication, the authors report the case of Southern Illinois University School of Medicine (SIU SOM), which has been an exemplary medical school for social accountability, receiving the 2013 AMEE ASPIRE Award in social accountability and the 2018 Josiah Macy Jr. Foundation Award for Institutional Excellence in Social Mission in Health Professions Education. This paper focuses on the school’s admission policies in the discussion of its social accountability. It starts with the background of central and southern Illinois, where the school is located to address the shortage of healthcare professionals in the areas. It discusses the school’s holistic admission policies and two pipeline programs—namely, MEDPREP and McNeese Physician Preparatory Pipeline Program (P4)—that are strategically designed as a long-term physician workforce development plan to address health disparities in rural areas. As of January 30, 2024, 3,233 students have earned the MD (Doctor of Medicine) degree at SIU SOM. In total, 770 alumni (33%) are practicing in primary care. Among 901 graduates practicing in Illinois, 484 (54%) are practicing in SIU SOM service area counties (i.e., central and southern Illinois). Social accountability is the core value and organizational identity of SIU SOM and the guiding principle of the school’s innovation and excellence.

How Americans and Saudis Make Requests: A Politeness Theory Analysis

This study elucidates how speakers of different cultures, namely, Saudi Arabia and United States employ the speech act of requesting, drawing upon various politeness features. It conducted a qualitative analysis to offer explanations for different strategies of requests used by both groups and how they employ politeness features. The present study also conducted small statistics (frequencies and percentages) to explore the most and least common strategies that were used by participants in this study. The sample of this study included 20 Saudis and 20 Americans who were students at Southern Illinois University. The findings revealed that while Saudi participants used more direct strategies than their American counterparts, these direct strategies were characterized as positive politeness. That is, Saudi participants relied on directness feature to minimize the social distance with the addressee. However, American students were more formal than their Saudi counterparts, suggesting that they were less direct when they made requests. But this type of directness is negative as it doesn’t aim at removing social borders between interlocutors. This study indicates that Saudis tend to be more informal (and hence less indirect) than Americans when they make requests. The present study demonstrates that culture is a key social factor to determine how this speech act is employed by speakers of different cultures. It can thus be argued that directness has social implications as it plays an important role in eliminating social borders and minimizing social distance between the interlocutors.

Abstract P102: Reducing Testing Burden in Patients Screened for Primary Aldosteronism

Introduction: Primary aldosteronism (PA) is an increasingly recognized secondary cause of hypertension characterized by higher cardiovascular, renal, and metabolic disease rates than blood pressure-matched essential hypertensives. Current literature suggests expanding screening for PA to include the majority, if not all, hypertensive patients. This expansive screening would place considerable burden on patients and the healthcare system. A simple clinical risk prediction model that identifies patients with low risk for PA could reduce this testing burden. Methods: We evaluated 111 hypertensive patients in the Southern Illinois University Hypertension Clinic who underwent a screening test and, if positive, had subsequent confirmatory testing for PA. We characterized patients based on routine clinical measures including antihypertensive treatment intensity, blood pressure, serum electrolytes, and body size. Classification trees incorporating 96 patients without missing data points for any considered predictor variable were used to identify hypertensive screen-positive patients who have low to absent risk for PA as determined by confirmatory testing. Results: Patients with PA had higher serum aldosterone levels at screening (mean = 22.5 ng/dl ± SD = 11.6 vs. 15.2 ± 4.5, p < 0.001), higher BMI (35.8 kg/m 2 ± 9.9 vs. 29.9 ± 5.8, p < 0.001), lower potassium (3.9 mmol/L ± 0.5 vs. 4.1 ± 0.6, p = 0.03), and more intense antihypertensive drug therapy (defined by the World Health Organization defined daily dose [6.1 ± 3.2 vs. 4.4 ± 3.0, p = 0.01]) than hypertensive patients without PA. The optimal classification tree model performed relatively poorly at differentiating those with PA from those without PA (sensitivity = 0.76, specificity = 0.86, positive predictive value = 0.87, and negative predictive value = 0.73). However, the model did reveal a subset of individuals who consistently tested negative for PA. Out of 14 patients with serum aldosterone concentration < 25.5, serum potassium > 3.55, and BMI < 27, none had PA. Conclusion: We identified a set of readily available clinical variables for identifying hypertensive patients who screened positive for PA but in whom PA was subsequently proven to be absent. Applying these criteria to our screen-positive hypertensive cohort reduces confirmatory testing by approximately 15%. Study in a larger sample size and external validation of this model is needed prior to recommending it for use in clinical decision-making.

Assessment of the Incidence of Müllerian Anomalies in Central Illinois

Introduction: Müllerian anomalies include a spectrum of malformations resulting from the underdevelopment of the Müllerian duct during embryological development. This results in a malformed vagina, uterus or both. Complete agenesis of one or both of these structures in a subset of these cases is known as Mayer‐Rokitansky‐Küster‐Hauser (MRKH) syndrome. There are two types of Müllerian agenesis: Type I MRKH only affects the upper vagina, cervix and uterus, whereas Type II MRKH has associated malformations affecting the renal, auditory and skeletal systems. The reported prevalence is approximately 1 in 5,000 for MRKH syndrome and ~5.5 in 100 for all Müllerian anomalies; however, there is a broad range in the described incidence rates. Purpose: We hypothesized the patient population served by the Department of Ob/Gyn, Division of Reproduction, Endocrinology and Infertility (REI) at Southern Illinois University (SIU) School of Medicine has a higher incidence of Müllerian anomalies and MRKH. Our objective was to assess the incidence of these Müllerian anomalies and describe the types of anomalies that affect women in Central Illinois. Methods: All patients receiving care at SIU Ob/Gyn, Division of REI from 01/1/2010-07/31/2021 were queried using specific ICD-9 and 10 codes and further screened to verify eligibility. A retrospective review (IRB# 21-893) was then conducted on all eligible subjects and relevant health information was extracted from the electronic health record. Continuous variables were measured by central tendency (mean or median) and dispersion (standard deviation or range). Categorical variables were described using frequencies and percentages. Results: The initial query identified 282 individuals of which 81 were deemed eligible (i.e., confirmed Müllerian anomaly). The total number of unique patients who underwent an ultrasound at REI during that time of study approval was 697. Based on these data, the calculated incidence of Müllerian anomalies in the REI patient population is ~11.6% and the incidence of MRKH is 57 in 5000. Demographics included: 74 subjects were White (91.4%), two Black or African American (2.5%), one Asian (1.2%) and 4 declined to report their race or identified as more than one race (4.9%); two subjects were of Hispanic ethnicity (2.5%). Mean ages at menarche and diagnosis were 12.7 ± 1.7 and 27.8 ± 6.4 years, respectively. Eight subjects diagnosed with MRKH had Type I MRKH. The specific type of anomalies identified included: uterine septum (29.1%), arcuate uterus (25.3%), unicornuate uterus (19.0%), agenesis (10.1%), bicornuate uterus (6.3%), uterus didelphys (6.3%) and 3.8% had another type of anomaly. The majority of patients underwent surgery within approximately one year of diagnosis (74%). Postoperative complications were rare (~7%) and included mild constipation, urinary retention and bleeding from the incision site. Pregnancy outcomes were as follows: prior to diagnosis, 3 (30%) infants were preterm vs. 7 (70%) term and those were spontaneous conceptions; after diagnosis 4 (30%) infants were preterm vs 9 (70%) term deliveries and the most common methods of conception were spontaneous and ovulation induction; post-surgery 11 (31%) infants were born preterm vs 24 (69%) term deliveries, and the most common methods of conception were ovulation induction and in-vitro fertilization. Conclusions: From this initial investigation, we found the incidence of Müllerian anomalies in the SIU Ob/Gyn, REI population is higher than the wide range of reported values. As expected, the vast majority of these patients underwent surgical management with little or no complications. We aim to further study what factors/exposures may be impacting the development of female fetuses resulting in Müllerian anomalies.

Standardizing Patient and Provider Education to Address Breastfeeding Inequity

Introduction: Breastfeeding provides many infant, maternal and societal benefits. Breastfeeding reduces maternal and infant risks for a number of diseases, encourages maternal-infant bonding, is more environmentally friendly and lowers healthcare costs. Based on the most recent Women, Infants and Children (WIC) program data, the obstetrical patient population served by the Department of Ob/Gyn at Southern Illinois University School of Medicine (SIU-SM) was significantly lacking in breastfeeding initiation rates (~16% in 2020) when compared to the Healthy People 2020 goal for ever breastfed infants of 81.9%. We aimed to assess areas of patient care that could be improved upon when counseling our patients about breastfeeding. Purpose: Our primary goal was to evaluate current breastfeeding initiation rates and whether these improved after implementation of the standardized breastfeeding education materials that were to be provided to both healthcare professionals and patients. Methods: In partnership with the Illinois Public Health Institute (IPHI), all patients who received prenatal care at SIU-SM, Department of Ob/Gyn were offered standardized brochures that supplemented our prenatal counseling regarding breastfeeding. Nurses, residents, and other healthcare providers were also provided information on counseling patients. Breastfeeding rates were assessed in our prenatal population prior to and after implementing standardized breastfeeding educational materials (IRB# 22-133) and compared with Chi-square tests. Results: Patient demographics were as follows: 55.9% White, 31.8% Black/African American; 95.7% non-Hispanic; 93.4% utilized Medicaid services for insurance; the mean age was 26.8 ± 6.1 years of age. Baseline breastfeeding initiation rates of ever breastfed infants were significantly higher in the interventional group compared to the control group (75% vs.60%; p=0.002). Breastfeeding rates at the first postpartum visit were also significantly increased after the intervention (65% vs. 43%; p=0.008). A significant increase in the percentage of breast pumps provided in the prenatal clinic was also noted (28.4% vs. 0%; p<0.0001). Conclusions: Breastfeeding rates in our patient population were significantly lower than the Healthy People’s 2020 goal. Raising awareness through this initiative and improving our educational tools via the partnership with IPHI improved breastfeeding initiation rates. As obstetrical providers, we are optimistic about this data, but acknowledge additional interventions may be necessary to improve health equity across our disadvantaged patient population. Future directions include looking at data for ever breastfed infants vs. continuation of breastfeeding through the American Academy of Pediatrics recommended 6 months of exclusive breastfeeding. We would also like to explore how partner involvement and occupation type might impact breastfeeding initiation rates.

Comparative analysis of course prerequisite networks for five Midwestern public institutions

We present the first formal network analysis of curricular networks for public institutions, focusing around five midwestern universities. As a first such study of public institutions, our analyses are primarily macroscopic in nature, observing patterns in the overall course prerequisite networks (CPNs) and Curriculum Graphs (CGs). An overarching objective is to better understand CPN variability and patterns across different institutions and how these patterns relate to curricular outcomes. In addition to computing well known network centrality measures to capture courses of importance in the CPNs studied, we have also formulated some newer methods with specific relevance to the curricular domains and corresponding graph types at hand. We have discovered that a new graph theoretic measure of node importance which we call reach, based on the well-known concept of reachability, is needed to more accurately express the critical nature of some introductory courses in a university. Another analytical novelty that we introduce and apply to the subject of CPNs is the Longest Paths Induced sub-Graph (LPIG) of the CPN, which yields information on relatively constrained programs and pathways. Finally, we have established a new connection between clustering of the CG and meta-majors at Southern Illinois University Edwardsville (SIUE), providing clusterings of the other public institution CGs as useful heuristics of major groupings as well. This work is borne from collaboration between academic units and academic advising with hopes of practical benefits towards aiding student advising.

Omega-3 Fatty Acids Prevent Peripheral Neuropathy and Pro Inflammatory Adipose Tissue Macrophage Phenotype in High-Fat-Fed Mice

Obesity and/or consumption of a high fat diet is associated with the development of peripheral neuropathy (PN) which is characterized by changes in epidermal innervation and increased sensitivity in the extremities. Evidence indicates that omega-3 fatty acids prevent the development of PN and attenuate adipose inflammation, but the interaction of PN and adipose tissue macrophage (ATMΦ) phenotype have not been investigated. We hypothesized that a diet high in unsaturated fatty acids may prevent PN and adipose inflammation, despite the high fat content. PURPOSE: Assess the effects of omega-3 fatty acids on signs of PN and ATMΦ phenotype in high-fat-fed mice. Methods: Male C57Bl/6 mice were randomized to (n = 12-14/group): 10% low fat fish oil (10% FO); 54% high fat fish oil (54% FO); 10% low fat lard (10% L); or 54% high fat lard (54% L) for 14 weeks. PN was characterized by the von Frey test for hindpaw sensitivity at baseline then biweekly through week 14. After 14 weeks, intraepidermal nerve fiber density (IENFD) was quantified by immunohistochemistry of the hindpaw footpad skin using anti-PGP 9.5. The relative percentage of total macrophage cells (F4/80+CD11b+) and M1 (CD206-CD11c+) and M2 (CD206+CD11c-) cell populations in epididymal adipose were identified using flow cytometry. Group differences were identified by 2 x 2 factorial ANOVA. Pearson correlations were used to assess the relationship between hindpaw withdrawal threshold and ATMΦ. Results: 54% L (35.3 ± 1.0 g) had greater body mass compared to all other groups: 10% FO (26.5 ± 0.7, p < 0.001); 10% L (27.8 ± 0.6, p = 0.001); and 54% L (35.3 ± 1.0, p < 0.001). Similarly, fasting insulin was greater in 54% L (3.1 ± 0.4 ng/mL) compared to all other groups: 10% FO (1.0 ± 1.0, p < 0.001); 10% L (1.6 ± 0.2, p < 0.001), and 54% FO (1.0 ± 0.1, p < 0.001). Fasting glucose was greater in 54% L (225.8 ± 7.5 mg/dl) compared to 10% FO (216.1 ± 7.7, p =0.04) and 54% FO (182.6 ± 6.6, p = 0.03), but not 10% L (180.7 ± 17.1, p = 0.483). Following the same pattern as body mass and insulin, homeostatic model assessment of insulin resistance (HOMA-IR) was greater in 54% L (8.1 ± 1.1) compared to all other groups: 10% FO (2.2 ± 0.4, p < 0.001); 10% L (4.1 ± 0.6, p < 0.001); and 54% FO (2.2 ± 0.3, p < 0.001). Hindpaw sensitivity was greater in 54% L (0.08 ± 0.02 g) compared to 54% FO (0.19 ± 0.03, p = 0.02). IENFD was greater in 54% L (52.5 ± 2.2 fibers per mm) compared to 10% FO (44.1 ± 1.5, p = 0.04), but was not different from 10% L (49.7 ± 2.8, p = 0.47) or 54% FO (48.1 ± 3.0, p = 0.24). M1 ATMΦ percentage was greater in 54% L (11.7 ± 2.5 %) compared to all other groups: 10% L (3.8 ± 0.8, p = 0.001), 10% FO (5.2 ± 0.7, p = 0.014), and 54% FO (5.1 ± 0.6 %, p = 0.016). M2 ATMΦ percentage was greater in 10% L (59.7 ± 4.5 %) compared to all other groups: 10% FO (42.1 ± 5.0, p = 0.036), 54% L (41.4 ± 3.9, p = 0.027), and 54% FO (31.4 ± 3.6 %, p < 0.001), but there were no significant differences in M2 ATMΦ percentage in 54% L vs. 54% FO. There were no significant correlations between hindpaw sensitivity and M1 ATMΦ percentage, M2 ATMΦ percentage, or M1:M2 ratio. CONCLUSION: The negative metabolic effects of a high fat lard diet on body mass, glucose, insulin, and insulin resistance were prevented when the dietary fat source was omega-3 fatty acids instead of lard. Notably, mice fed a high fat lard diet had a higher percentage of the pro inflammatory M1 ATMΦ phenotype and developed signs of painful PN including hindpaw hypersensitivity and increased IENFD but these effects were prevented by omega-3 fatty acids in the 54% FO group, despite the high dietary fat content. Supported by the Southern Illinois University Edwardsville Vaughnie Lindsay New Investigator Award. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Discovering social learning ecosystems during clinical clerkship from United States medical students’ feedback encounters: a content analysis.

We examined United States medical students’ self-reported feedback encounters during clerkship training to better understand in situ feedback practices. Specifically, we asked: Who do students receive feedback from, about what, when, where, and how do they use it? We explored whether curricular expectations for preceptors’ written commentary aligned with feedback as it occurs naturalistically in the workplace. This study occurred from July 2021 to February 2022 at Southern Illinois University School of Medicine. We used qualitative survey-based experience sampling to gather students’ accounts of their feedback encounters in 8 core specialties. We analyzed the who, what, when, where, and why of 267 feedback encounters reported by 11 clerkship students over 30 weeks. Code frequencies were mapped qualitatively to explore patterns in feedback encounters. Clerkship feedback occurs in patterns apparently related to the nature of clinical work in each specialty. These patterns may be attributable to each specialty’s “social learning ecosystem”—the distinctive learning environment shaped by the social and material aspects of a given specialty’s work, which determine who preceptors are, what students do with preceptors, and what skills or attributes matter enough to preceptors to comment on. Comprehensive, standardized expectations for written feedback across specialties conflict with the reality of workplace-based learning. Preceptors may be better able—and more motivated—to document student performance that occurs as a natural part of everyday work. Nurturing social learning ecosystems could facilitate workplace-based learning such that, across specialties, students acquire a comprehensive clinical skillset appropriate for graduation.

ECR Spotlight – Jason Dallas

ECR Spotlight is a series of interviews with early-career authors from a selection of papers published in Journal of Experimental Biology and aims to promote not only the diversity of early-career researchers (ECRs) working in experimental biology but also the huge variety of animals and physiological systems that are essential for the ‘comparative’ approach. Jason Dallas is an author on ‘ Cross-species gut microbiota transplantation predictably affects host heat tolerance’, published in JEB. Jason conducted the research described in this article while a PhD student in Dr Robin Warne's lab at Southern Illinois University, USA. He is now a postdoctoral research assistant in the lab of Dr Donald Walker at Middle Tennessee State University, USA, investigating herpetofauna ecophysiology including thermal biology, host microbiome and responses to human activity.

The influence of Area Deprivation Index on cognition in cognitively‐normal adults as measured by Principal Component Analysis of Neuropsychological Data

AbstractBackgroundPrevious research has demonstrated that neighborhood disadvantage is associated with worse health outcomes including increased risk for dementia. The Area Deprivation Index (ADI) measure represents the theoretical domains of income, education, employment, and housing quality, which allows for the ranking of neighborhoods based on socioeconomic disadvantage. In the present study, we hypothesized that greater neighborhood disadvantage (i.e., higher ADI scores) would be associated with lower cognitive function after controlling for age, education, and sex.MethodPrincipal component analysis (PCA) was used to examine the component structure of a neuropsychological test battery administered to 852 adult participants enrolled in the Southern Illinois University Longitudinal Cognitive Aging Study (SIU LCAS). The vast majority of the cohort was White/Not Hispanic (>98.0%) and female (72.4%). Mean age and education were 67.5 years and 14.8 years, respectively. Linear regression analysis was used to examine the relationship between ADI and PCA cognitive component scores after controlling for age, education, and sex.ResultPCA identified four cognitive components, which were labeled speed/flexibility, visuospatial skills, word list learning/memory, and story memory (immediate and delayed recall). Regression analysis revealed that all three demographic variables were significantly associated with each cognitive component score (p<0.001). After controlling for age, gender, and education, higher ADI scores were associated with lower cognitive component scores for only the speed/flexibility component (p = 0.03). Age, education, and sex accounted for 23% of the variance in the speed/flexibility component. ADI accounted for only an additional 0.4% of the variance in the speed/flexibility component. There was no significant relationship between ADI scores and the visuospatial skills, word list learning/memory, and story memory components.ConclusionOur results suggest that the relationship between greater neighborhood disadvantage and poorer cognitive function are very subtle and may only be present for some, but not all, cognitive domains. One major limitation in the present study was that collection of cognitive data and ADI calculations were not synchronous. More studies are needed to better understand the relationship between neighborhood disadvantage and cognitive functioning.

The Marion Experiment: Long-term Solitary Confinement and the Supermax Movement edited by Stephen C. Richards. Carbondale (IL): Southern Illinois University Press (2015) 336 pp.

The Marion Experiment: Long-term Solitary Confinement and the Supermax Movement edited by Stephen C. Richards. Carbondale (IL): Southern Illinois University Press (2015) 336 pp.

PSI-9 Efficacy of Electrolyte Chews in Horses

Abstract Oral supplementation with electrolytes is commonly practiced among horse owners. However, practical ease of administration can be challenging due to palatability issues. The objective of this study was to investigate the efficacy of a novel electrolyte product form during routine exercise. Protocol approval (21-029) by Southern Illinois University Institutional Animal Care and Use Committee was obtained before initiation of this work. Privately-owned local foxhunting horses (n = 15) were evaluated. Treatment groups were identified based on voluntary consumption of chews and include control (CON) = 0 chews; light (LIG) 6 to 9 chews; and moderate (MOD) 15 to 20 chews. Jugular venipuncture and vitals assessments were completed 30 minutes before and 30 minutes following a 2-hour ride. Electrolyte chews were offered in two sessions: 30 minutes pre-ride and immediately post-ride. Serology values for Na, K, Cl, Ca, HCO−3, Mg were measured as well as respiratory rate (RR), skin turgor (SKN), and rectal temperature (BT). Categorical variables included body condition score (BCS), sex, and breed (BRD). Data were analyzed via PROC GLM, PROC FREQ and PROC CORR dependent on test with SAS (v. 9.5). Significance for all tests was set at P < 0.05. Serological values were unaffected by electrolyte consumption (P > 0.05). Body temperature was significantly higher for all horses following exercise, regardless of treatment group (P = 0.0005). Skin turgor showed significantly more time before return to original state during post-ride evaluation (P = 0.0013). Respiratory rate was noted to decrease post-exercise, suggesting an increased baseline due to recent transport (P = 0.0158). Directional serum changes between Cl and K were correlated (P = 0.0227) as well as Mg and Cl (P = 0.0316). Correlations of relational change between Ca and HCO−3 in addition to Ca and Na were approaching significance (P = 0.0707; P = 0.0800). Mares demonstrated a greater ability to maintain lower post-ride serum calcium levels than geldings (P = 0.013). Preliminary effect of breed on serological calcium change may also be considered (P = 0.0312). To conclude, differences in sex may alter electrolyte use pathways, such as calcium. The exercise challenge was sufficient based on vitals assessments. These data suggest key factors associated with chewable electrolyte form administration. Further research is needed to identify the impacts of electrolyte form on efficacy as well as improve palatability.

432 Fluctuations in Equine Cutaneous Ph and Trans-Epidermal Water Loss Associated with Anatomical Location, Time, and Weather

Abstract Although skin health is of critical importance for all horse owners, understanding of cutaneous pH and trans-epidermal water loss (TEWL) and the normal ranges of these variables is lacking. Cutaneous pH and TEWL measures provide insight into the barrier function of the epidermis and have the potential to determine the resident dermal microbiota. However, these measures have been recorded to fluctuate due to a variety of factors such as environment and anatomical locations in other species. Accordingly, the objectives of this study were to identify the impacts of anatomical location, weather, and time of day on cutaneous pH and TEWL in equines. This study utilized nine (n = 9) stock type mares, group-housed in a pasture setting at Southern Illinois University Equine Center. Researchers measured cutaneous pH and TEWL three times (6:00 AM, 12:00 PM, 6:00 PM) daily across five anatomical locations (nose, whither, heart-girth, mid-back, and base of tail) for five consecutive days. All statistical analysis was conducted using SAS On Demand for Academics (P < 0.05). Analysis of changes in variables associated with time, anatomical location, and day were conducted utilizing a PROC GLM three-way repeated measures ANOVA utilizing a Greenhouse-Geiser correction. Cutaneous pH results displayed significant main effects of day (P = 0.0052) and time (P = 0.0073) as well as a significant interaction of day and location (P = 0.0004). Mean cutaneous pH fluctuated daily, however, certain anatomical locations fluctuated more than others each day. Additionally, pH was highest in the morning (mean of 7.28) and lowest in the evening (mean 7.011). However, the mean overall pH for the study is 7.14 which is congruent with other work. TEWL measurements had significant main effects of day (P < 0.0001), time (P < 0.0001), and location (P = 0.0231), as well as a significant interaction of day, time, and location (P < 0.0001). TEWL measurements fluctuated with day, likely a result of weather changes. Mean TEWL measurements were less in the morning (mean 24.68) and greatest in the afternoons (mean 38.52). Overall mean TEWL measurement was 30.25. The results of this work indicate fluctuations in dermal barrier variables are associated with day, anatomical location, and time of day. These findings may have implications for applications of dermal treatments for horses as well as catalog the natural fluctuations which may affect future research.

Lincoln and Native Americans By Michael S.Green, Carbondale: Southern Illinois University Press. 2021. pp. 176

Lincoln and Native Americans By Michael S.Green, Carbondale: Southern Illinois University Press. 2021. pp. 176

THU608 Evaluation Of Incidental Adrenal Masses After Initial Radiographic Diagnosis

Abstract Disclosure: V. Williams: None. N. Wazzan: None. M. Abu Limon: None. J.O. Abdelkarim: None. M.G. Jakoby: None. G. Sydney: None. A. Gagen: None. H. O'neil: None. U. Tarabichi: None. Background. Incidental adrenal masses (IAM’s) are masses of the adrenal glands ≥ 1 cm in diameter discovered during imaging for an indication other than adrenal pathology. Diagnosis of IAM’s has increased with improved resolution of computed tomography (CT), but little is published on how often IAM’s are appropriately evaluated and factors that predict if assessment will occur. This study was conducted to determine the frequency with which IAM’s are evaluated according to American Association of Clinical Endocrinologists (AACE) guidelines when diagnosed on CT scans ordered by providers at the Southern Illinois University (SIU) School of Medicine, an academic medical center in rural Central Illinois. Methods. A retrospective single cohort study was performed. Patients age ≥ 18 years undergoing CT from January 1 - December 31, 2017 were eligible. Potential cases were screened by searching for “adrenal mass,” “adrenal nodule,” “adrenal lesion,” or “adrenal adenoma.” Cases were excluded if the mass had been noted before January 1, 2017, imaging was ordered for an adrenal disorder or cancer staging, or the adrenal mass was < 1 cm in largest diameter. Cases were reviewed to determine if recommended metabolic screening and imaging was conducted. Demographic data, insurance status, reason for imaging, type of CT scan, clinical setting, radiology description of the adrenal mass, selected comorbidities (hypertension, hypokalemia, type 2 diabetes mellitus, obesity, and osteoporosis), and referral to an endocrinologist were included as potential predictors of guideline compliant evaluation. Results. A total of 86 IAM’s were identified among 801 CT scans for a prevalence of 10.7%. Only 10 patients (11.6%) underwent metabolic evaluation, 22 had imaging follow-up (25.6%), and only 6 received both (7.0%). All patients with metabolic evaluation were referred to an endocrinologist (P < 0.001). Patients who underwent evaluation were more likely to have CT scans of the abdomen or abdomen and pelvis (P = 0.004) and be diagnosed with hypertension (P = 0.01). Notably, there was no difference in IAM size (evaluated 2.2 ± 1.1 cm, unevaluated 2.0 ± 1.2), and the descriptors “benign” or “benign adenoma” were included in the radiology reports of 88.9% and 88.1% of evaluated and unevaluated patients, respectively. Imaging follow-up was more likely in patients with an endocrine referral (p=0.03), on public insurance (p=0.02), and who were obese (p=0.02). Conclusion. The rate at patient’s with IAM’s were evaluated in accordance with AACE guidelines in this study was very low and may have been strongly influenced by inclusion of the descriptors “benign” or “benign adenoma” in nearly 90% of radiology reports. Providers at SIU who order CT scans need education and guidance on evaluation of IAM’s for metabolic activity and monitoring for changes in size that could indicate adrenocortical carcinoma. Presentation: Thursday, June 15, 2023

Abstract P101: Clinical Risk Prediction Scores For Primary Aldosteronism

Introduction: Primary aldosteronism (PA) is a common and often underdiagnosed secondary cause of hypertension with cardiovascular, kidney, and metabolic disease rates far in excess of essential hypertension matched for blood pressure levels. Current clinical scoring algorithms could reduce patient and healthcare burdens associated with expanded PA screening but have not been extensively validated in external cohorts. Methods: We evaluated six PA scoring algorithms in two populations of patients seen in the Southern Illinois University (SIU) Hypertension clinic: all patients screened for PA where a negative screen was assumed to rule out PA without further testing (n = 592) and only screen positive patients with subsequent confirmatory testing (n = 90). Area under the receiver operating characteristic curve (AUC) was used to determine their overall performance predicting PA. Negative predictive value (NPV) was used to assess the ability to identify patients with a low probability of PA. Results: Only one score showed an acceptable ability to predict PA (AUC > 0.7). NPV was inflated in the all screen cohort compared to confirmatory testing, where known status yielded low NPV for all scores. Conclusion: Currently available scoring algorithms poorly predict those with PA under current diagnostic guidelines. Equating a negative screen with a negative confirmatory test, as was common in score development, artificially inflates the NPV of these scores. Scores show limited utility in identifying screen positives that do not need to undergo further evaluation. More accurate PA risk prediction scores are needed to guide decision-making in patients suspected of having PA.

Do compressed in-person classes yield student performance results comparable to traditional 16-week in-person classes?

Institutions of higher learning are offering an increasing number of compressed in-person classes with the goal of providing to their diverse student populations flexibility of instruction delivery. Southern Illinois University (SIU) and many other colleges are offering an increasing number of classes with compressed schedules to increase student enrollment (Krug et al., 2015). The increase in the number of compressed classes presents the challenge of ensuring that the same academic rigor and breadth of knowledge are maintained in comparison to the traditional 16-week semester. Therefore, it is necessary for the compressed courses to provide the same student learning outcomes and cover the same course material, requiring faculty to use the same textbooks and course content. The purpose of this research study was to determine any variance in overall student academic performance after two groups of undergraduate students completed the same course taught in two different modalities, as indicated by comparing students’ final course grades. This study compared the performance of two groups of undergraduate students enrolled in the same Southern Illinois University (SIU) course that was delivered in two different modalities. An independent samples t-test was conducted in SPSS to determine if there was a significant difference between the on-campus and off-campus classes’ final course grades. There was no significant difference found between the on-campus and off-campus classes. These results suggest that the delivery formats of the course, traditional 16-week format or compressed off-campus weekend format, did not result in meaningful differences in the final course grades for the participating classes.

Resilience Theory, Human Agency, and Political Archaeology: A RT Revised Model for the Understanding of the Late Bronze – Iron Age Transition in the Post-Hittite World

Abstract Over the last twenty years, due to the growing concern with the human-environment relationship in the contemporary world as well as in the study of the ancient world, Resilience Theory (RT) has been adopted and adapted from the study of ecosystems to the study of stress dynamics within socio-political systems. The adaptation is indebted to the seminal work of Holling and Gunderson (2002. “Resilience and Adaptive Cycles.” In Panarchy: Understanding Transformations in Human and Natural Systems, edited by L. H. Gunderson, and C. S. Holling, 25–62. Washington, DC: Island Press), reviewed recently for application in archaeology in a volume edited by Faulseit (2016b. “Collapse, Resilience, and Transformation in Complex Societies: Modeling Trends and Understanding Diversity.” In Beyond Collapse: Archaeological Perspectives on Resilience, Revitalization, and Transformation in Complex Societies, edited by R. K. Faulseit, 3–26. Visiting Scholar Conference Volumes. Carbondale, IL: Southern Illinois University Press). While social scientists, anthropologists and archaeologists interested in system theories have welcomed this new interpretative tool for the study of rapid change in socio-political systems, RT has been considered unsatisfactory and substantially rejected by several scholars in the humanities because of the lack of freedom and intention assigned to human actors. After a short presentation of these premises, the paper seeks to affirm a different model for a social cycle of formation-growth-maturity-release, in which resilience is only one among a number of possible outcomes of the release phase, depending on the collective/political choice/orientation of a society. Put simply, the new model suggests reorganization and transformation as two alternative outcomes alternative to resilience. The model is applied to the case study of the Late Bronze Age (LBA) – Early Iron Age (EIA) transition in Anatolia and north Syria, corresponding to the time of the fall and aftermath of the Hittite empire. It will be shown that the adoption of the model offers a productive interpretive key to understand different outcomes in the new fragmented reality.

In patients with diabetes, is fluid replacement with balanced crystalloids more effective than normal saline when correcting electrolyte imbalances in diabetic ketoacidosis?

Southern Illinois University—Family and Community Medicine Decatur, Decatur, IL The corresponding author is Pooja Sheth-Dutt; [email protected] The authors declare no conflicts of interest.

Review: Engaging Museums: Rhetorical Education and Social Justice, by Lauren E. Obermark

Book Review| May 01 2023 Review: Engaging Museums: Rhetorical Education and Social Justice, by Lauren E. Obermark Engaging Museums: Rhetorical Education and Social Justice by Lauren E. Obermark. Carbondale: Southern Illinois University Press, 2022. 196 pp.; paperback, $40.00. Rachel Vogt Rachel Vogt The Columbus Museum Search for other works by this author on: This Site PubMed Google Scholar The Public Historian (2023) 45 (2): 146–147. https://doi.org/10.1525/tph.2023.45.2.146 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Rachel Vogt; Review: Engaging Museums: Rhetorical Education and Social Justice, by Lauren E. Obermark. The Public Historian 1 May 2023; 45 (2): 146–147. doi: https://doi.org/10.1525/tph.2023.45.2.146 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentThe Public Historian Search In Engaging Museums: Rhetorical Education and Social Justice, Lauren E. Obermark seeks to improve public rhetoric education in the United States, as well as argue for its renewed relevance in an increasingly divisive society. Museums, she posits, can offer models and methods to revise and modernize rhetorical education by challenging the very definition of where and how rhetoric is practiced. To explore this assertion, Obermark undertakes three rhetorical case studies at three sites of public history: the National Underground Railroad Freedom Center (Cincinnati, OH), the National World War I Museum (Kansas City, MO), and the Oklahoma City National Memorial Museum (Oklahoma City, OK). At each site, Obermark asks how museum pedagogy and practice can move rhetorical education forward to a place of greater equity, ultimately arguing that the needed improvement “can come from the centering of social justice” (6). By focusing on these lesser known, albeit national, museums, Obermark... You do not currently have access to this content.