Western University Of Health Sciences Research Articles

An osteopathic orientation to interprofessional education.

The osteopathic tenets may serve as a useful guideline for an interprofessional program. There is an alignment between the osteopathic tenets and the concept of interprofessional education (IPE). IPE occurs when students from two or more professions work with each other to collaborate or improve healthcare outcomes. Holistic treatment is fundamental in both instances, and the interrelatedness of structure and function requires acknowledgment of all healthcare professionals' roles in treating a patient. IPE allows students to gain a better understanding of their own professional roles and the roles of their fellow healthcare providers in treating patients more effectively. The objectives of this analysis are to evaluate the ability of an interprofessional summer workshop/lecture utilizing an osteopathic focus to educate students from different healthcare colleges about the interconnectedness of the systems of the human body and how working with a team-based approach will ultimately benefit their collective patients. A secondary objective was to determine the students' perceptions before and after the lecture/workshop to see if there were any perceived differences among students in different healthcare professions at either time. This was a retrospective data analysis conducted on pretest/posttest surveys completed by 73 incoming students from six different healthcare colleges participating in the Summer Preparedness and Readiness Course (SPaRC), held annually at Western University of Health Sciences (WUHS) in Pomona, California. Analysis was conducted on responses collected during the SPaRC programs of 2013, 2016, and 2019. Participants were given surveys containing five questions scored on a five-point Likert scale. The surveys were given before and after an integrated lecture/hands-on workshop presented at SPaRC that reviewed multiple studies showing the utility of connecting the healthcare professions to best treat a patient. A total of 73 students responded to both the prelecture and postlecture surveys. When the number of positive scores were totaled from students from all colleges, there was an increase in positive responses from 190 (52.2 %) in prelecture surveys when compared to 336 (92.3 %) in postlecture surveys. A Wilcoxon signed-rank test suggested that the lecture workshop elicited a significant improvement in scores from prelecture to postlecture for all students (Z=-6.976, p=0.000). Median scores improved from 3.60 at baseline to 4.40 after the lecture/workshop. Secondary analysis conducted utilizing Kruskal-Wallis H to examine the differences between the responses of the different colleges prelecture and postlecture showed no significant differences prelecture (H [6]=7.58, p=0.271) and a significant difference between postlecture answers (H [6]=14.04, p=0.029). A series of post hoc independent Kruskal-Wallis H analyses was conducted to identify where differences were, and the only identifiable difference after Bonferroni corrections was between students from the Doctor of Osteopathic Medicine college and the Physician Assistant's college after the lecture/survey (p=0.041). An interprofessional program with the osteopathic principles of focusing on body unity and relatedness of structure and function may serve as a helpful tool for uniting healthcare professionals in their ultimate goal of better serving their patients.

Intersection of AI and Healthcare

The rapid development of ChatGPT and other generative intelligence models has recently catalyzed the integration of artificial intelligence (AI) into medicine. This evolution raises critical challenges that require attention to technological literacy training in medical education. These generative intelligence models can create inaccurate information, known as hallucinations, and introduce bias into unforeseen workflows. Physician involvement remains pivotal in guiding AI applications, as they possess the most critical perspective on the impact of artificial intelligence on patient outcomes. Physicians must have a voice in AI development and contribute to fact-checking and risk reduction. The development of learning these tools in technology during medical school is vital in addressing these challenges. Institutions like the Western University of Health Sciences advocate for increased technological literacy among future healthcare providers. Improving technical proficiency in students will ensure responsible AI integration, potentially reducing healthcare disparities and empowering prospective providers for more patient-centric care.

A Bibliometric Analysis on Tuberculosis and Diabetes Mellitus 2: Visualization, Patterns, and Trends.

The convergence of type 2 diabetes mellitus (DM2) and tuberculosis (TB) may lead to increased mortality and complications, so the underlying mechanism is under investigation. Therefore, a bibliometric analysis was performed to describe the bibliometric indicators of publications evaluating the relationship between TB and DM2. A descriptive and observational bibliometric study was conducted using the Scopus database to identify documents published from 2016-2023, for which free and controlled terms (Medical subject headings and Emtree) were used. The variables collected comprised the number of published documents, institutions, countries, authors, journals, and type of collaboration, which were exported to Excel 2016 and analyzed with SciVal. A total of 456 documents, 1624 authors, and 2173 citations were identified, with Medicine and Immunology-Microbiology being the subcategories with the highest and lowest number of documents (367 and 80 documents), respectively, with a strong decreasing trend correlation (R2: 0.95; P < 0.5) between the number and year of publication. While the country with the highest production was China (71 papers), the country with the highest citation was the United States (952 citations). In terms of authors, the highest production was by the American Venketaraman, and the highest impact was by the Asian Kimberly To. The institution with the highest number of papers was the Western University of Health Sciences, while Stellenbosch had the highest impact. Although the scientific productivity of DM2 and TB have reported growth rates of 158.75% and 7.3%, respectively, our results found a decreasing trend in publications associating these two diseases. The thematic evolution of the concepts in both diseases suggests that the relationship between them is not yet known, so future studies evaluating the underlying mechanisms of this comorbidity are suggested.

177 Functional Annotation of an Array of Immune Cells and Various Tissues in the Chicken

Abstract Infection and disease negatively affect performance, growth, and health in production animals and has major economic impacts on commercial poultry production. Regulatory elements control the expression of genes and consequently phenotype. Epigenetic modifications such as histone tail modifications and DNA methylation are not only key to the regulation of unique transcriptome patterns, these modifications are indispensable as genome annotators to uncover cell- and tissue-specific regulatory elements. The objectives of our current projects are to leverage transcriptomic and epigenomic methods to annotate transcripts, coding and noncoding, and cis-regulatory elements in the chicken genome, including promoters, enhancers and insulators. In addition, we are employing single-cell sequencing to characterize new or rare cell populations in tissues relevant to production and investigate underlying mechanisms of disease resistance to pathogens. The transcriptome of a number of important cells and tissues has been analyzed, including immune, intestinal and reproductive. The animal procedure was approved and conducted according to guidelines established by the Western University of Health Sciences, Pomona, California (WesternU) Institutional Animal Care and Use Committee. Cell and tissue collection, processing and bioinformatic analysis for transcriptome studies were performed as described in Overbey et al. (2021; Frontiers Genetics). Single-cell studies were performed as described in Sparling et al. (2022; Journal of Immunology) using the 10x Genomics platform. Results for the transcriptome studies show that in the immune cells, many DEGs were mostly involved in cellular processes relating to differentiation and cell metabolism as well as basic functions of immune cells such as cell adhesion and signal transduction. This was to be expected, as there was no explicit immunological stimulus involved. Nevertheless, it was notable that DEGs in the comparison between bursa and thymus that were upregulated in the thymus were related to T cell differentiation and maturation. On the other hand, genes differentially upregulated in B cell vs Bursa or Bursa vs Thymus, are mostly involved in B cell development and differentiation, or activation. Genes differentially regulated in B cells and monocytes are involved in specific functions of the cell types. In the intestinal tissues, we were able to correlate most of the differential expressed genes to metabolic processes related to nutrient digestion and absorption. Several genes in the distal part of the intestine were particularly implicated in vitamin metabolism. Genes involved in energy metabolism are also abundant in the cecum, which suggests that microbial contribution of energy production in the intestine is especially important. Finally, single cell studies on the chicken shell gland are ongoing, but we found differences in cellular populations and gene expression dependent on the chicken haplotype profiled and differences in expression of Ig-like receptors that need to be further explored.

Building Strategic Agility to Balance What Is Desirable with What Is Possible

Leaders across the nation are eager to embed diversity, equity, and inclusion (DEI) into their recruitment and retainment processes, curriculum development, teaching pedagogy, and institutional operations as well as into the very fabric of their identity. However, in a historically traditional industry, many institutions struggle with managing DEI change. The concepts of evolution versus radical revolution provide a useful lens through which stakeholders may balance what is desirable with what is possible in the context of their unique organization. At ACAD's seventy-eighth annual meeting, keynote speaker Marjorie Haas, president of the Council of Independent Colleges, posed the general question, “Evolution versus radical revolution?” We think this is an excellent lens through which to contemplate higher education DEI endeavors. In this context, we see evolution as a process of gradual, progressive change that builds on what already exists, whereas radical revolution is a sudden fundamental change in thinking or doing. Both concepts may have their place in DEI strategy, and serious analysis is required by governing boards, administrators, faculty, staff, students, alumni, and other critical stakeholders to ascertain the practical implications of each before committing to one or the other. In table 1, we have categorized our perception of common characteristics of evolution and radical revolution that represent poles along a continuum. We want to be clear: it is less important to agree with our characterizations of evolution versus radical revolution than it is to contemplate the idea; reach intentional consensus about what the concepts mean in the context of each institution; decide which general concept is best given institutional capacity, culture, and history with DEI; and create appropriate goals and change management plans accordingly. (Takes time and presents the danger of waning support. Initiatives must be paced for timely, visible gains.) (Everything may be disrupted or broken and replacement systems must be ready, otherwise institutional capacity to achieve goals will be compromised.) Urgency is balanced with systematic implementation for sustainable progress. Urgency can supersede everything else. Inclusive syllabus—random college website: “As research has shown, diversity is a critical component to educational excellence. When students are able to see themselves represented in course content and discussion, it signals to them that their identities … are valued and respected in the classroom. Instructors can access students’ lived experiences and cultural backgrounds as part of their curriculum to enhance student learning.” Decolonize the syllabus—random college website: “We understand decolonization as the identification, interrogation, and dismantling of power structures that carry legacies of racism, imperialism, and colonialism in the production of knowledge. By decolonizing our syllabi, we make a conscious effort to change the way we understand how and where knowledge is produced. Our program contests the assumption that white, Western intellectual traditions are superior, or yet universal.” Assesses current organizational capacity and systematically prioritizes, plans, and monitors interventions. Change by any means necessary. More likely change that completely interrupts operations. We believe that DEI change in higher education is necessary and timely. Not all academic leaders or faculty members may be accustomed to the minutiae of practical day-to-day change management, but the complexity of modern organizations and the nature, pace, and scope of change demand such focus. Each institution has a unique relationship with DEI and a current capacity for sustainable change. It is essential to assess whether the right strategy for the organization's current state is being employed and whether the institution has the strategic agility to balance what is desirable with what is possible to meet the needs of all students. Donna M. Buchanan is president of Crucial Shift Consulting for Higher Education Change Management. Gail Evans Grayson is associate professor and executive vice dean (Pomona) and director of diversity, equity, and inclusion in the College of Health Sciences at Western University of Health Sciences. Email: drb@crucialshiftconsulting.com, gevans@westernu.edu

Osteopathic Medical Students’ Subjective Preparedness for LGBTQ+ Patient Care and Influencing Factors: A Multi-Institutional Survey Study

Abstract Objectives This study aims to investigate what factors correlate with osteopathic medical students’ preparedness to provide care for the LGBTQ+ community through a multi-institutional survey. Context This is one of the few formal research projects to assess the impact of LGBTQ+ medical education on osteopathic students’ comfort level with caring for the community. Methods This study was approved by the IRB at Western University of Health Sciences, Pomona, CA on 11/19/2020. An 18-question survey was created regarding the exposure to the LGBTQ+ population and healthcare education before and after attending osteopathic medical schools. The anonymous survey was electronically distributed at Western University of Health Sciences College of Osteopathic Medicine Pacific and Pacific Northwest, Idaho College of Osteopathic Medicine, Touro University, Philadelphia College of Osteopathic Medicine, Rocky Vista University College of Osteopathic Medicine, and Michigan State University College of Osteopathic Medicine between 1/6/21 and 5/8/21. The survey information was statistically analyzed via SAS University edition. Results The survey had 441 responses: 63% were female, 34% were male, and 3% selected other gender identities. From 441 responses to the survey, 378 responses were analyzed using a logistics regression model to comprehensively model a binary-dependent variable for the students’ preparedness. Students knowing the meaning of the acronym LGBTQ+ (p =0.04) and actively engaging in extracurricular activities for the LGBTQ+ population (p =0.01) showed the strongest correlation based on the logistic regression analysis. Additionally, Chi-square results identified 6 independent variables associated with students’ preparedness to care for the LGBTQ+ population: being a second year or a third year osteopathic medical student (p &amp;lt;0.01), having opportunities to learn about the LGBTQ+ population in college (p &amp;lt;0.01), having a formal presentation about LGBTQ+ health in medical school (p &amp;lt;0.01), the medical school offering extracurricular activities about the LGBTQ+ population (p &amp;lt;0.01), knowing what the LGBTQ+ acronym stands for (p =0.01), and actively being involved in extracurricular activities concerning the LGBTQ+ community (p=0.03). Conclusions Our study indicates that medical students’ educational exposure through college and medical school is a more correlating influencing factor for their preparedness to care for the LGBTQ+ population in comparison with student’s gender, hometown size, or socioeconomic, geographical, and religious background. Future studies to objectively identify medical students’ preparedness and experience with LGBTQ+ patients, as well as studying effective curricula for filling in knowledge gaps, will be necessary.

Characterization of cellular subpopulations and their gene expression by single-cell RNA sequencing in canine atopic dermatitis

Abstract Atopic Dermatitis (AD) is the most common, chronic, and inflammatory allergic skin disease worldwide, with a high prevalence both in children and adults, particularly in developed countries. There are limited effective treatments for severe allergic skin diseases available, thus, there is an unmet need of better understanding the molecular mechanisms and cellular populations involved in AD. Since AD in canines closely resembles the disease in humans, they are an attractive animal model for further studies. Leveraging single-cell RNA sequencing, we identified the cellular composition and shifts in cell populations in canine epidermis of atopic dogs compared to the epidermis from healthy controls. Fibroblasts and keratinocytes represented the largest cell populations, with fibroblasts decreasing in the atopic epidermis. Other populations such as endothelial vascular cells showed differences as well. Shifts in immune cell distribution included changes in subpopulations of dendritic cells and monocytes in the atopic skin. NK and T cells, particularly CD8 T cells were increased. Subclustering revealed specific cellular changes in AD dogs. We found signifiant changes in gene expression in most cell populations, with some genes differentially expressed across cells, while others were expressed in a cell specific manner. We also observed subtle differences between samples from animals with different disease progression, identifying gene expression markers changing with AD severity. Here we show that single-cell sequencing is a useful tool to define the cellular composition in canine atopic dermatitis, resolving changes in gene expression at the cellular level to advance our understanding of disease development and progression. Supported by intramural funds from Western University of Health Sciences

Looking Into Perioperative Nurses’ Other Roles

Looking Into Perioperative Nurses’ Other Roles

Local Geographic Variation of Periodontitis and Self-Reported Type 2 Diabetes Mellitus

ooth loss, periodontitis, Type 2 diabetes mellitus, age, race/ethnicity and gender are all correlated, and previous researchers developed mathematical models suggesting geographic disparities for these conditions for the Inland Empire region of California. By performing geospatial analysis of the medical charts from patients attending the dental center of the Western University of Health Sciences, the researchers provide further evidence for geographic health disparities to the ZIP code level in the northern half of the Inland Empire.

The socially distanced signature: Contactless paper form approvals from faculty.

Journal of Dental EducationVolume 85, Issue S1 p. 1145-1147 ADVANCING THROUGH INNOVATION The socially distanced signature: Contactless paper form approvals from faculty Hubert K. Chan DDS, Corresponding Author Hubert K. Chan DDS [email protected] Integration of Technology, Curriculum, and Learning Environments, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA Correspondence Dr. Hubert K. Chan, College of Dental Medicine, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766-1854, USA. Email: [email protected]Search for more papers by this authorAlexander L. Lee DMD, Alexander L. Lee DMD Dental Informatics, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USASearch for more papers by this author Hubert K. Chan DDS, Corresponding Author Hubert K. Chan DDS [email protected] Integration of Technology, Curriculum, and Learning Environments, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA Correspondence Dr. Hubert K. Chan, College of Dental Medicine, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766-1854, USA. Email: [email protected]Search for more papers by this authorAlexander L. Lee DMD, Alexander L. Lee DMD Dental Informatics, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USASearch for more papers by this author First published: 11 July 2020 https://doi.org/10.1002/jdd.12308Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. Volume85, IssueS1Supplement: Advancing Through Innovation in a Challenging TimeJune 2021Pages 1145-1147 This article also appears in:Advancing Through Innovation in a Challenging Time RelatedInformation

Judge rules against university

Case name: Rogers v. Western University of Health Sciences, No. 18‐55003 (9th Cir. 10/03/19).

Judge rules against university

Case name: Rogers v. Western University of Health Sciences, No. 18‐55003 (9th Cir. 10/03/19).

Judge rules against university

Case name: Rogers v. Western University of Health Sciences, No. 18‐55003 (9th Cir. 10/03/19).

Neck Muscle Morphology and Function in Primates

The cervical spine lies at intersection between the cranium and postcranium and plays a crucial role in orienting the head relative to the substrate during locomotion. Previous work demonstrates that bony features of the cranial base and cervical spine are related to positional behavior in primates. How soft tissues of the neck vary across primate taxa is relatively unknown yet is critical for understanding function, head carriage, and locomotion in this clade. The objective of this study was to describe the relationship between the extrinsic and intrinsic muscles of the neck and postural and locomotor behaviors in primates. We collected and dissected 26 primate cadavers from 17 different genera representing each major primate clade. We hypothesized that trunk and neck posture, as well as forelimb dominated below‐branch suspensory behaviors and neck rotational capabilities all influence the attachment sites and size of the dorsal neck musculature.Using gross anatomical dissection, we qualitatively described and compared the attachment sites of the dorsal neck, back, and shoulder muscles of taxa that display contrasting behaviors and quantified muscle mass. Using the dissection data combined with contrast enhanced microCT data, we constructed 3D models of the head and neck to visualize the in situ neck muscle attachment sites for Propithecus, Aotus, and Carlito.Gross anatomical dissections demonstrate that among nonhuman apes, hylobatids lack cranial attachments of the trapezius and rhomboideus. Additionally, strepsirrhines display anatomy that is more nonprimate mammal‐like in the distribution of the trapezius, rhomboideus, and semispinalis muscles. Results of phylogenetic regressions indicate that neck muscle masses are best predicted by body size, but also demonstrated significant results for both postural and locomotor behaviors as predictors of overall muscle mass (p &lt; 0.05). This study represents the first comprehensive description of the functional anatomy of the neck muscles across primates. Future work will focus on quantifying biomechanically‐relevant variables such as physiological cross‐sectional area using novel fascicle‐tracking methods and estimating muscle moments to compare across taxa.Support or Funding InformationThis work was funded by the Leakey Foundation, National Science Foundation, American Association of Anatomists, Western University of Health Sciences, and University of Missouri.

Council of Deans Chair Report, July 2019

There has been a variety of activity taking place within the AACP Council of Deans (COD) during this academic year: ### Community Engagement Task Force Members: Dan Robinson, (Chair, Western University of Health Sciences); Alex Adams (invited guest); Gary Delander (Oregon State University);

Economic Evaluation of Anticyclic Citrullinated Peptide Positivity in Rheumatoid Arthritis.

Anticyclic citrullinated peptide (anti-CCP) positivity may be a strong predictor of joint erosion and a potential biomarker for guiding treatment decisions for rheumatoid arthritis (RA). However, limited studies are currently available on the effect of anti-CCP positivity on health care utilization and/or medical costs of RA patients. To investigate short-term and long-term direct health care expenditures associated with anti-CCP positivity in newly diagnosed RA patients. A retrospective cohort study was conducted in adult RA patients within a U.S. integrated health care delivery system (January 1, 2007-June 30, 2015). Patients were required to have 2 RA diagnoses and treatment with a conventional or biologic disease-modifying antirheumatic drug (DMARD) within 12 months. The first RA diagnosis date was labeled as the index date, and patients were followed until they left the health plan, died, or reached the end of the study period. Patient demographics, anti-CCP results, comorbid conditions, and health care resource utilization during baseline (12 months before the index date) and follow-up periods were collected. Nationally recognized direct medical costs were assigned to health care utilization to calculate health care costs in 2015 U.S. dollars. The baseline differences between anti-CCP positivity and negativity and differences in censoring during follow-up were addressed using propensity scores. The mean differences in costs were estimated using recycled prediction methods. 2,448 newly diagnosed RA patients were identified and followed for a median of 3.7 years (range = 1-8 years). At baseline, 65.8% of patients were anti-CCP positive. Anti-CCP-positive patients had fewer comorbid conditions at baseline. During the first 12 months of follow-up, median (interquartile range) total health care expenditures for anti-CCP-positive and anti-CCP-negative patients were $6,200 ($3,563-$13,260) and $7,022 ($3,885-$12,995), respectively. After adjusting for baseline differences, total incremental mean cost associated with anti-CCP positivity during the first 12 months was estimated to be $2,163 per patient (P = 0.001). The annual incremental costs in anti-CCP-positive patients became progressively larger over time, from $2,163 during the first year to $5,062 during the fourth year. Anti-CCP positivity was associated with higher prescription, laboratory testing, and rheumatologist utilization. A higher percentage of anti-CCP-positive patients received 1 or more biologic DMARDs (11.6% for anti-CCP-positive vs. 5.7% for anti-CCP negative; P < 0.001) compared with anti-CCP-negative patients during the 12-month follow-up, which resulted in $2,499 in incremental prescription costs (P < 0.001). Total additional burden associated with anti-CCP positivity during the first 4 years was estimated to be $14,089 per patient. In newly diagnosed RA patients, higher economic burden associated with anti-CCP positivity was mainly driven by prescription costs. This research and manuscript were funded by Bristol-Myers Squibb (BMS). Alemao and Connolly are employees and shareholders of BMS and participated in the design of the study, interpretation of the data, review/revision of the manuscript, and approval of the final version of the manuscript. An and Cheetham received a grant from BMS for this research. At the time of this study, An was employed by Western University of Health Sciences, and Cheetham was employed by Kaiser Permanente Southern California. Bider-Canfield, Kang, and Lin have nothing to disclose. Some study results were presented as a poster at the American College of Rheumatology Annual Meeting; November 5, 2017; San Diego, CA, and at the International Society for Pharmacoeconomics and Outcomes Research Meeting; May 19, 2018; Baltimore, MD.

A Longitudinal Evidence-Based Medicine Curriculum and Its Impact on the Attitudes and Perceptions of Student Pharmacists

Objective. To describe a longitudinal evidence-based medicine (EBM) curriculum and to evaluate its impact on the attitudes and perceptions of student pharmacists toward EBM. Methods. Western University of Health Sciences has had a structured, longitudinal, EBM curriculum for more than 10 years, spanning the first to third years, including the introductory experiential experiences. A survey was administered prior to the main EBM course and at the completion of the course at three time periods to assess student pharmacists' attitudes and perceptions of EBM and interactive pedagogical methods. Student pharmacists at Western University of Health Sciences voluntarily participated in the self-administered survey. The three time periods examined included: directly after completion of the EBM course, after completion of the didactic curriculum, and after completion of the advanced pharmacy practice experiences (APPE). Results. The response rates were: pre-survey 94% and post-survey 53%. The three classes surveyed had similar baseline characteristics. Students' perceptions of EBM skills and attitudes improved at all time periods post-course. Students felt strongly both before and after exposure to the EBM course and the longitudinal EBM curriculum about learning new EBM skills and that all pharmacists should have these skills. Significantly more students appreciated all the interactive pedagogical methods after APPE completion (>85% of students), as compared with over 74% of students directly after the EBM course, and over 79% of students after didactic completion. Conclusion. The attitudes and perceptions of student pharmacists toward EBM improved after exposure to a longitudinal EBM curriculum.

Exploring the Effects of Participation in a Shelter Medicine Externship on Student Knowledge and Self-Confidence.

With the recognition of shelter medicine as a sub-discipline of veterinary medicine, many veterinary programs are including clinical shelter experiences in their curricula. A concurrent mixed-methods study was designed with the aim to determine the effectiveness of a 4-week clinical shelter medicine program on students' perception of canine and feline surgical proficiency and shelter medicine knowledge as well as gain information on student attitudes toward shelter medicine and interest in pursuing this career path. Year 4 veterinary students at Western University of Health Sciences who were enrolled in a shelter medicine externship from 2014 to 2016 were invited to complete pre- and post-course online surveys. Of the 168 enrolled students, 77.4% were invited to participate, and 114 completed the survey. There was no statistically significant difference in student veterinary career interest before and after completing the externship. There was an overall increase in student rating of their ability to perform six shelter medicine tasks as well as ovariohysterectomy/ovariectomy (OVH/OE) and castration surgeries after completing their externship; all were statistically significant ( p < .001). There was a statistically significant difference in the proportion of students who were familiar with the Asilomar Accords and the Association of Shelter Veterinarians (ASV) Guidelines for Standards of Care in Animal Shelters after completion of their externship ( p < .001). Students largely supported pediatric spay and neuter, stating it was an effective means of population control. Based on the themes that emerged from the qualitative analysis, it appeared most students had an accurate understanding of the term no-kill.

Human Papillomavirus and Vaccine Knowledge Among Health Professional Students [19O

INTRODUCTION: Human Papillomavirus (HPV) is known to be associated with cancer, therefore, it is important that all health care team members are well educated about HPV screening and prevention. This study seeks to explore knowledge gaps among students in different health professional programs. METHODS: A 45-question survey was available on Google Forms from July 5 - September 1, 2017 for students in osteopathic medicine, nursing, physician assistant (PA), and pharmacy schools at Western University of Health Sciences (WesternU). Seventeen questions (yes/no answers) were used to assess knowledge of HPV. This study was approved by the Institutional Review Board at WesternU on an exempt basis. RESULTS: This report is based on 265 completed surveys. Two-thirds (65.2%) of respondents were women; 60.4% were age 25-29; and 81.5% were osteopathic medical students. The correct answer percentage ranged from 32.8% (when dual testing begins) to 93.6% (if vaccinated women still require Pap smears). Half (50.6%) correctly reported the recommended age for vaccination. Women were more likely to know this fact (55.2% vs. 41.3%, P=.031) and that HPV infection is usually asymptomatic (69.8% vs. 57.6%, P=.0476). Osteopathic medical students were more likely than PA students to know the HPV subtypes associated with carcinoma (65.7% vs. 42.9%, P=.003). CONCLUSION: There is a diverse deficit in HPV knowledge among health professional students from various programs. While post-graduate experiences may provide opportunities to close those gaps, it is important to recognize that more education is needed across programs regarding HPV testing and prevention.

Catalytic strategy and inhibition of the prokaryotic specific GTP cyclohydrolase IB

GTP cyclohydrolase I catalyzes the first step in folic acid biosynthesis in bacteria and plants, biopterin biosynthesis in mammals, and the biosynthesis of 7‐deazaguanosine modified tRNA nucleosides in bacteria and archaea. The type IB GTP cyclohydrolase (GCYH‐IB) is a prokaryotic‐specific enzyme found in several pathogens. GCYH‐IB is structurally distinct from the canonical type IA GTP cyclohydrolase involved in biopterin biosynthesis in humans and animals, and thus is of interest as a potential antibacterial drug target. We report kinetic and inhibition data of Neisseria gonorrhoeae (Ng) GCYH‐IB, and two high‐resolution crystal structures of the enzyme; one in complex with the reaction intermediate analog and a competitive inhibitor 8‐oxo‐GTP, and one with a TRIS molecule bound in the active site which mimics another reaction intermediate. Comparison of these GCYH‐IB crystal structures with the type IA enzyme bound to 8‐oxo‐GTP, reveals an inverted binding mode of the inhibitor's ribosyl moiety. Taken together with site‐directed mutagenesis data, suggests that the two enzymes utilize different strategies for catalysis. Additionally, the inhibitor interacts with a conserved active site residue Cys149 which is S‐nitrosylated in the structures. This is the first structural characterization of a biologically S‐nitrosylated bacterial protein. Mutagenesis and biochemical analyses demonstrate that Cys149 is essential for the cyclohydrolase reaction, and S‐nitrosylation maintains enzyme activity, suggesting a potential role of the S‐nitrosothiol in catalysis. These structures and information were used to perform structure based drug design using a combination of in silico screening and de novo design methods to generate molecules that inhibit NgGCYH‐IB selectively over human GCYH‐IA. A few compounds named G1, G2 and G1‐triphosphate have been generated and currently being tested for inhibition.Support or Funding InformationThis project was supported by NSF grant CHE‐1309323 to D. Iwata‐Reuyl and M.A. Swairjo,NIH grant GM110588 to M.A. Swairjo and D. Iwata‐Reuyl, NIH grant GM70641 to D. Iwata‐Reuyl, andan intramural grant from Western University of Health Sciences to M.A. Swairjo.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.