POSTER SESSION
Table of Contents and Abstracts
NOTE: Alphanumeric identifiers to the left of title correspond to the poster board numbers.
A. CHILD GROWTH AND OBESITY
A1. WAIST HIP RATIO (WHR) VS BODY MASS INDEX (BMI) TO ASSESS
RELATIONSHIP BETWEEN OBESITY AND GERD. Nasser Hajar, Sonia Brar,
Nazif Chowdhury, Shahid Ali, Richard Rackett, Amine Hila.
A2. CHILDHOOD OBESITY IN THE SOUTHERN TIER: A REVIEW AND
COMPARISON OF PREVALENCE IN SIXTH GRADERS. Martin M. Fernandez,
Marc Lichtenfeld, and Ralph M. Garruto.
A3. GEOGRAPHY OF BODY MASS INDEX IN THE GREATER BINGHAMTON
AREA. Marie DeFeo, MLS, GISSA, Richard Terry, DO, MBA, FACOFP.
A4. SECULAR TRENDS IN AGE AT MENARCHE IN VANUATU. Alysa Pomer, Chim
W Chan, Kelsey N Dancause, Gwang Lee, Kathryn M Olszowy, Harold Silverman,
Cheng Sun, Spencer A Waldman, Martin M Fernandez, Len Tarivonda, George Taleo,
Marcelin Abong, Ralph Regenvanu, Akira Kaneko, Charles A Weitz, Ralph M Garruto,
and J Koji Lum.
A5. EXPLORING THE HEALTH TRANSITION IN VANUATU: CROSSSECTIONAL AND LONGITUDINAL DATA COMPARISONS FROM 2007 to
2011. Kathryn M Olszowy, Alysa Pomer, Kelsey N Dancause, Cheng Sun, Harold
Silverman, Chim W Chan, Gwang Lee, Martin M Fernanedez, Spencer A Waldman, Len
Tarivonda, George Taleo, Marcelin Abong, Ralph Reganvanu, Akira Kaneko, Charles A
Weitz, J Koji Lum, and Ralph M Garruto.
A6. MODERNIZATION AND DIFFERENTIAL PHYSICAL ACTIVITY AMONG
THE ISLANDS OF VANUATU. Harold Silverman, Cheng Sun, Alysa Pomer, Chim W
Chan, Kathryn M Olszowy, Kelsey Needham Dancause, Gwang Lee, Spencer A
Waldman, Martin M Fernandez, Akira Kaneko, Len Tarivonda, George Taleo, Marcelin
Abong, Ralph Regenvanu, Charles A Weitz, Ralph M Garruto, J Koji Lum.
A7. IMPACT OF USE OF CONSUMER ELECTRONICS ON TRADITIONAL
LIFESTYLES IN VANUATU. Cheng Sun, Harold Silverman, Alysa Pomer, Chim W
Chan, Kathryn M Olszowy, Kelsey N Dancause, Gwang Lee, Spencer A Waldman,
Martin M Fernandez, Akira Kaneko, Len Tarivonda, George Taleo, Marcelin Abong,
Ralph Regenvanu, Charles A Weitz, Ralph M Garruto, J Koji Lum.
Posters: A1-A7
A8. EIGHTY YEAR TRENDS IN INFANT WEIGHT AND LENGTH GROWTH: THE
FELS LONGITUDINAL STUDY. William Johnson, Audrey C Choh, Laura E Soloway,
Stefan A Czerwinski, Bradford Towne, and Ellen W Demerath.
A9. PROTECTING THE FETUS FROM TOO MUCH ESTRADIOL IN OBESITY:
PLACENTAL 17 β-HYDROXYSTEROID DEHYDROGENASE-2 ACTIVITY. L.
Dhariwal, S. Arya, M. Dallou, O. Muneyyirici, D. Sherer, V. Nacharaju, O. Abulafia, and
JG. Kral.
A10. A STUDY ON STRESS RELATED WEIGHT-GAIN IN MEDICAL RESIDENCY:
DOES THE CARE OF OTHERS EVENTUALLY COMPROMISE THE CARE OF
ONE’S SELF? D. Chin, MD, K. Paudel, MD, B. Siddiqui, MD.
A11. HEAT BALANCE IN YOUNG ADULTS. Shwetana Sunkari, Craig B. Laramee, and
Kenneth J. McLeod.
A12. INFLUENCE OF TRANSIENTLY INCREASED CORE BODY TEMPERATURE
ON BODY MASS CHANGES IN YOUNG ADULT WOMEN. Nicole Stroke, Rachel
Engelberg, Eileen Shimizu, Richard Goettel, Kenneth J. McLeod and Leann M.
Lesperance.
B. INFECTIOUS DISEASE
B1. THE BINGHAMTON UNIVERSITY BIOSPECIMEN ARCHIVE FACILITY: A
RESEARCH RESOURCE. Kaitlin Drouin, Jennifer Lavelle, Kristen Rachfal, and
Ralph M. Garruto.
B2. APPLIED FIELD TECHNIQUES FOR COLLECTING BLACK-LEGGED
TICKS (IXODES SCAPULARIS) FOR DISEASE ECOLOGY RESEARCH.
Amanda Pachomski, John M. Darcy II, Mellie Riddle, Sarah Hempstead, Tra Vu,
Hannah Keppler, Chelsea Lucas, Rita Spathis and Ralph M. Garruto.
B3. TESTING LOCAL AND REGIONAL PREVALENCES OF LYME DISEASE IN
IXODES SCAPULARIS POPULATIONS. Hannah Keppler, Chelsea Lucas, Sarah
Hempstead, John M Darcy II, Mellie Riddle, Amanda Pachomski, Rita Spathis and Ralph
M Garruto.
B4. ENVIRONMENTAL AND BEHAVIORAL FACTORS IN MODELING RISK OF
LYME DISEASE TRANSMISSION. John M. Darcy II, Dinesh Kommareddy, Ralph
M. Garruto.
B5. GENE FLOW OF P. FALCIPARUM IN THE PAPUA NEW GUINEA
HIGHLANDS FROM 1959-1979. Alysa Pomer, Abigail MacFadden, Rita Spathis,
Chim W. Chan, Sayantan Banerjee, Ralph M. Garruto, J. Koji Lum.
Posters: A8-B5
B6. A RETROSPECTIVE ANALYSIS OF PFCRT AND PFMDR1 VARIATION AND
THEIR CONTRIBUTION TO CHLOROQUINE RESISTANCE IN THE
PACIFIC. Chim W. Chan, Rita Spathis, Cheng Sun, Satish K. Dhingra, Krithivasan
Sankaranarayanan, Kathleen F. Clancy, Jacqueline A. Odgis, Ralph M. Garruto, J. Koji
Lum.
C. HEALTH MONITORING AND DIAGNOSTICS
C1. PARTIAL LEAST SQUARES (PLS) APPLIED TO MEDICAL
BIOINFORMATICS. Walker H. Land, Jr., William Ford, Jin-Woo Park, Ravi Mathur,
Nathan Hotchkiss, John Heine, Steven Eschrich, Xingye Qiao and Timothy Yeatman.
C2. A NEW TOOL FOR SURVIVAL ANALYSIS: EVOLUTIONARY
PROGRAMMING/EVOLUTIONARY STRATEGIES (EP/ES) SUPPORT
VECTOR REGRESSION HYBRID USING BOTH CENSORED/NONCENSORED DATA. Walker H. Land, Jr., Xingye Qiao, Dan Margolis, Ron Gottlieb.
C3. PNN/GRNN ENSEMBLE PROCESSOR DESIGN FOR EARLY SCREENING OF
BREAST CANCER. Walker H. Land, Jr., Jin-Woo Park, J. David Schaffer, and John
Heine.
C4. TOWARD TRUSTWORTHY MEDICAL MONITORING. Zhanpeng Jin, Homa
Alemzadeh, Zbigniew Kalbarczyk, and Ravishankar Iyer.
C5. HEIGHTENED DIURNAL ENDOCRINE LEVELS IN HEALTHY WOMEN
WITH A FAMILY HISTORY OF HYPERTENSION. Gary D. James.
C6. INFRASONIC STROKE VOLUME MONITORING. Ohad Barsimantov, J. David
Schaffer, and Kenneth J. McLeod.
C7. VIBROMYOGRAPHIC ASSESSEMENT OF KNEE MUSCLE BALANCE IN
OLDER ADULTS WITH KNEE PAIN. Amy Chaffee and Kenneth McLeod.
C8. ASSESSING MUSCLE IMBALANCES IN THE LOWER BACK. Xue Liu, Amy
Chaffee and Kenneth McLeod.
C9. VIBROMYOGRAPHIC ASSESSMENT OF UPPER EXTREMITY
MUSCULATURE DURING ISOKINETIC CONTRACTION. Kyle E Stone, Leann
Lesperance and Kenneth J. McLeod.
C10. FLEXOR DIGITORUM ACCESSORIOUS LONGUS AS AN ETIOLOGY OF
TARSAL TUNNEL SYNDROME. Michael Peck, DPM (PGY-3), Marshal Gwynn, DPM
(PGY-2), Jessica Duggan, DPM (PGY-2), Adam Bills, DPM (PGY-1), and Darren
Weinheimer, DPM.
Posters: B6-C10
C11. EVOLUTIONARY COMPUTATION WITH NOISE PERTURBATION AND
CLUSTER ANALYSIS TO DISCOVER BIOMARKER SETS. Ravi Mathur, J. David
Schaffer, Walker H. Land Jr., John J. Heine, Steven Eschrich, Timothy Yeatman.
C12. COMPARATIVE GRIP STRENGTH ANALYSIS AMONG POPULATIONS
ACROSS ISLANDS AND AGE IN VANUATU. Gwang Lee, Cheng Sun, Chim W Chan,
Alysa Pomer, Kathryn M Olszowy, Harold Silverman, Kelsey N Dancause, Spencer A
Waldman, Martin M Fernandez, Len Tarivonda, George Taleo, Marcelin Abong, Ralph
Regenvanu, Akira Kaneko, Charles A Weitz, J Koji Lum, and Ralph M Garruto.
D. HEALTH INTERVENTION
D1. THE IMPACT OF ACUTE ONSET NASAL CONGESTION AND RURAL
RESIDENCE ON PULMONARY FUNCTION AND ASTHMA CONTROL IN
ADULTS WITH ASTHMA AND ALLERGIC RHINITIS. Donna G. Hogan, APRNBC, PhD.
D2. CALF MUSCLE PUMP STIMULATION AS AN ADJUVANT TREATMENT
FOR FIBROMYALGIA. Lynn Baniak, BS, R.N., Carolyn S. Pierce, DSN., R.N., Erik
Hiester, D.O., and Kenneth J. McLeod, PhD.
D3. RECTIFICATION OF RADIO FREQUENCY FIELDS IN A COUPLED
SYSTEM. Sree Koneru, C. Roger Westgate, Kenneth McLeod.
D4. PACEMAKER DEVELOPMENT FOR THE SECOND HEART. Qionghua Weng,
Kenneth J. McLeod.
D5. POST-TREATMENT LYME DISEASE SYNDROME (PTLDS) AND
UNTREATED CHRONIC LYME DISEASE (CLD): COMMON CLINICAL
THREADS. Tra Vu, Mellie Riddle, John M. Darcy II, Sarah Hempstead, Hannah
Keppler, Chelsea Lucas, Amanda Pachomski, Rita Spathis, and Ralph M. Garruto.
E. BASIC RESEARCH – SCREENING AND DIAGNOSTICS
E1. ELECTROCHEMICAL MEASUREMENTS OF BIOFILM DEVELOPMENT
USING POLYPYRROLE ENHANCED FLEXIBLE BIOFILM SENSORS. Leo
Zheng, Robert Congdon, Omowunmi Sadik, Claudia Marques, David Davies, Bahgat
Sammakia, Leann Lesperance, James N. Turner.
E2. ULTRASONIC VOCALIZATIONS: A REAL-TIME INDEX OF APPETITIVE
VERSUS AVERSIVE STIMULI? Laura M. Darnieder, Michael E. Nizhnikov, and
Norman E. Spear.
E3. NOVEL DYNAMICS OBSERVED IN A SPIKING NEURAL NETWORK
MODEL OF THE NTS IN THE RAT HIND-BRAIN. Jingyi Zhou, J. David Schaffer,
Craig Laramee, and Patricia DiLorenzo.
Posters: C11-E3
E4. SIMPLE DESIGN RULES FOR SPIKING NEURAL NETWORK-BASED
GENERAL PURPOSE NETWORKS. Arnab Roy, Craig Laramee, and J. David
Schaffer.
E5. STATIC MAGNETIC FIELD INDUCTION OF STOCHASTIC GENE
EXPRESSION. Megan Brady, Paul Frisch, Kenneth J. McLeod, Craig B. Laramee.
E6. TOWARDS DEMENTIA DIAGNOSIS WITH SPEECH. J. David Schaffer, Shawn
Berkowitz, Laura Bronstein, and Stephen Zahorian.
E7. VALIDATION OF A NEW PNN-GRNN ORACLE HYBRID FOR SCREENING
USING BOTH PLS AND KPLS. Walker H. Land, Jr., William Ford, Xinpei Ma ,JinWoo Park.
E8. GENETIC EXPRESSION OF OBESITY BMI WITH LOW AND HIGH
PERCENTAGE OF BODY FAT. Karen L. Zanni.
F. COMMUNITY PARTNERS & LOCAL SERVICE PROVIDERS:
PROJECTS, PROGRAMS, AND POLICIES TO ADDRESS CHILDHOOD
OBESITY
F1. RN TO BS PROGRAM PROVIDES “WINNABLE BATTLE” LEADERSHIP IN
COMMUNITY PARTNERSHIPS FOR RURAL CHILD OBESITY WORK.
Margaret S. Argentine, Nannette Cowen.
F2. FARM TO YOU – RESTAURANTS AND COMMUNITY ASSETS.
Laura Biasillo.
F3. THE PATRIOT BREAKFAST PROGRAM. Mark Bordeau, Ray Denniston, Yvonne
Johnston, Julie Tucker.
F4. ROCK ON CAFÉTM. Mark Bordeau, Ray Denniston, Yvonne Johnston, Julie Tucker.
F5. STAY HEALTHY KIDS. Pat Fell, Jenny English, Nalini Kalanadhabhatta.
F6. LEARNING IN MOTION. David Garbarino, Mary McFadden.
F7. CHILDHOOD OBESITY: ASSESSMENT AND TREATMENT IN A PHYSICIAN
NETWORK SYSTEM. Robin Mosher.
F8. LIVABLE COMMUNITIES ALLIANCE: A COLLABORATION FOR A
SUSTAINABLE LIVABLE REGION. Caroline P. Quidort, Amelia LoDolce, Tarik
Abdelazim.
F9. WSKG’S WORKING ON WELLNESS INTIATIVE – COMMUNITY BASED
APPROACH TO ADDRESSING CHILDHOOD OBESITY. Jackie Stapleton, Nancy
Coddington.
F10. THE YMCA: ENSURING A HEALTHIER FUTURE FOR OUR YOUNGEST
GENERATION. Leigh Tiesi, Martin Dyson.
Posters: E4-F10
WAIST HIP RATIO (WHR) VS BODY MASS INDEX (BMI) TO ASSESS
RELATIONSHIP BETWEEN OBESITY AND GERD
Nasser Hajar1, 2, Sonia Brar1, Nazif Chowdhury1, Shahid Ali2, Richard Rackett1, Amine
Hila1
1
Department of Gastroenterology, United health services, Johnson City, NY, United States;
2
Gastroenterology, SUNY Upstate Medical University Hospitals, Syracuse, NY, United States.
Background: Many studies have shown that reflux during recumbency is associated with a high
disease burden due to decreased esophageal defense mechanisms. Obesity is also an important
factor in increased gastroesophageal reflux disease (GERD).
Aim: To evaluate the association between obesity and GERD during recumbency using MII-pH.
Methods: Retrospective review of 122 consecutive MII-pH studies of adult patients (70%
females, mean age = 49 years). Data were collected between 11/2006 and 02/2009. We evaluated
the total number of reflux episodes during recumbency using MII-pH. Patients were divided into
3 groups according to their BMI: normal ≤ 25, Overweight 25-30, and obese ≥ 30. All MII-pH
studies were done while patients were on daily proton pump inhibitor (PPI) therapy.
Results: A total of 122 patient studies were analyzed; 30 in the normal BMI group, 41 in the
overweight group, and 51 in the obese group. Mean values of BMI: Normal 22.67 kg/m2,
Overweight: 27.54 kg/m2, Obese: 36.46 kg/m2. The total number of reflux episode during
recumbency increased significantly as BMI increased (p= 0.0088; Kruskal Wallis test).
Conclusion: This study shows a clear association between increased reflux as detected by MIIpH during recumbency and higher BMI. This indicates that obesity remains a risk factor for
reflux, even during recumbency.
Keywords: GERD, obesity
Poster: A1
CHILDHOOD OBESITY IN THE SOUTHERN TIER: A REVIEW AND COMPARISON
OF PREVALENCE IN SIXTH GRADERS
Martin M. Fernandez1, Marc Lichtenfeld2, and Ralph M. Garruto1
1Laboratory of Biomedical Anthropology and Neurosciences, Department of Anthropology,
Binghamton University, Binghamton, NY 13902
2
Office of Competitive Grants, Geisinger Health System, Danville, PA 17821
Contact information: mfernan5@binghamton.edu.
Background: Obesity is a major risk factor for chronic disease and is a pressing health concern
across the nation, with prevalence rates seemingly rising every year. Upstate New York is no
different, and also reflects this detrimental trend. Specifically, Broome County has one of the
highest overweight/obesity rates in the state of New York, and possibly the country at 63.7%,
compared to the state estimate of 59.3% (New York State Department of Health, 2009).
Childhood obesity is strongly tied to an array of negative short term and long term health affects,
adult obesity, and cardiovascular events later in life. The Southern Tier also reflects a high
prevalence of childhood obesity. Our purpose is to re-examine and present primary childhood
obesity data collected in Broome County in 2006 and compare it to state and national prevalence
rates. In addition, the dietary and activity-related trends of the study population, state, and nation
will also be addressed to better explain why the problem might be escalating.
Methods: The original study was conducted in 2006 and resulted in a doctoral dissertation
(Lichtenfeld, 2009). Anthropometric and behavioral data were collected from 787 sixth grade
students (395 males, 392 females) from three different middle schools in the county. Overweight
and obesity were addressed through a variety of anthropometric measurements and indices,
however, for the purposes of this comparative study only BMI will be used. Nutritional and
activity-related variables were assessed via interviews and questionnaires, and then analyzed in
the form of indices (healthy vs. unhealthy food, activity vs. inactivity). State and national level
trends and statistics were gathered from the CDC's 2009-2010 NHANES survey, the New York
State Department of Health (2009), and the New York Statewide School Health Services Center
(2009). Trends and figures were then compared by age/sex.
Results/Anticipated Results: The overall prevalence of obesity among boys of the study
population is 28%, substantially higher than the 20.1% national prevalence approximation
suggested by the 2009-2010 NHANES. For girls, the local rate of 25.3% is also substantially
higher than the national average (15.7%). Both prevalence rates are also much higher than the
estimated figure for New York State (exclusive of New York City), which is 18% for the nearest
age group (7th/10th Graders). Comparison of behavioral observations and trends may help to
explain the differences in prevalence and increasing obesity rates.
Conclusions: Comparison of prevalence statistics suggests that childhood obesity is an
extremely pressing health concern in Broome County, and social and behavioral observations
may serve to help explain the epidemic.
Keywords: Childhood obesity, regional differences, comparative study
Poster: A2
GEOGRAPHY OF BODY MASS INDEX IN THE GREATER BINGHAMTON AREA
Marie DeFeo, MLS, GISSA, Richard Terry, DO, MBA, FACOFP
UHS Wilson Medical Center, Johnson City, NY 13790
Contact Information: marie_defeo@uhs.org, richard_terry@uhs.org
Introduction: Does the built environment play a role in one’s body mass index (BMI) or could
it be socioeconomic factors? This study aims to spatially analyze the body mass index of JC
Family Care Center patients in the Greater Binghamton Area in relation to the built environment,
and in particular, neighborhood food sources, using geographic information systems and the
home addresses of the patients. Correlations between socioeconomic factors will also be
explored by using demographic data from 2010 Census.
Methods: Using geographic information systems, the home addresses of the JC Family Care
Center patients were geocoded into latitude and longitude and plotted on a digital map. The data
was then aggregated into 2010 census tracts and average BMI and median BMI were calculated
for each census tract. A series of choropleth maps were created for Broome County showing
average BMI per census tract, average BMI deviation from the mean BMI, and the obesity
research included number of obese patients per census tract, percent of the total obese population
per census tract and obesity density showing the number of obese patients per square mile. The
locations of supermarkets, small grocery stores and restaurants were geocoded and a spatial
analysis was performed. In addition, using demographic data from the 2010 Census a
correlational analysis was performed to determine BMI correlations between socioeconomic
factors.
Results: Preliminary data demonstrate that BMI is related to a number of demographic
variables: it is directly and also inversely associated with a variety of household composition
measures (basically it looks like high numbers of single parent homes is associated with higher
BMI’s where high number of married couple homes is related to lower BMI’s. There is an
inverse relationship w/ household income (-.514; p<.002) and median age of the tract (-.376;
p<.03). There is a direct relationship between BMI and ethnic percentages of the tract,
particularly minority populations. Specifically with the % Black (.613, p<.001; % Native
American (.520, p<.002); % Hispanic (p<.416, .016) and % other (.427, p<.013).
Summary:
Our data suggest that l BMI is related to ethnicity and Socioeconomic status (SES), with lower
SES having higher BMI. Access to food via having fast food restaurants, convenience stores, or
a supermarket in the tract does not appear to have an effect on BMI.
Keywords: BMI, geography
Poster: A3
SECULAR TRENDS IN AGE AT MENARCHE IN VANUATU
Alysa Pomer1,2,3, Chim W Chan1,2,3, Kelsey N Dancause5, Gwang Lee3, Kathryn M
Olszowy1,3, Harold Silverman2,3, Cheng Sun2,3, Spencer A Waldman2,3, Martin M
Fernandez1,3, Len Tarivonda7, George Taleo7, Marcelin Abong8, Ralph Regenvanu9, Akira
Kaneko10,11,12, Charles A Weitz6, Ralph M Garruto1,3,4, and J Koji Lum2,3,4.
1
Laboratory of Biomedical and Neurosciences, Binghamton University, 2Laboratory of
Evolutionary Anthropology and Health, Binghamton University, 3Department of Anthropology,
Binghamton University, 4Department of Biological Sciences, Binghamton University,
5
Psychosocial Research Division, Douglas Hospital Research Center, McGill University,
6
Department of Anthropology, Temple University, 7Ministry of Health, Republic of Vanuatu,
8
Kaljoral Senta, Republic of Vanuatu, 9Ministry of Justice and Social Affairs, Republic of
Vanuatu, 10Island Malaria Group, Department of Microbiology, Karolinska Institutet,
11
Department of Parasitology, Osaka City University Graduate School of Medicine, 12Institute of
Tropical Medicine, Nagasaki University
Contact information: alysa.pomer@binghamton.edu
Background: The last century has seen a significant decrease in age at menarche for young
women in modernized populations, from about age 15 years to a present average of 12.5 years in
the United States. Lifestyle changes associated with modernization, particularly changes in
nutrition, have been accepted as the cause for this observed shift in age at menarche. Our
research in the Pacific island nation of Vanuatu indicates that a similar phenomenon is occurring
among young Ni-Vanuatu women. Additionally, our research indicates that this decrease in age
at menarche may be occurring in fewer generations than it has in developed western nations (one
to two generations in Vanuatu, as opposed to at least three generations in the United States and
Europe).
Methods: In 2011, we surveyed age at menarche via recall in females on five islands of Vanuatu,
representing varying levels of economic development (Efate, Aneityum, Nguna, Futuna, and
Ambae). Of 944 females surveyed (730 age 10 or above), 506 responded to our question about
date of menarche. The data was obtained as part of a larger survey on the health transition in
Vanuatu.
Results: Analysis of the collected data shows that women 20 years of age and older at the time
of our survey experienced menarche around age 15 across all islands surveyed (mean 14.8 to
15.8); however, young women less than 20 years old at the time of the survey reported
experiencing menarche at a younger average age (13.5).
Conclusions: The decrease in age at menarche is particularly distinct on islands where the
process of modernization has become a prevalent force in society, especially those islands in
greatest proximity to the urbanized capital city of Port Vila. Those islands which are less
modernized maintain an older average age at menarche than those islands which are more
modernized.
Funding: Wenner-Gren Foundation for Anthropological Research, Harper College Grants in
Support of Research, Scholarship, and Creative Work.
Keywords: menarche, health transitions, adolescent health, Vanuatu
Poster: A4
EXPLORING THE HEALTH TRANSITION IN VANUATU:
CROSS-SECTIONAL AND LONGITUDINAL DATA COMPARISONS FROM 2007 to 2011
Kathryn M Olszowy1, 3, Alysa Pomer1, 2, 3, Kelsey N Dancause5, Cheng Sun2, 3, Harold
Silverman2, 3, Chim W Chan1, 2, 3, Gwang Lee3, Martin M Fernanedez1,3, Spencer A Waldman2,3,
Len Tarivonda7, George Taleo7, Marcelin Abong8, Ralph Reganvanu9, Akira Kaneko10,
Charles A Weitz 6, J Koji Lum 2, 3, 4, and Ralph M Garruto 1, 3, 4.
1
Laboratory of Biomedical and Neurosciences, 2Laboratory of Evolutionary Anthropology and
Health, 3Department of Anthropology, and 4Department of Biological Sciences, Binghamton
University; 5Psychosocial Research Division, Douglas Hospital Research Center, McGill University;
6
Department of Anthropology, Temple University; 7Ministry of Health, 8Kaljoral Senta, and
9
Ministry of Justice and Social Affairs, Republic of Vanuatu; 10Island Malaria Group, Department of
Microbiology, Tumor and Cell Biology, Karolinska Institutet.
Contact Information: kolszow1@binghamton.edu
Background: Vanuatu, similar to other South Pacific nations, is undergoing a rapid health transition
as a consequence of modernization and accompanying changes in diet and lifestyle. The global
health transition results in increased rates of chronic diseases, including obesity, type II diabetes, and
hypertension, while infectious disease burdens do not necessarily decline. We surveyed individuals
on three islands of varying economic development in Vanuatu in 2007 and 2011: Ambae, the most
rural, Aneityum, rural with tourism, and Efate, the most urbanized. We hypothesized that overweight
and obesity would be greatest on Efate and least on Ambae as a result of the impact of modernization
on health.
Methods: In 2007, a field research team from Binghamton University collected anthropometric
measurements, including body mass index (BMI), percent body fat (%BF), skinfold measurements
and body circumferences, on Ni-Vanuatu men, women and children from three islands (Ambae,
Aneityum and Efate). In the summer of 2011, the field research team returned to Vanuatu and
collected the same biological measurements on many of the same individuals. Statistical analysis to
evaluate overweight and obesity was performed using SPSS 16.0.
Results: Preliminary cross-sectional analysis of BMI and %BF reveal a clear pattern in both 2007
and 2011: During both years in men and women, mean BMI and % BF showed a pattern of
significant increase between Ambae to Aneityum, and Aneityum to Efate, supporting the notion that
overweight and obesity would increase significantly on the most modernized island (p<0.05) for both
variables. Differences in other anthropometric measurements are currently being analyzed. Further
analysis should reveal if the statistically significant differences reported here are also biologically
significant. Longitudinal analysis is currently underway and will be presented to help clarify the
trends seen in the cross-sectional analysis.
Conclusions: Vanuatu is experiencing a rapid health transition away from traditional to more
modernized lifestyles. This transition includes increased rates of overweight and obesity, and
indicates increased risk for the development of obesity-associated diseases. Future analysis of dietary
and activity patterns should help clarify the drivers behind the health transition in Vanuatu.
Funding: Wenner-Gren Foundation for Anthropological Research and Harper College Grants in
Support of Research, Scholarship, and Creative Work
Keywords: Obesity, modernization, health transitions, Vanuatu
Poster: A5
MODERNIZATION AND DIFFERENTIAL PHYSICAL ACTIVITY AMONG THE
ISLANDS OF VANUATU
1,2
Harold Silverman , Cheng Sun1,2, Alysa Pomer1,2,3, Chim W Chan1,2,3, Kathryn M
Olszowy2,3, Kelsey Needham Dancause5, Gwang Lee2, Spencer A Waldman1,2 ,Martin M
Fernandez2,3, Akira Kaneko6, Len Tarivonda7, George Taleo7, Marcelin Abong8, Ralph
Regenvanu9, Charles A Weitz10, Ralph M Garruto2,3,4, J Koji Lum1,2,4
1
Laboratory of Evolutionary Anthropology and Health, 2Department of Anthropology,
3
Laboratory of Biomedical Anthropology and Neurosciences, and 4Department of Biological
Sciences, Binghamton University, 5Psychosocial Research Division, Douglas Hospital Research
Center, McGill University, 6Island Malaria Group, Department of Microbiology, Karolinska
Institutet, 7Ministry of Health, 8Kaljoral Senta, and 9Ministry of Justice and Social Affairs,
Republic of Vanuatu, 10Department of Anthropology, Temple University
Contact Information: Hsilver1@binghamton.edu
Background: In western countries modernization (physical infrastructure) and the associated
decrease in physical activity have been linked to noncommunicable diseases (NCD) such as
obesity and hypertension. However, the precise role of physical activity in the development of
NCD is unknown. The Republic of Vanuatu, a developing nation in the South Pacific, consists of
82 islands of which over 60 are inhabited, each with varying levels of modernization. This makes
Vanuatu a perfect natural model to test the correlation between NCD and physical activity. We
hypothesize that higher levels of obesity and modernization will correlate with lower levels of
physical activity, thus giving us some insight into the role of physical activity in NCD.
Methods: In summer 2011 from five islands in Vanuatu (Ambae, Aneityum, Futuna, Efate, and
Nguna) we collected anthropometric measurements (including height, weight, %BIA, and blood
pressure) along with information on diet and lifestyle for 1914 Ni-Vanuatu men, women and
children. The data presented here, specifically related to physical activity and anthropometric
measurements, are correlated with NCD.
Results: Preliminary results show a difference in physical activity across each of the five islands
of individuals age 16 to 60 (N=875). On average the two most modernized islands, Efate and
Nguna have the fewest number of gardens per person. The average amount of time walking to
food and other stores showed that as islands become more modernized their walking time
decreases. Thus Futuna has the greatest walking time followed by Ambae, Aneityum, Nguna,
Efate (least walking time), respectively. A similar trend is also generally seen in obesity rates:
Ambae (6.67%), Futuna (7.19%), Aneityum (13.74%), Nguna (22.29%), and Efate (34.27%).
However the proportion of individuals who play sports does not follow any clear pattern across
the islands.
Conclusions: Our findings generally support our hypothesis that increasing modernization and
obesity are associated with decreasing activity levels. The most modern islands with the highest
levels of obesity have the fewest gardens to tend to, and spend the least amount of time walking
to stores. The proportion of people that play sports on each island is unexpectedly high and
shows no trend, but can be explained by understanding sports as a free or leisure time activity.
More data is needed to come to a full conclusion, including information on sedentary time, and
total time engaged in physical activity, which could help in understanding the role of physical
activity in NCD and modernization.
Funding: Wenner-Gren Foundation for Anthropological Research, Harper College Grants in
Support of Research, Scholarship, and Creative Work.
Keywords: Obesity, physical activity, Vanuatu, modernization.
Poster: A6
IMPACT OF USE OF CONSUMER ELECTRONICS ON TRADITIONAL LIFESTYLES
IN VANUATU
Cheng Sun1,3, Harold Silverman1,3, Alysa Pomer1,2,3, Chim W Chan1,2,3, Kathryn M
Olszowy2,3, Kelsey N Dancause5, Gwang Lee3, Spencer A Waldman1,3, Martin M
Fernandez2,3, Akira Kaneko6, Len Tarivonda7, George Taleo7, Marcelin Abong8, Ralph
Regenvanu9, Charles A Weitz10, Ralph M Garruto2,3,4, J Koji Lum1,2,4
1
Laboratory of Evolutionary Anthropology and Health, 2Laboratory of Biomedical Anthropology
and Neurosciences, 3Department of Anthropology, and 4Department of Biological Sciences,
Binghamton University; 5Psychosocial Research Division, Douglas Hospital Research Center,
McGill University, 6Island Malaria Group, Department of Microbiology, Karolinska Institutet,
7
Ministry of Health, 8Kaljoral Senta, 9Ministry of Justice and Social Affairs, Republic of
Vanuatu; 10Department of Anthropology, Temple University
Contact Information: csun1@binghamton.edu
Background: In Western countries, the use of consumer electronics (UCE) including computer
and television constitutes a major part of the modern sedentary lifestyle, which contributes to
chronic health problems such as obesity. However, few studies have been conducted in
developing countries such as Vanuatu, an archipelago in the South Pacific, where the adoption of
modern technologies has just begun and the rates of such adoption vary among islands. We
hypothesize that a higher frequency in UCE correlates with a lower level of physical activity and
thus a higher prevalence of obesity.
Method: As part of a broader research project on modernization and health transition in
Vanuatu, we conducted a survey to assess ownership and use of consumer electronics and their
relationships with physical activity level and obesity on five islands which showed a gradient in
economic development. In total, 875 volunteers from 16 to 60 years were included in this study.
Results: Preliminary analysis showed that there was a significant difference in the number of
consumer electronics owned per person across five islands (Ambae, 0.91, Futuna, 0.99,
Aneityum, 1.95, Nguna, 2.63, and Efate, 3.68; ANOVA, p<0.001), which suggests different
levels of UCE on these islands. On a weekly basis, people from islands with higher UCE levels
engaged in more types of sedentary activities (including those associated with UCE), than on
islands with lower UCE levels (0.8, 1.2, 1.4, 1.9, 3.3; ANOVA, p < 0.001). Furthermore, islands
with higher UCE levels were also associated with fewer gardens owned per person and fewer
types of weekly sports, suggesting lower physical activity levels. Mean percent body fat and
prevalence of obesity also varied significantly among islands (ANOVA, p < 0.001; Chi-square,
p<0.001). Islands with higher UCE had a higher mean percentage of body fat (20.6, 21.8, 24.1,
26.0, and 27.5%) and obesity rate (6.7, 7.2, 13.7, 22.3, and 34.3%).
Conclusion: The study showed the rates of technology adoption in Vanuatu, especially the use
of consumer electronics, vary from island to island. An increase in UCE was associated with 1) a
decrease in physical activity and an increase in sedentary activity; and 2) an increase in obesity
rate. This suggests adoption of technology during the process of modernization could lead to an
increase in chronic health problems such as obesity.
Funding: Wenner-Gren Foundation for Anthropological Research, Harper College Grants in
Support of Research, Scholarship, and Creative Work.
Keywords: Sedentary activity, physical activity, consumer electronics use, body fat
Poster: A7
EIGHTY YEAR TRENDS IN INFANT WEIGHT AND LENGTH GROWTH: THE FELS
LONGITUDINAL STUDY.
William Johnson1, Audrey C Choh2, Laura E Soloway3*, Stefan A Czerwinski2, Bradford
Towne2,4, and Ellen W Demerath1.
1
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
2
Department of Community Health, Wright State University, Dayton, OH
3
Bureau of Cancer Epidemiology, NYS Department of Health, Albany, NY
4
Department of Pediatrics, Wright State University, Dayton, OH
*Contact Information: les08@health.state.ny.us
Background: Few published studies exist on secular trends in infant growth, and those available
have assessed trends over short periods in the second half of the 20th century, and did not
account for the possibility that a trend in increasing size may be explained by a trend in the
maturational clock as greater size is often a function of developmental pace. Here, we investigate
secular trends in weight and length growth from birth to 3 years in infants born 1930–2008, and
assess whether these trends were mediated by concurrent trends in pace of infant skeletal
maturation and maternal BMI.
Methods: Using the Fels Longitudinal Study database, longitudinal weight and length data from
620 (302 girls) infants were analyzed using mixed effects modeling to produce growth curves
and predicted anthropometry for infants born 1930–1949, 1950–1969, 1970–1989, and 1990–
2008.
Results: Significant associations of cohort with growth were observed, with the most
pronounced differences occurring in the first year of life. Infants born after 1970 were ~450 g
heavier and ~1.4 cm longer at birth, but demonstrated slower growth to 1 year, than infants born
before 1970. Growth trajectories converged after 1 year of age, and there was no evidence that
relative skeletal age, maternal BMI, or maternal age together mediated associations between
cohort and growth.
Conclusions: Recent birth cohorts may be characterized not only by greater birth size, but also
by subsequent catch-down growth. Pediatricians should be aware that trends over time in human
growth do not increase monotonically, and that growth velocity in the first year may actually
have declined compared to preceding generations.
Financial disclosure: This study was supported by grants from the National Institutes of Health:
R01 HD012252 and R01 HD053685.
Keywords: longitudinal study, secular trends, infant growth
Poster: A8
PROTECTING THE FETUS FROM TOO MUCH ESTRADIOL IN OBESITY:
PLACENTAL 17 β-HYDROXYSTEROID DEHYDROGENASE-2 ACTIVITY. L.
Dhariwal, S. Arya1, M. Dalloul1, O. Muneyyirici1, D. Sherer1, V. Nacharaju1, O. Abulafia1,
and JG. Kral2
1
Department of Obstetrics and Gynecology and 2 Department of Surgery, State University of
New York Downstate Medical Center, Brooklyn, New York 11203, USA
Contact Information: ldhariwal1@gmail.com
Estradiol (E2) levels are elevated in obesity and during pregnancy and may play an important
role in insulin resistance. The fetus is protected from exposure to this high level of maternal
estradiol by placental conversion to inactive estrone through the action of 17β -hydroxysteroid
dehydrogenase type 2 (17βHSD-2), which is upregulated by E2. We hypothesize that placental
17βHSD-2 levels are elevated in obesity. Several methods exist to analyze 17βHSD-2 activity
but Liquid Chromatography–Mass Spectrometry (LC/MS) and Gas Chromatography–Mass
Spectrometry (GC/MS) are superior as they enable analysis of multiple hormones in a single run
incorporating metabolic programs. We developed a GC/MS method using Ion Trap GC/MS
(GC/MS/MS) to quantitate estrogen metabolites. Placental homogenates from 6 full-term
women, BMI 28-44, were incubated with E2 before passage through C-18 columns to obtain
methoxime-trimethylsilyl (MO-TSM) derivatives of steroid hormones such as estradiol and
estrone. Further GC/MS analysis by GC/MS/MS enabled quantitative estimation of estrone, even
in the presence of excess estradiol. All six placentas showed measurable 17βHSD-2 activity
assessed by estrone formation in the presence of estradiol and the E1/E2 ratio. The correlation
between E1/E2 and BMI was statistically significant (R²=0.86; p<0.01) implying elevated levels
of 17βHSD-2 in gestational obesity.
Keywords: intrauterine environment; gestational obesity; trans-placental transfer of metabolic
disease
Poster: A9
A STUDY ON STRESS RELATED WEIGHT-GAIN IN MEDICAL RESIDENCY: DOES THE
CARE OF OTHERS EVENTUALLY COMPROMISE THE CARE OF ONE’S SELF?
D. Chin, MD, K. Paudel, MD, B. Siddiqui, MD;
United Health Services Hospitals, Johnson City, NY 13790
Email: buddersiddiqui@hotmail.com
Introduction: Medical residency is an intricate part of medical training. It provides real-time
experience and facilitates the transition of medical knowledge to actual patient care. In this transition,
there is an increase in work load, work hours and responsibility. Fatigue among residents has been the
target of the Accreditation Council of Graduate Medical Education, resulting in mandatory duty hour
restrictions; however, reports suggest that despite decreased fatigue due to duty hour restrictions, stress
persists. With increased stress levels, there comes a point where caring for others becomes prioritized
over caring for one’s self and weight gain may be one of the earliest manifestations. It is proposed that
increased levels of stress will correlate with respective increases in BMI.
Methods: The goal of this study is to determine if there is overall weight gain during medical
residency and if this correlates with levels of stress respective to medical residents in the first, second
and third post-graduate years (PGY). The research project will be approached through a retrospective
survey protocol. Participant population will be restricted to the residents and attending physicians
(controls) within the United Health Services (UHS) Hospitals. Basal metabolic index (BMI) changes
from the beginning of the past residency year to present will be recorded. They will be correlated to
respective stress levels measured by the Modified Physician Job Stress Survey (MPJSS) created
specifically for this study. Respective data will be analyzed using one-tail directional T-Test, as well as
the Pearson Correlation Coefficient.
Results: Our results showed that residents of UHS reported significantly more stress than their
attending physicians (p<0.001). However, weight gain increased with stress only in PGY 2 residents
with a statistically significant (p<0.05), when compared to the controls. Results from the Pearson
Correlation showed a mild correlation between stress level and weight-gain for PGY 2 residents with a
correlation coefficient of 0.196. Although the slope of the line on the linear regression graph was
positive, there was a wide distribution of BMI changes against stress level without a strong correlation
between the two variables.
Conclusion: Although the results of this study did show a positive correlation between stress level and
weight-gain in medical residency, it was not statistically significant. The results imply that there was no
significant increase in weight or BMI with increase in stress level, as was the proposed hypothesis.
Discussion: Medical residents around the world sacrifice time and energy to help their fellow mankind
in innumerable fields of medicine. Due to time constraints, efforts to maintain one’s own health can be
challenging. With data from this research project, future residency programs can be tailored to best
facilitate mental and physical health in future physicians. Prospectively, the MPJSS can be extended to
residencies nation-wide to establish and record overall stress levels as well as variability between
programs. The ultimate goal is to create the optimal learning environment.
Limitations: First of all, the population for review was restricted to UHS hospitals and generalization
beyond these boundaries may be inaccurate due to hospital protocol variance. Our protocol neither
included objective measures of stress nor perceived workload characteristics. In addition, individuals
perceive emotional stress to different degrees and may appraise similar situations differently.
Keywords: weight gain, young adults, stress
Poster: A10
HEAT BALANCE IN YOUNG ADULTS
Shwetana Sunkari, Craig B. Laramee, and Kenneth J. McLeod,
Program in Biomedical Engineering, Watson School of Engineering and Applied Sciences,
Clinical Science and Engineering Research Center, Binghamton University, Binghamton, NY,
Email: ssunkari@binghamton.edu
Introduction: Obesity has increasingly been cited as a major health issue in the United States,
with national surveys suggesting a steady rise in obesity over the last 40 years. While obesity is
widely accepted to result from voluntary behavior such as excessive eating or inadequate
physical exercise, we investigate obesity from a complex systems perspective, which would
suggest that body weight is an emergent property arising through a physiologic adaptation to the
environment. Specifically, humans have evolved numerous adaptation processes for maintaining
body temperature (heat balance) in a wide range of thermal environments. Previous work has
shown that young women (age 17-21 years) tend to be in negative heat balance when in an air
conditioned environment. Here we investigate how heat balance changes in women as they age.
Methods: A convenience sample of 25-40 year old women was recruited. Height, weight, skin
temperature and skinfold thickness was obtained in a 22oC, 40% RH environment. Skin
temperature was taken at five sites on the body (forehead, upper arm, lower arm, neck, stomach)
using a thermocouple recorder. Percent body fat was calculated using skinfold thickness
measurements at four sites (bicep, tricep, subscapula and suprailliac). To estimate heat balance,
basal heat generation was calculated (Katch and McArdle; 1996), and this was multiplied by 1.4
to get total heat generation. Heat lost from the body by radiation, convection and conduction,
and heat transfer due to breathing were also calculated. These depend on the body surface area
which was determined using Mosteller’s formula (1987). Heat balance was then calculated as a
difference between heat generation and heat loss (QG-QL).
Results: In our initial analysis of 42 women under age 28 years, the women had an average
negative heat balance (-3.04+/- 7.82 watts). With increasing age, three patterns were observed.
Women appear to progressively gain body mass (0.33kg/year), but they also increase their
percent body fat (0.57%/year) and hence fat mass (0.46 kg/year; p = 0.005) such that lean body
mass and therefore metabolic heat generation declines with age (0.18 W/year). In addition, the
increased body mass is associated with an increase in body surface area (0.0032 m2/year),
resulting in greater heat losses. Correspondingly, we observe that with increasing age heat
balance becomes even more negative at a rate of 0.67 watts/year. As a result, an 18 year old
woman with an average weight of 59kg, with 25% body fat, and -3.40 W out of heat balance,
would be expected to gain 7 kg by age 38, have 36% body fat, and be 16W out of heat balance.
Discussion: Contrary to our initial presumption that women would tend to transition into heat
balance as they age, our results suggest that women, in fact, move further out of heat balance up
through age 40. This appears to be primarily the result of decreased lean body mass, even though
the women continue to gain weight. As our older cohort (28 – 40 years) is still quite small, it is
possible that with increased number of subjects the results may shift. However, this conclusion is
consistent with the theory that the human body is a complex adaptive system, and that body
weight is an emergent behavior arising from the dynamic adaptation of the body to its
environment.
Keywords: Obesity, adaptation, built environment, heat balance
Poster: A11
INFLUENCE OF TRANSIENTLY INCREASED CORE BODY TEMPERATURE
ON BODY MASS CHANGES IN YOUNG ADULT WOMEN
Nicole Stroke1, Rachel Engelberg2, Eileen Shimizu2, Richard Goettel2,
Kenneth J. McLeod2 and Leann M. Lesperance2
1
Department of Biological Sciences, 2Department of Bioengineering
Clinical Science and Engineering Research Center
Binghamton University, Binghamton, NY 13902
Background: Obesity continues to be a significant health concern in the U.S. Innumerable
strategies focused on altering an individual’s diet and/or activity levels have been proposed and
studied, yet few, if any, show sustained benefit in terms of reduced body weight and maintenance
of that lower weight. As a result, investigators have turned to pharmacologic approaches. One
pharmacologic agent which holds promise is recombinant growth hormone (GH). A recent
meta-analysis indicates that regular injections of GH are able to stimulate significant reductions
in adiposity in overweight individuals. An alternative means for raising serum GH levels in the
body is to increase core body temperature. GH synthesis is strongly dependent on core body
temperature; recent research has shown that increasing body temperature in non-athletes from the
normal 37oC to 39oC results in an over 100-fold increase in serum GH levels. Core body
temperature can be raised either by increasing metabolic heat production (via physical activity)
or exposing the body to higher environmental temperatures. Thirty minutes of total body
immersion in 39oC water raises core body temperature to almost 39.5oC. The objective of this
research is to determine if the transient rise in core temperature associated with warm water
immersion is sufficient to stimulate significant weight loss in healthy young adult women.
Methods: Healthy, non-pregnant female students at Binghamton University with BMI in the
“overweight” category (i.e. 24 or greater) were recruited for this IRB-approved study. After the
women gave their informed consent, initial body height, body weight, and body fat composition
(using calipers to obtain skin fold thickness at five body sites) were obtained. In addition, skin
surface temperature at the five sites where skin-fold thickness was measured was also obtained to
permit calculation of heat balance. The women then started the study period, spending 30
minutes in a 39oC hot tub (21st Century Pools and Spas, Vestal, NY) three times weekly which
will run for a total of 10 weeks. Linear regression was used to track body mass loss as a function
of time and as a function of the number of completed 30 minute treatments sessions.
Results: Five women have been recruited to date, with ages ranging from 19-21 years, body
weights ranging from 70-90 kg, and BMIs ranging from 24-39 kg/m2. Over the first four weeks
of water immersion therapy, average body weight declined at a rate of 0.58 kg/week (p=0.05).
Total number of immersions ranged from five to nine over this time period and as a function of
total number of treatments, the rate of body weight loss has been 0.78 kg/treatment (p=0.3).
Discussion: Three thirty-minute sessions per week of moderately intense exercise is the general
recommendation for reducing body weight and maintaining a lowered weight. Interestingly, 30
minutes of moderately intense exercise is sufficient to raise core body temperature above 39oC,
raising the question of whether the effect of exercise on body weight is mediated more by the
core temperature effect on GH production than by calories burned. Our results lend credence to
the hypothesis that the critical factor in weight loss is ensuring at least transient rises in core
body temperature. If these results are sustained, a wide variety of techniques for inducing and
maintaining weight loss could be proposed, at least for young adult women.
Key Words: Obesity, Core Body Temperature, GH Synthesis
Poster: A12
THE BINGHAMTON UNIVERSITY BIOSPECIMEN ARCHIVE FACILITY:
A RESEARCH RESOURCE
1,2
Kaitlin Drouin , Jennifer Lavelle1,2, Kristen Rachfal1,2,and Ralph M. Garruto 1,2
1
Binghamton University Biospecimen Archive Facility
2
Laboratory of Biomedical Anthropology and Neurosciences
Binghamton University, Binghamton, NY 13902
Contact Information: kdrouin1@binghamton.edu
Introduction: The Biospecimen Archive Facility is dedicated to the restoration, archiving, and storage
of biological specimens collected as a part of IRB-approved past biomedical and bioanthropological
research from isolated and modernizing human populations globally. The collection housed in the
Biospecimen Archive Facility is unique among archives and biorepositories, and continues to operate
as an important resource for biomedical research.
Background to Collection: In 2003, the Laboratory of Biomedical Anthropology and Neurosciences
(LBAN) was awarded seven years of funding from the National Institutes of Health (NIH), National
Institute of Neurological Disorders and Stroke to archive a large collection of human sera, much of
which was collected over 50 years ago by investigators and collaborators of the former NIH
Laboratory of Central Nervous System Studies. The samples were housed in Rockville, MD until
2003, whereupon they were shipped to the LBAN under a Material Transfer Agreement with
Binghamton University. The collection consists of serum from populations in the Pacific Islands,
Asia, the Middle East, Latin America and the Caribbean.
Archive Facility: The collection is housed in the Biospecimen Archive Facility of Binghamton
University. The facility includes a temperature controlled cryogenics room, an archiving laboratory,
and a database management office. The cryogenics room houses thirteen -25oC freezers and one -80oC
freezer. Permanent archiving of the serum samples occurs in the laboratory adjoining the cryogenics
room, where specimens are archived according to a unique and detailed manual developed by the
facility. Information on each specimen is entered into a computer database in a secure database
management office adjoining the laboratory.
Archival Methods: Once the physical condition of each specimen is recorded, the specimens are
transferred from their original containers and vials into sealed o-ring cryovials in cryo-tolerant plastic
inventory cases. A database entry is created for each vial which includes the physical description of
the specimens and critical supporting information regarding the population. Vials are labeled with a
thermal barcode which provides the corresponding archived information upon scanning. Finally, the
associated field notes and specimen information are scanned, and coded into a metadata file for future
retrieval from an electronic database.
Archival Research: Prior to the collection’s acquisition by Binghamton University, past research
includes its use in the discovery of prion and other transmissible infectious agents and diseases such as
cytomegalovirus and Epstein Barr virus, arboviruses, malaria, measles, toxoplasmosis, and
oncornaviruses, among many others. The samples in the archive have also been used to assess genetic
susceptibility to disease and the genetic structure of human populations. The collection is currently
being used under IRB approved protocols for studies of herpes viruses, T-cell Leukemia virus (HTLV1), dengue fever virus, malaria and drug resistance studies, genetic susceptibility to ALS, Parkinsonism
and other chronic diseases, and an investigation into the strains of influenza that caused the 1890 and
earlier pandemics. The collection is open for use by all qualified researchers within and outside
Binghamton University who have an approved IRB protocol. Preparations are underway to develop a
website that will provide a means for investigators to acquire aliquots of the samples.
Keywords: Biomedical research, infectious agents, genetics, biospecimen archive
Poster: B1
APPLIED FIELD TECHNIQUES FOR COLLECTING BLACK-LEGGED TICKS
(IXODES SCAPULARIS) FOR DISEASE ECOLOGY RESEARCH
Amanda Pachomski,1,4 John M. Darcy II,1,2 Mellie Riddle,1,2 Sarah Hempstead,1,2 Tra Vu,1,3
Hannah Keppler,1,3 Chelsea Lucas,1,2 Rita Spathis1,2 and Ralph M. Garruto1,2,3
Laboratory of Biomedical Anthropology and Neurosciences,1 Departments of Anthropology,2
Biology3 and Environmental Studies,4 Binghamton University, Binghamton, NY 13902
Contact Information: apachom1@binghamton.edu
Background: Biomedical researchers have increasingly emphasized the importance of
understanding the ecological context in which vector-borne diseases develop and transmit to
humans. Lyme disease is a vector-borne disease in temperate North America and Eurasia that
serves as a model for extra-tropical disease ecology research. While several species of Ixodid
(hard bodied) ticks can transmit Lyme, black-legged ticks (Ixodes scapularis) are the primary
vectors for Lyme disease in the eastern United States. Therefore, the risk of exposure to Borrelia
burgdorferi, the bacteria which causes Lyme disease, is strongly dependent upon factors which
affect I. scapularis distribution, density, and infection rates. This field project seeks to optimize
tick sampling techniques to collect I. scapularis from the Binghamton University (BU) Nature
Preserve and other nearby locations for laboratory testing and analysis.
Methods: To construct a tick drag cloth we attached a 1 x 1 meter piece of white corduroy fabric
to a wooden dowel. By drilling two holes into both ends of the dowel, we were able to string
both ends of the nylon rope through the dowel and tie the ends together. Along 20 meter
transects at each sampling location, we dragged the cloth with the ridged side facing the ground
to allow ticks to latch onto the fabric. Every 10 meters we check the fabric for ticks, use forceps
to place any identified I. scapularis individuals into a 70% ethanol solution in O-ring cryovials.
The forceps and collection vessels are sterilized with bleach. This technique has been employed
in Chester County, PA, Chenango County, NY, and within the BU Nature Preserve. Ticks are
collected and labeled according to life stage (larva, nymph adult). GPS coordinate recording will
be added in the 2012 field season.
Results: To date we have collected ticks from three different sites and sent the collected tick
samples to our laboratory to be analyzed for B. burgdorferi infection. Over 100 ticks have been
collected and analyzed. All sites have produced ticks testing positive for B. burgdorferi infection
including the BU Nature Preserve. To our knowledge we have documented for the first time that
black-legged ticks from the BU Nature Preserve are infected with B. burgdorferi. These results
will be compared to a larger sample pool already underway in the 2012 field collection season.
Conclusion: Field sampling of Ixodid ticks allows for a better understanding of the ecology of
Lyme disease. By establishing tick infection rates and locating areas where humans are at a high
risk for B. burgdorferi exposure, field research can provide state and county health departments
with information necessary to target Lyme disease prevention strategies and to better monitor
and control disease outbreaks. Our study will help to evaluate tick monitoring methods and to
establish whether or not Lyme disease is a cause for concern within the Binghamton University
community.
Keywords: Tick dragging, drag cloth, tick collecting
Poster: B2
TESTING LOCAL AND REGIONAL PREVALENCES OF LYME DISEASE IN IXODES
SCAPULARIS POPULATIONS
Hannah Keppler,1,3 Chelsea Lucas,1,2 Sarah Hempstead,1,2 John M Darcy II,1,2
Mellie Riddle, 1,2 Amanda Pachomski,1,4 Rita Spathis1,2 and Ralph M Garruto 1,2,3
Laboratory of Biomedical Anthropology and Neurosciences,1 Departments of Anthropology,2
Biology3 and Environmental Studies,4 Binghamton University, Binghamton, NY 13902
Contact Information: hkepple1@binghamton.edu
Background: Tick-borne diseases are becoming more prevalent throughout North America. In
the northeast United States the most common tick-borne illness is Lyme disease, caused by the
spirochete bacteria, Borrelia burgdorferi. According to the Centers for Disease Control,
incidences of Lyme disease continue to rise from Virginia to Maine. We have begun
investigating the tick vectors that transmit Lyme disease for disease prevalence on a local and
regional scale to assess the increasing risk to human populations in these areas. Our efforts to
date have focused on assessing the prevalence of B. burgdorferi, the Lyme disease agent, in
Ixodes scapularis (black-legged or deer tick). It is also possible that some of the symptoms
exhibited by chronic Lyme disease patients may be attributed to co-infection with other
infectious agents carried by the tick, such as Anaplasma phagocytophilum, for which screening
has begun. Molecular techniques analyzing DNA were employed in the identification process.
Our work concentrates on three geographic areas: Chenango County, NY; Broome County, NY
including the Binghamton University (BU) Nature Preserve and Chester County, PA.
Methods: Ticks were collected during the 2011 field season from New York and Pennsylvania
and stored in individual O-ring cryovials containing 70% ethanol. DNA was extracted by placing
individual ticks in 100 μl 0.7M NH4OH (ammonium hydroxide), and heating to 99.9° C for 20
minutes. This was followed by incubation at 90° C for 20 minutes with the caps open to allow
for evaporation of the ammonium hydroxide gas. The extracted DNA was PCR (polymerase
chain reaction) amplified using Ixodes scapularis ITS2a, B. burgdorferi and A. phagocytophilum
groEL specific primers. Presence of PCR product was confirmed by agarose gel electrophoresis
and the identity of the product was verified by Sanger sequencing.
Results: Initial results of laboratory analysis indicate variation in the prevalence of B.
burgdorferi from 17%- 45 % across the tick populations tested so far. As of the writing of this
abstract we have tested 87 ticks for B. burgdorferi. Sample sizes are variable with 9 from the BU
Nature Preserve, 31 from Chester County, PA and 47 from Chenango County, NY. The current
initial prevalence rates are 44%, 45% and 17% respectively. Eight of the 87 ticks tested positive
for A. phagocytophilum. Tick collection and screening continues in order to yield a sample set
that can be assessed statistically for significance to local human populations.
Conclusions: There appears to be variation in positive rates for Lyme disease across geographic
ranges in local and regional tick populations. The significance of this initial variation will
become clearer as the sample size is increased during the current field season. Variation in the
prevalence rates locally and regionally has implications for disease risk as human populations
come into increasingly more frequent contact with the tick vector for Lyme disease.
Keywords: Lyme disease, PCR, Ixodes scapularis, prevalence
Poster: B3
ENVIRONMENTAL AND BEHAVIORAL FACTORS IN MODELING RISK OF LYME
DISEASE TRANSMISSION
John M. Darcy II,1,2 Dinesh Kommareddy,1,4 Ralph M. Garruto1,2,3
Laboratory of Biomedical Anthropology and Neurosciences,1 Departments of Anthropology,2
Biology3 and Biochemistry,4 Binghamton University, Binghamton, NY 13902
Contact Information: jdarcyi1@binghamton.edu
Introduction: Modeling of disease dynamics is an important part of contemporary
epidemiological research. Models are becoming increasingly complex and must include a broad
range of disease related variables in order to be useful to medicine and public health. The factors
affecting disease transmission are particularly diverse in vector-borne diseases like Lyme
disease. As part of a larger modeling project termed the Binghamton University (BU) Lyme
Disease Modeling Project, we propose quantifying the environmental and behavioral factors
necessary to develop a comprehensive mathematical model. Such factors include residential
areas, proximity to forests, elevation, proximity to water and land use categories with human
behavioral risk factors that influence the likelihood of coming into contact with the Lyme disease
tick vector (Ixodes Scapularis). These two types of risk categories will be incorporated into the
BU Lyme Disease Modeling Project in order to enhance its effectiveness in predicting an
individual’s likelihood of infection.
Methods: The environmental factors identified as important to the probability of encountering
ticks infected with Lyme disease include type of residential area; domicile distance to wooded
area; altitude; distance to sources of water; and dominant type of land use. Human behavioral
factors relevant to vector exposure include occupation associated risk (forestry vs. office work);
recreational preferences, physical activity level and degree of mobility or travel. Under each
category (environmental or behavioral), each component is assigned a graded weight of either
0.0, 0.25, 0.50, 0.75 or 1.0 where 0 indicates the lowest risk factor and 1.0 the highest risk factor.
The sum of the factors for each category will be divided by the number of components in that
category and will then be added to the BU Lyme Disease Modeling Project.
Results: We expect individuals who live near wet, forested and mixed forested areas, at low to
moderate altitude environments to have a higher overall composite environmental score. A
higher composite environmental score will contribute more heavily towards the overall risk
scoring system for determining an individual’s overall risk of infection. Likewise, we expect that
certain behaviors associated with occupations such as forestry and agriculture combined with
high risk recreational activities like hiking will yield higher behavioral composite scores that will
be calculated into the overall risk score contributing to a model reflecting weighted
environmental and behavioral factors leading to risk of infection.
Conclusion: Designing contemporary models for predicting disease risk requires analysis of a
significant number of factors in vector-borne disease epidemiology. The risk modeling project
requires particular attention to the environmental and behavioral factors affecting Lyme disease
transmission. Using a weighted system to assess these two categories will yield a more reliable
model for predicting the likelihood of an individual contracting Lyme disease.
Keywords: Lyme disease, modeling, environment, behavior
Poster: B4
GENE FLOW OF P. FALCIPARUM IN THE PAPUA NEW GUINEA HIGHLANDS
FROM 1959-1979
Alysa Pomer1,2,3, Abigail MacFadden1,4, Rita Spathis1,2,3, Chim W. Chan1,2,3, Sayantan
Banerjee1,4, Ralph M. Garruto2,3,4, J. Koji Lum1,3,4
1
Laboratory of Evolutionary Anthropology and Health, Binghamton University, 2Laboratory of
Biomedical and Neurosciences, Binghamton University, 3Department of Anthropology,
Binghamton University, 4Department of Biological Sciences, Binghamton University
Contact information: alysa.pomer@binghamton.edu
Background: Chloroquine resistance in the malaria parasite Plasmodium falciparum is a major
impediment to malaria eradication in the Pacific. Our previous study on genetic variation in the
P. falciparum chloroquine transporter (pfcrt gene) from archived samples suggested that
chloroquine resistance might have first appeared in the Eastern Highlands of Papua New Guinea
by 1979. To investigate the origin of these resistant parasites, we examined the temporal
variation in the mitochondrial genome of parasites from 1959 to 1979, a critical period spanning
the evolution of chloroquine resistance. Mitochondrial DNA (mtDNA) is a neutral genetic
marker often used to infer populations origins and movement. For this project, we are using four
genetic markers on the mitochondrial genome of the malaria parasite P. falciparum to examine
change in the parasite population in the highlands of Papua New Guinea over two decades.
Methods: Approximately 200 human serum samples previously identified as positive for P.
falciparum were included in this study. These samples were collected from 10 sites in the
highlands of Papua New Guinea between 1959 and 1979. Since most of the P. falciparum
mtDNA variation is represented by polymorphisms at four nucleotide positions (np), we
amplified by PCR four fragments containing these polymorphisms of interest (np 772, 1692,
4179, and 4952). Sequences were determined by DNA sequencing and polymorphisms were
identified by comparison with a reference sequence (GenBank accession number M76611).
Results: Preliminary analysis indicated that there was no difference in mtDNA diversity between
samples that had pfcrt mutations and those that did not (wildtype). MtDNA diversity also did not
vary significantly over time. Parasites in the later sample years were not genetically distinct from
those in the earlier sample years.
Conclusions: It does not appear that the mitochondrial genetic diversity in the P. falciparum
parasite in the highlands of Papua New Guinea was affected by the increasing incidence of
chloroquine drug resistance in the mid-twentieth century. The observation that parasites in the
later sample years were not genetically distinct from those in the earlier sample years suggests
that there was little introgression (gene flow) of parasites from other areas into the highlands of
Papua New Guinea. Such pattern of temporal variation in mtDNA is also consistent with the idea
that chloroquine drug resistance developed in situ in the highlands of Papua New Guinea.
Funding: National Institutes of Health (R01GM080593)
Keywords: malaria, genetics, Papua New Guinea
Poster: B5
A RETROSPECTIVE ANALYSIS OF PFCRT AND PFMDR1 VARIATION AND THEIR
CONTRIBUTION TO CHLOROQUINE RESISTANCE IN THE PACIFIC
Chim W. Chan1,2,3, Rita Spathis1,2, Cheng Sun1,3, Satish K. Dhingra1,4, Krithivasan
Sankaranarayanan1,4, Kathleen F. Clancy1,4, Jacqueline A. Odgis1,4, Ralph M. Garruto2,3,4,
J. Koji Lum1,3,4
1
Laboratory of Evolutionary Anthropology and Health, Binghamton University, 2Laboratory of
Biomedical Anthropology and Neurosciences, Binghamton University, 3Department of
Anthropology, Binghamton University, 4Department of Biological Sciences, Binghamton
University
Contact Information: aramidus44@gmail.com
Background: Malaria is a major health risk for more than half of the world’s population today.
Drug resistance in Plasmodium falciparum, the most deadly human malaria parasites, presents a
crucial obstacle to malaria eradication. Chloroquine (CQ) was once the ubiquitous treatment for
malaria, however CQ treatment failure worldwide had greatly exacerbated the malaria burden
over the last few decades. CQ resistant strains of P. falciparum are distinguished from their
sensitive counterparts by multiple single nucleotide substitutions (SNPs) in pfcrt, with the
substitution at codon 76 showing perfect correlation with CQ resistance. SNPs in pfmdr1 have
also been associated resistance to multiple drugs including CQ. The evolution of these complex
CQ resistant pfcrt and pfmdr1 haplotypes remains unknown however. It has been hypothesized
that mutant pfcrt SNPs accumulated sequentially, so that each additional mutation confers
increasing levels of CQ tolerance. Since CQ resistance in P. falciparum from the Southwest
Pacific is believed to have evolved independently, an examination of archived specimens from
the region may reveal valuable insights into the evolution of CQ resistance.
Methods: A total of 6,383 human blood samples provided by the Binghamton University
Biospecimen Archive Facility were included in this study. These samples were collected
between 1959 and 1987 from various Pacific populations residing in diverse environments with
varying malaria endemicities. Total genomic DNA was extracted from 200 µl of human serum.
Regions containing the SNPs of interest (pfcrt codons 72-76, 220, 271, 326, 356, and 371;
pfmdr1 codons 86, 184, 1034, 1042, and 1246) were amplified by PCR and sequenced by the
Sanger chain-termination method. Mutations were identified by comparison with sequences from
parasite clone 3D7.
Results: Infection rates as detected by our molecular methods were consistent with those from
conventional malariometric surveys, with the highest rates seen in the coastal areas and the
lowest in the highlands. Most of the genetic variation in pfcrt was observed in exon 2, which
contains codons 72-76. Pfcrt genetic diversity showed a general increase over time and was
highest in areas where malaria transmission was less intense. Two pfmdr1 SNPs (Y184F and
N1042D) were observed in the earliest samples from the coastal areas and islands, coincident
with heavy quinine and quinacrine (Atebrin) use by Allied troops during WWII. However the
frequencies of mutant pfmdr1 alleles in these areas did not increase over time even though CQ
use also increased over the same time period.
Conclusions: In P. falciparum, variation in pfcrt exon 2 appeared to be crucial in the evolution
of CQ resistance. Pfmdr1 did not appear to be directly involved in CQ resistance, however the
persistence of these mutant pfmdr1 alleles over time suggested that they might have been
advantageous to the parasites by conferring increased CQ tolerance.
Funding: United States National Institutes of Health (R01GM080593)
Keywords: Malaria, drug resistance, Pacific
Poster: B6
PARTIAL LEAST SQUARES (PLS) APPLIED TO MEDICAL BIOINFORMATICS
Walker H. Land, Jr. a*, William Ford a*, Jin-Woo Park a*, Ravi Mathur a*, Nathan
Hotchkiss a*, John Heine b*, Steven Eschrich b*, Xingye Qiao c* and Timothy Yeatman b*
a* Dept. of Bioengineering, Binghamton Univ., Binghamton NY, 13902-6000, USA.
b* Moffitt Cancer Center and Univ. of South Florida, Tampa FL, 33612, USA.
c* Dept. of Mathematical Sciences, Binghamton Univ., Binghamton NY, 13902-6000, USA.
Background: Lung Cancer is the leading cause of death in cancer patients worldwide. The
American Cancer Society predicts that 156,940 people will fall victim to the disease in 2011,
accounting for 27% of all cancer deaths. The 5-year survival rate of lung cancer patients is 16%
primarily due to late stage diagnosis. Of the 221,130 estimated cases that will be diagnosed 2011,
85% will have late stage tumours (stages II, III, IV) that have begun to advance. For these
patients, treatment often includes surgical resection of tumours where possible, post-operative
radiation and adjuvant chemotherapy. The 5-year survival rate for early stage (stage I), non-small
cell lung cancer (NSCLC) patients is 53% and treatment often only includes surgical resection .
However, 35%-50% of these patients will suffer a relapse of the disease within 5 years of
surgery [3]. Post-operative chemotherapy can improve survival in early stage cancer patients, but
its use is controversial. Doctors currently lack a validated and clinically accepted method to
predict which patients are at high risk of recurrence. High risk patients might benefit from postoperative adjuvant chemotherapy, whereas low risk patients can be spared the side effects.
Methods: To address the clinical issue of determining risk of recurrence, two classification
experiments were designed. The first aimed to classify NSCLC patients as high risk if they were
likely to recur cancer within 3 years of surgery and low risk otherwise. A cut-off of 3 years was
chosen because the majority of patients that do relapse will do so within the first 3 years. The
second experiment aimed to classify patients as high risk if they were likely to recur cancer
within 5 years of surgery and low risk otherwise. This cut-off was chosen because, in clinical
practice, a patient that does not recur cancer within 5 years is considered cancer free.
Conclusions: To support the hypothesis that PLS can be used to find stable biomarkers, we
compared the ‘important’ genes found using PLS to those found using the GA-SVM method.
Several common genes were identified (see Mathur et al. (2011)) as being important indicators
of prognosis and the biological significance of these genes is being investigated further. We
found that the validation Az peaked at one latent variable, and was about 10% higher (around
0.77) than the models using all 271 features This is further evidence that PLS can be used to rank
the importance of features. The data presented herein support the goals which we stated at the
beginning of this section. We have found certain genes that explain much of the variability in the
data, and are therefore important predictors of prognosis. This is further supported by the fact
that many of these genes were also found by a completely different technique (GA-SVM). We
achieved the second goal of overcoming the over-fitting problem by fairly high validation Az
values. Furthermore, since the average validation Az values increased when only the 30 most
important genes were used as predictors further supports the first goal.
Keywords: Partial Least Squares, Stable Biomarkers, Microarray Data
Poster: C1
A NEW TOOL FOR SURVIVAL ANALYSIS: EVOLUTIONARY
PROGRAMMING/EVOLUTIONARY STRATEGIES (EP/ES) SUPPORT VECTOR
REGRESSION HYBRID USING BOTH CENSORED/NON-CENSORED DATA
Walker H. Land, Jr. a, Xingye Qiao b, Dan Margolis a, Ron Gottlieb c,
a
b
Department of Bioengineering, Binghamton University, Binghamton, NY 13902, USA.
Department of Mathematical Sciences, Binghamton University, Binghamton, NY 13902, USA.
c
Department of Radiology, University of Arizona, Tuscan, AZ 85724, USA.
Background: Survival analysis is a well-known technology in the medical field related to
analyzing and predicting the time until the occurrence of an event, such as death, progression of
cancer, or need for a replacement joint. This technology has been applied not only in clinical
research, but also in epidemiology, reliability engineering, marketing, insurance, and many other
fields. In medicine, it plays a pivotal role in determining courses of treatment, developing new
pharmaceuticals, preventative medicine, and improving hospital procedures. Performing
meaningful survival analysis has greatly improved medicine and the health care system.
However, existing methods provide only some of the potential benefit that more advanced forms
of survival analysis could offer.
Methods: Support Vector Machine (SVM) is a widely used large-margin classification method.
SVM uses a hinge loss function. In the linear case, the resulting separating hyperplane minimizes
the empirical hinge loss of the training data set with a penalty term which controls the
complexity of the model. The SVM optimization problem can be viewed as maximizing a notion
of the margin between the two classes, while keeping the misclassification of the training data to
be as small as possible. Significant previous experience with the problem of determining the best
parameters for a Support Vector Machine (SVM) led to the creation of an Evolutionary
Programming / Evolutionary Strategies SVM Hybrid (EP-SVM) that was successfully utilized
many times on different types of data. This process has been modified for use with the SVRc.
The chromosome includes kernel type, kernel parameters (gamma, coeff, and degree), cost
function, and epsilons, though many of these can be locked by the user if desired. An initial
population of SVRc chromosomes are created, mutated, and then selected using tournament
selection with or without replacement for a number of generations. However, SVRc is a
regression technique, and thus mean squared error or the concordance index is used to measure
fitness of a chromosome. The EP/ES Hybrid method allows the user to find an optimal set of
SVRc parameters quickly but without premature convergence. This combined technique will be
referred to as the EP-SVRc.
Results: Dataset: Mayo Clinic’s Primary Biliary Cirrhosis (PBC) survival dataset, which has
survival times and censored data in the form of either: a patient still alive at time of last contact,
or a patient who received a liver transplant. It had 276 samples of which 165 were censored The
EP-SVRc is a promising new application of stochastic technology, but additional research and
testing are required. Preliminary tests show the fundamental theory and technology works as
expected and that it has the potential to perform effective survival analysis. Results will be
described in PP presentation.
Keywords: Lung cancer Survival Analysis, Support Vector Regression, Evolutionary
Programming/ Stratagies
Poster: C2
PNN/GRNN ENSEMBLE PROCESSOR DESIGN FOR EARLY SCREENING OF
BREAST CANCER
Walker H. Land, Jra., Jin-Woo Parka, J. David Schaffera, and John Heineb
a
Department of Bioengineering, Binghamton University, Binghamton, NY 13850, USA,
b
H. Lee Moffitt Cancer Center and Research Institute,
University of South Florida, Tampa, FL 33612, USA
Background: Conventional x-ray mammography is the most common method for breast cancer
screening. Unfortunately, it has a high false positive rate causing many (66% - 85%) unnecessary
biopsies. A data set of about 200 breast cancer screening cases was extracted from the archives
of the Moffitt Cancer Research Institute and Florida State University project “Computer Aided
Diagnosis (CAD) in Breast MRI based on Biological Neural Network”. From the pathologist
reports, about half of these cases were benign and half malignant. We seek to identify a
combination of characteristics of women with positive screening findings that can identify those
unlikely to be malignant, thus reducing the unnecessary biopsies.
Methods: There are many data mining techniques available for inducing discriminating
classifiers from features, each with its own strengths and weaknesses. These differences tend to
produce classifiers that yield different patterns of errors. We have developed a method, called the
GRNN oracle that seeks to combine multiple classifiers (models) that make different errors into a
single ensemble classifier that should make fewer errors on future cases. This oracle intelligently
combines the outputs of several of these models by using gate variables (weights on the original
case features). The inputs are from 10 Probabilistic Neural Network (PNN) models. Goal is to
design an oracle that uses the gate variables to intelligently combine the outputs of the competing
models. When an unknown case is processed, the gate variables are used by the GRNN to decide
which models are likely to be best for this particular case (training, validation or test sample).
These models are weighted more heavily than the likely inferior models. The oracle’s gate
variables are trained using Differential Evolution (DE). DE is similar to ordinary genetic
optimization in that it uses a population of parameter sets and applies crossover and mutation
with survival of the fittest, but can give better performance for continuous variables. By
repeating this process enough times, the best member of the final population is hopefully close to
the global optimum.
Results: Using a clinical breast cancer data set of 117 samples containing 10 covariates
(features) ,10 separate PNNs were trained using each separate feature , where the AZ values for
each of these PNNs varied from 0.52 to 0.76 . Using these PNN trained outputs as GRNN oracle
inputs resulted in an 0.83 AZ oracle output, a 30% improvement when compared to the average
AZ input of the 10 PNNs , which was 0.64.
Keywords: Breast cancer screening, clinical and image features, ensemble classifiers
Poster: C3
TOWARD TRUSTWORTHY MEDICAL MONITORING
Zhanpeng Jin1, Homa Alemzadeh2, Zbigniew Kalbarczyk2, and Ravishankar Iyer2
1
Deptartment of Electrical and Computer Engineering, Binghamton University, SUNY
Binghamton, NY 13902; 2Coordinated Science Laboratory, University of Illinois at UrbanaChampaign Urbana, IL 61801
Contact Information: zjin@binghamton.edu; alemzad1@illinois.edu; kalbarcz@illinois.edu;
rkiyer@illinois.edu
Background: Safety-critical medical monitoring systems aim to measure and analyze individual
physiological and behavioral data in real time and provide accurate diagnoses and health alerts.
However, current health monitoring systems are often subject to a non-negligible rate of false
alarms, misdetection, and failures. Alarms are becoming an increasing nuisance for patients and
caregivers, often interfere with a physician's ability to perform other critical tasks, and contribute
to desensitization of caregivers to real events. In fact, monitoring systems have always suffered
from sensitivity to external perturbations and/or internal faults, which could be catastrophic for
patients. Given the criticality of application to the human life, medical monitoring systems have
to be resilient in both accurate and timely delivery of results, despite the changes in the patient
activities and ambient environment and even in the face of accidental errors.
Method: We argue that a promising approach is to engineer a comprehensive, reliable,
lightweight, and flexible medical monitoring system capable of accurately analyzing a wide
variety of physiological signals. Therefore, we proposed a novel reconfigurable embedded
device that enables (i) accurate diagnosis of medical conditions through concurrent processing of
multiple physiological signals, computing a unified health index, and data fusion, (ii) dynamic
system adaptation to address various medical needs, and (iii) resiliency to accidental errors and
failures. A unique feature of the proposed approach is that, by carefully identifying the most
fundamental computing kernel functions among various physiological processing algorithms
based on frequency and cost-benefit analysis, we will enable computation-intensive tasks to
execute on application-specific, customized hardware without introducing significant overhead.
The reconfigurable nature of the proposed hardware, jointly with efficient signal analysis
techniques, represents a viable heading towards the realization of resilient autonomic medical
monitoring devices.
Results: To illustrate the potential of this approach, we study two examples of patient-specific
and multi-parameter analysis of physiological signals measured in a cardiac intensive care unit.
The data used in these examples are systolic arterial blood pressure (ABP Sys.), heart rate (HR),
and ECG waveform signals, from the publicly available MIMIC database. Provided examples
focus on the use of a simple yet effective fusion technique based on a majority voting process
executed on different medical parameters. Under this fusing mechanism, any biased and
corrupted behavior of an individual signal caused by faults in sensed data or processing engines
can be masked, allowing a much more reliable detection of abnormalities. This approach
improves diagnostic accuracy by reducing false alarms and maintains an appropriate level of
operation even in the case of sensor or processing engine failures. It also mitigates false alarms
caused by patient movement artifacts or monitor noise.
Keywords: medical monitoring, multiparameter, reconfigurable, false alarms, resiliency
Poster: C4
HEIGHTENED DIURNAL ENDOCRINE LEVELS IN HEALTHY WOMEN WITH A
FAMILY HISTORY OF HYPERTENSION
Gary D. James
Decker School of Nursing, Department of Anthropology, and Program in Biomedical
Engineering, Watson School of Engineering and Applied Science,
Binghamton University, Binghamton, NY 13902
Contact Information:gdjames@binghamton.edu
Background: Previous studies suggest that otherwise healthy individuals who have a family
history of hypertension (FH+) have an accentuated reactive rise in catecholamines and cortisol
to laboratory stressors compared to those with no familial history (FH-); however, few if any
studies have evaluated whether stress related diurnal variation of these hormones in FH+ subjects
is also greater. The purpose of this study was to compare the variation in diurnal urinary
catecholamines (epinephrine and norepin-ephrine) and cortisol excretion as well as ambulatory
blood pressures (BP) between healthy, normotensive women with and without a family history of
hypertension.
Methods: The 134 women in this study all worked in clerical, technical or professional
positions at a major medical center in NYC; 62 women (age=35.2+9.1) were FH+, while 72
(age=33.8+ 10.0) were FH-. Urinary hormone excretion rates and ambulatory BP were
measured in three contrasting daily microenvironments: work (11AM-3PM), home (approx.
6PM-10PM) and during sleep (approx. 10PM- 6AM) in order to evaluate stress associated
variation that occurs with the microenvironmental change. Family history group comparisons
across the microenvironments were evaluated using MANCOVA models, with BMI as a
covariate.
Results: The results show that epinephrine excretion among FH+ women was 36% higher than
FH- women (p<.008) over the entire day, and that the diurnal variation of cortisol excretion was
also greater among FH+ women (p<.045). FH+ women also had statistically significantly higher
systolic BP (4 mmHg higher; p<.01) and diastolic BP (2 mmHg higher, p<.03) compared to FHwomen over the whole day.
Conclusions: These findings suggest that there may be genetically linked mechanisms which
either elevate tonic epinephrine levels and diurnal cortisol variability or facilitate an enhanced
sympathetic adrenal medullary and HPA response to daily stress in women with a familial
history of hypertension. It may be speculated that this enhanced stress hormone response
contributes to the development of allostatic load in affected individuals, potentiating the
development of hypertension in later life.
Funding: Supported by NIH grant HL47540.
Keywords: Epinephrine, cortisol, blood pressure, family history of hypertension
Poster: C5
INFRASONIC STROKE VOLUME MONITORING
Ohad Barsimantov, J. David Schaffer, and Kenneth J. McLeod
Clinical Sciences Research Center, Department of Bioengineering,
Thomas J. Watson School of Engineering & Applied Science,
State University of New York, Binghamton, NY 13902.
Contact Information: ohad@binghamton.edu
Introduction: Cardiac Output (CO) represents the volume of blood the heart pumps each minute
and can be calculated as the product of the stroke volume (SV) and the heart rate (HR). While
HR can be easily measured, stroke volume typically requires an invasive procedure. With the
advent of ultrasonic imaging technology, ejection fraction (EF; the percent volume change of the
left ventricular during contraction) has become commonly used as a surrogate measure of SV.
CO and SV vary substantially during activity, as well as due to various states of health and
illness and so these parameters are of great interest. However, neither SV nor CO monitoring is
readily available outside of the hospital or critical care environment. The development of noninvasive SV and CO monitoring technology would likely find application in a wide range of
healthcare, athletic, gaming, and military applications.
Methods: Chest motions just caudal to the xiphoid process were recorded using 2g
accelerometers, bandpass filtered at 8Hz and 360 Hz. The signal was digitized at 2 KHz
(BIOPAC Model 110 and subsequently low pass filtered at 50 Hz. Subjects were maintained in
the supine position with chest motion recordings obtained during rest and while cycling. Multiple
three minute periods of cycling with five minutes rest periods were executed over one hour. SV
and CO were simultaneously monitored using a non-invasive CO monitor (NICOM ; Cheetah
Medical) which served as standard reference, along with the subject’s EKG (BIOPAC, Inc).
Acceleration data underwent wavelet packet decomposition. Wavelet packet coefficients
coincident with the QRS interval were evaluated and served as input to a Genetic Algorithm
(GA) for identification of packet sets which maximally correlated to the NICOM data.
Results: Data from four young, healthy, adult males (21-25 years) have been obtained to date.
NICOM recordings showed that, in these individuals, SV varied from 90±10 at rest to 180±20 ml
during intense cycling exercise; while HR varied from 65±15 to 125±15 BPM, and CO varied
from 7±2 to 20±7 L/min. GA evaluation of wavelet packet data has been able to identify a
specific packet set from one subject which provides better SV correlation to the NICOM in those
subjects than performing wavelet reconstruction.
Discussion and Conclusion: Additional subject data will be required to provide a broader range
of data for the GA. We would like to expand the study to include both older individuals as well
as women. The application of wavelet analysis at various decomposition levels will produce a
large number of packets for possible inclusion. For example: if we use 50 different wavelet sets,
and five level of decomposition which generate 32 packets at the lowest level and another 32
packets at the previous levels, in total we have 32 + 32 = 64 packets from a specific wavelet
filter, which when multiplied by the number of the wavelet filters yields 64*50 = 3200 possible
selections. If we need to select four packets from this basket, the probability to select a specific
3200!
3200
set will be (
) = 4!(3200−4)! = one in 4.3 trillion, illustrating the importance of utilizing a
4
genetic algorithm in this design.
Keywords: Cardiac output, stroke volume, genetic algorithm, wavelet packet analysis
Poster: C6
VIBROMYOGRAPHIC ASSESSEMENT OF KNEE MUSCLE BALANCE
IN OLDER ADULTS WITH KNEE PAIN
Amy Chaffee1,2 and Kenneth McLeod2
1
Clinical Science and Engineering Research Center, Binghamton University, Binghamton, NY,
2
Sonostics Inc., 123 Court Street, Binghamton NY
Email: KMcLeod@Binghamton.edu
Background: Muscle imbalances are a well accepted cause of musculo-skeletal pain, yet
clinicians lack a simple, non-invasive, and reproducible means to assess muscle effort during
movement reflecting normal activities of daily living. To address this issue, we have been
developing vibromyography (VMG) as a means to quantitatively assess muscle mechanical
effort such that accurate muscle effort ratios can be determined in the clinic. In this study, VMG
was used to characterize muscle imbalances in older adults with low-level knee pain while they
performed step-up and step-down activities. In addition to determining whether VMG can
identify the imbalances previously reported in individuals with knee pain, we address the
question of whether these knee muscle imbalances were a likely cause of knee pain, or whether
the imbalances represented a coping response for pre-existing knee pain.
Methods: Adults, of age 35 years or older, with either unilateral or bilateral knee pain were
recruited. Pain levels, using a 0-10 visual analogue scale (VAS), along with age, height and
weight were obtained. Muscle effort during a typical activity of daily living (i.e. 10 inch step-up
and step-down) of four knee muscles; vastus lateralis (VL), vastus medialis (VM), biceps
femoris (BF), and Sartorius (SR), was obtained using multi-channel VMG recording technology
(MyoWave, Sonostics, Inc.). Each subject performed ten step up-down cycles using the leg with
the painful knee. The first and last step cycles were discarded and the remaining eight cycles
were time averaged. If both knees were painful in a subject, then the procedure was repeated
with the alternate leg. Antagonistic and complementary muscle ratios were obtained during the
point of peak muscle action during both step-up and step-down phases of the protocol. Robust
multiple regression analysis was used to identify the factors best correlated to knee pain.
Results: Thirty men and women, ranging in age from 35-85 years, with a total of 42 painful
knees, were assessed. Muscle effort peaked in all four muscles halfway through the step-up and
step-down phases, with VL and VM closely tracking each other, and BF and SR typically
tracking each other. Step-wise regression analysis indentified weak hip abductor muscle effort
relative to hamstring muscle effort as the best correlate of knee pain (p=0.00006), with weak VL
effort in eccentric contraction, relative to concentric contraction, being the second best predictor
(p=0.0003). These muscle imbalances were able to account for 40% of the variation in reported
pain. Despite the common perception that excess weight is a dominant factor in the development
of knee pain, body mass was found to be only a weak predictor of knee pain. The observed
pattern of increasing knee pain with increasing quadriceps strength during concentric contraction
leads us to infer that the observed muscle imbalances are not the result of a protective action by
the individual, but rather are a principle cause of the knee pain.
Discussion and Conclusions: More than 14 million Americans visit their physician each year
with a primary complaint of knee pain. Muscle imbalance is widely believed to play a significant
role in this condition as fewer than half of knee pain patients have any physical evidence of joint
injury. While quad/hamstring imbalance and VL/VM are commonly believed to be the major
imbalances involved, we found that hip abductor/hamstring imbalance and eccentric/concentric
imbalance in the quads to be of far more importance. The ability to identify these imbalances sets
the stage to introduce exercise and behavioral interventions that can reverse the imbalances,
hopefully leading to reduced pain and improved mobility in this patient population.
Keywords: Osteoarthritis, knee pain, muscle imbalance, vibromyography
Poster: C7
ASSESSING MUSCLE IMBALANCES IN THE LOWER BACK
Xue Liu1, Amy Chaffee2 and Kenneth McLeod1
1
Program in Biomedical Engineering; 2Sonostics, Inc.
Clinical Science and Engineering Research Center
Binghamton University, Binghamton, NY 13902-6000
Email: xliu25@binghamton.edu
Background: Back pain is a common cause of physical activity limitation in people, and one of
the most common causes of surgery. As muscle imbalance is the primary cause of most joint
pain, we hypothesized that muscle imbalance may be an important cause of lower back pain
(LBP) as well. Muscle imbalance can arise from overuse, exercise, or as a behavioral response to
an injury somewhere else in the body. Both bedrest and surgery have equal outcomes in treating
LBP, but involve extended recovery periods which place a substantial burden on the individual,
families, employers, and the healthcare system. If back muscle imbalance could be identified
either before or after an injury, it may be possible to develop focused exercises which could
either prevent injury or return the individual to their normal activities of daily living in a shorter
time period. Vibromyography (VMG) technology was developed to provide a convenient noninvasive means for assessing voluntary muscle effort, and is widely used to evaluate knee muscle
imbalance in sports and rehabilitation medicine. In this study we evaluate whether VMG
technology can be used to identify back muscle imbalance.
Methods: We have conducted a series of pilot experiments on a healthy young (22 year old)
male volunteer. Using commercially available VMG technology (MyoWave, Sonostics, Inc.), we
recorded muscle effort of the lower trapezius (T8, 6cm from spine) and erector spinae thoracic
(T8, 4cm from spine) during functional activity. The subject started in an upright standing
position, bent at the hips until his back was approximately parallel to the floor, and then returned
to an upright position. This movement was completed with just the upper body loading the back,
then with 2, 5 and 10 Kg masses added to the body load at the position of the neck. Movements
were repeated 10 times, and the results averaged after eliminating the 1st last event . Linear
regression was used to evaluate muscle effort as a function of the torque produced.
Results: VMG as able to differentiate erector spinae muscle activity from trapezius muscle
activity, and we found the lumbar region of the erector spinae muscles to contribute more to back
flexion and extension than the thoracic region. A distinct muscle symmetric activity pattern was
evident during the exercise without external loading, with muscle activity in both left and right
erectors peaking at 45o of flexion during both eccentric and concentric contraction. With
external loading, significantly higher forces were recorded during extension, compared to
flexion, and a distinct imbalance was observed between left and right erectors.
Discussion and Conclusion: The MyoWave technology is designed to identify primarily Type II
muscle fiber activity, and while a substantial VMG signal was recorded in the absence of
external loading, the results seem to suggest that Type I muscle fibers may be making a
significant contribution to back flexion/extension when there is no external loading. Type I
fibers contract at a frequency below the operating frequency regime which our VMG apparatus is
designed to measure and so subsequent studies will need to address how the VMG algorithm
could be modified in order to quantify both Type I and II fiber activity and thereby provide a
more complete assessment of lower back muscle balance.
Keywords: muscle imbalance, low back pain, vibromyography
Poster: C8
VIBROMYOGRAPHIC ASSESSMENT OF UPPER EXTREMITY MUSCULATURE
DURING ISOKINETIC CONTRACTION
Kyle E Stone, Leann Lesperance and Kenneth J. McLeod
Program in Biomedical Engineering, Watson School of Engineering and Applied Sciences
Clinical Science and Engineering Research Center
Binghamton University, Binghamton, NY 13902
Email: kstone3@binghamton.edu
Background: Over 55% of high school students (~8 million students) participate in sports, and
as student participation has increased, the number of sports-related injuries has increased as well.
Not only do these injuries place strain on the healthcare system, but the injured students often
develop lifelong disabilities. Because the majority of musculoskeletal injuries arise from muscle
imbalances, that is, misuse of the musculature, an accurate, noninvasive means for screening for
muscle imbalances may limit the number of sports-related injuries and/or enhance rehabilitation
following injury. Here we address the potential for vibromyography (VMG) to serve as such a
screening technology for muscle imbalance at the elbow.
Methods: VMG is a noninvasive technique used to measure voluntary muscle effort, and it has
been shown to accurately assess isometric muscle force over the full range of a voluntary
contraction. In this pilot study, we addressed whether VMG could track muscle force during
isokinetic contraction at the elbow, focusing on a major flexor (biceps brachii) and a major
extensor (triceps) of the upper arm. The experimental protocol involved subjects performing
eight flexion and extension cycles (0-130 degrees) using a muscle dynamometer (Biodex
System3). Two VMG signals from the flexor and extensor muscles, along with dynamometer
torque, angular velocity, and position were recorded simultaneously (BIOPAC MP150).
Estimated muscle force from the VMG was converted to torque using kinematic data (Ramsay
2008) and corrected for gravitational loading on the limb. Since the biceps brachii and triceps
share an antagonistic relationship, torque generated by the biceps brachii was considered positive
and that from the triceps was considered negative. The two calculated torques were summed and
compared to the elbow torque measured by the dynamometer using linear regression.
Results: Recordings from two young male subjects were obtained. With the dynamometer set to
an angular velocity of 30 degrees per second, the subjects were able to maintain isokinetic torque
over the angular range of ~20-100 degrees of flexion. Torque over this range varied from 31-38
N-m in one subject and 44-56 N-m in the second. VMG recordings showed that during flexion,
antagonist (i.e. triceps) activity ranged from 18-88% of agonist (biceps) activity. Significant
correlations (p=0.0001) between the torques calculated from muscle effort and torques measured
on the dynamometer were obtained, with R2 values ranging from 0.46 to 0.54.
Discussion and Conclusions: While antagonistic muscle activity is generally thought to be
minimal during open-chain contraction, we have observed that antagonistic muscle activity is, in
fact, substantial during dynamometer assessment. The level of correlation observed between
VMG-assessed muscle activity and measured torque in the initial evaluations was found to be
negative without inclusion of antagonist muscle activity, but positive and substantial when
antagonist activity is taken into consideration, suggesting that VMG can provide a good estimate
of muscle force during isokinetic contraction when appropriate forces are considered. As flexion
of the arm involves over eighteen different flexors in the forearm and upper arm, the inclusion of
additional flexor activity in the analysis would be expected to further improve the correlation.
Keywords: Vibromyography, elbow biomechanics, elbow pain
Poster: C9
FLEXOR DIGITORUM ACCESSORIOUS LONGUS AS AN ETIOLOGY OF TARSAL
TUNNEL SYNDROME
Michael Peck, DPM (PGY-3), Marshal Gwynn, DPM (PGY-2), Jessica Duggan, DPM
(PGY-2), Adam Bills, DPM (PGY-1), and Darren Weinheimer, DPM
United Health Services Podiatric Residency Program
Contact Information: Michael_Peck@uhs.org
Tarsal Tunnel is not an uncommon pathology encountered by the foot and ankle surgeon. Tarsal
tunnel syndrome is defined as an entrapment neuropathy of the tibial nerve along its course
through the tarsal tunnel. Common symptoms include aching in the longitudinal arch,
intermittent dysesthesias, paresthesias, and anesthesias in the plantar aspect of the foot, burning
pain at night that radiates distally or proximally, or both. Etiologies are numerous and include
soft tissue masses, tenosynovitis, hyperlipidemia, post traumatic fibrosis, valgus/varus angulation
of rearfoot, varicosities, hypertrophic sustentaculum tali, muscular anomalies, and idiopathic
causes. Treatment consists of releasing the laciniate ligament, proximal and distal tunnels,
removing any space occupying mass. In effect, correction is achieved by increasing the available
volume for the nerve within the tarsal tunnel. While there are many etiologies for tarsal tunnel
syndrome, one cause is attributed to an accessory muscle found within the tunnel itself. Four
accessory muscles have been described in this location. In this case study, tarsal tunnel syndrome
caused by an accessory flexor digitorum longus muscle is discussed.
Funding: None disclosed
Keyword: Tarsal Tunnel Syndrome, Nerve Entrapment
Poster: C10
EVOLUTIONARY COMPUTATION WITH NOISE PERTURBATION AND CLUSTER
ANALYSIS TO DISCOVER BIOMARKER SETS
Ravi Mathur1, J. David Schaffer1, Walker H. Land Jr.1, John J. Heine2, Steven Eschrich2,
Timothy Yeatman2
1
Department of Bioengineering, Binghamton University, Binghamton, NY 13850, USA;
2
H. Lee Moffitt Cancer Center and Research Institute, University of South Florida, Tampa, FL
33612, USA
Contact Information: wland@binghamton.edu
Background: Data mining is the interdisciplinary field that attempts to find influential and
important information or knowledge from a large dataset. The advent of gene expression
microarrays has stimulated much data mining activity as people sought to discover “gene
signatures” for complex diseases like cancer. But it was soon observed that the data sets were
feature-rich, but case poor: they had measurements on many more genes than they had patients.
This promoted the discovery of spurious patterns (also called overfitting). In addition, the
inherent noisiness of microarray measurements exacerbated the problem. A third challenging
factor is the inherent complexity of the biology of cancer. We can expect there to be multiple
gene signatures that are real. How are we to locate the patterns likely to be real among data sets
likely to contain many patterns that are false?
Methods: We developed a data mining method that combines a genetic algorithm (GA) that uses
a population of gene signatures (maintaining diversity), a support vector machine (SVM)
learning classifier (to assess the fitness of the signatures), and noise perturbation of the gene
measurements (to combat overfitting). With no noise perturbation, we find too many patterns:
evidence of overfitting. If we increase the noise perturbation enough we can obscure all patterns.
By backing off on the noise, we adjust it until we repeatedly find a modest number of the similar
patterns: the “strongest signal in the data.” We applied this method to a cohort of 104 colon
cancer patients whose time to recurrence was greater or less than 36 months. Biopsy samples
were assayed on the Affymetrix HG-133+ GeneChip yielding 54,675 probes, RMA normalized.
These features were reduced to a set of 271 by eliminating those with too little variance or too
weak a correlation with time to recurrence. Nevertheless, there still remained 1081 possible
feature subsets to explore.
Results: Titrating the noise, we found a “sweet spot” that yielded 38 “similar” (by hierarchical
clustering) candidate gene signatures. Their biological similarities/differences were illustrated by
network graphs. We combined them into an ensemble classifier whose accuracy in the training
cases was Az=.96, but on a validation set was AZ=.72. This indicates some degree of over fitting
still remains.
Conclusions: We are exploring more sophisticated methods for building the ensemble classifier.
Keywords: Stable biomarkers, colon cancer; noise perturbation GA-SVM hybrid;
Poster: C11
COMPARATIVE GRIP STRENGTH ANALYSIS AMONG POPULATIONS ACROSS
ISLANDS AND AGE IN VANUATU
1
1,2
Gwang Lee , Cheng Sun , Chim W Chan1,2,3, Alysa Pomer1,2,3, Kathryn M Olszowy1,3,
Harold Silverman1,2, Kelsey N Dancause5, Spencer A Waldman1,2, Martin M Fernandez1,3,
Len Tarivonda7, George Taleo7, Marcelin Abong8, Ralph Regenvanu9, Akira Kaneko10,11,12,
Charles A Weitz6, J Koji Lum1,2,4, and Ralph M Garruto1,3,4.
1
Department of Anthropology, 2Laboratory of Evolutionary Anthropology and Health,
3
Laboratory of Biomedical and Neurosciences, and 4Department of Biological Sciences,
Binghamton University, 5Psychosocial Research Division, Douglas Hospital Research Center,
McGill University, 6Department of Anthropology, Temple University, 7Ministry of Health,
8
Kaljoral Senta, 9Ministry of Justice and Social Affairs, Republic of Vanuatu, 10Island Malaria
Group, Department of Microbiology, Karolinska Institutet.
Contact information: glee1@binghamton.edu
Background: Modernization has led to greater accessibility of low quality calorie-dense foods,
decreased physical activity, sedentary occupations and recreation among populations all over the
world. These changes are more apparent within developing nations that have recently been
undergoing rapid modernization, resulting in changes that are driving health transitions. Our
research in the Republic of Vanuatu between June 2011 and July 2011 indicates that such trends
exist within male populations across varying islands of economic development. We predicted
that islands that are more economically developed would have a decrease in grip strength and
forearm lean area as a result of changes in modernization.
Methods: As a part of a larger survey on the health transitions of Vanuatu, we obtained
anthropometric measurements including handgrip strength tests, weight, %BF (Body Fat), skin
folds, and forearm circumferences. We analyzed MVC (Maximum Voluntary Contraction)
handgrip strength measurements on men between the ages of 20-59 from five islands (Efate,
Aneityum, Nguna, Ambae, Futuna) in Vanuatu using a C.H. Stoelting dynamometer. Three
MVC readings were recorded, and the highest values were used for analysis. We subtracted the
skinfold measurement from forearm circumference to obtain forearm lean radius, which was then
used to calculate the lean area ( x forearm lean radius2). Subjects were grouped into age cohorts
of ten years and were compared across islands of varying economic development.
Results: Preliminary data analysis showed that males on the island of Efate had the highest mean
forearm lean area (53.7 cm2), weight (77.0 kg), and %BF (28.0%). However, the mean MVC of
males on Efate (50.9 kg) was less than the MVC value of Futuna (51.3 kg) and was only
significantly greater than males on Ambae (p=0.006). In addition to MVC, forearm lean area,
weight, and %BF were significantly lower on Futuna (p<0.000, p<0.000 p<0.000, respectively),
an island comparatively less modernized than Efate. When comparing between age cohorts,
younger ages (20-39) have significantly higher MVC values when controlling for lean area than
older populations (40-59).
Conclusion: We found a direct relationship between an increase in economic development and
an increase in both forearm lean areas and %BF. However, this trend does not apply to MVC
values. While the two most modernized islands, Efate and Nguna, have the highest mean forearm
lean area, weight, and %BF values, neither island has the highest mean value for MVC. A
decrease in physical activity levels for Efate and Nguna may be a possible explanation. Further
analysis of the data will be done to identify factors that contribute to and explain these
differences among islands.
Funding: Wenner-Gren Foundation for Anthropological Research, Harper College Grants in
Support of Research, Scholarship, and Creative Work.
Keywords: Modernization, Vanuatu, Health Transitions, Forearm Grip Strength
Poster: C12
THE IMPACT OF ACUTE ONSET NASAL CONGESTION AND RURAL RESIDENCE
ON PULMONARY FUNCTION AND ASTHMA CONTROL IN ADULTS WITH
ASTHMA AND ALLERGIC RHINITIS
Donna G. Hogan, APRN-BC, PhD
Doctoral Program in Rural Health, Decker School of Nursing, Binghamton University,
Binghamton, New York 13902; Bassett Healthcare Network, Clinical Resarch and
New York Center for Agricultural Medicine and Health, Cooperstown, New York
Contact Information: donna.hogan@bassett.org
Background: Improved asthma control has been the goal of recent revisions to national
asthma management guidelines, as well as Healthy People 2010. Combined objectives included
identification of predictors of exacerbation, control of upper and lower airway symptoms, and
overcoming barriers to healthcare access, particularly for rural populations. Unfortunately,
asthma prevalence rates continue to increase, with similar outcomes for rural and non-rural areas.
It was hypothesized that the acute onset nasal congestion would precede clinical evidence of
deteriorating pulmonary function, or worsening asthma. It was further hypothesized that
physiological measures would be similar between rural and non-rural residences. The purpose of
this study was threefold: 1. Examine the impact of early onset (acute) nasal congestion on
pulmonary function and asthma control in adults with asthma and allergic rhinitis, 2. Explore the
potential for utilizing acute onset nasal congestion as a predictor of worsening asthma, and
3. Compare and contrast rural and non-rural asthma outcomes.
Methods: A predictive, retrospective chart review was conducted at 3 clinical sites along
the NY/PA border resulting in a study sample of 117 patients (95% allergist subspecialty). Nasal
congestion measures (presence, duration, severity and combined duration/severity) were
examined for their relationship with pulmonary function scores (PEF% predicted) and asthma
control (80% predicted). Daws SPSS 18 statistical software was utilized for analysis of five
research questions, which included descriptives, ANOVA, pairwise comparisons corrected with
Bonferroni and regression analyses (binary logistic and multivariate).
Results: Rural residence, age, and gender were not related to pulmonary function or
asthma control. Presence (p = .03) and severity (p = .02) of nasal congestion were associated
with pulmonary function. A 10% or greater decrease in mean pulmonary function scores was
associated with moderate and severe nasal congestion. Presence, duration and severity of nasal
congestion were associated with asthma control (p < .05). The risk of uncontrolled asthma
increased 6-fold with the presence of nasal congestion. Higher risks were associated with
moderate nasal congestion (8-fold increase); nasal congestion duration of > one week (9-fold
increase); and, combined moderate nasal congestion of > one week duration (16-fold increase).
Nasal congestion was inversely associated with both pulmonary function and asthma control; the
greatest mean pulmonary function scores were associated with no nasal congestion.
Conclusions: The presence of acute onset nasal congestion produced statistically
significant decreases in pulmonary function. Uncontrolled asthma risks varied 6 to 16-fold, with
the greatest risk associated with moderate nasal congestion of greater than one week duration.
Overall, increased duration and severity of acute onset nasal congestion was associated with a
10-15% decrease in pulmonary function when compared to those with no nasal congestion. Nasal
congestion severity was the best indicator of worsening asthma. Rural residence, in this study
population, did not significantly affect pulmonary function or asthma control.
Key Words: Nasal congestion, rural residence, pulmonary function, asthma control
Poster: D1
CALF MUSCLE PUMP STIMULATION AS AN ADJUVANT TREATMENT FOR
FIBROMYALGIA
Lynn Baniak, BS, R.N.1,2, Carolyn S. Pierce, DSN.1,2,3, R.N.,
Erik Hiester, D.O.2,4, and Kenneth J. McLeod, PhD2,3.
1
Decker School of Nursing State University of New York, Binghamton, NY 13902, 2Clinical
Science and Engineering Research Center, 3Program in Biomedical Engineering, Binghamton
University, Binghamton, NY 13902, 4Lourdes Hospital, Binghamton, NY 13905
Background: Fibromyalgia (FMS) is a complex chronic pain syndrome, characterized by
widespread pain, multiple tender points, sleep disturbances, fatigue, and cognitive difficulties
which can lead to decreased productivity and disability. Diagnostic criteria are set forth by the
American College of Rheumatology (ACR; 2010) but diagnosis is largely based on exclusion.
Prevalence ranges from 2–10%, with the vast majority being women (~6-8% of adult women).
Hypotension is a commonly associated with FMS, and we propose that chronic hypotension may
play a causal role in the development of the numerous symptoms. The purpose of this study is to
measure the quality of life (QOL) in persons with Fibromyalgia Syndrome (FMS) over the
course of three months of calf muscle pump stimulation (CMP) which serves as a means to
reverse the chronic hypotension. CMP stimulation involves stimulating the mechanoreceptors on
the plantar surface of the foot to activate the soleus muscle in the calf which has been reported to
be inadequate to sustain venous return in more than 40% of adult women.
Methods: This is an IRB approved dose response clinical study with no concurrent control. A
convenience sample (N=30) of persons diagnosed with FMS will be recruited. Potential subjects
are monitored for blood pressure response to 20 minutes of quiet sitting using beat-to-beat blood
pressure monitoring (PortaPres) to ensure that they are hypotensive, then for 20 minutes with
CMP stimulation to ensure that CMP activation serves to normalize BP without creating
hypertension (i.e. a BP rise over 140 mmHg). A CMP stimulation device is installed in each
subject’s home or workplace for daily utilization over a three month period with instructions to
use at least1hr/day or as tolerated. Functional status and QoL are assessed using the Widespread
Pain Index (WPI), Symptom Severity Scale (SS), and the Revised FMS Impact Questionnaire
(FIQR) tool (Bennett; 2009, Arthritis Research & Therapy 11:R120. Scores are gathered at
baseline, weekly by phone call follow up, and at the final evaluation.
Results: To date, ten subjects have been enrolled into the study and four subjects have
completed the 12 week protocol. Average daily usage of plantar stimulation was 41 minutes per
day (range 14-90 minutes). Average adjusted FIQR for the individuals started at 56 and rose to
73 over 12 weeks, a significant improvement (p = 0.0005). Sleep quality scores (based on
question 15) started at 1.3 and increased significantly to end at 6.2, and energy level scores
(based on question 13) rose from an average of 2.2 at the start of therapy to 5.5 at the end of 12
weeks.
Conclusions & Implications: Preliminary data is consistent with our initial hypothesis that
normalization of BP in fibromyalgia subjects would be associated with a reduction in symptoms.
The most dramatic changes have been associated with improvements in sleep and overall
“energy” levels during the day, and so our survey instrument has been expanded to include more
detailed questions regarding these two symptomatic categories.
Keywords: fibromyalgia syndrome, calf muscle pump stimulation, FIQR
Poster: D2
RECTIFICATION OF RADIO FREQUENCY FIELDS IN A COUPLED SYSTEM
Sree Koneru1, C. Roger Westgate2, Kenneth McLeod1,2
Clinical Science and Engineering Research Center
1
Program in Biomedical Engineering, 2Department of Electrical Engineering
Binghamton University, Binghamton, NY 13902-6000
Email: skoneru1@binghamton.edu
Introduction: Radio frequency (RF) field generators are now widely used in close proximity to
the human body due to the widespread adoption of cell phones, entertainment devices, RFID
devices, and various medical devices. Bio-electromagnetic research has shown that for
frequencies beyond 10 MHz, RF waves should not interact with nerves or other tissues in the
body because no demodulation (i.e. non-linear) processes exist in living tissues which are
effective at these frequencies. These observations, however, are made from a reductionist
perspective, that is, by assuming there is no significant cross-coupling between the body tissue
and the field generator. Here we take a complex systems perspective and assume the field
generator and living system are strongly cross-coupled, and investigate the conditions under
which a rectified D.C. field could appear within body tissues due to exposure to an RF field. We
utilized a simulation model to investigate the non-linear dynamics of this complex system.
Methods: The model consists of a closely coupled RF field generator and a “pick-up coil”
(representing human tissue) with reciprocal feedback loops. A delay line, representing layers of
tissue below the skin and a terminating load with a high impedance load (representing, for
example either bone or the tissue-air interface) are included. A seven step process is being
simulated, involving: 1) the creation of an RF current (and corresponding magnetic field) in a
wire loop via a load dependent generator; 2) induction of an electric field in the tissue; 3)
transmission of a traveling wave through the tissue; 4) reflection of the travelling wave at the
tissue interface; 5) summation of the incident field and reflected field; 6) feedback of the
resultant field (back E.M.F) into wire loop of generator; and 7) modulation of the wave generator
output by the back E.M.F . Travel times through the tissue were modified in order to investigate
the influence of the reflected wave components on the generator output.
Results: Simulation of four complete wave cycles have been obtained to date. An offset in the
electric field can be observed, resulting from a pattern of asymmetric, conjugate half cycles
arising from the interference of the incident and reflected waves. The amplitude and shape of the
wave distortions are strongly dependent on the time delays associated with the transmission of
the waves through the body tissues. Various simulation results pertaining to different time delays
confirm that manipulation of various incident wave features could be used to maximize the
induced D.C. field levels in the tissue.
Conclusion: These results lead us to propose that RF waveforms at frequencies greater than 10
MHz may have an effect on tissue if the source generator is strongly load dependent and closely
coupled to the body. The inclusion of additional parameters in the model, such as the nature of
the wave transmission through the tissue and the strength of coupling between the source and the
tissue, should allow us to optimize this demodulation effect where a large tissue interaction is
desired, such as in medical devices, or minimize the demodulation effect where they are not
desired, such as in cellular phone communication. A major focus of this research is to determine
the possibility of developing a non-contact TENS device for chronic pain therapy.
Keywords: RF field therapy, cell phones, medical devices
Poster: D3
PACEMAKER DEVELOPMENT FOR THE SECOND HEART
Qionghua Weng, Kenneth J. McLeod
Program in Biomedical Engineering, Watson School of Engineering and Applied Science,
Clinical Science and Engineering Research Center,
Binghamton University, Binghamton, NY 13902
Contact Information: qweng1@binghamton.edu
Background: The soleus muscle serves to return blood and lymphatic fluid from the lower
extremities to the upper body through involuntary muscle contraction, and so is commonly
referred to as the “second heart.” The most immediate effects of inadequate second heart activity
is lower limb fluid pooling and hypotension, resulting in decreased peripheral and cerebral blood
flow. These physiologic responses lead to a number of long term health conditions ranging from
syncope and venous insufficiency to cardiac failure and Alzheimer’s disease. Second heart
activity can be enhanced through stimulation of a postural reflex arc originating with the
Meissner’s corpuscles on the plantar surface. While a plantar stimulation device can be readily
designed for use in a fixed setting, an individual with second heart failure will likely need second
heart stimulation (pacing) throughout the day, independent of where they are located. We are
therefore working to develop a portable, low-cost footwear based mechanical stimulation device
that would provide appropriate second heart stimulation as needed by an individual.
Methods: Meisner’s corpuscles are activated by a minimum of 10 microns of displacement of
the skin surface at an optimal frequency of 45 Hz. Initial experimentation utilized coin type DC
motors, such as those used in modern cell phones as the mechanical enunciator. Prototype
devices were provided by I Need Electrical Co. Ltd in Zhejiang, China. They are flat permanent
magnet motors which have a single-phase connection and 4 magnet poles. Three prototype
models were tested: 1) C1027L-10, with thickness of 2.7mm and a rated operating voltage of 3V;
2) C1027L-11 which shares the same dimensions but has an operating voltage at 2.5V; and, 3)
C1034L-27 with a thickness of 3.4mm which gives place for a larger rotor inside. A Kistler
accelerometer (Type 5210) was used to examine the vibration frequency and potential
displacement of each motor. Soft texture foam was utilized to simulate the skin surface, with
weights (0.16kg) implemented to simulate foot pressure.
Results: The first model operated at a speed ranging from 7200 rpm to 15000 rpm which
corresponds to a frequency range from 120Hz to 250Hz. This result is consistent with the typical
application of these motors which is to activate Pacinian corpuscles. The second model could be
run in a lower frequency range (50Hz to 150 Hz) but produced minimal acceleration under load
(less than 0.1g) until the frequency was over 75Hz. The third model contains a larger rotor made
of tungsten steel that produces greater motor output power. This model of motor produces
approximately 0.1g vibration under load, at 55Hz, when operating at 1.3V.
Discussion and Conclusions
While rotational motors are quite inexpensive, and may, with appropriate design be made to
operate in the frequency range of interest, ensuring sufficient displacement of the skin surface
represents a considerable challenge. Therefore, before continuing the pursuit of a d.c. rotational
motor design for the footwear based “pacemaker” device, we have elected to undertake testing of
recently developed low-profile piezoelectric displacement transducers.
Keywords: calf muscle pump activation, mechanical stimulation, chronic disease
Poster: D4
POST-TREATMENT LYME DISEASE SYNDROME (PTLDS) AND UNTREATED
CHRONIC LYME DISEASE (CLD): COMMON CLINICAL THREADS
Tra Vu,1,3 Mellie Riddle,1,2 John M. Darcy II,1,2 Sarah Hempstead,1,2 Hannah Keppler,1,3
Chelsea Lucas,1,2 Amanda Pachomski,1,4 Rita Spathis,1,2 and Ralph M. Garruto1,2,3
Laboratory of Biomedical Anthropology and Neurosciences,1 Departments of Anthropology,2
Biology3 and Environmental Studies,4 Binghamton University, Binghamton, NY 13902
Contact Information: tvu2@binghamton.edu
Background: Lyme disease is a bacterial tick-borne disease that is widely recognized in its acute
form by its hallmark bull’s-eye rash, joint pain and flu-like symptoms. The Centers for Disease
Control (CDC) report that 10%-20% of Lyme disease patients report persistent symptoms lasting
6 months or more without evidence of active infection. Symptoms include fatigue, general pain,
joint pain and myalgia and continue despite antimicrobial therapy. CDC refers to this as PostTreatment Lyme Disease Syndrome or PTLDS, also known as Chronic Lyme Disease (CLD).
Undiagnosed Lyme disease Patients who have persistent idiopathic Lyme disease symptoms with
antibodies are categorized as having untreated Chronic Lyme Disease. Diagnosis is elusive and
controversial since the Infectious Diseases Society of America and the CDC recognize no active
infectious basis for these syndromes. We examined the literature to search for a common
symptomology that might suggest the etiologic underpinnings of these clinical phenomena.
Methods: Varying symptomologies found in PTLDS and CLD were assessed from an extensive
review of the literature. This analysis builds on Masters degree research by John Darcy on Lyme
disease’s history and evolution as well as evidence collected locally and in Chester County, PA
with the University of Pennsylvania. A table was generated with reference to twelve different
publications and subdivided into different categories containing the major body systems,
including the nervous system, cardiovascular system, and, sensory system. Symptoms were
tabulated according to their classification, graphed and analyzed for commonalities.
Results: Recurring common symptoms seen in PTLDS and CLD patients include fibromyalgia,
arthritis, myalgia, encephalopathy, chronic fatigue, depression/irritability, sleep disturbance,
facial/Bell’s palsy, and headaches. Establishing common clinical threads between PTLDS and
CLD can be of value in determining further diagnostic modalities or treatment protocols for a
substantial number of patients who do not present with standard Lyme disease symptoms.
Symptoms identified in five or more publications are consistent with a diagnosis of long-term
effects from Lyme disease infection.
Conclusions: Our data suggest that PTLDS and CLD are legitimate syndromes. Our data show
common recurring neurological and muscular-skeletal symptoms among those complaining of
PTLDS and CLD. The Binghamton University (BU) Lyme Disease Research Group has designed
a ground up approach to studying this phenomenon using ecological techniques and patient
centered approaches involving antibody, molecular and bio-behavioral evaluations for studying
this emerging disease phenomenon.
Keywords: Lyme disease, idiopathic, misdiagnosis, symptomology
Poster: D5
ELECTROCHEMICAL MEASUREMENTS OF BIOFILM DEVELOPMENT USING
POLYPYRROLE ENHANCED FLEXIBLE BIOFILM SENSORS
Leo Zheng1, Robert Congdon2, Omowunmi Sadik2, Claudia Marques3, David Davies3,
Bahgat Sammakia1, Leann Lesperance4, James N. Turner5
Mechanical Engineering Dept1., Chemistry Dept.2, Biological Sciences Dept.3, Bioengineering
Dept.5, S3IP5
Binghamton University, Binghamton, NY
Contact Information: lzheng1@binghamton.edu
Background: Bacterial biofilms form when bacteria adhere to a surface and secrete extracellular
polymeric substances, forming an extremely robust protective gelatinous shell around the
bacteria. Such biofilms are 10-1000 times more resistant to antibiotics than free-floating
planktonic bacteria. Given sufficient time bacterial biofilms are capable of forming on virtually
any surface, including those of a wound bed in health care and inner walls of water pipes in
industry. There is a wide spread need for an in-situ sensor to detect and characterize the
development stages of bacterial biofilms. These applications range from medicine to civil
infrastructure.
Methods: We are developing an electrochemical approach to detect and characterize bacterial
biofilms using Polypyrrole (PPy) enhanced flexible biofilm sensors based on organic substrates
of Polyethylene terephthalate (PET). PPy films act as a functionalization material on gold
electrodes to reduce their electrical impedance thereby enhancing the detection of
electrochemical signals. Flexible PET substrates enable sensors to be placed in systems with
complex geometries and to be produced in using low cost roll-to-roll manufacturing.
Measurements of electrochemical impedance spectroscopy (EIS) using the PET flexible biofilm
sensors have been correlated with fluorescence microscopy using bacteria that express green
fluorescent protein (GFP). The EIS measurements and images have been correlated with the
developmental stages of Pseudomonas aeruginosa biofilms.
Results: The charge transfer resistance increase in the early stages of biofilm formation and
decreases in the later maturing stages. The slope of the constant phase element (CPE)
capacitance keeps increasing as the result of increment of biofilm fouling on the electrode.
Conclusions: The biofilm sensors successfully detected the changes of charge transfer resistance
and capacitance corresponding to the biofilm maturing stages.
Funding: This work is supported by the grant of Flexible Electronics for Biological and Life
Science Applications (FlexEBio) that is collaboration with Cornell University and Binghamton
University under the Integrative Graduate Education and Research Traineeship (IGERT)
program of National Science Foundation under the Grant No. DGE-0654112. Sensor
fabrications were carried out in the facilities of CAMM, ADL and Nanofabrication lab of
Binghamton University.
Keywords: Biofilm, Biosensor, Electrochemical, Flexible Electronics
Poster: E1
ULTRASONIC VOCALIZATIONS:
A REAL-TIME INDEX OF APPETITIVE VERSUS AVERSIVE STIMULI?
Laura M. Darnieder, Michael E. Nizhnikov, and Norman E. Spear
The Center for Development and Behavioral Neuroscience, Binghamton University
Contact Information: ldarnieder@gmail.com
Background: Whether a developing animal finds a drug rewarding or aversive is a central
question to the understanding of addiction and alcoholism. However, the determination of the
aversive or appetitive nature of a stimulus is often problematic because of the physiological
immaturity of neonatal and infant subjects. Rodent ultrasonic vocalizations (USVs) are a known
behavior that could offer a methodology for measuring stimulus valence. Infant rodents increase
USVs production when they are removed from the dam (40-kHz isolation induced call) and in
juvenile and adult rodents, USVs have been associated with appetitive (i.e. copulation, play,
amphetamines) as well as aversive (i.e. foot shock, air puff) stimuli. We hypothesized that 40kHz USVs could serve as a real-time behavioral index of stimuli valence in PND10 infant rat
pups.
Methods: Three sets of studies examined the effects of type of infusion (continuous or pulsating)
and solution (appetitive or aversive) during a 5-minute test. Experiment 1 continuously infused
rat pups with either 10% ethanol or water while Experiment 2 infused pups with one pulse per
minute (15s pulse/45s pause) of water, 10% ethanol, 0.1% saccharin, or 0.1% quinine.
Experiment 3 utilized a 2-minute baseline period prior to test and a reduced pulse of 2-seconds
twice a minute for 5 minutes (2s pulse/28s pause). The set of stimuli in Experiment 3 remained
the same as Experiment 2. All USVs were recorded simultaneously for the 5-minute infusion test
in all experiments as well as for the 2-minute baseline in Experiment 3. Rate of infusion
remained the same across all experiments at 1.25% of the average body weight of each litter.
Subsequent analyses examined temporal differences in vocalizing as well as overall effects of
fluid type.
Results: PND 10 pups in Experiment 1 vocalized in the 40-kHz range significantly more during
a continuous infusion of water than 10% ethanol. A temporal analysis indicated that pups
vocalized equally across the first and second 2.5 minutes of the test. Experiment 2 showed that
pups vocalized significantly more when infused with 0.1% quinine than when infused with 10%
ethanol and also more than non-infused controls. Pups infused with water also vocalized more
than non-infused controls. A minute-by-minute analysis during infusions and pauses of USV
production for each fluid revealed a significant decrease in vocalizing across time for control
pups. Quinine (0.1%) and water pups did not decrease vocalizing across either infusions or
pauses. However, 10% ethanol pups significantly decreased their vocalizations only across pause
intervals. Experiment 3 showed that USVs emitted during the 5-minute test were significantly
higher for water infused pups when compared to both 10% ethanol and 0.1% saccharin pups.
Additionally, 0.1% saccharin pups vocalized significantly less than 0.1% quinine pups. Relative
to baseline scores, 0.1% quinine pups vocalized significantly more than non-infused controls,
10% ethanol, and 0.1% saccharin subjects.
Conclusions: Relative to controls in Experiments 2 and 3, we found increased 40-kHz
vocalizing in response to 0.1% quinine infusion and no differences in response to 10% ethanol or
0.1% saccharin. Water treated pups vocalized significantly more as the continuous nature of the
infusion increased (from Experiment 3 to Experiment 1. Taken together, these data indicate both
a possible role for 40-kHz vocalizations in assessing the aversive nature of a stimulus as well as,
apparently, the anxiolytic effects of 10% ethanol and 0.1% saccharin.
Acknowledgements: This work was supported by grants from NIAAA to Michael Nizhnikov:
R21AA018164 and P50AA017823 and Norman Spear: R01AA015992, RO1AA13098, and
1P50AA017823
Keywords: Ethanol, ontogeny, appetitive, aversive, vocalizations
Poster: E2
NOVEL DYNAMICS OBSERVED IN A SPIKING NEURAL NETWORK MODEL
OF THE NTS IN THE RAT HIND-BRAIN
1
Jingyi Zhou , J. David Schaffer1, Craig Laramee1, and Patricia DiLorenzo2
Department of Bioengineering1, Department of Psychology2
Thomas J. Watson School of Engineering & Applied Science,
State University of New York, Binghamton, NY 13902.
Contact Information: dschaffe@binghamton.edu
Introduction: The Nucleus of the Solitary Tract (NTS) is a hind-brain structure in the rat that is
the first way-station in taste processing. Its structure and function are poorly understood.
Recently our group produced a model, implemented as a spiking neural network (SNN)
simulation that successfully replicated experimental data. The model's topology was manually
devised and the parameters were set by a genetic algorithm. The model consisted of two identical
triads of neurons, each devoted to a different taste modality (say salt and sugar) and cross
connected in a fashion optimized by the genetic algorithm so that it replicated a suite of
measurements taken from the brains of anesthetized rats. The next challenge was to try to
understand the full dynamics of this model, and see if this knowledge might generate new
understanding of the NTS, perhaps by suggesting new hypotheses that might be tested on living
rats.
Methods: We began exploring the model’s inherent dynamics using many established
engineering approaches: ping it with single spikes, attempt to induce it to reveal its resonant
frequencies, explore it for chaotic dynamics.
Results: In the end, most of these approaches revealed little, but when we drove the model’s two
inputs with spike trains that began in synch, and then drifted into and out of synchrony, we
observed a striking winner-take-all decision-making dynamic. One triad of the model neurons
(one taste modality) took over all spiking behavior, shutting off the other triad through strong
inhibition. It should be noted that such behaviors were not included in the initial training data;
this was an emergent phenomenon. Contrary to our initial hypothesis, the winning triad could not
be predicted to be the one whose inputs first began to arrive faster (or slower) than the other.
Furthermore, the dominant pattern was able to persist even when the winner’s inputs went silent
for some period while the suppressed triad’s input continued. By analyzing the internal
dynamics, (which is possible with a model but not with living animals), we identified the precise
decision mechanism, and came to understand how it depends on the precise timing of only a few
spikes.
Discussion and Conclusion: The observed behavior may be an artifact of the model and not
characteristic of the NTS. It remains for additional experiments on rats to confirm or reject this
model prediction. Nevertheless, these observations: that neural dynamics can depend sensitively
on precise spike timing and not only on large scale frequency differences, should contribute to
currently active debates in the neurophysiology research community. In addition, we are
optimistic that this paradigm: (1) build-evolve a SNN model that is consistent with measurement
data, (2) probe the network dynamics using engineering methods, (3) generate new hypotheses to
test in the lab, may prove of value.
Keywords: spiking neural networks, rat brain, taste processing, precise spike timing
Poster: E3
SIMPLE DESIGN RULES FOR SPIKING NEURAL NETWORK-BASED
GENERAL PURPOSE NETWORKS
Arnab Roy, Craig Laramee, and J. David Schaffer
Department of Bioengineering,
Thomas J. Watson School of Engineering & Applied Science,
State University of New York, Binghamton, NY 13902.
Email: aroy2@binghamton.edu
Introduction: When the spiking neural network (SNN) computing paradigm emerged about a
decade ago, there was much excitement that this new paradigm might achieve machine
intelligence capabilities that previous generations of neural networks have so far failed to
achieve. Their novel mechanisms, rather closer to real neurons, were shown to have impressive
computing capabilities. Of particular interest was the possibility that information coded in a
spike train emanating from one neuron, might be attended to by many downstream neurons, each
potentially extracting different aspects of the information. In addition, synaptic plasticity opens
possibilities for autonomous learning and memory. However, the intervening years have shown
that achieving the dream has proven rather challenging; no design rules for creating networks for
specific tasks have yet emerged. If these computational abilities can be harnessed, applications in
Bioengineering should abound such as monitoring bioelectric signals and smart prosthetics. A
major advantage of SNNs for interacting with the body is the use of a common signal encoding:
spike trains.
Methods: We offer design approaches for three networks that perform tasks of some general
utility: a sequence detector (firing only when spikes arrive on parallel input channels in a
specified order), a temporal pattern detector (firing only when spike trains arriving on a serial
input channel contain a specified pattern), and a network capable of mapping any given input
spike sequence to a given output spike sequence. All three of these designs are feed-forward and
modular, where each module is a 2-channel synchrony detector. We derived the constraint
equations that govern the allowed network parameters, and wrote a program that will generate a
solution for any given input specification (i.e. the patterns to be detected).
Results: A design program and a SNN simulator have been built to demonstrate the
effectiveness of the design approach. These simulations show that the networks work as
designed.
Discussion and Conclusion: The larger goal of this work is the development of general purpose
spatio-temporal pattern classifiers (STC). The output spike pattern generated by such a spatiotemporal classifier can then be used for driving output transducers for controlling motor
behavior, audio generation or any other desired behaviors. Our current efforts are focusing on
evolutionary approaches capable of “growing” networks and adding synaptic plasticity.
Keywords: spiking neural networks, design rules, temporal/sequential pattern detector
Poster: E4
STATIC MAGNETIC FIELD INDUCTION OF STOCHASTIC GENE EXPRESSION
Megan Brady1, Paul Frisch2, Kenneth J. McLeod1, Craig B. Laramee1
1
Bioengineering Department, Binghamton University, Binghamton, NY
2
Biomedical Engineering, Medical Physics Department,
Memorial Sloan-Kettering Cancer Center, New York, NY
Email: mbrady3@binghamton.edu
Introduction: Due to the complex nature of living systems, it is difficult to detect singular
responses. Studying the emergent behavior of the system allows the collective properties to be
observed and characterized. These properties can be seen at the genomic level. Because noise
exists within cell models, variation among the system is often seen. However, when external
noise is used to perturb the system, it may work in synergy with the system’s intrinsic noise to
produce a change in stable state. This phenomenon, known as stochastic resonance (SR), is
responsible for shifts in gene expression of the overall system.
Methods: Two cell lines (human mammary non-tumorigenic epithelial cell line MCF-10A and
Rat-1 fibroblasts from MSKCC) were used to study the effects of static magnetic field exposure
and SR genomic response. Cells were exposed to static magnetic field strengths that ranged
from 0.1 to 440 mT over periods up to 48 hrs. Responses were then examined as a function of
exposure dose and duration using a luciferase reporter system as well as Affymetrix gene
expression microarrays.
Results: The luciferase assay showed that although small, magnetic fields are able to contribute
to a stress response of the system that was dependent exposure duration and on dose. However
the dose dependence was non-linear and peaked for the 10 and 100 mT exposures. Gene
expression microarrays also confirmed this dose response. However the genomic response was
not represented by a single gene but by a pattern shift in the expression of many genes. This
result was found to be consistent across cell lines, experimental replication and across
normalizations.
Conclusions: While single gene responses to magnetic field exposures have been observed, they
are often difficult to replicate and are near the detection cutoff limits. Our results suggest that
magnetic fields are capable of altering gene expression through a shift in the pattern of
expression for many genes. The replication of this pattern across different experimental
platforms provides evidence that the cells are indeed responding to the external noise presented
by the static magnetic fields.
Keywords: static magnetic fields, stochastic resonance, gene expression
Poster: E5
TOWARDS DEMENTIA DIAGNOSIS WITH SPEECH
J. David Schaffer1,4, Shawn Berkowitz4,5, Laura Bronstein2,4, and Stephen Zahorian3
1
Department of Bioengineering, 2Department of Social Work,
3
Department of Electrical Engineering, 4Institute for Intergenerational Studies and Southern Tier Center
on Aging, State University of New York, Binghamton, NY 13902.
5
SUNY Upstate Medical University, Binghamton, NY 13904
Contact Information: dschaffe@binghamton.edu
Introduction: Dementia is a growing problem. Alzheimer’s disease (AD), the leading form of
dementia, is currently the 6th leading cause of death in the USA and the only one among these that is
increasing. The Alzheimer’s Association estimates that over 5.4 million Americans suffer from AD and
that roughly twice that number of caregivers are providing over $172B in unsupported services each
year. The aging of the population is a major factor in the estimates that the number of affected
Americans is likely to double by 2050. Currently there is no cure, but research may yield some progress
in the not too distant future.
Diagnosis of Alzheimer’s is very challenging, involving neuropsychological tests by trained
technicians, brain imaging, and other tests. There is a need for a test with high sensitivity and
specificity, that is inexpensive, and as minimally burdensome as possible. In addition to early detection
that can help families prepare, a more precise diagnostic may hasten the development of new
therapeutics. Clinical trials of putative AD agents are greatly hampered by not having methods for
recruiting precisely the types of patients most likely to benefit, thus diluting the statistical power of
these trials.
Methods: There are known aphasias associated with dementia, and some metrics have been devised in
attempts to quantify them. Some neuropsychological tests key on them. Advances in the technical
domains of natural language processing (NLP, computer-based approaches to human language
analysis), and speech processing (the signal processing of human speech, including speech-2-text), have
reached levels where a concerted effort to combine the best approaches may well bring the dream of a
speech-based diagnostic for dementia within reach. In addition, we have expertise in statistical learning
methods for pattern discovery.
Results: At this time, we have running computer code for almost all the steps in this chain. A popular
speech acquisition protocol is to ask the subject to describe what is happening in a picture (we should
explore other protocols). Software is in hand to capture the microphone signals and output an audio
standard digitized file (wav). We have prototype software to quantify pauses from this file. There are
commercial packages to handle speech-2-text. We have a parser that can output part-of-speech-tagged
text that in turn can be input to software that extracts certain sentence complexity metrics. Other
software can extract idea density metrics and measures of vocabulary richness.
Discussion and Conclusion: The first goal will involve a pilot study in which speech samples are
acquired from a modest cohort of subjects with a known dementia (i.e. where the diagnosis is not in
question) and a matching cohort who are cognitively normal. In this study we will begin to acquire
insights into the best methods for each step in the chain, leading to publication(s) and grant
application(s).
Keywords: dementia, Alzheimer’s, diagnosis, speech, natural language processing
Poster: E6
VALIDATION OF A NEW PNN-GRNN ORACLE HYBRID FOR SCREENING USING
BOTH PLS AND KPLS
Walker H. Land, Jr., William Ford, Xinpei Ma ,Jin-Woo Park a
Department of Bioengineering, Binghamton University, Binghamton, NY 13902, USA.
Background: Cancer screening is recommended for the general population for many cancer
types beginning, for example, at 40 for breast cancer screening and ~50 for colon cancer.
However, many of these screening modalities, such as digital mammography (DM), magnetic
resonance mammography (MRM), computer tomography (CT), etc., can be expensive, while
other modalities, such as fine needle aspirate (FNA) and core biopsy are evasive as well as
expensive. To address this cost / evasive modality problem, we have developed a screening
process , using CAS technology, that processes only clinical data (i.e. data collected from a
patient during an office visit / interview) that is both non evasive and inexpensive. This CAS
hybrid processes, first uses a PNN to obtain a set of results, then enhances these to obtain a more
accurate result by intelligently combining them using covariates. Consequently, we have a more
accurate determination of who should or should not be called back for further “work up”. The
theory / approach have been preliminarily validated using a clinical breast cancer data set. This
software process is not restricted to any cancer type or to screening cancer for that matter. It was
designed to screen any set of covariates that contain information for classification, detection and
/ or prediction (prediction will require more data than the other two approaches. However,
because it is a completely new paradigm, it’s results must be verified by another, completely
different known and validated statistical learning theory (SLT) process.
Methods: To validate this new PNN-GRNN oracle hybrid, we used the partial least squares
(PLS) for linear processing, and the krenalized PLS (K-PLS) approach for the non-linear
processing. PLS was first developed for the social sciences and then later extended to
chemometrics by both Herman and Savante Wold, and modified and then adapted to cancer
screening by the first two above authors. While this statistical learning theory (SLT) process
results in a global minimum (which minimizes both FP and FN errors) , one cannot physically
interpret the results, relative to which subset (if any) of covariates contributes to an accurate
result, because of a transformation of the data and process to a latent variable space.
Results: The PLS and K-PLS were compared to the PNN/GRNN oracle. As expected, the PLS
results, 0.58 Az, were on par with the results gained from the PNN alone but were not
comparable with the PNN/GRNN oracle results. The K-PLS was done with multiple kernels such
as Gaussian, radial basis and dot product. Preliminary results show that PNN/GRNN Oracle
performs as good or better as current known and validatated STL process such as the K-PLS.
Keywords: Statistical Learning theory, Kernalized partial least squares, Cancer screening
Poster: E7
GENETIC EXPRESSION OF OBESITY BMI WITH LOW AND HIGH PERCENTAGE
OF BODY FAT
Karen L. Zanni
Decker School of Nursing
Binghamton University, Binghamton, NY 13902
Contact Information: kzanni1@binghamton.edu
Background: Obesity continues to increase in epidemic levels worldwide. The number of genes
associated with human obesity continues to increase. Current studies that use Body Mass Index
(BMI) as a standard for defining the overweight phenotype are limited in that patients with high
muscle mass may be inappropriately classified as overweight/obese. BMI is most commonly
used to quantify body anthropometrics due to its simplicity, but more refined measurements of
body fat composition are needed to truly understand the variations in gene expression. The
purpose of the study was to clarify individuals as overweight based on BMI and body fat
percentage, and to examine differences in gene expression based on these classifications.
Methods: We studied 66 subjects, 50% male between the ages of 14 to 44 years, mean age 26.1,
BMI 25.9 ± 7.0 (18.9 – 32.9), % body fat 28.0 ± 11.8 (16.2 – 39.8), all Caucasian. Whole-body
air displacement plethysmography (BOD POD®) for determining percentage of body fat was
completed on 66 participants. Height and weight was measured to calculate BMI. Morning
fasting whole blood was collected peripherally using PAXgene™ blood RNA tube. RNA was
extracted with PAXgene™ Blood miRNA Kit. Quantitative real-time PCR array (RT2 Profiler
PCR Array) was then used to determine gene expression in 96 genes related to obesity. Gene
expression correlations between subjects with a high BMI and subjects with high body fat
percentage were compared to appropriate controls.
Results: ADCYAP1, CCK, CRHR1, GH2, HTR2C genes were upregulated in both high BMI
and high body fat percentage subjects when compared to appropriate controls. IL-1A was
upregulated in subjects with high BMI when compared to controls (low BMI), but was not noted
in high body fat percentage subjects.
Conclusions: This study reveals differences in gene expression between classifying a subject
based on BMI versus classifying based on body fat percentage. The findings from this pilot study
show the need
Funding source: NINR Summer Genetics Institute stipend for proper subjects’ classification in
genetic studies.
Keywords: Obesity, gene expression, body composition
Poster: E8
RN TO BS PROGRAM PROVIDES “WINNABLE BATTLE” LEADERSHIP IN
COMMUNITY PARTNERSHIPS FOR RURAL CHILD OBESITY WORK
Margaret S. Argentine, PhD, RN, CNE, Principle Investigator & Professor of Nursing,
Director, RN to BS Nursing Program, Morrisville State College
Nannette Cowen, MS, APRN-BC, FNP, Assistant Professor, Associate and Baccalaureate
Nursing, Morrisville State College & Binghamton University Doctoral Student
Background Issue/Project Objectives: Uniting RNs’ need for real-world clinical experience
and the child obesity epidemic in a community partner context in rural Central New York
enables a whole rural community to become an active player in the CDC ‘Winnable Battle” to
reduce childhood overweight and obesity. The 2007 NYS Body Mass Index (BMI) mandate for
school nurse reporting (to NYSDOH) expanded nursing’s influence to impact healthy behaviors.
By addressing a baseline gap for primary data on BMI and weight status for the Pre-K to Grade
12 student population, two objectives emerged: Partner with school nurses to obtain and
document reliable and valid BMI data in 100% of participating school districts’ Pre-K to grade
12 populations. Using local evidence, work with community partners on child obesity research
that expands assessment, health promotion, research and leadership skills of students.
Project Description: “From 1980 to 2000, obesity rates for adults doubled and rates for
children tripled” (Ogden, et al 2012.) In 2008, the percentage of obese adults in Madison County,
NY was 26.2 percent (CDC, 2012) but local data on childhood obesity was not available. Wide
variations (Stoner and Walker, 2006) in child measurement practice impact valid results. This
project documented weight status for 3,953 data-producing children, ages 2-19, from six districts
in two counties during the 2008-2009 school year. Results verified a mean percentage of 21.86
percent overweight and 19 percent obese, for an overall combined percentage of 40.86 percent
overweight or obese statistic in the child age groups. Students learned to connect health
assessment, health promotion and nursing research within a curriculum that supports student
engagement in public health projects.
Project Evaluation: Outcome measures: valid and reliable baseline BMI-weight status records
for participating districts; mentoring and support for school nurses new to the reporting process;
enriched experiences for students and faculty. Partner districts received unique summary reports,
and are in varying stages of planning for interventions. Partnering organizations reported the
ability to identify funding sources using the local data to support new activities in health
improvement. The 2009 Madison County DOH report describes the condition of overweight and
obesity in the County, and identifies strategies to reduce or prevent adult and child obesity.
Madison-Oneida BOCES was able to focus on parent education for fitness, nutrition and health
education efforts are beginning.
Challenges/Lessons Learned: Questioning of nursing students/faculty to have legal access to
school-age children; reporting results to parents with no legal mandate; protecting privacy and
confidentiality of children and schools throughout the project. Significant lessons for nursing
curriculum; maintaining credibility in designing, conducting, evaluating and networking within
an entire community; promoting a sensitive culture to help families with health promoting
behaviors. Future: identify targeted at-risk school-age population for interventional doctoral
study to improve wellness, health outcomes and life-long healthy habits.
Keywords: childhood obesity, school nursing, community partnerships
Posters: F1
FARM TO YOU – RESTAURANTS AND COMMUNITY ASSETS
Laura Biasillo, Cornell Cooperative Extension – Broome County
Background Issue/Project Objectives: The “Farm to You” initiative looked to address the lack of
healthier choices at community assets located in the City of Binghamton through a mechanism known as
a “greencart” as well as enhancing menu option at restaurants in the City of Binghamton using local
farm’s products – primarily produce and facilitating conversations between local institutional users and
distributors and farmers.
Project Description: Five “greencarts” have been constructed for use at various community assets
throughout the City of Binghamton, including the Binghamton Mets Stadium, Ross Park Zoo,
Binghamton Housing Authority and the Binghamton Senators games at the Arena. Multiple restaurants in
the City of Binghamton were connected with local farms to supplement their menu offerings with inseason produce.
Project Evaluation: Evaluation measures for this project included sustainability measures: did they
continue with the project after little to no outside support from our agency; Profitability measures: What
were the sales numbers by local farms through the “Farm to You” initiative; and Knowledge measures:
Did local chefs and operators of those “greencarts” possess a better understanding of how to integrate
local produce into their menus as well as the challenges local farms face in becoming a supplier to an
institutional purchaser?
Challenges/Lessons Learned: Through this project we were excited to learn that while challenges exist
in both procurement and transportation of local farm products for institutional buyers, both local farmers
and purchasers/distributors see the value in the “buy local” movement and want to support local farms.
Challenges encountered included difficulties in sourcing the quality and quantity of produce required on a
weekly basis through multiple channels; coming to an agreement on price for products, and transportation
of the produce to ensure it stays the correct temperature. It was also a challenge to find institutional
buyers willing to take on new vendors of produce as their staff are time sensitive and adding another two
places to contact for purchasing sometimes is unreasonable. It is also difficult to evaluate the success of
due to behavior chance taking a long time. We are working with community assets to offer healthier
choices and while someone may not take advantage of it the first, or even, second time they are offered, it
is important they understand it is available and they will eventually take advantage. When working with
the local restaurants it is easier to track success due to number of meals that had been purchased using the
local products as well as whether they continue these choices after our involvement stops. It is exciting to
know that the majority of purchasers who have participated have taken this on as their own cause and will
operate without our oversight after the initial year (or two).
Keywords: Agriculture, healthy meal/snack choices
Posters: F2
THE PATRIOT BREAKFAST PROGRAM
Mark Bordeau, Broome Tioga BOCES Senior Food Service Director
Ray Denniston, Broome Tioga BOCES Special Projects Coordinator
Yvonne Johnston, MS, MPH, RN, FNP, Clinical Assistant Professor, Binghamton University
Julie Tucker, RD, CDN, SNS, Broome Tioga BOCES Registered Dietitian
Background Issue/Project Objectives: The Broome County Strategic Alliance for Health in
partnership with Broome Tioga BOCES Food Services, established the Patriot Breakfast
Program, an evidence-based strategy for serving universal breakfast in the classroom. The setting
for this project was the Woodrow Wilson School in the Binghamton City School District located
in upstate New York. In this school district, almost 60% of students are eligible for free or
reduced-price lunch. In some schools in the district, such as Woodrow Wilson Elementary
School, 72% of students qualify for this program. In this high-need area, many students do not
have the opportunity to eat breakfast at home and only about 43% of students at Woodrow
Wilson were eating breakfast at school as of October 2008.
Project Description: The Patriot Breakfast Program was piloted in four second grade
classrooms beginning in October, 2008 and was expanded to include all grade levels by the end
of February 2009 reaching a total of 428 elementary school children. Students have the choice
between a nutritious hot and cold breakfast delivered to their classroom each morning. They eat
breakfast with their teacher and peers in a small group setting. Teachers, parents, and students
felt the Patriot Breakfast Program had positive behavioral, social, cognitive, and health benefits.
Project Evaluation: School staff, parents and students were surveyed before, during and after
completion of the program. The results indicated that breakfast participation for the entire
elementary school increased from 43% (October 2008) to 88% (October 2010). Children’s
readiness to learn increased from 41% to 79% and ability to focus on learning increased from
31% to 79%. 82% of parents surveyed felt their student made healthier food choices at home as a
result of the program. Evaluation results also indicated that the program did not interfere with the
school day and more than 90% of stakeholders hope that the program continues to be offered.
Due to the success of the program at the school, Broome-Tioga BOCES is working with
principals of other schools in the district to encourage them to implement program.
Challenges/Lessons Learned: The support of school administrators, principals, food service
staff, custodians, teachers and parents are key to the programs overall success.
Keywords: Community, Food Services, Nutrition, School Breakfast
Posters: F3
ROCK ON CAFÉTM
Mark Bordeau, Broome Tioga BOCES Senior Food Service Director
Ray Denniston, Broome Tioga BOCES Special Projects Coordinator
Yvonne Johnston, MS, MPH, RN, FNP, Clinical Assistant Professor, Binghamton University
Julie Tucker, RD, CDN, SNS, Broome Tioga BOCES Registered Dietitian
Background Issue/Project Objectives: The rising rate of overweight poses a significant threat
to the health of children. Because roughly one third of a child's dietary intake occurs during
school hours and because both health and academic outcomes have been linked to children's
nutrition, school nutrition policies and programs have been identified as a key area for
intervention. Current Rock on Café projects include Breakfast in the Classroom and Sodium
Reduction in school meals. The Rock on Café promises to be a model for creating a school
environment that supports healthy dietary behaviors among children.
Project Description: The Rock on Café is the result of partners working together and building on
previous successes. It started in 1993 with 15 school districts creating a unified bid and launching
the Rock on Café in 2007. The Rock on Café program is in its 5th year and is proud to continue to
offer taste tested recipes and products at an affordable price. This program is a service of BroomeTioga BOCES and currently 15 school districts throughout Broome and Tioga County are
participating serving approximately 7,500 breakfasts and 20,000 lunches a day. The Rock on Café
program is designed by the cooperative effort of all of the Food Service Directors and their
nutrition expert, Julie Tucker. Elementary schools have been the main focus, but expansion is
occurring in the middle and high schools. All 15 school districts participate in cooperative
bidding, promotions, recipe development, and create standardized elementary menus.
Project Evaluation: When the Rock on Café began, a pretest–posttest design with data
collection methods that included pre- and post-menu analysis for calories and macronutrients,
pre- and post-food purchases and costs, pre- and post-school lunch participation rates, media
reach measures, pre- and post-cross-sectional surveys of parents, and posttest surveys of Food
Service Directors were conducted. Continuous evaluation occurs with feedback from Food
Service Directors on a monthly basis.
Challenges/Lessons Learned: This intervention was conducted in a county with a racially and
ethnically homogenous demographic profile, limiting its generalizability to different or more
diverse populations. The Rock on Café was innovative for its consolidation of food procurement
and menu planning across a regional area and its use of contracted dietary services to school
districts. The full participation of all school districts, the high level of satisfaction with the
program, and the initial improvements observed in a constrained set of impact measures suggests
that despite these limitations the Rock on Café may improve the dietary intake of school-aged
children. The lessons learned from this experience were mostly positive. First, a commitment to
the larger goal of providing nutritious food items and quality food services for children should
supersede individual district preferences. Second, the importance of soliciting the support of the
school district at all levels and engaging key stakeholders from both the school and community
cannot be understated. Third, efforts should capitalize on existing programs. Collaborative
partnerships between schools and community can create synergistic rather than competing
effects. Last, planning and piloting new ideas in settings where considerable enthusiasm and
commitment exists can be catalysts for success.
Keywords: Community, Food Services, Nutrition, School Meals
Posters: F4
STAY HEALTHY KIDS
Pat Fell, RN, MS, ANP-C, Director Community Health Services
Jenny English, RN, AE-C, Project Coordinator, Stay Healthy Center
Nalini Kalanadhabhatta, Americorps
Background Issue: Per the CDC approximately 17% (or 12.5 million) of children and
adolescents aged 2—19 years are obese. Since 1980, obesity prevalence among children and
adolescents has almost tripled. With a growing number of children becoming overweight or
obese this will in turn shorten the lifespan of our children due to complications of obesity.
Pediatric health care providers have many topics to cover in a short amount of time at office
visits. Following the Pediatric Obesity Guidelines and using a multidisciplinary team we wanted
to streamline office visits and provide a resource for referral to a family centered fitness and
nutrition education program.
Project Objectives:
1. Participants will learn how UHS incorporated Childhood Obesity Screening Guidelines
into their screening practices within the electronic medical record.
2. Participants will learn how children were identified as having a BMI above 85% and
referred to the Stay Healthy Kids Club, an education/support for parents as well as a
fitness and nutrition class for the children.
3. Participants will learn about Parents/Guardians who received evidence based education
and materials and if they were able to make behavioral changes based on pre and post
testing.
Project Evaluation: We have continued support from our pediatricians and family practice
providers with referrals. The families involved in the program have had some behavior changes
in a positive direction. We also have seen maintenance and decrease in BMI within the 12 week
class period.
Challenges/Lessons Learned: Once children were identified we continued to face challenges
with commitment to a lengthy program, care for younger children, age range, and transportation
issues. The team has worked diligently together to find creative solutions to our barriers.
Keywords: Obesity Prevention, Obesity Treatment Program
Posters: F5
LEARNING IN MOTION
David Garbarino, Director of Health, Physical Education & Athletics, City of Binghamton
School District
Mary McFadden, Supervising Public Health Educator, Broome County Health Department
Background Issue/Project Objectives: As identified by the initial CHANGE assessment
process, City of Binghamton Schools were not meeting the mandated New York State
Department of Education (NYSED) 150 minutes of physical education per week per child. The
United States Surgeon General’s physical activity requirement states that all schools must adopt
a policy where students have physical activity outside of physical education.
Project Description: Broome County Strategic Alliance for Health helped to mobilize efforts for
teachers to be trained with an evidence based curriculum called Learning in Motion. Physical
Education teachers were trained in Learning in Motion and helped provide the training to
classroom teachers in the 7 elementary schools. This approach allowed children in the
Binghamton City School District to meet the required minutes of physical activity apart from
physical education and assisted with obtaining the overall 60 minutes a day recommendation from
the U.S. Surgeon General.
Project Evaluation: One-hundred ten Binghamton City School District classroom teachers were
trained using an evidence-based curriculum called Learning in Motion to integrate 15 minutes of
extra physical activity per day for children in the classroom. Thirty new Learning in Motion
curricular elements were written and implemented in grades K-5 across 7 elementary schools,
reaching approximately 2,300 students. Teachers have met to begin the development of infusing
physical activity lessons into existing curricula and policy language to be submitted for approval
by the school board.
Challenges/Lessons Learned: By training physical education teachers, the school district is able
to sustain the program and ensure capacity to integrate physical education into classroom
instruction.
Keywords: Physical Activity, Schools, Obesity Prevention
Posters: F6
CHILDHOOD OBESITY: ASSESSMENT AND TREATMENT IN A PHYSICIAN
NETWORK SYSTEM
Robin Mosher, RN, BSN-BC, Nurse Manager, Lourdes Physician Network
Background Issue/Project Objectives: Background includes a pediatric physician office which
serves a predominately lower income population, and meeting the challenges of incorporating all
aspects of the recommendations from the American Academy of Pediatrics for treating childhood
obesity. Recommendations include promoting a healthy diet, increasing activity, measuring
BMI, and incorporating psycho-social assessment as part of assessment and treatment.
Objectives included:
• Identify a population of pediatric patients within the practice, who met criteria of obese by
BMI measurement. This was done through data retrieval from a computerized billing system,
accessing those patients within a specific age group, and who had a diagnosis of obesity.
• Incorporate on-site nutrition specialist for access to more concentrated specific nutritional
guidance.
• Partner with community facilities to incorporate physical activity into the plan of treatment.
This was done through programs conducive to patients and families with limited financial
resources, through programs offered at the YMCA.
• Utilize on-site social worker for additional help with addressing any psycho-social barriers.
• Provider and Nurse focused interventions for children identified.
• When able, incorporating electronic health records to help identify and manage patients who
are currently obese, and further identify those at risk for developing obesity.
Project Description: A task force was formed in DePaul Pediatrics consisting of Providers (MD
and FNPs), Nurse Manager, RN, LPNs and Social Work. The primary objective was to identify
the population of children who were currently obese, and begin a systematic approach to
implement ACP guidelines for treatment of childhood obesity. Special attention needed to be
addressed related to financial constraints of lower income families, when developing
interventions to address nutrition and increasing activity. In addition, a higher than average
missed appointment rate for many patients, also presented challenges that needed to be
addressed. Educational materials were purchased to assist in educating those patients who were
identified as obese. Collaborations were formed with Nutrition counselors employed by Lourdes
Hospital, and located within the 303 Main Street location, making access for the patient easier.
Additionally, collaborations were formed with Community agencies such as the Broome County
Health Department and the YMCA. The YMCA offered classes and memberships at reduced
cost or free, for those who qualified for financial assistance. Plans were initiated to utilize the
impending implementation of an electronic health record to help manage patient populations,
although to date, DePaul Pediatrics has not transitioned to an electronic chart. In addition,
clinical skill development was obtained by sending one Nurse Practitioner and one Registered
Nurse to attend a pediatric obesity conference. Plans are in effect to host a learning lunch for
Lourdes Hospital, where information guidelines, strategies and recommendations can be
disseminated throughout the organization, to enhance a systems change and awareness of
childhood obesity.
Posters: F7
Project Evaluation: The initial phase was to identify the population of DePaul Pediatrics
children classified as currently obese through our computerized billing system. Once we
identified these children, appointments were made with providers, and a complete physical
assessment was completed, including measurement of BMI. Success was realized in the project
by utilizing resources that we already had available, for example dietician counseling at the same
location. In addition, social work and Youth services at Lourdes provided access for individual
patient counseling if necessary, to supplement provider counsel. The staff and providers at
DePaul Pediatrics acquired additional education by attending a Pediatric Obesity Conference in
California, and utilized various educational tools to teach patients and parents about nutrition and
activity. Educational DVDs, portion plates, and education items representing fat content in food
enhanced educational experiences for patients and their families. Referrals were made to an
affordable program at the YMCA, to help with increasing activity.
Willingness of patients/parents to make changes in lifestyle, activity, diet, Decreased BMI
Challenges/Lessons Learned: Challenges included:
• The electronic health record has not yet been implemented in the DePaul Pediatric Clinic
• Finding adequate low-cost referral sources for activity inclusion in a lower-income based
population
• Difficulty with patient/parent compliance with attending programs
• A Learning Lunch is in the planning stages, which will allow information to be shared with
Providers and staff at Lourdes Hospital related to Pediatric Obesity.
• Information sharing will be realized through collaboration of Nursing staff between Network
offices, as well through Providers and Nurse Manager
Keywords: Pediatric Obesity, Pediatrics
Posters: F7
LIVABLE COMMUNITIES ALLIANCE: A COLLABORATION FOR A SUSTAINABLE
LIVABLE REGION
Caroline P. Quidort, AICP, City of Binghamton
Amelia LoDolce, City of Binghamton
Tarik Abdelazim, Formerly of City of Binghamton
Background Issue/Project Objectives: Identify the specific issue, problem, or need that the
project was designed to address and state the purpose or primary objective(s) of the project.
The Broome-Tioga region has a history of successful collaborative initiatives that have
implemented a spectrum of programs and projects. Through these collaborative efforts it was
discovered that various organizations were working towards similar goals but had not fully
realized the synergistic nature of the work. In 2010 the City of Binghamton in association with
representatives from the local office of the NYS Department of Transportation, the Broome
County Health Department, Binghamton Regional Sustainability Coalition, Binghamton
Metropolitan Transportation Study, Broome County Planning Department and local public
broadcast station WSKG collaborated to establish the Livable Communities Alliance (LCA)
which builds upon previous successful intermunicipal collaborations, including the Broome
County Strategic Alliance for Health. The LCA is an open collaborative of diverse
professionals, organizations and concerned citizens created to preserve and enhance the quality
of life of rural and urban communities while strengthening the regional economy in Broome and
Tioga County. The LCA hopes to achieve these goals by providing educational programming,
opportunities to engage in meaningful discourse, and support for regional planning initiatives.
Project Description: Provide a brief description of the program or intervention including a brief
description of the background evidence that supported development of the program or
intervention.
Growing out of the success of Broome County’s Strategic Alliance for Health, the Livable
Communities Alliance was convened in early 2010 to provide a forum to share information on
the myriad of work occurring in the region that is supportive of the principles of smart growth
and livability. The LCA developed a mission statement and agreed to guidance from the
principles of smart growth developed by Smart Growth America and the Livability Principles
developed for US EPA-DOT-HUD Partnership for Sustainable Communities. The LCA’s main
focus is to provide quality educational opportunities to members and the community at-large.
What began as weekly meetings of a core group of seven has resulted in two community events,
one with national speakers, and the successful grant application and award of a $486,000 HUD
Community Challenge Planning Grant to the City of Binghamton which, among other
deliverables, will result in almost two years of programming for the LCA.
Project Evaluation: Describe specific process, outcome, or impact measures used to evaluate
the program or methods used to assess the effectiveness of the intervention. This section should
include either a narrative summary of the project results and/or quantitative analyses of
evaluative data.
No formal evaluation process has been developed for the LCA but some individual events have
been evaluated. An online survey of attendees from the 2011 May symposium was conducted.
Posters: F8
The attendance at LCA events, the number of endorsing partners, and the attendance at LCA
general meetings are tracked and feedback is monitored. Additionally, the City of Binghamton’s
successful award of the HUD Community Challenge Planning Grant application, which
incorporates the LCA and individual LCA partners can be seen as a success of the LCA’s efforts.
Challenges/Lessons Learned: Identify challenges encountered during project development,
implementation, or evaluation, and provide a summary of the lessons learned including
implications for future efforts in this area.
A priority of the LCA was not to develop another formal organization that would duplicate
efforts of a local non-profit. This resulted in a loosely governed alliance with limited resources
and limited ability to implement the educational goals. The on-going work of the LCA to create
educational opportunities and provide a forum for discourse will see continued success if
administrative and operational challenges are resolved.
Keywords: Sustainability, Livability, Collaboration
Posters: F8
WSKG’S WORKING ON WELLNESS INTIATIVE – COMMUNITY BASED
APPROACH TO ADDRESSING CHILDHOOD OBESITY
Jackie Stapleton, MS, Director of Education & Outreach, WSKG Public Broadcasting
Nancy Coddington, Community Outreach Coordinator, WSKG Public Broadcasting
Background: WSKG Public Broadcasting covers twenty-one counties across two states and is
posed to bring community organizations together to discuss and address important topics such as
childhood obesity. WSKG convenes local health, schools and organizations, combining their
synergy to address this topic in innovative ways. The current childhood obesity epidemic is the
result of many factors and may not be resolved by any single action. Rather, resolution of the
childhood obesity epidemic will require concerted action across many sectors and settings such
as child care facilities, communities, and schools. Several approaches to tackle this problem
offer effective tools for families to address this complex issue.
Project Description: Through the Working on Wellness initiative, WSKG has connected our
community with experts in childhood obesity, offered engaging educational resources and
programs and provided our community with tools to make a change. Programming included Art
for the Heart billboard contest, After School Fuel recipe contest, Stride with Pride pedometer
program, Songwriting Contest, family health education forums, radio community conversations
and our award winning children's show Move It! The Stride with Pride pedometer program
tracked student’s daily steps during the school day over a six week period.
Project Evaluation: The program saw an increase in the daily steps students took and created an
awareness of daily movement and exercise. In 2010, WSKG was awarded national recognition
from the Corporation for Public Broadcasting for the Working on Wellness project earning the
MySource Education Innovation Award. Working on Wellness was a three-year initiative
generously supported locally by the Conrad and Virginia Klee Foundation and nationally by the
Corporation for Public Broadcasting. WSKG remains committed to addressing childhood
obesity and is embarking on another three year community focused project.
Keywords: partnering with schools and community based organizations, Stride with Pride
walking program, movement in the classroom, media
Posters: F9
THE YMCA: ENSURING A HEALTHIER FUTURE FOR OUR YOUNGEST
GENERATION
Leigh Tiesi, Director of Childcare, YMCA of Broome County
Martin Dyson, Director of Health and Wellness, YMCA of Broome County
Background Issue/Project Objectives: In keeping with the Y’s mission to provide programs
that build a healthy spirit, mind and body for all, and to strengthen the foundations of community
through our focus on youth development, healthy living and social responsibility, the Y is
compelled to provide the healthiest environment and programs for all our participants, especially
for our 0-5 year-olds. This is all the more important in light of the declining health of the nation
and the increasing prevalence of childhood obesity.
Project Description: The YMCA of Broome County’s childcare program does as much as
possible to provide a healthy experience for the children in its’ care. Nutritionally, we follow the
CACFP guidelines regarding portion size, menu content, grouping of foods to ensure a balanced
eating plan, dairy (specifically milk). With regards to physical activity, we are fortunate to have
access to the full Y facility which includes swimming pool, gymnasium, playgrounds, group
exercise room and racquetball courts. All children participate in large motor activities in the
morning and the afternoon. For the 2-4 year olds, this includes swimming lessons twice a week.
We also have walking routes mapped out from our facility. We recently joined the Let’s Move!
campaign started by First Lady, Michelle Obama. Of the 5 components – physical activity,
screen time, food, beverages, breast-feeding – with just a few minor adjustments to our program,
we will be 100% aligned with their objectives.
Project Evaluation: Children that graduate from YMCA childcare are better prepared for school
compared to the other childcare providers in the area. We also believe that our participants are
healthier as a result of their involvement at the Y. Annually, all the children under our care must
have a physical and we must receive a medical statement from their doctor. In the past year, we
have only received one statement regarding an overweight child.
Challenges/Lessons Learned: A challenge we have encountered in recent months is to be able
to meet 100% of the dietary and beverage requirements (particularly the Let’s Move!
requirements) due to limited refrigeration space. After losing our kitchen in the floods of
September 2011, we were still able to set up a temporary kitchen so we can continue to provide a
well-balanced meal plan throughout the day.
Keywords: Childcare, healthy options, physical activity, YMCA
Posters: F10