Research Symposium 2021

The annual Research Symposium is a showcase of the hard work and dedication to intellectual curiosity by student doctors, residents, fellows, and faculty at KCU over the past year. We are so proud of their outstanding work and their contributions to the study of medicine through research. 

Research Symposium 2021

The annual Research Symposium is a showcase of the hard work and dedication to intellectual curiosity by student doctors, residents, fellows, and faculty at KCU over the past year. We are so proud of their outstanding work and their contributions to the study of medicine through research. 

2021 Research Symposium Award Recipients

We are proud to report that KCU’s Research Symposium event, April 6-9, 2021, hosted approximately 200 students from all of KCU’s academic programs. These students participated in producing 114 poster presentations and abstract submissions. Numerous faculty members participated in mentoring 19 KCU students in the live Zoom student presentations. Thirty-one KCU GME-Consortium Residents presented their research efforts from residency sites. Over the four days of the 2021 Research Symposium, an average of 130 people attended each of the live Zoom sessions.

All of this was done in a virtual format that exemplifies your resilience and commitment to research. The quality and value of the research presented this year was inspiring!

The 2021 Research Symposium award winners are in order by category below. Click on the red arrow to read the submission's accompanying abstract, if available.

Posters

College of Osteopathic Medicine

Introduction/Background: While performing en bloc dissections of the central nervous system, we found a novel connection between the occiput and the cervical spinal dura that has not been previously described. We termed this structure the ligamentum kryptos craniale (LKC). In this study, we provide a descriptive analysis of the LKC. Methods: A total of 13 cadavers were dissected.Two received total spinal laminectomy and 11 cadaver craniums were cut at the euryon in transverse section. Five of the 11 cadaver were hemisected to the level of C5. Measurements of the LKC were taken with Mitutoyo Absolute IP-67 digital calipers, and photo evidence was documented. Results: The LKC was found in all bodies (13 specimens). Its shape was triangular as it exited the foramen magnum and inserted onto the cervical spinal dura. Its origin spanned across the internal occipital crest, inferior ridge of the cerebellar fossa, and the opisthion. Measurements of the LKC were made and expressed as means ± SD including the length from origin to opisthion (1.94 ± 0.3 cm, N = 10), thickness at opisthion (0.58 ± 0.05 mm, N = 6), length from opisthion to cervical dura (10.51 ± 2.59 mm, N = 5) and width at opisthion (5.05 ± 0.44 cm, N = 10). Conclusion: Based on the findings of this study, we believe the LKC is a novel component of the cranium and cervical spine. In the clinical setting, the LKC may be relevant to unknown causes of head and neck pain.

Introduction/Background: Retinopathy of prematurity (ROP) is a complication occurring in most premature infants leading to visual impairment and possible blindness. Factors contributing to ROP development include chronic hypoxia and disordered vascular genesis primarily through the vascular endothelial growth factor (VEGF) signaling pathway. Premature infants are treated with laser surgery or intraocular injections of bevacizumab (Avastin) to prevent ROP progression. Bevacizumab, an inhibitor of VEGF signaling, may have positive effects on preventing ROP, but may worsen lung function and promote pulmonary hypertension. Our study aimed to review outcomes of infants with ROP to determine factors associated with laser surgery versus bevacizumab and assess differences in growth and respiratory outcomes up to 24 months of age. Retrospective data was collected from infants at risk of needing treatment for ROP at Children's Mercy Kansas City. Data included maternal and birth demographics and respiratory status at time of treatment. Subjects were divided into three groups based on whether they were treated with bevacizumab, laser surgery, or no treatment. Statistical analysis was performed using SPSS 24 with continuous variables analyzed using Kruskal-Wallis Test and categorical data using ANOVA. We found the infant demographic was similar between the three groups, with the group undergoing laser surgery initially small for gestational age, requiring positive pressure ventilation, and having pulmonary hypertension. However, the infants receiving laser surgery showed better growth parameters and less respiratory support requirements. We concluded that infants undergoing laser surgery for ROP initially display more severe lung disease but may benefit in respiratory function and growth.

College of Biosciences

Introduction/Background: SARS-CoV-2 is part of the class of coronavirus responsible for the infectious COVID-19 pandemic, and although recent studies have shown greater severity in male patients, the genetic variants associated with disease severity in female patients have not been extensively investigated. Research suggests that membrane cholesterol plays a significant role in the entry regulation of the virus. High plasma levels of HDL (high density lipoprotein)-cholesterol reduce the amount of membrane cholesterol, potentially dampening endocytosis of the virus into the host cell. Hypothesis: Female patients over 60 years-old that tested positive for COVID-19 with reduced levels of HDL-cholesterol expression have an increased risk of being hospitalized for severe symptoms. Methods: We used bioinformatics tools to analyze RNA-Seq data isolated from peripheral blood and obtained from Gene Expression Omnibus (GEO). Using the randomizer tool in Microsoft Excel, we selected 20 female patients (from a total of 126) over and under 60 years-old diagnosed with COVID-19. The patients were equally divided into four cohorts: non-ICU > 60 years-old, ICU > 60 years-old, non-ICU < 60 years-old, ICU < 60 years-old. Results and Conclusions: Our analysis examines the gene expression patterns of HDL-cholesterol based on age and severity of COVID-19 symptoms. Our findings should contribute to the ongoing search for factors that affect severity of COVID-19 immune response.

Introduction/Background: scaRNAs are small nucleolar RNAs located in the Cajal body and involved in directing biochemical modification at specific nucleotides in spliceosomal RNAs (snRNAs). Our previous studies focused on analyzing heart tissue from infants with Tetrology of Fallot (TOF), a severe congenital heart defect (CHD). This research revealed that 12 scaRNAs are involved in regulating alternative splicing of mRNA and influencing vertebrate heart development. Two of these scaRNAs have been investigated in our lab so far, scaRNA1 and snord94, using human embryonic cells, and zebrafish and quail embryos. Knockdown of these scaRNAs resulted in a disruption of heart development and an alteration in cardiac regulatory genes. Due to these promising results, the next logical step is to investigate the impact of the other 10 scaRNAs. I will focus on two of those scaRNAs (scaRNAs 2 and 9) that target multiple nucleotides for biochemical modification. I expect that these two scaRNAs may have significant influence on spliceosome function. I will develop and characterize tools for modifying the expression of scaRNAs 2 and 9 so that we can investigate their influence on the spliceosome and cardiac development. I will present my current progress in examining the biochemical mechanisms that may contribute to CHD, specifically to TOF.

Oral Presentations

College of Osteopathic Medicine

No abstract available.

College of Biosciences

Introduction/Background: Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease (CHD). While TOF has unknown etiology, our team’s previous research has identified two potential contributors to TOF: dysregulation of small noncoding RNAs (ncRNAs) and an increase in mRNA splice isoforms. A different category of non-coding RNAs, long non-coding RNAs (lncRNAs), are greater than 200 nucleotides in length and have recently been associated with a wide range of diseases. However, no one has examined the potential contributory role of lncRNAs in TOF. To investigate the dysregulation of lncRNAs in TOF, an expression analysis was performed to compare lncRNA expression levels in right ventricular tissue from TOF patients vs control tissue. After Benjamini correction for multiple testing (p=.01), 45 lncRNAs were found to have significantly dysregulated expression (36 downregulated, 9 upregulated). Further bioinformatic analysis of the downstream regulatory effects of these lncRNAs indicate that lncRNAs may impact the expression of key cardiac developmental genes including PITX2 and FOS. These data suggest lncRNAs are a novel contributor of developmental dysregulation that warrant further research.

Summer Student Research Fellowship Presentations

Introduction/Background: Head and neck squamous cell carcinoma (HNSCC) resistance to radiotherapy has prompted a need to develop adaptive radiation therapy protocols to improve patient outcomes. This study investigates the hypothesis that lipid metabolism regulates cell cycle phase specific radiation sensitivity of HNSCC cells. Previous studies showed that HNSCC tumors with more G0+G1 phase cells (low proliferative index, LPI) are resistant to radiation versus HNSCC tumors with more S+G2 phase cells (high proliferative index, HPI). RNA-seq and bioinformatics identified lipid metabolism as the major intrinsic pathway that differs between HPI and LPI HNSCC cultures. mRNA and protein levels of G0-G1 Switch 2 (G0S2) gene, regulator of quiescence and lipid metabolism, were upregulated in LPI compared to HPI HNSCC cultures. G0S2 negatively regulates adipose triglyceride lipase (ATGL), resulting in less lipolytic activity. siG0S2 treatment of LPI cultures recruited cells into the proliferative cycle and exacerbated radiation sensitivity. To override G0S2 action, we incubated LPI cultures with the fatty acid palmitate and examined cellular metabolic stress markers. Compared to controls, LPI cultures treated with palmitate showed increased reactive oxygen species levels, lipid peroxidation and oxygen consumption rate coupled with increased mitochondrial fission. Palmitate also resulted in significant radiation sensitization. Furthermore, using the fluorescent based cell cycle real-time imaging system, we showed that palmitate treatment sustained cell proliferation (higher S+G2) compared to controls (higher G1). In summary, we demonstrate that G0S2 dependent lipid metabolism regulates cell cycle phase specific radiation sensitivity of HNSCC cells and identified G0S2 and palmitate as novel targets for radiation therapy.

Introduction/Background: Recent studies have revealed 3D-printers capable of producing sterile components from non-sterile feedstock of thermoplastic without treatment after fabrication (Neches et al., 2016). However, the ability to re-sterilize these products for repeat use remained difficult due to the inherent porosity derived from the internal lattice structure, or “infill” traditionally used in 3D printing. This problem can be circumvented by producing objects via single-walled polypropylene printing, thus revolutionizing 3D printing’s role in the medical industry. The 3D-printer offers an expansive avenue for medical devices and industrial use. Amongst the most important of the medical devices in current pandemic include personal protective equipment (PPE), intubation tubing, negative pressure regulation, and surgical replacements. For healthcare workers to properly handle situations with infectious or toxic exposure their own protection is paramount. A nationwide scarcity of N95 masks has provided a major problem revealing our community’s need for alternative solutions in either the industrial or biomedical fields, or both. Here we provide a single-walled polypropylene 3D-printed mask production and sanitization protocol that could likely be incorporated into the current biomedical and industrial food production settings. The sole use of single-walled polypropylene approach we describe renders these 3D-printed masks durable, chemically resistant, easy to sanitize, reusable and extremely versatile with respect to their filtration assembly. Our data open the possibility of future efforts focused on widening the use of the single-walled polypropylene 3D-printing approach to additional applications other than N95-like masks for use in industrial and biomedical settings.

Resident Research Award

Introduction/Background: Vertigo is defined as an illusion of motion caused by a mismatch of information between the visual, vestibular, and somatosensory systems. The most common diagnosis associated with whirling vertigo is Benign Paroxysmal Positional Vertigo (BPPV). This affects approximately 3.4% of patients greater than 60 years of age. Objective: This paper aims to educate primary care providers on how to diagnose BPPV by performing the canalith repositioning maneuvers (CRM) at the initial point of care. Timely treatment of BPPV in the primary care office is believed to reduce healthcare costs by way of limiting unnecessary diagnostic testing and lowering referrals for specialty care. Immediate treatment is also believed to improve the quality of healthcare delivery for the vertigo patient by reducing morbidity and resolving the condition without the need for referrals or imaging. Population Health: Cost, Access, Quality: A review of the literature finds that delayed diagnosis and treatment of BPPV is associated with a host of deleterious effects on patients. Population health impacts include increased rates of anxiety and depression, loss of work, and/or change of career paths, inappropriate use of medications, inappropriate use of emergency care resources, decreased access to healthcare services, increasing healthcare costs, and reduced quality of care. Diagnosis: A history of positional vertigo and evidence of nystagmus with Dix-Hallpike positioning confirms the diagnosis. A detailed description of the performance of this test is elucidated. Treatment: The observed nystagmus is analyzed and classified based on directionality. Treatment can be initiated immediately with canalith repositioning maneuvers.

Introduction/Background: Frailty describes a state of reduced physiologic reserve and risk for poor surgical outcomes. A frailty index validated in surgical populations uses a series of variables found to predict mortality in the aging population. In this study, attending surgeons were blinded to the index result. They then made a determination of the patient’s frailty status based on typical clinical history and physical exam. Patients aged 60 and older presenting for elective surgery were included. (Who did we exclude?) The ability of the surgeons to predict frailty was assessed. A total of 43 patients with an average age of 69.6 (±7.2) years old participated. The 12 patients whose surgeon determined they were frail (M=17.6, SD = 7.6) compared to the 31 patients whose surgeon determined them as non-frail (M = 11.9, SD = 9.2) demonstrated no statistical difference in the total frailty score (p=0.06). The Cohen’s Kappa Statistic used to assess agreement between the surgeon’s determination and total frailty score showed agreement of 62.8% or fair agreement (Cohen’s Kappa = 0.232). The total frailty score was 5.6 points higher in the frail group versus the non-frail group according to the surgeon’s opinion. There is a fair agreement between the surgeon’s opinion and total frailty score. This study demonstrates that clinical impression alone is insufficient to adequately predict frailty, and therefore risk of morbidity and mortality with elective surgeries in the aging population. The routine use of a frailty index can assist with properly counseling the aging population in the pre-operative setting.

Yale U. Castlio, DO, Prize for Research Fund 2021 Honoree

Introduction/Background: Chronic ischemia causes a derangement in tissue healing. Induction of endothelial cells has been shown to rescue tissue from situations of ischemia. This induction can be performed via novel tissue nano-transfection (TNT). Induction of endothelial-like cells offers a viable therapeutic adjunct in the treatment of ischemic tissue and wound regeneration. This work builds on the recent report on the successful use of TNT delivery to convert fibroblasts into vascularly active cells in vivo. This research outlines the mechanism by which dermal fibroblasts can be converted vasculogenic cells in the use of tissue regeneration. METHODS Previous work from our lab identified the role of reprogramming factors, EFF (Etv2, Foxc2, and Fli1) in the induction of endothelial cells. To that end, C57BL/6 mice that were subjected to ischemic conditions and treated with TNTEFF. Tissue biopsies were then obtained from the mice. Specific fibroblasts were identified and isolated using fluorescent laser capture microdissection. Downstream analysis was then performed to identify the expression of endothelial markers. These endothelial markers, such as VEGFR2 and CDH5 serve as a proxy to measure the amount of vasculogenic conversion taking place. RESULTS There exists significant increase in expression of endothelial specific markers such as VEGFR2 and CDH5 in COL1A1 positive tissue elements treated with TNTEFF (n =3, p<0.05). CONCLUSION; This increase in expression mimics our hypothesis that TNTEFF can induce dermal fibroblasts to vasculogenic cells. The potential use will have profound impacts on reducing morbidity and mortality of ubiquitous diseases such as diabetes and peripheral artery disease.

Congratulations, everyone, on research well done!


Appreciation and Acknowledgements

Special appreciation and acknowledgement:

    • Gwen Dodd for her tremendous effort to organize the event. This was an especially challenging year due to the obstacles of COVID-19 and the necessity of changing the format to virtual. Without Gwen, there would have been no symposium.

    • Jeff Staudinger who worked tirelessly to get the symposium uploaded and presented virtually. Dr. Staudinger’s effort on behalf of student researchers should remind us all of what can be done if you believe in something and won’t take no for an answer.

    • Judges:
      Thank you to our many judges! Your contribution of time and expertise was invaluable.
      Amanda Walls
      Dr. Asma Zaidi
      Dr. Abdulbaki Agbas
      Dr. Barth Wright
      Dr. Bob Rogers
      Dr. Bradley Creamer
      Dr. Bruce Williams
      Dr. Carol Karila
      Dr. Charlie Withnell
      Dr. Cindy Schmidt
      Dr. David Sine
      Dr. Dennis Wolff
      Dr. Diane Karius
      Dr. Ehab Sarsour
      Dr. Eugene Konorev
      Dr. George Chou
      Dr. Jennifer Dennis
      Dr. Juan Jaramillo
      Dr. Ken Stewart
      Dr. Kerrie Jordan
      Dr. Kirby Randolph
      Dr. Marcus Iszard
      Dr. Mike Johnston
      Dr. Monica Kinde
      Dr. Nicole Ford
      Dr. Phil Brauer
      Dr. Pratima Singh
      Dr. Robynne Lute
      SD Naem Mufarreh
      Dr. Sharon Gordon

  • Missouri Southern State University (MSSU) for their kindness and collaborative spirit in enabling this momentous event. Specifically, Drs. Alan Marble, Paula Carson, Marsi Archer, Donna Johnson and Crystal Lemmons were instrumental in driving the formation of the MSSU-KCU Research Consortium (MKRC). They have provided free and unfettered access to their laboratory facilities throughout the process at the Reynolds Annex on the campus of MSSU. Furthermore, access to their ‘Southern’ WiFi network, in addition to their passion, drive and motivation for our regional collaboration and partnership was instrumental in making this wonderful event possible. Without their partnership none of this would have been possible.

  • Presenters - We hope you will continue to include research in your careers as you continue forward. Each of you should be proud of the work you did.