Institute News

Marshfield Clinic Research Foundation to cohost 22nd Annual HCSRN Conference

Tue, 09 Feb 2016 18:58:14 GMT

Marshfield Clinic Research Foundation (MCRF) will co-host the annual Health Care Systems Reseearch Network (HCSRN) conference along with Henry Ford Health System Research Centers (HFHS). The three-day conference will be held April 14-16, 2016 at the Hyatt Regency in Atlanta, GA. Robert Greenlee, PhD, MPH at MCRF and Lois Lamerato, PhD at HFHS are the Scientific Co-chairs. MCRF last cohosted the 14th annual meeting in 2008, in Minneapolis, MN.

The 2016 conference theme will be “Advancing Population Health: New Models and The Role of Research.” Visit www.HCSRNmeeting.org for more information about the conference

New Flu Vaccine Research Highlights Variable Protection Against Vaccine Strains

Tue, 05 Apr 2016 18:50:00 GMT

A systematic review of nearly a decade of influenza studies across the globe shows influenza vaccines provided substantial protection against the H1N1 strain that has circulated since the 2009 pandemic, and against type B viruses. The study also found that vaccination generates lower protection against the H3N2 viruses that have been infecting humans since the 1960s.

The findings are based on a report published in The Lancet Infectious Diseases. The analysis, which included studies published from 2007 through early 2015, was conducted by Edward Belongia, MD and colleagues at Marshfield Clinic Research Foundation (MCRF) and the University of Minnesota.

The research team screened 3,368 studies and selected 56 that met strict criteria for assessing vaccine effectiveness against different flu subtypes. Seasonal flu vaccines are updated each year and contain two subtypes of influenza A virus (H3N2 and H1N1) and one or two strains of influenza B.

The study team found that seasonal vaccines provided 61 percent protection against the H1N1 strain and 54 percent protection against type B. Vaccine protection was only 33 percent for the H3N2 strain. Although vaccine effectiveness can decline in older adults due to aging of the immune system, the review found that protection against H1N1 and type B was maintained even in the oldest age groups.

“It’s reassuring to see that flu vaccines around the world consistently provide moderately high protection against two major flu subtypes,” said Belongia, director, MCRF Center for Clinical Epidemiology & Population Health. “This year we are seeing mostly H1N1 and B infections, and mid-season estimates from the U.S. and Canada show substantial vaccine protection as expected based on our systematic review.”

Influenza seasons are unpredictable with circulation of different virus subtypes. Seasons with mostly H3N2 viruses tend to be more severe, and H3N2 evolves more rapidly to evade the immune system compared to other flu viruses.

“The reasons for lower vaccine protection against H3N2 are unclear, but we suspect continuous virus evolution in nature and egg-based vaccine production may be contributing,” Belongia said. When H3N2 vaccine strains are adapted to grow in eggs, mutations can occur that affect the ability of the immune system to target the virus.

The review included studies that measured vaccine effectiveness by comparing vaccination frequency in patients with lab confirmed flu and in control patients who had a similar illness but tested negative for the flu virus. This “test-negative” approach was first used in 2005 and has been widely adopted in several countries. Three quarters of the studies included in the review were conducted in Europe or North America, and over 90 percent were published after 2010.

MCRF has conducted annual studies of influenza vaccine effectiveness for the past 12 years. There was no funding source for this study.

A copy of this paper can be found at http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(16)00129-8/abstract.

Marshfield Clinic Earns Accreditation for Human Subject Research Protection

Thu, 26 Mar 2015 20:11:02 GMT

Marshfield Clinic’s human research protection program has earned national recognition for its commitment to protect research participants.

The Clinic was accredited by the Association for the Accreditation of Human Research Protection Programs, Inc. (AAHRPP), which promotes high-quality research through an accreditation process that helps organizations worldwide strengthen human research protection programs.

This accreditation demonstrates Marshfield Clinic Research Foundation (MCRF) strengthened protections for research participants, which helps build public trust and confidence in research.

AAHRPP accreditation is considered the gold standard for quality research programs. All major U.S. independent institutional review boards (IRB) are AAHRPP accredited. More than 60 percent of U.S. research-intensive universities and 65 percent of U.S. medical schools are either AAHRPP accredited or have begun the accreditation process.

“Accreditation demonstrates our ongoing commitment to human subjects’ protections and quality in research,” said Steve Ziemba, PhD, MCRF associate director. “It also raises our national profile and makes the Clinic a more attractive option for clinical trials and research.”

The process began more than two years ago after the University of Wisconsin and the Medical College of Wisconsin, which partners with MCRF on numerous research projects, received accreditation.

“We saw their programs go through the process and recognized the value they received,” said Linda Jaros, Clinic research compliance officer. “We knew our program was of high quality and a candidate for accreditation so we committed to the process.”

MCRF conducted a thorough review of policies and procedures and submitted more than 500 pages that detailed quality measures and other requirements. An AAHRPP site visit last fall further documented the Clinic’s commitment to quality improvement.

Lori Scheller, MCRF IRB administrator, said federal regulation guidelines are considered a baseline for compliance. Accreditation has a higher level of compliance.

“Sponsors for medical device manufacturers and pharmaceutical companies look for an organization or research program doing human research trials above and beyond federal regulations,” Scheller said. “This gives us a competitive advantage when pharmaceutical sponsors are looking for trial sites. They know we run quality research programs.”

Some of the Clinic’s research collaborations require data and specimen sharing among accredited institutions. This ensures privacy, data protection, and bio-banking meet high standards and demonstrates a built-in trust between institutions.

Study: New approach helps ID possible novel uses for existing drugs

Tue, 21 Apr 2015 20:37:25 GMT

Finding new uses for existing drugs has become increasingly important for treating diseases. A Marshfield Clinic-led research team has proven a new way to speed up the process, according to a study published Wednesday, April 8, in Nature Biotechnology.

Drug repurposing is the process of discovering new uses for existing drugs. The process is becoming increasingly important in drug development as success rates for new drugs in clinical trials decrease and costs increase. Initially identifying candidate drug-disease relationships is critical to drug repurposing.

Using a type of genetic study called a phenome-wide association study, researchers identified thousands of potential disease and drug relationships. This could serve as an early clue when looking for drugs that may effectively treat diseases they are not currently prescribed for.

“This is a proof of principle study demonstrating phenome-wide association data may be rapidly applied to developing or repurposing existing drugs,” said Scott Hebbring, Ph.D., principal investigator and research scientist, Marshfield Clinic Research Foundation’s Center for Human Genetics. “Unlike other genetic-based approaches, a phenome-wide association study allows us to look at thousands of diseases at once, rather than just one disease at a time.”

A team of researchers, using the phenome-wide approach, identified more than 14,800 examples of where a drug might be used to treat an unrelated disease. They did this by cross-referencing drug-disease pairs identified by phenome-wide data with existing medical literature to find examples where a disease and drug were mentioned in the same article.

“While we didn’t provide context for these relationships, we hope these novel findings offer researchers clues that allow them to prioritize which potential relationships to study first,” Hebbring said. “That, in turn, could help us more quickly find new uses for current drugs.”

They also found more than 38,000 novel drug-disease relationships not yet studied, according to the medical literature. These results suggest phenome-wide association study data may bring to light many additional diseases that may be treated with already developed drugs.

To read the full study, go to Nature Biotechnology.

April 2015 Publications

Wed, 20 May 2015 13:54:29 GMT

Almane D, Jones JE, Jackson DC, Seidenberg M, Koehn M, Hsu DA, Hermann BP. Brief clinical screening for academic underachievement in new-onset childhood epilepsy: Utility and longitudinal results. Epilepsy Behav. 2015 Feb;43:117-21.

Elhendy A. Prognostic significance of ischemia location on stress myocardial perfusion SPECT: Tracing the fingerprints of the widow maker. J Nucl Cardiol. 2015 Apr 2. [Epub ahead of print]

Engel JM, Stankowski-Drengler TJ, Stankowski RV, Liang H, Doi SA, Onitilo AA. All-cause mortality is decreased in women undergoing annual mammography before breast cancer diagnosis. AJR Am J Roentgenol. 2015 Apr;204(4):898-902.

Griesbach S, Lustig A, Malsin L, Carley B, Westrich KD, Dubois RW. Best practices: an electronic drug alert program to improve safety in an accountable care environment. J Manag Care Spec Pharm. 2015 Apr;21(4):330-6.

Martin RF. Perioperative management. Surg Clin North Am. 2015 Apr;95(2):xiii-xiv.

Preston JF, Diggs BS, Dolan JP, Gilbert EW, Schein M, Hunter JG. Biliary dyskinesia: a surgical disease rarely found outside the United States. Am J Surg. 2015 Feb 13. pii: S0002-9610(15)00058-6.

March 2015 Publications

Wed, 13 May 2015 18:12:38 GMT

Almane D, Jones JE, Jackson DC, Seidenberg M, Koehn M, Hsu DA, Hermann BP. Brief clinical screening for academic underachievement in new-onset childhood epilepsy: Utility and longitudinal results. Epilepsy Behav. 2015 Feb;43:117-21.

Elhendy A. Prognostic significance of ischemia location on stress myocardial perfusion SPECT: Tracing the fingerprints of the widow maker. J Nucl Cardiol. 2015 Apr 2. [Epub ahead of print]

Engel JM, Stankowski-Drengler TJ, Stankowski RV, Liang H, Doi SA, Onitilo AA. All-cause mortality is decreased in women undergoing annual mammography before breast cancer diagnosis. AJR Am J Roentgenol. 2015 Apr;204(4):898-902.

Griesbach S, Lustig A, Malsin L, Carley B, Westrich KD, Dubois RW. Best practices: an electronic drug alert program to improve safety in an accountable care environment. J Manag Care Spec Pharm. 2015 Apr;21(4):330-6.

Martin RF. Perioperative management. Surg Clin North Am. 2015 Apr;95(2):xiii-xiv.

Preston JF, Diggs BS, Dolan JP, Gilbert EW, Schein M, Hunter JG. Biliary dyskinesia: a surgical disease rarely found outside the United States. Am J Surg. 2015 Feb 13. pii: S0002-9610(15)00058-6.

Peissig Named BIRC Director

Mon, 23 Feb 2015 16:21:08 GMT

Peggy Peissig, PhD, MBA, has been named Director of the Biomedical Informatics Research Center (BIRC) at Marshfield Clinic Research Foundation (MCRF). “Peggy has shown outstanding leadership serving as the Interim Director and we are delighted that she has accepted the position of Director,” said Dr. Robert Steiner, MCRF Executive Director. “Dr. Peissig will also serve as Chief Research Informatics Officer for MCRF.”

BIRC conducts cutting-edge biomedical research and translates scientific discoveries into clinical and dental practice through innovation, collaboration, and application of informatics best practices to improve patient health. “We use information technology to solve clinical problems so that our physicians can benefit and provide the best possible care to the patient,” Peissig said. “It’s our way of helping Marshfield Clinic patients.”

BIRC is involved in many of the integral day-to-day operations and behind-the-scene work that support research and MCRF operations. BIRC provides analytics, data knowledge, application development, software evaluation, and a state-of-the-art computing environment to its researchers. BIRC’s research makes a difference in patient care. For example, BIRC recently collaborated with representatives from the Center for Human Genetics, Marshfield Laboratory, Pharmacy, and Marshfield Clinic Information Systems to develop drug prescribing alerts that notify physicians of a possible adverse drug reaction when prescribing a medication to a patient. These alerts are based on a patient’s genetic makeup and reaction to a specific medication.

Dr. Peissig is a nationally recognized expert in electronic health record (EHR) phenotyping. Peissig specializes in the application of machine learning methods for detecting adverse drug events and EHR phenotyping; implementing pharmacogenomics alerts into clinical practice; and evaluating brand-name and generic medication utilization and patient outcomes. She has published over 45 original peer-reviewed publications and retains solid research grant funding from the National Institute of Health and the FDA.

Dr. Peissig has contributed to the success of Marshfield Clinic Health System for almost 25 years, with more than two decades of experience in the area of information technology and translational and clinical informatics. While working in Marshfield Clinic Information Systems, Peissig led the development of the enterprise data warehouse along with overseeing decision support and administrative systems development.

“Peggy has done a tremendous job leading BIRC as interim director and has contributed to the success of Marshfield Clinic Health System in many different ways over the past 25 years,” said Dr. Robert Steiner. “We very much look forward to her continuing to lead this vital research center.”

February 2015 Publications

Tue, 17 Mar 2015 17:08:26 GMT

Belongia EA, Sundaram ME, McClure DL, Meece JK, Ferdinands J, VanWormer JJ. Waning vaccine protection against influenza A (H3N2) illness in children and older adults during a single season. Vaccine. 2015 Jan 1;33(1):246-51.

Bibbo C, Nelson J, Ehrlich D, Rougeux B. Bone morphogenetic proteins: indications and uses. Clin Podiatr Med Surg. 2015 Jan;32(1):35-43.

Chong JX, McMillin MJ, Shively KM, Beck AE, Marvin CT, Armenteros JR, Buckingham KJ, Nkinsi NT, Boyle EA, Berry MN, Bocian M, Foulds N, Uzielli ML, Haldeman-Englert C, Hennekam RC, Kaplan P, Kline AD, Mercer CL, Nowaczyk MJ, Klein Wassink-Ruiter JS, McPherson EW, Moreno RA, Scheuerle AE, Shashi V, Stevens CA, Carey JC, Monteil A, Lory P, Tabor HK, Smith JD, Shendure J, Nickerson DA; University of Washington Center for Mendelian Genomics, Bamshad MJ. De Novo Mutations in NALCN Cause a Syndrome Characterized by Congenital Contractures of the Limbs and Face, Hypotonia, and Developmental Delay. Am J Hum Genet. 2015 Mar 5;96(3):462-73. doi: 10.1016/j.ajhg.2015.01.003. Epub 2015 Feb 12.

Darghosian L, Free M, Li J, Gebretsadik T, Bian A, Shintani A, McBride BF, Solus J, Milne G, Crossley GH, Thompson D, Vidaillet H, Okafor H, Darbar D, Murray KT, Stein CM. Effect of omega-three polyunsaturated fatty acids on inflammation, oxidative stress, and recurrence of atrial fibrillation. Am J Cardiol. 2015 Jan 15;115(2):196-201. doi: 10.1016/j.amjcard.2014.10.022. Epub 2014 Oct 29.

Havers FP, Flannery B, Clippard JR, Gaglani M, Zimmerman RK, Jackson LA, Petrie JG, McLean HQ, Nowalk MP, Jackson ML, Monto AS, Belongia EA, Eng HF, Lamerato L, Campbell AP, Fry AM. Use of influenza antiviral medications among outpatients at high risk for influenza-associated complications during the 2013-14 influenza season. Clin Infect Dis. 2015 Feb 25. pii: civ146. [Epub ahead of print]

Kanth R, Mali P, Roy PK. Outcomes in Dieulafoy's Lesion: A 10-Year Clinical Review. Dig Dis Sci. 2015 Feb 8. [Epub ahead of print]

Khan AN, Sabbagh S, Ittaman S, Abrich V, Narayan A, Austin B, Rezkalla SH. Outcome of Early Revascularization Surgery in Patients with ST-Elevation Myocardial Infarction. J Interv Cardiol. 2015 Feb;28(1):14-23.

King JP, McCarthy DM, Serper M, Jacobson KL, Mullen RJ, Parker RM, Wolf MS. Variability in Acetaminophen Labeling Practices: a Missed Opportunity to Enhance Patient Safety. J Med Toxicol. 2015 Feb 20. [Epub ahead of print]

Klein NP, Lewis E, Fireman B, Hambidge SJ, Naleway A, Nelson JC, Belongia EA, Yih WK, Nordin JD, Hechter RC, Weintraub E, Baxter R. Safety of measles-containing vaccines in 1-year-old children. Pediatrics. 2015 Feb;135(2):e321-9.

Lewis MA, Zhao F, Jones D, Loprinzi CL, Brell J, Weiss M, Fisch MJ. Neuropathic Symptoms and Their Risk Factors in Medical Oncology Outpatients with Colorectal versus Breast, Lung or Prostate Cancer: Results from a Prospective Multicenter Study. J Pain Symptom Manage. 2015 Jan 13. pii: S0885-3924(15)00035-4. doi: 10.1016/j.jpainsymman.2014.11.300. [Epub ahead of print]

Lipke MM, Cutlan JE, Smith AC. Cold panniculitis: delayed onset in an adult. Cutis. 2015 Jan;95(1):21-4.

Martin RF. Caring for geriatric surgical patients. Surg Clin North Am. 2015 Feb;95(1).

McPherson E, Cold C, Johnson P, Schema L, Zaleski C. Neuroblastoma in a 17-week fetus: a stimulus for investigation of tumors in a series of 2786 stillbirth and late miscarriages. Am J Med Genet A. 2015 Jan;167A(1):246-9.

Nguyen NP, Davis R, Bose SR, Dutta S, Vinh-Hung V, Chi A, Godinez J, Desai A, Woods W, Altdorfer G, D'Andrea M, Karlsson U, Vo RA, Sroka T; International Geriatric Radiotherapy Group. Potential applications of image-guided radiotherapy for radiation dose escalation in patients with early stage high-risk prostate cancer. Front Oncol. 2015 Feb 2;5:18.

O'Connor PJ, Schmittdiel JA, Pathak RD, Harris RI, Newton KM. Response to comment on O'Connor et Al. Randomized trial of telephone outreach to improve medication adherence and metabolic control in adults with diabetes. Diabetes care 2014;37:3317-3324. Diabetes Care. 2015 Mar;38(3).

Osterholm MT, Kelley NS, Belongia EA, Jackson LA, Jackson ML. Reply: Cochrane rearranged. Vaccine. 2015 Jan 1;33(1):12.

Othman RA, Myrie SB, Mymin D, Merkens LS, Roullet JB, Steiner RD, Jones PJ. Ezetimibe reduces plant sterol accumulation and favorably increases platelet count in sitosterolemia. J Pediatr. 2015 Jan;166(1):125-31.

Patel MB, Humble SS, Cullinane DC, Day MA, Jawa RS, Devin CJ, Delozier MS, Smith LM, Smith MA, Capella JM, Long AM, Cheng JS, Leath TC, Falck-Ytter Y, Haut ER, Como JJ. Cervical spine collar clearance in the obtunded adult blunt trauma patient: A systematic review and practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2015 Feb;78(2):430‑41.

Rohr JR, Civitello DJ, Crumrine PW, Halstead NT, Miller AD, Schotthoefer AM, Stenoien C, Johnson LB, Beasley VR. Predator diversity, intraguild predation, and indirect effects drive parasite transmission. Proc Natl Acad Sci U S A. 2015 Mar 10;112(10):3008-13.

Rutter CM, Greenlee RT, Johnson E, Stark A, Weinmann S, Kamineni A, Adams K, Doubeni CA. Prevalence of colonoscopy before age 50. Prev Med. 2015 Mar;72:126-9.

Salanova V, Witt T, Worth R, Henry TR, Gross RE, Nazzaro JM, Labar D, Sperling MR, Sharan A, Sandok E, Handforth A, Stern JM, Chung S, Henderson JM, French J, Baltuch G, Rosenfeld WE, Garcia P, Barbaro NM, Fountain NB, Elias WJ, Goodman RR, Pollard JR, Tröster AI, Irwin CP, Lambrecht K, Graves N, Fisher R; SANTE Study Group. Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy. Neurology. 2015 Mar 10;84(10):1017-25.

Searles Nielsen S, Checkoway H, Zhang J, Hofmann JN, Keifer MC, Paulsen M, Farin FM, Cook TJ, Simpson CD. Blood α-synuclein in agricultural pesticide handlers in central Washington State. Environ Res. 2015 Jan;136:75-81.

Singh VK, Vaish M, Johansson TR, Baum KR, Ring RP, Singh S, Shukla SK, Moskovitz J. Significance of Four Methionine Sulfoxide Reductases in Staphylococcus aureus. PLoS One. 2015 Feb 13;10(2):e0117594.

Vazquez-Benitez G, Desai JR, Xu S, Goodrich GK, Schroeder EB, Nichols GA, Segal J, Butler MG, Karter AJ, Steiner JF, Newton KM, Morales LS, Pathak RD, Thomas A, Reynolds K, Kirchner HL, Waitzfelder B, Elston Lafata J, Adibhatla R, Xu Z, O'Connor PJ. Preventable Major Cardiovascular Events Associated With Uncontrolled Glucose, Blood Pressure, and Lipids and Active Smoking in Adults With Diabetes With and Without Cardiovascular Disease: A Contemporary Analysis. Diabetes Care. 2015 Feb 20.

Wiley JR, Shivaram P, Resnick JM, Fish DL, Park RW, Haws RM. Diarrhea in a post-renal transplant child: Questions. Pediatr Nephrol. 2015 Apr;30(4):589-90.

Wiley JR, Shivaram P, Resnick JM, Fish DL, Park RW, Haws RM. Diarrhea in a post-renal transplant child: Answers. Pediatr Nephrol. 2015 Apr;30(4):591-3.

Ye Z, Mayer J, Ivacic L, Zhou Z, He M, Schrodi SJ, Page D, Brilliant MH, Hebbring SJ. Phenome-wide association studies (PheWASs) for functional variants. Eur J Hum Genet. 2015 Apr;23(4):523-9.

Commonwealth Fund Spotlights Oral Health

Mon, 02 Mar 2015 17:54:58 GMT

In Focus: Integrating Oral Health into Primary Care

This article touches upon the importance of integrating oral health as part of improving the overall quality of health. It also highlights the important work at the Marshfield Clinic Health System in which the Family Health Center and Institute for Oral and Systemic Health are involved. As you will read in the article, oral health is an important area that is currently being discussed at the national level.

Clinic researchers' study finds prior flu season vaccines may provide residual protection

Wed, 08 Oct 2014 18:31:29 GMT

Influenza vaccines given in prior years may provide protection against the flu for more than one year, according to a study published online Monday, Sept. 29, in the journal Clinical Infectious Diseases.

The study, conducted by flu experts at Marshfield Clinic Research Foundation (MCRF) and the Centers for Disease Control and Prevention (CDC), also reported protection from the flu, due to vaccination, was greatest among people who had no history of flu vaccination in the prior five years.

“We found current season influenza vaccines were effective against the flu regardless of vaccine history, showing that vaccination still offers the best prevention against getting the flu. Study participants who were unvaccinated were the most likely to get the flu,” said Huong McLean, Ph.D., an MCRF epidemiologist and the study’s lead investigator.

For the observational study, researchers looked at the effect of prior flu vaccinations on current season effectiveness over eight seasons, in patients participating in an annual vaccine effectiveness study at Marshfield Clinic. Researchers collected samples from patients who went to the doctor with flu-like symptoms and calculated vaccine protection by comparing the flu rate in vaccinated and unvaccinated people.

“Other studies have looked at the effect of vaccination in the previous season, but this is the first study to look back at the five-year vaccination history and see how it affects vaccine protection in the current season,” McLean said.

Researchers found adults had similar levels of protection if they received the flu vaccine in the current season, the previous season or both seasons. They also found that vaccine effectiveness was 27-41 percent higher for adults who were vaccinated for the first time in the past five years, compared to those who got the vaccine almost every year. She said reasons for the increase in effectiveness is not yet clear and more research is needed to understand how repeated flu vaccination affects the immune system.

“This study raises questions about a complicated and important issue that needs to be examined further, preferably in a clinical trial,” McLean said. “Although this study raises some new questions, it also confirms that the flu vaccine is effective when given every year and it remains the best strategy for preventing serious flu infections.”

She also said getting vaccinated once every five years might provide better protection for that season but it would be a bad strategy during the other four seasons. Some flu seasons are mild, some are severe and it would be risky to skip vaccination.

The CDC recommends annual flu vaccination for all adults and children who are at least six months old. The vaccine is safe and effective.

This study was conducted using data collected from Marshfield Clinic for the U.S. Flu Vaccine Effectiveness Network. MCRF was the first Network site to receive CDC funding to study flu vaccine effectiveness and was the sole provider of this information for four flu seasons beginning in 2004-05.

The complete report is available online.

National Children's Center receives major grant for agriculture safety

Wed, 08 Oct 2014 18:35:56 GMT

Farm parents, insurers, youth organizations and others increasingly turn to the unique capabilities of the National Children’s Center for Rural and Agricultural Health and Safety, to help ensure the safety of the next generation of farmers.

Recognizing the role played by the National Children’s Center in the steady decline of childhood agricultural nonfatal injury rates over the past decade, the National Institute for Occupational Safety and Health (NIOSH) announced Sept. 25 that it’s awarding the Center a $1.2 million per year competitive grant renewal for a five-year cycle.

NIOSH has funded the National Children’s Center since 1997. It also is supported by Marshfield Clinic and through generous donations and other grants.

The National Children’s Center is a program of the National Farm Medicine Center, Marshfield Clinic Research Foundation (MCRF).

“This major award will significantly expand our efforts to integrate proven safety strategies into programs of organizations and businesses that are best-positioned to influence the safety of children living and working on farms,” said Barbara Lee, Ph.D., National Children’s Center director. “We expect to facilitate partnerships with private sector organizations such as agricultural employer associations, insurance companies, bankers and youth-serving groups. We want to ensure that optimal safety interventions and guidelines are sustained beyond the span of the grant period.

“Innovative approaches will address safety for beginning farmers and ranchers; child care services for migrant and seasonal farm worker parents; and supervisor training of youth hired for agricultural employment.”

While the overall decrease in childhood nonfatal injury rates is encouraging, a child is killed in a farm accident an average of every three days, indicating there’s work to be done. Also of concern is the injury rate for children younger than age 10 is increasing.

The new NIOSH grant includes seven distinct projects, along with administrative, scientific and evaluation oversight. Principal investigators from MCRF include Lee; Barbara Marlenga, Ph.D.; Matthew Keifer, M.D.; and Casper Bendixsen, Ph.D. External principal investigators include Amy K. Liebman, Migrant Clinicians Network; Dennis Murphy, Ph.D., Penn State University; and Diane Rohlman, Ph.D., University of Iowa.

Families Across the Country Supporting CRIBBS at MCRF

Fri, 03 Oct 2014 19:47:24 GMT

The world’s first rare disease registry for Bardet-Biedl Syndrome was launched at Marshfield Clinic Research Foundation at the end of June, 2014. To date, nearly 100 people from across the country have signed up to participate in the Clinical Registry Investigating BBS (CRIBBS). Funds are needed to ensure all of these interested individuals are able to enroll into the registry.

Realizing the future potential for BBS patients, members of the Bardet-Biedl Syndrome Family Association from across the country have rolled up their sleeves and are helping generate philanthropic support for CRIBBS. The first of volunteer fundraiser events will take place in Minneapolis, MN on September 22 and the second in Atlanta, Georgia on October 23. Proceeds from both of these events will support CRIBBS at MCRF.

Bring Light to BBS – Minneapolis: https://www.facebook.com/events/1462075820710171/

Donation page: http://cribbs.kintera.org/BringLight2BBSmpls

Bring Light to BBS – Atlanta: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07e9s4lkodd16769e6&oseq=&c=&ch

Donation page: http://cribbs.kintera.org/BringLight2BBSatlanta

A video promo for the Minneapolis event is available here: http://www.youtube.com/watch?v=OM4-5271kUQ

ALS "Steps for Hope" Run/Walk and Ice Bucket Challenge

Thu, 18 Sep 2014 13:02:19 GMT

On Saturday, September 6th, over 300 people gathered at Wildwood Park in Marshfield to participate in the 1st Annual Amyotrophic Lateral Sclerosis (ALS) Steps for Hope event. This run/walk was organized by the Braun family in memory of their father and brother, John Braun.

With the goal of raising awareness for ALS and raising funds for ALS Research at Marshfield Clinic, the Braun family worked tirelessly for three months to plan and organize this inaugural event. Dr. Jaime Boero attended the event to speak about ALS and the importance of research in providing hope for future generations. ALS, often referred to as "Lou Gehrig's Disease," is a progressive neurodegenerative disease that affects nerve cells in the brain and the spinal cord. Marshfield Clinic would like to express our thanks to the Braun family for their enthusiasm and passion for ALS research.

As a way to promote the event, Darrin Braun challenged Jaime Boero, MD, PhD, Narayana Murali, MD, and his uncle, Gary Braun to participate in the Ice Bucket Challenge. In addition, Timothy Boyle, MD, Benjamin Lawler, MD, and Pete Schmeling also participated in the challenge, which took place on August 28th. Rules for this challenge, which raised millions of dollars for ALS research over the summer, are that those challenged must record a video of themselves announcing that they have accepted the challenge, nominate others for the challenge, and then have a bucket of icy water dumped over their heads.

United Nations Human Rights Office Interviews Dr. Murray Brilliant

Wed, 17 Sep 2014 17:39:38 GMT

On July 28, 2014 a representative from the United Nations Human Rights Office came to Marshfield to interview and film Dr. Murray Brilliant, Director of the Center for Human Genetics, on the conditions of people with albinism in East Africa. The interview will be part of the UN agency’s efforts to protect the rights and lives of people with albinism. Brilliant is an expert on the genetics of albinism, identifying three of the genes associated with the condition. One of the genes, OCA2, is associated with the most common form of albinism in Africa. Brilliant has described a common mutation in the OCA2 gene in Africa, implying that most Africans with albinism had a shared ancestor. His studies estimate that this ancestor lived about 2,500 years ago.

Africans with albinism are at a very high risk for skin cancer and because of a lack of treatment, most will die from this. Unfortunately, they face even more extreme peril in East Africa, where superstition holds that their bones, hair, and other body parts can be used magically. In the past, this was largely limited to grave robbing, but in the past few years living people are increasingly targeted and murdered for their body parts. Dr. Brilliant has worked to bring attention to their plight. You can view a Learning Channel Special, now on YouTube: (https://www.youtube.com/watch?v=9YjjzKusVu8) about these people. This ancestral OCA2 mutation is carried by nearly 1 in 19 Tanzanians. Ironically, it is highly likely that it is also carried by at least a few of the murderers of people with albinism. Perhaps if the people of Tanzania knew that albinism is a manifestation of one of their ancestors, the murders would stop. Brilliant is scheduled to speak at the PanAfrican Summit on Albinism in Dar Es Salaam, Tanzania, in January, 2015.

August 2014 Publications

Wed, 17 Sep 2014 15:13:48 GMT

Anderson JL, Dieckman JL, Reed KD, Meece JK. Canine Blastomycosis in Wisconsin: A Survey of Small-Animal Veterinary Practices. Med Mycol. 2014 Sep 3. [Epub ahead of print]

Aswani VH, Tremblay DM, Moineau S, Shukla SK. Complete Genome Sequence of a Staphylococcus epidermidis Bacteriophage Isolated from the Anterior Nares of Humans. Genome Announc. 2014 Aug 7;2(4).

Bethoux F, Rogers HL, Nolan KJ, Abrams GM, Annaswamy TM, Brandstater M, Browne B, Burnfield JM, Feng W, Freed MJ, Geis C, Greenberg J, Gudesblatt M, Ikramuddin F, Jayaraman A, Kautz SA, Lutsep HL, Madhavan S, Meilahn J, Pease WS, Rao N, Seetharama S, Sethi P, Turk MA, Wallis RA, Kufta C. The effects of peroneal nerve functional electrical stimulation versus ankle-foot orthosis in patients with chronic stroke: a randomized controlled trial. Neurorehabil Neural Repair. 2014 Sep;28(7):688-97.

Bibbo C, Ehrlich DA, Nguyen HM, Levin LS, Kovach SJ. Low Wound Complication Rates for the Lateral Extensile Approach for Calcaneal ORIF When the Lateral Calcaneal Artery Is Patent. Foot Ankle Int. 2014 Jul 1;35(7):650-656. [Epub ahead of print]

Chacón GR, Green CB, Kim SD, Stratman EJ. Granuloma Inframammary Adultorum. JAMA Dermatol. 2014 Jul 9. [Epub ahead of print]

Cronin RM, Field JR, Bradford Y, Shaffer CM, Carroll RJ, Mosley JD, Bastarache L, Edwards TL, Hebbring SJ, Lin S, Hindorff LA, Crane PK, Pendergrass SA, Ritchie MD, Crawford DC, Pathak J, Bielinski SJ, Carrell DS, Crosslin DR, Ledbetter DH, Carey DJ, Tromp G, Williams MS, Larson EB, Jarvik GP, Peissig PL, Brilliant MH, McCarty CA, Chute CG, Kullo IJ, Bottinger E, Chisholm R, Smith ME, Roden DM, Denny JC. Phenome-wide association studies demonstrating pleiotropy of genetic variants within FTO with and without adjustment for body mass index. Front Genet. 2014 Aug 5;5:250.

Goswami S, Yee SW, Stocker S, Mosley JD, Kubo M, Castro R, Mefford JA, Wen C, Liang X, Witte J, Brett C, Maeda S, Simpson MD, Hedderson MM, Davis RL, Roden DM, Giacomini KM, Savic RM. Genetic variants in transcription factors are associated with the pharmacokinetics and pharmacodynamics of metformin. Clin Pharmacol Ther. 2014 Sep;96(3):370-9.

Kahl BS, Hong F, Williams ME, Gascoyne RD, Wagner LI, Krauss JC, Habermann TM, Swinnen LJ, Schuster SJ, Peterson CG, Sborov MD, Martin SE, Weiss M, Ehmann WC, Horning SJ. Rituximab Extended Schedule or Re-Treatment Trial for Low-Tumor Burden Follicular Lymphoma: Eastern Cooperative Oncology Group Protocol E4402. J Clin Oncol. 2014 Aug 25.

Kvale PA, Johnson CC, Tammemägi M, Marcus PM, Zylak CJ, Spizarny DL, Hocking W, Oken M, Commins J, Ragard L, Hu P, Berg C, Prorok P. Interval lung cancers not detected on screening chest X-rays: How are they different? Lung Cancer. 2014 Jul 24. [Epub ahead of print]

Land ME, Cooper RF, Young J, Berg E, Kitchner T, Xiang Q, Szabo A, Ivacic LC, Stepien KE, Page CD, Carroll J, Connor T Jr, Brilliant M. Cone Structure in Subjects with Known Genetic Relative Risk for AMD. Optom Vis Sci. 2014 Aug;91(8):939-49.

McClure DL, Kieke BA, Sundaram ME, Simpson MD, Meece JK, Sifakis F, Gasser RA Jr, Belongia EA. Seasonal incidence of medically attended respiratory syncytial virus infection in a community cohort of adults ≥50 years old. PLoS One. 2014 Jul 15;9(7):e102586.

McKiernan FE, Berg RL, Fuehrer J. Clinical and radiographic findings in adults with persistent hypophosphatasemia. J Bone Miner Res. 2014 Jul;29(7):1651-60.

McNeil MM, Gee J, Weintraub ES, Belongia EA, Lee GM, Glanz JM, Nordin JD, Klein NP, Baxter R, Naleway AL, Jackson LA, Omer SB, Jacobsen SJ, DeStefano F. The Vaccine Safety Datalink: successes and challenges monitoring vaccine safety. Vaccine. 2014 Aug 6. [Epub ahead of print] Review.

Onitilo AA, Liang H, Stankowski RV, Engel JM, Broton M, Doi SA, Miskowiak DA. Geographical and seasonal barriers to mammography services and breast cancer stage at diagnosis. Rural Remote Health. 2014 Jul-Sep;14(3):2738. Epub 2014 Jul 14.

Reisin E, Graves JW, Yamal JM, Barzilay JI, Pressel SL, Einhorn PT, Dart RA, Retta TM, Saklayen MG, Davis BR; ALLHAT Collaborative Research Group. Blood pressure control and cardiovascular outcomes in normal-weight, overweight, and obese hypertensive patients treated with three different antihypertensives in ALLHAT. J Hypertens. 2014 Jul;32(7):1503-13; discussion 1513.

Sanfelippo MJ, Engel JM, Onitilo AA Antithrombin levels are unaffected by warfarin use. Arch Pathol Lab Med. 2014 Jul;138(7):967-8.

Strelitz J, Engel LS, Keifer MC. Blood acetylcholinesterase and butyrylcholinesterase as biomarkers of cholinesterase depression among pesticide handlers. Occup Environ Med. 2014 Sep 4. [Epub ahead of print]

Wall D, Ray W, Pathak RD, Lin SM. A Google Glass Application to Support Shoppers With Dietary Management of Diabetes. J Diabetes Sci Technol. 2014 Jul 11. [Epub ahead of print]

Ye Z, Mayer J, Ivacic L, Zhou Z, He M, Schrodi SJ, Page D, Brilliant MH, Hebbring SJ. Phenome-wide association studies (PheWASs) for functional variants. Eur J Hum Genet. 2014 Jul 30.

After Visit Summaries: A Tool Whose Time Has Come for Use in Dentistry

Thu, 11 Sep 2014 12:37:52 GMT

Dr. Amit Acharya, Director of Institute for Oral and Systemic Health (IOSH) was recently invited by the Institute of Medicine (IOM) to write a discussion paper on application of After Visit Summary (AVS) in the field of dentistry. Dr. Acharya collaborated with Alice M. Horowitz, Ph.D., R.D.H. from University of Maryland, Lindsey A. Robinson, D.D.S. from California Dental Association and Man Wai Ng, D.D.S., M.P.H. from Harvard School of Dental Medicine, on this publication.

In dentistry, AVS can be thought of in both the context of a standalone dental practice and as a combined summary integrating oral health-related information with medical information. In this commentary, the authors explored the AVS from both perspectives and made a case for considering AVS as an important piece of the larger puzzle needed to improve oral health and general health literacy for all patients, as well as highlighted the success at Marshfield Clinic in developing AVS for dentistry as a case report.

“It was an honor to discuss the efforts going on here at Marshfield Clinic Research Foundation and Family Health Center of Marshfield, especially in an article invited by the Institute of Medicine as it reaches a wide national and international audience,” said Dr. Acharya.

After Visit Summaries: A Tool Whose Time Has Come for Use in Dentistry

July 2014 Publications

Tue, 09 Sep 2014 16:47:42 GMT

Anderson KP. Biological clocks and ventricular tachyarrhythmias. J Am Coll Cardiol. 2014 Jun 24;63(24):2709‑11.

Antoniotti NM, Drude KP, Rowe N. Private payer telehealth reimbursement in the United States. Telemed J E Health. 2014 Jun;20(6):539-43.

Bibbo C, Spellman J. Successful salvage of complicated calcaneal blastomycosis in disseminated disease with staged surgical reconstruction and local-systemic antifungal therapy. J Foot Ankle Surg. 2014 Jul-Aug;53(4):472-9.

Borne RT, Peterson PN, Greenlee R, Heidenreich PA, Wang Y, Curtis JP, Tzou WS, Varosy PD, Kremers MS, Masoudi FA. Temporal Trends in Patient Characteristics and Outcomes Among Medicare Beneficiaries Undergoing Primary Prevention Implantable Cardioverter-Defibrillator Placement in the United States, 2006-2010: Results from the NCDR® ICD Registry. Circulation. 2014 Aug 5.

Corry JJ. The use of targeted temperature management for elevated intracranial pressure. Curr Neurol Neurosci Rep. 2014 Jun;14(6):453.

Dart RA, Egan BM. Formation of community-based hypertension practice networks: success, obstacles, and lessons learned. J Clin Hypertens (Greenwich). 2014 Jun;16(6):393-7.

DeBarber AE, Luo J, Giugliani R, Souza CF, Chiang JP, Merkens LS, Pappu AS, Steiner RD. A useful multi-analyte blood test for cerebrotendinous xanthomatosis. Clin Biochem. 2014 Jun;47(9):860-3.

Epperla N, McKiernan FE. An uncommon cause of acquired osteosclerosis in adults: hepatitis C-associated osteosclerosis. Skeletal Radiol. 2014 Sep;43(9):1313-8.

Gao F, Ballantyne C, Ma L, Virani SS, Keinan A, Brautbar A. Rare LPL gene variants attenuate triglyceride reduction and HDL cholesterol increase in response to fenofibric acid therapy in individuals with mixed dyslipidemia. Atherosclerosis. 2014 Jun;234(2):249-53.

Havers F, Thaker S, Clippard JR, Jackson M, McLean HQ, Gaglani M, Monto AS, Zimmerman RK, Jackson L, Petrie JG, Nowalk MP, Moehling KK, Flannery B, Thompson MG, Fry AM. Use of Influenza Antiviral Agents by Ambulatory Care Clinicians During the 2012-2013 Influenza Season. Clin Infect Dis. 2014 Jul 16.

Kang JH, Loomis SJ, Yaspan BL, Bailey JC, Weinreb RN, Lee RK, Lichter PR, Budenz DL, Liu Y, Realini T, Gaasterland D, Gaasterland T, Friedman DS, McCarty CA, Moroi SE, Olson L, Schuman JS, Singh K, Vollrath D, Wollstein G, Zack DJ, Brilliant M, Sit AJ, Christen WG, Fingert J, Forman JP, Buys ES, Kraft P, Zhang K, Allingham RR, Pericak-Vance MA, Richards JE, Hauser MA, Haines JL, Wiggs JL, Pasquale LR. Vascular tone pathway polymorphisms in relation to primary open-angle glaucoma. Eye (Lond). 2014 Jun;28(6):662-71.

Kanth R, Samji NS, Inaganti A, Komanapalli SD, Rivera R, Antillon MR, Roy PK. Endotherapy in symptomatic pancreas divisum: A systematic review. Pancreatology. 2014 July - August;14(4):244-250.

Martin RF. Management of burns. Surg Clin North Am. 2014 Aug;94(4):xiii-xiv.

McPherson E, Zaleski C, Ye Z, Lin S. Rodriguez syndrome with SF3B4 mutation: a severe form of Nager syndrome? Am J Med Genet A. 2014 Jul;164(7):1841-5.

Miller AW, McCarty CA, Broeckel U, Hytopoulos V, Cross DS. Development of reusable logic for determination of statin exposure-time from electronic health records. J Biomed Inform. 2014 Jun;49:206-12.

Onitilo AA, Engel JM, Stankowski RV. Cardiovascular toxicity associated with adjuvant trastuzumab therapy: prevalence, patient characteristics, and risk factors. Ther Adv Drug Saf. 2014 Aug;5(4):154-66.

Peissig PL, Santos Costa V, Caldwell MD, Rottscheit C, Berg RL, Mendonca EA, Page D. Relational machine learning for electronic health record-driven phenotyping. J Biomed Inform. 2014 Jul 15.

Rafiullah F, Tanimu S, Onitilo AA. Gangliocytic paraganglioma, a rare ampullary tumour treated with open transduodenal resection and sphincteroplasty. BMJ Case Rep. 2014 Jul 2;2014.

Swary JH, Stratman EJ. Practice gaps in patient safety among dermatology residents and their teachers: a survey study of dermatology residents. JAMA Dermatol. 2014 Jul 1;150(7):738-42.

Swenson E, Schema L, McPherson E. Radiographic evaluation of stillbirth: What does it contribute? Am J Med Genet A. 2014 Jul 10.

White SB, Tutton SM, Rilling WS, Kuhlmann RS, Peterson EL, Wigton TR, Ames MB. Percutaneous in utero thoracoamniotic shunt creation for fetal thoracic abnormalities leading to nonimmune hydrops. J Vasc Interv Radiol. 2014 Jun;25(6):889-94.

Ye Z, Mayer J, Ivacic L, Zhou Z, He M, Schrodi SJ, Page D, Brilliant MH, Hebbring SJ. Phenome-wide association studies (PheWASs) for functional variants. Eur J Hum Genet. 2014 Jul 30.

Marshfield Clinic selected to participate in NIH-funded StrokeNet trial

Wed, 10 Sep 2014 14:24:18 GMT

Marshfield Clinic has been selected to participate with the Regional Coordinating Center at University of Wisconsin-Madison in the Stroke Trials Network (StrokeNet) for stroke research.

The National Institutes of Health created StrokeNet in 2013 to conduct clinical trials and research studies to advance acute stroke treatment, stroke prevention and recovery, and rehabiliation following a stroke. The network of 25 regional centers across the U.S., involving more than 200 hospitals, is designed to serve as the infrastructure and pipeline for new potential treatments for patients with stroke and those at risk for stroke. StrokeNet also will provide an educational platform for stroke physicians and clinical trial coordinators.

StrokeNet's national coordinating center is at the University of Cincinnati and the national data management center is at the Medical University of South Carolina.

"The importance of StrokeNet stems from the need to identify the signs and symptoms of stroke early, to minimize damage, and to effectively manage the after-effects of a stroke," said Steve Ziemba, Ph.D., associate director, Marshfield Clinic Research Foundation (MCRF). "Associated research is all the more critical as our population ages and the incidence of stroke is expected to increase."

Kenneth Madden, M.D., Ph.D., Neurology, and Kathy Mancl, research coordinator in MCRF's Clinical Research Center, will represent the Clinic. Up to nine trials covering prevention, acute care and recovery are anticipated.

The Clinic has participated in stroke trials for nearly three decades, but this is the first time it's part of a large, collaborative effort. Prior Clinic research for the Carotid Revascularization Endarterectomy versus Stenting Trial found that both procedures were safe and effective treatment options for carotid artery stenosis, a precursor to emolus and stroke. Clinic researchers also examined the potential benefit of anticoagulants in treatment and prevention of stroke and the importance of giving tissue plasminogen activators to patients who exhibit symptoms of stroke.

The Clinic expects to learn its exact role in the new trials in the coming months.

A benefit of the Clinic participating in the trials for patients is that they receive medication and treatment options before the general public has access, and at a reduced expense.

"These trials are designed to look for optimal treatments for a number of conditions," Dr. Madden said. "The end goals is to have better knowledge on how to treat stroke patients in the future."