Author Archives: Ellen Davis

Strokes Final Podcast

Ellen Davis, Muznah Khan, Tate Powell

Sources:

American Stroke Association
http://www.strokeassociation.org/STROKEORG/

Healthline
http://www.healthline.com/health/stroke

Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/stroke/home/ovc-20117264

WebMD
http://www.webmd.com/stroke/features/stroke-prevention-lifestyle-tips?page=3

CDC
http://www.cdc.gov/stroke/index.htm

National Stroke Association
http://www.stroke.org/

Intro Clip of woman having a stroke on House (Season 3 Episode 17)
https://www.netflix.com/watch/70274552?trackId=13752289&tctx=0,16,36c29fcc-454a-438a-b573-ea5a45401341-47581077

Treatment/ Prevention of a stroke
http://www.sciencedirect.com/science/article/pii/S0140673608606947

Carotid endarterectomy
http://www.strokecenter.org/patients/stroke-treatment/carotid-endarterectomy/

African Americans more prone to strokes
http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/African-Americans-and-Heart-Disease_UCM_444863_Article.jsp#.VwLaieffCuU

Andee Poulos
http://www.andeesarmy.com/about-andee/

Birth Control
https://www.sciencedaily.com/releases/2015/09/150918132654.htm

Stents/Surgery
http://www.albanydailystar.com/health/research-on-stent-shows-stents-are-effective-prevention-for-stroke-miami-gardens-tech-week-16686.html

Sleep Research
http://www.eurekalert.org/pub_releases/2016-03/uos-nrh031516.php

New Research
http://blogs.biomedcentral.com/on-medicine/2015/04/29/new-stroke-research/

Cover Letter: UNC Administrative Internship Program

Ellen Davis | 403 Nantucket Drive | 919-XXX-XXXX | ellenmd@live.unc.edu

March 11, 2016

Charnae Rogers
UNC Hospitals Administrative Internship Program
UNC Hospitals Executive Office
101 Manning Drive
Campus Box 7600
Medical School Wing E
Chapel Hill, NC 27514-7600

Dear Ms. Rogers:

As a first year undergraduate at the University of North Carolina at Chapel Hill, I became aware very quickly of the prominence of UNC Hospital on campus. Daily I hear helicopters and the EMS rushing people to this cornerstone. When I discovered an internship related to my future career goals that would allow me to work at this campus hub, I was elated and excited to apply.

My name is Ellen Davis and I am pursuing a Bachelor of Science in Public Health with a focus in Biostatistics. After attaining my bachelors, I plan to complete a master’s degree in statistical analysis. The UNC Administrative Internship Program is a perfect fit for me because it provides exposure to the workings of a hospital through performance of administrative duties while at the same time allowing me to sharpen my analytical skills through analysis of different trends of hospital data.

While this internship would fulfill many of my hopes, I feel that I would also be an asset to the program. I have had experience with administrative internships and data analysis. During the summer of 2013 I completed a paid internship under Chief Justice Mark Martin of the Supreme Court of North Carolina. I worked 40 hours a week and performed many administrative duties like shelving books, scanning papers, printing copies, and running errands in order to keep the library running smoothly. Also, I gained much experience with data analysis and identifying trend data through AP Statistics.

Additionally, I have experience with independent work. I was a member of Key Club, a volunteer-based club, for three years in high school. During those years, I was elected to the Key Club board twice, serving as Projects Chair junior year and Secretary/Treasurer senior year. My time on the board improved my collaboration and decision-making skills. As projects chair, I was expected independently to contact different organizations and find volunteer opportunities for the club. This position polished my communication skills and led to my increased activity in my community.

The UNC Hospital Administrative internship fully aligns with my career goals and would be a valuable experience for me. Furthermore, I am excited at the possibility of this internship and the skills I could gain from it.

Thank you for your time and consideration,

Ellen Davis
University of North Carolina at Chapel Hill
Biostatistics Major | Class of 2019
ellenmd@live.unc.edu

UNC Administrative Internship Program

The UNC Health Care’s Administrative internship Program (AIP) is completed at the UNC hospital and the mission of AIP is to expose students interested in public health to real life health care experiences and to modern health care delivery practices. The internship lasts exactly 12 weeks and one can start the internship in either May or June. The hours per week were not listed, however this internship is very formal and I think the hours would be the same day and same time every week.

During this internship, I would be involved in different work projects, attend weekly “learning series”, communicate with my mentor, and complete an end of summer presentation. In past years, interns’ projects have focused on topics such as patient relations (patient satisfaction analysis), preparation of a Medicare cost report, and profit/loss analysis and business line development. Through this internship, I will gain an understanding of how a teaching hospital operates by working with different departments in the hospital.

The requirements are that I am an under-grad or grad student, I have completed at least one semester of college, I am legally eligible for employment in the US, and that I have a 3.0 GPA or higher. The application for the internship was online, but the application is no longer available because the internship deadline passed in early January. I believe the application would require at least one letter of recommendation and at least one essay question. However, I recently emailed Administrative.Fellow@unchealth.unc.edu and will find out the specific details of the application process soon.

The strengths of this internship are that it is directly related to my future career path, it is paid, and it could most likely give me an EE credit. The weaknesses are that it is located in Chapel Hill, so I would probably have to commute everyday and that the deadline for the internship already passed. The costs of the internship would mostly come from gas money and parking.

Even with these weaknesses, this internship would be very beneficial. So I plan to apply for the internship next year. This internship occurs at UNC, so I would get to observe a variety of different medical practices at a reputable hospital. Also, I think this internship would look extremely good on my resume, especially since I am considering a career in this field. I am particularly interested in public health and I want to apply to the Gillings School of Public Health next year. I plan on applying to the Biostatistics major at the School of Public Health. Biostatistics involves statistical analysis of large amounts of data. After reviewing topics past interns did projects on, I feel like this job does include some statistical analysis, which is very relevant to my interests. While this job is only an administrative position, I still think it would benefit me since the internship comes in direct contact with public health and public policy.

Why Have A Pancreas?

Why Have A Pancreas?

Ellen Davis

The Past

It was the summer and Susan just got back from sleep away camp. Camp was a weird experience for her this year. She felt thirsty all the time and didn’t have the energy to participate in her favorite activities. She came home and it was noted that Susan lost 13 pounds while at summer camp! She was taken to the doctor and was promptly diagnosed with Type 1 Diabetes at 12 years old.

It has been two years since Susan was diagnosed with Type 1. At first, I couldn’t believe it was true. But now after much time has passed, I understand that diabetes is not as rare as I thought. It is said that around 80 people per day are diagnosed with Type 1.

With numbers only growing, when will modern technology take the next big step in bettering the lives of diabetics?

The Present

Hormones have more control over your body than you think. This is especially apparent when it comes to diabetics, who have botched hormones. Diabetics do not have two of the most important hormones, insulin and glucagon. These hormones keep your blood-glucose level at a set point.

Insulin is a hormone that allows glucose to enter cells and thereby decreases your blood sugar. This may seem negligible, but because of this function you can eat a dozen donuts without having blurred vision or numbness in your appendages.

Glucagon is a hormone that lets glucose leave the cell and thereby increases your blood sugar. This function is also vital because it gives you the ability to skip breakfast without passing out or falling into a coma.

Due to these hormonal challenges, diabetics must implement different treatments in order to live relatively normal lives. One of the newest treatments is the artificial pancreas (AP). The artificial pancreas is a bit of a misnomer. When you think artificial, you may picture a pancreas made up of actual human tissues; however, this artificial pancreas is completely mechanical.

According to the FDA, the artificial pancreas is composed of a continuous glucose monitor (CGM), an insulin pump, and a computer algorithm. The CGM and insulin pump are two devices that are commonly used to treat diabetes today.

The CGM continuously monitors a diabetic’s glucose level, while the insulin pump delivers the hormone insulin to the diabetic’s body. A diabetic will typically use a CGM to identify blood-sugar level. Based on the blood-sugar level, the diabetic will complete calculations to determine appropriate insulin dosage. Finally, the diabetic will press buttons on the insulin pump to deliver the insulin.

The artificial pancreas is different in that it combines both of these functions. According to the FDA article, an AP combines the CGM and pump together with an algorithm. This algorithm collects data from the CGM, then decides insulin dosage, and finally commands the insulin pump to deliver a correct insulin dosage. Thus, as the Diabetes Technology & Therapeutics article postulated, the AP “closes the loop” and creates a mechanical pancreas that can operate without human help.

Currently there are a handful of algorithm variations. The top algorithms appear to be Model Predictive Control (MPC) and Proportional-Integral-Derivative (PID). These algorithms work differently and result in different levels of success.

Based on a paper in the Journal of Diabetes Science and Technology, it is understood that MPC is a model-based algorithm. Past and current blood-sugar-level data helps form this model, and from that model future insulin dosage can be predicted.

Because model-based algorithms become personalized to your body the longer you use them, they are generally a better product. In comparison, PID algorithms only predict insulin dosage based on current data.

While the model algorithm may seem like the best option, clinical trials of a variety of algorithms have occurred and all have boasted hopeful results. One study, called the “Safety auxiliary feedback element for the artificial pancreas in type 1 diabetes,” used a PID algorithm. The study was done on 10 virtual patients and its main focus was to test a safety auxiliary feedback element (SAFE).

SAFE is a system that ensures correct amount of insulin dosages are given. If an incorrect amount of insulin is given, this could lead to a hypoglycemic episode, which can result in a coma or death. While the study centers around SAFE, the study did use the PID algorithm and gave promising results. The number of hypoglycemic episodes was constrained and the length of these episodes was decreased by more than 50%.

Another study, “Clinical evaluation of an automated artificial pancreas using zone-model predictive control and health monitoring system,” used a model algorithm. The study included 12 patients with Type 1 Diabetes and it lasted 24 hours. The study also included some real life situations, like unannounced meals and exercise. The algorithm kept the blood glucose level between 70 and 180 for 80% of the study. However, after mealtime the blood glucose stayed in this range less than 70% of the time.

While improvement is clearly needed for implementation in real life, these results are optimistic. The artificial pancreas is the next big step.

The Future

While progress is being made, the “real world” is much different than the controlled bubble in which most of these artificial pancreas studies have been conducted. To truly improve the quality of life of diabetics, the artificial pancreas must handle unpredictable eating, exercise, and stress.

Susan’s current insulin and glucose regimen was not adequate in dealing with the influence exercise has over her blood sugar. Exercise caused her blood glucose levels to become unpredictable; they would descend from a high of 300 to a low of 70. These sporadic highs and lows were not ideal for team sports, which are only successful if everyone is pulling his or her weight. So, club soccer, which Susan had played for the last 7 years, disappeared from her life.

This story may seem a bit depressing, however my family is hopeful. The AP is currently undergoing outpatient studies. This means the AP is finally being tested in real life environments. One day, the AP may withstand the challenges of daily life and this could lead to Susan joining a team sport again.

 

Sources

Caudal, Arianne, Matt Mulroy, Wesley Wagers, Eran Atlas, and Eyal Dassau. “Closing the Loop.” Mary Ann Liebert. Mary Ann Liebert, 13 Feb. 2015. Web. 23 Jan. 2016. http://online.liebertpub.com/doi/pdf/10.1089/dia.2015.1504

Teixeira, Rodrigo E., and Stephens Malin. “The Next Generation of Artificial Pancreas Control Algorithms.” NCBI. National Center for Biotechnology Information, Jan. 2008. Web. 9 Feb. 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2769707/

“What Is the Pancreas? What Is an Artificial Pancreas Device System?” FDA U.S. Food and Drug Administration. U.S. Food and Drug Administration, n.d. Web. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ArtificialPancreas/ucm259548.htm

Query Letter: Artificial Pancreas

Ellen Davis
510 Hinton James Drive
Chapel Hill, NC 27515
ellenmd@live.unc.edu

February 4, 2016

Dear Ms. Boyd,

I am a current student at the University of North Carolina at Chapel Hill and I am pursuing a degree in a field related to health medicine. I am searching for a cutting-edge magazine, like your own, that will publish my most recent article, “Why Have A Pancreas?” This article chronicles the very real connection between Type 1 Diabetes and a faulty pancreas. Type 1 Diabetes is a very scary disease at large today. While only 5 to 10% of diabetics suffer from Type 1, the disease is extremely horrifying because it targets children. However, this article will also bring solace to parents and family of diabetics because it describes a new device called the Artificial Pancreas that ideally will give diabetics back the control they desire over their body and their lives.

Hormones have more control over your body than you think. This is especially true when it comes to diabetics, who have botched hormones. Diabetics do not have two of the most important hormones, insulin and glucagon. These hormones keep your blood glucose level at a set point. Insulin is a hormone that signals cells to allow glucose to enter the cell and therefore decreases your blood sugar. This may seem negligible, but because of this function you can eat a dozen donuts without having blurred vision or numbness in your appendages. Glucagon is a hormone that signals cells to let glucose leave the cell and therefore increases your blood sugar. This function is also vital because it gives you the ability to skip breakfast without passing out or falling into a coma.

Due to these hormonal challenges, diabetics have to implement different treatments so they can live relatively normal lives. There are many treatments available at present; however, one of the newest treatments is the artificial pancreas. The artificial pancreas is a bit of a misnomer. When you think artificial, you picture a pancreas made up of actual human tissues; however, this artificial pancreas is completely mechanical.

The artificial pancreas is composed of a continuous glucose monitor (CGM), an insulin pump, and a computer algorithm. The CGM and insulin pump are two devices that are commonly used to treat diabetes. The CGM continuously monitors a diabetic’s glucose level, while the insulin pump delivers the hormone insulin to the diabetic’s body. A diabetic will typically use a CGM to identify blood sugar level. Once blood sugar level is found the diabetic will complete calculations to determine appropriate insulin dosage. Finally the diabetic will press buttons on the insulin pump to deliver the insulin. However, the artificial pancreas (AP) is different in that is combines both of these functions. An AP combines the CGM and pump together with an algorithm. This algorithm collects data from the CGM, then decides insulin dosage, and finally commands the insulin pump to deliver a correct insulin dosage. Thus the AP “closes the loop” and creates a mechanical pancreas that can operate without human help.

The remainder of my article will explain how the old treatments worked and compare them with the workings of the artificial pancreas. It will go on to explain why the artificial pancreas is so beneficial, and then provide a personal story that gives insight into how the artificial pancreas could improve daily life of diabetics. I will also present some hopeful results from the latest clinical trials.

This article is informative and fascinating. I believe it will fit well with the magazine you have built.

Thank you for your time,

Ellen Davis

Annotated Bibliography: Artificial Pancreas

Blaszczak-Boxe, Agata. “Artificial Pancreas May Improve Type 1 Diabetes Treatment.” Live Science. Live Science, 26 Nov. 2014. Web. 28 Jan. 2016. http://www.livescience.com/48932-artificial-pancreas-type-1-diabetes-treatment.html

  • This article details the advancements of the artificial pancreas (AP) in the last couple years and it describes a specific study where a comparison between the insulin pump and the artificial pancreas were made. A comparison in the duty was also made between an AP with a store of insulin and an AP equipped with glucagon and insulin. The study verifies that the AP significantly reduces low blood sugar episodes at night. The study also points out that there is no “significant benefit” to having an AP with insulin and glucagon over an AP with only insulin. This article is helpful because it points out the immense benefits derived from the AP.

Caudal, Arianne, Matt Mulroy, Wesley Wagers, Eran Atlas, and Eyal Dassau. “Closing the Loop.” Mary Ann Liebert. Mary Ann Liebert, 13 Feb. 2015. Web. 23 Jan. 2016. http://online.liebertpub.com/doi/pdf/10.1089/dia.2015.1504

  • This article defines what closing the loop means by first differentiating between closed and open loop. Closed loop describes a device that can measure blood sugar and then decide what amount of insulin to deliver. Open loop describes devices that measure one’s blood sugar, but do not deliver insulin. The article then goes on to describe what encompasses an artificial pancreas: CGM, Insulin Pump, and Algorithm. Then it lists the three leading algorithms. Finally the article mentions that the artificial pancreas testing has changed from clinical trials to out patient trials and it lists a multitude of studies that have occurred this past year. One study tested the artificial pancreas on 10 patients in an extremely controlled environment for 24 hours. The results were amazing in that 7 of the 10 patients had no blood sugar lows during the time period. Another study test the artificial pancreas on 10 virtual patients for 10 days. The artificial pancreas was only used for 16 hours a day. These two studies show progress in that the artificial pancreas is moving towards being tested for longer periods of time. This article is useful because it can be used to support my argument that the artificial pancreas helps type 1 people better live their lives. This article is reliable because it mentions a variety of different clinical studies and points out each trial’s pros and cons.

“Two Clinical Trials Could Lead to FDA Approval for Type 1 Diabetes Device.” Science Daily. Science Daily, 4 Jan. 2016. Web. 27 Jan. 2016. http://www.sciencedaily.com/releases/2016/01/160104130828.htm

  • This article talks about how far along the artificial pancreas is in testing. According to the article there will be two final clinical trials in 2016. These trials will test how an artificial pancreas acts in a real life setting.  The trials will be conducted at UVA and at Harvard. There will be trials internationally as well. These trials are for long periods of time (6 months). This article is good because it conveys the how cutting-edge this topic is and how the artificial pancreas could become a device used regularly to treat diabetes.

“What Is the Pancreas? What Is an Artificial Pancreas Device System?” FDA U.S. Food and Drug Administration. U.S. Food and Drug Administration, n.d. Web. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/HomeHealthandConsumer/ConsumerProducts/ArtificialPancreas/ucm259548.htm

  • The pancreas is an extremely important organ in your body because it regulates the use of the hormones insulin and glucagon. Insulin helps lower blood sugar and glucagon helps raise blood sugar. However, these hormones malfunction in people with Type 1 Diabetes, which leads to blood sugar highs and lows. Type 1 is an autoimmune disease where the body attacks itself and thus depletes the body of insulin (beta cells). An artificial pancreas (AP) combines different technologies already in existence to make handling Type 1 Diabetes easier. A continuous glucose monitor, blood glucose monitor, algorithm, and insulin pump are all different devices that combine to form an AP. This source will help me define jargon. This source has reliable information because it is written by a well-known source the FDA.

 

 

 

 

Autism

The article we read about detailed the history of autism and how it has become more recognized overtime. The author points out a figure in history named Howe, who was a social activist. He first set about helping the blind learn. After success in this realm, he went on an taught “idiots.” Although Howe was not comfortable using the term idiot because many of the individuals he studied showed talent in a specified field. For example: in one case, a man had the talent of perfect pitch. Howe went on to create a school for “idiots.” These “idiots” many times would be labeled as autistic in present day.