Spartan Traveler 2022

Spartan Traveler

A report from the MSU Institute for Global Health

ADVANCING THE ONE HEALTH APPROACH

In late 2021, Michigan State University announced a renewed focus on promoting the One Health Approach following a presentation from Dr. Kimberly Dodd, Associate Professor, Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, “The MSU Veterinary Diagnostic Laboratory: An Emerging Leader in One Health,” to the board of Trustees.

Shortly after that presentation, the university authorized the search for faculty that could guide and assist in the current efforts of One Health.

The Institute for Global Health, created 36 years ago, has been promoting the interrelation of the One Health Concept and Global Health for the past eight years since the Global Health/ One Health Committee was created. This committee meets bi-monthly to discuss research projects, educational opportunities and capacity building activities across campus and with international partners. Examples of multidisciplinary and collaborative work on addressing Global Health/

One Health matters, the committee includes a wide range of specialists from the College of Natural

FALL 2022

Resources, Veterinary Medicine, Natural Sciences, Human Medicine, Social Sciences and International Studies and Programs.

In November 2021, The Institute for Global Health had its first celebration of “One Health Day.” Organized by the One Health Commission,

HENRY FORD HEALTH + MSU HEALTH SCIENCES: CONNECTING GLOBAL HEALTH TEAMS

During August 2022, the Global Health Initiative (GHI) team at Henry Ford Health and the Institute for Global Health team at the College of Osteopathic Medicine, MSU participated in the second retreat to review potential collaborations in research and education worldwide. Directors, coordinators and staff members from both teams gathered for about five hours in the Patenge Room at the College of Osteopathic Medicine to share current projects and identify areas with potential space to work together.

John Zervos and Kate Zenlea directors at GHI led the opening remarks and overview with Dr. William Cunningham and Sung Soo Chung, directors at IGH. Dr. Arpon Shahed from IGH and Ms. Doreen Dankerlui from GHI presented to the team on educational opportunities and focus for programs abroad and to receive international students and faculty.

During the afternoon session, the teams split into smaller groups to do a sprint work session on the topics of research and education.

Soon the teams will start joining efforts in research areas related to Mental Health, with a particular focus on HFH GHI Zero Suicide Initiative, and explore educational abroad opportunities for the medical team at HFH to serve as preceptors in MSUCOM programs.

Ms. Kate Zenlea, Managing Director at Henry Ford Health, GHI.

2022 Speakers. Left to right: Dr. William Cunningham (IGH, College of Osteopathic Medicine), Dr. Ramjee Ghimire (College of Agriculture and Natural Resources), Dr. Megan Milbrath (College of Agriculture and Natural Resources), Dr. Melinda Wilkins (College of Veterinary Medicine, University of Minnesota), Dr. Shannon Manning (College of Natural Sciences), Dr. Douglas Buhler (Office of Research, MSU), Dr. Gyanendra Gongal (World Health Organization) joined virtually for the event.

IGH joined the efforts in promoting One Health awareness on Nov. 3, 2021. Addressing local and global factors that impact optimal health and the well-being of humans, animals, and the environment was a priority at this event. The celebration also encompassed an international webinar on “Global One Health effects of low-level radiation on human health” featuring speakers from Japan, Canada, and the U.S. in correlation with MSU efforts on radiation effects research.

In November 2022 IGH led the efforts again promoting awareness of the One Health concept around campus with a hybrid event at the Interdisciplinary Science and Technology Building building on the MSU campus on Nov. 9, 2022. The focus was on Antimicrobial Resistance and Climate Change with a set of panelists from many disciplines. Sixty participated including students and faculty from the Midwest, Latin America and Asia.

Dr. Melinda Wilkins, former MSU professor at the College of Veterinary Medicine and Professor of Veterinary Medicine at the University of Minnesota, provided an overview of One Health Education.

Dr. Gyanendra Gongal, from the World Health Organization,

SPEAKER PANEL

CANR and IGH Received 700K AWARD for ONE HEALTH Project

The College of Agriculture and Natural Resources and the Institute for Global Health of the College of Osteopathic Medicine at Michigan State University (MSU) jointly implemented a three-year Cooperative Agreement project (September 2022 – September 2025), the Mekong One Health Innovation Program (MOHIP). MOHIP aims to improve health security in three Mekong countries, namely, Laos, Thailand, and Vietnam, through strengthening the One Health approach. Funded by the U.S. Department of State, Bureau of East Asian and Pacific Affairs (EAP), the overarching goal of this project is to connect U.S. health experts with key Mekong researchers and create a transnational health security network that focuses on the lower Mekong sub-region. Such a network will enable sharing of tools and resources that U.S. experts have created for researching One Healthrelated issues and supporting Mekong researchers as they make informed decisions about their country’s health security practices and policies. The project activities include a series of monthly webinars on health security issues, a virtual short course on ‘Health Security, One Health, and Zoonoses’ for Mekong researchers, and funding research projects pertinent to One Health and health security in the lower Mekong sub-region. Check out the upcoming webinars in ighealth.msu.edu

joined virtually from Nepal and provided insights on “Anti-Microbial Resistance: Challenges and opportunities around the world.”

Dr. Megan Milbrath and Dr. Ramjee Ghimire from the College of Agriculture presented on pollinators, food safety and climate change effects; reviving the importance of focusing on the three components of One Health.

Dr. Ghimire presented a case study with a current grant

training project in the Mekong region in Asia about expanding One Health among academics and government agencies.

For the closing, Dr. Shannon Manning College of Natural Sciences and MSU Foundation Professor reminded attendees of the importance of antimicrobial resistance foodborne pathogens and why they continue to be a One Health concern.

To see videos of these events, please visit us at: ighealth.msu. edu/Onehealth.

SPECIAL CONTRIBUTIONS

Kristy Murray, DVM, PhD Baylor College of Medicine

Ijeoma Nnodim Opara, MD Wayne State University

Pham Duc Phuc MD, MSc, Ph.D. Hanoi University

Melinda Wilkins DVM, MPH, Ph.D. Michigan State University

Keiji Suzuki, Ph.d University of Nagasaki

Carmel Mothersill, Ph.D McMaster University

Douglas Gage Ph.D. Office of Research and Innovation Michigan State

Thomas Glasmacher, Ph.D Facility for Rare Isotope Beams (FRIB) Michigan State University

Christopher Contag Ph.D Institute for Quantitative Health Science, Michigan State University.

James Trosko, Ph.D Institute for Integrative Toxicology Michigan State University

William Cunningham DO, MHA Institute for Global Health Michigan State University

INSTITUTE FOR GLOBAL HEALTH RESEARCH ACTIVITIES 2021-2022

The Institute for Global Health facilitates research by supporting faculty members and students through engagement with potential international research partners, funding efforts to develop global health research proposals, and providing students with research experiences during education abroad.

RESEARCH PUBLICATIONS:

• Payumo, J.; Alocilja, E.; Boodoo, C.; Luchini-Colbry, K.; Ruegg, P.; McLamore, E.; Vanegas, D.; Briceno, R.K.; CastanedaSabogal, A.; Watanabe, K.; et al. Next Generation of AMR Network. Encyclopedia 2021, 1, 871–892. doi.org/10.3390/ encyclopedia1030067

• Maleeha Naseem, Hajra Arshad, Syeda Amrah Hashmi, Furqan Irfan, Fahad Shabbir

Ahmed,Predicting mortality in SARS-COV-2 (COVID-19) positive patients in the inpatient setting using a novel deep neural network, International Journal of Medical Informatics, Volume 154, 2021, 104556, ISSN 1386-5056, doi. org/10.1016/j.ijmedinf.2021.104556

Abstract: Background The nextwave of COVID-19 pandemic is anticipated to be worse than the initial one and will strain the healthcare systems even more during the winter months. Our aim was to develop a novel machine learning-based model to predict mortality using the deep learning Neo-V framework. We hypothesized this novel machine learning approach could be applied to COVID-19 patients to predict mortality successfully with high accuracy. Methods: We collected clinical and laboratory data prospectively on all adult patients (≥18 years of age) that were admitted in the inpatient setting at Aga Khan University Hospital between February 2020 and September 2020 with a

clinical diagnosis of COVID-19 infection. Only patients with a RT-PCR (reverse polymerase chain reaction) proven COVID-19 infection and complete medical records were included in this study. A Novel 3-phase machine learning framework was developed to predict mortality in the inpatients setting. Phase 1 included variable selection that was done using univariate and multivariate Cox-regression analysis; all variables that failed the regression analysis were excluded from the machine learning phase of the study. Phase 2 involved new-variables creation and selection. Phase 3 and final phase applied deep neural networks and other traditional machine learning models like Decision Tree Model, k-nearest neighbor models, etc. The accuracy of these models were evaluated using test-set accuracy, sensitivity, specificity, positive predictive values, negative predictive values and area under the receiver-operating curves. Results:After application of inclusion and exclusion criteria (n=)1214 patients were selected from a total of 1228 admitted patients. We observed that several clinical and laboratorybased variables were statistically significant for both univariate and multivariate analyses while others were not. With most significant being septic shock (hazard ratio [HR], 4.30; 95% confidence interval [CI], 2.91–6.37), supportive treatment (HR, 3.51; 95% CI, 2.01–6.14), abnormal international normalized ratio (INR) (HR, 3.24; 95% CI, 2.28–4.63), admission to the intensive care unit (ICU) (HR, 3.24; 95% CI, 2.22–4.74), treatment with invasive ventilation (HR, 3.21; 95% CI, 2.15–4.79) and laboratory lymphocytic derangement (HR, 2.79; 95% CI, 1.6–4.86). Machine

RESEARCH cont. next page

DEAN’S MESSAGE

The vision of the Michigan State University College of Osteopathic Medicine guides us to prepare “physicians in the science of medicine, the art of caring and the power of touch, with a world view open to all people.”

These guiding principles have been evident in the work of the Institute for Global Health (IGH) within our college over the past few decades. For example, last year, IGH, along with Family Community Medicine (FCM) and with the support of the dean’s office, led the International Preceptorship programs for the first time. To date, more than 60 students have completed their preceptorship requirement for second-year medical students internationally.

Last July, IGH received for the first time 25 international students from Latin America and Mexico for an 18-day academic immersion course at our MSU East Lansing campus, sponsored by the Yucatan government.

And lastly, IGH held two retreats with Henry Ford Health’s global health initiative team to explore collaborations in research in countries in Asia and Latin America. I was excited to meet the team during a retreat at our MSU campus last August.

These initiatives help us to build relationships and collaborate with others across the world, following our guiding principles to serve all people.

learning results showed our deep neural network (DNN) (Neo-V) model outperformed all conventional machine learning models with test set accuracy of 99.53%, sensitivity of 89.87%, and specificity of 95.63%; positive predictive value, 50.00%; negative predictive value, 91.05%; and area under the receiver-operator curve of 88.5 Conclusion: Our novel Deep-Neo-V model outperformed all other machine learning models. The model is easy to implement, user friendly and with high accuracy.

• Noreen N, Rehman SAU, Naveed I, Niazi SUK, Furqan IB Pakistan’s COVID-19 Outbreak

Preparedness and Response: A Situational Analysis. Health Secur. 2021 Nov;19(6):605-615. doi: 10.1089/hs.2021.0006. Epub 2021 Nov 11. PMID: 34762516.

• Jacobsen KH, Zeraye HA, Bisesi MS, Gartin M, Malouin R, Waggett CE. Master of Public Health Concentrations in Global Health in 2020: Preparing Culturally Competent Professionals to Address Health Disparities in the Context of Globalization. Health Promot Pract. 2021 Jul;22(4):574-584. doi: 10.1177/1524839920913546. Epub 2020 Apr 3. PMID: 32242750.

• Shabab, J., Dubisky, A., Singh, A., Aldrich A., et al. A descriptive study on the multisystem inflammatory syndrome in children in a single center in West Michigan. Pediatr Rheumatol 19, 172 (2021). doi.org/10.1186/s12969-658-3

• Vitale, E., Ruggirello, G., Eaton, R., Sergent, S., Willyerd, G. and Restini, C. (2021), Association between diabetes education and diabetes management in

STUDENTS PROJECTS:

an under-resourced community: A pilot study. The FASEB Journal, 35:. doi.org/10.1096/ fasebj.2021.35.S1.03501

• Liang Zhao, Yangyang Zou, Yabing Li, Brijen Miyani, Maddie Spooner, Zachary Gentry, Sydney Jacobi, Randy E. David, Scott Withington, Stacey McFarlane, Russell Faust, Johnathon Sheets, Andrew Kaye, James Broz, Anil Gosine, Palencia Mobley, Andrea W.U. Busch, John Norton, Irene Xagoraraki, Five-week warning of COVID-19 peaks prior to the Omicron surge in Detroit using wastewater surveillance, Science of The Total Environment, Volume 844,2022,157040, ISSN 0048-9697, doi.org/10.1016/j. scitotenv.2022.157040.

Abstract: Wastewater-based epidemiology (WBE) is useful in predicting temporal fluctuations of COVID-19 incidence in communities and providing early warnings of pending outbreaks.

BUREAU OF INTERNATIONAL OSTEOPATHIC MEDICINE 24TH GLOBAL HEALTH

First Prize: Student: Paige Mallema, OMS-II, COM

Research Advisors: Kenny Briceno, MD; Evangelyn Alocilja, Ph.D.

To investigate the relationship between SARS-CoV-2 concentrations in wastewater and COVID-19 incidence in communities, a 12-month study was conducted between Sept. 1, 2020, and Aug. 31, 2021, prior to the Omicron surge. Four hundred and seven untreated wastewater samples were collected from the Great Lakes Water Authority (GLWA) in southeastern Michigan. N1 and N2 genes of SARS-CoV-2 were quantified using RT-ddPCR. Daily confirmed COVID-19 cases for the City of Detroit and Wayne, Macomb and Oakland counties between Sept. 1, 2020, and Oct. 4, 2021, were collected from a public data source. The total concentrations of N1 and N2 genes ranged from 714.85 to 7145.98 gc/L and 820.47 to 6219.05 gc/L, respectively, which were strongly correlated with the seven day moving average of total daily COVID-19

cases in the associated areas, after five weeks of the viral measurement. The results indicate a potential five week lag time of wastewater surveillance preceding COVID-19 incidence for the Detroit metropolitan area. Four statistical models were established to analyze the relationship between SARSCoV-2 concentrations in wastewater and COVID-19 incidence in the study areas. Under a five week lag time scenario with both N1 and N2 genes, the autoregression model with seasonal patterns and vector autoregression model was more effective in predicting COVID-19 cases during the study period. To investigate the impact of flow parameters on the correlation, the original N1 and N2 gene concentrations were normalized by wastewater flow parameters. The statistical results indicated

the optimum models were consistent for both normalized and non-normalized data. In addition, we discussed parameters that explain the observed lag time. Furthermore, we evaluated the impact of the omicron surge that followed, and the impact of different sampling methods on the estimation of lag time.

• Irfan FB, Minetti R, Telford B, Ahmed FS, Syed AY, Hollon N, Brauman SC, Cunningham W, Award ME, Saleh KJ, Waljee AK, Brusselaers N. Coronavirus pandemic in the Nordic countries: Health policy and economy trade-off. J Glob Health 2022;12:05017.

• Irfan, F.B., Consunji, R.I.G.D.J., Peralta, R. et al. Comparison of in-hospital and out-ofhospital cardiac arrest of

RESEARCH cont. page 8

ANTHROPOMETRIC PILOT PROJECT IN DOMINICAN REPUBLIC

A pilot research project was started to assess the health and nutritional status of children in the sugar plantation communities near San Pedro de Macoris, during Spring Break 2022 and as part of an Education Abroad course in the Dominican Republic.

The research was led by primary investigators from the Michigan State University College of Osteopathic Medicine, Albert Moeller, M.D., Rene Hinojosa, Ph.D., Arpon Shahed, D.O., William Cunningham, D.O., M.H.A., and Darren Eblovi M.D, from the MSU College of Human Medicine, and assisted by Suruchi Dash, a thirdyear MSUCOM medical student. Under the supervision of faculty, MSUCOM medical students took anthropometric measurements of children ages 3 months to 5 years.

Anthropometrics are a set of non-invasive quantitative body measurements used to assess children’s growth and development. Body measurements, when compared to reference growth charts, like the World Health Organization or Center for Disease

Control and Prevention’s growth standards, are used to monitor the health of populations. What reference values should be used for given populations is still controversial. This pilot study is perhaps the starting point for developing reference charts specific to the population of the Dominican Republic.

A survey questionnaire, approved by the MSU Institutional Review Board, was used to record measurements to determine children’s height, weight, head and waist circumference, and skinfolds according to the World Health Organization (WHO) and United Nations Children’s Fund (UNICEF) 2019 guidelines. In addition, parents and guardians were asked to sign their consent and provide information about geographic location, gender, living arrangements, education and household income.

A total of 77 children were measured between March 8-10, 2022, in three different communities. The survey information was entered into Qualtrics, and from there the investigators have been organizing the data for analysis. Several MSUCOM students are interested in continuing their participation. Dash is also looking forward to preparing a poster presentation and an article for publication. This project was possible through a travel grant from the MSU Office of Education Abroad and a generous donation by Dr. Charles Gliozzo, professor emeritus and former director of MSU Education Abroad.

MSU Students in their way to Villa Inocencia, one of the study sites

From left to right: Emily Wells, Tyler Prentiss, Rene Hinojosa, John Zervos, Michael Miller, Doreen Dankerlui, Sabrina Vieyra Hollenbeck, William Cunningham, Usamah Mossallam, Morris Blake, Rusti Sidel, Rebecca Malouin, MaryAnne Walker, Kate Zenlea, Arpon Shahed, Qing Xia, Sung Soo Chung, Napoleon Gilmore Lii.

Dr. Arpon Shahed, Clinical Coordinator for Study Abroad Programs in IGH.

Ms. Doreen Dankerlui, Sr. Program Manager at Henry Ford Health, GHI.

Dr. Cunningham, Director of IGH , Dr. Mossallam, Medical Director GHI and Mr. Chung, Associate Director listen to the presentations.

GLOBAL HEALTH OPPORTUNITIES: CULTIVATING WIDER PERSPECTIVES IN MEDICAL TRAINING

An Interview with the Director of the Institute for Global Health

Why is global health a priority for the College of Osteopathic Medicine?

A physician must assimilate a wide perspective on people, culture and languages. It is critical for the development of a well-rounded, holistic caregiver. Applying that experience and knowledge in a global context helps us understand different cultures and treat people who don’t have the same level of access to resources. Global health experience opens your consciousness to think in terms of the patient and their culture. It develops an empathetic mindset and challenges the clinician to respond with compassion when they’re facing language barriers or communication challenges. You use all of your mind-body awareness to treat patients.

When you talk about health care in the U.S., people think of a doctor with a stethoscope, but in most of the world, health is defined very differently. The patients we serve think about health as food security, clean drinking water, a roof over their heads, basic hygiene or care for a mother and a newborn. Developing this experience, knowledge and understanding of global health and the inequities across the world shapes how we as physicians provide care and serve patients.

How does bringing our knowledge and skills to other places help improve global health and vice versa?

Every time we go abroad, we bring a broader perspective of health care to those areas, but the countries we visit provide us more insight and education than we provide them. We learn how to handle difficult situations—how to provide care when you don’t have the resources or how to treat a patient for a certain disease when

you don’t know if they’ll have access to long-term follow-up. It teaches us to be flexible and resourceful in how we provide care.

Our health care in the U.S. is the most expensive in the world. In our global health partnerships, we have learned that other countries with fewer resources and much less spending on health care have achieved the same, if not better, health metrics than the U.S. We can learn so much from these countries in how they do more with less.

What are your thoughts on the interconnectedness of health, and how what we are doing at MSU can impact health elsewhere, and vice versa?

One Health is one of the guiding principles of the Global Health Master’s curriculum; it is holistically based, like osteopathic medicine. You cannot separate the practice of human medicine, animal health, environmental

health and ecological health. They’re all inextricably linked. The politics, the economy and social factors are all intertwined with the people and the populations, but also the health of the country itself. This isn’t just about medicine— it’s about having a holistic understanding of health and taking an integrated approach to promote, protect and improve the health of the populations we serve and that of the planet.

What are some global partnership highlights at the Institute for Global Health?

Our longest-running program is our education and research in Malawi with Dr. Terrie Taylor, which has been practicing for 27 years. She lives there seven months out of the year and returns in the fall to teach a course in tropical medicine. MSU has a dorm for students studying abroad in Malawi.

We also have trips to Peru, Cuba and Mexico that have been running for over a decade, and

“You cannot separate the practice of human medicine, animal health, environmental health, and ecological health. They’re all inextricably linked.”

those countries have College of Osteopathic Medicine faculty living in the country to provide a sustainable presence for their patients and research projects.

The programs we’ve developed are focused on sustainability, education and forming meaningful community partnerships. Our commitment to building sustainable programs allows us to offer continuity of care to the patients and the communities we serve—we revisit the same place and the same patients multiple times a year to provide follow-up care and to build on our research.

Three years ago, we formed the Education and Research Consortium of the Americas to advance education, research and capacity-building in other countries. We now have 12 members in a consortium in eight countries in Latin and South America.

What role does research play in these global health experiences for students and faculty?

On all our study abroad trips, faculty can introduce potential research to students with our partners in those countries. Our work in Iquitos, Peru, over the last eight years has resulted in

more than 90 research projects and multiple publications from faculty and students working with our partner universities.

I’m excited about the increased emphasis on research in our college’s strategic plan. It will allow us to drive research initiatives through these programs.

What kind of growth or upcoming opportunities can we expect to see at IGH?

We are in the process of finalizing a consortium for the Middle East North Africa (MENA) region and developing a refugee resettlement program.

We are also expanding our international programs into clinical preceptorships, where not only will it be a study abroad program, but second-year students will receive credit for one week of the preceptorship program. They can see patients with a faculty member in a teaching environment while experiencing a culturally diverse setting and diseases not commonly seen in the United States.

For the last two years, COVID-19 has ravaged the world and we

have been home-bound. The thirst of students to travel globally with us has not abated since the start of the pandemic and our programs continue to be very competitive.

We’re very fortunate to have the support of the college and faculty. The faculty in these programs teach, deliver, and impart their years of experience to the students. Our faculty and research drive these international opportunities and we could not continue without their support and the support of the Dean.

Stay Safe and Be well

William Cunningham, D.O., M.H.A. Associate Dean for Global Health Director of MSU Institute for Global Health

RESEARCH cont. from page 5

trauma patients in Qatar. Int J Emerg Med 15, 52 (2022). doi.org/10.1186/s12245-02200454-0

• Bano, S., Xia, Q., & Dirkx, J. (2022). Developing Intercultural Competency in Public Health Study

Abroad Program: What Does Cultural Learning Mean for Undergraduate Chinese Students? Journal

of Comparative & International Higher Education, 14(4), 6–21. doi.org/10.32674/jcihe. v14i4.3639

• Sofia Rani Saggu, L Preethi, Prakasini Satapathy, Subhanwita Manna, Eshwar Sai Tipirisetty, Aiman Perween Afsar, Khaiwal Ravindra, Kamalesh Chakravarty, Furqan B. Irfan, Ranjit Sah, Bijaya Kumar Padhi, Acute necrotizing encephalitis outbreak in India: A little-known disease among the adult

population, Brain, Behavior, and Immunity, Volume 107, 2023, Pages 383-384, ISSN 0889-1591, doi.org/10.1016/j. bbi.2022.11.002.

UPCOMING:

• Miyani, Briceno, Xagoraraki, Wastewater Surveillance for Identification of Endemic and Emerging Viral Diseases in Trujillo-Peru.

THE INSTITUTE FOR GLOBAL HEALTH CELEBRATED IT’S 35 YEAR ANNIVERSARY IN 2022.

Originally, the Institute of International Health (IIH), was established at Michigan State University (MSU) in January 1987 to marshal university resources to address problems of world health by:

• Promoting faculty and student research and academic interest in internationalhealth, through scholarly activities, such as seminars, conferences, workshops, forums and summer non- internationalhealth endeavors of faculty and students;

• Serving as a focal, coordinating point at MSU for visiting international-health scientists and students;

• Securing external funding for collaborative international- health projects between MSU and institutions in overseas countries;

• Serving as a center for information gathering, exchange and dissemination on world health problems.

IIH first funded projects:

• Prevention and treatment of cardiovascular diseases in Bulgaria

• Molecular methodology for vaccine development against Schistosomiasis in Egypt

• Workshop on Tropical Diseases

• Training in Medical Informatics in SubSaharan African Countries

• Environmental Sciences in Japan

• Kellogg International Fellowship Program in Health (29 fellows in 18 countries)

• Medical Trainer course College Japan

The hallmark of these initial IIH projects was the multidisciplinary approach; typically, no less than four colleges and seven faculty from these colleges were involved in each project. Multidisciplinary research on international-health issues and effective outreach to communities abroad and in Michigan were central to the mission of the IIH.

Currently, IGH supports 12 healthrelated study abroad programs globally. Students, faculty and researchers from MSU’s health care colleges (College of Osteopathic Medicine (COM), College of Human Medicine (CHM), College

of Nursing (COM), College of Veterinary Medicine (CVM)) participate in these programs, as well as seven other participating colleges at the university

IGH currently has funded research projects in 10 countries on four continents.

IGH hosts faculty and students from many countries to deliver continuing health education seminars. Students and faculty from Egypt, South Korea, China, Peru, Japan, Dominican Republic, Cuba, Guatemala and other countries, are frequent enrollees in these courses.

International became Global on September 20, 2017. The Advisory Board Committee of IGH approved the name change to Institute for Global Health, reflecting the increased interaction with health professionals and with health care systems around the world.

There is a global need to educate the next generation of faculty and researchers utilizing the One Health educational concept that will incorporate human, animal, ecology and environmental factors in addressing the health of the world. The One Health discipline is integrated into all of the courses in the MSGH In 2020, IGH accepted the first students in the Master of Science in Global Health (MSGH) and has graduated over 20 students in the past 2 years.

With the concept of preparing the Institute to be a center for information and promoting attention to world health problems at MSU, the Education and Research Consortium of the Americas (ERCA), was established in 2019. Six institutions from Latin America and South America, which IGH has been partnering with for the past decade, joined

this consortium in the collaborative effort to develop global education, research and capacity building. The results of the annual research conference were the establishment of four online Virtual Institutes for continuing to partner in education and research. Research partners decided upon the four Virtual Institutes: Psychosocial Determinants of Health, Tropical Medicine/Infectious Diseases, Water Quality/Waste Management and the Ecology Institute. In 2022, after the first workshop of ERCA, hosted in Lima, Peru, a fifth virtual institute was established to address non-communicable diseases.

IGH continues to flourish as MSU’s focal point for global health by expanding training programs on the MSU campus, study abroad programs, as well as collaborative partnerships on research and capacity building around the world.

Please visit our website at: https://ighealth.msu.edu/ and get involved with IGH by following us on social media: @ighmsu @ighmsu @ighmsu

The Institute for Global Health (IGH) Michigan State University College of Osteopathic Medicine

SUMMER IMMERSION PROGRAM IN STEM

(Science, Technology, Engineering and Math): Yucatan Government

The Institute for Global Health at the College of Osteopathic Medicine have over a decade strengthened the relationships with different departments of the Yucatecan Government. The Health Secretariat of Yucatan, the Innovation, Research and Higher Education Secretariat and the Secretary of International Affairs that reports to the Office of the Governor, have been at the front of every educational program IGH has developed.

The Institute for Global Health received — for the first time in its history — 25 students from the Yucatan Peninsula for an English Cultural Immersion and Global Citizenship program. Activities and classes were customized to support the State English Agenda, from the Secretariat for Research, Innovation and Higher Education, in achieving its goal of raising the English proficiency of students at decentralized institutions of higher education in the State of Yucatan.

The class helped students improve their vocabulary and communication skills in various business environments in STEM. The class helped students to get familiarized with technical terms in the STEM fields. Students became familiar with common American business concepts, such as leadership, diversity, team building, interpersonal communication, decision making, marketing, innovation, and globalization. Activities included

lectures, reading and discussion, listening to business conversations, case studies and making group conclusions regarding common problems in the rapidly changing world. Students visited MSU labs like Dr. Xagoraraki’s lab in the College of Engineering and learned about methods of analysis of wastewater. They also participated in human resources and business conversations under diversity and inclusion guidelines with the visit to Peckham Companies in

Students arrived back in Merida, Mexico

Brijen Miyani provides insight on Wastewater analysis at Irene Xagoraraki’s lab.

Lansing Sister’s City Commission team and Mayor Andy Schor hosted a barbeque for the visiting students enhancing the commitment for Lansing and Merida to continue to work together.

Global Health Faculty Development Training Program

(GHFDT) for Armed Forces College of Medicine in Egypt (AFCM):

IGH hosted three faculty members from the Armed Forces College of Medicine in Egypt (AFCM), from June 4 to June 25, 2022. The Global Health Faculty Development Training Program (GHFDT) is designed to provide participants with opportunities to actively engage in the customized learning experiences in the MSU community and hospitals in Michigan under the guidance of expert

faculty members and healthcare professionals. This training was in order to gain understanding and knowledge of the best practices in medical education and clinical practice. It enabled students to apply this in the future in their role in the delivery of medical education and best practices in healthcare. The program had a strong focus on simulation and leadership.

UPCOMING PROGRAMS

Medical English: Universidade São Francisco in Brazil (USF) In coordination with the English Language Center at MSU and the Institute for Global Health, will host two groups (30 each) of medical students and healthcare professionals for a one-week Medical English Program this Summer Semester (July 2023). The program is designed to increase students understanding of the medical profession in the U.S. and improve their English communication skills.

The program highlights

Lansing, and the Learning and Assessment Center Simulation Hospital on the 6th floor of the College of Osteopathic Medicine.

Students ended the program with presentations of their work and learning experiences. A graduation ceremony took place at the Radiology Building conference room. Representatives of IGH and MSU professors who guided the students throughout their schedule on MSU campus were in attendance.

• 18 days living on MSU campus, from July 10 to July 18, 2022.

• English classes with a focus on STEM provided by Michigan State University professors.

• Academic field trips to learn about American society, culture and tradition through experiences and professional speakers from various areas, such as technology, government and social services, among others.

• Cultural Excursions to different areas around Michigan.

• Interaction with American students through group discussion activities and daily life activities while staying in MSU Campus dorms.

Students at Spartan Stadium

Students half-day session at the COM Learning and Assessment Center

Students visited Peckham companies in Lansing and met with Human Resources

VISIT TO TURKEY

COVID-19 in the MENA* Region: Lessons Learned in Research, Public Health Policy and Clinical Practice,

The Gaziantep University in Turkey hosted a public health conference, May 30-31. The conference was organized by the University of Nebraska Medical Center; Gaziantep University; Global Health Research, Management and Solutions; and the American University of Beirut, faculty of Health Sciences. Michigan State University was one of the major sponsoring partners for this event.

Other MSU units joined IGH to support this international conference, including the College of Osteopathic Medicine; the International Studies and Programs; the Muslim Studies Program; the Center for European, Russian, and Eurasian Studies; and the Muslim Mental Health Consortium of the Department of Psychiatry.

Facing the ongoing global pandemic and various disruptions, this scientific forum aimed to exchange COVID-19 lessons and knowledge and build bridges and commitments among scientists, researchers and policymakers in the MENA region, North America and Europe. The priorities are to prevent diseases, reduce health disparities and

promote wellness in the global community through health research collaboration and interventions. Distinguished researchers and healthcare practitioners shared lessons from the COVID-19 pandemic through presentations, panels, workshops and poster sessions. In addition, IGH hosted a hybrid panel discussion on refugee resettlement and COVID-19. The panelists from MSU were William Cunningham, D.O., M.H.A., Furqan Irfan, M.D., Ph.D., and Stephanie Nawyn, Ph.D.

The United Nations High Commissioner for Refugees (UNHCR) estimated that global forced displacement had surpassed 80 million by mid-year 2020, and roughly 35 million (almost 50%)

live in the MENA region, with 31% of this population being children. The challenges to refugees and displaced people on many fronts are exacerbated further by climate change, such as safety and security, resettlement, health and well-being, education and employment. While refugees and displaced populations may face different challenges in different societies, in the US, their most significant challenges include, but are not limited to, English language and cultural barriers, children’s education, employment, housing, transportation and access to services. As a result, there is an urgency to strengthen research, practice, teaching and learning of the challenges

TURKEY cont. page 19

Dr. Stephanie Nawyn and conference panel

AFCM/MSU’s ACADEMIC COOPERATION IS APPROACHING THE END OF YEAR FIVE

Five Years ago, MSUCOM and IGH entered into an agreement with the Armed Forces College of Medicine in the Arab Republic of Egypt to revise their medical school curriculum and develop multiple training programs. The curriculum and clinical mapping were completed, and a continuous quality improvement plan was designed to keep the AFCM curriculum up to date. Many productive workshops were created and implemented to achieve the professional development that AFCM sought to enhance the medical knowledge of its faculty, and medical students.

Technological support and training, as well as software, were provided to facilitate teaching and achieve the goals of AFCM. A simulation training took place in both AFCM and MSU and was very productive. Administrative, leadership and other training in medical education also took place frequently and consistently. An intense and fruitful discussion about building a solid background for research at AFCM also took place at MSU and Egypt consistently. An intense and fruitful discussion regarding building research at AFCM also took place and will be detailed in the next phase of 2023-2026.

During the last 5 years IGH/ MSUCOM carefully considered the general and long-term goals set by AFCM, hired a team of consultants and specialists in

medical education and designed its plans to fulfill those goals. MSU will continue to strategically enhance this partnership with MENA countries and support AFCM during future projects to enable them to achieve “a world-class military medical school and international accreditation.” AFCM will continue its efforts to implement best practices in medical education to produce high-quality physicians, scientists and researchers in the MENA region.

Since 2017, IGH’s team of consultants has supported AFCM in successfully implementing the transition from the 6+1 medical curriculum (known as the LEGACY curriculum) to the new requirements for the 5+2 curriculum (NUCU). This requires, among other things, solidifying and extending AFCM’s technological capacities for

effective curriculum management. This includes monitoring and assessing the progress of AFCM’s students and the effectiveness of their learning, as well as the efficacy of the faculty’s teaching.

The project aims to achieve five main objectives: medical education curriculum revision, technology enhancement and learning (ET/IT), professional faculty development, accreditation readiness and clinical and diagnostic medical skills.

The professional development of AFCM includes the planning and evaluation process to ensure that faculty at AFCM have the support and resources to instruct their medical students. The clinical training and internships aim to identify and address any weaknesses that AFCM may have in mastering the competencies in medicine needed to be successful in accreditation from the National Authority for Quality Assurance and Accreditation of Education (NAQAAE) and Liaison Committee on Medical Education (LCME).

AFCM has been accredited by the NAQAAE, which allows its graduates

AFCM cont. page 19

EXPANDING PRECEPTORSHIPS COURSE FOR MEDICAL STUDENTS INTERNATIONALLY

Sustainable Medical Sites with local partners where the offerings are available include:

• Iquitos and Lima, Peru (every year in the Summer)

• San Pedro de Macoris, Dominican Republic (every year on Winter break)

• Merida, Mexico Summer break, August 19 to August 26, 2023. (NEW!)

IGH is expecting to launch a Preceptorship Offering in Costa Rica in 2024.

In August 2022, the department of Family Community Medicine (FCM) in collaboration with the Institute for Global Health at the College of Osteopathic Medicine launched the International Pre-Clerkship Course FCM 660.

This course allows second-year medical students at the College of Osteopathic Medicine (OMS-II) to complete the requirements of the preceptorships course abroad while gaining international experience in global health matters.

Students participating in this course are required to:

• Participate in orientation

• Attend structured education didactics, global health, common primary care medical complaints, osteopathic principles/manipulation, cultural competency, and appropriate physical exam skills.

• Work alongside multiple MSU clinical preceptors

• Complete 35+ hours of clinical exposure

• Complete necessary documentation requirements:

- Fall and Diabetic needs assessment

- Adult Acute Office Visit Note, - uploading the documentation via D2L.

• Participate in daily and end of the trip debriefings and fill out courses.

If you are interested in in applying for an international preceptorship, please contact Ms. Rebecca Reagan reagan@ msu.edu or Ms. Shannon Grochulski-Fries grochuls@ msu.edu

MASTER OF SCIENCE IN GLOBAL HEALTH

The new academic year began in fall 2022 and admission application were being accepted for summer enrollment. Students in the program do not need to have medical experience and come from a wide variety of backgrounds. Anyone interested in learning more is encouraged to reach out to the program to schedule an informational meeting.

The faculty within the Global Health Studies program are highly skilled in their areas of expertise and come from various colleges from across campus, as well as from external global health-related organizations.

The Global Health Studies program is now in its fourth year and has had nine graduates with master’s of science degrees and five who have earned graduate certificates. During the spring semester of 2022 alone, there were six MS graduates and one certificate completion.

Spring semester was also the first time Global Health Studies graduates were able to attend their graduation ceremony in person on campus in East Lansing. Director Rebecca Malouin, Ph.D., escorted two students to the stage to receive the diplomas.

HIGHLIGHTS OF SAN

PEDRO DE MACORIS, DOMINICAN REPUBLIC AND MÉRIDA, MEXICO EXPERIENCES IN 2022.

“In the essay, I wrote in my MSUCOM application, I distinctly remember writing about how ecstatic I was for the prospect of participating in the international trips offered by IGH. As a student with a lifelong passion for traveling and learning from different cultures, this was the ultimate selling point for me to apply to MSU. So far, I have been extremely fortunate to have been able to participate in the Dominican Republic and Mérida trips and to say that these experiences have surpassed my expectations would be an understatement. These trips have provided us with an opportunity to immerse ourselves in a way that an ordinary traveler would not be able to experience on their own.

For example, a highlight of the Dominican Republic trip was when we visited the local sugar cane farms (Batey) to treat patients who didn’t have regular access to healthcare.

I was extremely impressed by the sustainable structure of this program in that we were able to play an active role in

supervised triage for hundreds of patients each day, with the ability to provide referrals for serious cases to the local clinic with transportation for continued care if needed. I was able to gain a wide spectrum of knowledge from the diverse cultural viewpoint of medicine to the different barriers to care patients face each day, and I will always be able to carry that with me through medical school and beyond.

My trip to Merida gave me a different set of invaluable experiences in that I was able to see first-hand how different locations, cultures, and lifestyles can play a huge role in the type of conditions we may encounter as physicians. I think it’s easy for us to become hyper-focused on the scans, lab values, and the classic presentations of symptoms, but this experience gave me a much-needed reminder of why I fell in love with Osteopathic Medicine in the first place – the emphasis on mind, body, and spirit. Watching our very own OMM guru Dr. Gordon help a patient release

his childhood traumas using OMM opened a whole new world of medicine for me. I think I can speak for the rest of my group in saying that we were all blown away by the amount of effort the IGH team invested from start to finish to make this trip unforgettable for us, and each time we thought the trip couldn’t get any better, we were proven wrong.

I feel extremely fortunate to have had these unique opportunities to integrate my passion for medicine with my passion for travel at MSUCOM. I have been able to gain a unique set of skills, knowledge, and cultural appreciation that I know will shape me into a stronger physician, and I hope to take advantage of as many experiences as I can during my time here. If someone asks me in 50 years’ time what my favorite part of medical school was, I know that I’ll be able to confidently answer with the stories from these trips. Through IGH, I was able to discover my love for OMM, kidney stones, and seeing the faces of the families after successful life-saving surgeries and for that, I will be forever grateful.”

Laura Miller

REFLECTION ON THE DOMINICAN REPUBLIC PROGRAM MARCH 2022

I have always had the desire to be involved in global health efforts. It has never been a question of if I would be involved, but rather when. When an opportunity presented itself to travel to the Dominican Republic over the spring break of my first year of medical school, I jumped at the chance. I had very little experience with the people in Central America prior to this trip, and I was excited to learn more about their culture, their model of healthcare, and how sugarcane plantation workers’ healthcare may differ from other Dominicans’.

We began our trip at a local medical school learning about the history of the Dominican Republic and the local sugarcane plantation communities, also known as Bateys. It was important for us to receive this background information to better understand the people we would be meeting and treating over the next several days. We visited three local Bateys with the support of local leaders to provide treatment for acute health issues as well as referral and follow-up information for other health issues as appropriate. This gave us a glimpse into the medical issues that are more prominent in their communities, and how these may be similar or different from the medical issues we often encounter here in the United States.

Our team in these clinics consisted of 20 medical students and several physicians. Together, we were able to see a few hundred patients in just three days. While I believe it’s safe to say that our clinical skills improved, I believe it was our non-clinical skills that saw the most growth through this experience. Despite the language barriers that may have been present with our patients, we were able to connect and learn from them by making the effort both verbally and non-verbally to

understand what was most important to them and how we could be of help to them. We emphasized that they were our top priority at that moment and we were there to support them.

As I continue my preclerkship education and move into my clerkship years, I will carry this experience from the

Dominican Republic with me. This will aid me in working with both native and non-native English speakers, and more generally in communicating with all of my future patients. I hope to return to the Dominican Republic one day to continue serving the communities that taught me many valuable lessons in just a few short days.

Zachary Tapper

ENJOYS HIS TRIP TO MÉRIDA

The Global Health trip to Mérida, Mexico is a phenomenal experience. On top of all the great cultural experiences that enrich travel, students also have the opportunity to shadow and observe surgery at local hospitals as well as childbirth at the local maternity clinic. Furthermore, there is nothing quite like watching and participating in OMM with Dr. Gordon. He is an incredible teacher and offers a unique perspective on OMM that is not soon to be forgotten.

The surgical observations range from appendectomies to cardiothoracic surgery. On any given day, you will be able to observe, ask questions, and interact with attendings, residents, ancillary staff, and often other international medical students. The surgeons and residents are very open to teaching; they create a very comfortable environment to ask questions, learn, and step into the world of surgery.

The experience you’ll have at the maternity clinic is incredibly memorable. Students can observe both natural births as well as cesarean sections! The maternity clinic loves having students and encourages involvement with postnatal care. If desired, you can gain experience caring for newborns in the immediate postnatal period, calculating an APGAR score, testing postnatal reflexes, and just generally interacting with adorable newborns!

At Dr. Gordon’s OMM clinic, you’ll see medicine as it is meant to be practiced. No patients are rushed through the door. If it takes 45 minutes to get to the bottom of a case, then the patient gets 45 minutes of medical attention. It is truly inspiring to see the level of dedication Dr. Gordon puts into both the community and education. Furthermore, students are very involved in care at the OMM clinic. If you are new to OMM this will be an invaluable opportunity, as Dr. Gordon provides a very involved hands-on experience that will allow

you to get a sense of what you’re feeling beneath your fingers. If you are a more advanced student, this is also an excellent opportunity to use your skills, receive direct feedback from a full-time OMM physician, grow as a clinician, and impact a community of patients who are grateful for your service.

Finally, this write-up would be far from complete without mention of the amazing coordinators that make the experience in Mexico so enjoyable. They are fun, knowledgeable, and incredibly well-versed in making sure everyone has an amazing time. The trip coordinators serve as a direct link between students and the culture/ people of Mérida! Every experience in Mexico is enhanced by their presence, and you’ll want to book another trip to Mexico just to visit them!

The Global Health Trip to Mérida, Mexico is one that should be on the top of every travel-minded MSUCOM student’s to-do list during their first two years. The trip offers an amazing experience from the moment you arrive in Mexico and leaves you wishing for another week by the time you’re boarding your flight home. ¡Disfruta tu viaje!

to access GME training in the U.S. and be recognized as conforming to the USA standards for medical school graduates. The Educational Commission for Foreign Medical Graduates (ECFMG) requires medical schools outside the United States to

be accredited by their national accrediting authority by 2023 for their graduates. The ECFMG accreditation process requires AFCM to address each standard and provide a method of meeting specific requirements.

Faculty and students from AFCM also visited MSU in an

intensive training program that included observation, leadership, administrative work and human resources. Some AFCM faculty were granted adjunct faculty positions at MSU that enabled them to access various resources from the MSU library.

refugees face and identify solutions. In addition, IGH is striving to collaborate with members at MSU to lead the research, education and corporation in this area and make them more accessible to the global society.

About 500 participants attended the conference, representing 100 academic and research centers and government and non-government health and human service organizations around the globe. The various exchange venues facilitated networking among the participants and created opportunities to form collaborative teams. IGH associate

directors, Sung Soo Chung and Dr. Qing Xia, also traveled to Gaziantep University to attend the conference. They connected with more people in the MENA region and identified institutional partners for future research, education and capacitybuilding collaborations. A follow-up visit to the University of Gaziantep, Turkey is pending for 2023 after the devastating news of the earthquake. The IGH team is aiming to have feet on the ground by the middle of the year and start collaborating in refugee resettlement, research and open educational exchange and international rotations for students at MSU again.

Michigan State University’s College of Osteopathic Medicine Global Health Institute has been involved in conference planning and fundraising efforts since early 2021.

IGH Associate Director Sung Soo Chung receives conference participants at MSU exhibit table.

*MENA region includes countries in the Middle East and North Africa.

TURKEY cont. from page

INSTITUTE FOR GLOBAL HEALTH COURSES

OST 690: Global Health: Dominican RepublicHealthcare Delivery System and Culture

OST 691: Global Health: Guatemala- Tropical Medicine and Infectious Diseases

OST 686: Global Health: Mexico- Community Medicine and Mayan Culture in the Yucatan

OST 687: Global Health: Peru Medical Service

Ost 693: Global Health: Korean Healthcare Delivery System

OST 688: Global Health: Cuban Healthcare Delivery System

OST 689: Global Health: Haiti- Intro to Global Health and Culture

OST 694: Global Health: Nepal- One Health in Nepal

OST 685: International Clerkship Rotation (set-up for individual clerkship rotations)

NEW! OST 695: Global Health: Costa Rica- Pre-Clinical Observation, Culture and Medicine

IGH Faculty and Staff:

William Cunningham, DO, MHA, Director

Sung Soo Chung, MS, MPH, Associate Director

Rene Hinojosa,PhD, Director of Research

Rebecca Malouin, PhD, Director of Global Health Studies

Michael Miller, PhD, Fiscal Officer

Qing Xia, PhD

Associate Director for Global Health Education

Travis Gordon, DO

Assistant Director of Merida Medical Education

Arpon Shahed, DO Clinical Coordinator for Study Abroad Programs

Ruben Kenny Briceno, MD

Peru Medical Education and Research

MaryAnne Walker, MA Senior Research specialist

Suna Barber, MS Accountant

Sabrina Vieyra Hollenbeck, BA, Consortium and Study Abroad Coordinator

LEARN MORE ABOUT OUR PROGRAMS HERE:

UPCOMING EVENTS

MOHIP Webinar #5: One Health implementation and experience in Latin America: South-South partnership with the lower Mekong region

• When: Mar 23, 2023, 9 AM Indochina Time

• Register in advance is required for this webinar:

• https://msu.zoom.us/webinar/register/WN_eKLTJTOZRV66L_Qy4LGuVQ

CUGH Conference: Global Health at a Crossroads: Equity, Climate Change and Microbial Threats

• When: April 14-16, 2023

• Washington Hilton, Washington DC

• More information and registration: https://www.cugh2023.org/

EDITOR IN CHIEF

William Cunningham, D.O., MHA

CONTRIBUTING WRITERS

Vilitcia Barghouti

Sung Soo Chung

Rene Hinojosa

Sabrina Vieyra Hollenbeck

Stephanie Six

Qing Xia

ADVISORY BOARD

Agnew Dalen, DVM, Ph.D., DACVP

Keith English, MD

Pilar Horner, MSW, Ph.D

Jose Jackson Malete, Ph.D

Karim Maredia, Ph.D

Michael Stokes, CPA

Gerald Urquhart, Ph.D

Lorena Mier y Teran Medina, BA, Merida Coordinator and Assistant

Study Abroad Program

Leaders:

Richard Bryce, DO

Program Leader Guatemala

Sung Soo Chung, MS, MPH

Program Leader Korea

Rene Hinojosa, PhD

Program Leader Cuba

Travis Gordon, DO

Jake Rowan, DO

Program Leader Mexico

Arpon Shahed, DO

Program Leader Dominican Republic (graduates)

MaryKay Smith, PhD

Program Leader Dominican Republic (undergraduates)

Gary Willyerd, DO

Program Leader Peru

EMERITUS ADVISORS

Charles Gliozzo Ph.D

John Kaneene DVM, MPH, Ph.D

James Trosko Ph.D