Sachin Chaudhary

Interests

Teaching

ILDCritical CareTransplant Pulmonology

Research

ILD

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Kam, M. L., Tjong, E. L., Chaudhary, S., Koelsch, T. L., Pryor, J. B., Koslow, M., Mohning, M. P., Solomon, J. J., Huie, T. J., Swigris, J. J., & Fernández Pérez, E. R. (2025). Development and Validation of a Clinical, CT, Genomic Classifier and BAL Scoring System for Diagnosing IPF. The European respiratory journal.
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  The utility of incorporating a usual interstitial pneumonia (UIP) genomic classifier (GC) and bronchoalveolar lavage (BAL) cell count analysis alongside traditional clinical-imaging assessment in aiding in the multidisciplinary diagnosis of IPF in patients with a non-definite HRCT UIP pattern is uncertain.We reviewed consecutive adult patients presenting with fibrotic interstitial lung disease (fILD) and non-definite HRCT UIP pattern who underwent BAL and GC. The initial fILD diagnoses were re-evaluated after bronchoscopy and a final multidisciplinary consensus diagnosis was provided. We created a clinical score by analyzing fILD clinical characteristics, GC, and BAL results from 139 National Jewish Health (NJH) patients and validated it at the University of Arizona, n=52. A multivariable model was developed and assessed using receiver operating characteristic curves.43/139 (31%) and 29/52 (56%) of patients in the derivation and validation cohort, respectively, were diagnosed with IPF after bronchoscopy, and 85/139 (61%) and 32/52 (61%) had a change in treatment, respectively. Compared to non-IPF, IPF patients had a similar progression-free survival (HR, 1.50; 95%CI, 0.76, 2.95). The final model, assigned a score to eight predictors: age, sex, HRCT probable UIP pattern, exposures, connective tissue disease signs/symptoms, Velcro crackles, CG results, and BAL lymphocyte and monocyte count. The final score demonstrated an AUC of 0.90 (95% CI 0.85 to 0.95) in the derivation cohort and 0.91 (95% CI 0.83 to 0.99) in the validation cohort.The clinical-HRCT-BAL-GC IPF score may accurately estimate the post-test probability of IPF in patients with a non-definite HRCT UIP pattern.
• Fernández Pérez, E. R., Leach, S. M., Vestal, B., & , P. S. (2024). Rationale and design of the prognostic transcriptomic signature in fibrotic hypersensitivity pneumonitis (PREDICT) study. ERJ open research, 10(1).
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  Hypersensitivity pneumonitis is an immunologically mediated form of lung disease, resulting from inhalational exposure to a large variety of antigens. A subgroup of patients with fibrotic hypersensitivity pneumonitis (FHP) develop symptomatic, functional and radiographic disease progression. Mortality occurs primarily from respiratory failure as a result of progressive and self-sustaining lung injury that often occurs despite immunosuppression and removal of the inciting antigen. The development and validation of a prognostic transcriptomic signature for FHP (PREDICT-HP) is an observational multicentre cohort study designed to explore a transcriptomic signature from peripheral blood mononuclear cells in patients with FHP that is predictive of disease progression. This article describes the design and rationale of the PREDICT-HP study. This study will enrol ∼135 patients with FHP at approximately seven academic medical sites. Participants with a confirmed diagnosis of FHP are followed over 24 months and undergo physical examinations, self-administered questionnaires, chest computed tomography, pulmonary function tests, a 6-min walk test and blood testing for transcriptomic analyses. At each 6-month follow-up visit the study will assess the participants' clinical course and clinical events including hospitalisations and respiratory exacerbations. The PREDICT study has the potential to enhance our ability to predict disease progression and fundamentally advance our understanding of the pathobiology of FHP disease progression.
• Maher, T. M., Ford, P., Brown, K. K., Costabel, U., Cottin, V., Danoff, S. K., Groenveld, I., Helmer, E., Jenkins, R. G., Milner, J., Molenberghs, G., Penninckx, B., Randall, M. J., Van Den Blink, B., Fieuw, A., Vandenrijn, C., Rocak, S., Seghers, I., Shao, L., , Taneja, A., et al. (2023). Ziritaxestat, a Novel Autotaxin Inhibitor, and Lung Function in Idiopathic Pulmonary Fibrosis: The ISABELA 1 and 2 Randomized Clinical Trials. JAMA, 329(18), 1567-1578.
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  There is a major need for effective, well-tolerated treatments for idiopathic pulmonary fibrosis (IPF).
• Chaudhary, S., Weigt, S. S., Neto, M. L., Benn, B. S., Vu Pugashetti, J., Keith, R., Chand, A., Oh, S., Kheir, F., Ramalingam, V., Solomon, J., Harper, R., Lasky, J. A., & Oldham, J. M. (2022). Interstitial lung disease progression after genomic usual interstitial pneumonia testing. The European respiratory journal.
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  A genomic classifier for usual interstitial pneumonia (gUIP) has been shown to predict histologic UIP with high specificity, increasing diagnostic confidence for idiopathic pulmonary fibrosis (IPF). Whether those with positive gUIP classification exhibit a progressive, IPF-like phenotype remains unknown. A pooled, retrospective analysis of patients who underwent clinically indicated diagnostic bronchoscopy with gUIP testing at seven academic medical centers was performed. We assessed the association between gUIP classification and eighteen-month progression-free survival (PFS) using Cox proportional hazards regression. PFS was defined as the time from gUIP testing to death from any cause, lung transplant, ≥10% relative decline in forced vital capacity (FVC) or censoring at the time of last available FVC measure. Longitudinal change in FVC was then compared between gUIP classification groups using a joint regression model. Of 238 consecutive patients who underwent gUIP testing, 192 had available follow-up data and were included in the analysis, including 104 with positive gUIP classification and 88 with negative classification. In multivariable analysis, positive gUIP classification was associated with reduced PFS (HR 1.58, 95% CI 0.86-2.92; p=0.14), but this did not reach statistical significance. Mean annual change in FVC was -101.8 mL (95% CI -142.7 mL, -60.9 mL; p
• Malo, J., Natt, B., Chaudhary, S., & Knox, K. S. (2022). Prophylaxis in Lung Transplant Recipients. Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.
• Podolanczuk, A. J., Kim, J. S., Cooper, C. B., Lasky, J. A., Murray, S., Oldham, J. M., Raghu, G., Flaherty, K. R., Spino, C., Noth, I., Martinez, F. J., & , P. S. (2022). Design and rationale for the prospective treatment efficacy in IPF using genotype for NAC selection (PRECISIONS) clinical trial. BMC pulmonary medicine, 22(1), 475.
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  Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease with few treatment options. N-acetylcysteine (NAC) is a well-tolerated, inexpensive treatment with antioxidant and anti-fibrotic properties. The National Heart, Lung, and Blood Institute (NHLBI)-sponsored PANTHER (Prednisone Azathioprine and NAC therapy in IPF) trial confirmed the harmful effects of immunosuppression in IPF, and did not show a benefit to treatment with NAC. However, a post hoc analysis revealed a potential beneficial effect of NAC in a subgroup of individuals carrying a specific genetic variant, TOLLIP rs3750920 TT genotype, present in about 25% of patients with IPF. Here, we present the design and rationale for the Phase III, multi-center, randomized, double-blind, placebo-controlled Prospective Treatment Efficacy in IPF Using Genotype for NAC Selection (PRECISIONS) clinical trial.
• Tighe, R. M., & Chaudhary, S. (2022). Uncovering the Epidemiology of Idiopathic Pulmonary Fibrosis in the Veterans Affairs Health System. Annals of the American Thoracic Society, 19(2), 161-162.
• Harris, D. T., Badowski, M., Jernigan, B., Sprissler, R., Edwards, T., Cohen, R., Paul, S., Merchant, N., Weinkauf, C. C., Bime, C., Erickson, H. E., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., El Aini, T., Rischard, F., Campion, J., , Chopra, M., et al. (2021). SARS-CoV-2 Rapid Antigen Testing of Symptomatic and Asymptomatic Individuals on the University of Arizona Campus. Biomedicines, 9(5).
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  SARS-CoV-2, the cause of COVID19, has caused a pandemic that has infected more than 80 M and killed more than 1.6 M persons worldwide. In the US as of December 2020, it has infected more than 32 M people while causing more than 570,000 deaths. As the pandemic persists, there has been a public demand to reopen schools and university campuses. To consider these demands, it is necessary to rapidly identify those individuals infected with the virus and isolate them so that disease transmission can be stopped. In the present study, we examined the sensitivity of the Quidel Rapid Antigen test for use in screening both symptomatic and asymptomatic individuals at the University of Arizona from June to August 2020. A total of 885 symptomatic and 1551 asymptomatic subjects were assessed by antigen testing and real-time PCR testing. The sensitivity of the test for both symptomatic and asymptomatic persons was between 82 and 90%, with some caveats.
• Lasky, J. A., Case, A., Unterman, A., Kreuter, M., Scholand, M. B., Chaudhary, S., Lofaro, L. R., Johnson, M., Huang, J., Bhorade, S. M., & Kennedy, G. C. (2021). The Impact of the Envisia Genomic Classifier in the Diagnosis and Management of Patients with Idiopathic Pulmonary Fibrosis. Annals of the American Thoracic Society.
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  The diagnosis of idiopathic pulmonary fibrosis (IPF) remains challenging and can result in delayed or misdiagnosis. IPF diagnosis is based upon the presence of either a radiographic or histologic usual interstitial pneumonia (UIP) pattern in the absence of an identifiable etiology. The Envisia Genomic Classifier is a clinically validated molecular diagnostic test that identifies UIP in transbronchial biopsies.
• Martinez, F. J., Yow, E., Flaherty, K. R., Snyder, L. D., Durheim, M. T., Wisniewski, S. R., Sciurba, F. C., Raghu, G., Brooks, M. M., Kim, D. Y., Dilling, D. F., Criner, G. J., Kim, H., Belloli, E. A., Nambiar, A. M., Scholand, M. B., Anstrom, K. J., Noth, I., & , C. I. (2021). Effect of Antimicrobial Therapy on Respiratory Hospitalization or Death in Adults With Idiopathic Pulmonary Fibrosis: The CleanUP-IPF Randomized Clinical Trial. JAMA, 325(18), 1841-1851.
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  Alteration in lung microbes is associated with disease progression in idiopathic pulmonary fibrosis.
• Stahl, C., Frederick, K., Chaudhary, S., Morton, C. J., Loy, D., Muralidharan, K., Sorooshian, A., & Parthasarathy, S. (2021). Comparison of the Filtration Efficiency of Different Face Masks Against Aerosols. Frontiers in medicine, 8, 654317.
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  The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic can spread through virus-containing aerosols ( ≤ 5 μm) and larger airborne droplets. Quantifying filtration efficiency of different kinds of masks and linings for aerosols that fall within the most penetrating particle size (80-400 nm) is critical to limiting viral transmission. The objective of our experiment was to compare the "real-world" filtering efficiency of different face masks for fine aerosols (350 nm) in laboratory simulations. We performed a simulated bench test that measured the filtering efficiency of N95 vs. N99 masks with elastomeric lining in relation to baseline ("background") aerosol generation. A mannequin head was placed within a chamber and was attached to an artificial lung simulator. Particles of known size (350 ± 6 nm aerodynamic diameter) were aerosolized into the chamber while simulating breathing at physiological settings of tidal volume, respiratory rate, and airflow. Particle counts were measured between the mannequin head and the lung simulator at the tracheal airway location. Baseline particle counts without a filter (background) were 2,935 ± 555 (SD) cm, while the N95 (1348 ± 92 cm) and N99 mask with elastomeric lining (279 ± 164 cm;
• Unterman, A., Tom, J., Scholand, M. B., Lofaro, L., Lasky, J., Kreuter, M., Kennedy, G., Johnson, M., Huang, J., Chaudhary, S., Case, A., & Bhorade, S. (2021). Title: THE IMPACT OF THE ENVISIA GENOMIC CLASSIFIER IN THE DIAGNOSIS AND MANAGEMENT OF PATIENTS WITH INTERSTITIAL LUNG DISEASE. Chest, 160(4), A1257-A1258. doi:10.1016/j.chest.2021.07.1150
• Casanova, N. G., Gonzalez-Garay, M. L., Sun, B., Bime, C., Sun, X., Knox, K. S., Crouser, E. D., Sammani, N., Gonzales, T., Natt, B., Chaudhary, S., Lussier, Y., & Garcia, J. G. (2020). Differential transcriptomics in sarcoidosis lung and lymph node granulomas with comparisons to pathogen-specific granulomas. Respiratory research, 21(1), 321.
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  Despite the availability of multi-"omics" strategies, insights into the etiology and pathogenesis of sarcoidosis have been elusive. This is partly due to the lack of reliable preclinical models and a paucity of validated biomarkers. As granulomas are a key feature of sarcoidosis, we speculate that direct genomic interrogation of sarcoid tissues, may lead to identification of dysregulated gene pathways or biomarker signatures.
• Chaudhary, S., Natt, B., Bime, C., Knox, K. S., & Glassberg, M. K. (2020). Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused. Frontiers in medicine, 7, 539.
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  After decades of research, two therapies for chronic fibrotic lung disease are now approved by the FDA, with dozens more anti-fibrotic therapies in the pipeline. A great deal of enthusiasm has been generated for the use of these drugs, which are by no means curative but clearly have a favorable impact on lung function decline over time. Amidst a flurry of newly developed and repurposed drugs to treat the coronavirus disease 2019 (COVID-19) and its accompanying acute respiratory distress syndrome (ARDS), few have emerged as effective. Historically, survivors of severe viral pneumonia and related acute lung injury with ARDS often have near full recovery of lung function. While the pathological findings of the lungs of patients with COVID-19 can be diverse, current reports have shown significant lung fibrosis predominantly in autopsy studies. There is growing enthusiasm to study anti-fibrotic therapy for inevitable lung fibrosis, and clinical trials are underway using currently FDA-approved anti-fibrotic therapies. Given the relatively favorable outcomes of survivors of virus-mediated ARDS and the low prevalence of clinically meaningful lung fibrosis in survivors, this perspective examines if there is a rationale for testing these repurposed antifibrotic agents in COVID-19-associated lung disease.
• Chaudhary, S., Natt, B., Bime, C., Knox, K. S., & Glassberg, M. K. (2020). Corrigendum: Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused. Frontiers in medicine, 7, 604640.
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  [This corrects the article DOI: 10.3389/fmed.2020.00539.].
• Graney, B. A., He, C., Marll, M., Matson, S., Bianchi, P., Cosgrove, G. P., Lee, J. S., & , P. C. (2020). Essential Components of an Interstitial Lung Disease Clinic: Results From a Delphi Survey and Patient Focus Group Analysis. Chest.
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  Management of patients with interstitial lung disease (ILD) requires subspecialized, comprehensive, multidisciplinary care. The Pulmonary Fibrosis Foundation established the Care Center Network (CCN) in 2013 with identified criteria to become a designated CCN site. Despite these criteria, the essential components of an ILD clinic remain unknown.
• Ripperger, T. J., Uhrlaub, J. L., Watanabe, M., Wong, R., Castaneda, Y., Pizzato, H. A., Thompson, M. R., Bradshaw, C., Weinkauf, C. C., Bime, C., Erickson, H. L., Knox, K., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., Aini, T. E., Rischard, F., , Campion, J., et al. (2020). Detection, prevalence, and duration of humoral responses to SARS-CoV-2 under conditions of limited population exposure. medRxiv : the preprint server for health sciences.
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  We conducted an extensive serological study to quantify population-level exposure and define correlates of immunity against SARS-CoV-2. We found that relative to mild COVID-19 cases, individuals with severe disease exhibited elevated authentic virus-neutralizing titers and antibody levels against nucleocapsid (N) and the receptor binding domain (RBD) and the S2 region of spike protein. Unlike disease severity, age and sex played lesser roles in serological responses. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. RBD- and S2-specific and neutralizing antibody titers remained elevated and stable for at least 2-3 months post-onset, whereas those against N were more variable with rapid declines in many samples. Testing of 5882 self-recruited members of the local community demonstrated that 1.24% of individuals showed antibody reactivity to RBD. However, 18% (13/73) of these putative seropositive samples failed to neutralize authentic SARS-CoV-2 virus. Each of the neutralizing, but only 1 of the non-neutralizing samples, also displayed potent reactivity to S2. Thus, inclusion of multiple independent assays markedly improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the viral antigen. In contrast to other reports, we conclude that immunity is durable for at least several months after SARS-CoV-2 infection.
• Ripperger, T. J., Uhrlaub, J. L., Watanabe, M., Wong, R., Castaneda, Y., Pizzato, H. A., Thompson, M. R., Bradshaw, C., Weinkauf, C. C., Bime, C., Erickson, H. L., Knox, K., Bixby, B., Parthasarathy, S., Chaudhary, S., Natt, B., Cristan, E., El Aini, T., Rischard, F., , Campion, J., et al. (2020). Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low-Prevalence Communities and Reveal Durable Humoral Immunity. Immunity, 53(5), 925-933.e4.
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  We conducted a serological study to define correlates of immunity against SARS-CoV-2. Compared to those with mild coronavirus disease 2019 (COVID-19) cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against the nucleocapsid (N) and the receptor binding domain (RBD) of the spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks after PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months after onset, whereas α-N titers diminished. Testing 5,882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low-seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
• Zuwallack, R., Madipally, D. J., Chaudhary, S., Chaturvedi, A., & Chandrika, P. (2019). DEPRESSION ASSOCIATES WITH INCREASED RISK OF COPD-RELATED HOSPITALIZATIONS: INSIGHTS FROM NATIONAL INPATIENT SAMPLE. Chest, 156(4), A469. doi:10.1016/j.chest.2019.08.487
• Natt, B., Chaudhary, S., Ateeli, H., & Ali, H. (2018). Medical image of the week: Dobhoff tube placement with Roux-en-Y gastric bypass. Southwest Journal of Pulmonary and Critical Care, 16(4), 226-227. doi:10.13175/swjpcc045-18
• Natt, B., Chaudhary, S., Ateeli, H., & Ali, H. (2018). Medical image of the week: atypical deep sulcus sign. Southwest Journal of Pulmonary and Critical Care, 16(4), 224-225. doi:10.13175/swjpcc044-18
• Wickstrom, K., Chaudhary, S., & Ateeli, H. (2018). Medical image of the week: cardiac magnetic resonance imaging findings of severe RV failure. Southwest Journal of Pulmonary and Critical Care, 16(5), 252-253. doi:10.13175/swjpcc047-18
• Zaid, L., Chaudhary, S., & Ateeli, H. (2018). Medical image of the week: acute pneumonitis secondary to boric acid exposure. Southwest Journal of Pulmonary and Critical Care, 16(2), 108-109. doi:10.13175/swjpcc025-18
• Chaudhary, S., Meinke, L., Ateeli, H., Knox, K. S., Raz, Y., & Ampel, N. M. (2017). Coccidioidomycosis among persons undergoing lung transplantation in the coccidioidal endemic region. Transplant infectious disease : an official journal of the Transplantation Society, 19(4).
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  Coccidioidomycosis, an endemic fungal infection, is more likely to be symptomatic and severe among those receiving allogeneic transplants. While several case series have been published for various transplanted organs, none has described the incidence and outcomes in those receiving lung transplants within the coccidioidal endemic region.
• Chaudhary, S. (2016). Bronchial Artery Embolization. Southwest Journal of Pulmonary and Critical Care.
• Jarrett, B., Ghazala, S., Chao, J., & Chaudhary, S. (2016). Case of Steven-Johnson Syndrome in a male with breast cancer secondary to docetaxel/cyclophosphamide therapy. BMJ case reports, 2016.
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  The mortality rate for Stevens-Johnson syndrome (SJS) is estimated to be ∼12% and for toxic epidermal necrolysis (TEN) it is around 30%. It continues to be a severe life-threatening drug reaction. We present a 60-year-old Caucasian man with a medical history significant for breast cancer status post mastectomy and chemotherapy with docetaxel and cyclophosphamide who presented with severe mucositis and a progressing skin rash consistent with SJS. He was started on high-dose corticosteroids and IVIG but continued to have worsening mucosal ulcerations and severe bleeding from the oral, conjunctival and genital mucosa. He underwent several rounds of plasmapheresis and additional high-dose steroids with mild improvement in the mucocutaneous manifestations. He subsequently developed respiratory failure, which required mechanical ventilation, as well as disseminated intravascular coagulation, diffuse alveolar haemorrhage, with Pneumocystis jirovecii pneumonia which led to his demise on hospital day 15.
• Wong, C., Fernandes, A., Huang, J., & Chaudhary, S. (2015). Medical image of the week: ascaris lumbridoies. Southwest Journal of Pulmonary Critical Care.
• Chaudhary, S. (2010). Coccidioidomycosis in Lung Transplant Recipients in an Endemic Area. Chest.
• Chaudhary, S., Knox, K. S., Raz, Y., & Meinke, L. E. (2010). Coccidioidomycosis in Lung Transplant Recipients in an Endemic Area. American College of Chest Physicians.

Presentations

• Poojary, I., Meinke, L. E., & Chaudhary, S. (2011, January/Winter). Pulmonary Arterial Hypertension When Seen in HIV Clinical Case Puzzlers. CHEST. Honolulu, HI.
• Chaudhary, S., Knox, K. S., Raz, Y., & Meinke, L. E. (2010, October/Fall). Coccidioidomycosis in Thoracic Transplants. Infectious Disease Conference at the University of Arizona. Tucson, AZ.
• Chaudhary, S., & Goldman, J. (2006, May/Spring). Myxedema Coma. American College of Physicians Chapter Meeting. Troy, MI.

Poster Presentations

• Ahmad, K., & Chaudhary, S. (2015, May/Spring). Recurrent Diffuse Alveolar Hemorrhage Induced By Hepatitis C Associated Mixed Cryoglobulinemia. American Thoracic Society. Denver, CO.
• Chaudhary, S., Goldschmid, M., & Szerlip, H. (2010, September/Fall). Riding out of the storm: treatment of Thyroid storm. American College of Physicians Meeting Arizona Chapter. Phoenix, AZ.
• Nagaraja, V., Underwood, S., Munagala, P., Chaudhary, S., Potharaju, A., & Szerlip, H. (2010, September/Fall). Interns' acquaintance to the system, poster presentation. American College of Physicians Arizona Chapter Annual Meeting. Phoenix, AZ.
• Doraiswamy, V., Nagaraja, V., Chaudhary, S., & Goldschmid, M. (2008, October/Fall). Middle aged man with altered Mental Status, severe Metabolic Acidosis and Acute Renal Failure. American College of Physicians Arizona Chapter.
• Nagaraja, V., Doraiswamy, V., Bucknor, Y., Chaudhary, S., Answer, F., & Goldschmid, M. (2008, October/Fall). Thyroid storm and coma-an atypical presentation, poster presentation. American College of Physicians Arizona Chapter.
• Chaudhary, S., Grandhi, J., & Goldman, J. (2007, March/Spring). Thyrotoxic Hypokalemic Periodic Paralysis. Annual Research Day at Synergy Medical Education Alliance. Saginaw, MI.
• Chaudhary, S., Talati, S., Khan, U., & Kogulan, P. (2007, May/Spring). A Unique Case of Posterior Reversible Encephalopathy Syndrome (PRES). Annual Research Day at Synergy Medical Education Alliance. Saginaw, MI.