• Return to Golf Post Subscapularis Repair: Consideration of Regional Interdependence

      Williams, Katelyn; Ebert, Jeffrey G. (2021)
      Return to golf post subscapularis repair Background Isolated subscapularis tears are uncommon in relation to the frequency of rotator cuff (RTC) pathology. However, in specific populations such as golfers, the subscapularis is the second most torn RTC muscle. Purpose The purpose of this case is to encourage clinicians to consider regional interdependence between a subscapularis tear/repair and a history of low back pain in a recreational golfer. Standard rehabilitation specific to the shoulder post subscapularis repair achieved full functional use of the upper extremity, but limitations persisted specific to golf. This case report highlights the importance of assessing golf mechanics with regional interdependence in mind in order to assist a patient in returning to functional golf performance. Case description A 42-year-old male, recreational golfer since age 14, presented to the clinic post subscapularis RTC repair with a goal of returning to golf. Golf swing analyses were performed pre and post treatment and test retest treatment methods assessed patient�s lingering pain complaints during golf. Outcomes The FOTO and numeric pain rating scale were used to measure improvement along with the patient�s subjective report and golf swing analysis with video footage. The patient�s FOTO score improved by 50 points over 6 months of rehabilitation indicating return to functional use of the UE. Patient�s pain decreased to 0/10 during golf game.
    • An Update on Nonalcoholic Fatty Liver Disease (NAFLD)

      Kang, Anna; Dickerson, Lisa (2021)
      Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease with a prevalence of 25% worldwide. NAFLD is categorized into nonalcoholic fatty liver (NAFL), or simple steatosis, and the more severe form, nonalcoholic steatohepatitis (NASH), a combination of fatty liver plus liver inflammation and injury. Up to 30% of Americans have NAFLD, 20% of whom have NASH. NASH can progress to life-threatening cirrhosis and is a risk factor for developing hepatocellular carcinoma. Considering NAFLD and understanding risk factors is paramount to helping at-risk patients receive timely screening and diagnosis before liver damage is irreversible. The gold standard for diagnosis is liver biopsy, but emerging studies show that noninvasive serum biomarkers and scores as well as novel imaging techniques are acceptable alternatives for the diagnosis and staging of fatty liver. In the absence of approved drug therapy, the gold standard treatment for NAFLD is lifestyle intervention, namely weight loss as a result of diet and exercise. This article will review the epidemiology, pathophysiology, clinical features, diagnostic approach, and treatment recommendations for patients with NAFLD.
    • The Bridge to Better Health

      Gould, Chelsea; Washington, Kayla; Thomas, Joy; Lepp, Erin; May, Stephanie (2021)
      Nutrition education is important for all individuals but most people do not have this knowledge. The lack of nutritional knowledge is a growing problem that contributes to the growth of obesity in Dekalb county. In Dekalb county, approximately 30% of adults and 13% of high school students are obese. Even more people in Dekalb county (73.4% of adults and 79% of youth) do not consume the recommended amount of fruits and vegetables per day(CDC, 2013). Objectives: Increasing knowledge of healthy foods Increasing understanding of nutritional value Ability to participate in healthier eating habits Increasing community support for a healthier well-being Identifying barriers to healthy eating Methods: Mercer University College of Health Professions, Department of Public Health, and the professional program in Physician Assistant Studies program partnered with the Bridge at Austin Community Center's leaders, Dr. Stephanie May and Ms. Bernita Reese. Interactive and educational sessions are held online using Zoom. They are open to both males and females of all ages in Dekalb county. Participants filled out a registration form which included information on their name, children�s names, phone number, address, email, race/ethnicity, ages of household members, and what they are looking to learn from the sessions. This intervention is still currently in progress. The goal of the intervention was to help improve health and wellness for participants.
    • Understanding Teachers-Researcher Collaboration: Designing a Next Generation Science Standards (NGSS) Aligned Curriculum

      Jenkins, Tynetta; Hochuli, Caitlin; Sharma, Meenakshi (2021)
      National curriculum framework for science education (NRC, 2012) makes various recommendations for increasing collaborations among various stakeholders to facilitate the implementation of NGSS. This ongoing study presents a case that exemplifies such a collaboration between two certified teachers (co-authors) and a science education researcher (primary author). The partnership was initiated for designing a K-8 STEM curriculum focused on 3D learning (core ideas, science & engineering practices and crosscutting concepts). This is a qualitative study that uses data from regular curriculum development meetings that involve planning, design, and feedback regarding the STEM curriculum. Teachers and researcher constantly reflect on their role, contributions, and biases during these meetings and by keeping individual written reflective journals to deeply understand the nature of the existing collaboration. The goal of the study is to understand the strengths, dilemmas, and challenges of this collaboration. Most importantly as participants, we strive to understand how we develop a shared vision, how the researcher recognizes teacher voice and how teachers develop a deeper understanding of the NGSS in the process. Initial findings reveal that this partnership is a dynamic process that involves constant negotiations and compels us to revisit and rethink our current roles, values and priorities as we transition to being joint curriculum developers. We are examining changes in teachers� understanding of NGSS as an outcome of this partnership. Also, researcher�s recognition of the school contexts and students� needs as seen through the eyes of teachers will also be examined. Such collaborations are being highly advocated by the NRC (2012) committee. Our research finding can provide useful insights and strategies to build productive learning communities among teachers and researchers to support the goals of K-12 science education. National Research Council. (2012). A framework for K-12 science education: Practices, crosscutting concepts, and core ideas. National Academies Press.
    • A Prophylactic Gonorrhea Vaccine: Evaluation of In vivo Immune Response

      Bagwe, Priyal; Bajaj, Lotika; Gala, Rikhav; Zughaier, Susu; D'Souza, Martin (2021)
      Neisseria gonorrhoeae is the bacteria causing gonorrhea and has gradually developed antimicrobial resistance. Currently, there is no vaccine for gonorrhea. This study aims to investigate the immunogenicity of novel whole-cell inactivated gonococcal microparticulate vaccine formulation loaded in dissolving microneedles for skin delivery. The efficacy of vaccine formulation was assessed in vivo using female mice. The mice were immunized with a prime dose at week 0 followed by two boosters at weeks 2 and 4. Enzyme linked immunosorbent assay (ELISA) was used to measure immunoglobulin levels in collected mice sera. Formalin-fixed gonococci were intact as observed by SEM. The average length of microneedles as observed by SEM was 350 �m. ELISA demonstrated significantly higher serum immunoglobulin levels in groups receiving adjuvanted gonorrhea particulate vaccine when compared to untreated group (p<0.001). The particulate vaccine allows better uptake of antigen facilitated by the APCs causing improved antigen presentation and subsequent immune response by activation of T cells. Skin delivery of the inactivated whole-cell gonococcal microparticulate vaccine formulation loaded in dissolving microneedles is therefore an effective strategy.
    • Evaluation of Hypoglycemia Causes and Treatment at a Community Hospital

      Carbone, Kristina; Murphy, Sarah (2021)
      Hypoglycemia is defined as dangerously low blood glucose levels of less than 70 mg/dL where action, such as administration of glucose, is required to raise the blood glucose levels to the target range. This review seeks to analyze hypoglycemic episodes to determine the cause of hypoglycemia, assess treatment, and identify areas for improvement to enhance patient outcomes and prevent hypoglycemia. This is a retrospective chart review of patients who experienced a hypoglycemic event during their stay between 1/2020 to 12/2020. Patients who experienced a blood glucose level less than 70 mg/dL were identified and randomly selected for review. Patients under 18 years of age and obstetrical patients were excluded. 120 patients were reviewed, with a median blood glucose of 59 mg/dL. 19.2% of patients experienced a severe blood glucose less than 50 mg/dL. Basal insulin was the most common cause of hypoglycemia along with low feeding status. Average time between last basal insulin dose and hypoglycemia was approximately 10 hours with a majority of basal insulin given in the evening and hypoglycemia occurring in the morning. 95.8% of patients had the institutional standard hypoglycemic treatment protocol orders available for use prior to the hypoglycemic event, and 62.5% of patients were treated per protocol. The treatment protocol should always be used to treat hypoglycemia to ensure standardization, and education to nurses on how to use the protocol appropriately is necessary.
    • Effect of barrier integrity on topical/transdermal delivery of diclofenac sodium via iontophoresis

      Dandekar, Amruta; Kale, Madhura S.; Mahadevabharath, R. Somayaji; Garimella, Harsha T.; Banga, Ajay K. (2021)
      Introduction: Application of a drug product on compromised skin may result in altered drug delivery leading to potential systemic toxicity. In this study, we investigated the effect of barrier integrity on the topical and transdermal delivery of brand: generic pair of diclofenac sodium (model anti-inflammatory drug) via iontophoresis. Methods: In vitro drug permeation studies were performed on normal and compromised skin using vertical Franz diffusion cells. A compromised skin model was created using ten tape strips on dermatomed human skin. We compared marketed brand and generic formulations of diclofenac sodium (Voltaren� and 1% diclofenac sodium topical gel by Amneal) via cathodal iontophoresis (0.5 mA/cm2; 2h followed by passive delivery till 6h) using 700 �L of formulation. Results/Conclusion: No significant difference observed between brand and generic formulations for delivery of diclofenac sodium via normal (149.78�18.43�g/cm2(brand);145.53�12.61�g/cm2(generic)) and compromised skin (233.13�8.32 �g/cm2(brand); 242.07�11.17 �g/cm2(generic)). The total delivery of diclofenac was significantly higher for the brand-generic pair into and across compromised skin as compared to normal skin indicating the effect of barrier integrity on delivery of diclofenac sodium. However, there was no significant difference in skin delivery of diclofenac sodium for normal (94.18�15.08 �g/cm2 (brand); 76.97�14.15 �g/cm2 (generic)) and compromised skin (76.74�8.75 �g/cm2 (brand); 72.36�5.18 �g/cm2 (generic)).
    • Business as Usual: Reflections on Life as Mothers and Educators during a Pandemic

      Friedrich, Jami; Perrotta, Katherine; Evans, Amberley; Curl, Jennifer (2021)
      The COVID-19 pandemic marks a major turning point in contemporary history. Teachers and those in the education field face unique challenges regarding the balance of family and work obligations, coping with the stress of preventing infection, and helping students understand the multitude of social and political events that are occurring simultaneously with the pandemic. It is important to record our lived experiences to provide insight into how the COVID-19 pandemic has impacted the history of education in the United States. This poster presents the findings of self-study reflections of four women in four different stages of their personal life and careers in education. Our major findings show that each woman experienced various pressures concerning parenting, balancing family and professional obligations, and navigating the world of academia. We no longer feel like we can separate being a mother and an educator. Instead, we all feel the pressure to be both the best mother and best educator at all times simultaneously because whether in a pandemic or not, life must go on-business as usual. We hope that this research leads to future studies with regard to the impact and changes the COVID-19 pandemic will have on the teachers and teaching in K-16 settings.
    • Assessing Expression and Function of Serotonin Receptors and Transporter in Fmr1 Knockout Mice

      Saraf, Tanishka Satyajit; Chen, Yiming; Armstrong, Jessica; Prophitt, Jennifer; Canal, Clinton (2021)
      The serotonin receptors (5-HTRs) and transporter (SERT) modulate excitation-inhibition altered in autism and its leading monogenic cause, fragile X syndrome (FXS). Here, we assessed their expression and function in adult Fmr1 knockout (KO) mice, a model of FXS, compared to wild type (WT) mice. We performed autoradiography on brain sections using [3H]5-CT for 5-HT1ARs, [3H]Ketanserin for 5-HT2ARs, [3H]Mesulergine for 5-HT2CRs, [3H]Citalopram for SERT. Regions of interest were analyzed using ImageJ. Saturation binding assay was performed for 5-HT1ARs with [3H]5-CT. Behavioral effects of 1,2mg/kg (R)-8-OH-DPAT, 1 mg/kg (�)-DOI, 1,3,10mg/kg lorcaserin and 10mg/kg escitalopram were used to probe in vivo functional activity of 5-HT1A, 5-HT2A, 5-HT2CRs, and SERT, respectively. KO males have higher 5-HT1AR expression in lateral septum and frontal cortex, lower 5-HT2AR expression in isocortex layer V and lower 5-HT2CR expression in anterior olfactory nucleus and nucleus accumbens, than WT males. Saturation binding analysis confirmed the increased 5-HT1AR expression. WT and KO males had lower 5-HT2CR expression in choroid plexus and caudate putamen than females. KO mice showed more pronounced responses to (R)-8-OH-DPAT, decreased DOI-elicited head twitches, and similar lorcaserin-induced hypolocomotion compared to WT mice. SERT expression and function are being evaluated. This shows perturbations in key 5-HTRs in Fmr1 KO mice, suggesting dysfunctions in the central 5-HT system in FXS.
    • A Comparison of 3 Methods of Neonatal Intensive Care Unit (NICU) Mortality and Morbidity Risk Scoring Assessments (CRIB, SNAPPE-II, NTISS): A Systemic Analysis

      Ul-Haque, Anum; Baskaran, Vikraman (2021)
      The NICU aims to provide real-time updates on the medical status of its infant patients. Along with medical techniques, the use of mortality risk scoring systems is necessary in enabling the medical team to make better predictions about the conditions of its patients. Currently, there are many scoring systems used in the NICU, each of which focus on different characteristics to assist the physicians and determine the best course of action and treatment plans. A few common NICU mortality scoring systems are CRIB, SNAPPE-II, and NTISS. CRIB and SNAPPE-II assess infant morbidity at different timepoints post-birth in a cross-sectional methodology. NTISS conducts continuous observations in a longitudinal methodology to record patient healthcare outcomes after different treatments are applied. To conduct thorough research on these NICU patient mortality and morbidity scoring systems, literature searches will be conducted to determine the prevalence of these NICU scoring systems. Specific keywords will be utilized to search multiple databases related to the NICU by focusing on patient categorizations, successful variables, and ineffective scoring systems. After this preliminary research, the evolution of these systems over the past 20 years will also be studied, to learn how the scoring techniques were modified for different clinical scenarios. Finally, a new NICU scoring system will be proposed for future implementation, and a systematic analysis will be written with these results.
    • FoxM1 upregulation correlates with worse recurrence-free survival in breast cancer

      Nguyen, Tro; Nahta, Rita (2021)
      Breast cancer is the second most deadly malignancy among women in the US. Breast cancers harbor intrinsic heterogeneity, allowing stratification into molecular subtypes. Basal-like breast cancer (BLBC) is an aggressive subtype with a high rate of metastasis and poor overall survival. Due to poor understanding of the molecular drivers, few therapeutic options exist for BLBC. Studies suggest that the forkhead box M1 (FoxM1) transcription factor is upregulated in breast cancer. However, the clinical implications of FoxM1 upregulation, including in BLBC, remain unclear. The aims of this study were to (1) compare FoxM1 expression in breast cancer vs normal breast, and (2) correlate FoxM1 expression with clinical outcome using publicly accessible databases. First, we searched breast cancer datasets in Oncomine using FoxM1 as a query term. FoxM1 expression was significantly (p<0.001) higher in invasive ductal breast carcinoma vs normal breast. Next, we searched the KM Plotter breast cancer database using FoxM1 as a query. Among 4,929 patients with breast cancer, median recurrence-free survival (RFS) was significantly (p<0.001) lower in patients with high (upper quartile, 34.13 months) vs low (upper quartile, 80 months) FoxM1 expression. A sub-analysis for BLBC (n=846) demonstrated that median RFS did not significantly (p<0.053) differ in patients with high (upper quartile, 25.2 months) vs low (upper quartile, 26 months) FoxM1. These results suggest that FoxM1 is upregulated in breast cancer in association with worse clinical outcome. Future studies will examine the mechanisms through which FoxM1 is upregulated and strategies for targeting FoxM1 in breast cancer.
    • Direct regulation of cerebral artery contractility by simvastatin and rosuvastatin

      Zerin, Farzana; Pandey, A.; Hasan, A.; Menon, S.; Hasan, R. (2021)
      Statins are amongst the most widely prescribed drugs in the world with a range of vascular effects that have been primarily attributed to the inhibition of cholesterol and mevalonate biosynthesis, and the inhibition of mevalonate-dependent Rho/ROCK signaling upon long-term treatment. However, no studies have investigated the direct effects of acute statin application on fresh isolated resistance cerebral arteries using therapeutic concentrations of statins. Here, we examined acute vascular effects of therapeutically relevant concentrations of statins on male and female Sprague Dawley rat cerebral arteries and underlying molecular mechanisms using pressurized arterial myography as well as Ca2+ fluorescence and diameter measurement. Our data showed that the application of 1nM rosuvastatin and simvastatin constricted cerebral arteries within 2-3 minutes of drug application. The removal of extracellular Ca2+ with EGTA or the application of nimodipine, a selective blocker of smooth muscle cell voltage-gated Ca2+ channel, CaV1.2, each abolished cerebral artery vasoconstriction by statins, indicating that the Ca2+ entry through CaV1.2 plays a critical role here. Since Ca2+ entry into smooth muscle cells induces Ca2+ release from intracellular Ca2+ stores such as sarcoplasmic reticulum and endoplasmic reticulum. Altogether, our data suggests that smooth muscle cell CaV1.2 opening and Ca2+ influx is the primary mechanism underlying statin-induced constriction of cerebral arteries.
    • Perceptions, Attitudes, and Beliefs of Young, Underrepresented Minorities in Clinical Trials

      Ross, Allison; Wong, U.; Nguyen, J. (2021)
      Introduction:This study is designed to ask Millennials (1981-1996) and early Generation Zers (1997-2002) about their perceptions of clinical trials. This will provide insight to identify reasons for the lack of diversity in age, ethnicity, and background for the advancement of future medicine. Methods:The data provided evaluated Millennials and Generation Zers using a survey. Participants were recruited via convenience sampling. Questions included personal demographics, knowledge of clinical trials, willingness to participate in clinical trials. Results:A chi-square test was performed to examine potential associations between individual demographics and responses(N=172, Minority=126, Male=37.7%). For the likelihood of participating in vaccine-focused clinical trials, 62.4% of the respondents reported that it would be unlikely for them to participate in a study; 76.9% Millennials versus Gen Z (N=125, p=0.009). When analyzing gender, women were found to be 69.5% more likely than men to deny participating in a clinical trial for vaccines (N=81, p=0.0005). Discussion:In regard to participating in a clinical trial with a focus on vaccinations, Millennials were less likely to indicate participation than Gen Zers. Between both generations, females were most opposed to the concept. Increased representation in gender and minority-based ethnicity (significantly in the Hispanic and/or Asian community) will allow more comprehensive insight for future implementation and analysis.
    • A Microparticulate Vaccine Microneedle patch for pain-free Immunization against Coronavirus Disease

      Vijayanand, Sharon; Patil, Smital R.; Joshi, Devyani; D'Souza, Martin J. (2021)
      Microneedle (MN) patches for vaccine delivery is an effective immunization strategy suitable for mass immunization. Here, we test the level of immunity provided by a microparticulate (MP) heat-inactivated coronavirus vaccine when administered via the skin as pain-free dissolving MN patches. The vaccine formulation utilizes an MP matrix that provides protection of the antigen and improved antigen uptake by antigen-presenting cells (APCs). The microparticles (MPs) were formulated using a double emulsion method, lyophilized, characterized, and assessed for their in vitro immunogenicity. The in vivo efficacy of the MP vaccine was tested in mice. The immunization was done in 3 doses. ELISA was done to assess the IgG level in mice sera. The animals were sacrificed at week 10 and their organs were harvested for further analysis and expression of immune markers. The results show that the MPs were less than 1 microns in size and the MP vaccine induced a strong innate immune response in vitro. Serum analysis showed higher IgG levels of the vaccine groups. The vaccine groups showed a higher expression of antigen-presenting molecules. Based on the results, we summarize that the MP vaccine can produce an effective immune response when administered as an MN patch via the skin. Moreover, MN patches allow self-administration, which greatly increases patient compliance in addition to decreasing the need for trained pharmacists for immunization.
    • Introducing a Mitigation Strategy into EHR Systems for Drug Shortages

      Nisanian, Meetra T.; Baskaran, Vikraman (2021)
      Nationally, hospitals are feeling the effects of the drug shortages on the quality of patient care. These shortages pose strenuous difficulties on patients, clinicians, and healthcare facilities. These shortages can be caused by many factors including, manufacturing problems lack of raw materials, business decisions, regulatory problems, as well as other external factors. The lack of available medications can cause adverse outcomes due to the need for substitution of commonly used medications that can compromise or delay procedures and lead to medication errors. This also places a burden on the hospital and the hospital staff as well. A mitigation strategy needs to be introduced in order to allow the facility in order to act efficiently in the midst of a crisis. The Rehabilitation Hospital of Southern New Mexico, located in the city of Las Cruces, is a specialized facility that provides rehabilitative services to patients recovering from disabilities causes by illnesses, injuries, or chronic medical conditions. This organization is a member of a large hospital network system known as Ernest Health; However, the hospital is managed locally in order to serve the needs of the community. When a drug shortage occurred, the hospital was not prepared. Therefore, introducing a mitigation strategy was vital for the assurance of continuation of quality patient care.
    • The positive impacts on the adoption and advancement of patient portals within a healthcare facility.

      Kamra, Navneet; Baskaran, Vikraman (2021)
      The intention of this research study is to encourage clinical facilities that do not have a patient portal system, to encourage them to adapt one for their facility or to upgrade outdated patient portal when necessary. Patient portal systems, now more than ever, are a powerful tool for patients to be able to keep track of their health. Despite the many reasons to adopt a patient portal system, many practices are still reluctant to provide a patient portal system for their patients, in fear that they may be making the right investment or may be jeopardizing their provider-patient relationship. The question this research will answer is, Is patient turnout and satisfaction positively impacted based on the adoption of a patient portal within a healthcare facility? In order to answer this questions, It is important to research what patients want out of a patient portal and how patient portals can increase patient satisfaction. Ultimately patient satisfaction is correlated to an increased number of patients/new patients.An increased number of patients generally means a potential increase in revenue. To do this research Lifeline Primary Care Clinic was chosen which is a clinic that has switched through three patient portals over the years; e-clinicalworks, Healow app (after merging with eclinicalworks in 2014) and AthenaHealth. The clinic has also expanded into other locations as well. Thus making this clinic an ideal facility for the proposed research. Another factor of choosing this clinic was due to the vast data the clinic has produced that is relevant to this research and health IT overall. In order to start the research process, a literature review was conducted in regards to the patient portal, as well as how they were perceived by both patients and healthcare providers. Upon reviewing the relevant articles on the topic, a methodology was mapped out to be able to collect patient data from each portal implementation and transition to be able to detect whether or not each transition had increased number of current and new patients due to the potential decrease in phone times by the staff with the portals having appointment and messaging systems. The data from these findings would then be compiled in an excel spreadsheet to show upward or stagnant trends in a line graph. Along with this, survey questions were generated through surveymonkey.com to be able to assess patient satisfaction by the current and by past patient portals based on preferences. Another survey was also created for the medical staff as well, in order to see the staff�s perception on patient portals and if the patient portals have impacted their workload in a positive manner or not.
    • Assessment of Current Opioid Stewardship Activities and Evaluation of Health Informatics Tools to Reduce Opioid Prescribing

      Parker, Julie; Baskaran, Vikraman (2021)
      Background: Overprescribing opioids has become a public health emergency in which 128 people in the United States die every day after overdosing on opioids. This also poses a problem in the acute care setting, as many institutions do not continually monitor daily opioid administrations. Currently, opioid use in the hospital setting can be tracked using morphine milligram equivalents (MME) calculators. Several studies have shown that monitoring MMEs can help identify patients at risk for overdose death. In particular the CDC recommends using caution when increasing to >50 MME per day, and to avoid or carefully justify increasing doses to >90 MME per day. The CDC has also outlined high risk conditions for opioid related harm including patients >65 years, pre-disposing conditions such as mental health or substance abuse disorders, and previous naloxone use. Through this research project, we will be able to assess our current opioid stewardship activities through a survey presented to pharmacy staff and then discussing health informatics-based options for the monitoring of MMEs in an acute care hospital system. Objective: The primary objective of this study is to assess the current opioid stewardship activities and to discuss the need to implement clinical decision support tools to provide EHR-based opioid prescribing guidelines. Methods: A voluntary survey will be administered to pharmacy staff to assess how pharmacists current screen patients� profiles for pain medication administration and how they currently approach avoiding pain duplication and overprescribing of opioids. Through this survey, we will be able to address: � PDMP review � MEDD calculator use � Long-acting opioid appropriateness � Interdisciplinary communication with provider � Chart review for naloxone use or respiratory depression � PRN opioid order monitoring This survey will provide information for how pharmacists are performing opioid stewardship activities. This information will also be used to discuss current health informatics tools that could be utilized to provide an EHR-based approach to this real-time monitoring for the development of a process to integrate into workflow. Results & Conclusions: In progress
    • Analysis of electronic health record (EHR) tracking and computing system for Breast Imaging Reporting and Data System (BIRADS 3) Probably Benign breast lesions

      Harris, Julie M. (2021)
      The purpose of this study is to determine if the EHR is beneficial in tracking and monitoring patients with BIRADS 3. The study will determine if the follow up imaging intervals are necessary. The current tracking system does not have an algorithm that is able to monitor patient outcome statuses.
    • Improving Nursing Documentation in Patients With Sudden Cardiac Arrest Requiring Cardiopulmonary Resuscitation (CPR) in Long Term Acute Care

      Abdulkadir, Zeinab; Baskaran, Vikraman (2021)
      Healthcare documentation is a very important required task when working in any healthcare setting. From every patient encounter, prescription refill, and laboratory testing; all healthcare providers are required to document. As a Nurse, accurate documentation is vital in improving patient safety and quality of care. In emergency situations, such as a sudden cardiac arrest requiring cardiopulmonary resuscitation, precise documentation is rarely accomplished, due to the hectic nature of the patient's health status. In many circumstances, healthcare providers have witnessed the designated nurse attempting to document interventions on a napkin, whiteboard, or glove. The patient primary nurse is responsible for documenting a narrative note in the patient chart after the incident. The subjective nature of the nursing narrative note after CPR is often inaccurate, incomplete, or lacks details. Several research studies have highlighted the significance of CPR, the assessment of time keeping roles in cardiac arrests, and the evaluation of nursing documentation. This research study will analyze and provide possible solutions to the challenges faced by Nurses in long term acute settings during the documentation process on patients with sudden cardiac arrest requiring CPR. This study will evaluate, anonymous and randomly extracted, narrative notes from patient�s charts. The analysis will identify a CPR documentation template that can be implemented to reconstruct and improve the documentation process. This effort will promote efficiency and accuracy in capturing, analyzing, and reporting of data in resuscitation science to help improve patient outcomes and workflow.
    • COVID-19 Subunit Vaccine: A novel microparticulate microneedle vaccine using spike S1 protein

      Patil, Smital Rajan; Vijayanand, Sharon; Joshi, Devyani; Gomes, Keegan Braz; Menon, Ipshita, J; D'Souza, Martin J. (2021)
      COVID-19 has affected around 118 million people and caused more than 2 million deaths worldwide. Currently, the Food Drug Administration (FDA) authorized vaccines such as Pfizer for COVID-19 require cold chain storage, thus their availability in developing countries is challenging. Microparticles (MPs) are suitable delivery vehicles for vaccine antigens as they are better taken up by antigen-presenting cells, and they eliminate the need for cold chain storage. The spike S1 protein is a suitable antigen candidate due to its ability to produce a robust immune response. For this study, the spike protein was loaded into poly (lactic-co-glycolic acid) (PLGA) MPs and then incorporated into dissolving microneedles, a promising delivery system for large molecules such as proteins. The microparticles were characterized and assessed for innate and adaptive immune response in vitro. The vaccine particles induced a significantly higher nitrite production in mammalian cells compared to control groups. They also exhibited significantly higher expression of antigen-presenting molecules: major histocompatibility complex (MHC) I, CD80, MHC II, and CD40 on the surface of the dendritic cells. This formulated vaccine thus shows high immunogenicity in vitro and has the potential to produce a robust immune response in a murine model, conferring long-lasting protection against coronavirus. This has the potential to be a promising vaccine in the ongoing COVID-19 pandemic the world is facing currently.