• Gut microbiota-derived short chain fatty acids stimulate mesenteric artery vasodilation

      Menon, Sreelakshmi Nandakumar; Zerin, Farzana; Pandey, Ajay K.; Rahman, Taufiq; Hasan, Raquibul (2021)
      Authors: SN Menon, F Zerin, AK Pandey, T Rahman, and R Hasan Accumulating evidence suggests that gut microbiota-derived short-chain fatty acids (SCFA's) such as acetate, propionate and butyrate have beneficial effects on the cardiovascular system. However, whether these SCFAs can directly influence arterial contractility remains unclear. Here, we sought to examine the effects of sodium acetate and propionate on the contractility of resistance mesenteric arteries from Sprague Dawley rats, and characterize their mechanism of action. Our pressurized artery myography data showed that both acetate and propionate produced a concentration-dependent vasodilation in mesenteric arteries. Our data also showed that co-application of L-NNA, a selective inhibitor of endothelial nitric oxide synthase (eNOS), with acetate caused 35% reversal of acetate-evoked vasodilation, suggesting that additional vasodilatory mechanisms, including those of smooth muscle origin may be involved. On the other hand, co-application of L-NNA with propionate caused no reversal of sodium propionate-evoked vasodilation, precluding the role of endothelial nitric oxide production. Altogether, our data unveils a novel role for SCFA's in producing direct systemic mesenteric artery vasodilation, which is likely to be mediated by both endothelium- and smooth muscle-specific vasodilatory signaling. Future studies will be focused on dissecting the detailed mechanisms for SCFA-induced mesenteric artery vasodilation, and its relevance for systemic blood pressure regulation.
    • Head Above Water: A Study of K-12 Teachers' Perspectives on Emergency Remote Learning during the COVID-19 Pandemic

      Friedrich, Jami; Perrotta, Katherine (2021)
      In March of 2020, school districts across the country shifted to emergency remote teaching in response to the COVID-19 pandemic. As a result, school districts that closed for the remainder of the 2019-2020 academic year are indefinitely continuing online instruction or incorporating a hybrid model for the 2020-2021 school year. Although scholarship exists with regard to the impact of school closures due to unexpected events such as natural, there is a need to understand how this pandemic has posed specific challenges and benefits for teachers. The purpose of this research is to examine K-12 teachers' perspectives about their experiences transitioning to emergency remote teaching as a result of the COVID-19 pandemic. The major findings show that teachers experienced greater flexibility with regard to content and elimination of state exams. However, teachers expressed that they faced significant challenges with regard to promoting student engagement, maintaining communication, and ensuring students had access to technology and tools for remote learning.
    • How Covid-19 Has Affected the Healthcare Industry

      Griffin, Aundria; McCray, Justice; Mills, Keyonna; Swain, Shnean; Walthall, Sabrina (2021)
      Coronavirus infectious disease (Covid-19) first took rise in Wuhan city, China, in December 2019. The virus has spread globally to the point that the World Health Organization (WHO) declared a global pandemic on March 11, 2020 . Beyond our day-to-day life being brought to a halt, the pandemic has prompted a closer look at the country's health care system. In this research three categories of the healthcare system are identified as facing challenges during the pandemic. First, healthcare workers are affected by COVID-19 as their physical and mental health is challenged as they provide frontline critical care. Secondly, hospitals, especially those located in hotspot areas of the pandemic are increasingly overwhelmed within their management infrastructure and underprepared with inadequate facilities placing doctors and patients in life or death situations. Lastly, the insurance industry has not escaped the impact of COVID- 19 as enforced self-isolation rules has meant that elective procedures and consultations have been greatly curtailed and subsequently claim volumes have reduced in the short term. However, long-term, the treatment of COVID 19, the severity of the disease, and the length of hospital stays are expected to greatly increase the cost of insurance for individuals as insurance companies reexamine their losses. This research emphasizes the impact Covid-19 is having on sub-groups of the healthcare system.
    • How to save a life: Esketamine as a potential rapid pharmacological suicide intervention

      Montgomery, Kevin; Bedoya, Damian (2021)
      Suicide prevention and intervention efforts have been launched with hopeful results; however, research rarely focuses on pharmacological treatment for the acutely suicidal patient. Correlation between mental health diagnosis and suicide drives recommendations to tailor treatment to the mental health diagnosis rather than the acute life-threatening symptom. This article proposes treatment for the acutely suicidal patient should be intentionally directed at the suicidal ideation instead of the mental health diagnosis. Esketamine has been approved by the FDA, and randomized controlled trials show some evidence that this treatment is worth continued study as a method to rapidly reduce suicidal thoughts in at-risk patients.
    • Implementing Science and Engineering practices in K-12 classrooms : Learnings from a STEM course

      Sharma, Meenakshi (2021)
      The contemporary science education framework (NRC, 2012) advocates for the use of science and engineering practices(S&E) in classrooms because these practices represent an authentic view of inquiry or the “doing” of STEM in K-12 classroom. The current study examines teachers’ understanding and use of such S&E practices within a STEM endorsement course. Research participants were teachers who were enrolled in all courses offered as part of the endorsement. As a requirement for the endorsement, each teacher planned and enacted minimum three lessons in their respective classrooms that showcased their use of S&E practices in a real classroom setting. Primary data for this qualitative study includes video recordings of teachers’ classroom instruction. In addition, we use lesson artifacts, teachers’ written reflections on their teaching enactments, and recordings of feedback meetings with the course instructor (primary presenter) as secondary data. Initial analysis shows that implementation of S&E practices helped teachers to create a rigorous learning discourse in their classrooms. Teachers shared various accounts of active student participation as an outcome of using S&E practices during feedback interviews and written reflections. Teachers revealed varying extent of success in enacting these practices in their classrooms. Research Findings have implications for preparing preservice and in-service teachers to effectively implement S&E practices in the classrooms.
    • 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.
    • 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.
    • It takes two quad tendons to tango: A case report about dancing to recovery post spontaneous bilateral quad tendon rupture and repair

      Iskhakov, Vladislav; McMahon, Tim J. (2021)
      Abstract: Spontaneous quad tendon ruptures and resulting surgical repairs have shown to be disabling. Instances of bilateral quadriceps tendon ruptures (BQTR), although a rare occurrence, is more debilitating for the patient, making it harder to treat. Despite its rare occurrence, contemporary research shows a steady increase in incidences of all tendon ruptures, including BQTR, hypothesized to stem from more active lifestyles in the adult population as life expectancy increases. Purpose: This case report focuses on ballroom dance specific intervention strategies used to achieve a full return to amateur ballroom dancing. This case features a non-simultaneous instance of BQTR, which required surgery on a 69 year old, relatively healthy male patient with a strong desire to return to ballroom dance activities. Outcomes: Outcomes used to measure patient’s progress includes lower extremity functional scale, patient specific functional scale, and global rating of change scale Discussion: BQTR is an extremely rare occurrence, providing a unique feature to this case. The therapeutic approach used to reach the patient’s goals is also unique in that it allowed for challenges in strength, proprioception, balance, and ROM, with dance specific activities throughout the protected phased approach which considered HOAC model of healing. Dance specific activity, as well as therapeutic alliance, have been shown to have great benefits with regards to functional outcomes as well as fall risk.
    • Knowledge, Attitude, and Practice (KAP) Survey about COVID-19 and Telehealth and Virtual Medicine Services of Atlanta College of Professional Advancement students

      Ramadan, Awatef A. Ben (2021)
      The study investigator constructed a survey tool to estimate the students' reactions to different public health precautions and interventions that may be practiced during the current pandemic. The study aims: To measure the knowledge, attitude, and practice (KAP) regarding COVID-19 among Atlanta College of Professional Advancement students. To evaluate the students' KAP about telehealth and virtual medical services to screen, diagnose, and treat COVID-19 and other current acute and chronic The results of this study are expected to: Assist in better preparation for the campus and the university COVID-19-related awareness interventions Tailor different interventions and campaigns to educate the students about the effectiveness and efficiency of Telemedicine and telehealth information technology and motivate them to use these safe healthcare services during this infectious pandemic to manage COVID-19 and other health issues. Methods: Study Design: A cross-sectional descriptive study will be conducted at Atlanta College of Professional Advancement, targeting all undergraduate and graduate students, all races, all gender, and all nationalities. Study Survey: It is a structured questionnaire with closed-ended questions. The study tool comprises 60 structured questions that assess the students' KAP during the COVID-19 pandemic and assess their KAP towards telemedicine and telehealth services to manage the pandemic and follow-up on their current or future different health problems. The survey constructed into a Survey-Monkey format. A link to the survey was created and has been disseminated to the students' emails from March, 24, 2021 to the present. Data Analysis: In this poster, we present the results that we retrieved from the survey monkey's results link from March 24 to April 1, 2021.
    • Management of Crohn's Disease: Early and Aggressive Treatment Using Biologics and Immunomodulators

      Martin, Erin; Sadowski, Catherine (2021)
      Crohn's Disease (CD) is an incurable type of inflammatory bowel disease (IBD), in which the intestines are chronically inflamed, causing intestinal and extra-intestinal symptoms. CD patients experience a cycle of remission and relapse of symptoms as the disease progresses to serious complications, including small bowel obstructions, malnutrition, and decreased quality of life. Since CD is incurable, medical management is the mainstay of treatment to obtain and maintain remission. Traditional treatment relies on anti-inflammatories. New management strategies focuses on early and aggressive therapy with immunomodulators and biologics to reduce the rate of mucosal and intestinal damage early in the disease course.
    • Microparticulate vaccine for transdermal measles immunization

      Joshi, Devyani; Gala, Rikhav; Uddin, Mohammad N.; D'Souza, Martin J. (2021)
      Measles is a major global cause of death. Since children are primary targets for vaccine, we aimed at delivering the vaccine via needle-free transdermal route. Vaccine microparticles were formulated using Buchi spray dryer B-290. The induction of immune response by the microparticles was confirmed by Griess's assay. Expression of antigen-presenting molecules, MHC I, MHC II, and co-stimulatory molecules CD80, CD40 was assessed using flow cytometry. Cytotoxicity of microparticles was assessed by MTT assay. In vivo efficacy of was studied in the mouse model. For transdermal immunization, P.L.E.A.S.E. ablative laser was used. It creates micropores of defined size on the skin for transdermal immunization. The animals were administered with a prime and a booster dose. The serum was collected, and IgG and IgM antibody titers were measured. Microparticulate vaccine showed significantly higher release of nitric oxide compared to the blank microparticles. It resulted in significantly higher cell-surface expression of MHC I, MHC II, CD80 and CD40. The vaccine and adjuvant microparticles were non-cytotoxic. The in vivo studies demonstrated elevated humoral immune responses in the mice receiving vaccine and adjuvant microparticles via both, subcutaneous and transdermal routes. The microparticles augment the immunogenic properties of vaccine. Transdermal administration produced comparable results as of the subcutaneous administration indicating the potential of the transdermal vaccination.
    • Pen Pal Project to Write Away Isolation: An IRB-approved Project Aimed at Decreasing Isolation During a Global Pandemic

      Barfield, Kailey; de la Cruz, Jennifer; Lepp, Erin F. (2021)
      As the COVID-19 pandemic radically upended the daily lives and routines of many people, those considered vulnerable faced increased physical isolation due to efforts of increased protection. While interventions such as social distancing have been appropriate to maintain physical health, mental health has taken the brunt of the pandemic. To create connections while maintaining safe physical distance, a letter writing project was created between Mercer Physician Assistant Students and volunteers in the community. This project was created for the Paul Ambrose Scholars Program in which students in medical professions are selected to design a community health project focusing on one of the Leading Health Indicators (LHI) of Healthy People 2020. Suicide was the LHI chosen for this project. As depression increases among elderly, isolated individuals during the pandemic, the risk of suicide increases as well. Letter writing is a cheap, easy way to maintain emotional connections with others despite social distancing guidelines. This project has been IRB approved and included nineteen Mercer Physician Assistant (PA) students and nineteen volunteer letter recipients throughout the United States. A screening tool was used to assess depression levels of volunteer letter recipients both prior to and after receiving letters from PA students over the course of 4-5 months. This poster is a summary of the research project.
    • 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.
    • Physical Therapy Evaluation and Management of a Patient with Acute Anterior Cruciate Ligament and Meniscal Tears Complicated by Hereditary Multiple Osteochondromas in the Occupational Health Setting: A Case Report

      Pendergrast, Sarah; Ebert, Jeffrey (2021)
      Background: Hereditary Multiple Osteochondromas (HMO) is a disease that primarily affects the musculoskeletal system. Sequelae of the disease are often treated via outpatient orthopedic physical therapy. There is a lack of literature on HMO in physical therapy. The purpose of this report is to discuss management of a man with HMO and an acute orthopedic injury. Description: A 44-year-old male with HMO and acute knee injury presented with instability and structural abnormalities as well as impaired range of motion, gait, and muscle performance. MRI confirmed anterior cruciate ligament rupture, meniscal tear, and nondisplaced fibular fracture. The examination and plan of care for this patient included special considerations due to the presence of HMO and nuances of the occupational health setting and insurance. Outcomes: The lower extremity functional scale was used to assess the patient�s functional abilities related to his injury, and objective tests and measures were used to assess the impairments. Discussion: Clinicians should treat within the individual context of each patient, including all comorbidities and patient specific findings in order to make effective clinical decisions. Evaluating and treating a patient in the occupational health setting with HMO that has sustained an acute orthopedic injury requires a combination of disease knowledge, clinical reasoning, collaboration with other healthcare providers, and diagnostic imaging.
    • Platelet-Rich Plasma for Chronic Plantar Fasciitis

      Shimada, Yoichiro; Heard, Henry (2021)
      Platelet-rich plasma (PRP), also referred to as autologous platelet gel, has been increasingly used for musculoskeletal injuries, including Achilles tendonitis, shoulder impingement, rotator cuff tear, lateral epicondylitis, patellar tendinopathy, and plantar fasciitis. Chronic plantar fasciitis is defined as degenerative irritation of the plantar fascia that has failed to respond to conservative therapy, and it presents with non-inflammatory, fibroblastic hypertrophy and dysfunctional vasculature. With the chronic degenerative changes of the tissue along with zones of avascularity, chronic plantar fasciitis is difficult to treat, and the recurrence is common even after prolonged rest. Current treatments for chronic plantar fasciitis include corticosteroid injection, extracorporeal shock wave therapy, and surgery. Corticosteroid injections are common treatments for chronic plantar fasciitis; however, there are potential disabling complications associated with corticosteroid injections. PRP has been proposed as an effective, safer alternative treatment option for chronic plantar fasciitis. Due to the hypovascularity and hypocellularity nature of the injury, directly introducing growth factors and cytokines found in PRP to the fascia is believed to promote tissue heal. The purpose of this review is to examine current literature on PRP treatment for chronic plantar fasciitis.
    • Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health

      Griswold, Allison McKenzie; Ramadan, Awatef A. Ben (2021)
      The Preference and Perception of Mobile Health Applications Educating African American Women on Sexual and Reproductive Health First author: Allison Griswold Co-author: Awatef Ben Ramadan Abstract Background: Previous studies have found that African American women are affected by sexually transmitted diseases and reproductive health issues at a higher rate than any other race. Study Aims: To increase awareness of cultural barriers, and to explore the need for medically accurate sexual and reproductive health information through mobile health applications. Methods: The Institutional Review Board approved an anonymous online survey using convenience sampling of African American women between the ages of 18-50. Respondents answered questions regarding past sexual education course experience, use of women�s health applications, interest in health messages, the importance of health information, personal knowledge satisfaction, and preference for receiving information. The study results presented as graphs, which were generated through excel spreadsheets. Results: Of the 159 respondents that completed the survey, 38.5% currently use any form of women�s mobile health application very frequently. However, 65.8% are interested in receiving information on sexual and reproductive health through women�s health applications. Of the 159 respondents, only 27% were very satisfied with their current sexual and reproductive health knowledge. Conclusion: This study proves that African American women are open to learning and gaining sexual and reproductive facts through mobile applications. Keywords: African American women, period trackers, mobile health applications, sexual health, reproductive health
    • Recovery and Discovery: Developing a trauma-sensitive theology model which informs wholistic pastoral care for African American Women

      Stubbs, Tiffany (2021)
      Abstract: This research study seeks to examine the experience and responses of trauma within the realms of intersectionality and trauma informed care for African American women. The criticality of examining the duality of trauma and theology is filtered through a literature review and theological discourse. There is evidence of a correlation between the StrongBlackWoman schema and intergenerational epigenetic trauma. The trauma of living through the intersectional lanes of what it means to be an African American woman has consequently imbued African American Women with an obligation to bear the burden of strength and resiliency. This obligation has had detrimental effects on African American women’s physical, emotional and spiritual well-being. In order to provide space for transformative healing, I have suggested a construct of pastoral care model that encompasses a trauma-sensitive theological approach as a pathway to transformative healing. The goal of the pastoral care model is to provide strategies of recovery from trauma and discover ways to cope.
    • Reliability of Low-Cost Thermometers for Monitoring Foot Temperature

      Doolittle, Kristen M.; Wendland, Deborah M. (2021)
      Diabetes prevalence is high and often burdens the economically disadvantaged. With the risk for foot complications in those with diabetes, foot temperature monitoring can help lessen ulcer risk. Higher cost thermometers have been validated. Validation of lower cost thermometers could improve access for the underserved. Purpose: To assess device repeatability, reliability, and ease of use. Methods: 3 inexpensive infrared thermometers were compared against a reference thermometer for repeatability. Rater reliability was assessed by 2 raters using 3 trials at 3 sites across 25 subjects. Feasibility was assessed by subjects ranking the thermometers after testing them. Data Analysis: Descriptive statistics were used for device repeatability. Intra-class correlation coefficient was used to assess rater reliability. Results: Device repeatability: single day coefficients of variation (CV) ranged from 0.20%-0.91%; all days CVs ranged from 3.32%-4.69%. Rater reliability: 25 subjects (49.6�15.8 years). Intra-rater ICC was >0.99 for researchers and thermometers. Inter-rater ICC was 0.965 - 0.975. Thermometers were ranked based on comfort, handling, size, and the light presence. Discussion: Reliability and repeatability of thermometers were good and measurements correlated strongly with the reference. The subjects had little difficulty using the devices. Conclusions: Inexpensive, commercially available infrared thermometers can be a reliable/valid way to assess local skin temperature.
    • 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.
    • School-Based Health Centers and Mental Health Access among Minority and Low-Socioeconomic Adolescents

      Barfield, Kailey; Martinelli, LeAnne (2021)
      School-Based Health Centers (SBHCs) are comprehensive health clinics that provide a myriad of services to the students that they serve. SBHCs are meant to overcome barriers students face when it comes to accessing healthcare such as transportation, limited clinic hours, and parent work schedules. However, many of the most vulnerable populations - like those living in poverty and those that identify as racial/ethnic minorities - may still encounter barriers when it comes to accessing mental healthcare. A review of previous studies was done, and suggestions were provided for improved access to mental health services through SBHCs to even the most vulnerable populations.