• Development of Openness to Self-Healing Scale (OTS-HS)

      Caroline Fernandes
      Development of a holistic integration psychometric scale to measure openness to self-healing in counseling
    • 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.
    • Does the Use of Health Apps to Monitor Hypertension Improve the Knowledge, Attitudes, and Practices of African-Americans towards Hypertension Self- and Active-Management

      Lindsey, Jacquetta; Ramadan, Awatef A. Ben (2021)
      Showcase: Does the Use of Health Apps to Monitor Hypertension Improve the Knowledge, Attitudes, and Practices of African-Americans towards Hypertension Self- and Active-Management First Author: Jacquetta Lindsey Co-author: Awatef Ben Ramadan Background: Despite the many medical advancements available today, cardiovascular disease remains the leading cause of death in the African American community. Hypertension is considered the most modifiable cardiovascular disease, and African Americans are disproportionately affected by this disease � 43% compared to 28% of White Americans. Study Aim: To determine if the knowledge, attitudes, and practices (KAP) of African Americans towards hypertension self-management and active engagement in the healthcare process improved with the use of a mobile health application to monitor their condition. Methods: Study participants were recruited from community-based resources. Participants first completed a pre-survey to determine their baseline KAP. Next, they downloaded the AVAX Blood Pressure Diary to daily monitor their blood pressure. Lastly, participants completed the post-survey and system user satisfaction (SUS) survey on the blood pressure application. Results: Majority of the participants were women (70%) with 50% on medication for their hypertension. Most of the participants (87.5%) believed that their hypertension was better managed after using the health app. The average SUS score for the hypertension mobile health application was 89.75. Conclusion: It appears that the mobile health application assisted participants with monitoring their blood pressure daily and being aware of changes that needed to be made to improve their self-management.
    • Drug Use In The LGBT Community

      Cleary, Drew (2021)
      Drug use in the LGBT community is a large problem. Rates of drug use in the community is higher than in the heterosexual community. There are several factors that contribute to the high rates that are unique to the LGBT community. One way to conceptualize these unique factors is to use the minority stress model. There are a few therapeutic options as well as directions for future research.
    • Dry needling with electrical stimulation in the post-ACL reconstruction management of a female basketball athlete with persistent quadriceps palsy: A case report

      Pyle, Rebecca; Lucado, Ann (2021)
      Background and Purpose: Anterior Cruciate Ligament (ACL) injury is common in sports.1 Well-developed protocols on post-surgical management do not address all potential complications. Our purpose is to determine the effectiveness of dry needling with electrical stimulation (DNES) to address persistent quadriceps palsy (PQP) post ACL reconstruction (ACLR). Methods: A 16-year-old female basketball athlete post-ACLR with quadriceps tendon graft followed the Baylor ACLR Accelerated Protocol with appropriate modifications. DNES to the quadriceps began at post-op week 15 for PQP. Findings: The Lower Extremity Functional Scale (LEFS), knee ROM, MMTs, and circumferential measurements were tracked. All surpassed significant values. Clinical Relevance: When neuromuscular electrical stimulation (NMES) is ineffective for PQP, DNES offers an alternative intervention strategy for increasing maximal voluntary contraction. Conclusion: Data suggest improvement in outcome measures and may promote voluntary muscle contraction of the quadriceps. Further research is required for optimal protocols. Keywords: Neuromuscular control, voluntary contraction
    • ED Treatment of Acute Ischemic Strokes: The Future of the Brain Cath Lab

      Crider, Allie; Bedoya, Damien (2021)
      Acute ischemic strokes are defined as a sudden cessation of blood flow to an area of the brain, resulting in hypoxic death of brain tissue and subsequent loss of neurologic function. They are a leading cause of serious disability worldwide and cost the US healthcare system roughly $3.2 billion per year.1 Historically, first-line treatment for acute ischemic strokes has been thrombolytic therapy with Tissue-Type Plasminogen Activation (tPA), which works by systemically altering the blood�s clotting cascade. tPA is a very effective therapy, however, it carries with it a significant risk of life-threatening bleeding events. Because of the wide array of contraindications to tPA, many patients with prior history of bleeding, anticoagulation use, or prolonged presentation of symptoms are ineligible for this therapy. Mechanical thrombectomy (MT) is an alternative treatment which involves placing catheter-guided stents directly at the site of intravascular blockages in the brain. This method has primarily been reserved for patients in which systemic anticoagulation is contraindicated and was considered a second-line treatment for years. During the early 2010�s, several studies supported the consideration of mechanical thrombectomy as an additional first-line treatment choice in certain patient populations, rather than strictly as an alternative to tPA. This research is essential in determining the safest, most effective treatment for stroke patients on an individual level. It may also lead to expedited triage protocols in the emergency department and faster time to treatment.
    • 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)).
    • Emerging Migraine Treatment Monoclonal Antibodies: Pathophysiology, Efficacy, and Recommendations

      Oliver, Hannah; Salmon, Arlene (2021)
      Migraines cause immobilizing headaches and are amongst the top causes of disability worldwide. In the past, migraines were understood as a vascular disorder, but in recent years researchers have attributed the cause of migraines to be a series of neurovascular events. This cascade of events causes a release of peptides, most notably, calcitonin gene-related peptide (CGRP) which triggers pain signals to be released from the trigeminal neurons in the brain. This development in comprehension has led to the production of a new treatment, monoclonal antibodies targeting CGRP, to treat migraines. Since 2018, four new drugs of monoclonal antibodies have been approved by the FDA and each drug has shown significant decrease in monthly migraine days when compared to placebo in people who suffer from episodic and chronic migraines. Today these medications are recommended in patients with migraines who have failed simple abortive therapy.
    • Emotional Intelligence, Burnout, and Professional Fulfillment among Clinical Year Medical Students

      Cody Blanchard
      Emotional intelligence is correlated with decreased levels of burnout and increased levels of professional fulfillment in a group of clinical year medical students.
    • Evaluating and comparing release profiles of four different non-prescription niacin formulations

      Shah, Sarthak; Uddin, Mohammad N. (2021)
      Niacin, nicotinic acid or vitamin B3 is critical portion of a balanced nutritional diet. None of the niacin's dissolution profiles were evaluated and compared in literature. Niacin, a supplement, is not subjected to Federal Drug Administration (FDA) monitoring. The study compared several different formulations such as immediate release (IR) powder, IR tablet, timed release (TR) capsule, extended release (ER) capsule, and controlled release (CR) tablet to validate the claims for each formulation provided by the manufacturer. In our in vitro study, dissolution apparatus was used. Two different media were prepared, simulated gastric fluid (SGF) at pH 1 and simulated intestinal fluid (SIF) at pH 7. UV/VIS Spectrophotometry for analysis was used. In IR form, maximum concentration was 80% concentration of the label's claim. In ER, in pH 7, drug remained constant at about 50% niacin concentration over 24-hour period. In TR, in both pH conditions, the maximal niacin release concentration was about 65-70%. In Slo-Niacin tablets, release rates were consistent in both pH 1 and pH 7. Our findings illustrate that the four release forms (IR, ER, TR, CR) and their modified drug formulations are aligned with their release definitions. Further research is encouraged and should evaluate other non-FDA formulations.
    • 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.
    • Exploring 5-HT2 Receptors as Targets for Treating Epilepsy in Fragile X Syndrome: A Preclinical Study of Fmr1 Knock-out Mice

      Tanishka Saraf; Yiming Chen; Jessica Armstrong; Clinton Canal
      This project explores the anticonvulsant potential of lorcaserin in Fragile X Syndrome in which epilepsy prevalence is ~25%. We did a full dose response (1-10 mg/kg) in an audiogenic seizure assay in Fmr1 knock-out mice. Lorcaserin did not affect prevalence at any dose but attenuated seizure severity to some extent.
    • Finding Clarity Through My ePortfolio (Capstone ePortfolios and Synthetic Learning)

      Adams, Brooke (2021)
      This presentation showcases some of the ePortfolios created by senior Liberal Studies majors. To improve students’ reflective skills and increase their chances of creating effective syntheses of their work to date, the Liberal Studies Department began using ePortfolios in the major. These student ePortfolios represent the results of the first time seniors in LBST 498 (Senior Capstone) used the ePortfolios. ePortfolios are considered the eleventh high-impact practice by the AACU. Done well, they do not merely store artifacts that record a student’s progress. They actively encourage students to reflect on their work and to synthesize it. They focus attention on the process of learning, and make that learning visible to student, faculty, and others alike. The LBST 498 ePortfolio required students to explain their degree to the public in a succinct format. The process of selecting artifacts, explaining them, and using them to make meaning for themselves of their degree helped students actively to synthesize their experiences with the perspectives they had gained through their concentrations and core courses. By demonstrating recent ePortfolios, we intend to document the initial success of the ePortfolio program, and generate discussion about the role of reflection in increasing student success. This presentation showcases some of the ePortfolios created by senior Liberal Studies majors. To improve students’ reflective skills and increase their chances of creating effective syntheses of their work to date, the Liberal Studies Department began using ePortfolios in the major. These student ePortfolios represent the results of the first time seniors in LBST 498 (Senior Capstone) used the ePortfolios. ePortfolios are considered the eleventh high-impact practice by the AACU. Done well, they do not merely store artifacts that record a student’s progress. They actively encourage students to reflect on their work and to synthesize it. They focus attention on the process of learning, and make that learning visible to student, faculty, and others alike. The LBST 498 ePortfolio required students to explain their degree to the public in a succinct format. The process of selecting artifacts, explaining them, and using them to make meaning for themselves of their degree helped students actively to synthesize their experiences with the perspectives they had gained through their concentrations and core courses. By demonstrating recent ePortfolios, we intend to document the initial success of the ePortfolio program, and generate discussion about the role of reflection in increasing student success.
    • 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.
    • 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.