Now showing items 21-40 of 97

    • Under the Law: The Invention of Race and Contemporary Lived Experiences

      Collins, Laura (2021)
      An initial exploration and analysis of colonial laws uncovered a pattern of diction and legal consequences used by the legislative authorities of colonial America to create divisions that still exist today. This research presents a selection of these laws and a sample of the ways they contribute to the auto ethnographies of twenty-first century Americans.
    • 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.
    • Chemotherapy Induced Cardiotoxicity

      Proto, Gabrielle Elizabeth; Salmon, Arlene (2021)
      Cancer affects approximately 38.4% of the population and is the second leading cause of death in America. Treatment for cancer has improved and the number of cancer survivors is expected to increase from about 11.7 million in 2007 to 18 million by 2020. However, chemotherapy and radiation therapies for cancer can have long lasting effects for patients. One notable side effect is cardiotoxicity, most commonly caused by anthracycline chemotherapeutic agents. There are several detection methods for anthracycline induced cardiotoxicity and treatment options to manage and prevent heart failure. The most promising diagnostic procedure has been tracking the decline of Left Ventricular Ejection Fraction (LVEF). The only approved treatment by the FDA is Dexrazoxane, though it is only approved for patients under 16. Adult patients are treated prophylactically with organic heart failure medications. Efficient detection and rapid treatment have become a high priority due to the increasing number of cancer survivors and therefore increased number of patients who will experience cardiotoxicity from their treatments.
    • Addressing Fear-Avoidance Beliefs in a Veteran with Sub-Acute Low Back Pain Who Is Non-Ambulatory

      Ferrari, Sofia; Taylor, Leslie F. (2021)
      Purpose: The aim of this case report is to discuss physical therapy management of a 59-year-old male veteran with sub-acute low back pain and elevated fear-avoidance beliefs about walking. Case Description: The patient is a 59-year-old male who was referred to physical therapy for evaluation and treatment of "Sciatica, right side." The patient was non-ambulatory for one month preceding his first physical therapy visit. His primary impairments on initial evaluation were elevated fear-avoidance beliefs, lower quarter weakness, and impaired gait mechanics. Interventions: Physical therapy management included strategies to address fear-avoidance beliefs in combination with gait training and lower quarter strengthening. Strategies used to manage fear-avoidance beliefs included patient education with cognitive restructuring, graded exposure in vivo, one-on-one patient care, and development of a therapeutic relationship. Outcomes: Fear-avoidance beliefs, disability, and gait were assessed at initial evaluation, 5 weeks, and 8 weeks (discharge). All outcome measures exceeded a minimal clinically important difference from initial evaluation to discharge. Conclusions: The patient demonstrated improvements in all functional outcome measures and was ambulating independently after eight weeks of physical therapy interventions aimed at reducing fear-avoidance behaviors.
    • 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.
    • 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.
    • 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.
    • Stress in Cancer Patients

      McLean-Clark, Stephanie (2021)
      o A major insurance company that employees over 70,000 persons and provides healthcare coverage to approximately 180 million people in more than 30 countries across the world. Every year they receive thousands of prior authorization requests related to tests for cancer patients. Currently, providers must submit these requests through a designated electronic system and these requests may take up to seven business days for processing. During this waiting period, Cancer patients experience stress upon learning that they may have cancer. Additional stress can be added when they are forced to wait for approval from the insurance company to have additional testing performed. The goal of this proposal is to decrease the wait time for cancer patients by providing an approval or denial by reconfiguring the system to move these requests to the top of the processing list.
    • Benefits of Telemedicine and Telehealth for Small Practices

      Kamra, Channu; Baskaran, Vikraman (2021)
      As the world has drastically changed due to the impacts of COVID-19, the healthcare industry is now adopting telemedicine a lot more. This heavy adoption rate has caused a lot of changes to how patient received their care. Smaller practices that once did not use telemedicine are now using it to keep their workers and patients safe. This research aims to understand the impacts these changes have on the patients and providers. Perspectives from both groups can yield results that allow telemedicine to grow more and create a more considerable impact on the healthcare industry. Before this can happen, telemedicine must prove to provide benefits to the groups being examined. This research looks to survey both the patients and the providers to see if telemedicine can benefit smaller practices. Data will also be collected to see the difference in costs between in-person and telemedicine visits. The practice where the research study will be taking place is called Lifeline Primary Care. Two different surveys will be used for this research. One survey will focus on the patients and gauging their interaction with the telemedicine visit. This survey will also grab some patient demographics to help understand any indirect costs associated with them. Information such as work, and distance traveled to receive care will be used to determine these indirect costs. The second survey will be provider-based and focus more on the questions that will show telemedicine's advantages and disadvantages. These surveys will be created on survey monkey and sent to patients via text or email, same for providers. Direct costs data will be collected from the providers for two months. These costs will help determine the cost-effectiveness of telemedicine. With all the information put together, a better case can be made for the future of telemedicine post-pandemic. Research articles mentioned in this proposal have run similar studies on telemedicine. So, the results should be similar to these studies. This research aims to see if telemedicine provides benefits to smaller practices today that are rapidly adopting it. These benefits could potentially allow for advancement or at least lead to improvements where telemedicine is currently lacking. It allows patients and providers to become more accustomed and make it part of their routine when visiting. Telemedicine has so much potential in providing quality care for patients in so many ways that understanding its benefits can help the healthcare industry go a long way.
    • 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.
    • Utilization of the patient portal billing feature for patients to improve the quality of care in the facility.

      Mohamed, Ekran (2021)
      Intro: Creating and being able to provide a really good quality of care is not only important but being able to have a really good patient satisfaction at your facility is very important also . Being able to use a system we already have in place and by looking into the different features that aren't in use in the facility is important. E-clinical systems would be able to help out the facilityand be able to minimize the patients call volume about financial aspect because the patient portal billing feature will be able to allow patients to be able to view and or pay their bills online, being able to view patient statements immediately, and being able to update their insurance information as soon as they get new insurance coverage or if an insurance term be able to update their information online, and lastly will be able to allow the patients to communicate with the staff members by being able to send messages instead of calling for explanations. Obj:Improving patient care & quality Reducing the number of calls Allowing patients, the ability to view/pay bills online, seeing payment statements immediately improve the revenue cycle management Methods:Take advantage of the patient portal we use at work by being able to use the different financial features that are offered to be able to create a much better quality and much better satisfaction care for the patients that come to the facility. Also, by looking into the software system we use and being able to look at the type of call volume about financial questions we mostly get our facility and being able to talk with coworkers and other people who do use the different features at their workplace and be able to compare and ask open ended questions to be able to analyze and see how this would be able to affect my facility and how will the type of quality we provide be able to increase the patient satisfaction. Results: After analyzing the data from interviews and literature reviews being able to use the patient portal billing feature would be a huge impact in improving the quality of care in the facility by being able to improve on the revenue cycle by being able to allow patents the opportunity to be able to view their statements and bd able to update any insurance information. This will also help by reducing the number of calls that are related to billing.
    • 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)).
    • 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.