2014 Abstracts
Comparative Analysis of Small Transducer and Large Transducer using High- Frequency Ultrasound on Bovine Heart Tissue
Nathan Bliss, Utah Valley University Health High-frequency (HF) ultrasound in the 20-80 MHz range has recently been found to be sensitive to pathology in tissue margins from breast cancer surgery. In order to improve the resolution and sensitivity of this method, however, transducers need to be employed that have piezoelectric elements that are smaller than those currently in use. The purpose of this study was to determine if similar results can be obtained from small element transducers (Blatek pachyometer, 50 MHz, element diameter < 2 mm) as compared to large element immersion transducers (Olympus NDT, V358-SU, 50 MHz, 6.35-mm diameter active element). Ultrasonic tests were performed on 10 bovine heart specimens of varying surface structure (myocardium, endocardium, and epicardium). Pulse-echo and through transmission measurements using a HF square-wave pulser/receiver (UTEX, UT340) and a digital storage oscilloscope (Agilent, DSOX3104A, 1 GHz, 4 analog channels) were acquired from a total of 2 sites per bovine specimen, first testing all specimens with the large transducers then again with the small transducers. Specimens were marked with India ink for location and accuracy of testing. The density of peaks in the ultrasonic spectra of the large transducers paralleled those of small transducers. Results from HF ultrasonic measurements of bovine heart tissue obtained from large transducers compared to the small transducers indicate that they produce statistically comparable peak densities.
Observing Temperature Dependent Changes in Bovine Cell Structure With High-Frequency Ultrasound
Amy A Fairbrother, Utah Valley University Health Research has shown that high-frequency (HF) ultrasound is capable of detecting structural and biomechanical property changes in tissues and cells at the microscopic level. This capability is currently being tested for the real-time identification of breast tissue pathology in surgical margins during lumpectomies. The objective of this study was to determine if structural and property changes arising in tissue from variations in temperature can be detected by using HF ultrasound. Once a tissue sample is excised from the body, the temperature of the sample decreases rapidly from body temperature to that of the surrounding room temperature. Because of the decrease in heat, the tissue can become more rigid and thus less fluid. These alterations in biomechanical properties can affect HF ultrasonic measurements such as wavespeed and attenuation. These biomechanical changes may also affect the ultrasonic signals sensitive to tissue structure such as the number of peaks in the ultrasonic spectra. The methodology of the research was as follows. Fresh samples of bovine tissue were ultrasonically tested at 3 different temperatures: 37º, 24.5º, and 15º C. Each sample was approximately 7.6 mm thick and 3.8 x 2.5 cm in size. To observe the overall effects of temperature on a sample, the tissue was slowly heated from room temperature to body temperature (37º C) and then tested with HF ultrasound. The sample was then cooled back down to room temperature (24.5º C) and tested again using HF ultrasound. Lastly, the sample was cooled further to 15º C and again tested using HF ultrasound. Ultrasonic waveforms were collected using 50-MHz pitch-catch and pulse-echo measurements. The data was then analyzed to determine changes in wavespeed, attenuation, and spectral peak density with temperature. Results from the study will be presented and discussed with respect to the improvement of HF ultrasound procedures for testing tissue samples.
Anatomy Academy: The Impact on Student Nurse Mentors
Matthew Wood, Brigham Young University Health Anatomy Academy (AA) is a recently developed school based educational program for fifth graders that uses college age students as small group mentor educators. This program aims to combat child obesity by improving the children’s understanding of nutrition, anatomy, exercise, and healthy behaviors. Our study specifically aimed to evaluate the impact of this mentoring opportunity on student nurses. As the largest population of healthcare workers, nurses play an essential role in patient and family education, especially in well populations. As healthcare costs increase, it will be increasingly important for nurses to actively participate in prevention efforts that empower individuals to develop healthy lifestyles. Currently, there exists a paucity of opportunities for student nurses to practice providing this health teaching to well populations and a lack of research literature on the subject. Anatomy Academy is one of these opportunities and our hypothesis is that there will be positive changes in the self-perceived abilities of the student nurses. After identifying undergraduate nursing students engaged in AA, we collected pre and post (5 scale Likert) surveys asking the nurses to rate their self-perceived ability of their skills to 1) adapt the message to the level of audience understanding, 2) communicate basic physiological concepts, 3) teach and model the link between concepts and health behaviors, 4) empower children toward healthy decisions, and 5) collaborate with organizations, like elementary schools, toward a common goal of helping children maintain healthy BMI and habits. A demographic survey and weekly reflective journals were also collected. Our results found statistically significant results in every perceived skill and we conclude that mentoring opportunities for student nurses in programs like AA improve their confidence and ability to communicate in a nursing role. We recommend that similar opportunities be included in the curriculum of all undergraduate nursing programs.
Surface roughness and air bubble effects on high-frequency ultrasonic measurements of tissue
Percy Segura, Utah Valley University Health High frequency (HF) ultrasound has been investigated for the detection of breast cancer in surgical samples, and has shown correlations to histology including precursors to cancer development. It is hypothesized that the sensitivity of HF ultrasound to breast cancer is due to changes in the microscopic structure of the tissue. With this approach, better diagnosis of breast cancer can be achieved for purposes such as the assessment of surgical margins in lumpectomy procedures. The microscopic structure of the tissue affects HF waves as they pass through the tissue. These structures can therefore be recorded and distinguished by the HF ultrasound. HF ultrasound will show differentiation between healthy tissue, benign pathologies such as hyperplasia, and advanced cancerous formation. With continuing development, variables are being studied which may skew or produce artifacts in the HF ultrasound results.
A Correlation Between Learning Styles and Fields of Study at Utah Valley University
Tyler Navarro, Utah Valley University Health PURPOSE: An Exercise Science class homework assignment revealed that a significant majority of the Exercise Science majors were Kinesthetic vs. Visual or Auditory learners. The researchers were curious what learning styles other fields of study had and if, like Exercise Science, other fields of study were dominated by one learning style or another. The purpose of this study was to identify the percentage of different learning styles of majors in various fields of study at UVU. Our hypothesis is that each field of study, by its very nature, would be lead by > 50% of the percentage points by one learning style over the others.
Mandatory cardiology consultation’s affects on number of adverse events and tests performed
Talmage Wood, University of Utah Health One of the challenges facing emergency room physicians is the number of tests and procedures to be performed on patients who present with chest pain but had negative initial findings. Since heart disease ranks as the leading cause of death in the United States, hospitals have protocols to monitor patients for a period of time before discharging them. At the University Of Utah’s Emergency Department our monitoring protocol was adjusted over a year ago to mandate consultation with a cardiologist for any and all chest pain patients being observed due to negative findings, whereas prior to the adjustment patients were monitored and consulted by normal emergency room physicians or advanced care providers.
Marital Status and Mortality: A Meta-Analysis
Tyler Harris, Brigham Young University Health Background
Underwater Treadmill Exercise in Adults with Osteoarthritis
Kristin Walker, Utah State University Health The purpose of this study was to quantify the efficacy of a six-week aquatic treadmill exercise program on measures of pain, balance, mobility, and muscle thickness. Three participants (age = 64.5 ± 10.2) with knee OA completed a six-week exercise training intervention. Outcome measures, collected before (pre) and after (post) the six-week intervention, included visual analog scales for pain, posturography for balance, a 10 m walk test for mobility, and ultrasound for muscle thickness. The exercise protocol included balance training and high-intensity interval training (HIT) in an aquatic treadmill using water jets to destabilize while standing and achieve high ratings of perceived exertion (14-19) while walking. Expected results include, reduced joint pain (pre = 50.3 ± 24.8 mm versus post = 15.8 ± 10.6 mm), improved balance (equilibrium pre = 66.6 ± 11.0 versus post = 73.5 ± 7.1), and mobility (walk pre = 8.6 ± 1.4 s versus post = 7.8 ± 1.1 s) after participating in the exercise protocol (p = 0.03-0.001). We expect that aquatic treadmill exercise that incorporates balance and HIT training will be well tolerated by patients with OA and may be effective at managing symptoms of OA.
The Effect of Marital Quality on Mortality: A Meta-Analysis
Tyler Harris, Brigham Young University Health Background
Comparison of Column Chromatography Techniques For The Purification of Influenza A/NWS/33 (H1N1) Virus
Jorgen Madsen, Utah State University Health The gold standard in purification of influenza virus is by means of ultracentrifugation. Although effective, this process is very expensive and thus impractical for developing countries. We hypothesize that column chromatography can be a cost efficient alternative that is as effective as ultracentrifugation. If correct, this method of purification could revolutionize vaccine production in third world countries. We tested the purification ability of column chromatography by comparing two different chromatography resins. The Capto Q resin separates proteins on the basis of protein charge. The Capto 700 resin separates proteins on the basis of both size and charge. Samples following chromatography were collected, and evaluated for virus specific proteins as well as total protein content. After chromatography selected samples were evaluated by electrophoresis to determine protein separation. Although it is evident that some protein separation occurred, the results are inconclusive and suggest more testing.
The Effect of Immunizations on Society
Breanne Woodbury, Dixie State University Health In this paper I will be discussing the health impacts of immunizations and how it affects the individual, the family, the community, and society. I will present information from both sides of the argument of immunizations, as well as my own conclusion on this controversial subject. Findings from leading experts in the medical field will be cited, including Dr. Paul Offit, co-inventor of vaccines and one of the most trusted advocates for vaccine safety, as well as award-winning scientific writer Seth Mnookin. Their research on vaccines, specifically the ingredients included in vaccines, possible side effects, and the nonexistent correlation between vaccines and autism, will support my thesis of vaccine safety and the need for immunizations. I will include current scientific studies which reveal the very serious results of a vaccine-free society and discuss the desperate need to change the anti-vaccine mindset. In conclusion, I will re-state, with supporting evidence, why immunization is absolutely crucial and why it plays a key role in the health of our society and in our personal daily living.
Evaluation of a Sexual Assault Nurse Examiner (SANE) Program on Sexual Assault Criminal Case Outcomes
Alyssa Lark, Brigham Young University Health The purpose of this study is to evaluate the effect of a community-based sexual assault nurse examiner (SANE) program on sexual assault criminal case outcomes in Salt Lake County, Utah.
Opuntia ficus indica: Red Blood Cell Viability and Agglutination Properties
Erin Horton, Dixie State University Health OPUNTIA FICUS INDICA: RED BLOOD CELL VIABILITY AND AGGLUTINATION PROPERTIES
Religiosity and Family Hardiness in Parents Raising a Child with a Disability
Brittni Carr, Brigham Young University Health Purpose/Aims: To examine religiosity and family hardiness in parents raising children with disabilities (CWD) to determine if there are differences according to parent gender and type of disability and if there is a relationship between the variables.
Reproducibility of High-Frequency Ultrasonic Signals in Breast Cancer Detection
Andrew Mackay Breivik, Utah Valley University Health The central research question of this project is to determine the reproducibility of high frequency (HF) ultrasonic signals in breast cancer detection. Previous studies on surgical specimens of breast tissue have shown that HF ultrasound (20-80 MHz) appears sensitive to a range of breast pathologies including fibroadenomas, atypical ductal hyperplasia, fibrocystic changes, and carcinomas. A measurement in the ultrasonic signal called the peak density appears most sensitive to the pathology of the breast. The reproducibility of this parameter has not been quantitatively measured in a comprehensive manner. In parallel to a clinical study being conducted at the Huntsman Cancer Institute, we are conducting a laboratory study of the reproducibility of these measurements using chicken and bovine tissue. The ability to reliably determine the pathology of breast tissue with a real-time intra-operative tool would greatly aid in the surgical removal of all malignant tissue, as well as greatly reduce the occurrences of repeat surgeries to remove margins of cancerous tissue that remained. The results of this study will reveal the degree of variability in the signals, thus supplementing previous studies as well as determining the reliability of the results from the current clinical study. The research methodology included the following. Fresh chicken breast and bovine tissue were cut into 4x3x0.5 cm and 4x3x1.5 cm cubes. The tissue was tested at room temperature (23.4oC) using HF ultrasound. Pitch-catch and pulse-echo waveforms were obtained in triplicate measurements of two types: Three measurements with the transducer not leaving the tissue, and three measurements with the transducer lifted off the tissue between measurements. A total of 640 measurements were acquired and analyzed to obtain the spectral peak densities. Preliminary results indicate that the measurements are reproducible to a statistically significant level, thus removing one possible source of uncertainty in the data.
Social Cognitive Predictors of Residential Radon Testing and Mitigation
Siena Davis, Brigham Young University Health In the U.S., exposure to radon gas (222Rn) is the second leading cause of lung cancer after tobacco smoke. 222Rn is a naturally occurring environmental carcinogen produced during the radioactive decay of uranium-238, which is found in many soils throughout the U.S. Because 222Rn is a gas, it has the ability to travel through the soil and into homes through cracks in foundation walls. Inhaled 222Rn has the potential to emit alpha radiation in the lungs, and long-term exposure is responsible for approximately 21,000 lung cancer deaths per year in the U.S. 222Rn is a colorless, odorless, and tasteless gas, so the only way to know it is in a home is to test for it. Studies show that even in areas with high radon levels, homeowners frequently do not test or mitigate their homes as recommended. This study aims to understand the psychosocial factors that influence whether Utah residents perform radon testing and mitigation. Radon-related lung cancer deaths would be significantly reduced if the psychosocial factors that influence radon testing and mitigation were better understood and used to design and implement effective interventions. To understand the psychosocial factors that influence radon testing, we will survey residents (n = 50) of the county who come to UCHD specifically to purchase a radon test kit. The survey will be based on social cognitive theory (SCT) constructs. We will administer the same survey to a comparison group (n = 50). The comparison group for the study will be individuals who visit UCHD’s office of vital records. Individuals from the study group with indoor radon levels above 4 pCi/L will be contacted by telephone 30 – 60 days after testing to complete a second survey. This survey will measure SCT factors that influence participants’ actions to reduce radon levels in their home.
Learning Hand-to-Mouth Movements via Triaxial Accelerometers
Stephen Clarkson, Brigham Young University Health While there is an abundance of mobile health apps for weight management on the market today, almost all focus entirely on net caloric intake (exercise minus calories consumed). Recording daily caloric intake can be cumbersome, inefficient and inaccurate. One rising suggestion in the health field for reaching weight goals is objectively recording hand-to-mouth movements (HTMMs) during meals throughout the day. This method focuses entirely on portion control and if any improvements are to be made in this area, an effective method of activity recognition must be developed. In this paper, we report our efforts to classify HTMMs and non-HTMMs in an effort to automate counting the number of HTMMs during meals throughout the day. We also report on the performance of several base-level classifiers such as k-NN, Naive Bayes and Decision Trees as well as meta-level classifiers (Voting, Bagging and Boosting).
Prevalence of Contraceptive Use Among Single Latter-Day Saints
Wesley Tietjen, Dixie State University Health High risk sexual behaviors, such as having unprotected sex, are a community health concern because of the heightened susceptibility to sexually transmitted diseases. An estimated 19.7 million people are newly infected with a sexually transmitted disease annually. Young people (ages 15-24) account for nearly half of all new incidences (CDC, 2008). Considering these statistics, the author, a Dixie State University Integrated Studies undergraduate student, conducted an interdisciplinary study to determine the correlation between the degree of self-reported religious devotion of Latter Day Saint (LDS) singles and their likelihood of purchasing or using protection during premarital intercourse. Seventy five students attending Dixie State University in Saint George, Utah participated in this study. Participants completed a 15-item survey consisting of questions inquiring how religious they consider themselves and their feelings towards premarital sex. Of the non-married participants who engage in sex, only 28% (n=4) of LDS respondents reported consistent use of birth control, compared to 84% (n=16) of non-LDS individuals. These results are suggestively significant and are consistent with findings from studies conducted by Douglas Kirby (2007) and others who have demonstrated that teaching abstinence, without providing education about birth control methods other than abstinence, leaves individuals unprepared to practice safe sex if the occasion arises. The relevance of the Dixie State University study to previous more broadly conceived research will be presented along with recommendations for future research.
The Effect of RaLight on Stress in Hospice Patients
Paydon Newman, Dixie State University Health Several studies (Shepley, 2012; Sherman-Bien, 2011; Walch, 2010) have found that sunlight has a stress-reducing effect on those who are exposed to it. An innovative new design of artificial lighting known as RaLight is proposed to reflect light with a color rendering index nearly identical to natural sunlight. This study will examine the relationship between exposure to RaLight (as a substitute for sunlight) and levels of stress. RaLight is predicted to decrease levels of stress in test subjects. In several hospice facilities, test subjects will consist of an estimated 100 patients both male and female with ages ranging from 65 to 85 years. This research is designed as a single subject experiment (ABA). The initial control condition will be the common indoor environment which exposes patients to standard fluorescent lighting. Replacing light fixtures with RaLight will then establish both the second phase of the experiment and the independent variable. A follow up re-installment of the initial fluorescent lighting will be conducted post-RaLight phase. Throughout each phase, questionnaires regarding the overall well-being of patients will be completed by hospice staff.
Results of Interventions to Fight Anemia in Children in an Impoverished Ecuador Community
Charity Anne Rowley, Brigham Young University Health Background: Since 2009 groups of professors and students from the College of Nursing have been traveling to Guayaquil, Ecuador and assessing anemia rates and nutrition among the school children there. The adverse effects of anemia can include: weakness, fatigue, shortness of breath, and poor concentration. Initial anemia rates were discovered ranging 30-50%.
Asthma and Omega-3 Fatty Acids
Matthew Mogensen, Southern Utah University Health The anti-inflammatory effects of omega-3 fatty acids (n-3) and their possible role in the regulation of asthma are promising for those suffering from the disease. Omega-3 fatty acids have been linked to the reduction of eicosanoids, which are signaling molecules that regulate the inflammatory response. Inflammation in the respiratory system is one of the most widespread symptoms of asthma and therefore poses the most risk to asthmatic individuals. This two phase study will test the effectiveness of n-3 in individuals with varying severities of asthma. In both stages of this study, a placebo or n-3 in the form of a krill oil capsule containing the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) will be administered, lung volumes and capacities will be measured weekly, and the frequency/severity of asthma attacks will be recorded. Phase one of the study will test whether n-3 reduces asthma symptoms with no activity modifications, while phase two will test whether n-3 is effective in reducing asthma symptoms associated with exercise. The two phases of the study will be separated in order to isolate the duration of n-3 ingestion as a variable in the experiment. As this is an ongoing experiment, results are not yet available. However, if n-3 is effective, we expect to see an increase in lung volume and a decrease in the frequency and severity of asthma attacks in individuals. These results would suggest that n-3 could be an effective and simple treatment that, when taken daily, could reduce the frequency/severity of asthma attacks and help improve quality of life for asthma sufferers.
Empathy in Nursing Students: the Impact of a Poverty Simulation
Kristen Hamblin, Brigham Young University Health Empathy is an essential characteristic in nursing. In fact, the skill of empathy, the ability to understand the feelings or situation of another, is of paramount importance to the nurse-patient relationship. Additionally, empathetic interactions often lead to increased patient satisfaction, compliance, and overall quality of life.
Seizure Generating Zone Determination via Automated High-Frequency Oscillation Detection
Micelle Reed, University of Utah Health For patients with medically intractable epilepsy, a neurological disorder characterized by seizures that are unable to be controlled with medication, surgical resection of the seizure generating zone is necessary to obtain seizure freedom. Intracranial electroencephalography (iEEG) is used for determining areas for resection when noninvasive techniques fail to pinpoint a specific area. High frequency oscillations (HFOs), observed through iEEG, are successful biomarkers for the seizure generating zones and are more localized to the source of seizures than areas of propagation. The most common method for determining HFO occurrence lies in expert epileptologist interpretation of the iEEG data, although this method is limited to small data sets and the expertise of the doctor. This study uses the signal processing techniques of spectrogram analysis and continuous waveform transforms to find high frequency content in sampled patient data. Through the use of Friedman’s Tests, statistical difference between channels is determined and subsequent Wilcoxon signed-rank tests are performed to find the channels with statistically greater high frequency content. This allows for an unbiased, automated determination of seizure generating channels. Localization of the seizure generating area can be decided because of the 1-1 correspondence between the channel signal and macroelectrode placement on the brain. If functional mapping reveals the cost of resection of that area of the brain to be less than the benefit of reduction in seizure activity, surgery will be performed. Through the determination of the true seizure generating zone, surgical resection will lead to the best patient outcome of potential seizure freedom and improved quality of life.
The effects of ultra marathons on foot volumetrics
Kevin Crockett, Utah Valley University Health Purpose
High-frequency ultrasound study of tissue margins from breast conservation surgery: Preliminary results
Teresa Wilson, Utah Valley University Health A critical issue in breast conservation surgery (lumpectomy) for breast cancer treatment is ensuring the tissue surrounding the excised tumor, the margins, are cancer-free. In collaboration with the Huntsman Cancer Institute at the University of Utah, students from Utah Valley University are using high-frequency (HF) ultrasound to test the pathology of lumpectomy surgical margins. This pre-clinical study is a blind study which will involve 80 patients, approximately 320 specimens, and use traditional pathology as the “gold standard” for measuring the HF ultrasound method’s accuracy. Ultrasonic waveforms of margins were acquired at the Huntsman Cancer Hospital in pitch-catch and pulse-echo modes using 50-MHz, 6.35-mm diameter transducers. The data were analyzed to obtain ultrasonic parameters such as wavespeed, attenuation, specimen thickness and spectral peak density (the number of peaks and valleys in a HF ultrasonic spectral band). The objective of this paper is to search for trends in the data acquired to date to provide an assessment of reliability, stability, and robustness of the study.
Female Collegiate Athletes and Body Image
Ashley Ostler, Southern Utah University Health Research indicates that collegiate athletes may be at risk of developing disordered eating and other distorted behavioral patterns. This may be due, in part, to the aesthetic and performance demands of their sports. The purpose of this study is to discover if female athletes acquire increased negative views towards their body image and food due to the pressures of being a collegiate athlete at Southern Utah University (SUU). An anonymous survey was given to approximately 150 female athletes participating in a variety of sports inquiring about body perception and eating behaviors relative to their sport. The survey evaluates the athlete’s attitude toward food, their relationship with food, if there are outside influences that affect how they eat, and if they are satisfied with their weight. Athletic teams were chosen based on meeting two of the three following requirements: tryouts are held, scholarships are offered, and there are regular competitions or performances. Athletic teams involved in the survey include tennis, volleyball, track & field, cross country, softball, basketball, gymnastics, soccer, drill team, ballroom dance and cheer. The data will provide information regarding Southern Utah University female athlete’s body perceptions and eating behaviors. Results will be compared to a similar study conducted five years ago at SUU.
Gait Comparison Between Right and Left Legs on Below the Knee Amputees
Taylor Colvin, Utah Valley University Health Introduction: There are millions of people in need of prosthetics worldwide and only a very small percentage currently have access to appropriate prosthetic care. As amputees are unable to afford a prosthetic, they are often incapable of maintaining many social interactions and provide for their basic needs. Utah Valley University’s Mobility Mission traveled to Guatemala to manufacture prosthetic limbs for those individuals in need. Our research can also encourage manufacturers to continue developing a better affordable prosthetic that can be donated to those amputees in need to restore quality of life to those individuals.
Identifying Medical Practices and Needed Supplies in Central America
Josh Lee, Dixie State University Health According to the World Health Organization (2012), health care systems in Central America rank in the top 50% of the 190 ranked countries in the world, yet thousands of people are in need of simple medical attention and supplies every day in these areas. Countries such as Honduras lack virtually all access to health services, with 83% of the country’s population without health insurance, and 30% with no health care access at all (Pearson et al., 2012). To address this issue, a 2013 Dixie State University study conducted by the author, an Integrated Studies major with disciplinary emphases in Spanish and Biology, interviewed fifty adult Central American immigrants at a Southern Utah health care facility with the aim to providing student groups embarking on health service projects a researched list of vitally needed medical supplies. Participants in the study were asked to provide information regarding their health care experiences in their countries of origin and draw upon their comparative experiences with health care in the United States in order to determine areas of need. The forty individuals in this study represented a total of seven Central American countries and the interviews were conducted in Spanish and translated into English. The interviews were conducted over an 8-week period of time and results suggested that diabetes, cold, flu, antibiotics, and anti diarrhea medicines and supplies are a few of the needed health care items in these neighboring countries. Although statistical significance was not a feature of this study due to the number of participants, significant consistencies in responses by former residents of a variety of Central American countries suggested that some medical needs are regionally shared and that larger scale follow-up studies may reliably identify these as key resources for student medical delegations traveling to Central America.
Assessment of Gait with Zero Drop Shoes While Walking
McKay Frandsen, Utah Valley University Health INTRODUCTION
The Influence of Charge Nurses on Patient Safety
Charity Anne Rowley, Brigham Young University Health In 2010, The Office of the Inspector General of the U.S. Department of Health and Human Services reported that adverse events during hospitalization contribute to the deaths of 180,000 patients each year! The purpose of this study is to improve patient safety in the hospital by understanding the role of the charge nurse(the 24/7 nursing supervisor in hospital units).
Rural School Employees and Vaccinations
Jennifer Orton, Brigham Young University Health In contrast to the success of America’s vaccination rates among children, adult vaccination rates remain suboptimal. Some adults, such as school employees, are in a position where they can easily contract and spread vaccine-preventable communicable diseases, yet mandatory vaccinations are usually lacking in this population. Schools may easily become communicable disease outbreak centers, especially for highly contagious diseases such as measles and influenza. The purpose of this study was to evaluate why rural Utah school employees remain vaccinated for measles and influenza, as well as to discover the perceptions of these school employees regarding mandatory vaccination policies. Of the 835 respondents, 71.7% reported they received the measles vaccination as a child, although only 26.9% reported having a measles booster vaccine as an adult. When asked why they had not received the measles booster, 46% of participants stated they were unsure if they needed one. Other participants also reported lack of an adult measles booster vaccine because it was not required by the school district (5%) and that they did not perceive the need because they were healthy (5%). Even more concerning, over half of the school employees (51%) had not received their influenza vaccine for the current year. When questioned about their lack of influenza vaccination, 26.4% believed the vaccine was ineffective and 25.4% were noncompliant because they did not have the time to get the vaccination. When questioned about their perceptions regarding mandatory vaccine policies for school employees, four major themes emerged: 1) adults should retain agency; 2) vaccine effectiveness was not guaranteed; 3) adults do not need vaccinations; and 4) cost of vaccines. Further education is needed regarding the need for adult vaccinations, especially among school employees in rural Utah. To control the spread of communicable diseases, school districts may consider mandatory vaccination of school employees.
Subsequent Primary Malignancies in Survivors of Childhood Cancer
Emily Matson, Brigham Young University Health Cancer, despite its common association with old age, is a leading cause of death for children age 1-14, second only to unintentional injuries. Improvements in diagnosis and treatment are increasing childhood cancer survival, and more research is needed on the risk of subsequent cancer following an initial diagnosis, of either the same or another site. Research on associations between childhood and secondary cancers may improve patient follow-up by providing health professionals with information about which subsequent cancers are likely to occur, which screenings to conduct and what symptoms to look for.
Glioma stem cells, hypoxia inducible factor 1 alpha, and brain tumor dynamics
Bradley Weaver, University of Utah Health High-grade gliomas, especially glioblastoma (GBMs, WHO Grade IV), are the most common primary brain tumors in humans. Despite recent advances in molecular targeted therapies for cancer, there has been little progress in treatment of GBMs. Median patient survival after diagnosis is dismal: approximately 12 months. Hypoxia is a key clinical marker of GBMs, which contain pockets of necrotic and hypoxic regions within the solid tumor mass. The transcription factors in the Hypoxia Inducible Factor (HIF) family are the master regulators of the cellular response to hypoxia. Their downstream targets include compounds that promote angiogenesis, increase glycolysis, and inhibit apoptosis. Recent research has identified glioma stem cells (GSCs) surviving within the hypoxic microenvironment, and has implicated HIF1α as a potential regulator of the GSC phenotype. GSCs are thought to promote therapeutic resistance and recurrence of GBMs after surgical resection. Clarifying the role of HIF1α in glioma stem cell dynamics is important for targeting both the tumor cells and their environment in new treatment. It is expected that GSC populations with more aggressive phenotypes will express higher levels of HIF1α and have higher proliferation rates under acute hypoxia. In this study, the HIF1α levels and proliferation dynamics of multiple, unique GSC cell lines are investigated. Cell lines used include two GSC lines isolated from primary patient tumors (NSC20/23) and a stem cell enriched high-grade glioma line. Preliminary results suggest that not all populations of GSCs respond the same way to hypoxic stress, and HIF1α may play a central role in stem cell dynamics, but not in the growth of non-stem tumor cells. Probing further into this relationship will increase our understanding of how brain tumors behave, and how to more effectively target them in patients. Further data and conclusions from this project will be available at the time of presentation.
Quantitative assay of neovascularization using high-frequency ultrasonic spectroscopy
Andrea Quiroz, Utah Valley University Health The stimulation and inhibition of tissue vascularization has important applications to tissue engineering and oncology. Approaches to quantitatively evaluate neovascularization in vivo in adult animals with differentiated tissue include both invasive methods that use an implanted or injury-induced matrix in the study organism, or noninvasive small animal imaging methods such as MRI, CT, and PET. The objective of this study was to determine if ultrasonic spectra in the 10-100 MHz range could be used as an in vivo neovascularization assay. Numerical simulations and phantoms were used as model systems to test the feasibility of the approach. The simulations modeled ultrasonic scattering from microscopic vascular networks using randomly oriented cylinders to represent blood vessels and cylindrical wave functions to represent ultrasonic waves. Phantoms were fabricated from a gelatin-soluble fiber mixture and agarose gel. The agarose gel was embedded in the gelatin-fiber in order to simulate vascular tissue. Ultrasonic tests were performed using two broadband ultrasonic transducers centered at 50 MHz. Pitch-catch data were collected and analyzed by calculating the peak density of the ultrasonic frequency spectrum, which is the number of peaks and valleys in the spectrum (a measure of the spectrum’s complexity). Control specimens were tested to determine the differences in the sound wave properties between the gelatin-fiber and the agarose gel. The controls demonstrated the instrument’s ability to differentiate between the two types of material. Measurements of agarose inclusions in the gelatin-fiber showed a significantly higher peak density than those for the control gelatin-fiber. These results indicate that the agarose gel structures are scattering sound to a greater extent than the gelatin-fiber alone. The results thus far have provided a strategy for proceeding with the project in the future. The phantoms will be refined and made more realistic to produce an adequate mimic for vascular tissue.
Screening for Anemia in Children of Rural India
Elise Corbett, Brigham Young University Health Background
The effect of evaporative coolers on indoor relative humidity and dust mite allergens in Utah homes.
Brooke Wahlquist, Brigham Young University Health Exposure to the house dust mite (HDM) allergens Der p 1 and Der f 1 has been implicated in the development and exacerbation of asthma, the leading chronic disease among children in the U. S. Indoor relative humidity (RH) is the most important determinant of HDM growth in homes. HDM populations reach a maximum size at 85% RH but can survive at RH levels as low as 54 %. The RH in the commonly arid climate of the western U.S. is often below 55%, and as such, HDM exposure in these areas has not been viewed as a significant health concern. However, studies have shown that evaporative coolers, or “swamp coolers”, can increase indoor RH levels enough in arid climates to support HDM growth. In this study, we propose to evaluate the relationship between HDM allergen levels in the home and evaporative cooler use in 46 single family homes in Utah County. Homes will be recruited from among BYU employees based on the age of home as well as type of cooling system used (evaporative cooler (n = 23) vs. central air conditioning (n = 23)). Der p 1 and Der f 1 will be measured in homes by reservoir dust and area air sampling. Additionally, continuous RH measurements will be taken in the home over a 72-hour period in order to more fully characterize fluctuations in indoor humidity, and their relationship to HDM concentrations. Samples and RH measurements will be collected up to 3 times in each home over the course of 1 year. Samples will be analyzed in the laboratory using enzyme-linked immunosorbent assay (ELISA) to detect Der p 1 and Der f 1, and by polymerase chain reaction (PCR) to detect HDM DNA on air sample filters.
The Current Economic Impact on Youth Sports
Sheri Casey, Utah Valley University Health Justification: According to many studies, low socioeconomics is positively correlated to sports participation. Little research explores the economic relationship correlated with youth sports.
The Effects of Social Intervention on Mortality: A Meta-analysis
Tim Smith, Brigham Young University Health Previous research studies have confirmed that life-threatening illness adversely impacts psychosocial well-being, from feelings of isolation and embarrassment to the onset of psychotic episodes and suicidality. To help patients cope with chronic and/or terminal symptoms, many healthcare providers advocate the benefits of social support groups as a palliative measure, such as weekly meetings of cancer patients. The rapid proliferation of such programs, as well as associated “survivor groups,” has attracted research attention, and the number of research studies on the topic is now substantial. The field would currently benefit from a quantitative synthesis of the extant findings. To systematically quantify the effect of such intervention groups on mortality (i.e., death rates), we undertook a meta-analysis of the research literature, comparing patient survival rates as a function of social interventions. Across 27 studies examined thus far, we encountered a surprising variability of intervention success in prolonging life. Although most intervention provided demonstrated evidence of increased survival rates among participants, several studies did not. Our presentation will discuss the implications of our findings for healthcare providers and pose questions that will need to be addressed in future research.
Effects of Formalin Fixation on High-Frequency Ultrasonic Measurements of Biological Tissue
Rhett Thomson, Utah Valley University Health Previous studies have shown high-frequency (HF) ultrasound may be sufficiently sensitive to detect and differentiate between both the histopathology and molecular subtypes of breast cancer. The goal of this study was to test the boundaries of HF ultrasonic testing methods. The parameter of interest was the effect of formalin fixation on tissue samples. Formalin has been found to stiffen tissues. Since ultrasound is sensitive to histological properties such as stiffness and adhesion factors, stiffening caused by fixation may compromise the results of the HF ultrasound analysis. This study monitored potential changes to HF measurements caused by tissue fixation. The fixation solution used was 10% neutral buffered formalin. The same formalin solution is used by hospitals after breast conserving surgery (BCS) to prepare and preserve excised tissue specimens for pathology. If no change in HF ultrasound analysis is detected in tissue samples before or after fixation, prepared tissue specimens from BCS patients may be used as viable samples for HF ultrasonic testing. Twenty tissue samples were used in this study. All samples were excised from the cortex, medulla, or ureter of a fresh cow kidney. Samples were tested with HF ultrasound. Testing conditions and procedures were identical to previous breast cancer tests. HF ultrasonic testing was completed at the zero hour mark and then repeated at five successive time intervals during fixation. Data collected from each sample was compared across all time intervals to detect any changes caused by fixation. Analysis of the data showed no significant changes in HF readings before, during, or after fixation up to 17 hours. Any variations observed were within experimental error. These findings demonstrate that formalin fixation does not affect the accuracy of HF ultrasonic testing techniques on bovine tissue samples. To reinforce the findings, this study will be repeated using different types of tissues.
Classifying Neurons in the Brainstem
Lee Leavitt, University of Utah Life Sciences The ventral respiratory column (VRC) is a region in the brainstem shown to control breathing patterns in mammals. Using activation and inhibition of neurons in this region, classes have been assigned based on response-combinations. Using a mouse model, cells from this region are dissociated, plated and incubated with a dye that indicates changes in cytoplasmic calcium levels. Hundreds of cells are measured while varieties of pharmacological agents are applied. Response-combinations provide a profile of the receptors found on these neurons. Previously, varieties of cell classes were shown to contain NMDA receptors (receptors linked to learning and memory). However, specific compositions of subunits within these receptors are not known. These receptors are ligand gated ion channels composed of four non-covalently bound proteins. Each subunit has a different activation profile determined by interactions of agonist and antagonists. Conantokins (peptides isolated from snail venom) and other compounds further afford understanding of the architecture the assigned cell-classes. This project has continued to classify the subunit compositions of NMDA receptors with the ultimate goal of understanding which NMDA receptor subunits are present in each class. This will provide valuable information on the VRC’s function, and will allow for pharmacological innervations to change behavior in this region.
Insect Phylogeography Study on Patagonia
Dasom Kim, Brigham Young University Life Sciences The main purpose of the project is to compare the phylogeography of a species of stonefly (Klapopteryx kuschelli) and a species of dragonfly (Rhionaeshna variegata) in Patagonia. Specifically, the project will study how geography and behavior (i.e., their dispersal abilities) have affected their evolutionary histories. Of all the varied climates and geography in South America, comparatively few phylogeographic studies have been conducted with insects, especially in Patagonia. This study will provide an important foundation for a comparative phlyogeographic study of two insect groups inhabiting the same regions of Patagonia. Also, if funded, this project will give me an exclusive opportunity to interact with international research institutions in South America as well as their scientists.
The Location and Dimensions of FGF Source are Critical for Proper Limb Pattern
Derrick Crawford, Brigham Young University Life Sciences Members of the FGF family of signaling factors are key components in distal outgrowth and patterning of the vertebrate limb. These factors are expressed and secreted by the apical ectodermal ridge (AER) on the distal margin of the limb. Blocking their function is known to truncate the limb skeleton. Conversely, replacing the AER with beads soaked in Fgf protein can rescue limb outgrowth and patterning. Our lab has demonstrated that one of the mechanisms whereby the Fgf/AER functions is to mediate directed outgrowth of the adjacent mesenchyme. As the AER regulates growth of mesenchyme toward itself, it would be predicted that the AER’s dimensions would be important for shaping the mesenchyme that it recruits. We have found that the shape of the AER changes over time in a manner that corresponds to the shape of limb elements as they form along the proximal distal axis. Further, mutants that exhibit defects in the dimensions of the AER show corresponding anomalies in the limb skeleton. Given these observations it would be predicted that an Fgf soaked bead being of fixed spherical dimensions would only be capable of forming a cylindrical, rod-shaped limb. A bead placed posteriorly fulfills this expectation whereas a bead placed apically does not. We provide a molecular explanation for this discrepancy. We have also manipulated the shape of the AER surgically and find that similar to beads the shape and the AP position of the AER dictates the shape of the forming limb skeleton.
Development of a Resin-Free Protein Purification Technique Utilizing Unique Biochemical Properties of the E. coli SSB Protein
Mark Soffe, Utah State University Life Sciences SSBs are DNA binding proteins that are essential components of cells and play key roles in DNA replication, repair, and recombination. Here we utilize two biochemical properties associated with the E. coli SSB protein to develop a novel procedure to purify proteins using a resin-free strategy. 1. E. coli SSB binds to single stranded DNA (ssDNA) with extremely high affinity (K = 1013 M-1), indicating very tight binding. 2. It is also a unique protein with respect to its purification – it is possible to obtain greater than 95% pure SSB from the total cell lysate without using any sort of column or resin, utilizing polyethyleneimine (PEI) and ammonium sulfate precipitation. Our design uses SSB as an affinity/solubility tag to enhance the solubility and expression of difficult-to-purify proteins, and allows for the simple, resin-free purification using PEI and ammonium sulfate precipitation. There also may be a possibility to co-express protein dimers and possibly tetramers using this method. Constructs have been made that include the SSB gene, along with the ability to fuse any gene of interest, as well as a TEV Protease cleavage sequence allowing for proteolytic cleavage after gene expression. Two genes of interest have been cloned in thus far—TEV protease and Rad51. In this proposal I outline experiments to develop this strategy further and test our proof of principle concept and its application to a broader set of target proteins.
Human Breast Cancer Response to Telomere Loss
Teressa Paulsen, University of Utah Life Sciences Breast cancer is still the most common cancer among women regardless of race or ethnicity. The focus of our research is to uncover the mechanism breast cancer cells use to escape the inherent limitations of the telomere and obtain immortality. The protective end of a chromosome, the telomere, degrades with each cellular division. The cellular response to telomere dysfunction is to activate programmed cell death. Therefore, this type of damage normally limits the proliferative potential of the cell and subsequently carcinogenesis.
American avocet (recurvirostra americana) incubation constancy throughout the nesting cycle on the great salt lake
Josh Hall, Weber State University Life Sciences Reproduction in birds is extremely conservative with the vast majority of the birds adopting bird-egg contact incubation to maintain an appropriate microclimate for embryonic development (Deeming, 2004). The Great Salt Lake is a vital nesting site for American Avocets (Recurvirostra Americana) that shows extreme temperatures and hostile environments where nest success can be as low as 1 -14% (Cavitt, 2008). Constancy of incubation, i.e. the time that the eggs are in contact with an adult, is a major indicator of nest success and environmental conditions. Our goals were to examine some of the costs natural selection places on embryos and parents to maintain a constant embryo temperature. We hypothesized that incubation attentiveness would increase across the nesting cycle. Over 200 AMAV nests were surveyed. Thermal probes were used to record various nest microclimates at every minute. A pseudonest with painted chicken eggs was also created and a thermal probe was placed to measure the ambient temperature without any adult incubation. A motion sensitive camera was placed over nests to examine differences in parental care. Nests will be divided into three phases: early, mid, and late incubation. Thermal data will be analyzed using descriptive statistics and mean variance values to calculate how incubation constancy varied throughout these phases. We expect this data to tell us more on how natural selection is working on these populations and some possible theories of how this developed.
Urban Noise as a Stressor in Side-Blotched Lizards
Marilize Van der Walt, Utah State University Life Sciences Urbanization is accompanied by a lot of changes to the landscape that have the potential to affect the native species inhabiting the area. If animals are chronically exposed to these anthropogenic disturbances and are unable to acclimatize, changes in circulating glucocorticoid hormones may cause adverse effects to the animal’s health, such as an impairment in innate immune activity. One such disturbance is human-induced noise. Using the side-blotched lizard, Uta stansburiana, because of their localized habitat and inability to escape such disturbances within the urban environment, we looked at the field and lab components of noise as a stressor. We first measured decibel levels in urban and rural field sites in their natural habitats in St. George, Utah, and conducted a lab study exposing U. stansburiana to either a synthesized urban sound recording or no sound recording (control) for nine days. We collected blood samples and measured circulating corticosterone and testosterone concentrations and bactericidal ability to determine if there are endocrine and immune alterations in response to increased noise decibels. Our results show that lizards exposed to urban noise experienced increased corticosterone levels indicative of stress. Furthermore, bactericidal ability was indirectly affected by noise through significant correlations between body condition and corticosterone and testosterone concentrations. These results indicate that an increase in ambient decibel levels acts as a stressor to animals in urban areas. By dissecting out an individual component of a complex stressor we can better understand the effects of urbanization as a whole.
Plant-Soil Feedback of Native and Exotic Species in the Inter-Mountain West
Molly Van Engelenhoven, Utah State University Life Sciences For thousands of years farmers have known that soil organisms can destroy crops but only in the past ten years have researchers begun to understand that complex interactions among soil organisms and plants can determine plant diversity and productivity. Much of the research in this young field of study has come from qualitative greenhouse experiments and separately from simple mathematical models. Here, we report findings from a six-year plant-soil feedback (PSF) field experiment that assessed the effects of soil organisms on the growth of twelve plant species common to the intermountain west. Initially, twelve native and exotic species were randomly assigned to 1550 experimental plots in a field. After four years of growth, the plants were killed. Next, the same plant species were randomly assigned to the 1550 plots again to test how each plant species responded to the soil microbial communities ‘cultivated’ by each other plant species. Two years later plant growth responses to different soil types were measured. Most plants showed large growth differences on different soil types. For example, Bromus tectorum grew twice as much on Pseudoroegneria spicata-cultivated soils than on self-cultivated soils. When the plant growth responses observed in this experiment were used in a mathematical model, PSFs were found to play a critical role in determining which plants were likely to be dominant in a community and how productive these different plant communities would be. In summary, this large-scale experiment provides strong evidence for the role of PSFs in plant productivity and diversity. Results have implications for natural methods of effective native plant restoration, biofuel production and weed control.
Long-term evaluation of Leafy Spurge biological control in Richmond, Utah
Jacob Anderson, Utah Sate University Life Sciences Leafy spurge (LS) is an aggressive Eurasian forb that has been successfully reduced in many areas in western North America through the biological control releases of flea beetles. Long term studies of this phenomenon are sparse. Three flea beetle species were released in the mid-1990s at a site dominated by LS in Richmond, Utah. This study assessed the long term effects of LS biocontrol on an ecological community at this site by addressing five questions: (1) Is LS abundance significantly lower now than in the 1990s? (2) What plant species are replacing LS and are they native or non-native? (3) Have the flea beetle populations persisted since their initial release? (4) What part does soil type play in which flea beetle species now dominate at the site? (5) In response to their unexpected presence, what role may long-horned beetles contribute to the long-term reduction of LS? It was found that LS abundance has significantly decreased from the 1990s; the dominant plant species are those of non-native grasses; flea beetles have persisted in significantly smaller numbers, with Aphthona lacertosa being the most abundant; and long-horned beetles appear to play a significant role in the reduction of sexual success of LS. The results of this project have implications for land managers when considering the vegetative response to LS biological control and the importance of long-horned beetles for long-term in managed, LS-reduced habitats.
Physiological and pathophysiological stimuli alter endothelial cell autophagy
J David Symons, University of Utah Life Sciences Autophagy plays a central role in cellular quality control by destroying damaged or excess proteins, lipids, membranes, and organelles that accumulate in response to deviations from homeostasis. The existence and role of autophagy in endothelial cells (ECs) and blood vessels has not been established. Autophagy can be quantified by assessing the ratio of the membrane bound conjugate of microtubule-associated protein light chain 3 (LC3-II) to the cytosolic non-lipidated conjugate LC3-1 (LC3-II:LC3-I) or GAPDH (LC3-II:GAPDH) via immunoblotting. We sought to determine the extent to which a variety of cellular stressors induces autophagy in ECs and intact blood vessels. LC3-II:LC3-I or LC3-II:GAPDH was elevated (p<0.05) (i) 450±6% (n=4) in ECs incubated for 2 h in amino acid (AA)-deplete vs. AA-replete media; (ii) 47±3% (n=3) in arteries from fasted (14 h) vs. fasted / refed (1 h) mice; (iii) 40±2% (n=3) in arteries from mice that completed acute exercise vs. sedentary controls; (iv) 38±1% in arteries from exercise-trained vs. sedentary mice under basal conditions (n=2 per group); and was decreased (p<0.05) (v) 57±8% (n=4) in arteries from ~30 month-old (i.e., old) vs. ~6 month-old (i.e., young) mice. Further, indices of autophagy were elevated (p<0.05) 101±6% in ECs exposed to 3 h x 500 uM palmitate vs. vehicle (n=4), and 50±6% in arteries from obese vs. lean mice (n=4 per group). Thus, autophagy is altered in ECs and blood vessels in response to physiological (e.g., fasting, acute exercise, exercise training, aging) and pathophysiological (acute lipotoxicity, diet-induced obesity) stimuli. Ongoing research will determine the functional role of vascular autophagy in health and disease.
Concentrations of Trace Pharmaceuticals Found in Hobble Creek
Janweb Lagazo, Brigham Young University Life Sciences The scientific community and the general public have long been interested in the effects of water pollution. Most studies on water pollution have focused solely on industrial pollution, but have failed to consider the potential impact of pharmaceuticals that unintentionally accumulate in aquatic ecosystems via wastewater treatment effluents. The purpose of this study is to advance our understanding on how these wastewater effluents affect aquatic ecosystems in Utah. We quantified the concentration of select pharmaceuticals in Hobble Creek using mass spectrometry. Then we sampled above the treatment plant, at the effluent outlet, and downstream of the effluent to determine pre-effluent and post-effluent drug concentrations. We are currently using this preliminary data to investigate how common endocrine disrupting, anti-inflammatory, analgesic, and anti-anxiety drugs may potentially affect the aquatic ecosystem of the endangered Chasmistes liorus, commonly known as June sucker.