2020 Abstracts

Huffcutt, Deanna (Brigham Young University)
Faculty Advisor: Christensen, Brian (Brigham Young University, Art)

How does our perspective influence us? This piece, created out of wood and metal, is a walk-around piece with three different sides. Each side has a different perspective, though each piece is identical and only appears different due to placement. Our perspective greatly impacts our lives. As a woman living in Utah who did not grow up in Utah, I find that my perspective sometimes varies from the women around me. I am interested in the multitude of perspectives that exist in women in Utah, as I do not think it can be defined in one work of art.

Huffcutt, Deanna (Brigham Young University)
Faculty Advisor: Christensen, Brian (Brigham Young University, Art)

I was curious about the idea of movement within natural restraints. As women, we face natural restraints all the time. Most of our restraints are cultural and self-made, so this artwork explores that idea.

Morgan Howard, Corinna Trujillo Tanner, Boyd Tanner, Brandon Thatcher, Janelle Macintosh (Brigham Young University)
Faculty Advisor: Trujillo Tanner, Corinna (Nursing, Nursing)

Purpose/Aims: The purpose of this Review of Literature is to present the most current and accurate information about e-cigarette use, or vaping, with recommendations for nursing practice.

Rationale/Conceptual Basis/Background: According to the CDC, to date over 1300 individuals have developed severe lung injury, associated with vaping, including 216 fatalities. Most of these cases involved young people in their teens or twenties. There are concerns that marketing for vaping specifically targets young people and leads potential users to consider the practice relatively safe. On the contrary, vaping is associated with several serious health risks, including lipoid pneumonia, acute respiratory distress syndrome and popcorn lung. Little is known about the effects of the 60+ compounds identified in vaping aerosol, which is inhaled directly into the lungs. Nurses are often the first point of contact for patients in primary care and urgent/emergent settings. Nurses provide valuable patient education, health assessment, and referral. It is important for nurses to have access to the latest information about this developing problem.

Methods: We conducted a review of literature. We reviewed and summarized information from the Food and Drug administration, Centers for Disease Control, American Medical Association, American Academy of Pediatrics, and other reputable sources. All information reviewed had been published within the last six months. Research questions which guided this review sought to identify important considerations for nursing assessment, and nursing interventions.

Findings/Clinical Implications:

Nursing Assessment: An important part of nursing assessment should include documentation of a patient's history of vaping. When a patient presents with respiratory symptoms and has a history of vaping, a detailed vaping history covering the previous 90 days should be obtained. When acute lung injury, caused by vaping is identified, it must be reported to local and state health departments, per the new CDC guidelines.

Nursing interventions should include patient education as follows: 98.7% of "vape juice" assayed by the FDA contained the addictive substance nicotine (even if labeled "nicotine free") Nicotine is highly addictive and damages developing brain tissue in fetuses, infants, children and teens Inhaled "second hand" vape aerosol is dangerous for pregnant women, infants, children and those with lung disease The inhaled solution is not "water vapor" but rather an aerosol created by an electric heating element within the vaping device The inhaled solution contains up to 60 + chemicals including heavy metals

There is no established standard for vaping safety

Flavorings in vape juice, although considered safe for ingestion, have not been approved for inhalation and are not known to be safe

Additional information and recommendations will be forthcoming as our understanding of the risks associated with vaping is rapidly evolving.

Wankier, Zakary; Sinclair, Sarina PhD; Drew, Alex PhD; Taylor, Carolyn MS; Kubiak, Eric MD; Agarwal, Jayant MD (University of Utah)
Faculty Advisor: Sinclair, Sarina (School of Medicine, Orthopaedics)

Introduction:

Osseointegration (�OI�) technology is the direct skeletal attachment of a prosthetic limb to bone using an intramedullary stem. For OI to be effective and secure, bone in-growth and remodeling around the implant must be achieved. Physicians need an effective way to measure bone remodeling in order to make informed decisions on treatments. This work describes methodology that was developed that utilizes computed tomography (CT) imaging as a tool for analyzing bone remodeling around an OI implant.

Method:

Subjects implanted with a new Percutaneous Osseointegrated Prosthesis (POP) had CTs taken of their residual femur at 6 and 52-weeks post-op. The CT images were used to segment and create three-dimensional models of the femur.

Following segmentation, models were aligned to a common world coordinate system. STLs of the aligned medullary cavity and femur volume were entered into custom Matlab code to calculate cortical and medullary morphology measurements. Morphology data from 6 and 52-week scans were compared in order to determine if bone remodeling around the POP implant could be detected.

Results:

Comparing data from post-operative visits suggests that important indicators of bone remodeling around the device could be detected. One year after implantation of the POP device the medullary parameters had minimal % differences (-1.5 and 2.2) compared to 6-weeks, validating that consistent alignment was achieved between scans from different time points. Cortical area, perimeter, and thickness around the POP implant showed positive percent changes at 12-months of 19.44%, 4.04% and 14.36% respectively. Increases in cortex morphology values indicate bone remodeling around the implant, with largest increases observed at the distal end for each parameter.

Discussion:

This pilot study utilized CT imaging as a tool for quickly and accurately analyzing bone remodeling around a new osseointegrated device. Additional work will further validate and optimize these methods for clinical use.

This study described an investigational device, limited by federal law to investigational use. No long-term data exists about its performance.

Hyman, Rachel; Light, Tim; Montague, Angela; Lucero, Jessica (Utah State University)
Faculty Advisor: Lucero, Jessica (College of Humanities and Social Sciences; Sociology, Social Work and Anthropology Department)

Refugees are recognized as having unique and complex health needs which demand attention upon arrival and throughout the resettlement process (Agrawal & Venkatesh, 2016). Refugee populations are particularly vulnerable to health disparities due to push factors influencing forced migration (Tempany, 2009). These factors include exposure to political violence, natural disasters, and other forms of anthropogenic conflict (UNHCR, 2014). Refugees may arrive in the host country with undiagnosed and untreated health issues, such as infectious diseases, mental distress due to prior traumas, undiagnosed chronic illness, and nutritional deficiencies (Deen & Bridges, 2011). Refugee populations represent high rates of mental and physical health problems compared with the host population (Kirmayer, Gomez-Carrillo, & Veissi�re, 2017). Additional dynamics compound health disparities facing refugees. These include: language barriers, unfamiliarity with a complex health care system, limited health literacy, and inadequate alignment of medical treatments with religious and cultural beliefs (Bowen, 2001; Brown, Carroll, Fogarty, & Holt, 2010). Though there is robust scholarship in the literature and analysis of prevalent health disparities and needs of refugees post-resettlement, few studies address the specific health care concerns of refugees resettled in northern Utah. This study seeks to expand previous findings related to the most salient health care issues facing the refugee community and develop community response to address health disparity. A secondary aim of the research is to determine best practices for the provision of appropriate and effective health services.

Varghese, Alyssa; Crandall, Hillary; Blaschke, Anne (University of Utah)
Faculty Advisor: Crandall, Hillary (University of Utah, Department of Pediatrics); Blaschke, Anne (University of Utah, Department of pediatrics)

Haemophilus influenzae serotype b (Hib) causes serious bacterial infections in children associated with high morbidity and mortality. The incidence of Hib disease decreased with widespread vaccination in the mid-1980's. However, other H. influenzae serotypes, such as serotype a (Hia), have emerged in specific pediatric populations, including Utah and indigenous populations in Alaska and Canada. Hia appears to cause disease similar to Hib in both severity and disease presentations.

Cases of invasive H. influenzae disease in children <18 years were identified via a search of electronic medical records within the Intermountain Healthcare system. Phylogenetic division was determined using sodC PCR. Whole genome sequencing (WGS) was performed on available isolates. Gene presence and absence data from resulting assemblies were utilized to build a relationship tree from all available Hia isolates, as well as select Hib, H. influenzae serotype f (Hif), and non-typeable H. influenzae (NTHi) isolates. Multi-locus sequence type (ST) was extracted from WGS data for each isolate.

118 cases of invasive H. influenzae disease were identified from 2007 to 2017. Fifty-one (43.2%) cases were Hia and 11 (9.3%) were Hib. Twenty-eight of 51 (56%) Hia isolates were available for further molecular analysis. Three STs were identified: ST56, ST62, and ST576. Twenty-one isolates (75%) belonged to ST62, clonal division II. The relationship tree indicates that ST62 Hia isolates are most closely related to each other and more closely related to Hif than to other Hia and Hib.

The molecular epidemiology of invasive Hia disease in Utah is unique, with a predominance of ST62 strains, a ST that has been infrequently reported in other studies of invasive Hia. Further genomic analysis will help us understand genetic determinants of virulence. These analyses will be critical in characterizing the clinical and molecular features of invasive H. influenzae disease in Utah.

Brammer, Brianna; Denham, Steven; Wambaugh, Morgan; Brown, Jessica. (University of Utah)
Faculty Advisor: Brown, Jessica (University of Utah, Pathology)

Cryptococcus neoformans is an opportunistic fungal pathogen, which primarily affects those with compromised immune systems, contributing to 15% of global AIDS-related deaths. Initial human exposure occurs after inhalation of desiccated cryptococcal cells, which undergo morphological changes in the lungs, including altering cell body and polysaccharide capsule size. Fatality occurs after C. neoformans disseminates to extrapulmonary organs, including the brain where it causes cryptococcal meningitis. Preliminary data show that fungal cells decrease in size throughout the course of infection; we hypothesize that this shift increases the ability of fungal cells to exit lung epithelium, either extracellularly or via macrophage, as small cryptococcal cells exhibit enhanced extrapulmonary dissemination. We later determined that this effect was not solely due to fungal cell size by inoculating mice with fluorescent beads corresponding to cryptococcal cell size groups. The beads showed similar dissemination trends, but were significantly less efficient at extrapulmonary dissemination, suggesting the necessity of cell surface factors. By measuring the exposure of various fungal factors relative to size, we have identified mannose as a potential key factor in dissemination, as small cells exhibit higher levels of exposed mannose relative to size. The hypothesized role of mannose in cryptococcal dissemination is investigated throughout this project utilizing a variety of techniques, including the addition of polysaccharides to macrophage-cryptococcal association assays to determine mannose-specific recognition, in vivo co-inoculation with mannose and cryptococcal cells, and identifying differential gene expression between cell sizes using RNA sequencing and gene ontology. These data have contributed to our working model of cryptococcal infection, where cryptococcal cells undergo morphological changes in the lungs, yielding a higher prevalence of small cells. Cell size is an important, but not determinant factor in dissemination, suggesting the role of cell surface factors, such as mannose, that increase virulence by promoting phagocytosis and intracellular survival.

Salas, Norma; Condie, Kali; Cook, Lauralee (Utah Valley University)
Faculty Advisor: Jensen, Francine (Utah Valley University, Nursing)

Problem Statement:

Depending on the provider a woman has during her delivery, the education, interventions, and care she receives will differ. Variations of care under an obstetrician and gynecologist (OB/GYN) compared to a midwife may produce differing satisfactory results for women experiencing labor and delivery.

Purpose:

The purpose of this research study is to discover if women who have delivered with both an obstetrician/gynecologist and a midwife are more satisfied with their birthing experience under the care of one provider compared to the other.

Research Question:

Are women who have experienced labor and delivery with an OB/GYN and a midwife more satisfied with their birthing experiences from one provider compared to the other?

Background:

In a patient-centered world, it should be up to the provider and expecting mother to choose the modality of delivery they would like, including the place, medical interventions, positioning, and methods of delivery. OB/GYNs and Midwives vary in practices, and implementations during gestation and delivery. Dissatisfaction with labor and delivery is an aspect of the current healthcare industry that needs to be addressed in order to improve patient care. Coxon, Sandall, and Fulop highlight this issue by pointing out that many women feel constrained with their decisions regarding labor and delivery and that delivery opportunities may be limited due to influences from cultural and historical associations as practiced by the provider (2014). Patient satisfaction is also influenced by pressures women in labor and delivery experience in order to accommodate their providers wishes.

Hope to accomplish:

We hope to determine if women's satisfaction during their labor and delivery experiences are higher with either a midwife or an obstetrician/gynecologist, as well as to promote better education and patient autonomy to increase patient experience satisfaction.

Linder, Caitlin; Linder, Lauri (University of Utah)
Faculty Advisor: Linder, Lauri (College of Nursing, Nursing)

Childhood cancer disrupts children's day-to-day experiences. The purpose of this study was to analyze children's responses to two questions included in a daily symptom reporting app: "What is the best thing about today?" and "What is bothering you the most today?" Responses were part of a larger study evaluating the feasibility and acceptability of the app. Children used the app to record daily symptoms and answer short questions about their day.

Children completed a trial of the app between visits at the hospital for chemotherapy. Daily responses to each question were analyzed using descriptive qualitative content analysis with each response serving as a unit of analysis. Coding was completed by each author and reviewed together to reach agreement. Children's responses were organized into categories and subcategories.

Participants were 19 children 6-12 years of age (median 8 years) (12 boys) receiving chemotherapy who used the app for a total of 83 days (median 4.5 days/child). Children provided 72 responses about the best thing about their day that were organized into nine categories: Activities (n=22), People (n=14), Food (n=9), Well-Being (n=9), School (n=7), Nothing (n=5), Object (n=4), Going Home (n=3), and Don't Know (n=1). Children provided 60 responses about the most bothersome aspect of their day that were organized into six categories: Nothing (n=22), Symptoms (n=17), Port (n=7), Cancer Treatment (n=5), Day-to-Day Stuff (n=5), and People (n=4).

Children's responses provide perspective of the impact of cancer on their daily lives. Their responses indicate the importance of maintaining developmentally normal activities and family relationships. Children's responses further indicate the pervasiveness of the cancer experience, such as symptoms, even on days when children are away from the hospital. Mobile health apps can help children not only track symptoms but also reflect on their day. Clinicians can use children's information to better understand children's experiences.

Perriton, Kiersten; Eppley, Sydnie; Young, Colleen (Utah Valley University)
Faculty Advisor: Jensen, Francine (Utah Valley University, Nursing)

Purpose: To determine the preparedness of new graduate nurses to practice after completion of nurse residency programs.

Background: New graduate nurses often feel anxious, concerned or ill prepared to practice as nurses on their own. New graduate nurses worry if the residency program has prepared them for their first nursing job sufficiently for them to gain enough confidence and skill to be on their own. Studies on nurse residency programs show that nurses who complete one-year nurse residency programs had remarkable increases in communicating with family, patients and team members, confidence in skills, and ability to prioritize and organize work. There is a need for continued education, such as nurse residency programs and an active interest in new graduate nurses, such as involved mentors or preceptors to help strengthen clinical reasoning and preparedness of new graduate nurses. Stress in new graduate nurses can impede patient safety and can result in the new nurse quitting the position. When new graduates have designated mentors, fit well with unit socialization, and are oriented to multiple areas, it has been identified that it can build their confidence levels and improve retention rates of new graduate nurses. Nurse residency programs need to provide high quality orientation to help them master their careers.

Significance: This research can give insight into whether the implementation of nurse residency programs helps new nurses feel ready to practice on their own. This information may help provide increased safety and quality of care to patients due to new graduate nurses feeling competent and confident to carry out the patient's health care plan. This can help healthcare companies determine if current programs are effective and what needs to be changed. New nurse graduates may gain confidence, practice with increased patient safety, and corporations may retain the new nurses they have just trained.

Barlow, Andrew; Beales, Joseph; Ekpo, Idongesit; Krueger, Emily; Lloyd, Trevor; Ross, Mimi; Sheets, Jared; Tessem, Jeffery; (Brigham Young University)
Faculty Advisor: Tessem, Jeffery (Brigham Young University; Nutrition, Dietetics, and Food Science)

One in eleven people worldwide suffer from diabetes, and 12% of the global health expenditure is attributed to its treatment. Despite spending over $300 billion on the treatment of diabetes, none offer curative therapies. Diabetes is characterized by the loss of pancreatic β-cell function, but research has shown changes in diet are beneficial in treating Type 2 Diabetes. Phytochemicals are commonly utilized in these diets, and recent studies show diets high in derived flavanols exert beneficial bioactivity for β-cells. However, given that these phytochemicals are rarely found in circulation, the direct mechanism of action is still under investigation. Gut bacteria metabolize flavanols into smaller, absorbable metabolites, which can be found in circulation. We hypothesize that these gut bacteria derived flavanol metabolites are absorbed and have direct effects on β-cell function. We test this hypothesis by feeding rats control diets or diets rich in the flavanol monomers catechin hydrate and epicatechin or grape seed extract. Here we present data regarding the in vitro effects of these absorbed gut bacteria derived flavanols on β-cell function. This study sheds further light on flavanols and their potential to promote insulin secretion and, ultimately, glucose homeostasis.

McQuinn, Sophie; Love, Tiffany (University of Utah)
Faculty Advisor: Love, Tiffany (University of Utah, Psychiatry)

Chronic pain is a major health crisis, and is considered the second major cause of disability in the world. People with chronic pain that lasts 6 months or longer often experience other symptoms as well, including depression. While the causes of chronic pain are often unknown, it has been shown that people with chronic pain exhibit brain structure differences compared to those who do not. It is important to know how chronic pain and brain structure are interconnected so that we can find a better way to treat patients. Gaining more knowledge of this connection can lead to a better understanding of the underlying causes. Brain structure goes hand in hand with neuroplasticity, which plays a key role in normal brain development. While it has been shown that chronic pain can have a significant effect on brain structure, it is unknown whether different symptoms affect different areas of the brain. The effects of chronic pain on the brain have only been looked at in a holistic sense and have not been quantified according to symptoms. Because chronic pain can have a variety of causes, this makes it difficult to determine a good method of treatment for individuals. Our aim was to determine how different symptoms of chronic pain affect the brain individually and evaluate possible overlap. The categories we tested were sensory, affective, unpleasantness, intensity, and depression. We used MRI scans from both healthy individuals and participants experiencing chronic lower back pain. The relative levels of each symptom that the participants were experiencing were determined via the McGill Pain Questionnaire and the Center for Epidemiologic Studies Depression Scale. Having a better understanding of how different symptoms of chronic pain affect the brain can aid in finding more personalized treatment for those experiencing it.

Daines, Savannah (Utah State University)
Faculty Advisor: Adams, Brett (College of Science, Biology Department)

Traumatic brain injury (TBI) occurs when external forces cause the brain to move rapidly within the skull, resulting in an alteration of brain function. Following the initial injury, a cascade of cellular events known as the secondary injury reduces cerebral energy production and exacerbates pathological consequences. Conditions that close the mitochondrial permeability transition pore (mPTP) provide effective treatment for TBI by restoring ionic balance and coupling of mitochondrial oxidative phosphorylation to ATP production. mPTP closure can be achieved during ketosis when the body metabolizes ketone bodies over glucose as a primary fuel source. Administration of exogenous ketones achieves therapeutic levels of ketosis more quickly and more effectively than fasting or ketogenic diets. No studies to date have evaluated the effectiveness of exogenous ketones in treating TBI in humans. This project will evaluate current scientific literature regarding the role of ketones in TBIs and identify potential future approaches to using ketones as a therapy for TBI.

Ouzts, Ethan (Brigham Young University)
Faculty Advisor: Matheson, Rebekka (BYU Family, Home, and Social Sciences; Psychology)

Ketamine was recently approved by the U.S. Food and Drug Administration as a therapeutic approach to treat individuals with treatment-resistant depression. This approval opens the door for other hallucinogens to be approved for psychiatric use. This review compares the antidepressant efficacy and safety of ketamine to serotonergic hallucinogens, such as lysergic diethylamide acid (LSD). Ketamine acts as the standard of comparison in this review. Serotonergic hallucinogens demonstrate similar short to mid-term responses in patients with depression and compares well to ketamine's safety. Researchers should conduct additional randomized, controlled experiments to better establish serotonergic hallucinogens' antidepressant potential. Despite this limitation, serotonergic hallucinogens warrant serious consideration for potential antidepressant treatment.

Tooley, Sarah (Utah State University)
Faculty Advisor: Powell, Jake (College of Agriculture and Applied Sciences, Landscape Architecture and Environment Planning Department)

The dry, arid climate of Utah makes water a limited and precious resource. However, Utahans are the second largest per capita water users in the nation, with over 60% of that water used on outdoor landscapes. High landscape water use in the face of limited availability is a complex socio-cultural phenomenon reaching back to when pioneers first settled Utah. Settlers were from places with cultural perceptions of landscapes and climates much different then what they found when they arrived. Their desire to create a place that felt like home established a cultural landscape vernacular where Utahan's prefer a landscape more lush and green than we have water to support. With the projected increase in Utah's population, the traditional Utah landscape is quickly becoming unsustainable. As an Extension service I designed 5 landscapes following established water wise design principles which are: planning and design, plant selection and hydro zones along with practical turf areas. The purpose of these designs was to demonstrate that water wise designs can both be water efficient as well as functional, sustainable and aesthetically pleasing. The results of these planning and design efforts are currently being installed into residences in two Utah communities. I will share the design and implementation methods and results of these designs and visitor feedback data from one of the sites. This design research showcases a potential method others in Utah can use to make their landscapes more water wise and begin to redefine the vernacular landscape in Utah and the Intermountain West.

Vasquez, Cesar; Dockstader, Patrick; Havertz, Brett; Phillips, Justin (Dixie State University)
Faculty Advisor: Chellamuthu, Vinodh (Dixie State University, Mathematics)

For any business, understanding the customer’s behavior is vital to maximizing income and minimizing costs. Our work aims to create an algorithm that analyzes the historical data from the customers and determines the target customers in an optimal way. We take on a data set from a transmission shop in California and seek out which factors produce higher potential for client value. We created a mathematical model that classifies the clients as low, medium, or high potential using this historical data. Furthermore, we demonstrated the model utility using the transmission shop’s data to compute the correlation of paying customers and customer history. The correlations are then used to create a conditional probability distribution which served to predict an expected rating score. Moreover, our results are validated by comparing the predicted ratings with the actual ratings in varying train and test cases from the data set. Our results show that the proposed algorithm is fast, simple, and intuitive, which could be utilized by the transmission shop in the future.

Heider, Emily; Simkins, Kylee (Utah Valley University)
Faculty Advisor: Heider, Emily (Utah Valley University, Chemistry)

Expansion of science literacy is increasingly accomplished outside of formal classroom settings with reports of informal learning (IL) experiences at nature centers, demonstration shows, science museums, and scouting. Some researchers have expanded the range of informal learning to also include media, libraries, and public parks. These informal portals to science knowledge provide inclusive settings for learning, and reports of their development research opportunities and benefits are garnering increasing attention. This research describes the integration of informal museum-based learning into college general chemistry courses using the School Museum Learning Framework. Outcomes related to course content were quantified using pre- and post- assessment measures. Additional outcomes quantifying student motivation were evaluated using the Science Motivation Questionnaire. Results show improvement in some course-related outcomes as well as differences in motivation for students who participate in informal learning when compared with students who complete a conventional chemistry course.

Rasmussen, Melissa; Lauritsen, Jake; Clarke-Midura, Jody; Lee, Victor; Recker, Mimi (Utah State University)
Faculty Advisor: Lee, Victor (Emma Eccles Jones College of Education & Human Services, Instructional Technology and Learning Sciences Department); Recker, Mimi (Emma Eccles Jones College of Education & Human Services, Instructional Technology and Learning Sciences Department)

With the rising perception of computer science as a universally useful skill in the twenty-first century, researchers and schools test ways to effectively interest and introduce young children to computer science. Our project develops a curriculum pairing an "unplugged" board game component with a "plugged" portion in MIT's Scratch, pairing short class lectures with hands-on student learning. In order to effectively work with our partner school district and implement a complete unit without taking too many class minutes, we integrate much of the hands-on portion of the curriculum into existing library time. We run several iterations of the curriculum for fifth graders, refining the 6-8 week unit as we go. Of particular concern in our design is the typical middle school teacher's unfamiliarity with coding and computer science concepts. We find that it may be possible to capitalize on this unfamiliarity in order to improve student outcomes. We look at student creativity and computational thinking during the unit, seeking an increase in ability and self-efficacy by closing the unit with student creation of their own game boards. Furthermore, we examine female engagement and interest in the programming portion, with the goal of pinpointing factors that could increase female participation in computer science or partially explain the current deficit. The results of the implementation of our curriculum, with particular focus on the successes and failures that can be generalized to other computer science curricula, will be discussed.