Fine Arts

Authors: Maddy Howard, Brooke Dension, Shanna Groesbeck. Mentors: Sandy Wilson. Insitution: Utah Valley University. AbstractThere are many systemic diseases that are linked to oral health. This literature review specifically examines different studies and academic journals that have studied the relationship between oral health, obesity, heart disease, and diabetes. Obesity is linked to the patient's oral health in many ways. When patients are consuming large quantities of food more often than normal, this results in a more acidic environment along with energy for bacteria to grow. One study found a correlation between obesity and risk factors such as “frequency of brushing teeth, smoking, tooth loss, gingivitis, and dental caries (Yilmax & Somay, 2021). This article discusses the strong correlation between oral health and heart disease. Several studies emphasize the importance of dental hygienists educating their patients about the link between their oral and cardiovascular health. The articles conclude that treating periodontal disease more effectively and aggressively could lead to a marked reduction in coronary heart disease rates and vice versa.Diabetes and periodontal disease is also examined at length in this literature review. Diabetes and periodontitis is described as a ‘two-way relationship’. Evidence shows that individuals with diabetes, type 1 or type 2, are 34% more likely to develop periodontal disease. On the other hand, individuals experiencing periodontal disease are 53% more likely to develop diabetes (Wu, et al., 2020). This literature review will explore the importance of oral health in keeping your entire body healthy.ReferencesArora, A., Rana, K., Manohar, N., Li, L., Bhole, S., & Chimoriya, R. (2022). Perceptions and practices of oral health care professionals in preventing and managing childhood obesity. Nutrients, 14(9), 1809. 10.3390/nu14091809.Batty, G. D., Jung, K. J., Mok, Y., Lee, S. J., Back, J. H., Lee, S., & Jee, S. H. (2018). Oral health and later coronary heart disease: Cohort study of one million people. European Journal of Preventive Cardiology, 25(6), 598-605. 10.1177/2047487318759112Centers for Disease Control and Prevention. (2022). Defining adult overweight & obesity. Centers for Disease Control and Prevention. Deraz, O., Rangé, H., Boutouyrie, P., Chatzopoulou, E., Asselin, A., Guibout, C., Van Sloten, T., Bougouin, W., Andrieu, M., Vedie, B., Thomas, F., Danchin, N., Jouven, X., Bouchard, P., & Empana, J. P. (2022). Oral condition and incident coronary heart disease: A clustering analysis. Journal of Dental Research, 101(5), 526-533. 10.1177/00220345211052507Sanchez, P., Everett, B., Salamonson, Y., Ajwani, S., Bhole, S., Bishop, J., Lintern, K., Nolan, S., Rajaratnam, R., Redfern, J., Sheehan, M., Skarligos, F., Spencer, L., Srinivas, R., & George, A. (2017). Perceptions of cardiac care providers towards oral health promotion in Australia. Collegian, 25(5), 471-478. https://doi.org/10.1016/j.colegn.2017.11.006Preshaw, P. M., Alba, A. L., Herrera, D., Jepsen, S., Konstantinidis, A., Makrilakis, K., & Taylor, R. (2012). Periodontitis and diabetes: A two-way relationship. Diabetologia, 55(1), 21-31. 10.1007/s00125-011-2342-yWu, C.-Z., Yuan, Y.-H., Liu, H.-H., Li, S.-S., Zhang, B.-W., Chen, W., An, Z.-J., Chen, S.-Y., Wu, Y.-Z., Han, B., Li, C.-J., & Li, L.-J. (2020). Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC oral health, 20, 204. 10.1186/s12903-020-01180-wYilmax, Busra. & Somay, Efsun. (2021). Is obesity a problem that threatens oral health in adults? Cukurova Medical Journal, 46(3), 1215-1221. DOI: 10.17826/cumj.950243

Authors: Danielle Terry, Seth Helton, Michael Creer. Mentors: Austin M Green. Insitution: University of Utah. With anthropogenic influence increasing worldwide, it is important to understand how wildlife behavior changes in response to urbanized landscapes. Urban ecosystems represent relatively novel landscapes with unique threats and opportunities that can completely restructure species’ population composition and dynamics. Mule deer (Odocoileus hemionus) have been shown to alter their temporal activity in response to urbanization across their range of the Intermountain West of the United States. In this study, we will investigate the effects of anthropogenic influence on mule deer temporal activity behavior across two distinct life stages: fawning and non-fawning. Data for this study will come from the citizen science camera trapping project, Wasatch Wildlife Watch. The full project area is separated into two study sites: “Rural” and “Urban”. This study will be based around the wild-to-urban interface of the Central Wasatch Mountain Range and the Bear River Mountain Range, which composes some of the most highly recreated portions of the Uinta-Wasatch-Cache National Forest, receiving approximately 9,000,000 visitors annually (U.S Forest Service). We will investigate the proposed differential effects of anthropogenic influence and urbanization on mule deer diel activity patterns in the fawning vs. non-fawning life stages. Also, we will inquire whether intraspecific responses in mule deer diel activity alter interspecific interactions, especially with fawning predators, and how these responses might interact with environmental factors. We predict that anthropogenic influence and urbanization alter the diel activity patterns of fawning mule deer more than non-fawning deer and that the presence and activity of fawn predators (e.g., coyote [Canis latrans]) would have a stronger effect on fawning deer activity than non-fawning deer activity.

Authors: Marie Gibb. Mentors: Francine Jensen. Insitution: Utah Valley University. Maternal mortality, also known as maternal death, is defined as the death of a woman during pregnancy and up to one year postpartum. (MacDorman et al., 2021; Spelke & Werner, 2018). The United States is the only developed nation where the rates of maternal mortality are rising, and they have been rising for twenty years (Simpson, 2019; Spelke & Werner, 2018). This incidence represents a maternal health crisis in the United States. On average, 700 women in the United States die each year from pregnancy-related complications. This equates to 17.2 maternal deaths for every 100,000 live births (Simpson, 2019). Currently, the maternal mortality rate for Utah is higher than the national average at 21.5 maternal deaths per 100,000 live births (Utah Department of Health and Human Services, 2023). According to More than 60% of these deaths are preventable (MacDorman et al., 2021; Simpson, 2019).The leading causes of maternal death in the United States are hemorrhage, preeclampsia, eclampsia, hypertension, embolisms, and cardiomyopathy, which often lead to cardiovascular disorders (MacDorman et al., 2021; Simpson, 2019). The Utah Health and Human Services (2023) reported that increases in heart disease, hypertension, diabetes, mental health disorders, and other chronic conditions complicate pregnancies and are contributing to maternal mortality in Utah. The American Heart Association has cautioned that pregnancy complications like preeclampsia, gestational diabetes, and preterm delivery are linked to maternal heart disease later in life (Parikh et al., 2021). Research suggests that each episode has a cumulative effect (Marill, 2021), meaning, the more pregnancies women have, and the more complications women have during pregnancy, the more elevated their risks are in general for cardiovascular disorders as they age. A qualitative survey was sent out using snowball sampling to women over the age of 18 in Utah asking about their understanding of cardiovascular risk factors and current health conditions. Findings showed that women were unaware of their potential cardiovascular risks associated with pregnancy. Raising awareness regarding these cardiovascular risks may be the number one preventative strategy, as women are the ones who bear the personal and physical risks. If pregnant women are aware of their cardiovascular risk factors, they can be empowered to raise concerns when necessary. Future interventions may include educating all women of childbearing years about cardiovascular risks prior to pregnancy, as well as more frequent screening of women during and after delivery (Marill, 2021). ReferencesMacDorman, M. F., Thoma, M., Declcerq, E., & Howell, E. A. (2021). Racial and ethnic disparities in maternal mortality in the United States using enhanced vital records, 2016‒2017. American Journal of Public Health, 111(9), 1673–1681. https://doi.org/10.2105/ajph.2021.306375Marill, M. C. (2021). Getting to the heart of America's maternal mortality crisis. Health Affairs, 40(12), 1824-1829. https://doi.org/10.1377/hlthaff.2021.01702Parikh, N. I., Gonzalez, J. M., Anderson, C. A. M., Judd, S. E., Rexrode, K. M., Hlatky, M. A., Gunderson, E. P., Stuart, J. J., & Vaidya, D. (2021, May 4). Adverse pregnancy outcomes and cardiovascular disease risk: Unique opportunities for cardiovascular disease prevention in women: A scientific statement from the American Heart Association. Circulation, 143(18), e902-e916. https://www.ahajournals.org/doi/10.1161/CIR.0000000000000961Simpson, K. (2019). Maternal mortality in the United States. MCN, The American Journal of Maternal/Child Nursing, 44 (5), 249-249. doi: 10.1097/NMC.0000000000000560.Spelke, B., & Werner, E. (2018). The fourth trimester of pregnancy: Committing to maternal health and well-being postpartum. Rhode Island Medical Journal (2013), 101(8), 30–33.Utah Department of Health and Human Services. (2023, March 16). Complete health indicator report of maternal mortality. Retrieved Sat, 09 September 2023 from the Utah Department of Health and Human Services, Indicator-Based Information System for Public Health website: http://ibis.health.utah.gov. https://ibis.health.utah.gov/ibisph-view/indicator/complete_profile/MatMort.html

Authors: Isaac Gillins, Zoe Thompson. Mentors: . Insitution: Utah Valley University. The pro-opiomelanocortin (POMC) gene is expressed in the hypothalamus and pituitary and is cleaved into several peptide hormones. One of these is melanocyte-stimulating hormone (MSH), which is involved in food intake and energy expenditure. A mutation in the POMC gene can result in a rare condition in which the subject displays early-onset obesity characterized by severe hyperphagia (i.e. excess hunger). Affected subjects may also show a lack of pubertal development. In this experiment, we will study mice with a mutation in the POMC gene. They show some of the same symptoms as humans with a POMC mutation, including hyperphagia, obesity & infertility. Specifically, we will investigate the estrous cycle in female mice to determine if they are cycling normally. The estrous cycle, similar to the menstrual cycle in humans, is characterized by changes in reproductive hormones, and can be divided into four stages: proestrus, estrus, metestrus, and diestrus. Cells lining the surface of the vagina have been previously collected using a pipette smear technique. Each stage can be characterized by the proportion of three cell types: epithelial cells, cornified cells, and leukocytes. These cells correspond to the fluctuating hormone levels during the estrous cycle. Images of these samples will be assessed for the composition of cells to determine the stage of the estrus cycle, and whether or not the cycle displays normal patterning. Because POMC-deficient mice are infertile, we hypothesize their estrous cycles may be atypical. For example, the estrous cycle of the POMC-deficient mice may appear in irregular order or with one stage being predominant over the rest. If the estrous cycle is atypical, then we will measure the hormones directly to confirm that the infertility is caused by changes in hormonal regulation. This will help us to understand more about how the POMC gene affects reproductive function.

Authors: Ishmael Elliott Molina-Zepeda, Brandt Jones, Myke Madsen, Douglas Sborov, Brian Avery, Nicola J. Camp . Mentors: Nicola J. Camp. Insitution: University of Utah. Multiple Myeloma (MM) is a malignancy of plasma cells and one of the more common hematological malignancies (6.3/100,000 new cases/year). Although treatments have improved, most patients fail their first line of treatment and ultimately do not survive beyond 5 years. Identifying patients at high risk of failing treatment early is a critical need. SPECTRA is a statistical technique developed by the Camp Lab to characterize global gene expression (the transcriptome) by representing it as multiple quantitative tumor variables. Spectra variables allow gene expression to be incorporated into predictive modeling to identify high-risk groups.Transcriptome data for myeloma cells was available from 768 patients in the international CoMMpass study where 39 spectra variables were derived. Each patient has a value for each of the 39 variables (their spectra “barcode”); patients can be compared for each bar in the barcode. Predictive modeling using spectra variables was successful in identifying risk groups for time to treatment failure, such that a patient’s tumor transcriptome can be used to predict whether they are at high risk of having their treatment fail earlier.To replicate the CoMMpass data findings, we collect and process local biological samples from MM patients at the Huntsman Cancer Institute (HCI). We collect bone marrow samples, which are then cell-sorted to identify tumor (CD138+) cells. RNA is extracted from these cells and sequenced to generate transcriptome data. Then the spectra barcode is calculated.Utilizing the SPECTRA technique provides a more complete understanding of MM by better characterizing the tumor. Each spectra is a tumor characteristic. Our future research includes an investigation of whether inherited variations (in normal DNA from saliva or whole blood) are associated with the transcriptome risk score. We are also pursuing the SPECTRA technique in several other cancers.

Authors: Sofia Denise Flowers. Mentors: Lauri Linder. Insitution: University of Utah. Background and Purpose: In the year 2023, roughly 9,000 children will be diagnosed with cancer each year in the United States. Dealing with a potentially fatal diagnosis is already difficult for many grown adults, let alone a young child. The aim of this project is to describe caregiving experiences of parents and children with cancer as related through feedback comments within written and oral feedback to proposed items to measure self-efficacy for managing their child’s symptoms and behaviors used to manage their child’s symptoms.Methods: This project involved a secondary analysis of qualitative data from 21 parents (19 mothers; mean age 38 years) of school-age children with cancer who participated in a study to establish the content validity of instruments to measure aspects of symptom management. Data consisted of interview transcripts and free responses to the content review surveys. The data were then uploaded to Dedoose. My mentor and I worked independently to identify statements pertaining to parents’ experiences in managing their child’s symptoms and responding to the child’s cancer diagnosis. We then met together to reconcile content and then organize parents’ statements into categories and subcategories. Results: 101 excerpts were extracted from the transcripts and included for the secondary analysis. Excerpts were grouped into four main categories: informational resources, social support, emotional support, and medication management Within these four main categories, subthemes of professional staff support, managing child attitude and mood changes, and balancing between being a parent and their child’s medical advocate were present. Conclusion: The insights gained from this project can guide the information healthcare providers need to provide better care to the child and additional support to parents. This can allow professional staff to get a stronger understanding of not just the family’s medical needs but their informational, social, and emotional needs as well.

Authors: Quinn Gerber, Lucas Carpenter, Jacob Clemons, Cindy Kin. Mentors: Cindy Kin. Insitution: Brigham Young University. Introduction: It is vital that patients are adequately prepared for surgical intervention. To meet this need, many medical centers have adopted prehabilitation protocols. The aim of this study was to establish an in-depth comprehension of the attitudes towards surgery and barriersand preferences to prehabilitation for patients identifying as Latino, in order to develop a preliminary framework for adapting prehab programs to best meet the needs of this specific patient population.Methods: We conducted qualitative semi-structured in-person one-on-one interviews with Latino patients who had recently undergone major abdominal surgery. The interviews, conducted at an academic medical center, were audio-recorded, transcribed verbatim, translated into English (as needed), iteratively coded, and discussed by four researchers to reach consensus. We used thematic analysis to identify shared attitudes held by patients and common barriers to the adoption of prehabilitation programs. Analysis of these attitudes and barriers, along with stated patient preferences, led to the development of several ideas that physicians can implement to increase prehab adoption among Latino patients.Results: We interviewed 16 patients, at which point we reached thematic saturation. The patients were on average 52 years old (range 20 to 79) and 50% were women. Our pooled kappa score was .92, indicating a very high degree of concordance among the coding researchers. We identified five common attitudes held by Latino patients regarding surgery: anxiety associated with hospitalizations and surgical procedures, deep trust in physicians, reliance on positivity, tight-knit families/communities, and prominent religious and cultural beliefs. A lack of understanding, physical limitations, a reactive/delayed approach to healthcare, dietary barriers, and mental barriers emerged as obstacles to prehabilitation adoption. These attitudes and barriers, along with direct patient feedback, led us to identify several programmatic priorities that may increase adherence to prehab. These components consist of face-to-face interaction, increased communication, patient and physician collaboration in program development, and family/support group engagement in surgical preparation.Conclusion: Our study provides physicians preliminary insight into customizing prehabilitation programs to best meet the needs and customs of the Latino community, including anxiety associated with hospitalizations, strong social support, and a dominant role of religious faith in coping with illness. We identified several critical components that may make prehab more culturally competent and thus more likely to be adopted by patients. These include in-person coaching, increased information about the upcoming operation and recovery, and engagement of family members. We recommend that healthcare teams committed to prehabilitation consider these needs to make their programs more attractive and accessible to their Latino patients.

Authors: Brock Sheehan, Bryson Edwards, Ivanna Soto, Justice Vance, Tyler Haywood, Jefferey Goddard, Logan Seegmiller, Mohammed A. El Saidi, Wissam R Zaidan , Asmahan El-Ezzi , Dr. Ruhul Kuddus. Mentors: Dr. Ruhul Kuddus. Insitution: Utah Valley University. Association of Cyclooxygenase 1 (COX-1) rs4648298 and Cyclooxygenase 2 (COX-2) rs20417 Polymorphisms and Prostatic diseases Among Lebanese MalesBrock J Sheehan1*, Bryson Edwards1, Ivanna Soto Medrano1, Justin Vance1, Tyler Haywood1, Jeffrey Goddard1, Logan Seegmiller1, Mohammed A. El Saidi2, Wissam R. Zaidan3, Asmahan A. El-Ezzi3, 4, Ruhul Kuddus11Department of Biology, 2Department of Strategic Management and Operations, Utah Valley University, Orem UT; 3Radioimmunoassay Laboratory, Lebanese Atomic Energy Commission, Beirut Lebanon; 4Department of Chemistry and Biochemistry, Lebanese University, Hadath, Lebanon. *- presenting author.Background: COX-1 and COX-2 genes encode prostaglandin-endoperoxide synthases (PTGS) isoenzymes, involved in inflammation and possibly neoplasms. The genes are expressed in the prostate gland. Both genes have several polymorphisms. Here we examine the association of rs4648298 (A-G transition) and rs20417 (G-C transversion) polymorphisms and prostatic diseases. This research was approved by the Utah Valley University IRB.Materials and Methods: DNA was extracted from a blood sample of 56 healthy volunteers, 51 volunteers with benign prostate hyperplasia (BPH), and 61 volunteers with clinical prostate cancer (PCa). Genotyping was conducted through PCR-RFLP analyses. The restriction enzymes used were BaeGI (for rs4648298) and AciI (rs20417), respectively. Alleles with the restriction site were considered recessive. The association was inferred through statistical analyses of the distribution of the genotypes (BB, Bb, and bb or AA, Aa and aa), and allele frequencies among the controls and the affected groups. A p-value of ≤0.05 was considered significant.Results: The distribution of the genotypes is in Hardy-Weinberg equilibrium for all three groups. The b allele of the COX-1 gene is extremely rare (less than 3%), and no significant association between the B or b allele or BB, Bb, and bb genotypes and prostatic disease was observed. The a allele of the COX-2 gene is more common in the BPH group (p=0.011), but not the PCa group (p= 0.472) or the combined affected group (p=0.068) compared to the control group.Conclusions: There is no association between the rs4648298 polymorphisms of the COX-1 gene and prostatic diseases. The a allele of the rs20417 polymorphisms of the COX-2 gene is associated with higher risks of BPH and possibly PCa. The small sample size, sampling from one ethnic group, and the low distribution of the b allele in the Lebanese population are limitations of this study.

Authors: Aljexi Olsen, Hali Lukacs. Mentors: Eddy Cadet. Insitution: Utah Valley University. Utah Lake is the third-largest freshwater body west of the Mississippi River and serves as a vital resource for just over 600,000 Utah Valley residents through agriculture, residential and recreational purposes. In addition to its utility, Utah Lake provides a haven for biodiversity for numerous species within its wetlands. Despite its utility and importance, the lake faces two significant challenges in the form of Trace Metal (TM) pollution and the encroachment of invasive plant species known as Phragmites australis (P. australis). Despite considerable investments of time, money, and resources by various state agencies to address these concerns, their success has been limited due to the agency’s isolated efforts for these large multifaceted issues. TM, though naturally occurring in the environment, has been found to be toxic to both people and the ecosystem when at elevated levels. P. australis, is a robust and fast-growing macrophyte, possessing remarkable adaptability to and tolerance for poor soils, enabling it to rapidly outcompete native species. Due to P. australis resilience and aggressive nature, many colonies have grown around the lake regardless of soil conditions. Studies have shown that P. australis has been utilized for remediation purposes around water bodies by extracting TMs from sediment. While P. australis must be addressed, can it be used as part of the solution by identifying TM polluted areas? This study aims to discern the variety in TM absorption by P. australis in both unpolluted and polluted sites in the wetlands surrounding the hyper-eutrophic Utah Lake. We selected nine sites around Utah Lake, considering their land use and proximity to pollution sources. At each site, three replicate samples encompassing P. australis, soil, and water were collected. These samples underwent a meticulous process, including washing, weighing, grounding, sieving, acid digesting using a CEM MARS 6, and analysis for TM content within an ICP-MS. Our preliminary findings reveal that in both unpolluted and polluted sites, soil concentrations of As and Cd exceeded background levels (11.73, 1.53 in unpolluted sites, and 27.47, 6.63 in polluted sites, respectively). Notably, in select polluted sites, such as UVU, P. australis displayed a remarkable capacity to hyper-accumulate As, with a transfer factor of 167.14% compared to the lowest unpolluted sites, like Lindon, which showed a rate of about 10%. Across all sites, the accumulation of Cr was relatively consistent (ranging from 17.13 to 19.7 ppm), irrespective of biomass. The examination of TM concentrations, transfer factor rates, and TM accumulation based on biomass suggests that P. australis may serve as a valuable biomarker for identifying TM-polluted sites. This research holds significant relevance, as it could offer state agencies a swift and effective means to pinpoint TM-polluted areas. Moreover, the areas where P. australis is thriving may be leveraged for phytoremediation efforts in TM-contaminated sites, providing an environmentally friendly solution to address this pressing concern.

Authors: Drew Allred, Vern Hart. Mentors: Vern Hart. Insitution: Utah Valley University. Surgery remains one of the most common and effective treatments for a variety of cancers, especially those that form solid, localized tumors such as breast and colorectal cancers. During these treatments, the palpable lesion is surgically resected with the assumption that cancerous cells have metastasized to nearby tissues. As such, surgeons will excise a tissue margin surrounding the tumor in hopes of removing any additional cancer, thus preventing further spread of the disease. However, this process is time-consuming and requires specialized expertise from a trained pathologist to verify that all cancer has been removed. Furthermore, if the pathology report indicates that not all cancerous cells have been extracted, additional follow-up visits and surgeries are typically required. In recent years a number of non-invasive technologies have been developed which seek to map cancerous cells in whole tissues. Training and validating these methods still requires a reliable ground truth, typically provided by an annotated pathology report. We propose a simpler model in which two cell species were co-cultured to provide a heterogeneous training sample. One of these species (PANC-1) was transfected with a vector coding for a fluorescent marker to represent healthy tissue, while the other species (COS-7) remained untreated, representing cancerous cells. An experiment was then conducted using a coherent diffraction imaging (CDI) system, in which laser light incident on the cells was used to quantify phase shifts produced by each cell type. Fluorescent microscopy was then used to create a map of transfected and non-transfected cells for comparison. Results will be presented demonstrating a correlation between the phase shifts produced by the two cell types and the corresponding fluorescent images, potentially facilitating optical cell identification without the need for pathology.

Authors: Hunter Morrill, Ryley Parrish. Mentors: Ryley Parrish. Insitution: Brigham Young University. Spreading depolarizations (SDs) are slow propagating waves of depolarization that move through the brain and have been associated with a wide variety of neuropathologies including the termination of seizures, the cellular correlate of aura in migraines, traumatic brain injury, and ischemic stroke. Though first characterized by Aristides Leão in the 1940s, only a very limited understanding of the mechanisms of SD induction has been achieved. SDs have been induced in mouse models using a variety of techniques, however regardless of the method of induction, high extracellular potassium and/or a strong cellular depolarization have been largely hypothesized as necessary conditions for SD induction. Interestingly, we have recently demonstrated that using a light-induced chloride pump (Halorhodopsin) to drive chloride ions into the neurons can reliably induce SDs even in the absence of high extracellular potassium levels (Parrish, 2023). It was also demonstrated that the triggering of archaerhodopsin, which removes protons from the cell and therefore hyperpolarizes the neuronal membrane without affecting chloride levels, did not induce SDs, suggesting the implication of chloride loading as a primary mechanism in SD induction. This challenges the prevalent hypothesis regarding the induction of SDs and results in a novel method of induction that allows for more characterization of the mechanisms involved. The use of genetically expressed light-gated ion channels or pumps is referred to as optogenetics. Using zebrafish, a common model for electrophysiology recordings that is also cost-effective to genetically manipulate, we have established an optogenetically induced model of SD induction. We are currently characterizing mechanisms that result in optogenetically induced SDs with pharmacology to further our understanding of SD initiation and propagation.Parrish, R. R.-G.-T. (2023). Indirect Effects of Halorhodopsin Activation: Potassium Redistribution, Nonspecific Inhibition, and Spreading Depolarization. The Journal of neuroscience: the official journal of the Society for Neuroscience, 43(5), 685-692.

Authors: Noah Bezzant, Mikayla Kimball, Ashley Allan. Mentors: Brent Feland. Insitution: Brigham Young University. BACKGROUND: General knee pain is a common complaint among both athletes and older adults. Osteoarthritis is a common etiology for knee pain that can interfere with function during aging and can be assessed by validated questionnaires. It remains unclear whether there exists a dose–response relationship between cartilage loss and pain worsening. Articular cartilage thickness of the femoral condyles can be measured by ultrasound imaging and few studies utilizing this form of measurement exist. It is currently unknown if articular cartilage thickness measured ultrasonographically correlates with pain related ratings in aging athletes. PURPOSE: The aim of this study was to assess whether articular cartilage thickness at the femoral condyles as measured by ultrasound imaging has any relationship to knee pain as rated by the modified KOOS (Knee Injury and Osteoarthritis Outcome Score) survey in senior athletes over the age of 50.METHODS: Data was collected from 35 volunteers (participants in the Huntsman World Senior Games) in St. George, Utah, 2023. All subjects (22 females: mean age = 64.9 ± 6.6 yrs, Ht = 158.7 ± 35.6 cm, Wt= 66.3 ± 10.0 kg; 13 males: mean age = 67.3 ± 8.3 yrs, Ht = 179.3 ± 10.7 cm, Wt= 84.3 ± 13.4 kg) signed an approved consent and completed a modified KOOS survey before being seated on a table, with their back flattened against the wall directly behind them. They were then asked to bring either knee as deeply into flexion against their torso as possible; approximating 120°-140° of knee flexion, depending on the range of motion the subject was capable of. In flexion, the patella was shifted inferiorly enough to expose the femoral condyles so that a short axis image of the articular cartilage was obtained and the thickness of the cartilage was assessed at 3 points.ANALYSIS: All data were analyzed using JMP ver16.2 with a Pearson product pairwise correlations to determine if a relationship between average cartilage thickness correlates with pain subscale scoring from the KOOS in males and females. Correlation between age and thickness was also examined.RESULTS AND CONCLUSION: There were no significant correlations between the pain subscale score and cartilage thickness in males (p=.6998, r=0.1316), females (p=.8733, r=0.0392), or combined (p=.7308, r=0.0655) in this group of senior athletes. Age and thickness was not significantly correlated (p=.1232, r= -0.2877), but did show a trend of decreasing cartilage thickness with age. The addition of more subjects should show age and thickness to be negatively correlated with each other.

Authors: Brett Pickett, Lincoln Sutherland, Jacob Lang. Mentors: Brett Pickett. Insitution: Brigham Young University. Introduction: Breast cancer is one of the most prevalent types of cancer present in society today, and is the second leading cause of cancer death for women. Approximately 13% (1 in 8) of women will develop invasive breast cancer, with 3% of women (1 in 39) dying from this type of cancer. Three important classifications used when formulating a treatment plan for breast cancer are the presence or absence of Estrogen Receptor (ER), Progesterone Receptor (PR), or Hormone Receptor (HR). Treating Estrogen Receptor Positive (ER+) breast cancer with aromatase inhibitors, such as Letrozole, is the current standard treatment for all postmenopausal women. A prior study by Lee et. al. identified PRR11 as the only gene that was significantly overexpressed in resistant vs non-resistant cancers among the 51 genes in chromosome arm 17q23. The goal of the current study is to perform a secondary analysis of this valuable dataset to identify genes, signaling pathways, and biomarkers across the whole human transcriptome that are significantly associated with treatment resistance in ER+ patients.Methods: We retrieved, preprocessed and analyzed 58 ER+ breast cancer samples from patients who had been treated with Letrozole, which are publicly available in the NCBI Gene Expression Omnibus (GEO) database. The Automated Reproducible MOdular Workflow for Preprocessing and Differential Analysis of RNA-seq Data (ARMOR) was used to process our data downloaded from NCBI. This workflow trimmed low quality reads from the RNA-sequence reads, mapped and quantified our data to generate a DEG list. Gene ontology enrichment with camera was also performed. Next, the genes were mapped to common gene identifiers and input to the signaling pathway impact analysis (SPIA) algorithm to identify intracellular signaling pathways that were enhanced by our DEGs. With that information, Pathway2Target was used to identify known drug targets within our identified pathways. Finally, a decision tree-based machine learning approach was used to predict features/expressed genes that could be used to most accurately classify responders vs nonresponders to Letrozole. Results: Our comparison of 36 responders versus 22 non-responders detected a total of 18,735 genes and identified 105 that were statistically significant (p-value < 0.05) after applying a false-discovery rate (FDR) correction, including SOX11, S100A8/S100A8, and IGLV3-25. We then used the Signaling Pathway Impact Analysis (SPIA) algorithm to determine whether any known intracellular signaling pathways were significantly enriched in DEGs (Bonferroni-adjusted p-value < 0.05). This analysis identified 4 pathways that were statistically significant in Non-Responders to Letrozole Treatment. We then used the pathway results to predict 60 existing therapeutic targets that could be repurposed to treat the resistance phenotype. Notably, the predicted targets for the non-response phenotype included VEGFA, a current target for solid tumors as well as ESR1, an Estrogen Receptor. We next wanted to determine whether we could predict transcriptional biomarkers that could aid with identifying patients that do not respond to treatment. To do so, we used the read counts for all samples as the input for this analysis and identified 278 transcriptional biomarkers. Performance metrics for all biomarkers identified yielded an area under the receiver-operator characteristic (AUROC) curve of 0.972 (Figure 2), indicating an exceptional ability to classify Letrozole responders vs non-responders by the transcriptional profile. Sensitivity for all transcriptional biomarkers was measured at 100%, and specificity at 94%. We used the top two biomarkers from our first analysis as input for a second analysis to determine the performance of a smaller subset. Our second analysis determined that PRDX4 and E2F8 together yielded an AUROC of 0.823 and an overall accuracy of 88.2%. Discussion:Our results identify additional DEGs, pathways, targets and biomarkers for further exploration in the treatment and categorization of ER+ breast cancer.

Authors: Eden Beazer, Aubree Bench, Ethan Jones, Jared Carter. Mentors: Jeffrey Tessem. Insitution: Brigham Young University. Incidence of diabetes worldwide has grown from 108 million people in 1980 to 422 million people in 2014, nearly tripling in just thirty-four years. Type 2 diabetes (T2D) is characterized by the loss of pancreatic beta cell mass and the failure of the remaining beta cells to provide adequate insulin. Contributing to the development of T2D is glucolipotoxicity (GLT), a condition characterized by the harmful elevation of glucose and fatty acid levels within beta cells. While there are existing treatments for symptoms of diabetes, much remains to be understood about its underlying causes and effective preventative measures. Flavonoids are naturally occurring phenolic compounds found in many fruits and vegetables that have various anti-inflammatory health benefits. Previous studies suggest that epicatechin, a flavonoid present in cocoa, can reduce the effects of diabetes by diminishing insulin desensitization and increasing glucose stimulated insulin secretion (GSIS). Interestingly, the bioavailability of epicatechin is poor, while its metabolites are more easily absorbed in the small intestine. Further studies demonstrated that under non-stressed conditions in beta-cells, hippuric acid, homovanillic acid, and 5-phenylvaleric acid, metabolites of epicatechin, stimulate insulin secretion at concentrations more realistically found in the body. However, the effects of these metabolites in glucolipotoxic conditions are unknown. Here, we present the effects of epicatechin and its metabolites hippuric acid, homovanillic acid, and 5-phenylvaleric acid on beta cell insulin secretion and mitochondrial respiration under GLT culture conditions. This study aimed to contribute to the limited body of knowledge on the bioactivity of flavonoid metabolites on beta cell function under damaging conditions observed with T2D, offering crucial insights for developing effective strategies to harness the health benefits associated with flavonoids.

Authors: Isaac Stubbs, Skyler Russell, Melissa Blotter, Maxwell Holmes. Mentors: Ryley Parrish. Insitution: Brigham Young University. Status Epilepticus (SE) is a severe medical condition marked by continuous seizures lasting over 5 minutes. When SE becomes resistant to anticonvulsant drugs, the condition is known as Refractory Status Epilepticus (RSE), which lacks effective treatments and has a mortality rate of 38%. RSE lacks effective treatments partially due to our limited understanding of the mechanisms that lead to patient drug resistance to commonly used anticonvulsants. This study aims to address this knowledge gap in two pivotal ways.First, we have employed a high-density multi-electrode array (HD-MEA) with acute mouse brain slices to better understand RSE propagation patterns and various seizure states with unparalleled spatial precision. The HD-MEA allows us to record from the entire brain slice with 4096 electrodes sampling electrophysiological activity at every 60 micrometers for many hours at a time. Our data demonstrates that different seizure states, such as phasic seizure-like events, short duration epileptic discharges, or RSE itself, occur within both the same brain region and in different brain regions simultaneously. With our novel data visualization software, we can visualize the unique propagation of this phenomenon. These findings indicate that RSE might be a progressive event, challenging conventional understanding of RSE. Second, we are currently exploring a potential pharmacoresistance mechanism that may contribute to the patient entering RSE, which suggests that changes in the chloride reversal potential may lead to a phenomenon known as depolarizing GABA. Depolarizing GABA may negate the effectiveness of the currently used antiepileptic drugs that rely on standard physiological chloride conductance to effectively limit seizure activity. We are studying this drug resistant mechanism with the HD-MEA by introducing anticonvulsant drugs to acute mouse brain slices during the evolution of RSE to locate a critical point at which the slice becomes resistant to these compounds.We hope this study will illuminate the complexities of RSE by revealing its progressive nature and drug resistant properties.

Authors: Mikayla Kimball, Noah Bezzant, Ashley Allan, Josh Sponbeck. Mentors: Brent Feland. Insitution: Brigham Young University. Ultrasonic analysis of patellar tendon thickness in active older athletesBACKGROUND: Recent research has suggested that patellar tendon loading through exercise and resistance training can help maintain and increase patellar tendon thickness in older adults. Limited research exists that identifies the average thickness of patellar tendons in younger athletes, however, it is unknown if this thickness remains or is maintained in older adult athletes who have maintained a very active lifestyle.PURPOSE: This study aimed to determine how gender correlates to patellar tendon thickness in the proximal and middle patellar tendon of active older athletes participating in sporting events at the Huntsman World Senior Games.METHODS: Data was collected from 59 volunteers (participants in the Huntsman WorldSenior Games) in St. George, Utah, 2022. All subjects (34 females: mean age = 61.09 ± 7.00 yrs, Ht = 162.41 ± 25.73 cm, Wt= 66.29 ±11.38 kg; 25 males: mean age = 68.68 ± 7.03 yrs, Ht = 178.21 ± 8.63 cm, Wt= 84.42±10.90 kg) signed an approved consent form and then sat on a treatment table with their legs relaxed and dangling off. The probe was placed vertically below the kneecap and an ultrasonic image was taken. Each image showed a small section of the patellar for reference. Each ultrasonic measurement showed the middle and proximal thickness of the patellar tendon. ANALYSIS: All data were analyzed using JMP ver16.2 with a stepwise multiple regression analysis to determine the effect of age, height, wt and gender on patellar tendon thickness. A sex*location mixed model was used to determine differences in middle and proximal thickness between gender. Data were normally distributed, not requiring transformation.RESULTS & CONCLUSIONS: Proximal tendon measurements were thicker than middle tendon measurements on both sides (p=0.0001). There was no significant difference either proximal tendon thickness (p=0.9323) or middle tendon thickness (p= 0.3993) between left and right sides. No significant difference between male and female tendon thickness at either location (p=0.7700). Proximal tendon thickness was greater and this has been found to be greater in younger athletes with a history of patellar tendinopathy. Aging athletes may also have a history of knee pain episodes that could have contributed to this finding. The lack of gender differences in thickness measures was surprising, but may be a result of the level of activity of senior athletes. In the future studies should look to compare active vs non-active aging athletes, more specific age range differences, and how knee replacements and other injuries affect patellar tendon thickness.

Authors: Caroline Cowley, Megan Jewell, Brenda Mendoza, Aubrey Cluff, Ryan Summerhays, Jason Hansen. Mentors: Jason Hansen. Insitution: Brigham Young University. Approximately 8 million newborns manifest a birth defect every year worldwide. One of the most common birth defects involve disruptions in musculoskeletal development. Oxidative stress has been found to propagate teratogenesis. Thioredoxin-1 (Trx1), an oxidoreductase, is an important antioxidant regulator required for proper embryonic development. Trx1 knockouts have been found to be embryolethal prior to implantation. A preliminary study to assess osteogenesis was conducted using mouse embryonic fibroblasts (MEFs) originating from transgenic conditional Trx1 knockout embryos. Upon confluence, MEFs were stimulated to undergo osteogenesis via commercially available media. A subset of cells were treated with doxycycline (DOX) prior to and throughout the culture period. MEFs were maintained over a 21 day period in a reduced oxygen environment. MEFs were then fixed in formalin and stained with Alizarin red to determine the degree of osteogenesis. MEFs treated with DOX were unable to undergo proper osteogenesis. While this would suggest that osteogenesis is regulated through proper functions of Trx1, it is unknown how Trx1 regulates osteogenesis in utero. Because Trx1 deletion is lethal prior to implantation it has been historically difficult to study the role of Trx1 during organogenesis. With the development of the DOX-inducible Trx1 conditional knockout mouse, we can now target specific developmental periods and evaluate post-implantation processes like osteogenesis. Using proper transgenic mice and breeding schemes, DOX-inducible Trx1 conditional knockout embryos were treated in utero with DOX through the dam’s drinking water, starting on gestational day (GD) 8.5. The embryos were collected on GD 16.5, fixed in 95% ethanol, and then skinned. To visualize bone and cartilage, the embryos were placed in ethanol and subsequently stained with Alizarin red and Alcian blue. The staining showed that embryos lacking Trx1 were significantly stunted in their skeletal maturation. With this data, we are the first to show that during organogenesis, the musculoskeletal system is affected by deletions of Trx1 at specific periods of development. Under oxidizing conditions which exceed the capacity of the oxidoreductase pathway of Trx1, Trx1 exists primarily in its oxidized form and can no longer reduce proteins that have been turned off by oxidation. Our Trx1 deletions model a highly oxidized state in which Trx1 is dysfunctional. Because regulatory redox control of protein activity is required for proper embryonic development, exposure to oxidizing environmental conditions specifically affecting Trx1 redox state may target the disruption of the musculoskeletal system.

Authors: Zach Fiore. Mentors: Jared Nielsen. Insitution: Brigham Young University. Gait apraxia is a type of apraxia that affects lower limb use in walking. It is characterized by difficulty initiating gait, freezing of gait, and other gait disturbances that cannot be attributed to complications affecting sensory, motor, or cerebellar function, psychiatric disease, nor ataxia. Symptoms often present following brain trauma. Previous research has indicated that gait apraxia may be linked to lesions in the frontal lobes, basal ganglia and supplementary motor area. However, the specific cerebral location has been debated with minimal research done on the symptom’s implicated neural circuits. The purpose of this study is to determine the networks in the brain that are involved in the pathophysiology of gait apraxia. To determine this, we used the lesion network mapping method. A systematic literature review was performed, with specific inclusion criteria, to find case studies of patients presenting with gait apraxia stemming from acquired brain injury (n=15). Lesion network mapping analysis (Fox et al., 2018) was performed on 15 cases with a large cohort of healthy control resting-state scans (n=1000). The analysis showed that lesions exhibited functional connectivity to the bilateral medial dorsal and pulvinar nuclei of the thalami (n=15), which supports previous associations of basal ganglia damage contributing to gait apraxia. A novel region, the cingulate cortex (n=15), was also found to be functionally connected to the lesion networks. This region is a part of the cingulo-opercular network, responsible for many functions, including action. This network has recently been found to display strong functional connectivity with the somato-cognitive action network, responsible for coordinating movements with cognitive processes. Further research is necessary to determine the mechanism of how these networks interact in contributing to gait apraxia.

Authors: Jordan Penfold, Cera Gowans, David T Fullwood, Anton E Bowden. Mentors: David T Fullwood. Insitution: Brigham Young University. Wearable nano-composite strain sensors created at Brigham Young University are used for biomechanical studies of human motion, due to their ability to follow and sense skin deformation. The manufacturing process for these sensors involves combining the raw materials that make up the sensors – silicone, nickel nanoparticles and nickel-coated chopped carbon fibers – in a planetary mixer, followed by extrusion of the uncured slurry through a syringe with a specialized tip. After extrusion, the sensor material strips are cut to length and subsequently casted and cured. However, undesirable variability in the final piezoresistive properties of the sensors was discovered. This variability was hypothesized to be attributable to sensor positioning during extrusion process. For example, fiber alignment may change as the extrusion process develops, or internal voids may be more evident in sensors cut from different parts of the extruded slurry. To test this hypothesis, several batches of sensors were created with precise records of each sensor position after extrusion. Some sensors were also set aside for CT scans to analyze their void content and nickel concentrations. The results suggested that the sensors located on the initial and terminal ends of the extruded slurry strips had statistically significant differences in piezoresistive properties when compared to the sensors from the central portion of the material strips. Sensors cut from the ends of extruded strips were more likely to have a lower standard deviation of average resistances while strained and relaxed, and were more likely to pass quality control inspection. As a result of this research, we learned that sensors with more consistent physical properties could be obtained by intentionally shortening the strips of slurry produced during the extrusion process (e.g., creating sensor batches with exclusively “end” sensors). After applying this change in methodology, sensor batches usually had more consistent physical properties when compared to sensors made with previous methods.

Authors: Alberto Miranda, Samannoy Ghosh, Yong Lin Kong. Mentors: Yong Lin Kong. Insitution: University of Utah. Microscale robots can impart a broad range of functionalities in the biomedical domain that can be leveraged to address unmet clinical needs, including noninvasive surgery and targeted therapies. Conventional robot navigation methods typically involve specific gaits suited for certain environmental conditions. However, implementing the same conventional methods inside a human body is highly challenging. As the human body is a complex and dynamic environment, a microrobot must adapt to these complex and challenging environments to perform targeted studies. Previous research demonstrated an integration of an untethered, 3D-printed three-linked-sphere crawler with a model-free reinforcement algorithm. The work done with the theoretical Najafi–Golestanian three-linked-sphere mechanism was its first experimental integration with a reinforcement learning algorithm as a relatively simple and highly scalable self-learning robot that can navigate in unconfined and confined spaces. The progress presented in the current research is a direct continuation of the previous work on the 3-linked-sphere crawler. While the previous work focused on developing a proof of concept for adaptive gait learning for the crawler, the current work focuses more on the challenges of implementing the robot in a low Reynolds number fluid medium. Our current research hypothesizes that a self-learning autonomous system could demonstrate successful gait adaptation in a low Reynold’s flow environment. The design of our robot has been significantly improved to make it sustainable for extended use under viscous fluids. The research presented outlines the work that has been done to transition the robot from a crawler into a swimmer, the challenges that have been faced, and how they have been addressed. Successful implementation of this 3-sphere-swimmer will be a step forward in integrating machine learning tools into microswimmers for autonomous gait adaptation inside the human body.

Authors: Josh D Gubler, Connor D Olsen, Fredi R Mino, Mingchuan Cheng, Jacob A George. Mentors: Connor Olsen. Insitution: University of Utah. The long-term goal of this research is to investigate how lower sampling rates of electromyographic (EMG) signals affect the performance of classification and regression algorithms. EMG signals measure the electrical activity of muscle contractions. Myoelectric interfaces can classify or regress features generated from the EMG signal to control devices like prostheses, exoskeletons, robotic systems, or human-computer interfaces. Most of the power of the EMG signal is contained between 50 and 500 Hz, and most recording devices sample EMG at 1 kHz with a 5-15 Hz high-pass filter and a 375-500 Hz low-pass filter. As myoelectric devices become wireless and integrated with wearable technology, reducing the sampling rate can substantially reduce battery consumption and processing power. We sampled EMG data at 30 kHz from the forearms of three participants while they performed six gestures. We then downsampled to rates ranging between 50-1000 Hz and calculated various EMG features from the downsampled data. We found significant effects for both EMG feature and sampling rate on regression performance of a modified Kalman Filter (p < 0.05, two-way ANOVA). The mean-absolute-value and waveform-length EMG features performed significantly better at low frequencies (<250 Hz) in contrast to zero-crossing, slope-sign-change, and mean-frequency EMG features (p < .05, multiple pairwise comparisons). Sampling rate also had a significant impact on the classification accuracy of a k-nearest neighbors algorithm (p < 0.05, two-way ANOVA). However, sampling rate had no impact on classification accuracy for a continuous Convolutional Neural Network (CNN) (p > 0.05, two-way ANOVA). Future work will validate the effectiveness of this CNN as a control modality when using downsampled EMG from wearable sensors. If proficient control can be achieved from down sampled EMG, this could substantially improve battery life and make EMG a more practical biosensor for wearable devices.

Authors: Davis Wing. Mentors: Matt Allen. Insitution: Brigham Young University. When thin structures vibrate under large forces, can exhibit geometric nonlinearity, which makes it very hard to compute their motion and the stresses they undergo. This work builds on prior efforts, which used a small number of computations derived from detailed models, together with machine learning techniques, to train a reduced order model (ROM). This ROM could then be simulated efficiently to estimate the dynamic, nonlinear response of the structure in a fraction of the time it takes to compute the full-order model.This reduced order modeling technique is called Gaussian Process ROM or GPR ROM, and was developed by Park et al. [MSSP, vol. 184, p. 109720, 2023]. The GPR-ROM approach works by applying a number of static loads to the detailed model of the thin structure, and then by integrating those loads over time, it produces an understanding of the dynamics. In addition to its speed, this approach also provides confidence bounds on its findings, meaning that researchers can gauge a number of plausible values for the nonlinear responses of the system being measured.This research further develops this approach to computing the dynamics of structures by applying the GRP-ROM to a more complicated structure than previously studied, namely, a gong. The gong as a test structure is significant, as the signature sound of a gong is produced through geometric nonlinearities. In order to capture the behavior of the gong, and thereby its sound, several modes need to be studied simultaneously, and thus more degrees of freedom are required to capture its behavior in a ROM. This work evaluates the GPR-ROM process for the gong by computing various ROMs for different load states, thereby capturing the geometric variability of the gong’s responses. Then, the non-linear normal modes (NNMs) of the system are calculated within 95% confidence, which allows for a reasonable understanding of the dynamics of the system. These will be compared to the NNMs computed, at great expense, from the full-order model to validate the method.

Authors: Rui Jin, Lindsay C Rupp, Anna Busatto, Rob S MacLeod. Mentors: Rob S. MacLeod. Insitution: University of Utah. Introduction: The electrocardiogram is the most common tool to diagnose and assess cardiac conditions, such as rhythm abnormalities, myocardial ischemia, and heart failure. However, clinical diagnosis and management of heart disease are challenging due to the remote nature of body-surface electrocardiogram measurements, with a median accuracy of 67% among physicians. One approach to improve the accuracy of electrocardiography is to conduct mapping studies in which 10-100 catheter-based electrodes are inserted within the heart. The recorded signals provide more proximity and thus accuracy, but they also require specialized software to analyze, quantify, and visualize. We developed the Signal Processor for Electrogram and Electroanatomic Data (SPEED), a new, open-source, unified pipeline to facilitate effective signal processing and visualization of such cardiac-mapping signals.Materials and Methods: Our pipeline is based on two existing toolboxes, the Preprocessing Framework for Electrograms Intermittently Fiducialized from Experimental Recordings (PFEIFER) and OpenEP. PFEIFER is a toolset for sophisticated signal-processing of cardiac electrograms that allows the user to select semi-automatically fiducial markers, which are time points and intervals of interest within a heartbeat. OpenEP primarily accepts as input complete electroanatomic data, including both processed cardiac electrograms and spatial geometry; OpenEP also provides built-in functions for analyzing and visualizing cardiac electrograms, such as displaying potentials on the cardiac geometry. Since both software packages provide complementary workflows for managing electrograms, our goal was to integrate the two software packages and present it to the user as a new Graphic User Interface utilizing both applications simultaneously.Results: It was natural to develop SPEED in MATLAB as this is also the language used for both PFEIFER and OpenEP. The primary interface to SPEED incorporates a data-centric design such that the user can provide the electrogram and geometry files to be processed, and the algorithm automatically determines the applicable functions based on the input type. Since both PFEIFER and OpenEP can parse data into more interpretable open-source formats, the user can also export the processed data for further analysis in addition to visualizing and quantifying the data features. Through integrating both software packages, SPEED can support the following main functionalities: (1) in-depth filtering and processing of electrogram signals, (2) visualizing anatomic geometry and electrode locations, and (3) mapping three-dimensional potential and activation of cardiac electrophysiology.Discussion: SPEED offers the user a more thorough and unified workflow in the analysis of cardiac-mapping signals than either of its components. The user can utilize the functionalities of both PFEIFER and OpenEP simultaneously, allowing for a versatile and powerful processing pipeline. For instance, the user can extract key features from the recorded electrograms and visualize the location of the corresponding electrodes, a feature that was previously not possible. In addition, the open-source nature of the software packages allows the user to modify or expand the functions to better suit their individual needs. The software design of SPEED is still in the early stages; thus, as with most software, further development and user testing will follow to make the algorithms compatible with more data types and implement additional features. Conclusion: SPEED processes and displays the complex information in a clear and accessible way, allowing the user to perform subsequent interpretations and analyses more easily. SPEED can be used by research cardiologists to facilitate a more efficient workflow, as well as to improve the efficiency and accuracy of clinical diagnosis of heart diseases.