Uninfected human blood free of anti-malarial medications is essential for the laboratory culture of Plasmodium falciparum, the causative agent of severe malaria, but is of limited availability in sub-Saharan Africa where research is conducted by the Macha Research Trust.  Cryopreservation of erythrocytes obtained from uninfected donors in the US would provide an adequate supply.  Our goal has been to identify methods of freezing that will preserve the capacity of RBCs to support asexual propagation and gametocyte formation by P. falciparum strain NF54 in serial asynchronous culture, as well as the shelf life of RBCs stored at -80ºC.  We have investigated RBCs cryopreserved using two types of freezing solutions: 1) a mixture of hydroxy ethyl starch (HES) and polyvinyl alcohol (PVA); 2) glycerol supplemented with human serum.  Our results reveal that blood frozen with hydroxy ethyl starch and polyvinyl alcohol failed to support asexual propagation of P. falciparum beyond three serial passages. Blood frozen using the glycerol & serum solution was able to support asexual propagation through at least nine serial passages, and later passages were capable of gametocyte generation.  NF54 parasites maintained in serial culture using glycerol/serum-frozen remained unable to proliferate when serially passaged using HES/PVA-frozen blood, confirming the absence of mutations that may have adapted the parasite to long-term culture in frozen blood.  These results will be discussed with respect to essential functions of the apicoplast, a parasite organelle required for erythrocyte invasion.

Pancreatic cancer has a 5-year survival rate of 8%, and the average prognosis has not improved in recent history. Chemotherapy is the primary clinical approach but carries poor efficacy and offers little improvement in patient survival due to the highly fibrotic collagen-rich tumor microenvironment. Our lab has previously confirmed that the gastrin receptor antagonist, proglumide, significantly decreases pancreatic tumor fibrosis in vivo.  In vitro efforts to elucidate the cellular target of proglumide have been unable to demonstrate a decrease in the mRNA expression of collagen (COL1A) or its post-translational processing enzymes, in either myofibroblast-like pancreatic stellate cells or cancer cells.  We hypothesize that quantification of deposited collagen matrix in vitro will better reflect the decreased fibrosis apparent in vivo. Utilizing the Sirius Red/Fast Green protein staining assay, collagen deposition was measured in cultured cells.  To normalize collagen to potentially disparate cell proliferation rates, we confirmed that the alamarBlue cell quantification assay does not interfere with subsequent Sirius Red/Fast Green protein staining.  Human pancreatic stellate cells (RLT-PSC), mouse pancreatic cancer cells (Panc02), and human pancreatic cancer cells (PANC-1) were stained 4 days after seeding.  Significantly higher collagen was evident in Panc02 and PANC-1 wells compared to stellate cells (p<0.05).  To test the impact of proglumide treatment, cells were treated with proglumide (200 μg/ml).  Lines showed no change in normalized collagen deposition after 4 days compared to untreated controls.  These preliminary data reflect the unchanged COL1A mRNA levels previously apparent in the stellate and cancer monocultures.  Further inhibition studies will utilize co-cultures to address potential heterotypic intercellular communication between these cell types, characteristic of the tumor microenvironment.

While heavy metals such as zinc and nickel are necessary for several life-sustaining processes, elevated levels of these metals pose a threat to humans, plants, and other forms of life. Researchers have found that certain plants known as hyperaccumulators tolerate higher levels of heavy metals than non-hyperaccumulating plants. They can be planted in heavy metal contaminated soil to take up excess heavy metals, thus decontaminating the soil in a process known as phytoremediation. In this research project, we will examine the altered heavy metal stress response of two Columbia-line Arabidopsis thaliana mutants that we hypothesize are hyperaccumulators of heavy metal divalent cations. This hypothesis will be tested using nickel tolerance and accumulation assays. The tolerance assays will compare the root length, a key indicator of plant health, of the two mutant A. thaliana plants against the Columbia-line wildtype plant in varying concentrations of nickel. The accumulation assay will be used to quantify the concentration of heavy metals present in the plant tissue. These analyses will allow us to determine the impact of the mutations on the nickel heavy metal stress response of the plant.

The cryopreservation of fresh, uninfected human red blood cells (RBCs) is fundamental in culturing Plasmodium falciparum, to create better preventive measures in combatting malaria. We hypothesize that human blood cryopreserved with hydroxyethyl starch and polyvinyl alcohol (HES/PVA) or glycerol and serum will support asexual parasite growth and gametocyte formation in culture following prolonged freezing at -80°C of A+ or O+ blood. These freezing techniques utilized multiple conditions to evaluate each of the ability for the culture to propagate sexually and asexually with the NF54 parasite strain. The conditions tested through serial propagation: fresh, never frozen blood, which acted as the control; short-term cryopreserved blood, which was stored at -80ºC for less than two weeks; and long-term frozen blood, which was stored at -80ºC from six months to one year. This shelf-life study found that HES/PVA cryopreservation technique supported the asexual propagation of P. falciparum through only two serial passages; parasites could not be rescued by subsequent addition of non-frozen blood. Blood frozen using the glycerol & serum solution was able to support NF54 propagation beyond a ninth dilution and re-plating (passage). Blood cryopreserved by either method supported the generation of mature gametocytes in the first passage.  Additionally, our results suggest that the NF54 strain did not accumulate mutations that abnormally enhanced or sustained growth on cyropreserved blood.

Vaccines are an integral part of modern-day disease prevention. Healthcare professionals should be aware of the basic immunological foundations of how vaccines work. Students in past offerings of Messiah University's Microbiology course were able to carry out an exercise in which commercially obtained polyclonal neutralizing antisera (samples from simulated patients) were compared for ability to inhibit infection of E. coli B cells by bacteriophage T4.  Unfortunately, the antiserum is no longer available for purchase.  Therefore, we seek to produce similar antibodies using monoclonal technologies.  Hybridoma clones capable of generating T4 neutralizing monoclonal antibodies will be produced from T4-immunized Balb/c mice. T4 virus stocks of known titer with reduced concentrations of endotoxin must be produced to vaccinate the mice.  Our approach has been to reduce endotoxin concentrations in commercially obtained T4 phage stocks by mild organic extraction, followed by dialysis and concentration using Centricon centrifugal filtration units.  titers of the concentrated stocks were determined by infection of E. coli B cells.  The endotoxin levels in the virus concentrates were measured to confirm reduction relative to viral titer.

That pancreatic cancer is unusually aggressive and deadly has prompted extensive research into its mechanisms and options for therapy. Our research seeks to develop a vaccine that will activate the tumor-bearing host immune system against a novel protein expressed by aggressive pancreatic tumors. Our approach is to engineer immortalized syngeneic cells to express a derivative of the Simian virus 40 Large Tumor antigen protein (SV40 T ag) that contains a 20 amino acid insertion corresponding to a unique sequence found in the CCK2i4svR pancreatic-cancer associated growth factor receptor. These cells will be used as a vaccine to cause the host to develop cellular or humoral immune responses against the cancer-associated CCK2i4svR epitope. Immortalized cell lines were produced by transfection of C57Bl/6 primary kidney cells with four plasmids, each encoding a different derivative of the SV40 T antigen with respect to presence and insertion site of the CCK2i4svR 20 codon sequence.  Transfected cultures were monitored for growth of dense foci which result from immortalization as a result of expression of the SV40 T ag. Foci were harvested, expanded and evaluated by indirect immunofluorescence using two SV40 T ag-specific monoclonal antibodies to confirm that they had been successfully transformed and expressed the SV40 T antigen protein derivative. SV40 T ag-positive lines were cryopreserved for characterization in subsequent immunization and tumor immunotherapy studies.

The myelin sheath is a protective insulating layer that covers neurons in the nervous system. Myelin supports the generation of rapid electrical signals to ensure efficient communication between neurons. Within the central nervous system, myelin is produced by specialized cells called oligodendrocytes. Unfortunately, in neurodegenerative diseases such as multiple sclerosis, the myelin sheath undergoes damage which leads to neuron degradation and disruption in neuron communication. In order to prevent and treat neurodegenerative diseases, current research seeks to further understand the mechanism underlying myelination and identify treatments that could promote remyelination of neurons. One pathway known to be involved in regulating myelination in oligodendrocytes is the muscarinic acetylcholine signaling pathway. Research suggests inhibiting specific receptors in this pathway promotes the generation of new myelin in humans. Our lab sought to further investigate the impact of several antagonists on oligodendrocyte precursor cells (OPCs) differentiation and remyelination. OPCs were isolated from neonatal rat brains, cultured, and treated with specific antagonists. Gene expression analysis was performed in order to assess oligodendrocyte maturation.

Oligodendrocytes are the myelinating cells of the central nervous system, and these cells and their myelin sheaths are the autoimmune targets in multiple sclerosis (MS). Increasing the differentiation of OPCs to myelinating OLs is a promising method for treating MS. Recent clinical trials have revealed a positive effect of clemastine, an antihistamine/muscarinic antagonist, in stimulating myelin repair in patients with MS. This study is investigating the combinatorial effects of muscarinic receptor antagonists darifenacin (M1) and pirenzepine (M3) on the rate of oligodendrocyte (OL) maturation.  Cultured oligodendrocyte progenitors were used to assess receptor subtype effects on myelin-specific gene expression and the rate of OL maturation during treatment for 4 days.  Combination treatments were also studied in the larval zebrafish model.  RNA was isolated and analyzed for changes in expression of myelin-specific genes MPZ and MAG. Several dosages of combinatorial treatment and time points were tested, but no significant changes in larval zebrafish gene expression were identified.  However, muscarinic agonist, cevimeline, was shown to reduce the expression of myelin-specific genes MPZ and MAG, which supports the hypothesis of the involvement of the muscarinic pathway in myelination. Muscarinic antagonists do not appear to enhance the vigorous myelination program of zebrafish larvae.

Post-Traumatic Stress Disorder (PTSD) can develop after experiencing an intensely distressing event. The condition exhibits as a maladaptation of the fear response, causing frequent activation of the sympathetic nervous system (fight and flight behavior) in response to benign stimuli. Persistent sympathetic activity results in chronic stress and precipitates other physical and psychological conditions—severely impacting the individual’s quality of life. Current treatments yield low recovery rates and poor prognosis, particularly when initiated long after the original trauma. New research explores opioids as a prospective preventative medication, as morphine seems to diminish PTSD acquisition if received during the critical period of memory consolidation. However, PTSD is often comorbid with increased rates of substance abuse, including opioid addiction.  Our research examined if PTSD treatment with morphine increases drug seeking behavior using a rodent model. Rats underwent Stress-Enhanced Fear Learning (SEFL) to induce PTSD like symptoms. After SEFL was completed, the rats were given two injections of morphine in a unique “Context A” and two injections of saline in “Context B”.  The rats were then allowed to pass between the chambers, and the relative amounts of time spent in either Context A or Context B was measured to determine if the rodents exhibited a Conditioned Place Preference (CPP). If SEFL subjected rats exhibit CPP for Context A, this indicates a correlation between receiving morphine treatment for PTSD and increased drug seeking behavior.

Malaria is caused by multiple species of the parasite Plasmodium and disproportionately affects people living in the developing world where effective control of or protection from the parasite is lacking. This study seeks to support ongoing research at the Macha Research Trust (MRT) which is located in the Southern Province of Zambia where the virulent species, Plasmodia falciparum is prevalent.  Our goal is to support the capacity of the laboratory at MRT to culture (propagate and preserve) locally-isolated or laboratory strains of Plasmodium.  Laboratory cultivation of P. falciparum requires fresh human blood.  However, it is difficult to assure the steady supply of fresh, uninfected human blood needed to sustain culture experiments at MRT because blood from local residents cannot be used, and because many visiting scientists and physicians routinely take prophylactic anti-malarial drugs which can make their erythrocytes unable to support asexual propagation of or gametocyte generation by P. falciparum in culture.  We are investigating methods that should allow for the cryopreservation of erythrocytes obtained in the US from uninfected individuals, with subsequent shipment to Zambia.  We have cryopreserved preparations of fresh, leukocyte-depleted erythrocyte suspensions using minimal aqueous volumes of solutions containing the hydroxyethyl starch (HES) and polyvinyl alcohol (PVA), or with glycerol-based solutions. This presentation will describe ongoing efforts to determine if cryopreserved RBCs can effectively support asexual propagation or gametocyte formation for the P. falciparum laboratory strain NF54, and how well this capacity is maintained following long-term storage at -80°C.

Pancreatic cancer is currently the fourth most deadly form of cancer in the United States. One factor implicated in pancreatic cancer growth is the hormone signaling pathway between gastrin and its receptor, CCK2R. In the early 2000’s, it was also discovered that pancreatic cancer cells can contain a variant (CCK2_i4svR) of the normal receptor protein. Crucially, this longer variant has been shown to be hyper-stimulated and to drive increased cancer growth. Measuring the relative abundance of these two receptors at the protein level can help us understand their role in pancreatic cancer and may represent prognostic value as a biomarker. However, while RNA detection and measurement have been reproducible, protein detection has been problematic. Using western blot analysis, we have been able to detect the receptors in cells expressing them at high levels; however, detection in wild type and stably-transfected lines more representative of physiological expression has been unclear. Thus, we hypothesize that low, natural abundance of the receptors requires enrichment for reliable quantification. Herein, we report our initial attempt to enrich for green fluorescent protein-tagged variants, CCK2R-GFP and CCK2_i4svR-GFP, utilizing a membrane extraction protocol based on the non-ionic detergent, Triton X-114. Following enrichment, western analysis demonstrated a significant decrease in cytosolic protein in control cells transfected with untagged GFP. Efforts to verify retention of membrane proteins in the hydrophobic fraction, and subsequent specific detection of the CCK2R variants, are ongoing.

Post-traumatic stress disorder (PTSD) is a chronic, debilitating disorder in which the heightened fear and arousal experienced during a traumatic event generalizes to nonthreatening stimuli. Previous research has suggested that administering morphine within 24-48 hours of a traumatic event inhibits memory consolidation and prevents future development of PTSD. The goal of this study was to block the reconsolidation of previously stored stress memories by administering morphine within 24-48 hours of conscious recall of the original stressor. A rat model of PTSD called stress-enhanced fear learning (SEFL) was used, which employed two distinct contexts, Context A and Context B. The severe stressor, which mimics trauma experienced by humans, occurred in Context A, during which 15 foot shocks were administered within a 90-minute period. Two reminder shocks were delivered in Context B. The first was followed by an injection of morphine or saline, and the second was delivered three weeks later without a subsequent pharmacological injection. The animals were video recorded for seven weeks in Context B to assess for freezing behavior, a classic fear response in rats. We hypothesized that the morphine-treated rats would exhibit less freezing behavior following both reminder shocks, whereas the saline-treated rats would exhibit a heightened fear response.

Pancreatic cancer is projected to become the third leading cause of cancer-related deaths in the United States and has a low 5-year relative survival of 10%. The poor response to treatment is attributed to the immunosuppressive and highly fibrotic nature of the pancreatic tumor microenvironment. Previous studies have demonstrated that proglumide treatment results in decreased fibrosis and may increase T-lymphocyte infiltration. Additionally, our lab has demonstrated that peptide immunization targeting the human CCK2_i4sv receptor, a cancer-associated splice variant of CCK2R, evokes a potent T-cell response in mice. We hypothesized that combination therapy utilizing concomitant immunization and anti-fibrotic treatment will further enhance T-cell infiltration and decrease tumor burden. To address this, we first analyzed T-cell infiltration in a pilot group of orthotopic murine pancreatic tumors (Panc02) obtained from mice treated +/- proglumide. Tumors were analyzed by immunohistochemistry (n=3 per grp), and infiltrating CD-3+ T-cells were numerated in five random photomicrographs for each tumor. Tumors treated with proglumide exhibited increased T-cell infiltrate and significantly less fibrosis. To assess the efficacy of combination therapy, mice (C57Bl/6) were immunized weekly with CCK2_i4sv and control peptides starting three weeks prior to orthotopic injection of syngeneic cancer cells (Panc02) engineered to express human CCK2_i4svR. Both groups received oral proglumide following tumor establishment. Upon necropsy (≤6 wks), mice exhibited no significant difference in tumor burden. Immunohistochemical analysis showed the number of infiltrating CD-3+ T-cells per tissue area trended higher in these proglumide-treated mice compared to the previous untreated pilot controls. However, no difference in infiltration was observed in tumors from CCK2_i4svR-immunized mice compared to control immunization. Our data confirm proglumide treatment may enhance immune access to the tumor; however, simultaneous analysis of the circulating lymphocyte response is necessary to thoroughly determine the efficacy of combined immunotherapy on T-cell infiltration.

Plant cells uptake metals from the soil by operating specific cellular pumps to transport metal nutrients. These pumps are crucial for maintaining the healthy concentration of metal elements. Metal Micronutrients, like zinc or nickel, are essential to plant growth and their uptake is controlled by the MTP1 transporter on the vacuoles in cells. Using Arabidopsis Thaliana as a model organism, the effect of mutations on the MTP1 gene can provide a window into MTP1 transporter function and metal nutrient uptake pathways. Two preliminary metal tolerance experiments were conducted on Columbia line wild-type seeds with zinc and nickel contamination to learn what effects the metal ions were having on the plants’ growth. Unfortunately, a problem found during a preliminary wild-type experiment highlighted problems somewhere in the experiment. After that result, the primary purpose became to troubleshooting the experimental method. Both experiments with zinc and nickel contamination yielded results that unexpectedly appeared to be hyper-concentrations of metal ions. Hyper-concentration pointed to a problem with the media, the metal ion solutions, or the seeds. The media was examined by chemical digestion and atomic absorption spectroscopy to quantify metal ion concentration. The analysis demonstrated the concentrations were not hyper-concentrated in the media meaning the problem was with the metal ion solutions. This semester began with a complete remake of metal ion stock solutions and growing a new batch of seeds that would hopefully fix the problems. Early experiments showed the same apparent hyper-concentration problem but with a noticeable consistency. The plants were reacting consistently to the presence of metal ions in a range between 20-60 uM with nickel contamination. This consistency is shown over multiple experiments and means an adjusted experiment range to can be used to test MTP1 mutant tolerance.

Carolina Laboratory Supplies was the sole commercial supplier of polyclonal antisera specific to bacteriophage T4, an essential item used in the Phage Neutralization Lab in Microbiology courses at Messiah University. Carolina ceased production of this antiserum, necessitating discontinuation the Phage Neutralization Lab. the goal of this study is to produce monoclonal T4-neutralizing antiserum so that the Phage Neutralization Lab can be restored. The T4 suspensions used need to have confirmed titers and be depleted of lipopolysaccharide (endotoxin) which are lethal to mammals. Determining the titer of the bacteriophage suspension, purifying it, and verifying that the endotoxin levels are below lethal concentrations must be done before immunization of the mice. The successful generation of antibodies against bacteriophage T4 would enable the project to continue to the next stage, where monoclonal antiserum can be produced using hybridoma technology. 

Goldenseal (Hydrastis canadensis) is a plant native to woodlands of east-central North America. Goldenseal roots contain antimicrobial compounds which promote respiratory and digestive health and the plant has been wild-harvested almost to the point of extinction. Plants are products of their environments and the concentration of medicinal compounds within a plant are affected by the conditions in which the plant was grown. Wild harvested plants are subject to the variations in their natural environment and it is almost impossible to accurately know the concentrations of desired medicinal compounds within plants that are wild-harvested.  With all medicinal compounds there exists a therapeutic dosage in which the compounds are beneficial for the body. Outside of this window, the compounds are either ineffective or toxic. It is crucial for supplements made from medicinal plants to contain known concentrations of the desired medicinal compounds in order to ensure the effectiveness and safety of the supplement. Due to these reasons it is crucial to develop a sustainable and controlled method of growing goldenseal, and aquaponic technology is a form of agriculture that serves as a hopeful solution to these concerns. Previously, goldenseal was aquaponically grown at Messiah University somewhat successfully, but many of the plants died prematurely of root rot. Other than the work completed at Messiah, there are no published studies that include growing goldenseal aquaponically. It is proposed that goldenseal be grown in an aquaponic system at various water levels to find a growing method that maximizes the plant's survival and productivity.

Horse cytochrome c (hCc) is a heme protein that operates in essential metabolic processes, including the electron transport chain to generate energy. Substitution of hCc’s heme with zinc can create Zn-hCc. Zn-hCc is a useful tool for studying protein folding and hCc’s cellular activity due to zinc’s intrinsic fluorescence. However, Zn-hCc has only been artificially synthesized, and the process is complicated, expensive, and wasteful. This study attempted an in vivo method that induces E. coli BL21 cells to synthesize Zn-hCc by themselves, eliminating the complications of artificial synthesis. The cells were grown in autoinducing minimal media supplemented with minimal iron and excess zinc to induce zinc-takeup in the heme. In addition to the wild-type HCCS, E. coli with an HCCS E138A mutant were grown. Analysis via UV/Vis spectrophotometry showed that greater Zn to Fe concentrations up to 250 uM Zn/5 uM Fe correlated to increased incorporation of zinc into the heme and the possible production of Zn-cyt c. The HCCS E138A mutant showed increased incorporation of zinc into the protein and higher yields of hCc than the wild-type, with the highest yield in the 250 uM Zn/5 uM Fe growths. A purification of the 5 uM Fe/25o uM Zn growths was attempted to confirm the synthesis of Zn-hCc. However, the purification was unsuccessful due to a very small yield of hCc. Future research will conduct larger-scale growths and attempt the purification again. If successful, the purified protein will be analyzed with SDS-PAGE, UV/Vis spectrophotometry, and fluorescence spectroscopy to determine whether Zn-hCc was synthesized.

Rapid Orthotics for Cure Kenya (ROCK) works with CURE, a non-profit orthopedic workshop in Kjabe, Kenya, to implement a 3D printing system for manufacturing custom prosthetics and orthotics.  The goal is to reduce the production time and cost for the current transtibial sockets being manufactured in the orthotic clinic to give the patients a way to integrate into society and reduce stigma from their communities. The team has developed a transtibial socket for below-the-knee amputees produced by a 3D printing system that converts a scan of the residual limb to a model that takes a third of the time to print versus the current manufacturing method. The current focus of the team is to develop a rigorous testing procedure adhering to the requirements set by the ISO 10328 Standard, an internationally recognized testing method. In order to ensure the safety of the sockets, tests must be run demonstrating that the product can withstand the different forces experienced during the gait cycle. Due to the complex geometry of the applied forces outlined in the ISO 10328, the team has designed a novel testing rig that interfaces with the MTS machine at Messiah University to apply the necessary forces according to the geometry outlined in the standard. Additionally, computer-based simulations are being developed in SolidWorks, a 3D modeling software, to determine how the components will behave under certain loading conditions. This is done to ensure accordance with the 10328 Standard and will be critical in the future for developing necessary cyclic tests.

Persons with disabilities in developing countries often lack the basic equipment needed to assist them in their daily lives. International Nepal Fellowship (INF) is a Christian medical organization located in Nepal that provides medical care and assistance to people with disabilities and other conditions. Currently, INF imports expensive wheelchairs that undergo a prolonged border process before being received. INF has reached out to the Collaboratory to design a wheelchair that can withstand the challenges of Nepal’s terrain and can be manufactured from local materials. The Nepal Wheelchair team accepted this challenge and set out to design a wheelchair that can fulfill their needs. The team began by researching wheelchair models for inspiration and eventually settled on two preliminary designs. In January 2020, the team traveled to Pokhara, Nepal to gain feedback from the staff at INF and select a final design based on their comments. During this trip, the team acquired and brought back locally available materials and parts available in Nepal in order to construct a prototype.  This year, prototyping has been completed for the following elements: the central frame, wheel lock, footrest, wheel mounting assemblies and armrest fixtures. As a result of knowledge gained during prototyping, some design changes to the wheelchair have been made. Moving forward, the team will test the overall prototype for durability and prepare a manufacturing manual for INF.

The Village Water Ozonation System (VWOS) team’s core mission statement is to provide economically sustainable and culturally sensitive drinking water solutions for communities, to empower communities with the ability to properly maintain their drinking water supply, and to transform people’s lives by decreasing the occurrences of waterborne diseases.

Currently, the VWOS team is partnering with Friends in Action to design and implement two drinking water treatment systems for the community living on Rama Cay, an island in the Bluefields Lagoon on the eastern coastline of Nicaragua. The wells on the island are contaminated with E. coli and other bacteria and contain high levels of salt that cause the water to be unhealthy, distasteful, and corrosive to metal equipment in the system. The team hopes to design a system that will disinfect the water, remove salinity from the well water with a safe and efficient disposal of all byproducts, and decrease corrosion agents.

VWOS is partnering with Forward Edge International for the third time (Nicaragua 2009 and Mexico 2016) to design water treatment systems for communities in Oaxaca, Mexico and Kijabe, Kenya. The system for Oaxaca is ready for implementation and awaits availability to travel.  The system for Kijabe is in the initial stage of communicating with the client on specifics for the design. 

Lower limb amputations are common in sub-Saharan Africa due to the prevalence of disease and infection in communities that lack access to adequate healthcare. Our project, Prosthetic Knee, partners with the CURE International Hospital in Kijabe, Kenya. In the region surrounding our client’s facility, there is a large number of lower-extremity amputations due to various infections and diseases. While many of these amputees only require a through-knee amputation, the lack of an affordable through-knee prosthesis often forces patients to undergo a more invasive transfemoral amputation to enable them to use a cheaper above-knee prosthesis. The goal of our project is to design and manufacture a financially accessible and user-friendly prosthetic knee for knee-disarticulation patients that can be manufactured in Messiah University’s machine shop (and ultimately, at the orthopedic facility in Kijabe).

This year, the team’s work has included finalizing the prototype design, conducting finite element analysis in SOLIDWORKS to evaluate the knee’s static and fatigue strength, and beginning the process of physical manufacturing. Additionally, a damping mechanism driven by a spring-loaded system has been developed and integrated into the design after completing motion analysis and SOLIDWORKS modeling. Our future goals include manufacturing a complete metal prototype of the knee, conducting physical strength and fatigue testing on the metal prototype, and continuing iterative prototyping of the damper in preparation for physical implementation.

The Landmine Neutralization team’s poster will present our team’s progress towards designing and prototyping an air excavation unit. To accomplish this, the project team is working with the HALO Trust, the world’s largest demining NGO. The HALO Trust works in many countries to remove the remnants of war, including improvised explosive devices (IEDs) and unexploded ordnance (UXOs). This project seeks to help deminers by providing a device that blows air at high velocity to clear dust and other debris away from potential IEDs and UXOs in war-torn areas to help in their effort of demining. We have focused on designing our prototype to operate reliably in harsh environments while fulfilling our client’s specifications. Our client requested that we design our excavation unit to be easily installed onto their Volvo 220 backhoes and their custom-made backhoe attachments. The current design is modular and consists of a hydraulic motor powering a fan from a backpack leaf blower, all of which is assembled within a steel frame that attaches to the rake of the HALO excavators. Due to circumstances beyond our control, our project will be wrapping up at the end of this semester, which is sooner than anticipated. This means the goals of our project have been narrowed to having a functional prototype and relevant documentation that we can present to our client.

The Mechanized Percussion Well Drilling (MPWD) Collaboratory project seeks to design a simple mechanized well drilling system for drilling shallow water wells in Western Africa. Our client, Open Door Development (ODD), seeks to make water accessible to all in the region, but has had difficulty drilling through hard soil layers. To combat this problem, the MPWD team has worked closely with Mr. Joseph Longenecker to develop a mechanized percussion well drilling rig that is capable of drilling through these harder layers. Currently, the MPWD team is seeking to provide recommendations to improve the lifetime of our client’s new, fully mechanized rig design. This year, our team’s work has been focused specifically on analyzing the lifetime of the rig’s driveline chains and also on its frame. For the driveline chains, the team will be conducting fatigue testing on a model of the driveline system to determine which type of chain should be used on the rig. To determine the lifetime of the frame, the team will be performing a series of static, buckling, and fatigue finite element analyses on the rig’s frame. The most recent accomplishments of the MPWD team have nearly proved that their design for the loading application will be feasible for use on the actual testing rig and that multiple studies of finite element analysis can be performed to simulate the different rig frame loading scenarios. 

For people suffering from spinal cord injuries, it is important to stay active. However, with spinal cord injuries, the use of a wheelchair isn’t feasible. These patients require a prone trolley. A prone trolley is a horizontal pad with four wheels that a patient can maneuver and control while lying in a prone position. Our partner, International Nepal Fellowship (INF), deals directly with patients who suffer from spinal cord injuries on a daily basis. INF, a Christian, medical organization, manages a hospital in Pokhara, Nepal which specializes in treating patients with spinal cord injuries. The Nepal Prone Trolley Team’s goal is to provide our partner with a sustainable prone trolley design and create the required manufacturing documentation to enable them to produce the prone trolleys in country at their Green Pastures hospital. The team began our work by researching what a prone trolley is, how it functions and what is currently available. During the research, the team discovered that there weren’t many examples of a manually powered prone trolley or critical dimensions for ergonomics for manually powered trolleys. This drove the team to develop testing methods and preliminary designs specifically for INF. Various basic designs were considered, but, through communication with INF, a single design was chosen. Computer modeling of this design was used to decrease the overall weight of the trolley and simplify the frame. With most of the design finalized, the team is ready to begin prototyping next semester.

The Sustainable Agriculture team is dedicated to developing alternative and sustainable agricultural solutions to alleviate poverty in western Africa. The team is currently working with Sheltering Wings in Yako, Burkina Faso and Trans World Radio in Parakou, Benin. Both clients currently have a working aquaponics system, but the type of system varies between clients. Sheltering Wings has a flood and drain system and Trans World Radio has an ebb and flow system.

Throughout this year, our team has focused on reducing power consumption and costs for our clients.  The development of the ebb and flow prototype was a consequence of this mission as we reduced power consumption by one pump using a manual siphon. We have also worked towards lowering the costs of water quality testing kits by introducing a Nutrient Film Technique with basil plants.  Lastly, we have strived to research best practice methods for fish food making and fish feeding in order to keep the biology of the prototypes healthy.  To support present and future clients, the year will conclude with final deliverables for the ebb and flow prototype including an operations and maintenance manual, a construction manual, and a troubleshooting manual.  

The Sustainable Mobility project of the Collaboratory empowers people living with a disability in rural West Africa to pursue educational and work opportunities and more fully participate in family and community life.  Our electric, 3-wheeled, off-road wheelchair has transformed the lives of dozens of clients through partnerships with the Center for the Advancement of the Handicapped in Mahadaga, Burkina Faso and the Center of Hope in Fada, Burkina Faso. Now, to reach more people in new locations and with more partners, Sustainable Mobility is working to reduce manufacturing time and cost, author image-driven fabrication guides to enable local fabricators to build trikes, create instructional trike assembly videos, and develop supply chains to bring parts and materials to build sites. We seek to put local fabricators to work building tricycles wherever they are needed.

The Panama Bridge project has partnered with Rio Missions Panama to design a bridge for the village of La Gigi, Panama. The mountain community of La Gigi experiences heavy rainfall during the rainy seasons. A stream runs along the community, restricting their access to schools, employment options, and other communities. While passable during dry seasons, the stream floods and becomes impassable after heavy rains. The residents are effectively cut off from their livelihoods, church, health services, and other communities during this time.

To accommodate this need, the Panama Bridge Team has spent the last two academic years designing a 90 foot aluminum truss bridge. The design includes a unique construction strategy to deal with challenging site constraints.

Around seventy million people internationally have a stutter, a form of a fluency disorder.  Some fluency assistance devices are available to the public, but most are highly expensive or unreliable.  The Fluency Assistive Device (FAD) team seeks to assist a niche community of these individuals who currently rely on a device known originally as the Edinburgh Masker by partnering with Dave Germeyer. Utilizing his expertise in repairing the Edinburgh Masker, FAD is developing two new versions of the masker to increase its portability, functionality, and cost-effectiveness. The first is an update of the original called the Analog Masker (Version 1.1). A prototype of the Analog Masker v1.1 has been developed, tested and is currently being revised based on the results. Revisions include updating the layout of the board and finalizing the power supply circuitry. The second version, known as the Digital Masker (Version 1.0), will use a Bluetooth-enabled microcontroller to achieve masker functionality. Bluetooth audio output for the Digital Masker has been tested, and two algorithms have been created for the masking output. The supporting software for the Digital Masker is nearing completion. The schematic and the layout design have been started for future implementation of the hardware. 

Due to the rapid growth of children and the high cost of myoelectric technology, children are not given the same opportunities to use myoelectric prosthetics as adults. The Muscle Activated Prosthesis (MAP) team is developing an affordable, transradial, myoelectric prosthetic for a thirteen-year-old girl. The MAP team is designing a myoelectric prosthetic that will cost under $1,000, over 90% less than custom myoelectric devices on the market. This device has an EMG sensor, a microprocessor, a printed circuit board (PCB), linear actuator motors, and a battery organized within a 3D-printed transradial prosthesis to open and close the hand grip when the EMG detects electrical signals via muscle contractions in the client’s flexor carpi radialis. Currently, the team has fully assembled a prosthetic prototype and will obtain feedback from the partner, Ability Prosthetics, and the client to deliver a final prototype. This poster details the recent mechanical and electrical design optimizations, grip strength testing, and integration of mechanical and electrical components to build the current functioning prosthesis.

Trans World Radio (TWR) is a mission organization focused on broadcasting the Gospel around the world. TWR now serves 190 countries by transmitting in 275 languages, using radio to deliver the message to as many people as possible. The organization’s West Africa Transmitter Site in Benin currently has accessibility problems due to high streamflows and saturated ground conditions during the rainy season. The site also needs a secure perimeter to reduce trespassing and theft.

To address these issues, our client, Garth Kennedy, Director of the West Africa Transmitter Station, has asked the team to design two culverts, one at the upstream property boundary and one at the downstream boundary.  Culverts are advantageous for this scenario because they can act as a bridge, while the pipe size can be restricted to inhibit trespassing. Once the culverts are built, the fence and perimeter road can be extended over them.

For both sides of the property, the team has designed a series of U-shaped, pre-cast concrete box culverts. The team calculated the design flows based on rainfall data and the topography of the site to determine the size and number of box sections. The team has also designed the culverts and the supporting concrete structures to bear the load of vehicles and the machinery on site. TWR plans to construct the pre-cast culverts on-site, and then build the supporting structures and install the culverts during their dry season.

Approximately 90 million people in Africa lack access to safe drinking water, despite having water infrastructure installed in their community. The India Mark II and the Afridev handpumps are among the most widely used handpumps in the world. Sadly, studies show that approximately 30% of these handpumps are non-operational due to failures of the bearings, seals, head flange, and other common components. The Better Pumps team of the Collaboratory provides engineering support for partners who are working to improve handpump sustainability. We partnered with Tony Beers and AlignedWorks to validate a bearing test methodology for the India Mark II handpump. By modifying the loading conditions in our handpump test machine, we were able to replicate failures observed by AlignedWorks in a field trial of their bearing design. We partnered with Matt Schwiebert and Living Water International to test new seal designs for the India Mark II and Afridev handpumps and to measure head flange deflections in the India Mark II handpump.  Seal performance data collected by the team was used to validate a new design in advance of field trials by Living Water International.  Head flange deflection data was collected for partner benchmarking of their computational analysis. Test methodologies and results are reported.

The Land Development Team has partnered with Tree 4 Hope and Hope Academy in Santa Lucía Milpas Altas, Guatemala to improve the outdoor facilities of the school. Jenn and David Hope-Tringali are the client/partner representatives of the school for this project. The goal of the project is to provide design and construction drawings for three main elements of the proposed land development:  (1) a parking lot for buses and school vehicles that enter the site, (2) a single sports court that can accommodate basketball and soccer, and (3) a playground that is directed towards themes associated with STEAM (science, technology, engineering, art, and math). The team has completed project drawings to allow construction by local personnel, or by student or church mission teams when travel is allowed to resume post-pandemic. 

The Intelligent Water System, which improves access to clean water by autonomously monitoring and reporting on the health of hand pumps in developing countries, has been under development for several years.  This development has included short-term prototype field tests in several countries.  The design has matured to the point that an extended field trial to demonstrate performance and reliability has been requested by our client.  In light of this, the team has implemented design changes to address issues from our most recent prototype field test and begun manufacture of the first five systems intended for installation in Burkina Faso.  This poster highlights the code changes enabling more accurate determination of the volume of water pumped and the simplified mounting of the system’s Handle Motion Sensor.

The DVD team is developing a cost-effective technique for measuring HIV load in resource-restricted regions. Our client is Dr. Phil Thuma and the Macha Research Trust in Zambia. Our design is based on advanced fluorescence spectroscopy that utilizes a fluorescence protein probe, confocal optics, and low-cost, low-power electronics to assess viral load in a patient blood sample. Our timeline for a functional exploded prototype is Fall 2021.

Specifically, we are employing a method of spectroscopy that seeks to identify individual viruses in dilute samples by characteristic “bursts” in fluorescent and elastically scattered light. We have assembled a housing for a custom-designed detector, associated electronics, and signal processing hardware. One project goal is to integrate this modular design into a single printed circuit board. Communication between signal processing hardware and a software-based user interface implemented on a Raspberry Pi and touchscreen is achieved by the use of a Serial Peripheral Interface (SPI) protocol. The entire system is battery-powered. This system will allow for fast, effective viral load determinations in remote settings.

The work of the Solar PV Team is to design and install Solar PV systems which enable our clients to fulfill their mission in the presence of unreliable or non-existent electrical power.  In order to experiment with different Solar PV configurations and train new members, the Solar PV team last year designed a Solar Lab to be installed in and next to Frey 70.  This work paralleled the design/component selection typically performed prior to an installation site trip.  This year, the team modeled the efforts typically done at the installation site by building and configuring the Solar Lab design.  This poster will focus on the lessons learned about decisions that need to be made in the field to convert a Component Selection level design into a Functioning PV System.

Clubfoot is a musculoskeletal birth defect characterized by an inward twisting of an infant’s feet. Currently, a series of casts are used to correct the clubfoot, and a boots-and-bar brace is used to maintain the correction. However, this method has concerns with compliance, comfort, and social stigma. Hope Walks and their clinic in Kijabe, Kenya are interested in implementing a new maintenance brace that addresses these concerns. Mr. Jerald Cunningham, CPO, designed and is utilizing a unilateral clubfoot maintenance brace called the Cunningham Clubfoot Brace. He asserts his brace reduces treatment time, lessens social stigma, and increases child mobility. However, to date, there is not enough published research on its biomechanics and patient success rates to confirm his findings.

The Cunningham Clubfoot Brace Collaboratory project seeks to validate the effectiveness of the Cunningham design through biomedical testing and increase brace availability through sustainable manufacturing. To do this, the team is measuring the biomechanical forces applied by the brace with multiple force sensor systems and an infant foot model. The team is assisting Mr. Cunningham in his plans to use injection molding to increase brace production by scanning and creating CAD files of the brace. The team is also completing a failure and reuse analysis of the Cunningham Brace for the clinic in Kijabe. Furthermore, the ongoing clinical study at CURE International's hospital in Kijabe, Kenya, and Dr. Emily Farrar’s research paper will provide greater insight into the effectiveness of the Cunningham Brace. These collaborative efforts will allow for further understanding of the effectiveness of the Cunningham Brace and its acceptance as an alternative clubfoot maintenance brace.

Partnering with Brethren in Christ (BIC) Church in Zambia, the Egg Incubator Team is seeking to help provide a source of income for the growing churches in Choma, Zambia. They will accomplish this by designing and building a high-quality, low-cost egg incubator fabricated from local parts and cheap internationally available parts for The Nahumba Mission, in Choma, Zambia. The team’s design will provide the means for the Mission to hatch and sell chickens to provide both food security and a sustainable supplemental income. With the specifications to maintain temperature, humidity and constant ventilation, the team selected heating and humidity concepts for their incubator series. The team completed both mechanical and electrical designs for the setter and hatcher. In preparation for testing the incubator design with fertilized eggs, the team has also produced an incubation and hatching plan and achieved IACUC approval. Currently, the team is in the prototyping phase, while simultaneously monitoring the temperature and humidity in an existing incubator setter design. Once the team finishes their hatcher prototype and verifies that the temperature and humidity specifications are met, they will be ready to test designs using fertilized chicken eggs. 

The effects of caffeine on task performance and attentional focus during movement have been suggested to be influenced by the interaction between the adenosine (ADORA2A) and dopamine (DRD2) receptors in the dopaminergic pathways and specific centers in the brain. Individual polymorphisms of 1976 T/C (ADORA2A) and C957T (DRD2) are thought to influence the varied response of caffeine during movement. PURPOSE: The purpose of this study is to determine the influence of caffeine, 1976 T>C ADORA2A polymorphism, and C957T (DRD2) polymorphism on measures of unilateral and bilateral motor tasks. METHODS: The Purdue Pegboard Test and the Minnesota Dexterity Test were used to assess fine motor abilities following both placebo or caffeine ingestion (5mg•kg-1 bodyweight). Buccal epithelial cells of each subject were retrieved by a 0.9% NaCl mouth rinse. To collect the DNA samples, the cells were lysed via proteinase k and isolated with QiAmp Mini spin columns. The polymorphisms were identified using a TaqMan® SNP Assay for ADORA2A (rs5751876) and DRD2 (rs1800497) and allelic discrimination via One-Step qPCR amplification. All samples were run in duplicate with negative and positive controls. RESULTS/DISCUSSION: The Results and Discussion will be presented at the Symposium.

Individual responses to caffeine are suggested to be genetically influenced by polymorphisms of the cytochrome P450 enzymes, specifically the -163 A>C CYP1A2, for metabolism in the liver and through the adenosine receptor, 1976 T>C ADORA2A, for sensitivity of specific target cells. Individuals with the AA variant are caffeine responders, while those with the AC/CC variants are caffeine non-responders. ADORA2A TT variants demonstrate an increased sensitivity to caffeine compared to TC/CC variants. Purpose To examine the effect of caffeine and CYP1A2 and ADORA2A polymorphisms on anaerobic power during exhaustive exercise. Methods Fifteen elite NCAA male athletes (age=20.1 yrs, weight=77.4 kg, height=176.7 cm) participated in a double-blind study. Subjects performed two separate 90-s Wingate Tests (WAnT90) separated by two to four days on a Velotron cycle ergometer, resistance=0.05 kg•BW(kg)^-1. Subjects ingested a bolus of caffeine, 5mg•kg^-1BW, or a placebo (maltodextrin) one hour prior to each trial that were administered in a randomized/counterbalanced design. Peak power (W•kg^-1), total power (W•kg^-1), and average power (W•kg^-1) were calculated for the 90-s and each 30-s interval. Buccal epithelial cells were collected using a mouth rinse, 0.9% NaCl, and DNA was extracted via spin columns and proteinase k. Allelic discriminations for CYP1A2 (rs762551) and ADORA2A (rs5751876) were procured via an assay and a One-Step qPCR amplification. Samples were run in duplicate, with positive and negative controls. The data was analyzed using a factorial ANOVA with repeated measures (p > 0.05) for each variable. Results/Discussion The results and the discussion will be presented at the Symposium.

Heart rate variability (HRV) is a non-invasive measurement of the autonomic nervous system (ANS) which uses the frequency and time domains of an ECG to determine the magnitude of sympathetic and parasympathetic activity.  Decreased HRV has been associated with several disease conditions whereas increased HRV indicates increased parasympathetic drive, which attenuates physiological and psychological stress conditions.  The short-term HRV, 5-minute, average, denotes the temporal and dynamic functioning of the ANS and can be used to monitor acute changes in allosteric load. Increased parasympathetic activity secondary to acute bouts of controlled breathing holds conflicting results in current research. Objective: To determine the effect of an acute bout of controlled breathing on the time domain measures of HRV. Methods: Twenty-nine subjects (x= 19.4 + 0.8 yrs) volunteered for the meditation activity.  The subjects attended a familiarization session to give informed consent, to adjust to the lab setting, and to practice a guided breathing technique, 6 breaths/min.  The subjects returned to the lab for a 15-minute experimental protocol during which, they sat quietly breathing normally for 5 minutes to establish a baseline, followed by 5 minutes of the guided breathing, and finished with 5 minutes of normal breathing. The ECG recorded continuously over the 15-minute protocol using a Polar H10 heart rate monitor.  The raw data was downloaded into the commercially available Kubios HRV software program and the 5-minute average for heart rate (HR), low frequency (LF), high frequency (HF), peak HF/LF ratio, standard deviation of the normal-normal R-R (SDNN), and root mean square of the standard deviation (RMSSD) were calculated for baseline, guided breathing and recovery periods. Results: 5 minutes of guided breathing elicited significant differences in measures within the frequency domain (HF and LF) and the time domain (RMSSD and SDNN) heart rate variability.  HF baseline was 52.0 + 20.7 nu significantly decreased to 18.7 + 10.1 nu following controlled breathing, and significantly increased to 37.0 + 17.4 nu during the recovery.  LF baseline was measured at 47.9 + 20.8 nu, increased to 81.3 + 10.1 nu during controlled breathing and returned to 63.0 + 17.4 nu during recovery.  The RMSSD baseline was 64.8 + 36.3. It increased significantly to 79.5 + 37.8 and returned to baseline measures 60.3 + 35.4 following the breathing exercise.  The SDNN baseline was 63.4 + 32.2 which increased significantly to 114.9 + 40.5 during controlled breathing, and then significantly decreased to 67.8 + 31.2 during recovery. during recovery. Discussion:  The frequency domains of HF (parasympathetic) and LF (sympathetic) appear to respond in the opposite direction from the anticipated change in parasympathetic activity; however, these variables are not reliable indicators of parasympathetic activity at paced breathing of 6 breaths/minute or slower.  Within the time domain, RMSSD and SDNN have been identified as indicators of short-term parasympathetic activity, specifically vagal nerve activation.  The RMSSD and SDNN results demonstrated that controlled breathing provided significant parasympathetic response during the controlled breathing technique; however, the acute increase in activity was not sustainable past the breathing intervention.

Heart rate variability, the variation in time between heartbeats, is used to measure the autonomic balance between the sympathetic and parasympathetic nervous systems. It can be influenced by meditation and various breathing techniques. The purpose of this study was to evaluate the effects of a meditation and breathing training program on the heart rate variability of inexperienced meditators. Participants in the study were male and female college students, ranging in age from 18 to 22 years. They participated in a synchronous pre-test training session, during which baseline data was collected during spontaneous and controlled breathing. Over the following week, participants meditated independently using a guided breathing app. They then returned for a synchronous post-test training session, during which data was collected and compared to the pre-test baseline data. Results and data will be discussed at the Symposium. 

The addition of resistance to a sprint interval training program could potentially increase different aspects of sprint performance. PURPOSE: To determine the effects of a two week, 10% resisted speed training program on power performance. METHODS: Six active males participated in a two-week resisted sprint interval training program that met three times a week (six total sessions). Each participant completed a pre and post-test that includes a 30 second Wingate test and a vertical jump test. The training regime began with three sprints on a Woodway Curve 3 treadmill and increased repetitions throughout each session. Each participant completed the training program with a weighted vest that contains 10% of their body weight. RESULTS AND DISCUSSION: The data and results will be discussed at the symposium.

Flexibility and power output are two critical components of dance performance; however, recent research suggests that acute bouts of stretching may decrease muscular power. PURPOSE: The purpose of this study was to compare the effects of dynamic stretching (DS) and static stretching (SS) on muscular power in dancers. METHODS: 12 female, collegiate dance majors volunteered for this study. The subjects attended a familiarization session, gave informed consent, and were oriented to all testing procedures. Three different experimental sessions were conducted in randomized order for each stretching condition: DS, SS, and no stretching (NS), with a minimum of 48 hours between testing days. The sessions began with a warm-up (5 min walk) followed by a guided stretching protocol for each condition. Muscular power (peak torque, Watts) was obtained for the plantar/dorsiflexors with an isokinetic dynamometer (60o/s and 180o/s) and vertical power (W/kg BW) was obtained using both a squat (SJ) and countermovement jump (CMJ). One-way ANOVA with repeated measures with Tukey HSD post-hoc tests was conducted to determine significance (p< 0.05) for each variable. RESULTS: The results indicated that there were no significant differences for the power output of dancers after incorporating DS, SS, or NS as part of a warm-up. Isokinetic muscular power isolating the plantar flexors demonstrated no significant difference at 60o/s (DS, 57.1 + 22.7 W; SS, 57.8 +28.4 W; NS, 62.7 + 19.3 W, p = 0.82) or at 180o/s (DS, 28.3 + 9.50 W; SS, 30.5 + 14.7 W; NS, 32.2 +16.2 W, p = 0.76). In addition, measurements of power incorporating whole body power demonstrated no significant difference in jump height for the SJ (DS, 21.05 + 3.36 cm; SS, 20.83 +3.55 cm; NS, 20.9 + 3.14 cm, p = 0.893) or the CMJ (DS, 23.8 + 3.9 cm; SS, 23.7 + 5.7 cm; NS, 24.7 +6.8 cm, p = 0.98). CONCLUSION: Although some research suggests that varying forms of stretching may decrease muscular power, this study suggests that neither acute static stretching nor dynamic stretching will elicit a significant change in muscular power in dancers.  The jump athlete data is still being collected at the time of abstract submission.

As the presence of technology has increased, its incorporation into physical activity has become vital for making exercise more enjoyable and enticing. Various types of distraction have been used to test if, during exercise, a form of distraction may alter the VO2max, RPE, energy expenditure or heart rate values of a participant. PURPOSE: The purpose of this study is to investigate how the presence or absence of a predetermined 15-minute action clip during 15 minutes of biking affects RPE, heart rate, breathing rate, affect and performance. METHODS: Participants will come in for a familiarization session as well as two testing sessions. One will involve a 15-minute action clip and the other will involve no distraction. Pre-test, post-test, and every 5 minutes during the test the participants’ heart rate, VO2, and breathing rate will be recorded as well as the participants' RPE and Affect using the Feeling Scale. RESULTS AND DISCUSSION: Results will be discussed at the Symposium.  

Brain-derived Neurotrophic factor or BDNF is a protein involved in the growth and maintenance of brain cells and overall brain function. Research has shown both moderate and high-intensity aerobic exercise improve brain health and function. This study sought to examine the relationship between serum BDNF levels and moderate-intensity continuous training (MICT) compared to high-intensity interval training (HIIT). Ten healthy males from Messiah University participated in this study and were taken through VO2 Max and peak power (W_peak ) testing to establish a baseline to be used for the MICT and HIIT protocols. The HIIT protocol involved 60 seconds at 75% (W_peak) followed by 60 seconds at 40% (W_peak) and repeated 10 times. The MICT protocol involved 20 minutes at 60% (W­_peak). Serum was collected before, immediately after, and 15 minutes post-exercise for both protocols. The serum was then tested for BDNF concentrations using the Quantikine enzyme-linked immunosorbent assay (ELISA) kit from R&D systems. The ELISA kit showed BDNF concentrations were significantly elevated immediately post-exercise compared to the pre-exercise levels. There were no significant differences between time points for the exercise protocols. This supported the hypothesis that moderate and high-intensity aerobic exercise increases serum BDNF levels as well as supporting the American College of Sports Medicine statement about exercising at a range of intensities enhances overall health.                  

Background and significance of clinical problem/question: Delirium occurs in 60-80% of Intensive Care Unit patients who are ventilated (Martinez, Donoso, Marquez, & Labarca, 2017). Currently, there is no standard protocol used to prevent delirium in ICU patients. As a result, delirium commonly develops, leading to prolonged hospital stays, increased costs of care, and decreased patient satisfaction (Rivosecchi, Smithburger, Svec, Campbell, & Kane-Gill, 2015).

PICO Questions: In ICU patients, does the implementation of a multi-faceted approach improve the prevention of delirium?

Methods of Literature Search: The literature search was conducted using CINAHL and PubMed. The article dates range from 2015-2020. A total of 448 articles were found, and 6 articles were chosen that answer the PICO question. Based on the John Hopkins Nursing Evidence-Based Practice Model, the evidence ranged from a level II to level III with an A or B quality.

Findings from EBP Project: Evidence supports the use of a multi-faceted approach to prevent delirium. The multi-faceted intervention decreased delirium incidence from 38% to 24% (p = 0.02) and from 38% to 23% (p = 0.01) respectively (Martinez et al., 2017; Bounds et al., 2016). The odds of developing delirium were reduced by 78% (p = 0.001) and 60% (p < 0.002) using a multi-faceted approach (Smith & Grami, 2017; Pun et al., 2019). Similarly, mean reduction in the incidence of delirium was 24.7%, with a range of 9.7%-31.8% in a study using a multi-faceted approach (Rivosecchi et al., 2015).

Recommendations for practice: Based on the literature reviewed, the evidence supports the use of a multi-faceted approach to prevent delirium. The approach should be implemented in institutions after proper education of the staff to ensure successful application.

Background and significance: A knowledge deficit exists in prevention, treatment, and recognition of pediatric delirium (Flaigle et al., 2016). Delirium is present in 30% of critically ill children (Flaigle et al., 2016). Pediatric patients with delirium had longer hospitalizations (p < 0.001) and days on mechanical ventilation (p < 0.001) (Ista et al. 2018; Simone et al., 2017).

PICO question: In PICU patients, what are the effects of implementing a delirium care bundle as compared to no delirium interventions on patient outcomes?

Methodology: The literature search included: Medline, PubMed, CINAHL, and AACN.org.  A total of 128 articles were found ranging from 2013 – 2020 and 10 addressed the PICO question. Using John Hopkins Nursing Evidence Based Practice Model, there were 5 Level III and 5 Level V articles, of B quality.

Findings: Delirium risks include mechanical ventilation, sedation, and analgesic therapies (Flaigle et al., 2016; Holly et al., 2018). Symptoms include anxiety, poor eye contact, labile affect, and agitation (Holly et al., 2018; Ista et al., 2018). Delirium education improved delirium management confidence (p<0.001) (Simone et al., 2017). Prevention strategies include protocols to promote alertness, mobilize early, and decrease sedation (p< 0.001) (Simone et al., 2017). Delirium screening every 8 hours promoted earlier diagnosis (Ista et al., 2018). Unidentified and undertreated delirium contributes to familial and financial burdens (Holly et al., 2018). Early recognition and prevention may be enhanced by routine use of valid screening tools (Flaigle et al., 2015, Holly et al., 2018, Malas et al., 2017, Mason et al., 2017, Smith et al., 2016).

Recommendations for practice: Delirium screening using psCAM-ICU or PD-scale is indicated for early recognition and intervention. Multi-site randomized controlled trials are needed to strengthen the evidence, explore prevention strategies and implementation barriers.

Background and significance of clinical problem/question: High dose opioid prescription is the common practice in the treatment regimen of vaso-occlusive pain crises (Applequist, 2017), which leads to an undesirable side effect profile. Thus, it is imperative to find better options of treatment that will protect patients from experiencing unnecessary effects and provide better pain control.

PICO Question: In patients experiencing vaso-occlusive crisis, does ketamine administration provide better pain control and a decreased side effect profile compared to opioid monotherapy?

Methods of Literature Search: The literature search included PubMed, CINAL, American Society of Hematology, MEDline, and UpToDate. The articles ranged from 2013-2020. Of the 37 total articles found, 13 were used to address the PICO question. The John Hopkins Nursing Evidence-Based Practice Model was used to rate the level and quality of the articles. The levels ranged from Level I to V with a quality range of A to B.

Findings from EBP project: Pain scores in patients without acute chest syndrome (ACS) were decreased with ketamine use compared to opioid use (Twafic 2014, p=0.01; Kilinc, 2018, p<0.05). Ketamine administration also resulted in a decreased need for opioid usage (Nobrega, 2018, p<0.001; Neri, 2014, p=0.0038; Tawfic, 2014, p=0.007; Hagedorn, 2019; Jennings, 2013; Gowhari, 2013). Side effect profiles were less severe with ketamine monotherapy (Palm, 2018; Hagedorn, 2019).

Background & Significance: Poor oral health is associated with increased incidence of cardiovascular disease (CVD). Oral health care interventions (OHC) improve serum cardiovascular markers including triglycerides, total cholesterol, and HbA1C (Lavigne & Forrest, 2020). Determining appropriate early childhood OHC may prevent CVD later in life.

PICO Question: In early childhood, what oral healthcare interventions reduce the risk of cardiovascular disease across the lifespan?

Methods of Literature Search: Literature search included Medline and CINAHL articles from 2013-2020. Ninety-one articles met the search criteria; 11 addressed the PICO question. Evidence included Level I, II, III, and V, with A or B quality using the John Hopkins Nursing Evidence-Based Practice Model.

Findings: Education about proper oral hygiene during the prenatal period (p<0.05), preschool years (p<0.05), and elementary years (p<0.001) is associated with decreased incidence of childhood caries (Blake et al., 2015; Burgette et al., 2017; Kuter & Uzel, 2020; Xiao et al., 2020). Topics of proper toothbrushing, flossing, and decreased sugar intake were found effective (p<0.001) (Blake et al., 2015). School dental screenings and professional flossing may also reduce caries’ risk (Burgette et al., 2017; Salzer et al., 2017). Computerized reminders with older children encourage toothbrushing (Walker et al., 2015). Use of fluoride treatment modalities is also associated with better OHC outcomes (p<0.001) (Brecher & Lewis, 2018; Clarke & Stevens, 2019, Marinho et al., 2013). Physicians and dentists should work in collaboration to educate about other risk factors associated with CVD (Dietrich et al., 2017).

Recommendations for Practice: Multi-disciplinary OHC should begin during the prenatal period and continue into primary school using age-appropriate incentives. Education to reduce risk of CVD should include use of fluoride toothpaste, flossing, and decreased sugar intake. School-based dental screenings and professional flossing should be conducted.

Background: Current standards of practice only focus on analgesic medication for pain, without considering nonpharmacologic interventions (Suresh, De Oliveira, & Suresh, 2015). Prolonged pain in children can result in adverse psychological effects such as increased anxiety, bedwetting, fear of pain, and eating disorders (Woragidpoonpo et al., 2013). It is crucial to determine effective pain management to provide patient-centered care.

PICO Question: In perioperative pediatric patients, which nonpharmacologic interventions with pharmacotherapy decrease pain and increase comfort compared to pharmacological therapy alone?

Methods of Literature Search: Literature was reviewed using PubMed and CINAHL with article dates ranging from 2013 to 2020. A total of 818 articles were found with 6 articles addressing the PICO question. According to the Johns Hopkins Nursing Evidence-Based Practice Model, evidence ranged from Level I to Level III with quality ratings of an A or B.

Findings: Evidence showed support for a wide variety of nonpharmacologic techniques. Audiobooks and music interventions (Suresh, De Oliveira Jr, & Suresh, 2015), quiet rooms (McKay, et. al., 2019), guided imagery (Vagnoli, et. al., 2019), and skin to skin contact (Lisanti, et. al, 2020) incorporated into post-operative care all showed a decrease in the child’s pain scores. Parent-nurse-patient relationships and massages also correlated with pain relief (Woragidpoonpo, et. al., 2013). There was a discrepancy in parent and nurse expectations for pain control, suggesting a need for more family education in the pre-operative period (Harvey, & Kovalesky, 2018).

Recommendations: According to the reviewed literature, strong evidence of various nonpharmacological interventions including relaxation-guided imagery, music and audiobook therapy, and a quiet room, along with pharmacotherapy, decrease pain and increase comfort. These interventions should be implemented in pediatric patients undergoing surgery.

Key words: pediatrics, pain, nonpharmacologic, comfort, pre-operative, post-operative

Background & Significance: Nurses spend more time with critically ill and end-of-life (EOL) patients than any other healthcare professionals (Ferrell et al., 2016). As the population ages, nurses need to be prepared to care for patients at the EOL. Unfortunately, undergraduate nursing students are beginning professional practice with little confidence in caring for patients at the EOL.

PICO Question: In undergraduate nursing students, what is the effect of end-of-life simulation on students' confidence in providing end-of-life care?

Literature Search Method: The evidence was obtained from CINAHL, Medline, and PubMed. Dates of publication ranged from 2014-2020, 38 total articles were retrieved with eight used. Based on the Johns Hopkins EBP model, evidence consisted of one Level I, quality B, four Level II quality B, and three Level V quality B.

Findings: The evidence reviewed supported the use of EOL simulation as having a positive impact on student confidence. Tamaki et al. (2019) found improved confidence among the EOL simulation group students for both, physical assessment (p=0.00) and psychological care (p=0.00). Using the Frommelt Attitudes toward Care of the Dying Scale (FATCOD), four studies reported significant increases in mean scores following simulations: Bryne et al. (2020) (p=0.03), Dame and Hoebeke (2016) (p<0.001), Kirkpatrick et al. (2020) (p<0.001), and Lewis (2016) (p<0.001). In literature reviews, Gillian et al. (2014) and Kirkpatrick et al. (2017) found that improved self-confidence and self-efficacy were outcomes of EOL simulations and Carman’s (2014) case report indicated that EOL care simulation had an improved effect on students’ confidence.

Recommendations:  Based on the consistency of the evidence in support of EOL simulation, an undergraduate pilot project is recommended. However, experimental studies with larger sample sizes and identification of reliable and valid student confidence tools are needed to strengthen the evidence.

Background and significance of clinical problem/question: Nursing burnout is a phenomenon that affects individual nurses and nursing as a whole. Nursing burnout affects patient outcomes, patient satisfaction, nursing job satisfaction, and the longevity of a nursing career (Zhao et al., 2018).

PICO Question: For registered nurses, does the use of mindfulness reduce the future risk of burnout compared to no intervention?

Methods of Literature Search: The literature was reviewed using CINAHL and PubMed. The article dates ranged from 2013 to 2020. Of the 965 articles retrieved, six articles were used. Utilizing the Johns Hopkins Nursing Evidence-Based Practice Model, the levels of evidence ranged from level V to level I with a quality of A or B.

Findings from EBP project: Evidence supports mindfulness as a means to reduce nursing burnout. In various studies, implementing mindfulness resulted in stress decreases that were statistically significant (p < .001) (Duarte, 2016). Mindfulness also increases compassion satisfaction (95% CI, p = .027), decreases burnout (95% CI, p = .003), and decreases secondary trauma (95% CI, p = .047) (Hevezi, 2016). One quasi-experimental study showed a correlation among mindfulness and self-compassion and empathy as well as serenity and wellbeing (p < .001) (Penque, 2019; Van Der Riet, Levett-Jones, & Aquino-Russell, 2018). A separate literature review found that of various interventions used to reduce burnout, mindfulness was the most successful (Suleiman-Martos et al., 2020). A cross-sectional survey showed moderately reduced levels of burnout when mindfulness was utilized (p < .05) (Zhao et al., 2018).

Recommendations for practice: Based on the literature reviewed, mindfulness should be implemented as a pilot study in individual hospitals to reduce burnout among registered nurses. Measurement of mindfulness intervention implementation could provide additional evidence about its ability to reduce burnout.

Background and significance of clinical problem/question: Women have an increased mortality rate compared to men presenting to the ED with chest pain. 12-month mortality following percutaneous coronary intervention for men versus women was 7% and 12% respectively (p= 0.035) (Dreyer et al., 2013). The use of a traditional triage tool in the ED often leaves room for subjectivity and could contribute to a delay in care.

PICO question: In women presenting to the Emergency Department with chest pain, does the use of a traditional triage index tool cause a delay in care as compared to men with the same complaint?

Methods of Literature Search: Comprehensive literature searches of MEDLINE and CINHAL were completed. Article dates ranged from 2010-2020. 539 articles were found, and 5 addressing the PICO question were selected. Based on the Johns Hopkins Nursing Evidence-Based Practice Model, all articles were Level III and Quality B.

Findings from EBP Project: Evidence supports that the average treatment time was faster for men presenting with chest pain compared to women (p = 0.04) (Kuhn et al., 2013). Proportionally more women were triaged incorrectly compared to men (p < 0.001) leading to significant delays in initial treatment of women (Kuhn et al., 2013). Specifically, women experienced significant delays in initial examination (Mnatzaganian et al., 2019), door to balloon time (Dreyer et al., 2013), and time to initial ECG (Zégre-Hemsey et al., 2011).

Recommendations: Findings suggest women experiencing chest pain who present to the ED are more likely to receive delayed care. Further research is needed to determine if an objective triage tool exists or if one should be developed to eliminate this disparity. Additional research may also identify why this disparity exists.

Background and significance of clinical problem/question: Nurses are often responsible for facilitating communication with patient’s family members. Due to continuous changes in patient status and care plans, this is often time-consuming and can result in inconsistent communication resulting in nurses spending less time on patient care and increased family dissatisfaction.

PICO Question: In the adult intensive care setting, does daily nurse driven communication with patient's family improve family satisfaction compared to less frequent communication?

Methods of Literature Search: The literature was searched using CINAHL and Medline. Article dates ranged from 2015-2020. Keywords included communication, intensive care unit, family satisfaction, and family centered care. A total of 357 articles were found and 5 articles that addressed the PICO question were utilized. Based on the John Hopkins Evidence-Based Practice Model, the evidence ranged from level II-level V, and quality ratings were level A to level C.

Findings: Evidence supports the idea that family involvement in rounds can increase family knowledge regarding the patient’s care (p<0.001) and nurses felt that it supported patient advocacy (Allen, et al., 2016). Bell, et al. (2016) found that electronic communication via a portal improved family satisfaction and knowledge. Loeslie, et al. (2017) found that family knowledge and satisfaction increased with scheduled family meetings (p<0.01). The evidence consistently supports nurse driven communication improving family satisfaction and knowledge.

Recommendations for Practice: Based on the literature reviewed, there is not enough evidence to suggest a practice change and more research is needed. We recommend developing or finding a family satisfaction survey to assess communication strategies and performing a high quality randomized control trial with a consistent nurse education communication strategy based on that survey.