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Determining Prosthesis Acceptance: Differences in Patient Characteristics and Utilization of Rehabilitation after Lower Limb Amputation
No full textPeople with lower limb amputation that use a prosthesis have higher quality of life and mobility than those who do not, and prosthesis fitting occurs after comprehensive medical care and rehabilitation. However, the amount of medical care and rehabilitation provided for different causes of amputation preceding prosthesis fitting and receipt is unknown. This study aims to retrospectively identify the medical care and rehabilitation necessary for people with lower limb amputation from vascular and non-vascular etiologies to have an initial prosthesis fitting
CULTIVATING SUPPORTIVE AND CARING IEP PROCESSES: ADDRESSING THE UNDERLYING CONDITIONS FOR SPECIAL EDUCATORS
No full textStudents with disabilities and their families have a right to informed consent in a supportive and caring IEP process. To do so, understanding the conditions that impact special educator professional capacity and effective collaboration between special educators and the general education teachers and administrators is necessary. In a participatory activist and action research (PAAR) study at an urban charter high school in Oakland, California, I facilitated a project and study as a practitioner-researcher and worked closely with a co-practitioner researcher (CPR) team of site-based special educators. Using Community Learning Exchange (CLE) axioms and practices (Guajardo et al., 2016) to examine current practices, I determined two finding related to the underlying conditions that are necessary for effective IEP processes: (1) To cultivate the necessary emotional resilience that special educators need for their work, the special educators need structured time for personal and professional reflection, and (2) special educators and general education teachers must engage in conversations about shared values and the school processes necessary for effective collaboration before they can co-plan inclusive practices and co-develop supportive IEP processes for students and families. To address the underlying conditions necessary for effective IEP design and implementation, schools must mitigate the impact of burnout and compassion fatigue by tending to the emotional resilience of special educators and providing space and time for individual and collective reflection and self-care. In addition, school leaders must design systemic structures that provide time and space for collaborating, building relational trust, and centering decisions on a shared values system that encourage collaborative practices to address the needs of students with disabilities. Broader implications include improving the preparation of administrators and special educators for the responsibilities related to serving students with disabilities, providing coaching and mentoring to administrators and special educators early in their careers, and expanding opportunities for building relational trust and deeper understanding of the hopes and dreams of our students and families
Complementary Analysis of Colorectal Cancer-Associated DNA Using Square Wave Voltammetry and LC-MS/MS in a Murine Model
No full textMitochondrial dysfunction has emerged as a critical factor in colorectal cancer development, contributing to altered cellular metabolism, increased oxidative stress, and genomic instability that can drive carcinogenic processes. To study mitochondrial dysfunction's role in carcinogenesis, colorectal cancer model NDUFS4 knockout (KO) mice were analyzed alongside wild-type (WT) controls. Electrochemical methods coupled with liquid chromatography-tandem mass spectrometry (LC-MS/MS) were applied to investigate DNA modifications in colorectal cancer under conditions of mitochondrial dysfunction. Square wave voltammetry (SWV) at layer-by-layer modified electrodes with immobilized DNA allowed detection of guanine oxidation changes catalyzed by the electrochemical mediator, Ru(byp)32+. Peak current differences of tumor samples compared to normal samples indicated DNA structural alterations, which were validated through comprehensive LC-MS/MS base compositional analysis of acid-hydrolyzed DNA samples.
Applying the electrochemical approach, DNA from WT tumor samples displayed
statistically significant (p < 0.05) decreased oxidative currents versus normal tissue, a response consistent with guanine depletion. In contrast, KO sample sets showed heterogeneous responses, with some exhibiting increased currents suggesting guanine preservation, while others showed decreased currents similar to WT trends. Subsequent LC-MS/MS composition analysis validated these findings, allowing quantification of all four DNA bases (guanine, adenine, cytosine, thymine) and detection of oxidatively damaged bases (8-oxoguanine) and epigenetic modifications (5-methylcytosine).
The electrochemical-LC-MS/MS analysis approach revealed three potential carcinogenic pathways: a classical oxidative damage pathway in WT tumors characterized by G:C to A:T transitions and global hypomethylation; a protective adaptation pathway in the KO Set 1 tumor sample showing enhanced G:C content preservation and stable methylation; and a compromised repair pathway in KO Set 2 tumor samples exhibiting 8-oxoguanine accumulation with nucleotide depletion. The results suggest a hypothesis that mitochondrial complex I deficiency fundamentally alters the mechanisms of DNA modification in colorectal cancer. This work provides insight into the complex relationship between mitochondrial dysfunction and genomic instability, opening new avenues for understanding and treating metabolically-driven cancers.
Strong correlations between guanine content changes and electrochemical signals validated the reliability of the electrochemical method for rapid DNA modification screening. Combining electrochemical and mass spectrometry techniques provided validation of DNA modifications observed in cancer progression while offering a versatile, cost-effective approach to investigate metabolic influences on genomic stability
Exploring Self-Awareness of Emotions Among BSN Nursing Students: Developing Strategies to Manage Emotions Through Reflective Practice
No full textThe development of emotional intelligence (EI) for BSN students is crucial to further their critical thinking skills and assurance of patient safety. The concept of EI has been defined in a multitude of ways, though lead theorists have defined it as the ability to recognize, integrate, and understand emotions to facilitate thinking and manage emotions to support personal growth. Literature supports that the implementation of EI in nursing curricula empowers students to handle emotionally charged situations confidently, competently, and safely by firstly understanding their own emotions. Additionally, EI works synergistically with the rational mind to enhance intellectual abilities, directly impacting an individual’s success in their role. The purpose of this study was to explore student perceptions of how self-awareness of emotions influenced the development of strategies to manage their emotions in future situations. IRB approval was obtained prior to analysis. Secondary qualitative data analysis was conducted using in vivo and focused coding of reflective prompts in journals kept by BSN students in a mental health clinical rotation. The data was gathered in the spring of 2023 from a convenience sample of 31 participants and was de-identified prior to analysis to maintain anonymity. Thematic analysis revealed four themes: Understanding Others’ Perspectives, Grounding Self with Mindfulness and Intentionality, Communicating to Connect, and Taking a Breath. Supporting the development of EI in the nursing curricula is important to help students identify and understand their emotions to guide clinical decision-making and ensure safe patient care is provided
The effect of the cold pressor test on arterial wave reflection amplitude and timing in young healthy adults
No full textSympathoexcitatory stimuli, such as the cold pressor test (CPT), increase vascular resistance and brachial blood pressure. Cardiovascular responses to the CPT can predict cardiovascular risk. Previous research has demonstrated that surrogate measures of wave reflection (augmentation index) are increased during the CPT. However, this measure does not differentiate the effect of wave reflection amplitude and return time of the reflected wave. The purpose of this study was to test the hypothesis that the CPT would increase the amplitude of the backward pressure wave and result in an earlier return of wave reflection. Methods: Twelve non-obese, non-hypertensive, healthy adults between the ages 18 – 40 years participated. For the CPT, participants submerged their hand in ice water for three minutes. Brachial blood pressure and arterial pressure waves were measured via applanation tonometry at baseline and during the last minute of the CPT. Wave separation analysis was performed to determine the maximal amplitude of forward and backward pressure waves as well as the reflected wave transit time. Reflection magnitude was calculated as ratio of backward relative to forward pressure wave amplitude. Results: In agreement with previous research, there was a significant increase in aortic systolic and diastolic blood pressure, as well as augmentation index (all, p<0.05). The novel finding was that despite
no changes in the forward pressure wave amplitude (28.16.8 vs. 28.19.4 mmHg, p=0.997), there was a significant increase in the backward pressure wave amplitude (10.82.7 vs. 12.85.4 mmHg, p=0.043) as well as reflection magnitude (386 vs. 455%, p=0.001). Lastly, there was a trend for a shortened reflected wave transit time (332.465 vs. 28860.1 ms, p=0.02). Conclusion: A sympathoexcitatory stimuli (i.e. CPT) in young healthy adults increased the amplitude of the backward pressure wave and tended to lead to an earlier arrival of wave reflections to the heart
Empowering Families Through Online Access: A Digital Toolkit for Adolescent Substance Use Support
No full textAdolescent substance use disorder (SUD) is a critical public health concern, often resulting in long-term cognitive, emotional, and social consequences. Families navigating adolescent SUD face significant barriers, including limited access to comprehensive, accessible, and stigma-free resources. This Doctor of Nursing Practice (DNP) project aimed to address this gap by designing and implementing a community-specific, evidence-informed website toolkit for families in Carteret County, North Carolina. Guided by the PRECEDE-PROCEED model and King’s Theory of Goal Attainment, the project engaged interdisciplinary partners to develop a digital platform offering crisis intervention contacts, legal and therapeutic support links, educational materials, and peer-guided strategies.
Outcome measures included quantitative engagement tracked via Google Analytics and qualitative feedback collected through online surveys. Although engagement rates partially met initial targets, analytics revealed sustained user interest, high interaction with critical resource pages, and positive qualitative feedback. Identified barriers included limited survey participation and initial site visibility, informing future enhancements. This project demonstrates how nurse-led digital interventions can bridge service gaps, align with national health objectives, and offer scalable models adaptable to other rural and underserved communities. By leveraging technology and interdisciplinary collaboration, the resource toolkit empowered families with accessible tools to support adolescent recovery and familial resilience.D.N.P
Investigating Cadmium and Calcium Binding to Full-length Human Cardiac Troponin C Using Intrinsic Fluorescence
No full textCadmium (Cd), a prevalent toxic metal, poses significant health risks even at low exposure levels, particularly affecting cognitive development, kidney function, and cardiovascular health. Previous research has indicated that divalent Cd can bind to and potentially displace divalent calcium (Ca) ions from essential binding proteins, disrupting Ca-dependent cellular signaling pathways. However, there are gaps in the literature regarding how this process occurs at a molecular level. This study aims to characterize the binding affinities of Cd to human cardiac troponin C (hcTnC), a key calcium-binding protein involved in heart muscle contraction, using intrinsic fluorescence spectroscopy. The results demonstrate that Cd binds to hcTnC with significantly higher affinity than Ca, with the first Cd ion binding more tightly than the second, unlike the cooperative binding of Ca. The results of this study enhance our understanding of how Cd interacts with proteins at the molecular level and contribute to the broader body of research on toxic metal interactions. Additionally, this study offers valuable information for developing novel methods to remove Cd from individuals exposed to this toxic metal
Biodiversity and habitat characteristics as indicators of community change following oyster reef restoration
No full textAs coastal habitats, oyster reefs are often on the frontlines of both direct and indirect sources of anthropogenic ecological degradation. This has profound impacts on both the structure and function of these foundational habitats, which offer a litany of ecosystem services to the surrounding environment and its inhabitants as well as the nearby coastal communities. Restoration of these ecologically significant habitat-forming species offers not only a way to study the resilience and recovery of communities following human disturbance and over time, but also provides a mechanism for restoring lost ecosystem function and services following these disturbances. To this end, two oyster restoration approaches were implemented in 2018 in the Rachel Carson Reserve in Beaufort, North Carolina: a traditional shell bag approach, and at the time, a novel biodegradable substrate, Oyster CatcherTM. These restored sites underwent initial post-restoration monitoring (habitat: 2018-2020 and biodiversity: 2018-2019), but had not been reassessed since that time. My project analyzed changes habitat characteristics and community composition of the two restoration approaches and nearby natural reefs five years post-restoration relative to these earlier monitoring points. My results shed light on the roles that substrate and time can play on the effectiveness of oyster reef restoration efforts, as well as the applicability of restoration as a tool for studying ecological succession.
For habitat characteristics, I compared previous monitoring data to samples collected in 2023 to determine how oyster densities and elevation varied by restoration treatment. While oyster densities steadily increased from 2018-2020 in the previous monitoring effort, my results showed a significant decrease in oyster densities from 2020-2023. Moreover, in 2020, the restored oyster reefs were within the “Optimal Growth Zone”, while in 2023, varying water levels resulted in all live oysters on the reefs residing above this ideal elevation range. In all cases, however, Oyster Catcher reefs outperformed shell bag reefs in terms of oyster densities, offering some insight into the potential application of novel breakwater substrates to the issue of oyster reef restoration efforts.
For community composition, I examined both free-living and parasite communities and compared samples gathered in 2023 to previous data to understand how these metrics have changed with time since restoration. While free-living fish communities peaked in biodiversity one-year post restoration, the species documented are typically more transient species; by contrast, the species more strongly affiliated with the 2023 samples (the oyster toadfish, Opsanus tau, for example) are broadly recognized as true reef resident species. Free-living crab communities showed a different trend, with biodiversity increasing with time post-restoration. In both cases, treatment was not a significant driver of community composition, although mud crab abundances appeared to be higher at restored reefs than nearby loose cultch reefs. For parasite communities, samples collected from fish and snail hosts broadly reflected trends described in previous literature, with increasingly prevalence and biodiversity with time. However, crab parasite data revealed a peak in prevalence one-year post-restoration, with significantly lower prevalence across most taxa in 2023. These results illustrate the utility of using surrogate taxa, such as parasites, to augment biodiversity surveys and provide an additional metric by which community composition and function can be assessed. Above all, the habitat and biodiversity results collectively stress the importance of monitoring oyster reef restoration projects over time, as early post-restoration trends do not consistently reflect the long-term condition of these efforts
EXPLORING THE ETHICAL DECISION-MAKING DIFFERENCES BETWEEN ACCOUNTING STUDENTS AND PROFESSIONALS
No full textPossessing the skill of ethical decision making is crucial for accounting professionals. This is so important that continuing education exploring ethics is required for CPAs to maintain their licensure. Despite the importance placed on ethics at the professional level, there is debate about when and where professionals should begin to develop ethical decision making. This study examines the differences in ethical decision-making for seasoned professionals and those that are beginning their accounting careers. By surveying both undergraduate and graduate accounting students along with accounting professionals, this study will help to determine whether ethics education should be introduced earlier in a student’s educational journey. These individuals were surveyed using a ten-question scenario-based quiz to evaluate their ethical reasoning. The undergraduate accounting students represent those that have received minimal ethics education, graduate students represent those who have received some ethics education, and professionals representing those who have developed experience in ethical decision-making. In addition to examining when ethics education should be introduced, the study also intends to provide broader insight into how ethics education can impact the accounting profession