2025 Wiggins Memorial Library Academic Symposium

Assessing the risk of major adverse cardiac events (MACE) before initiating aerobic exercise is vital with direct access to physical therapy (PT). While there are various methods, PT lacks a standardized approach. This scoping review yielded 1,519 articles; 35 articles met established criteria. Five methods were identified: (1) risk factor assessment (2) questionnaires (3) calculators (4) physical examinations (5) exercise testing with electrocardiogram. Risk factor assessment yielded the most statistical information regarding MACE. Risk calculators provided a clearer assessment low, medium, or high-risk categories. PTs can use these tools to assess risk and identify patients that require further evaluation.

Over the past few decades in the US, opioids, despite their limited effectiveness for long-term pain management and addictive nature, were commonly prescribed for acute and chronic non-cancer pain. This has contributed to a significant public health crisis in which overdose deaths have surged. The current study analyzed National Ambulatory Medical Care Survey (NAMCS) data from 2010-2019 to assess the association between chronic pain diagnoses and visits with an opioid, while also considering factors like visit demographics and characteristics. Chronic pain visits had higher odds of receiving opioids, suggesting opioid use from 2010-2019 contradicted current guidelines, emphasizing the guidelines’ importance.

Research suggests mental health challenges escalated during the COVID-19 pandemic, posing historic public health concerns. This study evaluated the pandemic’s impact on anxiety and depression among U.S. adults from 2019 through 2022 via the National Health Interview Survey. Understanding the prevalence and factors influencing these conditions is essential to address resource allocation, treatment strategies, and preventive interventions. Suitable for clinicians, researchers, and policymakers.

The Johnston County Health Department has the highest number of permitted Mobile Food Units (MFUs) across all North Carolina counties. Despite this, less than 2% of MFUs undergo the three yearly required food safety and health inspections due to key challenges of MFU mobility outside of county lines and communication barriers. This project will explore these challenges through analysis of phone-based surveys and propose strategies to improve the Johnston County Health Department’s permit application process and knowledge of MFU operational patterns.

For centuries, plants have played a vital role in medicinal practices. Flavonoids, polyphenols, and anthocyanins found in plants provide important antioxidant benefits. Aristotelia chilensis (Maqui) and Berberis microphylla (Calafate) are a tree and an evergreen shrub native to the temperate rainforests of Chile and southern Argentina and are both recognized for their antioxidant-rich berries. Neuroblastoma (NB) is a tumor of the peripheral nervous system and is the most common cancer and extracranial solid tumor in infants. N18TG2 is an established mouse NB cell line. We hypothesize that Maqui leaves extract and Calafate berry extracts exert anti-proliferative effects on N18TG2 cells.

This study examined fibromyalgia diagnosis trends and associated comorbidities using NAMCS data from 2010-2019, evaluating changes as the American College of Rheumatology's criteria evolved from 1990 to 2016. FM diagnosis increased after the 2010 criteria but decreased significantly following the 2016 revisions. Rheumatoid arthritis (OR 5.51, 95% CI 2.87-10.58) and depression (OR 2.61, 95% CI 1.90-3.58) were strongly associated with fibromyalgia diagnosis, while other comorbidities had minimal associations. The fluctuation in diagnosis post-2016 criteria suggests current criteria may not accurately capture fibromyalgia's complexity, highlighting rheumatoid arthritis and depression as key comorbidities in fibromyalgia diagnosis.

Metoprolol succinate, a commonly prescribed beta blocker for heart failure, can cause underrecognized central nervous system (CNS) effects such as hallucinations, delirium, and sleep disturbances. The likelihood of these effects depends on the drug's lipophilicity. We report a heart failure patient who developed new-onset visual hallucinations after starting metoprolol succinate. Once the association between beta blockers induced hallucinations was recognized, metoprolol was discontinued leading to resolution of symptoms. This case highlights the importance of recognizing this potential adverse effect of beta blocker induced hallucinations, as well as understanding the differences among agents within this drug class.

Significant challenges exist related to women’s health during childbirth, including complications from pain management, emergency cesarean births due to complications, and effects of coexisting conditions. A literature search was conducted based on the PICO question, “If pregnant women add moderate exercise into their daily life, what impact does it have on the reduction of birth complications as compared to a lack of moderate daily exercise?” Overall, results show implementing a daily, moderate exercise program is beneficial for reducing labor complications in healthy women. Future research should focus on the effect of exercise during pregnancy in women with existing health conditions.

Within various healthcare environments worldwide, healthcare personnel and patients alike are often surprised by the prevalence of violent encounters. Healthcare organizations would seldom choose to be defined as facilities that are unsafe to care for their patients. Government data shows healthcare personnel account for 73% of violent related injuries that require time off to recover. It is important to recognize warning signs and provide support to organizations that appeal to lawmakers on behalf of healthcare workers. In understanding the repercussions of workplace violence, healthcare systems must implement effective changes to the training programs that are provided to their employees.

Mental health services must improve. A New Jersey law increased psychiatric involuntary commitment in emergency departments, delaying transfer to a psychiatric facility. Although this law was created with positive intent, it does not address the root issue: the inability of people to find adequate psychiatric care in their communities. Emergency department directors, staff, and patients agree that the emergency department lacks resources to provide specialized treatment for this population. Patients with longer stays are at greater risk for complications. The state should focus on increasing community funding to provide preventive care, psychiatric walk-in clinics, employment, and transportation.

This study sought to assess the relationship between receiving education (on diabetes, exercise, weight reduction, diet/nutrition) and patient characteristics among adults with Type II Diabetes Mellitus (T2DM). This was a retrospective, cross-sectional study using data from the National Ambulatory Medical Care Survey (2012-2019). Multivariable logistic regression models were constructed to evaluate available predictors of interest on each type of education received. No racial/ethnic disparities were identified. Disparities in patient education for rural areas, visits to a specialist, and smokers highlight the necessity of targeted interventions to improve education access. The poster will provide complete study findings, conclusions and a discussion.

This project tested a hypothesis for a novel cause of bipolar disorder involving changes in levels of brain cholesterol. Mice were treated daily for 7 days with a vehicle (as a control) or a combination of 2 drugs at two different doses. These treatments were hypothesized to reduce brain cholesterol. At the end of the treatment, mice were tested for signs of depression using the spontaneous activity test, change in body weight and the forced swim test. Final results indicated that the only significant effect of either treatment with either dose was that drug-treated mice gained less weight than controls.

A tablet that effectively combines immediate and modified-release properties will be developed by compressing the tablet with a hollow core, applying an enteric coating, and filling the core with concentrated drug granules. Acetaminophen will be used as a model drug. The thickness, hardness, friability, and disintegration tests will be performed on the tablets. Key manufacturing parameters, including formulation matrix, choice of excipients, and coating will be optimized to achieve the desired release profile. A design of experiment (DoE) approach will be implemented via to systematically evaluate and refine these parameters, ensuring the effective release and stability of the formulation.

Physician-assisted suicide or physician-assisted death (PAD) occurs when a healthcare professional aids in providing lethal medication to a patient with a terminal illness. Healthcare policy plays a vital role in shaping protocols related to this issue. North Carolina is 1 of 4 states that has no specific laws or policies regarding physician-assisted death. Whether or not policymakers believe physician-assisted suicide should be legal, there should be clear legislation to determine a physician's role in PAD to eliminate confusion for the physician and patient. Physician-assisted suicide is an ethical issue that requires legislation for the safety and legal practice of physicians.

Montelukast, approved by the FDA in 1998, is a widely prescribed leukotriene receptor antagonist for asthma, exercise-induced bronchoconstriction, and allergic rhinitis. Concerns about its neuropsychiatric side effects prompted several FDA labeling updates, including an update to the patient and prescribing information to include several post-marketing adverse events including depression, suicidality, and anxiety in 2007, an update to the “precautions” of drug’s prescribing information in 2009, ultimately a Black Box Warning in 2020. This study aimed to analyze prescribing trends of montelukast before and after FDA safety warnings using data from the National Ambulatory Medical Care Survey (NAMCS) for 2003–2019.

This observational, retrospective, cross-sectional study included outpatient visits for patients aged two years and older with respiratory complaints. This study was deemed not human subject research by the Campbell University Institutional Review Board due to the nature of the publicly available de-identified database. The primary outcome was the proportion of visits with montelukast. The primary predictor compared two periods: 2003–2007 (pre-warning) and 2008–2019 (post-warning). Secondary and tertiary analyses assessed prescribing trends and the association of demographic and clinical factors available in the dataset with montelukast use. Statistical methods included a plot of the proportion of visits with montelukast by year and a multivariable logistic regression model (MLRM).

Findings showed a slight decline in montelukast prescribing, from 5.3% of visits in 2003–2007 to 4.4% in 2008–2019 (OR 0.89, 95% CI 0.70–1.14, from the MLRM after adjusting for covariates). The plot of the annual proportion of visits with montelukast revealed a slight decline in prescribing over time, with a significant drop in prescribing after 2007, coinciding with updated FDA safety information. The MLRM provided no evidence of significant predictors or the identification of disparities between groups/levels of demographic variables.

The findings suggest that FDA safety communications and the introduction of alternative therapies may have influenced prescribing practices.

The study aims to express and purify the receptor-binding domain (RBD) of the SARS-CoV-2 spike (S) protein using recombinant protein techniques and evaluate its binding affinity to the human ACE2 receptor. HEK293T cells were transfected with two plasmids: one expressed RBD fused with a His-tag allowing protein purification via immobilized metal affinity chromatography (IMAC) and the other expressed RBD fused with an sfGFP-tag allowing fluorescence detection of protein expression. Purification of the recombinant His-tagged RDB and sfGFP-tagged RBD protein products using IMAC, Hydrophobic interaction chromatography (HIC) and Ion exchange chromatography is ongoing. BCA protein assay, SDS-PAGE, Western blotting, and ELISA will be performed to assess expression yield, purity, and binding interactions. The research enhances understanding of the effects of two common tags on SARS-CoV-2 RBD dynamics and their potential applications in diagnostics, therapeutics, and vaccine development against COVID-19.

Oxidative stress plays a crucial role in Alzheimer’s disease (AD) pathology. This study explores the potential of targeting the Keap1-Nrf2 pathway as a therapeutic approach. Keap1 negatively regulates Nrf2, a key antioxidant defense mechanism. Using molecular modeling and virtual screening, we identified and modified compounds such as Andrographolide, Farrerol, and Curcumin analogs to enhance their binding affinity to Keap1. By disrupting Keap1-Nrf2 interaction, these compounds could activate Nrf2, reducing oxidative damage and neuroinflammation. Our findings highlight promising drug candidates for AD treatment, with improved binding affinity and potential blood-brain barrier penetration.

A 33-year-old male with a past medical history of a traumatic brain injury (TBI) secondary to a fall 8 years prior, attended the Campbell Community Wellness Clinic for physical therapy services. Upon evaluation, impairments in ankle mobility were hypothesized to impacted running speed and distance. Pre-intervention, the patient was able to run 0.4 miles at 4.14 mph. Interventions during an 8-week program consisted of therapeutic exercise, taping, and manual therapy to improve ankle range of motion. The patient’s time, distance and speed varied from week to week proving no correlation in interventions and running outcomes this patient.