Athletic Training Student Patient Encounter Characteristics during Immersive and Non-Immersive Experiences: A Report From the Athletic Training Clinical Network

Context: Professional athletic training programs are now required to include at least one immersive clinical experience (ICE), which allow students to see more patient-care opportunities and job responsibilities that athletic trainers complete than those at a non-immersive clinical experience (N-ICE). Therefore, the purpose of this study was to compare the characteristics of patient encounters (PEs) that occurred at ICEs and N-ICEs. Methods: This study used a multi-site panel design in which 336 athletic training students from 12 professional, CAATE-accredited programs (5 undergraduate, 7 graduate) logged PEs for one academic year (2018-2019). PEs were documented in E*Value (MedHub, Minneapolis, MN), and descriptive statistics were used to summarize the characteristic of each PE. Chi-Square tests were used to compare the percentages of student role during PEs in ICEs and N-ICEs (p\u3c0.05). Results: A total of 10,999 PEs occurred at ICEs and 18,228 PEs occurred at N-ICEs. Immersive experiences mostly occurred at collegiate settings (64%) followed by secondary school settings (29.8%); similar frequencies were found with N-ICEs (collegiate=67.2%, secondary school=24.4%). At ICEs, students performed 70.6% of reported PEs, assisted with 17.2%, and observed 12.2%. At N-ICEs, students performed 72% of reported PEs, assisted with 16.3%, and observed 11.7%. Participants averaged 0.80 diagnoses and 1.35 procedures per PE during ICEs, compared to 0.82 diagnoses and 1.33 procedures per PE during N-ICEs. Chi-square analyses revealed that there were no significant differences in the percentages of observed (χ2(1) = .00, p=1.00), assisted (χ 2(1)=.03, p=.862), or performed (χ 2(1)=.007, p=.933) PEs between ICEs and N-ICEs. Conclusions: Student role during PEs, clinical site type, and PE length similarly occurred at both ICEs and N-ICEs. Programs may intend to use ICEs later in their curriculum to demonstrate progressive clinical autonomy, but there were no statistically significant differences in student role during ICEs or N-ICEs in this study.https://digitalcommons.odu.edu/gradposters2020_healthsciences/1005/thumbnail.jp

Peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) restores carbapenem susceptibility to NDM-1-positive pathogens in vitro and in vivo

The objective of this study was to test the efficacy of an inhibitor of the New Delhi metallo-β- lactamase (NDM-1). Inhibiting expression of this type of antibiotic-resistance gene has the potential to restore antibiotic susceptibility in all bacteria carrying the gene.Methods: We have constructed a peptide-conjugated phosphorodiamidate morpholino oligomer (PPMO) that selectively inhibits the expression of NDM-1 and examined its ability to restore susceptibility to meropenem in vitro and in vivo.Results:In vitro, the PPMO reduced the MIC of meropenem for three different genera of pathogens that express NDM-1. In a murine model of lethal E. coli sepsis, the PPMO improved survival (92%) and reduced systemic bacterial burden when given concomitantly with meropenem.Conclusions: These data show that a PPMO can restore antibiotic susceptibility in vitro and in vivo and that the combination of PPMO and meropenem may have therapeutic potential against certain class B carbapenem- resistant infections in multiple genera of Gram-negative pathogens

Mitochondria Exert Age-Divergent Effects on Recovery from Spinal Cord Injury

The extent that age-dependent mitochondrial dysfunction drives neurodegeneration is not well understood. This study tested the hypothesis that mitochondria contribute to spinal cord injury (SCI)-induced neurodegeneration in an age-dependent manner by using 2,4-dinitrophenol (DNP) to uncouple electron transport, thereby increasing cellular respiration and reducing reactive oxygen species (ROS) production. We directly compared the effects of graded DNP doses in 4- and 14-month-old (MO) SCI-mice and found DNP to have increased efficacy in mitochondria isolated from 14-MO animals. In vivo, all DNP doses significantly exacerbated 4-MO SCI neurodegeneration coincident with worsened recovery. In contrast, low DNP doses (1.0-mg/kg/day) improved tissue sparing, reduced ROS-associated 3-nitrotyrosine (3-NT) accumulation, and improved anatomical and functional recovery in 14-MO SCI-mice. By directly comparing the effects of DNP between ages we demonstrate that mitochondrial contributions to neurodegeneration diverge with age after SCI. Collectively, our data indicate an essential role of mitochondria in age-associated neurodegeneration

Trans-cerebral HCO3- and PCO2 exchange during acute respiratory acidosis and exercise-induced metabolic acidosis in humans

This study investigated trans-cerebral internal jugular venous-arterial bicarbonate ([HCO(3)(−)]) and carbon dioxide tension (PCO(2)) exchange utilizing two separate interventions to induce acidosis: 1) acute respiratory acidosis via elevations in arterial PCO(2) (PaCO(2)) (n = 39); and 2) metabolic acidosis via incremental cycling exercise to exhaustion (n = 24). During respiratory acidosis, arterial [HCO(3)(−)] increased by 0.15 ± 0.05 mmol ⋅ l(−1) per mmHg elevation in PaCO(2) across a wide physiological range (35 to 60 mmHg PaCO(2); P < 0.001). The narrowing of the venous-arterial [HCO(3)(−)] and PCO(2) differences with respiratory acidosis were both related to the hypercapnia-induced elevations in cerebral blood flow (CBF) (both P < 0.001; subset n = 27); thus, trans-cerebral [HCO(3)(−)] exchange (CBF × venous-arterial [HCO(3)(−)] difference) was reduced indicating a shift from net release toward net uptake of [HCO(3)(−)] (P = 0.004). Arterial [HCO(3)(−)] was reduced by −0.48 ± 0.15 mmol ⋅ l(−1) per nmol ⋅ l(−1) increase in arterial [H(+)] with exercise-induced acidosis (P < 0.001). There was no relationship between the venous-arterial [HCO(3)(−)] difference and arterial [H(+)] with exercise-induced acidosis or CBF; therefore, trans-cerebral [HCO(3)(−)] exchange was unaltered throughout exercise when indexed against arterial [H(+)] or pH (P = 0.933 and P = 0.896, respectively). These results indicate that increases and decreases in systemic [HCO(3)(−)] – during acute respiratory/exercise-induced metabolic acidosis, respectively – differentially affect cerebrovascular acid-base balance (via trans-cerebral [HCO(3)(−)] exchange)