Poster Day 2022: Abstracts: Outreach & Narrative Review

Zara Siddiqui

Human trafficking (HT), the solicitation of persons for the purpose of commercial sex or forced labor through the use of force, fraud, or coercion, is a prevalent crime and human rights violation. Studies have found that up to 88% of HT victims visit with a health care professional at some point during their captivity, yet most go unidentified. The purpose of this review is to assess whether the medical field, specifically physicians and medical students, is prepared and equipped to recognize a victim of human trafficking and to intervene by providing the appropriate resources. 

This study was conducted via review of the current literature including prior studies that have assessed physician and medical student knowledge of HT as well as studies that have reviewed existing education and resources for physicians. 

Numerous studies found that most physicians and medical students lack knowledge of the scope of human trafficking and do not know how to intervene in situations of a trafficked patient. There remains limited published curricula regarding sex trafficking for medical trainees and only 4 medical schools across the US provide educational interventions on HT. Additionally, medical institutions are largely unequipped with standardized protocols to identify and treat victims of HT.

Given the disparity between the need for HT education as illustrated in this review and the presence of formal education and resources, healthcare providers and institutions are not yet appropriately equipped to identify and treat victims of human trafficking.

Somesh Singh, Jarrod Adkinson MD

Low Grade Gliomas have many characteristic mutations that continue to be studied today. IDH mutations are well known to be common among these types of tumors and indicate a favorable prognosis due to a decreased acidity of the tumor microenvironment.   

TERT, or telomerase reverse transcriptase, is another implicated gene and mutations in this gene alone indicate a poor prognosis due to a paradoxical enhanced survival of the tumor cell. Why then are combination TERT and IDH mutations associated with the best prognosis among these cancers is widely unknown. This presentation highlights some biochemical reasoning as to why this is. 

Andrew D. Vogel, M.S., Jennie H. Kwon, M.D., Alekhya Mitta, B.S., Curry Sherard, B.S., Kelvin G.M. Brockbank, Ph.D., Taufiek K. Rajab, M.D.

Pediatric valvular disease continues to be a topic of interest due to the clinical manifestations that present in these young patients. Complications from valve replacement including lack of valve growth and accelerated structural valve degeneration lead to morbid reoperations to replace the previous valve implant. Homologous or homograft heart valves present as a compelling option for valve replacement in the pediatric population but are susceptible to structural valve degeneration. The immunogenicity of homologous heart valves is not fully understood, and the field has not developed a well-documented comprehensive mechanism to illustrate how implanted heart valves are attacked.   

It has been demonstrated that preservation methods determine homograft cellular viability and there may be a direct correlation between increased cellular viability and higher immune response. This is composed of an early increase in HLA-class I and II antibodies over days to months post homograft implantation followed by the sustained increase in HLA-class II antibodies for years after implantation. Cytotoxic T lymphocytes and T-helper lymphocytes specific to both HLA classes can infiltrate tissue almost immediately after implantation. Furthermore, increased HLA-class II mismatches are synonymous with increased cell-mediated response and accelerated rate of structural valve degeneration, especially in younger patients. 

The immunological mechanisms composing certain homograft heart valves resemble the immunological response identified in solid organ transplantation. Further long-term clinical studies should be completed investigating the immunological mechanisms and their relation to structural valve degeneration as well as testing immunosuppressant therapies to determine the needed immunosuppression for homologous heart valve implantation.

Cory Pisarra and Dr. Robert Parker 

Kratom affects the pain-modulating descending pathways, including acting on the μ-opioid receptor without negative effects such as constipation. Mitragynine and 7-hydroxymitragynine are the main psychoactive alkaloids of kratom and are competitive antagonists at the kappa and delta-opioid receptors. Mitragynine has a weaker opioid effect, in comparison to other opioids. Despite these active ingredients being weaker than standard opioids, 7-hydroxymitragynine usage can result in dependency. As such, abstinence from kratom can lead to both physical and psychological withdrawal symptoms. Moreover, kratom dependency may cause chronic pain, diarrhea, fatigue, and unsociability. Notably, Kratom is currently sold in a wide variety of doses, packaging, and formulations for recreational intoxication but not for addiction treatment.    

Addiction affects 21 million Americans, contributing to a national health crisis. Standard treatment options like naltrexone, buprenorphine, and methadone transition opioid-addicted individuals to a sober lifestyle; however, most patients on these medications relapse. Kratom is currently being explored as an alternative to traditional medication regimens. 

This narrative review summarizes eight papers found on PubMed using a refined search: “kratom”, “kratom dosage”, “kratom addiction”, “kratom withdrawal”, and “kratom treatment”. 

If kratom administration and dosing were standardized for opioid-addicted individuals, going from a stronger opioid to a weaker partial agonist could ease the transition to abstaining from narcotics. While more robust research should compare kratom with other treatment modalities, kratom may be a viable OTC alternative for individuals that are struggling with substance abuse disorder.

Sarah Adkins-Jablonsky, Ryleigh Fleming, Marco Esteban, Cinnamin Cross, Amy Chatham, and Samiksha Raut 

Over 50,000 people die from opioid overdose per year in the United States, a particular cause for concern in states like Alabama that have higher rates of overall drug use. Science instructors have the unique opportunity teach students, particularly non-majors who otherwise have limited science training, how to better serve opioid-using populations.   

Previous studies have demonstrated the importance of engaging non-major students in innovative pedagogies like service-learning, but the impact of service-learning about opioids remains unexplored. We introduced a novel opioid service-learning module (including the science behind opioids, Naloxone training, and student discussions with physicians and former illicit substance user) in a non-major’s biology course in a central Alabama university. 

Following IRB approval, our assessment of the thematic analysis of open-ended pre- and post- module reflection data from 87 consenting students revealed the highest gains in students humanizing addiction and awareness of the cultural context of opioid addiction and increased awareness. We followed up with eight students in one-on-one semi-structured interviews, which further revealed students were personally impacted by the epidemic and greatly valued its curricular inclusion. 

Our data supports service-learning not only provides direct training for narcotic overdose related to opioids but enable students to envision the opioid epidemic as a phenomenon inexplicably intertwined with human lives. Continued work should champion much-needed advocacy by connecting opioids with the advancement of science education and public outreach.

Rebecca Donham

Clean air is shown to decrease incidence of heart disease, stroke, lung cancer, and both acute and chronic respiratory ailments. Air pollution-related illnesses cost over $150 billion in health-care related costs, $790 billion in lost productivity, and over 100,000 premature deaths in the United States annually.  

An immediate, widely implementable, cost-effective, and efficient technique for improving air quality is needed. Ideal solutions are those that can be distributed across multiple locations and communities within the United States with differing resources. Further, the ideal solution should be non-disruptive to each community, implore long-term and low-maintenance effects, engender nearly zero negative impacts, and exist without reliance on changes in community member’s social behaviors.

Titanium dioxide-infused paint reacts with particles of smog to convert them into a harmless neutral salt. Also known as Smog-Eating paint, this clear coated paint can be layered over the external face of buildings to effectively and immediately reduce air pollution. Within Dothan, AL, less than 2 gallons of Smog-Eating paint covers 800 square feet (the average size of one of it’s downtown murals) which neutralized 276,000 metric tons of carbon dioxide (equivalent in weight to 3 aircraft carriers) annually. A single coat of 2 gallons offsets more than the entirety of Dothan’s vehicle emissions produced every year. Two gallons of titanium dioxide-infused paint have a one-time estimated investment of under $1500 and last over 10 years without maintenance.

Smog-eating paint is a simple, low-risk, high-impact solution to immediately improve air quality and ameliorate air pollution-related illnesses and associated costs.

Neil Vuppala, Amogh Reddy, Austin Nguyen, Rajesh Metuku

Monkeypox is the most significant orthopoxvirus since the eradication of smallpox. The enveloped dsDNA virus is a high-threat pathogen with a mortality rate of 10%, endemic to Africa, and spread via close contact with other infected individuals through lesions, body fluids, and respiratory droplets. Monkeypox has since been imported into the US with insufficient data about its virulence and spread.   

A search of CDC and PolicyMap was performed to determine factors causing a higher prevalence of monkeypox. Graphs obtained from PolicyMap include Estimated Number of Same-sex Unmarried Partners between 2016-2020 and Estimated Number of Same-sex Married Partners between 2016-2020. Graphs obtained from CDC include United States Monkeypox Case Reporting Rate and Total JYNNEOS Vaccine Doses Administered. 

By comparing both sets of data, there was no clear overlap between areas with high density of same-sex couples and areas with high monkeypox reporting rates. Based on this lack of overlap, we found there to be no sufficient evidence showing that same-sex couples are at a disproportionately higher risk of contracting monkeypox.  

Monkeypox appears to be more prevalent in gay populations because they are isolated and close contact is conducive to rapid spread. While anyone is at risk of getting monkeypox, it seems that the gay population is more proactive in getting care, explaining the high rates of gay people getting tested. This study dispels the notion that monkeypox is a disease limited to the LGBTQ community. Getting more information over time will help us better understand the disease.