Moravian University

Research, editorials, anecdotes, and personal experience in the classroom after the COVID-19 pandemic all point to one reality: Student resilience and persistence on assignments, especially those requiring critical thinking, are less robust than before the lockdown began in the spring of 2020. Through the lens provided by the discipline of psychology, we review some post-pandemic challenges educators face (including student mental well-being issues, students’ perceptions of the value and meaning of academics or thinking critically, the prevalence of social media and technology use among students, and the plethora of dis- and misinformation) when trying to promote critical thinking about human behavior among our students. We suggest strategies for helping students navigate these challenges in order to create a classroom context that fosters the learning of critical thinking skills. Our focus will be on providing practical guidance for educators to apply in their classroom teaching and when constructing assignments.

Cancer screening can detect cancer at an early stage and decrease cancer morbidity and mortality. Refugee populations may have had limited access to cancer screening before arrival in the United States. A cross-sectional analysis of cervical, breast, and colorectal cancer screening was conducted among refugees with primary care visits between 2018 and 2022 at a refugee health clinic in Philadelphia, Pennsylvania. Cancer screening outcomes included the number and type of screenings; the number of normal, inconclusive, and abnormal screening results; completion of follow-up tests for inconclusive and abnormal results; and the number of cancer diagnoses. Among 149 refugee women aged 21–65, 80.5% were screened for cervical cancer at least once. Among 181 cervical cancer screenings, 89.0% were normal, 3.9% were unsatisfactory, and 7.2% were abnormal. Among 38 refugee women aged 50–74, 92.1% were screened for breast cancer at least once. Among 111 breast cancer screenings, 81.1% were normal, 11.7% were incomplete, and 7.2% were abnormal. Among 107 refugees aged 50–75, 80.4% were screened for colorectal cancer at least once. Among 189 colorectal cancer screenings, 76.2% were normal, 11.1% were inconclusive, and 12.7% were abnormal. There were 0 cancer diagnoses. Longitudinal outcomes beyond the domestic medical exam are valuable to provide insight into cervical, breast, and colorectal cancer screening among refugees in the United States. This could serve as a foundation for future quality improvement interventions to increase cancer screening.

The rising demand for assistive technology (AT) highlights the potential of 3D printing as an innovative occupational therapy (OT) tool. This cost-effective technology enables the creation of customized AT devices that enhance client participation and well-being through remediation and adaptive approaches. However, adoption in OT practice faces several barriers, including limited practitioner awareness, insufficient training, and time and maintenance challenges. This commentary proposes a tiered approach focused on expanding education and integrating 3D printing into OT training and practice settings. In addition, it advocates for developing and using validated outcome measures to evaluate the effectiveness of 3D-printed devices. Client-reported satisfaction and participation metrics should be prioritized across practice settings to ensure that 3D-printed devices meet occupational goals and user needs. Expanding educational opportunities and developing validated assessment tools focusing on participatory outcomes will support broader integration of 3D printing in OT practice, improving AT access through client and practitioner collaboration.

Background/Objectives: As the world’s population ages, the growing number of individuals affected by Alzheimer’s disease and related dementias (ADRDs) will undoubtedly continue to impose social and economic challenges. Informal caregivers play a crucial role in providing essential support for individuals with ADRD. However, there is limited research that investigates the psychosocial functioning of caregivers (partners) from minoritized groups. Methods: This study aimed to explore the experiences of lesbian, gay, bisexual, transgender and queer (LGBTQ+) caregivers of individuals with ADRDs. Semi-structured in-depth interviews were conducted with seven caregivers of partners diagnosed with ADRDs. Three themes were identified based on reflexive thematic analysis: (i) experiencing familial alienation; (ii) fear about the future; and (iii) finding strength in the face of adversity. Results: The research highlighted difficulties reported by LGBTQ+ caregivers, while also showing how such caregivers cope. The findings provide a basis for developing targeted interventions for caregivers from minoritized groups. Conclusions: These findings have important implications for policy and intervention development concerning LGBTQ+ caregivers’ mental and physical health outcomes.

Background Achilles tendinopathy is a common overuse condition that can become persistent despite conservative treatment. Sensitization of both the peripheral and central nervous systems may contribute to the persistent pain. Both exercise and electrical stimulation have the potential to modulate the nervous system’s sensitivity to painful stimuli. Hypothesis/Purpose The purpose of this study was to describe the changes in pain sensitivity and self-reported function in runners with chronic Achilles tendon pain following sequential treatment with noxious electrical stimulation (NxES) and eccentric plantarflexion exercise. Study Design Single group, repeated measures design. Methods Sixteen participants with chronic Achilles tendinopathy completed the Lower Extremity Functional Scale (LEFS) and the Victorian Institute of Sport Assessment-Achilles scale (VISA-A) and quantitative sensory tests (pressure pain threshold, heat temporal summation, and heat pain threshold) at baseline, one week, seven weeks, and then at a one month post intervention follow-up. The NxES was applied for one week, then followed by plantarflexion eccentric exercise for six weeks. Changes across timepoints were assessed using repeated measures ANOVA and post hoc analysis to describe differences. Hedges g effect sizes were also calculated. Results There was a significant improvement in LEFS (p < 0.001) and VISA-A (p < 0.001) from baseline to one month follow-up, with a mean change of 9.6 ± 7.7 and 19.4 ± 17.7 points respectively. Pressure pain threshold of the involved Achilles tendon increased over time (p < 0.001) with significant improvements after NxES application (p = 0.002) and after six weeks of eccentric exercise (p < 0.001). There were significant improvements from baseline to one month follow-up for heat temporal summation (p = 0.001) and heat pain threshold ( p < 0.001). Conclusions For individuals with chronic Achilles tendinopathy, a sequential treatment of NxES followed by eccentric exercise resulted in a clinically significant improvement in self-reported pain and function. During the first week of treatment there was a reduction in mechanical hyperalgesia during the NxES-only phase, while a large reduction in primary heat hyperalgesia and additional desensitization to mechanical pain occurred during the eccentric training phase of treatment. Level of Evidence 2b

Teachers need to plan, use, and evaluate their use of questioning. Effective questioning supports students to use their own thinking to make sense of mathematics.

Background Given the widespread of tele‐assessment and tele‐rehabilitation in speech language pathology and clinical neuropsychology for monolingual English‐speaking patients with acquired neurogenic language and cognitive disorders, there is an urgent need to implement a culturally and linguistically tailored telepractice for multilingual people living with dementia (MPLWD), for whom there is no consensus on a standard model. This study aims to investigate the delivery model of remote assessment and intervention for this population. Method A systematic scoping review was conducted in December 2023 following frameworks described by Arksey and O’Malley (2007). A literature search was conducted for articles published in English that addressed telepractice services MPLWD in the field of speech language pathology and clinical neuropsychology. Factors that contributed to the successful delivery of telepractice sessions were described in terms of technological medium, modality of intervention (assessment vs rehabilitation), as well as target population (patients, caregivers or both). Result A total of 53 articles were identified through search engines and 12 duplicates were excluded. After title and abstract screening, another 32 studies were removed. Finally, a total of 9 full‐text studies were selected. This review has demonstrated a need for setting up tele‐rehabilitation for the benefit of MPLWDs. Despite the paucity of studies addressing multilingual considerations and needs of patients with dementia and their caregivers, the focus on caregivers was reported in 7 studies using different remote services (web‐based intervention, mobile, draw‐care), while 2 studies reflected on gender and health disparities stemming from Latino, Korean, American and Australian contexts. MPLWDs may experience a mild or severe loss of one or more of their acquired languages as a result of the neurodegenerative trajectory of their disease. They may also present cognitive, communicative, and socio‐professional impairments impeding their daily life functioning. Conclusion The scarcity of studies reflects a need for future research of MPLWD. More inclusive model of telepractice is the leitmotiv for cross‐linguistic studies in ethnically diverse population with dementia. The underrepresentation of multilingual telepractice should be taken into consideration and technological advances should be made accessible to diverse MPLWDs in different cultures and languages through equity and digital inclusion.

Genomics is an increasingly important part of biology research. However, educating undergraduates in genomics is not yet a standard part of life sciences curricula. We believe this is, in part, due to a lack of standard concepts for the teaching of genomics. To address this deficit, the members of the Genomics Education Alliance created a set of genomics concepts that was then further refined by input from a community of undergraduate educators who engage in genomics instruction. The final genomics concepts list was compared to existing learning frameworks, including the Vision and Change initiative (V&C), as well as ones for genetics, biochemistry and molecular biology, and bioinformatics. Our results demonstrate that the new genomics framework fills a niche not addressed by previous inventories. This new framework should be useful to educators seeking to design stand-alone courses in genomics as well as those seeking to incorporate genomics into existing coursework. Future work will involve designing curriculum and assessments to go along with this genomics learning framework.

Phosphorylation of connexin 43 (Cx43) is an important regulatory mechanism of gap junction (GJ) function. Cx43 is modified by several kinases on over 15 sites within its ∼140 amino acid-long C-terminus (CT). Phosphorylation of Cx43CT on S255, S262, S279, and S282 by ERK has been widely documented in several cell lines, by many investigators. Phosphorylation of these sites by JNK and p38, on the other hand, is not well-established. Indeed, ERK is a kinase activated by growth factors and is upregulated in diseases, such as cancer. JNK and p38, however, have a largely tumor-suppressive function due to their stress-activated and apoptotic role. We investigated substrate specificity of all three MAPKs toward Cx43CT, first by using purified proteins, and then in two cell lines (MDCK - non-cancerous, epithelial cells and porcine PAECs—pulmonary artery endothelial cells). Cx43 phosphorylation was monitored through gel-shift assays on an SDS-PAGE, immunodetection with phospho-Cx43 antibodies, and LC-MS/MS phosphoproteomic analyses. Our results demonstrate that p38 and JNK specificity differ from each other and from ERK. JNK has a strong preference for S255, S262, and S279, while p38 readily phosphorylates S262, S279, and S282. While we confirmed that ERK can phosphorylate all four serines (255, 262, 279, and 282), we also identified T290 as a novel ERK phosphorylation site. In addition, we assessed Cx43 GJ function upon activation or inhibition of each MAPK in PAECs. This work underscores the importance of delineating the effects of ERK, JNK, and p38 signaling on Cx43 and GJ function.

This cross-sectional study examines publicly available data to estimate school-based radon and radiation dose exposure to children attending school in 5 eastern Pennsylvania districts to estimate children’s annual additional risk as a result of those locations.

Cholera, an acute waterborne diarrheal disease, remains a major global health challenge. Despite being curable and preventable, it can be fatal if left untreated, especially for children. Bangladesh, a cholera‐endemic country with a high disease burden, experiences two peaks annually, during the dry pre‐monsoon spring and the wet post‐monsoon fall seasons. An early warning system for disseminating cholera risk, which has potential to reduce the disease burden, currently does not exist in Bangladesh. Such systems can raise timely awareness and allow households in rural, riverine areas like Matlab to make behavioral adjustments with water usage and around water resources to reduce contracting and transmitting cholera. Current dissemination approaches typically target local government and public health organizations; however, the vulnerable rural populations largely remain outside the information chain. Here, we develop and evaluate the accuracy of an early warning system—CholeraMap that uses high‐resolution earth observations to forecast cholera risk and disseminate geocoded risk maps directly to Matlab's population via a mobile smartphone application. Instead of relying on difficult to obtain station‐based environmental and hydroclimatological data, this study offers a new opportunity to use remote sensing data sets for designing and operating a disease early warning system. CholeraMap delivers monthly, color‐coded geospatial maps (1 km × 1 km spatial resolution) with household and community cholera risk information. Our results demonstrate that the satellite‐derived local‐scale risk model satisfactorily captured the seasonal cholera pattern for the Matlab region, and a detailed high‐resolution picture of the spatial progression of at‐risk areas during outbreak months.

Supply chain finance (SCF) has gained significant popularity and has been extensively implemented in practical applications to facilitate cash flow by involving financial institutions. However, there are very few empirical studies on SCF. This study examines whether and how much SCF can alleviate financial constraints of small and medium-sized enterprises (SMEs). Furthermore, we examine the impact of information asymmetry, financial development depth, and economic policy uncertainty on the effectiveness of SCF. These three moderating factors correspond to the influence of firms, local financial development, and national government on SCF effectiveness, respectively. The empirical analysis shows that SCF can alleviate SMEs’ financial constraints significantly, and this effect is more pronounced for firms with higher information disclosure quality and located in financially developed areas. Our findings have important implications for firms and authorities, such as understanding the dynamics of SCF and developing appropriate measures and frameworks to promote the broad adoption and effective utilization of SCF.

The lack of a cohesive, stakeholder-informed refugee health research agenda has been a barrier to promoting, funding, and conducting health research with refugee populations in North America. A cross-sectional study was conducted among individuals working in refugee health in North America (N = 93) to describe major domains within the field of refugee health research and to develop refugee health research priorities. Open-ended survey questions included: (1) What research topics specific to refugee research would you like to see in an international research agenda? (2) Please describe current and important gaps that you believe exist in refugee research and why? Overarching themes focused on the need for the development of research partnerships with refugee communities that are intentional, effective, and driven by the needs of refugee communities. The survey also identified a need for best practices in creating sustainable, community-based research partnerships (effective models and evidence-based strategies) that translate across 12 domains. The refugee health research priorities for North America described in this manuscript should continue to be modified over time as political, economic, social, and medical contexts change.

Purpose This clinical case report examines the case of a 52-year-old man who experienced a hemorrhagic stroke in the basal ganglia, resulting in severe aphasia as well as motor speech and cognitive-communication difficulties. The speech-language pathology services provided in this complex case are reviewed, including the assessment and management of this case that incorporate a life participation approach to speech and language intervention. A quality assessment of services is provided, along with recommendations for alternative interventions. Conclusion This clinical case highlights the important role subcortical areas of the brain play in communication and provides information and evidence-based direction for future clinical management of similar cases.

Vertical loading rate (VLR) and pelvic floor muscle activity (PFA) increase with running velocity, which may indicate a relationship between VLR and PFA. Foot strike pattern has been shown to influence VLR while running, but little is known about its influence on PFA. Twenty healthy women ran on a treadmill for 2 conditions: with a rearfoot strike and with a forefoot strike. PFA was measured with electromyography. Running kinematics associated with VLR were collected using inertial measurement units and tibial accelerometers. Change scores between conditions were calculated for average PFA and running kinematics: peak vertical tibial acceleration, vertical excursion of the center of mass (VO), and cadence. Paired t tests assessed differences between running conditions for all variables. Pearson correlations assessed the relationships between changes in PFA and running kinematics. PFA was significantly higher during the forefoot compared with the rearfoot strike condition. Change in vertical tibial acceleration was positively correlated with change in PFA during the right stance. Change in cadence was negatively correlated, and change in vertical excursion of the center of mass was positively correlated with change in PFA during left stance. The average PFA increased during the forefoot strike pattern condition. Changes in PFA were correlated with changes in running kinematics associated with VLR.