According to Rita Charon, founder of the developing field of narrative medicine, "medicine practiced with narrative competence, called narrative medicine, is proposed as a model for humane and effective medical practice," which "offers fresh opportunities for respectful, empathetic, and nourishing medical care" (Charon, 2001). Narrative medicine is composed of three key practices: close reading, reflective writing, and active listening. Developing each of these skills, Sharon proposes, can foster compassion and empathy in medical providers. The demonstration of these practices has been shown to "facilitate an authentic partnership by building empathy and trust," as well as "promote physician well-being and prevent burnout" (Khawand-Azoulai, et. al. 2022, Stumbar, S. E et. al. 2020). Medical education currently is striving to incorporate humanistic training to develop a holistic approach to patient care, but narrative medicine training has yet to be extensively explored in undergraduate pre-health education (Pentiado, J. A. et. al., 2016, Barron, L., 2017). Narrative competence, defined by Charon as "the ability to acknowledge, absorb, interpret, and act on the stories and plights of others," has been proposed as a pre-requisite to developing good patient-care skills (Charon, 2001, Baron, L., 2017). The incorporation of humanistic training for undergraduate pre-medical students in the form of narrative medicine practices can prepare future professional school students to begin developing a patient-centered perspective of healthcare. The undergraduate years have the "potential to shape the kinds of caregivers we want for our patients, for friends, for our families, and for ourselves" (Barron, L. 2017). It is therefore important to gain an understanding of how medical humanities education can impact undergraduate students because foundational knowledge of these concepts prepares students for later development of humane medical practice in professional school. The three avenues of narrative medicine training that I have chosen to analyze include a narrative medicine workshop series, a group of pre-health students called the Illness Narrative Listening Project that gathers regularly to intentionally listen to patients stories, and lastly, my own reflective writing from experiences in medical contexts. Data is collected through a mixed methods approach, gleaning insight through both qualitative and quantitative research methods, in the form of interviews and surveys respectively, will illuminate the complexities of the research question. The goal of the workshops and listening project is to teach these practices to undergraduate students in order to explore if the same benefits seen in clinical practice and medical education could be demonstrated in undergraduate pre-health education.

Alzheimer’s disease (AD) currently afflicts well over six million people in the United States, and this number is projected to increase exponentially in the coming years. While much remains to be understood about the causes and pathogenesis of AD, two potential risk factors are chronic insufficient sleep and long-term consumption of an unhealthy diet. Both of these lifestyle factors are often studied separately, and evidence suggests that each has negative impacts on brain health and cognitive function, perhaps due to increases in inflammation, which itself is associated with increased anxiety and cognitive dysfunction. The current study investigated the combined effects of long-term consumption of a typical American-style diet (TAD) and six weeks of chronic sleep restriction on locomotor activity and anxiety-like behavior in male and female wild-type mice not otherwise predisposed to disease pathology. Female mice that underwent sleep restriction and consumed the TAD displayed greater anxiety-like behavior compared to mice that the TAD and did not undergo sleep restriction. This difference was not observed in male mice. Furthermore, male mice that underwent chronic sleep restriction displayed greater locomotor activity compared to controls. These differences were not observed in females. Given the prevalence of AD and the projected rise in AD cases, understanding how controllable lifestyle or environmental factors can increase AD risk is essential. Importantly, as AD is more prevalent in women compared to men, it is imperative that research efforts utilize male and female animals seek to understand the mechanisms driving this phenomenon.

There is an oxidative stress component to a wide range of neurobiological diseases. In Alzheimer’s disease (AD), secondary brain injury is associated with an imbalance between oxidant and antioxidant agents. This imbalance contributes to the pathophysiology of AD through the oxidation of macromolecules, destabilization of neuronal cells, and generation of ROS that upregulates synthesis and deposition of p-tau and Amyloid-β (Aβ). The expression of antioxidant defense enzymes can decrease damaging reactive oxygen species, so some efforts to alleviate secondary injury focus on this mechanism of reducing oxidative stress. One pathway that is activated in response to oxidative stress is the Nrf-2/ ARE pathway. Under stress conditions, the protein sensor for oxidation levels Keap1 that is bound to Nrf2 is oxidized, and Nrf2 levels are stabilized and subsequently increased in the cell. The Nrf2 transcription factor then translocates into the nucleus and binds to the antioxidant response element (ARE) promoter to turn on the expression of downstream antioxidant genes. The genes that are expressed include heme-oxygenase (HO-1) and NADPH quinine oxidoreductase 1 (NQO1). These antioxidants can then regulate the redox balance in the internal environment and reduce oxidative stress. The goal of my research is to design an assay to measure Nrf2 activation, so we can test drugs shown to reduce oxidative stress in vitro.

Alzheimer’s disease (AD), currently the seventh leading cause of death in the United States, is a neurodegenerative disease characterized by amyloid beta (Aβ) plaques and chronic inflammation in the brain. Microglial cells, which act as the immune cells of the central nervous system (CNS), function in response to Aβ by secreting pro-inflammatory cytokines and reactive oxygen species (ROS). Microglial activation is a healthy response in the brain, but chronic activation of these cells and thus chronic secretion of neurotoxic factors creates a cyclic process that leads to neuronal cell death. In order to protect against oxidative stress, cells activate the nuclear factor erythroid 2-related factor (Nrf2) pathway. Nrf2 is a transcription factor that regulates the expression of antioxidant enzymes, which can protect the cell from ROS. Here we focus on the therapeutic potential of cannabidiol (CBD) to mitigate oxidative stress in both microglial and peripheral macrophage cell lines. We show that CBD can activate the Nrf2 pathway and thus increases the expression of several antioxidant proteins such as Heme oxygenase-1 (HO-1). This research is significant because it could provide evidence for the use of CBD as a potential therapy in AD patients.

Zebra mussels are an introduced species that has spread throughout much of the eastern United States and recently invaded Texas. These freshwater mussels cause ecological damage by reducing food available and outcompeting native clams. They cause significant economic damage by attaching to hard surfaces in the water such as pipes to factories and water treatment plants. Understanding where they might spread is an important step in controlling their invasion. Predicting their distribution can be challenging; however, several factors are indicative of where zebra mussels may spread (pH levels, temperature, calcium). Of these factors, calcium is currently viewed as the most significant. Zebra mussels needing calcium for general blood physiology, creating their calcium carbonate shells, and by developing larvae which have small shells. The working model is that zebra mussels will thrive in waters with calcium levels greater than 27mg/L, zebra mussel adults may survive but the larvae may not survive in calcium levels between 27-12 mg/L, and less than 12mg/L of calcium is too low for any stage of mussels to survive for an extended period. My projected look at survival of zebra mussels at varying concentrations of calcium in waters on zebra mussels. Differing calcium levels of 0, 5, 10, 20, and 30 mg/L in artificial pondwater were be used to determine at what levels of calcium zebra mussels are able to survive.