This presentation seeks to summarize a solution to helping the visually-impaired navigate new areas. While previous solutions have been relatively successful, many lacked two key features that we hope our solution addresses: being affordable and allowing customization towards those with compounding disabilities. Our solution consists of two main parts: (1) a user-interface created for Fusion 360, a popular 3D-modeling application, that is built upon an existing framework detailed in Hofmann (2018) called PARTs (Parameterized Abstractions of Reusable Things), and (2) an optimization algorithm to generate maps that are tailored for its users. Through PARTs, we developed different variations of modular pieces of map (e.g., roads, buildings, and sidewalks), which increases ease of customization. After the user specifies personal information and preferences through the PARTs UI—such as the width of their finger, their physical limitations, their understanding of braille, and their desired map features—the optimization algorithm will select the best combination of features from the PARTs database for that specific user. At the end of the process, users have a model of a tactile map in Fusion 360 which can be printed out with commercially-available 3D-printers. With 3D-printers becoming more affordable, this solution is significantly less cost prohibitive than other means of generating tactile maps, which required an initial investment upwards of a thousand dollars. Through user studies, we also test how blind users interpret these maps, which helps us guide design improvements in the future. In this presentation, we discuss the efficacy of our solution by comparing it to previous works and detail our plans to improve the system by making the PARTs user-interface more accessible and incorporating user feedback about the map itself. 

The associations between toxic stress, adversity, and mental health are widely documented in public health, medicine, and social science research. Much of this work stems from the findings of the CDC-Kaiser Permanente Adverse Childhood Experiences (ACE) Study from the late 1990s. The results of this study showed that individuals who experienced significant childhood adversities and traumas were at a higher risk for depression and suicide attempts, health risk behaviors, and adult diseases such as cancer and heart disease (Felitti et al., 1998). This research has been invaluable in improving the health of populations who have faced such severe stress, but it is somewhat limited in that it does not acknowledge other aspects of health, such as immune function and frequency of acute illnesses. It also does not take into account adversity that occurs after childhood and adolescence. Recent studies demonstrate that toxic stress and adversity in different stages of the life-span can have negative effects on immune function. This indicates a need for more emphasis on the immune impacts of adversity in future health interventions and research, as well as a need for integration of trauma-informed practice into clinical settings. Although more research is needed to thoroughly establish the causal pathway between adversity and immune dysfunction, the studies discussed in this review demonstrate a strong correlation between these variables, thus providing justification for these interventions.

The formation of dental biofilm (plaque) is promoted through the consumption of dietary sugars, which serves as a precursor to the metabolic process that bacteria must undergo. Organic acids are byproducts of this metabolism, and encourage the demineralization of the enamel which if left untreated leads to formation of dental caries (tooth decay). Evaluation of the acidity of plaque deposits on patient’s teeth can be used as a preventative measure to allow dentists to detect areas vulnerable to dental decay. A ratiometric fluorescence pH sensing device has been developed using an FDA approved dye, Fluorescein, and blue LED excitation. Fluorescent spectral profiles were collected using a spectrometer and analyzed with a spectral unmixing algorithm for calibration over the pH range of 4.5-7, the ideal range to measure the acidic environment of the mouth. A 420 nm LED housed with an electronic driver served as the fluorescein excitation source. Spectral profiles were collected within the 450-650 nm range. In an in vivo pilot study, we found that the dye solution which consists of fluorescein powder and deionized water causes retention issues on interproximal areas. In order to achieve accurate results from the spectrometer, the fluorescein dye must penetrate and diffuse through the dental plaque. To allow enough time for the fluorescein solution to adhere, glycerol was added to increase viscosity. Tests were performed to evaluate the effect of the glycerol addition on the spectral data. Solutions ranging from 0%-50% glycerol were measured. Glycerol addition increases the peak wavelength of the spectra by no more than 1%. The pH of the solution has no effect on this trend. An in vivo case study was performed for high caries risk patients to validate the device. The pH device has the potential to predict early caries, reducing oral restorative procedures and dental expenses.

Modifiable psychosocial and behavioral factors place youth at risk for severe and persistent pain after major surgery. Opportunity exists prior to surgery to intervene with youth and families to prepare them for surgery including helping to manage distressing cognitions and teaching non-pharmacologic coping strategies, to reduce acute pain and prevent chronic post-surgical pain. This study aims to develop and evaluate a cognitive behavioral program in reducing acute and chronic pain in youth undergoing major surgery. In the pilot study, fourteen children ages 10-18 years (M= 14.5), 71.4% female, scheduled for major spine surgery, and their parents, were enrolled into the study. Enrollment rates were excellent with 88% (14 of 16) of families approached agreeing to participate in the study, with a range of 4 to 16 weeks (M = 6.3, SD = 1.3) until surgery at the time of enrollment. Teens and their parents completed three pre- surgical modules containing surgical preparation and relaxation tips during the month preceding surgery. Participants completed three post-surgical modules during the 6 weeks following surgery containing tips for managing pain and returning back to school and activities. Each module was accessed online and followed by a coaching phone call with a trained study team member to ensure comprehension of module content. All of the participants completed all pre-surgery and post-surgery modules within the prescribed time frame. Parents and teens completed assessments at four timepoints: 1 month pre-surgery, 1 week pre-surgery, 6 weeks after surgery, 3 months after surgery. The majority of parents and children (79%) completed the study phone calls within the prescribed time period. Preliminary results indicate excellent program feasibility. Further study must be done on patient outcomes to assess efficacy of the program in a larger population.

Approximately 25% of inpatients in a hospital setting receive a catheter during their stay. This statistic corresponds to a diverse group of practitioners inserting catheters which, if done improperly, can lead to urethral trauma and catheter associated urinary tract infections. My undergraduate research at the Center for Research in Education and Simulation Technologies is aiming to address the gap between practitioners in the hospital by developing a high-fidelity urethral catheter simulator, CREST Sim. Modified elastomeric materials were developed to simulate the male genitourinary anatomy and mechanical behaviors. Quantitative studies between the CREST Sim and LifeForm Male Urethral Simulator were conducted using a uniaxial load cell to measure the force of insertion of a lubricated Bardex catheter. In collaboration with the UWMC OR nursing staff, the integration of CREST Sim in the onboarding training of nurses provided feedback in the form of a survey. Similar insertion forces were observed between CREST Sim and LifeForm Male’s simulator. Preliminary results from the survey have reported positive training responses regarding the state of the CREST Sim. Through our collaboration with UW Willed Body, we will characterize the biomechanical properties from genitourinary tissues of deceased males in-situ. This data, along with more robust survey data, will be integrated into the next generation of CREST Sim.

Orbital fractures are one of the most common facial fractures and often result in functional deficits if not treated appropriately. No prior reports have assessed dynamic visual acuity (DVA) in these patients, which is critical in visually tracking objects during head movement. Our research seeks to determine the effect of orbital fractures on DVA and assess whether DVA will change over time in those who undergo surgical reconstruction of the orbit. We hypothesize that DVA is adversely affected in orbital fracture patients and improves after surgical reconstruction. We designed a prospective pilot study at a Level I trauma center. Adult patients who presented with an orbital fracture between November 2017-January 2019 without prior ocular history were eligible. All enrolled subjects underwent static visual acuity (SVA) and DVA testing twice: once within one month post-injury before surgery, and another at least ten days following surgery. SVA was assessed using a mobile Snellen eye chart. DVA was measured by having the subject rotate their head at a standard frequency while again reading a Snellen chart. DVA is defined as abnormal if acuity falls more than two lines on the Snellen chart compared to SVA. Eleven patients have been enrolled and tested. Four(36%) patients exhibited abnormal DVA prior to surgery, compared to two(18%) after surgery. For all patients, the mean change in visual acuity (DVA logMAR minus SVA logMAR per subject) before surgery was 0.17 (SD=0.09). Following surgery, the mean difference in visual acuity across all patients was 0.07 logMAR (SD=0.07). Our data shows that, surprisingly, the majority of orbital fractures patients tested did not have abnormal DVA. In patients that did demonstrate abnormal DVA, half improved after surgery. The mean difference in visual acuity of all patients also improved after surgery. A larger study is needed to determine the prevalence of abnormal DVA in this patient population.