Forward - UT Tyler Research Magazine

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THE RESEARCH MAGAZINE OF THE UNIVERSITY OF TEXAS AT TYLER

2020 EDITION

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D. L. Simmons Assistant Professor, UT Tyler Department of Art and Art History EVANGELINE (80” x 93”) Multiple Process Acrylic and Enamel Carbon Transfer/2018

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uring the past year, The University of Texas at Tyler faculty have conducted important research and scholarship that serves as a testament to

the University’s strengths and reputation. These works, which cross six col-

WELCOME TO FORWARD, THE UNIVERSITY OF TEXAS AT TYLER RESEARCH MAGAZINE

leges, have had an impact on improving the quality of life in East Texas, the state and nation.

These significant endeavors helped UT Tyler achieve Carnegie’s doctoral research institution classification. As one of only 162 universities in the nation to hold this distinction, being reclassified as a doctoral-professional university reflects our aspiration to raise our institution’s profile by offering a wider range of relevant and excellent programs for our current and future students.

Moving forward, our desire is to continue to provide opportunities for our faculty to pursue research and scholarship in ways that improve society, pedagogy and opportunities for external funding.

Each year we host the East Texas Research Conference (ETRC), in collaboration with UT Health Science Center at Tyler, Texas College and Jarvis Christian College. The ETRC assembles a diverse group of professionals from education, business and industry, nonprofit organizations and local governments to explore the types of scholarship and conversations that create a stronger East Texas. While COVID caused the cancellation of the 2020 conference, we anticipate convening the conference in 2021.

This inaugural issue of Forward captures the research, growth and development that helped place 2019–2020 among the most distinguished research and scholarship years at UT Tyler. We enjoyed marked success thanks to the unyielding pursuit of discovery that is shared among all members of the UT Tyler community.

I hope you enjoy this collection of articles. They represent a small sample of the great discoveries and creative work that take place at The University of Texas at Tyler.

Michael Tidwell President The University of Texas at Tyler

PRESIDENT’S LETTER

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The power of UT Tyler lies in our people In my new role as associate provost for research and scholarship, I am greatly impressed with the quality of research conducted by our faculty and students across our 24 departments and six colleges. The power of UT Tyler lies in the faculty who envision and test valuable ideas, the staff who support them, and the students who learn and draw inspiration from their successes. The quality and quantity of research and scholarship at UT Tyler have never been stronger.

This issue of the Forward magazine, which covers only a small fraction of the ongoing work taking place at UT Tyler, highlights five faculty colleagues whose work exemplifies the enterprising, interdisciplinary and innovative spirit of research and scholarship at UT Tyler. Their projects cover a broad and diverse range of topics including applying new and emerging technologies to conduct neuropsychological assessments and to predict life threatening events in humans, and using photography to understand health and illness at individual and community levels.

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These stories highlight the University’s commitment to scholarly activities and research with a focus on translating basic ideas into applications for societal good and contributing to the University’s mission, vision and goals.

I hope you will find this issue of Forward worthwhile and fun to read.

Kouider Mokhtari, Ph.D. Associate Provost for Research and Scholarship Anderson-Vukelja-Wright Endowed Professor Director, K-16 Literacy Center

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TA B L E O F C O N T E N T S

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CONTENTS

A PUBLICATION HIGHLIGHTING RESEARCH FROM THE UNIVERSITY OF TEXAS AT TYLER MOVING EAST TEXAS AND THE WORLD FORWARD

2020 EDITION

FEAT U R E S ADMINISTRATION

6 Investigating COVID-19

UT Tyler faculty and students respond to the global pandemic by working to solve problems surrounding the crisis.

8 Testing Memory Virtually

Dr. Michael Barnett is improving neurocognitive tools to help improve the lives of those impacted by dementia.

16 Remote Intervention

Dr. Premananda Indic is developing wearable biosensors that improve access to medical and mental care.

20 Worth a Thousand Words

Dr. Cheryl Cooper gathers new insights on health and illness through participant-generated photography.

22 The Math Behind Innovation

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Dr. Justin Reinert’s objective is a healthier East Texas as he takes on opioid use and adolescent vaping in his work with substance abuse management research.

Dr. Kassie Archer analyzes numeric patterns that impact fields from medicine to financial analysis.

Dr. Michael Tidwell President Dr. Amir Mirmiran Provost

PUBLISHER

Lucas Roebuck Chief Communications Officer and Vice President for Marketing

EDITOR

Dr. Kouider Mokhtari, Ph.D. Associate Provost for Research and Scholarship

PUBLICATION STAFF

Emily Battle Managing Editor Matt Snyder Design Jonathan McSwain Photography Editor

ADDITIONAL SUPPORT

Olivia Paek, Hannah Buchanan, Amber Friday, Cheryl Riley Special thanks to the Office of Research and Scholarship.

ALSO IN THIS ISSUE

FORWARD is published annually by UT Tyler Press. Correspondence and feedback can be mailed to Dr. Kouider Mokhtari, 3900 University Blvd., Tyler, Texas 75799. Find the publication online at UTTyler.edu/FORWARD

4 Research News

5 Sponsored Research and Scholarship at UT Tyler

Visit UT Tyler Press online at UTTyler.edu/Press

24 STARs in Research @2020 The University of Texas at Tyler

TA B L E O F C O N T E N T S

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RESEARCH NEWS University Receives Carnegie’s Doctoral Research Designation UT Tyler has been categorized as a doctoral university by the Carnegie Classification of Institutions of Higher Education, the leading framework for categorizing U.S. colleges and universities.

Carnegie Classification includes all R1 and R2 universities as well as the new Doctoral/Professional Universities category, where the University is categorized.

UT Tyler is one of only 162 universities in the nation to hold this designation, which is based on factors including total research expenditures and number of doctoral degrees conferred.

The new classification reflects the growth of UT Tyler’s doctoral programs and its strategic focus on research that benefits East Texas and beyond.

The University offers doctoral programs in nursing, human resource development, clinical psychology, school improvement and pharmacy. Faculty in all six colleges conduct funded research, which serves as a bridge between classroom learning and community impact.

DR. YONG TAI WANG

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RESEARCH NEWS

Professors Awarded Patent for Strength Training Device The University has received its first U.S. Patent for a device that supports physical and mental health exercises and weight training, particularly in older adults and the disabled. The Tai Chi Ball was developed by Dr. Yong Tai Wang, dean of the College of Nursing and Health Sciences, and Dr. Chung Goh, assistant professor of mechanical engineering.

The unique feature of the device is that it can be separated into independent sections for weight training in the Tai Chi practice. Historically, Tai Chi balls have been used for light physical exercises, not weight training. As a result, users whose lean mass is reduced, from aging for instance, cannot effectively benefit from physical exercise.

The ball comes in three sizes and three weights to match individual physical and health conditions.

It is currently produced by UT Tyler using a 3D printer. An investment company will be secured in the future for mass production of the product.

Brown Aids U.S. Energy Department in Developing Building Technologies Dr. Fredericka Brown, associate professor of mechanical engineering, was selected by the American Association for the Advancement of Science to serve as a Science and Technology Policy Fellow for the U.S. Department of Energy.

Her yearlong contributions will be instrumental in the development of cost-effective technologies to reduce building energy use. She also will help advance research and development for heating and air-conditioning component technologies.

Gautier Receives Fulbright Award to Examine Environmental Policies in Spain Dr. Luis Gautier, associate professor of economics, received the prestigious Fulbright U.S. Scholar Award from the U.S. Department of State and the J. William Fulbright Foreign Scholarship Board.

The award will take Gautier to the University of Málaga in southern Spain, where he will engage in cutting-edge research and lay the groundwork for future collaborations between UT Tyler and the host university. While there, he will examine the market-based environmental policies of the olive oil sector. The area is one of the world’s largest producers of olive oil.

Biswas Collaborates With NASA on Planned Lunar Missions Dr. M. A. Rafe Biswas, assistant professor of mechanical engineering, was named one of eight summer 2020 NASA Faculty Glenn Fellows.

Biswas spent the summer at the Glenn Research Center in Cleveland, Ohio, assisting in NASA’s effort to send humans back to the moon by 2024. He participated in developing innovative, renewable fuel cell systems to power spacecrafts for the proposed lunar missions.

Sponsored Research and Scholarship at UT Tyler Forward-thinking research is conducted at UT Tyler, addressing an array of subject areas ranging from the arts and humanities, biology, education, health and wellness, engineering and economic development. This research is supported by external funding agencies as well as an internal grant program of the UT Tyler Office of Research and Scholarship.

Here is a sampling of sponsored research and scholarship at the University: National Institutes of Health Award. This subaward is part of a larger grant through the University of Illinois, aimed at controlling pneumonia using synthetic peptides. Principal investigator: Dr. Yanyan Wang, associate professor, Department of Pharmaceutical Sciences, Ben & Maytee Fisch College of Pharmacy.

Texas Military Department Award. Surveys of aquatic fauna are conducted at military training bases with existing ponds to better understand the impact of military training activities on aquatic communities and water quality. Principal investigator: Dr. Lance Williams, professor and chair, Department of Biology, College of Arts & Sciences.

Washington Sea Grant Award. This project is designed to convert sugar kelp (marine algae) into biofuels to benefit kelp aquaculture and renewable biofuels.

Principal investigator: Dr. Fernando Resende, associate professor and chair, Jasper Department of Chemical Engineering, College of Engineering.

U.S. Army Medical Research Acquisition Activity Award. Virtual reality applications are used to simulate a Virtual Environment Grocery Store and a virtual apartment to assess the practical abilities of individuals with dementia. Principal investigator: Dr. Michael Barnett, assistant professor, College of Education & Psychology.

U.S. Department of State, U.S. Embassy in Belize Award. This project builds teacher and school principal capacity to effectively reach and teach primary and elementary school students in marginalized communities of Belize. Principal investigator: Dr. Yanira Oliveras-Ortiz, associate professor, College of Education & Psychology.

National Science Foundation CyberTraining Award: This project develops Easy-Med, a medical training framework for educating STEM students about the sensing, security and privacy aspects of smart healthcare as possible career paths.

Principal investigator: Dr. Prabha Sundaravadivel, assistant professor, Department of Electrical Engineering, College of Engineering.

Global Strategic Operatives for the Eradication of Human Trafficking Award.

This project educates healthcare providers on best practices to identify victims of human trafficking and appropriate actions following identification. Principal investigator: Dr. Cathy Miller, associate professor, School of Nursing, College of Nursing & Health Sciences.

Department of Commerce Award. Technical assistance is provided to East Texas entrepreneurs, businesses and communities in responding to economic challenges resulting from COVID-19. Principal Investigators: Dr. Kerri Camp, associate professor, Department of Marketing, and Mr. Jeff Howlett, executive director, East Texas Entrepreneurship Center, Soules College of Business.

RESEARCH NEWS

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INVESTIGATING COVID-19 University Researchers Work to Answer Questions, Solve Problems

UT Tyler faculty and students across several fields of study are responding to the global challenge of COVID-19 through research. From evaluating the preparedness of first responders to identifying effective strategies for coping with stress and anxiety, teams of researchers are working to answer important questions and solve problems surrounding the crisis.

Pandemic-related investigations at the University include: The Effects of Problem-Focused Coping on Work/Life Conflict and Life Satisfaction in Working Parents of School-Aged Children During the COVID-19 Pandemic, Joanna Norman and Kim Nimon, principal investigators, Soules College of Business: Conducting quantitative statistical analysis to determine whether

problem-focused coping skills mediate the relationship between work and family conflict and life satisfaction during COVID-19.

Living With Parkinson’s Disease Amidst the COVID-19 Pandemic, Melinda Hermanns and Beth Mastel-Smith, co-principal investigators, College of Nursing & Health Sciences: Examining the experience of living with Parkinson’s disease during COVID-19.

Online Visits With Dementia Friends, Beth Mastel-Smith, UT Tyler College of Nursing and Health Sciences, and Michelle Kimzey and Jodi Patterson, Harris College of Nursing, Texas Christian University, co-principal investigators: Examining the effect of nursing student visits with people with dementia during a pandemic.

A North-South Qualitative Contrast of Hospital Orderlies in the U.S. and Brazil at the Peak of COVID-19 Response, Miguel Caldas, principal investigator, Soules College of Business: Comparing the experiences of hospital orderlies and laundry cleaning crews on the front lines of COVID-19 in two hot-zone countries.

Coping With COVID-19, Bridget Kennedy, principal investigator, Sarah Sass, faculty sponsor, and Emily Santistevan, Nguyen Nguyen, Priyanshi Chhabra, Kaitlyn Niederstadt and Candice Hayden, co-principal investigators, College of Education and Psychology: Examining ways in which individuals are coping mentally, emotionally and physically with COVID-19.

Discovering Risk Management and Future Education Planning Practices in the Marketing Discipline Under COVID-19, Barbara Wooldridge, principal investigator, Soules College of Business: Exploring the efforts of marketing departments to set best practices for the pandemic-induced disruption, and what they plan to do going forward.

Passion Plurality as a Buffer or Barrier for Work-Related and Well-Being Outcomes During the COVID-19 Outbreak, Marina Astakhova, principal investigator, Soules College of Business: Exploring ways in which passion for nonwork activities may help people with work passion adjust to workforce changes, including telecommuting, furloughs and unemployment.

Investigating the Influence of COVID-19 on University Enrollment, Christopher Thomas and Kristie Allen, co-principal investigators, College of Education and Psychology: Identifying the impact of the COVID-19 pandemic on the enrollment decisions of students.

Coping With COVID-19, Christopher Thomas, principal investigator, College of Education and Psychology: Identifying individual difference factors that influence people’s ability to cope with disaster events such as COVID-19.

An Examination of Police Officers’ Preparedness and Experiences With the COVID-19 Pandemic, Richard

Helfers, principal investigator, UT Tyler College of Arts & Sciences, and Johnny Nhan, co-investigator, Texas Christian University: Investigating the impact of police preparedness on their response to the COVID-19 pandemic.

Public Attitudes and Experiences Related to COVID-19 in Texas & Louisiana, Mark Owens, principal investigator, College of Arts & Sciences: Surveying individuals statewide to gage their experiences related to COVID-19, including financial, mental health and partner violence stresses.

Testing the Modality Effect in an Online Training of Virtual Workers: A Longitudinal Experiment Inspired by Social Distancing, Janice Chretien, principal investigator, Soules College of Business: Investigating advancements in online worker training methods to provide evidence-based instructional design recommendations for human resource development practitioners.

The Impact of Social Distancing and Personality on Health and Well-being, Candice Hayden, principal investigator, and Adam McGuire, faculty sponsor, College of Education and Psychology: Examining perceived social support for individuals in substance use recovery and the resulting impact on quality of life, psychological distress and abstinence self-efficacy, in the context of the pandemic.

Small Business Loan With PPP, Alex Brandt, principal investigator, and Veronda Willis, faculty sponsor, Soules College of Business: Compiling information from a sample size of small businesses to examine adherence to Small Business Administration guidelines for Paycheck Protection Program loans during the pandemic.

COVID-19 and Differential Family Structures, Amy Hayes, Candice Hayden, Nancy Tran, Nguyen Nguyen and Rawda Tomoum, principal investigators, College of Education and Psychology: Exploring the impact of COVID-19 on stress and well-being in families in the U.S., including effects on childcare, education and health of school-aged children.

Effect of Religiosity on the Attitudes of People Through the COVID-19 Crisis and Social Distancing, Anjit Aryal, principal investigator, and Eric Stocks, faculty sponsor, College of Education and Psychology: Examining the role of religion in helping people to remain positive through the pandemic, and determining whether the inability to practice communally affects their attitudes toward COVID-19 control measures.

Attitudes and Usage of Face Masks Among Allied Healthcare Professionals, Stephen Cage, principal investigator, College of Nursing & Health Sciences: Investigating the attitudes and usage of face masks among allied healthcare professionals during the COVID-19 pandemic.

F O R W A R D // 7

TESTING MEMORY Simulated Environments Designed to VIRTUALLY Measure Dementia’s Impact on Daily Life In his work as a neuropsychologist, Dr. Michael Barnett has witnessed the challenges and uncertainties a diagnosis of dementia brings to a family. He also realizes the limitations of conventional memory assessments in answering a family’s questions about their loved one’s capacity to function in life.

Although memory assessments are a vital tool in diagnosing Alzheimer’s disease and other forms of dementia, they are typically given via pencil and paper, providing limited insight into an individual’s ability to perform tasks such as preparing a meal or driving a vehicle, said Barnett, an assistant professor of psychology and director of The University of Texas at Tyler Memory Assessment and Research Center (MARC).

He is using virtual reality technology to develop cognitive assessments that will provide a clearer picture of dementia’s impact on daily life. The project is funded by the U.S. Department of Defense’s Congressionally Directed Medical Research Program.

“Conventional neuropsychological assessments, in which a person is asked to recall a series of words or numbers, are good for predictive purposes but only allow us to make inferences as to the individual’s capacity to function independently, particularly during the early, subtle stages of cognitive decline,’’ Barnett said. “The basic rationale of my research is to use virtual reality to simulate daily life and to use that to create tests that measure specific functional abilities.’’

Barnett is conducting the research with his team of neuropsychology graduate students at the MARC, an off-campus center that works in partnership with the Alzheimer’s Alliance of Smith County.

Participants in the study are asked to perform tasks in virtual environments including an apartment,

kitchen and what is known as the Virtual Environment Grocery Store.

In the grocery store, for example, study participants are given a list of items to purchase and a budget to follow. The test administrator can manipulate the shopping environment by increasing the crowd size, noise level and other distractions.

Can the study participants remember what to purchase without reviewing their list? Are they able to stay on budget? How well do they perform with distractions such as a store announcement or baby crying? The test is designed to measure a variety of functional abilities.

For comparison, the grocery store assessment is given to senior adults with healthy memories and those with cognitive impairment. “We can see a map of how efficiently the participant walks around the store,’’ Barnett said. “People without cognitive impairment go right to the items they need to purchase, but those with dementia often wander around the store in an inefficient manner.’’

As part of the project, Barnett and his team are investigating the impact of traumatic head injury on dementia. Study participants include Alzheimer’s patients who sustained traumatic head injuries during military service, he said, noting that persons with severe head injuries are at greater risk for developing dementia.

C O L L E G E O F E D U C AT I O N A N D P S Y C H O L O G Y

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SHOPPING STUDY Participants in the Virtual Environment Grocery Store walk the aisles of a virtual store and are asked to perform various tasks. They are given a list of items to purchase and a budget to follow, and need to adapt to changes in crowd size, noise level and other distractions created by the test administrator. The two store layout images (at left) illustrate the difference in efficiency between a higher cognitive functioning individual and a lower functioning individual.

The higher functioning individual entered the virtual store (yellow arrows) and headed directly to the pharmacy.

They completed some assigned shopping tasks efficiently (red arrows) and then went directly to the pharmacy to pick up their prescription when their number was called (green arrows). The lower functioning individual was much less efficient at those same tasks. The contrasting results are to be expected, but the primary goal of this research is to build assessments that simulate everyday life, in order to then measure those expected differences.

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C O L L E G E O F E D U C AT I O N A N D P S Y C H O L O G Y

DR. MICHAEL BARNETT

The team is collecting statistical data from the study to help determine the validity of virtual-based assessments. In addition, study participants are given both the virtual and pencil-and-paper assessments and asked to rate them. “We’re hoping that most patients and their spouses will say the virtual test provides more practical information,’’ said Barnett, who also provides counseling services to caregivers in association with the Alzheimer’s Alliance.

The MARC is preparing to create other types of virtual environments to address major concerns such as the financial exploitation of persons with cognitive impairment.

The financial exploitation of vulnerable seniors is a growing issue nationwide and represents a major focus of Barnett’s research. Financial abuse and fraud costs older Americans more than $2.6 billion annually, as estimated by the National Center on Elder Abuse. Seniors with dementia are more susceptible to financial exploitation because of impairments in memory, communication abilities and judgment.

The team is developing a virtual environment that will measure an individual’s ability to make sound decisions in the face of financial interactions. The environment will include a variety of solicitor personalities. Some will have pleasant facial expressions. Others will appear to be angry.

“AS THE OLDER POPULATION CONTINUES TO “Some of those virtual persons will be scammers, and GROW, SO TOO WILL THE PREVALENCE OF what I expect to happen is that DEMENTIA AND RELATED ISSUES. OUR GOAL persons with dementia will over-rely on facial expressions,’’ IS TO CONTINUE IMPROVING NEUROCOGNITIVE Barnett said. “Most likely, TOOLS TO HELP IMPROVE THE LIVES OF they will not recall that the INDIVIDUALS AND FAMILIES IMPACTED BY virtual persons with nice faces defrauded them.’’

THE DISEASE.’’ DR. MICHAEL BARNETT His upcoming projects also include the development of a dementia caregiving simulation to prepare families for patient care and decision-making at various stages of the disease.

“As the older population continues to grow, so too will the prevalence of dementia and related issues,’’ Barnett said, noting that nearly 6 million Americans have been diagnosed with dementia and the number is expected to more than double by 2050.

“While no treatment is currently available to cure dementia or alter its progressive course,’’ he said, “our goal is to continue improving neurocognitive tools to help improve the lives of individuals and families impacted by the disease.’’ The U.S. Army Medical Research Acquisition Activity, 839 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Assistant Secretary of Defense for Health Affairs, through the FY18 Peer Reviewed Alzheimer’s Research Program New Investigator Research Award under Award No. W81XWH1910798. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Department of Defense.

C O L L E G E O F E D U C AT I O N A N D P S Y C H O L O G Y

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FOR A HEALTHIER EAST TEXAS Taking the Lead in Substance Abuse Management Research, Intervention Programming Dr. Justin Reinert first became involved in sub-

stance abuse research while completing a critical care residency in 2017 at Mercy Health St. Vincent Medical Center in Toledo, Ohio. That year also marked the waning of the first wave of the opioid epidemic.

Reinert saw that illicit opioids were having a massive impact on the intensive care unit, which led to his initial research into heroin abuse. He sought to quantify the effects of overdose patients on hospital admissions and healthcare resources and their likelihood to require interventions.

“There is a need to better understand all facets of substance abuse and not just from an ICU medicine standpoint,” said Reinert, an assistant clinical professor in The University of Texas at Tyler Fisch College of Pharmacy.

FISCH COLLEGE OF PHARMACY

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The related research presentation he conducted in Croatia, where many over-abused substances are legal, propelled his career as an international clinical researcher. His interest then turned to overdoses and the clinical management of them with a specific emphasis on pharmacologic modalities.

The epidemic regarding illicit opioids like heroin and street fentanyl began in 2010, he said, noting that 40,000–50,000 annual deaths occurred during the epidemic’s peak as a direct result of opioid abuse.

Reinert believes the United States has entered what is considered “Phase Two” of the opioid epidemic. For the first time in years, deaths from heroin, fentanyl and prescription opioids are falling dramatically, but deaths from other, lesser-known substances, both over the counter and prescribed, are growing.

Recent research examines novel and emerging substances of abuse, including prescription medications, nonprescription agents and natural toxins.

“These substances are all being used in order to take the place of opioids in persons with either a substance abuse problem or opioid use disorder,” Reinert said. Patients who are no longer able to obtain either prescription or illicit opioids frequently turn to other substances to get the same “high,” prevent themselves from going into withdrawal or simply provide the pain relief they need, he added.

Prescription agents include gabapentin, originally approved in 1993 as an adjunct treatment for seizures, and modafinil, which has been increasingly used since its introduction to the US market in 1998 for off-label indications including attention-deficit/hyperactive disorder.

A nonprescription example is loperamide, marketed as an antidiarrheal agent available for over-the-counter purchase since 1982.

Natural agents that can be ingested or inhaled include salvia, a Mexican herb, and kratom, a tropical tree native to Southeast Asia.

Research into adolescent vaping, which Reinert considers a type of substance abuse, was guided by the timing of adolescent vaping-related lung injuries and deaths last year.

“Healthcare professionals first became concerned in October 2019, as teens began to die from adulterated vaping products, which either could have been purchased

that way or could have been adulterated by the user at home,” Reinert said.

This revelation led to a diagnosis coined E-cigarette or vaping product use-associated lung injury (EVALI), he said. Since then, Texas has seen about 300 EVALI cases from the roughly 3,000 national cases.

Led by Reinert, the Fisch College of Pharmacy in partnership with UT Health Science Center at Tyler has connected with five regional independent school districts to provide educational in-services on the health ramifications of nicotine use and vaping. About 650 high school students in Smith and Van Zandt counties have been reached so far.

The initial outreach program was completed in spring 2020. The intervention class phase, set to start this fall, was halted due to the coronavirus pandemic and will start again at the first available opportunity.

Reinert said the usage rate is alarmingly high among East Texas teens. Data shows 41.7 percent are using tobacco, and of those, 77.8 percent are using an electronic nicotine delivery system (ENDS). An estimated 27 percent of high school students nationwide are using tobacco of any kind, and nearly 21 percent utilize some type of ENDS, according to the Centers for Disease Control and Prevention.

Dose escalation also is a growing concern within the healthcare community, he said. One cigarette may have anywhere from six to 28 milligrams of nicotine, but several ENDS cartridges can have upwards of 50 milligrams, Reinert added, noting a person may be exposed to a whole pack of cigarettes if just one vaping cartridge is used.

Reinert said there are still many unknowns about the safety of vaping, e-cigarette and other non-traditional delivery methods of tobacco that warrant additional research. Most studies about the enduring effects of vaping have focused on lung cancer, although additional research could link vaping to other dangers, including other cancer types.

Reinert’s research has shifted to opioid use disorder. He’s currently working to identify medications that can be used as alternatives or as combinations with lower dose opioids to provide pain relief to patients, which is called multimodal analgesia. Reinert has published several systematic reviews on a group of drug classes that have promise in this regard, and he hopes to build a foundation for his work for future clinical-trial application.

“It’s imperative that we find alternative pain relief regimens for patients to prevent opioid use disorder and substance abuse disorders while still providing the pain relief that they need,” he said. “By using combinations of agents, it has been demonstrated that fewer opioid doses are

DR. JUSTIN REINERT

“IT’S IMPERATIVE THAT WE FIND ALTERNATIVE PAIN RELIEF REGIMENS FOR PATIENTS TO PREVENT OPIOID USE DISORDER AND SUBSTANCE ABUSE DISORDERS WHILE STILL PROVIDING THE PAIN RELIEF THAT THEY NEED.” DR. JUSTIN REINERT

required to provide a similar or greater amount of analgesia. This of course varies with the type of pain, but it’s certainly possible.”

Regarding vaping intercession programming, Reinert said its success is dependent upon the participants’ dedication to cessation. Community engagement opportunities and initial town hall meetings also are being planned, and two more districts plan to participate.

He also believes there’s research opportunities with regard to pharmacologic aides to assist with adolescent nicotine cessation.

Reinert said the ultimate goal is providing the community with adequate resources to enhance overall health and wellness. “The overall message rings true with drugs of abuse as well as other public health endeavors – it’s all about getting patients healthy and keeping them that way.” FISCH COLLEGE OF PHARMACY

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REMOTE INTERVENTION Wearable Biosensors Developed to Improve Access to Rural Medical, Mental Care 16 // F O R W A R D

COLLEGE OF ENGINEERING

Healthcare access is a pressing issue in rural communities, particularly when emergency services are needed and the nearest hospital or urgent care facility is several miles away.

The University of Texas at Tyler Center for Health Informatics and Analytics (CHIA) is working to provide rural residents a direct connection to medical and mental health services when critical care is needed.

Led by Dr. Premananda Indic, assistant professor of electrical engineering, the center is developing wearable biosensors to predict adverse health events among some of East Texas’ most vulnerable residents – infants born prematurely, individuals with suicidal ideation and persons recovering from substance abuse disorders.

“Our region has the highest rate of suicide “OUR RESEARCH FOCUSES ON DEVELOPING and second highest rate LOW-COST WEARABLE SENSOR SYSTEMS of infant mortality in Texas, and the opioid THAT CAN BE DEPLOYED TO RURAL AREAS TO epidemic is a major MONITOR THE VITAL SIGNS OF PEOPLE WHO concern locally as it is across the nation,’’ Indic ARE AT RISK FOR SEVERE HEALTH EVENTS.” said, “but half of the DR. PREMANANDA INDIC East Texas population lives in rural areas with limited access to healthcare. Our research focuses on developing low-cost wearable sensor systems that can be deployed to rural areas to monitor the vital signs of people who are at risk for severe health events.’’

COLLEGE OF ENGINEERING

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WRIST-WORN DEVICE

I oT CLOUD

MOBILE APP

The wearable sensor acquires physiological signals such as motion detection, pulse rate and temperature

The information is transferred through the internet to the cloud where the data is processed using a custom algorithm

Feedback is instantly sent to the mobile device of the user

Based in the College of Engineering, the center involves UT Tyler researchers of various disciplines, including engineering, computer science, nursing, health sciences, psychology and pharmacy. The research is supported with $1.6 million from the National Institutes of Health, National Science Foundation, U.S. Department of Veterans Affairs, The University of Texas System and other funding agencies.

The research team is creating biosensors in the form of smart watches for adults and patches for infants to provide information remotely to clinicians for effective patient management and treatment.

Systems are in development to predict life-threatening events in premature infants, detect the suicidal ideation of veterans and other high-risk groups, and identify the cravings of individuals recovering from substance abuse.

“Our goal is to build systems to monitor physiological signals such as heart rate, oxygen saturation rate, temperature and blood pressure, and alert clinicians or caregivers through a wireless network when signals indicate an individual is at high risk of an adverse event,’’ Indic said. “We want to prevent the adverse health event from actually occurring.’’

Infants are preterm when born before the 37th week of pregnancy and are prone to complications such as cessation of breathing, slowing heart rate and oxygen desaturation. They often require special care in neonatal intensive care units and are at risk of being readmitted to the hospital after they go home.

Indic, a specialist in biomathematics and signal processing, serves as a principal investigator in the analysis of data from neonatal intensive care units, collaborating with medical schools and other institutions across the nation. He leads efforts funded by the National Science Foundation and National Institutes of Health to develop machine learning algorithms to predict a possible life-threatening event in a preterm infant.

Research indicates that a preterm infant’s biometrics often follow patterns before certain health events, Indic said. Algorithms will be used to develop biosensors for predicting critical health events in both hospital and home settings to allow for timely medical intervention.

“These biosensors will transcend traditional monitoring systems by incorporating body sensor networks with advanced signal processing approaches,’’ Indic said. “The sensor networks will be tailored specifically to an infant’s individual physiology to accurately detect and anticipate precursors to life-threatening events.’’

One wireless, wearable device will replace the numerous wired sensors that are typically attached to an infant in the hospital, Indic added, noting that the wired systems are not designed for home settings.

Indic and his team are working with the Department DR. PREMANANDA INDIC of Veterans Affairs to create biosensors to detect suicidal ideation in veterans and other high-risk groups.

The VA estimates that veterans are 1.5 times more likely to die by suicide than Americans who never served in the military. For female veterans, the risk factor is 2.2 times more likely.

“OUR GOAL IS TO BUILD SYSTEMS Indic’s team is collecting TO MONITOR PHYSIOLOGICAL anonymous data from the VA SIGNALS AND ALERT CLINICIANS OR to develop algorithms based on CAREGIVERS THROUGH A WIRELESS veterans’ physiological signals.

Through a mix of data such as NETWORK WHEN SIGNALS INDICATE heart rate, breathing, gross body AN INDIVIDUAL IS AT HIGH RISK OF movements and sleep patterns, AN ADVERSE EVENT. WE WANT TO research indicates a marked difference between the activity PREVENT THE ADVERSE HEALTH EVENT of healthy individuals and those FROM ACTUALLY OCCURRING.’’ with depression, Indic said.

DR. PREMANANDA INDIC “Those who have major issues with depression often experience disturbed sleep patterns, their movement activities slow down and there are several other physiological signals,’’ he said. “Our aim is to develop systems to remotely track those signals, enabling software to indicate when suicidal ideation is likely to occur.’’

Likewise, a biosensor system is in development to assist in the care of persons recovering from opioid addiction. Signals related to drug cravings will be tracked to prevent adverse events.

Indic plans to expand the project to address postpartum depression and a variety of other health issues.

“It may not be possible to build a hospital in every single community, but we want to help close the gap so that all individuals have access to care,’’ he said.

“The technology is already available. Our homes are safeguarded with smart security monitoring systems.

Sensor systems are used to gather atmospheric data for weather forecasts. Those types of technologies and algorithms also can be applied to healthcare.’’ COLLEGE OF ENGINEERING

F O R W A R D // 19

WORTH A THOUSAND WORDS Participant-Generated Photography Offers New Insights on Health and Illness

“MY HOME”

WOMEN’S WORK: “WE FIND THE RIGHT CLAY AND MAKE COMALES.” GUATEMALAN MIDWIVES WERE GIVEN DISPOSABLE CAMERAS AND ASKED TO TAKE PHOTOGRAPHS REFLECTING HEALTH AND ILLNESS IN THEIR VILLAGES. THE SUBMITTED PHOTOS SPURRED HELPFUL DISCUSSIONS THAT REVEALED OTHERWISE HIDDEN ISSUES AND CONCERNS. SOME OF THE PHOTOS FEATURED HERE INCLUDE PARTICIPANT REMARKS.

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Dr. Cheryl Cooper, a health sciences professor at The University of Texas at Tyler, joined other faculty and students on trips to provide healthcare to the people of Guatemala.

While volunteering at a clinic in the highlands southwest of Guatemala City, she began doing research to gain a deeper understanding of the patients’ health-related lives.

Cooper and co-investigator Dr. Susan Yarbrough met with a group of comadronas or midwives from surrounding villages and asked them to describe the health-related strengths and concerns in their communities. After the discussion, participants were given disposable cameras and asked to take photographs reflecting those strengths and concerns.

This was Cooper’s first investigation into the use of participant-generated photography, also known as photovoice, to understand health and illness from the individual perspective. Health researchers, she said, are trained to be more literary than visual and are only beginning to learn about the value of photography as a useful data collection method.

When the Guatemalan midwives returned to display and comment on their photographs, the discussion was far more informative than the previous one.

Their photos and related narratives revealed some otherwise hidden problems, such as the prevalence of developmental disabilities and alcoholism as well as concerns about child labor and elderly care.

“As health professionals, we typically have all the numbers, statistics, percentages and risk factors, but we do not always know the people behind the numbers,’’ she said. “I have come to agree with photographer Susan Sontag’s

belief that ‘to take a photograph is to participate in another person’s mortality, vulnerability, mutability.’’’

In addition to an article Cooper published in the journal, “Qualitative Health Research,” the Guatemala project was highlighted in a chapter of the book, “Giving Through Teaching: How Nurse Educators are Changing the World,’’ by Kathleen Shultz.

Cooper has since conducted several studies using participant-generated photography, providing new insights into physical and mental health. One project focused on Parkinson’s disease and how patients coped with the illness from day to day. Another delved into the experiences and health-related concerns of Asian international students as they adjusted to American life. Her work often reflects upon the intersection between health and culture.

She recently became the principal investigator on a grant from the National Institute for Occupational Safety and Health to investigate the high prevalence of injuries and deaths among shrimp fishermen on the Texas Gulf Coast. The study was in progress but was placed on hold due to COVID-19. She is looking forward to resuming the project.

“What we know is that the commercial fishermen have very high accident rates, and there are many ideas to why that is,’’ Cooper said. “We are going to ask the fishermen to tell us about it – and to show us through participatory photography.’’

“AS HEALTH PROFESSIONALS, WE TYPICALLY HAVE ALL THE NUMBERS, STATISTICS, PERCENTAGES AND RISK FACTORS, BUT WE DO NOT ALWAYS KNOW THE PEOPLE BEHIND THE NUMBERS.” DR. CHERYL COOPER

GIRLS’ WORK: “THEY GATHER WOOD FOR THE COOK STOVE.”

THE MATH BEHIND INNOVATION Study of Numeric Patterns Impacts Many Fields from Medicine to Financial Analysis Numbers are connected to nearly every aspect of life. They are used to keep track of days and years. They are counted in dollars and cents, and measured in inches and yards.

But math is about more than just numbers. Mathematical patterns, which are studied in advanced fields such as linear algebra and cryptography, also manifest in daily life, notes Dr. Kassie Archer, an assistant professor of mathematics.

“Google decides on the best search results to our inquiries based on the principles of probability and linear algebra. When we shop online, cryptography and number theory are applied to protect our information. How do engineers ensure that our bridges are sturdy? Through the use of differential equations and analysis,’’ she said.

Mathematical patterns are the primary focus of Archer’s research at The University of Texas at Tyler. She analyzes permutations – variations in the way numbers are ordered within a sequence – to

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determine the presence or absence of patterns and identify possible consequences.

Research in permutation patterns first appeared in the study of algorithms, or coded instructions, in THOSE OF US WHO STUDY PURE MATHEMATICS ARE OFTEN DRIVEN BY THE LOVE OF MATH, JUST AS ARTISTS ARE MOTIVATED TO CREATE ART AND WRITERS ARE MOTIVATED TO WRITE. DR. KASSIE ARCHER

computer programming. Computer scientists discovered that an algorithm only needed to be applied once to sort a sequence of numbers from least to greatest – if there were no numbers in the sequence appearing in the order of middle-largest-smallest,

also referred to as the 2-3-1 pattern. In that case, the algorithm would have to be applied more than once to complete the task.

The study of permutations continues to be applied to computer science, and many other real-world applications have been developed.

Archer focuses on pure mathematics in her research, working primarily to expand knowledge in the math itself. But her branch of studies in permutation patterns and pattern avoidance has led to advancements in other fields of research including RNA sequencing, cancer modeling, social choice theory, artificial intelligence and finance.

“In the finance industry, for instance, we can look at patterns that are occurring in stock market fluctuations,’’ she said. “If one particular pattern has occurred, what might happen next? If the stock market went up yesterday, is it more likely to go up today or more likely to go down? Predictions can be made by analyzing permutation patterns in data generated by previous fluctuations.’’

Archer often examines the algebraic structure of permutations, which has applications to other areas of mathematics including logistic modeling in statistics. In the study of animal populations, for example, the logistic model is used to understand when a population gets larger or smaller and what happens in the long term.

Focusing on the math behind the applications, Archer compares her research to the work of an artist or writer.

“Some math researchers are motivated first and foremost by applications to the real world, but those of us who study pure mathematics are often driven by the love of math, just as artists are motivated to create art and writers are motivated to write,’’ she said. “It turns out that even pure mathematics can have important applications, sometimes discovered after the fact.’’

UNDERSTANDING PERMUTATION PATTERNS A permutation is an arrangement of numbers in some order. In this example, the permutation is 247135968. You can get this by looking at the heights of the dots from left to right. The first dot is at height 2, so the first permutation entry is 2. The second dot is at height 4, so the second permutation entry is 4, etc.

The permutation 247135968 contains the sequence 739 (which is highlighted).

This is a 213 pattern since it is in the order of middle-lowest-highest.

This particular permutation avoids the pattern 321. In other words, there is no occurrence of three numbers (left to right) in the order greatest-middle-lowest.

C O L L E G E O F N U R S I N G & H E A LT H S C I E N C E S

F O R W A R D // 23

University Receives Awards to Recruit and Retain World-Class Faculty UT Tyler faculty members have received awards from the UT System Science and Technology Acquisition and Retention (STARs) program for their leading-edge research that impacts East Texas and beyond. STARs program funds are used to acquire laboratory equipment and facilities and pay for research activities that will support UT institutions in recruiting and retaining outstanding faculty. UT System provides up to $500,000 and $300,000 for STARs and Rising STARs awardees, respectively. STARs are senior faculty members and Rising STARs are tenure-track assistant or early associate professors. UT Tyler awardees include: STARs

Rising STARs

2020 Mena Souliman, Ph.D., an associate professor of civil engineering, is addressing challenges of the U.S. transportation system. He is focused on improving the infrastructure of rural roads and the durability and cost efficiency of highways and bridges.

2020 Matthew J. Greenwold, Ph.D., is an assistant professor of biology. His research integrates empirical molecular biology, comparative genomics and applied bioinformatics to address fundamental questions about major evolutionary novelties.

2020 YanYan Wang, Pharmacology Ph.D., an associate professor of pharmaceutical sciences, is investigating the molecular and cellular mechanisms underlying certain neuropsychiatric disorders and neural plasticity.

2020 Jounsup Park, an assistant professor of electrical engineering, is working to advance multimedia networks, wireless communication and the quality of the augmented/virtual reality experience.

2019 Fernando Resende, Ph.D., is an associate professor of chemical engineering and interim chair of the Jasper Department of Chemical Engineering. He is exploring innovative methods for converting biomass into liquid transportation fuels.

2018 Premananda Indic, Ph.D., an assistant professor of electrical engineering, is developing wearable sensor systems and associated machine learning algorithms for the prediction of life threatening events in humans.

2020 Shawana Tabassum, Ph.D., is an assistant professor of electrical engineering. She is investigating sensors, micro- and nano-optics, microfluidic devices, micro-electro-mechanical systems and their applications in biomedicine, sustainable agriculture and the environment.

2018 Ayman K. Hamouda, Ph.D., is an associate professor of pharmaceutical sciences. His research focuses on neuronal nicotinic acetylcholine receptors, which play a central role in a variety of brain functions including pain perception and the development of nicotine addiction.

2017 Joseph S. Glavy, Ph.D., an associate professor of pharmaceutical sciences, is examining nuclear pore complexes and proteins associated in DNA damage response pathways. His work has helped set the foundation for understanding the nuclear pore’s role in aging and diseases.

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S TA R S I N R E S E A R C H

GLAVY

HAMOUDA

TABASSUM

PARK

GREENWOLD

INDIC

RESENDE

WANG

SOULIMAN

STARS IN RESEARCH

WORKS BY MERRIE WRIGHT Chair and Associate Professor UT Tyler Department of Art and Art History

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