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East Tennessee State University

Theses/Dissertations

2020

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Full-Text Articles in Medicine and Health Sciences

Collectivism, Individualism, And Interprofessional Education: A Comparison Of Faculty Across Five Academic Health Sciences Colleges, S. Alicia Williams Dec 2020

Collectivism, Individualism, And Interprofessional Education: A Comparison Of Faculty Across Five Academic Health Sciences Colleges, S. Alicia Williams

Electronic Theses and Dissertations

Collaborative practice among interprofessional groups of health care providers is essential to the provision of safe and effective medical care. However, health professions training programs have not traditionally prepared students for interprofessional practice. One challenge in transforming health professions education programs has been a limited number of faculty prepared to teach students in an interprofessional learning environment. Thus, faculty development programs aimed at preparing faculty to provide interprofessional learning experiences across disciplines are increasingly important. Unfortunately, best practice in training faculty for interprofessional education programs is not well-defined.

Interprofessional education faculty development programs should aim to train faculty to model …


Technology Aiding In Neonatal Lung Developmental Care, Megan Kirk Dec 2020

Technology Aiding In Neonatal Lung Developmental Care, Megan Kirk

Undergraduate Honors Theses

In this paper, old as well as new technological findings to decrease premature infant mortality are reviewed. This paper discusses fetal development throughout pregnancy from conception to full-term status as well as fetal lung development specifically from conception until full-term status. Several ideas to rapidly develop and mature fetal lungs are discussed such as mothers ingesting artificial surfactant supplements, either independently or coupled with antenatal corticosteroids, as well as intra-amniotic instillation prior to 28 weeks gestational. Drawbacks regarding these two are mentioned as well such as the fetus’s lungs not being mature enough to use the artificial surfactant leading into …


Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor Dec 2020

Effect Of A Self-Care And Self-Awareness Education Program On Resilience To Burnout And Depression In Clinically Experienced Nursing Students, Andrew Taylor

Undergraduate Honors Theses

The purpose was to examine the effect of a self-care educational intervention on nursing student resilience and thus the potential for compassion fatigue, depersonalization, burnout, depression, and inadequate self-care. A one-group pretest-posttest research design was applied to a convenience sample of 104 nursing students near the end of their last semester in a baccalaureate nursing program. The measurements were demographics, a psychometric resilience scale, program evaluation, and reflection question. The intervention was a standardized, intensive 30 min training program on the high degree of stress and burnout nurses face and the core self-care methods that can promote resilience to these …


The Lived Experience Of Obesity, Spirituality, And Health Behaviors In African American Women, Andrea S. Poynter Dec 2020

The Lived Experience Of Obesity, Spirituality, And Health Behaviors In African American Women, Andrea S. Poynter

Electronic Theses and Dissertations

Obesity is one of the fastest-growing health concerns impacting all racial, ethnic, gender, and socioeconomic groups in the United States of America. More than one-third of the U.S. adult population is classified as being obese (Obesity Society, 2014). Novak and Brownell (2012) identified that “obesity rates are consistently rising higher each year than in previous years” (p. 2345). Obesity has reached epidemic proportions in all races and genders within the US with African American women comprising a majority of those impacted by this chronic health condition. Obesity rates are well documented within the literature but what is lacking is the …


Undergraduate Nursing Students’ Learning Style Preferences And Preferred Faculty Teaching Methods Compared To The Actual Methods Used By Faculty, Linda Simpson Dec 2020

Undergraduate Nursing Students’ Learning Style Preferences And Preferred Faculty Teaching Methods Compared To The Actual Methods Used By Faculty, Linda Simpson

Electronic Theses and Dissertations

Aim. The aim of this study was to examine the generational differences of undergraduate nursing students’ learning style preferences and their preferred faculty teaching methods to the teaching methods used most often by nursing faculty in the classroom.

Background. Nursing educators are responsible for creating learning environments that are effective for students that are in different generations and nursing educational pathways. Each generational cohort brings a collective set of characteristics, expectations, and preferences to the classroom, challenging educators to balance the generational learning styles of all students with respectable, evidence-based, pedagogical approaches. This study was one of the …


A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck Dec 2020

A Qualitative Analysis Of End-Of-Life Healthcare In Tennessee: Politics, Principles, And Perceptions, Erin Mauck

Electronic Theses and Dissertations

The unprecedented growth of the aging population in Tennessee is a significant demographic trend that highlights the necessity for healthcare policy that tackles end-of-life issues. This study examined the perceived quality of end-of-life healthcare in Tennessee, areas that are in need of improvement, policies that have the potential to influence improvements, and the role of politics in end-of-life healthcare policy. It also assessed the support for end-of-life healthcare policy that would advance quality of care and expand end-of-life choices for Tennesseans, while evaluating the policy-making process that legislators employ.

For this study, data were collected using semi-structured, in-depth interviews with …


Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes Dec 2020

Assessing Nurse Practitioners' Knowledge And Clinical Practice With Regard To The Oral-Systemic Link, Angela Haynes

Electronic Theses and Dissertations

Nurse Practitioners (NPs) comprise a significant portion of the U.S. primary care workforce and play an essential role in patients' health awareness, prevention strategies, disease management, and in providing appropriate provider referrals. Nurse Practitioners receive education on the oral-systemic connection, yet there have been limited studies on the clinical practice of NPs assessing the oral cavity to evaluate the condition of the teeth and the oral tissues. The purpose of this study was to explore the nurse practitioners’ knowledge and practice habits of assessing the oral cavity for diseases or abnormalities in the mouth that can, in turn, affect overall …


Chronic Effects Of Methylphenidate On Neuronal Viability And Plasticity, Hannah Oakes Dec 2020

Chronic Effects Of Methylphenidate On Neuronal Viability And Plasticity, Hannah Oakes

Electronic Theses and Dissertations

Methylphenidate (MPH) is the most commonly prescribed drug to treat Attention Deficit Hyperactivity Disorder (ADHD). ADHD is now considered a life-long disorder; therefore, patients take MPH from adolescence into adulthood, highlighting the need for research studying chronic MPH use. MPH increases dopamine and norepinephrine within the synaptic cleft; therefore, chronic use of MPH may lead to changes within important dopaminergic pathways. One pathway, the mesolimbic pathway, includes the hippocampus, an area where adult neurogenesis occurs. We investigated the effects of chronic low and high doses of MPH on neurogenesis and examined levels of a few key proteins linked to cell …


The Inhibitory Effects Of An Antimicrobial Gel On The Staphylococcus Species, Mara Trinkle Aug 2020

The Inhibitory Effects Of An Antimicrobial Gel On The Staphylococcus Species, Mara Trinkle

Undergraduate Honors Theses

The prevalence of antibiotic resistant bacteria has made the choices for topical treatments for patients who experience burns wounds extremely limited. The Staphylococcus genus is naturally occurring in and on the human body but can become harmful once it enters the bloodstream. A novel antimicrobial gel has been shown by our laboratory to inhibit both the planktonic growth and biofilm formation of Staphylococcus aureus in previous studies. The antimicrobial gel is made of seven natural compounds including antioxidants (vitamin C and E). We wanted to examine the effects of the antimicrobial gel on numerous other Staphylococcal species because it is …


Investigation Of Factors Affecting The Hiv Continuum Of Care In Tennessee, Elaine Loudermilk Aug 2020

Investigation Of Factors Affecting The Hiv Continuum Of Care In Tennessee, Elaine Loudermilk

Electronic Theses and Dissertations

Introduction: Factors contributing to the HIV continuum of care (HCC) for adults in Tennessee (TN) have not been studied in depth with known predictors for HIV risk, specifically adverse childhood experiences (ACEs), among low annual income or sexual minority groups [lesbian, gay, bisexual, or transgender (LGBT)].

Methods: A mixed methods study design was used to assess factors related to the HCC. Quantitative analysis used the TN Behavioral Risk Factor Surveillance System data to examine at risk and ever tested for HIV, to (1) investigate ACEs among adults with low-income (<$25,000 annually) in 2016-2017 and (2) among LGBT in 2018. Descriptive statistics and multiple logistic regression (MLR) analysis stratified by TN grand division were performed. Qualitative analysis included 11 interviews with persons living with HIV (PLWH) receiving care at a local clinic to evaluate surveillance questions related to ACEs and the HCC to develop a culturally appropriate survey.

Results: Quantitative results found that among LGBT (N=262) and low-income …


A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso Aug 2020

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …


The Relationship Between Cell-Free Dna And Resistance Training, Henry Lang Aug 2020

The Relationship Between Cell-Free Dna And Resistance Training, Henry Lang

Electronic Theses and Dissertations

The primary purposes of this dissertation were to explore relationship between cell free DNA (cf-DNA), creatine kinase (CK), C-reactive protein (CRP), vertical jump testing delayed onset muscle soreness (DOMS) in response to a high-volume resistance training protocol, and to assess the sensitivity of cf-DNA to different resistance training volume loads. The secondary purpose was to examine the relationship between cf-DNA and relative strength. Study 1 was an exploratory attempt to discover relationships between cf-DNA, CK, CRP, delayed onset muscle soreness, and performance variables. Seventeen resistance trained males were recruited, 9 were randomly assigned to receive BCAAs while 8 received a …


The Effects Of Increasing Running Speed On Vgrf And Asymmetry, Kaela M. Hierholzer Aug 2020

The Effects Of Increasing Running Speed On Vgrf And Asymmetry, Kaela M. Hierholzer

Electronic Theses and Dissertations

Biomechanical and physiological parameters related to running performance are usually studied separately. However, evaluating both aspects together could be beneficial in improving athletic performance. The purpose of this study was to observe the change in peak vGRF and asymmetry as speed increases, while observing physiological responses during a O2maxtest. Data from athlete monitoring of 12 cross-country and triathlon athletes were analyzed. The athlete monitoring protocol included three unweighted countermovement jumps and a O2maxtest performed by the athletes. The athletes had an average O2maxof 53.4 ± 7.7 mL/kg/min, while their average vGRF asymmetry throughout the …


Development, Expansion And Role Of Myeloid-Derived Suppressor Cells In Post-Sepsis Immune Suppression, Tuqa Alkhateeb Aug 2020

Development, Expansion And Role Of Myeloid-Derived Suppressor Cells In Post-Sepsis Immune Suppression, Tuqa Alkhateeb

Electronic Theses and Dissertations

Myeloid-derived suppressor cells (MDSCs) numbers increase significantly in sepsis and are associated with high mortality rates. These myeloid cell precursors promote immunosuppression, especially in the late (post sepsis) stage. However, the mechanisms that underlie MDSC expansion and programming are not completely understood. To investigate these mechanisms, we used a cecal-ligation and puncture (CLP) mouse model of polymicrobial sepsis that progresses from an early/acute proinflammatory phase to a late/chronic immunosuppressive phase. Previous studies in our laboratory showed that microRNA (miR)-21 and miR-181b elevate levels of the transcription factor nuclear factor 1 (NFI-A) that promotes MDSC expansion. We report here that miR-21 …


Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt Aug 2020

Serious Mental Illness And Rural Primary Care: Provider Training, Attitudes, And Opinions, Lydia Eisenbrandt

Electronic Theses and Dissertations

Healthcare resources are especially limited in rural regions of the US. The lack of Primary Care Providers (PCPs) and mental/behavioral health services is problematic, as there are high rates of behavioral and medical concerns within rural populations. Special populations, such as rural persons with Serious Mental Illness (SMI), are medically complex and represent a vulnerable and underserved population. Healthcare outcomes for persons with SMI are poor compared to the general population and commonly lead to premature death. Various barriers prevent this population from accessing optimal healthcare, especially in rural areas, due to negative perceptions/stigma, a lack of understanding from PCPs, …


Bdnf-Related Gene Expression Of Laser Capture Microdissected Glutamate Neurons From The Anterior Cingulate Cortex In Mouse Models Of Autism Spectrum Disorder, Misty Owens Aug 2020

Bdnf-Related Gene Expression Of Laser Capture Microdissected Glutamate Neurons From The Anterior Cingulate Cortex In Mouse Models Of Autism Spectrum Disorder, Misty Owens

Electronic Theses and Dissertations

Autism spectrum disorder (ASD) is a neurodevelopmental disorder affecting social behaviors. ASD affects 1 in 59 children with males affected more frequently. ASD is postulated to result from excitatory and inhibitory neurotransmission imbalances. Brain-derived neurotrophic factor (BDNF) signaling affects ASD by influencing synaptogenesis, plasticity, and survival. Studying early in-utero neuropathological changes within ASD requires the use of animal models. Expression of BDNF-associated genes were analyzed within laser capture microdissected pyramidal neurons from the anterior cingulate cortex of male and female BTBR and valproic acid mouse models. No expression differences were found in any gene comparing the three groups. Gender comparisons …


The Effects Of Bilingualism In Post-Stroke Aphasia Patients: Clinical Implications Within The United States, Kristen Bennett May 2020

The Effects Of Bilingualism In Post-Stroke Aphasia Patients: Clinical Implications Within The United States, Kristen Bennett

Undergraduate Honors Theses

The consistent increase of cultural diversity and immigration within the United States over the last fifty years has contributed to a societal shift towards a growing bilingual population. The growth of this population has generated a need to evaluate current assessment and treatment plans for bilingual post-stroke aphasia patients within the United States to ensure that these individuals are receiving effective healthcare. This study aims to investigate the current knowledge gap surrounding appropriate methods of assessing and treating bilingual post-stroke aphasia patients within the United States and suggest potential approaches based on existing research. In order to synthesize information regarding …


Synaptic Protein Expression In Human Postmortem Brain Tissue Of Autism Spectrum Disorder, Alexandra Duggan May 2020

Synaptic Protein Expression In Human Postmortem Brain Tissue Of Autism Spectrum Disorder, Alexandra Duggan

Undergraduate Honors Theses

It is estimated that one in 59 children in the US are affected by autism spectrum disorder (ASD). ASD is distinguished by social and communication deficits that can be displayed throughout a wide range of severity. This resulting spectrum of behaviors observed in ASD suggests that a complex etiology is involved. Previous studies have shown a genetic susceptibility to autism including paternal age, twin and sibling concordance. Genetic sequencing of those affected as well as first order relatives have identified alterations in genes associated with neuronal synaptic communication. However, very little information is available regarding the pathophysiology of synapses in …


Levels Of Parp1-Immunoreactivity In The Human Brain In Major Depressive Disorder, Aamir Shaikh May 2020

Levels Of Parp1-Immunoreactivity In The Human Brain In Major Depressive Disorder, Aamir Shaikh

Undergraduate Honors Theses

MDD is a severe and debilitating disorder that is associated with a growing global economic burden due to reduced workplace productivity along with increased healthcare resource utilization. Furthermore, depression markedly enhances the risk for suicide, mortality that is especially worrisome given that 30% of depressed individuals have an inadequate response to current antidepressants. This inadequacy of antidepressants necessitates the discovery of a better understanding of the pathobiology of MDD. Most current antidepressants work through monoamine neurotransmitters, and their relative efficacy in depression led to the now dated monoamine-deficiency hypothesis. The limited usefulness of antidepressants has led to a reinvigorated search …


The Effects Of Total Body Proton Irradiation On Mouse Myometrium, Lillith Bulawa May 2020

The Effects Of Total Body Proton Irradiation On Mouse Myometrium, Lillith Bulawa

Undergraduate Honors Theses

The boundaries of human space exploration continue to expand with new technology and discoveries making it even more important to investigate the effects of space on biological systems. Although humans have explored space in small increments, reproductive studies must be conducted to determine if stable short- or long-term residences for humans can exist in space. This study explored the effects of whole-body proton radiation on uterine smooth muscle known as the myometrium. Two types of mice utilized in this study were C57BL/6 and B6.129S6Cybbtm1Din/J NOX2 knockout mice. C57BL/6 mice are standard laboratory mice that were used to represent the wildtype …


Dna Transfer In The Soil Bacterium Rhodococcus, Jaimin Maheshbhai Kapadia May 2020

Dna Transfer In The Soil Bacterium Rhodococcus, Jaimin Maheshbhai Kapadia

Undergraduate Honors Theses

Gene transfer plays an important role in bacterial evolution. Especially in an under explored species like Rhodococcus, a type of bacteria found in the soil. Rhodococcus has several applications in the pharmaceutical industry and in the production of antibiotics. Rhodococcus possess several unique sets of properties which makes it beneficial to have a reliable method of producing mutants of Rhodococcus. The goal of the experiment was to find an efficient way of forming Rhodococcus colonies with kanamycin resistant genes. The project began from an unexpected observation from an earlier experiment with Rhodococcus strain MTM3W5.2. where I attempted to transform this …


The Effects Of Nursing School Peer Tutoring On Tutors, Yelyzaveta Soboleva May 2020

The Effects Of Nursing School Peer Tutoring On Tutors, Yelyzaveta Soboleva

Undergraduate Honors Theses

An integrative review was used to examine the effects of being a tutor versus not being a tutor. The matrix method was used to guide the research process, to identify articles that met the inclusion criteria, and to reduce data into common topics of peer tutoring. The results of the integrative review yielded 20 articles and suggested that students in the position to assist others are more confident in communicating in groups and have higher knowledge in the subject they help with than their fellow peers. The literature showed that students in the position to assist others have defined personal …


The Effects Of Farnesol, A Quorum Sensing Molecule From Candida Albicans, On Alcaligenes Faecalis, Savannah Hutson May 2020

The Effects Of Farnesol, A Quorum Sensing Molecule From Candida Albicans, On Alcaligenes Faecalis, Savannah Hutson

Undergraduate Honors Theses

Quorum sensing molecules have become a recent focus of study to learn if and how they can be used, both on their own and in conjecture with current antimicrobial methods, as a means of bacterial control. One such quorum sensing molecule is the sesquiterpene alcohol, Farnesol, which is synthesized and released by the fungus, Candida albicans. In most in-vivo cases, our laboratory has shown that Alcaligenes faecalis overtakes C. albicans, preventing its growth. However, as a way to counteract this inhibitory effect, Farnesol may be one way that Candida has found to fight back. In this study, we …


A Study Of The Polymicrobial Inhibitory Interactions Between Alcaligenes Faecalis And Staphylococcus Aureus, Blakeley Griffin May 2020

A Study Of The Polymicrobial Inhibitory Interactions Between Alcaligenes Faecalis And Staphylococcus Aureus, Blakeley Griffin

Undergraduate Honors Theses

Members of the Staphylococcus genus are found as a part of normal microflora in humans and can commonly be found on the skin or in the nasal cavity. However, these microorganisms can cause serious and life-threatening opportunistic infections when there is a break in the physical barrier of skin. These infections have become difficult to treat as resistant strains emerge, particularly Methicillin Resistant Staphylococcus aureus (MRSA). MRSA has become a commonly acquired nosocomial infection which is difficult to treat with conventional antibiotics of the blactam class. Even Vancomycin, a last resort antibiotic, has been ineffective on some infections. Furthermore, …


Comparing Heatwave Related Mortality Data From Distressed Counties To Affluent Counties In Central And Southern Central Appalachia, Miranda Taylor Pardue May 2020

Comparing Heatwave Related Mortality Data From Distressed Counties To Affluent Counties In Central And Southern Central Appalachia, Miranda Taylor Pardue

Undergraduate Honors Theses

The Appalachian Mountains are home to some of the most culturally rich places in the United States, but also some of the most impoverished communities as well. Several recent events support climate change across the globe. It is expected that Appalachian communities may suffer more dire consequences, as many communities lack strategies to help relieve some of the worst effects of climate change. Heatwaves are predicted to increase in duration and frequency over time, and communities that are not well prepared for the damaging effects of heatwaves can suffer unduly. This study aims to quantify the likelihood that people living …


Examination Of The Polymicrobial Interaction: Inhibitory Effects Of Alcaligenes Species On Members Of The Candida Species, Madelyn Whitlock May 2020

Examination Of The Polymicrobial Interaction: Inhibitory Effects Of Alcaligenes Species On Members Of The Candida Species, Madelyn Whitlock

Undergraduate Honors Theses

Candida species are commonly found in the human normal flora, however they are a major cause of nosocomial infections that can be life threatening. This fungal species is an opportunistic pathogen and causes infection in individuals who are immunosuppressed. A key characteristic of Candida’svirulence is the ability to change its morphology from ovoid yeast to filamentous hyphae. Alcaligenes species are common bacteria found in the environment that rarely, if at all, cause infections in humans. It has been observed that when allowed to interact, Alcaligenes faecalis changes the morphology of Candida albicans from yeast cells to hyphal cells. When …


Lack Of Osteopontin Induces Systolic And Diastolic Dysfunction In The Heart Following Myocardial Ischemia/Reperfusion Injury, Caytlin James May 2020

Lack Of Osteopontin Induces Systolic And Diastolic Dysfunction In The Heart Following Myocardial Ischemia/Reperfusion Injury, Caytlin James

Undergraduate Honors Theses

Ischemic heart disease is a leading cause of death worldwide. Osteopontin (OPN), a cell-secreted extracellular matrix protein, is suggested to play a cardioprotective role in mouse models of ischemic heart disease. The objective of this study was to examine the role of OPN in modulation of systolic and diastolic functional parameters of the heart following mouse ischemia/reperfusion (I/R) injury. For this, wild-type (WT) and OPN-knockout (KO) mice aged approximately 4 months were subjected to cardiac ischemia for 45 minutes by the ligation of the left anterior descending coronary artery (LAD) followed by reperfusion of LAD by snipping the ligature. Heart …


Effect Of Gender On Intentional Learning Orientation, Sarah Anderson, Loyd Lee Glenn May 2020

Effect Of Gender On Intentional Learning Orientation, Sarah Anderson, Loyd Lee Glenn

Undergraduate Honors Theses

Knowledge of how gender affects learning is scarcely understood in the realm of nursing education. Prior studies have indicated certain learning styles are predictors of passing board examinations. Pinpointing specific learning styles could improve educational outcomes and produce thoroughly equipped nurses. Previous researchers have studied the differences in learning preferences according to gender; however, no studies have solely concentrated on gender specific learning preferences among undergraduate nursing students. Learning Interest, as well as Goal Orientation, were found to be statistically significant between genders.


Effects Of Nicotinamide Riboside And Beta-Hydroxybutyrate On C. Elegans Lifespan, Jeffery Peters May 2020

Effects Of Nicotinamide Riboside And Beta-Hydroxybutyrate On C. Elegans Lifespan, Jeffery Peters

Undergraduate Honors Theses

The nicotinamide riboside (NR) form of vitamin B3and the ketone body ß-hydroxybutyrate (BHB) are two of the most promising natural compounds yet identified for the treatment of aging and aging-related diseases. Forms of vitamin B3are precursors for the synthesis of the coenzymes nicotinamide adenine dinucleotide (NAD(H)) and nicotinamide adenine dinucleotide phosphate (NADP(H)). In aged cells levels of NAD+decline, decreasing metabolism and decreasing activity of protective sirtuin protein deacetylases. In aged cells NR, but not more common forms of vitamin B3, boost NAD+levels. BHB is naturally produced by the body when individuals fast …


Second Messenger Cyclic-Di-Gmp Regulation In Acinetobacter Baumannii, Justin Deal May 2020

Second Messenger Cyclic-Di-Gmp Regulation In Acinetobacter Baumannii, Justin Deal

Undergraduate Honors Theses

Over time, “superbugs,” or bacteria that have become resistant to antibiotics, have become a great concern in modern medicine. Viable alternates are currently being looked into as effective and safe ways to prevent or treat infections caused by these superbugs. One such method is through the utilization of the second messenger molecule cyclic-di-GMP (c-di-GMP) that has been shown to regulate phenotypes within other bacteria that may control surface colonization in Acinetobacter baumannii. Through a series of experiments, the active enzymes that create c-di-GMP - diguanylate cyclases - and break down c-di- GMP - phosphodiesterases - have been inactivated in …