Medicine and Health Sciences Commons^™

Upper Extremity Use In Older Adults During A Floor Transfer: Biomechanical Implications And Relationships To Self-Report Measures, Ethan Klein, Daniel Farag, Isaiah Cappelen, Joshua Naughton, Evan Robinson, Lyndsay Stutzenberger, Tyler Whited

Student-Faculty Research - College of Physical Therapy

Getting up from the floor is progressively challenging with age and associated with higher morbidity and lower functional capacity1,2,3

Little is known about the associations of fear of falling (FoF) and physical activity (PA) levels on upper extremity (UE) use with getting up from the floor and the influence of UE use on the biomechanical demands of a floor transfer (FT) task

Study purpose: Determine the associations of UE use with FoF and PA levels and the effects of arm use and limb position on lower extremity kinetics

Hypotheses: Greater FoF and less PA would be positively correlated to greater …

Effect Of Clinical Expertise On Efficacy Of Vocal Function Exercises In Individuals With Typical Voice, Maria H. Bane, Vrushali Angadi, Richard D. Andreatta, Joseph C. Stemple

Communication Sciences and Disorders Faculty Publications

Objectives/Hypothesis: To determine the effect of clinical expertise on efficacy of Vocal Function Exercises (VFEs) as measured by change in percent of maximum phonation time goal attained. The hypothesis was that clinical expertise would result in greater increases in percent of maximum phonation time goal attained.

Study Design: Randomized controlled trial.

Methods: A convenience sample of 19 individuals with typical voice was recruited in a university academic clinic setting. All participants completed baseline assessment and 17 completed all study procedures. Participants were randomized to receive VFEs from an expert voice clinician with more than 40 years’ experience (expert group (EG)) …

Social Health Programming During Adolescence Is Associated With Increased Serum Levels Of Carotenoids, Vitamin A, And Vitamin E In Young Women: An Observational Cohort Study, Rebecca Drakowski, Matthew Vanormer, Laura Ebers, Katie Mayhan, Anum Akbar, Colman Freel, Taija Hahka, Rebekah Rapoza, Corrine K. Hanson, Keyonna King, Aaryn Mustoe, Melissa K. Thoene, Ann Anderson-Berry

Journal Articles: Pediatrics

Over 85% of young women in the United States do not meet fruit and vegetable intake recommendations, placing them at risk for low antioxidant nutrient intake. Social health programming (SHP) can improve dietary intake of fruits and vegetables, but it is not known how SHP impacts serum levels of specific antioxidant nutrients. This observational cohort study assessed the effect of participation in SHP through Girls Inc., Omaha, on serum carotenoid, retinol, and tocopherol levels for 12–29-year-old women. Serum nutrient levels were measured using high-performance liquid chromatography and nutrient intake from diet was measured using three 24 h dietary recalls (ASA24 …

Evaluating The Impact Of Glidant And Predicting Tablet Sticking Using Powder Rheology, And Tablet Compression Technologies, Bhavin Vishnubhai Parekh

Selected Full-Text Dissertations 2020-

Two-thirds of all pharmaceutical formulations are delivered orally, and more than half are in the form of a tablet. Tablets are the most popular in terms of both the marketed products and the volume of manufacturing. On the other hand, tablet sticking is an extremely expensive and time-consuming problem that must be addressed. Because of limited tabletpressing cycle runs and incomplete information, trying to predict the sticking propensity of a new formulation has been extremely difficult during early-development batches. A model of drugs, ketoprofen, Acetaminophen, and salicylamide, was used to predict the effect of glidants (Aerosil® 200, Talc, and Syloid® …

Caregiver Training: Improving Social Determinants Of Health, Patient Safety, Empowerment Through Improving Elder Care Education And Skills, Kathleen Thimsen

Nursing Faculty Research

Caregiver training (CaGi TRaining) is a time-tested intervention aimed at improving safety in elders living and aging in place in the community. While elder abuse and maltreatment was the intial purpose of the project, with over 3500 Caregivers graduated from this program since 2009, the course has addresses social determinants of health, and improved workforce pipelines by providing stable employment, improved self-efficacy, and confidence demonstrated by self-reports at graduation and in follow up surveys. Previously learners without a high school diploma retruned to school to obtain a GED (40%), with an additional return to school for bacalaureate and degrees (27%) …

Hallucinogen Use Among Parents Of Children In The United States: Associations With Mental Health And Substance Use, Maggie K. Richardson

Theses and Dissertations--Educational, School, and Counseling Psychology

Hallucinogen use has reemerged in the United States amid expanding clinical research and shifting social and policy contexts. However, population-based evidence remains limited regarding hallucinogen use among adults living with children and its relationship with mental health impairment severity in caregiving environments. Therefore, this study’s objective was to examine associations between past-year hallucinogen use and past-year mental health impairment among U.S. adults, and to test whether associations differ by parental status and number of children in the household. A secondary aim examined correlates of co-occurring substance use among those reporting hallucinogen use.

Data were drawn from the 2023 National Survey …

Counselors' Lived Experiences Of Moral Injury: A Social Ecological Perspective, Lisa M. Belknap

Antioch University Dissertations & Theses

This study explores the lived experiences of counselors who encountered moral injury when sociopolitical, institutional, and organizational conditions constrained their ability to practice in alignment with their personal morals, professional values, and the counseling profession’s code of ethics. Participants (N = 15) included licensed counselors who self-identified as having experienced moral injury in response to directives from legitimate authorities that conflicted with professional ethics, social justice commitments, or client welfare. Grounded in social ecological systems theory, this phenomenological study employed a confidential, cross-sectional online survey. Reflexive thematic analysis identified seven themes: (a) Profit Over People, (b) Structural Forces Contributing to …

Bridging Worlds Of Care: A Qualitative Exploration Of Integrating Non-Western Healing Modalities With Mental Health Counseling, Douglas Valdez

Antioch University Dissertations & Theses

The aim of the study is to explore the experiences of practitioners who treat individuals presenting with depression and anxiety using culturally integrative non-Western healing modalities. Participants included 15 experienced practitioners (minimum five years of practice) who identified as Traditional Chinese Medicine providers (e.g., acupuncturists, herbalists) and/or Curandero/x/as. The approach was qualitative, utilizing open-ended survey responses collected electronically and analyzed with thematic analysis. Results indicated six primary themes: (a) Philosophies in Healing, highlighting culturally grounded conceptualizations of depression and anxiety; (b) Traditional Chinese Medicine Interventions, including acupuncture, botanical, nutritional, manual, and movement-based practices; (c) Curanderismo Pláticas and Integrative Western Healing …

"Why Don't I Talk To A Therapist?": Motivations And Reflections Of Female-Identifying Chinese Immigrants Seeking Psychotherapy For Depression, Qiuyi Wei

Antioch University Dissertations & Theses

This phenomenological study explored the lived experiences of Chinese immigrants and temporary residents struggling with depressive symptoms and their process of seeking and accepting psychotherapy support. The study aimed to describe the factors that motivated participants to enter therapy for depression while also addressing their internal concerns about treatment. Nine female-identified Chinese immigrant adults with such experiences were recruited. Participants’ perceptions of their depressive symptoms and the factors contributing to their decision to seek professional therapy were explored through in-depth, semi-structured qualitative interviews conducted in Mandarin. The interview transcripts were analyzed in Mandarin using interpretative phenomenological analysis, through which four …

Bi+ Cismale Experiences With Straight Cismale Friends, Taylor M. Hardock

Antioch University Dissertations & Theses

Minority Stress Theory (2006) posits that individuals with a marginalized sexual identity have unique challenges and stressors. Bisexual+, or bi+, individuals have particular stressors related to not holding a monosexual identity, including specific mental health challenges. Research has shown that friendship can have many positive benefits on individuals, though the literature looking at friendship among bi+ identifying people is very limited. This qualitative study investigates the experiences of friendship between bi+ and straight cis men, especially as they may relate to minority stress and experiences of resilience and community belongingness. A thematic analysis was utilized to understand the personal experiences …

One-Stop-Shop (Oss): Community Health Nursing: (For Undergraduate Nurses), Sarmad Muhammad Soomar

Books

No abstract provided.

Dupilumab For The Treatment Of Prurigo Nodularis, Iain Noel Encarnacion, Noelle Desir, Simona A. Alomary, Nicole Baker

SKMC Student Presentations and Publications

Prurigo nodularis (PN) is a chronic, intensely pruritic dermatosis driven by neural and immune dysregulation, with historically limited FDA-approved treatment options. In September 2022, dupilumab became the first FDA-approved therapy for PN. To review the clinical efficacy of dupilumab in PN, with emphasis on pivotal clinical trials, real-world evidence, and safety profile. We examined mechanistic studies of dupilumab, early case reports and series, phase 3 LIBERTY-PN PRIME and PRIME2 randomized trials, real world observational studies, and safety data. Dupilumab, a human monoclonal antibody targeting IL-4Rα, suppresses type 2 inflammation. In PRIME (n = 151) and PRIME2 (n = 160), dupilumab …

Using The Dynamic Appraisal Of Situation Aggression (Dasa) Tool In An Inpatient Psychiatric Unit, Doose J. Onarinde

Doctor of Nursing Practice Final Project Abstract

Purpose: This quality improvement project evaluated whether implementation of the Dynamic Appraisal of Situational Aggression (DASA) tool reduced aggressive incidents compared with unstructured clinical judgment.

Background: Workplace violence is a persistent safety concern in inpatient psychiatric settings, contributing to staff injury, burnout, and compromised patient care.

Methods: Guided by Lewin’s Change Model, a pre–post intervention design was implemented over eight weeks on a 23-bed male forensic psychiatric unit. Registered nurses received standardized education and completed daily DASA assessments for all admitted patients. Data were collected from incident reports, DASA scores, and pre- and post-intervention nurse surveys. Descriptive statistics were used …

Implementation Of A Pressure Injury Prevention Bundle To Reduce Hospital-Acquired Pressure Injuries In The Intensive Care Unit, Xibo Lan

Doctor of Nursing Practice Final Project Abstract

Purpose

The goal of this quality improvement project was to utilize the SKINSAFE pressure injury prevention bundle during 12 weeks of implementation to increase evidence-based pressure injury prevention practices adherence and decrease risk of hospital-acquired pressure injury (HAPI) in the intensive care units (ICU).

Background

ICU patients experience high risk for hospital acquired pressure injuries (HAPIs) secondary to immobility and device related pressure. Initial adherence to SKINSAFE bundle was 55-56%. There was inconsistent use of heel offloading devices, wound photography and documentation. Prevention bundles were affected by staffing fluctuations and leadership turnovers.

Methodology

The Plan-Do-Study-Act cycle for this project included …

Enhancing Patient Satisfaction Through A Telehealth -Enabled Post-Discharge Follow-Up Program In An Adult Medical-Surgical Unit, Helen T. Idowu, Helen Temitope Idowu

Doctor of Nursing Practice Final Project Abstract

Abstract

Purpose: This quality improvement (QI) project evaluated the effectiveness of a telehealth-enabled post-discharge follow-up program in improving patient satisfaction among adult medical–surgical patients discharged following arteriovenous (AV) fistula placement.

Background: Ineffective communication during transitional care contributes to poor patient understanding, decreased confidence in self-management, and lower patient satisfaction. Internal organizational data identified a baseline satisfaction rate of 55%, demonstrating the need for a structured post-discharge intervention.

Methodology: A 12-week QI initiative was conducted using the Plan–Do–Study–Act framework. Registered nurses completed standardized telehealth follow-up calls within 24–48 hours of discharge to reinforce discharge education, assess symptoms, and address patient …

Nurse-Driven Initiatives To Reduce Supply Waste Produced In The Intensive Care Unit, Lance Prince

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this quality improvement (QI) project was to implement a needs-based supply retrieval system using mobile carts and evaluate its effectiveness in reducing supply costs and improving resource stewardship among nursing staff over an 8-week period.

Background

intensive care units are high-resource environments where medical supply overconsumption leads to significant financial strain and environmental impact. Preliminary audits in a high-acuity unit revealed a trend of excess waste driven by the automatic opening of standardized, pre-packaged admission kits regardless of individual patient needs.

Methodology

Guided by the Iowa Model of Evidence-Based Practice, a pre/post-intervention design evaluated 49 patient …

Facilitating Shared Reading Exposure To Promote Health Outcomes In A Rural Pediatric Primary Care Clinic, Meredith L. Longino

Doctor of Nursing Practice Final Project Abstract

Purpose

The purpose of this scholarly project was to address a gap in early literacy promotion for rural children by incorporating the Reach Out and Read program. This program bolsters foundational literacy by providing a book and anticipatory guidance at every well-child visit from birth through age 5. This project was expected to decrease no-show well-child attendance rates and improve provider morale.

Background

The project was implemented in an established rural pediatric primary care clinic in Northeast Texas. 

Methodology

Process implementation was measured through books distributed and EHR documentation of the intervention. Process objectives were measured by no-show rates for …

Improving Parental Self-Efficacy And Stress Management Among Parenting Youth Experiencing Homelessness: Development And Implementation Of A Standardized Group Parenting Curriculum At An Urban Homeless Shelter, Liam Jerez

Doctor of Nursing Practice Final Project Abstract

Purpose

This quality improvement (QI) project developed and implemented an evidence-informed group parenting curriculum, The Parenting Hub: Mindful Moments (TPHMM), at an urban youth shelter, aiming to increase parental self-efficacy by 20% and decrease parental stress by 20% among homeless parenting youth.

Background

Nearly half (49%) of 18–24-year-olds in families experiencing homelessness are parents, often facing low parenting confidence, limited support, and high stress. The project site, serving up to 150 youths, with a fluctuating number of young parents, lacked a standardized parenting curriculum.

Methodology

This pre-/post-test QI pilot used the Model for Improvement; Plan-Do-Study-Act cycles refined delivery in the …

Improving The Continuity Of Care For Opioid Use Disorder: Investigating Fentanyl Overdose Outcomes And Pharmacy-Level Buprenorphine Access, Lyn Yuen Choo

Graduate Theses, Dissertations, and Problem Reports (ETD)

Opioid overdose (OD) deaths remain a leading cause of injury-related death in the United States (US) and approximately 76,516 drug OD deaths were predicted in the past year prior to April 2025. While previous research has focused on fatal opioid ODs, less is known about outcomes following non-fatal opioid ODs (NFOO) involving fentanyl. Patients who experienced a fentanyl OD may develop significant morbidity and inpatient mortality due to fentanyl’s high potency, rapid onset of action, and decreased response to naloxone. Research efforts to improve continuity of care for opioid use disorder (OUD) are highly needed to ensure appropriate follow-up care …

The Hidden Process Of Student Placements: Perspectives From Slp, Ot, And Pt Coordinators, Almara Jane Sidney Hutchinson

Graduate Theses, Dissertations, and Problem Reports (ETD)

This comparative multi-case study examined the unseen processes behind clinical placement planning in allied health education. Clinical placements are essential to preparing students in speech-language pathology (SLP), occupational therapy (OT), and physical therapy (PT); however, little research has explored how Directors and Coordinators of Clinical Education (DCE/CCEs) navigate the complex decision-making involved in planning these experiences. Guided by Greco and Myers’ (2024) framework conceptualizing placement planning as an interaction between process and experience, this study explored how coordinators described their planning processes and the role of student-centeredness within them.

Semi-structured interviews were conducted with 12 DCEs/CCEs representing SLP, OT, and …

Navigating Family, Culture, And Well-Being: A Qualitative Study Of First-Generation Adult Children Of Middle Eastern Immigrants In The United States, Ramona Amely

Antioch University Dissertations & Theses

The purpose of this study is to explore the lived experiences of first-generation adult children of Middle Eastern immigrant parents/caregivers living in the United States. This was a phenomenological study with reflexive thematic analysis. Participants (N=10) were interviewed via Zoom, and transcripts were analyzed using Reflexive Thematic Analysis (RTA). The results included four themes: (1) Migration Contact and Cultural Formation, (2) Bicultural Identity Development, (3) Family System Adaptation, and (4) Emotional Socialization and Psychological Impact. This study highlights how first-generation adult children of Middle Eastern immigrants navigate complex, interwoven processes of bicultural identity development, family adaptation, and emotional socialization shaped …

Ultrasound-Derived Liver Composition And Metabolic Flexibility Under Exercise Stress, Rhodes Van Houten

All Master's Theses

Metabolic Associated Fatty Liver Disease (MAFLD) is characterized by abnormal liver fat accumulation in conjunction with metabolic syndromes. MAFLD affects 33% of individuals worldwide, though little is known about how increased liver fat impacts physiological responses to exercise. This study aimed to analyze the relationship between liver composition and metabolic flexibility during a graded exercise test.  Body composition was analyzed via dual-energy X-ray absorptiometry. Liver ultrasound was evaluated for echogenicity, where elevated mean gray volume (MGV) indicates abnormal liver tissue. Rates of fat (FATox) and carbohydrate (CHOox) oxidation (g/min), respiratory exchange ratio (RER), and blood lactate concentrations ([LA^-], …

Examining The Effects Of Virtual Nature Exposure And Video Immersion On State Hope With Nature Relatedness As A Covariate, Zachary Arneson

All Master's Theses

Previous work in the field of environmental psychology has shown that virtual nature exposure can produce many psychological benefits for the viewer. Within this literature, however, there has been no examination of the effects of virtual nature exposure on levels of state hope, a goal-directed positive psychological construct made up of two types of thought: agency and pathways. Additionally, there has been no direct examination of the effect of immersion level of the virtual nature exposure on psychological measures. To fill this gap in the literature, the current study examined the effects of virtual nature exposure and video immersion on …

Adolescent Girls’ Experiences Of Digital Dating Abuse Through Social Media: A Scoping Review, Kiara E. Rodriguez

Social Work Theses

Teen dating violence (TDV) is a prevalent adverse childhood experience with lasting psychological and behavioral consequences. As adolescents increasingly engage with social media, with 95% of teens aged 13-17 reporting using it, digital spaces have become a significant context in which dating abuse can occur. Digital dating abuse (DDA) refers to patterns of abusive behaviors that are directed toward a dating partner through digital technologies, including social media and mobile phones. Despite the growing role of social media in adolescent relationships, research on how adolescent girls experience DDA in these contexts remains limited. The central question for this scoping review …

How Effective Is Online Teaching Of Physiology Modules? Perception Of Rwandan Health Sciences Students, Abdullateef Isiaka Alagbonsi, Mojeed Akorede Gbadamosi, Mathieu Nemerimana, Makinde V. Olubiyi, Olufunke Onaadepo, Akaninyene Ubong Ime, Abdul-Rahuf Aderemi Feyitimi, Ruth Wanjiru Mungai, Florent Rutagarama, Simiat Elias

Biomedical Sciences, East Africa

Background: While blended teaching is approved in Rwandan medical education, the perceived effectiveness of online-only delivery for physiology modules remains unclear. This uncertainty limits its continued use. The present study assessed Rwandan health sciences students’ perceptions of the effectiveness of online teaching for physiology modules.

Methods: A total of 528 students from medicine and surgery (n = 300), pharmacy (n = 99), dentistry (n = 89), and clinical psychology (n = 40) programs at the University of Rwanda completed an online questionnaire. Data were analyzed using multivariable logistic regression and non-parametric tests (Mann-Whitney U, Kruskal-Wallis) with corresponding effect …

Optimized Nano-Bilosomes Loaded Ocular Insert As A Promising Approach For Boosting Voriconazole Ocular Bioavailability: In-Vitro, Microbiological, And In-Vivo Assessments, Eman Gomaa, Eman Gomaa

Nanotechnology Research Centre

The eye possesses numerous physiological barriers that significantly limit the absorption of administered drugs, as only < 5 % get through. These barriers restrict drug bioavailability, often necessitating multiple dosing, which can lead to poor patient compliance. The study goal is to efficiently incorporate Voriconazole (VRC), a widespectrum antifungal candidate with a short half-life, into stable, biocompatible, non-irritating bile salt nanoparticles (Bilosomes, BLOs) to enhance its ocular delivery. Bilosomes were prepared by the ethanol injection method. Experimental (33 ) Box–Behnken Design (BBD) was employed; the amount of bile salt, cholesterol, and span-60 were chosen as independent variables, while entrapment efficiency (EE%), cumulative VRC release (Q8h), particle size (PS), zeta potential (ZP), and polydispersity index (PDI) were the dependent variables. The formula of optimization showed EE% (59.04 ± 1.88 %), cumulative release after 8 h (81.35 ± 0.69 %), PS (222.53 ± 2.04 nm), ZP (− 72.53 ± 1.75 mV), and PDI (0.225 ± 0.03). It was chemically characterized using DSC and FTIR. Its spherical arrangement was confirmed using TEM. For ophthalmic application, the optimized formula was included in ocular inserts to extend ocular residence time while minimizing dosing frequency. The optimal VRC-loaded bilosomal ocular insert met the acceptable physicochemical criteria, was sterilized using UV radiation for conducting microbiological assay, in-vivo study, and pharmacokinetic analysis. For safety evaluation, an eye irritation study and histopathological examination were conducted. The results confirmed its effectiveness as evidenced by a significantly larger inhibition zone and 8.39-fold enhancement in VRC bioavailability compared to its suspension. These findings support the potential of bilosomes-loaded ocular insert as an effective ocular delivery of VRC.

Electromyography Of The Coracobrachialis—Construct Validity And Implications For Rehabilitation Of Anterior Shoulder Dislocation, Alon Rabin, Timothy L. Uhl, Ido Druckmann, Zvi Kozol, Yossi Ruah, Dani Rotman, Dan Stein

Physical Therapy Faculty Publications

Background: The coracobrachialis (CB) is an important anterior shoulder stabilizer, yet no study has previously reported its electromyography (EMG). The purpose of this study was to validate a novel technique for surface EMG (sEMG) of the CB.   Methods: Thirty-two (21 females) healthy individuals participated in this cross-sectional study. A surface landmark for recording the CB was identified within the medial aspect of the proximal arm using real-time ultrasound imaging and cadaver dissection. The EMG from this landmark as well as from the biceps brachii (BB) were simultaneously recorded during shoulder horizontal adduction (SHAd) (a CB-dominant test), and during elbow flexion …

Developing A Multidisciplinary Pediatric Cancer Predisposition Service At A Mid-Sized Children’S Hospital, Amanda M. Harrington, John August D'Orazio

Markey Cancer Center Faculty Publications

Roughly one in ten children and young adults diagnosed with cancer has an underlying genetic variant that may explain his/her malignancy. It is critical to identify patients with cancer predisposition syndromes (CPSs) to provide personalized cancer treatment, surveillance, counseling, psychosocial support, and in some cases, risk-reducing interventions to maximize long-term outcomes. Over the past five years, we developed a comprehensive pediatric CPS program at our institution. We engaged our institutional adult cancer center for clinical cancer genetic counseling services and needed research shared resource facilities. We also initiated a clinical study called “Project Inherited Cancer Risk” (PICR) to identify pediatric …

Expanding The Boundaries Of Bedside Practice: Transport Nursing As A Living Model Of Clinical Nurse Specialist Competencies, Ian A. Lane

Faculty Publications (Peer-Reviewed)

Objectives: The purpose of this paper is to argue that clinical nurse specialist (CNS) education represents the most conceptually and professionally continuous advanced practice pathway for critical care transport nurses, and to highlight transport nursing as an underrecognized practice context that aligns closely with CNS competencies and warrants deliberate attention from CNS educators and programs.

Description:  This paper presents a conceptual analysis of transport nursing through the CNS spheres of influence, emphasizing continuity with bedside nursing expertise while extending into quality improvement and systems leadership. This perspective examines how transport nurses routinely navigate high-acuity clinical cases and interfacility system constraints. …

An Anti-Adhesive Compound Modulating The Production Of Staphylococcus Aureus Cell Wall-Anchored Proteins, Allison C. Leonard, Ruina Bao, Cindy Menjivar, Megan J. Myers, Telmo O. Paiva, Zhiyong Zheng, Kirsten A. Berry, Kenneth W. Bayles, Ronald S. Flannagan, Yves F. Dufrêne, Jeffrey L. Bose, David E. Heinrichs, Georgina Cox

Journal Articles: Pathology and Microbiology

As one of the leading global causes of death associated with antimicrobial resistance, Staphylococcus aureus frequently colonizes the human nasal cavity and adheres to keratinized skin, establishing reservoirs that drive subsequent infections and emphasize the need for new decolonization strategies. Using a high-throughput, whole-cell screening platform, here we identify geranylgeranoic acid (GGA), a naturally occurring polyunsaturated, branched-chain fatty acid, as having dual activity against methicillin-resistant S. aureus (MRSA). At elevated concentrations, GGA exhibits microbicidal effects, whereas at sub‑microbicidal doses, it effectively inhibits MRSA adhesion to keratin, fibronectin, fibrinogen, and immunoglobulins. GGA possesses anti-adhesive activity against a panel of multidrug-resistant S. …