ASP Newsletter, Spring 2018 by University of Tennessee Health Science Center

LL RES EA E RC H

S ON CE SI SERVI

NTE S

Spring 2018

HEALTH PRO OF FE CLINIC S AL C

N ATIO UC ED

T HE

The Department of Audiology & Speech Pathology

T EN

TH NESSEE HEAL

Annual Newsletter

IMPROVING LIFE’S CONNECTIONS

Letter from the Dean Dear Friends:

I am honored to have become Dean of the College of Health Professions just before the new year. By way of introduction, my wife and three sons and I have moved from West Virginia, where we have spent the past 18 years. During this time, I held the positon of Chair of the Division of Exercise Physiology, Executive Chair of the Department of Human Performance and Applied Exercise Science, and Senior Assistant Dean for Research and Graduate Studies at West Virginia University School of Medicine. I have a PhD in Neuroscience from McMaster University. My lab studies muscle wasting, and muscle regeneration/repair under conditions of aging, disuse and neurological disorders. My primary goal for the College of Health Professions is to raise our national visibility and ranking in research, and to increase our community impact. To accomplish this, we must invest in research and faculty that will help to better prepare our students for even more impactful health care delivery. I am proud of the great faculty who make up the Department of Audiology and Speech Pathology (ASP) and their many accomplishments, and I look forward to working together to increase ASP’s impact in research, teaching, and service to our communities. Yours sincerely, as we build our future together. Inside this edition Stephen E. Alway, PhD, FACSM Dean, College of Health Professions Contact Us

Phone: (865) 974-5019 Email: Pamela at pwilli25@uthsc.edu utaspalumniandfriends Check out our new website: www.uthsc.edu/asp

Improving Life’s Connections p. 2—3 Dreaming BIG p. 4—5 Adult Medical SLP p. 6—7 Balance & Tinnitus p. 8—9 Animal Audiology p. 10—11 Socialization p. 12—13 The Community p. 14—15 In Our Clinics & Labs

IMPROVING LIFE’S CONNECTIONS by...Dreaming BIG

Tamika Catchings Supports ASP in a BIG Way On October 27, more than 300 people gathered at the Foundry for dinner with Tamika Catchings. ASP and the UT Foundation hosted this event to honor Catchings who, as a Lady Vol basketball standout, received audiology and speech pathology services in the department for her significant bilateral hearing loss. After finishing her career with the Lady Vols, Catchings went on to become a WNBA star and fourtime Olympian. At the dinner, she delivered an inspirational speech to an audience of faculty, students, clients, ASP friends, university and athletic department representatives, Lady Vol fans, and student athletes from two local middle schools. Catchings described her childhood as a time when she experienced challenges in school. As a young student who excelled at sports, Catchings refused to wear her hearing aids and learned how to compensate for her hearing loss. However, as a freshman, Coach Pat Summit insisted that she wear hearing aids again and attend speech therapy, both of which occurred in ASP.

Mickey Dearstone, Voice of the Lady Vols, emceed the event and described his personal connections to the department. At the conclusion of her speech, Catchings presented Dr. Ashley Harkrider with a $50,000 check for the Tamika Catchings Endowed Scholarship Fund, started in 2016 by ASP Community Development Board Member Jerry Faerber and his wife Peggy, to support a graduate student in audiology. At the end of the event, Bear Stephenson auctioned a youth basketball clinic led by Catchings. After goodhearted exchanges, Lady Vol Head Coach Holly Warlick and UT President Emeritus Dr. Joe Johnson won the auction. Proceeds totaling $33,000 were raised from the dinner and will be equally split between the scholarship and a newly created Tamika Catchings Amplification Assistance Fund, which will help patients in need. Catchings plans to continue her relationship with ASP and explore new ways to give back to a program that helped her in a way that was “life changing.”

“Tamika demonstrates daily how you can overcome a disability. She is committed to help people improve their self-esteem, self-respect, and chances to succeed .” - Holly Warlick 2

Goal Tending On April 7, Catchings returned to Knoxville to lead the free basketball clinic for a gym full of area youth, including children from the Boys & Girls Clubs, patients who receive hearing services from ASP, and a group of young people from the general community and Lady Vol fan base. The 2-hour clinic focused on developing the fundamentals of basketball, encouraging children to set goals and work hard, and having loads of fun! At the conclusion of the clinic, Catchings challenged each child to Dream BIG. The clinic’s overarching theme was echoed on t-shirts and squishy balls that each child received. With the group of captivated children and volunteers, she broke down the word BIG, having everyone shout the words “Believe”, “Inspire”, and “Greatness”. Catchings’ enthusiasm was infectious, and her desire to make a positive impact on today’s youth was apparent throughout the clinic, as she gave many pats on backs and high fives during times of instruction. The clinic was staffed with a variety of volunteers, ranging from current graduate students, faculty, and ASP Community Development Board members, as well as a former patient, a local high school basketball coach, several high school basketball record-setters, a local principal, and a former UT football player and sports radio personality. The clinic was so successful that Catchings indicated she is looking forward to returning next year to do it all again! The clinic was held at the Regal Teen Center of the Boys & Girls Clubs of the Tennessee Valley. Bart McFadden, President and CEO noted, “Having Tamika here today embodies the message that we to give to our kids….regardless of your background and your circumstances, you can achieve your full potential.” McFadden went on to say about some of the kids who attended the clinic, “They may not see success in their everyday environments. To be able to put somebody like Tamika in front of them who has a very tangible and real story about overcoming, it really helps young people understand that the words they hear from our staff can be realized.”

IMPROVING LIFE’S CONNECTIONS ...Adult Medical SLP It’s on the Tip of My Tongue! Anomia, the inability to automatically recall names and words, is a frequent and frustrating condition that can occur due to a stroke, traumatic brain injury, or degenerative disease. It is also an early symptom of dementia. Drs. Eun Jin Paek and Ellen Hamby hope to bridge the gap between science and practice by adding to the knowledge base about this disorder and improving treatment outcomes for patients. Their current study evaluates the effects of word retrieval treatment on individuals with acquired neurogenic language disorders, including aphasia, dementia, or traumatic brain injury. Study participants receive extensive pretreatment testing in Dr. Paek’s Adult Language and Brain Lab (ALAB) followed by 20 plus hours of treatment in the Hearing and Speech Center, then retesting. Dr. Hamby conducts the clinical treatment aspects of the study. Undergraduate and graduate assistants and student clinicians assist in data collection and treatment delivery, providing them with opportunities to participate in evidence-based research and practice.

Changing the Image Drs. Paek and Hamby, in collaboration with Roberto Fernandez, MD at the Pat Head Summitt Clinic at University of Tennessee Medical Center, plan to use brain imaging to determine if there are changes in neural activity following treatment for patients with dementia. Delivered by Dr. Hamby and SLP students, patients will receive treatment for multiple language and cognitive processes, rather than traditional treatment which focuses on a single language target. Dr. Paek hopes to determine if simultaneous treatment of multiple language and cognitive processes will promote generalization, leading to better functional outcomes for patients with dementia. Dr. Paek is in her first year on the ASP academic faculty and Dr. Hamby has been with UT for 28 years. 4

Undergraduate student ready to assist Dr. Paek with fMRI data collection at UT Medical Center.

Following Swallowing Angie Orr has been around the block a time or two when it comes to diagnosing and treating swallowing disorders. More accurately, she has traveled miles to Florida and back in pursuit of her certification in fiberoptic endoscopic evaluation of swallowing (FEES), then used her unique expertise to assess and treat patients in six states for two years. Her certification in FEES, combined with 22 years of experience with patients who have difficulties swallowing, has prepared her well for her new position in ASP as Clinical Assistant Professor and coordinator of the dysphagia program. Ms. Orr provides hands-on clinical education for our students while serving patients both on- and off-campus. This summer, she will teach a course in FEES that will provide interested students with their first big step towards a certification that will set them apart from other graduating students. Ms. Orr also teams with Dr. Kevin Reilly on the academic faculty to conduct research and teach the required course in dysphagia.

In Other News

On April 6, Dr. Kenn Apel joined us for the 23rd Annual Sol Adler Memorial Lecture Series, where he spoke about spelling and literacy. Over 100 students, faculty, and professionals were present from around the region. ASP is grateful to the Adler family for their continued support of this conference and proud of Sol’s legacy that lives on through this event!

The Tennessee Department of Health recently awarded ASP with short-term funding to provide families across the state free tele-audiology visits. Faculty and AuD students counseled families of children birth-three who are beginning their journey with amplification. Tele-visits addressed parental concerns about their child’s amplification and educated parents about the development of auditory skills in their new listener. One parent from Chattanooga commented, “It is very useful for parents who are sailing into the unknown territory alone and need guidance.” 5

IMPROVING LIFE’S CONNECTIONS...Balance & Tinnitus Kids Get Dizzy Too! Expanding research from the ASP Vestibular and Balance Lab (VBL) and improved evaluation techniques are contributing to a clearer picture of dizziness in the 5 - 8 % of children from the general population who experience it. Dizziness in children is often overlooked due to an inability of the child or parent to describe the symptoms or the symptoms being attributed to misbehavior or poor coordination. Additionally, many professionals believe that children under 6 years old may not be able to complete vestibular testing. According to Clinical Associate Professor Dr. Steven Doettl, who directs the VBL and coordinates the ever-growing vestibular specialty clinic, “No child is ‘too young’ to evaluate if there is reasonable suspicion of dizziness, imbalance, or gross motor delay.” This is especially the case when the risk of potential vestibular dysfunction is higher than normal due to hearing loss and/or genetic conditions. Dr. Doettl is sharing his knowledge with other professionals by publishing his research in journals like American Journal of Audiology, Journal of the American Academy of Audiology, and International Journal of Clinical & Experimental Otolaryngology. In an invited paper for ASHA SIG 6 Perspectives, he also highlights the importance of balance assessments in children before and after cochlear implantation. One of his co-authors on this paper, Dr. John Little, an otolaryngologist with Children’s Ear, Nose, and Throat group in Knoxville, has had a significant influence on Dr. Doettl’s experimental and clinical approaches. Dr. Doettl’s interest in pediatric vestibular testing stemmed from a call he received about 10 years ago when Dr. Little asked if there was any way a vestibular assessment could be performed on a 4 year old. From that time on, the two have worked closely to collect data on, and more fully serve the needs of 6

Drs. Little (left) and Doettl (right), shown here with AuD student Morgan Stansberry, discuss the best treatment strategy for their patient.

children in East Tennessee who are dizzy, including those receiving cochlear implants. When medical management and/or vestibular rehabilitation is needed it can be fully implemented by Drs. Little, Doettl, and the AuD students learning from them. Additional Information regarding the VBL and Dr. Doettl’s research can be found at: http://uthsc.edu/asp/research/vbl.php

Award-Winning Student Research Mary Easterday, AuD, a PhD student in ASP, is conducting research on the physiology of the VestibuloOcular Reflex (VOR), with the hope that her findings will refine clinical protocols, improving assessment procedures for dizzy patients and clinicians. Currently, there is a limited body of knowledge regarding how sound stimulation can affect VOR function, especially during clinical measurements using videonystagmography and rotational chair testing. For this study, Dr. Easterday was awarded the Vestibular Research Student Investigator Grant by the “Dr. Easterday’s research is critical to better American Academy of Audiology (2017) and the James understand how the VOR and the auditory system and Susan Jerger Award for Excellence in Student Reinteract with each other in daily-life in order to search at the Audiology Now Conference (2017). Dr. improve clinical evaluations of the dizzy patient. Easterday’s mentors include Drs. Patrick Plyler and It is truly unique work with significant scientific James Lewis from the academic faculty and Dr. Steven and clinical relevance.” -Dr. Steven Doettl Doettl from the clinical faculty.

ASP Tinnitus Patient Brings Personal Story to the Classroom Clinical Assistant Professor, Dr. Brittany Grayless, first met Ms. Diane Smith when she sought treatment for her tinnitus in 2016. Ms. Smith was in a car accident that left her with multiple injuries, including a traumatic brain injury, left sided hearing loss, and bilateral tinnitus. Her tinnitus affected her in a variety of ways, including her ability to concentrate, communicate with others, and work. Dr. Grayless recommended that Ms. Smith complete the tinnitus counseling series offered at the UT Audiology Clinic. Through the series, Ms. Smith was given the tools she needed to address her suffering and gain control over her tinnitus. Dr. Grayless will share Ms. Smith’s case study as a poster presentation at the American Academy of Audiology Conference in Nashville this April. Dr. Grayless teaches a tinnitus course for AuD students and, for the last two years, Ms. Smith has shared her personal experiences. Her presentation gives students an opportunity to hear firsthand from a tinnitus patient who has overcome many obstacles to gain control over this debilitating problem.

“UT Audiology Clinic was my last effort to get help, giving me hope and support to accept and manage my disability and have an improved quality of life.“ -Ms. Smith

IMPROVING LIFE’S CONNECTIONS with...Animal Audiology Puppies Can Have Their Hearing Screened Too!

Recently, Drs. Ashley Harkrider and Erin Plyler teamed up with Dr. Michael Sims, now retired Professor of physiology and past director of the UT College of Veterinary Medicine (UTCVM) Electrodiagnostic Laboratory, to determine the best way to detect hearing loss in puppies. In an article published in the Journal of the American Animal Hospital Association, data they collected from 34 puppies demonstrate that a handheld otoacoustic emission (OAE) screener is just as effective in identifying cochlear, conductive, and mixed hearing loss as the more costly, invasive, and time-consuming auditory brainstem response test. Even better, the puppies do not need to be sedated while conducting OAE testing, making for happier pet owners and healthier pups! Possibly the most important point made by this research is that OAE screeners are affordable, portable, and results are easy to interpret, making hearing testing more accessible to all veterinary practitioners. This means pet owners who are concerned their furry friends are deaf do not have to travel to a college of veterinary medicine for testing, saving them time and money. The earlier a dog owner realizes his puppy is deaf, the sooner training with hand signals rather than verbal commands and development of strategies to ensure their pet’s safety can begin.

FUN FACTS #1 When Drs. Plyler and Harkrider were students at UT, Dr. James W. Thelin connected them with UTCVM. Dr. Sims served on Dr. Plyler’s thesis committee (1997) and Dr. Harkrider was his graduate assistant (1995) – proof that good working relationships last decades! 8

#2 It takes approximately 50 seconds to perform an OAE screen in one ear of an awake puppy.

#3 Hearing Aids for Dogs? Believe it or not, there are amplification options for your pets. They may cost as much as $5,000 though, so let’s hope your little fur baby doesn’t eat them when you’re not looking!

AuD Student Obtains Unique Animal Audiology Certification Inspired by her love for animals and research collaboration between ASP and the UT College of Veterinary Medicine, Bethany Watson saw Animal Audiology as a way to apply her clinical skills to a broader population. Bethany is dually enrolled in the AuD program at UT and in Animal Audiology at the University of Cincinnati (UC). Her experience in animal audiology includes taking courses in animal bioacoustics and making frequent trips to the Facility for Education and Testing of Canine Hearing and Laboratory for Animal Bioacoustics (FETCHLABTM), under the supervision of Dr. Peter Scheifele. Dr. Scheifele pursued Animal Audiology and now trains students like Bethany because “80 breeds of dogs suffer congenital deafness due to poor breeding.” This inspired him to create the FETCHLAB which he states is “the only place in the world where an AuD or practicing clinician can get certified in Animal Audiology.” At the FETCHLAB, Bethany and her classmates perform auditory brainstem response (ABR) testing as a screening method for congenital deafness in puppies. Further, they perform diagnostic ABRs to detect presbycusis, ear pathologies, and identify progressive or acquired hearing impairments.

Bethany also has participated in the annual event, Canine Corps, conducting hearing screens for working canines from law enforcement and search and rescue agencies throughout the area. Most recently, she conducted ABR testing as a research assistant on bottlenose dolphins. Bethany will complete her fourth-year audiology externship at Mayo Clinic in Rochester while finishing her certification and classes at UC. As the first student from UTHSC to seek certification in Animal Audiology, she hopes to share her experiences with

other students and professionals, spark an interest in animal audiology, and potentially open her own FETCHLAB facility to teach the next generation of audiologists about this unique aspect of audiology.

IMPROVING LIFE’S CONNECTIONS through...Socialization Creating Successful Friendships

How do boys and girls with autism spectrum disorders (ASD) make friends? Dr. Erinn Finke’s research shows that boys with ASD have difficulty making new friends and figuring out who would be a good potential friend. Girls with ASD have difficulty handling group settings and conflict among friends. Thus, boys and girls need different types of support in intervention, and current techniques do not routinely teach these skills. Dr. Finke’s research calls for a reconceptualization of how therapy to improve friendship outcomes are structured, particularly by situating intervention within motivating contexts, like videogame play. For more information on her projects, see Dr. Finke’s lab website at: http://uthsc.edu/asp/research/asd.php or email her at: efinke1@uthsc.edu.

Autism Training Initiative For Caregivers

(ATI), established in 2014. Through ATI, UT and Maryville College students from any major can enroll For parents of a child with ASD, finding reliable child in an independent study to learn to be useful caregivcare is daunting. After-school programs and babyers. They engage in class lectures, video demonstrasitters are often ill-equipped to handle the limited tion, observation, and 15 hours of volunteer services communication skills, sensory needs, and emotional in the ASD community. Students participate in outbursts associated with ASD. Parents must be ‘on’ speech, occupational, and physical therapy sessions, 24/7 with no breaks. The extensive time commitas well as in-home care with the family during trainment may take a toll on ing. They also have opfamily dynamics, subportunities to meet with tracting focus from the child’s psychologist to siblings, and straining the learn how to implement relationship between the child’s home program. parents. With 1 in 68 Students emerge children diagnosed with from the ATI as compeASD, the demand for tent paraprofessionals qualified child care equipped to implement providers is significant. home programs, provide For these reasons, respite to overwhelmed academic and clinical faculty in ASP, including Dr. families, and serve as competent child care providers. Devin Casenhiser, Vickie Barnes, and Teresa Vaughn, Parents benefit from having a person in their home collaborated with Drs. Bill Allen and Brooke Browning who knows how to care for a child with ASD. at Cherokee Health Systems, Veronica Cordell of Interested? Contact Dr. Casenhiser at UT Autism Site Knoxville, and Dr. Ariane Schratter at (dcasenhi@uthsc.edu) or Dr. Schratter at Maryville Maryville College on the Autism Training Initiative College (ariane.schratter@maryvillecollege.edu). 10

Interiors Designed For years, speech-language pathologists have taken careful consideration in setting up their therapy rooms and designing their space to provide an optimal learning environment. However, there is no current research to indicate if such effort makes a difference. Associate Professor Dr. Casenhiser and Clinical Associate Professor Vickie Barnes are conducting a study to figure out if room design is relevant. In the study, each child is provided therapy in either a "desirable set-up" or a "standard set-up". Undergraduate and graduate research assistants code video recorded sessions to determine the quality of the child's engagement. Researchers anticipate that room design will improve the quality of a child's communicative interactions. Research To Practice Note Dr. Jillian McCarthy and Vickie Barnes presented their study "Does Picture Type Matter for Preschool Children with Autism?" at TAASLP. Data revealed that the use of contextualized versus decontextualized pictures makes no difference to the frequency of communication interactions. However, the examiners note that the number of vocalizations increases when pictures are used more frequently.

Far-Reaching Outreach Teresa Vaughn, Clinical Associate Professor, has served as NSSLHA faculty advisor since 2001, working to involve students in various outreach opportunities, including the Autism Society of America-East Tennessee Chapter (ASA-ETC). Ms. Vaughn also serves as Vice President on the board for the ASA-ETC. The chapter supports education for families in the community, develops fundraising initiatives, and provides familycommunity outreach. The UT ASP NSSLHA chapter participated in several activities to support the ASA-ETC. In 2017, the ASA-ETC hosted a Shrimp Boil at The Shrimp Dock for its annual fundraiser. Ms. Vaughn recruited families, students, and faculty to attend the seafood feast and raise money for families impacted by ASD. The Shrimp Boil will once again be held this year at the Shrimp Dock on April 27, 2018. Graduate students volunteered their time and their cars to the annual Trunk or Treat at West Park Baptist Church which also catered to children with ASD. Pictured: Ms. Vaughn works with NSSLHA President (top). AuD and SLP students staff the Trunk or Treat (bottom).

IMPROVING LIFE’S CONNECTIONS in...The Community

September: ASP Community Development Board Member Dr. Mark Gaylord (left) receives the UT College of Medicine Alumni Association's 2017 Outstanding Alumnus Award, presented by fellow ASP Community Development Board member and UT College of Medicine Alumni Association President-Elect Dr. John Little (right).

October: UT’s National Student Speech-Language-Hearing Association (NSSLHA) organization hosts a career fair each fall, with participation from a variety of potential employers from local, state, and national agencies.

November: ASP graduate students win the title of Grand Champion at the annual Tennessee Association of Audiologists and Speech-Language Pathologists (TAASLP) Trivia Bowl, beating out several university graduate programs (including Vanderbilt)!

August: ASP graduate students and faculty participate, along with Smokey, in the Walk to Defeat ALS, an event sponsored by the East Tennessee Amyotrophic Lateral Sclerosis Association.

April: Two of our talented SLP graduate students providing entertainment for the Celebration of World Voice Day, held at the Hearing & Speech Center. Free voice screens and vocal health education are offered to the community throughout the day.

December: ASP’s tacky holiday party for faculty and staff.

February: A representative from UT Delta Zeta sorority, which supports ASP clinics throughout the year, presents Valentine’s Day cards to be given to our pediatric patients who receive hearing services.

January: Distinguished guests, Drs. David Levine and Henry Spratt, from UT Chattanooga presented “Healthcare-associated Infections and Prevention Strategies in Clinical Settings” to a packed room of faculty, staff, and students.

February: Dr. Erin Plyler and Jestina Bunch provide in-service training about auditory processing disorder to teachers at The Episcopal School of Knoxville.

September: AuD graduate students and faculty volunteer at the Tennessee CARE Retreat, a weekend retreat held in Dayton for Tennessee families of children birth to 3 with hearing loss.

May: After just two years in ASP, Dr. James Lewis receives UTHSC Teaching Excellence Award from the Student Government Association Executive Council .

August: Beginner’s Bash at Lakeshore Park is a great chance for new students to meet faculty, staff, and returning students.

IMPROVING LIFEâ&#x20AC;&#x2122;S CONNECTIONS in...Our Labs and Clinics On any given day, you can walk down the halls of ASP and see our faculty and students bridging the gap between research and practice. Left page: [1] PhD student and mentor collecting neural data on children with Autism Spectrum Disorder; [2] pediatric amplification services; [3] fiberoptic endoscopy evaluation of swallowing; [4] PhD students conducting research on localization skills in children with cochlear implants; Right page: [5] early intervention session for children with communication delay; [6] therapy for language disorders, including reading/writing delay; [7] treatment for users of augmentative and alternative communication; [8] amplification and assistive device services for adults; [9] high definition imaging of vocal fold motion using videostroboscopy and a rigid endoscope; [10] research on music perception for hearing aid users.

6 5

9 At the beginning of 2018, we were pleased to unveil our reconstructed website. Visit it at www.uthsc.edu/asp to learn even more about our labs and clinics!

Department of Audiology and Speech Pathology University of Tennessee Health Science Center 578 South Stadium Hall Knoxville, Tennessee 37996

MARK YOUR CALENDARS Meet Dean Alway May 9, 2018 5:30-7 pm Calhoun’s on the River 400 Neyland Drive RSVP: alumni.uthsc.edu/dean18

ASP Graduation Ceremony

Volunteer Your Voice Summer Camp

September 9, 2018 at 4 pm Tyson Park June 4-8, 2018 Sertoma hosts this annual event to support One-week camp for children ages 8-15 with community groups serving those who are speech, language, and/or hearing disorders. deaf or hard-of-hearing. A portion of funds Includes fun times at the UT Hearing and Speech raised goes to ASP. Center and a 3-day, 2-night stay at the Great Contact: Sertoma.org Smoky Mountain Institute at Tremont.

May 10, 2018 at 11 am For ASP graduate and undergraduate students, families, & friends. Alumni Memorial Building, Cox Auditorium.

Tom Davidson Memorial Audiology Conference September 28, 2018 Holiday Inn, World’s Fair Park Join us to learn more about medical audiology & implantable devices from David Haynes, MD, Professor of Otolaryngology, Vanderbilt University Medical Center.

Parent’s Weekend November 9 -10, 2018 A great chance for families of our graduate students to meet faculty and learn more about ASP and Knoxville. Events include:  Open House in ASP  Reception at Crescent Bend  ASP tailgate before football game

Celebrate Sound Walk

Contact: brinehar@uthsc.edu Cost: $360* Contact: thedinge@uthsc.edu

*Some scholarships available

The University of Tennessee is an EEO/AA. Title VI/Title IX/Section 504/ADA/ADEA Institution in the provision of its education and employment programs and services. PAN: E07-3740-001-1