Life Sciences Commons^™

The Influence Of Nutrition On The Gut Microbiota And Psychiatric Disorders: A Review, Megha Bhagavan, Francis Jenney

Research Day

The symbiotic harboring of gut microorganisms within the gastrointestinal tract has a profound influence on host physiology, well-being, and disease pathology. More specifically, the gut bacteria are able to interact with dietary components from foods chosen by the host and consequently relay their beneficial or precarious effects locally and systemically. The gut bacteria have the capacity to maintain a healthy gut microbiome or perpetuate intestinal imbalance, known as gut dysbiosis. Gut dysbiosis has both local effects in gastrointestinal pathologies, such as intestinal bowel syndrome (IBS) and intestinal bowel disorder (IBD), as well as systemic pathologies, such as type II diabetes, …

Bridging The Gap: The Lived Experience Of Women With Diastasis Recti Abdominis, Jennifer Wiley, Ruth Maher

Research Day

Research on Diastasis recti abdominis (DRA) has primarily focused on diagnostic tools, surgical and conservative treatments. Despite the association of significant physical symptoms and impact on quality of life, evidence is absent regarding knowledge or education provided to women about this condition.

Purpose: This study explored the lived experience of women who either self-identified or were medically diagnosed with DRA. A deeper insight into the experience of women with DRA may serve to enhance the patient-provider interaction during this critical time.

Methods: Qualitative methodology with a basic interpretive approach and purposive sampling was used. Participants shared their experiences through a …

Comparison Of Estimated Glomerular Filtration Rate Using Five Equations To Predict Acute Kidney Injury Following Total Joint Arthroplasty, Hunter Hayes, Kevin Mekkawy, Yash Chaudhry, Michael Raad, Raj Amin, Harpal Khanuja

Research Day

Introduction: Primary total joint arthroplasty (TJA) is one of the most common procedures in the United States, and as the incidence of this surgery increases, identifying methods for improving outcomes and reducing complications is essential. Acute kidney injury (AKI) following TJA is a potential source of morbidity and mortality. Estimated glomerular filtration rate (eGFR) is used as an indicator of renal function. Several equations are commonly used to calculate eGFR. The purpose of this study was 1) to evaluate the agreement between five equations in calculating eGFR, and 2) to confirm which equation can best predict AKI in patients undergoing …

Soft Tissue Chondroma Of The Thumb, Harsha Upadhya, Darshdeep Singh

Research Day

A chondroma is a slow-growing, benign cartilaginous tumor. When a chondroma occurs in soft tissue without any involvement of the surrounding bone, it is known as a soft tissue chondroma which is an especially rare type of malignancy that has a predilection for the hands and feet. A soft tissue chondroma originates from either the synovial sheath of long tendons, para-articular tissues, or paratendinous soft tissues. This type of tumor can often be misdiagnosed as several different pathologies, including but not limited to, a ganglion cyst, osteochondroma, synovial chondromatosis, or even malignant examples such as a chondrosarcoma or synovial sarcoma. …

Social Media Use, Connectedness, And Depression In Graduate Students, Marisa Gretz, Stephen R. Poteau, Robert A. Ditomasso, Michael B. Roberts

Research Day

This study will examine the relationship between social media use, sense of connectedness, and depression among graduate students. Graduate students are often disconnected from their social supports due to their program's demands; additionally, the risk of depression in this population has been established in the literature. The impact of social media on depression has been investigated, and the results are discrepant. The relationship between a sense of connection, the use of social media, and depression in a graduate student population has not yet been explored. Graduate students at The Philadelphia College of Osteopathic Medicine (PCOM) and other universities studying psychology, …

Predictors Of Post-Deployment Distress In Female Veterans., Shalonda Griffin, Robert A. Ditomasso, Bradley Michael Rosenfield, Odelia Mcfadden

Research Day

Introduction: The female veteran population is expected to increase over the next few decades, representing approximately 16.3% of the living population by the year 2042. As women are discharged from the military, they are frequently challenged with the tasks of reintegrating into society and adjusting to life. While some women successfully readjust, many continue to struggle with combat-related challenges and reintegration stressors such as mental health, military sexual assault, substance abuse, interpersonal relationship issues, and everyday necessities. The purpose of the present study was twofold: (a) to identify factors associated with and predictive of postdeployment distress and (b) to identify …

Exploring The Relationship Between Mild, Repetitive Traumatic Brain Injury And Post-Traumatic Epilepsy: A Review, Alayna Nelson, Denah Appelt

Research Day

Objective: The objective of this review is to explore the relationship between traumatic brain injury and the development of post-traumatic epilepsy.

Background: According to the Centers for Disease Control and Prevention, traumatic brain injury (TBI) is considered a major public health problem in the United States. Each year, 2.53 million Americans, including 812,000 children, document a TBI-related emergency room visit. TBI is a disruption in the brain’s normal function, caused by a bump or blow to the head or by penetrating head injury. These injuries range in severity and can cause damage to one area of the brain, as in …

The Potential Benefit Of Oral Simethicone In Improving Colonic Visualization And Polyp Detection In Routine Colonoscopy Screenings, Phi Tran, Loukya Kanakamedala, Bhavin Dave

Research Day

Introduction: Colon cancer is the second leading cause of cancer deaths in the United States among men and women. Many of these cancers can be prevented through regular colonoscopy screening. However, the bowel preps used prior to the screening procedure create a frothy or “bubbly” appearance within the colon. Physicians have tried to overcome this with the flushing of water or using simethicone in the water canister during the procedure, but they have provided minimal efficacy and simethicone damages the colonoscope. As a result, physicians have a difficult time viewing the colonic mucosa and thoroughly inspecting the colon for polyps. …

Pericardial Effusion "Worm-Like Strands" On Transthoracic Echocardiogram, Annamarie Pontier, Andrew Rose Md, Meredith Mcnelis Pa-C

Research Day

Background: Fibrinous Pericardial Effusion is the accumulation of excess fluid in the pericardial fibroelastic sac. It can be a symptom of any pathological process that affects the pericardium from acute pericarditis to systemic disorders. This broad differential poses a diagnostic challenge in the setting of acute fluid accumulation.

Case Presentation: A 50-year-old male with a past medical history of extensive intravenous drug use complicated by bacteremia and left ankle abscess formation presented to the Emergency Department complaining of mild-moderate chest pain for four days. Within the last month, he presented to the Emergency Department three times for similar symptoms; however, …

It's All Fun And Games Until Someone Gets Hurt: An Analysis Of Trampoline Injuries In The Pennsylvania Trauma System, Megan Sullivan, Madison Morgan, Lindsey Perea, Frederick Rogers, Eric Bradburn

Research Day

Introduction: It is well known that trampolines can be a particular source of danger, especially in children. We sought to examine the profile of those patients with trampoline injuries. We hypothesized there would be certain injury patterns predicative of trampoline injuries.

Methods: All patients submitted to Pennsylvania Trauma Outcome Study (PTOS) database from 2016-2018 were analyzed. Trampoline injury was determined by ICD10 activity code. Injury patterns in the form of abbreviated injury scale (AIS) body regions were examined in the trampoline injured patients. Patient demographics and clinical variables were compared between those with trampoline injury versus those without.

Results: There …

Direct Oral Anticoagulants And Prosthetic Heart Valves: A Systematic Review Of Case Reports, Tyler Richie, Steven Carter, Jiehyun Lee

Research Day

Background: Direct oral anticoagulants (DOACs) are indicated to treat and prevent venous thromboembolism and to prevent stroke or systemic embolism in patients with non-valvular atrial fibrillation. The introduction of DOACs has provided an alternative to warfarin for patients in need of oral anticoagulation. It is, however, unclear whether DOACs are safe and effective in patients with heart valve replacement. The RE-ALIGN trial published in 2013 did not support the use of dabigatran in patients with mechanical valve replacements; however, there are ongoing studies, such as the PROACT Xa trial and the ATLANTIS trial, investigating the use of other DOACs in …

Stroke Centers Of Excellence In The United States: Certification, Access And Outcomes, Evan Kolesnick, Joshua Weinberg, Shyam Majmundar, Ahmad Sweid, Jane Khalife, Satish Gaddam, Zubin Hussain, Robin D'Ambrosio, Maureen Deprince, Pascal Jabbour, Stavropoula Tjoumakaris, M. Reid Gooch, Robert Rosenwasser, Nabeel Herial

Research Day

Introduction: Stroke is a leading cause of morbidity, mortality and healthcare costs in the United States. Evidence suggests that certified stroke centers have improved patient outcomes relative to non-certified hospitals. Our study explains the process, associated cost, quality and geographic proclivities of different certifying organizations.

Methods: Data was collected from published literature, information on certifying organizations’ websites and through direct communication with representatives of The Joint Commission (TJC), Det Norske Veritas and Germanischer Lloyd (DNV-GL), and Healthcare Facilities Accreditation Program (HFAP). Geographic mapping of thrombectomy capable centers and comprehensive stroke centers was performed with the ArcGIS online tool.

Results: Among …

Family History Of Acl Tears As Non-Modifiable Risk Factor In Acl Injury, Michael Valenzuela, Robert Roundy, Marshall Williams, Mathew Pombo

Research Day

Background: 100,000-200,000 anterior cruciate ligament (ACL) injuries occur each year in the United States. These injuries result in significant burden to the patient, and predisposition to ACL injuries is often multifactorial. Some researchers have looked into the genetic component to ACL injuries, both at the population and molecular level. We aim to study a large orthopaedic population in order to assess the association between personal and family history of an ACL injury.

Hypothesis/Purpose: We hypothesize that patients with a first-degree relative, who have a history of ACL injury, will have increased odds to sustain an ACL injury themselves.

Study Design: …

Inhibiting Ror1 Expression In Androgen-Independent Prostate Cancer Reduces Aggressive Cancer Phenotypes By Modulation Of Akt-Gsk3Ꞵ Pathway, Vignesh Sivaganesh, Nazifa Promi, Salma Maher, Bela Peethambaran

Research Day

Prostate cancer is a disease that has a high prevalence and mortality amongst men. The severity of the cancer is stratified by risk, which is based on the Gleason grade, prostate-specific antigen (PSA) level, and clinical staging. Unlike breast cancer which can be classified into subtypes based on molecular heterogeneity, prostate cancer has no such classification and is treated with observation, prostatectomy, or radiation if local, and non-specific chemotherapy and androgen deprivation therapy (ADT) if metastatic. It is of the utmost importance to investigate molecular targets that can specifically eradicate prostate cancer while retaining the functions of normal tissue. Receptor …

Virtually Building A Community Of Experts In The Medication-Assisted Treatment (Mat) Of Opioid Use Using The Project Echo Model, Matthew Momjian, Justin Canakis, Faraz Yousefian, Hayden Pond, Adrienne White, Gregory Mayer, Alison Essary

Research Day

Purpose: Project Extension for Community Healthcare Outcomes (ECHO) utilizes telemedicine to connect a multidisciplinary team of experts with a network of primary care physicians to enable rapid dissemination of evidence-based guidelines and practices at scale. In this study, the Project ECHO model disseminated the Arizona Pain and Addiction Curriculum to providers in rural Arizona with the goal to educate providers on MAT.

Methods: Participants engaged in biweekly, virtual teleECHO sessions and post-session surveys were used to collect data on provider satisfaction, self-efficacy, knowledge, barriers to change and changes in practice behavior. Results: Between February 2020 – November 2020, the MAT-ECHO …

Measuring The Effect Of A Resuscitation Academy On Out Of Hospital Cardiac Arrest Resuscitation Rates, Matthew Momjian, Jeffrey Kalczynski, Patrick Lombardi, Justin Canakis, Anna Mereminskaya, Thomas Depietro, Josh Baron

Research Day

According to the American Heart Association (AHA), rates of successful resuscitation after out of hospital cardiac arrest (OHCA) vary across the country. Amongst 132 counties in the United States, the rates of CPR survival to hospital discharge ranges between 3.4%-22.0%, and the rates of CPR survival with functional recovery ranges from 0.8%-20.1%. This large degree of variability between regions has been improved through programs that educate Emergency Medical Service (EMS) departments on ways to improve outcomes through an evidence-based lens. The Medic One EMS department in Seattle and King County, Washington developed a resuscitation academy (RA) that improved cardiac arrest …

A Computer-Based Intervention May Be Effective For Treating Bereavement As Measured By Scores Of Prolonged Grief, Anxiety, Depression, And Cognitive Distortions., Michael Kastelnik, Bradley Michael Rosenfield, Michael B. Roberts

Research Day

Many people suffer from complications due to grieving the death of a loved one, an experience known as bereavement. In addition to the emotional suffering, complications can lead to functional impairment, negatively impacting relationships, work, and health of those who grieve. Although there are evidence-based interventions for bereavements, there are barriers to treatment, including costs and accessibility. Computer-based interventions are empirically demonstrated to overcome these barriers. The present study aims to test the effectiveness of a computer-based single-session treatment for bereavement. It is hypothesized that individuals who complete a computer-based CBT intervention for bereavement will experience a significant decrease in …

The Relationship Between Adhd-Specific Cognitive Distortions And Adult Adhd After Accounting For Clinical Syndromes And Personality Pathology, Carly Gerbi

Research Day

Introduction: Adults with attention-deficit/hyperactivity disorder (ADHD) experience many difficulties in daily functioning, which are related to the symptoms of the disorder. Psychostimulants, although considered the front-line of treatment for ADHD, are not always effective. On the other hand, psychosocial treatments, particularly cognitive behavioral therapy, is an evidence-based treatment, both in combination with medication as well as a stand-alone treatment for ADHD. It is theorized that some of the symptoms experienced by adults with ADHD result from cognitive distortions. Although, previous studies have identified a preliminary relationship between cognitive distortions and ADHD, which may be accounted for by comorbid disorders; these …

Assessment Of Patient And Employee Mental Health During Covid-19, Lanerica Rogers, Tammy Phillips, Aerial Petty, Gabriana Freire, Carline Denis-Barnes

Research Day

Background: Many individuals in the United States have anecdotally reported a decline in their mental health due to worry and stress over the COVID-19 pandemic. Although much research has been dedicated to populations across the country, patients and employees at community health centers have been overlooked in terms of the effect of pandemic conditions on their mental health. The present study seeks to understand how the mental health of these populations has been impacted and offer recommendations for what can be done to address any unmet mental health needs.

Methods: Survey responses were compiled from patients and employees of the …

Inventory Of Cognitive Distortions-Youth Version: The Development And Validation Of A Psychometric Test For The Measurement Of Cognitive Distortions, Kelsey Jones, Robert A. Ditomasso, Susan Panichelli Mindel, Michael B. Roberts

Research Day

Cognitive distortions are systematic biases in an individual’s thinking that maintain a person’s belief in their negative views of themselves or others, even in the presence of contradictory evidence. The Inventory of Cognitive Distortions (ICD), created by Yurica and DiTomasso, provided a template to measure distorted thinking in adults. Currently, there is not a youth measure of cognitive distortions that adequately encapsulates the range of distorted thinking that may be present in youth. Therefore, the purpose of this study is to create and validate a newly designed instrument of cognitive distortions, The Inventory of Cognitive Distortions-Youth Version (ICD-YV), with youth …

Hyperostosis Frontalis Interna: Irregular Skull Ossification In Cadaveric Dissection, Anthony Sciuva, Sara Eliseo, Zhi Quan Kuat, Yeva Nayflish, Leslie Pryor Mcintosh

Research Day

Hyperostosis Frontalis Interna (HFI) is an unusual condition characterized by the thickening of the frontal bone of the skull. HFI has been found most often in post-menopausal women, with incidence rates surpassing men by nearly nine times. This abnormal thickening of the skull may compress the cerebrum leading to atrophy, frequent headaches, and cognitive impairment. In this case report, we describe an 88-year-old Caucasian female cadaver that originated with the Body Donor Program of PCOM Georgia with an extensive presentation of HFI. A distinct irregular ossification of the internal surface of the frontal bone was noted bilaterally with visibly demarcated …

Lumbar Sympathetic Block As A Treatment Modality For Complex Regional Pain Syndrome, Kelci Beardsley, Ronald Lincow

Research Day

Setting: Outpatient Pain Management

Patient: A 28-year-old male with a history of cryptogenic stroke, bilateral lower extremity compartment syndrome, and severe left foot pain secondary to emergent fasciotomy.

Case Description: This patient presented to the office with a chief complaint of left foot pain. Past medical history was significant for cryptogenic stroke and bilateral lower extremity compartment syndrome, status post emergent fasciotomy. Severe left foot pain began after emergent fasciotomy, and he required a walker for ambulation. While hospitalized, several different treatment modalities were utilized in an attempt to alleviate the pain. Previous treatments included tricyclic antidepressants, gabapentin, and saphenous …

Special Considerations In Facial Transplantation: A Systematic Review, Melanie Shpigel, Sammy Othman, Jason Cohn, Christopher Hill, Paige Bundrick, Gabriel F. Santiago, Chad Gordon

Research Day

Background: Vascularized composite allotransplantation (VCA) of the face is an exceedingly complex procedure, requiring extensive planning and surgical precision in order to successfully manage patients with facial disfigurements. This review aims to present an overview of the salient anatomic considerations in facial transplantation, as well as give attention to unique patient populations and special considerations.

Methods: A literature review was performed in search of articles pertaining to considerations in facial transplantation using the databases PubMed, Web of Science, and Cochrane. Articles selected for further review included full-text articles with an emphasis on specific anatomic defects and how they were addressed …

A Case Study Of The Anomalous Extensor Digitorum Brevis Manus, Herve Peacemaker Ineza, Darshan Patel, Jeanine Garcia, Macy Rowan, Leslie Pryor Mcintosh

Research Day

During routine forearm dissection of 12 cadavers, which originated from the PCOM Georgia Body Donor Program, at PCOM South Georgia, an aberrant muscle was discovered on the dorsal surface of the hand of a 72-year-old Caucasian male. The muscle, known as the Extensor Digitorum Brevis Manus (EDBM), was located bilaterally and deep to the tendons of the Extensor Digitorum. On assessment, the left hand of the donor had two EDBM tendons that intersected and attached to the proximal phalanx of the third digit. The right-hand tendons ran parallel and inserted onto the third digit of the proximal phalanx. An investigation …

De Novo Sox6 Variants Cause A Neurodevelopmental Syndrome Associated With Adhd, Craniosynostosis, And Osteochondromas, Dara Tolchin, Jessica P. Yeager, Abdul Haseeb, Marco Angelozzi, Véronique Lefebvre, Cédric Le Caignec

Research Day

Introduction: The SOX gene family consists of twenty transcription factors that play a pivotal role in cell fate and differentiation during the development of many organ systems. Within these SRY-related (SOX) genes is a highly conserved high mobility group (HMG) domain that has been shown to be critical for DNA binding and bending, nuclear trafficking, and protein-protein interactions. Mutations within this transcription factor family have been associated with rare congenital disorders, known as SOXopathies. These mutations are commonly de novo, heterozygous and inactivating, and exhibit gene haploinsufficiency. Of these twenty transcription factors, SOX6 is known to be involved in chondrocyte …

Effects Of Lycopene And The Mediterranean Diet On Prostate Cancer: A Critical Analysis Of The Data, Natalie Silk, Dianzheng Zhang

Research Day

Background: Prostate cancer (PCa) is one of the most widespread cancers diagnosed in men in the United States and is the second leading cause of cancer-related deaths worldwide. PCa will be a major cancer-related burden both socially and economically in the near future. It has been shown that dietary intake of natural anti-inflammatory agents are capable of inhibiting cancer progression, but due to the nature of dietary studies it is difficult to accurately conclude that diet is capable of impacting chronic diseases and mortality.This systematic review aims to collect and evaluate literature focused on prostate cancer progression and the natural …

The Effect Of Cardiopulmonary Disease On Lymph Node Hyperplasia And Structural Deviations, Yuhyun Kang, Vikas Damineni, Rice Kelsey, Shelley Dicecco

Research Day

Introduction: According to the Centers for Disease Control and Prevention, cardiopulmonary disease is the leading cause of death in the United States. Therefore, the different pathologies of the heart and lungs are studied extensively in the medical community. Current research hints at the possible association between the lymphatic system's dysfunction and cardiopulmonary disease's pathological progression. However, the effect of cardiopulmonary disease on the lymph nodes is not well known. A better understanding of the possible pathological changes to the lymphatic system associated with cardiopulmonary disease could help guide medical interventions.

Objective: This study aims to investigate the effect of cardiopulmonary …

Etiology Of Svc Syndrome And Its Role In Determining Best Treatment Approach - A Case Report, Molly Casey, Sagar Desai, Vinnit Khanna, Rakesh Ahuja

Research Day

Introduction: Obstruction of the Super Vena Cava (SVC) can result in symptoms, such as facial plethora and swelling, and be due to a variety of underlying causes besides lung malignancies, the rates of which have changed over time; the underlying etiology is used to determine the best management strategy.

Objectives: This case report aims to discuss the role of etiology in determining the best initial treatment for SVC syndrome (SVCS) and outlines the unique management for a patient that represents the changing demographics of SVCS causes.

Case Presentation: A 73-year-old male with end-stage renal disease (ESRD) and metastatic carcinoma of …

A Quality Control Study: Outcome Of Efforts To Improve Communication In The Cardiac Catheterization Lab, Molly Casey, Andrew Doorey

Research Day

Introduction: Implementing closed-loop communication (readbacks) can limit potentially devastating mistakes by facilitating an efficient but effective way of confirming the medical staff heard the physician order correctly.

Objectives: The objective of this study was to assess the success of efforts to improve the rates of closed-loop communication in the Cardiac Catheterization Lab.

Methods: This was an observational study that occurred at one location. A third-party observer recorded the rate of closed-loop communication over four weeks in the summer of 2019. Responses by medical staff to physician medication, equipment, and other miscellaneous orders were categorized as complete, partial from partial, partial, …

Hidden Constipation Presenting As Diarrhea, Phi Tran, Ashley Bloom, Clay Bunting, Harsha Upadhya, Bhavin Dave

Research Day

Introduction: Diarrhea and constipation are two of the most common gastrointestinal symptoms presenting in both inpatient and outpatient settings. Diarrhea presents as loose, watery stool often with increased frequency while constipation often presents as hard stool, decreased frequency, and increased straining. In a subset of patients that suffer from constipation, liquid stool from more proximal colonic segments may bypass impacted feces and result in diarrhea, thus creating a confusing clinical picture and potentially misleading treatment plan. Objectives: Our objective is to redefine IBSD with a new subset of patients with IBSD who have hidden constipation. This study could help open …