Digital Commons Network^™

The Effects Of Non-Pharmacologic Interventions On Glycemic Control In Type 1 Diabetes And Anxiety: A Clinical Review, Samuel Merr

The PA Department Journal of Medical Science

Introduction: Type 1 diabetes (T1D) carries significant psychological burden, including elevated rates of anxiety and diabetes-related distress. Both of these have been linked to worse glycemic control and outcomes. The purpose of this clinical review is to evaluate the current evidence on whether non-pharmacologic interventions, such as cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based interventions (MBI), are associated with meaningful reductions in HbA1c in adults with T1D and elevated anxiety.

Methods: PubMed was searched using key terms including “type 1 diabetes,” “anxiety,” “non-pharmacologic interventions,” and “glycemic control,” with MeSH terms and Boolean operators applied. …

Post-Cardiac Arrest Care: Evaluating Targeted Hypothermia And Targeted Normothermia, Lexie Johnston

The PA Department Journal of Medical Science

Introduction: Targeted temperature management plays an important role in post-cardiac arrest care and is aimed at reducing neurologic injury and improving survival following ROSC. While therapeutic hypothermia was once considered the standard of care, recent studies have questioned whether it provides additional benefit over targeted normothermia. This review evaluated current evidence comparing targeted hypothermia with targeted normothermia in adult patients following cardiac arrest.

Methods: A PubMed search was performed using key terms related to cardiac arrest, temperature management, mortality, and neurologic outcomes. The search was limited to randomized controlled trials, systematic reviews, narrative reviews, and meta-analyses published within this past …

Biologic Therapies Versus Methotrexate In Psoriatic Arthritis Management: A Literature Review, Yisel Ramos

The PA Department Journal of Medical Science

Introduction: Psoriatic arthritis (PsA) is a chronic inflammatory disease that can cause progressive joint damage, functional impairment, and reduced quality of life. Methotrexate (MTX) is commonly used as a systemic therapy, while biologic therapies target specific inflammatory pathways. This review evaluated the efficacy and safety of biologic therapies compared with MTX in adults with PsA.

Methods: A PubMed/MEDLINE search identified studies evaluating biologic therapies and MTX in adults with PsA. Four publications were included based on methodological quality, clinical relevance, and applicability to the PICO question. Outcomes included joint symptoms, disease activity, physical function, radiographic progression, and adverse …

Fecal Microbiota Transplantation For Recurrent Clostridioides Difficile Infection: A Clinical Review, Benjamin H. Drinkwalter

The PA Department Journal of Medical Science

Introduction: Clostridioides difficile infection (CDI) is a common healthcare-associated infection that frequently recurs after standard antibiotic treatment due to persistent disruption of the intestinal microbiome. Fecal microbiota transplantation (FMT) has emerged as a microbiota-based therapy that may reduce recurrence by restoring normal intestinal bacterial diversity.

Methods: A literature review was conducted using PubMed to identify English randomized controlled trials, systematic reviews, and meta-analyses published between 2021 and 2026. Four studies that directly compared FMT with standard antibiotic treatment were included. A fifth randomized controlled trial was added with a second targeted search because the initial search not contain enough randomized …

Prescribing Prevention: The Impact Of Non-Pharmacological Intervention Versus Medication On Maternal Mortality, Sheris Cox

The PA Department Journal of Medical Science

Hypertensive disorders of pregnancy (HDP), including preeclampsia, are one of the leading causes of maternal mortality in the world. The purpose of this literature review is to evaluate the effectiveness of nonpharmacological interventions, including supervised exercise, Mediterranean dietary patterns, and mindfulness-based therapies, in reducing and preventing HDPs and maternal mortality overall. A review of the current literature was conducted using PubMed, with a final search using the terms “preeclampsia,” “exercise,” “stress reduction,” and “maternal mortality.” With the use of certain filters applied to the search, results were condensed to 10 articles for review. Of the articles reviewed, it was found …

Laparoscopic Excision Versus Laparoscopic Ablation For Treatment Of Symptomatic Endometriosis, Jordan Kaplan

The PA Department Journal of Medical Science

Introduction: Endometriosis is a chronic inflammatory disorder characterized by the presence of endometrial-like tissue outside the uterine cavity.¹ This disorder affects 6% to 10% of reproductive-aged women and is associated with chronic pain, infertility, and menstrual irregularities.³ Laparoscopy is the gold standard for surgical management of symptomatic disease; however, uncertainty exists regarding whether laparoscopic excision provides better clinical outcomes compared to laparoscopic ablation.⁴

Methods: A literature search was conducted using the PubMed database with MeSH terms and Boolean operators related to endometriosis, laparoscopy, excision, and ablation. Filters were applied to include English-language, full-free text, randomized controlled trials, …

Pharmacologic Pain Management During Intrauterine Device Insertion, Taylor M. Long

The PA Department Journal of Medical Science

Introduction: Intrauterine devices provide long-acting reversible contraception for women wanting to prevent pregnancy, but pain during insertion is a major concern for many patients. This clinical review compared nonsteroidal anti-inflammatory drugs and local anesthetic options for pain control during and shortly following IUD insertion.

Methods: PubMed was searched using terms “intrauterine device insertion”, “nonsteroidal anti-inflammatory drugs”, “lidocaine”, “local anesthetics”, “pain”, and “analgesia”. The search returned 135 articles. After filters were applied, eleven articles remained, and five articles met the inclusion criteria and were selected for the clinical review.

Results: The review included four randomized controlled trials and one network meta-analysis. …

Efficacy Of Sglt2 Inhibitors In The Management Of Polycystic Ovarian Syndrome, Paige N. Curtis-Campbell

The PA Department Journal of Medical Science

Introduction: Polycystic ovarian syndrome (PCOS), recently proposed to be termed polyendocrine metabolic syndrome (PMOS), is a complex multifactorial disorder commonly associated with obesity, hyperandrogenism, infertility, and insulin resistance. First-line treatments for metabolic characteristics include lifestyle modifications and metformin; however, metabolic abnormalities may persist. Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent a potential therapeutic agent due to their effects on insulin resistance, glucose metabolism, and body weight.

Methods: A literature search of PubMed identified studies examining SGLT2 inhibitors in women with PCOS compared to metformin, standard therapies, or placebo. The search was restricted to randomized controlled trials (RCTs), systematic reviews, and meta-analyses available …

Effect Of Intramedullary Nailing Vs Plate Fixation On Bone Union Time In Distal Tibial Fractures, Madeline Wasmund

The PA Department Journal of Medical Science

Distal tibia fractures are complex fractures due to the intricate anatomy and minimal soft-tissue protection. There are currently two techniques that are mainstays for repairing a distal tibia fracture: intramedullary nailing and plate fixation. This study explores the bone union time between these two different techniques. PubMed was searched with a specific search strategy using the terms “intramedullary rod”, “plate/screw fixation”, “tibial fractures”, and “time to bone union.” Filters were applied to find articles that were most relevant, which resulted in 4 articles, each of which was appraised. Three articles were systematic reviews/meta-analyses comparing intramedullary nail fixation and plate fixation …

Catheter Directed Thrombolysis Vs Anticoagulant Therapy For The Management Of Pulmonary Embolisms, Kelsey A. Strawser

The PA Department Journal of Medical Science

A pulmonary embolism is a blood clot that develops within a blood vessel and travels to the lungs, leading to a blockage of blood flow where it can cause life threatening complications.¹ Currently, there is not one standard treatment for pulmonary embolisms. Treatment depends on the size and location of the emboli, as well as the risk it has to the patients’ health.⁹ While systemic anticoagulation is one of the most common treatment methods for pulmonary embolisms, catheter directed thrombolysis rapidly dissolves the clot, which can lead to quicker symptom relief and decreased strain on the heart.^{11 …}

Vitamin D And The Expression Of Systemic Lupus Erythematosus (Sle), Sonephet S. Phoumsavath

The PA Department Journal of Medical Science

Introduction: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that disproportionately affects women and minority populations, carrying significant morbidity. The purpose of this literature review is to analyze the effectiveness of vitamin D supplementation in reducing disease activity in SLE patients, compared with none.

Methods: PubMed was searched using a specific strategy with key terms including "vitamin D," "systemic lupus erythematosus," and "disease activity." Boolean operators and filters included a five-year publication limit and restriction to randomized controlled trials (RCTs), systematic reviews, and meta-analyses. This narrowed the results to five quality articles for review.

Results: Two meta-analyses and …

The Role Of Probiotics As Adjunctive Therapy In The Treatment Of Depressive Disorders, Maritza Lopez

The PA Department Journal of Medical Science

Major depressive disorder (MDD) is a common psychiatric disorder that remains difficult to treat for many patients despite available therapies. The purpose of this clinical review was to evaluate the effectiveness of adjunctive probiotic supplementation for adults with major depressive disorder. PubMed was searched using key terms including major depressive disorder, probiotics, Lactobacillus, Bifidobacterium, and gut-brain axis. Search filters and eligibility criteria narrowed the results to six relevant articles for review, including one randomized clinical trial, four systematic reviews, and one clinical practice guideline. Overall, the included studies generally reported reductions in depressive symptom severity and favorable safety …

Clomiphene Vs Letrozole For Fertility In Women With Pcos., Lauren Weissenberger

The PA Department Journal of Medical Science

Introduction: Polycystic ovary syndrome (PCOS) is a condition associated with ovulatory dysfunction and infertility in women. The purpose of this review is to analyze the efficacy of clomiphene versus letrozole in ovulation induction, pregnancy rate, and live birth rate in women with PCOS.

Methods: PubMed was searched strategically using key terms “polycystic ovary syndrome”, “clomiphene”, and “letrozole”. The following filters were applied: randomized controlled trials, systematic reviews, meta-analyses, free full text, English language, and publication dates restricted to the last five years. Results narrowed down to three relevant, quality articles for review.

Results: One article was an RCT comparing clomiphene …

Orthosis Versus Surgical Repair Outcomes Of Developmental Dysplasia Of The Hip In Children, Avery G. Hays

The PA Department Journal of Medical Science

Introduction:

            Developmental dysplasia of the hip (DDH) is one of the most common orthopedic malformations in children. Late detection of DDH can lead to more invasive treatment, higher risk of treatment related complications, and long-term sequelae like early onset osteoarthritis. The purpose of this clinical review is to analyze current treatments for DDH and provide a rationale for individualized treatment decisions and future implications.

Methods:

            A PubMed search was preformed using a specific strategy with key terms “developmental dysplasia of the hip,” “orthosis,” “surgical reduction,” and “complications.” Boolean operators and filters were used to narrow the results to 6 relevant, …

Hydroxyurea Versus Chronic Blood Transfusion Therapy For Reducing Vaso-Occlusive Crises In Children With Sickle Cell Disease: A Review Of Current Evidence, Stefanie L. Pertiller

The PA Department Journal of Medical Science

Introduction: Sickle cell disease (SCD) is one of the most common inherited hemoglobinopathies worldwide and is associated with significant chronic morbidity and early mortality in children, underscoring the need for effective long-term disease-modifying therapies. The purpose of this review is to evaluate the current evidence comparing hydroxyurea therapy with chronic blood transfusion therapy in children with sickle cell disease, with particular emphasis on their effectiveness in reducing the frequency of vaso-occlusive crises.

Methods: PubMed was searched with a specific search strategy using key terms “children with sickle cell disease”, “chronic blood transfusion therapy”, and “hydroxyurea therapy”. MeSH terms and Boolean …

Rimegepant For Migraine Prevention: A Review Of Current Evidence, Alexi N. Payne

The PA Department Journal of Medical Science

Introduction:

Migraine is a common neurologic disorder that causes substantial disability and negatively affects quality of life worldwide. This literature review evaluates the current evidence regarding the efficacy, safety, and tolerability of rimegepant for the preventive treatment of migraine.

Methods:

PubMed was searched using the key terms migraine, rimegepant, and prevention. After applying predefined eligibility criteria, five studies were included: two randomized controlled trials, one open-label extension study, one post hoc analysis, and one systematic review.

Results:

Overall, the included studies demonstrated that rimegepant significantly reduced monthly migraine days, improved health-related quality of life and patient-reported outcomes, and was generally …

Prevention Of Chronic Migraine With Injection Medications: Onabotulinumtoxina Vs Monoclonal Antibodies, Jillian Jesser

The PA Department Journal of Medical Science

Introduction: Adults diagnosed with chronic migraine (CM) frequently experience severe pain, nausea, vomiting, sensitivity to light or sound, and blurred vision. All of which are not conducive to routine daily functioning. The purpose of this review article is to explore the efficacy of preventative medications for CM such as OnabotulinumtoxinA injections (onabotA) and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs).

Methods: PubMed was searched using “OnabotulinumtoxinA,” “chronic migraines,” and “monoclonal antibodies”, and related branch terms. The 263 results of this search were reduced to 20 with the following filters: published date 2020-2025, randomized controlled trials (RTCs), systematic review, meta-analysis, free …

Selenium Supplementation For Treatment Of Subclinical Hypothyroidism And Autoimmune Thyroiditis, Lael Smith

The PA Department Journal of Medical Science

Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions of the world. It is characterized by autoimmune destruction of the thyroid gland, chronic inflammation, and progressive thyroid dysfunction. Selenium is an essential trace element involved in antioxidant defense of thyroid tissue and has been proposed as an adjunctive therapy. This review evaluates current evidence regarding the effects of selenium supplementation on thyroid function in patients with Hashimoto's thyroiditis and subclinical hypothyroidism. Three peer-reviewed studies, including randomized controlled trials, systematic reviews, and meta-analyses, were evaluated to examine the primary outcome of thyroid function by measurement of thyroid-stimulating hormone …

The Effects Of Low Dose Aspirin And Low Molecular Weight Heparin In Preventing Preeclampsia, Madison A. Deslatte

The PA Department Journal of Medical Science

Introduction: Preeclampsia is a prevalent hypertensive disorder of pregnancy that can lead to increased maternal and neonatal morbidity and mortality. The purpose of this review is to evaluate if low-molecular-weight heparin (LMWH) combined with low-dose aspirin (LDA) is more efficacious in preventing preeclampsia than the standard therapy of LDA alone.

Methods: PubMed was searched with a precise search strategy using key terms “preeclampsia”, “low-dose aspirin”, and “low-molecular-weight heparin”. Filters and operators narrowed the results to 4 relevant and high-quality articles that were used for the review.

Results: Three articles directly compared the use of LDA and LMWH combined to standard …

Restrictive Fluid Resuscitation With Early Vasopressor Initiation Vs Liberal Fluid Resuscitation In Adults With Septic Shock: A Review Of Mortality And Clinical Outcomes, Gabriel Locke

The PA Department Journal of Medical Science

Introduction

Septic shock is a life-threatening medical emergency characterized by profound hypotension, impaired organ perfusion, and significant risk of mortality. While large fluid resuscitation has been considered the commonplace, emerging evidence of increased adverse outcomes has prompted further investigation into restrictive fluid strategies in combination with early vasopressor use.

Methods

PubMed was searched with key terms “septic shock”, “vasopressors”, “norepinephrine”, “restrictive fluid resuscitation”, “liberal fluid resuscitation”, and “mortality”. Operators and filters were implemented such as randomized control trial, systematic reviews, meta-analyses published between 2021 and 2026. After applying these filters. Of the 39 results, 4 articles were selected based on …

Lifestyle Modifications Versus Antihypertensive Therapy: Efficacy In Blood Pressure Control Among Adults With Hypertension, Alexander J. Butler

The PA Department Journal of Medical Science

Hypertension is one of the leading causes of cardiovascular disease and preventable deaths in the United States. Pharmacological treatment remains the standard of care despite challenges such as cost, adherence, and side effects. The purpose of this article is to discover the effectiveness of non-pharmacological treatment in comparison to pharmacological treatment for reducing blood pressure in patients with hypertension. PubMed was searched using key terms such as “HTN,” “antihypertensive,” “antihypertensive agents,” “exercise,” “physical activity,” and “running.” Operators and filters were used to narrow results down to 31 where 4 quality articles were selected for review. Non-pharmacological treatment/lifestyle changes produced reductions …

Treating Adult Adhd: Comparing The Effectiveness And Tolerability Of Stimulant And Non-Stimulant Medications, Sara Dahbour

The PA Department Journal of Medical Science

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults …

Targeting Downstream Nmda Receptor Pathways In Ischemic Stroke: A Literature Review Of Emerging Adjunctive Therapies, Lauryn P. Pergal

The PA Department Journal of Medical Science

In the United States, an estimated 795,000 people experience a first or recurrent stroke each year.¹ Despite advances in early recognition protocol, reperfusion therapies, and rehabilitation, stroke is still the fourth leading cause of death, after heart disease, cancer, and accidental injury. Ischemic strokes account for around 87% of all strokes.¹ Long-term sequelae of ischemic stroke survivors include disability, dementia, depression, and ongoing fatigue.² As a result, stroke causes decreased quality of life, economic burden, and caregiver stress.

Management strategies for ischemic stroke have evolved considerably over the past several decades. The current acute treatment strategy focuses …

Evaluating Finerenone For Kidney Disease Progression In Patients With Type Two Diabetes And Chronic Kidney Disease, Erin C. Elgas

The PA Department Journal of Medical Science

Introduction: Type two diabetes contributes to chronic kidney disease progression in a multitude of ways within metabolic and hemodynamic factors. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, offers new solutions in slowing or stopping kidney disease progression in type two diabetics. The purpose of this review is to understand if adding finerenone can help slow kidney disease progression in adults with type two diabetes already receiving RAS inhibition.

Methods: A specific PubMed search with keywords including “type two diabetes”, “kidney disease” and “finerenone”, with filters and operators applied, supplied four articles for review.

Results: Finerenone was associated with decreased primary kidney …

The Bidirectional Effects Of Traumatic Brain Injury And Caudal Fin Amputation On Regeneration In Zebrafish (Danio Rerio), Makenna Wiebe

Theses and Dissertations (Comprehensive)

Traumatic brain injury (TBI) and caudal fin amputation initiate robust regenerative responses in adult zebrafish (Danio rerio), yet whether regenerative activity in one tissue influences repair at a distant site remains unclear. This study investigated the bidirectional effects of concurrent brain and peripheral injury on regeneration and functional recovery. Specifically, we assessed the effects of TBI on caudal fin regeneration, caudal fin amputation on neural stem cell-associated cellular responses, and combined injury on behaviour. Adult zebrafish received no injury, TBI, caudal fin amputation, abdominal puncture, or combined TBI and caudal fin amputation. I assessed caudal fin regeneration morphometrically and evaluated …

Diet Quality As Assessed By The Healthy Eating Index-2020 Among Individuals Diagnosed With And Without Type 2 Diabetes, Minghao Zhou, Hairui Yu, Renee Underwood, Hongning Cai, Tung Sung Tseng, Susu Luo

School of Public Health Faculty Publications

Background: Dietary management is key to preventing and controlling type 2 diabetes mellitus (T2DM). However, few studies have examined differences in Healthy Eating Index (HEI-2020) scores and components among individuals with and without diagnosed T2DM. This study aimed to assess gender differences in HEI-2020 scores and its 13 components by T2DM status. Methods: Using National Health and Nutrition Examination Survey (NHANES) data from 2011 to 2018, this cross-sectional study analyzed 19,464 adults. Diagnosed T2DM was identified via self-report or diabetes medication use. Diet quality was assessed using the HEI-2020, scored from 0 to 100, with a higher HEI score indicates …

Using Randomization To Compare Ai And Expert-Generated Formative Assessment Questions In Medical Education, Akshat Kumar, Katie Stinson, Litao Wang, Elizabeth Nugent, Yongsu Lee, Mark Hormann, Latanya Jones Love, Toufeeq Ahmed Syed

Faculty, Staff and Student Publications

Background: AI-generated content is being used across the education spectrum and is beneficial for creating complex multiple-choice questions, such as those used in medical education. However, evaluating AI-generated content is challenging, and existing testing and evaluation methods are falling short. This study uses randomization to compare medical students' performance on and subjective evaluation of AI versus expert-generated questions. We hypothesized that there would be no difference in student performance or subjective evaluation of AI vs expert-generated questions.

Methods: We designed a single-center, randomized study where medical student participants received either one AI- or expert-generated question per day over four weeks. …

Diagnostic Delays In Endometriosis Among Reproductive-Aged Women: An Evidence-Based Primary Care Policy Proposal, Francis P. Ronayne

Capstones

No abstract provided.

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …

Steroid Receptor Coactivator 3-Deficient Regulatory T Cells Eradicate Multiple Solid Tumors In Syngeneic Mouse Models, Nuri Sung, Eunsu Kim, Yosef Gilad, Yuri Park, Adam M Dean, Yan Xia, Jianming Xu, Clifford C Dacso, David M Lonard, Sang Jun Han

Faculty, Staff and Students Publications

Steroid receptor coactivator 3 (SRC-3) is highly expressed in regulatory T cells (Tregs) and is important for their immunosuppressive activity. Recently, we demonstrated that disrupting SRC-3 expression in Tregs eliminates triple-negative breast cancer (TNBC) and prostate cancer in syngeneic animal models by generating an anti-tumor immune microenvironment without inducing immune-related adverse events (irAEs). Further analysis of these mice revealed that SRC-3 knockout (KO) Tregs infiltrated breast tumors and facilitated the infiltration of CD8