Digital Commons Network^™

Bone Health And Healthcare Utilization Outcomes In Crohn’S Disease Patients Without Baseline Fracture Or Vitamin D Deficiency Treated With Infliximab Versus Adalimumab: A Propensity-Matched Cohort Study, Jashanveer S. Johal, Bianca Patel, Archana Salek, Mahmoud Al-Bataineh, Abdallah Hussein, Om Patel, Jason Hyman, Yecheskel Schneider

Rowan-Virtua Research Day

Background: Biologic therapies are central to Crohn's disease (CD) management, yet the comparative effects of infliximab and adalimumab on bone health and healthcare utilization remain poorly characterized in patients without baseline vitamin D deficiency or prior fractures.

Methods: A retrospective cohort study was conducted using the TriNetX U.S. Collaborative Network. Adult CD patients (≥18 years) initiating infliximab or adalimumab between 2018–2024 were included. Patients with ulcerative colitis, indeterminate colitis, or positive pregnancy tests were excluded. All patients had normal baseline vitamin D (≥20 ng/mL) and no history of pathological fracture. Propensity score matching (1:1) yielded 7,340 patients per cohort. Outcomes …

Health Disparities In Pediatric Epilepsy: A Narrative Review Of Barriers To Equitable Care, Nikhila Archakam, Akhila Archakam, Wesley Kim, Harshal Parmar

Rowan-Virtua Research Day

Epilepsy affects approximately 1% of children in the United States, representing over 456,000 pediatric patients with active seizure disorders. Despite advances in antiseizure medications and surgical interventions, the benefits of these developments are not distributed equally across racial, socioeconomic, and geographic groups. A narrative review of the literature was conducted using PubMed, Scopus, Embase, and Medline using search terms including "pediatric epilepsy," "health disparities," "health equity," "social determinants of health," "race," "socioeconomic status," and "access to care." Articles were included if they focused on pediatric populations aged 0 to 17, addressed at least one disparity domain, and were published between …

Racial Inequities In Maternal Health And Birth Outcomes In South Jersey, Yariza Orellana, Amenata Dukuray, Christine Ortiz

Rowan-Virtua Research Day

Racial disparities in maternal morbidity and mortality remain a persistent public health issue in the United States, with Black non-hispanic women experiencing a 2.4 to 3.3 greater risk of pregnancy-related complications compared to their white counterparts. In New Jersey, these disparities are similarly pronounced, with severe maternal morbidity occurring at more than twice the rate among non-Hispanic Black mothers. These inequities extend beyond maternal outcomes and contribute to adverse infant health outcomes, including stillbirth, preterm birth, and low birth weight. This study was conducted using databases such as PubMed and Google Scholar, as well as public health sources including the …

Comparative Evaluation Of Iris And Traditional Feeding Tube Placement Methods: A Review Of The Literature, Justin Le Oms-Ii, Nishant Patel Oms-Iii, Amy Glasofer Phd, Drnp, Rn, Emilio Mazza Md, Phd

Rowan-Virtua Research Day

Background

Enteral nutrition (EN) is preferred in patients with functional gastrointestinal tracts. Traditional feeding tube placement methods are time-consuming, radiation-dependent, and prone to misplacement. IRIS and electromagnetic (EM)-guided systems enable real-time bedside placement, though comparative data remain limited.

Methods

A qualitative literature review was conducted using PubMed (2004–2024) to identify studies evaluating IRIS technology compared with EM-guided and traditional placement methods. Outcomes of interest included procedural success, safety, complication rates, efficiency, and cost considerations across ICU and ward populations.

Results

IRIS demonstrated success rates ranging from 75–91.7%, with higher success observed in ICU and sedated patients. EM-guided placement showed consistent …

When Biomarkers Disagree: Diagnostic Challenges In Alzheimer’S Disease, Hayya Ali, Omar C. Chishti

Rowan-Virtua Research Day

Alzheimer’s disease (AD) is commonly diagnosed using a combination of clinical evaluation and biomarkers, including amyloid positron emission tomography (PET) imaging and tau protein levels. However, discordant biomarker findings can complicate diagnosis and clinical decision-making. We present a case study of a patient with progressive cognitive decline who demonstrated positive amyloid PET imaging but negative tau biomarkers. The objective of this case report is to demonstrate key diagnostic challenges in Alzheimer’s disease and highlight the need for a comprehensive, multimodal diagnostic approach. This case underscores the limitations of relying on a single biomarker modality and highlights the potential for overlap …

Tuberculosis In Long-Term Asian American Immigrant Residents: Trends And Risk Factors In Cases Diagnosed ≥10 Years After U.S. Arrival, Katherine Xie, Kai Mon Lee, Todd Schachter

Rowan-Virtua Research Day

Tuberculosis in Long-Term Asian American Immigrant Residents: Trends and Risk Factors in Cases Diagnosed ≥10 Years After U.S. Arrival

Katherine Xie, MSc¹, Kai Mon Lee, PhD¹, Todd Schachter, DO¹

¹Rowan-Virtua School of Osteopathic Medicine, 1 Medical Center Dr, Stratford, NJ 08084

Background

In the U.S., TB cases are largely due to reactivation of latent TB infections (LTBI) of immigrants from high-burden countries. The CDC and U.S. Preventive Services Task Force currently recommend screening newer immigrant populations, especially those born in highly-burdened areas with TB. This guideline mostly targets newly immigrated populations, defined as those …

Developing A Computational Pipeline For Biomarker Discovery In Ischemic Reperfusion Injury, Surabhi Panda, Kaitlyn Insana, Dimitri Pestov

Rowan-Virtua Research Day

Background: Ischemia-reperfusion injury (IRI) contributes significantly to tissue damage in cardiovascular disease. During IRI, stressed and dying cells release ribosomal RNA, which exhibits distinct fragmentation patterns that may serve as potential diagnostic biomarkers. Although these patterns have been observed using low-resolution biochemical techniques, there is currently no standardized computational approach to quantify and visualize RNA fragmentation for clinical interpretation.

Hypothesis: A computational pipeline can be developed to visualize and analyze ribosomal RNA fragmentation patterns, enabling identification of distinct fragmentation hotspots associated with ischemic conditions and potential biomarker discovery.

Methods: RNA fragmentation datasets generated from ribosomal RNA experiments in a Saccharomyces …

Left Waiting: Pediatric Primary Care Access For Hispanic Children In Mixed Status Households In South Jersey, Renzovic Francisco Escobedo, Andrea Trifundo, Ayair Hernandez

Rowan-Virtua Research Day

BACKGROUND: High-quality primary care is essential to a strong health system, yet many Hispanic children in mixed-status households face barriers that limit consistent access to pediatric care. In New Jersey, many immigrant families remain uninsured or under-enrolled in public insurance programs despite eligibility. These barriers are shaped not only by insurance and clinic availability, but also by language discordance, fear related to immigration status, and limited trust in the health care system. This project examines the intersecting barriers that affect pediatric primary care access for Hispanic children in mixed-status households in South Jersey.

METHODS: We conducted a literature review using …

Addressing Diabetes Risk Through Preventative Education In Multicultural And Economically Underserved South Jersey Communities, Bavly Nagy Halaka, Janet Jimenez-Merino, Izayah Diaz

Rowan-Virtua Research Day

BACKGROUND: Diabetes and prediabetes affect a substantial and growing portion of the U.S. population, with adolescent prediabetes rates more than doubling from 11% in 1999 to 28% in 2018. In multicultural and economically underserved South Jersey communities, structural barriers including food insecurity, limited access to preventive healthcare, and language gaps make early detection and prevention particularly difficult. We aimed to assess diabetes risk, management behaviors, and preferred education formats among a Camden-area bilingual community, and to identify culturally responsive intervention strategies.

METHODS: We conducted a literature review utilizing data from the CDC, NJ Department of Health, NJSHAD, and the U.S. …

Cannabis Use Disorder And Executive Function - A Literature Review, Jonathan Perumpail

Rowan-Virtua Research Day

Cannabis use disorder (CUD) is recognized as a psychiatric condition characterized by persistent and problematic cannabis consumption that leads to marked functional impairment. Growing evidence suggests that chronic CUD exerts significant effects on executive functions such as inhibitory control, cognitive flexibility, goal-directed behavior, and decision-making. This literature review integrates findings from 25 studies focusing specifically on individuals with objectively diagnosed CUD to explore the effects on cognition in this patient population. Across studies, deficits in executive function are consistently observed, with adolescents and early-onset users demonstrating increased vulnerability. Neuroimaging studies reveal structural and functional alterations in the prefrontal cortex and …

Metabolic And Bariatric Outcomes In Transgender Patients Receiving Gender Affirming Hormone Therapy: A Literature Review, Emily Sarett, Heather Dixon

Rowan-Virtua Research Day

Title: Metabolic and Bariatric Outcomes in Transgender Patients Receiving Gender Affirming Hormone Therapy: A Literature Review

Authors/Institutions: Emily Sarett, OMS-II1; Heather Dixon, PharmD2

Abstract:

Introduction: Obesity is a growing concern among transgender individuals, influenced by gender-affirming hormone therapy (GAHT) and social determinants of health. Bariatric surgery is effective, but metabolic outcomes and access to care remain understudied. Methods: A literature review was conducted using PubMed, Embase, and StatPearls databases (2020–2025). Studies evaluating bariatric outcomes, pharmacologic therapies, and metabolic effects of GAHT were included. Following screening and deduplication, 22 studies were analyzed. Results: GAHT is associated with increased fat mass and …

Acute Necrotizing Pancreatitis Due To Hypertriglyceridemia: A Case Report, Samantha Alyse Walkow, Pranaya Gade, Marina Bastawross, Ayesha Ain, Antonios Tsompanidis

Rowan-Virtua Research Day

Title: Acute Necrotizing Pancreatitis due to Hypertriglyceridemia: A Case Report

Background: Necrotizing pancreatitis is a severe complication of acute pancreatitis with a high risk of morbidity and mortality. Hypertriglyceridemia (HTG) is an uncommon but increasingly recognized etiology, often associated with more severe disease compared to biliary or alcoholic pancreatitis. Early recognition and targeted management are critical to prevent multiorgan failure.

Case Presentation: We present the case of a 39-year-old Hispanic male with a history of chronic hypertriglyceridemia and epilepsy who presented with acute onset of severe epigastric pain, nausea, and vomiting. Laboratory evaluation revealed markedly elevated serum triglycerides (TG) levels …

Assessing Risk Of Modern Energy Product Consumption Among Adolescents And Young Adults, Darshak Rana, Jeffery C. Powers

Rowan-Virtua Research Day

Background: Caffeine consumption among adolescents and young adults has increased significantly with the popularity of energy drinks, pre-workout supplements, and high-caffeine beverages. Excessive intake is associated with cardiovascular risk, yet awareness of safe limits remains low. This study evaluated caffeine use patterns, knowledge of guidelines, and self-reported cardiovascular effects among youth.

Methods: A cross-sectional survey was administered to individuals aged 15–25 years (n=27) in clinical settings. Respondents reported frequency of caffeine intake, product types consumed, knowledge of recommended daily limits, and cardiovascular symptoms experienced while caffeinated.

Results: Most participants (70%) consumed caffeine regularly, with coffee, soda, and energy drinks as …

Clinical Imaging Analysis Of An Investigational Novel Spinal Prosthetic, Nicholas C. Moscardelli, Erik Brewer, Liam Murphy

Rowan-Virtua Research Day

No abstract provided.

When Flashbacks Don’T Return: Lasting Ptsd Remission After Utilization Of Alpha-1 Adrenergic Antagonists, Priyal Pritesh Shah, Tara Young, Danah Atassi, Afshan Khan, Christie Richardson, Martin Forsberg

Rowan-Virtua Research Day

Introduction

Research has indicated that potentially 90% of older adults have undergone at least one potentially traumatic event in their lifetime. Post-traumatic stress disorder (PTSD) is a psychiatric illness that follows a traumatic life event where the person is exposed to death, threatened death, actual or threatened serious injury, or actual/threatened sexual violence. This event triggers symptoms including flashbacks, recurrent nightmares, hypervigilance, dissociative reactions, and physiologic reactions to traumatic cues. Some recent reports in PTSD treatment have indicated the potential for the use of centrally-acting alpha-1 antagonists, such as prazosin and doxazosin, as effective treatments for PTSD-associated flashbacks and nightmares. …

A Case Of Successful Survival In A High-Risk Elderly Patient With Copd After Endotracheal Intubation, Julia Cueto Oms-Ii

Rowan-Virtua Research Day

Exacerbations of chronic obstructive pulmonary disease (COPD) leading to acute respiratory failure (ARF) is one of the major causes of mortality worldwide, thus typically having poor outcomes. Risk factors such as the need for invasive mechanical ventilation (IMV), severity of disease, comorbidities, and increased age are predictors of increased mortality rates in COPD patients. Noninvasive ventilation (NIV), like bilevel positive airway pressure (BiPAP) or high flow nasal cannula (HFNC), is the initial standard of care for acute exacerbations of COPD. However, longer periods of NIV and failure of NIV therapy can lead to delayed endotracheal intubation and higher mortality rates. …

When Malingering Is Suspected: A Structured Clinical Framework For Assessment And Documentation, Thomas Sim, Timothy Wong

Rowan-Virtua Research Day

When Malingering is Suspected: A Structured Clinical Framework for Assessment and Documentation

BACKGROUND:

Distinguishing malingering from primary psychosis remains a common challenge across all psychiatric settings from emergency, consult-liaison, and to inpatient units. According to DSM-5-TR, malingering is defined as the intentional production of false or grossly exaggerated physical or psychological symptoms motivated by external incentives. Despite its prevalence, many clinicians receive limited formal training in its systematic assessment. Misidentification carries a bidirectional risk, as falsely labeling a genuinely psychotic patient as malingering may deny treatment whereas failure to detect malingering may result in misallocation of resources. Reliance on …

“This Wasn’T You”: Mania, Agency, And Moral Responsibility In Psychiatric Practice​, Phillip Mastoridis, Justin Scarano, Timothy Wong

Rowan-Virtua Research Day

A manic episode is a state of abnormally elevated or irritable mood with increased energy, impaired judgment, and risky or uncharacteristic behavior. This poster examines a case in which a woman, during a manic episode, placed doxylamine succinate, an over‑the‑counter sedating antihistamine, into her husband’s drink. After stabilization, she expressed shame and confusion about the act. In the clinical encounter, the treating psychiatrist responded, “It wasn’t you,” intending to reduce self‑blame and facilitate engagement in treatment. This reassurance was therapeutically effective but raises a deeper philosophical question: in what sense, if any, is it true?

Isolation And Quantification Of Rna From Extracellular Vesicles Derived From A549 Human Non-Small Cell Lung Cancer Cells Using Ultracentrifugation, Yousef Dimian, Vanessa Pizutelli, Dimitri Pestov

Rowan-Virtua Research Day

Extracellular vesicles (EVs) have gained attention as potential diagnostic tools due to their presence in body fluids and their ability to carry nucleic acids, including RNA. EV-derived RNA, particularly ribosomal RNA (rRNA), may reflect cellular stress and disease states, making it a promising biomarker1, 2. This project focuses on optimizing methods to isolate EVs and quantify their RNA content using human cell culture models. Differential ultracentrifugation was used to separate vesicle populations based on size, followed by RNA extraction and quantification using a high-sensitivity assay. Initial experiments using media from three 150 mm culture dishes yielded no detectable RNA, whereas …

Refractory Catatonia In Schizoaffective Disorder (Bipolar Type) Successfully Treated With Electroconvulsive Therapy, Shreya Kadi, Victoria Coles

Rowan-Virtua Research Day

Background: Catatonia is a neuropsychiatric syndrome

associated with mood and psychotic disorders and may

become life-threatening if untreated. While benzodiazepines

are first-line therapy, some cases are refractory and require

electroconvulsive therapy (ECT).

Hypothesis: Early use of ECT in refractory catatonia leads to

improved clinical and functional outcomes.

Methods: We present a retrospective case analysis of a 62-

year-old female with schizoaffective disorder, bipolar type,

who developed severe catatonia during inpatient psychiatric

hospitalization. Clinical course, Bush–Francis Catatonia Rating

Scale scores, and response to treatment were reviewed.

Results: The patient presented with severe catatonia (Bush–

Francis score 19) and elevated creatine kinase …

Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do

Rowan-Virtua Research Day

No abstract provided.

Impact Of Routine Yoga Practice On Metabolic And Hormonal Outcomes In Women With Polycystic Ovary Syndrome, Priya Patel

Rowan-Virtua Research Day

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder affecting approximately 8–12% of reproductive-aged women and is commonly associated with insulin resistance, hyperandrogenism, and metabolic dysfunction¹. Lifestyle modification remains first-line therapy; however, adherence to conventional interventions is often limited²,³. As a result, there has been growing interest in complementary approaches such as yoga, which integrates physical activity, breath control, and stress reduction⁴.

This focused literature review evaluates the impact of routine yoga practice on metabolic and hormonal outcomes in women with PCOS. A comprehensive search of PubMed, Scopus, CINAHL, and Embase was conducted, identifying 201 articles. After screening and applying …

Acute Coronary Syndrome Presenting As Pericarditis, Oliwia A. Dalek, Zamin Kazmi, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 71-year-old male with a past medical history of myocardial infarction (MI) who initially presented to the emergency department (ED) with a chief complaint of chest pain and shortness of breath.  After consultation with Cardiology in the ED, the presumed diagnosis was pericarditis, and heparin drip was not initiated.  The patient subsequently developed a complete heart block indicating an atrioventricular (AV) nodal knock out, likely due to an ischemic event.  This case highlights the importance of identifying acute coronary syndrome (ACS) as early as possible in order to intervene and achieve the best possible outcomes …

A Systems-Based Approach To Supporting Resident Scholarly Productivity:Building A High-Throughput Academic Pipeline In Emergency Medicine Residency Training Through Poster Development Apprenticeship, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:

Many residency programs require scholarly output; however, consistent and high-volume production of posters and publications can be challenging. Anecdotal evidence from a variety of programs suggests variability in outcomes across programs, often influenced by differences in mentorship, structure, and available scholarly infrastructure.

Objective: To describe a reproducible, systems-based model for generating high-volume resident scholarly output through alignment of expectations, culture, infrastructure, and faculty engagement.

Methods  and Conceptual Model: We outline a multi-domain framework derived from sustained programmatic experience, incorporating structural requirements, leadership alignment, cultural reinforcement, workflow standardization, and active faculty participation. The model is supported by practical tools including …

Conceptualizing The Transition From Stable Operations To Turbulent States : Reframing Emergency Department Operations. Learning From Fluid Dynamics And Complexity Science, James Espinosa, David Ho, Alan Lucerna

Rowan-Virtua Research Day

Background: Emergency departments are frequently described using the language of patient flow, implying  smooth and predictable movement of patients through a system versus known obstructions to flow.  Clinicians, however, often observe abrupt shifts in operational stability.

Objective: To explore whether concepts from fluid dynamics and complexity science offer a useful framework for understanding these transitions.

Methods: Conceptual synthesis drawing on emergency medicine operations research, human factors, systems science, and fluid mechanics.

Results (Conceptual): Emergency departments exhibit behaviors analogous to systems approaching turbulence, including sensitivity to perturbation, amplification of delays, and nonlinear responses.

Conclusion: Viewing ED operations through the lens of …

Resensitization Of Clinical Isolates Of Mdr-Acinetobacter Baumannii To Antibiotics Using Bacteriophage Therapy, Zainab Mubasher, Valerie J. Carabetta

Rowan-Virtua Research Day

Acinetobacter baumannii is a Gram-negative, opportunistic pathogen notorious for causing severe infections in immunocompromised patients, particularly those with prolonged hospitalizations or invasive procedures1. Originally susceptible to many antibiotics in the 1970s, this bacterium has since evolved extensive resistance, making it one of the most challenging members of the ESKAPE group of multidrug-resistant (MDR) pathogens2. Its ability to survive in harsh environments and acquire resistance determinants has led to its classification as a “red alert” pathogen by health authorities worldwide. The increasing prevalence of MDR A. baumannii infections in healthcare settings underscores an urgent need for alternative treatment strategies as conventional …

Quantifying Qtc Prolongation Risk At Scale: Cardiac Safety Implications Of Moxifloxacin-Based Tb Regimens, Wesley Augustus Kim, Nikhila Arcakam, Brandon Velazquez

Rowan-Virtua Research Day

Tuberculosis treatment is undergoing its most significant transformation in decades. In recent years, updated ATS/CDC/ERS/IDSA guidelines introduced a new 4-month drug-susceptible TB regimen that incorporates moxifloxacin as a core component. These landmark guideline shifts mean that moxifloxacin exposure among TB patients globally is set to expand dramatically. This drug replaces the ethambutol component of standard TB regiment commonly associated with optic neuritis as a side effect. Yet there is a critical blind spot: while individual studies have documented moxifloxacin’s QT interval-prolonging effects, no research has modeled what happens when this drug is rolled out to millions of patients who simultaneously …

Effective Peer Feedback With The Situation-Behavior-Impact (Sbi) Model, Steven Garwood, Dawn Shell, Emily Hoffman

Rowan-Virtua Research Day

Providing effective peer feedback is an essential professional skill in medical education, yet students often receive limited formal training in how to deliver feedback constructively. This study describes the design, implementation, and outcomes of a one‑hour synchronous workshop introducing first‑year medical students to the Situation–Behavior–Impact (SBI) feedback model. The interactive session combined didactic instruction, large‑group discussion of effective feedback characteristics, and small‑group practice creating structured SBI feedback statements. Effectiveness was evaluated using pre‑ and post‑workshop confidence surveys and a rubric‑based analysis of 75 group‑generated feedback statements. Following the workshop, 98% of students agreed or strongly agreed they could apply the …

Ketamine With Opioids Vs. Ketamine With Non-Opioid Analgesics For Vaso-Occlusive Crisis In Sickle Cell Disease: A Prisma-Style Scoping Review, Akhil Tumpudi

Rowan-Virtua Research Day

Vaso-occlusive crises (VOCs) are the hallmark of Sickle Cell Disease (SCD) and a leading cause of hospitalization. Pain management relies heavily on opioids, but repeated exposure carries risks including tolerance, hyperalgesia, and adverse effects. Ketamine, an NMDA receptor antagonist, has emerged as an adjunctive agent with potential opioid-sparing effects (1–3,7). Systematic reviews suggest ketamine may reduce pain scores and possibly opioid requirements, though pooled results remain inconsistent (5,6,8). While ketamine + opioid regimens have been studied, the feasibility, efficacy, and safety of ketamine combined with non-opioid analgesics for VOC remain largely unknown. Understanding the comparative effectiveness of these approaches is …

Anticholinergic Toxicity Presenting As Acute Stroke Mimic: A Case Report, Dean Austin Esma, Kelsey Murray, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Anticholinergic toxicity classically presents with a constellation of peripheral and central symptoms including tachycardia, mydriasis, dry skin, urinary retention, and altered mental status. However, central anticholinergic effects can predominate, presenting as isolated delirium without peripheral manifestations. This report presents a case of a 57-year-old woman who developed acute altered mental status and aphasia following cumulative anticholinergic exposure from over-the-counter cold medications, initially triggering a stroke alert