Digital Commons Network^™

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

Facial Skin Discoloration After Topical Silver Sulfadiazine: A Case Report, Hannah Culleny, Philip Carhart, James Espinosa, Neel Parikh, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Silver sulfadiazine (Silvadene) is a topical antimicrobial commonly used in burn management. Although generally well tolerated, excessive or prolonged application may result in cutaneous pigmentation changes due to silver deposition.

Here we present the case of a a 45-year-old woman who presented with diffuse gray-blue facial discoloration five days after sustaining a minor thermal injury. She had been prescribed topical silver sulfadiazine but applied the medication to her entire face and continued use after wound resolution. Physical examination demonstrated asymptomatic hyperpigmented gray-blue macules confined to areas of application. There were no signs of inflammation or systemic involvement. Discontinuation of the …

A Systems Perspective On Workstation Ergonomic Principles And Their Application In Emergency Care Environments, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Workstation ergonomic principles are commonly included in mandatory healthcare training programs. These recommendations—monitor height relative to eye level, neutral arm positioning, and adjustable seating—derive largely from occupational ergonomics literature designed to reduce musculoskeletal strain and improve comfort during computer work. Emergency Departments (EDs), however, represent dynamic environments with shared workstations and workflow interruptions that may influence the implementation of these recommendations.

Objective: To summarize the evidence supporting commonly taught workstation ergonomic principles and frame them within a systems perspective of ED work environments.

Methods: Narrative review of occupational ergonomics guidelines, ergonomic intervention studies, and human factors literature relevant to …

The Ed Is Inherently Interleaved: The Learning Theory Case For Hybrid Resident Conference Curriculum Design In Emergency Medicine: Block For Onboarding And For Specialized Topics With Predominant Interleaving For Intermediate And Advanced Residents, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Emergency medicine (EM) training occurs within a clinical environment characterized by rapid context switching, diagnostic uncertainty, and frequent transitions between unrelated clinical problems. Didactic curricula that rely only on block-based topic organization may not fully reflect the cognitive demands of real emergency department practice.

Objective

To propose a developmentally adaptive hybrid model of EM curricular design that integrates early block learning during the onboarding phase of new residents, progressing to a general approach of interleaved learning. Specialized topics,  can be introduced using block learning at any time during the residency years.

Methods / Conceptual Approach

This conceptual educational model …

Might Ite And Board Preparation Be Both Informative And Neurobiologically Formative? A Plausibility Argument Linking Study Processes To Hippocampal–Cortical Memory Consolidation, Pattern Recognition Networks, And Cognitive Efficiency, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:  The in-service training exam ( ITE ) and board preparation are traditionally framed as processes of information acquisition and evaluation. Educational discussions typically focus on knowledge transfer, study strategies, and examination performance. However, modern neuroscience suggests that sustained, emotionally salient, and repetitive cognitive challenge in adulthood can produce durable neuroplastic adaptations. Might such residency training be not only informative but also formative?

Objective: To propose a conceptual framework in which board preparation may be both informative and neurobiologically formative, functioning as a training environment that promotes integration of neural systems involved in memory retrieval, pattern recognition, and decision-making under …

The Use Of Prazosin In Individuals With Post-Traumatic Stress Disorder: A Scoping Review Protocol, Priyal Pritesh Shah, Marisa Riebesell, Afshan Khan, Amanda M. Carey, Emily Balog, Martin Forsberg

Rowan-Virtua Research Day

Background: Post-Traumatic Stress Disorder (PTSD) is a prevalent and debilitating condition, and is most often associated with sleep disturbances such as nightmares, flashbacks, and heightened arousal. Prazosin, an alpha-1 adrenergic antagonist, has been widely used for PTSD symptoms, however findings across studies are variable and limited, and the scope of existing evidence is not well established.

Objective: This scoping review aims to systematically map the literature on the use of prazosin in individuals with PTSD across diverse populations, settings, and study designs.

Methods: The scoping review will be conducted in accordance with JBI methodology and reported following PRISMA-ScR guidelines. A …

Neuro Visual Training For Post Tbi Rehabilitation: A Three-Patient Case Series, Isha Shashi, Joseph Clark, Aidan Butler, Kevin Kohmescher

Rowan-Virtua Research Day

Abstract.

Introduction:

Post-concussion syndrome (PCS) often presents with persistent symptoms following mild traumatic brain injury (mTBI), leading to significant delays in recovery. This case study explores the efficacy of a novel rehabilitation approach, of intensive NeuroVisual Training (NVT), in treating PCS for three patients presenting with chronic symptoms. We initiated an intense training program for 1 week, 8 hours per day, and call this a bootcamp.

Methods:

This is a three-patient case series. All patients were evaluated using traditional NeuroVisual assessments and cognitive assessments. All patients were greater than 6 months post-injury. All underwent a full 5-day bootcamp specifically tailored …

Sleep Architecture And Delirium In Patients With Intracerebral Hemorrhage: A Preliminary Observational Study, Lily Roessler, Kevin Eaise, Jamie Feinour Msn, Crnp, Jennifer Jond Ms, Pa-C, Vanessa Salasky Md, Mikel Shea Ehntholt Md, Bethany C. Young

Rowan-Virtua Research Day

Background: Delirium is common among ICU stroke patients and could possibly be associated with disrupted sleep. However, the relationship between specific sleep characteristics and delirium remains unclear.

Objective: To evaluate the association between sleep architecture and delirium in intracerebral hemorrhage (ICH) patients in the ICU.

Methods: We performed a primary analysis of 14 ICU ICH patients who underwent polysomnography. Sleep variables included total sleep time, sleep efficiency, sleep stages (N1, N2, N3, REM), arousal index, and sleep latency. Delirium was assessed using the Confusion Assessment Method for the ICU (CAM-ICU). Patients were categorized by presence or absence of delirium. Continuous …

Vitamin K And The Vaccine Cascade: Pediatric Patterns In Southern Nj, Kianna Bruzzo, Clare Stephens, Nicole Streeks-Wooden

Rowan-Virtua Research Day

Background:

Intramuscular (IM) vitamin K is recommended at birth to prevent vitamin K deficiency bleeding (VKDB), a potentially life-threatening condition that can result in intracranial hemorrhage or death. Prior research suggests a relationship between refusal of vitamin K prophylaxis at birth and subsequent vaccination patterns, with refusal potentially extending to other neonatal preventive services. In New Jersey, vaccination trends from 2017–2025 demonstrate a decline in the proportion of pre-kindergarten children meeting school vaccination requirements. This study aims to explore whether vitamin K administration at birth is associated with subsequent vaccination patterns in South Jersey.

Methods:

A retrospective cohort study was …

Invisible Shipwrecks And Neurological Endangerment: The Trade-Off In Seeking Asylum - Reframing The Neurobiological Cost Of Forced Migration, Eisha Giran

CISLA Senior Integrative Projects

Forced migration along the Spain–Morocco route represents one of the most visible humanitarian crises of the twenty-first century, yet its neurological dimensions remain insufficiently examined. This paper investigates how prolonged displacement and trauma reshape neural systems involved in stress regulation, memory, and emotional processing. It introduces the concept of neurological endangerment, defined as a condition of prolonged and inescapable threat exposure during forced migration in which stress-response systems remain chronically activated, opportunities for recovery are structurally constrained, and cumulative neurobiological risk persists beyond the period of immediate danger.

To address the gap between biological measurement and lived experience, this paper …

Point-Of-Care Intestinal Ultrasound Is Associated With Reduced Colonoscopy Utilization And Improved Clinical Decision-Making In Ibd, Lakumi Dias, Ashlyn Mcclelland, Amy Glasofer, Charalampos Papachristou, Yecheskel Schneider, Sanket Patel

Rowan-Virtua Research Day

Background:

Point-of-care intestinal ultrasound (IUS) enables real-time assessment of bowel inflammation, and it is underutilized in the United States. IUS provides visualization of bowel wall thickness, vascularity, and complications without radiation or bowel preparation. Prior studies demonstrate that IUS changes management and reduces reliance on invasive testing. This study hypothesizes that IUS will impact downstream clinical decision-making in a U.S. outpatient IBD cohort by decreasing invasive procedures and supporting appropriate treatment decisions.

Methods:

A retrospective cohort study was performed. Logistic regression and chi-square tests assessed associations between IUS use, colonoscopy referral, hospital utilization, and treatment modification. A derived “surveillance-due” variable …

Assessing Medical Trainees Knowledge Of Secondary Traumatic Stress Before And After Clinical Experiences At The Cares Institute: A Literature Review, Anastasiya Matveyenko, Sarah Kleinle, Paul Furtaw, Rachel Silliman Cohen

Rowan-Virtua Research Day

Secondary Traumatic Stress (STS) has been positively correlated with burnout in healthcare professionals through numerous studies. It is defined as the natural consequent behaviors and emotions resulting from knowing about a traumatizing event experienced by another individual. Medical students experience high level of STS due to exposure to trauma during multiple clinical rotations. Child Abuse Research Education and Service (CARES) Institute treats children who have experiences of abuse, neglect, and other forms of trauma. As part of the current curriculum, Rowan SOM students rotate at the CARES Institute for at least a day for up to a month and might …

Improving Blood Pressure Through A Multimodal Intervention, Kalynn Solomey

Evidence-Based Practice Project Reports

Hypertension is a major modifiable risk factor for cardiovascular disease and remains a significant public health concern in the United States (Centers for Disease Control and Prevention [CDC], 2023a). Despite the availability of effective pharmacological therapies, many patients struggle to achieve adequate blood pressure control, highlighting the need for accessible, evidence-based lifestyle interventions. An extensive literature search of five databases provided 11 articles for utilization. The purpose of this project was to evaluate the effectiveness of a multimodal intervention that included hypertension education, individualized lifestyle counseling, self-measured blood pressure training, and a progressive walking program in reducing systolic blood pressure …

Missense Mutations In The Snca Gene: Molecular Mechanisms And Clinical Implications, Pranaya Gade, Nishant Patel, Jamir Pitton Rissardo, Jorge Patino, Ana Fornari-Caprara, Ian Walker

Rowan-Virtua Research Day

The SNCA gene on chromosome 4 encodes the alpha-synuclein (αSyn) protein, which plays a central role in the pathogenesis of synucleinopathies, including Parkinson’s disease (PD), dementia with Lewy bodies (DLB), and multiple system atrophy (MSA). While αSyn has established roles in synaptic vesicle dynamics and neuronal signaling, alterations in SNCA regulation and sequence contribute to protein misfolding, aggregation, and loss of function. Alterations in secondary and tertiary structure, as well as protein aggregation, affect biochemical interactions, ultimately leading to pathogenesis. This review outlines the molecular architecture of the SNCA gene, including regulatory regions, alternative splicing, and untranslated regions that influence …

Prevalence And Clinical Correlates Of Restless Legs Syndrome In Neuromyelitis Optica Spectrum Disorder: A Systematic Review And Meta‑Analysis, Jamir Pitton Rissardo Md, Daarsh Goradia, Jarvish Shah, Nishant Patel, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Restless legs syndrome (RLS) is increasingly recognized in neuromyelitis optica spectrum disorder (NMOSD), yet published prevalence estimates remain highly variable, largely because of small sample sizes and methodological heterogeneity. We sought to estimate the pooled prevalence of RLS in NMOSD using published observational studies. Methods: A systematic literature search of PubMed was performed using the terms “restless legs syndrome” AND “neuromyelitis optica spectrum disorder”, identifying all original studies reporting RLS prevalence in NMOSD. Seven studies (2016–2026) met inclusion criteria. Study‑level data on RLS events and NMOSD sample size were extracted. A proportion‑weighted fixed‑effect meta‑analysis was performed. Pooled prevalence estimates …

Informed Consent For Porcine Islet Xenotransplantation To Treat Type 1 Diabetes: A Scoping Review, Jennifer Kovalcik, Sheetal Mohanty, Mairead Clare Higgins, Daniel J. Hurst

Rowan-Virtua Research Day

Purpose: The objective of this review is to systematically map and synthesize the existing literature regarding informed consent for porcine islet xenotransplantation for the treatment of Type 1 Diabetes.

Methods: The search was conducted in May 2025 through the following databases: PubMed, SCOPUS, EMBASE, and CINAHL. Broad search strings were used to combine the text words “islet” AND “xenotransplantation” AND “consent” or similar permutations and combinations. Peer-reviewed articles were included if they were published between January 1990 and May 2025 and written in English. The final search results were manually exported to a reference manager system (Zotero), and the PRISMA-ScR …

Impact Of Early Term Induction Of Labor On Cesarean Delivery And Impact Of Early Term Induction Of Labor On Cesarean Delivery And Maternal-Fetal Outcomes In Patients With Obesity: A Maternal-Fetal Outcomes In Patients With Obesity, Priya Patel, Nathanael Hoskins

Rowan-Virtua Research Day

Introduction: Obesity (body mass index [BMI] ≥30 kg/m²) in pregnancy is associated with increased risks, including gestational diabetes, hypertensive disorders, and higher cesarean delivery (CD) rates. Evidence supporting early-term (37 0/7–38 6/7 weeks) induction of labor (IOL) to improve outcomes remains limited. This study evaluated whether IOL in patients with obesity is associated with decreased CD rates.

Methods: This retrospective cohort study included pregnancies undergoing IOL between 37 0/7 and 41 6/7 weeks from 2018–2023 at a single institution. Exclusion criteria included spontaneous labor, prior CD, multiple gestations, fetal anomalies, non-vertex presentation, and pre-labor rupture of membranes. Primary exposures were …

Case Report: Pott’S Puffy Tumor, A Rare Complication Of Sinusitis, Je Seong Lee, Esai A. Hernandez, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

We report the case of an 11-year-old female who presented with lethargy and new left upper extremity weakness after a recent Emergency Department visit for fever, rhinorrhea, and head fullness, and was subsequently diagnosed with Pott’s Puffy Tumor(PPT). Pott’s Puffy Tumor is a frontal bone osteomyelitis with an frontal  subperiosteal abscess and represents a rare but potentially life-threatening complication of sinusitis. Prompt imaging and timely clinical intervention are critical, though variable presentations can make diagnosis challenging. This case highlights the importance of early recognition, appropriate imaging, and prompt surgical and antibiotic management given the PPT’s  strong association with intracranial complications. …

Case Report: Adult Distal Lleal Perforation Mimicking Meckel's Diverticulum, Dip Patel, Wayne Tamaska, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Meckel’s diverticulum is the most common congenital anomaly of the gastrointestinal tract, but clinically significant disease in adulthood is uncommon and often difficult to diagnose before surgery. In adults, symptomatic Meckel’s most often presents with obstruction, bleeding, or inflammation, and cross-sectional imaging may not clearly distinguish it from other distal ileal processes.

We report the case of a 35-year-old man who presented with several days of fever, abdominal pain, vomiting, and diarrhea. CT imaging suggested a complicated distal ileal diverticular process, most concerning for perforated Meckel’s diverticulum with an adjacent abscess. He underwent emergent small bowel resection and abscess drainage. …

Reframing Emergency Medicine (And Healthcare) Wellness Measures: The Case For Adding Measures Of Physiological Sustainability, Exercise, Restoration, And Meaning, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Physician wellness measurement in Emergency Medicine (EM) in particular and in healthcare in general has largely focused on identifying distress states such as emotional exhaustion and depersonalization. Instruments such as the Maslach Burnout Inventory and related derivative surveys have been well-validated and  have played a central role in identifying the scope of burnout across healthcare systems.

Conceptual Framing

While current measures of distress are essential, they may not fully characterize the spectrum of clinician health. In many fields outside healthcare—including occupational health, resilience research, and positive psychology—assessment of well-being includes behaviors and experiences associated with sustained health, such as …

Reframing The Ed–Hospitalist Admission As A Clinical Handoff: The Ed To Hospital Admission As A Cross-System Handoff In A Complex Adaptive Clinical Environment. The Case For Systems Approaches To Enhance Safe And Effective Transitions Across A True System Interface, James Espinosa, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Background

Transitions from the Emergency Department (ED) to hospital medicine represent a high-stakes clinical handoff across systems. While often experienced as challenging, these interactions are better understood as occurring between services operating under different cognitive loads, operational priorities, and time horizons. Reframing the ED–hospitalist admission as a structured handoff aligns this process with broader patient safety efforts.

Objective

To characterize the ED–hospitalist admission as a cross-system clinical handoff and to identify practical strategies that enhance safety, clarity, and alignment during this transition.

Methods

Conceptual analysis informed by clinical experience, systems theory, and teaching observations. Key domains of potential misalignment were …

Title: Impact Of Hypertriglyceridemia ≥500 Mg/Dl On Acute Pancreatitis Outcomes: A Propensity Score–Matched Cohort Study, Jashanveer S. Johal, Bianca Patel, Mahmoud Al-Bataineh, Archana Salek, Om Patel, Jason Hyman, Yecheskel Schneider, Abdallah Hussein

Rowan-Virtua Research Day

Background: Hypertriglyceridemia is a recognized cause of acute pancreatitis, but the prognostic impact of markedly elevated triglycerides (TG) on clinical outcomes remains unclear. We evaluated whether TG ≥500 mg/dL at presentation predicts worse pancreatitis outcomes.

Methods: Using the TriNetX multicenter electronic health record network, adults hospitalized with acute pancreatitis and a TG measurement within 48 hours of admission between 2018–2024 were identified. Patients with TG ≥500 mg/dL were compared with those with TG < 500 mg/dL after 1:1 propensity score matching on demographics and comorbidities (n=7,014 per group). Primary outcomes included ICU stay, pancreatic complications, need for procedure, and all-cause mortality. Secondary outcomes included acute renal failure, cardiovascular events, repeat pancreatitis, infection, and liver failure. Odds ratios (OR) with 95% confidence intervals were estimated.

Results: Compared with TG < 500 mg/dL, patients with TG ≥500 mg/dL had higher risks of ICU admission (25.3% vs. 17.2%; OR 1.63), pancreatic complications (5.3% vs. 4.5%; OR 1.19), and mortality (4.6% vs. 3.3%; OR 1.39). Need for procedural intervention was lower in the high-TG group (1.2% vs. 3.6%; OR 0.34). Secondary outcomes including acute renal failure (15.5% vs. 10.7%; OR 1.54), repeat pancreatitis (58.6% vs. 51.9%; OR 1.31), and infection (13.7% vs. 12.0%; OR 1.17) were all significantly elevated. Cardiovascular events and liver failure did not differ significantly.

Conclusions: TG ≥500 mg/dL in acute pancreatitis was associated with greater ICU utilization, complications, and mortality, but lower procedural intervention rates. Admission triglyceride …

Glp-1 Receptor Agonists And Neurocognitive Outcomes In Type 2 Diabetes: A Propensity-Matched Real-World Analysis Of Cognitive Impairment, Neurodegeneration, And Mortality, Om Patel, Shefali Waghray Do, Jashanveer S. Johal, Jason Hyman, Tatiana Gandrabura

Rowan-Virtua Research Day

Background: GLP-1 receptor agonists improve glycemic and cardiovascular outcomes in type 2 diabetes mellitus (T2DM), but their impact on neurocognitive and neurological outcomes remains incompletely characterized. We evaluated the association between GLP-1 agonist use and incident cognitive impairment, neurodegeneration, and healthcare utilization in T2DM patients without baseline cognitive deficits.

Methods: A retrospective cohort study was conducted using the TriNetX Global Collaborative Network. Adults (≥40 years) with T2DM and no prior cognitive impairment, Alzheimer's disease, Parkinson's disease, multiple sclerosis, or cerebral infarction were identified. Cohort 1 received a GLP-1 agonist (semaglutide, tirzepatide, liraglutide, or dulaglutide) after T2DM diagnosis; Cohort 2 received …

A Retrospective Comparison Of Dobhoff Nasogastric Feeding Tubes To Iris Feeding Tubes, Nishant Patel Oms-Iii, Justin Le Oms-Ii, Amy Glasofer Phd, Drnp, Rn, Emilio Mazza Md, Phd

Rowan-Virtua Research Day

Background

Postpyloric feeding is essential in critically ill patients. Traditional Dobhoff tube (DHT) placement, often performed blindly, is widely used due to low cost but carries risks of misplacement and reliance on radiographic confirmation. In contrast, Kangaroo™ IRIS (camera-guided) technology enables real-time visualization during placement, potentially improving accuracy and workflow, though at higher cost.

Hypothesis

IRIS-guided placement provides comparable safety and success to DHT, with similar procedural efficacy without increasing complications.

Methods

A retrospective cohort study was conducted using the electronic medical records from multiple Virtua Health hospitals (01/01/13, through 01/31/25), including 200 patients undergoing nasogastric tube placement with DHT …

In The Era Of The Smartphone: The Case For The Continued Role Of Mnemonics As Cognitive Scaffolds That Support Encoding, Working Memory Efficiency, And Rapid Cue-Dependent Retrieval, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: The ubiquity of smartphones and point-of-care digital references has prompted questions regarding the continued relevance of mnemonic devices in medical education. If information can be instantly retrieved, is memorization—and by extension mnemonic structure—still necessary? Objective: To reframe mnemonics not as relics of pre-digital pedagogy, but as cognitive scaffolds that support encoding, working memory efficiency, and rapid cue-dependent retrieval in time-pressured clinical environments. Discussion: Cognitive science demonstrates that working memory remains inherently limited regardless of technological access. Mnemonics function as structured chunks that reduce cognitive load, support pattern recognition, and facilitate transition from novice encoding to expert automaticity. In emergency …

Training Vs. Reality: The Challenges Of Preventing Heat-Related Illness In Migrant Farmworkers, Sonya Homami

Rowan-Virtua Research Day

Background: Heat‑Related Illness (HRI) is a major occupational hazard for migrant farmworkers, who are 35 times more likely to die from HRI than workers in other industries. Although HRI training aims to improve prevention knowledge, its effect on actual HRI outcomes is unclear.

Methods: Following PRISMA guidelines, a systematic review of PubMed, Embase, and Web of Science identified studies evaluating HRI training and reporting HRI prevalence or related symptoms. Fifteen studies met inclusion criteria.

Results: HRI training did not reduce HRI prevalence or provide protective effects. Training increased reporting of workplace injuries and concern about HRI. Despite high training uptake—over …

Worsening Obsessive Compulsive Disorder (Ocd) With New Onset Dementia, Melvin D. Ways Jr

Rowan-Virtua Research Day

Obsessive-compulsive disorder (OCD) is a chronic psychiatric condition typically characterized by intrusive thoughts and repetitive behaviors with preserved insight. Dementia, a progressive neurocognitive disorder, is frequently associated with behavioral and psychiatric symptoms; however, its impact on pre-existing OCD is less well understood.

Subject of study includes evaluation of neurodegenerative processes to exacerbate pre-existing OCD symptoms. Evidence suggests that dysfunction in shared fronto-striatal circuits—particularly involving the orbitofrontal cortex and basal ganglia—may underlie this relationship. Additionally, cognitive impairment may reduce the ability to inhibit intrusive thoughts, further reinforcing compulsive behaviors. Emerging research also indicates a bidirectional association, with OCD linked to an …

Physician Bedside Communication Posture (Sitting Versus Standing) In Relation To Patient Satisfaction: A Focused Literature Review And Areas For Potential Research, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background:

Sitting during patient encounters is commonly recommended in communication training, with the assumption that it improves patient satisfaction. However, the empirical evidence supporting this recommendation in Emergency Department (ED) settings appears limited.

Objective:

To review the existing literature examining physician posture (sitting versus standing) and its association with patient satisfaction and perceived communication quality.

Methods:

Narrative review of ED and non-ED studies evaluating posture during clinical encounters, with attention to study design, sample size, setting, and outcome measures.

Results:

ED-specific evidence remains heterogeneous. Some studies demonstrate that sitting increases patients’ perception of time spent at bedside without increasing actual …

Case Study: 46-Year-Old Female With Auditory Hallucinations, Ahmed Aly, Tayeb Ahamed, Chien Y. Cepeda, Apn

Rowan-Virtua Research Day

The case study discusses a patient seen at a voluntary psychiatric unit. Patient has been prescribed benzodiazepine and bupropion; she became dependent on the benzodiazepine due to social difficulties that have not been addressed by her prescriber. The study highlights the dependency of benzodiazepine while being offered bupropion (which lowers seizure threshold), which can be deadly if accompanied with benzodiazepine withdrawal