Digital Commons Network^™

Association Between Psychiatric Diagnosis And Academic Major In College Students, Maryam Ali, Ambika Menon, Amani Carson, Larry Tupler

Research Day

Introduction: Prior literature has highlighted the high prevalence of psychiatric diagnoses amongst college students. We propose that developmental influences that shape the emergence of psychiatric disorders amongst individuals are reflected in early intellectual pursuits. Furthermore, we propose that collegiate institutional stressors relating to these pursuits can further the declaration of a disorder in students with a psychiatric diathesis. Methods: We acquired data anonymously from 1,133 colleges via a Web-based survey of 17,425 students who were ≤ 22 years old. We report the association between psychiatric disorder and choice of academic major in the first collegiate year to illuminate early developmental …

Eating Disorders In Hispanic Females Living In The Us: A Review Of Literature, Yesenia P. Stephens, Natalia Miles

Research Day

INTRODUCTION: According to the United States Census, Hispanics make up 19.1% of the total population, making it the nation’s largest racial or ethnic minority. Of interest, nearly 22% of Hispanic adults report having a mental illness, yet only 36% receive mental health services compared to non-Hispanic Whites (52%).2

OBJECTIVES: There is limited research on diagnosing eating disorders in Hispanic females living in the US. To understand this disparity, the aims of this study are to 1) gain understanding of what psychological constructs are unique to the experience of Hispanic females living in the US and 2) determine the risk factors …

Exploring The Potentials Of Pulmonary Malignancy As A Contributing Factor To Pulmonary Edema, Mykala C. Jackson, Kenyot’A C. Russell, Evelyn O. Orusa, Joshua Owolabi

Research Day

The goal of this study is to investigate the cause of pulmonary edema as a result of pulmonary malignancy. The first phase of investigation occurred with a dissection of gross anatomy. When opening the thoracic cavity, the left lung was grazed and copious amounts of fluid seeped from the lung. Upon the initial observation of gross anatomy, both lungs appeared to be enlarged and exhibited an abnormal color. During the dissection, the left lung was noticeably larger than the right lung which could have compressed the heart. Upon palpation of the right lung, a large mass could be felt in …

Diagnostic Utility Of Cerebrospinal Fluid Biomarkers In Patients With Rapidly Progressive Dementia, Lindsey A. Kuchenbecker, Philip W. Tipton, Yuka Martens, Matthew R. Brier, Nihal Satyadev, Richard S. Dunham, Evelyn B. Lazar, Maxwell V. Dacquel, Rachel L. Henson, Guojun Bu, Michael D. Geschwind, John C. Morris, Suzanne E. Schindler, Elizabeth Herries, Neill R. Graff-Radford, Gregory S. Day

Research Day

Objective:This study was undertaken to apply established and emerging cerebrospinal fluid (CSF) biomarkers to improve diagnostic accuracy in patients with rapidly progressive dementia (RPD). Overlap in clinical presentation and results of diagnostic tests confounds etiologic diagnosis in patients with RPD. Objective measures are needed to improve diagnostic accuracy and to recognize patients with potentially treatment-responsive causes of RPD.

Methods: Biomarkers of Alzheimer disease neuropathology (amyloid-β42/40 ratio, phosphorylated tau [p-tau181,p-tau231]), neuroaxonal/neuronal injury (neurofilament light chain [NfL], visinin-like protein-1 [VILIP-1], total tau), neuro-inflammation (chitinase-3-like protein [YKL-40], soluble triggering receptor expressed on myeloid cells 2 [sTREM2],glialfibrillary acidic protein [GFAP], monocyte chemoattractant protein-1 [MCP-1]), …

Rare Presentation Of Aberrant Renal Vessels, A Case Report, Diamond Alexander, Ralph W. Brown, Hannah K. Da Cruz, Justin T. Nguyen, Stephanie Suarez, Joshua Owolabi

Research Day

Introduction

Aberrant renal arteries can be due to abnormal ascension or rotation of the fetal kidney. Aberrant arteries from the inferior pole are only seen in 3% of dissected cadavers, providing an opportunity to understand the rare variation and its effects on physiological and histological findings1. These anomalies can be asymptomatic or lead to impaired urine flow through the ureter, leading to hydronephrosis.

Methods

A 76-year-old male donor cadaver was dissected in the PCOM South Georgia anatomy lab in accordance with the first year curriculum for abdominal and kidney dissection. Observations and measurements were noted.

Results

The left kidney presented …

Successful Treatment Of Primary Melanoma Of The Ascending Colon: A Case Report And Literature Review, Maryam Ali, Mailyn Cruz, Wenhui Zhu

Research Day

Introduction: Malignant melanoma typically originates from the skin. Gastrointestinal melanomas are rare, representing 1-3% of neoplasms of the gastrointestinal tract. Cases of primary melanoma originating de-novo from the gastrointestinal (GI) tract are exceptionally rare. Of those cases originating from the GI tract, only 37 cases of primary colonic melanoma have been reported to date.

Case Presentation: Herein, we present the case of a 66-year-old Caucasian male presenting with Stage IV metastatic primary malignant melanoma of the ascending colon found on routine surveillance colonoscopy. The patient’s past medical history was significant for hypertension, dyslipidemia, and pulmonary embolism. Upon initial presentation, the …

Actions Speak Louder Than Words: The Assertive Community Treatment Program In Rural South Georgia, Maryam Ali, Anthony Cimmino, Janai Groves, Brandon Krout

Research Day

Introduction: The Assertive Community Treatment (ACT) program offers patient-centered mental-health treatment to those in need with mental illness, addictions, and/or developmental disabilities. The ACT program is unique in providing mental health services in non-restrictive milieus that facilitate patient independence within their natural environment. These services include a variety of multi-disciplinary interventions, such as behavioral health assessments, behavioral health crisis units, family/individual/group counseling, crisis intervention, and various community support services. Our ACT team in rural South Georgia specifically covers Colquitt, Decatur, Grady, Mitchell, Thomas, and Seminole counties.

Case Presentation: Herein, we present the case of a 51-year old African American male …

Analyses Of The Correlation Of Hpv Vaccination And Oropharyngeal Cancer/Lesion In Men: From Allofus Research Database, Anna M. Terzian, Ahmad B. Cader, Qian Chen

Research Day

Human papillomavirus (HPV) is one of the most common sexually transmitted infections worldwide. It is most well-known as the leading cause of cervical cancer. However, there is a rising prevalence of HPV-related oropharyngeal cancers, particularly in men from high-income countries. Therefore, it is urgent to advocate prevention. This study aims to understand the correlation between the HPV vaccination and reduced HPV-related oropharyngeal cancer development. Additionally, many factors, such as race, income, risky sexual behavior, smoking, and recreational drugs are worth analyzing to appreciate their role in cancer development. This study was conducted using the AllofUs research database. The keywords included …

Adjunctive Therapies In The Management Of Tibial Stress Fractures: A Systematic Review Of The Literature, Hunter Smith, Joshua Rogers, Merrick Wetzler

Research Day

I. Introduction

Tibial stress fractures are common overuse injuries that are a source of pain, disability, and missed time from athletic activity. There are established protocols currently for return-to-play programs, but little consensus on the use of adjunctive modalities during the recovery period to reduce the recovery period. The purpose of this review is to summarize the results of randomized controlled literature evaluating the effectiveness of modalities to reduce time to healing in posteromedial tibial stress fractures.

II. Methods

A systematic search of PubMed, EMBASE, and Google Scholar was conducted between September 2022 and July 2023, following PRISMA guidelines. The …

Effects Of Mitoquinone And Dexrazoxane On Doxorubicin’S Anti-Tumor Efficacy, Le Mai An, Aakash Belsare, James Huang, Juliet Melnik, Meagan Lyons, Lloyd Yan, Lindon H. Young, Robert J. Barsotti, Qian Chen

Research Day

Introduction

Doxorubicin (DOX) is a well-known chemotherapy drug for various cancers, including breast cancer. However, DOX-induced cardiotoxicity set a significant barrier limiting its clinical application. Dexrazoxane (Dex) is the only FDA-approved drug to protect the heart against DOX-associated damage. Nonetheless, it is still arguable if Dex induces secondary malignancy. Our lab previously showed that pretreating H9c2 myoblast with a mitochondrial-targeted antioxidant, mitoquinone (MitoQ), demonstrated significantly higher cell viability than cotreatment with DOX. Still, whether MitoQ pretreatment or cotreatment would potentiate DOX’s efficacy on cancer cells is unclear. Furthermore, it is intriguing to evaluate if MitoQ’s effects on DOX’s anti-tumor capacity …

Double Crush Syndrome Presenting As Foot Drop Due To A Peroneal Neuropathy And An L5 Radiculopathy: A Case Report, James Petrera, Ronald Lincow

Research Day

Introduction: The purpose of this research is to describe a patient who presented with double crush syndrome that originally presented with signs and symptoms of a peroneal neuropathy at the fibular head. However, Electromyography (EMG) later confirmed an L5 lumbar radiculopathy. In this case report, we aim to present a rare occurrence which has been recognized, however, very few detailed reports exist.

Case Description: This is a case report of a 77-year-old male farmer who presented to the private practice with complaints of right foot-drop and bilateral low back pain. These symptoms began after falling off a ladder about 2 …

Comparative Analysis Of Caffeine Therapy Guidelines In Neonates, Abigail E. Vangorder, Brandon Poterjoy

Research Day

INTRODUCTION:

Clinical guidelines are utilized in the effort to practice evidence-based medicine. Despite caffeine citrate’s common use in the treatment of apnea of prematurity (AOP) in neonates, there is not a commonly adopted clinical guideline for caffeine therapy. We aim to explore how variation in cited sources influences variation in published recommendations for caffeine therapy in the treatment of apnea of prematurity.

METHODS:

We utilized comparative analysis to identify qualitative variances in clinical guidelines for caffeine therapy to treat apnea of prematurity (AOP) in neonates and bibliometric analysis to identify to what degree citations vary or overlap between clinical guidelines. …

Challenges In Capacity: A Case Report Exploring Social Determinants Of Health And Psychiatric Illness, Hunter Smith, Jacob Light, Jenys Allende

Research Day

I. Introduction

An assessment of capacity is a critical part of the surgical consent process in order to ensure that the patient understands the risks, benefits, and alternatives to treatment. When a patient refuses life-saving care, it is essential to evaluate them to determine their capacity for decision-making. While there are specific components to a capacity evaluation, the capacity assessment process can be clouded by other factors in the patient’s history. The purpose of this case study is to illuminate the myriad challenges faced by surgeons assessing capacity in patients with complex social and psychiatric backgrounds.

II. Case

A 53-year-old …

Mycobacterium Avium Complex-Associated Vertebral Osteomyelitis In An Immunocompetent Patient: A Case Report, Jory P. Parson, Jack A. Grossweiler, Ira M. Garonzik, James E. Conway

Research Day

Introduction

Mycobacterium avium complex (MAC) infection in the spine is extremely rare, with its pathogenesis and epidemiology remaining poorly understood. Clinically, MAC infections commonly present with pulmonary, musculoskeletal, and disseminated disease. Manifestation of MAC infections, specifically disseminated disease to the spine, is uncommon in patients without human immunodeficiency virus or acquired immune deficiency syndrome.

Case Presentation

In December 2017, a 46-year-old immunocompetent man presented with severe lower back pain, right lower extremity pain, and a previous L5-S1 fusion. Imaging revealed pseudarthrosis at L5-S1 with halos around S1 screws. In March 2018, he underwent revision surgery with partial relief and began …

Academic Degree Bias Among Speaking And Leadership Roles At The American Academy Of Orthopaedic Surgeons Annual Meeting 2016-2021, Lucas Bartlett, Alton Daley, Adam Kazimierczak, Brandon Klein, Casey Humbyrd, Adam Bitterman, Randy Cohn

Research Day

Objective: This study examined the proportion of osteopathic physicians (DO) across various speaking and leadership roles at recent American Academy of Orthopaedic Surgeons (AAOS) annual meetings.

Design: Meeting programs from the AAOS were publicly accessed and compiled between 2016 and 2021. Two categories of AAOS meeting participants were created. Invited speaker and faculty roles included moderators of symposia and program committee members while authors of presented papers were classified into academic roles. The proportion of DOs in each role type (invited speaker, academic) were recorded for each meeting program. The representation of DO's in these roles were then examined longitudinally …

Lasers And Topical Therapies For The Treatment Of Rosacea: A Systematic Review, Jane Mundadan, Margaret Chou, Maria J. Karim, Jessica Labadie, Robin Ashinoff

Research Day

Rosacea, a multifaceted skin condition characterized by facial redness, visible blood vessels, and acne-like bumps, lacks a definitive cure. Treatment options encompass oral medications, topical creams, and laser therapy. To assess the efficacy of combining laser procedures with topical treatments, a systematic review was conducted following PRISMA guidelines. The search, which included databases like PubMed and Embase, identified 496 studies, of which 8 met inclusion criteria.

These studies, involving a total of 200 patients aged between 33.8 to 51.1 years, utilized various combinations of laser therapy and topical agents. Most commonly used lasers included pulsed dye laser (PDL), potassium titanyl …

A Rare Case Of High Grade Lymphoma Presenting As Large Bowel Obstruction With Testicular Mass, Gianna Martini, Gino Pezzone, Tiffany Pompa, Vijaykumar Gandhi

Research Day

Large bowel obstructions can occur in many settings, including a volvulus, adhesive disease, strictures, hernias, and malignancy. In the setting of malignancy, a bowel resection is the most common initial treatment option, and histologic examination of the resected specimen can identify the underlying source of the obstructing mass. Most commonly, large bowel obstruction is due to colorectal cancer, and if metastasis is present, it will most commonly involve the liver, followed by the lungs, bone, and brain. We present a case of a 36-year-old male who presents with a large bowel obstruction and a testicular mass noted on admission. The …

Improving Iol Calculators’ Total Corneal Astigmatism Predictions With Deep Learning, Jason Fink, Mathieu Gauvin, Chirag Shah, Mark Cohen, Avi Wallerstein

Research Day

Precise intraocular lens (IOL) selection plays a critical role in optimizing surgical outcomes for patients undergoing IOL surgery. Traditionally, only the anterior corneal astigmatism (ACA) was considered during IOL selection. However, the posterior corneal astigmatism (PCA), also significantly impacts vision, though it is more challenging to measure directly. Advancements in deep learning offer a promising solution. By analyzing existing ACA measurements, deep learning algorithms can predict total corneal astigmatism (TCA) with high accuracy, effectively inferring PCA and enabling more precise IOL selection.

We employed a multivariate linear regression neural network (NN) and evaluated its performance through R-squared and root mean …

Evaluation Of Operative Delays Secondary To Radiotracer Injection In Breast Cancer Surgery, Iman Elkhashab, Elisheba Kassa, Jory Parson, Joshua Madera, Trieu Ton, Jandie Posner

Research Day

BACKGROUND: Breast cancer is the most prevalent diagnosed malignancy among females in the United States. Current treatment protocols require surgical excision, often involving mastectomy and lymph node biopsy, to evaluate the spread of cancer. This either requires axillary lymph node dissection or sentinel lymph node biopsy utilizing a radiotracer to identify cancer-draining lymph nodes. Debate persists over the safety, efficacy, and efficiency of perioperative injections versus preoperative injections or tracers.

METHODS: We conducted a retrospective analysis of patients who underwent radiotracer injection prior to sentinel lymph node biopsy or targeted lymph node biopsy between November 2021 and July 2023. The …

Increasing Motivation In Stem Education: A Self-Talk Classroom Intervention, Tiffany L. Copeland, Richard Allen, Sofia Pham, Kristin Gagnier

Research Day

INTRODUCTION: This study examines a social-emotional learning intervention that teaches positive self-talk to high school students from underrepresented minority groups in science, technology, engineering, and math (STEM). The setting of this study is a place-based program that immerses students in hands-on STEM activities while located in Philadelphia’s life science hub. Before taking a science assessment, students will learn to say self-talk statements such as “I will give my best effort” and “I can achieve a high score.”

METHODS: This mixed method quasi-experimental design compares pre- and post-program data using an ANOVA. Student science performance will be measured using a probe …

Sleep Quality Monitoring With Wearable Devices After Primary Total Knee Arthroplasty, Yash P. Chaudhry, Hunter Hayes, Efstratios Papadelis, Thomas Muzzonigro, Mark Lagreca, Kenneth Wojnowski, John Hobbs, Jackson Harvi, Andrew Star

Research Day

INTRODUCTION:

Patients undergoing total knee arthroplasty (TKA) are often subjected to immediate postsurgical pain and disruption of sleep. Recent studies have explored the role of postoperative sleep disruption using subjective assessments, however the literature on objective markers of sleep quality remain sparse. The aim of this pilot study was to assess objective measures of sleep quality in the immediate postoperative period following TKA.

METHODS:

Patients undergoing primary unilateral TKA at a level two medical center were enrolled in a prospective study in which they wore wearable sleep tracking devices (WHOOP, USA) for at least a week prior to surgery and …

The Prevalence Of Demodex Folliculorum And Brevis Colonization In Patients Presenting With Blepharitis To An Outpatient Resident Clinic, David Broytman, Eric Rosenberg, Alanna Nattis, Ryan Kent, Vinh Ngo

Research Day

Purpose: To examine the prevalence of Demodex in two large, tertiary care, outpatient resident clinic settings; meanwhile, exploring demographic variables, use of ocular medications, and OTC cosmetic products with respect to prevalence. Lastly, analyze potential inadequacies in the rate of treatment amongst patients in the resident clinic setting.

Methods: A cross-sectional non-randomized, prospective study investigating the prevalence of Demodex folliculorum (DF) and brevis (DB) in patients presenting with blepharitis, and in control patients without clinical evidence of dry eye blepharitis syndrome (DEBS). Epilation of one eyelash from each lid was performed and studied under high power light microscopy. Each patient …

Enhancing Intracellular Delivery Of Protein Kinase C Beta Ii Via N-Terminus Conjugation Of Myristic Acid-Trans-Activator Of Transcription To Attenuate Superoxide Release In Rat Polymorphonuclear Leukocytes, Alexandra Barrera, Jennifer Dang, Denise Pinto, Alexis Verwoert, Sunit Singh, Emily Andrews, Arjun Nair, Devani Johnson, Taylor Dilisi, Annam Humayun, Tameka Dean, Juliet Melnik, Mai An Le, Qian Chen, Robert J. Barsotti, Lindon H. Young

Research Day

Introduction

Protein kinase C beta II (PKCβII) activation promotes polymorphonuclear (PMN) superoxide (SO) production by phosphorylating serine and threonine amino acid residues on NADPH oxidase (NOX-2). Previous studies have shown that cell-permeable myristic acid-conjugated PKCβII inhibitor (myr-PKCβII-; SLNPEWNET) (20 µM) attenuated phorbol 12-myristate 13-acetate (PMA)-induced PMN SO release when compared to scrambled peptides (myr-Tat-PKCβII- scram; WNPESLNTE), unconjugated peptides and nontreated controls by ~35%. This suggests an enhanced intracellular delivery of PKCβII-. Studies have also shown that SO release is attenuated via the trans-activator of transcription-conjugated (Tat; YGRKKRRQRRR) NOX-2 inhibitor (Nox2ds-Tat) (80 µM) by ~37%. There have not been evaluations of …

Informed Consent In Shoulder And Elbow Surgery, Puru Sadh, Antonio J. Almeda-Lopez, Benjamin Hershfeld, Dan Monessa, Brandon Klein, Randy M. Cohn, Adam D. Bitterman

Research Day

Introduction:

Informed consent, a dynamic process, involves explaining procedure details to patients. Crucial for preserving autonomy, it requires comprehensive discussions, emphasizing necessity for documentation. Laws ensure awareness, but legal standards lack protection against paternalistic bias, posing legal risks. In orthopaedics, inadequacies in informed consent training contribute to litigation.

Methods:

A comprehensive literature review was conducted using the PubMed database to explore the landscape of informed consent practices in the context of shoulder and elbow surgery. The search strategy utilized a combination of Medical Subject Headings (MeSH) terms and free-text keywords, including "informed consent," "shoulder surgery," "elbow surgery," and "patient communication." …

Analysis Of Oite By Subsection From 2017 - 2022 With Comparison To Abos Part 1 Certifying Examination, Nicholas Abate, Mark Lagreca, Brandon Klein, Luke Bartlett, Randy Cohn

Research Day

Introduction:

In light of recent efforts of the American Academy of Orthopaedic Surgeons (AAOS) and the American Board of Orthopaedic Surgeons (ABOS) to align the Orthopaedic In-Training Examination (OITE) with the Part I Certifying Exam, this study assessed each section of recent OITEs and compared content between the OITE exams and the ABOS part 1 exam outline.

Methods:

A cross-sectional review was performed using questions from 2017 – 2022 OITE exams. Question domains, subtopics, journal references, publication lag time, imaging modalities, and question taxonomy were reviewed for each exam section. The AAOS ResStudy online module was used to extract question …

Research For The Whole Person: 13 Years Of Research Day At Pcom, Jackie K. Werner

Research Day

In 2011, Philadelphia College of Osteopathic Medicine’s Center for Chronic Diseases of Aging and Sigma Xi chapter jointly sponsored PCOM’s first annual Research Day. In honor of PCOM’s 125th anniversary, this poster takes a look at how Research Day has grown over the years and how the research shared has impacted many communities.

Non-St Elevation Myocardial Infarction Presentation In Severe Aortic Stenotic Patient, Margi Desai, Daniel Maysonet

The Journal of Integrated Primary Care

This case report demonstrates a patient who presents with typical findings for a diagnosis of NSTEMI. Upon further evaluation, this diagnosis was able to be ruled out. Presentations and labs consistent with NSTEMI masked the true diagnosis of aortic stenosis due to oxygen supply/demand mismatch.

The Attitudes, Level Of Interest, And Knowledge Held By Physicians And Psychologists Toward Integrated Healthcare Practices And The Patient-Centered Medical Home Model, Mark Cassano, Robert A. Ditomasso, Barbara Golden, Scott D. Glassman

The Journal of Integrated Primary Care

As the healthcare system evolves, issues related to cost and access to care continue to persist. In response to this concern, integrated models of healthcare, like the Patient-Centered Medical Home (PCMH), have been developed to work toward reducing cost for both patients and providers, increasing patient access to quality care, and improving patients’ overall satisfaction with the care that they are provided. However, despite the overwhelming evidence found in the literature supporting the efficacy and benefit of these treatment models, it is unclear as to why more providers do not choose to practice and support collaborative forms of healthcare provision. …

Biopsychosocial Management Of Long Covid Fibromyalgia: Lessons From The Penn Medicine Lancaster General Health Fibromyalgia Program, Joseph Harrison, Dennis Given Psy.D.

The Journal of Integrated Primary Care

The COVID-19 pandemic has increased the prevalence of chronic health concerns worldwide, leading to a new population of patients suffering from Long Covid. Patients with Long Covid often experience persistent symptoms impacting multiple organ systems, including neuroimmune and neurological manifestations. Recently, attention has grown toward Long Covid patients developing chronic widespread pain similar to fibromyalgia. Fibromyalgia is a nociplastic pain disorder characterized by widespread pain and central sensitization with fatigue, sleep disturbances, and impairments in cognitive functioning. Given the nascent and limited research exploring new treatment options, patients need support now from biopsychosocial multi-modal pain management strategies. The Fibromyalgia Program …

An Exploration Of Self-Reported Training Needs For Anxiety Interventions Among Primary Care Behavioral Health Consultants, Katherine Buckheit, Ryan Willard, Kyle Possemato, Robyn Shepardson, Abigail Lashinsky, Jen Funderburk

The Journal of Integrated Primary Care

Introduction: Despite the need for greater training in evidence-based interventions for the treatment of anxiety in primary care behavioral health (PCBH), there are limited data on which interventions are desired by behavioral healthcare consultants (BHCs). The objective of this study was to identify which interventions BHCs desired more training in when treating anxiety in PCBH practice, and to examine if this preference was associated with theoretical orientation. Method: We conducted an online survey of PCBH providers regarding their training preferences for treatment of anxiety symptoms. The final sample comprised 291 BHCs recruited from e-mail listservs of national professional organizations. Providers …