Digital Commons Network^™

Nonurgent Use Of The Emergency Department For Medication Refills, Bobak M. Ossareh, James Paxton

Medical Student Research Symposium

No abstract provided.

Effects Of Marijuana Use In Patients Undergoing Abdominal Free Flap Breast Reconstruction, Tala Al-Saghir, Kinan Sawar, Alexander Vraa, Dunya Atisha

Medical Student Research Symposium

PURPOSE: Marijuana use is associated with incidence of vascular inflammation and clotting, resulting in endothelial damage and arteritis. As marijuana use rises, few studies have evaluated its impact on surgical outcomes, wound healing, and vascular anastomoses in free flap breast reconstruction.

METHODS: A retrospective cohort study of patients undergoing abdominal free flap breast reconstruction between 2016 and 2022 at a large metropolitan healthcare system was performed. Patient demographics, comorbidities, procedural details, and complications were analyzed. Minor complications were defined as skin necrosis, any wound requiring management in the clinic, hematoma, seroma, or fat necrosis that did not require intervention. Major …

Racial Disparities In The Future Development Of Lethal Prostate Cancer Based On Psa Levels In Midlife, Matthew Davis, Alexander Stephens, Chase Morrison, Sami Majdalany, Rafe Affas, Sohrab Arora, Nicholas Corsi, Ivan Rakic, Akshay Sood, Craig C. Rogers, Firas Abdollah

Medical Student Research Symposium

Objective

This study examined racial disparities in PCa mortality based on midlife PSA results in a North American population.

Methods

White and Black men aged 40-59 years, with their first PSA test (baseline) between 1995 and 2019 were included. Patients were divided into 4 age categories; 40 to 44, 45 to 49, 50 to 54, and 55 to 59. Baseline PSA was categorized based on median and 90th percentile for each age category. Fine-Gray regression was used to examine the impact of baseline PSA on the risk of developing prostate cancer-specific mortality (PCSM) by race.

Results

A total of 112,967 …

Top 100 Urology Influences On Twitter: Is Social Media Influence Associated With Academic Impact?, Nicholas Corsi, David-Dan Nguyen, Mohit Butaney, Sami Majdalany, Matthew Corsi, Taylor Malchow, Austin Piontkowski, Quoc-Dien Trinh, Stacy Loeb, Firas Abdollah

Medical Student Research Symposium

Introduction: The purpose of this cross-sectional study is to identify and describe the top 100 urology influencers on the social media platform Twitter. Furthermore, we aim to correlate each individual's Twitter influence with academic impact in urology.

Materials and Methods: Twitter influence scores for the topic search “urology” were collected in April 2022 using the Right Relevance software, which accounts for the individual's connections (followers/following) to other influencers in urology as well as engagement (likes, retweets, and views) on the platform. The top 100 personal accounts with the highest computed scores were linked to individuals’ names, all-time h …

Tendonitis And Tendon Rupture In Low-Profile Dorsal Versus Volar Plating For Distal Radius Fractures: A Systematic Review And Meta-Analysis, Matthew Myhand, Dr. Charles S. Day, Hardy Evans Md, Noopur Ranganathan, Shreya Balusu

Medical Student Research Symposium

INTRODUCTION: Dorsal plating of distal radius fractures has been associated with high rates of hardware removal, tendonitis, and tendon rupture. Much of this research was performed using 2.5mm thick distal radius plating, whereas modern dorsal plates are thinner (1.2mm-1.5mm). We examine whether modern plates have higher rates of complications than volar plates.

METHODS: We search Ovid MEDLINE, Web of Science, and EMBASE for literature describing tendon complications associated with plating of distal radius fractures. Inclusion criteria included any comparison between volar and dorsal plating and report of tendon complication. Exclusion criteria included: failure to specify low-profile dorsal plates; lack of …

Covid-19 Vaccine Hesitancy Among Arab Americans, Jamil Jomaa, Rouba Ali-Fehmi

Medical Student Research Symposium

(1) Background: Coronavirus disease-2019 (COVID-19) vaccines have a significant impact on reducing morbidity and mortality from infection. However, vaccine hesitancy remains an obstacle in combating the pandemic. The Arab American (AA) population is understudied; thus, we aimed to explore COVID-19 attitudes within this community. (2) Methods: This was a cross-sectional study. An anonymous online survey was distributed to members of different AA associations and to the community through the snowball method. (3) Results: A total of 1746 participants completed the survey. A total of 92% of respondents reported having received at least one dose of a COVID-19 vaccine. A total …

Topical Anesthetic Gel Interferes With Antibacterial Efficacy Of Povidone-Iodine Both In Vitro And In Vivo, Cecilly Kelleher Bs, Jacob Im Md, Linda Kang Bs, Aleksey Mishulin Md, Sukhvinder Singh Phd, Ashok Kumar Phd

Medical Student Research Symposium

Purpose: To evaluate the effects of viscous lidocaine gel on the antimicrobial efficacy of povidone-iodine (PI) and their order of application in both in vitro and in vivo models.

Methods: In vitro antibacterial effects were tested against Staphylococcus aureus (S. aureus) with disc diffusion methods for application of lidocaine alone, PI alone, PI before lidocaine, and lidocaine before PI. Zones of inhibition were measured after incubation at 37°C overnight. Mouse eyes were colonized with S. aureus for in vivo study to which PI and/or lidocaine were applied in various combinations. Eyes were then rinsed with saline, and …

The Impact Of Caregiver And Community Education On Influenza Vaccination Acceptance, Austin Mueller, Sandra Bronni Md, Jenny Lachance, Ruba Allabwani Md, Bianca Yaldo Md, Abigail Howell

Medical Student Research Symposium

Introduction: Pediatric populations are particularly vulnerable to influenza, and rely on parental approval of the pediatric influenza vaccine (PIV). We conducted a survey to better understand our community’s perspective on the PIV.

Methods: An urban pediatric clinic’s records were gathered for the 2017-2019 flu seasons (i.e., pre-survey period). Surveys were distributed during the 2019-2020 flu season to assess vaccination status and their reasoning for acceptance or rejection of the PIV for their child(ren). Children vaccination rates were divided into 3 groups: 6 months-3 years, 3-5 years, and 5-18 years.

Results: During the 2017-2018 flu season, the overall vaccination rate (n=1791) …

Impact Of A Health Fair On Student Organizations Providing Care To The Detroit Hispanic/Latinx Community And Barriers Affecting Patients Of A Student-Run Clinic Primarily Serving This Population, Amanda Rodriguez Bs, Lucas Edgren Bs, Sanjana Rao Bsph, Diane L. Levine Md, Jennifer Mendez Phd, Joel Appel Do

Medical Student Research Symposium

Current literature shows Hispanic/Latinx populations in the U.S. face health inequities. Amigos Medicos (AM) Clinic, located in Southwest Detroit, is a student-run free clinic that addresses these issues through preventive health screenings. We hosted a health fair in 2022 and invited other student organizations in efforts to connect the community to resources. Our aim is to identify specific barriers faced by our population in receiving health care and to identify the impact of participation in the fair on those organizations. One survey was administered to patients attending clinic that identified health barriers they face. The other survey was administered to …

Outcomes Of A Modification Of The Brain Injury Guidelines (Big) On Resource Utilization And Its Impact On Outcomes, Jay Getzinger, Alison Karadjoff Do, Alita Pitogo, Samantha Tarras Md Facs

Medical Student Research Symposium

Background:

Brain injury guidelines (BIG) were developed to classify traumatic brain injury (TBI) patients and identify those that did not require ICU admission. Our aim was to implement our modified BIG (mBIG) in hopes of decreasing use of ICU beds for small TBI hemorrhages without compromising outcomes.

Methods:

Our mBIG protocol was implemented in January 2021 at Detroit Receiving Hospital with patients classified per the Table. Concurrent and retrospective data collected included demographics, ICU admission, outcomes, head CT scans and need for neurosurgical intervention. One-way ANOVA and chi-squared analysis were used with a p-value of ≤0.05 being significant.

Results:

125 …

The Effect Of A Magnetic Resonance Imaging Sedation Protocol On Increasing Sedation Related Adverse Event Reporting Frequency And Anesthesia Utilization In The Henry Ford Health System, Bohdan Matsko, Mousab Eteer Md, Khalid Eteer Md, Muhammad Ibrahim Md

Medical Student Research Symposium

INTRODUCTION: Procedural sedation is intended to help patients minimize body movement and successfully complete an MRI scan. Although MRI sedation is becoming increasingly more common, it is associated with complications. There has been anecdotal evidence of MRI sedation adverse events occurring at relatively high frequency at HFHS in the past, although such events often went unreported. The study aim is to address this rising concern by instituting a protocol system that also intends to increase the reporting of MRI sedation adverse events.

METHODS: This Quality improvement (QI) project is established based on the Lean Six Sigma process improvement methodology. The …

Development And Validation Of A Novel Decision Aid For Walant Hand Surgeries: Investigating Patient Preferences, Majd Faraj Bs, Alex Lindahl Bs, Shreya Balusu Bs, Rachel Feldstein Ba, Charles S. Day Md, Mba, Elizabeth King Md, Andrew Baron Md

Medical Student Research Symposium

INTRODUCTION: This study aims to develop a novel decision aid packet (DAP) for hand surgery patients deciding between Wide-Awake-Local-Anesthesia-No-Tourniquet (WALANT) and traditional anesthesia.

METHODS:

Development:

The DAP was developed following International Patient Decision Aid Standards.

Validation:

Alpha Testing

Seven hand surgeons experienced in WALANT and traditional surgeries belonging to the WALANT Research Consortium in the U.S. commented on the DAP through three rounds of editing utilizing the Delphi method. Seven patient advocates provided readability feedback.

Beta Testing

Orthopedic hand surgery patients were assigned to the control or experimental group. The experimental group was given the DAP pre-surgery. Both groups completed …

Understanding Asthma Care And Management Challenges In Pediatric Patients, Alexander Wind, Priya Spencer, Amy Delaroche

Medical Student Research Symposium

Background:

Asthma is a common pediatric health condition with highly variable manifestations. It may require daily management with medications and lifestyle adjustments throughout childhood. Due to the varied severity of the disease, effective management of asthma can place undue demands and challenges on asthmatic children and their families.

Objective:

To understand the challenges families face in managing their child’s asthma.

Methods:

Currently ongoing since November 18, 2021, this study enrolls 5-11 years old presenting with an acute asthma exacerbation to the emergency room of a tertiary care children’s hospital. We use structured questionnaires to collect information on …

Assessment Of The Nanodropper Eye Drop Adaptor For Glaucoma Medications, Nicholas Pryde, Parker J. Williams, Faisal Ridha Al-Timimi, John Michael Guest

Medical Student Research Symposium

Assessment of the Nanodropper Eye Drop Adaptor for Glaucoma Medications

Nicholas Pryde, BS¹; Parker J. Williams, DO ¹; John-Michael Guest, MD¹; Bret A. Hughes, MD¹; Faisal Ridha MD¹

¹Kresge Eye Institute and Wayne State University Department of Ophthalmology, Detroit, MI, USA

Purpose: To determine the dispensed volume change for seven medications with and without the Nanodropper adaptor.

Methods: Sequentially, 100 µL of each medication was dispensed by micropipette into a 1.5 mL Eppendorf tube, and mass without the tube was determined with a precision balance (Practum, Germany). The mean mass was …

Gender Disparities In The Diagnosis Of Sleep Disordered Breathing, Kenna Haile, Nesrine Ibrahim, Safwan Badr, Apala Vaishnav

Medical Student Research Symposium

Introduction: Current diagnostic guidelines for sleep disordered breathing (SDB) require that apneas and hypopneas be accompanied by a 4% desaturation for it to constitute a respiratory event (AHI-Accepted). However, the American Academy of Sleep Medicine recommends expanding the diagnostic criteria to include apneas and hypopneas accompanied by a 3% desaturation or a cortical arousal for diagnosis (AHI-Recommended). We hypothesized that a clinical sample of both men and women would demonstrate that women are more likely to be misdiagnosed using the accepted criteria compared to the recommended criteria.

Methods: The clinical sample consisted of all patients receiving a PSG at the …

Residential Racial Segregation And Neighborhood Adversity: Associations With Hemoglobin A1c In Adolescents With Type 1 Diabetes, Zechariah Jean, April Carcone, Deborah Ellis

Medical Student Research Symposium

Black adolescents with Type 1 Diabetes (T1D) are at increased risk for disparities in health outcomes. More research is necessary on the effects of neighborhood characteristics such as residential racial segregation (RRS) and neighborhood adversity on health.

149 Black youth with T1D were recruited from seven pediatric diabetes clinics in Detroit and Chicago to participate in a clinical trial to improve diabetes management. RRS was calculated at the census block group level based on US census data using Location Quotients. LQs represented the ratio of patients to total population in the block group compared to the same ratio in the …

High Output Heart Failure, A Lethal And Forgotten Cause Of Heart Failure, Neiberg A. Lima Md, Ian Detroyer Bs, Saman Razzaq Md, Oluwale Adegbala Md, Preeti Ramappa Md

Medical Student Research Symposium

Introduction

Cardiac output (CO) is usually low or normal in patients with heart failure. However, some patients have a high CO deemed high-output heart failure (HOHF). HOHF is not well characterized and continues to be under-recognized clinically. At the Detroit VA, we conducted a quality improvement project to define the characteristics of this unique patient population, identify predictors and increase awareness of this entity.

Methods

Patients with HOHF were compared to patients with heart failure with preserved ejection fraction (HFpEF) and normal CO. HOHF was defined as CO >8 L/minute on right heart catheterization performed between 2008-2021. Retrospective data regarding …

Dueling Active Surveillance: Does Utilization Of Active Surveillance For Low Risk Prostate Cancer Correspond With Utilization Of Active Surveillance For Small Renal Masses?, Sophie Wittenberg, Kevin Ginsburg Md, Michael Wang Md

Medical Student Research Symposium

Background: Active surveillance (AS) is the recommended management strategy for low-risk prostate cancer (LR CaP) and has also been shown to be safe for management of small renal masses <4cm (SRM). We assessed surgeon-level practice patterns for the use of AS in two different genitourinary malignancies: LR CaP and SRM.

Methods: We retrospectively reviewed the Michigan Urological Surgery Improvement Collaborative’s (MUSIC) prospectively maintained prostate and kidney registries to identify surgeons that managed at least 10 patients with SRMs and 10 patients with LR CaP from 2017-2021. The outcome was to assess for an association between AS for LR CaP with AS for SRMs among MUSIC surgeons.

Results: 27 urologists met inclusion criteria. 82% of men with LR CaP …

Signaling The Signaler: What Do Radiology Directors Advise Radiology Applicants About The Supplemental Application?, Harika K. Bollineni, Nathan Sim, Unie Háng, Ahmed Ayantayo, Arif Musa Md, Ali Harb Md

Medical Student Research Symposium

No abstract provided.

Glutamate, And Its Relationship To Task-Induced Functional Connectivity In The Human Brain: A Focus On Schizophrenia, Kathleen Liu Young, John Kopchick, Jeffrey Stanley, Vaibhav Diwadkar

Medical Student Research Symposium

Glutamate is the brain’s major excitatory neurotransmitter mediating both neuroplasticity and network function (Zhou & Danbolt, 2014). Basal glutamate (Glu) measured using proton magnetic resonance spectroscopy (1H-MRS) provides insight into a region’s density of neuropil related to the glutamatergic system. Moreover, given the role of glutamate in mediating brain network function, Glu levels may play a role in the brain’s functional connectivity (FC), which is typically estimated from functional magnetic resonance imaging (fMRI) time series data. These questions converge when considering the clinical syndrome of schizophrenia (SCZ). Patients with SCZ show abnormalities in basal Glu in the hippocampus and prefrontal …

Preoperative Promis Depression Scores Can Predict Failure To Improve After Trapeziectomy And Lrti, Shreya Balusu, Hardy Evans Md, Eric Jiang Md, Matthew Myhand, Noopur Ranganathan, Charles Day Md

Medical Student Research Symposium

INTRODUCTION: Patient-Reported Outcomes Measurement Information System (PROMIS) scores have been utilized in setting realistic post-intervention expectations. Having a model to stratify likelihood of improvement based on pre-operative variables may allow for better decision making and patient counseling. We hypothesized that preoperative PROMIS scores correlate with patients’ subjective level of improvement after trapeziectomy and ligament reconstruction with tendon interposition (LRTI)

METHODS: Retrospective chart review was performed to identify patients who underwent trapeziectomy and LRTI. Demographic data along with preoperative PROMIS Upper Extremity (UE), Pain Interference (PI), Depression (DP), and QuickDASH (QD) scores were collected. At their follow-up appointment, patients were asked …

The Effects Of Different Antihypertensives, Steroids, And Beta Blockers On Covid-19 Outcomes In A Ckd And Non-Ckd Cohort In Detroit, Michigan, Vidhya Nadarajan, Maham Ahmed, Katerina Furman, Zoya Gurm, Priyanka Kale, Zaina Khoury, Paul Kim, Sara Koussa, Dana Labuda, Margo Mekjian, Pooja Polamarasetti, Charlotte Thill, Sophie Wittenberg, Sorabh Dhar, Dragana Komnenov

Medical Student Research Symposium

Initial studies during the COVID-19 pandemic reported angiotensin converting enzyme 2 inhibitors (ACE2i) could be associated with worse disease course due to potential increase in ACE2 receptors which SARS-CoV2 virus uses for cellular entry. Subsequent studies refuted such concerns, reporting that continued use of ACEis and angiotensin receptor blockers (ARBs) in hypertensive individuals is protective. However, there remains a paucity of data evaluating effects of various antihypertensive medications, steroids, and beta blockers in chronic kidney disease (CKD) populations and in individuals with normal kidney function. This study was designed to evaluate the potential risks associated with antihypertensive medications and COVID-19 …

Preoperative Promis Depression Scores Can Predict Failure To Improve After Trapeziectomy And Lrti, Shreya Balusu, Hardy Evans Md, Eric Jiang Md, Matthew Myhand, Noopur Ranganathan, Charles Day Md

Medical Student Research Symposium

Introduction

Patient-Reported Outcomes Measurement Information System (PROMIS) scores have been utilized in setting realistic post-intervention expectations. Predicting likelihood of improvement based on pre-operative variables may allow for better decision-making and patient counseling. We hypothesized that preoperative PROMIS scores correlate with patients’ subjective level of improvement after trapeziectomy and ligament reconstruction with tendon interposition (LRTI)

Methods

Retrospective chart review was performed to identify patients who underwent trapeziectomy and LRTI. Preoperative PROMIS Upper Extremity (UE), Pain Interference (PI), Depression (DP), and QuickDASH (QD) scores were collected. At follow-up appointments, patients were asked an anchor question: “Since your treatment, how would you rate …

High Variability Exists In Reporting Clinical And Patient-Reported Outcome Measures Following Meniscal Surgery, Leah Shephard, Varag Abed, Michael Nichols, Andrew Kennedy, Camille Khalily, Caitlin Conley, Cale Jacobs, Austin V. Stone

Medical Student Research Symposium

Purpose: To evaluate the variability in outcomes following surgical meniscal repair and compare responsiveness between patient reported outcome measures (PROMs).

Methods: A systematic search of the PubMed/MEDLINE and Web of Science databases was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. A total of 257 unique studies met inclusion criteria. Patient and study attributes were extracted, including pre- and postoperative means for PROMs. Of the studies that met inclusion criteria for responsiveness analysis (2+ PROMs reported, 1-year minimum follow-up; n=172), we compared the responsiveness between PROM instruments using effect size and relative efficiency (RE) if …

Assessing Accessibility And Equity Of Autism Spectrum Disorder Screening Tools, Kiernan S. Bloye, Joseph Aderemi Md, Roman Grossi, Tessa Hampton, Melissa Maye Phd

Medical Student Research Symposium

Introduction: Disparities to accessing autism spectrum disorder (ASD) screening tools have been demonstrated across race, ethnicity, socioeconomic status, and language. Additionally, there are concerns that existing screening tools are not as accurate for minoritized individuals. Thus, it is likely that level 1 screening tools must be adapted and developed for, and with, marginalized populations in the United States to promote increased levels of universal screening access and accuracy among minoritized populations.

Methods: Using the PRISMA scoping review checklist, an initial search produced 1880 unique records. Following title and abstract review, 35 articles met criteria for full manuscript review. Finally, 7 …

Assessing Peer Mentor Skill Development In Participating In A Novel Medical Student Mentoring Initiative, Chelsea Yu, Dhruvil Patel, Jack Considine, Madison Graifman, Kyla Kosidowski, Megan Seyerle, Elise Turke, Kathleen Young, Sahar Elmenini, Nicole White, Latoya Sherman, Eric Ayers Md

Medical Student Research Symposium

Background
Learning communities in medical schools create a bridge for senior students to engage with junior peers, providing advice and support as mentors. In this process, mentors are likely to gain skills in communication, empathy, and leadership - well received traits for residency.

Methods
We aim to elucidate an objective measure of mentor growth and development during the mentorship program. We will evaluate opinions on the program's ability to foster professional attributes including leadership, communication, and empathy; determining features that benefit them while assessing for paradigms of improvement. We will survey 24 M2-students through self-rated queries on a Likert scale. …

Determining Access Of In-Person Vs Virtual Clinic Visits In Orthopedic Medicine, Mithil Gudi, Nevil Khurana, Nicholas Livingston, Ahmad Chouman, Jack T. Mcconnell, Charles S. Day Md, Mba

Medical Student Research Symposium

INTRODUCTION: Virtual visits in orthopedics provide added benefits compared to in-person visits. We hypothesize that virtual visits will offer patients greater same-day and future access to orthopedic physicians.

METHODS: Two previously established methodologies were used to measure orthopedic surgeons: same-day and third-next-available. Same-day access is analyzed using a ratio of unfilled to filled virtual return and in-person return appointments for every clinic day of each physician. Third-next-available is measured as the number of total non-clinic days and clinic days until each physician’s third next-available-virtual and in-person appointments.

RESULTS: For same-day access, the ratio of unfilled virtual to filled virtual appointments …

Outcomes Of Dupilumab Treatment In Patients Presenting With Severe Asthma Or Chronic Rhinosinusitis With Nasal Polyps, Over The Age Of 65, Keisha Arielle Best, Samiat Awosanya, Chandala Chitguppi, Marc Rosen, Mindy Rabinowitz, Elina Toskala, Gurston Nyquist, Jessica Most

Medical Student Research Symposium

Introduction:

Dupilumab is an IL-4/13 inhibitor that has been successfully implemented in the treatment of severe asthma and chronic rhinosinusitis with nasal polyps (CRSwNP). The safety and efficacy of Dupilumab has not been reported for these indications in patients over the age of 65. This study aims to determine the long-term benefits of dupilumab while detailing adverse effects.

Methods:

This study is a single institution retrospective review of patients receiving dupilumab for severe asthma and/or CRSwNP from 2018 to present. Charts were reviewed for patient demographics, Sino-nasal Outcome Test (SNOT-22) scores, asthma control test (ACT) scores, polyp scores, and adverse …

Intravital Imaging Of Cellular Response Due To Traumatic Brain Injury Using Confocal Microscopy, Enoch G. Kim, Jeffrey Horbatiuk, Carolyn Harris

Medical Student Research Symposium

Introduction: Cellular reaction to traumatic brain injury is complex and involves considerable interactions between cells and reactivity to foreign bodies. Our objective was to assess neurons, microglia, astrocytes, and intracellular Ca²⁺ signaling by creating a novel confocal microscopy technique involving an air immersed lens that does not sacrifice resolution and limits signal attenuation. This study aimed to create a consistent dynamic methodology to observe the cortical cellular response using real-time intravital imaging as trauma is being induced.

Methods: Once surgical plane was achieved, rodent cortices were exposed via craniotomy and blunt insertion with a silicone shunt catheter into the …

Gender And Financial Implications Of Parental Leave Utilization At A Major Us Academic Institution, Maurgan Lee, Lucki Word, Mayra Shafique, Julie Crego, Leah Robinson Phd, Anil Aranha Phd, Beena Sood

Medical Student Research Symposium

Background and Purpose: In the United States, women on average are paid $0.83 for every dollar earned by male counterparts. Creating a family can promote heightened obligations for both parents, however, women tend to take on amplified responsibility associated with childrearing. Studies show females are more likely to utilize parental leave (PL) compared to men. Our study aims to evaluate the impact of PL usage on financial and earning potential based on gender.

Methods: Analysis of retrospective human resources data of WSU employees was conducted. Data parameters included: demographics, length, usage, and number of parental leaves. Data was analyzed using …