Digital Commons Network^™

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 …

The Ramifications Of German Ostpolitik: How Germany’S Foreign Policy Influenced The Russia-Ukraine Conflict, John Aton

Senior Theses

German Ostpolitik, established during the Cold War, was the main foreign policy of Germany emphasizing international cooperation and diplomatic engagement with Russia. As the Russia-Ukraine conflict remains active, the challenges of this particular foreign policy’s adoption are evident within certain actions and decisions Germany made in the pursuit of mutual cooperation with Russia. By conducting a thorough analysis of the historical events in German Ostpolitik’s formation and its security policy, while assessing Germany’s leap for economic interdependence alongside Russia, this paper reveals a troubling dynamic where certain actions taken under the doctrine of German Ostpolitik influenced Germany to misjudge and …

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

A Preliminary Study On Composing For Reed Quintet, John O. Ford

Recital Papers

This paper is for the composer that aspires to write for the reed quintet ensemble. It discusses the ensemble’s short history and explains analyses of different reed quintet works to identify roles, pairings, and combinations of the five instruments and their timbral and textural capabilities.

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 …

Unfixed Bodies, Soph Shufelt

Theses

This thesis emerges from that tension between protest and living.  It considers what it means to have one’s existence continually framed as resistance, and how that condition reshapes embodiment, temporality, and identity.  By situating my lived experience within broader social and political structures, I examine how bodily autonomy functions not only as a personal necessity, but as a regulated site of power.  The work that follows investigates how queer and transgender bodies navigate visibility and risk, how time is warped through prolonged struggle, and how survival becomes a form of authorship.

Living Archaeology: A Comparative Perspective On How Archaeologists Can Study And Document The Present, Alia S. Moran

Honors Capstones

Archaeology has long remained a social science that has tended to exclude sustained consideration of contemporary societies in the analysis of material culture. In recent decades, approaches such as ethnoarchaeology and the archaeology of the contemporary have expanded the field to include the study of present-day societies through material culture. Inspired by my involvement in the Thais in Illinois Project, which focused on documenting the Thai American immigrant experience in the greater Chicago area to produce an oral history collection, alongside other goals, this thesis intends to further explore how archaeological practice can be used to understand everyday issues in …

The Effect Of Climate Change On California’S Agricultural Economy, Anmol Singh

Honors Capstones

This study examines the relationship between climate variability and agricultural production in California, focusing on major specialty crops including almonds, walnuts, pistachios, and grapes. Using annual data from 1993 to 2023, the analysis evaluates how temperature and precipitation influence agricultural output while controlling for differences across crop types. The study employs ordinary least squares regression models using the natural logarithm of crop production as the dependent variable. In addition to a baseline linear specification, an extended nonlinear model including squared temperature and precipitation terms is estimated to test for potential nonlinear climate effects.

The results indicate that temperature has a …

The Effects Of Misinformation And Source Credibility On False Recall In College Students, Ashlee Smolenski

Honors Capstones

Eyewitness testimony if often treated as strong evidence in legal systems, yet psychological research consistently shows that memory is not a perfect recording of events. Instead, memory is reconstructive and vulnerable to distortion. The present study examined whether exposure to misleading post-event information and differences in perceived source credibility would influence false recall in college students. Using a 2 x 2 factorial design, participants watched a brief video of a car accident and later received either misleading or neutral questions presented by a high credibility (police officer) or low credibility (elderly man) source. It was predicted that misinformation would decrease …

Spartan Daily, May 6, 2026, San Jose State University, School Of Journalism And Mass Communications

Spartan Daily, 2026

Volume 166, Issue 42