Digital Commons Network^™

Pharmacologic Pain Management During Intrauterine Device Insertion, Taylor M. Long

The PA Department Journal of Medical Science

Introduction: Intrauterine devices provide long-acting reversible contraception for women wanting to prevent pregnancy, but pain during insertion is a major concern for many patients. This clinical review compared nonsteroidal anti-inflammatory drugs and local anesthetic options for pain control during and shortly following IUD insertion.

Methods: PubMed was searched using terms “intrauterine device insertion”, “nonsteroidal anti-inflammatory drugs”, “lidocaine”, “local anesthetics”, “pain”, and “analgesia”. The search returned 135 articles. After filters were applied, eleven articles remained, and five articles met the inclusion criteria and were selected for the clinical review.

Results: The review included four randomized controlled trials and one network meta-analysis. …

Efficacy Of Sglt2 Inhibitors In The Management Of Polycystic Ovarian Syndrome, Paige N. Curtis-Campbell

The PA Department Journal of Medical Science

Introduction: Polycystic ovarian syndrome (PCOS), recently proposed to be termed polyendocrine metabolic syndrome (PMOS), is a complex multifactorial disorder commonly associated with obesity, hyperandrogenism, infertility, and insulin resistance. First-line treatments for metabolic characteristics include lifestyle modifications and metformin; however, metabolic abnormalities may persist. Sodium-glucose cotransporter-2 (SGLT2) inhibitors represent a potential therapeutic agent due to their effects on insulin resistance, glucose metabolism, and body weight.

Methods: A literature search of PubMed identified studies examining SGLT2 inhibitors in women with PCOS compared to metformin, standard therapies, or placebo. The search was restricted to randomized controlled trials (RCTs), systematic reviews, and meta-analyses available …

Effect Of Intramedullary Nailing Vs Plate Fixation On Bone Union Time In Distal Tibial Fractures, Madeline Wasmund

The PA Department Journal of Medical Science

Distal tibia fractures are complex fractures due to the intricate anatomy and minimal soft-tissue protection. There are currently two techniques that are mainstays for repairing a distal tibia fracture: intramedullary nailing and plate fixation. This study explores the bone union time between these two different techniques. PubMed was searched with a specific search strategy using the terms “intramedullary rod”, “plate/screw fixation”, “tibial fractures”, and “time to bone union.” Filters were applied to find articles that were most relevant, which resulted in 4 articles, each of which was appraised. Three articles were systematic reviews/meta-analyses comparing intramedullary nail fixation and plate fixation …

Catheter Directed Thrombolysis Vs Anticoagulant Therapy For The Management Of Pulmonary Embolisms, Kelsey A. Strawser

The PA Department Journal of Medical Science

A pulmonary embolism is a blood clot that develops within a blood vessel and travels to the lungs, leading to a blockage of blood flow where it can cause life threatening complications.¹ Currently, there is not one standard treatment for pulmonary embolisms. Treatment depends on the size and location of the emboli, as well as the risk it has to the patients’ health.⁹ While systemic anticoagulation is one of the most common treatment methods for pulmonary embolisms, catheter directed thrombolysis rapidly dissolves the clot, which can lead to quicker symptom relief and decreased strain on the heart.^{11 …}

Vitamin D And The Expression Of Systemic Lupus Erythematosus (Sle), Sonephet S. Phoumsavath

The PA Department Journal of Medical Science

Introduction: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that disproportionately affects women and minority populations, carrying significant morbidity. The purpose of this literature review is to analyze the effectiveness of vitamin D supplementation in reducing disease activity in SLE patients, compared with none.

Methods: PubMed was searched using a specific strategy with key terms including "vitamin D," "systemic lupus erythematosus," and "disease activity." Boolean operators and filters included a five-year publication limit and restriction to randomized controlled trials (RCTs), systematic reviews, and meta-analyses. This narrowed the results to five quality articles for review.

Results: Two meta-analyses and …

The Role Of Probiotics As Adjunctive Therapy In The Treatment Of Depressive Disorders, Maritza Lopez

The PA Department Journal of Medical Science

Major depressive disorder (MDD) is a common psychiatric disorder that remains difficult to treat for many patients despite available therapies. The purpose of this clinical review was to evaluate the effectiveness of adjunctive probiotic supplementation for adults with major depressive disorder. PubMed was searched using key terms including major depressive disorder, probiotics, Lactobacillus, Bifidobacterium, and gut-brain axis. Search filters and eligibility criteria narrowed the results to six relevant articles for review, including one randomized clinical trial, four systematic reviews, and one clinical practice guideline. Overall, the included studies generally reported reductions in depressive symptom severity and favorable safety …

Clomiphene Vs Letrozole For Fertility In Women With Pcos., Lauren Weissenberger

The PA Department Journal of Medical Science

Introduction: Polycystic ovary syndrome (PCOS) is a condition associated with ovulatory dysfunction and infertility in women. The purpose of this review is to analyze the efficacy of clomiphene versus letrozole in ovulation induction, pregnancy rate, and live birth rate in women with PCOS.

Methods: PubMed was searched strategically using key terms “polycystic ovary syndrome”, “clomiphene”, and “letrozole”. The following filters were applied: randomized controlled trials, systematic reviews, meta-analyses, free full text, English language, and publication dates restricted to the last five years. Results narrowed down to three relevant, quality articles for review.

Results: One article was an RCT comparing clomiphene …

Orthosis Versus Surgical Repair Outcomes Of Developmental Dysplasia Of The Hip In Children, Avery G. Hays

The PA Department Journal of Medical Science

Introduction:

            Developmental dysplasia of the hip (DDH) is one of the most common orthopedic malformations in children. Late detection of DDH can lead to more invasive treatment, higher risk of treatment related complications, and long-term sequelae like early onset osteoarthritis. The purpose of this clinical review is to analyze current treatments for DDH and provide a rationale for individualized treatment decisions and future implications.

Methods:

            A PubMed search was preformed using a specific strategy with key terms “developmental dysplasia of the hip,” “orthosis,” “surgical reduction,” and “complications.” Boolean operators and filters were used to narrow the results to 6 relevant, …

Hydroxyurea Versus Chronic Blood Transfusion Therapy For Reducing Vaso-Occlusive Crises In Children With Sickle Cell Disease: A Review Of Current Evidence, Stefanie L. Pertiller

The PA Department Journal of Medical Science

Introduction: Sickle cell disease (SCD) is one of the most common inherited hemoglobinopathies worldwide and is associated with significant chronic morbidity and early mortality in children, underscoring the need for effective long-term disease-modifying therapies. The purpose of this review is to evaluate the current evidence comparing hydroxyurea therapy with chronic blood transfusion therapy in children with sickle cell disease, with particular emphasis on their effectiveness in reducing the frequency of vaso-occlusive crises.

Methods: PubMed was searched with a specific search strategy using key terms “children with sickle cell disease”, “chronic blood transfusion therapy”, and “hydroxyurea therapy”. MeSH terms and Boolean …

Rimegepant For Migraine Prevention: A Review Of Current Evidence, Alexi N. Payne

The PA Department Journal of Medical Science

Introduction:

Migraine is a common neurologic disorder that causes substantial disability and negatively affects quality of life worldwide. This literature review evaluates the current evidence regarding the efficacy, safety, and tolerability of rimegepant for the preventive treatment of migraine.

Methods:

PubMed was searched using the key terms migraine, rimegepant, and prevention. After applying predefined eligibility criteria, five studies were included: two randomized controlled trials, one open-label extension study, one post hoc analysis, and one systematic review.

Results:

Overall, the included studies demonstrated that rimegepant significantly reduced monthly migraine days, improved health-related quality of life and patient-reported outcomes, and was generally …

Prevention Of Chronic Migraine With Injection Medications: Onabotulinumtoxina Vs Monoclonal Antibodies, Jillian Jesser

The PA Department Journal of Medical Science

Introduction: Adults diagnosed with chronic migraine (CM) frequently experience severe pain, nausea, vomiting, sensitivity to light or sound, and blurred vision. All of which are not conducive to routine daily functioning. The purpose of this review article is to explore the efficacy of preventative medications for CM such as OnabotulinumtoxinA injections (onabotA) and calcitonin gene-related peptide monoclonal antibodies (CGRP mAbs).

Methods: PubMed was searched using “OnabotulinumtoxinA,” “chronic migraines,” and “monoclonal antibodies”, and related branch terms. The 263 results of this search were reduced to 20 with the following filters: published date 2020-2025, randomized controlled trials (RTCs), systematic review, meta-analysis, free …

Selenium Supplementation For Treatment Of Subclinical Hypothyroidism And Autoimmune Thyroiditis, Lael Smith

The PA Department Journal of Medical Science

Hashimoto's thyroiditis is the most common cause of hypothyroidism in iodine-sufficient regions of the world. It is characterized by autoimmune destruction of the thyroid gland, chronic inflammation, and progressive thyroid dysfunction. Selenium is an essential trace element involved in antioxidant defense of thyroid tissue and has been proposed as an adjunctive therapy. This review evaluates current evidence regarding the effects of selenium supplementation on thyroid function in patients with Hashimoto's thyroiditis and subclinical hypothyroidism. Three peer-reviewed studies, including randomized controlled trials, systematic reviews, and meta-analyses, were evaluated to examine the primary outcome of thyroid function by measurement of thyroid-stimulating hormone …

The Effects Of Low Dose Aspirin And Low Molecular Weight Heparin In Preventing Preeclampsia, Madison A. Deslatte

The PA Department Journal of Medical Science

Introduction: Preeclampsia is a prevalent hypertensive disorder of pregnancy that can lead to increased maternal and neonatal morbidity and mortality. The purpose of this review is to evaluate if low-molecular-weight heparin (LMWH) combined with low-dose aspirin (LDA) is more efficacious in preventing preeclampsia than the standard therapy of LDA alone.

Methods: PubMed was searched with a precise search strategy using key terms “preeclampsia”, “low-dose aspirin”, and “low-molecular-weight heparin”. Filters and operators narrowed the results to 4 relevant and high-quality articles that were used for the review.

Results: Three articles directly compared the use of LDA and LMWH combined to standard …

Restrictive Fluid Resuscitation With Early Vasopressor Initiation Vs Liberal Fluid Resuscitation In Adults With Septic Shock: A Review Of Mortality And Clinical Outcomes, Gabriel Locke

The PA Department Journal of Medical Science

Introduction

Septic shock is a life-threatening medical emergency characterized by profound hypotension, impaired organ perfusion, and significant risk of mortality. While large fluid resuscitation has been considered the commonplace, emerging evidence of increased adverse outcomes has prompted further investigation into restrictive fluid strategies in combination with early vasopressor use.

Methods

PubMed was searched with key terms “septic shock”, “vasopressors”, “norepinephrine”, “restrictive fluid resuscitation”, “liberal fluid resuscitation”, and “mortality”. Operators and filters were implemented such as randomized control trial, systematic reviews, meta-analyses published between 2021 and 2026. After applying these filters. Of the 39 results, 4 articles were selected based on …

Lifestyle Modifications Versus Antihypertensive Therapy: Efficacy In Blood Pressure Control Among Adults With Hypertension, Alexander J. Butler

The PA Department Journal of Medical Science

Hypertension is one of the leading causes of cardiovascular disease and preventable deaths in the United States. Pharmacological treatment remains the standard of care despite challenges such as cost, adherence, and side effects. The purpose of this article is to discover the effectiveness of non-pharmacological treatment in comparison to pharmacological treatment for reducing blood pressure in patients with hypertension. PubMed was searched using key terms such as “HTN,” “antihypertensive,” “antihypertensive agents,” “exercise,” “physical activity,” and “running.” Operators and filters were used to narrow results down to 31 where 4 quality articles were selected for review. Non-pharmacological treatment/lifestyle changes produced reductions …

Treating Adult Adhd: Comparing The Effectiveness And Tolerability Of Stimulant And Non-Stimulant Medications, Sara Dahbour

The PA Department Journal of Medical Science

Introduction: Adult ADHD can impair work, relationships, and quality of life. Stimulants are commonly first-line treatment, but adverse effects, misuse concerns, contraindications, and medication availability can limit use. This review compared stimulant and non-stimulant medications in adults with ADHD for effectiveness and tolerability.

Methods: PubMed was searched using the terms “ADHD,” “stimulant medications,” and “non-stimulant medications.” Filters were applied for English-language, free full-text articles published from 2021 through 2026, including randomized controlled trials, systematic reviews, and meta-analyses. Of 38 filtered results, four articles were selected for relevance to effectiveness, tolerability, adverse effects, and quality of life in adults …

Targeting Downstream Nmda Receptor Pathways In Ischemic Stroke: A Literature Review Of Emerging Adjunctive Therapies, Lauryn P. Pergal

The PA Department Journal of Medical Science

In the United States, an estimated 795,000 people experience a first or recurrent stroke each year.¹ Despite advances in early recognition protocol, reperfusion therapies, and rehabilitation, stroke is still the fourth leading cause of death, after heart disease, cancer, and accidental injury. Ischemic strokes account for around 87% of all strokes.¹ Long-term sequelae of ischemic stroke survivors include disability, dementia, depression, and ongoing fatigue.² As a result, stroke causes decreased quality of life, economic burden, and caregiver stress.

Management strategies for ischemic stroke have evolved considerably over the past several decades. The current acute treatment strategy focuses …

Evaluating Finerenone For Kidney Disease Progression In Patients With Type Two Diabetes And Chronic Kidney Disease, Erin C. Elgas

The PA Department Journal of Medical Science

Introduction: Type two diabetes contributes to chronic kidney disease progression in a multitude of ways within metabolic and hemodynamic factors. Finerenone, a non-steroidal mineralocorticoid receptor antagonist, offers new solutions in slowing or stopping kidney disease progression in type two diabetics. The purpose of this review is to understand if adding finerenone can help slow kidney disease progression in adults with type two diabetes already receiving RAS inhibition.

Methods: A specific PubMed search with keywords including “type two diabetes”, “kidney disease” and “finerenone”, with filters and operators applied, supplied four articles for review.

Results: Finerenone was associated with decreased primary kidney …

A Policy Analysis Of Accountability And Governance In Journalism By Artificial Intelligence (Ai) In Egypt, Amira Ahmed Salama

Theses and Dissertations

The growing use of Generative Artificial Intelligence (GenAI) and AI-assisted tools in journalism raises governance questions concerning accountability, human oversight, transparency, verification, editorial responsibility, and implementation. In Egypt, these issues arise within an emerging but fragmented governance environment that includes national AI guidance, media regulation, professional self-regulation, and developing newsroom practices. This study examines how these arrangements can be integrated into a coherent national sector-specific policy framework for GenAI and AI-assisted journalism.

The study adopts a qualitative methodology combining a descriptive qualitative document analysis with stakeholder semi-structured interviews. Four governance instruments were analyzed: the Council of Europe’s Guidelines on the …

Grievability Of The Abject As Narrated By Exiles, Sylvia Azmy

Theses and Dissertations

This thesis analyzes two novels: Inaam Kachachi’s Sawaqi al-Qulub (2005) and Shady Lewis’s ʿAla Khatt Grinitsh (2019), to understand the relationships between figures of migration, as the exile narrates his encounters with refugees. It uses Julia Kristeva’s Powers of Horror: An Essay on Abjection (1980) and Judith Butler’s Frames of War: When Is Life Grievable? (2009) as theoretical frameworks to examine the deaths of refugees and their corpses (utmost of abjection) in the two novels. Scholars have argued that the literature of forced migration is becoming more inclusive than migration narratives, a term that has focused on student travelers, exilic …

Pathways Of Influence: Indigenous Peoples’ Agency And Leadership In Arctic Governance, Justin Barnes

Theses and Dissertations (Comprehensive)

For the peoples and communities who have lived in the Arctic since time immemorial, Arctic governance is not only about international cooperation, environmental management, or geopolitical competition. It is also about sustaining and advocating for Indigenous livelihoods, relationships with land and water, rights and responsibilities, and opportunities for future generations – all themes directly affected by political decisions made across local, regional, national, and international levels. This dissertation begins from a central question about how Indigenous Peoples exercise their agency and influence in Arctic governance despite operating within an international system largely organized around states. It examines this phenomenon by …

The Bidirectional Effects Of Traumatic Brain Injury And Caudal Fin Amputation On Regeneration In Zebrafish (Danio Rerio), Makenna Wiebe

Theses and Dissertations (Comprehensive)

Traumatic brain injury (TBI) and caudal fin amputation initiate robust regenerative responses in adult zebrafish (Danio rerio), yet whether regenerative activity in one tissue influences repair at a distant site remains unclear. This study investigated the bidirectional effects of concurrent brain and peripheral injury on regeneration and functional recovery. Specifically, we assessed the effects of TBI on caudal fin regeneration, caudal fin amputation on neural stem cell-associated cellular responses, and combined injury on behaviour. Adult zebrafish received no injury, TBI, caudal fin amputation, abdominal puncture, or combined TBI and caudal fin amputation. I assessed caudal fin regeneration morphometrically and evaluated …

The Power Of The Mind: Exploring The Perceived Benefits Of Spiritual Meditation For Children's Loss And Grief, Shefali Bhalla

Theses and Dissertations (Comprehensive)

Grief and loss can significantly affect children’s emotional, cognitive, and social development, yet many existing interventions remain difficult to access due to stigma, cost, and limited cultural fit. Meditation has shown promise as a low-cost and adaptable strategy for supporting emotional regulation, but little is known about how children themselves perceive its usefulness in grief-related contexts. The present study explored children’s beliefs about the usefulness of spiritual meditation as a coping strategy across grief, interpersonal conflict, and positive emotional vignettes. Fourteen children between the ages of 8 and 13 participated in individual Zoom sessions in which they listened to three …

Endogenous Light In The Brain: Investigating Sources, Propagation, And State-Dependent Emission, Emre Cicek

Theses and Dissertations (Comprehensive)

Ultraweak photon emission (UPE), and by extension light, has long been thought to be a modality of communication in nature. Prior studies have already identified that UPE can depend on cell type and can be used to discern between malignant and benign cells. However, besides theoretical models, not much effort has been made to identify possible biological structures that would allow for light to be used as a method of communication in the human body. According to the framework set by Shannon’s Information Theory, for communication to be possible at minimum a transmitter, a transmission channel, and a receiver are …

Time Series Mediation Analysis With Non-Linear And Machine Learning Methods, Timothy Marsh

Theses and Dissertations (Comprehensive)

Non-linearity in mediation analysis has been primarily studied in the context of binary variables which encode a treatment and control, estimating a `direct` and `indirect` effect of a covariate (a.k.a. treatment) X on a response Y, with a third variable M (the `mediator`) that is affected by X and in turn affects Y. The focus of mediation analysis in general is to quantify the overall effect of X on Y, including the effect through M. This presentation will focus on one or more continuous treatments and apply non-linear methods, including splines and machine learning models, to mediation analysis in a …

Sediment Redox-Driven Iron Flux And Phytoplankton Community Responses: Implications For Cyanobacterial Suppression And Functional Stability Across Boreal Lakes, Julia K. Kozak

Theses and Dissertations (Comprehensive)

Freshwater eutrophication contributes towards the development of cyanobacterial harmful algal blooms (cHABs), but nutrient availability alone does not fully explain variation in phytoplankton community composition or physiological performance. While phosphorus (P) availability has been known to regulate phytoplanktonic biomass, iron (Fe) is an important micronutrient supporting Fe-heavy processes within cyanobacteria (i.e., nitrogen fixation and photosynthetic electron transport). Sediment Fe availability in freshwater ecosystems is regulated by reduction oxidation (redox) conditions at the sediment-water interface (SWI), where nitrate (NO₃^-) has been found to maintain oxidizing conditions and prevent the reduction of Fe(III) to more readily bioavailable soluble Fe(II), …

Integrating Landsat And Ecostress To Explore The Value Of Additional Thermal Infrared Satellite Observations For Field-Scale Evapotranspiration Mapping, Hui Liu, Yun Yang, Martha C. Anderson, Feng Gao, Christopher R. Hain, John M. Volk, Zoe Amie Pierrat, Kerry Cawse-Nicholson, Forrest S. Melton, Christine M. Lee, Adam J. Purdy, Weina Duan, Tian Li, Jiaxin Wang

AES Faculty Publications and Presentations

Landsat has provided an indispensable foundation for field-scale evapotranspiration (ET) mapping but is constrained by its overpass temporal frequency. Although integrating additional thermal data offers a pathway to bridge this gap, the magnitude of improvement varies across observation characteristics and surface context and remains less understood. Here, ECOsystem Spaceborne Thermal Radiometer Experiment on Space Station (ECOSTRESS) is used as an additional thermal source on top of the Landsat baseline to evaluate the value of more frequent thermal observations for improving field-scale ET time series. We implemented a Google Earth Engine -based Disaggregated Atmosphere-Land Exchange Inverse + Data Mining Sharpener framework …

Optimizing Human Fcrn Mouse Models To Improve Pharmacokinetic Evaluation Of Antibody Drug Candidates., Gregory J. Christianson, Zachary M Howard, Samantha Kenney, Emily Lowell, Nijaguna Bethur, Derry C. Roopenian, Elena Gonzalo-Gil

Faculty Research 2026

The use of animal models that can reliably predict drug performance in human patients is critical to antibody therapeutic development. Along with assessing toxicity and efficacy, determining the pharmacokinetic (PK) properties of therapeutics in Tg32 and Tg276 mice is essential to preclinical characterization. While Tg32 mice have been well established as indispensable in their ability to model the PK properties of antibody therapeutics, their intact immunity leaves them capable of mounting anti-drug antibody responses that interfere with PK interpretation. Here, we demonstrate the negative impact anti-drug responses can have on PK parameters derived from Tg32 mice, and provide strong evidence …

Optimizing Human Fcrn Mouse Models To Improve Pharmacokinetic Evaluation Of Antibody Drug Candidates., Gregory J. Christianson, Zachary M Howard, Samantha Kenney, Emily Lowell, Nijaguna Bethur, Derry C. Roopenian, Elena Gonzalo-Gil

Faculty Research 2026

The use of animal models that can reliably predict drug performance in human patients is critical to antibody therapeutic development. Along with assessing toxicity and efficacy, determining the pharmacokinetic (PK) properties of therapeutics in Tg32 and Tg276 mice is essential to preclinical characterization. While Tg32 mice have been well established as indispensable in their ability to model the PK properties of antibody therapeutics, their intact immunity leaves them capable of mounting anti-drug antibody responses that interfere with PK interpretation. Here, we demonstrate the negative impact anti-drug responses can have on PK parameters derived from Tg32 mice, and provide strong evidence …

Limosilactobacillus Reuteri Promotes Melatonin Release From Human Intestinal Organoids Via 5′Ectonucleotidase Activity, Micah D Forshee, Erika J Nachman, Esha R Shenoy, Heather A Danhof, Ludwig Ermann Lundberg, Stefan Roos, Robert A Britton

Faculty, Staff and Students Publications

Strains of Limosilactobacillus reuteri have been used to prevent or treat various conditions; however, the mechanisms by which they exert beneficial effects are not completely understood. Infant colic is one example in which L. reuteri DSM 17938 reduces clinical symptoms. While the etiology of colic is unknown, abnormal melatonin levels in infants have been suggested as a possible contributor. L. reuteri DSM 17938 has been shown to produce adenosine from AMP via production of the extracellular enzyme 5′ectonucleotidase (5′NT). Adenosine is a potent signaling molecule that impacts several important aspects of host physiology, including the release of melatonin from the …