Medicine and Health Sciences Commons^™

Conceptualization Of Intervention In Pediatrics Systematic Review, Kaitlyn Hansen, Mark C. Navin, Jason Wasserman, Stephanie Swanberg

Posters

Navigating when to intervene against parents’ wishes is a difficult task in pediatrics. Different frameworks have been proposed, but disagreements remain. One problem debated about in pediatric intervention principles often refer to different kinds of interventions (e.g. calling Child Protective Services, consulting the Ethics Committee). This project reports results of a critical scoping review of recent bioethics literature about the concept of pediatric intervention principles.

Analyzing Medical Student Call To Action Letters Following 2020 Black Lives Matter Protests, Nick Mcmillen, Jason A. Wasserman

Posters

The Flexner Report, written in 1910, may have revolutionized medical education, but it also recommended and led to the closure of all but two Black medical schools. While recent decades have lead to increased attention to diversity and inclusion, representation of historically marginalized groups among students and faculty has been slow to materialize.

Black Lives Matter protests encouraged a national dialogue over the need for more effective DEI initiatives and increased antiracist material in medical school curricula. Organizations such as White Coats 4 Black Lives developed “Call to Action” letters to medical school administrations across the country.

'Best Interest' In Clinical Medicine: A Critical Scoping Review, Joshua R. Jones, Saketh Akula, Jason Wasserman, Mark Navin

Posters

The Best Interest Standard (BIS) has been a much-debated guidance principle in clinical ethics with ambiguous definition and application. In this study we focus on the conceptions of best interests that differ according to which kinds of interests are included. While there is wide agreement that ‘best interests’ include the physiological welfare of a patient, there is still substantial disagreement about which other interests are included in wider accounts of welfare, the balancing of those other interests, and whether interests are objective or subjective.

Conceptualization Of Effective Surrogate Decision Making, Zachary Armstrong, Michael Bourgoin, Abram Brummett, Jason Wasserman, Mark C. Navin, Stephanie Swanberg

Posters

Surrogate decision making is a key component in the hierarchy of medical decisions, whereby an assigned individual makes choices on behalf of a patient incapable of making the decision themselves. Although this is common in healthcare, there are still many questions about best surrogate practices and ethical credibility. This capstone project aspires to map these concepts and discuss issues related to the current landscape of surrogate decision making with regards to medical ethics through the use of a systematic literature review.

Drug Metabolizing Enzymes And Transporters May Help Determine Effective Budesonide Dosing In Eoe, Laurie Mccann, Lisa Harvey, Norah Almahbub, Wendy Y. Wang, Erin C. Boone, Janelle R. Noel-Macdonnell, Rachel Chevalier

Posters

Background: Eosinophilic esophagitis (EoE) is a chronic inflammatory disorder diagnosed in children with painful or difficult swallowing, vomiting, or poor weight gain.  Current treatment models adopt a trial-and-error approach in regard EoE treatment, including restrictive elimination diets, proton pump inhibitors, and topical budesonide. This approach can delay effective treatment which increases risk of disease progression and increases medical costs to families for frequent clinic visits and endoscopy.   Objectives/Goal: The objective of this study is to determine the CYP3A5 genotype and expression of patients with eosinophilic esophagitis to discover which patients will respond to standard dosing of topical budesonide treatment (1, …

Changes In Electrocardiographic And Cardiac Implantable Electronic Device Parameters Following Transcatheter Aortic Valve Replacement, Elizabeth Seeley, Luai Madanat, Nishaki Mehta

Posters

Transcatheter aortic valve replacement (TAVR) is known to cause conduction abnormalities leading to the need for permanent pacemaker implantation. However, the impact of TAVR-related conduction abnormalities on cardiac implantable electronic device (CIED) parameters in patients with preexisting devices is not known. We sought to investigate and describe changes in EKG and CIED parameters following TAVR in patients with preexisting CIEDs.

Development And Evaluation Of A Peer Education-Based Ultrasound Curriculum With Emphasis On Clinical Reasoning, Nisha Patel, Arati Kelekar

Posters

Point-of-care ultrasonography (POCUS) is being increasingly incorporated in pre-clerkship physical diagnosis courses. However, the development of such a curriculum at many medical schools is limited by financial constraints, the availability of trained faculty, and the recent COVID-19 pandemic. Here, we describe an optional POCUS curriculum that circumvents these barriers while still providing basic image acquisition skills and pathophysiological correlations.

Assessment Of Radiographic Features In Predicting Complete Quadriceps And Complete Patellar Tendon Ruptures In The Pre-Operative Setting, Mitchell Pfennig, Matthew Astolfi, Christopher Vasileff, Betina Hinckel

Posters

Acute patellar tendon or quadriceps tendon rupture is a severely debilitating injury resulting in complete loss of the knee extensor mechanism. Early diagnosis and prompt surgical repair are preferential in order to achieve good functional outcomes. In the setting of trauma and knee pain, plain film radiographs of the knee are obtained to rule out fractures. Patellar and quadriceps tendon rupture is primarily a clinical diagnosis but can benefit from additional imaging to differentiate between a partial and complete tear when there is uncertainty. Our goal is to assess the reliability and reproducibility of radiographic features in a population with …

Surveillance Of Dual-Mobility Hip Systems: Damage Mode And Clinical Data Analysis, Camilla Cascardo, Conner D. Ahlgren, Michael J. Maxwell, Tyler Vovos, Mark Karadsheh, Drew Moore

Posters

Hip instability following total hip arthroplasty (THA) is a prominent indication for revision surgery. Dual mobility (DM) implants are designed to increase stability, and trending use makes characterizing in vivo damage and clinical failure modes important. This study expounds upon micro- and macroscopic damage mode findings of Lombardo et al., including novel screw ring damage using an updated retrieval registry.

Iatrogenic Nerve Injuries During Surgeries Of The Neck: A Systematic Review, Tajuldeen Al-Hasani, Jickssa Gemechu, Varna Taranikanti

Posters

Iatrogenic nerve injuries in the neck can present with a wide spectrum of symptoms ranging from mild pain, numbness, or weakness, to devastating consequences for patients such as permanent irreversible damage, disability, or even death. Surgical interventions in the neck region, especially those requiring radical dissections in the neck carry a significant risk of iatrogenic injury to several vital nerves passing through the neck such as vagus, phrenic, brachial plexus, cervical plexus, and ansa cervicalis.

The Routine Use And Cost Analysis Of Acid-Fast Bacilli And Fungal Cultures In Foot And Ankle Surgery: A Retrospective Study, Margaret Bohr, Robert Dean, Zein El-Zein, Megan Audet, Paul Fortin, Zachary Vaupel

Posters

Infection is a significant complication seen in orthopaedic surgery. In such cases, samples are sent to be cultured for aerobes, anaerobes, acid-fast bacilli (AFB) and fungi. AFB and fungi are generally slow-growing, difficult to culture, and rarely the pathogen, whereas aerobic and anaerobic cultures are routinely positive and guide antibiotic treatment. The goal of this study is to evaluate the value of routinely ordering AFB and fungal cultures in the setting of foot and ankle surgery.

Young Professionals, Lehigh Valley Health Network

Young Professionals

No abstract provided.

Chief Complaint And Geriatric Depression: Assessing Risk For 30- And 90-Day Readmission, Eric James, Michelle Moccia, Victoria Lucia

Posters

Readmission to the hospital has significant monetary costs and represents a care gap for older adults. This investigation examines how a positive geriatric depression screen and chief complaint contribute to 30- and 90-day readmission risk. Depression recognition with follow-up care is a critical first step to prevent adverse outcomes such as readmission.

Phenotype Characterization Of Genetic Murine Mouse Models Of Developmental Dysplasia Of The Hip (Ddh), Stephanie Mrowczynski, Kevin Baker, Michael Newton

Posters

Developmental dysplasia of the hip (DDH) is a congenital hip alteration that changes the “ball in socket” movement of the leg inside the pelvis. Genome-wide association studies have identified CX3CR1 polymorphisms associated with increased risk of Developmental Dysplasia of the Hip. Mouse models of CX3CR1 knock-out (KO) mice show unilateral, bony discrepancies between the femur head and acetabulum in comparison to wild-type (WT) mice, as well as gait impairment similar to that of humans with osteoarthritis (which develops in DDH patients later in life). The primary goal of this project is to assess joint congruity in a CX3CR1 KO model …

Beyond Covid-19: The Impact Of Recent Pandemics On Medical Students And Their Education: A Scoping Review, Moneb Bughrara, Stephanie Swanberg, Victoria Lucia, Keaton Schmitz, Dawn Jung, Tracy Wunderlich-Barillas

Posters

Over the past two years, COVID-19 has greatly altered undergraduate medical education (UME) as well as daily life. Medical schools across the world were disrupted and had to immediately adapt the educational experience to the online environment in order to continue the delivery of quality UME. However, COVID-19 was not the only recent pandemic. This posed the question, were similar disruptions and adaptations also seen in recent past pandemics such as Severe Acute Respiratory Syndrome (SARS) or Middle East Respiratory Syndrome (MERS) that could have prepared UME for COVID-19? This scoping review investigated the educational and personal impact of recent …

Comparative Study Of Pain Perception With Use Of Vibration And/Or Cold Stimulation Applied During Local Anesthetic Delivery In A Dental Setting: A Systematic Review, Tara Craven, Gage Williams, Brenda S Bohaty

Posters

Delivery of local anesthetic can be one of the most difficult parts of the procedure for pediatric patients undergoing dental treatment and can prevent the child from being able to cooperate for treatment as well as instill anxiety for future visits.1 Several methods can be utilized to help mitigate pain control during the local anesthetic injection including behavior management, vibration, cold sensation, warming the anesthetic, and topical anesthetic.4 These methods are essential to helping the child have a good experience and ultimately be able to tolerate treatment for caries management and a long term positive view of the dentist. One …

Urodynamic Characteristics Of Patients With Urge Incontinence Treated With Sacral Neuromodulation And Adjunct Botulinum Toxin Injection, Brent Yelton, Jason Gilleran

Posters

Sacral neuromodulation (SN) and intradetrusor botulinum toxin (BTX) are effective treatments for refractory overactive bladder (OAB) and urge incontinence (UI).1 The decision on which treatment to use is based on several factors. Urodynamics (UDS) have not been proven to determine who will respond to SN. Detrusor overactivity (DO) suggests that BTX may be more effective, given its direct role on muscle. The purpose of this study is to determine if presence and severity of DO on UDS is associated with failure of SN and response to BTX.

Evaluating The Effect Of The Covid-19 Pandemic On The Use And Impact Of Social Media In The Urology Residency Match: A Review Of The Literature, Shivam Patel, Brent Yelton, Andrew Shanholtzer, Brianna Walter, Syed Mohammad Jafri

Posters

Social media (SoMe) use within healthcare has changed significantly since the start of the COVID-19 pandemic. This project highlights recent changes in SoMe use within the field of urology and summarizes how they have impacted the urology residency application and match process.

A Retrospective Review Of Catheter-Directed Therapy For Patients With Intermediate Risk Pulmonary Embolisms, Austin Lehew, Michael Tucciarone

Posters

Each year, hundreds of patients present to the William Beaumont hospital system with intermediate risk pulmonary embolisms (IRPE) with common symptoms of chest pain, shortness of breath, and hypoxia. Conventional treatments include anticoagulants alone, or a more aggressive approach with systemic thrombolytics which come with a higher risk of major bleeding and death. However, in the last few years, catheter-directed therapies (CDT) have been developed to mechanically remove clots in a minimally invasive fashion. The goal of this study is to determine the safety and efficacy of novel CDT at Beaumont Troy and Royal Oak.

Pillow Cpr: Using A Low Resource Method To Teach Hands-Only Cpr To Hispanic Adolescents In A Community Setting, Benjamin Goldstein, Ekaterina Clark, Alan Silverman, Virginia Uhley

Posters

Hands-only Cardiopulmonary resuscitation (CPR) training for adolescents in community settings is often limited by training device availability. This pilot study’s objective was to investigate the feasibility, participant knowledge gains, and attitude changes through hands-only CPR training using a pillow for skill development.

Medical Student Knowledge Of Physician Involvement In The Holocaust And The Importance Of Incorporating Holocaust Studies And Ethics Into Medical School Curricula, Megan Bricely, Jason Wasserman

Posters

A 2019 Claims Conference study demonstrated an alarming lack of knowledge about the Holocaust in the United States general population. There is currently no specific data on medical student knowledge of the Holocaust and the role that the medical community played. The goal of this study was to gather baseline data on medical student knowledge of the Holocaust and medicine’s involvement to demonstrate the need for Holocaust teaching in medical school.

Combining Drip Score And Rapid Diagnostics For Improved Antibiotic Stewardship, Richard Ramirez, Matthew Sims

Posters

Treatment analysis patterns for broad-spectrum antibiotic use in pneumonia revealed that 60% of patients were overtreated, highlighting the need for effective antibiotic stewardship practices. Systems such as the Drug Resistance in Pneumonia (DRIP) score select patients more likely to require broad spectrum antibiotics but still leads to overtreatment as it does not target specific pathogens. Rapid diagnostics such as the Unyvero Lower Respiratory Tract Panel (LRTP) combined with the DRIP score can identify specific pathogens to further narrow antibiotic use.

Review Of Salvage Therapy For Mrsa Bacteremia At Beaumont Health System, Hazem Alakhras, Matthew D. Sims, Tracey A.H. Taylor

Posters

Treating methicillin-resistant Staphylococcus aureus (MRSA) effectively is imperative to reduce mortality rates, as it contributes to a large amount of healthcare-associated bacteremia in the U.S. However, due to the insufficient and sometimes contradicting studies to guide salvage therapy, there is a lack of clear consensus on treatment of MRSA bacteremia after vancomycin failure. The goal of this study is to showcase the salvage therapies of choice for patients with MRSA bacteremia at Beaumont Health System.

Designing A Surgical Scorecard To Inform And Evaluate Appropriate Perioperative Antibiotic Prophylaxis, Rehan Tariq, Paul Chittick

Posters

Perioperative antibiotic prophylaxis (PAP) implementation is a widespread strategy used to ensure the minimization of surgical site infections (SSIs) during various surgical procedures including hip and knee replacements and organ transplants. Despite the widespread implementation of PAP, there exists a gap in understanding what is considered appropriate PAP. This may be due in part to the absence of a feedback mechanism that educates physicians on which antibiotics are truly appropriate for preventing the SSIs arising from certain surgical procedures. The goal of this project is to design an informative surgical prophylaxis scorecard that physicians can use to determine which antibiotic …

Outcomes Of Da R-Epoch Versus R-Chop In Treating Patients Diagnosed With Double-Expressor Lymphoma, Phat Duong, Ishmael Jaiyesimi

Posters

Double-expressor lymphoma (DEL) is a subtype of Diffuse Large B-cell lymphoma (DLBCL) that is associated with poor prognosis. The standard treatment for DLBCL is rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP). It is hypothesized that the aggressive nature of DEL deserves a more intense regimen such as dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin plus rituximab (DA-R-EPOCH). A comparison of outcomes between those two treatments is needed to guide clinical decisions.

Demographics And Survival In Aml Patients Over 60 Years Of Age. A Single Institutional Analysi, Damilola Gbadebo, Nwabundo Anusim, Ishmael Jaiyesimi

Posters

Acute Myeloid Leukemia (AML) is a malignancy of the myeloid cell line. Patients diagnosed with AML, typically exhibit symptoms of neutropenia, anemia and thrombocytopenia. The diagnosis of AML is based on greater than 20 percent of myeloid cells in the bone marrow (1). Some risk factors for acquiring the disease include, but not limited to age, sex, smoking, exposure to certain chemicals, radiation, genetic predisposition and being treated with certain chemotherapeutic agents (2).
AML is frequently diagnosed among people between ages 65-74, with a current relative survival rate for AML being 28.7%. Men account for majority of these cases, at …

Gestational Weight Gain And The Associated Perinatal Outcomes In Middle Eastern Women, Dana Rector, Zeynep Alpay-Savasan

Posters

Gestational Weight Gain (GWG) can impact perinatal outcomes for mothers and infants, especially if the mother gains inadequate or excessive weight during pregnancy. We hypothesized that Middle Eastern women would be more likely to gain inadequate weight, compared to the general population, resulting in adverse perinatal outcomes.

Self-Triage Among Patients Who Are Homeless, Jimmy Clemmens, Jason Wasserman

Posters

People who are homeless present to urban emergency departments at a higher rate per 1000 people than those who are housed.1 With those added difficulties, people who are homeless frequently turn to Emergency Departments for primary, rather than only emergency, health care treatment.2,3 There is great need for investigation into the thought process for the self-triage of the patient who is homeless. This study was undertaken to survey adults at HOPE adult shelter about their ability to determine the most appropriate place to seek treatment for different common conditions of varying acuity, as well as to evaluate the efficacy of …

Outbreak Risks At Religious Schools: Prevalence Of Nonmedical Vaccination Exemptions Among Michigan Kindergartens, Flora Martz, Patrick Karabon, Mark C. Navin

Posters

Religious community membership is relevant to immunization policy, as in the case of 2019 US measles outbreaks clustered in Orthodox Jewish communities. US immunization policy focuses on school enrollment requirements, which apply both to public and private (usually religiously-affiliated) schools. Most US states exempt students from these requirements for nonmedical reasons, including religious reasons, though some states, including New York, California, and Maine, have recently eliminated nonmedical exemptions. This study uses 2017-18 data from the state of Michigan to illuminate relationships between nonmedical exemption (NME) rates and attendance at religious schools with the aim of providing information about high-value targets …

Conceptualization Of Evidence Used By Surrogate Decision-Makers To Determine A Patient’S Wishes, Michael Bourgoin, Zach Armstrong, Abram Brummett, Mark C. Navin, Jason Wasserman, Stephanie Swanberg

Posters

Many modern concepts within clinical bioethics can be conceptualized in various ways. This subjectivity is demonstrated when analyzing ideas in the literature about the types of evidence that can or should be used by surrogate decision-makers to determine a patient’s wishes. This project aims to explore normative claims on this topic in order to map out the current landscape of the various understandings of this concept.