Medicine and Health Sciences Commons^™

Management Of Libman-Sacks Endocarditis: The Role Of Anticoagulation And Immunosuppressive Therapy, Klaudia Matanaj, Demi Poulathas, David Altimore

Rowan-Virtua Research Day

Background: Libman-Sacks endocarditis (LSE) is a nonbacterial thrombotic endocarditis detected in 10-40% of patients with systemic lupus erythematosus (SLE), depending on imaging modality. LSE is strongly associated with antiphospholipid syndrome (APS). The condition significantly increases the risk of cerebrovascular accidents and inpatient mortality compared to SLE without cardiac involvement. Despite these serious complications, optimal management remains uncertain. Objective: To review the current evidence on the pathophysiology and management of LSE. Methods: A literature review was conducted using 12 peer-reviewed articles addressing LSE pathophysiology, clinical outcomes, and treatment strategies. Results: Combination anti-inflammatory and antithrombotic therapy achieved 76% …

Age And Genotype-Dependent Baseline Characterization Of Spatial Learning And Memory In App/Ps1 Rats Using The Morris Water Maze, Thomas George, Mohammadreza Arbab, Nathanael Ricardo Alicea, Mahdie Kerdari, Christopher Janson

Rowan-Virtua Research Day

Background: Alzheimer’s disease (AD) is characterized by progressive cognitive decline. Transgenic APP/PS1 rat models offer improved translational relevance compared to mouse models due to closer similarity to human neurobiology.

Objective: To establish a baseline profile of spatial learning and memory across age and genotype in rate model.

Methods: The Morris Water Maze (MWM) was used to assess four groups of rats: young Wild Type (WT), young APP/PS1 (AD), middle-aged WT, and middle-aged AD. Spatial learning was evaluated during acquisition (Day 1–4) using cumulative proximity and escape latency. Memory was assessed using probe trials (Day 2–4). Swim velocity …

Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.

Rowan-Virtua Research Day

The legal and ethical evolution of involuntary psychiatric medication in New Jersey has been shaped through the landmark legal cases Rennie v. Klein and Brandt v. Monte. To this effect, this poster explores how each case shaped state hospital policy and the balance between patient autonomy and clinical judgment. Rennie v. Klein (1978) established a constitutional right for involuntarily committed patients to refuse psychotropic medication, except in emergencies or with due process safeguards. Decades later, Brandt v. Monte (2006) exposed flaws in New Jersey’s administrative procedures—particularly Administrative Bulletin 78-3—which permitted coercive practices under the guise of emergency treatment and lacked …

Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi

Rowan-Virtua Research Day

No abstract provided.

Tat-Beclin 1 And Exercise: Investigating Their Potential Synergy In Improving Sarcopenia-Related Muscle Changes In A Mouse Model, Shreya Krishnan, Thuan Thien Tchen, Kleiton Silva, Gabryel Sales Nascimento

Rowan-Virtua Research Day

No abstract provided.

Improving Adherence To Comprehensive Gynecological Assessments In Female Rectal Cancer Patients Prior To Rectal Cancer Treatment, Rachael Smith, Eleanor Williams, Emily Young

Rowan-Virtua Research Day

Background: A retrospective chart review of 139 female patients with Stage I-III rectal cancer treated at our institution (2017-2022) revealed only 32.6% (n=45) had documented age-appropriate gynecologic screenings prior to surgical intervention. These findings were disseminated to colorectal surgeons, medical oncologists, and radiation oncologists through departmental meetings and tumor boards. This follow-up study evaluates the impact of that educational initiative on gynecologic referral patterns. 

Hypothesis: Targeted education of colorectal surgeons, medical oncologists, and radiation oncologists would significantly increase gynecologic referral rates for female rectal cancer patients. 

Methods: This pre-post quality improvement study compared gynecologic referral rates among female patients with …

Understanding The Immune Responses Of Macrophages And Neutrophils In Synovial Fluid And Post-Operative Joint Environments, Allison Noelle Snyder

Rowan-Virtua Research Day

Periprosthetic joint infections (PJI) are devastating complications of total joint replacement (TJA). Even with aggressive antibiotic treatments, PJI recurrence rates are >17%, and 5-year survival is only 87.3%. Understanding the levels of inflammatory markers and cell types present at different timepoints is crucial in maximizing antimicrobial therapy and preventing adverse outcomes following TJA. This study tests the hypothesis that the synovial fluid environment of PJI induces immunosuppression in human macrophages, thereby hindering their ability to kill bacteria.

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim

Rowan-Virtua Research Day

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …

Psychiatry Meets Ai: Are Residents Ready?, Jacob De Castro, John Case

Rowan-Virtua Research Day

Artificial intelligence (AI) use is increasing in healthcare, but psychiatry residency training remains unstructured. In a 20-resident pilot survey, AI was frequently used for literature review and clinical support, with limited confidence and institutional guidance. We found most residents desired formal training and would use AI more if institutionally supported. Findings highlight a gap between rapid adoption and structured education.

Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta

Rowan-Virtua Research Day

Background: As ambient temperature rises, regions experiencing extreme heat face serious health concerns. This disproportionately affects lower socioeconomic status (SES) individuals in urban areas. This review examines how these “heat islands” affect the health outcomes for those in different socioeconomic statuses.

Methods: The databases used were PubMed, Embase, and Medline, and were searched with keywords such as “heat islands”, “social inequality”, “SES”, and “health outcomes”. After compiling, articles were screened using the inclusion criteria of ages, gender, peer-reviewed and English-written publications, from any location, social determinants as a primary outcome, and directly compared heat with social determinants of health. Articles …

Evaluation Of Possible Suicide Attempt And Treatment Of Chronic Serotonin Syndrome: A Case Report, Lalitya Karra, Colin Villarin

Rowan-Virtua Research Day

No abstract provided.

Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung

Rowan-Virtua Research Day

Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …

Ai-Augmented Digital Auscultation For Point-Of-Care Screening Of Valvular Heart Disease: A Systematic Review And Meta-Analysis, Harshal Parmar, Akhila Archakam, Nikhila Archakam, Wesley Kim, Eduard Koman Md

Rowan-Virtua Research Day

Background: Valvular heart disease (VHD) affects >10% of adults aged 75+ yet remains underdiagnosed when asymptomatic due to declining auscultatory proficiency. AI-augmented digital auscultation offers a point-of-care screening solution, though no meta-analysis has pooled diagnostic accuracy across VHD subtypes in adults using echocardiography as the reference.

Methods: A systematic review and meta-analysis were conducted per PRISMA guidelines. PubMed, Embase, Cochrane, IEEE Xplore, and Scopus were searched without date restriction. Studies applying AI or machine learning to digital auscultation or phonocardiography for VHD classification in adults with echocardiographic reference and patient-level diagnostic metrics were included. Studies using only public datasets, pediatric …

In Patients With Acne Vulgaris, How Do Standard Acne Treatments Combined With Adjunct Microbiome-Targeted Therapies Compare To Standard Acne Treatments Alone In Affecting Clinical Outcomes?, Sree Gowri Sudharshan

Rowan-Virtua Research Day

Background: Acne vulgaris is a very common chronic skin condition that occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. Nearly 50 million Americans are affected annually, and it usually occurs around puberty. Due to rising antibiotic resistance and unwanted side effects to current mediations, emerging research on the role of skin and gut microbiome in acne development is of interest.

Hypothesis: Adjuvant microbiome-targeted therapies may offer better clinical outcomes than standard acne treatments alone.

Methods: Literature search performed in PubMed and Embase using keywords related to acne vulgaris, microbiome-targeted therapies, and targeted acne treatments. Of …

Evaluating Referral Coordination And Scheduling In Primary Care: A Qualitative Study Of Workflow Gaps, Aprupa Alahari, Philycia Foote, S. Vincent Grasso

Rowan-Virtua Research Day

Background

Healthcare referral workflows remain fragmented despite widespread adoption of electronic health records. Primary care to specialty referrals frequently rely on fax, phone calls, manual scheduling, and disconnected communication systems, creating delays, incomplete referrals, and administrative burden.1,2 Prior literature has identified a lack of referral tracking, referral leakage, and lack of closed-loop communication as major barriers to coordinated care. Altogether, efforts are required to keep cases from falling into the “referral black hole” that plagues health systems.2-4

Hypothesis

We hypothesized that:

1. there is substantial patient burden

2. there is substantial operational fragmentation

3. current referral systems contain limited visibility or verification

Methods …

What Is The Role Of The Gut Microbiome In Modulating Immune Tolerance And The Development Of Allergic Disease In Infants?, Priyal Gajera

Rowan-Virtua Research Day

Introduction: The infant gut microbiome plays a critical role in immune system development during the early-life “window of immune education.”¹ Microbial colonization influences immune tolerance through mechanisms such as regulatory T-cell (Treg) induction, short-chain fatty acid (SCFA) production, and mucosal immune regulation. Disruptions in this process (dysbiosis) are associated with increased risk of allergic diseases, including food allergy, atopic dermatitis, and asthma. Environmental and maternal factors such as delivery mode, antibiotic exposure, and feeding practices significantly impact microbial composition and immune outcomes.²

Methods: A literature review was conducted using PubMed with search terms related to the gut microbiome, …

Resensitization Of Clinical Isolates Of Mdr-Acinetobacter Baumannii To Antibiotics Using Bacteriophage Therapy, Priyal Gajera, Valerie J. Carabetta

Rowan-Virtua Research Day

Introduction:

Antibiotic resistance poses a major global health threat, particularly with multidrug-resistant (MDR) pathogens such as Acinetobacter baumannii, which exhibits resistance to multiple antibiotic classes, including carbapenems.¹ As conventional treatments become less effective, alternative therapies such as bacteriophage therapy are gaining attention. Bacteriophages offer targeted antibacterial activity and may enhance antibiotic efficacy or resensitize resistant strains. This study investigates the synergistic effects of bacteriophage ΦCO03 combined with antibiotics against MDR A. baumannii.

Methods:

Clinical isolates (M20, M5) of A. baumannii were cultured in LB broth at 37°C. Bacteriophage ΦCO03 was isolated and purified using plaque assays. Synergy between phage …

Incidence Of Stroke Post Pulmonary Thrombectomy: Implications For Periprocedural Management, Rohan Umrani, Rameez Shahid, Luai Tabaza

Rowan-Virtua Research Day

Background: The incidence of stroke after pulmonary thrombectomy (PT) remains unknown. Given the incidence of patent foramen ovale (PFO) of 25% in autopsy studies, the concern for paradoxical embolus in this patient population warrants evaluation of periprocedural management.

Methods: We queried the EPIC EHR at Virtua Health in New Jersey for all patients who underwent PT from 2021-2025, categorized by utilization of the Inari Flowtriever system or the Penumbra thrombectomy device. We assessed post-PT cerebrovascular accident (CVA), PFO presence by transthoracic echocardiogram (TTE), and gender via descriptive statistics. Age, average anesthesia time and procedure supply cost were assessed via two-sided …

Enhancing Wellness And Healthcare Support For Medical Students At Rowan-Virtua Som: A Comprehensive Needs Assessment, Han Jie Liu, Karen Welding-Brown, Joanne Kaiser Smith

Rowan-Virtua Research Day

Introduction: While the rigors of medical education are well-documented, high stress levels have been shown to negatively impact academic performance. Despite this, Rowan-Virtua SOM currently lacks structured programs that address students’ unique healthcare and wellness needs. This study evaluates the wellness challenges and healthcare barriers faced by pre-clinical students (classes of 2028 and 2029) to inform targeted institutional support.   Methods: A descriptive survey-based study was distributed to all pre-clinical students at Rowan-Virtua SOM. The IRB-expempt (PRO-2025-114) Qualtrics survey assessed four domains: 1) demographics, 2) mental and physical wellness, 3) lifestyle patterns, and 4) access to healthcare and barriers.   Results: Fifty-four …

Effect Of Parkinson’S Disease On The Lateralization Of The Digastric Muscle In A Rodent Model, Estelle Richardson, Francois Gould

Rowan-Virtua Research Day

In Parkinson’s disease, the loss of dopaminergic neurons in the substantia nigra can cause dysphagia, which affects all phases of swallowing. In swallowing, bilateral pairs of muscles under the control of independent unilateral neural mechanisms must simultaneously activate to coordinate their movements and produce a swallow. However it is unknown how Parkinson’s disease impairs the activation of the right and left sides of those muscles. In this study we tested how Parkinson’s disease impacts the lateralization of the digastric muscle in rats. We hypothesized that Parkinson’s disease will cause a difference in activation of the right and left digastric muscles …

Assessment Of Health Disparities Among Community Clinic Patients In Southern New Jersey, Hetasvi Saraiya, Priyal Gajera, Mahhum Naqvi, Nils Brolis

Rowan-Virtua Research Day

Introduction:

The Rowan Community Health Center (RCHC) is a student-run free clinic that provides primary care services to uninsured and underserved populations in southern New Jersey. Access to quality healthcare remains a persistent challenge for these communities due to social and economic barriers1 . This study aims to identify and analyze the most common health disparities and barriers to care. The primary outcome of this study was to assess health disparities and barriers to care, secondary outcomes included characterizing chief complaints and identifying alternative care options patients would pursue if not seen at the clinic

Methods:

This survey-based study was …

Atypical Presentation Of Alpha-Gal Syndrome Identified During Evaluation Of Transient Neurologic Symptoms, Austin J. Wong, Todd Schachter

Rowan-Virtua Research Day

Alpha-gal syndrome (AGS) is an IgE-mediated hypersensitivity reaction to galactose-α-1,3-galactose, typically associated with tick exposure and delayed allergic reactions to mammalian meat products. While most commonly presenting with urticaria, gastrointestinal symptoms, or anaphylaxis, atypical and systemic manifestations remain poorly characterized.

We present the case of a 39-year-old male with minimal vascular risk factors who developed acute onset shortness of breath, chest pressure, and transient neurologic symptoms concerning for a transient ischemic attack. Extensive cardiac, vascular, and autoimmune evaluation was largely unremarkable aside from abnormalities in lupus anticoagulation screening and elevated homocysteine and protein C levels.

Further evaluation revealed elevated alpha-gal–specific …

The Effects Of Blue Light From Technology On Sleep Health In Adolescents And Young Adults: A Literature Review, Matthew F. Dilloian, Dianne Langford Ph.D., Charalampos Papachristou Ph.D.

Rowan-Virtua Research Day

Background: Digital screens, such as smartphones, computers, and tablets, emit blue light in the short wavelength range of ~400–500 nm. This exposure impacts the suprachiasmatic nucleus, the brain's biological clock, which regulates the sleep-wake cycle via melatonin secretion from the pineal gland. Blue light is known to suppress melatonin, potentially leading to poor sleep quality and sleep disruptions. Significance: With approximately 90% of Americans using electronic devices within one hour of bedtime, understanding these effects is critical for public health. Previous research often excluded young adults, specific target populations, like athletes, or focused solely on the biochemistry of blue …

Lactate-Induced Mitochondrial Magnesium Uptake And Its Metabolic Implications In The Mcardle’S Disease Model, Thiruvelselvan Ponnusamy, Jeremy Mehta, Haris Waseem, Marianne Assogba, Dianne Langford, Natarajaseenivasan Kalimuthusamy, Shanmughapriya Santhanam

Rowan-Virtua Research Day

McArdle disease, caused by mutations in the PYGM gene, impairs glycogenolysis in skeletal muscle, reducing lactate production and leading to energy deficits, fatigue, and risk of rhabdomyolysis. Using a CRISPR/Cas9-generated PYGM knockout (KO) rat model, we investigated whether reduced lactate production disrupts mitochondrial magnesium (Mg²⁺) homeostasis. KO rats failed to elevate lactate during static muscle contraction and showed diminished mitochondrial Mg²⁺ uptake, disrupted ATP synthesis, and impaired mitochondrial respiration. In vitro, caffeine-stimulated KO myotubes lacked lactate production and mitochondrial Mg²⁺ uptake despite preserved Ca²⁺ oscillations. Raising glucose concentration restored lactate levels, rescued mitochondrial Mg²⁺ transport, and improved metabolic output in …

Comparative Efficacy Of Intravenous Ketamine And Lidocaine Infusions For Pain Management In Sickle Cell Vaso-Occlusive Crisis (Voc), Akhil Tumpudi Md

Rowan-Virtua Research Day

Sickle cell disease (SCD) is a hereditary hemoglobin disorder characterized by vaso-occlusion and recurrent acute painful crises, which are the leading cause of hospitalization in affected individuals (1,2). Opioids remain the primary treatment for vaso-occlusive crisis (VOC) pain but are associated with adverse effects, tolerance, and risk of dependence, prompting investigation into opioid-sparing adjuncts (1,2). Intravenous ketamine, an NMDA receptor antagonist, has shown modest opioid reduction in randomized and observational studies, though pain score improvements are inconsistent (3–6). Intravenous lidocaine, a sodium channel blocker, has also demonstrated potential opioid-sparing effects in retrospective cohorts with limited evidence of analgesic superiority (7–9). …

Cold Agglutinin Disease A Case On Diagnostic Pitfalls And Decision-Making Strategy, Portia Shaheed, Shefali Waghray Do, Te Du Md, Phd

Rowan-Virtua Research Day

Cold agglutinin disease is a rare subtype of autoimmune hemolytic anemia (AIHA) characterized by complement-mediated hemolysis triggered by cold temperatures. Because of its rarity and variable presentation, cold agglutinin disease is frequently underrecognized, often leading to extensive and sometimes unnecessary diagnostic evaluations. By recognizing cold agglutinin disease as a differential diagnosis in patients with recurrent admissions for hemolysis, clinicians can avoid unnecessary workups, consults, and distress for their patients.

Focal Status Epilepticus In A Patient With Responsive Neurostimulation: A Rare Complication And Management Insights, Ana Leticia Fornari Caprara Md, Jamir Pitton Rissardo, Pranaya Gade, Estefania Joselinne Alba-Rodriguez Md, Eric P. Nagele Md, Salman Assad Md, Islam Fayed Md, Evren Burakgazi-Dalkilic Md

Rowan-Virtua Research Day

Introduction: Responsive neurostimulation (RNS) is an established therapy for drug-resistant focal epilepsy, yet device-related complications during acute seizures remain underreported. We describe a case of focal status epilepticus in a patient with RNS, illustrating the interplay of possible device malfunction, systemic illness, and medication nonadherence. Case Report: A 39-year-old man with drug-resistant focal epilepsy and schizoaffective disorder, status post right frontal craniotomy and RNS implantation, presented with focal status epilepticus after several days of antiseizure medication (ASM) nonadherence, febrile illness, vomiting, and urinary tract infection (UTI). On admission, he was lethargic with frequent focal seizures (< 30 s) characterized by left head turn, left arm followed by bilateral arm tonic stiffening, and impaired awareness. Continuous EEG confirmed focal status epilepticus. Family declined intubation. A ketamine bolus (20 mg) followed by infusion (0.25–0.5 mg/kg/hr) for 24 hours achieved seizure cessation. Despite broad ASM therapy (phenytoin, zonisamide, perampanel, levetiracetam, clorazepate, cenobamate, carbamazepine, clonazepam, lacosamide), seizures persisted until RNS interrogation revealed high lead impedance; the device was deactivated. ASM doses were optimized, PEG tube placed for consistent delivery, and UTI treated. He stabilized and was discharged to rehabilitation. Conclusion: This case highlights the need for comprehensive evaluation in RNS patients presenting with focal status epilepticus. Device malfunction, systemic illness, and inconsistent ASM adherence can synergistically worsen seizure control. Multidisciplinary management including neurocritical care, device troubleshooting, and nutritional support was pivotal for recovery.

Data-Driven Analysis Of Lecture Capture Transcript Accuracy Of The Biomedical Foundations Course Using Automated Speech Recognition, Eleni Papadopoulos, Shaniece Lawrence, Steve Garwood, Dawn Shell, Jacqueline A. Giacobbe

Rowan-Virtua Research Day

To increase the accessibility and utility of lecture capture recordings, schools may utilize automated speech recognition (ASR) to generate closed-captions and transcripts. But, how accurate are these systems? This study analyzed 50 ASR-generated transcripts using word error rate (WER) and further sought to determine factors that impact accuracy. Only 19 of 50 (38%) transcripts met the 99% accuracy standard required by the Americans with Disabilities Act (ADA). The lecturer's accent was the most significant factor affecting accuracy, though medical jargon also presented a challenge. These findings suggest system improvements and manual review are necessary to ensure students receive accurate information.

Methadone-Associated Qt Prolongation: The Importance Of Early Recognition And Monitoring In The Emergency Department, Uma Murrugappan, Kelsey Murray, James Espinosa Md, Alan Lucerna

Rowan-Virtua Research Day

We report a case of a 43-year-old female with cervical cancer and bilateral percutaneous nephrostomy tubes receiving high-dose methadone maintenance therapy who presented to the emergency department with bilateral flank and abdominal pain. She denied cardiac symptoms. Electrocardiogram obtained during evaluation revealed marked QT prolongation (QTc 596 ms) following recent methadone dose escalation. The patient was placed on continuous cardiac monitoring and intravenous magnesium was ordered. While intravenous access was being obtained, she developed polymorphic ventricular tachycardia consistent with torsades de pointes and became pulseless. Advanced cardiac life support was initiated including defibrillation and magnesium administration, with return of spontaneous …