Medicine and Health Sciences Commons^™

Vitamin D3 Supplementation At 5000 Iu Daily For The Prevention Of Influenza-Like Illness In Healthcare Workers: A Pragmatic Randomized Clinical Trial., Noud Van Helmond, Tracy L Brobyn, Patrick J Lariccia, Teresa Cafaro, Krystal Hunter, Satyajeet Roy, Brigid Bandomer, Kevin Q Ng, Helen Goldstein, Ludmil Mitrev, Alan Tsai, Denise Thwing, Mary Ann Maag, Myung K Chung

Cooper Medical School of Rowan University Faculty Scholarship

Vitamin D supplementation has been shown to reduce the incidence of acute respiratory infections in populations at risk. The COVID-19 pandemic has highlighted the importance of preventing viral infections in healthcare workers. The aim of this study was to assess the hypothesis that vitamin D3 supplementation at 5000 IU daily reduces influenza-like illness (ILI), including COVID-19, in healthcare workers. We conducted a prospective, controlled trial at a tertiary university hospital. A random group of healthcare workers was invited to receive 5000 IU daily vitamin D3 supplementation for nine months, while other random healthcare system workers served as controls. All healthcare …

Vitamin D3 Supplementation At 5000 Iu Daily For The Prevention Of Influenza-Like Illness In Healthcare Workers: A Pragmatic Randomized Clinical Trial., Noud Van Helmond, Tracy L Brobyn, Patrick J Lariccia, Teresa Cafaro, Krystal Hunter, Satyajeet Roy, Brigid Bandomer, Kevin Q Ng, Helen Goldstein, Ludmil V Mitrev, Alan Tsai, Denise Thwing, Mary Ann Maag, Myung K Chung

Cooper Medical School of Rowan University Faculty Scholarship

Vitamin D supplementation has been shown to reduce the incidence of acute respiratory infections in populations at risk. The COVID-19 pandemic has highlighted the importance of preventing viral infections in healthcare workers. The aim of this study was to assess the hypothesis that vitamin D3 supplementation at 5000 IU daily reduces influenza-like illness (ILI), including COVID-19, in healthcare workers. We conducted a prospective, controlled trial at a tertiary university hospital. A random group of healthcare workers was invited to receive 5000 IU daily vitamin D3 supplementation for nine months, while other random healthcare system workers served as controls. All healthcare …

Behavioral Health Models To Understand High-Risk Prenatal Patient Adherence To Visit Schedule In Camden, Olivia Nicolais-Julian, Md, Michael Monaghan, Md, Jocelyn Mitchell-Williams Md, Phd

Cooper Rowan Medical Journal

ABSTRACT:

Introduction: Despite improvement initiatives, patient non-adherence remains an issue in healthcare. Patients with high-risk pregnancies require more frequent monitoring to reduce complications. This study aims to better understand visit non-adherence with high-risk prenatal appointments. We hypothesized that patients’ perceived logistic barriers would be the most prominent determinant of visit non-adherence.

Methods: This study included adult, English speaking patients of the high-risk prenatal clinic at Cooper University Hospital that missed at least one appointment. We completed three, one hour focus groups with seven participants. Constant comparison analysis was used to determine common themes discussed by participants. Axial coding and basic …

Establishment Of An In Vivo Streptozotocin-Induced Type 1 Diabetes Model Recapitulating Early Brain And Retinal Fibrosis, Kia Bourdot, Lucy Dawson, Igor Kuzin, Arturo Bravo Nuevo, Zeus Antonello

Cooper Rowan Medical Journal

INTRODUCTION: Diabetes has risen to one of the top American public health concerns. The hyperglycemic state of chronic diabetes leads to microvascular and macrovascular changes that predispose patients to delayed wound healing and organ fibrosis. The validation of models to specifically detect early, quantifiable fibrotic changes seen in the diabetic state is of fundamental importance for understanding the diabetic pathophysiology and exploring earlier management options. Here, we investigated if we could detect early signs of internal fibrosis in a streptozotocin (STZ) diabetic mouse model by quantifying α-SMA expression in various organs using flow cytometry.

METHODS: We used a low-dose STZ-induced …

A Prospective Analysis Of Sources Of Referral To A Student Run Free Clinic In Camden, Nj, Samir Shah, Anjali Desai, Behjath Jafry

Cooper Rowan Medical Journal

Background: A center for learning and a haven for minority, marginalized, and medically indigent patients, the student run free clinic (SRFC) has emerged as a cornerstone of care at many academic medical centers (AMC). However, little is known regarding the demographics of patients who utilize SRFC and the manner in which they come to know of the free and quality care available at SRFC .

Methods: Participants were administered a survey wherein they were asked their ethnicity, how they came to know of the clinic, and how long they have remained a patient at the Cooper Rowan Clinic (CRC) – …

Breast Implant-Associated Anaplastic Large Cell Lymphoma: A Case Report, Jennie Tan, Jamie Johnson-Eddy, Wesley Tang, Yanchun Li

Cooper Rowan Medical Journal

This report aims to review a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) by comparing the patient's course with the current literature.

BIA-ALCL is a specific type of T-cell lymphoma that can develop after breast implantation, but has only recently been recognized within the last decade. Although overall rare, certain types of breast implants have increased association with developing subsequent lymphoma. This case occurred after mastectomy with breast reconstruction for unilateral invasive ductal carcinoma with a textured, saline Allergan breast implant. BIA-ALCL manifested and was symptomatic nine years after implantation.

Acute Hemiplegia And Ataxia From Lyme Disease, Shaili Babbar, Jonathan Galati, Jasmine Corona, Sohail Zahid

Cooper Rowan Medical Journal

Lyme disease is a zoonotic illness caused by Borrelia burgdorferi, which present with skin, joint, heart, and central nervous system complications. Central nervous system manifestations of this disease are common, and typically include meningitis, facial nerve palsies, and radiculoneuritis. In this case report, we present a patient who presented with acute right sided hemiplegia and ataxia with negative neuroimaging findings of stroke, inflammation, or mass. Further investigation with cerebrospinal fluid studies and infectious panels revealed the patient had active Lyme disease. The patient improved his motor function, coordination and sensation with ceftriaxone treatment over a few weeks. Acute hemiplegia and …

Dpc29 Promotes Mitochondrial Translation Post-Initation In Saccharomyces Cerevisiae, Kyle Andrew Hubble

Graduate School of Biomedical Sciences Theses and Dissertations

Although the cytosolic and bacterial translation systems are well studied, much less is known about translation in mitochondria. In the yeast Saccharomyces cerevisiae, mitochondrial gene expression is predominately regulated by translational activators. These regulators are thought to promote translation by binding the elongated 5’-UTRs on their target mRNAs. Since mammalian mitochondrial mRNAs generally lack 5’-UTRs, they must regulate translation by other mechanisms. As expected, most yeast translational activators lack orthologues in mammals. Recently, a mitochondrial gene-specific translational activator, TACO1, was reported in mice and humans. To better define its role in mitochondrial translation I examined the yeast TACO1 orthologue, DPC29. …

The Impact Of Video Conference On Orthopaedic Resident Education: A Survey, Michael Booth, Michael Niemann, Andrea Lese, John Taras

Cooper Rowan Medical Journal

Background: Covid and required social distancing has accelerated the use of video conferencing. We hypothesized that residents and faculty would be less receptive to the video lecture format and prefer traditional didactic methods.

Methods: A 16-question anonymous survey was distributed nationally to orthopaedic residents and faculty. The survey collected basic demographic information such as, level in training, gender, and age. We then asked the respondent to rate their agreement or disagreement with 8 statements on a Likert scale (1-5) about video conferencing regarding orthopedic education. Likert scale responses were evaluated using basic descriptive statistics. Respondents were divided into groups of …

Discovering New Potential Inhibitors To Sars-Cov-2 Rna Dependent Rna Polymerase (Rdrp) Using High Throughput Virtual Screening And Molecular Dynamics Simulations., Dylan Brunt, Phillip M Lakernick, Chun Wu

Faculty Scholarship for the College of Science & Mathematics

RNA dependent RNA polymerase (RdRp), is an essential in the RNA replication within the life cycle of the severely acute respiratory coronavirus-2 (SARS-CoV-2), causing the deadly respiratory induced sickness COVID-19. Remdesivir is a prodrug that has seen some success in inhibiting this enzyme, however there is still the pressing need for effective alternatives. In this study, we present the discovery of four non-nucleoside small molecules that bind favorably to SARS-CoV-2 RdRp over the active form of the popular drug remdesivir (RTP) and adenosine triphosphate (ATP) by utilizing high-throughput virtual screening (HTVS) against the vast ZINC compound database coupled with extensive …

Successful Buprenorphine Transition While Overlapping With A Full Opioid Agonist To Treat Chronic Pain: A Case Report, Kishan V. Patel, Sidharth Sahni, Lanvin F. Taylor

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Buprenorphine is a partial mu opioid agonist that has been increasingly utilized to treat patients with chronic pain and opioid use disorder (OUD). The drug has proven to provide significant chronic pain relief at low doses ranging from 75 to 1800 mcg. The conventional buprenorphine transitional process delays its introduction until patients begin withdrawal. However, this process can pose a barrier to both patients and providers due to some patients' inability to tolerate traditional prerequisite withdrawal. To our knowledge, this is a rare reported case to describe a transitional process utilizing buccal buprenorphine in which a patient with chronic pain …

An Introduction To Pediatric Ophthalmology, Ian J. Mcclain, Md

Cooper Rowan Medical Journal

Pediatric ophthalmology can feel like a completely different world compared to its adult counterpart. Children can sometimes be extremely challenging to examine and pediatric ophthalmologists examine a wide variety of age groups, including the non-verbal infant, the animated toddler, the adolescent, and the nonverbal adult. Careful exams are important at each stage of development because visual development is most critical in the first decade of life. Each patient group requires a distinctive expertise to perform an effective eye exam.

This review gives a brief introduction to some topics central to pediatric ophthalmology, including common clinical tests, common pathology, and some …

Emerin Interacts With Histone Methyltransferases To Regulate Repressive Chromatin At The Nuclear Periphery., Nicholas Marano, James M. Holaska

Cooper Medical School of Rowan University Faculty Scholarship

X-Linked Emery-Dreifuss muscular dystrophy is caused by mutations in the gene encoding emerin. Emerin is an inner nuclear membrane protein important for repressive chromatin organization at the nuclear periphery. Myogenic differentiation is a tightly regulated process characterized by genomic reorganization leading to coordinated temporal expression of key transcription factors, including MyoD, Pax7, and Myf5. Emerin was shown to interact with repressive histone modification machinery, including HDAC3 and EZH2. Using emerin-null myogenic progenitor cells we established several EDMD-causing emerin mutant lines in the effort to understand how the functional interaction of emerin with HDAC3 regulates histone methyltransferase localization or function to …

Mechanistic Research Approaches In Music Therapy For Pain: Humanizing And Contextualized Options For Clinician-Researchers, Andrea M. Hunt

College of Performing Arts Faculty Scholarship

No abstract provided.

A Qualitative Exploration Of Social Support In Males And Females Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

INTRODUCTION: The purpose of this study was to qualitatively investigate and compare male and female experiences of infertility in the context of social support.

METHODS: A Qualtrics survey (Qualtrics, Provo, Utah, United States) was posted to online fertility support groups and the responses were thematically analyzed. Only participants that completed the qualitative component of the survey were included in the study. Responses were subsequently thematically analyzed.

RESULTS: A sample of 110 participants (13 males and 97 females) were included in the present study. Thematic analyses revealed that isolation and loneliness, stigma, sentiments of misunderstanding, insensitive reactions, and others' unhelpful attempts …

Peer Reviewed Evaluation Of Registered End-Points Of Randomised Trials (The Pre-Report Study): A Stepped Wedge, Cluster-Randomised Trial., Christopher Jones, Amanda Adams, Benjamin S Misemer, Mark A Weaver, Sara Schroter, Hayat Khan, Benyamin Margolis, David L Schriger, Timothy F Platts-Mills

Cooper Medical School of Rowan University Faculty Scholarship

OBJECTIVE: To test whether providing relevant clinical trial registry information to peer reviewers evaluating trial manuscripts decreases discrepancies between registered and published trial outcomes.

DESIGN: Stepped wedge, cluster-randomised trial, with clusters comprised of eligible manuscripts submitted to each participating journal between 1 November 2018 and 31 October 2019.

SETTING: Thirteen medical journals.

PARTICIPANTS: Manuscripts were eligible for inclusion if they were submitted to a participating journal during the study period, presented results from the primary analysis of a clinical trial, and were peer reviewed.

INTERVENTIONS: During the control phase, there were no changes to pre-existing peer review practices. After journals …

Pregnancy Back Pain: Its Prevalence, Pattern, And The Practice Of Ergonomic Behaviors Among Pregnant Women In Rural Sule Tankarkar Local Government Area Of Jigawa State Nigeria, Daha G. Muhammad, Sani Abdullahi, Yusuuf Tunde Gbonjubola, Mustafa Isyaku, Saadatu Abubakar Maiwada

Cooper Rowan Medical Journal

Background: Studies on Back pain in pregnancy have reported rates ranging from 25% and 90%, with most studies estimating that 50% of pregnant women will suffer from back pain during the course of their pregnancy. Low back is the most common region affected followed by posterior pelvic region and upper back region being the region least affected. In Nigeria, relative to the minimum wage, back pain consumes a significantly high amount of money in accessing health care thereby incurring both direct and indirect cost. Therefore, this study explored pregnancy back pain and the practice of ergonomic behaviors among pregnant women. …

Possible Gender Differences In The Level Of Perceived Social Support In Couples Who Are Experiencing Issues With Infertility., Maya Pinzon, Shawna Rotoli

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Objective The purpose of this study is to examine whether there are gender differences in the level of perceived social support in couples experiencing issues with fertility. Methods A total of 938 participants aged 18-47 years, with self-reported issues of infertility, were evaluated using the Multidimensional Scale of Perceived Social Support (MSPSS) which comprises three subscales which correspond with distinct sources of social support: significant other (SO), family, and friends. Differences between sexes for total score and for all subscale scores were subsequently analyzed using SPSS Statistics (IBM Corp, Armonk, USA). Results Mean total scores and scores on all subscales …

How Did The Dietary Habits Of Patients With Chronic Medical Conditions Change During Covid-19?, Sahil K. Patel, Adarsh Gupta

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: Previous studies have examined the changes in the dietary habits of general populations during the COVID-19 pandemic but have not focused on specific populations such as those with chronic medical conditions (CMCs). Prior to major vaccination efforts, 96.1% of deaths were attributed to patients with preexisting CMCs, thus it is important to examine how this population has endured changes.

OBJECTIVES: The purpose of this study was to identify differences in dietary habits, lifestyle habits, and food attitudes between those with CMCs compared to the populations without chronic medical conditions (non-CMCs) since the beginning of the COVID-19 pandemic.

METHODS: An …

Is Cadaveric Dissection Essential In Medical Education? A Qualitative Survey Comparing Pre- And Post-Covid-19 Anatomy Courses, Smriti Kochhar, Tasfia Tasnim, Adarsh Gupta

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: With the surge of the novel coronavirus (SARS-CoV-2 [COVID-19]), the modality of teaching anatomy has shifted from in-person cadaveric dissection to virtual lessons for incoming first-year medical students. As a result, we aim to assess the impact that this curriculum change has on student perspectives.

OBJECTIVES: This study aims to understand the relative effect of a virtual anatomy course implemented during the pandemic (2019-2020) on the confidence, skills, and perspectives of first-year medical students compared to medical students who had traditional in-person anatomy at Rowan University School of Osteopathic Medicine (Rowan SOM) in Stratford, New Jersey.

METHODS: The authors …

Clinical Decision Support For Intervention Reduction In Neonatal Patients: A Usability Assessment, Patrice Dolhonde Tremoulet

Faculty Scholarship for the College of Science & Mathematics

Objective This study investigated how effectively simplified cognitive walkthroughs, performed independently by four nonclinical researchers, can be used to assess the usability of clinical decision support software. It also helped illuminate the types of usability issues in clinical decision support software tools that cognitive walkthroughs can identify. Method A human factors professor and three research assistants each conducted an independent cognitive walkthrough of a web-based demonstration version of T3, a physiologic monitoring system featuring a new clinical decision support software tool called MAnagement Application (MAP). They accessed the demo on personal computers in their homes and used it to walk …

Dual Mechanisms Implemented By Lin-28 For Positive Regulation Of Hbl-1 Are Necessary For Proper Development Of Distinct Tissues In Caenorhabditis Elegans, Madeleine Minutillo

Graduate School of Biomedical Sciences Theses and Dissertations

In Caenorhabditis elegans, the heterochronic pathway is comprised of a hierarchy of genes that control the proper timing of developmental events. hbl-1 (Hunchback Like-1) encodes an Ikaros family zinc-finger transcription factor that promotes the L2 stage cell fate events of the hypodermis. The downregulation ofhbl-1 is a crucial step for the transition from the L2 to the L3 stage. There are two known processes through which negative regulation of hbl-1 occurs: suppression of hbl-1 expression by 3 let-7 miRNAs through the hbl-1 3’UTR and inhibition of HBL-1 activity by LIN-46. The mechanisms by which hbl-1 is positively regulated have not …

A Conserved Mechanism For Hormesis In Molecular Systems, Sharon N. Greenwood, Regina G. Belz, Brian P. Weiser

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

Hormesis refers to dose-response phenomena where low dose treatments elicit a response that is opposite the response observed at higher doses. Hormetic dose-response relationships have been observed throughout all of biology, but the underlying determinants of many reported hormetic dose-responses have not been identified. In this report, we describe a conserved mechanism for hormesis on the molecular level where low dose treatments enhance a response that becomes reduced at higher doses. The hormetic mechanism relies on the ability of protein homo-multimers to simultaneously interact with a substrate and a competitor on different subunits at low doses of competitor. In this …

Phq-2 Scores In Broward County’S Homeless: Prevalence, Barriers, And Proposed Solutions To Mental Health Disparities, Jeena A. Kar, Reeja Raj, Ariba Hashmi, Tahia Hossain, Joshua Berko, Joseph S. Degaetano, Patrick Hardigan

Cooper Rowan Medical Journal

Introduction: Florida ranks 9th in states with highest prevalence of mental illness among homeless individuals. The state also ranks 43rd of 52 states in providing adequate access for mental health concerns in homeless individuals. This study surveyed people experiencing homelessness in Broward County to investigate utilization of healthcare and mental health resources and accessibility of the target population to adequate care.. Aims included a collection of demographics concerning homelessness such as age and gender, prevalence of mental illness, history of substance use and emergency department, and then correlating these with scores from a standardized depression rating scale (PHQ-2). Methods: The …

Thyrotoxic Periodic Paralysis: A Case Report And Discussion Of Clinical And Imaging Features, Kristian Quevada, Kishan Patel, Pauline Germaine

Cooper Rowan Medical Journal

Thyrotoxic Periodic Paralysis (TPP) is a rare manifestation of thyrotoxicosis, resulting in periodic episodes of acute onset muscle weakness in the setting of hypokalemia. The thyrotoxic form of Hypokalemic Periodic Paralysis (HPP) is less studied than the more well-known familial form due to fewer reported cases and smaller prevalence. This case study presents a 30-year-old African American male with multiple episodes of acute lower extremity muscle weakness, tachycardia, and a history of heat intolerance. Abnormal findings on thyroid ultrasound coupled with increased thyroid related immunoglobulins led to a diagnosis of TPP related to exacerbation of newly-found Graves’ disease. The case …

Rowan Community Health Center’S Ask First Model: Building Authentic & Impactful Community Relationships By Asking A Simple Question, Patrick J. Tempera, Christian Diliberto, Ruchi Shah, Daniel Hurst

Cooper Rowan Medical Journal

Spring of 2017, Rowan University School of Osteopathic Medicine’s student-run free clinic, the Rowan Community Health Center, launched an outreach initiative named the Unity Project. This is an ongoing initiative aimed at fostering relationships with Camden, New Jersey organizations to both educate community members about our clinic services and collaborate on improving Camden’s health. The objective of the Unity Project is to work towards affecting long-term change by forming authentic and impactful relationships with organizations that are already participating in meaningful community work. In order to achieve such a goal, we needed to overcome the traditional model of medical school …

Igm Multiple Myeloma: A Rare Clinical Entity And Diagnostic Dilemma, Keerthy Joseph, Alison Greidinger, Marjan Koch, Eric Behling, Tulin Budak-Alpdogan

Cooper Rowan Medical Journal

IgM multiple myeloma is a rare disease that shares many common features with Waldenström macroglobulinemia and lymphoplasmacytic lymphoma. It has been described in the literature as having unique diagnostic findings that separate it from the more common IgG and IgA myelomas. It is important for physicians to be able to differentiate between IgM multiple myeloma, Waldenström macroglobulinemia and lymphoplasmacytic lymphoma as their treatments vastly differ. This case report describes the clinical presentation of a patient with IgM lambda multiple myeloma and highlights the pathologic and clinical findings that are specific to this rare entity. We aim to provide further evidence …

A Sailor’S Disease Presenting In Urban America With Red Spots On The Legs, John A. Buchan, Bruce H. Gray

Cooper Rowan Medical Journal

Sailors were often affected by nutritional deficiencies due to the absence of fresh foods on long voyages. One example is the development of scurvy from a lack of vitamin C ingestion. In modern society in which fresh food are available this disease is infrequently recognized. The following case describes a 62-year-old male who presented with “red spots” on his legs and a large area of ecchymosis on his thigh. After initial testing failed to elicit a cause, a dietary history revealed that the patient had a peculiar diet of only ice cream with a total avoidance of fruits and vegetables. …

Effect Of Provider Education On Urinary Incontinence Knowledge And Assessment, Kendra L. Roloff, Patricia Parker, Rhonda Schafer-Mclean, Robert West

Cooper Rowan Medical Journal

Nearly 50% of women in the United States will experience urinary incontinence at some point during their lives. Urinary incontinence impacts multiple aspects of a woman’s life, yet remains underdiagnosed by primary care providers. The Women’s Preventative Service Initiative released a recommendation in 2018 to screen all women annually for urinary incontinence. The recommendation was in response to the lack of women who seek care for urinary incontinence.

The purpose of this project was to implement education and reminders for primary care providers, in order to improve urinary incontinence knowledge and assessment of women 18 years of age or older. …

A Brief Literature Review On Heparin: To Bolus Or Not To Bolus, That Is The Question, Alex Gechlik, James Espinosa, Alan Lucerna, Kishan Patel

Rowan-Virtua Research Day

Heparin is an anticoagulant medication, used to inhibit the formation of thrombi that pose arteriolar and vein-occlusive risk. The choice between starting a heparin infusion with or without an initial bolus is case dependent based on whether a patient is already anticoagulated and if so, foregoing an initial bolus. In contrast, both anticoagulated and non-anticoagulated patients share the same goal when receiving Heparin for various thromboembolic syndromes, and that is to be within aPTT target range of 1.5-2.5 or 45 to 75 seconds. Falling below goal range leads to a 20-25% recurrence of VTE, and aPTT above goal range has …