Medicine and Health Sciences Commons^™

Techno-Enviro-Economic Analysis Of Precipitated Calcium Carbonate Production From Carbon Dioxide In Cement Industry Flue Gas And Calcium Hydroxide, Natalia Debora Panggabean, Widodo Wahyu Purwanto

Journal of Materials Exploration and Findings

CCUS is a technological solution to reduce emissions from the cement industry, which is the second largest CO2-intensive industry. This study aims to analyze technical, economic, and environmental performance of Precipitated Calcium Carbonate (PCC) synthesis in cement industry flue gas. The process simulation includes the CO2 capture system from cement plant, CO2 captured used as feedstock for PCC synthesis process through its reaction with calcium hydroxide. The simulation was carried out using ASPEN Plus software. Technical analysis was performed to determine the CO2 capture efficiency and PCC synthesis efficiency. Economic analysis was conducted to calculate CO2 capture cost and production …

Feasibility Analysis Of Thermal Oxidizer To Determine Remaining Life Using Fitness- For-Service Level 3 Method, Yudhi Yudistirawan, Donanta Dhaneswara, Wahyuaji Narottama Putra, Gama Widyaputra, Dewi Kurnia Suci, Agung Putra Mahardhika

Journal of Materials Exploration and Findings

An aged thermal oxidizer (TOX) in the oil and gas industry necessitates a comprehensive evaluation to ensure its continued safe operation. This study presents a Remaining Life Assessment (RLA) and a Fitness for Service (FFS) evaluation for the four main components of the TOX, in accordance with API 510, API 579/ASME FFS-1, and ASME BPVC Section VIII Div-1 standards. The investigation includes the determination of maximum stress and maximum temperature required to assess the operational viability of the reactor. The four components are radiant, convection, transition, and stack sections—were modeled using the finite element method (FEM). Following the geometric modeling, …

A Rare Presentation Of Extra-Appendiceal Mucinous Neoplasm Of The Anus, Pincus Joshua, Marianne Estrada, Lance Horner University Of Nevada, Las Vegas

School of Medicine Research Poster Showcase

Introduction: Mucinous neoplasm of the anus is an uncommon malignancy, representing less than 3% of all anal cancers. Even more rare is extra-appendiceal mucinous neoplasm. As a result, limited literature exists to define diagnostic strategies and optimal management. Our case report details the presentation and management of a patient with recurrent mucinous neoplasm of the anus. Methods: A retrospective chart review was performed which includes clinic documentation., operative notes, pathology reports. Results: The patient is a 76-year-old male with a history of T3N0M0 anal mucinous carcinoma diagnosed in 2015 and treated with neoadjuvant chemoradiation with complete pathological response. In 2024, …

Role Of Occupational Therapy In Hippotherapy And Therapeutic Riding: A Mental Health Perspective, Ava Morrison

Capstone Projects

The purpose of my doctoral capstone experience (DCE) was to gain knowledge about the unique role that occupational therapy (OT) plays in equine-assisted therapy at the Cheff Therapeutic Riding Center, with an emphasis on Therapeutic Riding. Equine-assisted therapy, including hippotherapy and therapeutic riding, is an emerging area of occupational therapy practice that promotes physical, cognitive, emotional, and social well-being through structured interactions with horses. Despite growing evidence supporting the therapeutic benefits of equine-assisted interventions, confusion remains regarding the distinctions between hippotherapy and therapeutic riding, highlighting the need for increased education and advocacy within the field. In addition, there is a …

Advocating For Occupational Therapy Services In Adult Outpatient Physical Therapy Clinics: Enhancing Interprofessional Collaborative Care, Hannah Peyerk

Capstone Projects

The topic of this capstone project is to define occupational therapy’s (OT) role at an adult outpatient physical therapy (PT) clinic. The project focuses on advocacy and education related to OT’s scope of practice and role on an outpatient interdisciplinary team. Literature suggests that healthcare professionals have limited understanding of OT’s specific roles on the rehabilitation team. This can impact referrals and involvement of OT in interprofessional collaboration. The best way to advocate and educate about OT’s role is by active collaboration with other healthcare professionals. This project takes place at Ivy Rehab Physical Therapy (Ortonville), an outpatient PT clinic …

Exploring Occupational Therapy’S Role In Addressing Mental Health Disparities And Emergency Service Utilization Among Homeless Populations: A Comprehensive Review, Megan Darnell

Capstone Projects

Occupational Therapy (OT) is a healthcare profession focused on enabling individuals to engage in meaningful activities and roles through a client-centered approach. This doctoral capstone experience (DCE) was completed in the Emergency Department (ED) at Bronson Methodist Hospital, where individuals experiencing homelessness frequently present with unmet mental health needs. A gap was identified in the accessibility and utilization of community-based mental health and social resources, contributing to repeated ED utilization. The purpose of this DCE was to examine how resource provisions impact the frequency of ED visits and engagement with community mental health services among this population. Objectives include developing …

Natural History Of 15 Patients With Autosomal Dominant Wfs1 Pathogenic Variants Associated With Sensorineural Hearing Loss And Optic Atrophy, Jessica P Roberts, Abby F Tang, Daniela Hernandez, Brianna Carman, Liam Oiknine, Cris Brown, Stacy Hurst, Yunshuo Tang, Fumihiko Urano

2020-Current year OA Pubs

OBJECTIVE: Autosomal dominant pathogenic variants in WFS1 cause a spectrum of disorders with phenotypic manifestations including low-frequency sensorineural hearing loss, optic nerve atrophy accompanied by low- to mid-frequency sensorineural hearing loss, non-syndromic diabetes mellitus, and early-onset cataracts. These conditions are generally milder than autosomal recessive Wolfram syndrome, except for Hattersley-Urano syndrome. Despite growing recognition of these disorders, data on clinical progression and long-term outcomes remain limited. This study aims to expand knowledge on disease severity and progression in autosomal dominant WFS1-related disorders. APPROACH: Clinical data were obtained from the Washington University International Registry and Clinical Study for Wolfram Syndrome and …

First Covid-19 Vaccination Rates Among Pregnant Tennessee Women By Month Of Conception And Urbanization Level: March 2021 – November 2021, Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate

Journal of Appalachian Health

Introduction: Throughout the pandemic, COVID-19 vaccination coverage was lower for the general population living in rural counties than in urban counties. In Tennessee (TN), COVID-19 vaccinations became available to pregnant women in March 2021. Little is known about rates of COVID-19 vaccination in pregnancy during the pandemic, or whether these rates changed or differed by urbanization level.

Purpose: The purpose of this study is to describe COVID-19 vaccination rates among pregnant women in TN by month of conception and urbanization level.

Methods: COVID-19 vaccination data from the TN Immunization Information System and the TN Surveillance for Emerging Threats to Mothers …

Evaluating The Feasibility And Preliminary Effectiveness Of A Tailored Diabetes Education Program For Rural Residents, Brittany L. Smalls, Oluwatosin Leshi, Suraksha Khanal, Grejika E. Abram-Erby

Journal of Appalachian Health

Introduction: Diabetes is a top ten Rural Healthy People 2030 priority for health improvement among rural Americans. Socioeconomic, environmental, geographic and political barriers contribute to the type 2 diabetes (T2D) prevalence and its disparate impact in rural communities. However, promoting proper self-care behaviors via self-management education can help people with diabetes better manage their condition.

Purpose: To account for the social environmental factors that affect rural residents, a tailored diabetes education program was developed, and the program’s effectiveness in improving diabetes knowledge and T2D-related health outcomes was assessed.

Methods: Using data collected from Appalachian Kentucky residents enrolled in a six-week, …

Rural Community Perspectives On Hurricane Helene In Western North Carolina, Jennifer A. Horney, Lilly Moreau, Search Wnc

Journal of Appalachian Health

Introduction: After making landfall on the Florida Gulf Coast in September 2024, Hurricane Helene impacted Western North Carolina (WNC) with historic flooding, landslides, and hurricane-force winds. More than 100 deaths in the region were attributed to the storm’s direct impacts.

Purpose: The purpose of this study was to assess community perspectives of long-term recovery in Mitchell and Yancey Counties, two rural WNC counties severely impacted by Hurricane Helene.

Methods: A 14-question interview guide was developed based on prior disaster research and the community engagement work of Sustaining Essential and Rural Community Healthcare (SEARCH). Questions covered post-Helene experiences related to access …

Exploring Systemic Challenges In The Western North Carolina Dental Safety Net: A Qualitative Analysis, Blaire Mirmow, Bill Milner, Nadia Laniado

Journal of Appalachian Health

Introduction: Despite statewide growth, rural communities in Western North Carolina (WNC) face persistent barriers to oral health care driven by chronic dental workforce shortages and systemic geographic disparities. Within this Appalachian region, the dental safety net serves as a vital yet strained support system, struggling with limited financial resources and a lack of provider participation that leaves many underserved populations without essential oral health services.

Purpose: This study aims to explore the experiences of individuals working within the WNC dental safety net to identify barriers and strategies required to strengthen the delivery of oral health care in high-need rural settings. …

Infective Endocarditis Hospitalizations In Kentucky, 2008-2018: Spatial And Temporal Trends, Meera Marji, Steve Browning, W. Jay Christian, Richard Charnigo, Steve W. Leung, Anna Kucharska-Newton

Journal of Appalachian Health

Introduction: Infective endocarditis (IE) hospitalization rates have increased significantly in the last decade, primarily due to the opioid epidemic. In 2016, Kentucky (KY) ranked among the top ten states for opioid-related overdose deaths, but limited data exist on IE trends in KY.

Purpose: This study seeks to examine county-level spatial and temporal trends in IE hospitalization rates in KY.

Methods: Hospital inpatient discharge data from 2008–2018 for KY residents aged 18 and older were analyzed. IE admissions and drug use status were identified using ICD-9 & 10 diagnosis codes. U.S. Census data calculated yearly IE hospitalization rates per 100,000 residents. …

The Effects Of Hurricane Helene On Mental Health And Physical Activity, Hunter Smathers, Robyn York, Jarrett Walbolt

Journal of Appalachian Health

Introduction: Hurricane Helene brought widespread damage to Southern Appalachia, disrupting utilities, health care, and recreation. While natural disasters are linked to declines in mental and physical health, few studies have examined their effects on distinct types of physical activity (PA).

Purpose: This study evaluated the effects of Hurricane Helene on perceived stress, depressive symptoms, post-traumatic stress disorder (PTSD) symptomology, and intentional (exercise for health benefits) and incidental (physical labor or transportation) PA. Evacuation status influence was also explored.

Methods: Twenty participants completed assessments four weeks before (BASE), immediately after (0POST), and four weeks after landfall (4POST). Measures included the Perceived …

Starting With Story, Not Symptom: Narrative Collapse And Cultural Repair In Appalachia, Wayne Coombs Ph.D.

Journal of Appalachian Health

Appalachia’s opioid crisis reflects uneven burdens, especially in distressed coalfield counties, and it cannot be solved by symptom tracking alone. This commentary argues for a narrative shift, starting with story and cultural repair alongside clinical care. Narrative collapse is defined here as the loss of shared, dependable public meaning across groups, not the absence of storytelling in families, churches, and recovery circles. Trauma science suggests that chronic threat reshapes nervous systems across generations, making safety a prerequisite for renewed trust. Drawing on narrative identity research, the piece proposes peer story work as infrastructure that can reduce shame, support treatment engagement, …

When Lightning Strikes Twice: Synchronous Appendiceal Neoplasms, Alston Gremillion, Eriq Krugman, Michaela Abraham, Farris Obaid, William Kliefoth

Research Day

Appendiceal neoplasms are often clinically silent until later stages, when they may mimic appendicitis with right lower quadrant (RLQ) or nonspecific abdominal pain. Neuroendocrine tumors, while rare in the overall population, are the most common appendiceal malignancies, with a prevalence of approximately 7 per 100,000. In comparison, low-grade appendiceal mucinous neoplasms (LAMNs) make up 0.2-0.3% of appendectomy specimens. Mucoceles, frequently associated with mucinous neoplasms, vary in size, with the largest reported measuring 17cm by 4cm in 2005. We report a rare case of a large appendicular mucocele, measuring 10.7cm by 7.0cm, with final pathologies of both a LAMN and a …

Exploring The Misdiagnosis Of Schizophrenia In The Setting Of Underlying Neurological Disorders, Jade M. Mcnulty, Andrea N. Weir

Research Day

Introduction: Hallucinations, delusions, and thought disorganization are hallmark features of schizophrenia; however, these symptoms are not pathognomonic and may occur in a variety of neurological conditions. Current guidelines from the American Psychiatric Association during initial evaluation of psychosis recommend comprehensive psychiatric assessment and medical history, but routine neuroimaging is not considered standard of care in typical presentations. Failure to adequately investigate organic causes may result in delayed diagnosis and suboptimal treatment. In cases of atypical features or poor response to antipsychotics, clinicians should broaden the differential diagnosis and reconsider underlying neurological etiologies.

Methods: A narrative literature review was conducted to …

Language-Based Exclusion In Depression Clinical Trials: Implications For Generalizability, Kruti Patel, Natalia Santiago

Research Day

Background: Major depressive disorder (MDD) affects approximately 21 million U.S. adults annually. Nearly 22% of individuals in the United States speak a language other than English at home. Language-based exclusion criteria in clinical trials may limit participation of non-English-speaking populations and reduce external validity in psychiatric research.

Objective: To evaluate the prevalence of English-language requirements in U.S.-based adult depression clinical trials and assess the availability of translation accommodations.

Methods: We conducted a cross-sectional review of U.S.-based interventional clinical trials listed on ClinicalTrials.gov. Adult (≥18 years) trials focused on major depressive disorder were included. Pediatric-only trials were excluded. Trials were assessed …

Alzheimer’S Is A Delivery Problem: A Neurosurgery-Enabled Evidence Map Of Focused Ultrasound Blood-Brain Barrier Opening As A Cns Delivery Platform, Gargee Sree Nallanukala, Veer Nallanukala, Lauren Noto-Bell, Jacquelyn Gerhart

Research Day

Introduction: Disease-modifying therapies for Alzheimer’s disease (AD) provide modest benefit in selected early-AD populations, but their use is limited by safety risks (e.g., amyloid-related imaging abnormalities [ARIA]) and intensive monitoring. A key reason many therapies underperform is that the blood–brain barrier (BBB) acts like a protective “filter,” allowing only a small fraction of systemically delivered drugs, especially large molecules, to reach the brain. MRI-guided focused ultrasound, paired with intravenously administered microbubbles, can temporarily and locally “loosen” the BBB at a chosen brain region, then allow it to reseal. This approach is being studied as a noninvasive delivery platform that could …

An Extensive Abdominal Aortic Aneurysm In A 95 Year-Old: A Cadaver Case Study, Manisha Kodavatiganti, Mia Cudmore, Stephanie E. Evans, Mallory P. Gersh, Lucie V. Ngaba, Kayla R. White, Michael Mcguinness

Research Day

An aneurysm is defined as a localized abnormal dilation of a blood vessel caused by weakening of the vessel wall. Common types include abdominal, thoracic, cerebral, and peripheral aneurysms.

According to the Mayo Clinic, risk factors for AAAs include tobacco use, age, sex (men are at higher risk than women), being caucasian, family history of AAAs, and history of prior aneurysms.

Dissection of a 95 year old female, whose cause of death was listed as an abdominal aortic aneurysm (AAA) revealed an enlarged aorta throughout the thorax and abdomen. The width of the enlarged aorta was compared with the average …

Postpartum Depression, Anxiety, And Psychological Flexibility In Nicu Mothers: Implications For Acceptance And Commitment Therapy, Riya Desai, Alexa Bonacquisti

Research Day

Pregnancy and the postpartum period may be physiologically and psychologically demanding for women as they navigate a multitude of factors. This experience may be further complicated by stressful reproductive events, such as newborn admission into the Neonatal Intensive Care Unit (NICU). Having a baby admitted to the NICU is often particularly challenging for mothers from a psychological perspective, serving as an added layer that may contribute to postpartum depression and anxiety. Psychological flexibility is the concept of openness, adaptability, and readiness in the face of adversity. For NICU mothers, psychological flexibility serves as a possible therapeutic target to address postpartum …

A Preliminary Investigation On The Relationship Between Established Dietary Habits And Willingness To Adopt New Food Groups, Graziella Greco, Rasika Singh, Kristen Berry, Autumn Dye

Research Day

Introduction: Obesity is a nationwide health crisis that predisposes individuals to a host of other diseases including hypertension and diabetes. In Philadelphia alone, approximately 41% of children between the ages of 6-17, and 33% of adults are obese. It has been shown that education on nutrition positively correlates with healthy eating behaviors, which can minimize the chances of obesity developing into its comorbidities. This study aims to see if food demonstrations and healthy recipe samples will lead to patients incorporating new foods into their diets. Adult patients in a combined adult and pediatric primary care office are offered three healthy …

Cardioprotective Role Of Spermidine In Ischemia-Reperfusion Injury, Isabella Brosious, Robert J. Barsotti, Lindon H. Young, Qian Chen

Research Day

Introduction: Timely reperfusion of the heart to restore blood flow and oxygen is critical to rescue ischemic myocardium in the setting of myocardial infarction and reduce cardiac morbidity and mortality. However, reperfusion following prolonged ischemic injury exhibits salvaging, but paradoxically, additional cellular damage, contributing to a larger infarct size. Termed ischemia-reperfusion injury (IRI), the myocardium undergoes various pathophysiological changes following reperfusion – such as apoptosis, oxidative stress, and mitochondrial dysfunction – thus exacerbating cellular damage and death caused by ischemic injury. The research on attenuation of IRI is critical to maximize the benefit of reperfusion. Spermidine is a natural polyamine …

Factors Associated With Concussion Knowledge And Misconceptions In Students Depending On Athlete Status, Joseph Fontanals, Ruta Clair

Research Day

Introduction: Concussions represent a significant public health concern, with widespread implications across various populations from athletes and military personnel to the general public. Despite increased attention in both research and public discourse, substantial gaps in knowledge and persistent misconceptions continue to influence concussion recognition, reporting, and management behaviors. Research consistently demonstrates variable levels of concussion knowledge across different populations. Misconceptions about concussions persist even among populations with higher general awareness. Despite education and public awareness campaigns many adults have surface knowledge of symptoms and misunderstand injury and recovery. These identified knowledge gaps and misconceptions have significant implications for public health, …

Significant Response To Third-Line Zenocutuzumab In Metastatic Nrg1 Fusion–Positive Pancreatic Adenocarcinoma: A Case Study, Sarah Davis, Sukhrob Makhkamov, Vladimir Limonnik

Research Day

Background

Pancreatic adenocarcinoma is an aggressive malignancy with limited treatment options. In metastatic disease, first‑line regimens like FOLFIRINOX or gemcitabine plus nab‑paclitaxel provide modest survival benefits and are commonly limited by toxicity and disease progression.

Recent advances in precision oncology have identified genomic alterations in a subset of pancreatic cancers. Neuregulin‑1 (NRG1) gene fusions occur in < 1% of pancreatic adenocarcinomas and lead to activation of HER3 signaling through interaction with HER2, promoting tumor growth and survival.

Zenocutuzumab is a bispecific monoclonal antibody designed to target HER2 and HER3. By binding HER2 and preventing ligand-induced activation of HER3, zenocutuzumab disrupts NRG1-driven signaling while preserving HER2 receptor engagement for antibody-mediated targeting. In the eNRGy trial, zenocutuzumab achieved an objective response rate of …

Increasing Lead (Pb) Screening Participation Rates In The Pediatric Patient Population At The Philadelphia College Of Osteopathic Medicine Lancaster Avenue Community Healthcare Center, Jacob P. Varrato, Autumn Dye

Research Day

Elevated blood lead levels (EBLLs) are an ongoing public health crisis predominantly affecting children under six in low-income communities located in major cities across the United States. Chronic lead exposure due to outdated housing, polluted water, and contaminated soil is especially harmful in early childhood when a high rate of hand to mouth contact increases the risk of ingesting particulate matter containing lead (CDC). EBLLs can lead to neurocognitive deficits, cardiovascular disease, and epigenetic modifications to gene expression patterns. While precautionary measures and timely screening protocols greatly reduce the risk of developing severe disease, families within these communities continue to …

Rehabilitation Of Dipeptidyl-Peptidase-Like Protein 6 (Dppx) Encephalitis: A Case Report, Madison James, Emily Andrews, Mithra Maneyapanda

Research Day

Introduction

A 50 year old man presented to the emergency department after a seizure. He had gastrointestinal upset, cognitive impairments, ataxia, and myoclonus. Workup was normal except for an inflammatory CSF profile. The patient was trialed on carbidopa-levodopa, intravenous methylprednisone, and intravenous immunoglobulins with minimal improvement. Myoclonus was resolved with clonazepam. The patient was discharged with a diagnosis of possible autoimmune encephalitis.

One month later, serum and CSF analysis resulted positive for DPPX antibodies. He was readmitted to the hospital for plasma exchange with minimal neurologic improvement. Subsequent treatment with Rituxan resulted in mild improvement. He was then transferred to …

Anatomical Basis Of Symptom Presentation In Pancreatic Cancer: A Cadaver-Based Study, Emma L. Davis, Daniel T. Zelch, Kelsey J. Short, Vanesa M. Brecher, Jasmine Sethi, Alexandra C. Olanescu, Michael Mcguinness

Research Day

Pancreatic cancer remains one of the most aggressive malignancies in the United States today. In 2025, it was estimated that 67,440 Americans would be diagnosed with pancreatic cancer in the U.S., and more than 51,980 would die from the disease. It is currently the third-leading cause of cancer-related death in the U.S., with an overall five-year survival rate of approximately 13%. Early detection of the disease proves to be difficult due to the fact that symptoms appear only after the disease has progressed. A case study was conducted with an 86 year-old female cadaver whose cause of death was pancreatic …

Representation Of Adults Over 75 Years Old In Dialysis Outcome Studies: Implications For Generalizability, Anand Thakkar, Priyesh Thakkar

Research Day

Background: End-stage renal disease (ESRD) disproportionately affects older adults, with the incidence rate of patients aged ≥75 increasing and representing a growing segment of the dialysis population. However, many trials and cohort studies either underrepresent very elderly patients, particularly those with frailty or multiple comorbidities, or do not explicitly analyze outcomes in this age group. This raises questions about the applicability of research evidence to the patients most commonly encountered in clinical practice.

Objective: To evaluate how adults aged 75 and older are represented in dialysis outcome studies and to summarize survival and quality-of-life evidence relevant to this group.

Methods: …

Risk Factors For Lithium-Induced Chronic Kidney Disease In Bipolar Disorder Patients: A Literature Review, Anand Thakkar, Kruti Patel, Siddharth Patel, Priyesh Thakkar

Research Day

Background: Lithium remains the gold-standard mood stabilizer for bipolar disorder due to its efficacy in reducing mood episodes and suicide risk. However, long-term lithium use has been associated with renal effects, including impaired urinary concentrating ability and chronic kidney disease (CKD). The absolute risk of severe CKD attributable to lithium is modest, but identifying risk factors that predispose patients to renal decline is crucial for personalized monitoring and treatment planning.

Objective: To summarize evidence on patient-level and treatment-related factors associated with increased risk of CKD in individuals treated with lithium for bipolar disorder, and to highlight implications for clinical practice. …

Exploring Parental Barriers Contributing To Vaccine Hesitancy In An Urban West Philadelphia Population, Ryan Pinto, Simone Mileto, Autumn Dye

Research Day

Vaccine hesitancy has been a growing phenomenon over the past two decades due to a variety of social, informational, and political factors with families becoming skeptical of the established childhood vaccination schedule. This skepticism provides increased risk of vaccine preventable illnesses and death amongst the childhood population. This study aims to find why families in the urban West Philadelphia community, which has lower vaccination rates compared to the greater Philadelphia area, are skeptical to adhere to childhood vaccination schedules. Using the Vaccine Based Assessment Tool (VBAT) questionnaire, we gathered parental responses regarding their views on vaccinating their children from October …