Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Breaking The Cycle Of Telemetry Overuse: A Resident-Led Quality Improvement Initiative, Jose Donis, Jose J. Loayza Pintado, Luis Salcedo, Renzo Aller, Andres Suarez

Research Symposium

Background: Telemetry monitoring is a critical tool in detecting arrhythmias but is frequently overutilized outside of guideline-based indications, contributing to alarm fatigue, unnecessary costs, and resource strain. National guidelines (AHA 2017; BHRS 2020) recommend targeted use, yet adherence remains inconsistent. This quality improvement (QI) project was designed to assess baseline adherence and implement a resident-led intervention to optimize telemetry utilization in a general medicine unit.

Methods: The project was conducted in the 2-West Internal Medicine Unit at Rio Grande Regional Hospital. Residents were integrated into daily telemetry decision-making beginning in November 2024, following structured education with workshops, simulation training, and …

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 …

Brief Review : Listening Closely--Stethoscopes, Hygiene Gaps, And The Unfinished Work Of Healthcare-Associated Infection Prevention, James Espinosa, Swet Patel, Robin Lahr, Sergey Medlenov, Russell Mordecai, James Lee, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Healthcare-associated infections (HAIs) remain a persistent patient safety challenge. While hand hygiene has received sustained institutional focus, stethoscope hygiene remains inconsistently addressed despite longstanding evidence of contamination. Stethoscopes function as portable, patient-to-patient devices that may serve as under-recognized fomites in emergency and inpatient settings. Prior pilot work demonstrated that clinicians were unable to reliably distinguish between disposable and standard stethoscopes, and that perceived acoustic degradation from a diaphragm barrier was minimal. These findings suggest that acoustic concerns may not represent a primary barrier to hygiene-enhancing strategies. This brief review examines the literature surrounding stethoscope contamination and cleaning behavior, frames the …

Procedural Narration As An Important Cognitive Adjunct To Analgesia: Naming And Neurobiologically Grounding An Established Emergency Medicine Practice, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background: Experienced emergency physicians routinely provide real-time verbal guidance during procedures. Although widespread and intuitive, this practice has not been commonly conceptualized within pain neuroscience.

Objective: To name and mechanistically ground procedural narration as a form of cognitive analgesia, and to promote its intentional use and teaching in Emergency Medicine.

Methods: Narrative review integrating predictive coding theory, placebo/nocebo research, affective neuroscience, descending inhibitory pathway literature, and attentional modulation studies.

Results: Procedural narration reduces uncertainty, aligns expectation with sensation, modulates limbic threat processing, engages prefrontal cortical regulation, and supports descending inhibitory control of nociception.

Conclusion: Procedural narration is not a novel …

Stroke Mimics And Stroke Chameleons: Leveraging The False Positive/False Negative Diagnostic Schema In Resident Teaching, James Espinosa, Alan Lucerna

Rowan-Virtua Research Day

Background

Stroke mimics and stroke chameleons contribute significantly to diagnostic uncertainty in Emergency Medicine. Traditional teaching often relies on enumerating examples, yet residents struggle to internalize these distinctions.

Objective

To present a conceptual teaching framework that maps stroke mimics to false positives and stroke chameleons to false negatives, leveraging pre-existing diagnostic schemas.

Methods

Using representative cases—including hypoglycemic hemiparesis and spinal epidural lipomatosis presenting as stroke mimic—we developed an explanation for residents involving framing mimics as false positives and chameleons as false negatives.

Results

Framing mimics as false positives and chameleons as false negatives activates existing learner schemas related to sensitivity …

X-Ray Versus Ct For Femoral Landmark Identification: A Systematic Review And Meta-Analysis, Akash B. Patel, Marzieh Saeedi-Hosseiny, Mohammad Abedin-Nasab

Rowan-Virtua Research Day

Background Accurate femoral bone landmark identification is essential for orthopedic surgical planning, deformity correction, and fracture risk assessment. Radiography offers accessibility and low cost, while CT provides superior spatial resolution and three-dimensional visualization. Despite technological advances, no quantitative synthesis has compared these modalities specifically for femoral landmark identification.

Hypothesis CT provides superior measurement accuracy and interobserver reliability compared to radiography for femoral bone landmark identification.

Methods Following PRISMA 2020 guidelines, Embase, Scopus, and PubMed were searched from 2015-2025. Studies comparing radiography and CT for femoral landmark identification with quantitative outcomes were included. Dual-reviewer screening of 604 records yielded 27 studies …

Efficacy Of Repetitive Transcranial Magnetic Stimulation In Reducing Pain Intensity In Chronic Neuropathic Pain: A Sham-Controlled Analysis, Aprupa Alahari, Nathan Nhan, Cindy Nguyen, Samnit Gill, Simran Parmar, Annelisse Zara

Rowan-Virtua Research Day

Background 

Chronic neuropathic pain (CNP) can be refractory to traditional pharmacologic therapies, giving rise to the investigation of non-invasive alternatives such as repetitive transcranial magnetic stimulation (rTMS). rTMS utilizes magnetic fields to modulate neuronal activity within specific brain regions, offering a targeted approach to analgesia without the side effects of systemic medication1,2,3,4.

Hypothesis 

rTMS produces a greater reduction in reported pain intensity compared to sham stimulation in adults diagnosed with CNP.

Methods 

A systematic review and analysis  were conducted, utilizing PubMed and Embase (2004–2025) for sham-controlled randomized controlled trials (RCTs) and relevant meta-analyses. The review focused on outcomes such as …

Comparative Evaluation Of Iris And Traditional Feeding Tube Placement Methods: A Review Of The Literature, Justin Le Oms-Ii, Nishant Patel Oms-Iii, Amy Glasofer Phd, Drnp, Rn, Emilio Mazza Md, Phd

Rowan-Virtua Research Day

Background

Enteral nutrition (EN) is preferred in patients with functional gastrointestinal tracts. Traditional feeding tube placement methods are time-consuming, radiation-dependent, and prone to misplacement. IRIS and electromagnetic (EM)-guided systems enable real-time bedside placement, though comparative data remain limited.

Methods

A qualitative literature review was conducted using PubMed (2004–2024) to identify studies evaluating IRIS technology compared with EM-guided and traditional placement methods. Outcomes of interest included procedural success, safety, complication rates, efficiency, and cost considerations across ICU and ward populations.

Results

IRIS demonstrated success rates ranging from 75–91.7%, with higher success observed in ICU and sedated patients. EM-guided placement showed consistent …

Refractory Catatonia In Schizoaffective Disorder (Bipolar Type) Successfully Treated With Electroconvulsive Therapy, Shreya Kadi, Victoria Coles

Rowan-Virtua Research Day

Background: Catatonia is a neuropsychiatric syndrome

associated with mood and psychotic disorders and may

become life-threatening if untreated. While benzodiazepines

are first-line therapy, some cases are refractory and require

electroconvulsive therapy (ECT).

Hypothesis: Early use of ECT in refractory catatonia leads to

improved clinical and functional outcomes.

Methods: We present a retrospective case analysis of a 62-

year-old female with schizoaffective disorder, bipolar type,

who developed severe catatonia during inpatient psychiatric

hospitalization. Clinical course, Bush–Francis Catatonia Rating

Scale scores, and response to treatment were reviewed.

Results: The patient presented with severe catatonia (Bush–

Francis score 19) and elevated creatine kinase …

Point-Of-Care Intestinal Ultrasound Is Associated With Reduced Colonoscopy Utilization And Improved Clinical Decision-Making In Ibd, Lakumi Dias, Ashlyn Mcclelland, Amy Glasofer, Charalampos Papachristou, Yecheskel Schneider, Sanket Patel

Rowan-Virtua Research Day

Background:

Point-of-care intestinal ultrasound (IUS) enables real-time assessment of bowel inflammation, and it is underutilized in the United States. IUS provides visualization of bowel wall thickness, vascularity, and complications without radiation or bowel preparation. Prior studies demonstrate that IUS changes management and reduces reliance on invasive testing. This study hypothesizes that IUS will impact downstream clinical decision-making in a U.S. outpatient IBD cohort by decreasing invasive procedures and supporting appropriate treatment decisions.

Methods:

A retrospective cohort study was performed. Logistic regression and chi-square tests assessed associations between IUS use, colonoscopy referral, hospital utilization, and treatment modification. A derived “surveillance-due” variable …

A Retrospective Comparison Of Dobhoff Nasogastric Feeding Tubes To Iris Feeding Tubes, Nishant Patel Oms-Iii, Justin Le Oms-Ii, Amy Glasofer Phd, Drnp, Rn, Emilio Mazza Md, Phd

Rowan-Virtua Research Day

Background

Postpyloric feeding is essential in critically ill patients. Traditional Dobhoff tube (DHT) placement, often performed blindly, is widely used due to low cost but carries risks of misplacement and reliance on radiographic confirmation. In contrast, Kangaroo™ IRIS (camera-guided) technology enables real-time visualization during placement, potentially improving accuracy and workflow, though at higher cost.

Hypothesis

IRIS-guided placement provides comparable safety and success to DHT, with similar procedural efficacy without increasing complications.

Methods

A retrospective cohort study was conducted using the electronic medical records from multiple Virtua Health hospitals (01/01/13, through 01/31/25), including 200 patients undergoing nasogastric tube placement with DHT …

Wearable And Technology‑Assisted Gait And Balance Interventions In Parkinson’S Disease: A Systematic Review And Meta‑Analysis, Jamir Pitton Rissardo Md, Nishant Patel, Jarvish Shah, Daarsh Goradia, Pranaya Gade, Ana Leticia Fornari Caprara Md

Rowan-Virtua Research Day

Background: Wearable sensors and cue‑based technologies are increasingly used to augment rehabilitation in Parkinson’s disease (PD). However, the magnitude of benefit across clinical domains remains uncertain. Objective: This meta‑analysis aimed to quantify the effects of technology‑assisted interventions in PD. Methods: Randomized controlled trials evaluating wearable‑assisted interventions were systematically identified from PubMed. Outcomes included motor severity (Movement Disorders Society Unified Parkinson Disease Rating Scale Part III), balance (Berg Balance Scale, Mini‑BESTest, POMA balance), gait speed, walking endurance, freezing of gait (FOG‑Q/NFOG‑Q), fear of falling, and quality-of-life (PDQ‑39/PDQ‑8). Meta‑analyses were performed using random‑effects models to account for between‑study heterogeneity. Statistical heterogeneity was …

Refeeding Syndrome In A Person Experiencing Homelessness: A Case Report, James Espinosa, Jose Gerald Aragon, Md Fateha, Alan Lucerna

Rowan-Virtua Research Day

Refeeding syndrome (RFS) is a potentially life-threatening metabolic disturbance that occurs following nutritional reintroduction in severely malnourished individuals. It is characterized by rapid intracellular shifts of electrolytes—most notably hypophosphatemia—driven by insulin-mediated metabolic changes. Although commonly associated with eating disorders and chronic illness, RFS may also occur in socially vulnerable populations.

We report the case of a 64-year-old male experiencing homelessness who presented to the emergency department with weakness, muscle cramps, and confusion after resuming regular meals at a local shelter following prolonged minimal intake. Laboratory evaluation revealed severe hypophosphatemia (0.7 mg/dL), hypokalemia (3.0 mmol/L), and hypomagnesemia (1.2 mg/dL). Electrocardiogram demonstrated …

The Case For Intraprocedural Ultrasound Guidance In Lumbar Puncture--From Landmarking To Navigation In Lumbar Puncture. A Conceptual Review And Research Agenda, James Espinosa, Frank Wheeler, Robin Lahr, Sergey Medlenov, Alan Lucerna, Henry Schuitema

Rowan-Virtua Research Day

Ultrasound guidance for lumbar puncture (LP) is well established for pre-procedural landmark identification, particularly in patients with difficult anatomy. However, most current approaches discontinue ultrasound prior to needle insertion, returning the operator to a blind technique. Current emergency medicine ultrasound guided intravenous line insertion demonstrate feasibility of real-time needle visualization.  However,  the development and adoption of real-time guidance in the setting of lumbar puncture remains limited. Prior simulation work demonstrated that ergonomics, operator experience, and workflow integration significantly influence performance in ultrasound-assisted LP (Horn, Espinosa et al., 2016).  Here we make the case that LP is not a static targeting …

Pcl And Pegdma Nanoyarns Feasibility For Antimicrobial Suture Applications, Wynn Bastianelli, Dominique Hassinger, Vincent Beachley, Sean Mcmillan

Rowan-Virtua Research Day

Abstract Title: PCL and PEGDMA Nanoyarns Feasibility for Antimicrobial Suture

Nanofibers represent an innovative class of materials with diverse applications, including tissue engineering and drug delivery.¹ Among the most promising areas of research is their use in surgical sutures, particularly for complex orthopedic injuries with high re-tear rates. Polycaprolactone (PCL) nanofibers have shown promise as alternatives to standard sutures as their unique properties support superior healing compared to standard materials.² Our lab aims to further optimize these healing capabilities by adding Poly(ethylene glycol) dimethacrylate (PEGDMA), a molecule that tethers peptides to PCL nanoyarns, developing a suture with greater …

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

A Comprehensive Review Of Photothermal Therapy: Tumor Responses, Safety, And Clinical Translation, Taniya Sood

Rowan-Virtua Research Day

Background: Cancer affects 1 in 2 men and 1 in 3 women in the United States. Traditional treatments such as chemotherapy, radiation, and surgery often lack selectivity, resulting in significant systemic side effects. Photothermal therapy (PTT) is an emerging modality that utilizes light-activated nanoparticles to generate localized heat, selectively destroying cancer cells while minimizing damage to surrounding healthy tissue.

Methods: A comprehensive literature review was conducted utilizing PubMed, Embase, and Web of Science (2009–2024). Inclusion criteria included randomized controlled, cohort, and controlled trials involving adults (18+) with a confirmed cancer diagnosis. Studies were required to evaluate PTT using gold nanomaterials …

Improving Glp-1 Ra Initiation In Primary Care Through A Paper-Based Clinical Decision Support Tool, Carissa R. Bowery, Karen Carver

Epsilon Sigma at-Large Research Conference

Title: Improving GLP-1 RA Initiation in Primary Care Through a Paper-Based Clinical Decision Support Tool

Authors: Carissa R. Bowery, MSN, FNP-C; East Tennessee State University College of Nursing. Karen M. Carver, PhD, APRN, FNP-C; East Tennessee State University College of Nursing

This quality improvement project focuses on improving evidence-based pharmacologic management of adults with type 2 diabetes mellitus (T2DM) and obesity through implementation of a paper-based clinical decision support (CDS) tool in primary care. The aim is to increase initiation of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among eligible patients and improve provider adherence to current clinical guidelines.

Processes: This …

Optimizing Itpa R178c Assays Via Hplc, Jared J. Reisnouer, Wally D. Pines

2026 Symposium

Two of the major nucleotide bases in DNA and RNA (Adenine and Guanine) are derived from the purine Inosine Monophosphate (IMP). IMP may occasionally form the noncanonical nucleotide Inosine Triphosphate (ITP) within the cell and become incorporated into DNA during replication, leading to potentially lethal errors. To combat this, human cells produce the “housekeeping” enzyme Inosine Triphosphatase (ITPA) to revert ITP to IMP. A mutation of this protein that replaces the 178th amino acid Arginine with Cysteine (R178C) is associated with a fatal infantile encephalopathy. Previous assessments of enzyme-substrate binding and catalysis for ITPA variants have been run at a …

Dermal: A Multi-Input Deep Learning Model For Improving Access To Dermatological Screening, Aubreye Freeman

ATU Scholars Symposium

According to the World Health Organization's press release on December 12, 2024, global healthcare spending is dropping significantly, leaving a large percentage of the world without proper healthcare. In an attempt to alleviate this problem, with respect to the field of dermatology, we created a deep learning model, Dermatology Enhanced by Recognition and Machine Aided Learning (DERMAL), to assist in diagnosing skin conditions. DERMAL was trained on a portion of the Google and Stanford Medicine's SCIN dataset, which has more than 10,000 images of various skin conditions. The 9 most common skin conditions of the dataset were selected as the …

Improving Anesthesia Provider Confidence In The Identification, Management, And Treatment Of Postoperative Delirium, Brittany M. Whistle, Charles Dustin Phelps

Scholars Week

Purpose: Postoperative Delirium (POD) is a potentially devastating complication of anesthesia that is poorly understood by clinical staff leading to poor outcomes for surgical patients. This study is meant to determine if a focused knowledge presentation accompanied by visual aids could increase anesthesia providers confidence in identifying, diagnosing, and treating Postoperative Delirium.

Methodology: Utilizing a statistical model to analyze respondents results on a standardized test administered before and after an informational presentation with visual aids on the topic of Postoperative Delirium.

Results: Results indicated a statistically significant difference between pretest and posttest scores, with a p-value of .002, t(11) = …

When The Machine Lets Go: Designing Drug Delivery Devices Patients Can Rely On, Katie Stubits, Liam Brennan

Student Research Symposium (SRS)

Semi-automated drug delivery systems, such as closed-loop insulin pumps, smart infusion devices, and patient-controlled analgesia (PCA) tools, are transforming healthcare by improving dosing precision and empowering patients with greater autonomy. However, their safety and efficacy depend critically on trust calibration—the dynamic alignment between patient trust in automation and actual system reliability (Hoff & Bashir, 2015; Lee & See, 2004). Miscalibrated trust can lead to misuse or disuse, jeopardizing patient safety in high-stakes contexts (Fallon et al., 2010). Grounded in theories of human–automation interaction (Lee & See, 2004) and recent empirical research findings (Zheng et al., 2022), this work conceptualizes trust …

Relationships Between Clinical Symptom Scales And Eeg Biomarkers In Oud Patients, Jess Delange, Benjamin M. Latey, John Glinski, Braden Ashcraft, Jasmine Pannu, Cassidy Beatty, Lauren Knudson, Benjamin Chafetz, Bryan Fugal, Patrick Tanner Brain, N P. Griffin, Christopher Gowans, Amanda Brandaris, Amanda Page, Blake D. Harris, Sophia Delgado, Lorissa Thorpe, Kyle Bills, Andrew Payne

Annual Research Symposium

This poster examines the relationship between clinical symptom scales and electroencephalographic (EEG) biomarkers in patients with Opioid Use Disorder (OUD). Participants from inpatient substance use treatment facilities completed validated mental health and withdrawal assessments, including the COWS, PHQ-9, HAM-A, and ASRS followed by cognitive testing while undergoing 19-lead EEG recording.

Preliminary findings indicate that synthetic opioid use is associated with prolonged P300 response latency across brain regions, suggesting measurable neurophysiologic differences tied to substance type and addiction severity. The study explores how EEG metrics may complement subjective symptom reporting to provide more objective markers of addiction status, co-morbid psychiatric burden, …

The A1 Segment Of The Anterior Cerebral Artery: A Systematic Review Of Cadaveric Morphometry Studies, Marlena Muszynska, Emily Awdish, Afua Osei-Wusu, Parker Ballard

Annual Research Symposium

No abstract provided.

The P1 Segment Of The Posterior Cerebral Artery: A Systematic Review Of Cadaveric Morphometry Studies, Marlena Muszynska, Afua Osei-Wusu, Emily Awdish, Parker Ballard

Annual Research Symposium

No abstract provided.

Review Of Methodological Practices In Cadaveric Cerebral Arterial Morphometry: Variability In Contemporary Protocols (2015-2025), Marlena Muszynska, Emily Awdish, Afua Osei-Wusu, Parker Ballard

Annual Research Symposium

No abstract provided.

Myocardial Pi3k-Akt Pathway And Cardiovascular Disease Etiology, Bryson Lovorn, Brennan Kaplan

Student Scholar Symposium

Cardiovascular diseases (CVD) are the leading causes of death in the United States according to recent data from the Center for Disease Control (CDC). Myocardial infarctions, heart attacks, Coronary Artery Disease, ischemic reperfusion injuries, and hypertrophic cardiomyopathies represent common pathologies leading to the hospitalization of Americans. The etiologies of these diseases vary, however there is a common link. The phosphatidylinositol-3-kinase (PI3K) AKT pathway is a cellular pathway that is commonly overexpressed or repressed in myocytes. The human body is in an active limbo to maintain homeostasis. At a cellular level this can be simplified to a delicate balance between cell …

Unveiling Hidden Hazards: A Complementary Approach To Affordable Non-Destructive Heavy Metal Detection, Mario Faragalla, Gulsin Barwari, Makenzie Brinkoeter, Eimy Lozano-Fuentes, Isabelle Riera

Student Scholar Symposium

History has bestowed upon us vast treasures, with the Victorian Era offering a wealth of gifts, such as vibrant art and even secrets preserved in books of this period. However, concealed within the pigments that bring these works to life lie heavy metals. Not only do they pose significant health risks, but they can also be found within these pieces centuries later. Intrigued by the Winterthur project, Beaman librarians, Jan Cohu and Kayla Rutledge, discovered that our library housed some of these Victorian Era books. From there, the Beaman staff sent an inquiry to the chemistry department and Dr. Weinstein-Webb …

Implementing Evidence-Based Cluster Care To Improve Preterm Infant Stability, Kendal B. Hargrove, Mattie C. Kent

Scholars Week

Premature infants in neonatal intensive care units (NICUs) are frequently exposed to excessive handling, light, and noise, which can disrupt sleep and hinder growth. This project investigates whether current caregiving schedules at Deaconess Henderson Hospital’s NICU support adequate rest and development in preterm neonates. Analysis revealed an absence of clear policies regarding clustered care, inconsistent implementation, and limited staff understanding of its evidence-based benefits. Guided by the Roy Adaptation Model, this project proposes the development and implementation of a standardized clustered care policy to promote neonatal adaptation and stability. Evidence from multiple studies (Wang et al., 2021; Hendy et al., …

Implementing A Specific And Standardized Grading Scale For Therapeutic Injection Site Reactions To Improve Adverse Event Reporting, Priya Kale, Kavita Sarin

Research Colloquium

Up to 15.5% of patients taking biologic medication experience injection site reactions (ISRs) leading to morbidity, early discontinuation, and reduced treatment compliance. As biologic medications are increasingly used to treat chronic inflammatory conditions, including psoriasis and atopic dermatitis, there needs to be an improved understanding of ISRs. However, current methods of grading ISRs are nonspecific and unstandardized leading to a lack of understanding of medication-specific ISRs and ambiguity in perceptions of treatment tolerability. Here we aim to develop a standardized ISR grading scale for use in clinical trials. A scoping review was performed to evaluate current ISR grading scales and …