Digestive, Oral, and Skin Physiology Commons^™

High Burden Of Elevated Fib-4 In Metabolically At-Risk Primary Care Patients: Simple Predictors To Guide Hepatic Fibrosis Triage, Ridwan Ademola Lawal, Fatimah Bello, Rashmee Patil, Juliana Yang

Research Symposium

Background: Metabolic dysfunction–associated steatotic liver disease (MASLD), including metabolic dysfunction–associated steatohepatitis (MASH), is a leading cause of chronic liver disease worldwide. Current guidelines recommend fibrosis-based risk stratification using noninvasive tools such as the Fibrosis-4 (FIB-4) index in patients with metabolic risk factors, followed by secondary assessment (e.g., transient elastography or enhanced liver fibrosis(ELF) testing) for those with elevated scores. However, data on the real-world prevalence of elevated FIB-4 in U.S. primary care populations, particularly in safety-net settings, and the downstream implications for fibrosis evaluation remain limited. We aimed to quantify the burden of elevated FIB-4 in a primary care setting …

Titanium Dioxide: An Inquiry Into The Mechanisms And Implications Of Exposure In Gut Dysbiosis And Metabolic Disorders, Meghan Gardiner

Senior Honors Theses

Titanium dioxide (TiO₂) is one of the most prevalent food additives utilized in commercial products in the United States. While TiO₂ was originally hailed as a nontoxic and cost-effective additive, studies are beginning to reveal that TiO₂ is not as safe as it once seemed. TiO₂ may contribute to the development of insulin resistance and metabolic disorders through direct and indirect mechanisms. The compound induces gut dysbiosis, leading to alterations in bacterial metabolites and pro-inflammatory cytokines, which results in the selective resistance of glucocorticoid receptors. Additionally, TiO₂ itself can translocate from the gut to …

The Impact Of Gastric Sleeve And Roux-En-Y Gastric Bypass On Chief Cell Function And Protein Digestion In Obese Patients, Garikoitz Mikel Gainza

Honors Undergraduate Theses

Obesity has become one of the largest global health concerns of the 21^st century, correlating with numerous associated diseases. To help address the growing prevalence and burden of obesity, sleeve gastrectomy and Roux-en-Y gastric bypass have become two commonly performed surgical procedures done to promote weight loss by altering the anatomical structure of the stomach and surrounding organs of the gastrointestinal system. Although the benefits of improved metabolism linked to these surgical procedures are well studied, their impact on the physiology of gastric cells, and more specifically chief cells as they relate to protein digestion post-surgery, is yet to …

A Hard Problem: Managing Constipation In The Geriatric Population, William G. Jones, Veeraen Jonnalagadda, Alexandra E. Thomson, Victoria Grumbles, Chase Cottle, Christian Robertson, Maulikkumar Patel

HCA Healthcare Journal of Medicine

Constipation is a common condition among geriatric patients with different presenting symptoms and potential serious complications. Additionally, the condition causes a significant burden on our healthcare system. Here, we summarized recommendations from several societies, including the American College of Gastroenterology, American Geriatrics Society, and American Academy of Family Physicians to provide guidance on managing constipation with geriatric patients. Our aim was to emphasize the importance of prevention of constipation in this population and methods to do so. We also give recommendations on how to manage constipation when it does develop and how to manage it across different healthcare settings. These …

Impact Of Aromatherapy On Surgical Patients' Perceived Nausea And Vomiting, John Brennan, Ryan Brennan Bs, Sue Garrison Ma, Bsn, Rn, Cheryl Green, Evelyn Jacovino Msn, Rn, Cmsnl, Cynthia Martins Msn, Rn, Shelly Simonet Bsn, Rn, Jannet Serra Ma, Bsn, Rn, Beth Williams Dnp, Rn, Ec-Bc, Andrew Quito Bsn, Mba

Posters

Postoperative nausea and vomiting (PONV) is the most common adverse effect of surgery. In the United States, it is estimated that 20- 30% of all surgical encounters, or 75 million Americans yearly experience some form of PONV. Holistic management of PONV has the potential to save a significant amount of resources when compared to standard treatment modalities (Amirshahi et al., 2020; Asay et al., 2019).

Prior to implementation of this quality improvement project, it was estimated that roughly 20% of orthopedic surgery patients at Bridgeport Hospital Milford Campus experienced PONV, a serious practice concern. The goal of this project was …

Gut Feeling: A Holistic Digital Tool For Managing Irritable Bowel Syndrome And Food Sensitivities, Hailey M. Olberding

Honors Program: Senior Projects (Public)

Irritable Bowel Syndrome (IBS) and food intolerances are increasingly prevalent chronic gastrointestinal (GI) conditions that significantly impair quality of life. While the low-Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols (FODMAP) diet has demonstrated success in symptom management, current digital tools fail to offer integrated, user-friendly platforms that holistically track contributing health factors. Gut Feeling is a mobile app (Appendix 1) and complementary website (Appendix 2) developed to fill this gap. By incorporating symptom logging, food intake tracking and complementary database, stress and sleep monitoring, and trend analysis, this platform empowers users to better understand their bodies and manage GI symptoms proactively. …

Screening For Relative Energy Deficiency In Sport (Reds) And The Female Athlete Triad In Female Undergraduate Collegiate Athletes: A Quality Improvement Project, Maria A. Marziano

West Chester University Doctoral Projects

This quality improvement (QI) project investigated female collegiate athletes’ knowledge and prevalence of Relative Energy Deficiency in Sport (REDs) and the Female Athlete Triad (Triad). The increase in female athletics brings a growing concern for performance-related health risks, including low energy availability (LEA), menstrual dysfunction, and low bone mineral density (BMD). This study assessed the effectiveness of education and self-screening in identifying at-risk athletes and encouraging resource application for intervention. A mixed-methods design was employed, utilizing retrospective data along with pre- and post-intervention surveys. The study involved 33 female collegiate athletes from lean endurance sports, assessing knowledge, risk factors, and …

Elucidating The Adverse Effects Of Chronic Pfos Exposure On Gastrointestinal Pathology And Colorectal Cancer, Jerika Durham

Theses and Dissertations--Toxicology and Cancer Biology

Commonly referred to as "forever chemicals," per- and polyfluoroalkyl substances (PFAS) have been linked to a number of detrimental health effects, including an elevated risk of cancer. One "long-chain" subtype of PFAS, perfluorooctanesulfonic acid (PFOS), has a long elimination half-life and a significant propensity for bioaccumulation. Because PFOS is commonly found in drinking water, the gastrointestinal system absorbs it at a high rate. Recent studies demonstrate that PFAS exposures promote intestinal inflammation and gut barrier dysfunction. However, how a long-term PFOS exposure affects colorectal cancer (CRC) progression is not known. Therefore, the purpose of this research is to understand how …

Reducing The Incidence Of Nosocomial Aspiration Pneumonia In Adult Oncology Patients Through Improved Compliance With Oral Hygiene Protocols, Rickey Maung

Master's Projects and Capstones

Objective: Oncology patients undergoing chemotherapy are at increased risk of mucosal barrier injuries and aspiration pneumonia, with current aspiration pneumonia rates exceeding target levels. Enhanced oral hygiene protocols and improved compliance have been shown to reduce these complications in this vulnerable population.

Context: The microsystem under review comprises six oncology units within Hospital A, a major medical center in California. Aspiration pneumonia, frequently linked to mucosal barrier injuries, poses a significant threat to patient safety and increases treatment costs and complications in oncology care. Recognizing the critical need to address this issue, an aspiration pneumonia task force has prioritized efforts …

Investigating A Mediterranean Dietary Pattern With White Potatoes On Cardiometabolic Health In Adults With Pre-Diabetes From Diverse Racial And Ethnic Backgrounds, Sedona Gronna, Neda S. Akhavan, Sara K. Rosenkranz, Richard R. Rosenkranz

Undergraduate Research Symposium Posters

In the United States, one in three adults has pre-diabetes, and 80% are unaware that they are at risk of developing type-2 diabetes (T2D). Elevated blood glucose levels are associated with an increased risk of heart disease, obesity, dyslipidemia, and hypertension. African-American and Hispanic individuals are disproportionately affected by pre-diabetes and its complications, such as arterial stiffness and obesity, compared to Caucasians. Approximately 70% of those with pre-diabetes may develop T2D, therefore it is crucial to find effective ways to manage and reverse these conditions. Potatoes, which contain a good source of resistant starch, potassium, and other beneficial nutrients, might …

Pancreatic Cancer; From Effective Prevention And Early Diagnosis To Personalized Therapy, Adrian Silaghi, Dragos Serban, Bogdan Gaspar, Valentin Verlas, Dragos Epistatu, Cristian Paius, Roxana Sfetea, Liliana Andronache, Ioana Paunica, Irina Ruxandra Strambu, Daniela Gabriela Bălan, Alexandru Florin Motofei, Vlad Denis Constantin

Journal of Mind and Medical Sciences

Despite substantial improvements in survival rates for most cancers, pancreatic cancer still remains a leading cause of death from malignancy. The disease has no symptoms in the initial stages, it can early invade the surrounding organs, and treatment methods have poor long-term prognosis. In addition, this neoplasia is starting to be diagnosed more and more frequently in young people. High incidences have been found in developed regions such as Europe, North America, Australia, but recent data show that this condition is increasing in other regions as well. Pancreatic cancer involves multiple factors such as cigarette smoking, obesity, diabetes, alcohol consumption, …

Extraction Method Effects On Structural Properties And Functional Characteristics Of Dietary Fiber Extracted From Ginseng Residue, Xiaoyu Feng, Kashif Ameer, Karna Ramachandraiah, Guihun Jiang

School of Medicine Faculty Publications

In this research, the dietary fibers (DFs) from ginseng residue were extracted by employing three different extraction methods (alkaline: AL, acidic: AC, enzymatic: EN). The extracted DFs were characterized in terms of their structural and functional properties. The results clearly showed that, regardless of the extraction methods, all DF samples exhibited representative infrared spectral features. The DF extracted by AC (citric acid) had more porous structures with a looser configuration, in conjunction with high apparent viscosity, whereas the DF extracted by EN (α-amylase and protease) exhibited higher thermal stability. Moreover, the monosaccharide composition of the DF samples was significantly influenced …

Effects Of Synergistic Application Of Viscozyme L–Wet Ball Milling On Structural, Physicochemical And Functional Properties Of Insoluble Dietary Fiber From Ginseng Residue, Guihun Jiang, Kashif Ameer, Karna Ramachandraiah, Xiaoyu Feng, Chaoyi Tan, Nanjie Cai

School of Medicine Faculty Publications

Synergistic effect of Viscozyme L with wet ball milling treatment on structural, physicochemical and functional aspects of insoluble dietary fiber (IDF) from ginseng residue were examined. SEM examination showed that IDF extracted by Viscozyme L in conjunction with wet ball milling (WBE-IDF) exhibited loose microstructural arrangement, and particle size of WBE-IDF was much smaller than that of IDF extracted by Viscozyme L (E-IDF) and along IDF (untreated). The FTIR spectra demonstrated the variations in the peak intensities in three modified ginseng IDFs. Besides, the highest thermal stability and viscosity was displayed by WBE-IDF among examined samples. In addition, WBE-IDF has …

Effects Of Limosilactobacillus Reuteri Strains Pta-126787 And Pta-126788 On Intestinal Barrier Integrity And Immune Homeostasis In An Alcohol-Induced Leaky Gut Model, Dharanesh Gangaiah, Min Gu, Aline Zaparte, Olaf Will, Laurie C. Dolan, Anthony Goering, Jason Pillai, Shrinivasrao P. Mane, German Plata, Emily B. Helmes, David A. Welsh, Arvind Kumar Mahajan

School of Graduate Studies Faculty Publications

Intestinal barrier is a first line of defense that prevents entry of various harmful substances from the lumen into the systemic environment. Impaired barrier function with consequent translocation of harmful substances into systemic circulation (“leaky gut”) is a central theme in many gastrointestinal, autoimmune, mental, and metabolic diseases. Probiotics have emerged as a promising strategy to maintain intestinal integrity and address “leaky gut”. Using in silico, in vitro and avian in vivo analyses, we previously showed that two novel L. reuteri strains, PTA-126787 (L. reuteri 3630) and PTA-126788 (L. reuteri 3632), isolated from broiler chickens possess favorable safety profiles. Consistent …

Preventive Effects Of Quercetin On The Leaky Gut By Suppression Of Il-1beta-Induced Transcription Factors Involved In An Inflammatory Pathway In Colonic Epithelial Cells, Wannaporn Chayalak, Sumpun Thammacharoen, Chatsri Deachapunya, Sutthasinee Poonyachoti

The Thai Journal of Veterinary Medicine

Flavonol quercetin (Q), found in vegetables and fruits, demonstrates the most potent anti-inflammatory effect. The preventive effect and cellular mechanisms of Q (Q1, Q10, and Q100 µM) on IL-1β induced leaky gut via the signaling molecules of inflammatory pathway, NF-κB p65-iκB/or p38/ERK1/2/MLCK/phospho(p)-MLC were investigated in Caco-2 cells. The cytotoxic effect of Q was initially determined by MTT assay. Transepithelial electrical resistance (TER) and apical-to-basolateral fluorescein isothiocyanate-labeled dextran (FD-4) flux were used to determine paracellular permeability. The protein expression of signaling molecules was examined by Western blot analysis, and their target MLCK mRNA expression was determined using real-time PCR. All Q …

Understanding The Role Of Mastl In Colon Homeostasis And Colitis-Associated Cancer Development, Kristina Pravoverov

Theses & Dissertations

Colitis-associated cancer (CAC) is the most devastating complication of longstanding inflammatory bowel disease (IBD). Understanding the mechanisms underlying the switch from damage-repair to dysplasia in IBD is critical for identifying novel therapies to facilitate mucosal healing while mitigating CAC risk. Microtubule-associated serine-threonine kinase-like (MASTL), though crucial in cell growth and repair, is upregulated in sporadic colorectal cancer and CAC. This study sought to delineate the role of MASTL in colitis and CAC development.

First, we examined whether MASTL is associated with colitis and recovery. Review of publicly available data found significant elevation of MASTL and interleukin (IL)-22 in biopsies from …

Sump Syndrome: The Forgotten Cause Of Painless Jaundice In The Elderly, Mark Ayoub, Amna Anees

Journal of Community Hospital Internal Medicine Perspectives

Painless jaundice is a common presentation of abdominal malignancy seen in elderly patients. While malignancy may be a common cause of obstructive jaundice in that population group, anchor bias should always be avoided. We present a case of an elderly woman who presented with painless jaundice and weight loss. She had a very remote history of cholecystitis. She was found to have Sump syndrome due to a stricture at the Choledochoduodenostomy (CDD) site. She underwent endoscopic retrograde cholangiopancreatography (ERCP) with stent placement which shortly led to resolution of her jaundice. Biopsy from the stricture site came back negative for malignancy.

Gut Microbiome And Nutrition Interplay In Regulating And Improving Autism Spectrum Disorder Related Social Symptoms, Irenonsen Juliet Eigbe, Christian Moya Gamboa, Jana Gjini, Jaydeep Mukherjee, Susrut Dube

Rowan-Virtua Research Day

The composition of the gut microbiome has been shown to play a role in the onset of neurological disorders, including Autism Spectrum Disorder(ASD). A small variety of recent research articles identify a possible link between onset and severity of ASD related behaviors and the composition of the gut microbiome. The purpose of this review is to identify gaps in the current understanding of the role that nutrition plays in changing the gut microbiome and subsequently altering the onset and severity of behavioral phenotypes in children with ASD. Inclusion criteria comprises peer-reviewed publications relating to children with autism. Exclusion criteria consists …

Recurrent Nontraumatic Subgaleal Hematomas In A Pediatric Patient With Sickle Cell Disease, Irtiza N Sheikh, Olayinka Okeleji, Rabya Afzal, Eliana Bonfante, Monica Kodakandla, Neethu M Menon

Faculty, Staff and Student Publications

Spontaneous subgaleal hematoma in pediatric patients with sickle cell disease (SCD) is a rare occurrence that can present with symptoms mimicking ischemic stroke, a known complication of SCD. However, unlike ischemic stroke, subgaleal hematoma is nonlethal and can be managed conservatively without major sequelae. Here, we present the case of an adolescent with SCD who presented with 2 episodes of subgaleal and epidural hematomas, 2 years apart. The latter episode occurred while on crizanlizumab, an anti-P-selectin antibody, approved for use in SCD in 2019 to reduce the number of acute pain crises. We demonstrate the diagnosis of subgaleal hematoma and …

Development Of Solitary Keratoacanthoma From A Cutaneous Wart, Joshua M. Ninan, Veronica Salazar

Research Symposium

Background: Common cutaneous warts, referred to in medicine as verrucae vulgaris, are proliferative lesions caused by human papillomavirus. These lesions are mostly benign and usually resolve without incident, except in the case of the patient mentioned in this report. Our patient developed a solitary keratoacanthoma, currently accepted as a clinical variant of squamous cell carcinoma, as a result of several risk factors and traumatic exposure. The current literature does not have an established association of HPV with solitary keratoacanthomas. This case report explores the presentation and pathogenesis of solitary keratoacanthomas within the setting of HPV.

Case Presentation: 48-year-old Caucasian female …