Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

A Critically Appraised Topic: Effectiveness Of Hydrogen-Rich Water Therapies In Reducing Inflammation, Bill Craig, Dawn Hammerschmidt, Jay Albrecht

Dissertations, Theses, and Projects

Inflammation is an important part of healing, but prolonged inflammation or inflammatory disease can cause excess pain and tissue damage. Hydrogen-rich water therapies have shown to have positive effects on this wide variety of conditions and may have a role in future therapeutic intervention for inflammatory conditions and acute injury care. Hydrogen is a commonly known element that has recently been the subject of scientific studies to analyze its beneficial properties when used as a therapeutic intervention. Hydrogen is physically the smallest element on the periodic table, and when two hydrogen atoms combine to form H2, it is known as …

What Are The Specific Parameters Of Cold-Water Immersion On Its Positive Effects On Recovery And Sleep In The Physically Active Population?, Landyn L. James, Jay Albrecht, Dawn Hammerschmidt

Dissertations, Theses, and Projects

Cold-water immersion (CWI) is widely used in athletic and rehabilitative settings to enhance post‑exercise recovery, yet optimal treatment parameters remain inconsistent across clinical practice. Physically active individuals frequently seek recovery strategies that improve muscle function and sleep quality, creating a need to evaluate the evidence supporting specific CWI protocols. Focused Clinical Question: The purpose of this critically appraised topic (CAT) was to determine which temperature and duration parameters of CWI most effectively improve muscle recovery and sleep in physically active populations. A focused clinical question was developed using the PICO framework. Search Strategies: Systematic reviews and meta-analyses were identified through …

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 …

Evaluating The Efficacy Of The Confusion Assessment Method For The Icu (Cam-Icu) In Reducing Length Of Stay Among Critically Ill Patients: A Scoping Review, John Simmons, Fay Nelson, Keith Hunt, Lindsey Waller, Tracy Mcclinton Dnp, Aprn, Agacnp-Bc, Hget-C, Ebp-C

Doctor of Nursing Practice Projects

Purpose/Background

Delirium is a prevalent complication among critically ill patients in intensive care units (ICUs), associated with increased mortality, prolonged hospital stays, and higher healthcare costs. The Confusion Assessment Method for the ICU (CAM-ICU) is a validated tool designed to aid in the early identification of delirium; however, systematic screening remains low among healthcare professionals. This scoping review aims to evaluate the efficacy of the CAM-ICU in identifying delirium and its potential impact on reducing ICU length of stay.

Method

            This scoping review began by establishing inclusion criteria to ensure the results were applicable to the researchers’ patient population, including …

Medication-Assisted Treatment For Patients With Substance Use Disorder And Depression: A Scoping Review, Josiane Deguenon Bsn-Rn, Elisabeth Fritz Bsn-Rn, Jesse Jean Bsn-Rn, Tucker Mckinney Bsn-Rn, Laura Reed Dnp, Aprn, Fnp-Bc, Cne, Fnap

Doctor of Nursing Practice Projects

Purpose/Background

Substance use disorder (SUD) frequently co-occurs with depression and increases relapse risk and healthcare utilization. Although medication-assisted treatment (MAT) is an evidence-based intervention for SUD, outcomes for adults with co-occurring depression remain inconsistently reported due to variation in study designs, treatment settings, and measures. This scoping review examines evidence on MAT use among adults with co-occurring depression and SUD and summarized reported clinical and healthcare utilization outcomes.

Methods

From August 2023 to November 2025, a scoping literature review was conducted on PubMed/MEDLINE, CINAHL, and the Cochrane Library, using MeSH search terms and Boolean operators to link the concepts defined …

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 …