Osteopathic Medicine and Osteopathy Commons^™

Do Research Day Program 2026, Lincoln Memorial University, Debusk College Of Osteopathic Medicine

DO Research Day

DO Research Day was hosted by the DeBusk College of Osteopathic Medicine at Lincoln Memorial University. This program features abstracts from the LMU-DCOM community.

Gene Therapy Access, Financing, And Equity For Medicaid Populations: A Scoping Review To Inform Tenncare Coverage Policy, Trey Henderson, Brandy Fuesting

DO Research Day

High-cost gene therapies lists at $0.85M–$3.5M per treatment, and Medicaid coverage requirements obligate state programs like TennCare to confront reimbursement they were not designed to absorb. Objective: To map what existing literature reports on gene therapy access models, financing, equity, and coverage barriers to inform TennCare policy. Methods: JBI/PRISMA-ScR scoping review; 245 sources charted across four themes (access barrier, financing model, equity focus, payer relevance, study design). Results: Pricing/affordability is the dominant barrier for patients (67%). Outcomes-based contracts are the leading proposed financing mechanism and cluster in Medicaid-relevant work. Conclusions: Evidence points to outcomes-based, multi-state Medicaid financing, anchored by the …

Beyond Burnout: A Systematic Review Of The Mental Health Impact Of The Covid-19 Pandemic On Physicians In The U.S., Tiffany Iheanacho, Fred Wenger, Etianna E. Cadet, Yahya Korteh, Muhammed Gaye

DO Research Day

Background: Five years after the COVID-19 pandemic, its long-term psychological impact on physicians remains important to assess. Physicians experienced PTSD, burnout, anxiety, insomnia, distress, and depression, yet few studies reported outcomes disaggregated by race, limiting understanding of disparities among marginalized physicians.

Objectives: To quantify the prevalence of mental health outcomes among U.S. physicians during COVID-19 and identify interventions and systemic strategies to mitigate physician mental health burdens during future public health emergencies.

Method: Following PRISMA guidelines, PubMed, Google Scholar, and the Lincoln Memorial University Library were searched for studies published from 2020–2025. Of 48 studies identified, 21 met inclusion criteria. …

Association Between Nutrition Access And Birth Outcomes In Rural Vs Urban Tennessee: A County-Level Analysis, Adiva Haq, Nathalie Mendoza-Salas, Mary Carrasco, Natalie E. Freeman Phd

DO Research Day

Food insecurity and limited access to nutritious foods are linked to gestational diabetes, low birth weight, and maternal stress.1,3 Rural residents often have fewer full-service grocery stores and rely on convenience stores with little fresh food.4 Rural communities may also face broader gaps in health resources and care,2 which may widen maternal and infant health disparities. This matters in Tennessee, where rural counties make up a substantial proportion of the state’s area and population. Few studies have examined food insecurity and birth outcomes across Tennessee, especially by rurality. We evaluated these associations across all 95 counties, emphasizing rural–urban differences, to …

Impacts Of Semaglutide On Monocyte–Endothelial Crosstalk In Atherosclerosis Pathophysiology, Yukta Bichala, Seeba Gupta, Kathryn Pofok, Abrar Hussain, Andrea Linares, Mir S. Adil Phd

DO Research Day

Background: Atherosclerosis is a chronic inflammatory disease in which monocyte-endothelial interactions contribute to early plaque development through inflammatory activation of endothelial adhesion molecules, including ICAM-1 and VCAM-1. Although the GLP-1 receptor agonist semaglutide reduces cardiovascular events clinically, its direct effects on inflammatory monocyte-endothelial interactions remain unclear. Objective: To establish an in vitro model of monocyte-endothelial interactions under inflammatory conditions and investigate whether semaglutide reduces TNF-α-induced monocyte adhesion and migration across activated endothelial cells. Methods: EA.hy926 endothelial cells and THP-1 monocytes were cultured under optimized conditions. TNF-αwas used to induce endothelial inflammation, with PBS as a negative control and atorvastatin as …

Slicing Through Innovation: Assessing The Durability And Effectiveness Of 3d Printed Scalpel Handles, Christopher Root, Chad Clark, Stephen Mcnichol, Natalie Freeman

DO Research Day

Advancements in 3D printing technology have revolutionized the manufacturing of medical instruments, offering new possibilities for creating customized and cost-effective tools. This study investigates the mechanical properties and breaking points of 3D printed scalpel handles using three different thermoplastic materials: Polyethylene Terephthalate Glycol (PETG), Polylactic Acid (PLA), and Acrylonitrile Butadiene Styrene (ABS). The handles were designed to replicate standard surgical scalpel dimensions and were printed using identical parameters across all samples to ensure consistency. Mechanical testing, including tensile and flexural strength tests, was conducted on all specimens to determine their breaking points under stress typically encountered during surgical procedures. Results …

Prolonged Hormonal Contraceptive Use And Reproductive Recovery: A Narrative Review Of Fertility Outcomes, Hannah Himsl, Beverly Hamilton Ph.D

DO Research Day

Background: Hormonal contraceptives are widely used for pregnancy prevention and management of gynecologic conditions. Because these methods alter endocrine function, many women worry that prolonged use may make it harder to become pregnant after stopping. This review examines current evidence on fertility recovery following long-term hormonal contraceptive use.

Objective: To evaluate evidence regarding:

• Return to fertility after discontinuation
• Differences among contraceptive methods
• Effects on ovarian reserve markers (AMH and AFC)
• Long-term reproductive outcomes
• Clinical implications for patient counseling

Methods:

• Design: Narrative literature review
• Databases: PubMed/MEDLINE, Embase, Web of Science, Google Scholar, hand search of Fertility and Sterility
• Search Period: December …

Graphite Foreign-Body Granuloma Decades After Pencil Trauma: A Melanoma Mimic, Caddie Nguyen, Thomas Brown, Do, Bruce Green, Md, Wang Cheung,

DO Research Day

Pigmented lesions arising at sites of remote trauma can create diagnostic uncertainty when their clinical appearance overlaps with melanocytic neoplasms. A 64-year-old man presented with an asymptomatic 6-mm blue dermal nodule on the left fifth digit at the site of a penetrating pencil injury sustained during childhood. After remaining unchanged for decades, the lesion gradually enlarged over three years and produced mild nail plate deformity without periungual or subungual pigmentation. Cellular blue nevus, nodular melanoma, and graphite foreign-body granuloma were considered. Shave biopsy revealed a well-demarcated intradermal lesion containing abundant dark amorphous pigment and sclerosis. Higher-power examination demonstrated coarse granular …

Differences In Genetic Testing Perspectives Between Adolescents With Sickle Cell Disease And Parents, Danielle Johnson, Liza-Marie Johnson, Yunusa Olufadi, Guolian Kang, Ambria A. Williams, Rakhshanda Ramzan, Ozan Gurcan, Meaghann S. Weaver

DO Research Day

Background: Sickle cell disease (SCD) is one of the most common inherited genetic disorders worldwide and disproportionately affects individuals of African ancestry. Despite advances in genomic medicine, these populations remain underrepresented in genomic research, potentially limiting the equitable application of genetic discoveries. As genetic testing becomes increasingly integrated into clinical care, understanding patient and family perspectives is important for effective communication, informed decision-making, and implementation.

Objectives: To examine attitudes and preferences regarding genetic testing among adolescents with SCD and parents of children with SCD in order to inform communication strategies, informed consent, and patient- and family-centered care.

Methods: We analyzed …

Racial And Socioeconomic Disparities In Time To Treatment Initiation In Acute Myeloid Leukemia, Michael Amankwaah, Bryan Ortiz, Katherine Zhou, Thuy Ho, Patrick Willard, Jinlei Zhao, Faith Reed, Keri R. Maher

DO Research Day

Acute myeloid leukemia (AML) is an aggressive hematopoietic malignancy with poor prognosis in adults despite therapeutic advances. Although cytomolecular risk, functional status, and comorbidities are established prognostic factors, social determinants of health (SDOH), including socioeconomic factors, geographic location, literacy, social support, and structural racism, may also influence AML care and outcomes. This study examined whether SDOH burden was associated with time to treatment initiation and early mortality.

Association Between Subendocardial Viability Ratio And Body Anthropometrics, Brayden Eftink, Mikaela K. Brown, Nicholas A. Carlini, Bradley Fleenor, Matthew P. Harber

DO Research Day

Lower myocardial perfusion, assessed non-invasively as the subendocardial viability ratio (SEVR), is associated with greater cardiovascular disease (CVD) risk. Waist circumference (WC) and body mass index (BMI) are two metrics associated with CVD risk, yet less is known if these factors are associated with SEVR. We hypothesized a higher WC and BMI will be correlated with a lower SEVR.

Investigating The Effects Of Semaglutide On Hepatic Cytochrome P450 Enzyme Expression, Maanasi Bulusu, Kavya Vasudevan, Mir S. Adil Phd

DO Research Day

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor agonist widely used to treat type 2 diabetes and obesity. Because many patients taking semaglutide also use other medications, understanding its potential effects on drug metabolism is important. Hepatic cytochrome P450 (CYP450) enzymes metabolize many commonly used medications, and changes in their expression may alter drug levels and treatment response. However, the effects of semaglutide on hepatic CYP450 expression remain poorly understood.: To determine whether semaglutide alters hepatic CYP450 enzyme expression and establish a human liver cell model for studying its potential effects on drug metabolism. Publicly available mouse gene expression data (GEO …

Effects Of Warm And Cold Ischemia On The Human Myocardium Over Time, Shawnaleh Cada, Kenneth Bedi, Eliot Peyster, Yoshikazu Suzuki, Surendra Dasari, Kenneth B. Margulies

DO Research Day

Background: Myocardial protection strategies employed in cardiac surgery and transplantation have centered around in situ cardioplegic arrest combined with hypothermic cooling to mitigate myocardial damage and reperfusion injury. The cardioplegic solution is delivered directly to the myocardium at 4°C, producing electromechanical silencing and reduced metabolic demand, while the patient is typically cooled systemically to ~33°C. In transplantation static cold storage at ~4°C has been the standard method for preserving donor hearts for the past 60 years. A handful of cardiac surgical reports have examined warm-ischemic myocardium, but the molecular trajectory of myocardium receiving neither protection (mimicking infarction or the warm …

A Retrospective Analysis Using The National Health And Nutrition Examination Survey (Nhanes) To Investigate Food Insecurity On Phq9 Score, Dornu Biragbara, Amanda Mccoy, Jaimini Chauhaun-James

DO Research Day

Food insecurity is an important social determinant of health that has been consistently associated with poorer mental health outcomes. Prior U.S. NHANES research found that food insecurity is significantly associated with depression among adults, with the worst being among individuals experiencing very low food security. The relationship between food insecurity and mental health may also vary according to sociodemographic factors, including sex/gender, race/ethnicity, education, marital status, and socioeconomic characteristics. Food insecurity may affect mental health through mechanisms including financial stress, uncertainty surrounding basic needs, and sleep disturbance. This study used NHANES 2021-2023 to examine the association between household insecurity and …

Barriers To Healthcare Utilization Among First- And Second-Year Medical Students: A Cross-Sectional Survey Study, Yusuf Ahmed, Lindsey Miller Phd

DO Research Day

Background: Medical students face compounding stressors that may deter them from seeking their own healthcare. This study examined the prevalence of healthcare avoidance and its associated barriers among first- and second-year medical students.

Methods: A cross-sectional electronic survey was administered to 1181 first or second-year medical students. Of 106 responses, 97 met inclusion criteria. Spearman rank-order bivariate correlation assessed relationships between financial stress, academic stress, self-reported healthcare utilization change since starting medical school, and rated barriers to care (financial concerns, lack of time, academic stress, fear of diagnosis, and transportation). Holm-Bonferroni correction was applied to control for multiple comparisons. Healthcare …

Development And Research Of A 3d-Printed Cricothyroidotomy Model, Sydney Dills, Matia Fagen, Ojash Patel, Joshua Krech, Cory Kim

DO Research Day

Background: Cricothyrotomy is a last-resort emergency procedure that is performed due to airway obstructions. The importance of this procedure isn’t well represented by traditional training models as they lack anatomical accuracy, complexity, and structures.

Objectives: The objective of this project is to develop a highly realistic, anatomically detailed neck model for practicing cricothyrotomy using modern 3D techniques.

Method: De-identified CT imaging data was segmented into layers of neck structures using 3D Slicer and imported into Blender as STL files, where the surfaces were cleaned, enhanced, superimposed, and solidified to create digital tissue layers and casting molds. The molds were exported …

Investigating Monocyte–Endothelial Interactions: Development Of An In Vitro Model Of Doxorubicin-Associated Endothelial Dysfunction, Kiley Moore, Mikah Chandler, Trinity Soto, Samyuktha Athreya, Andrea Linares, Kavya Vasudevan, Mir S. Adil Phd

DO Research Day

Doxorubicin (DOX) is an effective chemotherapeutic agent whose clinical use is limited by cardiovascular toxicity. In addition to direct cardiomyocyte injury, vascular endothelial dysfunction may contribute to chemotherapy-associated cardiovascular injury. Our broader research investigates whether DOX-induced monocyte changes influence endothelial cells through secreted factors and potentially extracellular-vesicle-associated signaling. Preliminary data demonstrated that DOX increases human endogenous retrovirus-K (HERV-K) mRNA expression in THP-1 monocytes. We sought to establish an in vitro monocyte–endothelial conditioned-medium transfer model and identify appropriate controls for evaluating monocyte-derived effects on endothelial cells. THP-1 monocytes and EA.hy926 endothelial cells were cultured under optimized conditions. As an initial model-development …

Development Of A Standardized Pathway For Management Of Pediatric Severe Traumatic Brain Injury, Jordyn White, Joseph Tannuzzo, Joanelle A. Bailey

Research Projects

Background: Traumatic brain injury (TBI) is the leading cause of death and disability for pediatric patients. Approximately 5.4 million children globally sustain a TBI, with 45,500 deaths annually. Severe TBls (8 on the Glasgow Coma Scale) account for the majority of these fatalities. Patients also experience significant disability and have lifelong effects on health and development.

Method: We performed a structured review of contemporary pediatric severe TBl guidance, including the Brain Trauma Foundation guidelines1, institutional clinical pathways2, and relevant peer-reviewed literature3-8_ Recommendations were compared across key domains including initial stabilization and imaging, neuromonitoring, intracranial pressure (ICP) and cerebral perfusion pressure …

Development Of A Standardized Pathway For Management Of Pediatric Severe Traumatic Brain Injury, Jordyn White, Joseph Tannuzzo, Joanelle A. Bailey

DO Research Day

Background: Traumatic brain injury (TBI) is the leading cause of death and disability for pediatric patients. Approximately 5.4 million children globally sustain a TBI, with 45,500 deaths annually. Severe TBls (8 on the Glasgow Coma Scale) account for the majority of these fatalities. Patients also experience significant disability and have lifelong effects on health and development.

Method: We performed a structured review of contemporary pediatric severe TBl guidance, including the Brain Trauma Foundation guidelines1, institutional clinical pathways2, and relevant peer-reviewed literature3-8_ Recommendations were compared across key domains including initial stabilization and imaging, neuromonitoring, intracranial pressure (ICP) and cerebral perfusion pressure …

Diabetes Mellitus And Wound Care Gaps Among Unhoused And Temporarily Housed Individuals In Knoxville, Tn, Andrew Tenaglia, Emily C. Wyatt, Danielle Darter

DO Research Day

Background: Individuals experiencing homelessness face disproportionately high rates of chronic disease and wound-related complications due to limited access to preventive healthcare, hygiene resources, and longitudinal medical management. Street medicine programs provide an opportunity to identify and treat wounds before progression to severe infection or operative intervention.

Objectives: To characterize the prevalence and distribution of diabetes mellitus and wound related conditions among patients receiving care through Knoxville Street Medicine Outreach (KSMO).

Method: A retrospective chart review was performed using de-identified electronic medical records from 604 patients treated by KSMO between June 12, 2024, and July 10, 2026. Patients with documented diabetes …