Summer Interdisciplinary Research Symposium (SIReS)

This experiment aimed to test the limits of environmental extremes that Neurospora crass could withstand. Due to our limited ability to manipulate all conditions simultaneously, these conditions were studied independently. To study low-pressure effects on N. crassa, inoculated plates were placed in a vacuum chamber at varying pressures to see what growth effects would transpire, including the search for the threshold for development. High gravity experiments were conducted by inoculating nutrient media tubes, running them in a centrifuge at increasing speeds, measuring in revolutions per minute, and finally evaluating growth length up the sides of the tube. This procedure allows us to see how the fungi grows directly against gravity. The low-pressure experimental results showed that N. crassa was not completely hindered by lowering the pressures and when compared to the control, both sets of conditions grew about the same. High-gravity experimental results showed a negative linear relationship between relative centrifugal force and average growth up the centrifuge tube. The low and high gravity, low pressure, and temperature experiments suggest that Neurospora crassa may survive and grow in the environment found on Mars should the proper nutrients be available.

In the colon, the Cl-driven fluid secretion is dependent on the basolateral Na+ K+ Cl- cotransporter 1 (NKCC1). Activation of protein kinase C (PKC) causes the internalization of NKCC1. However, the PKC-dependent signal causing NKCC1 internalization is not known. We hypothesize that ubiquitin may be the signal responsible. We used Madin-Darby Canine Kidney (MDCK) cells expressing eGFP-tagged NKCC1 to monitor its internalization using fluorescent microscopy. We used phorbol 12-myristate 13-acetate (PMA) which activates PKC and PYR-41 (dissolved in DMSO) to inhibit ubiquitin ligase. Finally, we combined both PYR+PMA to test whether inhibiting ubiquitin ligase will reduce the effect of PKC on NKCC1 internalization. We used FIJI to count the number of internalized NKCC1 vesicles and the number of nuclei. Our results, calculated as vesicles per cell, were as follows: control (3.6±0.6 vesicles/cell, n=18), DMSO (2.4±0.5, n=18), PMA (12.6±3.7 vesicles/cell, n=12), PYR (5.6±0.8 vesicles/cell, n=30), and PYR+PMA (4.5±0.4 vesicles/cell, n=18). A one-way ANOVA found a significant difference between our conditions (p=<0.001). A Tukey’s post-hoc test showed that PMA significantly increased internalization compared to control (p=<0.001), PYR+PMA had significantly less internalization than PMA alone (p=<0.001), and control vs PYR was not significant (p=0.7). Our results suggest that ubiquitin may be the signal responsible for the internalization of NKCC1 during PKC activation.

Zeolites are a class of materials that are composed of oxygen, silicon, and aluminum with channels embedded in the crystalline structure. Zeolites have many applications, some of which include water purification, biomass conversion, or as molecular sieves. The zeolite’s crystal structure allows them to act as a host for smaller guest molecules without chemical bonding between the host and guest molecules. An example of a guest dye molecule is Brooker’s Merocyanine. Brooker’s Merocyanine is zwitterionic, where there are opposite charges on each end, and is a unique property that could be used to enhance the dye organization within the channel. By combining the host zeolite with the guest molecule Brooker’s Merocyanine, the dye is expected to go into the zeolite channels by a cation exchange process, based on previous work. This project focused on a zeolite known as Mordenite, chosen due to this lab’s previous work with other similar zeolites studied with Brooker’s Merocyanine that included LTL and ZSM-5. The purpose of this project was to optimize the combination of the Mordenite and Brooker’s Merocyanine. We used UV-Visible spectroscopy to confirm the dye is interacting with the zeolite. Dye loading Mordenite was most successful when refluxing the sample in acidic aqueous dye solution in the dark overnight with stirring. Through these experiments, we found that Mordenite can interact with Brooker’s Merocyanine more than LTL or ZSM-5.

Bacterial and fungal infections are among the greatest causes of death worldwide. With the development of more adept antimicrobials comes resistant superbugs. Because of this, the need for new and alternative pathways for fighting these diseases is both necessary and prevalent. Previous students have worked with extracts of the Argemone mexicana plant to identify key molecules that give the plant its antimicrobial properties. Our work centers around berberine, one of the key molecules, and designing and synthesizing variants. The goal is to create and test bioactive molecules in order to discover new, more potent, antimicrobial drugs. Through different coupling reactions, reductions, aminations, etc. we have created new variants of berberine. We have tested different pathways and reaction conditions to enhance our product and yield. The reactions we perform will lead us to the development of new variants and new antimicrobial drugs.

Air quality makes up a large portion of pollution. An important metric is particulate matter (PM), which can vary in sizes less than one micron and greater than ten microns and is measured in micrograms per cubic meter. Time was dedicated to measuring the concentration of PM using low-cost PurpleAir (PA) sensors in Northwest Indiana (NWI), locating the particles origins, reading articles and papers for appropriate conversion factors (CF), and running experiments on the PA sensors. The PA sensors take one data point every ten seconds. That equates to more than three million data points per sensor per year, while multiple PA sensors are operating in NWI. Previous work has relied on Excel for generating monthly and yearly plots and distributions of PM concentration. Utilizing Python for data processing has significantly reduced the time to get to the analyze step. Other issues surrounding the PA sensors is whether they are providing a correct and unbiased concentration to other commercial and scientific grade instruments. This has led to searching and optimizing for the best CF equation(s) and running high-grade sensors alongside PA sensors. Many questions surround the PA instruments for whether they are a high-quality tool for air quality research. Comparing PA data alongside the Indiana Department of Environmental Managements sensors is vital and has revealed issues in IDEMs lack of data points. Air quality is also being measured by TEMPO, a satellite currently measuring NO₂, O₃, and formaldehyde hourly across the US from Canada to Mexico.

The goal of this study is to understand whether a body powered prosthesis prototype project is associated with a change in students’ knowledge of bioengineering, specifically regarding human centered design. Seven high school students participated in the prosthesis project for Valparaiso University’s 5-day summer engineering camp. They were split into 3 groups and tasked with creating a hand for a bypass prosthesis that they would wear to complete events in a Cybathlon. They were given special tasks to accomplish by user personas played by research assistants to simulate client interaction and feedback. Students were exposed to actual prosthesis users as well as prosthetists throughout the design process. Data was collected via a KWL (know, want to know, learn) survey in which the students wrote down what they knew about bioengineering and wanted to know about bioengineering prior to the camp activities and then once again after. The data reported that the number of references to human involvement increased from 3 to 4 after the camp. The 3 references prior to the camp could suggest a prior knowledge of human centered design in those students. The increase of 1 indicates that a larger pool of data is needed in order to more accurately conclude on the effectiveness of the activities in shifting their view of bioengineering to a human centered mindset. Further research should be designed to capture information on participants’ exposure to human centered principles as part of their education experience prior to project participation.

Objective: Compare progestin-only contraceptives and combination birth control in their efficacy of preventing pregnancy and the number of side effects, such as acute venous thromboembolism. Methods: Literature review conducted on PubMed, Google Scholar, and Valparaiso Library Summon. Included 5 studies including one nested case-control studies, one systematic review and meta-analysis, and three literature reviews. Results: The results of this literature have shown that progestin only mini-pill birth control are comparable in effectiveness of preventing pregnancy. Additionally, progestin-only contraceptives control were found to have a lower associated risk of acute VTE when compared to oral combination birth control. Conclusion: Providers should consider prescribing POPs to women considering starting oral birth control due to comparable effectiveness in preventing pregnancy and lower risk of acute VTE. Additionally, educating for both provider and patient is critical when choosing a contraceptive.

Keywords: progestin-only contraceptive, combined oral contraceptives, acute venous thromboembolism, contraceptive efficacy, contraceptive education

Abstract

Objectives: Brown adipose tissue (BAT) is a thermogenic and metabolically active tissue that has been hypothesized as a potential target to combat metabolic disease in humans. The aim of this review is to analyze the existing evidence regarding cold water immersion as a mechanism to activate BAT and thus influence cardiometabolic health.

Methods: This was accomplished by utilizing the Valparaiso Library Summon Database, Google Scholar, and PubMed for up to date research articles.

Results: After analyzing the available literature, clear correlations were appreciated between BAT activation and improved markers of metabolic health in both healthy and metabolically unhealthy rodents and humans. It was also clearly demonstrated that cold water immersion is able to effectively activate brown adipose tissue, as well as influence the “browning” of white adipose tissue into an intermediate and more metabolically active beige adipose tissue.

Conclusions: The available date on the topic of cold exposure and cardiometabolic health suggests an optimistic future regarding protocols to promote positive short and long-term health outcomes. However, the degree to which the metabolically protective mechanisms associated with BAT activation are helpful for promoting longevity in humans is mostly unknown and will require a great deal more research going forward to solidify these interpretations.

Keywords: Brown adipose tissue, beige adipose tissue, inflammation, ice bathing, cardiometabolic disease

Abstract

Objective: Treatment resistant depression (TRD) affects many individuals diagnosed with major depressive disorder (MDD). This paper aims to compare the efficacy of ketamine in comparison to previously established treatment options such as transcranial magnetic stimulation (TMS) and electroconvulsive therapy (ECT). Methods: Recent literature was used to conduct a systematic review and compare ketamine, ECT, and TMS, in the management of TRD. Studies within the last five years were included and made use of both randomized control trials and retrospective cohort studies. Primary endpoints were measured using depression rating scales such as HAMD, MADRS, CGI, QIDS, and BDI. Results: Ketamine demonstrated effectiveness in achieving remission in some cases and reducing overall depressive symptoms. Although more acute side effects were noted with ketamine, long-term adverse events were fewer than that of ECT and TMS. Conclusion: Ketamine demonstrates promise as a treatment option for TRD. Further research is indicated to determine optimal dosing and methods of administration to favor improved patient outcomes

Keywords: treatment resistant depression, ketamine, electroconvulsive therapy, transcranial magnetic stimulation, remission, TRD, ECT, TMS, esketamine

Objective: Aortic valve stenosis is the most common valvular disease in developed countries, with notable patient morbidity and mortality. Historically, it has been treated with surgical aortic valve replacement (SAVR). In the last 25 years, the development of transcatheter aortic valve replacement (TAVR) has revolutionized this treatment, offering a much less invasive procedure. Current literature supports equivalent mortality after 1 year for both procedures, but long-term evaluation has not been well studied. The objective of this paper is to evaluate the efficacy of SAVR vs TAVR at 5 years.

Methods: A literature search was conducted utilizing PubMed, Google Scholar, and Valpo Summon, yielding around 20,000 results, of which 5 were chosen. These studies included 2 meta-analyses, 2 randomized controlled trials, and 1 retrospective study. The primary endpoint is all-cause mortality with secondary endpoints including long-term complications, quality of life, and valve function and durability.

Results: TAVR and SAVR have similar performance when evaluated at 1 year postoperatively. However, at 5 years, SAVR appears to have lower incidences of all-cause mortality, as well as better valve performance, with decreased valvular regurgitation and destruction.

Conclusion: SAVR has a lower all-cause mortality and better valve performance after 5 years when compared to TAVR, making it better for patients with longer life expectancies after surgery, but further investigation with larger sample sizes and multiple valve options is necessary.

Keywords: TAVR, SAVR, aortic valve stenosis, long-term outcomes, all-cause mortality, valve deterioration

Abstract

Objectives: This paper investigates the impact of probiotic supplementation on the gut microbiome and its correlation with the pathogenesis of polycystic ovarian syndrome (PCOS), to elucidate potential therapeutic avenues for managing PCOS-related symptoms, including insulin resistance, weight gain, irregular menstrual cycles, and infertility. Methods: The Valparaiso University online library catalog, PubMed and Google Scholar were utilized to find peer-reviewed articles and clinical trials. Sources were limited to the last five years to ensure the most recent and accurate data. Results: The diverse effects of probiotic supplementation on various endocrine markers in women with PCOS highlight the complex interactions within the endocrine system. While some studies suggest a decrease in total testosterone levels and improvements in insulin sensitivity, others show mixed results. Consistent findings indicate a decrease in fasting plasma glucose levels and potential improvements in lipid profiles with probiotic use. Clinical effects such as weight reduction, improvements in menstrual cycle regularity, and hirsutism reduction suggest promising therapeutic avenues for managing PCOS-related symptoms. However, further research is needed to clarify optimal probiotic strains, dosages, and treatment durations for maximizing clinical benefits. Conclusion: Probiotic supplementation demonstrates promising results in improving hormonal balance, metabolic parameters, and quality of life indicators among women with PCOS. These findings highlight the potential of probiotics as a complementary therapeutic approach for managing PCOS-related symptoms.

Keywords: Polycystic Ovarian Syndrome, Probiotic supplements, PCOS, Probiotics, Gut microbiome, hormonal parameters, metabolic marks, inflammatory marks, hirsutism, and menstrual irregularity.

Objective: The objective of this paper is to determine if antipsychotic (AP) drug usage in the elderly population, specifically with elderly who have dementia, has a significant effect on the morbidity and mortality of this select population.

Methods: In this paper the articles included: 2 meta-analysis, 1 prospective cohort, 1 matched cohort study, 1 randomized control trial, and a systematic review that included studies about patients using AP drugs, and studies with patients with dementia.

Results: AP drug use in the elderly population, specifically in those with dementia, has an overall increased mortality rate and an increased possibility of adverse events. Risperidone has the highest risk out of all AP drugs, and quetiapine has the lowest risk.

Conclusion: Administration of AP drugs in patients with dementia have an increased effect on their morbidity and mortality, it would be wise for providers to explore non-pharmacological treatments for BPSD management.

Keywords: Dementia, antipsychotic drugs, mortality, morbidity, behavioral and psychological symptoms of dementia.

Objective: Alzheimer’s disease presents a significant public health problem, characterized by a progressive loss of cognitive functioning ability, ultimately leading to severe dementia and loss of basic motor functions. With these patients accounting for a large percentage of hospital stays and healthcare expenditures, the urgency to address this disease is evident, particularly considering the projected growth of the aging population. This paper aims to explore new drug treatments that may alter the underlying process of Alzheimer’s disease and potentially prevent cognitive decline in future generations. Methods: Through a comprehensive review of studies examining monoclonal antibody drugs including aducanumab, lecanemab, and gantenerumab, their safety and efficacy was evaluated. To identify relevant studies, Google scholar was used with the following search terms” “Alzheimer’s disease”, “monoclonal antibody”, “aducanumab”, “lecanemab”, and “gantenerumab”. Results: While monoclonal antibody drugs have shown promise in reducing amyloid-beta plaques in the brain, their clinical significance in improving cognitive function remains unclear. Furthermore, limitations such as conflicting trial results, consideration of genotype-related factors, and need for long-term trials stress the complexity of treatment for Alzheimer’s disease. Conclusion: Future research should focus on confirming the underlying pathophysiology that causes cognitive impairment as well as exploring interventions beyond amyloid-beta reduction to address the multifaceted nature of Alzheimer’s disease.

Objective: To determine if platelet rich plasma has an effect on improvement in healing, function, and pain levels in orthopedic conditions. Methods: The studies included were a triple blinded randomized control study, randomized control trials, meta-analysis, and systematic reviews.Results: Overall through this research, there is limited evidence on PRP injections for healing purposes, however a significant amount of evidence shows improvement in both function and pain levels with PRP injections over time. Conclusion: The use of PRP injections have shown optimal results over time for both pain and function, however more research is needed to be conducted with a larger sample size to increase the validity of the findings.Keywords: Platelet Rich Plasma (PRP), Healing, Function, Pain, Orthopedic Conditions

Objective: To find how the father plays a role in maternal outcomes, particularly preeclampsia.

Methods: Using online databases and the search terms maternal outcomes, paternal genome, preeclampsia, and paternal health, 5 studies were identified for this paper. They include prospective cohort studies, retrospective cohort studies, meta-analysis, and systematic reviews.

Results: The father does play a role in preeclampsia, but not in terms of genetics. His health and the time over which the woman is exposed to his sperm have been found to be related to risk of preeclampsia.

Conclusion: Paternal variables such as preconception health and sperm exposure timeline have been found to affect the risk of preeclampsia, however more research is needed due to the complexity of preeclampsia.

Keywords: Maternal outcomes, paternal genome, preeclampsia, paternal health, sperm exposure, paternal variables.

Objectives: Subclinical hypothyroidism (SCH) is defined as an elevated thyroid-stimulating hormone (TSH) with normal thyroxine (T4) levels, and there are multiple opinions on the benefits of treatment for increasing quality of life, decreasing neuropsychiatric symptoms, decreasing cardiovascular events, and decreasing mortality risks in those diagnosed with the condition. However, there is not much consolidated data or general overview of its potential benefits. This paper summarizes the impact of thyroid hormone therapy and the effects of being untreated for those with subclinical hypothyroidism. Methods: Valparaiso Summons and PubMed were the two research databases that were used to find the five articles that were utilized in this paper regarding the outcomes of treatment in SCH. Data was limited to the last eight years. Results: Treating subclinical hypothyroidism in those less than 65 years of age was found to decrease all-cause mortality while treatment in those greater than 65 years of age did not show as much benefit. Thyroid-related symptoms were not resolved with treatment in those with subclinical hypothyroidism aged 32 and older. Conclusions: There needs to be further research regarding cardiovascular disease risk and treatment in those who are older than 65 years of age, but treatment is overall beneficial in decreasing all-cause mortality in those less than 65 years of age.

Keywords: subclinical hypothyroidism, mortality, cardiovascular events, cardiovascular disease, thyroid-related symptoms, quality of life

Objectives: To determine the first line therapy for treating non-small cell lung cancer (NSCLC), based on the efficacy of immunotherapy plus chemotherapy in comparison to chemotherapy alone using overall survival and progression-free survival data. Methods: A literature review was performed by searching on Valpo Summon. The randomized controlled trials (RCTs) compared immunotherapy plus chemotherapy to chemotherapy alone in NSCLC with available primary endpoints of progression-free survival (PFS) and overall survival (OS). In addition, randomized controlled trials that compared immunotherapy as a monotherapy to chemotherapy monotherapy in NSCLC with progression-free survival and overall survival as secondary endpoints. Results: Progression-free survival and overall survival were markedly increased in both immunotherapy plus chemotherapy and immunotherapy monotherapy in comparison to chemotherapy alone. Conclusion: Immunotherapy alone and Immunotherapy plus Chemotherapy increased overall survival and progression free survival in comparison to chemotherapy alone in NSCLC.

Keywords: non-small cell lung cancer (NSCLC), chemotherapy, immunotherapy, overall survival, progression free survival.

Objective: Evaluate one year post Zephyr Valve placement the lung function and the symptomatic scales. Methods: Valve: Valpo Summon, Google Scholar, and PubMed. Search terms within the databases included “Zephyr Valve + effects”, “COPD + Emphysema”, “Long-term management COPD”, and “Long term effects + side effects + Zephyr”. There were 46 results that appeared on Valpo Summon. Five studies selected: two retrospective analyses, two randomized control trials, and one multicenter prospective randomized control trial crossover. Results: Zephyr Valve shown improvement for lung function and symptomatic scales. Conclusion: Zephyr Valve was promising for improvement of the lung function and symptomatic scales for COPD-e.

Keywords: Zephyr Valve, COPD, Emphysema, Exacerbation, Lung function

Objectives: This paper compares effectiveness of clomiphene citrate and letrozole in treating anovulation in women experiencing anovulatory infertility due to polycystic ovarian syndrome (PCOS). Included are secondary comparisons effectiveness between letrozole and clomiphene citrate on rates of pregnancy and risks of multiple pregnancies.

Methods: Google scholar, PubMed, and Cochrane Library were the websites used. The date of articles published was set from 2019 to the present. Exclusion criteria included any other form of infertility that was not contributed to PCOS, articles not written in English, articles without full text available, and studies investigating fertility treatments other than clomiphene citrate and letrozole. A total of five studies were analyzed.

Results: Studies selected compared the rates of ovulation between two groups of women. One group was treated with letrozole and the other with clomiphene citrate. Population ranged from 28 to 200 participants. Letrozole was proven to have higher ovulation rates than in the groups that were given clomiphene citrate. Results were measured by number of women who ovulated. Secondary endpoints were recorded.

Conclusion: Letrozole was found to be more effective at increasing rates of ovulation in women with infertility due to anovulatory PCOS than clomiphene citrate. Secondary endpoints showed that the use of letrozole had higher probability of successful pregnancy and live birth, whereas clomiphene citrate had higher probability of spontaneous abortion. Letrozole was more probable to result in single gestation where clomiphene citrate showed higher potential of multiple gestation.

Keywords: clomiphene citrate, clomid, letrozole, infertility, anovulation, PCOS, polycystic ovarian syndrome

Objective: Cosmetic surgery is significantly trending upward in society with many new procedures available. The overall goal is to evaluate the efficacy, patient satisfaction, and safety of submental fat reduction methods of deoxycholic acid and liposuction.

Methods: Studies included peer reviewed articles, a meta-analysis, placebo controlled trials, and a prospective study using search engines of Google Scholar, PubMed, and ScienceDirect.

Results: Through the use of both clinician and patient rated scales, deoxycholic acid compared against placebo was found to reduce submental fat, with common side effects of pain, swelling, and numbness. Liposuction was also found to effectively reduce submental fat with improvement in patient satisfaction when compared to preoperative results. Social media surveys also concluded that liposuction remained a preferred method when compared to modern non-invasive techniques.

Conclusion: Both procedures result as safe and effective for reducing submental fat with significant patient satisfaction and positive psychological impact. Choosing the correct procedure type depends on factors such as patient characteristics and treatment goal.

Key words: submental fat, submental adipose, deoxycholic acid, kybella, ATX-101, liposuction, submental liposuction, reduction, patient satisfaction, cost

Abstract

Objective: To determine the effectiveness between topiramate and botulinum toxin type A in the prevention of chronic migraine and if there is a superior treatment option between the two. Migraines are a debilitating condition worldwide and determining the most effective treatment can help patients who suffer from them. Methods: Online databases were used to find academic sources that compared the use of topiramate and botulinum toxin type A. Only sources published within the last 5 years were included in this research paper. Results: Both topiramate and botulinum toxin type A were effective in decreasing monthly migraines, but botulinum toxin type A was slightly more effective. Topiramate had more adverse effects when compared to its counterpart, making the treatment option less tolerable. Conclusion: Because of the frequent adverse effects that result from topiramate, botulinum toxin type A is the superior treatment in the prevention of chronic migraine.

Keywords: chronic migraine, adults, prophylaxis, topiramate, botulinum toxin type A

Objective: When it comes to early-stage breast cancer, many individuals choose to undergo a mastectomy out of fear of the worst, believing there are no other effective, long-lasting treatments available. The objective of this paper is to determine the effectiveness of breast-conservation therapy (BCT) compared to a mastectomy alone (MA) at improving the overall survival and quality of life in patients diagnosed with early-stage breast cancer.

Methods: An electronic literature review was conducted using Google scholar, Science direct, BMC cancer, PubMed, and Valparaiso University Christopher center to evaluate the prognosis and quality of life of early-stage breast cancer patients who underwent BCT versus MA.

Results: It was found that among early-stage breast cancer patients who underwent BCT versus MA, overall survival, psychosocial well-being, and sexual well-being were superior in BCT versus MA. Those with the breast cancer (BrCA) gene mutation had higher locoregional recurrence rates and equivocal overall survival with BCT versus MA. Physical well-being was found to be superior in MA versus BCT, but research was limited in this finding.

Conclusion: At this time, there is sufficient evidence to conclude that BCT is a viable alternative to a MA in improving prognosis and quality of life in those diagnosed with early-stage breast cancer.

Keywords: early-stage breast cancer, breast conservation therapy, mastectomy, overall survival, quality of life, BREAST-Q, EQ-5D-3L

Objective: Assessing depression in patients with dementia presents challenges due to the inherent nature of the disease. This review aims to explore the potential effect of music therapy in mitigating agitation and depression symptoms by fostering positive memories and facilitating connections to the patient’s past.

Methods: A comprehensive literature and systematic review was conducted, examining published studies and analyses comparing music therapy’s effects to standard care or alternative care.

Results: Various forms of music intervention have demonstrated a considerable reduction in overall depressive and agitation symptoms, notably for short-term intervention. Music therapy can be applied either independently or in conjunction with pharmacotherapy to effectively alleviate symptoms in dementia patients.

Conclusion: Music therapy has the potential to reduce depression and agitation symptoms in dementia patients. Future research and studies should include more patients, varying environments, and subtype analysis regarding specific types of dementia and their relation to the music processing centers.

Keywords: Music therapy, Dementia, Depression, Agitation, Quality of life

Objectives: Given the rising prevalence of obesity and the growing demand for bariatric interventions, it is essential to provide evidence-based comparisons of the two most common procedures, Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) and Laparoscopic Sleeve Gastrectomy (LSG). This research essay aims to examine the difference in excess weight loss and type 2 diabetes mellitus (T2DM) resolution outcomes between the procedures, empowering patients to make informed medical decisions about which surgical technique they would prefer. In evaluating these outcomes and educating patients about them, individuals can align their post-op goal with the most suitable bariatric surgical intervention. Methods: Valpo summon and Google Scholar were searched for English language meta-analysis and randomized controlled trials (RCTs) comparing roux-en-Y gastric bypass and sleeve gastrectomy published from 2018-2024. Results: Five studies were included in the final analysis, 3 meta-analysis and 2 RCTs. Overall, results revealed no significant differences between LRYGB and LSG in terms of excess weight loss and T2DM resolution. Conclusion: There is no significant difference between LRYGB and LSG in terms of T2DM resolution and excess weight loss. Some study’s findings suggest that LRYGB yields greater excess weight loss with statistical significance, but the actual difference is not great enough to be clinically relevant for patients choosing which surgery to undergo.

Keywords: Roux-en-Y gastric bypass, sleeve gastrectomy, weight loss, type 2 diabetes mellitus

Abstract

Objective: When cardiologists and cardiac surgeons are evaluating patients who are experiencing a myocardial infarction, both coronary artery bypass grafting, and percutaneous coronary intervention are amongst the most widely used management options. Although there are pros and cons to each option, this poses a difficult decision amongst providers to choose the best management for patients with an acute myocardial infarction. The overarching goal of this paper is to investigate each treatment option and its effect on cardiovascular mortality. Methods: A literature search has been performed using Google Scholar, PubMed, and Summon from 2018 to current accounting for 17,900 sources. Out of these sources, 6 studies were selected using inclusion and exclusion criteria. One of the studies is retrospective leaving the other five to be meta-analysis studies of randomized controlled trials. These studies must have included patients ages fifty or greater undergoing coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI) with measurements of cardiovascular mortality. Outcomes of interest include cardiovascular mortality, overall mortality, and major adverse cardiac-cerebral outcomes (MACCE). Results: In this study, patients who underwent CABG had lower rates of cardiovascular mortality whereas patients with PCI had higher rates of cardiovascular mortality. Conclusion: CABG is the preferred method of treatment for patients with myocardial infarction regarding reducing cardiovascular mortality; however, it is still unclear if these results vary from patient to patient in regard to their personal past medical history, length of follow up, and if they are undergoing these procedures after an acute myocardial infarction or with acute on chronic coronary artery disease.

Keywords: STEMI, CABG, PCI, acute, cardiovascular mortality, revascularization, recurrent myocardial infarction, stroke, MACCE

Objective: Approximately 20% of patients with a history an ischemic stroke will have a recurrent stroke, which can be very debilitating events. This research paper aims to determine the effectiveness of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9 inhibitors) as secondary prevention to reduce the incidence of ischemic strokes. Methods:Google Scholar and Summon were used to research articles. Academic studies published within the past 5 years were selected. Filters placed on the searching platforms were ‘peer reviewed journals’, ‘full text available’, ‘meta-analysis’, ‘systemic review’, ‘randomized control studies’, and ‘retrospective analysis’. Results: PCSK9 inhibitors decrease the incidence of recurrent ischemic strokes when used in combination with statin therapy or monotherapy compared to statin monotherapy and no therapy respectively. The use of PCSK9 inhibitors had no correlation with the incidence of hemorrhagic strokes or neurocognitive events. Conclusion: PCSK9 inhibitors are an effective therapy for secondary prevention of ischemic strokes in patients with statin tolerance or hyperlipidemia resistant to statin therapy without increasing the risk of hemorrhagic strokes or neurocognitive events.

Keywords: PCSK9 inhibitors, statin, ischemic stroke, hemorrhagic stroke, neurocognitive effects

Objective: To evaluate the efficacy and safety of the Watchman device in patients with atrial fibrillation, specifically proving the prevention or reduction of major complications when compared to anticoagulant use. Major complications can include thrombotic events which can consist of stroke, clinically relevant bleeding, and device related thrombi.

Methods: Research was conducted in reviewing studies consisting of two meta-analyses, one systematic review, and two randomized controlled trials. These studies needed to include the use of the Watchman device being compared to different types of anticoagulants in patients with atrial fibrillation. In total, twenty research studies were reviewed and five were chosen. Research studies needed to be after 2018 and peer-reviewed to be considered. Primary endpoints included risk of stroke, all cause mortality, and cardiovascular mortality. Secondary endpoints included clinically relevant bleeding and device related thrombi.

Results: The use of the Watchman provided promising results in being safe, effective, and viable option for patients with atrial fibrillation who are not able to tolerate anticoagulant therapy. The risk of thrombotic events in the Watchman device is comparable to anticoagulant therapy and in some cases a better long term option.

Conclusion: The Watchman device is a promising alternative compared to the mainstay treatment of anticoagulant therapy in patients with atrial fibrillation. Since this device is not a first line treatment, more research should be done to build up a solid foundation on the long term safety and efficacy of the device.

Keywords: watchman procedure, atrial fibrillation, anticoagulant therapy, left atrial appendage, thrombotic events

Objective: The goal of this paper is to determine the effect of transcutaneous electrical nerve stimulation (TENS) on pain relief compared to opioid analgesics within the postoperative period.

Methods: This study compiled data from four different databases and includes two randomized controlled trials, two systematic reviews and meta-analysis, one retrospective case control study, and one prospective comparative study. Primary endpoints included level of pain within the postoperative period and analgesic use. Secondary endpoint evaluated was recovery time.

Results: Results found that TENS as an adjunct to standard post operative pain control measures, decreased Visual Analogue Scale (VAS) rating of pain in cardiothoracic surgeries, cholecystectomies, laparoscopic gynecologic and orthopedic surgeries. Additionally, TENS use decreased time spent in post-anesthesia care unit (PACU), increased patient mobility postoperatively, and was found to be more effective than other non-pharmacological methods of pain control.

Conclusion: Adjunct TENS use can decrease post operative pain and opioid consumption. Additionally, adjunct TENS can be just as effective as opioid analgesics in the postoperative period, however more research is needed to determine if TENS alone can be used for post operative pain control.

Keywords: post operative pain relief, TENs, transcutaneous electrical nerve stimulation, visual acuity scale, opioid, analgesia.

Purpose: When patients with polycystic ovary syndrome fail conservative options for weight loss, utilizing medications such as metformin and glucagon-like peptide-1 receptor agonists may be considered. Metformin has been the first line agent for treating weight loss and improving menstrual frequencies in polycystic ovary syndrome; however, a newer medication class, glucagon-like peptide-1 (GLP-1) receptor agonists, may be more effective.

Methods: A literature search was conducted using Google Scholar, PubMed, and Summon. There were 970 results returned, and after careful consideration, five sources were selected for this review. The studies include one single center retrospective cohort study and four systematic reviews. The studies ultimately compared weight loss, body mass index, insulin resistance levels, and menstrual frequencies. Studies must have been published between 2018 to 2023, utilized metformin and or glucagon-like peptide-1 receptor agonists as the treatment, diagnosed with polycystic ovary syndrome, and measure weight loss.

Results: Patients receiving treatment for polycystic ovary syndrome with glucagon-like peptide-1 receptor agonists had larger improvements in weight loss, body mass index reduction, and lowering insulin resistance. There was no significant difference between metformin and glucagon-like peptide-1 receptor agonists in increasing menstrual frequencies.

Conclusion: Utilizing metformin and GLP-1 are both beneficial treatment options for weight loss and increasing menstrual frequencies in patients with PCOS. GLP-1 were far more efficacious in weight loss, body mass index reduction, and lowering insulin resistance levels. There was no significant difference in improving menstrual cycle frequencies between metformin and GLP-1.

Keywords: Glucagon-like peptide-1 receptor agonists, polycystic ovary syndrome, obesity, weight loss, metformin, menstrual frequency

Objective: Comparing outcomes of different treatment approaches for rotator cuff tears in terms of pain and function. Other factors to consider are postoperative complications and patient satisfaction. Comparing arthroscopic surgery, mini-open surgery, and conservative measures.

Methods: Comparing data from 1 Cross sectional case control study, 3 Systematic Review and Meta-analysis, and 1 Meta-analysis.

Results: The results were not found to be clinically significant when comparing conservative measures, arthroscopic repair, and mini-open repair.

Conclusions: More data is needed to reach a definitive conclusion. All three treatment modalities provided relief of symptoms.

Keywords: Rotator cuff, mini-open repair, arthroscopic repair, conservative treatment, pain, function

Question: In adolescents and young adults suffering from sports related concussions, does initial aerobic exercise management shorten recovery time compared to rest?

Objective: This paper will review current literature to assess the effectiveness and safety of aerobic exercise after sports-related concussions in young athletes.

Methods: A literature review was performed using the search engines of Pub-Med, Google Scholar, and Valpo Summons.

Results: Subthreshold aerobic exercise has been shown to have beneficial effects on recovery times, return to sport, and symptomatic reporting compared to placebo programs or rest in young athletes suffering from SRC.

Key Words: concussion, sports-related, adolescent, exercise, exercise therapy, rest, recovery.

Objective: To compare efficacy rates of metformin as monotherapy versus clomiphene, an ovulation inducer, in increasing pregnancy rates among women with polycystic ovary syndrome (PCOS).

Methods: Multiple databases were explored to compile a list of potential sources to answer the main study question. Multiple search terms and various combinations of the terms were used including PCOS, polycystic ovary syndrome, Clomid, Metformin, pregnancy, and ovulation. After applying inclusion criteria and exclusion criteria, five sources were selected. Two meta-analyses, two randomized control trials, and one prospective cross-sectional study were selected. Primary endpoints included live birth rates and clinical pregnancy rates. Results from each study were compared to decide if metformin as monotherapy was as effective as clomiphene in increasing pregnancy rates in women with PCOS.

Results: Metformin as monotherapy does improve pregnancy rates more than no medical treatment. However, combined therapy of metformin plus clomiphene provided the most statistically significant increase in live birth rates and clinical pregnancy rates.

Conclusion: Combination therapy, metformin plus clomiphene citrate, proves to be the most effective treatment option to increase rates of pregnancy as well as live birth rate among women with PCOS who are infertile. However, monotherapy of either is better than no treatment at all.

Keywords: polycystic ovary syndrome, metformin, clomiphene, ovulation, pregnancy, infertility, live birth rate, hormones, comorbidities

Objective: This paper aims to evaluate the efficacy of first-line FDA-approved pharmacotherapy (naltrexone, acamprosate, and disulfiram) compared to cognitive behavioral therapy (CBT) in rates of alcohol consumption in adults aged 18 to 65 diagnosed with alcohol use disorder (AUD).

Methods: Search engines utilized include PubMed, Cochrane Library, and APA PsychInfo, as well as the National Institute of Health. Search terms included “cognitive behavioral therapy,” “pharmacologic therapy,” “substance use disorder,” and “alcohol use disorder.” The primary endpoint was rates of alcohol consumption. Filters included English texts, publication date from 2018 to present, randomized controlled trials, meta-analyses, and systemic reviews. Inclusion criteria included adults aged 18-65 years old diagnosed with AUD.

Results: Naltrexone was found to increase abstinence and reduce heavy drinking. Acamprosate was found to increase rates of abstinence but was not found to reduce heavy drinking. Disulfiram was found to reduce heavy drinking but was not found to increase abstinence. CBT was found to reduce rates of alcohol consumption but was not found to increase abstinence. Multimodality therapy with CBT and first-line pharmacotherapy had a greater reduction of alcohol consumption and relapse compared to monotherapy with pharmacotherapy. Comparisons between the efficacy of CBT and first-line pharmacotherapy were inconclusive.

Conclusion: A synergistic relationship between CBT and first-line pharmacotherapy has been found to exist, that of which could prove to be highly beneficial toward the treatment of individuals with AUD.

Keywords: alcohol use, abstinence, heavy drinking, monotherapy, multimodality therapy, naltrexone, acamprosate, disulfiram, cognitive behavioral therapy

Objective: The primary goal of this literature review is to assess the recurrence rate of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) after micrographically oriented histographic surgery (MOHS) compared to the recurrence rate of BCC and SCC following superficial radiation therapy (SRT), using data gathered from multiple clinical studies.

Methods: Search engines used included Google Scholar, Pub Med, Valpo Summon, and UpToDate. The inclusion criteria set stated the studies should be within 5 years, meta-analysis, retrospective cohort studies, cross-sectional studies, adult participants, and non-melanoma skin cancer. Exclusion criteria included those with diagnoses other than BCC or SCC, as well as no evidence of regional lymph node metastasis. Four retrospective cohort studies and 1 prospective cohort study were included. The endpoints of interest include recurrence rates of BCC/SCC using MOHS, recurrence rates of BCC/SCC using SRT treatment, cure rates using MOHS, and cure rates using SRT. The secondary endpoints include survival rates of BCC/SCC after either treatment, as well as cosmetic results.

Results: The recurrence rate over at least a year ranged from 1.9%-7.3% using MOHs, and 0.7-2.1% using SRT treatment.

Conclusion: The overall recurrence rates of both BCC and SCC using either MOHS or SRT are relatively equal. The decision to use either treatment modality can be a provider-patient individualized decision.

Key Words: MOHS, SRT, non-melanoma skin cancer, recurrence rates, efficacy, squamous cell carcinoma, and basal cell carcinoma.

Objectives: Colorectal cancer is a devastating disease, resulting in high mortality rates across the globe. Within this research paper, an in-depth analysis of the current literature will bring light to the association between diet and its effect on the incidence of colorectal cancer. Methods: Multiple databases, including PubMed, Valpo Library Summon, and Science Direct, were utilized with keywords relating to colorectal cancer and diet. With the inclusion of articles within the past five years, adults over the age of 18 with no history of cancer, and articles including both men and women, a total of six sources met the requirements to analyze further. Results: Statistically, certain foods or food groups were proven influential on the risk of colorectal cancer. The highest-risk diets included ones with increased intake of red meat, processed foods, and alcohol, while preventative foods such as dairy and whole grains decreased the overall risk of developing colorectal cancer. Conclusion: As colorectal cancer becomes more prevalent in society, diet is a key preventative measure that needs to be taken in clinical settings. Although new and updated research is needed due to the change in eating habits over recent years, prophylactic measures such as moderation of high-risk foods and increased intake of protective foods can bring about a noteworthy change in the overall incidence of colorectal cancer.

Keywords: colorectal cancer, colon cancer, prevention, diet, food

Abstract

Objective: Incidence rates of new-onset Type 1 Diabetes Mellitus have been increasing over time, particularly following the COVID-19 pandemic. This research paper aims to investigate whether the COVID-19 vaccine is associated with a higher risk of developing Type 1 Diabetes.

Methods: Data was gathered through a literature review of five evidence-based studies sourced from online databases PubMed and Summon. Only studies with adults 18 years and older who were either vaccinated against or exposed to COVID-19, and without a prior diabetes diagnosis, were included. The outcome of interest was the incidence of Type 1 Diabetes after exposure to COVID-19 or after vaccination.

Results: Five evidence-based studies were identified and evaluated. Among the cases, three indicated that Type 1 Diabetes incidence was increased due to exposure to the COVID-19 antigen. Two case studies implied that the onset of disease followed COVID-19 vaccination. Conclusions: Given the absence of causal studies, COVID-19 vaccination can not be directly correlated to the development of Type 1 Diabetes; the potential risks associated with the vaccination do not outweigh its established benefits.

Keywords: COVID-19 vaccination, Type 1 Diabetes Mellitus, SARS-CoV2, autoimmune conditions, mechanism of vaccination, immunity

Objective: Atrial fibrillation is the most common arrhythmia presenting to emergency departments in the United States. There are a multitude of options available for restoring normal sinus rhythm in patients who have acute onset of atrial fibrillation. The goal of this paper is to investigate the efficacy of electric and chemical cardioversion at restoring normal sinus rhythm for patients with acute onset atrial fibrillation. Methods: An extensive literature review was conducted through Google Scholar and Valpo Summons. This search yielded 11,228 results, of which six studies were chosen including 2 randomized control trials, 2 retrospective cohort study, meta analysis, and a randomized factorial study. These studies were chosen based on inclusion and exclusion criteria. They were published between 2012-2023 and examine cardioversion strategies in adult patients who have acute onset of atrial fibrillation. Primary endpoints included restoration of normal sinus rhythm. Results: There is conflicting data regarding the efficacy restoring of normal sinus rhythm between electrical and chemical cardioversion. Electrical cardioversion may result in quicker conversion times. Both methods are associated with a low adverse effect profile, including minimal risk of stroke and death. Conclusion: Both electrical and pharmacological cardioversion are effective at restoring normal sinus rhythm. The choice to pursue one method over another must be carefully considered by the provider taking into account the patient’s medical history and available resources at the setting of presentation.

Keywords: atrial fibrillation, electric cardioversion, pharmacologic cardioversion, chemical cardioversion

Objective: To discuss how safe injection sites (SIS) help to decrease the incidence of infective bacterial endocarditis in intravenous drug users. Methods: Six studies were chosen from online databases utilizing the search terms infective endocarditis, intravenous drug use, and SIS. They include a case-control study, retrospective cohort study, proposal, semi-structured interviews, narrative review, and cohort study. Results: SIS are imperative in the management and treatment of people who inject drugs (PWID) with infective endocarditis (IE). They help identify associated risk factors and provide a stable and safe environment for PWID as well as provide medical care. Conclusion: Patients who have IV substance use disorders deserve access to feel safe in active addiction. There are effective harm reduction interventions where lives are saved and a connection to treatment is provided including outpatient IE medical care. The United States should follow suit by supporting SIS as they are already showing promise in other countries around the world.

Keywords: Intravenous (IV) drug use, SIS and associated laws, endocarditis, left against medical advice and drug use, infective bacterial endocarditis, and bacterial endocarditis with IV drug use.

Objectives: Prosthetic joint infection can be caused by several infective routes but can cause severe management and provide difficult outcomes in quality of life. This research paper aims to determine the role and viability of antibiotic prophylaxis in those with joint arthroses prior to invasive dental procedures. In addition, the determination of harm made to the patient if antibiotic prophylaxis is continued. Methods: Multiple search terms including Prophylaxis, prophylactic antibiotics, total joint arthroplasty, joint arthroplasty, minor procedure, Joint replacement, Invasive Dental prophylaxis and Dental procedures were used on platforms such as PubMed, Google Scholar, Elsevier and EBSCOhost to perform a literature review of multiple sources within the last 5 years from 2019-2024. Results: Multiple sources show that antibiotic prophylaxis does not decrease the occurrence of prosthetic joint infection following invasive dental procedures. Other prevention measures actually show a decreased rate of bacteremia and seeding of oral bacterial strains. Conclusion: Antibiotic prophylaxis has no true role prior to normal invasive dental procedures and thus the rate of infection is overexaggerated. Options such as oral hygiene management and chlorhexidine mouth washes should be used to decrease the risk of oral bacterial spread to joint prostheses.

Keywords: prosthetic joint infection(s), invasive dental procedures, antibiotic prophylaxis, bacteremia, hematogenous bacteremia, biofilm prophylaxis

Objectives: Prosthetic joint infection can be caused by several infective routes but can cause severe management and provide difficult outcomes in quality of life. This research paper aims to determine the role and viability of antibiotic prophylaxis in those with joint arthroses prior to invasive dental procedures. In addition, the determination of harm made to the patient if antibiotic prophylaxis is continued. Methods: Multiple search terms including Prophylaxis, prophylactic antibiotics, total joint arthroplasty, joint arthroplasty, minor procedure, Joint replacement, Invasive Dental prophylaxis and Dental procedures were used on platforms such as PubMed, Google Scholar, Elsevier and EBSCOhost to perform a literature review of multiple sources within the last 5 years from 2019-2024. Results: Multiple sources show that antibiotic prophylaxis does not decrease the occurrence of prosthetic joint infection following invasive dental procedures. Other prevention measures actually show a decreased rate of bacteremia and seeding of oral bacterial strains. Conclusion: Antibiotic prophylaxis has no true role prior to normal invasive dental procedures and thus the rate of infection is overexaggerated. Options such as oral hygiene management and chlorhexidine mouth washes should be used to decrease the risk of oral bacterial spread to joint prostheses.

Objective: Alzheimer’s Disease (AD) is a progressive neurocognitive disease that has effects on many different aspects of an individual’s life, if diagnosed. The purpose of this research study is to obtain data and research about the relationship between sleep and the increased risk for AD. Methods: Many different databases and resources were used in order to obtain data and studies about the subject. Of the studies used, 2 were cohort studies, 1 was a randomized control trial, 1 was a meta-analysis, and 1 was a cross-sectional study. Studies were found using PubMed, Google Scholar, and Valpo Library Summons. Primary endpoints included measuring increased A? and tau burden after altered sleep. Results: Results from these studies concluded that impaired sleep is associated with increased AD pathology and cognitive impairment. Similarly, research also found that quality sleep acts as a protective factor against AD. Conclusion: Sleep is a modifiable risk factor for AD. Research studies did not include long term data about how severely sleep could affect AD, therefore further research would need to be conducted in order to see these long term effects.

Keywords: Alzheimer’s Disease, impaired sleep, neurocognitive degeneration, risk factor, amyloid-beta, tau neurofibrillary tangles, risk factor.

Purpose: When conservative measures are unsuccessful in improving pain and function in patients with knee osteoarthritis, a unicompartmental or total knee arthroplasty may be considered. Choosing between the two can be a difficult decision without unbiased and credible evidence. The goal of this paper is to investigate the outcomes of a unicompartmental knee arthroplasty on pain and function compared with a total knee arthroplasty within one year in patients with knee osteoarthritis.

Methods: A literature search has been performed using Google Scholar, PubMed, and Summon since 2018. From 16,700 sources, five studies were selected using inclusion and exclusion criteria. These studies include one systematic review, three prospective cohort studies, and one retrospective cohort study. These studies compared the Knee Society Score, Numerical Pain Rating Scale, Oxford Knee Score, UCLA activity-level scores, revision rate, and annual revision rate. Studies must have been published from 2018 to 2023, have a minimum of one year follow up, and have isolated osteoarthritis.

Results: After a minimum of one year follow up, patients receiving a unicompartmental knee arthroplasty had a larger improvement in patient-reported outcomes whereas patients receiving a total knee arthroplasty had lower revision rates and longer implant survivorship.

Conclusions: After a minimum of one year follow-up, unicompartmental knee arthroplasties led to improved patient-reported pain and functional outcomes whereas total knee arthroplasties had improved implant survivorship and decreased revision rates.

Keywords: total knee arthroplasties, unicompartmental knee arthroplasties, pain and function, Knee Society Score, Numerical Pain Rating Scale, UCLA Activity-Level Score, Oxford Knee Score, and annual revision rate.

Objective: Sliding-scale insulin (SSI) is commonly used for hospitalized type 2 diabetics despite the American Diabetes Association’s (ADA) recommendations supporting basal-bolus insulin (BBI). This paper aims to distinguish what insulin regimen is beneficial for hospitalized diabetics, critical and non-critical, to improve patient outcomes.

Methods: A qualitative analysis of research conducted by different hospital systems and physicians in the past 5 years including 2 integrative literature reviews, 2 retrospective cohorts, 2 ambi-directional cohorts, and 1 quasi-experiment. After inclusion and exclusion criteria were applied, 7 studies were selected for this review. Outcomes of interest included target glycemic control (110-179mg/dL), decreased hypoglycemic rates, and length of hospital stay from admission.

Results: BBI has been proven to improve in-target ranges of blood glucose levels, decrease hypoglycemia episodes, decrease admission length, and decrease the delay of basal insulin administration. When implemented in hospitals through educational materials and employee training, their results show improved patient outcomes when switched to BBI regimens from standard SSI.

Conclusion: A BBI regimen is the best practice guideline for treating non-critical hospitalized type 2 diabetics.

Keywords: type 2 diabetes, hospitalization, basal-bolus insulin, sliding-scale insulin, glycemic control, length of admission, hypoglycemic episodes

Abstract

Objective: This review should aid in the education of medical professionals on the correct medical practices in prophylaxis of breast cancer in women who have tested positive for the BRCA gene mutation.

Methods: In order to investigate the best form of prophylaxis for BRCA mutation carriers, 2,660 results were available from 2019. Nine studies were selected to evaluate the efficacy of both Tamoxifen and BRRM for the prophylaxis of breast cancer in BRCA gene mutation carriers.

Results: Women who took Tamoxifen had a 10.9% incidence of cancer while those who did not had a 14.3% incidence of cancer but is also found to be dependent on the type of BRCA mutation. Eighty three percent of BRCA1 breast cancers are ER negative while 76% of BRCA2 breast cancers are ER positive. Tamoxifen reduced breast cancer incidence by 62% among BRCA2 carriers due to their ER positive composition while not reducing the incidence of breast cancer in those with BRCA1 gene mutation. Bilateral risk reducing mastectomy provides a 90% risk reduction in breast cancer development but is associated with a 32.8% complication rate.

Conclusions: Overall bilateral risk reducing mastectomy (BRRM) is statistically the better option for breast cancer prophylaxis over Tamoxifen but decisions need to be made on a personal and multidisciplinary approach. Tamoxifen is not thoroughly researched for this indication and has many side effects while BRRM involves major surgery that can possibly lead to cosmetic complications.

Keywords: BRCA gene mutation, tamoxifen, tamoxifen side effects, mastectomy, mastectomy complications, breast cancer prophylaxis

Objective: compare the efficacy of gender-affirming care and mental health management for reducing suicide rates and suicidality in transgender adolescents. Methods: relevant, peer-reviewed research studies published within the past five years were identified by searching the Valparaiso University Christopher Center Library online databases. Results: both gender-affirming care and mental health interventions/programs are highly successful in reducing suicidality in transgender youth. For all transgender adolescents, social support systems composed of family, friends, and trusted adults are essential for reducing suicidality and accessing medical transition if desired. Conclusion: at this time, available research studies are limited in number and reliability (due to confounding factors), thereby limiting the ability to draw a definitive conclusion; however, available evidence suggests the efficacy of both modalities and an inherent need for both modalities to be utilized.

Key Words: transgender youth, gender diversity, gender nonconforming, gender nonbinary, gender-affirming care, mental health, suicide, psychotherapy, counseling, puberty suppression, gender-affirming hormones, adolescent mental health, depression, anxiety

Objective: Determine a difference in a home versus hospital birth on neonatal and maternal mortality, intrapartum intervention rates, postpartum care, and overall cost in the United States.

Methods: Multiple online databases were used to find research articles that focused on home and hospital births. Studies with a publication date from 2018 to present were used to determine an up to date and accurate review of this topic.

Results: Neonatal adverse outcomes are less likely in-home births, and the lowest neonatal mortality rate is seen in midwife-assisted hospital birth in the United States. The maternal mortality rate is similar between both home birth and hospital birth. Patients with planned home birth are at lower risk for intrapartum interventions. Postpartum care in the United States is severely lacking and not up to standards with patient preferences. The cost of care from a midwife is less than an obstetrician and has more comprehensive care but is not covered by most insurances.

Conclusion: Midwife-assisted hospital birth is the safest option in the United States. Neonatal adverse outcomes and intrapartum interventions are less likely in a home birth. Maternal mortality rates are similar in both home and hospital births. Postpartum care needs to be better utilized and insurance coverage is negatively impacting a patient’s ability to choose a location of birth.

Keywords: Mortality, interventions, postpartum care, cost, midwife, obstetrician, home birth, hospital birth

Objective: To evaluate if the addition of Lateral Extra-Articular Tenodesis (LET) with the Iliotibial (IT) band during Anterior Cruciate Ligament Reconstruction (ACLR) in athletes is more advantageous when compared to an isolated ACLR. Specifically looking at patient outcomes, return to sport time, graft rupture, and laxity in the knee post-surgical intervention.

Methods: A review of the literature was conducted utilizing multiple databases. Inclusion criteria for this paper were radiologic evidence of ACL rupture, patients undergoing isolated ACLR, patients undergoing ACLR with LET, and participation in sports/physical activity. Exclusion criteria for this paper were studies published prior to 2018, not participating in sports/physical activity, and studies that were not available as full text online. Primary outcomes included return to sport and re-rupture rates. Secondary outcomes included patient reported outcome measures and overall knee stability. After applying the criteria listed above, five studies were chosen to be included in this research paper.

Results: Athletes who undergo ACLR with LET have better return to sport time, decreased laxity in the knee, and more satisfactory patient outcomes when compared to those who undergo isolated ACLR. Studies demonstrate efficacy of the procedure with statistically relevant results.

Conclusion: The ACLR with LET gives the joint more anterolateral laxity and increases overall stability. This procedure helps athletes return to their pre-injurious activity level. The technique is safe and efficacious in professional, collegiate, and pediatric athletes.

Keywords: anterior cruciate ligament, lateral extra-articular tenodesis, iliotibial band, Physical activity, return to sport, laxity, elite athlete, pediatric population

Abstract

Objectives. This paper is aimed to evaluate the efficacy of using probiotics as a supplemental treatment in Parkinson’s Disease to help decrease symptom severity.

Methods. PubMed, Valpo Summon, Google Scholar, Annual Review of Medicine, and the Journal of Neuroinflammation were used to research articles for this paper. The date of publication was set from 2019 to present, ensuring the most recent and accurate data on the topics.

Results. The studies reviewed in this paper used diverse methodologies, including clinical trials and animal models, to demonstrate promising outcomes regarding the reduction of motor symptoms and inflammatory markers in PD patients following probiotic supplementation. Probiotic interventions, such as Lactobacillus plantarum (PS128), Bifidobacterium animalis subsp. lactis (Probio-M8), and a prebiotic mixture, exhibit significant improvements in motor function, UPDRS scores, and inflammatory biomarkers. Additionally, in vitro studies highlight the potential of specific probiotic strains, particularly Lactobacillus salivarius and Lactobacillus acidophilus, to modulate cytokine profiles associated with PD pathology. These findings collectively underscore the emerging role of probiotics as a promising adjunctive therapeutic approach for managing motor symptoms and inflammation in Parkinson’s disease.

Conclusion. Studies delving into the implications of incorporating probiotics as an adjunct therapy in patients with Parkinson’s disease provides promising insights. The observed improvements in PD symptoms suggest that probiotics may serve as a valuable complementary intervention to standard therapy. However, further extensive research is imperative to ascertain the efficacy of probiotics as a therapeutic modality for patients afflicted with Parkinson’s disease.

Keywords: Parkinson’s Disease, probiotics, treatment, motor symptoms, UPDRS

This project is the first step in determining precise temperatures for hot white dwarf stars using ultraviolet spectra from the Hubble Space Telescope. A way to get the temperature of a hot white dwarf is through performing binary modeling. This project used a list of hot white dwarfs that was obtained from our Hubble Space Telescope Heritage project named, “A Treasury Far Ultraviolet Survey of the Hottest White Dwarfs”, and evaluated if there was periodic variation in brightness or not. The list contained coordinates, which were put into the database Zubercal to obtain photometric (brightness) data and a light curve (or plot of brightness over time). The photometric data was used to determine if there was brightness variability present and whether that variability was periodic, or changed in a regular, repeating pattern. For any white dwarfs that showed periodic variability, their photometric data were used with a Python code to get a more accurate and precise period. If the white dwarf still showed signs of periodic variability, then it was plotted to the period that found along with a fitted sine curve.

Planetary nebulae are the ejected outer layers of dying stars. At the center of these planetary nebulae remains the cores of the dead stars that created them. These remaining cores eventually become what we call white dwarfs. In order to understand planetary nebulae, white dwarfs, and their origins we can study the remaining core, or central star, inside the planetary nebula. We can do this by determining the physical properties of these central stars. One way to do this is if the central star has a companion and thus is in a binary star system. So I modeled the central star of the planetary nebula PN G012.1-11.2 which has a binary star system at its center. Using the PHOEBE modeling software I was able to create models that I qualitatively matched to the light curve (brightness variations) of this system. These models allowed me to find a range of radii, masses and temperatures for the stars along with the inclination of the system’s orbit. I will present the results of my modeling as well as discuss what it tells us about this particular object and how it helps us understand planetary nebulae and white dwarfs more broadly.

Planetary nebulae are one of the last stages of stellar evolution for low-mass stars, those that have a mass of less than about eight times the mass of the Sun. As the star ejects its outer layers at the end of its life, the high temperature of the remaining core, what we call the central star, can ionize the gaseous ejected layers and make them glow. Many complex carbon-based and oxygen-based molecules can form in these ejected layers, and their presence can be detected through spectroscopy. Also detected in some planetary nebulae are binary central stars, where another object is in orbit with the central star of the planetary nebula. We gathered previously published data about binary planetary nebulae, as well as previously published data about planetary nebulae with detection and measurements of carbon and oxygen. We are looking for correlations between pieces of data such as the amount of carbon and oxygen, the shape, whether the planetary nebula is a binary, and the masses of the two stars for these systems, and how they compare in the context of the overall sample.

Planetary nebulae emit unidentified infrared emission (UIE) lines that come from an unknown source. A proposed source for these UIE lines is polycyclic aromatic hydrocarbons (PAHs) which are composed of fused carbon rings. We have calculated the absorption spectra from various PAHs and compare them to observed UIE lines to try to determine where the UIEs come from. Our goal is to observe how ionization and nitrogen or oxygen heteroatom substitutions affect the infrared (IR) spectrum. We used the Gaussian 09 program to calculate the structures and IR absorption spectra for about ninety different PAHs. These include linear and non-linear fused ring structures and nitrogen and oxygen substitutions, both in neutral and ionized states. We determined the vibrational modes associated with each of the peaks observed in the IR spectra. These modes involve C-H stretching, C-C stretching and both in-plane and out-of-plane C-H bending modes. Oxygen and nitrogen substitutions tend to increase the intensity of of the C-C stretching and C-H in-plane bending modes. We also determined that PAH molecules must have hydrogen atoms with specific numbers of neighboring hydrogen atoms in order to match the observed UIE bands. While none of the molecules we have studied match the UIE bands exactly, our results limit possible candidates for PAHs that can reproduced the major UIE peaks in planetary nebulae spectra.

The white dwarf GD 803 is known to be a non-eclipsing close-binary system. It has an orbital period of less than a day, a hot white dwarf as the central star, and a cool main sequence star as the companion. Using luminosity data, in our case, luminosities in the SDSS-g and SDSS-r filters, light curves showing how the luminosity changes over time were created. Model light curves can be generated through adjustable parameters using the PHOEBE binary star modeling software. These model curves can then be compared to the data. By altering parameters to get generated light curves that are as close as possible to the data, information about the system can be estimated. The temperatures, masses, and radii of both the white dwarf and main sequence star, as well as the albedo of the main sequence and the inclination of the system are what we attempt to narrow down with this method.

Nuclear physics students and faculty at Valparaiso University worked on two experiments: the STAR Experiment, and the nEDM Experiment. A major goal of the STAR Experiment at Brookhaven National Laboratory is understanding the gluon’s contribution to the proton’s spin. A proton contains quarks and gluons whose individual spins contribute to an overall spin of ½ ?. At the Relativistic Heavy Ion Collider (RHIC) high energy polarized proton beams are collided, producing a large number of neutral pions (?0) and eta (?) mesons. These particles promptly decay into two photons whose energies and positions are measured by the Endcap Electromagnetic Calorimeter (EEMC). Pairs of photons are combined to calculate the invariant mass of the particles from which they decayed. Our mission was to perform quality assurance on the data taken in 2013 and 2015 to ensure it is good for further analysis. Our quality-assured data will then be used to calculate the assymetry of ?0 and ? particles produced in the polarized proton beam collisions. These calculations can then be used to determine the gluon’s contribution to the proton’s spin. Results from the quality assurance of the data will be presented.

The neutron Electric Dipole (nEDM) experiment at Los Alamos National Laboratory is designed to search for the nEDM at the level of 10-27 e*cm. The experiment is enclosed in a magnetically shielded room (MSR) to null external magnetic fields. A shielding factor characterizes the performance of the MSR. Discussion of the progress on the shielding factor measurement and optimization of neutron delivery will be presented.