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  Effectiveness of Internet Based Treatment Methods for Symptom Management of Vestibular Disorders: A Systematic Review

  Nina Acosta, Rowan Pepe, Samantha Pavolko, Morgan Carline, and Devin Conlon

  Introduction: The objective of this systematic review is to investigate the effectiveness of internet-based and blended therapy for patients with peripheral, central, or mixed vestibular dysfunction based on current research.

  Methods: Medline, CINAHL Complete, PubMed, and The Cochrane Library were searched from September 2022 to January 2023 using the search terms “vestibular,” “internet,” “computer,” “management,” “online,” “self-efficacy,” “vestibular disorder,” “rehabilitation,” “treatment,” “dizziness,” and “phys* ther*.”Studies were included if they used internet-based interventions for patients with diagnosed vestibular dysfunction caused by pure vestibular pathology. Three independent reviewers performed the selection process based on title, abstract, and full-text reading. In total, 8 studies were selected, three reviewers independently extracted data related to intervention technique, duration of intervention, symptoms relief, and overall outcome. The PEDro and hierarchy of evidence scales were used to assess the methodological quality of selected articles.

  Results: Of 8 articles, seven were randomized controlled trials (RCTs), and one was a qualitative design study. Hierarchy of evidence rating scores ranged from level 2 to level 3. Six of the articles had a level 2 score, and two articles had a level 3 score. PEDro scores ranged from 2/10 to 8/10, including three 8/10, two 7/10, two 2/10, and one 3/10 scores. Primary outcome measures reviewed in this study include the Vertigo Symptom Scale-Short Form and Dizziness Handicap Inventory. Secondary outcome measures include Dynamic Gait Index, Hospital Anxiety and Depression Scale, Visual Analogue Scale, quality of life measures, and subjective reports.

  Discussion: Although PEDro scores ranged from poor to good, internet vestibular rehabilitation (IVR) was shown to be an effective form of improvement in reported dizziness, anxiety related to symptoms, and dynamic postural stability. IVR did not significantly improve quality of life or severity of symptoms.

  Conclusion: Based on present findings, IVR can be recommended to patients as a means to reduce chronic symptoms outside of the clinic.

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  Shielding in Computed Tomography

  Amanda Agne

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  Duckweed in Wastewater Management: Species Comparison of Spirodela polyrhiza and Lemna minuta

  Lindsey Chepalonis

  Wastewater is any liquid or water-carried waste accrued from sanitary operations. This waste contains toxins that must be purified, as they pose an environmental and public health hazard. Specifically, this risk is high in developing countries. Aquatic plants can be used to purify wastewater. Duckweed is a free-floating aquatic plant with over 37 species, but Lemna minor is typically used for wastewater management. This research focuses on finding different species to use in wastewater management. Spirodela polyrhiza and Lemna minuta chlorophyll concentration and frond increase were compared with Lemna minor. The species were maintained in varying concentrations of Hoagland’s solution for a range of weeks before they were harvested. Results show Lemna minor is the preferred species of duckweed for wastewater management.

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  The Role of Low-Dose CT in Diagnosing Lung Cancer

  Hailey Colabelli

  The Role of Low Dose CT in Diagnosing Lung Cancer

  Student Researcher: Hailey Colabelli

  Faculty Advisor: Dr. Elaine Halesey, Ed.D., R.T(R)(QM)

  Abstract

  Lung cancer is the most diagnosed malignancy worldwide, with an estimated 2,093,876 new cases and 1,761,007 deaths in 2018. It has a poor prognosis with a 5-year survival rate of 16%. When detected in asymptomatic patients, most cases can be treated with an overall survival rate of 92%. Low-dose CT lung screening is a routine annual scan for those with a high risk of developing lung cancer. It can help doctors detect cancer at an earlier stage, making it easier to treat. Through dose reduction techniques like dual source, dual energy, and iterative reconstruction, low-dose screening options are available for patients. Only 141,260 of the 7.6 million estimated eligible smokers underwent screening in 2016, according to 2018 research. Lung cancer mortality rates have decreased by 20%, and if more patients get access to screening, they may continue to decline. There are risks and benefits to every medical procedure, but all individuals with a high risk should consider low-dose lung screening due to the favorable results.

  Keywords: low-dose, lung cancer, lung screening

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  Exploring the Transition from General Ultrasound to Veterinary Ultrasound: Challenges and Opportunities

  Kali Foltz and Juliette Myers

  Objective: The objective of the interview and research study was to identify the various challenges and opportunities that may be presented to an individual seeking a transition from human to veterinary ultrasound.

  Methods: An interview was conducted between two senior sonography students and one experienced veterinary sonographer.

  Results: The interview and research provided information and detail on the transition process, what a sonographer should know prior to the transition, and what benefits and obstacles a sonographer may encounter.

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  The Role of Schwann Cells in Nerve Injury: Forskolin-Mediated cAMP Activation Upregulates TNFα Expression Despite NF-κB Downregulation in LPS-Treated Schwann Cells

  Caitlyn E. Henry and Angela L. Asirvatham Ph.D.

  Although Schwann cells are known to play a role in axonal regeneration following nerve injury and inflammation, the exact mechanism is unknown. This study explores two potential mechanisms: the NF-κB and cAMP pathways. The NF-κB pathway produces cytokines, such as TNFα, to regulate inflammation, whereas the cAMP pathway is anti-inflammatory and regulates Schwann cell proliferation via AKAP95 and cyclin D3. Although it is well-known that NF-κB and cAMP are involved in inflammation, not much is known regarding the effects of forskolin-mediated cAMP activation on LPS-mediated NF-κB activation in Schwann cells. In this study, RT4-D6P2T immortalized rat Schwann cells were treated with 0.1, 1, or 10 μg/mL of LPS, with or without 2 μM of forskolin, for 3 hours, and then an MTT viability assay and Western blot were performed. It was found that cAMP activation decreased cell viability regardless of LPS dose compared to the control. It was also found that at high doses of LPS, cAMP activation upregulated TNFα expression despite a downregulation of NF-κB, meaning cAMP may regulate TNFα through NF-κB-independent mechanisms. Furthermore, at high doses of LPS, cAMP activation downregulated AKAP95 and cyclin D3 expression and decreased cell viability, meaning that at high LPS doses, NF-κB might inhibit cAMP's ability to upregulate AKAP95 and cyclin D3, decreasing cell proliferation and thus viability. A better understanding of the potential interactions between the NF-κB and cAMP pathways in Schwann cells may help to find a potential therapeutic target for the treatment of nerve injury and inflammation.

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  Effectiveness of Sensory Integration on School-Age Children with Attention Deficit Hyperactivity Disorder

  Maryssa Hodder, Lauren Cunfer, and Saige Miller

  Introduction: Attention Deficit Hyperactivity Disorder (ADHD) is a common mental disorder that poses significant effects on an individual’s ability to effectively carry out daily functions; characteristics include hyperactive, inattentive, and impulsive behaviors (Dogru; Kadam). ADHD is problematic for school-aged children; children with ADHD lack the ability to integrate sensory information. The purpose of this systematic review is to explore the effectiveness of sensory integration therapy in managing ADHD symptoms in school aged children.

  Methods: A search of literature was conducted during September of 2022 and January of 2023. Databases used to complete the search included EBSCO Host, Academic Search Ultimate, and National Library of Medicine. Search terms comprised children or kids or youth, ADHD or attention deficit hyperactive disorder or attention deficit-hyperactive disorder, children with ADHD, and sensory integration or sensory modulation or sensory integration therapy or sensory based intervention. The search yielded forty-two academic journals total, with eleven journals meeting inclusion criteria of publication date between 2006-2022, subjects between the ages of six through twelve, subjects with a diagnosis of ADHD, and subjects who have undergone sensory integration therapy. Each journal was reviewed and scored using the Oxford Centre for Evidence Based Medicine 2011 Levels of Evidence.

  Results: Eleven articles were included in this study. An analysis using the Hierarchy of Evidence Scale identified two articles as level 2 and 9 as level three. Articles used common outcome measures, such as Parent-Teacher reports and ADHD scales. These outcome measures were sued to look at how sensory integration impacted motor control, executive function and sensory processing in children with ADHD.

  Discussion: Sensory integration therapy provides interventions that target seven key senses including; tactile, visual, olfactory, taste, auditory, proprioception, and vestibular. Interventions are delivered at varying intensities in order to desensitize the individual to achieve a more controlled response to daily environments. Overall, research has supported that sensory integration therapy helps improve sensory integration, motor control, and executive function and can lead to long term benefits in children with ADHD. Improvements in these areas may lead to improved behaviors, academic achievement, and social development. Implicating sensory integration interventions into physical therapy treatment sessions in school-aged children with ADHD will be beneficial for the children based on the evidence found in our systematic review.

  Conclusion: Sensory integration therapy is a beneficial intervention to improve symptoms in children with ADHD. More research is needed to further support the benefits of sensory integration therapy.

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  Radiation Oncology: Breast Cancer

  Julia Hornberger

  Radiation Oncology: Breast Cancer

  Student Researcher: Julia Hornberger

  Faculty Advisor: Dr. Elaine Halesey, Ed.D., R.T.(R)(QM)(ARRT)

  Abstract

  This project explains breast cancer and the role of radiation therapy. Breast cancer is the most commonly diagnosed malignancy in the world for women. Types of breast cancers, the pathology and risk factors associated, the signs and symptoms, imaging, simulation setup, diagnosis, and treatment, as well as some general statistics and prevention are discussed. In 2022, 280,000 new cases of breast cancer occurred with 40,000 deaths occuring. Breast cancer should be known as it effects 1 in 8 women are diagnosed within their lifetime. Treatment of breast cancer with radiation therapy is roughly 4-7 weeks. The radiation is not felt when entering the body but may cause some changes within the skin as it can become dry, red, and irritating. Radiation therapy is essential in management of breast cancer after surgical removal of the tumor. Performing self-breast exams, drinking in moderation, exercise, healthy weight and diet, and regular screenings are crucial in helping prevent breast cancer.

  Keywords: radiation therapy, breast cancer

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  The Effect of an 8-week Core Training Program on 1-Mile and 100-Meter Dash Outdoor Running Times in College-Aged Athletes

  Kelcie Hromisin, Robert Wagner, Anthony Tirro, Zachary Orzell, Cydney Moore, James Prentice, and Melissa Cencetti

  The Effect of an 8-week Core Training Program on 1 Mile and 100-M Dash Outdoor Running Times in College-Aged Athletes

  Background:

  The core provides proximal stability of the trunk which enhances power production and strength with distal limb movement. With almost half a million NCAA athletes in the United States, in a high-revenue industry, there is a strong incentive for athletes, coaches and industry alike to discover strategies to improve athletic performance. Available literature has studied the correlation between increasing core strength and the augmentation of balance and stability, power generation, core endurance, neuromuscular control and injury prevention. However, these studies are limited in females>males and in sports specific environments.

  Objective:

  The objective of this study is to investigate the impact of an 8-week core training program on the outdoor running performance of college-aged athletes, specifically their 1 mile and 100-meter dash times. The study aims to determine whether incorporating a core training program into the regular training regimen of college-aged athletes will lead to significant improvements in their running times.

  Methods:

  Participants:Participants include male and female college-aged athletes between the ages of 18 and 25 years of age and must either have a minimum of 1 year of athletic participation on a collegiate-level sports team or currently be listed on an active collegiate athletic roster. Additionally, inclusion criteria includes only English-speaking participants secondary to lack of resources for adequate translation. Recruitment: Participants are recruited from three local college campuses, Misericordia University, King’s College, and Wilkes University on a volunteer basis via the use of flyers being posted in buildings around campus and emails that will be sent to athletic directors and coaches. Program Interventions: Following initial data collection (week 0), participants complete an 8-week core endurance program. Participants complete an exercise log following each training session and survey. The program is completed 3 times per week and lasts approximately 45 minutes, 30 minutes for exercise and 15 minutes for logging data at the end of each week.

  Procedures:

  Participant data for the 100 Meter dash and 1-Mile run and core endurance collected at pretest (week 0), mid-test (week 4) and posttest (week 8) utilizing Dashr Timing System and McGill Core Endurance test, respectively. The running assessments take place at Mangelsdorf field at Misericordia University (Dallas, PA) on an NCAA approved outdoor running track. The McGill core endurance tests consist of three exercises completed within a series and includes the following: a trunk flexor endurance test, a trunk lateral endurance test (on both sides), and a trunk extensor endurance test. Following data collection, participants perform an 8-week core training program 3X/week with two sessions performed as a home exercise program and one session performed with the researchers at the University. Over the course of the training program the subjects will complete weekly check-ins, one time per week via the online google survey, to ensure they are completing exercises with the intended form and intensity.

  Hypothesis:

  Based on prior studies we hypothesize that by increasing the strength and endurance of the core musculature there will be a decrease in the amount of time it takes to complete a 100-meter sprint and a 1 mile run, an increase in core strength, and a negative correlation between core strength and running times.

  Results/Conclusion:

  To be determined.

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  Artificial Intelligence in Interventional Cardiology

  Aaron Hummer

  Artificial Intelligence in Interventional Cardiology

  Student Researcher: Aaron Hummer

  Faculty Advisor: Dr. Elaine Halesey, Ed.D, R.T.(R)(QM)(ARRT)

  Abstract

  This research project explains the fundamentals of artificial intelligence (AI) and the ways that AI can be useful in interventional cardiology (IC), particularly in cardiac catheterization. In cardiac catheterization, intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are two imaging devices that are used in interventional procedures, such as percutaneous coronary interventions (PCI). While still early in the research phase, OCT combined with AI shows the most promising results for the future of IC. Presently, IVUS maintains the highest results during interventional procedures, but as more randomized, multicenter studies are performed using OCT, the paradigm shift that will occur in IC represents where the cardiology profession is headed in the future. Due to the number of advancements being researched in the use of OCT and AI, the application of this imaging device may happen sooner into departments than initially expected. Numerous studies being performed in Asia and Europe offer the most insight as to what the future may hold for this field. As with any novel technology, disappointment and disillusionment are bound to occur because of the unrealistic expectations that may be associated with this technology. While this technology might be new and exciting, the focus on improving and maintaining clinical outcomes during interventional procedures should be a current concern of the field of cardiology.

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  Osteological Identification and Morphological Comparison of Extant Sciurids

  Amber Kalinowski and Mateusz Wosik

  Bone elements can reveal varying characteristics for each rodent, so it is best to analyze overlapping elements between and among taxa when drawing comparative conclusions.

  Fossorial animals present robust skeletons, strong scapular girdles, short fore- and hind limbs, and prominent attachment sites for muscles. In an animal that is primarily cursorial it is expected to see a slimmer forelimb because the need for strong limbs to deal with biochemical strains is not present.

  Using a sample of Marmota monax (groundhog) and Tamias striatus (chipmunk), two common taxa found in northeastern Pennsylvania, we can examine the locomotory modes of these closely related Sciurid rodents.

  We found that the groundhog has more robust features while the chipmunk has more gracile elements. In the groundhog we found the epiphysis to be more porous indicating its juvenile nature. The groundhog also showed larger trochanters on both its femurs compared to the chipmunk. The chipmunk has its tibia and fibulas fused together while the groundhogs are two separate bones. The inferior epiphysis of the groundhog appears more robust and has a defined olecranon fossa.

  Our results demonstrate how chipmunks use a cursorial pattern and how groundhogs use a fossorial pattern. Robust limbs allow for the animal to deal with biomechanical strains such as compression and bending. A robust limb is not as flexible as a gracile one. In addition to being gracile, the limbs are also elongated allowing for longer strides.

  Future osteohistological research will be conducted to further compare biomechanical characteristics using bone microstructure.

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  Assessing Women's Understanding of Mensuration: Knowledge Gaps and Educational Needs

  Makenzie Kapitula, Alexis Hendrickson, and Sarah Lalli

  The menstrual cycle is more complex than what seems to be taught in the education system. School systems focus on the basics of the menstrual cycle, like for example what to do when a young female gets her menstrual cycle for the first time and telling the young female that she can get pregnant but then do not go into detail on the timeframe when pregnancy can occur. It consists of more information than what is taught in the public school system and should be better taught to young females to prevent the unpreventable. The main objective of the study was to evaluate how much women know or think they know about the menstrual cycle, and where in their education they learned the information. In order to generate responses, a survey was created and sent out to women that asked multiple questions. The questions were regarding the menstrual cycle and were specific to the knowledge that they have obtained or have not obtained in their lifetime.

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  Integrating Second Moment of Area with Osteohistology to Identify Limitations in Weight-Bearing Limb Bones

  Justin Kramer, Jeffrey Stephens, and Mateusz Wosik

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  CT-Guided Lung Biopsy in the Detection of Lung Cancer

  Brooke Lininger

  CT-Guided lung Biopsy in the Detection of Lung Cancer

  Student Researcher: Brooke Lininger

  Faculty Advisor: Dr. Elaine Halesey Ed., R.T. (R)(QM)(ARRT)

  Abstract

  This project explains computed tomography(CT)-guided lung biopsies in the detection of lung cancer. The project discusses CT, CT-guided lung biopsies, statistics, steps of the procedure, indications, contraindications, complications, pulmonary nodules, fine vs. core needle, as well as future advancements. Lung cancer is the most common type of cancer in the world. There are many factors that contribute to lung cancer such as smoking or being exposed to smoke. There are also three different types of lung cancer. CT-guided lung biopsies help to diagnose patients who are suspected of having a nodule or mass in their lung. CT-guided lung biopsies are minimally invasive and have high success rates. Generally, the patient will be discharged within a few hours post biopsy. As technology advances, CT-guided lung biopsies are being taken over by robotic bronchoscopies. Robotic bronchoscopies use CT imaging to enhance visualization of lung anatomy, resulting in an accurate resource to diagnose pulmonary nodules.

  Keywords: Computed tomography, CT-guided lung biopsy, lung cancer, pulmonary nodule, robotic bronchoscopy

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  Case Study: Effects of Virtual Reality on Motor Control with a Child Diagnosed with Spastic Ataxic Cerebral Palsy

  Alyssa Madison, Princess Roblete, and Maureen Rinehimer

  Background: Cerebral palsy is a neuromuscular disorder that affects a person’s motor control and balance. These individuals have difficulty co-contracting musculature resulting in decreased trunk control, hyper- or hypotonia, lack of body coordination, and sudden contractions when attempting to move. A recent technology that is beginning to be explored within the therapy world is the use of virtual reality (VR) to treat those with cerebral palsy.

  Objective: The objective is to evaluate the effect of virtual reality technology with children who have cerebral palsy by focusing on motor control such as: functional reach, functional movements to promote independence, sitting balance, and trunk control.

  Design: This will be a randomized case study research design.

  Setting: The study will take place at Misericordia University’s Pro Bono Clinic.

  Participants: One participant will be recruited through purposive sampling between the ages of 13 to 17 years old with a diagnosis of spastic, ataxic cerebral palsy.

  Intervention: The participant will follow the study protocol consisting of ten minutes of manual stretching, ten minutes of postural control, thirty minutes of virtual reality, and ten minutes of postural analysis for a total of sixty minutes per session. This study will consist of twenty four sessions with an addition of three warm-up sessions to allow the participant to become acquainted with virtual reality.

  Measurements: Three outcome measures will be used to measure functional independence, functional reach, sitting balance, and trunk control: Gross Motor Function Measure (GMFM), Trunk Control Measurement Scale (TCMS), and the Pediatric Outcomes Data Collection Instrument (PODCI). Data will be collected prior to beginning the virtual reality protocol, halfway through the twenty four sessions, and after all twenty four sessions are completed.

  Conclusion: The results of this study may contribute to an improved treatment method for children with spastic, ataxic cerebral palsy to improve overall quality of life.

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  Clinical Effectiveness of an Aquatic Exercise Program on Strength, Balance, Quality of Life and Emotional Well-Being in Those with Visual Impairments: A Protocol Study

  Laura Murphy, Nicole Joers, and Alyssa Buonavolonta

  As of 2019, at least 2.2 billion people worldwide are living with some degree of visual impairment according to the World Health Organization. Generic physical therapy has been shown to benefit those with visual impairments. In a 2014 systematic review, researchers analyzed multiple studies that focused on the visually impaired population and their progress on strengthening after participating in exercise programs. They found that the generalized PT helped to improve the performance on tests of physical function in those with visual impairments. There has been minimal research on aquatic therapy and those with visual impairments, yet there have been other studies looking at aquatic therapy with other impairments. Due to the lack of previous research on the topic, the purpose of this study was to see how aquatic therapy affects those with visual impairments in the areas of strength, balance, quality of life and emotional well being. Twenty participants with visual impairments intend to be recruited from the Northeast Sight Services in Exeter, PA. These participants will take place in a 6 week exercise program adapted from the Ohio State Aquatic Therapy Exercise Program. Pre and post exercise program measurements will be assessed in the areas of strength via the 30 Second STS test, balance via the BERG balance scale, and quality of life and emotional well being via the SF-36 and additional qualitative questions. The researchers hypothesize that there will be improvements in the post exercise program assessments. This is a protocol study.

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  Exploring the Transition from General Ultrasound to Veterinary Ultrasound: Challenges and Opportunities

  Juliette Myers, Kali Foltz, Emily Downs, and Shaun McNamara

  Student Researchers: Juliette Myers, Kali Foltz

  Interviewed Person: Emily Downs M.Ed., RDMS, RVT, RDCS, RT

  Internship Mentor: Shaun McNamara, RDMS, AB, BR, OB/GYN, RVT, VT, St. Luke's Hospital, Monroe Campus, Stroudsburg, PA

  The similarities, differences, and challenges of transitioning from general to veterinary ultrasound were explored through an interview and literary review. An interview was conducted with an experienced general and veterinary sonographer, Emily Downs. After the interview was completed, a literary review was conducted as evidence for the information received from the interview. The interview and research provided great information and detail on the transition process, what a sonographer should know prior to the transition, and what benefits and obstacles a sonographer may encounter. Some similarities include the use of similar ultrasound machines, indications, preparation for the exam, and purposes of ultrasound. The differences include the sonographic appearances with some anatomy such as the gastrointestinal system, adrenal glands, lymphatic system, and foreign bodies. Some challenges may include the emotional aspect of caring for an animal, physical demand, utilization of specialized ultrasound machines, and having the animal sedated for an ultrasound. With formal veterinary ultrasound training the transition can go smoothly.

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  Computed Tomography Simulation in Radiation Therapy for Non-small Cell Lung Cancer

  Victoria Narbone

  The purpose of this research is to educate readers on the role of computed tomography (CT) simulation in the radiation therapy process, specifically for patients with lung cancer. The goal of radiation therapy treatment is to maximize the dose to a target, usually a tumor, while minimizing the dose to the normal surrounding tissue. CT imaging creates cross-sectional images of the patient’s anatomy which can be used to create a treatment plan. In non-small cell carcinoma (NSCLC) there are four critical structures of concern including the spinal cord, esophagus, heart, healthy lung. CT simulation uses images to localize the tumor then define the size and shape of the treatment volume relative to the critical structures. For NSCLC treatment, a major concern in planning is breathing motion. The text utilized in the research included information on the principles of radiation therapy and CT simulation. Several studies are included to demonstrate the techniques used to manage motion including deep inspiration breathhold (DIBH) and four-dimensional computed tomography (4D-CT). 4D-CT uses advanced respiratory motion management techniques including respiratory gating and tumor tracking to measure the respiratory phase during simulation. A limitation to this research is the lack of research and studies on the topic of CT simulation in radiation therapy. Future literature should be published to highlight the importance of CT use in radiation therapy.

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  Comparing Work Related Injuries between Sonographers and Occupational Therapists: A Retrospective Analysis

  Kelley Osborne and Amber Robert

  Work related injuries are more prevalent in Sonographers compared to Occupational Therapists. Work-related injuries in ultrasound and occupational therapy are the result of multiple factors, including repetitive motions, heavy lifting or transfers, awkward postures, non-ergonomic work environments, and equipment. These risk factors have been identified as the main contributors to work-related injuries among Sonographers and Occupational Therapists. This research will continue the discussion of the differences and similarities between work-related injuries amongst Sonographers and Occupational Therapists, ergonomics, types of injuries, and the importance of injury prevention.

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  Diagnosis and Treatment of Triple Positive Breast Cancer

  Caroline Seibert

  Diagnosis and Treatment of Triple Positive Breast Cancer

  Student Researcher: Caroline Daisy Seibert

  Faculty Advisor: Dr. Elaine Halesey, Ed.D., R.T.(R)(QM)(ARRT)

  Abstract

  This project goes through the ways that triple positive breast cancer is diagnosed and the ways it can be treated. It also follows Patient X with how they were diagnosed and what current treatments they are doing to help stop the spread of the cancer. Breast cancer is one of the most common malignancies found in women and about 10% are diagnosed with triple positive breast cancer. Treatment options are discussed and has studies that show positive outcomes. Hormone therapy and targeted therapy are some of the treatments that are commonly used as a treatment for triple positive breast cancer. Studies showed that hormone therapy helped with treating the estrogen and progesterone receptors that are found, while targeted therapy helped with treating the human epithelial growth factor receptor 2 (HER2). With these positive findings, the need for continuing research on the best ways to stop the reoccurrence of triple positive breast cancer.

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  Minimally Invasive vs. Surgical Approach for Treatment of Uterine Fibroids

  Breanna Smith

  
  

  Minimally Invasive vs. Surgical Approach for Treatment of Uterine Fibroids

  Student Researcher: Breanna Smith

  Faculty Advisor: Dr. Elaine Halesey, Ed. D., R.T. (R)(QM)(ARRT)

  
  

  Abstract

  Uterine fibroids are solid neoplasms that are common in women of reproductive age. These neoplasms are often present as benign, however they have an intense impact on the quality of life. Historically treatments involved surgery, however modern medical advancements allow for the option of minimally invasive treatments. Uterine artery embolization (UAE) is a method of using embolic material to cut off blood supply to the fibroid, which shrinks and kills it. More invasive procedures include hysterectomy and myomectomy. Hysterectomy includes the complete removal of the uterus. A myomectomy is an invasive treatment to remove the fibroid, while keeping the uterus intact. There are many studies evaluating the effectiveness, safety, and benefits/risks of each procedure. The infection rate of these procedures is an efficient aspect of comparison. UAE (7.5%) and myomectomy (5%) have significantly higher infection rates than a hysterectomy (2.1%). The benefits, however, are preservation of the uterus and reproductive ability. The surgical approaches have a much longer recovery period than the minimally invasive UAE; approximately 30 days in comparison to 7 days. The presence of infection and complication rates with all the procedures indicates the need for further research and procedural development.

  Keywords: uterine fibroid, uterine artery embolization, hysterectomy, myomectomy, microscopic, laparoscopic

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  Examining the Relationship between Stress and Exercise among College Freshmen: A Correlational Study

  Georgia Smith and Shayla Heckman

  Scientific research was performed by conducting a survey. The survey was sent out to the freshman class of 2026 at Misericordia University. The objective of the survey was to compare the relationship between physical activity and stress levels. The students answered a series of questions related to physical activity in high school, college, their stress levels in high school and college, and their preferred type of physical activity. The results of the survey were then compared to peer reviewed articles to form a conclusion on the research performed.

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  The Influence of a Plant-Based Diet from Birth to Early Childhood on Anthropometric Measures, Developmental Milestones, and Micronutrient Levels: A Systematic Review

  Madison Swartout and Johanna Matsko

  Purpose: The primary purpose of this study is to investigate the feasibility of a plant-based lifestyle on the development of children from birth to four years of age. The secondary purpose of this study is to discuss the implications of a plant-based diet during early childhood on the profession of physical therapy.

  Methods: Two separate searches were completed using different search terms. The databases utilized by both searches included CINAHL Complete, Academic Search Ultimate, Health Source: Nursing/Academic Edition, and MEDLINE. Inclusion criteria were 1) studies published within the past 10 years, 2) children receiving a plant-based diet, 3) children postpartum up to years of age. Studies were excluded if they were systematic reviews, studies focusing solely on the effects of a plant-based diet of the mother and not the child, children with developmental disorders.

  Results: The search resulted in 11 studies that met the criteria and were used in this systematic review. Of the 11 studies, the results were summarized amongst three categories; anthropometrics, development, and micronutrients. Of the seven studies using anthropometrics, one had significant findings showing children in the unhealthful plant-based diet being stunted when measured against the WHO standards of height for age. Three studies used one developmental outcome measure each to evaluate the plant-based groups. Two of the three studies showed that children following a plant-based diet had better developmental scores when receiving B12 supplements compared to the scores of children not receiving B12 supplementation. The third study showed no relevant significance of development while measuring the age of sitting and walking amongst children on either diet. Lastly, seven studies looked at micronutrient levels of children on plant-based diets. Of the seven studies multiple micronutrient levels were evaluated, notably vitamin B12, folate, iodine, and choline. Five studies looked at B12 micronutrient levels, three of which included folate because of the intimacy of the two micronutrients. Findings showed that levels of B12 are of a normal value when supplemented in a child following a plant-based diet. Of the micronutrients a study was dedicated to each choline and iodine. Results from the study centered around choline showed that mothers following a plant-based diet provide adequate levels of choline to their children via breast milk. The iodine study compared the iodine levels of children receiving an OM, VG, and VN diet, all of which had iodine levels being below the recommended values but the omnivorous had the highest iodine levels of the three diets compared. Lastly, the current study gathered results from the 11 articles regarding cholesterol and fatty acid levels. The cholesterol and fatty acid panels of the plant-based groups showed lower total cholesterol, lower saturated fatty acids, and higher total polyunsaturated fatty acids when compared to the omnivorous groups.

  Conclusion: Plant-based diets can be sustainable for infants and children up to age four if implemented properly. Insufficiencies in micronutrient levels can occur in this target population, though there were little to no delays in development or growth based on pediatric outcome measures and anthropometric analyses. Any micronutrient insufficiencies can be remedied with proper supplementation, though guidance is recommended in this area as hypervitaminosis may occur. Regarding the role of physical therapy, if applicable within the therapist's jurisdiction, expanding personal scope of practice to include nutrition can be beneficial for the clinician and their patients.

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  Outpatient Physical Therapists’ Knowledge, Attitudes, and Behaviors Regarding Eating Disorder Screening

  Esther Thomas, Morgan Russo, Kara Martin, Kristen Karnish, and Audrey Campbell

  Background & Purpose: Approximately 9% of Americans will have an eating disorder in their lifetime1 and these disorders can impact the recovery of patients receiving physical therapy services. Physical therapists (PT) should be aware if a patient has a history of, or current history of an eating disorder or nutritional deficiency as these can negatively impact a patient’s participation and optimal functioning. Minimal research has been performed related to physical therapy and eating disorders. Determining outpatient physical therapists’ knowledge, attitudes, and behaviors towards eating disorders and if they are screening for eating disorders is the first step in furthering research to help bridge the gap in the literature and improve patient care for this population This is a descriptive cross-sectional study investigating outpatient physical therapists’ knowledge, attitudes, and behaviors regarding eating disorder screening as a part of physical therapy practice. Participants: 231 licensed physical therapists working in an outpatient clinic setting. Methods: Researchers created a survey based on current literature on eating disorder screening and three physical therapists reviewed it for clarity. Questions were structured to target three main topics: knowledge, attitudes, and behaviors of physical therapists on eating disorder screening. The electronic survey was created and distributed via employer emails, APTA listservs, and social media. Results: A total of 231 participants with an average age of 35.67 years old (±10.42 years) consented to participate in the study. The majority of the sample population, 63.06%, reported having no education on eating disorders. A total of 83.34% of participants agreed or strongly agreed that screening for eating disorders is within the physical therapists scope of practice. However, only 6.54% of participants routinely screen for eating disorders. Discussion: The vast majority of physical therapists surveyed did not screen patients for eating disorders. However, the majority of participants agreed/strongly agreed that screening for eating disorders is within the PT scope of practice and that they wanted to play a role in helping patients prevent poor eating habits. Educating patients about eating disorders should include providing appropriate resources to patients, whether that is a referral to another medical professional, a hotline/helpline, or general CDC nutritional guidelines. To identify patients with eating disorders screening is the first step. Physical therapists can then give education, refer to other professionals and modify the PT plan of care appropriately.

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  Effectiveness of Interventions to Address Kinesiophobia in Individuals with Chronic Low Back Pain: A Systematic Review

  Olivia Visaggio and Taylor O'Keefe

  Chronic low back pain (CLBP) is the most common musculoskeletal condition and can impact individuals’ quality of life and work productivity. Along with CLBP, individuals with this chronic condition have an altered perception of their pain and may experience a fear of movement, or kinesiophobia. Thus, this systematic review seeks to address the effectiveness of various physical therapy interventions for individuals with CLBP who demonstrate kinesiophobia. Eleven randomized controlled trials (n = 1004) were assessed, which all utilized interventions consisting of cognitive-based interventions (including education), exercise-based interventions, manual therapy, or a combination of these. The following areas were assessed in the articles using a variety of outcome measures: disability, kinesiophobia, pain intensity, quality of life, and self-efficacy. Due to the improvements seen among both control and experimental groups with varying interventions, there is inconclusive evidence regarding the most effective interventions to use in physical therapy when working with patients who have CLBP and kinesiophobia. Thus, a variety of cognitive-based interventions, exercise-based interventions, manual therapy, or a combination of any of the three, can be beneficial to patients with CLBP who present with kinesiophobia.