Virginia Research Day 2025

2025 Via Research

Recognition Day

Welcome

Welcome to the twentieth annual Edward Via College of Osteopathic Medicine Via Research Recognition Day on the VCOM-Virginia campus. Held annually, the Via Research Recognition day is a significant event for VCOM that supports the mission of the College to provide medical education and research that prepares globally minded, community-focused physicians and improves the health of those most in need. VCOM's Research Recognition Day offers a forum for health professionals and scientists at academic institutions, teaching hospitals and practice sites to present and benefit from new research innovations and programs intended to improve the health of all humans. By attending the sessions with the speakers, participants have the opportunity to learn cutting edge information in the physiological bases of osteopathic manipulative therapy efficacy, new trends in physician-based research networks, and how to develop innovative research projects with high impact for human health. Poster sessions allow participants to learn about the biomedical, clinical and education-simulation research activities at VCOM-Virginia and its partner institutions.

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Agenda 7:30 am

Check-In Desk Opens

8:00 - 10:30 am

Poster Viewing + Final Round of Poster Competition

10:30 -10:35 am

Welcome and Opening Comments James E. Mahaney, PhD, Associate Dean for Biomedical Affairs and Research, VCOM-VC

10:35 -10:55 am

“The State of Research at VCOM” P. Gunnar Brolinson, DO, FAOASM, FAAFP, FACOFP Vice President for Research Edward Via College of Osteopathic Medicine - Virginia Campus

11:00 am - 11:40 pm “Omniblind Controls: Towards Rigor & Reproductiblity in Osteopathic Research” Mark D. Unger Jr., DO, MS, BC-AOBNMM Assistant Professor, OMM & OPP Liberty University College of Osteopathic Medicine

11:45 am - 12:25 pm “Clinical AI to Improve Patient Diagnosis and Outcomes" Nicholas L. Rider, DO, FAAAAI, FCIS Professor, Health Systems & Implementation Science Virginia Tech Carilion School of Medicine

12:30 - 1:00 pm

Poster Competition Awards & Researcher of the Year Awards Ceremony

Closing Remarks and Adjournment

1:00 pm

*To go boxed lunches available after the closing remarks for those who registered for the event.

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2025 Research Recognition Day

RESEARCH changes the world.

IN THE PHOTO: Nicholas Torre

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Table of Contents

College Leadership & Program Moderators.............................................................................................................................6 Speakers P. Gunner Brolinson, DO, FAOASM, FAAFP, FACOFP............................................................................................................10

Mark D. Unger Jr., DO, MS, BC-AOBNMM.............................................................................................................................11

Nicholas L. Rider, DO, FAAAAI, FCIS......................................................................................................................................12

Abstracts Faculy Research - Biomedical................................................................................................................................................15

Undergraduate Student Research - Biomedical ...................................................................................................................16

Faculty Research - Clinical......................................................................................................................................................17

Graduate Student Research - Clinical....................................................................................................................................18

Faculty Research - Education and Simulation.......................................................................................................................19

Graduate Student Research - Biomedical..............................................................................................................................20

Medical Student Research - Public Health.............................................................................................................................24

Medical Student Research - Education and Simulation........................................................................................................31

Medical Resident Research - Case Reports..........................................................................................................................41

Medical Student Research - Biomedical................................................................................................................................66

Medical Student Research - Case Reports............................................................................................................................93

Medical Student Research - Clinical.....................................................................................................................................129

Click a Title to Navigate to Abstract Section

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2025 Research Recognition Day

College Leadership

Dixie Tooke-Rawlins, DO, FACOFP President Edward Via College of Osteopathic Medicine

Dr. Dixie Tooke-Rawlins has served as the Administrative Officer principal to the founding of the Edward Via Virginia College of Osteopathic Medicine in 2001. As the founding Dean for VCOM, she led the College in the development of the curriculum, clinical site affiliations, budget and long range plan, and assisted in the design of the first educational and research facilities. She currently holds the position of President and Provost as well as the academic title of Professor in the Department of Family Medicine at VCOM. In 2011, Dr. Tooke-Rawlins again served as a founding Dean in the opening of the Carolina campus of VCOM in Spartanburg, South Carolina and again in 2015 in the opening of the Auburn Campus of VCOM in Auburn, Alabama. Prior to this appointment Dr. Tooke-Rawlins held the position of Interim Dean at Kirksville College of Osteopathic Medicine (KCOM) in Kirksville, Missouri. Past appointments include Associate Dean for Academic and Clinical Affairs at KCOM, Director of Osteopathic Medical Education and Program Director of the Osteopathic Family Practice Residency at St. Luke’s Hospital in Allentown, Pennsylvania, and Family Practice Residency Director at Metropolitan Hospital in Grand Rapids, Michigan. She currently holds several appointments nationally and the state level including President of the Virginia College of Osteopathic Family Physicians, Governor appointee to the Virginia Council on Healthcare Reform and the Virginia Healthcare Workforce Development Authority. Dr. Tooke-Rawlins is a member of the Board of Governors of the American Association of Colleges of Osteopathic Medicine, and has served on the inspection teams for both osteopathic post-graduate training institutes and osteopathic family medical

residencies. She is a board member of the American Osteopathic Foundation, and she has been a member of the American Osteopathic Association and the American College of Osteopathic Family Physicians for more than 20 years. Dr. Rawlins has focused her career on the interests of Osteopathic Medicine, Osteopathic Medical Education, Rural Health/Rural Medicine, Health Care Disparities, and Global Health. She was instrumental in the establishment of the VCOM International Medical Missions program that provides year round primary care clinics in Honduras, El Salvador and the Dominican Republic. She participates in annual outreach programs in Appalachia including remote community outreach programs by the college and has for many years served the uninsured and medically underserved with time committed to community service. Dr. Tooke-Rawlins is a graduate of Northeast Missouri State (now Truman State University) and the Kirksville College of Osteopathic Medicine with a Doctorate of Osteopathic Medicine degree. She completed her post-graduate work at Grandview Hospital in Dayton, Ohio and entered the field of Emergency Medicine for the first seven years of her early career. She returned to Kirksville where she entered the field of Family Medicine and became board certified in Family Medicine by the American Board of Osteopathic Family Practice.

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College Leadership

Deborah West, EdD Provost Edward Via College of Osteopathic Medicine

Deborah West, EdD, currently serves as provost for the Edward Via College of Osteopathic Medicine (VCOM). Dr. West has served in various administrative roles while at VCOM, most recently serving as the vice provost for academic affairs and accreditation. During her tenure at VCOM, she established the Center for Institutional, Faculty, and Student Success, which is focused on supporting students throughout their medical education journey and continuously advancing the quality of education by providing faculty with resources, programs and support that promote excellence in teaching.

Previous to her employment at VCOM, she served for 15 years in the public education setting as a school counselor and school principal. In 2019, Dr. West earned a Doctor of Education Degree in Curriculum and Instruction from Liberty University. She majored in Education at Concord College and completed her graduate degree in counseling from Marshall University. Dr. West is passionate about helping students reach their full potential and creating an educational environment where students and faculty thrive.

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2025 Research Recognition Day

College Leadership

Ron Januchowski, DO, FACOFP Dean, Virginia Campus Edward Via College of Osteopathic Medicine

Ronald Januchowski, DO, FACOFP graduated from the New York College of Osteopathic Medicine in 1993 and did a one-year internship at Botsford Hospital in Farmington Hills, Michigan. He began active duty in the Army at Fort Bragg, initially in an operational capacity and then completed his Family Medicine residency at Womack Army Medical Center in 1998. After leaving active duty in 2001, he went into private practice in Gastonia, North Carolina, and eventually moved to the Spartanburg, South Carolina, area to become the Osteopathic Family Medicine residency director at the first osteopathically accredited residency site in South Carolina. While at Spartanburg Medical Center, he served as the chair of the family medicine department as well as the IRB chair.

Dr. Januchowski started at the VCOM-Carolina’s campus when it opened in 2011 and has served as the associate dean for clinical education and then as the Associate Dean For Preclinical Education. He was very excited to begin his tenure as dean of the VCOM-Virginia campus in October 2023. Dr. Januchowski is a fellow of the American College of Osteopathic Family Physicians and a professor in the Family Medicine Department of VCOM. He retired from the military with the rank of colonel.

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Program Moderator

James E. Mahaney, PhD Associate Dean of Biomedical Affairs & Research Edward Via College of Osteopathic Medicine

Dr. Jim Mahaney is professor and chair of the biomedical sciences department and serves as the associate dean for biomedical affairs and research at the Edward Via College of Osteopathic Medicine – Virginia campus. He is also a research associate professor in the department of biochemistry at Virginia Tech. Dr. Mahaney received his BS degree in chemistry from Virginia Tech in 1984, and his PhD in chemistry/biophysical chemistry from the University of Virginia in 1989. He pursued post-doctoral research training in the department of biochemistry at the University of Minnesota Medical School in Minneapolis from 1989-1994. His first faculty appointment was as an assistant professor in the department of biochemistry at West Virginia University School of Medicine in 1994, and in 2001 he was granted tenure and was promoted to associate professor. During this time, Dr. Mahaney established his independent research program designed to elucidate the molecular mechanism of calcium transport regulation in the heart, focusing on age-based and disease-based changes in calcium transport and its regulation. For this work, Dr. Mahaney combined the biophysical techniques of fluorescence spectroscopy and electron paramagnetic resonance spectroscopy with pre-steady state and steady state enzyme kinetics methods. The goal was to correlate specific enzyme dynamic transitions with key steps in calcium transport processes related to cardiac muscle relaxation. Dr. Mahaney’s work at West Virginia University was carried out by four graduate students and twelve undergraduate research students, with the help of a full-time technician. His work was funded by an American Heart Association Established Investigator grant and an American Heart Association Grant-in-Aid, and Dr. Mahaney was a co-investigator on two separate NIH R01 awards.

In 2003, Dr. Mahaney moved to Blacksburg, VA and served as the founding discipline chair for biochemistry at VCOM. He continued his research work at VCOM with the help of two additional graduate students and eight undergraduate research students from Virginia Tech. He was also funded with new grants from the American Heart Association and an NIH R15 award. In 2008, Dr. Mahaney became the associate dean for biomedical affairs and research and shifted his focus to managing the biomedical division for VCOM and promoting research for all research active faculty on the Virginia campus. He also works to create opportunities for increased medical student involvement in research and encourages student participation in a wide variety of settings and projects. Dr. Mahaney is an active member of the Biophysical Society and serves on the cell transport and metabolism grant review group for the National American Heart Association. He also serves as a reviewer for the American Osteopathic Association Research Division. In 2004, he received the VCOM Biomedical Educator Award – Peer Choice, and the VCOM Biomedical Educator Award – Student Choice. In 2009 and again in 2014, Dr. Mahaney received the VCOM Golden Apple Award for Excellence in Teaching from the medical students. In 2012, Dr. Mahaney received the VCOM Golden Apple Award for Excellence in Teaching from the post-baccalaureate class.

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2025 Research Recognition Day

Program Moderator & Speaker

P. Gunnar Brolinson, DO, FAOASM, FAAFP, FACOFP Vice Provost for Research Edward Via College of Osteopathic Medicine

Dr. Brolinson is vice provost for research, professor of family and sports medicine at the Edward Via College of Osteopathic Medicine and team physician for Virginia Polytechnic Institute and State University. He is an adjunct professor in the department of mechanical engineering at Virginia Tech. He is the fellowship director emeritus of the primary care sports medicine fellowship at VCOM and Virginia Tech. He is also a volunteer physician for the United States Olympic Committee and a team physician for the United States Ski Team and was head team physician for the Freestyle Ski Team at the 2006 Winter Olympic Games in Torino, Italy. He was also named to the medical staff for the 2010 Winter Olympic Games in Vancouver, British Columbia and was medical director of the USOC performance services center. He obtained his undergraduate training from the University of Missouri at Columbia earning a degree in biology. A 1983 graduate of the Kirksville College of Osteopathic Medicine, Dr. Brolinson is board certified in family practice and holds a subspecialty certification in sports medicine. Prior to coming to Virginia, he was the co-director of the primary care sports medicine fellowship training program at The Toledo Hospital in Toledo, Ohio, and team physician for University of Toledo. He has extensive experience in undergraduate and post-graduate medical education. Dr. Brolinson has served

on the boards of the American Osteopathic Academy of Sports Medicine, the American Medical Society for Sports Medicine and the Midwest Chapter of the American College of Sports Medicine. He is a past president of the American Osteopathic Academy of Sports Medicine. Dr. Brolinson is a fellow of the American Osteopathic Academy of Sports Medicine, the American Academy of Family Practice and the American College of Osteopathic Family Practice. In 1997, he was named outstanding young physician in Ohio by the Ohio State Medical Association. He is a former associate editor for the "Clinical Journal of Sports Medicine" and a former member of the editorial board of the physician and sports medicine. He is former section editor for Competitive Sports and pain management in the journal "Current Sports Medicine Reports". Dr. Brolinson is a frequent speaker at national sports medicine meetings and often teaches didactic laboratory sessions on the use of osteopathic manipulative therapy for athletic injuries. Dr. Brolinson is a contributing author in the latest edition of "Foundations for Osteopathic Medicine" and he has published several scholarly articles and book chapters in the area of sport and exercise medicine. His research interests have included exercise and immune function, exercise and bone mineral density, mild traumatic brain injury in sports, impact biomechanics, human factors in auto safety, sports performance and manipulation and other health and disease prevention related topics.

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Speaker

Mark D. Unger Jr., DO, MS, BC-AOBNMM Assistant Professor of OMM & OPP Liberty University College of Osteopathic Medicine

Dr. Mark D. Unger Jr. is deeply passionate about providing relief to patients who are grappling with persistent, severe pain. Dr. Unger sees patients as a Neuromusculoskeletal Medicine specialist at Collaborative Health Specialty Services. Dr. Unger is an Assistant Professor of OMM & OPP at Liberty University College of Osteopathic Medicine, where his research focuses on the development of new treatments for chronic biopsychosocial pain. After obtaining his DO from the University of New England College of

Osteopathic Medicine, Dr. Unger’s professional training included industry-level research experience in chronic pain prior to completing residency training in Neuromusculoskeletal Medicine. Dr. Unger has authored numerous peer reviewed journal articles and has been awarded federal funding to pursue his research. Dr. Unger’s personal interests include rock climbing, cryptography, and, alongside his lovely wife, cooking the perfect pizza.

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2025 Research Recognition Day

Speaker

Nicholas L. Rider, DO, FAAAAI, FCIS Professor, Health Systems and Implementation Science Virginia Tech Carilion School of Medicine

Dr. Nicholas L. Rider is a board certified clinical immunologist and clinical informaticist. He has longstanding expertise in the clinical management of patients with complex immunologic disease and in clinical data science approaches for optimizing patient care. Dr. Rider serves as a Professor in

the Department of Health Systems & Implementation Science at the Virginia Tech Carilion School of Medicine. Additionally, he is an Associate Chief Medical Information Officer focused on research data operations at the Carilion Clinic. Dr. Rider also sees patients at the Carilion Clinic Tanglewood location.

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2025 Research Recognition Day

RESEARCH breaks down barriers.

IN THE PHOTO: Pranav Varrey and Christine Lewis

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Faculty Research Biomedical

01 NANOG induces skeletal muscle reprogramming and enhances reinnervation after peripheral nerve injury

Pihu Mehrotra; James Jablonski; John Toftegaard; Yali Zhang; Shahryar Shahini; Jianmin Wang; Carey W. Hung; Reilly Ellis; Gabriella Kayal; Nika Rajabian; Song Liu; Susan B. Udin; Stelios T. Andreadis; Kirkwood E. Personius; Kelly C. S. Roballo Corresponding author: kroballo@vcom.edu

Peripheral Nerve Injuries (PNI) affect more than 20 million Americans and severely impact the quality of life by causing long-term disability. PNI is characterized by nerve degeneration distal to the site of nerve injury resulting in long periods of skeletal muscle denervation. During this period, muscle fibers atrophy and frequently become incapable of “accepting” innervation because of the slow speed of axon regeneration post-injury. We hypothesize that reprogramming the skeletal muscle to an embryonic like state may preserve its reinnervation capability University at Buffalo Roswell Park Comprehensive Cancer Center Edward Via College of Osteopathic Medicine Virginia-Maryland College of Veterinary Medicine, Virginia Tech Center of Excellence in Bioinformatics and Life Sciences Center for Cell, Gene and Tissue Engineering (CGTE)

following PNI. To this end, we generate a mouse model in which NANOG, a pluripotency-associated transcription factor is expressed locally upon delivery of doxycycline (Dox) in a polymeric vehicle. NANOG expression in the muscle upregulates the percentage of Pax7+ nuclei and expression of eMYHC along with other genes that are involved in muscle development. In a sciatic nerve transection model, NANOG expression leads to upregulation of key genes associated with myogenesis, neurogenesis, and neuromuscular junction (NMJ) formation.

Further, NANOG mice demonstrate extensive overlap between synaptic vesicles and NMJ acetylcholine receptors (AChRs) indicating restored innervation. Indeed, NANOG mice show greater improvement in motor function as compared to wild-type (WT) animals, as evidenced by improved toe-spread reflex, EMG responses, and isometric force production. In conclusion, we demonstrate that reprogramming muscle can be an effective strategy to improve reinnervation and functional outcomes after PNI.

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2025 Research Recognition Day

Undergraduate Student Research Biomedical

01 The effect of Biolaminin in horse Schwann cells in vitro culture

Juliana Lopez-Vivas; Taylor Dickson; Kelly C. S. Roballo Corresponding author: julianalvivas@vt.edu

Edward Via College of Osteopathic Medicine Virginia-Maryland College of Veterinary Medicine, Virginia Tech

Full-length laminins are essential for cells in the body; therefore, they make a real difference in the cell functionality of ex vivo cell cultures. Biolaminin products offer a biologically relevant matrix that mimics the authentic extra-cellular matrix-cell interaction. In this project, we tested how biolaminin could improve horse Schwann cell culture, for that two types of laminins were tested, and cell growth and overall cell quality were tracked. The first biolamin tested was biolaminin 521 LN, which is the natural laminin for cells, reliably facilitating the self-renewal of cells in a chemically defined, feeder-free, and animal-origin-free stem cell culture system. Biolaminin 521 enables efficient single-cell

cells and progenitor cells. Laminin products are scientifically proven to increase cell proliferation rate with stable phenotype and facilitate the use of low passage cell lines for the production of clinically relevant cell numbers of differentiated cell types. Our preliminary result showed that horse Schwann cells growth rate were 2-folds more than control cultures in the first 30 days of culture, and laminin 211 were better than 521. As our next step, we are planning to test these laminins in other cell types, and also test the cell viability of horse Schwann cell when in contact with laminin.

passaging of genetically stable and pluripotent stem cells without the need for any apoptosis inhibitors, ensuring superior quality for your cells and studies. Second, we tested the laminin 211, which is a major laminin isoform synthesized by Schwann cells in the developing peripheral nervous system, important for axonal elongation/neurite extension and myelinization. Laminins containing the α2-chain (such as laminin 211) are expressed in the ventricular zone extra cellular matrix in the developing mouse central nervous system. Since laminins are known to contribute to the stem cell niche in the brain, this suggests that laminin 211 could play an important functional role in the regulation of neural stem

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Faculty Research Clinical

01 Patient Preferences for Whole Health Treatment Plans for Chronic Pain Within an Interdisciplinary Pain Program at a VA

Jody Caretti, BS; Stephanie Smith, RN, BSN; Teresa Johnson, PhD; Rena E. Courtney, PhD Corresponding author: rena.courtney2@va.gov

Salem VA Health Care System Virginia Tech Carilion School of Medicine Veterans Integrated Service Network 6 Mental Illness Research, Education, and Clinical Center (VISN 6 MIRECC) Edward Via Collage of Osteopathic Medicine

to determine the feasibility and acceptability of PREVAIL IDT Track. Patients who enrolled in PREVAIL IDT Track from Jan 2022 through June 2024 were included. Data on which of the 8 Whole Health self-care components (2 minimum, 4 maximum) each patient chose during their initial evaluation was extracted from the medical record. The data were summarized using descriptive statistics. Results: Five hundred sixty-one veterans completed the PREVAIL IDT Track initial evaluation. Seventy-four percent chose Moving the Body (i.e., exercise), 51% chose Power of the Mind (i.e., mental health), 48% chose Food and Drink (i.e., nutrition), 40% chose Rest and Recharge (i.e., sleep), 35% chose Personal Development, 24% chose Surroundings (e.g., de-cluttering), 16% Family, Friends, and Co-Workers (i.e., relationships), and 8% chose Spirit and Soul (i.e., spirituality). Conclusion: This study was the first of its kind to demonstrate Veterans’ preferences for their patient

centered, Whole Health-focused treatment plans for chronic pain. When given the chance to select their own areas for self-care, Veterans report motivation to increase engagement in physical activity, better manage their mental health, and improve their diet. This patient-centered approach to treatment planning may allow clinicians can determine the areas of self care which patients feel are most important and on which they are most willing to work. The sense of agency for the Veteran may increase the likelihood of increased participation in self-care, resulting in better outcomes. Further research is warranted to evaluate the difference in engagement and outcomes when patients choose their own goal areas versus when they are assigned goal areas by the clinicians. This study was approved by the Salem VAHCS IRB (protocol # REC 0001).

Introduction: The Whole Health approach emphasizes patient-centered care within team-based settings. However, there is extant data on patient preferences for the content of these treatment plans. The PREVAIL Interdisciplinary Team Track Program (PREVAIL IDT Track) at the Salem Veterans Affairs Health Care System (Salem VAHCS) utilizes the Whole Health approach to develop individualized treatment plans for pain. During the initial evaluation with 5 pain specialists (interventional pain, psychology, pharmacy, nutrition, physical therapy), veterans grade how well they are doing in eight Whole Health self-care areas that may be influencing their chronic pain. Veterans are then asked to select at least two self-care areas to focus on during the six month program as a method of improving their pain and other symptoms. Methods: Patients at the Salem VAHCS who were actively participating in the PREVAIL IDT Track program and who experienced chronic pain were enrolled in this IRB-approved study designed

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2025 Research Recognition Day

Graduate Student Research Clinical

01 The Validity of a Pose Estimation App Compared to a Universal Goniometer to Measure Joint Position

Niels Gainsback; Ben Harris; Haley Highsmith; Sarah Howell; Kevin Chui; Kevin Parcetich Corresponding author: kparcetichii@radford.edu

Radford University

shoulder ROM. Eleven participants were trained to use the PET application on a mobile device and were instructed to capture joint position after researchers set a joint position using the universal goniometer. The joint position was recorded from the PET mobile application and compared to the set measurement obtained by the goniometer. Accuracy, inter-rater, and intra-rater reliability were determined. Results: Intraclass Correlation Coefficients (ICC) and Bland Altman analyses were performed to determine inter-rater reliability, intra-rater reliability, and observe trends between each of the 5 motions. Small differences were observed using the Bland Altman plots with an overall trend of overestimating joint position values using PET. Model 1 intra-rater reliability for abduction mid-range ICC of 0.597 (CI 0.083-0.869, p=0.014), IR end range ICC of 0.542 (CI -0.011-0.849, p=0.013), and ER beginning range ICC of 0.525 (CI –0.059-0.844, p=0.041). Model 2 intra rater reliability for abduction mid-range ICC of 0.548 (CI –0.044-0.855, p=0.036) and ER end-rage ICC of 0.617 (CI 0.073-0.880, p=0.018). Inter-rater reliability

between “raters”, findings report flexion beginning range ICC of 0.505 (CI 0.121-0.999, p<0.001), flexion mid-range ICC of 0.361 (CI 0.054-0.998, p=.004), flexion end-range ICC of 0.574 (CI 0.132 0.999, p=0.004), and abduction beginning-range ICC of 0.574 (CI 0.155-0.999, p<0.001). Implications: The initial pilot data suggests pose estimation technology may overestimate shoulder joint positions and can provide reliable measurements for select positions with large confidence intervals. Limitations of this study include assess over larger sample size with varying demographics and anthropometric characteristics, use in different joints, and in those with pathologies that impair ROM. Approved by Radford University IRB, protocol #2024 026-RUC. Authors received patient consent to use data for report.

Introduction: Joint position is measured with a universal goniometer to quantify impaired movement and monitor the progress of physical rehabilitation treatments. Pose Estimation Technology (PET) has become a more common method of capturing joint position, using computer algorithms and deep learning models to recognize and track anatomical landmarks. PET has implications in the field of telehealth, allowing for increased patient access, however, accurate and reliable virtual physical assessments are required to replace in-person assessments. Purpose: The purpose of this study is to determine the accuracy and reliability of a mobile PET application when measuring different joint positions of the glenohumeral joint. Methods: The right shoulder of two asymptomatic “models” was used to capture joint positions across beginning, middle, and end ranges of motion for 5 different shoulder motions (flexion, extension, abduction, internal and external rotation). Two researchers, proficient in the use of a universal goniometer, set shoulder joint positions at different points in the available

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Faculty Research Education and Simulation

Daniels T.; Perera IR.; Moriarty S.; Noor S.; Rastogi S.; Crouse C.; Kharel A.; Januchowski R.; Looney J.; Gittings K.; Rawlins II F. Corresponding author: frawlins@vcom.edu tdaniels@vcom.edu 01 Comparison Of Novel Voice Recognition Models In Medical Student Decision Making During Case Presentation

Center for Simulation and Educational Technology Edward Via College of Osteopathic Medicine - Virginia Campus

text (STT) in medical student MDM during clinical case presentations. Methods: Approximately 154 previously de identified Integrated Clinical Case (ICC) recordings were transcribed by student researchers and validated by an attending physician. These initial transcripts were considered True Transcriptions. Additionally, recordings were transcribed by Deepgram Nova-2 and Whisper V3, for comparison of STT. The textual output was cleaned for abbreviations, punctuation, grammar, and other textual impurities. This process was universally applied to both Deepgram Nova-2 and Whisper V3. Next, the textual output for the models was analyzed using Term Frequency Inverse Document Frequency (TFIDF). The textual output of the two Large Language Models (LLM) was then paired against the true transcription, generating standard LLM error metrics: 1. Jaccard Similarity, 2. Jaro-Winkler Distance, 3. Leveshtein Distance, 4. Word Error Rate, 5. Word Information Loss, 6. Match

Error Rate, and 7. Character Error Rate. The metrics of the two LLMs were analyzed and compared utilizing paired t-tests. Results: Comparison of Deepgram Nova-2 and Whisper V3 demonstrated a statistically significant difference in all seven LLM error metrics (P < 0.05). Conclusion: Deepgram Nova-2 outperformed Whisper V3 in all STT LLM evaluation metrics, demonstrating its ability to produce an accurate medical transcript in medical student MDM during clinical case presentations. Innovative educational technology leveraging this model could be implemented into the medical student curriculum to elevate both VCOM and our students to a higher tier of academic excellence.

Context: Medical schools are required by accrediting bodies to ensure students attain mastery of medical knowledge, patient care, and appropriate communication within an interdisciplinary healthcare team to collaborate in medical decision making (MDM). VCOM meets the accrediting core competency of communication through its Integrated Clinical Cases (ICC) course. Medical students are required to make an oral presentation of their simulated patient encounter and complete a self-assessment of their performance. However, for medical schools to produce students of the highest caliber we must provide instantaneous high-quality expert feedback related to student MDM, this is an area in which our current curricular practices are inadequate. The introduction of a novel voice recognition software could bridge this gap. Objective: To compare two novel voice recognition models, Deepgram Nova-2 and Whisper V3, on their ability to accurately convert speech-to

IRB #2112436-4.

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2025 Research Recognition Day

Graduate Student Research Biomedical

01 Investigating Regional Diffrences in Migroglia Phenotype Across Combined Repetative Blast Exposure and Delayed Closed Head Controlled Cortical Impact Induced Traumatic Brain Injury

Nora Ahmed; Jessica Wilkes; Susan Murphy; Pamela VandeVord Corresponding author: noraa23@vt.edu

Virginia Tech Wake Forest School of Biomedical Engineering & Sciences

Traumatic brain injury (TBI) continues to be a serious clinical challenge. When focusing on the military population, it is known that Service Members with TBIs are at higher risk of subsequent TBIs because of risk-taking behaviors. Veterans diagnosed with TBI had a substantially greater risk of being hospitalized for motor vehicle accidents than those without TBI diagnoses. Thus, one of the goals of this research was to optimize a preclinical model that simulates a delayed secondary impact in a solider that was exposed to blast. This study focuses on how microglia respond to this dual-TBI paradigm. Microglia

serve as the brain's active immune cells and exhibit various functional roles based on their morphological presentation and transcriptional profiles after a blast injury. Even though the molecular presentation of microglia have been shown to vary spatially and temporally across brain injuries, the phenotypic differences of microglia across a dual-injury model has yet to be explored. Here in this study, adult male Sprague Dawley rats were subjected to a repetitive blast injury and then to a single closed head cortical impact (cCCI) injury 2 weeks later. Brains were then collected 2 weeks following impact and microglial

activation was explored using immunohistochemistry. The results show that overall microglia exhibit shorter process length and less endpoints per cell in the dual repetitive blast exposure and delayed cCCI-induced injury compared to a single cCCI injury. Overall, the study shows that morphological changes in microglia continue to persist chronically following a Veteran relevant complex TBI model and could contribute to long-term neuropathology.

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Graduate Student Research Biomedical

02 Gut Microbiota Immunomodulations in CX 3 CR1 Deficient Lupus Mice

Rana Estaleen 1 ; David Oakland2; Razan Alajoleen1; Ran Lu1; Hilary Montano1; Pavly Amin3; Aida Shakeri3; Xin M. Luo1 * ; Christopher M. Reilly 1 ,4* Corresponding author: erana@vt.ed

1 Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech 2 Translational Biology, Medicine and Health Graduate Program, Virginia Tech 3 Department of Biological Sciences, College of Science, Virginia Tech 4 Department of Biomedical Sciences, Edward Via College of Osteopathic Medicine

The gut microbiota contributes to the health and disease of host and an imbalance of the gut microbiota is linked to systemic lupus erythematosus (SLE), which is an autoimmune disease where the immune system attacks its tissues and organs. CX 3 CR1 is a chemokine receptor that initiates intracellular signaling cascades responsible for modulating cellular activity, proliferation, and survival. CX 3 CR1 is expressed on various types of cells, including lymphocytes and myeloid cells. The absence of CX 3 CR1 compromises the integrity of the intestinal barrier and changes the gut microbiota composition. In this study, we hypothesized that CX 3 CR1

modulates lupus-associated disease through gut microbiota-mediated renal infiltration of T cells producing interleukin 17 (IL-17). We developed Cx3cr1 -deficient (KO) MRL/ lpr lupus-prone mice by backcrossing MRL/ lpr with B6/ Cx3cr1 gfp/gfp for 12 generations. We investigated the effects of the gut microbiota on glomerulonephritis in Cx3cr1 wildtype (WT) and KO MRL/ lpr mice by performing a co-housing experiment for twelve weeks. Mice eat other mice feces a process called coprophagy. To this extent, co-housing of mice will allow exchange of the microbiome between animals. We observed that

KO MRL/ lpr mice co-housed with WT mice had a significant reduction of proteinuria. In addition, in renal lymphocytes, there was a substantial reduction of T helper cells producing IL-17A in KO MRL/ lpr mice co-housed with WT mice, albeit no effect on IL-17F production. Furthermore, co-housing with WT mice moderately decreased naïve CD4 + T cells in KO MRL/ lpr mice. The introduction of KO microbiota in WT mice, on the other hand, induced the production of cytotoxic T cells in WT MRL/ lpr mice. Our findings suggest that the gut microbiota may influence different T cell subsets to exacerbate lupus in Cx3cr1 deficient MRL/ lpr mice.

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2025 Research Recognition Day

Graduate Student Research Biomedical

03 Evaluation of Novel Synthetic Antimicrobial Peptides Against Vancomyci-Resistant Enterococci (VRE)

Abdelmegeed S. 1,2 ; Mohamed M. 1,2 ; Abouelkhair A.A. 1,2 ; Abutaleb N.S. 1,2 ; Abdelsattar A. 1,2 ; Seleem M 1,2 Corresponding author: somaiamahmoud@vt.ed

1 Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Tech, Blacksburg, VA 2 Center for One Health Research, Virginia Tech, Blacksburg, Virginia

Vancomycin-resistant Enterococci (VRE) present a significant challenge in clinical settings due to their resistance to conventional antibiotics. This study explores the antimicrobial efficacy of newly designed derivatives of a short αhelical peptide, RR. Among the variants, RR4 and its D-enantiomer, D-RR4, exhibited over a 32-fold enhancement in antimicrobial activity

against multi-drug resistant VRE strains. Notably, D-RR4 demonstrated superior biofilm disruption compared to traditional antibiotics. Mechanistic investigations revealed that these peptides depolarize and permeabilize bacterial membranes, leading to the leakage of intracellular contents. Additionally, the peptides displayed rapid bactericidal action.

Similar to linezolid, D-RR4 demonstrated 100% survival of infected mice in a VRE peritonitis model. Interestingly, D-RR4 caused significant reduction of bacteria inside kidney and spleen compared to both untreated and linezolid. These results highlight D-RR4 as a promising therapeutic option in combating VRE infections.

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Graduate Student Research Biomedical

04 Measurement of Glucose Uptake in an Alzheimer’s Disease Rat Model Post Cranial Osteopathic Manipulation Using FDG-PET Imaging

There is an estimated 6.7 million Americans diagnosed with Alzheimer’s Disease, which is growing in prevalence each day. The mechanism of action and cause of this neurodegenerative disease is still uncertain. However, a popular theory amongst the scientific community is that the build-up of amyloid plaque causes downstream effects leading to the death of neurons on a massive scale. Research has also shown that amyloid beta impairs cerebral fluid circulation resulting in a decrease in clearance by the central nervous system’s lymphatic system. This not only increases the likelihood of the development of neuroinflammation but also decreases glucose uptake by the tissue. Currently, there lacks physiological and pharmacological mechanisms to assist and improve clearance, but mechanical manipulation by way of cranial osteopathic manipulative medicine/ therapy (COM) has shown to be effective. Previous 1 Department of Biomedical Engineering and Mechanics, Virginia Tech 2 Edward Via, Virginia College of Osteopathic Medicine 3 Virginia Tech Center for One Health Research 4 Virginia–Maryland College of Veterinary Medicine, Virginia Tech De’Yana Hines 1,3 ; Hope Tobey2; Pamela VandeVord1; Blaise Costa 2,3,4 Corresponding author: deyanahines@vt.edu

experiments performed have shown that COM influences AD expression on the behavior level. Behavioral data collected from the MWM, NOR, and Open Field Test (OFT) assays were used to assess learning, memory, and spatial awareness in a cohort of aged and transgenic Fischer 344 18-month-old male and female rats. The cohorts were split by sex and treatment received creating four groups, male and female COM treated (M-COM, F-COM) and male and female untreated (M-UT, F-UT). COM was performed for 8 days with a professionally trained osteopathic doctor wearing FingerTPS’s nanosensor gloves to quantify the pressure applied to the occipital squama. Results demonstrated that aged COM treated rats showed less frantic and better memory associated behaviors in the NOR and OFT assays. The transgenic COM-treated rats also showed a significant improvement in learning and memory based on their

distance traveled and velocity in the MWM assay. With these results in mind, we decided to investigate the changes glucose uptake for the aged Fischer 344 rats to assess molecular level changes. Using 6 rats from each treatment group, an injection of the FDG tracer was administered via tail-vein. Then the 60-minute static PET/CT scan was performed at the Fralin Biomedical Research Institute’s Imaging Corp. Quantification and normalization of standard uptake was performed in PMOD, an image processing software. Using an atlas each rats’ brain region was segmented for individual analysis of tissue in that area. Averaged uptake values for each region per rat were normalized and compared to a control using a 2-way-ANOVA. Findings from this will depict differences in regional retention of the tracer between the treatment groups.

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2025 Research Recognition Day

Medical Student Research Public Health

01 Impact of Socioeconomic Status on Osteoarthritis Progression in Weight-Bearing Joints: An Analysis Using the All-of-Us Database

Osscar Gonzalez Sandoval, MS; Ramu Anandakrishnan, PhD; Micah Jones, DO; Michael Breiner, MD Corresponding author: ogonzalezsandoval@vt.vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus

across these groups, controlling for age, sex, BMI, and comorbidities. Expected Outcomes: This research aims to establish a link between lower SES and faster OA progression, potentially highlighting mediating factors like occupational risks and healthcare accessibility. Findings may contribute to developing targeted intervention strategies to slow OA progression in vulnerable populations.

Abstract: This study investigates the correlation between socioeconomic status (SES) and the progression of osteoarthritis (OA) in weight-bearing joints, using data from the All-of-Us Research Program. Osteoarthritis, a degenerative joint disease, commonly affects joints like the knees and hips, causing significant pain and limiting mobility. We hypothesize that lower SES is associated with accelerated OA progression due to factors such as increased occupational hazards, limited healthcare access, and delayed early interventions.

Methodology: Data was sourced from the All-of-Us database, encompassing X-rays, clinical symptoms, and demographic information. The study population includes individuals diagnosed with OA in weight-bearing joints. SES indicators include income level, education, employment status, and area-based SES metrics, while OA progression is measured by changes in X-ray findings (e.g., joint space narrowing, osteophyte formation) and symptom severity over time. Participants were categorized into low, medium, and high SES tiers, and regression analysis was employed to compare progression rates

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Medical Student Research Public Health

02 Enhancing Childhood Educator Knowledge and Confidence: Virtual “Coffee Chat” Interventions with Medical Professionals

Prutha Patel*, BS; Yash Desai*, BS; Harsha Bhagtani, MD, FAAP; David Redden, Ph ; Sofia Abraham-Hardee, DO/PhD, FACOP, FAAP, CS Corresponding author: ydesai@vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus

two years. The initial sessions focused on educators in the New River Valley, Virginia, and the final session expanded statewide. Topics included common illnesses (e.g., cough, diarrhea), trauma management, obesity, and behavioral issues such as self-regulation and temper tantrums. Each session consisted of a brief evidence-based presentation followed by interactive discussions. Participants were recruited through local and statewide childcare organizations, and surveys were used to assess changes in their confidence and knowledge levels. Descriptive statistics and a Wilcoxon Signed Rank test were applied to analyze the data, while qualitative feedback from open-ended responses was categorized thematically. Results: Across the seven sessions, 27 registrations were recorded, with 16 unique participants, some of whom attended multiple sessions. Pre- and post survey results demonstrated significant improvements in knowledge and confidence, with an overall p-value of <0.0001. Six out of seven topics showed increased post-survey scores, with the session on self regulation and temper tantrums, which had the largest cohort (N = 10), yielding a significant improvement (p = 0.0041), highlighting its broad impact and

relevance. Feedback from participants highlighted the value of practical, evidence-based strategies and the opportunity to engage directly with healthcare professionals. However, variability was observed in some topics, such as diarrhea, where post-survey scores declined slightly, pointing to potential areas for improvement. Conclusion: Virtual “coffee chat” sessions proved to be an effective, scalable method for improving the health management skills of ECEs. The intervention’s interactive and accessible format was particularly appreciated by participants and could serve as a model for ongoing professional development in childcare settings. Future efforts should focus on refining content, expanding participation, and exploring long term impacts on both educator practices and child outcomes. This project received an IRB waiver from the Edward Via College of Osteopathic Medicine Institutional Review Board, Project number 2120724-1.

Context: Early childhood educators (ECEs) are central to the development and care of children, but they often lack adequate access to resources and expert guidance for managing common childhood health issues. These challenges can lead to significant stress for both educators and parents. To address this gap, a pilot intervention involving virtual “coffee chat” sessions was implemented. These sessions aimed to provide ECEs with evidence-based knowledge and practical strategies to handle frequent childhood health concerns. Objective: The primary objective of this study was to enhance the knowledge and confidence of ECEs in addressing common health and behavioral issues among children. The sessions, facilitated by pediatricians and medical students, covered a range of topics identified as high priority by educators. The goal was to create a sustainable educational model for improving child health management in childcare settings. Methods: This study used a self-designed pre- and post-survey format to measure the effectiveness of seven virtual “coffee chat” sessions conducted over

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2025 Research Recognition Day

Medical Student Research Public Health

03 Impact of Childhood Competitive Sports Participation on Young Adult’s Mental Wellbeing

Danielle Sullivan, OMS4; Edward Magalhaes, PhD; Divya Rengarajan, DO; Ramu Anandakrishnan, PhD Corresponding author: ddrywa@vcom.edu

Edward Via College of Osteopathic Medicine - Virginia Campus

provided information on demographics, team sports participation, mental health status, and ACE scores. Fisher’s Exact Test, Pearson’s Chi-squared test with Yates continuity correction, and Kruskal-Wallis rank sum tests were employed to evaluate relationships between sports participation, mental health conditions, and ACE scores. Results: Among respondents, 91% reported participating in organized team sports during childhood. Overall, 38% had been diagnosed with a mental health condition, and 66% either had a formal diagnosis or felt they struggled with mental health issues with no formal diagnosis. Mental health concerns were significantly higher among females (75%) than males (51%) (p=0.0003), although participation rates in team sports were comparable (90% of females and 93% of males). Those who did not participate in youth sports had a higher prevalence of mental health struggles (diagnosed or undiagnosed) (90%) compared to participants (64%, p<0.05). No significant differences in mental health outcomes were found concerning the number of sports played, years of participation, seasons per year, or average sport intensity, although the specific sport may play a role.

Higher ACE scores were strongly associated with both diagnosed and undiagnosed mental health conditions (p<0.002 for diagnosed conditions; p<0.0005 without formal diagnosis). Logistic regression showed that higher ACE scores increased the odds of both a mental health diagnosis and struggles without a diagnosis by 24% and 21%, respectively (p<0.05), as well as suggesting a dose-response relationship. Conclusions: Participation in youth team sports may be associated with reduced mental health struggles in adulthood, particularly among those without a history of ACEs. Findings also confirm that higher ACE scores are associated with increased mental health risks, supporting a dose-response relationship between ACE exposure and mental health diagnoses. Further research is warranted to explore how specific sports characteristics might contribute to these protective effects. Edward Via College of Osteopathic Medicine Institutional Review Board deemed project approved, VCOM IRB Record Number: 2023-173.

Context: Anxiety and depression are widely prevalent in adults, with higher rates among young adults aged 18-25, highlighting the importance of identifying mental health protective factors for this population. Previous research indicates that physical activity, particularly team-based sports, may lower the risk of mental health disorders. However, more studies are needed to determine optimal sports characteristics and assess the role of sports in individuals exposed to adverse childhood experiences (ACEs). Objective: This study aimed to assess whether participation in team sports between ages 8 and 17 is associated with reduced mental health issues in young adults aged 21 to 30, and to determine if specific characteristics of sports participation play a role. Additionally, we sought to explore the impact of sports participation on mental health outcomes in individuals with a history of adverse childhood experiences (ACEs). Methods: This cross-sectional study used data collected from an anonymous online survey distributed via social media. Participants were made up of 227 young adults aged 21-30 who

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