2016 research day program

Research Day10TH Annual

March 14, 2016

NevadaHeart.com 702-CARDIAC (227-3422)

Dr. Chowdhury AhsanDr. Jose Aquino

Dr. Robert BerkleyDr. Deepak Sharma

Dr. William ReshDr. Robert Wesley

Dr. John BowersDr. Raj ChanderrajDr. Arjun Gururaj

Dr. Richard ShehaneDr. C. Allen Rhodes

Dr. Sunil KallaDr. Shahabuddin Khan

Dr. John LeeDr. Nicholas TselikisDr. Stephen Savran

Dr. Sanjay MalhotraDr. Arturo Marchand Jr.

Dr. Cres Miranda Jr.Dr. Branavan Umakanthan

Dr. Rafael Valencia

Nevada Heart and Vascular Center is a proud leader in cardiovascular care and an active supporter of the only Cardiology Fellowship

Program in the state at University Medical Center.

CongratulationsTO TOURO UNIVERSITY

ON YOUR 10TH ANNUAL RESEARCH DAY











Dr. Rafael Valencia















Dr. Rafael Valencia





WELCOMEShelley Berkley, CEO & SR. PROVOST TOURO UNIVERSITY WESTERN DIVISION

It has been my distinct pleasure to serve as CEO and Senior Provost of Touro University Western Division for more than two years now. Touro University Nevada is a campus that is engaging and exciting. The faculty and students are committed to academic excellence, and today’s celebration of the 10th Annual Research Day is a wonderful testament to this commitment.

I want to thank Dr. Mahboob Qureshi and the members of the Research Committee for their dedication to promoting research at Touro University Nevada. Their work is critical to further enhancing our reputation with prospective and current students as well as faculty, staff, our local community and the world.

I am proud to be able to share the important research our faculty and students are engaged in – it shows the breadth and depth of research focus on campus. As you view the poster presentations, listen to our distinguished guest speaker, and participate in the oral presentations, I encourage you to note the wide variety of research areas our students and faculty are pursuing and to thank the participants for the contributions they are making to our community, culture and world through their valuable research endeavors.

Mazel Tov and best wishes for a successful event.

Touro universiTY

W E S T E R N D I V I S I O N

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Dr. Ray Alden III Provost, Touro University Nevada

I am happy to welcome all faculty, students, staff and guests to the 10th Annual Research Day of Touro University Nevada. Since this will be my first Research Day at TUN, I am particularly looking forward to learning about the scholarly activities in which the University community has been engaged over the past year.

Whether it involves the scholarship of discovery, application, integration or pedagogy, research is critical for advancing our professions and our world. Knowledge in many disciplines is doubling in a matter of a few years, so we all have to be life-long learners, to be able to think creatively, and to learn from the scholarship of others. When teams of faculty and students work together on research, it advances knowledge, engaged learning occurs, and creativity is stimulated. Research Day is an opportunity for the entire Touro community to learn from and be inspired by the research of others. Thus, I hope that all participants will find this event to be interesting and meaningful.

I would like to congratulate the faculty, staff and students for their research efforts. I would also like to express my appreciation to Dr. Qureshi, the Research Committee, Ms. Melody Crickman and the Office of Advancement for making this event successful.

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Mahboob Qureshi, MD, PhD Associate Dean for Research, Touro University Nevada

Touro University Nevada is celebrating our 10th Annual Research Day. This is a great event that provides opportunity for our students, faculty and staff to share their research activities with the campus community and local guests. The TUN Annual Research Day reflects the commitment and dedication of our faculty and students, who make time for pursuing research amongst very busy and challenging schedules.

The Research activities at the TUN involve basic sciences bench research, translational research, clinical and epidemiological research and educational research. This comprises a wide range of studies including, but not limited to, neurological disorders; allergy, asthma and infectious diseases; cardiovascular diseases; stem cell; cancer; as well as environmental health research. The research endeavors of our faculty members at the College of Osteopathic Medicine and College of Health and Human Services are timely and significant, which would further TUN as an academic and research institution.

The Research Department is grateful to this year’s keynote speaker, Dr. Ira Schwartz, who is a Professor and Chair of the Department of Microbiology and Immunology for New York Medical College. His presentation will discuss lyme disease, carbohydrate metabolism and the borrelia burgdorferi enzootic cycle.

I appreciate the participation from faculty and students. I look forward to attending all of the presentations. The Research Day organizing committee deserves commendation for arranging a successful event every year. I would also like to extend my gratitude to the Touro senior administration for their continued support in maintaining a productive and vibrant research program.

I would like to thank Ms. Melody Crickman and Ms. Cully Ruiz for their impeccable work of coordinating the program book. We are grateful to Dr. Terrence Miller, Ms. Kainath Durre Qureshi and Ms. Jackie Boiman for their support. I also would like to thank facilities and the information technology teams. Finally, special thanks to all attendees and sponsors of the 10th TUN Research Day.

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Dr. John Dougherty Dean, College of Osteopathic Medicine

Welcome faculty, students, staff and guests to Touro University Nevada’s 10th Annual Research Day. Today’s event showcases some of the hard work, diligence and collaboration between dedicated students and faculty.

Institutions of higher education are measured, in part, by their commitment to research and the contribution to new knowledge in the fields of medicine and health and human services. Touro University Nevada has made this commitment and support through the promotion of collaboration between faculty and students and through financial support.

I would especially like to extend my gratitude to Mahboob Qureshi, M.D., Ph.D., the Associate Dean for Research; Terrence Miller, Ph.D., the Senior Associate Dean for Academic Affairs; Kainath Durre, B.S., the Research Lab Manager; and members of the Research Day Sub – Committee for their efforts in making Research Day happen.

Great job.

Dr Andrew Priest Dean, College of Health and Human Services

I want to express my appreciation to the faculty, staff and students for their efforts involved in conducting and disseminating scholarly activity. Research and other scholarly activities provide the evidence upon which we practice our professions. Without it, we would not continue to discover how to best help our patients and influence the outcomes of our various activities. I am quite pleased that Touro University Nevada is able to host the annual Research Day and express my thanks to those who are involved and have made this happen.

Congratulations to all.

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RESEARCH COMMITTEE MEMBERS

Mahboob Qureshi, MD, PhD (Chair) Basic Science - COM

Angela Silvestri-Elmore, PhD, MSN, RN School of Nursing, CHHS

Julia Hause, MS Jay Sexter Library

Marina Ioudina, MD, PhD Basic Science - COM

Cynthia Lau, PhD, OTR/L Occupational Therapy - CHHS

Terrence Miller, PhD Basic Science - COM

Cully Ruiz Administrative Assistant Dept. of Research & Student Promotion Committee

Aurelio Muyot, MD Primary Care, COM

Michael Wells, PhD Basic Science - COM

Michael Laymon, PT, DSc, OCS Physical Therapy - CHHS

Jayabala Pamidimukkala, PhD Basic Science - COM

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PROGRAM EVENT SCHEDULE

8:00-9:00am Poster Session

9:00-9:10am Welcome

9:10-10:10am Keynote Address

“EVEN BACTERIA MUST WATCH THEIR CARBS: LYME DISEASE, CARBOHYDRATE METABOLISM AND THE BORRELIA BURGDORFERI ENZOOTIC CYCLE” Ira Schwartz, PhD Professor and Chair, Dept. of Microbiology and Immunology New York Medical College

10:20am-12:30pm Oral Presentations

All students, faculty and colleagues are welcome. Breakfast and snacks will be served.

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10:20-10:35O1: Influence of triathlon wetsuit on resting blood pressure and heart rate variability

Presenter: A. Prado (DO19) Touro University Nevada College of Osteopathic Medicine

10:35-10:50O2: Comparison of Different Harvesting & Processing Technologies in Autologous Stem & Fat Cell Viability & Yield

Presenter: R. Troell, MD Touro University Nevada College of Osteopathic Medicine

10:50-11:05O3: Evaluation of a Mentoring Program: Should Mentoring be Limited to “At Risk” Medical Students?

Presenter: C. Saab (MHS16) Touro University Nevada College of Osteopathic Medicine

11:05-11:20O4: Selective Action of Aqueous Maté Extract on Human Breast Cancer

Presenter: K. Nisbett (DO17) Touro University Nevada College of Osteopathic Medicine

11:20-11:35O5: Chronic Traumatic Encephalopathy Resulting from an 8 Year Career as an NFL Running Back:

A Case Study Using Diffusion Tensor ImagingPresenter: L. Ranzenberger (DO17)

Touro University Nevada College of Osteopathic Medicine

11:35-11:50O6: Educational Impact on Perceived Barriers to Early Progressive Mobilization in the ICUPresenters: J. Grimm DNP APRN, A. Silvestri-Elmore PhD RN, E. Grimm (DO17)

Touro University Nevada School of Occupational Therapy

11:50-12:05O7: Changes in Gastric Myoelectrical Activity in Response to Selected Cranial Osteopathic Manipulations in Healthy Young Individuals

Presenter: S. Kaldawi (DO18) Touro University Nevada College of Osteopathic Medicine

12:05-12:20O8: Recurrent Renal Cell Carcinoma Post Radical Nephrectomy: A Case Report

Presenter: A. Polepalle (DO17) Touro University Nevada College of Osteopathic Medicine

12:20-12:35O9: Would the Use of Specific Library Resources Predict Academic Success in Medical School?

Presenter: R. Taguba (MHS16) Touro University Nevada College of Osteopathic Medicine

ORAL PRESENTATIONS

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Ira Schwartz, PhD Professor and Chair, Dept. of Microbiology and Immunology School of Medicine, New York Medical College

Dr. Ira Schwartz is Professor and Chairman of Microbiology and Immunology at New York Medical College since 2002. In addition to his primary appointment, Schwartz is also a professor of medicine and biochemistry and molecular biology at the college. He is author of more than 150 publications in the peer-reviewed literature. Research activities in his laboratory focus on emerging tick-borne infectious diseases, primarily Lyme disease.

Projects include development of molecular diagnostics, characterization of heterogeneous populations of Borrelia burgdorferi in nature and Lyme disease patients and mechanisms of B. burgdorferi pathogenesis.

His laboratory was one of the first to apply molecular analysis to the study of B. burgdorferi. Among early contributions were sequencing of the B. burgdorferi ribosomal RNA operon (before the genome was sequenced) and utilizing this information to develop diagnostic assays for detection of the spirochete in Lyme disease patients, wildlife and ticks. Dr. Schwartz spearheaded the use of microarray technology to study B. burgdorferi transcriptional regulation and pathogenesis.

His group also developed a PCR-based assay for typing spirochetal isolates which led to the seminal observation that B. burgdorferi genotype predicted its capacity for hematogenous dissemination. These investigations led to current studies applying genomic and genetic approaches with the goal of identifying genes that might be responsible for this differential pathogenicity.

“ EVEN BACTERIA MUST WATCH THEIR CARBS: Lyme Disease, Carbohydrate Metabolism and the Borrelia Burgdorferi Enzootic Cycle”

Lyme disease is the most commonly reported arthropod-borne disease in the United States. It is caused by infection with the spirochete, Borrelia burgdorferi, which is transmitted by the bite of an infected tick. As a vector-borne pathogen, B. burgdorferi must adapt to the vastly different environments it encounters in the vector and mammalian host. The outline for this presentation is: 1) aspects of Lyme disease and B. burgdorferi biology; 2) differential carbohydrate uptake and utilization by B. burgdorferi; 3) B. burgdorferi Transcriptome in ticks and mammals; 4) mechanisms regulating carbohydrate utilization by B. burgdorferi.

KEYNOTE SPEAKER

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P1: Telehealth Interventions of Patients Diagnosed with Neurodegenerative DiseasesT. Bartolotta (OT16) & M. Wilson (OT16) Touro University Nevada School of Occupational Therapy, Henderson, NV

Neurodegeneration is an umbrella term encompassing a wide variety of diseases in which progressive loss of neuron structures occur which decreases an individual’s quality of life. As symptoms advance throughout the disease progression, individuals struggling with neurodegenerative diseases may become homebound, making it increasingly challenging to leave home and access services needed. Telehealth has been shown to be a low-cost for those that are homebound or living in rural areas requiring long travel time to access care needed. By providing services via telehealth, individuals may access needed practitioners in the comfort of their own home.

Research studies utilizing telehealth have been done using a variety of medical professionals including an occupational therapist, physical therapist, nurse, psychologist, doctor, etc. Telehealth may be utilized to deliver encompassing services for evaluation, intervention, consultation, education, and supervision of students or other personnel. Additionally, as technology becomes more widely utilized and accepted, healthcare professionals need to be open and willing to provide services in this avenue. This will in turn remove barriers in regards to accessing healthcare, including social stigma, travel, socioeconomic and cultural barriers. Use of telehealth as a service delivery model within the medical profession will increase access to care and ameliorate shortages of care in underserved populations. This poster was originally presented for occupational therapy faculty and students as a poster presentation, October 2015, Henderson, NV.

P2: Utilization of Annual Physical Therapy Checkup in a Clinical SettingK. Boyd, C. Kapp, & T. Catalino Touro University Nevada School of Physical Therapy, Henderson, NV

Physical therapists are considered “movement specialists” by the American Physical Therapy Association (APTA) and could prevent injury, address impairments to optimize function, and improve the quality of life for all populations through an annual check-up. The APTA created a physical therapy annual check-up form for the adult population, however it is unknown if physical therapists actually perform annual check-ups, and if so, do they using the APTA form. Purpose: To determine if physical therapists perform annual check-ups, and if so, do they use the APTA form. An online survey was distributed via social media outlets targeted to physical therapists. The survey asked questions about the use of annual check-ups and template forms. 147 physical therapists completed the survey. 90% of our sample do not perform annual checkups. 6% of our sample were aware of the APTA’s annual checkup form and of those, none use the template to perform checkups. 19% of the respondents who do not perform annual checkups indicated they are “very likely” to perform checkups if they had access to a template. Performing annual checkups is beneficial in multiple ways and the APTA supports physical therapist practice to include annual checkups. However, the results of this study indicate physical therapists are not currently performing checkups for their patients and are not aware of the APTA annual checkup template. More information is needed to determine whether our findings are due to lack of awareness, policy, or practice setting.

P3: What Interventions Improve Motor Performance Skills in Children with Developmental Coordination Disorder?S. Burneo (OT16) & N. Druzinski (OT16) Touro University Nevada School of Occupational Therapy, Henderson, NV

This systematic review analyzed 10 pieces of research literature related to children with developmental coordination disorder (DCD) and motor performance skills. Children with DCD experience deficits in balance, gross motor control, fine motor, and eye-hand coordination. These deficits may cause the child to experience difficulties in school, ADLs, feeding, and social participation. This topic is important because the need for occupational therapists throughout the continuum of care will persist to assist children with the engagement in meaningful activities as the prevalence of DCD increases. Occupational therapists have utilized various interventions to improve deficits that children with DCD experience in everyday life. Therefore, in our study, we completed a systematic review to find the “gold standard” or best intervention approach to improve motor performance skills in children with DCD. Interventions that were shown to improve motor performance skills in children with DCD included virtual reality, sensory integration, neuromotor task training, core stability, and group motor skill interventions. The study concluded that there is not one specific intervention that should be used, rather using components from multiple interventions

POSTERS

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may have the most significant effect on children with DCD on improving motor performance. NOTE: This poster was previously presented in Systematic Review of Literature in Occupational Therapy in October 2015.

P4: Skill Based Interventions for Incarcerated Youth: A Systematic Review

S. Carnevale (OTS16) & F. Wilkins (OTS16) Touro University Nevada College of Health and Human Services, Henderson, NV

In 2014, the National Alliance on Mental Illness reported 70% of youth who were incarcerated had a diagnosed mental health disorder. The U.S. Department of Justice found that most incarceration facilities—for youth with criminal records and mental health disorders—are inadequately prepared to address the mental health needs of this vulnerable population. If a facility is providing therapeutic interventions, it is often an individualized psychotherapy approach to treatment. Through our research, we explored the current options for skilled based treatments for incarcerated youth that fall within the scope of practice of occupational therapists. Programs focusing on familial involvement, communication, self-regulation, self-efficacy, and the establishment of positive coping skills had the greatest impact on recidivism rates. Occupational therapists can assist in the development of the capacity for successful community reintegration through meaningful and skill-based interventions that promote occupational engagement and improved self-efficacy. Thus, we concluded that current treatment options for incarcerated youth are not effective in the development of usable skills that encourage community reintegration. Occupational therapy practitioners should develop programming focused on familial involvement, communication, self-regulation, self-efficacy, and the establishment of positive coping skills. To best create programming options based in skill development it is time for the occupational therapy profession to refine ecological theories to address the occupational deprivation associated with incarceration.

P5: Correlation of Total Tau, p-Tau 181, p-Tau 205, and A Accumulations in Brain and Retina of Individuals with Late Stage Alzheimer’s Disease

N. Christensen & V. Bondarenko Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Alzheimer’s disease (AD) is a growing financial and emotional burden on our society. The elderly population has a high incidence of AD, and consequently, the number of patients diagnosed with AD continues to grow as the average life span of the population increases. No cure is available. If diagnosed early, the progression of the disease may be slowed using existing therapies. However, early diagnosis presents a challenge due to the invasive nature of certain diagnostic methods. Therefore, the development of a non-invasive, early method of detection will greatly increase effectiveness in treating AD and significantly improve patient’s quality of life. It was determined that tau protein aggregates in the cerebral cortex correlate with aggregates in the retina of patients with late stages of AD. This study will determine if total tau (tau), Alzheimer’s associated phosphorylated tau (p-tau), and amyloid beta (A) detected in the cerebrospinal fluid (CSF) and cerebral cortex of patients with AD are also detectable in the retina. Using cadavers, we found that tau, p-tau, and A content in brain tissue correlates with such in retinal tissue. Immunohistochemistry was used to qualitatively and quantitatively determine the presence of the proteins. Western Blot complemented immunohistochemical data. Through further research and development, early diagnosis of AD could be possible through a routine retinal exam.

P6: Nursing Education and SBAR Handoff Reporting: An Innovative Learning Activity

C. Chung PhD RN Touro University Nevada School of Nursing, Henderson, NV

The Joint Commission has documented that 65% of sentinel events in hospitals between 1995 – 2004 were a result of handoff communication errors. SBAR (Situation, Background, Assessment, and Recommendation) is an evidence-based handoff communication tool that students must learn to be safe clinicians. SBAR has been proven to increase the effectiveness of communication between healthcare providers, and improve patient outcomes. This poster explains an innovative assignment used to assess nursing student SBAR quality. The assignment uses standardized unfolding case studies from the National League for Nursing’s Advancing Care Excellence for Seniors (ACES) curriculum and voice-over PowerPoint software. Note: This poster was originally presented at the International Conference on Communication in Healthcare, October 2015, New Orleans, LA.

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P7: Transcriptional Regulation of Differential Pulmonary Immune Response to RSV in PupsN. Corbet, X. Wang, E. Clayton, K. Durre, & M. Qureshi Touro University Nevada College of Osteopathic Medicine, Henderson, NV

More than 150,000 infants require hospitalization per year for acute RSV bronchiolitis and pneumonia. Up to 10% of these young lives do not survive the hospitalization and frequently require mechanical ventilation. The survivors face an increased risk of developing asthma later in their lives. Previous studies in mouse models by our lab have shown that RSV-infected pups develop a predominant Th2 immune response in their lungs. Of note, young hosts tend to maintain a predominant Th2 environment developmentally, as evidenced by constitutive upregulated expression of anti-inflammatory mediators including TGF-beta and IL-10. RSV-infected pup lungs have increased RNA expression of both GATA3 and STAT6 when examined using reverse transcription PCR (RT-PCR). Both transcriptional factors are implicated in promoting a Th2 immune response. In the current study, we intended to examine the transcriptional regulation of differential immune responses to RSV in the pup lungs. Using real-time PCR (qT-PCR), we re-examined the RNA expression of STAT6 and GATA3 and investigated the expression of Tbet in the young host in acute RSV infection. We administered exogenous osteopontin (an immunomodulator) to modulate the outcome of acute RSV infection and examined its effect on the above mentioned transcriptional factors. RSV-infected Pups, when treated with osteopontin, showed suppression of Th2 response as demonstrated by decreased RNA expression of STAT6 and slightly increased expression of GATA3. The cellular immune response to RSV infection is likely the cause of downregulation of GATA3 in the pup lungs, while osteopontin restored the expression of GATA3 to the stead-state level. The RNA expression of STAT6 did not change compared to control and infected animals, however osteopontin significantly down regulated STAT6 RNA

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expression. T-bet appears to demonstrate a similar trend. This could be due to a plateau phase of Th1 response which could not be further elevated. In order to fully understand the dynamics of differential immune responses, we intend to examine the RNA expression of the above mentioned transcriptional factors at different time points after RSV infection and osteopontin treatment.

P8: The Effectiveness of Mind-Body Interventions on Self-confidence and Social Communication in Children with Mental IllnessesM. Dunlap & M. Viveros Touro University Nevada School of Occupational Therapy, Henderson, NV

According to the Centers of Disease Control and Prevention (CDC) children with mental illnesses experience changes in the way they learn, behave, or handle their emotions (CDC, 2013). These changes impact a child’s ability to engage in social communication, thus limiting the child’s selfconfidence. There is an increasing need for occupational therapy to address the public health issue in mental health among children due to its great impact on the child, family, and community. Therefore, in our present study, we researched the question, “In children (ages 8-19) with mental illnesses, does relaxation techniques, yoga, and Mindfulness-Based Interventions help improve self-confidence and increase social communication?” The systematic review concluded that mind-body interventions such as yoga, stress reduction, and relaxation techniques should be considered in occupational therapy treatment as it has been shown to help children with mental illnesses deal with anxiety, depression, ruminating thoughts, attention, and behavioral problems. The principles of mind-body interventions, including self-control and awareness, permits children to fully attend to the present moment with use of learned breathing and relaxation techniques, thus allowing for a reduction in negative stress symptoms. The research indicated that active participation in mind-body interventions helps increase self-confidence and social communication, which are needed for effective participation in childhood roles such as student, peer, and family member. This poster was presented at the Systematic Review for Touro University Nevada, School of Occupational Therapy on October 8, 2015.

P9: Promoting Sleep in the Intensive Care Patient: A Multi-Disciplinary ApproachJ. Grimm DNP, APRN ACNP-BC Touro University Nevada School of Nursing, Henderson, NV

This poster presentation will address the growing problem of sleep deprivation in the critically ill population. Critically ill patients experience an increased incidence of reduced sleep efficiency, reduced restorative sleep, and more frequent awakenings in the night. A multidisciplinary approach in prevention and treatment of this issue can serve to improve patient outcomes. Sleep disturbance in critically ill patients has been associated with poor patient outcomes including prolonged hospital stay, increased incidence of ICU psychosis, immune system compromise, cognitive and muscular complications, respiratory compromise, increased healthcare costs, and increased morbidity and mortality rates. Many factors associated with sleep disturbance in the ICU are

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preventable, and often overlooked. Additionally, addressing sleep through a standardized patient care approach involving the interdisciplinary healthcare team may improve patient outcomes. This poster will present an evidence based clinical guideline to the prevention and treatment of sleep disturbance in the ICU patient. Nonpharmacologic approaches to sleep hygiene as well as pharmacologic approaches will be explored.

P10: Does Physical Exercise Improve the Driving Performance of Older Adults? A. Guiliano (OTS) & D. Palmer (OTS) Touro University Nevada School of Occupational Therapy, Henderson, NV.

This systematic review analyzed ten pieces of research literature related to physical exercise and the driving performance of older adults. Driving is an instrumental activity of daily living (IADL) that is very important to older people. Driving enables older adults to live independently, making access to shopping, leisure and social activities, and medical management possible. Staying behind the wheel is important for the health and wellness of older adults because it keeps them involved with meaningful activities. Finding alternative transportation can be inconvenient, causing older adults to withdraw from engaging in activities that define who they are as occupational beings (Singh, 2004). There is limited research on the direct impact of physical exercise on the driving performance of older adults (Singh, 2004). The objective of this critically appraised topic (CAT) is to summarize the body of evidence resulting from studies related to the effects of physical exercise on the driving performance of older adults. Our findings delineated the performance skills of driving that be impacted by physical exercise. *** This poster was previously presented in Systematic Review of Literature in Occupational Therapy in October 2015.

P11: Selective Action of Aqueous Maté Extract on Human Breast CancerV. Halvorsen (OMS2)1, C. Nguyen, (OMS2) 1, C. He (OMS2) 1, K. Nisbett (OMS3) 1, & A. Sadik, MS,PhD, MSMEd1 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Ilex paraguariensis, Yerba Maté, is a subtropical plant native to South America, where it is consumed several times daily as a tea made with roasted leaves. Several studies have been conducted to elucidate the beneficial effects of this plant. A recent study has shown that saponins isolated from Yerba Maté extract induce apoptosis in human colon cancer cells, while another study indicated that the consumption of Maté tea causes higher incidence of esophageal cancer. Our study looked into the effects Yerba Maté extract have on human breast cancer cells and non-cancer cells from the same tissue. The findings show a decrease in viable T47D breast cancer cells after treatment with crude Maté extract in a dose-dependent manner, whereas the normal cells, MCF12A, seem to be equally affected by Maté extract and PBS/water. To elucidate the mechanism by which Maté extract causes breast cancer cells to die, and how the non-cancerous cells die regardless of the medium content, we quantified different markers of apoptosis. With the use of flow cytometry, caspase 3-AF 647 and p53 FITC assays allowed us to detect an increase in both caspase 3 and p53 concentrations. These findings suggest that the treatment with Yerba Maté extract results in an upregulation of proapoptotic markers in breast cancer cells, thereby decreasing their viability through apoptosis, which is a programed cell death mechanism, whereas the non-cancerous cells do not respond to Maté treatment in any particular manner. Consequently, Maté extract seems to kill cancerous cells in a selective manner.

P12: Effective Interventions for Improving Quality of Life in Adults with Multiple SclerosisL. Hawkins & C. Sanchez Touro University Nevada School of Occupational Therapy, Henderson, NV

Multiple sclerosis (MS) is a disease affecting the neural pathways of the human body. Intense fatigue, pain, and muscle weakness are the most common symptoms. While the correlation between MS and quality of life (QOL) has just begun to be researched more, little is known about how to improve the QOL within the MS population. QOL is assessed within occupational therapy by building an occupational profile. The primary aim of our review was to find which specific interventions affect the QOL in individuals diagnosed with MS. Our initial literature search yielded 76,898 articles; however, only 11 of those met our inclusion criteria. Four major themes emerged from the articles: exercise, education, rehabilitation, and psychosocial. Overall, we found that the prevalence of low QOL in the MS population is due to the severity of the symptoms and the decreased participation in meaningful occupations. Occupational therapy is needed in order to improve functioning, decrease fatigue, and improve QOL. Successful interventions include exercise (i.e., elliptical training, aquatic exercise, strength training), education programs to improve self-efficacy, and multidisciplinary rehabilitation programs.

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P13: Microbial Reduction of Perchlorate

R. Hayer1, A. Jafri1, X. Wang1, & T. Else1 1Touro University Nevada College of Osteopathic Medicine, Master of Health Sciences Program, Henderson, NV

Perchlorate is a waste product produced from the industrial manufacturing of products such as rocket fuel, and often is found as a contaminant in our water supply. Perchlorate inhibits thyroid function because perchlorate competes against iodine for binding to thyroid receptors. Given perchlorate’s solubility in water, current methods involve using ion-exchange chromatography to remove perchlorate from water. Newer methods have investigated using microbes to reduce perchlorate levels in water through anaerobic respiration using perchlorate as the terminal electron acceptor. We are studying a strain of Pseudomonas aeruginosa, isolated from waste water, using kinetic assays to measure the growth of the microbe and reduction of perchlorate over time under varying conditions, such as microbe concentration, perchlorate concentration, pH, carbon source, and temperature. The reduction of perchlorate is studied under these varying conditions to determine the optimal environment for reduction of perchlorate by Pseudomonas aeruginosa. The perchlorate concentrations are measured using ion specific electrodes and cell densities are measured in absorbance units using a spectrophotometer set at 600nm. Preliminary results with Pseudomonas aeruginosa have shown reduction in perchlorate levels from 1336 ppm ± 13 S.D., to 0.4 ppm ± 0.004 S.D. This reduction was measured over a thirteen day period. Work is ongoing to measure the expression of the perchlorate reductase gene in the perchlorate reduction assays to confirm the biochemical mechanism involved in perchlorate reduction. With this data, environmental engineers may be able to design bioreactors to specifically remediate perchlorate.

P14: The Enrichment of Bacillus Cereus for Optimizing Perchlorate ReductionJafri, A.1, Hayer, R.1, Wang, X.1, and T. Else1 1Touro University Nevada College of Osteopathic Medicine, Medical Health Sciences Program, Henderson, NV

Perchlorate is an environmental contaminant that is commonly found in rocket fuels and pyrotechnics. Perchlorate is a major concern because it acts as a competitive inhibitor of the thyroid sodium-iodide symporter. Hence, it may cause hypothyroidism by interfering with iodine uptake into the thyroid gland in people who consume it in their drinking water. Perchlorate has a high reduction potential and therefore microorganisms known as dissimilatory perchlorate reducing bacteria (DPRB) can combat perchlorate contamination via donation of electrons (reduction). The aim of this study was to optimize growth conditions to enhance perchlorate reduction by Bacillus cereus, a gram-positive bacterium that shows promise as a perchlorate reducer. A series of

growth kinetic assays were set up to measure the rate of growth and perchlorate reduction over time. Different conditions are being tested such as different carbon sources, perchlorate concentrations, pH, and temperature. Cell density was measured using a spectrophotometer at 600nm. Perchlorate concentration was measured using ion specific electrodes. Based on current data, perchlorate re-duction by B. cereus may occur more efficiently using glucose as a carbon source. This is based on a kinetic assay (pH = 6.8) in which perchlorate concentrations decreased from an average of 1494±49 ppm to 1380±11 ppm (about 8%). This data may be useful to determine the growth conditions to provide optimal perchlorate reduction and can be used to design bioreactors that will efficiently remove perchlorate from drinking water supplies.

P15: Immobilization of Cutaneous Tissues around Transcutaneous DevicesC. Jee, S. Martinez, & M. Wells Department of Basic Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, NV

The eventual integration of prosthetic devices directly to body tissue holds great promise for devices that will mimic natural body functions. The purpose of this research is to determine if skin can be better immobilized and attached to a porous titanium surface if subcutaneous connective tissue is removed. A primary problem that plagues the progression of this vital research is that skin epithelium does not typically form stable connections with foreign objects that penetrate the skin.

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Previous research suggests that skin mobility is primarily difficult in obtaining a good connection between the metal surface of a device and the skin epithelium. However, research does show removing subcutaneous tissue and suturing the metal onto the subdermal surface of the skin has the greatest probability of attachment with the least disruption in healing. During this research 18 rats were used and divided into an experimental and control group. The experimental group had subcutaneous tissue removed by scraping before the titanium plate was immobilized under the skin. The control group had the same plate implanted in their back but the subcutaneous tissue was left intact. After 45 days of healing, the mobility of the skin was measured through histological analysis of the titanium and skin. The area of direct adhesion of dermal tissues to the porous titanium was measured as a percentage of the cross sectional area of the titanium implant. Our hypothesis is that the removal of subcutaneous tissue will significantly improve skin adhesion to porous subcutaneous titanium implants.

P16: Does a Sensory Integration Approach Help Regulate Maladaptive Behaviors in Children with Sensory Processing Disorders?

O. Kabaei (OTS)1 & S. Silverberg (OTS)1 1Touro University Nevada School of Occupational Therapy, Henderson, NV

Recently, there has been an increase in the number of children being treated for sensory processing disorders. This disorder is described to be an elusive disability that is easily misinterpreted for poor behavior or psychological issues. Symptoms fluctuate in severity and presentation from child to child, complicating caregiver ability to predict and prevent undesirable behaviors. Sensory processing disorders often lead to disruptive and aggressive behaviors, poor attention, and lower scores in cognitive measures. Subsequently, sensory processing disorders impact age expected social, cognitive, and sensory functioning. Behavioral challenges often occur as a result of problems with sensory discrimination, perception, proprioception, tactile discrimination, visual perception and vestibular processing. Not only do these behavioral issues impact behavior, but places a barrier in developing positive skills in academics and socialization. Occupational therapists play a vital role in implementing sensory processing strategies when addressing the sensory needs of children. Often occupational therapists implement core principles of Ayres’ sensory integration in treatment which includes “the precise use of sensory input, wherein the therapist guides challenges and scaffolds adaptive responses”. The primary focus of treatment is on engagement in child-directed, sensory-rich experiences that are individually designed to address each child’s specific sensory needs. The evidence suggests that utilization of a sensory integration approach is controversial and inconclusive when treating children with sensory processing disorder. The aim of this critically appraised topic is to evaluate existing research and determine the efficacy of this approach when treating this population. NOTE: This poster was prepared and presented for OCCT 643 at Touro University Nevada Department of Occupational Therapy in October 2015.

P17: Changes in Gastric Myoelectrical Activity in Response to Selected Cranial Osteopathic Manipulations in Healthy Young Individuals

S. Kaldawi (OMS2), P. Samra (OMS2), E. Toder DO, & M. Ioudina MD, PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV.

Osteopathic manipulations in the cranial field (cranial manipulation, CM) are a part of osteopathic manipulative treatment and are commonly used to treat patients. It is suggested that CM affects the autonomic nervous system. We hypothesized that CM may have an effect on the digestive system and have conducted this study to measure gastric electrical activity in response to selected CM using non-invasive cutaneous electrogastrography (EGG). Healthy 25-35 year old men and women participated in this study. Subjects were divided into three groups. The first group received CM (occipital-atlantal decompression, occipital-mastoid decompression, and compression of the fourth ventricle), the second received sham manipulations, and the third was a “no touch” control group. All manipulations were performed by one osteopathic physician. Data were recorded and analyzed using BIOPAC Systems, Inc. equipment and software. Changes in gastric electrical activity were evaluated using the peak power at the dominant frequency associated with gastric slow waves. Preliminary results indicate that the selected cranial techniques decreased the peak power of the gastric electrical activity, P-values of <0.001. There were no significant changes in gastric electrical activity in both sham and “no touch” control groups at the end of the measured time period. These findings

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suggest that the selected cranial techniques may be used as a part of osteopathic treatment to decrease gastric motility in certain patients. Furthermore, studies need to be performed to elucidate the mechanism of CM on gastric electrical activity. This project was funded by the TUN Research Grant Award.

P18: Effects of Backward Running on Motor Unit Recruitment Following Cycling in Triathletes: A Case StudyI. Khowailed, D. Meade, K. Jarvis, & A. Cook Touro University Nevada School of Physical Therapy, Henderson, NV

The purpose of this study was to assess the effectiveness of long stride backward running “LSBR” on the EMG activity of the hip extensors inhibited by the prolonged aerodynamic cycling posture assumed during triathlons. Three triathletes mean (±SD) 26.33 ± 2.08 years, height 172.47 ±7.35 cm, body weight 70.43 ±7.02Kg, and body mass index 23.67 ± 0.65 kg/m² volunteered to participate in the study. The kinetic analysis of treadmill running at 10 Km/h was performed pre- and post-intervention after 30 min of aerodynamic cycling posture. Postintervention data indicated a significant decrease across time in the EMG activity of the Gluteus Maximus (GMax) in the pre-activation and absorptive phase of running post cycling (P<0.005). A significant increase was denoted in the preactivation amplitude of the GMax between the non LSBR and LSBR. LSBR was associated with a significant increase in the EMG activity of the gluteus medius (GMed) during the weight acceptance phase. The findings of this study indicate that changes in motor patterns are possible and can be accomplished with LSBR. The prolonged hip flexion posturing during the cycle portion of the triathlon created an adaptive inhibition, of GMax and GMed. LSBR showed a significant neuromuscular facilitation in the EMG activity of GMax and GMed.

P19: Does Cognitive Behavioral Therapy Improve Sleep In Adults and Older Adults With Insomnia?

M. Klatt (OTS16) & J. Tom (OTS16) Touro University Nevada School of Occupational Therapy, Henderson, NV

Insomnia is a disorder that affects the quantity and quality of sleep. It increases fatigue, affects work productivity, reduces quality of life and relationship satisfaction, and negatively affects overall health. Epidemiologic studies worldwide report the prevalence of a clinical insomnia disorder being at 10% and 12%. Additionally, longitudinal investigation has shown that once an insomnia disorder is established, the disorder tends to persist. Chronic insomnia may also serve as a risk factor for the development of other mental and physical health issues, and its importance and relevance to public health

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is demonstrated by high healthcare costs that are reported in nations such as the USA. Cognitive behavioral therapy (CBT) is a type of psychotherapy in which negative patterns of thought about oneself and the world are challenged in order to change unwanted behavior patterns or treat certain mood disorders. One of the main advantages of CBT is that it is a non-invasive and nonpharamocological approach to treating insomnia symptoms. Increasing evidence has demonstrated the effectiveness of CBT in combating insomnia symptoms in adults and older adults, and supports CBT’s use in therapy for clients who may suffer from primary or comorbid insomnia. This evidence implies that CBT may be an effective intervention strategy that occupational therapists may utilize in practice to improve quality of sleep in clients who are living with a diagnosis of insomnia. This poster was presented for OCCT 643 Research Day on October 14, 2016 at Touro University Nevada

P20: Expression of the CUB domain of tumor necrosis factor-induced protein 6

E. Klein1 & C. Fulop2 1Master of Medical Health Sciences Program and 2Department of Basic Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Tumor necrosis factor-induced protein-6 (TNFIP6 also known as TSG-6) is a necessary component in the formation of the extracellular matrix of the cumulus cell-oocyte complex (COC) during ovulation and plays a crucial role in female fertility. TNFIP6 has been shown to bind hyaluronan and the heavy chains of inter-alpha-trypsin inhibitor (major components of the COC extracellular matrix) in a catalytic process that stabilizes the extracellular matrix. While the overall function of TNFIP6 is known, further information is needed to understand the role of the two TNFIP6 domains; the LINK and CUB domains. The LINK domain has been shown to interact with hyaluronan, but the function of the CUB domain is still poorly understood. In this study, we generated a fusion protein between the CUB domain and an immunoglobulin Fc region (CUBFc) in aims to further investigate the functions of the CUB domain. Using polymerase chain reaction, we created the CUB cDNA and cloned it into a Lonza-Fc expression vector. We then transfected the construct into Chinese Hamster Ovary cells and detected the CUB-Fc fusion protein in the culture medium of the transfected cells by ELISA. The generation of this fusion protein will now allow us to dissect the detailed role of the CUB domain in the assembly of the COC extracellular matrix. On a medical platform, the insights from this study will help further advancement of female fertility treatments, and can also help create alternatives for female contraceptives.

P21: Systematic Literature Review of Efficacy for Spinal Decompression Therapy Treatment in Patients with Chronic Low Back Pain

B. Krisak (MHS16), B. Vogel (MHS16) & J.M. McKivigan, DC, PT, MPA, MA Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Chronic lumbosacral pain is a major problem in the healthcare industry. Conservative health care providers need to know the most sufficient and reliable forms of treatment to best serve the needs of their patients suffering from chronic low back pain (LBP). Medical providers need many literature articles critically analyzed to provide exceptional patient care. There are only a few non-surgical modalities currently in use for patients who are not candidates for surgery. Vertebral axial decompression (VAX-D) is a spinal traction treatment method that is designed to relieve pressure and manage pain in structures that may cause LBP. The VAX-D technology uses an algorithm computer to apply distractive tensions allowing a reduction in intradiscal pressure from a positive to a favorable negative value. If VAX-D is found to offer promising results as an alternative conservative method to surgery or medication, it could help many individuals with this debilitating chronic disorder return to a functional level of activity. This study is being conducted using a systematic review of the literature. There is currently an insufficient amount of articles to use a meta-analysis. The results are pending based on the impending statistical analysis. The objective of this study is to conduct a systematic review of the literature to explore the efficacy of VAX-D therapy as a noninvasive, holistic approach to the treatment of chronic LBP.

P22: A Systematic Review on the Efficacy of Iontophoresis as a Treatment of Lateral EpicondylitisJ. McKivigan, B. Yamashita, D. Smith, E. Hiipaka, & J. Washburn Touro University of Nevada College of Health and Human Services, Henderson, NV

Lateral epicondylitis is a painful condition that is typically caused by overuse of the tendons, resulting in tendinopathy, inflammation, pain, and tenderness to the lateral elbow. This condition involves the extensor carpi radialis brevis that helps stabilize the wrist to generate a useful and powerful grip for the hand. Up to 15% of workers, using highly repetitive movements develop this condition. Iontophoresis is a technique that delivers medicine

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through the skin using an electrical current. This technique enhances the absorption of drugs across biological tissue such as skin. We performed a systematic review where over 50 peer-reviewed articles were analyzed on the methods of delivery and medications using iontophoresis. From our selection process, we found 12 articles that meet our criteria to be critically analyzed for their effectiveness using the Pedro Scale and assessed using the Oxford Centre for Evidence-based Medicine Levels of Evidence. This systematic review is to provide physical therapy clinicians with pertinent information regarding the progression of lateral epicondylitis treatment using iontophoresis and to analyze the evidence for the efficacy of the method in physical therapy. At this time, there is not enough evidence of high quality to recommend iontophoresis in the treatment of lateral epicondylitis.

P23: Correlations of Uric Acid Changes During Hemodialysis with Oxidative Stress in End-Stage Renal Disease

I. Mustafa (OMS3)1, R. Wills (OMS4)1, B. Shan (OMS1)2, R. Caccavello2, L. Lehrner1,3, & A. Gugliucci2 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2Glycation, Oxidation and Disease Laboratory, Touro University California, COM, Vallejo, CA 3Kidney Specialists of Southern Nevada, Las Vegas, NV

The major cause of mortality in patients with end-stage renal disease (ESRD) receiving renal replacement therapy is cardiovascular disease associated with oxidative stress. Uric acid (UA) is an important plasma antioxidant that is not present in hemodialysis (HD) fluids, so the procedure leads to wide excursions of urate. These may then change the delicate balance pro-oxidant/antioxidant of urate in a cyclic, pro-oxidant fashion. We hypothesize that HD-induced cyclical, fast and large excursions in UA are associated with changes in plasma total antioxidant capacity (TAOC) which may explain part of the increased oxidative stress in these patients. 47 ESRD patients on HD were selected from the patient population at KSOSN (Kidney Specialists of Southern Nevada). Blood was drawn at initiation of HD and upon completion of HD. TAOC, UA, electrolytes, BUN, creatinine were assayed. In the basal state, UA strongly correlated with TAOC (R² = 0.68, p <0.01) in normouricemic whereas it did not correlate in hyperuricemic patients. The correlation was lost in patients on statins. After hemodialysis, UA decreased significantly with a delta of 5.35 +/-1.97 mg/dL, p= 9 x 10-9. TAOC decreased by 10% from 2.34 +/- 0.32 mmol/L to 2.13 +/- 0.21 mmol/L (p< 0.03). The change in UA strongly correlated with the change in TAOC (R² = 0.49, p <0.01). UA levels correlate strongly with TAOC only at reference range levels, suggesting a key role for uric acid as an antioxidant at those levels and not at high levels where it becomes pro-oxidant.Our data suggest and added antioxidant role of statins. TAOC decreases after dialysis as UA is depleted, and both changes are strongly correlated showing the increase in oxidative stress generated by the procedure.

P24: Testing for the Existence of a Non- G protein Associated, New G protein Coupled Receptor Signaling Pathway-the Potential CXCR4-GRK-NPM1 Signaling Axis

T. Nagamine (MHS16)1, D. Alp2 & C. So2 1Department of Basic Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2 Department of Pharmaceutical Sciences, College of Pharmacy, Roseman University of Health Sciences

G protein coupled receptor kinases (GRKs) are protein kinases that phosphorylate activated G protein coupled receptors (GPCRs), leading to signal desensitization. The function of these kinases is controlled by conformation changes of the receptor elicited by ligand binding to the receptor. Since GRKs can also phosphorylate non-GPCRs as well, these phosphorylation events could be potentially new signaling pathways controlled by the GPCRs. A potential signaling axis worthy of testing is that involving the chemokine receptor, CXCR4, GRKs and the multifunctional phosphoprotein, nucleophosmin (NPM1). Previously, it was shown that CXCR4 can activate GRKs and interacts with nucleophosmin. GRKs were then also shown to interact with NPM1 and phosphorylate the protein at various sites. Therefore, CXCR4 activation can potentially activate GRKs to phosphorylate the nearby nucleophosmin protein that interacts with CXCR4. NPM1 can then carry out activities potentially independent of the G protein and arrestin signaling pathways. To test this, however, we must first establish the method to carry out this hypothesis. In this early report, we look at the expression of CXCR4, NPM1 and GRKs in various cancer and non-cancer cell lines. We will also use some purified proteins to establish the selectivity of the phospho-selective antibodies we will use to study NPM1 phosphorylation. In the future, we plan to test for the existence of this CXCR pathway by activating the receptor using its putative agonist, SDF1 alpha, as well as using new CXCR4 allosteric agonists derived from pepducins, a new class of peptide drugs. If this signaling axis exists, this could be a potentially targetable new drug development pathway for GPCRs.

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P25: Use of Nanoparticle Tracking Analysis of Plasma Extracellular Vesicles for Minimally Invasive Assessment of Glioblastoma

G. Nikogosyan1, M. Santos2, & A. Lorico2 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2Roseman University of Health Sciences, College of Medicine, Las Vegas, NV 2Research Mentor

Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor. It shows poor response to chemotherapy/radiotherapy, has high clinical recurrence rate, and a low survival rate. Membrane-enclosed extracellular vesicles (EVs) have recently come to the limelight as complex mediators of homeostatic intercellular communication with pleiotropic effects. We aimed to create a methodology to diagnose GBM earlier using non-invasive methods utilizing the quantification of EVs from the patient’s plasma. We performed an assessment of the feasibility of the study by comparing EVs isolated from plasma and EVsisolated from serum of six patients with GBM. EVs were isolated by a multi-step differential centrifugation protocol and analyzed by nanoparticle tracking analysis (NTA). Light-scattering characteristics of 488 nm laser light was used on EV preparations undergoing Brownian motion by continuous flow into a sample chamber of an LM10 NTA unit (Nanosight, Amesbury, UK). Video recordings were then analyzed for each sample using the NTA 3.0 software (Nanosight).Data represents the average and standard deviation of the analysis for the total number of EVs. Analysis of EV concentrations of the six patients with GBM were 2.51e+10 EVs/mL (S.E.M. 6.20e+09) in serum and 5.02e+10 EVs/mL (S.E.M. 9.60e+09) in plasma, with a corresponding p=0.0527. The concentration of EVs obtained from plasma is sufficient for further studies which will compare the number and volume of EVs from plasma of healthy controls, non-malignantbrain pathologies and GBM. Note: This poster was presented at AACOM National Presentation in January, 2016

P26: Attitudes Toward Obese Patients Among Physical Therapy Students

S. Ouvrard (DPT16)1, C. Sando (DPT16) 1, & T. Catalino1 1Touro University Nevada School of Physical Therapy, Henderson, NV

Obesity is an increasing problem in the U.S., with one-third of the population classified as obese as of 2010. Weight discrimination is prevalent in the US, with reports of discrimination increasing by 66% in the past decade. Anti-fat attitudes are not just found amongst general society, but they are also common among healthcare professionals. These attitudes have been shown to deter patients from seeking care. Physical therapists agree treating obesity is within their scope of practice, but there is a low competency level in providing weight loss interventions. The purpose of this study is to examine physical therapy students’ attitudes toward obesity and how it relates to the amount of obesity related instruction received in the classroom. A survey was distributed to physical therapy students who completed all their didactic course work. The survey included demographic information, the Fat Phobia Scale, and 6 additional questions created by the researchers to evaluate beliefs and education about obesity. Ninety-two surveys were used in the data analysis. It was determined that the more education a physical therapy student receives about obesity had the greatest impact in reducing obesity bias (Regression Coefficient: -2.018, p-value: 0.013). There is a need for increased education related to physiology of obesity and interventions to address the condition. This will allow for increased confidence amongst new graduates in treating obesity as they enter the field.

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P27: Recurrent Renal Cell Carcinoma Post Radical Nephrectomy: A Case Report

A. Polepalle (OMS3)1, N. Dasu (OMS3)1, A. Freilich (OMS4)1, & J. Krishnan, DO, MBA2 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2Cleveland Clinic, Glickman Urological and Kidney Institute, Las Vegas, NV

We are presenting the case of a 73-year-old Caucasian male presenting with an asymptomatic right adrenal mass. He initially presented to the Emergency Department (ED) on 9/6/15 with abdominal pain and a small bowel obstruction, where a right adrenal mass was found incidentally. Past medical history is significant for history of abdominal pain in 2007, during which a CT scan showed a 12 cm lesion on the left kidney. He subsequently underwent an open radical left nephrectomy and left adrenalectomy via midline incision. During the initial ED visit in September 2015, a noncontrast CT scan showed a 3.1 cm low-density right adrenal nodule indicative of a lipid rich adenoma in addition to a right lung lower lobe 8 mm rounded nodule that was nonspecific and present on previous imaging. Repeat CT scan with contrast on 10/7/15 showed a 2.9 x 2.4 cm enhancing lesion involving the right adrenal gland consistent with metastatic disease and a 8 mm nodule in the right lower lobe, which was suspected to be metastatic disease. A CT guided core biopsy done on 12/30/15 revealed metastatic renal cell carcinoma (RCC). With the treatment options presented to our patient, he opted for adjuvant therapy after resection of the solitary metastatic RCC lesion. The medical team consisting of a urologist, endocrinologist, and medical oncologist prepared him for an adrenalectomy by starting preoperative steroids. He was consented for a right robotic adrenalectomy with possible conversion to open if necessary. The surgery was successfully completed robotically. NOTE: This poster was presented at the National SOSA Convention in February 2016

P28: Influence of Triathlon Wetsuit on Resting Blood Pressure and Heart Rate VariabilityA. Prado (OMS1), J. Mercer, J. Dufek, J. Navalta, & N. Lough University of Nevada- Las Vegas, Las Vegas, NV

The purpose of this study was to investigate the effects of wearing a wetsuit on resting cardiovascular measures (blood pressure (BP), heart rate variability (HRV)). The influence of position (upright, prone) and wetsuit size were also explored. Participants (n=12 males, 33.3±12.1 years) had BP and HRV measured during six resting conditions: standing or prone while not wearing a wetsuit (NWS), wearing the smallest (SWS), or largest (LWS) wetsuit (based upon manufacturer guidelines). Heart rate was recorded continuously over 5-mins; BP was measured three times per condition. HRV was represented by the ratio of low (LF) and high (HF) frequency (LF/HF ratio); mean arterial pressure (MAP) was calculated. Each dependent variable was analyzed using a 2 (position) x 3 (wetsuit) repeated measures ANOVA (=0.05). Neither parameter was influenced by position x wetsuit condition interaction (p>0.05) and MAP was not influenced by position (p=0.717). MAP and LF/HF ratio were both influenced by wetsuit condition (p<0.05) with MAP higher during SWS than NWS (p=0.026) while LF/HF ratio was lower during SWS compared to NWS (p=0.032). LF/HF ratio was influenced by position being greater during standing vs. prone (p=0.001). It was concluded that wearing a small, tight-fitting wetsuit altered cardiovascular parameters during rest.

P29: (CART) ReceptorD. Praxidio (MHS16), H. Zhao (MHS16), & S. Prinster PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Since the initial studies on CART peptides began, we have gained a better insight on the effects of CART as regulators of body weight, obesity, reward, addiction and drug abuse, and energy metabolism. Studies have shown that during the acute administration of amphetamine or cocaine, there was a particular mRNA that exhibited upregulation. This was later referred to as the cocaine- and amphetamine regulated transcript or CART. Despite the advancements in the study of CART, the mechanism of its signaling pathway is still unknown. This is mostly due to the fact that the receptor that mediates CART peptide’s effects has not yet been identified. Currently, information on the CART receptor strongly suggests that it is a G protein-coupled receptor (GPCR) with effects on cAMP production. We have determined that long-term (24 hours) treatment with CART peptide affects expression of the mRNA for several GPCRs, making them possible candidates for the CART receptor. We have validated this change in mRNA expression following long-term treatment with CART peptide using Real Time PCR. Furthermore, we have investigated the transfection of these receptors in HEK cells in assays of ERK activation, and adenylyl cyclase activity. In these assays, ERK phosphorylation was enhanced when cells were transfected with GRM3. These assays will allow us to better characterize the CART peptide receptor.

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P30: Kinematic Alterations in Subjects with Ankle Instability During a Jump TaskS. Probert, Y. Kim, M. Seeley, & T. Hopkins FACSM Brigham Young University Human Performance Research Center, Provo, UT

Ankle instability (AI) continues to affect a large percentage of the physically active following ankle injury. Movement strategies that perpetuate the chronic nature of AI are poorly understood. The purpose was to evaluate lower extremity motion during a demanding jump task in subjects with AI. Methods included 39 AI (31M, 25F: 22.4+2.2yrs, 174.1+9.4cm, 72.5+14.4kg), and 34 controls (18M, 25F: 22.3+2.7yrs, 172.9+9.6cm, 70.7+14.1kg). Subjects were categorized using the Foot and Ankle Ability Measure (FAAM) and the Modified Ankle Instability Index (MAII). Three-dimensional joint kinematics were calculated via a ten-camera VICON MX system. Both groups went through the same procedures under identical conditions. Test subjects were instructed to perform five forward jumps of 1m at maximum height, land on a force plate with their involved leg, and then immediately transition laterally to jump to the side of the force plate landing on their uninvolved leg. A functional analysis (p < 0.05) was used to compare the entire stance phase of AI subjects to control subjects (function). This analysis allowed us to compare variables as polynomial functions rather than discrete values. Group differences were significant if the difference and the corresponding 95% confidence intervals crossed zero. AI subjects demonstrated greater valgus from 0-60% of stance along the frontal plane. Plantarflexion was greater in AI subjects from 0-40% of stance along the sagittal plane. AI subjects also had a less amount of knee flexion from 0-40% of stance along the sagittal plane. Inversion was greater in AI subjects throughout all stance phase (0-100%). AI subjects may be using the observed movement strategy to reduce overall impact during landing. The demonstrated decrease in dorsiflexion, knee flexion and varus, possibly created the perception of increased stability to ankle and knee joints during landing. More research is needed to further evaluate if this strategy affects injury risk. Note: This poster was presented at the ACSM Annual Conference in May, 2014.

P31: The Effects of Music Therapy on Communication & Socialization Skills in Children with Autism Spectrum DisordersK. Puliafico (OTS16), & J. Unck (OTS16) Touro University Nevada College of Health and Human Services, Henderson, NV

Autism spectrum disorder (ASD) comprises a range of developmental disabilities, and the prevalence of ASD has been increasingly rapidly in the United States since 2000. ASD can affect performance in a variety of daily activities with significant impacts on socialization and communication. The symptoms of ASD and their manifestation in child behavior is individualized, therefore, it is difficult to determine whether or not a certain intervention method will work for every child. A fairly new area of research is focused on the effectiveness of musical interventions for increasing communication and socialization skills in children with ASD. Research showed improvements in social engagement, social behaviors and emotional understanding after music therapy. Research has also found that various structures in music, such as rhythms, patterns, and tempo, act as a good medium for teaching children with ASD about these life skills. Individuals with ASD show affinity for music tasks due to increased activation in specific brain areas related to music. In addition, music therapy is effective for directing and obtaining the attention needed for interpersonal responsiveness in children with ASD. Occupational therapists are knowledgeable in activities of daily living that may be affected by ASD and strive to implement interventions for this population to better their quality of life. Musical interventions can be made client-centered and motivate children to participate in therapy. Ultimately, the positive outcomes of musical intervention for increasing communication and socialization skills in children with ASD warrants further research to efficaciously incorporate it into intervention programs. This poster was presented at OCCT 643 Systematic Review Presentation in October, 2015 at Touro University Nevada School of Occupational Therapy

P32: A Mathematical Model on Tumor Immune Response Kinetics: Cures and BeyondJ. Quinonez & M. Qureshi MD, PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Mathematical modeling of tumor-immune interactions provides a framework by which to address specific scenarios in regards to tumor-immune dynamics. An important aspect of tumor-immune surveillance is the elimination of tumor cells from a host’s cell-mediated immunity. In present studies, our mathematical model examined the role of antigen presenting cells. Dendritic cells are known to bridge the innate and adaptive immune responses; this study examined the roles after antigen presentation with respect to macrophage and CD8 T cells. The constructed model is presented as an extension of a mathematical model developed by De Pillis et al (2005) and modified from a previous project. All equations describing tumor-immune growth, antigen presentation, immune response, and interaction rates were numerically simulated with an open-source differential equation solver (GNU Octave) and all

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generated data and figures were compared to an effective method of tumor elimination. Several graphs were generated and compared on one another to determine the principle cell of cancer elimination as well as a possible exogenous method of elimination. The results show that macrophages play a role in cytotoxic T-cell activation as initially macrophage populations outnumber dendritic cells in the initial stages of tumor surveillance. Later on in the course of cytotoxic T-cell activation, the principal cell in tumor antigen presentation is dendritic cells as graphs show that dendritic cells increase in proportion to the production of cancer antigen compared to macrophages as they also have phagocytic functionality. Thus, due to the quick responsiveness of dendritic cells, cancer clearance is quicker compared tumor antigen presentation by macrophages. When comparing a vaccine composed of activated CD8 cytotoxic T cells and macrophages, a vaccine containing CD8 T cells has a greater rate of killing tumor cells. The model suggests that dendritic cells have a more important role in antigen presentation than that of macrophages. This model can have a larger implication in oncological research and management as it can predict the course of tumor expansion. The model can also infer the results of how vaccines of dendritic cell or cytotoxic T cell origin can be used to prevent the reoccurrence of cancer as the model predicts a vaccine primed heavily with CD8 T cells to cancer antigen more efficiently than a vaccine with primed macrophage cells. The use of this model will eventually be tailored further to determine the impact of chemotherapeutics on different cancer types.

P33: Transcriptional Regulation of Osteopontin (OPN)-induced Immunomodulation in RSV Infected Infants

N. Qureshi, E. Clayton, K. Durre, & M. Qureshi

Touro University Nevada College of Osteopathic Medicine, Henderson, NV

RSV bronchiolitis and pneumonia in infancy is known to be associated with increased susceptibility to asthma. This phenomenon is characterized by a hyper reactive airway with a predominant Th2 response and a skewed dendritic cell (DC) polarization, which can be modulated by exogenous OPN administration. OPN is an immunomodulatory agent inducing a strong Th1 polarization in RSV infected lungs. In our present study, we used a neonatal mouse model to examine the transcriptional regulation of this immunomodulation in RSV-infected pups. RSV-infected pups were intranasally administered with or without different doses of OPN, and messenger RNA (mRNA) expression of GATA-3 and STAT-6 were examined by PCR and RTPCR methods. At day 3 post-infection, GATA-3 expression was significantly higher in the OPN treated lungs compared to that in the PBS treated lungs, contradicting the enhanced Th1 cytokine responses observed after OPN treatment. Interestingly, an enhanced expression of STAT-6 was also observed at the same time point in the OPN treated and RSV infected pups compared to that in the PBS treated pups. Of note, STAT-6 l influences IL4 transcription which has a prominent role in Th2 differentiation. On the other hand, IL-4 instructs DC to promote Th1 differentiation which is STAT-6 dependent. Thus, the transcriptional regulation of OPN-induced immunomodulation is not one dimensional and will need further investigations into the dynamics of other transcriptional factors (e.g. T-bet and Foxp3) to establish OPN as a novel therapeutic in the prevention of RSV-induced susceptibility to asthma.

P34: A Review of Methods Employed by Physical Therapy Programs to Promote Cultural Diversity

E. Relles (MHS16), K. Tran (MHS16), & J. McKivigan Touro University Nevada, Henderson, NV

Cultural diversity defines the American population and therefore should reflect the population of the healthcare field. This research is dedicated to examining the cultural diversity in physical therapy programs and how they proceed to match the cultural diversity of the United States population.

Methods include performing literature analysis and creating a survey to determine whether physical therapy programs are using specific methods to parallel the cultural diversity within the United States. This survey will be distributed to program directors, the American Physical Therapy Association and the Commission on the Accreditation for Physical Therapy Education. The survey will search for the methods in which physical therapy programs use to recruit their students in hopes of revealing what is causing the lack of diversity. Furthermore, this research can be used to encourage programs to implement strategies to increase diversity. Cultural diversity is important not only to Physical Therapy programs but all across the health care field. Researching this one domain can hopefully lead to other studies being done within other fields.

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P35: How Accurately Does Kolb Learning Style Predict Medical Students Performance in the Preclinical Years?

A. Sadik, MS., Ph.D., MSMEdL, C. Fulop, Ph.D., & V. Bondarenko, PhD. Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Kolb learning style Inventory (LSI) test was used to identify the learning styles of doctor of osteopathy students in three consecutive years. Kolb predicts that students of assimilating or converging learning style perform better in medical school than those with accommodating or diverging learning style. We analyzed students’ scores of 15 disciplines in the preclinical years in order to verify the veracity of this test’s predictions. Preclinical grades were received from the registrar’s office after obtaining an exempt IRB approval. Anonymity was preserved by replacing the name of each student with the code of his or her learning style. Statistical analysis of variance was done using ANOVA and Kruskal-Wallis rank sum tests. When comparing the performance of students with assimilating or accommodating learning styles to that of students with diverging or converging learning style, there were significant differences between the grades earned by each of these two groups. Overall, students with assimilating learning style seem to do consistently well, while students with diverging learning style seem to have lower performance in the majority of the disciplines. Kolb classifies people with diverging learning style as being sensitive to different perspectives, able to build trust, capable of dealing with ambiguity and variety as well as identifying problems and making sense of things. These characteristics may lead medical students with diverging learning style to perform better in the clinical years. Kolb learning style inventory test can be a possible predictive tool of successful students in medical school during the preclinical years. NOTE: This poster was originally presented at the sixth International Association of Biochemistry Educators (ABE) conference in May 2015, Santa Fe, NM

P36: Culturally Diverse Discharge Planning and EducationD. Santacroce, DNPc, RN, CCM Touro University Nevada School of Nursing, Henderson, NV

Readmission rates have been increasing over the past several years; therefore, the Affordable Care Act has required Social Security to create a program known as the Hospital Readmissions Reduction Program (HRRP). The main objective of the HRRP is for the Centers for Medicare and Medicaid Services (CMS) to reduce reimbursement to hospitals with excessive readmission rates. Extensive research has revealed several factors that are contributing to an increase in readmission rates and poor patient outcomes; one is a gap in communication and lack of cultural competency in nursing care. Therefore, the aim of this project will be to encourage nursing faculty to develop curriculum for culturally diverse discharge planning and education for all levels of nursing courses, with the goal being to contribute to improved patient outcomes and decreased readmission rates. Utilizing Madeleine Leininger’s Theory of Culture Care and Universality as a model, a conceptual framework Culturally Diverse Discharge Planning and Education was created to assist in developing a curriculum to increase awareness and foster student nurse critical thinking skills of the discharge planning and education process.

The following will be used as methods to obtain data: A) Discuss the information pertaining to readmission rates and poor patient outcomes utilizing evidence based literature. B) Pre-Assignment provided to students the night before role-play of scenario C) Students Role-Play the unfolding case study. D) Debriefing session. Evaluation will include: a. Assess the knowledge, skills, and attitude of students; b. Assess the student’s ability to properly discharge a patient; c. Assess participants’ perception of the value of this teaching strategy.

The role-play of a culturally diverse unfolding case study with a debriefing session that is peer observed was found to increase cultural awareness and competency of the students. Due to the overwhelming literature revealing poor patient outcomes and an increase in readmission rates; it is paramount faculty incorporate case studies pertaining to cultural diversity nursing courses at all levels. This will impact student learning and contribute to positive patient outcomes and reduce readmissions.

P37: Would the Use of Specific Library Resources Predict Academic Success in Medical School?

R. Taguba (MHS16), A. Sadik MS, PhD, & K. Duus, PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Current studies report that students who use their university library have a higher GPA than students who do not. Although there is a connection between library usage and the earned GPA, there are very few studies that examine this connection at the level of professional schools, and no identification of specific

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resources that lead to success have been studied. There is a need for a process that identifies the resources that contribute the most to student success. This study aims to define the usage level of currently offered library resources and to what degree they affect student academic performance. First through fourth-year osteopathic medical students at Touro University Nevada are provided an opportunity to anonymously participate in a short online survey about the usage of their library’s resources as well as usage of resources outside of the library. This input is compared to de-identified records of their earned GPA and board exam scores provided by the Registrar’s Office. Data is then analyzed according to the participants’ year of study and self-reported degree of performance in their studies. The preliminary data analyses indicate that resource usage patterns associated with academic success change as students progress through the four years of medical education.

P38: Isolation, Analysis, and Identification of Antibacterial Compound(s) Found in Extract of Lichen Parmelia vagans.

W. Techathaveewat & V. Bondarenko Department Basic Sciences, Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Antibiotic resistance bacteria is becoming a growing problem in today’s world. This, along with a decreased funding for development of new antibiotics, forces researches to turn back to natural sources for potential antimicrobial compounds. Secondary metabolites of lichens has been found to possess this wanted activity. Lichen is a plant-like organism which stems from symbiotic relationship between fungal, mycobiont, and phytobiont and has been used as natural remedies in the past. In this study, secondary metabolites of lichen Parmelia vagans was extracted and tested for antimicrobial property. Lichen Parmelia vagans was initially extracted using ethyl acetate/acetone and redissolved in DMSO. The crude extract was then tested for antimicrobial activity against 10 different strains of gram positive and gram negative bacteria. The antimicrobial activity was tested using resaruzin cell viability assay and the minimal inhibitory concentration (MIC) was determined using fluorometric and colorimetric spectroscopy. The extract showed strong inhibition against gram positive bacteria but much weaker inhibition against gram negative bacteria. The crude extract was also analyzed using analytical and preparative TLC. Using information from previous studies, two fractions were extracted and tested for antimicrobial activity. Flash chromatography will be used to achieve better separation of the crude extract and mass spectrometry will be used the structure(s) of the antimicrobial compound(s).

P39: Voices of Success: Exploration of Successful Medical and Allied Health Professional Students: Their Attributions about the Sources and Origin of Success, Motivation, Emotional and Family Support Structures

P. Terbio, M.S. (OMS1), A. Poliquin, PhD, & K. Lindquist, M.S., Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Qualitative methods were employed to identify sources and reported origins of motivational success factors from students of graduate professional programs of Touro University Nevada. This preliminary study hopes to encourage greater consideration of the significance of nonacademic performance in student success for admissions and student support programming during their years of study. Themes and categories were identified from responses obtained from an online survey. They gave insight into the role these factors play in the success of students on this campus prior to admission and beyond. These factors may predict and/or sustain the success of many students on this campus. Students pre and post admission may need to develop, examine, and/or strengthen these areas too encourage and support their success.

A 15-item online survey was distributed electronically to graduate students in the Physical Therapy, Occupational Therapy, Physician Assistant, and Doctor of Osteopathic Medicine programs of Touro University Nevada. Former Masters in Health Sciences students who matriculated into their respective graduate programs were also included. Survey items were open ended and Likert scale type questions regarding motivational views and attributions and whether they contributed to student success. Qualitative analysis was conducted to develop themes and categorize their responses.

Success is impacted by personal experiences. These factors may play an important role in the successful entrance and completion of graduate programs. Academic achievement does not tell the whole story, nor completely guarantee preparedness for rigorous programs.

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P40: Identifying Various Ferret Immune Genes to Expand the Ferret Model for Studying Influenza A Pathogenesis1 J. Yang, B.S., M.H.S. (DO19), 1S. Martinez, B.S., 2J. Fuller, BS, 2,3D. Fuller, PhD, & 1K. Duus, PhD 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2Department of Microbiology, University of Washington School of Medicine, Seattle, WA; 3Washington National Primate Research Center, Seattle, WA

The ferret (Mustela purtorius furo) infection model is utilized for studying the pathogenicity and transmission of Influenza A. The ferret is a highly favored model because of the similar clinical symptoms in humans with Influenza A infection. A current disadvantage of using the ferret model is the lack of monoclonal antibody reagents to study ferret immune responses. The ferret genome was recently fully sequenced by the Board Institute in 2011 but has not yet been annotated. Identification of ferret interleukin 10 (IL10), 12a (IL12a) and b (IL12b), 1b (IL1b), CD40, and CD40LG was performed on Ensembl using a BLAST search against canine (Canis lupus familiaris) and feline (Felis catus) homologous sequences to the ferret genes of interest. Through the BLAST search results comparing the percentage identity and E-value between each of the target (Mustela purtorius furo) and the query (Canis lupus familiaris or Felis catus) sequences, cDNA sequences were compiled of each of the targeted ferret immune proteins. PCR primers for each of the cDNA sequences have been designed for cloning into a mammalian expression vector. Further testing of the validity of the identified and isolated gene sequence to its targeted protein product will be performed with the cloned cDNA. Identifications of these immune genes will allow the potential for further understanding of molecular virus-host interactions of Influenza A using ferret models by subsequent generation of mouse monoclonal antibodies against the ferret immune proteins. This poster was presented at Roseman University Research Symposium, Henderson Campus in March, 2016.

P41: Uncovering the Veil on Undiagnosed Eating Disorders as they Relate to AddictionT. Young (MHS16), & R. Hedger, DO Touro University Nevada College of Osteopathic Medicine, Henderson NV

Approximately 30 million Americans, 10% of the population, are affected by eating disorders in their lifetime. The Diagnostic and Statistical Manual of Mental Disorders has specific criteria for diagnosing anorexia, bulimia, binge eating disorder, and other specified feeding and eating disorders. However, not all physicians are adequately trained to recognize eating disorders, and not all victims fall into the specifically defined diagnostic categories. Studies show that individuals with eating and weight concerns tend to express an increased amount of somatic complaints. Thus, the active eating disorder is missed when these complaints are not combined with other physical findings of the patient. Increasing eating disorder awareness and education among health professionals and the public would greatly improve the recognition and diagnosis of eating disorders. The state of New York took a step in this direction by recently passing a bill to promote public awareness of eating disorders. The aim of this review is to improve the recognition and diagnosis of eating disorders, offer insight into the treatment of them, and investigate the common characteristics between eating disorders and addiction. This will be done by reviewing case reports and research of eating disorder genetics, prevalence, severity, and neuropsychological effects. As well, interviews with trained personnel at eating disorder treatment centers, support systems, and recovering individuals will be conducted to learn about all of the stages of eating disorders from varying perspectives.

P42: Do home modifications improve function in adults with physical disabilities?G Frimpong (OT16) & J. Hansen (OT16) Touro University Nevada School of Occupational Therapy, Henderson, NV

Many adults wants to remain independent as long as possible and have access to the care they need to allow them to age in place. According to recent studies, “older Americans prefer receiving services that allow them to stay in their current home” (American Association of Retired Persons [AARP], 2003, para. 2). Adults today are living longer and the need for affordable healthcare continues to increase (Mann, Ottenbacher, Fraas, Tomita, & Granger, 1999). Additionally limitations to successfully perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) independently may develop in this population. Home modifications is an emerging practice in occupational therapy, however few adults receive beneficial adaptations to their homes. Home modifications are adaptations and additions to the home environment that increase independent function for the individual. Home modification is important to address for individuals with physical disabilities to promote autonomy and independence in their home. In the adult population, some individuals may experience difficulties in completing their daily routines and activities at home due to loss of functioning and disability. This critically appraised topic looked at the current evidence surrounding the ability for home modifications to improve function in adults with physical disabilities. NOTE: This poster was originally presented as part of OCCT 643 research day, October 2014, Henderson, NV.

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PLATFORM PRESENTATIONS

01: Influence of Triathlon Wetsuit on Resting Blood Pressure and Heart Rate Variability

A. Prado (OMS1), J. Mercer, J. Dufek, J. Navalta, and N. Lough University of Nevada Las Vegas, Las Vegas, NV

The purpose of this study was to investigate the effects of wearing a wetsuit on resting cardiovascular measures (blood pressure (BP), heart rate variability (HRV)). The influence of position (upright, prone) and wetsuit size were also explored. Participants (n=12 males, 33.3±12.1 years) had BP and HRV measured during six resting conditions: standing or prone while not wearing a wetsuit (NWS), wearing the smallest (SWS), or largest (LWS) wetsuit (based upon manufacturer guidelines). Heart rate was recorded continuously over 5-mins; BP was measured three times per condition. HRV was represented by the ratio of low (LF) and high (HF) frequency (LF/HF ratio); mean arterial pressure (MAP) was calculated. Each dependent variable was analyzed using a 2 (position) x 3 (wetsuit) repeated measures ANOVA (α=0.05). Neither parameter was influenced by position x wetsuit condition interaction (p>0.05) and MAP was not influenced by position (p=0.717). MAP and LF/HF ratio were both influenced by wetsuit condition (p<0.05) with MAP higher during SWS than NWS (p=0.026) while LF/HF ratio was lower during SWS compared to NWS (p=0.032). LF/HF ratio was influenced by position being greater during standing vs. prone (p=0.001). It was concluded that wearing a small, tight-fitting wetsuit altered cardiovascular parameters during rest.

02: Comparison of Different Harvesting & Processing Technologies in Autologous Stem & Fat Cell Viability & Yield

R.J. Troell, MD, FACS, Adjunct Professor Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Clinical use of autologous stem cells is currently used in nearly every medical disorder. In the United States, cultured stem cells cannot be used clinically. However, harvesting one’s fat, processing the fat to isolate the stromal vascular fraction (SVF), containing the stem cells, can be performed if the complete procedure done on the surgical day. Comparison of the different techniques in harvesting, processing, and administration of fat and stem cells was examined.

Cellular assays were completed at the CGMP American Cryostem laboratory for fat and stem cell (stromal vascular fraction) viability and yield after acquiring the samples on the same surgical patient using different harvesting and processing techniques. The samples were transported over-night in transport media and then examined for bacteria contamination and cellular assays. A Nexolon cytometer measured the cellular data.

Fat cell viability studies revealed 80-92% viability and SVF viability was between 92-97% in all techniques. Fat cell yield was noted to be undisturbed by ultrasound-assisted liposuction. SVF numbers were greater when less centrifugation speeds were used and fat cell yield and purity was greater with higher speeds with filter use. Liposuction techniques to acquire stem cells can optimize the viability and yield in clinical use for treating patients requesting aesthetic improvements and a multitude of medical disorders safely and effectively.

03: Evaluation of a Mentoring Program: Should Mentoring be Limited to “At Risk” Medical Students?

C. Saab, MHS16 & A. Sadik MS., PhD., MSMEdL Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Currently, mentoring is limited to “at risk” medical students. The criteria for mentor selection, the effectiveness of the mentoring program, and the mentee feedback collection are undefined. Mentoring programs are documented to have tremendous benefits for students throughout medical school, offering support for successful transition into clinical rotations, residencies and beyond. Limiting mentorship to academically challenged students may restrict opportunities for others who would benefit from adequate and timely mentorship. The goal of this project is to investigate the criteria for mentor assignment and the perception of the program effectiveness from both mentor and mentee perspectives.

Preliminary results show that 100% of low-performing students have assigned mentors, whereas only 12% of high-performing students have mentors, all self-selected. The most mentioned limitation to seeking a mentor was “too intimidated to ask”. The majority indicated their mentor as “having a positive impact on their career” and had the most influence in “work/life balance” and “personal goals”. Approximately 50% felt their mentor was “key to their academic success”. For program improvement, increased communication of the mentoring program’s objectives and availability was specified. Nearly all

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mentors indicated that a monitoring process is necessary to ensure improvement and success. The majority of clinical faculty (57%) believes that mentoring should be extended to all students regardless of the rate of participation, whereas only 19% of the basic science faculty members support this belief. Mentors recommended regular training sessions for participating faculty and frequent solicitation of feedback from students to evaluate and improve the current mentoring program.

04: Selective Action of Aqueous Maté Extract on Human Breast Cancer

K. Nisbett, MS., OMSIII, C. Nguyen, OMSII, V. Halvorsen, OMSII, C. He, OMSII, & A. Sadik, MS, PhD, MSMEd Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Ilex paraguariensis, Yerba Maté, is a subtropical plant native to South America, where it is consumed several times daily as a tea made with roasted leaves. Several studies have been conducted to elucidate the beneficial effects of this plant. A recent study has shown that saponins isolated from Yerba Maté extract induce apoptosis in human colon cancer cells, while another study indicated that the consumption of Maté tea causes higher incidence of esophageal cancer. Our study looked into the effects Yerba Maté extract have on human breast cancer cells and non-cancer cells from the same tissue. The findings show a decrease in viable T47D breast cancer cells after treatment with crude Maté extract in a dose-dependent manner, whereas the normal cells, MCF12A, seem to be equally affected by Maté extract and PBS/water. To elucidate the mechanism by which Maté extract causes breast cancer cells to die, and how the non-cancerous cells die regardless of the medium content, we quantified different markers of apoptosis. With the use of flow cytometry, caspase 3-AF 647 and p53 FITC assays allowed us to detect an increase in both caspase 3 and p53 concentrations. These findings suggest that the treatment with Yerba Maté extract results in an upregulation of proapoptotic markers in breast cancer cells, thereby decreasing their viability through apoptosis, which is a programed cell death mechanism, whereas the non-cancerous cells do not respond to Maté treatment in any particular manner. Consequently, Maté extract seems to kill cancerous cells in a selective manner.

05: Chronic Traumatic Encephalopathy Resulting from an 8 Year Career as an NFL Running Back: A Case Study Using Diffusion Tensor Imaging

L. Ranzenberger1, T. Snyder2, & W. Orrison2 1Touro University Nevada College of Osteopathic Medicine, 2Nevada Imaging Centers; Nevada Imaging Centers

This case study provides data for and explores the efficacy and future of diagnosing chronic traumatic encephalopathy (CTE) with diffusion tensor imaging (DTI). A 36 year old professional football player with a history of numerous head injuries during his 8 year NFL career as a running back presented to us with gradually progressing symptoms of irritability, impulsivity, aggression, depression and short-term memory loss. Diffusion tensor and magnetic resonance (MR) imaging was collected including fractional anisotropy (FA) of the corpus callosum (CC). The CC was split into 5 sections and given FA values, similar to current literature’s suggestions. Anterior-Inferior FA = 0.683, Anterior FA = 0.546, Mid-Body FA = 0.575, Posterior FA = 0.634, Posterior-Inferior FA = 0.642. These DTI findings in association with our case’s clinical symptoms are consistent with CTE, which is a progressive neurodegenerative disease that occurs in association with repetitive traumatic brain injury. Currently the definitive way to diagnose CTE is through biopsy post-mortem and due to the microscopic nature of the disease, no evidence is found on standard MR and CT imaging. Through investigating and collaborating data collected with more sensitive imaging modalities such as DTI, we can fortify diagnostic data values for CTE.

06: Educational Impact on Perceived Barriers to Early Progressive Mobilization in the ICU

G. Pearson (OT15), J. Bhullar (BSN15), E. Grimm (DO17), K. Klingler (DPT16), S. Nye (DPT16), J. Grimm DNP APRN, & A. Silvestri-Elmore PhD RN Touro University Nevada College of Health and Human Services, Henderson, NV

Early mobilization is the initiation of movement when a patient is hemodynamically stable, adequately oxygenated, and minimally able to participate. Early mobility has been linked to decreased morbidity and mortality as inactivity has a profound adverse effect on the brain, skin, skeletal muscle, pulmonary and cardiovascular systems. Literature supports early mobilization and physical therapy as a safe and effective intervention that can have a positive impact on functional outcomes. While the benefits of early mobilization in the ICU have been well documented in recent years, many ICUs are unable to effectively integrate early/progressive mobility into their daily practice. Therefore, the purpose of this study is to examine reported compliance scores related to knowledge, skill in implementation, and attitudes (KSA, knowledge, skill, attitude) toward implementation of the Early Progressive

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Mobilization (EPM) Protocol at the Desert Springs Hospital Intensive Care Unit, as well as determining whether there is a difference in reported compliance scores among various disciplines. A pre-test survey designed to examine KSA, the perceived barriers to early mobilization and the reported compliance with the EPM protocol was administered. Educational sessions were provided to participants on the EPM Protocol after the pre-test. A post-test was administered after the educational session to determine the educational impact of the KSA as it relates to the EPM protocol. Preliminary data analysis using frequency distributions will be done until enough participants have been recruited to achieve statistical power. The findings of this project will be used internally by Nevada Critical Care in quality improvement projects in conjunction with the Desert Springs ICU multidisciplinary team to effectively promote positive patient outcomes in this area. **This poster will be presented at the Western Institute of Nursing Research Conference in April, 2016.

07: Changes in Gastric Myoelectrical Activity in Response to Selected Cranial Osteopathic Manipulations in Healthy Young Individuals

S. Kaldawi (OMS2), P. Samra (OMS2), E. Toder DO, & M. Ioudina MD, PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Osteopathic manipulations in the cranial field (cranial manipulation, CM) are a part of osteopathic manipulative treatment and are commonly used to treat patients. It is suggested that CM affects the autonomic nervous system. We hypothesized that CM may have an effect on the digestive system and have conducted this study to measure gastric electrical activity in response to selected CM using non-invasive cutaneous electrogastrography (EGG). Healthy 25-35 year old men and women participated in this study. Subjects were divided into three groups. The first group received CM (occipital-atlantal decompression, occipital-mastoid decompression, and compression of the fourth ventricle), the second received sham manipulations, and the third was a “no touch” control group. All manipulations were performed by one osteopathic physician. Data were recorded and analyzed using BIOPAC Systems, Inc. equipment and software. Changes in gastric electrical activity were evaluated using the peak power at the dominant frequency associated with gastric slow waves. Preliminary results indicate that the selected cranial techniques decreased the peak power of the gastric electrical activity, P-values of <0.001. There were no significant changes in gastric electrical activity in both sham and “no touch” control groups at the end of the measured time period. These findings suggest that the selected cranial techniques may be used as a part of osteopathic treatment to decrease gastric motility in certain patients. Furthermore, studies need to be performed to elucidate the mechanism of CM on gastric electrical activity. **This project was funded by a TUN Research Grant Award.

08: Recurrent Renal Cell Carcinoma Post Radical Nephrectomy: A Case ReportA. Polepalle, OMS 31, N. Dasu, OMS 31, A. Freilich, OMS 41, J. Krishnan, DO MBA2 1Touro University Nevada College of Osteopathic Medicine, Henderson, NV 2Cleveland Clinic, Glickman Urological and Kidney Institute, Las Vegas, NV

We are presenting the case of a 73-year-old Caucasian male presenting with an asymptomatic right adrenal mass. He initially presented to the Emergency Department (ED) on 9/6/15 with abdominal pain and a small bowel obstruction, where a right adrenal mass was found incidentally. Past medical history is significant for history of abdominal pain in 2007, during which a CT scan showed a 12 cm lesion on the left kidney. He subsequently underwent an open radical left nephrectomy and left adrenalectomy via midline incision. During the initial ED visit in September 2015, a noncontrast CT scan showed a 3.1 cm low-density right adrenal nodule indicative of a lipid rich adenoma in addition to a right lung lower lobe 8 mm rounded nodule that was nonspecific and present on previous imaging. Repeat CT scan with contrast on 10/7/15 showed a 2.9 x 2.4 cm enhancing lesion involving the right adrenal gland consistent with metastatic disease and a 8 mm nodule in the right lower lobe, which was suspected to be metastatic disease. A CT guided core biopsy done

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We know that as parents, you want the best care for your child; and that for many families a diagnosis of a developmental disability can be life-changing. At our state-of-the-art facility we evaluate and treat children with a wide range of developmental issues. We put together a comprehensive treatment plan aimed to help you and your child find successes that were otherwise unobtainable. All of this occurs at one location, providing convenience and individualized care. You can now finally envision having a support team that is special and makes a difference for you and your child.

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on 12/30/15 revealed metastatic renal cell carcinoma (RCC). With the treatment options presented to our patient, he opted for adjuvant therapy after resection of the solitary metastatic RCC lesion. The medical team consisting of a urologist, endocrinologist, and medical oncologist prepared him for an adrenalectomy by starting preoperative steroids. He was consented for a right robotic adrenalectomy with possible conversion to open if necessary. The surgery was successfully completed robotically. ** This poster was presented at the National SOSA Convention in February 2016

09: Would the Use of Specific Library Resources Predict Academic Success in Medical School?R. Taguba, MHS16, A. Sadik MS, PhD, MEdL, & K. Duus, PhD Touro University Nevada College of Osteopathic Medicine, Henderson, NV

Current studies report that students who use their university library have a higher GPA than students who do not. Although there is a connection between library usage and the earned GPA, there are very few studies that examine this connection at the level of professional schools, and no identification of specific resources that lead to success have been studied. There is a need for a process that identifies the resources that contribute the most to student success. This study aims to define the usage level of currently offered library resources and to what degree they affect student academic performance. First through fourth-year osteopathic medical students at Touro University Nevada are provided an opportunity to anonymously participate in a short online survey about the usage of their library’s resources as well as usage of resources outside of the library. This input is compared to de-identified records of their earned GPA and board exam scores provided by the Registrar’s Office. Data is then analyzed according to the participants’ year of study and self-reported degree of performance in their studies. The preliminary data analyses indicate that resource usage patterns associated with academic success change as students progress through the four years of medical education.

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702.777.4808

874 American Pacific DriveHenderson, NV 89014

www.tun.touro.edu

BEHIND EVERY CHILD WITH SPECIAL NEEDS

Is a special place to support you and your child.

We know that as parents, you want the best care for your child; and that for many families a diagnosis of a developmental disability can be life-changing. At our state-of-the-art facility we evaluate and treat children with a wide range of developmental issues. We put together a comprehensive treatment plan aimed to help you and your child find successes that were otherwise unobtainable. All of this occurs at one location, providing convenience and individualized care. You can now finally envision having a support team that is special and makes a difference for you and your child.

EVALUATION

TREATMENT

SUCCESS

CALL FOR AN APPOINTMENT

Most health insurance plans are accepted.

Need a Primary Care Provider?The Health Center at Touro has Physicians, Medical Residents and Nurse Practitioners that can see to your primary healthcare needs.

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