Campbell Medicine Newsletter | 2021 Special Edition

Campbell Medicine Newsletter The latest news from North Carolina’s only osteopathic medical school | Special Edition

PRESIDENT J. Bradley Creed

DEAN Brian Kessler

ASSOCIATE DEANS Michael Mahalik, Eric Gish, Terri Hamrick, Victoria Kaprielian, Robin King-Thiele, James Powers, Robert Terreberry, David Tolentino

CONTRIBUTORS Sarah Bowman, Shelley Hobbs Amanda Dockery, Illustrator

WE LOVE WHEN OUR ALUMNI MAKE US PROUD Promote your professional accomplishments or share personal announcements by submitting a class note: medicine.campbell.edu/alumni.

HAVE KUDOS, A NEWS TIP OR UPCOMING EVENT? Let us know! The Office of Marketing and Communications is here to share the exceptional work being done at Campbell University School of Osteopathic Medicine: medicine@campbell.edu.

Established in 2011, the Campbell University Jerry M. Wallace School of Osteopathic Medicine is the first and only osteopathic medical school in the state of North Carolina. We prepare students to be lifelong learners and practitioners that are holistic in their approach. Our strong and diverse programs provide applied learning experiences for all students, as well as opportunities for interprofessional education and collaborative practice, both at Campbell University and in the surrounding health care community.

Campbell Medicine's newsletter is a publication designed to keep faculty, staff, students, alumni and the community informed of news, events and announcements at Campbell University School of Osteopathic Medicine. For questions or comments, contact Sarah Bowman, Executive Director of External Affairs and Alumni Engagement: medicine@ campbell.edu.

2021© Campbell University Jerry M. Wallace School of Osteopathic Medicine Opinions expressed in this publication are those of the authors and do not necessarily reflect viewpoints of the editors or official policy of Campbell University.

Healthier Together Grant funded COVID-19 Outreach to Eastern North Carolina Tribes This fall, Dr. David Tillman, chair of public health in the College of Pharmacy and Health Sciences, and Dr. Amy Hinkelman, assistant professor of microbiology and immunology, along with the Harnett County Coharie Indian Association received a Healthier Together Grant funded by the NC Counts Coalition.

The Campbell faculty worked alongside community leaders within the Coharie Tribe to train tribal outreach workers, provide educational materials, hold local community events to address concerns and questions about the COVID-19 vaccines, and connect tribal members with local resources including the CUCCC mobile clinic to get vaccinated.

Educational sessions were well attended by Coharie tribe members, and COVID-19 vaccination numbers increased among tribe members.

These efforts have sparked additional opportunities to extend this outreach to other tribal communities, including the Waccamaw Tribe and collaborations with Dr. Ronny Bell of the Lumbee Tribe and Dr. Linwood-Watson of the Haliwa-Saponi Tribe.

The hope is to continue to collaborate with tribal leaders to improve the health of our local tribal communities. **Dr. Hinkelman is featured on the left of the cover illustration.

Editor’s note:

The Campbell Medicine Newsletter has been published since 2018. Each issue is a little bit different and strives to capture milestones and important events as well as the personality of CUSOM. The Summer/Fall 2021 issue is a special edition highlighting some of the research our students, fellows, residents, faculty and staff are conducting.

Research has grown exponentially over the past few years at Campbell. The addition of the lab space in Smith Hall, financial and infrastructure support of the University, and the curiosity and passion of everyone involved deserves to be recognized. This issue is our longest to date, yet it only covers a fraction of all of the research being conducted! We hope you enjoy the special illustrations featuring some of our faculty, and we look forward to highlighting others in the near future.

Cover Illustration: Drs. Amy Hinkelman (L) and Kassim Traore (R) mentoring a student in Smith Hall Research Lab The focus of Dr. Traore’s research is in the area of reproductive toxicology and aging, related to altered steroid hormone synthesis, including endocrine pathologies, male reproductive disorders, and cancer.

Dr. Traore recently established an organ-culture technology in his labs to examine the effect of environmental toxicants on Leydig cell development and steroidogenic process.

His work has led to better understanding of the mechanism by which phthalates inhibit testosterone biosynthesis in testis.

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Mobile clinics provide COVID-19 testing and vaccinations in Mt. Olive Campbell University School of Osteopathic Medicine’s brand new Mobile Health Education Clinics (MHEC) debuted in June during a week-long local mission trip serving migrant farm workers and their families in Mt. Olive, NC. Overall, the team provided health assessments, COVID testing, and administered the Johnson and Johnson COVID vaccine for 76 patients. They enrolled 100 patients, including children, for continued follow-up and primary care through the Department of Global Health’s mobile and free clinic offerings.

Medical outreach trips – both local and abroad – provide students with direct access and experience learning, serving and providing medical care first-hand with rural and underserved populations. Students not only hone their clinical skills, but they learn the importance of developing trust and connection with their patients.

The MHEC fleet includes two 40-ft. units and a 26-ft. unit.

The 40-ft. units each have two full-sized treatment rooms and are equipped to provide any service available in a family practitioner’s office, from general health screenings to minor surgical procedures.

“The students see how important it is to relate directly and develop a relationship with their patients,” said Dr. Capippoio. “They take everything they’re learning in medical school and are able to put it right to work and see how it can be effective. That kind of first-hand experience will impact them as a future physician or healthcare provider.”

“This has afforded us the ability to really expand,” shared Dr. Joe Cacippoio, chair of community and global health and associate professor of emergency medicine. “We are 100% fully equipped to do full-fledged primary care for communities that have no access to healthcare otherwise.”

“This [first trip] has been a real success,” he continued.

“We’re identifying so many people that really need ongoing care. I think I’m going to have an overbooked clinic for the next several weeks!”

CUSOM’s medical outreach team worked alongside two other NGOs throughout the week that were providing diapers and supplies for new moms, and meals for patients coming through each evening.

“The real success [this week] was student education and the ability to offer care for people who have no other resource,” shared Dr. Cacippoio.

Dr Joe Cacippoio meets with a patient during an evening clinic.

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“We talk a lot about empathy and connecting with patients,” echoed Mr. Doug Short, Administrative Director of the Department of Community and Global Health. “Today, I asked the students to focus on three things – eye contact, facial expression and body posture. Each of these things communicates to patients that [the student] is present with them.”

Brittany Lugmayer, a rising second-year medical student, shared her experience serving in Mt. Olive – her first medical outreach trip with CUSOM. “I think it really helps you see the difference between learning medicine and doing medicine,” said Lugmayer.

“I want Brittany Lugmayer, MS-II (left) helps with patient [patients] registration. to be able to learn to make healthy choices that impact them. That’s important, especially in a rural area, because people don’t have access to [healthcare]. I like helping to others help themselves and making it sustainable so that it’s something they can continue doing … it’s uplifting to see how grateful the patients are for your time and care. It reminds you why you’re here and why you want to be a doctor.”

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The Mt. Olive outreach was also Emmanuel Ayeni’s first trip with CUSOM. A rising second-year MSBS student, Ayeni was excited to gain new experience alongside physicians and PAs to give back to the underserved community.

“Seeing all of the healthcare workers and medical students doing hard work – it inspired me,” he shared.

“I haven’t had very much experience working with underserved populations, so I thought it would be great to jump in and volunteer … to do my part.”

Ms. Jaclyn Blair, PA-C, works with students during medical outreach events and weekly at the Community Care Clinic. She shared how these opportunities are great for students because they can spend more time with the patient in a healthcare setting than they are able to during clinical skills labs.

“The students get to see patients that have multiple problems at once and sit with them for 30-45 minutes – collecting a complete history and practicing their skills on their own without a provider with them,” she explained. “Then they come back out, ask us questions, and we can affirm what they’ve found and go in and see the patient together. It gives them a good experience … and I think it can help them with empathy as well.

“We are also able to see that there are different ways to get access and to care for underserved populations.

That’s important because it’s not something you always just have a class on … but there are people willing to give their time, money and efforts to see people who don’t have the resources otherwise. Hopefully, it can open their eyes and heart to maybe one day also do the same.”

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Emmanuel Ayeni, 2nd year MSBS student (photo above - left) and Ms. Jaclyn Blair, PA-C (photo below - middle) working with patients during an evening clinic with the North Carolina migrant farm workers.

Alumni Research Spotlight: Dr. Rachel Ranson (‘21) Dr. Rachel Ranson (‘21) was the first Campbell Medicine student to receive Honorable Mention from the AACOM Student Researcher of the Year Award.

Dr. Ranson took a gap year as an MS-III to participate in a research year at New York University’s Orthopedic Surgery Department and is now in residency for orthopedic surgery at George Washington University in Washington, DC. She recently shared the details of her experiences with medical research before and during medical school that she believes were instrumental in her receiving Honorable Mention as well as her continued work while in residency.

“I would like to thank Dr. Craig Fowler for telling me about the AACOM Research Award and for mentoring me regarding the required letters of recommendation, personal essay and CV of my research. Dr. Fowler also advised me through the process of seeking a research gap year, and I was very fortunate to get accepted to NYU for a 2019-2020 research year where I gained significant research experience.

“There were hundreds of applications, a winner, the runner up, and a handful of honorable mentions. To be among those who received Honorable Mention was amazing because a huge component of the award criteria is osteopathic – ‘how is your research helping osteopathic students?’

Unfortunately, I hadn’t published anything of that nature yet, even though I’m working on it now, I was really honored that they respected my drive and what I’m doing.”

WHAT PROMPTED YOU TO APPLY FOR THE RESEARCH YEAR AT NYU? I went to medical school to be an orthopedic surgeon. I really knew what I wanted to do. I was obviously open to other things, but in my heart, I knew that’s what I wanted. So, I tried to get involved in some research, but it was difficult to get ortho specific research without a home [Campbell affiliated] ortho program.

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Doctor Fowler showed me an article about gap years research years. A lot of allopathic students have been doing this, and he suggested I pursue one.

It was really hard to grapple with taking a year off - knowing you are putting another year between you and graduating losing a year of pay. But, I decided if it can solidify a spot in something I know I want to do, I’ll do it, and then I got the most amazing opportunity.

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up with a lot of the treatment principles. They chose NYU to be one of the sites for this multinational study, and I was the sole person setting it up for the whole institution. A guy came from Switzerland to train me. He also brought me chocolates which was super nice.

In addition to the databases, I was going to IRB meetings myself and presenting, coming up with protocols, talking to the legal department, et cetera. I got to see the inner workings of research from an administrative standpoint as well - that was really unique.

Unfortunately, SARS COV-2 hit while I was in the program in New York, but it provided an opportunity for some really interesting research on the orthopedic impacts of the virus that we were able to publish. Using our hip fracture database and many man hours, we got all of our data for the COVID papers in about 2 weeks.

SARS-COV-2 and Hip Fractures - you have a hip fracture, and you have COVID-19, what’s your mortality risk?

If you have COVID, it can be terrible. If you have a hip fracture, that’s terrible because within a year of hip fracture, there’s a 30% mortality risk in and of itself. For geriatric patients, either one is a pretty rough thing to happen, so we were interested to see how COVID-19 + hip fractures impacted mortality rates.

Turns out it’s really bad.

When I got into the fellowship at NYU, I had no idea how impactful it was going to be. The Primary Investigator I did research with, Dr. Kenneth Egol, is quite significant in the ortho world, and he’s a great guy. He wrote The Handbook of Fractures and was the program director for NYU for quite some time -one of the top orthopedic programs in the country - and he is now the vice chair. Later, when I was doing residency interviews, folks asked me “You got to work with Ken? Wow, that’s pretty cool”.

WHAT WERE THE SPECIFICS OF YOUR PROJECTS AT NYU? NYU has had this research program for almost 20 years, so it’s a well-oiled machine as far as what fellows do; you are assigned certain internal databases. I was in charge of a large geriatric database and one about proximal humerus fractures. Additionally, I created a hip fracture database with NYU’s data, which they have continued using since I left, resulting in several publications already.

Also, they had just created a tibial shaft database which was an international, multi-center study with the AO Foundation - a huge trauma conglomerate in Switzerland who come 6 SPECIAL EDITION - 2021

more.

We looked at data from 2019 and compared to 2020 and the mortality risk was significantly

Using the database, we factored in patients’ age, their comorbidity index, the injuries they sustained, and plug that information into an algorithm to calculate the percentage risk of patient death within their hip fracture hospitalization and even 30 days out.

Our paper shared how we can use this tool for patients to risk stratify them in quartiles and every single person who had COVID was in the highest quartile. It was predictive of their death rate, which was really upsetting, but it also gave us a better treatment algorithm for patients who have both conditions. Typically, if you have hip fracture, you get surgery right away, but if you have COVID symptoms, it’s actually in your best interest to hold off until you’re asymptomatic.

It was a really interesting project because it affected patients in the moment of the evolving pandemic. I’m still working with NYU, and we are about to do a one-year follow-up.

Unfortunately, the data is looking bleak in regards to patient morbidity. It quite sad, yet it is such important information.

We published to the Journal of Orthopedic Trauma.

The papers can be found on PUB Med as well as a few international journals. Later, when I was interviewing for residency, interviewers said “Oh, I read your paper! We’re teaching it and updating our hip fracture policy because of it” - that was a bit surreal and definitely exciting. It was in that moment when I realized how truly impactful the project was; I knew research could be impactful, but it got me even more excited to continue doing research.

Articles published: “Increased Mortality and Major Complications in Hip Fracture Care During the COVID-19 Pandemic: A New York Perspective” “Modifications of Validated Risk Stratification Tool in Characterize Geriatric Hip Fracture Outcomes and Optimize Care in a Post-COVID-19 World”

OUTSIDE OF THE NEW DIRECTION IN YOUR RESEARCH, HOW WERE YOU IMPACTED PERSONALLY BY THE COVID PANDEMIC? I got COVID pretty early in 2020. Thankfully, it wasn’t terrible for me. It was like a week-long flu.

I only lost my taste for a day, so really, I had best case scenario with it. My cat got sick too though, so that was really sad. I was really worried. She had horrible breathing, and the vets weren’t even open, but she recovered, too.

New York City is usually so lively and vibrant with something always going on, but when everything was fully shut down, no one was out. It was like a ghost town. It was terrifying. It made you realize how serious the situation was.

I was in research, but we had a huge clinical component to this year as well, so I was going to clinic and the hospitals after I recovered. Then, I got pulled out like all nonessential hospital staff from the end of March or early April until June.

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That’s when things were getting really bad; I went to the hospital and patients were packed along the hallways like sardines because there weren’t enough beds. It was exactly like what the media said happened. I saw the Red Cross come...It was pretty scary.

Luckily, I didn’t have a lot of first-hand experience compared to all of the physicians who have, unfortunately, gone through a lot of trauma. I was only peripherally there seeing it all.

In April and May, we weren’t allowed to be in the lab, so we did our research remotely. June 1st, we went back. To be by yourself in a tiny apartment for two months…it was rough for a while, but we made it through.

WHAT ARE YOUR PLANS FOR FUTURE RESEARCH WHILE IN RESIDENCY AT GW? I’ve continued the research with NYU, and I’ve started some new projects.

NYU Hip Fracture Anesthesia One of my main projects with NYU was looking at a new anesthesia technique for hip fracture care.

Instead of doing general anesthesia or a spinal, it was like when you are under for a dental procedure - it’s called MAC sedation, along with injections of lidocaine in your hip, so it’s the most minimal.

We did this for patients who were really sick, when it was not recommended to do general anesthesia, and spinal’s can be hit or miss, so we were seeing if this was a more safe and effective option. It turned out great especially in light of COVID and other patients who are really, really sick.

We want to do a multi-center clinical trial, and I’m hoping to do it with George Washington, Cedars Sinai, and NYU.

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Publication: “Monitored Anesthesia Care and Soft-Tissue Infiltration With Local Anesthesia: An Anesthetic Option for HighRisk Patients With Hip Fractures” The Tulane Project: Osteopathic Presence in Orthopedics I’ve started working with Dr. Mary Mulcahey at Tulane who’s also an allopathic (MD) physician. My research year was at NYU, which is allopathic, and I was the first and only DO ever to enter into the NYU research program. This inspired me to look at osteopathic students, residents, and physicians in orthopedics, especially academic medicine.

An important component of the AACOM Research Award is how it’s helping raise the profile of osteopathic medicine and, through my experience at NYU, I saw how underrepresented DO’s are in orthopedic research. Given DOs’ additional musculoskeletal training, I thought it was pretty crazy how osteopathic medicine is not well represented in orthopedic surgery, so I pursued doing a study to document how many DOs, both faculty and residents, are in academic medicine by reviewing all of the residency program websites.

Eventually, I want to compare DO’s versus MD’s board scores because you would think intuitively DO scores would be higher since we have more MSK training, at least initially.

Some board data that’s out there has shown DOs outperform MDs in the early years of residency.

Unfortunately, we cannot gain access to the in-training examination raw data, so we cannot tell if this is statistically significant, yet.

Currently, we’ve decided to make a broader study to see where osteopathic students are going in general; we are looking at The Match data. Also, we will look at DO residents in orthopedics and then DO faculty in ortho - compare and contrast. For example, if there are more DO faculty, does that correlate to more DO residents in these academic centers?

Historically, DOs are more “community based”, so more rural or suburban, but I think we need to realize that even big cities are a community, right? So, it’s translatable. I don’t want there to be a bias at community programs towards researchers thinking “they are too big league for us” and that researchers will only want an academic, ivory-tower environment.

Community research should be done as well so we can reveal how to treat all patient populations. We need a more accepting environment both ways - more from the 8 SPECIAL EDITION - 2021

osteopaths to support those who want to get more involved in academic medicine as well those who want to be community medicine focused and more major academic institutions to be accepting towards osteopathic practitioners. No matter what, don’t discourage.

Dr. Mulcahey and I are also interested in females in positions of power. If there are more female faculty members, do those programs have more female residents?

She is the vice president of the Ruth Jackson Orthopedic Society, and she is passionate about getting women and POC involved in orthopedics as well as the cause of equality for osteopathic residents and physicians. Being able to work alongside her has been phenomenal. Our research is specific to orthopedics, but it also affects all women going into surgery, because women are underrepresented in surgery in general, but especially orthopedic surgery. I idolize her cause and want my career path to emulate hers – by helping marginalized populations achieve their goals.

Personally, I want to represent us - women and DOs - in these specialized fields where we don’t currently see as many, and I hope these studies will help increase our numbers, too.

Campbell Medicine Spotlight Medical Student Summer Research Scholars The Medical Student Summer Research Scholars (MSSRS) Program is a summer research opportunity open to rising MS-II students only. The project period is 7 weeks during the summer, and students are expected to devote at least 6 full weeks to the project. Students attend weekly work-in-progress sessions and provide the opportunity for MSSRS participants to present their work to student peers. A final report is presented in the form of a poster or oral presentation at a local, regional, or national meeting.

The Interprofessional Education Symposium held each spring at Campbell University is an opportunity to present, and all MSSRS participants are encouraged to present a poster at the event.

ROBYN NARON

Hometown: High Point, NC Education: Bachelor of Science in Psychology, University of North Carolina; Masters in Public Heath, A.T. Still University Hobbies: Spending time with my husband and two pups; hanging out with friends and family; listening to live music; watching College Basketball (Go Heels!); exploring new cities, reading, soccer, hiking, baking, working with children, and giving back to my community.

Project title and research role: Analysis of Pediatric Car Seat Restraint Use in Rural Emergency Department I served as one of the primary investigators for this project by collecting and analyzing survey data in collaboration with Dr. Elizabeth Gignac, two Emergency Medicine Residents at UNC Southeastern Regional Medical Center, and two fellow CUSOM medical students.

UNC Southeastern is located in Robeson County, NC and is the home to one of CUSOM’s clinical sites and residency programs.

Robeson County has one of the highest percentages of pediatric trauma by motor vehicle crash due to improper restraint use in the state. Our goal was to examine why this is happening in hopes to shape future community-based health interventions on this issue.

Why did you choose to participate in the summer scholars program and what are you learning? I am very interested in pediatric medicine and wanted to find a clinical research opportunity that combined my love for pediatrics while expanding my experiences in scholarly research. I love the idea of being able to make a difference at a community-level, so the project at UNC Southeastern appealed to me for so many reasons.

The Summer Scholars program is so much more than just involvement with a research project. Since I participated in a clinical project, I also had the opportunity to shadow within the Emergency Department and found this experience extremely valuable to my medical education. We also had small group meetings weekly with several CUSOM faculty members to advance our knowledge on the research process and challenge us to become confident student researchers.

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Advice to MS-I’s and future medical students: Surround yourself with people who will lift you up and support you through this process. I would have felt so lost through my first-year of medical school without my friends, study buddies, family, and the encouraging staff at CUSOM. Having a strong support network can make all the difference during the particularly tough weeks.

Also, please don’t be afraid to reach out to older students for encouragement – we have been in your shoes and can offer some very valuable advice!

JUSTIN BAIRD

Hometown: Raleigh, NC Education: Bachelor of Science in Physiology and Neurobiology, NC State University; Master of Science in Medical Sciences, LECOM-Bradenton Hobbies: Weight lifting, basketball, camping, night life, trying new restaurants, and traveling Research project title and role: Deltoid Fiber Architecture. PI: Dr. Maxx Toler My role, along with my partner Sarah Bogan, was to dissect a few cadavers and take measurements of the deltoid muscle. We also performed acid digestion of the muscles and measured the lengths of the individual muscle fibers. I also helped to create an oral presentation and write a paper with the summary of our findings.

Why did you choose to participate in the Summer Scholars Program and what did you learn? I applied to participate because I wanted to use my summer to learn more about the field of research. I thought it would be beneficial to put on my resume in the future when applying to residencies. It also gave me the opportunity to learn more about cadavers since we did not have an in-person anatomy lab during our first year due to the COVID-19 pandemic.

I learned how to dissect cadavers in the anatomy lab – due to COVID-19, my class had not had that opportunity. I also was able to build a closer relationship with anatomy faculty members and some fellow classmates.

I also learned how to present research in a presentation and in a final research paper summarizing our findings. I learned a lot about other research projects from fellow medical students’ presentations C AMPBELL MEDICINE NE WSLET TER

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and realized how many cool research projects are happening at CUSOM! Advice to MS-I’s and future medical students: Spend the summer between your first and second year doing what makes you happy.

You don’t necessarily have to have a research experience. If you want to have something that would be nice to have on your resume, then you should do that. However, it is most important to use this summer to help you recharge and get ready for the second year.

ERIC YU

Hometown: Sparta, New Jersey Education: Bachelor of Science in Chemistry, University of Richmond; CERT Virginia Commonwealth University Hobbies: Golfing, video games, and reading.

Research project title and role: Analysis of the presence of anti tNASP antibody in the serum of patient with 10 most common types of cancers. PI: Dr. Oleg Alekseev I worked together with Madeline Walker analyzing patient serum for anti tNASP antibody, which has potential to be a cancer biomarker. A cancer biomarker can help with early diagnosis, treatment, and prevention of cancer.

Why did you choose to participate in the summer scholars program and what did you learn? I chose to participate in the summer scholars program because I love doing research. Before pursuing medicine, I worked as a chemistry graduate researcher at Virginia Commonwealth University pursuing lowering the cost of active pharmaceutical ingredients.

interest in metabolic health and the pathophysiology of insulin resistance. I was very excited to work with Dr. Pennings who shares this passion and has performed numerous studies looking at this very topic.

Advice to MS-I’s and future medical students: Year 1 is a busy year, but if something catches your interest try to reach out to the lecture professor to learn more about that idea. Our professors are real people with real interests, and they would love to spend the time sharing their passion with you.

JOSHUA JENKINS Hometown: Bristow, VA

Education: B.S. in Biology with Minor in Biochemistry, Christopher Newport University Hobbies: golf, disc golf, baseball, video games, and adventures with my wife.

Research project title and role: Performance Improvement – Trauma Guidelines and Algorithm Adherence at WakeMed Raleigh with Sarah McIntyre, Trauma Nurse Coordinator; Research Assistant Why did you choose to participate in the Summer Scholars Program and what did you learn? I decided to participate in summer scholars because resurgent scholarship is the most important tool for the advancement of medicine. I want to be part of something that could improve the bigger picture of patient care.

From this experience, I learned a significant amount of the inner workings of a hospital setting, Guideline development and improvement of patient care in an acute clinical environment.

Over the summer, I really wanted to do some type of research, and the summer scholars program offered the opportunity to do that.

Dr. Alekseev has been a great mentor and instructor, and I highly recommend the summer scholars program.

Advice to MS-I’s and future medical students: Medical school is just one piece of a long journey. Do not let it be the only thing that defines you. Doing things that make you happy makes all the work worth it.

Advice to MS-I’s and future medical students: Find the plan that works the best for you and stick with it. Be efficient with your time, always make time for yourself, and always make time to help others.

SARAH BOGAN

LUIS ANTHONY ACEVEDO

Education: BS Pre-medical Biology , Campbell University

Education: Bachelor of Science in Health Sciences, University of Florida

Hobbies: Taking my dog hiking, traveling, target shooting, exploring new food, going to zoos and aquariums, and mudding!

Hobbies: Competitive Powerlifting and coffee connoisseur.

Research project title and role? Deltoid Muscle Fiber Architecture.

Hometown: Gainesville, FL

Research project title and role: Comparison of fasting glucose, fasting insulin, and their combination for assessing diabetes risk. PI: Dr. Nick Pennings My role in the project was to do a deep dive of current research utilizing insulin to predict the progression to diabetes. Our analysis would provide more evidence to this body of research by analyzing the CARDIA cohort for the utility of fasting insulin as a predictive blood marker for progression to diabetes in a large population of people.

Why did you choose to participate in the summer scholars program and what did you learn? I have always had a great 10 SPECIAL EDITION - 2021

Hometown: Sanford, NC

I worked with classmate Justin Baird on this project; we dissected cadavers to remove their deltoid muscles. We digested the muscles in nitric acid and measured the fibers lengths and observed muscle pennation.

Why did you choose to participate in the summer scholars program and what did you learn? Anatomy was my favorite class during our first year of medical school, and I missed not working with cadavers due to COVID-19. I thought the MSSR program would be a great opportunity to dive deeper in anatomy while getting hands-on experience with cadavers at the same time. I never thought of specializing in surgery, but I think I’m pretty

talented with a knife due to all this practice.

Advice to MS-I’s and future medical students: Find a study schedule that works for you and stick with it. This is likely to be very different from how you studied in undergrad. Also, you don’t have to use ANKI to do well in medical school. I really hate flashcards.

MADELINE WALKER (ABOVE)

Hometown: Andover, MN Education: Bachelor of Science in Biology and Biochemistry with a Minor in Psychology, First Year, UW-Madison, then transferred to University of Northern Iowa, Hobbies: Hiking, traveling, going to coffee shops, listening to podcasts, and watching movies Research project title and role?

Anti-tNASP Antibody in the Serum of Patients with Lung Cancer and Thyroid Cancer; student research assistant for Dr. Oleg Alekseev.

Why did you choose to participate in Summer Scholars program and what did you learn? I saw this as an opportunity to immerse myself in a field of medicine that I am interested in as well as being able to contribute to a project that may have huge implications for diagnosing patients with cancer.

I have learned so much about the research process and the impact we as medical students can have in the medical community.

Advice for MS-Is and future medical students: Take the advice you receive about studying with a grain of salt because everyone is MEDICINE.C AMPBELL.EDU

In addition to serving as a Summer Scholars mentor, Dr. Bonnie Brenseke (illustration above) is a PI for the Collaborative Anatomy-Pathology (CAP) Project with Drs. Foster, Green, Mitchell, Newton, Proia, and Toler.

The CAP Project provides medical students a deeper understanding of anatomy, histology, pathology, and medicine via linking disease seen at gross and microscopic levels with clinical implications of the disease.

First year medical students document lesions found during gross anatomy dissection. Samples are collected and undergo routine histologic processing. The resulting glass slides are scanned to permit virtual microscopy. After extensive literature review, participating students construct scientific posters, under faculty guidance, for presentation at local symposia.

This project started in 2013, was a student initiative, generally involves 20 to 100 students each year, and the students complete the work on the project largely in the summertime between the first and second year of medical school.

Currently, she has project proposals submitted for •

Animal Model of Bipolar Disorder with Christopher Breivogel, Tara Adams, and Krisztian Toth; grant submitted to the Milken Institute, Baszucki Brain Research Fund, which would examine the underlying cause bipolar disorder.

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Tracking Chagas disease in NC through a Sentinel Species with Sarah Hamer, Kathryn Purple, Andeliene Croce, and Grace Mathis, Which would create a multi-institutional collaborative to submit and assess samples of sentinel species (e.g., opossums and raccoons) to determine the incidence and prevalence of Chagas disease in North Carolina and surrounding states.

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“Our lab focuses on the role of mitochondrial DNA mutations in major human diseases, particularly cancer. Mitochondria are organelles inside of cells that are mainly responsible for generating energy.

Most of your genes are contained in DNA in the nucleus of the cell but mitochondria also have a small amount of DNA with a few genes that are involved in energy production. In many disease processes, the functions of mitochondria become compromised and often we can detect mutations in mitochondrial DNA. In many of those cases, it is not clear if the mitochondrial DNA mutations are the cause or a consequence of the disease process.

Summer Scholars Faculty Mentor: Dr. Warren Lushia, Vice Chair of Biochemistry and Genetics, Associate Professor of Biochemistry (Madeline Walker cont’d) unique and what works for someone else may not work for you. Be honest with yourself about how you best study, and if something that used to work for you is no longer doing the job, then don’t be afraid to try something new!

CELESTE R. GRACEY Hometown: Kirkland, WA

Education: Bachelor of Arts in Communications-Journalism, University of Washington Hobbies: Hiking, family bike rides, and baking/cooking.

Research project title and role: An Investigation of COVID-19 Vaccine Hesitancy within Rural Regions of North Carolina Why did you choose to participate in the summer scholars program and what did you learn? Summer Scholars is an amazing opportunity to get connected to the research community at Campbell and in North Carolina. My research is also on a topic that is near and dear to my heart. Not only has vaccine hesitancy in my home state led to measles outbreaks, but the first major COVID-19 outbreak in the US occurred in the neighborhood where I grew up. Vaccines are the most significant advancement ever made in medicine. Understanding why people are uncertain about them and learning how to address those concerns will only increase that impact.

Advice to MS-I’s and future medical students: Change your definition of success. Perfect grades and high scores may have played an important role in making it this far, but you are about to enter a world where your success is not limited by what the people sitting on your left and your right are doing. While passing classes alone is truly a triumph, the deluge of information does not let up after an exam. Everything has to be done with sustainability 12 SPECIAL EDITION - 2021

The main focus of our lab is to develop a way for us to alter the DNA inside the mitochondria.

This would allow us to examine if such alterations can cause human diseases, and potentially provide therapeutic options for treating such diseases. If successful, the technology we are developing would open doors for looking at the role of mitochondrial DNA mutations in many of the major diseases affecting people. There is also potential for developing the technology into “gene therapy” that could be used to treat people who have a disease caused by mitochondrial DNA mutations.”

- Dr. Lushia on his current research project.

and persistence in mind, which means it is essential to build experiences into your schedule that re-energize your body and spirit.

SUMIYAH ENAYET Hometown: Cary, NC

University

Education: Bachelor of Arts in Interdisciplinary Studies, Minors in Chemistry and Broadcast Journalism, University of North Carolina Chapel Hill; Masters of Science in Nutrition, Columbia

Hobbies: I love to spend time with my two cats named Zuko and Katara, play video games, run, sing, draw and sew!

Research project title and role: “Outcomes for Intensive Interventions in Tertiary Clinical Pediatric Weight Management Program”, Research Assistant for Dr. Samareh Hill and Dr. Shirley Huang at WakeMed Why you chose to participate in the summer scholars program and what you are learning? Research is the foundation for new innovations in medicine and is vital for improving treatment and shaping policy. During my masters program, I enjoyed conducting research and learning more about nutrition and obesity. I saw Summer Scholars as a valuable opportunity to get more research experience and learn more about a topic I am passionate about. I have been able to learn about targeting the multiple facets of health when treating patients and meeting patients where they are in order to help them reach their health goals.

Advice to MS-Is and future medical students: Take everything one day at a time and focus on becoming a better version of yourself everyday rather than comparing yourself to others. Find something you love to do outside of school for the days you need a break, and don’t be afraid to ask for help when you need it!

MELISSA JENKINS SOARES

Hometown: LaSalle, IL (but I have spent the last 20 years in Asheville, NC and claim it as home!)

Education: BS in Biology, minor in business management, UNCA Hobbies: Yoga, Brazilian Jiu Jitsu, and hiking with my husband and 2 kids.

Research project title and role? Urine Drug Screen Measuring Medication Absorption Rates in the Bariatric Population. My role is data collection and analysis plus shadowing in the bariatric clinic and OR. Why did you choose to participate in the summer scholars program and what did you learn? As a future family med physician, I want to understand the unique needs of any population that might seek my care. This project focuses on how different bariatric surgeries may affect the absorption rates of many common MEDICINE.C AMPBELL.EDU

medications prescribed in a family med setting.

Advice to MS-Is and future medical students: When things seem overwhelming, stay focused, trust the process, and take it one day at a time. You’ve got this and you deserve to be here!

KELSEY TSCHOPP

Hometown: Orlando, FL Education: Bachelor of Science in Chemistry, Loyola University Chicago Hobbies: Plant Care and Art Research project title and role: Improving Hypertension Care with Checklist Use. PI: Dr. Victoria Kaprielian Why did you chose to participate in the summer scholars program and what did you learn? I was looking to gain experience in clinical research since my previous research has all involved bench research. I was really excited to take part in a research project which involves the CUCCC because I am a Floor Supervisor for the clinic.

I spend most [Tuesday evenings] at the CUCCC, so it has been nice being able to contribute to research that involves the patients of the clinic. This research project is aiming to improve care for patients with hypertension by implementing a checklist at the clinic.

While we are still auditing charts and gathering data, it appears using a checklist certainly helps the student-doctors during their patient visits. I am looking forward to analyzing whether an improvement in patient care was observed.

I learned how to conduct a quality improvement study and how these studies are frequently used in medicine to improve patient care. It was great to perform a quality improvement study at the CUCCC and see the improvement in patient care by the student doctors.

Advice to MS-I’s and future medical students: All of your professors at CUSOM are extremely helpful and want to see you succeed! Don’t be afraid to reach out to them to ask questions or get clarification on something. I also found that studying with a small group of peers occasionally really helped me prepare for quizzes/ exams since we would often test each other and help each other through difficult topics.

MELANIE DOMANN

Hometown: Saint Charles, IL Education: Bachelor of Science in Biology, University of Wisconsin – Whitewater Hobbies: Exercising, BIG AnimalLover, Football Season Fanatic Research project title and role: “Can Trauma be an Opportunity to Identify and Treat Non-Injury Medical Conditions in Young Adults?” PI: Dr. Jaclyn PortelliTremont My role in the project was to analyze trauma cases from within the last two years and to determine whether there were any previous diagnoses of hypertension, diabetes mellitus, substance/alcohol C AMPBELL MEDICINE NE WSLET TER

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abuse, or obesity. We would then examine whether the patient had any indicators during their hospital stay that would fit the criteria of any of the above diagnoses.

Why did you chose to participate in the summer scholars program and what did you learn from the experience? I am extremely interested in Emergency Medicine, and I think that this research topic is very important in the early diagnosis of common health conditions. Many of these patients don’t see a primary care provider regularly to ensure that there are no serious underlying health conditions. By using trauma as a way of identifying these diseases early on, it can prevent serious complications from arising later in life.

Advice to MS-I’s and future medical students: Use your free time to do what makes you happy. Don’t study every second of every day and rely on your friends as your support system. You are all going through this together, so use this to motivate each other when you are feeling stressed.

ABIHA JAFRI

Hometown: Shenandoah County, Virginia Education: Bachelor of Science in Biomedical Engineering with a double minor in Biology and Electrical Engineering; The George Washington University Hobbies: Traveling, reading, cooking and baking Research project title and role: The Effect of Health Literacy on Healthcare Utilization in Trauma Patients; Research assistant with Dr. Jaclyn Tremont Why did you choose to participate in the summer scholars program and what did you learn? Summer Scholars is a great way to learn more about research as well as get involved in community projects. I saw this as an opportunity to immerse myself in a field of medicine that I hadn’t considered before: surgery and trauma care. While my primary role in this project was extracting and transferring patient data, I was able to learn more about the inner workings of the hospital and the surgical/trauma field.

Advice to MS-I’s and future medical students: Enjoy your time in medical school. This is just the beginning of your journey to becoming a physician, so take the time to celebrate your accomplishments and have fun. Four years are going to fly by fast!

DILLON PHAM

Hometown: Huntington Beach, CA Education: UCLA Hobbies: watching sports, escape rooms, hiking, video games, and exploring food Research project title and role: Transformation of Mitochondrial DNA; research assistant for Dr. Warren Lushia Why did you choose to participate in the Summer Scholars Program and what did you learn? It seemed like a super interesting project with a lot of potential future application in the 14 SPECIAL EDITION - 2021

field of medicine. I’m learning specifics of mitochondria and the cell for yeast as well as the process of researching as a whole.

Advice for MS-Is and future medical students: Don’t sacrifice your outside interests when you start med school! Having interests and activities outside of studying helps keep you sane.

REBEKAH MILLER

Hometown: Belle, Missouri Education: Associate of Arts, St. Louis Community College; Bachelor of Science in Biology, Truman State University Hobbies: Walking trails with my new dog and reading fiction and Christian books Research project title and role: “Core faculty attitudes and perspectives regarding the attainment of Osteopathic Recognition in Campbell University sponsored residencies” My role included assisting with the IRB application process, helping develop interview questions that will be used in our research methodology, and completing a literature search to construct a strong background rationale for our study. Additionally, I received mentorship in research methodology, qualitative data assessment, and presentation development, while also gaining experience in NVIVO software analysis.

Why did you choose to participate in the summer scholars program and what did you learn? Summer Scholars was wonderful to understand what goes into research design and implementation and the teamwork/mentorship that was necessary for my professional growth and the advancement of the study. Also, it was a great way to get involved with a study that may impact the future of the medical profession. All that I have learned I will carry forth in my future endeavors.

Advice to MS-I’s/future medical students: There are many different ways to succeed in medical school through different study habits and resources. Find what works best for you, continue with it, and don’t compare yourself to others.

“Comparison is the thief of joy.” – T. Roosevelt

ABBY DANIELS

Hometown: Mocksville, NC Education: Bachelor of Science in Biology, Western Carolina; Master of Science in Biomedical Science, Campbell University Hobbies: I enjoy being outside in nature whether it be camping, fishing, hiking, or archery. I love playing with my dogs, Jolene and Norton, and spending time with my family.

Research project title and role: “Analysis of pediatric safety restraint use in a rural emergency department.”

My role as a student researcher was to organize the distribution of surveys to the parents and/or guardians of pediatric patients in the Southeastern Regional Medical Center Emergency Department. I

would collect the data received and input the information into our database to later analyze. When I was not actively collecting data, I had the opportunity to shadow the residents and physicians while in the Emergency Department.

procedures, discussed patient cases thoroughly, and have learned the process of seeing a patient from start to finish. I will take these experiences with me throughout my career and use them to make myself a better physician.

Why did you chose to participate in the summer scholars program and what did you learn? I chose to participate in the Summer Scholars program to expand my experience regarding research and clinical practice. While being involved in the research, I have also been able to shadow the residents and attendings in the Emergency Department. I have been able to take the knowledge I have gained from my first year of medical school and apply it to patients I have seen come into the ED. The experience I have had has been invaluable to my medical education. I have watched many

Advice to MS-I’s and future medical students: My #1 piece of advice to MSI’s and future medical students is to make sure you are taking care of yourself! Medical school, and life in general, is always going to be challenging at times. It is so important to make sure your mental health is appropriately cared for in order to face those challenges. Take time to do the things you love outside of medical school, spend time with your friends and family, and just take a break sometimes!! Having a well rested mind can make a world of difference.

Research Awards from NCS-ACOFP IN THE CATEGORY OF ORIGINAL RESEARCH, WHICH INCLUDED BIOMEDICAL AND QUALITY IMPROVEMENT POSTERS FIRST PLACE AWARD

B3: Evaluating Fasting Insulin with Standard Glucose Screening Methods to Predict Type 2 Diabetes Risk Authors: Stephanie Everest1, Lauren Thomas1, Matthew Peterson2, Nicholas Pennings1 Affiliations: 1Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek NC; 2University of North Carolina Wilmington College of Health & Human Services, Wilmington NC

RUNNER UP AWARD B2: Deviations from the Guidelines for Venous Thromboembolism Prophylaxis in Mild and Moderate Risk Traumatic Brain Injury Patients Authors: Jacques Lara-Reyna1, Lea Alali3, Raymond Wedderburn2, Konstantinos Margetis1 Affiliations: 1Mount Sinai Health System, New York NY; 2Mount Sinai Morningside/Mount Sinai West, New York NY; 3Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek NC

IN THE CATEGORY OF CASE REPORT (17 POSTERS) FIRST PLACE AWARD

C11: Recurrent Nephrolithiasis in MEN 1: A Case Report

BACK ROW (L-R): Stephanie Everest, Lauren Thomas, Aakash Patel FRONT ROW (L-R): Lea Alali, Caitlyn Cross, Anjali Agrawal, Chung-Tang Liu

RUNNER UP AWARDS C4: Anti-Cardiolipin syndrome Presenting with Acute renal Infarction in a Health 26-year-old Female Authors: Caitlyn Cross, James Cappola Affiliations: Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek NC C9: A Case of Symptomatic Acute Myocarditis Following Administration of the Pfizer/BioNTech BNT162b2 mRNA Vaccine Authors: Aakash Patel, Elizabeth Onyeaso Affiliations: Cape Fear Valley Health System, Fayetteville NC C14: Recurrent Invasive Breast Cancer with Idiopathic Type Change into Mucinous Carcinoma Post Bilateral Mastectomy

Authors: Anjali Agrawal, Matthew Conti

Authors: Chung-Tang Liu1, Katia Kyriakoulis1, Morgan Eudy1, Gavin Misner2, Gregory Mitro2, Amy Hinkelman1

Affiliations: Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek NC

Affiliations: 1Campbell University Jerry M. Wallace School of Osteopathic Medicine, Buies Creek NC; 2Novant Health Rowan Medical Center Wallace Cancer Institute, Salisbury NC

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Campbell Received $1.1 Million for Osteopathic Research

A

n anonymous philanthropic gift was recently made to Campbell University to support Dr. Tom Motyka’s research in musculoskeletal dysfunction and pain; specifically, identifying the mechanism in prolotherapy and the efficacy of OMT in increasing range of motion.

the diaphragm to increase the range of motion.

Efficacy of OMT

“We can characterize gait or movement patterns in large sample sizes of people that may have important clinical or behavioral implications. For example, nursing home residents or migrant farm workers, or just residents of Harnett County. That hasn’t really been done before.”

Thanks to the generous gift, the team purchased an Optitrack system with Theia3D software for motion capture of human subjects. The goal is testing for efficacy of OMT treatments comparing before and after for range of motion. The first step is capturing sample data and learning the system.

“We are working with the software support folks to upload and evaluate test videos capturing us walking, running, jogging, squatting and lunging - standardized movements they use to train us to use the system properly,” explained Dr. Adam Foster, associate professor of anatomy, whose background is in biomechanics.

“Our goal is to use this system to more precisely and reliably measure movements that can be prone to inter-observer measurement error. Once they have established proficiency with the system, the first study will examine the efficacy of OMT on

The team is already brainstorming future projects on the epidemiology of movement with large numbers of human subjects.

Prolotherapy inflammatory marker cellular work: “Given the number of people who suffer from chronic pain and/ or motor dysfunction of joints, prolotherapy offers a potentially efficacious therapy to reduce pain and even stimulate healing processes while being minimally invasive and non-addictive.”

“Although prolotherapy has been reported to reduce pain and improve mobility and function of joints, it has yet to gain a lot of traction in the medical world as a recommended therapy.

There simply is not sufficient research yet, but that is the really exciting component about this research project—it is unchartered territory. Anything we find out will be new and helpful in better understanding this therapy and its potential to becoming a safe and established therapy that could help thousands of patients, improving their quality of life. In particular, we are really interested in the mechanistic component of prolotherapy because no one really knows what it’s doing at the cellular or tissue level,” Dr. Amy Hinkelman, assistant professor of microbiology and immunology said. “If you look in the literature, there are just a few labs that have done work on it.

This is a prime opportunity to fill in those gaps.”

“Even if we find negative data, at least that is something that we can provide to the scientific community, and say ‘it’s not this; it doesn’t do this’. So, there are lots of different things that you can investigate and explore. We’re starting with fibroblasts.”

THE INAUGURAL OSTEOPATHIC RESEARCH FELLOW, CAILEE DEAN. Dr. Motyka expressed his thanks for Student Doctor Dean’s willingness to embark on this project as the inaugural fellow.

“As a rising 3rd year student, she completed Sim Month and passed her boards, then she totally changed her life in a matter of a few weeks. She was set to start rotations, but once we were able to offer her the fellowship, she quickly moved back and changed her plans.”

Student Doctor Dean is part of Dr. Motyka’s research team looking at prolotherapy as well as efficacy of OMT and while assisting with MS-I and MS-II instruction in the OMM labs , and working with Doctor Motyka in the University Health Center to receive more clinical training and OMT practice.

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“Fibroblasts are known to be modulators of inflammatory and other immune responses. They can secrete growth factors, cytokines, etc.—all kinds of things that can guide the immune response from being anti-inflammatory and quieting things down all the way to promoting inflammatory responses to stimulating tissue repair and growth.”

“With the assistance of CUSOM Medical Research Fellow, Cailee Dean, we are investigating how these cells respond to the therapeutic doses of compounds used in prolotherapy. How does their phenotype and expression of certain markers change? How does their function change? What

factors do they secrete in response? We hope these in vitro studies will guide and inform other branches of the research project as we move into an animal model and then, eventually studies in humans.”

Dr. Snezana Petrovic & Dr. Tom Motyka: Physical function and dietary acid load in older adults (Metabolomics of oral bicarbonate supplementation) Maintaining good physical function is a cornerstone of aging well. Yet, other than exercise, there are no established approaches to prevent age-associated decline in physical function, although more than half of adults over 65 reports at least one limitation in a basic activity of daily living! Because of that, novel and synergistic approaches to ameliorate ageassociated disability, arthritis, and decline of physical function are urgently needed.

Our approach is to evaluate the effects of dietary interventions and supplements that may help older adults maintain good physical function and be free from arthritis. One such possibility is to neutralize harmful high dietary acid load of the contemporary diets.

It can be done by increased consumption of fruits and vegetables or supplementation with small amounts of baking soda (the base, bicarbonate).

Our current study uses cutting edge-analysis of small chemicals in the blood (the “metabolites”) of healthy elderly individuals who eat a diet with high dietary acid load but have taken controlled, small amounts of baking soda as a supplement to neutralize the high dietary acid load. We will compare them with those who also eat a diet with high dietary acid load, but used a placebo supplement instead of baking soda. We expect this analysis will tell us who MEDICINE.C AMPBELL.EDU

PROLOTHERAPY IN ANIMAL SUBJECTS: The project also has an interprofessional and interinstitutional collaboration with Penn State to look at prolotherapy using an animal model. “Our research will attempt to identify what cells and inflammatory markers may be involved which can help refine treatment regimens for osteoarthritis.”

ILLUSTRATION ABOVE: DR. ADAM FOSTER AND DR. MAXX TOLER

are good candidates to benefit from such supplementation and which parts of metabolism may be involved in these beneficial effects.

The potential benefits of establishing novel ways to better preserve physical function and prevent arthritis by modifying diet or using baking soda as a supplement, go well beyond prevention of disability.

The harmful effects of high dietary acid load we study include (but are not limited to) higher mortality, cognitive impairments, decrease in bone density, and faster decline of kidney function, to mention a few. Therefore, we expect the current analysis will have many useful ramifications to help older people age well, without disability and disease.

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US Army conducts ground-breaking research in the Campbell Gross Anatomy Lab Can a commercial technology create a capability for a downrange, non-surgical provider to give surgical care for a discrete number of predetermined tasks for fellow soldiers to save lives and limbs?

T

he Vyas Anatomy Lab is serving as the host facility for a research project with partnerships between Womack Army Community Hospital’s Col. (Dr.) Tyler Harris, the principal investigator and orthopedic hand surgeon, the Uniformed Services University of Health Sciences, and Bio Mojo, a woman-owned small business based in Research Triangle Park.

Bio Mojo focuses on XR, extended reality, related technologies and has been working with the U.S. Army at Fort Bragg since 2017 on the idea that you could use commercial technology to create a capability for downrange non-surgical providers to provide surgical care for a discrete number of predetermined tasks for fellow soldiers. Phase 2 of the project led by Col. Dr. Harris is being tested at Campbell.

“This specific project is an outgrowth of the initial work we started in 2017. It went from, ‘is this even possible?’

To, ‘how does this become something that is rolled into training?” said Jerry Heneghan, chief design officer for Bio Mojo.

“Under the leadership of Lt. Col. (Ret.) Steve Delellis at the Fort Bragg Research Institute, the Army came up with a dozen tasks deemed that a physician assistant, a nonsurgical physician, or a special forces medic, ought to be able to do to save a life downrange. Bio Mojo got involved to provide augmented reality heads-up display so that a remote expert, a surgeon, could draw on the heads-up display to identify physiological anatomical landmarks and provide visual guidance via HoloLens – kind of like John Madden on the screen when you are watching a football game.”

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Doctor Boyer, a renowned trauma surgeon at the Uniformed Services Medical School, created and teaches a course accredited by the American College of Surgeons for such downrange interventions and it has been used at Fort Bragg.

The study at Campbell is evaluating the use of a pictorial flipbook of procedures versus the heads-up display specifically to treat compartment syndrome by dissecting apart and releasing fascia. One such procedure - a twoincision, four-compartment fasciotomy of the lower leg - is an effort to save the life and limb who has sustained significant trauma to the lower leg. The procedure releases pressure from internal bleeding inside the fascia saving muscle tissue and preventing toxins that develop and can cascade to a variety of life-threatening conditions.

In Phase 1 of the study, small cohorts of 15 to 20 military personnel were brought into the medical simulation training center at Fort Bragg and trained on these procedures including a didactic review the anatomy and physiology, as well as a pre-test to establish participants’ baseline knowledge of fasciotomy, what compartment syndrome is, and when it’s an appropriate treatment.

About a year after this training, the study brings them back for Phase 2 at Campbell to determine their proficiency in retaining the knowledge of how to do the procedure.

The evaluation process consists of pre and postprocedure questions and a compartment syndrome procedure on cadavers with some participants using the heads-up display with live guidance and some of them using the flipbook.

Bio Mojo was hired to provide the technology for the study, which Jerry Heneghan explains in four key components.

once did, so the PA’s who are pushed out with the units need to be able to do these types of procedures that would otherwise be done by surgeons in a field hospital.”

“The military can give someone a fairly complex piece of equipment, train them up in about 15 minutes on how to use it, explain the goals for how this would work in the future - in the field - they would connect through a satellite connection or a tactical phone or radio connection, and talk to a surgeon at Walter Reed or in Germany who will guide them through the procedure.”

“A scalpel is being given to a non-surgical provider in some cases for the first time. In that case, it’s cutting edge, but I think forward thinking people like the folks that hired us to do this know that in near peer kind of conflicts, access to surgical providers is not necessarily guaranteed,” affirmed Heneghan.

Lt. Col. Dan Hankes, deputy surgeon for clinical operations at 18th Airborne Corps and Corps Senior Physician Assistant is serving as a liaison between the director of this program and the operational force to bring in the PAs to actually execute the test procedure and share the potential future life and limb saving significance of the project.

“Over the past 20 years, the United States has been involved in the global War on Terror in places like Afghanistan and Iraq, where we have had air support.

Outside of shooting at us from the ground, there have been no helicopters or other types of aircraft in the air to shoot down our aircraft including those airlifting injured soldiers in need of emergency treatment.”

“In this uncontested environment, we have been able to medevac patients off the battlefield within the golden hour pretty much with impunity. We have had little problem getting them back from the battlefield, where they were treated and stabilized by the medic and the PA, then to be transported if needed to an operating room if they are an emergent surgical case. We have been able to put them in a helicopter, and in relatively short order, get them there pretty quickly.”

“This project is inspired by preparedness. These are America’s sons and daughters, and we need to provide them the best care possible to get them home.”

“If, God forbid, we ever have a war where the air space is part of the battlefield, and we won’t have easy medivac ability. We won’t have the freedom of movement that we MEDICINE.C AMPBELL.EDU

“This all came about through the vision of Col. (Dr.) Tyler Harris when he was in Afghanistan a few years ago. He contacted me and asked ‘can you build something for me where you can see through my eyes and see what I’m seeing? I’m an orthopedic surgeon, and I have to deal with everything that comes into my facility, and you know I need sometimes subject matter expert or different occupational areas to help me to do my job’. So, we put something together for him that seemed to work.”

“Now, the goal of all of this research - and this is just one of many procedures that Dr. Harris and the Uniformed School wanted to train our soldiers on - is to equip our PAs in a war zone to do advanced provider techniques damage control procedures that would be otherwise done by a surgeon in an operating room. Once this project is done, then they’ll move on to a different procedure. There is a whole host of other procedures this training could apply to.”

Gerald Robertson, research assistant on the project and a former special forces medic, has also been key in all aspects of the project including supporting Lt. Col. Hankes in coordinating personnel participants.

Lt. Col. Hankes shared the participants in this project include PAs along with special operations combat medics, special forces medics, conventional side medics and some sister service medics and corpsman from the Navy for a total of 70 personnel completing Phase One, the training, and the Phase Two procedure in Campbell’s lab.

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study has proven midlevel providers can do this with skill and safety into an expert level,” explained Lt. Col. Hankes.

“There are lots of details to work out. How HoloLens would be incorporated into our kits and how they would hold up in the field, for example. But to be able to go to a General and say, this is a dynamite piece of equipment helps.”

could be anywhere in the world through the magic of an Internet connection, and he has the ability to see in 3D what the downrange provider sees. Whether you get the flipbook Dash 1, which is a book that gives you step by step instructions with photographs, pictures, good imagery to jog your memory and give you a good landmark of where you need to cut and separate the muscles, or HoloLens in Phase 2 is randomized.”

The project has been impacted by COVID-19.

“The intent was to bring back the participants from Phase 1 six to eight months later, but because of COVID, all kinds of complications got in the way. So now, it’s been roughly a year since the first cohort. I was in the first cohort, and when I came in to do Phase 2, I was feeling like ‘Oh my gosh I’m so rusty!’

“I was selected to use HoloLens where the surgeon can see what you see - they can see the leg; they can see everything. They can see your hands moving and talk you through it; if you get hung up, they can help you or just reassure you that you are doing fine. For me, it was a good fasciotomy.”

Dr. Harris’ thesis is that he can train personnel to do these types of procedures in a day, and Bio Mojo is refining the technological process with the hope that the study affirms this process works and the Generals can approve implementation for real practice.

“Dr. Harris’ intent is to use the data from Phase 1, a year ago with the didactic and the hands-on training, then Phase 2 a year later to see how much you retained, and then put all the results together to move forward with the army credentialing and privileging bodies after the 20 SPECIAL EDITION - 2021

The collaborative team is already thinking about applications for the project in civilian medicine.

“This is starting to happen in other countries, not necessarily ours - folks are looking at how to use this for emergency medicine,” shared Heneghan. “You’ve got paramedic talking to attending physician in the ER at a tier one facility in terms of what’s happening at the car wreck that’s 20 miles away. I think this will eventually transition out to be used when appropriate.”

Bio Mojo is focused on the technology at the operator level - what’s the operator seeing and doing. What information are they collecting? Also, what are the options for connectivity?

“In the aftermath of a hurricane, it could be a satellite truck, or a blimp, or a balloon. It could be anything. So, our question is, how do you plug into that network to take a signal and then manage a situation and get help for folks?”

“Campbell has bought into the idea of researching this cutting-edge approach, and I’m excited to be here,” said Heneghan. “I’ve worked at universities, and I think Campbell has provided unique capabilities here in terms of the anatomy lab and some of the faculty and the staff here available to this study. Everything is set up. It’s very efficient. This is a world-class operation here in terms of putting this together that I haven’t really seen anywhere before, so I think from an integration standpoint, Campbell has really provided that role in terms of providing the study resources, the staff, the faculty, the resources in the anatomy lab for this to happen in a way that could have taken more time.”

“Hopefully this will save some lives, Heneghan concluded.

“If it saves one life, it’s worth it, right? So, that’s what we’re trying to do.”

Addressing Adolescent Mental Health: Peds Club Connects with Local Schools

MS-III Andrew Brackins and MS-II Meaghan Nazareth led the Campbell Medicine Pediatrics Interest Group (aka Peds Club) in responding to the call for a national response to pediatric mental health – specifically in adolescent patients. Here, they share the details of the project and the hoped for impact.

INTRODUCE THE PROJECT AND HOW IT WAS INSPIRED. Each year the American Academy of Pediatrics (AAP) selects one area of pediatric well-being to be the focus of an advocacy campaign. This year’s topic is Pediatric Mental Health, and each chapter of the AAP was tasked with creating their own project to highlight the importance of Pediatric Mental Healthcare. As our club’s AAP National Representatives, we sought the counsel of the Harnett County School’s mental health specialists and determined we would create a series of videos discussing various behavioral health issues. These short videos could then be shared with Harnett County middle and high students.

WHAT ARE THE KEY COMPONENTS OF THE PROJECT AND WHO WAS INVOLVED? Ultimately, four videos were scripted, prepared, and filmed by members of the Pediatric Interest Group with supervision from our advisor, Dr. Stephen DeMeo. These videos cover symptoms, personal stories, and advice on how to overcome topics like depression, eating disorders, impostor syndrome, and anxiety. Medical students chose topics that had personally affected them with the hope middle and high school age students would understand they aren’t alone in struggling with anxiety, depression, eating disorders, or any of the other topics discussed.

A huge thanks to the following Campbell Student Doctors for their contribution to the creation of the videos, as well as the Campbell Video Production team: Medical Students – Hannah Agnew, Kara Brads, Taylor Coles, Karlye Denner, Diana Ivancev, Matthew Maffey, Ben Legere, Matthew Lucito, Robyn Narron, Madeline Walker; Video Production – Charles Phillips and Samantha Steichen HOW DID YOU CONNECT WITH HARNETT COUNTY SCHOOLS AND HOW WILL THEIR STUDENTS BE INVOLVED? We reached out to the Harnett County School System Student Support Services team of Mental Health Specialists – specifically, Jessalyn Pedone and Brittny Gainey and School Counseling Services Director Lauren Cappola. The goal is for the videos to be shared via Harnett County Schools messaging pathways this fall.

WHERE CAN THE VIDEOS BE FOUND AND ARE THERE ADDITIONAL RESOURCES YOU RECOMMEND FOR TEENS AND THEIR PARENTS? Videos can be found together in a playlist on the Campbell Medicine YouTube channel, and the AAP has several great resources for families.

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PUBLICATIONS June - October 2021

DR. NICHOLAS PENNINGS: collaboration - Herbst, Karen L., et al. “Standard of care for lipedema in the United States.”

Phlebology (2021): 02683555211015887. https://journals.sagepub.com/ doi/10.1177/02683555211015887 DR. YUNBO LI AND DR. HONG ZHU: •

Collaborated with Kan, S; Chavez, J; H. Zhu, X; Chiu, N.H.; Zhang W; Yin, Z; Han, J; Yang, J; Sigler, R; Tian, S; Wei, J; Yi, X; Jia, Z. Novel carbon nanodots inhibit oxidized-LDL-induced injury and monocyte adhesion to endothelian cells through scavenging reactive oxygen species. J. Biomed Nanotechnol

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“Nanoceria Potently Reduce Superoxide Fluxes from Mitochondrial Electron Transport Chain and Plasma Membrane NADPH Oxidase in Human Macrophages”. Published online prior to print. Li YR, Zhu H. Mol Cell Biochem.

2021 Sep 3. doi: 10.1007/s11010-02104246-7. Online ahead of print. PMID: 34478033

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“Vitamin C for Sepsis Intervention: From Redox Biochemistry to Clinical Medicine”. Published online prior to print. Li YR, Zhu H. Mol Cell Biochem.

2021 Sep 3:1-12. doi: 10.1007/s11010021-04240-z. PMID: 34478032 Free PMC article.

DR. KHALIL ELDEEB: “Crystal Structure of the Cannabinoid Receptor Interacting Protein 1a (CRIP1a) Reveals Unexpected Possibilities for CB1 Receptor Signaling by William T. Bootha, Jill C. Clodfelter, Sandra LeoneKabler, Erin K. Hughes, Khalil Eldeeb, Allyn C. Howlett, W. Todd Lowther, Submitted to Journal of Biological Chemistry.

DR. ALAN PROIA: Lee, T., Semenova, E., Proia, A.D., and Materin, M.A. A case of high-risk ciliary body melanoma arising in an eye following resection of an iridociliary melanocytoma. Retinal Cases & Brief Reports (In press; published online 06/24/2021).

DR. AMY HINKELMAN: Enwezor CH, Peacock JE Jr., Seals AL, Edelstein SL, Hinkelman AN, Wierzba TF, Munawar I, Maguire PD, Lagarde WH, Runyon MS, Gibbs MA, Gallaher TR, Sanders JW III, Herrington DM. Changing Attitudes toward the COVID-19 Vaccine among North Carolina Participants in the COVID-19 Community Research Partnership.

Vaccines. 2021; 9(8):916. https://doi. org/10.3390/vaccines9080916 C AMPBELL MEDICINE NE WSLET TER

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NEW HIRES

ALICIA KUCH Office Manager at the Health Center SHANI SCHWAB MHPE Fellowship Coordinator TONYA CARLYSLE, DC OMM Coordinator

CUSOM Welcomes the Class of 2025

GAIL SPANGLER, CPA Business Office Manager

PROMOTIONS CHUCK TOSCANO Director of IT for the Health Sciences Campus

162 students

92 female & 70 male

JEFF CLARK Assistant Director of IT for the Health Sciences Campus AMANDA LEE, MMSC, PA-C Director of Simulation Education DR. TIFFANY LOWE-PAYNE Director of Clinical Education LORI STRICKLAND Assistant Director of Clinical Education

66 students from North Carolina

25 states & Canada represented

Over 35 colleges/ universities represented

7 Campbell graduates

ALLIE SCHOFIELD Third Year Student Medical Education Clinical Coordinator

KUDOS THE GREAT DUCK RACE raised over $3,000 for medical education scholarship funds. Over 200 ducks were sponsored to “paddle” down the Cape Fear River.

DR. ROBIN KING-THIELE was installed as President of the North Carolina Osteopathic Medical Association (NCOMA) in June.

DR. ERIC GISH was also installed as Membership Chairperson of NCOMA in June.

DR. TIFFANY LOWE-PAYNE AND DR. DAVID TOLENTINO were installed as Trustees of NCOMA in June.

DR. TIFFANY LOWE-PAYNE was installed as the President of the NCS-ACOFP for the 2021-2022 year in August.

THE DEPARTMENT OF COMMUNITY AND GLOBAL HEALTH now offers primary care for underserved communities three nights a week and several Saturdays each month. The addition of the MHEC units provides free health care for farm workers in Harnett and Johnston counties on Mondays and Duplin County on Wednesdays. The CUCCC is open and provides patient care on Tuesday evenings.

22 SPECIAL EDITION - 2021

Avg. GPA 3.61 Avg. Science GPA 3.55

Avg. MCAT 506

White Coat Ceremony The White Coat Ceremonies for the Class of 2024 and the Class of 2025 were held September 17, 2021 at the Hobson Performing Arts Center in D. Rich Hall. The white coats were presented to 302 students by the students’ academic advisors. In addition to their white coats, as is the CUSOM tradition, they also received pins from the North Carolina Osteopathic Medical Association and the Arnold P. Gold Foundation. The White Coat Address was presented by Elizabeth Willis, (Class of 2017) Anesthesiology Resident at UNC.

Harvard Research Fellowship Spotlight Maren Downing, MEng HOMETOWN: Columbia, SC

EDUCATION: BS and MEng Biomedical Engineering, Clemson University; Summer Research Fellowship - Harvard University Longwood T-35 Vascular Surgery Fellowship FELLOWSHIP OVERVIEW: Student Doctor Downing was a Research Fellow at HarvardLongwood Vascular Surgery Short Term Research Harvard University Surgical Bioinformatics Lab, Boston, MA | 2021 Downing worked under Dr. Gabriel Brat on an intra-operative computer vision model in conjunction with Stanford University to measure surgical behaviors. Witnessed over 40 surgeries spanning across General, Plastics, Vascular, and Cardiac specialties.

She worked to characterize challenges and successes in mobilizing healthcare data during a crisis by analyzing lessons on rapid evidence generation in the era of COVID-19.

WHAT RESEARCH ARE YOU INVOLVED IN NOW? I am still a part of the Surgical Informatics lab with Dr. Brat. I was invited to continue after my short summer experience. I meet with the lab as I can throughout the week and contribute remotely.

I am seeing what kind of role AI plays in surgery and healthcare in general, and looking to see how I can be involved with this in the future. I aspire to combine Biomedical Engineering into my professional career, whether that be through medical devices or bio-informatics.

ARE YOU INVOLVED IN RESEARCH IN ANY OTHER WAY? I am working to bring research projects to the University’s free clinic: The Campbell University Community Care Clinic. I am the Executive Director of the clinic this year, and have been working to start Osteopathic Manipulative Medicine research in the rural and underserved population. This would set precedent for the classes to come to continue to utilize our very own clinic for projects, and to provide = data coming from a student run clinic.

ACE 2020 OUTSTANDING PEER TUTORS 2020 RECIPIENTS: Haley Baas Gabrielle Cortese Cullen Farragher Megan Gannon Alessandra Martorella Kathleen McDermott Madison Mumpower Andrew Trexler Jenna Zschaebitz TOTAL SERVICE HOURS: 452 ANNUAL TUTOR RECOGNITION: Tutors served 20 hours minimum ACTIVE TUTORS: 27 TUTEES: 42

SEE WHAT'S HAPPENING AT #CAMPBELLMEDICINE medicine.campbell.edu/news medicine.campbell.edu/events

HOW DOES THIS FIT WITH YOUR FUTURE? I want to be a surgeon, and I want to use medical devices in my career somehow. Product innovation during my previous degrees has led me to work with many clinicians. I aspire to be on the other side and serve as a consultant. Every medical device needs a clinician on board, and I think I could apply these experiences to help move medicine forward in that way.

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Jerry M. Wallace School of Osteopathic Medicine 4350 US 421 South Lillington, NC 27546

medicine.campbell.edu |