Digital Commons Network^™

Standardizing Icu-To-Ward Transitions: Implementing Icu-Pause In The Process Of Medical Intensive Care Unit Downgrade, Edwin Perez, Md, Benjamin Tasevac, Md, Timothy J. Kuchera, Md, Erika J. Yoo, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• The ICU-to-ward transition is a high-risk process in which unstandardized communication can increase the risk for adverse events.
• Variability exists in documentation content, quality, and even authorship.
• Aims:
  • Institute the standardized ICU-PAUSE framework for ICU downgrades
  • Reassign documentation responsibility to the sending rather than receiving team
  • Evaluate the impact of these interventions on provider satisfaction & understanding of patient care

Interpreting Difficult Conversations In The Virtual World - Interpreter’S Perspective, Joyce Zhang, Bs, Kaitlyn Williams, Ms, Kathleen Mechler, Md

Health Equity and Quality Improvement (HEQI) Summit

Background

• Medical Interpreters are essential in language discordant patient-family-team interactions
  • Facilitate clear communication
  • Aid in understanding diagnosis, prognosis, and treatment options
• Prior studies highlight range in interpreter comfort with serious illness conversations (SIC) though limited to in-person interpreter experience
• Rise of quick-access virtual interpreter services across the nation in many healthcare setting

Ensuring Timely Interventional Radiology Biopsy Procedures With Standardized Pre-Procedural Protocol And Guidelines, Joy Zhao, Md, Mohsin Arsiwala, Md, Minki Hong, Md, John Scalise, Md, Limi Jamma, Md, Hanna S. Ellingsen, Md

Health Equity and Quality Improvement (HEQI) Summit

Proposal

• Aim
  • To decrease rate of canceled or delayed IR biopsy procedures by 25% by implementing pre-operative order sets for inpatient IR procedures at Jefferson Center City Hospital in the next 6 months 
• Population of Interest
  • Jefferson Center City teaching team patients requiring IR biopsies
• Intervention
  • Implementing pre-operative order sets that include diet restrictions, anticoagulation guidelines, pre-operative labs, and pre-operative blood pressure and glucose goals 
• Quantifiable Outcome Measurement
  • Comparing rates of canceled and/or delayed IR biopsy procedures in the patient group that use the pre-operative order set compared to those who did not use the order set 
• Data Collection Methods …

Safe Paralytic Reversal For Neurologic Examinations, Keenan Piper, Md

Health Equity and Quality Improvement (HEQI) Summit

AIM Statement

Institute a protocol for safe administration of sugammadex to obtain neurologic exams with a goal of 90% adherence and three or less agitation-related complications over a 6-month period

Enhancing Diabetes Management With Visual Tools: A Multimodal Approach For High-Risk Urban Populations, Mikyla R. Futz, Jesse Edwards, Md, Fhm

Health Equity and Quality Improvement (HEQI) Summit

Background & Objective

Patients from historically marginalized communities face disproportionate barriers to diabetes mellitus (DM) management due to limited health literacy, language discordance, and a lack of culturally responsive educational resources. These structural challenges contribute to poorer glycemic control, higher complication rates, and reduced adherence to recommended care. While visual communication tools have demonstrated efficacy in improving comprehension, self-efficacy, and disease outcomes in chronic illness, their integration into diabetes care remains limited and inconsistently implemented.

Visual interventions may be particularly impactful in populations with low health literacy or limited digital access, yet few have been embedded into routine outpatient workflows. …

Enhancing Primary Care Navigation For D/Deaf And Hard-Of-Hearing Patients: A Wayfinding Intervention Proposal, Mikyla R. Futz, Mary L. Micou, Robert S. Pugliese, Pharmd, Bcps, Jesse Edwards, Md, Fhm

Health Equity and Quality Improvement (HEQI) Summit

Background

Auditory-dependent healthcare environments present persistent barriers to patients who are d/Deaf or hard of hearing (d/DHH), particularly where verbal instructions and auditory notifications dominate communication workflows. This contributes to delayed access to care, decreased satisfaction and strained patient provider-relationships, and significantly higher hospitalization rates —16-21% for individuals with mild to moderate hearing loss, respectively. Additionally, these patients experience higher rates of chronic conditions, lower health literacy, and reduced healthcare satisfaction. Existing interventions are often fragmented and narrowly focused, failing to capture the heterogeneity of d/DHH patients’ needs. This project introduces a scalable, continuous solution grounded in inclusive design principles …

Agenda (Pdf), Department Of Surgery

Surgery Research Symposium

Agenda for the 3rd Annual Surgery Research Symposium held May 15, 2025.

Commencement, South Georgia (2025), Philadelphia College Of Osteopathic Medicine

Commencements

South Georgia Campus Commencement Program, 2025. Degrees include Doctor of Osteopathic Medicine and Master of Science in Biomedical Sciences.

Commencement Speaker: Joseph A. Giaimo, DO '87.

The Identification Of Xpr1 As A Voltage- And Phosphate-Activated Phosphate-Permeable Ion Channel, Hongjiang Wu, Liang Sun, Tong Huo, Theodore G Wensel, Frank T Horrigan, Zhao Wang

Faculty, Staff and Students Publications

Maintaining a balance of inorganic phosphate (Pi) is vital for cellular functionality. Proper phosphate levels are managed through Pi import and export; and the processes governing Pi export remain the least understood. Xenotropic and Polytropic retrovirus Receptor 1 (XPR1) has been identified as the only known Pi export protein in mammals. In this study, we introduce the cryogenic electron microscopy structure of human XPR1 (hXPR1), unveiling a structural arrangement distinct from that of any known ion transporter. Our structural results suggest that hXPR1 may operate as an ion channel, a hypothesis supported by patch clamp recordings revealing hXPR1's voltage- and …

Assessments Of Social Vulnerability On Laryngeal Cancer Treatment & Prognosis In The Us: Epidemiology, David J. Fei-Zhang, Camaren M. Cuenca, Angela D. Haskins, Andrew P. Stein, David G. Lott, Urjeet A. Patel, Stephanie S. Smith, Amy L. Dimachkieh, Nosayaba Osazuwa-Peters, Jill N. D’Souza, Anthony M. Sheyn, Jeffrey C. Rastatter, Daniel C. Chelius

School of Medicine Faculty Publications

Background: Previous social determinants of health (SDoH) studies on laryngeal cancer (LC) have assessed individual factors of socioeconomic status and race/ethnicity but seldom investigate a wider breadth of SDoH-factors for their effects in the real-world. This study aims to delineate how a wider array of SDoH-vulnerabilities interactively associates with LC-disparities. Methods: This retrospective cohort study assessed 74,495 LC-patients between 1975 and 2017 from the Surveillance-Epidemiology-End Results (SEER) database using the Social Vulnerability Index (SVI) from the CDC, total SDoH-vulnerability from 15 SDoH variables across specific vulnerabilities of socioeconomic status, minority-language status, household composition, and infrastructure/housing and transportation, which were measured …

Burnout And Self-Efficacy: Exploring The Rewards And Challenges Faced By Crisis Counselors Working In Emergency Department Settings, Ellen Dotas

Dissertations, 2020-current

This dissertation explores burnout and self-efficacy in counselors who work with clients in crisis in emergency department settings. Mental health and emergency departments are two areas that tend to report higher levels of burnout than are reported in other occupational fields. While much research has been done on the topics of burnout and self-efficacy, limited information is available about counselors who work in these crisis roles. This dissertation follows a three-manuscript format and includes a conceptual, qualitative, and quantitative manuscript. The conceptual manuscript explores the nature of the crisis assessment itself, focusing on the area of risk assessment. The qualitative …

Intertrial Coherence As A Measure Of Synchrony In Ocular Vestibular Evoked Myogenic Potentials And The Effect Of Gaze Angle, Sydney Brown

Dissertations, 2020-current

Ocular vestibular evoked myogenic potentials (oVEMPs) are produced by highly synchronous bursts of extraocular muscle activity in response to stimuli. These responses reflect utricular function and can be recorded using surface electromyography electrodes. Traditional analysis of oVEMPs is limited to time-domain waveform measurements, such as amplitude and latency of response peaks. Objective synchrony-based measures have not yet been applied to the analysis of oVEMPs, particularly in the comparison of synchrony across gaze angles. We followed the new time-frequency method of analysis developed by Clinard et al. (2022) that was successfully applied to cervical VEMPs to quantify response synchrony. Air-conducted oVEMPs …

Long-Term Efficacy Of Pembrolizumab And The Clinical Utility Of Ctdna In Locally Advanced Dmmr/Msi-H Solid Tumors, Michael Lapelusa, Wei Qiao, Bryan Iorgulescu, Francis San Lucas, Keyur Patel, Deepak Bhamidipati, Jane Varkey Thomas, Nancy You, Wai Chin Foo, Dipen Maru, Selvi Thirumurthi, Van Morris, Scott Kopetz, Michael Overman, Kaysia Ludford

Faculty, Staff and Student Publications

Neoadjuvant immunotherapy can induce pathologic complete response (pCR) in patients with localized deficient mismatch repair (dMMR)/microsatellite instability-high (MSI-H) tumors. The long-term outcomes of these patients are unknown, as is the clinical utility of measuring circulating tumor DNA (ctDNA). Follow-up was evaluated in patients enrolled in a phase II trial (NCT04082572) that evaluated the efficacy and safety of pembrolizumab in patients with localized dMMR/MSI-H tumors. The primary outcomes of this trial have previously been reported. 3-year EFS and OS rates were 80% (95% CI: 66% - 93%) and 94% (95% CI: 86% - 100%). Patients without detectable ctDNA after pembrolizumab had …

Mental Health Diagnoses Amongst Children With Complex Chronic Medical Conditions, Maria Newmaster M.D., Matt Hall, Adrienne Deporre, Molly Krager, Cy Nadler, Laura Plencner, Henry T. Puls

Research Days

Background: Mental health (MH) diagnoses are known to complicate outcomes of underlying medical conditions in pediatrics, but the prevalence of MH diagnoses across the array of medically complex and/or chronic conditions are not well known.

Objectives/Goal: To compare prevalence of MH diagnoses across levels of medical complexity and chronicity, and identify factors associated with MH diagnoses among children with complex chronic conditions (CCC).

Methods/Design: This retrospective cross-sectional study included children ages 5-17 years with at least 11 months of continuous Medicaid enrollment in 2022 from the Merative Marketscan Medicaid Database which collects data from all children with Medicaid in the …

Spatial Epigenomic Niches Underlie Glioblastoma Cell State Plasticity, Sam Kint, Subhi Talal Younes, Shuozhen Bao, Gretchen Long, David Wouters, Erin Stephenson, Xing Lou, Mei Zhong, Di Zhang, Graham Su, Archibald Enninful, Mingyu Yang, Huey-Miin Chen, Katrina Ellestad, Colleen Anderson, Jennifer Moliterno, John Kelly, Jennifer A Chan, Alejandro Sifrim, Jiangbing Zhou, Ana Nikolic, Rong Fan, Marco Gallo

Faculty, Staff and Students Publications

IDH-wildtype glioblastoma (GBM) is an aggressive brain tumor with poor survival and few therapeutic options. Transcriptionally-defined cell states coexist in GBM and occupy defined regions of the tumor. Evidence indicates that GBM cell states are plastic, but it remains unclear if they are determined by the underlying epigenetic state and/or by microenvironmental factors. Here, we present spatially-resolved epigenomic profiling of human GBM tissues that implicate chromatin structure as a key enabler of cell plasticity. We report two epigenetically-defined and spatially-nested tumor niches. Each niche activates short-range molecular signals to maintain its own state and, surprisingly, long-range signals to reinforce …

Direct Parieto-Occipital Connectivity Of The Amygdala Via The Parahippocampal Segment Of The Cingulum Bundle, Arash Kamali, Kamand Khalaj, Atif Ali, Farbod Khalaj, Diana Kokash, Andres R Gonzalez, Michael A Jacobs, Alireza Akhbardeh, Paul E Schulz, Khader M Hasan

Faculty, Staff and Student Publications

Background

The amygdala is a key structure involved in memory, emotional processing, and sensory integration. While the cortical connectivity of the amygdala with the frontal and temporal lobes has been extensively studied, its direct connections with the parieto-occipital cortices remain underexplored. This study aims to delineate the direct connectivity between the amygdala and the parietal and occipital cortices via the parahippocampal segment of the cingulum bundle.

Methods

High-resolution diffusion-weighted imaging (DWI) tractography was performed on 30 healthy adult brains. Fiber tracking was conducted using three regions of interest (ROIs) placed in the parietal, occipital, and medial temporal lobes. A fractional …

Theta Oscillons In Behaving Rats, M S Zobaer, Nastaran Lotfi, Carli M Domenico, Clarissa Hoffman, Luca Perotti, Daoyun Ji, Yuri Dabaghian

Faculty, Staff and Students Publications

Recently discovered constituents of the brain waves—the oscillons—provide a high-resolution representation of the extracellular field dynamics. Here, we study the most robust, highest-amplitude oscillons recorded in actively behaving male rats, which underlie the traditional θ-waves. The resemblances between θ-oscillons and the conventional θ-waves are manifested primarily at the ballpark level—mean frequencies, mean amplitudes, and bandwidths. In addition, both hippocampal and cortical oscillons exhibit a number of intricate, behavior-attuned, transient properties that suggest a new vantage point for understanding the θ-rhythms’ structure, origins and functions. In particular, we demonstrate that oscillons are frequency-modulated waves, with speed-controlled …

Comparative Analysis Of Drug-Induced Sleep Endoscopy With Positive Airway Pressure And Therapeutic Continuous Positive Airway Pressure In The Treatment Of Obstructive Sleep Apnea, Elliott M. Sina, Nicole Molin, Praneet C. Kaki, Henry Ideker, Stephen White, Maurits Boon, Colin Huntley

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

No abstract provided.

Developing The Mycancergene Digital Health Portal To Improve Patients' Understanding Of Germline Cancer Genetic Test Results: Development, User, And Usability Testing Study, Phillip Trieu, Dominique Fetzer, Briana Mcleod, Kathryn Schweickert, Lauren Gutstein, Brian Egleston, Susan Domchek, Linda Fleisher, Lynne Wagner, Kuang-Yi Wen, Cara Cacioppo, Jessica E. Ebrahimzadeh, Dana Falcone, Claire Langer, Elisabeth Wood, Kelsey Karpink, Shelby Posen, Enida Selmani, Angela R. Bradbury

Department of Medical Oncology Faculty Papers

BACKGROUND: The use of multigene panels has significantly increased the likelihood that genetic testing will leave patients with uncertainties regarding test interpretation, implications, and recommendations, which will change over time. Effective longitudinal care models are needed to provide patients with updated information and to obtain patient and family history updates.

OBJECTIVE: To bridge this gap, we aimed to develop a patient- and genetic provider-informed digital genetic health portal (GHP), MyCancerGene, to improve longitudinal patient understanding of and responses to genetic testing.

METHODS: We used a 5-step process to develop MyCancerGene. To better understand their interest in and willingness to use …

"Bridging Research, Outreach, And Care: Advancing Community-Driven Cancer Solutions", Rachel M. Ceballos Phd​, Angie Fausett Agnp-C, Dnp​, Allison Foust Mha, Mches​

Utah Conference on Community Engagement

"This panel will provide an overview of Huntsman Cancer Institute’s (HCI) collaborative efforts to enhance cancer care through innovative community outreach and local treatment programs, with a specific focus on rural outreach and care. Panelists will discuss HCI’s approach to fostering partnerships with community champions, integrating regional outreach through initiatives like the Mountain West Cancer Collaborative (MWCC), and expanding local treatment options to increase accessibility and equity in care, especially in rural areas. By highlighting how these initiatives align with HCI’s mission to reduce cancer disparities, the panel will emphasize strategies for improving cancer prevention, treatment, and survivorship in underserved …

Asking About Gender Identity In Pediatric And Adolescent Gynecology Clinic: Patient, Family And Provider Perspectives (The Reflective Study), Madeline Ross, Hariye Sema Baghaki, Hannah Suffian, Lauren Roth, Jeanette Higgins, Tazim Dowlut-Mcelroy

Research Days

Background

The provision of medical and psychosocial support requires the identification of gender diverse individuals in health care settings. However, in primary care settings, some adolescents and parents expressed that gender identity screening (GIS) was offensive and clinicians expressed that GIS negatively affected their workflow. We sought to assess the acceptability and feasibility of GIS in Pediatric and Adolescent Gynecology (PAG) clinics of a large tertiary care children’s hospital in the United States (US) Midwest.

Methods

A GIS survey developed in the US West Coast was modified with permission. After IRB approval, the anonymous single-site cross-sectional survey was administered to …

Implementation Of A Weaning Protocol For Inhaled Nitric Oxide In A Level Iv Neonatal Intensive Care Unit, Elizabeth Loughman, Julie Weiner Do, Maryam El Tawil, Chris Nitkin Md

Research Days

Background: Decrease time to begin iNO weaning from 13 hours to 9.75 hours by 31 December 2024 in patients with persistent pulmonary hypertension of the newborn (PPHN).

Methods: Countermeasures include (1) provider education at each disciplinary level, (2) badge reminder cards and laminated copies of the protocol available at the bedside, (3) order set modifications, (4) abnormality tracking at huddles. Data collection will be automated through weekly Business Objects report. The main outcome measure will be time to first wean of iNO after meeting protocol criteria. Feedback regarding the ease of weaning will be generated via Gemba Rounds.

Results: These …

Disruption Of Oocyte Sumoylation Impacts Critical Regulatory Processes During Folliculogenesis In Mice, Zian Liao, Tessa E Steenwinkel, Bruno Moscoso, Ernesto Salas, Bethany K Patton, Amanda Rodriguez, Anna Malovannaya, Stephanie A Pangas

Faculty, Staff and Students Publications

The conjugation of small ubiquitin-like modifiers (SUMO) to target proteins, known as SUMOylation, plays a crucial role in regulating protein homeostasis, activity, interaction with other proteins, and subcellular localization. Loss of SUMOylation in nongrowing oocytes by conditional deletion of the E2 SUMO conjugating enzyme, Ube2i, at the primordial follicle stage leads to female sterility due to complex changes in oocyte development, including altered folliculogenesis, defective meiotic progression, and premature loss of the ovarian reserve. In this study, proteomics was used to compare control and Ube2i conditional knockout ovaries during the first wave of folliculogenesis to identify key differences that may …

Integrating Artificial Intelligence In Orthopedic Care: Advancements In Bone Care And Future Directions, Rahul Kumar, Kyle Sporn, Joshua Ong, Ethan Waisberg, Phani Paladugu, Swapna Vaja, Tamer Hage, Tejas C. Sekhar, Amar S. Vadhera, Alex Ngo, Nasif Zaman, Alireza Tavakkoli, Mouayad Masalkhi

SKMC Student Presentations and Publications

Artificial intelligence (AI) is revolutionizing the field of orthopedic bioengineering by increasing diagnostic accuracy and surgical precision and improving patient outcomes. This review highlights using AI for orthopedics in preoperative planning, intraoperative robotics, smart implants, and bone regeneration. AI-powered imaging, automated 3D anatomical modeling, and robotic-assisted surgery have dramatically changed orthopedic practices. AI has improved surgical planning by enhancing complex image interpretation and providing augmented reality guidance to create highly accurate surgical strategies. Intraoperatively, robotic-assisted surgeries enhance accuracy and reduce human error while minimizing invasiveness. AI-powered smart implant sensors allow for in vivo monitoring, early complication detection, and individualized rehabilitation. …

Polychlorinated Biphenyl-126 Activates Axl/Erb/Dnmt3a Axis To Drive Endometriosis Progression, Yuri Park, Nuri Sung, Eunsu Kim, Jaeyeong Jeong, Juhee Sim, Mi Jin Park, John Lydon, Xiaoming Guan, Sang Jun Han

Faculty, Staff and Students Publications

Endometriosis is a pathological condition in which endometrial cells proliferate outside the uterine cavity, resulting in pelvic pain and infertility. Exposure to endocrine-disrupting chemicals (EDCs) has been implicated in the progression of endometriosis, though the precise mechanisms remain largely undefined. Among EDCs, elevated levels of polychlorinated biphenyl (PCB)-126 have been strongly associated with endometriosis, particularly in patients with deep infiltrating disease. In a mouse model of endometriosis, PCB-126 exposure significantly promoted the growth of ectopic lesions by activating the Steroid Receptor Coactivator-1 (SRC-1) isoform/Matrix Metalloproteinase-9 (MMP9)/Estrogen Receptor-β (ERβ) axis, a key driver of disease progression. PCB-126 also enhanced ERβ activity …

Can Flywheel Training Serve As A Viable Intervention For Dynamic Strength Index Based Programs?, Jeffrey Ruiz

Doctorate in Kinesiology

The purpose of this case series was to examine the effects that flywheel training had on a person’s dynamic strength index in comparison to concurrent training (DSI). It has been shown that with strength training alone there can be an overall decrease in the DSI, due to an increase the IMTP peak force and no significant change in the CMJ performance (Comfort et al., 2018). Flywheel training’s effect on the DSI specifically have not been previously examined. It was hypothesized that a regimented flywheel training intervention will demonstrate an

improvement in the peak force for the countermovement jumps as well …

Ogg1s326c Variant Frequent In Human Populations Facilitates Inflammatory Responses Due To Its Extended Interaction With Dna Substrate, Jinling Han, Meichen Zhang, Jiakun Ge, Zhihua Ji, Jianyi Zhao, Yinchao Hu, Chunshuang Li, Yaoyao Xue, Xining Li, Haiwang Zhao, Zixu Cui, Miaomiao Tian, Xu Zheng, Dapeng Wang, Jing Wang, Min Wei, Zsolt Radak, Yusaku Nakabeppu, Istvan Boldogh, Xueqing Ba

Faculty, Staff and Student Publications

8-oxoguanine (8-oxoGua) is one of the most frequent forms of oxidative DNA base lesions, repaired by 8-oxoguanine DNA glycosylase 1 (OGG1) via base excision repair (BER) pathway to maintain genome fidelity. The human allelic variant hOGG1^S326C, prevalent in Caucasians and Asians, has been regarded as a susceptibility factor for various diseases, yet its pathogenic mechanism remains elusive. In this study, we demonstrate that Ogg1^S326C/S326C mice exhibit increased and sustained airway inflammation compared with wild-type (WT) Ogg1^S326/S326 mice. Mechanistically, in response to inflammatory stimulation, OGG1S326C undergoes reactive oxygen species-induced dimerization, which impairs its base excision function, but …

Phase I Study Of Pomalidomide In Relapsed Or Refractory Waldenström Macroglobulinaemia, Karan L Chohan, Donna M Weber, Lei Feng, L Michael Wang, Sattva S Neelapu, Jasper Olsem, Ralph J Johnson, Claudia Morales De Partovi, Robert Z Orlowski, Sheeba K Thomas

Faculty, Staff and Student Publications

No abstract provided.

Structural Proteomics Defines A Sequential Priming Mechanism For The Progesterone Receptor, Matthew D Mann, Min Wang, Josephine C Ferreon, Phoebe S Tsoi, Michael P Suess, Antrix Jain, Anna Malovannaya, Roberto Vera Alvarez, Bruce D Pascal, Raj Kumar, Dean P Edwards, Patrick R Griffin

Faculty, Staff and Students Publications

The progesterone receptor (PR) is a steroid-responsive nuclear receptor with two isoforms: PR-A and PR-B. Disruption of PR-A:PR-B signaling is associated with breast cancer through interactions with oncogenic co-regulatory proteins (CoRs). However, molecular details of isoform-specific PR-CoR interactions remain poorly understood. Using structural mass spectrometry, we investigate the sequential binding mechanism of purified full-length PR and intact CoRs, steroid receptor coactivator 3 (SRC3) and p300, as complexes on target DNA. Our findings reveal selective CoR NR-box binding by PR and unique interaction surfaces between PR and CoRs during complex assembly, providing a structural basis for CoR sequential binding on PR. …

Re: Physician And Advanced Practice Clinician Burnout In Rural And Urban Settings., Cody J Klinker

Ambulatory and Primary Care Articles

No abstract provided.