Digital Commons Network^™

Tetralogy Of Fallot: Anatomy, Physiology, And Outcomes, Edo Bedzra, Eli Contorno, Herra Javed, Amna Qasim, James St Louis, Taufiek Konrad Rajab

Manuscripts, Articles, Book Chapters and Other Papers

Since the first identification of Tetralogy of Fallot in 1671, consisting of a combination of anatomical defects including biventricular origin of the aorta, maligned ventricular septal defect, overriding aorta, and narrowing or atresia of the pulmonary outflow tract. The first successful operation consisted of a shunt between the left subclavian artery and pulmonary artery. Following this palliative procedure, complete repair is performed once the patient reaches indicative criteria. Since the first attempts at surgical palliation and repair, techniques and outcomes have improved drastically. Definitive repair of Tetralogy of Fallot consists of a multi-patch closure of any Ventricular Septal Defect along …

Comparing Patency Of Pulmonary Stent Implantation And Balloon Angioplasty In Pulmonary Vein Stenosis: A Systematic Review And Meta-Analysis, Izza Batool, Muhammad K. Khan, Muhammad Zohaib, Ibrahim A. Khan, Syed A. A. Bukhari, Shreeja Shah, Khaled Harmouch, Hussam Al Hennawi, Bruce D. Klugherz

Abington Jefferson Health Papers

Pulmonary vein stenosis (PVS) is an insidious diagnosis associated with morbidity and mortality. Pharmacologic therapy may suffice initially, but advanced stages demand mechanical intervention. Pulmonary stent implantation (PSI) and pulmonary balloon angioplasty (PBA) are common strategies, both carrying restenosis risks. This meta‐analysis compares PSI and PBA to determine the superior revascularization strategy. We systematically searched databases until November 2023, identifying 11 studies with 780 patients. Studies, including those involving patients undergoing balloon angioplasty (BA) or stent angioplasty (SA) for PVS, were selected. Case reports, editorials, and cross‐sectional studies were omitted. Primary outcomes included restenosis requiring reintervention, 5‐year freedom from restenosis, …

Feasibility And Psychometric Quality Of Smartphone Administered Cognitive Ecological Momentary Assessments In Women With Metastatic Breast Cancer, Ashley M. Henneghan, Emily W. Paolillo, Kathleen M. Van Dyk, Oscar Y. Franco-Rocha, Soyeong Bang, Rebecca Tasker, Tara Kaufmann, Darren Haywood, Nicolas H. Hart, Raeanne C. Moore

Research outputs 2022 to 2026

Objective: Metastatic breast cancer (MBC) is associated with burdensome side effects, including cognitive changes that require ongoing monitoring. Cognitive ecological momentary assessments (EMAs) allow for assessment of individual cognitive functioning in natural environments and can be administered via smartphones. Accordingly, we sought to establish the feasibility, reliability, and validity of a commercially available cognitive EMA platform. Methods: Using a prospective design, clinical cognitive and psychosocial assessments (cognitive batteries; patient reported outcomes) were collected at baseline, followed by a 28-day daily EMA protocol that included self-ratings for symptoms and mobile cognitive tests (memory, executive functioning, working memory, processing speed). Satisfaction and …

Optimal Bag Valve Mask Ventilation Efficacy Of Smart Bag Ventilation Compared To Traditional Adult And Paediatric Bag Valve Ventilation During Cardiopulmonary Resuscitation, Ian Dawson

Theses: Doctorates and Masters

Background: Out-of-Hospital Cardiac Arrest (OHCA) is one of the world’s leading causes of mortality. Survival rates are low, ranging from 3.1–20.4% internationally. The most effective oxygenation method for patients during pre-hospital cardiac arrest is ventilating using a self- inflating Bag-Valve-Mask (BVM). Yet, extensive research has identified a lack of compliance with ventilator guidelines during OHCA cardiopulmonary resuscitation (CPR). As a result, clinicians often ventilate patients too aggressively using the BVM, delivering breaths excessively higher than the International Liaison Committee on Resuscitation (ILCOR) recommended rate of 10 breaths per minute (BPM). Hyperventilation can lead to complications such as aspiration, barotrauma, and …

Platypnea-Orthodeoxia And Patent Foramen Ovale In A Patient In The Setting Of Covid-19, Laura Sarmiento, Riyad Kherallah, Guilherme Vianna Silva

The Texas Heart Institute Journal

Platypnea-orthodeoxia syndrome is a rare condition characterized by positional dyspnea and hypoxemia, with symptoms presenting in the upright position and improving when recumbent. Hypoxemia in platypnea-orthodeoxia syndrome is defined as a drop in Pao

Accidental Left Ventricular Placement Of A Leadless Micra Pacemaker Through A Patent Foramen Ovale, Hamza Alkowatli, Mahmoud Kutmah, Adnan Shaik, Osama Hallak

The Texas Heart Institute Journal

The Micra device is a leadless pacemaker implanted in the right ventricle via a femoral vein transcatheter approach. There are several indications for and advantages to using a leadless pacemaker, and the device's role in the field of cardiology will probably continue to increase. This article presents the case of a rare complication probably due to inadvertent placement of the device in the left ventricle across an undiagnosed patent foramen ovale.

Double Atrial Septum With Interatrial Space In Patients Experiencing Ischemic Attack, Blerim Berisha, Fadhel Hamidani, Mathias Humm

The Texas Heart Institute Journal

No abstract provided.

A Comprehensive Uhplc-Ms/Ms And Extraction Method Reveals Flavonoid Profile And Concentration Are Diverse In Spinach (Spinacia Oleracea L), Michael P Dzakovich, Elaine A Le, Alvin L Tak, Shaji K Chacko

Children’s Nutrition Research Center Staff Publications

INTRODUCTION: Spinach produces an array of unique flavonoids not commonly found in other fruits and vegetables. These molecules likely serve as defense agents against biotic and abiotic stress and may have health beneficial properties for humans. Current methods to analyze spinach flavonoids are incomplete and only capture a portion of this uncharacterized pathway. A comprehensive analysis method is needed to determine how genetics, environmental conditions, and other factors influence spinach flavonoid biosynthesis.

METHODS: We developed and validated a high-throughput extraction and ultra high-performance liquid chromatography tandem mass spectrometry (UHPLC-MS/MS) method to separate and quantify 39 spinach flavonoid species in 11.5 …

Overview Of The Head And Neck Tumor Segmentation For Magnetic Resonance Guided Applications (Hnts-Mrg) 2024 Challenge, Kareem A Wahid, Cem Dede, Dina M El-Habashy, Serageldin Kamel, Michael K Rooney, Yomna Khamis, Moamen R A Abdelaal, Sara Ahmed, Kelsey L Corrigan, Enoch Chang, Stephanie O Dudzinski, Travis C Salzillo, Brigid A Mcdonald, Samuel L Mulder, Lucas Mccullum, Qusai Alakayleh, Carlos Sjogreen, Renjie He, Abdallah S R Mohamed, Stephen Y Lai, John P Christodouleas, Andrew J Schaefer, Mohamed A Naser, Clifton D Fuller

Faculty, Staff and Student Publications

Magnetic resonance (MR)-guided radiation therapy (RT) is enhancing head and neck cancer (HNC) treatment through superior soft tissue contrast and longitudinal imaging capabilities. However, manual tumor segmentation remains a significant challenge, spurring interest in artificial intelligence (AI)-driven automation. To accelerate innovation in this field, we present the Head and Neck Tumor Segmentation for MR-Guided Applications (HNTS-MRG) 2024 Challenge, a satellite event of the 27th International Conference on Medical Image Computing and Computer Assisted Intervention. This challenge addresses the scarcity of large, publicly available AI-ready adaptive RT datasets in HNC and explores the potential of incorporating multi-timepoint data to enhance RT …

Survey And Improvement Strategies For Gene Prioritization With Large Language Models, Matthew B Neeley, Guantong Qi, Guanchu Wang, Ruixiang Tang, Dongxue Mao, Chaozhong Liu, Sasidhar Pasupuleti, Bo Yuan, Fan Xia, Pengfei Liu, Zhandong Liu, Xia Hu

Duncan NRI Faculty and Staff Publications

Motivation: Rare diseases remain difficult to diagnose due to limited patient data and genetic diversity, with many cases remaining undiagnosed despite advances in variant prioritization tools. While large language models have shown promise in medical applications, their optimal application for trustworthy and accurate gene prioritization downstream of modern prioritization tools has not been systematically evaluated.

Results: We benchmarked various language models for gene prioritization using multi-agent and Human Phenotype Ontology classification approaches to categorize patient cases by phenotype-based solvability levels. To address language model limitations in ranking large gene sets, we implemented a divide-and-conquer strategy with mini-batching and token limiting …

Intraocular Lens Power Calculation In Challenging Cases, Jack X Ma, Li Wang, Douglas D Koch

Faculty, Staff and Students Publications

In this article, we reviewed recently published papers of intraocular lens (IOL) power calculation in special eyes. In short eyes, accurate estimation of effective lens position is critical, and the ZEISS artificial intelligence IOL calculator produces the best outcomes. In long eyes, accuracy has been improved with axial length (AL) adjusted formulas such as the Wang-Koch AL adjustment and newer IOL formulas. In keratoconic eyes, hyperopic refractive outcomes increase with steeper keratometric values, and accuracy is poor in eyes with keratometric values ≥50.0 D. Two keratoconus-specific formulas (Barrett True K for keratoconus and Kane keratoconus) have been introduced. In eyes …

Skewed Adaptive Immune Responses Are Involved In Alpha-1 Antitrypsin Deficiency Emphysema, Joselyn Rojas-Quintero, Scott A Ochsner, Hyun-Sung Lee, Christine Cong, Alan Waich Cohen, Adrianne S Colborg, Konstantin Tsoyi, Maria C Basil, Edward Cantu, Ivan O Rosas, Neil J Mckenna, Raúl San-José Estépar, Igor Barjaktarevic, Andrew A Wilson, Francesca Polverino

Faculty, Staff and Students Publications

No abstract provided.

Commentary: Impact Of Resistance Training Intensity On Body Composition And Nutritional Intake Among College Women With Overweight And Obesity: A Cluster Randomized Controlled Trial, Joshua L Keller, Sarah E Deemer, Gian Luca Di Tanna, Sherri L Pals, Kevin R Fontaine, David B Allison

Children’s Nutrition Research Center Staff Publications

No abstract provided.

Demographic And Clinical Characteristics Of Patients With Charcot Neuro-Osteoarthropathy In People With Diabetes Mellitus In Six Countries: A Multicenter Observational Study From 1996 To 2022, E. B. Jude, C. Siafarikas, A. Rastogi, R. Bem, T. Tankova, M. -F. Kong, Javier La Fontaine, J. Pappachan, N. Tentolouris

School of Podiatric Medicine Publications

Aim: To describe the demographic and clinical characteristics of patients with Charcot neuro-osteoarthropathy (CNO) and to examine for differences between participants with Type 1 diabetes mellitus (DM) (T1DM) and Type 2 diabetes mellitus (T2DM).

Materials and Methods: Multicenter observational study in eight diabetic foot clinics in six countries between January 1, 1996, and December 31, 2022. Demographic, clinical, and laboratory parameters were obtained from the medical records. Analyses were performed using parametric or nonparametric statistical tests for variables with normally or nonnormally distributed values, respectively. Comparisons of the qualitative data were performed using the chi-square test.

Results: Seven hundred seventy-four …

Recommendations For Diagnosis And Treatment Of Functional Hypothalamic Amenorrhea In Females Of Reproductive Age, Monica Foster

Capstone Showcase

Hypothalamic amenorrhea (HA) accounts for approximately 30% of total cases of secondary amenorrhea in women of reproductive age. HA is defined as the absence of menses due to inadequate secretion of gonadotropin-releasing hormone (GnRH) by the hypothalamus leading to lack of secretion of gonadotropins from the anterior pituitary gland and steroid hormones from the ovaries. This feedback loop, called the hypothalamic-pituitary-gonadal (HPG) axis, regulates reproductive activity in animals and humans. When this system is disrupted in females due to a hormonal imbalance, menstrual abnormalities may emerge. Functional hypothalamic amenorrhea (FHA) is defined as the absence of menses in which anatomic …

Evaluation And Treatment Of Baseball Pitchers: There’S More To Assess Than The Arm, Matthew L. Gauthier, Casey A. Unverzagt, George J. Davies

Physical Therapy Faculty Publications

Injuries are commonplace in the overhead athlete, with many occurring to the shoulder and elbow. The increasing prevalence of injuries to the shoulder and elbow has been discussed at length in recent years, with increased research focus being placed on arm care for rehabilitation and prevention strategies. Even though the pitching motion is well-established as a whole-body kinetic chain movement, most attention in rehabilitation and prevention efforts is often placed on the upper extremity. The purpose of this clinical commentary is to highlight the impact the lower extremity and trunk have on the upper extremity during the throwing motion, better …

Clonal Hematopoiesis Of Indeterminate Potential And The Risk Of Cognitive Impairment In The Women’S Health Initiative Memory Study, Yasminka A. Jakubek, Aaron P. Smith, Xiaoyan I. Leng, Megan E. Hall, Daniel Ezzat, Yash Pershad, Jason M. Collins, Md Mesbah Uddin, David W. Fardo, Pradeep Natarajan, Alexander G. Bick, Jacob O. Kitzman, Michael C. Honigberg, Kathleen M. Hayden, Joann E. Manson, Siddhartha Jaiswal, Eric A. Whitsel, Alexander P. Reiner

Internal Medicine Faculty Publications

INTRODUCTION

Clonal hematopoiesis of indeterminate potential (CHIP) confers an increased risk of several chronic aging-related diseases. Paradoxically, CHIP was associated with lower risk of dementia in recent studies.

METHODS

We examined associations between baseline CHIP and incident mild cognitive impairment (MCI) and/or probable dementia in the Women's Health Initiative Memory Study. CHIP was detected using blood-based targeted sequencing. Cox proportional hazards models examined time to onset of cognitive impairment, adjusting for traditional risk factors.

RESULTS

Using a conventional variant allele fraction (VAF) threshold of 2%, CHIP was not associated with incident cognitive impairment. The presence of larger CHIP clone (VAF …

"The Perfect Storm": Weathering Black Racial Trauma Across The Lifespan And The Impact Of Covid-19, Taryne M. Mingo, Kiauhna Haynes

Adultspan Journal

Descendants of Africans Enslaved in the United States (DAEUS), who lived in the South prior to 1965 and experienced decades of legalized discrimination, were found to have been disproportionately impacted by the COVID-19 pandemic. Arline Geronimus (1992) coined the term “weathering” to acknowledge the accumulation of racial trauma stored within the body over extended periods of time. The purpose of this interpretive phenomenological study, aligned by the tenets of Critical Race Theory, explores how continuous racial trauma impacted DAEUS citizens’ well-being and trust in the COVID-19 vaccine. Three Group Experiential Themes emerged during this study, all connected with the experiences …

Diabetes Device Knowledge And Confidence Among School Nurses: A Mixed Methods Study, Cassandra F. Moffitt

Nursing Theses and Dissertations

Problem: Type 1 diabetes is one of the most common chronic medical conditions in childhood. While manageable, these children may spend half of their day in the school setting and often need assistance from a school nurse to manage their care.

Theory: Bandura’s Social Cognitive Theory (1977) served as the theoretical framework for this study.

Research Questions: The research questions explored knowledge, confidence, and additional predictors of confidence related to diabetes devices.

Design/Methods: An explanatory sequential mixed methods design was used. The Diabetes Device Confidence Scale (DDCS) was used to measure device confidence, while Subscale 10 of the KAT-1 instrument …

Unintentional Lead Dislodgement In Twiddler’S Syndrome, Howard Tan, Ashok Chaudhary, Nishant Nerella, Suman Pasupuleti

West Florida Division GME Research Day 2025

No abstract provided.

Interaction Between Dapsone And Warfarin Causes Supratherapeutic Inr, Farhan Hiya, Omar Jureyda, Zachary Harwood, Fernando Lugo, Andrew Niclosi

West Florida Division GME Research Day 2025

No abstract provided.

Advantages Of Prone Positioning In Nuclear Stress Imaging, Casper Chen, Matthew Bommarito, Milan Patel, Neha Patel, Rami Akel, Rami Akel, Rami Akel

West Florida Division GME Research Day 2025

No abstract provided.

A Fatal Case Of Central Pontine Myelinolysis With Chronic Inflammatory Demyelinating Polyneuropathy, Miguel Serrano, Grant Read, Karen Joseph

West Florida Division GME Research Day 2025

No abstract provided.

A Spine-Specific Lexicon For The Sentiment Analysis Of Interviews With Adult Spinal Deformity Patients Correlate With Sf-36, Sf-36, And Odi Scores: A Pilot Study Of 25 Patients, Ross Gore, Michael M. Safaee, Christopher J. Lynch, Christopher P. Ames

VMASC Publications

Classic health-related quality of life (HRQOL) metrics are cumbersome, time-intensive, and subject to biases based on the patient’s native language, educational level, and cultural values. Natural language processing (NLP) converts text into quantitative metrics. Sentiment analysis enables subject matter experts to construct domain-specific lexicons that assign a value of either negative (−1) or positive (1) to certain words. The growth of telehealth provides opportunities to apply sentiment analysis to transcripts of adult spinal deformity patients’ visits to derive a novel and less biased HRQOL metric. In this study, we demonstrate the feasibility of constructing a spine-specific lexicon for sentiment analysis …

Food Allergies And Quality Of Life In Older Adults: Development Of A Food Allergy Questionnaire, Avalon F. Mustafa

UNF Graduate Theses and Dissertations

The United States is experiencing a rapid increase in the number of older adults, yet there is a lack of research on food allergies in this demographic. While there are survey instruments available to study food allergies and quality of life, none of these are tailored to the unique needs of elderly individuals. This study aims to create and validate an on-line survey instrument specifically designed for older adults, focusing on their quality of life in the context of food allergies. The survey will be used to establish a food allergy severity score and a quality-of-life score, enabling comparison between …

Week 96 Results Of Bictegravir/Emtricitabine/Tenofovir Alafenamide For Hiv Treatment In People With Substance Use Disorders, Joshua P. Havens, Sara Bares, Elizabeth Lyden, Nada A. Fadul, Susan Swindells

Journal Articles: Infectious Diseases

BACKGROUND: The BASE study (NCT03998176), a phase 4, 48-week (W), single-arm, prospective trial, revealed that the use of bictegravir/emtricitabine/tenofovir alafenamide (B/F/TAF) in people with HIV and substance use disorders (PWH/SUD) was safe and effective without emergent antiretroviral resistance despite incomplete adherence. Here, we present the W96 results.

METHODS: A retrospective analysis of all participants enrolled in the BASE study was completed from W48 to W96. End points of interest at W96 included the proportion of participants with viral suppression (VS; HIV RNA < 50 copies/mL [c/mL]), incidence of protocol-defined virologic failure (PDVF; 2 consecutive ≥400 c/mL), safety, adherence (percentage of days covered [PDC]), retention in care, and prevalence of ongoing substance use.

RESULTS: All enrolled BASE participants (n = 43) were included in the W96 analysis. At W48, 21 participants …

Assessment Of Cerebrospinal Fluid And Blood-Based Biomarkers In Degenerative Cervical Myelopathy: Systematic Review And Meta-Analysis, Harshit Arora, Hassan Darabi, Cassandra C. Wolsh, Kelsey N. Karnik, John C. Gensel, Francis Farhadi

Neurosurgery Faculty Publications

Study Design: Systematic Review and Meta-Analysis.

Objectives: Degenerative cervical myelopathy (DCM), the leading cause of spinal cord injury globally, may clinically manifest with hand numbness and tingling, loss of hand dexterity and impaired balance and gait. Biomarkers have been identified as disease indicators with recent studies exploring the role of structural and inflammatory biomarkers in diagnostic and treatment outcome prediction. The review aims to identify relevant cerebrospinal fluid (CSF) and blood-based biomarkers associated with DCM diagnosis and prognostication.

Methods: The systematic review was conducted as per PRISMA guidelines. A comprehensive search strategy was devised to identify articles evaluating biomarkers in …

A Reflection-Spectroscopy Measured Skin Carotenoid Score Strongly Correlates With Plasma Concentrations Of All Major Dietary Carotenoid Species Except For Lycopene, Qiang Wu, Cheryl Webb Cherry, Stephanie Jilcott Pitts, Melissa N Laska, Neal Craft, Nancy E Moran

Children’s Nutrition Research Center Staff Publications

Skin carotenoids can be measured non-invasively using spectroscopy methods to provide a biomarker of total dietary carotenoid and carotenoid-rich fruit and vegetable intake. However, the degree to which skin carotenoid biomarkers reflect intakes of specific carotenoids must be determined for specific devices. Previously, findings were mixed regarding the correlation between reflection spectroscopy (RS)-assessed skin carotenoids and individual plasma carotenoid concentrations. The current study expands on prior analyses to examine the cross-sectional associations between adult RS-assessed skin carotenoids and individual carotenoid species intakes and plasma concentrations, controlling for potential covariates. We hypothesized that RS-assessed skin carotenoid scores would strongly correlate with …

Tryptophan Kynurenine Pathway-Based Imaging Agents For Brain Disorders And Oncology-From Bench To Bedside, Erik Stauff, Wenqi Xu, Heidi H. Kecskemethy, Sigrid A. Langhans, Vinay V. R. Kandula, Lauren W. Averill, Xuyi Yue

Jefferson Hospital Staff Papers and Presentations

Tryptophan (Trp)-based radiotracers have excellent potential for imaging many different types of brain pathology because of their involvement with both the serotonergic and kynurenine (KYN) pathways. However, radiotracers specific to the kynurenine metabolism pathway are limited. In addition, historically Trp-based radiopharmaceuticals were synthesized with the short-lived isotope carbon-11. A newer generation of Trp-based imaging agents using the longer half-lived and commercially available isotopes, such as fluorine-18 and iodine-124, are being developed. The newly developed amino acid-based tracers have been demonstrated to have favorable radiochemical and imaging characteristics in pre-clinical studies. However, many barriers still exist in the clinical translation of …

Comparison Of Machine Learning Models For Colon Cancer Survival: Predictive Modeling Approach, Reuben Adatorwovor, Motolani E. Ogunsanya, Bin Huang, Richard Charnigo, Olufunmilola Abraham

Biostatistics Faculty Publications

Background: Colon cancer is a leading cause of cancer-related deaths worldwide, with survival influenced by risk factors, treatment type, and patient characteristics. Traditional statistical models, such as Kaplan-Meier curves, have been widely used to estimate survival probabilities. However, these models often have difficulty handling complex interactions, covariates, and nonlinear relationships between risk factors. Recently, machine learning (ML) techniques have emerged as promising tools for improving survival prediction by handling large covariates and capturing complex patterns.

Objective: This study compares several ML models to accurately estimate colon cancer survival by leveraging data from the Kentucky Cancer Registry. By identifying key risk …