Digital Commons Network^™

In-Person And Virtual Adaptation Of An Interprofessional Palliative Care Communications Skills Training Course For Pediatric Oncology Clinicians, Karen Moody, Clark R. Andersen, Robert M. Arnold, Julie Bradley, Allie Carter, Lauren Draper, Timothy Garrington, Jonathan B. Gill, Douglas J. Harrison, Masanori Hayashi, Amy Heaton, Cynthia Holladay, Alex Lion, Alakh Rajan, Beatriz N. Rozo, Daniel V. Runco, Shermini Saini, Laura K. Salvador, Kathryn Sutton, Verna Ferguson

Advances in Cancer Education and Quality Improvement

Introduction

Empathic communication is crucial for clinicians when discussing palliative and end-of-life (PC/EOL) care with parents of children with cancer. Unfortunately, many parents report inadequate communication at these distressing times. This study evaluates the communication skills training (CST) clinicians received to deliver a PC/EOL communication intervention as part of a multi-site randomized-controlled trial (RCT). Training was provided using an in-person format and then adapted to a virtual platform to accommodate remote learners.

Methods

Clinicians were trained in dyads (one physician and one nurse [RN] or advanced practice provider [APP]) over 3 days (in-person or virtually). Four pediatric oncology cases were …

Rising Use Of Immune Checkpoint Inhibitors And The Escalating Burden Of Gastrointestinal And Hepatic Toxicities: A Nine-Year Analysis, Donghyun Ko, Do Han Kim Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Francis F. Fadi, Jana G. Hashash, Francis A. Farraye, Paul T. Kroner Md

Posters

The advent of immune checkpoint inhibitors (ICIs), including programmed death 1 (PD-1), PD-L1, and cytotoxic T-lymphocyte-associated antigen 4 (CTLA-4) inhibitors, has revolutionized cancer therapeutics, markedly improving survival in various malignancies. However, their expanding utilization has been paralleled by the emergence of immune-related adverse events (irAEs), particularly gastrointestinal (GI) and hepatic toxicities, which pose significant challenges in clinical practice. These toxicities can manifest as a spectrum of conditions, from mild transient symptoms to severe, life-threatening complications, necessitating a better understanding of their prevalence and trends. This study aims to evaluate the temporal changes in ICI use and associated GI and hepatic …

Low Dose Aspirin Is Associated With Improved 30-And 92-Day Outcomes In Patients With Acute Pancreatitis: A Multinational Multicenter Analysis, Do Han Kim Md, Donghyun Ko Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

Currently, no medications are known to formally treat or prevent acute pancreatitis (AP). Significant attention has been devoted to aspirin (ASA), with rodent models showing that it is associated with decreased inflammatory cytokine levels and protects against acinar cell necrosis. Current human studies, which are limited to retrospective inpatient outcomes only on the index hospitalization for AP, do suggest that patients on ASA have improved outcomes. The aim of our study was to explore de 30- and 90- day outcomes of patients with AP on long-term ASA use.

Long-Term Use Of Oral Factor X(A) Inhibitors Is Associated With Increased Rates Of Pancreatic Necrosis At 30- And 90-Days In Patients With Acute Pancreatitis: A Multinational Multicenter Analysis, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

The aim of this study is to explore the association between use of long-term anticoagulation with FXaI and the odds of pancreatic necrosis in patients with AP using a large multinational database.

Chronic Antiplatelet Agent Use Is Associated With Decreased 90-Day Morbidity And Mortality In Patients With Acute Pancreatitis, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Frank J. Lukens Md, Paul T. Kroner Md

Posters

The aim of this study is to explore the association between the use of antiplatelets and outcomes of patients with AP using a large multinational database.

Acute Pancreatitis With Acute Kidney Injury Is Associated With Worse 30 And 90-Day Outcomes: A Multinational Multicenter Analysis, Donghyun Ko, Do Han Kim Md, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Frank J. Lukens Md, Paul T. Kroner Md

Posters

Acute kidney injury (AKI) in patients with acute pancreatitis (AP) has been consistently shown to impact clinical outcomes and is a marker of organ dysfunction, being a primary indicator and driver of disease severity. The cornerstone of management of AP is aggressive intravenous fluid administration, and AKI has traditionally been a surrogate measure of the adequacy of volume repletion and is even recommended by the current ACG guidelines to be monitored in 6-hour intervals for 24-48 hours from presentation. While having been proven to be a factor of paramount importance on prior studies, the aim of our study is to …

Evolocumab Is Associated With Lower Mortality When Compared To Statin In Masld/Mash Patients: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Evolocumab is typically used as an add-on or replacement therapy for patients with dyslipidemia who are already on the maximum tolerated dose of statins or are intolerant to statins. While statins are effective in lowering lipid levels and have been shown to improve liver-related outcomes and reduce major adverse cardiovascular events (MACE), statin intolerance is increasingly encountered with their widespread use. The aim of our study is to compare the benefits of using evolocumab as monotherapy versus statins as monotherapy in patients with metabolic-dysfunction-associated steatotic liver disease (MASLD) and metabolic-dysfunction-associated steatohepatitis (MASH).

Rectal Indomethacin Decreases Post-Ercp Pancreatitis In Elderly Patients Without Increasing The Risk Of Acute Kidney Injury, Do Han Kim Md, Donghyun Ko Md, Jose A. Porres, Wilhelm S. Basegoda Md, Carlos Eilzondo-Alatorre Md, Luis M. Nieto Md, Miguel Salazar Md, Paul T. Kroner Md, Pedro Palacios Argueta Md, Frank J. Lukens Md

Posters

This study examines the association of use of rectal indomethacin with clinical outcomes in elderly patients undergoing ERCP using a large population-based multinational database.

Valproate Use Is Associated With Higher Mortality And Hepatic Decompensationin Patients With Masld/ Mash: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate is a widely used anti-seizure medication for treating epilepsy. However, it significantly impacts lipid metabolism by interfering with the beta-oxidation pathway of fatty acids in mitochondria. This disruption is expected to accelerate the progression of metabolic dysfunction-associated steatotic liver disease (MASLD) and steatohepatitis (MASH) in patients on chronic valproate therapy. The aim of this study is to determine whether the chronic use of valproate increases the risk of liver-related and cardiovascular events

History Of Bariatric Surgery Is Not Associated With Worse Clinical Outcomes At 5 Years In Patients Who Undergo Liver Transplantation, Do Han Kim Md, Donghyun Ko, Pedro Palacios Argueta Md, Wilhelm S. Basegoda Md, Jose A. Porres, Klaus E. Monkemuller, Paul T. Kroner Md

Posters

This study explores and compares outcomes of LT alone with LT in patients with a prior history of RYGB or SG, using a large multinational database.

Sglt-2 Inhibitor Use Is Associated With Lower Mortality In Patients With Alcoholic Cirrhosis And Type 2 Diabetes Mellitus: A Multinational Analysis, Do Han Kim Md, Donghyun Ko, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

In our study, we aimed to investigate whether SGLT2 inhibitors are associated with a reduced risk of all-cause mortality, liver-related events, and cardiovascular outcomes in patients with alcoholic cirrhosis and T2DM.

Pancreatic Ascites: Update On Diagnosis And Management, Lefika Bathobakae, Heba Farhan, Derya Mücahit, Dina Rohira, Kashyap Chauhan, Yana Cavanagh, Walid Baddoura, Derick J Christian

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Pancreatic ascites is a rare condition characterized by the accumulation of high-amylase ascitic fluid in the peritoneal cavity. This condition is often associated with chronic pancreatitis, pancreatic trauma, or pseudocyst rupture. Because of its rarity and ill-defined clinical presentation, pancreatic ascites is often a diagnostic and therapeutic challenge in clinical practice. The current diagnostic criteria include an amylase level >1000 mg/dL, a protein level >3 g/dL, and a serum ascites albumin gradient < 1.1 g/dL. The clinical features vary, but may include progressive abdominal distension, diffuse abdominal pain, weight loss and peritonitis. The management of pancreatic ascites remains controversial, and there is no consensus regarding the optimal approach. Conservative medical management, which includes nutritional support, pain control, therapeutic paracentesis and the use of somatostatin analogs, has been associated with a high failure rate and significant morbidity. Interventional therapies, such as surgery and endoscopic transpapillary stenting, have shown more promising outcomes. However, the choice between these methods is still debated, with some advocating for endoscopic approaches, because of their minimally invasive nature and reduced morbidity compared with surgical options. Endoscopic approaches remain underutilized in practice, probably because of the need for repeated interventions, the potential risks associated with endoscopic retrograde cholangiopancreatography, or a lack of skilled personnel. Although they show significant perioperative morbidity and mortality, surgical options provide definitive resolution of pancreatic ascites. Herein, we provide an updated review of pancreatic ascites, highlighting advances in diagnostic techniques and therapeutic approaches, and summarizing insights from recent clinical cases and retrospective studies.

Valproate Use Is Associated With Lower Hepatic And Cardiovascular Outcomes When Compared To Levetiracetam In Patients With Masld/Mash: A Multinationalanalysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

Valproate and levetiracetam are commonly used to manage epilepsy. While valproate is well-documented to significantly affect lipid metabolism, less is known about the effects of levetiracetam. Given this, worse outcomes in MASLD/MASH are anticipated in patients treated with valproate.

The aim of our study is to compare hepatic and cardiovascular outcomes in MASLD/MASH patients treated with valproate versus levetiracetam.

Immune-Related Adverse Events Associated With Pembrolizumab In Dmmr/Msi-H Colorectal Cancer: A Single Arm Safety Meta-Analysis, Joshi Simran, Saman Javid, Gaurav Sharma, Corinne Caissie, Armando Dominguez-Diaz

Posters

Pembrolizumab, a PD-1 checkpoint inhibitor, enhances immune response and has proven effective against various cancers, including melanoma, non-small cell lung cancer, and head and neck squamous cell carcinoma.

Clinical trials have also shown its efficacy in treating various types of cancers with different mismatch-repair statuses. However, the spectrum and frequency of immune-related adverse events (irAEs) in the dMMR (deficient mismatch repair) / MSI-H (microsatellite instability-high) colorectal cancer remain underexplored.

Therefore, this meta-analysis aims to evaluate pembrolizumab's safety profile in this colorectal cancer subset.

Glp1 Ra Reverses The Harmful Association Of Body Weight Variability With Cvd Outcomes Across Different Metabolic Profiles, Sarpong Boateng, Yussif Issaka Md, Basile Njei

Posters

This study aimed to investigate the impact of GLP1 RA on this known negative relationship between BMI variability and cardiovascular (CVD) outcomes across different metabolic profiles.

Glp-1ra Use Is Not Associated With Immediate Worse Outcomes In Patients Undergoing Ercp: A Multinational Analysis, Donghyun Ko, Do Han Kim Md, Wilhelm S. Basegoda Md, Jose A. Porres, Carolos Elizondo Altorre, Luis M. Nieto Md, Miguel Salazar Md, Paul T. Kroner Md, Pedro Palacios Argueta Md, Frank J. Lukens Md

Posters

Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to treat biliary and pancreatic conditions with increased therapeutic utilization over recent decades. Limited evidence exists regarding the potential impact of glucagon-like peptide-1 receptor agonists (GLP-1RA) on post-ERCP pulmonary outcomes. Increasing concern for retention of gastric contents has led to recent recommendations on holding these agents prior to upper endoscopic intervention. The aim of this study is to assess if use of GLP-1RA prior to ERCP leads to worse cardiopulmonary outcomes.

Efficacy Of Neuromuscular Ultrasound In Diagnosing And Treating A Mammogram-Induced Brachial Plexus Injury-A Case Report, Jaime Dougherty, Tyler Pigott, Altamash E Raja

Rowan-Virtua School of Osteopathic Medicine Departmental Research

A 40-year-old woman presented with chronic left anterior shoulder, upper arm, and axillary pain following a routine mammogram 3 years prior. Despite multiple interventions, her pain persisted significantly affecting her quality of life. Ultrasound examination revealed fascicular edema in the medial brachial cutaneous nerve (MBCN), intercostobrachial cutaneous nerve (ICBN), and a positive sono-Tinel. Ultrasound-guided hydrodissection of these nerves provided complete axillary pain relief and significant improvement in anterior arm pain, sustained for 6 months. This case highlights the diagnostic challenges of cutaneous nerve entrapment syndromes, often overlooked and misdiagnosed, especially without a clear inciting injury. Ultrasound proves superior to electrodiagnostic …

Untreated Subclinical Hypothyroidism Is Associated With Higher Mortality And Hepatic Decompensation In Patients With Masld/Mash: A Multinational Analysis, Do Han Kim Md, Donghyun Ko Md, Jose A. Porres, Wilhelm S. Basegoda Md, Cristina H. Makarian, Luis M. Nieto Md, Pedro Palacios Argueta Md, Paul T. Kroner Md, Frank J. Lukens Md

Posters

This study aims to explore whether subclinical hypothyroidism contributes to the progression of MASLD/MASH, reflected as an increased risk of liver-related outcomes.

Menstruation Cycles And The Impact On A Female Athlete's Performance And Perception Of Performance, Mckenzie Mcaloon

Honors Projects in Biological and Biomedical Sciences

This two-part study investigates the impact of menstrual cycle hormone levels on performances and perception of performance among division I athletes. A survey was given to the captains of all Bryant University female sports teams for the dispersal amongst their teams. Each of the 13 female sports teams participated and contributed. A total of 107 survey responses were collected. Data regarding the perception of menstrual cycle on specific aspects of their athletic lives were collected, as well as whether they were on contraception, their age of menarche and heaviness of flow. The results indicate that 83% of athletes surveyed believe …

Ultrasound-Guided Epidural Placement Vs. Conventional Technique - Evaluating Effectiveness: A Scoping Review, Skylar R. Kuehn, Bsn, Rn, Ccrn-Cmc, Jacob B. Morphis, Bsn, Rn, Sarah D. Price, Bsn, Rn, Katherine E. Pritchard, Msn, Rn, Jordan Isaac Dnp, Crna, Sharon Little Dnp, Aprn, Fnp-Bc, Tracy Mcclinton

Doctor of Nursing Practice Projects

Purpose/Background

Epidural anesthesia is a cornerstone of perioperative pain management, offering effective analgesia and reduced opioid dependency. However, traditional landmark-based epidural placement (EP) techniques often result in variable first-pass success rates (FPSR) and increased risks of complications. Ultrasound-guided (USG) EP has emerged as an alternative, providing real-time anatomical visualization to improve accuracy and safety. This scoping review synthesizes evidence on the comparative efficacy of USG EP and conventional techniques in adult patients undergoing perioperative epidural anesthesia.

Methods

This review commenced September 2023 and included full-access, peer-reviewed journal articles published in English between 2014-2023. Databases searched included PubMed, CINAHL, Cochrane Library, …

A Curious Case Of Heart Failure With Reduced Ejection Fraction In A Lupus Patient, Farah Khan Md

Posters

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with cardiovascular risks, including coronary artery disease (CAD) and typically heart failure (HF) with preserved ejection (HFpEF). We report an SLE patient with ventricular arrhythmias and HF with reduced ejection fraction (HFrEF) due to myocarditis, responding positively to Guideline-Directed Medical Therapy (GDMT) for both conditions

Impact Of Post-Operative Radiation Therapy On Survival In Nsclc Patients With Incomplete Surgical Resection, Farrah R. Khan Md

Posters

Postoperative radiation therapy (PORT) has a limited role in the management of resectable non-small cell lung carcinoma (NSCLC). A relatively strong indication for its use is in the presence of residual tumor after surgical resection, as PORT has been shown to improve survival in such patients. However, it is unclear how much of the survival detriment of incomplete resection PORT is able to offset compared to negative margins. We aim to answer this question in our study

A Fatal Triad: Concurrent Pulmonary Infections With Candida, Mucorales, And Aspergillus In An Immunocompromised Patient With Underlying Vasculitis And Diabetes, Paridhi Ghai, Kavitha Gopalratnam

Posters

We present a case of disseminated fungal disease involving simultaneous infections with Candida, Mucorales, and Aspergillus.

All Clear For Virtual Simulation In Transition To Practice, Stephanie Barrett Msn, Rn, Onc, Rebecca Riznyk Msn, Rn, Cne, Npd-Bc

Posters

The goal of this innovative project was to increase new graduate nurses’ comfort with emergency management, improve communication with the interdisciplinary team, and provide a valuable and engaging experience in a TTPP at a large health care system

Contamination To Clarity: Reducing Blood Culture Contaminations By Implementing An Initial Specimen Diversion Technique, Giovanna Tiago Bsn, Rn, Jaclyn Godfrey Msn, Rn, Judson Mary, Cj Lucia, Jacqueline Laird, John Brennan, Mason Everlith, Stacey Peace Rn, Anne M. Aquila

Posters

The aims of this initiative were:

• Target a unit with high blood culture contamination rates, with secondarily high central line utilization rates.
• Implement an evidence-based initial specimen diversion technique.
• Determine if technique had an impact on a unit’s blood culture contamination rate.
• Revisit the literature and modify as needed

Key Diagnostic Factors In Steatotic Liver Disease And Their Longitudinal Impact On Overall Mortality, Do Han Kim Md, Donghyun Ko Md, Pojsakorn Danpanichkul, Meena B. Bensal Md, Mazen Noureddin, Karn Wijarnpreecha, Mark Muthiah

Posters

This study evaluates the effect of diagnostic criteria on overall mortality across the SLD spectrum.

Targeting Student Outcomes Through Implementation Of Laboratory Experiences In A First Year Medical Neuroanatomy Course, Grant Boxey

Anatomical Education Dissertations

The pillars of anatomical sciences, including neuroanatomy, have undergone massive shifts in their teaching methodologies in recent years. With the increased enrollment in graduate medical education, as well as the introduction of new technologies, the anatomical sciences have reformed the ways in which future healthcare practitioners learn. Among the challenges to neuroanatomical education have been reliable access to donor specimens, and a decrease in laboratory-based hours. This study evaluated the introduction of voluntary laboratory-based experiences within a first-year medical neuroanatomy course. The first research question evaluated the effect of hands-on laboratory experiences on examination performance between participants and non-participants. There …

The Moderating Effect Of Self-Efficacy On The Interaction Between The Patient-Provider Relationship And Medication Adherence, Jonas M. Manalo

2025 Spring Honors Capstone Projects - Archive

Older adults taking multiple medications are at high risk for experiencing adverse drug events that result in hospitalization. Nurses are one of the first points of contact for patients and serve as patient educators. Many factors influence medication adherence, such as the patient-provider relationship and patient self-efficacy. This study aims to assess what impact patient self-efficacy has on the interaction between the patient-provider relationship and medication adherence.

The sample comprises adults aged 50 or older taking five or more medications. The Medication Understanding and Use Self-Efficacy (MUSE) Scale was used to measure patient self-efficacy and the patient-provider relationship while the …

A New Approach: Evaluating The Effectiveness Of Artificial Intelligence Developments For Trauma Triage In The Emergency Department, William C. Anoka

2025 Spring Honors Capstone Projects - Archive

Triage in emergent situations occurs when patients are assigned to areas of the hospital with different levels of care according to the perceived risks determined by their signs and symptoms. The variability of current triage protocols substantially increases the proportion of lower acuity patients who die unexpectedly due to improper risk stratification. However, recent artificial intelligence (AI) developments have been applied to trauma triage situations to improve accuracy and patient outcomes. To further evaluate the effectiveness of this new tool, this study used various AI models to assess the presenting assessments of multiple situations and determine the appropriate level of …

Comparison Of Graft Patency Between Sta, Ra, And Sv Grafts Of Intracranial Aneurysms Of The Internal Carotid Artery, Nassos Tziviskos, Hallie Tiburzi, Susrut Dube

Rowan-Virtua Research Day

Abstract

Background: Patients with intracranial internal carotid artery (ICA) aneurysms that are not amenable to treatments like coiling, stenting, or clipping have limited treatment options. One option is vascular bypass of the aneurysm to introduce a stable route for cerebral perfusion, which can be performed using the superficial temporal artery (STA) or alternatively radial artery (RA) or saphenous vein (SV) grafts, among other vessels.

Methods: The major databases were searched to identify studies that explored graft patency and functional outcome for patients who underwent bypass for intracranial ICA aneurysms with STA, RA, or SV grafts and proportion meta-analysis was performed. …