Digital Commons Network^™

Short-Term Bayesian Influenza Forecasting In A Hospital Environment Using A Linear Kalman Filter., Shankar Kaleeswaran Mani, Grzegorz A Rempala, Eben Kenah, Fernanda L Schumacher

Ambulatory and Primary Care Articles

Accurately forecasting the weekly number of influenza (flu) lab tests and positive cases is important for hospitals as they work to plan staffing, manage supplies, and provide timely patient care. In this paper, we describe a practical use of a Bayesian Kalman filter to forecast weekly flu tests and positives in a hospital setting. Using data from a large hospital system in Ohio, we show that this approach, which blends real-time hospital information with historical patterns, offers a dependable way to anticipate flu-related patient volume as far as four weeks ahead.

Development Of Small-Molecule Therapeutics Targeting Neurodegenerative Diseases And Oncology, Thomas Webster

Theses & Dissertations

Alzheimer’s disease (AD), Parkinson’s disease (PD), and colorectal cancer (CRC) remain significant clinical challenges requiring improved therapeutic strategies. This dissertation describes the design, synthesis, and pharmacological evaluation of structurally diverse small-molecule scaffolds targeting the sigma-1 receptor (S1R) for symptomatic modulation in AD, the dopamine D4 receptor (D4R) for management of L-DOPA–induced dyskinesia in PD, and claudin-1 for targeted intervention in CRC. Fused azabicyclic scaffolds were developed as S1R modulators, and systematic structure–activity relationship (SAR) studies identified key structural features governing receptor affinity, selectivity, metabolic stability, and central nervous system penetration. Optimized analogs demonstrated improved metabolic stability and favorable brain exposure, …

Multi-Site Dms Probing Reveals Higher-Order Structure Of Rna-Protein Complexes In Living Cells, Irfana Saleem, Thomas Miller, Lucas Kearns, Anthony Hoang, Joshua Meehan, Ritwika Bose, David Mitchell, David H Price, Calla M Olson, Chase A Weidmann, Anthony M Mustoe

Faculty, Staff and Students Publications

Identifying tertiary structures and protein binding sites in RNA molecules remains a key challenge in RNA biology. We describe multi-site dimethyl sulfate (DMS)-mutational profiling (MaP) (msDMS-MaP), a strategy that enables simultaneous measurement of RNA secondary, tertiary, and quaternary structures via a single DMS chemical probing experiment. Optimized reverse transcription decodes typically invisible DMS N7-methylguanine (N7-G) modifications via a tautomer-induced mutational signature concurrent with N1 and N3 modifications. We show that N7-G reactivity reports on higher-order RNA structures, revealing key functional motifs such as pseudoknots and protein binding sites. Using msDMS-MaP, we find that E. coli ribosomal RNAs encode numerous independently …

Gut Microbiota Modulation Of Regulatory Dna Elements Revealed By Massively Parallel Functional Characterization, Chadmirah Zaratiana, Adheet Ganesh, Yang E Li, Et Al.

2020-Current year OA Pubs

Cis-regulatory elements (CREs) are central to dynamic gene regulation in hepatocytes, yet most functional annotations derive from in vitro models that poorly capture physiological regulation. We systematically profiled 109,386 human liver-derived CREs using massively parallel reporter assays in hepatocytes under matched in vitro and in vivo conditions. In vivo-active functional CREs (fCREs) were enriched for H3K27ac and chromatin accessibility and were regulated by diverse transcription factors in the human liver. We further demonstrate that gut microbiota-derived signals modulate fCRE activity and target gene expression in vivo, in part via the KEAP1/NFE2L2 antioxidant pathway. Specific microbial metabolites directly altered the activity …

Cellular And Molecular Basis Of Pfcoronin Function In Artemisinin Resistance In Plasmodium Falciparum, Imran Ullah, Eva S Istvan, Et Al.

2020-Current year OA Pubs

Artemisinin combination therapies are central to malaria control, but their efficacy is threatened by the emergence of resistant Plasmodium falciparum strains. While the role of Pfkelch13 mutations is well established, mutations in Pfcoronin have also been implicated in treatment failure, revealing layers of resistance complexity. Here, we define the cellular mechanism of Pfcoronin‑mediated artemisinin resistance. PfCoronin interacts with PfActin and localizes to the parasite plasma membrane, the digestive vacuole membrane, and small vesicles containing host cell material. Mutations in PfCoronin disrupt its localization and perturb PfActin homeostasis, altering the distribution of ring‑stage morphologies, including a reduced proportion of parasites adopting …

Genetic Analysis Of The X-Linked Adrenoleukodystrophy Gene Abcd1 In Drosophila Uncovers A Conserved Phenotype, Joshua Manor, Sharayu V Jangam, Hyung-Lok Chung, Pranjali Bhagwat, Jonathan C Andrews, Hillary Chester, Shu Kondo, Saurabh Srivastav, Juan Botas, Ann B Moser, Suzette M Huguenin, Michael F Wangler

Duncan NRI Faculty and Staff Publications

X-linked adrenoleukodystrophy (X-ALD) is a progressive neurodegenerative disorder caused by a loss-of-function (LOF) mutation in the ATP-binding cassette subfamily D member 1 (ABCD1) gene, leading to the accumulation of very long-chain fatty acids (VLCFAs). This disorder exhibits striking heterogeneity; some male patients develop an early childhood neuroinflammatory demyelination disorder, while other patients, including adult males and most affected female carriers, experience a chronic progressive myelopathy. Adrenocortical failure is observed in almost all male patients, with the age of onset varying, sometimes being the first diagnostic finding. The gene underlying this spectrum of disease encodes an ATP-binding cassette (ABC) transporter that …

Ultra-Rare Functional Variants Reveal Early-Onset Breast Cancer Risk Genes And Pathways In The Uk Biobank And All Of Us Research Program, Jennifer Asmussen, Kevin Wilhelm, Kwanghyuk Lee, Chen Wang, Panagiotis Katsonis, Yi Li, Lawrence A Donehower, Olivier Lichtarge

Faculty, Staff and Students Publications

Breast cancer (BRCA) affects one in eight women, and while past studies have identified susceptibility genes and variants, those driving early-onset disease remain opaque. We introduce EA-Pathways, a control-free association method that aggregates ultra-rare germline coding variants weighted by Evolutionary Action to detect functional impact distribution biases in genes and pathways. In UK Biobank women with BRCA, EA-Pathways prioritized candidate risk genes across pathways enriched in known familial genes. Ultra-rare, high-impact variants in these genes were BRCA specific, and variants from eight pathways were associated with 2-year-earlier disease, including homology-directed DNA repair, TP53, and pexophagy pathways. The early-onset effect replicated …

Mind Over Measure: The Role Of Self-Care Practices In Mitigating Mental Health Strain Among K-12 Educators, Jerry Burkett, Ryan Hulla

School Leadership Review

Teacher mental health is a critical concern in K-12 education, with high rates of burnout demanding effective protective strategies. This study investigated the relationship between five dimensions of teacher self-care (Physical, Psychological, Emotional, Spiritual, and Professional) and overall mental health outcomes, while specifically exploring differences between elementary (K-5) and high school (9-12) educators. A sample of K-12 teachers completed the Mental Health Inventory (MHI-5) and the Self-Care Inventory. Correlational analysis found that all five self-care dimensions were significantly and positively associated with mental health, with Professional Self-Care demonstrating the strongest link (r=.48, p

Screening Novel Secreted Proteins For Their Effects On Pancreatic Islet Function Using Qpcr-Based Gene Expression Analysis, Deepti Agarwal, Neha Mishra, Marcus Seldin

Cumberland Medica

Type 2 diabetes (T2D) involves progressive dysfunction of pancreatic β-cells and systemic insulin resistance. Although a handful of secreted factors acting on pancreatic islet have emerged as important therapeutic targets, many additional signaling processes remain unknown. The identification of such mediators can make a new contribution to the regulation of islet biology and serve as another approach for disease treatment. This study aimed to investigate whether three novel peptides could modulate islet-specific gene expression in vivo. Methods: Male C57BL/6J mice were injected with proteins then pancreatic tissues were collected six hours post-treatment. Total RNA was isolated, converted to cDNA, and …

Comparative Analysis Of Antegrade And Retrograde Nailing For Proximal, Shaft, And Distal Femur Fractures, Saahil Noupada

Rowan-Virtua Research Day

Background:

Antegrade and retrograde intramedullary nailing are widely used for femoral fractures, yet their relative advantages across fracture locations remain debated. This study compares union rates, time to union, malunion, and functional outcomes between approaches, stratified by AO/OTA classification.

Methods:

A systematic review of PubMed, Embase, Cochrane Library, Web of Science, and Scopus (2015 to 2025) was performed. Studies reporting outcomes of antegrade and/or retrograde nailing for proximal (31), diaphyseal (32), and distal (33) femoral fractures were included. Data on demographics, fracture classification, fixation method, and outcomes were extracted. Risk of bias was assessed using ROBINS-I. Pooled estimates were calculated …

Medical Providers’ Perspective On Barriers Faced By Intellectual And Developmental Disabled (Idd) Patients From Medically Underserved Backgrounds, Mayra A. Flores

Rowan-Virtua Research Day

•Complexities of obtaining healthcare access can be difficult for all patients across the board, so much so that it’s viewed as a maze. Studies have shown that these challenges are added on for medically underserved communities.2-3 Some of these challenges include insurance, language barriers, appointment availability, stigma, financial limitations and lack of transportation.2 •Identify the barriers that patients with intellectual and developmental disabilities (IDD) from medically underserved backgrounds face in healthcare access. •Intellectually and developmentally disabled patients from medically underserved communities face exacerbated barriers in healthcare access. •Participating medical providers from the Regional Integrated Special Needs Center (RISN) – Sewell …

Management Of Libman-Sacks Endocarditis: The Role Of Anticoagulation And Immunosuppressive Therapy, Klaudia Matanaj, Demi Poulathas, David Altimore

Rowan-Virtua Research Day

Background: Libman-Sacks endocarditis (LSE) is a nonbacterial thrombotic endocarditis detected in 10-40% of patients with systemic lupus erythematosus (SLE), depending on imaging modality. LSE is strongly associated with antiphospholipid syndrome (APS). The condition significantly increases the risk of cerebrovascular accidents and inpatient mortality compared to SLE without cardiac involvement. Despite these serious complications, optimal management remains uncertain. Objective: To review the current evidence on the pathophysiology and management of LSE. Methods: A literature review was conducted using 12 peer-reviewed articles addressing LSE pathophysiology, clinical outcomes, and treatment strategies. Results: Combination anti-inflammatory and antithrombotic therapy achieved 76% …

Age And Genotype-Dependent Baseline Characterization Of Spatial Learning And Memory In App/Ps1 Rats Using The Morris Water Maze, Thomas George, Mohammadreza Arbab, Nathanael Ricardo Alicea, Mahdie Kerdari, Christopher Janson

Rowan-Virtua Research Day

Background: Alzheimer’s disease (AD) is characterized by progressive cognitive decline. Transgenic APP/PS1 rat models offer improved translational relevance compared to mouse models due to closer similarity to human neurobiology.

Objective: To establish a baseline profile of spatial learning and memory across age and genotype in rate model.

Methods: The Morris Water Maze (MWM) was used to assess four groups of rats: young Wild Type (WT), young APP/PS1 (AD), middle-aged WT, and middle-aged AD. Spatial learning was evaluated during acquisition (Day 1–4) using cumulative proximity and escape latency. Memory was assessed using probe trials (Day 2–4). Swim velocity …

Involuntary Medication Administration Review: A Historical Look At New Jersey Psychiatric Law And Its Significance, Casey Burke, Joon Min Chun D.O., Ramya Kommidi D.O., Salvatore Montana Messina D.O.

Rowan-Virtua Research Day

The legal and ethical evolution of involuntary psychiatric medication in New Jersey has been shaped through the landmark legal cases Rennie v. Klein and Brandt v. Monte. To this effect, this poster explores how each case shaped state hospital policy and the balance between patient autonomy and clinical judgment. Rennie v. Klein (1978) established a constitutional right for involuntarily committed patients to refuse psychotropic medication, except in emergencies or with due process safeguards. Decades later, Brandt v. Monte (2006) exposed flaws in New Jersey’s administrative procedures—particularly Administrative Bulletin 78-3—which permitted coercive practices under the guise of emergency treatment and lacked …

Behind The Screen: The Effect Of Screen Time On The Pediatric Population, Arthi Rameshkumar, Tanvi Shah, Liam Courtney, Talia Hartman, Tanya Kadrmas-Iannuzzi

Rowan-Virtua Research Day

No abstract provided.

Tat-Beclin 1 And Exercise: Investigating Their Potential Synergy In Improving Sarcopenia-Related Muscle Changes In A Mouse Model, Shreya Krishnan, Thuan Thien Tchen, Kleiton Silva, Gabryel Sales Nascimento

Rowan-Virtua Research Day

No abstract provided.

Improving Adherence To Comprehensive Gynecological Assessments In Female Rectal Cancer Patients Prior To Rectal Cancer Treatment, Rachael Smith, Eleanor Williams, Emily Young

Rowan-Virtua Research Day

Background: A retrospective chart review of 139 female patients with Stage I-III rectal cancer treated at our institution (2017-2022) revealed only 32.6% (n=45) had documented age-appropriate gynecologic screenings prior to surgical intervention. These findings were disseminated to colorectal surgeons, medical oncologists, and radiation oncologists through departmental meetings and tumor boards. This follow-up study evaluates the impact of that educational initiative on gynecologic referral patterns. 

Hypothesis: Targeted education of colorectal surgeons, medical oncologists, and radiation oncologists would significantly increase gynecologic referral rates for female rectal cancer patients. 

Methods: This pre-post quality improvement study compared gynecologic referral rates among female patients with …

Understanding The Immune Responses Of Macrophages And Neutrophils In Synovial Fluid And Post-Operative Joint Environments, Allison Noelle Snyder

Rowan-Virtua Research Day

Periprosthetic joint infections (PJI) are devastating complications of total joint replacement (TJA). Even with aggressive antibiotic treatments, PJI recurrence rates are >17%, and 5-year survival is only 87.3%. Understanding the levels of inflammatory markers and cell types present at different timepoints is crucial in maximizing antimicrobial therapy and preventing adverse outcomes following TJA. This study tests the hypothesis that the synovial fluid environment of PJI induces immunosuppression in human macrophages, thereby hindering their ability to kill bacteria.

How Do Adverse Social Determinants Of Health Influence 30-Day Hospital Readmission Rates Among Patients With Heart Failure?, Noor Baig

Rowan-Virtua Research Day

Heart failure is one of the leading causes of hospitalization in the United States, with nearly 1 in 4 patients readmitted within 30 days of discharge. Clinical severity largely accounts for this risk, but social determinants of health (SDOH), including income, housing stability, transportation access, and health literacy, also play a role in post-discharge outcomes. This review synthesized seven cohort, observational, and qualitative studies from PubMed (2018–2025) examining the relationship between SDOH and 30-day readmission in heart failure patients.

Several patterns emerged across the literature. Neighborhood socioeconomic disadvantage, measured through ADI and SDI, was independently associated with higher readmission and …

Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim

Rowan-Virtua Research Day

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …

Psychiatry Meets Ai: Are Residents Ready?, Jacob De Castro, John Case

Rowan-Virtua Research Day

Artificial intelligence (AI) use is increasing in healthcare, but psychiatry residency training remains unstructured. In a 20-resident pilot survey, AI was frequently used for literature review and clinical support, with limited confidence and institutional guidance. We found most residents desired formal training and would use AI more if institutionally supported. Findings highlight a gap between rapid adoption and structured education.

Health Outcomes In Heat-Intense Areas In Response To Socioeconomic Status, Victoria Zheng, Chandni Patel, Emily Fried, Jayanth Ambat, Lincoln Opara, Rohan Gupta

Rowan-Virtua Research Day

Background: As ambient temperature rises, regions experiencing extreme heat face serious health concerns. This disproportionately affects lower socioeconomic status (SES) individuals in urban areas. This review examines how these “heat islands” affect the health outcomes for those in different socioeconomic statuses.

Methods: The databases used were PubMed, Embase, and Medline, and were searched with keywords such as “heat islands”, “social inequality”, “SES”, and “health outcomes”. After compiling, articles were screened using the inclusion criteria of ages, gender, peer-reviewed and English-written publications, from any location, social determinants as a primary outcome, and directly compared heat with social determinants of health. Articles …

Evaluation Of Possible Suicide Attempt And Treatment Of Chronic Serotonin Syndrome: A Case Report, Lalitya Karra, Colin Villarin

Rowan-Virtua Research Day

No abstract provided.

Challenges For Older Veterans In Disaster-Prone Rural Areas, Umayma Saifuddin, Joshua Ehrenberg, Elizabeth Tran Phung

Rowan-Virtua Research Day

Purpose: To describe a case in which an elderly veteran was unable to receive necessary health services due to environmental factors and routine natural disaster in his rural coastal town. Methods: A case report is presented. Results: A 95 year-old WWII veteran with a complex medical history and numerous disabilities including hearing impairment, visual impairment, and chronic pain struggles to receive proper care as he lives in a small coastal town. The patient’s son lives an hour away and this area is prone to flooding, making accessing health services extremely challenging. In order to respect the patient’s wishes to remain …

Ai-Augmented Digital Auscultation For Point-Of-Care Screening Of Valvular Heart Disease: A Systematic Review And Meta-Analysis, Harshal Parmar, Akhila Archakam, Nikhila Archakam, Wesley Kim, Eduard Koman Md

Rowan-Virtua Research Day

Background: Valvular heart disease (VHD) affects >10% of adults aged 75+ yet remains underdiagnosed when asymptomatic due to declining auscultatory proficiency. AI-augmented digital auscultation offers a point-of-care screening solution, though no meta-analysis has pooled diagnostic accuracy across VHD subtypes in adults using echocardiography as the reference.

Methods: A systematic review and meta-analysis were conducted per PRISMA guidelines. PubMed, Embase, Cochrane, IEEE Xplore, and Scopus were searched without date restriction. Studies applying AI or machine learning to digital auscultation or phonocardiography for VHD classification in adults with echocardiographic reference and patient-level diagnostic metrics were included. Studies using only public datasets, pediatric …

In Patients With Acne Vulgaris, How Do Standard Acne Treatments Combined With Adjunct Microbiome-Targeted Therapies Compare To Standard Acne Treatments Alone In Affecting Clinical Outcomes?, Sree Gowri Sudharshan

Rowan-Virtua Research Day

Background: Acne vulgaris is a very common chronic skin condition that occurs when hair follicles become clogged with oil, dead skin cells, and bacteria. Nearly 50 million Americans are affected annually, and it usually occurs around puberty. Due to rising antibiotic resistance and unwanted side effects to current mediations, emerging research on the role of skin and gut microbiome in acne development is of interest.

Hypothesis: Adjuvant microbiome-targeted therapies may offer better clinical outcomes than standard acne treatments alone.

Methods: Literature search performed in PubMed and Embase using keywords related to acne vulgaris, microbiome-targeted therapies, and targeted acne treatments. Of …

Evaluating Referral Coordination And Scheduling In Primary Care: A Qualitative Study Of Workflow Gaps, Aprupa Alahari, Philycia Foote, S. Vincent Grasso

Rowan-Virtua Research Day

Background

Healthcare referral workflows remain fragmented despite widespread adoption of electronic health records. Primary care to specialty referrals frequently rely on fax, phone calls, manual scheduling, and disconnected communication systems, creating delays, incomplete referrals, and administrative burden.1,2 Prior literature has identified a lack of referral tracking, referral leakage, and lack of closed-loop communication as major barriers to coordinated care. Altogether, efforts are required to keep cases from falling into the “referral black hole” that plagues health systems.2-4

Hypothesis

We hypothesized that:

1. there is substantial patient burden

2. there is substantial operational fragmentation

3. current referral systems contain limited visibility or verification

Methods …

What Is The Role Of The Gut Microbiome In Modulating Immune Tolerance And The Development Of Allergic Disease In Infants?, Priyal Gajera

Rowan-Virtua Research Day

Introduction: The infant gut microbiome plays a critical role in immune system development during the early-life “window of immune education.”¹ Microbial colonization influences immune tolerance through mechanisms such as regulatory T-cell (Treg) induction, short-chain fatty acid (SCFA) production, and mucosal immune regulation. Disruptions in this process (dysbiosis) are associated with increased risk of allergic diseases, including food allergy, atopic dermatitis, and asthma. Environmental and maternal factors such as delivery mode, antibiotic exposure, and feeding practices significantly impact microbial composition and immune outcomes.²

Methods: A literature review was conducted using PubMed with search terms related to the gut microbiome, …

Resensitization Of Clinical Isolates Of Mdr-Acinetobacter Baumannii To Antibiotics Using Bacteriophage Therapy, Priyal Gajera, Valerie J. Carabetta

Rowan-Virtua Research Day

Introduction:

Antibiotic resistance poses a major global health threat, particularly with multidrug-resistant (MDR) pathogens such as Acinetobacter baumannii, which exhibits resistance to multiple antibiotic classes, including carbapenems.¹ As conventional treatments become less effective, alternative therapies such as bacteriophage therapy are gaining attention. Bacteriophages offer targeted antibacterial activity and may enhance antibiotic efficacy or resensitize resistant strains. This study investigates the synergistic effects of bacteriophage ΦCO03 combined with antibiotics against MDR A. baumannii.

Methods:

Clinical isolates (M20, M5) of A. baumannii were cultured in LB broth at 37°C. Bacteriophage ΦCO03 was isolated and purified using plaque assays. Synergy between phage …

Incidence Of Stroke Post Pulmonary Thrombectomy: Implications For Periprocedural Management, Rohan Umrani, Rameez Shahid, Luai Tabaza

Rowan-Virtua Research Day

Background: The incidence of stroke after pulmonary thrombectomy (PT) remains unknown. Given the incidence of patent foramen ovale (PFO) of 25% in autopsy studies, the concern for paradoxical embolus in this patient population warrants evaluation of periprocedural management.

Methods: We queried the EPIC EHR at Virtua Health in New Jersey for all patients who underwent PT from 2021-2025, categorized by utilization of the Inari Flowtriever system or the Penumbra thrombectomy device. We assessed post-PT cerebrovascular accident (CVA), PFO presence by transthoracic echocardiogram (TTE), and gender via descriptive statistics. Age, average anesthesia time and procedure supply cost were assessed via two-sided …