Digital Commons Network^™

A Narrative Review On The Neurobiology Of Lucid Dreaming: Mechanisms And Therapeutic Potential, Tirath Patel, Ashfaq Ahmed, Kinza Irshad, Rahat Ullah, Anaya Noor, Eiman Anwar, Rai Muhammad Umar Khan, Moazzam Akhtar, Fathimathul Henna, Nikhilesh Anand

School of Medicine Publications

Background: Lucid dreaming (LD), which involves being aware of and controlling one's dreams, is of particular interest in the study of consciousness and has potential therapeutic applications. In this narrative review, we highlight the neurobiological aspects of LD, specifically its mechanisms associated with the activation of prefrontal and parietal areas, increased gamma oscillations, and the influence of cholinergic and dopaminergic signaling, primarily during rapid eye movement (REM) sleep.

Objective: To evaluate human data on brain mechanisms and clinical effects, synthesizing the neurobiological foundations and therapeutic possibilities of LD, including remarkably controlled lucid dreams.

Methods: A narrative review of peer-reviewed research …

Epidemiology And Outcomes Of Sporotrichosis: A Descriptive Real-World Analysis From A Global Cohort, Samantha Schapiro, Nicholas Pulciano, Julian Galindo-Ramirez, Nicholas Rau, Jose Tuells, Nelson Iván Agudelo Higuita, George R. Thompson Iii, Daniel B. Chastain, Andrés F. Henao-Martínez

School of Medicine Publications

Background: Sporotrichosis is a dimorphic fungal infection of increasing global relevance. Although usually cutaneous or lymphocutaneous, disseminated disease occurs in immunocompromised hosts. Large-scale data on its epidemiology, treatment and outcomes remain limited.

Objectives: To characterise the clinical features, comorbidities, antifungal prescribing patterns and one-year mortality associated with sporotrichosis, with emphasis on patients with HIV and other forms of immunosuppression.

Patients/methods: We performed a retrospective global cohort study using the TriNetX Research Network. Adults (≥ 18 years) diagnosed with sporotrichosis were identified using ICD-9/10 codes (1995-2024). Demographics, comorbidities, laboratory parameters and antifungal prescriptions were analysed. The primary outcome was all-cause mortality …

Artificial Intelligence In Cardiology: An Updated Systematic Review With Ethical Considerations And Challenges In Implementing Artificial Intelligence Models, Dev Patel, Reshmitha Kantamneni, Jabez David John, Tirath Patel, Arnesh Shukla, Ayesha Salma, Nikhilesh Anand

School of Medicine Publications

The integration of artificial intelligence (AI) in cardiovascular medicine presents a transformative opportunity to enhance diagnostic accuracy and improve patient outcomes. This systematic review evaluates the impact of AI on cardiovascular diagnostics with a focus on its ability to surpass traditional methods in accuracy, efficiency, and predictive capabilities. Machine learning and deep learning have demonstrated significant advancements in areas such as echocardiography, electrocardiography, computed tomography angiography, and predictive analytics.

AI algorithms have demonstrated superior performance in identifying subtle patterns and anomalies. Additionally, AI has shown promise in predictive analytics, forecasting disease progression and tailoring treatment plans, thereby improving patient outcomes. …

A Narrative Review On The Therapeutic Potential Of Stem Cells In Neurodegenerative Diseases: Advances, Insights, And Challenges, Tirath Patel, Fathimathul Henna, Iman Sharif, Inaya Javed, Fatima Mustafa, Hannan Sharif, Fatima Nasir, Mirat Javaid

School of Medicine Publications

Background: Neurodegenerative diseases (NDs) such as Parkinson's disease (PD), Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), Huntington's disease (HD) are set apart by progressive neuronal loss and concomitant functional decline. Traditional therapies are equipped with only symptomatic relief, devoid of neurorestorative properties. Stem-cell-based therapies have the potential to revolutionize neurological care by replenishing lost cells, mitigating inflammation, and fostering a neuroprotective environment.

Objectives: This narrative review aims to appraise the treatment potential of various stem cell types in managing NDs, highlighting their functional pathways, delivery methods, and current experimental validation.

Methods: A comprehensive literature search was carried out based on …

Overcoming Barriers To Hpv Vaccination In Pakistan: A Critical Need For A Proactive And Culturally-Sensitive Strategy, Syed Ahtisham Halim, Tirath Patel, Syeda Ramish Zehra Kazmi, Momina Khabir, Nikhilesh Anand

School of Medicine Publications

Cervical cancer continues to be one of the major causes of cancer-related mortalities among women worldwide, with a considerable share of this burden affecting developing countries like Pakistan. The addition of the HPV vaccine to the national immunization program of Pakistan had been a crucial leap toward the prevention of cervical cancer. Nevertheless, challenges that threaten the success of such a program are conspicuous. The most important ones are discussed in the letter, including the widespread dissemination of misinformation via social media on unfounded grounds, such as infertility resulting from the vaccine; deep-seated cultural taboos relating to sexual health; and …

Minifast: A Sensitive And Fast Miniaturized Microscope For In Vivo Neural Recording, Jill Juneau, Guillaume Duret, Joshua P Chu, Blake Madruga, Conor C Dorian, Alexander V Rodriguez, Savva Morozov, Daniel Aharoni, Jacob T Robinson, François St-Pierre, Peyman Golshani, Caleb Kemere

Faculty, Staff and Students Publications

Significance: Observing the activity of large populations of neurons in vivo is critical for understanding brain function and dysfunction. The use of fluorescent genetically encoded calcium indicators (GECIs) in conjunction with miniaturized microscopes is an exciting emerging toolset for recording neural activity in unrestrained animals. Despite their potential, current miniaturized microscope designs are limited using image sensors with low frame rates, sensitivity, and resolution. Beyond GECIs, there are many neuroscience applications that would benefit from the use of other emerging neural indicators, such as fluorescent genetically encoded voltage indicators (GEVIs) that have faster temporal resolution to match neuron spiking, yet …

Rethinking The Centrality Of Brain Areas In Understanding Functional Organization, Benjamin Yost Hayden, Sarah R Heilbronner, Seng Bum Michael Yoo

Faculty, Staff and Students Publications

Parcellation of the cerebral cortex into functionally modular brain areas is foundational to cognitive and systems neuroscience. Here, we question the central status of brain areas from the perspectives of neuroanatomy and electrophysiology. We argue that the major ostensible determinants of brain function, such as cytoarchitecture and connectivity, seldom produce convergent parcellations. Brain areas themselves are just one of several equally important organizing principles; others include macroscale gradients, distributed networks, layers, columns and patches. We further argue that the evidence for a close correspondence between areal parcellation and cognitive function is weaker than is generally supposed. Indeed, many important cognitive …

Trans-Broad-Ligament Abdominal Cerclage Versus Blind Needle-Piercing Abdominal Cerclage During Pregnancy: A Comparison Of Surgical Outcomes, Qiannan Yang, Daniel Y Lovell, Joseph Nassif, Lubna Chohan, Jugnu Biba Nijjar, Nurul Farhanah Binte Abdul Latif, Zhenkun Guan, Xiaoming Guan

Faculty, Staff and Students Publications

No abstract provided.

Patient Adherence To Glucagon Like Peptide-1 Receptor Agonists In Obesity Management: A Narrative Review Of Real-World Evidence, Zainab M. Al-Shammaa, Heba M. Attash, Rahma S. Almallah, Abdulla Thamer, Fahad Saleem

Maaen Journal for Medical Sciences

Obesity has become a widespread public health problem in many regions of the world. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have a dual effect on glycemic control and weight loss. Liraglutide, semaglutide, and dulaglutide were first used in the management of type 2 diabetes (T2D), and their use is now growing among people without diabetes. Obesity management requires long-term or even lifelong interventions, so adherence to prescribed therapy is critical for achieving weight loss and maintaining it over time. Patient adherence to GLP-1RAs varies depending on the medication used, its dosing frequency, and whether findings come from clinical trials or real-world …

Humanity Is Evolving Its Consciousness: The Role Of Archetypal Energies As Guides During An Unfolding Weeding Out And Alignment Process, Carroy U. Ferguson

Psychology Faculty Publication Series

Humanity is evolving its consciousness at individual and collective levels.  Given these seemingly tumultuous times, as of this writing (January 2026), to make such a statement may sound like a strange thing to say.  However, I suggest that if you are alive today and if you are reading these words, these are the very times for which you were born—to assist Humanity as it evolves its consciousness with your unique gifts, whatever they may be.  That is, this period of our individual and collective human being-ness may be characterized as an unfolding period of weeding out and alignment with the …

Salivary Protein Quantity, Ionic Value, And Protein Movement In Stunted And Non-Stunted Children In Indonesia, Munifah Abdat, Sri Rezeki, Putri N. Zulkifli, Mela R. Adinda, Ardiansyah S. Pawinru, Eka Setyawardana

Journal of Dentomaxillofacial Science

Objective: This study aimed to analyze total salivary protein quantity, ionic activity, and protein molecular movement in children with and without stunting.

Material and Method: Saliva samples were collected from 30 children aged 4-6years (15stunted and15 non-stunted). Proteins were extracted using 0.1 M HCI. The total protein quantity was determined using the Bradford assay and Fourier Transform Infrared (FTIR) spectroscopy. Salivary ionic activity (dissolved oxygen, conductivity, and total dissolved solids) and salivary viscosity were measured using an ionic meter and an Ostwald viscometer, respectively. Statistical analyses included independent t-tests, Kruskal-Wallis tests, and Spearman correlation analyses (a=0.05).

Results: Stunted children had …

Analysis Of Coverage Of Tuberculosis Prevention Therapy (Tpt): Literature Review, Septia Rahmalina, Ede Surya Darmawan

Journal of Indonesian Health Policy and Administration

Tuberculosis Preventive Therapy (TPT) is a crucial intervention for tuberculosis (TB) control, particularly among high-risk groups such as household contacts of TB patients and people living with Human Immunodeficiency Virus (HIV). Despite being recommended by the World Health Organization (WHO), TPT implementation still faces challenges at the primary care level. This study employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method to review 11 articles published between 2021 and 2025 that were relevant to TPT implementation in various high-TB burden countries, including Indonesia. The main barriers identified were input (logistics, training), process (tracing, education, monitoring), and output …

The Relationship Between Accessibility Factors And Post-Inpatient Control Visits Among Non-Jkn Participants At Hospital X, Putri Candaika, Desy Kartika Ningsih, Risky Kusuma Hartono

Journal of Indonesian Health Policy and Administration

The rate of post-inpatient control visits remains relatively low due to various factors, including accessibility. At Hospital X, 220 of non-Jaminan Kesehatan Nasional (JKN) participants scheduled for post-inpatient control visits between January and March 2025, 71.82% attended, and 28.18% did not. Patients who did not attend control visits were twice as likely to be readmitted. This study aimed to determine the relationship between accessibility and post-inpatient control visits for non-JKN participants at Hospital X. This quantitative study employed an analytical cross-sectional design, with a population of 220 patients and a sample of 142 patients selected using probability sampling. Bivariate …

Thoracic Aorta Calcification And Risk Of All-Cause Mortality And Cardiovascular Outcomes: A Systematic Review And Meta-Analysis, Yasir Salah Jumah Alam, Hussein Nafakhi, Alaa Salah Jumaah, Akeel Abed Yasseen, Zahraa Alaa Salah Alam, Ali Athir Abdulraheem

Sultan Qaboos University Medical Journal

This review aimed to assess thoracic aorta calcification (TAC) as a predictor of all-cause mortality, cardiovascular (CV) morbidity and mortality across various clinical settings using different imaging modalities. Medical databases were systematically searched up to mid-July 2025 for studies linking TAC with mortality and CV outcomes. A total of 43 studies involving 176,738 participants were included. TAC was associated with higher risks of all-cause mortality (hazard ratio [HR] = 1.614), CV mortality (HR = 2.130), coronary events (HR = 1.423), major adverse cardiac events (HR = 2.011) and stroke (HR = 1.450. Computed tomography showed the strongest associations (all-cause mortality …

Evaluation Of Large Language Models As Decision Support Tools For Head And Neck Cancer Management: A Blinded Multidisciplinary Simulation Study, Sholem Hack, Ron J. Karni, Antonino Maniaci, Christopher E. Fundakowski, Luca Castellani, Fabiola Incandela, Remo Accorona, Miguel Mayo-Yanez, Martina Violati, Lorenzo Giannini, Niccolo' Mevio, Alberto Maria Saibene

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

BACKGROUND: The management of head and neck cancer relies on multidisciplinary expertise; however, access to tumor boards remains variable. Large language models (LLMs) may support guideline-based decision-making, although performance in complex oncologic scenarios is not well defined.

METHODS: Fourteen synthetic cases based on real tumor board encounters were evaluated. Five blinded comparator arms produced recommendations: a human expert, Non-RAG-GPT-4, Non-RAG-GPT-5, RAG-GPT-4, and RAG-GPT-5. Eight head and neck oncologic surgeons scored each recommendation for appropriateness, clarity, specificity, and feasibility using 5-point Likert scales. Paired permutation testing and inter-rater reliability were assessed.

RESULTS: LLM outputs showed close alignment with expert recommendations. RAG-based …

Private Sector Healthcare Investment In Indonesia: Leveraging Australia-Indonesia Partnerships For Health System Transformation, Susan Josephine Neuhaus

Journal of Indonesian Health Policy and Administration

Australia and Indonesia are strategic partners with expanding bilateral trade valued at AUD 26.7 billion (2022-23). Health care partnerships between the two countries offer significant opportunities for private sector engagement. Indonesia’s large population, rapidly growing middle class, and implementation of Universal Health Coverage (UHC) through the Jaminan Kesehatan Nasional (JKN) present partnership opportunities to strengthen health system capacity, address infrastructure gaps and workforce shortages, and contribute to shared economic and prosperity goals. This study explores how Australian private healthcare investment can complement government initiatives in supporting Indonesia’s UHC while advancing Australia’s regional engagement. A descriptive qualitative analysis was conducted using …

Prophylactic Antibiotic Analysis In Obs-Gyn, Orthopedics, Gastrointestinal Surgery At A South Tangerang Hospital, January-March 2024, Evelina Endang Nurjaman, Helen Andriani

Journal of Indonesian Health Policy and Administration

Inappropriate use of prophylactic antibiotics (PAs) remains a primary driver of antimicrobial resistance (AMR); however, global adherence to established prescribing guidelines remains suboptimal. This study aimed to analyze the compliance and rationality of PA prescription and to evaluate the underlying causes of physician non-adherence in obstetrics, orthopedic, and gastrointestinal surgeries at a hospital in South Tangerang City, Indonesia. Adopting a mixed-methods approach, this investigation combined a quantitative assessment of 208 surgical patient records (January–March 2024) with qualitative exploratory interviews conducted with three specialist peer group heads. This design allowed the triangulation of prescribing data with underlying clinical perspectives. PA rationality …

Factors Associated With Upstaging In Patients With Resectable Non-Small Cell Lung Cancer: A Modern Institutional Sample, Sneha Alaparthi, Hamza Rshaidat, Luke Meredith, Scott H. Koeneman, Christina Grindley, Jacob Heilizer, Purab Kothari, Prarthna Chandar, Tyler Grenda, Nathaniel R. Evans Iii, Olugbenga T. Okusanya

Department of Surgery Faculty Papers

BACKGROUND: There is significant value in predicting and better assessing patients who are at risk of post-surgery upstaging in lung cancer. The objective of this study is to review patients who were upstaged following resection and evaluate their clinical and demographic data to elucidate which factors portend an increased risk of pathologic upstaging at our institution (the Thomas Jefferson University Hospital).

METHODS: A retrospective review of institutional data was performed between 2011 and 2023. Patients with stage I-II non-small cell lung cancer (NSCLC) were included. Patients were excluded if they received neoadjuvant systemic therapy, including chemotherapy and/or immunotherapy, and were …

Cancer Vaccine Targeting Mutated Gnaq-Expressing Uveal Melanoma, Vitali Alexeev, Mizue Terai, Sergei Koshkin, Olga Igoucheva, Takami Sato

Department of Medical Oncology Faculty Papers

Background/Objectives: Uveal melanoma (UM) is the most common intraocular malignancy in adults. Although brachytherapy of the primary tumor provides an approximate 80% five-year survival, with time, nearly half of patients experience predominant liver metastases. It was proposed that malignant cells migrate early and stay dormant as they adapt to the liver microenvironment. We propose that cancer vaccine-mediated activation of UM-targeted immunity in primary UM patients could prevent progression of metastatic disease from dormant cells or malignant seeds. Thus, this study explored DNA vaccination as a measure to educate the immune system to recognize the most common UM-associated Q209L tumor driver …

Dual Tyk2/Jak1 Inhibition By Brepocitinib Reprograms Synoviocyte Pathobiology: Mechanistic Insights Into Targeted Therapy For Rheumatoid Arthritis, Umar Saeed, Zahra Zahid Piracha, Andromeda M. Nauli, Surya M. Nauli

Pharmacy Faculty Articles and Research

Background:

Rheumatoid arthritis (RA) is a chronic autoimmune disorder characterized by synovial hyperplasia, persistent inflammation, and joint destruction. Targeted inhibition of intracellular signaling pathways, such as JAK-STAT, has improved RA treatment outcomes, though safety and selectivity remain as concerns. Brepocitinib, a dual TYK2/JAK1 inhibitor, has shown clinical efficacy in the management of autoimmune diseases, yet its mechanistic impact on synoviocytes remains underexplored.

Objectives:

To investigate the molecular and functional effects of brepocitinib on MH7A and RA-FLS synoviocytes, a key effector cell type in RA pathogenesis.

Methods:

MH7A and RA-FLS cells were treated with brepocitinib (0.5 µM, 1 µM, and 5 …

Targeting The Cd47/Calreticulin Axis In Triple Negative Breast Cancer Using Ha Grafted Chitosan Nanoparticles Loaded With Doxorubicin And Polygodial, Hadir M. Emara

Theses and Dissertations

Background: Triple-negative breast cancer (TNBC) is considered the most aggressive subtype of breast cancer. Although progress in cancer treatment has led to better results for different types of breast cancer, TNBC remains particularly challenging due to persistent resistance to both chemotherapy and immunotherapy. This resistance ultimately renders chemotherapy less effective and is frequently associated with substantial side effects. Immunosurveillance significantly impacts the onset of cancer, the rise of resistance to therapies, and the likelihood of tumor recurrence. In this immunomodulatory process, Cluster of Differentiation 47 (CD47) and Calreticulin (CALR) are two key regulators. CD47 expression is strongly linked to anti-phagocytic …

Harmonization And Ambiguity In Regulations For Physicians With Family Medicine Competence Post-Law No. 17 Of 2023, Danar Wahyu Giwang Katon, Dumilah Ayuningtyas, Purnawan Junadi, Wahyu Sulistiadi, Roberth J. Pattiselanno, Fitria Fitria, Ika Fitri Alfiani

Journal of Indonesian Health Policy and Administration

Strengthening primary care services in Indonesia requires that community health centers, namely Pusat Kesehatan Masyarakat (Puskesmas), involve medical personnel with family medicine competence. However, the fulfillment of physicians with this competence, especially Primary Care Family Medicine Specialists or Spesialis Kedokteran Keluarga Layanan Primer (Sp.KKLP), still face significant obstacles. This qualitative research uses the integrated Easton's System Model and Buse's Policy Framework to analyze the dynamics of this policy. The findings reveal a gap between the strong legal foundation and weak implementation mechanisms on the ground. First, there is ambiguity in terminology and lack of harmonization among regulations, especially concerning the …

Ease The Quease! Educating Nurses On Non-Pharmacologic Nausea Intervention, Hawa Abdalla, Hannah Bookout, Leslie Martinez, Sidney Mcgregor, Jillian Norman, Gabriella Tadlock, Lucille Willians

2025

No abstract provided.

Mechanical Characterization And Modeling Of Rat Myocardia Under The Influence Of Epirubicin, Abdallah Mahmoud Alkhaiyat

Theses and Dissertations

Cancer remains a predominant health challenge that is responsible for a significant portion of global morbidity and mortality. Epirubicin (EPI), a chemotherapeutic anti-cancer drug, has shown remarkable efficacy in combating various malignancies. However, it is known to have undesirable side effects on the heart, collectively referred to as cardiotoxicity. This research investigates the adverse effects of chemotherapy on cardiac contractility through an in vitro examination of the mechanics of healthy and infarcted animal heart tissues. Electrically stimulated slices of rat ventricular tissue were tested using an isometric force measurement tissue bath. The tissue slices were subjected to uniaxial stretching, allowing …

An Impact Assessment Of The Effectiveness Of Utilizing Informal Health Communication Interventions To Spread Health Recommendations And Change Public Perception, Lina Mohamed Ezzat Ahmed Abdel Mawgoud

Theses and Dissertations

Brain health is an increasingly urgent but critically under-addressed public health priority in Egypt and the wider MENA region. Despite its centrality to aging, productivity, and overall quality of life, public understanding of brain health remains limited, and stigma continues to shape responses to dementia and cognitive decline. This study evaluates the effectiveness of informal, culturally adapted health communication as a tool to shift perception, increase awareness, and promote behavior change among non-medically trained adults in Egypt.

Grounded in global evidence on cognitive reserve, neuroplasticity, and the life-course approach to brain health, the intervention translated expert-informed brain health recommendations into …

A Virtual-Reality-Based Dental Simulator For Endodontics With Automated Formative Feedback, Yousef Salah Abo El Ela

Theses and Dissertations

Advancements in virtual reality (VR) and haptic technology are transforming the landscape of medical and dental education, offering new avenues for safe, immersive, and repeatable training experiences. Within dentistry, endodontics presents unique challenges for preclinical education due to anatomical complexity, limited access to extracted teeth, ethical concerns, and the shortcomings of conventional plastic models. Despite endodontics specific plastic teeth being available, they fall short of replicating the hardness of real extracted teeth, are relatively costly compared to generic plastic teeth, and are ultimately a disposable item which makes them inadequate as a sustainable long-term solution. Extracted teeth do a much …

Investigating The Risk Factors Affecting The Control Of Diabetes And Hypertension In The Refugees Living In Egypt, Noura Seada

Theses and Dissertations

Introduction: Non-Communicable Diseases (NCDs) account for 74% of global deaths, with high prevalence of Diabetes and Hypertension worldwide. Egypt hosts over 1 million registered refugees and asylum seekers, often lacking inclusion in social protection or insurance schemes. This study aimed to assess the factors affecting the control of Type 2 Diabetes (T2D) and Hypertension (HTN) among Syrian and Sudanese refugees in Egypt, focusing on healthcare access, sociodemographic characteristics, lifestyle, and health behaviours.

Methods: This study employed a cross-sectional design using a self-administered questionnaire and BMI measurement. Data were collected from 246 refugees diagnosed with type T2D and/or HTN in the …

Determinants Of Severe Financial Distress In U.S. Acute Care Hospitals: A National Longitudinal Study, James R Langabeer, Francine R Vega, Audrey Sarah Cohen, Tiffany Champagne-Langabeer, Andrea J Yatsco, Karima Lalani

Faculty, Staff and Student Publications

Background: Financial sustainability remains a central challenge for U.S. hospitals as rising operating costs, shifting federal reimbursement, and policy uncertainty intensify economic pressures. This study estimates the prevalence and recent changes in financial distress among U.S. short-term acute care hospitals.

Methods: We conducted a national longitudinal analysis of all U.S. short-term acute care hospitals from 2021 to 2023 using financial and operational data from Medicare cost reports linked with community-level data from the American Community Survey. Financial distress was measured using the Altman Z-score, with severe distress defined as Z ≤ 1.8. Logistic regression models were used to …

Global Dose Prescription Variances Exemplified Through Oropharynx Cancer: When Is 70 Gray 70 Gray?, Christian Rønn Hansen, Tony Tadic, Manju Sharma, Gareth Price, Jens Petersen, Mohamed A Naser, Ying Xiao, Nataliya Kovalchuk, Pernille Lassen, Jens Overgaard, Lachlan Mcdowell, Prabhakar Ramachandran, Jun Won Kim, Clifton David Fuller, David J Thomson, Jørgen Johansen, Jeppe Friborg, Sue S Yom, Andrew Hope

Faculty, Staff and Student Publications

Purpose/objectives: Radiation therapy treatment planning hinges on a critical factor: the prescribed dose. Surprisingly, there is no consistent, standardized global approach to evaluating the dosimetry of this prescription across different centers treating head and neck cancer (HNC). This study aimed to quantify global dose variations for identical prescriptions across international centers treating oropharyngeal cancer, to establish the foundation for future outcome-based studies and improve consistency of interpretation worldwide.

Materials and methods: The study included patients with oropharyngeal cancer who were consecutively treated from 2017 onward with intensity-modulated radiation therapy or volumetric modulated arc therapy at 8 globally recognized radiation therapy …

Preoperative Malnutrition Is Associated With Increased Postoperative Complications Following Lumbar Fusion: A Propensity-Matched Analysis, Ali Mehaidli, Muaaz Wajahath, Jad Lawand, Omar Abdalla, Lorenzo Deveza, Noah Hodson, Ryan J Berger, Kevin Taliaferro

Faculty, Staff and Students Publications

Background: Lumbar fusion (LF) is a common surgical intervention for degenerative spinal conditions but carries significant short- and long-term risks. Preoperative malnutrition, characterized by low serum albumin or leukocyte counts, impairs wound healing and increases susceptibility to infection, yet its influence on LF outcomes remains underexplored. This study evaluates the association between preoperative malnutrition and long-term postoperative outcomes following LF.

Methods: Adult patients undergoing LF between 2003 and 2023 were identified in the TriNetX US Collaborative Network. Malnutrition was defined as serum albumin < 3.5 g/dL or leukocyte count < 1,500/mm3 within 1 year preoperatively. A 1:1 propensity score match was performed for demographics, comorbidities, surgical approach, and body mass index (BMI), yielding two cohorts (n=20,693 each). Ninety-day and 5‑year postoperative outcomes were compared using hazard ratios (HRs) with 95% confidence intervals (CIs).

Results: Malnourished patients experienced significantly higher 90‑day rates of transfusion (8.4% vs. 4.5%; HR 1.87, 95% CI: …