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Primary Membranoproliferative Glomerulonephritis: Natural History, Pathogenesis, And Treatment, Edward J. Filippone, John L. Farber

Division of Nephrology Faculty Papers

Primary membranoproliferative glomerulonephritis (MPGN) is an ultrarare disease characterized by immunofluorescence microscopy as either immune-complex mediated (IC-MPGN) or C3 glomerulopathy (C3), the latter subdivided by electron microscopy to C3 glomerulonephritis (C3GN) and dense deposit disease (DDD). Both IC-MPGN and C3G typically have obvious C3 staining differentiating them from other causes of MPGN histology. Secondary causes must be excluded, including infections, autoimmune disease, and neoplasia. Clinical presentations are variable, including urinary sediment abnormalities, nephrotic syndrome, or a rapidly progressive course. The prognosis is unfavorable with about 50% reaching kidney failure by 10 years. Recurrence following transplantation is frequent, and allograft survival …

Reliability Of Existing Measures And Classification Systems For Trochlear Dysplasia, Sean R. Waldron, Nihar S. Shah, Matthew W. Veerkamp, Brendan A. Williams, John A. Schlechter, Lauren H. Redler, Matthew D. Ellington, Shital N. Parikh

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Patellofemoral instability (PFI) is common in adolescent patients and can lead to a reduction in quality of life and function, as well as long-term arthritis. Treatment of PFI involves assessing and, at times, surgically correcting underlying anatomic abnormalities. Trochlear dysplasia is the most common anatomic risk factor present in PFI.

PURPOSE: To determine the interrater reliability of existing measures and classification systems for the assessment of trochlear dysplasia.

STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 3.

METHODS: As part of the PRISM (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) patellar instability Research Interest Group (RIG) project, a …

Green Vessel Signal On Multicolor Imaging As An Early Sign Of Ischemic Vasculitis In Irvan Syndrome: A Case Report, Daniel M. Markowitz, Jirat Nimworaphan, Carl Regillo, James P. Dunn, Robert C. Sergott

Wills Eye Hospital Papers

PURPOSE: Idiopathic retinitis, vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is typically diagnosed after characteristic intravenous fluorescein angiography (IVFA) findings develop. This case demonstrates that identifying a green intravascular and perivascular signal on multicolor fundus imaging may be a potential noninvasive imaging sign for ischemic retinal vasculitis in IRVAN.

OBSERVATIONS: A 55-year-old female presented with bilateral optic disc edema and subtle peripapillary retinal vascular changes. Multicolor imaging showed a distinct green intravascular and perivascular signal before undergoing IVFA evaluation. Subsequent IVFA ultimately showed peripheral capillary nonperfusion, microaneurysms, and leakage consistent with IRVAN.

CONCLUSIONS AND IMPORTANCE: This case demonstrates the potential utility …

The Relationship Between Disease-Modifying Therapy And Quality Of Life For People Living With Sickle Cell Disease, Lana King, Sophie Lanzkron

Phase 1

Introduction/Purpose: Despite the availability of disease-modifying therapies (DMT), adults with sickle cell disease (SCD) experience a multitude of adverse health effects that impact quality of life (QOL), with pain being the most common complication. There are few studies that objectively assess the relationship between DMT use and QOL in adults. This study aims to understand whether the currently used tools are sensitive to the use of DMT.

Methods: Data included 141 adult patients from three institutions in a national sickle cell disease registry (GRNDaD). A validated questionnaire, specific for patients with SCD (ASCQ-Me), was used to assess QOL in 5 …

A Retrospective Analysis On Oxygen Therapy And Adverse Outcomes, Matthew Marhefka, Brian Schonewald,, Ross Summer

Phase 1

Introduction/Purpose: Oxygen therapy is widely utilized for cases of hypoxemia. However, limited data evaluate the adverse effects of oxygen therapy in large cohorts. We hypothesize oxygen therapy correlates to an increased rate of trips, falls, and fractures, potentially due to limited mobility and the oxygen tubing posing a hazard.

Methods: TriNetX, a deidentified electronic health record database, was utilized to create two cohorts. Both cohorts consisted of patients with a COPD diagnosis, validated with PFTs. One group had the criterion of “dependence on supplemental oxygen,” while the other group had it excluded. In order to have more balanced cohorts, both …

Reproducibility Of Spatially-Defined Structural Cluster Analysis Using Automated Superpixel Metrics On Swept-Source Optical Coherence Tomography, Sahil Shah, Fabio Lavinsky, Bo Young Kim, Darron King, Ronald Zambrano, Fernanda Mari Fujihara, Dilru Amarasekera, Lauren E. Hock, Ping Huang, Natasha Kolomeyer, Reza Razeghinejad, Jonathan Myers, Gadi Wollstein, Joel Schuman

Phase 1

INTRODUCTION: Optical Coherence Tomography (OCT) is essential to detect and monitor structural damage in glaucoma. However, current practices focus on global and sectoral values, not localized changes. The study explores a novel approach using spatially determined superpixel clusters from swept- source OCT (SS-OCT) to assess localized changes in both healthy and glaucomatous eyes. We hypothesize that this method will provide reproducible results comparable with standard OCT parameters.

METHODS: Healthy and glaucoma subjects with ≥ 2 qualified same-visit optic nerve head (ONH) and macular Triton SS-OCT scans were included. Automated segmentation generated superpixel thickness values from 3D disc and macula arrays. …

Evaluating The Residential Lead Remediation Program In The City Of Lancaster, Kaitlin Mcgowan, Divine Oludi, Harriet Okatch

Phase 1

Introduction: Residential lead remediation is an effective primary prevention approach for addressing lead exposure. Current guidelines require residents of a home get relocated during the remediation. Relocation is often for a period of ten days; however, no study has explored the effect of relocation on families. This study aims to understand the experiences of relocated families with a goal to develop a framework for relocation informed by the experiences of previously relocated families.

Methods. Ten semi-structured interviews were conducted with individuals from the city of Lancaster whose homes had been remediated during the last two years. Participants described their …

Trauma-Informed Care In Graduate Nursing Education: A Scoping Review, Keziah Smallhouse, Stephen Didonato, Phd, Lpc

Phase 1

Introduction
Trauma-Informed Care (TIC) is a holistic, organizational framework that recognizes the widespread impact of trauma and emphasizes creating safe, supportive, and empowering environments. There is a lack of standardized and evidence-based approaches for delivering TIC education in graduate nursing programs. This project aims to examine current practices and enhance the delivery of TIC education for nursing students.

Methods
A scoping review was conducted to map the existing literature on trauma-informed nursing education in higher education settings. The review followed PRISMA-ScR guidelines, with study screening and management using Covidence. Eligible studies described higher education and included nursing students or faculty, …

Editorial: Unveiling The Next Generation Of Cancer Immunity & Immunotherapy, Mohanraj Sadasivam, Nethaji Muniraj, Chellappagounder Thangavel

Center for Translational Medicine Faculty Papers

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Impact Of Type 2 Diabetes Mellitus Without Retinopathy On Longitudinal Oct And Visual Field Changes In Primary Open-Angle Glaucoma, Amer Ahmed, Deena Shefter, Fabio Lavinsky, Ronald Zambrano, Qiang (Ed) Zhang, Dilru Amarasekera, Lauren E. Hock, Ping Huang, Natasha Kolomeyer, Reza Razeghinejad, Jonathan S. Myers, Gadi Wollstein, Joel S. Schuman

Phase 1

Introduction/Purpose: Primary open-angle glaucoma (POAG) is a leading cause of irreversible blindness, and diabetes mellitus (DM) is common in this population. However, the effect of DM without diabetic retinopathy (DR) on glaucoma progression is unclear. We evaluated whether structural and functional progression differ between POAG eyes with DM, but no DR, and age- and visual field (VF) mean deviation (MD)-matched non-diabetic POAG eyes.

Methods: We conducted a retrospective longitudinal study at three academic centers comparing POAG+DM (no DR) with POAG-only eyes. Eligibility required ≥3 qualified OCT scans and ≥3 reliable VFs over ≥1 year; eyes with DR or other major …

Age-Related Challenges Of Blood Pressure Management In Patients With Spinal Cord Injury, Brian Frost, Maclain Capron, Michael Stillman

Phase 1

Introduction/Purpose: Autonomic dysreflexia (AD), orthostatic hypotension (OH), and postprandial hypotension (PPH) are forms of dysautonomia that can affect people with spinal cord injury (SCI). Life expectancy for individuals with SCI has increased in recent decades, so it is critical to understand how triggers of these conditions change throughout the lifespan. This study will answer the question “What challenges do patients with SCI face regarding autonomic dysfunction as they age, and what are their perceptions of these challenges?”

Methods: This survey-based study aims to better understand dysautonomia in order to educate the medical community about specific challenges of growing older with …

Quantifying The Delay In Treatment For Patients With Newly Diagnosed Breast Cancer, Rosemary Kaufman, Meghan Maceyko, Kelsey Van Housen, Mariah Bloomfield, Scott Koeneman, Allison Doermann, Melissa Lazar

Phase 1

Introduction/Purpose: Current American Society of Breast Surgeons guidelines recommend screening or diagnostic MRI for newly diagnosed breast cancer in high-risk patients but provide no lower threshold for use. Several studies show limited benefit of preoperative MRI (pMRI), leading to inconsistent practices. As pMRI ordering increases at our institution, we aimed to evaluate the frequency of contralateral findings on pMRI and its impact on time to treatment in newly diagnosed breast cancer patients.

Methods: This retrospective review analyzed 1,580 patients with a BIRADS-6 diagnosis between 2020–2025 within the Jefferson system. The intervention group included patients who underwent pMRI after diagnosis and …

The Impact Of Icare Home Tonometry On Glaucoma Management: A Retrospective Observational Study, Irene P. Kim, Natasha Nayak Kolomeyer, Jonathan Myers, Reza Razeghinejad

Phase 1

Introduction/Purpose: Home intraocular pressure (IOP) monitoring helps detect elevated IOPs that may be missed during routine office visits for glaucoma. This study examined whether home IOP tonometry provides additional information that changes glaucoma management.

Methods: This study included 82 eyes from 46 patients examined by the Wills Eye Glaucoma Service that had iCare HOME tonometry done between 2020 to 2023. Patient demographic data, prior surgical interventions and medications, and management changes following home tonometry were collected. iCare HOME tonometry data and the presence of IOP spikes were also recorded. Physician interpretations of optical coherence tomography imaging and visual field testing …

Maternal Microchimerism In Cord Blood Of Neonates With Hypoxic-Ischemic Encephalopathy, Saniya Lakhiani, Elizabeth Wright-Jin

Phase 1

Hypoxic-ischemic encephalopathy (HIE) affects three million neonates every year, often leading to conditions including cerebral palsy, epilepsy, and motor or cognitive deficits. A risk factor for neonatal HIE is maternal inflammation; however, little is known about the mechanism behind this. Maternal inflammation may increase maternal microchimerism, maternal cells that enter the fetal compartment. Maternal microchimerism may change fetal inflammatory pathways, organ repair, and immune system development. We hypothesized that patients with HIE have a greater percentage of maternal cells in their cord blood or circulating postnatal blood than those without HIE. To test this hypothesis, fetal cord blood or early …

The Impact Of Follow-Up Visits For Pediatric Patients Readmitted With Asthma, Keerti Mallur, Talia Gillespie, Kanika Gupta, Adil Solaiman

Phase 1

Introduction/Purpose: Asthma is a leading cause of hospital admissions in pediatric patients. In addition, kids may end up readmitted to the hospital after being discharged. This negatively affects the quality of life and health of children in our country, while also placing stress on the healthcare system. Follow-up visits may improve asthma management, therefore reducing readmissions. We aim to elucidate a potential relationship between short-term readmissions and follow-up visits in pediatric patients readmitted with asthma.

Methods: This is a retrospective chart review of 128 patients at Nemours Children’s Hospital from Jan 2020 to Oct 2024 who were initially admitted with …

Exploring Spinal Anatomic Targets For Spinal Cord Stimulation, Jp Ponce, Kevin Hines, Caio Matias

Phase 1

Introduction: For more than 50 years, spinal cord stimulation (SCS) has been effectively employed as a surgical intervention for chronic pain management. Despite its clinical success, up to 40% of patients fail to achieve significant pain relief. Computational models have identified epidural lead positioning and the conus medullaris as potential anatomical targets influencing stimulation efficiency. Given the limited availability of clinical data on potential targets of SCS modulation, this project seeks to investigate these anatomical targets in the clinical setting.

Methods: We conducted a retrospective cohort study involving Epic charts of 105 patients who underwent SCS implantation for chronic pain …

Evaluating Overuse Of Nicu For Hypothermia, Solomeya Marynovych, Lillian Walton Masters, Julie Cooper, Neera Goyal

Phase 1

Introduction/Purpose: Hypothermia of the newborn may be environmental or due to immature physiology but also may be an early sign of sepsis or other complications. Our study aimed to assess outcomes of newborns who were transferred to the NICU for hypothermia, and to evaluate if clinical risk factors are associated with receiving interventions in the NICU.

Methods: A retrospective cohort study of neonates born from July 2021 to January 2025 at TJU Hospital transferred from the nursery to the NICU was conducted. Data was manually abstracted from electronic medical records to REDCap by single reviewers. Descriptive statistics were performed, and …

Time From Stereotactic Electroencephalography To Surgery: Effect On Seizure Outcome, Sanyam Ratan, Robert Ziechmann, Katelyn Mann, Chengyuan Wu

Phase 1

Introduction: Epilepsy is a major neurological disorder affecting approximately 1% of adults in the United States. Among the nearly one-third of patients with drug-resistant epilepsy, resective surgery guided by prior stereotactic electroencephalography (SEEG) can be curative. However, the optimal interval between the procedures remains poorly defined. Prolonged intervals may allow for evolution of the epileptogenic network, potentially affecting surgical outcomes. This study evaluated seizure outcomes in patients undergoing both SEEG and subsequent resective surgery.

Methods: In this retrospective, single-institution study, electronic medical records of 29 patients who underwent SEEG followed by resective surgery were reviewed. Patients were divided into early …

Pre-Infusion Evaluation Of Pain In Children And Adults With Osteogenesis Imperfecta (Oi) Receiving Cyclic Pamidronate, Andrew Stolfe, Cristina Mcgreal, Sarah Little, Shannon Bonner, Ricki Carroll, Mahim Jain

Phase 1

Introduction/Purpose: Chronic pain is common in OI patients, but standardized pain assessment and treatment is lacking. Pamidronate, a bisphosphonate traditionally administered to OI patients to increase bone mineral density, could play a role in pain management. This study will describe baseline pain before receiving pamidronate to contribute to the characterization of pain in OI and justify the need for evaluating the impact of pamidronate on pain over time.

Methods: 54 patients with mild to severe OI were selected from the Nemours Skeletal Dysplasia Program (mean age 10.5±6.6 years [range 2-31 years]; 54% male, 46% female). Pain was assessed using the …

Effect Of Als-Associated Ubiquilin-2 Mutation On Autophagy In Ipsc-Derived Neurons, Marina Pilger, Dorothy Benton, Juliet Goldsmith

Phase 1

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease that progresses to respiratory paralysis and death. Defective protein homeostasis is a major driver of disease pathogenesis, and autophagy, a cellular recycling and degradation system, is often disrupted in disease. UBQLN2 mutation is linked to a small percentage of familial ALS. Despite UBQLN2’s known role in protein homeostasis, the effect of its ALS-associated mutation on neuronal autophagy remains unclear. This study used iPSC-derived excitatory cortical-like (iCN) and lower motor (iLMN) neurons to quantify the effects of the familial UBQLN2 mutation (P506T) on autophagic flux. Live cell imaging and ImageJ were used …

Interrelationship Between Body Mass Index, Venous Sinus Pressures, Craniospinal Elastance, And Intracranial Pressure In Idiopathic Intracranial Hypertension, Rachel Wang, Scott W. Keith Phd, Pascal Jabbour Md, Stavropoula Tjoumakaris Md, Michael J. Marmura Md, M. R. Gooch Md, Hsiangkuo Yuan Phd

Phase 1

Introduction/Purpose: Body mass index (BMI), venous sinus pressure (VSP), and craniospinal elastance each correlate with lumbar puncture opening pressure (LP OP) in idiopathic intracranial hypertension (IIH), but their mechanistic interactions remain unclear. This study examined how these factors jointly influence OP, hypothesizing that BMI has a stronger positive association with intracranial pressure (ICP) when elastance is elevated.

Methods: A single-center retrospective review was conducted to identify patients who underwent venous manometry (8/2021–11/2025) followed by LP within 7 days. VSPs were recorded at the torcula (TP) and sigmoid/jugular (SIJ) sinuses. Elastance was calculated as (OP – closing pressure)/volume of CSF removed. …

Cardiovascular Outcomes In Smoking And Nonsmoking Psoriasis Patients On Low- And Moderate-Intensity Statin Therapy, Eliana Khojasteh, Mahaa Ayub, Julianne Bartz, Matthew Keller, Md

Phase 1

Introduction: Psoriasis is associated with increased cardiovascular risk, and smoking amplifies this burden by worsening cardiovascular outcomes and psoriasis severity. Statins are the cornerstone of cardiovascular risk reduction; however, their lipid-lowering effectiveness in psoriasis patients across smoking statuses remains incompletely understood. This study evaluated whether smoking status influences LDL-C before and after statin initiation in adults with psoriasis.

Methods: We conducted a retrospective chart review of adults with psoriasis treated at Thomas Jefferson University Hospital between 2014 and 2024 who were prescribed low- or moderate-intensity statins. Data collected included smoking status (current vs. former/never) and LDL-C values before and at …

Evaluating Concordance Between Ai-Generated Cartilage Grading And Physician-Reported Systems: A Scoping Review, Alex R. Charlton, Bs, Caroline A. Markmann, Bs, Isabella T. Wu, Md, Mph, Kevin B. Freedman, Md

Phase 1

Introduction: Accurate grading of cartilage pathology is essential for diagnosis and operative planning, yet physician-reported grading systems remain difficult to standardize. Artificial intelligence (AI)has the potential to automate cartilage assessment, but its methodology and clinical applicability remain unclear. This scoping review evaluates current applications of AI for cartilage grading and assesses their translational readiness.

Methods: A scoping review was conducted in accordance with PRISMA-ScR guidelines, including a systematic literature search, predefined eligibility criteria, transparent study selection, and structured data extraction. Eligible studies included English-language human research describing AI models for cartilage evaluation that were assessed against human or clinical grading …

Evaluating The Clinical Utility Of Large Language Models In Otolaryngology Patient Education, Shaunak Ganju, Bs, Adam Luginbuhl, Md

Phase 1

Introduction

Large Language Models (LLMs) have rapidly entered consumer-facing health information platforms, yet their reliability for patient education remains uncertain. Otolaryngology involves complex surgical procedures where clear perioperative counseling is essential for patient understanding and safety. This project evaluates whether LLMs can provide accurate and readable answers to common perioperative questions for septoplasty and cochlear implant procedures. We hypothesized that LLMs would generate accurate responses with readability levels appropriate for patients, with ChatGPT performing best.

Methods

Two common pre-operative and two post-operative questions for septoplasty and cochlear implantation were converted into standardized prompts. Each prompt was submitted to ChatGPT-5.1 and …

Utility Of Neurosurgery-Specific Rag-Llm In Accurate Patient Outcome Prediction, Alexander Hone, Basel Musmar, Joanna Roy, Pascal Jabbour

Phase 1

Large Language Models (LLMs) have been previously utilized in the medical field to successfully generate information. However, LLMs may hallucinate, which generates a response based on false or misleading information. This can negatively impact healthcare outcomes, thus, there is an increasing need to develop a model free of hallucinations.

A multi-target voting ensemble (Random Forest with HistGradientBoosting) algorithm was utilized in the analysis of 454 training data and 114 test data. Raw accuracy and macro-F1 statistics determined that the model is capable of identifying clinically meaningful data for majority classes, while minority-class detection was insignificant. This demonstrates moderate predictive value …

Noninvasive Patient-Level Detection Of Nafld Using Mri Radiomics And Machine Learning, Vladimir Kirichenko, Rajanikanth Vadigepalli

Phase 1

Introduction— Current noninvasive assessment of nonalcoholic fatty liver disease (NAFLD) relies primarily on MRI-based fat quantification, such as proton density fat fraction (PDFF). This study explored the use of an MRI radiomics–based machine learning approach for accurate patient-level classification of NAFLD.

Methods— Liver MRI images from patients with suspected NAFLfD were retrospectively analyzed. Radiomics features were extracted using PyRadiomics from full-liver masks across 4–6 axial slices per patient. Slice-level features were aggregated to the patient level using summary statistics (mean, median, and standard deviation). To reduce redundancy and multicollinearity, features were pruned using Pearson correlation analysis with a threshold of …

Smart Heart: Assessing The Impact Of An Electronic Health Record Intervention On Guideline-Directed Medical Therapy Prescribing In Heart Failure, Shriya Baweja, Bsc, Alan Kubey, Md, Facp

Phase 1

Introduction: Heart failure (HF) affects millions in the U.S., yet guideline-directed medical therapy (GDMT) and the supportive utilization of EHR-based clinical decision support systems (CDSS) for uptake remain underexplored. This project evaluated whether CDSS implementation increased GDMT prescribing at discharge for patients with HFrEF/HFimpEF.

Methods: The analysis included HF patients discharged from 11 hospitals on our enterprise EHR (Epic) from July 2023 to June 2025. Data was extracted from an automated data platform (Qlik). Patients were grouped into matched pre- and post-intervention periods, accounting for seasonality and concurrent financial and multidisciplinary workgroup HF initiatives. CDSS tools implemented in November 2024 …

Shield-Up: Screening For Home Gun Inventory: Education And Lock Distribution In Urban Philadelphia, Brendan Chen, Tinysha Mims, Chanel Sumpter, Kevin Carroll, Wanique Handy, Darnell Gray-Taylor, Patrick Moeller, Quinn Plunkett, Christine Pham, Mph, Nicola Cianci, Christine James, Phd, Lsw, Amy Leader, Drph, Mph, Joria Le, Rn, Bsn, Christopher Wetzel, Jen Geller, Md, Rosemary Frasso, Phd, Msc, Cph, Stanton Miller, Md, Mph

Phase 1

Purpose: Between 2009-2017, there was an average of 42,847 emergency department (ED) visits per year for unintentional nonfatal gun injuries. Current literature shows gun locks are effective in preventing unintentional gun-related injuries. We hypothesize that cancer screening outreach events with community health workers are an effective manner of distributing gun locks and the distribution of gun locks results in behavior modification towards utilization of safe storage practices.

Methods: Community health workers at the screening events register participants through an 8- question consent form. Participants then complete a 24-question baseline survey to consenting participants asking about firearm ownership status, firearm storage …

Comparative Analysis Of Demographic Data For Eligible Lifestyle Medicine Program Participants, Cajetan Ejianreh, Amy Cunningham

Phase 1

Introduction: Obesity is a major comorbidity linked to a myriad of health complications and poor treatment outcomes. Through partnership with the PCORI Institute, a comprehensive lifestyle medicine program is being developed to refer eligible patients within the Jefferson Health System. This comparative analysis aims to identify the demographics of these eligible patients.

Methods: Data was extracted from EPIC electronic health record from patients who had a “qualifying” encounter with one of the following specialties: OB/GYN, Geriatrics, Internal Medicine, and Family Medicine. Qualification of patients in this data collection was based on an encounter with one of the aforementioned specialties within …

Seeing What Sticks: Evaluating Factors That Affect Adoption Of A Novel Heart Failure Order Set At An Academic Medical Center, Maela Whitcomb, Alan Kubey, Md

Phase 1

Introduction: Guideline-directed medical therapy (GDMT) improves heart failure outcomes, yet GDMT prescribing is low. Order sets can alter prescribing behavior. This study seeks to identify characteristics associated with order set use.

Methods: We conducted a retrospective cohort study on 841 adult patients admitted to TJUH with a primary diagnosis of heart failure. Variables included type of service (cardiology, hospital medicine, emergency department and other), whether the service attending was incentivized, and patient status (inpatient, observation). Association with order set use using chi-square tests. Data were extracted using Qlik. Analyses were conducted using Microsoft Excel. P-values of less than 0.05 were …