Digital Commons Network^™

Leveraging Ancestral Recombination Graphs For Scalable Mixed-Model Analysis Of Complex Traits, Jiazheng Zhu, Georgios Kalantzis, Ali Pazokitoroudi, Árni Freyr Gunnarsson, Hrushikesh Loya, Han Chen, Sriram Sankararaman, Pier Francesco Palamara

Faculty, Staff and Student Publications

Recent algorithmic advances have enabled the inference of genome-wide ancestral recombination graphs (ARGs) from large genomic cohorts, providing detailed models of genealogical relatedness along the genome. These inferred ARGs can complement genotype imputation by capturing the effects of unobserved variants, but their use in large-scale linear mixed-model analyses has been computationally prohibitive. Here, we develop methods that leverage the ARG to perform genotype-matrix multiplications in sublinear time and implement scalable randomized algorithms for mixed-model analyses. We introduce ARG-RHE, a randomized Haseman-Elston approach for estimating narrow-sense heritability and performing region-based association testing using ARGs, enabling parallel analysis of multiple quantitative traits. …

Correction: The Hsp90-Myc-Cdk9 Network Drives Therapeutic Resistance In Mantle Cell Lymphoma, Fangfang Yan, Vivian Jiang, Alexa Jordan, Yuxuan Che, Yang Liu, Qingsong Cai, Yu Xue, Yijing Li, Joseph Mcintosh, Zhihong Chen, Jovanny Vargas, Lei Nie, Yixin Yao, Heng-Huan Lee, Wei Wang, Johnnelson R Bigcal, Maria Badillo, Jitendra Meena, Christopher Flowers, Jia Zhou, Zhongming Zhao, Lukas M Simon, Michael Wang

Faculty, Staff and Student Publications

No abstract provided.

Identifying Alzheimer's Disease Progression Subphenotypes Via A Graph-Based Framework Using Electronic Health Records, Yu Huang, Jie Xu, Zhengkang Fan, Yu Hu, Xing He, Aokun Chen, Yuxi Liu, Rui Yin, Jingchuan Guo, Steven T Dekosky, Michael Jaffee, Manqi Zhou, Chang Su, Fei Wang, Yi Guo, Jiang Bian

Faculty, Staff and Student Publications

Understanding the heterogeneity of neurodegeneration in Alzheimer's disease (AD) and identifying distinct progression pathways is critical for improving diagnosis, treatment, prognosis, and prevention. Motivated by this need, this study aimed to identify disease progression subphenotypes among patients with mild cognitive impairment (MCI) and AD using electronic health records (EHRs). We developed a novel approach that combines a graph neural network (GNN)-based framework with time series clustering to characterize progression subphenotypes from MCI to AD. We applied the proposed framework to a real-world cohort of 2,525 patients (61.66% female; mean age 76 years), of whom 64.83% were Non-Hispanic White, 16.48% Non-Hispanic …

Third-Party Effects On Intergroup Trust: The Role Of Punishment/Compensation And Group Regulatory Focus, Xiaowei Geng, Jie Cui, Jie Wang, Feng Zhang, Wei Wang

Faculty, Staff and Student Publications

Intergroup trust refers to a collective prediction and belief among members of one group regarding those of another in intergroup interactions. It plays an important role in avoiding intergroup conflicts, and thereby sustaining social development. This study was designed to investigate the effects of third-party punishment and compensation, as well as group regulatory focus, on intergroup trust. The findings revealed that, at both individual and group levels, prevention-focused groups exhibited higher levels of intergroup trust than promotion-focused groups under third-party compensation conditions. In contrast, under the third-party punishment conditions, promotion-focused groups displayed greater trust than prevention-focused groups, although this difference …

Identification Of Gene Signatures Of Metabolic Dysfunction-Associated Steatotic Liver Disease In Patients With Pancreatic Ductal Adenocarcinoma Via Whole Transcriptome Sequencing, Chaitanya Karimanasseri Bse, Pongsakorn Choochuen Md, Phd, Yotsawat Pomyen Phd, Hien Dang Phd

Phase 1

Introduction
Pancreatic ductal adenocarcinoma (PDAC) is a leading cause of cancer-related mortality worldwide. While the only curative treatment for PDAC is surgical excision of the tumor, often surgery is ineffective due to early metastasis to other organs. A better understanding of PDAC’s risk factors would contribute to earlier PDAC diagnoses and thus more effective surgical resections before metastasis occurs.

One pathology related to PDAC is metabolic dysfunction-associated steatotic liver disease (MASLD), a metabolic disease leading to triglyceride accumulation in the liver. MASLD is known to cause worse PDAC outcomes versus non-MASLD PDAC. Further elucidating the mechanism through which MASLD increases …

Mapping The Pathology Competencies For Medical Education (Pcme) To The Sidney Kimmel Medical College’S Jeffmd Gi Curriculum, Emma Sanders, Alexander Macnow, Md, Mhpe

Phase 1

Introduction/Purpose: Sidney Kimmel Medical College’s competency-based curriculum, JeffMD, is structured around SMART objectives. However, evaluation of the alignment of these objectives against the PCME, a collection of graduation competencies published by the Association for Academic Pathology, has not yet been performed. This study investigated how comprehensively the GI/Liver block of the JeffMD curriculum addresses the corresponding PCME learning objectives, thereby piloting a pathology curriculum map and allowing evaluation of this curriculum.

Methods: In this study, a curriculum map was created of all learning events covered within the JeffMD GI/Liver block. Each learning event was cross-matched with competencies within the gastrointestinal …

Interviewing Rural Primary Care Physicians To Inform Learning Objectives For A Rural Health Curriculum, Luke May, Caleb Gayman, Robert J. Motley, Md, Mhcds

Phase 1

Introduction/Purpose: Pennsylvania has a large rural population with too few physicians to meet medical needs. The Physician Shortage Area Program (PSAP) at SKMC works to address the shortage of primary care physicians in rural Pennsylvania. To adequately prepare future rural physicians, this project sought to obtain input from practicing PSAP graduates to inform learning objectives for a future curriculum intervention for preclinical PSAP students.

Methods: The target learner population is preclinical PSAP students at SKMC. A codebook was generated based on SKMC Graduation Competencies. Semi-structured interviews with PSAP graduates were conducted via video call, focused on those graduates practicing primary …

Interviewing Rural Primary Care Physicians To Inform Learning Objectives For A Rural Health Curriculum, Caleb Gayman, Luke May, Robert J. Motley, Md, Mhcds

Phase 1

Introduction/Purpose: There is a significant shortage of physicians in rural Pennsylvania. Programs like the Physician Shortage Area Program (PSAP) at SKMC aim to address this gap by providing support and guidance for medical students who grew up in rural areas and hope to return to practice in a rural area. This project focuses on identifying rural health topics and modes of delivery recommended by practicing primary care physicians to inform new learning objectives (LOs) for a future curriculum intervention for first and second-year medical students.

Methods: SKMC PSAP graduates practicing in rural areas were interviewed using semi-structured interviews that included …

Artificial Intelligence In Case-Based Learning: A Survey Of Student Current Practices In Small Group Self-Directed Learning Pedagogy, Clarice Pamplona, Joshua Kim

Phase 1

Introduction: Although Artificial Intelligence (AI) is expected to become an essential clinical tool, its incorporation into the undergraduate medical curricula is disproportionately lacking. Notably, limited research remains on medical student use and perspective on AI, specifically within small-group learning settings. This study explores AI use and perspectives among medical students within Case-Based Learning (CBL) groups at Sidney Kimmel Medical College (SKMC) with the aim to establish a formal AI curriculum.

Methods: The population studied includes the Class of 2028 at SKMC. An anonymous Qualtrics survey was distributed within the class Group Me between April and May 2025, exploring student demographics, …

Agent-Based Modeling Of Cellular Dynamics In Adoptive Cell Therapy, Yujia Wang, Stefano Casarin, May Daher, Vakul Mohanty, Merve Dede, Mayra Shanley, Eleonora Dondossola, Ludovica La Posta, Rafet Başar, Katayoun Rezvani, Ken Chen

Faculty, Staff and Student Publications

Adoptive cell therapies (ACT) leverage tumor-immune interactions to cure cancer. Despite promising phase I/II clinical trials of chimeric-antigen-receptor natural killer (CAR-NK) cell therapies, molecular mechanisms and cellular properties required to achieve clinical benefits in broad cancer spectra remain underexplored. While in vitro and in vivo experiments are essential, they are expensive, laborious, and limited to targeted investigations. Here, we present ABMACT (Agent-Based Model for Adoptive Cell Therapy), an in silico approach employing agent-based models (ABM) to simulate the continuous course and dynamics of an evolving tumor-immune ecosystem, consisting of heterogeneous "virtual cells" created based on knowledge and omics data observed …

Precision Chemotherapy In Biliary Tract Cancer Moving From Empiric Intensification To Biomarker-Guided Treatment: Editorial On "Molecular Determinants Of Outcome To Gemcitabine, Cisplatin, And Nab-Paclitaxel In Patients With Advanced Btc", Sung Hwan Lee, Ahmed O Kaseb, Ju-Seog Lee

Faculty, Staff and Student Publications

No abstract provided.

The George-Anne Daily, Georgia Southern University

George-Anne Media Group: Newsletters & Magazines

No abstract provided.

The End Of Means-End Scrutiny, Francesca Procaccini

Duke Law Journal

It is black-letter law that courts apply means-end scrutiny to evaluate laws that burden constitutional rights. Not anymore. Discreetly and pervasively, the Supreme Court has ousted means-end scrutiny from constitutional law. It has done so through a series of smaller and seemingly unconnected doctrinal incursions, including the introduction of history and tradition tests, the transformation of equality doctrines, and the embrace of formalist rules to govern constitutional law.

This Article provides a complete and interconnected critique of the numerous doctrinal transformations that together comprise the larger constitutional revolution of ending means-end scrutiny. It tracks how this upheaval now touches nearly …

Supervising The Omnipresent Casino: Evaluating The Role Of State And Local Regulation In Stemming Youth Addiction To Sports Gambling, Matthew Connor Flink

Duke Law Journal

Since 2018, state legalization of sports betting and the industry’s corresponding proliferation has driven an epidemic of youth addiction. Current state legislation and regulations do little to combat youth addiction. Many legal scholars emphasize the value that a federal regulatory regime would provide to reign in youth sports betting. This Note explores the value that state and local government can have in the sports gambling space. To illustrate the unique importance of state and local legislation and regulation of sports betting, this Note analogizes to another addictive product with a history of youth addiction: nicotine.

Nicotine has been a regulatory …

Balancing Acts: Gender Parity Law And Cultural Boundaries In Senegal, Seulgie Lim

All Faculty Scholarship

This article investigates the intersection of global gender equality norms with local contexts, focusing on Senegal’s implementation of the 2010 gender parity law. Despite the global trend towards electoral gender quotas, the effectiveness and societal acceptance of these measures vary significantly. Through a critical examination of existing literature on gender quotas and an analysis of the parity law’s reception in Senegal, this article explores the nuanced dynamics between legislative measures and societal norms. It argues that, while gender quotas can enhance women’s visibility in politics, deeply ingrained cultural and religious norms may undermine the more substantive impact of such legislated …

Three-Dimensional Versus Two-Dimensional Echocardiographic Assessment Of Left Atrial Volume And Deformation In Children, Alexander J Kiener, James Croft, Krista N Harris, Ankona Banerjee, Aura A Sanchez, Xander H T Wehrens, Anitha Parthiban, Xiaotian Gao, Tam T Doan, Minh B Nguyen

Faculty, Staff and Students Publications

Background: Left atrial (LA) volume and function are important for assessing pediatric diastolic dysfunction (DD). Three-dimensional echocardiographic (3DE) LA assessment may overcome limitations and assumptions inherent in two-dimensional echocardiographic (2DE).

Methods: We conducted a cross-sectional study of children under 18 years of age with structurally normal hearts, using transthoracic 3DE apical volume datasets. LA volumetric function and phasic deformation analyses were performed using 3DE (GE, EchoPAC 4DLAQ v206, near fully-automated) and 2DE (TomTec, TTA2.51, CPA, manual) was performed by three operators and processing time was collected. Agreement and reproducibility was assessment for each modality.

Results: Fifty patients (median age 12.8 …

2025 State Of Nonprofits And Philanthropy Annual Report, Tessa Tinkler, Cristina Sanchez-Kerr, Laura Deitrick, Eo Hanabusa, Bryan Cardenas, Timothy Nelson, William Piper

State of Nonprofits and Philanthropy in San Diego

The 2025 State of Nonprofits and Philanthropy in San Diego examines how federal policy changes, funding volatility, and rising community needs are reshaping the region’s nonprofit sector. Drawing on survey data from nonprofit leaders and employees, public opinion polling, and financial and employment analysis, the report provides an early assessment of the sector’s financial health, workforce capacity, and its role as a primary access point for services such as housing, food, education, healthcare, and the arts. It highlights mounting pressures on nonprofit infrastructure alongside the sector’s enduring strengths in public trust, collaboration, advocacy, and shared investment strategies that will shape …

Community Participatory Co-Design And Development Of A Digital Diabetes Prevention Education Program For Hispanic Families With Obesity: Mixed Methods Study, Sandra Mihail, Marbelly Partida, Lizette Villanueva, Debbe Thompson, Teresia M O'Connor, Salma M Musaad, Maria J Redondo, Erica G Soltero

Children’s Nutrition Research Center Staff Publications

Background: Digital health interventions (DHIs) can extend the reach of disease prevention interventions; however, few are evidence-based, theoretically grounded, or developed for high-risk youth and families. Co-design approaches engage end users in the design and development of the DHI, which can lead to increased accessibility and engagement.

Objective: This study aimed to describe the adaptation of an evidence-based diabetes prevention program for remote, digital delivery.

Methods: The adaptation of the in-person intervention was guided by a modified Inclusive Digital Health Intervention Design to Promote Health Equity framework and conducted in collaboration with Hispanic adolescents (n=23) with obesity (BMI ≥95th percentile) …

Final 2022 Unreclaimed Sites Sampling: Ur-28 Site Evaluation Summary Report, Pioneer Technical Services, Inc.

Silver Bow Creek/Butte Area Superfund Site

No abstract provided.

Prevalence Of Premenstrual Syndrome, Premenstrual Dysphoric Disorder, And Dysmenorrhea In Nursing Students: A Systematic Review, Meta-Analysis, And Evidence-Based Recommendations, Sabyasachi Maity, Bharathi Gadad, Hansapani Rodrigo, Seham Noorani, Ayesha Usman, Chloe Lark, Mona Attarpour, Ivy Mageto, Lucas Schwartz, Nikhilesh Anand

School of Medicine Publications

Introduction: Menstrual disorders—including premenstrual syndrome (PMS), premenstrual dysphoric disorder (PMDD), and dysmenorrhea—are highly prevalent among women of reproductive age and are associated with impaired academic performance, psychological distress, and reduced social functioning. Nursing students are particularly vulnerable due to the combined demands of intensive academic schedules and clinical training, yet prevalence estimates and institutional responses remain inconsistent.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO (CRD420251109363). PubMed, Scopus, Web of Science, CINAHL Ultimate, and APA PsycINFO were searched for studies published between 2016 and 2025. Eligible studies reported prevalence or …

Sand Fly Endosymbionts In Kenya: Rickettsia And Wolbachia Associations With Leishmania And Detection Of Rickettsia Africae, Steve Kiplagat, Damaris Matoke-Muhia, Barrack O. Owino, David P. Tchouassi, Daniel K. Masiga, Gregory D. Hurst, Jandouwe Villinger

All Peer-Reviewed Publications

BACKGROUND: Sand flies are small hematophagous insects known as leishmaniasis vectors. Similar to most arthropods, they harbor nonobligate endosymbionts that may influence host adaptation and pathogen transmission, but these symbiont communities remain poorly characterized in Leishmania-endemic African sand flies. METHODS: We screened 1700 wild-caught phlebotomine sand flies (1266 females, 434 males) from Kenya's Baringo, Nakuru, and Kajiado counties, and 253 colony Phlebotomus duboscqi, for Rickettsia, Wolbachia, Spiroplasma, Cardinium, Arsenophonus, Microsporidia, and Leishmania by high-resolution melting analysis and sequencing of PCR products. RESULTS: In wild sand flies (Phlebotomus and Sergentomyia spp.), Wolbachia spp. were most common (8.5%, 145/1700), with particularly high …

Retrieving Personalized Content Using Ai Agents And User Profile Information, Benjamin Azose, Akancha Gupta

Defensive Publications Series

Agentic workflows can automate many user journeys. However, when a user journey involves choosing between different options, e.g., dietary preferences, the AI agent may be inadequate in automating the user journey, requiring manual actions and/or user inputs to make a choice. This disclosure describes techniques that automate agentic workflows by permitting an AI agent to access user preferences from a user profile prior to performing a corresponding task. With user permission, user preferences are obtained via explicit input, user browsing history, transactions, etc. and are stored in a user profile that is accessible to AI agents. When summoned to perform …

Emotional Intelligence : The Road To Professionalism Development, Wuttipat Iammeechai, Tanapat Prakairungtong

Chulalongkorn Medical Journal

Abstract

Medical professionalism development is a significant challenge of medical education, even though it is essential for medical practitioners. The Dynamics and ambiguity of medical professionalism cause difficulty in setting specific learning objectives, creating validated assessment methods, and designing effective teaching methodologies. Meanwhile, emotional intelligence is a growing area of study in medical education. There is a significant connection between medical professionalism and emotional intelligence. Certain attributes of emotional intelligence contribute to developing professionalism. Numerous pieces of literature illustrated emotional intelligence development and assessment in health professions education. Emotional intelligence is potentially the path to developing medical professionalism.

Bioprinting: Revolutionizing Biology With 3d Innovation, Gopalarethinam Janani Ms, Naven Kumar Rk, Agnishwar Girigoswami Prof, Koyeli Girigoswami Prof

Chulalongkorn Medical Journal

3D bioprinting is an innovative technology that enables the creation of bioengineered structures through computer-guided processes. This technique has been in use for more than 35 years and has made a huge contribution in the biomedical field. Utilizing biomaterials with regenerative properties has significantly impacted tissue engineering, regenerative medicine, and pharmaceutical research. Various bioprinting techniques, including inkjet, extrusion, laser-assisted, and stereolithography, offer unique advantages for precise tissue construction. Bioinks used for printing, can be derived from natural and synthetic sources. It ensures biocompatibility, mechanical integrity, and controlled degradation. Advanced bioinks—such as nanoengineered, biomolecular, multimaterial, self-assembling, and stimuli-responsive variants—enhance applications in …

A Rare Case Of Hirayama Disease With Ulnar Nerve Palsy: Expanding The Clinical Spectrum, Chaitanya Kulkarni, Medhavi Joshi, Sakshi Mhase, Manasi Metkar

Chulalongkorn Medical Journal

ABSTRACT

Hirayama disease, or monomelic amyotrophy, is a rare, self-limiting cervical myelopathy that primarily affects young males. It leads to muscle atrophy and weakness, especially in the hands and forearms, often due to cervical spinal cord compression during neck flexion. We report a case of a 41-year-old female from rural India who presented with progressive weakness in her left hand, resulting from ulnar nerve compression. The patient was unable to actively extend the metacarpophalangeal joint of her left hand, significantly impairing her hand function. Notably, she did not exhibit autonomic symptoms, which are commonly seen in cervical myelopathies. This case …

Etiologies, Management, And Outcomes Of Pediatric Stroke In A Tertiary Care Center, Supinya Naruphanthawart, Tanitnun Paprad, Tanai Trongmonthum, Tunchanok Paprad, Krisanachai Chomtho

Chulalongkorn Medical Journal

Background

Recent developments in neuroimaging and treatments, such as thrombolysis and endovascular thrombectomy, have improved across pediatric stroke diagnosis and management. However, no contemporary data exist on stroke characteristics related to clinical outcomes among Thai children.

Objectives

To study clinical characteristics, investigations, and treatments associated with outcomes in Thai pediatric stroke patients.

Methods

Methods: We enrolled children aged 28 days to 18 years with "cerebrovascular disease" recorded as ICD 10 and inpatient records from January 2011 to September 2022. Outcomes included disability at discharge (mRS grade 4-5), in-hospital mortality, and two-year recurrent stroke rate.

Results

Of 206 patients, 53.4% had …

Treatment Outcomes And Factors Associated With Treatment Failure Among Mild-Moderate Covid-19 Patients Receiving Five-Days Oral Molnupiravir Vs Three-Days Intravenous Remdesivir In A Real-World Practice, Sarawut Kittikasemsook, Pattama Torvorapanit, Chotirat Nakaranurack

Chulalongkorn Medical Journal

Background: The initiation of antiviral treatment for coronavirus disease 2019 (COVID-19) is based on the patient's risk of developing severe symptoms. Molnupiravir and remdesivir are new antiviral agents with limited data in real-world practice, especially in Thailand.

Objectives: This study aimed to evaluate the treatment outcomes, adverse drug reactions (ADRs), and factors associated with treatment failure in mild-moderate symptoms of adult COVID-19 who received molnupiravir or three days- intravenous remdesivir at the initiation of treatment.

Methods: This retrospective study was conducted at King Chulalongkorn Memorial Hospital, Thai Red Cross Society. The inclusion criteria were mild-moderate symptoms of COVID-19 patients …

Diagnostic Accuracy Of Cerebral Amyloid Angiopathy Criteria In The First Pathologically Confirmed Thai Cohort: A Pilot Study, Thanapoom Taweephol, Thachamai Smitasiri, Thanakit Pongpitakmetha, Sekh Thanprasertsuk, Anand Viswanathan

Chulalongkorn Medical Journal

Background: The gold standard for diagnosing cerebral amyloid angiopathy (CAA), full brain post-mortem examination, is rarely performed. Current diagnostic criteria, primarily based on clinico-radiological features, were developed from Western populations and may have limited applicability to Asian populations.

Objective: We aimed to evaluate the accuracy of current diagnostic criteria and examine the clinico-radiological characteristics of Thai CAA patients.

Methods: Brain histopathological specimens from patients with clinical symptoms of CAA who underwent neurosurgical procedures, including intracerebral hemorrhage (ICH) evacuation, between 2011 and 2021 at King Chulalongkorn Memorial Hospital, Thailand, were reviewed. Patient characteristics and clinical events for each individual were retrospectively …

How Does Pattern Of Bone Healing Affect The Strain Of Plate Implant Via Frequency Detection? A Biomechanical Cadaveric Study, Chavarin Amarase, Chanyaphan Virulsri, Pairat Tangpornprasert, Pisitpong Chancharoen, Saran Tantavisut

Chulalongkorn Medical Journal

Background: Detecting bone union is a crucial process in treating bone fractures to prevent complications, including implant failure and bone nonunion. Nowadays, there are many methods and new innovative devices for detecting bone union through strain measurements, such as strain gauges, fluid level displacement, contrast media, and frequency changes. There is also a trend toward increasing these methods in the future. However, the patterns of bone healing studied with these methods still do not provide a standard for determining the true bone healing process. The aim of this study is to identify the most appropriate bone healing pattern for …

Elucidation Of Hub Genes And Pathway Associated With Gut Microbiome Dysbiosis And Alzheimer’S Disease Via Data Analytic Approaches, Premaanand Rawi, Ying Pei Wong, Ee Xion Tan, Anna Pick Kiong Ling

Chulalongkorn Medical Journal

Background: Recent studies have highlighted the relationship between gut microbiome and Alzheimer’s disease (AD), revealing the ways of how gut microbial balance impacts conditions ranging from inflammatory bowel diseases to neurological disorders. The emerging field of the gut-brain-axis suggests production of microbial metabolites influences AD progression. However, there is limited understanding of molecular mechanisms involved in neurological disease when gut microbiome dysbiosis occurs. This study aimed to identify hub genes and pathways associated with gut microbiome dysbiosis and AD through data analytics approaches.

Methods: Public gene expression datasets on gut microbiome dysbiosis, and AD were obtained from the GEO and …