Digital Commons Network^™

Performance Of Fecal Calprotectin And Serum Procalcitonin For The Diagnosis Of Spontaneous Bacterial Peritonitis In Patients With Cirrhosis: A Prospective Diagnostic Accuracy Study, Mandip Singh Bhatia, Devarakonda Uday Teja, Nipun Verma, Archana Angrup, Saurabh Chandrabhan Sharda

Faculty, Staff and Students Publications

Background:: Spontaneous bacterial peritonitis (SBP) is a life-threatening complication in patients with cirrhosis and ascites. This study aimed to evaluate the diagnostic performance of biomarkers—calprotectin (serum, ascitic, fecal) and serum procalcitonin (PCT)—for SBP.

Methods:: This prospective diagnostic accuracy study, enrolled 137 consecutive patients with cirrhosis and ascites at a tertiary care center in India. Participants were categorized into SBP (n = 55) and non-SBP (n = 82) groups based on the reference standard of ascitic fluid neutrophil count. Serum, ascitic fluid, and fecal calprotectin were measured by enzyme-linked immunosorbent assay, and serum PCT was measured by electrochemiluminescence immunoassay. …

Development And Validation Of The A-Tango Organ Failure Score For Acute-On-Chronic Liver Failure In Global Cohorts, Cornelius Engelmann, Nipun Verma, Tingting Qi, Annarein Johanna Catharina Kerbert, Julian Pohl, Carrie Morgan, Michal Kowalski, Fausto Andreola, Marcelo Oscar Silva, Jose Luis Perez Hernandez, Renato Palma-Fernandez, Manuel Mendizabal, Osvely Mendez-Guerrero, Jose Luis Marin, Sebastián Marciano, René Male-Velazquez, Maria Sarai González-Huezo, Adrian Gadano, Fernando Bessone, Carlos Benitez, Oscar Alfredo Beltran Galvis, Mauricio Castillo Barradas, Marco Arrese, Karen Vagner-Danielsen, Peter Jarcuska, Boglarka Balogh, Zsuzsanna Vitalis, Antonella Putignano, Manuel Tufoni, Michael Manns, Claire Francoz, Manuel Romero-Gomez, Stephen Ryder, Pierre Nahon, Sven Francque, Osman Özdogan, Cristina Sole, Jose Presa Ramos, Heinz Zoller, Manuela Merli, Flemming Bendtsen, Thomas Berg, Alexander Zipprich, Pietro Gatti, Juan Acevedo, Martin Janicko, Frank Erhard Uschner, Carmine Gabriele Gambino, Giacomo Zaccherini, Xianbo Wang, Xin Zheng, Guohong Deng, Yan Huang, Zhongji Meng, Yanghang Gao, Zhiping Qian, Xiaobo Lu, Feng Lui, Yu Shi, Jia Shang, Yubao Zheng, Yingli He, Sunil Taneja, Pratibha Garg, Hans Van Vlierberghe, Christian Steib, Rudolf Stauber, German Soriano, Raj Mookerjee, Henning Gronbaek, Andrea De Gottardi, Minneke Coenraad, Rafael Banares, Stefan Zeuzem, Alexander Gerbes, Marco Domenicali, Faouzi Saliba, Francois Durand, Hai Li, Ajay Duseja, Jinjun Chen, Rajiv Jalan

Faculty, Staff and Students Publications

Background & aims: Acute-on-chronic liver failure (ACLF) is characterised by multiorgan failure and high short-term mortality in hospitalised patients with acute decompensation of cirrhosis. Although the EASL-CLIF criteria are widely used for diagnosis and prognostication, evolving definitions of organ dysfunction and emerging therapies require updated, tailored criteria to improve diagnostic accuracy, treatment assessment, and applicability in clinical trials. We aimed to develop and validate the A-TANGO organ failure (OF) score to refine ACLF diagnosis and enhance its utility for treatment response evaluation and risk stratification.

Methods: We performed a retrospective analysis of prospective observational cohorts. The derivation cohort comprised three …

Mental Health Stigma In Latin American Youth With Obsessive-Compulsive Disorder, Ryan J Mccarty, Matias Jensen, Elissa Paz Jensen Santa Cruz, Melisa N Sagarnaga, Pamela Claisse Quiroz, Tomás Miño, Paola Giusti-Rodriguez, Mayra C Martinez Mallen, Maria B Moyano, Dayan Berrones, Jacey L Anderberg, Renee M Frederick, Hannah C Moore, Josselyn S Muñoz, Vanessa Zavala Cruz, Latin American Trans-Ancestry Initiative For Ocd Genomics (Latino), Brazilian Obsessive-Compulsive Spectrum Working Group (Gttoc), Ogechi C Onyeka, Andrew D Wiese, James J Crowley, Eric A Storch

Faculty, Staff and Students Publications

Obsessive-compulsive disorder (OCD) is an impairing mental health condition that affects individuals across the lifespan. Some literature has evaluated mental health stigma in adults with OCD but limited attention has been given to youth, as well as those of Latino ancestry. The present study reported the extent of stigma experiences among Latin American youth with OCD, as well as examined sociodemographic, clinical and psychological correlates. 235 youth with clinician confirmed diagnoses of OCD from 10 North and South American countries completed questionnaires assessing stigma experiences, symptomatology, and functioning. Sociodemographic and clinical variables were also collected. The average OCD stigma response …

Quality Domains In Home-Based Pediatric Hospice And Palliative Care: Adolescent And Young Adult Perspectives, Daniel H Grossoehme, Claire A Crawford, Jhansi Chandra Ellakula, Toluwalase Ajayi, Justin N Baker, Sarah Friebert, Lisa Humphrey, Jillann Jarrell, Rachel Thienprayoon, Pamela S Hinds

Faculty, Staff and Students Publications

Background: Current United States palliative care practice guidelines are intended to cover care across all age groups. Previous research with pediatric providers and caregivers concluded that pediatric hospice and palliative care have unique attributes. Not known is how adolescent hospice and palliative care patients understand quality palliative care. The purpose of this study was to characterize and define quality of care domains as described by adolescent and young adult patients receiving home-based hospice and palliative care.

Methods: Semi-structured interviews with 10-26 year-olds who received home-based hospice and/or palliative care visits in the prior three years at six diverse sites in …

An Examination Of Buprenorphine And Norbuprenorphine Concentrations In Inpatients Receiving Medications For Opioid Use Disorder, Michèle Haykal, Benjamin Li, Andres Avellaneda Ojeda, Roberto Sanchez, Nancy Shenoi, Asim Shah, Nidal Moukaddam

Faculty, Staff and Students Publications

Background: Interpretation of urine buprenorphine and norbuprenorphine concentrations is widely used to assess adherence during treatment for opioid use disorder. However, the relationships between dose, timing of sample collection, and metabolite ratios remain unclear, leading to potential misinterpretation in clinical practice.

Methods: Data were collected from patients on a psychiatry unit who were either inducted on or continued buprenorphine therapy and underwent urine testing for buprenorphine and its metabolite, norbuprenorphine. Urine samples were collected 16 to 786 min after the last buprenorphine dose. Norbuprenorphine-to-buprenorphine ratios were calculated. Data analysis using Python included polynomial regression and random forest models.

Results: Daily …

Reciprocal Compensation Of Caspase-2 And P53 Regulates The Dna Damage Response In Hct116 Colon Cancer Cells, Karla E Lopez, Leslie Bandera, Luiza E Coutinho, Karen Zúñiga, Sarah Wright, Lisa Bouchier-Hayes

Faculty, Staff and Students Publications

Caspase-2 has positive and negative effects on tumor growth in different cancer models. The mechanisms determining these dual outcomes of caspase-2 activation are unclear underscoring the need to assess caspase-2 function in different cell types. We report that high caspase-2 expression is associated with lower survival in patients with colon cancer and increased tumor size in HCT116 colon cancer xenografts. We investigated the interplay between caspase-2 and p53 in regulating the proliferation of these cells. While neither of these proteins had much of an effect on cell cycle arrest on their own, deficiency in both caspase-2 and p53 led to …

Development And Evaluation Of An Automated Report-Based Chart Checking Tool In External Beam Radiotherapy, Andrew Wroe

All Publications

Background: Computerized radiotherapy chart checking tools have revolutionized the initial physics chart review process as they offer verification of large amounts of plan parameters in seconds and allow physicists to concentrate on high-skill-level items that are challenging for automation. Both commercialized and in-house chart check solutions typically rely on access to the patient data within the live SQL database of the radiation oncology information system (ROS). This is a complex task potentially posing risks to both database integrity and overall system performance when accessed during clinic operation hours.

Purpose: The aim of this study was to develop and test a …

Mapping Dna Methylation Signatures To Identify Epigenetic Variation Across Subcortical Regions Of The Human Posttraumatic Stress Disorder Brain, Hongyu Li, Yujing Liu, Yiming Shi, Jiawei Wang, Tuan P Nguyen, Yuhan Xie, Wangjie Zheng, Youshu Cheng, Dianne A Cruz, Jennifer L Modliszewski, Rosemarie Terwilliger, Alexa-Nicole Sliby, José Jaime Martínez-Magaña, Janitza L Montalvo-Ortiz, John D Roache, Lynnette A Averill, Stacey Young-Mccaughan, Paulo R Shiroma, Bertrand R Huber, David A Lewis, Jill Glausier, Paul Holtzheimer, Matthew J Friedman, Jing Zhang, Alan L Peterson, Chadi G Abdallah, Amir Valizadeh, Xinyu Zhang, Ke Xu, John H Krystal, Ronald S Duman, Hongyu Zhao, David L Corcoran, Douglas E Williamson, Matthew J Girgenti

Staff and Researcher Publications

Background: Posttraumatic stress disorder (PTSD) is a mental disorder that may occur in the aftermath of severe psychological trauma. Epigenetic changes in the brain may play a critical role in understanding the neurobiology of PTSD by linking environmental traumatic stress exposure to lasting alterations in gene expression that shape neuronal function.

Methods: We examined 1,065,750 DNA methylation (DNAm) sites from 171 donors including neurotypical controls and PTSD and major depressive disorder (MDD) cases across 6 regions implicated in the fear circuitry of the brain. We performed RNA sequencing (RNA-seq) to examine changes in gene expression and linked these changes to …

Antibiotic Administration After Previable Preterm Prelabor Rupture Of Membranes Is Associated With Prolonged Latency, Alexandra L Hammerquist, Alexander M Saucedo, Selina L Bowler, Mohan Pammi, Catherine Eppes, Ignatia Van Den Veyver, Michael D Jochum, Enrico R Barrozo

Duncan NRI Faculty and Staff Publications

Introduction: While antibiotics have been shown to increase the interval to delivery between rupture of membranes and delivery (latency) and improve neonatal outcomes after viable preterm prelabor rupture of membranes (PPROM), this has not been well investigated in the previable PPROM population. We aimed to investigate the association between antenatal antibiotics and latency following previable PPROM. Secondarily, we examined various maternal and neonatal outcomes. We hypothesized that the administration of antibiotics would prolong latency in pregnancies with previable PPROM.

Methods: Single-center retrospective cohort study that included pregnancies diagnosed with previable PPROM between 140/7 and 216/7 and delivered between 2012 and …

Understanding The Experiences Of Faculty Members Who Teach Case Conceptualization, Asianna Harris

Dissertations (1934 -)

Competence in case conceptualization (CC) is a core skill in clinical training. However, many graduate programs lack a structured process for teaching this complex and dynamic clinical skill. While most research focuses on students’ perspectives on learning CC, there is a distinct gap in research on faculty experiences, successful teaching methods, and the assessment of teaching practices. Therefore, this study addressed the gap in extant literature by exploring how doctoral programs’ faculty taught transtheoretical CC and how they evaluated the effectiveness of their instruction. A Consensual Qualitative Research (CQR) design was employed to deeply examine the experiences of 13 faculty …

Carrying The Midwife’S Bag Across The Atlantic: German Midwives And Paraprofessional Midwifery In The Us, 1850s-1920s, Melanie Simone Lorenz

Dissertations (1934 -)

This dissertation compares the occupational development of midwifery in the United States and Germany between the 1850s and the 1920s. It examines how midwifery in nineteenth-century Germany developed into an early paraprofession through its inclusion in the paramedical division of labor and the creation of professional associations and a trade journal. In the United States, by contrast, such a development did not occur. Instead, physicians excluded midwives from the emerging paramedical division of labor. Even though a dedicated group of German American physicians and midwives attempted to replicate the German model of midwifery in St. Louis, Missouri, this paraprofessional form …

Coping With Uncertainty In Everyday Situations (Cues©): The U.S. Pilot Study, Sarah Lehman

Dissertations (1934 -)

Autistic youth experience anxiety at an increased rate compared to their neurotypical counterparts. The presence of anxiety often amplifies the social and functional difficulties faced by autistic youth, which can exacerbate poor outcomes. Intolerance of uncertainty (IU), defined as negative beliefs and reactions to unpredictable or ambiguous situations, has been identified as a key factor to the manifestation of anxiety in autistic populations. The current study aimed to replicate the protocol and results from Rodgers et al. (2023) by conducting the first U.S. pilot study examining the feasibility and efficacy of Coping with Uncertainty in Everyday Situations (CUES©); an 8-week …

Beyond The Catalog: Library Professionals' Adoption Of Ai And Ai Tools Through The Lens Of Utaut, Dr. Sankar P, Anjaline R

Library Philosophy and Practice (e-journal)

The exponential growth of Artificial Intelligence (AI) technology has radically changed the information landscape, making it essential to explore how library professionals perceive and utilize these new tools. This study examines attitudes of library professionals toward AI and AI-based tools through the lens of the Unified Theory of Acceptance and Use of Technology (UTAUT). A structured questionnaire survey was conducted amongst 165 library professionals from academic, public and special libraries spread across India. The study applies Structural Equation modeling (SEM) with the use of AMOS 26.0 to analyze the relationships among UTAUT constructs such as Performance Expectancy (PE), Effort Expectancy …

Integration Of A Task Strengthening Strategy For Hypertension Management Into Hiv Care In Nigeria: Baseline Characteristics Of Participants In A Cluster Randomized Controlled Trial, Weixi Chen, Juliet Iwelunmor, Et Al.

2020-Current year OA Pubs

BACKGROUND: Improved access to antiretroviral therapy (ART) has increased survival among people living with HIV (PLWH) but also the burden of cardiovascular risk factors like hypertension. While the task-strengthening strategy for hypertension control (TASSH) is a viable integrated care model, evidence of its clinical impact in Africa is limited. This report presents baseline findings from a trial evaluating 2 implementation strategies for integrating TASSH into HIV care across primary health centers (PHCs) in Lagos, Nigeria.

METHODS: A total of 3,504 PLWH on antiretroviral therapy in 30 PHCs were screened, and 830 were enrolled. Baseline data on patient sociodemographic, clinical, laboratory …

Managing Risks Under Nuclear Power Plant Projects: A Latent Similarity-Guided Contract Customization, Mariam Elazhary, Islam H. El-Adaway

Civil, Architectural and Environmental Engineering Faculty Research & Creative Works

Global energy is transforming, with nuclear power emerging as a pivotal player in achieving sustainable and low-carbon energy goals. The nature of nuclear technology introduces unique challenges, such as stringent safety and environmental requirements. Existing studies focus on general risk identification, such as supply chain delays, cost overruns, and public perception issues. However, these studies fail to address integrating these risks into tailored contractual provisions, which are critical for navigating the unique challenges of nuclear projects. The goal of this paper is to examine how standard construction contracts can be tailored to better accommodate the risks inherent in nuclear power …

How Does Competitive Adsorption Between Vma And Pce Influence Yield Stress Of Cement Paste? A Novel Insight From Interparticle Forces And Percolation Threshold, Huamin Sun, Le Teng, Xiaohan Yu, Xin Shu, Zhangli Hu, Jiaping Liu, Kamal H. Khayat

Civil, Architectural and Environmental Engineering Faculty Research & Creative Works

Viscosity modifying admixture (VMA) and polycarboxylate superplasticizer (PCE) are often combined to optimize rheological properties of cement-based materials. However, the competitive adsorption of these complex admixtures can greatly influence rheological properties. Many studies have investigated the variation of yield stress due to competitive adsorption between VMA and PCE; but the mechanisms are not fully understood. This study aims to shed a new light on this question in cement paste systems prepared with low water-to-binder ratios of 0.16–0.30. The competitive adsorption of VMA and PCE was quantitatively assessed using the Total Organic Carbon and Ultraviolet-Visible Spectroscopy measurements. The effect of competitive …

Digital Twin-Assisted Optimization Of 6g Wireless Networks: Ensuring Deterministic Communication, Yingpu Nian, Bo Yi, Xingwei Wang, Sajal K. Das

Computer Science Faculty Research & Creative Works

With the rapid advancement of 6G technology and the increasing use of smart devices, Deterministic 6G Wireless Networks (D6WN) have emerged to meet the growing network transmission demands. In particular, applications such as autonomous vehicles, remote surgery, and industrial automation require extremely low transmission latency to function effectively, highlighting the critical need for D6WN in supporting these time-sensitive use cases. Yet, the conventional TCP/IP framework lacks effective unified traffic and congestion control scheduling, aggravating latency and uncertainty, posing a challenge to ensuring reliable real-time critical applications. To address the challenges of deterministic transmission in D6WN, this paper integrates Digital Twin …

The Power And Peril Of Awe In Leadership: Transforming Follower Identity And Behavior, Jack Mcguire, Daniel Mcallister, Jochen Menges, David De Cremer

Research Collection Lee Kong Chian School Of Business

Awe is a profound emotion that has captured significant attention within psychological research. While the potential for leaders to inspire awe in followers has received some recognition, systematic research on the nature and effects of awe in leadership—and within organizational contexts more broadly—remains limited. In this article, we offer a conceptual framework that explains the multifaceted and transformative nature of leadership through the power of awe. Specifically, we identify four leader behaviors—charismatic leadership tactics, exceptional performance, problem reframing, and self-sacrificial behavior—that elicit awe among followers. We further propose three variants of awe-inspiring leaders, describing how variation in a leader’s self-construal …

Investigation Into Molecular Bases Of Pregnancy-Associated Malaria, Nicole Pozo

Biochemistry and Molecular Biology

Plasmodium falciparum causes the most severe and deadly form of malaria and remains a major global health problem, especially in sub-Saharan Africa (Milner, 2018). The parasite infects and multiplies inside red blood cells, leading to fever, anemia, organ damage, and death if untreated (Milner, 2018; Song et al., 2022). It is especially dangerous because it avoids the immune system by changing surface proteins called Plasmodium falciparum erythrocyte membrane protein 1 (PfEMP1), which are encoded by more than 60 var genes. By switching between these genes, the parasite hides from immune detection and creates repeated waves of infection (Deitsch & Dzikowski, …

Oerfsj Faculty Confidence Survey, Oerfsj

OERFSJ Templates & Resources

Template for assessing faculty confidence in evaluating, adapting, creating, and assessing the classroom use of OER. Questions will cover three categories: 

• Find and Evaluate OER  
• Adapt and Create OER 
• Assessment 

Color Shift: A Graphic Design Process Book Exploring How Color And Motion Influence Emotional Perception And Brand Connection In Affordable Women's Fashion Jewelry, Elizabeth Voight

Theses

This study examines how manipulating color and motion within a single brand identity system influences consumer emotional response and brand consistency. Using a fictional modern jewelry brand, Quanta & Co., the research isolates color as the primary variable by applying nine distinct mid-range color palettes to identical layouts, logos, and structures across both print and digital touchpoints. These collateral assets include jewelry packaging, vehicle wraps, digital advertisements, and an animated logo. A quantitative survey was executed to capture real-time audience impressions regarding brand traits, perceived quality, and the overall alignment of each color variation with the brand's identity.

The findings …

Universal Injunctions And The Executive-Judicial Relationship In America, Jeremy Kang

Senior Honors Theses

This thesis examines a specific type of legal controversy surrounding the Trump administration’s dealings with the judicial branch. Central to the matter is the concept of universal injunctions: how a federal court can enjoin even non-parties to a case from behaving in certain ways.

The history of universal injunctions, from pre-Enlightenment England to modern America, is initially discussed. Then special attention is given to their use against President Donald Trump in particular, culminating in the Supreme Court curtailing them, and district court judges ignoring the high court’s ruling. Finally, previous examples of conflict between the American executive and judicial branches …

Analysis Of Physicians Who Trained And Remain At Lehigh Valley Healthnetwork, Partof Jefferson Health: Factors Influencing Satisfaction And Retention, Michela Biondi, Terri Vian, Joseph E. Patruno Md

Research Scholars

No abstract provided.

Efficacy Of Volume-Based Enteral Feeding Compared With Standard Rate-Based Enteral Feeding, Tashia Stevens Rn, Kelly St Jean Rn, Darah Thomas Rn

Nurse Residency

Is volume-based enteral feeding more effective than standard rate-based enteral feeding in achieving nutritional goals and improving clinical outcomes in critically ill patients?

Fall Prevention, Alicia Frasier Rn, Paige Sperry Rn, Heather Tozier Rn

Nurse Residency

In elderly patients (P), does education of fall prevention (I) compared to bed/chair alarms (C) reduce falls.

The Implementation Of Q2 Turns Compared To Air Mattresses For Hapi Prevention In Adult Medical Surgical Patients Over The Course Of Their Stay, Elizabeth Mchugo Rn, Lily Fifield Rn

Nurse Residency

How does the implementation of q 2 turns compare to air mattresses for preventing HAPIs in adult medical surgical patients over the course of their stay?

Acute Intermittent Hypoxia And Acute Intermittent Hypercapnic Hypoxia Elicit Cortico-Diaphragmatic Plasticity In People With Chronic Spinal Cord Injury, Alysha Bogard, Michela Mir, Tommy Sutor, Jessica Dunn, Kathryn Cavka, Arian Vistamehr, Hannah Snyder, Joseph Welch, Jayakrishnan Nair, Gina Brunetti, Gordon Mitchell, Emily Fox

Department of Physical Therapy Faculty Papers

Respiratory impairment is a leading cause of morbidity and mortality after spinal cord injury (SCI), highlighting the need for interventions that improve breathing function. In people with SCI, acute intermittent hypoxia (AIH) elicits respiratory motor plasticity and improves inspiratory function. However, in uninjured people facilitation of corticospinal diaphragm motor evoked potential (MEP) amplitude occurs only when AIH is combined with mild hypercapnia (acute intermittent hypercapnic hypoxia; AIHH). It remains unclear whether AIHH similarly enhances diaphragm corticospinal excitability after SCI. We tested the hypothesis that AIHH increases diaphragm MEP amplitude and reduces MEP onset latency in individuals with chronic SCI, whereas …

Cerebrovascular Risk With Calcitonin Gene-Related Peptide Monoclonal Antibodies Versus Onabotulinumtoxina In Patients With Migraine: A Real-World Pharmacoepidemiologic Study In The National Institutes Of Health All Of Us Research Program, Sedat Gül, Bradley Ong, Stephen Trudeau, Nicolas Thompson, Hsiangkuo Yuan

Department of Jefferson Headache Center Papers and Presentations

AimTo evaluate whether initiation of calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) was non-inferior to initiation of onabotulinumtoxinA with respect to the hazard of ischemic stroke or transient ischemic attack (IS + TIA) in a real-world cohort of adults with migraine.MethodsWe conducted a retrospective, active-comparator, new-user pharmacoepidemiology study using the NIH All of Us Research Program Registered Tier Dataset (v8). Adults with migraine initiating CGRP mAbs (erenumab, fremanezumab, galcanezumab, eptinezumab) were compared with initiators of onabotulinumtoxinA from January 2018 through September 2023. The primary outcome was IS + TIA occurring more than 90 days after treatment initiation. Inverse probability of …

Assessing Natural Lighting In Historic School Buildings In Algeria: A Simulation-Based Design Perspective, Nesma Fercha, Akila Benbouaziz, Djamel Alkama

Iraqi Journal of Architecture and Planning

This study evaluates daylighting performance in a primary school classroom in Ain M'lila, Algeria, combining field measurements with advanced simulation. A representative classroom was modeled in DIVA-for-Rhino using accurate geometric, material, and climatic data. Illuminance measurements were taken on 28 March 2022 at 09:30, 11:30, and 14:30, and the results were compared with simulation results. The comparison showed good agreement, with minor discrepancies in shaded areas, confirming model reliability through mean squared error (MSE) and root mean squared error (RMSE) analyses. Five design scenarios were tested to enhance daylight performance by varying glazing type, louvre geometry, and surface reflectance. Spatial …

The Effect Of Morphological Transformations On The Emergence Of Complex Urban Systems: The Historical Karkh Urban Systems In Baghdad Is A Ase Study, Sara Abdul Aalie Rasheed, Wahda Shuker Al-Hinkawi

Iraqi Journal of Architecture and Planning

Cities emerge as multi-component urban systems that exhibit complexity and synergy and are shaped by morphological transformations in their structural composition. From here, the research idea was launched to demonstrate the role of morphological transformations in the emergence of urban systems with multiple characteristics and their integration to form the complex urban system. The research aims to demonstrate the impact of transformations on the emergence of the complex urban system, a fundamental characteristic of the city's growth and development, which comprises different urban structures that arise over time. The research adopted a qualitative descriptive-analytical approach and applied it to a …