Digital Commons Network^™

Comprehensive Atrial Fibrillation Burden And Symptom Reduction Post-Ablation: Insights From Decaaf Ii, Charbel Noujaim, Ala Assaf, Chanho Lim, Han Feng, Hadi Younes, Mario Mekhael, Nour Chouman, Ghaith Shamaileh, Abdel Hadi El Hajjar, Tarek Ayoub, Nino Isakadze, Mihail G Chelu, Nassir Marrouche, Eoin Donnellan

Faculty, Staff and Students Publications

Aims: Traditional atrial fibrillation (AF) recurrence after catheter ablation is reported as a binary outcome. However, a paradigm shift towards a more granular definition, considering arrhythmic or symptomatic burden, is emerging. We hypothesize that ablation reduces AF burden independently of conventional recurrence status in patients with persistent AF, correlating with symptom burden reduction.

Methods and results: Ninety-eight patients with persistent AF from the DECAAF II trial with pre-ablation follow-up were included. Patients recorded daily single-lead electrocardiogram (ECG) strips, defining AF burden as the proportion of AF days among total submitted ECG days. The primary outcome was atrial arrhythmia recurrence. The …

A Genetic Association Study Of Circulating Coagulation Factor Viii And Von Willebrand Factor Levels, Paul S. De Vries, Paula Reventun, Michael R. Brown, Adam S. Heath, Jennifer E. Huffman, Ngoc Quynh Le, Allison Bebo, Jennifer A. Brody, Gerard Temprano-Sagrera, John Blangero

School of Medicine Publications

Coagulation factor VIII (FVIII) and its carrier protein von Willebrand factor (VWF) are critical to coagulation and platelet aggregation. We leveraged whole-genome sequence data from the Trans-Omics for Precision Medicine (TOPMed) program along with TOPMed-based imputation of genotypes in additional samples to identify genetic associations with circulating FVIII and VWF levels in a single-variant meta-analysis, including up to 45 289 participants. Gene-based aggregate tests were implemented in TOPMed. We identified 3 candidate causal genes and tested their functional effect on FVIII release from human liver endothelial cells (HLECs) and VWF release from human umbilical vein endothelial cells. Mendelian randomization was …

A New Pharmacology For Tracheal Intubation - Or A Dangerous Distraction?, J Sneyd

Peninsula Medical School

No abstract provided.

Cytotoxic Sigma-2 Ligands Trigger Cancer Cell Death Via Cholesterol-Induced-Er-Stress, Rony Takchi, Bethany C Prudner, Qingqing Gong, Takaomi Hagi, Kenneth F Newcomer, Linda X Jin, Suwanna Vangveravong, Brian A Van Tine, William G Hawkins, Dirk Spitzer

2020-Current year OA Pubs

Sigma-2-ligands (S2L) are characterized by high binding affinities to their cognate sigma-2 receptor, overexpressed in rapidly proliferating tumor cells. As such, S2L were developed as imaging probes (ISO1) or as cancer therapeutics, alone (SV119 [C6], SW43 [C10]) and as delivery vehicles for cytotoxic drug cargoes (C6-Erastin, C10-SMAC). However, the exact mechanism of S2L-induced cytotoxicity remains to be fully elucidated. A series of high-affinity S2L were evaluated regarding their cytotoxicity profiles across cancer cell lines. While C6 and C10 displayed distinct cytotoxicities, C0 and ISO1 were essentially non-toxic. Confocal microscopy and lipidomics analysis in cellular and mouse models revealed that C10 …

The Long Non-Coding Rna Gene C027288.3 Plays A Role In Human Endometrial Stromal Fibroblast Decidualization, Rupak Thapa, Kevin Marmo, Liang Ma, Donald S Torry, Brent M Bany

2020-Current year OA Pubs

During the secretory phase of the menstrual cycle, endometrial fibroblast cells begin to change into large epithelial-like cells called decidual cells in a process called decidualization. This differentiation continues more broadly in the endometrium and forms the decidual tissue during early pregnancy. The cells undergoing decidualization as well as the resulting decidual cells, support successful implantation and placentation during early pregnancy. This study was carried out to identify new potentially important long non-coding RNA (lncRNA) genes that may play a role in human endometrial stromal fibroblast cells (hESF) undergoing decidualization in vitro, and several were found. The expression of nine …

What It Takes To Live This Lifestyle: An Investigation Into Black Women’S Identity Progression When Practicing Soft Life, Monique Fontella Pollock

Electronic Theses and Dissertations Archive

The Strong Black Woman schema has served the Black woman well in modern history, as it has given formidable warnings to all others that this demographic cannot be easily defeated. What would make this intersection, female and Black, needing of this title? Possibly as Malcolm X stated in one of his most famous speeches, “The most disrespected person in America is the Black woman. The most unprotected person in America is the Black woman. The most neglected person in America is the Black woman” (X, 1962). Even with these obstacles, Black women have gone on record to lead in entrepreneurship …

Developing Engineering Career Pathway Perceptions For Students Interacting With Near-Peer Mentors In An Informal Learning Environment, Deidre Horne Mangin

Electronic Theses and Dissertations Archive

Given the worldwide shortfall of engineers that threatens innovation and global stewardship, educators and industry must find ways to engage and prepare the next generation of engineers. To attract and train candidates to fill global needs, researchers need to expand engineering career pathway perceptions for students of all ages. Engineering education programming, whether formal or informal, not only encourages students to hone soft skills such as design thinking, communication, emotional intelligence, and evaluation but also promotes traditional technical skills. Fostering engineering self-efficacy and thus promoting engineering career pathways is an emerging area of study that has the potential to mitigate …

Agent Type Effects In Service And Hiring Contexts, Della Clark

Electronic Theses and Dissertations Archive

In this dissertation, I examine consumer expectations of service agents in different contexts across two essays. This is the first empirical research to examine differences in the probabilistic expectations of an event (within a service recovery context where outcomes are specific, known, and desired by the consumer) is known occurring when dealing with different agent types (human vs. artificial intelligence (AI)). While the proliferation of ‘A New Age of AI’ news narrative is warranted and certainly the reality of service contexts, I aim to show that consumers systematically perceive events as more likely to occur when dealing with human agents, …

A Transcription Of Johannes Brahms’S Piano Quartet No. 1 In G Minor Op. 25 For Modern Wind Band, Christian Blake Carichner

Electronic Theses and Dissertations Archive

This project contains a transcription of Johannes Brahms’s Piano Quartet No. 1 in G minor, Op. 25 for wind band. The dissertation project includes documentation regarding the transcription process, as well as historical background and references for Brahms, Arnold Schoenberg - who originally transcribed the quartet for symphony orchestra — the relationship between Brahms and Schoenberg, the influences on Brahms which led to this original composition, and the viability of the piano quartet as a chamber music ensemble. Brief analyses of the 4th movements of the orchestral transcription, along with the original work, are presented to contextualize the transcription process.

Software Reliability Model Estimation For An Indeterministic Crime Cluster Through Reinforcement Learning, Dileep Kumar Kadali, R.N.V. Jagan Mohan, M. Chandra Naik

Neutrosophic Systems with Applications

The software reliability model estimates the probability of data failure in a specific environment, significantly impacting reliability and trustworthiness. The paper study focuses on cluster crime data, i.e., indeterministic in Neutrosophic Logic, using a software reliability model. The study utilizes reinforcement learning, Neutrosophic logic, and non-homogeneous Poisson process crime data to estimate indeterministic cluster data in crime. The "Non-homogeneous Poisson Process with Neutrosophic Logic" technique performs well in evaluating and deterring crime based on crime data analysis. The crime cluster involving offenders correctly classified as failure to accomplish does better than uncertain cluster reliability estimation with least squares and logistic …

On Heptagonal Neutrosophic Semi-Open Sets In Heptagonal Neutrosophic Topological Spaces: Testing Proofs By Examples, Subasree R, Basarikodi K

Neutrosophic Systems with Applications

In terms of heptagonal neutrosophic topological spaces, the purpose of this paper is to present the idea of heptagonal neutrosophic semi-open sets. Additionally, we examine a few of its characterizations and heptagonal neutrosophic semi-interior and heptagonal neutrosophic semi-closure operators.

Using A Novel Approach To Explore Women's Caesarean Birth Experience, Linda J. Deys, Valerie Wilson, Sara Bayes, Shahla Meedya

Research outputs 2022 to 2026

How a woman experiences birth is influenced by how she is treated, and who has power and control in the birthing environment. Focus on 'delivery' of an infant disregards the transformative event for the woman, with poorer physical and psychological outcomes. New evidence is needed to understand how to prevent trauma and improve maternal wellbeing.This paper presents a feminist methodology to view the lived experience of caesarean birth. Feminist birthing theories integrated with a phenomenological perspective provide insight for those working in maternity care and create a novel framework for researchers considering the position of women in a medicalised healthcare …

Comparative Analysis Of Cutting Forces In Axial-Compliant And Rigid Chamfering Tools, Sultonmurod Bekpulatovich Normatov, Oybek Tuyboyov, Azimjon Axror O'G'Li Pardayev, Alisher G‘Ayratjon Ogli Boratov, Shohjahon Tuxtasin Ogli Abdullayev

Technical science and innovation

This study delves into the analysis of cutting forces in axial-compliant systems, focusing specifically on the comparison between axially spring-compensated 90° conical tools and rigid chamfering tools. The research incorporates a predictive model for chamfer size calculation in the axially spring-compensated tools, verified through experimental tests on representative parts. The study aims to control chamfer size within tolerances by adjusting process conditions and optimizing processing efficiency. By exploring the fundamentals of the chamfering process, this research offers insights into breaking sharp edges on components with positional errors and shape deformations, with a particular emphasis on aero-engine casings. The integration of …

Regarding 'Original Sound' (关于 《《原音》》）, Huan Zhang 張洹

Zhou Documents

No abstract provided.

Artist Resume, Huan Zhang 張洹

Zhou Documents

This document contains the resume of the artist, Zhang Huan. (Nicole Wang '26).

A Rare Case Of High Grade Lymphoma Presenting As Large Bowel Obstruction With Testicular Mass, Gianna Martini, Gino Pezzone, Tiffany Pompa, Vijaykumar Gandhi

Research Day

Large bowel obstructions can occur in many settings, including a volvulus, adhesive disease, strictures, hernias, and malignancy. In the setting of malignancy, a bowel resection is the most common initial treatment option, and histologic examination of the resected specimen can identify the underlying source of the obstructing mass. Most commonly, large bowel obstruction is due to colorectal cancer, and if metastasis is present, it will most commonly involve the liver, followed by the lungs, bone, and brain. We present a case of a 36-year-old male who presents with a large bowel obstruction and a testicular mass noted on admission. The …

The Use Of A Behavior And Symptoms Rating Scale As A Predictor Of Suicidal Ideations And Attempts In Adolescent Psychiatric Inpatients, Jessica L. Lamont-George, Susan Panichelli Mindel, Robert A. Ditomasso, Jacquelyn D'Amico

Research Day

Introduction: Suicidality is a health concern among adolescents. Approximately, 1 million people attempt suicide each year and it is the second leading cause of death for those aged 10-19. Inpatient hospitalizations may be beneficial for individuals who pose a danger to themselves or others since it provides a safe environment for the individual to receive individualized care. Many individuals who have been admitted for psychiatric inpatient hospitalization have suicidal ideations or attempts. The Child and Adolescent Behavior Assessment-Youth Scale (CABA-Y) explores an individual’s stressors and problem behaviors that may be contributing to the reasons for hospitalization.

Objective: The purpose of …

Exploring The Demographic Dynamics Of Bronchopulmonary Dysplasia: Insights From A Multicenter Study, Pallavi Kawatra, Sharon Mcgrath Morrow, Joseph Collaco, Nancy Li, Yun Li

Research Day

Introduction: Bronchopulmonary dysplasia (BPD) is a chronic lung disease commonly seen in premature infants, characterized by impaired lung development and respiratory complications. Its prevalence has been steadily increasing due to advancements in neonatal care, resulting in improved survival rates of extremely premature infants. This study aims to explore the demographic relationship between gestational age and BPD outcomes, shedding light on the impact of prematurity on disease severity and long-term pulmonary health.

Methods: Data was collected from 1351 patients, with 894 patients from Johns Hopkins and 457 from Children's Hospital of Philadelphia (CHOP) from 2008 to 2023. Three hundred forty-three patients …

Renal Function As A Predictor For Post-Amputation Mortality, Danich Qadir, Theja Bhamidipati, Nadia Awad, Evan Deutsch

Research Day

Abstract

The impact of renal insufficiency on mortality and healing potential in patients undergoing limb amputation is well-known. Previous literature has pointed towards renal function and dialysis dependency as the largest contributory factors towards postoperative complications. This study reviews renal function as an independent risk factor for post-amputation complications and examines the relationship between the degree of renal dysfunction and thelikelihood of post-amputation complications.

Methods

The NSQIP database for Division of Vascular Surgery from 2022-2023 was queried and 139 amputations were reviewed. Five cases were excluded due to incomplete renal data. A total of 134 cases remained for analysis. Patient …

Bertolotti’S Syndrome: Discovery In An Elderly Patient With Persistent Back Pain, Antonio Forte, Patrick Frick, Ron Lincow

Research Day

Background: Bertolotti’s syndrome is a congenital disorder where a lumbosacral transitional vertebrate articulates with the iliac crest of the pelvis, often causing back pain in young adult patients. In the elderly, this condition is rarely incidentally found and may be due to extraforaminal stenosis with the iliac crest.

Case Summary: We report the unusual case of a 76-year-old with an over 20-year history of bilateral back pain that occasionally radiates into the left buttock and calf found to have L5 left-sided lumbosacral articulation incidentally on lumbar imaging among multiple levels of spinal stenosis. This patient completed conservative management and multiple …

Informed Consent In Shoulder And Elbow Surgery, Puru Sadh, Antonio J. Almeda-Lopez, Benjamin Hershfeld, Dan Monessa, Brandon Klein, Randy M. Cohn, Adam D. Bitterman

Research Day

Introduction:

Informed consent, a dynamic process, involves explaining procedure details to patients. Crucial for preserving autonomy, it requires comprehensive discussions, emphasizing necessity for documentation. Laws ensure awareness, but legal standards lack protection against paternalistic bias, posing legal risks. In orthopaedics, inadequacies in informed consent training contribute to litigation.

Methods:

A comprehensive literature review was conducted using the PubMed database to explore the landscape of informed consent practices in the context of shoulder and elbow surgery. The search strategy utilized a combination of Medical Subject Headings (MeSH) terms and free-text keywords, including "informed consent," "shoulder surgery," "elbow surgery," and "patient communication." …

Mycobacterium Avium Complex-Associated Vertebral Osteomyelitis In An Immunocompetent Patient: A Case Report, Jory P. Parson, Jack A. Grossweiler, Ira M. Garonzik, James E. Conway

Research Day

Introduction

Mycobacterium avium complex (MAC) infection in the spine is extremely rare, with its pathogenesis and epidemiology remaining poorly understood. Clinically, MAC infections commonly present with pulmonary, musculoskeletal, and disseminated disease. Manifestation of MAC infections, specifically disseminated disease to the spine, is uncommon in patients without human immunodeficiency virus or acquired immune deficiency syndrome.

Case Presentation

In December 2017, a 46-year-old immunocompetent man presented with severe lower back pain, right lower extremity pain, and a previous L5-S1 fusion. Imaging revealed pseudarthrosis at L5-S1 with halos around S1 screws. In March 2018, he underwent revision surgery with partial relief and began …

Clinical Outcomes And Complication Rates When Using Lyoplant Onlay Between Serial Craniectomy And Cranioplasty: A Single-Center Experience, Nathaniel Neavling, Manisha Koneru, Hamail Iqbal, Joseph Ifrach, Clint Badger, Corey Mossop, Ajith Thomas, Daniel Tonetti

Research Day

Introduction: Decompressive craniectomy is a pervasive treatment modality for malignant ischemic stroke and traumatic injury. Usage of dural substitute onlay during craniectomy closure is largely determined by provider preference. Complication rates and clinical outcomes associated with Lyoplant (Aesculap, Center Valley, PA, USA) onlay is currently not well characterized. Here, we examined the rate of complications and clinical outcomes in craniectomies performed with either Lyoplant or another dural substitute.

Methods: Patients undergoing cranioplasty following either ischemic stroke or traumatic injury at a single site were analyzed between December 2013 and June 2023. Mann-Whitney U tests and Fisher’s exact tests were performed …

Premature Closure Of The Ductus Arteriosus As A Cause Of Intrauterine Fetal Demise: A Case Report, Amélie Harpey, Walter Kobasa, Noel Anupol

Research Day

INTRODUCTION

The ductus arteriosus (DA) is a cardiac structure present in utero, allowing for the bypass of the pulmonary circulation during fetal development. The DA closes within 24-48 hours of birth. DA patency is maintained in utero by a low oxygen gradient in the blood, endothelial NO production, and prostaglandins E1 and E21. Premature closure of the DA is a rare condition and can be idiopathic, a result of abnormal levels of circulating prostaglandins, or secondary to maternal ingestion of non-steroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or polyphenol-rich foods2. Prenatal closure of the DA can lead to cardiovascular dysfunction, resulting in …

Quantifying Pthlh And Ihh Gene Expression In The Growth Plate Forming And Non-Forming Ends Of The Mouse Metatarsal, Maria Biancaniello, Sherrie Wallace, Sarah Doelp, Kelsey M. Kjosness, Philip Reno

Research Day

INTRODUCTION: The Parathyroid hormone-related protein (PTHrP, the product of the Pth-like hormone, Pthlh, gene)/Indian hedgehog (Ihh) feedback loop is a fundamental regulator of skeletal growth plates. The chondrocytes within the growth plate undergo the sequential resting, proliferative, and hypertrophic stages before being replaced by bone. Just prior to undergoing hypertrophy, pre-hypertrophic chondrocytes express Ihh, which signals back to resting cells to promote the expression of Pthlh. PTHrP then signals proliferating chondrocytes to limit their differentiation to hypertrophy and maintain a pool of mitotic cells in the growth plates of typical long bones. However, the metatarsals (MT) do not grow like …

Improvement In Coma Recovery Scale-Revised Score Following Trendelenburg Positioning In Syndrome Of The Trephined: A Case Report, Jesus Alvarado Salinas, Kayla Davenport, Ranjeev Chabra, Mithra B. Maneyapanda

Research Day

Disclosures: None

Setting: Inpatient Rehabilitation Facility

Patient: 44-year-old woman status post decompressive hemicraniectomy with suspected syndrome of the trephined.

Case Description: The patient sustained a non-traumatic brain injury secondary to ruptured right posterior communicating artery aneurysm. She required aneurysm coiling and right decompressive hemicraniectomy. Her course was complicated by right hemispheric strokes, seizures, and hydrocephalus requiring ventriculoperitoneal shunt (VPS) placement. She was admitted to inpatient rehabilitation for a specialized disorder of consciousness (DOC) program 6 weeks after the initial bleed. Her initial Coma Recovery Scale-Revised (CRS-R) score was a 3 of 23 indicating unresponsive wakefulness syndrome (UWS).

Assessment/Results: Patient remained …

Vesicular Eruption In A Woman With Systemic Lupus Erythematosus, Shane B. Devine, Harold Essenfeld, Katrina Hansen

Research Day

Introduction

Bullous systemic lupus erythematosus (BSLE) is a rare autoimmune blistering disorder that presents as a vesiculobullous eruption in around 5% of patients with a known diagnosis of systemic lupus erythematosus (SLE). The incidence of BSLE is greater in middle aged, African-American females. In some cases, BSLE is the initial clinical presentation leading to a SLE diagnosis. The development of BSLE may be associated with active extra-cutaneous manifestations of SLE, so a prompt diagnosis of BSLE is crucial to prevent any further complications of SLE. We present a case of a vesicular eruption in a woman with a previous diagnosis …

Childhood Obesity Treatment And Approach Quality Improvement Project, Kimberly Townsend, Autumn Dye

Research Day

Introduction

Childhood obesity has become an important public health issue in the United States. Obesity is defined as a BMI at or above the 95th percentile for age and sex. Childhood obesity can be associated with many comorbidities and adverse effects, including type 2 diabetes, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia.

Methods

The data was taken from data collected throughout 2023 and 2024 from the AAP QI project on childhood obesity and treatment. The data was collected from charts at PCOM’s Lancaster Avenue clinic. Additional methods will include a literature review to outline the importance of …

Treatment Of Rosacea During Pregnancy: A Literature Review, Emily M. Garelick, Margaret C. Hurley, Lauren Noto-Bell

Research Day

Rosacea is a chronic inflammatory skin condition that affects the face and presents in many forms, including pustules, papules, painful erythema, edema, and more. The pathogenesis of rosacea is largely undetermined, but general mechanisms include immune dysregulation, neurovascular reactivity, skin barrier dysfunction and demodex infestation, genetics, and certain environmental triggers. Rosacea is commonly exacerbated during pregnancy, but the lack of treatments that are safe for a developing fetus poses a problem for patients and their physicians. The go-to treatment for rosacea consists of a variety of topical and oral antibiotics and anti-inflammatory medications that are typically not recommended for use …

The Prevalence Of Demodex Folliculorum And Brevis Colonization In Patients Presenting With Blepharitis To An Outpatient Resident Clinic, David Broytman, Eric Rosenberg, Alanna Nattis, Ryan Kent, Vinh Ngo

Research Day

Purpose: To examine the prevalence of Demodex in two large, tertiary care, outpatient resident clinic settings; meanwhile, exploring demographic variables, use of ocular medications, and OTC cosmetic products with respect to prevalence. Lastly, analyze potential inadequacies in the rate of treatment amongst patients in the resident clinic setting.

Methods: A cross-sectional non-randomized, prospective study investigating the prevalence of Demodex folliculorum (DF) and brevis (DB) in patients presenting with blepharitis, and in control patients without clinical evidence of dry eye blepharitis syndrome (DEBS). Epilation of one eyelash from each lid was performed and studied under high power light microscopy. Each patient …