Medicine and Health Sciences Commons^™

Systemic Α₂-Agonist Use And Lower Hazard Of Glaucoma Compared With Β-Blockers: A Cohort Study, Ibrahim Abboud, Amin Z. Khudari, Abdelaziz Abdelaal, Amr Almobayed, Subhi J. Al'aref, Jonathan S. Myers, Richard K. Lee, Abdelrahman M. Elhusseiny

Wills Eye Hospital Papers

OBJECTIVE: Systemic antihypertensive medications may influence glaucoma-related outcomes through intraocular pressure-dependent and vascular mechanisms. While topical α₂-agonists are established glaucoma therapies, the association between systemic α₂-agonists and glaucoma hazard remains unexamined; we compared their hazard with systemic β-blockers in adults with hypertension.

METHODS AND ANALYSIS: We conducted a multicentre retrospective cohort study using deidentified electronic health records. Adults aged ≥40 years with hypertension and chronic exposure to systemic α₂-agonists or β-blockers were included. Patients with pre-existing ocular hypertension (OHT), primary open-angle glaucoma (POAG), concomitant comparator use, or inadequate ophthalmic follow-up were excluded. We balanced cohorts using propensity score matching (PSM) …

Machine Learning-Based Prediction Of Proximal Junctional Pathology After Adult Spinal Deformity Surgery: A Systematic Review And Diagnostic Test Accuracy Meta-Analysis, Shaan Patel, Shiva A. Nischal, Yi Hein Chai, Kush M. Kale, Kevin Hines, Joshua Pelta-Heller, Jack Jallo, James S. Harrop, Srinivas K. Prasad

Department of Neurosurgery Faculty Papers

BACKGROUND: Proximal junctional kyphosis (PJK) and failure (PJF) remain challenging and incompletely predictable adverse event following adult spinal deformity (ASD) surgery. Machine learning (ML) models have been proposed to improve risk stratification, but performance varies and clinical applicability remains uncertain. A systematic review and diagnostic test accuracy meta-analysis was performed to synthesize the predictive performance of ML-based models for proximal junctional pathology after ASD surgery.

METHODS: PubMed, Embase, and CENTRAL were searched from inception to February 2026. Studies developing or validating ML models predicting PJK or PJF following ASD surgery were included. Diagnostic performance was synthesized using random-effects models, pooling …

Celiac Plexus Radiosurgery For Retroperitoneal Pain In Advanced Cancer: A Pre-Specified Secondary Analysis Of Health-Related Quality Of Life In A Phase Ii Single-Arm Trial, Aisling Barry, Ronen Fluss, Laura Dawson, David Hausner, Michael Buckstein, Talia Golin, Laurence Freedman, Marcin Miszczyk, Dayssy Diazpardo, Artur Aguiar, Dror Limon, Raphael Pfeffer, Moaz Ben-Ayun, Liat Hammer, Ziv Symon, Ofir Morag, Gali Jacobson, Adam Dicker, Jerzy Wydmanski, Camilla Zimmermann, Yaacov Lawrence

Department of Radiation Oncology Faculty Papers

BACKGROUND: Retroperitoneal pain syndrome seen in pancreatic cancer is a major clinical challenge. Celiac plexus radiosurgery, a new palliative technique for retroperitoneal pain syndrome, decreased pain levels in a phase II study. Here Health-Related Quality of Life (HRQOL) outcomes are reported.

METHODS: Evaluable patients, who were enrolled between January 2018 and December 2021, in an international single-arm Phase II ethics-approved study (NCT03323489), were included. The pre-specified secondary endpoint-change in HRQOL from baseline to 3- and 6-weeks post-treatment, was measured by the Functional Assessment of Cancer Therapy - Hepatobiliary (FACT-Hep) version 4 questionnaire. Mean change was deemed clinically significant (CS) if …

Anthropometric Measurements Inform Complete Concentric Collapse Status In Patients With Obstructive Sleep Apnea, Jordan Weiner, Eugene Chio, Raj Dedhia, Colin Huntley, Michael Hutz, Phillip Huyett, Daniel Lee, Philip Losavio, Ilya Perepelitsyn, Ryan Soose, David Kent

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: Hypoglossal nerve stimulation in the US requires drug-induced sleep endoscopy to exclude patients with complete concentric collapse. This is an expensive and time-consuming requirement. We hypothesized that supine pharyngeal width, and other demographic and polysomnographic variables would associate with complete concentric collapse.

STUDY DESIGN: Prospective, multicenter cohort study.

SETTING: 10 centers in the United States with experience selecting patients for and performing airway surgeries for sleep apnea including hypoglossal nerve stimulation implantation.

METHODS: 600 patients meeting criteria for hypoglossal nerve stimulation underwent measurement of supine pharyngeal width and collection of demographic and polysomnographic data followed by drug-induced sleep endoscopy. …

Cystic Fibrosis Mental Health And Wellness Questionnaire - Factors And Properties Of A Comprehensive Cf-Specific Self-Report Measure, C. Virginia O'Hayer, Patrick J. Smith, Max J. Genecov, Christopher F. Drescher, Heather Bruschwein, Chelsi N. Nurse, Katherine Lawliss, Darcy C. Esiason, Gunnar H. Esiason

Department of Psychiatry and Human Behavior Faculty Papers

BACKGROUND: Existing mental health self-report measures have been criticized for over-simplification, lack of CF-specific focus, susceptibility to measurement reactivity bias, and conflation of symptoms of anxiety and/or depression with CF-related symptoms and/or treatment side effects. The CF Mental Health and Wellness Questionnaire (CFMHWQ) is a 25-item measure assessing CF-specific mental health burden symptoms.

METHODS: To examine common underlying factors contributing to scores on the CFMHWQ, principal component analysis (PCA) was conducted of all 25 items. We conducted cross-validation of CFMHWQ principal components, examining unadjusted correlations between each principal component, demographic characteristics (age and biological sex), negative affect (mean rank global …

Occupational Therapy Program Development In Unhoused Communities, Abbigayle Jackson, Emma Pacheco, Mariko Turley, Jennifer Wickham, Tina M. Deangelis, Edd, Ms, Otr/L, Faota

Doctorate of Occupational Therapy Program Capstone Presentations

Objectives

- Outline the Modified Delphi process and its purpose for manual development

- Describe foundational elements of occupational therapy (OT) program development for unhoused populations

- Illustrate a program's community and societal impact

Isass Brave New Continuing Medical Education World: The Stifling Of Innovation In Spine Surgery Through Overrestriction Of Collaboration, Morgan P. Lorio, Kai-Uwe Lewandrowski, Óscar L. Alves, Avelino Parajón, Matthew Scott-Young, Hansen A. Yuan, Alex R. Vaccaro

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: in 2020, the accreditation Council for Continuing Medical education (aCCMe) released the Standards for Integrity and Independence in Accredited Continuing Medical Education, effective january 1, 2022, to ensure that accredited activities are accurate, balanced, evidence-based, and clearly separated from marketing and sales. although these aims are broadly supported, implementation may have unintended consequences in procedure-intensive specialties such as spine surgery, where surgeon–industry collaboration often drives device innovation, clinical trials, and dissemination of new techniques.

OBJECTIVE: To examine how current interpretations of ACCME eligibility and financial-relationship standards may affect continuing medical education in spine surgery and to propose practical adaptations …

Tropomyosin-Related Kinase Receptor Type B Agonism In Geographic Atrophy-The Translational Challenges From Preclinical Data To A First-In-Human Trial, David Brown, Oliver Zeitz, Clare Bailey, Sunir J. Garg, Karl Csaky, James Talks, Sobha Sivaprasad, Peter M. Benz, Rolf Herrmann, Remko A. Bakker, Sebastian Bandholtz, Ankit Mittal, Qihong Huang, Serge Kosobokovs, Gudrun Simons, Andrea Giani, Jochen Huber, Martin Gliem

Wills Eye Hospital Papers

OBJECTIVE: To report results of the first-in-human trial of intravitreal tropomyosin-related kinase receptor type B (TrkB) agonist BI 754132 in participants with geographic atrophy (GA). To discuss BI 754132 clinical data in the context of the preclinical findings and their translation into human data.

DESIGN: An open-label, uncontrolled, nonrandomized phase I trial (NCT04002310) assessing the safety, tolerability, and pharmacokinetics of BI 754132 in participants with GA supported by preclinical data.

PARTICIPANTS: Participants with GA recruited between July 2019 and August 2022 in the United States and UK.

METHODS: Clinical trial comprising a single rising dose (SRD) part (n = 15) …

Reimagining Occupational Therapy Fieldwork Mentorship Through A Cultural Wealth Lens: A World Café Study, Nandita A. Singh, Mph, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy (OT) fieldwork education plays a critical role in professional socialization; however, supervision models often privilege dominant sociocultural norms, disadvantaging students from non-dominant cultural and linguistic backgrounds and potentially limiting equitable workforce preparation.

Objectives: To examine how OT fieldwork partners conceptualize reciprocal mentorship within fieldwork education identify strategies grounded in Community Cultural Wealth (CCW) to support inclusive communication and strengths-based professional development.

Methods: Participatory qualitative study using a virtual World Café methodology, involving United States-based academic and clinical OT fieldwork contexts. Data were collected through audio-recorded discussions, digital whiteboards, and reflexive memos, and were analyzed using Braun …

Development Of A Unique Surgical Implant To Address The Development Of Iatrogenic Trigeminal Neuralgia Following Maxillomandibular Advancement Surgery For Osa, Erika L. Manning, Kun Yoon, Robert Diecidue, Joseph Harrington

Department of Oral and Maxillofacial Surgery Faculty Papers

A 58 y/o male with no significant past medical history presented in 2021 with obstructive sleep apnea (OSA), including trouble breathing through his nose due to hypoplastic maxilla, retrognathic mandible and chin, and microgenia. He underwent a LeFort 1 maxillary osteotomy, bilateral sagittal split osteotomy (BSSO), and genioplasty with fat graft on 2/10/2022. Postoperatively, the patient developed moderate pain and facial edema, which progressed into hypoesthesia with pain in the face with a sensation of fullness in the left ear and left masseter tightness. He also developed a positive Tinel sign in the left mandibular area and was diagnosed with …

Metabolic Dysfunction And Metabolic Management In Episodic Migraine, Delora E. Denney, Michael J. Marmura

Department of Jefferson Headache Center Papers and Presentations

PURPOSE OF REVIEW: Evidence suggests a significant link between migraine and metabolic syndrome,, especially in those with chronic or refractory migraine. Weight loss and exercise may effectively prevent migraine. Here, we review the evidence behind exercise and weight loss as migraine treatments.

RECENT FINDINGS: While metabolic syndrome and pain have long had a known association, only recently have strong studies demonstrated a higher risk of developing metabolic syndrome in people with migraine. Additionally, other sequelae of metabolic syndrome, obesity, hypertension, hypercoagulability, and diabetes also interplay with migraine. New medications like GLP-1 agonists may be a potential treatment for migraine as …

Personalized Treatment Of Chronic Tendinopathy Using Ultrasound And Neuroimmune Markers: A Narrative Review, Rohan Phadke, Samer Salman, Kirtan Patel, Jad Wardeh, Akhil Marupudi, Rahul Kumar, Arbaz A. Momin, Alireza Tavakkoli

Department of Neurosurgery Faculty Papers

Introduction: : Chronic tendinopathy affects approximately 30% of musculoskeletal consultations, yet treatment outcomes remain inconsistent despite numerous available interventions. This variability stems from the absence of validated frameworks to match individual patients to optimal treatments based on underlying pathophysiology. To synthesize current evidence on ultrasound imaging biomarkers, neuroimmune mechanisms, and interventional therapies in chronic tendinopathy, and propose a clinically applicable framework integrating ultrasound phenotyping with neuroimmune assessment to guide personalized treatment selection. Methods: A systematic literature search was conducted across PubMed, Scopus, and Web of Science through December 2025. Studies examining ultrasound/elastography imaging, neuroimmune mechanisms, or treatment interventions in chronic …

Comparative Effectiveness Of Immunotherapy Alone Or With Chemotherapy As First-Line Treatment For Marginal Zone Lymphoma, Adam Olszewski, Thomas Ollila, Dai Chihara, Geoffrey Shouse, Natalie Grover, Reem Karmali, Pallawi Torka, Colin Thomas, Praveen Ramakrishnan Geethakumari, Stefan Barta, Nancy Bartlett, Narendranath Epperla

Cardeza Foundation for Hematologic Research

No abstract provided.

Unusual Presentation Of Pulmonary Hypertension From Subacute Hyper Viscosity: A Case Report, Jonathan Martin, Tara Rakiewicz, Ubaldo Martinez-Outshoorn, Adam Binder

Jefferson Hospital Staff Papers and Presentations

No abstract provided.

Midwives' Self-Efficacy In Perimenopause Care: An Educational Intervention, Yinka Sokunbi

Doctor of Midwifery Advances in Midwifery Projects

Study Purpose: This project evaluated the effectiveness of an asynchronous continuing education (CE) webinar in improving midwives’ self-efficacy to provide comprehensive perimenopause care.

Research Questions

1. What is the impact of a targeted CE webinar on midwives’ self-efficacy in providing comprehensive perimenopause care?

2. How do participants perceive the impact and acceptability of a pilot CE webinar?

Significance/Background: Despite midwifery’s defined role in lifespan care, engagement in perimenopause management remains limited. Gaps in formal education and continuing professional development contribute to low confidence in this area. Guided by Social Cognitive Theory, this project targeted self-efficacy as a modifiable factor influencing …

Assessment Of Correctness, Content Omission, And Risk Of Harm In Large Language Model Responses To Ophthalmology Continuing Medical Education Questions, Jacqueline L. Chen, Amanda J. Lu, Rohan Verma, Li Wang, Douglas D. Koch, Allison J. Chen

SKMC Student Presentations and Publications

PURPOSE: To evaluate the accuracy and prose responses of 2 large language models (LLMs) to ophthalmology continuing medical education questions.

DESIGN: Question prompts and multiple choice (MC) answer options were input into the 2 LLMs, and responses were analyzed for accuracy and assessed for evidence of correctness, completeness, bias, and potential harm using a previously reported standardized rubric.

SUBJECTS: Basic and Clinical Science Course questions and MC answer options from the American Academy of Ophthalmology question bank were used as inputs into the 2 LLMs (ChatGPT-4 and Google Vertex's Gemini Pro 1.5).

METHODS: The MC responses were assessed for accuracy …

Improving Outreach To Residents Through Semi-Structured Interviews, Emmett Booth, Mlis, Ahip, Gary Kaplan, Mlis, Ahip, Abby Adamczyk, Mlis, Ahip, John Caruso, Md

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Objectives

Our academic medical center has a large number of residents and fellows across programs based out of multiple hospitals, five of which receive direct support from the libraries. Two librarians supporting the scholarly activities of residents and fellows were hired by the university in the last six years. As these positions evolve, we seek to understand if outreach is working, whether support is effective, and whether scholarly support needs are changing. Building on survey results from last year,1 the team is conducting interviews with residents and program directors to better understand their perceptions of library support and services.

A Word From The Writing Team (May 2026), Pam Walter, Mfa, Laura Deloretta, Phd

A Word From the Writing Team (Newsletter)

No abstract provided.

Domain-Specific Concussion Knowledge And Reporting In United States Major League Rugby Players, Julie Stamm, Katherine Hunzinger, Owen Sheehy, Christine Baugh

Department of Exercise Science Faculty Papers

Previous research indicates high concussion knowledge is not associated with better concussion reporting, with research examining the relationship between reporting and global concussion knowledge. Concussion knowledge has not yet been investigated in United States Major League Rugby (MLR) players. This study evaluated domain-specific concussion knowledge, concussion history, and reporting behaviors among active MLR players. In a cross-sectional design, 207 MLR athletes (age 26.6 ± 3.4 years) completed a survey assessing concussion history, knowledge, and nondisclosure reasons. While in the MLR, 24% reported an undisclosed concussion, with nondisclosure reasons related to a lack of concussion knowledge, a desire to continue playing, …

Aspirin And Preterm Birth Among Pregnant People With Increased Heat Exposure: Secondary Analysis Of A Randomized Clinical Trial, Gabriella Meltzer, Luke Duttweiler, Sarah Saleem, Kartik Shankar, Manolo Mazariegos, Antoinette Tshefu, Jackie Patterson, Elwyn Chomba, Waldemar Carlo, Shivaprasad Goudar, Richard Derman, Archana Patel, Patricia Hibberd, Edward Liechty, Fabian Essamai, Edwin Asturias, Denise Babineau, Janet Moore, Cascade Tuholske, Andrew Zimmer, Brent Coull, Elizabeth Mcclure, Robert Goldenberg, Nancy Krebs, Matthew Hoffman, Blair Wylie

Global Health Articles

IMPORTANCE: Scalable interventions are urgently needed to mitigate the adverse effects of heat on pregnancy and newborn health.

OBJECTIVE: To evaluate whether low-dose aspirin modifies the association between heat exposure and preterm birth.

DESIGN, SETTING, AND PARTICIPANTS: This secondary analysis of the Global Network for Women's and Children's Health Research Aspirin Supplementation for Pregnancy Indicated Risk Reduction in Nulliparas (ASPIRIN) randomized, double-blinded, placebo-controlled clinical trial was conducted from March 2016 to June 2018. Statistical analyses were performed from June 2024 to June 2025. The study settings included the Democratic Republic of Congo, Zambia, Kenya, Guatemala, Pakistan, and Belagavi and Nagpur, …

The First Cut Is The Deepest: Understanding Learner Trauma In The Emergency Medicine Clerkship, Dimitrios Papanagnou, Leela Raj, Karen E. Watkins, Xiao C. Zhang, Andres Fernandez, Md, Victoria J. Marsick

Department of Emergency Medicine Faculty Papers

BACKGROUND: As third-year medical students transition into high-stakes, high-stress clinical environments like the emergency department (ED), they may experience significant personal trauma. However, little is known about how this trauma is experienced early in their training - specifically during the transition from preclinical to clinical learning environments. This study addresses that gap by exploring third-year medical students' experiences of trauma during the emergency medicine (EM) clerkship through the lens of Trauma-Informed Care (TIC) and identifies workplace factors and intersectional demographics influencing these experiences.

METHODS: This qualitative study used the critical incident technique to explore emotionally-significant events encountered by third-year medical …

Population Pharmacokinetics And Dosing Simulations Of Pentobarbital In The Pediatric Population, Victoria Etges Helfer, Lorena Medina-Aymerich, William J. Muller, Marisa Meyer, Amira Al-Uzri, Russell Mcculloh, Chi D. Hornik, Stephen J. Balevic, Rachel G. Greenberg, Daniel K. Benjamin, Sarah G. Anderson, Daniel Gonzalez

Department of Pediatrics Faculty Papers

Pentobarbital is a barbiturate with sedative and anticonvulsant properties, occasionally used in pediatric patients for preoperative sedation, deep sedation during mechanical ventilation, and seizure control. Despite its long-standing clinical use, age-appropriate dosing remains challenging due to variability across studies and limited pediatric pharmacokinetic (PK) data. This study (NCT01431326) aimed to characterize the population pharmacokinetics of pentobarbital in pediatric patients (birth to 21 years) and evaluate dosing strategies using model-based simulations. A two-compartment population PK model, allometrically scaled to total body weight, adequately described pentobarbital plasma concentrations, with no additional covariates identified as significant. Simulations were conducted across four age groups: …

Eptinezumab In Treatment-Resistant Chronic Migraine: Four-Year Real-World Effectiveness And Treatment Persistence, Wan-Jen Hsieh, Kelly Nicol, Chai Ching Ng, Tsung-Wei Hou, Phillip Phan, Scott W. Keith, Brittany Heckel, Michael J. Marmura, Hsiangkuo Yuan

Department of Neurology Faculty Papers

AimTo evaluate 48-month real-world outcomes of eptinezumab users in chronic migraine (CM), including longitudinal effectiveness, treatment persistence, reasons for discontinuation, and post-discontinuation anti-calcitonin gene-related peptide (CGRP) treatment patterns.MethodsWe conducted a retrospective cohort study of 112 CM subjects initiating eptinezumab at a tertiary headache center between 2019 and 2021. Monthly headache days (MHD), migraine disability assessment (MIDAS), and average pain intensity (API) were extracted at baseline and every 6 months for up to 48 months using a predefined outcome form at each visit. Longitudinal changes were analyzed using generalized estimating equations (GEE) with an unstructured correlation matrix, adjusting for age, sex, …

Combined Middle Meningeal Artery Embolisation And Subdural Evacuation Port System Drainage For Chronic Subdural Haematoma: A Systematic Review, Single-Arm Meta-Analysis, Meta-Regression, And Cost-Benefit Analysis, Shiva A. Nischal, Santosh Guru, Shaan Patel, Ashviniy Thamilmaran, Mary Murphy

Department of Neurosurgery Faculty Papers

BACKGROUND: Chronic subdural haematoma (cSDH) is an increasingly prevalent condition in older, anticoagulated, and medically frail patients, in whom recurrence and perioperative risk remain substantial despite standard surgical evacuation. Growing recognition of cSDH as an angiogenic, inflammatory disorder has prompted interest in minimally invasive strategies that combine mechanical decompression with targeted modulation of the underlying vascular pathology. This study aimed to evaluate the safety, effectiveness, and health-economic profile of combined middle meningeal artery embolisation and subdural evacuation port system (MMAE-SEPS) drainage for cSDH, compared with conventional burr-hole evacuation.

METHODS: MEDLINE, Embase, and CENTRAL were searched from inception to 24th August …

The Camus Initiative: A Multiphase, Multicentre International Collaboration To Redefine Risk Stratification, Reporting, And Grading Of Surgical Complications In Urology., Christopher Soliman, Niranjan J. Sathianathen, Niall M. Corcoran, Nathan Lawrentschuk, Patrick Y. Wuethrich, Marc A. Furrer, Paul Chung, Camus Study Group Collaborators

Department of Neurology Faculty Papers

Surgical complications remain a major source of preventable morbidity, mortality, and health care expenditure, but existing frameworks such as the Clavien-Dindo classification and Comprehensive Complication Index are clinician-centred and intervention-focused and fail to capture cumulative patient-centred outcomes. This protocol outlines the Complications After Major and Minor Urological Surgery (CAMUS) initiative, a global, multiphase effort to redefine complication reporting, risk stratification, and outcome measurement in urological surgery. CAMUS aims to address these limitations via an integrated, seven-arm programme combining retrospective and prospective data analysis, consensus development, and digital infrastructure design. Arm 1 has assembled a retrospective data set of 130 034 …

Safety And Efficacy Of Individualised Exercise And Nad+ Precursor Supplementation In Patients With Friedreich’S Ataxia In The Usa: A Single-Centre, 2 × 2 Factorial, Randomised Controlled Trial, Kimberly Lin, Anna Bucha, Kara Mcsweeney, Kristin Wade, Antoneta Karaj, Jaclyn Tamaroff, Shannon O'Malley, Nicole Chung, Nicolette Cilenti, Julianne Wanner, Gabriel Adzika, Clementina Mesaros, Ian Blair, Teerapat Rojsajjakul, Suraj Serai, Jennifer Farmer, Kyle Bryant, Yingying Lu, Michael Harhay, David Weber, Stephen Paridon, Erin Seifert, Mary Putt, Payman Zamani, Joseph Baur, David Lynch, Shana Mccormack

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND:Friedreich's ataxia is a rare, chronic, progressive, neurodegenerative condition affecting multiple organ systems, including neurological, musculoskeletal, cardiac, and endocrine systems, and is marked by low cardiopulmonary fitness. We tested the effect of exercise and NAD⁺ precursor supplementation with nicotinamide riboside, which have each shown benefits in animal and early clinical studies, on cardiopulmonary fitness in individuals with Friedreich's ataxia.

METHODS: This 12-week, outpatient, phase 2, single-site (Children's Hospital of Philadelphia, Philadelphia, PA, USA), randomised, 2 × 2 factorial clinical trial recruited individuals aged 10–40 years with an ejection fraction of 45% or greater who were able to exercise. A …

Qualitative Beta-2-Adrenoceptor Signaling In The Regulation Of Human Airway Epithelia Mucin And Cytokine Production, Fred Graumuller, Diana Cervantes, Tung O. Chan, Niccolette Schaunaman, Dominic R. Villalba, Burton F. Dickey, Julia K. L. Walker, Hong Wei Chu, Raymond B. Penn

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

BACKGROUND: Numerous in vivo studies have demonstrated beta-2-adrenoceptor (β2AR) -agonism as permissive in the development of allergic lung inflammation, and have implicated the arrestin-dependent signaling arm of the β2AR in mediating this effect. However, the specific cell type(s) mediating β2AR regulation of allergic lung inflammation remain unestablished.

METHODS: To explore the potential contribution of airway epithelia in this phenomenon, we compared the ability of ractopamine (RP), recently identified as a Gs-biased beta-agonist, to that of the unbiased/balanced beta-agonist albuterol (ALB), on IL-13-stimulated mucin and cytokine production in human airway epithelia cultures in air-liquid interface (HAE).

RESULTS: ALB, which activates both …

Knowledge Gaps In High-Energy Sacral Fracture Treatment And Management, Ashraf N. El Naga, Marko H. Neva, Ahmed Abdelazim Hassan, Gregory D. Schroeder, Mohammad El-Sharkawi, Sebastian F. Bigdon, Andrei F. Joaquim, Klaus Schnake, Richard Bransford, Emre Yilmaz

Rothman Institute Papers

High-energy sacral fractures (HESF) are often challenging injuries due to the location of the sacrum at the junction of the spine and pelvis, the complex biomechanics of the pelvic ring and the wide spectrum of injury patterns, which make treatment standardization challenging. Despite advances in classification systems - particularly the AOSpine Sacral Injury Classification - significant gaps remain in understanding optimal management. To review and discuss the management and identify knowledge gaps related to HESF. A narrative review of the literature was conducted, focusing on five domains: 1. Relative instability and biomechanics affected in different injury patterns; 2. The significance …

Evaluation Of A Wearable Wireless Respiratory Monitoring System (Rms) For Detecting And Predicting Clinical Deterioration, Shreya Kolipaka, Jeffrey I. Joseph, Do

Student Papers, Posters & Projects

Introduction & Objectives

- Mortality within 30 days after major surgery is the third leading cause of death worldwide.¹

- Post-operative adverse events leading to mortality include pneumonia, respiratory failure, sepsis, kidney failure, pulmonary embolism, and major cardiac events.^2,3

- Early warning signs of clinical deterioration are commonly missed due to infrequent clinical assessments, delaying timely diagnosis and intervention.^2,4

- On the general hospital floors, vital signs are monitored every 4 to 8 hours, suggesting patients could be unmonitored 96% of their hospital stay.¹

- Changes in respiratory rate (RR) are the earliest and most sensitive …

Reinforcement Learning Improves Llm Accuracy And Reasoning In Disease Classification From Radiology Reports, Yishu Wei, Yi Lin, Adam Flanders, George Shih, Yifan Peng

Department of Radiology Faculty Papers

Accurate disease classification from radiology reports is essential for many applications. While supervised fine-tuning (SFT) of lightweight LLMs improves accuracy, it can degrade reasoning. We propose a two-stage approach: SFT on disease labels followed by Group Relative Policy Optimization (GRPO) to refine predictions by optimizing accuracy and format without reasoning supervision. Across three radiologist-annotated datasets, SFT outperformed baselines and GRPO further improved classification and enhanced reasoning recall and comprehensiveness.