Medicine and Health Sciences Commons^™

Long-Term Liver-Targeted Aav8 Gene Therapy For Mucopolysaccharidosis Iva, Shaukat A. Khan, Eliana Benincore-Florez, Fnu Nidhi, Jose Victor Álvarez, Dione A. Holder, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Mucopolysaccharidosis IVA (MPS IVA) is a lysosomal storage disease with an autosomal recessive trait caused by the deficiency of N-acetylgalactosamine-6-sulfate sulfatase (GALNS) enzyme, which leads to the accumulation of chondroitin-6-sulfate and keratan sulfate, primarily in cartilage and its extracellular matrix, resulting in a direct impact on cartilage and bone development, as well as subsequent systemic skeletal dysplasia. ERT and HSCT are current treatment options, but they have a limited effect on bone lesions. In this article, we investigated liver-specific AAV8 vectors with a thyroxine-binding globulin promoter in the MPS IVA murine model to evaluate the long-term (24 weeks in males …

Managing Anticoagulation In A Patient With Calciphylaxis And Mechanical Valve: A Therapeutic Dilemma, Qutaiba Qafisheh, Abdalhakim Shubietah, Mohanad Qwaider, Muath A. Baniowda, Abdalrahman Assaassa, Roaa Aljunaidi, Abubakar Nazir

Division of Cardiology Faculty Papers

BACKGROUND: Calciphylaxis is a rare, life-threatening vasculopathic syndrome most commonly seen in end-stage renal disease (ESRD) and associated with high mortality. Vitamin K antagonists complicate management in patients with mechanical valves by potentially exacerbating vascular calcification while remaining essential for thromboprophylaxis.

CASE PRESENTATION: A 50-year-old woman with ESRD on hemodialysis and a mechanical mitral valve on warfarin presented with severe abdominal pain and rapidly progressive necrotic ulcers. Despite broad-spectrum antibiotics and sodium thiosulfate, lesions worsened. Biopsies were nondiagnostic; however, the clinical phenotype was consistent with calciphylaxis. A multidisciplinary team transitioned anticoagulation from warfarin to subcutaneous unfractionated heparin (UFH) (333 U/kg …

Use Of Emr Automated Fib-4 As A Tool For Masld Screening In The Primary Care Setting, Maria Winte, Md, Rebecca Loh, Md, Sanjna Shelukar, Md, Ananya Venkatesh, Md, Bryan O'Connell, Md, Dina Halegoua-De Marzio, Md

Division of Gastroenterology and Hepatology Posters

Introduction

• MASLD affects up to 40% of the population in North America and is increasing.
• Screening for advanced fibrosis is now widely recommended, including formal guidelines from the AGA, AASLD, and ADA.
• We implemented an automated Fibrosis-4 (FIB-4) Index for liver fibrosis screening as a tool within our electronic medical record (EMR) to increase screening in patients with risk factors for MASLD.
• Our study examines the impact of this intervention on the appropriate MASLD screening rates among 50–65- year-old patients in the primary care clinic.

Effect Of Valemetostat On The Pharmacokinetics Of Midazolam And Digoxin: A Phase 1 Drug-Drug Interaction Study In Patients With Non-Hodgkin Lymphoma, Masaya Tachibana, Steven Horwitz, Eric Jacobsen, Francine Foss, Pamela Allen, Pierluigi Porcu, Tatyana Feldman, Jia Ruan, Jonathan Brammer, Jie Wang, Shinichi Inaba, Yuka Iko, Keiko Nakajima, Yasuyuki Kakurai, Noriaki Kitami, Yang Chen, Yvonne Lau

Department of Medicine Faculty Papers

Valemetostat tosylate (valemetostat) is an oral, potent, dual inhibitor of enhancer of zeste homolog (EZH)2/1, under investigation in non-Hodgkin lymphomas (NHLs) and solid tumors. In vitro, it inhibits cytochrome P450 3A (CYP3A) and P-glycoprotein (P-gp) when combined with sensitive CYP3A or P-gp substrates. This drug–drug interaction (DDI) sub-study is part of the phase 1 trial of valemetostat monotherapy (DS3201-A-J101; NCT02732275), assessing the effect of valemetostat on the pharmacokinetics (PK) of sensitive CYP3A and P-gp substrates midazolam and digoxin, respectively, in patients with relapsed or refractory NHL, and its safety and efficacy. Patients received two simultaneous single doses of midazolam and …

Adherence To Integrative Care, Oncology Healthcare Utilization, Opioid Use And Hospitalization, Eran Ben-Arye, Dan Greenberg, Noah Samuels, Ana Maria Lopez, Tzahit Simon-Tuval

Kimmel Cancer Center Faculty Papers

Research on the relationship between integrative oncology (IO) programs and dispensing of chemotherapy agents and supportive care drugs, and hospitalization rates is limited. The present study examined these outcomes in chemotherapy-treated patients with cancer, comparing patients highly adherent to integrative care (high-AIC) to those with low adherence (low-AIC). Data from patients with cancer treated with taxane and/or platinum-based agents participating in an ongoing prospective, controlled pragmatic trial were examined retrospectively. Patients were referred to an IO consultation and weekly treatments at 3 medical centers in Northern Israel, with high-AIC defined as attending ≥4 sessions at 6 weeks; low-AIC, 0-3 sessions. …

Management Of Stone Disease In The Spina Bifida Patient, Meghan F. Davis, Kyle L. Yu, Arun K. Srinivasan

Department of Medicine Faculty Papers

PURPOSE OF THE REVIEW: This review provides a detailed overview of the specifics of presentation, diagnosis, and management of upper and lower urinary tract stone disease for individuals with spina bifida.

RECENT FINDINGS: Recent studies highlight the significant burden of stone disease for spina bifida patients. Individuals with spina bifida require lifelong urologic care. They are more likely to have stone disease and have complications from management. This is a particularly salient issue for patients who have undergone bladder augmentation. Given the frequency and severity of these issues, it is critical that urologists be familiar with the nuances of stone …

Validation Of A Prognostic Nomogram For Locally Advanced Oropharyngeal Carcinoma Treated With Intensity-Modulated Radiotherapy With/Without Systemic Therapy, P. Bossi, R. Gili, S. Calza, L. Licitra, M. Maddalo, A. Bacigalupo, L. Belgioia, J. Cacicedo, N. Facchinetti, A. Garcia Castano, M. Oliva, P. Bonomo, G. Sanguineti, P. Franco, A. Argiris, A. Psyrri, E. Orlandi

Kimmel Cancer Center Faculty Papers

BACKGROUND: Head and neck squamous-cell carcinoma (HNSCC), particularly oropharyngeal cancer (OPC), exhibits diverse prognostic factors influenced by demographic and lifestyle variables. Prognostic nomograms, such as the one developed by Fakhry et al., incorporate clinical and biological markers to predict overall survival (OS) and progression-free survival (PFS) in OPC patients. However, their applicability to European populations remains unverified. This study aimed to externally validate Fakhry's prognostic nomogram in a large European cohort of locally advanced OPC patients treated with definitive intensity-modulated radiotherapy (IMRT) with or without systemic therapy.

METHODS: This is a retrospective external validation study conducted on 805 OPC patients …

Cd5 Expression In Ctcl And Its Implications For Anti-Cd5 Car T-Cell Therapy, Leena Wardeh, Madeline Williams, Courtney Prestwood, Zachary Wolner, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Cutaneous T-Cell Lymphomas (CTCL) are a heterogenous group of T-cell malignancies in the skin and have poor treatment outcomes in advanced stages. CD5, a surface glycoprotein expressed on most mature T cells, has emerged as a promising target for chimeric antigen receptor (CAR) T-cell therapy in systemic T-cell lymphomas. However, its expression profile in CTCL and relevance for targeted therapy remain unclear. Notably, in CTCL, the cell surface expression of receptors, such as CD7 and CD26, tends to become downregulated on the surfaces of malignant T cells In this study, we analyzed single-cell RNA sequencing (scRNA-seq) data from patients at …

Power Of Meaningful Learning Moments: Relationships In Academia, Jillian Bollinger, Ots, Rebecca Loughran, Ots, Alexandria Krasin, Otd, Otr/L, Madison Via, Bs, Audrey L. Zapletal, Otd, Otr/L, Cla, Chse

Department of Occupational Therapy Posters and Presentations

Background

• The demanding nature of graduate-level coursework creates rigorous academic environments that can strain student-faculty relationships.¹⁻⁶
• Graduate students often come from diverse backgrounds, which shape their approaches to coursework, classroom engagement, comfort in accessing resources, and relationship-building with faculty.⁴
• In such settings, faculty may question students' academic integrity, potentially undermining mutual trust and camaraderie.¹
• However, fostering a culture of expressed gratitude in academia can help students acknowledge the meaningful contributions faculty make to their education while enhancing their learning and behavior. This, in turn, enhances faculty motivation and may reduce burnout.2,³,⁶
• By encouraging gratitude in academic environments, institutions can strengthen …

Perceived Gaps In Preparation For Pathology Residency And Opportunities For Improvement, Barbara Knollmann-Ritschel, Julie Karp, Stephanie Barak, John Childs, Kristen Johnson, Amanda Lofgreen, Mary Berg, Satyapal Chahar, Hailey Gosnell, Cindy Mccloskey, Balaram Puligandla, Kristie White, Bronwyn Bryant

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The transition from medical school to residency is both a transformative and a challenging process. International literature suggests that there are known or perceived gaps in preparation for residency training in many areas of medicine. However, in the current published literature, there is no discussion of perceived gaps existing in pathology residency preparation. This study surveyed both pathology residency program directors and first-year pathology residents about the knowledge of pathology and basic medical skills residents received in medical school, perceptions about readiness for pathology residency, and perceived gaps in preparation for pathology residency that could be addressed. This survey found …

Professional Development Program: Sexual And Gender Minorities Education And Training, Aiden Echols, Bs, Madison Via, Bs, Audrey L. Zapletal, Otd, Ms, Otr/L, Cla, Chse, Karla A. Bell, Pt, Dpt, Phd, Fnap

Department of Occupational Therapy Posters and Presentations

Background

LGBTQ+ communities experience health care and health disparities; some reasons include:

• barriers in care
• negative attitudes
• lack of awareness by healthcare providers.

Studies have found healthcare professionals are not adequately trained in LGBTQ+ care

Educators benefit from professional development related to LGBTQ+ inclusivity in higher education.

Predicting Intravitreal Treatment Response Using Ultrawide-Field Angiographic Biomarkers In Diabetic Retinopathy, Karthik Reddy, Callie Deng, Boonkit Purt, Yue Liang, Nikhil Bommakanti, Gina Yu, Julie Rosenthal, Yannis M. Paulus

Wills Eye Hospital Papers

BACKGROUND: Diabetic retinopathy (DR) is a sight-threatening retinal disease with pathological mediation by vascular endothelial growth factor (VEGF). Intravitreal anti-VEGF injections are commonly used to manage DR. Ultra-wide-field fluorescein angiography (UWF-FA) can assess DR severity and characterize the amount of non-perfused retina (non-perfusion area, NP), neovascularization (neovascular area, NV), and foveal avascular zone (FAZ). However, the association between anti-VEGF treatment and NP, NV, and FAZ characterized by UWF-FA is not well established.

METHODS: A retrospective, single-center cohort study involved eyes of patients with Type 1 or 2 diabetes mellitus with at least one UWF-FA image. The area of the FAZ, …

A Structured, Competency-Based Framework For Aspiring Cardiothoracic Surgeons, Adham Ahmed, Samantha Colon, Gianna J. Dafflisio, Purab Kothari, Nina Uzoigwe, Alice Zhou, Juli Buchwald, Betemariam Sharew, Carter Glenn, Steven Medvedovsky, Justin Olivera, Ryan Kramer, Gabrielle Colon, Jonathan M. Tomasko, Sara J. Pereira, Mara Antonoff, Marc Pelletier, Irbaz Hameed

Student Papers, Posters & Projects

OBJECTIVE: Cardiothoracic surgery requires mastery of a broad knowledge base and advanced skillset to manage critically ill patients. Although competency-based assessment frameworks have been developed in several specialties, there remains a paucity of resources to guide practical progression for early cardiothoracic surgical trainees.

METHODS: Members of the Thoracic Surgery Residents Association, Thoracic Surgery Medical Student Association, and attending cardiothoracic surgeons with a strong track record of surgical education were invited to share their insights and experiences. A structured, milestone-driven roadmap was developed on the basis of their contributions.

RESULTS: We developed a structured, competency-based framework for early surgical trainees, with …

Creation And Evaluation Of Standardized Electronic Health Record Templates For Transition Of Care In Sickle Cell Disease: A Pilot Study, Stephanie Howe Guarino, Mohan Madisetti, Payal C. Desai, Akshat Jain, Kenneth Rivlin, Jerome A. Osheroff, Robin Miller, Brandi Campanella, Sophie Lanzkron, Julie Kanter

Cardeza Foundation for Hematologic Research

Objective The objective of this pilot project was to create a standardized Transition Note in the electronic health record (EHR) to facilitate clinician communication during the transition process from pediatric to adult care for youth with sickle cell disease (SCD). Methods Using a modified Delphi process, consensus was reached among 78 member centers from the National Alliance of Sickle Cell Centers (NASCC) on the essential health data elements for a standardized EHR Transition Note. Templates were created in 2 different EHR systems and piloted at 2 SCD centers. Perceived clinician acceptability, appropriateness, and feasibility were assessed using the AIM-IAM-FAM measures …

Modeling Surgeon Belief Updating Under Bias: A Bayesian Simulation In Shoulder Arthroplasty, Mariano Menendez, Michael Moverman, Surena Namdari, Frederick Matsen, David Ring

Rothman Institute Papers

BACKGROUND: Shoulder surgeons often offer markedly different treatment recommendations for a given patient and pathophysiology within the context of a common body of evidence. Prior beliefs and cognitive bias may contribute to this variability. Using Bayesian decision theory informed by principles of behavioral science, we modeled how surgeons with different initial beliefs and degrees of bias update their treatment preferences in response to new evidence comparing anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) when making surgery recommendations for advanced primary glenohumeral osteoarthritis.

METHODS: We developed a Bayesian simulation involving 3 hypothetical surgeons with distinct initial beliefs: …

The Mycancergene Study: A Hybrid Type 1 Effectiveness-Implementation Randomized Study Comparing A Patient-Centered Digital Genetic Health Portal To Usual Care After Receipt Of Cancer Genetic Testing, Daniel Chavez-Yenter, Dominique Fetzer, Brian Egleston, Susan Domchek, Linda Fleisher, Lynne Wagner, Kuang-Yi Wen, Kelsey Karpink, Lauren Gutstein, Shelby Posen, Enida Selmani, Briana Mcleod, Arravinth Anantharajah, Sarah Brown, Cara Cacioppo, Jacqueline Cappadocia, Jessica Ebrahimzadeh, Dana Falcone, Sarah Howe, Claire Langer, Beth Mccarthy-Wood, Michelle Weinberg, Angela Bradbury

Department of Medical Oncology Faculty Papers

BACKGROUND: Genetic testing has become more complex with the transition from single gene testing to multi-gene panels and whole-exome sequencing. The adoption of more complex genetic testing and the promise of precision medicine has created a critical and urgent need for longitudinal clinical follow-up with patients who undergo cancer genetic testing given the residual uncertainty. There is an increasing need for multidisciplinary translational research that focuses on how to advance precision medicine discoveries into clinical practice and to capitalize on connectivity (e.g. digital health) interventions in ways that optimize cancer risk reducing behaviors in real-world clinical populations.

METHODS: The overall …

Setdb1 Is Critically Required For Uveal Melanoma Growth And Represents A Promising Therapeutic Target, Imène Krossa, Céline Pisibon, Yann Cheli, Karine Bille, Mélanie Dalmasso, Sabah Hamadat, Chrystel Husser, Marie Irondelle, Julien Cherfils-Vicini, Frédéric Soysouvanh, Sacha Nahon-Esteve, Arnaud Martel, Sandra Lassalle, Jean-Pierre Caujolle, Célia Maschi, Stéphanie Baillif, Dan Hasson, Saul Carcamo, Andrerw E. Aplin, Irwin Davidson, Emily Bernstein, Valeria Naim, Robert Ballotti, Corine Bertolotto, Thomas Strub

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Metastatic uveal melanomas are highly resistant to all existing treatments. To identify actionable vulnerabilities, we conducted a CRISPR-Cas9 knockout screen using a library composed of chromatin regulators. We revealed that the lysine methyltransferase, SETDB1, plays a critical role in metastatic uveal melanoma cell proliferation and survival. Functionally, SETDB1 deficiency induces a DNA damage response, senescence-like state and growth arrest. Knockdown of SETDB1 is associated with a decreased expression of genes related to replication and cell cycle. Moreover, deficiency in CDC6, an essential regulator of DNA replication, phenocopies SETDB1 inhibition. Using a pre-clinical model, we further demonstrated that anti-SETDB1 therapy impairs …

Assessment Of Long-Term Endocrine Sequelae Of Completion (2-Stage) Versus Total (Single-Stage) Pancreatectomy: A Multi-Institutional Research Network And Single-Institution Analysis, Michael Chang, Matthew Kraft, Zachary Kaplan, Harish Lavu, Charles Yeo, Wilbur Bowne, Avinoam Nevler

Department of Surgery Faculty Papers

BACKGROUND: Total pancreatectomy can be associated with severe endocrine complications. This study compares endocrine outcomes of patients who underwent a single-stage total pancreatectomy versus a 2-stage completion pancreatectomy.

METHODS: We used data from a multi-institutional research network (TriNetX), which identified 1,079 propensity score-matched total pancreatectomy and completion pancreatectomy patient pairs for age, gender, and race. These data were validated by a single-center review of a prospectively maintained database of 1,600 pancreatectomies, from which 88 completion and total pancreatectomy patients treated between 2013 and 2023 were identified. The primary endpoints were postoperative rates of hypoglycemia and diabetic ketoacidosis during the first …

Perfusion Assessment In Ceus Imaging For Estimating Pancreatic Cancer Response To Sonoporation-Enhanced Chemotherapy., Omri Adler, Priscilla Machado, Trang Vu, Flemming Forsberg, Odd Helge Gilja, Dan Adam

Department of Radiology Faculty Papers

Accurate assessment of perfusion in vital organs like the pancreas is crucial for monitoring various pathologies, particularly tumors and their growth. While tumor growth inhibition usually results in decreased vascularization, current techniques for non-invasive and cost-effective perfusion assessment lack sufficient vessel separability for pancreatic applications, hindering optimal treatment selection and monitoring. Ultrasound (US) imaging offers advantages like low cost, rapid acquisition, non-invasiveness, and non-ionizing radiation. However, speckle, patient-related and acquisition-related motion artifacts, and limitations in distinguishing contrast-enhanced blood vessels, particularly in single frames, pose significant challenges. This study presents a novel solution utilizing image analysis of US contrast agents (UCAs) …

Association Between End-Of-Third-Year Objective Structured Clinical Examinations And Accreditation Council For Graduate Medical Education Milestones During Intern Year, Katherine Berg, Jillian Zavodnick, Dianna Cheney-Peters, Heather Heiman, Sally Santen, Yoon Soo Park, Anita Wilson

Department of Medicine Faculty Papers

BACKGROUND: The Objective Structured Clinical Examinations (OSCEs) administered in medical schools have increased in importance with the elimination of United States Medical Licensing Exam (USMLE) Step 2 Clinical Skills (CS).

OBJECTIVE: The purpose of this study was to understand the association between student performance on an end-of-third-year OSCE and performance in residency.

METHODS: This study explored the correlations between OSCE performance and relevant Accreditation Council for Graduate Medical Education (ACGME) milestone 1.0 performance. This study included students’ scores from 139 Sidney Kimmel Medical College (SKMC) students who completed an end-of-third-year OSCE during 2015 and 2016 and completed an intern year …

Acute Mastoiditis In Children During The Covid Era: A Systematic Review And Meta-Analysis, Erin Briggs, Isabelle J. Chau, Shaun A. Nguyen, Justin C. Pelic, Erin A. Harvey, Ted A. Meyer

SKMC Student Presentations and Publications

OBJECTIVE: Explore the impact of the COVID-19 pandemic on pediatric acute mastoiditis (AM).

DATA SOURCES: CINAHL, Cochrane Library, PubMed, Scopus.

METHODS: Literature was searched from 2014 to 2025 for articles reporting AM in children. Specific outcomes included clinical presentation, bacterial epidemiology, complications, and management. Primary outcome measures included continuous measures (mean), proportions (%), mean difference (Δ), and relative risk (RR) with 95 % confidence intervals (CI).

RESULTS: There were seven included studies (N = 1001 children) with 632 patients in the pre-COVID cohort and 369 in the COVID-era cohort. There was a significant difference in the proportion of intracranial complications …

Enhancing Cyberattack Resiliency Through The Radiotherapy Backup And Recovery Dashboard Tool, Justin Pijanowski, Eric Nguyen, Yasin Abdulkadir, Justin Hink, Yevgeniy Vinogradskiy, James Lamb

Department of Radiation Oncology Faculty Papers

PURPOSE: Radiation Oncology departments impacted by recent cyberattacks were unable to access data backups or their Record and Verify (R&V) system and therefore faced challenges to resume patient treatments in a timely manner. We present a novel software tool that backs-up critical radiotherapy treatment information and displays essential information for on-treatment patients in an intuitive and accessible dashboard allowing clinics to continue radiotherapy treatments. The purpose of this report is to describe implementation details, challenges, and share open-source code to facilitate radiation oncology clinics' efforts to develop tools to improve cyberattack resiliency.

METHODS: The Radiotherapy Backup and Recovery Dashboard Tool …

Tetanus And Diphtheria Vaccination Coverage And Electronic Health Record Alerts For Immigrants And Refugees At Three United States Health Systems, 2017-2023, Abigail Steiner, Ann Settgast, Malini Desilva, Colleen Payton, Kristine Knuti Rodrigues, Margaret Nolan, Ella Chrenka, Mateo Frumholtz, Jeremy J Michel, Amy Stein, Blain Mamo, Janine Young

Department of Medicine Faculty Papers

Tetanus and diphtheria (tetanus/diphtheria) infections are rare in the United States (U.S.), but adequate vaccination is essential to prevent disease and associated morbidity and mortality. Compared with U.S.-born persons, immigrant and refugee adults have lower completion rates for tetanus/diphtheria vaccination series. However, most electronic health record (EHR)-generated recommendations only advise tetanus/diphtheria vaccines every 10 years for persons ≥18 years. This analysis compared documented completion of tetanus/diphtheria 3-dose vaccination series with EHR-generated recommendations for immigrant and refugee patients at three U.S. health systems seen during 2017-2022. The EHR documented complete 3-dose tetanus/diphtheria vaccine series for 28 % of 50,829 adult immigrant …

Rtx-303, An Orally Bioavailable Polθ Polymerase Inhibitor That Potentiates Parp Inhibitors In Brca Mutant Tumors, Gurushankar Chandramouly, William Fried, John Gordon, Douglas Ralph, Channita Keuk, Sangeeta Kumari, Mercy Ramanjulu, William Auerbacher, Leonid Minakhin, Taylor Tredinnick, Bernadette Tiberi, George Morton, Robert Betsch, Kathy Q. Cai, Umeshkumar M Vekariya, Mrityunjay Tyagi, Tomasz Skorski, Sergey Karakashev, Neil Johnson, Wayne E. Childers, Xiaojiang S. Chen, Richard T. Pomerantz

Department of Biochemistry and Molecular Biology Faculty Papers

DNA polymerase θ (Polθ) is a polymerase-helicase fusion protein that is synthetically lethal with homologous recombination (HR) factors, such as BRCA1/2, and confers resistance to PARP inhibitors (PARPi) and other genotoxic cancer therapies. Previously developed Polθ polymerase (Polθ-pol) inhibitors (Polθi) exhibited limited pharmacological activity and metabolic stability, warranting the development of a Polθi with improved drug-like properties. Here, we developed RTx-303, a selective allosteric small-molecule Polθ-pol inhibitor that exhibits 5.1 nM IC50, 88% oral bioavailability, and a prolonged half-life along with its equipotent metabolite. X-ray crystallography highlights the development of a solvent-exposed side-chain that is essential for the optimal drug-like …

Influences On Emergency Clinician Use Of Health Information Exchange: Interview Study, Brian E. Dixon, Umesh Ghimire, Benjamin Richter, Corinne Bowditch, Saurabh Rahurkar, John T. Finnell, Joshua R. Vest

Division of Internal Medicine Faculty Papers & Presentations

BACKGROUND: Health information exchange (HIE) supports clinical decision-making in emergency medicine settings. Despite evidence and policies that encourage the adoption of HIE, use by clinicians is limited. Moreover, few studies examine HIE use years after adoption by hospitals or clinics.

OBJECTIVE: This study aims to examine the perceptions and use of a mature, operational HIE system by emergency department clinicians years after its implementation.

METHODS: We interviewed 21 clinicians in various roles (eg, attending physician and nurse practitioner) across multiple health systems that participate in a statewide HIE network. We asked questions about their use of the HIE system and …

Analysis Of Physician-Modified Endograft Utilization Using Online Databases And Social Media, Robert Tatum, Michael Nooromid, Paul Dimuzio, Babak Abai

Department of Surgery Faculty Papers

Background: To characterize the present landscape of physician-modified endograft (PMEG) use and the impact of an institution's investigational device exemption (IDE) status on endograft use by analyzing publication trends and social media coverage.

Methods: We used the social media platform X and three online bibliographic databases to perform a keyword search using the following terms: PMEG, physician-modified endograft, and laser fenestration. Data extracted from X and online articles included authorship, IDE protocol status, pertinent clinical outcome measures, and others. An internet search was performed to determine which institutions offered revascularization with a custom-made device within an IDE protocol and which …

Assessing The Cardiac Safety Of A Multimodal Protocol For 'Tranq Dope' Withdrawal: A Retrospective Qtc Analysis, Kory London, Emily Deschler, Sabrina Butt, Steven Graver, Jake Figaniak, Nathan Hersh, Ariana Rucker, Bogdan Popa, Jenna Hoopes, Jennifer Kahoud, Behzad Pavri

Department of Emergency Medicine Faculty Papers

BACKGROUND: "Tranq dope"-fentanyl adulterated with xylazine-has complicated the management of opioid withdrawal in emergency departments (EDs). A novel withdrawal protocol was implemented to address these challenges, utilizing concurrent agents to intentionally synergize and potentiate effects. Questions remain about the safety of its components, some of which may prolong the QT interval.

METHODS: We conducted a retrospective cohort study of adult ED patients with suspected fentanyl/xylazine exposure treated utilizing novel protocol across two urban hospitals in Philadelphia, PA between September 2022 and October 2024. Patients with both pre- and post-treatment electrocardiograms (ECGs) were included. QTc intervals were reviewed by an experienced …

Regorafenib Pulmonary Toxicity: A Case Of Cavitary Lung Disease And Ards Treated With Infliximab, Michael Dong, Mackenzie Kramer, Tanmay Gandhi, Gautam George

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

Regorafenib-induced pneumonitis and acute respiratory distress syndrome (ARDS) are rare and poorly characterized toxicities. We describe a 43-year-old male with metastatic colorectal cancer who developed hypoxic respiratory failure after two cycles of regorafenib. Imaging revealed cavitary lung lesions and diffuse ground glass opacities. Despite antibiotics and high-dose corticosteroids, his condition deteriorated, requiring ICU admission and mechanical ventilation. Bronchoalveolar lavage revealed bacterial pathogens, and he was treated for pneumonia. After multidisciplinary discussion, he was assessed to have regorafenib-induced pneumonitis as a major driver of his respiratory failure, and after limited steroid response, infliximab was administered with marked respiratory improvement. However, he …

A Pooled Sample Study Of Opioid Use Disorder Treatment Wait Time Among A Pregnant Population In New York, Stanley Nkemjika, Gulshan Begum, Bolaji Yoade, Vaibhav Vyas, Henry Onyeaka, Olubusola Olatunji, Olaniyi Olayinka, Ayana Jordan

Department of Psychiatry and Human Behavior Faculty Papers

Background and Aim: Opioid use disorder (OUD) during pregnancy has become a major public health issue, with its prevalence rising significantly in recent years. The incidence of neonatal abstinence syndrome (NAS) has also surged, from 1.5 cases per 1000 hospital births in 1999 to 6.0 cases per 1000 in 2013. This study aims to identify and analyze the concerns faced by pregnant people in accessing OUD treatment on time, specifically focusing on New York. Methods: The pooled sample of 225,275 individuals represents pregnant patients with OUD who received treatment at substance use disorder (SUD) facilities across New York State between …

Utility And Safety Of Artificial Intelligence For Patient-Initiated Contact After Functional Rhinoplasty, W. Jack Palmer, Dana Michlin, Leonard Estephan, Jason Tasoulas, Khashayar Arianpour, Harleen K. Sethi, Daniel J. Campbell, Howard Krein, Ryan Heffelfinger

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: To understand the content of patient calls after functional rhinoplasty and to evaluate artificial intelligence chatbots' ability to provide accurate, intelligible, and safe responses.

STUDY DESIGN: Retrospective review.

SETTING: Tertiary-care institution.

METHODS: A single-institution, retrospective review was conducted for patients who underwent functional rhinoplasty between 2017 to 2023. Postoperative calls and messages prior to first follow-up were analyzed, and 48 representative prompts were generated, including 6 "Red Flag Questions" indicating potential complications. Prompts were input into 4 chatbots (ChatGPT, Claude, Perplexity, and Gemini). Two independent, blinded experts graded responses using a Likert-style Global Quality Scale (GQS) and a binary …