Medicine and Health Sciences Commons^™

Characterization Of Litigation After Tympanoplasty And Mastoidectomy In The United States, Alyssa D. Reese, Lauren A. Dinardo, Soumya Gupta, Kristina F. Powers, Samuel Colca, Michele M. Carr

Department of Otolaryngology (ENT) Faculty Publications

Introduction

Tympanoplasty and mastoidectomy are common procedures performed by otolaryngologists that can result in complications for which patients may seek compensation. Medical malpractice case analyses may offer insight into how clinicians can avoid risk and improve patient satisfaction. We aimed to comprehensively characterize litigation after mastoidectomies and tympanoplasties in the United States.

Methods

The Westlaw Campus Research legal database was searched for all available court decisions associated with claims of medical malpractice after tympanoplasty and/or mastoidectomy in the United States between 1975 and 2022. Information on the plaintiffs' relationships to the patients, patient characteristics, states where the procedures took place, …

Size Of Pediatric Tracheostomy Tube And Predictors Of Postoperative Complications, Soukaina Eljamri, Jordyn Lucas, Amber Shaffer, Basil Hashimi, Marina Rushchak, Reema Padia

Department of Otolaryngology (ENT) Faculty Publications

Objective

(1) To investigate weight as an alternative guide for trach tube choice. (2) Evaluate complications 3-month posttracheostomy and associations with patient and trach tube factors.

Study design

Retrospective cohort study.

Setting

Single academic medical center.

Methods

Patients < 2 years old who underwent tracheostomy placement from 2017 to 2022 were identified. Associations between trach characteristics, trach size/length, chest x-ray (CXR) and intraoperative endoscopy measurements, and complications within 3 months posttracheostomy placement were evaluated.

Results

In total, 68 patients were included in the study, with a median age of 4 months (range: 1 day to 1.74 years) and weight of 4.1 kg (range: 1.8-11.6 kg) at the time of the procedure. The length of the trachea measured on CXR was more closely associated with weight (ρ = 0.403, P = .0007) than with age (ρ = …

Otolaryngology Applicants' Preferences For Virtual Vs. In-Person Interviews During The 2023-2024 Application Cycle, Taylor S. Erickson, Robert Frederick, Steven D. Pletcher, Aileen Dowden, Dana Dunleavy, Eric J. Dobratz

Department of Otolaryngology (ENT) Faculty Publications

Background Since the shift to virtual residency interviews, applicants and programs have reported difficulty distinguishing themselves in a virtual format, reduced exposure to medical campuses, and limited opportunity to establish personal connections. The 2023-2024 application cycle was the first time virtual and in-person interview formats were available in otolaryngology–head and neck surgery (OHNS). Programs offered one or both formats, and in some cases, applicants were given the choice between the 2.

Objective To assess the perceptions of OHNS applicants regarding virtual versus in-person interviews during the 2023-2024 application cycle.

Methods A 20-question survey was distributed via email through the Association …

A Comparison Of Allergen Sensitization Profiles In Patients With Chronic Rhinosinusitis With And Without Nasal Polyposis, Lauren Trzcinski, Suhas Bharadwaj, Randall A. Bloch, Joseph K. Han, Kent K. Lam

Department of Otolaryngology (ENT) Faculty Publications

Chronic rhinosinusitis (CRS) and allergic rhinitis (AR) are common comorbid sinonasal conditions. CRS is classically divided into two distinct phenotypes: CRS with nasal polyposis (CRSwNP) and CRS without nasal polyposis (CRSsNP). The purpose of this retrospective observational study is to determine whether aeroallergen sensitization profiles in patients with comorbid CRS and AR can distinguish between CRSwNP and CRSsNP. A total of 241 patients diagnosed with comorbid CRS and AR who underwent skin prick testing or in vitro allergy testing in a single tertiary rhinology practice were included for evaluation. The rates of allergen-specific sensitizations in CRSwNP patients were compared with …

Wrongful Migration: A Hidden Culprit Behind Flank Pain, Ryan Miller, Anjeza Cipi, Emma Pierce

Department of Emergency Medicine Faculty Publications

[Introduction] A 32-year-old woman with no significant past medical history presented to the emergency department with 11 days of fever, fatigue, chills, and new-onset fullness in her left flank. She denied dysuria, abdominal pain, or vaginal bleeding. Vital signs showed fever and mild hypotension, and the physical examination revealed left-sided abdominal distension. Laboratory results demonstrated leukocytosis and a lactate of 3.2 mmol/L. She appeared nontoxic but was persistently febrile despite initial fluids and antibiotics. Computed tomography—shown in Figure 1, and ultrasound—shown in Figure 2, were obtained and revealed the diagnosis.

Diffuse Unilateral Leg Swelling, Bruce M. Lo, Kylie Butler, Navjot Kaur, Kirsten Pennell

Department of Emergency Medicine Faculty Publications

[Patient Presentation] A 46-year-old woman with a history of hypertension presented with 14 days of right leg pain. The pain began after straining her leg while lifting heavy boxes at work, with diffuse leg swelling noted 3 days later. She reported subjective fever but no other complaints. Patient denies any illicit drug use. Initial vital signs included a temperature of 100.1 °F, heart rate of 122 beats per minute, and blood pressure of 158/91 mm Hg. Physical examination revealed a diffusely swollen and tender right leg (Fig 1). Computed tomography (CT) of the right leg identified a 19 X 7 …

Ai Significantly Improves Detection Of Prenatal Ultrasounds Suspicious For Major Congenital Heart Defects By Obgyn/Mfms, Jennifer Lam-Rachlin, Rajesh Punn, Sarina K. Behera, Miwa Geiger, Matthias Lachaoud, Nadine David, Sara Garmel, Matthew K. Janssen, Kendra Sylvestser, John Kennedy

Conference Presentation Abstracts

Objective: Congenital heart defects (CHDs) are a leading cause of infant morbidity and mortality partly due to low prenatal detection rates. We evaluated whether an artificial intelligence (AI) system can improve the detection of CHDs on fetal ultrasound exams among both general OBGYNs and MFM specialists. Study Design: The AI system analyzes all grayscale 2D ultrasound cines of an exam and detects 8 morphological findings associated with severe CHDs. The presence of any such finding should justify patient referral for further examination. The AI system identifies each finding as present, absent or inconclusive, and highlights frames where findings can be …

Cerebroplacental Doppler Ratio For The Prediction Of Adverse Perinatal Outcomes In Late-Onset Fetal Growth Restriction, Sonia Sajja, Onur Turkoglu, Torey Asao, Perry Friedman, Ray Bahado-Singh

Conference Presentation Abstracts

Objective: Late-onset fetal growth restriction (LO-FGR), defined as onset 3 32 weeks gestation, is the more common subgroup of FGR. The umbilical artery Doppler is usually unaffected. There are no subgroup-specific guidelines for monitoring pregnancies affected by LO-FGR. We compared the utility of the cerebroplacental Doppler ratio (CPR) to the Biophysical Profile (BPP), a widely endorsed FGR monitoring tool, for the prediction of adverse perinatal outcomes (APO). Study Design: This is a retrospective cohort study of LO-FGR, defined as estimated fetal weight < 10th%, from 2013-2018. Using logistic regression analysis, we determined whether low CPR < 5th% and BPP score £ 6 significantly independently predicted the composite APO defined as one or more complications: cord pH < 7.20, 5-minute Apgar score of < 5, operative or cesarean delivery secondary to non-reassuring fetal heart tracing, assisted respiration at birth, NICU admission, and/ or perinatal death. Secondarily, we also evaluated prediction of severe neonatal morbidity (SNM) defined in Table 1 (legend). Results: There were 233 cases of LO-FGR of which 76 (34%) had a low CPR percentile and 28 (13%) had a low BPP score. There were 22 (9.9%) cases with SNM of which 5 (2.1%) had a low CPR percentile and 4 (1.8%) had a low BPP score. A low CPR was associated with a significantly higher rate of individual and composite APO than cases with normal CPR percentile (p < 0.001) [Table 1]. Both a low CPR percentile and a low BPP score significantly predicted APO overall. CPR appeared to be a better predictor of the APO, controlling for gestational age at testing [Table 2]. Only BPP significantly predicted SNM: CPR (OR = 4.64, p = 0.13) and BPP (OR = 4.11, p = 0.038). Conclusion: A low CPR percentile was a significant independent predictor of perinatal complications in LO-FGR, including abnormal fetal heart rate tracing, smaller birthweight percentile, and NICU admission. CPR appeared superior to BPP overall. CPR should be considered as a fetal surveillance tool in LO-FGR.

Defining An Irrelevant Plasma Concentration For Trichlormethiazide In Racing Horses – A Case Report And Analysis, Kimberly Brewer, Justin C. Holmes, Clara Fenger, Abelardo Morales-Briceño, Andreas F. Lehner, George A. Maylin, Robert Holland, Levent Dirikolu, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

This communication reviews the matter of the clinical, pharmacological, and regulatory significance of a 4.95 nanogram/ml identification of trichlormethiazide in urine from a horse six days after administration of a compounded trichlormethiazide/ dexamethasone preparation. This combination of dexamethasone and trichlormethiazide has historically been widely used in bovine and equine medicine to reduce local inflammation and edema. The horse was administered an oral formulation of trichlormethiazide 400 mg /dexamethasone 10 mg per packet under veterinary supervision on days 7 and 6 before the race in question. Following the race, the post-race urine sample from the horse tested “positive” for trichlormethiazide at …

Trace Level Identifications Of N-Ethylnicotinamide In Racing Horses Associated With A Vitamin B3 Supplement: Case Reports And Analysis, Clara Fenger, Kimberly Brewer, Abelardo Morales-Briceño, Andreas F. Lehner, George A. Maylin, Robert Holland, Levent Dirikolu, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

Nikethamide, N,N-diethyl-3-pyridinecarboxamide (Coramine®) is a central nervous system stimulant at one time used therapeutically in human medicine but no longer marketed in the US. Nikethamide is classified a Drug Class 1, Penalty Class A substance by the Association of Racing Commissioners International (ARCI) and as a Horseracing Integrity and Safety Authority (HISA) SO or banned Stimulant that lacks FDA approval. Identifications of Nikethamide or its metabolite N-Ethylnicotinamide in racing samples can result in significant penalties in horse racing. Nikethamide is rapidly metabolized to N-Ethylnicotinamide, which remains detectable in plasma and urine leading to its use as a regulatory “marker” of …

Combination Of Hsp90 Inhibitors And Hsp70 Inducers Prevent Hydrochloric Acid-Induced Pulmonary Fibrosis In Rabbits, Ruben M. L. Colunga Biancatelli, Pavel A. Solopov, Tierney Day, Dan E. Austin Jr., Len E. Murray, John D. Catravas

Bioelectrics Publications

Combined therapies with Heat Shock Protein 90 (HSP90) inhibitors and Heat Shock Protein 70 (HSP70) inducers are gaining significant interest in cancer and cardiovascular research. Here, we tested the hypothesis that HSP90 inhibitors and HSP70 inducers, together, can block the development of pulmonary fibrosis. We exposed New Zealand White Rabbits to hydrochloric acid (HCl, 0.1 N, 1.5 mL/kg), one of the top five chemicals most commonly involved in accidental exposures and inhalation injuries worldwide, and treated animals with either the orally available HSP90 inhibitor TAS-116 (1.7 mg/kg 5x/week) or TAS-116 combined with the HSP70 inducer, geranylgeranyl acetone (GGA, 50 mg/kg, …

Potentiation Of Gelonin Cytotoxicity By Pulsed Electric Fields, Olga N. Pakhomova, Eleni Zivla, Giedre Silkuniene, Mantas Silkunas, Andrei G. Pakhomov

Bioelectrics Publications

Gelonin is a ribosome-inactivating protein with extreme intracellular toxicity but poor permeation into cells. Targeted disruption of cell membranes to facilitate gelonin entry is explored for cancer and tissue ablation. We demonstrate a hundreds- to thousands-fold enhancement of gelonin cytotoxicity by pulsed electric fields in the T24, U-87, and CT26 cell lines. The effective gelonin concentration to kill 50% of cells (EC₅₀) after electroporation ranged from <1 nM to about 100 nM. For intact cells, the EC₅₀ was unattainable even at the highest gelonin concentration of 1000 nM, which reduced cell survival by only 5–15%. For isoeffective electroporation treatments using 300 ns, 9 µs, and 100 µs pulses, longer pulses were more efficient at lowering gelonin EC₅₀. Increasing the electric field strength of 8, 100 µs pulses from 0.65 to 1.25 kV/cm reduced gelonin EC₅₀ from 128 nM to 0.72 nM. Conversely, the presence of 100 nM gelonin enabled a more than 20-fold reduction in the number of pulses required for equivalent cell killing. Pulsed electric field-mediated delivery of gelonin shows promise for hyperplasia ablation at concentrations sufficiently low to minimize or avoid systemic toxicity.

The Effect Of Liquid Conductivity On A Helium Plasma Jet And The Hydrogen Peroxide Production, Edwin A. Oshin, M. Ziaur Rahman, Chunqi Jiang

Bioelectrics Publications

Understanding plasma-liquid interactions and the impact of the electrical conductivity (σ) of liquid on plasma is important for plasma applications in water treatment and medicine. Ultrapure water, phosphate-buffered saline (PBS) solution, biological media, and sodium chloride (NaCl) solutions at various concentrations were used in this study to provide a broad range of conductivity values ranging from 0.055 μS cm⁻¹ to 222 mS cm⁻¹. A helium atmospheric pressure plasma jet (APPJ) impinging on liquid was generated in ambient air using a hollow-needle electrode that was powered by 200 ns, 7 kV pulses at a pulse repetition frequency of …

The Ptp4a3 Inhibitor Kvx-053 Reduces Severe Acute Respiratory Syndrome Coronavirus 2 (Sars-Cov-2) Virulence, Inflammation, And Development Of Acute Lung Injury In K18-Hace2 Mice, Ruben M. L. Colunga-Biancatelli, Pavel A. Solopov, Caitlin M. Woodson, Irving Coy Allen, Ivan Akhrymuk, Maryna Akhrymuk, Brittany N. Heath, Hannah M. Ivester, Tierney Day, Dan E. Austin, Kylene Kehn-Hall, John S. Lazo, Elizabeth R. Sharlow, John D. Catravas

Bioelectrics Publications

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has caused a global health crisis, marked by high transmissibility and virulence. Despite widespread vaccination efforts, effective treatments for COVID-19, particularly for severe cases leading to Acute Respiratory Distress Syndrome (ARDS), remain limited. This study investigates the efficacy of KVX-053, a protein tyrosine phosphatase type IVA (PTP4A3) small molecule inhibitor, in modulating SARS-CoV-2-induced inflammation and lung injury using in vitro cell models and in vivo K18-hACE2 transgenic mice. KVX-053 reduced in vitro pro-inflammatory cytokine expression, including TNFα, CXCL10, and CXCL11, without impacting viral replication or cell viability. K18-hACE2 mice treated with KVX-053 demonstrated …

Anabolic Properties Of The Progestin Altrenogest And Its Regulation As An Environmental Substance In Horse Racing – Review And Analysis, Andreas F. Lehner, Levent Dirikolu, Sarah Jacob, Kimberly Brewer, Abelardo Morales Briceñoe, Robert Holland, George Maylin, Clara Fenger, Thomas Tobin

Maxwell H. Gluck Equine Research Center Faculty Publications

Altrenogest is a progestogen substance used in equine medicine for the synchronization of ovulation during the spring breeding season and the control of estrus in mares. It accomplishes its actions by down-regulation of endometrial progesterone receptors and repression of estrogen receptor transcriptional activation. However, various groups have also measured androgen receptor binding activity for altrenogest in vitro; these findings combined with androgenic and anabolic properties roughly 1/20 in potency of testosterone and its structural similarity to the anabolic steroid trenbolone have created concerns among racing authorities of altrenogest’s potential abilities to alter the outcome of equine athletic performance, even though …

The Mediating Effect Of Injury On The Relationship Between Running Mileage And Depressive Symptoms In Division 2 Cross Country Athletes, Jaxon Leduc

Cal Poly Humboldt theses and projects

Training for a cross-country season requires athletes to accumulate a high volume of training miles at different intensities. Over a period of months and years, consistent high training volumes have been shown to contribute to overuse injuries in cross country athletes. Injuries have been shown to negatively impact athlete’s mental health; this is especially true in student athletes. The purpose of this research is to explore the mediating effect of injuries on the relationship between training volume and mental health in collegiate cross-country runners. Participants in this study were 40 members of NCAA Division 2 Cross Country teams with eligibility …

A Comparative Analysis Of Perineuronal Nets In Trout And Zebrafish Models, Adnan Alyan

Cal Poly Humboldt theses and projects

Perineuronal nets (PNNs) are specialized extracellular matrix structures that surround certain types of neurons in the central nervous system. Research from the past few decades has cemented PNNs as an integral player in the closure and onset of critical periods, memory modulation, and neural plasticity. These effects are thought to occur when PNNs form around a neuron and structurally stabilize its synaptic connections. PNNs have been directly linked to behavioral changes, making them of interest to psychologists as well as neuroscientists. Several PNN components, such as Hapln1 and aggrecan such as have been found in zebrafish, a teleost fish (Kang …

Tickborne Illness, Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Animal Bites (Mammal), Children's Mercy Kansas City

Clinical Pathways

No abstract provided.

Utilizing A Virtual Discharge Nurse To Help Decrease Patient Length Of Stay And Improve Earlier Discharge Times, Carol A. Romano

West Chester University Doctoral Projects

Abstract

This Doctor of Nursing Practice (DNP) project explores the impact of implementing a Virtual Discharge Nurse (VDN) on patient length of stay (LOS) and discharge timing at Paoli Hospital within the Main Line Health system. Hospital discharges are often complex and can negatively impact patient flow and outcomes. This study highlights the urgent need for innovative discharge practices in healthcare and supports the potential benefits of integrating technology into nursing roles to improve patient care and operational efficiency. The project's significance lies in addressing these challenges by utilizing VDN to enhance communication, education, and resource management during discharge. We …

Cultivating Civility, Courtney Ruck

West Chester University Doctoral Projects

Nurse leaders play a vital role in creating, sustaining, and ensuring a culture of civility along with a healthy work environment for both staff and patients. A challenge nurse leaders face today is the prevalence of bullying and incivility that continues to grow within the nursing profession and has detrimental effects on nursing staff, patient satisfaction, and healthcare organizations. Bullying and incivility can have disastrous effects on the mental, emotional, physical, and professional lives of those victimized by such behavior. When a culture of incivility is prevalent, patients suffer as secondary victims; patient safety and patient satisfaction are compromised. Organizations …

Development Of An Artificial Intelligence Powered Software For Automated Analysis Of Skeletal Muscle Ultrasonography, Zoe Calulo Rivera, Felipe González-Seguel, Arimitsu Horikawa-Strakovsky, Catherine Granger, Aarti Sarwal, Sanjay Dhar, George Ntoumenopoulos, Jin Chen, V. K. Cody Bumgardner, Selina M. Parry, Kirby P. Mayer, Yuan Wen

Center for Muscle Biology Faculty Publications

Muscle ultrasound has high utility in clinical practice and research; however, the main challenges are the training and time required for manual analysis to achieve objective quantification of muscle size and quality. We aimed to develop and validate a software tool powered by artificial intelligence (AI) by measuring its consistency and comparability of expert manual analysis quantifying lower limb muscle ultrasound images. Quadriceps complex (QC) and tibialis anterior (TA) muscle images of healthy, intensive care unit, and/or lung cancer participants were captured with portable devices. Manual analyses of muscle size and quality were performed by experienced physiotherapists taking approximately 24 …

The Effect Of Fructose Metabolism On Hepatic De Novo Lipogenesis And Adipose Tissue Insulin Resistance, Taghreed Ibrahim Fadhul

Theses and Dissertations--Nutritional Sciences

There is a worldwide epidemic of obesity and metabolic dysfunction. The root cause of obesity is driven by a positive energy balance, which is a consequence of increased caloric intake and decreased energy expenditure. Energy intake is the more dominant force, as increasing energy expenditure is a time-consuming and labor-intensive process. The caloric surplus can be mainly accounted for by increased consumption of high-fat and high-sugar diets. While the risks associated with fat consumption are well-documented, the impact of sugar intake is less understood.

Fructose is a simple sugar widely consumed in modern diets. Its intake has been associated with …

Menstrual Hygiene Screening Needs Assessment In South Dakota, Mariah M. Shafer, Denyelle Kenyon

Scholarship Pathways Program

Introduction: Menstrual hygiene management (MHM) is essential to women’s reproductive health; literature demonstrates there are mental, social, and economic consequences to inadequate MHM in rural and developing countries. Emerging studies show that US women who are impoverished, experiencing homelessness, or incarcerated also face poor MHM. To understand the implications of poor MHM in South Dakota, a largely rural state, a thorough gynecologic health history is essential; this needs assessment explores the scope of MHM questions asked by SD providers.

Methods: This study used survey methodology to determine the quality and depth of gynecologic health histories commonly taken regarding hygiene. The …

Sharksrx Newsletter Spring 2025, Nova Southeastern University

NSU Sharks Rx

No abstract provided.

Factors And Outcomes Associated With Using Scratch‐Cooked, Organic, And Locally Grown Foods In School Meals In California, Monica D. Zuercher, Dania Orta-Aleman, Caitlin D. French, Juliana F.W. Cohen, Christina A. Hecht, Kenneth Hecht, Leah Elizabeth Chapman, Margaret Read, Punam Ohri-Vachaspati, Marlene B. Schwartz, Anish I. Patel, Lorrene D. Ritchie, Wendi Gosliner

Health Sciences Faculty Publications

No abstract provided.

Synthesis, Characterization, And Biological Activity Of Ni(Ii) And Co(Iii) Thiosemicarbazone Complexes As Potential Anticancer Agents, Jack Martin

Pitzer Senior Theses

The mechanics by which Reactive Oxygen Species work is an area of great interest given ROS’s wide range of biological applications. From cell signaling and mitochondrial regulation to pathogenesis and tumor cell death, varying concentrations of ROS in a system can lead to a whole host of positive and negative effects. In a similar vein, thiosemicarbazones are known to be equally useful for their myriad of antibacterial, antifungal, antiviral, and antitumoral effects. They have been at the core of the pharmaceutical world or the better part of the last century. The purpose of this work is to synthesize, characterize and …

Optimizing Decision-Making In A Cerebral Palsy Model Using Reinforcement Learning, Richard Ampah

Pitzer Senior Theses

This study presents an original interdisciplinary investigation into how reinforcement learning (RL) can model motor and cognitive defects and potentially improve motor and cognitive functions in individuals with cerebral palsy (CP), a non-progressive neurological disorder that impairs movement and adaptability. Integrating computational neuroscience and machine learning, the research applies policy gradient methods and Markov Decision Processes (MDPs) to simulate adaptive learning in agents with and without CP-related constraints.

The central aim is to compare the cumulative rewards of optimal policies, derived from value iteration, and human-like learning policies using the REINFORCE algorithm, both with and without the Bellman baseline. The …

Evaluation Of Corticosteroid Use In Pediatric Patients With Bronchiolitis, Kaitlyn Margraf Pharmd

Pharmacy Residency

Presented at Midyear Clinical Meeting.

Nearly 67% of pediatric patients treated for bronchiolitis received steroids with no underlying indication, which deviates from clinical guidelines. Patients who received steroids without an indication had an apparent trend toward more oxygen support and had an increase in maximum flow rate compared to patients with an indication for steroid use.

Use Of Finerenone For Chronic Kidney Disease In Type 2 Diabetes: A Cross-Sectional Study At A Large Health System, Robert D. Beckett

Parkview Pharmacy Department

Presented at the Midyear Clinical Meeting.

While most patients met individual KDIGO finerenone initiation criteria, fewer than one-third met all guideline recommended parameters. Guideline directed K+ monitoring following initiation was underperformed, highlighting a need for improved follow up Procedures.