Medicine and Health Sciences Commons^™

Survival-Inferred Fragility Of Statistical Significance In Phase Iii Oncology Trials, Alexander D Sherry, Yufei Liu, Pavlos Msaouel, Timothy A Lin, Alex Koong, Christine Lin, Joseph Abi Jaoude, Roshal R Patel, Ramez Kouzy, Molly B El-Alam, Avital M Miller, Mohannad Owiwi, Jonathan Ofer, David Bomze, Zachary R Mccaw, Tomer Meirson, Ethan B Ludmir

Faculty, Staff and Student Publications

In phase III oncology trials, superiority is defined by statistical significance using P thresholds. However, this approach has been criticized because P is continuous. Here, we reconstruct patient-level data for 230 phase III oncology trials to model the robustness of statistical significance by estimating the survival-inferred fragility index (SIFI), defined as the smallest number of patients changing arms that alters the statistical significance interpretation. The median SIFI was 8 patients (IQR 4-19), representing 1.4% of enrollments (IQR 0.7%-3%). As a continuous statistic, P-but not the significance interpretation-was correlated with SIFI. Moreover, overall survival endpoints were more fragile than surrogate endpoints. …

Feasibility Of Manufacturing And Antitumor Activity Of Til For Advanced Endometrial Cancers, Yongliang Zhang, Kathleen N Moore, Amir A Jazaeri, Judy Fang, Ilabahen Patel, Andrew Yuhas, Patrick Innamarato, Nathan Gilbert, Joseph W Dean, Behzad Damirchi, Joe Yglesias, Rongsu Qi, Michelle R Simpson-Abelson, Erwin Cammaart, Sean R R Hall, Hequn Yin

Faculty, Staff and Student Publications

Lifileucel, a tumor-infiltrating lymphocyte (TIL) cell therapy approved for advanced melanoma, demonstrates promise for treating other solid tumors, including endometrial cancer (EC). The current study evaluates the feasibility of manufacturing TILs from EC tumors using Iovance’s proprietary 22-day Gen2 manufacturing process. Key parameters, including TIL yield, viability, immune phenotype, T-cell receptor clonality, and cytotoxic activity, were assessed. Of the 11 EC tumor samples processed at research scale, 10 (91%) successfully generated >1 × 109 viable TIL cells, with a median yield of 1.1 × 1010 cells and a median viability of 82.8%. Of the four EC tumor samples processed at …

Conjugative Delivery Of Toxin Genes, Yang Grace Li, Daniel Haeusser, William Margolin, Peter J Christie

Faculty, Staff and Student Publications

The bacterial type IV secretion systems (T4SS) are medically problematic for their roles in the dissemination of mobile genetic elements or effector proteins, but they also have great potential for new antimicrobial therapies. Recent studies have deployed the T4SS subfamily of conjugation systems to deliver gene editing CRISPR/Cas systems to disrupt drug resistance genes or kill targeted bacterial recipients. However, the therapeutic potential of conjugative CRISPR/Cas delivery is compromised by mutations or host repair systems that diminish the efficiency with which CRISPR/Cas induces double-strand breaks in new transconjugants. Here, we compared the efficiencies of conjugation-based killing systems based on the …

Skin Care Excellence: Increasing Rn Skin Check Frequency To Prevent Hapis, Yu Jian Kwan

Master's Projects and Capstones

Background:
This quality improvement project was implemented in the Transitional Cardiac Unit (TCU), a 32-bed telemetry unit primarily serving older adults recovering from cardiac procedures. A microsystem assessment revealed a hospital-acquired pressure injury (HAPI) rate of 1.49 per 1,000 patient days, exceeding the regional target of 0.82. Key barriers included limited skin assessment frequency, inconsistent documentation, and gaps in staff training.

Problem:
From June to December 2024, six HAPIs occurred in the TCU. Despite existing protocols requiring two-RN skin assessments at admission, transfer, and discharge, early detection of skin breakdown remained insufficient. Contributing factors included inconsistent surveillance, varied assessment skills, …

Machine-Learning Driven Strategies For Adapting Immunotherapy In Metastatic Nsclc, Maliazurina B Saad, Qasem Al-Tashi, Lingzhi Hong, Vivek Verma, Wentao Li, Daniel Boiarsky, Shenduo Li, Milena Petranovic, Carol C Wu, Brett W Carter, Girish S Shroff, Tina Cascone, Xiuning Le, Yasir Y Elamin, Mehmet Altan, Simon Heeke, Ajay Sheshadri, Joe Y Chang, Percy P Lee, Zhongxing Liao, Don L Gibbons, Ara A Vaporciyan, J Jack Lee, Ignacio I Wistuba, Cara Haymaker, Seyedali Mirjalili, David Jaffray, Justin F Gainor, Yanyan Lou, Alessandro Di Federico, Federica Pecci, Mark Awad, Biagio Ricciuti, John V Heymach, Natalie I Vokes, Jianjun Zhang, Jia Wu

Faculty, Staff and Student Publications

Immune checkpoint inhibitors (ICIs), either as monotherapy (ICI-Mono) or combined with chemotherapy (ICI-Chemo), improves survival in advanced non-small cell lung cancer (NSCLC). However, prospective guidance for choosing between these options remains limited, and single-feature biomarkers like PD-L1 prove inadequate. We develop a machine learning model using clinicogenomic data from four cohorts (MD Anderson n = 750; Mayo Clinic n = 80; Dana-Farber n = 1077; Stand Up To Cancer n = 393) to predict individual benefit from adding chemotherapy. Benefit scores are calculated using five distinct functions derived from 28 genomic and 6 clinical features. Our integrated model, A-STEP (Attention-based …

The Sodium-Glutamate Antagonist Riluzole Improves Outcome After Acute Spinal Cord Injury: Results From The Riscis Randomised Controlled Trial Analysed Using A Global Statistical Analytic Technique, Michael G. Fehlings, Karlo M. Pedro, Mohammed Ali Alvi, Ali Moghaddamjou, James S. Harrop, Ralph Stanford, Jonathon Ball, Bizhan Aarabi, Paul M. Arnold, James D. Guest, Shekar N. Kurpad, James M. Schuster, Ahmad N. Nassr, Karl M. Schmitt, Jefferson R. Wilson, Darrel S. Brodke, Faiz U. Ahmad, Albert Yee, Wilson Z. Ray, Nathaniel P. Brooks, Jason Wilson, Diana S-L Chow, Elizabeth G. Toups, Kevin E. Thorpe, Jiaxin Huang, Peng Huang

Department of Neurosurgery Faculty Papers

BACKGROUND: Spinal cord injury (SCI) clinical trials typically rely on a single primary endpoint to assess drug efficacy. This strategy fails to adequately capture the full impact of treatment in heterogenous neurological conditions like SCI. A more patient-centric analysis requires assessment of neurological function, functional capacity, and quality of life, incorporating meaningful patient-reported outcomes. The global statistical test (GST) addresses this challenge using a unified statistical conclusion regarding the superiority of a treatment strategy over another by evaluating multiple trial endpoints simultaneously.

METHODS: The RISCIS trial (Safety and Efficacy of Riluzole in Acute Spinal Cord Injury Study) data was analysed …

Genotoxicity Assessment Of Conventional And Cad/Cam Denture Base Materials, Alanood Aldubayan

Master's Theses (2009 -)

Aim: In prosthodontics, polymethyl methacrylate (PMMA) has been widely used. Their biocompatibility and potential genotoxicity remain a concern due to the residual monomer release. Computer-aided design and manufacturing (CAD/CAM) denture base materials have emerged and offered some improved mechanical and physical properties compared to the standard conventional heat-cured denture base material. However, their long-term biocompatibility remains unstudied. Therefore, this study evaluates the genotoxicity effects of conventional and CAD/CAM denture base materials on human gingival fibroblasts (HGFs). Methodology: Disk-shaped samples were fabricated of six denture base resins, including heat-cured PMMA, milled PMMA, and four 3D-printed resins. HGFs were exposed to the …

A Genetically-Engineered Thyroid Gland Built For Selective Triiodothyronine Secretion, Cintia E. Citterio, Berenice Morales-Rodriguez, Xiao-Hui Liao, Catherine Vu, Rachel Nguyen, Jessie Tsai, Jennifer Le, Ibrahim Metawea, Ming Liu, David P. Olson, Samuel Refetoff, Peter Arvan

Pharmacy Faculty Articles and Research

Thyroid hormones (thyroxine, T₄, and triiodothyronine, T₃) are indispensable for sustaining vertebrate life, and their deficiency gives rise to a wide range of symptoms characteristic of hypothyroidism, affecting 5–10% of the world’s population. The precursor for thyroid hormone synthesis is thyroglobulin (Tg), a large iodoglycoprotein consisting of upstream regions I-II-III (responsible for synthesis of most T₄) and the C-terminal CholinEsterase-Like (ChEL) domain (responsible for synthesis of most T₃, which can also be generated extrathyroidally by T₄ deiodination). Using CRISPR/Cas9-mediated mutagenesis, we engineered a knock-in of secretory ChEL into the endogenous TG …

A Multi-Modal Pelvic Mri Dataset For Deep Learning-Based Pelvic Organ Segmentation In Endometriosis, Xiaomin Liang, Linda A Alpuing Radilla, Kamand Khalaj, Haaniya Dawoodally, Chinmay Mokashi, Xiaoming Guan, Kirk E Roberts, Sunil A Sheth, Varaha S Tammisetti, Luca Giancardo

Faculty, Staff and Students Publications

Endometriosis affects approximately 190 million females of reproductive age worldwide. Magnetic Resonance Imaging (MRI) has been recommended as the primary non-invasive diagnostic method for endometriosis. This study presents new female pelvic MRI multicenter datasets for endometriosis and shows the baseline segmentation performance of two auto-segmentation pipelines: the self-configuring nnU-Net and RAovSeg, a custom network. The multi-sequence endometriosis MRI scans from two clinical institutions were collected. A multicenter dataset of 51 subjects with manual labels for multiple pelvic structures from three raters was used to assess interrater agreement. A second single-center dataset of 81 subjects with labels for multiple pelvic structures …

Project Evolve: An International Analysis Of Postimmunotherapy Lineage Switch, An Emergent Form Of Relapse In Leukemia, Sara K Silbert, Alexander W Rankin, Chloe N Hoang, Alexandra Semchenkova, Regina M Myers, Elena Zerkalenkova, Hao-Wei Wang, Alexandra E Kovach, Constance M Yuan, Dana Delgado Colon, Loïc Vasseur, Alex Bataller, Samuel John, Kaylyn Utley Lyons, Barbara Friedes, Anna Alonso-Saladrigues, Hisham Abdel-Azim, Estelle Balducci, Ahmed Assim Aljudi, Marie Balsat, D Nathan Biery, Aghiad Chamdin, Bill H Chang, Raymund S Cuevo, Barbara De Moerloose, David S Dickens, Ulrich Duffner, Nicolas Duployez, Firas El Chaer, Michelle Ann Elliott, Gabriele Escherich, Sneha Fernandes, Mandi R Fitzjohn, Zhubin Gahvari, Stephan A Grupp, Rui Rochelle He, Cynthia Harrison, Christopher B Hergott, Emily M Hsieh, Annette S Kim, Dennis J Kuo, Daniel P Larson, Benjamin J Lee, Thibaut Leguay, R Coleman Lindsley, Abhishek A Mangaonkar, Kerstin Mezger, Holly L Pacenta, Jing Pan, Marlie Provost, Latika Puri, Sunil S Raikar, Armando Martinez, Isabella Bristol, Kyle Murphy, Lauren Reiman, Michele Redell, Kelly Reed, Gabrielle Roth-Guepin, Jeremy Rubinstein, Süreyya Savaşan, Kristian Schafernak, Alexandra Stevens, Aimee Talleur, Naomi Torres Carapia, Jacques Vargaftig, Anant Vatsayan, Matthias Wölfl, Liping Zhao, Susana Rives, Vanessa A Fabrizio, Koji Sasaki, Ibrahim Aldoss, Nicolas Boissel, Susan R Rheingold, Kara L Davis, Sara Ghorashian, Elad Jacoby, Alexander Popov, Adam J Lamble, Nirali N Shah

Faculty, Staff and Students Publications

Lineage switch (LS), defined as the immunophenotypic transformation of acute leukemia, has emerged as a mechanism of relapse after antigen-targeted immunotherapy, which is associated with dismal outcomes. Through an international collaborative effort, we identified cases of LS after a host of antigen-targeted therapies (eg, CD19, CD22, CD38, and CD7), described how LS was diagnosed, reviewed treatment approaches, and analyzed overall outcomes for this form of postimmunotherapy relapse. Collectively, 75 cases of LS were evaluated, including 53 (70.7%) cases of B-cell acute lymphoblastic leukemia (B-ALL) transforming to acute myeloid leukemia (AML), 17 (22.7%) cases of B-ALL transforming to mixed phenotypic acute …

Anxious Traits Intensify The Impact Of Depressive Symptoms On Stigma In People Living With Hiv, Alexia Koukopoulos, Antonio Maria D'Onofrio, Alessio Simonetti, Delfina Janiri, Flavio Cherubini, Paolo Vassalini, Letizia Santinelli, Gabriella D'Ettorre, Gabriele Sani, Giovanni Camardese

Faculty, Staff and Students Publications

Background/Objectives: Despite medical advances, stigma remains a major challenge for people living with HIV (PLWH). This study examined clinical, sociodemographic, and psychological predictors of HIV-related stigma, and explored whether affective temperament moderates the impact of depression on stigma.

Methods: This cross-sectional observational study included 97 PLWH attending a tertiary infectious disease unit in Rome, Italy. Participants completed a battery of validated psychometric instruments assessing depressive symptoms, anxiety, manic symptoms, mixed affective states, general psychopathology, impulsivity, and affective temperament. HIV-related stigma was evaluated using the Berger HIV Stigma Scale, which measures personalized stigma, disclosure concerns, negative self-image, and concerns …

Achieving Equity For International Medical Graduates: A Systematic Review, Sangeeta G. Saxena, Elizabeth Tisdell, Elana Farace, Thomas Godfrey, Betsy Aumiller, Esther Dell, Omrana P. Razzak, Bernadette N. Kumar, Kristin K. Sznajder

Public Health

Introduction: Foreign-born and foreign trained International Medical Graduates (FIMGs) face greater challenges in acculturation to their host countries than IMGs who train abroad and return to practice in their home country. As FIMGs are likely to fulfill a shortage of physicians in High Income Countries in the foreseeable future, we conducted a systematic review of literature to identify acculturation interventions that help FIMGs assimilate better in their host country health systems. This improves their productivity and satisfaction, allows health systems to be more accepting of FIMGs, and most importantly, enhances patient outcomes.

Methods: Following the PRISMA statement, we searched PubMed, …

Kids Exploring The World With Chatbots, Maggie Mckay, Mark Connelly

Parent-ish Podcast

Are your kids chatting away with AI? In this episode, we provide parents with the tools they need to understand the implications of children's interactions with chatbots. Find out what signs to look for and how to set healthy boundaries to protect your child from potential pitfalls of digital companionship.

Click here to stream the podcast episode.

Supporting Children In Managing Extracurricular Activities, Maggie Mckay, Simone Moody

Parent-ish Podcast

As the school year nears, so do busy schedules and the "extras" that kiddos do outside of school. While children love their sports, clubs and other extracurriculars, it can be hard to balance them with school and other important activities. Simone Moody, PhD, Clinical Psychologist at Children's Mercy in Kansas City, discusses signs your child might be overextended, how to find balance and more in this podcast.

Click here to stream the podcast episode.

Temporal And Generational Changes In Depression Among Young American Adults, Ashley W. Kranjac, Dinko Kranjac, Valentine Chung

Sociology Faculty Articles and Research

The prevalence of depression among young American adults has risen significantly over the past two decades, but the mechanisms that underlie the population-level changes in depressive symptoms severity remain unclear. We used data from the 2005–2023 National Health and Nutrition Examination Survey (NHANES) and hierarchical age–period–cohort (HAPC) analysis to examine developmental (i.e., age), life stage (i.e., period), and generational (i.e., cohort) distribution of depressive symptoms among American adults aged 20–30 years old over an 18-year period. Our model results indicate that the probability of either mild, moderate, or severe depression increased among young adult females and males between 2005 and …

The Influence Of Myocardin Effector Genes On The Tgf-Beta Smad3 Signaling Pathway In Human Pleural Mesothelial Cells, Hema Chandra Hrushi Dusharla

Biotechnology Theses

Pleural Fibrosis (PF) involves excessive extracellular matrix (ECM) deposition, mainly by myofibroblasts, leading to pleural thickening and impaired lung function. Pleural mesothelial cells (PMCs) contribute via mesothelial and mesenchymal transition (MesoMT), triggered by cytokines like TGF-β. Our lab identified Myocardin (MyoCD), a transcriptional co-activator of cardiac and smooth muscle, is a master regulator of pleural fibrosis through interactions with serum response factor (SRF) and Smad2/3 transcription factors which initiate fibrosis signaling. RNA sequencing and qPCR analysis revealed that silencing MyoCD decreased the expression of CTNNB1, MDFI, and Tspan2. MDFI emerged as a potent candidate, as this gene affecting the expression …

The Influence Of Sociodemographic Factors On Opioid Mortalities In The U.S. State Of Georgia, Theresa Highsmith

Walden Dissertations and Doctoral Studies

Since the late 1990s, the United States has been in the midst of an opioid epidemic that continues to present significant public health challenges. Opioid-related mortality, particularly involving fentanyl, has disproportionately affected vulnerable populations. The purpose of this quantitative study was to examine the associations between educational level, homelessness, and alcohol use with opioid-related overdose deaths involving fentanyl, while controlling for age, gender, and marital status, among Black and White populations in the U.S. state of Georgia. The theoretical framework was Bronfenbrenner’s socioecological model, which recognizes that individual behavior is influenced by multiple levels of factors, including interpersonal, community, and …

Adolescents' Use Of Music For Pain Management., Rebecca J. Lepping, Lora L. Black, Kymberly A. Kline, Deanna Hanson-Abromeit, Andrea L. Chadwick, Dustin Wallace, William R. Black

Manuscripts, Articles, Book Chapters and Other Papers

To investigate the experiences of adolescents with chronic pain who participated in an intensive interdisciplinary pain treatment program, this secondary study analyzes the themes that emerged regarding the spontaneous utilization of music in coping strategies for chronic pain. During research interviews focused on coping skills and treatment engagement, participants spontaneously reported using music as an effective coping strategy for managing pain. A deductive thematic analysis revealed key themes related to their usage, including using music as a distractor, motivator and in other ways as coping strategies. Since participants indicated that music is essential to their experiences of coping with pain, …

Effects Of Oxygen Manipulation On Myofibroblast Phenotypic Transformation In Patients With Radiation-Induced Fibrosis, Eric Mastrolonardo, Sarah Sussman, Bo Yun, Victor Jegede, Dev Amin, Joel Rosenbloom, Andrew P. South, Voichita Bar-Ad, Peter J Wermuth, Adam J. Luginbuhl

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

We tested if hyperoxic conditions can reduce the proportion of active myofibroblasts, which are assumed to be a major driver of head and neck radiation-induced fibrosis, as measured by expression levels of pro-fibrotic genes. Radiated, non-cancerous soft tissue from the head and neck and skin/soft tissue from non-radiated flap donor site were collected from each patient. Myofibroblast density was quantified using immunofluorescence staining with α-SMA and DAPI and visualisation under confocal microscopy and compared between baseline non-radiated and radiated tissue from the same patient. From each tissue specimen, fibroblast cell lines were cultured and exposed to either normoxic, hypoxic, or …

Uncharted Territory: The First Case Of Cardiac Myxoma In A Patient With Nf2, Muhammad Sabri, Zinya Talukder, Naila Ijaz, Joseph Neri

Rothman Institute Papers

BACKGROUND: Cardiac myxoma is a benign tumor, typically originating in the left atrium, and is often linked to Carney complex. In our literature review, there are no case reports of cardiac myxoma in patients with neurofibromatosis type 2 (NF2).

CASE SUMMARY: A 60-year-old man presented with dizziness and was found to have meningioma and vestibular schwannoma, consistent with NF2. Cardiac myxoma was incidentally diagnosed through echocardiography and confirmed by cardiac magnetic resonance imaging and tissue pathology. The mass was surgically resected. The patient was offered genetic testing; however, he decided to not undergo further testing.

DISCUSSION: NF2 is an inherited …

Causes Of Mortality In Patients With Inborn Errors Of Immunity: An 18-Year Retrospective Cohort Study, Salem Al-Tamemi, Musab Al Jabri, Eiman Abdalla, Ibrahim Al-Busaidi, Khalfan Al-Zeedy, Laila Al Yazidi

Sultan Qaboos University Medical Journal

Objectives: Inborn errors of immunity (IEI) are a diverse group of disorders arising from defects in the development and/or function of the immune system. However, data concerning the microbiological aspects of infections and direct causes of mortality in patients with IEI are limited and fragmented. This study aimed to elucidate the causes of disease and terminal events leading to death in a cohort of patients with IEI. Methods: This retrospective study included deceased patients who were diagnosed with primary immunodeficiency at Sultan Qaboos University Hospital in Muscat, Oman, over an 18-year period between 2005 and 2023. Data on clinical features, …

Concurrent Presentation Of An Anomalous Right Coronary Artery And An Unusual Bovine Arch: Case Report, Vasiliki Tasouli-Drakou, Jasmine Dugal, Divuansh Sharma, Kachon Lei, Chowdhury Ahsan

Department of Internal Medicine Faculty Research

Anomalous coronary arteries from the opposite sinus of Valsalva are rare but can increase the risk for life-threatening complications. We present the case of a 59-year-old man who was found to have an anomalous right coronary artery and a rare bovine arch variant with a single common brachiocephalic trunk, along with severe proximal left anterior descending artery stenosis on left heart catheterization. The patient underwent a minimally invasive coronary artery bypass graft and unroofing of the anomalous coronary artery. To our knowledge, this is the first reported case of these concurrent anomalies in an individual without tetralogy of Fallot.

Comparing The Mechanical Properties Of Conventional, Milled, And 3d-Printed Occlusal Splint Materials: An In Vitro Study, Sadeem Alzaghran

Master's Theses (2009 -)

Aim: Evidence on the mechanical properties of digitally manufactured occlusal splint materials remains scarce. The aim of this study was to evaluate and compare the mechanical properties of CAD/CAM fabricated occlusal splint materials versus conventionally heat-cured acrylic resin materials. Materials and Methods: A total of 100 specimens were manufactured for the present study. One CAD-CAM milled (ProArt CAD Splint), one heat-polymerized (SR IVOcap Clear), and three 3D-Printed (KeySplint Hard, NightGuard Firm2 and RoDIN Splint 2.0) resin materials were evaluated. Flexural strength, flexural modulus and surface hardness were measured. The three-point flexure test was used for the determination of flexural strength …

Microrna Signatures In Dental Pulp Stem Cells Following Nicotine Exposure, David Vang, Leyla T. Hardin, Nabil Abid, Der Thor, Nan Xiao

Pacific Faculty Work

Background and Objectives: Nicotine is the most well-studied toxic substance in cigarette smoke and e-cigarette vape. However, smoke and vape are composed of other components that have a negative impact on health. The objective of this study is to investigate whether nicotine has a distinctive impact on molecular mechanisms in stem cells. Methods: The cellular impact of nicotine on the regenerative capacity of human dental pulp stem cells (DPSCs) and the microRNA (miRNA) profile was examined. Bioinformatic analysis was performed to identify miRNA-regulated cellular pathways associated with nicotine exposure. These pathways were then compared to those induced by cigarette smoke …

Infectious Scleritis: A Comprehensive Narrative Review Of Epidemiology, Clinical Characteristics, And Management Strategies, Hamidreza Ghanbari, Masoud Rahimi, Ali Momeni, Kiana Hassanpour, Nikoo Bayan, Karen E. Lee, Alex Hansen, Ali R. Djalilian, Christopher J. Rapuano, Mohammad Soleimani

Wills Eye Hospital Papers

This study aims to provide an update on infectious scleritis (IS). A comprehensive search was conducted using Google Scholar, Scopus, and PubMed. IS is a rare but critical condition that presents significant diagnostic challenges and often leads to poor visual outcomes. It accounts for approximately 5%-10% of scleritis cases and warrants significant attention due to its delayed diagnosis. Ocular surgery is the primary contributor to IS, accounting for a substantial proportion of cases ranging from 58% to 83%, followed by trauma contributing to approximately 10% of cases. IS can be caused by various microorganisms, including bacteria (86%-87%), fungi (11%-13%), viruses, …

Association Between Homelessness And Maternal Health Outcomes Among Non-Hispanic Black Women In Georgia, Miranda Weaver

Walden Dissertations and Doctoral Studies

Maternal health disparities among homeless non-Hispanic Black women in Georgia represent a critical public health concern, driven by inequitable access to care and elevated risks of adverse pregnancy outcomes. This study examined how homelessness influences perinatal care utilization (timing and frequency of prenatal visits and postpartum checkups) and pregnancy complications (gestational diabetes, hypertension, and depression), and whether these associations differ by geographic context (urban versus rural). Grounded in the Social Determinants of Health framework, the study used a quantitative cross-sectional design, analyzing secondary data (n = 1,540; weighted ≈ 203,571) from Phase 8 (2017–2021) of the Pregnancy Risk Assessment Monitoring …

Effects Of Long Covid On Healthcare Utilization, Michael Gottlieb, Erica S. Spatz, Huihui Yu, Imtiaz Ebna Mannan, Michelle Santangelo, Caitlin Malicki, Nicole L. Gentile, Rachel E. Geyer, Alex Charlton, Jonathan W. Dyal, Joann G. Elmore, Kristyn Gatling, Mandy J. Hill, Juan Carlos C. Montoy, Kelli N. O'Laughlin, Kristin L. Rising, Sharon Saydah, Kari A. Stephens, Ralph C. Wang, Lauren E. Wisk, Arjun K. Venkatesh, Robert A. Weinstein

Jefferson Center for Connected Care Faculty Papers

BACKGROUND: While most research on Long COVID (LC) has focused on symptoms and quality of life, there remains a critical need to better understand the effect of LC on resource utilization. This study sought to determine the type and amount of healthcare utilization among participants with versus without LC.

METHODS: This was a secondary analysis of a prospective, longitudinal, multicenter U.S. study of adult participants with symptomatic COVID-19, confirmed with testing, who completed 3-month post-infection surveys and had electronic health record data for at least 180 days pre- and post-index testing. We excluded participants with any COVID-19 infections within the …

One-Year Clinical Outcomes In Patients With Acute Coronary Syndrome Treated With Clopidogrel Versus Prasugrel Versus Ticagrelor: Results Of The Polish Registry Of Acute Coronary Syndromes (Pl-Acs), Julia M. Umińska, Michał Skrzypek, Małgorzata Ostrowska, Piotr Adamski, Aldona Kubica, Piotr Niezgoda, Robert Gajda, Marek Gierlotka, Bartosz Hudzik, Wiktor Kuliczkowski, Diana A. Gorog, Paul A. Gurbel, Jolanta Siller-Matula, Łukasz Szarpak, Michael Savage, Grzegorz Skonieczny, Udaya Tantry, Przemysław Trzeciak, Eliano P. Navarese, Jacek Kubica, Mariusz Gąsior

Division of Cardiology Faculty Papers

BACKGROUND: Efficient dual antiplatelet therapy is crucial in reducing adverse cardiovascular events in patients with acute coronary syndrome (ACS). Comparative effectiveness between clopidogrel, prasugrel, and ticagrelor remains unclear in real-world settings.

AIMS: The objective was to evaluate one-year clinical outcomes in ACS patients treated with clopidogrel, prasugrel, or ticagrelor using data from the Polish Registry of Acute Coronary Syndromes (PL-ACS).

MATERIAL AND METHODS: This retrospective cohort study analyzed 381 278 ACS patients from the PL-ACS registry from 2009 to 2022, who were treated with clopidogrel, prasugrel, or ticagrelor during hospitalization with a 12-month consistent regimen. The primary outcome was one-year …

Multiscale Modeling And Dynamic Mutational Profiling Of Binding Energetics And Immune Escape For Class I Antibodies With Sars-Cov-2 Spike Protein: Dissecting Mechanisms Of High Resistance To Viral Escape Against Emerging Variants, Mohammed Alshahrani, Vedant Parikh, Brandon Foley, Gennady M. Verkhivker

Mathematics, Physics, and Computer Science Faculty Articles and Research

The rapid evolution of SARS-CoV-2 has underscored the need for a detailed understanding of antibody binding mechanisms to combat immune evasion by emerging variants. In this study, we investigated the interactions between Class I neutralizing antibodies—BD55-1205, BD-604, OMI-42, P5S-1H1, and P5S-2B10—and the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein using multiscale modeling, which combined molecular simulations with the ensemble-based mutational scanning of the binding interfaces and binding free energy computations. A central theme emerging from this work is that the unique binding strength and resilience to immune escape of the BD55-1205 antibody are determined by leveraging a broad epitope …

Enhancing Onboarding And Role Transition For Advanced Practice Clinicians Through The Development Of A Structured Mentorship Program, Christina Sternesky

Walden Dissertations and Doctoral Studies

The assimilation of advanced practice clinicians (APCs), nurse practitioners, and physician assistants into healthcare systems is significantly dependent on the quality of their onboarding experience and the availability of a structured mentorship program. Without mentorship programs, APCs often experience job dissatisfaction, reduced confidence, undefined role clarity, and increased burnout. In this quality improvement Doctor of Nursing Practice project, I conducted a comprehensive assessment of the needs of APCs and subsequently developed a structured, evidence-based mentorship program. The program, approved by an expert panel, was designed to support the onboarding of APCS, their role transition, and ongoing professional development within a …