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Articles 1711 - 1740 of 79082
Full-Text Articles in Medical Specialties
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
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 …
Anatomy Of Teamwork: Leveraging Peer Feedback To Build A Bespoke Team Charter Assignment, Emily Tenniswood, Stefanie Attardi
Anatomy Of Teamwork: Leveraging Peer Feedback To Build A Bespoke Team Charter Assignment, Emily Tenniswood, Stefanie Attardi
Posters
Post-COVID-19, students in our M1 Anatomical Foundations of Clinical Practice (AFCP) courses increasingly request faculty guidance or intervention in managing intra-dissection team conflict.
Clinical Outcomes Of A Non-Diffractive Extended Depth Of Focus Intraocular Lens In Post-Refractive Eyes, Collin Olevson, John P. Berdahl, Tanner J. Ferguson
Clinical Outcomes Of A Non-Diffractive Extended Depth Of Focus Intraocular Lens In Post-Refractive Eyes, Collin Olevson, John P. Berdahl, Tanner J. Ferguson
Scholarship Pathways Program
Clinical outcomes of a non-diffractive extended depth of focus intraocular lens in post-refractive eyes
Collin Olevson, MD1 | John Berdahl, MD1,2 and Tanner Ferguson, MD1,2
1University of South Dakota Sanford School of Medicine, Vermillion, SD
2Vance Thompson Vision, Sioux Falls, SD
Introduction: Eyes with prior corneal refractive surgery (i.e laser-assisted in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK)) pose challenges during cataract surgery due to altered corneal curvature. The AcrySof IQ Vivity intraocular lens (IOL) is a non-diffractive extended depth-of-focus (EDOF) IOL designed to provide a broader range of vision. Limited data exists on its …
Visual Outcomes And Quality Of Life In A Randomized Trial Of Topography-Guided Lasik With Novel Gis-Software Versus Wavefront Optimized Lasik, Elise V.H. Meide, Tanner J. Ferguson, John P. Berdahl, Vance M. Thompson, Daniel C. Terveen
Visual Outcomes And Quality Of Life In A Randomized Trial Of Topography-Guided Lasik With Novel Gis-Software Versus Wavefront Optimized Lasik, Elise V.H. Meide, Tanner J. Ferguson, John P. Berdahl, Vance M. Thompson, Daniel C. Terveen
Scholarship Pathways Program
Visual Acuity and Quality of Life Results in a Randomized Trial of Topography-Guided with GIS-Software Versus Wavefront Optimized LASIK
Elise V.H. Meide, MD | Daniel C. Terveen, MD
Purpose: To compare post-operative visual acuity, refractive outcomes and patient-reported visual quality of life between topography-guided (TG) laser-assisted in situ keratomileusis (LASIK) with novel geographic imaging system (GIS) based software versus wavefront-optimized (WFO) LASIK. Main outcome measures included the rate of patients with uncorrected distance visual acuity (UDVA) of 20/16 or better 3 months post-operatively. Secondary and exploratory endpoints include best corrected visual acuity (BCVA), residual refractive error, low contrast visual acuity, …
Nudging Implementation Of Low Tidal Volume Ventilation: A Stepped Wedge, Cluster Randomized Trial, Meeta Prasad Kerlin, Michael O. Harhay, Fan Li, Dylan S. Small, Yingying Lu, Wei Wang, Barry D. Fuchs, Mark E. Mikkelsen, Teresa Tran, Aerielle Belk, Jasmine A. Silvestri, Tamar Klaiman, Stefania Scott, Elizabeth Levy, Michael W. Sjoding, Rachel Kohn, Karsten J. Roberts, Rinad S. Beidas, Scott D. Halpern
Nudging Implementation Of Low Tidal Volume Ventilation: A Stepped Wedge, Cluster Randomized Trial, Meeta Prasad Kerlin, Michael O. Harhay, Fan Li, Dylan S. Small, Yingying Lu, Wei Wang, Barry D. Fuchs, Mark E. Mikkelsen, Teresa Tran, Aerielle Belk, Jasmine A. Silvestri, Tamar Klaiman, Stefania Scott, Elizabeth Levy, Michael W. Sjoding, Rachel Kohn, Karsten J. Roberts, Rinad S. Beidas, Scott D. Halpern
College of Health Professions Faculty Papers
BACKGROUND: "Nudges" embedded in the electronic health record (EHR) facilitate desired decisions while preserving autonomy and may provide a scalable strategy to overcome the common implementation barrier of lack of knowledge about a best practice. We sought to test whether EHR-based nudges targeting two intensive care unit (ICU) clinician groups would safely increase evidence-based use of low tidal volume ventilation.
METHODS: We performed a stepped-wedge, cluster randomized, hybrid type 3 effectiveness-implementation trial in 12 ICUs from February 2021 to May 2023 to test three nudges targeting clinicians responsible for order entry and respiratory therapists responsible for operationalizing orders and documentation. …
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
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 …
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
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) …
Ultra-Rare Functional Variants Reveal Early-Onset Breast Cancer Risk Genes And Pathways In The Uk Biobank And All Of Us Research Program, Chen Wang, Panagiotis Katsonis, Yi Li, Lawrence A Donehower, Olivier Lichtarge
Ultra-Rare Functional Variants Reveal Early-Onset Breast Cancer Risk Genes And Pathways In The Uk Biobank And All Of Us Research Program, Chen Wang, Panagiotis Katsonis, Yi Li, Lawrence A Donehower, Olivier Lichtarge
Faculty, Staff and Students Publications
Breast cancer (BRCA) affects one in eight women, and while past studies have identified susceptibility genes and variants, those driving early-onset disease remain opaque. We introduce EA-Pathways, a control-free association method that aggregates ultra-rare germline coding variants weighted by Evolutionary Action to detect functional impact distribution biases in genes and pathways. In UK Biobank women with BRCA, EA-Pathways prioritized candidate risk genes across pathways enriched in known familial genes. Ultra-rare, high-impact variants in these genes were BRCA specific, and variants from eight pathways were associated with 2-year-earlier disease, including homology-directed DNA repair, TP53, and pexophagy pathways. The early-onset effect replicated …
Optimizing Patient-Facing Ai Chatbot Questions To Improve Readability And Actionability In Anesthesia Education, Sarah Kadado, Bianca Elias, Roy Soto
Optimizing Patient-Facing Ai Chatbot Questions To Improve Readability And Actionability In Anesthesia Education, Sarah Kadado, Bianca Elias, Roy Soto
Posters
In anesthesia, high patient anxiety and limited counseling time increase the need for clear, usable information. Artificial intelligence (AI) chatbots (e.g., ChatGPT) are increasingly used for patient anesthesia education. Many AI-generated responses exceed the recommended 6th-8th grade reading level for patient education information. Responses also often lack actionable guidance for patients. This study quantifies how optimizing patient-facing prompts improves readability, understandability, and actionability.
Perceptions Of Radiology Residency Staffing Models Across Years Of Training, Alex Zhang, Alexander Swantek, Adela Pouzar, Sayf Al-Katib
Perceptions Of Radiology Residency Staffing Models Across Years Of Training, Alex Zhang, Alexander Swantek, Adela Pouzar, Sayf Al-Katib
Posters
Case staffing is the primary method by which radiology residencies teach at the workstation. Despite this, the styles and methods for how staffing is performed have not yet been comprehensively described. Understanding these models and evaluating resident perspectives can inform best practices and enhance radiology education.
Agenda (Pdf), Department Of Surgery
Agenda (Pdf), Department Of Surgery
Surgery Research Symposium
Agenda for the 4th Annual Surgery Research Symposium held May 7, 2026.
Short-Term Bayesian Influenza Forecasting In A Hospital Environment Using A Linear Kalman Filter., Shankar Kaleeswaran Mani, Grzegorz A Rempala, Eben Kenah, Fernanda L Schumacher
Short-Term Bayesian Influenza Forecasting In A Hospital Environment Using A Linear Kalman Filter., Shankar Kaleeswaran Mani, Grzegorz A Rempala, Eben Kenah, Fernanda L Schumacher
Ambulatory and Primary Care Articles
Accurately forecasting the weekly number of influenza (flu) lab tests and positive cases is important for hospitals as they work to plan staffing, manage supplies, and provide timely patient care. In this paper, we describe a practical use of a Bayesian Kalman filter to forecast weekly flu tests and positives in a hospital setting. Using data from a large hospital system in Ohio, we show that this approach, which blends real-time hospital information with historical patterns, offers a dependable way to anticipate flu-related patient volume as far as four weeks ahead.
Pharmacogenomic-Guided Prescribing And Polypharmacy Across Age Groups In Obsessive-Compulsive Disorder: A Retrospective Study, Rachel A Schwartz, Nicolette Weisensel, Martin E Franklin, Madeline M Hartig, Maharaj Singh, Sreya Vadapalli
Pharmacogenomic-Guided Prescribing And Polypharmacy Across Age Groups In Obsessive-Compulsive Disorder: A Retrospective Study, Rachel A Schwartz, Nicolette Weisensel, Martin E Franklin, Madeline M Hartig, Maharaj Singh, Sreya Vadapalli
Faculty, Staff and Students Publications
Background: This study evaluated medication utilization in children, adolescents, and adults with obsessive-compulsive disorder (OCD), a chronic psychiatric condition characterized by intrusive thoughts and repetitive behaviors. Although first-line treatments include selective serotonin reuptake inhibitors (SSRIs) and cognitive behavioral therapy (CBT), the heterogeneous biological underpinnings contribute to suboptimal outcomes, with 40-60% of individuals not responding to SSRIs. This complex phenotype often leads to psychotropic polypharmacy, which may be mitigated by incorporating combinatorial pharmacogenomic (PGx) testing into protocol-based care to identify potential gene-drug interactions.
Methods: A retrospective review was conducted of individuals with OCD aged 8 to 65 years who received either …
Multi-Site Dms Probing Reveals Higher-Order Structure Of Rna-Protein Complexes In Living Cells, Anthony Hoang, Joshua Meehan, Ritwika Bose, David Mitchell, David H Price, Calla M Olson, Chase A Weidmann, Anthony M Mustoe
Multi-Site Dms Probing Reveals Higher-Order Structure Of Rna-Protein Complexes In Living Cells, Anthony Hoang, Joshua Meehan, Ritwika Bose, David Mitchell, David H Price, Calla M Olson, Chase A Weidmann, Anthony M Mustoe
Faculty, Staff and Students Publications
Identifying tertiary structures and protein binding sites in RNA molecules remains a key challenge in RNA biology. We describe multi-site dimethyl sulfate (DMS)-mutational profiling (MaP) (msDMS-MaP), a strategy that enables simultaneous measurement of RNA secondary, tertiary, and quaternary structures via a single DMS chemical probing experiment. Optimized reverse transcription decodes typically invisible DMS N7-methylguanine (N7-G) modifications via a tautomer-induced mutational signature concurrent with N1 and N3 modifications. We show that N7-G reactivity reports on higher-order RNA structures, revealing key functional motifs such as pseudoknots and protein binding sites. Using msDMS-MaP, we find that E. coli ribosomal RNAs encode numerous independently …
Genetic Analysis Of The X-Linked Adrenoleukodystrophy Gene Abcd1 In Drosophila Uncovers A Conserved Phenotype, Joshua Manor, Sharayu V Jangam, Hyung-Lok Chung, Pranjali Bhagwat, Jonathan C Andrews, Hillary Chester, Shu Kondo, Saurabh Srivastav, Juan Botas, Ann B Moser, Suzette M Huguenin, Michael F Wangler
Genetic Analysis Of The X-Linked Adrenoleukodystrophy Gene Abcd1 In Drosophila Uncovers A Conserved Phenotype, Joshua Manor, Sharayu V Jangam, Hyung-Lok Chung, Pranjali Bhagwat, Jonathan C Andrews, Hillary Chester, Shu Kondo, Saurabh Srivastav, Juan Botas, Ann B Moser, Suzette M Huguenin, Michael F Wangler
Duncan NRI Faculty and Staff Publications
X-linked adrenoleukodystrophy (X-ALD) is a progressive neurodegenerative disorder caused by a loss-of-function (LOF) mutation in the ATP-binding cassette subfamily D member 1 (ABCD1) gene, leading to the accumulation of very long-chain fatty acids (VLCFAs). This disorder exhibits striking heterogeneity; some male patients develop an early childhood neuroinflammatory demyelination disorder, while other patients, including adult males and most affected female carriers, experience a chronic progressive myelopathy. Adrenocortical failure is observed in almost all male patients, with the age of onset varying, sometimes being the first diagnostic finding. The gene underlying this spectrum of disease encodes an ATP-binding cassette (ABC) transporter that …
Examining A Positive Variation Of The Good Behavior Game With Head Start Children At Risk For Child Adversity And Externalizing Behavior Problems., Alexandra Gibson, Courtney P D Goldenberg, Malinda J. Colwell, Amelia E. Talley, Joaquín Borrego, Adam T. Schmidt
Examining A Positive Variation Of The Good Behavior Game With Head Start Children At Risk For Child Adversity And Externalizing Behavior Problems., Alexandra Gibson, Courtney P D Goldenberg, Malinda J. Colwell, Amelia E. Talley, Joaquín Borrego, Adam T. Schmidt
Manuscripts, Articles, Book Chapters and Other Papers
BACKGROUND: Children participating in the Head Start program in the United States are predominantly from underserved groups, have increased rates of child adversity, and are at risk for externalizing behavior problems in the classroom. The Good Behavior Game (GBG) is an effective classroom management strategy for reducing disruptive and off-task classroom behaviors. However, previous research has not examined the GBG within the Head Start context.
METHODS: The current case-controlled study evaluated the effectiveness of the GBG in six Head Start children aged 3-5. Researchers conducted daily classroom behavioral observations of disruptive behaviors, and teachers completed pre- and post-treatment assessments of …
Applying User-Centered Design To Develop A Culturally Sensitive, Low-Calorie Meal Plan For Enhancing Dietary Behavioral Control In Masld, Ivonne Arguelles, Crystal Arguelles, Terri L Fletcher, Natalia I Heredia, Myriam Ibarra, Anna Christine Rome
Applying User-Centered Design To Develop A Culturally Sensitive, Low-Calorie Meal Plan For Enhancing Dietary Behavioral Control In Masld, Ivonne Arguelles, Crystal Arguelles, Terri L Fletcher, Natalia I Heredia, Myriam Ibarra, Anna Christine Rome
Faculty, Staff and Students Publications
Background: Dietary changes are essential for managing metabolic dysfunction-associated steatotic liver disease (MASLD), yet patients often face barriers related to knowledge, skills, cost, time, and cultural fit.
Aims: The purpose of this paper is to report a process for culturally tailoring a dietary intervention and its application to create a calorie-restricted meal plan for Mexican and Central American patients with MASLD. Guided by the Theory of Planned Behavior and user-centered design, we produced a culturally tailored seven-day structured meal plan aligned with dietary guidelines for MASLD and weight loss.
Methods: We conducted a three-phase, mixed-methods process among Mexican/Central American patients …
From Clinical Observation To Scholarly Question Academic Curiosity As A Professional Virtue In Emergency Medicine Introducing The Mindful Observation → Curious Inquiry → Clinical Structuring → Scholarly Sharing (Moccs) Model, James Espinosa, Alan A. Lucerna
From Clinical Observation To Scholarly Question Academic Curiosity As A Professional Virtue In Emergency Medicine Introducing The Mindful Observation → Curious Inquiry → Clinical Structuring → Scholarly Sharing (Moccs) Model, James Espinosa, Alan A. Lucerna
Rowan-Virtua Research Day
Emergency Medicine generates continuous clinical observations, yet many potentially meaningful insights never progress beyond informal reflection. This poster reframes every day shift observations as the ecological foundation of scholarly inquiry. Conceptual Framework: We propose a simple, repeatable process to lower the activation energy for academic engagement The Mindful Observation → Curious Inquiry → Clinical Structuring → Scholarly Sharing (MOCCS) Model. This model centers disciplined noticing as a professional virtue. By naming and normalizing the “hmmm” and “huh?” moments, this approach validates frontline clinical wisdom, democratizes scholarly participation, and restores intellectual joy within high-stress clinical environments. Conclusion: Curiosity is not hierarchical. …
Brief Review: Does Red Hair Phenotype Affect Propofol Pharmacokinetics Or Pharmacodynamics?, James Espinosa, Frank Wheeler, Robin Lahr, Sergey Medlenov, Alan Lucerna
Brief Review: Does Red Hair Phenotype Affect Propofol Pharmacokinetics Or Pharmacodynamics?, James Espinosa, Frank Wheeler, Robin Lahr, Sergey Medlenov, Alan Lucerna
Rowan-Virtua Research Day
Background: A persistent belief within Emergency Medicine and perioperative culture suggests that individuals with red hair require altered anesthetic dosing. While early studies demonstrated increased requirements for certain volatile anesthetics in red-haired individuals, this association is frequently generalized to propofol without clear supporting evidence.
Objective: To review current literature regarding the relationship between red hair phenotype (and MC1R variants) and propofol pharmacokinetics (PK) and pharmacodynamics (PD).
Methods: A focused narrative review of controlled human studies and relevant clinical outcome data evaluating propofol PK and PD in red-haired individuals.
Results: Evidence supporting altered anesthetic requirement in red-haired individuals primarily derives from …
Towards More Effective And Efficient Ite And Board Preparation In Emergency Medicine: A Conceptual Framework Using Personality Preferences (Mbti) To Inform Study And Test-Taking Behaviors, James Espinosa, Robin Lahr, James Lee, Alan Lucerna
Towards More Effective And Efficient Ite And Board Preparation In Emergency Medicine: A Conceptual Framework Using Personality Preferences (Mbti) To Inform Study And Test-Taking Behaviors, James Espinosa, Robin Lahr, James Lee, Alan Lucerna
Rowan-Virtua Research Day
Background: Preparation for high-stakes examinations in Emergency Medicine (EM) relies heavily on question-bank practice, rapid decision-making, and targeted review. Despite standardized board-preparation resources, trainees demonstrate substantial variability in study behaviors and perceived efficiency. The Myers-Briggs Type Indicator (MBTI), widely used in medical education for communication and self-reflection, may offer a framework for understanding differences in study and test-taking behaviors, though it is not designed as a predictive psychometric tool.
Objective: To review existing literature relating MBTI preferences to learning behaviors and academic performance, and to propose a conceptual framework linking personality preferences to board-style test-taking patterns in EM trainees.
Methods: …
Protecting The Protectors: Supporting Emergency Department Security Officer Wellness: A Brief Conceptual Review And Research Agenda, James A. Espinosa Md, Paul Sarnese, Alan Lucerna
Protecting The Protectors: Supporting Emergency Department Security Officer Wellness: A Brief Conceptual Review And Research Agenda, James A. Espinosa Md, Paul Sarnese, Alan Lucerna
Rowan-Virtua Research Day
Background: Workplace violence in emergency departments (EDs) has been widely studied, yet the occupational wellness of ED security officers has received comparatively limited focused attention in emergency medicine literature.
Objective: To conceptually examine the role of ED security personnel within the emergency care environment and outline a research agenda addressing their wellness.
Discussion: Security officers frequently respond to behavioral crises, assist with restraint events, and help maintain safety for patients, visitors, and staff. These duties include vigilance between events, sudden physical exertion, and exposure to aggression. ED security work often follows a recognizable rhythm: baseline vigilance, rapid escalation response, physical …
When The Clock Stands Still: Clock Time Vs. Experienced Time In The Emergency Department Brief Review: Neurobiology Of Time Perceptiontemporal Distortion As A Marker Of Cognitive Load And Operational Turbulence, James Espinosa, Alan Lucerna
When The Clock Stands Still: Clock Time Vs. Experienced Time In The Emergency Department Brief Review: Neurobiology Of Time Perceptiontemporal Distortion As A Marker Of Cognitive Load And Operational Turbulence, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background: Emergency clinicians frequently report that time during ED shifts can feel unusually slow or unusually fast. This shared observation has rarely been examined formally in emergency medicine. Altered time perception has also been described in high demand professions such as aviation, sports, military operations, and emergency response. Individuals often report time dilation during critical events and time compression during highly coordinated performance. These findings suggest that temporal perception reflects underlying neurocognitive responses to environmental demands. Emergency departments share many characteristics with these environments, including rapid decision making, task switching, and intermittent high stakes events.
Objective: Brief narrative review concerning …
When Individual Implicit Bias Meets Ed System Turbulence: Expanding The Implicit Bias And Cultural Bias Conceptual Frame To Support Reflective Decision Making Through Both Individual Bias Reduction Strategies As Well As System-Level Design Approaches, James Espinosa, Alan Lucerna
When Individual Implicit Bias Meets Ed System Turbulence: Expanding The Implicit Bias And Cultural Bias Conceptual Frame To Support Reflective Decision Making Through Both Individual Bias Reduction Strategies As Well As System-Level Design Approaches, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background
Cultural and implicit bias have been widely studied as contributors to disparities in healthcare delivery. Prior literature has largely conceptualized bias as an individual-level cognitive phenomenon occurring within clinician–patient interactions. However, emergency departments (EDs) function as complex adaptive systems (CAS), characterized by time pressure, uncertainty, cognitive load, and environmental noise. These conditions may contribute to the expression of implicit bias in clinical care.
Objective
To reframe cultural and implicit bias in the ED as both an individual cognitive property as well as a system-dependent and modulated phenomenon and to propose that the operational state of the ED influences the …
Reframing The Step Study: The Health Significance Of Emergency Physician Step Count Results In Light Of Contemporary Benchmark Evidence, James A. Espinosa Md, Alan Lucerna
Reframing The Step Study: The Health Significance Of Emergency Physician Step Count Results In Light Of Contemporary Benchmark Evidence, James A. Espinosa Md, Alan Lucerna
Rowan-Virtua Research Day
Background:
The STEP study (2023), a prospective observational study of emergency medicine residents and attending physicians, demonstrated that clinicians rarely achieve the commonly cited 10,000-step benchmark during clinical shifts. Since that time, large-scale dose–response analyses suggest that substantial health benefits occur at lower step counts (~7,000 steps/day), with diminishing returns beyond this range.
Objective:
To reinterpret the findings of the STEP study in light of contemporary evidence regarding step count and health outcomes.
Methods:
We revisited observational data from the STEP study, which measured step counts during emergency department shifts across three campuses using pedometers. These findings were compared with …
Designing Patient Update Intervals In The Emergency Department: A Queueing-Theory And Operational Science Model Of Patient Updates And Progress Signaling To Improve Patient Experience, James Espinosa, Alan Lucerna, Henry Schuitema
Designing Patient Update Intervals In The Emergency Department: A Queueing-Theory And Operational Science Model Of Patient Updates And Progress Signaling To Improve Patient Experience, James Espinosa, Alan Lucerna, Henry Schuitema
Rowan-Virtua Research Day
Background Patients in the Emergency Department (ED) frequently experience uncertainty while awaiting diagnostic results, reassessment, and disposition. Even when clinical processes are progressing, prolonged informational silence may create the perception of that those processes are not advancing.
Objective To develop a conceptual and operational mathematical, queuing-theory based model linking bedside communication, conversational time, and informational silence to patient experience.
Methods A back-of-the-envelope operational model was constructed to estimate the time required for bedside update communication during a typical physician shift. A queueing-theory framework was applied to examine how intervals between informational updates influence perceived waiting burden. Concepts from queueing theory …
Identifying And Generalizing Best Attending Teaching Practices: A Proposal For The Use Of Appreciative Inquiry To Enhance Emergency Medicine Residency Teaching Practices, James Espinosa, Alan Lucerna
Identifying And Generalizing Best Attending Teaching Practices: A Proposal For The Use Of Appreciative Inquiry To Enhance Emergency Medicine Residency Teaching Practices, James Espinosa, Alan Lucerna
Rowan-Virtua Research Day
Background
Teaching in the Emergency Department (ED) occurs within a complex adaptive system characterized by time pressure, interruptions, and high cognitive load. Studying what works well in clinical teaching , even in such a challenging environment for teaching, may reveal reproducible patterns that strengthen educational culture, enhance resident learning, and accelerate the development of teaching expertise. In complex clinical environments, excellence is often present but under-recognized; An approach called Appreciative Inquiry provides a structured method for making it visible.
Conceptual Framework
Appreciative Inquiry (AI) offers an alternative approach by systematically studying successful practices rather than failures. AI explores how and …
X-Ray Versus Ct For Femoral Landmark Identification: A Systematic Review And Meta-Analysis, Akash B. Patel, Marzieh Saeedi-Hosseiny, Mohammad Abedin-Nasab
X-Ray Versus Ct For Femoral Landmark Identification: A Systematic Review And Meta-Analysis, Akash B. Patel, Marzieh Saeedi-Hosseiny, Mohammad Abedin-Nasab
Rowan-Virtua Research Day
Background Accurate femoral bone landmark identification is essential for orthopedic surgical planning, deformity correction, and fracture risk assessment. Radiography offers accessibility and low cost, while CT provides superior spatial resolution and three-dimensional visualization. Despite technological advances, no quantitative synthesis has compared these modalities specifically for femoral landmark identification.
Hypothesis CT provides superior measurement accuracy and interobserver reliability compared to radiography for femoral bone landmark identification.
Methods Following PRISMA 2020 guidelines, Embase, Scopus, and PubMed were searched from 2015-2025. Studies comparing radiography and CT for femoral landmark identification with quantitative outcomes were included. Dual-reviewer screening of 604 records yielded 27 studies …
Mid- To Long-Term Durability Of Thoracic Endovascular Aortic Repair For Blunt Thoracic Aortic Injury: Outcomes In ≥ 45 Comparator Cohort, Andrew Lawrence Frankini, Gianna Rose Zanghi, Margaret Schwab, Valentina Sara Sica, Larry Andrew Frankini Md
Mid- To Long-Term Durability Of Thoracic Endovascular Aortic Repair For Blunt Thoracic Aortic Injury: Outcomes In ≥ 45 Comparator Cohort, Andrew Lawrence Frankini, Gianna Rose Zanghi, Margaret Schwab, Valentina Sara Sica, Larry Andrew Frankini Md
Rowan-Virtua Research Day
Blunt traumatic thoracic aortic injury (BTAI) is a primary cause of mortality in blunt trauma injuries, with motor vehicle collisions representing the majority of cases.1-4 Thoracic endovascular aortic repair (TEVAR) is the standard of care for managing this vascular emergency.5 While TEVAR demonstrates favorable short-term outcomes, there is an insufficient characterization of cumulative mid- to long-term reinterventions and device-related complications in BTAI patients.
We conducted a meta-analysis/systematic review of studies reporting outcomes after TEVAR for BTAI in patients ≥45 years. This review was conceptualized as a comparator to the previously reviewed outcomes in younger patients (< 45 years) performed by Frankini et al. (2026)6, …
A Case Of Successful Survival In A High-Risk Elderly Patient With Copd After Endotracheal Intubation, Julia Cueto Oms-Ii
A Case Of Successful Survival In A High-Risk Elderly Patient With Copd After Endotracheal Intubation, Julia Cueto Oms-Ii
Rowan-Virtua Research Day
Exacerbations of chronic obstructive pulmonary disease (COPD) leading to acute respiratory failure (ARF) is one of the major causes of mortality worldwide, thus typically having poor outcomes. Risk factors such as the need for invasive mechanical ventilation (IMV), severity of disease, comorbidities, and increased age are predictors of increased mortality rates in COPD patients. Noninvasive ventilation (NIV), like bilevel positive airway pressure (BiPAP) or high flow nasal cannula (HFNC), is the initial standard of care for acute exacerbations of COPD. However, longer periods of NIV and failure of NIV therapy can lead to delayed endotracheal intubation and higher mortality rates. …
Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do
Unmasking Neurosyphilis: A Psychotic Presentation With A Hidden Cause, Fazal Choudhary Do, Lalitya Karra Do
Rowan-Virtua Research Day
No abstract provided.