Digital Commons Network^™

Cavernous Wonders: Delving Into Cavernous Sinus Syndrome In Neuro-Ophthalmology, Anza Rizvi, Ba

inSIGHT

Cavernous sinus syndrome (CSS) is any disease process that affects the cavernous sinus. This syndrome is marked by a complex interplay of neurovascular symptoms, primarily due to the compression or dysfunction of the cranial nerves that traverse the cavernous sinus. Understanding the intricate details of this syndrome is critical to providing optimal care and improving patient outcomes.

Seeing Clearly: A Bright Future With Light Adjustable Intraocular Lenses For Presbyopia, Shady Mina, Bs

inSIGHT

Presbyopia, or the age-related decline in the ability to focus on near objects, is a common vision disorder that affects 1.8 billion people globally, with this number expected to increase to 2.1 billion by 2030.^1-4 A diminished accommodation response is the primary cause of presbyopia.¹ The eye has a very complex accommodation mechanism that permits people to distinctly see objects from various distances.^1,3 Even though the precise mechanism of accommodation is yet to be determined, the current evidence strongly supports Helmholtz’s theory, which claims that the thickness and curvature of the eye’s lens increase while its diameter …

Medical Missions, Ethical Considerations And The Future For Healthcare Delivery In Ophthalmology, Robert Medina, Ba

inSIGHT

Beginning hundreds of years ago, priests from Europe embarked on ‘medical missions’ with the goals of delivering care to the body, mind, and soul. Hundreds of years later, members of the United States healthcare system set out on humanitarian medical missions to provide medical assistance to communities in developing countries.¹ The concept of providing care internationally as a product of global social responsibility has become engrained in the United States healthcare system, and is popular among providers, trainees, and pre-medical students. In 2023, 21.8% (n = 3264) of matriculating medical students reported participating in international volunteer work, while 7.0% …

Chronic Progressive External Ophthalmoplegia, Bahram Pashaee, Mph, Bs

inSIGHT

Chronic progressive external ophthalmoplegia is an inherited or sporadic form of dystrophy that preferentially affects the extraocular muscles of the eye. While this dystrophy can manifest systemically, the extraocular muscles are commonly involved due to their constant metabolic demands and vulnerability to oxidative stress.¹ This preferential involvement of the eyelid levator muscle and extraocular muscles makes CPEO an important condition to consider in a differential diagnosis for eyelid asymmetry and double vision among other conditions such as myasthenia gravis, thyroid-associated ophthalmoplegia, and other mitochondrial myopathies.² This dystrophy tends to occur in the third or fourth decade of life. …

Macular Holes: Diagnosis, Treatment, And Complications, Ayra Khan, Bs

inSIGHT

Macular hole is a condition that affects the central visual field of the eye. Without prompt diagnosis and intervention, macular holes can progressively worsen, significantly impacting both vision and overall quality of life.

Cmv Retinitis: An Expert’S Perspective, Caitlyn Kwun, Ba

inSIGHT

Uveitis is a rare inflammatory disease with a prevalence of around 38 per 100,000 people and is the overall 5th leading cause of blindness in the developed world.^1,2 Uveitis is most commonly found in patients younger than 40 years of age, but it can occur in any age group with an etiology that varies within each age demographic.^1,3 While the etiology of certain forms of uveitis are not fully understood, there are some that are autoimmune in nature and others that are associated with systemic diseases such as sarcoidosis.⁴ Uveitis may be inflammatory or infectious. It may …

Bridging The Global Gap Of Blindness Through Artificial Intelligence - Exploring The Tools Of Ai To Address The Top Causes Of Blindness In Under-Resourced Communities Worldwide, Nathan Delacth, Bs

inSIGHT

Technological advancements have allowed us to submerge in a sea of innovation and excellence in medicine. Electronic health records transformed the healthcare landscape, improving portability of patient information while streamlining communication and fostering collaboration.¹ Imaging technologies, such as magnetic resonance imaging (MRI) and Optical computed tomography (OCT), granted us the ability to view internal structures using non-invasive methods. In a similar vein, artificial intelligence (AI) has emerged as an impactful force in various fields of medicine, and its influence on ophthalmology is no exception.

Evolution Of Lamellar Keratoplasty, Ishan Kasat, Bs

inSIGHT

Overview of Keratoplasty The evolution of corneal transplantation, or keratoplasty, has seen a paradigm shift from traditional penetrating keratoplasty (PKP) to the refined precision of lamellar keratoplasty (LK). Penetrating, or full thickness, keratoplasty is a replacement of all corneal layers: epithelium, Bowman's layer, stroma, Descemet's membrane, and endothelium.¹ Lamellar, or partial thickness, keratoplasty involves replacement of either epithelium and stroma (anterior lamellar) or Descemet’s membrane and endothelium (posterior lamellar).² From 1985 to 2004, over 95% of graft tissues were used for PKP. However, from 2005 to 2014, the percentage of PKP procedures decreased from 95% to 42%, while …

The Myopia Epidemic: Exploring The Pathology And Management Of The World’S Most Common Eye Disorder, Gabriella Baldassarre, Bs

inSIGHT

Myopia is the most common eye disorder in the world and an increasing cause of vision impairment in children.¹ Myopia is an imbalance in the refractive components of the eye and its length, leading to inaccurate focusing of light rays in front of the retina tissue instead of on it. There is a spectrum of severity of myopia, from mild nearsightedness to a more severe form known as high or degenerative myopia, which has the potential to cause vision loss and blindness. There is evidence of a developing myopia epidemic, with an estimated one-third of the world population affected …

Insight, Volume 4, Issue 1, 2024

inSIGHT

Contents

8 - The Myopia Epidemic: Exploring the Pathology and Management of the World’s Most Common Eye Disorder
By Gabriella Baldassare

15 - Evolution of Lamellar Keratoplasty
By Ishan Kasat

19 - Bridging the Global Gap of Blindness Through Artificial Intelligence
By Nathan Delacth

24 - CMV Retinitis: An Expert’s Perspective
By Caitlyn Kwun

29 - Macular Holes: Diagnosis, Treatment, and Complications
By Ayra Khan

36 - Chronic Progressive External Ophthalmoplegia
By Bahram Pashaee

39 - Medical Missions, Ethical Considerations, and the Future for Healthcare Delivery in Ophthalmology
By Robert Medina

43 - Shaping the Future of Vision: The Rise …

Gibbon Surgical Review, Volume 7, Issue 1, 2024

Gibbon Surgical Review

Table of Contents

6 - Socially Responsible Surgery: Better Practices for Better Outcomes

8 - Interview with Dr. Talar Tatarian - Assistant Professor

10 - Global Surgery : Current State and Involvement as a Trainee

12 - Interview with Dr. Ibnouf Sulieman - Transplant Surgery Fellow

14 - Resident Spotlight - Dr. Sam Nasser - PGY3

16 - A Review of the FIRST and SECOND Trials

18 - Residency Signaling in General Surgery

20 - Navigating Competency: Entrustable Professional Activities (EPAs)

22 - The Effect of Language Barriers on Surgical Outcomes

24 - Research Spotlight: The First Complete Human Eye …

Meet An Ipe/Cp Student Champion From Thomas Jefferson University, Joria Le, Rn, Bsn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

My first involvement with JCIPE programs was with the Interprofessional Palliative Care (IPC) program. Here, I was able to meet diverse students across Jefferson from Couple and Family Therapy, Medicine, Nursing, Physical Therapy, and more. Together, we addressed case studies with our various backgrounds and learned how to build upon each other’s strengths as a precursor to our future in the field. Especially coming from a Nursing background and now shifting towards medicine, it was a great experience to apply my knowledge and intertwine it with other fields.

Since then, I have immersed myself with research relating to the Health …

Meet An Ipe/Cp Staff Champion From Thomas Jefferson University, Mollie Cherson, Mphil, Lcsw

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In June 2021, the Integrated Behavioral Health (IBH) team was invited by JCIPE to pilot a new series of interprofessional sessions for primary care teams utilizing the ECHO (Extension for Community Healthcare Outcomes). This model has been utilized and researched worldwide to help with disseminating information across various subject matters within healthcare, with the goal of decreasing health disparities. Through use of subject matter experts, brief didactic education, and case consultations, communities of learners come together to enhance patient care and health outcomes.

The IBH team, which consists of clinicians from behavioral health, primary care, nutrition, occupational therapy, psychiatry, pharmacy, …

Translation Of Collaborative Skills From Undergraduate Interprofessional Education Curriculum To The Workplace: Results Of A Pilot Program, Erin Choice, Phd, Cscs, Shelene Thomas, Pt, Dpt, Edd, Gcs, Fnap

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Background

Interprofessional education (IPE) has become an increasingly necessary component of healthcare and health science curricula (Institute of Medicine, 2015; World Health Organization, 2010). However, the longitudinal impact of IPE and students’ ability to transfer knowledge and skills from the classroom to the workplace remains unknown (Breitbach et al., 2020). Training future healthcare providers (i.e., physical therapists, occupational therapists, exercise scientists) to work in interprofessional (IP) teams should arguably begin at the undergraduate (UG) level, rather than graduate level, in order to improve effective translation of skills to the workplace (Breitbach et al., 2020; Cooper et al., 2001; Murdoch et …

Team Care Planning: Black Maternal Health Case, Kenna Hersey, Ba

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In support of Thomas Jefferson University’s effort to be on the cutting edge of care, JCIPE (Jefferson Center for Interprofessional Practice & Education) supports educational programs that focus on understanding and addressing health disparities. Team Care Planning (TCP) is an educational simulation experience where teams of students from different professions collaborate with each other, and interact with standardized patients, to create a care plan. The initial case developed for TCP involves an interprofessional student team developing a discharge plan for an older adult who was hospitalized after a stroke. The interprofessional student team meets with the patient and her adult …

Spotlight On An Interprofessional Clinical Team, Andrew Chapman, Md, Emily Hajjar, Pharmd, Ms, Bcps, Bcacp, Bcgp, Lora Rhodes, Msw, Lsw, Melissa Denton, Rdn, Cso, Ldn, Lauren Hersh, Md

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Take a closer look at a clinical team at Thomas Jefferson University Hospital and how they practice interprofessionally every day!

The Senior Adult Oncology (SAO) Center at Jefferson Health focuses on cancer care for adults over the age of sixty-five, taking a whole-person approach in creating a personalized treatment plan.

JCIPE interviewed an SAO team about their roles, their interprofessional dynamic, and what they have learned from each other. The team then reviewed the case of C.S.

Who Are We Inviting To The Ipe Table?, Daniel S. Ferguson, Ms

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” – Martin Luther King

Health outcomes and life expectancy in the United States of America differ substantially based on race. For example, people of color are more likely to die of cardiovascular disease or stroke; more likely to have diabetes; and have higher infant and maternal mortality rates as compared to their white counterparts (Frieden, 2013). Achieving health equity is a key focus of Healthy People 2030 (HHS, 2013), which prioritizes addressing social determinants of health, including access to timely, high-quality healthcare and effective …

Jcipe Updates

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE Updates

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

As we begin a new year, we in the Jefferson Center for Interprofessional Practice and Education (JCIPE) are grateful for a fall semester and holiday season which brought connection and renewed our commitment to collaboration and inclusivity. We enjoyed seeing many of you in person again at our 8th biennial conference, when we hosted approximately 165 interprofessional colleagues from across the country and even around the world, to ponder and discuss issues of the day. We learned so much about what drives you and the field of interprofessional collaborative practice, and we appreciate this opportunity to reflect on our takeaways …

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 14, Number 1, Fall 2023/Winter 2024

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• Letter from the Editors
• JCIPE Updates
• Who are we inviting to the IPE table?
• Spotlight on an Interprofessional Clinical Team
• Team Care Planning: Black Maternal Health Case
• Translation of Collaborative Skills from Undergraduate Interprofessional Education Curriculum to the Workplace: Results of a Pilot Program
• Meet an IPE Staff Champion
• Meet an IPE Student Champion

Full Issue: Volume 19, Number 1 - Summer 2023

Jefferson Surgical Solutions

A publication for friends and colleagues of Jefferson’s Department of Surgery

In This Issue

Cover Story
Nicoletti Kidney Transplant Center Takes Swift Action to Address Equity in Transplantation - Page 1

Overview
Health Care Worker: Burnout Versus Moral Injury - Page 2

Please Welcome
Our Categorical Interns - Page 2

Education
‘General Residency Survival Guide’ Offers Practical Advice - Page 2

Changing Lives Through Research
Jefferson Breast Surgeon Selected for Second Cohort of Robert A. Winn Career Development Award - Page 3

On the Job
New Faculty - Page 3

Giving Opportunity
Honickman Center to Include Employee Wellness Space - …

News In Brief

Jefferson Surgical Solutions

Scott W. Cowan, MD, has been promoted to Professor. Dr. Cowan is also the Enterprise Medical Director of Risk Management for Jefferson Health.

Hien Dang, PhD, was awarded a National Institutes of Health R01 grant supporting “Deciphering the role of NELFE in modulating MYC signaling in hepatocellular carcinoma.” Dr. Dang is one of 11 scientists selected for the inaugural cohort of Cancer Moonshot Scholars, President Biden’s program to support outstanding early-career researchers.

Aditi Jain, PhD, has been promoted to Research Assistant Professor. She was recently awarded a National Institutes of Health (NIH) Investigator-Initiated Small Research Grant (R03) entitled “Elucidating the …

Honickman Center To Include Employee Wellness Space

Jefferson Surgical Solutions

Jefferson’s Honickman Center is being built to create an exceptional patient experience that combines comfortable, healing spaces with the convenience of many care services in a single location. In addition to supporting patients’ health and well-being, the building will offer an abundance of resources to support employee wellness.

“The COVID-19 pandemic revealed just how difficult it can be to work in healthcare,” explains Catriona McDonald Harrop, MD, Senior Vice President of Jefferson Medical Group and Clinical Associate Professor of Medicine. “The pandemic also compounded longstanding challenges related to stress and burnout among care teams.”

Alongside growing emphasis on more holistic …

New Faculty

Jefferson Surgical Solutions

Kenneth A. Andreoni, MD, has joined the Division of Transplant Surgery as Surgical Director of our Kidney Transplant Program. Dr. Andreoni is a graduate of Yale University School of Medicine. He then went to Johns Hopkins Hospital where he completed his surgical residency, a research fellowship in Transplant Immunology and an Advanced Gastrointestinal Surgery fellowship. From there, he went on to complete an additional fellowship in Clinical Transplantation at the Division of Abdominal Transplantation at Ohio State University. He cares for patients at the Nicoletti Kidney Transplant Center at Thomas Jefferson University Hospital.

Wassim G. El-Habre, MD, has joined the …

Jefferson Breast Surgeon Selected For Second Cohort Of Robert A. Winn Career Development Award

Jefferson Surgical Solutions

The Bristol Myers Squibb Foundation established the Robert A. Winn Career Development Award (CDA) to increase diversity in clinical trials and transform the clinical research landscape. The program aims to improve representation among two key populations: patients participating in trials as well as the clinicians and scientists leading clinical trials. Assistant Professor of Surgery Adeseye Adekeye, MD, PhD, is one of 64 early-stage investigators selected for the second cohort of the Winn CDA program. The program funds $120,000 a year for two years, with the awardees spending at least 40% of their time on the program. Dr. Adekeye and the …

‘General Residency Survival Guide’ Offers Practical Advice

Jefferson Surgical Solutions

There were no work-hour restrictions when Professor of Surgery Alec C. Beekley, MD, was completing his own surgical training in the 1990s. Back then, he says, it wasn’t uncommon to be at the hospital for days at a time or to work for 30 hours straight.

“The old adage in surgery was, ‘if you’re only on call every other night, you miss half the good cases,’” he says. Today’s surgical residents are training in a different era – one in which there’s greater awareness of the risk of burnout among healthcare providers. There are also restrictions on the number of …

Our Categorical Interns

Jefferson Surgical Solutions

Thomas Jefferson University Hospital

• Itohan Aikhionbare, MD, Northeast Ohio Medical University
• Mia Brownfield, MD, Sidney Kimmel Medical College at Thomas Jefferson University
• Saba Daneshpooy, MD, Cooper Medical School of Rowan University
• Candice Dunn, MD, Rutgers Robert Wood Johnson Medical School-Piscataway
• Mitchell Hirsch, MD, Rutgers New Jersey Medical School
• Deirbhile Martin, MD, University of Massachusetts Medical School
• Aakash Shingala, MD, Medical University of South Carolina College of Medicine

Jefferson Abington Hospital

• Hudson Carter, MD, Sidney Kimmel Medical College at Thomas Jefferson University
• Gianfranco Galantini, MD, University of Connecticut School of Medicine
• Nnenna Nwaelugo, MD, Medical College of Wisconsin
• Jesse Ottaway, MD, …

Health Care Worker: Burnout Versus Moral Injury, Charles Yeo, Md, Facs

Jefferson Surgical Solutions

Much has been written about health care worker (HCW) burnout – defined as a constellation of symptoms which include exhaustion, cynicism and decreased productivity; it has been clearly linked to increased rates of depression, suicide and departure from health care employment. Surveys show that large percentages of HCWs report burnout. We have all read the various studies.

But Talbot and Dean* suggest a different perspective – they opine that the concept of burnout resonates poorly with many HCWs, as it suggests a failure of resilience, grit and resourcefulness (traits present in most HCWs; learned and practiced through long training and …

Nicoletti Kidney Transplant Center Takes Swift Action To Address Equity In Transplantation

Jefferson Surgical Solutions

The general public may assume that waitlists for organ transplantation follow a simple tenet: The sicker a patient, the higher their position on the waitlist. But for decades, a formula for kidney transplantation was disadvantaging Black patients. The calculation adjusted these patients’ kidney function scores up, which delayed their placement on the list to receive a transplanted kidney.

The Nicoletti Kidney Transplant Center (NKTC) at Jefferson adopted a race-neutral calculation in 2021. In the summer of 2022, the United Network for Organ Sharing (UNOS), the nonprofit that serves as the nation’s transplant system under contract with the federal government, mandated …

Expanding The Primary Care Interprofessional Team: Creating Space For Behavioral Health Consultants, Rachelle Rene, Phd, Bcb, Hsmi, Cgp, Mollie Cherson, Mphil, Lcsw

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Statement of issue or problem addressed

Despite a growing need for mental and behavioral health services, access to these services has been limited due to constraints in insurance coverage and location of services outside of medical care. As a result, mental and behavioral health needs have frequently fallen to the primary care system to support.