Medicine and Health Sciences Commons^™

Social And Psychosocial Determinants Of Racial And Ethnic Differences In Cardiovascular Health: The Masala And Mesa Studies, Nilay S. Shah, Xiaoning Huang, Lucia C. Petito, Michael P. Bancks, Alka M. Kanaya, Sameera Talegawkar, Saaniya Farhan, Mercedes R. Carnethon, Donald M. Lloyd-Jones, Norrina B. Allen, Namratha R. Kandula, Sadiya S. Khan

Student Papers, Posters & Projects

BACKGROUND: Social and psychosocial determinants are associated with cardiovascular health (CVH).

OBJECTIVES: To quantify the contributions of social and psychosocial factors to racial/ethnic differences in CVH.

METHODS: In the Multi-Ethnic Study of Atherosclerosis and Mediators of Atherosclerosis in South Asians Living in America cohorts, Kitagawa-Blinder-Oaxaca decomposition quantified the contributions of social and psychosocial factors to differences in mean CVH score (range 0-14) in Black, Chinese, Hispanic, or South Asian compared with White participants.

RESULTS: Among 7,978 adults (mean age 61 [SD 10] years, 52 % female), there were 1,892 Black (mean CVH score for decomposition analysis 7.96 [SD 2.1]), 804 …

Fluorescent Peptide For Detecting Factor Xiiia Activity And Fibrin In Whole Blood Clots Forming Under Flow, Yue Liu, Jennifer Crossen, Timothy J. Stalker, Scott L. Diamond

Cardeza Foundation for Hematologic Research

Background

During clotting, thrombin generates fibrin monomers and activates plasma-derived transglutaminase factor (F) XIIIa; collagen and thrombin-activated platelets offer thrombin-independent cellular FXIIIa (cFXIIIa) for clotting. Detecting fibrin on collagen and tissue factor surfaces in whole blood clotting typically uses complex reagents like fluorescent fibrinogen or antifibrin antibody.

Objectives

We want to test whether the peptide using the α2- antiplasmin crosslinking mechanism by FXIIIa is a useful tool in both monitoring FXIIIa activity, and visualize and monitor fibrin formation, deposition, and extent of crosslinking within fibrin structures in whole blood clots formed under flow.

Methods

We tested a fluorescent peptide derived …

Nonlinear Model Predictive Control Of Vagal Nerve Stimulation To Regulate Hemodynamic Variables, Oluwasanmi Adeodu, Michelle Gee, Babak Mahmoudi, Rajanikanth Vadigepalli, Mayuresh Kothare

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Various pre-clinical investigations indicate that the electrical stimulation of the cervical branch of the vagus that innervates the heart has therapeutic value in the management of various cardiac diseases. In theory, the design of a closed-loop control mechanism that automatically adjusts vagal nerve stimulation (VNS) parameters based on real-time physiological feedback can eliminate intra-patient variability in VNS outcomes and therefore represents a major step towards patient-specific therapy. This study develops a nonlinear model predictive control (NMPC) approach for VNS of a pulsatile, human cardio-baroreflex system. The manipulated variables are the frequency and amplitude of a charge-balanced biphasic current. The effects …

Large Right Lower Quadrant Abdominal Mass, Isheeta Madeka, Cannon Greco-Hiranaka, Ozlem Kulak, Wilbur Bowne

Jefferson Hospital Staff Papers and Presentations

No abstract provided.

Impact Of Climate Change On Surgery: A Scoping Review To Define Existing Knowledge And Identify Gaps, Tina Bharani, Rebecca Achey, Harris Jamal, Alexis Cherry, Malcolm K. Robinson, Guy J. Maddern, Deirdre K. Tobias, Divyansh Agarwal

Department of Surgery Faculty Papers

With climate change accelerated at a worrisome rate, global warming also will have implications for surgery and surgical practice. The goal of this current study was to systematically survey the literature and better understand how climate change has affected surgical disease burden, surgical care delivery, and surgical outcomes. We performed a comprehensive scoping review, screening 3334 unique citations from three databases – 1766 from Embase, 1329 from Pubmed and 239 from Scopus – to identify studies that had associated climate change with surgery. After systematic searching, quality appraisal, and data extraction, we synthesized findings from qualitative and quantitative studies. Twenty-six …

Educational Case: Endometrial Ectopia In Endometriosis And Adenomyosis, Carolyn G. Chen, Joanna S.Y. Chan

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

No abstract provided.

Mavs Is A Double-Edged Sword, Christina Huang, Jack L. Arbiser

Student Papers, Posters & Projects

No abstract provided.

Tav-In-Tav And Beyond: How Far Can We Go?, Taramasso Maurizio, Ana Paula Tagliari, David L. Fischman

Division of Cardiology Faculty Papers

No abstract provided.

Characteristics And Outcomes Of Patients Who Underwent Coronary Atherectomy In Centers With And Without On-Site Cardiac Surgery, Mohamed Dafaalla, Muhammad Rashid, Saadiq Moledina, Tim Kinnaird, Peter Ludman, Nick Curzen, Sarah Zaman, James Nolan, Mamas A. Mamas

Department of Medicine Faculty Papers

We aimed to describe the clinical characteristics and outcomes of patients who underwent atherectomy at the time of percutaneous coronary intervention in centers with on-site surgical centers (SCs) versus nonsurgical centers (NSCs). Patients treated with coronary atherectomy between January 1, 2006, to December 31, 2019, from the British Cardiovascular Society Intervention (BCIS) registry were included. Primary outcomes were in-hospital all-cause mortality and major adverse cardiovascular and cerebrovascular events. A total of 20,833 patients were treated with coronary atherectomy, of which 7,983 (38%) were performed at NSC. The proportion of coronary atherectomies performed in NSC increased from 12.5% in 2006 to …

Transmission Of Yellow Fever Vaccine Virus Through Blood Transfusion And Organ Transplantation In The Usa In 2021: Report Of An Investigation, Carolyn V. Gould, Rebecca J. Free, Julu Bhatnagar, Raymond A. Soto, Tricia L. Royer, Warren R. Maley, Sean Moss, Matthew A. Berk, Rebecca Craig-Shapiro, Rosy Priya L. Kodiyanplakkal, Lars F. Westblade, Thangamani Muthukumar, Yoram A. Puius, Amresh Raina, Azam Hadi, Kymberly A. Gyure, Danielle Trief, Marcus Pereira, Matthew J. Kuehnert, Vennus Ballen, Debra A. Kessler, Kimberly Dailey, Charles Omura, Thuy Doan, Steve Miller, Michael R. Wilson, Jennifer A. Lehman, Jana M. Ritter, Elizabeth Lee, Luciana Silva-Flannery, Sarah Reagan-Steiner, Jason O. Velez, Janeen J. Laven, Kelly A. Fitzpatrick, Amanda Panella, Emily H. Davis, Holly R. Hughes, Aaron C. Brault, Kirsten St George, Amy B. Dean, Joel Ackelsberg, Sridhar V. Basavaraju, Charles Y. Chiu, J. Erin Staples

Department of Medicine Faculty Papers

BACKGROUND: In 2021, four patients who had received solid organ transplants in the USA developed encephalitis beginning 2-6 weeks after transplantation from a common organ donor. We describe an investigation into the cause of encephalitis in these patients.

METHODS: From Nov 7, 2021, to Feb 24, 2022, we conducted a public health investigation involving 15 agencies and medical centres in the USA. We tested various specimens (blood, cerebrospinal fluid, intraocular fluid, serum, and tissues) from the organ donor and recipients by serology, RT-PCR, immunohistochemistry, metagenomic next-generation sequencing, and host gene expression, and conducted a traceback of blood transfusions received by …

C9orf72 Poly(Pr) Mediated Neurodegeneration Is Associated With Nucleolar Stress, M. E. Cicardi, J. H. Hallgren, D. Mawrie, K. Krishnamurthy, S. S. Markandaiah, A. T. Nelson, V. Kankate, E. N. Anderson, P. Pasinelli, U. B. Pandey, C. M. Eischen, D. Trotti

Farber Institute for Neuroscience Faculty Papers

The ALS/FTD-linked intronic hexanucleotide repeat expansion in the C9orf72 gene is aberrantly translated in the sense and antisense directions into dipeptide repeat proteins, among which poly proline-arginine (PR) displays the most aggressive neurotoxicity in-vitro and in-vivo. PR partitions to the nucleus when heterologously expressed in neurons and other cell types. We show that by lessening the nuclear accumulation of PR, we can drastically reduce its neurotoxicity. PR strongly accumulates in the nucleolus, a nuclear structure critical in regulating the cell stress response. We determined that, in neurons, PR caused nucleolar stress and increased levels of the transcription factor p53. …

Arthroscopic Treatment Of Shoulder Stiffness With Rotator Cuff Repair Yields Similar Outcomes To Isolated Rotator Cuff Repair, Parker L. Brush, Adrian Santana, Ruchir Nanavati, Gregory R. Toci, Tariq Z. Issa, Daniel J. Fletcher, Joshua Hornstein

Rothman Institute Faculty Papers

Purpose To compare patient-reported and surgical outcome measures in patients with and without secondary shoulder stiffness (SSS) undergoing rotator cuff repair (RCR).

Methods Patients undergoing rotator cuff repair from 2014 to 2020 with complete patient-reported outcome measures (PROMs) by the short-form 12 survey (SF-12) were retrospectively reviewed to identify if operative intervention for SSS was performed alongside the RCR. Those patients with operative intervention for SSS were propensity matched to a group without prior intervention for stiffness by age, sex, laterality, body mass index, diabetes mellitus status, and the presence of a thyroid disorder. The groups were compared by rotator …

Gene Signature Reveals Decreased Sox10-Dependent Transcripts In Malignant Cells From Immune Checkpoint Inhibitor-Resistant Cutaneous Melanomas, Timothy J. Purwin, Signe Caksa, Ahmet Sacan, Claudia Capparelli, Andrew E. Aplin

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

Evidence is mounting for cross-resistance between immune checkpoint and targeted kinase inhibitor therapies in cutaneous melanoma patients. Since the loss of the transcription factor, SOX10, causes tolerance to MAPK pathway inhibitors, we used bioinformatic techniques to determine if reduced SOX10 expression/activity is associated with immune checkpoint inhibitor resistance. We integrated SOX10 ChIP-seq, knockout RNA-seq, and knockdown ATAC-seq data from melanoma cell models to develop a robust SOX10 gene signature. We used computational methods to validate this signature as a measure of SOX10-dependent activity in independent single-cell and bulk RNA-seq SOX10 knockdown, cell line panel, and MAPK inhibitor drug-resistant datasets. Evaluation …

The Impact Of Covid-19 On Hospitalization Outcomes Of Patients With Acute Myocardial Infarction In The Usa, F.E. Markson, E. Akuna, C.Y. Lim, L. Khemani, A, Amanullah

Einstein Health Papers

Background/study objective: The effect of the COVID-19 pandemic affected health care delivery, as it led to variable outcomes in different disease states including cardiovascular diseases. In this study, we evaluated the impact of coexisting COVID-19 on Acute Myocardial Infarction (AMI). Design/setting: We analyzed discharge records of AMI patients from the National Inpatient Sample (NIS) in the year 2020.

Main outcome measures: Using propensity score matching, we assessed the impact of COVID-19 infection on the in-hospital outcomes of patients presenting with AMI.

Results: There were 1154 patients with concomitant COVID-19 infection and AMI who were matched with 109,990 patients with AMI …

Impact Of Social Media And Multimedia Platforms: View From The Jacc: Case Reports Some Editors, Estefania Oliveros, Yevgeniy Brailovsky, Alessandro Beneduce, Hooman Bakshi, Edoardo Zancanaro, Indah Sukmawati, Mrinali Shetty, Gina Lundberg

Division of Cardiology Faculty Papers

No abstract provided.

Acute Diplopia After Glabellar Hyaluronic Acid Filler Injection, Caroline W. Chung, Eric J. Shiuey, César A. Briceño, Vivian Lee

SKMC Student Presentations and Publications

Purpose: Blindness is a well-known complication of filler injection in the glabellar region. Acute diplopia from filler injection without vision loss is a rare complication that typically results in clinical ophthalmoplegia which can have permanent sequelae. Here, we describe a patient who presented with acute diplopia with grossly intact full extraocular motility after glabella hyaluronic acid filler injection that resolved after 1 month.

Observations: A previously healthy 43-year-old woman underwent her first hyaluronic acid injection in the glabella and developed immediate binocular double vision with severe pain and skin mottling above her right eyebrow and central forehead. Hyaluronidase injections, nitroglycerin …

Automated Subfield Volumetric Analysis Of Amygdala, Hippocampus, And Thalamic Nuclei In Mesial Temporal Lobe Epilepsy, Arichena Manmatharayan, Michael Kogan, Caio Matias, Mashaal Syed, India Shelley, Amar Chinni, Kichang Kang, Kiran Talekar, Scott H. Faro, Feroze B. Mohamed, Ashwini Sharan, Chengyuan Wu, Mahdi Alizadeh

Department of Neurosurgery Faculty Papers

Purpose: Identifying relationships between clinical features and quantitative characteristics of the amygdala-hippocampal and thalamic subregions in mesial temporal lobe epilepsy (mTLE) may offer insights into pathophysiology and the basis for imaging prognostic markers of treatment outcome. Our aim was to ascertain different patterns of atrophy or hypertrophy in mesial temporal sclerosis (MTS) patients and their associations with postsurgical seizure outcomes. To assess this aim, this study is designed in 2 folds: (1) hemispheric changes within MTS group and (2) association with postsurgical seizure outcomes.

Methods and materials: 27 mTLE subjects with mesial temporal sclerosis (MTS) were scanned for conventional 3D …

Impact Of The Covid-19 Pandemic On The Management Of Risk Factors In Patients With Stable Atherosclerotic Vascular Disease, Dean Karalis, Patrick Moeller, Albert Crawford, Maria Janelli, Scott Hessen

Division of Cardiology Faculty Papers

Background

Effective control of risk factors in patients with ASCVD is important to reduce recurrent cardiovascular events. However, many ASCVD patients do not have their risk factors controlled, and this may have worsened during the COVID-19 pandemic.

Methods

We retrospectively evaluated risk factor control among 24,760 ASCVD patients who had at least 1 outpatient encounter both pre-pandemic and during the first year of the pandemic. Risk factors were uncontrolled if the blood pressure (BP) ≥ 130/80 mm Hg, LDL-C ≥ 70 mg/dL, HgbA1c ≥ 7 for diabetic patients, and patients were current smokers.

Results

During the pandemic, many patients had …

Publication Rates Of Abstracts Presented Across 6 Major Spine Specialty Conferences, Tariq Z. Issa, Yunsoo Lee, Mark J. Lambrechts, Christopher Reynolds, Ryan Cha, James Kim, Jose A. Canseco, Alex R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder, Alan S. Hilibrand

Rothman Institute Faculty Papers

Background: Although scientific researchers aim to present their projects at academic conferences as a step toward publication, not all projects mature to become a peer-reviewed manuscript. The publication rate of meetings can be utilized to assess the quality of presented research. Our objective was to evaluate the contemporary publication rate of abstracts presented at spine conferences.

Methods: We reviewed annual meeting programs of North American Spine Society (NASS), Scoliosis Research Society (SRS), International Meeting on Advanced Spine Techniques (IMAST), Spine Global Spine Congress (GSC), Lumbar Spine Research Society (LSRS), and Cervical Spine Research Society (CSRS) from 2017 to 2019. Abstracts …

Incidence And Risk Factors For Retinal Detachment And Retinal Tear After Cataract Surgery: Iris® Registry (Intelligent Research In Sight) Analysis, Michael J. Morano, M. Ali Khan, Qiang Zhang, Colleen P. Halfpenny, Douglas M. Wisner, James Sharpe, Alexander Li, Maurizio Tomaiuolo, Julia A A. Haller, Leslie Hyman, Allen C. Ho

Wills Eye Hospital Papers

Objective To report the incidence of and evaluate demographic, ocular comorbidities, and intraoperative factors for rhegmatogenous retinal detachment (RRD) and retinal tear (RT) after cataract surgery in the American Academy of Ophthalmology IRIS® Registry (Intelligent Research in Sight).

Design Retrospective cohort study.

Participants Patients aged ≥ 40 years who underwent cataract surgery between 2014 and 2017.

Methods Multivariable logistic regression was used to evaluate demographic, comorbidity, and intraoperative factors associated with RRD and RT after cataract surgery.

Main Outcome Measures Incidence and risk factors for RRD or RT within 1 year of cataract surgery.

Results Of the 3 177 195 …

Advances In Retinopathy Of Prematurity Imaging, Taku Wakabayashi, Samir N. Patel, J. P. Campbell, Emmanuel Y. Chang, Eric D. Nudleman, Yoshihiro Yonekawa

Wills Eye Hospital Papers

Retinopathy of prematurity (ROP) remains the leading cause of childhood blindness worldwide. Recent advances in ROP imaging have significantly improved our understanding of the pathogenesis and pathophysiological course of ROP including the acute phase, regression, reactivation, and late complications, known as adult ROP. Recent progress includes various contact and noncontact wide-field imaging devices for fundus imaging, smartphone-based fundus photography, wide-field fluorescein angiography, handheld optical coherence tomography (OCT) devices for wide-field en face OCT images, and OCT angiography. Images taken by those devices were incorporated in the recently updated guidelines of ROP, the International Classification of Retinopathy of Prematurity, Third Edition …

1485-Pub: Assessing Correlates Of Microvascular Complications Among Patients With Diabetes Mellitus, Kenneth Izuora, Amalie Alver, Arpita Basu, Kavita Batra, Shelley J. Williams, Jeffrey L. Ebersole

Internal Medicine Faculty Publications

Background: Microvascular complications associated with diabetes (DM) are important predictors of morbidity and mortality. Understanding the factors associated with these complications is important in reducing their burden. Method: Using a cross-sectional study design, seventy-one ambulatory patients with Type 2 DM (female 60.6%, white 36.6%, mean age 64.1± 10.3 years, and mean duration of DM 15.8±9.1 years) were recruited using an investigator-administered questionnaire and chart review. Variables of demographics, smoking, HbA1c, DM duration, and complications were collected. CRP was measured and oral health status was assessed by a clinical exam. Data were analyzed using Chi-square/Fisher exact tests and binomial logistic regression …

Therapists’ Observations In Reduction Of Unpleasant Emotions Following Advanced Integrative Therapy Interventions, Gregory P. Brown, Kavita Batra, Suzie S. Hong, Robert Sottile, Raveena Bakhru, Emily Dorin

Psychiatry & Behavioral Health Faculty Publications

Objective: To assess the potential clinical efficacy of a novel model of energy psychology intervention, Advanced Integrative Therapy (AIT), this pilot study assessed clinician perceptions of AIT through a cross-sectional survey. Methods: A 17-item web-based questionnaire was administered to AIT therapists in November of 2021. The survey included clinician demographics and the clinician-observed response to AIT treatment based upon changes in reported Subjective Units of Distress (SUD), the associated emotion, and somatic sensation (when present). Result: A total of 76 complete responses were analyzed. The sample respondents were predominantly female (81.6%) and non-Hispanic white (68%). Over 80% of the respondents …

Early-Learners' Expectations Of And Experience With Ipe: A Multi-Institutional Qualitative Study, Sharon K. Lanning, Karen Pardue, Kathrin Eliot, Amanda Goumas, Ginge Kettenbach, Bernice Mills, Kelly Lockeman, Anthony Breitbach, Tina P. Gunaldo

Center for Interprofessional Education and Collaborative Practice Papers

Background: Multi-institutional qualitative studies are scarce within the interprofessional education (IPE) literature; such a report would provide comprehensive evidence for the application of interprofessional instruction among earlier learners. Objective: This investigation explored students' expectations of and barriers to introductory IPE across four institutions. Design: Qualitative inductive content analysis was utilized to interpret students' narrative responses to assigned pre- and post-survey questions. Setting: Health science schools of four U.S. institutions at Institution A, Institution B, Institution C, and Institution D. Participants: Twenty-two percent (n = 385) of eligible participants completed both pre- and post-surveys. Nursing student participation was greatest (n = …

Outcomes For Hand Burns Treated With Autologous Skin Cell Suspension In 20% Tbsa And Smaller Injuries, George Malcolm Taylor, Scott A. Barnett, Charles T. Tuggle, Jeff E. Carter, Herb A. Phelan

School of Medicine Faculty Publications

In order to address the confounder of TBSA on burn outcomes, we sought to analyze our experience with the use of autologous skin cell suspensions (ASCS) in a cohort of subjects with hand burns whose TBSA totaled 20% or less. We hypothesized that the use of ASCS in conjunction with 2:1 meshed autograft for the treatment of hand burn injuries would provide comparable outcomes to hand burns treated with sheet or minimally meshed autograft alone. A retrospective review was conducted for all deep partial and full-Thickness hand burns treated with split-Thickness autograft (STAG) at our urban verified burn center between …

Who Will Be The Caretakers Of Peripheral Arterial Disease?, Claudie Sheahan

School of Medicine Faculty Publications

No abstract provided.

Clinical Use Of Lactate Measurements: Reply, Richard M. Pino, Jaskaran Singh

School of Medicine Faculty Publications

No abstract provided.

Use, Yield, And Risk Of Device-Assisted Enteroscopy In The United States: Results From A Large Retrospective Multicenter Cohort, Michael G. Noujaim, Alice Parish, Daniel Raines, Seth A. Gross, David Cave, Iris Vance, David Beyer, Diana Liu, Benjamin Hoffman, Zoe Lawrence, Gabriel Castillo, Tanya Pavri, Donna Niedzwiecki, Daniel Wild

School of Medicine Faculty Publications

Introduction: Since 2001, device-Assisted enteroscopy (DAE) has revolutionized the diagnostic and therapeutic capabilities for managing small bowel pathology. Though commonly performed, there have been no recent large studies to assess the use, yield, and risks of DAE and none that include all 3 DAE modalities. We hypothesized that DAE is safe with high diagnostic and therapeutic yields achieved within reasonable procedure duration and here we present a large retrospective multicenter US study evaluating the use, yield, and complications of DAE. Methods: After obtaining institutional review board approval, electronic records were used to identify all DAE's performed for luminal small bowel …

Atypical Osteochondroma Of The Lumbar Spine Associated With Suprasellar Pineal Germinoma: A Case Report, Patrik Suwak, Scott A. Barnett, Bryant M. Song, Michael J. Heffernan

School of Medicine Faculty Publications

BACKGROUND Osteochondromas are the most common benign bone tumor, accounting for 36% of benign bone tumors. Often found within the appendicular skeleton, osteochondromas of the spine are rare, comprising 4% to 7% of primary benign spinal tumors. CASE SUMMARY We report a case of a solitary lumbar osteochondroma in an 18-year-old male with a history of a suprasellar pineal germinoma treated with combined chemotherapy and radiation. He underwent mass excision and partial laminectomy with the ultrasonic bone scalpel (Misonix, Farmingdale, NY, United States) at the L5 Level without the use of adjuvants. The patient returned to work and full activities …

Prevalence And Subgroup Comparisons Of Obesity And Severe Obesity Among Mississippi Public School Students, Lei Zhang, Xiaoshan Z. Gordy, Jerome Kolbo, Jacquelynn Johnson

Faculty Publications

This study examined the prevalence of obesity and severe obesity among Mississippi K-12 public school students and the obesity rate differences within subgroups categorized by sex, race, and grade level. Anthropometric data from a weighted, representative sample of Mississippi public school students were collected through the biennial Child and Youth Prevalence of Obesity Survey (CAYPOS). Overall prevalence rates and those of the subgroups were calculated and compared. The 2017 data indicated that overall 23.7% of Mississippi public schools students met the criterion of class I obesity, 9.1% met the criterion of class II obesity, and 3.2% met the criterion of …