Digital Commons Network^™

Electronic Notebooks To Facilitate Student Learning Within And Beyond The Classroom, Mary Muhlenhaupt, Otd, Otr/L, Faota, Mary Ann Wagner-Graham, Phd, Gary E. Kaplan, Mslis, Ahip

Thomas Jefferson University Faculty Days

Introduction

Electronic Research Notebooks (ERN), also called Electronic Lab Notebooks, are becoming standard in many industries and academic labs where documentation, reproducibility, online access, and collaboration tools are important (1,2, 3). Jefferson launched cloud-based LabArchives in 2018 as its ERN. The product includes a Classroom Edition for use with students. It offers instructors options to embed course readings, documents, assignments, images, videos, audio files and links to other online resources. Students can type and save notes in their electronic notebook, complete and submit assignments, draw and annotate images and illustrations. Instructors can update the students’ notebooks anytime, grade assignments, comment …

Engaging Students To Improve Research Competencies, Sam Bardarik, Mlis, Paul Hunter, Dmd, Mlis, Gary Kaplan, Mslis, Ahip

Thomas Jefferson University Faculty Days

By increasingly incorporating a variety of student engagement methods into instruction sessions, librarians will be able to build on basic skills (remembering, understanding, applying) and develop students’ higher order learning skills (analysis, evaluation, and creation). For example, a skill librarians have recently introduced is critical appraisal of the literature, one component that ensures students effectively incorporate evidence-based practice into patient care. Librarians also aim to assess student learning and make appropriate iterative modifications to ensure these methods effectively set up students for success. Together, librarians and faculty are laying the groundwork to facilitate lifelong learning in Jefferson students.

Jeffmd’S Wellness Thread: Lessons Learned, Nethra Ankam, Md

Thomas Jefferson University Faculty Days

Background

“Nearly half of U.S. medical students experience symptoms of burnout such as feeling emotionally exhausted, detached from patients, and that their efforts do not make a difference” –Dyrbye & Shanafelt 2011

Systems solutions must be pursued to promote wellness and reduce burnout. Per Shanafelt & Noseworthy 2017, when groups/organizations operate under the assumption that wellness and burnout are the sole responsibility of the individual, efforts to improve wellness are looked upon with skepticism by physicians and organizational factors are neglected. Individuals may pursue strategies to mitigate burnout that work for the individual, but not for the group/organization. Systems strategies …

Faculty Writing: A Year-Long Approach To Producing Publishable Manuscripts, Jennifer Wilson, Ms, Els, Pamela Walter, Mfa, Julie Phillips, Phd

Thomas Jefferson University Faculty Days

For faculty, the ability to write about their research and publish their findings can advance their academic career while contributing information to their field. Yet faculty often lack confidence in their ability to write for publication and struggle to find time to write.

An interdisciplinary faculty group asked us for help prioritizing their writing and meeting their publishing goals, and in response we developed a yearlong month by- month program of achievable small tasks to guide the manuscript writing process and make publishing less overwhelming.

Roles Of Gm-Csf In The Pathogenesis Of Autoimmune Diseases: An Update., Noushin Lotfi, Rodolfo Thome, Nahid Rezaei, Guang-Xian Zhang, Abbas Rezaei, A. M. Rostami, Nafiseh Esmaeil

Department of Neurology Faculty Papers

Granulocyte-macrophage colony-stimulating factor (GM-CSF) was first described as a growth factor that induces the differentiation and proliferation of myeloid progenitors in the bone marrow. GM-CSF also has an important cytokine effect in chronic inflammatory diseases by stimulating the activation and migration of myeloid cells to inflammation sites, promoting survival of target cells and stimulating the renewal of effector granulocytes and macrophages. Because of these pro-cellular effects, an imbalance in GM-CSF production/signaling may lead to harmful inflammatory conditions. In this context, GM-CSF has a pathogenic role in autoimmune diseases that are dependent on cellular immune responses such as multiple sclerosis (MS) …

Peripheral Synucleinopathy In A Dj1 Patient With Parkinson Disease, Cataracts, And Hearing Loss, Derek P. Narendra, Risa Isonaka, Diana Nguyen, Alice B. Schindler, Angela D. Kokkinis, Debra Ehrlich, Tanya M. Bardakjian, David S. Goldstein, Tsao-Wei Liang, Pedro Gonzalez-Alegre

Department of Neurology Faculty Papers

No abstract provided.

Brainstem Atrophy In Focal Epilepsy Destabilizes Brainstem-Brain Interactions: Preliminary Findings., Susanne G. Mueller, Lisa M. Bateman, Maromi Nei, Alica M. Goldman, Kenneth D. Laxer

Department of Neurology Faculty Papers

BACKGROUND: MR Imaging has shown atrophy in brainstem regions that were linked to autonomic dysfunction in epilepsy patients. The brainstem projects to and modulates the activation state of several wide-spread cortical/subcortical regions. The goal was to investigate 1. Impact of brainstem atrophy on gray matter connectivity of cortical/subcortical structures and autonomic control. 2. Impact on the modulation of cortical/subcortical functional connectivity.

METHODS: 11 controls and 18 patients with non-lesional focal epilepsy (FE) underwent heart rate variability (HRV) measurements and a 3 T MRI (T1 in all subjects, task-free fMRI in 7 controls/ 12 FE). The brainstem was extracted, and atrophy …

Sternoclavicular Joint Arthropathy Mimicking Radiculopathy In A Patient With Concurrent C4-5 Disc Herniation, Prateek Agarwal, Ab, Nitin Agarwal, Md, David Hansberry, Md, Phd, Neil Majmundar, Md, Ira M. Goldstein, Md

Department of Radiology Faculty Papers

Background

Patients with sternoclavicular joint arthropathy, which can result from septic arthritis, often present with localized sternoclavicular pain as well as shoulder pain. Such pain may be similar to the presenting symptoms of cervical intervertebral disc herniation.

Clinical presentation

A 47-year-old female presented with 1 month of significant pain in the neck as well as right anterior chest and deltoid. The patient was found to have reduced strength in the right deltoid muscle on physical examination. MRI revealed a C4-C5 herniated nucleus pulposus. The patient underwent successful C4-C5 anterior cervical discectomy, but subsequently developed painful swelling in the region of …

The Effect Of Mirror Therapy On Upper Extremity Functioning For Patients Poststroke: A Systematic Review, Caitlin Beach, Halie Finke, Abby Garrity, Amanda Norcini, Lily Postus, Kristen Tekel, Lyn Kaiser, Otd, Otr/L

Student Papers, Posters & Projects

Due to the high incidence of stroke and the detrimental impact it can have on a patient’s independence, several systematic reviews examining the effect of MT on post-stroke rehabilitation for upper extremity functioning have been conducted. However, it is necessary to provide an update to existing systematic reviews to include new clinical studies that have recently been published. Since stroke is a leading cause of disability, this study aims to determine the effectiveness of MT in post-stroke rehabilitation for upper extremity function as compared to conventional therapy.

Randomized Phase 3 Evaluation Of Trifarotene 50 Μg/G Cream Treatment Of Moderate Facial And Truncal Acne., Jerry Tan, Diane Thiboutot, Georg Popp, Melinda Gooderham, Charles Lynde, James Del Rosso, Jonathan Weiss, Ulrike Blume-Peytavi, Jolanta Weglovska, Sandra Johnson, Lawrence Parish, Dagmara Witkowska, Nestor Sanchez Colon, Alessandra Alió Saenz, Faiz Ahmad, Michael Graeber, Linda Stein Gold

Department of Dermatology and Cutaneous Biology Faculty Papers

BACKGROUND: Acne vulgaris often affects the face, shoulders, chest, and back, but treatment of nonfacial acne has not been rigorously studied.

OBJECTIVES: Assess the safety and efficacy of trifarotene 50 μg/g cream, a novel topical retinoid, in moderate facial and truncal acne.

METHODS: Two phase III double-blind, randomized, vehicle-controlled, 12-week studies of once-daily trifarotene cream versus vehicle in subjects aged 9 years or older. The primary end points were rate of success on the face, as determined by the Investigator's Global Assessment (clear or almost clear and ≥2-grade improvement), and absolute change from baseline in inflammatory and noninflammatory counts from …

Annual Report 2018-2019, Jeffrey Ashley, Amy Patrone

Annual Reports & Administrative Documents

No abstract provided.

Competency-Based Curriculum Development To Meet The Needs Of People With Disabilities: A Call To Action., Nethra S. Ankam, Md, Glendaliz Bosques, Carley Sauter, Steven Stiens, Maya Therattil, Faren H. Williams, Caleb C. Atkins, R. Samuel Mayer

Department of Rehabilitation Medicine Faculty Papers

People with disabilities constitute 22.2% of the population in the United States, and virtually all physicians have people with disabilities in their clinical practice across a wide range of diagnostic groups. However, studies demonstrate that people with disabilities are inadequately served by the health care system, leading to high costs and poor outcomes. The authors argue that one cause of this discrepancy is that medical students receive limited training in the care of people with disabilities and may therefore not be able to adequately meet the competencies that underlie the Core Entrustable Professional Activities for Entering Residency. To address these …

Single Institution Implementation Of Permanent 131cs Interstitial Brachytherapy For Previously Irradiated Patients With Resectable Recurrent Head And Neck Carcinoma, Voichita Bar-Ad, Emily Hubley, Adam Luginbuhl, David Cognetti, Joseph Curry, Amy Harrison, Jennifer Johnson, James Keller, Cheng Peng, David To, Laura Doyle

Department of Radiation Oncology Faculty Papers

Purpose: Permanent interstitial brachytherapy is an appealing treatment modality for patients with locoregional recurrent, resectable head and neck carcinoma (HNC), having previously received radiation. Cesium-131 (131Cs) is a permanent implant brachytherapy isotope, with a low average photon energy of 30 keV and a short half-life of 9.7 days. Exposure to medical staff and family members is low; patient isolation and patient room shielding are not required. This work presents a single institution’s implementation process of utilizing an intraoperative, permanent 131Cs implant for patients with completely resected recurrent HNC.

Materials & Methods: Fifteen patients receiving 131Cs permanent seed brachytherapy were included …

Promoting Adherence To Influenza Vaccination Recommendations In Pediatric Practice., Lloyd N. Werk, Maria Carmen Diaz, Adriana Cadilla, James P. Franciosi, Jobayer Hossain

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

OBJECTIVES: In the United States, nonadherence to seasonal influenza vaccination guidelines for children and adolescents is common and results in unnecessary morbidity and mortality. We conducted a quality improvement project to improve vaccination rates and test effects of 2 interventions on vaccination guidelines adherence.

METHODS: We conducted a cluster randomized control trial with 11 primary care practices (PRACTICE) that provided care for 11 293 individual children and adolescents in a children's health care system from September 2015 through April 2016. Practice sites (with their clinicians) were randomly assigned to 4 arms (no intervention [Control], computerized clinical decision support system [CCDSS], …

Portugal In Ruins: From "Europe" To Crisis And Austerity, Samuel Weeks

College of Humanities and Sciences Faculty Papers

This article engages the analyses of Poulantzas, Anderson, and Ferreira do Aramal to outline the main politico-economic contours of post-Carnation Revolution Portugal. The account that follows examines the effects of accession to the European Economic Community (EEC), European Union (EU) structural funding and liberalization policies, and the euro currency. The article concludes by situating the troika’s 2011 “rescue” of the Portuguese state—and the accompanying austerity measures—within the post-1974 process of “Europeanization.”

Quantitative Sensory Testing In Children With Sickle Cell Disease: Additional Insights And Future Possibilities., Robin E. Miller, Dawn S. Brown, Scott W. Keith, Sarah E. Hegarty, Yamaja Setty, Claudia M. Campbell, Suzanne M. Mccahan, Suhita Gayen-Betal, Hal Byck, Marie Stuart

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Quantitative sensory testing (QST) is used in a variety of pain disorders to characterize pain and predict prognosis and response to specific therapies. In this study, we aimed to confirm results in the literature documenting altered QST thresholds in sickle cell disease (SCD) and assess the test-retest reliability of results over time. Fifty-seven SCD and 60 control subjects aged 8-20 years underwent heat and cold detection and pain threshold testing using a Medoc TSAII. Participants were tested at baseline and 3 months; SCD subjects were additionally tested at 6 months. An important facet of our study was the development and …

Which Osteotomy For Osteonecrosis Of The Femoral Head And Which Patient For The Osteotomy?, Young-Kyun Lee, Beomseok Lee, Javad Parvizi, Yong-Chan Ha, Kyung-Hoi Koo

Rothman Institute Papers

Transtrochanteric curved varus osteotomy (TCVO) and transtrochanteric rotational osteotomy (TRO) are joint-preserving procedures for osteonecrosis of the femoral head. The purpose of this review is to provide up-to-date guidelines for the osteotomies. One retrospective comparison revealed that TCVO has shorter operation time, less bleeding, lower incidence of osteophyte formation, and lower rate of secondary collapse. To obtain successful results of the osteotomy, the patient should be younger than 40 years and should have a body mass index of less than 24 kg/m². The osteotomy should be performed in early stages of femoral head osteonecrosis before marked collapse of …

Comparison Of Surgical Outcomes Of The Posterior And Combined Approaches For Repair Of Cervical Fractures In Ankylosing Spondylitis., Panya Luksanapruksa, Paul William Millhouse, Victor Carlson, Thanase Ariyawatkul, Joshua Heller, Christopher K. Kepler

Department of Orthopaedic Surgery Faculty Papers

STUDY DESIGN: Retrospective cohort study.

PURPOSE: To evaluate surgical outcomes and complications of cervical spine fractures in ankylosing spondylitis (CAS) patients who were treated using either the posterior (P) or combined approach (C).

OVERVIEW OF LITERATURE: Ankylosing spondylitis typically causes progressive spinal stiffness that makes patients susceptible to spinal fractures. CAS is a highly unstable condition. There is contradictory evidence regarding which treatment option, the posterior or the combined approach, yields superior clinical results.

METHODS: A single institution database was reviewed for data in the period 1999 to 2015. All CAS patients who underwent posterior or combined instrumented fusion were …

Effect Of Motor Imagery On Children With Developmental Disabilities, J. Bonner, Ots, L. Finnegan, Ots, V. Leonard, Ots, M. Scuderi, Ots, A. Shacklett, Ots, J. Thiel, Ots, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review provides a comprehensive summary of current research evidence with the intent to help OTs working in pediatric settings understand the potential outcomes of using MI with children with DD.

A Systematic Review: Light Therapy For Individuals With Dementia And Implications For Practice, E. Goodman, Ots, A. Milione, Ots, C. Mikus, Ots, E. Jacobs, Ms, Ots, A. Torres, Ots, V. Vu, Ots, L. Kaiser, Otd, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review seeks to answer the question: is light therapy an effective intervention for sundowning symptoms experienced by individuals who have dementia?

A Prospective, Population-Based Study Of Trends In Operative Vaginal Delivery Compared To Cesarean Delivery Rates In Low- And Middle-Income Countries, 2010-2016., Margo S. Harrison, Sarah Saleem, Sumera Ali, Omrana Pasha, Elwyn Chomba, Waldemar A. Carlo, Ana L. Garces, Nancy F. Krebs, K. Michael Hambidge, Shivaprasad S. Goudar, S. M. Dhaded, Bhala Kodkany, Richard J. Derman, Archana Patel, Patricia L. Hibberd, Fabian Esamai, Edward A. Liechty, Antoinette Tshefu, Adrien Lokangaka, Melissa Bauserman, Carl L. Bose, Fernando Althabe, Jose M. Belizan, Pierre Buekens, Janet L. Moore, Dennis D. Wallace, Menachem Miodovnik, Marion Koso-Thomas, Elizabeth M. Mcclure, Robert L. Goldenberg

Global Health Articles

OBJECTIVE: Few data are available on cesarean delivery and operative vaginal delivery trends in low- and middle-income countries. Our objective was to analyze a prospective population-based registry including eight sites in seven low- and middle-income countries to observe trends in operative vaginal delivery versus cesarean delivery rates over time, across sites.

STUDY DESIGN: A prospective population-based study, including home and facility births among women enrolled from 2010 to 2016, was performed in communities in Argentina, Democratic Republic of Congo, Guatemala, India, Kenya, Pakistan, and Zambia. Women were enrolled during pregnancy and delivery outcome data were collected.

RESULTS: We analyzed 354,287 …

Electrocardiogram And Cardiac Testing Among Patients In The Emergency Department With Seizure Versus Syncope., Jennifer L. White, Judd E. Hollander, Jesse M. Pines, Peter M. Mullins, Anna Marie Chang

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Cardiogenic syncope can present as a seizure. The distinction between seizure disorder and cardiogenic syncope can only be made if one considers the diagnosis. Our main objective was to identify whether patients presenting with a chief complaint (reason for visit) as seizure or syncope received an electrocardiogram in the emergency department across all age groups.

METHODS: We conducted a secondary analysis of data collected in the 2010 to 2014 National Hospital Ambulatory Medical Care Survey comparing patients presenting with a chief complaint of syncope versus seizure to determine likelihood of getting an evaluation for possible life threatening cardiovascular disease. …

Efficacy Of Alternative Seating On Attention, In-Seat Behavior, And Occupational Performance In Children With Attention Deficit Hyperactivity Disorder, A. Chacko, K. Kosztyo, N. Long, Z. Mullan, J. Norkitis, L. Wratcher, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

Currently, there is one systematic review conducted by Gochenour and Poskey7 that synthesize current research evidence regarding alternative seating for students with attention difficulties. A limitation of this review, as noted by the authors, is a lack of a consistent definition of attention difficulty in the studies they included. A systematic review focused on a specific, well-defined diagnosis will better contribute to practice recommendations since these recommendations will be tailored to a clear and comprehensive understanding of the child’s attentional and occupational challenges. The review also included studies of children with autism spectrum disorder (ASD).7 While those with ASD may …

The Endocannabinoid System In Migraine: From Bench To Pharmacy And Back., Cristina Tassorelli, Rosaria Greco, Stephen D. Silberstein

Department of Neurology Faculty Papers

PURPOSE OF REVIEW: Migraine is a common, highly disabling disorder. Its treatment involves acute and preventive therapy. Many of available preventive medications are not well tolerated, which results in poor compliance and limited effectiveness. Cannabinoids have been proposed for the treatment of migraine but their efficacy and tolerability are controversial.

RECENT FINDINGS: Cannabinoids modulate functions and activity of signaling pathways that have a key role in pain control. Growing preclinical evidence and initial clinical findings suggest that modulation of the endocannabinoid system, via endogenous or exogenous cannabinoids may be relevant for migraine via multiple mechanisms.

SUMMARY: The endocannabinoid system qualifies …

Biomarkers In Patients With Mucopolysaccharidosis Type Ii And Iv., Honoka Fujitsuka, Kazuki Sawamoto, Hira Peracha, Robert W. Mason, William Mackenzie, Hironori Kobayashi, Seiji Yamaguchi, Yasuyuki Suzuki, Kenji Orii, Tadao Orii, Toshiyuki Fukao, Shunji Tomatsu

Department of Pediatrics Faculty Papers

Glycosaminoglycans (GAGs), dermatan sulfate (DS), heparan sulfate (HS), and keratan sulfate (KS), are the primary biomarkers in patients with mucopolysaccharidoses (MPS); however, little is known about other biomarkers. To explore potential biomarkers and their correlation with GAGs, blood samples were collected from 46 MPS II patients, 34 MPS IVA patients, and 5 MPS IVB patients. We evaluated the levels of 8 pro-inflammatory factors (EGF, IL-1β, IL-6, MIP-1α, TNF-α, MMP-1, MMP-2, and MMP-9), collagen type II, and DS, HS (HS0S, HSNS), and KS (mono-sulfated, di-sulfated) in blood. Eight biomarkers measured were significantly elevated in untreated MPS II patients, compared with those …

Whole Genome Metagenomic Analysis Of The Gut Microbiome Of Differently Fed Infants Identifies Differences In Microbial Composition And Functional Genes, Including An Absent Crispr/Cas9 Gene In The Formula-Fed Cohort, Matthew D. Di Guglielmo, Karl Franke, Courtney Cox, Erin L. Crowgey

Department of Pediatrics Faculty Papers

Background: Advancements in sequencing capabilities have enhanced the study of the human microbiome. There are limited studies focused on the gastro-intestinal (gut) microbiome of infants, particularly the impact of diet between breast-fed (BF) versus formula-fed (FF). It is unclear what effect, if any, early feeding has on short- term or long-term composition and function of the gut microbiome.

Results: Using a shotgun metagenomics approach, differences in the gut microbiome between BF (n = 10) and FF (n = 5) infants were detected. A Jaccard distance principle coordinate analysis was able to cluster BF versus FF infants based on the presence …

Tendinosis Develops From Age- And Oxygen Tension-Dependent Modulation Of Rac1 Activity., Rowena Mcbeath, Richard W. Edwards, Brian J. O'Hara, Mitchell G. Maltenfort, Susan M. Parks, Andrzej Steplewski, A. Lee Osterman, Irving M. Shapiro

Department of Orthopaedic Surgery Faculty Papers

Age-related tendon degeneration (tendinosis) is characterized by a phenotypic change in which tenocytes display characteristics of fibrochondrocytes and mineralized fibrochondrocytes. As tendon degeneration has been noted in vivo in areas of decreased tendon vascularity, we hypothesized that hypoxia is responsible for the development of the tendinosis phenotype, and that these effects are more pronounced in aged tenocytes. Hypoxic (1% O₂ ) culture of aged, tendinotic, and young human tenocytes resulted in a mineralized fibrochondrocyte phenotype in aged tenocytes, and a fibrochondrocyte phenotype in young and tendinotic tenocytes. Investigation of the molecular mechanism responsible for this phenotype change revealed that …

A Systematic Review Of The Efficacy Of Motivational Interviewing On Occupational Performance, J. Binder, Ots, C. Hannum, Ots, C. Mccarthy, Ots, E. Mcleod, Ots, J. Overpeck, Ots, L. Kaiser, Otd, Ms, Otr/L, M.-C. Potvin, Phd, Otr/L

Student Papers, Posters & Projects

This systematic review aims to review the efficacy of MI to address such performance goals falling within the occupational therapy scope of practice.

Intra-Arterial Chemotherapy In Retinoblastoma - A Paradigm Change., Fairooz P. Manjandavida, Christina Stathopoulos, Jing Zhang, Santhosh G. Honavar, Carol L. Shields

Wills Eye Hospital Papers

Intra-arterial chemotherapy (IAC), also known as superselective ophthalmic artery chemotherapy or chemosurgery, is currently widely accepted as one of the primary treatment modalities for intraocular retinoblastoma worldwide. Following the introduction of the technique in 1998, IAC has evolved over the past decades to be safer and more effective. Accumulated evidence shows that IAC is more effective in providing eye salvage in group D and E retinoblastoma as compared to conventional systemic intravenous chemotherapy (IVC). In contrast to IVC, IAC has the added benefits of reduced overall treatment duration and minimal systemic toxicity. This review provides a comprehensive update on the …

Coats Disease In 351 Eyes: Analysis Of Features And Outcomes Over 45 Years (By Decade) At A Single Center., Carol L. Shields, Sanika Udyaver, Lauren A. Dalvin, Li-Anne S. Lim, Hatice T Atalay, Chloe T.L. Khoo, Mehdi Mazloumi, Jerry A. Shields

Wills Eye Hospital Papers

Purpose: To assess features and outcomes of Coats disease over 5-decades.

Methods: Retrospective review of Coats disease patients at a single center. Features and outcomes were compared based on decade of presentation.

Results: There were 351 patients with Coats disease. The presenting median age (6 years), male sex (84%), and unilaterality (100%) did not change per decade. Coats disease classification did not change per decade with Stage 1 (1%), Stage 2 (21%), Stage 3 (68%), Stage 4 (6%), and Stage 5 (1%). Clinical features that changed per decade (1970s vs. 1980s vs. 1990s vs. 2000s vs. 2010s) included 1980s features …