Digital Commons Network^™

Generative Ai In Education: Insights From Rehabilitation Sciences Students, Erin Pletcher, Travis Pollen, Robert Dekerlegand, Malachy Clancy, Alison Bell

Department of Exercise Science Posters

Background

• Generative artificial intelligence (GenAI) creates original, contextually relevant outputs that mimic human-like creativity and reasoning.
• GenAI promises to reshape health care from student and clinician education to comprehensive patient management in rehabilitation sciences.
• Insight into students’ perceptions and use of GenAI in education can help guide instructional strategies to facilitate its responsible implementation.

Endovascular Repair Of Graft-To-Graft Ascending Aortic Pseudoaneurysm, Joshua R. Chen, Vishal N. Shah, Mitchell Hirsch, Thomas Jefferson University, Gaurang Joshi, Konstadinos A. Plestis, Babak Abai

Department of Surgery Faculty Papers

No abstract provided.

Remote Functional Assessment: Experiences Of People Living With Spinal Cord Injury, Adrian David, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Background: As telerehabilitation gains traction in occupational therapy, validating functional measures is crucial. Understanding clients' views on telehealth is essential, yet literature on spinal cord injury (SCI) in this context is sparse.

Objective: This study aims to describe the experiences of people living with SCI regarding remote and in-person functional testing.

Methods: A qualitative design was used, involving participants from a previous study validating the GRASSP, SCIM, and SCI-MovIN for remote use. Semi-structured interviews explored experiences, and transcripts were coded for thematic analysis. Twenty-five individuals with SCI, aged 18-80 and at least nine months post-injury, were included.

Results: Four themes …

Facilitators And Barriers For Occupational Therapy Using Ayres Sensory Integration® (Ot-Asi) For School-Aged Autistic Students: Special Education Team Perspectives, Brooke E. Loughery, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy using Ayres Sensory Integration® (OT-ASI) is an evidence-based approach that addresses sensory integration differences to support participation for autistic students in daily occupations, including education (Hume et al., 2021; Schaaf & Mailloux, 2015). However, its evidence for its use in school-based practice is still emerging (Whiting et. al., 2023; Whiting et al., 2025). A recent study showed that occupational therapists feel this approach is valuable and are interested in using it in schools (Cerase McKeon et al., 2024), but more information is needed to explore teacher and school administrators’ perception of its use.

Objectives: To explore the …

Development And Content Validation Of A Social-Emotional Learning Workshop Series For Teachers Of Preschool English Language Learners And Newcomers From The Middle East, Linda M. Lilly, Otd, Mot, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

The United States is the destination for many individuals to take refuge from the Middle East (Arab American Institute Foundation, 2021; Shryock & Abraham, 2000). Many of the refugees and immigrants (newcomers) have fled war and political oppression (Mossad, 2016; U.S. Department of Homeland Security, 2016), and thus may be at higher risk of developing adverse mental health outcomes (Mawani, 2014). Core stressors related to the newcomer status for many students in a metro-Detroit public school district can contribute to the overall mental health needs and interfere with performance in the educational setting. Social-emotional learning (SEL) programs are a typical …

The Development Of A Self-Reflection Training Module For Enhancing Students Professional Behavior Growth During Level Ii Fieldwork, Tarah Romano, Ms, Otr/L

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction: Occupational therapy students are expected to demonstrate competence in professional behavior skills, such as communication and incorporating constructive feedback, to be considered ready for entry-level practice. Poor professional behavior skills have been linked to challenges and failure during level II fieldwork (Gutman et al. 1998; James & Musselman, 2005). A growing body of research has supported the importance of students’ professional behaviors during fieldwork (Andonian, 2013; Brown et al., 2021; Jensen & Daniel, 2010; Mason & Mathieson, 2018); however, there is a gap in the occupational therapy research on effective methods for teaching professional behaviors to support fieldwork performance. …

Perceived Facilitators And Barriers To The Implementation Of Ayres Sensory Integration® In South African Primary School Settings, Celiané Van Der Westhuizen, Bot

Post-Professional Occupational Therapy Doctorate Culminating Presentations

Introduction

Ayres Sensory Integration^® is a highly preferred evidence-based occupational therapy approach that is utilized worldwide (Benson et al., 2019; Cerase et al., 2023; van der Merwe et al., 2011). However, more data is needed on its application and utilization in school settings (Schaaf et al., 2018; van der Merwe et al., 2011), which is a major working environment for occupational therapists (American Occupational Therapy Association, 2023; Frolek Clark & Hollenbeck, 2019; Jackson, 2007; Sonday et al., 2012).

Objectives

This study assessed the use of OT-ASI intervention in South Africa and explored the perceived facilitators and barriers of South …

Parent And Primary Care Clinician Perceptions About Pediatric Hypertension, Abbas H. Zaidi, Erica Sood, Sarah De Ferranti, Samuel Gidding, Varsha Zadokar, Jonathan Miller, Anne Kazak

Department of Pediatrics Faculty Papers

IMPORTANCE: Despite published guidelines and a prevalence of pediatric hypertension of approximately 3%, less than 25% of affected children are identified, with 60% not receiving any intervention despite detection. Understanding the knowledge and perceptions of parents or caregivers and health care teams is crucial to identify factors that may contribute to these unacceptably low detection rates.

OBJECTIVE: To examine the knowledge and perceptions of parents and health care teams regarding pediatric hypertension to identify common themes contributing to low hypertension detection.

DESIGN, SETTING, AND PARTICIPANTS: This qualitative study, interviewed parents of children diagnosed with hypertension who did not follow up …

A Kinetic Model For Compound Heterozygous Pathogenic Variants In Tyrosyl-Trna Synthetase Gene Yars2-Associated Neonatal Phenotype, Thomas W Christian, Sunita Maharjan, Sitao Yin, Yuka Yamaki, Isao Masuda, Fenglin Li, Colleen Muraresku, Sheila Clever, Rebecca Ganetzky, Ya-Ming Hou

Department of Biochemistry and Molecular Biology Faculty Papers

Human genetic disorders are often caused by mutations of compound heterozygosity, where each allele of the mutant gene harbors a different genetic lesion. However, studies of such mutations are hampered due to the lack of an appropriate model. Here we describe a kinetic model of compound heterozygous variants in an obligate enzyme dimer that contains one mutation in one monomer and the other mutation in the second monomer. This enzyme is encoded by human YARS2 for mitochondrial tyrosyl-tRNA synthetase (mt-TyrRS), which aminoacylates tyrosine to mt-tRNA^Tyr. YARS2 is a member of the genes for mt-aminoacyl-tRNA synthetases, where pathogenic mutations …

The Importance Of Parent And Clinician Stakeholder Input-Guiding The Guidelines On Pediatric Hypertension, Carissa M. Baker-Smith

Department of Medicine Faculty Papers

No abstract provided.

Nursing Home Staff Perspectives Of The Benefits And Challenges Of Providing Dementia Care, Carin M. Wong, Dominique H. Como, Cara Lekovitch, Felicia Chew, Natalie E. Leland

Department of Occupational Therapy Faculty Papers

OBJECTIVES: To capture nursing home staff perspectives on the benefits and challenges related to caring for residents living with Alzheimer disease and other related dementias. These perspectives will inform the initial development of strategies to help with staff retention.

DESIGN: A secondary qualitative analysis of semistructured interviews conducted with nursing home staff, which was embedded within a pragmatic clinical trial.

SETTING AND PARTICIPANTS: Purposive sampling was used to capture perspectives of staff spanning across job roles from 23 nursing homes.

METHODS: During the parent study primary analysis, staff experiences providing dementia care were consistently described. In response, this study completed …

Personalized And Culturally Tailored Features Of Mobile Apps For Gestational Diabetes Mellitus And Their Impact On Patient Self-Management: Scoping Review, Catherine Jones, Yi Cui, Ruth Jeminiwa, Elina Bajracharya, Katie Chang, Tony Ma

College of Pharmacy Faculty Papers

BACKGROUND: Gestational diabetes mellitus (GDM) is an increasingly common high-risk pregnancy condition requiring intensive daily self-management, placing the burden of care directly on the patient. Understanding personal and cultural differences among patients is critical for delivering optimal support for GDM self-management, particularly in high-risk populations. Although mobile apps for GDM self-management are being used, limited research has been done on the personalized and culturally tailored features of these apps and their impact on patient self-management.

OBJECTIVE: This scoping review aims to explore the extent to which published studies report the integration and effectiveness of personalized and culturally tailored features in …

Efficacy Of Dietary Interventions For Irritable Bowel Syndrome: A Systematic Review And Network Meta-Analysis, Hossein Haghbin, Fariha Hasan, Manesh Kumar Gangwani, Nurruddinkhodja Zakirkhodjaev, Wade Lee-Smith, Azizullah Beran, Faisal Kamal, Benjamin Hart, Muhammad Aziz

Division of Gastroenterology and Hepatology Faculty Papers

Introduction: Irritable bowel syndrome (IBS) is a common condition that alters the quality of life of patients. A variety of dietary interventions have been introduced to address this debilitating condition. The low-FODMAP diet (LFD), gluten-free diet (GFD), and Mediterranean diet are examples showing efficacy. The aim of this network meta-analysis was to compare these interventions to find the best approach. Methods: We performed a systematic review of the available literature through 14 March 2024 in the following databases: Embase, PubMed, MEDLINE OVID, Web of Science, CINAHL Plus, and Cochrane Central. We only included randomized controlled trials (RCTs). We used a …

Defining Renal Recovery In Patients With Hepatorenal Syndrome-Acute Kidney Injury: Experience From North American Studies, Muhammad A. Mujtaba, Hussien Elsiesy, Sara Faiz, Syed A. Hussain, Ann Kathleen N. Gamilla-Crudo, Aftab Karim, Mohammad I. Khan, Muhammad W. Khattak, Zunaira Zafar, Michael Kueht, Khurram Jamil

Jefferson Health - Northeast Papers (formerly Aria Health Papers)

INTRODUCTION: The degree of improvement in serum creatinine (SCr) has previously been suggested as a sensitive indicator of treatment response in patients with hepatorenal syndrome-acute kidney injury (HRS-AKI), while HRS reversal remains the primary endpoint in clinical trials.

METHODS: A total of ≥ 30% SCr improvement was analyzed as an exploratory prespecified endpoint in the CONFIRM trial. In this post hoc analysis, intent-to-treat population data from three Phase 3 studies (OT-0401, REVERSE, and CONFIRM) conducted in North America in patients with HRS-AKI were pooled to assess the incidence of > 30% improvement in SCr and its association with clinical outcomes.

RESULTS: …

Guideline-Directed Medical Therapy After Hospitalization For Acute Heart Failure: Insights From The Connect-Hf, Satoshi Shoji, Lisa Kaltenbach, Bradi B. Granger, Gregg C. Fonarow, Hussein R. Al-Khalidi, Nancy M. Albert, Javed Butler, Larry A. Allen, David E. Lanfear, Jennifer T. Thibodeau, Brittany M. Chapman, Sandra M. Oliver-Mcneil, G. Michael Felker, Ileana L. Piña, Christopher B. Granger, Adrian F. Hernandez, Adam D. Devore

Division of Cardiology Faculty Papers

BACKGROUND: Significant gap remains in the implementation of guideline-directed medical therapy (GDMT) in patients with heart failure after a hospitalization. We aimed to evaluate the use and titration of GDMT at discharge and over a 12-month period after hospital discharge and to identify factors associated with GDMT use and titration.

METHODS AND RESULTS: The CONNECT-HF (Care Optimization Through Patient and Hospital Engagement Clinical Trial for Heart Failure) trial evaluated the effect of a hospital and postdischarge quality improvement intervention in participants with heart failure with reduced ejection fraction. In this secondary analysis, we examined use and titration to at least …

Angiogenin-Catalyzed Cleavage Within Trna Anticodon-Loops Identified By Cp-Rna-Seq, Megumi Shigematsu, Ryuma Matsubara, Justin Gumas, Takuya Kawamura, Yohei Kirino

Computational Medicine Center Faculty Papers

Angiogenin (Ang), an endoribonuclease belonging to the RNase A superfamily, cleaves the anticodon-loops of tRNAs to produce tRNA-half molecules. Although previous studies have demonstrated the involvement of Ang in the pathobiology of neurodegenerative disorders, the characterization of Ang-generated tRNA halves in neuronal cells remains limited. This is partly due to the technical limitations of standard RNA-seq methods, which cannot capture Ang-generated RNAs containing a 2',3'-cyclic phosphate (cP). In this report, we established an Ang-treatment model using SH-SY5Y, a human neuroblastoma cell line, and demonstrated Ang-dependent accumulation of tRNA halves. By performing cP-RNA-seq, which selectively captures cP-containing RNAs, we identified Ang-generated …

High Intracranial Pressure Following Endoscopic Third Ventriculostomy: Illustrative Case, Zachary Sokol, Rohan V. Gupta, Robert Ziechmann, Scott R. Shepard

Jefferson Hospital Staff Papers and Presentations

BACKGROUND: Endoscopic third ventriculostomy (ETV) is an effective procedure for the treatment of triventriculomegaly associated with aqueductal stenosis. However, some patients can develop severe and symptomatic intracranial pressure (ICP) elevations in the immediate postoperative period that can be monitored and treated with external ventricular drain (EVD) placement and controlled cerebrospinal fluid (CSF) diversion until the ICP normalizes and symptoms resolve.

OBSERVATIONS: The authors describe the case of a 39-year-old male who underwent ETV and intraoperative EVD placement for obstructive hydrocephalus associated with aqueductal stenosis. The patient was noted to have sustained ICP elevations in the immediate perioperative period but ultimately …

Access To Virtual Care In Behavioral Health: A Social Determinant Of Health, Patrick J. Hearle, Emily A. Smith, Richard J. Caplan, Ram A. Sharma

SKMC Student Presentations and Publications

Abstract Objective: In the wake of COVID-19, the use of virtual modalities to provide healthcare has increased significantly. While virtual care services, particularly for behavioral health encounters, have become commonplace in many healthcare systems, there is limited data describing to what extent access to virtual care is affected by social determinants of health. The present study aims to characterize the utilization of virtual (video, phone) and non-virtual (in—person office visits) behavioral health care encounters among differing socioeconomic and demographic populations in two campuses served by a tertiary care center in Delaware to identify trends and potential barriers to these services. …

Factors Associated With Receipt Of Tobacco Treatment Integrated With Nurse Navigation In A Centralized Lung Cancer Screening Program At An Urban Academic Medical Center, Christine S. Shusted, Sarah Mukhtar, James Lee, Brooke Ruane, Emily Muse, Lawrence Emeigh-Mcbride, Eboni Gatson-Anderson, Gregory C. Kane, Kuang-Yi Wen, Hee-Soon Juon, Julie A. Barta

Division of Pulmonary, Allergy, and Critical Care Medicine Faculty Papers

PURPOSE: Optimal approaches for tobacco treatment counseling among individuals who currently smoke and are undergoing shared decision-making (SDM) and lung cancer screening (LCS) are unknown. The objective of this cross-sectional study was to determine the rate of reported interest in tobacco treatment counseling and pharmacotherapy among individuals who currently smoke and are receiving integrated nurse navigation for LCS and tobacco treatment in a centralized LCS Program.

METHODS: We identified individuals undergoing SDM through our centralized LCS Program between March 2021 and March 2022. The LCS Program tobacco treatment protocol includes counseling both in-person and via telephone during SDM, LCS results …

Adipocyte-Derived Small Extracellular Vesicles Exacerbate Diabetic Ischemic Heart Injury By Promoting Oxidative Stress And Mitochondrial-Mediated Cardiomyocyte Apoptosis, Lu Gan, Jianli Zhao, Peng Yao, Theodore A. Christopher, Bernard Lopez, Wayne B. Lau, Walter Koch, Erhe Gao, Xin-Liang Ma, Yajing Wang

Department of Emergency Medicine Faculty Papers

BACKGROUND: Diabetes increases ischemic heart injury via incompletely understood mechanisms. We recently reported that diabetic adipocytes-derived small extracellular vesicles (sEV) exacerbate myocardial reperfusion (MI/R) injury by promoting cardiomyocyte apoptosis. Combining in vitro mechanistic investigation and in vivo proof-concept demonstration, we determined the underlying molecular mechanism responsible for diabetic sEV-induced cardiomyocyte apoptosis after MI/R.

METHODS AND RESULTS: Adult mice were fed a high-fat diet (HFD) for 12 weeks. sEV were isolated from plasma or epididymal adipose tissue. HFD significantly increased the number and size of plasma- and adipocyte-derived sEV. Intramyocardial injection of an equal number of diabetic plasma sEV in nondiabetic …

Medicare To Veterans Affairs Cost Shifting-A Challenging Conundrum, Kenneth W. Kizer, Said A. Ibrahim

JeffMD Academic Affairs

No abstract provided.

Impact Of Aetiology On Short- And Long-Term Outcomes In Open Descending And Thoracoabdominal Aneurysm Repair, Joshua R. Chen, Christopher D. Pritting, Vishal N. Shah, Colin King, Jacqueline Mcgee, Konstadinos A Plestis

Department of Surgery Faculty Papers

OBJECTIVES: We analysed the impact of chronic type B aortic dissection (cTBAD) and degenerative aneurysm (DA) on the short- and long-term outcomes of patients undergoing open descending thoracic aortic aneurysm and thoracoabdominal aortic aneurysm repair.

METHODS: We performed a retrospective analysis of a prospectively maintained aortic database. From 1999 to 2023, 245 patients underwent open descending thoracic aortic aneurysm or thoracoabdominal aortic aneurysm repair. We compared preoperative comorbidities, postoperative complications and operative and long-term mortality for patients with cTBAD (120 patients, 49%) and DA (125 patients, 51%).

RESULTS: Patients with cTBAD were significantly younger, more likely to be male and …

Transcriptional Regulation In The Absence Of Inositol Trisphosphate Receptor Calcium Signaling, Michael Young, David M. Booth, David Smith, Marco Tigano, György Hajnóczky, Suresh K. Joseph

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The activation of IP3 receptor (IP3R) Ca2+ channels generates agonist-mediated Ca2+ signals that are critical for the regulation of a wide range of biological processes. It is therefore surprising that CRISPR induced loss of all three IP3R isoforms (TKO) in HEK293 and HeLa cell lines yields cells that can survive, grow and divide, albeit more slowly than wild-type cells. In an effort to understand the adaptive mechanisms involved, we have examined the activity of key Ca2+ dependent transcription factors (NFAT, CREB and AP-1) and signaling pathways using luciferase-reporter assays, phosphoprotein immunoblots and whole genome transcriptomic studies. In addition, the diacylglycerol …

Virtual Primary Care In A Large Delaware-Based Independent Academic Medical Center: Impact And Opportunity, Darrell C. Dow, Sarah E. Schenck, Tracy L. Bell, Stephanie C. Roth, Omar Khan

Department of Family & Community Medicine Faculty Papers

COVID-19 and related challenges to patient access necessitated the development of new models of care to ensure a healthy patient population. This paper describes the outcomes of a pilot virtual primary care program at a large independent academic health center in Delaware. The preliminary results are encouraging from the perspective of provider and patient satisfaction, as well as the utility of the operational model. A complete cost-benefit analysis was beyond the scope of the paper; thus, future operational research should focus on the metrics of cost and quality as key indicators of model sustainability.

30- And 90-Day Readmission Rates Following Traumatic Spinal Cord Injury: A Systematic Review And Meta-Analyses, Marjan Hesari, Seyed Danial Alizadeh, Hamid Malekzadeh, Reza Tabrizi, Mohammad-Rasoul Jalalifar, Alireza Shahmohammadi, Zahra Eskandari, Zahra Ghodsi, James Harrop, Vafa Rahimi-Movaghar

Department of Neurosurgery Faculty Papers

Study Design

Systematic Review and Meta-Analyses.

Objective

To assess the 30- and 90-day readmission rates after a traumatic spinal cord injury (SCI).

Methods

A systematic search of MEDLINE and Embase was performed. The period was from inception to June 2022, with no language restrictions. All studies investigating the 30- and/or 90-day readmission rate following traumatic SCI were included. A random-effects model to combine effect sizes in our meta-analysis was applied.

Results

Seven out of 2959 reports met eligibility. The mean age of the patients was 50.2 ± 19.9, with a male-to-female ratio of 2.4:1. The most common traumatic SCI was …

Advancements And Emerging Insights In Thoracolumbar Spine Trauma, Jonathan Neuhoff, Alex R. Vaccaro, Cumhur Oner, Klaus Schnake, Frank Kandziora

Department of Orthopaedic Surgery Faculty Papers

Thoracolumbar spine trauma represents a complex and evolving field within spinal surgery, with a continuous shift in treatment paradigms as research refines optimal approaches for specific patient populations. This special issue, with contributions from 20 peer-reviewed articles, brings together recent advancements in thoracolumbar trauma care, offering insight into improved diagnostic protocols, emerging surgical techniques, patient-centred outcomes, and the integration of new technologies.

A Latent Class Assessment Of Healthcare Access Factors And Disparities In Breast Cancer Care Timeliness, Matthew Dunn, Didong Li, Marc Emerson, Caroline Thompson, Hazel Nichols, Sarah Van Alsten, Mya Roberson, Stephanie Wheeler, Lisa Carey, Terry Hyslop, Jennifer Elston Lafata, Melissa Troester

Kimmel Cancer Center Faculty Papers

BACKGROUND: Delays in breast cancer diagnosis and treatment lead to worse survival and quality of life. Racial disparities in care timeliness have been reported, but few studies have examined access at multiple points along the care continuum (diagnosis, treatment initiation, treatment duration, and genomic testing).

METHODS AND FINDINGS: The Carolina Breast Cancer Study (CBCS) Phase 3 is a population-based, case-only cohort (n = 2,998, 50% black) of patients with invasive breast cancer diagnoses (2008 to 2013). We used latent class analysis (LCA) to group participants based on patterns of factors within 3 separate domains: socioeconomic status ("SES"), "care barriers," and …

Concomitant Epidural And Longitudinal Anterior Spinal Artery Contrast Spread In A Lumbar Transforaminal Epidural Steroid Injection (Tfesi), Philip J. Koehler Iii, Paul M. Kitei, David S. Stolzenberg, Elaine H. Hatch

Rothman Institute Papers

A 78-year-old female with a remote history of L3-4 decompression and fusion presented with several months of low back and radicular leg pain. MRI revealed moderate L2-L3 spinal canal stenosis, ligamentum flavum infolding, moderate bilateral foraminal stenosis, and a grade I retrolisthesis. A right sided L2-L3 TFESI was performed using multiplanar fluoroscopic imaging with a subpedicular supraneural approach. During live iodinated contrast injection, imaging revealed concomitant epidural and central arterial contrast spread. The needle was retracted and repeat live fluoroscopic imaging demonstrated no vascular uptake. Desired epidural and nerve root contrast spread remained in place with repeat still imaging. Dexamethasone …

Teaching Matters In Formula Preparation-A Measure Of Equity And Nutritional Safety, Matthew D. Di Guglielmo

Department of Pediatrics Faculty Papers

No abstract provided.

Adiposity Throughout Adulthood And Risk Of Young-Onset Breast Cancer Tumor Subtypes In The Young Women's Health History Study, Lydia Marcus Post, Dorothy R. Pathak, Ann S. Hamilton, Kelly A. Hirko, Richard T. Houang, Emily H. Guseman, Dan Sanfelippo, Nicole Bohme Carnegie, L. Karl Olson, Hallgeir Rui, Ann G. Schwartz, Ellen M. Velie

Department of Pharmacology, Physiology, and Cancer Biology Faculty Papers

BACKGROUND: The role of adult adiposity in young-onset breast cancer (YOBC) subtype risk is not well understood.

METHODS: In this population-based case (n = 1812)-control (n = 1,381) study of invasive YOBC (ages <50 >years), cases were identified from the Los Angeles County and Metropolitan Detroit Surveillance, Epidemiology, and End Results registries, 2010 to 2015. Area-based, frequency-matched controls were sampled from the 2010 Census. General adiposity [body mass index (BMI)] and central adiposity (waist circumference and waist-to-height ratio) across adulthood and covariates were collected from in-person interviews and measurements. ORs and 95% confidence intervals (CI) for adiposity and YOBC tumor subtypes …