Digital Commons Network^™

Global Outcomes For Microsurgical Clipping Of Unruptured Intracranial Aneurysms: A Benchmark Analysis Of 2245 Cases, Richard Drexler, Thomas Sauvigny, Tobias F. Pantel, Franz L. Ricklefs, Joshua S. Catapano, John E. Wanebo, Michael T. Lawton, Aminaa Sanchin, Nils Hecht, Peter Vajkoczy, Kunal Raygor, Daniel Tonetti, Adib Abla, Kareem El Naamani, Stavropoula I. Tjoumakaris, Pascal Jabbour, Brian T. Jankowitz, Mohamed M. Salem, Jan-Karl Burkhardt, Arthur Wagner, Maria Wostrack, Jens Gempt, Bernhard Meyer, Michael Gaub, Justin R. Mascitelli, Philippe Dodier, Gerhard Bavinzski, Karl Roessler, Nico Stroh, Matthias Gmeiner, Andreas Gruber, Eberval G. Figueiredo, Antonio Carlos Samaia Da Silva Coelho, Anatoliy V. Bervitskiy, Egor D. Anisimov, Jamil A. Rzaev, Harald Krenzlin, Naureen Keric, Florian Ringel, Dougho Park, Mun-Chul Kim, Eleonora Marcati, Marco Cenzato, Manfred Westphal, Lasse Dührsen

Department of Neurosurgery Faculty Papers

BACKGROUND AND OBJECTIVES: Benchmarks represent the best possible outcome and help to improve outcomes for surgical procedures. However, global thresholds mirroring an optimal and reachable outcome for microsurgical clipping of unruptured intracranial aneurysms (UIA) are not available. This study aimed to define standardized outcome benchmarks in patients who underwent clipping of UIA.

METHODS: A total of 2245 microsurgically treated UIA from 15 centers were analyzed. Patients were categorized into low- ("benchmark") and high-risk ("nonbenchmark") patients based on known factors affecting outcome. The benchmark was defined as the 75th percentile of all centers' median scores for a given outcome. Benchmark outcomes …

Can The Date Of Last Menstrual Period Be Trusted In The First Trimester? Comparisons Of Gestational Age Measures From A Prospective Cohort Study In Six Low-Income To Middle-Income Countries, Archana Patel, Carla M. Bann, Vanessa R. Thorsten, Sowmya R. Rao, Adrien Lokangaka, Antoinette Tshefu Kitoto, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sherri Bucher, Sarah Saleem, Robert L. Goldenberg, Elwyn Chomba, Waldemar A. Carlo, Shivaprasad Goudar, Richard Derman, Marion Koso-Thomas, Elizabeth Mcclure, Patricia L. Hibberd

Global Health Articles

OBJECTIVES: We examined gestational age (GA) estimates for live and still births, and prematurity rates based on last menstrual period (LMP) compared with ultrasonography (USG) among pregnant women at seven sites in six low-resource countries.

DESIGN: Prospective cohort study SETTING AND PARTICIPANTS: This study included data from the Global Network's population-based Maternal and Newborn Health Registry which follows pregnant women in six low-income and middle-income countries (Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia). Participants in this analysis were 42 803 women, including their 43 230 babies, who registered for the study in their first trimester based …

Epicutaneous Sensitization To The Phytocannabinoid Β-Caryophyllene Induces Pruritic Inflammation, Saadet Inan, Sara J Ward, Citlalli T Baltazar, Gabrielle A. Peruggia, Elham Javed, Ajay P. Nayak

Center for Translational Medicine Faculty Papers

In recent years, there has been increased accessibility to cannabis for recreational and medicinal use. Incidentally, there has been an increase in reports describing allergic reactions to cannabis including exacerbation of underlying asthma. Recently, multiple protein allergens were discovered in cannabis, yet these fail to explain allergic sensitization in many patients, particularly urticaria and angioedema. Cannabis has a rich chemical profile including cannabinoids and terpenes that possess immunomodulatory potential. We examined whether major cannabinoids of cannabis such as cannabidiol (CBD) and the bicyclic sesquiterpene beta-caryophyllene (β-CP) act as contact sensitizers. The repeated topical application of mice skin with β-CP at …

The Use Of Iodophor-Impregnated Drapes In Patients With Iodine-Related Allergies: A Case Series And Review Of The Literature, Andrew Fraval, Nicolina Zappley, William J. Hozack

Rothman Institute Papers

Background

Methods

Does Physical Therapy Impact Clinical Outcomes After Lumbar Decompression Surgery?, Jeremy C. Heard, Nicholas D. D'Antonio, Mark J. Lambrechts, Payton Boere, Tariq Z. Issa, Yunsoo A. Lee, Jose A. Canseco, Ian David Kaye, Barrett R. Woods, Alan S. Hilibrand, Alexander R. Vaccaro, Christopher K. Kepler, Gregory D. Schroeder

Rothman Institute Papers

OBJECTIVES: The objectives of our study were to (1) determine if physical therapy (PT) impacts patient-reported outcomes (PROMs) after lumbar decompression surgery and (2) determine if PT impacts postsurgical readmissions or reoperations after lumbar decompression surgery.

METHODS: Patients >18 years of age who underwent primary one‑ or two‑level lumbar decompression at our institution were identified. Patient demographics, surgical characteristics, surgical outcomes (all‑cause 90 days readmissions and 90 days surgical readmissions), and patient‑reported outcomes (PROMs) were compared between the groups. Multivariate linear regression was utilized to determine the individual predictors of 90 days readmissions and PROMs at the 1‑year postoperative point. …

Lateral Approach To The Lumbar Spine: The Utility Of An Access Surgeon, Matthew Meade, Yunsoo Lee, Parker Brush, Mark Lambrechts, Eleanor Jenkins, Cristian Desimone, Michael Mccurdy, John Mangan, Jose Canseco, Mark Kurd, Alan Hilibrand, Alexander Vaccaro, Christopher Kepler, Gregory Schroeder

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Lateral lumbar interbody fusions (LLIFs) utilize a retroperitoneal approach that avoids the intraperitoneal organs and manipulation of the anterior vasculature encountered in anterior approaches to the lumbar spine. The approach was championed by spinal surgeons; however, general/vasculature surgeons may be more comfortable with the approach.

OBJECTIVE: The objective of this study was to compare short-term outcomes following LLIF procedures based on whether a spine surgeon or access surgeon performed the approach.

MATERIALS AND METHODS: We retrospectively identified all one- to two-level LLIFs at a tertiary care center from 2011 to 2021 for degenerative spine disease. Patients were divided into …

Neighborhood Disadvantage And Neural Correlates Of Threat And Reward Processing In Survivors Of Recent Trauma, E. Kate Webb, Timothy D. Ely, Grace E. Rowland, Lauren A.M. Lebois, Sanne J.H. Van Rooij, Steven E. Bruce, Tanja Jovanovic, Stacey L. House, Francesca L. Beaudoin, Xinming An, Thomas C. Neylan, Gari D. Clifford, Sarah D. Linnstaedt, Laura T. Germine, Kenneth A. Bollen, Scott L. Rauch, John P. Haran, Alan B. Storrow, Christopher Lewandowski, Paul I. Musey, Phyllis L. Hendry, Sophia Sheikh, Christopher W. Jones, Brittany E. Punches, Robert A. Swor, Jose L. Pascual, Mark J. Seamon, Elizabeth M. Datner, Claire Pearson, David A. Peak, Roland C. Merchant, Robert M. Domeier, Niels K. Rathlev, Paulina Sergot, Leon D. Sanchez, Ronald C. Kessler, Karestan C. Koenen, Samuel A. Mclean, Jennifer S. Stevens, Kerry J. Ressler, Nathaniel G. Harnett

Department of Emergency Medicine Faculty Papers

IMPORTANCE: Differences in neighborhood socioeconomic characteristics are important considerations in understanding differences in risk vs resilience in mental health. Neighborhood disadvantage is associated with alterations in the function and structure of threat neurocircuitry.

OBJECTIVE: To investigate associations of neighborhood disadvantage with white and gray matter and neural reactivity to positive and negative stimuli in the context of trauma exposure.

DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, survivors of trauma who completed sociodemographic and posttraumatic symptom assessments and neuroimaging were recruited as part of the Advancing Understanding of Recovery After Trauma (AURORA) study between September 2017 and June 2021. Data …

Multilevel Ossification Of The Posterior Longitudinal Ligament Causing Cervical Myelopathy: An Observational Series Of North American Patients, Jonathan A. Ledesma, Tariq Z. Issa, Mark J. Lambrechts, Cannon Greco Hiranaka, Khoa Tran, Patrick O'Connor, Jose A. Canseco, Alan S. Hilibrand, Christopher K. Kepler, Todd J. Albert, Alex R. Vaccaro, Gregory D. Schroeder, David Greg Anderson

Department of Orthopaedic Surgery Faculty Papers

BACKGROUND: Few studies regarding ossification of the posterior longitudinal ligament (OPLL) outside of Asia currently exist in the literature. A set of patients with multilevel cervical OPLL causing symptomatic myelopathy or radiculopathy from a North American sample is analyzed.

OBJECTIVE: The objective of this study was to describe the demographics, radiographic findings, and surgical outcomes of a cohort of North American patients with degenerative spondylosis presenting for operative management of multilevel (>3 segments) cervical OPLL.

MATERIALS AND METHODS: Forty-three patients diagnosed with multilevel cervical OPLL and degenerative spondylosis presenting with symptomatic cervical myelopathy or radiculopathy were surgically treated over …

Bilateral Severe Iatrogenic Pigmentary Glaucoma Following Laser Treatment For Cosmetic Iris Color Change, Jiaru Liu, Salim Korban, Marlene R. Moster, Marc-André Rhéaume, Qianqian Wang

Wills Eye Hospital Papers

PURPOSE: We report a case of bilateral severe pigmentary glaucoma and paracentral acute middle maculopathy (PAMM) following laser treatment for iris color change.

OBSERVATIONS: A 32-year-old female presented to our emergency clinic after having undergone 4 sessions of bilateral cosmetic iris laser treatment in Turkey to lighten the color of her dark brown irides. Visual acuity was 20/150 in the right eye (OD) and counting fingers in the left eye (OS) at presentation. Intraocular pressures (IOP) were 50 mmHg in the right eye and 42 mmHg in the left eye, with 4+ free-floating pigmented cells in the anterior chamber. The …

Association Between Number Of Vasopressors And Mortality In Covid-19 Patients, Michael Sunnaa, Mina Kerolos, Max Ruge, Ahmad Gill, Jeanne M. Du-Fay-De-Lavallaz, Perry Robin, Joanne Michelle Dumlao Gomez, Kim Williams, Anupama Rao, Annabelle Santos Volgman, Karolina Marinescu, Tisha Marie Suboc

COVID-19 Papers, Posters, and Presentations

Study objective

Study the clinical outcomes associated with the number of concomitant vasopressors used in critically ill COVID-19 patients.

Design

A single-center retrospective cohort study was conducted on patients admitted with COVID-19 to the intensive care unit (ICU) between March and October 2020.

Setting

Rush University Medical Center, United States.

Participants

Adult patients at least 18 years old with COVID-19 with continuous infusion of any vasopressors were included.

Main outcome measures

60-day mortality in COVID-19 patients by the number of concurrent vasopressors received.

Results

A total of 637 patients met our inclusion criteria, of whom 338 (53.1 %) required the …

The Philadelphia Lung Cancer Learning Community: A Multi-Health-System, Citywide Approach To Lung Cancer Screening, Julie A. Barta, Cherie P. Erkmen, Christine S. Shusted, Ronald E. Myers, Chelsea Saia, Sarah Cohen, Jocelyn Wainwright, Charnita Zeigler-Johnson, Farouk Dako, Richard Wender, Gregory C. Kane, Anil Vachani, Katharine A. Rendle

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

Background

Lung cancer screening uptake for individuals at high risk is generally low across the United States, and reporting of lung cancer screening practices and outcomes is often limited to single hospitals or institutions. We describe a citywide, multicenter analysis of individuals receiving lung cancer screening integrated with geospatial analyses of neighborhood-level lung cancer risk factors. Methods

The Philadelphia Lung Cancer Learning Community consists of lung cancer screening clinicians and researchers at the 3 largest health systems in the city. This multidisciplinary, multi-institutional team identified a Philadelphia Lung Cancer Learning Community study cohort that included 11 222 Philadelphia residents who …

Molecular Characterization Of Streptococcus Pneumoniae Causing Disease Among Children In Nigeria During The Introduction Of Pcv10 (Gsk), Stephanie W. Lo, Paulina A. Hawkins, Binta Jibir, Fatimah Hassan-Hanga, Mahmoud Gambo, Rasaq Olaosebikan, Grace Olanipekun, Huda Munir, Nicholas Kocmich, Amy Rezac-Elgohary, Safiya Gambo, Danstan Bagenda, Paul Fey, Robert F. Breiman, Lesley Mcgee, Stephen D. Bentley, Stephen K. Obaro, Community Acquired Pneumonia And Invasive Bacterial Disease Capibd Consortium

Student Papers, Posters & Projects

Streptococcus pneumoniae (pneumococcus) is a leading vaccine-preventable cause of childhood invasive disease. Nigeria has the second highest pneumococcal disease burden globally, with an estimated ~49 000 child deaths caused by pneumococcal infections each year. Ten-valent pneumococcal conjugate vaccine (GSK; PCV10) was introduced in December 2014 in a phased approach. However, few studies have characterized the disease-causing pneumococci from Nigeria. This study assessed the prevalence of serotypes, antibiotic susceptibility and genomic lineages using whole genome sequencing and identified lineages that could potentially escape PCV10 (GSK). We also investigated the potential differences in pneumococcal lineage features between children with and without sickle …

Ciliochoroidal Melanoma Masquerading As A Conjunctival Nevus, Samantha Pastore, Konica Singla, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

Development Of A Sensitive Microplate Assay For Characterizing Rna Methyltransferase Activity: Implications For Epitranscriptomics And Drug Development, Isaiah K. Mensah, Allison B. Norvil, Ming He, Emma Lendy, Nicole Hjortland, Hern Tan, Richard T. Pomerantz, Andrew Mesecar, Humaira Gowher

Department of Biochemistry and Molecular Biology Faculty Papers

RNA methylation is a ubiquitous post-transcriptional modification found in diverse RNA classes and is a critical regulator of gene expression. In this study, we used Zika virus RNA methyltransferase (MTase) to develop a highly sensitive microplate assay that uses a biotinylated RNA substrate and radiolabeled AdoMet coenzyme. The assay is fast, highly reproducible, exhibits linear progress-curve kinetics under multiple turnover conditions, has high sensitivity in competitive inhibition assays, and significantly lower background levels compared with the currently used method. Using our newly developed microplate assay, we observed no significant difference in the catalytic constants of the full-length nonstructural protein 5 …

Epidural Hematoma Risks Associated With Ceasing Vs. Maintaining Anticoagulant And/Or Antiplatelet Medications For Cervical And Thoracic Interlaminar Epidural Steroid Injections, Michael Furman, Jesse Bernstein, Lelia Gilhool, Christopher Bednarek, Holden Caplan, Ajay Kurup, Byron Schneider

SKMC Student Presentations and Publications

Background: There is a lack of substantiated evidence to support or refute the risks of ceasing vs maintaining anticoagulant and/or antiplatelet medications (ACAP) prior to cervical and thoracic interlaminar epidural steroid injections. The ACAP medication is frequently stopped pre-procedure due to concerns for potential bleeding complications, particularly epidural hematomas (EH). This article provides evidence regarding EH incidence in this population. Methods: Data for this study was collected retrospectively on all patients from September 19, 2009–Jun 16, 2017 who were scheduled for an Interlaminar Cervical and/or Thoracic Epidural Steroid Injections (IL-CTESI) and were on an ACAP medication at the time a …

Identification Of Sentinel Lymph Nodes In Esophageal Cancer Patients Using Contrast-Enhanced Eus With Peritumoral Injections, Ji-Bin Liu, Priscilla Machado, John R. Eisenbrey, Sriharsha Gummadi, Flemming Forsberg, Corinne E. Wessner, Anand Raman Kumar, Austin Chiang, Anthony Infantolino, Alexander Schlachterman, Thomas Kowalski, Robert Coben, David Loren

Department of Medicine Faculty Papers

OBJECTIVES: The objective of this pilot study was to compare the performance of contrast-enhanced EUS (CE-EUS)-guided fine-needle aspiration (FNA) with EUS-FNA for lymph node (LN) staging in esophageal cancer.

METHODS: Thirty-seven subjects with esophageal cancer undergoing EUS staging were enrolled, and 30 completed this institutional review board-approved study. A Prosound F75 US system (Hitachi Medical Systems, Tokyo, Japan) with harmonic contrast imaging software and GF-UCT180 curvilinear endoscope (Olympus, Tokyo, Japan) was utilized. All LNs identified by standard EUS were first noted. Sonazoid (dose: 1 mL; GE Healthcare, Oslo, Norway) was administered peritumorally, and all enhanced LNs were recorded. Fine-needle aspiration …

Radio-Pathomic Approaches In Pediatric Neurooncology: Opportunities And Challenges, Ariana M. Familiar, Aria Mahtabfar, Anahita Fathi Kazerooni, Mahsa Kiani, Arastoo Vossough, Angela Viaene, Philip B. Storm, Adam C. Resnick, Ali Nabavizadeh

Department of Neurosurgery Faculty Papers

With medical software platforms moving to cloud environments with scalable storage and computing, the translation of predictive artificial intelligence (AI) models to aid in clinical decision-making and facilitate personalized medicine for cancer patients is becoming a reality. Medical imaging, namely radiologic and histologic images, has immense analytical potential in neuro-oncology, and models utilizing integrated radiomic and pathomic data may yield a synergistic effect and provide a new modality for precision medicine. At the same time, the ability to harness multi-modal data is met with challenges in aggregating data across medical departments and institutions, as well as significant complexity in modeling …

Examining Pi3k-Signaling-Dependent Regulation Of Lens Organelle Free Zone Formation Via Immunolocalization And Immunoblotting In Chick Embryos, Rifah Gheyas, A. Sue Menko

Computational Medicine Center Faculty Papers

The elimination of lens organelles during development, required for mature lens function, is an autophagy-dependent mechanism induced through suppression of PI3K signaling. Here, we present a protocol for investigating the signaling pathways responsible for induction of the formation of this lens organelle free zone. We describe steps for preparation of lens organ culture and use of signaling pathway inhibitors. We then detail procedures for analyzing their impact using both confocal microscopy imaging of immunolabeled lens cryosections and immunoblot approaches. For complete details on the use and execution of this protocol, please refer to Gheyas et al. (2022).

"I Believe More In The Ability Of The Small Person To Make Big Changes": Innovation And Social Entrepreneurship To Promote Public Health In Israel., Keren Dopelt, Nila Mordehay, Shir Goren, Aviya Cohen, Paul Barach

College of Population Health Faculty Papers

Social entrepreneurship has grown worldwide in recent decades as it attempts to create and implement innovative solutions to social and environmental issues through business strategies. The aim of this study was to explore what motivates public health social entrepreneurs to act, the challenges and barriers they face, achievements, and competencies required for success. As such, we interviewed 15 social entrepreneurs in Israel. Budget issues, regulatory barriers, and struggles against powerful companies were the frequent barriers to success. The interviewees indicated several achievements at the health policy level by positioning and becoming an authority in the field, positively influencing other people's …

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 …

Randomized Controlled Trial Of Mechanical Thrombectomy Vs Catheter-Directed Thrombolysis For Acute Hemodynamically Stable Pulmonary Embolism: Rationale And Design Of The Peerless Study, Carin F. Gonsalves, C Michael Gibson, Stefan Stortecky, Roger A Alvarez, Daren M Beam, James M Horowitz, Mitchell J Silver, Catalin Toma, John H Rundback, Stuart P Rosenberg, Craig D Markovitz, Thomas Tu, Wissam A Jaber

Department of Radiology Faculty Papers

BACKGROUND: The identification of hemodynamically stable pulmonary embolism (PE) patients who may benefit from advanced treatment beyond anticoagulation is unclear. However, when intervention is deemed necessary by the PE patient's care team, data to select the most advantageous interventional treatment option are lacking. Limiting factors include major bleeding risks with systemic and locally delivered thrombolytics and the overall lack of randomized controlled trial (RCT) data for interventional treatment strategies. Considering the expansion of the pulmonary embolism response team (PERT) model, corresponding rise in interventional treatment, and number of thrombolytic and nonthrombolytic catheter-directed devices coming to market, robust evidence is needed …

Biosafety And Biohazard Considerations Of Hsv-1-Based Oncolytic Viral Immunotherapy., Elizabeth Robilotti, Nathalie C Zeitouni, Marlana Orloff

Department of Medical Oncology Faculty Papers

Oncolytic viral immunotherapies are agents which can directly kill tumor cells and activate an immune response. Oncolytic viruses (OVs) range from native/unmodified viruses to genetically modified, attenuated viruses with the capacity to preferentially replicate in and kill tumors, leaving normal tissue unharmed. Talimogene laherparepvec (T-VEC) is the only OV approved for patient use in the United States; however, during the last 20 years, there have been a substantial number of clinical trials using OV immunotherapies across a broad range of cancers. Like T-VEC, many OV immunotherapies in clinical development are based on the herpes simplex virus type 1 (HSV-1), with …