Digital Commons Network^™

Differences In The Academic Attributes Of Matched And Unmatched Orthopaedic Surgery Residency Applicants Are Narrowing, Suleiman Y. Sudah, Nareena Imam, Francis Sirch, Allen D. Nicholson, Surena Namdari, Mariano E. Menendez

Rothman Institute Papers

Background: Orthopaedic surgery remains one of the most competitive residency specialties, with the number of applicants outpacing the availability of residency positions each year. The purpose of this study was to analyze present-day orthopaedic surgery match data, identify differences between matched and unmatched applicants, and compare our findings to previous trends.

Methods: Applicant data from the National Resident Matching Program from 2016 to 2022 were analyzed. The number of matched and unmatched US allopathic senior orthopaedic applicants relative to the number of available positions was used to determine respective match rates. Performance metrics and applicant characteristics were compared by match …

Assessment Of Anti-Hiv-1 Guide Rna Efficacy In Cells Containing The Viral Target Sequence, Corresponding Grna, And Crispr/Cas9., Alexander G Allen, Cheng-Han Chung, Stephen D. Worrell, Glad Nwaozo, Rebekah Madrid, Anthony R. Mele, Will Dampier, Michael R. Nonnemacher, Brian Wigdahl

Kimmel Cancer Center Faculty Papers

The Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR)/Cas9 gene editing system has been shown to be effective at inhibiting human immunodeficiency virus type 1 (HIV-1). Studies have not consistently used a trackable dual reporter system to determine what cells received the Cas9/gRNA to determine the overall knockdown of HIV. Some studies have used stably transduced cells under drug selection to accomplish this goal. Here a two-color system was used that allows tracking of viral protein expression and which cells received the CRISPR/Cas9 system. These experiments ensured that each gRNA used was a perfect match to the intended target to remove …

Experiential Exposure As The Key To Recruiting Medical Students Into Pathology, Ashley M. Holloman, Mary P. Berg, Bronwyn Bryant, Lisa Ross Dixson, Melissa R. George, Julie Katz Karp, Barbara E.C. Knollmann-Ritschel, Victor Gerardo Prieto, Charles F. Timmons, John Michael Childs, Amanda Lofgreen, Kristen Johnson, Cindy B. Mccloskey

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Medical student interest and pursuit of a career in pathology have been steadily declining since 2015. We conducted three separate surveys of medical students to better understand these trends. In our first survey, we focused on assessing U.S. allopathic medical students understanding and perceptions of pathology. We later surveyed U.S. osteopathic medical students as a companion to the allopathic medical student survey, in which many similarities were discovered with some key differences. In our final survey, we specifically looked at curriculum differences between the U.S. allopathic medical schools that graduate the most students who enter pathology training programs (Group 1) …

How Influential Are Medical School Curriculum And Other Medical School Characteristics In Students’ Selecting Pathology As A Specialty?, Cindy B. Mccloskey, Mark Brissette, John Michael Childs, Amanda Lofgreen, Kristen Johnson, Melissa R. George, Ashley M. Holloman, Bronwyn Bryant, Mary P. Berg, Lisa Ross Dixon, Julie Katz Karp, Barbara E.C. Knollmann-Ritschel, Victor Gerardo Prieto, Charles F. Timmons, Robert D. Hoffman

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

There has been a significant decline in the number of United States allopathic medical students matching to pathology residency programs. Data acquired from the American Association of Medical Colleges (AAMC) show sustained variation in the medical school production of students who go on to pathology residency. When divided into groups based on the medical school's historical volume of graduates entering pathology, the schools in groups labeled Group 1 and Group 2 produced significantly higher and lower proportions of pathology residents, respectively. This study aimed to identify what medical school curriculum elements and other medical school characteristics might explain the differences …

The Prescription Drug Monitoring Program In A Multifactorial Approach To The Opioid Crisis: Pdmp Data, Pennsylvania, 2016–2020, Jenna R. Adalbert, Amit Syal, Karan Varshney, Brandon George, Jeffrey Hom, Asif M. Ilyas

College of Population Health Faculty Papers

Background: Prescription opioids remain an important contributor to the United States opioid crisis and to the development of opioid use disorder for opioid-naïve individuals. Recent legislative actions, such as the implementation of state prescription drug monitoring programs (PDMPs), aim to reduce opioid morbidity and mortality through enhanced tracking and reporting of prescription data. The primary objective of our study was to describe the opioid prescribing trends in the state of Pennsylvania (PA) as recorded by the PA PDMP following legislative changes in reporting guidelines, and discuss the PDMP's role in a multifactorial approach to opioid harm reduction.

Methods: State-level opioid …

A Scoping Review Of Microwave Ablation Versus Partial Nephrectomy For Treatment Of Renal Cell Carcinoma, Benjamin Odumah

Master of Science in Applied Health Economics and Outcomes Research Capstone Presentations

Renal cell carcinomas (RCC) make up 80 to 85% of primary renal neoplasms. Over 90% are low grade and slow growing with low probability of metastasis. Advantages of percutaneous techniques including microwave ablation (MWA) over surgical approach such as partial nephrectomy (PN), including cost effectiveness, minimally invasive, better renal preservation rates, lower procedure-related morbidity, and reduced hospitalization time make the case compelling. The major limitations for MWA are lack of prospective RCT or long-term follow-up data. The objective of this capstone was to conduct a scoping review on MWA versus PN regarding oncologic, perioperative, and functional outcomes in the treatment …

Use Of Integrative, Complementary, And Alternative Medicine In Children With Epilepsy: A Global Scoping Review, Zahra Zhu, Daniela Dluzynski, Nouran Hammad, Deepika Pugalenthi, Sarah A. Walser, Rea Mittal, Debopam Samanta, Melanie L. Brown, Ali A. Asadi-Pooya, Angelina Kakooza-Mwesige, Alberto Spalice, Martina Capponi, Alain Lekoubou, Ashutosh Kumar, Sita Paudel, Paul R. Carney, Gayatra Mainali, Sunil Naik

Department of Neurology Faculty Papers

(1) Background: Epilepsy is one of the most common chronic neurological disorders in childhood. Complementary and alternative medicine (CAM) use is highly prevalent in patients with epilepsy. Despite CAM’s widespread and increasing popularity, its prevalence, forms, perceived benefits, and potential risks in pediatric epilepsy are rarely explored. (2) Methods: We performed a scoping review of the available literature on the use of CAM in pediatric epilepsy. (3) Results: Overall, global cross-sectional studies showed a variable degree of CAM usage among children with epilepsy, ranging from 13 to 44% in prevalence. Popular types of CAMs reported were supplements, cannabis products, aromatherapy, …

Predictors And Characteristics Of Rib Fracture Following Sbrt For Lung Tumors, Michael P. Carducci, Baskaran Sundaram, Benjamin Greenberger, Maria Werner-Wasik, Gregory C. Kane

Department of Radiology Faculty Papers

Background: The utilization of stereotactic body radiation therapy (SBRT) is increasing for primary and secondary lung neoplasms. Despite encouraging results, SBRT is associated with an increased risk of osteoradionecrosis-induced rib fracture. We aimed to (1) evaluate potential clinical, demographic, and procedure-related risk factors for rib fractures and (2) describe the radiographic features of post-SBRT rib fractures.

Methods: We retrospectively identified 106 patients who received SBRT between 2015 and 2018 for a primary or metastatic lung tumor with at least 12 months of follow up. Exclusion criteria were incomplete records, previous ipsilateral thoracic radiation, or relevant prior trauma. Computed tomography (CT) …

Blood Pressure Surge With Alarm Is Reduced After Exercise And Diet Intervention In Firefighters, Deborah L Feairheller, Macie Smith, Megan Carty, Emily H Reeve

College of Population Health Faculty Papers

BACKGROUND: Cardiac-related incidents are a public health concern for tactical occupations, and cardiovascular disease rates are higher in these populations compared with civilians. Research is needed to examine blood pressure (BP) responses in firefighters. The pager alert is one occupational hazard, and it is unknown if lifestyle change can reduce the systolic surge response.

PURPOSE: To measure BP surge with alarm in firefighters to determine whether the magnitude is lower after a 6-week tactical exercise and Mediterranean-diet intervention.

METHODS: SBP and DBP and BP surge levels, circulating markers, vascular health, and fitness were analyzed. BP surge with alarm was captured …

The Sustainability Of Industrial Hemp: A Literature Review Of Its Economic, Environmental, And Social Sustainability, Gurinder Kaur, Ron Kander

School of Design and Engineering Papers

Industrial hemp is a versatile, sustainable plant with several applications of its various forms, including fiber obtained from hemp stalks, food obtained from hemp seeds, and oil obtained from hemp flowers and seeds. Industrial hemp has the potential to offer a solution to the crisis of climate change, since it is a viable energy source that satisfies the three pillars of sustainability, namely economy, environment, and society. Although industrial hemp has been growing as an agricultural commodity in different parts of the world for decades, its production was banned until recently in the U.S. because of its association with marijuana. …

A Working Taxonomy For Describing The Sensory Differences Of Autism, Jason L He, Zachary J Williams, Ashley Harris, Helen Powell, Roseann C. Schaaf, Teresa Tavassoli, Nicolaas A J Puts

Department of Occupational Therapy Faculty Papers

Background: Individuals on the autism spectrum have been long described to process sensory information differently than neurotypical individuals. While much effort has been leveraged towards characterizing and investigating the neurobiology underlying the sensory differences of autism, there has been a notable lack of consistency in the terms being used to describe the nature of those differences.

Main body: We argue that inconsistent and interchangeable terminology-use when describing the sensory differences of autism has become problematic beyond mere pedantry and inconvenience. We begin by highlighting popular terms that are currently being used to describe the sensory differences of autism (e.g. "sensitivity", …

A Rare Metastatic Mesenteric Malignant Pecoma With Tsc2 Mutation Treated With Palliative Surgical Resection And Nab-Sirolimus: A Case Report, Luke Meredith, Timothy Chao, Avinoam Nevler, Atrayee Basu Mallick, Rajan Singla, Peter Mccue, Wilbur Bowne, Wei Jiang, Md, Phd

Kimmel Cancer Center Faculty Papers

BACKGROUND: Malignant perivascular epithelioid cell tumors (PEComas) are exceedingly rare malignant mesenchymal neoplasms with characteristic morphological and immunohistochemical (IHC) patterns. However, some malignant PEComas are poorly differentiated with atypical histopathological features, making a definitive diagnosis difficult. PEComas are most commonly found in females and often show either TSC1 or TSC2 alterations, which result in the activation of the mTOR pathway, or TFE3 fusions. Given these molecular characteristics, mTOR inhibitors have recently been approved by the FDA in the treatment of malignant PEComas, particularly in those with TSC1/2 alterations. Therefore, molecular analyses may be helpful for both the diagnostic workup of …

Scar Formation In The Presence Of Mitomycin C And The Anti-Fibrotic Antibody In A Rabbit Model Of Glaucoma Microsurgery: A Pilot Study, Aakriti Garg Shukla, Tatyana Milman, Jolanta Fertala, Andrzej Steplewski, Andrzej Fertala

Wills Eye Hospital Papers

Purpose: This study aimed to evaluate the utility of a rationally engineered antibody that directly blocks collagen fibrillogenesis to reduce scar tissue formation associated with subconjunctival glaucoma surgery.

Material and methods: Fourteen eyes of 7 adult rabbits underwent glaucoma filtering surgery using XEN 45 Gel Stent. The rabbits’ eyes were divided randomly into three treatment groups: (i) treated with the antibody, (ii) treated with mitomycin C, and (iii) treated with the antibody and mitomycin C. Following surgeries, the intraocular pressure and bleb appearance were evaluated in vivo. The rabbits were sacrificed 8 weeks after the surgery, and their eyes were …

Comprehensive Review Of Acute Pancreatitis Pain Syndrome, Jacob Beiriger, Adnan Khan, Brian Yan, Heather Ross, Makala Wang, Michael Carducci, Natali Salinas, Salil Chowdhury, Ryan Erwin, Sarah Chen, Alexis Gerber

Jefferson Hospital Staff Papers and Presentations

Pancreatitis is a condition that causes inflammation in the pancreas, an organ located behind the stomach. This condition often presents as neuropathic, inflammatory, and/or visceral pain. Acute pancreatitis is typically characterized by sudden and severe abdominal pain, often in the upper right part of the abdomen. The pain from pancreatitis can be caused by different mechanisms, such as abnormal activation of pancreatic zymogens or NF-κB mediated inflammation in the pancreas. The treatment of pancreatitis depends on its type, severity, and underlying cause. Hospitalization and medications are typically necessary, while in others, surgery may be required. Proper management of pancreatitis is …

Facile Green Synthesis Of Cinnamomum Tamala Extract Capped Silver Nanoparticles And Its Biological Applications, Sajina Narath, S. Sharath Shankar, Saranya Kothaplamoottil Sivan, Bini George, T. Dennis Thomas, Sankarannair Sabarinath, Sajithkumar K. Jayaprakash, Stanisław Wacławek, Vinod V.T. Padil

Department of Medicine Faculty Papers

The plant mediated biogenic synthesis of nanoparticles is of magnificent concern due to its eco-benign and single pot nature. Here, Cinnamomum tamala (C. tamala) aqueous leaf extract was utilised for the silver nanoparticles’ (Ag NPs) synthesis. The phytoconstituents in the leaf extract were analysed by standard methods. These metabolites, especially carbohydrate polymers reduce Ag ions to Ag NPs accompanied by a reddish-brown coloration of the reaction mixture. The visual observation of intense brown colour is the first indication of the formation of Ag NPs. Various spectro-analytical techniques further characterise the Ag NPs. The green synthesised spherical Ag NPs were crystalline …

Prevention Of Surgical Site Infection: A Ten-Step Approach, Saad Tarabichi, Javad Parvizi

Rothman Institute Papers

Surgical site infection (SSI) is a common cause of morbidity and mortality in patients undergoing surgery. Similarly, periprosthetic joint infection (PJI), is a major cause of failure after total joint arthroplasty (TJA). As the annual volume of TJA procedures is projected to rise, so will the rate of subsequent SSI and PJI. Currently, prevention has been identified as the single most important strategy for combating SSI/PJI. Hence, the present article will serve as a summary of an evidence-based ten-step approach for SSI/PJI prevention that may help orthopedic surgeons with their infection prevention strategies.

Cold Atmospheric Pressure Plasma-Antibiotic Synergy In Pseudomonas Aeruginosa Biofilms Is Mediated Via Oxidative Stress Response, Jordanne-Amee Maybin, Thomas P. Thompson, Padrig B. Flynn, Timofey Skvortsov, Noreen J. Hickok, Theresa A. Freeman, Brendan F. Gilmore

Department of Orthopaedic Surgery Faculty Papers

Cold atmospheric-pressure plasma (CAP) has emerged as a potential alternative or adjuvant to conventional antibiotics for the treatment of bacterial infections, including those caused by antibiotic-resistant pathogens. The potential of sub-lethal CAP exposures to synergise conventional antimicrobials for the eradication of Pseudomonas aeruginosa biofilms is investigated in this study. The efficacy of antimicrobials following or in the absence of sub-lethal CAP pre-treatment in P. aeruginosa biofilms was assessed. CAP pre-treatment resulted in an increase in both planktonic and biofilm antimicrobial sensitivity for all three strains tested (PAO1, PA14, and PA10548), with both minimum inhibitory concentrations (MICs) and minimum biofilm eradication …

News In Brief

Jefferson Surgical Solutions

At the 20th Annual Jefferson Gala on November 30, Nathaniel R. Evans III, MD, received the 2022 Achievement Award in Medicine. This award honors a physician who has embraced Jefferson’s mission, provided exemplary care to their patients, and has been a recognized leader in their field. Dr. Evans is Director of the Division of Thoracic and Esophageal Surgery and Chief of Cancer Services at Sidney Kimmel Cancer Center.

Taki Galanis, MD, has been promoted to Associate Professor. He sees patients at the Jefferson Vascular Center in Center City.

Amanda Kohli, PA-C, received the Jefferson Enterprise Advanced Practice Providers (APP) Award …

Full Issue: Volume 18, Number 1 - Winter 2023

Jefferson Surgical Solutions

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

In This Issue

Cover Story
Enterprise Collaboration Drives Surgical Quality, Safety Across Jefferson Health - Page 1

Overview
The Phillies, the Union, the Eagles and Jefferson Health - Page 2

Please Welcome
Our Categorical Interns - Page 2

Education
Jefferson Hosts Meetings of Two National Surgical Societies - Page 2

Changing Lives Through Research
Thoracic & Esophageal Surgery Team Conducts Diverse Research Studies to Improve Patient Care - Page 3

On the Job
New Faculty - Page 3

Correction
Summer 2022 Issue: Changing Lives Through Research - Page 3 …

Grateful Patient Supports Dr. Plestis And Jefferson Aortic Center

Jefferson Surgical Solutions

For Renée Cardwell Hughes, April 30, 2021, started as an ordinary Friday. She arrived early to her office at Philadelphia Opportunities Industrialization Center (OIC), the workforce development corporation where she was president and chief executive officer.

The day took a turn just before 9 a.m. – when Hughes experienced crushing pain while walking from the ladies’ room back to her office.

“It felt like Wonder Woman had slammed her shield into my chest,” she recalls.

Security footage shows Hughes, who was alone on the fourth floor, stumbling in the hallway. She made it back to her office, where she collapsed …

Correction - Summer 2022 Issue: Changing Lives Through Research

Jefferson Surgical Solutions

An article last Summer incorrectly stated that the Jefferson Molecular Profiling of Pancreatic Cancer (JMP PaC) Program was developed by a handful of researchers in the Department of Surgery.

The program was spearheaded by Hien Dang, PhD, Director of the Division of Surgical Research, in collaboration with surgeons Charles J. Yeo, MD, Wilbur Bowne, MD, and Harish Lavu, MD. Senior leadership also includes representatives from non-surgical specialties: Babar Bashir, MD, and Jennifer M. Johnson, MD, PhD (Medical Oncology); Wei Jiang, MD, PhD (Pathology); and Christopher McNair, PhD, Associate Director for Data Science at Sidney Kimmel Cancer Center.

New Faculty

Jefferson Surgical Solutions

John D. Jacob, MD, has joined the Division of Thoracic and Esophageal Surgery. Dr. Jacob is a graduate of the University of Santo Tomas Faculty of Medicine and Surgery in the Philippines. He completed his general surgery residency at Abington Memorial Hospital in 2016 followed by a surgical critical care fellowship at the University of Pennsylvania and a thoracic surgery fellowship at the Montefiore Medical Center/Albert Einstein College of Medicine. Dr. Jacob is based at Jefferson Abington Hospital and also sees patients at Thomas Jefferson University Hospital, Jefferson Methodist Hospital, Jefferson Health – Northeast and Jefferson Health – Einstein.

Heather …

Jefferson Hosts Meetings Of Two National Surgical Societies

Jefferson Surgical Solutions

In September 2022, the Department of Surgery hosted annual meetings for two surgical societies – both of which were the first in-person conferences since 2019.

Annual Conference of the Women’s Leadership in Surgery Society: September 10–11, 2022

Achieving pay equity. Building resilience and leadership skills. Deciding whether, when and how to start a family (and then managing the demands of work and home). Such challenges are common to many working women; they can be even more complex for female surgeons.

Those challenges were among the topics covered at the Annual Conference of the Women’s Leadership in Surgery Society (WLISS). Launched …

Thoracic & Esophageal Surgery Team Conducts Diverse Research Studies To Improve Patient Care

Jefferson Surgical Solutions

Surgeons Nathaniel R. Evans III, MD, Tyler R. Grenda, MD and Olubenga T. Okusanya, MD, provide thoracic and esophageal surgical care to patients at Thomas Jefferson University Hospital in Center City, and throughout Jefferson Health. They also lead and participate in a variety of research initiatives aimed at further optimizing that care. As Dr. Evans, who leads the Division, notes, “Our research portfolio has become very diverse, running the gamut from simple to very complex questions.”

Past clinical trials have worked to enhance care to patients with esophageal and lung cancer. For example, one aimed to identify which patients with …

The Phillies, The Union, The Eagles And Jefferson Health, Charles Yeo, Md, Facs

Jefferson Surgical Solutions

We are in the midst of a very successful spectator sports year in the City of Brotherly Love. The Phillies defied the odds, ended the regular season strong, and treated us to a World Series spectacle – playing baseball in November. (The World Series is now a November event; so much for the old moniker “Mr. October.”) The Union were there right up to the last minutes, in the MLS Cup, the championship game. Finally, the Eagles won the National Football Conference championship and headed to Super Bowl LVII.

The winning analogy is to Jefferson Health and our Department. We …

Our Categorical Interns

Jefferson Surgical Solutions

Thomas Jefferson University Hospital

• Allison Doermann, MD, Sidney Kimmel Medical College at Thomas Jefferson University
• Lindsay Edwards, MD, Chicago Medical School
• George Ibrahim, MD, Virginia Commonwealth University School of Medicine
• Haley Kittle, MD, University of Illinois at Chicago College of Medicine
• Ellius Kwok, MD, Penn State University College of Medicine
• Meghan Maceyko, MD, Lewis Katz School of Medicine at Temple University
• Khaled Noueihed, MD, Sidney Kimmel Medical College at Thomas Jefferson University
• Jacob Woodroof, MD, University of Tennessee Health Science Center

Jefferson Abington Hospital

• Jennifer Dai, MD, Ohio State University College of Medicine
• Brian Lifschutz, DO, Des Moines University College …

Enterprise Collaboration Drives Surgical Quality, Safety Across Jefferson Health

Jefferson Surgical Solutions

Hospital-acquired infections, such as pneumonia, can affect a patient’s length of stay, cost of care and risk of mortality following surgery. In 2016, a Department of Surgery team at Thomas Jefferson University Hospital in Center City launched a program aimed at reducing the incidence of postoperative pneumonia and respiratory failure. By applying a care bundle called ICOUGHSM, a significant decrease in postoperative pneumonia and respiratory failure has been observed through the Agency for Healthcare Research and Quality patient safety indicator reporting system.

More recently, a multidisciplinary team – including nurses and physicians, as well as speech and swallow experts – …

Measuring The Effect Of A Poverty Simulation On Cultivating Empathy In Healthcare Professions Students, H. Alex Hoyen

Master of Science in Population Health Capstone Presentations

Introduction: Poverty is generally defined on a fiscal metric despite the fact that it disrupts every facet of a patient’s life. The United Nations (UN) recently published its campaign focused on Ending Poverty. In this publication, the UN describes poverty as “entailing more than the lack of income and productive resources to ensure sustainable livelihoods.” The manifestations include hunger, safe housing, transportation, education, and social discrimination. To fully appreciate the effects of conditions such as poverty requires a deeper understanding of the complex social environment that impoverished individuals are forced to navigate. Poverty simulations are one practice to provide a …

Incidence Of Cutaneous Melanoma And Merkel Cell Carcinoma In Patients With Primary Cutaneous B-Cell Lymphomas: A Population Study Of The Seer Registry, Lauren Banner, Daniel Joffe, Emily Lee, Pierluigi Porcu, Neda Nikbakht

Department of Dermatology and Cutaneous Biology Faculty Papers

Introduction: The increased incidence of cutaneous melanoma (CM) and Merkel cell carcinoma (MCC) in patients with hematologic malignancies (HM) is well established. While the risk of CM has been assessed in some subtypes of HM including cutaneous T-cell lymphoma, the incidence in patients with primary cutaneous B-cell lymphoma (PCBCL) has not been interrogated.

Methods: Here we evaluated the standardized incidence ratio (SIR) of CM and MCC in 5,179 PCBCL patients compared to approximately 1.5 billion individuals in the general population using the Surveillance, Epidemiology and End Results (SEER) database. Among patients with PCBCL, we identified subgroups that were at increased …

Emergency And Disaster Management Requires Complex Systems Thinking And Practices, Larry M. Starr, Phd

School of Business Faculty Papers

There are two broad classes of challenges (problems and opportunities) that may be addressed by educators in the academic and practice domain of Emergency and Disaster Management (EDM). Graduate education programs should acknowledge both kinds when formulating and presenting curricula and courses. However, the conventional approach is to treat all problems as part of a single type as if there is a one-size-fits-all premise underpinning how to think about, frame, decide, respond, and follow-up to EDM problems. I argue that a second conceptualization of EDM challenges should be formally acknowledged and added. I also argue that to adequately appreciate the …