Digital Commons Network^™

Comparative Analysis Of Demographic Data For Eligible Lifestyle Medicine Program Participants, Cajetan Ejianreh, Amy Cunningham

Phase 1

Introduction: Obesity is a major comorbidity linked to a myriad of health complications and poor treatment outcomes. Through partnership with the PCORI Institute, a comprehensive lifestyle medicine program is being developed to refer eligible patients within the Jefferson Health System. This comparative analysis aims to identify the demographics of these eligible patients.

Methods: Data was extracted from EPIC electronic health record from patients who had a “qualifying” encounter with one of the following specialties: OB/GYN, Geriatrics, Internal Medicine, and Family Medicine. Qualification of patients in this data collection was based on an encounter with one of the aforementioned specialties within …

Seeing What Sticks: Evaluating Factors That Affect Adoption Of A Novel Heart Failure Order Set At An Academic Medical Center, Maela Whitcomb, Alan Kubey, Md

Phase 1

Introduction: Guideline-directed medical therapy (GDMT) improves heart failure outcomes, yet GDMT prescribing is low. Order sets can alter prescribing behavior. This study seeks to identify characteristics associated with order set use.

Methods: We conducted a retrospective cohort study on 841 adult patients admitted to TJUH with a primary diagnosis of heart failure. Variables included type of service (cardiology, hospital medicine, emergency department and other), whether the service attending was incentivized, and patient status (inpatient, observation). Association with order set use using chi-square tests. Data were extracted using Qlik. Analyses were conducted using Microsoft Excel. P-values of less than 0.05 were …

Sodium-Glucose Cotransporter 2 Inhibitors And Vulvovaginal Candidiasis, Gabriela Skovronsky, Natalie Suozzi, Paul Nyirjesy

Phase 1

Introduction: Sodium-glucose cotransporter-2 inhibitors (SGLT2is) are widely used for type 2 diabetes management, but are associated with increased risk of genital infections. Despite their use, there is limited evidence to quantify this risk. We conducted a systematic review to determine the incidence of vulvovaginal candidiasis (VVC) in patients taking SGLT2is compared to other diabetes treatments. We hypothesized that SGLT2i use would be associated with an increased incidence of VVC compared to other treatments.

Methods: Using PRISMA guidelines, we searched five databases using MESH terms for studies examining VVC in females with type 2 diabetes mellitus treated with SGLT2is versus …

Patient Experiences With Provision Of Telehealth Addiction Treatment Services, Kaleigh Spollen, Shane Nieves, Mph, Gregory Jaffe, Md, Msed, Vanessa Short, Phd, Mph

Phase 1

Introduction: Substance use disorder (SUD) is a nationwide public health crisis, and deaths from opioids have risen significantly since 1999. In recent years, telehealth has emerged as a novel modality for SUD treatment. This study aims to evaluate patient experiences with a telehealth program for SUD, identifying barriers and facilitators to participation in the program, as well as opportunities for program improvement.

Methods: This qualitative study comprises an online survey and semi-structured interview. Individuals 18 years of age or older who have attended at least one session of Jefferson’s telemedicine program for SUD treatment were enrolled in the …

Training Protocol Efficacy On Empowerment And Sustainability In Staff Serving Marginalized Youth In Peru, Hannah Park, Abigail Sugarman, Stephen Didonato, Phd, Lpc, Ncc

Phase 1

Introduction: In Peru, there is limited longitudinal research evaluating trauma-informed care (TIC) training for residential child-care staff, despite evidence that it reduces distress, improves confidence and expertise. This project addresses this gap, studying the impact of a trauma-informed training protocol on staff perceptions of the residential care environment and on staff self-awareness. We hypothesize that an effective protocol would yield improvements in both domains.

Methods: As Phase 3 of a study under Dr. Stephen DiDonato (Jefferson College of Nursing) and Dr. Wayne Centrone (Health Bridges International, HBI), this phase evaluates supplemental training under an established protocol while introducing a self-sustainability …

Healthcare Capital: Leveraging Social Connections To Navigate The Healthcare System, Ona Ichoku, Nicholas Wahba, Rosemary Frasso, Phd, Sm, Cph

Phase 1

Introduction: Navigating the healthcare system can be overwhelming for patients, who face rising costs, long wait times, and complex health information. Many patients leverage personal connections to decode healthcare information, yet little is understood about that process. The objective of this study is to investigate how do patients leverage social connections, “Healthcare Capital,” to navigate their healthcare?

Methods: In this study, qualitative semi-structured interviews were conducted with a sample of adults who sought healthcare within the last 12 months. Participants were selected through convenience and snowball sampling. 30-minute interviews were recorded on Zoom, transcribed, and de-identified. A directed content analysis …

Cardiovascular Outcomes Of Youth Female Athletes: Stratifications Of Risk Using Subdivisions In Sports, Jillian D'Souza, Nikta Nair, David Shipon, Md

Phase 1

Introduction: Sudden cardiac death (SCD) in youth athletes is a rare, but devastating event that may proactively be prevented through identification of pathologic structural, functional and electrical cardiac remodeling changes. Pathological changes in female athletes along with the associated risk and protective factors related to SCD are understudied. This study aims to identify pathological cardiac changes in female athletes and inquire whether strength-based versus endurance-based sports carry different levels of risk.

Methods: The HeartBytes database was compiled from cardiac screenings of youth athletes in Southeastern Pennsylvania conducted from 2014 to 2021. Screenings collected information from health questionnaires, physical …

Sodium-Glucose Cotransporter 2 Inhibitors And Vulvovaginal Candidiasis, Natalie Suozzi, Gabriela Skovronsky, Paul Nyirjesy

Phase 1

Introduction: Sodium-glucose transporter 2 inhibitors (SGLT2is) are associated with an increased risk of vulvovaginal candidiasis (VVC), negatively impacting quality of life. Most studies evaluate risk with individual SGLT2is or the class as a whole, rather than comparing risk between different SGLT2is. The objective of this study was to compare the risk of VVC across individual SGLT2is.

Methods: We conducted a systematic review to find studies examining VVC rates in women taking SGLT2is. Of 74 studies identified, four met inclusion criteria for a meta-analysis, with several others used for background. For canagliflozin, ertugliflozin, and empagliflozin, we calculated risk ratios and …

Leveraging Social Media To Disseminate Evidence-Based Messaging About Substance Use To Reduce Stigma And Promote Harm Reduction In Adolescents And Young Adults, Jacob Mihalic, Gregory Jaffe, Md, Msed

Phase 1

Introduction

Substance use disorder (SUD) remains a major contributor to morbidity and mortality in Philadelphia, with adolescents and young adults (AYAs) particularly vulnerable due to peer influence and digital exposure. However, harm reduction messaging rarely targets AYAs directly. This project will explore how AYAs engage with social media, how these platforms shape their perceptions of SUD, and how digital messaging can be leveraged to reduce stigma and support prevention.

Methods

This qualitative project will conduct three focus groups with Philadelphia AYAs aged 13-18, recruited through local Boys and Girls Clubs. Discussions will explore how AYAs engage with SUD-related content online, …

Deafmed Through Deaf Eyes: A Patient-Centered Approach Of The Deafmed Program, Allie Capik, Julia Croce

Phase 1

Introduction
DEAFMed, a Humanities selective within the JeffMD curriculum, aims to enhance cultural competency in caring for Deaf patients. This study predominantly assesses DEAFMed’s impact from the viewpoint of Deaf patients to determine whether the training improves medical student preparation for culturally competent care.

Methods
Deaf individuals were recruited and trained as Standardized Patients (SPs) for 15-minute history-taking encounters with first-year medical students. Twelve non-DEAFMed-trained and sixteen DEAFMed-trained students were randomized to SPs blinded to their training status. SPs evaluated students quantitatively on trust, eye contact, respect, communication, and comfort, and provided qualitative feedback on strengths and areas for improvement. …

Narrative Perspectives On Providing Gender Affirming Care In Primary Care Settings, Sofia Lemberg, Ma, Robert Mcclowry, Md

Phase 1

Introduction: Gender affirming (hormone) care (GAC) has come under bureaucratic scrutiny over the 21st century despite increasing social support of LGBTQ+ individuals. Primary care healthcare professionals (PCHPs) are uniquely situated to oversee and maintain patients’ GAC. Despite this, there is little research investigating PCHPs’ experiences providing GAC, particularly from a narrative lens. This approach may help us understand these perspectives, by promoting reflection upon personal experiences and emphasizing what PCHPs think is important for providing GAC.

Hypothesis: This study investigates what perspectives and experiences PCHPs hold regarding providing GAC in primary care settings. The investigators hypothesize that PCHPs will have …

Alumni Reflections On The Impact Of Participating In Artz @ Jefferson, Clarissa Martin, Rosemary Frasso

Phase 1

Introduction
Alzheimer’s disease and related dementias (ADRD) are becoming increasingly prevalent, with 13.8 million Americans age 65 and older predicted to be living with ADRD by 2060. Humanities-based interventions in medical education can foster person-centered approaches towards people living with dementia (PLWD). ARTZ @ Jefferson pairs health-studies students (mentees) with PLWD and care partners (mentors) in arts-based sessions that facilitate discussion of the lived experience of dementia. This study aims to explore how health-studies’ alumni reflect on the long-term impact of their participation in ARTZ @ Jefferson.

Methods
A qualitative design was used to capture student alumni reflections on their …

Exploring Music As A Therapeutic Tool For Patients, Andrew Rosario, Josh Robinson

Phase 1

Introduction: Music is a remarkably powerful art form that has the potential to impact people in innumerable ways. This project seeks to explore the many ways patients think about and use music in their lives, whether it be as a source of healing, a reminder of their past memories, an outlet to express emotions, or a companion through whatever challenges they may face.

Methods: This project partnered with an existing workshop run by Josh Robinson for patients in the Headache Unit at Jefferson Methodist Hospital. The first part of these sessions involved a “Soundtrack to My Life” activity where …

The Impact Of Neighborhood Socioeconomic Factors And Insurance Status On Outcomes Following Reduction Mammoplasty, Shin Heng Teresa Chan, Kelsey Van Housen, Emily Isch, Judith Monzy, Julianne Bartz, Matthew Jenkins, David Kim, Andrew Newman, Heather Mcmahon

Phase 1

Introduction: The impact of and neighborhood socioeconomic factors on surgical outcomes in reduction mammoplasty remains unclear. This study evaluated the effect of area deprivation index (ADI) and insurance status on postoperative outcomes following reduction mammoplasty.

Methods: A retrospective review of reduction mammoplasty cases was conducted at a single institution over a 7-year period. Patients ≥18 years old who underwent reduction mammoplasty for benign macromastia were included. Zip-code linked ADI, insurance type, and postoperative complication rate were assessed.

Results: In total, 594 patients were analyzed. Mean age was 36.2 ± 13.1 years, mean body mass index (BMI) was 32.6 ± 5.2 …

Age-Related Challenges Of Blood Pressure Management In Patients With Spinal Cord Injury, Brian Frost, Maclain Capron, Michael Stillman

Phase 1

Introduction/Purpose: Autonomic dysreflexia (AD), orthostatic hypotension (OH), and postprandial hypotension (PPH) are forms of dysautonomia that can affect people with spinal cord injury (SCI). Life expectancy for individuals with SCI has increased in recent decades, so it is critical to understand how triggers of these conditions change throughout the lifespan. This study will answer the question “What challenges do patients with SCI face regarding autonomic dysfunction as they age, and what are their perceptions of these challenges?”

Methods: This survey-based study aims to better understand dysautonomia in order to educate the medical community about specific challenges of growing older with …

Designing A Multilingual Instructional Language Tool For Patient Communication In Interventional Radiology, Ahlam Houssein, Samuel Almodóvar, Gregg Khodorov, Md, Mba, Sahib Sohal, Md, Robert Pugliese, Pharmd, David Dwyer, Md

Phase 1

Introduction: Language barriers in healthcare contribute to medical errors, reduced patient adherence, and increased procedural risk among patients with limited English proficiency (LEP), particularly in interventional radiology (IR), where real-time verbal instruction is essential for procedural success. Current virtual translation services lack the immediacy, specificity, and workflow integration required for intraprocedural communication. This project asks how a digital platform can enable IR professionals to communicate procedural instructions to LEP patients accurately and efficiently in real time, hypothesizing that a structured, phrase-based translation system will improve procedural efficiency and safety.

Methods: On-site interviews and workflow observations were conducted with IR physicians, …

A Novel Ankle Sprain Rehabilitation Device, Ian Argento, Bs, Jack Rifkin, Bs, Brady Stillman, Bs, Robert Pugliese, Pharmd

Phase 1

Background: Ankle sprains are among the most common musculoskeletal injuries across all patient groups. Structured rehabilitation with resistance bands decreases re-injury by improving balance, range of motion, and strength, but protocols vary widely. Furthermore, patients often struggle to perform resistance band exercises correctly, limiting their effectiveness.

Aim: To design and develop a wearable rehabilitation device that standardizes resistance band therapy for ankle sprains by controlling resistance vectors and progressive overload.

Methods/Design: We conducted a needs assessment of current rehabilitation practices and identified limitations in resistance band use, including lack of standardization, variability in patient adherence, and difficulty replicating exercises at …

Design Of A Standardized Resistance-Based Rehabilitation Device For Ankle Sprain Recovery, Jack Rifkin, Bs, Brady Stallman, Bs, Ian Argento, Bs, Robert Pugliese, Pharmd

Phase 1

Introduction: Ankle sprains are among the most common musculoskeletal injuries, particularly in adolescents and athletes. Although many patients recover quickly, a substantial number experience poor healing, leading to chronic ankle instability, weakness, and reinjury. While structured rehabilitation improves outcomes, inconsistent protocols and difficulty performing resistance-based exercises limit effectiveness. This project addresses the need for a standardized and accessible rehabilitation approach for ankle sprain recovery.

Methods: We designed a novel rehabilitation device that reimagines traditional resistance band therapy by standardizing resistance vectors and enabling controlled progressive overload. The design supports reproducible ankle movements targeting strength, range of motion, and proprioception. Iterative …

Analysis Of Predictive Variables For Atrial Fibrillation Detection In Patients With Cryptogenic Stroke, Paranshu Shah, Cindy Fang, Avinash Saraiya, Behzad Pavri

Phase 1

Introduction: Underlying atrial fibrillation (AF) is commonly screened for in patients with stroke of unknown cause, cryptogenic stroke (CS), using implantable loop recorders (ILRs). However, the risk factors correlated with AF detection after CS are poorly identified. Thus our goals were to elucidate which characteristics correlate with AF detection in patients with CS and to investigate if there is an age below which ILR implantation is clinically irrelevant.

Methods: We conducted a retrospective cohort study on patients with CS who underwent ILR implantation at TJUH from 4/2019-4/2021 (n=282). Exclusion criteria were < 6 months of follow-up data, ILR placement >1 year after CS, or pre-existing AF (n=64). Demographics …

Development Of A Novel Resistance-Integrated Device To Optimize Ankle Strength Recovery, Brady Stallman, Bs, Jack Rifkin, Bs, Ian Argento, Bs, Robert Pugliese, Pharmd

Phase 1

Introduction: Ankle sprains occur when ligaments of the ankle are stretched or torn due to excessive force, such as twisting or rolling. Ankle sprains are the most common injury in athletes, with re-injury rates as high as 47%. We aim to design a device with integrated resistance to standardize re-strengthening care in patients with sprained ankles.

Methods: A crucial aspect of ankle rehabilitation involves regaining strength and proprioception through resistance band exercises. Currently, resistance band exercises are difficult to complete alone, which is a necessary part of at-home exercises. Our wearable ankle-strengthening device standardizes the exercises, allowing for easier use …

Pre-Infusion Evaluation Of Pain In Children And Adults With Osteogenesis Imperfecta (Oi) Receiving Cyclic Pamidronate, Andrew Stolfe, Cristina Mcgreal, Sarah Little, Shannon Bonner, Ricki Carroll, Mahim Jain

Phase 1

Introduction/Purpose: Chronic pain is common in OI patients, but standardized pain assessment and treatment is lacking. Pamidronate, a bisphosphonate traditionally administered to OI patients to increase bone mineral density, could play a role in pain management. This study will describe baseline pain before receiving pamidronate to contribute to the characterization of pain in OI and justify the need for evaluating the impact of pamidronate on pain over time.

Methods: 54 patients with mild to severe OI were selected from the Nemours Skeletal Dysplasia Program (mean age 10.5±6.6 years [range 2-31 years]; 54% male, 46% female). Pain was assessed using the …

Improving Options For Prehospital Management Of Hyperthermia, David Azizi, Connor Coyle, Robert Pugliese, Pharmd

Phase 1

Introduction: Hyperthermia, particularly heatstroke, is a life-threatening failure of thermoregulation that requires rapid cooling to prevent serious sequelae. Despite effective hospital-based systems, prehospital and austere environments lack portable solutions capable of achieving timely temperature reduction. This project investigates whether a lightweight, field-ready garment incorporating endothermic salts can improve prehospital hyperthermia management.

Methods: We conducted a literature review and expert interviews with emergency and wilderness medicine clinicians to identify limitations of existing tools and define design requirements. A prototype was designed with a thermally conductive inner layer and insulating outer layer integrating off-the-shelf chemical cold packs. Planned testing includes quantifying heat …

Impact Of Solid Organ Transplant History On Outcomes In Head And Neck Microvascular Reconstruction, Domenica Voli, Sarah R. Harrington, Daniel Uralov, Janvi J. Shukla, Hani Samarah, Marina Aweeda, Krishna Koka, Shaunak Ganju, Kelly Bridgham, Eric V. Mastrolonardo, Arielle G. Thal, Richard A. Goldman, Adam J. Luginbuhl, Larissa Sweeny, Mark K. Wax, Joseph M. Curry

Phase 1

Introduction/Purpose: Free tissue transfer (FTT) is a commonly used technique in head and neck reconstructions. Many factors influence FTT success, including immunosuppression. Patients with solid organ transplants represent a unique population, as the lifelong immunosuppression predisposes them to head and neck cancers and poor wound healing. This study assesses postoperative outcomes and long-term survival in patients with head and neck cancer requiring FTT with a history of solid organ transplant (SOT), compared to matched non-transplant controls.

Methods: Patients with head and neck cancer who underwent FTT were identified in multi-institutional databases and the national TriNetX database. Patients with a history …

Temperature Control Vest For Use In Acute Hyperthermic Episodes, Connor Coyle, David Azizi, Isaac Kravatz, Robert Pugliese, Pharmd

Phase 1

Introduction: In the acute treatment of acute hyperthermia that is treated in austere conditions, there is a lack of a portable, effective, and inexpensive device that can rapidly lower the temperature of the patient back to baseline levels. With rapidly rising global temperatures, we anticipate an increase in acute heat strokes where correction by cooling can save countless lives. We want to create a medical device that is effective in cooling a patient with hyperthermia to increase survival and recovery outcomes. Our main inquiry is whether it is reasonable to design, produce, and test a cooling device that fits within …

A 3d-Printed Enclosure To Improve Precision And Reduce Tearing In Laser Fenestration Of Endovascular Grafts, Tuyaa Bi, Babak Abai, Md, Robert Pugliese, Pharmd

Phase 1

Introduction

In-situ laser fenestration has become increasingly critical in endovascular surgery. However, the higher risk of endoleak and microthrombosis has raised concerns about achieving optimal outcomes.

In a previous study, researchers performed laser fenestration on several commonly used graft materials and compared fabric fraying and directional tear propagation. However, the experimental environment was suboptimal because the fenestration angle was not controlled. This may limit the validity of the results.

In this SI project, we aim to create a more controlled environment for laser fenestration by designing and 3D printing an enclosure that mimics the anatomy of the aorta and the …

Identification Of Socioeconomic And Demographic Predictors Of Somatic Genomic Testing Rates In Prostate Cancer, Erin Welch, Kevin K. Zarrabi, Khaldoun Hamade, Christopher Mcnair

Phase 1

Introduction/Purpose: Somatic genomic testing in metastatic prostate cancer (mPC) identifies genomic variants which provide clinical insight into the disease biology. Somatic testing results determine eligibility for standard of care targeted therapies and clinical trial eligibility. While national guidelines recommend testing for all mPC patients, patients with adverse social determinants of health (SDOH), racial minority groups and patients with low socioeconomic status (SES) have historically undergone lower rates of testing compared to national standards. This study aims to identify barriers to testing in mPC patients in the Jefferson system and ultimately understand the factors that influence testing rates.

Methods: Epic’s clinical …

Progression Of Optic Nerve Head And Macular Parameters From Optical Coherence Tomography In Glaucomatous Eyes With Concomitant Epiretinal Membrane, Alisha Desai, Fabio Lavinsky, Joel S. Schuman

Phase 1

Introduction/Purpose: Epiretinal membrane (ERM) can distort macular and peripapillary architecture, altering optical coherence tomography (OCT)–derived measurements and potentially obscuring glaucomatous progression. The present study aimed to determine whether glaucoma-related structural progression can still be detected over time in primary open-angle glaucoma (POAG) eyes with concomitant ERM by evaluating longitudinal changes in optic nerve head (ONH) and macular parameters. Understanding these changes may reduce the risk of delayed diagnosis and irreversible vision loss.

Methods: This retrospective longitudinal study included adults (>18 years) with POAG and ERM from two tertiary care centers. Eyes with at least three visits were included, while …

Auravena, Isaac Kravatz, Bassem Fayek, Robert Pugliese, Pharmd

Phase 1

Introduction: Over 200 million peripheral IVs are placed annually, serving as critical access points for medications and therapies, yet up to 40% fail on the first attempt. While heat is often used to support IV placement, current methods are insufficient compared to what the literature suggests. Therefore, we asked: how might heat be applied more efficiently and sustainably to improve first-attempt success rates for patients with difficult IV access?

Methods: We began by interviewing nursing staff at an outpatient infusion center, uncovering a significant gap in care for patients with difficult IV access. These insights drove iterative design cycles focused …

Effect Of Als-Associated Ubiquilin-2 Mutation On Autophagy In Ipsc-Derived Neurons, Marina Pilger, Dorothy Benton, Juliet Goldsmith

Phase 1

Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease that progresses to respiratory paralysis and death. Defective protein homeostasis is a major driver of disease pathogenesis, and autophagy, a cellular recycling and degradation system, is often disrupted in disease. UBQLN2 mutation is linked to a small percentage of familial ALS. Despite UBQLN2’s known role in protein homeostasis, the effect of its ALS-associated mutation on neuronal autophagy remains unclear. This study used iPSC-derived excitatory cortical-like (iCN) and lower motor (iLMN) neurons to quantify the effects of the familial UBQLN2 mutation (P506T) on autophagic flux. Live cell imaging and ImageJ were used …

Beyond Naloxone: A Human Centered Overdose Response And Education Kit To Destigmatize Opioid Use Disorder For First-Year Medical Students, Hope Friel, Justin Leggin, Madeleine Peele, Donya Zarrinnegar, Abigail Kay, Md

Phase 1

Introduction: Opioid related deaths are a leading cause of death in adults in the United States and Thomas Jefferson University equips each first year medical student (M1) with a box of Narcan at the White Coat Ceremony. Research has shown that there are knowledge and training gaps in M1s and harmful stigmas surrounding drug users. This project examines how we might provide an education-focused opioid overdose response kit and intervention for JeffMD M1s in order to reduce stigma and improve clinical readiness for drug-related emergencies.

Methods: Class of 2029 M1s will take a pre-post survey to capture the baseline level …