Medicine and Health Sciences Commons^™

From The Editors, Nehar Damle, Md, Pharmd, Hamzah Shariff, Md, Allison Kayne, Md, Jasmine Lee, Md

The Medicine Forum

As physicians in training, much of our work is shaped by immediacy – responding to evolving clinical situations, navigating diagnostic uncertainty, and making decisions with present information. In this environment, it can be easy to prioritize action over reflection. Yet it is through reflection, inquiry, and shared scholarship that we deepen our understanding of medicine and the patients we serve.

It is within this spirit that we present Volume 27 of The Medicine Forum. This publication represents not only scholarly achievement, but also the intellectual curiosity and dedication that define our community.

This year, we were particularly struck by …

From The Desk Of The Residency Program Director, Christopher Henry, Md. Facp

The Medicine Forum

I am excited to once again share this year’s The Medicine Forum. It continues to open a window into the tireless commitment our residents bring to the bedside and to the field of medicine at large. As is uniquely our brand at Jefferson, the residents accomplish this with as much rigorous intellect as with their abundant enthusiasm and personality.

In an era where artificial intelligence has become an ever-burgeoning tool in the clinical landscape, the ingenuity displayed by our residents both in their artistic talents and their scholarly pursuits serves as a vital reminder. It reminds me that the …

Table Of Contents: The Medicine Forum, Volume 27, 2025-2026

The Medicine Forum

Table of Contents: The Medicine Forum, Volume 27, 2025-2026

The Medicine Forum: Volume 27

The Medicine Forum

The Journal of Thomas Jefferson University Hospital - Department of Internal Medicine, Volume 27, 2025-2026

TABLE OF CONTENTS

• Case Reports
• Letter to the Editor
• Research Studies
• Humanities & Reflections

First Photographic Record Of A Pale-Colored Wild Boar (Sus Scrofa) Consistent With Leucism In The Zagros Mountains, Iraqi Kurdistan, Bahez F. Ali, Hana A. Raza, Nabaz Horeni

AUIQ Complementary Biological System

Pigmentation anomalies in wild mammals are rare and poorly documented in wild boar (Sus scrofa) populations. Leucism, characterized by partial loss of melanin while retaining normal eye pigmentation, represents one of the least frequently reported coloration anomalies in the species. During a camera-trap survey in Bamo Mountain, Zagros Mountains of Iraqi Kurdistan, an unusually pale-colored wild boar consistent with leucism was recorded. The individual exhibited cream to light-blond pelage with retained darker pigmentation on the snout and distal limbs, while the eyes remained normally pigmented. Its morphology and behavior were otherwise consistent with those of a typical wild …

Discordance Between Self-Report And Performance-Based Measures Among At-Risk Older Adults: A Secondary Data Analysis, Chiung-Ju Liu, Wen-Pin Chang, Inga Wang

Occupational Therapy Faculty Publications

Importance: Subtle, age-related declines in occupational performance among at-risk older adults may go undetected when assessed solely with self-report measures, potentially leading to missed intervention opportunities. Understanding discrepancies between self-reported and performance-based occupational performance outcomes can inform assessment selection and interpretation.

Objective: To examine the discrepancies between the two types of measure among community-dwelling older adults at risk for losing independence.

Design: Cross-sectional study using secondary data analysis.

Participants: Seventy-one community-dwelling older adults (M age = 74 yr, SD = 9) who showed muscle weakness and reported difficulty with activities of daily living.

Outcomes and measures: Canadian Occupational Performance Measure …

Understanding How Fire Impacts Soil Carbon And Nutrient Cycling: Toward Standardized Reporting Of Fire Metrics For The Integrated Plant-Soil System, Julia B. Gaudinski, Kate Wilkin, Jasquelin Peña, Mary E. Miller, Margaret S. Torn

Michigan Tech Publications

Fire events impact soil carbon (C) and nutrient stocks immediately due to combustion of biomass and organic matter and set up additional post-fire changes to ecosystem inputs and losses. The literature on this topic is expanding rapidly as large and intense wildfires are increasingly affecting communities globally. However, many of these studies do not describe initial post-fire soil conditions adequately or consistently, nor do they link the impacts of fire on C and nutrient cycling to key soil properties and soil inputs, stocks and fluxes. Here we conduct a systematic analysis of 56 review- papers published in 2010 or later …

Community-Based Tuberculosis Screening With Computer-Aided Detection Technology Alone And In Combination With Point-Of-Care C-Reactive Protein Testing: A Paired Screen-Positive Trial, Klaus Reither, Fiona Vanobberghen, Anna Verjans, Harsh Harkare, Bart Jacobs, Alastair Heerden, Shriya Misra, Fabrizio Tedios, Curdin Brugger, Alfred Keter

Population Health, East Africa

Background Active tuberculosis case-finding in communities is crucial for early disease detection and disruption of transmission; however, it is complex and costly. A thorough analysis of tuberculosis screening strategies is essential, particularly because the health systems affected often have limited resources. We aimed to compare two community screening approaches in terms of tuberculosis case yield and cost.

Methods This pragmatic community trial, with a paired screen-positive design (ie, within-person comparison), was conducted in the Butha-Buthe District in Lesotho and the uMgungundlovu District in South Africa. All household members aged at least 18 years were eligible to participate, except those who …

Sharksrx Newsletter Summer 2026, Nova Southeastern University

NSU Sharks Rx

No abstract provided.

Effects Of Targeted Interventions On Hiv Testing, Knowledge And Sexual Risk Behaviours Among Long-Distance Truck Drivers: A Systematic Review And Meta-Analysis, Cyrus Mutie, Berrick Otieno, Kawira Kithuci, John Gachohi, Grace Mbuthia

School of Nursing & Midwifery, East Africa

Objectives We aimed to systematically summarise and quantify the empirical evidence on targeted interventions and their effects on various HIV prevention outcomes for long-distance truck drivers (LDTDs) globally.

Design A systematic review and meta-analysis.

Data sources We searched PubMed, PubMed Central (PMC), Cumulated Index to Nursing and Allied Health Literature (CINAHL), ProQuest Central, EBSCOhost, ScienceDirect, World Health Organisation (Global Index Medicus), Cochrane Library, Scientific Electronic Library Online (SCiELO), Japan Science and Technology Information Aggregator, Electronic (J-STAGE) and China National Knowledge Infrastructure (CNKI) up to 15th May 2026.

Eligibility criteria We included original peer-reviewed interventional studies involving LDTDs of either gender …

Shsp Dean's Newsletter, Summer 2026, Brian J. Nickerson

SHSP Dean’s Newsletter

No abstract provided.

Ultrasound-Guided Iv Placement In Difficult Access Patients, Hilary P. Babb Bsn, Rn

Nurse Residency

In hospitalized adult patients with difficult intravenous access, how does ultrasound-guided peripheral IV catheter insertion compared with traditional landmark/palpation techniques affect first-attempt success and catheter failure rates during hospitalization?

Enhancing Colonoscopy Effectiveness: The Impact Of Split Dose Bowel Preparation, Samantha Balestrieri Bsn, Rn

Nurse Residency

In patients undergoing screening colonoscopies, does a split-dose bowel preparation regimen, compared with a standard single-dose regimen, result in improved colonic visualization and adenoma detection?

Optimizing Nursing Management Of Alcohol Withdrawal In The Emergency Department: A Comparison Of Benzodiazepines And Phenobarbital, Brook Kulis Bsn, Rn

Nurse Residency

In adult patients presenting to the emergency department with alcohol withdrawal syndrome, how does phenobarbital treatment compared with benzodiazepine-based treatment protocols affect emergency department and hospital length of stay, medication requirements, rates of hospital readmission, and overall patient outcomes?

Improving Patient Outcomes Through Nurse-Led Care Coordination, Anna Berry Rn

Nurse Residency

In patients admitted to the hospital, how does nurse-led care coordination compared to none, or patient reliance alone, impact better patient outcomes, better medication management and reduce hospital readmissions?

Reducing Caregiver Burden In Hospice Care, Aubrey Martin Bsn, Rn

Nurse Residency

In family caregivers of adult hospice patient’s, does a nurse-led support program, compared with usual hospice education, reduce caregiver burden?

Comparing Intraosseous (Io) Access To Intravenous (Iv) Access, Isabella Ouellette Rn, Charlyn Achola Rn, Catherine Marcoullier Rn

Nurse Residency

In adult patients experiencing cardiac arrest, how does intraosseous access compared to intravenous access affect time to medication administration and return of spontaneous circulation (ROSC) during resuscitation?

Behavioral Risks, Sophie Coro Rn, Katelyn Piche Rn, Maria Neihauser Rn, Mia Martel Rn

Nurse Residency

In nurses caring for behavioral risk patients, does the use of electronic behavioral alert systems compared to no alert systems reduce nurse-patient workplace violence?

The Impact Of Emergency Nurse Experience On Triage Accuracy During High-Volume Emergency Department Shifts, Grace Littlefield Rn, Mia Cianchette Rn, Benjamin Drummey Rn, Charles Stever Rn

Nurse Residency

PICOT Question: In adult emergency department patients, how does assigning an experienced emergency room nurse to the triage role compared to assigning a less experienced nurse improve triage accuracy rates during high-volume shifts?

Manual Blood Pressure Readings Versus Automatic Blood Pressure Readings, Logan Delano Rn, Rae Hebert Rn, Hannah Rogers Rn

Nurse Residency

In patients under 60, how does manual blood pressure readings compared to automatic blood pressure readings affect the treatments received in a single hospital admission?

Working Out Loud Resilience In Cooperative Extension: Results From An Internal Pilot Program, Lyndi M. Buckingham-Schutt, Debra Sellers, Barbara Dunn Swanson, Jody Catherine Gatewood

Journal of Human Sciences and Extension

This study evaluates Working Out Loud (WOL) Resilience, a program designed to enhance resilience through peer-to-peer learning, targeting social isolation and self-determination. The WOL Resilience pilot program, delivered by Iowa State University Extension and Outreach facilitators, included 29 participants and 5 facilitators over 8 weeks. Participants engaged in weekly sessions focusing on 8 resilience attributes. Evaluation included baseline, midpoint, and post surveys; facilitator feedback forms; and interviews. Results showed improvements in resilience attributes from baseline to post-program and indicated high program acceptability and positive behavioral changes. The peer-to-peer learning model proved beneficial for participants and feasible for delivery through Extension …

Evaluating The Impact Of A Community-Based Prenatal Education Program On Maternal Knowledge And Intentions In Utah, Aaron T. Hunt, Jenna Dyckman, Kaylee Cox

Journal of Human Sciences and Extension

Maternal and infant health in the U.S. has worsened, with rising rates of maternal mortality, gestational diabetes, postpartum depression, and infant mortality. Prenatal education is a proven strategy to improve outcomes, yet many expecting parents rely on unvetted information or lack access to reliable resources. To address this gap, a pilot prenatal education program was implemented through Utah State University Extension to improve knowledge, attitudes, and intentions related to breastfeeding, nutrition, mental health, and other key topics. The program consisted of 3 1-hour, evidence-based workshops incorporating lectures and interactive activities. A retrospective pre-post survey was completed by 28 pregnant participants …

Geomapping With Python: An Innovative Data Visualization Technique, Tirna Purkait, Dipti Dev

Journal of Human Sciences and Extension

No abstract provided.

Psychological And Neuromechanical Recovery After Concussion: Dual-Task Stability And Kinesiophobia From Return To Play To Six Months., Melissa Anderson, Daniel Le, Mallory Faherty, Carolyn Killelea, Jeffrey Bytomski, Corina Martinez, Michael Bergeron, Timothy Sell

OhioHealth Research Institute Articles

BACKGROUND: Sport-related concussion (SRC) increases the risk of subsequent musculoskeletal injury, yet the mechanisms underlying this vulnerability remain unclear. Fear of movement (kinesiophobia) may contribute to impaired motor control.

PURPOSE: This study examined kinesiophobia and postural stability in adolescent athletes at return-to-play (RTP) after SRC and evaluated changes six months later.

DESIGN: Observational analytical study with cross-sectional (case-control) and prospective cohort components.

METHODS: Thirty-seven concussed athletes (15.7 ± 1.3 years, 45.9% female) and 17 matched controls (16.4 ± 2.1 years, 52.9% female) completed static single-leg stance and dynamic single-leg landing tasks under single- and dual-task (Stroop) conditions. Fear of movement …

Molecular Classification And Association With Survival Outcomes In High-Intermediate And High-Risk Early-Stage Endometrial Cancers: Ancillary Analysis Of Gog-0249., Lindsay M Kuroki, Danielle M Enserro, Heather A Lankes, Kyle C Strickland, Rebecca Previs, Aine Clements, Matthew A Powell, Ann Klopp, Elena Ratner, Paul Disilvestro, Casey Cosgrove, Guilherme Henrique Cantuaria, Nicola M Spirtos, Michael Carney, Mitchell Edelson, Gottfried Konecny, Penny Anderson, Christopher Tarney, Britt K Erickson, Meredith Newton, Krishnansu S Tewari, Premal H Thaker, David Warshal, Amy Armstrong, Xun Clare Zhou, Angeles Alvarez Secord

Women’s Health Articles

OBJECTIVE: Determine whether mismatch repair (MMR) and p53 expression predict recurrence-free survival (RFS) and overall survival (OS) in early-stage endometrial cancer (EC) patients treated with vaginal cuff brachytherapy plus chemotherapy (VCB/C) versus pelvic radiation therapy (RT).

METHODS: In the GOG-0249 trial, 601 patients with high-intermediate risk (HIR) early-stage EC were randomized to VCB/C (carboplatin/paclitaxel for 3 cycles) or pelvic RT. Molecular subgroups, deficient MMR (dMMR), p53 wildtype (p53wt), p53 abnormal (p53abn), were determined by immunohistochemistry. Five-year RFS and OS were analyzed using Kaplan-Meier curves and Cox proportional hazards models, adjusting for lymphadenectomy, planned VCB, and treatment group.

RESULTS: Among 315 …

Perspectives Of Scholars, Families, And Advisors On 360-Degree Video Technology In Graduate Education, Oluwatobi A. Mogbojuri, Bridget A. Walsh, Matthew Aguirre

Journal of Human Sciences and Extension

This study explored the experiences of scholars in creating and sharing 360-degree videos, as well as the perspectives of families and advisors who viewed the videos. Focus groups and individual interviews were conducted online using a videoconferencing platform. Perspectives from 20 participants (15 scholars, three advisors, and two family members) were analyzed using thematic analysis. Three primary themes were identified: (1) barriers to 360-degree video use, (2) perspective shifts and limited change, and (3) storytelling and scholar visibility. Findings suggest that 360-degree video technology may be an innovative tool for enhancing recruitment and retention, especially for historically marginalized groups, through …

Lasting Memories: Effects Of Previous Healthcare Experiences On Young Adults’ Pain Tolerance, Emily Goldstein Sigman, Sherwood Burns-Nader

Journal of Human Sciences and Extension

This cross-sectional study investigated the connections between previous healthcare experiences, young adults’ pain tolerance, and healthcare fear and anxiety. Prior healthcare experiences, current fear of medical procedures, and pain tolerance were reported by 257 young adults via a survey. Structural equation modeling revealed that increased numbers of previous healthcare experiences were associated with higher pain tolerance and decreased fear and anxiety towards healthcare procedures in young adulthood. Conversely, individuals with fewer previous healthcare experiences exhibited lower pain tolerance and heightened fear and anxiety towards medical procedures as young adults. These findings suggest that the relationship between previous healthcare experiences and …

Covid-19 Case Study, Armando Olmeda

Distinguished Student Scholarship Collection

Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, continues to affect healthcare systems and public health worldwide. This case study examines COVID-19 from an epidemiological perspective by looking at how the disease spreads, the populations most affected, the major risk factors, and the impact on healthcare systems. It also analyzes key epidemiological measures, including incidence, prevalence, hospitalization, and mortality trends, to better understand how the pandemic has changed over time. The findings show that older adults, individuals with chronic medical conditions, and socially disadvantaged populations continue to experience the greatest burden of disease, with social determinants of health playing an important …

Pearson Syndrome: Expanding The Clinical Spectrum Of A Mitochondrial Cytopathy-A Case Report, Alizah Faisal, Hooria Waqas, Hania Masood, Armeen Butt, Saad Rahman, Muhammad Sheraz Hameed, Syed Rafay Hussain Zaidi, Ali Iqbal, Muhammad Usama Naveed

Department of Medicine Faculty Papers

BACKGROUND: Pearson syndrome (PS) is a rare multisystem mitochondrial disorder characterized by single large-scale mitochondrial DNA deletions (SLSMDs). It typically presents in infancy with refractory sideroblastic anemia, exocrine pancreatic insufficiency, and failure to thrive. Due to its heterogeneous manifestations and resemblance to other hematological conditions, early diagnosis remains a clinical challenge.

CASE PRESENTATION: A south asian male infant presented with persistent pancytopenia, severe anemia unresponsive to intravenous and oral iron and multivitamin supplements, exocrine pancreatic insufficiency, failure to thrive, and metabolic acidosis. Born to consanguineous parents, the child had a significant family history of early infant deaths and hematological abnormalities. …

Developing And Sustaining Indigenous Nursing Leadership: The Heal Southwest Leadership Cohort, Cristina Rivera Carpenter, Adriann Begay

Indigenous Health Posters and Presentations

While Indigenous Peoples represent 2.9% of the total United States (US) population (Office of Minority Health, 2025), only 0.4% of the 4.7 million Registered Nurses (RN) in the US are Indigenous (AACN, 2024). This disparity in nursing representation impacts healthcare delivery and access in Indigenous communities. Healthcare services in Indigenous communities, such as those provided through Indian Health Services (IHS) and 638 facilities, often face high vacancies and high turnover rates (Kruse 2022). There are gaps in mentorship, professional development, community of practice, and available curriculum to practicing Indigenous Nurses who serve their communities. These gaps must be addressed to …