Medicine and Health Sciences Commons^™

Partnering With Social Media Influencers To Promote Hpv Vaccination In Diverse Communities, Amy Leader, Amelia Burke-Garcia, Dasha Afanaseva, Erin Cutroneo, Preethi Selvan, Kayla Madden, Joshua Banks, Angela Sustaita-Ruiz

Department of Medical Oncology Faculty Papers

BACKGROUND: While human papillomavirus (HPV) vaccination is one of the most effective ways to prevent HPV-related cancers, many children and adolescents remain unvaccinated. Resistance often stems from parental vaccine hesitancy and mistrust of the health care system, both of which may be higher in communities of color. Partnering with social media influencers may be an effective method for disseminating health messages. We tested the impact of HPV social media posts developed by influencers on outcomes of knowledge, attitudes, and intentions to vaccinate.

METHODS: Ten social media influencers who identified as African American or Hispanic created posts about the HPV vaccine. …

Structural Basis For Polθ-Helicase Dna Binding And Microhomology-Mediated End-Joining, Fumiaki Ito, Ziyuan Li, Leonid Minakhin, Htet A. Khant, Richard T. Pomerantz, Xiaojiang S. Chen

Department of Biochemistry and Molecular Biology Faculty Papers

DNA double-strand breaks (DSBs) present a critical threat to genomic integrity, often precipitating genomic instability and oncogenesis. Repair of DSBs predominantly occurs through homologous recombination (HR) and non-homologous end joining (NHEJ). In HR-deficient cells, DNA polymerase theta (Polθ) becomes critical for DSB repair via microhomology-mediated end joining (MMEJ), also termed theta-mediated end joining (TMEJ). Thus, Polθ is synthetically lethal with BRCA1/2 and other HR factors, underscoring its potential as a therapeutic target in HR-deficient cancers. However, the molecular mechanisms governing Polθ-mediated MMEJ remain poorly understood. Here we present a series of cryo-electron microscopy structures of the Polθ helicase domain (Polθ-hel) …

Adjuvant Radiotherapy In Pt3-4n0m0 Major Salivary Gland Cancer Without Other Adverse Features, Aman M. Patel, Afash Haleem, Praneet C. Kaki, Jake J. Lee, Russell Maxwell, Jason A. Brant, Robert M. Brody, Ryan M. Carey

SKMC Student Presentations and Publications

OBJECTIVE: To investigate adjuvant radiotherapy (aRT) utilization and associated differences in overall survival (OS) in pT3-4N0M0 major salivary gland cancer (MSGC) without evidence of other adverse pathologic features.

METHODS: The 2006 to 2018 National Cancer Database was queried for patients with MSGC classified as pT3-4N0M0. Patients with evidence of lymphovascular invasion or positive surgical margins were excluded. Multivariable binary logistic and Cox regression models adjusting for patient demographics, pathologic features including histology, and treatment were implemented.

RESULTS: Of 897 patients satisfying inclusion criteria, 368 (41.0 %) underwent aRT. Compared with those not undergoing aRT, patients undergoing aRT were younger (median …

Short Report: The Variants In Chek2 In Metastatic Uveal Melanoma, Mizue Terai, Rino S. Seedor, Usman Ashraf, Gretchen Hubbard, Sergei A. Koshkin, Marlana Orloff, Takami Sato

Department of Medical Oncology Faculty Papers

No abstract provided.

Midrc Mrale Mastermind Grand Challenge: Ai To Predict Covid Severity On Chest Radiographs, Samuel G. Armato, Karen Drukker, Lubomir Hadjiiski, Carol C. Wu, Jayashree Kalpathy-Cramer, George Shih, Maryellen L. Giger, Natalie Baughan, Benjamin Bearce, Adam E. Flanders, Robyn L. Ball, Kyle J. Myers, Heather M. Whitney, The Midrc Grand Challenge Working Group

Department of Radiology Faculty Papers

PURPOSE: The Medical Imaging and Data Resource Center (MIDRC) mRALE Mastermind Grand Challenge fostered the development of artificial intelligence (AI) techniques for the automated assignment of mRALE (modified radiographic assessment of lung edema) scores to portable chest radiographs from patients known to have COVID-19.

APPROACH: The challenge utilized 2079 training cases obtained from the publicly available MIDRC data commons, with validation and test cases sampled from not-yet-public MIDRC cases that were inaccessible to challenge participants. The reference standard mRALE scores for the challenge cases were established by a pool of 22 radiologist annotators. Using the MedICI challenge platform, participants submitted …

Developing An Online Community Advisory Board (Cab) Of Parents From Social Media To Co-Design An Human Papillomavirus Vaccine Intervention: Participatory Research Study, Regan M. Murray, Shawn C. Chiang, Ann C. Klassen, Jennifer A. Manganello, Amy E. Leader, Wen-Juo Lo, Philip M. Massey

Department of Medical Oncology Faculty Papers

BACKGROUND: Social media health interventions have grown significantly in recent years. However, researchers are still developing innovative methods to meaningfully engage online communities to inform research activities. Little has been documented describing this approach of using online community advisory boards (CABs) to co-create health communication interventions on social media.

OBJECTIVE: This study describes the formation, engagement, and maintenance of an online CAB focused on co-creating a health education intervention for parents regarding the human papillomavirus (HPV) vaccine. The study provides guiding principles for public health researchers implementing such CABs in future digital health interventions.

METHODS: In May 2020, Twitter was …

A Review Of Recent Studies On The Pathogenesis Of Systemic Sclerosis: Focus On Fibrosis Pathways, Sergio A. Jimenez, Fabian A. Mendoza, Sonsoles Piera-Velazquez

Scleroderma Center Faculty Papers

Systemic Sclerosis (SSc) is a systemic autoimmune disease of unknown etiology characterized by the development of frequently progressive cutaneous and internal organ fibrosis accompanied by severe vascular alterations. The pathogenesis of SSc is highly complex and, despite extensive investigation, has not been fully elucidated. Numerous studies have suggested that unknown etiologic factors cause multiple alterations in genetically receptive hosts, leading to SSc development and progression. These events may be functionally and pathologically interconnected and include: 1) Structural and functional microvascular and endothelial cell abnormalities; 2) Severe oxidative stress and high reactive oxygen species (3); Frequently progressive cutaneous and visceral fibrosis; …

Acute Pain Treatment In Patients With Sickle Cell Disease Transitioned To Buprenorphine: Evidence Of Equivalent Pain Relief, Christopher P. Carroll, Elizabeth J. Prince, Ashley P. Lauriello, Lydia H. Pecker, Sophie M. Lanzkron

Cardeza Foundation for Hematologic Research

Objectives Buprenorphine is a novel opioid analgesic with complex receptor pharmacology. It is safer than high dose chronic treatment with full agonist opioids. However, buprenorphine can inhibit conventional opioids, complicating acute pain treatment. Methods We compare acute pain treatment outcomes in 55 sickle cell disease patients in the year before and after transition to buprenorphine. Infusion center visits, ED visits, and hospital admissions were compared before and after transition, and pain outcomes were compared using linear mixed effects models with patients entered as random effects to account for differential contribution to the outcomes by visit rates. Results Acute care visits …

Evolution Of The Tumor Immune Landscape During Treatment With Tebentafusp, A T Cell Receptor-Cd3 Bispecific, Joseph Sacco, Peter Kirk, Emma Leach, Alexander Shoushtari, Richard Carvajal, Camille Britton-Rivet, Sophie Khakoo, Laura Collins, Luis De La Cruz-Merino, Zeynep Eroglu, Alexandra Ikeguchi, Paul Nathan, Omid Hamid, Marcus Butler, Sarah Stanhope, Koustubh Ranade, Takami Sato

Department of Medical Oncology Faculty Papers

Metastatic uveal melanoma is an aggressive disease with poor outcome, which is refractory to immune checkpoint inhibitors. A T cell receptor (TCR)-based CD3 bispecific, tebentafusp, delivers clinical benefit in patients with metastatic uveal melanoma. Understanding the molecular basis for the anti-tumor activity of tebentafusp in an indication where checkpoint inhibitors are ineffective could aid in identification of other solid tumor indications where CD3 bispecifics may serve an unmet need. By analyzing tumor biopsies taken prior to treatment, early on-treatment, and at progression (NCT02570308), using RNA sequencing (RNA-seq) and immunohistochemistry (IHC), we show that expression of interferon-related genes in the tumor …

Plasma Proteomic Biomarkers Of Physical Frailty In Heart Failure: A Propensity Score Matched Discovery-Based Pilot Study, Quin Denfeld, Noelle Pavlovic, Christopher Lee, Jon Jacobs, Mary Roberts Davis, Samantha Powell, Marina Gritsenko, Susan Joseph, Beth Habecker

Division of Cardiology Faculty Papers

BACKGROUND: Physical frailty is highly prevalent in heart failure (HF), but we lack an understanding of the underlying pathophysiology. Proteomic evaluation of plasma samples may elucidate potential mechanisms and biomarkers of physical frailty in HF.

OBJECTIVES: We aimed to identify plasma proteomic biomarkers that are differentially expressed between physically frail and non-physically frail adults with HF.

METHODS: This was a secondary analysis of a subset of data and plasma samples from a study of frailty among patients with New York Heart Association (NYHA) Functional Classification I-IV HF. Physical frailty was measured using the Frailty Phenotype Criteria. Propensity score matching was …

Association Between High Triglyceride-Glucose Index And Macce In Hypertriglyceridemia Patients Undergoing Percutaneous Coronary Intervention, Yichuan Wang, Yanfeng Lu, Shanshan Gao, Zhong Zhong, Jasmine Bao, Bo Liu, Ruihan Fan, Ning Guo

SKMC Student Presentations and Publications

BACKGROUND: With a focus on metabolism-related cardiovascular diseases, the triglyceride-glucose (TyG) index has been used as a surrogate marker of insulin resistance in the prognosis of coronary heart disease. However, the prognostic role of the TyG index in patients with elevated triglycerides, still requires further research. This study aimed to investigate the association between the TyG index and Major Adverse Cardiac and Cerebrovascular Events (MACCE) in patients with hypertriglyceridemia undergoing drug-eluting stent percutaneous coronary intervention (DES-PCI).

METHODS: Out of 2250 patients, 813 with hypertriglyceridemia who underwent DES-PCI were retrospectively analyzed. MACCE was regarded as the primary endpoint. Kaplan-Meier (KM) curves …

Hexasodium Fytate (Snf472 Or Csl525) Inhibits Ectopic Calcification In Various Pseudoxanthoma Elasticum And Calcinosis Cutis Animal Models, Miguel Ferrer, Maria Pérez-Ferrer, Marc Blasco, Ida Jacobs, Qiaoli Li, Olivier Vanakker, Lisa Dangreau, Andrea López, Gianluca Malagraba, Firas Bassissi, Joan Perelló, Carolina Salcedo

Department of Biochemistry and Molecular Biology Faculty Papers

Background/Objectives: Ectopic calcification is a pathological condition characterized by the mineralization of soft tissues due to the deposition of calcium phosphate crystals. Hexasodium fytate (CSL525, previously known as SNF472) is a crystallization inhibitor being developed for the treatment of ectopic calcification-related disorders. Our aim was to investigate CSL525 for the treatment of soft-tissue calcification disorders in animal models of pseudoxanthoma elasticum and calcinosis cutis. Methods: In a first study, abcc6^-/- zebrafish larvae were exposed to 1 mM CSL525 for 7 days or kept under the same conditions without CSL525, and spinal mineralization was quantified. In a second study, abcc6 …

Virtual Reality Respiratory Biofeedback In An Outpatient Pediatric Pain Rehabilitation Program: Mixed Methods Pilot Study, Kristin Recker, Julia Silliman, Karolina Gifford, Parth Patel, Lisgelia Santana, Aimee K. Hildenbrand, Shreela Palit, Rachel Wasserman

Department of Pediatrics Faculty Papers

BACKGROUND: Chronic pain in adolescents is a significant and growing concern, as it can have negative implications on physical and psychosocial development. Management can be complicated by the increasing risks associated with opioid misuse, highlighting the need for effective nonpharmacological interventions. Biofeedback is an empirically supported behavioral intervention for chronic pain that targets the self-regulation of physiological responses. Virtual reality (VR) is a novel delivery method for biofeedback that could serve as an engaging and effective platform for adolescents.

OBJECTIVE: The goal of this study was to assess the feasibility, acceptability, and preliminary effectiveness of integrating a VR-delivered respiratory biofeedback …

Optimizing Transcutaneous Spinal Cord Stimulation: An Exploratory Study On The Role Of Electrode Montages And Stimulation Intensity On Reflex Pathway Modulation, Shirin Madarshahian, Michael Trakhtorchuck, Tatiana Guerrero, Kristin Gustafson, James Harrop, Caio Matias, M. J. Mulcahey, Alessandro Naopli, Alex Vaccaro, Mijail Serruya

Farber Institute for Neuroscience Faculty Papers

Transcutaneous spinal cord stimulation (tSCS) is a promising non-invasive method to improve motor function in individuals with spinal cord injury (SCI) by enhancing spinal reflex pathways. This study aimed to investigate the effects of different tSCS electrode placement montages and targeted spinal levels on neurophysiological responses such as spinally evoked motor responses (sEMRs), dorsal root reflex activation, and muscle recruitment in individuals with SCI and healthy controls to optimize stimulation strategies for motor recovery. Five participants (three individuals with SCI and two controls) underwent transcutaneous spinal cord stimulation using various electrode montages, target spinal level stimulation, and single- and paired-pulse …

Machine Learning To Optimize Use Of Natriuretic Peptides In The Diagnosis Of Acute Heart Failure, Dimitrios Doudesis, Kuan Ken Lee, Mohamed Anwar, Adam J. Singer, Judd Hollander, Md, Camille Chenevier-Gobeaux, Yann-Erick Claessens, Desiree Wussler, Dominic Weil, Nikola Kozhuharov, Ivo Strebel, Zaid Sabti, Christopher Defilippi, Stephen Seliger, Evandro Tinoco Mesquita, Jan C. Wiemer, Martin Möckel, Joel Coste, Patrick Jourdain, Komukai Kimiaki, Michihiro Yoshimura, Irwani Ibrahim, Shirley Beng Suat Ooi, Win Sen Kuan, Alfons Gegenhuber, Thomas Mueller, Olivier Hanon, Jean-Sébastien Vidal, Peter Cameron, Louisa Lam, Ben Freedman, Tommy Chung, Sean P. Collins, Christopher J Lindsell, David E. Newby, Alan G. Japp, Anoop S V Shah, Humberto Villacorta, A Mark Richards, John J V Mcmurray, Christian Mueller, James L. Januzzi, Nicholas L. Mills

Department of Emergency Medicine Faculty Papers

AIMS: B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) testing are guideline-recommended to aid in the diagnosis of acute heart failure. Nevertheless, the diagnostic performance of these biomarkers is uncertain.

METHODS AND RESULTS: We performed a systematic review and individual patient-level data meta-analysis to evaluate the diagnostic performance of BNP and MR-proANP. We subsequently developed and externally validated a decision-support tool called CoDE-HF that combines natriuretic peptide concentrations with clinical variables using machine learning to report the probability of acute heart failure. Fourteen studies from 12 countries provided individual patient-level data in 8493 patients for BNP and 3899 …

Machine Learning To Optimize Use Of Natriuretic Peptides In The Diagnosis Of Acute Heart Failure, Dimitrios Doudesis, Kuan Ken Lee, Mohamed Anwar, Adam J. Singer, Judd E. Hollander, Camille Chenevier-Gobeaux, Yann-Erick Claessens, Desiree Wussler, Dominic Weil, Nikola Kozhuharov, Ivo Strebel, Zaid Sabti, Christopher Defilippi, Stephen Seliger, Evandro Tinoco Mesquita, Jan C. Wiemer, Martin Möckel, Joel Coste, Patrick Jourdain, Komukai Kimiaki, Michihiro Yoshimura, Irwani Ibrahim, Shirley Beng Suat Ooi, Win Sen Kuan, Alfons Gegenhuber, Thomas Mueller, Olivier Hanon, Jean-Sébastien Vidal, Peter Cameron, Louisa Lam, Ben Freedman, Tommy Chung, Sean P. Collins, Christopher J. Lindsell, David E. Newby, Alan G. Japp, Anoop S. V. Shah, Humberto Villacorta, A. Mark Richards, John J V Mcmurray, Christian Mueller, James L. Januzzi, Nicholas L. Mills, Gordon Moe, Carlos Fernando, Hanna K. Gaggin, Antoni Bayes-Genis, Roland Rj Van Kimmenade, Yigal Pinto, Joost H. W. Rutten, Anton H. Van Den Meiracker, Luna Gargani, Nicola R. Pugliese, Pemberton Christopher, Michael Neumaier, Michael Behnes, Ibrahim Akin, Michele Bombelli, Guido Grassi, Peiman Nazerian, Giovanni Albano, Philipp Bahrmann

Department of Emergency Medicine Faculty Papers

AIMS: B-type natriuretic peptide (BNP) and mid-regional pro-atrial natriuretic peptide (MR-proANP) testing are guideline-recommended to aid in the diagnosis of acute heart failure. Nevertheless, the diagnostic performance of these biomarkers is uncertain.

METHODS AND RESULTS: We performed a systematic review and individual patient-level data meta-analysis to evaluate the diagnostic performance of BNP and MR-proANP. We subsequently developed and externally validated a decision-support tool called CoDE-HF that combines natriuretic peptide concentrations with clinical variables using machine learning to report the probability of acute heart failure. Fourteen studies from 12 countries provided individual patient-level data in 8493 patients for BNP and 3899 …

Association Of Driving With Blood Delta-9-Tetrahydrocannabinol: A Systematic Review, Danial Behzad, Sampson Zhao, Reena Besa, Bruna Brands, Christine M. Wickens, Marilyn A. Huestis, Bernard Le Foll, Patricia Di Ciano

Institute of Emerging Health Professions Faculty Papers

IMPORTANCE: Driving under the influence of cannabis increases the risk of motor vehicle collisions. In some jurisdictions, deterrence rests on the ability to detect delta-9-tetrahydrocannabinol (THC) in blood. Recent evidence suggests that there may be a nuanced relationship of blood THC to driving.

OBJECTIVE: The purpose of this systematic review was to summarize all published papers investigating the presence of a linear relationship between blood THC and driving, primarily measured by simulated driving in the lab.

OUTCOMES: The main outcomes assessed included "weaving"/lateral control (eg, standard deviation of lateral position), speed, car following (following distance; coherence), reaction time, and overall …

Vasoactive Selection For Pediatric Septic Shock-Where To Begin?, Scott L. Weiss

Department of Pediatrics Faculty Papers

No abstract provided.

Addressing Frailty In Heart Failure: Essential Tools & Strategies For Occupational Therapists, Malachy Clancy, Phd, Otr/L, Bcpr

Department of Occupational Therapy Posters and Presentations

Learning Objectives

• Understand and describe the concept of frailty and its impact on occupational performance for patients with heart failure (HF).
• Identify comprehensive assessments that encompass physical, cognitive, and psychosocial domains to provide a holistic assessment of frailty.

Heterozygous Hereditary Vitamin D-Dependent Rickets Type 2a (Vddr2a) In A Patient Presenting With Pseudoarthrosis, Risa Goldberg, Gunjan Umarji, Serge Jabbour

Division of Endocrinology, Diabetes and Metabolic Diseases Faculty Papers

This case report is centered on an atypical presentation of Hereditary Vitamin D-dependent Rickets 2A (VDDR2A), a rare disorder caused by defects in the gene encoding the vitamin D receptor (VDR). While this disorder is primarily autosomal recessive in inheritance, this case demonstrates that a single heterozygous variant in the VDR gene could be linked to both phenotypic and laboratory manifestations of this condition. To understand the pathogenesis of this condition, one must know the typical roles of vitamin D, calcium, and parathyroid hormone (PTH) in maintaining homeostasis in the body. This case report focuses on the underlying pathogenesis of …

A Vomiting And Dyspneic Teenager, Janet Han, Do, Shireen Khan, Md

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

History of Present Illness

CHIEF COMPLAINT: Shortness of Breath

15 y/o female with no pertinent PMHx presents to the emergency department with shortness of breath onset 3 days ago. Patient is also reporting cough, congestion, sore throat, subjective fever and chills, myalgias, as well as nausea and vomiting. Today, she states she is so nauseous she has tried to force herself to throw up several times. Since then, she has been experiencing neck pain with movement. Patient is UTD with all her vaccines. Denies alcohol and drug use. Initially denies vaping/smoking; later states she has vaped daily until her symptoms’ …

Protecting Global Health Partnerships In The Era Of Destructive Nationalism, Maya Adam, Desiree Labeaud, Nokwanele Mbewu, Jennifer Gates, Randall Waechter, Mercy Borbor-Cordova, Lydiah Kibe, Sonia Alvarez, Annie Dori, Anil Bilimale, Meggie Mwoka, Jessica Deffler, Michele Spring, Avriel Diaz, Rachael Farquhar, Willy Dunbar, Comfort Phiri, Valerie Luzadis, Nicole Redvers, Cristina Alonso, Rosemary Rochford, Rachel Lowe, Kareem Coomansingh, Moses Laman, Rebeca Sultana, Sadie Ryan, Amaya Bustinduy, Anita Hargrave-Bouagnon, Shazia Ruybal-Pesántez, Zebedee Kerry, Trevor Kelebi, Samuel Mcewen, Leanne Robinson, Maritza Salazar Campo, Till Bärnighausen

Department of Family & Community Medicine Faculty Papers

No abstract provided.

3d-Printed Organ-Realistic Phantoms To Verify Quantitative Spect/Ct Accuracy For 177lu-Psma-617 Treatment Planning, Lydia J. Wilson, Sara Belko, Eric L. Gingold, Shuying Wan, Rachel Monane, Robert S. Pugliese, Firas Mourtada

Department of Radiation Oncology Faculty Papers

Background/Objectives: Accurate patient-specific dosimetry is essential for optimizing radiopharmaceutical therapy (RPT), but current tools lack validation in clinically realistic conditions. This work aimed to develop a workflow for designing and fabricating patient-derived, organ-realistic RPT phantoms and evaluate their feasibility for commissioning patient-specific RPT radioactivity quantification. Methods: We used computed tomographic (CT) and magnetic resonance (MR) imaging of representative patients, computer-aided design, and in-house 3D printing technology to design and fabricate anthropomorphic kidney and parotid phantoms with realistic organ spacing, anatomically correct orientation, and surrounding tissue heterogeneities. We evaluated the fabrication process via geometric verification (i.e., volume comparisons) and leak testing …

Molecular Subtyping Of Hypertensive Disorders Of Pregnancy, Michal Elovitz, Elaine Gee, Nathaniel Delaney-Busch, Alison Moe, Mitsu Reddy, Arkady Khodursky, Johnny La, Ilma Abbas, Kay Mekaru, Hunter Collins, Farooq Siddiqui, Rory Nolan, Rupsa Boelig, Daniel Kiefer, Pamela Simmons, George Saade, Antonio Saad, Ebony Carter, Thomas Mcelrath, Stephen Quake, Mark Depristo, Carrie Haverty, Manfred Lee, Eugeni Namsaraev, Vincenzo Berghella, Ai-Ris Collier, Antonia Frolova, Esther Park-Hwang, Luis Pacheco, Elizabeth Sutton, Maneesh Jain, Kara Rood, William A Grobman, Joseph Biggio, Cynthia Gyamfi-Bannerman, Arun Jeyabalan, Morten Rasmussen

Department of Obstetrics and Gynecology Faculty Papers

Hypertensive disorders of pregnancy (HDP), including preeclampsia, affect 1 in 6 pregnancies, are major contributors to maternal morbidity and mortality, yet lack precision medicine strategies. Analyzing transcriptomic data from a prospectively-collected diverse cohort (n = 9102), this study reveals distinct RNA subtypes in maternal blood, reclassifying clinical HDP phenotypes like early/late-onset preeclampsia. The placental gene PAPPA2 strongly predicts the most severe forms of preeclampsia in individuals without pre-existing high risk factors, months before symptoms, and its overexpression correlates with earlier delivery in a dose-dependent manner. Further, molecular subtypes characterized by immune genes are upregulated in less severe forms of HDP. …

Daily Acute Intermittent Hypoxia Elicits Age & Sex-Dependent Changes In Molecules Regulating Phrenic Motor Plasticity, Jayakrishnan Nair, Alexandria Marciante, Carter Lurk, Mia Kelly, Maclain Capron, Gordon Mitchell

Department of Physical Therapy Faculty Papers

Acute intermittent hypoxia (AIH) elicits a form of respiratory motor plasticity known as phrenic long-term facilitation (pLTF). Exposure to repetitive daily AIH (dAIH) enhances pLTF, a form of metaplasticity. Little is known concerning cellular mechanisms giving rise to dAIH-induced metaplasticity and the age-dependent sexual dimorphism of AIH associated pro-plasticity mRNA expression. To test if age, sex, and dAIH effects are associated with differential expression of molecules that regulate the Q- and S-pathways and their cross-talk interactions to phrenic motor facilitation, we analyzed key regulatory molecules in ventral spinal (C3-C5) homogenates from young (3-month) and middle-aged (12-month) male and female Sprague-Dawley …

Hickam’S Dictum Of The Great Vessels: Saddle Embolism And Dissection, Eric Wetzel, Do, Kyle Mohney, Do, Jessica Schumann, Do, Olubunmi Olarewaju, Do

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

History of Present Illness

Chief Complaint:
Shortness of breath

History of Present:
Illness A 66-year-old female with a past medical history of hypertension presents to the emergency department concerned for shortness of breath and palpitations. She reports her symptoms started abruptly while on a morning walk. She notes she took her home blood pressure medication this morning per her usual routine and had otherwise been feeling well. She describes feeling like she is having a “high grade panic attack”, similar to past panic attacks but with increased intensity. She denies associated weakness, numbness, chest pain, nausea, vomiting, or abdominal pain. …

Ototoxicity Monitoring: The Evolution Of A Protocol For Head And Neck Cancer Patients, Jena Patel, Jacob Beiriger, Kalena Liu, Zachary Urdang, Julia Croce, Molly Wolfson, Jacob Hulswit, Olivia Giglio, Jacob B. Hunter, Irina L. Middleton

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

OBJECTIVE: We evaluated an ototoxicity monitoring program (OMP) for improving audiologic follow-up in head and neck cancer (HNC) patients.

STUDY DESIGN: Retrospective cohort study.

SETTING: Tertiary academic center.

METHODS: Two hundred and forty patients were recommended for chemotherapy between January 2017 and June 2022. An OMP was implemented in March 2021; every patient received an audiology referral and was contacted to schedule a pretreatment audiogram. Patients were divided into pre-OMP and post-OMP cohorts. Main outcome measures included rates of pretreatment audiograms, posttreatment audiograms, posttreatment otologic symptoms, and hearing aid utilization.

RESULTS: There were 131 patients evaluated pre-OMP and 109 evaluated …

Targeted Ehr-Based Communication Of Diagnostic Uncertainty (Tecu) In The Emergency Department: Protocol For An Effectiveness Implementation Trial, Danielle M Mccarthy, Sara Malone, Dimitrios Papanagnou, Benjamin E Leiby, Amandy M B Doty, Phillip Watts, Rahul Yadav, Julia K Pugliese, Jonathan Woodworth, Tracy Esteves Camacho, Efrat Kean, Kristin L Rising

Department of Emergency Medicine Faculty Papers

BACKGROUND: At least 37 % emergency department (ED) patients are discharged without a definitive diagnosis, resulting in diagnostic uncertainty. Transitions of care are high-risk periods for patient safety, especially for patients discharged with diagnostic uncertainty. Effective communication between clinicians and patients improves these care transitions. Previous research developed tools to support high quality discharge in the setting of diagnostic uncertainty, including: a communication checklist, a physician training program, and a patient-facing information sheet.

METHODS: This study aims to enhance transitions for patients leaving the ED with diagnostic uncertainty through an electronic health record (EHR)-based strategy. The intervention, the Targeted EHR-based …

Structural Updates To The Implant And Refill Needle Of The Port Delivery Platform, Dante J. Pieramici, Peter A. Campochiaro, Margaret Chang, Ian Pearce, Carl D. Regillo, Shamika Gune, Nancy Holekamp, Carlos Quezada-Ruiz, Shrirang V. Ranade, Natasha Singh, Geoffrey Wise, Joshua Horvath

Wills Eye Hospital Papers

PURPOSE: The purpose of this study was to report the impact of component-level changes and manufacturing process improvements on septum durability in the ocular implant of the Port Delivery Platform (PD-P), more commonly known as the Port Delivery System with ranibizumab (PDS) with its current formulation.

METHODS: Laboratory tests were conducted to determine (1) the bond strength of the septum to the overmold, (2) the amount of force utilized for the refill needle to puncture the septum, and (3) septum durability over 50 years. To simulate multiple refill-exchanges over long-term clinical use, implants were aged at elevated temperature in saline …

Pediatric And Congenital Cardiac Services: An Innovative And Empowering Approach To Global Training And Equitable Care, Wyman W. Lai, Dominique Vervoort, David Bradley, Antonio G. Cabrera, Casey Culbertson, Alejandro Floh, Saurabh K. Gupta, Babar S. Hasan, Adrian Holloway, Jeffrey P. Jacobs, Kathy J. Jenkins, R. K. Kumar, L.A. Larrazabal, Colin J. Mcmahon, Daniel J. Penny, Alistair Phillips, Emilio Quezada, Craig A. Sable, Shubhika Srivastava, Sandra L. Staveski, Patcharapong Suntharos, David F. Teitel, Betsy Tirado, Brian C. Tran, Bistra Zheleva, Liesl Zuhkle, Anthony C. Chang

Division of Cardiology Faculty Papers

Congenital heart disease is a leading cause of preventable death in children, with a disproportionate impact on low- and middle-income countries. Despite progress in treating congenital heart disease globally, significant challenges remain in accessing specialized cardiovascular care, particularly cardiac surgery, in low- and middle-income countries. This review examines current models of assistance and proposes a novel global training program to address these inequities. Key challenges identified include building program infrastructure, training health care providers, ensuring financial sustainability, and promoting local engagement. The proposed program, structured under a new international organization, will leverage emerging technologies to deliver accessible and rigorously assessed …