Medicine and Health Sciences Commons^™

Nocardiosis Of The Central Nervous System: A Rare Complication Of Covid Management?, Matthew Dimeglio, Hamadullah Shaikh, Jennifer Newman, Gustavo Vazsquez-Rubio

Division of Infectious Diseases and Environmental Medicine Faculty Papers

This case report examines a previously immunocompetent male that was treated with a prolonged course of corticosteroids for COVID pneumonia. He then returned with worsening headaches followed by flaccid paralysis of extremities due to cerebral and spinal cord abscesses secondary to Nocardia farcinica. A review of the literature on the mechanism of immunosuppression with COVID infection and corticosteroids is provided.

Standardizing Evaluation Of Patient-Specific 3d Printed Models In Surgical Planning: Development Of A Cross-Disciplinary Survey Tool For Physician And Trainee Feedback, Lauren Schlegel, Michelle Ho, M. Fields, Erik Backlund, Robert S. Pugliese, Kristy M. Shine

Department of Emergency Medicine Faculty Papers

Background: 3D printed models are becoming increasingly popular in healthcare as visual and tactile tools to enhance understanding of anatomy and pathology in medical trainee education, provide procedural simulation training, and guide surgical procedures. Patient-specific 3D models are currently being used preoperatively for trainee medical education in planning surgical approaches and intraoperatively to guide decision-making in several specialties. Our study group utilized a modified Delphi process to create a standardized assessment for trainees using patient-specific 3D models as a tool in medical education during pre-surgical planning.

Methods: A literature review was conducted to identify survey questions administered to clinicians in …

2022 James B. Erdmann Award Recipients

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Jefferson Center for Interprofessional Practice and Education (JCIPE) congratulates this year’s interprofessional education (IPE) and collaborative practice (CP) award winners and thanks them for all their efforts to support and advance this work on campus and beyond. Their contributions are immeasurable!

Reflections On Jcipe’S Interprofessional Palliative Care Program, Brian Donnelly Bsn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE’s Interprofessional Palliative Care Program is a semester-long learning collaborative in which small interprofessional student teams learn about the team-based provision of palliative care for persons with serious illness and at the end of life. Using the National Consensus Project’s Clinical Practice Guidelines for Quality Palliative Care as a framework, teams work collaboratively through case-based discussions and presentations. Additionally, participants have an opportunity to observe Jefferson’s Palliative Care Team’s interdisciplinary rounds and to shadow a Jefferson palliative care provider.

Curricular Revision And Assessment Of Undergraduate Interprofessional Education, Erin Choice Phd, Cscs, Shelene Thomas Pt, Dpt, Edd, Gcs, Fnap

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

College students who desire a career in the health professions, begin their discovery of professional scope through their undergraduate programs. Currently, there lacks uniformity in undergraduate curricula in knowledge, skills and behaviors necessary for collaborative practice in future healthcare systems (Aldriwesh et al., 2022).

Raising The Bar: Evolution Of A Statewide Interprofessional Education Program Following A 5-Year Outcomes Evaluation, Brittany J. Daulton Phd, Ms, Zachary A. Weber Pharmd, Bcps, Bcacp, Cdces, Fash, April D. Newton Pt, Dpt, Ma, Fnap, Laura Romito Dds, Ms, Mba, Fnap, Barbara Manz Friesth Phd, Rn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Indiana University is a complex campus system across the state of Indiana. IU-Bloomington hosts the main campus with nearly 50,000 students, while Indiana University-Purdue University Indianapolis (IUPUI) has approximately 30,000. Additionally, there are seven regional medical school campuses located throughout the state in Gary, Evansville, Fort Wayne, Muncie, South Bend, Terre Haute, and West Lafayette.

Meet An Ipe Student Champion From Thomas Jefferson University, Meredith Gray Ost

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I had the opportunity to work with two JCIPE programs as a Graduate Assistant – Team Care Planning (TCP) and Enhancing Services for Homeless Populations (ESHP). Team Care Planning involves interprofessional groups of students participating in a simulated discharge planning meeting with a standardized patient. For TCP, I analyzed data from simulation sessions to identify common themes that students discuss when reflecting on their simulation experience. I also worked with the Team Care Planning team to put together materials to market TCP to other universities. Enhancing Services for Homeless Populations is a virtual simulation program utilizing the program Second Life …

Meet An Ipe Faculty Champion From Thomas Jefferson University, Jeannette Kates Phd, Crnp, Agpcnp-Bc, Gnp-Bc

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

I have the privilege of working with JCIPE in several ways. I am currently faculty co-lead for Alzheimer’s Virtual Interprofessional Training (AVIT) and faculty lead for the new Interprofessional Palliative Care Program. Additionally, I have had the opportunity to participate in other JCIPE programs by facilitating for Introductory TeamSAFE and the Health Mentors Program.

Micro-Credentials In Ipe: The Ipe Path Of Distinction And Badger Programs In University Of Wisconsin-Madison, Hossein Khalili Bscn, Mscn, Phd, Fnap, Susan Wenker Pt, Phd, Laura Birkeland Ms, Cgc, Meghan Cotter Phd, Benjamin Weber Ma, Mb, (Ascp)Cm, Julia Schiller Spt, Roberta Rusch Mph

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

The UW CIPE Badger Program is a branch of the UW–Madison Badger program in which we provide focused IPE academic training, called IPE Badges, with fewer academic requirements than a typical degree and/or certificate program. IPE Badges are formal, virtual, micro-credentials issued to learners (students, faculty, staff, or practitioners) who participate in and successfully complete designated IPE offerings and activities at UW–Madison and its partners.

Jcipe Updates

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE Updates

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

We’re so excited to share this Spring/ Summer edition of our newsletter! As the academic year comes to a close, we look back on another year filled with ups and downs, incredible accomplishments and ongoing challenges. Life during the COVID-19 pandemic has changed. Relative widespread vaccination and declining mortality and hospitalization rates have allowed a slow return to prior routines and activities for many. Yet infection rates are still on the rise as we continue to mourn the lives lost to COVID in the U.S. and globally, and grapple with its prolonged impact. For many of us, COVID has highlighted …

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 12, Number 3, Spring/Summer 2022

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

In this Issue:

• Letter from the Editors
• JCIPE Update
• Micro-Credentials In IPE: The IPE Path of Distinction and Badger Programs in University of Wisconsin-Madison
• Meet an IEP Faculty Champion
• Meet an IPE Student Champion
• Raising the Bar: Evolution of a Statewide Interprofessional Education Program Following a 5-Year Outcomes Evaluation
• Curricular Revision and Assessment of Undergraduate Interprofessional Education
• Reflections on JCIPE's Interprofessional Palliative Care Program
• 2022 James B. Erdmann Award Recipients

A Genome-Wide Screen Identifies Pdpk1 As A Target To Enhance The Efficacy Of Mek1/2 Inhibitors, Weijia Cai, Nicole A. Wilski, Timothy J. Purwin, Megane Vernon, Manoela Tiago, Andrew E. Aplin

Department of Cancer Biology Faculty Papers

Melanomas frequently harbor activating NRAS mutations. However, limited advance has been made in developing targeted therapy options for NRAS mutant melanoma patients. MEK inhibitors (MEKi) show modest efficacy in the clinic and their actions need to be optimized. In this study, we performed a genome-wide CRISPR-Cas9-based screen and demonstrated that loss of Phosphoinositide-dependent kinase-1 (PDPK1) enhances the efficacy of MEKi. The synergistic effects of PDPK1 loss and MEKi was validated in NRAS mutant melanoma cell lines using pharmacological and molecular approaches. Combined PDPK1 inhibitors (PDPK1i) with MEKi suppressed NRAS mutant xenograft growth and induced gasdermin E-associated pyroptosis. In an immune-competent …

Grk2 Regulates Adp Signaling In Platelets Via P2y1 And P2y12., Xuefei Zhao, Matthew Cooper, James V Michael, Yanki Yarman, Aiden Baltz, J Kurt Chuprun, Walter J Koch, Steven E. Mckenzie, Maurizio Tomaiuolo, Timothy J Stalker, Li Zhu, Peisong Ma

Department of Medicine Faculty Papers

The critical role of G protein-coupled receptor kinase 2 (GRK2) in regulating cardiac function has been well documented for >3 decades. Targeting GRK2 has therefore been extensively studied as a novel approach to treating cardiovascular disease. However, little is known about its role in hemostasis and thrombosis. We provide here the first evidence that GRK2 limits platelet activation and regulates the hemostatic response to injury. Deletion of GRK2 in mouse platelets causes increased platelet accumulation after laser-induced injury in the cremaster muscle arterioles, shortens tail bleeding time, and enhances thrombosis in adenosine 5'-diphosphate (ADP)-induced pulmonary thromboembolism and in FeCl3-induced carotid …

A Qualitative Exploration Of The Functional, Social, And Emotional Impacts Of The Covid-19 Pandemic On People Who Use Drugs, Erin L Kelly, Megan K Reed, Kathryn M Schoenauer, Kelsey Smith, Kristina Scalia-Jackson, Sequoia Kay Hill, Erica Li, Lara Weinstein

Department of Family & Community Medicine Faculty Papers

Since 2020, people who use drugs (PWUD) experienced heightened risks related to drug supply disruptions, contamination, overdose, social isolation, and increased stress. This study explored how the lives of PWUD changed in Philadelphia over a one-year period. Using semi-structured interviews with 20 participants in a Housing First, low-barrier medication for opioid use (MOUD) program in Philadelphia, the effects of the first year of the COVID-19 pandemic on the daily lives, resources, functioning, substance use, and treatment of PWUD were explored. Interviews were analyzed using a combination of directed and conventional content analysis. Six overarching themes emerged during data analysis: (1) …

Implementation And Outcomes Of A Remote Hepatitis B Screening Program Designed To Overcome Covid-19 Pandemic-Related Disruptions To Community-Based Screenings For Asians In Greater Philadelphia: A Descriptive Study, Yoonhee P Ha, Yusha Sun, Jack Wilkinson, Sonia Wang, Lillian Chien, Marisa Wu, Evangeline Wang, Catherine Freeland

College of Population Health Faculty Papers

No abstract provided.

The Hearst Health Prize: The First Five Years, Alexa M. Waters, Alexis Skoufalos, Emily Frelick, Gregory Dorn, David B. Nash

Department of Family & Community Medicine Faculty Papers

The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. …

Feasibility Of The Transport Plus Intervention To Improve The Transitions Of Care For Patients Transported Home By Ambulance: A Non-Randomized Pilot Study, Kevin G Munjal, Sai Kaushik Yeturu, Hugh H Chapin, Nadir Tan, Diana Gregoriou, Daniela Garcia, Corita Grudzen, Ula Hwang, Barbara Morano, Hayley Neher, Ksenia Gorbenko, Glen Youngblood, Anjali Misra, Staley Dietrich, Cyndi Gonzalez, Giselle Appel, Erica Jacobs, Albert Siu, Lynne D Richardson

Student Papers, Posters & Projects

BACKGROUND: The growing population of patients over the age of 65 faces particular vulnerability following discharge after hospitalization or an emergency room visit. Specific areas of concern include a high risk for falls and poor comprehension of discharge instructions. Emergency medical technicians (EMTs), who frequently transport these patients home from the hospital, are uniquely positioned to aid in mitigating transition of care risks and are both trained and utilized to do so using the Transport PLUS intervention.

METHODS: Existing literature and focus groups of various stakeholders were utilized to develop two checklists: the fall safety assessment (FSA) and the discharge …

Development Of The Centrifugal Blood Pump For A Hybrid Continuous Flow Pediatric Total Artificial Heart: Model, Make, Measure, Carson S Fox, Thomas Palazzolo, Matthew Hirschhorn, Randy M Stevens, Joseph Rossano, Steven W Day, Vakhtang Tchantchaleishvili, Amy L Throckmorton

Department of Medicine Faculty Papers

Clinically-available blood pumps and total artificial hearts for pediatric patients continue to lag well behind those developed for adults. We are developing a hybrid, continuous-flow, magnetically levitated, pediatric total artificial heart (TAH). The hybrid TAH design integrates both an axial and centrifugal blood pump within a single, compact housing. The centrifugal pump rotates around the separate axial pump domain, and both impellers rotate around a common central axis. Here, we concentrate our development effort on the centrifugal blood pump by performing computational fluid dynamics (CFD) analysis of the blood flow through the pump. We also conducted transient CFD analyses (quasi-steady …

Impact Of The Time To Surgery On Visual Outcomes For Rhegmatogenous Retinal Detachment Repair: A Meta-Analysis, Amirthan Sothivannan, Arshia Eshtiaghi, Arjan S. Dhoot, Marko M. Popovic, Sunir J. Garg, Peter J. Kertes, Rajeev H. Muni

Wills Eye Hospital Papers

PURPOSE: To determine the relationship between time from symptom onset or presentation to repair and visual outcomes for macula-on and macula-off rhegmatogenous retinal detachment (RRD).

DESIGN: Meta-analysis.

METHODS: We searched MEDLINE, EMBASE, and Cochrane Library for randomized controlled trials and observational studies comparing best-corrected visual acuity (BCVA) based on time to RRD repair. Study identifiers, baseline characteristics, intervention characteristics, and visual outcomes were extracted. We conducted a random effects meta-analysis. Sensitivity analyses included leave-1-out and influence analyses. Primary outcomes included mean difference (MD) in final BCVA, MD between preoperative and final BCVA (∆BCVA), and relative risk of final BCVA24 hours. …

A Systematic Review Of Reproductive Counseling In Cases Of Parental Constitutional Reciprocal Translocation (9;22) Mimicking Bcr-Abl1, Zimeng Gao, Stephanie M Rice, Sascha Wodoslawsky, Sara C Long, Zi-Xuan Wang, Mehnoosh Torkzaban, Ana Milena Angarita Africano, Jinglan Liu, Huda B Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

We aim to determine the spectrum of cytogenetic abnormalities and outcomes in unbalanced offspring of asymptomatic constitutional balanced t(9;22) carriers through a systematic literature review. We also include a case of a constitutional balanced t(9;22) carrier from our institution. Among the 16 balanced t(9;22) carriers in our review, 13 were maternal and 3 were paternal. Of the 15 unbalanced translocation cases identified, 13 were live births, one was a missed abortion, and one resulted in pregnancy termination. The spectrum of established syndromes reported among the live births was the following: trisomy 9p syndrome (6/13), dual trisomy 9p and DiGeorge syndrome …

Outcomes Following Abiraterone Versus Enzalutamide For Prostate Cancer: A Scoping Review, Yash B, Shah, Amy L. Shaver, Jacob Beiriger, Sagar Mehta, Nikita Nikita, William Kevin Kelly, Stephen J. Freedland, Grace Lu-Yao

Department of Medical Oncology Faculty Papers

Abiraterone acetate (AA) and enzalutamide (ENZ) are commonly used for metastatic prostate cancer. It is unclear how their outcomes and toxicities vary with patient-specific factors because clinical trials typically exclude patients with significant comorbidities. This study aims to fill this knowledge gap and facilitate informed treatment decision making. A registered protocol utilizing PRISMA scoping review methodology was utilized to identify real-world studies. Of 433 non-duplicated publications, 23 were selected by three independent reviewers. ENZ offered a faster and more frequent biochemical response (30-50% vs. 70-75%), slowed progression (HR 0.66; 95% CI 0.50-0.88), and improved overall survival versus AA. ENZ was …

Association Between Social Vulnerability Index And Cardiovascular Disease: A Behavioral Risk Factor Surveillance System Study, Vardhmaan Jain, Mahmoud Al Rifai, Safi U Khan, Ankur Kalra, Fatima Rodriguez, Zainab Samad, Yashashwi Pokharel, Arunima Misra, Laurence S Sperling, Jamal S Rana, Waqas Ullah, Ankit Medhekar, Salim S Virani

Division of Cardiology Faculty Papers

Background Social and environmental factors play an important role in the rising health care burden of cardiovascular disease. The Centers for Disease Control and Prevention developed the Social Vulnerability Index (SVI) from US census data as a tool for public health officials to identify communities in need of support in the setting of a hazardous event. SVI (ranging from a least vulnerable score of 0 to a most vulnerable score of 1) ranks communities on 15 social factors including unemployment, minoritized groups status, and disability, and groups them under 4 broad themes: socioeconomic status, housing and transportation, minoritized groups, and …

A Scoping Review Of Penile Implant Biofilms-What Do We Know And What Remains Unknown?, Joon Yau Leong, Courtney E Capella, Maria J D'Amico, Selin Isguven, Caroline Purtill, Priscilla Machado, Lauren J Delaney, Gerard D Henry, Noreen J Hickok, Flemming Forsberg, Paul H Chung

Department of Urology Faculty Papers

Background: Penile prosthesis (PP) is a gold standard for treatment of erectile dysfunction given its reliability and efficacy. Infection remains the most feared complication of prosthetic surgery, which usually results in device removal, and places a significant economic burden on the healthcare system. While biofilms have shown to support the persistence of microorganisms, the degree by which this matrix is truly pathogenic remains unknown given its high prevalence even in asymptomatic patients. We aim to review and summarize the current literature pertaining to biofilm formation in the setting of PP surgeries in clinically infected and non-infected cases.

Methods: Searches were …

Ondansetron To Reduce Neonatal Opioid Withdrawal Severity: A Randomized Clinical Trial, Gary Peltz, Lauren M. Jansson, Susan Adeniyi-Jones, Carol Cohane, David Drover, Steven Shafer, Meiyue Wang, Manhong Wu, Balaji Govindaswami, Priya Jegatheesan, Cynthia Argani, Salwa Kahn, Walter K. Kraft

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Objective
To determine if treatment with a 5-HT3 antagonist (ondansetron) reduces need for opioid therapy in infants at risk for neonatal opioid withdrawal syndrome (NOWS).

Study Design
A multicenter, randomized, placebo controlled, double blind clinical trial of ninety (90) infants. The intervention arms were intravenous ondansetron or placebo during labor followed by a daily dose of ondansetron or placebo in infants for five days.

Results
Twenty-two (49%) ondansetron-treated and 26 (63%) placebo-treated infants required pharmacologic treatment (p>0.05). The Finnegan score was lower in the ondansetron-treated group (4.6 vs. 5.6, p=0.02). A non-significant trend was noted for the duration of …

A Word From The Writing Team (August 2022), Pam Walter, Mfa, Liz Declan, Ma, Mfa

A Word From the Writing Team (Newsletter)

This issue includes:

• Upcoming Workshops
• Writing Opportunity
• Summer's End

Acute Effects Of Percussive Therapy On The Posterior Shoulder Muscles Differ Based On The Athlete's Soreness Response, Jack H Trainer, Matthew Pascarella, Ryan W. Paul, Stephen J. Thomas

Department of Exercise Science Faculty Papers

Background: Percussive therapy is hypothesized to speed recovery by delivering gentle, rhythmic pulses to soft tissue. However, patients often present with a differential soreness response after percussive therapy, which may lead to altered clinical outcomes.

Purpose: To compare the acute effects of percussion therapy on passive range of motion (ROM) and tissue-specific ultrasound measures (pennation angle [PA] and muscle thickness [MT]) between healthy individuals responding positively vs. negatively to percussive therapy performed on the dominant arm posterior rotator cuff.

Study design: Cross-sectional laboratory study.

Methods: Fifty-five healthy individuals were assessed on a subjective soreness scale before and after a five-minute …

Household Transmission Of Group A Streptococcus Necrotizing Fasciitis., Michael Markowitz, Stephanie Kwan, Jonas Matzon

Department of Orthopaedic Surgery Faculty Papers

A healthy 40-year-old woman was diagnosed with necrotizing fasciitis 2 days after her husband's death from the same infectious process. Prompt identification and immediate surgical intervention prevented a similar result in this patient. Additional investigation into both patients' medical records found the inciting organism to be group A streptococcus. Although the exact mechanism of inoculation is unknown, the spread of this infection within a household prompts the question of whether antibiotic prophylaxis should be given among close contacts in future cases of necrotizing fasciitis.

The Number Of Shoulder And Elbow Questions On The Orthopedic In-Training Examination Is Increasing With Greater Emphasis On Critical Thinking Over Recall, Suleiman Y. Sudah, Robert D. Faccone, Christopher R. Michel, Christopher N. Dijanic, Daniel J. Kerrigan, Mariano E. Menendez, Surena Namdari, Allen D. Nicholson

Rothman Institute Papers

Background: It is critical for orthopedic surgery residents and residency programs to have a current understanding of the content and resources utilized by the Orthopedic In-Training Examination (OITE) to continuously guide study and educational efforts. This study presents an updated analysis of the shoulder and elbow section of the OITE. Methods: All OITE questions, answers, and references from 2013 to 2019 were reviewed. The number of shoulder and elbow questions per year was recorded, and questions were analyzed for topic, imaging modalities, cognitive taxonomy, and references. We compared our data to the results of a previous study that analyzed shoulder …

Mortality Among Patients With Covid-19 And Different Interstitial Lung Disease Subtypes: A Multicenter Cohort Study., Joy Zhao, Brandon Metra, Gautam George, Jesse Roman, Joseph Mallon, Baskaran Sundaram, Michael Li, Ross Summer

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

No abstract provided.