Medicine and Health Sciences Commons^™

The Relationship Between Vitamin C Or Thiamine Levels And Outcomes For Severe Sepsis Patients Admitted To The Icu., Nandan Prasad, Anne V. Grossestreuer, Nuala J. Meyer, Sarah M. Perman, Mark E. Mikkelsen, Judd Hollander, David F. Gaieski

Department of Emergency Medicine Faculty Papers

Preliminary data have produced conflicting results regarding whether initial vitamin C levels in patients with severe sepsis correlate with mortality outcomes. We hypothesized that low plasma ascorbic acid or thiamine levels in severe sepsis patients admitted from the Emergency Department (ED) to the Intensive Care Unit (ICU) would be associated with increased mortality and an increased incidence of shock. Retrospective analysis of a prospective database of severe sepsis patients admitted to the ICU at an urban, academic medical center. Ascorbic acid and thiamine levels were analyzed in relation to survivors vs. non-survivors and shock vs. non-shock patients. 235 patients were …

Rnase Κ Promotes Robust Pirna Production By Generating 2',3'-Cyclic Phosphate-Containing Precursors, Megumi Shigematsu, Takuya Kawamura, Keisuke Morichika, Natsuko Izumi, Takashi Kiuchi, Shozo Honda, Venetia Pliatsika, Ryuma Matsubara, Isidore Rigoutsos, Susumu Katsuma, Yukihide Tomari, Yohei Kirino

Computational Medicine Center Faculty Papers

In animal germlines, PIWI proteins and the associated PIWI-interacting RNAs (piRNAs) protect genome integrity by silencing transposons. Here we report the extensive sequence and quantitative correlations between 2′,3′-cyclic phosphate-containing RNAs (cP-RNAs), identified using cP-RNA-seq, and piRNAs in the Bombyx germ cell line and mouse testes. The cP-RNAs containing 5′-phosphate (P-cP-RNAs) identified by P-cP-RNA-seq harbor highly consistent 5′-end positions as the piRNAs and are loaded onto PIWI protein, suggesting their direct utilization as piRNA precursors. We identified Bombyx RNase Kappa (BmRNase κ) as a mitochondria-associated endoribonuclease which produces cP-RNAs during piRNA biogenesis. BmRNase κ-depletion elevated transposon levels and disrupted a piRNA-mediated …

Genomic Variability In The Survival Motor Neuron Genes (Smn1 And Smn2): Implications For Spinal Muscular Atrophy Phenotype And Therapeutics Development, Matthew E R Butchbach

Department of Pediatrics Faculty Papers

Spinal muscular atrophy (SMA) is a leading genetic cause of infant death worldwide that is characterized by loss of spinal motor neurons leading to muscle weakness and atrophy. SMA results from the loss of survival motor neuron 1 (SMN1) gene but retention of its paralog SMN2. The copy numbers of SMN1 and SMN2 are variable within the human population with SMN2 copy number inversely correlating with SMA severity. Current therapeutic options for SMA focus on increasing SMN2 expression and alternative splicing so as to increase the amount of SMN protein. Recent work has demonstrated that not all …

Standardizing Definitions Of Hematopoietic Recovery, Graft Rejection, Graft Failure, Poor Graft Function, And Donor Chimerism In Allogeneic Hematopoietic Cell Transplantation: A Report On Behalf Of The American Society For Transplantation And Cellular Therapy., Mohamed A. Kharfan-Dabaja, Ambuj Kumar, Ernesto Ayala, Mahmoud Aljurf, Taiga Nishihori, Rebecca Marsh, Lauri M. Burroughs, Navneet Majhail, A. Samer Al-Homsi, Zaid S. Al-Kadhimi, Merav Bar, Alice Bertaina, Jaap J. Boelens, Richard Champlin, Sonali Chaudhury, Zachariah Defilipp, Bhagirathbhai Dholaria, Areej El-Jawahri, Suzanne Fanning, Ellen Fraint, Usama Gergis, Sergio Giralt, Betty K. Hamilton, Shahrukh K. Hashmi, Biljana Horn, Yoshihiro Inamoto, David A. Jacobsohn, Tania Jain, Laura Johnston, Abraham S. Kanate, Ankit Kansagra, Adetola Kassim, Leslie S. Kean, Carrie L. Kitko, Jessica Knight-Perry, Joanne Kurtzberg, Hien Liu, Margaret L. Macmillan, Zahra Mahmoudjafari, Marco Mielcarek, Mohamad Mohty, Arnon Nagler, Eneida Nemecek, Timothy S. Olson, Betul Oran, Miguel-Angel Perales, Susan E. Prockop, Michael A. Pulsipher, Iskra Pusic, Marcie L. Riches, Cesar Rodriguez, Rizwan Romee, Gabriela Rondon, Ayman Saad, Nina Shah, Peter J. Shaw, Shalini Shenoy, Jorge Sierra, Julie Talano, Michael R. Verneris, Paul Veys, John E. Wagner, Bipin N. Savani, Mehdi Hamadani, Paul A. Carpenter

Department of Medical Oncology Faculty Papers

Allogeneic hematopoietic cell transplantation (allo-HCT) is potentially curative for certain hematologic malignancies and nonmalignant diseases. The field of allo-HCT has witnessed significant advances, including broadening indications for transplantation, availability of alternative donor sources, less toxic preparative regimens, new cell manipulation techniques, and novel GVHD prevention methods, all of which have expanded the applicability of the procedure. These advances have led to clinical practice conundrums when applying traditional definitions of hematopoietic recovery, graft rejection, graft failure, poor graft function, and donor chimerism, because these may vary based on donor type, cell source, cell dose, primary disease, graft-versus-host disease (GVHD) prophylaxis, and …

3d Single Cell Scale Anatomical Map Of Sex-Dependent Variability Of The Rat Intrinsic Cardiac Nervous System., Clara Leung, Shaina Robbins, Alison Moss, Maci Heal, Mahyar Osanlouy, Richard Christie, Navid Farahani, Corey Monteith, Jin Chen, Peter Hunter, Susan Tappan, Rajanikanth Vadigepalli, Zixi Jack Cheng, James S. Schwaber

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

We developed and analyzed a single cell scale anatomical map of the rat intrinsic cardiac nervous system (ICNS) across four male and three female hearts. We find the ICNS has a reliable structural organizational plan across individuals that provide the foundation for further analyses of the ICNS in cardiac function and disease. The distribution of the ICNS was evaluated by 3D visualization and data-driven clustering. The pattern, distribution, and clustering of ICNS neurons across all male and female rat hearts is highly conserved, demonstrating a coherent organizational plan where distinct clusters of neurons are consistently localized. Female hearts had fewer …

Characterization Of Hnrnpa1 Mutations Defines Diversity In Pathogenic Mechanisms And Clinical Presentation., Danique Beijer, Hong Joo Kim, Lin Guo, Kevin O'Donovan, Inès Mademan, Tine Deconinck, Kristof Van Schil, Charlotte M Fare, Lauren E Drake, Alice F Ford, Andrzej Kochański, Dagmara Kabzińska, Nicolas Dubuisson, Peter Van Den Bergh, Nicol C Voermans, Richard Jlf Lemmers, Silvère M Van Der Maarel, Devon Bonner, Jacinda B Sampson, Matthew T Wheeler, Anahit Mehrabyan, Steven Palmer, Peter De Jonghe, James Shorter, J Paul Taylor, Jonathan Baets

Department of Biochemistry and Molecular Biology Faculty Papers

Mutations in HNRNPA1 encoding heterogeneous nuclear ribonucleoprotein (hnRNP) A1 are a rare cause of amyotrophic lateral sclerosis (ALS) and multisystem proteinopathy (MSP). hnRNPA1 is part of the group of RNA-binding proteins (RBPs) that assemble with RNA to form RNPs. hnRNPs are concentrated in the nucleus and function in pre-mRNA splicing, mRNA stability, and the regulation of transcription and translation. During stress, hnRNPs, mRNA, and other RBPs condense in the cytoplasm to form stress granules (SGs). SGs are implicated in the pathogenesis of (neuro-)degenerative diseases, including ALS and inclusion body myopathy (IBM). Mutations in RBPs that affect SG biology, including FUS, …

A Single Dose Of Replication-Competent Vsv-Vectored Vaccine Expressing Sars-Cov-2 S1 Protects Against Virus Replication In A Hamster Model Of Severe Covid-19., Delphine C. Malherbe, Drishya Kurup, Christoph Wirblich, Adam J. Ronk, Chad Mire, Natalia Kuzmina, Noor Shaik, Sivakumar Periasamy, Matthew A. Hyde, Julie M. Williams, Pei-Yong Shi, Matthias J. Schnell, Alexander Bukreyev

Department of Microbiology and Immunology Faculty Papers

The development of effective countermeasures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent responsible for the COVID-19 pandemic, is a priority. We designed and produced ConVac, a replication-competent vesicular stomatitis virus (VSV) vaccine vector that expresses the S1 subunit of SARS-CoV-2 spike protein. We used golden Syrian hamsters as animal models of severe COVID-19 to test the efficacy of the ConVac vaccine. A single vaccine dose elicited high levels of SARS-CoV-2 specific binding and neutralizing antibodies; following intranasal challenge with SARS-CoV-2, animals were protected from weight loss and viral replication in the lungs. No enhanced pathology was observed …

Developing Standardized Patient-Based Cases For Communication Training: Lessons Learned From Training Residents To Communicate Diagnostic Uncertainty., Dimitrios Papanagnou, Matthew R Klein, Xiao Chi Zhang, Kenzie A Cameron, Amanda Doty, Danielle M Mccarthy, Kristin L. Rising, David H Salzman

Department of Emergency Medicine Faculty Papers

Health professions education has benefitted from standardized patient (SP) programs to develop and refine communication and interpersonal skills in trainees. Effective case design is essential to ensure an SP encounter successfully meets learning objectives that are focused on communication skills. Creative, well-designed case scenarios offer learners the opportunity to engage in complex patient encounters, while challenging them to address the personal and emotional contexts in which their patients are situated. Therefore, prior to considering the practical execution of the patient encounter, educators will first need a clear and structured strategy for writing, organizing, and developing cases. The authors reflect on …

Exploiting The Power Of Information In Medical Education., William B. Cutrer, W. Anderson Spickard, Marc M. Triola, Bradley L. Allen, Nathan Spell, Steven K. Herrine, John L. Dalrymple, Paul N. Gorman, Kimberly D. Lomis

Division of Gastroenterology and Hepatology Faculty Papers

The explosion of medical information demands a thorough reconsideration of medical education, including what we teach and assess, how we educate, and whom we educate. Physicians of the future will need to be self-aware, self-directed, resource-effective team players who can synthesize and apply summarized information and communicate clearly. Training in metacognition, data science, informatics, and artificial intelligence is needed. Education programs must shift focus from content delivery to providing students explicit scaffolding for future learning, such as the Master Adaptive Learner model. Additionally, educators should leverage informatics to improve the process of education and foster individualized, precision education. Finally, attributes …

Pre-Operative Fluid Resuscitation In The Emergency General Surgery Septic Patient: Does It Really Matter?, Benjamin Moran, Erin Major, Joseph A Kufera, Samuel A Tisherman, Jose Diaz

Department of Emergency Medicine Faculty Papers

OBJECTIVE: Emergency general surgery (EGS) patients presenting with sepsis remain a challenge. The Surviving Sepsis Campaign recommends a 30 mL/kg fluid bolus in these patients, but recent studies suggest an association between large volume crystalloid resuscitation and increased mortality. The optimal amount of pre-operative fluid resuscitation prior to source control in patients with intra-abdominal sepsis is unknown. This study aims to determine if increasing volume of resuscitation prior to surgical source control is associated with worsening outcomes.

METHODS: We conducted an 8-year retrospective chart review of EGS patients undergoing surgery for abdominal sepsis within 24 h of admission. Patients in …

Virchow At 200 And Lown At 100 - Physicians As Activists., Salvatore Mangione, Mark L. Tykocinski

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

No abstract provided.

Global Initiative For Asthma (Gina): What’S New In Gina 2021?, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Distinct Cortical Systems Reinstate The Content And Context Of Episodic Memories., James E. Kragel, Youssef Ezzyat, Bradley C. Lega, Michael R. Sperling, Gregory A. Worrell, Robert E. Gross, Barbara C. Jobst, Sameer A. Sheth, Kareem A. Zaghloul, Joel M. Stein, Michael J. Kahana

Department of Neurology Faculty Papers

Episodic recall depends upon the reinstatement of cortical activity present during the formation of a memory. Evidence from functional neuroimaging and invasive recordings in humans suggest that reinstatement organizes our memories by time or content, yet the neural systems involved in reinstating these unique types of information remain unclear. Here, combining computational modeling and intracranial recordings from 69 epilepsy patients, we show that two cortical systems uniquely reinstate the semantic content and temporal context of previously studied items during free recall. Examining either the posterior medial or anterior temporal networks, we find that forward encoding models trained on the brain's …

Lncrna Nonhsat069381 And Nonhsat140844 Increase In Aging Human Blood, Regulating Cardiomyocyte Apoptosis., Jinyang Zhao, Xiaolong Lin, Haoxuan Sun, Donghui Zhao, Qin Ma, Wayne Bond Lau, Zichao Cheng, Fanqi Li, Jinghua Liu, Qian Fan

Department of Emergency Medicine Faculty Papers

Aging augments postischemic apoptosis via incomplete mechanisms. Our previous animal study suggests that in addition to proapoptotic effects, lncRNAs also exert antiapoptotic effects in cardiomyocytes. However, whether this unexpected phenomenon exists in humans is unknown. In the present study, we investigated the relationship between aging and apoptosis regulation in human blood samples and confirmed their role by utilizing the cardiomyocyte lines (AC16 cells). Human blood samples were collected from 20 pairs of older adult and young volunteers. Age-different apoptotic regulatory lncRNAs and miRNAs were identified by microarray and bioinformatics analysis. The results indicated that lncRNA (NONHSAT069381 and NONHSAT140844) and miRNA …

Patient Resilience Has Moderate Correlation With Functional Outcomes, But Not Satisfaction, After Primary Unilateral Total Knee Arthroplasty., Amer Haffar, Sean Bryan, Marc Harwood, Jess H. Lonner

Rothman Institute Papers

Background: As many as 20% of patients who undergo total knee arthroplasty (TKA) are dissatisfied. Psychological factors have been shown to play a role in outcomes after TKA. The purpose of this study was to investigate the impact of patient resilience on functional outcomes and satisfaction after primary unilateral TKA.

Methods: Eighty-six patients who underwent primary unilateral TKA by a single surgeon were studied. Primary outcomes were the Brief Resilience Scale (BRS), mental health component of the Veterans Rand 12-Item Health Survey (VR-12 MCS), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement, and New Knee Society Score. Correlations between …

Caregiver Health-Related Quality Of Life, Burden, And Patient Outcomes In Ambulatory Advanced Heart Failure: A Report From Revival., Nisha A. Gilotra, Salpy V. Pamboukian, Maria Mountis, Shawn W. Robinson, Michelle Kittleson, Keyur B. Shah, Rhondalyn C. Forde-Mclean, Donald C. Haas, Douglas A. Horstmanshof, Ulrich P. Jorde, Stuart D. Russell, Wendy C. Taddei-Peters, Neal Jeffries, Shokoufeh Khalatbari, Catherine A. Spino, Blair Richards, Matheos Yosef, Douglas L. Mann, Garrick C. Stewart, Keith D. Aaronson, Kathleen L. Grady

Abington Jefferson Health Papers

Background

Heart failure (HF) imposes significant burden on patients and caregivers. Longitudinal data on caregiver health‐related quality of life (HRQOL) and burden in ambulatory advanced HF are limited.

Methods and Results

Ambulatory patients with advanced HF (n=400) and their participating caregivers (n=95) enrolled in REVIVAL (Registry Evaluation of Vital Information for VADs [Ventricular Assist Devices] in Ambulatory Life) were followed up for 24 months, or until patient death, left ventricular assist device implantation, heart transplantation, or loss to follow‐up. Caregiver HRQOL (EuroQol Visual Analog Scale) and burden (Oberst Caregiving Burden Scale) did not change significantly from baseline to follow‐up. At …

Retinoids As Chemo-Preventive And Molecular-Targeted Anti-Cancer Therapies., Victoria O. Hunsu, Caroline O.B. Facey, Jeremy Z. Fields, Bruce M. Boman

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Retinoic acid (RA) agents possess anti‐tumor activity through their ability to induce cellular differentiation. However, retinoids have not yet been translated into effective systemic treatments for most solid tumors. RA signaling is mediated by the following two nuclear retinoic receptor subtypes: the retinoic acid receptor (RAR) and the retinoic X receptor (RXR), and their isoforms. The identification of mutations in retinoid receptors and other RA signaling pathway genes in human cancers offers opportunities for target discovery, drug design, and personalized medicine for distinct molecular retinoid subtypes. For example, chromosomal translocation involving RARA occurs in acute promyelocytic leukemia (APL), and all‐trans …

Here Comes The Sun … For Retinoblastoma, Carol L Shields, Jerry A Shields

Wills Eye Hospital Papers

No abstract provided.

A Single Cell Transcriptomics Map Of Paracrine Networks In The Intrinsic Cardiac Nervous System., Alison Moss, Shaina Robbins, Sirisha Achanta, Lakshmi Kuttippurathu, Scott Turick, Sean Nieves, Peter Hanna, Elizabeth H. Smith, Donald B. Hoover, Jin Chen, Zixi Jack Cheng, Jeffrey L. Ardell, Kalyanam Shivkumar, James S. Schwaber, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

We developed a spatially-tracked single neuron transcriptomics map of an intrinsic cardiac ganglion, the right atrial ganglionic plexus (RAGP) that is a critical mediator of sinoatrial node (SAN) activity. This 3D representation of RAGP used neuronal tracing to extensively map the spatial distribution of the subset of neurons that project to the SAN. RNA-seq of laser capture microdissected neurons revealed a distinct composition of RAGP neurons compared to the central nervous system and a surprising finding that cholinergic and catecholaminergic markers are coexpressed, suggesting multipotential phenotypes that can drive neuroplasticity within RAGP. High-throughput qPCR of hundreds of laser capture microdissected …

Ketamine In The Past, Present, And Future: Mechanisms, Metabolites, And Toxicity., Eric S. Schwenk, Basant Pradhan, Rohit Nalamasu, Lucas Stolle, Irving W. Wainer, Michael Cirullo, Alexander Olsen, Joseph V. Pergolizzi, Marc C. Torjman, Eugene R. Viscusi

Department of Anesthesiology Faculty Papers

PURPOSE OF REVIEW: While ketamine's analgesia has mostly been attributed to antagonism of N-methyl-D-aspartate receptors, evidence suggests multiple other pathways are involved in its antidepressant and possibly analgesic activity. These mechanisms and ketamine's role in the nociplastic pain paradigm are discussed. Animal studies demonstrating ketamine's neurotoxicity have unclear human translatability and findings from key rodent and human studies are presented.

RECENT FINDINGS: Ketamine's metabolites, and (2R,6R)-hydroxynorketamine in particular, may play a greater role in its clinical activity than previously believed. The activation of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) and the mammalian target of rapamycin by ketamine are mechanisms that are still being …

N-Acetyl Cysteine Administration Affects Cerebral Blood Flow As Measured By Arterial Spin Labeling Mri In Patients With Multiple Sclerosis., Shiva Shahrampour, Justin Heholt, Andrew Wang, Faezeh Vedaei, Feroze B. Mohamed, Mahdi Alizadeh, Ze Wang, George Zabrecky, Nancy Wintering, Anthony J. Bazzan, Thomas P. Leist, Daniel A. Monti, Andrew B. Newberg

Department of Radiology Faculty Papers

Background: The purpose of this study was to explore if administration of N-acetyl-cysteine (NAC) in patients with multiple sclerosis (MS) resulted in altered cerebral blood flow (CBF) based on Arterial Spin Labeling (ASL) magnetic resonance imaging (MRI).

Methods: Twenty-three patients with mild to moderate MS, (17 relapsing remitting and 6 primary progressive) were randomized to either NAC plus standard of care (N = 11), or standard of care only (N = 12). The experimental group received NAC intravenously (50 mg/kg) once per week and orally (500mg 2x/day) the other six days. Patients in both groups were evaluated initially and after …

The Effect Of Mindfulness Meditation On Sleep Quality, Crystal Gonzalez, Russell Souders

Abington Jefferson Health Nurse Residency Posters

No abstract provided.

Inhibitory Molecules Pd-1, Cd73 And Cd39 Are Expressed By Cd8+ T Cells In A Tissue-Dependent Manner And Can Inhibit T Cell Responses To Stimulation, Corinne J. Smith, Christopher M. Snyder

Department of Microbiology and Immunology Faculty Papers

The salivary gland is an important tissue for persistence and transmission of multiple viruses. Previous work showed that salivary gland tissue-resident CD8+ T cells elicited by viruses were poorly functional ex vivo. Using a model of persistent murine cytomegalovirus (MCMV) infection, we now show that CD8+ T cells in the salivary gland and other non-lymphoid tissues of mice express multiple molecules associated with T cell exhaustion including PD-1, CD73 and CD39. Strikingly however, these molecules were expressed independently of virus or antigen. Rather, PD-1-expressing T cells remained PD-1+ after migration into tissues regardless of infection, while CD73 was activated on …

Medical Nutrition Therapy For Diabetes, Cheryl Marco, Rd, Cde

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Discovery Of A New Cdk4/6 And Pi3k/Akt Multiple Kinase Inhibitor Aminoquinol For The Treatment Of Hepatocellular Carcinoma., Zhong-Kun Xia, Wei Wang, Jian-Ge Qiu, Xi-Nan Shi, Hong-Jian Li, Rong Chen, Kun-Bin Ke, Chao Dong, Ying Zhu, Shi-Guo Wu, Rong-Ping Zhang, Zhuo-Ran Meng, Hui Zhao, Peng Gu, Kwong-Sak Leung, Man-Hon Wong, Xiao-Dong Liu, Feng-Mei Zhou, Jian-Ying Zhang, Ya-Ting Yao, Si-Jia Wang, Chun-Yang Zhang, Yan-Ru Qin, Marie Chia-Mi Lin, Bing-Hua Jiang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Background: Hepatocellular carcinoma (HCC) is a lethal malignancy lacking effective treatment. The Cyclin-dependent kinases 4/6 (CDK4/6) and PI3K/AKT signal pathways play pivotal roles in carcinogenesis and are promising therapeutic targets for HCC. Here we identified a new CDK4/6 and PI3K/AKT multi-kinase inhibitor for the treatment of HCC.

Methods: Using a repurposing and ensemble docking methodology, we screened a library of worldwide approved drugs to identify candidate CDK4/6 inhibitors. By MTT, apoptosis, and flow cytometry analysis, we investigated the effects of candidate drug in reducing cell-viability,inducing apoptosis, and causing cell-cycle arrest. The drug combination and thermal proteomic profiling (TPP) method were …

Robotic Assistance In Unicompartmental Knee Arthroplasty Results In Superior Early Functional Recovery And Is More Likely To Meet Patient Expectations., Meredith P. Crizer, Amer Haffar, Andrew Battenberg, Mikayla Mcgrath, Ryan Sutton, Jess H Lonner

Rothman Institute Papers

Robotic technology has reduced the errors of implant alignment in unicompartmental knee arthroplasty (UKA), but its impact on functional recovery after UKA is poorly defined. The purpose of this study was to compare early functional recovery, pain levels, and satisfaction in UKA performed with either robotic assistance or conventional methods. A retrospective analysis was performed on 89 matched consecutive patients who underwent outpatient UKA by a single physician using either conventional instruments (n = 39) or robotic methods (n = 50), with otherwise identical perioperative protocols. Outcomes studied included Lower Extremity Functional Score (LEFS), new Knee Society Score …

Capacity Building For A New Multicenter Network Within The Echo Idea States Pediatric Clinical Trials Network., Robert D Annett, Scott Bickel, John C Carlson, Kelly Cowan, Sara Cox, Mark J Fisher, J Dean Jarvis, Alberta S Kong, Jessica S Kosut, Kurtis R Kulbeth, Abbot Laptook, Pearl A Mcelfish, Mary M Mcnally, Lee Pachter, Do, Barbara A Pahud, Lee A Pyles, Jennifer Shaw, Kari Simonsen, Jessica Snowden, Christine B Turley, Andrew M Atz

Department of Medicine Faculty Papers

Introduction: Research capacity building is a critical component of professional development for pediatrician scientists, yet this process has been elusive in the literature. The ECHO IDeA States Pediatric Clinical Trials Network (ISPCTN) seeks to implement pediatric trials across medically underserved and rural populations. A key component of achieving this objective is building pediatric research capacity, including enhancement of infrastructure and faculty development. This article presents findings from a site assessment inventory completed during the initial year of the ISPCTN.

Methods: An assessment inventory was developed for surveying ISPCTN sites. The inventory captured site-level activities designed to increase clinical trial research …

Predictors Of Permanent Pacemaker Implantation In Patients Undergoing Transcatheter Aortic Valve Replacement - A Systematic Review And Meta-Analysis., Waqas Ullah, Salman Zahid, Syeda Ramsha Zaidi, Deepika Sarvepalli, Shujaul Haq, Sohaib Roomi, Maryam Mukhtar, Muhammad Atif Khan, Smitha Narayana Gowda, Nicholas Ruggiero, Alec Vishnevsky, David L. Fischman

Abington Jefferson Health Papers

Background As transcatheter aortic valve replacement (TAVR) technology expands to healthy and lower-risk populations, the burden and predictors of procedure-related complications including the need for permanent pacemaker (PPM) implantation needs to be identified.

Methods and Results Digital databases were systematically searched to identify studies reporting the incidence of PPM implantation after TAVR. A random- and fixed-effects model was used to calculate unadjusted odds ratios (OR) for all predictors. A total of 78 studies, recruiting 31 261 patients were included in the final analysis. Overall, 6212 patients required a PPM, with a mean of 18.9% PPM per study and net rate …

What Children Learn About Death From Film, Elissa Miller, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Discuss popular films and how they affect what children know about death
• Discuss child development and development-related concepts of death and dying
• Discuss using films to help discuss death and dying with children

Cascade Screening And Treatment Initiation In Young Adults With Heterozygous Familial Hypercholesterolemia., Amy L. Peterson, Matthew Bang, Robert C. Block, Nathan D. Wong, Dean G. Karalis

Division of Cardiology Faculty Papers

Heterozygous familial hypercholesterolemia (HeFH) creates elevated low-density lipoprotein cholesterol (LDL-C), causing premature atherosclerotic cardiovascular disease (ASCVD). Guidelines recommend cascade screening relatives and starting statin therapy at 8-10 years old, but adherence to these recommendations is low. Our purpose was to measure self-reported physician practices for cascade screening and treatment initiation for HeFH using a survey of 500 primary care physicians and 500 cardiologists: 54% "always" cascade screen relatives of an individual with FH, but 68% would screen individuals with "strong family history of high cholesterol or premature ASCVD", and 74% would screen a child of a patient with HeFH. The …