Medicine and Health Sciences Commons^™

Umbilical Amnion And Amniotic Membrane Transplantation For Infectious Scleritis And Scleral Melt: A Case Series., Zeba Syed, Christopher J Rapuano

Wills Eye Hospital Papers

Purpose: To report the outcomes of two cases of infectious scleritis with severe scleral thinning managed using combined mechanical debridement, cryopreserved umbilical amnion (UA) and amniotic membrane (AM) grafts, and antimicrobial therapy.

Observations: Two patients presented with severe infectious scleritis with progressive scleral melts secondary to Pseudomonas aeruginosa subsequent to pterygium surgery and intravitreal injection, respectively. Surgical debridement was followed by UA grafting, AM transplantation, and antimicrobial therapy. Epithelialization and vascularization were seen within 1–4 weeks post-operatively. At last follow up of 5–6 months, the structural integrity of the sclera remained preserved with no infection recurrence, graft necrosis, or wound …

Biomechanics Of Circumferential Cervical Fixation Using Posterior Facet Cages: A Cadaveric Study., Bernardo De Andrada Pereira, Joshua Pelta-Heller, Jennifer N Lehrman, Anna G U Sawa, Brian P Kelly

Department of Neurosurgery Faculty Papers

OBJECTIVE: Anterior cervical discectomy and fusion (ACDF) is a common procedure for the treatment of cervical disease. Circumferential procedures are options for multilevel pathology. Potential complications of multilevel anterior procedures are dysphagia and pseudarthrosis, whereas potential complications of posterior surgery include development of cervical kyphosis and postoperative chronic neck pain. The addition of posterior cervical cages (PCCs) to multilevel ACDF is a minimally invasive option to perform circumferential fusion. This study evaluated the biomechanical performance of 3-level circumferential fusion with PCCs as supplemental fixation to anteriorly placed allografts, with and without anterior plate fixation.

METHODS: Nondestructive flexibility tests (1.5 Nm) …

Initial Experience In Monitoring Qt Intervals Using A Six-Lead Contactless Mobile Electrocardiogram In An Inpatient Setting., Daniel Frisch, Eitan Frankel, Darius Farzad, Md, Sang H Woo, Alan Kubey

Division of Cardiology Faculty Papers

Mobile electrocardiograms (ECGs) (mECGs) using smartphone applications are an emerging technology. In the coronavirus disease 2019 (COVID-19) era, minimizing patient contact has gained increasing importance. Additionally, increased QT/corrected QT (QTc) monitoring has concurrently been required. The KardiaMobile 6L ECG device, cleared by the United States Food and Drug Administration (FDA) for recording ECGs, along with the KardiaStation tablet application is a platform (AliveCor, Mountain View, CA, USA) that addresses these two issues. A team of residents, fellows, hospitalists, and cardiologists identified inpatients in need of QT/QTc interval monitoring to pilot the adoption of a system composed of a KardiaMobile 6L …

Can Early Treatment Of Twitcher Mice With High Dose Aavrh10-Galc Eliminate The Need For Bmt?, Mohammad Rafi, Paola Luzi, David A Wenger

Department of Neurology Faculty Papers

Introduction: Krabbe disease (KD) is an autosomal recessive disorder caused by mutations in the galactocerebrosidase (GALC) gene resulting in neuro-inflammation and defective myelination in the central and peripheral nervous systems. Most infantile patients present with clinical features before six months of age and die before two years of age. The only treatment available for pre-symptomatic or mildly affected individuals is hematopoietic stem cell transplantation (HSCT). In the animal models, combining bone marrow transplantation (BMT) with gene therapy has shown the best results in disease outcome. In this study, we examine the outcome of gene therapy alone.

Methods: Twitcher (twi) mice …

Assessing Civility At An Academic Health Science Center: Implications For Employee Satisfaction And Well-Being., Lisa A Campbell, Jenna R Lafreniere, Mhd Hasan Almekdash, David D Perlmutter, Huaxin Song, Patricia J Kelly, Rohali Keesari, Kay Leigh Shannon

College of Nursing Faculty Papers & Presentations

Incivilities are pervasive among workers in healthcare institutions. Previously identified effects include deterioration of employee physical and mental health, absenteeism, burnout, and turnover, as well as reduced patient safety and quality of care. This study documented factors related to organizational civility at an academic health sciences center (AHSC) as the basis for future intervention work. We used a cross-sectional research design to conduct an online survey at four of five campuses of an AHSC. Using the Organizational Civility Scale (OCS), we assessed differences across gender, race (White and non-White) and job type (faculty or staff) in the eleven subscales (frequency …

Covid-19 In Solid Organ Transplantation: Disease Severity And Clinical Update., Akanksha Arya, Michael Li, Nana Aburjania, Pooja Singh, Tricia. Royer, Sean Moss, Katherine A. Belden

Department of Medicine Faculty Papers

BACKGROUND: Solid organ transplant (SOT) recipients are a complex, immunocompromised population in whom greater coronavirus disease 2019 (COVID-19) mortality has been reported compared with the general population.

METHODS: We examined a retrospective cohort of 58 SOT recipients with first-wave COVID-19, comparing patients with severe and nonsevere illness. Additionally, SOT recipients are compared with general patients with first-wave COVID-19.

RESULTS: Organs transplanted included 38 kidneys, 8 livers, 5 hearts, and 3 pancreases. Average SOT recipient age was 57.4 years; 62% were male; 46.6% were African American 36.2% were white. Comorbidities included hypertension (86%), chronic kidney disease (86%), diabetes mellitus (50%), coronary …

Considerations Of Expanded Carrier Screening: Lessons Learned From Combined Malonic And Methylmalonic Aciduria., Marie Cosette Gabriel, Stephanie M. Rice, Jennifer L. Sloan, Matthew H. Mossayebi, Charles P. Venditti, Huda B. Al-Kouatly

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: Expanded carrier screening (ECS) utilizes high-throughput next-generation sequencing to evaluate an individual's carrier status for multiple conditions. Combined malonic and methylmalonic aciduria (CMAMMA) due to ACSF3 deficiency is a rare inherited disease included in such screening panels. Some cases have been reported with metabolic symptoms in childhood yet other cases describe a benign clinical course, suggesting the clinical phenotype is not well defined.

METHODS/CASE REPORT: Clinical and laboratory findings during the prenatal period were obtained retrospectively from medical records.

RESULTS: A 37-year-old nulliparous woman and her partner were each identified as carriers of ACSF3 variants and presented at 9 …

Glioma Stem Cells As Immunotherapeutic Targets: Advancements And Challenges, Keenan Piper, Lisa Depledge, Michael Karsy, Charles Cobbs

Department of Neurosurgery Faculty Papers

Glioblastoma is the most common and lethal primary brain malignancy. Despite major investments in research into glioblastoma biology and drug development, treatment remains limited and survival has not substantially improved beyond 1–2 years. Cancer stem cells (CSC) or glioma stem cells (GSC) refer to a population of tumor originating cells capable of self-renewal and differentiation. While controversial and challenging to study, evidence suggests that GCSs may result in glioblastoma tumor recurrence and resistance to treatment. Multiple treatment strategies have been suggested at targeting GCSs, including immunotherapy, posttranscriptional regulation, modulation of the tumor microenvironment, and epigenetic modulation. In this review, we …

Psychological Experience And Coping Strategies Of Patients In The Northeast Us Delaying Care For Infertility During The Covid-19 Pandemic., David B Seifer, William D Petok, Alisha Agrawal, Tanya L Glenn, Arielle H Bayer, Barry R Witt, Blair D Burgin, Harry J Lieman

Department of Obstetrics and Gynecology Faculty Papers

BACKGROUND: On March 17, 2020 an expert ASRM task force recommended the temporary suspension of new, non-urgent fertility treatments during an ongoing world-wide pandemic of Covid-19. We surveyed at the time of resumption of fertility care the psychological experience and coping strategies of patients pausing their care due to Covid-19 and examined which factors were associated and predictive of resilience, anxiety, stress and hopefulness.

METHODS: Cross sectional cohort patient survey using an anonymous, self-reported, single time, web-based, HIPPA compliant platform (REDCap). Survey sampled two Northeast academic fertility practices (Yale Medicine Fertility Center in CT and Montefiore's Institute for Reproductive Medicine …

Determinants Of The Outcome Of The Transition Of Children With Sickle Cell Disease To Adult Programs., Samir K. Ballas, Gaye Riddick-Burden, Elisabeth Congdon-Martin

Cardeza Foundation for Hematologic Research

Transition of adolescents with sickle cell disease to adult programs is associated with increased morbidity and mortality. The reasons for this poor outcome are not well known. This report describes the various factors that affect the outcome of the transition process. These include four inter-personal factors: country of residence, region within the country of residence, the health care system and intra-personal factors. Each factor is described in some detail. Understanding these factors and the establishment of guidelines or recommendations could improve the outcome of this critical transition in the life of patients with sickle cell disease.

Three-Dimensional Structure Of Human Cyclooxygenase (Hcox)-1., Morena Miciaccia, Benny Danilo Belviso, Mariaclara Iaselli, Gino Cingolani, Savina Ferorelli, Marianna Cappellari, Paola Loguercio Polosa, Maria Grazia Perrone, Rocco Caliandro, Antonio Scilimati

Department of Biochemistry and Molecular Biology Faculty Papers

The beneficial effects of Cyclooxygenases (COX) inhibitors on human health have been known for thousands of years. Nevertheless, COXs, particularly COX-1, have been linked to a plethora of human diseases such as cancer, heart failure, neurological and neurodegenerative diseases only recently. COXs catalyze the first step in the biosynthesis of prostaglandins (PGs) and are among the most important mediators of inflammation. All published structural work on COX-1 deals with the ovine isoenzyme, which is easier to produce in milligram-quantities than the human enzyme and crystallizes readily. Here, we report the long-sought structure of the human cyclooxygenase-1 (hCOX-1) that we refined …

Mir-21 Plays A Dual Role In Tumor Formation And Cytotoxic Response In Breast Tumors, Tu Dan, Anuradha A. Shastri, Ajay Palagani, Simone Buraschi, Thomas Neill, Jason E Savage, Aastha Kapoor, Tiziana Deangelis, Sankar Addya, Kevin Camphausen, Renato V. Iozzo, Nicole L Simone

Department of Radiation Oncology Faculty Papers

Breast cancer (BrCa) relies on specific microRNAs to drive disease progression. Oncogenic miR-21 is upregulated in many cancers, including BrCa, and is associated with poor survival and treatment resistance. We sought to determine the role of miR-21 in BrCa tumor initiation, progression and treatment response. In a triple-negative BrCa model, radiation exposure increased miR-21 in both primary tumor and metastases. In vitro, miR-21 knockdown decreased survival in all BrCa subtypes in the presence of radiation. The role of miR-21 in BrCa initiation was evaluated by implanting wild-type miR-21 BrCa cells into genetically engineered mouse models where miR-21 was intact, heterozygous …

Meet An Ipe Faculty Champion From Thomas Jefferson University, Kelly Pagnotta

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

I currently help facilitate sessions within the Health Mentors Program.

Infusing Interprofessional Education Core Competencies And Collaborative Practice Into Standards-Driven Curricula, Paula S. Currie, Phd, Ccc-Slp, Luanne Billingsley, Dnp, Mba, Aprn, Acns-Bc, Ryan Green, Phd, Atc, Ralph Wood, Phd, Ches

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

One challenge facing healthcare training programs is balancing the need to provide students with interprofessional education (IPE) and collaborative practice (CP) opportunities in the context of highly prescribed standards-driven curricula (e.g. nursing and speech-language pathology). An infusion-based approach is an option for institutions and standards-driven programs that do not have specific IPE/CP courses or open electives in their curriculum.

Striving For Consistency Among Change And Uncertainty: A Year Of Interprofessional Student Hotspotting, Tracey Earland, Phd, Otr/L, Megan Hershman, Ms, Samantha Burke, Otd

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

In Student Hotspotting, interprofessional teams provide hands-on, individualized interventions to patients with high healthcare utilization to address underlying social determinants of health (such as education, economic stability, or neighborhood safety), promote interprofessional collaboration, and reduce unnecessary hospital admissions for patients with complex health and social needs.

Meet An Ipe Student Champion From Thomas Jefferson University, Umara Iftikhar

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

For the past year and a half, I have been a graduate assistant (GA) for JCIPE and have had the opportunity to work on various projects.

Collaborative Interprofessional Work As Means To Prepare Better Healthcare Professionals, Oksana Kazharova, Msw, Lcsw, Lcadc

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

Over the past few years, I've had the honor to represent Pathways to Housing PA in the interprofessional collaborative work with JCIPE on the project called ESHP (Enhancing Services for Homeless Populations). This partnership opportunity was as much exciting as it was needed. Many professionals in the healthcare field have the driving compassion and desire to improve someone's life; after all, staying healthy is one of the most important aspects of life. While many who choose to work in a health profession strive to deliver the best service, young healthcare professionals have very little practice and/or knowledge on how to …

Jefferson Center For Interprofessional Practice And Education Conference

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

The purpose of this conference is to showcase scholarly work and works in progress related to interprofessional education and/or practice. This conference reflects on innovative implementation and evaluation strategies of the interprofessional competencies. Educators, clinicians, practitioners, researchers, health system leaders, policymakers, patient organizations, students, and other interested stakeholders in the health and social services fields are welcome to attend.

People Building A Better World Together, Wendy Ross, Md

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

Community participation can be an issue across all areas of life. What about when it applies to medical care? The numbers of those with autism began steeply climbing in 2003, meaning that over the next decade, over half a million individuals with autism will be reaching adulthood and require adult medical care.

Interprofessional Practice And Education During The Pandemic, Christine Arenson, Md

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

As the unique year that is 2020 comes to a close, it seems an appropriate moment to reflect back on Jefferson's history as a national leader in interprofessional practice and education, and to look forward to the future. This has been a year filled with transitions for me personally, and uniquely colored by the COVID-19 pandemic for us all.

Jcipe Update

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

JCIPE Update

From The Editors

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

Welcome to the fall 2020/winter 2021 issue of the JCIPE newsletter. 2020 was a year like no other. We witnessed and weathered the impact of the COVID pandemic in a variety of ways, and felt it on nearly every aspect of our professional and personal lives. We also collectively witnessed atrocities too numerous to count, resulting from the deep-seated systemic racism that is intrinsically tied to health disparities and inequities in this country.

The pain and adversity has made this a dark time in our history, yet, has enabled us, individually and communally, to heed and recognized historically marginalized voices, …

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 11, Number 2, Fall 2020/Winter 2021

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

In this Issue

1 - From the Editors

2 - JCIPE Update

2 - Interprofessional Practice and Education During the Pandemic

4 - PEOPLE Building a Better World Together

6 - Collaborative Interprofessional Work as Means to Prepare Better Healthcare Professionals

7 - Meet an IPE Student Champion from Thomas Jefferson University

8 - Striving for Consistency Among Change and Uncertainty: A Year of Interprofessional Student Hotspotting

11 - Infusing Interprofessional Education Core Competencies and Collaborative Practice Into Standards-Driven Curricula

14 - Meet an IPE Faculty Champion from Thomas Jefferson University

Allocation Of Anchors During Labral Repair: A Multicenter Cohort Analysis Of Labral Treatment In Hip Arthroscopy., Ryan P Mcgovern, John J Christoforetti, Benjamin R Kivlan, Shane J Nho, Andrew B Wolff, John P Salvo, Dean Matsuda, Thomas J Ellis, Allston J Stubbs, Dominic S Carreira

Rothman Institute Papers

Background: While previous studies have established several techniques for suture anchor repair of the acetabular labrum to bone during arthroscopic surgery, the current literature lacks evidence defining the appropriate number of suture anchors required to effectively restore the function of the labral tissue.

Purpose/Hypothesis: To define the location and size of labral tears identified during hip arthroscopy for acetabular labral treatment in a large multicenter cohort. The secondary purpose was to differentiate the number of anchors used during arthroscopic labral repair. The hypothesis was that the location and size of the labral tear as well as the number of anchors …

Correspondence Between Perceived Pubertal Development And Hormone Levels In 9-10 Year-Olds From The Adolescent Brain Cognitive Development Study., Megan M Herting, Kristina A Uban, Marybel Robledo Gonzalez, Fiona C Baker, Eric C Kan, Wesley K Thompson, Douglas A Granger, Matthew D Albaugh, Andrey P Anokhin, Kara S Bagot, Marie T Banich, Deanna M Barch, Arielle Baskin-Sommers, Florence J Breslin, B J Casey, Bader Chaarani, Linda Chang, Duncan B Clark, Christine C Cloak, R Todd Constable, Linda B Cottler, Rada K Dagher, Mirella Dapretto, Anthony S Dick, Nico Dosenbach, Gayathri J Dowling, Julie A Dumas, Sarah Edwards, Thomas Ernst, Damien A Fair, Sarah W Feldstein-Ewing, Edward G Freedman, Bernard F Fuemmeler, Hugh Garavan, Dylan G Gee, Jay N Giedd, Paul E A Glaser, Aimee Goldstone, Kevin M Gray, Samuel W Hawes, Andrew C Heath, Mary M Heitzeg, John K Hewitt, Charles J Heyser, Elizabeth A Hoffman, Rebekah S Huber, Marilyn A. Huestis, Luke W Hyde, M Alejandra Infante, Masha Y Ivanova, Joanna Jacobus, Terry L Jernigan, Nicole R Karcher, Angela R Laird, Kimberly H Leblanc, Krista Lisdahl, Monica Luciana, Beatriz Luna, Hermine H Maes, Andrew T Marshall, Michael J Mason, Erin C Mcglade, Amanda S Morris, Bonnie J Nagel, Gretchen N Neigh, Clare E Palmer, Martin P Paulus, Alexandra S Potter, Leon I Puttler, Nishadi Rajapakse, Kristina Rapuano, Gloria Reeves, Perry F Renshaw, Claudiu Schirda, Kenneth J Sher, Chandni Sheth, Paul D Shilling, Lindsay M Squeglia, Matthew T Sutherland, Susan F Tapert, Rachel L Tomko, Deborah Yurgelun-Todd, Natasha E Wade, Susan R B Weiss, Robert A Zucker, Elizabeth R Sowell

Institute of Emerging Health Professions Faculty Papers

Aim: To examine individual variability between perceived physical features and hormones of pubertal maturation in 9-10-year-old children as a function of sociodemographic characteristics.

Methods: Cross-sectional metrics of puberty were utilized from the baseline assessment of the Adolescent Brain Cognitive Development (ABCD) Study—a multi-site sample of 9–10 year-olds (n = 11,875)—and included perceived physical features via the pubertal development scale (PDS) and child salivary hormone levels (dehydroepiandrosterone and testosterone in all, and estradiol in females). Multi-level models examined the relationships among sociodemographic measures, physical features, and hormone levels. A group factor analysis (GFA) was implemented to extract latent variables of pubertal …

Global Point-Of-Care Ultrasound Education And Training In The Age Of Covid-19., Onyinyechi F Eke, Patricia C. Henwood, Grace W Wanjiku, Abiola Fasina, Sigmund J Kharasch, Hamid Shokoohi

Department of Emergency Medicine Faculty Papers

The COVID-19 pandemic has disrupted traditional global point-of-care ultrasound (POCUS) education and training, as a result of travel restrictions. It has also provided an opportunity for innovation using a virtual platform. Tele-ultrasound and video-conferencing are alternative and supportive tools to augment global POCUS education and training. There is a need to support learners and experts to ensure that maximum benefit is gained from the use of these innovative modalities.

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Perinatal Maternal Mood Disorders, Sarah Elizabeth Hirsh Cokenakes, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

1. To identify the spectrum of peripartum mood disorders, their features, diagnostic criteria, and treatments.
2. To review FDA pregnancy safety categories and lactation categories for commonly prescribed mood medications.
3. To identify the role of family physicians in identifying and treating peripartum mood disorders.

Anti-Sars-Cov-2 Antibodies Within Ivig Preparations: Cross-Reactivities With Seasonal Coronaviruses, Natural Autoimmunity, And Therapeutic Implications, Marinos Dalakas, Kleopatra Bitzogli, Harry Alexopoulos

Department of Neurology Faculty Papers

Introduction: Cross-reactivity to SARS-CoV-2 antigenic peptides has been detected on T-cells from pre-pandemic donors due to recognition of conserved protein fragments within members of the coronavirus's family. Further, preexisting antibodies recognizing SARS-CoV-2 with conserved epitopes in the spike region have been now seen in uninfected individuals. High-dose Intravenous Immunoglobulin (IVIg), derived from thousands of healthy donors, contains natural IgG antibodies against various antigens which can be detected both within the IVIg preparations and in the serum of IVIg-receiving patients. Whether IVIg preparations from pre-pandemic donors also contain antibodies against pre-pandemic coronaviruses or autoreactive antibodies that cross-react with SARS-CoV-2 antigenic epitopes, …

Mapping Major Sars-Cov-2 Drug Targets And Assessment Of Druggability Using Computational Fragment Screening: Identification Of An Allosteric Small-Molecule Binding Site On The Nsp13 Helicase., Matthew R Freidel, Roger S Armen

College of Pharmacy Faculty Papers

The 2019 emergence of, SARS-CoV-2 has tragically taken an immense toll on human life and far reaching impacts on society. There is a need to identify effective antivirals with diverse mechanisms of action in order to accelerate preclinical development. This study focused on five of the most established drug target proteins for direct acting small molecule antivirals: Nsp5 Main Protease, Nsp12 RNA-dependent RNA polymerase, Nsp13 Helicase, Nsp16 2'-O methyltransferase and the S2 subunit of the Spike protein. A workflow of solvent mapping and free energy calculations was used to identify and characterize favorable small-molecule binding sites for an aromatic pharmacophore …