Medicine and Health Sciences Commons^™

Jefferson Center For Interprofessional Practice And Education (Jcipe): Enhancing Services To Underserved Populations Through Innovative Virtual World Training And Collaborative Partnerships, Susan Toth-Cohen, Phd, Otr/L, Brooke Salzman, Md, Oksana Kazharova, Lcsw, Lcadc

Department of Occupational Therapy Posters and Presentations

Objectives

After attending this presentation, participants will be able to:

1. Discuss the development, implementation, and evaluation of two interprofessional virtual training programs focused on vulnerable populations
2. Articulate the key role of community partners in creating and sustaining virtual training programs
3. Identify useful strategies for implementing virtual training incorporating the flexible learning framework
4. Apply basic information and lessons learned to your own ideas about current or potential training programs

Characterization Of Resistance To A Potent D-Peptide Hiv Entry Inhibitor., Amanda R Smith, Matthew T Weinstock, Amanda E Siglin, Frank G Whitby, J Nicholas Francis, Christopher P Hill, Debra M Eckert, Michael J Root, Michael S Kay

Department of Biochemistry and Molecular Biology Faculty Papers

BACKGROUND: PIE12-trimer is a highly potent D-peptide HIV-1 entry inhibitor that broadly targets group M isolates. It specifically binds the three identical conserved hydrophobic pockets at the base of the gp41 N-trimer with sub-femtomolar affinity. This extremely high affinity for the transiently exposed gp41 trimer provides a reserve of binding energy (resistance capacitor) to prevent the viral resistance pathway of stepwise accumulation of modest affinity-disrupting mutations. Such modest mutations would not affect PIE12-trimer potency and therefore not confer a selective advantage. Viral passaging in the presence of escalating PIE12-trimer concentrations ultimately selected for PIE12-trimer resistant populations, but required an extremely …

Perturbed Mitochondria-Er Contacts In Live Neurons That Model The Amyloid Pathology Of Alzheimer's Disease., Pamela V. Martino Adami, Zuzana Nichtova, David B. Weaver, Adam Bartok Dr., Thomas Wisniewski, Drew R. Jones, Sonia Do Carmo, Eduardo M. Castaño, A. Claudio Cuello, György Hajnóczky, Laura Morelli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The use of fixed fibroblasts from familial and sporadic Alzheimer's disease patients has previously indicated an upregulation of mitochondria-ER contacts (MERCs) as a hallmark of Alzheimer's disease. Despite its potential significance, the relevance of these results is limited because they were not extended to live neurons. Here we performed a dynamic in vivo analysis of MERCs in hippocampal neurons from McGill-R-Thy1-APP transgenic rats, a model of Alzheimer's disease-like amyloid pathology. Live FRET imaging of neurons from transgenic rats revealed perturbed 'lipid-MERCs' (gap width <10 nm), while 'Ca2+-MERCs' (10-20 nm gap width) were unchanged. In situ TEM showed no significant differences in the lipid-MERCs:total MERCs or lipid-MERCs:mitochondria ratios; however, the average length of lipid-MERCs was significantly decreased in neurons from transgenic rats as compared to controls. In accordance with FRET results, untargeted lipidomics showed significant decreases in levels of 12 lipids and bioenergetic analysis revealed respiratory dysfunction of mitochondria from transgenic rats. Thus, our results reveal changes in MERC structures coupled with impaired mitochondrial functions in Alzheimer's disease-related neurons.This article has an associated First Person interview with the first author of the paper.

Maternal Characteristics Affect Fetal Growth Response In The Women First Preconception Nutrition Trial., K Michael Hambidge, Carla M Bann, Elizabeth M Mcclure, Jamie E Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S Goudar, Sangappa M Dhaded, Omrana Pasha, Sumera A Ali, Richard J Derman, Robert L Goldenberg, Marion Koso-Thomas, Manjunath S Somannavar, Veena Herekar, Umber Khan, Nancy F Krebs

Global Health Articles

The objective of this secondary analysis was to identify maternal characteristics that modified the effect of maternal supplements on newborn size. Participants included 1465 maternal-newborn dyads in Guatemala, India, and Pakistan. Supplementation commenced before conception (Arm 1) or late 1st trimester (Arm 2); Arm 3 received usual care. Characteristics included body mass index (BMI), stature, anemia, age, education, socio-economic status (SES), parity, and newborn sex. Newborn outcomes were z-scores for length (LAZ), weight (WAZ), and weight to length ratio-for-age (WLRAZ). Mixed-effect regression models included treatment arm, effect modifier, and arm * effect modifier interaction as predictors, controlling for site, …

Thriving After Pediatric Sci: Two Life Stories, Samantha Betz, Otd, Otr/L, Caitlin Cadematori, Otd, Otr/L, Mj Mulcahey, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

• To understand the lived experiences of spinal cord injury (SCI) as described by two people with SCI through life story interviewing.
• Narrative inquiry is a useful method to study the experience of living with a disability because story-telling allows individuals to explain how their conditions have influenced their everyday lives.1,3,7,12,13,14
• Existing narrative studies have explored lived experiences of SCI and the distinct perspectives of men and women, athletes with SCI, and caregivers of persons with SCI.3,9,12,13,15
• This study may be among the first accounts of life stories of adults with pediatric onset SCI. *The two participant’s names have been changed …

Health Coaching In Context: A Descriptive Case Study, Caitlin Cadematori, Otd, Otr/L, Samantha Betz, Otd, Otr/L, Winnie Dunn, Phd, Otr/L, Faota, Mj Mulcahey, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Persons with spinal cord injury (SCI) often report challenges with accessing employment, reliable transportation and opportunities for social engagement, resulting in decreased independence and self-efficacy.¹ When challenges with access are addressed, participation in valued activities is possible and supports social-emotional health, physical health, and quality of life.^2,3

“Health Coaching in Context” is a skillful dialogue that adheres to coaching competencies and draws from the tenets of health coaching and positive psychology. “Health Coaching in Context” reflects authentic client centeredness, and develops problem solving skills that address solutions that lead to meaningful engagement in everyday living despite the presence …

Occupational Therapy Students’ Perception Of Types Of Class Preparation Activities, Caitlin Taylor, Margaret A. Ryan, Marie-Christine Potvin, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

This mixed-methods pilot study examined OT student perceptions of the practicality and perceived benefits of 4 class preparation activities used in 3 occupational therapy courses.

Understanding Participation In A Community-Based Art Program, Melody Taban, Otd, Otr, Gabrielle Kains, Otd, Otr/L, Lydia Navarro-Walker, Otd, Otr/L, Namrata Grampurohit, Phd, Otr/L

Department of Occupational Therapy Posters and Presentations

Objectives

1. To understand the perceived benefits of occupational engagement with art for people with dementia and their informal caregivers
2. To understand the art program’s influence on interpersonal relationships

Third-Wave Cognitive Behavioral Therapy, Mindfulness, And Behavioral Activation, Sonny Misa, Mary Muhlenhaupt, Otd, Otr/L, Faota

Department of Occupational Therapy Posters and Presentations

Learning Objectives

• Restate Active Participation, Just-right Challenge, Motivating and Rewarding, and Therapist as Coach in their own words
• Differentiate between Cognitive Behavioral Therapy and Third-wave Cognitive Behavioral Therapy
• Illustrate the difference between meditation and mindfulness
• Discuss the implication of extended Behavioral Activation for occupational therapy practice

Does Perioperative Use Of Renin-Angiotensin System Inhibitors Improve Patient Outcomes In Cardiac Surgery?, Qian Ding, Mark Berguson, Zugui Zhang, Hong Liu, Huang Nie, Jordan E. Goldhammer, Rohinton J. Morris, Jianzhong Sun

Department of Anesthesiology Posters

• 2011 ACCF/AHA Guidelines for CABG: Uncertain about the safety of the preoperative administration of ACE inhibitors or ARBs in patients on chronic therapy and the safety of initiating ACE inhibitors or ARBs before hospital discharge
• 2014 ESC Guidelines: ACE inhibitors might be stopped 1 to 2 days before CABG to avoid the potential deleterious consequences of perioperative hypotension
• Guidelines state that ACE inhibitors or ARBs should be initiated postoperatively in CABG patients who were not receiving them preoperatively if they have an LVEF ≤40%, hypertension, diabetes, or CKD (Level of Evidence: A)
• There is still a lack of large clinical …

Heat Shock Factor 1-Mediated Transcription Activation Of Omi/Htra2 Induces Myocardial Mitochondrial Apoptosis In The Aging Heart., Dan Liu, Linguo Wu, Ye Wu, Xin Wei, Wen Wang, Suli Zhang, Ming Yi, Jing Li, Huirong Liu, Xin-Liang Ma

Department of Emergency Medicine Faculty Papers

BACKGROUND: Increased cardiac apoptosis is a hallmark of the elderly, which in turn increases the risk for developing cardiac disease. The overexpression of Omi/HtrA2 mRNA and protein contributes to apoptosis in the aged heart. Heat shock factor 1 (HSF1) is a transcription factor that binds to the promoter of Omi/HtrA2 in the aging myocardium. However, whether HSF1 participates in cardiomyocyte apoptosis via transcriptional regulation of Omi/HtrA2 remains unclear. The present study was designed to investigate whether HSF1 plays a role in Omi/HtrA2 transcriptional regulation and myocardial apoptosis.

METHODS AND RESULTS: Assessment of the hearts of mice of different ages was …

The Case For Revamping New Faculty Orientation: Integrating Case-Based Learning Into Faculty Onboarding., Mansoor Siddiqui, Dimitrios Papanagnou, Samantha Bruno, Karen Novielli

Department of Emergency Medicine Faculty Papers

Introduction: New faculty orientation (NFO) for onboarding faculty members is replete with critical information and resources. Most NFO sessions are facilitated through lecture-based slide presentations. We employed a case-based learning (CBL) format to promote learner engagement through active use of the content being taught. We hypothesized that a CBL format would lead to improved learner satisfaction.

Methods: An inventory of topics presented at NFO was generated by reviewing previous orientation sessions. Cases and discussion questions were developed to link to specific content areas from previously delivered lectures. Participants were assigned cases with discussion questions, followed by a large-group debriefing. In …

Generational Differences In Nursing Influencing Job Satisfaction, Sarah Carter, Rn, Capa, Maryjo Marino Hertzog, Rn, Bsn, Capa, Demetrius Trihoulis, Rn, Viktor Hum, Rn

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

Purpose

A generation is defined as a group of individuals who are roughly the same age, and who experience and are influenced by the same set of significant historical events during key developmental periods in their lives.

With multiple Nursing generations working together in the heath care setting identifying and understanding generational differences that influence job satisfaction will help to promote a healthy work environment and a sustainable work force.

Does Having A Nurse Navigator Vs. Not Having A Nurse Navigator Decrease The Cost Of Healthcare In Patients With A Sepsis Diagnosis?, Marybeth Forward, Rn, Amanda Kuzewycz, Bsn, Rn-Bc, Sandra Little, Msn, Rn, Anne Lyons, Bsn, Rn-Bc, Kelly Panei, Bsn, Rn, Pccn, Diane Yaple, Ms, Lpc

Jefferson Health - Northeast Posters (formerly Aria Health Posters)

Purpose

The nurse navigator facilitates the care of a patient with the diagnosis of sepsis across the healthcare continuum. This includes:

• Promoting optimal outcomes
• Preventing readmissions
• Patient education
• Decreasing length of stay in skilled nursing facilities

The coordination of transition of care starts from the time of admission through the 90 day post acute period.

Using The System Of Care Approach To Distinguish School Refusal From School Truancy, Connie Chang, Md, Aneela Khan, Md

Department of Psychiatry and Human Behavior Posters

Learning Objectives

To recognize the importance of taking a system of care approach to determine whether the symptoms of school avoidance are due to mental illness

Comparison Of Mri- And Trus-Informed Prostate Biopsy For Prostate Cancer Diagnosis In Biopsy-Naive Men: A Systematic Review And Meta-Analysis., Hanan Goldberg, Ardalan E. Ahmad, Thenappan Chandrasekar, Laurence Klotz, Mark Emberton, Masoom A. Haider, Samir S. Taneja, Karan Arora, Neil Fleshner, Antonio Finelli, Nathan Perlis, Mark D. Tyson, Zachary Klaassen, Christopher J.D. Wallis

Department of Urology Faculty Papers

PURPOSE: Multiparametric magnetic resonance imaging (mpMRI) with informed targeted biopsies (TGBX) has changed the paradigm of prostate cancer (PCa) diagnosis. Randomized studies have demonstrated a diagnostic benefit of Clinically significant (CS) for TGBX compared to standard systematic biopsies (SBX). We aimed to evaluate whether mpMRI-informed TGBX has superior diagnosis rates of any-, CS-, high-grade (HG)-, and clinically insignificant (CI)-PCa compared to SBX in biopsy-naive men.

METHODS: Data was searched in Medline, Embase, Web of Science, and Evidence-based medicine reviews-Cochrane Database of systematic reviews from database inception until 2019. Studies were selected by two authors independently, with disagreements resolved by consensus …

Incorporating Mpmri Biopsy Data Into Established Pre-Rp Nomograms: Potential Impact Of An Increasingly Common Clinical Scenario, Joon Yau Leong, Jaime O. Herrera-Caceres, Hanan Goldberg, Elwin Tham, Seth Teplitsky, Leonard G. Gomella, Neil E. Fleshner, Costas D. Lallas, Edouard J. Trabulsi, Thenappan Chandrasekar

Department of Urology Faculty Papers

Background: We examine the practical application of multiparametric MRI (mpMRI) prostate biopsy data using established pre-RP nomograms and its potential implications on RP intraoperative decision-making. We hypothesize that current nomograms are suboptimal in predicting outcomes with mpMRI targeted biopsy (TBx) data.

Materials and methods: Patients who underwent mpMRI-based TBx prior to RP were assessed using the MSKCC and Briganti nomograms with the following iterations: (1) Targeted (T) (targeted only), (2) Targeted and Systematic (TS) and (3) Targeted Augmented (TA) (targeted core data; assumed negative systematic cores for 12 total cores). Nomogram outcomes, lymph node involvement (LNI), extracapsular extension (ECE), organ-confined …

Resident Experience Discussion (Red): Resident-Led Discussion Groups To Promote Resilience, Timothy Kuchera, Colin J. Thomas, Candace L. Haddox, Hannah C. Nordhues, Deanne T. Kashiwagi, Alan Kubey

Department of Medicine Posters

We sought to promote resident wellness through a resident-initiated-and-run discussion forum outside the formal residency structure

Online Learning & Medical Education … You Can Do It!, Carmin Bermudez, Med, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Posters

• Engaging learners and building community online improves learning and motivation for learners
• Faculty presence incorporates integral feedback and increases student success
• The CTL provides ongoing training and support, you are not alone!

Mindfulness Based Stress Reduction Increases Pathology Resident Self Wellness, Kaitlin Collura, Md, Phd, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Posters

Stress during medical residency is a common, complex issue influenced by time demands, level of social support, and environmental factors. Increased stress levels can lead to resident burnout, and may contribute to the high rates of depression and suicide seen among physicians. In 2015, the ACGME began a campaign to promote resident wellness by calling on programs to implement strategies to develop resiliency, identify problems, and promote wellbeing. Mindfulness based stress reduction (MBSR) strategies have been shown to decrease burnout, improve mood, and increase compassion in healthcare providers. We implemented a wellness retreat to educate residents on the principles of …

Wellness Initiative Program And Effect On Pathology Resident Burnout Rate, Kaitlin Collura, Md, Phd, Michelle Nagurney, Md, Joanna Chan, Md

Department of Pathology, Anatomy, and Cell Biology Posters

Increasing rates of physician burnout are reported across many medical specialties, including Pathology. In 2014, 52.5% of pathologists experienced symptoms of burnout compared to 37.6% in 2011. Suicide and depression rates in physicians are also higher than the average population. As a result, the ACGME began a campaign, in 2015, to foster resident wellness. The campaign calls for strategies to develop resiliency, identify problems, and promote well-being. While wellness initiatives may not change underlying mental illness, they may mitigate environmental factors that can exacerbate mental illness or suicidal behavior. Here we report results from a recently implemented resident wellness initiative …

Variable Levels Of Drift In Tunicate Cardiopharyngeal Gene Regulatory Elements., William Colgan, Alexis Leanza, Ariel Hwang, Melissa B. Debiasse, Isabel Llosa, Daniel Rodrigues, Hriju Adhikari, Guillermo Barreto Corona, Saskia Bock, Amanda Carillo-Perez, Meagan Currie, Simone Darkoa-Larbi, Daniel Dellal, Hanna Gutow, Pascha Hokama, Emily Kibby, Noah Linhart, Sophia Moody, Allison Naganuma, Diep Nguyen, Ryan Stanton, Sierra Stark, Cameron Tumey, Anthony Velleca, Joseph F. Ryan, Brad Davidson

Student Papers, Posters & Projects

Background: Mutations in gene regulatory networks often lead to genetic divergence without impacting gene expression or developmental patterning. The rules governing this process of developmental systems drift, including the variable impact of selective constraints on different nodes in a gene regulatory network, remain poorly delineated.

Results: Here we examine developmental systems drift within the cardiopharyngeal gene regulatory networks of two tunicate species, Corella inflata and Ciona robusta. Cross-species analysis of regulatory elements suggests that trans-regulatory architecture is largely conserved between these highly divergent species. In contrast, cis-regulatory elements within this network exhibit distinct levels of conservation. In particular, while most …

Continuous Aspiration Mechanical Thrombectomy For Tissue Diagnosis Of Indeterminate Inferior Vena Cava Thrombus, Varun Singh, Christopher Molloy, Md, Geogy Vatakencherry, Md

Student Papers, Posters & Projects

Purpose

To illustrate the utility of a continuous aspiration mechanical thrombectomy catheter in the tissue-proven determination and retrieval of hepatocellular carcinoma (HCC) tumor thrombus in the inferior vena cava (IVC ) of a 61 year-old non-cirrhotic male with Hepatitis C on ledipasvir/sofosbuvir therapy and hepatic segment VIII lesion with right atrial invasion

Targeted Epidural Blood Patches Under Fluoroscopic Guidance For Incidental Durotomies Related To Spine Surgeries: A Case Series., Andrew K. Wong, Mohammad Rasouli, Andrew Ng, Dajie Wang

Department of Anesthesiology Faculty Papers

Introduction: Incidental durotomies are usually managed conservatively. However, 1.8% of patients require surgical dural repair for CSF leak. There are limited data available regarding the use of epidural blood patches (EBP) for persistent CSF leaks secondary to incidental durotomies. This case series aims to evaluate the efficacy of targeted EBPs under fluoroscopic guidance in the treatment of incidental durotomies.

Methods: Four patients with incidental durotomies after spine surgeries (one cervical decompression, one revision of L5-S1 decompression and fusion, and two lumbar decompressions) were included in this series. These patients did not respond to conservative management and subsequently underwent EBPs. Magnetic …

Twitter And Academic Urology In The United States And Canada: A Comprehensive Assessment Of The Twitter-Verse In 2019., Thenappan Chandrasekar, Hanan Goldberg, Zachary Klaassen, Christopher J. Wallis, Joon Yau Leong, Spencer Liem, Seth Teplitsky, Rodrigo Noorani, Stacy Loeb

Department of Urology Faculty Papers

OBJECTIVE: To provide the first comprehensive analysis of the Twitter-verse amongst academic urologists and programs in North America.

METHODS: Using national accreditation and individual program websites, all active urology residency programs (USA & Canada) and academic Urology faculty at these programs were identified. Demographic data for each program (AUA section, resident class size) and physician (title, fellowship training, Scopus H-index and citations) were documented. Twitter metrics (Twitter handle, date joined, # tweets, # followers, # following, likes) for programs and physicians were catalogued (data capture: March-April 2019). Descriptive analyses and temporal trends in Twitter utilization amongst programs and physician were …

Recovery Priorities In Degenerative Cervical Myelopathy: A Cross-Sectional Survey Of An International, Online Community Of Patients., Benjamin Davies, Oliver Mowforth, Iwan Sadler, Bizhan Aarabi, Brian Kwon, Shekar Kurpad, James S Harrop, Jefferson R Wilson, Robert Grossman, Michael G Fehlings, Mark Kotter

Department of Neurosurgery Faculty Papers

OBJECTIVES: To establish the recovery priorities of individuals suffering with degenerative cervical myelopathy (DCM).

DESIGN: A cross-sectional, observational study.

SETTING: Patients from across the world with a diagnosis of DCM accessed the survey over an 18-month period on Myelopathy.org, an international myelopathy charity.

PARTICIPANTS: 481 individuals suffering from DCM completed the online survey fully.

MAIN OUTCOME MEASURES: Functional recovery domains were established through qualitative interviews and a consensus process. Individuals were asked about their disease characteristics, including limb pain (Visual Analogue Scale) and functional disability (patient-derived version of the modified Japanese Orthopaedic Association score). Individuals ranked recovery domains (arm and …

Relating The Gut Metagenome And Metatranscriptome To Immunotherapy Responses In Melanoma Patients., Brandilyn A. Peters, Melissa Wilson, Una Moran, Anna Pavlick, Allison Izsak, Todd Wechter, Jeffrey S. Weber, Iman Osman, Jiyoung Ahn

Department of Medical Oncology Faculty Papers

BACKGROUND: Recent evidence suggests that immunotherapy efficacy in melanoma is modulated by gut microbiota. Few studies have examined this phenomenon in humans, and none have incorporated metatranscriptomics, important for determining expression of metagenomic functions in the microbial community.

METHODS: In melanoma patients undergoing immunotherapy, gut microbiome was characterized in pre-treatment stool using 16S rRNA gene and shotgun metagenome sequencing (n = 27). Transcriptional expression of metagenomic pathways was confirmed with metatranscriptome sequencing in a subset of 17. We examined associations of taxa and metagenomic pathways with progression-free survival (PFS) using 500 × 10-fold cross-validated elastic-net penalized Cox regression.

RESULTS: Higher …

Going Beyond Accessibility By Advocating For Inclusive Playgrounds, Alexander Herrera, Otas, Amanda Shoffner, Otas, Kiondrah Wilson, Otas, Sara Loesche, Ms, Otr/L, Cht

School of Continuing and Professional Studies Posters

Play is the primary occupation of all children and is vital for the development of physical, cognitive, and social-emotional skills. Children of all abilities benefit from play and should all have equal opportunity to use and explore playground equipment. Many community playgrounds are limiting and create barriers which do not allow all children to use them. It is important that occupational therapy practitioners (OTPs) step up and utilize their skills and knowledge to bring about a change.

Occupational therapy practitioners, with their knowledge of environmental barriers, understanding of disability and specific knowledge of activities, are in an ideal position to …

Community-Based Level Ii Fieldwork Program At An Adult Day Program For Clients With Memory Loss: Site, Academic Program, & Fw Educator’S Perceptions, Nakia L. Lynn, Otr/L, Caps, Jeanne M. Coviello, Otd, Otr/L, Nadine Sabila, Ms, Lnha, Csw

Department of Occupational Therapy Posters and Presentations

• At the conclusion of this poster, participants will be able to describe at least three benefits of creating a community-based Level I and Level II fieldwork at Adult Day Programs.
• At the conclusion of this poster, participants will be able to state at least three benefits of using the collaborative fieldwork model for Level II OT practitioner students.

Parenting With Down Syndrome: The Role Occupational Therapy Plays, Kalhie M. Mayer, Bs, Otas, Aubrey Rubin, Otas, Jessica Schatzan, Otas, Sara Loesche, Ms, Otr/L, Cht

School of Continuing and Professional Studies Posters

• OTPs can help individuals with Down Syndrome complete their activities of daily living so they can be independent and start a family
• Sex education is an very important area for OTPs to work on with individuals who have Down Syndrome or other intellectual disabilities
• OTPs play a huge role in helping people with Down Syndrome parent efficiently and effectively through various strategies such as recommending adaptations to support the occupations of a parent
• OTPs can be instrumental in advocating for individuals with Down Syndrome who have children through linking them with agencies, completing performance assessments, and testifying in legal proceedings …