Medicine and Health Sciences Commons^™

Partnering For Success! Occupational Therapy, Industrial Design, & Medicine: Creating Innovative Solutions, Brenna Jacko, Ots, Megan Vesey, Ots, Nuriya Neumann, Ots, Mikael Avery, Ms, Otr/L, M. Arch, Kim Mollo, Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

No abstract provided.

Drug Abuse Manifesting As Persistent Hypoglycemia: A Case Report Of Hidden Sulfonylurea Poisoning, Frederick B. Peng, Sharon Li, Md

Department of Medicine Posters

Background

• Prescription drug abuse is on the rise. According to the Philadelphia Department of Health data in 2017, up to 26% of adults may be using benzodiazepines and/or opioids (Table 1).
• 12% or 1/8 Philadelphians are estimated to be current benzodiazepine users and have taken one in the last 7 days. Benzodiazepine use is most common among people with household incomes below $25,000 and among the 45-54 years old age group (17.7%) [1].
• Most current users (84%) obtain benzodiazepines from health care providers [1]. However, with new policies to closely monitor controlled substances, those with dependence on benzodiazepines may turn …

Reflecting The Communities That We Serve: Embracing Diversity And Inclusion Initiatives In Occupational Therapy Education, Jonette Ishmael, Ots, Nuriya Neumann, Ots, Tracey Vause-Earland, Otr/L, Phd

Department of Occupational Therapy Posters and Presentations

Background

• There is a current lack of diversity seen in OT classrooms across the country.
• It is paramount we create a diverse occupational therapy student body in order to meet the needs of the diverse communities we serve.
• Students, educators, and therapists, need to develop cultural reflexivity, humility and safety when serving patients of various background (Taff & Blash, 2017).
• Through establishing diversity and inclusion initiatives within OT education we can increase awareness and provide education that will radically shape the OT workforce in coming years.
• Efforts to diversify OT programs is key to progressing as a profession, and reflecting …

Multi-Institution Analysis Of Racial Disparity Among African- American Men Eligible For Prostate Cancer Active Surveillance, Michael Dinizo, Weichung Shih, Young Suk Kwon, Daniel Eun, Adam Reese, Laura Giusto, Edouard J. Trabulsi, Bertram Yuh, Nora Ruel, Daniel Marchalik, Jonathan Hwang, Shilajit D. Kundu, Scott Eggener, Isaac Yi Kim

Department of Urology Faculty Papers

There is a significant controversy on whether race should be a factor in considering active surveillance for low-risk prostate cancer. To address this question, we analyzed a multi-institution database to assess racial disparity between African-American and White-American men with low risk prostate cancer who were eligible for active surveillance but underwent radical prostatectomy. A retrospective analysis of prospectively collected clinical, pathologic and oncologic outcomes of men with low-risk prostate cancer from seven tertiary care institutions that underwent radical prostatectomy from 2003–2014 were used to assess potential racial disparity. Of the 333 (14.8%) African-American and 1923 (85.2%) White-American men meeting active …

Refusing To Let The Dust Settle: Creative Evaluation Of A Concept-Based Curriculum, Jeannette Kates, Phd, Gnp-Bc, Rn, Mary Hanson-Zalot, Edd, Rn, Julia Ward, Phd, Rn, Jamie Smith, Msn, Rn, Ccrn, Valerie Clary-Muronda, Phd, Msn-Ed, Rn

College of Nursing Posters

Concept-based curricula are being implemented in nursing education as a means to shift the emphasis from content to an emphasis on concepts and conceptual learning (Giddens & Brady, 2007). This paradigm shift requires concomitant changes in how faculty teach and how students learn. In concept-based curricula, teachers use student-centered learning activities, such as case studies, questions, or problems to engage students in active learning (Giddens, Caputi, & Rodgers, 2015).

Review Of The Safety And Efficacy Of Echocardiographically Guided Pericardiocentesis: A Retrospective Single-Center Analysis, 2009 – 2016, Robert Park, Md, Michael Valentino, Md, Phd, Rajiv Kabadi, Md, Matthew Decaro, Md, Gregary Marhefka, Md

Division of Cardiology Posters

Aims

• To investigate the safety and efficacy of EGP given the relatively limited data of this modality’s safety profile in American healthcare centers over the past decade
• To evaluate the characteristics of and risk factors of those needing EGP

Rehabilitation: The Health Strategy Of The 21st Century., Gerold Stucki, Jerome Bickenbach, Christoph Gutenbrunner, John L. Melvin

Department of Rehabilitation Medicine Faculty Papers

There is strong evidence that population ageing and the epidemiological transition to a higher incidence of chronic, non-communicable diseases will continue to profoundly impact societies worldwide, putting more pressure on healthcare systems to respond to the needs of the people they serve. These trends argue for the need to address what matters to people about their health: limitations in their functioning that affect their day-to-day actions and goals in life. From its inception, rehabilitation, 1 of the 4 health strategies identified in the Declaration of Alma Ata in 1978, has had functioning as its outcome of interest. Its practitioners are …

Strengthening Health-Related Rehabilitation Services At National Levels., Christoph Gutenbrunner, Jerome Bickenbach, John L. Melvin, Jorge Lains, Boya Nugraha

Department of Rehabilitation Medicine Faculty Papers

OBJECTIVE: One of the aims of the World Health Organization's Global Disability Action Plan is to strengthen rehabilitation services. Some countries have requested support to develop (scale-up) rehabilitation services. This paper describes the measures required and how (advisory) missions can support this purpose, with the aim of developing National Disability, Health and Rehabilitation Plans.

RECOMMENDATIONS: It is important to clarify the involvement of governments in the mission, to define clear terms of reference, and to use a systematic pathway for situation assessment. Information must be collected regarding policies, health, disability, rehabilitation, social security systems, the need for rehabilitation, and the …

Scaling Up Rehabilitation - Towards An International Policy Agenda., Christoph Gutenbrunner, Jerome Bickenbach, Kristian Borg, Boya Nugraha, John L. Melvin, Gerold Stucki

Department of Rehabilitation Medicine Faculty Papers

No Abstract (Guest Editorial).

Spontaneous Coronary Artery Dissection: A Case Series Of 9 Patients With Literature Review., Ali Raza Ghani, Md, Faisal Inayat, Nouman Safdar Ali, Reema Anjum, Michael Viray, Arsalan Talib Hashmi, Iqra Riaz, Bruce D. Klugherz, Hafeez Ul Hassan Virk

Abington Jefferson Health Papers

Spontaneous coronary artery dissection is an increasingly recognized nonatherosclerotic cause of acute coronary syndrome. Reports regarding the prognosis and natural history of this disease are limited. In addition to the diagnostic difficulty, this condition poses a significant therapeutic challenge due to the lack of specific management guidelines. We present here a case series of 9 patients with spontaneous coronary artery dissection. Additionally, this article reviews the incidence, clinical characteristics, risk factors, diagnostic modalities, therapeutic approaches, and patterns of recurrence in patients with spontaneous coronary artery dissection.

Evaluation Of Hepatocellular Carcinoma Transarterial Chemoembolization Using Quantitative Analysis Of 2d And 3d Real-Time Contrast Enhanced Ultrasound., Kibo Nam, Maria Stanczak, Andrej Lyshchik, Priscilla Machado, Yuko Kono, Flemming Forsberg, Colette M. Shaw, John R. Eisenbrey

Department of Radiology Faculty Papers

Quantitative 2D and 3D contrast-enhanced ultrasound (CEUS) was assessed to evaluate early transarterial chemoembolization (TACE) treatment response. Seventeen patients scheduled for TACE for the treatment of hepatocellular carcinoma participated in the study. 2D and 3D CEUS were performed for each patient at three time points: Prior to TACE, 1-2 weeks post TACE, and 1 month post TACE. Peak-intensities of the tumor and surrounding liver tissue were calculated from 2D and 3D data before and after TACE and used to evaluate tumor treatment response. Residual tumor percentages were calculated from 2D and 3D CEUS acquired 1-2 weeks and 1 month post …

Primary Care-Ot For Older African Americans With Diabetes And Mild Cognitive Impairment: Intervention Approaches And Case Stories, Catherine Verrier Piersol, Phd, Otr/L, Faota, Susan Santalucia, Ms, Otr/L, Michele Rifkin, Mhsed, Otr/L, Barry Rovner, Md, Robin Casten, Phd, Neva White, Np, Crnp, Cde

Department of Occupational Therapy Posters and Presentations

Purpose:

To test the efficacy of a collaborative intervention to lower hemoglobin A1c levels (HbA1c) in older African Americans with Type 2 diabetes (DM), Mild Cognitive Impairment (MCI), and suboptimal medication adherence and glycemic control.

Aims:

1. To reduce HbA1c level by 0.5% at 6 and 12 months.
2. To increase MEMS-measured adherence to an oral DM medication at 6 and 12 months.

Hypotheses:

1. Fifty-five percent of intervention participants, compared to 25% of control participants, will have a reduction in HbA1c of 0.5% at 6 months (short term effect) and 12 months (maintenance effect).
2. The Primary Care-Occupational Therapy intervention will increase MEMS-measured …

Preclinical Comparison Of Proteasome And Ubiquitin E1 Enzyme Inhibitors In Cutaneous Squamous Cell Carcinoma: The Identification Of Mechanisms Of Differential Sensitivity, Angela Mchugh, Kenneth Fernandes, Andrew P. South, Jemima E. Mellerio, Julio C. Salas-Alanis, Charlotte M. Proby, Irene M. Leigh, Mark K. Saville

Department of Dermatology and Cutaneous Biology Faculty Papers

Proteasome inhibitors have distinct properties and the biochemical consequences of suppressing ubiquitin E1 enzymes and the proteasome differ. We compared the effects of the proteasome inhibitors bortezomib, ixazomib and carfilzomib and the ubiquitin E1 enzyme inhibitor MLN7243/TAK-243 on cell viability and cell death in normal keratinocytes and cutaneous squamous cell carcinoma (cSCC) cell lines. The effects of both a pulse of treatment and more extended incubation were investigated. This is relevant to directly-delivered therapy (topical treatment/intratumoral injection) where the time of exposure can be controlled and a short exposure may better reflect systemically-delivered inhibitor pharmacokinetics. These agents can selectively kill …

Credibility, Replicability, And Reproducibility In Simulation For Biomedicine And Clinical Applications In Neuroscience., Lealem Mulugeta, Andrew Drach, Ahmet Erdemir, C A Hunt, Marc Horner, Joy P. Ku, Jerry G Myers, Rajanikanth Vadigepalli, William W. Lytton

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Modeling and simulation in computational neuroscience is currently a research enterprise to better understand neural systems. It is not yet directly applicable to the problems of patients with brain disease. To be used for clinical applications, there must not only be considerable progress in the field but also a concerted effort to use best practices in order to demonstrate model credibility to regulatory bodies, to clinics and hospitals, to doctors, and to patients. In doing this for neuroscience, we can learn lessons from long-standing practices in other areas of simulation (aircraft, computer chips), from software engineering, and from other biomedical …

Reversible Cerebral Vasoconstriction Disorder In A Patient With A Chief Complaint Of Headache., Simran Buttar, Anuja Trivedi, Dimitrios Papanagnou, Md

Department of Emergency Medicine Faculty Papers

As emergency medicine physicians, we have formulated an approach to managing patients with a chief complaint of headache that starts with considering the story the patient relays in the context of a wide differential. Here we will describe a case that presented to our emergency department in hopes to broaden your differential. Reversible cerebral vasoconstriction syndrome (RCVS), well described in the neurology literature, is characterized by severe headaches that may or may not be accompanied by neurological symptoms and is definitively diagnosed by diffuse constriction of cerebral arteries on cerebral angiogram. Here we present a case of a patient who …

Layout And Flow Of Dermatology Clinics: Principles From Operations Management., Jordan V. Wang

Department of Dermatology and Cutaneous Biology Faculty Papers

Dermatology is a medical specialty that experiences high patient demand and long patient wait times. Dermatology clinics should look for ways to improve efficiency through the incorporation of principles from operations management. Addressing the layout and flow of a clinic can lead to operational efficiency. An ideal layout may lead to increased patient volume, satisfaction, and retention.

Optimizing Visiting Clerkships In Dermatology: A Dual Perspective Approach., Jordan V. Wang, Kathleen P. Mcguinn, Matthew Keller

Department of Dermatology and Cutaneous Biology Faculty Papers

Matching into a dermatology residency program has become increasingly more challenging for medical students. As students continue to explore various methods to help them standout to programs, recent medical literature has continued to show evidence of the important role that visiting clerkships play. Visiting clerkships offer several benefits to both students and programs. In order to optimize visiting clerkships, the perspectives of both students and programs are each examined with recommendations provided to help maximize its benefits.

An Inpatient Patient Safety Curriculum For Pediatric Residents., John Szymusiak, Michael D Fox, Catherine Polak, Kwonho Jeong, Doris Rubio, Stephanie Dewar, Andrew Urbach, Alda Maria Gonzaga

Department of Pediatrics Faculty Papers

Introduction: Patient safety is recognized as an important part of pediatric resident education. There is a lack of published safety curricula targeting pediatric residents. A local needs assessment showed that while residents felt safety was an important part of their current and future jobs, they did not feel prepared to apply safety principles to their future careers or participate in a root cause analysis (RCA).

Methods: This curriculum was delivered to senior-level pediatric and multiple-board residents during five monthly, hour-long, multidisciplinary sessions. Sessions covered systems-based thinking, terminology, the second victim phenomenon, RCA, and medication errors, while providing feedback on recent …

Understanding Patient Uncertainty As A Driver Of Emergency Department Utilization: A Concept Mapping Approach, Angela Gerolamo, Phd, Rn, Shannon Doyle, Mph, Rhea E. Powell, Md, Mph, Amanda M.B. Doty, Ms, Marianna Lanoue, Phd, Kristin L. Rising, Md, Mshp

Department of Emergency Medicine Posters

Background and Purpose

• Most previous research regarding factors associated with increased risk of emergency department (ED) use has been done via retrospective review of medical records rather than obtaining patients’ perspectives.
• Recent research identified patient uncertainty related to symptoms as a primary motivator for seeking ED care, and ongoing uncertainty at the time of ED discharge as an unmet need (Rising et al. 2015; Rising, Hudgins, Reigle, Hollander, & Carr 2016).
• While providers have limited ability to influence many factors identified by retrospective medical record review (e.g. financial concerns), patient uncertainty can be addressed by providers directly. To do so …

Regulation Of Nociceptive Glutamatergic Signaling By Presynaptic Kv3.4 Channels In The Rat Spinal Dorsal Horn., Tanziyah Muqeem, Biswarup Ghosh, Vitor Pinto, Angelo C. Lepore, Manuel Covarrubias

Farber Institute for Neuroscience Faculty Papers

Presynaptic voltage-gated K⁺ (Kv) channels in dorsal root ganglion (DRG) neurons are thought to regulate nociceptive synaptic transmission in the spinal dorsal horn. However, the Kv channel subtypes responsible for this critical role have not been identified. The Kv3.4 channel is particularly important because it is robustly expressed in DRG nociceptors, where it regulates action potential (AP) duration. Furthermore, Kv3.4 dysfunction is implicated in the pathophysiology of neuropathic pain in multiple pain models. We hypothesized that, through their ability to modulate AP repolarization, Kv3.4 channels in DRG nociceptors help to regulate nociceptive synaptic transmission. To test this hypothesis, we …

Changing Characteristics Of The Surface P Wave With Aging, And Insights Into Inter-Atrial Conduction - A Study Of 2,156 Patients Over 9 Decades Of Life, Chamaka Kalutota, Bs, Gregory Troutman, Bs, Goutham Ravipati, Bs, Anna Carleen, Ba, Matthew Decaro, Md, Behzad B. Pavri, Md

Sigma Xi Student Research Day

Objective

To define changes in surface ECG P-wave morphology, vector, and duration with advancing age, and make inferences about IAC and risk of atrial fibrillation

Puma Amplifies Necroptosis Signaling By Activating Cytosolic Dna Sensors., Dongshi Chen, Jingshan Tong, Liheng Yang, Liang Wei, Donna B. Stolz, Jian Yu, Jianke Zhang, Lin Zhang

Department of Microbiology and Immunology Faculty Papers

Necroptosis, a form of regulated necrotic cell death, is governed by RIP1/RIP3-mediated activation of MLKL. However, the signaling process leading to necroptotic death remains to be elucidated. In this study, we found that PUMA, a proapoptotic BH3-only Bcl-2 family member, is transcriptionally activated in an RIP3/MLKL-dependent manner following induction of necroptosis. The induction of PUMA, which is mediated by autocrine TNF-α and enhanced NF-κB activity, contributes to necroptotic death in RIP3-expressing cells with caspases inhibited. On induction, PUMA promotes the cytosolic release of mitochondrial DNA and activation of the DNA sensors DAI/Zbp1 and STING, leading to enhanced RIP3 and MLKL …

Optimizing Vaccine Immunotherapy For Prostate Cancer, G. Hattier, E. K. Bongiorno, C. Portocarrero, Trevor R. Baybutt, Adam E. Snook, U. Rodeck

Sigma Xi Student Research Day

Introduction: Treatment options for metastatic prostate cancer are limited and cures are rare. In other cancers immunotherapy has shown remarkable efficacy in certain patient subsets particularly when combined with other treatment modalities. Our previous work showed that combining radiation and vaccine therapy slows the growth of syngeneic prostate cancer in mice more effectively than single modality treatment arms. Here we tested the hypothesis that addition of immune checkpoint inhibitors targeting the PD1/PD-L1 axis further improves efficacy of the dual radiation/vaccine treatment.

Methods: Mice were injected with tumor cells expressing human prostate specific antigen (TPSA-23). The mice were divided into six …

Near-Infrared Spectroscopy’S Predictive Ability Of Neurological Injury In Ecmo Patients, Spencer Liem, Bs, Nicholas Cavarocchi, Md, Hitoshi Hirose, Md, Phd

Sigma Xi Student Research Day

Objectives

• Elucidate sensitivity and specificity of NIRS in detecting neurological injury
• Determine magnitude of NIRS decline in ECMO patients with neurologic injury
• Explore how effective cerebral O2 monitoring is regionally and globally

Incidence Of Ocular Hypertension After Intravitreal Injection Of 2 Mg Triamcinolone Acetonide (Ivt), Jake Goodman, Bs, Maitri Pancholy, Bs, Philip Storey, Md, Mph, Anthony Obeid, Md, Durga Borkar, Md, Carl Regillo, Md, Daniel Su, Md

Sigma Xi Student Research Day

Purpose

To report the incidence of OHT following injection of 2mg IVT

Radiomic Features From Muti-Institutional Glioblastoma Mri Offers Additive Prognostic Value To Clinical And Genomic Markers, Spencer Liem, Bs, Gaurav Shukla, Md, Phd, Spyridon Bakas, Phd, Sung Min Ha, Ms, Saima Rathore, Phd, Christos Davatzikos, Phd

Sigma Xi Student Research Day

Objective

Synergies between clinical, genomic, and radiomic features should improve the predictive value of each group of features and their combinations through a prognostic classifier based on machine learning in patients with glioblastoma.

Long-Term Visual Outcomes In Optic Nerve Sheath Meningiomas Following Fractionated Stereotactic Radiotherapy, Sana Dastgheyb, Christian Fernandez, Md, Maria Werner-Wasik, Md, Voichita Bar-Ad, Md, David Andrews Md, James Evans, Md, Kevin Judy, Md, Sara Lally, Md, Carol Shields, Md, Arman Mashayekhi, Md, Wenyin Shi, Md, Phd, Christopher Farrell, Md

Sigma Xi Student Research Day

Introduction

Radiation therapy is often used for tumors of the optic nerve. The challenge with irradiating tumors surrounding structures associated with the eye is the risk of exposing the optic nerve, or other structures important to maintaining vision to potentially damaging radiation.

Fractionated stereotactic radiotherapy (FSRT) is commonly used for the treatment of optic nerve sheath meningiomas (ONSMs) for vision preservation. However, long term visual data in the literature is limited. We investigated visual outcomes in 27 patients with ONSMs after FSRT.

Visualization Of Fibronectin Assembly Using Crispr And Fluorescence Imaging, Brenda French, Sophie Astrof

Sigma Xi Student Research Day

Objectives

Surprisingly, the mechanisms of fibronectin assembly remain largely unknown. This project aims to elucidate the process by which fibronectin assembles through fluorescent labeling. Fluorescent tags allow for the visualization of fibronectin to clarify how this extracellular matrix protein may influence migration and signaling.

Success And Limitations Of Hepatitis C Screening In The Inpatient Setting, Madalene Zale, Mphc, Priya Mammen, Md, Mph

College of Population Health Posters

This study evaluates the outcomes that a state level mandate for HCV screening with HCV-Antibody-only has on linkage to care and access to treatment, compared to a specific programmatic effort, which includes HCV confirmation.

Dealing With Deans And Academic Medical Center Leadership: Advice From Leaders., Fred Sanfilippo, Deborah Powell, Robert Folberg, Mark Tykocinski

Department of Medicine Faculty Papers

The 2017 Association of Pathology Chairs Annual Meeting included a session for department chairs and other department leaders on "how to deal with deans and academic medical center leadership." The session was focused on discussing ways to foster positive relationships with university, medical school, and health system leaders, and productively address issues and opportunities with them. Presentations and a panel discussion were provided by 4 former pathology chairs who subsequently have served as medical deans and in other leadership positions including university provost, medical center CEO, and health system board chair. There was a strong consensus among the participants on …