Medicine and Health Sciences Commons^™

Evaluating Bone Fracture Healing Utilizing Novel Ultrasound Modes, X-Ray And Dual-Energy X-Ray Absorptiometry In A Rabbit Model, Priscilla Machado, Rachel Blackman, Ji-Bin Liu, Flemming Forsberg, Traci Fox

Department of Radiology Posters

Background and Purpose

Healing in bone fractures is a complex process involving local inflammation, angiogenesis (i.e., the creation of new blood vessels), and formation of a bone-building callus, all of which leads to returning the bone nearly to its pre-fracture state. This is the process in a bone where the fracture is clean and the fractured ends oppose each other. Five to 10 percent of fractures are described as non-union, which can lead to poor healing and long-term complications. The purpose of this study was to compare fracture healing in a rabbit model using x-ray, the traditional method for evaluating …

Social Needs Risk And Patient Outcomes With Supportive Oncology Care, Rebecca Cammy, Lcsw, Joshua Banks, Ma

Department of Medical Oncology Posters

Objective

This study utilized social risk data in the electronic heath record collected in routine clinical practice and examined relationships with supportive oncology care contacts and patient outcomes.

Prognostic Properties Of Kras Gene Mutation Subtypes In Resected Pancreatic Cancer, Faria Nusrat, Eliyahu Gorgov, Md, Wilbur Bowne, Md, Obehioye Isesele, Akshay Khanna, Harish Lavu, Md, Aditi Jain, Phd, Charles J. Yeo, Md, Avinoam Nevler, Md

Alpha Omega Alpha Research Symposium Posters

Introduction

• Pancreatic ductal adenocarcinoma (PDAC) is an aggressive and therapy-resistant cancer with an overall 5-year survival rate of almost 12%, making it among the most lethal of all major cancers.¹
• PDAC has a distinct genomic profile, with somatic KRAS protooncogene mutations in ~90% of cases.^2,3
• Current literature has not reached a consensus on disease prognosis based on KRAS mutation subtype.^2-5

Determining Bystander Motivations And Hesitations To Intervene During An Opioid Overdose Event, John Wahlstedt, Alana Platukus, Eric Fei, Yasmine Eichbaum, Noah Streitfeld, Robert S. Pugliese, Kelly Kehm

Alpha Omega Alpha Research Symposium Posters

Background

Harm reduction initiatives have been shown to improve morbidity and mortality of overdose; however, the rate of death due to opioid overdose continues to rise in Philadelphia. One aspect of the overdose scenario that requires more focus is the response of witnesses to overdose.

A Konnyaku Jelly Model For Ultrasound-Guided Fascia Iliaca Compartment Block, Arthraj J. Vyas, Matthew C. Lo, Arthur Au, Md

Alpha Omega Alpha Research Symposium Posters

Purpose

Konnyaku Jelly:

•Previously used as effective ultrasound-guided IV access phantom

•Withstands multiple needle piercings without phantom deterioration

•<$3 per pack

Preoperative Predictors Of Arthroscopic Partial Meniscectomy Outcomes: The Apm Index Score, Natalie Lowenstein, Yuchiao Chang, Hanna Mass, Angela M. Mercurio, Chierika Ukogu, Jeffrey N. Katz, Elizabeth G. Matzkin

Alpha Omega Alpha Research Symposium Posters

Problem Statement:

- Arthroscopic partial meniscectomy (APM) has been shown to be the most common meniscal surgical treatment in the United States

- Pre-op risk factors known to contribute to poor outcomes after APM:

• Symptom duration and radiographic OA at baseline

• Baseline knee functional score, location of meniscal tear, BMI, activity level, age, sex, and chondral damage on MRI

Project AIM:

To create an index score using easily available preoperative risk factors such as Kellgren-Lawrence (KL) grade, age, duration of symptoms, BMI, activity level, and preoperative outcome scores to predict the …

Melanosome Maturation Defects In Tyrosinase Deficient Human Retinal Pigment Epithelium, Charles Deyoung, Aman George, Brian P. Brooks

Alpha Omega Alpha Research Symposium Posters

Purpose

• Oculocutaneous albinism type 1A (OCA1A) = recessive genetic condition caused by mutations in TYROSINASE
• Created in vitro disease model for OCA1A using human induced pluripotent stem cell (iPSC) derived retinal pigment epithelium (RPE)
• Role of autophagy (Fig. 2) in melanosome degradation and melanosomal trafficking
• Aim to investigate whether loss of melanosomes in OCA1A-iRPE might impact autophagy

Actin Depolymerization Of Tenocytes Promotes A Tendinosis-Like Gene Expression, Kameron Inguito, Ba, Valerie West, Karl Matthew Ebron, Justin Parreno, Phd

Alpha Omega Alpha Research Symposium Posters

Optimal cellular mechanotransduction is essential for tendon matrix homeostasis. We recently developed an in vivo rat model of tendinosis, where the plantaris tendon are overloaded through ablation of the synergistic Achilles tendon. Using this model we determined that tissue overload disrupts matrix-cell interactions, which results in under-stimulation of tendon cells (tenocytes) (Fig.1)

Using an ex vivo model of tendon stress deprivation by maintaining tail tendon fascicles in floating culture we showed that tenocyte under-stimulation results in destabilization of filamentous (F-)actin (Fig.2). F-actin destabilization coincides with tendinosis-like gene expression: downregulation of tenogenic genes (Col1, Tnc, asma, Scx), upregulation of chondrogenic (Acan, …

The Effectiveness Of Jeffwlp For Weight Loss And General Nutritional Knowledge In Obese Patients, Scott Kozarsky, Ba, Olivia Ackley, Bs, Cynthia Cheng, Md, Phd

Alpha Omega Alpha Research Symposium Posters

PURPOSE: The increasing prevalence of obesity urgently requires effective management strategies. This study evaluates the effectiveness of Jefferson Weight Loss Program (JeffWLP), a trained medical student-delivered health education program in a predominantly African-American patient cohort.

METHODS: A randomized controlled trial was performed enrolling 30 patients with an average socioeconomic status of 5.8 (10 maximum). The intervention group (n=18) completed JeffWLP, a low-cost, 12-week health coaching program combining education sessions with graded step exercises. The control group (n=12) received usual care. Mean baseline age, BMI, and General Nutritional Knowledge Questionnaire (GNKQ) scores were: 46±13 years, 38±5, and 14.7±1.9 (maximum score=17) respectively. …

Emotional Stressors Faced By Medical Students Expressed Using Cartoons: A Qualitative Study, Casey Fishman, Ba, Justin Do, Bs, Fred W. Markham Jr., Md

Alpha Omega Alpha Research Symposium Posters

Purpose: Empathy, a fundamental pillar of medicine, has been shown to decrease in medical school. Increased stress is linked to decreased empathy, but specific stressors remain unclear. The goal of this study was to qualitatively explore specific stressors among third year medical students.

Methods: Third year medical students (n=248) participated in Reflection Rounds with a clinician and a member of pastoral care at Thomas Jefferson University and in their final sessions created a cartoon to express sentiments surrounding medicine. Qualitative analysis of the cartoons was conducted on both the images and text. Common themes were identified from the students’ …

Addressing Burden In Caregivers Of Older Adults With Cancer, Lora Rhodes, Lcsw, Kristine Swartz, Md, Caroline Glavin, Lsw, Charlotte Zuber, Kuang-Yi Wen, Phd

Department of Medical Oncology Posters

Background

Forty-two million adults in the United States are providing unpaid care for a family member or friend over the age of 50. For approximately 2.5 million of these caregivers, cancer is the primary illness or disability of their care recipient (National Alliance for Caregiving and AARP, 2020). As baby boomers continue to age, and the number of cancer survivors continues to increase, the need for informal caregivers will expand exponentially.

While Comprehensive Geriatric Assessment (CGA) is recommended for older patients with cancer and distress screening is recommended for all cancer patients, there are currently no recommendations regarding screening for …

Longitudinal Monitoring Of Gait Parameters For Lower Limb Prosthetic Users With Physical Therapy Using Video-Based Gait Analysis, Alisha Agarwal, Bs, Anthony Cimorelli, Cpo, R. James Cotton, Md, Phd

Alpha Omega Alpha Research Symposium Posters

Introduction

Gait training in physical therapy is a common standard of practice for new lower limb prosthetic users. Progress is typically assessed through functional outcome measures such as the 10-meter or 6-minute walk tests1. While these tests measure walking speed and endurance, they fall short of capturing gait quality or quantifying gait parameters which literature shows to be of therapeutic value 2,3. Routine access to quantitative gait assessment could provide clinicians with benchmarks to optimize treatment interventions. Traditional gait analysis systems require specialized equipment making them very resource-intensive and inconvenient to operate. Using human pose estimation techniques, we have developed …

Epidemiologic Profile And Treatment Analysis Of Cervicalgia In Patients With Migraine Vs. Tension-Type Headaches From A Multicenter Electronic Medical Record Database (Trinetx), Ethan J. Le, Victor S. Wang, Md, Hsiangkuo Yuan, Md, Phd

Alpha Omega Alpha Research Symposium Posters

BACKGROUND

• Cervicalgia, or chronic neck pain, remains an understudied and undertreated comorbid condition in patients with headache disorders that benefits from both pharmacologic and non-pharmacologic treatment profiles.

• Cervicogenic headaches present a significant global healthcare burden, with estimates projecting up to 4.1% of the global population and 20% of headache complaints are attributed to cervicalgia (Fernandez et al. 2020).

• What is the global demographic, treatment, and migraine preventive profile of cervicalgia in patients with either concurrent migraine (CM) or tension-type (CT) headaches?

Aging Expectations Predict Subjective Cognitive Decline Among Community-Dwelling Older Adults, Justin Do, Bs, Casey Fishman, Ba, Sakshi Bhargava, Phd, Emily Bratlee-Whitaker, Phd, Rn, Jennifer R. Turner, Phd, Jacqueline Mogle, Phd, Ms, Nikki L. Hill, Phd, Rn

Alpha Omega Alpha Research Symposium Posters

Purpose: Subjective cognitive decline (SCD), or perceived decline in cognition, is a precursor to mild cognitive impairment, a prodrome of Alzheimer’s disease. SCD’s predictive utility is limited as it is impacted by multiple psychosocial factors. Expectations regarding aging among older adults have been linked to self-efficacy and health-related outcomes; however, their relationship with SCD is unknown. The aim of this cross-sectional study was to investigate the relationships between older adults’ aging expectations regarding physical, mental, and cognitive health, and SCD.

Methods: An online survey of community-dwelling adults aged 65 years or older (n=582, M(SD)=71.36(4.80)) with no history of dementia …

Implementation Of Multipronged Approach In Patients With Chest Trauma Reduces Vap And Unplanned Admission To The Icu, Julie Donnelly, Msn, Rn, Trcn, Kristen Firely, Msn, Rn, Nicole Olszewski, Bsn, Rn, Jessica Byrne, Msn, Rn-Bc, Tiffani Stanley, Cstr, Joshua A. Marks, Md, Facs, Fccm, George Koenig

Department of Surgery Posters

Problem

The incidence of pulmonary complications in trauma patients with chest trauma has been reported to be as high as 49% (Ruibel L, 2022). However, all trauma patients are at risk for developing pulmonary complications due to a multitude of factors some pre-existing while others injury related sequela. Within our institution, we observed an increase in pulmonary complications through review of our TQIP (Spring 2020) and state registry data.

Validation Of The Factor Structure Of The Health Professionals’ Attitudes Toward The Homeless Inventory (Hpathi), Susan Toth-Cohen, Maria Brucato, Kerry Dinardo, Richard Hass

JCIPE Posters

Background

- Considerable stigma exists toward persons experiencing homelessness (PEH)—a vulnerable population at greater risk for health disparities.^{1, 2}

- Many healthcare students begin their programs without interacting with PEH and with preconceived notions influenced by societal stigma.

- Interprofessional education programs, such as the Enhancing Services for People Experiencing Homelessness program below, have incorporated experiential learning into curricula to address student biases and develop understanding and compassion.

• Educating students to understand issues that PEH face can help mitigate healthcare disparities.

- Evaluating the effectiveness of these interprofessional educational experiences requires valid assessment of the attitudes, interest, and confidence …

We Are What We Pre-Attend To Be: Piloting A Pre-Attendingship Rotation In Hospital Medicine, Timothy Kuchera, Md, Gretchen Diemer, Md, Jillian Zavodnick, Md, Rebecca Jaffe, Md

Department of Medicine Posters

Problem Definition

• New-to-practice attendings (NPTAs) lack readiness for independent practice
• Graduated autonomy – understood but not structurally enforced in residency training
• Curricular expectations not explicitly defined despite experiential differences between graduate training levels of PGY2 and PGY3 internal medicine residents
• Although residents achieve competencies established by the ACGME prior to graduation, NTPAs feel unprepared suggesting opportunities to change the clinical learning environment to increase

From The Lung To The Finger: An Unusual Presentation Of Adenosquamous Cell Carcinoma, Preeti Badve, Md, Sussy Obando Lara, Md, Elisenda Valdez Pena, Md, Myriah Magaris, Do, Zunaira Naeem, Md, Charalambos Solomides, Md, Avnish Bhatia

Department of Medical Oncology Posters

Learning Objective

To recognize unusual presentations of metastatic lung disease.

Inducing Accelerated Lung Toxicity In Mice Using A Partial Arc Sbrt Technique, Andrew Gerry, Charita Kunta, Noelle Francois, Tiziana Deangelis, Anuradha Shastri, Nicole Simone, Reza Taleei

Department of Radiation Oncology Posters

Background

• Radiation-induced pulmonary fibrosis (RIPF) is a frequent outcome of thoracic radiation therapy, constraining safe tumor radiation dosage. Various animal models, such as mice, rats, and pigs, have been devised to study RIPF
• Current methods for inducing lung fibrosis in mice involve whole lung irradiation with doses between 2-20 Gy. These methods used fixed anterior and posterior (AP/PA) x-ray beams at 0º and 180º with analysis typically commencing 24 to 52 weeks post-radiation
• Current methods are unrepresentative of modern radiation therapy techniques and are limited by the associated long latency of RIPF

The Efficacy Of Fecal Microbiota Transplantation (Fmt) On Symptom Reduction In Patients With Irritable Bowel Syndrome (Ibs), Carly Liberatore

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

• IBS is a functional gastrointestinal tract disorder that affects 5-10% of the population.¹
• Symptom severity ranges from mild to severe interference with daily life.¹
• Current treatments are highly ineffective and focus on relieving symptoms rather than solving the root problem, gut dysbiosis.^{5, 6}
• Aim: To determine if FMT significantly reduces symptom severity in IBS patients

Safety And Efficacy Of Adjunctive Esketamine Vs. Maois In Trd In Adults, Riley Guinan

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background:

Depression affects millions globally - Treatment-resistant depression (TRD) is defined as failure to respond to two antidepressant trials of adequate dose and duration

Traditional Treatment for TRD:

Switching or adding medications atypical antipsychotics - Limitations include delayed action, side effects, and limited efficacy

Alternative Treatment Options:

- Ketamine:

• A dissociative anesthetic with potential antidepressant effects
• Targets the NMDA receptor and activates AMPA receptor.
• Shows rapid and potent antidepressant effects; however, not FDA-approved for depression

- Monoamine Oxidase Inhibitors (MAOIs):

• Antidepressants used since the 1950s
• Inhibits the enzyme metabolizing neurotransmitters.
• Limitations: Dietary restrictions and drug interactions and longstanding safety concerns …

Augmenting Addiction Management: The Potential Efficacy Of Combining Rtms With Cbt, Dylan Schroeder

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Abstract

Non-substance and substance related addictive disorders contribute a high global disease burden with relatively poor treatment options with poor craving control and high relapse rates. CBT is a well-documented treatment modality which is the cornerstone for top-down behavioral management of cravings and preventing relapse, but its clinical efficacy is limited. Repetitive transcranial magnetic stimulation (rTMS) is an emerging treatment method which may reduce cravings and relapse rates through a bottom-up neurochemical approach.

There is potential that the rTMS reduction of bottom-up cravings may synergistically enhance the top-down control of cravings established with CBT. Existing primary research demonstrates that a …

The Effectiveness Of Tirzepatide (Gip/Glp-1 Receptor Co-Agonist) Vs Glp-1 Receptor Agonists On Lowering A1c In Adults With Type 2 Diabetes Mellitus, Madison Laplante

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

In the United States, 34.2 million people are currently diagnosed with diabetes mellitus, which accounts for 10.5% of the total population.¹ Type 2 diabetes mellitus (T2DM) holds 94.2% of all diabetes diagnoses. The American Association of Diabetes estimates approximately $327 billion annually and is broken up as follows:¹

The Safety And Efficacy Of Spironolactone Versus Oral Antibiotics For Moderate-Severe Acne In Post-Adolescent Females, Bhav Patel

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• Acne is a common skin condition when the pores are clogged by particles like dead skin or oil, affecting approximately 50 million individuals in the U.S.¹
• Over a third of females experience moderate-severe forms that persist into adulthood and that number seems to be on the rise³
• Persistent moderate-severe acne often requires systemic medications and oral antibiotics are the most frequently prescribed therapy²
• Dermatologists prescribe more antibiotics per provider than any other specialty, and often for longer durations than recommended²
• The inappropriate use of oral antibiotics is contributing to bacterial resistance and disruption of the …

The Combination Of Platelet Rich Plasma And Corticosteroids In Musculoskeletal And Musculotendinous Pathologies, Mikayla Stoudt

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

- 126 million Americans reported to have a musculoskeletal or musculotendinous pathology in 2012¹

- Combined direct and indirect cost of these injuries in 2015 was $874 billion¹

- Corticosteroid injections have been the mainstay of invasive management after conservative methods fail
Long-term effects of corticosteroids

• Intra-articular injections for knee osteoarthritis resulted in cartilage volume loss¹⁰
• Harm to flexor tendons, neurovascular structures, and compromised integrity^{7, 11}

- Platelet Rich Plasma

• Sample patient blood --> Centrifuge --> Separate plasma and platelets from other blood products --> Reconcentrate the platelets into the plasma
• Platelets release growth factor …

A Comparison Of Bleeding Risk In Patients With Cardiovascular Disease Treated With Aspirin Versus Clopidogrel, Laboy Alyssa

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Background

Cardiovascular disease is the leading cause of death for men and women in the United States.⁷­­

There are four main types of CVD:

1. Coronary heart disease
2. Strokes & TIAs
3. Peripheral arterial disease
4. Aortic disease

Coronary artery disease (CAD) is the most prevalent and most common cause of atherosclerosis

Antiplatelet medications remain the cornerstone of medical therapy for primary and secondary atherosclerotic CAD prevention.

Aspirin is prescribed for:

• Individuals with a history of MI or ischemic stroke to prevent a recurrence.
• When a myocardial infarction (MI) is suspected to avoid further infarction.
• Thromboembolism prevention after hip surgeries, transient …

In Stable Phase Copd Patients Does Oral Magnesium Supplementation Vs Nothing Decrease The Number Of Copd Related Hospitalizations?, Georgina Garvey

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

- Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease that leads to significant morbidity and mortality. Magnesium deficiency is known to lead to increased risk of both respiratory and cardiovascular diseases1. This deficiency can lead to an inflammatory state and increased bronchoconstriction that would exacerbate a disease state like COPD.² Magnesium deficiency is seen in aging populations and those with chronic diseases³ and has also been seen in the population of patients coming into the emergency room with acute exacerbations of COPD.⁴

- Treatment with IV magnesium has been shown to be efficacious in …

The Impact Of Police Transport Of Patients With Penetrating Traumas On Mortality, Breanne Grove

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• 2020: For people aged 1 to 44 in the U.S., firearm-related injuries ranked in the top five leading causes of death.¹
• 2022: 44,343 total gun violence deaths, 38,593 gun injuries & 646 mass shootings²
• 1987: Philadelphia became first U.S. municipality to allow police personnel to follow a “scoop and run” policy.^3,4 Necessity for police transport came from the lack of EMS availability when firearm homicide rates rose by 123%.⁵

Pocus Use For Emergency Airway Management In Rural Emergency Departments, Margaret Downing

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

- Preparation and accurate prediction of difficult airways in emergent situations is necessary for successful first pass intubation

- Current methods for airway assessments require patient cooperation and may vary by provider

• Mallampati score: open mouth, protrude tongue, see what structures are visible³
• LEMON criteria: look externally, evaluate 3-3-2 rule, Mallampati score, obstruction, neck mobility
• Thyromental distance: measure thyroid cartilage to tip of chin with neck extended³

- Difficult airways have successful first pass intubation only 82.2% of the time (vs 92.4% for non-difficult airways)⁶

- Adverse effects occurred in 14.2% of patients with successful first …

Mobile Health As A Potential Tool To Treat Children In Obesity, Olivia Carey

Master of Science in Physician Assistant Studies Capstone Presentations (Center City)

Introduction

• Pediatric obesity prevalence is estimated to be 22% in 2020 of all children in the US³
• Obesity is defined as greater or equal to the 95th percentile for age and sex⁴
• Childhood obesity leads to adulthood hypertension, hyperlipidemia, respiratory complications, and reduced quality of life⁴⁴
• The AAP released new 2023 guidelines that define the standard of care as a multi-modal, chronic-care treatment plan that prescribes healthy eating choices, an increase in physical activity, and mental health support.⁵
• Mobile health is the use of mobile phones and wireless technology in healthcare³
• A meta analysis of …