Medicine and Health Sciences Commons^™

Cime Newsletter : December 2018, Cime

Centre for Innovation in Medical Education (CIME) Archives

-Training the Future Healthcare Leaders for the best!
-A collaborative approach to train the residents of the Department of Surgery, Section of Urology
-Training of Trainers
-Provost Talk on “Policymaking in Health”
-Certificate Course in Simulation-Based Cataract Surgery
-Identifying and managing patients at high risk in orthopaedics
-Management of Oncology Patients with Neutropenia
-Death and Dying Simulation Scenario

Clabsi Rangers: A Team Approach To Extinguishing Clabsi, Alisa Bowman, Christine Bartlett, Sarah Gattis, Staci Hartmann, Eddie Lesage, Heidi Mosher, Joya Picket, Sarah Potts

Books, Presentations, Posters, Etc.

Purpose: Decrease incidence of Central line Associated Bloodstream Infection (CLABSI) in the ICU/IMCU at Swedish Medical Center by August 31^st 2018, with the overall goal of zero CLABSI stemming from the ICU’s.

Synthesis of Evidence: A review of CLABSI costs, the problem as a whole, and products that help decrease CLABSI was completed. Swedish’s current CLABSI state was discussed and ways to improve existing practices investigated. Ideas to engage and educate patients, family and staff in order to bolster infection prevention practices was reviewed.

Change in practice: Based on the evidence and our protocols we began reviewing patient charts …

250 Miles Apart, Saving Lives Together: Stop Sepsis, Ann C. Eells, Christiana Paul, Caroline Williams, Robert Fitting, Mauren Disbot, Bradley Shroeder, Jenifer Rofkahr, Amy Samolis

Books, Presentations, Posters, Etc.

No abstract provided.

December 2018, Swosu Bulldog Wellness Committee

SWOSU BULLDOG WELLNESS

Money savers for Holiday Shoppers

We hate to be negative this time of year, but gift-giving can get expensive! How to pay for all those gifts? Here are a few suggestions…

Healthy Holiday Habits

Travel, parties, big meals and snack foods at the office all create a challenging environment for eating healthy. Add in several days of travel with little scheduled physical activity, and it becomes a real effort to stay on track. Here are some helpful hints to help keep your holidays healthy!

What's Happening: November 26, 2018, Maine Medical Center

What's Happening

No abstract provided.

What's Happening: November 19, 2018, Maine Medical Center

What's Happening

No abstract provided.

Week Of November 19, 2018, New York Medical College

InTouch

• Center for Disaster Medicine Hosts "Mass Casualty Events and 'Stop the Bleeding'" Symposium
• School of Medicine Alumni Association Hosts Annual Reunion
• Department of Pediatrics and the Children's Health and Research Foundation Hosts Eighth Annual Assistant Professor Pediatric Research Symposium
• NYMC Helps Move the Needle Forward in Developing Anti-Chemical Warfare Drugs
• NYMC Hosts Fourth Annual Human Rights Institute for Middle School Student Leaders

Optimizing Psychosocial Care Of Older Adults With Cancer: An Early Assessment And Intervention Model, Lora Rhodes, Lcsw, Andrew Chapman, Do, Facp

Department of Medical Oncology Posters

Background

Jefferson Multidisciplinary Senior Adult Oncology Center

History

• Established September 2010
• First multidisciplinary geriatric oncology evaluation center in the tristate area

Demographics

• 890 patients evaluated to date
• All tumor types
• Age 70 and above & Pre-transplant (Bone Marrow) evaluation age 65 and above

Format

• Consultative service
• Two sessions weekly
• Average evaluation time: two hours

Multidisciplinary Team

• Navigator, Medical Oncologist, Geriatrician, Pharmacist, Nutritionist, Social Worker
• As needed: Psychiatry, Rehab Medicine, Radiation Oncology, Surgery

Identifying And Addressing Hepatitis C Linkage Barriers Through An Institutional Screening Process, Madalene Zale, Mph, Priya Mammen, Md, Mph

Department of Emergency Medicine Posters

Aim

This study evaluates the impact of Act 87 on HCV screening in an urban, academic hospital system with particular attention to disparate care and barriers to linkage to specialty treatment

What's Happening: November 12, 2018, Maine Medical Center

What's Happening

No abstract provided.

Week Of November 12, 2018, New York Medical College

InTouch

• GSBMS Launches New M.S. in Clinical Laboratory Sciences Program
• NYMC Takes Hard Hat Tour of Ellis Island
• HSL Hosts Special Presentation on "The Art of Observation"

Steve & Anita, Steve, Anita, Tsos

TSOS Interview Gallery

Steve and Anita Canfield helped the Church of Jesus Christ of Latter-day Saints in Turkey. They helped send blankets, coats, and washing machines to Syrian refugees. They were assigned to Frankfurt to assess refugee camps, soup kitchens, warehouses, and immigrant communities. The couple visited refugee camps and soup kitchens all over Europe to determine what was needed most by refugees.

The Canfields established the Friendship Center in Rome. The center offers classes in Italian, English, Italian, and a Red Cross course. It also has a gospel choir, a popular activity for primarily African refugees. The LDS Church has plans to …

The Santa Clara, 2018-11-08, Santa Clara University

The Santa Clara

No abstract provided.

What's Happening: November 5, 2018, Maine Medical Center

What's Happening

No abstract provided.

Cariogenic Pathogens: One Less Thing To Wine About, Jordan White, Kathleen Kersey, Jessica Darcy

Dental Hygiene Student Research Posters

Recently, studies have explored how biologically active compounds in wine benefit human teeth. Dietary polyphenols, in particular wine polyphenols, seem to balance the composition of the oral microbiota, thus leading to potentially more effective anti-carious effects on the individual. Recent research has discussed the main action mechanisms of polyphenols against oral microbial diseases and highlighted the antiadhesive capacity of caffeic and p-coumaric acids as well as grape seed and red wine extracts. It has been found that polyphenols increased their inhibition potential against S. mutans adhesion when combined with S. dentisani.¹ Other research regarding polyphenols, specifically resveratrol, discussed the anti-inflammatory …

A Barefoot Running Program For A College Lacrosse Player With Chronic Exertional Compartment Syndrome: A Case Report, Erica Mazzarelli, Kirsten Buchanan

Case Report Posters

Barefoot running protocols have been effective in decreasing anterior and lateral chronic exertional compartment syndrome (CECS), but they have not been studied in patients with posterior CECS. Additionally, there is a lack of research that has investigated a barefoot running protocol in a college lacrosse athlete. The purpose of this case report was to examine the effects of adopting a forefoot strike pattern, through a barefoot running program, in a 20-year-old college lacrosse player with posterior chronic exertional compartment syndrome.

Mckenzie Approach To Treating Lumbar Radiculopathy With A Lateral Shift: A Case Report, Carly Theriault

Case Report Posters

Lumbar radiculopathy is compression of a spinal nerve root, typically due to a herniated nucleus pulposus. It can present as low back pain (LBP) that radiates to one lower extremity (LE) and may be associated with diminished sensation, strength and reflexes on the affected side. The McKenzie approach is an evaluation and treatment technique that focuses on the movement of the nucleus pulposus within the intervertebral disc during trunk movement. This approach involves having a patient perform repeated motions, while monitoring their symptoms for centralization. Centralization refers to the concept that radiating symptoms into the lower extremities can move proximally …

The Effect Of Medical Therapeutic Yoga On Adhesive Capsulitis: A Case Report, Cameron Vallie, Matthew Somma

Case Report Posters

The number of Americans who practice yoga jumped to 16.5 million between 2004 and 2008 (87% increase), making it a top 10 modality in alternative medicine according to the National Institutes of Health. Medical Therapeutic Yoga is the practice of yoga in medicine, rehabilitation, and wellness settings by a licensed health care professional credentialed by the Professional Yoga Therapy Institute. Shoulder pain has been found to be the third most common site of musculoskeletal pain in the community. Adhesive capsulitis (AC) is a particularly disabling condition whose incidence is estimated to be between 2% and 5% of the general population …

Relieving Low Back Pain And Improving Mobility For An Adult Patient With Progressive Multifocal Leukoencephalopathy: A Case Report, Derek Schwaiger, Matthew Somma

Case Report Posters

Progressive Multifocal Leukoencephalopathy (PML) is a progressive demyelinating disease caused by the John Cunningham Virus (JCV). There is no FDA approved JCV- specific treatment. This case report examines interventions administered to address low back pain (LBP) and functional mobility deficits.

The Santa Clara, 2018-11-01, Santa Clara University

The Santa Clara

No abstract provided.

Mertk Is A Therapeutic Target In Combination With Radiation To Promote Adaptive Immune Tumor Responses, Garth Tormoen, Jason R Baird, Gwen Kramer, Shelly Bambina, Marka R Crittenden, Michael J. Gough

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Mertk is a member of the Tyro3-Axl-Mertk (TAM) family of receptors and regulates phagocytosis of dying cells by macrophages. Cancer cells killed by radiation therapy direct repolarization of macrophages into immune suppressive phenotypes. Mertk-/- mice grafted with immunogenic tumors have enhanced tumor control following ionizing radiation compared to Mertkwt mice. Gas6 is the endogenous ligand for Mertk and its ability to signal through Mertk requires a post-translational vitamin k-dependent modification that is inhibited by warfarin.

Methods: Mertk-/- and WT mice were injected subcutaneously in the flank with 5E4 CT26 cells (BALB/c) or 5E6 Panc02-SIY cells (C57BL/6) and allowed to …

Mv-626, A Potent And Selective Inhibitor Of Enpp1 Enhances Sting Activation And Augments T-Cell Mediated Anti-Tumor Activity In Vivo, Jason Baird, Gregory Dietsch, Vincent Florio, Michael Gallatin, Clayton Knox, Joshua Odingo, Marka Crittenden, Michael J. Gough

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: STING is an endogenous sensor of cGAMP, which is synthesized by cGAS following detection of cytoplasmic DNA. STING activation leads to interferon production and activation of inflammatory pathways that facilitate cytolytic T cell priming. STING agonists administered intratumorally show potent anti-tumor efficacy in a range of preclinical models; several agonists are in clinical development. Radiation therapy also increases cytoplasmic DNA levels in cancer cells, resulting in STING activation and secretion of inflammatory cytokines. Ectonucleotide pyrophosphatase/phosphodiesterase 1 (ENPP1) is the phosphodiesterase that negatively regulates STING by hydrolyzing cGAMP. MV-626, a highly potent and selective ENPP1 inhibitor with 100% oral bioavailability …

Preliminary Evaluation Of A Novel Whole Slide Multispectral Assessment Of Seven Markers: Potential To Minimize Bias In The Characterization Of The Tumor Immune Environment, Carmen Ballesteros Merino, Shawn Jensen, Carla Coltharp, Kristin Roman, Chichung Wang, Nikhil Lonberg, Sebastian Marwitz, Tarsem Moudgil, William Miller, William Redmond, Yoshinobu Koguchi, Carlo Bifulco, Clifford Hoyt, Bernard A. Fox

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: PD-L1 expression and tumor-mutational burden enrich for patients that respond to checkpoint blockade, but these evaluations are only a component of the entire story. Recently, our lab reported that evaluation of specific cell-cell relationships provided a powerful biomarker for overall survival in patients with HPV- head and neck cancer (HNSCC). However, the areas selected for analysis were operator selected “hot spots”. This approach introduces the potential for unconscious bias in the selection process. To address this, we have sought to perform whole slide evaluations of sections to compare with hot spot analysis. This study is a preliminary report applying …

Pegzilarginase In Combination With Agonist Anti-Ox40 Therapy Enhances T Cell Priming And Effector Function Leading To Improved Tumor Regression And Survival, Melissa Kasiewicz, Annah Rolig, Elizabeth Sturgill, Mark Badeaux, Scott Rowlinson, William L. Redmond

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Tumor cells defective in enzymes required for arginine biosynthesis are dependent upon arginine uptake from the environment. Extracellular depletion of arginine directly affects tumor cells, inducing autophagy and apoptosis. Pegzilarginase (AEB1102) is a bioengineered, pegylated, human arginase 1 (Aeglea Biotherapeutics) currently in phase I clinical trials. This arginine-depleting agent has been shown to both inhibit arginine auxotrophic tumor growth and to enhance the efficacy of PD-L1 blockade in preclinical models. In the current study, we investigated the therapeutic efficacy and mechanism of action of combined pegzilarginase/anti-OX40 (aOX40) immunotherapy. We hypothesized that pegzilarginase/aOX40 treatment would synergize to enhance T cell …

Integrative Spatially-Resolved, High-Plex Digital Profiling Enables Characterization Of Complex Immune Biology In The Tumor Microenvironment Of Mesothelioma, Carmen Ballesteros-Merino, Moritz Widmaier, Sarah Church, Thomas Herz, Alexei Budco, Das Medrikova, Ivan Kanchev, Andrew White, Douglas Hinerfeld, Shawn Jensen, John Handy, Rachel Sanborn, Carlo Bifulco, Sarah Warren, Joseph Beechem, Bernard .. Fox

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Malignant mesothelioma is an aggressive cancer with poor prognosis and few effective therapies. Since mesothelioma is derived from the mesothelium of the lung, we hypothesize that immune cells in the tumor microenvironment (TME) may behave differently than other solid tumors. In our previous studies, utilizing multi-plexed immunofluorescence, we did not find immune phenotypes associated with improved patient survival. Here we describe a novel combination of two technologies to spatially characterize the interface between mesothelioma cells, stroma and immune cells in the TME in a high-plex capacity.

Methods: Ten FFPE mesothelioma tumors were characterized by Definiens’ Immune-Oncology Profiling (IOP) and …

Preliminary Results From A First-In-Human Phase 1 Study Of The Cd40 Agonist Monoclonal Antibody (Mab) Cdx-1140, Rachel Sanborn, Michael S. Gordon, Mark O'Hara, Nina Bhardwaj, Yi He, Tracey Rawls, Tibor Keler, Michael Yellin

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Agonist CD40 mAbs can mediate antitumor immunity through multiple mechanisms, including enhancing tumor antigen presentation, activation of tumoricidal macrophages, and direct growth inhibition/killing of CD40- expressing tumor cells. To fully exploit these mechanisms may require the mAb to be dosed at levels that provide significant tumor and tissue penetration, without dose-limiting-toxicities (DLT) from systemic CD40 activation. Our agonist CD40 mAb, CDX-1140, was selected based on its unique and linear dose-dependent in vitro and in vivo activity and is postulated will achieve maximum agonist activity at dose levels associated with good systemic exposure. CDX-1140 is a fully human IgG2 agonist …

Nktr-214 (Cd122-Biased Agonist) And Nktr-262 (Tlr7/8 Agonist) Combination Treatment Pairs Local Innate Immune Activation With Systemic Cd8+ T Cell Expansion To Enhance Anti-Tumor Immunity, Annah S. Rolig, Daniel Rose, Saul Kivimäe, Deborah Charych, Werner Rubas, Jonathan Zalevsky, William L. Redmond

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Radiation therapy (RT) remains the standard of care for many human cancers. Combining NKTR-214, a CD122-biased cytokine agonist conjugated with releasable polyethylene-glycol (PEG) chains, with local RT significantly enhanced therapeutic efficacy in preclinical models. Mechanistically, NKTR-214 provides sustained signaling through the IL-2 receptor pathway (IL-2Rβγ) to preferentially activate and expand effector CD8+ T and NK cells and RT modulates the tumor microenvironment (TME) to induce antigen-release. Together, NKTR-214/RT treatment resulted in improved therapeutic responses compared to either treatment alone. However, abscopal responses in murine tumors were modest, leading us to explore alternative approaches with the potential to elicit more …

Combined Anti-Pd-1 And Anti-Lag-3 Checkpoint Blockade Enhances Cd8+ Til Effector Function While Reducing Tregs Leading To Reduced Immune Suppression And Improved Overall Survival, Elizabeth Sturgill, Courtney Mick, David Jenkins, Johanna Kaufmann, William L. Redmond

Society for Immunotherapy of Cancer 2018 Annual Meeting Posters

Background: Checkpoint inhibition is a potent strategy to reinvigorate T cells. However, aCTLA-4 or aPD-1 monotherapy has not been effective for the majority of patients, resulting in the exploration of combinatorial approaches to improve treatment efficacy. One such target is LAG-3, which is upregulated on T cells that have experienced repeated antigen exposure, such as in the tumor microenvironment (TME), and is associated with reduced T cell effector function. In addition, high LAG-3 expression on regulatory T cells (Tregs) has been reported for patients with varying cancer types, providing an additional rationale for targeting LAG-3 with the aim of reducing …

When Failure Is Not An Option, Lindsey Ago, Caitlin Digirolamo, Dylan Gagner

Dental Hygiene Student Research Posters

This research poster addresses the question, “What treatment modalities are most effective at treating peri-implantitis (PI)?” Dental implants are one of the most innovative ways to support dental prosthetics. They can support heavy physical loads. However, infection causes inflammation and bone loss around implants. Studies indicate that there are many factors that can increase the risk for PI. These factors include: Smoking; pre-existing periodontal disease; oral hygiene, quality of prosthetic reconstruction; some systemic conditions and medications.

There are a significant amount of treatment options for PI that range from surgical, nonsurgical, antibiotics, and even lasers. While reviewing studies related to …

Breastfeeding: The Best Formula For The Oral Microbiome, Eliza Lopes, Alexandra Cabana

Dental Hygiene Student Research Posters

This research poster addresses the question “What differences are seen between formula and breastfed babies in the development of the oral microbiome?” The bacteria that make up the oral microbiome begins accumulating from birth through interactions with the environment and caregivers. When it comes to the oral cavity, bacteria such a Streptococcus mutans and Lactobacilli, can be transferred through saliva or feeding. Breastfeeding provides important nutritional and immunological benefits to the development of infants but it also plays a vital role in the development of the oral microbiome that may be superior to that of formula-feeding. Studies show that the …