Medicine and Health Sciences Commons^™

Inspire : Vol 2, Issue 2, Department Of Medicine

INSPIRE – Department of Medicine Archives

Content

• Message From the Chair
• Accelerating the elimination of viral hepatitis's Lancet Gastroenterology & Hepatology Commission
• Peritoneal Dialysis Programby Syed Farrukh Umair
• Department of Medicine at National and International Forums
• What Are Academics Around the World Reading This Month?
• Featured Faculty Profile
• Dr. Saman Ali; “Stay true to yourself, stay humble, work hard but also try to have fun while doing it.”
• Publications

Clinical Research In Pneumonia: Role Of Artificial Intelligence, Timothy L. Wiemken, Robert R. Kelley, William A. Mattingly, Julio A. Ramirez

The University of Louisville Journal of Respiratory Infections

No abstract provided.

The Relationship Between Pitching Volume And Arm Soreness In Collegiate Baseball Pitchers, Angel L. Lazu, Shawn D. Love, Timothy A. Butterfield, Robert A. English, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: Excessive baseball pitch volume has been associated with increased risk of injury in adolescents. However, many collegiate athletes report non-time loss injuries over the course of the season. It is unknown how pitch volume throughout a collegiate baseball season affects arm soreness.

Purpose: The primary purpose of this study was to determine the relationship between pitch volume and self-reported arm soreness. A secondary purpose was to determine the relationship between change in pitch volume and change in arm soreness over the course of the season for collegiate baseball pitchers.

Study Design: Prospective Cohort.

Methods: Seven collegiate baseball …

Neuromuscular Adaptions Following A Daily Strengthening Exercise In Individuals With Rotator Cuff Related Shoulder Pain: A Pilot Case-Control Study, Amee L. Seitz, Lisa A. Podlecki, Emily R. Melton, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: The goal of therapeutic exercise is to facilitate a neuromuscular response by increasing or decreasing muscular activity in order to reduce pain and improve function. It is not clear what dosage of exercise will create a neuromuscular response.

Purpose: The purpose of this study was to assess the effects following a three-week home program of a daily single exercise, the prone horizontal abduction exercise (PHA), on neuromuscular impairments of motor control as measured by scapular muscle EMG amplitudes, strength, and secondarily outcomes of self-reported pain and function between individuals with and without subacromial pain syndrome.

Study Design: Prospective Case-Control, …

Acute Treadmill Exercise Discriminately Improves The Skeletal Muscle Insulin-Stimulated Growth Signaling Responses In Mice Lacking Redd1, Cory M. Dungan, Bradley S. Gordon, David L Williamson

Physical Therapy Faculty Publications

A loss of the regulated in development and DNA damage 1 (REDD1) hyperactivates mechanistic Target of Rapamycin Complex 1 (mTORC1) reducing insulin‐stimulated insulin signaling, which could provide insight into mechanisms of insulin resistance. Although aerobic exercise acutely inhibits mTORC1 signaling, improvements in insulin‐stimulated signaling are exhibited. The goal of this study was to determine if a single bout of treadmill exercise was sufficient to improve insulin signaling in mice lacking REDD1. REDD1 wildtype (WT) and REDD1 knockout (KO) mice were acutely exercised on a treadmill (30 min, 20 m/min, 5% grade). A within animal noninsulin‐to‐insulin‐stimulated percent change in skeletal muscle …

Managing Severe Tbi In The Icu Setting Using A Three Tier Approach, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Assess the effects of injury to the brain in the neurologic injured patient and implement a tiered approach to manage severe TBI
• Evaluate TBI patients using multimodality monitoring
• Apply interventions to manage brain injury & integrate the complex multi-system issues and manage these patients using an actual case study.

Implementation Of Coordinated Telestroke Program In An Urban Setting Improves Acute Stroke Care, John Zurasky, Leslie Corless, Lindsay Lucas, Elizabeth Baraban

Books, Presentations, Posters, Etc.

Purpose: Telestroke has been shown to improve acute ischemic stroke (AIS) care in rural settings, but few studies have examined the impact of telestroke in an urban setting. In an urban area, there was a planned transition from an outpatient-based acute stroke provider pool to a centralized telehealth team of neurovascular and neurocritical care providers. This study assessed the impact of this change by comparing patient outcomes during three time periods: pre-initiation (PRE), transition after initiation (TRAN) and post-transition (POST).

Methods: Data for AIS patients 18 and older from five urban hospitals were used. Outcomes were hospital length of stay …

Impact Of Early Mobilization On 90-Day Outcomes In Thrombectomy Patients, Tamela Stuchiner, Diane Clark, Lindsay Lucas, John Robinson, Lisa Yanase

Books, Presentations, Posters, Etc.

Introduction: Early mobilization of ischemic stroke patients receiving IV alteplase (tPA) did not worsen 90-day outcome at two urban stroke centers in a prior study, but there are no studies evaluating outcomes of early mobilization after thrombectomy. The mobility protocol used in the previous study was also utilized to mobilize stroke patients receiving thrombectomy treatment at these two centers, once minimum number of hours for groin precautions was complete and the groin puncture site was stable. The objective of this study was to determine for post-thrombectomy patients mobilized within 24 hours, whether earlier mobilization worsened outcomes.

Methods: Medical records of …

The Underdeveloped Innate Immunity In Embryonic Stem Cells: The Molecular Basis And Biological Perspectives From Early Embryogenesis, Yan-Lin Guo

Faculty Publications

Embryonic stem cells (ESCs) have been intensively studied as a promising cell source for regenerative medicine. The rapid advancements in the field have not only proven the feasibility of ESC‐based cell therapy, but also led to a better understanding of pluripotent stem cells (PSCs) as a unique cell population at an early stage of embryogenesis. Recent studies have revealed that both human and mouse ESCs have attenuated innate immune responses to infectious agents and inflammatory cytokines. These findings raise interesting questions about the rationale for ESCs, the PSCs experimentally derived from preimplantation stage embryos, to not have an innate defense …

Biphenotypic Sinonasal Sarcoma-Case Report And Review Of Clinicopathological Features And Diagnostic Modalities., Chandala Chitguppi, Ian Koszewski, Kaitlin Collura, Mark Curtis, Gurston G. Nyquist, Mindy R. Rabinowitz, Marc Rosen

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Background

Biphenotypic sinonasal sarcoma is a recently described malignancy showing dual differentiation with both myogenic and neural elements. Due to its histologic similarities to other sinonasal malignancies, it is a diagnostic challenge.

Objective

The main purpose of this article is to report a case of biphenotypic sinonasal sarcoma and to consolidate data and provide a comprehensive review regarding pathological differences between biphenotypic sarcoma and other sinonasal malignancies and diagnostic modalities used for biphenotypic sarcoma.

Material and Methods

A systematic review of all cases of biphenotypic sinonasal sarcoma was performed using electronic databases (PubMed and Medline). Data collected included age, gender, …

Temperature Management: All Shook Up! Managing Shivering In Normothermia, Mary Kay Bader

Books, Presentations, Posters, Etc.

Objectives:

• Identify key factors related to maintaining normothermia
• Describe the use of the Bedside Shivering Assessment Scale
• Provide interventions to manage shivering in the Neuro patient population

Cost Analysis Of Implementing Standardized Stroke Patient Education Materials In A Large Five State Health System, Natalie Swearingen, Leslie Corless, Jessica Swann, Kailey Cox, Diane Lada, Elizabeth Baraban

Books, Presentations, Posters, Etc.

No abstract provided.

Effect Of Tort Reform On Diagnostic Imaging Rates, Israel Ojalva, Ba, Arthur Hong, Md, Mph

Phase 1

Introduction: Defensive medicine, is defined as “order[ing] tests, procedures, or visits, or avoid certain high-risk patients or procedures, primarily (but not solely) because of concern about malpractice liability.” Nearly all physician who fear malpractice litigation have admitted to practicing some degree of defensive medicine. In response, many states have enacted policy reforms to lighten the threat of malpractice on physicians.

Objective: The most common defensive medicine behavior is ordering diagnostic imaging tests when it is potentially unwarranted. Many states have enacted non-economic damage caps from 2000-2010. We explored if these laws had an impact on the rates of diagnostic imaging …

Identifying The Causes Of Cancer Readmissions: A Patient Centered Approach, Katie Holland, Emily Wei, Allison Zibelli

Phase 1

While there are large efforts to decrease readmission rates in the United States, cancer patients represent a population that has been overlooked. Cancer patients are a vulnerable population who make up a large portion of hospital readmissions. Most of the current research on the causes of readmissions in cancer patients focuses on medical chart reviews and insurance claims. Many of these studies fail to incorporate patient input which could further the understanding of the complete burden associated with cancer readmissions. The goal of this study is to understand the personal reasons behind the decision of cancer patients to return to …

Enhancing Services For Homeless Populations: Impact Of A Virtual-Reality Training Tool On Health Professional Students’ Self-Efficacy In Working With Homeless Populations, Madeline Russell, Susan Toth-Cohen, Phd, Otr/L

Phase 1

INTRODUCTION

Despite the rising prevalence and unmet healthcare needs of homeless populations, most healthcare providers do not receive specific training on working with this population. The growth of simulation-based technology in the medical classroom offers new opportunities for such training. Virtual-reality tools have been shown to facilitate learning and minimize restraints such as time and travel. The Enhancing Service to Homeless Populations (ESHP) program was designed to provide health professions students at Thomas Jefferson University with training on how to interact with homeless populations using an interprofessional virtual-reality setting, with the ultimate goal of improving students’ self-efficacy.

METHODS

Participants (n=15) …

Clinical Genome Sequencing In An Unbiased Pediatric Cohort., Isabelle Thiffault, Emily G. Farrow, Lee Zellmer, Courtney D. Berrios, Neil Miller, Margaret Gibson, Raymond Caylor, Janda L. Jenkins, Deb Faller, Sarah E. Soden, Carol J. Saunders

Manuscripts, Articles, Book Chapters and Other Papers

PURPOSE: We report for the first time, the use of clinical genome sequencing (GS) in an unbiased pediatric cohort. We describe the clinical validation, patient metrics, ordering patterns, results, reimbursement, and physician retrieval of results for the first consecutive 80 cases.

METHODS: Clinical GS was performed for both inpatients and outpatients undergoing etiologic evaluations. Results were reported in the electronic medical record. Evidence of report retrieval by clinicians and whether interpretation was concordant with laboratory report was obtained through retrospective chart review.

RESULTS: Twenty definitive diagnoses were made in 19 patients (24%; n = 80). Except for two partial gene …

Handoffs From The Operating Room To The Intensive Care Unit After Cardiothoracic Surgery: From The Society Of Thoracic Surgeons Workforce On Critical Care, Subhasis Chatterjee, Jay G Shake, Rakesh C Arora, Daniel T Engelman, Michael S Firstenberg, Charles M Geller, Hitoshi Hirose, Vassyl A Lonchyna, Francis T Lytle, Rita K C Milewski, Rainer G H Moosdorf, Joseph Rabin, Rohan Sanjanwala, Marianne Galati, Glenn J Whitman

Library Staff Publications

No abstract provided.

Quality Of Life And Psychological Distress In Cancer Survivors: The Role Of Psycho-Social Resources For Resilience, Craig A. Harms, Lynne Cohen, Julie Ann Pooley, Suzanne K. Chambers, Daniel A. Galvao, Robert U. Newton

Research outputs 2014 to 2021

OBJECTIVE: To examine the association between scores on the Protective Factors for Resilience Scale (PFRS) (as a measure of a person's psycho-social resources for resilience) and quality of life as well as symptoms of psychological distress for adult cancer survivors.

METHODS: In this cross-sectional study, 295 cancer survivors (59% female) provided background demographic information and completed the PFRS as well as measures of quality of life and psychological distress previously validated with cancer survivors. Most of the survivors were diagnosed with breast or prostate cancer.

RESULTS: Analysis of the data confirmed the factor structure for the PFRS …

Deep Learning Based Medical Image Analysis With Limited Data, Jiaxing Tan

Dissertations, Theses, and Capstone Projects

Deep Learning Methods have shown its great effort in the area of Computer Vision. However, when solving the problems of medical imaging, deep learning’s power is confined by limited data available. We present a series of novel methodologies for solving medical imaging analysis problems with limited Computed tomography (CT) scans available. Our method, based on deep learning, with different strategies, including using Generative Adversar- ial Networks, two-stage training, infusing the expert knowledge, voting based or converting to other space, solves the data set limitation issue for the cur- rent medical imaging problems, specifically cancer detection and diagnosis, and shows very …

The Master Synaptic Regulator: Activity Regulated Cytoskeleton Associated Protein, Arc, In Normal Aging And Diseases With Cognitive Impairment, Amber Khan

Dissertations, Theses, and Capstone Projects

Alzheimer’s disease (AD) is a progressive neurodegenerative disease with complex underlying pathogenic mechanisms. Epidemiological studies have forecasted that in the next 3 decades, the number of AD cases will rise to epidemic proportions with enormous medical, emotional and financial burdens impacting individuals affected and society. Among many risk factors for AD, advancing age is clearly essential and necessary. Revelation of molecular changes in synaptic activities leading to the prodromal, mild cognitive impairment (MCI) stage may help illuminate the course of pathogenic progression and its cause-effect relationship with various targets thereby enabling target-driven disease-modifying therapeutic agents for AD.

Activity-regulated cytoskeleton-associated (Arc) …

Green Tea Extract, Epigallocatechin Gallate, Protect Against Methamphetamine-Induced Striatal Neurotoxicity In Mice, Allen L. Pan

Dissertations, Theses, and Capstone Projects

Methamphetamine (METH) is a strong psychostimulant and its exposure can lead to serious neurological complications. METH-induced neuronal injury is the result of a complex interplay of different factors including dopamine (DA) overflow, oxidative stress and neuroinflammation. Although the mechanisms of METH-induced neurotoxicity have been extensively studied, there is still no effective therapeutic treatment. Therefore, it is essential to study potential drug candidates that can treat METH-induced neurotoxicity. Green tea extract, epigallocatechin gallate (EGCG), has emerged as a neuroprotective agent that can protect against several neurodegenerative diseases such as Alzheimer’s and Parkinson’s diseases. Recently, our lab has shown that EGCG prevents …

Ck2 Negatively Regulates 5-Ht4 Receptor Signaling In The Prefrontal Cortex And Mediates Depression-Like Behaviors, Julia Castello Saval

Dissertations, Theses, and Capstone Projects

The serotonergic system has been the major candidate in the pathophysiology of mood related disorders such as anxiety and major depressive disorder (MDD). Unfortunately, current antidepressant drugs are ineffective in 50% of the population and require chronic administration for a period of 3-6 weeks before the onset of therapeutic response. 5-HT4 receptor (5-HT₄R) agonists have emerged as potential candidates for fast antidepressant action, since an antidepressant response can be achieved after 3 days of pharmacological administration in rodents.

This dissertation aims to investigate the role of casein kinase 2 (CK2) as a regulator of 5-HT₄R expression …

Intimate Partner Violence Among Expectant Adolescent Couples: Psychological And Relational Predictors And Sexual Risk, Jessica Lewis

Dissertations, Theses, and Capstone Projects

BACKGROUND/PURPOSE: Intimate partner violence (IPV) is prevalent and tends to be bilateral in adolescent relationships. Expectant adolescent couples are at even higher risk. Using the Actor-Partner Interdependence Model (APIM), this study sought to: (1) describe the patterns of physical/sexual and psychological IPV victimization of women and men in expectant adolescent couples from pregnancy through twelve months postpartum; (2) examine the associations between psychosocial and relational factors during pregnancy and postpartum IPV; and (3) investigate the relationship between IPV victimization and later sexual risk across the perinatal period.

METHODS: Data were collected from pregnant adolescents and their male partners (N=296) recruited …

The Morphology And Evolution Of The Primate Brachial Plexus, Brian M. Shearer

Dissertations, Theses, and Capstone Projects

Primate evolutionary history is inexorably linked to the evolution of a broad array of locomotor adaptations that have facilitated the clade’s invasion of new niches. Researchers studying the evolution of primates and of their individual locomotor adaptations have traditionally relied on bony morphology – a practical choice given the virtual non-existence of any other type of tissue in the fossil record. However, this focus downplays the potential importance of the many other structures involved in locomotion, such as muscle, cartilage, and neural tissue, which may each be influenced by separate selective forces because of their different roles in facilitating movement. …

The Effect Of Fibular Reposition Taping On Postural Control In Individuals With Chronic Ankle Instability: A Critically Appraised Topic, Bradley C. Jackson, Robert T. Medina, Stephanie H. Clines, Julie M. Cavallario, Mathew H. Hoch

Rehabilitation Sciences Faculty Publications

Clinical Scenario: History of acute ankle sprains can result in chronic ankle instability (CAI). Arthrokinematic changes resulting from CAI may restrict range of motion and contribute to postural control deficits. Mulligan or fibular reposition taping (FRT) has been suggested as a means to realign fibular positional faults and may be an effective way to improve postural control and balance in patients with CAI. Clinical Question: Is there evidence to suggest that FRT will improve postural control for patients with CAI in the affected limb compared with no taping? Summary of Key Findings: Three of the 4 included studies found no …

Clinical And Procedural Effects Of Transitioning To Contact Force Guided Ablation For Atrial Fibrillation., Daniel R. Frisch, Sean J. Dikdan

Division of Cardiology Faculty Papers

Background: A major innovation in atrial fibrillation (AF) ablation has been the introduction of contact force (CF) sensing catheters.

Objective: To evaluate procedural and clinical effects of transitioning to CF-guided AF ablation.

Methods: Consecutive AF ablation patients were studiedduring the period of time of transitioning from a non-CF to CF sensing catheter. Procedural data recorded was total radiofrequency time, time to isolate the left pulmonary veins (LPVs), and time to isolate the right pulmonary veins (RPVs). Clinically, the 3 and 12-month maintenance of sinus rhythm was noted and compared by: paroxysmal vs. persistent AF; CT scan LA volume more or …

The American Academy Of Ambulatory Care Nursing's Invitational Summit On Care Coordination And Transition Management: An Overview, Sheila Haas, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

The American Academy of Ambulatory Care Nursing convened an Invitational Summit of national leaders to assist with strategic planning for promulgation of the care coordination and transition management (CCTM™) model. The conference was devoted to CCTM and the roles of registered nurses (RNs) across the care continuum to ensure safety and quality health care. The specific emphasis was on embedding the CCTM RN in healthcare policy and payment reform, as well as integration into academic and ongoing education across all care settings and specialties.

Just Another Chalazion?, Jonathan Mclaughlin, Sara E. Lally, Carol L. Shields

Wills Eye Hospital Papers

No abstract provided.

The Anatomy Of An Insult: Popular Derogatory Terms Connote Important Individual Differences In Agreeableness/Antagonism, Courtland S. Hyatt, Jessica L. Maples-Keller, Chelsea E. Sleep, Donald R. Lynam, Joshua D. Miller

Department of Psychological Sciences Faculty Publications

In the current series of studies, we investigate the psychosocial connotations of common insults. In Studies 1 and 2, we investigated the most frequently used insults to denigrate men and women (asshole, dick, bitch), and generated trait profiles that can be considered prototypical of each insult. In Studies 3 and 4, we examined how these insults are relevant to other key indicators of interpersonal functioning, including aggression, social information processing, personality disorders, and substance use. We also gathered thin-slice and informant reports. Each of the insults was associated with trait Antagonism, as well as other behaviors that comprise Antagonism’s nomological …

Low Cost Reconstructive Options After Musculoskeletal Tumour Resection In Developing Countries: Affordable, Effective And Durable Alternatives, Arif Ali, Obada Hasan, Ahmed Habib, Masood Umer

Section of Orthopaedic Surgery

Over the last two, three decades, the overall survival rates for non-metastatic malignant tumours of the bone have dramatically improved. This has become possible due to the recent advances and multidisciplinary approach towards these diseases, specifically the advent of multi-agent chemotherapy and radiotherapy. Limb salvage has now become the norm in the treatment of musculoskeletal tumours without compromising on the overall survival and recurrence of the disease. In the era of metal, prosthetic reconstruction has become the standard procedure specifically in the large tumours which involve the joints as this method of reconstruction helps in joint mobility and early weight-bearing. …