Medicine and Health Sciences Commons^™

Translation Of Ephb2 In Pkcgamma And Calretinin Interneuron Subpopulations After Spinal Cord Injury, David A. Jaffe, Nicolette Heinsinger, Angelo Lepore

Phase 1

Introduction: Neuropathic pain is a common, debilitating occurrence after spinal cord injury (SCI). EphB signaling has been implicated in neuropathic pain, but different populations of neurons that upregulate EphB after SCI must be discovered. Understanding whether EphB2 is upregulated in specific subpopulations of dorsal horn interneurons (e.g. those expressing PKCgamma or calretinin) after injury would increase the understanding of SCI-induced neuropathic pain.

Methods: Mice were either given a contusion-type SCI (n=7) or a laminectomy-only (n=6) at cervical level 5/6. After two weeks of recovery, mRNA was labeled using RNAscope in the sectioned spinal cords. Four different targets were visualized …

Appropriate Ecmo Screening Protocols For Critically Ill Patients During Covid-19, Hudson Carter, Michael Baram, Md

Phase 1

Introduction: The use of Extracorporeal membrane oxygenation (ECMO) for COVID-19 patients has proven to have several advantages that advocate for increased use, but current screening protocols have limited its use and availability. The purpose of this study was to evaluate screening criteria for ECMO patients during COVID-19 and determine their appropriateness based on resource availability.

Methods: The population included patients referred for ECMO screening, and were stratified based upon referral outcome, survival length and patient disposition. The referring physicians were contacted to gather information regarding the referral process, the patient’s status prior to referral, and possible referral to another …

Effectiveness Of A Primary Care Nutrition Education/Vlcd Diet Program, Jessica Vitale, Ayesha Baig, Steven Chang, Hannah Kostan, Connor Mcelwee, Ketav Patel, Cindy Cheng

Phase 1

Introduction: Jefferson currently has a Medical Nutrition Therapy (MNT) program via an educational component delivered via Zoom to assist patients with managing their diet, exercise, medication changes and understanding the physiology of their conditions. We aim to study the effectiveness of the MNT program, along with the impact of duration of program participation, on weight loss, blood pressure, glucose and total cholesterol. In addition, I am focusing on triglycerides, HDL and LDL. We hypothesize that patients in our MNT program will have lower weight, blood pressure, blood glucose and total cholesterol, with a further positive effect of longer participation …

Continuous Positive Airway Pressure Therapy Effects On Lipid And Hepatic Function Test Values, Grace Severance, Cynthia Cheng, Md, Phd, Amy He, Peter Zhang, Dani Yellanki, Zachary Feuer, Olivia Taylor, Natali Salinas

Phase 1

Introduction : Continuous positive airway pressure (CPAP) therapy is an established therapy for patients diagnosed with obstructive sleep apnea (OSA). The following study aims to measure the impact of CPAP therapy on lipid and liver profiles of patients diagnosed with OSA. We hypothesize that CPAP therapy will improve patient serum lipid and liver measures in this patient population compared to patient baseline prior to CPAP therapy. Furthermore, we also will examine differences in hepatic ultrasound results for OSA patients on CPAP therapy.

Methods: The target patient population has moderate-severe OSA, defined as an Apnea-Hypopnea Index greater than 15. The intervention …

Validation And Accuracy Of Synovial Alpha Defensin In A Suburban Academic Center After Implantation As Part Of The Workup For Periprosthetic Joint Infections, Donald Willier, Iii, Kenneth J. Mcalpine, Md, Anthony F. De Giacomo, Md, John S. Garfi, Ms, Lawrence M. Specht, Md, Michael S. Kain, Md

Phase 1

Introduction

Periprosthetic joint infection (PJI) is a leading cause of total hip and knee arthroplasty failure. The Musculoskeletal Infection Society (MSIS) criteria for PJI has allowed diagnosis standardization. To increase the MSIS criteria accuracy, synovial fluid biomarkers have been tested. Studies evaluating synovial alpha defensin have reported both sensitivity and specificity up to 100%. In this study, we report our analysis on the use of alpha defensin testing in a suburban academic tertiary referral center.

Methods

We performed a retrospective analysis of a prospectively collected database of 133 patients tested for PJI over a 6 year period. From 2014, our …

A Meta-Analysis Of The Effects Of Sglt-2 Inhibitors On Serum Electrolytes, Mark Leibensperger, Jingjing Zhang, Md, Phd, Yonghong Huan, Md

Phase 1

Introduction: Previous studies have reported that sodium-glucose co-transporter 2 (SGLT2) inhibitors affect serum electrolytes levels, especially magnesium. This study aims to integrate direct and indirect trial evidence to evaluate the relative effects of all SGLT2 inhibitors against each other on electrolyte levels in patients with type 2 diabetes (T2D).

Methods: Electronic databases were systematically searched through December 2018 to identify eligible randomized controlled trials (RCTs) that reported mean changes in serum electrolyte levels, including magnesium, sodium, potassium, phosphate, calcium, and urate in patients with T2D. Random-effects pairwise and network meta-analyses were performed to calculate the weighted mean difference (WMD) …

Radiographic Results Of Expandable Interbody Devices, Jonathan Ledesma, Mark Kurd, Md, Kris Radcliff, Md, D. Greg Anderson, Md

Phase 1

Introduction: Minimally invasive surgery for transforaminal lumbar interbody fusion (MIS-TLIF) has become a mainstay procedure in the treatment of degenerative conditions of the lumbar spine. Expandable interbody devices have gained popularity in recent times due to several well-cited advantages including greater correction of disc height and lordosis and decreased intraoperative disruption of neurologic structures. However, the clinical benefits offered by these devices compared to traditional static implants remain unclear. This study seeks to investigate differences in the radiographic and clinical outcomes between traditional static versus expandable interbody devices used in MIS-TLIF.

Methods: Patients who underwent MIS-TLIF performed by three …

Effect Of Recipient Diabetes Status On Immune Rejection After Descemet Stripping Endothelial Keratoplasty, Elliot Cherkas, Zeba Syed, Michael Sulewski

Phase 1

This study seeks to determine whether recipient diabetes status relates to incidence of immune rejection following Descemet Stripping Endothelial Keratoplasty (DSEK). We hypothesized that patients with diabetes would have a greater risk of graft immune rejection.

This is a retrospective cohort study to compare recipient diabetes status in 794 DSEK surgeries at Wills Eye Hospital between January 2008 and July 2019. Kaplan-Meier functions of survival time until first immune rejection was compared between groups. Pearson’s chi square test and Wilcoxon test were used to test the null hypothesis.

During the study period, 146 of 794 DSEK recipients had diabetes. At …

Evaluating The Efficacy Of Telestroke Intervention In A Large Community Hospital Network, Daniel Moylan, Daniel Joffe, Charles Morse, Michael Knapp, Ahmad Sweid, Pascal Jabbour

Phase 1

Introduction: Telemedicine for acute ischemic stroke (Telestroke) allows live consultation between patients, remote stroke specialists, and providers to facilitate administration of IV tissue plasminogen activator (IV-tPA) within the 4.5 hour window. Small cohort studies have demonstrated thrombolytic therapy conveys significant benefit to stroke outcomes and yet is underutilized due to difficulties in recognition and delivery of medication. This study proposes that access to telestroke care across the Thomas Jefferson University Hospital network will result in increased thrombolytic reperfusion rates and improved patient outcomes for stroke.

Methods: A retrospective cohort study was designed to utilize a telestroke database collecting information from …

Tumor Doubling Time Of Pulmonary Carcinoid Tumors Measured By Ct, Douglas Russ, Julie Barta, Md, Nathaniel R. Evans, Md, Robert T. Stapp, Do, Gregory C. Kane, Md

Phase 1

Introduction:

Pulmonary carcinoid tumor (PCT) is a rare neuroendocrine lung cancer that is known clinically to be a slow-growing neoplasm. Few studies have established the true growth rate of these tumors when followed over time by radiography. Therefore, we sought to determine PCT tumor doubling time using longitudinal Computed Tomography (CT) scans. Nodule guidelines may misclassify early PCT nodules with a small diameter as benign if tumor growth is too slow to be appreciable on follow up radiographic scans completed between six months and two years after initial detection.

Methods:

We performed a retrospective analysis of available CT imaging …

Evaluation Of Firearm Suicide Among Patients Treated Across The Jefferson Enterprise, Connor Mcpartland, Allegra Bermudez, Stanton B. Miller, Md, Mph, Facs

Phase 1

Introduction and Objective:

Firearm suicide is a leading cause of mortality. This study aims to identify risk factors associated with patients who attempt suicide with a firearm. The hypothesis is that adolescents of non-Hispanic white race/ethnicity are at the highest risk of firearm suicide.

Methods:

Patients treated at Thomas Jefferson University Hospital between 3/1/2017 and 12/1/2020 for a self-inflicted gunshot wound and/or attempted suicide were included in the study. Patients were identified through ICD-10 codes and a clinical research software tool known as TriNetX was used to analyze incidence of suicide as well as potential risk factors such as …

Contrast-Enhanced Endoscopic Ultrasound For Identification Of Sentinel Lymph Nodes In Esophageal Cancer, Bethanne Venkatesan, Ji-Bin Liu, Md, John R. Eisenbrey, Phd, Sriharsha Gummadi, Md, Thomas Kowalski, Md, Robert Coben, Md, Flemming Forsberg, Phd, Corinne Wessner, Priscilla Machado, Md, David Loren, Md

Phase 1

Introduction:

In esophageal carcinoma, lymph node involvement is a crucial aspect of nodal staging and determining treatment strategies. Although grayscale endoscopic ultrasound (EUS) is the standard of care for staging, it is unable to identify lymph node drainage from primary tumors or sentinel lymph nodes (SLN). The goal of this study was to determine if Contrast Enhanced Endoscopic Ultrasound (CE- EUS) is superior to EUS in the identification of SLNs and nodal staging in esophageal carcinoma.

Methods:

In the unblinded pilot study, patients with newly diagnosed esophageal carcinoma were recruited to undergo CE-EUS and standard EUS. EUS was performed …

The Effect Of Cpap Treatment On T2dm In Moderate To Severe Osa Subjects, Dani Yellanki, Amy He, Grace Severance, Peter Zhang, Zach Feuer, Natali Salinas, Olivia Taylor, Rani Patel, Hannah Kostan, Carl Sun, Catherine Liu, Humaal Khan, Katie Keck, Mikayla Cochrane, Ronak Ahir, Sammy Alfonsi, Will Connolly, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a significant risk factor for type 2 diabetes mellitus (T2DM). CPAP treatment can potentially improve glycemic control in such subjects. However, the exact effects of CPAP treatment on diabetes are uncertain. The objective of this study is to examine the effect of CPAP treatment on HbA1c levels in subjects with moderate to severe OSA and T2DM.

Methods: This is a combined retrospective and prospective study collecting data through EPIC medical record reviews. We are collecting HbA1c levels (primary outcome variable) before and after CPAP treatment in subjects with moderate to severe OSA and T2DM. …

Evaluating The Accuracy And Use Of Continuous Glucose Monitoring In Hospitalized Patients: A Systematic Review And Meta-Analysis, Caroline Purcell, Jeffrey I. Joseph, Do

Phase 1

Introduction:

Glycemic variability in hospitalized patients is associated with poor clinical outcomes, longer length of stay, and increased cost. Advances in subcutaneous continuous glucose monitoring (CGM) technology may reduce glycemic excursions and improve clinical outcomes in hospitalized patients, yet CGM is not used due to a lack of evidence on accuracy. The objective of this study was to review and summarize the evidence on the accuracy of CGM in hospitalized, diabetic patients.

Methods:

A search was conducted for literature evaluating CGM accuracy in hospitalized, diabetic patients. Relevant studies were identified through full-text review and data was extracted for analysis. …

The Effect Of Medical Nutrition Therapy On Weight Loss, Ayesha Baig, Hannah Kostan, Cynthia Cheng

Phase 1

Introduction: In this retrospective study, we evaluated the effects of Jefferson’s medical nutrition therapy (MNT) program on weight loss. We anticipate that participation in the MNT program will lead to an improvement in weight and metabolic syndrome parameters.

Methods: We selected a convenience sample of 10 participants with BMI > 25 for this pilot retrospective chart review. Subjects were screened for various exclusion criteria such as past bariatric surgery, heart failure, malignancy, renal dialysis, and uncontrolled conditions such as hypothyroidism, anemia, or B12 deficiency. Weight measurements were collected from EPIC records starting from baseline, defined as 3 months prior to initiation …

Outcomes Following Open Reduction And Internal Fixation For Distal Humerus Fracture: Does Handedness Matter?, Charlotte N. Shields, Joseph R. Johnson, Jack M. Haglin, Sanjit R. Konda, Md, Kenneth A. Egol, Md

Phase 1

Introduction: No studies have assessed the relationship between extremity dominance and distal humerus fractures. This study sought to compare post-operative outcomes between patients with distal humerus fractures treated by open reduction and internal fixation (ORIF) of their non-dominant vs dominant arm.

Methods: A retrospective review of patients who sustained a distal humerus fracture treated with ORIF at one hospital between 2011-2015 was performed. Data collection included demographics, hand dominance, injury information, and surgical management. Post-operative outcomes included complications, time to fracture union, painful hardware, removal of hardware, Mayo Elbow Performance Index (MEPI), and range of motion.

Results: Of the …

Primary Care Obstructive Sleep Apnea Screening, Benjamin Espenhorst, Grant Gillan, Cynthia Cheng, Md, Phd

Phase 1

Introduction: Obstructive sleep apnea (OSA), a disorder characterized by upper airway collapse during sleep, is currently underdiagnosed and undertreated. The goal of this project is to evaluate the efficacy of utilizing a targeted screening protocol to identify previously undiagnosed OSA in an adult primary care population.

Methods: This prospective quality improvement project included 210 patients in the Jefferson Department of Family Medicine not previously diagnosed with OSA. These patients were targeted based on 3 STOP-BANG criteria: hypertension, age >50 years, and BMI >35 kg/m2. Patients were initially contacted by mail, followed by 3 weekly phone calls. Patients were screened …

Chronic Kidney Disease Is Associated With Mortality From Covid-19 During Hospitalization In Male Vs. Female Adults, Katherine Senter, Jingjing Zhang

Phase 1

No abstract provided.

Incidence Of Marginal Ulceration Following Primary Versus Revisional Roux-En-Y Gastric Bypass Surgery: A Multi-Center Retrospective, Brigitte Anderson, Talar Tatarian, Md, Alec Beekley, Md

Phase 1

No abstract provided.

Application Of The Breakthrough Research Social And Behavior Change Costing Guidelines To The Rise Ii Project In Niger, Nicole M. Bellows, Lori Bollinger, Rudolph Chandler

Poverty, Gender, and Youth

Breakthrough RESEARCH drafted its Guidelines for Costing Social and Behavior Change Health Interventions, in consultation with affiliate Breakthrough ACTION and other programmers, to promote quality social and behavior change program costing studies for a range of uses including budgeting, planning, economic evaluation, and advocacy. In March 2020, Breakthrough RESEARCH began applying the Guidelines to the Resilience in the Sahel (RISE) II program in Niger for a cost-effectiveness analysis through 2022. This report shares findings from application of the Breakthrough Costing Guidelines and provides an example and guidance for social and behavior change researchers and implementers on how these guidelines can …

Food Insecurity Measurement And Prevalence Estimates During The Covid-19 Pandemic In A Repeated Cross-Sectional Survey In Mexico, Pablo Gaitán-Rossi, Mireya Vilar-Compte, Graciela Teruel, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Objective: To validate the telephone modality of the Latin American and Caribbean Food Security Scale (ELCSA) included in three waves of a phone survey to estimate the monthly household food insecurity prevalence during the COVID-19 pandemic in Mexico. Design: We examined the reliability and internal validity of the ELCSA scale in three repeated waves of cross-sectional surveys with Rasch models. We estimated the monthly prevalence of food insecurity in the general population and in households with and without children and compared them with a national 2018 survey. We tested concurrent validity by testing associations of food insecurity with socio-economic status …

Constructing Curriculum: Centering Identities In Sex Education, Jozette Belmont

Dissertations, Theses, and Capstone Projects

Sex education (sex ed) is a state-by-state and school-by-school issue, and there are no federal laws which mandate medically accurate education. In New York, schools only offer one semester of health education which often happens in the last semester of twelfth grade. Further, LGBTQIA+ people’s sexual health and identities are rarely mentioned. Therefore, this project asks: What are the ways sex ed curricula and policies in New York address the needs of LGBTQIA+ youth? To answer this question, I use a critical policy analysis to compare curriculum from the New York City Department of Education (NYCDOE) and Peer Health Exchange …

Cell Cycle Progression Effects Of Albumin, Sharmeen Uddin

Dissertations, Theses, and Capstone Projects

Progression through G₁ phase of the cell cycle is controlled largely by growth factors in early G₁ and by nutrients in late G₁ indicating sufficient raw material for cell division. We previously mapped a late G₁ cell cycle checkpoint for lipids upstream from a mammalian target of rapamycin complex 1 (mTORC1)-mediated checkpoint and downstream from a mid-G₁ checkpoint known as the Restriction point. We therefore investigated a role for lipids in progression through late G₁ into S-phase. Quiescent BJ-hTERT human fibroblasts primed back into G1 with FBS treatment, were treated with a mixture of …

Think Twice Before Prescribing Antibiotics For That Swollen Knee: The Influence Of Antibiotics On The Diagnosis Of Periprosthetic Joint Infection., Graham S Goh, Javad Parvizi Md

Rothman Institute Papers

Periprosthetic joint infection (PJI) is a rare but devastating complication after total joint arthroplasty. An estimated 7-12% of patients have negative cultures despite clear clinical evidence of infection. One oft-cited reason for this occurrence is the administration of antibiotics in the weeks prior to obtaining cultures. This article reviews the influence of antibiotics on the diagnosis of PJI. Specifically, we examine the effect of prophylactic and therapeutic antibiotic administration on the diagnostic accuracy of microbiological cultures as well as serum and synovial biomarkers. We also explore the potential of molecular techniques in overcoming these limitations in patients who have received …

A Scoring Tool And Predictive Model To Detect Risk Of Hospitalization From Covid-19, Nicholas Russo Bs, Zhe Chen Md, Matthew M. Miller Do, Robert X. Murphy Jr, Md, Ms, David B. Burmeister Do, Facep, Cpe

Department of Medicine

No abstract provided.

January / February 2021, Randy Curry, Cindy Brooks

RURAL ROCKS

Rural Rocks, the Rural Health Network newsletter by the SWOSU College of Pharmacy.

Indigenous Knowledge Of Rift Valley Fever Among Somali Nomadic Pastoralists And Its Implications On Public Health Delivery Approaches In Ijara Sub-County, North Eastern Kenya, Geoffrey Otieno Muga, Washington Onyango-Ouma, Rosemary Sang, Hippolyte Affognon

All Peer-Reviewed Publications

Rift Valley Fever (RVF) is a zoonotic disease whose outbreak results in heavy economic and public health burdens. In East Africa, RVF is mainly experienced in arid and semi-arid areas predominantly inhabited by the pastoralists. These areas experience sudden, dra-matic epidemics of the disease at intervals of approximately 10 years, associated with widespread flooding and the resultant swarms of mosquitoes. Pastoralists’ indigenous knowledge and experience of RVF is critical for public health interventions targeting prevention and control of RVF. The study adopted a descriptive cross-sectional design combining both quantitative and qualitative methods of data collection. A total of 204 respondents …

Afrotropical Sand Fly-Host Plant Relationships In A Leishmaniasis Endemic Area, Kenya, Iman B. Hassaballa, Catherine L. Sole, Xavier Cheseto, Baldwyn Torto, David P. Tchouassi

All Peer-Reviewed Publications

The bioecology of phlebotomine sand flies is intimately linked to the utilization of environmental resources including plant feeding. However, plant feeding behavior of sand flies remains largely understudied for Afrotropical species. Here, using a combination of bio-chemical, molecular, and chemical approaches, we decipher specific plant-feeding associa-tions in field-collected sand flies from a dry ecology endemic for leishmaniasis in Kenya. Cold-anthrone test indicative of recent plant feeding showed that fructose positivity rates were similar in both sand fly sexes and between those sampled indoors and outdoors. Analysis of derived sequences of the ribulose-1,5-bisphosphate carboxylase large subunit gene (rbcL) from fructose-positive specimens …

Exploring The Influence Of Different Habitats And Their Volatile Chemistry In Modulating Sand Fly Population Structure In A Leishmaniasis Endemic Foci, Kenya, Iman B. Hassaballa, Baldwyn Torto, Catherine L. Sole, David P. Tchouassi

All Peer-Reviewed Publications

Phlebotomine sand flies transmit many viral protozoan and bacterial pathogens of public health importance. Knowledge of the ecologic factors influencing their distribution at local scale can provide insights into disease epidemiology and avenues for targeted control. Animal sheds, termite mounds and houses are important peri-domestic and domestic habitats utilized by different sand flies as resting or breeding habitats. However, our knowledge for selection of these habitats by sand flies remains poor. Here, we tested the hypothesis that these habitat types harbor different composition of sand fly species and differ in their volatile chemistry that could influence sand fly selection. To …

Racial Disparities In Occupational Risks And Lung Cancer Incidence: Analysis Of The National Lung Screening Trial., Hee-Soon Juon, Alicia Hong, Marcella Pimpinelli, Madhuwani Rojulpote, Russell Mcintire, Julie A. Barta

College of Population Health Faculty Papers

The relationship between racial disparities in occupational risk and lung cancer diagnosis is not well defined. We examined occupational exposure to asbestos, silica, and other workplace chemicals, fumes, or dusts as reported in the National Lung Screening Trial (NLST). Descriptive analyses and multivariate logistic regression models were performed. Among the NLST study cohort, 3.9% were diagnosed with lung cancer. African-Americans had a higher rate of lung cancer diagnosis than White individuals (4.3% vs. 3.9%). About 28% reported at least one occupational exposure, including 6.5% exposed to silica and 4.7% to asbestos. African-Americans reported occupational exposure more frequently than White participants, …