Medicine and Health Sciences Commons^™

Telemedicine Consultation To Assess Neonatal Encephalopathy In Rural Community Hospitals And Tertiary Care Centers, Rachel Coffey, Misty Melendi, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Teleconsultation is used in tertiary care hospitals to evaluate neonatal encephalopathy. Neonates born in community hospitals, however, often experience delayed evaluation due to transport to the tertiary care center. We studied teleconsultations in community hospitals to decrease this disparity.

Methods: Prospective observational study in 9 community hospitals and 1 neonatal intensive care unit. Inclusion criteria: gestational age greater than or equal to 35 weeks and one of the following: umbilical cord pH less than or equal to 7.2, 5-minute Apgar less than 7, prolonged respiratory support, perinatal event, or abnormal neurological exam. We performed synchronized, unscheduled telemedicine consults with …

A Four-Year Longitudinal Curriculum To Improve Feedback-Seeking Behaviors For Medical Students, Vicki Hayes, Robert Bing-You, Tamara Palka, Marybeth D. Ford, Robert Trowbridge Jr

Journal of Maine Medical Center

Introduction: Feedback is essential for performance improvement and plays a pivotal role in competency-based medical education. Medical learners need training to acquire skills to effectively seek feedback for their unique situations.

Methods: We developed a 4-year longitudinal curriculum designed to encourage feedback-seeking by medical students. The 4.5-hour curriculum consisted of interactive lectures, feedback-seeking surveys, trigger videotapes, and peer-group discussions in small- and large-group formats.  A volunteer study cohort (n = 14/37, 38%) was interviewed in 4 separate waves in individual and focus-group formats to explore perceptions about feedback-seeking and effectiveness of the curriculum.

Results: Themes and student quotes related to …

Senior Academic Ranks In Us Anesthesiology Programs: Differences Between Women And Men And Examination Of Independent Factors For Success, Brenda Lee, Farhad Zahedi, Ina Zaimi, Roman Schumann

Journal of Maine Medical Center

Introduction: Gender equality among faculty is a challenge in academic medicine, including anesthesiology. We investigated the likelihood that several factors were associated with academic success in the United States (US), defined as having achieved a senior academic rank (SAR) in a US anesthesiology training program.

Methods: We collected data available on the Internet on 131 anesthesiology programs, including faculty academic rank, gender, number of faculty, graduate status from an American medical school, fellowship training status, number of residents, number of program fellowships, and geographic location. SAR was defined as either associate professor or professor. Data were analyzed with logistic regression. …

Inpatient Discharge-By-Noon: Are Fewer Better Than All?, Nicholas Ballester, Pratik J. Parikh, Kara Combs, Jordan S. Peck

Journal of Maine Medical Center

Introduction: To address boarding in hospital emergency departments, discharge-by-noon could free up inpatient beds earlier in the day. However, discharging all patients by noon can heavily burden inpatient units and may not be feasible. In this study, we determine the number of discharges after which the benefits of an additional discharge-by-noon diminish.

Methods: We conducted a simulation analysis to quantify how occupancy rate, mean daily number of discharges, and peak discharge time impact upstream boarding time in an inpatient neurology unit at Maine Medical Center. Using a day-of-discharge simulation model with one year of retrospective data, we assessed configurations approximating …

Desperately Seeking Feedback: A Phenomenographic Study Of Medical Students’ Experiences During A 4-Year Longitudinal Feedback Curriculum, Robert Bing-You, Victoria Hayes, Tamara Palka, Marybeth Ford, Robert Trowbridge

Journal of Maine Medical Center

Introduction: The focus of feedback in medical education recently shifted to a dialogic partnership between teachers and learners, co-creating effective feedback exchanges. We previously described a prototype, longitudinal 4-year curriculum for medical students to develop feedback-seeking behaviors. We explored the students’ experiences as participants in this novel program.

Methods: Beginning in academic year 2017-2018, we assessed the 4-year experiences of 14 medical students with a phenomenographic, qualitative approach. Three waves of semi-structured, individual interviews were conducted during the first 3 years. Focus groups were conducted in the final year of the program. Meaning units were identified, and categories were determined …

Monthly Trends Of Substance Use Among Mainers Receiving Buprenorphine Treatment During The Covid-19 Pandemic, Sarosh Khan

Journal of Maine Medical Center

Introduction: Drug-related deaths in Maine increased by 23% in the first quarter of 2020 compared to the last quarter of 2019. Most of these deaths were accidental overdoses involving at least one opioid, and 65% of these deaths were caused by fentanyl, according to the Maine Center for Disease Control and Prevention.

Methods: This research explored substance use in Maine during 2020. Among the sample of individuals, 46% were homeless and receiving recovery services at a buprenorphine-assisted treatment program at a federally qualified health center in Maine. Charts of 35 patients were reviewed for emergency room visits and urine drug …

How Do You Measure The Success Of A New Journal Launch?, Robert Bing-You, Devin Carr, Carolyne Falank, Vicki Hayes, Dina Mckelvy, Charlotte Bailey

Journal of Maine Medical Center

No abstract provided.

Thomas Jefferson University Research - Convergent Thinking, Creative Application

Thomas Jefferson University Research Magazine

One way we accomplish our distinctive programmatic approach to research is by organizing as multidisciplinary centers and institutes around specific challenges. Led by visionaries and staffed by experts, these entities enable us to more quickly move discovery to translation and application; and they are excellent environments for training colleagues and students to address the practical challenges the world presents.

Sending Jefferson Research To Space

Thomas Jefferson University Research Magazine

Three of Jefferson’s collaborative research projects will become part of the upcoming Rakia space mission, the first-ever private mission to the International Space Station. Scheduled for early 2022, Rakia will include 44 research projects to help scientists explore topics including the effects of low-gravity and space travel on the human body.

“The Rakia mission selected all three of the projects submitted by Jefferson and its institutional collaborators—Sheba Medical Center, the Ramon Foundation and the Israeli Space Agency at the Ministry of Science and Technology,” explains Zvi Grunwald, MD, James D. Wentzler Professor of Anesthesiology and executive director of the Jefferson …

Anticipating Risk For Joint Replacement Problems

Thomas Jefferson University Research Magazine

Research teams led by Javad Parvizi, MD, clinical research professor and vice chair of orthopedic surgery, have identified risk factors associated with two major postoperative issues for patients undergoing total hip or knee replacements.

Despite ongoing improvements in technology and perioperative protocols, some patients undergoing total joint arthroplasty (TJA) experience serious medical complications requiring postoperative intensive care. With TJA increasingly being performed in ambulatory surgical settings, it is important to understand which patients are most at risk for such complications. Dr. Parvizi and his colleagues conducted a study to identify patient risk factors for admission to an intensive care unit …

Jeffsolves With Student Innovation

Thomas Jefferson University Research Magazine

The JeffSolves MedTech program teams industrial design and medical students to develop innovative solutions to specific healthcare problems. Having chosen particular, concrete challenges faced by medical patients, student teams collaborate to conduct in-depth user research and problem identification, develop potentially marketable solutions and create prototype products. “The solutions these teams create are consistently remarkable and effective,” says Bon Ku, MD, assistant dean for health and design at Sidney Kimmel Medical College.

A Design For Mitigating Patient Hypothermia

Thomas Jefferson University Research Magazine

General anesthesia during surgery can impair the body’s autonomic temperature regulation and lead to patients having dangerously low body temperature. That, in turn, increases an array of clinical risks, including poor wound healing and infection, excess blood loss, cardiac arrhythmias and impaired renal function. Unfortunately, current surgical gowns— which have very little thermal capability—provide no significant protection against heat loss.

For that reason, a cross-disciplinary team of Jefferson students and faculty—with expertise in anesthesiology, mechanical engineering, textile engineering, textile technology and fashion design—is creating a new type of patient garment that is intended to mitigate the problem of surgically related …

Does Art Reduce Bias Among Healthcare Providers?

Thomas Jefferson University Research Magazine

Katherine Cambareri, who earned an MPH from Jefferson in 2019, works as a clinical research coordinator at Children's Hospital of Philadelphia. She is also a serious photographer and deeply interested in exploring the synergies between public health and art.

In 2016, Cambareri created a photographic exhibition by documenting the clothes worn by survivors of sexual violence when they were assaulted. The exhibit’s photographs—individually straightforward, collectively powerful—were created with the intention of increasing understanding of sexual assault and challenging false assumptions of those who blame the victim. The exhibition titled “Well, What Were You Wearing?” has been presented across the country …

Measuring Empathy Among The Healthcare Team

Thomas Jefferson University Research Magazine

We live in a time when empathy seems more important than ever. Two recent studies assess opportunities and challenges for training physicians and nurses to develop stronger skills in empathy.

Jefferson research professor of psychiatry and human behavior Mohammadreza Hojat, PhD, led a nationwide study of empathy in nearly 11,000 osteopathic medical students in the United States. The study used the Jefferson Scale of Empathy (JSE), a validated measurement tool developed at Jefferson and used in 85 countries and translated into 56 languages. Among its findings were that women tended to score higher on the empathy scale than men, and …

Canine Intervention For Ptsd

Thomas Jefferson University Research Magazine

Strong anecdotal evidence suggests that trained service dogs can help mitigate symptoms of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). In particular, they may help reduce incidence of substance abuse and suicide in military veterans with PTSD and TBI. Two Jefferson College of Nursing faculty members— assistant professor Jennifer Shiroff, PhD, and instructor Jacquelyn O’Rourke-Fulford, MSN— have begun the process of formally assessing the effectiveness of service dogs as a therapeutic intervention for veterans with PTSD or TBI.

Assessing Trauma’S Effects On Children

Thomas Jefferson University Research Magazine

“Children who are exposed to adverse experiences early in life may not think, feel or behave the same way that typically developing children do,” says Kirby L. Wycoff, PsyD, associate professor of counseling and behavioral health and director of Jefferson’s Community and Trauma Counseling program. “If behavioral health professionals are not cognizant of the effects of trauma in the lives of children, they may actually be providing ineffective and inefficient care—and doing a disservice to the children and their families.”

Brain Implant Aims To Restore Movement After Stroke

Thomas Jefferson University Research Magazine

In the United States, someone has a stroke every 40 seconds. Often, these victims have long-term physical disabilities—the inability to use an arm and hand properly, for example. While rehabilitation can restore some function, improvements typically plateau well short of full recovery. Seeking to help stroke patients gain a fuller return-to-function, a research group led by assistant professor of neurology Mijail Serruya, MD, PhD, has begun a clinical trial of a brain implant and motorized robotic brace that could enable greater mobility. The work represents a convergence of disciplines, including computer science, fashion design, mechanical engineering, neurology, physics and rehabilitation …

Immune Signals In Parkinson’S Disease

Thomas Jefferson University Research Magazine

The Jefferson Comprehensive Parkinson’s Disease Center is one of the Parkinson’s Foundation’s 33 Centers of Excellence in the United States. Its director, Richard Smeyne, PhD, professor of neuroscience, and his research group are examining the cell signaling and cascade of events that leads to initiation of Parkinson’s disease (PD), seeking important clues about ways to arrest the condition’s progression. Mutation within the Leucine-rich Repeat Kinase 2 (LRRK2) gene is thought to underlie about 20 percent of all PD cases. Two of the group’s recent studies suggest that immune signaling from T-cells and B-cells in the blood plays an unexpected and …

How Does Calcium Impact Cardiac Mitochondria?

Thomas Jefferson University Research Magazine

The ability of a cardiac cell to work hard and continuously depends on the energy-producing function of its mitochondria. Calcium is key to proper mitochondrial function—but only in the right amounts. Too much calcium leads to cell death; too little suppresses production of the fuel a cell needs to function.

Research collaborators Shey-Shing Sheu, PhD, professor of medicine, and Gyorgy Csordas, MD, research associate professor of pathology, anatomy and cell biology, are studying the mechanisms by which cardiac mitochondria use calcium and other molecules. And they are shedding light on how dysfunction in those mechanisms contribute to ischemic heart disease, …

Paradigm-Changing Immunotherapy For Multiple Sclerosis

Thomas Jefferson University Research Magazine

In multiple sclerosis (MS), the body’s immune system attacks the myelin sheath, the protective layer surrounding nerve axons. Current MS therapies act by suppressing the immune system broadly—with sometimes serious side effects, including infection and cancer. However, a team of researchers led by Abdolmohamad Rostami, MD, PhD, professor and chair of neurology, has found a way to prevent immune cells from attacking myelin—while leaving the rest of the immune system intact. In mouse models of MS, their approach has halted disease progression.

Studying Hiv Antiretroviral Therapy

Thomas Jefferson University Research Magazine

Combination antiretroviral therapy (ART) has turned HIV infection into a treatable, chronic condition, rather than one that is almost inevitably fatal. As a result, as they age, people with HIV often begin taking other medications to treat medical conditions ranging from heart disease to gastrointestinal problems to cancer. The increased number of medications creates a risk for drug-drug interactions. Jason Schafer, PharmD, professor and vice chair of pharmacy practice, is exploring combinations of ART drugs that can reduce the number and severity of those interactions.

Exploring Dna Damage Repair

Thomas Jefferson University Research Magazine

A cell’s ability to repair damaged DNA is key to its maintaining normal biology and protecting against cell death. But the repair process can be a two-sided coin: keeping a normal cell healthy is beneficial; keeping a malignant cell healthy can promote cancer. The mechanisms by which cells recognize and attempt to repair damage are myriad and complex; and individual DNA-repair proteins can be involved in multiple pathways. Jefferson researchers across several fields are working to understand the genomic and molecular processes at work in DNA repair—and the problems created when those processes go awry.

Images Of Exploration And Discovery

Thomas Jefferson University Research Magazine

There are many ways of capturing the phenomenon and processes that biomedical researchers investigate. Steady advances in imaging technologies provide windows into microscopic forms and functions—views that can be appreciated, in different ways, by scientists and nonscientists alike. Here are a small sample of the images that emerge from the work of Jefferson researchers

Reinvigorating Immune Response To Advanced Melanoma

Thomas Jefferson University Research Magazine

Melanoma represents a small fraction of skin cancerrelated malignancies, yet accounts for the majority of its mortalities—and the incidence of cutaneous melanoma is rising. While treatments using smalltargeted inhibitors and immune checkpoint antibodies have increased long-term survival in advancedstage cutaneous melanoma, many patients still do not realize any benefit from the treatments. Another group of patients initially have beneficial results but ultimately find their disease progressing, in part due to cancer cells’ acquired resistance to immune response. And still other patients have difficulty with the treatment’s high toxicity.

Emad Alnemri, PhD, Thomas Eakins Professor of Biochemistry and Molecular Biology, and …

Attacking Cancer With Immunotherapies

Thomas Jefferson University Research Magazine

Jefferson scientists and clinicians continue to advance new approaches for cancer therapies. Two potential immune-prompting treatments—one for solid tumors and advanced non-small-cell lung carcinoma, and a second for recurrent gastrointestinal tumors—entered clinical trials in fall 2020.

The first drug is based on multi-functional immunorecruitment protein based on a fusion protein platform developed by Mark Tykocinski, MD, Jefferson provost and Anthony F. and Gertrude M. DePalma Dean of Sidney Kimmel Medical College. Created through the chimerization of proteins with carefully selected characteristics, the treatment is designed to have a two-part action: first, disabling cancer cells’ ability to camouflage themselves from the …

Computational Intelligence On Eye Disease

Thomas Jefferson University Research Magazine

“The use of big data in research holds enormous potential for improving public health and healthcare delivery, generating new knowledge more quickly than traditional scientific approaches, and providing a holistic understanding of specific illnesses,” says Amna Al-Alawi, DM, who recently completed her Doctor of Management degree from Jefferson’s Strategic Leadership program. “Ultimately, I believe it can offer enhanced care so that practitioners can understand more accurately the patient’s unique combination of genes, environmental risks and disease phenotype, which can help detect certain diseases at an earlier stage.”

Examining Healthcare Mutual Fund Performance

Thomas Jefferson University Research Magazine

Specialty mutual funds such as healthcare funds offer investors the opportunity to focus on high total return, income and further diversification within a specific industry. Although extensive research has been conducted on mutual fund performance generally, little such work has been conducted on healthcare-related mutual funds.

D.K. Malhotra, PhD, professor of finance and Nydick Family Term Chair and colleagues, sought to decode the characteristics and performance of healthcare mutual funds by examining their risk-adjusted rate of return from 2001 to 2018. He studied a broad range of healthcare-related funds, including those that focused on pharmaceuticals, biotechnology, health insurance, manufacture of …

Cold-Brew Chemistry

Thomas Jefferson University Research Magazine

Despite the growing consumption of cold-brew coffee around the world, little is known about the drink’s chemical makeup. Three researchers are helping to fill that gap with new findings on its level of beneficial antioxidants.

A recent study by Niny Rao, PhD, associate professor of chemistry, Megan Fuller, PhD, former assistant professor of chemistry and pre-medical studies student Meghan Grim found that the healthpromoting antioxidants in cold-brew coffee can differ significantly from traditional hot-brew coffee prepared with the same beans, particularly for dark roasts. While similar amounts of antioxidants were observed in hot and cold preparations made from lighter-roast coffee …

Fast-Paced, Frontline Research

Thomas Jefferson University Research Magazine

While the clinicians of Jefferson Health were on the front lines of the battle with COVID-19— treating nearly 16,000 COVID patients and testing 35,000+ people—just behind them were the basic science researchers working hard to understand the molecular and cellular mechanisms driving the disease and the clinician-scientists working to adapt existing therapeutics to the unique challenges created by SARS-CoV-2.

Since early 2020, Jefferson researchers published more than 260 research studies on the coronavirus’s biology and on treatments

Covid’S Impact On Cancer Diagnosis

Thomas Jefferson University Research Magazine

While there are studies underway to characterize the direct effects of the COVID-19 pandemic on the care of patients with cancer, there have been relatively few quantitative reports of the impact that efforts to control the pandemic have had on the normal course of cancer diagnosis and treatment encounters. However, a multicenter research team led by Jack London, PhD, research professor emeritus of cancer biology, and Christopher McNair, PhD, associate director for data science at Sidney Kimmel Cancer Center and assistant professor of cancer biology, is studying that now. They have used encounter data from 20 healthcare institutions to compare …