Medicine and Health Sciences Commons^™

Simulation Of Status Epilepticus Is Effective Teaching For Junior Neurology Residents, Pankhuri Jha, Navya George, Jeffrey Ratliff

Phase 1

Purpose: Status Epilepticus (SE) represents a potentially fatal neurologic emergency. At Jefferson, acute management of SE falls to the inpatient neurologist, requiring early competency.

Methods: During a 2 week educational “bootcamp”, 9 PGY2 residents participated in a 2 hour simulation of acute SE with two clinical scenarios. Scenarios included a patient with SE requiring adequate benzodiazepine dosing and another with seizures requiring IV anticonvulsant therapy. Prior to and following the simulation, residents took a survey to gauge their knowledge and confidence in managing SE.

Results and Conclusions: There was an increase in the number of residents expressing confidence in their …

A Module Based Method Of Teaching A Novel Approach To Electrocardiogram Interpretation, Emily Fishbein, Alexandra Koutsoubis, Jennifer White, Md, Dimitrios Papanagnou, Md

Phase 1

Purpose: The traditional approach to 12-lead electrocardiogram interpretation has limitations in the ED setting because it is tedious and does not emphasize pattern recognition for potentially fatal conditions that ED physicians must recognize. Additionally, while lecture-based learning is necessary, learning modules can help learners gain a better understanding of the material. The purpose of this study was to create and implement a self-paced learning module that teaches a novel way of ECG interpretation through the following steps: is it sinus? is it wide? is there ischemia? and does this herald sudden death?

Methods: The objective endpoint of this study was …

Medical Student Knowledge Of Narcolepsy, Alyssa Sinko, Karl Doghramji, Md

Phase 1

Background: Narcolepsy is a sleep disorder, whose main symptoms include daytime sleepiness, cataplexy, sleep paralysis, disturbed sleep, and hypnagogic hallucinations. The disorder is poorly identified in medical settings. We hypothesized that lack of knowledge of narcolepsy and its hallmark symptoms are a cause for the low levels of identification of this disorder. This was a pilot study into medical student knowledge of narcolepsy at Sidney Kimmel Medical College of Thomas Jefferson University (SKMC).

Methods: Two groups of SKMC students, years 1 and 2 (before sleep medicine education) and years 3 and 4 (after sleep medicine education) were the subjects of …

Examining Israeli Emergency Medical Preparedness In The Context Of Jefferson And Affiliates Practices, Jamie D. Garden, Amit S. Padaki

Phase 1

Introduction: Recent domestic disasters have demonstrated the challenges and vulnerabilities in the US health care disaster preparedness framework, challenges that extend to Thomas Jefferson University Hospital System (TJUH), in Philadelphia, PA. As Israel serves as a global leader in civilian defense and disaster preparedness, this study examines best practices in response to a mass casualty event at Hadassah Hospital in Jerusalem, Israel, and compares them with existing protocol at TJUH. The list of best practices generated from this research allows for a greater understanding of standards that are feasibly employable at TJUH.

Methods: This study examined hospital staff response practices …

Systems Analysis Of The Community Elder Caregiver Program At The Spirit Lake Nation, Morgan Ferrell, Robert Motley, Md, Mhcds, Christine Burd, Phd, Rn

Phase 1

Native Americans (NA) disproportionately reside in areas with significantly more social, economic, and health disparities than any other population, and have the lowest employment rates nationally. Additionally, the NA Baby Boomer generation is aging, with senior citizen services largely unavailable on reservations. The Community Elder Caregiver (CEC) Program at Spirit Lake was developed with two aims: 1) to meet the needs of unemployed natives and 2) to develop a competent workforce to help elders safely “age in place”. In the initial pilot, seventeen individuals started the initial (NECC) training, with three completing the Qualified Service Provider (QSP) training. We analyzed …

College Women's Knowledge And Understanding Of Women Health Issues: A Descriptive Study, Dana Brown

Mahurin Honors College Capstone Experience/Thesis Projects

Breast self-examinations, pap smears, Obstetrician and Gynecologist (OBGYN) visits, mammograms, and other preventative measures are all vital pieces of women’s health that can help determine a variety of issues and illnesses (U.S. National Library of Medicine, 2020). Women are presumed to have acquired information on these issues through certain sources to guide them through their adult lives. Not every woman is familiar with, or follows, the recommended guidelines for breast self-examination or gynecological visits. According to the Centers for Disease Control and Prevention (CDC), about 94,000 U.S. women are diagnosed each year with some form of gynecologic cancer, which disproportionately …

Automated Generation Of Gene Summaries At The Alliance Of Genome Resources., Ranjana Kishore, Valerio Arnaboldi, Ceri E Van Slyke, Juancarlos Chan, Robert S Nash, Jose M Urbano, Mary E. Dolan, Stacia R Engel, Mary Shimoyama, Paul W Sternberg, The Alliance Of Genome Resources

Faculty Research 2020

Short paragraphs that describe gene function, referred to as gene summaries, are valued by users of biological knowledgebases for the ease with which they convey key aspects of gene function. Manual curation of gene summaries, while desirable, is difficult for knowledgebases to sustain. We developed an algorithm that uses curated, structured gene data at the Alliance of Genome Resources (Alliance; www.alliancegenome.org) to automatically generate gene summaries that simulate natural language. The gene data used for this purpose include curated associations (annotations) to ontology terms from the Gene Ontology, Disease Ontology, model organism knowledgebase (MOK)-specific anatomy ontologies and Alliance orthology data. …

Methods For Comparative Chia-Pet And Hi-C Data Analysis., Dan Capurso, Zhonghui Tang, Yijun Ruan

Faculty Research 2020

The three-dimensional architecture of chromatin in the nucleus is important for genome regulation and function. Advanced high-throughput sequencing-based methods have been developed for capturing chromatin interactions (Hi-C, genome-wide chromosome conformation capture) or enriching for those involving a specific protein (ChIA-PET, chromatin interaction analysis with paired-end tag sequencing). There is widespread interest in utilizing and interpreting ChIA-PET and Hi-C. We review methods for comparative ChIA-PET and Hi-C data analysis and visualization. The topics reviewed include: downloading ChIA-PET and Hi-C data from the ENCODE and 4DN portals; processing ChIA-PET data using ChIA-PIPE; processing Hi-C data using Juicer or distiller and cooler; viewing …

Updated Poster Presentation Abstract (N = 58) From 2020 Combined Sections Meeting Of The American Physical Therapy Association: How Well Do Clinical Walking Measures Predict Natural Walking Behavior In Parkinson Disease?, James T. Cavanaugh, Cristina Colon-Semenza, Tammy Deangelis, Ryan P. Duncan, Daniel Fulford, Martha Hessler, Michael Lavalley, Timothy Nordahl, Lisa Quintiliani, Kerri S. Rawson, Marie Saint-Hilaire, Cathi A. Thomas, Jenna A. Zajac, Gammon M. Earhart, Terry D. Ellis

Physical Therapy Faculty Publications

Declines in the amount and intensity of natural walking behavior in people with Parkinson disease (PD) may precede declines in motor behavior, gait, and balance. Physical interventions targeting walking behavior in PD may have the greatest impact on slowing the progression of disability. Despite a lack of supporting evidence, however, clinicians may be more likely to rely on quick performance measures of walking speed, capacity, and balance to make inferences about a patient’s walking health, rather than direct measures of natural walking behavior. Our primary purpose, therefore, was to examine the extent to which clinical walking measures might predict natural …

The Impact Of Body Mass Index On Functional Rehabilitation Outcomes Of Working-Age Inpatients With Stroke, Alejandro Garcia-Rudolph, John D. Kelleher, Blanca Cegarra, Joan Sauri Ruiz, Vasudevan Nedumpozhimana, Eloy Opissso, Jose M. Tormos, Montserrat Bernabeu

Articles

BACKGROUND: Stroke is the most relevant cause of acquired persistent disability in adulthood. The relationship between patient’s weight during rehabilitation and stroke functional outcome is controversial, previous research reported positive, negative and no effects, with scarce studies specifically addressing working-age patients.
AIM: To evaluate the association between Body Mass Index (BMI) and the functional progress of adult (<65 >years) patients with stroke admitted to a rehabilitation hospital.
DESIGN: Retrospective observational cohort study.
SETTING: Inpatient rehabilitation center.
POPULATION: 178 stroke patients (ischemic or hemorrhagic).
METHODS: Point-biserial and Spearman’s correlations, multivariate linear regressions and analysis of covariance were used to describe differences …

Sport In The Face Of The Covid-19 Pandemic: Towards An Agenda For Research In The Sociology Of Sport, Adam B. Evans, Joanna Blackwell, Paddy Dolan, Josef Fahlén, Remco Hoekma, Verena Lenneis, Gareth Mcnarry

Articles

These are extraordinary times. Less because we are currently in the midst of a global pandemic; humanity has been here multiple times in the past, sometimes with even more devastating results (the ‘Black Death’ of 1346–1353, or Cocolitzli Epidemics in the 16th Century, for example). Rather, these are extraordinary times due to both the huge shutting down of industry, travel and borders, and the enormous level of coverage and discussion of the crisis through both traditional and social media formats (Stevens & Prins, 2020). Moreover, global, regional and national comparisons and discussions have become commonplace with regards to everything …

Achieving Access Parity For Inpatient Psychiatric Care Requires Repealing The Medicaid Institutions For Mental Disease Exclusion Rule, Briony Marie Dubose Mhi, Rn, Lss Bb, Eileen K. Fry-Bowers Phd, Jd, Rn, Cpnp, Faan

School of Nursing and Health Science: Faculty Scholarship

Approximately 3.4% of Americans have a mental health condition and suicide is the 10th leading cause of death. While the rate of mental health conditions has slightly increased for adult populations, America’s youth has experienced a significant rise in depression. From 2008 to 2017, occurrence of depression in the adolescent population increased from 8.3% to 13.3%. As adolescents mature into adults; it is likely the rate of mental health conditions for the adult population will rise as well as it is the common thread that binds the “diseases of despair”: drug abuse, alcoholism and suicide.

Arising out of the deinstitutionalization …

Differences In Evaluating Fall Risk By Primary Care Provider Type, Janice Mark, Yara K. Haddad, Elizabeth R. Burns

Nursing and Health Professions Faculty Research and Publications

This study assessed differences in clinical fall risk assessment of older adults (65+) and clinical resources used by primary care providers (PCP). We used Porter Novelli's 2016 DocStyles survey to examine clinical behavior data from PCPs (n=1128). Compared to other practitioners, nurse practitioners (NP) reported a higher percentage of their patients were older adults. The majority of NPs reported screening for falls risk routinely, but most did not use standardized fall-risk assessments to assess risk factors. There were also differences in the types of clinical resources used by NPs and other PCPs to evaluate the safety profile of medications.

Stochastic Expression Of Sae-Dependent Virulence Genes During Staphylococcus Aureus Biofilm Development Is Dependent On Saes, Elizabeth A. Delmain, Derek E. Moormeier, Jennifer L. Endres, Rebecca E. Hodges, Marat R. Sadykov, Alexander R. Horswill, Kenneth W. Bayles

Journal Articles: Pathology and Microbiology

The intricate process of biofilm formation in the human pathogen Staphylococcus aureus involves distinct stages during which a complex mixture of matrix molecules is produced and modified throughout the developmental cycle. Early in biofilm development, a subpopulation of cells detaches from its substrate in an event termed “exodus” that is mediated by SaePQRS-dependent stochastic expression of a secreted staphylococcal nuclease, which degrades extracellular DNA within the matrix, causing the release of cells and subsequently allowing for the formation of metabolically heterogenous microcolonies. Since the SaePQRS regulatory system is involved in the transcriptional control of multiple S. aureus virulence factors, the …

Tolle Lege Works Published In 2020, Mcquade Library

Bibliographies

Compiled Tolle Lege bibliography of works published by members of the Merrimack College Community in 2020. Works include journal articles, books, book chapters, conference presentations and posters, and more.

Progressive Dyspnea After Use Of Electronic Vaping, Taylor Studsrud, Morgan Zegers, Gary Cook, Narrani Kanapathippillai, Hilton Alemar-Hernandez

West Florida Division GME Research Day 2020

No abstract provided.

Donut Hole Summer 2020, Medicare Donations & Design Committee

Donut Hole Newsletter

No abstract provided.

Mucin-Rich Vs. Mucin-Poor Endocrine Mucin-Producing Sweat Gland Carcinoma: A Comparison Of Two Cases, Christina E. Borchers, Michael Heaphy, Ronald E. Warwar, Nicholas Shamma

Dermatology Faculty Publications

No abstract provided.

A Comparison Of Dietary Intake Of Children/Adolescents With And Without Myopia, Niamh Burke, John Butler, Daniel Ian Flitcroft, James Loughman

Conference Papers

Myopia is caused by an eye which has grown too long. The prevalence of myopia has increased drastically in recent years and half of the world’s population is expected to be myopic by 2050.(1) Consequently, a significant increase in sight threatening diseases will follow.(1) Myopia most commonly develops in youth, and we now know that environmental factors affect its development. Nutritional status strongly influences growth and development, including that of the eye. It has been hypothesised, therefore, that nutrition may play a role in this excessive eye growth. Current findings are conflicted, with a clear gap in the evidence.(2,3) Therefore, …

The Impact Of Exercise In Spaceflight And Microgravity Environments, William Bybee

Mahurin Honors College Capstone Experience/Thesis Projects

Since mankind’s first spaceflight, a significant barricade in reaching distant planets has been the damaging effects of microgravity upon the human body. Effects range from loss in bone mineral density and severe muscle atrophy to autoimmune disorders. The most effective countermeasure of these effects to date is exercise. Implementation of exercise in microgravity is not an easy task, so various specialized equipment must be utilized to effectively administer it. Even with this equipment, exercise as it is currently used does not entirely prevent body systems from undergoing detrimental changes. New modalities and implementations are currently being investigated that may significantly …

A Novel Vaccine Candidate Based On Chimeric Virus-Like Particle Displaying Multiple Conserved Epitope Peptides Induced Neutralizing Antibodies Against Ebv Infection., Xiao Zhang, Bingchun Zhao, Mingmei Ding, Shuo Song, Yinfeng Kang, Yang Yu, Miao Xu, Tong Xiang, Ling Gao, Qisheng Feng, Qinjian Zhao, Mu-Sheng Zeng, Claude Krummenacher, Yi-Xin Zeng

College of Science & Mathematics Departmental Research

Epstein-Barr virus (EBV) is the causative pathogen for infectious mononucleosis and many kinds of malignancies including several lymphomas such as Hodgkin's lymphoma, Burkitt's lymphoma and NK/T cell lymphoma as well as carcinomas such as nasopharyngeal carcinoma (NPC) and EBV-associated gastric carcinoma (EBV-GC). However, to date no available prophylactic vaccine was launched to the market for clinical use.

Neuropsychological Change After A Single Season Of Head Impact Exposure In Youth Football, Arthur C. Maerlender, Eric Smith, P. Gunnar Brolinson, Joseph J. Crisco, Jillian Urban, Amaris Ajamil, Steven Rowson, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Emily Kieffer, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joel Stitzel, Richard M. Greenwald, Stefan Duma

Center for Brain, Biology, and Behavior: Faculty Publications

Objectives: Head impact exposure (HIE) in youth football is a public health concern. The objective of this study was to determine if one season of HIE in youth football was related to cognitive changes.

Method: Over 200 participants (ages 9–13) wore instrumented helmets for practices and games to measure the amount of HIE sustained over one season. Pre- and post-season neuropsychological tests were completed. Test score changes were calculated adjusting for practice effects and regression to the mean and used as the dependent variables. Regression models were calculated with HIE variables predicting neuropsychological test score changes.

Results: For the full …

The Effect Of In-Service Methodology On Learning Transfer For School Personnel Managing Students Following Concussion, Jennifer Parent-Nichols, Angela Desilva Mousseau, Joshua Cleland, Jonathan D. Lichtenstein, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

Background: It is essential to increase the knowledge base of teachers involved in facilitating return to learning in middle school students following a concussion. However, the best method to enhance the transfer of learning for teachers remains to be elucidated. Application of Adult Learning Theory (ALT) is a plausible solution to this problem. Purpose: The purpose of this randomized post-test study was to examine the effects of ALTon the transfer of learning in teachers who work with individuals with concussion. Methods: A convenience sample of 169 teachers at four middle schools were randomized to receive an in-service regarding concussion management …

Sleep And Stress In The Acute Phase Of Concussion In Youth, Arthur C. Maerlender, Caitlin Masterson, Jessica L. Calvi, Todd Caze, Ross Mathiasen, Dennis Molfese

Center for Brain, Biology, and Behavior: Faculty Publications

This study sought to address the complex interplay between both biological and psychological perceptions of stress and sleep in the acute stages following a mild traumatic brain injury. A secondary goal was to identify potential targets for intervention. Eleven acutely injured youth (mean age 12 years) were studied at home with overnight actigraphy, salivary cortisol and melatonin assays, and subjective ratings of stress and fatigue (injured group). Nine matched control youth also were assessed (control group). Results suggested longer sleep latencies (time to fall asleep) and higher levels of fatigue in the injured group exist (p ¼ 0.025 and p …

The Global Assessment Of School Functioning (Gasf): Criterion Validity And Interrater Reliability, Arthur C. Maerlender, Joseph Palamara, Jonathan Lichtenstein

Center for Brain, Biology, and Behavior: Faculty Publications

The Global Assessment of School Functioning (GASF) provides a robust estimate of a student's overall level of functioning within the school environment. It is intended to capture a global metric reflecting academic, social and general behavioral functioning within the school. It is a modification of the Global Assessment of Functioning and reflects functioning across academics, interpersonal relationships, school behavior, and school participation. It was developed to allow school personnel a means to communicate the general level of student functioning without re- verting to specific issues or immediate concerns. This paper reports on the scale's criterion validity and interrater reliability. Confirmations …

Psychometric Properties Of The Standardized Assessment Of Concussion In Youth Football: Validity, Reliability, And Demographic Factors, Arthur C. Maerlender, Eric Smith, P. Gunnar Brolinson, Jillian Urban, Steven Rowson, Amaris Ajamil, Eamon T. Campolettano, Ryan A. Gellner, Srinidhi Bellamkonda, Mireille E. Kelley, Derek Jones, Alex Powers, Jonathan Beckwith, Joseph J. Crisco, Joel Stitzel, Stefan Duma, Richard M. Greenwald

Center for Brain, Biology, and Behavior: Faculty Publications

The objective of this study was to determine the psychometrics (reliability, validity) of the original Standardized Assessment of Concussion (SAC) in a youth sample (ages 11 to 13). Demographic factors of race, level of vocabulary knowledge, mother’s level of education were also considered. Over 150 youth football athletes completed the SAC and a brief battery of NIH Toolbox cognitive tests as part of a larger study on biomechanical factors in youth sport concussion. This was a within-subjects design (pre-season, post-season assessments), and correlational analysis of convergent and discriminant validity. Between groups analysis based on demographic differences was also employed. The …

Modeling Interactions Between Brain Function, Diet Adherence Behaviors, And Weight Loss Success, Amanda N. Szabo-Reed, Laura E. Martin, Jinxiang Hu, Hung-Wen Yeh, Joshua Powell, Rebecca J. Lepping, Trisha M. Patrician, Florance J. Breslin, Joseph E. Donnelly, Cary R. Savage

Center for Brain, Biology, and Behavior: Faculty Publications

Summary

Introduction: Obesity is linked to altered activation in reward and control brain cir-cuitry; however, the associated brain activity related to successful or unsuccessful weight loss (WL) is unclear.

Methods: Adults with obesity (N = 75) completed a baseline functional magnetic res-onance imaging (fMRI) scan before entering a WL intervention (ie,3-month diet and physical activity [PA] program). We conducted an exploratory analysis to identify the contributions of baseline brain activation, adherence behavior patterns, and the asso-ciated connections to WL at the conclusion of a 3-month WL intervention. Food cue-reactivity brain regions were functionally identified using fMRI to index brain activation …

Males With Chronic Ankle Instability Demonstrate Deficits In Neurocognitive Function Compared To Control And Copers, Adam B. Rosen, Melanie L. Mcgrath, Arthur C. Maerlender

Center for Brain, Biology, and Behavior: Faculty Publications

The purpose of this study was to determine if there were neurocognitive deficits among controls, copers and those with chronic ankle instability (CAI). Participants included those without history of ankle injury (n = 14), ankle sprain copers (n = 13) and patients with self-reported CAI (n = 14). They completed a battery of valid and reliable computer-based neurocognitive tests. The differences between neurocognitive domain scores were compared across the Control, Coper and CAI groups. Patients with CAI had lower composite memory, visual memory and simple attention compared to controls. In males with CAI, large differences in memory and attention were …

Neural Bases Of Phonological And Semantic Processing In Early Childhood, Avantika Mathur, Douglas H. Schultz, Yingying Wang Dr.

Center for Brain, Biology, and Behavior: Faculty Publications

During the early period of reading development, children gain phonological (letter-to-sound mapping) and semantic knowledge (storage and retrieval of word meaning). Their reading ability changes rapidly, accompanied by learning-induced brain plasticity as they learn to read. This study aims at identifying the neural bases of phonological and semantic processing in early childhood by using a combination of univariate and multivariate pattern analysis. Nineteen typically developing children between the age of five and seven performed visual word-level phonological (rhyming) and semantic (related meaning) judgment tasks during functional magnetic resonance imaging scans. Our multivariate analysis showed that young children with good reading …

Meat Consumption, Cooking Practices, And Blood Harmane Concentrations In Essential Tremor: A Population-Based, Environmental Study In The Faroe Islands, Monica Ferrer Socorro

Yale Medicine Thesis Digital Library

Background: Essential tremor (ET) is among the most prevalent neurological disease, yet potential modifiable environmental factors contributing to its etiology are poorly understood. Harmane [1-methyl-9H-pyrido(3,4-b)indole], is a potent neurotoxin, of which elevated levels may be linked to ET. Possible etiologies for this elevation include increased dietary consumption, impaired metabolism, or increased endogenous production. Harmane is particularly abundant in meats and long cooking times can increase its concentrations. One previous study provided preliminary data of a dietary difference between male ET cases and controls. To clarify the relationship between ET and harmane we conducted a population-based, case-control study, in the Faroe …