Medicine and Health Sciences Commons^™

Automated Assessment Of Cardiothoracic Ratios On Chest Radiographs Using Deep Learning, Varun Danda, Paras Lakhani, Md

Phase 1

Introduction: The cardiothoracic ratio (CTR) is a quantitative measure of cardiac size that can measured from chest radiography (CXR). Although radiologists using digital workstations possess the ability to calculate CTR, clinical demands prevent calculation for every case. In this study, the efficacy of a deep convolutional neural network (dCNN) to assess CTR was evaluated.

Methods: 611 HIPAA-compliant de-identified CXRs were obtained from [institution blinded] and public databases. Using ImageJ, a board-certified radiologist (reader #1) and a medical student (reader #2), measured the CTR by marking four pixels on all CXRs: the right- and left-most chest wall, the right- and left-most …

Understanding Subscription-Based Automated Electronic Notification Usage In Hospitals: A Qualitative Study, William J.K. Vervilles, Benjamin Slovis, Md, Ma, Jeffrey Riggio, Md

Phase 1

Introduction: The potential exists for patient harm when clinicians do not respond to clinical results in a timely manner. Much of the research on asynchronous electronic notifications (pager, cellphone or wearable devices) comes from home-grown electronic health records (EHR). Little is known about factors influencing notifications from vendor-based EHRs and the effect of subscription-based notifications, where providers select which results for notification. This study investigates what factors influence a clinician’s decision to order result notifications, the perceived role of these notifications in the clinical setting, and ways to improve notifications in a vendor-based EHR.

Methods: We queried the EHR to …

Evaluating The Impact Of Kardiamobile On Healthcare Expenditures, Christopher Gerace, Mph, Daniel Frisch, Md

Phase 1

Background: KardiaMobile is a mobile ECG device, with smartphone connectivity, that is able to detect atrial fibrillation (a-fib). The device captures a 30 second reading and an algorithm differentiates a-fib from sinus rhythm. The mobile application can alert the user to an a-fib reading and also send the ECG output to their personal physician. By monitoring a-fib without accessing traditional care, KardiaMobile has the potential to reduce healthcare costs for patients with a-fib. This study looked to evaluate the effect of KardiaMobile on healthcare utilization for patients with suspected or diagnosed a-fib and who see a clinical cardiac electrophysiologist.

Methods: …

Assessment Of A Wearable Device For Minute Ventilation In Detecting Different States Of Ventilation, Michael Morano, Yash Patel, Marc J. Torjman, Phd, Indupriya Eedara, Ms, Moeness Amin, Phd, Channy Loeum, Jeffrey Joseph, Do

Phase 1

Introduction: Minute ventilation (MV) and breathing status are valuable vital signs to measure in patients clinically such as in detecting opioid induced respiratory depression. However, there are few devices capable of continuously monitoring MV in an accurate fashion. RTM Vital Signs, LLC and TJU are developing a non-invasive wearable Tracheal Sound Sensor to determine if a device can accurately and continuously measure respiratory rate (RR), tidal volume (TV), MV, and changes in ventilation patterns based on sound recordings of breathing.

Methods: Tracheal breathing sounds were recorded in six researchers using a prototype sensor placed on the skin above the sternal …

Angiogenin Mrna Expression Levels In Prostate Cancer Tissue, Bowen Yao, Megumi Shigematsu, Phd, Kamlesh Ganesh Pawar, Phd, Venetia Pliatsika, Ms, Yohei Kirino, Phd

Phase 1

Introduction: Prostate cancer is the most commonly diagnosed cancer in men and second leading cause of cancer deaths. Studies have shown that tRNA fragments are upregulated in prostate cancers and play important roles in carcinogenesis. This project looks at how tRNA cleaving enzyme angiogenin expression is regulated in prostate cancer tissues.

Methods: Clinical data and mRNA expression levels of selected tRNA cleaving enzymes were extracted from the TCGA website. mRNAs were sequenced using IlluminaGA_RNASeqV2 at University of North Carolina.

Results: 546 samples from 494 patients, with normal tissue from 53 patients were collected. ANG mRNA levels were lower in patients …

Evaluation Of Ventricular Repolarization In Patients Undergoing Cardiac Resynchronization Therapy (Crt) Using Two Modalities: Conventional Biventricular Pacing Vs. His-Bundle Pacing, Anshul Gupta, Behzad B. Pavri, Md, Fhrs

Phase 1

Introduction:

Permanent His-bundle pacing (HBP) is being used as an alternative to biventricular pacing (BiVP) for CRT. HBP preserves the physiologic pattern of ventricular activation and markedly reduces ventricular dyssynchrony. While ventricular depolarization with HBP vs. BiVP has been studied, the effects of the 2 modalities on repolarization have not been compared. The purpose of this study was to compare ventricular repolarization in patients with HBP and BiVP. We hypothesize that HBP provides more physiologic repolarization as compared to BiVP.

Methods: ECG repolarization parameters were analyzed in patients who underwent HBP and BiVP using the first available ECG post implant. …

Comparison Of Patient Satisfaction With Telehealth And In-Clinic Post-Operative Visits, Lillian Matthews, Bryan Renslo, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has grown rapidly in the healthcare industry as a time efficient, affordable, and accessible means to provide care. Jefferson’s Department of Urology currently employs telehealth for post-operative visits but its efficacy in post-nephrectomy patients has not been well studied. We aim to demonstrate that patient satisfaction is the same for telehealth versus in-clinic post-operative visits in nephrectomy patients. Secondarily we will examine distance saved for telehealth patients.

Methods: We will administer an IRB approved questionnaire to all nephrectomy patients via the EPIC^® EMR platform after their post-operative visit. Each questionnaire will be specific to telehealth or …

Cognitive Changes In Patients Treated For Obstructive Sleep Apnea With Upper Airway Stimulation, Maxillomandibular Advancement, Or Expansion Sphincter Pharyngoplasty, Nicolas Zingas, Colin Huntley, Matthew Stewart, Ramez Philips

Phase 1

Introduction: Obstructive sleep apnea (OSA) is a prevalent diagnosis that has been shown to not only affect sleepiness, but daytime cognitive function — specifically attention, working memory, and executive function. CPAP treatment is troublesome for some patients and it is possible that superior treatment options, specifically novel surgical techniques, are available, though none have been evaluated for their long-term effects on neurocognition. We hypothesize that treating patients with upper airway stimulation surgery (UAS) UAS, maxillomandibular advancement surgery (MMA), and expansion sphincter pharyngoplasty surgery (ESP) for OSA produces a significant improvement in cognition from baseline.

Methods: For inclusion in the study, …

Utilizing The Smart Rooms Device To Improve Patient Experience In Hospitals, Thomas Hurysz, Alison Romisher, Daniel Campbell, Maia Ottenstein

Phase 1

Introduction: Utilizing smart room assistants in a hospital setting has the capacity to improve both the patient and provider experience, as well as improve patient outcomes. Thomas Jefferson University Hospital created the Smart Rooms device, a HIPAA compliant voice assistant, specifically for hospital settings.

Methods: A prospective, cross-sectional study was conducted in 11 rooms on the Methodist Hospital postoperative floor between March 2019 and September 2019 to study the impact of the Smart Rooms device on patient experience. Patients were given a survey using a Likert scale which asked questions about their satisfaction with their stay. During this time, surveys …

Pilot Evaluation Of The Usability And Utility Of A Wearable Technology To Monitor And Evaluate Health Condition, Drew Nielsen, David Shipon, Md, Facc, Facp

Phase 1

Introduction: Cardiac rehabilitation programs have particularly poor attrition and rehospitalization from cardiac-related events is a large burden on the medical system, as 8.9% of patients who have acute MI are rehospitalized within one year. External barriers may exist that prevent patients from adequately completing in-house cardiac rehabilitation, which makes them strong candidates for a home-based rehab program (HBCR). Previous randomized trials have generated evidence that HBCR can achieve similar cardiac improvements in 3- 12-month clinical outcomes. With the large-scale adoption of wearable technologies, with an estimated 8.2 million devices owned by individuals over 55, we have an opportunity to incorporate …

Comparison Of Patient Satisfaction Between Telehealth And In-Clinic Post-Operative Visits, Bryan Renslo, Lillian Matthews, Deborah T. Glassman, Md

Phase 1

Introduction: Telehealth has the potential to be an efficient, affordable, and accessible means to give care. In the field of Urology, its use has large potential but has not been well studied. We hypothesize that the use of telehealth for post-op nephrectomy patients will maintain the same level of patient satisfaction. We also hypothesize that telehealth visits will take less time and save patients money by eliminating the need to travel.

Methods: From May through July 2019, post-nephrectomy patients who consented to the study were given either a telehealth or in-clinic post-operative visit. Outcome metrics and demographics information were obtained …

Smart Rooms Devices As A Modality Of Enhancing Patient Engagement, Daniel Campbell, Alison Romisher, Thomas Hurysz, Maia Ottenstein, Anna Marie Chang, Md

Phase 1

Introduction: Recent literature has demonstrated that increased patient engagement is linked to improved patient outcomes. As such, hospitals are currently attempting to increase patient engagement via use of digital tools. One potential digital tool is a Smart Rooms Device, a voiceassistant integrated into hospital rooms. The goal of this investigation is to identify modalities by which patients intend to engage with the Smart Rooms Device.

Methods: This is a prospective interview study conducted between 11/20/2019 and 12/17/2019, whereby patients from the TJU Observation Unit were asked pre-determined interview questions in order to ascertain potential device usages.

Results: 12 patients were …

An Investigation Of Infectious Etiologies Of Sporadic Inclusion Body Myositis, Tyler Kennedy, Michele Meltzer, Md

Phase 1

Introduction: Sporadic inclusion body myositis (sIBM) is a rare, debilitating disease that can significantly lower one’s quality of life. Unfortunately, there are no current effective treatments, as the underlying causes are still unknown. We hypothesize that preceding infections do not cause sporadic inclusion body myositis.

Methods: The study investigated patients with a diagnosis of inclusion body myositis, with a concurrent or previously documented infection. Men represented a larger proportion of the population as they have an increased preponderance of those affected. The primary objective was to discern which infection, if any, could induce the inflammatory and degenerative changes in muscle …

Maintaining Effective Infection Control Protocol, Lauren Eusner, Kimberly Lintag

Dental Hygiene Faculty Publications

The safety of clinicians and patients in the dental office rests on adherence to evidence-based infection control standards.

Equipping Early Childhood Educators To Manage "Behaviors That Challenge" In The Early Childhood Years, Shanna Scott

Doctor of Nursing Practice Projects

This scholarly project pursues the development, implementation, and evaluation of techniques to help improve the health and well-being of children ages 1-5, who have difficulties with challenging behaviors, to effectively manage stress and boost resilience through the incorporation of music and educational techniques of the early childhood educator.

This paper will discuss the positive or negative outcomes on external factors affecting child health, such as economic, judicial, societal, cultural, cognitive development, parental separation, and mental health concerns of all members of the family. It will also discuss the positive effects educational strategies and music can have on young children experiencing …

Evaluation Of The Coordinated Approach To Child Health (Catch) Program In Third Through Fifth Graders In Northern Illinois, Paulina Karecka

Graduate Research Theses & Dissertations

Background: The Coordinated Approach to Child Health (CATCH) is a school-based education program designed to improve dietary habits and increase physical activity among children and adolescents based on the Social Cognitive Theory (SCT). The objective of this study was to evaluate the effectiveness of CATCH program, delivered by dietetic interns and Northern Illinois University (NIU) students, to 3rd-5th graders in Northern Illinois, in increasing their nutrition knowledge and healthy choices behavior. Methods: In total, 167 elementary school children in grades 3-5 in Northern Illinois participated in a non-experimental program evaluation study. We delivered 6 CATCH lessons throughout the academic year …

Effects Of Dietary Sodium Intake On Blood Flow Regulation During Exercise In Salt Resistant Individuals, Kevin P. Decker, Morgan T. Kimmel, Hunter L. Reed, Alex H. Chiu, Austin C. Hogwood, Jennifer B. Weggen, Ashley M. Darling, Ryan S. Garten

Graduate Research Posters

PURPOSE: Dietary sodium intake guidelines is ≤2,300 mg/day, yet is exceeded by 90% of Americans. This study examined the impact of a high sodium diet on blood flow regulation during exercise. METHODS: Six males (25 ± 2 years) consumed dietary sodium intake guidelines for two weeks, with one week salt-capsule supplemented (HS: 6,900 mg/day of sodium) and the other week placebo-capsule supplemented (LS: 2,300 mg/day of sodium). At the end of each week, peripheral hemodynamic measurements [blood flow (BF), shear rate (SR), and flow mediated dilation (FMD)/SR)] of the brachial and superficial femoral artery were taken during handgrip (HG) and …

Prevalence Of Mental Health Disorder Symptoms And Rates Of Help-Seeking Among University-Enrolled, Black Men, Kofoworola D. A. Williams, Amy Adkins, Sally I-Chun Kuo, Jessica G. Larose, Shawn O. Utsey, Jeanine P. D. Guidry, Danielle Dick, Spit For Science Working Group, Kellie E. Carlyle

Graduate Research Posters

Background. Black men in college represent a subgroup of emerging adults who are at increased risk of developing mental health disorders (MHDs), such as anxiety and depression. Such risk has been attributed to disproportionate experiences with everyday racial discrimination and high levels of psychological distress. Despite being at higher risk, university-enrolled, Black men are not utilizing mental health or health resources at optimal rates. The current evidence base describing prevalence of MHDs and health services utilization among Black men in college is limited. The present study addresses this by examining mental health prevalence among university-enrolled, Black men and their rates …

The Effect Of Whole-Body Vibration On Thermographic Readings Of The Equine Back And Distal Forelimb, Megan Leclerc

Undergraduate Honors Thesis Projects

Modern horses are sophisticated athletes, which puts them at a high risk for injury. One therapy now being utilized is whole-body vibration. The purpose of this study was to examine the effects of whole-body vibration on the distal forelimb and the back of the healthy horse using thermography.

Data were collected over a 30-day period. Test horses stood on the vibration plate (n=10) 3 days a week for 30-minute sessions with the plate vibrating at 30-40 Hz. The control horses (n=10) received no treatment during the study. Baseline thermographic images were taken for all horses, and post treatment images were …

Test–Retest Reliability Of The Friedreich’S Ataxia Rating Scale, Christian Rummey, Theresa A. Zesiewicz, Santiago Perez-Lloret, Jennifer M. Farmer, Massimo Pandolfo, David R. Lynch

Neurology Faculty Publications

The modified Friedreich Ataxia Rating Scale (mFARS) is a disease specific, exam-based neurological rating scale commonly used as a outcome measure in clinical trials. While extensive clinimetric testing indicates it’s validity in measuring disease progression, formal test–retest reliability was lacking. To fill this gap, we acquired results from screening and baseline visits of several large clinical trials and calculated intraclass correlation coefficients, coefficients of variance, standard error, and the minimally detectable changes. This study demonstrated excellent test–retest reliability of the mFARS, and it’s upright stability subscore.

Direct Oral Anticoagulant Failure In Stroke/Transient Ischaemic Attack: Neurologic And Pharmacokinetic Considerations, David Z. Rose, W. Scott Burgin

Neurology Faculty Publications

No abstract provided.

Implementing The Icelandic Model For Preventing Adolescent Substance Use, Alfgeir L. Kristjansson, Michael J. Mann, Jon Sigfusson, Ingibjorg E. Thorisdottir, John P. Allegrante, Inga Dora Sigfusdottir

Public and Population Health Faculty Publications and Presentations

This is the second in a two-part series of articles about the Icelandic Model for Primary Prevention of Substance Use (IPM) in this volume of Health Promotion Practice. IPM is a community collaborative approach that has demonstrated remarkable effectiveness in reducing substance use initiation among youth in Iceland over the past 20 years. While the first article focused attention on the background context, theoretical orientation, evaluation and evidence of effectiveness, and the five guiding principles of the model, this second article describes the 10 core steps to practical implementation. Steps 1 to 3 focus on building and maintaining community …

Opioid And Non-Opioid Prescribing Rates For Ankle Fractures In Emergency Departments Across The United States Between 2006 And 2015, Lucy C. Bowers, Kyle B. Kosik, Alejandro G. Villasante Tezanos, Matthew C. Hoch, Phillip A. Gribble

Posters-at-the-Capitol Presentations

This presentation describes the percentage of patients prescribed a controlled and non-controlled medication in an United States Emergency Department for a diagnosed ankle fracture.

Exploring The Influence Of Virtual Reality On Adults With Indications Of Early Stage Dementia, Nicole Chilivis

Doctor of Ministry Doctoral Projects

Virtual reality (VR) has the potential to transport people to compelling worlds and bring positive spiritual benefits to persons with dementia and their caregivers. The purpose of this qualitative phenomenological study was to understand the influence of VR on participants with indications of early stage dementia. This study explored how five elderly participants in a Seattle-based Program of All-Inclusive Care for the Elderly (PACE) program experienced immersive virtual reality by means of a Windows Mixed Reality headset. Using an episode from the 2016 VR series, theBlu—a colorful and immersive underwater experience with soothing audio accompaniment—each participant spent up to one …

Time Spent Exercising And Obesity: An Application Of Lewbel’S Instrumental Variables Method, Charles J. Courtemanche, Joshua C. Pinkston, Jay Stewart

Institute for the Study of Free Enterprise Working Papers

This paper examines the role physical activity plays in determining body mass using data from the American Time Use Survey. Our work is the first to address the measurement error that arises when time use during a single day—rather than average daily time use over an extended period—is used as an explanatory variable. We show that failing to account for day-to-day variation in activities results in the effects of time use on a typical day being understated. Furthermore, we account for the possibility that physical activity and body mass are jointly determined by implementing Lewbel’s instrumental variables estimator that exploits …

Identifying Factors Underlying The Decision For Genetic Carrier Screening Among Women In Montgomery County, Sowon Kim

Scholarship in Medicine - All Papers

As medical scientific technologies evolve, numerous medical tests help not only physicians with their clinical judgment, but also patients by empowering them with more knowledge of their own health. An example is Genetic Carrier Screening (GCS) [1-2]. Genetic Carrier Screening (GCS) is a genetic test that allows patients to find out if they carry genes for certain genetic disorders. The results of the test enable patients to make changes to their family planning decisions and prenatal care when appropriate and allow them the opportunity to seek further medical and social support [3]. The clinical utility of GCS is evident in …

Food Insecurity And Healthy Food Availability In The State Of Ohio, Yanley Sánchez

Scholarship in Medicine - All Papers

Objective: This research study aims to determine the impact of food insecurity and healthy food availability in the state of Ohio. It investigates how food insecurity in Ohio has changed between 2016 and 2020. It also investigates how food insecurity correlates with education level by looking at high school graduation rates. It also investigates how Ohio, a state with a high level of food insecurity, compares to California which has low levels of food insecurity. This study also compares how food insecurity differs in rural and urban counties throughout the state of Ohio.

Methods: ANOVA with posthoc will be conducted …

Understanding The Relationship Between Early Childhood Education And Long-Term Health And Quality Of Life Outcomes, Ryan Mcnulty

Scholarship in Medicine - All Papers

Education is widely understood to be beneficial with regard to social opportunity, health outcomes, and quality of life scoring. Society opinion and literature are in accordance with this understanding. Much of the current literature, however, focuses on how higher education provides many of these benefits, but little investigates how early childhood education correlates with such outcomes. The objective of this study is to investigate what relationships there are between early childhood education performance and long-term health and quality of life outcomes. This investigation will explore Ohio’s third grade reading and math scores on standardized exams as compared to a national …

Marijuana Use And Mental Health Among Emergency Department Patients, Megan Hanna

Scholarship in Medicine - All Papers

Background: According to the Centers for Disease Control and Prevention (CDC), marijuana is the most commonly used illicit drug in the U.S. with an increasing number of users in recent years.

Objective: This study was undertaken to identify common reasons for marijuana use and any relationship between its use and mental health among Emergency Department (ED) patients. Methods: A total of 303 ED patients participated from the Miami Valley Hospital Emergency Department. Eligible participants included those with any marijuana use. Subjects were administered a survey which identified age of first use, reasons for use, and presence of anxiety and depression …

The Verbal Numeric Pain Scale: Ed Patient Understanding And Perspectives, Bracey Bayonnet

Scholarship in Medicine - All Papers

Objective: The objective of this study is to identify patient self-reported pain scores and understanding and perspectives of the Verbal Numeric Pain Scale. Methods: In this prospective survey study, eligible participants were interviewed by research assistants. Data collected included ED patients self-reported pain scores, previous painful experiences, and their understanding of the Verbal Numeric Pain Scale,

Results: Among 164 participants (92% response rate), the mean triage pain score was 6.4 (95% CI 6.0-6.9). Many participants had experienced significant painful experiences in the past, including major surgery (N = 113), broken bone (N = 102), childbirth (N = 89) and kidney …