Medicine and Health Sciences Commons^™

Additional Strategies To Heal A Fracture: The Impact Of Lifestyle Modifications To Improve Bone Repair, Katie Duquette

Bone Bulletin

Suffering from a bone fracture can hinder a patient’s ability to work and greatly diminish their quality of life. Depending on fracture characteristics, treatment options consist of non-operative and operative management. Regardless of intervention needed, the process of bone healing is multi-factorial. Therefore, patients who are interested in maximizing their functional recovery can make changes within their control to optimize the healing process. Changes as simple as adding beets and probiotics could have a significant impact on returning function earlier and alleviating pain sooner.

If physicians elevate their current recovery strategy advice, it may be possible to improve a patient’s …

Exploring The Use Of Robotics In Orthopaedic Surgery, Daniel Givner

Bone Bulletin

Over the last few decades, the use of robotics has dramatically increased across all surgical specialties. While initially only utilized in a few gynecological and urological procedures, robotics are now used in a wide range of surgical procedures ranging from general surgery, cardiovascular surgery, to otolaryngology and orthopaedic surgery. One study noted in the field of general surgery, roughly 15% of all surgeries are utilizing some form of robotics.1 Surgical robotics assist in a variety of ways ranging from guiding procedures by creating 3D images of the anatomic landscape, to allowing physicians to operate through telemanipulating in a separate room. …

Biologic Augmentation In Osteochondral Lesions Of The Talus, Yashas Reddy

Bone Bulletin

Introduction

Osteochondral lesions of the talus (OLT) are injuries involving damage to the cartilage and bone associated with the talar dome. They occur in up to 50% of ankle sprains and 73% of ankle fractures, varying in stability and severity.¹ Standard weightbearing ankle radiographs may allow for visualization of the lesions if substantial bone fragmentation is involved but CT and MRI are more sensitive for subchondral bone damage and purely cartilaginous lesions, respectively (Figure 1). The majority of patients with OLT are active individuals in their 20s and 30s, and often present after sustaining an acute inversion injury.^{2 …}

A Day In The Life Of An Orthopaedic Surgeon With Dr. Rachel Shakked, Anne Cohen

Bone Bulletin

From a young age, Dr. Shakked knew she wanted to be a doctor and started medical school with an interest in pursuing medical oncology. As a third year, she did her surgery rotation with low expectations but ended up loving it and discovering the field of orthopaedics. After completing her fellowship in 2016, she is now a foot and ankle specialist at the Rothman Institute where she experiences a mix of both private and academic practice. This conversation was born from her desire to show students what life is like beyond medical school and residency, and the importance of living …

First Job Considerations As An Orthopaedic Surgery Attending: Picking A Practice Setting, Purab Kothari

Bone Bulletin

A career in medicine is a journey with many forks in the road as medical students choose specialties, then subspecialties, and finally a practice setting. Particularly with the latter, becoming familiar with the various practice options early on can lead to an easier decision when the time to join the workforce arrives. Additionally, the ability to work in a setting that aligns with one’s career goals may ultimately lead to increased job satisfaction and reduced burnout risk. The following article aims to define various practice settings, including academic, private, community, “privademics” and locum tenens, and explore key considerations orthopaedic surgery …

New Trends In Orthopaedic Surgery Residency Applications: The Role Of Preference Signaling, J. Liam Gibbons

Bone Bulletin

Introduction

Orthopaedic surgery is known to be one of the most competitive specialties for medical students to pursue. It is important for applicants to have a strong portfolio of achievements, including research, presentations, and volunteering to increase chances of matching. USMLE scores and AOA membership tend to be higher among residency applicants that match into orthopaedic surgery. Moreover, the match rate for orthopaedics is lower at 74% compared to the overall match rate of 93.8%.¹ To increase chances of matching into an orthopaedic program, it is recommended to start preparing early and stay informed about trends and strategies in …

A Practical Guide To Etiquette In The Orthopaedic Or For The Rotating Medical Student, Tyler Radack

Bone Bulletin

The Operating Room, the operating theatre, the lair of the Orthopaedic surgeon, it goes by many names. It is a place most try to avoid, but this daunting windowless room is a classroom and training ground for many. And for the medical student interested in an orthopaedic surgery career, making an impression in the operating room is vital to matching into their desired orthopaedic residency.¹

Unfortunately, making an impression in the operating room is difficult, or more precisely, making a good impression in the operating room is difficult. Furthermore, every operating room dynamic can be different, and the personalities …

Injuries, Management, And Prevention In The Weekend Warrior, John Paulik

Bone Bulletin

Introduction

Sports medicine is known for heroically returning competitors back to the big game just in the nick of time for the winning play. This storybook ending is a reality of sports medicine. However, the majority of athletes will not end up on ESPN in the newest 30 for 30. This begs the question - who is an athlete? To some, it may be defined as someone who participates in an organized sport, culminating in regular competition and requiring systematic training.¹ This definition, however, excludes those who regularly exercise with the goal of improving their health or appearance.^{2 …}

Foreword, Alan S. Hilibrand

Bone Bulletin

As the Director of Undergraduate Medical Education for the Department of Orthopedic Surgery at the Sidney Kimmel Medical College, I am thrilled to have this opportunity to introduce the inaugural issue of the Bone Bulletin. Through the activities of the DePalma Orthopaedic Society, medical students at SKMC have had an excellent venue to learn about orthopaedic surgery, and our surgeons here at Rothman Orthopaedics have enthusiastically mentored younger students interested in the field of orthopedic surgery. The DePalma leadership has worked hard on many initiatives in recent years: providing forums for orthopaedic faculty to speak about their work, assembling lists …

Editor's Note, Payton Boere, Ari Clements

Bone Bulletin

We are thrilled to introduce the inaugural issue of the Bone Bulletin, DePalma Orthopaedic Society’s student-run, non-peer reviewed journal for Sidney Kimmel Medical College (SKMC) students. The journal’s aim is to provide yet another way to be involved with orthopaedics in medical school and to promote student interest in orthopaedics by reporting on diverse aspects of the field through editorial and opinion pieces. Under the close 1-on-1 mentorship of a physician from the Rothman Orthopaedic Institute, students have a hands-on opportunity to write about and directly engage with orthopaedic research and developments.

Within the pages of this journal, you …

2023 May 16 - Medical Student Education Committee Minutes, Medical Student Education Committee, East Tennessee State University

Medical Student Education Committee Minutes

No abstract provided.

The Role Of Clock Genes In Maintaining Circadian Rhythm And Rheumatoid Arthritis Pathophysiology., Arathi Kulkarni, Michelle Demory-Beckler, Marc M. Kesselman

HPD Articles

Rheumatoid arthritis (RA) is a chronic, progressive autoimmune condition that affects up to 1% of the world population and symmetrically affects the joints leading to joint stiffness and decreased mobility. RA patients present with increased pain and chronic inflammation within their joint spaces, which researchers have linked to poorer sleep patterns, including difficulty falling asleep and non-restorative sleep. As such, identifying mediators of poor sleep quality among RA patients may improve their long-term quality of life. More recently, researchers identified an association between chronic inflammation in RA patients and their circadian rhythm. Altered circadian rhythms negatively impact the hypothalamic-pituitary-adrenal (HPA) …

Benefit Of Visual Speech Information For Word Comprehension In Post-Stroke Aphasia, Anna Krason, Gabriella Vigliocco, Marja-Liisa Mailend, Harrison Stoll, Rosemary Varley, Laurel J. Buxbaum

Moss-Magee Rehabilitation Papers

Aphasia is a language disorder that often involves speech comprehension impairments affecting communication. In face-to-face settings, speech is accompanied by mouth and facial movements, but little is known about the extent to which they benefit aphasic comprehension. This study investigated the benefit of visual information accompanying speech for word comprehension in people with aphasia (PWA) and the neuroanatomic substrates of any benefit. Thirty-six PWA and 13 neurotypical matched control participants performed a picture-word verification task in which they indicated whether a picture of an animate/inanimate object matched a subsequent word produced by an actress in a video. Stimuli were either …

Post-Activation Potentiation For Firefighter Daily Preparedness, Nick Curtis

Master of Science in Kinesiology

Firefighters commonly face dangers that call upon numerous energy systems to achieve fireground objectives. If firefighters could be put in a state of greater physical activation, then it may be possible to achieve better outcomes regarding speed and safety of objective completion. Post-activation potentiation (PAP) is a possible mechanism for achieving this readiness state that translates to firefighter activity. This paper is going to investigate whether a low volume, but high-power exercise routine will reduce time to completion of fireground simulating tasks such as a stair climb, charged hose line advance, and victim drag. Pre-intervention data will be collected before …

Review Of Gynaecological Cancer Among Aboriginal And/Or Torres Strait Islander People In Australia, Aime Powell, Ami Morseu-Diop, Maya Morton Ninomiya, Uday Narayan Yadav, Emily Phillips, Devendra Raj Singh, Tamara Butler, Emma Allanson, Lisa J. Whop

Journal of the Australian Indigenous HealthInfoNet

Gynaecological cancers bear a significant burden on the health of Australians. Whilst Australia has made great strides in reducing the overall gynaecological cancer burden nationally, Aboriginal and/or Torres Strait Islander women continue to experience disproportionately high rates of gynaecological cancers.

This review focuses on the social, cultural, and historical contexts that contribute to inequitable gynaecological cancer rates among Aboriginal and/or Torres Strait Islander women. An in-depth discussion on cervical cancer, ovarian cancer, and uterine cancer are described; including the incidence, mortality, survival, and management of these diseases for Aboriginal and/or Torres Strait Islander women.

It highlights both the persistent barriers …

Longitudinal Trends (2011–2020) Of Premature Mortality And Years Of Potential Life Loss (Ypll) And Associated Covariates Of The 62 New York State Counties, Maria-Isabel Roldos, John Orazem, Talita Fortunato-Tavares

Publications and Research

Background

New York State (NYS) is the 27th largest state and the 4th most populous state in the U.S., with close to 20 million people in 62 counties. Territories with diverse populations present the best opportunity to study health outcomes and associated covariates, and how these differ across different populations and groups. The County Health Ranking and Roadmaps (CHR&R) ranks counties by linking the population’s characteristics and health outcomes and contextual factors in a synchronic approach.

Methods

The goal of this study is to analyze the longitudinal trends in NYS counties of age‑adjusted premature mortality rate and years of potential …

Sarcopenia And Cardiovascular Diseases, Abdulla A Damluji, Maha Alfaraidhy, Noora Alhajri, Namit N Rohant, Manish Kumar, Christina Al Malouf, Samira Bahrainy, Min Ji Kwak, Wayne B Batchelor, Daniel E Forman, Michael W Rich, James Kirkpatrick, Ashok Krishnaswami, Karen P Alexander, Gary Gerstenblith, Peggy Cawthon, Christopher R Defilippi, Parag Goyal

Faculty, Staff and Student Publications

Sarcopenia is the loss of muscle strength, mass, and function, which is often exacerbated by chronic comorbidities including cardiovascular diseases, chronic kidney disease, and cancer. Sarcopenia is associated with faster progression of cardiovascular diseases and higher risk of mortality, falls, and reduced quality of life, particularly among older adults. Although the pathophysiologic mechanisms are complex, the broad underlying cause of sarcopenia includes an imbalance between anabolic and catabolic muscle homeostasis with or without neuronal degeneration. The intrinsic molecular mechanisms of aging, chronic illness, malnutrition, and immobility are associated with the development of sarcopenia. Screening and testing for sarcopenia may be …

Fiducial Markers Allow Accurate And Reproducible Delivery Of Liver Stereotactic Body Radiation Therapy, Marina Moskalenko, Bernard L. Jones, Adam Mueller, Shirley Lewis, Jay C. Shiao, Sara J. Zakem, Tyler P. Robin, Karyn A. Goodman

Department of Radiation Oncology Faculty Papers

Fiducial markers are utilized for image guided radiotherapy (IGRT) alignment during the delivery of liver stereotactic body radiosurgery (SBRT). There are limited data demonstrating the impact of matching fiducials on the accuracy of liver SBRT. This study quantifies the benefit of fiducial-based alignment and improvements in inter-observer reliability. Nineteen patients with 24 liver lesions were treated with SBRT. Target localization was performed using fiducial markers on cone-beam computed tomography (CBCT). Each CBCT procedure was retrospectively realigned to match both the liver edge and fiducial markers. The shifts were recorded by seven independent observers. Inter-observer variability was analyzed by calculating the …

Association Of Brain Age, Lesion Volume, And Functional Outcome In Patients With Stroke, Sook-Lei Liew, Nicolas Schweighofer, James H. Cole, Artemis Zavaliangos-Petropulu, Bethany P. Lo, Laura K.M. Han, Tim Hahn, Lianne Schmaal, Miranda R. Donnelly, Jessica N. Jeong, Zhizhuo Wang, Aisha Abdullah, Jun H. Kim, Alexandre Hutton, Giuseppe Barisano, Michael R. Borich, Lara A. Boyd, Amy Brodtmann, Cathrin M. Buetefisch, Winston D. Byblow, Jessica M. Cassidy, Charalambos C. Charalambous, Valentina Ciullo, Adriana Bastos Conforto, Rosalia Dacosta-Aguayo, Julie A. Dicarlo, Martin Domin, Adrienne N. Dula, Natalia Egorova-Brumley, Wuwei Feng, Fatemeh Geranmayeh, Chris M. Gregory, Colleen A. Hanlon, Kathryn Hayward, Jess A. Holguin, Brenton Hordacre, Neda Jahanshad, Steven A. Kautz, Mohamed Salah Khlif, Hosung Kim, Amy Kuceyeski, David J. Lin, Jingchun Liu, Martin Lotze, Bradley J. Macintosh, John L. Margetis, Maria Mataro, Feroze B. Mohamed, Emily R. Olafson, Gilsoon Park, Fabrizio Piras, Kate P. Revill, Pamela Roberts, Andrew D. Robertson, Nerses Sanossian, Heidi M. Schambra, Na Jin Seo, Surjo R. Soekadar, Gianfranco Spalletta, Cathy M. Stinear, Myriam Taga, Wai Kwong Tang, Greg T. Thielman, Daniela Vecchio, Nick S. Ward, Lars T. Westlye, Carolee J. Winstein, George F. Wittenberg, Steven L. Wolf, Kristin A. Wong, Chunshui Yu, Steven C. Cramer, Paul M. Thompson

Department of Neurology Faculty Papers

BACKGROUND AND OBJECTIVES: Functional outcomes after stroke are strongly related to focal injury measures. However, the role of global brain health is less clear. In this study, we examined the impact of brain age, a measure of neurobiological aging derived from whole-brain structural neuroimaging, on poststroke outcomes, with a focus on sensorimotor performance. We hypothesized that more lesion damage would result in older brain age, which would in turn be associated with poorer outcomes. Related, we expected that brain age would mediate the relationship between lesion damage and outcomes. Finally, we hypothesized that structural brain resilience, which we define in …

Cancer Stem Cell Assay-Guided Chemotherapy Improves Survival Of Patients With Recurrent Glioblastoma In A Randomized Trial, Tulika Ranjan, Soma Sengupta, Michael J. Glantz, Richard M. Green, Alexander Yu, Dawit Aregawi, Rekha Chaudhary, Ricky Chen, Mario Zuccarello, Christine Lu-Emerson, Hugh D. Moulding, Neil Belman, Jon Glass, Aaron Mammoser, Mark Anderson, Jagan Valluri, Nicholas Marko, Jason Schroeder, Steven Jubelirer, Frances Chow, Pier Paolo Claudio, Anthony M. Alberico, Seth T. Lirette, Krista L. Denning, Candace M. Howard

School of Medicine Faculty Publications

Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors. In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2–14.7) compared with 9 months (95% CI, 4.2–13.8) in the physician-choice group (p = …

Genome-Wide Association Study Of Breast Density Among Women Of African Ancestry, Shefali Setia Verma, Lindsay Guare, Sarah Ehsan, Aimilia Gastounioti, Gabrielle Scales, Marylyn D Ritchie, Despina Kontos, Anne Marie Mccarthy, Penn Medicine Biobank

2020-Current year OA Pubs

Breast density, the amount of fibroglandular versus fatty tissue in the breast, is a strong breast cancer risk factor. Understanding genetic factors associated with breast density may help in clarifying mechanisms by which breast density increases cancer risk. To date, 50 genetic loci have been associated with breast density, however, these studies were performed among predominantly European ancestry populations. We utilized a cohort of women aged 40-85 years who underwent screening mammography and had genetic information available from the Penn Medicine BioBank to conduct a Genome-Wide Association Study (GWAS) of breast density among 1323 women of African ancestry. For each …

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

2020-Current year OA Pubs

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …

From Bugs To Drugs: Bacterial 3-Iaa Enhances Efficacy Of Chemotherapy In Pancreatic Cancer, Y David Seo, Jennifer A Wargo

Faculty, Staff and Student Publications

Tintelnot et al. identified enrichment of indole-3-acetic acid (3-IAA), a tryptophan metabolite produced by gut microbiota, as a predictor of chemotherapy response in pancreatic adenocarcinoma. Recapitulated in mouse models, 3-IAA represents a novel potential therapeutic approach for chemotherapy sensitization.

Evaluation Of 89zr-Labeled Anti-Pd-L1 Monoclonal Antibodies Using Dfo And Novel Hopo Analogues As Chelating Agents For Immuno-Pet, Bhasker Radaram, Sarah E Glazer, Ping Yang, Chia-Wei Li, Mien-Chie Hung, Seth T Gammon, Mian Alauddin, David Piwnica-Worms

Faculty, Staff and Student Publications

Programmed death ligand 1 (PD-L1) is a type 1 transmembrane immunosuppressive protein that is expressed on a wide range of cell types, including cancer cells. Anti-PD-L1 antibodies have revolutionized cancer therapy and have led to improved outcomes for subsets of cancer patients, including triple-negative breast cancer (TNBC) patients. As a result, PET imaging of PD-L1 protein expression in cancer patients has been explored for noninvasive detection of PD-L1 expressing tumors as well as monitoring response to anti-PD-L1 immune checkpoint therapy. Previous studies have indicated that the in vivo stability and in vivo target detection of antibody-based radio-conjugates can be dramatically …

Supervised Deep Learning With Vision Transformer Predicts Delirium Using Limited Lead Eeg, Malissa A. Mulkey Phd, Aprn, Ccns, Ccrn, Cnrn, Huyunting Huang, Thomas Albanese, Sunghan Kim, Baijian Yang Ph.D.

Publications

UNLABELLED: Critically ill patients with COVID-19 experience high rates of delirium and coma. Whether delirium occurs through novel mechanisms in COVID-19 is not known. We analyzed the relationship among biomarkers of inflammation (C-reactive protein [CRP]), hypercoagulability (d-dimer), and lung macrophage activation (ferritin), and the primary composite outcome of delirium/coma next day. We also measured associations between biomarkers and next day delirium and coma independently, and delirium severity. DESIGN: Retrospective, observational cohort study. SETTING: ICUs at two large, urban, academic referral hospitals. PATIENTS: All consecutive adult patients admitted to the ICU from March 1, 2020, to June 7, 2020, with COVID-19 …

Apolipoprotein E Dyslipidemia And Nephrotic Syndrome: A Rare Connection, Sahana Tito, Avica Atri, Shivaraj Patil, Saima Dean, Sweta Carpenter

Einstein Health Papers

Severe hyperlipidemia warrants an extensive evaluation. We report a case of a 25-year-old man of Chinese descent seen in the cardiology-lipid clinic. He was found to have a serum low-density lipoprotein cholesterol of 12.12 mmol/L (468 mg/dL) and serum triglycerides of 2.29 mmol/L (203 mg/dL) during routine screening. Work-up revealed nephrotic-range proteinuria, and renal biopsy showed dilated glomerular capillary loops with lipid deposits, pathognomonic of lipoprotein glomerulopathy. Genetic studies showed apolipoprotein E3/E4 phenotype. He was treated with a high-intensity statin and fibrate therapy, which resulted in a marked improvement in dyslipidemia and proteinuria.

Low Educational Attainment Is Associated With Higher All-Cause And Cardiovascular Mortality In The United States Adult Population, Najah Khan, Zulqarnain Javed, Isaac Acquah, Kobina Hagan, Madiha Khan, Javier Valero-Elizondo, Ryan Chang, Umair Javed, Mohamad B. Taha, Salim S. Virani

Office of the Provost

Introduction: Educational attainment is an important social determinant of health (SDOH) for cardiovascular disease (CVD). However, the association between educational attainment and all-cause and CVD mortality has not been longitudinally evaluated on a population-level in the US, especially in individuals with atherosclerotic cardiovascular disease (ASCVD). In this nationally representative study, we assessed the association between educational attainment and the risk of all-cause and cardiovascular (CVD) mortality in the general adult population and in adults with ASCVD in the US.
Methods: We used data from the 2006-2014 National Death Index-linked National Health Interview Survey for adults ≥ 18 years. We generated …

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

Faculty, Staff and Student Publications

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …

How Does Facilitation In Healthcare Work? Using Mechanism Mapping To Illuminate The Black Box Of A Meta-Implementation Strategy, Amy M Kilbourne, Elvin Geng, Ingrid Eshun-Wilson, Shannon Sweeney, Donna Shelley, Deborah J Cohen, Joann E Kirchner, Maria E Fernandez, Michael L Parchman

Faculty, Staff and Student Publications

BACKGROUND: Healthcare facilitation, an implementation strategy designed to improve the uptake of effective clinical innovations in routine practice, has produced promising yet mixed results in randomized implementation trials and has not been fully researched across different contexts.

OBJECTIVE: Using mechanism mapping, which applies directed acyclic graphs that decompose an effect of interest into hypothesized causal steps and mechanisms, we propose a more concrete description of how healthcare facilitation works to inform its further study as a meta-implementation strategy.

METHODS: Using a modified Delphi consensus process, co-authors developed the mechanistic map based on a three-step process. First, they developed an initial …

Protocol For The Promoting Resilience In Stress Management (Prism) Intervention: A Multi-Site Randomized Controlled Trial For Adolescents And Young Adults With Advanced Cancer, Alison O’Daffer, Liam Comiskey, Samantha R. Scott, Chuan Zhou, Miranda C. Bradford, Joyce P. Yi-Frazier, Abby R. Rosenberg

Psychology: Faculty Scholarship

Background

Adolescents and young adults (AYAs) with cancer are at high risk of poor psychosocial outcomes, and evidence-based interventions designed to meet their psychosocial and communication needs are lacking. The main objective of this project is to test the efficacy of a new adaptation of the Promoting Resilience in Stress Management intervention for AYAs with Advanced Cancer (PRISM-AC).

Methods/design

The PRISM-AC trial is a 2-arm, parallel, non-blinded, multisite, randomized controlled trial. 144 participants with advanced cancer will be enrolled and randomized to either usual, non-directive, supportive care without PRISM-AC (“control” arm) or with PRISM-AC (“experimental” arm). PRISM is a manualized, …