The Use of Telemetry Monitoring Among General Medicine Patients

Objective: To determine why and when general medicine non-ICU patients are upgraded from a non-telemetry level of care to telemetry monitoring at Thomas Jefferson University Hospital (TJUH). Comparison of the reasons for initiation of continuous ECG monitoring with the AHA and ACC guidelines would provide a greater understanding of the applicability of these recommendations to non-ICU general medicine patients. This information can provide guidance to identify areas of intervention to decrease inappropriate and/or overutilization of telemetry. The ultimate goal is to identify general medicine patients who are likely to benefit from continuous ECG monitoring, without negatively affecting clinical outcomes for those who do not receive cardiac monitoring.https://jdc.jefferson.edu/patientsafetyposters/1025/thumbnail.jp

Unraveling the Complexity of Critical Consciousness, Political Efficacy, and Political Action Among Marginalized Adolescents

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141719/1/cdev12446.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141719/2/cdev12446_am.pd

An Industry-University Response to Global Competition

In 1998, representatives of New Mexico\u27s chile pepper industry approached New Mexico State University\u27s College of Agriculture and Home Economics for help in gaining the edge on new global competition. The result was the New Mexico Chile Task Force, which brought together industry, university, and government partners to apply the most up-to-date knowledge and technology to industry problems. Key to the task force\u27s success is the search conference format used in the initial strategic planning phase. This method, pioneered by Emery and Trist in the 1960s, brought together parties with divergent opinions and empowered them to develop strategies to manage change

Revisiting the bulge-halo conspiracy I: Dependence on galaxy properties and halo mass

We carry out a systematic investigation of the total mass density profile of massive (Mstar>2e11 Msun) early-type galaxies and its dependence on galactic properties and host halo mass with the aid of a variety of lensing/dynamical data and large mock galaxy catalogs. The latter are produced via semi-empirical models that, by design, are based on just a few basic input assumptions. Galaxies, with measured stellar masses, effective radii and S\'{e}rsic indices, are assigned, via abundance matching relations, host dark matter halos characterized by a typical LCDM profile. Our main results are as follows: (i) In line with observational evidence, our semi-empirical models naturally predict that the total, mass-weighted density slope at the effective radius gamma' is not universal, steepening for more compact and/or massive galaxies, but flattening with increasing host halo mass. (ii) Models characterized by a Salpeter or variable initial mass function and uncontracted dark matter profiles are in good agreement with the data, while a Chabrier initial mass function and/or adiabatic contractions/expansions of the dark matter halos are highly disfavored. (iii) Currently available data on the mass density profiles of very massive galaxies (Mstar>1e12 Msun), with Mhalo>3e14 Msun, favor instead models with a stellar profile flatter than a S\'{e}rsic one in the very inner regions (r<3-5 kpc), and a cored NFW or Einasto dark matter profile with median halo concentration a factor of ~2 or <1.3, respectively, higher than those typically predicted by N-body numerical simulations.Comment: 23 pages, 10 figures, 3 Appendices (with an extra 7 figures). ApJ, accepted. Main results in Figures 3, 5, 6,

Effects of nanoparticles on murine macrophages

Metallic nanoparticles are more and more widely used in an increasing number of applications. Consequently, they are more and more present in the environment, and the risk that they may represent for human health must be evaluated. This requires to increase our knowledge of the cellular responses to nanoparticles. In this context, macrophages appear as an attractive system. They play a major role in eliminating foreign matter, e.g. pathogens or infectious agents, by phagocytosis and inflammatory responses, and are thus highly likely to react to nanoparticles. We have decided to study their responses to nanoparticles by a combination of classical and wide-scope approaches such as proteomics. The long term goal of this study is the better understanding of the responses of macrophages to nanoparticles, and thus to help to assess their possible impact on human health. We chose as a model system bone marrow-derived macrophages and studied the effect of commonly used nanoparticles such as TiO2 and Cu. Classical responses of macrophage were characterized and proteomic approaches based on 2D gels of whole cell extracts were used. Preliminary proteomic data resulting from whole cell extracts showed different effects for TiO2-NPs and Cu-NPs. Modifications of the expression of several proteins involved in different pathways such as, for example, signal transduction, endosome-lysosome pathway, Krebs cycle, oxidative stress response have been underscored. These first results validate our proteomics approach and open a new wide field of investigation for NPs impact on macrophagesComment: Nanosafe2010: International Conference on Safe Production and Use of Nanomaterials 16-18 November 2010, Grenoble, France, Grenoble : France (2010

Investigating Gender Disparities in Internal Medicine Residency Awards

Background: Significant gender disparities persist in career advancement for physicians. Studies have highlighted the lack of female representation in awards from both academic institutions and professional societies; these awards play a role in promotions, making them a fundamental building block of success. Objectives: We aim to explore the gender breakdown among resident awards presented by several Internal Medicine residency programs across the United States in this pilot study. Our ultimate goals are to define disparities in award selection, determine what variables contribute to these disparities, and work to mitigate these variables. Methods/Research: We generated a survey in REDCap to collect retrospective data about resident award selection from academic Internal Medicine residency programs across the country. This survey gathered awards data from 2009-2019 and included variables such as gender breakdown of the program, gender of resident award recipients, and details about how awards are selected. Eight programs completed the survey; these programs were from six different states in various geographic regions. Overall 43.1 percent of residents were female. Across all residency programs and years, there were 51 distinct resident awards with 290 (39.7%) female winners. Of the 51 distinct awards, there were 10 which were awarded to female residents with the same or higher frequency as males; 6 of these mentioned words that have been differentially associated with women in medicine such as “ambulatory,” “community,” “compassion,” and “humanism.” In the 41 awards favoring males, there was only a single mention of the word “compassion,” and no mention of the others. Conclusions/Impact: This data shows a concerning disparity in gender of award winners. In the future we will collect data from more residency programs and perform a thorough investigation of selection mechanisms that may help mitigate bias in order to ultimately propose strategies to reduce these gender disparities.https://jdc.jefferson.edu/sexandgenderhealth/1007/thumbnail.jp

Application of the Instrumental Inequalities to a Mendelian Randomization Study With Multiple Proposed Instruments

BACKGROUND: Investigators often support the validity of Mendelian randomization (MR) studies, an instrumental variable approach proposing genetic variants as instruments, via. subject matter knowledge. However, the instrumental variable model implies certain inequalities, offering an empirical method of falsifying (but not verifying) the underlying assumptions. Although these inequalities are said to detect only extreme assumptio

IM with Her: Fostering Career Advancement of Female Internal Medicine Residents

Background: Despite the rising number of matriculating female medical students, a gender gap favoring men exists in multiple arenas within academic medicine. Prior studies suggest that gender-specifc professional networking groups increase the likelihood of women attaining leadership positions. Objectives: Our goal was to create a multidisciplinary group with a flat hierarchy within the Internal Medicine Department in order to foster mentorship, sponsorship, allyship, and scholarship to ultimately improve professional advancement opportunities for female internal medicine residents. Methods/Research: A group named “IM with Her” was created at Thomas Jefferson University Hospital in July 2018. IM with Her is composed of internal medicine residents and faculty of all genders. The group has hosted monthly onehour conferences called “Monday Mentors” that pair a resident with a faculty member to host a discussion surrounding a topic of their choosing related to adversity and disparity faced by female physicians. Additionally, the group has held periodic evening sessions discussing topics such as salary and contract negotiation. Conclusions/Impact: The IM with Her group has made significant progress toward its goals. The pairing of a resident and faculty member for Monday Mentors discussions allows for one-on-one mentorship regarding both personal and professional topics. These sessions also provide dedicated time for networking amongst residents and faculty, facilitating sponsorship and allyship. Additionally, the sessions often lead to further initiatives spearheaded by IM with Her members including scholarly projects and examinations of institutional policies (for example those surrounding sexual harassment and lactation room accessibility). In the future, IM with Her will focus on continuing to foster mentorship, sponsorship, and allyship, on advancing research related to gender disparities in medicine, and on developing institutional changes.https://jdc.jefferson.edu/sexandgenderhealth/1008/thumbnail.jp

Influence of NiTi wire diameter on cyclic and torsional fatigue resistance of different heat-treated endodontic instruments

We compared the mechanical properties of 2Shape mini TS2 (Micro-Mega, Besançon, France) obtained from 1.0 diameter nickel-titanium (NiTi) wires and 2Shape TS2 from 1.2 diameter nickel-titanium (NiTi) wires differently thermally treated at room and body temperature. We used 120 NiTi TS2 1.0 and TS2 1.2 files made from controlled memory (CM) wire and T-wire (n = 10). Cyclic fatigue resistance was tested by recording the number of cycles to fracture (NCF) at room and body temperatures using a customized testing device. Maximum torque and angle of rotation at failure were recorded, according to ISO 3630-1. Data were analyzed by a two-way ANOVA (p &lt; 0.05). The CM-wire files had significantly higher NCFs at both temperatures, independent of wire dimensions. Testing at body temperature negatively affected cyclic fatigue of all files. The 1.0-mm diameter T-wire instruments showed higher NCF than the 1.2-mm diameter, whereas no significant differences emerged between the two CM wires at either temperature. The maximum torque was not significantly different across files. The TS2 CM-wire files showed significantly higher angular rotation to fracture than T-wire files. The TS2 CM-wire prototypes showed higher cyclic fatigue resistance than T-wire prototypes, regardless of wire size, exhibiting suitable torsional properties. Torsional behavior appears to not be affected by NiTi wire size