Deprtment of Medicine 2023 Annual Report

2023 ANNUAL REPORT

DEPARTMENT OF MEDICINE

Cover Photo ©Thomas Jefferson University Photography

CHAIRMAN'S LETTER OF INTRODUCTION

Dear Friends and Colleagues:

As we leave fears of COVID-19 behind and begin to see it as part of the background of respiratory viruses in our community, we continue to contend with societal change, the call for social justice, and changes in our city environment. Nowhere has this change been more evident than in are very own Sidney Kimmel Medical College and University It continues to be obvious that diverse leadership teams provide access to new ideas and new ways of succeeding that may have previously escaped us. Despite this upheaval, we consistently “put patients first” and demonstrate that we are “better together”, never shying away from a crisis. In FY23, the Department of Medicine demonstrated that it shall continue to lead through its clinical and basic science research, through our daily attention to teaching, through its ongoing Grand Rounds and educational programming, and through excellence in patient care. Each of our divisions from Internal Medicine and Hospital Medicine, to each of the subspecialties have continued to thrive despite the challenges and our educational programs have emerged stronger than ever.

Highlights from this past year include growth and success in each of our solid organ transplant programs – kidney, liver and heart. New for FY25, we will be launching of our lung transplantation program heralded by the arrival of Dr. Niraj Sinha, our first Medical Director, who will be joining Dr. Keshava Rajagopal, our first Surgical Director, as we look forward to our first lung transplant over the next two years. Launching this service underscores Jefferson Health’s market penetration in key subspecialties of Medicine necessitating that we think seriously about offering the most complex therapies to the market we serve which now comprises more than one quarter of the 5,000,000 plus population in the Philadelphia and South Jersey region!

I invite you to read about our strength and excellence across a broad array of programs. Highlights of the year include our continued growth in our outpatient practices despite COVID-19; our total outpatient visits topped 245,000, with more than 43,000 of those being new patient visits. Additionally, our telehealth services expanded dramatically from 9,000 visits in FY20, to over 58,000 in FY21 and settled at 31,723 in FY23. It is clear that telehealth has become a mainstay of our core business providing flexibility for both patients and providers. We also continued to grow our volume in the Bala Cynwyd multispecialty practice from 15,634 in FY21, to 19,199 visits in FY22, up to 19,298 visits in FY23. In this location, providers from Primary Care, Cardiology, Endocrinology, Gastroenterology, Nephrology, Pulmonary, and Rheumatology see outpatients in a multidisciplinary setting. Our ability to exceed budget at this multispecialty site has further enhanced the health of the enterprise.

The numbers referenced at the right side column are impressive, but I am reminded that we see each individual patient one at a time. We are not defined by visits or volume, or revenues and profits, it is by delivering on the promise of exceptional care, with learners and without, in every single encounter that we demonstrate who we truly are as a Department. And it is the character of our relationships, through which we leave our legacy.

Thanks for your interest, and we look forward to continuing to serve our patients, colleagues, trainees and students.

Sincerely,

Gregory C. Kane, MD, MACP

The Jane and Leonard Korman Professor of Pulmonary Medicine Chair of the Department of Medicine

246,653

Total outpatient visits

43,873

New patient visits in 2023

31,723

Telehealth visits

2

Divisions Ranked in USNWR Top 50

68

Best of Philadelphia Doctors

79 Liver Transplants

98 Kidney Transplants

14 Heart Transplants

DIVISION OF CARDIOLOGY

The Division of Cardiology is a core component of Jefferson’s Cardiovascular Service Line, combining cardiology, cardiac surgery, vascular medicine, vascular surgery, and interventional radiology to focus on the care of patients with heart and vascular disease. The Jefferson Heart Institute at 925 Chestnut Street is the hub of outpatient cardiology teaching and clinical activity. It is the primary site of the clinical practice for the thirty-eight Jefferson University Physicians (JUP) cardiologists and the location of the Cardiac Anticoagulation Program and the Cardiovascular Risk Reduction Program. On-site stress testing, nuclear cardiology, vascular imaging, echocardiography, and electrophysiologic device testing and management are available for patient convenience.

The Jefferson Heart Institute is committed to excellence in patient care, education, research, and graduate medical education. We continue to strive to meet the needs of our patients, community, and institution. Our reach extends from Center City to the Northeast and South Jersey. We are actively recruiting the best and the brightest physicians to help the Jefferson Heart Institute grow and deliver the best healthcare to our patients and lead in innovation, education, clinical care, and research.

PATIENT CARE

OUTPATIENT

Outpatient care and consultation are provided in Center City at 925 Chestnut (general cardiology, electrophysiology, advanced heart failure and transplantation, and instruction of cardiology fellows), and at 6210 Gibbon (interventional and structural heart disease). Strong demand to see JHI cardiologists continues at Center City and across all our practice sites. In Center City, the number of patients seen grew by 13% from the previous year. 29,125 outpatients were seen, 19% of whom were new patients. Over 41,000 visits took place across all our sites.

The Jefferson Outpatient Cardiac Imaging Center, located at 925 Chestnut, is the principal cardiac imaging site for JHI and for TJUH. Satellite imaging sites in Center City are located at 6210 Gibbon, plus a site at the Korman Respiratory

Institute supporting our joint programs in cardiopulmonary medicine. In 2023, 13,264 imaging studies were performed at the Center City locations, representing an 11% increase from the previous year. A total of 19,825 cardiac imaging studies were done across all our sites for a 10.7% increase.

The section of Nuclear Cardiology continues to expand its offerings with pyrophosphate scans to assist the advanced heart failure program with the diagnosis of TTR amyloidosis.  We are now performing MUGA scans as well.  For the past year, we have been doing PET/CT using Rubidium.  This procedure has a greater diagnostic accuracy than conventional SPECT imaging.  It also allows for the absolute quantitation of coronary blood flow, which improves the diagnosis of transplant arteriopathy and microvascular disease.

The JHI has three outpatient satellite locations; the largest is in

Northeast Philadelphia, with others in Bala Cynwyd, PA, and Voorhees, NJ. Convenient access to clinical cardiologists, subspecialty physicians in electrophysiology and heart failure, Jefferson vascular surgeons, as well as advanced cardiac imaging, are provided at our satellite locations.

In 2023, the JHI faculty expanded to support growth in our clinical cardiology programs. We added one clinical and imaging cardiologist and two advanced heart failure and transplant physicians. For 2023-2024, a third cardiac intensivist joined the JHI, who completed an additional fellowship in critical care medicine after graduating from our own cardiology fellowship program.

The JHI provides expert consultation and cardiac assessment with a special focus on perioperative cardiac assessment and management with a rapid access program with the Patient Testing Center to facilitate patient

FACULTY

Rene J. Alvarez, Jr., MD, FACC, FAHA, FACP

Lubert Family Professor of Cardiology

Division Director

Enterprise Executive Lead, Cardiovascular Service Line

Barbara A. Berko, MD

Clinical Assistant Professor of Medicine

Yevgeniy Brailovsky, DO

Assistant Professor of Medicine

Sung-Hae Cho, MD

Clinical Assistant Professor of Medicine

Ira S. Cohen, MD

Clinical Professor of Medicine

Indranil Dasgupta, MD, MPh, MBA

Assistant Professor of Medicine

Mark DeCaro, MD

Clinical Assistant Professor of Medicine

Danielle Duffy, MD

Associate Professor of Medicine

David L. Fischman, MD

Professor of Medicine

Lori Frank, MD

Clinical Assistant Professor of Medicine

Daniel R. Frisch, MD

Associate Professor of Medicine

Gregory Gibson, MD

Clinical Assistant Professor of Medicine

Paulina Gorodin-Kiliddar, MD

Clinical Associate Professor of Medicine

Arnold J. Greenspon, MD Professor of Medicine

Christopher L. Hansen, MD

Professor of Medicine and Radiology

Reginald T. Ho, MD

Professor of Medicine

Drew Johnson, MD

Assistant Professor of Medicine

Andria Jones, DO

Clinical Assistant Professor of Medicine

Yair Lev, MD

Clinical Associate Professor of Medicine

Gregary D. Marhefka, MD

Professor of Medicine

Praveen Mehrotra, MD

Associate Professor of Medicine

care, and partnering with the Farber inpatient neurohospitalists. We offer a one-call continuum of high value, patient-oriented outpatient and inpatient cardiac assessment and management, and access to our specialized cardiology programs, across the Jefferson Center City Campus.

INPATIENT

The Cardiovascular Intensive Care Unit (CVICU) is a 25 bed, shared Medical and Surgical sub-specialty ICU on both the 3rd and 4th floors of the Gibbon building with highly trained Critical Care Registered Nurse (CCRN) certified nursing staff. The medical patients are now managed exclusively by three Cardiac Intensivists (Gregary D. Marhefka, MD (Director, Medical CVICU), Mark J. DeCaro, MD and Darius Farzad, MD) in three repeating 7-day continuous shifts ensuring the highest level of expertise, quality and continuity of care. In addition to rounding on some of the sickest patients admitted from within the hospital and transferred from the surrounding tristate area, the attending faculty provide critical care cardiology consultative services to the other intensive care units and are an integral part of the multi-disciplinary Cardiogenic Shock Team. Dedicated Advanced Heart Failure & Transplant cardiologists provide highly specialized consultative services to both the Medical and Surgical CVICU patients. Cardiovascular conditions treated by our devoted staff include: complicated STsegment Elevation Myocardial Infarction (STEMI) and high-risk non-STEMI; out-of-hospital and inhospital cardiac arrest and anoxic brain injured patients; hypertensive emergencies including acute aortic syndromes (active site for the International Registry of Acute Aortic Dissection (IRAD)); lethal arrhythmias including ventricular tachycardia storm; heart block

requiring temporary transvenous pacing; pericardial diseases including cardiac tamponade requiring pericardiocentesis; cardiogenic shock in acute and chronic advanced heart failure patients some of whom go on to require mechanical circulatory support such as left and/or right ventricular assist devices, Venous-Arterial Extra Corporal Membrane Oxygenation (VAECMO), Venous-Venous ECMO, and those who ultimately require left ventricular assist devices (LVAD) or orthotopic heart transplantation (OHT); high risk Maternal Fetal Medicine patients with complex cardiovascular conditions through delivery; acute endocarditis with severe valvular heart failure; and before and after structural heart disease interventions like higher risk Transcatheter Aortic Valve Replacement and MitraClip percutaneous mitral valve repair.

ECHOCARDIOGRAPHY

The Echocardiography laboratory provides a wide array of cardiac ultrasound services at Thomas Jefferson University Hospital (TJUH), Jefferson of the Hospital of the Neurosciences (JHN), and several outpatient facilities across the greater Philadelphia area managed by the Jefferson Heart Institute. The lab is comprised of eighteen sonographers, fourteen full-time faculty members in the Division of Cardiology, and four nurses. The lab provides several fundamental cardiac ultrasound services, including transthoracic echocardiography (TTE), transesophageal echocardiography (TEE), and stress (treadmill and pharmacologic) echocardiography, as well as several advanced services including contrast, threedimensional, myocardial strain, and interventional echocardiography.

In FY23, the echocardiography lab performed 21,809 transthoracic

echocardiograms, 1,108 stress echocardiograms, and 1,138 transesophageal echocardiograms including 164 transesophageal studies to guide interventional structural heart disease procedures. The volume of total echocardiographic studies increased by 7% from FY22 with the volume of transesophageal echocardiograms increasing by 7% and the volume of stress echocardiograms increasing by 11%. This past year, the echocardiography lab added one new full-time faculty member –Dr. Meghan Nahass.

Members of the echocardiography laboratory continue to be active at the national and local level. Dr. Praveen Mehrotra served on the planning committee for the American Society of Echocardiography Scientific Sessions for 2022. Both Drs. Mehrotra and Wiener served as faculty for American Society of Echocardiography meeting in 2021. Dr. Wiener serves as Chair of the Guidelines and Standards committee for the American Society of Echocardiography and as an advisor to the Board of Directors for the Intersocietal Accreditation Commission for echocardiography. Dr. Sung-Hae Cho serves on the ABIM Cardiovascular Disease ItemWriting Task Force. Drs. Praveen Mehrotra and Barbara Berko also sit on the Board of Directors for the Delaware Valley Echocardiography Society.

The echocardiography laboratory continues to be active in research. In addition to supporting multiple research studies in the Department of Medicine, the echocardiography lab led by Drs. Lev and Mehrotra continue to affiliate with multiple industry partners to help develop artificial intelligence software in the field of echocardiography guidance and interpretation. Drs. Cohen and Mehrotra continue to collaborate

FACULTY

Meghan Nahass, MD

Clinical Assistant Professor of Medicine

David O’Neil, MD

Clinical Assistant Professor of Medicine

Alyson N. Owen, MD

Clinical Assistant Professor of Medicine

Behzad B. Pavri, MD

Professor of Medicine

Ashley Pender, MD

Clinical Assistant Professor of Medicine

Andrew Peters, MD

Assistant Professor of Medicine

Ileana Piña, MD

Professor of Medicine

Robert M. Stein MD FACC FAHA '68 Professor in Cardiovascular Quality and Safety

Indranee Rajapreyar, MD

Associate Professor of Medicine

Jesus Eduardo Rame, MD

Louis R. Dinon MD Professor of Medicine and Surgery

Steven A. Roberts, MD

Clinical Assistant Professor of Medicine

Nicholas J. Ruggiero II, MD Professor of Medicine

Michael P. Savage, MD

Ralph J. Roberts Professor of Cardiology

Preya Simlote, MD

Clinical Assistant Professor of Medicine

Alexis B. Sokil, MD

Associate Professor of Medicine

Eugene Storozynsky, MD

Professor of Medicine

Marc A. Tecce, MD

Clinical Assistant Professor of Medicine

Oleg Vishnevsky, MD

Assistant Professor of Medicine

Paul Walinsky, MD

Professor of Medicine

Howard H. Weitz, MD

Bernard L. Segal Professor of Cardiology

David J. Whellan, MD

Professor of Medicine

David H. Wiener, MD

Clinical Professor of Medicine

with the Division of Radiology to develop a novel, non-invasive tool to measure intracardiac pressures with contrast ultrasound. Lastly, in a collaboration with the cardiac catheterization laboratory, the echo lab led a research study examining three-dimensional imaging based effective orifice areas of transcatheter heart valves implanted during transcatheter aortic valve implantation – a study which was published in the May 2022 issue of Journal of the American Society of Echocardiography. Lastly, Dr. Mehrotra continues to serve as co-investigator with pediatric cardiologists at Nemours to study the ventricles of patients with Tetralogy of Fallot with three-dimensional contrast echocardiography

ELECTROPHYSIOLOGY

The section of clinical cardiac electrophysiology is committed to delivering compassionate and innovative care to patients with a variety of heart rhythm disorders. Our section consists of three full-time faculty members, a nurse practitioner, two clinical nurses, and one nurse dedicated to remote monitoring of CIEDs. We are recruiting a 4th EP attending and a 2nd nurse practitioner. We have two stateof-the-art EP laboratories located at Thomas Jefferson University Hospital with two computerized mapping systems to assist in catheter ablation procedures. Currently, we perform more than 1,000 procedures, including ablation for atrial fibrillation, supraventricular and ventricular arrhythmias, as well as implantation of CIEDs including pacemakers, ICDs, cardiac resynchronization devices (CRT), and implantable loop recorders (ILRs). We also implant leadless pacemakers, conduction system pacing leads, cardiac implantable loop recorders for

remote ECG monitoring and left atrial occlusion (WATCHMAN) devices for left atrial appendage occlusion collaboratively with our colleagues in the structural heart section. Additionally, we are able to implant cardiac contractility modulation therapy systems and implantable systems for central sleep apnea. We have been a center for complex lead extraction procedures utilizing laser sheaths and mechanical sheaths. We have been at the forefront of delivering the latest technology to the care of our patients.

In the last year, we have transitioned most patients with CIEDs to remote monitoring of their devices. This was particularly important during the COVID-19 pandemic. Remote monitoring is another form of telehealth where patients do not have to come to their physician’s office for interpretation of their device function or cardiac rhythm disturbance. Currently, we are following more than 3,000 patients. In addition, we have developed a program with stroke neurologists and neurosurgeons for evaluating patients with unexplained stroke who may have occult atrial fibrillation. Patients have ILRs implanted at the time of their hospitalization at JHN. Our team follows them remotely. If atrial fibrillation is detected, the stroke neurologist and primary care physicians receive an immediate message via the EPIC EMR, which significantly shortens the time to anticoagulation.

Jefferson is a local leader in the implantation of the MICRA leadless pacemaker. We have performed >100 implants. We have participated in a study of the latest version of the device, the MICRA AV, which may provide atrial synchronous pacing rather than single chamber VVI pacing alone.

INTERVENTIONAL CARDIOLOGY

Jefferson’s Interventional Cardiology Section has a long tradition of clinical excellence and innovation. Over 25 years ago, Drs. David Fischman and Michael Savage were the lead authors of the landmark STRESS and SAVED trials published in the New England Journal of Medicine. These studies revolutionized the management of coronary artery disease. Their coronary brachytherapy program for in-stent restenosis of drug eluting stents, an interdisciplinary collaboration involving Interventional Cardiology and Radiation Oncology has been regional referral center for this specialized procedure for many years. Their contributions to interventional cardiology with investigator initiated studies, ongoing clinical trials and multicenter meta-analyses have answered many important questions for the practicing clinician.

The Structural Heart Program, led by Dr. Nicholas Ruggiero, in conjunction with Dr. Alec Vishnevsky, has become a national leader in trans-catheter valve therapies. Structural heart procedures including aortic and mitral balloon valvuloplasty, TAVR, TMVR, MitraClip, Watchman for left atrial appendage closure, ASD closure, VSD closure, PFO closure, PDA closure and paravalvular leak closure are performed routinely. Research studies such as the Ancora Heart Corcinch Trial for left ventricular remodeling in patients with cardiomyopathies, Abbott CardioMems Guide HF Trial, BARD TRUE balloon Trial, Cordella Pulmonary Artery Pressure Sensor Trials are ongoing. Upcoming trials looking at new PFO closure devices (ENCORE PerFOrm Trial), novel tricuspid and mitral valve

HEART RHYTHM CLIN & RESCH SOLUTIONS, LLC

Award Title: A Multi-Center, Real-World Evidence Registry to Assess Outcomes for the Long-Term Impact of Catheter Ablation for Atrial Fibrillation: DYNAMIC AF Registry

PRINCIPAL INVESTIGATOR:

DANIEL FRISCH, MD

Date: 08/31/2022

TOTAL AMOUNT: $10,750

DUKE UNIVERSITY

Award Title: Participant Engagement And pReference study for cLinical outcomes associated with Atrial Fibrillation (PEARL-AF)

PRINCIPAL INVESTIGATOR:

DANIEL FRISCH, MD

Date: 01/02/2023

TOTAL AMOUNT: $30,000

YALE UNIVERSITY

Award Title: The DISCOVER INOCA Prospective Multi-center Registry Determining the Cause of Coronary Vasomotor Disorders in Patients with Ischemia and No Obstructive Coronary Artery Disease .

PRINCIPAL INVESTIGATOR:

MICHAEL SAVAGE MD

Date: 02/02/2023

TOTAL AMOUNT: $30,775

AISAP, LTD

Award Title: Prospective Acquisition of Cardiac Ultrasound Images at the Point of Care

PRINCIPAL INVESTIGATOR:

PRAVEEN MEHROTRA, MD

Date: 02/21/2023

TOTAL AMOUNT: $142,150

interventions (EMPOWER Trial) will be starting in the next few months.

The Cardiogenic Shock and Temporary Mechanical Circulatory Support program, led by Dr. Alec Vishnevsky, is a multidisciplinary effort involving Interventional Cardiology, Heart Failure/Transplant, Cardiac Surgery, and Cardiac Intensivists that enables a nuanced and tailored approach for each patient presenting with Cardiogenic Shock. Since its inception, the program has been very successful, achieving a survival rate of 72% in patients with shock who require temporary mechanical circulatory support, including ECMO, Impella, TandemHeart, and ProtekDuo. Under Dr. Vishnevsky’s leadership, the Jefferson Enterprise has joined the Cardiogenic Shock Working Group, a multicenter, multinational registry consortium of over 40 health systems, and is one of the highest enrollers each year. This collaborative initiative has lead to numerous publications and continues to be at the forefront of cutting edge care for patients with Cardiogenic Shock. The continued growth of the program has also lead to the initiation of numerous device trials, including Aortix and Alleviant, investigating the use of novel therapies for these patients. With these efforts, the Jefferson Enterprise has quickly become amongst the national leaders in care of patients with Cardiogenic Shock. Dr. Vishnevsky has recently been awarded a grant to investigate the role of temporary mechanical support platforms in predicting patients who may not improve with destination LVAD therapy.

From 2022 to 2023, under the direction of Dr. Nicholas

Ruggiero, the Jefferson catheterization laboratory performed over 5,500 diagnostic and interventional procedures. Complex percutaneous coronary interventions are performed with the utilization of state-of-the-art devices, including excimer laser, orbital atherectomy, rotational atherectomy, Shockwave lithotripsy, fractional flow reserve, instantaneous flow reserve and intravascular imaging (both intravascular ultrasound and optical coherence tomography). The tradition of exemplary patient outcomes continues, in the most recent NCDR PCI registry report, Jefferson’s outcomes were above the 90% percentile.

The Jefferson Angioplasty Center provides a unique regional resource as a secondopinion center for thousands of high-risk patients with complex cardiovascular disease each year looking to bypass open heart surgery. The section is also very academically productive as seen by over 50 peer reviewed manuscripts, numerous abstracts and complex case presentations. The section members have been honored to be selected to edit multiple prestigious journals including JACC Case Reports and JSCAI. They have served as faculty at SCAI, TCT, ACC and the AHA scientific meetings.

The Center’s Philadelphia Cardiovascular Congress Meeting has become a national entity with international faculty and attendees. Drs. Savage, Fischman and Ruggiero have been annually named as “Philly Top Docs” in Interventional Cardiology.

STRUCTURAL HEART PROGRAM

The Jefferson Structural Heart Program, under the leadership of Dr. Nicholas Ruggiero, in conjunction with Dr. Alec Vishnevsky and stewardship of

Rebecca Marcantuono CRNP has grown exponentially over the past 5 years into a preeminent program with national recognition. During that time, the procedural volumes have increased exponentially to on average, greater than 120 TAVRS, 25 Mitraclips, 40 Watchman, and 40 PFO closures per year.

The “Heart-Brain-Blood” model of collaboration between Neurology, Hematology and Cardiology to evaluate patients with PFO and cryptogenic stroke has become the national gold standard for managing patients with this diagnosis. Drs. Ruggiero, Vishnevsky, Tzeng, and Dharia have published and spoken extensively on this topic, awarding Jefferson the designation of a National PFO Center of Excellence. Our Jefferson Structural Heart Program prides itself on not only the ability to scientifically provide improved quality of life with trans-catheter therapies, but also the ability to make our patients feel comfortable and safe.

We believe that collaboration is the key to success, and we have created relationships with multiple cardiology groups throughout the tri-state area, as well as created unique relationships with our cardiothoracic surgery, electrophysiology, and imaging colleagues. Drs. John Entwistle and Vakhtang Tchantchaleishvili have been integral in providing surgical support to the TAVR and Mitraclip programs. Dr. Daniel Frisch of Electrophysiology has been instrumental in the growth of the left atrial appendage occlusion program. Drs. Konstadinos Plestis of Cardiothoracic Surgery and Paul Dimuzio of Vascular Surgery are instrumental in the management of patients with complex aortic disease. Drs. Mehrotra, Peters and Pender, our interventional echocardiographers, have been paramount to our program’s success and have taken the lead

NOTABLE ACHIEVEMENTS

2023 Philadelphia Magazine

Top Doctors and 2023 America’s Top Doctors

RENE ALVAREZ, MD, FACC, FAHA, FACP

SUNG-HAE CHO, MD

INDRANIL DASGUPTA, MD, MPH, MBA

DANIELLE DUFFY, MD

DAVID FISCHMAN, MD

LORI FRANK, MD

DANIEL FRISCH, MD

PAULINA GORODIN-KILIDDAR, MD

ARNOLD GREENSPON, MD

CHRISTOPHER HANSEN, MD

REGINALD HO, MD

GREG MARHEFKA, MD

BEHZAD PAVRI, MD

NICHOLAS RUGGIERO, MD

MICHAEL SAVAGE, MD

ALEXIS SOKIL, MD

HOWARD WEITZ, MD

DAVID WIENER, MD

on multiple groundbreaking investigator initiated trials including our upcoming presentation at the AHA Scientific Sessions looking at a PFO Cover Index by 3D-TEE to Predict Residual Shunting After Transcatheter Closure.

Our team continues to look forward to representing Jefferson as a leader in the delivery of transcatheter therapies and further evolution of our Structural Heart Program for many years to come with an emphasis on providing cutting-edge treatment with patient focused care.

ADVANCED CARDIAC AND PULMONARY VASCULAR DISEASE

The field of heart failure is dynamic with multi-faceted acute and chronic syndromes that require timely targeted interventions delivered by an integrated medical and surgical team. Since the first successful application of heart-lung bypass in May of 1953 by Dr. John Gibbon to surgically correct a young woman suffering from an atrial septal defect at Jefferson University Hospital, the teams at Jefferson have been committed to innovation and clinical excellence in the management of complex cardiovascular disease. Nearly 70 years later, the current teams at Jefferson are applying a broad spectrum of medical and device innovation for patients with inherited and acquired cardiomyopathies— from novel therapeutics and remote monitoring systems to short-term and durable mechanical cardiopulmonary support and transplantation—are committed with the same rigor to excellence in the delivery of complex, personalized clinical care. To meet the current challenge of delivering targeted and timely multi-disciplinary care across the Jefferson Enterprise for patients with chronic heart

failure, the section for Advanced Cardiac and Pulmonary Vascular Disease was established under the leadership of Dr. J. Eduardo Rame in the spring of 2020. The vision—to have a group of physician faculty, nursing clinical providers and clinical staff working together at the nexus of advanced heart failure and pulmonary hypertension to provide the most specialized and uncompromising care for patients progressing along the stages of complex heart disease. Focused on these goals, the multi-disciplinary team at Jefferson currently boasts the highest rating in heart transplantation in our region and has continued to remain one of the leading centers successfully implanting long-term ventricular assist device (LVAD) therapy.

A long-standing legacy of heart transplantation and mechanical circulatory support devices including total artificial heart already existed at Thomas Jefferson University Hospital. Beyond focusing on advanced surgical therapies for heart failure, the section has grown with expertise in cardiomyopathic, pulmonary vascular and inherited heart and vascular disease. From three attendings in the spring of 2020 to now being the academic and clinical practice hub for 10 faculty members staffing two independent inpatient services focused on advanced and critical care patients. Consistent with its clinical goals of bringing expertise and extending access to the periphery of Jefferson Health, the faculty see patients on a regular basis at 12 distinct clinical sites across the Enterprise. With expertise in the areas of myocardial recovery, cardiovascular genetics, right heart failure and pulmonary vascular disease, multi-organ transplantation, and ventricular assist device (VAD) /total artificial

heart (TAH) technologies, the recently recruited team boasts a cumulative experience in the practice of advanced heart disease of > 200 years. Most recently, Dr. Ileana Pina, an internationally recognized expert in HF disease management, was recruited as Jefferson’s Chief Quality Officer for the Cardiovascular Service Line.

This year, several unique areas of expertise deserve mention as programs have launched to bring specialized tailored care to patients living with complex cardiovascular disease.

I. Working closely with critical care, cardiac surgery, and interventional cardiology, the section has promoted a program in cardiac recovery from cardiogenic shock. The multidisciplinary program working within the SHOCK team model addresses the acute aspects of heart recovery and then transitions to the chronic phase of promoting durable and optimized cardiac performance for patients who were treated for cardiopulmonary shock.

II. Another area of expertise that being developed is the reversal of end-stage heart failure using long-term mechanical circulatory support with ventricular assist devices. In this area, the group has experience evaluating for and ultimately performing left ventricular assist (LVAD) decommissioning or explanation in the appropriate patient who has been tested rigorously for cardiac recovery.

III. The clinical program for an integrated center for Amyloidosis involves cardiovascular [Dr. Brailovsky], Neurology

[Dr. Hristelina S. Ilieva] and structural heart disease and electrophysiology has come together to establish a multi-disciplinary clinic serving patients across the spectrum of amyloid heart disease.

IV. The Enterprise-wide CardioOncology Program [Dr. Storozynsky] provides tailored and timely input for patients with heart disease and cancer diagnoses.

V. Collaborating with the center for aortic disease [Dr. Konstadinos Plestis and Jacqueline McGee CRNP], a multidisciplinary inherited vascular disease program is bringing together the disciplines of cardiac surgery, vascular surgery and medicine to deliver first-in-region specialized care focusing on patients and their families with genetic aortic disease and aortopathies.

VI. Collaborating with the cardiac MRI Center the section is also the home of the inherited cardiomyopathy program which is growing at a very fast pace over the past year with the advent of myosin inhibitors that are now available to treat hypertrophic obstructive cardiomyopathy (HOCM). The current program in genetic cardiomyopathy and hypertrophic obstructive cardiomyopathy incorporates expertise from cardiac surgery [Dr. Rakesh Suri] cardiopulmonary Pathology, [Dr. John Farber], Cardiovascular Genetics, [Dr, Glen Gerhard] from Temple University, Cardiac Imaging [Dr. Carolina Mazri and Dr. Andrew Peters] and expertise from Sports Cardiology

[Dr. Drew Johnson and Dr. David Shipon]. This program works to bring together the surgical, medical and device [Electrophysiology] therapies to treat patients with symptomatic hypertrophic cardiomyopathy.

VII. In close collaboration with the Division of MaternalFetal Medicine, the cardioobstetrics program works to provide highly tailored care to women with high risk pregnancies with complex cardiovascular and cardiopulmonary disease.

VIII. Collaborating closely with the Korman Institute and Pulmonology Sections of Pulmonary Hypertension [Dr. Michael Scharf] and Interstitial Lung Disease, the Integrated program for Pulmonary Heart Disease and Right Heart Failure focuses on bringing highly specialized care to the patient with refractory right ventricular failure.

Across all these programs, the Section for Advanced Cardiac and Pulmonary Vascular Disease incorporates three pillars to strengthen the clinical and academic mission.

1 Timely, Tailored, and Team-Oriented Clinical management of patients across the spectrum of left and right heart failure.

2 A commitment by our engaged full-time Faculty to train the fellows and academic clinicians who will define the future of this field.

3 A commitment by our world-class faculty to innovative scholarship and research that will advance the science in our field.

These clinical teams with proven excellence in building advanced cardiac disease management programs and shaping discovery and innovation in research will be leading Jefferson Health in this new era of heart transplantation and heart failure while training the next generation of academic clinicians in the field.

QUALITY INITIATIVES

The Divisional quality efforts, led by Dr. Yair Lev, have included multiple quality projects over the past year. We are focusing on inpatient and outpatient projects to improve quality of care. Examples include tracking the utilization of important cardiac medications for conditions such as heart failure; when we recognize that we underutilize an important class of medications, we investigate why, and take actions to improve the situation. This includes education steps, grand rounds, conversations, emails, EPIC tools, and other steps. Another example is recognition of potential barriers for early defibrillation for patients who have a cardiac arrest during hospitalization; this includes building an online education module with pre and post test assessments. We also are involved in other projects collaborating with our colleagues; an exciting project is to glean information about the coronary arteries based on chest CTs done for any reason. We have created work groups incorporating Radiology, Pulmonary, Medicine, and Cardiology, to improve the detection of coronary artery disease based on incidental findings on CT scans that will translate to better patient care. These are some of many projects underway, which are further detailed in the Departmental Annual Quality Report.

EDUCATION

The Division of Cardiology has been providing comprehensive training of Cardiovascular Disease fellows since 1959, later introducing sub-specialty training in Interventional Cardiology in 1982 (with Structural Heart Disease added in 2017), Clinical Cardiac Electrophysiology in 1984, and Advanced Heart Failure & Transplant in 2004. Our 4 fellowship programs are accredited by the ACGME (American College of Graduate Medical Education).

The Interventional Cardiology program has an optional nonaccredited second year for selected fellows who wish to focus on advanced structural heart and peripheral vascular disease. The Division of Pulmonary and Critical Care, in conjunction with the Division of Cardiology, provides a one-year ACGME accredited training program in critical care cardiology for fellows who have completed a Cardiovascular Disease Fellowship.

Sung-Hae Cho, MD, is the Program Director of the General Cardiovascular Disease Fellowship supervising 23 general fellows during a 3-year program. Of these fellows, there are 6 (2 per class) in the community track with Abington Jefferson Health in partnership with Associate Program Director, Adam Cohen, MD, from Abington, and 2 currently in the newly formed community track with Jefferson Torresdale Hospital with Associate Program Director, Mohammed Murtaza, MD, from Torresdale. David L. Fischman, MD, is the Program Director for the Interventional Cardiology Fellowship, supervising 3 fellows. Behzad Pavri, MD, is the Program Director for the Clinical Cardiac Electrophysiology Fellowship, overseeing 2 fellows. Indranee Rajapreyar, MD, is the Program Director for the Advanced Heart

Failure & Transplant Fellowship, supervising 1 fellow. David Oxman, MD, is the Program Director for the Critical Care Medicine Fellowship.

The faculty provides direct teaching and supervision of fellows, with fellows playing an active role in patient care, including diagnosis and management of a wide range of cardiac conditions. The inpatient care includes general cardiology, heart failure, electrophysiology, critical care, and postoperative care of the cardiac surgery patients. The fellows receive comprehensive hands-on training in both inpatient and outpatient procedures which include cardiac catheterization, percutaneous intervention, structural interventions, electrophysiology studies, ablations, device placements, transthoracic and transesophageal echocardiography, stress echocardiography, interventional echocardiography, and nuclear cardiology. The program also provides training in cardioobstetrics, women’s health, cardiooncology, cardiac MRI, and congenital heart disease.

Core faculty update and deliver a daily, rigorous 45-minute morning lecture curriculum in a repeating weekly format: ECG and Electrophysiology (coordinated by Behzad Pavri, MD), Interventional Cardiology (coordinated by David L. Fischman, MD), Echocardiography (coordinated by Sung-Hae Cho, MD), and Clinical Cardiology Conference, also known as Cardiology Grand Rounds, for all faculty and fellows (coordinated by Gregary D. Marhefka, MD). Both Echocardiography and Clinical Cardiology Conferences are ACCME (Accreditation Council for Continuing Medical Education) accredited. Friday morning conferences also include monthly Morbidity & Mortality Conference, 8 combined Radiology-Cardiology Advanced Imaging Conferences, and a quarterly funded Louis R.

Dinon, MD, Memorial Lectureship, attracting highly renowned, external speakers from all over the world. This past year’s speakers were: Raj Janhardanan, MD, MRCP, FACC, FASE, ASE editorial board member for 3D echocardiography; Carl Pepine, MD, MACC, former chief of cardiology at the University of Florida, the founding editor of Cardiology Today, and Editor-inChief for American Heart Journal Plus: Cardiology Research and Practice; Robert Perkel, MD, Professor of Medicine at Thomas Jefferson University Hospital with expertise in medical ethics; Martin Maron, MD, Medical Director of the Hypertrophic Cardiomyopathy Center and the co-director of the Cardiac CT and MRI program at Lahey Hospital and Medical Center.

On a repeating monthly basis, core faculty provide lectures to our fellows in Nuclear Cardiology (coordinated by Christopher L. Hansen, MD), Advanced Heart Failure & Transplant (coordinated by Yevgeniy Brailovsky, DO), Adult Congenital Heart Disease (coordinated by Gregary D. Marhefka, MD, also ACCME accredited), Journal Club (coordinated by David Fischman, MD, Alec Vishnevsky, MD, and Sung-Hae Cho, MD). Additionally, there are lectures/didactics in Cardiac MRI (coordinated by Andrew Peters, MD), General Cardiovascular Disease Board Review (coordinated by Alec Vishnevsky, MD), and Echocardiography Board Review (coordinated by Sung-Hae Cho, MD). Furthermore, the Interventional and Structural Heart Disease and the Advanced Electrophysiology programs provide weekly educational conferences for their own subspecialty fellows. Last, but not least, the Cardiology Division also provides recurring formal didactics to Internal Medicine and Family Medicine residents, to residents and fellows from other

departments and divisions, as well as to medical students, both from Sidney Kimmel Medical College (coordinated by Lori Frank, MD) and visiting from abroad.

RESEARCH

For research within the Cardiology Division, despite continued challenges from the ongoing global pandemic, our team was incredibly active. From fellows initiating independent projects to sponsored trials, investigatorinitiated studies, and faculty grants, the Jefferson Cardiology group continues to strive to maintain their competitive edge at the forefront of cardiology knowledge.

There are currently 16 cardiac trials open to enrollment, with an overall total accrual of 122 patients across all studies. Dr. Brailovsky, Dr. Frisch, Dr. Lev, Dr. Marhefka, Dr. Mehrotra, Dr. Pavri, Dr. Rame, Dr. Roberts, Dr. Savage, Dr. Shipon, Dr. Ruggiero, Dr. Vishnevsky, and Dr. Whellan are currently involved in funded research exceeding $7,000,000 in overall award amount. Topics include long-term outcomes of catheter ablation, point of care ultrasound acquisition, coronary vasomotor disorders, and catheter ablation for atrial fibrillation. The team has continued to benefit from a full-time senior research project manager, Jordan Price, who joined the program last year. This year Price has coordinated the cardiology group’s involvement with several prospective registries, and helped to match several students and fellows with ongoing faculty research. She has also assisted numerous cardiologists in applying for grants, developing and implementing investigatorinitiated trials as well as managing research projects from conception to execution, documenting results and drafting presentations.

PUBLICATIONS

(2022-2023)

Acharya D, Manandhar-Shrestha N, Leacche M, Rajapreyar I, William P, Kazui T, et al. Extracorporeal membrane oxygenation as a bridge to advanced heart failure therapies. Journal of Heart and Lung Transplantation. 2023;42:1059-1071

Al-Soodani AT, Wu X, Kelp NC, Brown AJ, Roberts SA, Her C. Hmsh5 regulates nhej and averts excessive nucleotide alterations at repair joints. Genes. 2022;13

Alyesh D, Pavri BB, Choe W, Chandara M, Sani MU, Phan PD, et al. Advancing global equity in cardiac care as cardiac implantable electronic device reuse comes of age. Heart Rhythm O2 2022;3:799-806

Attin M, Reifenstein K, Mehta S, Arcoleo K, Lin CD, Storozynsky E. Reported signs, symptoms, and diagnostic tests before cardiotoxicity among women with breast cancer: A pilot study. Journal of Cardiovascular Nursing 2022;37:104-111

Bauer TM, Weber MP, O'Malley TJ, Moncure H, Pirlamarla PR, Shah MK, et al. Assessing donorrecipient size metrics for heart transplant outcomes: Unos database analysis. Clinical Transplantation. 2022;36

Beavers CJ, Ambrosy AP, Butler J, Davidson BT, Gale SE, Piña IL, et al. Iron deficiency in heart failure: A scientific statement from the heart failure society of america. Journal of Cardiac Failure. 2023;29:10591077

Bhardwaj A, Fedson S, Munagala M, Pinney S, Rajapreyar I, Mancini D. Pregnancy in patients with advanced heart failure: Impact of overturn of roe v wade ruling. JACC: Heart Failure. 2023,11:362364

Bohm KA, Morledge-Hampton B, Stevison S, Mao P, Roberts

SA, Wyrick JJ. Genome-wide maps of rare and atypical uv photoproducts reveal distinct patterns of damage formation and mutagenesis in yeast chromatin. Proceedings of the National Academy of Sciences of the United States of America 2023;120

Brailovsky Y, Lakhter V, Newman J, Allen S, Elkaryoni A, Desai P, et al. Fibrinolytic status and risk of death after acute pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis 2023;29

Brailovsky Y, Masoumi A, Bijou R, Oliveros E, Sayer G, Takeda K, et al. Fulminant giant cell myocarditis requiring bridge with mechanical circulatory support to heart transplantation. JACC: Case Reports. 2022;4:265-270

Brailovsky Y, Rajapreyar I, Alvarez R. Ttr amyloidosis: Current state of affairs and promise for the future. JACC: Case Reports 2023;10

Bruno ES, Mujer MTP, Desai PV, Brailovsky Y, Darki A. A metaanalysis of standard versus ultrasound-assisted catheterdirected thrombolysis in the management of acute pulmonary embolism. Journal of the Society for Cardiovascular Angiography and Interventions. 2023;2

Burton JO, Coats AJS, Kovesdy CP, Palmer BF, Piña IL, Rosano G, et al. An international delphi consensus regarding best practice recommendations for hyperkalaemia across the cardiorenal spectrum. European Journal of Heart Failure 2022;24:1467-1477

Chew DS, Li Y, Zeitouni M, Whellan DJ, Kitzman D, Mentz RJ, et al. Economic outcomes of rehabilitation therapy in older patients with acute heart failure in the rehab-hf trial: A secondary analysis of a randomized

clinical trial. JAMA Cardiology 2022;7:140-148

Chu NM, Hong J, Harasemiw O, Chen X, Fowler KJ, Dasgupta I, et al. Chronic kidney disease, physical activity and cognitive function in older adults - results from the national health and nutrition examination survey (2011-2014). Nephrology Dialysis Transplantation. 2022;37:21802189Co ML, Ho RT. Delayed termination and transformation of a supraventricular tachycardia—what is the mechanism? Heart Rhythm 2022;19:2125-2127

Co ML, Ho RT. Para-hisian pacing in a patient with a long rp tachycardia—what is the mechanism? Heart Rhythm. 2022

Collins KA, Reeves GR, Miller NH, Whellan DJ, O'Connor CM, Marcus BH, et al. Clinical predictors of adherence to exercise training among individuals with heart failure: The hf-action study. Journal of Cardiopulmonary Rehabilitation and Prevention. 2023;43:205-213

Darwish I, Fareed J, Brailovsky Y Hoppensteadt D, Slajus B, Bontekoe E, et al. Dysregulation of biomarkers of hemostatic activation and inflammatory processes are associated with adverse outcomes in pulmonary embolism. Clinical and Applied Thrombosis/Hemostasis 2022;28

Dasgupta I, Zoccali C. Is the kdigo systolic blood pressure target <120 mm hg for chronic kidney disease appropriate in routine clinical practice? Hypertension 2022;79:4-11

Datta T, Lee AJ, Cain R, McCarey M, Whellan DJ. Weighing in on heart failure: The potential impact of bariatric surgery. Heart Failure Reviews. 2022;27:755-766

Dharmavaram N, Esmaeeli A, Jacobson K, Brailovsky Y, Raza F. Cardiopulmonary exercise testing, rehabilitation, and exercise training in postpulmonary embolism.

Interventional Cardiology Clinics 2023;12:349-365

Didichenko SA, Velkoska E, Navdaev AV, Greene BH, Lorkowski SW, Duffy D, et al. Csl112 infusion rapidly increases apoa1 exchange rate via specific serum amyloid-poor hdl subpopulations when administered to patients post-myocardial infarction. Arteriosclerosis, Thrombosis, and Vascular Biology. 2023;43:855-869

Dikdan SJ, Co ML, Pavri BB Dyssynchronous heart failure: A clinical review. Current Cardiology Reports. 2022;24:1957-1972

DiMeglio M, Ullah W, Brailovsky Y, Rajapreyar IN, Vishnevsky A Trends and outcomes of transcatheter aortic valve implantation in hypertrophic cardiomyopathy. American Journal of Cardiology. 2022;179:117-118

Doshi H, Savage MP, Ruggiero N, Walinsky P, Davis M, Troia J, et al. Recyclable waste in the cardiac catheterization laboratory: The potential to curb the carbon footprint. JACC: Cardiovascular Interventions. 2023;16:737-738

Doyle M, Dikdan S, Farzad D, Marhefka GD. Three, dynamic variants of st segment elevations in a patient with osteosarcoma and cardiac metastasis. Journal of Electrocardiology. 2023;78:29-33

Dulam V, Keshavamurthy S, Kashem MA, Alvarez RJ Hamad EA, Toyoda Y. Giant ventral hernia following left ventricular assist device bridge to heart transplantation. Indian Journal of Thoracic and Cardiovascular Surgery. 2022;38:672-674

Ellis CR, Greenspon AJ, Andriulli JA,Gould PA, Carillo RG, Kolek MJ, et al. Randomized trial of stand-alone use of the antimicrobial envelope in high-risk cardiac device patients. Circulation: Arrhythmia and Electrophysiology 2023;16:E011740

Esposito C, Machado P, Cohen IS, Mehrotra P, Savage M, Fischman D, et al. Comparing central aortic pressures obtained using a sphygmocor device to pressures obtained using a pressure catheter. American Journal of Hypertension 2022;35:397-406

Esposito C, Machado P, McDonald ME, Savage MP, Fischman D, Mehrotra P, et al. Noninvasive evaluation of cardiac chamber pressures using subharmonic-aided pressure estimation with definity microbubbles. JACC: Cardiovascular Imaging 2023;16:224-235

Ezekowitz JA, Alemayehu W, Rathwell S, Grant AD, Fiuzat M, Whellan DJ, et al. The influence of comorbidities on achieving an n-terminal pro-b-type natriuretic peptide target: A secondary analysis of the guide-it trial. ESC Heart Failure. 2022;9:77-86

Farber J, Dikdan S, Ruge M, Johnson D, Shipon D. Relationship between caffeine consumption and young athletes’ comorbidities, exercise-related symptoms, and baseline electrocardiogram. Sports Health. 2023

Fischman DL, Mahadevan VS, Bates ER. The “evolving” role of intravascular imaging in myocardial infarction with nonobstructive coronary arteries. JACC: Case Reports. 2023;6

Fischman DL, Vidovich M, Bates E. Recognition and management of complications in cutting-edge contemporary care. JACC: Case Reports. 2022;4:505-506

Fradin J, Kim FJ, Lu-Yao GL, Storozynsky E, Kelly WK. Review of cardiovascular risk of androgen deprivation therapy and the influence of race in men with prostate cancer. Cancers. 2023;15

Frankel ES, Hajduczok AG, Rajapreyar IN, Brailovsky Y Recurrent giant cell myocarditis

after heart transplant: A case report. European Heart Journal - Case Reports. 2022;6

Gibson CM, Kazmi SHA, Korjian S, Chi G, Phillips AT, Montazerin SM, et al. Csl112 (apolipoprotein a-i [human]) strongly enhances plasma apoa-i and cholesterol efflux capacity in post-acute myocardial infarction patients: A pk/pd substudy of the aegis-i trial. Journal of Cardiovascular Pharmacology and Therapeutics. 2022;27

Gomaa S, Kelly WK, Mitchell E, Storozynsky E, Zeigler-Johnson C, Juon HS, et al. Racial disparities in new-onset diabetes mellitus in prostate cancer patients on androgen deprivation therapy: A retrospective analysis of trinetx data. World Journal of Urology 2023

Grandin EW, Gulati G, Nunez JI, Kennedy K, Rame JE, Atluri P, et al. Outcomes with phosphodiesterase-5 inhibitor use after left ventricular assist device: An sts-intermacs analysis. Circulation: Heart Failure. 2022;15:E008613

Grapsa J, Walsh MN, EnriquezSarano ML, Sorgente A, Vidovich MI, Fischman DL, et al. 2022 year in review: Countdown of the best manuscripts in 2022. JACC: Case Reports. 2023;7

Greene SJ, Ezekowitz JA, Anstrom KJ, Demyanenko V, Givertz MM, Piña IL, et al. Medical therapy during hospitalization for heart failure with reduced ejection fraction: The victoria registry. Journal of Cardiac Failure 2022;28:1063-1077

Groenland EH, Dasgupta I Visseren FLJ, van der Elst KCM, Lorde N, Lawson AJ, et al. Clinical characteristics do not reliably identify non-adherence in patients with uncontrolled hypertension. Blood Pressure. 2022;31:178-186

]Guedes M, Bieber B, Dasgupta I Vega A, Nitta K, Brunelli S, et al. Serum phosphorus level rises in us hemodialysis patients over the past

decade: A dopps special report. Kidney Medicine. 2023;5

Gupta A, Pavri BB. Conduction system pacing versus biventricular pacing: Reduced repolarization heterogeneity in addition to improved depolarization. Journal of Cardiovascular Electrophysiology 2022;33:287-295

Hamer R, Hameed A, Damery S, Jenkins K, Dasgupta I, Baharani J. Do we practice what we preach? Dialysis modality choice among healthcare workers in the united kingdom. Seminars in Dialysis. 2023

Hansen CL. The 'ramp filter' artifact in filtered back projection is due to attenuation not ramp filtering. Nuclear medicine communications. 2022;43:694-700

Hansen CL. Improving evaluation for ttr amyloidosis by interactive filtering of tc-99 m pyp spect images. The role for “clean blood pool” imaging. Journal of Nuclear Cardiology. 2023

Haroian NQ, Savage MP, Fischman DL. Transradialtransfistula access for cardiac catheterization in patients with abandoned hemodialysis fistulas. JACC: Case Reports. 2022;4

Hennessy-Strahs S, Kang J, Krause E, Dowling RD, Rame JE, Bartoli CR. Patient-specific severity of von willebrand factor degradation identifies patients with a left ventricular assist device at high risk for bleeding. Journal of Thoracic and Cardiovascular Surgery. 2022

Ho CJ, Ho RT. The frog sign revisited. Journal of Innovations in Cardiac Rhythm Management 2022;13:5184-5187

Ho RT. Does applying ice make the pain better? Journal of Cardiovascular Electrophysiology 2022;33:2048-2049

Ho RT. From argentina to denmark—the wine is still good. Heart Rhythm. 2022;19:260-261

Ho RT. “Wireless telegraphy” 100

years later—good for the world or a menace? Heart Rhythm 2023;20:520-521

Ho RT. Macroreentrant scarmediated atrial tachycardia terminated by a nonpropagated stimulus within a narrow diastolic isthmus: Electroanatomic correlation. Heart Rhythm 2023;20:307-308

Irabor OC, Nelson N, Shah Y, Niazi MK, Poiset S, Storozynsky E et al. Overcoming the cardiac toxicities of cancer therapy immune checkpoint inhibitors. Frontiers in Oncology. 2022;12

Jacob D, Savage MP, Fischman DL Novel approaches to coronary perforations: Everything but the kitchen sink. JACC: Case Reports 2022;4:142-144

Jain V, Gupta K, Bhatia K, Rajapreyar I, Singh A, Zhou W, et al. Coronary flow abnormalities in chronic kidney disease: A systematic review and metaanalysis. Echocardiography 2022;39:1382-1390

Johansen KL, Acharya A, Cizman B, Cobitz AR, CorreaRotter R, Dasgupta I, et al. Challenges of conducting clinical trials during the sars-cov2 pandemic: The ascend global program experience. Kidney360 2022;3:728-733

Junarta J, Dikdan SJ, Upadhyay N, Bodempudi S, Shvili MY, Frisch DR High-power short-duration versus standard-power standard-duration settings for repeat atrial fibrillation ablation. Heart and Vessels 2022;37:1003-1009

Junarta J, Dikdan SJ, Weitz HH Lip GYH, Frisch DR. Zero-burden atrial fibrillation: Does stroke risk diminish the longer a person is free from atrial fibrillation? Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology

2022;24:1369-1371

Junarta J, Marhefka GD Hypophosphatemia causing st elevation in a critically ill noncardiac surgery postoperative patient. Annals of Noninvasive Electrocardiology. 2022;27

Junarta J, O'Neill P, Dikdan SJ, Pang Z, Fradin JJ, Frisch DR. Mobile electrocardiographic devices and healthcare utilization in post-atrial fibrillation ablation patients. Journal of Electrocardiology. 2023;80:139142

Junarta J, Siddiqui MU, Riley JM, Dikdan SJ, Patel A, Frisch DR. Low-voltage area substrate modification for atrial fibrillation ablation: A systematic review and meta-analysis of clinical trials. Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 2022;24:1585-1598

Khan MS, Anker SD, Friede TIM, Jankowska EA, Metra M, Piña IL et al. Minimal clinically important differences in 6-minute walk test in patients with hfref and iron deficiency: Mcid for 6mwt in patients with hfref and iron deficiency. Journal of Cardiac Failure. 2023;29:760-770

Khan MZ, Brailovsky Y, Vishnevsky OA, Baqi A, Patel K, Alvarez RJ Clinical outcome of tavr vs. Savr in patients with cardiac amyloidosis. Cardiovascular Revascularization Medicine. 2022;43:20-25

Kingwell BA, Nicholls SJ, Velkoska E, Didichenko SA, Duffy D, Korjian S, et al. Antiatherosclerotic effects of csl112 mediated by enhanced cholesterol efflux capacity. Journal of the American Heart Association. 2022;11

Kocovic N, Greenspon AJ Dual tachycardia induced by electrocution terminated by an implantable cardioverter-

defibrillator. HeartRhythm Case Reports. 2023;9:486-488

Kuhrau S, Masic D, Mancl E, Brailovsky Y, Porcaro K, Morris S, et al. Impact of pulmonary embolism response team on anticoagulation prescribing patterns in patients with acute pulmonary embolism. Journal of Pharmacy Practice 2022;35:38-43

Leon SA, Rosen JL, Ahmad D, Austin MA, Vishnevsky A, Rajapreyar IN, et al. Microaxial circulatory support for percutaneous coronary intervention: A systematic review and meta-analysis. Artificial Organs 2023;47:934-942

Lewis GD, Docherty KF, Voors AA, Cohen-Solal A, Metra M, Whellan DJ,et al. Developments in exercise capacity assessment in heart failure clinical trials and the rationale for the design of meteoric-hf. Circulation. Heart failure. 2022;15:e008970

Lewis GD, Voors AA, Cohen-Solal A, Metra M, Whellan DJ, Ezekowitz JA, et al. Effect of omecamtiv mecarbil on exercise capacity in chronic heart failure with reduced ejection fraction: The meteorichf randomized clinical trial. JAMA 2022;328:259-269

Lohre J, Rame JE, Mechler K. The blood crown princess: Familycentered care of a parent on mechanical support. Artificial Organs. 2023;47:1226-1227

Love CJ, Hanna I, Thomas G, Greenspon AJ, Christie M, Goodman J, et al. Preclinical evaluation of a third-generation absorbable antibacterial envelope. Heart Rhythm. 2023;20:737-743

Marek-Iannucci S, Oliveros E, Brailovsky Y, Pirlamarla P, Roman A, Rajapreyar IN. Natriuretic peptide biomarkers in the imminent development of preeclampsia. Frontiers in Cardiovascular Medicine. 2023;10

Marek-Iannucci S, Rajapreyar IN,

Huaman MG, Uber P, Alvarez R, Rame EJ, et al. Covid-19 associated development of antibody mediated rejection in orthotopic heart transplantation patients. Clinical Transplantation. 2023

Marek-Iannucci S, Uber P, Rajapreyar I. Management of pregnancy in left ventricular assist device and heart transplant recipients: A concise review. Current Opinion in Cardiology 2023;38:257-265

Marek-Iannucci S, Ullah W, Uber P, Oliveros E, Brailovsky Y, Ramu B, et al. Association of chronic kidney dysfunction and preeclampsia: Insights of the nationwide inpatient sample: Chronic kidney dysfunction and preeclampsia: Cause or consequence? American Journal of Obstetrics and Gynecology MFM. 2023;5

Mitchell J, Storozynsky E Lopez AM. The nuance of studying and prescribing supplements. Journal of the American College of Cardiology. 2023;81:e149

Mitchell KA, Haddock AJ, Husainy H, Walter LA, Rajapreyar I, Wingate M, et al. Care of the postpartum patient in the emergency department: A systematic review with implications for maternal mortality. American Journal of Perinatology. 2023;40:489-507

Mohebi R, Liu Y, Felker GM, Ward JH, Piña IL, Butler J, et al. Mechanistic efficacy of sacubitril/ valsartan in ischemic versus nonischemic heart failure. Journal of the American Heart Association 2023;12

Mohebi R, Liu Y, Myhre PL, Felker GM, Prescott MF, Piña IL et al. Heart failure phenotypes according to natriuretic peptide trajectory following initiation of sacubitril/valsartan. JACC: Heart Failure. 2023;11:855-858

Mohebi R, Liu Y, Piña IL, Prescott MF, Butler J, Felker GM, et al. Dose-response to

sacubitril/valsartan in patients with heart failure and reduced ejection fraction. Journal of the American College of Cardiology 2022;80:1529-1541

Mohebi REZA, Liu YUXI, Felker GM, Prescott MF, Ward JH, Piña IL et al. Heart failure duration and mechanistic efficacy of sacubitril/ valsartan in heart failure with reduced ejection fraction. Journal of Cardiac Failure. 2022;28:16731682

Murphy SP, Ward JH, Piña IL Felker GM, Butler J, Maisel AS, et al. Age differences in effects of sacubitril/valsartan on cardiac remodeling, biomarkers, and health status. JACC: Heart Failure 2022;10:976-988

Murray EM, Whellan DJ, Chen H, Bertoni AG, Duncan P, Pastva AM, et al. Physical rehabilitation in older patients hospitalized with acute heart failure and diabetes: Insights from rehab-hf. American Journal of Medicine. 2022;135:82-90

Myhre PL, Prescott MF, Claggett B, Felker GM, Butler J, Piña IL, et al. Comparative effect of angiotensin receptor neprilysin inhibition on b-type natriuretic peptide levels measured by three different assays: The prove-hf study. Clinical Chemistry. 2022;68:1391-1398

Nelson MB, Gilbert ON, Duncan PW, Kitzman DW, Reeves GR, Whellan DJ, et al. Intervention adherence in rehab-hf: Predictors and relationship with physical function, quality of life, and clinical events. Journal of the American Heart Association. 2022;11

Nelson MB, Shiroma EJ, Kitzman DW, Duncan PW, Reeves GR, Whellan DJ, et al.

Physical activity and relationship to physical function, quality of life, and cognitive function in older patients with acute decompensated heart failure. American Heart Journal 2023;256:85-94

Oben AG, Walker ZW, Blanchard CT, Szychowski JM, Maier JG,

Rajapreyar I, et al. Racial disparities in reliable contraceptive use in women with heart disease*. European Journal of Contraception and Reproductive Health Care 2022;27:174-179

Oliveros E, Brailovsky Y Beneduce A, Bakhshi H, Zancanaro E, Sukmawati I, et al. Impact of social media and multimedia platforms: View from the jacc: Case reports some editors. JACC: Case Reports 2023;15

Oliveros E, Burgess S, Nadella N, Davidson L, Brailovsky Y, Reza N, et al. Becoming a parent during cardiovascular training. Journal of the American College of Cardiology. 2022;79:2119-2126

Pandey A, Keshvani N, Piña IL Prevalence and incidence of pre-hf among hispanics/latinos. JACC: Heart Failure. 2023;11:958-960

Pandey A, Kitzman DW, Nelson MB, Pastva AM, Duncan P, Whellan DJ, et al. Frailty and effects of a multidomain physical rehabilitation intervention among older patients hospitalized for acute heart failure: A secondary analysis of a randomized clinical trial. JAMA Cardiology. 2023;8:167-176

Pandey A, Segar MW, Singh S, Reeves GR, O'Connor C, Piña I, et al. Frailty status modifies the efficacy of exercise training among patients with chronic heart failure and reduced ejection fraction: An analysis from the hf-action trial. Circulation 2022;146:80-90

Pavri BB. Helping the hypertrophied (but nonobstructed) heart. Heart Rhythm. 2023

Pickup L, Loutradis C, Law JP, Arnold JJ, Dasgupta I, Sarafidis P, et al. The effect of admission and pre-admission serum creatinine as baseline to assess incidence and outcomes of acute kidney injury in acute medical admissions. Nephrology Dialysis Transplantation

2022;37:148-158

Pierce JB, Mentz RJ, Sun JL, Alhanti B, Whellan DJ, Kraus WE, et al. Titration of medical therapy and clinical outcomes among patients with heart failure with reduced ejection fraction: Findings from the hf-action trial. American Heart Journal 2022;251:115-126

Piña IL . Time to re-examine maternity leave in cardiology training: Proactive rather than reactive. Journal of the American College of Cardiology 2022;79:2127-2128

Piña IL . Consistency breeds confidence: The continuing story of sglt2 inhibitors. Circulation. 2023;147:635-637

Piña IL , Allen LA, Desai NR. Policy and payment challenges in the postpandemic treatment of heart failure: Value-based care and telehealth. Journal of Cardiac Failure. 2022;28:835844

Piña IL , Gibson GT, Zieroth S, Kataria R. Reflecting on the advancements of hfref therapies over the last two decades and predicting what is yet to come. European Heart Journal, Supplement. 2022;24:L2-L9

Poole JE, Swerdlow CD, Tarakji KG, Mittal S, Ellenbogen KA, Greenspon AJ, et al. Clinical performance of implantable cardioverter-defibrillator lead monitoring diagnostics. Heart Rhythm. 2022;19:363-371

Rajapreyar I, Le Jemtel TH. Need for unstructured preimplantation data to predict myocardial recovery in patients with a left ventricular assist device. Journal of the American Heart Association 2022;11

Rajapreyar I, Soliman O, Brailovsky Y, Tedford RJ, Gibson G, Mohacsi P, et al. Late right heart failure after left ventricular assist device implantation: Contemporary

insights and future perspectives. JACC: Heart Failure. 2023

Randhawa VK, Spataru A, Jory L, Moussa F, Bhardwaj A, Rajapreyar I

Effects of inhaled pulmonary vasodilators on perioperative right ventricular hemodynamics: Are these “nebs” simply nebulous?

Canadian Journal of Cardiology 2023;39:483-486

Raphael CW, Pavri BB

An unusual case of nonreentrant atrioventricular nodal tachycardia. Journal of Cardiovascular Electrophysiology 2022;33:1062-1066

Ravipati G, Luo M, Ullah W, Fischman DL, McCarey MM, Ruggiero NJ, et al. Three time loser or third time's the charm? Pci of recurrent restenosis after overlapped drug-eluting stents. Journal of the Society for Cardiovascular Angiography and Interventions. 2023

Round KJ, Ho RT. When left is not right—an avoidable complication of lead implantation. Journal of Interventional Cardiac Electrophysiology. 2022;64:193-194

Ruge M, Fischman DL, Rajapreyar I, Brailovsky Y. The value of right heart catheterization: Case series showing benefits in a variety of diagnoses. JACC: Case Reports 2023;21

Ruge M, Kochar K, Ullah W, Hajduczok A, Tchantchaleishvili V, Rame JE, et al. Impact of ventricular arrhythmia on lvad implantation admission outcomes. Artificial Organs. 2022;46:24782485

Ruge M, Marek-Iannucci S, Massey HT, Ruggiero NJ, Lawrence J, Mehrotra P, et al. Percutaneous decommissioning 11 years after initial cf-lvad placement. JACC: Case Reports. 2022;4

Ruge M, Marhefka GD Ivc measurement for the noninvasive evaluation of central venous pressure. Journal of

Echocardiography. 2022;20:133143

Sabouret P, Spadafora L, Fischman D, Ullah W, Zeitouni M, Gulati M, et al. De-escalation of antiplatelet therapy in patients with coronary artery disease: Time to change our strategy? European Journal of Internal Medicine 2023;110:1-9

Savage MP, Fischman DL

Resistant drug-eluting stent restenosis and resurrection of intracoronary brachytherapy: The lazarus of contemporary coronary intervention. Journal of the Society for Cardiovascular Angiography and Interventions. 2023;2

Saxena A, Curran J, Ahmad D, Nasher N, Miyamoto T, Brailovsky E, et al. Utilization and outcomes of v-av ecmo: A systematic review and meta-analysis. Artificial Organs 2023

Schneider SM, Kochar K, Ruge M, Marek-Iannucci S, Datta T, Hajduczok A, et al. Cardiogenic shock due to atrial arrhythmia as the initial presentation of transthyretin cardiac amyloidosis. JACC: Case Reports. 2022;4:14901495

Sherazi S, Schleede S, McNitt S, Casulo C, Moore JE, Storozynsky E et al. Arrhythmogenic cardiotoxicity associated with contemporary treatments of lymphoproliferative disorders. Journal of the American Heart Association. 2023;12

Siddiqui MU, Junarta J, Marhefka GD. Coronary revascularization versus optimal medical therapy in renal transplant candidates with coronary artery disease: A systematic review and metaanalysis. Journal of the American Heart Association. 2022;11

Siddiqui MU, Junarta J, Sathyanarayanan S, Kochar K, Ullah W, Fischman DL. Risk of coronary artery disease in patients with gout on treatment with colchicine: A systematic review

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Taramasso M, Tagliari AP, Fischman DL. Tav-in-tav and beyond: How far can we go? JACC: Case Reports. 2023;22

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Ullah W, Sana MK, Hajduczok AG, Brailovsky Y, Haas DC, Rajapreyar IN. Trend of left ventricular assist device related complications: Insight from the national inpatient sample database. American Heart Journal Plus: Cardiology Research and Practice 2023;26

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Weitz HH, Merli GJ. Annals consult guys - frailty: Its role as a risk factor in surgery. Annals of internal medicine. 2022;175:CG1

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Weitz HH, Merli GJ. Annals consult guys - endocarditis prophylaxis for patients with tavr. Annals of Internal Medicine. 2022;175:CG1

Weitz HH, Merli GJ. Annals consult guys - standardizing venous thromboembolism prophylaxis in the setting of orthopedic surgery free. Annals of Internal Medicine 2022;175

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DIVISION OF ENDOCRINOLOGY, DIABETES AND METABOLIC DISEASES

The Division of Endocrinology, Diabetes, and Metabolic Diseases has continued its high profile clinical, educational, and clinical research activities, with a primary focus on diabetes, obesity, and related disorders. Our clinical practice has accommodated the widespread activities of the Jefferson Health System, and we operate busy practice locations at Walnut Towers (9th street) in Center City, Methodist Hospital (Bove) in South Philadelphia, and Jefferson locations in Turnersville (NJ), Navy Yard, Art Museum, Bala Cynwyd, JIMA and Women’s Center.

We have numerous programs within the Division. A comprehensive weight management program that focuses on serving patients with medical complications of obesity and rapid weight loss for patients anticipating organ transplantation or major surgery. The Jefferson Diabetes Center where patients are seen by expert diabetologists and certified diabetes educators, offering the most advanced technology, including insulin pumps and continuous glucose sensors. We also have a Jefferson Thyroid and Parathyroid Center in collaboration with other departments, including ENT, surgery, radiology, and pathology. Our Jefferson Neuroscience Center, in collaboration with neurosurgery, offers the most advanced treatments for patients with a variety of pituitary disorders.

PATIENT CARE

The Division provides comprehensive services for inpatient and ambulatory care at TJUH, Methodist Hospital, Turnersville, Navy Yard, Art Museum, Bala Cynwyd, Women’s Center, and JIMA outpatient locations, covering all aspects of Endocrinology and Diabetes. We offer specialty care centers for diabetes, obesity, thyroid disease, parathyroid disease, pituitary diseases, adrenal disorders, calcium and bone disorders as well as gonadal disorders. We work in concert with other experts in different departments at Jefferson.

In FY23, the Division had 27,450 outpatient visits, which was a 10.8% increase over FY22.  Of these, 4,534 were new patient visits and 7,771 were telehealth visits.

In the outpatient setting, we also offer a variety of classes or individual sessions covering diabetes education as well as nutritional counseling in addition to a low-calorie diet combined with behavioral modification, which is an integral part of our weight management program.

In the inpatient setting, we see all of the endocrine consults. Our team was behind the creation and the cornerstone of all inpatient diabetes protocols and guidelines, including

FACULTY

Serge Jabbour, MD

Professor of Medicine Division Director

Intekhab Ahmed, MD Professor of Medicine

Jeffrey Miller, MD Professor of Medicine

Eric Shiffrin, MD

Assistant Professor of Clinical Medicine

Monika Shirodkar, MD

Associate Professor of Clinical Medicine

Barbara Simon, MD

Associate Professor of Clinical Medicine

Jessica Watari, DO

Assistant Professor of Clinical Medicine

Lubna Zuberi, MD

Assistant Professor of Clinical Medicine

the intravenous insulin infusion protocols, DKA/HHNK guidelines, hypoglycemia protocols, etc.

QUALITY INITIATIVES

Our quality committee representative is Dr. Eric Shiffrin. He works closely with our faculty and fellows on various quality improvement projects.

Quality Improvement (QI) activities within the Division of Endocrinology, Diabetes, and Metabolic Diseases in the past year have focused on various clinical outcome measures associated with diabetes.

EDUCATION

Our Division is involved in teaching at all levels of medical school and graduate school curriculum, residency, and fellowship programs: biochemistry and physiology clinical lectures, medical students lectures/case based learning, pharmacology course and physical diagnosis, medical students clerkships, ambulatory interns rotations, residency electives, and all facets of the clinical fellowship program in Endocrinology.

We also provide education (lectures, grand rounds) to all departments across Jefferson.

Our internal educational activities include: a weekly CMEactivity, Friday Forum, with case discussions/presentations (with other local endocrinologists); monthly thyroid conference in collaboration with ENT, surgery, radiology, and cytopathology; monthly pituitary conference in collaboration with neurosurgery; monthly Philadelphia Endocrine Society meetings (at Jefferson, in collaboration with local/regional endocrinologists); and the fellows weekly curriculum lectures.

RESEARCH

We have experience in both federally funded, pharmaceutical industry-sponsored clinical trials and investigator-initiated research studies. We have 10-20 active studies at any point in time.

In these research studies, our focus is mostly on diabetes and obesity. Occasional studies might focus on pituitary or adrenal disorders. We study new insulin analogs, new diabetes & obesity drugs, as well as new delivery systems for the management of high glucose levels (including insulin pumps and continuous glucose sensors) and novel

medications for the prevention or management of the complications of diabetes, including hypertension, lipid disorders, nephropathy, etc., in patients with type 1 and type 2 diabetes. We also have experience and interest in trials looking at cardiovascular outcomes in type 2 diabetes. Each study enrolls between 5 and 40 patients and lasts between 24 and 104 weeks, some with extensions up to 5 years.

The NIH-sponsored Diabetes Prevention Program Outcomes Study involves testing lifestyle and metformin in patients at high risk for diabetes to see if it can be prevented or its onset delayed. Cardiovascular endpoints are also evaluated in this study as an extension to the initial DPP study (called DPPOS). Jefferson is one of 27 centers in the U.S. to follow patients (our Jefferson cohort includes 150 patients) with impaired glucose tolerance to determine whether lifestyle modification or medications can prevent or delay the onset of type 2 diabetes or its vascular complications.

We are also part of another NIHfunded trial in collaboration with the Emergency Medicine research team: it is a pragmatic randomized controlled trial assessing the impact of medically tailored meals and medical nutrition therapy via telehealth among patients with poorly controlled diabetes.

SELECT PUBLICATIONS

Carlson AL, Daniel T, DeSantis A, Jabbour SA, Karslioglu-French E, Kruger D, Miller E, Ozer K, Elliot T. Efficacy of Flash Glucose Monitoring in Type 2 Diabetes Managed with Basal Insulin in the United States; a Retrospective Real-World Chart Review Study and Meta-analysis. BMJ Open Diabetes Research & Care 2022;10: e002590: 1-10

Khunti K, Jabbour SA, Cos X, Mudaliar S, Mende C, Bonaca M, Fioretto P. SGLT2 Inhibitors in Patients with Type 2 Diabetes: Barriers and Solutions for Improving Uptake in Routine Clinical Practice. Diabetes Obes Metab 2022 March;1–10

Intenzo C, Gulati A, Bober GT, Jabbour SA, Miller JL, Ahmed I, Furlong K, Kim S, Wu C, Capuzzi, D, Bilezikian J. Significant Interval Decrease in Bone Mineral Density in Osteopenic Patients: A Notable Limitation of FRAX Analysis in Dual-Energy X-Ray Absorptiometry. Armenian Journal of Health & Medical Sciences 2022; 2(1), 44–46

Poirrier JE, Meyers J, Nagar S, Patterson BJ, Glasser LI, Jabbour SA. Herpes Zoster in Adults with Type 2 Diabetes Mellitus in the United States: A Retrospective Database Analysis. Diabetes Care 2022;45(11):25852593

Jabbour SA, Ibrahim B, Argyropoulos C. Opinion Roundtable SGLT2i Review: Physician Concerns and Practice Recommendations Regarding the Use of SGLT2is. J Clin Med 2022; 11(6051):1-21

Intenzo C, Miller J, Gulati A, Colarossi D Parekh M.  Role of Nuclear Medicine in Benign Thyroid Disease. Seminars in Nuclear Medicine 2023; 53(4): 469-474

NOTABLE ACHIEVEMENTS

2023 Philadelphia Magazine

Top Doctors

SERGE JABBOUR, MD INTEKHAB AHMED, MD

Pituitary Symposium 04/28/2023

Philadelphia Endocrine Society Board BARBARA SIMON, MD ERIC SHIFFRIN, MD

US News & World Report

2023-2024: High Performing

DIVISION OF GASTROENTEROLOGY AND HEPATOLOGY

The Division of Digestive Health continues to be at the forefront and one of Jefferson’s flagship programs. This year the Division celebrates 27 years of growth and national prominence and starts an exciting new chapter under the leadership of our new Division Chief, David Kastenberg, MD. Prior to being Chief, David was a key player in the Division leading enterprise research, clinical pathways and a variety of integration activities centered on endoscopy including direct access colonoscopy, pre-procedure management and colon preparation. Under Dr. Kastenberg’s leadership Digestive Health will continue their commitment to philanthropy and raising support for the Honickman Center. In the Honickman Center, GI will occupy two floors and continue to embrace their mission to evolve and shape the changes in technology, education, research and clinical health care delivery systems. The Division is looking forward to the Honickman Center an environment which will support increasingly sophisticated, convenient and cost-effective care.

PATIENT CARE

IIn 2023 the Division had three major goals 1) recruitment to backfill vacant positions and for growth 2) to continue to integrate and standardize GI care across the Jefferson system and 3) to maintain and grow its reputation as a leader in therapeutic and diagnostic patient care. The Division ranked 31st in Adult Gastroenterology and GI Surgery Hospital in U.S. News and World Report this year. GI has been in the top 50 programs for over 12 years now. The Division continues to work hard on growing its national reputation.

This year, the liver program performed 82 transplants, performing the second highest number of transplants in the region. The program has done well over a 1,200 liver transplants in total. Transplant outcomes continue to exceed the national benchmark. This coming year, Jefferson Health will begin to

combine its transplant programs into one to optimally and efficiently serve patients.

Our clinical practices located at 132 South 10th Street, 1300 Wolf Street, in Bala Cynwyd and in New Jersey continue to offer patients easy access to our endoscopy suites as well as their treating gastroenterologist. The Jefferson Endoscopy Center in Bala Cynwyd is in its seventh year and continues to grow and performed almost 3,700 cases last year which was the highest volume yet. The Division’s network of private practice groups, extending from the southern tip of New Jersey to the Lehigh Valley, continues strong with referrals for advanced procedures and liver transplants. In addition, our new Jefferson Center of Excellence for Advanced Procedures in New Jersey completed 752 procedures in FY23 and will assist in growing our market share.

We continued to offer over 20 innovative clinical trials that

allow patients access to new and promising therapies.

In FY23, the Division of Gastroenterology and Hepatology continued to be recognized for the quality of its clinical programs and advanced medical services, which includes hepatobiliary endoscopy, third space endoscopy (POEM, G-POEM, and ESD) which completed 200 procedures this year, endobariatrics, capsule endoscopy, and liver transplant. The team is now comprised of 40 Faculty who are busy clinically and performed over 20,700 endoscopic procedures maintaining the unit as one of the busiest on the east coast. The Barrett’s Center performed over 1,200 RFA procedures to date making it the regional leader in this treatment. The Celiac Center now in its seventh year has diagnosed and treated over 2,700 patients. The GI Bleed Center developed a multidisciplinary “care pathway” that begins at admission and recently completed its first year in

FACULTY

David Kastenberg, MD

Division Chief J. Edward Berk Professor in Medicine

Jeffrey Abrams, MD

Clinical Assistant Professor

Christopher Adkins, MD

Assistant Professor

Monjur Ahmed, MD

Professor

Curtis Alloy, DO

Clinical Assistant Professor

Charles Andrew Kistler, MD, PharmD

Clinical Assistant Professor

Louis Broad, MD

Clinical Assistant Professor

Austin Chiang, MD

Assistant Professor

Cuckoo Choudhary, MD

Clinical Professor

Jesse Civan, MD

Associate Professor

Robert Coben, MD

The Anthony J. DiMarino, Jr., MD

Professor

Sidney Cohen, MD

Professor

Mitchell Conn, MD

Clinical Professor

Andrew Dargan, MD

Clinical Assistant Professor

Richard Denicola, MD

Clinical Assistant Professor

Anthony DiMarino, MD

Professor

Michael DiMarino, MD

Clinical Assistant Professor

Jonathan Fenkel, MD

Professor

Hie-Won Hann, MD

Professor

Dina Halegoua-DeMarzio, MD

Associate Professor

Christopher Henry, MD

Assistant Professor

Steven Herrine, MD

Professor

Anthony Infantolino, MD

Professor

Faisal Kamal, MD

Assistant Professor

Leo Katz, MD

Clinical Associate Professor

Epic. The Pancreaticobiliary Center and its physicians are advancing cancer treatment using minimally invasive endoscopic treatments to diagnose and manage cancers of the pancreas and biliary tree. Endobariatric procedures continue to grow and are a part of the Comprehensive Weight Management Center offering endoscopic non-surgical options for this patient population. Our mix of senior, mid-career and junior faculty continue to grow their practices and several of the faculty have advanced to the rank of Professor over the past year.

The Division’s faculty are committed to excellence in education, research and clinical care, providing the highest quality of care, compassionately. Their incredible work ethic is evidenced by 15 of our physicians being honored by “Castle Connolly” and named to “Top Doc in Philadelphia”. Six physicians were named “Top Doc in South Jersey” for the last several years. The Division looks forward to the New Year continuing with our mission to put patients and families first.

New practice models in New Jersey resulted in increased growth in our procedural areas, advanced endoscopies, direct access colonoscopies (went from 258 to 810) and our ASC’s (increased 19%), all of which increased our market share. Our GI enterprise Council is actively working on many levels to integrate and grow Jefferson Gastroenterology and Hepatology and make excellent care happen.

EDUCATION

The Division’s commitment to education continued its journey in excellence hosting three annual conferences:

The 41st “Advances in Gastroenterology Update Course” which updates over

150 Primary Care Physicians, Gastroenterologists and Nurse Practitioners on the newest diagnostic and therapeutic advances in GI disorders.

The 9th Annual Liver Disease Symposium which was a combined effort by Center City and Einstein Hepatology.

The 5th Women’s GI Conference, which was phenomenally successful and filled to capacity.

In the 2023 academic year, 36 medical students, 51 internal medicine residents and 18 outside fellows rotated through our Division. The Division’s Fellowship Program continued strong. Again, we received about 600 applications for 4 Fellowship positions, this along with the Advanced Endoscopy Fellowship (1 of 68 in the U.S.), the IBD Fellowship (1 of 28 in the U.S.) and the Advanced Hepatology Fellowship (1 of 59 in the U.S.) continues to foster our national reputation as leaders in GI/Hepatology and advanced training.

RESEARCH

We continue at the forefront of high quality cutting-edge clinical research with Co-PI’s on 2 NIH grants and over 20 Industry-sponsored clinical trials, and innumerable investigator initiated studies resulting in 92 peer reviewed publications 85 abstracts, 4 book chapters and over 70 invited lectures and presentations.

QUALITY INITIATIVES

The Division of Gastroenterology has an active Quality Improvement Program. Over the past year, our efforts have continued to focus on patient satisfaction, first case on-time starts (FCOTS), length of stay, readmissions,

colonoscopy metrics (cercal intubation rate, average withdrawal time, adenoma detection rates (ADR)), reduction of procedure cancellation rates and prep adequacy.

Several Fellow QI projects were undertaken, to improve teaching, documentation and overall patient care.

SELECT PUBLICATIONS

Abdelmalek MF, Sanyal AJ, Nakajima A, Neuschwander-Tetri BA, Goodman ZD, Lawitz EJ, Harrison SA, Jacobson IM, Imajo K, Gunn N, Halegoua-DeMarzio D, Akahane T, Boone B, Yamaguchi M, Chatterjee A, Tirucherai GS, Shevell DE, Du S, Charles ED, Loomba R. Pegbelfermin in Patients With Nonalcoholic Steatohepatitis and Compensated Cirrhosis (FALCON 2): A Randomized Phase 2b Study. Clin Gastroenterol Hepatol. 2023 Apr 23:S1542-3565(23)00311-7. doi: 10.1016/j.cgh.2023.04.012. Epub ahead of print. PMID: 37088458.

Ahmed M. Intestinal Parasitic Infections in 2023. Gastroenterology Res. 2023 Jun;16(3):127-140. doi: 10.14740/ gr1622. Epub 2023 Jun 11. PMID: 37351081; PMCID: PMC10284646.

Ahn K, Penn RB, Rattan S Panettieri RA Jr, Voight BF, An SS. Mendelian Randomization Analysis Reveals a Complex Genetic Interplay among Atopic Dermatitis, Asthma, and Gastroesophageal Reflux Disease. Am J Respir Crit Care Med. 2023 Jan 15;207(2):130137. doi: 10.1164/rccm.2022050951OC. PMID: 36214830; PMCID: PMC9893317.

Chhoun, C, Blair, B, Joo, L , Hashir, M, Dasu, N, Khalid, Y, Chiesa, D, Walters, R. Suga, H. Outcomes of Patients With Inflammatory Bowel Disease and

FACULTY

Cecilia Kelly, MD

Clinical Assistant Professor

Thomas Kowalski, MD

Professor

Patricia Kozuch, MD

Associate Professor

Howard Kroop, MD

Clinical Assistant Professor

Anand Kumar, MD

Clinical Associate Professor

David Loren, MD

Associate Professor

Aarati Malliah, MD

Clinical Assistant Professor

Aaron Martin, MD

Clinical Assistant Professor

Stephanie Moleski, MD

Associate Professor

Nicholas Orfanidis, MD

Clinical Assistant Professor

Jorge Prieto, MD

Clinical Assistant Professor

Satish Rattan, DVM

Professor

Leonard Salese, MD

Clinical Instructor

David Sass, MD

Professor

Debbie Schiller, MD

Instructor

Alexander Schlacterman, MD

Associate Professor

Raina Shivashankar, MD

Associate Professor

Kristen Singer, MD

Clinical Assistant Professor

Colin Smith, MD

Assistant Professor

Danielle Tholey, MD

Assistant Professor

Christina Tofani, MD

Associate Professor

Alcohol Use From The National Inpatient Sample. The American Journal of Gastroenterology 117():p S6, December 2022. DOI: 10. 14309/01.ajg. 0000897596.13855.26.

Chhoun, C, Blair, B, Joo, L , Hashir, M, Dasu, N, Khalid, Y, Suga, H, Chiesa, D, Walters, R. Hospital Outcomes in Depression and IBD. The American Journal of Gastroenterology 117(): p S6. December 2022. DOI: 10.14309/01. ajg.0000897592.39171.bc

Chhoun, C, Blair, B, Joo, L , Hashir, M, Dasu, N, Khalid, Y, Suga, H, Chiesa, D, Walters, R Impact of Anxiety on Patients With IBD: Insights From The National Inpatient Database (NIS)- 2015-2019. The American Journal of Gastroenterology 117 (): p S6, December 2022. DOI: 10.14309/01. ajg. 0000897588.54411.b0

Chowdhury S, Garrido D, Halegoua-DeMarzio D, Roth C, Hann HW. Poor Prognosis in HBV-associated Hepatocellular Carcinoma After Successful Viral Suppression: A Case Series Highlighting a Need for a Cure. J Immunological Sci. (2023); 7(1): 1-8

Dane B, Gupta A, Wells ML, Anderson MA, Fidler JL, Naringrekar HV, Allen BC, Brook OR, Bruining DH, Gee MS, Grand DJ, Kastenberg D, Khandelwal A, Sengupta N, Soto JA, Guglielmo FF. Dual-Energy CT Evaluation of Gastrointestinal Bleeding. Radiographics. 2023 Jun;43(6):e220192. doi: 10.1148/ rg.220192. PMID: 37167088.

Danielle M. Tholey, Sarah Lopatin, Nitzan Roth, Gene Y Im, What's in a name? Higher risks with donation after cardiac death than public health service increased risk livers, Journal of Liver Transplantation, Volume 9, 2023, 100133, ISSN 2666-

9676, https://doi.org/10.1016/j. liver.2022.100133.

Faggen AE, Kamal F, Lee-Smith W, Khan MA, Sharma S, Acharya A, Ahmed Z, Farooq U, Bayudan A, McLean R, Avila P, Dai SC, Munroe CA, Kouanda A. Overthe-Scope Clips Versus Standard Endoscopic Treatment for First Line Therapy of Nonvariceal Upper Gastrointestinal Bleeding: Systematic Review and Meta-Analysis. Dig Dis Sci. 2023 Jun;68(6):2518-2530. doi: 10.1007/s10620-023-07888-

3. Epub 2023 Mar 21. PMID: 36943590.

Hamidu, Rukaiya & Hann, Richard & Hann , Hie-Won (2023). Chronicles of HBV and the Road to HBV Cure. Livers. 3. 232-239. 10.3390/livers3020015.

Lin SY, D Halegoua-DeMarzio Block P, Kao YL, Civan J, Shieh FS, Song W, Hann HW, Su YH. Persistently Elevated HBV ViralHost Junction DNA in Urine as a Biomarker for Hepatocellular Carcinoma Minimum Residual Disease and Recurrence: A Pilot Study. Diagnostics (Basel). 2023 Apr 25;13(9):1537. doi: 10.3390/diagnostics13091537. PMID: 37174929; PMCID: PMC10177231.

Lin SY, Su YP, Trauger ER, Song BP, Thompson EGC, Hoffman MC, Chang TT, Lin YJ, Kao YL, Cui Y, Hann HW, Park G, Shieh FS, Song W, Su YH. Detection of Hepatitis B Virus-Host Junction Sequences in Urine of Infected Patients. Hepatol Commun 2021 Oct;5(10):1649-1659. doi: 10.1002/hep4.1783. Epub 2021 Aug 25. PMID: 34558837; PMCID: PMC8485884.

Kamal F, Khan MA, Lee-Smith W, Sharma S, Acharya A, Farooq U, Agarwal A, Aziz M, Chuang Kumar A, Schlachterman A, Loren D, Kowalski T, Adler D. Cold snare versus cold forceps polypectomy for endoscopic resection of diminutive polyps:

meta-analysis of randomized controlled trials. Gastrointest Endosc. 2023 Jul;98(1):7-18.e4. doi: 10.1016/j.gie.2023.03.008. Epub 2023 Mar 11. PMID: 36907527.

Mendoza FA, DiMarino A, Cohen S, Adkins C, Abdelbaki S, Rattan S, Cao C, Denuna-Rivera S, Jimenez SA. Treatment of Severe Swallowing Dysfunction in Systemic Sclerosis with IVIG: Role of Antimuscarinic Antibodies. J Clin Med 2022 Nov 10;11(22):6665. doi: 10.3390/jcm11226665. PMID: 36431141; PMCID: PMC9699580.

Mitsuhashi S, Chalikonda D, Nazir B, Agarwal A, Coben R Recurrent bleeding duodenal and colonic ulcers due to posttransplant lymphoproliferative disorder. Clin J Gastroenterol 2023 Feb;16(1):39-42. doi: 10.1007/s12328-022-017181. Epub 2022 Oct 17. PMID: 36251246.

Mujumdar S, Goldenberg J, Bieser S, Pang AS, Coben R Cholestatic Liver Injury in a Patient with Tertiary Syphilis. Case Rep Gastroenterol. 2022 Sep 19;16(3):552-556. doi: 10.1159/000526247. PMID: 36824700; PMCID: PMC9941764.

Noverati N, Nguyen A, Chalikonda D, HalegouaDeMarzio D, Hann HW The Role of Host in the Spectrum of Outcomes in Family Clusters of Hepatitis Infection: From Asymptomatic to Hepatocellular Carcinoma. Case Rep Gastroenterol. 2023 Feb 14;17(1):104-110. doi: 10.1159/000529153. PMID: 36818365; PMCID: PMC9929652.

Poluch, M., Ries, R., & Ahmed, M. (2022). Effect of COVID-19 Pandemic on Medical Students—A Single Center Study. International Medical Education.

NOTABLE ACHIEVEMENTS

41st Annual Advances in Gastroenterology Update Course

9 th Annual Jefferson Liver Disease Symposium

4th Jefferson Women and GI Health Symposium

Jefferson GI ranked 31st in US News and World Report

Philadelphia Magazine Top Doctors in Gastroenterology

DAVID KASTENBERG, MD

ROBERT COBEN, MD

THOMAS KOWALSKI, MD

STEVEN HERRINE, MD

RAINA SHIVASHANKAR, MD

PATRICIA KOZUCH, MD

MITCHELL CONN, MD

JONATHAN FENKEL, MD

JESSE CIVAN, MD

DINA HALEGOUA-DEMARZIO, MD

DAVID SASS, MD

CUCKOO CHOUDHARY, MD

ANAND KUMAR, MD

ALEXANDER SCHLACHTERMAN, MD

C. JONATHAN FOSTER, DO

DEBBIE E. SCHILLER, MD

Salil Chowdhury, Daniel Garrido, Dina Halegoua-DeMarzio

Christopher Roth, Hie-Won Hann.

Suga, H, Dasu, N, Khalid, Y, Dasu, K, Li, H, Chiesa, D. A

Presentation of a Follicular Lymphoma Incidentally Found In The Duodenum. Accepted in Gastroenterology and Hepatology Research

Suga, H, Truscello, D, Dasu, N, Dasu, K, Chiesa, D, Walters R. Gastric Outlet Obstruction Due to a Large Paraesophageal Hernia: An Uncommon Etiology With Fatal Consequences.

American Journal of Gastroenterology. 2022, Oct; 116 (Supplement, 2022 ACG): B0710. Pub status: Published.

Suga, H, Truscello, D, Pope, M, Chiesa, D. Necrotic Ulcer From Diffuse Large B-Cell Lymphoma. American Journal of Gastroenterology. 2022, Oct; 116 (Supplement, 2022 ACG): B0710. Pub Status: Published.

Sulkowski MS, Agarwal K, Ma X, Nguyen TT, Schiff ER, Hann HL, Dieterich DT, Nahass RG, Park JS, Chan S, Han SB, Gane EJ, Bennett M, Alves K, Evanchik M, Yan R, Huang Q, Lopatin U, Colonno R, Ma J, Knox SJ, Stamm LM, Bonacini M, Jacobson IM, Ayoub WS, Weilert F, Ravendhran N, Ramji A, Kwo PY, Elkhashab M, Hassanein T, Bae HS, Lalezari JP, Fung SK, Yuen MF. Safety and efficacy of vebicorvir administered with entecavir in treatment-naïve patients with chronic hepatitis B virus infection. J Hepatol 2022 Nov;77(5):1265-1275. doi: 10.1016/j.jhep.2022.05.027. Epub 2022 Jun 11. PMID: 35697332.

Torkzaban M, Wessner CE, Halegoua-DeMarzio D, Rodgers SK, Lyshchik A, Nam K. Diagnostic Performance Comparison Between Ultrasound Attenuation

Measurements From Right and Left Hepatic Lobes for Steatosis Detection in Non-alcoholic Fatty Liver Disease. Acad Radiol. 2023 Sep;30(9):1838-1845. doi: 10.1016/j.acra.2022.12.025. Epub 2022 Dec 29. PMID: 36586759; PMCID: PMC10307925.

Yost CC, Jimenez DC, Weber MP, Maynes EJ, Belden KA, Tchantchaleishvili V, Massey HT, Sass DA , Rame JE, Zurlo JJ, Aburjania N. Hepatitis B in Heart Transplant Donors and Recipients: A Systematic Review and Meta-Analysis. J Surg Res. 2023 Mar;283:1078-1090. doi: 10.1016/j.jss.2022.10.078. Epub 2022 Dec 15. PMID: 36914999.

Yuen MF, Agarwal K, Ma X, Nguyen TT, Schiff ER, Hann HL, Dieterich DT, Nahass RG, Park JS, Chan S, Han SB, Gane EJ, Bennett M, Alves K, Evanchik M, Yan R, Huang Q, Lopatin U, Colonno R, Ma J, Knox SJ, Stamm LM, Bonacini M, Jacobson IM, Ayoub WS, Weilert F, Ravendhran N, Ramji A, Kwo PY, Elkhashab M, Hassanein T, Bae HS, Lalezari JP, Fung SK, Sulkowski MS. Safety and efficacy of vebicorvir in virologically suppressed patients with chronic hepatitis B virus infection. J Hepatol. 2022 Sep;77(3):642-652. doi: 10.1016/j. jhep.2022.04.005. Epub 2022 Apr 20. PMID: 35460726.

DIVISION OF HEMATOLOGY AND C ARDEZA FOUNDATION FOR HEMATOLOGIC RESEARCH

The Division of Hematology and Cardeza Foundation for Hematologic Research provides inpatient and outpatient clinical Hematology services, trains students, residents, and fellows in clinical and research aspects of Hematology, runs an NIH-funded research enterprise, and provides administrative support to the Department of Medicine, Sidney Kimmel Medical College, and Thomas Jefferson University Hospital.

PATIENT CARE

High quality patient care was provided in the Hematology inpatient consult service of TJUH and JHN, and in the JUP Hematology practice. The Division saw 3,339 outpatients in FY23, which included 583 telehealth visits. Of those visits, 1,616 were new patient visits, which was a 1.04% increase in new patient visits, over the prior year. Additionally, we continued to have Centers of Excellence in the Cardeza Foundation Hemophilia and Thrombosis Center, which is federally and state-designated, and the Hereditary Anemias Center, with its state-designated Sickle Cell Program (in conjunction with the Division of Internal Medicine).

The Special Hemostasis laboratory was supervised by Drs. McKenzie and Rhoads in conjunction with the Department of Pathology. The Division also continued to provide inpatient consultative services to TJUH

QUALITY INITIATIVES

Quality improvement projects in the Division of Hematology have

primarily focused on our role as stewards for hematology-specific laboratory tests and transfusions of blood products. These projects have included ones aimed at decreasing the ordering of low-value inherited thrombophilia tests, as well as establishment of a preoperative anemia clinic in which surgical patients with anemia are seen by Hematology and treated preoperatively to improve anemia before surgery, with the goal of avoiding severe anemia, transfusions, and longer length of stay after surgery. Other recent projects have focused on improving care in our longitudinal patients, including studying the impact of menopause in women with sickle cell disease and nonattended appointments in our bleeding disorders patients.

EDUCATION

The Hematology-Oncology fellowship has 19 fellows in our 3-year training program. Dr. Joanne Filicko O’Hara has been the Program Director with Dr. Lindsay Wilde assuming the role in 2024, and Dr. Sanaa Rizk is Associate Program Director. Dr. Rhoades directs the Hematology

FACULTY

Steven E. McKenzie, MD, PhD

Leandro M. Tocantins, MD - Farid I. Haurani, MD Director, Cardeza Foundation for Hematologic Research

Thomas Drake Martinez Cardeza Research Professor in Medicine

Division Director

Co-Director, Hemophilia and Thrombosis Treatment Center

Douglass Drelich, MD

Assistant Professor

Lawrence Goldfinger, PhD

portion of Medicine Resident teaching, and our faculty make strong contributions to lecturing at fellow noon conferences. Dr. Rhoades supervises the Hematology portion of the JeffMD block for first year medical students and the inpatient elective for fourth year medical students. Divisional faculty also played major roles in MS, PhD, and MD/ PhD student education. Most faculty hold either secondary appointments in basic science departments or membership in graduate groups

RESEARCH

The Cardeza Foundation for Hematologic Research was established in 1939 by Thomas Drake Martinez Cardeza and his wife Mary in honor of Mr. Cardeza’s mother, Charlotte. The purpose is to support Hematology research. Cardeza faculty conduct translational, basic, clinical, and outcomes/ quality research. Translational and basic research in our state-of-the-art laboratories is based in the Cardeza Center for Hemostasis, Thrombosis, and Vascular Biology. Major

Professor Director, Integrative Physiology Graduate Program

Holleh Husseinzadeh, MD

Assistant Professor

John Kostyak, PhD

Research Assistant Professor

Peisong Ma, PhD

Assistant Professor

James Michael, PhD

Research Assistant Professor

Ulhas Naik, PhD

Professor

Director, Cardeza Center for Hemostasis, Thrombosis and Vascular Biology

Ruben Rhoades, MD

Assistant Professor

Co-Director, Hemophilia and Thrombosis Treatment Center

Sanaa Rizk, MD

Assistant Professor

Director, Hereditary Anemias Center

Associate Program Director, Hematology/Oncology Fellowship Program

Amit Srivastava, PhD

Assistant Professor

Timothy Stalker, PhD

Assistant Professor

efforts involve the basic biology, genetics, pharmacogenetics, and pathophysiology of blood platelets and bleeding and clotting disorders. Our faculty are recognized internationally for their work, and they are supported by multiple NIH research grants. Cardeza research involves collaborations with Sidney Kimmel Cancer Center, the Center for Computational Medicine, the Department of Biochemistry and Molecular Biology, the Divisions of Cardiology and Pulmonary Medicine, and the Center for Translational Medicine (CTM). Cardeza lab research faculty belong to several MS and PhD programs and are founding leaders with CTM faculty of the PhD Program in Integrative Physiology, with its focus on heart, lung, blood and vascular biology.

Hematology clinical foci include the Cardeza Hemostasis and Thrombosis Center, a federal and state-recognized center of excellence, and the Hereditary Anemias Center, which includes the Sickle Cell Disease Program, a joint effort with Internal Medicine and Hospital Medicine. Both industry-sponsored and investigator-initiated clinical trials are being conducted, along with outcomes and quality studies. These have led to impactful peer-reviewed publications. Hematology clinical faculty engage Hematology/Oncology fellows and medical students in these research projects.

SELECT PUBLICATIONS

Jalagadugula, G.*, Mao, G.*, Goldfinger, L.*, Wurtzel, J., Del Carpio-Cano, F., Lambert, M.P., Estevez, B., French, D.L., Poncz, M., Rao., A.K.: Defective RAB31mediated megakaryocytic early endosomal trafficking of vWF, EGFR and M6PR in RUNX1 deficiency.

Blood Advances, 6(17):5100-5112, 2022. *, equal contributors

Dangelmaier C, Mauri B, Patel A, Kunapuli SP, Kostyak JC. D121 Located within the DRY Motif of P2Y12 Is Essential for P2Y12Mediated Platelet Function. Int J Mol Sci. 2022 Sep 29; 23(19):11519. doi: 10.3390/ijms231911519.

Gupta S, Cooper M, Zhao X, Yarman Y, Thomson H, DeHelian D, Brass, LF, Ma P. A regulatory node involving Gq, PLC, and RGS proteins modulates platelet reactivity to critical agonists. J Thromb Haemost. 2023. PMID: 37657560.

Renna SA, Zhao X, Kunapuli, SP, Ma P, Holinstat M, Boxer MB, Maloney DJ, Michael JV McKenzie SE. A novel Strategy to combat the procoagulant phenotype in heparin-induced thrombocytopenia using 12-LOX inhibition. Arterioscler Thromb Vasc Biol. 2023. PMID: 37345522.

Boelig, RC, Cahanap, TJ, Ma, L, Zhan, T, Berghella, V, Chan, JSY, Kraft, WK, McKenzie, SE. Platelet protease activated receptor 4 (PAR 4) receptor genotype is associated with an increased risk of preterm birth. J Thromb Haemostas 2022 https://doi. org/10.1111/jth.15814

Huynh A, Arnold DM, Michael JV, Clare R, Smith JW, Daka M, Ianosi-Irimie M, McKenzie SE, Kelton JG, Nazy I. Characteristics of VITT antibodies in patients vaccinated with Ad26. COV2.S. Blood Adv. 2023; 7:246-250. doi: 10.1182/ bloodadvances.2022007336. PMID: 35377937

Rhoades R, French Z, Yang A, Walsh K, Drelich DA, McKenzie SE Perioperative Outcomes of Patients with Bleeding Disorders Undergoing Major Surgery at an Academic Hemophilia Treatment Center. Clin Appl Thromb Hemost. 2023 Jan-

Dec;29:10760296231165056. doi: 10.1177/10760296231165056. PMID: 36972481.

Zhao X, Cooper M, Michael JV, Yarman Y, Baltz A, Chuprun K, Koch WJ, McKenzie SE, Tomaiuolo, M, Stalker TJ Zhu L, Ma P. GRK2 regulates ADP signaling in platelets via P2Y1 and P2Y12. Blood Adv. 2022. Aug 9;6(15):4524-4536. PMID:35793439

McKenzie, S.E. A vision for a quicker definitive diagnosis of HIT. Blood 2022; 140:2657-2658. doi: 10.1182/blood.2022018158.PMID: 36548019

Renna SA, McKenzie SE, Michael JV. Species Differences in Platelet Protease-Activated Receptors. Int J Mol Sci. 2023; 24:8298. doi: 10.3390/ ijms24098298. PMID: 37176005

Giri, H., Srivastava, A.K., and Naik, UP. Apoptosis signalregulating kinase-1 regulates thrombin-induced endothelial permeability. Vascul. Pharmacol. 2022. Jul 4; 145:107088 PMID: 35798237

Lauko, A., Volovetz1, J., Turaga, S.M., Bayik, D., Silver,D.J., Mitchell, K., Mulkearns-Hubert, E.E., Watson, D.C., Desai, K., Midha, M., Hao, J., McCortney, K., Steffens, A., Naik, U.P., Ahluwalia, M.S., Bao, S., Horbinski, C., Yu, J., Lathia, J.D., Serpin B3 Drives Cancer Stem Cell Survival in Glioblastoma. 2022. Cell Rep.13;40(11):111348. PMID:36103817.

Tucker CM, Rhoades R, Sharma R, Gong JZ. Optimization of laboratory diagnosis of heparininduced thrombocytopenia using HemosIL-AcuStar-HIT-IgG assay. Laboratory Medicine. 2023; lmad029. Online ahead of print. PMID: 37094798.

Bedi SS, Scott MC, Skibber MA, Kumar A, Caplan HW, Xue H, Sequeira D, Speer A, Cardenas F, Gudenkauf F, Uray K, Srivastava AK, Prossin

AR, Cox CS. PET imaging of microglia using PBR28suv determines therapeutic efficacy of autologous bone marrow mononuclear cells therapy in traumatic brain injury. Scientific Reports, 13:16142, 2023.

Marar TT, Matzko CN, Wu J, Esmon C, Sinno T, Brass LF, Stalker TJ*, Tomaiuolo M*. (2022) Thrombin spatial distribution determines Protein C activation during hemostasis and thrombosis. Blood. 139(12):18921902. *Co-senior authors. PMCID: PMC8952187

Zhao L, Thorsheim C, Suzuki A, Stalker TJ, Min S, Krishnaswamy S, Cockcroft S, Anderson K, Weiderhand B and Abrams CS. (2023) Individual phosphatidylinositol transfer proteins have distinct functions that do not involve lipid transfer activity. Blood Adv. 7(16):42334246. PMCID PMC10424146.

GRANTS

LAWRENCE GOLDFINGER, PHD

R01HL159006-01 2021-2025

“Function and regulation of constitutive protein translation in platelets” As Principal Investigator (42% effort). NIH/NHLBI

TOTAL AWARD, DIRECT COSTS: $1,000,000

20TPA35490278 2021-2023

MicroRNA regulation of functional degradation in stored platelets” As Principal Investigator (20% effort)

American Heart Association, Transformational Project Award

TOTAL AWARD, DIRECT COSTS: $300,000

R41HL167303-01 STTR Phase I Grant 2023-2024

‘Phosphatidylserine-blocking nanoparticles as improved antithrombotic with reduced bleeding risk”

As Principal Investigator (for sub-award, 15% effort)

NIH/NHLBI

Applicant: Molecular Targeting Therapeutics, Inc.

TOTAL AWARD TO TJU: $120,000

R01HL109568 2018-2023

Human Platelet Defects in Transcription Factor RUNX1 Haplodeficiency” As Co-Investigator (1.5%; PI: Rao, A.K.)

NIH/NHLBI

TOTAL AWARD THIS YEAR:

$5,000

STEVEN MCKENZIE, MD, PHD 01/15/2019-12/31/2022, NOW AN STTR 07/231R01HL144970-01 (LIU)

NIH through the University of North Carolina at Chapel Hill Synthesis and Pharmacological Evaluation of Homogenous Ultra-Low Molecular Weight Heparins The goal of this project is to synthesize and characterize synthetic heparins that do not cause heparin-induced thrombocytopenia while having favorable pharmacologic properties.

Role: PI, Jefferson

1R21HD101127 and 3R21HD101127-01S1 (Boelig)

04/01/20 – 03/31/23

NIH

“Aspirin for preeclampsia prevention: pharmacodynamics and pharmacogenomics of platelet response and pregnancy outcomes “

The goal is to measure platelet miRNAs and a PAR4 SNV that correlate with response to aspirin in hypertensive disorders of pregnancy.

Role- co-PI

10/20/19-12/31/23

Veralox Therapeutics

ALOX12 inhibition in HIT

The goal of this project is to test ALOX12 as a molecular target in HIT.

ULHAS NAIK, PHD

NIH/NHLBI, 2R01 HL113118-08

12/01/2013-2/28/2024

Ask1 a novel regulator of platelet function”.

DIRECT COST: $1,564,172

NIH/NHLBI, 2R01 HL119374-08

7/1/2013-6/30/2024

“Endogenous suppression of integrin signaling”.

DIRECT COST: $1,861,311

NIH/NHLBI, 1R01 HL142959-03

7/1/2019-6/30/2024

“Regulation of platelet reactivity by S1P Signaling”.

DIRECT COST: $1,717,149

RUBEN RHOADES, MD July 2022 - present Comprehensive Hemophilia Program Grant

Commonwealth of Pennsylvania, Department of Health

PI ($75,162 ANNUALLY)

September 2022-present Public Health Surveillance for the Prevention of Complications of Bleeding Disorders

Centers for Disease Control and Prevention

PI ($12,790 ANNUALLY)

October 2022-present Hemophilia Treatment Centers (Special Projects of Regional and National Significance)

Health Resources and Services

Administration (HRSA)/Maternal and Child Health Bureau (MCHB)

PI ($12,790 ANNUALLY)

AMIT SRIVASTAVA, PHD

HT94252310138

03/01/2023-02/28/2025

DoD

Platelet-derived Extracellular Vesicles to Restore Neurovascular Integrity in ALS Principal Investigator

TOTAL COST: $660,922.00

DIVISION OF HOSPITAL MEDICINE

The Division of Hospital Medicine’s mission is “to deliver the highest value clinical care and medical education in a safe learning and working environment that cultivates respect and wellbeing for all patients and team members.”

A strong Hospital Medicine program is critical to the functioning of the Thomas Jefferson University Hospital, where we discharged approximately 21% of all inpatients (5,289) and 13% of all observation patients/short stay patients (1,336) in fiscal year 2023. We embrace a role beyond direct patient care extending to optimizing systems to meet population outcomes. The range of clinical diagnoses we care for and our engagement with interdisciplinary leaders enables us to provide insights aimed at improving safety, quality, value, and equity across the care continuum.

Despite another winter surge and increasing patient care and system complexity, we were able to maintain favorable performance metrics in FY23. To meet our goals, the division invested in co-management services, interprofessional care models, faculty development, and innovation in areas ranging from care for people with substance use disorder to patient flow and hospital throughput. For example, discharge orders before noon increased from 43% in FY22 to 46% in FY23, perhaps reflecting the benefit of our Admissionist role allowing continuity services to focus on patient progression and safe discharges.

The Division's clinical footprint expanded in FY23, most notably adding an admissionist to our team model, and committing one FTE to staff the Jefferson Addiction Multidisciplinary Consult Service (JAMS) starting July 2023. Aligning with Central Region capacity management strategies, we developed a process to support transfers from the University Hospital to Methodist Hospital leveraging the Medical Officer of the Day. As we expand, we continue to gain experience with novel clinical team structures and strive to optimize the impact of our advanced practice providers.

PATIENT CARE & QUALITY

CLINICAL PATHWAYS

Acute Hip Fracture: This pathway focuses on the care of geriatric hip fracture patients with a novel pathway involving Anesthesia, Cardiology, Vascular Medicine, Orthopedic Surgery, Nutrition, Physical Therapy, Hematology, and Endocrinology. Specific quality aims include reducing delirium with nerve blocks within two hours of admission and expedited preoperative evaluation; reduction in transfusion though integration of a blood management

program; and improved referral to osteoporosis management. Pathway performance is reviewed quarterly, and approximately 150 patients are cared for annually.

Renal Transplant: The nephrology transplant program at TJUH remains one of the top in the country, and all inpatient care after transplant is provided by Hospital Medicine. Over the past year we have worked with the Nephrology Division to educate our clinicians through case review, and have expanded our integration with transitions of care programs to reduce

FACULTY

Rebecca Jaffe, MD

Associate Professor

Division Director

Lily Ackermann, MD

Clinical Associate Professor

Lauren Ammerman, MD

Clinical Assistant Professor

Heather Baran, MD

Clinical Instructor

Sabrina Barik, MD

Clinical Instructor

Sonia Bharel, MD

Clinical Assistant Professor

Dianna Cheney-Peters, MD

Clinical Assistant Professor

Jillian Cooper, MD

Clinical Assistant Professor

Gretchen Diemer, MD

Professor

Marie DiMattia, MD

Clinical Assistant Professor

Philip Durney III, MD

Clinical Assistant Professor

Hanna Ellingsen, MD

Clinical Assistant Professor

Jonathan Foster, MD

Clinical Instructor

Alexis Gerber, MD

Clinical Assistant Professor

Maura Huffner, MD

Clinical Assistant Professor

Claire Ketchem, MD

Clinical Instructo

complications and readmission rates.

Interventional Radiology: We manage inpatient care of post procedure patients, targeting discharge in less than 24 hours. Our pathway facilitates admission communication and discharge care coordination. We are further involved in a clinical trial for a novel ileofemoral DVT thrombectomy pathway with Vascular Surgery, Vascular Medicine, and Interventional Radiology.

Chronic Regional Pain Syndrome: We work with physical medicine and rehabilitation, chronic pain,

Adnan Khan, MD

Clinical Instructor

Joanne Kim, MD

Clinical Instructor

Alan Kubey, MD

Clinical Assistant Professor

Timothy Kuchera, MD

Clinical Assistant Professor

Natalie Margules, MD

Clinical Assistant Professor

Naveed Mohsin, MD

Clinical Instructor

Rachelle Nelson, MD

Clinical Assistant Professor

Nimesh Patel, MD

Clinical Instructor

Lakshmi Ravindran, MD

Clinical Assistant Professor

Jeffrey Riggio, MD

Professor

and the acute inpatient anesthesia team on a pathway for ketamine use for acute, severe, uncontrolled pain in chronic regional pain syndrome patients.

QUALITY INITIATIVES:

OSH Transfer ImprovementHM/DOM: We aim to increase the use of templated notes encouraging clinicians to ask and document standard information when discussing outside hospital transfer request calls. Templated notes compared to no-notes are associated with decreases in mortality, and a promising trend in decreased RRTs and codes within 24 hours of arrival. We have expanded this effort across the Department of Medicine.

Electrolytes Repletion: This clinical decision support tool has helped clinicians to more effectively replete potassium and magnesium to within normal limits – 79% vs. 58% (prior practice) and 92% vs. 75%, respectively. The impact includes 906 patients per year avoiding severe electrolyte abnormalities that risk cardiac arrhythmia, 5,877 doses of unnecessary IV potassium, less time connected to an IV pole and/or telemetry, and a total cost savings of >$125K/year. We hope to improve repletion and include Ca/Phos in the next update.

Overnight Vitals as Predictor of Impending DoomAllowing Sleep Vs Monitoring /Delirium: Through analysis of >40,000 patient days, we were able to better characterize particularly low and particularly high-risk patient populations for deterioration overnight. We are working to pilot systems/ processes that will allow those low-risk patients to sleep throughout the night – to reduce delirium and promote healing

– while ensuring increased care/monitoring for those at particularly high risk.

Interprofessional Bedside Rounding: Through two pilot studies, this process has significantly improved nurse and medical team satisfaction while reducing unwanted/unnecessary disruptive communications/ orders in the afternoon.

Quality and Safety

Subcommittee of the Hospital Medicine Council: A multidisciplinary team characterized >2,500 patient days of data to better understand non-POA floor sepsis. Specifically, we now have detailed data on prevalence, medical team recognition sensitivity, treatment adherence, time from order to administration of sepsis treatments/diagnostics, documentation rates, as well as coding rates. We are sharing this data with leadership to inform interventional steps to improve sepsis care on the floors.

Outpatient Medication Cost Reduction: We will be studying through an RCT of whether a tool to reduce outpatient medication cost for those without insurance helps patients at a non-English speaking free clinic and a refugee clinic.

Evidence-Based Bowel Regimens: Removed an ineffective medication –docusate – from 512 enterprise admission ordersets which led to projected decrease of >125,000 doses of docusate per year across the enterprise (acquisition cost >$7,000/year). This also reduced pill burden to patients and administration burden/time to nurses. The enterprise admission order set bowel regimens were simplified to include evidence-based regimens.

SOCIAL MEDICINE INITIATIVES AND HEALTH EQUITY

Community Health Worker (CHW) Integration: Hospital Medicine has taken a proactive approach to address HealthRelated Social Needs (HRSN) in the acute care environment by partnering with the SKMC Clinical Experience Program and integrating Community Health Workers (CHWs) into the care team. Community Health Workers (CHW) are trusted experts in connecting patients to government and community programs. The integration of the CHW has had a positive impact in addressing HRSN barriers for Hospital Medicine patients, decreased case load of the HM SW/CM, improved patient trust and understanding in the healthcare system, and decreased moral distress of providers. SKMC students continue to benefit from this program, observing how the CHW interacts with hospitalized patients, addresses their social needs, and collaborates with providers.

The Jefferson Addiction Multidisciplinary Service Leadership Counsel: This cross departmental team is committed to developing an ecosystem for care for people with substance use disorder (SUD), lead by members of Psychiatry, Hospital Medicine, Emergency Medicine, and Family Medicine. Multiple initiatives grew under this leadership structure in FY23, including the JAMS Consult Service, and Steven and Sandra Sheller Bridge Pilot Program. JAMS development continues with business plans for expansion in the Central Region, surgical and wound care pathways, sublocade protocols, and other critical advancements. Hospital Medicine is contributing one physician to the Consult Service, including section

FACULTY

Samira Shahzeidi, MD

Clinical Instructor

Debika Shinohara, MD

Clinical Instructor

Seema Singh, MD

Clinical Assistant Professor

John Stewart, MD

Clinical Assistant Professor

Luis Taboada, MD

Clinical Assistant Professor

Jennifer Valentine, MD

Clinical Assistant Professor

Rebecca Vento, MD

Clinical Assistant Professor

Jenny Wang, MD

Assistant Professor

Alexis Wickersham, MD

Clinical Associate Professor

Lim Wong, MD

Clinical Assistant Professor

Alyssa Yeager, MD

Clinical Assistant Professor

Jillian Zavodnick, MD

Associate Professor

lead effort to collaborate on operational improvements.

Facilitated Dialysis Pathway: Community dialysis access has been scarce in the “postCOVID” era. In partnership with nephrology and emergency medicine, we developed a pathway to provide access to safe, reliable, and efficient renal replacement therapy for patients who would historically remain in the hospital awaiting outpatient dialysis assignment, as well as patients regionally denied due to social or medical complexity. Early evaluation suggests we have met the stated goals of decreased length of stay (LOS) of the index admission, decreased length of each routine HD encounter, avoiding hospital admission when no acute condition was identified, and increased patient access to quality renal care. In the first 6 months, 50% of patients received a community HD assignment. Given that these patients could have remained in the hospital awaiting community placement, this program stands to have saved up to 328 excess hospital days. In the first 3 months, there was a positive contribution margin of $86,634. The pathway served 36 patients in the first year. This project was awarded the 2023 Health Care Improvement Foundation Excellence in Health Care award.

OPERATIONS & THROUGHPUT

APP Developments: In FY23 we recruited and trained 3 APPs to fill vacated spots and ensured they were onboarded using our standardized 6-week onboarding process. This year we prioritized education, focusing on procedural training and clinical topics common to hospital medicine. We continue to train APPs in placement of Dobhoff tubes, and now offer ultrasound guided IV training

with the assistance of previous and current POCUS fellows. This initiative supports the autonomy of our clinical teams with decreased reliance on housestaff for procedures. We also launched a monthly clinical lecture series focusing on issues common to hospital based practice. Two of our APPs attended the Barkley Yearly Review conference in Boston, MA, and another attended the Society of Hospital Medicine conference in Austin, TX. Our employed PAs continued their education by completing the PA Bootcamp offered through the American Association of Physician Associates. In addition, we also help support education for APPS in school by providing on-site training to NPs and PAs placed on our non-resident teams.

Speed Rounds: Plan of care rounding is where physicians, Advanced Practice Providers (APPs), Case Managers, Social Workers, Physical and Occupational Therapists, as well as front-line nurses from multiple units come together to present morning care plans. Plan of care rounds offers substantial benefits to healthcare delivery by using a collaborative approach that enhances patient outcomes, interprofessional communication, and overall hospital efficiency.  We collaborated with hospital leadership in FY23 to design a geographic "one stop shop” for rounds, replacing a unit-based process requiring clinical teams to juggle multiple rounds in locations all over the hospital. In a single spot check, but capturing the benefit of this format, the new process permitted rounding on ~90% of hospital medicine patients in person compared to 38% in the traditional format.

Medical Officer of the Day (MOD) & TJUH/JMH Transfers: The MOD ensures patients are appropriate for medicine and triages any patient admitted or

transferred to the Department of Medicine to one of 22 teams, providing critical capacity management and patient flow services to the Department and to TJUH Inc. In FY23, providers placed 13,674 MOD orders to Hospital Medicine, 9,421 of which came from the ED. In June 2023, after a 9-month process design engagement, the MOD assumed responsibility for selecting patients for transfer to Methodist Hospital Medicine services and facilitating communication between sending and receiving teams. Over the course of the year, TJUH transferred 948 patients to Methodist, which is an increase from the prior year’s 751 Transfers, with transfer numbers increasing by ~20-30/month when the MOD role went live. This novel process supports load balancing across the central region, and efforts to reduce ED crowding.

Billing Improvements:

Throughout FY23, Hospital Medicine collaborated provided several physician-to-physician billing and coding education sessions. These sessions focused on appropriate billing of E&M codes for initial and subsequent hospital visits. Data showed that hospital medicine did not bill as many level 3s as other academic medical centers despite similarly complex patients. In FY22, hospital medicine billed 50% of initial visits as level 3s while industry benchmark is 74%. Similarly, in FY22, hospital medicine billed 9% of subsequent visits as level 3s while industry benchmark is 54%. By the end of the year, Hospital Medicine consistently met billing benchmarks which resulted in over $900K in additional net revenue.

PATIENT SAFETY

Hospital Medicine continues to partner on many interprofessional safety

committees focusing on prevention of hospital acquired conditions and optimizing emergency systems. In FY23, we included engagement in event reporting in the faculty incentive, aligning with priorities defined by the Enterprise OnPoint Program. As a result, 195 safety events were reported from Hospital Medicine with another 77 from Medicine residents.

Peer Review: The process of peer review is a cornerstone of our division’s safety work, providing a case-based review format to promote quality, accountability, and continuous improvement in patient care. As part of this process, all mortalities and patient safety indicator cases are screened monthly by our peer review physician, in addition to high yield ICU step up/mortality cases. From the screened cases or from referred cases, 2-4 cases per month are chosen for group discussion in our divisional Peer Review Committee meetings. As part of our effort to promote a culture of safety and to ensure that all voices are heard, all practitioners are part of our Peer Review Committee. All attendings lead peer review meetings and all attendings are reviewed.

Some examples of our program’s impact include changing institutional processes for outside hospital transfers, changing MRI contrast protocols, changing the order set for severe hyperkalemia in ESRD patients to minimize risk of hypoglycemia, and changing the multi-service management of infected sacral pressure injuries in our institution.

In addition to standard peer review meetings, our division also holds joint documentation peer review meetings with our coding and documentation partners. We also host the Internal Medicine Residency Program’s intern event review

curriculum, assuring that every first-year resident participates in a systematic interprofessional review of a real, recent, near miss safety event.

EDUCATION

Multiple division members have formal educational roles in CSSG, Phase 3/Gateways, the IM clerkship, IM residency, the POCUS Fellowship, and JCIPE.

UME: The Division of Hospital Medicine makes substantial contributions to the education of medical students. During FY23, the division hosted 124 3rd year medical students on its teaching services for the medicine clerkship. They hosted an additional 56 4th year students for their medicine sub-internship. The hospital medicine teaching services are among the most frequent team requests amongst students, particularly for 4th year medical students who anticipate applying to a medicine residency.

The vast majority of near-daily lectures for clerkship students are given by faculty from the Division.

Members of the Division are passionate about providing outstanding clinical education. When students of any year struggle during their clinical time in Medicine, remediation almost always occurs on a hospital medicine service because of the high level of education, faculty dedication to individualized learning plans, and quality of feedback for learners. We are consistently recognized by SKMC for excellence in medical education at the undergraduate level with members on the SKMC honor role.

The Medicine Clerkship, the Medicine Sub-internship, and all electives in the Department of Medicine are overseen and graded by faculty from the Division of Hospital Medicine. In addition, all

career counseling for students bound for medicine residency is done by Hospitalists. All Structured Letters of Evaluation (required for students applying to IM residency) are written by faculty from the division.

GME: Multiple members from our division have engaged in research and curriculum development focusing on trainee transition from Graduate Medical Education to independent practice. This engagement started in FY22 and is now a longitudinal project that has grown into research, curriculum development, and educational talks. In FY23, the “Preattendingship” model was presented nationally at ACGME. Two posters will be presented at Fall APDIM 2023 and two manuscripts are in preparation. We were awarded a $25,000 grant from the AMA ChangeMedEd Innovation Grant Program to further support our work, extending to concepts of “Precision Education.”

6 of the top 25 teachers in Internal Medicine were hospitalists in FY23.

Fellowship: In FY23 we maintained the POCUS fellowship in partnership with Emergency Medicine, Pulmonary Critical Care, and General Internal Medicine. We retained one of the two fellows as faculty with a formal role in his first year as an Associate Program Director for the Fellowship.

Orientation, Onboarding, & Faculty Development: Hospital Medicine regularly recruits new physicians out of residency. These providers are often both new attendings and new employees to Jefferson. This year, Hospital Medicine reinvigorated its orientation and made ongoing improvements to our “Mini-School” for first-

year attendings. For the first time since COVID, in July FY23 we held a 2 day in-person orientation covering everything from a tour of the hospital, to education on our clinical operations, pathways, billing and coding, faculty development, and salary structure.

Hospital Medicine has started a CME granting Grand Rounds series and is now looking forward to focusing faculty mentoring models for attendings 2 to 5 years out of residency.

RESEARCH & SELECT PUBLICATIONS

Faculty members in the division conducted research and published/presented over 30 original works in medical education, quality improvement, and patient safety. Representative national publications and presentations are included in Select Publications.

Bharel, S. Yeager, A ., Hayden, G., Ostroff, P., Horowitz, R., & Jaffe, R. (2023). Integrating Community Health Workers into Hospital Medicine Based Interprofessional Care Teams to Address Social Determinants of Health. Society of Hospital Medicine. Austin, TX: Society of Hospital Medicine.

Diemer, G. (2023). Six Ways Term Limits Helps Leaders with a Scarcity Mindset. Fast Company https://www.fastcompany. com/90853492/6-reasons-whyall-leaders-should-have-term-limits Gerber, A. (2023).

Comprehensive Review of Acute Pancreatitis Pain Syndrome. Gastrointestinal Disorders, 5, 144–166.

Gordon, D., Achuck, K., Kempner, D., Jaffe, R., & Papanagnou, D. (2022). Toward Unity and Inclusion in the Clinical Workplace: An Evaluation

of Healthcare Workforce Belonging During the COVID-19 Pandemic, 14, e29454.

Jaffe, R., Diemer, G., Kuchera, T., Papanagnou, D., & Zavodnick, J. (2023, February). Into the Deep End: Challenges with Transition to Independent Practice. ACGME Annual Educational Conference. Nashville, TN.

Kubey, A., Riggio, J., & Gallagher, K. (2023, March). Documenting Outside Hospital Transfer Communications to Improve Transitions of Care. Society of Hospital Medicine Annual Meeting. Austin, TX.

Kukulich, P. (2023). A Unique Case of Periodic Fever, Aphthous Stomatitis, Pharyngitis, Adenitis (PFAPA). (M. DiMattia, Ed.), SHM.

Reed, M. K., Murali, V., Sarpoulaki, N., Zavodnick, J. H., Hom, J. K., & Rising, K. L. (2022). Hospitalist perspectives on buprenorphine treatment for inpatients with opioid use disorder, 5, 100106.

Liotta, M., Kubey, A., Groome, S., Haines, C., Ackermann, L ., Berenbaum, K., … Yeager, A. (2022, October). Sepsis Squashing Squadron: Can Automated EHR Risk Scores Combined with Clinical Teams Improve Sepsis Identification and Treatment in an Urban, Academic, Tertiary Care Hospital? PA ACP Southeastern Region Poster Contest. Philadelphia

INFEC TIOUS DISEASES AND

ENVIRONMENTAL MEDICINE

The Division of Infectious Diseases is comprised of a core of clinical faculty who provide consultative expertise across the spectrum of infections and syndromes manifested by patients managed within the Thomas Jefferson University system. Members of the Division provide all ID consultative activities at Thomas Jefferson University Hospital, Thomas Jefferson Neurosciences Institute, Wills Eye Hospital, and Methodist Hospital. In addition, comprehensive HIV care services are provided by a Ryan White Care Act supported outpatient program. The Division has established and continues to develop a group of core programs, both clinical and non-clinical, that form a blueprint for future direction.

Infectious Diseases Division Programs

CLINICAL

Clinical Center City All

Methodist

Solid Organ Transplant ID Program

HIV/AIDS

Bone Marrow Transplant ID Program

OPAT

Royer*, Hancock (Almost all faculty)

Belden*, Coppock, Royer, Moss, Flomenberg

Coppock*, Braden, DeSimone, Green, Support staff

Flomenberg*, Moss

Brugger & Taupin*, Carr, Phillips, Livinsky, Zurlo

APP Brugger*, Carr, Green, Hancock, Livinsky

Orthopedic Infections

Lankenau

NTM

Belden*, Gancher, Hess, Kramer, Taupin, Zurlo

Gilbert**

Tucker*, Novick, Livinsky, Zurlo

SUD Kramer*, DeSimone, Novick, Seval, Tucker, Zurlo

OTHER

Fellowship Program

Weber*, Novick

Education Moss*, Weber, Kramer, Weber,, Tucker, Novick

Infection Control

Antimicrobial Stewardship

Research

Flomenberg*, Gancher, Hess

Hess*, Gancher, Braden

Flomenberg*, Coppock, Belden, Global Health Coppock*

ID Interest Group

Drexel Collaboration

Patient Safety/Quality

TJUH ID P&T Subcommittee

Pandemic Preparedness

*Signifies Lead **Lankenau Faculty

Coppock*, Weber, DeSimone, Novick

Zurlo*, Gancher, Seval, Coppock

Taupin*

Hess*, Belden, Flomenberg, Gancher, Royer, Tucker, Zurlo

Zurlo*, Coppock, Hess, Taupin

FACULTY

John Zurlo, MD

Professor of Medicine

The W. Paul and Ida Havens

Professorship of Infectious Diseases

Director, Division of Infectious Diseases

Chair, Jefferson Enterprise COVID Taskforce

Joseph A. DeSimone, MD Professor of Medicine

Phyllis R. Flomenberg, MD

Professor of Medicine

Infection Control Officer, Jefferson University Hospitals

Katherine Belden, MD

Associate Professor of Medicine

Director, Solid Organ Transplant ID Programr

Mudit Tyagi, PhD, PGDBT

Associate Professor of Immunology

Center for Translational Medicine

Bryan D. Hess, MD

Clinical Associate Professor of Medicine

Director, Antimicrobial Stewardship Programr

Dagan Coppock, MD

Associate Professor of Medicine

(newly promoted as of 7/1/23)

Assistant Director, Solid Organ Transplant ID Program

Interim Director, HIV/AIDS Program

Elizabeth Gancher, MD

Clinical Assistant Professor of Medicine

Associate Medical Director, Antimicrobial Stewardship Program

Carolyn Kramer, MD

Clinical Assistant Professor of Medicine

Thread-Director, Medical School Curriculumr

Sean Moss, MD

Clinical Assistant Professor of Medicine

Assistant Director, Solid Organ Transplant ID Program

COVID-19 & PANDEMIC PREPAREDNESS

As the academic year progressed, the challenges with COVID receded. Routine testing of all hospitalizations and masking among healthcare workers both ended. While various challenges remain with COVID moving forward, the focus has since shifted to pandemic preparedness for the Jefferson Enterprise. Dr. Zurlo has assumed the title of Clinical Advisor of Pandemic Preparedness for the Jefferson Enterprise and has been charged to co-direct pandemic preparedness for the health system with Ms. Kelly Zabriskie who serves as the Enterprise VP, Infection Prevention. Nineteen units/divisions that are part of Jefferson Health have been identified as having had significant involvement in the COVID response and will be involved in any future pandemic. A comprehensive institutional plan will be developed that will include quarterly meetings to address the needs of the Enterprise in its response.

CLINICAL

Sixteen clinical faculty members provided consultative support to the medical staff of Jefferson University Hospital, Jefferson Hospital for Neurosciences, Methodist Hospital, and Wills Eye Hospital and/or specialty care of patients with HIV/AIDS. Three of these faculty members worked on a part-time basis (Drs. Seval, Spacek, and Squires). Two of these individuals left the institution (Spacek and Squires). Both worked solely in the HIV/AIDS program. Dr. Seval is a faculty member at the Drexel HIV Partnership where 90% of his job description involves outpatient HIV care.

He is hired by the Jefferson ID division for the remaining 10% of his effort in which he provides inpatient infectious disease consultations for the population of patients with infections related to substance use disorder (SUD). Dr. Dagan Coppock has assumed the leadership role for the HIV/AIDS program at Jefferson, taking over from Dr. Spacek. With the loss of these two part time faculty members, the Division recruited an outstanding new faculty member who began work with the Division in July 2023. Dr. Elizabeth Braden was an Internal Medicine resident here at Jefferson who then completed her fellowship training in infectious diseases at George Washington University Hospital in Washington, DC. Her principal interests lie in HIV care, and she will assume a clinical role in the HIV program at Jefferson as well as providing inpatient consultative patient care. As of July 2023, the ID Division now has 16 total faculty, one of whom (Seval) is part time. We believe that we now have a sufficient physician work force to meet both the clinical and academic goals that we have set for the division.

We have established two new multispecialty clinical services. The first program was initiated for the management of patients with infections due to substance use disorder, more specifically to injection drug use. These patients are now concentrated onto one of our seven inpatient consult services (Silver team) and is managed by a group of faculty members who have a specialized interest and knowledge of this patient population, led by Dr. Carolyn Kramer. This newly formed service now coordinates care with the Jefferson Hospitalist services and with the Jefferson Addiction Multispecialty

Service (JAMS). The second program is a collaboration with Pulmonary and Critical Care Medicine focusing on the mainly outpatient population of patients with non-tuberculous mycobacterial (NTM) pulmonary infections. The team is led by Dr. Mollie Tucker who joined our faculty in July 2022. Patients are seen together in the pulmonary outpatient practice site that will transition to the new Honickman Center sometime after April 2024.

A total of five APPs work in the Division, led by Ms. Caroline Clark Brugger as Lead APP. Ms. Brugger and Ms. Carr, along with a dedicated nurse, Tom Phillips, manage a large number of patients receiving outpatient parenteral antimicrobial therapy (OPAT), averaging around 100 patients at any given time, the majority being those with orthopedic-related infections including prosthetic joint infections and osteomyelitis. These patients are typically seen first as inpatients and transitioned to the outpatient setting with a formalized handoff structure that is seamless. The team follows weekly laboratory results for each patient watching for antibioticassociated toxicities and serves as the principal contact for patients and their families. Ms. Sarah Green is a CRNP who works full time in our HIV/AIDS program. Ms. Molly Hancock is a PA who works exclusively at Methodist Hospital working on our inpatient infectious diseases consult service. Mr. Ross Livinsky is a PA who was hired to assist in our pandemic management program. He worked closely with the group arranging monoclonal antibody infusions during COVID and directed testing and treatment for MPox for the Jefferson Enterprise. He will continue in a standby role for future pandemics as he has

FACULTY

Elizabeth Novick, MD

Clinical Assistant Professor of Medicine

Associate Program Director, Infectious Diseases Fellowship Training Program

Tricia Royer, DO

Clinical Assistant Professor of Medicine

Assistant Director, Solid Organ Transplant ID Program

Vice Division Chief at Methodist Hospital

Nikhil Seval, MD

Assistant Professor of Medicine

Adjunct Faculty from Drexel University

Daniel Taupin, MD

Clinical Assistant Professor of Medicine

Director of Quality/Safety for the Division

Mollie Tucker, MD

Clinical Assistant Professor of Medicine

Devin Weber, MD

Clinical Assistant Professor of Medicine

Program Director, Infectious Diseases Fellowship Training Program

ADVANCED PRACTICE PROVIDERS

Caroline ClarkBrugger, CRNP

Lead APP for the Division

Rachel Carr, PA

TJUH Inpatient Services and OPAT Program

Sarah Green, CRNP

HIV/AIDS Program

Molly Hancock, PA

Methodist Inpatient Service

Ross Livinsky, PA

Pandemic-related Activities and OPAT management

transitioned to work in the HIV/ AIDS, program, the new NTM program, and will work on some of our inpatient services.

The Division has seen a continued increase in requests for inpatient consultations which has, in turn, driven RVU generation. The number of new consults has finally plateaued in 2023. Our new patient consults increased from 4,013 in 2015 (77 per week) to 5,763 in 2023 (110 per week) along with a corresponding rise in RVU generation.

HIV/AIDS PROGRAM

The Division also provides outpatient treatment for a variety of infectious diseases, including HIV/AIDS. The HIV/AIDS program receives grants awarded through the City of Philadelphia Department of Public Health and the Department of Health and Human Services (Ryan White Care Act) to provide HIV medical care, case management, outreach for the entire HIV patient population, and gynecologic care for female patients. Comprehensive HIV care is offered to all patients presenting to the Jefferson program regardless of their insurance status. Drs. Lisa Spacek and Kathleen Squires who were providers for this patient population have left Jefferson. Dr. Dagan Coppock has now taken over the directorship and Dr. Elizabeth Braden will take a new role in the program.

We have finalized a new relationship with the Drexel HIV Partnership clinic located several blocks from Jefferson. As part of this relationship, we will share faculty, create links for the Partnership HIV patients to our inpatient and outpatient specialty services, offer our ID trainees an excellent teaching site for their continuity clinics, and develop collaborative research opportunities. One new faculty member, Dr. Nikhil Seval

mentioned above, was hired by the Partnership to provide management of HIV patients. He will serve as a mentor for two ID fellows who began their continuity clinics at the Drexel Partnership in July 2023.

We expect that our outpatient site will be migrating to the Honickman Center beginning around April 2024. We currently see ID outpatients in two locations, 1015 Chestnut St. (non-HIV patients) and 33 S. 9th St. (HIV patients). Our two practices will be combined into one clinic site on the 11th floor of the Honickman Center. It has been a long-term goal to bring all our ID outpatients to one outpatient location.

Our Solid Organ Transplant ID Program has now increased to five faculty members led by Dr. Katherine Belden. All five have had specialized training and experience in transplant ID and have worked closely with the various transplant teams at Jefferson to provide expert consultation both in the pre- and post-transplant settings. The team has been preparing for the initiation of lung transplants at Jefferson and has created a set of guidelines for infection management for this complex group of patients.

ADMINISTRATIVE

Infectious Diseases Division faculty members staff hospital positions at Jefferson University Hospital and Methodist Hospital as Infection Control Officers (Drs. Phyllis Flomenberg and Elizabeth Gancher) and for Antibiotic Stewardship. Dr. Bryan Hess directs the Enterprise Antimicrobial Stewardship Council focused on aligning policies and procedures among all Jefferson Enterprise Hospitals and directs Antimicrobial Stewardship at the Center City hospitals along with Drs. Elizabeth Gancher and Mollie

Tucker in conjunction with the TJUH Pharmacy Department.

EDUCATION

The wide array of clinical problems seen by infectious disease specialists at Thomas Jefferson and Methodist Hospitals provides an outstanding environment for training medical students, house staff, and clinical fellows. Students, residents, and clinical fellows are provided education in infectious diseases care primarily on a dedicated teaching service. The infectious diseases elective remains one of the most popular among 4th-year medical students. A major project was completed to create a more formalized structure to the 4th year elective to include an orientation welcome pack, a series of lectures on key infectious diseases topics, and basics of clinical microbiology. The revised curriculum was initiated at the start of the 2021-22 academic year. Dr. Carolyn Kramer continues in her role as thread leader for the medical school Microbiology/ Immunology block. Beginning July 2023, we expanded the ID elective offerings for 4th year medical students effectively doubling the available slots. We now have students rotating with us on four of our consultation services for two, 2-week blocks.

INFECTIOUS DISEASES FELLOWSHIP PROGRAM

The Division continues to sponsor a training program for infectious disease physician trainees. The training program comprises all aspects of infectious diseases and venues that include the inpatient teaching service, other specialty inpatient services (e.g., transplant-related infections, surgical infections, etc.), outpatient services (e.g., HIV, sexually transmitted infections,

etc.), and conferences that include core curriculum, journal club, and guidelines review. With the generous donation from the Havens family, the program added an additional infectious diseases trainee in July 2022. We sought further funding and added another position beginning in July 2023 now increasing our total fellow compliment to six.

Despite a waning interest in careers in ID as evidenced by a continued fall in the number of applicants to fellowship positions, we fared exceptionally well in the fellow match for positions starting in July 2023. We ranked nearly 40 candidates and matched our three positions, all in the top 15 of our choices. We have made changes to the program:

• We have created a pandemic preparedness teaching module for ID fellows and for infection preventionists.

• We are creating a transplant concentration for interested fellows which we believe will make the program more attractive.

• We have expanded our continuity care clinic opportunities to include the Drexel HIV/AIDS Partnership. Two of our fellows began their continuity clinics there beginning July 2023.

RESEARCH

The Jefferson ID Division has long been known for its clinical and educational strengths and expertise. While research has been part of our mission, we have continued to develop our research portfolio. Multiple faculty members were successful in submitting manuscripts for publication. Our output of published works has expanded on a yearly basis. In addition, we are moving ahead with participation in multi-centered

clinical trials focusing on transplant infections and HIV. Drs. Belden, Coppock, and Flomenberg now lead a team focused on research for the Division. They maintain a catalogue of research projects for our program trainees, as well as medical residents and students who are considering careers in infectious diseases or who simply want to be involved in clinical research. As a division, we are also reaching out to develop collaborations with units at Jefferson including Clinical Microbiology and ID Pharmacy and units outside Jefferson, most notably at the Drexel HIV/AIDS Partnership. Our ultimate goals are to focus our research efforts on selected fields including HIV/ AIDS, transplant-related infections, orthopedic infections, substance use disorder, and non-tuberculous mycobacterial infections.

GLOBAL HEALTH

We have had plans to expand our division’s activities into the global health arena with the help of Dr. Gustavo Vasquez and his contacts in Peru. However, Dr. Vasquez left the Division in December 2021 to take a position with industry in vaccine development. One of our new fellows (Dr. Nikita Jaggernauth) is very interested in global health opportunities and has had great experience in her native Trinidad and Tobago. We will be looking for opportunities in global health for her during her second fellowship year.

QUALITY INITIATIVES

The Division’s quality initiatives center around our major hospital programs that are managed by the Division, namely Infection Control and Prevention (led by Dr. Phyllis Flomenberg) and Antimicrobial Stewardship (led by

Dr. Bryan Hess). Institution-wide quality projects have focused on C. difficile infection, central line associate bloodstream infections and improved antibiotic utilization. Our HIV/AIDS program has created a comprehensive set of quality measures and quality initiatives that have placed the program in the very highest levels of performance for programs in the City of Philadelphia. Dr. Daniel Taupin who joined our division in 2022 has now taken a divisional and departmental lead in quality initiatives as part of his job responsibilities.

NEW AND ONGOING INITIATIVES AND FUTURE PLANS

Substance Use Disorder (SUD). To help meet the growing problem of patients admitted with complications of SUD, most particularly those who inject, we now staff a seventh infectious diseases consult service focused on this patient group. erious infections are a major reason for hospitalization for these patients. Our initiative fits in with institutional efforts on multiple fronts to address this problem. We envision better coordination among the various services including hospitalists, psychiatry, pain medicine, and our Jefferson Addiction Multispecialty Service (JAMS).

Non-Tuberculous Mycobacteria (NTM). We have worked in setting up a new multi-specialty program focusing on patients with nontuberculous mycobacterial lung infections. This is a collaboration that includes the Division of Pulmonary and Critical Care Medicine, Clinical Microbiology, and Infectious Diseases that enhances our existing collaboration with National Jewish Health in Denver, CO which is a world leader in this and many other lung related diseases. For the ID Division, one

of our new faculty members, Dr. Mollie Tucker, will be leading this effort with assistance from Drs. Elizabeth Novick, John Zurlo, and a PA, Mr. Ross Livinsky. We have received a generous donation to purchase an automated instrument for our clinical microbiology laboratory for more rapid identification of NTM.

Drexel Collaboration. We have now completed the first steps of our collaboration with the Drexel HIV/AIDS Partnership. We now share faculty at each location. Two of our ID fellows now have their continuity clinics at the Partnership. We look forward to developing further collaborations on the research front.

Lung Transplant. Plans are in place to begin lung transplantation at TJUH beginning in the 2024 academic year. We have added one more faculty member to the transplant ID team, Dr. Mollie Tucker who has had specialized training in transplant infections during her ID fellowship at Yale.

Methodist Hospital. Dr. Tricia Royer continues in the role of Vice Division Chief at Methodist Hospital. She works closely with our PA (Molly Hancock) and the medical staff to meet the increasing demands for ID support.

Quality and Safety. We plan on introducing more formalized training in patient safety and quality to the fellowship and to the division as a whole. This effort will be led by Dr. Dan Taupin.

Pandemic Preparedness. Dr. John Zurlo along with Ms. Kelly Zabriskie (Jefferson Enterprise VP for Infection Control and Prevention) have been tasked to develop a pandemic prevention plan for the Jefferson Enterprise. A total of 19 units/divisions have been identified in the Enterprise that were involved in our COVID response and would be expected to again be involved with any future pandemics.

Citywide Conference. The Division continues to serve as host for the monthly Philadelphia region Citywide ID Conference.

SELECT PUBLICATIONS

Belden K, Hess B, Brugger C, Carr R, Braun T, DeRose J, Zurlo J. Anti-SARS-CoV-2 Monoclonal Antibodies for COVID-19 A RealWorld Experience. Infectious Diseases in Clinical Practice 2022;30(2):1-3

Belden K, Schultz J, Yeager L, Coppock D. Nirmatrelvir-ritonavir in solid organ transplant patients with COVID-19. Transplant Infectious Diseases. 2023 Feb 27;e14037.

Belden KA, Yeager S, Schulte J, Cantarin MPM, Moss S, Royer T, Coppock D. "Saving lives with nirmatrelvir/ritonavir one transplant patient at a time". Transpl Infect Dis. 2023 Apr;25(2):e14037. doi: 10.1111/ tid.14037. Epub 2023 Feb 27. PMID: 36847419.

Boyle E, Coppock D. Polymicrobial bacteremia and Strongyloides hyperinfection syndrome: Vigilance in patients on corticosteroids. IDCases. 2022 May 20;28:e01520. doi: 10.1016/j. idcr.2022.e01520. PMID: 35615701; PMCID: PMC9125627.

Chen R, Vaughan A, Cox R, Alfosi S,  Belden KA, Namdari, S. Shoulder Periprosthetic Joint Infection is Associated with Increased Mortality. J Shoulder Elbow Surg 2023 Feb 18;S1058-2746(23)00089

Coppock D, Pierre-Christian V, Vasquez G, Belden K, Foster M, et al. Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized Patents with COVID-19: A Randomized Clinical Trial. Life 2022 Mar 19;12(3):453

Coppock D, Violet PC, Vasquez G, Belden K, Foster M, Mullin B, Magee D, Mikell I, Shah L, Powers V, Curcio B, Daskalakis C, Monti D,

and Levine M. Pharmacologic Ascorbic Acid as Early Therapy for Hospitalized Patients with COVID-19: A Randomized Clinical Trial. Life. 2022, 12(3), 453.

Coppock D, Zurlo CE, Meloni JM, Goss SL, Zurlo JJ, Pettengill MA. Interferon gamma release assay mitogen responses in COVID-19. Inf Dis Clin Prac 2022 Jan 30;1, e1085. doi: 10.1097/ IPC.0000000000001085.

Gould CV, Free RJ, Bhatnagar J, Soto RA, Royer TL, Maley WR, Moss S, et. al. Yellow Fever Vaccine Virus Transplant and Transfusion Investigation Team. Transmission of yellow fever vaccine virus through blood transfusion and organ transplantation in the USA in 2021: report of an investigation. Lancet Microbe. 2023 Aug 3:S2666-5247(23)00170-2. doi: 10.1016/S2666-5247(23)001702. Epub ahead of print. PMID: 37544313.

Gung C, McGuire R, George M, Abdulkareem A, Belden KA, Porcu P, et al. Antibody Response to SARS-CoV-2 Vaccination in Patients with Lymphoproliferative Disorders and Plasma Cell Dyscrasias: Anti-Lymphoma Therapy as a Predictive Biomarker of Response to Vaccination. Front Oncol. 2022 Jul 7,12:840451

Haddad S, Zurlo J, Wang Z, Richards B, Badiatia N, Coppock D. Genetic sequencing of breakthrough SARS-CoV-2 infections in fully vaccinated healthcare workers. Infectious Diseases in Clinical Practice 31(1):e1202, January 2023

Hamiter M, Amorosa V, Belden K, Gidley PW, Mohan S, Perry B, Kim AH. Skull Base Osteomyelitis: Historical Perspectives, Diagnosis and Management Update. Otolaryngol Clin North Am. 2023 Jul 19: online ahead of print

Kim D, Gibson R, Her M, Mahoney M, Stering P, Padival S,  Taupin D, Porter M. Evaluation of

immunization status in psoriasis patients prior to initiation of immunosuppressive therapy- A multidisciplinary approach. Journal of Investigative Dermatology. 2022; Aug;142(8):s60.

Larnard J, Swords K, Taupin D Padival S. From sea to shining IV: the current state of OPAT in the United States. Therapeutic Advances in Infectious Disease. 2023 Jun 19;10:20499361231181486.

Lier AJ, Seval N, Vander Wyk B, Di Paola A, Springer SA.  Maintenance on extendedrelease naltrexone is associated with reduced injection opioid use among justice-involved persons with opioid use disorder. J Subst Abuse Treat. 2022 Nov;142:108852. doi:10.1016/j. jsat.2022.108852. Epub 2022 Jul 30. PMID 35988513

Luterbach CL, Chen L, Novick E, et al. Transmission of CarbapenemResistant Klebsiella pneumoniae in US Hospitals. Clin Infect Dis. 2023 January, Volume 76, Issue 2, pages 229-237. doi: 10.1093/cid/ciac791.

Morton AB, Boyle E, Pettengill MA, Gancher E. The Brief Case: Strictly Anaerobic and Staining Acid Fast. J Clin Microbiol. 2023 May 23;61(5):e0015022. doi: 10.1128/ jcm.00150-22. Epub 2023 May 23. PMID: 37219093; PMCID: PMC10204630.

Paziuk T, Cox RM, Gutman MJ, Rondon AJ, Nicholson T, Belden K

Namdari S. Periprosthetic joint infections of the shoulder: A 10-year retrospective analysis outlining the heterogeneity among these patients. Shoulder and Elbow. 2022 Dec (6):598-605

Seval N, Nunez J, Roth P, Schade MA, Strong M, Frank CA, Litwin AH, Levin FR, Brady KT, Nunes EV, SpringerSA. Inpatient Low Dose Transitions from Full Agonist Opioids Including Methadone onto Long-Acting Depot

Buprenorphine: Case Series from

a Multicenter Clinical Trial. J Addict Med.  2023 Jan 26. doi: 10.1097/ ADM.0000000000001136. PMID: 36701748

Tran C, Hargy J, Hess B, Pettengill M. Estimated Impact of Low Isolate Numbers on the Reliability of Cumulative Antibiogram Data. Microbiology Spectrum 2023: e03939-22

Tsang, D, Haddad S, Sahin Z, Vareechon C, Sternlieb M, and Royer T. "Cladophialophora Bantiana Brain Abscess and Concurrent Pulmonary Cryptococcus Neoformans Infection in a Patient Twenty Years After Renal Transplantation." IDCases (2022): e01639.ISSN 22142509, https://doi.org/10.1016/j. idcr.2022.e01639.

Weimer MB, Falker CG, Seval N, Golden M, Hull SC, Geirsson A, Vallabhajosyula P. The Need for Multidisciplinary Hospital Teams for Injection Drug UseRelated Infective Endocarditis. J Addict Med. 2022 JulAug;16(4):375-378. doi: 10.1097/ ADM.0000000000000916. Epub 2021 Sep 10. PMID: 34510088.

Yost CC, Jimenez DC, Weber MP, Maynes EJ, Belden KA, Tchantchaleishvili V, Massy HT, Sass DA, Rame JE, Zurlo JJ Aburjania N. Hepatitis B in heart transplant donors and recipients: A systematic review and metaanalysis. J Surg Res 2023;283, 1078-1090 doi.org/10.1016/j.

DIVISION OF INTERNAL MEDICINE

The Division of Internal Medicine comprises 42 faculty physicians who work in partnership with seven advance practice providers and other team members to provide comprehensive primary care and serve as educators and leaders across Jefferson.

PATIENT CARE

The Division of Internal Medicine provides care for a diverse population across the region, with 90,960 visits in FY23 at its ten clinical practices in Center City Philadelphia, South Philadelphia, Bala Cynwyd, and Havertown, including three resident outpatient continuity sites. The Division’s experienced clinicians are widely recognized for the quality of their care as well as their patientcentered orientation, earning 16 “Top Doc” recognitions this past year from Philadelphia Magazine. The Division’s core clinical service is providing high-quality comprehensive person-centered primary care for adults, buttressed by a culture of improvement and a strong infrastructure to support quality. In addition to the core primary care, the Division also provides expertise and leadership in several areas:

• The Division of Internal Medicine provides leadership in quality improvement for primary care. Dr. Bracken Babula, Vice Chair for Quality and Clinical Informatics, works with faculty leads in quality improvement and with clinical team members to reach quality goals for disease management and prevention. Our Division also works closely with Population Health team members across the enterprise to achieve quality goals. This year, Dr. Edgar Chou, stepped into the role

of Enterprise Medical Director for Population Health & Value Based Care.

• Within the Division of Internal Medicine, Dr. Janine Kyrillos is the Director of the Jefferson Comprehensive Weight Management program. Dr. Kyrillos leads the team in partnership with a nurse practitioner and dietician to provide comprehensive medical weight management and partners with Jefferson’s surgical weight management team.

• The Women’s Primary and Specialty Care practice in the Division offers comprehensive women's care with a team of primary care providers and specialists focused on women’s health. Within the practice, Dr. Katherine Sherif provides expertise in polycystic ovary syndrome and Dr. Shailaja Nair leads coordination with specialists to provide comprehensive care for women.

• Jefferson has one of the few Point of Care Ultrasound (POCUS) training programs located in an outpatient Internal Medicine Division in the country, and among the few Department of Medicine run POCUS fellowships in the country. Dr. Rebecca Davis leads the POCUS program in the Division of Internal Medicine, working closely with Dr. Barry Ziring in the

Division of Internal Medicine, and in collaboration with faculty in other Divisions and Departments at Jefferson.

• The Division of Internal Medicine continues to be home to one of the largest comprehensive sickle cell disease care programs in Pennsylvania. The program is led by Dr. David Axelrod and provides a comprehensive medical home for people living with sickle cell disease. Dr. Axelrod collaborates closely with colleagues in hematology, emergency medicine, and hospital medicine.

• Several faculty also have expertise in the care for important populations, including care for people living with disabilities (Dr. Michael Stillman) and gender affirming care (Dr. Sean Hurt).

EDUCATION

The Division of Internal Medicine has a number of gifted educators. Division faculty members are closely involved in the education of students and residents at every stage of their training. Dr. Susan Truong leads the casebased learning curriculum for the JeffMD program, and many internal medicine faculty participate as facilitators in the course. Dr. Nina Mingioni is the Director for JeffMD, Phase 2:

FACULTY

Rhea Powell, MD

Associate Professor Division Director

David Axelrod, MD

Associate Professor

Bracken Babula, MD

Clinical Associate Professor

Vice Chair for Quality and Clinical Informatics

Medical Information Officer

Karl T. Benedict III, MD

Clinical Assistant Professor

Joseph Boselli, MD

Clinical Associate Professor

Elizabeth Boyle, MD

Clinical Assistant Professor

John Caruso, MD

Professor

Senior Associate Dean, Graduate

Medical Education and Affiliates

Edgar Chou, MD

Clinical Associate Professor

Jennifer T. Cowan, MD

Clinical Assistant Professor

Rebecca Davis, MD

Clinical Associate Professor

Associate Program Director, Internal Medicine Residency

Associate Program Director, EM/IM Point of Care Ultrasound Fellowship

Marjorie Friedman, MD

Clinical Instructor

Mark Graham, MD

Professor

Sean Hurt, MD

Clinical Assistant Professor

Rong Ji, MD

Clinical Assistant Professor

Keino Johnson DO

Clinical Instructor

Sunaina Kaushal, MD

Clinical Assistant Professor

Barbara S. Knight, MD

Clinical Assistant Professor

Janine V. Kyrillos, MD

Clinical Associate Professor

Christine Laine, MD

Clinical Associate Professor

Hillary Landon, MD

Clinical Assistant Professor

Kenneth Lau, MD

Clinical Assistant Professor

Core Clinical Clerkships. Many Division faculty participate as facilitators in the Clinical Experience course for 1st-year medical students. An embedded health coach works closely with medical students to identify patients with unserved needs and provide resources for these patients. Faculty also act as facilitators for the 1st and 2nd year clinical skills small group course. Dr. John Spandorfer serves as the Roger B. Daniels Associate Dean of Professionalism in the medical school, coordinating professional education across all four years of the undergraduate curriculum.

The Division also contributes meaningfully to graduate medical education. Residents in internal medicine have their ambulatory internal medicine continuity clinic at one of three internal medicine practices. Faculty members provide ambulatory education to residents through precepting residents in their continuity clinic and didactic lectures.

The primary care track within the residency program, led by Dr. Jason Ojeda and Dr. Rebecca Davis, offers strong mentorship and focused primary care education for residents interested in general internal medicine careers. The Primary Care Program continues to match excellent residents each year.

RESEARCH AND SCHOLARSHIP

Faculty members have continued to produce meaningful scholarly work and present at national and regional meetings. Dr. Kyrillos is a nationally requested speaker on the topic of medical treatment for obesity; Dr. Hurt has presented on primary care for the LGBTQ+ community; and Dr. Axelrod has presented on the use of medical marijuana to manage gastrointestinal disease

symptoms. Dr. Sherif continues to be a nationally requested speaker on PCOS. Dr. Michael Stillman, who has a secondary appointment in the Department of Rehabilitation Medicine, publishes and leads research efforts investigating quality of care for people living with disabilities and opportunities to improve medical education surrounding the care of individuals with disabilities. Several faculty have published their work in peerreviewed journals.

SELECT PUBLICATIONS

Fitz M, Adams W, Heincelman M, Haist S, Whelan K, Cox L, Cao UT, Hingle S, Raff A, Houghton B, Fitzpatrick J, Nall R, Foster J, Apelbaum J, Grum C, Donovan A, Kiken S, Abraham R, Hlafka M, Miller C, Bansal S, Paauw D, Lai CJ, Pincavage A, Agarwal G, Burns C, Holzer H, Lappe K, John V, Barker B, Mingioni N, Rao D, Zakowsi L, Chakraborti C, Williams W, Kelly W. The Impact of Internal Medicine Clerkship Characteristics and NBME

Subject Exams on USMLE Step 2 Clinical Knowledge Exam Performance. J Gen Intern Med 2022;37(9):2208-2216.

Kyrillos J. Semaglutide 2.4-mg injection as a novel approach for chronic weight management. Am J Manag Care. 2022 Dec;28(15 Suppl):S297-S306. doi: 10.37765/ ajmc.2022.89293. PMID: 36525677.

Kyrillos JV, O'Neil PM, Wharton S. Introducing an important therapy for obesity to primary care: once-weekly subcutaneous semaglutide 2.4 mg. Postgrad Med. 2022 Jan;134(sup1):1-4. doi: 10.1080/00325481.2022.2149005. PMID: 36691310.

Kyrillos JV, Skolnik NS, Mukhopadhyay B, Pennings N. Integrating semaglutide into

obesity management - a primary care perspective. Postgrad Med 2022 Jan;134(sup1):37-49. doi: 10.1080/00325481.2022.2149964. PMID: 36691306.

Lee D, Chou EY, Moore K, Melly S, Zhao Y., Chen H., Bueler J.: Patient characteristics and neighborhood attributes associated with hepatitis C screening and positivity in Philadelphia. Prevent Medicine Reports. 30: 1-6, 2022.

Ney DB, Ankam N, Wilson A, Spandorfer J. The implementation of a required book club for medical students and faculty. Med Educ Online. 2023 Dec;28(1):2173045. doi: 10.1080/10872981.2023.2173045. PMID: 36718544; PMCID: PMC9891158.

Qaseem A, MacLean CH, Tierney S, Cross JT Jr, MacDonald ST, Goldzweig CL, Fitterman N, Andrews R, Basch P, Mathew SM, McLean RM, Mount CA, Powell RE, Saini SD. Performance Measures for Physicians Providing Clinical Care Using Telemedicine: A Position Paper From the American College of Physicians. Annals of Internal Medicine. 2023 May;176(5):694-698. doi: 10.7326/ M23-0140. PubMed PMID: 37068276.

Powell R, Felt-Lisk S, Chen A, Sullivan C. Optimizing clinical guidelines to address antimicrobial-resistant infections: A conceptual framework reflecting stakeholder perspectives. Antimicrobial Stewardship & Healthcare Epidemiology, 16 Feb 2023. 3(1), E30.

Rising KL, Cameron KA, Salzman DH, Papanagnou D, Doty AMB, Piserchia K, Leiby BE, Shimada A, McGaghie WC, Powell RE, Klein MR, Zhang XC, Vozenilik J, McCarthy DM. Communicating Diagnostic Uncertainty at Emergency Department Discharge: A

FACULTY

Albert Lee, MD

Clinical Assistant Professor

Associate Program Director, Internal Medicine Residency

Amanda Matheson, MD

Clinical Instructor

Nina Mingioni, MD

Professor

Director, Phase 2 Core Clinical Rotations

Director, Undergraduate Medical Education

Yuan Mirow, MD

Clinical Instructor

Shailajah Nair, MD

Clinical Associate Professor

Director, Integrated Program in Women's Health

Jason C. Ojeda, MD

Clinical Associate Professor

Director, Internal Medicine

Primary Care Program

Associate Program Director, Internal Medicine Residency

Kyong B. Park, MD

Clinical Assistant Professor

Aliza Rabinowitz, MD

Clinical Assistant Professor

Aparna Sarin, MD

Clinical Associate Professor

Karen Scoles, MD

Clinical Associate Professor

Katherine Sherif, MD

Professor

Vice Chair for Academic Affairs

Aleksandr Shpigel, MD

Clinical Assistant Professor

Swati Shroff, MD

Clinical Associate Professor

Christine V. Soutendijk, MD

Clinical Assistant Professor

John Spandorfer, MD

Professor

Associate Dean of Professionalism in Medicine

Michael Stillman, MD

Professor

Ashley K. Summer, MD

Clinical Assistant Professor

Susan Truong MD

Clinical Associate Professor

Director of Case Based Learning

Bianca Yuh, MD

Clinical Assistant Professor

Jonathan Zaid, MD

Clinical Assistant Professor

Barry Ziring, MD

Clinical Associate Professor

Simulation-Based Mastery Learning Randomized Trial. Academic Medicine. 2023. 98(3): 384-393.

Sagar A, Henry T, Shroff S, Leung T. Reading Between the Lines to Promote Diversity, Equity, and Inclusion. SGIM Forum: 46(4): 10-16, 2023.

Shroff S. Infectious Vaginitis, Cervicitis, and Pelvic Inflammatory Disease. Medical Clinics of North America: 107(2): 299-315, 2023. PMID: 36759099.

Stillman MD, Mallow M, Ankam N, Ojeda J, Stephens M, Heckert K, Gustafson K. The Dearth of Disability Medical Education and a Partial Solution. Teach Learn Med. 2022 Sep 9:1-6. doi: 10.1080/10401334.2022.2119239. Epub ahead of print. PMID: 36082770.

Stillman M. Death by Patient Portal. JAMA. 2023;330(3):223–224. doi:10.1001/jama.2023.11629

NOTABLE ACHIEVEMENTS

2023 Philadelphia Magazine Top Doctors

JOSEPH BOSELLI, MD

EDGAR CHOU, MD

JENNIFER COWAN, MD

JANINE KYRILLOS, MD

CHRISTINE LAINE, MD

ALBERT LEE, MD

NINA MINGIONI, MD

YUAN MIROW, MD

SHAILAJA NAIR, MD

KAREN SCOLES, MD

KATHERINE SHERIF, MD

ALEKSANDR SHPIGEL, MD

CHRISTINE SOUTENDIJK, MD

JOHN SPANDORFER, MD

ASHLEY SUMMER, MD

BARRY ZIRING, MD

DIVISION OF NEPHROLOGY

The Division of Nephrology continues its mission of education, research, and clinical care under the leadership of Jerry McCauley, MD. We continue to publish in prestigious, peer-reviewed journals and offer a Transplant Nephrology Fellowship that has been approved by the American Society of Transplantation.

PATIENT CARE

Our goal remains to provide the highest level of service to our patients as well as our colleagues. We strive to deliver these services with care, professionalism, teamwork, and respect. Our inpatient clinical activities remain robust among the Renal Dialysis Consult, Renal Medical Consult, and Renal Transplant Consult Services. The inpatient dialysis service provides treatment for an estimated 800-900 patients per month. We provide Medical Directorship for three outpatient dialysis units and patient care to 7 chronic units and 2 home units, and 3 long-term care facilities. Our outpatient service is a vital part of our patient care mission. In FY23, the division saw 10,700 outpatients, which is a 2% decrease from FY22. Of these, 2,301 were new patient visits, and 1,177 were telehealth visits. In addition to the ambulatory practice the division saw 3,795 outpatient dialysis patients in FY23.

We provide Medical Directorship at Magee Rehabilitation and patient care.

Under the Direction of Dr. Seyed Hamrahian, the Division of Nephrology retained Certification as the Jefferson Comprehensive Hypertension Center from the American Heart Association. This certification was made effective August 22, 2022, through August 23, 2025. We have been holding successful annual Jefferson Hypertension Symposiums

since 2019 with the last one on November 12, 2021.

TRANSPLANT OUTCOMES

Under the leadership and direction of Dr. Pooja Singh, the Kidney Transplant Program at TJUH currently has approximately 762 patients on the waitlist (kidney, kidney/pancreas, and pancreas). Our transplant list continues to grow, with a total of 200 new patients added to the waitlist during FY23. We more than doubled our referral volumes from 528 referrals in FY17 to 1068 FY23. Our living donor transplant program completed 16 live donor transplants in FY23 and a total of 98 kidney transplants overall.

We have maintained a strong presence with UNOS through Dr. McCauley’s election to OPTN President and Dr. Singh’s participation on the Membership and Professional Standards Committee (MPSC). Additionally in FY23 following a change in regulations that eliminated the race based calculations of egfr, transplant centers begun to apply for adjusted wait time for their African American patients.

As a result of the program’s swift work, 300 patients were reviewed and 174 patients gained a total of about 341 years of wait time and 10 patients were transplanted with more to come following the adjustments.

The Nicoletti Kidney Transplant Center, which opened in December 2016, is a

comprehensive multidisciplinary center wherein patients and live donors can come to be evaluated for transplantation and donation in one location. The hallmark of the Center, which is located on the corner of 9th and Chestnut Streets in Philadelphia, is the Living Donation Education Program. The Living Donor Education Program is a customized education and coaching program conducted twice monthly to assist patients in finding a living donor, which has been proven effective nationally.

Holding steadfast to our commitment of eliminating the financial burden of living donations, The Jefferson Transplant Institute became a Living Donor Circle of Excellence Center as well as a Donor Shield Center. We are the only Donor Shield Center in the Philadelphia area.

The Kidney Transplant Program continues to see patients conveniently in Egg Harbor Township, NJ, at Voorhees, NJ, Langhorne, PA and Bala Cynwyd, PA, and this FY23 expanded to Willow Grove, PA through a partnership with a site champion. Additionally, the program will begin seeing patients at the Navy Yard in early FY24 and we are working on further expansion at a location within the Lankenau Medical Center to service patients following the recent closure of the Mainline Kidney Transplant Program. Additionally, as a result of the Mainline Kidney Transplant

FACULTY

Jerry McCauley, MD

Division Director

Robert Capizzi Professor of Medicine

Hasan Arif, MD

Clinical Associate Professor

Xiaoying Deng, MD

Clinical Assistant Professor

Bonita Falkner, MD

Emeritus Professor

Jesse Goldman, MD

Clinical Professor

Rakesh Gulati, MD

Clinical Professor

Maitreyee Gupta, MD

Clinical Assistant Professor

Fitsum Hailemariam, MD

Clinical Assistant Professor

Seyed Hamrahian, MD

Professor

Associate Director

Omar Hussein Maarouf, MD

Associate Professor

Maria Martinez, MD

Associate Professor

Pooja Singh, MD, MBA

Enterprise Director, Kidney Transplant Services

Beatrice F. Nicoletti Professor in Nephrology

Hannah Troutman, DO

Clinical Assistant Professor

Anju Yadav, MD

Associate Professor

Jingjing Zhang, MD

Associate Professor

program closure, towards the end of FY23 the Kidney Transplant program collaborated closely with Mainline to execute a waitlist transfer of their patients to the Jefferson kidney transplant waitlist.

We have expanded our offering of non-oncology infusions from our Stratford campus to now include Jefferson Washington Township Hospital, Abington Hospital, Sidney Kimmel Cancer CenterBodine Center for Radiation Oncology and Jefferson Hospital for Neuroscience.

As part of our ongoing response to the COVID-19 crisis and under the direction of Dr. Pooja Singh, the Kidney Transplant team collaborated closely with our Transplant Pharmacy and Infectious Disease colleagues to operationalize the distribution of evusheld to our patients.

Through a partnership with Strive Health, the Jefferson Kidney Transplant Program begun participating in the Strive Kidney Contracting Entity in January 2023. Participation in the Kidney Contracting Entity builds upon the existing Comprehensive End Stage Renal Disease (ESRD) Care (CEC) Model structure in which dialysis facilities, nephrologists, and other health care providers form ESRDfocused accountable care organizations to manage care for Medicare beneficiaries with ESRD by adding strong financial incentives for health care providers to manage the care for patients with chronic kidney disease (CKD) stages 4 and 5 and ESRD, to delay the onset of dialysis and to incentivize kidney transplantation. The program will continue to expand participation in the Kidney Contracting Entity model and anticipates being able to provide these services to our New Jersey patients in January 2024.

QUALITY INITIATIVES

This year has been highly productive with quality improvement initiatives in all facets of kidney care, encompassing acute kidney injury (AKI), chronic kidney disease (CKD), end-stage renal disease (ESRD), and transplant care. Notably, all graduating nephrology fellows have successfully completed a Quality Improvement Project, and they have presented their findings through posters at both national and international meetings (ASN).

Over the past year, we have successfully completed several specific projects:

• We optimized workflows in the Acute Dialysis Unit (ADU) during the COVID-19 pandemic, both before and after vaccination.

• We implemented guidelines for the placement of AccuCath instead of midlines in patients with Chronic Kidney Disease (CKD), End-Stage Renal Disease (ESRD), and transplant patients.

• Guidelines for the administration of Gadolinium in CKD/ESRD patients were established.

• We introduced safety measures for effectively managing Hyperkalemia in ESRD patients by utilizing low-dose regular insulin instead of the standard dose. Additionally, Droxidopa has been added to our formulary to treat patients with low blood pressure.

Currently, our active projects aim to enhance patient care and satisfaction:

• We've implemented measures to expedite the transfer of ESRD patients

from the Emergency Department (ED) to the ADU, reducing ED congestion and improving patient triage. This initiative also benefits end-stage renal disease patients who may lack an outpatient dialysis unit due to behavioral or compliance issues. We have successfully placed these patients in outpatient dialysis units, alleviating the burden on the hospital, ED, and ADU.

• We are actively participating in the ESRD Treatment Choice Model (ETC) with a focus on pre-transplants, living donor transplants, and transitioning patients to home dialysis modalities, including peritoneal dialysis and home hemodialysis.

• The Center for Specialty Care in South Philadelphia is now operational, providing in-center dialysis patients with training and education on home dialysis modalities. We have initiated our first peritoneal dialysis (PD) patient and are currently training one home hemodialysis patient.

Furthermore, we have implemented numerous safety protocols at Magee Rehabilitation:

• We have established renal dosing guidelines for neuropathic pain medications (Pregabalin and Gabapentin) and antibiotics (Vancomycin and Gentamycin).

• Protocols for managing heart failure have been overhauled with the involvement of Jefferson Renal, incorporating medication reconciliation both upon admission and discharge from Magee.

NEW GRANTS/ CLINICAL TRIALS

JINGJING ZHANG, MD

PI: A Phase IIb Randomized, Double-Blinded, PlaceboControlled, Dose-Ranging Study to Evaluate the Efficacy and Safety of Atacicept in Subjects with IgA Nephropathy (IgAN)

TPI: A Double-Blind, Randomized, Placebo-Controlled Phase 2 Clinical Trial To Evaluate Safety And Efficacy Of US-APR2020 In Subjects With Chronic Kidney Disease Stage IV

OMAR HUSSEIN MAAROUF, MD. Small Molecule Inhibitors of APOL1 gene to reduce CKD progression. Vertex, inc. . Phase IIb/III Randomized Study to Evaluate the Efficacy and Safety of Inaxaplin in Patients with ApoL1 gene mutation in CKD.

Origin Study, Vera Therapeutics. Phase IIb Randomized Study to Evaluate the Efficacy and Safety of Atacicept in Patients with IgAN. Co-PI with Dr. Jingjing Zhang.

Safety and Efficacy of Polymyxin B Hemoperfusion (PMX) for Endotoxemic Septic Shock in a Randomized, Open-Label Study (TIGRIS). Spectral Diagnostics (US) Inc. Co_PI with Dr. Michael Baram.

• Through collaboration with the Pharmacy at Magee, we have added medications to the formulary for managing Hyperkalemia (Lokelma and Veltassa), Hyponatremia (UreNa), and Hypotension (Droxidopa).

These initiatives collectively reflect our commitment to enhancing patient care and safety across various aspects of renal and specialized healthcare.

EDUCATION

The division’s faculty members serve as the educational resource for students, interns, residents, and fellows year-round. Subspecialty fellows, as well as students and house staff rotating through our service, participate in didactic lecture series in Nephrology, basic and clinical research, journal club, clinical case conference, mortality and morbidity conference, and kidney biopsy conference. Our fellowship program continues to offer a Transplant Nephrology Fellowship (PGY 6) approved by the American Society of Transplantation. The purpose of this fellowship program is to be able to graduate UNOScertified transplant nephrologist from Jefferson and enhance the prestige and visibility of our transplant program.

The effectiveness of our educational mission is evidenced by a renewed interest in Nephrology as a career option for the Jefferson medical residents.

RESEARCH

Dr. McCauley encourages faculty in the continued development of clinical research activities. Our faculty and fellows are actively involved in both basic science and clinical research projects.

EDITORIAL, REVIEW / BOOK CHAPTERS

Falkner B. (2022) Development of Blood Pressure Norms and Definition of Hypertension in Children. In Pediatric Hypertension 5th Edition. Editors: Flynn JT, Ingelfinger JR, Brady T. Springer, Cham DOI: 10.1007/978-3-031-5_10 First online: 10 January 2023

Thaker V, Falkner B. (2022) Insulin Resistance and other Mechanisms of Obesity Hypertension. In Pediatric Hypertension 5th Edition.

Editors: Flynn JT, Ingelfinger JR, Brady T. Springer, Cham 2023 https://doi.org/10.1007/978-3-31931420-4_39-2

Mehrdad Hamrahian: Hyponatremia Chapter. Medscape – updated as first author 2022

Maarouf O, Hamrahian S, Teran F, Simon E : Hyponatremia Chapter - Updated Medscape 2023.

PUBLICATIONS

Haley JE, Woodly SA, Daniels SR, Falkner B, Ferguson M, Flynn JT, Hanevold C, Hooper SR, Ingelfinger JR, Khoury PR, Lande MB, Martin LJ, Meyers KE, Mitsnefes M, Becker RC, Rosner B, Samuels J, Tran A, Urbina E. Association of Blood Pressure-Related Increase in Vascular Stiffness on Other Measures of Target Organ Damage in Youth. Hypertension 2022:79:00 DOI:10.1161/ HYPERTENSIONAHA.121.18765

Falkner B. The Enigma of Primary Hypertension in Childhood. Frontiers in Cardiovascular Medicine. 2022;9:1033628. DOI: 10.3389/fcvm.2022.1033628

Falkner B, Gidding SS, Baker-Smith CM, Brady TM,

Flynn JT, Malle LM, South AM, Tran AH, Urbina EM; on behalf of the American Heart Council on Hypertension; Council on Lifelong Congenital Heart Health in the Young; Cuncil on Kidney tub Cardiovascular Disease; Council on Lifestyle and Cardiometabolic Health; and Council on Cardiovascular and Stroke Nursing. Pediatric Primary Hypertension: An Underrecognized Condition: A Scientific Statement From the American Heart Association. Hypertension. 2023 |Volume 80, Issue 6: e101–e111, Published Online:March 30, 2023,https://doi.org/10.1161/ HYP.0000000000000228

Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial. Gulati, R. Yi TW, Smyth B, Di Tanna GL, Arnott C, Cardoza K, Kang A, Pollock C, Agarwal R, Bakris G, Charytan DM, de Zeeuw D, Heerspink HJL, Neal B, Wheeler DC, Cannon CP, Zhang H, Zinman B, Perkovic V, Levin A, Mahaffey KW, Jardine M; CREDENCE Trial Investigators. Am J Kidney Dis. 2023 Jul;82(1):84-96. e1. doi: 10.1053/j.ajkd.2022.12.015.

Epub 2023 Mar 7. PMID: 36889425

Katz-Greenberg G, Gulati R Laboratory Diagnosis: Urine studies book chapter in Clinician’s Pocket Reference 12th edition by Gomella and Haist, McGraw Hill, July 2022

Seyed Mehrdad Hamrahian and Bonita Falkner: Approach to Hypertension in Adolescents and Young Adults Current Cardiology Reports – 24, 131-140 (2022)

Goni Katz-Greenberg, Michael Malinchoc, Dennis Broyles, David Oxman, Seyed M Hamrahian, Omar Maarouf: Urinary neutrophil gelatinase-associated lipocalin predicts ICU admission diagnosis: A Prospective Cohort Study. Kidney 360. September 2022, 3 (9) 15021510.

NEW GRANTS/ CLINICAL TRIALS

MAITREYEE GUPTA, MD.

A Prospective, multicenter, observational study to validate TruGraf in stable renal transplant patients to rule out subclinical acute rejection

Role: Principal Investigator

Patients Enrolled:15 (2022-2023)

A pivotal Phase 3 Trial to evaluate safety and efficacy of Clazakizumab for treatment of chronic active antibody-mediated rejection in kidney transplant recipients.

Role: Sub Investigator

HOPE in Action Prospective multicenter, clinical trial of deceased HIV donor positive kidney transplants for HIV+ recipients IRB approval received recently

Hamrahian SM, Maarouf OH, Fülöp T. A critical review of medication adherence in hypertension: barriers and facilitators clinicians should consider. Patient Preference and Adherence. Oct 2022, Volume16, 2749–2757

Hamrahian SM, Vilayet S, Herberth J, Fülöp T. Prevention of Intradialytic Hypotension in Hemodialysis Patients: Current Challenges and Future Prospects. International Journal of Nephrology and Renovascular Disease. 2023 Dec 31:173-81.

Serrano E, Whitaker-Menezes D, Lin Z, Roche M, Martinez Cantarin MP. Uremic Myopathy and Mitochondrial Dysfunction in Kidney Disease. Int J Mol Sci. 2022 Nov 4;23(21). doi: 10.3390/ ijms232113515. PubMed PMID: 36362298

Belden KA, Yeager S, Schulte J, Cantarin MPM, Moss S, Royer T, Coppock D. Saving lives with nirmatrelvir/ritonavir one transplant patient at a time. Transpl Infect Dis 2023 Feb 27;:e14037. doi: 10.1111/ tid.14037. PubMed PMID: 36847419

Serrano E, Shenoy P, Martinez Cantarin MP. Adipose tissue metabolic changes in chronic kidney disease. Immunometabolism (Cobham). 2023 Apr;5(2):e00023. doi: 10.1097/IN9.0000000000000023. eCollection 2023 Apr. Review. PubMed PMID: 37128293; PubMed Central PMCID: PMC10144329

McCauley, J. Chronic Kidney Disease, Diabetes, and Population Health: From Primary Care to Transplant. POPULATION HEALTH MANAGEMENT Volume 26, Supplement 1, 2023

Singh,P. Reese PP, Doshi MD, Hall IE, Besharatian B, Bromberg JS, Thiessen-Philbrook H, Jia Y, Kamoun M, Mansour SG, Akalin E, Harhay MN, Mohan S, Muthukumar T, Schröppel B, Singh P, Weng FL, Parikh CR.

Deceased-Donor Acute Kidney Injury and Acute Rejection in Kidney Transplant Recipients: A Multicenter Cohort. Am J Kidney Dis. 2023 Feb;81(2):222-231.e1. doi: 10.1053/j.ajkd.2022.08.011.

Epub 2022 Oct 1. PMID: 36191727; PMCID: PMC9868058.

Nishio-Lucar AG, Hunt HF, Booker SE, Cartwright LA, Larkin L, Gonzalez SA, Spiers JA, Srinivas T, Ahmad MU, Levan ML, Singh P, Wertin H, McAdams C, Lentine KL, Schaffer R 3rd. Utilizing Social Media to Identify Potential Living Donors: Learning from US Living Donor Programs. Curr Transplant Rep 2022;9(4):318-327. doi: 10.1007/ s40472-022-00382-1. Epub 2022 Nov 22. PMID: 36466961; PMCID: PMC9684893.

Singh, P. Mansour SG, Khoury N, Kodali R, Virmani S, Reese PP, Hall IE, Jia Y, Yamamoto Y, Thiessen-Philbrook HR, Obeid W, Doshi MD, Akalin E, Bromberg JS, Harhay MN, Mohan S, Muthukumar T, Singh P, Weng FL, Moledina DG, Greenberg JH, Wilson FP, Parikh CR. Clinically adjudicated deceased donor acute kidney injury and graft outcomes. PLoS One. 2022 Mar 3;17(3):e0264329. doi: 10.1371/ journal.pone.0264329. PMID: 35239694; PMCID: PMC8893682.

Telemedicine services for living kidney donation: A US survey of multidisciplinary providers.

Al Ammary F, Motter JD, Sung HC, Lentine KL, Sharfuddin A, Kumar V, Yadav A, Doshi MD, Virmani S, Concepcion BP, Grace T, Sidoti CN, Yahya Jan M, Muzaale AD, Wolf J. American Journal of Transplantation. 2022 Aug; 22(8):2041- 2051. Epub 2022 May 31. PMID: 35575439.

Jing Li, Mingyue Li, Jingjing Zhang, Yiqing Song. Associations between taste and smell alterations and diabetesrelated comorbidities among US adults: the National Health and Nutrition

Examination Surveys 2011–2014. Acta Diabetologica volume 59, 429–433 (2022)

Edwin Lam,Yi Ting (Kayla) Lien,Walter K. Kraft,Douglas F. Stickle,Beth Piraino,Jingjing Zhang Intraperitoneal pharmacokinetics of vancomycin in patients on automated peritoneal dialysis. CTS 15, (3), 649-657, 2022

Jingjing Zhang Yonghong Huan, Mark Leibensperger,Bojung Seo, and Yiqing Song. Comparative Effects of Sodium-Glucose Cotransporter 2 Inhibitors on Serum Electrolyte Levels in Patients with Type 2 Diabetes: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials. KIDNEY360 3: 477– 487, 2022.

Omar El Fadel, Anshel Kenkare, and Jingjing Zhang. Steroid responsive idiopathic calcitriol induced hypercalcemia: a case report and review of the literature. BMC Nephrology volume 24, Article number: 159 (2023)

JOURNALS

Journal Article Nugent, S., Karaisz, F., Elbadawi, M., Touati, A., Nikbakht, N., Lee, J. B., & Arif, H (2022). An unexpected case of non-uremic calciphylaxis in a patient with multiple risk factors. Dermatology Online Journal, 28.

NOTABLE ACHIEVEMENTS

RAKESH GULATI, MD

AWARDED, JAMES F. BURKE JR. MD FELLOWSHIP PROGRAM DIRECTOR JUNE 2022

RAKESH GULATI, MD

SKMC CLINICAL EDUCATORS HONOR ROLL JULY 2022

2022 Philadelphia Magazine, Top Doctors:

JESSE GOLDMAN, MD

RAKESH GULATI, MD

OMAR MAAROUF, MD: Health Care Improvement Foundation: 1st place excellence in health care: ED/HD program, 2023

JERRY MCCAULEY, MD,: President UNOS/ OPTN

POOJA SINGH, MD MBA, OPTN,: Membership and Professional Standards Committee UNOS

ZHANG, J,: Center of Excellence Designation from PKD Foundation $80,000 per year for 3 years for Patient Navigator position.

OF PULMONARY, ALLERGY & CRITICAL CARE MEDICINE

The Division of Pulmonary, Allergy and Critical Care Medicine and the Jane & Leonard Korman Respiratory Institute (KRI) have continued to grow in services and footprint. Since 2018, when the KRI was created, the division engaged in an aggressive strategy that resulted in the recruitment of new faculty; an increase in the number of physician extenders, nurses and medical assistants; the establishment of a robust clinical trials enterprise; and the development of ten new clinical programs of excellence. Today, the division houses 36 faculty (including 6 basic scientists) and four training programs distributed throughout multiple clinics and two hospitals, and is considered one of the strongest clinical, research, and education programs in the region. Thanks to these and related efforts, the Thomas Jefferson University Hospital was again ranked in the top 50 (#40) in Pulmonology by U.S. News & World Report, and ranked ‘high performing’ for the treatment of patients with COPD.

PATIENT CARE

The Division is the home to outstanding programs in several clinical areas including the Interstitial Lung Disease Program, considered one of the top programs in pulmonary fibrosis in the region. The program includes clinicians, clinical and basic science researchers, and its efforts include the development of patient support programs and quality improvement projects. The Critical Care Program played a crucial role during the COVID-19 pandemic, as many patients presented with or progressed to respiratory failure and shock. Efforts by this team helped standardize the care of critically ill patients throughout the enterprise. The Lung Cancer Program leads efforts to standardize lung cancer screening and treatment throughout Jefferson Health, and is studying the impact of community factors and race on compliance with screening guidelines. The Severe Asthma

Program has joined forces with the Allergy/Immunology Program to establish one of the largest biological delivery programs in the region. The Interventional Pulmonology Program helped orchestrate the deployment of robotic bronchoscopy throughout Jefferson Health. Finally, the Division now has a new Bronchiectasis Program in addition to others in Pulmonary Hypertension, COPD, Sarcoidosis, and Adult Cystic Fibrosis.

Division programs are focused on the delivery of high quality care, engaging in the education of trainees, evaluating outcomes via quality improvement projects, and driving discovery through clinical trials and/or collaborations that drive translational research. These efforts are performed in collaboration with other Jefferson programs including those of the Department of Otorhinolaryngology, Pathology, Radiology and the Divisions of Thoracic Surgery, Infectious Diseases, and Rheumatology as well as Palliative Care, among

FACULTY

Jesse Roman, MD

Ludwig Kind Professor of Medicine

CEO, Jane & Leonard Korman

Respiratory Institute

Director, Respiratory Enterprise at Jefferson

Bharat Awsare, MD

Clinical Associate Professor

Volunteer Faculty

Saqib Baig, MD

Clinical Assistant Professor

Co-Director of COPD Program

Director of Physiology

Michael Baram, MD

Professor

Director, In-Patient Research

others. The strengths of these programs are best highlighted by strong associations and/ or sponsorship from national organizations such as the Pulmonary Fibrosis Foundation, Cystic Fibrosis Foundation, Hermansky-Pudlak Syndrome Network, and Foundation for Sarcoidosis Research, and the American Lung Association.

QUALITY INITIATIVES

The Division of Pulmonary, Allergy & Critical Care Medicine is engaged in improving patient safety and quality of care across a diverse number of programs that cover the full range of pulmonary, allergy, and critical care medicine. Recently, faculty members engaged in an initiative to eliminate race-based outcomes in pulmonary function testing. In addition to projects within the division, faculty serve as leaders for several hospital-based quality and safety initiatives. For example, a new model for the maintenance of asthma across the enterprise

Director, Post-ICU Clinic

Julie Barta, MD

Assistant Professor

Co-Director Lung Cancer Program

Prarthna Chandar, MD

Clinical Assistant Professor Director, Interventional Pulmonology

Christina Chien, MD

Clinical Assistant Professor

Deepak Deshpande, PhD

Professor

Linda Earle, MD

Assistant Professor

Megan Ford, MD

Assistant Professor

Shirley Fung, MD

Clinical Assistant Professor

Gautam George, MD

Assistant Professor

Associate Fellowship Program

Director

Ritu Grewal, MD

Associate Professor

Monica Gupta, MD

Clinical Assistant Professor

Robert Hilton, MD

Clinical Assistant Professor

Jeffrey Hoag, MD

Professor

Director, Cystic Fibrosis

Adult Program

Gregory Kane, MD

Jane & Leonard Korman

Professor of Pulmonary Medicine

Chair, Department of Medicine

was rolled out. The division’s efforts have served to create a Jefferson Health-wide Quality Dashboard focusing of COPD, length of stay, mortality, and other key parameters.

EDUCATION

The Division houses four training programs. The Pulmonary –Critical Care Medicine Fellowship is an accredited 3-year program with 5 fellows per year. The Critical Care Fellowship is a 1-year training program with 1-2 fellows. The Point-of-Care Ultrasound (POCUS) Program is training fellows in this technology and recently expanded to train residents. Finally, the Division Allergy/Immunology Program supports the Allergy-Immunology Fellowship in partnership with Christiana in Delaware. We are extremely proud that our fellows have gone on to further their training in highly specialized areas or into fulfilling careers. The faculty has worked hard to promote education through faculty engagement and the mentorship of trainees. The Division continues to incorporate research into our training and supervise and measure mentorship activities. Members of the Division are heavily involved in the education and mentorship of medical students at the Sidney Kimmel College of Medicine.

The Division also engages in educational activities for the community ranging from patient support group sessions and virtual lectures on several respiratory related topics. Some recurrent sessions include the Annual Lung Cancer Screening Symposium, the Annual Lung Cancer Symposium, and the Annual Pulmonary Fibrosis Update. Finally, the Division participated in an effort to start a new Respiratory Therapy Program with two sites: Denver

and Philadelphia. This program has now recruited trainees and is active.

RESEARCH

Division faculty and trainees collaborate with basic scientists in translational projects, and fellows are taking advantage of this relationship. The Division’s Clinical Trials Program remains strong with over 20-25 clinical trials and registries performed alone or in collaboration with the Jefferson Clinical Research Institute, including studies in pulmonary fibrosis, asthma, pulmonary hypertension, sarcoidosis, critical care, and obstructive airways disease. Basic science projects are exploring factors involved and mechanisms of action related to lung airway, matrix, and fibroblast biology using sophisticated in vitro, ex vivo, and in vivo models including genetically engineered animals.

SELECT PUBLICATIONS

Baig SH, Gorth DJ, Yoo EJ Critical Care Utilization and Outcomes of Interhospital Medical Transfers at Lower Risk of Death. J Intensive Care Med. 2021 Jun 3:8850666211022613. doi: 10.1177/08850666211022613.

Epub ahead of print. PMID: 34080443.

Baig SH, Oxman DA, Yoo EJ. Weekend Admission Does Not Confer an Increased Risk of Mortality in Septic Shock. J Intensive Care Med. 2021 Aug 30:8850666211038549. doi: 10.1177/08850666211038549. PMID: 34459678.

Baig SH, Vaid U, Yoo EJ. The Impact of Chronic Medical Conditions on Mortality in Acute Respiratory Distress Syndrome. Journal of Intensive

Care Medicine. June 2022. doi:10.1177/08850666221108079

David Wyler, MD; Marc C. Torjman, PhD; Ron Leong, MD; Michael Baram, MD; William Denk, MD; Sarah C. Long, MD; Richard J. Gawel, BS; Eugene R. Viscusi, MD; Irving W. Wainer, PhD; Christine Radomski, MS; Scott W. Keith, PhD; Eric S. Schwenk, MD. Observational study of the effect of ketamine infusions on sedation depth, inflammation, and clinical outcomes in mechanically ventilated patients with SARS-CoV2. Anesthesia and Intensive CareAccepted Manuscript ID AIC-230038.R1

Carl B. Shanholtz, Michael L. Terrin, Thelma Harrington, Caleb Chan, Whittney Warren, Robert Walter, Faith Armstrong, Jeffrey Marshall, Rachel Scheraga, Abjihit Duggal, Perry Formanek, Michael Baram Majid Afshar, Nathaniel Marchetti, Sunit Singla, John Reilly, Dan Knox, Nitin Puri, Kevin Chung, Clayton H. Brown, Jeffrey D. Hasday, Design and rationale of the CHILL phase II trial of hypothermia and neuromuscular blockade for acute respiratory distress syndrome. Contemporary Clinical Trials Communications, Volume 33, 2023; 101155, ISSN 2451-8654. PMID: 37228902 https://doi.org/10.1016/j. conctc.2023.101155.

Pradhab Kirupaharan, DO; Cameron Blazoski, BA; Robert Hilton, MD, MEd; Ron Leong, MD; Eric Feduska, DO; Michael Baram, MD. Systemic Inflammatory Response Syndrome After Extracorporeal Membrane Oxygenation Decannulation in COVID-19 Patients. Cureus 15(3): e36436. March 20, 2023. PMID: 37090372 (Curious part of Springer Nature.) doi:10.7759/cureus.36436.

Cameron Blazoski, Pradhab Kirupaharan, Robert Hilton, Ron Leong, Michael Baram. : Outcomes of Extracorporeal

FACULTY

Daniel Kramer, MD

Clinical Assistant Professor Associate Fellowship Program Director

Salvatore Mangione, MD

Associate Professor Director, Physical Diagnosis Course

Christopher McGrath, MD

Clinical Assistant Professor

Jessica Most, MD

Clinical Associate Professor Director, Asthma Program Director, Clinic Operations Co-leader, Quality

Ajay Nayak, PhD

Assistant Professor

David Oxman, MD

Associate Professor Co-Leader, Quality Director, Critical Care Fellowship

Damaris Pena Evertz, MD

Assistant Professor

Raymond Penn, PhD

Professor Director, Center for Translational Research and Pulmonary Research

Tonio Pera, PhD

Assistant Professor

Rafael L. Perez, MD

Professor Director, Sarcoidosis Program

M aria Ramirez, PhD

Associate Professor

Michael Scharf, MD

Clinical Associate Professor Director of Pulmonary Vascular Program

William Sexauer, MD

Clinical Professor

Section Chief and Director, ICU at Methodist Co-Director COPD Program

Ross Summer, MD

Professor Director of ILD Program

Section Chief, TJU Hospital

Urvashi Vaid, MD

Associate Professor Director of Foundations in Clinical Medicine

Marcia Watson, DO

Clinical Assistant Professor Director, Methodist Pulmonary Ambulatory Clinics

Sandra Weibel, MD

Clinical Assistant Professor Director of In-patient Pulmonary Care

Frances Mae West, MD

Associate Professor

Fellowship Program Director Co-Director, Internal Medicine

Point-of-Care Ultrasound Fellowship

Co-Director, JeffPERT: Jefferson Pulmonary Embolism Response Team

Membrane Oxygenation in Immunosuppressed vs. Immunocompetent Patients. Heart and Lung. Volume 58, March–April 2023, Pages 179-184. PMID: 36535131

Neha Gupta, Lisa Settle, Brent R. Brown, Donna L. Armaignac, Michael Baram, Nicholas E. Perkins, Margit Kaufman, Roman R. Melamed, Amy B. Christie, Valerie C. Danesh, Joshua L. Denson, Sreekanth R. Cheruku, Karen Boman,Vikas Bansal, Vishakha K. Kumar, Allan J. Walkey, Juan P. Domecq, Rahul Kashyap, Christopher E. Aston, On behalf of the Society of Critical Care Medicine Discovery Viral Infection and Respiratory Illness Universal Study (VIRUS): COVID-19 Registry Investigator Group. Association of Renin Angiotensin Aldosterone System Inhibitors and Outcomes of Hospitalized Patients With COVID-19. Critical Care Medicine. Crit Care Med 2022 Oct 1;50(10):e744-e758. PMID: 35894609DOI: 10.1097/ CCM.0000000000005627 PMID: 35894609

Valerie Danesh; Leanne M Boehm; Tammy L Eaton; Alejandro C Arroliga; Kirby P Mayer; Shelli R Kesler; Rita N Bakhru; Michael Baram; Amy L Bellinghausen; Neha S Dangayach; Nir M Goldstein; K. Sarah Hoehn; Marjan Islam; Sugeet Jagpal; Annie B Johnson; Sarah E Jolley; Janet A Kloos; Eric J Mahoney; Jason H Maley; Jakob I McSparron; Marissa Mery; Howard Saft; Lekshmi Santhosh; Kristin Schwab; Dario Villalba; Carla M Sevin; Ashley A Montgomery. Characteristics of Post-ICU and Post-COVID Recovery Clinic Services in 29 US Health Systems. Crit Care Explor. 2022 Mar 9;4(3):e0658. doi: 10.1097/ CCE.0000000000000658. eCollection 2022 Mar. PMID: 35291316

Barta, JA. Variation in Adherence to Lung Cancer Screening

Among Vulnerable Populations. CHEST 2022; 161(1):16-17. PMID: 35000700

Daskalakis C, Shimada A, Myers RE, Eastburn K, DiCarlo MA, Shusted CS, Barta JA. Decision Preferences in Shared DecisionMaking for Lung Cancer Screening Among White and African-American Individuals. Annals of the American Thoracic Society 2023; Feb 24. doi: 10.1513/ AnnalsATS.202211-937RL.  PMID 36827233.

Miller R, Castillo R, Castillo E, Jones BL, Miften M, Kavanagh B, Lu B, Werner-Wasik M, Ghassemi N, Lombardo J, Barta J, Grills I, Rusthoven CG, Guerrero T, Vinogradskiy Y. Characterizing Pulmonary Function Test

Changes for Patients with Lung Cancer Treated on a 2-Institution, 4-Dimensional Computed Tomography-Ventilation

Functional Avoidance Prospective Clinical Trial. Advances in Radiation Oncology 2023; 8(2):101133. PMID 36618762.

Huang CY, Mack S, Grenda TR, Barta JA, Till BM, Evans NR, Okusanya O. Race is a Risk Factor for the Deferral of Resection and Radiation for Early-Stage Lung Cancer. Clinical Lung Cancer 2022; doi: 10.1016/j. cllc.2022.07.006. PMID 35989162

Russ D, Barta JA, Evans NR, Stapp RT, Kane GC. Volume

Doubling Time of Carcinoid Tumors Measured by Computed Tomography. Clinical Lung Cancer 2022; Jul 1;S1525-7304(22)001504. doi: 10.1016/j.cllc.2022.06.006. PMID 35922364.

Zhao AO, Barta JA, McIntire R, Shusted C, Zeigler-Johnson C, Juon HS. Racial difference in BMI and lung cancer diagnosis: Analysis of the National Lung Screening Trial. BMC Cancer 2022; 22(1): 797. PMID 35854273.

Shusted CS, Evans NR, Kane GC, Juon HS, Barta JA. Analysis

of Lung Cancer Screening by Race After USPSTF Expansion of Screening Eligibility in 2021. JAMA Network Open 2022; 5(6): e2217578. doi:10.1001/ jamanetworkopen.2022.17578. PMID 35704319.

DiCarlo M, Myer P, Daskalakis C, Shimada A, Hegarty S, ZeiglerJohnson C, Juon HS, Barta J Myers RE. Outreach to Primary Care Patients in Lung Cancer Screening: A Randomized Controlled Trial. Prev Med 2022; PMID 35469777.

Quinn ZL, Barta JA, Johnson JM. Molecular Lung Cancer: How Targeted Therapies and Personalized Medicine are ReDefining Cancer Care. Am J Med Sci 2022; PMID 35469765.

McIntire RK, Lewis E, Zeigler-Johnson C, Shusted C, Barta JA, Juon HS, Keith SW, Klein G. Estimating Eligibility for Lung Cancer Screening by Neighborhood in Philadelphia Using Previous and Current USPSTF Guidelines. Popul Health Manag 2022; 25(2):254-263. PMID 35442796.

Kane GC, Barta JA, Shusted CS, Evans NR. Now Is the Time to Make Screening for Lung Cancer Reportable. Ann Int Med 2022; PMID 35404673.

Majeed A, Ruane B, Shusted CS, Austin M, Mirzozoda K, Pimpinelli M, Vojnika J, Ward L, Sundaram B, Lakhani P, Kane G, Lev Y, Barta JA Frequency of Statin Prescription Among Individuals with Coronary Artery Calcifications Detected Through Lung Cancer Screening. Am J Med Qual 2022; PMID 35302536.

Herskovitz E, Solomides C, Barta J, Evans N, Kane G Detection of Lung Carcinoma Arising From Ground Glass Opacities After 5 Years – A Retrospective Review. Respiratory Medicine 2022; 196:106803. PMID 35305375.

Erika Yoo, MD

Associate Professor Director of TJUH MICUs Director, Critical Care Program FACULTY

NOTABLE

ACHIEVEMENTS

Hospital US News & Report

Ranking TOP 50 RANKING IN PULMONOLOGY & LUNG CANCER (40)

SKMC Dean’s Awards RITU GREWAL, MD

Excellence in Education PRARTHNA C. KULANDAISAMY

Faculty Team Award

ROSS S. SUMMER AND COLLEAGUES IN ILD PROGRAM

2023 Pulmonary & Critical Care Attending of the Year GAUTAM GEORGE, MD

Division Teaching Award SANDRA WEIBLE, MD

Teacher of the Year –Emergency Medicine ROBERT HILTON, MD

Fellow Teacher of the Year VINCE CHAN, MD

Fellow Southern Society for Clinical Investigation ERIKA YOO, MD

2023 ATS William Martin II Distinguished Achievement Award JESSE ROMAN, MD

Pennsylvania Society for Respiratory Care

2022 RESPIRATORY DEPARTMENT OF THE YEAR (TJU HOSPITALS)

2023 Philadelphia MagazineTop Doctors

GREGORY C. KANE, MD

JESSE ROMAN, MD

MICHAEL L. SCHARF, MD

National Posts JESSE ROMAN, MD Treasurer, American Thoracic Society

FY 2023 Symposia

-2ND PULMONARY FIBROSIS

-1ST WORLD ASTHMA DAY

-12TH ANNUAL LUNG CANCER

SYMPOSIUM

-5TH ANNUAL LUNG CANCER SCREENING SUMMIT

Savitch SL, Zheng R, Abdelsattar ZM, Barta JA, Okusanya OT, Evans NR, Grenda TR. Surgical Outcomes in the National Lung Screening Trial Compared to Contemporary Practice. Ann of Thorac Surg 2022; in press. PMID 35007506.

Santoshi, R.K., Chandar, P Gupta, S.S., Kupfer, Y. and Wiesel, O., 2022. From Chest Wall Resection to Medical Management: The Continued Saga of Parapneumonic Effusion Management and Future Directions. Cureus, 14(1).

George G, Kramer D, Summer R Diagnostic unification of UIP is a step back.  Lancet Respir Med. 2023 Jun;11(6):e53. doi: 10.1016/ S2213-2600(23)00132-7. Epub 2023 Apr 7. PMID: 37037208.

Biblowitz K, Menachem B, Malkani K, Perez R, George G, Kulandaisamy P, Yoo E. Unilateral Versus Bilateral Bronchoalveolar Lavage in Interstitial Lung Disease: What Should Be the Standard? Manuscript in press at Respiratory Investigation 2023.

Kramer D, George G, Summer R Moving Senolytics closer to the clinic in IPF. eBioMedicine 2023, Online article in press. https:doi. org/10.1016/j.ebiom.2023.104513

Kazi A, Summer R, Sundaram B, George G. Lung Recovery with prolonged ECMO following fibrotic COVID-19 acute respiratory distress syndrome. Am J Med Sci. 2022 Dec 16: S00029629(22)00492-X. doi: 10.1016/j. amjms.2022.12.008.

Zhao J, Metra B, George G, Roman J, Mallon J, Sundaram B, Li M, Summer R. Mortality among Patients with COVID-19 and Different Interstitial Lung Disease Subtypes: A Multicenter Cohort Study. Ann Am Thorac Soc. 2022 Aug;19(8):1435-1437. doi: 10.1513/AnnalsATS.202202137RL. PMID: 35499867; PMCID: PMC9353962.

Kramer, D, Hilton, R, Roman, J Pulmonary fibrosis and COVID-19. American Journal of Medical Sciences. Am J Med Sci; 4:245251, 2023.

Kirupaharan, P, Blazoski, C, Hilton R, Feduska E, Leong, R, Baram, M. Systemic Inflammatory Response Syndrome After Estracorporeal Membrane Oxygenation Decannulation in COVID-19 Patients. Cureus. Mar 2023, 15(3) e36436.

Blazoski C, Kirupaharan P, Hilton R, Leong R, Baram M. Outcomes of extracorporeal membrane oxygenation in immunosuppressed vs. Immunocompetent patients. Heart Lung. Dec 2022, 17;58:179184.

Hayama M, Maeda Y, Shikina T, Tatehara S, Inokuchi G, Hoag JB, Sato T, Obata S, Nakatani A, Anano Y, Hida E, Nibu KI, Inohara H. Validation of epistaxis severity score for hereditary hemorrhagic telangiectasia in Japan. Auris Nasus Larynx 2022 Jun;49(3): 415-420

Clemson PT, Hoag JB, Cooke WH, Eckberg DL, Stafanovska A. Beyond the baroreflex: A new measure of autonomic regulation based on the timefrequency assessment of variability, phase coherence and couplings. Frontiers in Network Physiology 2022 Jun(2); article 891604:1-18

Kirupaharan P, Kramer D Gandler A, Kenyon L, Summer R 68-year old man with progressive weakness and ventilator dependent respiratory failure: a case report of sporadic late onset nemaline myopathy. BMC Pulm Med. 2022

D’Souza G, Nwagu U, Ghanti R, Estephan L, Barton B, Unsal AR, Rabinowitz M, Rosen M, Nyquist G, Cohn J, Most JF Toskala E. Outcomes of aspirin exacerbated respiratory disease

patients treated with aspirin desensitization and biologics. Int Forum Allergy Rhinol. 2022 Mar;12(3):306-309. Doi: 10.1002/ alr.22900. Epub 2021 Oct 30.

Most JF Features, Factors, and Characteristics of SRBD. In E Olson and K Ramar (Eds) Encyclopedia of Sleep and Circadian Rhythms, 2nd Edition. Burlington, MA: Elsevier. 2022.

Katz-Greenberg G, Malinchoc M, Broyles DL, Oxman D, Hamrahian SM, Maarouf OH. “Urinary Neutrophil Gelatinase-Associated Lipocalin Predicts Intensive Care Unit Admission Diagnosis: A Prospective Cohort Study.” Kidney360. 2022 3(9):1502-1510. PMID: 36245663.

Oxman D. “Who’s really infected anyway? A new tool for retrospectively detecting sepsis in emergency department patients.” Am J Med Sci. 2022 364(2):137138. PMID: 35417679.

Todd JL, Neely ML, Overton R, Mulder H, Roman J, Lasky JA, de Andrade JA, Huang H, Leonard TB, Hesslinger C, Noth I, Belperio J, Flaherty KR, Palmer SM. Association of circulating proteins with death or lung transplantation in patients with idiopathic pulmonary fibrosis in the IPF-PRO Registry cohort. Lung. 2022; 200:11-18. Doi: 10.1007/s00408-021-00505-y.

Rizenthaler JD, Torres-Gonzalez E, Zheng Y, Zelko IN, van Berkel V, Nunley DR, Kidane B, Halayko AJ, Summer R, Watson WH, Roman J. The pro-fibrotic and senescence phenotype of old lung fibroblasts is reversed or ameliorated by genetic and pharmacological manipulation of Slc7a11 expression. Am J Physiol –LCMB, 2022; 322:L449-L461.

Zhao J, Metra B, George G, Roman J, Mallon J, Sundaram B, Li M, Summer R. Mortality among patients with SARS-CoV-2 and different interstitial lung disease

SELECTED GRANTS & CLINICAL TRIALS

RO1HL147088 (NIH/NHLBI)

Early life exposures and chronic lung disease

PI: Roman

RO1HL152703 (NIH/NHLBI)

Targeting latexin signaling for endothelial barrier dysfunction in inflammatory lung injury

MPI: Summer and Sun

SPONSOR: BOEHRINGER INGELHEIM PHARMACEUTICALS INC. THROUGH DUKE UNIVERSITY

ILD-PRO Registry. To valuate ILD progression in real life setting

PI: Roman

SPONSOR: CYSTIC FIBROSIS FOUNDATION THROUGH INDIANA UNIVERSITY

HERO2-OB-21

Home reported outcomes in people with CF taking Trikafta PI: Hoag

SPONSOR: CYSTIC FIBROSIS FOUNDATION THROUGH SETTLE’S CHILDREN’S HOSPITAL OUTREACH-OB-22

Care of cystic fibrosis patients PI: Hoag

SPONSOR: VERACYTE, INC

DHF-009-047 / NIGHTINGALE

Observational study of the utility of Envisia Genomic Classifier PI: Barta

SPONSOR: RENOVION, INC RVN-301

Care of cystic fibrosis patients PI: Hoag

SPONSOR: BOEHRINGER INGELHEIM PHARMACEUTICALS INC. THROUGH DUKE UNIVERSITY

1305-0014 (FIBRONEER) Effects of new intervention in IPF PI: Roman

SPONSOR: BOEHRINGER INGELHEIM PHARMACEUTICALS INC. THROUGH DUKE UNIVERSITY

1305-0023 (FIBRONEER 2)

Effects of new intervention in progressive pulmonary fibrosis PI: Roman

SPONSOR: AEROVATE THERAPEUTICS, INC

IMAHCT-FUL; AV-101-003

Pulmonary hypertension

PI: Scharf

subtypes: a multicenter cohort study. Annals ATS, 19:1435-1437, 2022.

Watson WH, Ritzenthaler JD, Torres-Gonzalez E, Arteel GE, Roman J. Mice lacking a4 nicotinic acetylcholine receptors are protected against alcohol-associated liver injury. Alcoholism: Clin Exp Res, 2022, doi:10.1111/acer.1483.

Greenwell JC, Torres E, Ritzenthaler JD, Roman J Fibroblast-derived conditioned media promotes lung cancer progression. Am J Med Sciences, 365:189-197, 2022.

Peljto AL, Blumhagen RZ, Walts AD, Cardwell J, Powers J, Corte TJ. Roman J.., Schwartz DA. Idiopathic pulmonary fibrosis is associated with common genetic variants and limited rare variants. Am J Respir Crit Care Med. 207:1194-1202, 2023.

Sexauer W, Crawford A, Watson M. Resumption of Pulmonary Rehabilitation after Pandemic Interruption: Patient Attitudes and Characteristics. Journal of Cardiopulmonary Rehabilitation and Prevention. 2022;42:133-134

Hurst M, Stull K, Flemming K, Baumgardner K, Sexauer W, Hoag J. Mechanical Airway Clearance Therapy: A Treatment of the Past? Accepted for presentation at North American Cystic Fibrosis Foundation Conference, Phoenix, AZ, 11/2/23.

Zhang C, Guo ZF, Liu W, Kazama K, Hu L, Sun X, Wang L, Lee H, Lu L, Yang XF, Summer R, Sun J. PIMT is a novel and potent suppressor of endothelial activation Elife 2023 Apr 18;12:e85754. [PMID: 37070640]

Basta MD, Petruk S, Summer R, Rosenbloom J, Wermuth PJ, Macarak E, Levin AV, Mazo A, Walker JL Changes in nascent chromatin structure regulate activation of the pro-fibrotic

transcriptome and myofibroblast emergence in organ fibrosis. iScience 2023 Apr 6;26(5): 106570. [PMID: 37250334].

Ritzenthaler JD, Torres-Gonzalez E, Zheng Y, Zelko IN, Van Berkel V, Nunley DR, Kidane B, Halayko AJ, Summer R, Watson WH, Roman J. The pro-fibrotic and senescence phenotype of old lung fibroblasts is reversed or ameliorated by genetic and pharmacological manipulation of Slc7a11 expression. AJP-Lung 2022 [PMID: 34984918]

Liu G, Summer R., Reclaiming the Balance: Blocking Glutamine Uptake to Restrain Pulmonary Fibrosis. Am J Respir Cell Mol Biol. 2023 Jul 18 [37463521]

George G, Kramer D, Summer R Diagnostic unification of usual interstitial pneumonia is a step back. Lancet Respir Med. 2023 Jun;11(6):e53 [PMID: 37037208 ]

Pradhab Kirupaharan, Daniel Kramer, Alan Gandler, Lawrence Kenyon, Ross Summer. 68-year old man with progressive weakness and ventilator dependent respiratory failure: a case report of sporadic late onset nemaline myopathy BMC Pulm Med  2022 Mar 19;22(1):97 [PMID 35305606].

Ziring D, Powell R, Vaid U, Nord G, L’Etoile N, Herrine S. A Cautionary Tale: Exploring Stakeholder Emotions during Curricular Change using Group Concept Mapping. Accepted for publication in Teaching and Learning in Medicine November 2021. Published Jan 2022.DOI:10. 1080/10401334.2021.2017942

Papanagnou D, Lundgren H, Alcid GA, Watkins KE, Marsick VJ, Vaid U. Informal and Incidental Learning in Complex Clinical Environments: An Examination of Critical Incidents of Frontline Physicians During the COVID-19 Pandemic and Implications for Medical Education. Academic

Medicine Vol. 97, No. 11S, November 2022.

Papanagnou D, Ankan N, Feingold-Link J, Poluch M, Kilpatrick J, Fernandez A, Vaid U, Ziring D. Practical tips for moving your patient panel online. Published online on MedEdPublish Mar 24, 2023. (https://doi.org/10.12688/ mep.19613.1)

Vaid U, Lundgren H, Watkins KE, Ziring D, Alcid GA, Marsick VJ, Papanagnou D. “Making Decisions “in the Dark”: Learning through Uncertainty in Clinical Practice During Covid-19”. Accepted for publication to Academic Emergency Medicine Education and Training.

Watson M et al. Resumption of Pulmonary Rehabilitation after Pandemic Interruption: Patient Attitudes and Characteristics, Journal of Cardiopulmonary Rehabilitation and Prevention in Vol. 42, No. 2, March 2022.

Bodempudi S, Wus L, Kloo J, Zeniecki P, Coromilas J, West FM Lev Y. Improving time to defibrillation following ventricular tachycardia (Vtach) and ventricular fibrillation (Vfib) cardiac arrest: a multicenter retrospective and prospective quality improvement study. Am J Med Qual. 38:73-80, 2023.

Selzer EB, Biblowitz K, Yoo EJ Diaphragmatic eventration and positive pressure ventilation. Am J Resp Crit Care Med. 2022 Aug 1;206(3):347-8. PMID 35584323.

Pandit PN, Mallozzi M, Mohammed R, McDonough G, Treacy T, Zahustecher N, Yoo EJ

A retrospective cohort study of short-stay admissions to the medical intensive care unit: Defining patient characteristics and critical care resource utilization. Int J Crit Illn Inj Sci. 2022;12:127-32. PMID 36506929.

Gandler A, Schulman ES, Yoo EJ Improving asthma outcomes

SELECTED GRANTS & CLINICAL TRIALS

SPONSOR: UNITED THERAPEUTICS CORP RIN-PF-301/TETON Intervention in idiopathic pulmonary fibrosis PI: George

SPONSOR: SEDANA MEDICAL AB INSPIRE-ICU2 PI: Baram

SPONSOR: DOMPE PHARMACEUTICAL SPA REPAVID-22 PI: Baram

SPONSOR: DELFI DIAGNOSTICS, INC. CASCADE-LUNG. Cancer Screening Assay using DELFI; A Clinical Validation Study in Lung PI: Bartaa

SPONSOR: UNITED THERAPEUTICS CORP ADP9811-301; ROR-PH-301

Pulmonary hypertension PI: Scharf

SPONSOR: ASTRAZENECA PHARMACEUTICALS LP (LOGOS) CHRONICLE / D3250R00023. Asthma PI: Most

JANSSEN RESEARCH AND DEVELOPMENT LLC AC-077A301, ADUE

Pulmonary hypertension PI: Scharf

SPONSOR: AEROVATE THERAPEUTICS INC AV-101-002

Pulmonary hypertension PI: Scharf

SPONSOR: HORIZON THERAPEUTICS IRELAND DAC HZNP-HZN-825-303

Idiopathic pulmonary fibrosis PI: Summer

SPONSOR: NIH THROUGH THE UNIVERSITY OF ALABAMA STRIVE – IPF

Management of acute exacerbation of IPF PI: Summer

during pregnancy in underserved communities. Immunology & Allergy Clinics. 2023 Feb;43(1):199208. PMID 36411005.

Morris L, Commins R, Loynd R, Chwiecko B, Hilton R, Yoo EJ, Oxman DA. A new metric to assess the efficiency of the ventilator liberation process. Am J Medical Quality. Accepted.

DIVISION OF RHEUMATOLOGY

In the Division of Rheumatology, faculty, physicians in training, nurse practitioner, nurses and medical assistants are committed to compassionate patient care. Faculty and fellows, participate in educational activities and conduct translational and clinical research.

CLINICAL

The Division of Rheumatology fosters collaborations with the Department of Dermatology, the Wills Eye Institute and the Departments of Neurology and Neurosurgery and the Division of Pulmonary and Critical Care Medicine. Faculty in the Division are dedicated to providing expert inpatient and outpatient consultative care to patients with autoimmune or autoinflammatory syndromes.

The Division’s primary clinical office location is at Walnut Towers, in Center City. The primary satellite location in Bala Cynwyd, complemented by a robust outpatient infusion program, is integrated in a multispecialty practice, supporting clinical collaborations with other disciplines in Medicine.

Dr. Loizidis led the satellite office in Voorhees NJ, matched with the adjacent infusion program, also embedded in Jefferson’s multidisciplinary practice in Voorhees. The practice enjoyed regional recognition and consistently received high recognition by local patients.

Dr. Andres Ponce and Dr. Amanda Nussdorf, established their thriving practice at Jefferson’s Navy Yard location. Dr. Nussdorf provides inpatient consultative rheumatology services at Methodist Hospital.

Dr. Timothy Wilson, recruited in August 2022, has been focusing on research of biomarkers in

rheumatoid arthritis. His clinical practice is dedicated to general rheumatology with a special interest in lung involvement in rheumatoid arthritis. Dr. Andres Ponce, in collaboration with Drs. Sherry Yang and Matthew Keller from the Department of Dermatology, leads the joint Rheumatology-Dermatology clinic, in the Division of Rheumatology, in Center City. Established in 2022, this collaboration has been supported by referring rheumatologists and dermatologists and provides a robust educational opportunity to residents and fellows of participating Departments.

Dr. Park has been steadily leading the multidisciplinary collaboration focusing on inflammatory eye and brain disease in collaboration with faculty from the Departments of Ophthalmology, Neurology and Neurosurgery. Dr. Leung’s expertise beyond the borders of Rheumatology, supported by board certification in Integrative Medicine, resulted in a thriving referral base for interdivisional consultation on the role of nutrition and dietary supplements in managing autoimmune and autoinflammatory disorders.

The specialized clinics on Scleroderma (Dr. Mendoza) and Lupus (Dr. Kiriakidou) attract referrals of challenging cases from the region of Delaware Valley and beyond and support involvement of patients and trainees in clinical research.

Jefferson’s multidisciplinary clinics are highly sought by

patients suffering from complex or orphan diseases.

EDUCATION

The Rheumatology Fellowship Program fosters two trainees per year. The program, supported by faculty dedicated in teaching and mentoring trainees, has been successfully recruiting qualified candidates.

Faculty in the Division teach and mentor medical students, Internal Medicine residents, residents rotating in Women’s Health specialties, and rotating residents from other institutions. The Division is receiving a large volume of rotation requests from international trainees and has been able to accommodate trainees from other countries.

Rotating Internal Medicine residents and medical students are exposed to a broad spectrum of outpatient and inpatient rheumatology consultations and participate in research projects. The Division’s faculty members participate in the Internal Medicine subspecialty lecture series and in the JeffMD curriculum. Dr. Chantel Park is a member of the core team of JeffMD instructors.

RESEARCH

Research activity in the Division includes translational and clinical research and offers the opportunity to fellows, residents, and medical students

FACULTY

Marianthi Kiriakidou, MD

The Magee Professor in Medicine

Associate Professor of Medicine

Division Director

Interim Fellowship Program Director

Fabian Mendoza, MD

Associate Professor of Medicine

Yiu Tak Leung, MD, PhD

Clinical Assistant Professor of Medicine

Giorgos Loizidis, MD

Clinical Assistant Professor of Medicine

Michele Meltzer, MD

Clinical Associate Professor, Adjunct

Amanda Nussdorf, MD

Clinical Assistant Professor

Chantel Park, MD

Clinical Assistant Professor

Andres Ponce, MD

Clinical Assistant Professor Associate Fellowship Program Director

Timothy Wilson, MD Assistant Professor of Medicine

to participate in a variety of scholarly activities.

Quality Improvement - Under the leadership of Dr. Loizidis, the Division established quality improvement goals and metrics, engaging fellows, and faculty. Areas of focus have included disease activity metrics in Lupus and Rheumatoid Arthritis, smoking cessation program in rheumatoid arthritis and osteoporosis prevention in high-risk patients. After Dr. Loizidis’ departure, the division’s quality improvement leadership is in transition.

SELECT PUBLICATIONS

Ultrasound quantitative assessment of ventral finger microvasculopathy in systemic sclerosis with Raynaud's phenomena: a comparative study. Nam K, Mendoza FA , Wessner CE, Allawh TC, Forsberg F.RMD Open. 2023 Feb;9(1):e002954. doi: 10.1136/ rmdopen-2022-002954.PMID: 36787926 Free PMC article.

Nephrogenic systemic fibrosisrelated pulmonary restriction: An under-appreciated manifestation potentially reversible with imatinib therapy Mansour J, Coleman C, Mendoza F, Lammi M, Saketkoo LA. J Scleroderma Relat Disord 2022 Oct;7(3):NP7-NP11. doi: 10.1177/23971983221088213.

Epub 2022 Apr 15.PMID: 36211205 Free PMC article.

Treatment of Severe Swallowing Dysfunction in Systemic Sclerosis with IVIG: Role of Antimuscarinic Antibodies Mendoza FA , DiMarino A, Cohen S, Adkins C, Abdelbaki S, Rattan S, Cao C, DenunaRivera S, Jimenez SA. J Clin Med. 2022 Nov 10;11(22):6665.

doi: 10.3390/jcm11226665. PMID: 36431141 Free PMC article.

Serum antibodies to peptidylarginine deiminase4 in rheumatoid arthritis associated-interstitial lung disease are associated with decreased lung fibrosis and improved survival. Wilson TM, Solomon JJ, Humphries SM, Swigris JJ, Ahmed F, Wang H, Darrah E, Demoruelle MK. Am J Med Sci. 2023 Jun;365(6):480487. doi: 10.1016/j. amjms.2023.03.003. Epub 2023 Mar 12.PMID: 36918112 Free article.

Updates in the diagnosis and management of Takayasu's arteritis. Somashekar A, Leung YT. Postgrad Med. 2023 Jan;135(sup1):14-21. doi: 10.1080/00325481.2022 .2159723. Epub 2023 Jan 2.PMID: 36588528 Review.

Musculoskeletal manifestations of syphilis in adults: secondary syphilis presenting with ankle inflammatory arthritis and bone involvement with calvarial and sternal lesions. What the rheumatologist needs to know Traczuk A, Chetrit DA, Balasubramanya R, Nwaoduah N, Lee JB, Spacek LA, Loizidis G Clin Rheumatol 2023 Apr;42(4):1195-1203. doi: 10.1007/s10067-02206458-8. Epub 2022 Dec 1.PMID: 36454341 Review.

Identification and Prognosis of Patients With Interstitial Pneumonia With Autoimmune Features Jiwrajka N, Loizidis G, Patterson KC, Kreider ME, Johnson CR, Miller WT Jr, Barbosa EJM Jr, Patel N, Beers MF, Litzky LA, George MD, Porteous MK. J Clin Rheumatol. 2022 Aug 1;28(5):257-264. doi: 10.1097/ RHU.0000000000001847. Epub

2022 Jun 11.PMID: 35697042

IgG4-related Disease With Destructive Nasal Bone Involvement Leading to Saddle Nose Deformity Loizidis G, Rabinowitz MR, Tuluc M. J Rheumatol. 2022 Jul;49(7):748-749. doi: 10.3899/ jrheum.200621. Epub 2022 Apr 15.PMID: 35428727 No abstract available

NOTABLE ACHIEVEMENTS

2018, 2019, 2020, 2021, 2022, 2023

Philadelphia Magazine Top Doctors

MARIANTHI KIRIAKIDOU, MD

2018, 2019, 2020, 2021, 2022, 2023

Castle Connolly Top Doctors

MARIANTHI KIRIAKIDOU, MD

2018, 2019, 2020, 2021, 2022, 2023

Exceptional Women In Medicine

MARIANTHI KIRIAKIDOU, MD

CENTER FOR TR ANSLATIONAL MEDICINE

FY 2023 represents the 10th year the Center for Translational Medicine has been under Dr. Penn’s leadership. Since 2013, the Center for Translational Medicine has grown from seven faculty in which six out of seven were in cardiovascular research, to seventeen faculty in which six are in cardiovascular, seven in pulmonary, one in musculoskeletal, one in HIV immunology, one in neurodegenerative disease, and one in bladder research. Since 2013, the Center for Translational Medicine has increased (total) funding from ~2.2 to 9.3 million dollars per year.

FACULTY

Raymond Penn, PhD

Robley Dunglison Professor of Pulmonary Research

Director, Center for Translational Medicine

Director, Pulmonary Research, Jane and Leonard Korman Lung Center

Tung Chan, PhD

Research Assistant Professor

Seo-Hee Cho, PhD

Associate Professor

Jason Choi, PhD

Assistant Professor

Deepak Deshpande, PhD

Professor

Boopathi Ettickan, PhD

Research Assistant Professor

Jarin Hongpaisan, DVM, PhD

Research Assistant Professor

Ajay Nayak, PhD

Assistant Professor

Tonio Pera, PhD

Assistant Professor

Khadija Rafiq, PhD

Assistant Professor

Maria Ramirez, PhD

Associate Professor

Pawan Sharma, PhD

Assistant Professorr

Shey-Shing Sheu, PhD

William Wikoff Smith Professor in Cardiovascular Research

Ross Summer, MD

Professor

Jianxin Sun, PhD

Professor

Mudit Tyagi, PhD

Associate Professor

During FY 2023, there were no changes in faculty composition.

Most research and educational opportunities remain the same in the Center for Translational Medicine since the last report. Since the development of the new medical school curriculum, opportunities for teaching of medical school students have been limited, although teaching in the new Integrative Physiology graduate school programs has increased.

Bin Wang, PhD

Associate Professor

EDUCATION

Dr. Deshpande and Dr. Ramirez teach in the SKMC JeffMD program. Drs. Penn, Pera, Wang, Rafiq, Choi, Sharma, Ettickan, Hongpaisan, Tyagi and Chan teach multiple classes in different graduate programs. Drs. Penn, Deshpande, Pera, Nayak, Choi, Sharma, and Chan are founding faculty in the Integrative Physiology graduate program and will be directing courses and lecturing in the coming year.

Due to our research success, we continue to attract excellent graduate students and Postdoctoral Fellows. We currently have 7 graduate students and 11 Post-doctoral Fellows. We are confident that this robust graduate and post-graduate training will continue. Moreover, our faculty members are actively participating in our school’s teaching for medical and graduate students.

In summary, we continued to succeed, each year in a progressive manner, in achieving our goals in research and education mission. After a significant loss of CTM faculty in the egress to Temple that occurred in 2012, our existing faculty members and new recruits have worked diligently to conduct innovative research and produce high impact scientific discoveries. It is our goal to further build the Center for Translational Medicine in the coming years to maintain and enhance our international reputation as leaders in translational research.

SELECT PUBLICATIONS

Tompkins E, Mimic B, CuevasMora K, Schorsch H, Shah SD, Deshpande DA, Benovic JL, Penn RB, Pera T. Am J Respir Cell Mol Biol. 2022 Aug 9. doi: 10.1165/rcmb.2021-0320OC.

PD 102807 Induces M3 mAChR-

dependent GRK-/arrestin-biased Signaling in Airway Smooth Muscle Cells Am J Respir Cell Mol Biol. 2022 Aug 9. doi: 10.1165/rcmb.2021-0320OC

Shah SD, Hernandez-Lara M, Yadav SK, Penn RB, and Deshpande DA. Functionselective targeting of ERK1/2 mitigates multiple pathological features of asthma in mice Am J Respir Cell Mol Biol 2022 in press

Ahn K, Penn RB, Rattan S, Panettieri RA Jr, Voight BF, and An SS. Mendelian Randomization Analysis Reveals a Complex Genetic Interplay Among Atopic Dermatitis, Asthma, and GERD.  A m J Respir Crit Care Med 2022 Oct 10.doi: 10.1164/ rccm.202205-0951OC

Shah S,, Lind C, De Pascali F, Penn RB, MacKerell AD, Deshpande DA. In silico identification of a b2adrenoceptor allosteric site that selectively augments canonical b2 AR-Gs signaling and function. Proc Natl Acad Sci U S A. 2022 Dec 6; 119(49):e2214024119.

An entosis-like process induces mitotic disruption in Pals1 microcephaly pathogenesis.

(1) Sterling NA, Park JY, Park R, Cho S.-H. and Kim S. An entosislike process induces mitotic disruption in Pals1 microcephaly pathogenesis. Nat Commun (2023) Jan 5;14(1):82.

Nahar, A., and Cho, S.-H.* Current perspectives in Leber congenital amaurosis type 8 mouse modeling (2022) Dev. Dyn. Jul;251(7):1094-1106.

Shah SD, Nayak AP, Sharma P, Villalba DR, Addya S, Huang W, Shapiro P, Kane M, Deshpande DA. Targeted inhibition of select extracellular signal-regulated kinases 1 and 2 functions mitigates pathological features of asthma in mice. Am J Respir Cell Mol Biol. 2023 Jan;68(1):23-38.

Deshpande DA, Penn RB. A cryptic mode of GPCR regulation revealed. Trends in Mol Med 2022 Nov;28(11):900-901.

Hernandez-Lara MA, Yadav SK, Shah SD, Okumura M, Yokoyama Y, Penn RB, Kambayashi T, Deshpande DA. Regulation of airway smooth muscle cell proliferation by diacylglycerol kinase: Relevance to airway remodeling in asthma. Int J Mol Sci. 2022 Oct 6;23(19):11868.

Singh B, Yokoyama Y, Tanaka Y, Hung L, Herbert D, Behrens E, Deshpande DA, Kambayashi T. Diacylglycerol kinase zeta deficiency attenuates papain-induced type 2 airway inflammation. Leukocyte Biology (Manuscript under revision).

Hernandez-Lara MA, Yadav SK, Shah SD, Conaway Jr. S, Penn RB Deshpande DA. Crosstalk between diacylglycerol kinase and protein kinase A in regulating airway smooth muscle cell proliferation. Manuscript to be submitted to AJP Lung

Richard J, Shah SD, HernandezLara MA, Penn RB, Vadigepalli R, Deshpande DA. Deciphering the role of diacylglycerol kinase in Gq signaling using computational approaches. Manuscript to be submitted.

Conaway Jr. S, Shah SD, Huang W, Kane M, Penn, RB, Deshpande DA Phosphoproteomics analysis of bitter taste receptor signaling in airway smooth muscle relaxation. Manuscript under preparation for submission to JBC

Boopathi E*, Den RB, Thangavel C*. Innate Immune System in the Context of Radiation Therapy for Cancer. Cancers (Basel), 2023, Aug 4; 15 (15): 3972. *Corresponding authors.

Boopathi E*, Birbe R, Shoyele SA, Den RB, Thangavel C*. Bone Health Management in the Continuum of Prostate

NOTABLE ACHIEVEMENTS

AJAY NAYAK, PHD

Professional appointments: Chair – Allergic Fungal Respiratory Diseases Committee, American Academy of Allergy, Asthma and Immunology.

ROSS SUMMER, MD

Completed 4 year tenure as member of NIH Study Section Appointed Pulmonary Fibrosis Foundation Care Center Network Steering Committee Appointed Pulmonary Fibrosis Foundation Site Selection Committee.

BIN WANG, PHD

NIH study sections of SBSR (June 2023), SBDD (February 2023), and SBSR (July 2022).

Cancer Disease. Cancers (Basel), 2022, Sep 2; 14 (17):4305. *Corresponding authors.

Saunders, J., Sikder, K., Phillips, E., Ishwar, A., Mothy, D., Margulies, K.B., and Choi, J.C. Med25 Limits Master Regulators That Govern Adipogenesis. Int J Mol Sci. Mar 24;24(7):6155. (2023). PMCID: PMC10093881

HIV Promotes Neurocognitive Impairment by Damaging the Hippocampal Microvessels. Sharma AL, Wang H, Zhang Z, Millien G, Tyagi M, Hongpaisan J Mol Neurobiol. 2022 Aug;59(8):4966-4986. doi: 10.1007/s12035-02202890-8. Epub 2022 Jun 4.PMID: 35665894.

Anxiolytics for Bronchodilation: Refinements to GABA A Agonists for Asthma Relief. Nayak AP, An SS. Am J Respir Cell Mol Biol. 2022 Oct;67(4):419-420. doi: 10.1165/rcmb.2022-0287ED. PMID: 35901197

Cannabis-related allergies: An international overview and consensus recommendations. Skypala IJ, Jeimy S, Brucker H, Nayak AP, Decuyper II, Bernstein JA, Connors L, Kanani A, Klimek L, Lo SCR, Murphy KR, Nanda A, Poole JA, Walusiak-Skorupa J, Sussman G, Zeiger JS, Goodman RE, Ellis AK, Silvers WS, Ebo DG; International Cannabis Allergy Collaboration. Allergy. 2022 Jul;77(7):2038-2052. doi: 10.1111/ all.15237. Epub 2022 Feb 14. PMID: 35102560

A review of cannabis allergy in the early days of legalization. Toscano A, Ebo DG, Abbas K, Brucker H, Decuyper II, Naimi D, Nanda A, Nayak AP Skypala IJ, Sussman G, Zeiger JS, Silvers WS; International Cannabis Allergy Collaboration. Ann Allergy Asthma Immunol 2023 Mar;130(3):288-295. doi: 10.1016/j.anai.2022.10.016. Epub 2022 Oct 27. PMID: 36384984

Immunomodulatory Actions of Cannabinoids: Clinical Correlates and Therapeutic Opportunities for Allergic Inflammation. Nayak AP, Loblundo C, Bielory L. J

Allergy Clin Immunol Pract. 2023 Feb;11(2):449-457. doi: 10.1016/j. jaip.2022.10.009. Epub 2022 Oct 22. PMID: 36280137

Impact of cannabis knowledge and attitudes on real-world practice. Zeiger JS, Silvers WS, Naimi DR, Skypala IJ, Ellis AK, Connors L, Jeimy S, Nayak AP, Bernstein JA, Zeiger RS; International Allergist Canna KAP Consortium. Ann Allergy Asthma Immunol. 2022 Oct;129(4):441450. doi: 10.1016/j. anai.2022.04.021. Epub 2022 Apr 25. PMID: 35472594

Relevance of lipid transfer protein to Cannabis sensitization in North America. Morelli HP, Thorpe C, Ebo DG, Chapman MD, Abbas K, Sussman GL, Nayak AP J

Allergy Clin Immunol Prac t. 2023 Oct;11(10):3248-3249. doi: 10.1016/j.jaip.2023.06.039. Epub 2023 Jun 28. PMID: 37391020

Epicutaneous Sensitization to the PhytocannabinoidCaryophyllene Induces Pruritic Inflammation. Inan S, Ward SJ, Baltazar CT, Peruggia GA, Javed E, Nayak AP Int J Mol Sci 2023 Sep 20;24(18):14328. doi: 10.3390/ijms241814328. PMID: 37762646

Proteomics-Based Approach for Detailing the Allergenic Profile of Cannabis Chemotypes. Loblundo C, Severa J, Peruggia GA, Black KR, Chandra S, Lata H, ElSohly M, Chapman MD, Deshpande DA, Nayak AP Int J Mol Sci. 2023 Sep 11;24(18):13964. doi: 10.3390/ ijms241813964. PMID: 37762267

Identification of a β-arrestinbiased negative allosteric modulator for the β2-adrenergic receptor. Ippolito M, De Pascali F, Hopfinger N, Komolov KE, Laurinavichyute D, Reddy

PAN, Sakkal LA, Rajkowski KZ, Nayak AP, Lee J, Lee J, Cao G, Donover PS, Reichman M, An SS, Salvino JM, Penn RB Armen RS, Scott CP, Benovic JL. Proc Natl Acad Sci U S A. 2023 Aug;120(31):e2302668120. doi: 10.1073/pnas.2302668120. Epub 2023 Jul 25. PMID: 37490535

Pro-Relaxant EP Receptors Functionally Partition to Different Pro-Contractile Receptors in Airway Smooth Muscle. Nayak AP, Javed E, Villalba DR, Wang Y, Morelli HP, Shah SD, Kim N, Ostrom RS, Panettieri RA Jr, An SS, Tang DD, Penn RB Am J Respir Cell Mol Biol. 2023 Jul 31. doi: 10.1165/rcmb.20220445OC. Online ahead of print.

PMID: 37523713

PD 102807 Induces M3 mAChRDependent GRK-/Arrestin-Biased Signaling in Airway Smooth Muscle Cells. Tompkins E, Mimic B, Cuevas-Mora K, Schorsch H, Shah SD, Deshpande DA Benovic JL, Penn RB, Pera T. Am J Respir Cell Mol Biol. 2022 Nov;67(5):550-561. doi: 10.1165/ rcmb.2021-0320OC. PMID: 35944139

Panda SR, Chaudhari VB, Ahmed S, Kwatra M, Jala A, Ponneganti S, Pawar SD, Borkar RM, Sharma P, Naidu VGM. Ambient particulate matter (PM(2.5)) exposure contributes to neurodegeneration through the microbiome-gut-brain axis: Therapeutic role of melatonin. Environ Toxicol Pharmacol. 2023 Aug;101:104183. PMID: 37321333.

Saha P, Jain S, Mukherjee I, Panda SR, Zeki AA, Naidu VGM,  Sharma P. The Effects of Dual IQOS and Cigarette Smoke Exposure on Airway Epithelial Cells: Implications for Lung Health and Respiratory Disease Pathogenesis. ERJ Open Res. 2023 May 30;9(3):005582022. PMID: 37260462; PMCID: PMC10227640.

NEW GRANTS

DEEPAK DESHPANDE, PHD R61 HL168723 (Deshpande, MPI) 06/15/2023-05/31/2025

“Optimizing function-selective ERK1/2 inhibitors for reducing AP-1-mediated airway.”

NIH/NHLB $150,000/YR DIRECT, $234,000/YR TOTAL

SHEY-SHING SHEU, PHD R01 HL164941 (Sheu, MPI) 04/01/2023-03/31/2027

“Crosstalk Ca2+ Signaling between Ryanodine Receptors Type 1 and 2 in the Pathogenesis of Cardiac Hypertrophy and Heart Failure”

NIH/NHLB $480,240/YR DIRECT, $582,440/YR TOTAL

Jain S, Saha P, Syamprasad NP, Panda SR, Rajdev B, Jannu AK, Sharma P*, Naidu VGM*. Targeting TLR4/3 using chlorogenic acid ameliorates

LPS+POLY I:C-induced acute respiratory distress syndrome via alleviating oxidative stress-mediated NLRP3/ NF- κB axis. Clin Sci (Lond). 2023,137 (10): 785–805. PMID: 36951146 (*equal senior and cocorresponding authors).

Saha P, Durugkar S, Jain S, Shantanu PA, Panda SR, Jala A, Gokhale S, Sharma P*, Naidu VGM*. Piperine Attenuates Cigarette SmokeInduced Oxidative Stress, Lung Inflammation, and Epithelial–Mesenchymal Transition by Modulating the SIRT1/Nrf2 Axis. Int J Mol Sci. 2022, Nov 25;23(23), 14722; PMID: 36499047; PMCID: PMC9740588 (*equal senior and co-corresponding authors).

Shah SD, Nayak AP, Sharma P, Villalba DR, Addya S, Huang W, Shapiro P, Kane MA, Deshpande DA. Targeted Inhibition of Select ERK1/2 Functions Mitigates Pathological Features of Asthma in Mice. Am J Respir Cell Mol Biol. 2023 Jan;68(1):23-38. PMID: 36067041; PMCID: PMC9817918. Klionsky DJ. Diversity, equity, and inclusion in autophagy research. Autophagy. 2022 Dec;18(12):2765-2768. PMID: 36369701; PMCID: PMC9673949.

Chatterjee A, Saha R, Mishra A, Shilkar D, Jayaprakash V, Sharma P, Sarkar B. Molecular determinants, clinical manifestations, and effects of immunization on cardiovascular health during COVID-19 pandemic era-A review. Curr Probl Cardiol. 2023 Aug;48(8). PMID: 35577079; PMCID: PMC9098920.

Wang P, Xu S, Xu J, Xin Y, Lu Y, Zhang H, Zhou B, Xu H, Sheu SS, Tian R, Wang W. Elevated

MCU Expression by CaMKIIĸB Limits Pathological Cardiac Remodeling. Circulation 145(14):1067-1083, 2022.

Bou-Teen D, Fernandez-Sanz C, Miro-Casas E, Nichtova Z, Bonzon-Kulichenko E, Casós K, Inserte J, Rodriguez-Sinovas A, Benito B, Sheu SS, Vázquez J, Ferreira-González I, RuizMeana M. Defective dimerization of FoF1-ATP synthase secondary to glycation favors mitochondrial energy deficiency in cardiomyocytes during aging. Aging Cell. 21(3): e13564, 2022.

Yoon Y, Lee H, Federico M, Sheu SS. Non-conventional mitochondrial permeability. transition: Its regulation by mitochondrial dynamics. Biochim Biophys Acta Bioenerg 2023. Jan 1;1864(1):148914.

Nichtová Z, Fernandez-Sanz C, De La Fuente S, Yuan Y, Hurst S, Lanvermann S, Tsai HY, Weaver D, Baggett A, Thompson C, Bouchet-Marquis C, Várnai P, Seifert EL, Dorn GW 2nd, Sheu SS*, Csordás G. Enhanced Mitochondria-SR Tethering Triggers Adaptive Cardiac Muscle Remodeling. Circ Res. 2023. May 26;132(11):e171-e187. (*cocorresponding author).

Bernardi P, Gerle C, Halestrap AP, Jonas EA, Karch J, Mnatsakanyan N, Pavlov E, Sheu SS*, Soukas AA. Identity, structure, and function of the mitochondrial permeability transition pore: controversies, consensus, recent advances, and future directions. Cell Death Differ 30, 1869–1885 (2023). (*corresponding author: Sheu SS, alphabetical order authorship).

Eyenga P, Rey B, Eyenga L, Sheu SS. Regulation of Oxidative Phosphorylation of Liver

Mitochondria in Sepsis. Cells 11(10):1598, 2022.

Lu Y, Sun Y, Xu K, Shao Y, Saaoud F, Snyder NW, Yang L, Yu J, Wu S, Hu W, Sun J, Wang H,

Yang X. Editorial: Endothelial cells as innate immune cells. Front Immunol. 2022 Oct 4:13:1035497.

Cai X, Jiang Y, Cao Z, Zhang M, Kong N, Yu L, Tang Y, Kong S, Deng W, Wang H, Sun J, Ding L, Jiang R, Sun H, Yan G. Mst1mediated phosphorylation of Nur77 improves the endometrial receptivity in human and mice. EBioMedicine. 2023;88:104433

Zhang G, Qin Q, Zhang C, Sun X, Kazama K, Yi B, Cheng F, Guo ZF, Sun J. NDRG1 signaling is essential for multiple aspects of endothelial inflammation and vascular remodeling. Circ Res 2023;132(3):306-319

Zhang C, Guo Z, Yi B, Kazama K, Liu W, Sun X, Lu L, Wang L, Yang XF, Summer R, Sun J. PIMT is a novel and potent suppressor of endothelial activation. Elife. 2023 Apr 18;12:e85754

Zhu N, Yi B, Kazama K, Yao HJ, Yang R, Qin YW, Guo Z, Sun J Epigenetic regulation of vascular smooth muscle cell phenotypic switch and neointimal formation by protein arginine methlytranseferase 5. Cardiovasc Res. 2023 Jul 24:cvad110

Joseph Hokello, Priya Tyagi, Shelly Dimri, Adhikarimayum Lakhikumar Sharma, and Mudit Tyagi. Comparison of the Biological basis for non-HIV Transmission to HIV-Exposed Seronegative Individuals, Disease non-progression in HIV Long-term Non-Progressors and Elite Controllers. Viruses 2023, Viruses 2023, 15(6), 1362; PMID: 37376660 PMCID: PMC10301403 DOI: 10.3390/v15061362.

Adhikarimayum Lakhikumar Sharma, Dylan Shafer, Daniel Netting, Mudit Tyagi. Cocaine sensitizes the CD4+ T-cells for HIV infection by co-stimulating NFAT and AP-1. Science 25, 105651, December 22, 2022, DOI: 10.1016/j.isci.2022.105651,

PMCID: PMC9722482, PMID: 36483012.

Adhikarimayum Lakhikumar Sharma, Huaixing Wang, Zongxiu Zhang, Guetchyn Millien, Mudit Tyagi, Jarin Hongpaisan. HIV Promotes Neurocognitive Impairment by Damaging the Hippocampal Microvessels. Mol Neurobiol. 2022 Jun 4. doi: 10.1007/s12035-022-02890-8. PMID: 35665894.

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Sonti S, Sharma AL, Tyagi M. HIV-1 persistence in the CNS: Mechanisms of latency, pathogenesis and an update on eradication strategies. Virus Res. 2021 Oct 2;303:198523. doi: 10.1016/j. virusres.2021.198523. Epub 2021 Jul 24. Review. PubMed PMID: 34314771.

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Sharma AL, Hokello J, Tyagi M. Circumcision as an Intervening Strategy against HIV Acquisition in the Male Genital Tract. Pathogens. 2021 Jun 25;10(7). doi: 10.3390/ pathogens10070806. Review. PubMed PMID: 34201976; PubMed Central PMCID: PMC8308621.

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PEER REVIEWED BOOK CHAPTERS

Sharma P, Conaway S Jr, Deshpande D. Bitter Taste Receptors in the Airway Cells Functions

Handb Exp Pharmacol. 2022; 275:203-227. PMID: 33604702.

GR ADUATE MEDICAL EDUCATION PROGR AMS IN INTERNAL MEDICINE

The Department of Medicine is poised to train both academic and practice leaders for the new millennium through advanced clinical training and active mentorship provided by an outstanding clinical and research faculty. Currently, the Department trains 129 residents and over 50 subspecialty fellows. The program has as its focus outstanding clinical training, but there is particular emphasis on training future clinician educators, clinical researchers, physicianscientists, as well as practicing physicians for the community.

MISSION STATEMENT

Our mission is to provide excellent training in Internal Medicine for physicians planning careers in General Internal Medicine practice, careers in Academic Medicine, or further training in a Medical Subspecialty. Our graduates shall possess clinical skills and knowledge, professional attitudes and behaviors, humanistic qualities, and a commitment to lifelong learning that is characteristic of the highest caliber Internist and Medical Specialist.

GOALS

• To train superior Internists for the 21st century.

• To assist our trainees in their transition to practice, fellowship, or further education.

• To serve as an educational leader – promoting high quality, innovative approaches to training in Internal Medicine.

• To serve our patients, the Jefferson community, and the citizens of Philadelphia and the surrounding region with competent and compassionate healthcare.

• To ensure quality care through measurement, advocacy,

advances in systems of care, and excellence.

• To educate the students who rotate through the Department providing a sound fundamental experience in Internal Medicine.

RESIDENCY - OVERVIEW AND RECRUITMENT

The Internal Medicine Residency Program at Thomas Jefferson University Hospital has as its core mission superior training in Internal Medicine. It is our intent that each resident will acquire the requisite clinical skills and medical knowledge, professional attitudes and behaviors, approach to problem solving, and concern for their patients that is characteristic of the Internist. We recognize that our graduates will be providing medical care in the local community and across the country for the first half of the 21st Century. As a result our goals include developing sound approaches to educating future Internists, emphasizing excellence, and dedication to the patients whom we serve.

The majority of the resident’s experience occurs at Thomas Jefferson University Hospital. It is here that each resident has the opportunity to work with our nationally recognized faculty in the

inpatient and outpatient arenas, nursing homes, and develop continuity care skills in the Jefferson Hospital Ambulatory Practice or Jefferson Internal Medicine Associates Practice. Selected rotations at affiliated hospitals broaden the resident’s experience beyond tertiary care. Residents have the opportunity to develop skills in research, and for those interested in research careers, the option to spend elective time in the laboratory of a faculty preceptor. As an academic program, the interns and residents not only learn via excellent teaching but also learn to become teachers themselves. Through informal discussions and a formal teaching skills seminar, our residents develop proficiency as educators to further enhance their preparation for academic medicine or clinical practice, where education of patients and families is a major goal. Furthermore, we have a dedicated medical education pathway with more robust instruction and opportunity for those interested in becoming clinical educators. Additionally, we have pathways within the residency for Hospital Medicine, Health System Science, and Disability Care which allow our residents to focus their training if they wish. The success of our program has been reflected in the remarkable increase in interest in the program that has developed over the last decade.

FACULTY

Christopher Henry, MD

Program Director, Internal Medicine Residency

Dianna Cheney-Peters, MD

Sub-Internship Course Director

Christie Crawford, MD

Associate Program Director

Rebecca Davis, MD

Associate Program Director for Primary Care Residency

Gretchen Diemer, MD

Vice Chair for Education

Associate Dean for GME and Affiliations

Director, Internal Medicine

Residency Education Elective

Timothy Kuchera, MD

Associate Program Director

Course Director, Hospitalist

Medicine Elective

Albert Lee, MD

Associate Program Director

Jason Ojeda, MD

Associate Program Director

Primary Care Track Program Director

Barbara Simon, MD

Associate Program Director

Jennifer Valentine, MD

Associate Program Director

JeffMD: Phase 3 Medicine

Pathway Director

Alexis Wickersham, MD

Associate Program Director

Jillian Zavodnick, MD

Associate Program Director Clerkship Director

APPLICANT STATISTICS

Combined Categorical/Preliminary Applicants

MATCH RESULTS: RANKED & MATCHED APPLICANTS

FELLOWSHIPS

The Department sponsors ACGME approved fellowships in all the subspecialties in Medicine providing for the demand for subspecialists in both academic and practice environments.

STUDENT PROGRAMS

Dr. Jillian Zavodnick acts as the Clerkship Director for Internal Medicine. The medicine clerkship lasts 8 weeks, and shares a 12-week block with the neurology clerkship. Internal Medicine didactics run throughout the 12-week block and are attended by students on neurology as well as internal medicine. The medicine clerkship consists of two four-week rotations, one at the central Thomas Jefferson University Hospital campus and one at an affiliate site. These rotations are completed on general medicine and subspecialty services. At the end of the rotation, students are assessed by their clinical supervisors using an evaluation of clinical performance; with an Observed Structured Clinical Encounter which emphasizes information-gathering, data synthesis, differential-building and patient communication; and with a shelf exam. With a robust clinical curriculum, students learn to evaluate patients with a broad array of medical problems and develop clinical reasoning skills that will be beneficial to their development as physicians, regardless of their career path. Moreover, students encounter positive role models who reinforce the professional values that internists hold as vital to the practice of medicine.

Dr. Dianna Cheney-Peters leads the Sub-Internship program as the Director.

MAJOR INITIATIVES INVOLVING THE TEACHING PROGRAM

and block rotation settings. The majority of residents are assigned to the JHAP or JIMA offices. JHAP is a Level 2 patient centered medical home (PCMH) that cares for mostly an underserved population. JIMA is a Level 3 PCMH which is also home to the Jefferson Internal Medicine Faculty Practice. Both JHAP and JIMA have a strong relationship with the Jefferson School of Pharmacy, ensuring an inter-professional approach to the management of patients with diabetes, anticoagulation and complex medication regimen management.

The Women’s Health clinic is another ambulatory training site for our residents led by Dr. Shailaja Nair and Dr. Elizabeth Boyle. This is a multidisciplinary site that seeks to educate residents in providing comprehensive care to women by highlighting sex and gender differences in disease presentation. They focus on the needs of women spanning the life cycle from adolescence to the geriatric years and includes training in reproductive and nonreproductive health, wellness and prevention, as well as illness and disease. A track is currently in development with both clinical and research faculty at Thomas Jefferson University committed to ensuring that residents are trained to provide optimal care for female patients using an integrated and multidisciplinary approach, while following Evidence Based Medicine guidelines.

residents in these subspecialty clinics to provide better structure, autonomy and education for the residents. Over the course of three years, residents will rotate through these same clinics multiple times, building a strong outpatient skillset across the medical subspecialties and a rapport working with subspecialist faculty repeatedly and directly and in doing so, also present an opportunity for mentorship. This model not only increases resident access to outpatient experiences, education and mentorship, but it also translates into a more robust outpatient education assuring great competency and success as future internists

PERSONALIZED CAREER PATHWAYS

An individualized approach to IM education in the new millennium.

AMBULATORY TRAINING

Jefferson continues to distinguish itself through outstanding ambulatory training in continuity

Recognizing that superior Internists also have a strong foundation in medical issues common to subspecialties, we have allocated more time for our residents in the outpatient subspecialty setting apart from their varied elective time. This change has placed a significant focus on outpatient education with a scheduling system that allocates patients directly for the

Our residents receive excellent training and broad exposure to the many facets of internal medicine during the first two years, becoming well versed in the core of internal medicine. Residents are given elective time in the first and second year to try different specialties and establish career preferences. Instead of dictating the content of the third year, we allow 14 weeks of elective time to target areas that will be most useful to each individual in pursuit of his or her career choice. In addition we offer unique curricular experiences in medical education, physical diagnosis, writing skills, research, and quality care that prepare the trainee for the challenges that lie ahead. The size of our program gives us the needed flexibility to offer this benefit. The wide variety of electives and our willingness to entertain unique ideas are other highlights of this program.

There are 7 areas that are recognized as the most common

career choices of our residents, but the design of our personalized career pathway allows for additional choices. The recognized areas include:

• Hospital Medicine

• Subspecialty Fellowship

• Primary Care Program

• Medical Education and Leadership

• Masters or Certificate in Clinical Investigation

• Disability Care

• Health Systems Science

Each track has a dedicated track coordinator who is available for mentoring and guidance throughout a resident’s career planning.

HOSPITAL MEDICINE CAREER PATHWAY

Dr. Timothy Kuchera oversees the direction of the formal hospital medicine pathway.  The Hospital Medicine Career Pathway is intended to provide practical experience and didactic instruction relevant to a career in hospital medicine. Residents in the program participate in elective rotations, receive instruction in relevant nonclinical topics, and engage in scholarship focused on inpatient care. Participants also have access to career planning resources and personalized guidance and mentorship. By fulfilling the requirements of the pathway, participants will: experience multiple practice environments within hospital medicine; develop the knowledge and skills necessary to be an excellent hospitalist; build nonclinical experience that will enhance their understanding of hospital medicine and prepare them to take advantage of leadership opportunities; and find a job in hospital medicine that is

aligned with their interests and goals. Requirements include 12 weeks of core clinical experiences, 12 weeks of clinical electives (including 6 weeks of hospital medicine-specific electives), a formal project, and completion of a non-clinical curriculum. In FY23, 6 residents completed the pathway and graduated with distinction in Hospital Medicine.

SUBSPECIALIST PATHWAY PROGRAM

Dr. Christopher Henry and Dr. Barbara Simon are working with residents to increase both access and meaningful mentorship for those residents interested in pursuing subspecialty fellowship. With a schedule that allocates 50% of resident clinical time in the outpatient setting, residents are being exposed to a greater volume and variety of subspecialties (see section I. Major Initiatives Involving the Teaching Program, Ambulatory Training). Aside from increasing their participation in both inpatient and now outpatient subspecialty patient care, residents are also exposed to a wider breadth of faculty mentors.

This includes Core Faculty members of the program, from which we have selected at least one member representing each medical subspecialty. These faculty additionally advise, mentor and coach residents as well as supporting and overseeing residents in scholarly works and building their subspecialty applications.

For interested residents, we have established a pathway comprised of suggested goals to achieve with each year of training to prepare them for a successful match in the fellowship of their choice. This pathway and mentorship includes more robust clinical training, added exposure for more confident career selection, increased opportunities for

research and scholarship and easier access to program leadership for guidance and support in fellowship application preparation. Additionally, several meetings are held throughout the year to provide guidance in anticipation of the fellowship application and interview season, including personalized review of applications, CVs, personal statements and interview preparation (including virtual formats).

PRIMARY CARE PROGRAM

The Jefferson primary care track was established in 2014 to help those with an interest in general internal medicine become better prepared to pursue primary care careers after residency. The mission of the program is to train superb clinicians who are dedicated to advancing the field of outpatient general internal medicine through patient care, education, advocacy, and research. The primary care program is predicated on the principles of community, mentorship, and curricular innovation.

To that end, residents within the program across all three years (Intern-Senior) rotate on ambulatory blocks together and have shared didactic experiences, which consist of lectures, workshops, and training sessions to ensure that each resident is able to deliver high quality, complete care to a varied population and develop the tools to understand and thrive in a changing healthcare system. Residents in the program benefit from early and frequent ambulatory time to build a strong panel of patients in a Level 3 PCMH and develop generalist mentors. To ensure residents are well prepared for a variety of practice settings after graduation, they also have a second longitudinal clinic experience in a federally qualified

health center or practice setting of the residents’ choosing.

MEDICAL EDUCATION AND PROGRAM LEADERSHIP PATHWAY

This pathway includes participation in the medical education elective in addition to 20 observed teaching hours and biannual meetings with education mentors in addition to their required core presentations during residency. The elective operates as a series of structured teaching sessions as well core seminars coordinated by Program Leadership featuring topics such as learning theory, bedside teaching, teaching groups, professionalism and diagnostic clinical reasoning. Residents spend the bulk of their time in the active process of teaching and preparing lessons for medical students and interns. Residents also spend time learning how to prepare and deliver effective feedback and evaluation and then practicing these skills with the use of standardized patients. In FY22, 18 residents graduated with distinction in medical education.

MASTERS OR CERTIFICATE IN CLINICAL INVESTIGATION

This pathway is available for those residents interested in a career involving clinical or translational research. Thomas Jefferson University offers a Masters in Human Investigation for clinicians who are interested in a career in human investigation or conducting clinical trials. This program requires a multi-year commitment and applicants should make their interest known in the second year of training, typically after acceptance into a fellowship program. Candidates participate in a conference and lecture series concurrent with their residency and fellowship training schedule and are required to finish a clinical research project

to receive this degree. Candidates in this program are from a broad spectrum of medical disciplines and have completed projects from basic molecular bench research to exclusively clinical projects. For additional information please visit: http:// www.jefferson.edu/university/ biomedical-sciences/degreesprograms/master-programs/ clinical-research-MS.html

DISABILITY CARE TRAINING PATHWAY

Beginning in the FY22 year, Dr. Michael Stillman in conjunction with Dr. Emily Stewart and Dr. Jason Ojeda fulfilled an educational need by creating this new pathway.

The disability care concentration was developed in an effort to give select residents knowledge of and expertise in the care of individuals with a variety of disabilities.  A narrow literature shows that small minorities of medical students and residents receive disabilityspecific education.  And, in a study conducted by SKMC faculty members in 2019, very few internal medicine and family medicine residents at programs across the Northeast felt comfortable comanaging common secondary conditions associated with disabilities or in identifying their patients' needs for home and community-based therapies and services.  In response to this educational dearth, residents in this first-of-its-kind concentration will rotate through inpatient rehabilitation services, through a variety of outpatient clinics in which individuals with intellectual and development, neurological, and mobility disabilities seek care, and with a Philadelphiabased home care organization, learning about transitions of care and community-based services.  They will also complete an on-line asynchronous certificate program in life care planning, preparing

them to anticipate the care needs of individuals with disabilities across their entire lives.

We expect that residents who complete this concentration will be positioned to lead educational and quality improvement efforts in their future workplaces.

HEALTH SYSTEMS SCIENCE PATHWAY

Dr. Sonia Bharel is the Director of the Health Systems Science (HSS) Distinction Pathway. This specialized pathway was formed with the goals of preparing a cohort of clinicians to lead innovative change within complex health systems, advancing health outcomes for vulnerable patient populations, and fostering career development within the domains of health systems science (health care delivery, health equity, value-based care, population/ public health, health advocacy, health policy and economics, clinical informatics, quality improvement, and patient safety). Requirements of the pathway include attending 70% of scheduled HSS didactics, completing 90% of scheduled pre-didactic modules, integrating HSS concepts in personal clinical teaching conferences to be reviewed for feedback, providing systems-based practice conferences, and completing a longitudinal clinical HSS project. Successful participation provides participants with various scholarship opportunities, directed educational experiences, 1:1 HSS coaching/ mentorship with a matched faculty member, and skills to lead as change agents within micro and macro health systems.

BEDSIDE TEACHING

Bedside teaching continues to be a major focus in the program and is an expectation for faculty

on teaching attending rounds. Our emphasis on bedside rounds continues, with particular focus on physical diagnosis and patient communication.

CONFERENCES AND CURRICULUM

We have a comprehensive series of lectures aligned with several curricula to prepare a wellrounded future internist. Our inpatient curriculum is largely comprised of traditional morning reports and noon conferences delivered by Jefferson residents, fellows and faculty. This is supplemented with our grand rounds series that features more nationally-renowned speakers on current or controversial topics in medicine. Additionally, we now offer a majority of these conferences virtually, so we can extend our audience to include learners across all our inpatient and outpatient sites. This has garnered increased attendance and participation.

We have separately created an intern lecture series, a session on "Teaching Residents to Teach", an ICU curriculum, a POCUS curriculum, and an ambulatory curriculum focusing on outpatientbased medicine topics. For the latter series, we have allocated a half day of lectures per week during their ambulatory rotation. This dedicated time away from any service obligations demonstrates to our residents the value we place on their education above all else. We also have started two new initiatives in order to ensure our curriculum is more dimensional than just encompassing core medical knowledge. Recent additions within the past 3 years include the recognition and discussion of diversity, equity and inclusion throughout our curriculum. We also incorporated health systems sciences as a mandatory objective in a number of our conference series. This year

we initiated a POCUS curriculum which is a comprehensive and multi-faceted approach incorporating teaching, simulation, and patient application to teach objectives of image acquisition, image interpretation, and clinical application.

All residents participate in a Quality Improvement and Patient Safety curriculum which is woven in throughout their training. Within the first six months of intern year, all PGY1s participate in a real-time safety event analysis with faculty facilitation and interprofessional collaboration, findings of which are presented to the Hospital Medicine Peer Review Committee. This learning experience engages residents early in their training and sets a strong foundation for continued safety involvement throughout their career. All residents participate in a foundations of quality improvement during their intern year which provides them improvement strategies and tools which they apply towards a longitudinal quality improvement project during their PGY2 year. Resident groups present their projects at our annual Health Equity and Quality Improvement Summit each spring. Many residents go on to conduct their own quality improvement projects and present safety event cases at our departmental MM&I conference highlighting their ongoing engagement in quality and safety.

To supplement our robust curriculum, we have implemented a number of adjunctive strategies for improved knowledge and educational support. We have an active curriculum committee comprised of residents with some faculty mentorship and supervision. This is to ensure that residents continue to find our curriculum relevant, appropriate and engaging. We have personalized boards preparation

strategy and troubleshooting for those residents who are struggling or seek out additional support with one of our associate program directors. We also provide our PGY2 residents with a year subscription to NEJM Knowledge+. This is a comprehensive question-based Boards preparation tool that offers both personalized and programmatic features. For the program, we can track learning objectives and corresponding performance, which help inform curriculum and lectures to address program-wide deficits. For the residents' benefit, we can also assign quizzes and the question bank links to additional content for added learning (NEJM Resident360). Lastly, this program offers "metacognition" so that it can assess not only accuracy of knowledge, but also appropriateness of an individual's confidence with each learning objective.

DIFFICULT DISCUSSION EDUCATION

Beginning in FY23, Dr. Gina Keiffer took over the Direction of this program designed to assess and refine the Interns’ communication skills in challenging scenarios through an OSCE for talking to patients/ families at the End of Life. The program consists of standardized patient interactions requiring each intern to deliver bad news and discuss goals of care.  The interns then receive individual, direct verbal feedback with the attending. The interns also participate in a small-group discussion with the session moderators and their peers wherein strategies for having difficult conversations are discussed. The overall goals of this experience are to promote professionalism, enhance communication skills and bedside manner, and teach

shared decision making with patients and their loved ones, all with empathy, compassion, and proficiency.

RESULTS OF THE INTERNAL MEDICINE BOARD EXAMINATION 2022

We previously reported our success for our residents taking the Internal Medicine Certification Exam in 2022.  Test takers included 36 senior residents.

Results include:

• 2022 exam: 100% Pass Rate 36 of 36

• Our three year pass rate is 99.1% 112 of 113

THE JEFFERSON MEDICAL FORUM

Inaugurated in 1999, our resident edited journal of scholarly work has become part of the tradition of excellence within the Department of Medicine. This year’s issue –our 24th edition- continues the tradition of quality and diversity that has come to characterize the journal. Planning is already underway for the year ahead. The publication has been generously supported by our faculty and graduates.

MEDICAL SIMULATION TRAINING

For over 16 years, we have conducted a program of ACLS skill preparation for our interns and new PGY2 residents. Initially, utilizing a cardiac monitor and CPR mannequins, the exercises tested resident’s abilities to recognize and respond to cardiac arrhythmias appropriately.

In 2000, the Medical College invested in a medical simulator which we have utilized to better prepare interns to advance their

rapid response and ACLS skills, as well as enhance their leadership roles in leading the team during high intensity clinical scenarios. Residents are also led through procedure simulation at the beginning of their PGY1 year as well as a refresher prior to starting PGY2. We now utilize the simulation center for additional training and exposure in the clinical application of POCUS.

TEACHING RESIDENTS TO TEACH

This year we continued our annual Teaching Residents to Teach course. It is a day-long retreat for PGY1 residents focused exclusively on topics related to being an educator and leader. Through this course and our continued emphasis on education, our Department has been recognized for its positive impact on student education.

WORK HOURS

The program closely monitors work hours and the work load carried by our residents. Reductions of inpatient team caps from 14 to 12 have improved the workload, allowing the residents to manage increasingly complex patient populations while still focusing on education, including high value care, bedside teaching and patient safety.

WELLNESS

In our residency program, we have a robust residentled Wellness Committee focusing on improving resident well-being. This Committee meets monthly to discuss initiatives identified by residents as common sources of frustrations in their days, brainstorm actionable ideas for improvement, and engage residents to in meaningful ways to enhance their well-being.

We host programing throughout the year for our residents, including several work-day sessions to best promote work-life balance. In FY23, we hosted several stressrelief events to promote wellbeing and social connection. We continued to ensure the personal well-being for our residents, including a robust sick-call pull system and offering Opt-Out Wellness check-in for all our residents at times throughout perceived with increase stress amongst our residents. Residents can meet with a licensed health professional to discuss current state of mental health, coping strategies, and be connected with ongoing services as interested. To highlight the culture of well-being we strive to emulate, many of our residents have been nominated or selected for our departmental I.M. Thankful Recognition Program and continue to be active nominators of their colleagues. New in FY23, we held a resident “Listening Session” to help uncover systems causes of frustration for residents and brainstorm ideas for improvement within the scope of the residency to impact change. We look forward to implementing quick wins in the residency’s scope of influence and advocating for resident wellbeing as needed at higher levels.

CONTRIBUTING TO THE STATE OF THE ART OF EDUCATION IN INTERNAL MEDICINE

The program leadership has continued to build its reputation through contributions to the peer reviewed literature (Academic Medicine, Seminars in Medical Practice, Academic Medicine, and the American Journal of Medicine), presentations at national

meetings (APDIM), contributions to programs and activities of the American College of Physicians (Resident Research Judging, participating in promotional brochures and videos), presentations and contributions to national medical subspecialty societies and delivering numerous invited lectures.

HIGHLIGHTS OF THE DEPARTMENT'S EDUCATIONAL PERFORMANCE

• An ABIM rolling 3 –year Pass Rate of 97.3% for the core Residency.

• Primary Care Track Board Pass Rate 100%.

• Ongoing increases in applications from US seniors over the last 8 years.

• A 4+2 block schedule and a trickle admission system ensure superior education over service obligations by mitigating work compression, increasing outpatient exposure and adding dedicated time to education and wellness.

• We have identified our top 25 Teachers and promote their recognition throughout the medical college and hospital.

• The professional educational staff (program directors and clerkship directors) are regularly presenting their work at national meetings or in the peer reviewed literature.

CONCLUSIONS

In summary, the Residency Training program is achieving its goal of training superior Internists for the 21st Century. Our focus remains upon developing and extending our traditions of excellence. A strong residency program enhances the mission of the entire Department by enhancing the quality of patient care and advancing the education of our students.

Our fellowships offer stateof-the-art clinical training and research opportunities for highly competitive residents from Jefferson and top programs across the country. The Center for Translational Medicine now offers many opportunities for Fellows from any discipline to gain cutting edge research experience.

Benefiting from the foundations described above our students also gain core competence in the approach to a variety of clinical problems and preparation for careers in a variety of specialties.

THOMAS JEFFERSON UNIVERSITY HOSPITAL

DEPARTMENT OF MEDICINE HOUSE STAFF: 2023-2024 INTERNS

PGY-1'S (CATEGORICAL)

Taha Awan, MD

Alicia Bao, MD

Hayley Barker, MD

Susanna Betti, MD

Tatianna Branch, DO

Emily Chiacchiaro, MD

Jonathan Colon Sanchez, MD

Andre Cunningham, DO

Emily Custer, DO

Michael DiMarino, MD

Daniel Elchediak, MD

Katherine Freedberg, MD*

Ryan Gardner, MD

Marina Gonzalez, MD

Virginia Gonzalez, MD

Yassamin Jamshidian, MD*

Kevan Josloff, MD, MPH

Mark Kilpatrick, MD

Natasa Kostic, MD

Tendal Marume, MD

Haley McCann, MD*

Kenneth Meserole, MD

Daniel Moylan, MD

Jason Ni, MD

Zachary Pany, MD

Avish Patel, MD

Edwin Perez, MD

Tran Phung, MD*

Benjamin Richter, MD

Douglas Russ, MD

Trishya Srinivasan, MD

Bertilla Tavarez, MD, MS

Tammy Tran, MD, MBA

Devin Vasoya, MD, MBA

Bethanne Venkatesan, MD

Ananya Venkatesh, MD

Mark Yorker, MD

NEUROLOGY INTERNS

Katherine Beard, MD

Sahil Chawla, MD

Caroline Donahue, MD

Kathleen Graveran-Perez, MD

Taylor Haddad, MD

*PC – Primary Care Program

MEDICAL SCHOOL

Cooper Medical School of Rowan University

Ohio State University College of Medicine

Western Michigan University Homer Stryker MD SOM

Rutgers New Jersey Medical School

Lake Erie College of Osteopathic Medicine

Cooper Medical School of Rowan University

Ponce Health Sciences University School of Medicine

Philadelphia College of Osteopathic Medicine

Philadelphia College of Osteopathic Medicine

Sidney Kimmel Medical College at Thomas Jefferson University

Lewis Katz School of Medicine at Temple University

Tufts University School of Medicine

Rutgers Robert Wood Johnson Medical School-Piscataway

Pennsylvania State University College of Medicine

Lewis Katz School of Medicine at Temple University

Sidney Kimmel Medical College at Thomas Jefferson University

Sidney Kimmel Medical College at Thomas Jefferson University

Virginia Commonwealth University School of Medicine

University of California, Irvine School of Medicine

University of Medicine and Health Sciences –St. Kitts

Georgetown University School of Medicine

New York University Long Island School of Medicine

Sidney Kimmel Medical College at Thomas Jefferson University

Albert Einstein College of Medicine

Sidney Kimmel Medical College at Thomas Jefferson University

Cooper Medicine School of Rowan University

Lewis Katz School of Medicine at Temple University

Eastern Virginia Medical School

Indiana University School of Medicine

Sidney Kimmel Medical College at Thomas Jefferson University

Wayne State University School of Medicine

State Univ. of New York Downstate Medical Center College of Medicine

University of California, Irvine School of Medicine

Rutgers New Jersey Medical School

Sidney Kimmel Medical College at Thomas Jefferson University

Virginia Commonwealth University School of Medicine

Cooper Medical School of Rowan University

OPHTHALMOLOGY PRELIMS

Helen Hernandez, MD

Regina Kurapova, MD

Rebecca Mayeda, MD

Gabrielle Mendez, MD

Kevin Thomas, MD, MPH

Ugochi Aguwa, MD

Henry Blair, MD, MBA

Martin Calotti, MD

Tiffany Cheng, MD

Mak Djulbegovic, MD

Sandy Samuel, MD

Charlotte Shields, MD

Turner Wibbelsman, MD

THOMAS JEFFERSON UNIVERSITY HOSPITAL

DEPARTMENT OF MEDICINE HOUSE STAFF: 2022-2023 CAREER PLANS

GRADUATING CHIEF RESIDENTS FUTURE PLANS

Tina Boortalary, MD

Raashi Mamtani, DO

Justin Robbins, MD

Svenja Schneider, MD

Gastroenterology- Thomas Jefferson University Hospital

Endocrinology-Hospital of the University of Pennsylvania

Gastroenterology-Thomas Jefferson University Hospital

Cardiology- Thomas Jefferson University Hospital

GRADUATING PRIMARY CARE RESIDENTS FUTURE PLANS

Carissa Cicchinelli, MD

Catherine Gong, MD

Margaret Szot, MD

Primary Care - Thomas Jefferson University

Primary Care-A Plus Primary Care

Primary Care-Weill Cornell Medicine Primary Care

GRADUATING CATEGORICAL RESIDENTS FUTURE PLANS

Carmine Ballarano, MD

Christian Cardillo, MD

Kashyap Chauhan, MD

Benjamin Claxton, MD

Dora Cobrinik, MD

Matthew DeMeglio, DO

Michael Dong, MD

Ryan Erwin, MD

Danielle Fitzpatrick, MD

Madison Force, MD

Brenda French, MD

Timur Ganapolsky, MD

Nicholas Gordon, MD

Jonathan Huang, MD

Jaya Janadhyala, MD

Grant Jirka, MD

Joey Junarta, MD

Abdul Kazi, MD

Kirpal Kochar, MD

Lauren Lally, MD

James Lee, MD

Connor McLaughlin, MD

Shuji Mitsuhashi, MD

Andrea Molin, MD

Sahaj Mujumdar, MD

Gillian Naro, MD

Nicholas Noverati, MD

Tara Rakiewicz, MD

Vinay Rao, MD

Sean Reilly, MD

Max Ruge, MD

Christa Smaltz, MD

Sameep Thapa, MD

Chantel Venkataraman, MD

Tamar Wolinksky, MD

Hospitalist-Brigham and Women’s Hospital

Pulmonary/Critical Care-Temple University Hospital

Transplant Hepatology – Beth Israel Lahey Health

Chief Medical Resident (1 yr.) Pulmonary/Critical Care

Endocrinology, Tufts Medical Center

Cardiology-Rush University Medical Center

Chief Medical Resident (1 yr.) Pulmonary/Critical Care

Gastroenterology-Albert Einstein Medical Center

Primary Care-Temple University Hospital

Gastroenterology- Thomas Jefferson University Hospital

Gastroenterology-Rutgers Robert Wood Johnson

Primary Care-Private Practice

Pulmonary/Critical Care-NYU Grossman School of Medicine

Hospitalist-Duke Regional Hospital

Cardiology-Cooper University Hospital

Hematology/Oncology-University of Southern California

Cardiology-NYU Grossman School of Medicine

Pulmonary/Critical Care- Thomas Jefferson University Hospital

Cardiology-North Shore University Hospital/Long Island Jewish Medical Center

Gastroenterology-Rutgers Robert Wood Johnson

MICU Hospitalist-Penn Presbyterian Medical Center

Hospitalist-Morristown Medical Center

Gastroenterology-Mayo Clinic

Infectious Disease-Temple University Hospital

Gastroenterology-University of Rochester

Hospitalist-Hospital of the University of Pennsylvania

Gastroenterology- Thomas Jefferson University Hospital

Hematology/Oncology- Thomas Jefferson University Hospital

Gastroenterology-George Washington University Hospital

Hematology/Oncology- Thomas Jefferson University Hospital

Cardiology-Cooper University Hospital

Gastroenterology-Temple University Hospital

Hematology/Oncology- Thomas Jefferson University Hospital

Chief Medical Resident (1 yr.), Hospital Medicine

Chief Medical Resident (1 yr.), Endocrinology

TOP 25

TEA C HERS AS RATED BY RESIDENTS* 2022-2023

Lily Ackerman, MD

Rene Alvarez, MD

Sonia Bharel, MD

Joseph Boselli, MD

Cuckoo Choudhary, MD

Jesse Civan, MD

Jillian Cooper, MD

Gretchen Diemer, MD

Hannah Ellingsen, MD

Lori Frank, MD

Rachel Grosso, MD

Christopher Henry, MD

Robert Hilton, MD

Gina Keiffer, MD

Barbara Knight, MD

Albert Lee, MD

Stephanie Moleski, MD

Evan Nardone, MD

Indranee Rajapreyar, MD

David Sass, MD

Barbara Simon, MD

Susan West, MD

Lindsay Wilde, MD

Lim Wong, MD

Erika Woo, MD

*Requires a minimum of 5 evaluations in the electronic rating database

UNDERGRADUATE MEDICAL EDUCATION

MISSION STATEMENT

The mission of the Department of Medicine for undergraduate medical education is to provide the students of Sidney Kimmel Medical College with a high quality educational experience. Specific facets of this mission include the enhancement of knowledge and the development of the clinical skills of the medical student, the promotion of outstanding professional behaviors and humanistic attributes and the support of altruistic activities. This mission spans the four years of the Sidney Kimmel Medical College curriculum, is directed by the faculty, and supported by the residents of the Department of Medicine.

The Office of Undergraduate Medical Education spearheads this mission by planning and implementing the individual educational experiences, by supporting the faculty and residents who deliver these educational activities, and finally by analyzing the educational outcomes and students’ perceptions of these experiences to ensure continual improvement in these programs.

DEPARTMENT PROGRAMS

MEDICINE 350: INTERNAL MEDICINE CLERKSHIP

Jillian Zavodnick, MD Director

Hannah Morgan, MAT Coordinator

The Internal Medicine clerkship is structured to allow student exposure to a diverse mix of internal medicine patients on inpatient services. Students spend four weeks of clinical experience at Thomas Jefferson University Hospital, and four weeks at one of our excellent affiliated institutions.

In addition to the clinical experiences on the wards,

students participate in a curriculum, which consists of small group sessions, brief lectures, and hands-on workshops and which teaches the diagnosis and treatment of common internal medicine diagnoses; the approach to common presentations and abnormal lab values; core skills like electrocardiogram and chest X-ray interpretation; and clinical reasoning. There is also a session in which students practice arterial puncture and venipuncture. An evidence-based medicine project reinforces the essential skills of performing a literature search to answer clinical questions that arise in the context of daily care of patients. Students are assessed by their clinical evaluators as well as for their evidence-based medicine project, via the NBME subject exam, and via an OSCE. The threestation OSCE assesses information gathering, data interpretation, differential building, recognition of emergencies, basic management, and patient communication.

For the 2023-2024 academic year Faculty that serve as Clerkship Site Directors are:

Abington Hospital: Delani DeLiana, MD

Atlantic Health/Moorestown: Rebecca Griffith, MD

Rafael Pajaro, MD

Albert Einstein Medical Center: Eduardo Antonio, MD

Bay Health: Zohaib Ghatala, MD

Haneef Khwaja, MD

Christiana Hospital: Matthew Burday, DO

Lankenau Hospital: Lia Desposito, DO

Methodist Hospital: Jennifer Procopio, MD

York Hospital: Daniel Fischman, MD

The learning objectives of the clerkship are:

• Obtain a history and perform a physical exam that is comprehensive for new patients and appropriately targeted for follow-up patients

• Determine appropriate diagnostic testing

• Understand the significance of normal and abnormal symptoms, findings, and test results in the context of a patient’s condition

• Develop an assessment of a patient’s primary reason for hospitalization using information from the history, physical, and tests

• Formulate a prioritized problem list, including a differential diagnosis and plan

• Develop oral presentations and written notes that present patient data clearly and concisely while describing clinical reasoning

• Maintain professionalism in demeanor, behavior, and dress at all times

• Communicate effectively and sensitively with patients, families, hospital staff, and medical team members

• Work as an effective and reliable member of a healthcare team

• Construct a useful clinical question and use the medical literature to guide clinical practice

• Use feedback and selfreflection to identify next steps in development; use self-directed study and deliberate practice to progress

EDUCATION APPENDIX

• Gain exposure to the broad variety of career opportunities in Internal Medicine

This academic year, the changes in this course have included:

• Increased in-person didactic offerings at affiliate sites

• Continued faculty development around assessment among affiliate site directors

• Addition of guidance for self-directed learning on weekends, in response to student feedback about the learning value of weekend time

MEDICINE 401: THE INPATIENT SUB-INTERNSHIP IN INTERNAL MEDICINE

Dianna Cheney-Peters, MD Director

Shannon Aubin, ABA Coordinator

This year, 234 senior students chose a Sub-Internship in Internal Medicine to fulfill their requirement for a fourth-year inpatient clerkship. One hundred and forty-eight of those students elected to rotate at Thomas Jefferson University Hospital for this experience and 86 at the affiliates.  In addition to the experiential learning the students partake in, there are formal didactic sessions dedicated to clinical problem solving, advanced decision-making and practical management considerations.

The learning objectives of this sub-internship include:

• Recognizing sick vs. non-sick patients – The development of the clinical acumen to distinguish patients requiring urgent or emergent management

• Knowing when to ask for assistance – The recognition of one’s limitations and ability to effectively request specialty/subspecialty consultation

• Managing time wisely –The application of time management skills to the work required for the care of a medical inpatient and to effectively organize and prioritize a daily patient care task list

• Communicating effectively with patients and families

– The application of interpersonal and communication skills when interacting with patients and their families

This academic year, the changes in this course have included:

• No major changes

MEDICINE 403 – 499: ELECTIVES IN INTERNAL MEDICINE

Jennifer Valentine, MD, and Selected Faculty

Shannon Aubin, ABA Coordinator

The Department of Medicine sponsored twenty-five electives in multiple sub-specialty areas. In the 2022-2023 academic year 516 elective spots were taken at Jefferson and 150 spots at the affiliated hospitals. We had 16 students do away rotations at other institutions. We had four international students complete rotations for credit in the Department of Medicine, and six international observers.

The educational goals of these electives include::

• The acquisition of advanced knowledge and clinical skills relevant to the care of the patient in a selected discipline in internal medicine.

• The advanced application of clinical reasoning skills acquired in the core ambulatory and inpatient clerkships of the third year of the curriculum.

• The development of a new skill set relevant to the activity of a consultant physician.

• The intensive exposure of the student to a small cadre of faculty with a resultant enhanced ability for faculty role modeling.

CAREER COUNSELING AND DEVELOPMENT

In the residency match of March 2023, 44 students matched into three-year residencies in Internal Medicine, and five into medicine-pediatrics combined residencies. It is critical that the Office of Educational Programs coordinates the career counseling for this sizable portion of the class, 18.6% - each of these students meets with a faculty advisor (Drs. Dianna Cheney-Peters, Lim Wong, or Jillian Zavodnick), who supports them throughout the application season. Additionally, each of the members of this student group requires a summary “Department Letter” for their residency application. For the 2022-2023 academic year, the Department furnished 59 letters for students applying for residencies in Internal Medicine – this includes students applying for combined residencies in internal medicine and pediatrics, as well as several who applied to medicine in addition to other specialties (such as orthopedic surgery or surgery), and 54 for those applying for Preliminary Residencies (these letters were written by Dr. Jennifer Valentine). We continue to use the APDIM/CDIM template for this letter.

FACULTY

The faculty with administrative roles within the Undergraduate Medical Education activities of the Department of Medicine are listed individually under their respective areas of supervision above.

Department of Medicine

College Building, Room 822

1025 Walnut Street

Philadelphia, PA 19107