Browsing by Author "Smith, Jessica"

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    Evaluating the Implementation of Virtual Reality to Improve the Quality of Life of Individuals with Dementia
    (2023-05) Long, Ryane; Sego, Daniel; Department of Occupational Therapy, School of Health and Human Sciences; Smith, Jessica
    Falls are the leading cause of morbidity and disability in the geriatric population. Although falls and fall-related injuries are highly prevalent, they are preventable. Through research, virtual reality has been identified as a promising tool used in cognitive and physical assessments and therapeutic interventions. The goal of the capstone project was to gain clinical knowledge and hands-on experience related to program development and the implementation of novel therapeutic technology, consisting of virtual reality (VR) during therapy treatment sessions. Additionally, the student analyzed and addressed cultural and economical facility specific barriers to the implementation of facility-wide programming with the goal of decreasing falls and improving the quality of life of the residents with cognitive deficits. Although the product quality and logistical barriers observed limited the use of MyndVR as a clinical tool, the project results found the use of virtual reality with the geriatric population to have positive outcomes. The capstone student led an in-service where the project findings were presented and the therapists were educated on other virtual reality devices and important features offered on more established systems. Additionally, a quick-start guide was created to increase the competence and confidence of staff members while operating the MyndVR system. The therapists at Heritage Pointe were receptive to the information presented and the resource created based on the increased confidence demonstrated through the survey results.
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    Impact of Lung Parenchymal-Only Failure on Overall Survival in Early-Stage Lung Cancer Patients Treated With Stereotactic Ablative Radiotherapy
    (Elsevier, 2021) Elbanna, May; Shiue, Kevin; Edwards, Donna; Cerra-Franco, Alberto; Agrawal, Namita; Hinton, Jason; Mereniuk, Todd; Huang, Christina; Ryan, Joshua L.; Smith, Jessica; Aaron, Vasantha D.; Burney, Heather; Zang, Yong; Holmes, Jordan; Langer, Mark; Zellars, Richard; Lautenschlaeger, Tim; Radiation Oncology, School of Medicine
    Introduction: The impact of lung parenchymal-only failure on patient survival after stereotactic ablative body radiotherapy (SABR) for early-stage non-small-cell lung cancer (NSCLC) remains unclear. Patients and methods: The study population included 481 patients with early-stage NSCLC who were treated with 3- to 5-fraction SABR between 2000 and 2016. The primary study objective was to assess the impact of out-of-field lung parenchymal-only failure (OLPF) on overall survival (OS). Results: At a median follow-up of 5.9 years, the median OS was 2.7 years for all patients. Patients with OLPF did not have a significantly different OS compared to patients without failure (P = .0952, median OS 4.1 years with failure vs. 2.6 years never failure). Analysis in a 1:1 propensity score-matched cohort for Karnofsky performance status, comorbidity score, and smoking status showed no differences in OS between patients without failure and those with OLPF (P = .8). In subgroup analyses exploring the impact of time of failure on OS, patients with OLPF 6 months or more after diagnosis did not have significantly different OS compared to those without failure, when accounting for immortal time bias (P = .3, median OS 4.3 years vs. 3.5 years never failure). Only 7 patients in our data set experienced failure within 6 months of treatment, of which only 4 were confirmed to be true failures; therefore, limited data are available in our cohort on the impact of OLPF for ≤ 6 months on OS. Conclusion: OLPF after SABR for early-stage NSCLC does not appear to adversely affect OS, especially if occurring at least 6 months after SABR. More studies are needed to understand if OLPF within 6 months of SABR is associated with adverse OS. These data are useful when discussing prognosis of lung parenchymal failures after initial SABR.
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    National Psoriasis Foundation COVID-19 Task Force Guidance for Management of Psoriatic Disease During the Pandemic: Version 1
    (Elsevier, 2020) Gelfand, Joel M.; Armstrong, April W.; Bell, Stacie; Anesi, George L.; Blauvelt, Andrew; Calabrese, Cassandra; Dommasch, Erica D.; Feldman, Steve R.; Gladman, Dafna; Kircik, Leon; Lebwohl, Mark; Lo Re, Vincent, III; Martin, George; Merola, Joseph F.; Scher, Jose U.; Schwartzman, Sergio; Treat, James R.; Van Voorhees, Abby S.; Ellebrecht, Christoph T.; Fenner, Justine; Ocon, Anthony; Syed, Maha N.; Weinstein, Erica J.; Smith, Jessica; Gondo, George; Heydon, Sue; Koons, Samantha; Ritchlin, Christopher T.; Medicine, School of Medicine
    Objective To provide guidance about management of psoriatic disease during the coronavirus disease 2019 (COVID-19) pandemic. Study design A task force (TF) of 18 physician voting members with expertise in dermatology, rheumatology, epidemiology, infectious diseases, and critical care was convened. The TF was supplemented by nonvoting members, which included fellows and National Psoriasis Foundation (NPF) staff. Clinical questions relevant to the psoriatic disease community were informed by questions received by the NPF. A Delphi process was conducted. Results The TF approved 22 guidance statements. The average of the votes was within the category of agreement for all statements. All guidance statements proposed were recommended, 9 with high consensus and 13 with moderate consensus. Limitations The evidence behind many guidance statements is limited in quality. Conclusion These statements provide guidance for the management of patients with psoriatic disease on topics ranging from how the disease and its treatments impact COVID-19 risk and outcome, how medical care can be optimized during the pandemic, what patients should do to lower their risk of getting infected with severe acute respiratory syndrome coronavirus 2 and what they should do if they develop COVID-19. The guidance is intended to be a living document that will be updated by the TF as data emerge.
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    Swine Model of Biofilm Infection and Invisible Wounds
    (MyJove Corporation, 2023-06-16) El Masry, Mohamed; Bhasme, Pramod; Mathew-Steiner, Shomita S.; Smith, Jessica; Smeenge, Thomas; Roy, Sashwati; Sen, Chandan K.; Surgery, School of Medicine
    Biofilm infection is a major contributor to wound chronicity. The establishment of clinically relevant experimental wound biofilm infection requires the involvement of the host immune system. Iterative changes in the host and pathogen during the formation of such clinically relevant biofilm can only occur in vivo. The swine wound model is recognized for its advantages as a powerful pre-clinical model. There are several reported approaches for studying wound biofilms. In vitro and ex vivo systems are deficient in terms of the host immune response. Short-term in vivo studies involve acute responses and, thus, do not allow for biofilm maturation, as is known to occur clinically. The first long-term swine wound biofilm study was reported in 2014. The study recognized that biofilm-infected wounds may close as determined by planimetry, but the skin barrier function of the affected site may fail to be restored. Later, this observation was validated clinically. The concept of functional wound closure was thus born. Wounds closed but deficient in skin barrier function may be viewed as invisible wounds. In this work, we seek to report the methodological details necessary to reproduce the long-term swine model of biofilm-infected severe burn injury, which is clinically relevant and has translational value. This protocol provides detailed guidance on establishing an 8 week wound biofilm infection using P. aeruginosa (PA01). Eight full-thickness burn wounds were created symmetrically on the dorsum of domestic white pigs, which were inoculated with (PA01) at day 3 post-burn; subsequently, noninvasive assessments of the wound healing were conducted at different time points using laser speckle imaging (LSI), high-resolution ultrasound (HUSD), and transepidermal water loss (TEWL). The inoculated burn wounds were covered with a four-layer dressing. Biofilms, as established and confirmed structurally by SEM at day 7 post-inoculation, compromised the functional wound closure. Such an adverse outcome is subject to reversal in response to appropriate interventions.