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Orthodontics and pediatric dentistry: Two specialties, one goal

Chapter by: Moskowitz, Elliott M.; Cisneros, George J.; Hochberg, Mark S.
in: Integrated Clinical Orthodontics by
[S.l.] : wiley, 2023
pp. 411-426
ISBN: 9781119870050
CID: 5614742

Osteoarthritis Research Society International (OARSI): Past, present and future

Mobasheri, Ali; Im, Gun-Il; Katz, Jeffrey N; Loughlin, John; Kraus, Virginia B; Sandell, Linda J; Berenbaum, Francis; Abramson, Steve; Lotz, Martin; Hochberg, Marc; Pelletier, Jean-Pierre; Madry, Henning; Block, Joel A; Lohmander, L Stefan; Altman, Roy D
We provide a detailed account of the origin and establishment of the Osteoarthritis Research Society International (OARSI) and celebrate its history from inception to the current day. We discuss the mission, vision and strategic objectives of OARSI and how these have developed and evolved over the last 3 decades. We celebrate the achievements of the society as we approach its 30th birthday, honor the entire presidential line and respectfully pay tribute to the past presidents who are no longer with us. We reflect on the strong foundations of our society, OARSI's efforts to disseminate understanding of the health, disability and economic burdens of osteoarthritis (OA) to policymakers, and the exciting initiatives to make the society inclusive and international. We thank our corporate and industrial sponsors, who have supported us over many years, without whom our annual congresses would not have been possible. We celebrate our longstanding strategic partnership with our publisher, Elsevier, and the successful launch of our new journal Osteoarthritis and Cartilage Open, the most significant new development in our dissemination toolbox. For the first time in the history of the organization, our annual congress was cancelled in April 2020 and the 2021 meeting will be virtual. Despite the numerous challenges posed by the ongoing COVID-19 pandemic and the need to adapt quickly to a rapidly changing landscape, we must remain optimistic about the future. We will take advantage of new exciting opportunities to advance our mission and vision to enhance the quality of life of persons with OA.
PMID: 36474983
ISSN: 2665-9131
CID: 5386792

Interleukin 1 receptor antagonist (IL1RN) gene variants predict radiographic severity of knee osteoarthritis and risk of incident disease

Attur, Mukundan; Zhou, Hua; Samuels, Johathan; Krasnokutsky, Svetlana; Yau, Michelle; Scher, Jose U; Doherty, Michael; Wilson, Anthony G; Bencardino, Jenny; Hochberg, Marc; Jordan, Joanne M; Mitchell, Braxton; Kraus, Virginia B; Abramson, Steven B
OBJECTIVE:gene with radiographic severity of symptomatic knee osteoarthritis (SKOA) and the risk of incident OA. We also explored these genetic polymorphisms in patients with new onset rheumatoid arthritis (RA). METHODS:haplotypes were also assessed for association with disease activity (DAS28) and plasma inflammatory markers in patients with RA. RESULTS:demonstrated that carriage of the TTG haplotype was associated with 4.1-fold (p=0.001) increased odds of incident rOA. Plasma IL-1Ra levels were lower in TTG carriers, while chondrocytes from TTG carriers exhibited decreased secretion of IL-1Ra. In patients with RA, the TTG haplotype was associated with increased DAS28, decreased plasma IL-1Ra and elevations of plasma inflammatory markers (hsCRP, interleukin 6 (IL-6)). CONCLUSION/CONCLUSIONS:TTG risk haplotype, associated with decreased IL-1Ra plasma levels, impairs endogenous 'anti-inflammatory' mechanisms.
PMID: 31852669
ISSN: 1468-2060
CID: 4242782

"I Cannot Take This Any More!": Preparing Interns to Identify and Help a Struggling Colleague

Zabar, Sondra; Hanley, Kathleen; Horlick, Margaret; Cocks, Patrick; Altshuler, Lisa; Watsula-Morley, Amanda; Berman, Russell; Hochberg, Mark; Phillips, Donna; Kalet, Adina; Gillespie, Colleen
BACKGROUND:Few programs train residents in recognizing and responding to distressed colleagues at risk for suicide. AIM/OBJECTIVE:To assess interns' ability to identify a struggling colleague, describe resources, and recognize that physicians can and should help colleagues in trouble. SETTING/METHODS:Residency programs at an academic medical center. PARTICIPANTS/METHODS:One hundred forty-five interns. PROGRAM DESIGN/UNASSIGNED:An OSCE case was designed to give interns practice and feedback on their skills in recognizing a colleague in distress and recommending the appropriate course of action. Embedded in a patient "sign-out" case, standardized health professionals (SHP) portrayed a resident with depressed mood and an underlying drinking problem. The SHP assessed intern skills in assessing symptoms and directing the resident to seek help. PROGRAM EVALUATION/RESULTS:Interns appreciated the opportunity to practice addressing this situation. Debriefing the case led to productive conversations between faculty and residents on available resources. Interns' skills require further development: while 60% of interns asked about their colleague's emotional state, only one-third screened for depression and just under half explored suicidal ideation. Only 32% directed the colleague to specific resources for his depression (higher among those that checked his emotional state, 54%, or screened for depression, 80%). DISCUSSION/CONCLUSIONS:This OSCE case identified varying intern skill levels for identifying and assessing a struggling colleague while also providing experiential learning and supporting a culture of addressing peer wellness.
PMID: 30993628
ISSN: 1525-1497
CID: 3810532

Surgical clerkship or medical clerkship first: Does it make a difference?

Adelsheimer, Andrew; Berman, Russell S; Pachter, H Leon; Hochberg, Mark S
INTRODUCTION: This study compares NBME surgical clerkship scores of students who completed their medicine clerkship before their surgical clerkship with the performance of those who had not previously completed their medical clerkship. METHODS: The study included 815 New York University School of Medicine students from the years 2014-2018 (571 students took medicine first, while 244 took surgery first). Performance on the surgical clerkship was assessed using the NBME SHELF examination. Statistical comparisons were performed via 2-tailed, independent-samples, unequal-variance t-tests. RESULTS: Mean NBME surgical SHELF scores of the students who had previously taken medicine were significantly higher than students who had not (mean 78.6 vs. 73.5, p < 0.001). Students who had solely medicine (as their first clerkship) before surgery also performed significantly better (mean 78.8 vs. 73.5, p < 0.001). Students who completed surgery later in the year did not perform better on the surgical SHELF, so long as both surgical clerkship cohorts had completed medicine. CONCLUSION: Students who completed their core medical clerkship prior to their surgical clerkship scored significantly better on the NBME surgical SHELF examination.
PMID: 29157890
ISSN: 1879-1883
CID: 2792432

Professionalism in Surgery: Crucial Skills for Attendings and Residents

Hochberg, Mark S; Berman, Russell S; Pachter, H Leon
PMID: 28797343
ISSN: 1878-0555
CID: 2664142

Midclerkship feedback in the surgical clerkship: the "Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills" application utilizing learner self-assessment

Hochberg, Mark; Berman, Russell; Ogilvie, Jennifer; Yingling, Sandra; Lee, Sabrina; Pusic, Martin; Pachter, H Leon
BACKGROUND: The Liaison Committee on Medical Education requires midclerkship formative (low stakes) feedback to students regarding their clinical skills. Student self-assessment is not commonly incorporated into this evaluation. We sought to determine the feasibility of collecting and comparing student self-assessment with that of their preceptors using an iPad application. These student self-ratings and preceptor ratings are jointly created and reviewed as part of a face-to-face midclerkship feedback session. METHODS: Using our iPad application for Professionalism, Reporting, Interpreting, Managing, Educating, and Procedural Skills ("PRIMES"), students answer 6 questions based on their self-assessment of performance at midclerkship. Each skill is rated on a 3-point scale (beginning, competent, and strong) with specific behavioral anchors. The faculty preceptors then complete the same PRIMES form during the face-to-face meeting. The application displays a comparison of the 2 sets of ratings, facilitating a discussion to determine individualized learning objectives for the second half of the clerkship. RESULTS: A total of 209 student-preceptor pairs completed PRIMES ratings. On average, student-preceptor ratings were in agreement for 38% of the time. Agreement between students and preceptors was highest for Professionalism (70%) and lowest for Procedural Skills (22%). On average, 60% of student-preceptor ratings did not agree. Students rated themselves lower than preceptors 52% of the time, while only 8% of students rated themselves higher than their preceptors' ratings (this difference is significant at the P value <.05 level). CONCLUSIONS: This study demonstrates the value of using the PRIMES framework to incorporate surgery clerkship students' self-assessment into formative face-to-face midclerkship feedback sessions with their preceptors with the goal to improve performance during the second half of the clerkship.
PMID: 27756451
ISSN: 1879-1883
CID: 2718782

Professionalism Training For Surgical Residents: Documenting the Advantages of a Professionalism Curriculum

Hochberg, Mark S; Berman, Russell S; Kalet, Adina L; Zabar, Sondra; Gillespie, Colleen; Pachter, H Leon
OBJECTIVES: Professionalism education is a vital component of surgical training. This research attempts to determine whether an annual, year-long professionalism curriculum in a large surgical residency can effectively change professionalism attitudes. SUMMARY OF BACKGROUND DATA: The ACGME mandated 6 competencies in 2003. The competencies of Professionalism and Interpersonal/Professional Communication Skills had never been formally addressed in surgical resident education in the past. METHODS: A professionalism curriculum was developed focusing on specific resident professionalism challenges: admitting mistakes, effective communication with colleagues at all levels, delivering the news of an unexpected death, interdisciplinary challenges of working as a team, the cultural challenge of obtaining informed consent through an interpreter, and the stress of surgical practice on you and your family. These professionalism skills were then evaluated with a 6-station Objective Structured Clinical Examination (OSCE). Identical OSCE scenarios were administered to 2 cohorts of surgical residents: in 2007 (before instituting the professionalism curriculum in 2008) and again in 2014. Surgical residents were rated by trained Standardized Patients according to a behaviorally anchored professionalism criteria checklist. RESULTS: An analysis of variance was conducted of overall OSCE professionalism scores (% well done) as the dependent variable for the 2 resident cohorts (2007 vs 2014). The 2007 residents received a mean score of 38% of professionalism items "well done" (SD 9%) and the 2014 residents received a mean 59% "well done" (SD 8%). This difference is significant (F = 49.01, P < .001). CONCLUSIONS: Professionalism education has improved surgical resident understanding, awareness, and practice of professionalism in a statistically significant manner from 2007 to 2014. This documented improvement in OSCE performance reflects the value of a professionalism curriculum in the care of the patients we seek to serve.
PMID: 27433908
ISSN: 1528-1140
CID: 2185352

Elevated peripheral blood leukocyte inflammatory gene expression in radiographic progressors with symptomatic knee osteoarthritis: NYU and OAI cohorts [Meeting Abstract]

Attur, M; Statnikov, A; Krasnokutsky, S; Kraus, V; Jordan, J M; Mitchell, B D; Yau, M; Patel, J; Aliferis, C F; Hochberg, M; Samuels, J; Abramson, S B
Purpose: We and others have demonstrated low grade inflammation exists in OA joint tissues, where it may contribute to disease pathogenesis. In the current studies we assessed whether inflammatory events occurring within joint tissues were reported in the peripheral blood leukocytes (PBLs) of patients with symptomatic knee OA (SKOA). Methods: PBL inflammatory gene expression (IL-1, TNFalpha, COX-2) was assessed in two independent cohorts of patients with SKOA, and a cohort of healthy control subjects: 1) 111 patients with tibiofemoral medial OA and 21 healthy volunteers from the NYUHJD Cohort, and 2) 200 patients from the OAI progression cohort who had "high quality radiographs", at both baseline and 24 months, and had KL2 or 3 in the signal knee at baseline. Radiographic progression was defined as narrowing of medial joint space width (JSW) in the signal knee between baseline and 24-months in each cohort. Radiographic progressors were defined as subjects who had JSN >0.0, 0.2 and 0.5mm over 24 months. For measuring predictive performance, we used the area under the curve (AUC) of a receiver operating characteristics (ROC). OAI SKOA subjects were dichotomized as radiographic non-progressors (JSN <0.0 mm) and progressors (JSN>0.0mm) for association studies. Results: Elevated PBL expression of IL-1, TNFalpha or COX-2 identified SKOA patients who were "fast progressors" (mean JSN 0= 0.71, 0.75 and 0.71 mm / 24 months, respectively) compared to patients with levels below the median. In a multivariable model, anthropometric traits alone (BMI, gender, age) did not predict progression, whereas addition of PBL gene expressions improved prediction of fast progressors (JSN>0.5mm). We next examined inflammatory gene expression in PBLs of radiographic progressors in the OAI cohort. Similar to the NYUHJD cohort, elevated expression of IL-1beta, TNFalpha and COX-2 mRNA distinguished radiographic progressors from non-progressors (Table 1). PBL IL-1beta expression found to be strongest predictor of all three radiographic progressors. In multivariate models that combine all three markers did not improve upon IL-1beta predictivity. We thus conclude that either the signal in TNFalpha and Cox-2 is already subsumed by IL-1beta and/or that it is not easy to capture the non-overlapping signals without increasing the sample size (i.e., fitting a stronger multivariate predictor will require more sample size). Conclusions: We identified, and confirmed in two cohorts, increased inflammatory gene expression (IL-1, TNFalpha or COX-2) by PBLs that predict radiographic progression in patients with SKOA. The data indicate that inflammatory events within joint tissues of patients with SKOA are reported in the peripheral blood. These PBL transcriptome signals of local joint inflammation merit further study as potential biomarkers for OA disease progression. (Table Presented)
ISSN: 1063-4584
CID: 1644422


Zabar, Sondra; Burman, Russell; Hochberg, Mark; Phillips, Donna; Shaker-Brown, Amara; Hanley, Kathleen; Kalet, Adina; Gillespie, Colleen
ISSN: 1525-1497
CID: 1729982