A Disturbingly Informative Trip to the Woodlands Cemetery

Students in the Karabots Junior Fellows Program demonstrate specimens to attendees of the Halloween Family Fun Day event at the Woodlands Cemetery

On October 21, students in the Karabots Junior Fellows Program traveled to the Woodlands to give visitors a small glimpse into the interesting and surprising specimens and objects in the College of Physicians of Philadelphia’s vast collection. Longtime readers will recall the Woodlands is a common field trip location for students in the Karabots Program and representatives of the Mütter Museum, including Karabots students, have participated in numerous events hosted by the Woodlands.

A group photo of students in the Karabots Junior Fellows Program in the Hamilton mansion at the Woodlands Cemetery

Established as the country home of Philadelphia socialite William Hamilton, the Woodlands became an active cemetery in 1840; it is the final resting place of numerous noteworthy Philadelphians, including several Fellows of the College of Physicians, such as Silas Weir Mitchell, John Ashhurst, and William Williams Keen, and the founder of the Campbells Soup Company among other notables. It is also the site of the largest grave marker in the United States, an 84-foot tall obelisk constructed for famous dentist and Penn Dental school founder Thomas Wiltberger Evans.

Students in the Karabots Junior Fellows Program demonstrate specimens to attendees of the Halloween Family Fun Day event at the Woodlands Cemetery

Our students were on-site as part of the Woodlands annual Halloween Family Fun Day, where visitors come to the historic rural cemetery to take part in fun activities. Visitors of all ages came dressed in costumes for Halloween and there was even a pet costume contest in which a dog dressed as a pumpkin took the grand prize. Our students spent the afternoon in the Hamilton Mansion demonstrating “Mini Mütter,” a sampling of the unique items on display at the Mütter Museum. The Junior Fellows displayed such items as anatomical models, replicas of bones and museum specimens (such as an arm with smallpox and a foot with elephantiasis), preserved brain slides, and a collection of Civil War medical tools. Several students even led anatomy-themed games, challenging visitors to identify bones, label pieces of the heart, and demonstrate using different parts of their brain. Our students acted as great ambassadors for the College of Physicians of Philadelphia, showed off their knowledge, and honed their public speaking skills. Just as important, they introduced people young and old to the amazing collections available at the Mütter Museum and offered insights into medicine and human anatomy.

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The Karabots Junior Fellows Visit the Karabots Center

Students in the Karabots Junior Fellows Program pose in front of a plaque devoted to Nicholas and Athena Karabots at the CHOP Karabots Pediatric Care Center

Frequent readers will know we strongly believe in bringing students in our youth programs to the places where healthcare and science take place. Last week, the students in the fifth cohort of the Karabots Junior Fellows Program visited the Karabots Pediatric Care Center of the Children’s Hospital of Philadelphia. Observant readers will notice the Center shares its name with our program, as both were made possible through generous contributions from Nicholas and Athena Karabots and the Karabots Foundation. While at the Center, our students toured their facilities and met with members of their dedicated healthcare staff.

Opened in 2013, and located in West Philadelphia, the Karabots Center offers a host of different healthcare and outreach services for communities in West Philadelphia and beyond. In addition to a variety of health services, the Center offers community health and wellness programs, assisting in such capacities as literacy, education for new mothers, asthma prevention, homeless assistance, support for victims of domestic violence. Their facilities see roughly 60,000 patients per year.

During their visit, they met with Tyra Bryant-Stephens, MD, a renowned specialist in childhood asthma. Dr. Bryant-Stephens is the founder and Medical Director of the Community Asthma Prevention Program (CAPP) at CHOP. She shared her personal journey, her work in asthma prevention, as well as some health and wellness tips. They also met with Andrea Bailer, MSN, CRNP, one of their experienced pediatric nurses who talked about her personal and professional experience.

Students in the Karabots Junior Fellows Program interact with a medical interpreter on a scree at the CHOP Karabots Pediatric Care Center

The students were excited to briefly tour the Center’s medical facilities. They also got to visit their community garden. Maintained by members of the West Philadelphia community, the garden produces healthy fruit, vegetables, and herbs for patients and families in the Healthy Weight Program. In 2016, the garden yielded roughly 1,000 pounds of herbs and vegetables.

We are thankful for CHOP opening their doors and sharing their wonderful work with our students.

CPP Curiosities: Kyrie Irving’s Knee Injury

Logo for CPP Curiosities

Welcome to the third and final installment in a series of articles written by students in the Karabots Junior Fellows Program. Previous articles by our students covered nineteenth century mental health and the 1918 influenza pandemic. Today, we’re shifting away from medical history to some current affairs.

On April 8, 2018, the Boston Celtics announced star point guard Kyrie Irving would miss the remainder of the 2018 NBA season following a surgery on his surgically repaired knee. The loss of Irving, the nature of his injury, and his subsequent recovery were highly-publicized topics in the world of sports punditry, and today we’re offering our own hot take. Allow me to introduce Al Ly. Al is a student in the Karabots Program, who is combining his interest in sports medicine with his love of basketball to share his thoughts on Irving’s injury.

Al, the floor is yours!

Cleveland Cavaliers point guard Kyrie Irving goes for a layup against a defender.

Kyrie Irving in 2015 Photo Credit: Erik Drost (Flickr Commons)

During the 2015 NBA Finals, Kyrie Irving, point guard for the Cleveland Cavaliers, fractured his left knee. He underwent a surgical procedure where doctors implanted two screws to keep his kneecap in place. About 2 ½ years later, on March 24, 2018, Irving, traded to the Boston Celtics during free agency, had to undergo additional surgery. Doctors went to remove the tension wire in his left knee, but they noticed that there was an infection. The infection came from the screws he had implanted after the injury in 2015.

The knee is the largest joint in your body. It is made up of bones, cartilage, ligaments, and tendons. The three bones that form the knee joint are the femur, tibia, and patella. Tendons connect the knee bones to the leg muscles that move the knee joint. Three main ligaments provide stability to the knee. The anterior cruciate ligament (ACL) prevents the femur from sliding backwards to the tibia. The posterior cruciate ligament (PCL) prevents the femur from sliding forward to the tibia. The lateral collateral ligaments (LCL) prevents the femur from sliding side to side.

Anatomy of the knee, identifying the major parts of the knee

Anatomy of the Knee
Image Source: Bruce Blausen (Wikimedia Commons)

Your knee works like a door hinge. When you open and close a door hinge, it uses a threaded bolt secured by two nuts at the top and bottom of the hinge called acorn nuts. There is also a piece called a sleeve that protects the threaded bolt. Door plates are also part of the hinge with one connected to the door and the other to the wall. With a human knee, the threaded bolt is your knee and the sleeve is the muscle around the knee. The muscle around your knee is patella ligament and your quadriceps femoris tendon. The door plates are your bones that are around the knee, so every time you open or close a door, it’s like bending your knee. The knee is one of the easiest joints to receive an injury, especially for professional athletes who are running and jumping, and, in some sports, making full contact, on a regular basis.

When a person receives an injury like the one Irving suffered in 2015, doctors support the knee using tension wires and screws; Tension wires hold broken bones in position. When a person receives them, it can cause pain and stiffness and a sense the knee is not the same as it was before the injury. People with knee injuries go through physical therapy to regain movement and can take medication for the pain. Keeping the leg elevated will also reduce pain. In the case of Kyrie Irving, doctors discovered the wires in the Irving’s knee were causing him pain. This can happen if the wires are being knocked around, and he had been knocking them around on the court for 2 ½ years while diving for loose balls, colliding with other players, and falling to the ground.

Doctors successfully removed the two screws that had infected Irving’s knee. His season was over; however, his doctors cleared him to be healthy by training camp next season. It could have been much worse due to the infection. Osteomyelitis is an inflammation of the bone or bone marrow due to an infection caused by bacteria, mycobacteria, or fungi. It affects roughly one out of every 5,000 people. There are multiple ways to treat osteomyelitis, including antibiotics and a procedure where doctors remove unhealthy tissue. During treatment, doctors perform blood tests to monitor for signs of infection and to ensure that the treatment is effective, with follow-up visits roughly every two weeks. It usually takes 6 weeks to recover.

The areas of dead bone are hard to treat because it’s difficult for the body’s white blood cells to fight off the infection. Without adequate blood supply, some parts of the bone may die. According to Dr. Derek Ochiai, orthopedic surgeon at Nirschl Orthopedic Center in Arlington, VA, “We don’t know everything obviously, but when you have an infection with hardware, that has the potential to cede the bone. So the infection goes to the bone, which is called osteomyelitis. That can be really difficult to treat.” Left untreated, the infection could have led to swelling, fever, and life-threatening sepsis, a condition where harmful bacteria or toxins infect the bloodstream. It can also lead to fractures in the infected bone, stunted growth (in children), and gangrene. Gangrene is a condition that occurs when body tissue dies. It’s caused by loss of blood supply due to an underlying illness, injury, or infection. The most commonly affected areas are fingers, toes, and limbs. Gangrene can also occur inside your body and it damages your muscles and organs.

Depictions of gangrene's progress from an 1835 book Source: Historical Medical Library of the College of Physicians of Philadelphia

Depictions of gangrene’s progress from an 1835 book Source: Historical Medical Library of the College of Physicians of Philadelphia

Irving’s surgery attracted a lot of attention from basketball fans and the sports press. In his first public comments following the announcement of Irving’s surgery Celtics head coach Brad Stevens said of Irving, “He’s really disappointed…Obviously, after the initial surgery, the thought was he’d be back in three to six weeks. We thought it would be closer to three than six, the way he was initially progressing. Just one of those things out of his control. But he’s bummed as you can imagine.” The Celtics thought he’d would be back in about a month, but they realized he had a bone infection in his left knee so it took longer than expected. Celtics fans were devastated to hear he would miss the rest of the 2017-2018 season, although the Celtics did manage to reach the Eastern Conference Finals, where they lost to the Cleveland Cavaliers (Irving’s former team).

Thanks, Al. Great job! If you are interested in learning more about medical history from our students, check out the links at the top of the article. Click here to learn more about the different youth programs the College of Physicians of Philadelphia has to offer.

As always, catch you on the strange side!

Sources:

Maloney, Jack. “Kyrie Irving’s knee injury and second story, explained by an orthopedic surgeon.” CBS Sports (April 10, 2018).

Weiss, Jared. “Brad Stevens explains Kyrie Irving bacterial infection knee surgery.” CelticsWire (April 6, 2018).

“What is Osteomyelitis?” Summit Medical Group.  

Zillgitt, Jeff. “Celtics star Kyrie Irving will have another knee surgery and miss the rest of the season.” USA Today (April 5, 2018).

 

CFE and WINS Youth Discuss Careers in STEM

Panelists speak to Philadelphia high school students at the College of Physicians of Philadelphia

In keeping with our commitment to introducing Philadelphia youth to the diverse science, technical, and medical careers available to them, students in our four youth programs–the Karabots Junior Fellows Program, the Teva Pharmaceuticals Internship, the Out4STEM Internship, and the Girls One Diaspora Club–gathered at the College of Physicians of Philadelphia with members of the Women in Natural Sciences (WINS) Program of the Academy of Natural Sciences. Together they met with a panel of outstanding women representing diverse fields in healthcare, medicine, and STEM (science, technology, engineering, and mathematics). Joining the students were:

  • Maria Benedetto, PT, DPT, MA, PCS (CPP Fellow), Associate Clinical Professor, Physical Therapy and Rehabilitation Sciences Department, Drexel University
  • Joanna Chan, MD, Jefferson University Physician
  • Drisana Henry, MD, MPH, Adolescent Medical Fellow, Craig-Dalsimer Division of Adolescent Medicine, Children’s Hospital of Philadelphia
  • Katherine Lynch, MLS, Senior Developer, University of Pennsylvania Libraries
  • Loni Philip Tabb, PhD., Associate Professor, Epidemiology and Biostatistics, Drexel University

Moderated by Kevin Impellizeri, Youth Program Coordinator, the panelists shared their personal journeys toward their fields and provided advice for aspiring medical and technological professionals. They proved there is no one set path to any career, explaining challenges and diversions they faced along the way. They also offered frank advice on challenges facing women professionals such as sexism and workplace harassment. They also shared the ways they cope with stress and how they found ways to relax when things get stressful. Our students offered insightful questions and gained a greater understanding of different professional pathways. We are extremely grateful to all the panelists who offered their time and expertise to these aspiring future professionals.

Let Curiosity Set Sail at the Independence Seaport Museum

Students in the Karabots Junior Fellows Program pilot a small submarine in a pool in the lobby of the Independence Seaport Museum

Did you know that during the 1940s, the Delaware River was so polluted, no organisms that relied on oxygen to survive could live in it? Or that Frederick Douglas escaped slavery by posing as a sailor? This was one of many surprising facts the students in the Karabots Junior Fellows Program learned during a recent visit to the Independence Seaport Museum.

Founded in 1960 as the Philadelphia Maritime Museum, the Independence Seaport Museum seeks “to deepen the understanding, appreciation, and experience of the Philadelphia region’s waterways.” It carries out its mission through exhibits, interactive activities, and historic artifacts. Among the items in their diverse collection are tools, paper records, model ships, and two historic maritime vessels: the Cruiser Olympia and the submarine USS Becuna. Recently, the Karabots Junior Fellows visited the Seaport Museum to learn more about maritime history, ecology, and the unique impact Philadelphia’s waterways have influenced local, national, and international history.

Upon their arrival, the students broke into small groups and took part in a photo scavenger hunt designed to immerse them in the exhibits, activities, and artifacts the Seaport Museum has to offer. Among the museum’s offerings are Tides of Freedom: African Presence on the Delaware River, a frank depiction of the African American experience in Philadelphia relative to shipping, sea travel, and manufacturing; a recreation of the bridge of a US Navy destroyer, numerous model ships (some of which were built by inmates at Eastern State Penitentiary), and a traditional boat shop where volunteers still practice boat building.

Students in the Karabots Junior Fellows Program play a search and rescue game at the Independence Seaport Museum

After exploring the site on their own, the students took part in Ecology of the Delaware, a hands-on lesson aimed at teaching environmental history and the important role the Delaware River plays in the daily lives of people living in the Delaware Valley. During the lesson, they conducted various tests on Delaware River water, including measuring depth, temperature, PH levels, and phosphate content.

Students in the Karabots Junior Fellows Program take part in the Ecology of the Delaware lesson at the Independence Seaport Museum

After our activities concluded, several opted to stay and explore the Cruiser Olympia and the submarine USS Becuna. Overall the experience gave our students a greater appreciation of the impact of Philadelphia’s waterways.

The Karabots Junior Fellows at National Biomechanics Day 2018

A Drexel graduate student attaches a motion sensor to a student's arm during National Biomechanics Day 2018

National Biomechanics Day is a global initiative that aims to introduce high school students and teachers to the field of biomechanics. Celebrated on April 11, organizations all over the world take part in hands-on activities to demonstrate the concepts of biomechanics and its diverse applications. During this year’s program, the fifth cohort of the Karabots Junior Fellows Program traveled to the Department of Physical Therapy and Rehabilitation Sciences at Drexel University’s College of Nursing and Health Professions to learn the ways scientists are using biomechanics to assist in physical therapy and recovery.

Breaking into small groups, the students met with Drexel graduate students, who oversaw interactive activities using mechanical sensors and detection equipment to map the way human bodies move, valuable information when monitoring a patient’s recovery and identifying potential mobility issues. At one station, students made use of MOCAP equipment to map out leg movement. Short for “motion capture,” mocap involves using a system of sensors to digitally record a person’s movement; popularized in video game design, mocap has myriad practical applications, including in the field of physical therapy. At another station, the students donned special sensors on their arms to record and monitor arm movement while performing simple tasks, such as lifting small weights and push-ups. The final station sought to transform physical therapy into an interactive game (game-based learning is no stranger to the Karabots Junior Fellows Program). Graduate students utilized a Microsoft Xbox Kinect, a motion-capture sensor designed for specialized video games (although it also has been used for scientific and medical applications) to map a players physical movements in order to play the arcade classic Pac-Man.

A student in the Karabots Junior Fellows Program jumps as he plays Pac-Man using a motion-detecting sensor at National Biomechanics Day

By jumping, flexing, and moving around, our students learned the different exciting ways biomechanics can be used to help patients recover from trauma and strengthen their mobility. We are thankful to Clare Milner, PhD, FACSM, Associate Professor, Department of Physical Therapy and Rehabilitation Sciences, Drexel University, and the rest of her time for an exciting event.

The Karabots Junior Fellows Identify the Building Blocks of Cancer

Students in the Karabots Junior Fellows Program take part in an activity about cancer biology by assembling walls made of Legos

Cancer is caused by miscommunications in cells brought upon by mutations in a patient’s DNA. Recently students in the fifth cohort of the Karabots Junior Fellows Program explored this concept using candy and Lego blocks.

A few weeks ago, the students met with Brad Davidson, a professor of developmental biology at Swarthmore College. Davidson, along with a student intern and members of the Center for Education, will be working with the Karabots students to design a Mütter Museum exhibit on cancer biology. In order to provide a basic insight into how cancer behaves, Davidson devised an interactive activity. Longtime followers of the blog will recall interactive and game-based activities are not unusual here at the Center for Education. Past lessons have taught the scientific method through a room escape, students designed games to teach the public about forensics, and we have done many, many quiz games. However, we’ve never integrated taste into our lessons, until now.

Dr. Davidson instructed the students to break into pairs. One student handled different flavors of candy and the other had a handful of Legos. Each candy corresponded with a different type of block. The pair had to attempt to build a wall out of blocks, using only taste to communicate. The student with the snacks fed specific candies to the student with the blocks; this was to illustrate how cell genes send signals to produce certain kinds of cells. Once they completed this activity, Davidson prepared new instructions to illustrate the way cancer interrupts this communication. The second phase of this activity had the student with the candy send conflicting messages, resulting in irregular or misshapen block walls in fashion similar to the way miscommunications between cells whose DNA is altered by cancer create cancer cells.

Students in the Karabots Junior Fellows Program take part in an activity about cancer biology by assembling walls made of Legos

Overall, Davidson’s innovative activity successfully conveyed the message and gave our students a useful framework for when they begin to develop their exhibit.