Medicine and Health Sciences Commons^™

Effect Of Oral Semaglutide Compared With Placebo And Subcutaneous Semaglutide On Glycemic Control In Patients With Type 2 Diabetes: A Randomized Clinical Trial., Melanie Davies, Thomas R. Pieber, Marie-Louise Hartoft-Nielsen, Oluf K.H. Hansen, Serge Jabbour, Julio Rosenstock

Department of Medicine Faculty Papers

Importance: Glucagon-like peptide-1 (GLP-1) receptor agonists are effective therapies for the treatment of type 2 diabetes and are all currently available as an injection.

Objectives: To compare the effects of oral semaglutide with placebo (primary) and open-label subcutaneous semaglutide (secondary) on glycemic control in patients with type 2 diabetes.

Design, Setting, and Patients: Phase 2, randomized, parallel-group, dosage-finding, 26-week trial with 5-week follow-up at 100 sites (hospital clinics, general practices, and clinical research centers) in 14 countries conducted between December 2013 and December 2014. Of 1106 participants assessed, 632 with type 2 diabetes and insufficient glycemic control using diet and …

Detection Of Activating Estrogen Receptor Gene (Esr1) Mutations In Single Circulating Tumor Cells, Carmela Paolillo, Zhaomei Mu, Giovanna Rossi, Matthew J. Schiewer, Thomas Nguyen, Laura Austin, Ettore Capoluongo, Karen E. Knudsen, Massimo Cristofanilli, Paolo Fortina

Department of Cancer Biology Faculty Papers

Purpose: Early detection is essential for treatment plans before onset of metastatic disease. Our purpose was to demonstrate feasibility to detect and monitor estrogen receptor 1 (ESR1) gene mutations at the single circulating tumor cell (CTC) level in metastatic breast cancer (MBC). Experimental Design: We used a CTC molecular characterization approach to investigate heterogeneity of 14 hotspot mutations in ESR1 and their correlation with endocrine resistance. Combining the CellSearch and DEPArray technologies allowed recovery of 71 single CTCs and 12 WBC from 3 ER-positive MBC patients. Forty CTCs and 12 WBC were subjected to whole genome amplification by MALBAC and …

A Pilot Study Evaluating Concordance Between Blood-Based And Patient-Matched Tumor Molecular Testing Within Pancreatic Cancer Patients Participating In The Know Your Tumor (Kyt) Initiative, Michael J. Pishvaian, R. Joseph Bender, Lynn M. Matrisian, Lola Rahib, Andrew Hendifar, William A. Hoos, Sam Mikhail, Vincent Chung, Vincent Picozzi, Craig Heartwell, Kimberly Mason, Katelyn Varieur, Metasebia Aberra, Subha Madhavan, Emanuel Petricoin Iii, Jonathan Brody

Department of Surgery Faculty Papers

Recent improvements in next-generation sequencing (NGS) technology have enabled detection of biomarkers in cell-free DNA in blood and may ultimately replace invasive tissue biopsies. However, a better understanding of the performance of blood-based NGS assays is needed prior to routine clinical use. As part of an IRBapproved molecular profiling registry trial of pancreatic ductal adenocarcinoma (PDA) patients, we facilitated blood-based NGS testing of 34 patients from multiple community-based and high-volume academic oncology practices. 23 of these patients also underwent traditional tumor tissue-based NGS testing. cfDNA was not detected in 9/34 (26%) patients. Overall concordance between blood and tumor tissue NGS …

Life After Being A Pathology Department Chair Ii: Lessons Learned., David N. Bailey, Mary F. Lipscomb, Fred Gorstein, David Wilkinson, Fred Sanfilippo

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

The 2016 Association of Pathology Chairs annual meeting featured a discussion group of Association of Pathology Chairs senior fellows (former chairs of academic departments of pathology who have remained active in Association of Pathology Chairs) that focused on how they decided to transition from the chair, how they prepared for such transition, and what they did after the transition. At the 2017 annual meeting, the senior fellows (encompassing 481 years of chair service) discussed lessons they learned from service as chair. These lessons included preparation for the chairship, what they would have done differently as chair, critical factors for success …

Efficiency Of Spinal Anesthesia Versus General Anesthesia For Lumbar Spinal Surgery: A Retrospective Analysis Of 544 Patients., John T. Pierce, Guy Kositratna, Mark A. Attiah, Michael J. Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Md, Paul J. Marcotte, W. Andrew Kofke, William C. Welch

Department of Anesthesiology Faculty Papers

BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons.

MATERIALS AND METHODS: A retrospective analysis was performed by querying the electronic medical record database for surgeries performed by a single surgeon between 2007 and 2011 using procedural codes 63030 for diskectomy and 63047 for laminectomy: 544 …

#Ilooklikeasurgeon: Embracing Diversity To Improve Patient Outcomes., Heather Logghe, Christian Jones, Alison Mccoubrey, Edward Fitzgerald

Department of Surgery Faculty Papers

No abstract provided.

Clinical Characteristics, Management, And Outcomes Of Suspected Poststroke Acute Coronary Syndrome., Sylvia Marie Biso, Marvin Lu, Toni Anne De Venecia, Supakanya Wongrakpanich, Mary Rodriguez-Ziccardi, Sujani Yadlapati, Marina Kishlyansky, Harish Seetha Rammohan, Vincent M. Figueredo

Department of Medicine Faculty Papers

Background: Acute coronary syndrome (ACS) can complicate acute ischemic stroke, causing significant morbidity and mortality. To date, literatures that describe poststroke acute coronary syndrome and its morbidity and mortality burden are lacking.

Methods: This is a single center, retrospective study where clinical characteristics, cardiac evaluation, and management of patients with suspected poststroke ACS were compared and analyzed for their association with inpatient mortality and 1-year all-cause mortality.

Results: Of the 82 patients, 32% had chest pain and 88% had ischemic ECG changes; mean peak troponin level was 18, and mean ejection fraction was 40%. The medical management group had older …

Collecting Qualitative Feedback For An Institutional Repository To Help Demonstrate Value To Stakeholders, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Presentation presented at Bucknell University Digital Scholarship Conference 2017

Complex Interplay Of Kinetic Factors Governs The Synergistic Properties Of Hiv-1 Entry Inhibitors., Koree W. Ahn, Michael J. Root

Department of Biochemistry and Molecular Biology Faculty Papers

The homotrimeric HIV-1 envelope glycoprotein (Env) undergoes receptor-triggered structural changes that mediate viral entry through membrane fusion. This process is inhibited by chemokine receptor antagonists (CoRAs) that block Env-receptor interactions and by fusion inhibitors (FIs) that disrupt Env conformational transitions. Synergy between CoRAs and FIs has been attributed to a CoRA-dependent decrease in the rate of viral membrane fusion that extends the lifetime of the intermediate state targeted by FIs. Here, we demonstrated that the magnitude of CoRA/FI synergy unexpectedly depends on FI-binding affinity and the stoichiometry of chemokine receptor binding to trimeric Env. For C-peptide FIs (clinically represented by …

The Use Of Palliative Performance Score In Patients With End-Stage Liver Disease, Drew Kotler, Md, Mital Shah, Md, Sheela S. Reddy, Md, Jonathan M. Fenkel, Md, John Liantonio, Md, Dina Halegoua-De Marzio, Md

Department of Medicine Posters

● Palliative Care services are often underutilized in patients with End-Stage Liver Disease (ESLD) and often only initiated at the end of life

● The Palliative Performance Score (PPS) is an important tool used in Palliative Care to assess functional status

● PPS has five functional dimensions: ambulation, activity level and evidence of disease, self-care, oral intake, and level of consciousness

● The aim of this study is to determine if there is a correlation between Model for End-Stage Liver Disease (MELD) score and PPS in ESLD patients

● MELD is used to predict mortality and to prioritize liver transplant …

Delaware Health Sciences Alliance Global Health Symposium: Refugee And Immigrant Access To Care Locally And Globally

Global Health Events

Welcome to the 6th annual Global Health Symposium! As always, we are pleased to highlight the latest in our growing Global Health interests across the DHSA. The Delaware Health Sciences Alliance is a partnership of:

• Christiana Care Health System
• Jefferson Philadelphia University & Thomas Jefferson University
• Nemours / Alfred I. duPont Institute for Children
• University of Delaware

Mir-181a Increases Foxo1 Acetylation And Promotes Granulosa Cell Apoptosis Via Sirt1 Downregulation., Mei Zhang, Qun Zhang, Yali Hu, Lu Xu, Yue Jiang, Chunxue Zhang, Lijun Ding, Ruiwei Jiang, Jianxin Sun, Haixiang Sun, Guijun Yan

Center for Translational Medicine Faculty Papers

Oxidative stress impairs follicular development by inducing granulosa cell (GC) apoptosis, which involves enhancement of the transcriptional activity of the pro-apoptotic factor Forkhead box O1 (FoxO1). However, the mechanism by which oxidative stress promotes FoxO1 activity is still unclear. Here, we found that miR-181a was upregulated in hydrogen peroxide (H

A Retrospective Analysis Of Nursing Students' Clinical Experience In An All-Male Maximum Security Prison., Mary T. Bouchaud, Madeline Brooks, Beth Ann Swan

College of Nursing Faculty Papers & Presentations

Prisons provide an ideal learning experience to prepare prelicensure students with the knowledge and skill set needed for practice in the 21st century. Beginning descriptive evidence demonstrates that correctional health is an innovative community resource to educate nursing students in today's changing model of health care delivery and practice. This article shares results from a retrospective analysis of the perceptions and experiences of nursing students during their community clinical rotation in an all-male maximum security prison.

Syntaphilin Controls A Mitochondrial Rheostat For Proliferation-Motility Decisions In Cancer., M Cecilia Caino, Jae Ho Seo, Yuan Wang, Dayana B. Rivadeneira, Dmitry I. Gabrilovich, Eui Tae Kim, Ashani T Weeraratna, Lucia R. Languino, Dario C. Altieri

Department of Cancer Biology Faculty Papers

Tumors adapt to an unfavorable microenvironment by controlling the balance between cell proliferation and cell motility, but the regulators of this process are largely unknown. Here, we show that an alternatively spliced isoform of syntaphilin (SNPH), a cytoskeletal regulator of mitochondrial movements in neurons, is directed to mitochondria of tumor cells. Mitochondrial SNPH buffers oxidative stress and maintains complex II-dependent bioenergetics, sustaining local tumor growth while restricting mitochondrial redistribution to the cortical cytoskeleton and tumor cell motility. Conversely, introduction of stress stimuli to the microenvironment, including hypoxia, acutely lowered SNPH levels, resulting in bioenergetics defects and increased superoxide production. In …

Jefferson Digital Commons Quarterly Report: July-September 2017, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi, James Copeland, Libt

Jefferson Digital Commons Reports

This quarterly report includes:

• Assorted articles
• Confronting Racism, Bias, and Social Injustice in Healthcare Lecture
• CREATE DAY OT Capstone presentations
• Grand Rounds
• Assorted Newsletters
• Nexus Maximus Posters
• University Wide Posters
• House Staff Quality Improvement and Patient Safety Posters
• CSHLA Scholar Day posters
• Student publications and presentations
• What People are Saying about the Jefferson Digital Commons

Nurses Alumni Association Bulletin, Fall 2017, Susan Albrecht Curcio, Aileen Ishuin Macmillan, Ruth Huff Iuliano

Nursing Alumni Bulletins

2017 – 2018 Meeting Dates Calendar

2018 Annual Luncheon & Meeting Notice

Officers, Committee Chairs, Satellite and Volunteers

2017 President’s Message

Treasurer’s Report

Resume of Minutes

Where do your Alumni funds go?

Office News

Committee Reports

Alumni Relations

Annual Giving

In Honor of and in Memory of

Janet C. Hindson Award

Janet C. Hindson 2017 Award Winner

News About and From Our Graduates

Pearls of Wisdom

Happy Birthday to Be 80 or More

50th Anniversary Class List for 1967

Brain Health by YOU

2017 Lunch Attendees

50th Anniversary Class List for 1968

Luncheon Photos

Annual Luncheon Comments

In Memoriam, Names …

Jefferson Review - Fall 2017

Jefferson Review

INSIDE

Features

• 6 - Introducing the New Jefferson: One Name. Two Legacies. Infinite Possibilities.
• 10 - The PhiladlephiaU Story: A History of Change and Innovation
• 18 - Two Alumnae, One Vision: A New Home Base for All Graduates

• 2 - The Provost's Column
• 5 - The Families We Choose: A Message from Elizabeth Dale

On Campus

• 22 - College of Biomedical Sciences
• 22 - College of Health Professions
• 23 - College of Nursing
• 24 - College of Pharmacy
• 26 - Carol Ammon, BSN '17, MBA: A Brand-New Nurse, on a Mission
• 28 - Alia Salam, MPH '17: Helping Refugees on …

One Jefferson News October 2017, Performance Excellence

One Jefferson News

Over the past month, we have continued our One Jefferson journey and achieved a number of integration successes for the organization as well as our patient and student communities. In this issue of One Jefferson News, we invite you to join us in celebrating the recent addition of Kennedy to Jefferson Health and a new college structure for Jefferson (Philadelphia University + Thomas Jefferson University) set to launch in 2018.

During this time of continued organizational evolution, we recognize the importance of frequent communications and celebrating the many accomplishments of our talented team. If you have questions or ideas, we …

Massage Therapy In Outpatient Cancer Care: A Metropolitan Area Analysis., Virginia S. Cowen, Robin Streit Miccio, Bijal Parikh

Department of Occupational Therapy Faculty Papers

Massage offers cancer patients general quality of life benefits as well as alleviation of cancer-related symptoms/cancer-treatment-related symptoms including pain, anxiety, and fatigue. Little is known about whether massage is accessible to cancer patients who receive treatment in the outpatient setting and how massage is incorporated into the overall cancer treatment plan. Outpatient cancer centers (n = 78) in a single metropolitan area were included this mixed-methods project that included a systematic analysis of website information and a telephone survey. Massage was offered at only 40 centers (51.3% of total). A range of massage modalities were represented, with energy-based therapies (Reiki …

Sacral Fractures And Associated Injuries., Ricardo Rodrigues-Pinto, Mark F. Kurd, Gregory D. Schroeder, Christopher K. Kepler, James C. Krieg, Jörg H. Holstein, Carlo Bellabarba, Reza Firoozabadi, F Cumhur Oner, Frank Kandziora, Marcel F. Dvorak, Conor P. Kleweno, Luiz R. Vialle, S. Rajasekaran, Klause J. Schnake, Alexander R. Vaccaro

Rothman Institute Papers

STUDY DESIGN: Literature review.

OBJECTIVE: The aim of this review is to describe the injuries associated with sacral fractures and to analyze their impact on patient outcome.

METHODS: A comprehensive narrative review of the literature was performed to identify the injuries associated with sacral fractures.

RESULTS: Sacral fractures are uncommon injuries that result from high-energy trauma, and that, due to their rarity, are frequently underdiagnosed and mistreated. Only 5% of sacral fractures occur in isolation. Injuries most often associated with sacral fractures include neurologic injuries (present in up to 50% of sacral fractures), pelvic ring disruptions, hip and lumbar spine …

Impact Of Superstorm Sandy On Medicare Patients' Utilization Of Hospitals And Emergency Departments., Benoit Stryckman, Lauren Walsh, Brendan G. Carr, Nathaniel Hupert, Nicole Lurie

Department of Emergency Medicine Faculty Papers

INTRODUCTION: National health security requires that healthcare facilities be prepared to provide rapid, effective emergency and trauma care to all patients affected by a catastrophic event. We sought to quantify changes in healthcare utilization patterns for an at-risk Medicare population before, during, and after Superstorm Sandy's 2012 landfall in New Jersey (NJ).

METHODS: This study is a retrospective cohort study of Medicare beneficiaries impacted by Superstorm Sandy. We compared hospital emergency department (ED) and healthcare facility inpatient utilization in the weeks before and after Superstorm Sandy landfall using a 20% random sample of Medicare fee-for-service beneficiaries continuously enrolled in 2011 …

A Word From The Writing Center (October 2017), Jennifer Wilson, Ms, Els

A Word From the Writing Team (Newsletter)

This issue includes:

• Selecting a target journal using journalguide.com
• Teaching and Communication Skills workshops

Correcting For Tissue Nitrogen Excretion In Multiple Breath Washout Measurements., Mica Kane, Jonathan H. Rayment, Renee Jensen, Reginald Mcdonald, Sanja Stanojevic, Felix Ratjen

Student Papers, Posters & Projects

Nitrogen excreted from body tissues impacts the calculation of multiple breath nitrogen washout (MBWN2) outcomes. The aim of this study was to determine the effect of tissue N2 on MBWN2 outcomes in both healthy subjects and patients with CF and to assess whether it is possible to correct for tissue N2. The contribution of tissue N2 to MBWN2 outcomes was estimated by comparing MBWN2-derived functional residual capacity (FRCN2) to FRC measured by body plethysmography (FRCpleth) and by comparing MBW outcome measures derived from MBWN2 and sulfur hexafluoride MBW (MBWSF6). Compared to plethysmography and MBWSF6, MBWN2 overestimated FRC and lung clearance …

Inhibition Of Apoptosis Signal-Regulating Kinase 1 Alters The Wound Epidermis And Enhances Auricular Cartilage Regeneration., Qian-Shi Zhang, Deepa S. Kurpad, My G. Mahoney, Marla J. Steinbeck, Theresa A. Freeman

Department of Orthopaedic Surgery Faculty Papers

Why regeneration does not occur in mammals remains elusive. In lower vertebrates, epimorphic regeneration of the limb is directed by the wound epidermis, which controls blastema formation to promote regrowth of the appendage. Herein, we report that knockout (KO) or inhibition of Apoptosis Signal-regulated Kinase-1 (ASK1), also known as mitogen-activated protein kinase kinase kinase 5 (MAP3K5), after full thickness ear punch in mice prolongs keratinocyte activation within the wound epidermis and promotes regeneration of auricular cartilage. Histological analysis showed the ASK1 KO ears displayed enhanced protein markers associated with blastema formation, hole closure and regeneration of auricular cartilage. At seven …

Association Of Disease Location And Treatment With Survival In Diffuse Large B-Cell Lymphoma Of The Eye And Ocular Adnexal Region., Aseef H H. Ahmed, C. Stephen Foster, Carol L. Shields

Wills Eye Hospital Papers

Importance: Primary diffuse large B-cell lymphoma (DLBCL) of the ocular region is rare, and the utility of surgery and radiation therapy remains unresolved.

Objective: To explore the clinical characteristics and determine factors associated with overall survival in primary vitreoretinal lymphoma (PVRL) and ocular adnexal (OA)-uveal DLBCL.

Design, Setting, and Participants: This retrospective analysis included 396 patients with ophthalmic DLBCL from January 1, 1973, through December 31, 2014, using the Surveillance, Epidemiology, and End Results database. The median follow-up was 39.0 months (interquartile range, 5.1-72.9 months). All patients diagnosed with primary DLBCL of the eye or retina (PVRL) or the eyelid, …

Developmental Lead And/Or Prenatal Stress Exposures Followed By Different Types Of Behavioral Experience Result In The Divergence Of Brain Epigenetic Profiles In A Sex, Brain Region, And Time-Dependent Manner: Implications For Neurotoxicology., Deborah A. Cory-Slechta, Marissa Sobolewski, Garima Varma, Jay S. Schneider

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Over a lifetime, early developmental exposures to neurocognitive risk factors, such as lead (Pb) exposures and prenatal stress (PS), will be followed by multiple varied behavioral experiences. Pb, PS and behavioral experience can each influence brain epigenetic profiles. Our recent studies show a greater level of complexity, however, as all three factors interact within each sex to generate differential adult variation in global post-translational histone modifications (PTHMs), which may result in fundamentally different consequences for life-long learning and behavioral function. We have reported that PTHM profiles differ by sex, brain region and time point of measurement following developmental exposures to …

Medication Complications In Extracorporeal Membrane Oxygenation., Ami G. Shah, Michelle Peahota, Brandi Thoma, Walter K. Kraft

College of Pharmacy Faculty Papers

The need for extracorporeal membrane oxygenation (ECMO) therapy is a marker of disease severity for which multiple medications are required. The therapy causes physiologic changes that impact drug pharmacokinetics. These changes can lead to exposure-driven decreases in efficacy or increased incidence of side effects. The pharmacokinetic changes are drug specific and largely undefined for most drugs. We review available drug dosing data and provide guidance for use in the ECMO patient population.

The Bulletin: Sidney Kimmel Medical College At Thomas Jefferson University, Volume 66, Issue 2, Fall 2017

The Bulletin (formerly the Jefferson Medical College Alumni Bulletin)

This issue includes:

• Introducing the New Jefferson: One Name. Two Legacies. Infinite Possibilities
• The PhiladelphiaU Story: A History of Change and Innovation
• Two Alumnae, One Vision: A New Home Base for All Graduates
• Second Opinions for Docs, Second Chances for Patients: The Jefferson Angioplasty Center Helps Cardiac Patients Avoid Open Heart Surgery
• Dean's Column
• Findings: Molecule May Help Maintain Brain's Synaptic Balance
• The Families We Choose: A Message from Elizabeth Dale
• On Campus
• Basil Harris, MD '02: Merging Medicine, Engineering, and Design to Revolutionize Digital Healthcare
• Big Things, Small Beginnings: Jefferson Surgeons Are Exploring New Therapies That May Make Standard …

Optical Coherence Tomography Angiography Features Of Iris Racemose Hemangioma In 4 Cases., Jason L. Chien, Kareem Sioufi, Sandor Ferenczy, Emil Anthony T. Say, Carol L. Shields

Wills Eye Hospital Papers

Importance: Optical coherence tomography angiography (OCTA) allows visualization of iris racemose hemangioma course and its relation to the normal iris microvasculature.

Objective: To describe OCTA features of iris racemose hemangioma.

Design, Setting, and Participants: Descriptive, noncomparative case series at a tertiary referral center (Ocular Oncology Service of Wills Eye Hospital). Patients diagnosed with unilateral iris racemose hemangioma were included in the study.

Main Outcomes and Measures: Features of iris racemose hemangioma on OCTA.

Results: Four eyes of 4 patients with unilateral iris racemose hemangioma were included in the study. Mean patient age was 50 years, all patients were white, and …

An Investigation Of Human Beta-Defensins And Cathelicidin Expression In Patients With Pterygium., Remzi Karadag, Nurettin Bayram, Serpil Oguztuzun, Huseyin Bayramlar, Busra Bozer, Gulcin Simsek, Christopher J Rapuano

Wills Eye Hospital Papers

PURPOSE: To investigate human beta-defensins (HBDs) and cathelicidin LL-37 (LL-37) expressions in patients with pterygium.

METHODS: In this retrospective consecutive case series, 26 pterygium specimens and 15 normal conjunctival specimens of 15 control subjects were in vestigated. Expressions of HBD-1, HBD-2, HBD-3, and LL-37 were assessed using immuno histochemical staining. A brown color in the cytoplasm and/or nuclei of epithelial cells indicated positive staining for HBDs and LL-37. For each antibody, the intensity of the reaction (negative [-], weak [1+], moderate [2+], or strong [3+]) was determined to describe the immunoreactions.

RESULTS: The median age was 52 years in both …