Medicine and Health Sciences Commons^™

Dysregulated Gpcr Signaling And Therapeutic Options In Uveal Melanoma., Vivian Chua, Dominic Lapadula, Clinita Randolph, Jeffrey L. Benovic, Philip B. Wedegaertner, Andrew E. Aplin

Department of Biochemistry and Molecular Biology Faculty Papers

Uveal melanoma is the most common primary intraocular malignant tumor in adults and arises from the transformation of melanocytes in the uveal tract. Even after treatment of the primary tumor, up to 50% of patients succumb to metastatic disease. The liver is the predominant organ of metastasis. There is an important need to provide effective treatment options for advanced stage uveal melanoma. To provide the preclinical basis for new treatments, it is important to understand the molecular underpinnings of the disease. Recent genomic studies have shown that mutations within components of G protein-coupled receptor (GPCR) signaling are early events associated …

Fibulin-4 Is Essential For Maintaining Arterial Wall Integrity In Conduit But Not Muscular Arteries., Carmen M. Halabi, Thomas J. Broekelmann, Michelle Lin, Vivian S. Lee, Mon-Li Chu, Robert P. Mecham

Department of Dermatology and Cutaneous Biology Faculty Papers

Homozygous or compound heterozygous mutations in fibulin-4 (FBLN4) lead to autosomal recessive cutis laxa type 1B (ARCL1B), a multisystem disorder characterized by significant cardiovascular abnormalities, including abnormal elastin assembly, arterial tortuosity, and aortic aneurysms. We sought to determine the consequences of a human disease-causing mutation in FBLN4 (E57K) on the cardiovascular system and vascular elastic fibers in a mouse model of ARCL1B. Fbln4^E57K/E57K mice were hypertensive and developed arterial elongation, tortuosity, and ascending aortic aneurysms. Smooth muscle cell organization within the arterial wall of large conducting vessels was abnormal, and elastic fibers were fragmented and had a moth-eaten appearance. …

Value Of Superb Microvascular Imaging Ultrasonography In The Diagnosis Of Carpal Tunnel Syndrome: Compared With Color Doppler And Power Doppler., Jie Chen, Li Chen, Lei Wu, Rui Wang, Ji-Bin Liu, Bing Hu, Li-Xin Jiang

Department of Radiology Faculty Papers

The aim of this study was to compare the value of superb microvascular imaging (SMI) in carpal tunnel syndrome (CTS) with that of color Doppler ultrasonography (CDUS) and power Doppler ultrasonography (PDUS).Fifty patients with symptomatic CTS and 25 healthy volunteers were enrolled. The cross-sectional area (CSA), CDUS score, PDUS score, and SMI score of the median nerve (MN) at the carpal tunnel were recorded. The value of different ultrasonography (US) diagnostic strategies was calculated.The blood flow display ratio in the MN of the healthy volunteers had no statistical difference between CDUS, PDUS, and SMI (20%, 32%, and 48%, respectively, P …

Improved Survival After Acute Graft-Versus-Host Disease Diagnosis In The Modern Era., Hanna J. Khoury, Tao Wang, Michael T. Hemmer, Daniel Couriel, Amin Alousi, Corey Cutler, Mahmoud Aljurf, Joseph H Antin, Mouhab Ayas, Minoo Battiwalla, Jean-Yves Cahn, Mitchell Cairo, Yi-Bin Chen, Robert Peter Gale, Shahrukh Hashmi, Robert J. Hayashi, Madan Jagasia, Mark Juckett, Rammurti T. Kamble, Mohamed Kharfan-Dabaja, Mark Litzow, Navneet Majhail, Alan Miller, Taiga Nishihori, Muna Qayed, Helene Schoemans, Harry C. Schouten, Gerard Socie, Jan Storek, Leo Verdonck, Ravi Vij, William A. Wood, Lolie Yu, Rodrigo Martino, Matthew Carabasi, Christopher Dandoy, Usama Gergis, Peiman Hematti, Melham Solh, Kareem Jamani, Leslie Lehmann, Bipin Savani, Kirk R. Schultz, Baldeep M. Wirk, Stephen Spellman, Mukta Arora, Joseph Pidala

Department of Medical Oncology Faculty Papers

A cute graft-versus-host disease remains a major threat to a successful outcome after allogeneic hematopoietic cell transplantation. While improvements in treatment and supportive care have occurred, it is unknown whether these advances have resulted in improved outcome specifically among those diagnosed with acute graft-versus-host disease. We examined outcome following diagnosis of grade II-IV acute graft-versus-host disease according to time period, and explored effects according to original graft-versus-host disease prophylaxis regimen and maximum overall grade of acute graft-versus-host disease. Between 1999 and 2012, 2,905 patients with acute myeloid leukemia (56%), acute lymphoblastic leukemia (30%) or myelodysplastic syndromes (14%) received a sibling …

A Case Matched Study Examining The Reliability Of Using Impact To Assess Effects Of Multiple Concussions., Trevor Barker, Stephen A. Russo, Gaytri Barker, Mark A Rice, Mary G Jeffrey, Gordon Broderick, Travis J A Craddock

Department of Neurology Faculty Papers

BACKGROUND: Approximately 3.8 million sport and recreational concussions occur per year, creating a need for accurate diagnosis and management of concussions. Researchers and clinicians are exploring the potential dose-response cumulative effects of concussive injuries using computerized neuropsychological exams, however, results have been mixed and/or contradictory. This study starts with a large adolescent population and applies strict inclusion criteria to examine how previous mild traumatic brain injuries affect symptom reports and neurocognitive performance on the Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) computerized tool.

METHODS: After applying exclusion criteria and case matching, 204 male and 99 female participants remained. These participants …

Osa And Primary Snoring: Palatal Surgery And Office-Based Procedures, Adam Vasconcellos, Md

Department of Otolaryngology - Head and Neck Surgery Presentations and Grand Rounds

PowerPoint slide deck. (No audio)

Opinion: Inhibition Of Blood-Brain Barrier Repair As A Mechanism In Hiv-1 Disease., Monique E. Maubert, Brian Wigdahl, Michael R. Nonnemacher

Kimmel Cancer Center Papers, Presentations, and Grand Rounds

No abstract provided.

Generation Of Crispr Knockout Of Idh1 In Pancreatic Ductal Adenocarcinoma Cell Line: An Optimal Model To Study Pancreatic Cancer Metabolic Reprogramming, Katerina Dukleska, Md, Mahsa Zarei, Phd, Ali Vaziri-Gohar, Phd, Charles J. Yeo, Md, Jonathan Brody, Md, Jordan M. Winter, Md

Department of Surgery Posters

Introduction

• Pancreatic ductal adenocarcinoma (PDA) is the third leading cause of cancer-related death in the US.

• PDA is resistant to conventional chemotherapy; however, mechanisms that contribute to this chemoresistance are not well-described.

• The tumor microenvironment in PDA has a dense stromal reaction, which is thought to result in low oxygen and low nutrient conditions (Feig, C., et al. 2012).

• Isocitrate Dehydrogenase 1 (IDH1) has been identified as an enzyme that plays an important role in chemoresistance in PDA (Zarei, M., et al. In progress).

• We sought to establish an IDH1 knockout cell line to further …

Evidence In Action: Impact Of Early Occupational Therapy Intervention In The Complex Stroke Patient, Gabriela Charles, Otr/L, Katie Connolly, Otr/L, Alan Cook, Otr/L, Megan Drollinger, Otr/L

Department of Occupational Therapy Posters and Presentations

Introduction

Cerebrovascular disorders represent the third leading cause of mortality and second major cause of long-term disability in North America (3). Patients who arrive at the emergency room within 3 hours of their first symptoms tend to have less disability 3 months after a stroke than those who received delayed care (4). Further, several studies suggest stroke rehabilitation is most effective when initiated early, and confirms the existence of a positive correlation between early rehabilitation interventions and improved functional outcomes (2). Rationale to support these findings is centered around various arguments that bed rest negatively affects various body systems and …

Book Club At Intern Orientation To Help Frame Professional Identity, Gretchen A. Diemer, Md, Emily Stewart, Md

Department of Medicine Posters

Background

Orientation is a whirlwind of regulations, reminders, rules and usually some social outlets. Very little of it helps new interns foster and celebrate their blossoming professional identity. The book club combats the hidden curriculum emphasizing regulations and policies by nurturing the growing sense of whom they are as physicians, actively placing value on the idea that they are developing a professional identity.

St Elevation Myocardial Infarction In A Young Adult: Expect The Unexpected, Shashank Jain, Md, Priya Rajagopalan, Md, Mitul Kanzaria, Md, Meir Mazuz, Md

Department of Medicine Posters

Background

• Acute myocardial infarction (MI) in young adults can present a diagnostic and therapeutic challenge
• Kawasaki disease (KD) is a vasculitis of unknown etiology that occurs in infancy and childhood
• Coronary artery aneurysms (CAA) are the most serious complication of untreated KD seen in upto 25% of patients
• Thrombosis of these CAA or coronary stenosis can present as MI in less than 2% of cases which mainly occur in the 1^st year of disease onset
• Late presentations in adult life is extremely rare

The Bug-Bag: Consolidating Medications To Cut Costs, James Harrigan, Pharmd, Ms3, Erin Bange, Md, Jessica Caro, Md, Sarah Yeager, Pharmd, David Manoff, Md

College of Pharmacy Posters

Background

Founded in 1991, JeffHOPE is an organization of student run medical clinics providing care to the homeless and underserved populations of Philadelphia. JeffHOPE currently operates at 5 different sites

• Eliza Shirley

Population served: Women and children

Serves as a transitional shelter and aims to help newly homeless women and children find more stable housing

• Sunday Breakfast

Population served: Men older than 18

Serves as a transitional shelter offering housing for 30 days for homeless men

• ACTS

Population served: Women and children

Provides long term housing for women and children who are homeless. The shelter is also located next to …

A Comparative Analysis Of The Paris System And Institutional Reporting System For Urine Cytology In Upper Tract Urothelial Specimens, Kim Hookim, Md, James P. Casey, Md, Rossitza Draganova-Tacheva, Md, Marluce Bibbo, Md, Charalambos C. Solomides, Md

Department of Pathology, Anatomy, and Cell Biology Posters

The authors of this abstract have no conflicts of interest

Introduction

Cytology is integral in the assessment of urothelial cell carcinoma (UCC). However, upper urinary tract (UUT) specimens are cytologically challenging due to limited tissue and reactive atypia. At our institution UUT biopsies are processed as cell blocks (CB). We compared our institution’s reporting system (IRS) with the recently proposed Paris System for Reporting Urine Cytology (PRS) (Table 1) in UUT specimens and correlated the findings with CB and follow-up resections.

Increased Density Of Axonal Spheroids In The Nucleus Gracilis Of The Lower Brainstem In Diabetic Versus Non-Diabetic Patients, Tiffany Morrison, Msiv, Lawrence C. Kenyon, Md, Phd

Department of Pathology, Anatomy, and Cell Biology Posters

Abstract

The presence of axonal spheroids is unusual in the absence of a clinical history of CNS injury. Nevertheless, increased numbers of axonal spheroids in the lower brainstem have been consistently observed in autopsied diabetic patients. A prospective comprehensive investigation of the density, size, and distribution of axonal spheroids in the brainstem and spinal cord was undertaken in 22 patients and correlated with comorbidities, age, and gender. In most cases, an increased density of axonal spheroids was identified within the nucleus gracilis of the lower brainstem. Moreover, the highest densities (p = 0.013) and circumferences (p = 0.002) of axonal …

Exploring The Role Of Life Review Videos With Patients Diagnosed With Advanced Cancer, Lisa M. Capparella, Mss, Lcsw, Osw-C, S. Otis-Green, Msw, Ma, Acsw, Lcsw, Osw-C

Department of Medical Oncology Posters

Background/Rationale

• Life Review Videos can provide patients with hope, help them finding meaning and value of life.
• Patients with cancer have limited opportunities to discuss their life before cancer.
• Insufficient research related to how patients would want their video to be used by family/friends and who they would chose to share their video with.
• Limited research regarding whether the relationship with the interviewer matters to participants of life review.

Perceptions Of Accelerated Bachelor Of Science In Nursing Program Graduates Regarding Andragogical Practices Employed By Faculty, Mary Hanson-Zalot, Edd, Msn, Rn, Aocn, Cne

College of Nursing Posters

Abstract

This research study was designed to examine accelerated, second-degree prelicensure baccalaureate graduates’ perceptions of the andragogical practices employed by faculty that prepared students best to begin practice as entry level professional nurses. Through listening to the voices of graduates an emic perspective of the perceptions of the second-degree graduates emerged. Six key themes were identified related to the educational experience.

Infection Prevention And Control In Baccalaureate Nursing Education: Identifying Content, Teaching Strategies And Gaps, Mary Lou Manning, Phd, Crnp, Cic, Faan, Monika Pogorzelska-Maziarz, Phd, Mph, Cic

College of Nursing Posters

Background

Healthcare-associated infections (HAI) are a major risk to patient safety. In the US, on any given day, 1 of every 25 inpatients has at least one HAI, resulting in significant health, social, and economic consequences.¹ It is estimated that up to 70% of some types of HAIs are preventable through improved infection prevention and control (IPC) practices of health care providers.²

Additionally, antibiotic resistant infections and emerging and re-emerging infectious diseases represent ongoing threats to population health.

Integrating IPC concepts and content in baccalaureate nursing education is crucial to ensure that nurses have the essential knowledge, skills …

Looking Beyond The Traditional: Integrating A New Curriculum Design Into An Immersion Practicum Evaluation Tool, Denise Brown, Msn, Rnc-Ob, Kathleen D. Black, Phd, Rnc-Ob, Maureen Fitzgerald, Msn, Rnc-Nic, Tara Flood, Msn, Cbc, Maureen Kane, Msn, Rn, Cen, Laura Roettger, Msn, Cpnp-Pc

College of Nursing Posters

Abstract

Changes in health care delivery and recent reports from the Institute of Medicine (IOM, 2010) call for nurse educators to reconstruct the way they prepare nursing students for practice in the 21st century. Health care delivery continues to shift from the acute care to outpatient and transitional settings, therefore faculty must assure that graduates are prepared to practice in those environments. In order to address these changes, the Jefferson College of Nursing at Thomas Jefferson University embarked on a mission to redesign their undergraduate curriculum. The new clinical courses, now referred to as Immersion Practicums, were designed to allow …

Occupational Therapy And People Living With Scoliosis And Undermineralized Bones, Curran Smith, Ids, Katie Ramin, Ots

Program of Industrial Design Posters

Poster highlights work with 7 year old boy Brendan. Created Prone Pillow which can be used as a back rest. It also features a handle for carrying and a removable cover.

Socioeconomic Status And Stroke Outcome, Sophia Dang, Jonathan C. Li, Kimon Bekelis, Md, Stavropoula Tjoumakaris, Md

Sigma Xi Student Research Day

Introduction

• International studies find socioeconomic status (SES) to be predictive of functional impairment after stroke.^1,2
• Lower socioeconomic status (LSE) is associated with increased severity of stroke onset, higher incidence of risk factors, and worse outcomes.³
• We sought to confirm the predictive significance of SES on acute ischemic stroke patient outcomes at a large urban, U.S. stroke center.

Pre-Admission Blood Pressure And Outcome In A Large Telestroke Cohort, Elias Atallah, Md, Kimon Bekelis, Md, Nohra Chalouhi, Md, Hasan Saad, Md, Sophia Dang, Jonathan C Li, Ayan Kumar, Bs, Justin Turpin, Randa R. Barsoom, Stavropoula Tjoumakaris, Md, David Hasan, Md, Jl, Robert H. Rosenwasswer Md, Pascal Jabbour, Md

Sigma Xi Student Research Day

Introduction

• 55% of Americans live within 60 miles of a primary stroke center.
• Telestroke (TS) units shorten treatment delivery times (e.g. rt-PA) and reduce permanent neurologic sequelae.^1,2
• TS units provide tele-consults with neurovascular specialists experienced in medical and surgical treatment of acute ischemic stroke (AIS).
• Maintenance of systolic blood pressure (SBP) > 140mmHg is recommended in AIS management. SBP < 140mmHg is independently predictive of poor neurologic outcome.³

• We analyzed all patients with AIS symptoms transported to Thomas Jefferson University Hospital (TJUH), via JeffSTAT EMS ground vehicles or helicopters, to verify efficiency of the TS system and the prognostic value of vital sign-monitoring throughout the transportation process.

Cost Savings And Efficiency Realized Decreasing Orders For Type And Crossmatching, Susan Garruto, Msha, Msn, Bsn, Rn, Aprn, Cnor, Rnfa, Katy Loos, Msn, Bsn, Rn, Acagnp, Rae Fierro, Rn, Cnor, Rnfa

Department of Neurosurgery Posters

Background

• Thomas Jefferson University Hospital (TJUH) is a Tertiary, Level 1Trauma Center and the Regional Spinal Cord Injury Center of the Delaware Valley with 900+ beds

• C/T Ratio is the ratio of RBC units cross matched for potential transfusion to the number of units actually transfused

• The American Association of Blood Banks (AABB) recommendation for C/T ratio is < 2

• TJUH blood bank, on periodic review by AABB and the College of American Pathologists (CAP) was cited as deficient in C/T ratio quality indicators

• Cost to cross match RBC units is on average $71 with the charge …

A Company-Wide Initiative To Improve Screening For Vision Impairment, Tami Levengood, Otr/L, Mscs, Otd, Marie Christine Potvin, Phd, Otr/L

CSHLA Scholar Day

Objectives:

• > 1 out of 6 point up in knowledge of vision impairment & confidence in screening (6 questions; 1=strongly disagree to 7=strongly agree)
• 40% of clients will undergo vision screening
• Identify & resolve barriers to vision screening (4 questions)

Sensory-Based Interventions In The School Setting: Perspectives Of Paraeducators, Lyn Carvell, Ms, Otr/L, Otd Candidate, Marie-Christine Potvin, Phd, Otr/L

CSHLA Scholar Day

Sensory experiences or environmental modifications can:

• Regulate behavior
• Improve sensory modulation
• Improve readiness for activities
• Improve focus for learning

Sleep Quality And Quantity May Differ By Design Versus Health Science Majors At Philadelphia University, T. Sweeney, T. Buonanno, B. Balsirow, J. Bhatt, B. Buleza, N. Grosso, T. Paulose, M. Pease, R. Petrie, A. Zaveri, A. Bower

CSHLA Scholar Day

Abstract:

Sleep deprivation in college students leads to a diminishment in motivation, ability to retain information, and shortens attention span which combined leads to lower academic performance. While some students may resort to caffeine or substance use to increase productivity, others forego drowsiness and consequently suffer from sleep deprivation. Increased stress and screen time both aggravate this situation. We hypothesize that there is a relationship between work demands related to a student’s choice of major and poor sleep quantity and quality. A 38-question survey was administered to 70 college students at Philadelphia University in March 2017 using Typeform, an on-line …

Image-Guided High-Dose Rate Intracavitary Brachytherapy In The Treatment Of Medically Inoperable Early-Stage Endometrioid Type Endometrial Adenocarcinoma, Scott E. Jordan, Md, Ida Micaily, Md, Enrique Hernandez, Md, J. Stuart Ferriss, Md, Curtis T. Miyamoto, Md, Facr, Shidong Li, Phd, Bizhan Micaily, Md

Division of Internal Medicine Faculty Papers & Presentations

To report the experience with high dose rate, image guided intracavitary brachytherapy in the treatment of medically inoperable, early stage endometrial cancer.

Poster presented at:

American Brachytherapy Society Annual Meeting April 20-22, 2017 in Boston MA.

A Genetically Encoded Fluorescent Trna Is Active In Live-Cell Protein Synthesis., Isao Masuda, Takao Igarashi, Reiko Sakaguchi, Ram G. Nitharwal, Ryuichi Takase, Kyu Young Han, Benjamin J. Leslie, Cuiping Liu, Howard Gamper, Taekjip Ha, Suparna Sanyal, Ya-Ming Hou

Department of Biochemistry and Molecular Biology Faculty Papers

Transfer RNAs (tRNAs) perform essential tasks for all living cells. They are major components of the ribosomal machinery for protein synthesis and they also serve in non-ribosomal pathways for regulation and signaling metabolism. We describe the development of a genetically encoded fluorescent tRNA fusion with the potential for imaging in live Escherichia coli cells. This tRNA fusion carries a Spinach aptamer that becomes fluorescent upon binding of a cell-permeable and non-toxic fluorophore. We show that, despite having a structural framework significantly larger than any natural tRNA species, this fusion is a viable probe for monitoring tRNA stability in a cellular …

Structural And Functional Analysis Of A Β2-Adrenergic Receptor Complex With Grk5., Konstantin E. Komolov, Yang Du, Nguyen Minh Duc, Robin M. Betz, João P.G.L.M. Rodrigues, Ryan D. Leib, Dhabaleswar Patra, Georgios Skiniotis, Christopher M. Adams, Ron O. Dror, Ka Young Chung, Brian K. Kobilka, Jeffrey L. Benovic

Department of Biochemistry and Molecular Biology Faculty Papers

The phosphorylation of agonist-occupied G-protein-coupled receptors (GPCRs) by GPCR kinases (GRKs) functions to turn off G-protein signaling and turn on arrestin-mediated signaling. While a structural understanding of GPCR/G-protein and GPCR/arrestin complexes has emerged in recent years, the molecular architecture of a GPCR/GRK complex remains poorly defined. We used a comprehensive integrated approach of cross-linking, hydrogen-deuterium exchange mass spectrometry (MS), electron microscopy, mutagenesis, molecular dynamics simulations, and computational docking to analyze GRK5 interaction with the β2-adrenergic receptor (β2AR). These studies revealed a dynamic mechanism of complex formation that involves large conformational changes in the GRK5 RH/catalytic domain interface upon receptor binding. …

The Value Of Cancer Immunotherapy Summit At The 2016 Society For Immunotherapy Of Cancer 31st Anniversary Annual Meeting, Howard L. Kaufman, Michael B. Atkins, Adam Dicker Md, Phd, Heather S. Jim, Louis P. Garrison, Roy S. Herbst, William T. Mcgivney, Steven Silverstein, Jon M. Wigginton, Peter P. Yu

Department of Medicine Faculty Papers

As healthcare costs continue to rise, there has been great interest in understanding and defining the value of current therapeutic strategies for the treatment of cancer. Cancer immunotherapy has emerged as a clinically beneficial alternative to conventional therapies for a variety of malignancies. Characterized by broad clinical activity, durable response rates, distinct side effects, and unique response kinetics, immune-based agents are vastly different compared with traditional cytotoxic or targeted therapies. To date, however, value assessments in oncology have not focused on the unique aspects of cancer immunotherapy, which has resulted in a lack of understanding of the true value of …

Association Of Magnet Status With Hospitalization Outcomes For Ischemic Stroke Patients., Kimon Bekelis, Symeon Missios, Todd A. Mackenzie

Department of Neurosurgery Faculty Papers

BACKGROUND: It is not clear whether Magnet recognition by the American Nurses Credentialing Center (nursing excellence program) is associated with improved patient outcomes. We investigated whether hospitalization in a Magnet hospital is associated with improved outcomes for patients with ischemic stroke.

METHODS AND RESULTS: We performed a cohort study of patients with ischemic stroke from 2009 to 2013, who were registered in the New York Statewide Planning and Research Cooperative System database. Propensity-score-adjusted multivariable regression models were used to adjust for known confounders, with mixed effects methods to control for clustering at the facility level. An instrumental variable analysis was …