Medicine and Health Sciences Commons^™

Cell-Free Circulating Mitochondrial Dna Content And Risk Of Hepatocellular Carcinoma In Patients With Chronic Hbv Infection., Ling Li, Hie-Won Hann, Shaogui Wan, Richard Hann, Chun Wang, Yinzhi Lai, Xishan Ye, Alison Evans, Ronald E. Myers, Phd, Dsw, Zhong Ye, Bingshan Li, Jinliang Xing, Hushan Yang

Department of Medicine Faculty Papers

Recent studies have demonstrated a potential link between circulating cell-free mitochondrial DNA (mtDNA) content and cancers. However, there is no study evaluating the association between circulating mtDNA as a non-invasive marker of hepatocellular carcinoma (HCC) risk. We conducted a nested case-control study to determine circulating mtDNA content in serum samples from 116 HBV-related HCC cases and 232 frequency-matched cancer-free HBV controls, and evaluate the retrospective association between mtDNA content and HCC risk using logistic regression and their temporal relationship using a mixed effects model. HCC cases had significantly lower circulating mtDNA content than controls (1.06 versus 2.47, P = 1.7 …

Association Between Knowledge And Performance In Clerkships And Usmle Step 2 Ck Scores: Implications For Counseling And Academic Decision-Making, Abigail Kay, Md, Kristin Desimone, Md, Jon Veloski, Ms, Steven Herrine, Md

Department of Family & Community Medicine Posters

Background

Step 2 CK scores are of increasing importance in medical student career planning. In the National Resident Matching Program 2014 Program Director Survey, Step 1 scores were the highest-rated among 33 factors used in screening applicants to be interviewed (94% cited it with a mean rating of 4.1 on a 5 point Likert scale); Step 2 scores were rated fourth in importance (80% cited it, mean rating of 4.1). When citing factors for ranking a given applicant, Step 1 scores ranked 5^th (80% cited, with mean rating of 4.1) and Step 2 CK scores ranked 7^th (71% …

Improving Outcomes By Optimizing Sleep Opportunities In The Critically Ill Neuroscience Patient, Marie Wilson, Bsn, Rn, Ccrn, Cnrn

Department of Nursing papers and presentations

Purpose

The purpose of the Neuroscience Intensive Care Unit is to provide specialized quality care to a high acuity and vulnerable critically ill population with the desired outcome of health improvement. It would appear that the goal for both Neuroscience Intensive Care Units and “sleep” would be one of healing; however it is also well documented that routine sleep disturbances due to either deprivation or disruption in neuroscience critical care units negatively affects patient outcomes.

Further exploration of sleep architecture, physiologic responses that occur during sleep and factors contributing to a lack of qualitative and quantitative sleep in critical care …

Ot & Industrial Design: Developing Client-Centered Product Designs To Enhance Occupational Performance & Participation, Kimberly S. Mollo, Otd, Otr/L, Robert W. Walsh, Ms, Otr/L, Michael Mcallister, Mid

Department of Occupational Therapy Posters and Presentations

Objectives

• Recognize the needs and benefits of broadening inter-professional collaborations outside traditional occupational therapy models of teaching, learning, and practice.
• Identify components required to create, conduct, and integrate effective inter-professional occupational therapy and industrial design collaboration
• Describe outcomes to measure effectiveness at the student, client, and inter-professional levels.

Using Animals During Occupational Therapy To Improve Quality Of Life, Lauren Morosky, Mat, Ots, Elizabeth Gina Fenn, Ots, Audrey Zapletal, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Background:

Integrating animals into occupational therapy intervention with individuals of various health conditions…

• Incorporating animals into an OT intervention plan is unique and can be an alternative to traditional device. Research suggests the animals may be viewed as a form of assistive technology(Camp, 2001).
• Occupational therapy intervention incorporating animals may:
• Increase participation in the community
• Augment the individual’s independence
• Positively impact the individual's psychosocial functioning (Camp, 2001)

Enhancing Occupational Therapy Student Systematic Reviews: An Occupational Therapy Faculty And Librarian Collaboration, Teal W. Benevides, Phd, Otr/L, Katie Moran, Ots, Gary E. Kaplan, Ms, Ahip, Paul Hunter, Mlis, Dmd, Daniel G. Kipnis, Msi

Department of Occupational Therapy Posters and Presentations

Objective: To describe the outcomes of a curriculum-based collaboration between Occupational Therapy faculty and librarians (‘collaboration’) to enhance graduate student skills for conducting and disseminating a systematic review (SR)

Teaching Mindfulness Strategies To Parents Of Adolescents With Executive Functioning Deficits To Support Caregiving Skills, Kimberly S. Mollo, Otd, Otr/L

Department of Occupational Therapy Posters and Presentations

SETTING & BACKGROUND

Health Horizons

• Suburban private medical practice located in suburbs of Philadelphia
  • General, integrative, and holistic medicine; psychiatry
• OT referrals contracted to Kimberly S. Mollo’s private homecare practice
  • Population: child, adolescent & young adult (ages 7-25)
  • Dx: ADHD, ODD, LD, NVLD, anxiety, & co-morbid executive dysfunction
  • OT sessions in home; parents are present to provide carryover
  • Fee-for-service pay structure

Executive Functioning

• Defined: complex neurological processes necessary for purposeful activity
• Skills emerge, combine, and mature during teenage years
• Lack of skill attainment:
  • Leads to difficulties in all areas of occupation
  • Predictor of level of occupational dysfunction in adulthood
• Parents …

Evaluating The Decision Making Process Of Pediatricians' Recommendations For First Complementary Foods In Infants, Gretchen Schmoyer

Master of Public Health Capstone Presentations

The purpose of this research study was to document the feeding guidelines from medical associations, understand what pediatricians are recommending to new mothers, and to capture the response from mothers regarding their understanding and personal practices in feeding. Previous studies have found that mothers were not following feeding recommendations by the American Academy of Pediatrics (AAP). Furthermore, the role of infant rice cereal as an early first food is currently under debate. Qualitative research was conducted through interviews with five mothers of children under 2 years, five healthcare providers in pediatric settings, and three policy experts. The Theory of Reasoned …

Vaccination Of Gerbils With Bm-103 And Bm-Ral-2 Concurrently Or As A Fusion Protein Confers Consistent And Improved Protection Against Brugia Malayi Infection., Sridhar Arumugam, Junfei Wei, Zhuyun Liu, David Abraham, Aaron Bell, Maria Elena Bottazzi, Peter J Hotez, Bin Zhan, Sara Lustigman, Thomas R Klei

Department of Microbiology and Immunology Faculty Papers

BACKGROUND: The Brugia malayi Bm-103 and Bm-RAL-2 proteins are orthologous to Onchocerca volvulus Ov-103 and Ov-RAL-2, and which were selected as the best candidates for the development of an O. volvulus vaccine. The B. malayi gerbil model was used to confirm the efficacy of these Ov vaccine candidates on adult worms and to determine whether their combination is more efficacious.

METHODOLOGY AND PRINCIPLE FINDINGS: Vaccine efficacy of recombinant Bm-103 and Bm-RAL-2 administered individually, concurrently or as a fusion protein were tested in gerbils using alum as adjuvant. Vaccination with Bm-103 resulted in worm reductions of 39%, 34% and 22% on …

Strategies For Integrating Health Literacy Into Entry-Level Ot Curricula: A Comprehensive Approach, Susan Toth-Cohen, Phd, Otr/L, Cheryl Miller, Drot, Otr/L, Mary Muhlenhaupt, Otd, Otr/L, Faota, Audrey Zapletal, Ms, Otr/L

Department of Occupational Therapy Posters and Presentations

Synopsis:

Health literacy is a significant factor impacting the efficacy of healthcare services. Initiatives related to health literacy demonstrate that OTs have unique opportunities to promote health literacy and facilitate its integration into practice. It is therefore critical to explore ways in which health literacy content can be incorporated into entry-­‐level OT curricula. Doing so will help ensure that future practitioners are prepared to meet key standards related to health literacy, including those established by ACOTE. This session will highlight strategies and methods to incorporate health literacy into entry-­‐level OT curricula.

Dcc Mediates Functional Assembly Of Peripheral Auditory Circuits., Young J Kim, Sheng-Zhi Wang, Stephen Tymanskyj, Le Ma, Huizhong W Tao, Li I Zhang

Department of Neuroscience Faculty Papers

Proper structural organization of spiral ganglion (SG) innervation is crucial for normal hearing function. However, molecular mechanisms underlying the developmental formation of this precise organization remain not well understood. Here, we report in the developing mouse cochlea that deleted in colorectal cancer (Dcc) contributes to the proper organization of spiral ganglion neurons (SGNs) within the Rosenthal's canal and of SGN projections toward both the peripheral and central auditory targets. In Dcc mutant embryos, mispositioning of SGNs occurred along the peripheral auditory pathway with misrouted afferent fibers and reduced synaptic contacts with hair cells. The central auditory pathway simultaneously exhibited similar …

Use Of Propensity Score Matching To Identify A Strong Association Between Strategic Concentration To Mitochondria-Sr Associations Of The Mitochondrial Ca2+ Uniporter: Ca2+ Uptake Hotspots In The Cardiac Mitochondria, Sergio De La Fuente, Caitlin Vail, Elorm J. Agra, Kira Holmstrom, Junhui Sun, Jyotsna Mishra, Toren Kinkel, Elizabeth Murphy, Suresh K. Joseph, Shey-Shing Shen, György Csordás

Department of Pathology, Anatomy, and Cell Biology Posters

Introduction:

• Control of the mitochondrial ATP production by SR-derived Ca²⁺ signals includes local, nanodomain Ca²⁺ transfer from ryanodine receptors (RyR2) to the mitochondrial matrix (excitation-bioenergetics coupling).
• Ca²⁺ crosses the inner mitochondrial membrane (IMM) via the mtCU, a low-affinity Ca²⁺-activated Ca²⁺ channel complex.
• The surface area of cardiac IMM is extensively enhanced by cristae folding; however, mitoplast patch clamp studies showed mtCU current density the lowest amongst a range of tissues (Fieni 2012. Nat Commun).

Gaining Competencies During Early Medical Training: Medical Students As Teaching Assistants In Dissection-Based Anatomy Course, Martin T. Brown, Bruce Fenderson, Guiyan Zhang

Department of Pathology, Anatomy, and Cell Biology Posters

Introduction and Objectives

• In 2002, ACGME identified six ACGME Core Competencies: patient care; medical knowledge; practice-based learning and improvement; interpersonal and communication skills; professionalism; and systems-based practice.
• AAMC recommended lists of similar competencies for the curricula of medical schools. Competency based curricula have been widely implemented in medical schools.
• Effective shifting in the graduate medical educational programs has been reported in various clinical specialties.
• There is a lack of reported efforts and development on competency training in early preclinical years of medical education.

Objectives:

• To explore methods for strengthening medical students’ competency training during preclinical undergraduate medical education.
• To measure …

Rare Case Of Large Adrenal Mass, Anitha Somasundaram, Md, Edward B. Ruby, Md

Department of Neurosurgery Posters

Background:

Giant hemangiomas of the adrenal gland are very rare. We present a case of giant adrenal hemangioma presenting as adrenal incidentaloma.

Jefferson Digital Commons Quarterly Report: January-March 2016, Daniel G. Kipnis, Msi, Kelsey Duinkerken, Msi, James Copeland, Libt

Jefferson Digital Commons Reports

This report includes:

• Adding Creative Commons Licenses to works in the JDC

• Assorted new assets added to the JDC including nursing oral histories, Physical Therapy student Capstone posters, Grand Rounds and much more

• What people are saying about the JDC from the following countries: Italy, Pakistan, Australia, Brazil, Zimbabwe and Ireland

Neonatal Abstinence Syndrome: Pharmacologic Strategies For The Mother And Infant., Walter K. Kraft, Megan W. Stover, Jonathan M. Davis

Department of Pharmacology and Experimental Therapeutics Faculty Papers

Opioid use in pregnancy has increased dramatically over the past decade. Since prenatal opioid use is associated with numerous obstetrical and neonatal complications, this now has become a major public health problem. In particular, in utero opioid exposure can result in neonatal abstinence syndrome (NAS) which is a serious condition characterized by central nervous system hyperirritability and autonomic nervous system dysfunction. The present review seeks to define current practices regarding the approach to the pregnant mother and neonate with prenatal opiate exposure. Although the cornerstone of prenatal management of opioid dependence is opioid maintenance therapy, the ideal agent has yet …

Evaluation Of Polymorphic Locus Sequence Typing For Candida Glabrata Epidemiology., Santosh Katiyar, Eric Shiffrin, Md, Celeste Shelton, Kelley Healey, John-Paul Vermitsky, Tom Edlind

Department of Medicine Faculty Papers

The opportunistic yeastCandida glabratais increasingly refractory to antifungal treatment or prophylaxis and relatedly is increasingly implicated in health care-associated infections. To elucidate the epidemiology of these infections, strain typing is required. Sequence-based typing provides multiple advantages over length-based methods, such as pulsed-field gel electrophoresis (PFGE); however, conventional multilocus sequence typing (targeting 6 conserved loci) and whole-genome sequencing are impractical for routine use. A commercial sequence-based typing service forC. glabratathat targets polymorphic tandem repeat-containing loci has recently been developed. These CgMT-J and CgMT-M services were evaluated with 56 epidemiologically unrelated isolates, 4 to 7 fluconazole-susceptible or fluconazole-resistant isolates from each of …

Telemedicine Resuscitation And Arrest Trial (Treat): A Feasibility Study Of Real-Time Provider-To-Provider Telemedicine For The Care Of Critically Ill Patients, Anish K. Agarwal, David F. Gaieski, Sarah M. Perman, Marion Leary, Gail Delfin, Benjamin S. Abella, Brendan G. Carr

Department of Emergency Medicine Faculty Papers

No abstract provided.

Opioid Exposed Mothers And Infants In Delaware: Clinical And Legal Considerations, Michele K. Savin, Msn, Nnp-Bc, David A. Paul, Md

College of Nursing Faculty Papers & Presentations

Drug use is on the rise in Delaware, as demonstrated by the continued increase in infants born with neonatal abstinence syndrome. Thoughful, evidence based, and coordinated approaches are necessary to impact this problem. There is solid evidence that mothers and infants who remain together have improved outcomes. Professional medical and nursing societies are unanimous in support of non-punitive approaches to care. Medical Professionals, legislators, and society in general would benefit from ongoing education on the addiction disease process in order to best care for the increasing number of mother/baby dyads with neonatal abstinence syndrome.

Advances In Allograft Monitoring After Intestinal Transplantation., Augusto Lauro, Md, Phd, Ignazio R. Marino, Md, Scd, Cal S. Matsumoto, Md

Department of Surgery Faculty Papers

PURPOSE OF REVIEW: The intestinal allograft, with an enormous lymphoid load, is a highly immunogenic organ which elicits a strong alloimmune response. In the early posttransplant period, a robust graft biopsy protocol via a temporary ileostomy is utilized for surveillance to detect rejection. In the later posttransplant period, after enteral continuity is reestablished, graft biopsies via a colonoscopy become more cumbersome. Alternative methods for intestinal allograft monitoring other than graft biopsy are of particular interest.

RECENT FINDINGS: Biomarkers and diagnostic tools, such as granzyme B, perforin, fecal calprotectin, citrulline, donor-specific antibody, and zoom video endoscopy have all been studied for …

Endothelial To Mesenchymal Transition (Endomt) In The Pathogenesis Of Systemic Sclerosis-Associated Pulmonary Fibrosis And Pulmonary Arterial Hypertension. Myth Or Reality?, Sergio A. Jimenez, Sonsoles Piera-Velazquez

Department of Dermatology and Cutaneous Biology Faculty Papers

Systemic Sclerosis (SSc) is a systemic autoimmune disease characterized by progressive fibrosis of skin and multiple internal organs and severe functional and structural microvascular alterations. SSc is considered to be the prototypic systemic fibrotic disorder. Despite currently available therapeutic approaches SSc has a high mortality rate owing to the development of SSc-associated interstitial lung disease (ILD) and pulmonary arterial hypertension (PAH), complications that have emerged as the most frequent causes of disability and mortality in SSc. The pathogenesis of the fibrotic process in SSc is complex and despite extensive investigation the exact mechanisms have remained elusive. Myofibroblasts are the cells …

Pay For Performance And Treatment Outcome, Emily Loscalzo, Psyd, A. Levit, Robert Sterling, Phd, Stephen Weinstein, Phd

Department of Psychiatry and Human Behavior Faculty Papers

Introduction:

Pay for Performance (P4P): Models which offer fiscal incentives to medical and behavioral health providers for meeting specific expectations related to patient care have gained popularity over the last decade as a means of improving quality of care (Bremer et al., 2008). Research by McLellan et al. (2008) has supported the feasibility of implementing such programs and the openness of substance abuse treatment facilities to participating in P4P.

A Case-Control Genome-Wide Association Study Identifies Genetic Modifiers Of Fetal Hemoglobin In Sickle Cell Disease., Li Liu, Alexander Pertsemlidis, Liang-Hao Ding, Michael D Story, Martin H Steinberg, Paola Sebastiani, Carolyn Hoppe, Samir K. Ballas, Betty S Pace

Cardeza Foundation for Hematologic Research

Sickle cell disease (SCD) is a group of inherited blood disorders that have in common a mutation in the sixth codon of the β-globin (HBB) gene on chromosome 11. However, people with the same genetic mutation display a wide range of clinical phenotypes. Fetal hemoglobin (HbF) expression is an important genetic modifier of SCD complications leading to milder symptoms and improved long-term survival. Therefore, we performed a genome-wide association study (GWAS) using a case-control experimental design in 244 African Americans with SCD to discover genetic factors associated with HbF expression. The case group consisted of subjects with HbF≥8.6% (133 samples) …

Cerebrospinal Fluid Leak After Microvascular Reconstruction Of Large Craniofacial Defects With Orbital Exenteration, Kurren Gill, Ba, David Hsu, Md, Patrick Tassone, Md,, John Pluta, Md, Gurston G. Nyquist, Md, Howard Krein, Md, Phd, Jurij Bilyk, Md, Ann P. Murchison, Md, Alfred Iloreta, Md, James J. Evans, Md, Ryan N. Heffelfinger, Md, Joseph M. Curry, Md

Department of Otolaryngology - Head and Neck Surgery Posters

Abstract

Objectives: To assess risk factors for cerebrospinal fluid (CSF) leak after microvascular reconstruction of extensive cranio-orbitofacial resection with orbital exenteration (CFOE).

Study Design: Retrospective Case Series

Methods: 70 consecutive patients at a tertiary hospital underwent 76 procedures with microvascular reconstruction of CFOE defects. Patients were stratified by extent of skull base exposure and presence or absence of dural resection. Patients with exposure of the orbital apex and roof alone were classified as minimal skullbase exposure (MSE, n=32). Those with exposure beyond the orbital apex and roof were classified as significant skullbase exposure (SSE, n=38), including those with dural resection …

A 22-Year-Old Man With Pleural Tuberculosis Associated Hydropneumothorax: Case Report And Literature Review., Lauren A Sharan, Thea Price, Md, Boyd Hehn, David Manoff, Md, Scott W. Cowan, Md

Department of Medicine Faculty Papers

A 22-year-old Asian male presented with fever, non-productive cough, right-sided pleuritic chest pain and was found to have a large right hydropneumothorax. A chest tube was placed. Pleural fluid analysis revealed a lymphocytic predominant exudate and he was subsequently started on four-drug daily anti-tuberculosis therapy (isoniazid, ethambutol, rifampin, pyrazinamide). Pleural biopsy revealed acid-fast bacilli. Given his persistent pleural effusion, he was given four doses of intrapleural tissue plasminogen activator (tPA) and dornase alpha (DNase) via his chest tube over a period of 6 days resulting in clinical and radiologic improvement. Pleural biopsy and pleural fluid culture specimens later revealed Mycobacterium …

A Novel Comparative Pattern Analysis Approach Identifies Chronic Alcohol Mediated Dysregulation Of Transcriptomic Dynamics During Liver Regeneration., Lakshmi Kuttippurathu, Egle Juskeviciute, Rachael P Dippold, Jan B. Hoek, Rajanikanth Vadigepalli

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Liver regeneration is inhibited by chronic ethanol consumption and this impaired repair response may contribute to the risk for alcoholic liver disease. We developed and applied a novel data analysis approach to assess the effect of chronic ethanol intake in the mechanisms responsible for liver regeneration. We performed a time series transcriptomic profiling study of the regeneration response after 2/3(rd) partial hepatectomy (PHx) in ethanol-fed and isocaloric control rats.

RESULTS: We developed a novel data analysis approach focusing on comparative pattern counts (COMPACT) to exhaustively identify the dominant and subtle differential expression patterns. Approximately 6500 genes were differentially regulated …

The Effects Of Cep-37440, An Inhibitor Of Focal Adhesion Kinase, In Vitro And In Vivo On Inflammatory Breast Cancer Cells., Israa Salem, Manal Alsalahi, I Chervoneva, Lucy D Aburto, Sankar Addya, Gregory R Ott, Bruce A Ruggeri, Massimo Cristofanilli, Sandra V Fernandez

Department of Medical Oncology Faculty Papers

BACKGROUND: Inflammatory breast cancer (IBC) is an aggressive type of advanced breast cancer with a poor prognosis. We recently found that focal adhesion kinase 1 (FAK1) is upregulated and phosphorylated (active) in IBC. In this study, we investigated the effect of CEP-37440, a dual inhibitor of FAK1 and anaplastic lymphoma kinase (ALK), using human IBC cell lines and preclinical models of IBC.

METHODS: Cell proliferation assays were performed in the presence of several concentrations of CEP-37440 using IBC and triple-negative breast cancer non-IBC cell lines. In vitro, we studied the expression of total FAK1, phospho-FAK1 (Tyr 397), total ALK and …

The Role Of Sonic Hedgehog Signaling In Osteoclastogenesis And Jaw Bone Destruction., Tsuyoshi Shimo, Kenichi Matsumoto, Kiyofumi Takabatake, Eriko Aoyama, Yuichiro Takebe, Soichiro Ibaragi, Tatsuo Okui, Naito Kurio, Hiroyuki Takada, Kyoichi Obata, Pai Pang, Masahiro Iwamoto, Hitoshi Nagatsuka, Akira Sasaki

Department of Orthopaedic Surgery Faculty Papers

Sonic hedgehog (SHH) and its signaling have been identified in several human cancers, and increased levels of its expression appear to correlate with disease progression and metastasis. However, the role of SHH in bone destruction associated with oral squamous cell carcinomas is still unclear. In this study we analyzed SHH expression and the role played by SHH signaling in gingival carcinoma-induced jawbone destruction. From an analysis of surgically resected lower gingival squamous cell carcinoma mandible samples, we found that SHH was highly expressed in tumor cells that had invaded the bone matrix. On the other hand, the hedgehog receptor Patched …

Conversion To Eslicarbazepine Acetate Monotherapy: A Pooled Analysis Of 2 Phase Iii Studies., Michael R Sperling, Jacqueline French, Mercedes P Jacobson, Ladislav Pazdera, Mallory Gough, Hailong Cheng, Todd Grinnell, David Blum

Department of Medicine Faculty Papers

OBJECTIVE: To assess the efficacy and safety of eslicarbazepine acetate (ESL) monotherapy.

METHODS: This post hoc pooled analysis of 2 randomized double-blind studies (093-045 and -046) included adults with partial-onset seizures medically uncontrolled by 1 or 2 antiepileptic drugs (AEDs). Following the baseline period (8 weeks), eligible patients were randomized 2:1 to receive ESL 1,600 mg or 1,200 mg once daily for 18 weeks; the primary endpoint was study exit by meeting predefined exit criteria (signifying worsening seizure control). In each study, treatment was considered effective if the upper 95% confidence limit for exit rate was lower than the historical …

Dielectric Properties Measurements Of Brown And White Adipose Tissue In Rats From 0.5 To 10 Ghz, Dario B. Rodrigues, Paul R. Stauffer, E. Colebeck, A. Z. Hood, S. Salahi, P. F. Maccarini, E. Topsakal

Department of Radiation Oncology Faculty Papers

Brown adipose tissue (BAT) plays an important role in whole body metabolism and with appropriate stimulus could potentially mediate weight gain and insulin sensitivity. Although imaging techniques are available to detect subsurface BAT, there are currently no viable methods for continuous acquisition of BAT energy expenditure. Microwave (MW) radiometry is an emerging technology that allows the quantification of tissue temperature variations at depths of several centimeters. Such temperature differentials may be correlated with variations in metabolic rate, thus providing a quantitative approach to monitor BAT metabolism. In order to optimize MW radiometry, numerical and experimental phantoms with accurate dielectric properties …