Medicine and Health Sciences Commons^™

Desmin Common Mutation Is Associated With Multi-Systemic Disease Manifestations And Depletion Of Mitochondria And Mitochondrial Dna., Elizabeth M. Mccormick, Lawrence C. Kenyon, Marni J. Falk

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Desmin (DES) is a major muscle scaffolding protein that also functions to anchor mitochondria. Pathogenic DES mutations, however, have not previously been recognized as a cause of multi-systemic mitochondrial disease. Here, we describe a 45-year-old man who presented to The Children's Hospital of Philadelphia Mitochondrial-Genetics Diagnostic Clinic for evaluation of progressive cardiac, neuromuscular, gastrointestinal, and mood disorders. Muscle biopsy at age 45 was remarkable for cytoplasmic bodies, as well as ragged red fibers and SDH positive/COX negative fibers that were suggestive of a mitochondrial myopathy. Muscle also showed significant reductions in mitochondrial content (16% of control mean for citrate synthase …

Membrane Proximal Ectodomain Cleavage Of Muc16 Occurs In The Acidifying Golgi/Post-Golgi Compartments., Srustidhar Das, Prabin D. Majhi, Mona H. Al-Mugotir, Satyanarayana Rachagani, Paul Sorgen, Surinder K. Batra

Journal Articles: Biochemistry & Molecular Biology

MUC16, precursor of the most widely used ovarian cancer biomarker CA125, is up regulated in multiple malignancies and is associated with poor prognosis. While the pro-tumorigenic and metastatic roles of MUC16 are ascribed to the cell-associated carboxyl-terminal MUC16 (MUC16-Cter), the exact biochemical nature of MUC16 cleavage generating MUC16-Cter has remained unknown. Using different lengths of dual-epitope (N-terminal FLAG- and C-terminal HA-Tag) tagged C-terminal MUC16 fragments, we demonstrate that MUC16 cleavage takes place in the juxta-membrane ectodomain stretch of twelve amino acids that generates a ~17 kDa cleaved product and is distinct from the predicted sites. This was further corroborated by …

The Effects Of Formalized Team Training On Transitions In Patient Care In The Otolaryngology Head And Neck Surgery Residency, Natalie Vercillo, Md, David Cognetti, Md, Brittany Czarick, Pa-C, Heather Rozencwaig, Crnp, Troy Derose, Crnp, Rnfa, Ancc-C, Maurits Boon, Md

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

BACKGROUND

With increasing regulations from the ACGME for resident work hours, the number of patient care hand-offs inevitably rises. Work hour restrictions have the potential to significantly reduce the incidence of medical mistakes related to excessive fatigue only if the transitions of care are do not create further errors as a result of miscommunication. For this reason, transitions of care must be thorough and complete, yet efficient as patient care must not cease during these hand-off periods.

At Thomas Jefferson University Hospital, the Otolaryngology-Head and Neck Surgery service has both a full inpatient census and consult census. Given the trend …

Occupational Deprivation Or Occupational Adaptation Of Mexican Americans On Renal Dialysis, Shirley A. Wells

Occupational Therapy Faculty Publications

The aim of this study was to explore the occupational changes and perceptions experienced by Mexican Americans with end-stage renal disease (ESRD) and their families living with dialysis. In-depth interviews were conducted with 17 Mexican Americans with ESRD and 17 family members. The participants with ESRD described altered or lost activity patterns, capacities and freedoms. With a heightened awareness of death, the family members made altered occupational choices, which were consistent with their cultural values. Changes in the physical body, adhering to the dialysis regimen and environmental restrictions created barriers to occupational participation. These findings suggest that living with dialysis …

Can Doctors Change? Attempts To Improve Adherence To The 2013 Statin Guidelines For Diabetic Patients At An Urban Academic Family Medicine Clinic, Marshall Miller, Md, Victoria Rose, Md, Jill Kropa, Md, Rina Edi, Md, Margaret Crenshaw, Md, Emily Levy, Md, Christopher Hwang, Md, Elizabeth Collins, Md, Danielle Dang, Md, Lori Atkinson, Md

Department of Family & Community Medicine Presentations and Grand Rounds

In November 2013 new statin guidelines were released. Generally, physicians are slow to adopt new guidelines and adherence to new guidelines often remains low even years after they have been issued. In this study, multiple interventions, including patient handouts, email reminders, and education sessions were implemented to increase adherence with new statin prescribing guidelines in a large urban practice. The numbers of prescriptions were analyzed for 6 weeks prior to and 6 weeks after the interventions. Statin prescribing in diabetic patients not already on a statin pre-intervention was 11.7% and post-intervention was 13.0% (p-value 0.5936). There was a small increase …

Cost Estimation In Public Health Services & Systems Research, Glen P. Mays

Health Management and Policy Presentations

Considerable uncertainty persists about the resources required to implement public health programs and policies, and about the factors that drive variation in resource needs and utilization across community and institutional settings. This paper reviews several alternative approaches to cost estimation that we have used in the field of public health services & systems research (PHSSR). This review was prepared for an expert panel meeting convened as part of a study commissioned by the U.S. Assistant Secretary for Planning and Evaluation (ASPE) to estimate the costs associated with public health emergency preparedness capabilities.

Outness As A Protective Factor Against Risky Sex In Gay Males, Margaret Levicoff

Theses and Dissertations

Homosexual men between the ages of 15 and 25 constitute a disproportionate majority of new sexually transmitted infections (STIs), including HIV/AIDS, worldwide (Harper, 2007). Men who have sex with men (MSM) more frequently engage in riskier health behaviors, such as drinking, substance use, and risky sexual practices than their heterosexual counterparts (Hamilton & Mahalik, 2009). The current study sampled 150 self-identified homosexual men between the ages of 18 through 30 to assess whether or not level of outness influenced the likelihood of an individual to engage in risky sexual behaviors. Participants completed an online survey that measured each individual's level …

Magnetic Resonance Imaging Of Folic Acid-Coated Magnetite Nanoparticles Reflects Tissue Biodistribution Of Long-Acting Antiretroviral Therapy., Tianyuzi Li, Howard Gendelman, Gang Zhang, Pavan Puligujja, Joellyn Mcmillan, Tatiana K. Bronich, Benson Edagwa, Xin-Ming Liu, Michael D. Boska

Journal Articles: Pharmacology & Experimental Neuroscience

Regimen adherence, systemic toxicities, and limited drug penetrance to viral reservoirs are obstacles limiting the effectiveness of antiretroviral therapy (ART). Our laboratory's development of the monocyte-macrophage-targeted long-acting nanoformulated ART (nanoART) carriage provides a novel opportunity to simplify drug-dosing regimens. Progress has nonetheless been slowed by cumbersome, but required, pharmacokinetic (PK), pharmacodynamics, and biodistribution testing. To this end, we developed a small magnetite ART (SMART) nanoparticle platform to assess antiretroviral drug tissue biodistribution and PK using magnetic resonance imaging (MRI) scans. Herein, we have taken this technique a significant step further by determining nanoART PK with folic acid (FA) decorated magnetite …

Respiratory Function Amongst Asymptomatic Hiv Positive And Hiv Negative Clients At Aga Khan University Hospital, Nairobi, Noah Kipkemei Murbiy

Master of Medicine in Internal Medicine

Background: Spirometry is used to asses respiratory function abnormalities. This is usually in reference to a validated normal range unique to a particular gender, race, age, weight and height. Majority of persons are usually asymptomatic until the expected FEV1 has decreased by 50%. Early intervention on the abnormalities even in this asymptomatic group has been shown to retard the rate of pulmonary deterioration. An unpublished audit at the Aga Khan University Hospital, Nairobi, revealed that majority of newly diagnosed HIV positive persons were admitted at the Critical Care Units with a pulmonary cause which later resulted in poor outcomes. This …

Anticancer Activity Of Cissus Quadrangularis: An In Vitro 2d Model Based Study, Saba Sheikh, Anupam Dhasmana, Sahabjada Siddiqui, Ejazul Haque

School of Medicine Publications

Cissus quadrangularis (CQ) is a perennial rambling shrub of the grape family commonly known as “Hadjora” (in Hindi) probably native to India or Sri Lanka. It is one of the valuable medicines in the Indian Traditional Systems of Medicine because of the presence of several bioactive compounds. However, in the present study we have checked its anticancer activity along with its safety profile on normal skin cells. Apart from this we have generated the spheroid HeLa culture in vitro model for analyzing the CQ extract response on the growth of HeLa tumoroid. From the present findings we have observed that …

Training And Application Of Correct Information Unit Analysis To Structured And Unstructured Discourse, Audrey Bretthauer Cohen

Dissertations and Theses

Correct Information Units (CIU) analysis is one of the few measures of discourse that attempts to quantify discourse as a function of communicating information efficiently. Though this analysis is used reliably as a research tool, most studies' apply CIUs to structured discourse tasks and do not specifically describe how raters are trained. If certified clinical speech-language pathologists can likewise reliably apply CIU analysis within clinical settings to unstructured discourse, such as the discourse of people with aphasia (PWA), it may allow clinicians to quantify the information communicated efficiently in clinical populations with discourse deficits. Purpose: The purpose of this study …

Characteristics Of Successful Nursing Students, Sergey G. Pugachov, David Maxwell, Jacob Youmans, Kurt Wahnschaff

Phi Kappa Phi Research Symposium (Archived)

In an attempt to look into ways to reduce attrition rates in nursing programs, we did a study to look into what non-academic factors can be looked at in addition to the current standard admission data. The research question of interest was “What non-academic characteristics of students can lead to best chance of success in nursing school?” Our sample included 115 students at Georgia Southern University School of Nursing, who have already completed at least one semester of nursing school. Instrument of collection was an IRB approved 20-item self-reported questionnaire with anonymous and passive content. Data was analyzed using SPSS …

Md Vs. Np: A Study On Nurse Practitioner Roles And Responsibilities And Their Acceptance In Our Generation, Celia A. Price, Neysa Hobbs, Lauren Stokes, Anquanett Scott

Phi Kappa Phi Research Symposium (Archived)

The purpose of this research was to compare the roles of physicians versus nurse practitioners in our community and raise awareness for nurse practitioners amongst our generation. It was hypothesized that there would be no difference in preference among the population to see a nurse practitioner or medical doctor as his/her routine provider. The null hypothesis was supported as evidenced by a p-value of 0.610. Results show that majority of the population understood the definition of a nurse practitioner. However, the surveyed population was unsure of the scope of practice of nurse practitioners. More than 90% of the studied population …

Orexin Receptor Activation Generates Gamma Band Input To Cholinergic And Serotonergic Arousal System Neurons And Drives An Intrinsic Ca(2+)-Dependent Resonance In Ldt And Ppt Cholinergic Neurons, Masaru Ishibashi, Iryna Gumenchuk, Bryan Kang, Catherine Steger, Elizabeth Lynn, Nancy Molina, Leonard M. Eisenberg, Christopher S. Leonard

NYMC Faculty Publications

A hallmark of the waking state is a shift in EEG power to higher frequencies with epochs of synchronized intracortical gamma activity (30-60 Hz) - a process associated with high-level cognitive functions. The ascending arousal system, including cholinergic laterodorsal (LDT) and pedunculopontine (PPT) tegmental neurons and serotonergic dorsal raphe (DR) neurons, promotes this state. Recently, this system has been proposed as a gamma wave generator, in part, because some neurons produce high-threshold, Ca(2+)-dependent oscillations at gamma frequencies. However, it is not known whether arousal-related inputs to these neurons generate such oscillations, or whether such oscillations are ever transmitted to neuronal …

Use Of Parthenolide Derivatives As Antileukemic And Cytotoxic Agents, Peter A. Crooks, Craig T. Jordan, Xiaochen Wei

Pharmaceutical Sciences Faculty Patents

To read this abstract, please download this patent.

Insulin-Resistant Subjects Have Normal Angiogenic Response To Aerobic Exercise Training In Skeletal Muscle, But Not In Adipose Tissue, R. Grace Walton, Brian S. Finlin, Jyothi Mula, Douglas E. Long, Beibei Zhu, Christopher S. Fry, Philip M. Westgate, Jonah D. Lee, Tamara Bennett, Philip A. Kern, Charlotte A. Peterson

Clinical and Translational Science Faculty Publications

Reduced vessel density in adipose tissue and skeletal muscle is associated with obesity and may result in decreased perfusion, decreased oxygen consumption, and insulin resistance. In the presence of VEGFA, Angiopoietin-2 (Angpt2) and Angiopoietin-1 (Angpt1) are central determinants of angiogenesis, with greater Angpt2:Angpt1 ratios promoting angiogenesis. In skeletal muscle, exercise training stimulates angiogenesis and modulates transcription of VEGFA, Angpt1, and Angpt 2. However, it remains unknown whether exercise training stimulates vessel growth in human adipose tissue, and it remains unknown whether adipose angiogenesis is mediated by angiopoietin signaling. We sought to determine whether insulin-resistant subjects would display an impaired angiogenic …

Amyloid Peptide Inactivating Enzyme To Treat Alzheimer's Disease Peripherally, Louis B. Hersh, Hanjun Guan

Molecular and Cellular Biochemistry Faculty Patents

Methods for treatment and/or prevention of Alzheimer's disease comprising inactivating peripheral AP in serum to a reduce A(3 in the brain. Methods comprise expression of amyloid peptide inactivating enzyme on bone marrow cells; and coupling of amyloid peptide inactivating enzyme to hematopoietic cells.

Pannexin1 Channels Dominate Atp Release In The Cochlea Ensuring Endocochlear Potential And Auditory Receptor Potential Generation And Hearing, Jin Chen, Yan Zhu, Chun Liang, Jing Chen, Hong-Bo Zhao

Otolaryngology--Head & Neck Surgery Faculty Publications

Pannexin1 (Panx1) is a gap junction gene in vertebrates whose proteins mainly function as non-junctional channels on the cell surface. Panx1 channels can release ATP under physiological conditions and play critical roles in many physiological and pathological processes. Here, we report that Panx1 deficiency can reduce ATP release and endocochlear potential (EP) generation in the cochlea inducing hearing loss. Panx1 extensively expresses in the cochlea, including the cochlear lateral wall. We found that deletion of Panx1 in the cochlear lateral wall almost abolished ATP release under physiological conditions. Positive EP is a driving force for current through hair cells to …

Test Question Editing Workshop - Improve Your Test Item Writing Skills Through Editing, Jennifer Mathews, Jane M. Souza

Pharmacy Faculty/Staff Publications

This workshop will be 75% hands-on editing of test questions. After an overview of learning objectives for the session and instruction on identifying common errors, participants will be provided a list of test questions containing errors frequently found in exams. They will be asked to edit the questions to improve the overall quality of the test items. Edited questions will be shared with all attendees. Through this process, participants will hone their skills at both writing and editing items.

Multiparametric Mr Enterography Without The Use Of Antiperistaltic Agents: Performance And Interpretation, Amelia M. Wnorowski, Md, Flavius Guglielmo, Md, Robert Ford, Md, Donald G. Mitchell, Md

Department of Radiology Faculty Papers

Purpose

To describe how to perform and interpret MR enterography (MRE) without using antiperistaltic agents.

Know Your Status: Alleviating Stigma From The Hiv Positive Community Of San Luis Obispo California, Mario Alberto Viveros Espinoza

Ethnic Studies

The purpose of this project is to alleviate stigma from the HIV community in San Luis Obispo, CA by creating an outreach program, “Know Your Status,” that raises awareness of HIV education and prevention. Research on HIV stigma and on ideologies for program development and implementation shows that HIV positive individuals face both internalized and externalized stigma. Program development and implementation can be effective by assessing and addressing the specific needs of those living within the community. This project includes the data needed for program development and implementation, collected through anonymous surveys from HIV positive community members, interviews with professionals …

The Use Of Parkinson’S Disease Specific Rehabilitative Interventions To Treat A Patient With Lewy Body Dementia: A Case Report, Cassandra Dawley

Case Report Papers

Background and Purpose: (Lewy Body Dementia) LBD is commonly known as a differential diagnosis of Parkinson’s Disease (PD) as they both have a similar epidemiology and present with similar symptoms. Due to the paucity of research on physical therapy (PT) interventions for LBD, it may be suitable to use PD specific interventions as a treatment. The proposal to use Parkinson specific interventions, primarily Lee Silverman Voice Treatment-Big (LSVT BIG), may be considered. The purpose of this case study was to provide information about what LBD is, how it presents, and how PD specific interventions were used as a treatment. Case …

Klf4-Sqstm1/P62-Associated Prosurvival Autophagy Contributes To Carfilzomib Resistance In Multiple Myeloma Models., Irene Riz, Teresa S. Hawley, Robert G. Hawley

Anatomy and Regenerative Biology Faculty Publications

Multiple myeloma (MM) is an incurable clonal plasma cell malignancy. Because of a high rate of immunoglobulin synthesis, the endoplasmic reticulum of MM cells is subjected to elevated basal levels of stress. Consequently, proteasome inhibitors, which exacerbate this stress by inhibiting ubiquitin-proteasome-mediated protein degradation, are an important new class of chemotherapeutic agents being used to combat this disease. However, MM cells still develop resistance to proteasome inhibitors such as carfilzomib. Toward this end, we have established carfilzomib-resistant derivatives of MM cell lines. We found that resistance to carfilzomib was associated with elevated levels of prosurvival autophagy, and Kruppel-like factor 4 …

Mental Health Outcomes Of Drug Conflict Among University Students At The U.S.-Mexico Border, Kathleen A. O'Connor, Maricarmen Vizcalno, Nora A. Benavides

Departmental Papers (S&A)

The purpose of this cross-sectional study was to investigate to what extent young adults with close ties to Mexico were at greater risk for self-reported negative mental health outcomes than comparison groups during drug-related armed conflict from 2008 through 2012, and the effect of type and number of traumatic events on mental health outcomes. Using the Harvard Trauma Questionnaire and the Hopkins Symptom Checklist, 202 university students living in the El Paso–Ciudad Juárez border region were surveyed for symptoms of depression, anxiety, and posttraumatic stress. Students with close ties to Mexico reported symptoms of anxiety and posttraumatic stress at significantly …

Multimorbidity In A Mexican Community: Secondary Analysis Of Chronic Illness And Depression Outcomes, Kathleen A. O'Connor, Maricarmen Vizcalno, Jorge M. Ibarra, Hector Balcazar, Eduardo Perez, Luis Flores, Robert L. Anders

Departmental Papers (S&A)

The aims of this article are: 1) to examine the associations between health provider-diagnosed depression and multimorbidity, the condition of suffering from more than two chronic illnesses; 2) to assess the unique contribution of chronic illness in the prediction of depression; and 3) to suggest practice changes that would address risk of depression among individuals with chronic illnesses. Data collected in a cross-sectional community health study among adult Mexicans (n= 274) living in a low income neighborhood (colonia) in Ciudad Juárez, Chihuahua, Mexico, were examined. We tested the hypotheses that individuals who reported suffering chronic illnesses …

Combination Of Id2 Knockdown Whole Tumor Cells And Checkpoint Blockade: A Potent Vaccine Strategy In A Mouse Neuroblastoma Model., Lina Chakrabarti, Clifford Morgan, Anthony D. Sandler

Surgery Faculty Publications

Tumor vaccines have held much promise, but to date have demonstrated little clinical success. This lack of success is conceivably due to poor tumor antigen presentation combined with immuno-suppressive mechanisms exploited by the tumor itself. Knock down of Inhibitor of differentiation protein 2 (Id2-kd) in mouse neuroblastoma whole tumor cells rendered these cells immunogenic. Id2-kd neuroblastoma (Neuro2a) cells (Id2-kd N2a) failed to grow in most immune competent mice and these mice subsequently developed immunity against further wild-type Neuro2a tumor cell challenge. Id2-kd N2a cells grew aggressively in immune-compromised hosts, thereby establishing the immunogenicity of these cells. Therapeutic vaccination with Id2-kd …

How Will Texas’ Affordable Care Act Implementation Decisions Affect The Population? A Closer Look, Sara J. Rosenbaum, Sara Rothenberg, Sara Ely

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

The Affordable Care Act (ACA) gives states two key choices: Whether to expand Medicaid to cover poor uninsured adults; and whether to establish a state Exchange. No population stands to gain more from these choices than residents of Texas, who experience the nation’s highest uninsured rate. National estimates show that by not expanding Medicaid, the state has foregone coverage for 1.5 million people. County‐level estimates show that in 249 out of 254 counties, the proportion of uninsured adults exceeds 20 percent of the total adult county population. In 31 counties, the proportion of low income uninsured adults exceeds 60 percent …

Never Too Early: Introducing Illness Scripts And Narrative Medicine As Foundational Clinical Approaches, Julia B. Frank, Seema Kakar, Gisela Butera, Thomas Harrod

Medicine Faculty Posters and Presentations

Educational Challenge: The foundations course of our reformed, organ-based curriculum introduces clinical interviewing when students know little clinical medicine. An exercise that introduces the complementary concepts of “illness scripts” and “narrative medicine” helps them structure early encounters with patients. It provides a framework for organizing future clinical knowledge while reinforcing the humanistic values that may deteriorate over the course of students’ education.

Method: Students conduct and write up a semi-structured interview of someone they know with chronic illness. They reflect on their experience in pairs, and then analyze sample encounters in small groups with faculty facilitation.

Outcome: Strongly favorable student …

Medical Education Departments: A Study Of Four Medical Schools In Sub-Saharan Africa, Elsie Kiguli-Malwadde, Zohray Talib, Hannah Wohltjen, Susan C. Connors, Jonathan Gandari, Sekelani S. Benda, Lauren A. Maggio, Susan C. Van Schalkwyk

Health Policy and Management Faculty Publications

Background

Many African countries are investing in medical education to address significant health care workforce shortages and ultimately improve health care. Increasingly, training institutions are establishing medical education departments as part of this investment. This article describes the status of four such departments at sub-Saharan African medical schools supported by the Medical Education Partnership Initiative (MEPI). This article will provide information about the role of these institutional structures in fostering the development of medical education within the African context and highlight factors that enable or constrain their establishment and sustainability.

Methods

In-depth interviews were conducted with the heads or directors …

Dysregulated Arginine Metabolism And Cardiopulmonary Dysfunction In Patients With Thalassaemia, Claudia Morris, Hae-Young Kim, Elizabeth Klings, John Wood, John B. Porter, Felicia Trachtenberg, Frans Kuypers, Elliott P Vichinsky, Frans A Kuypers

NYMC Faculty Publications

Pulmonary hypertension (PH) commonly develops in thalassaemia syndromes, but is poorly characterized. The goal of this study was to provide a comprehensive description of the cardiopulmonary and biological profile of patients with thalassaemia at risk for PH. A case-control study of thalassaemia patients at high versus low PH-risk was performed. A single cross-sectional measurement for variables reflecting cardiopulmonary status and biological pathophysiology were obtained, including Doppler-echocardiography, 6-min-walk-test, Borg Dyspnoea Score, New York Heart Association functional class, cardiac magnetic resonance imaging (MRI), chest-computerized tomography, pulmonary function testing and laboratory analyses targeting mechanisms of coagulation, inflammation, haemolysis, adhesion and the arginine-nitric oxide …