Medicine and Health Sciences Commons^™

Acute Exacerbations Of Progressive-Fibrosing Interstitial Lung Diseases., Martin Kolb, Benjamin Bondue, Alberto Pesci, Yasunari Miyazaki, Jin Woo Song, Nitin Y. Bhatt, John T. Huggins, Justin M. Oldham, Maria L. Padilla, Jesse Roman, Md, Shane Shapera

Department of Medicine Faculty Papers

Acute exacerbation of interstitial lung disease (ILD) is associated with a poor prognosis and high mortality. Numerous studies have documented acute exacerbation in idiopathic pulmonary fibrosis (IPF), but less is known about these events in other ILDs that may present a progressive-fibrosing phenotype. We propose defining acute exacerbation as an acute, clinically significant respiratory deterioration, typically less than 1 month in duration, together with computerised tomography imaging showing new bilateral glass opacity and/or consolidation superimposed on a background pattern consistent with fibrosing ILDs. Drawing on observations in IPF, it is suspected that epithelial injury or proliferation and autoimmunity are risk …

Immersive Virtual Reality For The Management Of Pain In Community-Dwelling Older Adults., Sara Benham, Minhee Kang, Namrata Grampurohit

Department of Occupational Therapy Faculty Papers

Immersive virtual reality (VR) can provide a high level of engagement and distraction analgesia to address pain. However, community-based applications of this technology for older adults have not been studied. The objective of this study was to examine the applicability and effectiveness of an immersive VR intervention for pain, depression, and quality of life (QOL) in older adults. This pretest–posttest, mixed-methods design included senior center members (n = 12) with pain that interfered with daily functioning. The outcomes included the Numeric Pain Rating Scale, Patient-Reported Outcomes Measurement Information System (PROMIS^®) depression scale, World Health Organization Quality of Life …

Checkpoint Inhibitors: What Gastroenterologists Need To Know., Monjur Ahmed

Division of Gastroenterology and Hepatology Faculty Papers

Checkpoint inhibitors are increasingly being used in clinical practice. They can cause various gastrointestinal, hepatic and pancreatic side effects. As these side effects can be serious, appropriate management is essential. The different checkpoint inhibitors with their mechanisms of action and indications, as well as evaluation and management of gastrointestinal, hepatic and pancreatic side effects, are discussed in this article.

Interpersonal Violence In Peacetime Malawi., Rebecca G. Maine, Brittney Williams, Jennifer A. Kincaid, Gift Mulima, Carlos Varela, Jared R. Gallaher, Trista D. Reid, Anthony G. Charles

Department of Surgery Faculty Papers

Background: The contribution of interpersonal violence (IPV) to trauma burden varies greatly by region. The high rates of IPV in sub-Saharan Africa are thought to relate in part to the high rates of collective violence. Malawi, a country with no history of internal collective violence, provides an excellent setting to evaluate whether collective violence drives the high rates of IPV in this region.

Methods: This is a retrospective review of a prospective trauma registry from 2009 through 2016 at Kamuzu Central Hospital in Lilongwe, Malawi. Adult (>16 years) victims of IPV were compared with non-intentional trauma victims. Log binomial …

The Addition Of Simvastatin Administration To Cold Storage Solution Of Explanted Whole Liver Grafts For Facing Ischemia/Reperfusion Injury In An Area With A Low Rate Of Deceased Donation: A Monocentric Randomized Controlled Double-Blinded Phase 2 Study., Duilio Pagano, Elisabetta Oliva, Simone Khouzam, Fabio Tuzzolino, Davide Cintorino, Sergio Li Petri, Fabrizio Di Francesco, Calogero Ricotta, Pasquale Bonsignore, Alessandro Tropea, Sergio Calamia, Federico Costanzo, Angelo Luca, Salvatore Gruttadauria

Student Papers, Posters & Projects

BACKGROUND: Liver transplantation is the best treatment for end-stage liver disease. The interruption of the blood supply to the donor liver during cold storage damages the liver, affecting how well the liver will function after transplant. The drug Simvastatin may help to protect donor livers against this damage and improve outcomes for transplant recipients. The aim of this study is to evaluate the benefits of treating the donor liver with Simvastatin compared with the standard transplant procedure.

PATIENT AND METHODS: We propose a prospective, double-blinded, randomized phase 2 study of 2 parallel groups of eligible adult patients. We will compare …

High Affinity Binding Of H3k14ac Through Collaboration Of Bromodomains 2, 4 And 5 Is Critical For The Molecular And Tumor Suppressor Functions Of Pbrm1., Lili Liao, Nilda L. Alicea-Velázquez, Lauren Langbein, Xiaohua Niu, Weijia Cai, Eun-Ah Cho, Meiling Zhang, Celeste B. Greer, Qin Yan, Michael S. Cosgrove, Haifeng Yang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

Polybromo-1 (PBRM1) is an important tumor suppressor in kidney cancer. It contains six tandem bromodomains (BDs), which are specialized structures that recognize acetyl-lysine residues. While BD2 has been found to bind acetylated histone H3 lysine 14 (H3K14ac), it is not known whether other BDs collaborate with BD2 to generate strong binding to H3K14ac, and the importance of H3K14ac recognition for the molecular and tumor suppressor function of PBRM1 is also unknown. We discovered that full-length PBRM1, but not its individual BDs, strongly binds H3K14ac. BDs 2, 4, and 5 were found to collaborate to facilitate strong binding to H3K14ac. Quantitative …

In Vitro Growth Of Human Ovarian Follicles For Fertility Preservation, Diego Marin, Min Yang, Tianren Wang

Department of Biochemistry and Molecular Biology Faculty Papers

Young female cancer survival rates significantly increased due to the great progress of cancer therapy. In fact, cryostorage and transplantation of ovarian tissue have already resulted in the birth of healthy babies. Follicle in vitro growth (IVG) has the great potential of restoring fertility by achieving functional oocytes from the most immature stages to maturation. This is suitable for a wide range of patients, from pubertal to perimenopause women. Notable achievements have been achieved in human follicle IVG in the past decade. Mature oocytes have been successfully collected from long-term sequential follicle IVG. However, it is still a major challenge …

Sarcoidosis Presenting As Acute Respiratory Distress Syndrome., Bilal Lashari, Ahmad Raza, Vincent Chan, William Ward

Abington Jefferson Health Papers

Sarcoidosis is a multisystem granulomatous disease of unknown origin. It typically involves the lungs and mediastinal lymph nodes in a chronic fashion. However, acute syndrome has been reported possibly in response to systemic release of proinflammatory cytokines. Acute pulmonary manifestations, especially acute respiratory failure or acute respiratory distress syndrome, remain extremely uncommon in individuals without a prior diagnosis. We present the case of a 41-year-old African American female, who presented with ARDS. An extensive workup into the cause of her illness remained negative, and she subsequently succumbed to her illness. A diagnosis of sarcoidosis was made upon autopsy, after exclusion …

Collaborative Healthcare: Interprofessional Practice, Education And Evaluation (Jcipe), Volume 9, Number 2, Fall 2018

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Download Entire Issue: Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE), Volume 9, Number 2, Fall 2018

Student Hotspotting Kickoff

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Student Hotspotting Kickoff

Academy For Professionalism In Health Care (Aphc) 2019 Annual Meeting

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Academy for Professionalism in Health Care (APHC) 2019 Annual Meeting

Health Mentors Program Reflection Essays, Cecilia Pivarunas, Karmanpreet Singh

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Health Mentors Program Reflection Essays

Meet An Ipe Faculty Champion From Thomas Jefferson University: Janet Jackson-Coty, Pt, Dpt, Pcs, Janet Jackson-Coty, Pt, Dpt, Pcs

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Meet an IPE Faculty Champion from Thomas Jefferson University: Janet Jackson-Coty, PT, DPT, PCS

An Interprofessional Approach To Understanding The Impact Of Poverty As A Social Determinant Of Health, Patrician Dillon, Phd, Rn

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

An Interprofessional Approach to Understanding the Impact of Poverty as a Social Determinant of Health

Meet An Ipe Student Champion From Thomas Jefferson University: Zachary Semenetz, Md Student, Class Fo 2019, Zachary Semenetz

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Meet an IPE Student Champion from Thomas Jefferson University: Zachary Semenetz, MD Student, Class fo 2019

Initiating Collaborative Care In Pain Management Curricula, Sharon Rainer, Phd, Aprn, Anp-Bc, Fnp-Bc, Emily Hajjar, Pharmd, Ms, Bcps, Bcacp, Bcgp

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

Research Question/Objectives/Purpose

This article describes a pilot study at Thomas Jefferson University that endeavored to address the following question: Is an IPE simulation session an effective method to improve knowledge and attitudes among prescribers regarding pain?

Interprofessional Care For The 21st Century: 6th Edition

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

JCIPE would like to thank all of our keynote speakers, presenters, participants, session moderators, abstract reviewers, and conference committee members for making this October 2018 conference a success. We are so grateful for your participation! Thank you again and we look forward to seeing you all at our 7th Biennial Conference in 2020!

From The Editors

Collaborative Healthcare: Interprofessional Practice, Education and Evaluation (JCIPE)

From the Editors

Rheumatoid Meningitis Sine Arthritis., Cathy Lee-Ching, Lawrence C. Kenyon, Matthew Berk, Chantel Park

Department of Medicine Faculty Papers

Rheumatoid meningitis is a rare and very serious extra-articular manifestation of rheumatoid arthritis. We present a case of a 7()year-old female with no history of arthritis who developed stroke-like symptoms, seizures, psychosis and compulsive behavior. Serial brain magnetic resonance images (MRI) over four months demonstrated progressive interhemispheric meningeal thickening. She had mild lymphocytic pleocytosis on the cerebrospinal fluid analysis and serum anti-cyclic citrullinated peptide antibodies resulted positive in high titers. She underwent a brain biopsy showing necrotizing granulomas consistent with rheumatoid meningitis. Her symptoms resolved with treatment with glucocorticoids and cyclophosphamide. She has not been diagnosed with rheumatoid arthritis even …

Trypanosoma Brucei Prmt1 Is A Nucleic Acid Binding Protein With A Role In Energy Metabolism And The Starvation Stress Response., Lucie Kafková, Chengjian Tu, Kyle L. Pazzo, Kyle P. Smith, Erik W. Debler, Kimberly S. Paul, Jun Qu, Laurie K. Read

Department of Biochemistry and Molecular Biology Faculty Papers

In Trypanosoma brucei and related kinetoplastid parasites, transcription of protein coding genes is largely unregulated. Rather, mRNA binding proteins, which impact processes such as transcript stability and translation efficiency, are the predominant regulators of gene expression. Arginine methylation is a posttranslational modification that preferentially targets RNA binding proteins and is, therefore, likely to have a substantial impact on T. brucei biology. The data presented here demonstrate that cells depleted of T. brucei PRMT1 (TbPRMT1), a major type I protein arginine methyltransferase, exhibit decreased virulence in an animal model. To understand the basis of this phenotype, quantitative global proteomics was employed …

Transgenic Mice Overexpressing Human Tnf-Α Experience Early Onset Spontaneous Intervertebral Disc Herniation In The Absence Of Overt Degeneration., Deborah J. Gorth, Irving M. Shapiro, Makarand V. Risbud

Department of Orthopaedic Surgery Faculty Papers

There is a well-established link between cytokine expression and the progression of intervertebral disc degeneration. Among these cytokines, interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) are the most commonly studied. To investigate whether systemic hTNF-α overexpression affects intervertebral disc health, we studied the spine phenotype of Tg197 mice, a widely used hTNF-α transgenic line. These mice were studied at 12-16 weeks of age using comprehensive histochemical and immunohistological analysis of the spinal motion segment. Micro-CT analysis was performed to quantify vertebral trabecular bone architecture. The Tg197 mice evidenced spontaneous annular tears and herniation with increased vascularity in subchondral bone and …

A Us Hospital Budget Impact Analysis Of A Skin Closure System Compared With Standard Of Care In Hip And Knee Arthroplasty., Kay Sadik, Jana Flener, Jeanine Gargiulo, Zachary D. Post, Steven Wurzelbacher, Andrew Hogan, Sarah Hollmann, Nicole Ferko

Department of Orthopaedic Surgery Faculty Papers

Background: Medicare's mandatory bundle for hip and knee arthroplasty necessitates provider accountability for quality and cost of care to 90 days, and wound closure may be a key area of consideration. The DERMABOND

Methods: A 90-day economic model was developed assuming 500 annual hip/knee arthroplasties for a typical US hospital setting. In current practice, wound closure methods for the final skin layer were set to 50% sutures and 50% staples. In future practice, this distribution shifted to 20% sutures, 20% staples, and 60% Skin Closure System. Health care resources included materials (eg, staplers, steri-strips, and traditional/barbed sutures), standard or premium …

Isolated Gonococcal Extensor Tenosynovitis, Cory Lebowitz, Jonas Matzon

Department of Orthopaedic Surgery Faculty Papers

Neisseria gonorrhoeae is a mucosal infection that has the propensity to disseminate, causing symptoms that commonly include arthralgias, skin lesions, fevers, chills, dysuria, genital discharge, septic arthritis, and/or tenosynovitis. Typically, gonococcal tenosynovitis affects the flexor sheath and is associated with arthralgias, skin lesions, or both. To the best of our knowledge, there has not been a documented case of isolated gonococcal extensor tenosynovitis. We report the case of a 16-year-old boy with isolated left upper-extremity gonococcal extensor tenosynovitis who was successfully treated with surgical debridement and antibiotic therapy.

A Systematic Review Of Ayres Sensory Integration Intervention For Children With Autism., Sarah A. Schoen, Shelly J. Lane, Zoe Mailloux, Teresa May-Benson, L. Dianne Parham, Susanne Smith Roley, Roseann C. Schaaf

Department of Occupational Therapy Faculty Papers

Sensory integration is one of the most highly utilized interventions in autism, however, a lack of consensus exists regarding its evidence base. An increasing number of studies are investigating the effectiveness of this approach. This study used the Council for Exceptional Children (CEC) Standards for Evidence-based Practices in Special Education to evaluate the effectiveness research from 2006 to 2017 on Ayres Sensory Integration (ASI) intervention for children with autism. A systematic review was conducted in three stages. Stage 1 involved an extensive database search for relevant studies using search terms related to sensory integration and autism, interventions suggesting a sensory …

Metabolic Dependencies In Pancreatic Cancer., Ali Vaziri-Gohar, Mahsa Zarei, Jonathan R. Brody, Jordan M. Winter

Department of Surgery Faculty Papers

Pancreatic ductal adenocarcinoma (PDA) is a highly lethal cancer with a long-term survival rate under 10%. Available cytotoxic chemotherapies have significant side effects, and only marginal therapeutic efficacy. FDA approved drugs currently used against PDA target DNA metabolism and DNA integrity. However, alternative metabolic targets beyond DNA may prove to be much more effective. PDA cells are forced to live within a particularly severe microenvironment characterized by relative hypovascularity, hypoxia, and nutrient deprivation. Thus, PDA cells must possess biochemical flexibility in order to adapt to austere conditions. A better understanding of the metabolic dependencies required by PDA to survive and …

Highly Efficient 5' Capping Of Mitochondrial Rna With Nad+ And Nadh By Yeast And Human Mitochondrial Rna Polymerase, Jeremy G Bird, Urmimala Basu, David Kuster, Aparna Ramachandran, Ewa Grudzien-Nogalska, Atif Towheed, Douglas C. Wallace, Megerditch Kiledjian, Dmitry Temiakov, Smita S. Patel, Richard H. Ebright, Bryce E. Nickels

Department of Biochemistry and Molecular Biology Faculty Papers

Bacterial and eukaryotic nuclear RNA polymerases (RNAPs) cap RNA with the oxidized and reduced forms of the metabolic effector nicotinamide adenine dinucleotide, NAD+ and NADH, using NAD+ and NADH as non-canonical initiating nucleotides for transcription initiation. Here, we show that mitochondrial RNAPs (mtRNAPs) cap RNA with NAD+ and NADH, and do so more efficiently than nuclear RNAPs. Direct quantitation of NAD+- and NADH-capped RNA demonstrates remarkably high levels of capping in vivo: up to ~60% NAD+ and NADH capping of yeast mitochondrial transcripts, and up to ~15% NAD+ capping of human mitochondrial transcripts. The capping efficiency is determined by promoter …

Taking Free Flap Surgery Abroad: A Collaborative Approach To A Complex Surgical Problem., Brian Swendseid, Md, Patrick Tassone, Md, Patrick Jean Gilles, Md, Magda Pavrette, Md, Matthew Stewart, Mercy Batatope, Donald Weed, Md, David Cognetti, Md, Adam J. Luginbuhl, Md, Joseph Curry, Md

Department of Otolaryngology - Head and Neck Surgery Faculty Papers

Accessibility to health care, especially complex surgical care, represents one of the major health care disparities in developing countries. While surgical teams may be willing to travel to these areas to help address these needs, there are many logistical and ethical dilemmas inherent in this pursuit. We reviewed our approach to the establishment of the team-based surgical outreach program, wherein we perform head and neck free tissue transfer surgery in Haiti. We describe the challenges encountered in the delivery of surgical care as well as ethical dilemmas relevant to surgical outreach trips, highlighting an approach reliant on strong local cooperation. …

Improving Bedside Procedural Safety Through Optimizing Timeout Documentation And A Pre-Procedure Checklist, Jennifer Harris, Md, R. Benson Jones, Md, Kristin Lohr, Md, Grant Turner, Md, Drew Kotler, Md, Justine Blum, Md, Megan Margiotta, Md, Matthew Bokhari, Md, Erica Li, Md, Riti Kanesa-Thasan, Md, Bracken Babula, Md, Rebecca Jaffe, Md

Department of Medicine Posters

Aim

GOAL: Improve the safety of patients undergoing bedside procedures while maintaining the full spectrum of graduated autonomy in procedure training for residents.

SMART Aim: Increase the rate of timeouts documented for bedside procedures from 29% to 50% by June 2018.

Genome-Wide Mega-Analysis Identifies 16 Loci And Highlights Diverse Biological Mechanisms In The Common Epilepsies., Bassel Abou-Khalil, Pauls Auce, Andreja Avbersek, Melanie Bahlo, David J. Balding, Thomas Bast, Larry Baum, Albert J. Becker, Felicitas Becker, Bianca Berghuis, Samuel F. Berkovic, Katja E. Boysen, Jonathan P. Bradfield, Lawrence C. Brody, Russell J. Buono, Ellen Campbell, Gregory D. Cascino, Claudia B. Catarino, Gianpiero L. Cavalleri, Stacey S. Cherny, Krishna Chinthapalli, Alison J. Coffey, Alastair Compston, Antonietta Coppola, Patrick Cossette, John J. Craig, Gerrit-Jan De Haan, Peter De Jonghe, Carolien G.F. De Kovel, Norman Delanty, Chantal Depondt, Orrin Devinsky, Dennis J. Dlugos, Colin P. Doherty, Christian E. Elger, Johan G. Eriksson, Thomas N. Ferraro, Martha Feuch, Ben Francis, Andre Franke, Jacqueline A. French, Saskia Freytag, Verena Gaus, Eric B. Geller, Christian Gieger, Tracy Glauser, Simon Glynn, David B. Goldstein, Hongsheng Gui, Youling Guo, Kevin F. Haas, Hakon Hakonarson, Kerstin Hallmann, Sheryl Haut, Erin L. Heinzen, Ingo Helbig, Christian Hengsbach, Helle Hjalgrim, Michele Iacomino, Andrés Ingason, Jennifer Jamnadas-Khoda, Michael R. Johnson, Reetta Kälviäinen, Anne-Mari Kantanen, Dalia Kasperavičiūte, Dorothee Kasteleijn-Nolst Trenite, Heidi E. Kirsch, Robert C. Knowlton, Bobby P.C. Koeleman, Roland Krause, Martin Krenn, Wolfram S. Kunz, Ruben Kuzniecky, Patrick Kwan, Dennis Lal, Yu-Lung Lau, Anna-Elina Lehesjoki, Holger Lerche, Costin Leu, Wolfgang Lieb, Dick Lindhout, Warren D. Lo, Iscia Lopes-Cendes, Daniel H. Lowenstein, Alberto Malovini, Anthony G. Marson, Thomas Mayer, Mark Mccormack, James L. Mills, Nasir Mirza, Martina Moerzinger, Rikke S. Møller, Anne M. Molloy, Hiltrud Muhle, Mark Newton, Ping-Wing Ng, Markus M. Nöthen, Peter Nürnberg, Terence J. O’Brien, Karen L. Oliver, Palotie Palotie, Faith Pangilinan, Sarah Peter, Slavé Petrovski, Annapurna Poduri, Michael Privitera, Rodney Radtke, Sarah Rau, Philipp S. Reif, Eva M. Reinthaler, Felix Rosenow, Josemir W. Sander, Thomas Sander, Theresa Scattergood, Steven C. Schachter, Christoph J. Schankin, Ingrid E. Scheffer, Bettina Schmitz, Susanne Schoch, Pak C. Sham, Jerry J. Shih, Graeme J. Sills, Sanjay M. Sisodiya, Lisa Slattery, Alexander Smith, David F. Smith, Michael C. Smith, Philip E. Smith, Anja C.M. Sonsma, Doug Speed, Michael R. Sperling, Bernhard J. Steinhoff, Ulrich Stephani, Remi Stevelink, Konstantin Strauch, Pasquale Striano, Hans Stroink, Rainer Surges, K. Meng Tan, Liu Lin Thio, G. Neil Thomas, Marian Todaro, Rossana Tozzi, Maria S. Vari, Ellen P.G. Vining, Frank Visscher, Sarah Von Spiczak, Nicole M. Walley, Yvonne G. Weber, Zhi Wei, Judith Weisenberg, Christopher D. Whelan, Peter Widdess-Walsh, Markus Wolff, Wolking Wolking, Wanling Yang, Federico Zara, Fritz Zimprich

Department of Neurology Faculty Papers

The epilepsies affect around 65 million people worldwide and have a substantial missing heritability component. We report a genome-wide mega-analysis involving 15,212 individuals with epilepsy and 29,677 controls, which reveals 16 genome-wide significant loci, of which 11 are novel. Using various prioritization criteria, we pinpoint the 21 most likely epilepsy genes at these loci, with the majority in genetic generalized epilepsies. These genes have diverse biological functions, including coding for ion-channel subunits, transcription factors and a vitamin-B6 metabolism enzyme. Converging evidence shows that the common variants associated with epilepsy play a role in epigenetic regulation of gene expression in the …

Coordinating Care And Managing Transitions For Individuals With Complex Care Needs Using The Cctm Rn Model, Sheila Haas, Phd, Rn, Faan, Beth Swan, Phd, Crnp, Faan, Traci Haynes, Msn, Rn, Cen, Ccctm

College of Nursing Posters

Objectives

• Discuss demand for care transition management for individuals with complex care needs across the care continuum
• Describe development of the Care Coordination and Transition Management (CCTM) dimensions and competencies
• Discuss challenges, future directions, and outcomes of the CCTM RN Model in managing care transitions for individuals with complex care needs