Medicine and Health Sciences Commons^™

The Structure And Regulation Of Cullin 2 Based E3 Ubiquitin Ligases And Their Biological Functions., Weijia Cai, Haifeng Yang

Department of Pathology, Anatomy, and Cell Biology Faculty Papers

BACKGROUND: Cullin-RING E3 ubiquitin ligase complexes play a central role in targeting cellular proteins for ubiquitination-dependent protein turnover through 26S proteasome. Cullin-2 is a member of the Cullin family, and it serves as a scaffold protein for Elongin B and C, Rbx1 and various substrate recognition receptors to form E3 ubiquitin ligases.

MAIN BODY OF THE ABSTRACT: First, the composition, structure and the regulation of Cullin-2 based E3 ubiquitin ligases were introduced. Then the targets, the biological functions of complexes that use VHL, Lrr-1, Fem1b, Prame, Zyg-11, BAF250, Rack1 as substrate targeting subunits were described, and their involvement in diseases …

The Pennsylvania Emergency Department Geriatric Readiness Project, Adam Perry, Md, Alyssa Sipes, Bs

College of Population Health Posters

BE THE ED DOC – Illustrating Geriatric Readiness

An independent, right handed 81 year old who lives alone trips and falls while walking with her walker. A thorough evaluation at her local ED reveals only a nonoperative right proximal humeral fracture. Her pain is well controlled with immobilization and oral analgesics.

What is her disposition?

• Discharge home with shoulder immobilizer and instructions to call orthopedics in the morning.
• Admit to Telemetry Bed for “Syncope” with orthopedics and cardiology consultations, with subsequent SubAcute Rehabilitation stay.
• Admit to Observation Status for “Ambulatory Dysfunction”.
• Discharge home with her daughter, who lives locally, with …

Role Of Target Specific Oral Anticoagulation After Operative Management Of Venous Thoracic Outlet Syndrome, Jeontaik Kwon, Md, Paul J. Dimuzio, Md, Babak Abai, Md, Dawn Salvatore, Md, Taki Galanis, Md, Geno J. Merli, Md, Luis H. Eraso, Md

Department of Surgery Posters

Background:

The purpose of this study is to review the efficacy of Target Specific Oral Anticoagulants (TSOAC) versus vitamin K antagonist (VKA) for post-surgical anticoagulation in patient with primary subclavian vein thrombosis. Rivaroxaban, a factor Xa inhibitor, was the first TSOAC approved by the FDA in 2012 for the treatment and prevention of deep vein thrombosis. However, the efficacy and safety of TSOAC for prevention of recurrent deep vein thrombosis after revascularization of upper extremity compression syndromes is largely unknown.

Effects Of Preoperative Aspirin On Major Outcomes In Graded High-Risk Patients Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Jordan E. Goldhammer, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Among patients with cardiovascular disease, nearly 70% take preventive aspirin.¹
• The benefits of aspirin are greater as a patient’s risk of cardiovascular events increases; patients with a lower risk of cardiovascular events derive less of a benefit from aspirin.²
• The effect of aspirin in surgical patients has not yet been investigated, in particular if there is an optimal effect based on operative risk when undergoing cardiac surgery.

Objective:

To determine the effects of preoperative aspirin on major outcomes after cardiac surgery in patients with low, medium, and high predicted operative mortality as determined by the EuroSCORE risk …

Effects Of Diabetes Mellitus And Chronic Kidney Disease On Major Outcomes In Patients Undergoing Cardiac Surgery, Mark W. Berguson, Jordan E. Goldhammer, Hong Liu, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Diabetes mellitus (DM) is the leading cause of chronic kidney disease (CKD). CKD typically manifests in late stages of DM.

• DM and CKD are prevalent in patients with cardiovascular disease.

• The impact of concurrent DM and CKD on major adverse cardiocerebral events (MACE) in patients undergoing cardiac surgery remains unclear.^1,2

Objective:

To determine the effect of DM and CKD on major outcomes in patients undergoing cardiac surgery.

Preoperative Aspirin And Major Perioperative Outcomes In Patients With Hypertension Undergoing Cardiac Surgery, Qian Ding, Eric Yuen, Mark Berguson, Hong Liu, Linong Yao, Rohinton Morris, Jianzhong Sun

Department of Anesthesiology Posters

Introduction:

• Hypertension is prevalent in patients undergoing cardiac surgery and associated with a higher incidence of cardiovascular complications.
• Aspirin has been shown to prevent cardiovascular events in patients with a high risk of cardiovascular disease.
• Very few studies have investigated aspirin and hypertension, particularly its effects on major outcomes in hypertensive patients undergoing cardiac surgery.^1,2

Objective

To determine the effects of preoperative aspirin on postoperative outcomes for patients with hypertension undergoing cardiac surgery.

To examine the impact of chronic kidney disease and heart failure superimposed with hypertension on outcomes after cardiac surgery.

Patient Perception Of Telehealth Primary Care Video Visits, Rhea E. Powell, Md, Mph, Jeffrey Henstenburg, Bs, Grace Cooper, Ba, Judd Hollander, Md, Kristin L. Rising, Md, Ms

Department of Medicine Posters

Introduction

• Telehealth (TH) is an innovative model of care delivery with potential to provide more patient-centered healthcare, allowing patients to receive care when and where is most convenient.
• To date, little is known about patient perceptions of receiving care with the use of TH video visits.

An Evaluation Of A Sexual Health Education Program For Adolescents In A Residential Treatment Program In The Philadelphia Area, Rachel Powell (Student), P. Smith, Amy Leader

College of Population Health Posters

BACKGROUND

The US is currently experiencing an epidemic; millions of American adolescents are affected by sexually transmitted diseases (STDs), teen pregnancy and intimate partner violence (IPV), costing the country both socially and economically:

• Adolescents 15-24 years of age account for 50% of the 20 million new STD cases each year
• US birth rates are significantly higher than countries in Europe
  • 6.8 times higher than teens living in the UK
  • 13.9 times higher than teens living the EU
• In 2010 18.7% of adolescents ages 11-17 experienced IPV for the first time
• Adolescents who are diagnosed with an STD, are teen parents …

New Create Day Presentations In The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

Collaborative Research and Evidence Among Therapists and Educators (CREATE) Day is a clinical education program presented by occupational therapy graduate students in partial fulfillment of the Master of Science degree in Occupational Therapy at Thomas Jefferson University. The latest CREATE DAY presentations have been loaded in the Jefferson Digital Commons and this round includes the following topics:

• Stand Tall, Don’t Fall: A Systematic Review on the Effectiveness of Tai Chi for Improving Balance in Healthy Older Adults
• Reframe the Pain: A Systematic Review of Occupational Therapy Interventions to Promote Quality of Life for Adults with Fibromyalgia
• Keeping Up with the …

Stand Tall, Don’T Fall: A Systematic Review On The Effectiveness Of Tai Chi For Improving Balance In Healthy Older Adults, Miya Cho, Ots, Moira Frain, Ots, Courtney Monk, Ots, Caitlin O'Neill, Ots, Kathryn Ricciardi, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives:

•Identify and describe the need for effective balance related interventions among the healthy older adult population

• Recognize occupational therapy’s role in improving balance to decrease risk of falls

• Discuss the effectiveness of Tai Chi as an intervention for improving balance within this population

PICO

• Is Tai Chi an effective intervention for improving balance in the healthy older adult population?

Presentation: 40:55

Handout at bottom of page.

Reframe The Pain: A Systematic Review Of Occupational Therapy Interventions To Promote Quality Of Life For Adults With Fibromyalgia, Alyssa Armstrong, Ots, Jonathan Forkin, Ots, Emma Jablonski, Ots, Shelby Moyer, Ots, Suzanne Sager, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives:

1. Define clinical presentation and three common characteristics of fibromyalgia (FMS) as it impacts quality of life (QOL).

2. Recognize the importance of an occupational therapy (OT) approach as an alternative to current practice methods.

3. Identify at least three effective EBP interventions within the scope of OT to address quality of life for individuals with FMS.

PICO:

What is the evidence to support the effectiveness of interventions within the scope of OT on improving quality of life for adults diagnosed with fibromyalgia?

Presentation: 43:56

Handout with references at bottom of page.

Keeping Up With The Preemies: Early Interventions In Occupational Therapy For Children Born Premature, Jennifer Donnelly, Ots, Angela Mancini, Ots, Heidi Miller, Ots, Taylor Vile, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives:

1. Identify areas of occupational performance that may be impacted by premature birth.

2. Understand current themes of interventions for promoting development after premature birth.

3. Apply evidence-based practice to interventions for children born prematurely.

PICO:

What is the evidence to support the use of early interventions in the scope of OT to promote development in children born prematurely?

Presentation: 53:18

Ergonomic Intervention For Injury Prevention In Healthcare Personnel: A Systematic Review, Marisa Andrews, Ots, Kory Collier, Ots, Erin Dougherty, Ots, Alyssa Vidovich, Ots

Collaborative Research and Evidence shared Among Therapists and Educators (CREATE Day)

Objectives:

1. Recognize the magnitude of work-related injury in healthcare and the need for intervention in this area

2. Discuss 2 ergonomic interventions within the scope of OT practice that can improve work-related injury

3. Recall 2 common themes that have emerged based on current literature for ergonomic intervention

Clinical Research Question:

Does ergonomic intervention prevent work-related injuries and associated outcomes for healthcare personnel engaged in patienthandling?

Presentation: 39:05

Utilization Of Hiv-1 Envelope V3 To Identify X4- And R5-Specific Tat And Ltr Sequence Signatures., Gregory C Antell, Will Dampier, Benjamas Aiamkitsumrit, Michael R Nonnemacher, Jeffrey M Jacobson, Vanessa Pirrone, Wen Zhong, Katherine Kercher, Shendra Passic, Jean W Williams, Gregory Schwartz, Uri Hershberg, Fred C Krebs, Brian Wigdahl

Department of Medicine Faculty Papers

BACKGROUND: HIV-1 entry is a receptor-mediated process directed by the interaction of the viral envelope with the host cell CD4 molecule and one of two co-receptors, CCR5 or CXCR4. The amino acid sequence of the third variable (V3) loop of the HIV-1 envelope is highly predictive of co-receptor utilization preference during entry, and machine learning predictive algorithms have been developed to characterize sequences as CCR5-utilizing (R5) or CXCR4-utilizing (X4). It was hypothesized that while the V3 loop is predominantly responsible for determining co-receptor binding, additional components of the HIV-1 genome may contribute to overall viral tropism and display sequence signatures …

Strategies To Improve Rn Communication Hcahps, Karen Montoro, Bsn, Rn, Ne-Bc

Department of Nursing papers and presentations

BACKGROUND

The impact of value based purchasing on reimbursement based on HCAHPS is a reality that Heath Care Organizations need to address. This Quality Improvement Project was designed by the CNO, Vice president of Nursing and the Nurse Manager to oversee the project. The decision was made to utilize an existing group of frontline staff who were engaged in efforts to improve patient satisfaction. This RN Communication Team met monthly beginning in March 2015.

Jefferson Digital Commons: Proving That Jefferson Is An International Phenomenon!, Daniel G. Kipnis, Msi

Academic Commons and Scott Memorial Library Staff Papers and Presentations

Write-up about Jefferson Digital Commons for the SKMC Alumni Bulletin Spring 2016 Issue.

Brucker And Potter Lectures Posted In The Jdc, Daniel G. Kipnis, Msi

Jefferson Digital Commons News

In case you missed these recent campus events, recordings are now available in the Jefferson Digital Commons for: 

Strangers in a Strange Land: Primary Care and Academic Medical Centers (24th Annual Paul C. Brucker, MD Lecture presented by Thomas L. Schwenk, MD, Dean, University of Nevada School of Medicine, Reno) – This annual series of lectures was established in 1990 to honor the former Dean’s important contributions to Thomas Jefferson University and to American medicine.

A Mitochondrial Etiology of Complex Diseases (2016 William Potter Lecturepresented by Douglas C. Wallace, PhD, University of Pennsylvania) – The Potter Lecture is sponsored …

Ictal Asystole In A Patient With Posterior Reversible Encephalopathy Syndrome (Pres) And Seizures: A Case Report, Joanna Suski, Md, Reginald T. Ho, Md, Maromi Nei, Md

Department of Neurology Posters

BACKGROUND

• Ictal asystole is rare, seen in less than 1% of patients with epilepsy, and typically seen in patients with temporal or frontal lobe seizures, rarely in occipital lobe seizures, and has never been described in a patient with PRES .
• PRES is a clinical-radiologic diagnosis in which there is a breakdown of the blood brain barrier caused by abrupt changes of blood pressure, or cytokines causing endothelial damage and this creates brain edema.
• The typical neurological symptoms of PRES include encephalopathy (50-80%), seizure (60-75%), headache (50%), and visual disturbance (35%).
• Brain imaging in PRES usually reveals vasogenic edema in …

Sonographic Findings Of A Semi-Professional Football Player With 1st Mtp Joint Pain: Gout Or Turf Toe?, David Jeong, Md, Caqsm, Cep, Rmsk, Danielle Snyderman, Md, Lauren Hersh, Md, Jeremy Close, Md

Department of Family & Community Medicine Posters

Purpose

Aim : To review the applications and indications of sonography for forefoot disorders, especially gout and plantar plate injury of 1^st MTP joint.

Introduction

• Forefoot disorders are common but forefoot ultrasound is underutilized.
• Point-of-Care Ultrasound was utilized in initial workup evaluating acute on chronic 1^st MTP joint pain in our case study.

Insights From Hur Biology Point To Potential Improvement For Second-Line Ovarian Cancer Therapy., Yu-Hung Huang, Weidan Peng, Narumi Furuuchi, James B Duhadaway, Masaya Jimbo, Andrea Pirritano, Charles J Dunton, Gary S Daum, Benjamin E Leiby, Jonathan Brody, Md, Janet A Sawicki

Kimmel Cancer Center Faculty Papers

This retrospective study aimed to investigate the role that an RNA-binding protein, HuR, plays in the response of high-grade serous ovarian tumors to chemotherapeutics. We immunohistochemically stained sections of 31 surgically-debulked chemo-naïve ovarian tumors for HuR and scored the degree of HuR cytoplasmic staining. We found no correlation between HuR intracellular localization in tumor sections and progression free survival (PFS) of these patients, 29 of whom underwent second-line gemcitabine/platin combination therapy for recurrent disease. Ribonucleoprotein immunoprecipitation (RNP-IP) analysis of ovarian cancer cells in culture showed that cytoplasmic HuR increases deoxycytidine kinase (dCK), a metabolic enzyme that activates gemcitabine. The effects …

Detection Of Circulating Tumor Cells In Uveal Melanoma By The Photoacoustic Method, Ryan M. Weight, Shingo Sato, Masahiro Ohara, Mizue Terai, Michael Mastrangelo, Marlana Orloff, Benjamin Goldschmidt, John Viator, Takami Sato

Department of Medical Oncology Posters

Abstract

Circulating tumor cells (CTCs) have been shown to be a prognostic marker in breast cancer¹. We hypothesize that circulating melanoma cell (CMC) detection could be utilized in the management of uveal melanoma, including early intervention. Prior methodologies for circulating uveal melanoma cell (CUMC) detection have been fraught with poor sensitivity, limiting their clinical utility². Development of an improved method is necessary to establish the clinical utility of CUMC monitoring. Photoacoustics, also referred to as laser-induced ultrasound, is a novel platform for the detection and capture of CMCs. Photoacoustics uses short duration pulsed light to create …

Molecular Treatment Effects Of Alemtuzumab In Skeletal Muscles Of Patients With Ibm., Karsten Schmidt, Konstanze Kleinschnitz, Goran Rakocevic, Marinos Dalakas, Jens Schmidt

Department of Neurology Faculty Papers

BACKGROUND: Mechanisms of inflammation and protein accumulation are crucial in inclusion body myositis (IBM). Recent evidence demonstrated that intravenous immunoglobulin failed to suppress cell-stress mediators in IBM. Here we studied the molecular changes in skeletal muscle biopsies from patients with IBM before and after treatment with alemtuzumab.

METHODS: Relevant inflammatory and degeneration-associated markers were assessed by quantitative-PCR and immunohistochemistry in repeated muscle biopsy specimens from patients with IBM, which had been treated in a previously published uncontrolled proof-of-concept trial with alemtuzumab.

RESULTS: There were no significant changes of the mRNA expression levels of the pro-inflammatory chemokines CXCL-9, CCL-4, and the …

Development Of A Temperature Sensitive Face Mask For Identification And Triage Of Febrile Patients, Annemarie Daecher, Flemming Forsberg, John R. Eisenbrey

Department of Radiology Posters

Abstract:

Many infectious diseases are most transmittable when the carrier is presenting with fever. We propose a disposable face mask that changes color as an indicator of fever to provide hospitals with a quick and inexpensive method for triaging infected patients while limiting exposure to others. Two blue thermochromatic dyes which transition to white at 89°F and 92°F were mixed with white paint and applied to 5 types of disposable face masks. During trials, a wearer either sat at rest or ran on a treadmill for 20 minutes and images were obtained every 5 minutes with a thermal camera to …

Dsg2 Increases Exosome Release And Enhances Egfr/C-Src Content: A Mechanism For Intercellular Mitogenic Effect, Andrew M. Overmiller, Jennifer A. Pierluissi, Peter J Wermuth, Ubaldo E. Martinez-Outshoorn, Md, Madalina Tuluc, Adam J. Luginbuhl, Joseph Curry, Larry A. Harshyne, James K. Wahl, Iii, Andrew P. South, M G Mahoney

Department of Dermatology and Cutaneous Biology Posters

Abstract:

Exosomes are nanoscale membrane-derived vesicles that are secreted by cancer cells and play a critical role in modulating the tumor microenvironment and disease pathogenesis. Dsg2, a desmosomal cadherin often overexpressed in skin malignancies including squamous cell carcinoma (SCC), can activate EGFR/c-Src signaling and promote oncogenesis. We sought to address the potential role of Dsg2 in exosome biogenesis and intercellular signaling in SCC. Here, purified exosomes from SCC cells and head/neck SCC patient sera were enriched with a processed 65 kDa membrane-associated C-terminal fragment of Dsg2. Cells overexpressing Dsg2 had increased exosome release and protein content and produced particles enriched …

Healthy Living An In-Depth Look, Nina Radcliff, Md, Kristin Detterline

Jefferson Sleep Disorders Center in the News

Features Dr. Ritu Grewal, pulmonologist and attending physician at Jefferson Sleep Disorder Center Women's Program.

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)