bluuebunny/crossref_metadata_2025 huggingface dataset:
Calcifications due to Mitral Valve Disease Induced by Rheumatoid Arthritis in K/B.g7 Mice
Authors: Konrath Elena , Binstadt, M.D., Ph.D Dr. Bryce
Published: October 2019

Background and Hypothesis: Rheumatoid arthritis (RA) is a rheumatic autoimmune disease wherein the host generates self-antibodies that target the synovial lining of joints. However, it’s been observed that patients with RA also develop Mitral Valve Disease (MVD), although the mechanism is not very well known. In my project, I focused on the physiological changes of the heart during the formation of MVD, specifically focusing on calcifications and whether they form on the inflamed valve. I hypothesized that calcifications are developing during disease progression, resulting in advancement of the inflammation cycle.
Experimental Design or Project Methods: A total of thirteen mouse hearts were removed and stored in OTC at -80 C: 5 K/B.g7 (7 months), 5 K/B.g7 (8 weeks) and 3 B6 (1.5 years). The hearts were sectioned and stained using calcium-staining Alizarin Red S. Additional sections were also stained with Hemotoxylin and Eosin stain.
Results: From my analysis, it was apparent that there were no calcifications on the mitral valves in any of the samples. Pigmentation was apparent, but potential calcium was ruled out when compared to the H&E stains. There were heavy calcium deposits in the aorta and aortic valve in forty percent of the MVD samples. Additionally, calcium was seen near the apex of the left ventricle in three of the ten MVD samples.
Conclusion and Potential Impact: In conclusion, it doesn’t appear that calcification occurs in the mitral valve, neither in the early nor late onset of RA. However, I pursued the calcifications seen in the aorta because of previous research done with calcifications seen in RA mice eating a high-fat diet. Currently, I am investigating further with the entirety of the aorta and staining to see if the calcification is isolated near the valve or if the calcifications spread. I am hoping that my findings will assist in identifying the physiological changes that are seen in rheumatoid arthritis.
Multiscale mathematical modeling of aqueous humor dynamics: Applications for precision care in glaucoma
Authors: Lang Matthew , Harris Alon , Verticchio Vercellin Alice Chandra , Mathew Sunu , Guidoboni Giovanna
Published: October 2019

Background and Hypothesis: Reduction of intraocular pressure (IOP) resulting from overproduction or impaired outflow of aqueous humor is, to date, the only approved medical treatment for the disease. IOP is determined by the balance between aqueous humor production at the ciliary body and drainage at the anterior chamber angle. A mathematical model describing aqueous humor (AH) flow was employed in order to study the effects of glaucoma medications and risk factors on IOP.
Experimental Design or Project Methods: IOP can be calculated as the unknown variable in the mathematical balance between AH inflow (Jin) and outflow (Jout). Model simulations using MATLAB were used to calculate IOP in conditions of varied trabecular meshwork resistance (R) over changes in episcleral venous pressure (EVP), uveosclearal outflow facility (Cuv), and ciliary capillary blood pressure (cBP) in order to simulate the effects of EVP reducing medications, prostaglandin analogs, and systemic BP, respectively.
Results: The simulated effects of EVP reducing medications and prostaglandin analogs led to IOP decrease of 13.12%, 5.51%, and 2.88% for conditions of R0, 3R0, and 6R0, respectively, where R0 is equal to the trabecular meshwork resistance when IOP = EVP. The simulated effects of prostaglandin analogs resulted an IOP decrease of 13.73%, 18.34%, and 19.83%, for conditions of R0, 3R0, and 6R0, respectively. The simulated effects of increasing systemic BP resulted in an IOP increase of 49.88%, 58.51%, and 60.71% for conditions of R0, 3R0, and 6R0, respectively.
Conclusion and Potential Impact: The model simulations predict differential efficacy in IOP reducing medications in patients of varied R as well as the differential impact of systemic BP on IOP in patients of varied R. This model has the potential to predict the IOP reducing effect of medications in an individual as well as the impact of risk factors such as systemic BP on IOP.
The Function of E6BP in Normal Human and HPV-Infected Cell Lines
Authors: Lima Amanda , Rietz Anne , Androphy Elliot A.
Published: October 2019

Background and Hypothesis: High-risk human papillomavirus type-16 and -18 cause approximately 70% of cervical and 60% of oropharyngeal cancers. While the majority of HPV infections are transient and resolve on their own, some infections persist and progress to cancer. The in vivo and in vitro high-risk HPV transformation ability works to immortalize primary human keratinocytes resulting from the activities of the viral oncoproteins E6 and E7. A well-studied effect of E6 is the degradation of tumor suppressor gene p53 via binding to the ubiquitin ligase E6AP. Additionally, E6 interacts with the cellular calcium-binding protein E6BP, but the functional significance remains unknown. Here we studied the effects of E6BP knockout in normal human and HPV-infected cell lines.
Experimental Design or Project Methods: CRISPR-Cas9 system was used to knockout E6BP in HPV-human cervical cancer cell lines: HeLa (high-copy HPV18) and SiHa (low-copy HPV16) as well as human keratinocyte HaCaT (mutant p53) and p53-null lung carcinoma H1299 cell lines. Cells were transfected with a puromycin-resistant CRISPR*Cas9 control plasmid (pLentiv2) and one that carries a guide RNA against E6BP (pLentiv2-E6BP) and selected with puromycin. RFP-GFP, which does not carry a puromycin resistance, was transfected into cells to establish transfection efficiency and to serve as the control for the puromycin. After successful selection, polyclonal populations of pLentiv2 control and pLentiv2-E6BP cells were screened for E6BP protein levels. pLentiv2-E6BP cell populations with reduced E6BP protein were serial diluted to generate monoclonal cell lines. Clones were then screened E6BP protein expression, and low expression clones were further processed for DNA sequencing of the E6BP gene editing site. Additionally, the effects of E6BP knockout in Siha and HeLa cells on p53, p21, and E6AP protein expression was studied by immunoblot.
Results: Monoclonal pLentiv2-E6BP cell lines for H1299 and HaCaT cells were established and as well as polyclonal pLentiv2-E6BP HeLa and SiHa cell populations. Preliminary results indicate that E6BP knockout in HeLa and Siha cells reduces the p53 and p21 levels compared to pLentiv2 control cells. Additionally, E6AP protein expression was not affected by E6BP knockout in the polyclonal SiHa cells.
Conclusion and Potential Impact: These preliminary results suggest that E6BP levels may influence p53 and p21 levels in HPV cells. It is of particular importance to further investigate if low levels of E6BP contribute to a worse outcome during HPV induced carcinogenesis.
Determining Health Information Technology Use by the Transgender Population: A Scoping Review
Authors: Liu Albert , Lee Joy , Weiner Michael
Published: October 2019

Background: Transgender people face many potential barriers in healthcare, such as real or perceived discrimination, inability to pay for healthcare services, and misinformation about transgender health needs. It has been hypothesized that, because of these barriers, transgender people may be more receptive to using health information technology than other populations. The purpose of this scoping review was to understand the ways transgender people use health information technology.
Methods: This scoping review included English studies that addressed use of technology by transgender people in health sciences literature. The inclusion criteria was studies that documented transgender technology use and did not include studies that only focused on technology use by healthcare providers. Included studies were sorted into categories based on the type of technology transgender participants used.
Results: Twenty-nine articles met the study inclusion criteria from an initial pool of 1,276 articles searched from online databases. Many studies were involved with multiple categories. Fourteen articles addressed websites targeting transgender people, twelve included the usage of online social media sites, seven articles involved transgender usage of online surveys, and four articles discussed transgender usage of smartphones in health management.
Conclusion and potential impact: Twenty-two studies focused on the application of interventions through websites and social media sites, nineteen of which concluded that web-based health information or interventions were feasible methods to affect the health of transgender people. Sixteen studies concluded that online interactions were accepted, if not preferred, by their transgender participants. This review suggests that further integration of online interventions and healthcare information into these mediums may increase transgender engagement in healthcare and reduce healthcare barriers. Future research to improve understanding of the outcomes of health information technology on the health of transgender people would be an asset for treating a historically medically underserved community.
Hemoglobin Expression and Function in Human Corneal Epithelium
Authors: McBride Ryan , Perez Erin , Talarico Ernest , Kennedy Brian
Published: October 2019

The corneal epithelium forms the outer layer of the cornea. It provides mechanical protection, prevents fluid loss and forms a barrier to invasive pathogens. Though hemoglobin expression has been extensively studied in erythroid cells, recent work in multiple cell systems has documented hemoglobin expression in cells of non-erythroid origin. However, the function of hemoglobin in non-erythroid cells has yet to be established. The hypothesis that hemoglobin is expressed in corneal epithelium and that it functions to protect against oxidative stress will be examined in the present work. Hemoglobin expression and function was examined by immunocytochemistry and western blot analysis. Native human corneal explants and an immortalized human corneal epithelial cell line were examined. Expression of hemoglobin beta and delta chains was demonstrated at the protein level in both native and cell culture preparations. Hexamethylene bisacetamide is a known inducer of hemoglobin beta chain expression in murine erythroleukemia cells. HMBA did function to increase beta chain expression in cultured corneal epithelium as well. Beta chain immunolocalization was primarily cytoplasmic, while the delta chain localized to both cytoplasmic and membrane domains. Oxidative stress, from hydrogen peroxide exposure, was shown to upregulate delta chain expression. In conclusion, hemoglobin chains are expressed in corneal epithelium and could function to protect against oxidative stress. This is relevant given that exposure to light and high oxygen tensions render the cornea particularly susceptible to oxidative damage.
Generation of liver organoids by 3D co-culturing of hepatocytes, hepatic stellate cells, and liver sinusoidal endothelial cells
Authors: Mulligan, MS1 Sean C. , Zhang, PhD Wenjun , Smith, PhD Lester J. , Gramelspacher, BS Erika , Li, PhD Ping , Ekser, MD, PhD Burcin
Published: October 2019

Background and Hypothesis: Recent progress with combination of chemicals in cell culture media prolongs hepatocyte (HC) function in vitro. However, without other cells of hepatic lineage that comprise natural liver, HC alone are not suitable for the study of complex liver diseases. Hepatic stellate cells (HSC) and liver sinusoidal endothelial cells (LSEC) play vital roles in physiological and pathological liver function in situ. We hypothesized that coculturing primary HC with HSC and LSEC as 3D liver organoids in the same chemical conditioned media would uphold HC function over time, creating a better physiological 3D liver microenvironment for liver disease research.
Experimental Design: Freshly thawed primary human HCs were combined with immortalized human HSC alone, or together with immortalized human LSECs, to generate 3D liver spheroids. Spheroids were formed in HC maintenance media (HMM, Lonza) using low adhesion 96-well plates for 6 days before switching to the media with different combination of chemicals (SB31542, Forskolin, IWP2, DAPT, and LDN193189) for culturing another 14 days. Spheroids characterization, albumin secretion, mRNA transcription (CYP3A4), and histological analysis were performed for HC differentiation, maturation, and function.
Results: Both co-cultures of HC:HSC (2.5:1 ratio), and HC:HSC:LSEC (2.5:1:1) formed spheroids in HMM within 4 to 6 days (Fig.1A). The introduction of the different chemical-based media affected the roundness and diameter of spheroids differently (Fig.1B). In the presence of all 5 chemicals (5C), HC function was better maintained up to 21 days in HC:HSC:LSEC spheroids, measured by albumin, CYP3A4, and CK-19 secretion (Fig.1C). Surprisingly, 5C-based media significantly upregulated the expression of CK-19, which is one of the markers for cholangiocytes and liver precursor cells.
Conclusion and Potential Impact: 3D liver organoids composed of HC, HSC, and LSEC would create a niche environment mimicking the in vivo condition. Optimization of complex hepatic spheroids, as well as optimization of complex hepatic spheroid culturing media, would allow for the generation of a unique model for studying complex liver diseases.
The Effects on Ishikawa Endometrial Cancer Cell Lines upon Treatment with Hormonal Agents and Novel Drug Target
Authors: Pandita Pooja , Wang Xiyin , Hawkins Shannon
Published: October 2019

Background and Hypothesis: Endometrial cancer is the most common gynecological malignancy in the US and will claim the lives of over 12,000 women in 2019. Women with high-risk histologic tumors, such as high-grade endometrial adenocarcinoma, represent over 50% of these deaths. Novel treatments are needed to treat these aggressive tumors. Decreased expression of the ribonuclease DICER is associated with high-grade and recurrent endometrial adenocarcinoma. To study the role of DICER in endometrial cancer, we used CRISPR/Cas9 to delete DICER in an endometrial cancer cell line. RNA sequencing revealed dysregulation of steroid hormone receptor signaling and high expression of APEX1 [apurinic/apyrimidinic endonuclease 1 (Ref-1/APE1)]. Elevated levels of Ref-1/APE1 have been found in various tumor types, and Ref1/APE1 inhibitors are in clinical trials. We hypothesize that our DICER deleted cell lines will be hormone insensitive yet respond to Ref-1/APE1 inhibitors by decreasing cellular proliferation.
Project Methods: Ingenuity Pathway Analysis provided an unbiased approach to determine dysregulated genes in steroid hormone signaling in our RNA transcriptomic data. QPCR was used to confirm gene expression in independent samples. Cells were treated with steroid hormones or Ref-1/APE1 inhibitors and proliferation was assessed using MTS.
Results: DICER deleted cell lines had downregulated expression of steroid hormone receptors. Treatment with steroid hormones did not have a significant effect on proliferation. However, treatment with Ref-1/APE1 inhibitors resulted in a significant decrease in proliferation.
Conclusion and Potential Impact: Ref-1/APE1 inhibitors affect cellular proliferation of endometrial cancer cell lines. Because survival has actually worsened for women with endometrial cancer, novel therapies such as Ref1/APE1 inhibitors deserve future study.
Non-invasive estimation of prostate tumor grade with PET [68Ga] Ga-PSMA-11 imaging
Authors: Patel Neal , Bahler Clint , Green Mark , Cheng Liang , Hutchins Gary
Published: October 2019

Background and Hypothesis: In the US alone, more than 160,000 men are diagnosed with prostate cancer each year. Prostate cancer grows slowly in many patients such that most die due to unrelated causes, yet 29,000 prostate cancer-related deaths occur annually in the US. The gravity of this mortality rate promotes over-treatment of low- and intermediate-risk cancer patients as well as monitoring of cancer via invasive biopsies to determine cancer grade. We hypothesize that molecular imaging methods can differentiate low- and intermediate- risk prostate cancer, guide optimal treatment, and eliminate morbidity associated with biopsy procedures.
Experimental Design or Project Methods: In this work, we used PET [68Ga] Ga-PSMA-11 imaging to estimate cancer grade through direct comparison with whole mount pathology, which is the gold standard for cancer grading. A tool was developed using Interactive Data Language (IDL) to automate 3D spatial registration of whole mount pathology slices with [68Ga] Ga-PSMA-11 PET images. Upon accurate spatial registration, quantitative analysis was performed to establish the relationship between regional [68Ga] Ga-PSMA-11 uptake and prostate cancer grade.
Results: Thus far, we have shown qualitatively that the whole mount pathology accurately maps to the correct 3D spatial location on the PET images. Upon spatial registration, using a ROC curve, we have found that [68Ga] Ga-PSMA-11 uptake could be used to detect both low- and high- risk tumor location (AUC = 0.82 and 0.84 respectively). Further, we demonstrated increasing uptake with greater risk.
Conclusion and Potential Impact: This study begins to establish the feasibility of noninvasive, imaging-based monitoring alternatives which can mitigate the need for invasive biopsies for prostate cancer. Ultimately, improved imaging methods have the potential for not only bettering prostate cancer monitoring but also for improving cancer outcomes and quality of life for prostate cancer patients.
Evaluating the Efficacy of Virtual Dissector Technology Implementation In Undergraduate Anatomy.
Authors: Persinger Jonah , Dunham Stacey , Husmann Polly
Published: October 2019

Background and Hypothesis: At the graduate and professional level, computer-aided instruction demonstrated a positive impact on knowledge gains when supplementing traditional teaching methods (Wilson et al). The present research sought to determine the efficacy of supplementing traditional pedagogical methods in an undergraduate anatomy lab with VH Dissector Software (VHD) on a large touchscreen terminal.
Experimental Design or Project Methods: Throughout Basic Human Anatomy (ANAT-A215), students took a pre-quiz before covering a topic followed by a post-quiz in the next class. Using VHD was the intervention, while using the traditional lab manual, models, and two prosected cadavers was the control. The mean difference between pre-test and post-test scores was calculated. Independent Samples T Tests compared the mean difference between intervention and control groups. Post-course surveys were obtained. Calculations were made of frequencies for each question and Spearman Rho correlations between questions.
Results: There was significant improvement in scores with the intervention (versus control) in the Spring 2019 semester (Meanintervention = 1.13, Meancontrol = 0.92, P <0.01). In the post-course survey, 54.1% of students indicated that they would not recommend using VHD in future semesters. Among these students, 50.1% stated they did not find VHD beneficial, 34% stated VHD helped to rotate structures, and 23.4% stated VHD was a change of pace from other lab responsibilities. Among the students that recommend using VHD, 64.8% stated VHD helped to rotate structures, 51.4% stated VHD provided context for what they saw on models, and 48.9% stated that VHD was a change of pace from other lab responsibilities. A significant correlation was found between enjoying use of the VHD and perception of learning using VHD (r = 0.794, P <0.01)
Conclusion and Potential Impact: These results indicate a benefit to supplementing traditional anatomy learning modalities with dissection software at the undergraduate level. Yet, while students recognize a benefit, they often recommended not using the tech in future semesters.
Liver Dysfunction may be Associated with QOL in Adults with CF
Authors: Rao, BS Megana , Weber, BS Regina , Chalasani, MD Naga
Published: October 2019

Background: More individuals with cystic fibrosis (CF) are living into their adulthood due to significant advances in medical care. The adult CF clinic at Indiana University cares for one of the largest adult populations with CF. Liver disease is common in children and adults with CF. However, the characteristics and consequences of CF liver disease (CFLD) in adults are not well understood. In this ongoing, IRB approved study, we systematically characterized the liver manifestations and their health related quality of life in adults with well characterized CF.
Methods: Individual patient demographics and clinical data were collected for study participants. Participants completed two quality of life study questionnaires: Chronic Liver Disease Questionnaire (CLDQ) and Revised Cystic Fibrosis Questionnaire (CFQ-R). 10mL of blood was collected for future research. Finally, participants underwent a bedside transient elastography via FibroScan®.
Results: There were 50 patients, with a mean age of 30.9 years, enrolled in the study. Pancreatic insufficiency was the most common co-morbidity, as it affected 90% of patients. The mean AST was 23.55 units/L, mean ALT was 25.20 units/L, and mean alkaline phosphatase level was 117.73 units/L. From the FibroScan®, the median liver stiffness measurement (LSM) was 4.65 kPa and the mean controlled attenuation parameter (CAP) was 219.52 dB/M. The mean CLDQ score was 5.343.
Conclusion: This ongoing study reveals that increased alkaline phosphatase and CAP scores are associated with a poor QOL. More data is needed to further understand the pathophysiology behind CFLD. Use of noninvasive imaging, noninvasive markers, and the CLDQ may aid in early identification of adult CFLD.
Synthetic lethality with cisplatin by targeting FACT complex in breast cancer
Authors: Swiezy Sarah , Dirks, MD Rebecca , Nakshatri, PhD Harikrishna
Published: October 2019

Background and Hypothesis: Previous work by our lab has shown that FACT (FAcilitates Chromatin Transcription) is upregulated from P(1º) ➝I(immortalized)➝R(Ras-transformed) cells. The FACT complex is targeted by curaxins, small molecules that “trap” FACT on chromatin, decreasing its ability to destabilize histone tetramers and facilitate DNA replication and transcription. The lab has also observed selective sensitivity to curaxins in the same pattern, P➝I➝R, suggesting the dependency of Ras-transformed cells on FACT for survival. Therefore, we hypothesized that by impairing the cancer cell’s ability to repair DNA, curaxins sensitize breast cancer cells to DNA damage-inducing chemotherapeutics, such as cisplatin. Cisplatin represents the current standard of care for triple negative breast cancer (TNBC), but is associated with exceedingly toxic side effects as well as resistance. Combination therapies may permit cisplatin dose reduction while simultaneously improving response.
Project Methods: We first determined which cancer cell lines (MCF7: ER+/PR+/HER2-; T47D: ER+/PR+/HER2-; and MDA-MB-453: TNBC) would be appropriate for demonstrating synergistic cisplatin + CBL0137 (specific curaxin) cytotoxicity. We then used BrdU assay and Western blot to assess the effects of the drugs individually and in combination on cancer cells.
Results: We observed heterogeneity in sensitivity of cancer cell lines to CBL0137 as well as statistically significant synthetic lethality between cisplatin and CBL0137.
Conclusion and Potential Impact: The knowledge gained by this research is actively being used to develop chemoprevention strategies and to enhance the effectiveness of chemotherapy. Prompted by our results, in vivo preclinical and clinical studies using cisplatin + CBL0137 to treat TNBC are planned.
Rapid Identification of Large Vessel Occlusion Stroke Subtype in the PreHospital Setting
Authors: Torolira, B.S. Daniel , Brown, M.D. Sara , Chang, M.D. Fen-Lei
Published: October 2019

Background and Hypothesis: Stroke treatment is highly time-sensitive, with an estimated 1.9 million neurons dying per minute during an untreated ischemic stroke. The recent advent of mechanical thrombectomy (MT) and its illustrated safety and efficacy in treating large vessel occlusion (LVO) strokes has generated a need to rapidly identify LVO patients who may otherwise be brought to the nearest hospital, which may not have the capability to perform the procedure. Accurate identification of LVO in the pre-hospital setting would allow immediate EMS transport to an MTcapable Comprehensive Stroke Center, thus reducing time-to-treatment and improving patient outcome. While various grading scales, such as the C-STAT, have been developed for this purpose, all have shown to lack sensitivity and specificity for accurate LVO determination. We hypothesize that a new scale combining common LVO presentations as positive values and those of other stroke subtypes, such as small vessel occlusion (SVO) and cardioembolic stroke (CE), as negative values will increase the accuracy of LVO determination.
Methods: This is a retrospective chart review analysis of 86 patients evaluated for stroke between January 2017-May 2018 at the Parkview Regional Medical Center with imaging confirmed LVO, SVO or CE diagnoses.  
Results: C-STAT stroke scale had a sensitivity of 54.5% and a specificity of 86.7% in differentiating LVO from other stroke subtypes. Compared to C-STAT, our new model showed a significantly higher sensitivity of 81.8% (p=0.0038) and a nonsignificant decreased specificity of 75.0% (p=0.061). 
Conclusion: Our findings suggest that our new scale combining common clinical presentations in LVO stroke patients as positive predictor values and those in SVO and CE stroke patients as negative predictor values may allow for a more accurate determination of LVO stroke in the pre-hospital setting without significant delay. A prospective, larger patient cohort in a pre-hospital setting is needed to validate these findings.
Exposure to Adipose-Enriched Bone Marrow Increased Breast Cancer Cell Expression of Genes that Drive Tumor Metastasis
Authors: Wright Laura E. , Suresh Sukanya , Regan Jenna N. , Pagnotti Gabriel M. , John Sutha , Mohammad Khalid S. , Guise Theresa A.
Published: October 2019

Background and Hypothesis: Previously thought to be inert, bone marrow adipose tissue (BMAT) has emerged as a significant fat depot that increases with age, radiation, estrogen deficiency, and high fat diet. Because bone is a preferred site for breast cancer metastasis, the lack of understanding regarding the effects of BMAT accrual on tumor cell migration and proliferation represents a significant knowledge gap in the cancer field. We hypothesized that exposure to adipokines secreted from BMAT-enriched bone marrow would induce changes in the tumor cell transcriptome.
Experimental Design or Project Methods: Twenty-week female C57Bl/6 mice were randomized and treated with control diet (5% kcal% fat) or high fat diet (HFD; 60% kcal% fat) for nine weeks. Relative to control mice, HFD mice had increased body weight, peripheral fat mass, BMAT volume, and circulating adipokines. Bone marrow was flushed and cultured for 24 hours, and control or BMAT-enriched conditioned media was collected. The adipokines leptin and MCP-1 were assayed by ELISA and found to be increased in media obtained from BMAT-enriched cultures. Human MDA-MB-231 breast cancer cells were then cultured in bone marrow conditioned media for 24 hours and tumor cells were processed for RNA sequencing.Results: Exposure to soluble factors derived from BMAT-enriched cultures resulted in significant increase in the expression of genes associated with cancer cell motility and neovascularization, including SEMA4C, PLXNA1, and VEGFA.
Conclusion and Potential Impact: These data indicate that BMAT contributes to the tumor microenvironment and may drive the progression of breast cancer bone metastases.
Designing a standard protocol for manually reviewing patient data demographics for record linkage
Authors: Xiong Sen , Grannis, MD, MS, FAAP Shuan
Published: October 2019

Background and Hypothesis: Accurate record linkage is essential to address fragmentation of patient data across independent healthcare organizations. To accurately evaluate record linkage methods, so-called “gold standard” data sets with labeled true matches and non-matches are needed. Human review, the process of manually assessing potentially linked patient demographic records and determining whether the record pair belongs to an idiosyncratic individual, is needed to create these datasets. However, the human review process is susceptible to bias and human error. Consequently, record linkage accuracy evaluations are prone to be biased by inaccurate gold standards. Consistent and scientifically rigorous methods for creating gold standard record linkage data sets must be developed, as none have yet been described. In this study, we describe a repeatable process for developing consistent manually reviewed datasets and analyze the results obtained from 15 human reviews of 200 record pairs following our protocol.
Experimental Design/Methods: We obtained patient records from the Indiana Network for Patient Care and Marion County Health Department. We created record pairs for manual reviews by probabilistically linking datasets using multiple blocking schemes. Two-hundred record pairs were then manually reviewed by 15 different individuals and the results were analyzed.
Results: Across the 200 record pairs reviewed by 15 reviewers, 155 were nondiscordant pairs whereas 45 were discordant, 40 among which were the result of outliers.
Conclusion and Potential Impact: From the record pair evaluation results, some empirical rules can be established for the process of manual review, though the nuances of evaluation reasoning require more discussion and a larger sample size. Nonetheless, establishing a standard for manual reviewing is a step towards better health care and complete patient records.
Study of acute appendicitis among surgery inpatients of a secondary care hospital
Authors: Puttaraju Shashidhara , Kailasam Abirami
Published: October 2019

Background: Pain in abdomen is one of the most common symptoms which patients presented at emergency department, which seeks urgent medical attention and treatment. Acute appendicitis is one among the predominant acute abdominal surgical emergency. This condition may be associated with complications and significant rise in morbidity and even mortality if there is a delayed diagnosis and treatment.Methods: This was a hospital based descriptive study of the patients admitted in the department of General Surgery of JSS Hospital, Chamarajanagar, between June 2017 and August 2019, with clinically diagnosed acute appendicitis, which was confirmed on ultrasonography, postoperatively confirmed by histopathology.Results: The present study showed that acute appendicitis was most common among the age group of 11-30 years (57.3%) and more among the males (58.8%). The surgery done for acute appendicitis was open appendectomy, done for 82.4% of the cases, 16.2% of the cases required laparotomy with peritoneal lavage and drainage, due to abscess formation, perforation and associated small bowel perforation.Conclusions: The most common age group affected with appendicitis in our study was 11-30 years. The most common intra operative finding was inflamed appendix, which showed that simple appendicitis is more common than complicated appendicitis in our study and appendectomy is the preferred surgery for acute appendicitis.
Comparison of outcome of Desarda versus Bassini repair in management of complicated inguinal hernia
Authors: Ansari Faiz Manzar , Hameed Tariq , Jain Sudhir Kumar , Dua Amrita , Nizam Adiba
Published: October 2019

Background: Complicated inguinal hernia is a common problem faced by surgeons across the world. Various methods of surgical repair have been described. It is important to identify the best repair technique of inguinal hernia to have better post-operative outcome.Methods: This randomised controlled study consisted of 84 cases of complicated inguinal hernias presenting to surgical emergency department of Maulana Azad Medical College. Patients were randomly allocated to two repair groups- Desarda and Bassini and various intra/post-operative parameters were compared.Results: Duration of surgery and postoperative pain scores were less in Desarda group. Time to return to strenuous daily activities was also less with Desarda repair. Desarda repair was associated with less incidence of chronic inguinodynia and post-operative complications.Conclusions: Desarda repair was found to be superior to Bassini group due to shorter duration of surgery. Patients required less analgesics following Desarda repair as compared to Bassini group. There was no recurrence in any group at four months follow up.
A study of surgical site infections in a tertiary care hospital
Authors: Jain Ayush , Tolpadi Anuradha , Chaudhary Bhupendra , Chaudhary Ansh , Misra Ankita
Published: October 2019

Background: Health care-associated infections remain as an important public health concern. Surgical site infections (SSIs) are known to be one of the most common causes of nosocomial infections worldwide.Methods: A prospective observational study was conducted across 12 months (May 2018-April 2019) in a tertiary care hospital. The present study includes 223 patients who were undergoing clean and clean contaminated surgery in the hospital. Contaminated and dirty surgeries were excluded. The demographic data of the patient, diagnostic criteria used, associated risk factors, use of prophylactic antimicrobial agents, the type and duration of surgery, clinical evaluation of wound and laboratory data was collected. All the pus samples or wound swabs of clinically suspects of SSI cases received in the Department of Microbiology were inoculated and interpreted according to Centre for Disease Control and Infection guidelines.Results: The study included 223 patients who underwent surgery in the hospital. Amongst them 9 (4%) developed SSI. The incidence of SSI was 4.03%. There was a direct relationship observed between the occurrence of SSI and certain co-morbid conditions such as diabetes. It was also observed that prolonged surgeries above two hours and females were more predisposed to develop a surgical site infection.Conclusions: SSIs being one of the most common causes of nosocomial infections. It was also the most important factor responsible for significant morbidity, mortality, unwanted prolonged hospitalization and additional cost of treatment in surgical patients which can be reduced by strictly following the guidelines of infection control along with judicious and rational use of antibiotics.
Pattern of ocular morbidity in school children and its association with academic achievement
Authors: Hashmi Gulfam Ahmed , Khalique Najam , Amitava Abadan K.
Published: October 2019

Background: Ocular morbidity describes any eye disease regardless of resultant visual loss. India is plagued by ocular morbidities in school going children. Refractive error is considered to be the major cause of visual impairment. The objectives of the present study were to compare the pattern of ocular morbidity in urban and rural school children, to study the association of academic achievement with ocular morbidity in study population and to suggest appropriate recommendations for addressing the problem of ocular morbidity in school children.Methods: A cross sectional study was conducted in the 9 primary and 5 junior high schools of field practice areas of Rural Health Training Centre and Urban Health Training Centre respectively, under Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh from September 2005 to August 2006.Results: Prevalence of ocular morbidity in the present study was 23.3%. Maximum prevalence of 28.7% of ocular morbidity was seen in the age group of 14-16 years. Prevalence of ocular morbidity was found to be 100 (51.6%) in males and 64 (40.1%) in females. 29.3% of the 164 school children having ocular morbidity showed poor academic achievement compared to 18.7% of the 541 children not having ocular morbidity and the association was found to be statistically significant.Conclusions: Refractive error was one of the major causes of ocular morbidity among school going children but most of them were of mild degree. Ocular morbidity was found to affect the academic achievement of school going children.
Endoscopic exploratory tympanotomy in cases of conductive hearing loss with intact tympanic membrane: our experience
Authors: Govindan Shankar Bettadapura , Chandrashekar Yogeshwar
Published: October 2019

Background: Determining the cause of conductive hearing loss with an intact tympanic membrane has been a challenge for the otologists for over decades. The aim of this study is to ascertain the usefulness of endoscopes to study the various middle ear pathologies on performing endoscopic exploratory tympanotomy.

Methods: A retrospective analysis of various pathologies encountered in the middle ear in 88 patients who underwent endoscopic exploratory tympanotomy done over a study period of 3.5 years (January 2015 to June 2018).  

Results: In our study, age of the patients ranged from 14 to 50 years with a mean age of 32 years. Most common finding on exploration was otosclerosis in 59 patients followed by revision stapedotomy in 12 patients. 5 patients had normal middle ear findings with all ossicles intact and mobile while other pathologies encountered were tympanosclerosis (4.6%), biscuit foot plate (2.3%), mucosal bands (3.4%) and middle ear developmental anomalies (3.4%).

Conclusions: On exploring the middle ear knowing the various aetiologies helps in better preoperative counseling of the patients for the outcome of surgery. Endoscopic approach for exploratory tympanotomy has the benefit of excellent resolution with higher magnification and wider panoramic view of middle ear anatomy.

 
Reconstrucción de una teoría politológica, el Sufragio Activo Meritocrático
Authors: Velasco Antonio
Published: October 2019

Se presenta una reconstrucción no formal de la teoría del Sufragio Activo Meritocrático, el cual consiste en la propuesta del voto plural en comunidades locales, con base en el mérito político, según la prosocialidad de la participación política local.  El método se basa en la metateoría estructuralista, adaptada al análisis de teorías de ciencias humanas.  Se reconstruyeron la red intrateórica e interteórica de la teoría, y se efectuó una crítica a ésta sobre la base de su ajuste al contexto social.  Se concluye que la teoría analizada está bien fundamentada, aunque amerita de desarrollo adecuado para su operacionalización y aplicación.
Are you a selective-realist dialetheist without knowing it?
Authors: Martinez-Ordaz María Del Rosario
Published: October 2019

Recently there has been a tendency on the part of some scientific realists to weaken their philosophical theses with respect to the success of science. Some of them have suggested that a satisfactorily realist standpoint should be a highly modest approach to scientific success , leaving many with the impression that scientific realism nowadays is nothing that we once thought it was. In light of that, the main concern of this paper is methodological, here I want to answer the question how far can we push the boundaries of our realist commitments and still be in control of our philosophical claims. In particular, I deal with the issue of how a certain type of weak version of selective realism will necessarily allow for true contradictions, dialetheias –even if that is not desirable. Here I argue that if one presents a very weak characterization of selective realism, one that is in line with contemporary projects, this type of realism will not forbid the possibility of things such as dialetheias. I also claim that, if that is the case, we face the following dilemma: or our general characterization of selective realism is mistaken or selective realists cannot provide a satisfactory explanation of why and how to forbid dialetheias in science
Are Neural Transactions in the Retina Performed by Phase Ternary Computation?
Authors: Johnson AS  , Winlow W
Published: October 2019

Substantial evidence has accumulated to show that the action potential is always accompanied by a synchronized coupled soliton pressure pulse in the cell membrane, the action potential pulse (APPulse). Furthermore, it has been postulated that, in computational terms, the action potential is a compound ternary structure consisting of two digital phases (the resting potential and the action potential) and a third-time dependent analogue variable, the refractory period. Together, with the APPulse, these phases are described as the computational action potential (CAP), which allows computation by phase. The nature of transmission, and thus computation across membranes, is dependent upon their structures, which have similar components from one neuron to another. Because perception and therefore sentience must be defined by the capabilities of the brain computational model, we propose that phase-ternary mathematics (PTM) is the native mathematical process underlying perception, consciousness and sentience. In this review, we take the CAP concept and apply it to the working of a well-defined neural network, the vertebrate retina. We propose an accurate working computational model of the retina and provide an explanation of computation of the neural transactions within it using PTM, and provide evidence that could form the basis of understanding neural computation within the entire nervous system. Evidence is presented of phase ternary computation (PTC), defined in phase ternary mathematics and shows an exact mathematical correlation between the activity of the amacrine cells, the bipolar cells and ganglion cells of the retina, once these cells have been activated by light falling on the cones. In this model, the computation of luminosity of multiple cones synapsed to a bipolar cell is performed by phase ternary mathematics at the points of convergence of CAPs. Redaction by the refractory periods of converging CAPs eliminates all but the leading APPulse resulting in sampling and averaging. In phase ternary analysis (PTA), the physiology of synapses defines their primary action as latency changers, changing the time taken for impulses to travel between points of convergence. This paper describes a novel type of computation, PTC, with evidence that it is the fundamental computational method used by the retina and by association the rest of the brain. By comparing the morphology of neurons it is now possible to explain their function singly and in networks. This has profound consequences both for our understanding of the brain and in clinical practice.
Intraoperative Usage of Blood Products in Patients Undergoing Cardiac Surgery on Cardiopulmonary Bypass
Authors: Phokontsi Charity , Muteba Michel Kasongo , Motshabi-Chakane Palesa
Published: October 2019

Background: Transfusion of blood products is increasingly recognised as an independent predictor of poor outcome after cardiac surgery. The aim of this study was to audit blood transfusion usage in a cardiothoracic unit at a tertiary academic centre, as part of a plan to establish a blood-conservation protocol.

Methods: A descriptive, retrospective audit. A consecutive convenience sampling method was used. One hundred and twenty-two adult patients who underwent their first elective cardiac surgery on cardiopulmonary bypass (CPB) were enrolled.

Results: The mean age of the population studied was 46.7 (16.2) years. Patients were predominantly male (60.7%). The mean (standard deviation) body mass index was 21.4 (5.6) kg/m2. Preoperative haemoglobin (Hb) and platelet counts were 12.8 (2.3) g/dl and 274.4 (121.9) 109/l, respectively. Following a clear fluid prime CPB technique, with a median [interquartile range (IQR)] priming volume of 1500 (1000–2000) ml, the first Hb measured on CPB was 8.9 (1.6) g/dl. Overall, 110 (90.2%) patients received donor blood products. Eighty-five (77.3%) patients received red blood cells (RBCs), 103 (93.6%) fresh frozen plasma (FFP) and 35 (31.8%) platelet transfusion. A total of 255 RBC, 225 FFP and 37 platelet units were transfused. Cell salvage technique was used in 94 (77.0%) patients. The median (IQR) volume of salvaged blood was 535 (250–754) ml.

Conclusion: A high rate of homologous blood product transfusion was found in patients undergoing cardiac surgery. Lack of institution-specific guidelines, point-of-care devices and use of higher Hb thresholds before initiating blood product transfusions contributed to high rate of transfusions.
A survey on the use of humanoid robots in primary education: Prospects, research challenges and future research directions
Authors: Tuna Gurkan , Tuna Ayse , Ahmetoglu Emine , Kuscu Hilmi
Published: October 2019

In parallel with the significant and exciting advancements in robot technologies, the use of humanoid robots to support teaching strategies and learning goals has become a popular topic. Different from the traditional instructional or learning tools, humanoid robots can exhibit mobile behaviours and numerous repetitions and are very helpful to the students in developing problem-solving and collaboration abilities. Presently, the roles of humanoid robots in classrooms fall into four main categories: learning materials, learning companions, teaching assistants and communication mediators to support group learning, respectively. With the humanoid appearance, anthropomorphism, interaction, flexibility, repeatability and digital data representation, humanoid robots have great potential to be useful especially in preschool and primary school education. In this paper, limitations and challenges of the use of humanoid robots as teaching assistants are presented in addition to exploring the relationship between humanoid robots and performance in learning.

Keywords: Humanoid robot, teaching, social interaction, learning tool, assisted learning.
Self-esteem of high school students: A structural equation modelling analysis
Authors: Atmaca Taner , Ozen Hamit
Published: October 2019

The aim of this study is to investigate the effect of the parentsâ€™ success pressure, academic stress and fear of negative evaluation on high school studentsâ€™ self-esteem. The relationships between self-esteem and parentâ€™s pressure for academic success, fear of negative evaluation and academic stress on high school students were investigated employing structural equation modelling. The data were collected from 499 students studying at an Anatolian high school in Duzce province with purposeful sampling method. The characteristic of this school is a project school with successful students who get the highest score in the High School Entrance Examination. The result demonstrates that parental pressure for academic achievement on students and associated academic stress increase studentsâ€™ fear of being evaluated negatively at school, which in turn affects studentsâ€™ self-esteem. The fear of negative evaluation is a partial mediator between parental pressure and self-esteem, and full mediation between academic stress and self-esteem.

Keywords: Parent pressure; fear of negative evaluation; academic stress; self-esteem, high school.