bluuebunny/crossref_metadata_2025 huggingface dataset:
PENILAIAN SAFETY INTEGRITY LEVEL IRADIATOR GAMMA KATEGORI-IV PADA KEGAGALAN SISTEM CRANE PENGONTROL SUMBER ZAT RADIOAKTIF
Authors: Pamungkas Niken Siwi
Published: December 2020

PENILAIAN SAFETY INTEGRITY LEVEL IRADIATOR GAMMA KATEGORI-IV PADA KEGAGALAN SISTEM CRANE PENGONTROL SUMBER ZAT RADIOAKTIF. Penelitian penilaian Safety Integrity Level (SIL) telah dilakukan di  fasilitas iradiasi kategori-IV pada sistem crane pengontrol pergerakan sumber zat radioaktif Cobalt-60. Tujuan dari penelitian ini adalah untuk menentukan  tingkatan SIL pada iradiator gamma kategori-IV pada simulasi kegagalan sistem pergerakan crane sumber zat radioaktif. Safety integrity level merupakan cara untuk menunjukkan tingkat kegagalan yang masih dapat diterima dari fungsi keselamatan tertentu. Metode pendekatan yang digunakan pada penelitian ini adalah metode probabilistic risk assessment (PRA) dan initial protection layer (IPL). Nilai frekuensi risiko terhadap paparan sumber zat radioaktif Cobalt-60 saat instalasi iradiator gamma beroperasi adalah bernilai 1,7 x 10-2 fail/year. Nilai sil dari simulasi kegagalan yang dilakukan adalah SIL-4 dengan nilai frekuensi kegagalan sebesar 7x10-7 dengan mengoptimalkan sistem perlindungan high alarm dan interlock systems. Presentase pengurangan risiko yang didapatkan adalah sebesar 99,99%.
PEMANFAATAN QUANTUM DOT SEBAGAI DETEKTOR SINAR-X DALAM UPAYA MENGURANGI DOSIS PENYINARAN
Authors: Bagus Ida
Published: December 2020

Quantum Dot merupakan material semikonduktor dengan ukuran kurang dari 10 nm yang memilikisifat khas yakni dapat memancarkan gelombang elektromagnetik pada panjang gelombang yang bervariasibergantung dari ukuran partikelnya. Dengan sifat tersebut, Quantum Dot dimanfaatkan dalam beberapabidang seperti untuk pencitraan biomedis, label dokumen hingga detektor. Dalam pencitraan yangmemanfaatkan sinar-X, bahan fosfor umumnya digunakan sebagai transduser yang mengkonversi sinar-Xmenjadi cahaya tampak. Selain menggunakan bahan fosfor, sinar-X juga dapat dideteksi menggunakansemikonduktor. Pemanfaatan semikonduktor khususnya Quantum Dot juga dapat disandingkan dengan bahanfosfor sebagai detektor sinar-X. Beberapa penelitian menunjukkan bahwa dengan kombinasi antara bahanfosfor dengan Quantum Dot dapat menghasilkan peningkatan pendaran cahaya tampak yang dihasilkan olehtransduser tersebut. Berkaitan dengan upaya optimisasi proteksi radiasi dalam pemanfaatan radiasi pengion yangmemegang prinsip ALARA (As Low As Reasonably Achievable), maka adanya kombinasi bahan fosfor danQuantum Dot sebagai detektor sinar-X dapat mendukung prinsip proteksi radiasi dengan mengurangi dosisradiasi yang diterima, baik untuk pasien, pekerja dan masyarakat. Peningkatan intensitas pendaran yangdihasilkan menunjukkan peningkatan efisiensi detektor dalam mengubah sinar-X menjadi cahaya tampak.Dengan efisiensi detektor fosfor-Quantum Dot yang lebih tinggi, maka dibutuhkan sinar-X dengan dosisyang lebih rendah untuk menghasilkan citra dengan kualitas yang sama dari hasil penyinaran menggunakandetektor fosfor biasa
Comparative and Legal Analysis of Legislations of Great Britain and Russia in the Field of Preventing Crimes in the Digital Sphere
Authors: Begishev Ildar , Khisamova Zarina
Published: December 2020

The paper presents a comparative analysis of criminal and information legislations, legal acts to ensure cybersecurity in the UK and Russia. The experience of the UK as the most digital country in the world in combating crimes committed with the use of digital technologies seems to be more than ever requested and topical. It notes that in Russia the damage to citizens and organizations from criminal attacks is five times higher than the similar damage to the UK citizens, while the total number of attacks registered in the Russian Federation is much lower than that of the official UK criminal statistics. The authors substantiate the thesis about feasibility of creating in the Russian legislation more universal norms with a certain threshold of strength to new types of digital threats. They argue that creation of effective mechanisms for application of legislation provisions in the digital sphere should be a separate area of domestic criminal policy of all countries. On the basis of the conducted research, they offer some mechanisms of securing relations in the digital sphere.
Land Market of Land Plots for Housing Construction in Irkutsk
Authors: Batoeva Eleonora , Zorina Elena
Published: December 2020

The article examines approaches to identifying land resources, plots of land, the market of land plots for housing housing construction. It shows the features of the legal regulation of land plots in the Russian Federation and other countries, the categories of land for the intended purpose. Land plots, as real estate items. It gives a description of the market state for housing construction in Irkutsk, its characteristics and features. The article brings forth the results of studying the structure of supply and demand on the land plot market for housing construction in Irkutsk. It carries out an analysis of pricing and costs of residential allotments, as well as the factors affecting the demand and supply and costs of plots of land. It presents a conclusion about the state of land plot market for housing construction in Irkutsk, offers directions and approaches to its development.
Influence of Psycho-Cult «Vedic Femininity» on Personal Autonomy
Authors: Turganova Gulnara , Lutoshliva Ekaterina , Osipenok Oksana , Kalinovskaya Evgenia
Published: December 2020

The article examines the problem of influence of psycho-cult «Vedic femininity» on personal autonomy of women-participants. It states that the main audience of the psycho-cult are women who are seeking to solve their personal and financial problems through participation in this psycho-cult. It gives a generalized characteristic of the phenomenon «personal autonomy» and shows that it is exactly the object for the impact of the Vedic femininity psycho-cult. The article substantiates availability of the destructive mind control by the Vedic femininity psycho-cult within the BITE-model of Hassana S. It describes the results of an empirical study on a sample of women aged 25 to 38 years studying in «Vedic femininity» schools through direct participation (seminars, lectures, trainings) and reading specialized literature, being under the influence of psycho-cult from 1 to 3 years. Comparison of the results of studying the personal autonomy of the women influenced by and of those not coming under the influence of the «Vedic femininity» psycho-cult testifies a decrease of such personal autonomy indicators among the women of the first group, such as: the level of self-determination, self-acceptance and self-respect, the level of conscious competence, the level of accepting own aggression and internal consistency of the motives, decisions and actions.
O uso do sistema CAD/CAM para confecção de próteses fixas: aplicações e limitações
Authors: Borges Luciana , Xisto Lima Emilena Maria Castor , Carvalho Adriana
Published: December 2020

O sistema CAD/CAM, sigla derivada do inglês Computer Aided Design / Computer Aided Manufacturing, é uma tecnologia baseada no desenho de uma estrutura protética em um computador seguida de sua confecção em uma máquina de fresagem. Tem como objetivo a simplificação na produção de estruturas protéticas, otimização do tempo de trabalho e a produção de estruturas com alto padrão de qualidade e estética. O emprego desta tecnologia consiste em três etapas: digitalização do preparo protético, planejamento virtual e produção da restauração. O preparo dentário pode ser digitalizado fora da cavidade oral, sobre o modelo de gesso, ou dentro da cavidade oral, através de um sistema de digitalização intra-oral. Após efetuada a digitalização do preparo, a imagem será transferida para um programa de desenho assistido por computador (CAD), pelo qual o operador poderá desenhar de forma virtual a restauração.  Através de uma fresadora ou da impressão digital em 3D, o sistema CAM irá reproduzir a reabilitação desejada. Dependendo da estrutura e do seu objetivo, pode-se optar por diversos materiais, como em resina acrílica, cerâmica, híbrido, metal, e resinas compostas. O objetivo do presente trabalho é explanar o uso do sistema CAD/CAM na Odontologia para confecção de próteses fixas através de um levantamento nas bases de dados Lilacs, Pubmed, Scielo e Google Acadêmico. Pôde-se concluir que a tecnologia CAD/CAM aumenta a versatilidade, a precisão e o custo-benefício da confecção de restaurações indiretas. Acredita-se que em breve, fará parte da rotina clínica da maioria dos cirurgiões-dentistas.
Avaliação in vitro da acurácia de um novo localizador eletrônico foraminal
Authors: Araújo Isaac de Sousa , Oliveira Anamim Larissa Querendo de , Borges Cirdes Ferreira
Published: December 2020

OBJETIVO: Avaliar, em condição in vitro,a acurácia das leituras eletrônicas obtidas por meio do localizador eletrônico foraminal iRoot Apex. MÉTODOS E MATERIAIS: trinta e um pré-molares inferiores humanos uniradiculados tiveram seus acessos, ampliação cervical e aferição do comprimento real realizados de forma padronizada. As medições eletrônicas foram realizadasnos pontos 1.0, 0.5 e 0.0 marcados na tela do aparelho e comparadas as medidas reais a 1mm, 0,5mm e no forame apical, respectivamente.Os dados foramtabulados e analisados utilizando-se os testes ANOVA e Bonferroni com significância de 5%. RESULTADOS: Os resultadosforam calculados em função dos valores absolutos dos erros médios e daacurácia (±0,5 mm) em cada referência de medição, obtendo-se respectivamente: 0,19 mm e 96,8% (0.0), 0,21 mm e 96,8%(0.5), 0,34 mm e 74,1% (1.0). Diferenças significantes foramobservadas apenas entre ospontos mais apicais (0.0 e 0.5) e as aferições realizadas na marcação 1.0 (P < 0,05). CONCLUSÃO: nas condições desteestudo, o aparelhoiRoot Apex®apresentou alta acurácia, todavia, as medições eletrônicas realizadas no ponto 1.0 do aparelho apresenta acurácia inferior às medidas eletrônicas obtidas no forame ou próximo deste ponto anatômico.
Restabelecimento do sorriso com restaurações em resina composta após clareamento dental: relato de caso
Authors: Vargas-Mendoza Madelei Jomhara , Junqueira Adriana Maria Ribeiro , Telles Claudia Cristina da Costa , Carnaúba Giovana Rodrigues Perin , Vieira-Junior Waldemir Francisco
Published: December 2020

INTRODUÇÃO: Atualmente, os pacientes almejam um sorriso harmônico e natural, e procedimentos minimamente invasivos devem ser priorizados. Dentre esses, o clareamento dental associado às restaurações diretas com resina composta são tratamentos indicados para alteração de cor e forma dental, devolvendo estética e função. OBJETIVO: O presente trabalho tem como objetivo apresentar, através de um relato de caso clínico, o restabelecimento de um sorriso possibilitado pelo clareamento dental e restaurações diretas em resina composta. RELATO DE CASO: Paciente do sexo feminino, 33 anos, compareceu em consulta clínica se queixando da estética do seu sorriso após a remoção do aparelho ortodôntico. Os dentes apresentavam alteração de cor e forma, e assim, foram planejados clareamento dental e restaurações diretas em resina composta. O clareamento dental foi realizado pela técnica combinada e após 14 dias, as restaurações em resina composta nos incisivos, caninos e pré-molares superiores foram confeccionadas. CONCLUSÃO: O tratamento clareador e as restaurações em resina composta são abordagens conservadoras que possibilitaram o restabelecimento estético do sorriso.
Zircônia ultra translúcida: Revisão de literatura
Authors: Almeida Carolina Caires , Fernandes Mirna Cristiane Ribeiro Cruz , Lima Emilena Maria Castor Xisto , Carvalho Adriana Oliveira
Published: December 2020

INTRODUÇÃO: A zircônia ultra translúcida (5Y-PSZ) possui propriedades ópticas superiores comparadas aos sistemas cerâmicos convencionais, proporcionando uma ampla aplicação na Odontologia estética. OBJETIVO: O presente estudo teve como objetivo apresentar informações relevantes sobre a cerâmica 5Y-PSZ. MATERIAL E MÉTODO: Foi realizada uma busca na literatura com artigos que avaliaram especificamente a zircônia ultra translúcida na base de dados PubMed, os artigos selecionados abrangiam o período entre 2010 e 2020, além de utilizar artigos mais antigos a fim de contextualizá-la. RESULTADOS: Os trabalhos selecionados descrevem as propriedades ópticas, mecânicas e aplicações clinicas da 5Y-PSZ. A literatura mostra que a composição química deste material proporciona translucidez maior que as demais zircônias e sua resistência flexural permite seu uso em restaurações unitárias posteriores e anteriores. CONSIDERAÇÕES FINAIS: A adesão não parece um empecilho para indicação desta zircônia em áreas não retentivas, e isso a torna um material promissor para aplicabilidade em laminados cerâmicos adotando-se uma abordagem mais conservadora. No entanto, como a 5Y-PSZ foi desenvolvida recentemente, ainda se faz necessário mais estudos que avaliem suas propriedades e diferentes situações clínicas para que o dentista eleja este material com confiança na prática clínica.
Plasmid Sequence Assembly from Long Reads v1
Authors: A Eccles David
Published: December 2020

This protocol demonstrates how to assemble reads from plasmid DNA, and generate a circularised and non-repetitive consensus sequence At the moment, this protocol uses Canu to de-novo assemble high-quality single-cut reads. Input(s): basecalled fastq files in barcodeXX directories, as produced from a rapid barcoding sequencing protocol (e.g. RBK-004 + MinKNOW) Output(s): Consensus sequence per barcode as a fasta file
Bruce Chatwin y su viaje a Patagonia: El nómada que se convierte en escritor
Authors: López Hernández Isabel
Published: December 2020

El escritor británico Bruce Chatwin (1940-1989) partió hacia Patagonia en busca de una respuesta a la pregunta que marcó su creación literaria: ¿por qué viaja el hombre en lugar de quedarse en casa? El resultado de ese periplo fue el análisis del espíritu nómada que le impulsaba a emprender el camino de manera obsesiva. El presente artículo se propone estudiar el despertar de su pasión por el nomadismo e indagar en cómo su aventura en Patagonia le transformó en un viajero literario herido por la nostalgia de un pasado nómada. Se había convertido en un héroe que emprendía un camino de carácter intelectual hacia el núcleo de su anhelo viajero.
The Flotilla Incident from the Perspective of International Law and the Judicial Rights of the Victims
Authors: Bedir Ömer
Published: December 2020

The Mavi Marmara flotilla, which sailed for a humanitarian mission and aimed to break the Israeli blockade to Gaza, was intercepted by the Israeli soldiers on high sea on 31st May 2010. In this raid, nine civilians have lost their lives on the spot and 55 others were wounded. States and their agents can be held accountable if they commit crimes. Therefore, the Mavi Marmara victims have the right to sue at national and international level the Israeli officers who took part in the operation. Some victims have filed criminal and civil cases before the Turkish courts against Israel and its officers. Besides these judicial cases brought before the national courts, a referral was also made by the Union of the Comoros, flag country of the Mavi Marmara vessel, to the International Criminal Court. Meanwhile, Turkey and Israel have signed a bilateral agreement for the compensation of the bereaved  families. This compensation agreement clears Israel and its officers off all legal responsibilities arising from the flotilla incident before the Turkish courts. This bilateral agreement is a legal obstruction imposed to the victims in their quest of justice. The Turkish Court of Cassation, in its recent decisions, has requested the courts of first instance to take into consideration the provisions of the said agreement.  Despite the above mentioned agreement, the victims shall have still the right to sue the Israeli officials responsible for the flotilla incident before national, foreign and international courts, on the grounds of crime against humanity, provided that the necessary requirements are fulfilled.
Any Chance for the Enforceability of the Human Right to Subsistence?
Authors: Fernández Aller Celia
Published: December 2020

It is not true that the idea of the right to subsistence should not give rise to much controversy. In fact, social rights are not considered as fundamental rights by everyone. The aim of this paper is to analyze whether abstract social rights –and the right to subsistence in particular- should be put in constitutions and laws and if judges should be given powers to interpret them. The philosophical foundations and the content of the right are studied and five great challenges are presented, although the most powerful one is to focus on the social and political enforceability of the fundamental right to subsistence. Assessing the effectiveness of the right to subsistence, and the right to food particularly, is a complex issue. In the legal discourse, the question seems to be only suggested.  Even when the Constitutions expressly recognize this right in some countries, its implementation faces many constraints. The progressive realization of ESC rights requires a complex interaction of policies and programs in a wide range of sectors and institutions.The scientific method used in this work is the legal-sociological method, regarding the understanding of the rules, the lack of them, their effectiveness,  etc.   Several methodological techniques have been used, such as social and legal analysis, legal deduction and induction, description and interdisciplinarity.
BASIC TYPES OF ENVIRONMENTAL SCIENTIFIC RESEARCH AND EDUCATION FACILITIES FOR PROTECTED NATURAL AREAS
Authors: VAVILOVA Tatiana Ya. , KOMAROVA Polina S.
Published: December 2020

The results of the research are presented, its tasks were the analysis and systematization of approaches to the design of buildings and structures for scientifi c research and educational purposes for specially protected natural areas (SPNA). It was revealed that Russian architectural science and design regulations do not cover this architectural-typological direction. Therefore, to search for relevant methods of architectural design, principles and techniques of volumetric-spatial organization, engineering solutions, foreign experience was involved. The study of best practices has shown that the infrastructural development of protected areas is associated with restrictions due to natural-climatic and regulatory factors, and the development of requirements for the consumer properties of objects for these territories is infl uenced by the principles of sustainable development - environmental, social and economic. Examples are given.
FUNCTIONAL DIFFERENTIATION OF SPACE AND THE TEN-ELEMENT NUMERICAL MODEL OF ANCIENT CULTURES
Authors: DENISOV Denis V. , ZHURAVLEV Mikhail Y. , LATYPOVA Nailya M. , MEDVEDEVA Nataliia Y. , DOSKOVSKAYA Maria S.
Published: December 2020

The probabilistic regularities in the principles of functional diff erentiation of ordered structures that arise in the process of human space exploration are analyzed. The authors provide the rationale for the ten-element functional model in the context of the wave approach of D.V. Denisov and the fractal-cluster model. Comparable results were obtained for the administrative division into inner-city districts, the structure of tram routes, and the distribution of premises of a Russian university. The analysis is carried out on the example of Samara and Samara State University of Railways.
HISTORICAL DEVELOPMENT AND FEATURES OF FORMATION OF THE CENTRAL AND PEDESTRIAN SPACES OF TOGLIATTI
Authors: VERETENNIKOV Dmitry B.
Published: December 2020

The purpose of this article is to study the development of the central and pedestrian areas of the city of Togliatt i, as an actual urban development trend. An analysis of all the general plans of Togliatt i showed that a high level of motorization and insuffi cient att ention to the problems of pedestrian traffi c in the city center system have formed an aggressive environment that does not promote active urban life. These problems can be solved by saturating the central pedestrian areas with additional functions. The article focuses att ention on the fact that the emergence of new att ractive places for citizens and their inclusion in the city center system will provide an opportunity for eff ective management of urban processes, with the subsequent improvement of the quality of the environment in a spatial and social aspect.
A NEW METHOD FPR ASSESSING THE RESISTANCE OF A REINFORCED CONCRETE COLUMN WITH A CIRCULAR CROSS SECTION
Authors: ILYIN Nikolay A. , MORDOVSKIY Sergey S. , POTATYEVA Yulia A. , REZYAPKINA Ksenia V.
Published: December 2020

The developed method for assessing fi re resistance relates to the fi eld of fi re safety of buildings and structures and can be used to classify a reinforced concrete column of circular cross-section according to fi re resistance indicators. The essence of the proposed solution is to assess the design limit of fi re resistance of a reinforced concrete column of circular cross-section for the loss of bearing capacity under fi re conditions according to a set of single quality indicators without direct testing. The description of the process of resistance of a reinforced concrete column to fi re impact is presented by a mathematical relationship that takes into account the dimensions of the cross-section of the column, the degree of reinforcement, the intensity of force stresses, the normative strength of concrete to the resistance to axial compression and the rate of thermal diff usion of concrete. To determine the fi re resistance limit of a reinforced concrete column with a circular cross-section, an analytical expression that combines all the described indicators is proposed. The proposed method for determining fi re resistance refers to a thermal strength problem, which makes it possible to determine the fi re resistance of a reinforced concrete column of circular cross-section without full-scale fi re exposure, and reduces economic costs.
ARCHITECTURAL FEATURES OF THE MINSK FACTORY-KITCHEN
Authors: ISAKOV Aleksandr S.
Published: December 2020

Architectural and planning features of the kitchen factory in Minsk are considered, including urban planning, functional planning and space-spatial organization, compositional and stylistic characteristics. The problems of preserving architectural objects of the constructivism period of the 1930s, including the studied kitchen factory, are revealed. New historical facts and archival materials are presented, which expand the research base and can contribute to the development of a scientifi cally sound strategy for preserving the kitchen factory in Minsk in the process of its functioning in modern conditions.
Oryginalne podejście do badania bułgarskiego obrzędu weselnego
Authors: Sotirov Petar
Published: December 2020

Recenzja książki: Mleczko, Joanna. Tradycyjny bułgarski obrzęd weselny. Studium etnolingwistyczne. Katowice: Wydawnictwo Uniwersytetu Śląskiego, 2018.
El Espacio Público en Zonas de Conservación Patrimonial de Latinoamérica y El Caribe
Authors: Díaz Barbosa Jair , Mayorga Cárdenas Miguel Yuri , García Carrillo Águeda , Palmett Padilla Aída Del Carmen
Published: December 2020

El estudio presenta un análisis de la evolución de las dinámicas sociales reflejadas en el espacio público correspondiente a las zonas de conservación patrimonial de Latinoamérica y El Caribe. Inicialmente se describe las actividades necesarias y complementarias que se desarrollan en el espacio público y su funcionalidad, realizando una investigación descriptiva con fuentes secundarias de información, identificando todas las zonas de conservación patrimonial de Latinoamérica y el Caribe, eligiendo cuatro centros históricos por su configuración urbana, por su comportamiento a través de la historia, por su similitud temporal después de la colonia en América y por representar un área de extensión entre 200 y 650 hectáreas, analizando los diferentes planes de desarrollo de estas zonas, se identifica que las metodologías adoptadas corresponden a las tradicionales como lo son la Metodología del Marco Lógico. Logrando como resultado un escaso material de apoyo para los profesionales que generan ciudad, siendo necesario la implementación y utilización de las tecnologías emergentes, para desarrollar una trazabilidad a todos y cada uno de los elementos que componen el espacio público y así tener a disposición la información adecuada y en tiempo real para la toma de decisiones, logrando una verdadera sostenibilidad.
The Role of the Integrated Stress Response and the Actin Cytoskeleton During Wound Healing
Authors: Aukerman Erica , Barriera Diaz Miguel , Spandau Dan
Published: December 2020

Background and Hypothesis: 
Chronic cutaneous wounds are a serious health concern afflicting millions of people. One of the primary factors preventing the closure of chronic wounds is the inability of keratinocytes to migrate across the wound bed. Epidermal keratinocytes migrate in a cohesive manner known as the keratinocyte collective cell migration (KCCM). Our lab has demonstrated that the integrated stress response (ISR) plays a key role in the KCCM. The ISR is initiated by stress-sensitive kinases, such as GCN2, and results in decreased global protein synthesis while preferentially increasing the translation of mRNAs encoding cytoprotective proteins. Wound repair also relies on the actin cytoskeleton, but the crosstalk between actin and the ISR is not well established. We hypothesize that the interaction between the ISR and the actin cytoskeleton is critical for KCCM during wound healing.  
 
Methods: 
Cutaneous wound healing was approximated in vitro using the KCCM-dependent scratch assay. Wild-type (WT) and GCN2-deleted (KO) keratinocytes were grown on coverslips, differentiated, scratched, and harvested at different times post-wounding. F-actin and vimentin (VIM) expression was monitored over time using fluorescent phalloidin-488 and immunofluorescence. In addition, WT keratinocytes were treated with actin-depolymerizing drugs and induction of ISR was measured using immunoblots.  
 
Results: 
Depolymerization of F-actin was observed along the leading edge of both wounded WT and GCN2-KO keratinocytes immediately following wounding. WT keratinocytes upregulated VIM expression at the leading edge whereas VIM expression remained unchanged in the wounded GCN2-KO keratinocytes. Treatment with latrunculin B and cytochalasin D, which both result in actin depolymerization, induced GCN2 phosphorylation in the differentiated WT keratinocytes. 
 
Conclusion and Potential Impact: 
F-actin depolymerization elicits a GCN2-mediated induction of the ISR. GCN2 and the ISR are critical components of the cutaneous wound repair process and their crosstalk with the actin cytoskeleton may serve as a novel therapeutic target in the treatment of chronic wounds.
Physical Activity Can Enhance Treatment for Substance Use Disorder: A Systematic Review
Authors: Blake Ethan , Sawyer Antonia , Savaiano Dennis
Published: December 2020

Background/Objective: Substance use disorder is a significant yet treatable mental health disorder affecting approximately 20.3 million Americans in 2018. Its continued prevalence indicates the need for additional approaches to complement existing therapies. Physical activity is one potential nontraditional therapy that has been utilized. A qualitative systematic review was conducted to investigate the effects physical activity as a therapy adjunct for non-alcohol and non-tobacco substance use disorder treatment, evaluating effects on substance use and craving levels.  
Methods: Using PRISMA guidelines, English language papers in CINAHL, PubMed, Embase, and APA PsycArticles were searched with no date restrictions. In total, 387 abstracts were screened, of which 342 were excluded because they investigated irrelevant outcomes, analyzed solely alcohol or tobacco use disorder, were not primary research, or were duplicates. The remaining 45 citations were reviewed independently by two authors, and 17 were included in the final review. The included studies were graded using a quality criteria checklist based on the quality constructs and domains for research studies reported by the Agency for Healthcare Research and Quality. 
Results: Of the 17 included studies, 9 reported favorable outcomes of physical activity on reducing substance use. Four of these articles were of positive quality, and 5 were of neutral quality. Additionally, 4 studies reported favorable outcomes of physical activity on reducing craving levels. All 4 of these studies were of neutral quality. No studies reported unfavorable outcomes. 
Conclusion: The findings indicate that exercise may help to reduce substance use and cravings in those undergoing treatment for substance use disorder, but research on which forms of exercise improve treatment for specific substances is needed. 
Impact and Implications: This study helps to clarify that further research is needed to optimize the effects of exercise as an adjunct treatment for substance use disorder.
Fenestrated Endovascular Aneurysm Repair (FEVAR) for Juxtarenal Abdominal Aortic Aneurysms (AAAs): A Community Based Experience
Authors: Bojrab Paul , Gray Douglas , Recht Kim
Published: December 2020

Background and Hypothesis: 
Rupture of abdominal aortic aneurysms (AAAs) comprise an estimated 4-5% of all sudden deaths. Half of all patients with ruptured AAAs never make it to the hospital. Of those who make it and receive emergent surgery, the mortality rate is still near 50%. Improved screening protocols and diagnostics tools have enhanced detection, monitoring, and if needed, repair of AAAs before rupture. Due to anatomical constraints, juxtarenal AAAs cannot be repaired using standard endovascular endograft repair (EVAR). A newer fenestrated EVAR (FEVAR) must be performed; however, it carries a higher risk for complications. This study will assess the complication rates and outcomes following FEVAR for juxtarenal AAAs at Parkview Heart Institute (PHI). We hypothesize that incidence of renal artery occlusion, limb occlusion, and endoleak will be consistent with those published in the literature and that the occurrence of these adverse effects has a significant effect on patient outcomes. 
Methods: 
The study is a retrospective review of the electronic medical records (EPIC) of PHI patients who underwent FEVAR for juxtarenal AAAs. Ruptured aneurysms and minors will be excluded. REDCap will be used for study data management. Patient demographics, medical history, hospital course, complication data, and follow-up visits will be analyzed. Analysis may include χ² test, Fisher exact test, Kaplan-Meier estimator, and two sample t-tests or the Mann–Whitney U tests. 
Results: 
This project resulted in a protocol and REDCap data collection tool for IRB submission. The researchers are seeking Parkview Health IRB approval in Fall 2020, with an anticipated study start date of Spring 2021. 
Potential Impact: 
This project will add to the current research on reintervention, complication, and morality rates for FEVAR for juxtarenal AAAs. Directions for future research include refining indications for FEVAR and evaluation of long-term outcomes compared to open repair.
Early Allograft Dysfunction to Assess the Liver Function Following Liver Transplantation
Authors: Bolujo Ifeoluwa , Aref Mohammad , Kubal Chandrashekhar , Mangus Richard , Ekser Burcin
Published: December 2020

Background: Early allograft disfunction (EAD) can be used as a tool to asses function of the liver after transplantation. Currently, most accepted EAD definition can be defined using a number of criteria including but not limited to total bilirubin > 10 mg/dL on post-operative day 7, INR > 1.6 on post-operative day 7, and ALT or AST > 2000 IU/L within the first post-operative 7 days. EAD is associated with mortality and morbidity after liver transplantation which leads to decreased recipient survival rates. It is considered a precursor step in the pathway to eventual graft loss. 
 
Methods: We have performed a literature review to understand what risk factors increase, including donor and recipient demographics as well as recipients’ MELD (Model for End Stage Liver Disease) scores, which predicts patients’ disease severity. We also compared the incidence of EAD between our center and the literature.  
 
Results: We found that incidence of EAD was between 23-40% (Table 2). It is higher when livers from donation after circulatory death (DCD) donors were used, as expected.   

Reference (year) 

Number of patients 

Incidence of EAD  

Ekser et al (2019) 

n = 2008 

29% 

Olthoff et al (2010) 

n = 300 

23% 

Wadei et al (2015) 

n = 1325 

27% 

Lee et al (2014) 

n = 205  

39.5% (DCD donors) 

 
 
Risk factors that can result in an increase occurrence of EAD were; (i) donor age, (ii) liver stenosis, (iii) expanding criteria for donor livers, (iv) prolonged warm ischemia time (WIT) and (v) cold ischemia time (CIT). Histologically, hepatocellular damage that is shown as coagulative necrosis can be seen immediately after reperfusion.  
 
Conclusions: During our literature review, potential strategies have been discovered to help prevent EAD including pharmacological treatment using glucose, antioxidants, anti-inflammatories, and apoptotic drugs. Although none of them significantly prevented the occurrence of EAD, it was clear that there are many tools that can be used to attempt to prevent EAD in order to offer a better outcome in patients undergoing liver transplantation.
Assessing follow-up care compliance in children hospitalized for traumatic brain injuries
Authors: Bozell Hannah , Vetor Ashley , Raymond Jodi , Hochstetler Alexandra , Bell Teresa
Published: December 2020

Background and Hypothesis: There is limited information regarding healthcare utilization and outcomes in children hospitalized for traumatic brain injury (TBI). Nearly 50% of adults hospitalized for trauma do not attend follow-up appointments, although completion of post-discharge care is associated with improved outcomes and decreased likelihood of subsequent emergency department (ED) visits. The Regestrief Institute Indiana Network for Patient Care (INPC) is a regional health information exchange (HIE) with health record data. This includes inpatient, outpatient, and ED visits, as well as imaging and lab data. The objective of this study is to use HIE data to assess long-term healthcare utilization, complications, and sequelae of pediatric patients hospitalized for TBI to see if follow-up compliance can identify patients at risk for post-TBI complications, including unplanned care, as well as long-term secondary health conditions. 
 
Methods: 387 patients treated at a pediatric level 1 trauma center in Indiana admitted for TBI were identified using trauma registry data. EHR data in the INPC on patients for two years post-discharged were analyzed. Associations between compliance with follow-up care instructions given at discharge/subsequent medical visits and longitudinal utilization/outcomes were examined using Fisher’s exact test.  
 
Results: After reviewing patient records, we found that 60.7% of patients received all follow-up care and 8.5% of patients received partial follow-up care, leaving 25.1% of patients receiving no follow up care and 5.7% of patients lost to follow-up after discharge. 12% of patients went to the ER for an injury-related issue and 6.2% of patients were readmitted. 19.4% of individuals experienced complications from injury while 12.4% of individuals had suspected sequela. Factors influencing recovery included race, age, insurance, injury severity, ICU admission, and ventilator usage. 
 
Implications and Importance: Using HIE data can identify factors of hospitalized children vulnerable to not achieving optimal recovery and determine what care is critical to improving long-term health and quality of life outcomes.
Geriatric Intensive Care Unit Admission Protocol
Authors: Byvoets Tom , Brewer Brian
Published: December 2020

Background and Hypothesis:  
The Society of Critical Care Medicine has recommended protocolized admission and discharge criteria for the ICU, but there is little supporting evidence for these guidelines. Our goal is to find predictors supported by data that can consistently triage patients appropriately on admission and decrease the need to upgrade the level of care during the same hospital stay. We hypothesized that applying a protocol would reduce the number of unplanned ICU admissions in our institution. 
 
Methods:  
We retrospectively applied our protocol to patients sixty-five years or older from the trauma registry at Methodist Hospital admitted between January 1 and December 31, 2019. Patients who did not have an unplanned ICU admission during hospital stay were used as the control group, while those who had an unplanned ICU admission event were considered the experimental group. After this, we used crosstabulation and Fisher’s exact test to analyze the data. 
 
Results:  
We reviewed one thousand one hundred forty-six (1146) subjects with 1088 in the control group and 58 in the experimental group. Subjects in the experimental group were statistically more likely to have COPD (OR: 2.646, p=0.001), been transfused > two units of PRBC in the first 24 hours (OR: 5.303, p=0.000), or to have greater than two rib fractures (OR: 2.469, p=0.002).  
 
Conclusion and Potential Impact:  
This study demonstrates that applying this protocol can capture elderly patients who will likely require ICU level care during their hospitalization. COPD, > two rib fractures, and transfusion of > two units PRBC during the first 24 hours appear to be significant predictors of clinical deterioration. Unplanned ICU admissions are associated with increased hospital and ICU length of stay. We must develop evidence-based protocols to decrease morbidity and cost associated with unplanned ICU admissions.
Creating a Simulated Dataset for Training Deep Convolutional Neural Networks for Use in Cardiovascular Photoacoustic Tomography
Authors: Chan Hayley , Goergen Craig , Leyba Katherine
Published: December 2020

Background/Objective: Photoacoustic tomography possesses increasing potential as a non-invasive imaging method that combines optical and acoustic imaging to maximize the visualization of tissue. Determining the composition, orientation, and location of anatomical structures in multidimensional space requires maximizing image resolution and differentiation from noise and reflection artifacts. Using simulations to develop and improve methods for image resolution allows for flexibility and variation of numerous variables. 
 
Methods: Binary masks were created from mouse common carotid ultrasound images using a graphical user interface for MATLAB. With the k-Wave toolbox, we performed time-reversal photoacoustic simulations using the masks. Medium properties for the simulations were assigned for sound speed and density for connective tissue (1540 m/s, 1027 kg/m3) and arterial walls (1569 m/s, 1102 kg/m3). The dataset was augmented through rotational and mirrored transformations and the addition of noise and reflection artifacts via Python open-source software. 
 
Results: A set of 87 binary masks was generated from common carotid ultrasound images. These masks were used to simulate initial pressure distributions through the k-Wave toolbox to reconstruct the structure of the common carotid. Each simulation yielded graphs for initial pressure and sensor distribution, simulated sensor data, reconstructed initial pressure, and a comparison profile between the original and reconstructed pressure. Data augmentation was implemented using the reconstructed pressure output from the 87 simulations, each producing 12 distinct images from rotations and mirroring with the addition of noise and reflection artifacts. The final dataset yielded 1044 images. 
 
Conclusion and Potential Impact: Future work will involve applying this dataset to a neural network to improve photoacoustic quality such that transfer learning can be applied on ex vivo and in vivo datasets. Thus, there is potential for use in diagnostic applications in patients with cardiovascular disease states like atherosclerosis and aneurysms that require high resolution visualization of tissue structure and composition.
Plastic Surgery Innovation Through War, Disaster and Pandemic
Authors: Clodfelter Kayla , Mailey Brian , Hassanein Aladdin
Published: December 2020

Introduction and Objectives: Mass casualties from modern warfare in World War I and advancements in medicine resulted in survivors with deformities. The field of Plastic Surgery developed from a need to reconstruct soft tissue injuries in these soldiers. Wars and disasters provide unique situations which push the development of new techniques that impact the field. The objective of this work was to identify innovations in plastic surgery that emerged from disasters. 
 
Project Methods: The PubMed and Ovid databases were searched for articles documenting origination of plastic surgery ideas during a disaster with the terms “disaster”, “war”, “plastic”, “burn”, “terror”, and/or “novel”. Types of disasters considered include: war, terrorism, accident and natural disaster. Articles were included if they discussed novel therapies published emerging from a disaster. 
 
Results: Twenty-one articles meeting inclusion criteria. Eleven papers described innovations during war including use of k-wires in hand fractures, gender affirmation surgery, delayed wound closure, cleft lip repair, vascular repair of acute trauma, sulfamylon antibiotics, and portable vacuum-assisted-closure (VAC) devices. Two articles resulted in surgical staff collaboration modeling and rapid recruitment from terrorist attacks. Five manuscripts defined accidents that brought about ideas of cultured epithelial autografts, VAC for burns, and targeted muscle reinnervation to decrease chronic pain in amputees. Natural disasters that caused change were depicted in three articles discussing adequate burn treatments for resource poor areas and using telemedicine for outpatient care and academic meetings. 
 
Conclusions and Potential Impact: The field of Plastic Surgery continues to advance from innovations developed during disasters. Our study found war resulted in the greatest novel advancements. Terrorism and natural disasters have emerged as sparking innovation during the last few decades. Physicians should be encouraged to look for opportunities of innovation using their ingenuity when faced with disaster. What progress will COVID-19 bring?
Reproducibility of Three-Dimensional Retinal Organoids as In Vitro Models of Human Retinal Development and Organization
Authors: Feder Elyse , Harkin Jade , Meyer Jason
Published: December 2020

Humans have limited ability to repair damaged central nervous system neurons, such as retinal ganglion cells, making it critical to advance towards ways to reconstruct a patient’s retina if one suffers from trauma or a neurodegenerative disease of the eye, such as glaucoma and other blinding disorders. The use of human pluripotent stem cells (hPSCs) provides powerful approaches to the development of novel therapeutic strategies to blinding diseases due to their ability to self-renew and form any cell type in the human body through targeted differentiation. Recently, hPSCs have been shown to self-form retinal organoids, which are three-dimensional aggregates of cells that mimic the spatial and temporal organization of the human retina in vitro. Therefore, retinal organoids provide an in vitro model of the human retina for drug screening, disease modeling, and cell replacement therapies.  
However, before these approaches can be fully realized, a critical need exists to refine these differentiation methods as current protocols lead to heterogeneity of organoids produced, as well as inconsistency in their shape and size, leading to significant variability within experiments. Thus, the goal of this research is to optimize current retinal organoid differentiation protocols to generate highly reproducible retinal organoids that are consistent in size, shape and cellular composition across various stem cell lines that can be used for disease modeling and high-throughput applications. The size and shape of retinal organoids was experimentally controlled for through the use of low-adhesion 96 well U-bottom plates with centrifugation to induce quick reaggregation of individual undifferentiated hPSCs. These aggregates were compared to those generated through traditional methods in which whole colonies were mechanically lifted. Resulting retinal organoids at early and later stages showed greater reproducibility in size and shape across different stem cell lines, demonstrating greater suitability for direct comparisons in disease modeling and drug screening experiments.
Role of PAR1 in Food Allergies
Authors: Garcia Jennifer , Buelow Lauren , Cook-Mills Joan
Published: December 2020

Background and Hypothesis: 
The prevalence of food allergies continues to rise. In a mouse model, food allergy to peanuts develops in flaky tail mice with skin barrier mutations and exposure to peanut (PNE) and Alternaria Alternata (fungal allergen, Alt) on the skin. In the skin, keratinocytes respond to proteases in allergens through protease activating receptor 1 (PAR1). Blocking PAR1 decreased the severity of viral induced inflammation in mice. Whether PAR1 has a major role in food allergies has not been investigated. We tested the hypothesis that blocking PAR1 would halt the development of food allergy to peanuts in neonatal mice. 
 
Project Methods: 
In our studies, pups were injected intradermally (i.d.) with a PAR1 antagonist and then treated with PNE/Alt. In another group, pups received i.d. injections of a PAR1 agonist and then treated with PNE only. Control groups received allergens only. Pups were treated and skin sensitized 5 times every 3-4 days. Forty-eight hours after the last treatment, pups were challenged with PNE through oral gavage, and temperatures were recorded every 15-30 minutes for 3 hours. Skin, ileum, and jejunum samples were collected and used for qPCR to determine the expression of inflammatory mediators. Plasma serum was used for analysis of anti-PNE specific antibodies by ELISA.  
  
Results:  
PAR1 antagonist blocked anaphylaxis in allergic mice sensitized with PNE and Alt. PAR1 agonist is sufficient to induce anaphylaxis in mice sensitized with PNE only.  
 
Conclusion and Potential Impact: 
This study demonstrates that PAR1 is involved in the development of food allergies, where blocking the receptor blocked food allergies in neonatal mice. The signaling mechanisms and activators of PAR1 need further studies, using PAR1 deficient mice. This novel pathway may lead to therapies to stop the development of food allergies.