bluuebunny/crossref_metadata_2025 huggingface dataset:
The Role of Alcohol in Hippocampal Calcium Channel (Cav1.2) expression
Authors: Kokoska Ryan , Rodriguez Eric , Yamamoto Bryan
Published: December 2020

Background and Hypothesis:  
Voltage-gated L-type calcium channels (Cav1.2 and Cav1.3) in the hippocampus play important roles in glutamatergic neurotransmission underlying memory and learning. Their overexpression has been implicated in neuroexcitatory cell death and disease states including chronic alcoholism. While increases in Cav1.2 gene expression have been reported in the hippocampus after chronic ethanol exposure in rats, the regional distribution of Cav1.2 protein after voluntary ethanol (EtOH) drinking has not been reported. We hypothesize that the expression of Cav1.2 channels within the hippocampus is increased by EtOH drinking in a region-specific manner. 
 
Methods: 
Male Sprague Dawley rats were allowed 28 days of intermittent access to a 10% EtOH solution.  At 24 hours after the last exposure to EtOH, brains were collected and processed for immunohistochemistry. Cav1.2 associated immunofluorescent signal from subregions of the hippocampus was quantified using ImageJ analysis software.  
 
Results: 
Immunohistochemical results indicate that Cav1.2 immunoreactivity in the hippocampal stratum granulosum layer within the Dentate Gyrus and the stratum pyramidale layer within CA1 and CA3 regions was increased in response to EtOH treatment. There was no significant change in Cav1.2 immunoreactivity for the CA2 region.  
 
Conclusion:  
This study suggests that calcium signaling in subregions of the hippocampus is differentially affected by EtOH consumption that may contribute to eventual calcium-mediated apoptosis. 
 
Impact and Implications: 
Understanding the process of EtOH-induced hippocampal calcium signaling presents opportunities for understanding the consequences of chronic alcohol exposure related to hippocampal function including memory and learning, and possible interventional therapies for alcohol damage.
The Impact of Covid-19 on Inmate Trust in Health Care and Willingness to Seek Treatment - A Qualitative Investigation
Authors: Kumalo Valarie , Nelson Alexander , Messmore Niki
Published: December 2020

Background and Objective: 
The coronavirus has disproportionately impacted vulnerable members of society. With the U.S. as the global leader in incarceration and the difficulties prison systems face implementing many of the mitigation strategies employed by the general population, the incarcerated population is in a uniquely vulnerable position particularly within an already strained prison healthcare system. Given the nature of prisons as total institutions, negative experiences with the virus coupled with a lack of autonomy could lead to a loss of trust in the healthcare system which has the potential to impact health-seeking behaviors. In this study, we aim to examine the effect of Covid-19 on Indiana inmates’ trust in healthcare.  
 
Project Methods: 
Data from 380 surveys distributed across Indiana’s prison system will be collected and analyzed. These results will be used to develop an interview protocol to conduct at least 25 in-depth interviews which will then be coded using NVivo to identify any emerging themes regarding their experiences with Covid-19. Prior to this, in-depth literature reviews were done on health care in prison populations and trust in healthcare. 
 
Results: 
The surveys and interview protocol will be developed in the ensuing months and thus no data has yet been collected. The literature review revealed that the quality and accessibility of care in prisons is lacking, an issue exacerbated by the pandemic. Because of the disproportionate number of preexisting issues, inmates worried about the ability of prison administrators to properly protect inmates from contracting the virus. Additionally, it was found that trust likely does have an effect on health, and that many commonalities of inmates are poor predictors for trust. 
 
Potential Impact: 
This study aims to identify potential loss of trust in healthcare systems to inform community reentry programs in developing strategies that prioritize inmate health needs and perceptions.
Effect of Prior History of Dementia and a Diagnosis of COVID-19 on Delirium in the ICU
Authors: Kupty Amira , Chang Fen-Lei
Published: December 2020

Background: Delirium occurred in nearly two out of every three patients in the ICU from prior studies. It is associated with poor health outcomes, including long-term cognitive and motor decline, increased risk of dementia, and increased mortality. In the context of COVID-19, patients are more likely to develop delirium due to the severity of the illness involving multiple organ systems. Our study evaluates factors contributing to the occurrence of delirium in the ICU for patients with or without a history of dementia and with or without a recent diagnosis of COVID-19. 
Methods: We performed a retrospective chart review of ICU patients in Fort Wayne, IN from January through the end of June of 2020. Patients were grouped by whether they developed delirium or not and whether they had pre-existing dementia. We recorded age, sex, race, BMI, level of education, high risk medications, comorbidities, enteric/NPO feeding, mechanical ventilation, mobility, and lab results including CBC and BMP at the onset of delirium. Additionally, we included severity of delirium, length of stay, functional status at time of discharge, and COVID-19 status.  
Results: We were unable to collect data at the time. However, we hypothesized that the incidence and severity of ICU delirium is associated with the severity of dementia and COVID status, among other factors. 
Potential Impact: This study can shed light on the contribution of dementia history to ICU delirium and potential factors contributing to delirium incidence and severity. The COVID pandemic offers opportunities to differentiate effects of neurological (dementia) versus non-neurological factors (respiratory, renal, cardiovascular, and metabolic) on ICU delirium.
Evidence-based lead mitigation strategies: Are the DIY lead mitigation recommendations by health departments supported by research?
Authors: Losiewicz Seth , Beidinger-Burnett Heidi , Knaub Christopher
Published: December 2020

Background: Legislation outlawing leaded paint in 1978 and tetraethyl lead from gasoline in 1992 effectively decreased blood lead levels (BLLs), but the effects of lead are still felt in the United States to this day. There is no safe level of lead in the body, and even low level lead exposure can lead to cognitive and developmental delays such as learning delay and disabilities; low IQ; and attention-deficit/hyperactivity disorder. The CDC has determined that a BLL of 5 μg/dL or higher is cause for environmental and educational intervention. Today, the EPA estimates that there are approximately 24 million housing units containing significant lead hazards, with 4 million being home to children. Many of the families that are faced with lead hazards in their homes are minorities and low socioeconomic status. To assist families with possible lead hazards in the home, interim controls of lead hazards may be paramount to reducing lead levels in the household in a simple, cost effective manner.
Methods: To that end, our research had two aims (a) conduct a systematic literature review to learn about do-it-yourself (DIY) interim controls that are evidence-based and effective in reducing lead hazards in the home and (b) conduct interviews with key personnel at each state health department to learn more about their lead prevention programs and the DIY mitigation strategies recommended to families.
Results: Our provisional findings suggest there is an inconsistent, wide range of mitigation strategies recommended by the state health departments that often lack empirical evidence. . While our literature review identified effective interim controls, the literature is outdated.
Conclusion and Potential Impact: We recommend more studies are needed to identify cost effective interim controls and the standardization of health department DIY interim controls across the nation.
Correlating mRUST scoring with fracture healing in the mouse model
Authors: McGuire Anthony , Knox Adam , Staut Caio de Andrade , Kacena Melissa , Natoli Roman , Collier Christopher
Published: December 2020

Background/Objective: Long bone fractures are an expensive and frequent cause of disability in humans. Research seeking to accelerate and improve the healing process is more essential than ever. Animal models, mice especially, provide an inexpensive and reproducible model of in vivo fracture healing. However, many measures of murine fracture healing outcomes are either expensive or destructive, limiting their ability to be translated to clinical studies. We seek to determine how these measures such as biomechanics, µCT, and histology correlate to the relatively new, inexpensive, and non-destructive method of mRUST scoring in a mouse model. 
Methods: One hundred and thirty-five, 12-week old male C57BL6/J mice were divided into nine groups of 15 mice. Mice underwent a surgically created, femoral fracture. At biweekly timepoints, anteroposterior and lateral radiographs were taken, and 15 mice were sacrificed at each time point (7, 10, 14, 17, 21, 24, 28, 35, and 42 days post-surgery) for biomechanical, µCT, and histological analyses. The modified Radiographic Union Scale for Tibial fractures (mRUST scoring) provides a score based on the visualization of a callus and fracture line in four cortices on the radiographs. Data analysis will be performed to determine the degree of correlation between mRUST scoring and other fracture healing outcomes. 
Results/Conclusion: Data collection in this experiment is still forthcoming. Upon successful completion of this project, we will have established numerical correlations between mRUST scoring and other fracture healing outcomes, such as biomechanics, µCT microarchitecture, and histology. These correlations will provide a powerful tool in future mouse fracture healing studies, as data on the state and strength of fracture repair could be determined by simple radiograph. 
Scientific/Clinical Policy Impact and Implications: This study will both provide future murine fracture studies with an inexpensive and non-destructive method of assessment that is more directly translatable to human fracture studies.
Serum Endothelin-1 Levels in Pediatric Patients after Cardiac Transplantation
Authors: O'Connor Stephen , Johansen Michael , Parent John
Published: December 2020

Background and Hypothesis: 
Worldwide, approximately 650 pediatric heart transplants occur annually. Coronary artery vasculopathy (CAV) is the foremost cause of allograft failure following heart transplantation, accounting for more than 25% of deaths within one-year post transplant. Within 10 years, 30-45% of children will be diagnosed with CAV, yet the mechanism of disease is still misunderstood. Endothelin-1 (ET-1) has been shown to play an important role in development and promotion of CAV, however no studies have evaluated ET-1 levels in the pediatric population following heart transplant. 
 
Methods:  
All patients enrolled in the study have underwent cardiac transplant and present for annual cardiac catheterization and blood draw, with data being stored in a REDCAP database. Centrifuged plasma will be analyzed for ET-1 levels and compared to accepted standard pediatric values. Relationships between ET-1 levels and other lab values will be evaluated for correlation. 
 
Results:  
Currently awaiting plasma results. 
 
Conclusion and Potential Impact:  
This study will establish ET-1 levels in pediatric patients post cardiac transplantation. If ET-1 levels are correlated with CAV severity and are increased, ET-1 levels have the potential to be an inexpensive and easily available biomarker for continuing to monitor CAV progression. Using currently available ET-1 therapies such as ERAs has the potential to lower morbidity and mortality rates by delaying or reducing re-transplantation in patients with CAV.
Food Prescriptions for Management of Prediabetes and Type 2 Diabetes among Food Insecure Youth: A Pilot Protocol
Authors: Oswald Jonathan , Yazel Lisa , Hannon Tamara
Published: December 2020

Introduction: Food access and food insecurity represent significant barriers to healthy eating in low-income communities. Food prescription programs have attempted to address these barriers by providing subsidized access to fresh produce through a physician-community collaboration. However, little is known about the health outcomes associated with food prescriptions, especially among youth with diabetes. To address this, we report data from the past two years of the Veggie Box program, a free produce distribution program of Indy Urban Acres. Additionally, we propose a feasibility study to 1) establish a food prescription program for food insecure youth with prediabetes and type 2 diabetes through the Veggie Box program and 2) assess health outcomes of youth who receive a prescription for Veggie Box.  
Methods: Through 2018 and 2019, the Veggie Box has been distributed weekly to a low-income community on the eastside of Indianapolis. Participant outcomes have been measured through survey assessment of food and beverage consumption, food insecurity, quality of life indicators, and program satisfaction. The proposed study aims to recruit 70 food insecure families with children aged 10-16 who have prediabetes or type 2 diabetes. Participants will receive a Veggie Box once every two weeks for a total of 12 weeks and will be provided access to a dietitian, health coach, and monthly group diabetes prevention sessions. Participant outcomes will be assessed at baseline and 12 weeks using the same surveys from the past two years with the addition of BMI and HbA1c measurements. 
Results: The past two years of Veggie Box distribution led to a statistically significant increase in fruit (p=0.009) and vegetable (p=0.001) consumption among Veggie Box recipients. There was not a significant change in reported food security. 
Discussion/Conclusion: Early results from the Veggie Box program showed that it increased fruit and vegetable consumption, indicating its potential use as a food prescription for food insecure youth with prediabetes and type 2 diabetes. This study will begin to fill the gap in knowledge related to health outcomes of food insecure youth with diabetes who are provided a food prescription.
Return to Driving After Hip and Knee Arthroscopic Procedures: A systematic review and meta-analysis
Authors: Palma Samantha , Patel Purva , Palan Jeya , Pandit HG , Van Duren BH
Published: December 2020

Background: Hip and knee arthroscopies are common orthopaedic procedures. As patients are looking to return to their regular schedules and regain their independence post-surgery, physicians often encounter the question of, “when can I drive again?” While safety of the patient is of the utmost importance when making these recommendations, it is equally important to consider the possibility of harm to others and potential legal ramifications. The purpose of this study is to consolidate evidence from available literature and undertake a systematic review and meta-analysis to determine when it is safe for patients to return to driving after hip and knee arthroscopic procedures. 
Methods:  A systematic review was conducted using PRISMA guidelines. OVID, EMBASE, and COCHRANE databases were searched through June 2020 for articles containing keywords and/or MeSH terms “Hip arthroscopy” and “knee arthroscopy” in conjunction with “total brake response time” or “reaction time” in the context of automobile driving. Title review and full article review were done to assess quality and select relevant articles. Review Manager Version 5.4 was utilized for statistical analysis.  
Results: 8 papers were included in the meta-analysis of Brake Reaction Time (BRT). Meta-analysis of all Knee BRTs showed times slower-than or equal-to-baseline BRTs through 5 weeks, with a trend of improving BRT from 6 to 10 weeks (only weeks 8 and 10 were significant P < 0.05). Of all Hip BRTs, week 2 showed slower-than-baseline BRTs, but after week 4 demonstrated a trend toward faster BRTs through week 8 (only week 8 was significant P < 0.05).  
Conclusion: BRTs met baseline/control values and continued to improve after 6 weeks following knee arthroscopy and after 4 weeks following hip arthroscopy. Based on these results it would be safe to recommend return to driving at 6 weeks after knee arthroscopy and 4 weeks after hip arthroscopic procedures.
Propofol-induced damage to the blood-brain barrier endothelium evinces a vascular endothelial growth factor (VEGF) -dependent mechanism.
Authors: Parsons Dustin , Hughes Jason , Canfield Scott
Published: December 2020

Background and Hypothesis: 
Propofol is an anesthetic commonly used to induce general anesthesia for a myriad of medical procedures. However, a growing corpus of evidence suggests that propofol-induced increases in VEGF may contribute to blood-brain barrier (BBB) leakiness in varying animal models. The BBB is a neurovascular structure which protects the central nervous system from pathogens, toxins, and other deleterious metabolites; therefore, considerations regarding BBB integrity in humans are indispensable to the practice of anesthesia. We hypothesize that propofol-induced BBB dysfunction in human models is partially mediated by an increase in VEGF expression. 
 
Methods: 
We utilized human induced pluripotent stem cells (hiPSC) to derive brain microvascular endothelial cells (BMECs)—the barrier forming cell type of the BBB. BMECs were then subjected to clinically relevant doses of propofol for 3 hours, and barrier integrity was monitored via transendothelial electrical resistance (TEER) and para-cellular permeability for up to 72 hours. Propofol-induced VEGF levels were determined with an ELISA assay. Axitinib, a VEGF receptor blocker, was further utilized to assess the role of VEGF in propofol-induced BBB breakdown. 
 
Results: 
Prior works, including this study, have shown that propofol induces BBB damage, as demonstrated by decreases in TEER; here, preliminary work with ELISA assays further suggest that BMECs treated with propofol demonstrate an upregulation of VEGF. Pretreatment of BMECs with Axitinib before the addition of propofol partially rescues TEER and thus attenuates the propofol-mediated diminution of TEER. These observations thereby implicate VEGF as a damage mediator after propofol treatment. 
 
Conclusion and Potential Impact: 
This study utilized an in vitro model to demonstrate that propofol may mediate, in part, damage to blood- brain barrier endothelium via a VEGF dependent mechanism; thus, this work may guide future investigations to facilitate the development of safer anesthetic alternatives, or towards additional pharmacologic interventions that counteract propofol-mediated damage during anesthetic induction.
Drivers and Barriers to the Use of Health Information Exchange Amongst Clinicians in the Emergency Department
Authors: Richter Ben , Dixon Brian
Published: December 2020

Background:  
Health Information Exchange (HIE) describes the exchange of medical data between various health care organizations. Though research is limited, widespread use of HIE may improve patient outcomes while improving efficiency and thus lowering health care costs for patients. The paucity of existing research necessitates further study into the effects of HIE use in the clinical setting. The Indiana Network for Patient Care (INPC) is one of the most comprehensive HIE networks in the country, and provides an ideal environment for conducting research regarding factors that influence HIE use.  
Methods: 
A group of 20 clinicians from the Emergency Department were chosen to answer a set of questions regarding their HIE use. This group included physicians, nurse practitioners, physician assistants, and registered nurses from various health care organizations across the state of Indiana. Interview questions were centered around four main themes: Performance Expectancy, Effort Expectancy, Social Influence, and Facilitating Conditions. Interviews were recorded and transcribed, then subject to qualitative analysis using NVivo software.  
Results: 
The Single Sign-On and EHR Button were the most commonly discussed features in terms of facilitating HIE use. Providers used HIE most often when the patient reported previous admission at a different hospital, or when the patient was incapacitated and could not provide information. Although clinicians had unanimous social support for using HIE, inadequate training regarding HIE was apparent, and served as the most common barrier to its use.  
Conclusion/Impact: 
The implementation of Single Sign-On and access to the INPC via a button integrated into the user’s EHR are critical for widespread use of HIE, while lack of physician training serves as a major barrier to its use. Implementing SSO and EHR button features while improving HIE training may spurn additional use of HIE and thus lower costs for both hospitals and patients.
Determining the prevalence and density of asymptomatic Plasmodium falciparum infections in low and high transmission settings in Western Kenya
Authors: Salgado Christina , Gaskin Erik , Macklin Michael , Onyango Eliud , Surridge Rachel , Nallandhighal Srinivas , Bhardwaj Jyoti , Datta Dibyadyuti , Turnbull Lindsey , O'Meara Wendy , Ayodo George , John Chandy , Tran Tuan
Published: December 2020

Background/Objective: Malaria remains a global health burden as 2018 saw 228 million cases worldwide. Pre-elimination efforts aim to decrease disease transmission, which depends on development of asexual parasites to sexual gametocytes within the human host. To better determine the relationship between asexual parasites and gametocytes, we aim to quantify both stages within the same blood sample by developing a multiplex RT-qPCR assay. We hypothesize that gametocytemia decreases linearly with asexual parasitemia at higher parasitemias but increases at lower parasitemia to improve transmission probability.  
 
Methods: We conducted a cross-sectional survey of healthy participants aged 0 to 92 years at four sites in Western Kenya (Ajigo, Webuye, Kipsamoite, Kapsisywa) with varying levels of transmission to determine prevalence of asymptomatic P. falciparum blood-stage infections. Parasite density was quantified by light microscopy and by quantitative PCR of genomic DNA isolated from dried blood spots using varATS primers. For varATS-positive samples, we isolated RNA from whole-blood and performed stage-specific quantification by multiplex Taqman RT-qPCR  targeting PfPIESP2 (asexual), Pfs25 (female), and Pfs230p (male).  
 
Results: Among all participants, 127 of 1355 (9.37%) were positive for asymptomatic P. falciparum infection by varATS-qPCR. Using varATS positivity as the standard, multiplex RT-qPCR  targeting PfPIESP2 yielded a sensitivity of 78%.  Across sites, overall parasite prevalence and gametocyte prevalence were highest in Ajigo (42.1%; 36%) followed by Webuye (10.5%; 9%) and Kipsamoite/Kapsisywa (0.873%; 0.1%). Pfs25-quantified gametocytemia decreased with decreasing varATS-quantified asexual parasitemia; however, the data poorly fit a linear model (R2 = 0.088).   
 
Conclusions: PfPIESP2 detected 78% of varATS-positive samples, suggesting it may be poorly sensitive at detecting low-density blood-stage infections. Assay design may improve with a more sensitive gene target and further optimization. Based on quantification results, the relationship between gametocytemia and asexual parasitemia appears direct but non-linear. Further work is necessary to better model the relationship between stage-specific parasitemia levels.
Using OCT Angiography as a Biomarker of Retinopathy Severity in Patients with Diabetes
Authors: Scheive Melanie , Reinhart Kathryn , Hajrasouliha Amir
Published: December 2020

Background and Hypothesis: Diabetic retinopathy (DR), the leading microvasculature and blindness-causing complication of diabetes mellitus, can be diagnosed and monitored using optical coherence tomography angiography (OCT-A) to visualize all retinal vasculature layers with greater resolution and limited invasiveness compared to the established technique of fluorescein angiography. We hypothesize that OCT-A can be used as a biomarker to correlate retinal vessel density (VD) from OCT-A with clinical severity of DR, visual acuity, and patient demographics as well as track anti-vascular endothelial growth factor (VEGF) treatment efficacy. 
Methods: This retrospective cohort study analyzed the automatically quantified VDs of the superficial vascular complex (SVC) and deep vascular complex (DVC), including the whole, foveal, and parafoveal VDs, on quality OCT-A scans in patients with diagnosed DR. A multivariate linear regression and ANOVA analysis was completed to compare VDs to DR severity, visual acuity, and demographic factors in patients with at least one quality OCT-A scan. A linear mixed analysis was performed to determine how VD was affected by whether anti-VEGF therapy was given to patients with OCT-A scans at two or more different timepoints.  
Results: There was found to be a positive correlation of the VDs in both the SVC whole and parafoveal VD and DVC parafoveal VD with decreased DR severity and increased visual acuity in the cross-sectional analysis (p ≤0.001). The DVC whole VD was also positively correlated with increased visual acuity (p<0.001). There was no difference in the VDs associated with anti-VEGF treatment over time. 
Conclusions and Potential Impact: OCT-A shows promise for the diagnosis and monitoring of DR as a biomarker for disease severity which correlates with visual acuity. Anti-VEGF did not show significant change in VD in DR patients. Longer follow-up periods may be needed to elaborate on the long-term effects of anti-VEGF.
Mixed method study focusing on cost effectiveness of utilizing Guideline Directed Medical Therapy using Secondary and Primary Data
Authors: Singh Lovekirat , Daley Carly , Wagner Shauna , Robertson Roy , Mirro Michael
Published: December 2020

Background and Hypothesis: 
In the United States, heart failure (HF) affects an increasing 5.8 million people, with healthcare costs estimated at $31 billion (2012). Guideline Directed Medical Therapy (GDMT) is the primary method to standardize medical care of patients diagnosed with Heart Failure reduced Ejection Fraction (HFrEF). GDMT lowers mortality rates, decreases readmission, and decreases the cost, but the success of GDMT is limited by adherence. We hypothesize increased GDMT prescription through integration of a pharmacist will decrease readmissions and hospital costs. 
 
Methods: 
This mixed-methods study involved a literature review and retrospective chart review. Online databases (PubMed, Embase, and Ovid) were searched using keywords related to GDMT and economic outcomes. The research was refined using empirical research and grey literature focusing on healthcare costs and readmission rates.  The chart review is part of a larger study examining the impact of integrating a pharmacist into a cardiology center on GDMT prescription. Inpatient and outpatient charges data was analyzed to determine if integration of a pharmacist led to decreased healthcare costs. This project was supported by Parkview Health and received funding from ACC Accreditation Foundation Board.  
 
Results: 
The study is currently ongoing. 70 articles and abstracts were reviewed, and 10 articles fit the criteria focusing on GDMT, healthcare cost, or readmissions. Articles supported a correlation between decreased readmission and overall healthcare cost with compliance to GDMT. Literature also supports the addition of an intervention leading to decreased readmissions. Preliminary charges data analysis showed a decrease in cost by 46% in inpatients and 35% in outpatients after pharmacist intervention.  
 
Conclusion: 
We conclude GDMT is associated with decreased healthcare costs due to decreased readmissions. Although there are multiple confounding variables when evaluating the primary data, data showed a  correlation between adding intervention (i.e. pharmacist) and decreasing readmissions and overall healthcare costs. Further studies need to be conducted to show causation.
Endogenous Maternal Lipids and Supplementation with Vitamin E Isoform Regulate Neonatal Dendritic Cells during Development of Allergic Disease
Authors: Tat Kiet , Cook-Mills Joan
Published: December 2020

Background and Hypothesis: CDllb+CDllc+ dendritic cells (DCs) play a role in the development of allergic disease. It has been shown that of the vitamin E isoforms, α-Tocopherol decreases and γ-Tocopherol increases the generation of bone marrow-derived CD11b+CD11c+ DCs in vivo. And, in vivo experiments have also shown that β-glucosylceramides, endogenous maternal lipids, increase the neonate proliferation of this same subset of DCs. The mechanism for β-glucosylceramide regulation of these specific DC subsets is not known. Furthermore, it is also not known how vitamin E isoforms regulate DC development and differentiation. We determined whether α-tocopherol decreases and γ-tocopherol increases responses to β-glucosylceramide by regulating Protein Kinase C (PKC) activation during CDllb+CDllc+ DC differentiation and proliferation.  
Project Methods: Cultured bone marrow cells (harvested from mice) were treated with lipid metabolites with and without supplementation of tocopherol isoforms, immunolabeled with antibodies that define DCs and with antibodies that detect active auto phosphorylated forms of PKC. Then, these cells were analyzed using flow cytometry. 
Results: In vitro β-glucosylceramide elevated DC PKCα/β activity during CDllb+CDllc+ DC differentiation and proliferation/activation. Furthermore, these effects of β-glucosylceramide on DC PKCα/β activity were blocked by α-Tocopherol and elevated by γ-Tocopherol.  
Potential Impact: These data provides a better understanding of how maternal β-glucosylceramide and dietary supplementation with vitamin E isoforms regulate DC proliferation and differentiation and ultimately development of allergic inflammation in offspring of allergic mothers.
Addressing Mental Health Needs of Health Care Workers through Peer Support Groups During the COVID-19 Crisis
Authors: Thornsberry Tanner , Nault Connors Jill , Welch Julie , Hayden Julie , Hartwell Jennifer , Ober Michael , Sotto Sylk , Draucker Claire , Wasmuth Sally , Boustani Malaz , Overley Ashley , Monahan Patrick , Kroenke Kurt
Published: December 2020

Background: 
The COVID-19 pandemic has placed a high psychological burden on frontline healthcare workers. Often quarantined away from their families and with little downtime to process their experiences, those on the frontlines of the pandemic are experiencing pronounced levels of distress and significantly elevated rates of burnout. Although many wellness and psychological resources are available to providers, there is low uptake and little is known about their effectiveness. In this study, we assess the impact of group-based peer support sessions on symptoms of acute distress, anxiety and depression, and provider burn out. 
 
Methods: 
An established peer support model is adapted for use with groups of frontline healthcare workers that will participate in 6 to 8 weekly group sessions using videoconferences. The study approach is a phased feasibility to research design. During the feasibility phase, we will initially test the intervention in 3 groups of 8 providers using a quasi-experimental, pre- post analysis of change. If preliminary results are positive, we will scale the intervention and progress to a more rigorous study design using a differences-in-differences approach to assess change over time between exposure and non-exposure groups. Outcomes will be measured at baseline, intervention completion, and 3- and 6- month follow ups. During the feasibility phase we will assess intervention fidelity and conduct qualitative analysis to assess the effects of the pandemic on work, family and social life.  
 
Results: 
This is a work in progress. At present we have recruited 28 emergency medicine physicians and residents with a target start date of August 1, 2020. 
 
Potential Impact: 
We anticipate the results of this study will provide evidence in support of a recent call for “the use of non-clinical mental health support, such as social or peer support” from the American College of Emergency Physicians in conjunction with 42 leading professional organizations in medicine. In addition, results may lead to advocacy for improved policies that mitigate against “fear of resultant loss of licensure, loss of income, or other career setbacks” for seeking mental health support.
Indiana Nonprofit Hospitals’ Community Health Needs Assessments Objectives and Evaluation
Authors: Walters Kevin , Savaiano Dennis
Published: December 2020

Background/Objective:  
Over half of the hospitals in the United States are not for profit and confer large tax advantages so long as they demonstrate community benefit. Since 2010 these hospitals have been required by law to conduct Community Health Needs Assessments (CHNAs) in order for community benefit to move from charity care to improved population health outcomes. For improved population health outcomes, we argue that effective community health programs must be put into place with high quality goals and evaluations to ensure effectiveness. We rated the objectives and evaluation plans of Indiana nonprofit hospitals’ CHNAs and then compared and correlated the quality of these plans with characteristics of the hospitals and health indicators of their community.  
  
Methods: 
CHNAs and Implementation Plans were obtained for 95 nonprofit hospitals in Indiana. The assessments and plans were independently scored by 2 assessors based on specific criteria for quality using a Likert scale which ranged from 0 to 5. We averaged the scores and then correlated and compared them to characteristics of the hospital, its local partnerships, and the health statistics of the communities in which they reside. 
 
Results: 
The average score for the objectives was 3.43 and for the evaluation 2.47 with large variations in the criteria met by each hospitals CHNA. Significant differences were found between the scores of system-based and independent hospitals for both evaluation and objectives (p=0.01, p<0.001).  
 
Conclusion and Potential Impact: 
Our data shows that the quality of CHNAs’ objectives and evaluation is universally poor and vary greatly from hospital to hospital. However, consistency and to a lesser degree quality of scores can be affected by system wide models. If the goal of these assessments is to create better population health outcomes through nonprofit hospitals, then the government needs to provide a high-quality model for hospitals to follow.
Decoding Mouse Behavior from neural activity in primary visual cortex
Authors: Williams Ari , Makin Maria
Published: December 2020

Background and Hypothesis: 
Brain-machine interfaces (BMIs) aim to restore motor control to patients. To develop effective BMIs, it is imperative that we build highly accurate models relating cortical neural activity with natural movements. Neurons in the visual cortex of the brain respond strongly to visual signals, but are also modulated by fluctuating internal states such as alertness, which closely correlates pupil size. We thus hypothesized that an animal’s pupil size can be decoded directly from the activity of a population of neurons in mouse primary visual cortex.  
 
Project Methods: 
We used an open-access dataset from the Allen Institute for Brain Science, which consisted of in-vivo 2 photon calcium imaging data of 128 neurons recorded from primary visual cortex of an awake mouse viewing a video screen. Video imaging was used to track the mouse’s pupil size.  
 
To relate neural activity with pupil size, we used linear regression, first smoothing the data with a Savitzky Gall filter. The model was fit on the first 80% of the data, and tested on the remaining 20%, using the computed coefficients to predict pupil size from neural activity. A Pearson correlation coefficient between the true and predicted data was computed. All analyses were performed in Python. 
 
Results: 
We found that there was a strong linear relationship between neural activity and pupil size, as the correlation coefficient between the true and predicted data was 0.376. Therefore, we have shown quantitatively that pupil size can be modeled based on neuronal activity within the visual cortex with a high level of accuracy. 
 
Conclusion and Potential Impact: 
This experiment demonstrates the feasibility of linear regression for modeling neuronal behavior in the visual system, particularly related to pupil size. Results suggest opportunities for further experimental analysis of the relationship between neural activity and other physiological markers, such as running speed.
Depressive Symptom Screening in Youth – Using a Community Diabetes Prevention Clinic
Authors: Wright Alexander , Yazel-Smith Lisa , Hannon Tamara
Published: December 2020

Background: Rates of youth diagnosed with diabetes and prediabetes are increasing and comorbidities like depression warrant strict monitoring to improve patient outcomes. 
Objective: The aim was to determine if increased depressive symptoms are associated with worse clinical findings, including BMI, obesity, diabetes, prediabetes, hemoglobin A1c (HbA1c), and demographic variables including age, gender, and race. 
Methods: The study is a retrospective chart review of patients referred to the Youth Diabetes Prevention Clinic (YDPC) based on increased risk for type 2 diabetes (T2D). The Patient Health Questionnaire (PHQ-9), a 9-question depressive symptom screening tool, was utilized to screen for depressive symptoms using a cut point of >=10 which indicates possible depression and a need for further evaluation. All available data were evaluated for clinic visits occurring between 2013 and 2020. 
Results: 178 patients filled out PHQ-9 screening forms and returned them to clinic. Age (p <0.01), sex (p <0.01), BMI (p <0.01), HbA1c (p <0.01), and obesity diagnosis (p = 0.01) were associated with increased depressive symptoms based on screening score cutoff. Race (p > 0.05), BMI z-score (p = 0.18), prediabetes diagnosis (p = 0.92), and diabetes diagnoses (p = 0.05) were not. Middle adolescent (ages 14-17) youth were 3.5 times more likely than early adolescents to fall into the moderate/high risk category for depression. Females were 2.6 times more likely and those with higher HbA1c or an obesity diagnosis were ~3 times more likely. A modest portion (36.5%) in this sample met criteria for possible clinical depression. 
Conclusion and Impact: Patients at risk for prediabetes and diabetes should be screened for depressive symptoms in order to intervene to decrease its adverse effects on diabetes management. Older youth, females, and those with obesity and higher HbA1c values are at particularly higher risk of having increased depressive symptoms.
Evaluation of Contraception Access within the Indianapolis Metropolitan Area
Authors: Yedlicka Grace , Theis Emily , Bernard Caitlin , Tucker Edmonds Brownsyne , Peipert Jeffrey , Wilkinson Tracey
Published: December 2020

Background: Access to family planning care and the full-spectrum of contraception, including same-day access to long acting reversible contraception (LARC) is critical to reduce unintended pregnancy and maternal/infant mortality. However, access remains variable for many women in Indiana. We sought to examine access to various contraceptive practices within the Indianapolis metropolitan area. 
 
Methods: A telephone survey of clinic managers was conducted between June-July 2020 of all identified IU Health, Eskenazi, and HealthNet primary care and OB/GYN providers in the Indianapolis metropolitan area. The 27-question survey gathered information regarding contraceptive practices (e.g. contraceptive method availability, same-day LARC insertion/removal, pregnancy intention screening, educational materials, and parental consent policies). The data was compared based on type of medical provider (OB/GYN, Family Medicine, and Pediatrics).  
 
Results: In total, 82 sites were identified, 58 surveys (70.7%) were completed. Oral contraception is the most commonly offered contraception (91.4%), followed by depot medroxyprogesterone acetate (DMPA) injection (84.5%), and the contraceptive patch (81.0%). LARC placement is available in 51.7% of all clinics, but only 34.5% offer same-day placements. Routine pregnancy intention screening is offered in 43.1% and educational materials in 74.1% of practices. OB/GYN clinics provide the most comprehensive access, 69.2% provide same-day LARC insertion (84.6% LARC removals). Family medicine practices are variable regarding contraceptive choices: over 91% offer oral contraception and DMPA injections, but only 20.8% place LARCs and 41.7% remove LARCs. Half (50%) of pediatric clinics provide oral contraception, while 50% do not provide any contraceptives. Parental consent for minors to obtain contraception provision is highly variable.  
 
Conclusion: Contraceptive practices vary among primary care and OB/GYN providers in the Indianapolis area. This variability in access leads to barriers for use, particularly for young women. Efforts to ensure comprehensive, same-day access to all forms of contraception (including LARCs), pregnancy intention screening, and contraceptive educational materials are needed.
Fryderyk Chopin i Furederikku Shopan — recepcja muzyki Fryderyka Chopina w kulturze japońskiej
Authors: Janczarek Rafał
Published: December 2020

Niniejszy artykuł koncentruje się na próbie odkrycia istoty fenomenu japońskiej fascynacji osobą i twórczością Fryderyka Chopina. To zjawisko zostało już fragmentarycznie zilustrowane w publikacjach naukowych. Dotychczas jednak nie udzielono odpowiedzi na pytanie, dlaczego recepcja Chopina jest w Japonii od lat tak intensywna. Autor artykułu stawia tezę, że źródeł japońskiego fenomenu Chopina należy szukać w kulturze japońskiej, nie zaś w japońskim zainteresowaniu kulturą polską. Kategorie wa, wabi, sabi, kanpekishugi, kawaii i manga pozwalają naświetlić tę kwestię z właściwej perspektywy. Za sprawą „twórczej odtwórczości” Japończycy przekształcają muzykę polskiego kompozytora i dostosowują ją do własnych upodobań. Na skutek tego procesu powstaje japońska „nowa jakość”, która nie jest tożsama z pierwotnym kontekstem. Fryderyk Chopin zyskuje w Kraju Kwitnącej Wiśni nowe japońskie oblicze.
Ceuta–Bab Sebta (Espagne–Maroc), le SARS-Cov-2 comme accélérateur de la reconfiguration frontalière
Authors: Goeury David
Published: December 2020

La frontière Ceuta-Bab Sebta est un point de tension récurrent entre les autorités marocaines et espagnoles. Cette enclave espagnole en Afrique est devenue l’un des points d’entrée des migrations clandestines en Europe mais aussi d’un commerce atypique au Maroc. La crise du SARS-CoV-2 a constitué une opportunité pour les autorités marocaines pour mettre fin au commerce atypique aux dépens des transfrontaliers marocains.
Retrospective Review of Complications of Liver Hydatid Cyst Surgery with Emphasis on Outcomes of Omentoplasty
Authors: HOSSEINI SHABANAN Sedighe , DASHTI Seyed Habibollah , ABBASI Mehrshad , JAFARIAN Ali , EBRAHIMI Amirpasha , AYOOBI YAZDI Niloofar
Published: December 2020

Background: The outcome and complications of liver hydatid cyst surgeries with new and old techniques are not well determined. We intended to present the results of operations done for patients with hepatic hydatid cyst in an endemic area.
Methods: Data of 112 patients referred and operated for liver hydatid cyst, in Imam Khomeini Hospital complex, Tehran, Iran, from 2015 to 2018, were collected including demographic characteristics, operation parameters and complication related statistics. The variables were presented for different surgical methods including operations with and without omentoplasty.
Results: Patients aged 39. 3 ± 13. 9 yr (70 females; 63. 5%). Most frequent clinical complaint was vague abdominal pain (n=45; 40. 2%). The most prevalent comorbidity was hypertension (18; 16.0%). Conservative methods were chosen more frequently including omentoplasty (44; 39. 3%), cyst drainage (27; 24. 1%), cyst resection (19; 17%) and marsupialization (3; 2. 7%). Overall, 56 patients (50%) were operated with omentoplasty as the single method or in combination with segmentectomy. Complications occurred less in patients operated with omentoplasty (41. 1 vs. 23. 2%; P=0. 043); particularly, biloma was more frequent in surgeries without omentoplasty (7. 1 vs 0. 0%; P=0. 042). Persistence and recurrence rates were 12. 5% and 3. 6% with relative predilection in, respectively, segmentectomy and lobectomy surgical methods compared to Omentoplasty. No mortality was recorded.
Conclusion: In our case series of hepatic hydatid cyst patients, omentoplasty was safe with less complication and similar long-term recurrence rate.
Parasite Burden Measurement in the Leishmania major Infected Mice by Using the Direct Fluorescent Microscopy, Limiting Dilu-tion Assay, and Real-Time PCR Analysis
Authors: HAGHDOUST Sepideh , AZIZI Mahdieh , HAJI MOLLA HOSEINI Mostafa , BANDEHPOUR Mojgan , MOHSENI MASOOLEH Mandana , YEGANEH Farshid
Published: December 2020

Background: We aimed to compare parasite burden in BALB/c mice, using three methods including the direct fluorescent microscopic using recombinant Leishmania major expressing an enhanced green fluorescent protein, limiting dilution assay, and real-time PCR technique.
Methods: The current study was carried out in 2018, to induce stable enhanced green fluorescent protein (EGFP) production. Initially, the linearized DNA expression cassette (pLEXSY-egfp-sat2) was integrated into the ssu locus of L. major. The expression of EGFP in recombinant parasite was analyzed using direct fluorescent microscopy. Afterward, BALB/c mice were infected with the L. majorEGFP, and the infection was evaluated in the foot-pads and inguinal lymph-nodes using an in vivo imaging system. Subsequently, eight BALB/c mice were infected with L. majorEGFP, and the results of evaluating parasite burden by a SYBR-Green based real-time PCR analysis and the limiting dilution assays were compared to the results obtained from the direct fluorescent microscopy.
Results: The results of the direct fluorescent microscopy showed that EGFP gene stably was expressed in parasites. Moreover, the in vivo imaging analysis of foot-pad lesions revealed that the infection caused by L. majorEGFP was progressing over time. Additionally, significant correlations were observed between the results of parasite burden assay using the direct fluorescent microscopy and either limiting dilution assay (r=0.976, P<0.0001) or quantitative real-time PCR assay (r=0.857, P<0.001).
Conclusion: Ultimately, the utilization of the direct fluorescent microscopy by employing a stable EGFP-expressing L. major is a suitable substitution for the existing methods to quantify parasite burden.
The Novel COVID-19 Infections in Iran: Management and Challenges
Authors: Kargar Shiva , Peyvand Mostafa , Hajizadeh Fateme
Published: December 2020

The article's abstract is not available.