bluuebunny/crossref_metadata_2025 huggingface dataset:
Digitalisasi Penyiaran Televisi di Indonesia
Authors: Gultom Amry Daulat
Published: January 2019

Penelitian ini dilakukan untuk memperoleh gambaran terkait status dan tantangan peralihan  penyiaran digital di Indonesia. Penelitian ini menggunakan pendekatan kualitatif dan studi literatur. Hasil penelitian menunjukkan bahwa Indonesia menghadapi beberapa tantangan di sisi regulasi, yaitu UU Penyiaran saat ini yang belum mengatur penyiaran digital secara spesifik dan permasalahan hukum terkait regulasi penyiaran digital yang berdampak tenggat waktu peralihan dari analog ke penyiaran televisi digital tahun 2018 tidak dapat dipenuhi*****This study was conducted to gather an overview of the current status and challenges of digital broadcasting in Indonesia. This study uses qualitative approach and literature studies. The results show that Indonesia faces several challenges on the regulatory side, namely the existing Broadcasting Act that has not regulated specific digital broadcasting and legal issues related to digital broadcasting regulation delayed the transition deadline from analog to digital television broadcasting in 2018
A TREM2 dependent control of Microglial and Astrocytic responses in a mouse model of Alzheimer's Disease
Authors: Achebe Nnamdi , Puntambekar, Ph.D Shweta S. , Lamb Bruce T.
Published: January 2019

Background and Hypothesis: 
Alzheimer’s Disease (AD) is characterized by deposition of extracellular amyloid beta plaques resulting in activation of plaque associated CNS glial cells, namely microglia and astrocytes. While extensive research has been directed to understand the role of microglia in neurodegenerative changes in AD, relatively little is known of astrocytic contributions to the disease. Studies using nerve injury models have shown that pro-inflammatory microglia can induce neurotoxic astrocytic phenotypes. In AD, the microglial gene TREM2 has been implicated in mediating neuroprotective immune functions. Research suggests that microglia go through TREM2-independent, followed by TREM2-dependent activation to mediate neuroprotection in diseases like AD, ALS and PD. The central objective of this project is to evaluate whether TREM2 dependent skewing of microglial activation generates neuro-protective/toxic astroglial populations.  
Experimental Design or Project Methods: 
We will use the 5XFAD mouse model of AD in this project. Changes in microglial and astroglial activation will be evaluated in 4-month-old 5xFAD; TREM2+/-mice using immunofluorescence and confocal microscopy 
Results: 
Our results show an increase in proinflammatory, plaque associated microglia expressing MHCII and C1qA in 5XFAD;TREM2+/- mice relative to 5XFAD;TREM2+/+ mice. This is accompanied by an increase in GFAP+S100B- reactive astrocytes in the hippocampus and subiculum. 
Conclusion and Potential Impact: 
TREM2 deficiency in a mouse model of AD skews the microglia to a proinflammatory phenotype, which may correlate with heightened astroglial reactivity and neurotoxicity. As loss of function mutations in TREM2 have been associated with an increased risk of neurodegenerative changes, these data shed light on how TREM2-mediated microglial-astrocytic crosstalk may influence disease progression.
Effects of Propofol on Transcytosis in an IPSC Derived Blood Brain Barrier Model
Authors: Bieber Dylan , Hughes Jason , Neese Olivia , Canfield Scott Canfield G.
Published: January 2019

Background: In 2016, the FDA released a report concerning the use of anesthetics in young children and pregnant women. This report states that prolonged or repeat exposure to anesthetic may lead to neurodevelopmental delay. Previously, Canfield et al., had determined a method for developing a human blood brain barrier model from induced pluripotent stem cells (iPSC). Preliminary data has shown that exposing this model to propofol at relevant concentrations significantly reduces barrier strength and may promote leakiness of the blood brain barrier. 
Design/Methods: Our efforts during these ten weeks focused on the effects of propofol on transcellular mechanisms in iPSC-derived brain microvasculature endothelial cells (BMEC). After exposing to propofol, fluorescently labeled dextran transcytosis and accumulation was analyzed on a fluorescent plate reader. Specifically, we monitored the transcellular movement of different molecular weighted dextrans. 
Results: Treatment of BMECs with 50uM propofol increased transcytosis and accumulation of 10kDa dextran as compared to control. Increased transcytosis in the absence of increased accumulation of 3kDa dextran may provide evidence of paracellular transport. Transcytosis and accumulation of 40kDa dextran were unchanged between treatment and control groups. These data may provide evidence that propofol affects transcytosis mechanisms differently. 
Potential Impact: We hope to more fully understand the mechanism by which anesthetics such as propofol effect the blood brain barrier. Due to the presence of tight junction proteins, transcytosis is an important mechanism for moving materials into the brain parenchyma. Further research will need to be done to determine the mechanism by which propofol affects BMEC transcytosis.
Forever-Fit Summer Camp
Authors: Boateng, BA Anthony O. , Yazel-Smith, MS, MCHES CCRP Lisa , McKinney, BS Brett , Haberlin, MPH, CHES Katie , Hannon, MD, MS Tamara , Perry, MPH Patrick
Published: January 2019

Background and Hypothesis: 
The objective of this study was to evaluate anthropometric and physical fitness measures from participants in the Forever-Fit Summer Camp (FFSC) between the years 2013 and 2017, comparing baseline and post-participation values. We hypothesized that participation in the FFSC would decrease the BMI Z-score of the campers during the 6-week program, as well as improve physical fitness measures. Further, we hypothesized that there would be an overall decrease in BMI and weight seen in campers who participated for multiple years. 
Experimental Design: 
In this 5-year cross-sectional evaluation, a total of 64 participants were included. During FFSC, biometrics, strength, endurance and flexibility were compared at baseline (Week 1) and 6 weeks after. This data from participants was compared using paired T-tests and compared the BMI Z-Score of campers over the years using repeated measures ANOVA. 
Results: 
Compared to baseline for each year, there was an overall decrease in BMI Z-Score and weight after the 6-week intervention. We observed an increase in strength and endurance, as seen with the 1-mile run and various strength test. Interestingly, we saw a decrease in flexibility in the campers as they progressed through the camp. Further, we observed an overall decrease in BMI Z-Score from 2013 to 2017.  
Conclusion and Potential Impact: 
The FFSC 6-week summer program had significantly decreased BMI and improved fitness measures. The activities performed in the FFSC could be implemented in other programs for youth to combat chronic conditions, such as Type 2 Diabetes.
Kidney Donor Contrast Exposure and Recipient Outcomes
Authors: Bajpai, MS2 Shivani , Mangus, MD MS FACS Richard S.
Published: January 2019

The use of contrast media in hospital procedures has been increasing since its conception in 1923. Despite developments in utility and safety overtime, contrast media has been associated with inducing kidney injury in patients. Several studies have investigated contrast-induced nephropathy (CIN) in hospital patients and kidney recipients post-transplant. However, there are few studies that connect donor contrast exposure to recipient kidney outcomes. This was a single-center, retrospective study on single-organ deceased kidney donors and recipients (n=1585) to explore the impact of pre-transplant contrast procedures on post-transplant kidney outcomes. The results indicated that the first, peak, and last serum creatinine values were not useful markers of CIN in kidney donors. An analysis of those donors who had contrast exposure and those who did not, as well as the amount of contrast exposure in the donor prior to transplant did not conclude significant impact on the recipient kidney outcomes at time points ranging from 7 days to 1-year post transplant. This data provides the largest statistical evidence currently available on this topic; it establishes the foundation for various research developments moving forward.
Skin Sympathetic Nerve Activity and Rate Control of Atrial Fibrillation
Authors: Douglas II Anthony , Kusayama, MD, PhD Takashi , Chen, M.D Peng Sheng
Published: January 2019

Background and Hypothesis 
Lifetime risks for atrial fibrillation (AF) are 1 in 4 for people 40 years of age and older. Rate and rhythm control are both important strategies in managing patients with AF. However, not all patients respond to beta blocker therapy. We hypothesize that sympathetic tone is important in rate control of AF, but the importance varied among patients. 
Experimental Design or Project Methods 
neuECG is a new noninvasive method to record skin sympathetic nerve activity (SKNA) and electrocardiogram. The present research recruited and recorded 2 paroxysmal and 3 persistent AF patients for 24 hours using neuECG. The average voltage of SKNA (aSKNA) and ventricular rate during AF was analyzed in one-min windows. 
Results 
The preliminary data reveal strong correlations (r=.783, r=.640, respectively, p<0.0001 for both) between aSKNA (1.19 ± 0.21 µV) and ventricular rate (110 ± 8 bpm) in the paroxysmal AF. High correlations were consistently observed when data were analyzed on an hourly basis. In comparison, strong correlations were found between aSKNA (1.13 ± 0.2 µV) and ventricular rate (88 ± 8.6 bpm) in persistent AF (r=.496, r= .796, r=.636 respectively, p<0.001 for both cases). However, hourly correlations displayed much higher variability between aSKNA and ventricular rate than that observed for paroxysmal AF.  
Conclusion and Potential Impact. 
aSKNA positively correlates with ventricular rate during AF. This relationship is stronger and more consistent during paroxysmal than persistent AF. These findings may be important in determining the efficacy of beta blocker therapy in rate control of AF.
Is Operative Diagnosis for Revision Total Hip Arthroplasty Related to Patient Reported Outcomes?
Authors: Holder, BA, BS Erik , Ciesielski, BS Alex , Ziemba-Davis, BA Mary , Meneghini, MD R. Michael
Published: January 2019

Background and Hypothesis:  Component loosening and instability are the leading causes of revision total hip arthroplasty (THA). The purpose of this study was to compare patient-reported outcomes after revision THA based on failure etiology. We hypothesized that outcomes would differ based on reason for revision.
Project Methods: 187 consecutive revision THAs performed between 2010 and 2017 were retrospectively reviewed. Prospectively collected preoperative and minimum one-year Hip Disability and Osteoarthritis Outcome Score/HOOS Jr., UCLA Activity Level, WOMAC Index, and patient satisfaction were assessed based on failure etiology.  Demographic variables and covariates were accounted for including sex, age, BMI, ASA classification, heart disease, lumbar spine pathology, narcotic use, fibromyalgia, depression, and autoimmune arthritis.  
Results: Latest UCLA activity level did not differ based on failure etiology (p=0.381). However, the degree of improvement in activity level was higher (p= 0.04) in patients revised for loosening, instability, and infection compared to ALTR and polyethylene wear. HOOS Jr (p=0.949) and WOMAC total (p=0.147) scores did not differ based on failure etiology at latest follow-up, although patients revised for loosening had greater WOMAC improvement compared to all other groups except polyethylene wear (p=0.016). Satisfaction did not vary based on failure etiology (p=0.365), and demographic and covariates were unrelated to outcomes (p[Symbol]0.165).   
Conclusion and Potential Impact: We observed that patient-reported outcomes following revision THA vary based on revision reason and activity level improvement is mitigated patients revised for ALTR and poly wear.  These findings may help surgeons and patients alike set expectations for recovery following revision THA.
A Bioinformatics Pipeline for Identifying Functional Explanations of SNP-Phenotype Associations on a Transcriptional Level
Authors: Hu Stephan , Rao Dr. Xi , Liu Dr. Yunlong
Published: January 2019

Background and Hypothesis: Genome-wide association studies (GWAS) have identified thousands of associations between single nucleotide polymorphisms (SNP) and traits of interest. These associations do not offer biological or functional explanations for differences in phenotype. This study works on filling the gap between these associations and their functional effect on phenotype by identifying variants that are associated due, at least in part, to their effect on a transcriptional level. 
Experimental Design or Project Methods: GWAS analysis and RNA-sequencing was run on the post-mortem brain tissue of heavy drinkers and non-drinkers. Genes that were associated with differential transcript production were overlaid with chromatin interaction data to identify potential enhancers. A number of properties of enhancers were used to narrow down the list.  
Results: Identified enhancers offer a potential functional explanation for the association between a SNP and trait. 
Conclusion and Potential Impact: This new technique offers a powerful tool to identify genetic variants in key regulatory regions. Although here it is used for an alcohol use disorder study, this protocol has the potential to be used in a wide range of statistical genomic settings to find functional explanations for associations between SNP and trait.
Marginal Utility of Additional Clinical Shifts on Milestone-Based Competency in an Emergency Medicine Clerkship
Authors: Gerena Rolando G , Whitaker Nash , Corson-Knowles Dan
Published: January 2019

Background: 
Emergency medicine clerkships are a required element of medical school programs. The optimal rotation structure is unknown, and in particular the number of clinical shifts required to achieve basic competency is unknown. In this analysis of one year of evaluations at an academic center, we assess the marginal utility of clinical shifts on competency, as assessed by historical preceptor milestone-based competency evaluations.   
The goal of the experiment is to observe the trend of passing rates throughout the course of an EM rotation using competencies including medical knowledge, data interpretation, and clinical judgement. The null hypothesis is that the percentage of students meeting the developmental milestones does not increase throughout the length of the clerkship.  
Methods: 
Clerkship evaluations of 200 students were retrospectively examined. A short form grading rubric was used to score students across eight developmental milestones. The average percentage of students meeting the developmental milestones were calculated and analyzed over the course of 14 shifts. A one-way ANOVA was used to compare the mean passing rates at different times of the clerkship.     
Results: 
The average percent of students achieving basic competency increased throughout the length of the clerkship, e.g. medical knowledge competency passing rates increased from 44.2% to 56.0%, first to last shifts respectively. Similar trends were observed in other competencies. The one-way ANOVA gave a p-value of less than 0.05; the null hypothesis was rejected.  
Conclusion/Potential Impact: 
The results can aid clerkship directors improve current grading rubrics to better assess student competency in their EM clerkships.
SILDENAFIL IS NOT PROTECTIVE TO THE BOWEL FOLLOWING INTESTINAL ISCHEMIA AND REPERFUSION INJURY
Authors: Moore, BS Hannah M. , Drucker, M.D. Natalie A. , Markel, M.D Troy A.
Published: January 2019

Background and Hypothesis: 
Acute Mesenteric Ischemia (AMI) occurs when blood supply to the intestine is decreased. This can lead to intestinal ischemia, cellular damage, necrosis, and if corrected, subsequent reperfusion injury. There are currently no medical treatments to help reverse ischemia and reperfusion injury (I/R) and, therefore novel treatments are necessary. Sildenafil, a compound that increases endogenous nitric oxide (NO) by blocking the phosphodiesterase-5 induced breakdown of cGMP, may function as a potent mesenteric vasodilator.  We therefore hypothesized that sildenafil would improve mesenteric perfusion during a mouse model of intestinal I/R.  
Experimental Design or Project Methods: 
Adult male C57Bl6J mice were anesthetized with isoflurane and a midline laparotomy performed. The base of the superior mesenteric artery was occluded with a non-crushing vascular clamp for 60 minutes. At the end of ischemia, sildenafil (1mg/kg, 10mg/kg, or 100mg/kg) or a PBS vehicle control were administered via intraperitoneal injection. Animals were then allowed to recover.  Twenty-four hours after ischemia, animals underwent assessment of mesenteric perfusion by Laser-Doppler imaging. Animals were then euthanized.  Perfusion was expressed as a percentage of baseline, depicted as mean +/- SEM, and analyzed by ANOVA.  P<0.05 was significant. 
Results: 
There were no significant differences in mesenteric perfusion between the vehicle group or any of the therapeutic groups.  (PBS: 53.03±11.35%; Sildenafil-low: 59.59±7.55%; Sildenafil-medium: 70.51±8.49; Sildenafil-high: 66.4±10.2, p=0.61).  
Conclusion: 
Sildenafil does not appear to be an effective treatment for improving mesenteric perfusion following intestinal ischemia. Further studies are required to determine the reasons for the ineffectiveness of sildenafil.  One possible explanation for these observations could be a lack of PGE5 in the intestinal vascular endothelium.
Using RNA Editing and ADARs to Increase Cell Sensitivity to Interferon Chemotherapies
Authors: Oakes Eimile , Nwosu Obi , Vadlamni Pranathi , Hundley Heather
Published: January 2019

Background and Hypothesis: During viral infection, viral double stranded RNAs (dsRNAs) are bound by and activate pattern recognition receptors (PRRs). Activated PRRs signal several downstream cellular events, including activating transcription of interferon (IFN). IFN-β can bind to cellular receptors and increase transcription of PRRs, interferon stimulated genes (ISGs), activate Protein Kinase R (PKR) and trigger apoptosis. The ability of IFN to trigger apoptosis makes it a potential chemotherapeutic. However, IFN therapy has had mixed efficacy in inducing tumor cell apoptosis.  One mechanism for this failure may be intrinsic mechanisms that prevent dsRNA from binding to and activating PRRs. ADAR1 binds to dsRNA and catalyzes deamination of adenosine to inosine, a process known as RNA editing. Normally, ADAR1 inhibits cellular dsRNAs from initiating the IFN response. Recent studies have shown ADAR1 is overexpressed in several cancers and contributes to oncogenic phenotypes, suggesting inhibition of ADAR1 may increase sensitivity to IFN-β. The Hundley lab recently identified an inhibitor of ADAR1 called ADAR3. ADAR3 has no deaminase activity and is highly expressed in glioblastoma (GBM) tumors. We hypothesize that ADAR3 expressing GBM cells should exhibit a greater antiproliferative effect in response to IFN-b treatment compared to control. 
Experimental Design or Project Methods: An MTT assay was conducted in which U87 ADAR3 +/- cell lines were exposed to IFN-β after 24 hours. Cell viability was measured for 3 days post-treatment. 
Results: U87 ADAR3 + cells are more sensitive to IFN-β treatment (n=2 biological replicates, p-value= 0.04). 
Conclusion and Potential Impact: The results suggest a mechanism to enhance IFN therapy for patients with ADAR3 expressing GBM.
Anxiety Screening in the Emergency Department
Authors: Pinto Michelle , Musey, Jr., MD Paul
Published: January 2019

Background and Hypothesis: 
Preliminary research completed in the Indiana University Health Methodist Emergency Department (ED) determined that the prevalence of undetected or unaddressed abnormal anxiety levels in patients with low-risk chest pain was greater than 45%. This subset was noted to have abnormal anxiety symptoms that persisted following visits and increased ED recidivism. We hypothesize that the prevalence of abnormal anxiety in the general ED population will be similar to the subset of patients with low-risk chest pain shown previously.  
Methods: 
We enrolled a convenience sample of adult patients with non-psychiatric chief complaints who presented to IUH Methodist and Eskenazi Emergency Departments. Participants were assessed for abnormal anxiety levels using the Generalized Anxiety Disorder 7-item Scale (GAD-7) and the Hospital Anxiety Depression Scale (HADS). Subjects will also complete these assessment tools at 30-days post-enrollment via phone or REDCap survey. Data regarding ED disposition, discharge diagnosis, and ED utilization over the previous 12 months and the 30 days post-enrollment will be collected from the electronic medical record (EMR). 
Results: 
Over four weeks, 108 patients were screened and 37 gave informed consent and were enrolled. Preliminary analysis shows that 21 subjects (56%) had a GAD-7 score ≥10, indicating abnormal anxiety levels. Full data analysis including comparison of HADS and GAD-7 scores will take place after 50 subjects have been enrolled, completed their 30-day follow-up surveys, and EMR review has taken place.  
Conclusion: 
Given data regarding ED visits in patients with low-risk chest pain, identification of anxiety and referral may reduce ED utilization.
The risk of bleeding following therapeutic endoscopy is low in patients with cirrhosis
Authors: Reinhart Kathryn , Phatharacharukul Parkpoom , Orman Eric
Published: January 2019

Background: Patients with cirrhosis may be at increased risk of bleeding after invasive procedures due to defects in coagulation; however the bleeding risk following therapeutic endoscopy remains poorly understood. We aimed to determine the incidence and risk factors for post-procedural bleeding for patients with cirrhosis undergoing therapeutic endoscopy.
Methods: We performed a retrospective cohort study of patients undergoing three common endoscopic procedures (colonoscopic polypectomy, endoscopic variceal ligation, and biliary sphincterotomy) at Indiana University Hospital between 2007 and 2014. Clinical and procedural data were collected, including complications in the 30 days following the proceduress. 
Results: We identified 447 procedures: 128 polypectomies, 63 sphincterotomies, and 256 variceal ligations. The incidence of bleeding was 2% (4 polypectomies, 1 sphincterotomy, and 4 variceal ligations) after a median of 4.5 days. . Prophlactic platelet transfusions were provided to 11 patients and plasma was transfused in 17 patients. Of those who received prophylactic transfusions, only one bled (post-polypectomy despite prophylactic hemoclip placement). The patients that bled had a median INR of 1.48 which was slightly elevated compared to the overall median INR 1.26. Post-polypectomy bleeding occurred following removal of fairly large polyps (8, 9, 10, 25 mm) compared to the median overall polyp size of 5 mm.  
Conclusion: The incidence of bleeding for patients with cirrhosis undergoing therapeutic endoscopy is low. More data on post-procedural bleeding are needed to determine risk factors and to inform appropriate prophylactic measures. These data may be used to guide clinicians in counseling patients prior to these procedures.
Utilizing Citizen Science to Reverse the Current Lead Testing Paradigm: Development of a Scalable, Low-cost Home Lead Test Kit
Authors: Sawyer Katlyn , Knaub Chris , Tighe Meghanne , Forbes Danielle , Marks Claire , Nicolay Lane , Gutierrez Citlali , Dowd Mike , Bielski Maggie , Sisk Matthew , Ngai Michelle , Lieberman Marya , Peaslee Graham , Beidinger Heidi
Published: January 2019

Background: The Center for Disease Control recommends case management begin at a blood lead level of 5 μg/dL, yet Indiana does not take action until a blood lead level of 10 μg/dL. Low levels of lead can cause irreversible neurological damage in children. The goal of this study was to design a scalable, low-cost Home Lead Test Kit to proactively find lead in homes. 
Methods: Individuals were recruited through community partnerships, community lead testing events, and flyers. Qualitative data was recorded during home visits as participants used the kit. An x-ray fluorescence analyzer was used in the field and laboratory to analyze lead levels of samples. Results were blinded during the analysis. 
Results: To date, 40 homes have been recruited, and 20 have been completed. The average completion time of the kit was 23.45 minutes.  Of the 8 pre-1950 homes 100% had elevated lead results, of the 7 1950-1978 homes 43% had elevated lead results, and of the 5 post 1978 homes 0% had elevated lead results.  
Conclusion and Potential Impact: The study is ongoing. Preliminary results support the hypothesis that pre-1950 homes have a high risk of lead exposure, and post 1978 homes have minimal to no levels of lead. Feedback from study participants regarding kit usability has been positive. Future plans are to produce a kit to be scaled up in St. Joseph County with the goal of a statewide model. This kit may allow citizens to identify lead hazards to prevent children from lead exposure.
IL-6 Stimulates Autophagy in Wild Type and NRF2 Knock Out Mice β-cells
Authors: Stucker K M , Marasco M R , Conteh C M , Muralidharan C , Linnemann A K
Published: January 2019

Background and Hypothesis: 
Pancreatic β-cells exhibit high levels of metabolic activity which generates reactive oxygen species (ROS).  ROS can  lead to β-cell damage and death,  which could contribute to diabetes development.  Therefore, pathways reducing ROS are of interest as potential therapeutic targets.  We have demonstrated that IL-6 stimulates autophagy and protects β-cells from ROS and apoptosis.  IL-6 also stimulates the translocation of NRF2 to the mitochondria, which is accompanied by several markers of mitophagy, the autophagic degradation of mitochondria.  In this study, we ask where NRF2 fits in the pathway downstream of IL-6 by asking if NRF2 is required for IL-6 stimulation of autophagy and/or mitophagy. 
Experimental Design or Project Methods: 
Wild type and NRF2 knockout mice were intraperitoneally injected with saline or IL-6 for thirty minutes, and the pancreata were cryopreserved, and cryosectioned.  Immunofluorescence staining was carried out for LAMP-1 (a component of lysosomes) and LC3 (a component of autophagosomes).  Slides were imaged with a LSM 700 confocal microscope. 
Results: 
IL-6 stimulated autophagy in wild type and NRF2 knockout mice, whereas saline injection did not. 
Conclusion: 
We have confirmed that IL-6 stimulates autophagy in pancreatic islets and shown that NRF2 is not required for this process.  Ongoing experiments are investigating if NRF2 is required for IL-6 stimulation of mitophagy. These results help us understand how NRF2 functions downstream of IL-6 in the protection of β-cells
Clinical and radiographic factors associated with appendectomy in pediatric patients with abdominal pain and equivocal imaging findings for appendicitis.
Authors: Tursunova Roziya , Landman, MD, MPH Matthew P.
Published: January 2019

Background and Hypothesis 
Acute appendicitis is a common surgical emergency in children. The diagnosis requires physicians to rely on clinical, radiographic and laboratory factors. The nonoperative management of appendicitis is becoming more frequent. This requires an accurate diagnosis prior to initiating therapy to prevent unnecessary antibiotic administration for abdominal pain unrelated to appendicitis. We hypothesize clinical and radiographic factors are associated with appendicitis in patients with abdominal pain and inconclusive imaging studies.  
Methods 
The DORIS (Dig Our RIS) interactive data-mining tool was utilized to identify patients<18 years of age presenting to the emergency department in 2016 with abdominal pain who obtained abdominal imaging suggestive of early acute appendicitis. Relevant clinical and radiographic information was obtained from the medical record for univariate analysis looking for associations with appendectomy.  
Results 
One hundred patients were identified with 21 excluded due to imaging for other reasons or with clear non-appendicitis etiologies for pain (e.g. trauma cases, ovarian cyst). Seventy-nine patients were included with 49 (62%) undergoing surgery and 30 who were observed and/or discharged from the ED. Important differences between surgical and nonsurgical patients included: white blood cell count (13.81±0.68 vs. 10.29±0.90, p=0.002), neutrophil percentage (78.31±1.90 vs. 67.78±2.65, p=0.002), appendiceal diameter on CT scan (9.37±0.53 vs. 7.58±0.30, p=0.013).  
Conclusion and Potential Impact 
In a group of patients with concern for appendicitis and imaging suggestive of early acute appendicitis, distinct clinical and radiographic characteristics are associated with appendicitis. Within a paradigm of nonoperative management of appendicitis, accurate diagnosis will prevent the overutilization of antibiotics.
Current Concepts in the Treatment of Patellofemoral Instability
Authors: Ulrich, BS Gary , Pandit, FRCS (Orth), DPhil (Oxon) Hemant
Published: January 2019

Background and Hypothesis: 
Patellofemoral instability represents a disabling condition, which presents primarily in active, young patients with an increased incidence in the female sex. A patellar dislocation can occur from a high-energy trauma or from an atypical anatomy, such as trochlear dysplasia, patellar dysplasia, patella alta, increased tibial tuberosity-trochlear groove (TT-TG) distance, increased Q-angle, and ligamentous laxity. When a patient presents with patellofemoral instability, the orthopedic surgeon faces many decisions regarding the treatment. Since the risk of a second dislocation after an acute dislocation resides at approximately 17%, many orthopedic surgeons treat the first patellar dislocation non-operatively barring the patient lacks any atypical anatomy. However, after a second dislocation, the likelihood of recurrent dislocations increases to approximately 50%, which directs most orthopedic surgeons to surgical treatment. The current work reviews the anatomical predispositions, clinical presentation, and treatment of patellofemoral instability.  
Experimental Design or Project Methods: 
The review was constructed via an extensive literature search utilizing the databases of MEDLINE/PubMed, SportDiscus, CINAHL, and Cochrane Central Register of Controlled Trials.  
Results: 
Multiple treatments exist for patellofemoral instability, which include non-operative treatment, MPFL reconstruction, tibial tubercle osteotomy, and trochleoplasty, along with many other procedures. Each case requires a tailored approach to successfully treat the patellofemoral instability.  
Conclusion and Potential Impact: 
Patellofemoral instability represents a potentially debilitating condition of anterior knee pain and limited activity. Understanding the anatomical predispositions, clinical presentation, and treatment of patellofemoral instability marks the first step to caring for patients with this condition.
Starting from the Roots: Observing Healthcare and Population Health Endeavors in a Lower Middle Income Country
Authors: Vonderohe Madalyn
Published: January 2019

The Slemenda Scholarship: 
The Slemenda Scholarship is a program that was developed in 1998 for rising second year medical students in order for them to gain experience in the field of global health through the context of the AMPATH Consortium in Eldoret, Kenya. As a medical professional aspiring to work internationally, it is an invaluable experience to observe practices in a well-established partnership such as the one between Moi Teaching and Referral Hospital, Moi University, and Indiana University. 
Community Experiences: 
The first half of the summer was spent visiting and participating in various AMPATH initiatives. This included rounding on the medical, surgical, gynecological, and pediatric wards, volunteering with the child life team, visiting community health and microfinance projects, observing rural HIV clinics, and working at a school developed for street children in Eldoret. 
Primary Project:  
The second half of the summer was spent working with the Maternal Newborn and Child Health team, specifically in the Reproductive Health department. I worked as a research assistant for a new project seeking to develop an antenatal care clinic for young girls aged 10-19 in Uasin Gishu County at the Rafiki Centre for Adolescents at Moi Teaching and Referral Hospital. I developed recruitment materials and a database for qualitative and quantitative data collection for the project.  
Moving Forward:  
On returning to Indiana, it is my goal to champion the work of the AMPATH Consortium and attempt to ensure its longevity through the next generation of globally-minded physician-scientists. I will take the lessons I learned and observations I made in this setting and work to apply them to improving healthcare in underserved areas in our own community as well.
BabyNoggin Pre-implementation Phase: Understanding How Clinical Teams and Parents Will Respond to BabyNoggin
Authors: Watkins Sarah W. , Chen Elizabeth Z. , Swec Katie , Huskins Jordan , Lee Jin , Miller Andrew D. , Bauer Nerissa S.
Published: January 2019

Background and Purpose: Mobile health (mHealth) apps hold potential to transform healthcare, but their adoption in clinical settings takes time and how providers and families use them is unknown. Three clinics at Riley Hospital for Children are preparing to implement BabyNoggin, an app that collects developmental screening tools typically collected via paper forms. The purpose of this study was two-fold: 1) to understand pre-implementation processes and provider perspectives of integrating BabyNoggin into clinic workflow; and 2) to examine parental attitudes towards the use of apps for child development. 
Project Methods: Pre-implementation clinical observations of workflow were performed in participating clinics. Semi-structured interviews informed by the Consolidated Framework for Implementation Research (CFIR) were conducted with each clinical team to understand perceived implementation facilitators and barriers. Lastly, parents with children aged 0-5 were recruited from study clinics and social media to participate in a 26-item survey to gauge their attitudes towards using apps in place of paper screening forms and for tracking their child’s development. 
Results: Implementation workflows were co-created with each clinical team that should not increase visit length. Five CFIR interviews highlighted facilitators and barriers towards implementation of BabyNoggin to be considered during implementation. Out of 199 parents who completed the survey, 72.9% (n=145) reported a higher likelihood of downloading a child health app that was recommended by their pediatrician.    
Conclusion and Future Steps: This study constituted the pre-implementation phase of a larger project involving the implementation of BabyNoggin. Future research will use these findings as a guide during implementation.
Impact of ED Scribes in a Residency Program
Authors: Munshi, BS Mumtaz , Corson-Knowles, MD Daniel , Whitaker Nash
Published: January 2019

Background and Hypothesis: In the electronic medical record era, clerical documentation has become a significant source of burden in the emergency department (ED). Medical scribes have been advocated as a method to reduce clerical documentation burden while improving physician productivity and satisfaction. The impact of scribes in a non-academic ED setting has been found to be beneficial, and a small survey suggested resident physicians found scribes to be a valuable fatigue-mitigation strategy. The goal of this study was to assess the impact of ED scribes on residents, including time burden of documentation, signals of emotional impact that contribute to burnout, and learning/teaching opportunities. 
Experimental Design or Project Methods: This observational time motion analysis assesses scribe impact on emergency medicine residents. Observations were pseudo-randomized in a 1:1 fashion to shifts without or with scribes. Trained observers tracked the activity of upper level residents in the high acuity section of a busy urban county ED for 4 hours of each shift. At the end of each shift, residents self-reported post-shift documentation time and completed a survey assessing residents’ perception of their shift and the impact of scribes. 
Results: Residents reported that scribes improved their overall experience during their shift. They also reported that scribes reduced documentation time (0:11:33 [Symbol]0:04:24 v. 0:08:56 [Symbol]0:05:36) and allowed them to better connect with and care more for their patients (9.6 [Symbol]0.8 v. 8.7[Symbol]1.3).  
Conclusion and Potential Impact: Scribes improved emergency medicine residents’ perceptions of their educational experience and reduced symptoms of burnout during shifts.
Measures of human development: a narrative
Authors: Vasthare Ramprasad , Dhaundiyal Shriya , Puri Sunaina
Published: January 2019

Human development is a direct function of human capability, understood through the different facets of the human development index. The impact of gender inequality, women empowerment, environmental and socioeconomic sustainability has also been described in this review. It brings forth and reinforces that national development is an assessment of not only per capita income but by other influential factors which affect development comprehensively, such as educational achievements and health. A thorough primary screening was done for articles on human development index using the data bases of PubMed, Scopus and Google Scholar using the key words human development, United Nations, measures, indicators and index, followed by a secondary screening, with due concern to avoid overlap of information. The articles were categorized based on the subject of Human Development with due prioritization. Human development index has evolved periodically taking into consideration the developments, limitations and criticisms. It has become an important indicator of human progress and serves as a guide to state, societal, community and individual developments. India currently holds a rank of 130 denoting medium human development.
Crônica de uma tradutora anunciada: Clarice e a tradução como dever
Authors: Cardoso Ferreira Rony Márcio , Pereira Germana Henriques
Published: January 2019

Clarice Lispector tornou-se conhecida por renovar a prosa intimista da literatura brasileira durante o século XX. Além de escritora, foi jornalista, repórter e entrevistadora na imprensa carioca, sem contar o seu ofício de tradutora, por meio do qual assinou a versão de cerca de 46 textos em língua portuguesa, entre eles romances, contos e peças teatrais. Contudo, seus trabalhos de tradução ficaram de lado quando se discutiu, no cenário da crítica, o peculiar caminho de seu projeto literário. Nesse sentido, o presente artigo visa a um estudo da primeira tradução assinada por Clarice antes mesmo da publicação de Perto do coração selvagem (1943): a versão em português do conto “Le missionnaire” (1921), de Claude Farrère. Em outras palavras, este estudo procura evidenciar o lugar sintomático da tradução diante do projeto da escritora-tradutora, mesmo antes da publicação de seu primeiro romance. Para tanto, a partir dos estudos da tradução literária, esta reflexão volta-se à versão em língua portuguesa do conto francês, procurando tomá-la como um dos marcos iniciais do percurso de Clarice enquanto tradutora. Percurso este que nunca esteve dissociado de seu projeto, mesmo quando a jovem Lispector era ainda uma desconhecida nas letras nacionais.
Causes of bullying in the workplace among primary school teachers of your paper
Authors: Cech Tomas , Kvintova Jana , Cakirpaloglu Simona Dobesova
Published: January 2019

Workplace bullying is a subtle manifestation of disturbed relationships in the workplace and it is considered an extreme type of social stressor at work. The present study is based on research regarding bullying in the workplace, specifically involving teachers in elementary schools in the Czech Republic. The sample consisted of 13 elementary school teachers who had been exposed to regular bullying by their colleagues or senior executives for at least six months. Based on in-depth interviews and subsequent coding and categorization of statements, the main aim of the research is to analyse the factors causing bullying in the workplace. The teachers who experienced bullying in the role of victims state that the main reasons for this kind of aggressive behaviour lie in the personality of the bully, personality of the victim, mutual antipathy of the perpetrator and the victim, and in  the job selection process.

Keywords: School; school climate; aggression; bullying in the workplace; causes of bullying.
Comparison effectiveness of cognitive-behavioural therapy and relaxation technique on curing premenstrual syndrome
Authors: Mahmoudi Farah
Published: January 2019

The main purpose of this study was to compare the efficacy of cognitive-behavioural therapy and relaxation technique in the treatment of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD). For this purpose, after screening 82 girls students, they were randomly divided into three groups: relaxation, cognitive-behavioral and control. Results showed the amelioration of PMS and PMDD with cognitive-behavioural therapy and relaxation technique but relaxation technique was a superior method. It can be recommended that the relaxation technique for relief of PMS and PMDD.

 

Keywords: Cognitive-behavioral therapy, relaxation technique, premenstrual syndrome.
Guatiní: un proyecto para fomentar el conocimiento de la avifauna cubana en las nuevas generaciones
Authors: Sepúlveda-Peña Juan Carlos , Vejo-Paula Bislandry , Villanueva-Hedesa Carlos , González-Guerra Juan Ramón , González-Alfonso Alieny , García-Lau Ianela , Hernández-Horta Gladis , Borrego Manuel , Socorro Gilberto , Amat-Álvarez Alberto , González-Moreno Maritza
Published: January 2019

En Cuba existen 29 especies de aves amenazadas o casi amenazadas, tres en peligro crítico, ocho en peligro, siete vulnerables, y once cercanas a la amenaza. Además de la pérdida y degradación de los hábitats, las aves de Cuba se ven amenazadas por la cacería, la colecta de huevos y el comercio ilegal.  Revertir esta situación va más allá de las leyes y acciones de las autoridades competentes, es necesaria una educación medioambiental desde las edades tempranas. Se necesita que los individuos y las colectividades se identifiquen con su entorno y adquieran los conocimientos, los valores, los comportamientos y las habilidades para participar responsable y eficazmente en la prevención y la solución de los problemas ambientales. En la actualidad, niños y jóvenes hacen un gran uso de los teléfonos móviles, tabletas y computadoras principalmente para jugar; en su mayoría, estos juegos solo entretienen y no educan, y en algunos casos se podría decir que enajenan. ¿Por qué no aprovechar estas tecnologías para incentivar desde edades tempranas el conocimiento y el amor por la flora y la fauna? El proyecto Guatiní tiene como objetivo desarrollar juegos y aplicaciones multimedia que permitan divulgar la información científica acumulada sobre la avifauna cubana y educar así principalmente a las nuevas generaciones en el cuidado del medio ambiente.
Calibración del plato forrajero en praderas de kikuyo (Pennisetum Clandestinum Hochst.ex Chiov) en el trópico alto colombiano
Authors: Moreno Diego , Fonseca Carolina , Rodríguez-Molano Carlos Eduardo , Pulido-Suarez Néstor Julián
Published: January 2019

La región andina colombiana, en el departamento de Boyacá a 2560 msnm en el cordón lechero colombiano, las explotaciones ganaderas se caracterizan por tener la especie forrajera perenne predominante conocida como Kikuyo (Pennisetum clandestinum Hochst.ex Chiov), gramínea de crecimiento estolonífero. El objetivo de este estudio, fue obtener la ecuación de regresión lineal para la adecuada calibración del plato forrajero con el fin de predecir la disponibilidad de materia seca por hectárea.  Esta investigación se realizó en el trascurso del año 2014, (desde marzo hasta diciembre); para esta investigación se realizaron mediciones con un Plato Forrajero en 21 predios ganaderos pertenecientes a la región del Alto Chicamocha. Se tomaron un total de cuatrocientas (400) muestras en época seca y de lluvias. Se procedió a desarrollar la formula por medio de un método matemático de regresión lineal simple, relacionando la altura comprimida del forraje y la disponibilidad real de materia seca obtenida mediante corte y posterior secado. %. De acuerdo a la formula se determinó que por cada unidad de medida del plato forrajero, la disponibilidad de fitomasa total se incrementó en 259.42 kg de Materia Seca (MS) y se obtuvo un intercepto de 2978.92. Estos resultados conllevan al uso de la ecuación como una alternativa de cálculo de la materia seca disponible durante todo el año en praderas de Kikuyo. La ecuación resultante para la calibración del Plato Forrajero en praderas de Kikuyo (Pennisetum clandestinum) fue Kg Ms/Ha = 259.42x + 2978.9 donde se reemplazó la altura comprimida por el plato forrajero y con un coeficiente de determinación (R2) de 77.67 %.
“Saatlerin Tıkırtısı” Hikâyesi Üzerine Metin Dil Bilimsel Bir İnceleme
Authors: Huseynzade Aysel
Published: January 2019

Bu incelemede; Yusuf
Atılgan’ın “zamanın geçmezliği” konusu üzerinde duran ve daha önce herhangi bir
dergide yayınlanmamış olan “Saatlerin Tıkırtısı” isimli hikâyesinin, metnin
bağdaşıklık görünümlerini yansıtan küçük yapısı ve tutarlılık görünümlerini
yansıtan büyük yapısı, metin dil biliminin ilkeleri ve yaklaşımları ışığında
ele alınarak incelenmiştir. Araştırmanın temel amacı; örneklerine çok az
rastlanan bu tür eserlerin analizinin yapılarak ilerleyen zamanlarda bu konuda
yapılacak araştırmalara katkı sunmaktır. Bu çalışmada nitel araştırma yöntemlerinden
doküman analiz yöntemi kullanılmıştır. Çalışma, Cibakaya 2.3 en son sürümü
kullanılarak gerçekleştirilmiştir. Hikâye toplam 790 kelime ve 177 cümleden
oluşmaktadır. Yusuf Atılgan’ın “Saatlerin Tıkırtısı” hikâyesi, metnin küçük
yapısı (gönderimsel ilişki, bağlantı öğesi, aynı kelimenin yinelemesi,
eksiltili yapı, çıkarsamalar, eylem zamanı, cümleler arası bağıntı öğeleri,
metnin belirticileri) ve büyük yapısı (özelleştirme, genelleştirme, sebep-sonuç
ilişkisi, karşılaştırma, karşıtlık ilişkisi) doğrultusunda incelendiğinde,
yazar tarafından titizlikle oluşturulmuş bir metinle karşı karşıya
kalınmaktadır. Çalışmamıza konu olan hikâyenin, parçaların birbirini
tamamladığı ve bütün olarak inceleme için uygun bir metin olduğu görülmektedir.
Embodied Cognition: Laying the Foundation for Early Language and Literacy Learning
Authors: Roessingh Hetty , Bence Michelle
Published: January 2019

For children, hands are the critical conduit for learning the world and constructing mental models of its size and shape.  Such embodied cognition (EC) is mediated through language in the social environment. In this paper we review the literature and develop the conceptual underpinnings for a framework for play-based pedagogy that integrates sensorimotor, cognitive, and linguistic systems that lay the foundations for early literacy experiences expected in the kindergarten and Grade 1 year. We provide suggestions for incorporating games and tasks in a play-based program that will promote EC.
Educators’ Explorations with Gender Performativities and Orientations: A Participatory Action Research Project in West Nile Sub-Region, Uganda
Authors: Jones Shelley
Published: January 2019

This paper discusses findings from a feminist participatory action research study conducted in the West Nile region of Northern Uganda with a group of 35 educators who attended a one-week intensive professional development course focused on promoting gender equality in schools. Through a theoretical and methodological framework of multiliteracies and multimodality, gender constructs were “exposed” (Butler, 1988) and “disoriented” (Ahmed, 2006), opening new spaces for the promotion of gender equality, as well as pedagogical approaches to literacy that the participants could integrate into their own teaching practice to facilitate transformative learning in their own school contexts.