bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity Can Enhance Treatment for Substance Use Disorder: A Systematic Review
Authors: Blake Ethan , Sawyer Antonia , Savaiano Dennis 
Published: December 2020

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

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

Background: Early allograft disfunction (EAD) can be used as a tool to asses function of the liver after transplantation. Currently, most accepted EAD definition can be defined using a number of criteria including but not limited to total bilirubin > 10 mg/dL on post-operative day 7, INR > 1.6 on post-operative day 7, and ALT or AST > 2000 IU/L within the first post-operative 7 days. EAD is associated with mortality and morbidity after liver transplantation which leads to decreased recipient survival rates. It is considered a precursor step in the pathway to eventual graft loss.

Methods: We have performed a literature review to understand what risk factors increase, including donor and recipient demographics as well as recipients’ MELD (Model for End Stage Liver Disease) scores, which predicts patients’ disease severity. We also compared the incidence of EAD between our center and the literature.

Results: We found that incidence of EAD was between 23-40% (Table 2). It is higher when livers from donation after circulatory death (DCD) donors were used, as expected.

Reference (year)

Number of patients

Incidence of EAD

Ekser et al (2019)

n = 2008

29%

Olthoff et al (2010)

n = 300

23%

Wadei et al (2015)

n = 1325

27%

Lee et al (2014)

n = 205

39.5% (DCD donors)

Risk factors that can result in an increase occurrence of EAD were; (i) donor age, (ii) liver stenosis, (iii) expanding criteria for donor livers, (iv) prolonged warm ischemia time (WIT) and (v) cold ischemia time (CIT). Histologically, hepatocellular damage that is shown as coagulative necrosis can be seen immediately after reperfusion.

Conclusions: During our literature review, potential strategies have been discovered to help prevent EAD including pharmacological treatment using glucose, antioxidants, anti-inflammatories, and apoptotic drugs. Although none of them significantly prevented the occurrence of EAD, it was clear that there are many tools that can be used to attempt to prevent EAD in order to offer a better outcome in patients undergoing liver transplantation.
Assessing follow-up care compliance in children hospitalized for traumatic brain injuries
Authors: Bozell Hannah , Vetor Ashley , Raymond Jodi , Hochstetler Alexandra , Bell Teresa 
Published: December 2020

Background and Hypothesis: There is limited information regarding healthcare utilization and outcomes in children hospitalized for traumatic brain injury (TBI). Nearly 50% of adults hospitalized for trauma do not attend follow-up appointments, although completion of post-discharge care is associated with improved outcomes and decreased likelihood of subsequent emergency department (ED) visits. The Regestrief Institute Indiana Network for Patient Care (INPC) is a regional health information exchange (HIE) with health record data. This includes inpatient, outpatient, and ED visits, as well as imaging and lab data. The objective of this study is to use HIE data to assess long-term healthcare utilization, complications, and sequelae of pediatric patients hospitalized for TBI to see if follow-up compliance can identify patients at risk for post-TBI complications, including unplanned care, as well as long-term secondary health conditions.

Methods: 387 patients treated at a pediatric level 1 trauma center in Indiana admitted for TBI were identified using trauma registry data. EHR data in the INPC on patients for two years post-discharged were analyzed. Associations between compliance with follow-up care instructions given at discharge/subsequent medical visits and longitudinal utilization/outcomes were examined using Fisher’s exact test.

Results: After reviewing patient records, we found that 60.7% of patients received all follow-up care and 8.5% of patients received partial follow-up care, leaving 25.1% of patients receiving no follow up care and 5.7% of patients lost to follow-up after discharge. 12% of patients went to the ER for an injury-related issue and 6.2% of patients were readmitted. 19.4% of individuals experienced complications from injury while 12.4% of individuals had suspected sequela. Factors influencing recovery included race, age, insurance, injury severity, ICU admission, and ventilator usage.

Implications and Importance: Using HIE data can identify factors of hospitalized children vulnerable to not achieving optimal recovery and determine what care is critical to improving long-term health and quality of life outcomes.
Geriatric Intensive Care Unit Admission Protocol
Authors: Byvoets Tom , Brewer Brian 
Published: December 2020

Background and Hypothesis:
The Society of Critical Care Medicine has recommended protocolized admission and discharge criteria for the ICU, but there is little supporting evidence for these guidelines. Our goal is to find predictors supported by data that can consistently triage patients appropriately on admission and decrease the need to upgrade the level of care during the same hospital stay. We hypothesized that applying a protocol would reduce the number of unplanned ICU admissions in our institution.

Methods:
We retrospectively applied our protocol to patients sixty-five years or older from the trauma registry at Methodist Hospital admitted between January 1 and December 31, 2019. Patients who did not have an unplanned ICU admission during hospital stay were used as the control group, while those who had an unplanned ICU admission event were considered the experimental group. After this, we used crosstabulation and Fisher’s exact test to analyze the data.

Results:
We reviewed one thousand one hundred forty-six (1146) subjects with 1088 in the control group and 58 in the experimental group. Subjects in the experimental group were statistically more likely to have COPD (OR: 2.646, p=0.001), been transfused > two units of PRBC in the first 24 hours (OR: 5.303, p=0.000), or to have greater than two rib fractures (OR: 2.469, p=0.002).

Conclusion and Potential Impact:
This study demonstrates that applying this protocol can capture elderly patients who will likely require ICU level care during their hospitalization. COPD, > two rib fractures, and transfusion of > two units PRBC during the first 24 hours appear to be significant predictors of clinical deterioration. Unplanned ICU admissions are associated with increased hospital and ICU length of stay. We must develop evidence-based protocols to decrease morbidity and cost associated with unplanned ICU admissions.
Creating a Simulated Dataset for Training Deep Convolutional Neural Networks for Use in Cardiovascular Photoacoustic Tomography
Authors: Chan Hayley , Goergen Craig , Leyba Katherine 
Published: December 2020

Background/Objective: Photoacoustic tomography possesses increasing potential as a non-invasive imaging method that combines optical and acoustic imaging to maximize the visualization of tissue. Determining the composition, orientation, and location of anatomical structures in multidimensional space requires maximizing image resolution and differentiation from noise and reflection artifacts. Using simulations to develop and improve methods for image resolution allows for flexibility and variation of numerous variables.

Methods: Binary masks were created from mouse common carotid ultrasound images using a graphical user interface for MATLAB. With the k-Wave toolbox, we performed time-reversal photoacoustic simulations using the masks. Medium properties for the simulations were assigned for sound speed and density for connective tissue (1540 m/s, 1027 kg/m3) and arterial walls (1569 m/s, 1102 kg/m3). The dataset was augmented through rotational and mirrored transformations and the addition of noise and reflection artifacts via Python open-source software.

Results: A set of 87 binary masks was generated from common carotid ultrasound images. These masks were used to simulate initial pressure distributions through the k-Wave toolbox to reconstruct the structure of the common carotid. Each simulation yielded graphs for initial pressure and sensor distribution, simulated sensor data, reconstructed initial pressure, and a comparison profile between the original and reconstructed pressure. Data augmentation was implemented using the reconstructed pressure output from the 87 simulations, each producing 12 distinct images from rotations and mirroring with the addition of noise and reflection artifacts. The final dataset yielded 1044 images.

Conclusion and Potential Impact: Future work will involve applying this dataset to a neural network to improve photoacoustic quality such that transfer learning can be applied on ex vivo and in vivo datasets. Thus, there is potential for use in diagnostic applications in patients with cardiovascular disease states like atherosclerosis and aneurysms that require high resolution visualization of tissue structure and composition.
Plastic Surgery Innovation Through War, Disaster and Pandemic
Authors: Clodfelter Kayla , Mailey Brian , Hassanein Aladdin 
Published: December 2020

Introduction and Objectives: Mass casualties from modern warfare in World War I and advancements in medicine resulted in survivors with deformities. The field of Plastic Surgery developed from a need to reconstruct soft tissue injuries in these soldiers. Wars and disasters provide unique situations which push the development of new techniques that impact the field. The objective of this work was to identify innovations in plastic surgery that emerged from disasters.

Project Methods: The PubMed and Ovid databases were searched for articles documenting origination of plastic surgery ideas during a disaster with the terms “disaster”, “war”, “plastic”, “burn”, “terror”, and/or “novel”. Types of disasters considered include: war, terrorism, accident and natural disaster. Articles were included if they discussed novel therapies published emerging from a disaster.

Results: Twenty-one articles meeting inclusion criteria. Eleven papers described innovations during war including use of k-wires in hand fractures, gender affirmation surgery, delayed wound closure, cleft lip repair, vascular repair of acute trauma, sulfamylon antibiotics, and portable vacuum-assisted-closure (VAC) devices. Two articles resulted in surgical staff collaboration modeling and rapid recruitment from terrorist attacks. Five manuscripts defined accidents that brought about ideas of cultured epithelial autografts, VAC for burns, and targeted muscle reinnervation to decrease chronic pain in amputees. Natural disasters that caused change were depicted in three articles discussing adequate burn treatments for resource poor areas and using telemedicine for outpatient care and academic meetings.

Conclusions and Potential Impact: The field of Plastic Surgery continues to advance from innovations developed during disasters. Our study found war resulted in the greatest novel advancements. Terrorism and natural disasters have emerged as sparking innovation during the last few decades. Physicians should be encouraged to look for opportunities of innovation using their ingenuity when faced with disaster. What progress will COVID-19 bring?
Reproducibility of Three-Dimensional Retinal Organoids as In Vitro Models of Human Retinal Development and Organization
Authors: Feder Elyse , Harkin Jade , Meyer Jason 
Published: December 2020

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

Background and Hypothesis:
The prevalence of food allergies continues to rise. In a mouse model, food allergy to peanuts develops in flaky tail mice with skin barrier mutations and exposure to peanut (PNE) and Alternaria Alternata (fungal allergen, Alt) on the skin. In the skin, keratinocytes respond to proteases in allergens through protease activating receptor 1 (PAR1). Blocking PAR1 decreased the severity of viral induced inflammation in mice. Whether PAR1 has a major role in food allergies has not been investigated. We tested the hypothesis that blocking PAR1 would halt the development of food allergy to peanuts in neonatal mice.

Project Methods:
In our studies, pups were injected intradermally (i.d.) with a PAR1 antagonist and then treated with PNE/Alt. In another group, pups received i.d. injections of a PAR1 agonist and then treated with PNE only. Control groups received allergens only. Pups were treated and skin sensitized 5 times every 3-4 days. Forty-eight hours after the last treatment, pups were challenged with PNE through oral gavage, and temperatures were recorded every 15-30 minutes for 3 hours. Skin, ileum, and jejunum samples were collected and used for qPCR to determine the expression of inflammatory mediators. Plasma serum was used for analysis of anti-PNE specific antibodies by ELISA.

Results:
PAR1 antagonist blocked anaphylaxis in allergic mice sensitized with PNE and Alt. PAR1 agonist is sufficient to induce anaphylaxis in mice sensitized with PNE only.

Conclusion and Potential Impact:
This study demonstrates that PAR1 is involved in the development of food allergies, where blocking the receptor blocked food allergies in neonatal mice. The signaling mechanisms and activators of PAR1 need further studies, using PAR1 deficient mice. This novel pathway may lead to therapies to stop the development of food allergies.
Resting State Functional MRI in Neonates with Prenatal Opioid Exposure: Analysis of Thalamocortical Functional Connectivity
Authors: Guckien Zoe , Dietrich Jonathan , Vishnubhotla Ramana , Picklesimer MaKayla , Sparks Christina , Haas David , Sadhasivam Senthilkumar , Radhakrishnan Rupa 
Published: December 2020

Background/Objective: Prenatal opioid exposure (POE) is a growing public health issue that can result in premature birth, Neonatal Abstinence Syndrome (NAS), and adverse neurodevelopmental outcomes. However, the neural basis for these findings remains relatively unknown. In this study, we aimed to investigate the neural correlates of POE based on neonatal thalamocortical functional connectivity using resting state functional magnetic resonance imaging (rs-fMRI).

Methods: In this prospective, IRB-approved study, nineteen neonates with POE and twenty opioid naive (ON) controls underwent non-invasive MRI during natural sleep at mean post-menstrual age (PMA) of 44.7 ± 2.6 and 44.6 ± 2.6 weeks respectively. MR imaging included anatomic T2-weighted images and rs-fMRI. General Linear Model (GLM) seed-based whole brain functional connectivity analysis was performed for each subject, with the right and left thalamus as distinct seed regions. Unpaired mixed-effects group analyses between POE and ON groups were conducted for each seed region corrected for PMA and sex.

Results: Thalamic connectivity to cortical and subcortical structures differed in the POE group compared to the ON control group. The POE group exhibited higher functional connectivity to deep gray structures, frontal, medial prefrontal, parietal, occipital, and anterior temporal cortices compared to controls. The POE group exhibited lower connectivity to the nuclei accumbentes, bilateral caudate nuclei, posterior cingulate gyri, superior frontal gyri, insular, and dorsolateral prefrontal cortices.

Conclusion and Potential Impact: Overall, these novel results suggest the presence of opioid exposure-related alterations in thalamic functional connectivity. Given that the thalamus plays a crucial role in early brain development, the described alterations in thalamocortical and thalamic-subcortical connectivity may have implications in stratifying risk and informing treatment for the adverse neurodevelopmental outcomes associated with POE. Future studies should explore the relationship between POE-associated disruptions in thalamic connectivity and developmental outcomes.