bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot Study to investigate Home Potassium testing in Heart Failure
Authors: Jakupco Nicholas , Nwaneri Francis , Mirro Michael 
Published: December 2020

Background and hypothesis: Heart failure (HF) is one of the leading causes of death in the United States. Normal potassium range is 3.5 to 5 mEq/L. Low potassium level is associated with fatal dysrhythmia, and elevated potassium levels result in slow cardiac rhythms and asystole. Current venipuncture methods used for potassium testing are complicated with hemolysis, which create false potassium results. Our study objective is assessing the effectiveness of an at home device that would enable HF patients to test potassium levels frequently to avoid any complications as it relates to dyskalemia. We hypothesize that by utilizing a home testing solution, patients can develop a home HF management strategy to improve health outcomes.

Experimental Design or Project Methods: Patients diagnosed with HF will be recruited from Parkview Physicians Group – Cardiology. A venipuncture and a finger stick sample will be collected simultaneously, and their serum potassium levels will be analyzed. Venipuncture blood will be analyzed by ion-selective electrode (ISE) and flame photometry analyses. Finger stick blood will be analyzed by a novel Blaire Biomedical device. Surveys about the device will be given to both patients and clinicians. Linear regressions comparing the Blaire Biomedical results to both the ISE and flame photometry results will be created.

Results: The r-values for the regressions will be analyzed. An r-value close to 1 would indicate that the results are directly correlated and clinically equivalent. Results of the surveys will be used to gauge interest in the device.

Conclusion and Potential Impact: This study will establish a more efficient way for HF patients to measure potassium levels and ensure levels stay in the range of 3.5 to 5 mEq/L. This device will assist in reducing potassium imbalance complications, which will translate to a decrease in mortality in HF patients as it relates to dyskalemia.
Efficacy of EGFR TKI Targeted Therapy versus TKI in Combination with Chemotherapy in Non-Small-Cell Lung Cancer
Authors: Johnston Alaina , Komiya Takefumi 
Published: December 2020

Background and Hypothesis:
Non-Small Cell Lung Cancer (NSCLC) constitutes the largest proportion of lung cancers and is the foremost cause of mortality associated with cancer around the world. Of patients with non-small cell lung cancer, approximately 15% of Caucasians and 30% of Asians have activating mutations in the epidermal growth factor receptor (EGFR) gene. Numerous studies have indicated increased progression free survival after treatment with tyrosine kinase inhibitors (TKI). However, the most efficacious combination of drugs, whether TKIs, chemotherapy, or anti-angiogenesis, is still unknown. This literature review will be constructed to determine whether tyrosine kinase inhibitor targeted therapy in combination with chemotherapy or anti-angiogenesis drugs is more effective in prolonging progression free survival in EGFR-mutated NSCLC as opposed to tyrosine kinase inhibitor targeted therapy alone.

Project Methods:
The methodology of this proposed literature review is an online search of PubMed, Journal of Clinical Oncology, and important scientific conferences. The treatment interventions consist of tyrosine kinase inhibitor targeted therapy in combination with chemotherapy and tyrosine kinase inhibitor targeted therapy alone. The projected outcome is an increase in progression free survival and overall survival. The proposed data analysis consists of constructing a forest plot in order to display the results.

Results:
The results are expected to support the hypothesis, that combination treatment with TKI and chemotherapy will allow patients with an opportunity to prolong their progression-free survival. The forest plot is expected to indicate a progression-free survival hazard ratio that favors combination therapy. P-values will be included to indicate statistically significant results.

Conclusion and Potential Impact:
The importance of finding the answer to this hypothesis is that it will improve treatment outcomes for patients with NSCLC. It will provide patients with a strong alternative to chemotherapy or tyrosine kinase inhibitor therapy alone. Most importantly, it will provide patients with an avenue to increase their progression-free survival.
Effects of Vegan and Ketogenic Diet Plans on Hemoglobin A1c Levels in Type 2 Diabetes
Authors: Jones Kimberly , Jefferson Erin , Henriksen Brian 
Published: December 2020

Background/Objective: Type 2 diabetes affects 8.5% of adults over the age of 18 and costs the United States an average of 327 billion dollars per year. Two diets, the ketogenic diet and the vegan diet have both been shown to promote weight loss as well as reduce A1c’s in individuals with type 2 diabetes. Ketogenic diets are best defined as high fat, low carbohydrate diets that induce a state of nutritional ketosis. Vegan diets are centered around the consumption of legumes, fruits, vegetables, and whole grains. All animal-derived products including gelatin are avoided. The primary goal of this study is to determine whether the vegan diet is non-inferior to the ketogenic diet in the reduction of hemoglobin A1c levels in adults with type 2 diabetes.

Methods: A total of 120 participants between the ages of 18 and 70 who have an A1c between 6.5 and 10.0 will randomly be assigned to either the vegan or ketogenic diet groups. Dietary interventions will be implemented for a total of 24 weeks. Hemoglobin A1c levels will be measured at weeks 0, 12, and 24 and values will be compared using the repeated-measures analysis of variance test to determine if there is a significant difference between groups.
Expected results: It is expected that both groups will experience a decrease in their hemoglobin A1c levels, but that a more significant reduction will occur in those following the vegan diet. Weight loss is also an anticipated side effect in both groups.
Conclusion/Potential impact: This study has the potential to provide individuals with a more cost-effective management strategy to medication therapy in type 2 diabetes. Choosing to adopt healthier dietary practices will ultimately lead to better blood glucose control and a lower likelihood of developing diabetic complications.
Review of Fracture Healing and Outcomes Assessment
Authors: Knoximprs Adam , McGuire Anthony , Collier Christopher , Kacena Melissa , Natoli Roman 
Published: December 2020

Background/Objective: Long bone fractures are of the most common and costly medical traumas humans experience. Adequate characterization of the fracture healing process and development of potential medical interventions generally involves fracture induction operations on animal models of varying treatment or genetic groups, then analyzing relative repair success via synthesis of diverse assessment methodologies. This review discusses the procedures, relevant parameters, special considerations, and key correlations of these major methodologies of fracture repair quantification.
Methods: A literature review was conducted for articles discussing the procedures or identifying correlations between each of the major fracture healing assessment methodologies.
Results: These methodologies include biomechanical testing, which provides the most direct quantification of skeletal functionality; micro-computed tomography, which enables high resolution visualization of fracture callus architecture; histology which helps elucidate the intricate processes underlying fracture repair; and x-ray which offers a non-invasive and clinically relevant view of fracture repair progress. Each of these methodologies measure parameters directly correlating to restored functionality of fractured bone.
Conclusion: When appropriately integrated, synthesis of relevant parameters from each methodology of fracture repair assessment enables a comprehensive understanding of varying fracture healing outcomes and associated causalities.
Scientific/Clinical Policy Impact and Implications: This review may guide the interpretation and planning of fracture healing studies utilizing murine models.
Are Diabetic Older Adults Equally Satisfied with Remote Consultation vs. Face to Face Consultation?
Authors: Lanie Shelby , Jefferson Erin , Henriksen Brian 
Published: December 2020

Background and Hypothesis:
The COVID-19 pandemic has likely made remote consultation (RC) a permanent part of healthcare. Older adults could greatly benefit from RC, and current literature indicates older adults are equally satisfied with RC vs. face to face consultation (FTFC). However, there is selection bias in the literature towards adults who feel comfortable enrolling in a technology study. We hope to fill this dearth by surveying diabetic older adults who were strongly encouraged by their physicians to utilize RC during the COVID-19 quarantine. We hypothesize older adults will be less satisfied by RC vs. FTFC.

Experimental Design or Project Methods:
We propose a retrospective case control cross-sectional telephone survey (data collected in RedCap) examining satisfaction with consultation in diabetic older adults who received care via RC during the spring 2020 COVID-19 quarantine. We will compare the RC condition to the FTFC sample (appointments that occurred before quarantine) using an unpaired t test. We also propose measuring commute time/distance and hearing difficulty as possible mediating factors on satisfaction, analyzed with a regression analysis and a chi square analysis respectively

Results:
We expect to see lower satisfaction rates in the RC vs. the FTFC condition. However, we expect this effect to be mediated by patients’ typical commute time/distance to their clinic. We also expect to see lower rates of satisfaction in the RC condition than the FTFC condition for patients with hearing difficulty.

Conclusion and Potential Impact:
The population is continuing to age, suffering from increased rates of diabetes and other chronic conditions that require more frequent, and more burdensome appointments. While RC has incredible potential to help older adults keep important appointments, their satisfaction is an integral part of successful care. This study could help dictate clinical decisions by informing providers and patients on older adults’ satisfaction with RC.
Changes in Cardiovascular Structure and Physiology Following Polystyrene Nanoparticle Exposure
Authors: Lett Zachary , Skidmore Shelby , Alves Nathan 
Published: December 2020

Background
Microplastic (MP) pollution has been a growing concern in recent decades due to the proliferation and ease of manufacturing regarding plastics products. Polystyrene (PS), being one the most abundant plastic polymers, is the subject of frequent studies due to its ubiquitous nature. Trophic transfer, inhalation, and dermal exposure are all routes by which humans may be exposed to MPs every day. There are undoubtedly more physiological consequences than we are currently aware of; however, many of these concerns are beginning to be better understood. Their distribution throughout the body dictates the potential threats to human health. The cardiovascular system is potentially the most susceptible, as it is the first medium the MPs are exposed to after entering the body. Consequently, the cardiovascular system and thrombus generation is one such area where much recent attention has been allocated.
Project Methods
Data was gathered from a variety of well-established research articles to review the relationship between PS exposure and thrombus formation in vivo. Additionally, this review looks at documented effects of MPs on platelet aggregation and discusses mechanisms through which these pathologies take place.
Results
PS plastics have varying impact on thrombus formation contingent upon both surface modifications and particle size. Aminated PS appears to be the most potent regarding the generation of thrombi in vivo. Literature on platelet aggregation is more consistent, with most studies revealing that carboxylated and aminated forms enhance aggregation while unmodified PS had insignificant effects.
Conclusion/Potential Impact
There is substantial ambiguity surrounding this field and more studies need to be conducted to reveal the full extent of pathologies caused by PS microplastics. Most studies have been done with marine life, which may not accurately reflect MPs effects in humans. Further research will allow us to begin developing viable solutions for those most susceptible to cardiovascular diseases.
Skeletal Muscle Atrophy in Chronic Kidney Disease (CKD)
Authors: Perez Javier , Moe Sharon , Chen Neal , Avin Keith 
Published: December 2020

Background:
Skeletal muscle atrophy and dysfunction occur with chronic kidney disease (CKD) progression leading to morbidity, mortality, and falls. Skeletal muscle dysfunction may be due to impaired fatty acid (FA) oxidation and enhanced pyruvate oxidation as demonstrated in preliminary metabolomic data. We performed multiple techniques to assess the extent of muscle dysfunction and associated pathways, including: systematic review and meta-analysis, assays of disease progression and FA metabolism, expression of markers associated with skeletal muscle FA metabolism and pyruvate oxidation.

Methods:
Meta-analysis: Multiple databases were used to identify relevant studies of muscle atrophy in preclinical and clinical models.
Experimental Study: 1)CKD rats and 2)Normal littermates (N=12/gr) at 35 weeks. Extensor digitorum longus (EDL) and soleus were harvested at sacrifice. Serum Biochemistry: Plasma BUN, calcium and phosphorus were analyzed using colorimetric assays. Carnitine Assay: Plasma carnitine levels was measured using ELISA kit. Protein Expression: Western blots with the lysate of EDL and soleus to determine the activity levels of PDH and PDK4.

Results:
A total of 4685 studies were screened in the meta-analysis, of which 646 were relevant. Subsequent steps are to perform full text review and data extraction. Animal studies: BUN and phosphorus were significantly increased in CKD compared to normal. Carnitine levels were significantly decreased in CKD rats compared to normal. PDH was not significantly different in the EDL or soleus. PDK4 is yet to be performed.

Conclusions:
The extent to which muscle atrophy occurs will be identified in the meta-analysis. Elevated BUN confirmed disease and carnitine assay confirmed low carnitine levels in CKD. Identifying low carnitine has led to an interventional study of carnitine supplementation to determine if there was improved FA oxidation. Testing of PDK4 is needed to determine significance of pyruvate regulation. Reviewing the literature and understanding the mechanism of skeletal muscle atrophy in CKD will allow future targeted therapeutics.
Determination of Fetal Spinal Cord Measurement for Every Gestation Age
Authors: Qureshi Hamna , Marine Megan Beth , Supakal Nucharin , Forbes-Amrhein Monica 
Published: December 2020

Background and Hypothesis:
Tethered spinal cord is challenging to identify in fetuses. If untreated, tethered spinal cord can result in neurologic weakness and sensory loss in the lower half of the body. The goal of this study is to develop a library of normal ratios of the position of the conus medullaris relative to the spinal canal from normal fetal magnetic resonance imaging (MRI) examinations at each gestation age. This will allow for early identification of tethered spinal cord and timely intervention. We hypothesize that the ratios will decrease throughout pregnancy as the level of the conus medullaris rises.
Experimental Design or Project Methods:
In this pilot study, a retrospective review of fetal MRIs from patients between 20-38 weeks gestation age were examined. Exclusion criteria included fetuses with fetal spinal or central nervous system anomalies, VACTERL, ventral wall defects, scoliosis, and sacrococcygeal teratoma. The length from the fetal obex to the conus medullaris was measured and defined as the spinal cord length. The length of the obex to the caudal thecal sac was defined as the spinal canal length. The ratio of the spinal cord length to the spinal canal length was calculated. The ratios at each gestation age were compared using ANOVA (p < 0.05).
Results:
A total of 225 patients were reviewed. We observed a statistically significant decreasing trend in fetal spinal ratios from 20-38 weeks of gestation age. The average ratio at 20 weeks gestation age is 0.756 and at 38 weeks is 0.696.
Conclusion and Potential Impact:
This retrospective pilot study of fetal MRIs will establish reference values for the ratio of spinal cord to spinal canal lengths at progressing gestation ages. Ultimately, these ratios can establish normal values for identification of tethered spinal cord during the fetal period, thereby allowing early intervention to mitigate complications.
Symptoms of Anxiety and Depression Among Community Dwelling Older Adults: Impact of Covid-19
Authors: Seibert Tara , Perkins Anthony , Fowler Nicole 
Published: December 2020

Background and Hypothesis:
Symptoms of anxiety and depression are prevalent in adults age 65 and older. Numerous factors impact the mental health of older adults including changes in overall health, isolation, and financial stress. Emotional support reduces the risk of mental illness. 12.2% of adults 65 and older “rarely” or “never” receive the social and emotional support they need. We hypothesize that the Covid-19 pandemic and associated shelter in place orders will increase symptoms of anxiety and depression in community dwelling older adults.

Methods:
We conducted a secondary analysis of data collected pre and post Covid-19 from a sample in Indiana from the Caregiver Outcomes of Alzheimer’s Disease Screening Trial (COADS) and a national sample from the Understanding America Study (UAS). 1,299 and 2,465 adults age 65 and older from Indiana and a nationwide sample, respectively, answered the Patient Health Questionnaire-4 (PHQ-4). The PHQ-4 is a validated 4-item screening tool for symptoms of anxiety and depression. Mean PHQ-4 scores were compared pre and post Covid-19 for both samples to explore the impact of Covid-19 on symptoms of anxiety and depression in this population.

Results:
No significant change in PHQ-4 scores pre and post Covid-19 were observed between the Indiana (1.23, 1.13, p-value=0.474) or the national samples (1.38, 1.35, p-value=0.793). An increase was observed in national depression scores, determined by a PHQ-4 subset score, post Covid-19 compared to pre Covid-19, but not statistically significantly higher (0.54, 0.56, p-value=0.679).

Conclusions and Implications:
In a sample of 3,764 participants, the mental health of adults age 65 and older nationwide remained steady despite unprecedented pandemic and social isolation. The mental health of older adults is known to be an important topic and the potential for the pandemic to exacerbate symptoms of anxiety or depression makes this a critical issue for both clinicians and researchers.
Cutaneous Manifestations of COVID-19: A Systematic Review
Authors: Singh Harjas , Kaur Harleen , Singh Kanhaiya , Sen Chandan 
Published: December 2020

Background: Coronavirus Disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), is currently a pandemic. Although pulmonary health has been the primary focus of studies during the early days of COVID-19, development of a comprehensive understanding of this emergent disease requires knowledge of all possible disease manifestations in affected patients.

Methods: This PRISMA-compliant review focuses on cutaneous manifestations reported in COVID-19 patients. Literature review was conducted using the PubMed database to examine various cutaneous manifestations related to the SARS-CoV-2 infection. Published articles related to search criteria from the onset of the COVID-19 pandemic to June 30, 2020 were included. In total 56 articles were used for data collection.

Results: Unique to many other symptoms of COVID-19, its cutaneous manifestations have been found in people of all age groups including children. The cutaneous manifestations of COVID-19 are varied and include maculopapular, chilblain-like, urticarial, vesicular, livedoid, and petechial lesions. In addition, rashes are common in multisystem inflammatory syndrome in children (MIS-C), a new and serious health condition that shares symptoms with Kawasaki disease and is likely related to COVID-19. Lastly, personal protective equipment (PPE)-related skin complications are of serious concern since broken cutaneous barriers can create an opening for potential COVID-19 infections and by inadvertently spreading the virus.

Conclusion and Potential Impact: As this virus continues to spread silently, mainly through asymptomatic carriers, an accurate and rapid identification of these cutaneous manifestations may be vital to early diagnosis and lead to possible better prognosis in COVID-19 patients. This systematic review provides a detailed analysis on the changes in skin morphology related to COVID-19 and discusses plausible underlying molecular mechanisms. Study of these cutaneous manifestations, their pathogenesis as well their significance in human health will help define COVID-19 in its entirety which is a prerequisite to its effective management.
The Effects of Multiple Exposure Ethanol on Barrier Tightness and Passive Permeability in a Human Stem Cell Derived Blood-Brain Barrier Model.
Authors: Stoffel Ryan , Bell Kameron , Canfield Scott 
Published: December 2020

Background and Hypothesis:
Numerous animal studies have shown the negative aspects of ethanol at sustained concentrations as well as the intense depressive effects of multiple ethanol exposures on the central nervous system. Chronic ethanol use as a possible contributor to earlier onset neurocognitive decline has been indicated. A portion of these studies have implicated that ethanol exposure induces blood-brain barrier (BBB) impairment; however, these effects are not completely understood. In humans the BBB serves as a protective barrier that restricts the passage of nutrients, metabolites, and pathogens into the central nervous system from the blood and is essential in protecting the brain tissue from harmful substances. We hypothesize that multiple doses of pathologically-relevant ethanol will cause decreased BBB tightness and increase passive permeability.
Experimental Design:
In this study, we utilized brain microvascular endothelial cells (BMECs) derived from human induced pluripotent stem cells (iPSCs) to assess the effects ethanol has on barrier tightness and passive permeability through the BBB. BMECs were treated with multiple exposures of 50mM ethanol and transendothelial electrical resistance and sodium fluorescein permeabilities were measured. Trolox, a free radical scavenger, was used to identify if ethanol-induced barrier damage could be salvaged by reducing its oxidative impact.
Results:
Upon multiple exposure treatment with ethanol, iPSC-derived BMECs displayed diminished transendothelial electrical resistance and elevated sodium fluorescein permeability when compared to non-treated BMECs. Additionally, BMECs that were treated simultaneously with Trolox and ethanol had reduced barrier damage compared to ethanol treatment alone.
Conclusion and Potential Impact:
From these results, we conclude that multiple ethanol exposure-induced barrier damage in iPSC-derived BMECs, is in part due to elevated oxidative stress. Disruption of the BBB can potentiate a number of negative effects on the brain parenchyma and can lead to earlier onset neurocognitive decline. Alcohol’s impact on the BBB must be studied to ensure we limit these effects.