51886 research outputs found
Sort by
Unlocking Conversations: Using Picture Books as Tools for Tackling Tough Topics
No full textPicture books are powerful tools that give children and adults an accessible way to approach challenging topics such as race, identity, and other societal issues. This presentation will explore how picture books can jumpstart difficult conversations as an entry point for discussions that foster empathy, understanding, and social-emotional growth. This talk will highlight how parents, educators, and librarians can use picture books to facilitate meaningful dialogue around real-world issues. In the current climate of book banning, it is more vital than ever to recognize how culturally relevant picture books can support the social-emotional development of young readers
Real world implementation of blood biomarkers in primary care
No full textPrimary Care (PC) clinicians are faced with numerous competing demands and priorities for maximizing patient care. These challenges make the implementation of strategies for early detection of Alzheimer’s Disease (AD) complex. Few real‐world implementation projects about early detection of AD in PC exist. From 2022‐2023 the Davos Alzheimer’s Collaborative (DAC) Health System Preparedness Flagship project included seven United States academic affiliated PC clinics. We implemented digital cognitive assessments using the Linus Health Core Cognitive Evaluation at routine PC encounters. Patients who failed the cognitive assessment were offered, as part of a research pilot, C2N Diagnostics’ blood biomarker (BBM) test, PrecivityAD, with results disclosure. PCPs were approached to receive education about BBM for AD and to consent to deliver results themselves or defer delivery to the research team. Of the patients approached for BBM, more than half declined. Providers were split on their willingness to deliver results. For patients whose provider did not elect to deliver results or who was unable to deliver results in the timeframe needed, a trained Registered Nurse was trained and observed to disclose results. This session will share perspectives on these real‐life facilitators and barriers to implementing cognitive screening and BBM in PC and how more fully engaging the whole primary care team may help mitigate some of these barriers
Presidents and Chairman of the Board for the James Whitcomb Riley Memorial Association and Riley Children’s Foundation, 1920-2025
No full textPGI2 signaling metabolically reprograms CD4 Th2 cells and represses allergic airway inflammation
No full textProstaglandin I2 (PGI2) is a lipid mediator known to inhibit T helper 2 (Th2) immune responses and allergic inflammation, but its role in regulating Th2 cell metabolism remains underexplored. Using the Seahorse assay, we evaluated the effects of PGI2 signaling on Th2 cell glycolysis and mitochondrial respiration. Our results show that cicaprost, a stable PGI2 analog, significantly reduced basal, maximal, and spare glycolytic capacities in wild-type Th2 cells, while these effects are absent in Th2 cells lacking the PGI2 IP receptor (IP knockout [KO]). Cicaprost also impaired mitochondrial respiration and adenosine triphosphate production in wild-type Th2 cells, but not in IP KO cells, indicating that PGI2 signaling is essential for these metabolic changes. Further analysis revealed that cicaprost decreased glucose transporter 1 expression and glucose uptake and inhibited mitochondrial mass and membrane potential, suggesting that PGI2 signaling inhibits Th2 cell metabolism by reducing glucose availability and mitochondrial respiratory functions. Metabolomic profiling of cicaprost-treated Th2 cells showed dose-dependent changes, with 126 downregulated and 233 upregulated metabolites showing over 2-fold significant changes compared with vehicle-treated cells. Pathway analysis of these altered metabolites suggests a shift from catabolism to anabolism in cicaprost-treated Th2 cells. In vivo, CD4-specific conditional IP KO mice (CD4Cre+IPflox) exhibited exacerbated lung inflammation following exposure to Alternaria alternata extract, marked by increased IL-5 and IL-13 production, enhanced eosinophilia, and elevated mucus production. These findings establish a mechanistic link between PGI2-mediated immunoregulation and metabolic reprogramming, reinforcing its role as a key modulator of allergic inflammation
State of Indiana's Health Workforce 2025 Report
No full textThis report, prepared by the Indiana Professional Licensing Agency in collaboration with the Bowen Center for Health Workforce Research and Policy, provides an overview of Indiana’s health workforce as of 2025. It compiles licensure data and supplemental information collected during the 2023–2024 biennial license renewal process, as mandated by IC 25-1-2-10
Return to Activity for On- and Off-Label Cervical Arthroplasty Patients: A Multicentered Expert Panel Recommendation
No full textBackground: Artificial disc replacement (ADR) has become an evidence-based alternative to traditional fusion surgery. Current guidelines for safe return-to-activity (RTA) levels following surgery have yet to be determined. This Modified Delphi study aimed to establish expert-sourced consensus for safe and optimized RTA recommendations following cervical disc arthroplasty.
Methods: Ten expert spine surgeons with an average of 15 years of surgical experience participated in a 3-round Modified Delphi Method. The first round presented experts with 11 clinical cases and 19 multiple-choice questions regarding recommendations for patient RTA following surgery for 1-, 2-, or 3-level arthroplasty. First-round responses were analyzed and presented in second-round surveys to the experts, who repeated 19 multiple-choice questions. The third round presented consensus recommendation statements derived from the second round for the final assessment of the expert agreement.
Results: Experts agreed on 19 of 22 (86.4%) postarthroplasty RTA recommendations. Eight recommendations achieved unanimous agreement; the most robust consensus (95%-100% agreement) included recommendations that patients may return to basic activities such as walking, social activities, sedentary work, air travel, and sexual activity within 2 weeks of arthroplasty surgery and that arthroplasty patients will have a shorter recovery, resuming normal activities sooner than fusion patients. Experts agreed that patients may return to light and heavy physical activity (strong consensus) earlier for 2- and 3-level ADR compared to hybrid constructs. Experts also agreed that ADR patients can resume light physical activity at 4 to 6 weeks and engage in intense conditioning and sport-specific training at 6 weeks. However, a weaker consensus was achieved for returning to physically demanding work at 4 to 6 weeks and high-intensity physical activity/sports at 6 weeks, indicating that individual patient factors and the specific nature of the activity should be considered.
Conclusion: This study provides the first consensus-based recommendations for RTA following cervical disc arthroplasty
Concurrent Bilateral M1 and Anodal Cerebellar tDCS Effects on Learning of a Bimanual Video Game Task
No full textPurpose: The primary motor cortex (M1) and the cerebellum are important sites of processing for motor learning of complex, bimanual tasks. However, little is known about the current and polarity effects of transcranial direct current stimulation (tDCS) when applied concurrently to these sites during learning. Therefore, the present study sought to examine the effect of bilateral primary motor cortex (M1) anodal tDCS coupled with anodal cerebellar tDCS (biM1a + CBa) on learning of a bimanual racing videogame.
Method: Forty-six subjects were enrolled and received either biM1a + CBa (n = 23) or biM1a + CBsham (n = 23) stimulation for a single practice session. Additional data from a previous study in our lab using bilateral primary motor cortex (M1) anodal tDCS coupled with cathodal cerebellar tDCS (biM1a + CBc, n = 21) and a SHAM condition (n = 20) was included in our analysis. Videogame performance was assessed before and after the practice session, and a follow-up assessment took place 24 h later.
Finding: Learning and previous gaming experience were negatively correlated, so experience was included as a covariant in the analysis of results. Consistent with the current literature, simultaneous tDCS of both motor cortices, without any cerebellar stimulation, improved learning the most within a single day (p = 0.025). No significant retention effects were observed for any of the conditions (p = 0.87).
Conclusion: These results reinforce the benefits of tDCS to M1 and that, at least in the video game task used in this study, cerebellar stimulation does not add to the learning effect. When using multifocal stimulation montages, careful consideration needs to be given to the relationship between electrode placement, task specificity, previous experience, and individual differences of the participants
A novel deep learning model with transformer architectures to enable multi‐scale whole genome sequence analysis for Alzheimer's disease dementia prediction
No full textBackground:
The importance of early prediction of Alzheimer's disease (AD) is emerging, and a genomic approach provides a promising path to this goal. One limitation is the high dimensionality of genomic data, which remains incompletely understood. Deep learning (DL) models hold potential for processing and interpreting such complex data. This study aimed to develop a novel DL model using a transformer architecture for predicting AD dementia based solely on whole genome sequencing (WGS) data.
Method:
We analyzed 1,050 WGS data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) and ADNI‐WGS‐2 with the Alzheimer's Disease Sequencing Project Follow‐Up Study (ADSP‐FUS1‐ADNI‐WGS‐2) (443 cognitively normal; 607 AD dementia). A 1,000,000 base pair segment of WGS data surrounding the APOE gene on chromosome 19 was utilized. Our DL model comprised three steps: (1) Window‐based step: calculation of attention scores using windowed WGS data. (2) Annotation‐enhanced step: analysis of attention scores across multiple layers of selected SNPs, incorporating annotated information to capture distant‐range influences, and generate global attention weights. (3) Prediction performance enhancement using graph convolutional network (GCN): a graph with key SNPs from the previous steps and their relationships was analyzed by GCN to enhance performance. The area under curves (AUCs) for AD dementia prediction from the window‐based step (local relationship patterns) and the entire model (integrating local and distant‐range relationships) were compared. Key SNPs relevant to ADD prediction were identified.
Results:
The window‐based step using 40bp‐sized windows yielded limited accuracy (AUC = 0.53), while the complete model showed significant improvement (AUC = 0.68). Among the top 25 SNPs identified via feature importance scores from the complete model, 9 were newly discovered compared to the SNPs from the window‐based step. Key SNPs included rs429358, rs120074114, rs120074111, and rs5122 located in APOE or APOC genes.
Conclusion:
Our DL model enabled multi‐scale analysis of WGS data and improved AD dementia prediction accuracy using WGS data and identified different significant SNPs by integrating local and distant‐range relationships. This study investigated the potential of DL‐based models with transformer architecture in early prediction of AD and established a foundation for efficiently processing WGS data
Novel Technique for Suture Suspension Arthroplasty of the Thumb Carpometacarpal Joint Using the Locking “Nice” Knot
No full textOsteoarthritis (OA) of the first carpometacarpal (CMC) joint is common and often presents as pain, weakness, or sense of instability in the joint. A common surgical technique for treatment is the suture suspension arthroplasty, which was first described in 2009 by DelSignore et al. with successful long term follow up reported in 2023. This technique involves piercing the flexor carpi radialis (FCR) tendon, which poses a risk of tendon rupture. Many adjustments to the original technique have been proposed, including modified suture patterns, suture buttons, and awake surgeries to avoid overtightening. The purpose of this paper is to discuss a novel modification to the original technique that eliminates the need to pierce the FCR tendon by utilizing the “Nice” knot. We believe this technique decreases rates of FCR rupture and also decreases surgical cost and time, which is important in today's value-based healthcare
landscape. Follow-up is needed to determine if these claims are true. Next, we plan to conduct a retrospective chart review to determine if this new technique truly leads to lower rates of FCR tendon rupture, decreased operative time, and decreased patient costs