Open Access Journals at IU Indianapolis
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Assessing Mouse Model Based Femur mRUST Scores via Intelligent Fracture Detection and Deep Learning Neural Networks
Full text linkBone fractures are a major issue worldwide. Beyond the physical affects, fractures may result in substantial economic burden due to hospitalization costs, surgical procedures, and rehabilitation. Modified Radiographic Union Score for Tibia fractures (mRUST) is a method for evaluating longbone fracture healing in humans using plain radiographs. Preliminary data from mRUST scored femoral midshaft mouse femurs proved the utility of mRUST in murine models. While mRUST is a reliable technique, it can be a time consuming and labor-intensive process. Additionally, there are concerns about inter-rater reliability. Radiographs are taken twice weekly for 42 days, and each radiograph must be prepared by cropping the image to include the femurs only for assessment. We proposed that artificial intelligence (AI) can be used to expedite the scoring of radiographic images and create uniformity throughout the process to enhance the consistency of the analysis of mRUST scores and produce results faster than humans. Using an AI/machine learning (ML) algorithm we allowed AI to analyze femoral shaft fracture radiographs that previously received an mRUST score by our orthopaedic surgeons. Following analysis, mRUST scores generated from AI were compared to the scores generated from the orthopaedic surgeons. Results indicated that the mRUST scores generated by AI matched the scores produced by the surgeons with 96% accuracy. Based on these findings, our team was able to enhance the production of mRUST scores by limiting the time that is required to score radiographs. Future studies will determine whether comparable results can be obtained for different skeletal sites and with human x-rays. Eventually, we hope to predict early after surgery who is likely to heal or go on to nonunion. Early intervention could substantially decrease pain, morbidity, and healthcare costs
Development of a Fitting Algorithm and Mobile Application for Portable Electrochemical Impedance Spectroscopy
Full text linkIntroduction: Electrochemical impedance spectroscopy (EIS) is a technique that utilizes alternating-current (AC) signals for analyzing charge transfer and chemical reaction kinetics. This technique has several clinical applications including biomolecular detection. While many potentiostats have been developed to make EIS more accessible, such as HELPStat, current portable potentiostat designs with EIS capabilities rely on external hardware for control of the device or for data analysis, limiting designs to non-portable applications.
Methods: To address this issue, a Levenberg-Marquardt fitting algorithm was implemented in the HELPStat firmware, allowing approximation of charge transfer resistance from empirical impedance measurements. The developed algorithm was compared to a MATLAB script, and both were evaluated using impedance data for ideal Randles circuits as well as potassium ferricyanide and cortisol aptamer binding Redox reactions. Results were analyzed using paired t-tests comparing absolute value of residuals and root-mean-squared-error (RMSE). In addition, an Android application was developed to perform bidirectional communication between the HELPStat potentiostat and a mobile device using Bluetooth Low-Energy (BLE), with a serial monitor being used to confirm that potentiostat measurements were being configured as expected.
Results: Testing of the fitting algorithm demonstrated a statistically significant difference between the developed algorithm and a similar MATLAB implementation. Further analysis revealed that the developed fitting algorithm had statistically comparable or lower errors. In addition, testing with a cortisol aptamer was able to successfully differentiate between 1.5 ng/ml and 7 ng/ml samples of cortisol. By developing a novel Android application and enabling true wireless functionality through BLE, we enable a better bridge of communication between user and device.
Conclusion: We developed a fitting algorithm in device firmware along with a novel Android application that allows device control and data analysis with the HELPStat potentiostat. By implementing this without dependence on external hardware, we enable device portability for point-of-care applications
Glaucomatous E50K Mutation in the Optineurin Gene Causes Mitophagy Defects for Retinal Ganglion Cells but Not for Motor Neurons
Full text linkBackground: Clearance of damaged mitochondria by lysosomes, known as mitophagy, is critical for maintaining mitochondrial homeostasis and cellular energy balance. Optineurin (Optn) is the central player for mitophagy found to be mutated among normal tension glaucoma (OPTNE50K) and in some familial forms of amyotrophic lateral sclerosis (OPTNE478G) patients. It is critical to understand how mitophagy mechanisms are altered for these inherited mutations in stem cells and differentiated neurons to gain insight into the disease’s developmental aspect.
Methods: We utilized human embryonic stem cell-derived retinal ganglion cells (hRGCs) and induced motor neurons (iMNs) with and without the OPTNE50K mutation. The cells were treated with DMSO (vehicle control) or with 10 M CCCP, an uncoupler that induces mitochondrial damage. We then analyzed the activation status of critical mitophagy players including Optn, Parkin, Pink and Lc3b. We further analyzed if OptnE50K mutant forms aggregate in iMNs as observed for hRGCs.
Results: We found that OPTNE50K mutation causes attenuated activation for Optn, Parkin, and LC3b in hRGCs under mitochondrial damage, while iMNs and hPSCs maintained healthy mitophagy. Additionally, mutant iMNs do not display distinct Optineurin aggregates, unlike in mutant hRGCs.
Conclusion: Our results suggest that the OptnE50K mutation may disrupt mitophagy in hRGCs but not in iMNs and stem cells. In addition, the lack of Optn aggregates in the OPTNE50K mutant iMNs suggests an alternative pathway that inhibits the aggregate formation, presumably for maintaining healthy mitophagy for longer survival.
Impact: The results from this project lay the groundwork for further investigation of the mechanisms behind mitophagy and its relation to glaucoma and ALS. Understanding what causes certain cell types to degrade while others remain healthy is key to understanding the genotype-phenotype specificity for inherited gene disorders
Dental Abnormalities in Congenital Ichthyoses: Case Report and Review of the Literature
Full text linkBackground/Objective: Ichthyoses are disorders of cornification characterized by “fish-like” scaling of skin due to abnormal differentiation and desquamation resulting in a defective cutaneous barrier. Herein, we describe an infant with keratitis-ichthyosis-deafness (KID) syndrome and natal teeth and investigate spectrum of dental abnormalities, associated ichthyoses, and implications for long-term oral health.
Methods: A literature review of ichthyoses and dental abnormalities was conducted using Ovid MEDline (1946-2024) and EMBASE (1974-2024). Inclusion criteria were English-language articles that reported patient(s) with a variant of ichthyosis that manifested a dental abnormality. Exclusion criteria were non-English articles, articles with overlapping ectodermal dysplasia or erythrokeratodermas, and articles that were unobtainable. Sex, age, country of origin, type of ichthyosis, dental findings, and genetic mutation were recorded when available. Ichthyoses were grouped into nonsyndromic and syndromic forms. Dental findings were categorized to reflect the type of anomaly: structure, eruption, number, and caries.
Results: Ninety-four articles included in our review described a total of 154 patients, with 74 (48.1%) males, 65 (42.2%) females and 15 (9.7%) patients with unspecified sex. Across all ichthyoses, the two most common dental anomalies reported were caries (51.3%) and structural abnormalities (40.9%), which include defects in shape, size, enamel, and color of teeth. Sjogren-Larsson, KID syndrome, trichothiodystrophy (TTD) and autosomal recessive congenital ichthyosis (ARCI) were most associated with dental anomalies.
Conclusion and Implications: We highlight the need for careful oral examination and dental evaluation of patients with ichthyosis. In rare cases of natal teeth, more emergent evaluation is warranted because natal teeth exhibit excess mobility and pose a risk for aspiration. Early referral to pediatric dentistry can help reinforce oral health habits, education, and infection prevention. Long-term follow-up can help limit extractions and improve oral health. 
Sex-Dependent Effects of Irisin on Bone in an Aged Mouse Model
Full text linkIrisin is a recently discovered protein that has garnered increasing attention due to its potential impact on metabolic health and disease prevention. This hormone, released from exercising skeletal muscle, is generated through the cleavage of the membrane protein FNDC-5 (fibronectin type III domain-containing protein 5). Irisin has been shown to play a role in the browning of white adipose tissue and serves as a mediator of exercise-induced metabolic improvements. Notably, bone and muscle tissues are known to communicate, influencing each other’s physiology. Previous research on Irisin demonstrated that Irisin’s effects on bone in response to stress exhibit sex-dependent differences. Specifically, female FNDC-5 knockout (KO) mice were protected from adverse bone phenotypes when subjected to a low calcium diet, while male FNDC-5 KO mice showed worse bone phenotypes at baseline, even before the diet began.
The prior study focused on 5-month-old mice. Our research aims to investigate the effects of FNDC-5 KO in aged mice, both at baseline and under stress conditions. We utilized 18-month-old wild-type (WT) and FNDC-5 KO male and female mice, feeding them a low calcium diet for 2 weeks. Our findings revealed similar results to the earlier study with younger mice: female FNDC-5 KO mice exhibited partial protection against the low calcium diet’s adverse effects on bone and skeletal muscle.
These results suggest that age and sex are critical factors in the bone-muscle crosstalk mediated by Irisin, highlighting the need for personalized approaches in nutritional and exercise interventions. Future research should explore the underlying mechanisms and potential therapeutic applications of Irisin in metabolic and musculoskeletal health.  
Determinants of Xenophobic Attitudes Towards Displaced Migrants Among Healthcare Workers
Full text linkDisplacement increases inequalities by preventing access to basic rights, especially the right to health. This cross-sectional study explains the level of xenophobic attitudes of healthcare professionals towards displaced migrants and related factors. A total of 436 health workers across varied health professions completed a Socio-demographic Information Form, a Xenophobia Scale, and a Cultural Intelligence Scale. Approximately 60% of the participants were female, with an average age of 29.7±7.32 years. The mean score obtained from the Xenophobia Scale, which has a maximum score of 66, was 52.8±11.03. The results showed that knowing a foreign language, having immigrant friends, receiving training on the healthcare needs of immigrants, and possessing high motivation scores were associated with reduced xenophobic attitudes. In contrast, immigrants having inadequate income or an elevated metacognition score was linked to xenophobic attitudes (p<0.05). In order to prevent inequalities in health and to ensure that displaced populations have access to the right to health, these findings are taken into consideration in the planning of social work interventions
Late Antenatal Corticosteroid Treatment in Twin Pregnancies and Neonatal Outcomes: A Systematic Review and Meta-Analysis
Full text linkObjective: To examine the impact of administering late-preterm corticosteroids on neonatal outcomes in twin pregnancies.
Study Design: A systematic review of the literature was conducted in four electronic databases between 2000-2024. Studies reporting on neonatal outcomes in twin pregnancies at risk of preterm birth receiving corticosteroid treatment for fetal lung maturity at the gestational age (GA) of 34 weeks and 0 days to 36 weeks and 6 days were included. Studies involving participants with specific conditions (twin-to-twin transfusion syndrome and intrauterine fetal demise of one fetus) were excluded. The primary outcome was incidence of respiratory distress syndrome (RDS). Secondary outcomes included need for mechanical ventilation, continuous positive airway pressure (CPAP), and neonatal hypoglycemia. Comparison groups included those receiving steroids vs those not. The random effect model was used to generate weighted mean differences (MD) and odds ratio (OR) along with their 95% confidence intervals (CI). Heterogeneity was assessed using the I2 value.
Results: 267 abstracts were screened of which 15 full-texts were fully reviewed. A total of three studies were included in the final analysis which comprised 489 twin pregnancies receiving steroids and 2807 pregnancies not receiving steroids. There were no differences in obstetric characteristics between groups, including maternal age, body mass index, preeclampsia, diabetes, and type of twin chorionicity. GA at delivery was significantly earlier in the steroids group (MD -0.91, 95% CI -1.50 to -0.32). For neonatal outcomes, there were no significant differences in incidence of RDS and need for mechanical ventilation between groups. There were higher chances for CPAP use (OR 2.69, 95% CI, 1.47 to 4.92) and neonatal hypoglycemia (OR 2.05, 95% CI, 1.18 to 3.56) in the steroids group.
Conclusion: This study found that antenatal corticosteroid treatment during the late-preterm period in twin pregnancies was not associated with a reduced risk of neonatal respiratory complications. 
Quality and Impact at Scale: Measuring Career Effectiveness Beyond Participation
Full text linkDue to scalability and resource constraints, career development efforts at a large higher education institution (10,000 students or more) can be intimidating to implement and assess. However, there are metrics beyond quantitative figures that can measure the impact and effectiveness of services and ways to engage in cross-campus partnerships to reach students across disciplines and backgrounds. This article focuses on assessment questions and methods that can be practically implemented in strategic efforts to collect and use critical data related to career development, experiential learning, and post-graduation outcomes
Developing and Assessing Meaningful Career Readiness Metrics
Full text linkReturn on investment and the value of a college degree are central topics related to U.S. higher education. National data indicate that alumni who received high levels of career support from their institutions are more likely to view their degrees as worthwhile investments and demonstrate a higher propensity to give back as alumni. Despite this, many colleges and universities prioritize metrics that provide little value to the student experience and focus on less impactful data. This piece illustrates how institutions can strategically develop and assess meaningful career readiness metrics focused on institutional effectiveness and student success beyond degree attainment. The process includes posing equity-minded questions that challenge current career readiness education models, aligning career readiness efforts with university priorities, and performing a comprehensive state of career readiness audit of the campus. By adopting these intentional, transparent, and collaborative methods, institutions can more effectively develop and assess metrics for measuring institutional career support and equitable student success
Licensing Inequities in Social Work: Financial Barriers, Test Bias, and Implications for Professional Education
No full textThe social work profession stands at a critical juncture where financial and regulatory mechanisms intersect with its core values of equity, justice, and empowerment. This think piece examines these intersections through the lens of Critical Race Theory (CRT), focusing on the tenets of intersectionality and interest convergence. It explores the inequities in licensure pass rates, shedding light on the compounded barriers faced by marginalized groups, where race, class, gender, and other social identities intersect to exacerbate disparities. Specifically, it analyzes how factors such as exam construction, educational preparation, and financial barriers disproportionately affect these groups, contributing to their lower pass rates. The historical context of how learning is acquired in social work is framed within an understanding of systemic oppression, emphasizing the tension between transactional operations and the profession’s commitment to transformative impact. The tenet of interest convergence highlights how changes in licensure processes may only occur when the interests of marginalized groups align with those of dominant groups, underscoring the need for structural reform that addresses systemic inequities and professional advancement opportunities. The discussion proposes strategies to mitigate these inequities, ensuring that licensure processes are accessible, just, and equitable for all social workers, particularly those from historically underrepresented communities