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Learn, adapt, act: A pragmatic approach for intervening on disparities in hepatocellular carcinoma outcomes
No full textThe agony and the efficacy: central mechanisms of GLP-1 induced adverse events and their mitigation by GIP
No full textTrauma-Informed Care within an Elementary School Classroom
No full textIUITrauma-informed care (TIC) has become a crucial framework in educational settings, particularly when addressing the needs of children who have experienced adverse childhood experiences (ACEs). Literature suggests that implementing TIC approaches significantly improves behavioral and academic outcomes. Despite its proven benefits, many educators lack comprehensive training in TIC, leading to a gap between the desired and actual implementation in the classroom. A needs assessment conducted at an elementary school identified this gap, revealing a discrepancy between the current staff’s knowledge of TIC and the school’s goal of incorporating trauma-informed practices. The purpose of this doctoral capstone project was to research, compile, and disseminate evidence-based trauma-informed care strategies that educators can apply in their classrooms. Based on the needs assessment and site preferences, an educational presentation was developed and delivered to staff, focusing on trauma-informed care and its application through Trust-Based Relational Intervention (TBRI). The effectiveness of this presentation was evaluated using pre- and post-surveys, which were analyzed by comparing question results. Results indicated significant growth in staff knowledge and application of TIC, with higher post-survey scores reflecting increased understanding and confidence in using TIC strategies in the classroom. These findings suggest that the educational presentation effectively enhanced staff proficiency in TIC, emphasizing the importance of ongoing professional development to foster positive educational outcomes for children.Occupational Therap
A clear approach: Hemostatic gel as a novel adjunct for pediatric upper gastrointestinal bleeding
Full text linkPediatric upper gastrointestinal bleeding (UGIB) is a significant clinical concern, with a mortality rate of approximately 2%. Endoscopic management of UGIB in children includes various techniques such as injections, mechanical devices, thermal therapies, and topical agents. PuraStat®, a clear hemostatic gel, has been used in adults to create a physical barrier for hemostasis without obscuring the endoscopic view. However, its use in pediatric UGIB has not been well-documented. A review of four pediatric cases where PuraStat® was used to treat UGIB showed that it was applied as an adjunct to other hemostatic methods like clip placement or epinephrine injections, and in one case, as monotherapy for a large duodenal ulcer/site of recently contained perforation. The gel was easy to use, appeared to be beneficial, and was well-tolerated in this small cohort, although conclusions regarding its safety and efficacy are limited by the sample size
Comparing adolescent glomerular disease clinical outcomes to the clinical outcomes in childhood, young adult, and adult-onset glomerular disease in the CureGN database
No full textBackground: There is a lack of evidence to suggest that outcomes of adolescent and adult-onset glomerular disease differ. Still, most glomerular disease trials include adults but exclude adolescents.
Methods: We designed a retrospective study using the CureGN database to compare individuals with adolescent-onset glomerular disease relative to individuals with older and younger age at onset. The two main outcomes were sustained proteinuria remission off immunosuppression treatment and composite eGFR decline.
Results: Our data did not show a significant difference in sustained proteinuria remission off treatment or composite eGFR decline between adolescent onset glomerular disease and either childhood (age 5-12), young adult (age 20-29), or adult (age 30-39) onset glomerular disease. Having high-risk APOL1 alleles and hypertension at the time of study enrollment decreased the likelihood of achieving sustained proteinuria remission off treatment. While participants with minimal change disease and IgA nephropathy were similarly likely to achieve sustained proteinuria remission off treatment, participants with focal segmental glomerulosclerosis and membranous nephropathy were less likely to achieve sustained proteinuria remission off treatment compared to participants with minimal change disease. CKD stage, high-risk APOL1 alleles, hypertension stage, and education all significantly impacted the likelihood of progression to the composite eGFR decline outcome.
Conclusions: Approximately 25% of each age cohort reached the composite eGFR decline outcome within 5 years. As more glomerular disease clinical trials become available, we must consider opening these trials to people with childhood and adolescent onset disease since like adults they are at high risk of progressive kidney function decline
History of Chemotherapy
No full textPresentation slides for lecture delivered by George E. Sandusky, DVM, PhD (Senior Research Professor of Pathology & Laboratory Medicine at the Indiana University School of Medicine, Director of the IU Simon Cancer Center Tissue Bank, and Co-Director of the Indiana Center for Biomarker Research in Neuropsychiatry) on February 18, 2025. In this presentation, Dr. Sandusky discusses the beginnings of chemotherapy, starting with General Ulysses S. Grant’s treatment for throat cancer, and ending with Dr. James Allison’s recent developments in immunotherapy. He also introduces the chemotherapy stories of Dr. Paul Ehrlich, Dr. Louis Goodman and Alfred Gilman, Babe Ruth, and Dr. Sidney Farber.
Presentation recording available online: https://purl.dlib.indiana.edu/iudl/media/791s45xk5mThis event was sponsored by the John Shaw Billings History of Medicine Society, IU School of Medicine History of Medicine Student Interest Group, IU Indianapolis Medical Humanities & Health Studies Program, and the Ruth Lilly Medical Library
Stabilization of a protein by a single halogen‐based aromatic amplifier
No full textThe utility of halogenation in protein design is investigated by a combination of quantitative atomistic simulations and experiment. Application to insulin is of complementary basic and translational interest. In a singly halogenated aromatic ring, regiospecific inductive effects were predicted to modulate multiple surrounding electrostatic (weakly polar) interactions, thereby amplifying changes in thermodynamic stability. In accordance with the simulations, we demonstrated stabilization of insulin by single halogen atoms at the ortho position of an invariant phenylalanine (2-F-PheB24, 2-Cl-PheB24, and 2-Br-PheB24; ΔΔGu = -0.5 to -1.0 kcal/mol) located at the edge of a protein crevice; corresponding meta and para substitutions had negligible effects. Although receptor-binding affinities were generally decreased (in accordance with packing of the native Phe at the hormone-receptor interface), the ortho-analogs retained biological activity in mammalian cells and in a rat model of diabetes mellitus. Further, the ortho-modified analogs exhibited enhanced resistance to fibrillation above room temperature in two distinct assays of physical stability. Regiospecific halo-aromatic stabilization may thus augment the shelf life of pharmaceutical insulin formulations under real-world conditions. This approach, extending principles of medicinal chemistry, promises to apply to a broad range of therapeutic proteins and vaccines whose biophysical stabilization would enhance accessibility in the developing world
Association Between MIND Diet Score and Cortical Thickness in an Aging Population
Full text linkBackground
The Mediterranean diet has been associated with decreased brain atrophy (Staubo et al. 2016,Alz&Dem), but the MIND (Mediterranean‐Dietary Approaches to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay) diet, designed for dementia prevention (Morris et al. 2015, Alz&Dem), remains underexplored for its impact on brain atrophy. We investigated the MIND diet’s association with cortical thickness (CT) in the Indiana Alzheimer’s Disease Research Center (IADRC) sample.
Methods
134 participants (49 CN, 45 SCD, 30 MCI, 10 AD/other) completed a self‐report MIND diet questionnaire at the IADRC, which was coded into high, medium, or low intake groups for each food (5 ‘unhealthy’ food groups were reverse scored) and completed an MRI scan on a 3T scanner. The cortical surface was parcellated using FreeSurfer v6. We selected two regions of interest (ROIs) reflecting AD‐associated neurodegeneration: temporal and global CT. We examined the association of MIND diet scores (0‐15) and food groups with CT using regression models adjusted for age, sex, race, education, and diagnosis.
Results
Higher MIND diet scores were associated with greater mean temporal CT (r = 0.269, p = 0.002) and greater mean global CT (r = 0.230, p = 0.008). In multivariable‐adjusted models, the association persisted for temporal but not global CT. Among the 15 food components, greater olive oil (r = 0.034, p<0.001), fish (r = 0.181, p = 0.040), beans (r = 0.237, p = 0.008), and nuts (r = 0.214, p = 0.014), and reduced fast food intake (r = 0.188, p = 0.035) were significantly associated with temporal CT. These associations, except for nuts, remained significant in multivariable‐adjusted models, with an additional relationship found for chicken (r = 0.189, p = 0.038). Among the 15 food components, greater olive oil (r = 0.243, p = 0.008), and beans (0.180, p = 0.044), and reduced fast food (r = 0.212, p = 0.017) were significantly associated with global CT. Only reduced fast food retained significance in the multivariable‐adjusted models.
Conclusions
Greater adherence to the MIND diet was associated with greater CT in both global and temporal regions. Specific components, including increased olive oil, beans, nuts, fish, and reduced fast food, showed significant associations with CT, suggesting elements within the diet driving this association. These findings highlight the potential neuroprotective effects of the MIND diet, emphasizing the importance of dietary patterns in preserving brain health during aging