Jennifer Beckman, Elizabeth Mast, David Shepherd, Michelle K. Zimmerman, Rejwi Dahal
Background and Hypothesis: IU Health Pathology Laboratory (IUHPL) recently added qualitative fentanyl screening to its test menu. However, fentanyl screening is not currently part of the urine drugs of abuse (DAU) panel which includes amphetamine, barbiturates,benzodiazepines, buprenorphine, cannabinoids, methadone, cocaine, opiates, oxycodone, and phencyclidine. Since fentanyl screen is a standalone test, we were interested in determining how often specimens had this ordered in conjunction with the DAU, as we suspected not all of them did. Our hypothesis was that positive urine drug screens may also be positive for fentanyl/fentanyl analogs. Project Methods: Urine specimens sent for routine drug screens at IU Health Arnett, Ball, Bloomington, and IUHPL between June and mid-July 2023 were subjected to fentanyl screening. Specimen that screened positive were confirmed by LC-MS/MS for presence offentanyl and norfentanyl. Additionally, specimens were tested for 4ANPP (fentanyl precursor) and xylazine; if they were positive for either, they were sent to an outside laboratory to ascertain if other fentanyl analogs or designer opioids were present. Results: Of the 1,893 DAU specimens received, 51.2% were positive for at least one drug class. Only 28 had an associated fentanyl screen order. Cannabinoids represented the most prevalent drug class with a 26.7% positivity rate. Only 1,724 samples were available to screen for fentanyl as part of this study. Of these, 214 specimens were positive for fentanyl, with a positivity screen rate of 12.4%. Confirmatory testing by LC-MS/MS indicated 206 of the 214 were true positives. Conclusion and Impact: These results highlight the need for fentanyl testing and continued clinician education to increase awareness about the inability of standard urine drug screens to detect fentanyl. Dialogue between patients and clinicians would potentially decrease overdoses and/or result in more treatment referrals. Additionally, integrating fentanyl screening into the DAU panel will facilitate qualitative fentanyl testing.
背景与假设：IU 健康病理实验室（IUHPL）最近在其检验菜单中增加了芬太尼定性筛查。然而，芬太尼筛查目前并不属于尿液滥用药物（DAU）检测项目，该项目包括苯丙胺、巴比妥类药物、苯二氮卓类药物、丁丙诺啡、大麻类药物、美沙酮、可卡因、阿片剂、羟考酮和苯环利定。由于芬太尼筛查是一项独立的检测项目，我们有兴趣确定标本在进行 DAU 检测的同时进行芬太尼筛查的频率，因为我们怀疑并非所有标本都进行了芬太尼筛查。我们的假设是，尿液药物筛查阳性也可能是芬太尼/芬太尼类似物阳性。项目方法：对 2023 年 6 月至 7 月中旬期间送往 IU Health Arnett、Ball、Bloomington 和 IUHPL 进行常规药物筛查的尿液标本进行芬太尼筛查。筛查呈阳性的标本通过 LC-MS/MS 确认是否含有芬太尼和诺芬太尼。此外，还对标本进行了 4ANPP（芬太尼前体）和异丙嗪检测；如果其中任何一种检测结果呈阳性，则将标本送至外部实验室，以确定是否存在其他芬太尼类似物或特制阿片类药物。结果：在收到的 1,893 份 DAU 标本中，51.2% 的标本至少对一种药物呈阳性反应。只有 28 份样本有相关的芬太尼筛查指令。大麻类是最常见的毒品类别，阳性率为 26.7%。作为本研究的一部分，只有 1724 份样本可用于芬太尼筛查。其中 214 份样本的芬太尼检测结果呈阳性，阳性筛查率为 12.4%。通过 LC-MS/MS 进行的确认测试表明，214 份样本中有 206 份样本呈阳性。结论和影响：这些结果凸显了对芬太尼检测的需求，以及继续开展临床医生教育以提高对标准尿液药物筛查无法检测芬太尼的认识的必要性。患者和临床医生之间的对话将有可能减少过量用药和/或导致更多的治疗转介。此外，将芬太尼筛查纳入 DAU 面板将促进芬太尼定性检测。
{"title":"Prevalence of Positive Urine Drug Screen for Fentanyl and its Analogs in Indianapolis","authors":"Jennifer Beckman, Elizabeth Mast, David Shepherd, Michelle K. Zimmerman, Rejwi Dahal","doi":"10.18060/27843","DOIUrl":"https://doi.org/10.18060/27843","url":null,"abstract":"Background and Hypothesis: IU Health Pathology Laboratory (IUHPL) recently added qualitative fentanyl screening to its test menu. However, fentanyl screening is not currently part of the urine drugs of abuse (DAU) panel which includes amphetamine, barbiturates,benzodiazepines, buprenorphine, cannabinoids, methadone, cocaine, opiates, oxycodone, and phencyclidine. Since fentanyl screen is a standalone test, we were interested in determining how often specimens had this ordered in conjunction with the DAU, as we suspected not all of them did. Our hypothesis was that positive urine drug screens may also be positive for fentanyl/fentanyl analogs. \u0000Project Methods: Urine specimens sent for routine drug screens at IU Health Arnett, Ball, Bloomington, and IUHPL between June and mid-July 2023 were subjected to fentanyl screening. Specimen that screened positive were confirmed by LC-MS/MS for presence offentanyl and norfentanyl. Additionally, specimens were tested for 4ANPP (fentanyl precursor) and xylazine; if they were positive for either, they were sent to an outside laboratory to ascertain if other fentanyl analogs or designer opioids were present. \u0000Results: Of the 1,893 DAU specimens received, 51.2% were positive for at least one drug class. Only 28 had an associated fentanyl screen order. Cannabinoids represented the most prevalent drug class with a 26.7% positivity rate. Only 1,724 samples were available to screen for fentanyl as part of this study. Of these, 214 specimens were positive for fentanyl, with a positivity screen rate of 12.4%. Confirmatory testing by LC-MS/MS indicated 206 of the 214 were true positives. \u0000Conclusion and Impact: These results highlight the need for fentanyl testing and continued clinician education to increase awareness about the inability of standard urine drug screens to detect fentanyl. Dialogue between patients and clinicians would potentially decrease overdoses and/or result in more treatment referrals. Additionally, integrating fentanyl screening into the DAU panel will facilitate qualitative fentanyl testing.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathleen Sherman, Aaron Williams, Jana Sanders, Thomas Gutwein
Suicide rates at a national and state level have been on the rise over the past two decades. Patterns observed at the local level is less understood and underrepresented in research. Since local government can have a large impact on resource allocation in a community, revealing local suicide patterns could help facilitate targeted preventative efforts for at-risk populations. This study aims to analyze demographic patterns observed in Allen County suicides from 2013 –2022, focusing on age groups and education attainment. Data collection was completed on the 604 individuals who died by suicide in Allen County over the past decade. The collection process included documenting various demographics accessed through death certificates and coroner’s files. Within the county, suicide numbers increased over the decade. Results showed that males represented more than a 3:1 ratio of total suicides, a gunshot wound was the method of injury for 53% of all suicides, and decedents with a high school degree or less represented 62% of suicides within the population. These results echo what research has shown at the national level. Additionally, the 20-34 and the 35-54 age groups produced the greatest number of suicides consistently over the 10 years, and these suicides occurred most often in late spring and early summer. Within the 20-34 age group, individuals were more likely to commit suicide by gunshot wound (p = 0.000133). Decedents of minority ethnic and racial groups had lower education attainment compared to non-Hispanic (p = 0.000027) or white (p = 0.003314) individuals. This information could be provided to local schools with the hopes of implementing more targeted preventative measures for at-risk groups. Knowledge of suicide patterns in healthcare could lead to improved care for patients. Finally, public health entities can use these findings to adapt current health initiates to fit the needs of Allen County.
{"title":"Retrospective Analysis of Suicide Deaths in Allen County Indiana, 2013 – 2022","authors":"Kathleen Sherman, Aaron Williams, Jana Sanders, Thomas Gutwein","doi":"10.18060/27783","DOIUrl":"https://doi.org/10.18060/27783","url":null,"abstract":"Suicide rates at a national and state level have been on the rise over the past two decades. Patterns observed at the local level is less understood and underrepresented in research. Since local government can have a large impact on resource allocation in a community, revealing local suicide patterns could help facilitate targeted preventative efforts for at-risk populations. This study aims to analyze demographic patterns observed in Allen County suicides from 2013 –2022, focusing on age groups and education attainment. Data collection was completed on the 604 individuals who died by suicide in Allen County over the past decade. The collection process included documenting various demographics accessed through death certificates and coroner’s files. Within the county, suicide numbers increased over the decade. Results showed that males represented more than a 3:1 ratio of total suicides, a gunshot wound was the method of injury for 53% of all suicides, and decedents with a high school degree or less represented 62% of suicides within the population. These results echo what research has shown at the national level. Additionally, the 20-34 and the 35-54 age groups produced the greatest number of suicides consistently over the 10 years, and these suicides occurred most often in late spring and early summer. Within the 20-34 age group, individuals were more likely to commit suicide by gunshot wound (p = 0.000133). Decedents of minority ethnic and racial groups had lower education attainment compared to non-Hispanic (p = 0.000027) or white (p = 0.003314) individuals. This information could be provided to local schools with the hopes of implementing more targeted preventative measures for at-risk groups. Knowledge of suicide patterns in healthcare could lead to improved care for patients. Finally, public health entities can use these findings to adapt current health initiates to fit the needs of Allen County.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Linh Dang, Kurt Kroenke, Timothy Stump, Patrick O. Monahan, J. Connors, Yelena Cherynak, Paul Musey
Background/Objective: Low-risk chest pain (LRCP), i.e. chest pain that does not pose an imminent risk or have a cardiovascular cause, constitutes the majority (80%) of cases of chest pain presenting to the emergency department (ED). Past research shows that in patients withLRCP without a history of cardiovascular disease, many will meet criteria for panic or generalized anxiety disorder. The purpose of this project is to examine the psychiatric comorbidities of patients with LRCP including differences by severity of anxiety. Methods: Baseline data collected in the Patient-Centered Treatment of Anxiety after Low-Risk Chest Pain in the Emergency Room (PACER) study were analyzed to determine: the rates of depression, somatization, posttraumatic stress disorder (PTSD), disability, and low self-efficacyin relation to increasing levels of anxiety (low anxiety but positive for panic disorder vs moderate vs severe anxiety). Also, anxiety severity groups are compared for demographic and other patient characteristics to identify potential predictors of anxiety severity. Results: In 265 patients with LRCP who screened positive for panic disorder and/or generalized anxiety disorder, the proportion with low, moderate and severe anxiety symptoms was 9%, 44% and 47%, respectively. Overall, 57% (n=150) also screened positive for depression, 54%(n=144) for somatization syndrome, and 56% (n=149) for PTSD. Rates of depression, somatization, PTSD, and disability increased as the level of anxiety increased. Compared to patients with low to moderate anxiety, patients with severe anxiety were more likely to have depression (odds ratio = 3.0), somatization (OR = 2.7), PTSD (OR = 2.6), disability (OR = 2.4), and low self-efficacy (OR = 3.5). Conclusion and Potential Implications: Patients with LRCP and anxiety are likely to have other psychiatric comorbidities. Additionally, as rates of comorbidities increase with the anxiety severity, detection and management of anxiety is essential to provide optimal care for low-riskchest pain.
{"title":"Elevated Psychiatric Comorbidities in Patients with Low-risk Chest Pain Presenting in The Emergency Department","authors":"Linh Dang, Kurt Kroenke, Timothy Stump, Patrick O. Monahan, J. Connors, Yelena Cherynak, Paul Musey","doi":"10.18060/27776","DOIUrl":"https://doi.org/10.18060/27776","url":null,"abstract":"Background/Objective: Low-risk chest pain (LRCP), i.e. chest pain that does not pose an imminent risk or have a cardiovascular cause, constitutes the majority (80%) of cases of chest pain presenting to the emergency department (ED). Past research shows that in patients withLRCP without a history of cardiovascular disease, many will meet criteria for panic or generalized anxiety disorder. The purpose of this project is to examine the psychiatric comorbidities of patients with LRCP including differences by severity of anxiety. \u0000Methods: Baseline data collected in the Patient-Centered Treatment of Anxiety after Low-Risk Chest Pain in the Emergency Room (PACER) study were analyzed to determine: the rates of depression, somatization, posttraumatic stress disorder (PTSD), disability, and low self-efficacyin relation to increasing levels of anxiety (low anxiety but positive for panic disorder vs moderate vs severe anxiety). Also, anxiety severity groups are compared for demographic and other patient characteristics to identify potential predictors of anxiety severity. \u0000Results: In 265 patients with LRCP who screened positive for panic disorder and/or generalized anxiety disorder, the proportion with low, moderate and severe anxiety symptoms was 9%, 44% and 47%, respectively. Overall, 57% (n=150) also screened positive for depression, 54%(n=144) for somatization syndrome, and 56% (n=149) for PTSD. Rates of depression, somatization, PTSD, and disability increased as the level of anxiety increased. Compared to patients with low to moderate anxiety, patients with severe anxiety were more likely to have depression (odds ratio = 3.0), somatization (OR = 2.7), PTSD (OR = 2.6), disability (OR = 2.4), and low self-efficacy (OR = 3.5). \u0000Conclusion and Potential Implications: Patients with LRCP and anxiety are likely to have other psychiatric comorbidities. Additionally, as rates of comorbidities increase with the anxiety severity, detection and management of anxiety is essential to provide optimal care for low-riskchest pain.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 45","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:Geminus Head Start is a federal program that works with children under five years old from low-income communities to promote school readiness. The organization in Northwest Indiana provided anecdotal data on delayed social and emotional development of children during the pandemic. Studies have shown that adverse childhood development can have a severe psychological and physiological impact on health outcomes into adulthood. However, there has been a lack of research on quantifying the extent of damage from the pandemic on our Head Start children, who mainly identify as Black/African American. Methods:Geminus Head Start provided demographic data including race, postal codes and DECA for over 4650 students from 2019-2023. DECA, Devereux Early Childhood Assessment, is used by educators to evaluate children’s social emotional competence for early intervention. In this study, we are investigating the DECA categories, including initiative, self-control, and attachment/relationships. We analyzed DECA scores via ANOVA along with listening into the teacher focus groups. Results:Students had increased attachment/relationship scores from the 2019-2020 school year to the 2020-2021 school year (36.69 to 44.59). However, following COVID-19 to the 2021-2022 and 2022-2023 school years, these scores dropped to 23.51. When looking at the second protective factor, self-regulation, the opposite trend was found. The scores went from 18.79 in 2019-2020 down to 14.68 in 2020-2021 and eventually up to 23.51 in 2021-2022. Conclusion:Like most institutions, the pandemic has created a time of isolation and instability for our children and their families. In particular, these children have not been able to access adequate conditions to develop emotional and social maturity. Lacking this development can lead to several negative health outcomes as it may impact mental health and the ability to create healthy supportive networks.
{"title":"Retrospective Analysis of COVID-19 Impact on Social + Emotional Development in Children of Low-Income Communities from Head Start","authors":"Gabrielle S. Li, Satya P. Sanapati, Amy Han","doi":"10.18060/27720","DOIUrl":"https://doi.org/10.18060/27720","url":null,"abstract":"Background:Geminus Head Start is a federal program that works with children under five years old from low-income communities to promote school readiness. The organization in Northwest Indiana provided anecdotal data on delayed social and emotional development of children during the pandemic. Studies have shown that adverse childhood development can have a severe psychological and physiological impact on health outcomes into adulthood. However, there has been a lack of research on quantifying the extent of damage from the pandemic on our Head Start children, who mainly identify as Black/African American. \u0000Methods:Geminus Head Start provided demographic data including race, postal codes and DECA for over 4650 students from 2019-2023. DECA, Devereux Early Childhood Assessment, is used by educators to evaluate children’s social emotional competence for early intervention. In this study, we are investigating the DECA categories, including initiative, self-control, and attachment/relationships. We analyzed DECA scores via ANOVA along with listening into the teacher focus groups. \u0000Results:Students had increased attachment/relationship scores from the 2019-2020 school year to the 2020-2021 school year (36.69 to 44.59). However, following COVID-19 to the 2021-2022 and 2022-2023 school years, these scores dropped to 23.51. When looking at the second protective factor, self-regulation, the opposite trend was found. The scores went from 18.79 in 2019-2020 down to 14.68 in 2020-2021 and eventually up to 23.51 in 2021-2022. \u0000Conclusion:Like most institutions, the pandemic has created a time of isolation and instability for our children and their families. In particular, these children have not been able to access adequate conditions to develop emotional and social maturity. Lacking this development can lead to several negative health outcomes as it may impact mental health and the ability to create healthy supportive networks.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background/Objective: Thoracic aortic aneurysm (TAA) is a prevalent disorder that predisposes to aortic dissection. Prior work identified the ubiquinone biosynthesis gene COQ8B as a genetic modifier of TAA progression. We sought to determine the impact of decreased COQ8B on global transcription in aortic smooth muscle cells (SMCs). Methods: Primary human aortic SMCs from a healthy donor were seeded in 12-well plates. Six experimental conditions were created, each with 3 replicates: 1) siRNA targeting COQ8B (siCOQ8B); 2) siRNA targeting the dominant TAA gene SMAD3 (siSMAD3); 3) negative controlsiRNA (siNeg); 4) siCOQ8B and siSMAD3; 5) siCOQ8B with Angiotensin II (AngII) stimulation (siCOQ8B+AngII); 6) siNeg+AngII. RNA was extracted approximately 48 hours post-siRNA transfection and, for AngII conditions, after 1 hour of incubation with AngII (100 nM). mRNAsequencing was performed and downstream analysis utilized R packages EdgeR and topGO. Results: Multidimensional scaling identified distinct clustering of samples by experimental condition. Downregulated genes in siCOQ8B were enriched for Gene Ontology pathways related to cell proliferation including cell cycle regulators, DNA replication, and mitosis. MYOCD, a master regulator of SMC homeostasis, was downregulated. Similar proliferation-related pathways were enriched in siCOQ8B+siSMAD3 and siCOQ8B+AngII compared to siNeg. Pathways related to cell proliferation in siCOQ8B+AngII cells were downregulated when compared to siCOQ8B which indicates that AngII infusion in the context of COQ8B silencing may further dysregulate cell proliferation pathways. Conclusion: The results indicate that COQ8B has an important role in cell cycle processes in aortic SMCs, including when SMCs are exposed to stressors associated with TAA development. Stimulation of angiotensin receptors may exacerbate the effects of decreased COQ8B in these processes. To investigate these experimental results in human pathology, bulk RNA samples and intact nuclei have been isolated from frozen human aortic specimens and prepared for transcriptomic analysis.
{"title":"Silencing COQ8B in Aortic Smooth Muscle Cells Reveals Cellular Dysfunction Related to Changes in Cell Proliferation","authors":"Joshua Davis, Benjamin Landis","doi":"10.18060/27779","DOIUrl":"https://doi.org/10.18060/27779","url":null,"abstract":"Background/Objective: Thoracic aortic aneurysm (TAA) is a prevalent disorder that predisposes to aortic dissection. Prior work identified the ubiquinone biosynthesis gene COQ8B as a genetic modifier of TAA progression. We sought to determine the impact of decreased COQ8B on global transcription in aortic smooth muscle cells (SMCs). \u0000Methods: Primary human aortic SMCs from a healthy donor were seeded in 12-well plates. Six experimental conditions were created, each with 3 replicates: 1) siRNA targeting COQ8B (siCOQ8B); 2) siRNA targeting the dominant TAA gene SMAD3 (siSMAD3); 3) negative controlsiRNA (siNeg); 4) siCOQ8B and siSMAD3; 5) siCOQ8B with Angiotensin II (AngII) stimulation (siCOQ8B+AngII); 6) siNeg+AngII. RNA was extracted approximately 48 hours post-siRNA transfection and, for AngII conditions, after 1 hour of incubation with AngII (100 nM). mRNAsequencing was performed and downstream analysis utilized R packages EdgeR and topGO. \u0000Results: Multidimensional scaling identified distinct clustering of samples by experimental condition. Downregulated genes in siCOQ8B were enriched for Gene Ontology pathways related to cell proliferation including cell cycle regulators, DNA replication, and mitosis. MYOCD, a master regulator of SMC homeostasis, was downregulated. Similar proliferation-related pathways were enriched in siCOQ8B+siSMAD3 and siCOQ8B+AngII compared to siNeg. Pathways related to cell proliferation in siCOQ8B+AngII cells were downregulated when compared to siCOQ8B which indicates that AngII infusion in the context of COQ8B silencing may further dysregulate cell proliferation pathways. \u0000Conclusion: The results indicate that COQ8B has an important role in cell cycle processes in aortic SMCs, including when SMCs are exposed to stressors associated with TAA development. Stimulation of angiotensin receptors may exacerbate the effects of decreased COQ8B in these processes. To investigate these experimental results in human pathology, bulk RNA samples and intact nuclei have been isolated from frozen human aortic specimens and prepared for transcriptomic analysis.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139626498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and Hypothesis: The limited regenerative capacity of the mammalian adult myocardium is a significant roadblock for therapeutic approaches in cardiovascular disease. Cell cycle arrest following S-phase is widely considered a primary contributor to the reduced proliferative capacity of adult cardiomyocytes. Recently, expression of troponin I-interacting kinase (Tnni3k) was shown to increase cardiomyocyte S-phase activity in mice. Tnni3k was previously shown to enhance ROS formation and adverse cardiac remodeling following injury. Our primary hypothesis was that TNNI3K-induced cardiomyocyte DNA synthesis resulted from enhanced ROS signaling. To test this, cardiomyocyte S-phase activity in TNNI3K-expressing mice was compared between those treated with the ROS scavenging agent mitoTEMPO and untreated mice. Project Methods: Transgenic mice expressing TNNI3K were subjected to 14 days infusion with mitoTEMPO (experimental group) or vehicle (control group). The mice were also subjected to 14 days infusion with bromodeoxyuridine (BrdU) to identify DNA synthesis during S-phase (all mice carried a cardiomyocyte-restricted nuclear-localized transgenic reporter to aid in cardiomyocyte nuclei identification). The proportion of cardiomyocytes in S-phase was determined and mean S-phase activity was compared between treatment groups. Ploidy analysis was also conducted to determine if cardiomyocytes completing S-phase progressed through karyokinesis. Results: The percentage of cardiomyocytes in S-phase in the control and mitoTEMPO treated group were 0.819% ± 0.163% and 0.855% ± 0.138%, respectively (mean ± SEM, p=0.873). Ploidy analysis revealed no overt difference in DNA content in S-phase-positive cardiomyocyte nuclei between the groups. Hence, we have shown that there is no appreciable difference in cell cycle induction or progression in cardiomyocytes from control vs. mitoTEMPO treated mice expressing TNNI3K. Conclusion and Potential Impact: These data suggest that (a) TNNI3K-induced cardiomyocyte S-phase activity is not secondary to elevated ROS activity, and (b) reduction of ROS activity does not relax the cell cycle block between S-phase and karyokinesis in adultcardiomyocytes.
背景与假设：哺乳动物成体心肌的再生能力有限，这是心血管疾病治疗方法的一大障碍。人们普遍认为，S 期后的细胞周期停滞是导致成体心肌细胞增殖能力下降的主要原因。最近，研究表明表达肌钙蛋白 I-互作激酶（Tnni3k）可提高小鼠心肌细胞 S 期活性。Tnni3k 以前曾被证明能增强 ROS 的形成和损伤后的不良心脏重塑。我们的主要假设是 TNNI3K 诱导的心肌细胞 DNA 合成是由增强的 ROS 信号转导引起的。为了验证这一假设，我们比较了用 ROS 清除剂 mitoTEMPO 处理的 TNNI3K 表达小鼠和未处理小鼠的心肌细胞 S 期活性。项目方法：对表达 TNNI3K 的转基因小鼠进行为期 14 天的 mitoTEMPO（实验组）或药物（对照组）输注。小鼠还需输注溴脱氧尿苷（BrdU）14 天，以鉴定 S 期的 DNA 合成（所有小鼠均携带心肌细胞限制性核定位转基因报告物，以帮助鉴定心肌细胞核）。测定处于 S 期的心肌细胞比例，并比较不同治疗组的平均 S 期活性。还进行了倍性分析，以确定完成 S 期的心肌细胞是否进行了核动分裂。结果对照组和 mitoTEMPO 治疗组处于 S 期的心肌细胞百分比分别为 0.819% ± 0.163% 和 0.855% ± 0.138%（平均值 ± SEM，P=0.873）。倍性分析显示，各组间 S 期阳性心肌细胞核中的 DNA 含量无明显差异。因此，我们已经证明，对照组与经 mitoTEMPO 处理的表达 TNNI3K 的小鼠的心肌细胞在细胞周期诱导或进展方面没有明显差异。结论和潜在影响：这些数据表明：(a) TNNI3K 诱导的心肌细胞 S 期活动并非继发于 ROS 活性的升高；(b) ROS 活性的降低并不会放松成体心肌细胞 S 期和核动期之间的细胞周期阻滞。
{"title":"Ineffectiveness of mitoTEMPO on Cardiomyocyte S-phase Activity in TNNI3K-expressing Mice","authors":"Elias Chahoud, Sean Reuter, Loren Field","doi":"10.18060/27848","DOIUrl":"https://doi.org/10.18060/27848","url":null,"abstract":"Background and Hypothesis: The limited regenerative capacity of the mammalian adult myocardium is a significant roadblock for therapeutic approaches in cardiovascular disease. Cell cycle arrest following S-phase is widely considered a primary contributor to the reduced proliferative capacity of adult cardiomyocytes. Recently, expression of troponin I-interacting kinase (Tnni3k) was shown to increase cardiomyocyte S-phase activity in mice. Tnni3k was previously shown to enhance ROS formation and adverse cardiac remodeling following injury. Our primary hypothesis was that TNNI3K-induced cardiomyocyte DNA synthesis resulted from enhanced ROS signaling. To test this, cardiomyocyte S-phase activity in TNNI3K-expressing mice was compared between those treated with the ROS scavenging agent mitoTEMPO and untreated mice. \u0000Project Methods: Transgenic mice expressing TNNI3K were subjected to 14 days infusion with mitoTEMPO (experimental group) or vehicle (control group). The mice were also subjected to 14 days infusion with bromodeoxyuridine (BrdU) to identify DNA synthesis during S-phase (all mice carried a cardiomyocyte-restricted nuclear-localized transgenic reporter to aid in cardiomyocyte nuclei identification). The proportion of cardiomyocytes in S-phase was determined and mean S-phase activity was compared between treatment groups. Ploidy analysis was also conducted to determine if cardiomyocytes completing S-phase progressed through karyokinesis. \u0000Results: The percentage of cardiomyocytes in S-phase in the control and mitoTEMPO treated group were 0.819% ± 0.163% and 0.855% ± 0.138%, respectively (mean ± SEM, p=0.873). Ploidy analysis revealed no overt difference in DNA content in S-phase-positive cardiomyocyte nuclei between the groups. Hence, we have shown that there is no appreciable difference in cell cycle induction or progression in cardiomyocytes from control vs. mitoTEMPO treated mice expressing TNNI3K. \u0000Conclusion and Potential Impact: These data suggest that (a) TNNI3K-induced cardiomyocyte S-phase activity is not secondary to elevated ROS activity, and (b) reduction of ROS activity does not relax the cell cycle block between S-phase and karyokinesis in adultcardiomyocytes.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"2 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139438123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ankyloglossia, commonly known as tongue-tie, is reported to affect 7% of infants and can impact ability to breastfeed. A comprehensive review of literature was taken which included an assessment of which diagnostic tools are most accurate in determining ankyloglossia associated with difficult breastfeeding. It was noted that there was not a standardized approachto identifying and treating ankyloglossia in breastfed infants. Based on this review, a multidisciplinary team was established to develop a team for a holistic assessment of breastfeeding efficacy. A protocol was developed for assessment of frenotomy impact on breastfeeding. It included LATCH, Coryllos Scale, and IBFAT as the most useful evaluation tools and developed a prospective assessment in infants with ankyloglossia. This study is in the early data collection phase. The goal of this study is to fill an important gap in the knowledge of the impact of ankyloglossia in sustained breastfeeding.
{"title":"Ankyloglossia and its Importance in Sustained Breastfeeding","authors":"Chelsea Fathauer, Danielle Tingley, Sarah Burgin","doi":"10.18060/27897","DOIUrl":"https://doi.org/10.18060/27897","url":null,"abstract":"Ankyloglossia, commonly known as tongue-tie, is reported to affect 7% of infants and can impact ability to breastfeed. A comprehensive review of literature was taken which included an assessment of which diagnostic tools are most accurate in determining ankyloglossia associated with difficult breastfeeding. It was noted that there was not a standardized approachto identifying and treating ankyloglossia in breastfed infants. Based on this review, a multidisciplinary team was established to develop a team for a holistic assessment of breastfeeding efficacy. A protocol was developed for assessment of frenotomy impact on breastfeeding. It included LATCH, Coryllos Scale, and IBFAT as the most useful evaluation tools and developed a prospective assessment in infants with ankyloglossia. This study is in the early data collection phase. The goal of this study is to fill an important gap in the knowledge of the impact of ankyloglossia in sustained breastfeeding.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"15 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139438817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kaitlyn A. Roberts, Emaan G. Bhutta, Adnan Bhutta, Megan S. McHenry, Polycarp Mandi, Eric Ngetich, Faith Sila, Hellen Jemeli, Sarah Kimetto, Laura J. Ruhl, Joram Nyandat, Julika Kaplan
Background: High-flow nasal cannula (HFNC) is a relatively safe, effective, and well-tolerated form of non-invasive ventilation for children with respiratory distress and is regularly used in resource-rich settings. Pediatric HFNC has been successfully implemented in resource-limited settings; however, little is known about the training process required to integrate HFNC into care. The present study evaluates a pediatric HFNC training program conducted at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya prior to HFNC implementation at Shoe4Africa Children’s Hospital. Methods: This study took place within the Academic Model Providing Access to Healthcare (AMPATH) program, a partnership among MTRH, Moi University, and a consortium of North American universities led by Indiana University. The training program curriculum included information about HFNC; clinical signs of respiratory distress; a demonstration and hands-on practice with HFNC machines; a locally adapted protocol for pediatric HFNC implementation; and a sample patient case. Fifty-nine acute care providers (nurses, clinical officers, medical officers, and registrars) participated in training. Participants completed pre-tests and post-tests (immediate and 3-month follow-up) containing open-ended questions to assess HFNC knowledge and five-point Likert scale questions to assess HFNC comfort and attitudes. Data were analyzed using descriptive statistics and two-proportion Z-tests (α=0.05). Results: Average knowledge assessment scores significantly increased from pre-test (2.19/6) to post-test (5.59/6; p<0.001). While scores decreased slightly at the 3-month follow-up, they remained increased from pre-test levels (4.53/6; p<0.001). The percentage of respondents who answered each knowledge assessment question correctly on the post-test and 3-month followup were significantly increased from the pre-test. Participant comfort using HFNC was increased on both the post-test (p<0.001) and 3-month follow-up (p=0.038). Conclusions: This program successfully trained providers in pediatric HFNC use at MTRH and could inform future HFNC training in resource-limited settings. Future studies should evaluate pediatric outcomes at Shoe4Africa after HFNC implementation.
{"title":"Evaluation of a Pediatric High-Flow Nasal Cannula Training Program for Providers at Moi Teaching and Referral Hospital in Eldoret, Kenya","authors":"Kaitlyn A. Roberts, Emaan G. Bhutta, Adnan Bhutta, Megan S. McHenry, Polycarp Mandi, Eric Ngetich, Faith Sila, Hellen Jemeli, Sarah Kimetto, Laura J. Ruhl, Joram Nyandat, Julika Kaplan","doi":"10.18060/27761","DOIUrl":"https://doi.org/10.18060/27761","url":null,"abstract":"Background: High-flow nasal cannula (HFNC) is a relatively safe, effective, and well-tolerated form of non-invasive ventilation for children with respiratory distress and is regularly used in resource-rich settings. Pediatric HFNC has been successfully implemented in resource-limited settings; however, little is known about the training process required to integrate HFNC into care. The present study evaluates a pediatric HFNC training program conducted at Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya prior to HFNC implementation at Shoe4Africa Children’s Hospital. \u0000Methods: This study took place within the Academic Model Providing Access to Healthcare (AMPATH) program, a partnership among MTRH, Moi University, and a consortium of North American universities led by Indiana University. The training program curriculum included information about HFNC; clinical signs of respiratory distress; a demonstration and hands-on practice with HFNC machines; a locally adapted protocol for pediatric HFNC implementation; and a sample patient case. Fifty-nine acute care providers (nurses, clinical officers, medical officers, and registrars) participated in training. Participants completed pre-tests and post-tests (immediate and 3-month follow-up) containing open-ended questions to assess HFNC knowledge and five-point Likert scale questions to assess HFNC comfort and attitudes. Data were analyzed using descriptive statistics and two-proportion Z-tests (α=0.05). \u0000Results: Average knowledge assessment scores significantly increased from pre-test (2.19/6) to post-test (5.59/6; p<0.001). While scores decreased slightly at the 3-month follow-up, they remained increased from pre-test levels (4.53/6; p<0.001). The percentage of respondents who answered each knowledge assessment question correctly on the post-test and 3-month followup were significantly increased from the pre-test. Participant comfort using HFNC was increased on both the post-test (p<0.001) and 3-month follow-up (p=0.038). \u0000Conclusions: This program successfully trained providers in pediatric HFNC use at MTRH and could inform future HFNC training in resource-limited settings. Future studies should evaluate pediatric outcomes at Shoe4Africa after HFNC implementation.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"36 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background:Parkin is a mitochondrial autophagy protein that is associated with Parkinson’s Disease (PD), as well as auditory function. Parkin dysfunction in the context of PD allows accumulation of protein aggregates, leading to dopaminergic neurotoxicity. Previous work has demonstrated that Parkin plays an essential role in normal auditory function, as Prkn-/- mice exhibit significantly reduced hearing sensitivity. However, Prkn-/- mice also experience a protective effect from cochlear hair cell death and hearing loss caused by aminoglycosides, which are commonly used antibiotics that can cause permanent hearing loss. Multiple antibodies marketed as suitable for immunohistochemistry (IHC) have been validated using Prkn-/- tissues; however, they exhibit non-specific activity. This project aims to generate a highly specific antibody for accurate and reliable detection of Parkin expression. Project Methods:Rabbits were immunized using two Parkin peptides, notated P1 and P2, and the resulting serum was collected. A two-step purification process was utilized in this project, first isolating the IgGs from serum via protein A/G columns, and secondly using affinity purification to obtain specific antibodies against antigens P1 and P2. Additionally, two different protocols for affinity purification were tested and compared. Purity of serum, IgG, and specific antibodies was assessed by Western blot and immunofluorescence. Results:Utilizing the first purification protocol, IHC antibodies were applied in Western blot, and all demonstrated a prominent ~50kD band specific to Parkin, with some degree of nonspecific binding. Immunostaining confirmed functionality of the IHC antibodies and revealed those against P2 exhibited higher binding specificity. The second purification protocol generated IHC antibodies of similar, if not slightly superior specific interaction. Conclusion/Implications:Further investigation of Parkin expression would facilitate a better understanding of how it may be associated with the development of PD, as well as auditory function, with the potential of utilizing Parkin as a therapeutic target in PD treatment and preventing aminoglycoside ototoxicity.
{"title":"Affinity Purification of Anti-Parkin Antibodies from Rabbit Serum for their Application in Immunohistochemistry","authors":"Noah McMurtry, Bo Zhao","doi":"10.18060/27735","DOIUrl":"https://doi.org/10.18060/27735","url":null,"abstract":"Background:Parkin is a mitochondrial autophagy protein that is associated with Parkinson’s Disease (PD), as well as auditory function. Parkin dysfunction in the context of PD allows accumulation of protein aggregates, leading to dopaminergic neurotoxicity. Previous work has demonstrated that Parkin plays an essential role in normal auditory function, as Prkn-/- mice exhibit significantly reduced hearing sensitivity. However, Prkn-/- mice also experience a protective effect from cochlear hair cell death and hearing loss caused by aminoglycosides, which are commonly used antibiotics that can cause permanent hearing loss. Multiple antibodies marketed as suitable for immunohistochemistry (IHC) have been validated using Prkn-/- tissues; however, they exhibit non-specific activity. This project aims to generate a highly specific antibody for accurate and reliable detection of Parkin expression. \u0000Project Methods:Rabbits were immunized using two Parkin peptides, notated P1 and P2, and the resulting serum was collected. A two-step purification process was utilized in this project, first isolating the IgGs from serum via protein A/G columns, and secondly using affinity purification to obtain specific antibodies against antigens P1 and P2. Additionally, two different protocols for affinity purification were tested and compared. Purity of serum, IgG, and specific antibodies was assessed by Western blot and immunofluorescence. \u0000Results:Utilizing the first purification protocol, IHC antibodies were applied in Western blot, and all demonstrated a prominent ~50kD band specific to Parkin, with some degree of nonspecific binding. Immunostaining confirmed functionality of the IHC antibodies and revealed those against P2 exhibited higher binding specificity. The second purification protocol generated IHC antibodies of similar, if not slightly superior specific interaction. \u0000Conclusion/Implications:Further investigation of Parkin expression would facilitate a better understanding of how it may be associated with the development of PD, as well as auditory function, with the potential of utilizing Parkin as a therapeutic target in PD treatment and preventing aminoglycoside ototoxicity.","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139534503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Early integration of palliative care in oncology has been shown to benefit patients on an individual level, especially regarding mood and quality of life. These patients both have a difficult disease course – where palliative care can help with interpersonal, spiritual, physical, and care planning concerns – and represent a substantial burden on inpatient facilities like intensive care units and emergency departments. This study explores relationships between early palliative oncology, patient healthcare experience, and broader burden on the health system. Methods: A retrospective chart review was performed comparing oncology patients at Parkview Regional Medical Center in Fort Wayne, IN. Cohort A (200 patients) received palliative care along with standard oncology care while cohort B (200 patients) received standard oncology care alone. Post-diagnosis emergency department visits, inpatient stays, and intensive care unit stays were compared. So were in-hospital deaths, referrals to hospice, and record of advance care planning documents. Results: Two endpoints evaluated by Chi2 analysis were statistically significant (p values <0.01): Cohort A was more likely than cohort B to be referred to hospice (79.5% vs 31.5%) and more likely to have advance care planning documents on file (38.5% vs 21%). Additionally, a T-test showed statistically significant difference (p=.001) for inpatient stays post-palliative care encounter versus patients who had no palliative care (1.75 vs 2.41). Conclusion: This study shows correlation between integrated oncology care with patients filing ACP documents and being referred to hospice. Additionally, it finds that cancer patients who visit the palliative care office have fewer inpatient stays after their visit than those who don’t visit at all. Future Implications: Future studies in this area should explore the latter finding from new perspectives, perhaps focusing on the differences between palliative care visit promptly after diagnosis/staging and palliative care implemented long after diagnosis/staging or not administered at all.
背景：事实证明，将姑息关怀尽早纳入肿瘤治疗可使患者个人受益，尤其是在情绪和生活质量方面。这些患者的病程艰难，姑息关怀可以帮助他们解决人际交往、精神、身体和护理计划等方面的问题，同时也给重症监护病房和急诊科等住院设施带来了沉重负担。本研究探讨了早期肿瘤姑息治疗、病人的医疗体验和医疗系统的更广泛负担之间的关系。 研究方法对印第安纳州韦恩堡帕克维尤地区医疗中心的肿瘤患者进行了回顾性病历审查。队列 A（200 名患者）在接受标准肿瘤治疗的同时接受姑息治疗，队列 B（200 名患者）则只接受标准肿瘤治疗。对诊断后的急诊就诊率、住院时间和重症监护室停留时间进行了比较。此外，还对院内死亡、转诊至临终关怀机构以及预先护理计划文件的记录进行了比较。 结果：通过Chi2分析评估的两个终点具有统计学意义（P值小于0.01）：队列 A 比队列 B 更有可能被转诊至临终关怀机构（79.5% 对 31.5%），也更有可能拥有预先医疗规划文件（38.5% 对 21%）。此外，T检验显示，接受姑息关怀后的住院时间与未接受姑息关怀的患者住院时间（1.75 vs 2.41）之间存在显著差异（p=.001）。 结论这项研究表明，肿瘤综合治疗与患者提交 ACP 文件和被转诊至临终关怀机构之间存在相关性。此外，研究还发现，到姑息关怀办公室就诊的癌症患者在就诊后的住院时间少于未就诊的患者。 未来意义：该领域的未来研究应从新的角度探讨后一项发现，或许可以重点研究在确诊/分期后立即就诊的姑息关怀与确诊/分期后很久才实施姑息关怀或根本就不实施姑息关怀之间的差异。
{"title":"The Effects of Integrative Palliative Oncology on Health System Burden","authors":"Jackson Brandon, J. McCollom","doi":"10.18060/27950","DOIUrl":"https://doi.org/10.18060/27950","url":null,"abstract":"Background: Early integration of palliative care in oncology has been shown to benefit patients on an individual level, especially regarding mood and quality of life. These patients both have a difficult disease course – where palliative care can help with interpersonal, spiritual, physical, and care planning concerns – and represent a substantial burden on inpatient facilities like intensive care units and emergency departments. This study explores relationships between early palliative oncology, patient healthcare experience, and broader burden on the health system. \u0000Methods: A retrospective chart review was performed comparing oncology patients at Parkview Regional Medical Center in Fort Wayne, IN. Cohort A (200 patients) received palliative care along with standard oncology care while cohort B (200 patients) received standard oncology care alone. Post-diagnosis emergency department visits, inpatient stays, and intensive care unit stays were compared. So were in-hospital deaths, referrals to hospice, and record of advance care planning documents. \u0000Results: Two endpoints evaluated by Chi2 analysis were statistically significant (p values <0.01): Cohort A was more likely than cohort B to be referred to hospice (79.5% vs 31.5%) and more likely to have advance care planning documents on file (38.5% vs 21%). Additionally, a T-test showed statistically significant difference (p=.001) for inpatient stays post-palliative care encounter versus patients who had no palliative care (1.75 vs 2.41). \u0000 Conclusion: This study shows correlation between integrated oncology care with patients filing ACP documents and being referred to hospice. Additionally, it finds that cancer patients who visit the palliative care office have fewer inpatient stays after their visit than those who don’t visit at all. \u0000 Future Implications: Future studies in this area should explore the latter finding from new perspectives, perhaps focusing on the differences between palliative care visit promptly after diagnosis/staging and palliative care implemented long after diagnosis/staging or not administered at all. ","PeriodicalId":20522,"journal":{"name":"Proceedings of IMPRS","volume":" 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139625333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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