Indianapolis, IN, United States


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Horner D.K.,Indianapolis
Plastic Surgical Nursing | Year: 2017

The purpose of study was to determine whether mentoring based on Watson's Caring Model positively influences nurse practitioner (NP) job satisfaction. This nonexperimental mixed-methods study utilized an online survey, administered through Qualtrics containing demographic and mentoring variables. Job satisfaction results were obtained from the Misener Nurse Practitioner Job Satisfaction Scale (MNPJSS). Also, open-ended questions regarding mentoring were reported. There was a 54% response rate in which 37 of the 69 participants responded ( n = 37), with statistical significance set at p < .05. All or 100% of participants reported that the mentor experience/relationship positively influenced job satisfaction. Scores from the MNPJSS ranged from 141 to 246, with a mean of 195.26 ( SD = 28.29) corresponding to "minimally satisfied" or a mean of 4.44 on the 6-point scale. These results are similar to the MNPJSS score with a mean of 4.39. A mentoring experience can provide a positive environment, which can lead to increased job satisfaction. In turn, a higher level of satisfaction in the work environment can be associated with reduced turnover and improved retention and patient outcomes. Ultimately, a safer health care system will evolve and improve patient care and outcomes. Through Watson's Caring Model, a reciprocal relationship between the mentor and the mentee can provide a new NP hire a sense of community and direct availability. By experiencing a mentor relationship, job satisfaction can improve, which is a key factor in retaining NPs. As E-mentoring is a newer topic in nursing literature, further research is needed. Further studies could also review and develop one-on-one mentoring programs. Copyright © 2017 American Society of Plastic Surgical Nurses.

Bennett J.D.,Indianapolis
Oral and Maxillofacial Surgery Clinics of North America | Year: 2017

Every patient is different and has the potential to respond unfavorably to anesthetic and surgical intervention. Preparation is the key to optimizing patient outcome. © 2017 Elsevier Inc.

Condello S.,Indianapolis | Morgan C.A.,MS 4019 | Nagdas S.,University of Virginia | Cao L.,Indianapolis | And 5 more authors.
Oncogene | Year: 2015

Cancer cells form three-dimensional (3D) multicellular aggregates (or spheroids) under non-adherent culture conditions. In ovarian cancer (OC), spheroids serve as a vehicle for cancer cell dissemination in the peritoneal cavity, protecting cells from environmental stress-induced anoikis. To identify new targetable molecules in OC spheroids, we investigated gene expression profiles and networks upregulated in 3D vs traditional monolayer culture conditions. We identified ALDH1A1, a cancer stem cell marker as being overexpressed in OC spheroids and directly connected to key elements of the β-catenin pathway. β-Catenin function and ALDH1A1 expression were increased in OC spheroids vs monolayers and in successive spheroid generations, suggesting that 3D aggregates are enriched in cells with stem cell characteristics. β-Catenin knockdown decreased ALDH1A1 expression levels and β-catenin co-immunoprecipitated with the ALDH1A1 promoter, suggesting that ALDH1A1 is a direct β-catenin target. Both short interfering RNA-mediated β-catenin knockdown and A37 ((ethyl-2-((4-oxo-3-(3-(pryrrolidin-1-yl)propyl)-3,4-dihydrobenzo «4,5»thioeno «3,2-d»pyrimidin-2-yl)thio)acetate)), a novel ALDH1A1 small-molecule enzymatic inhibitor described here for the first time, disrupted OC spheroid formation and cell viability (P<0.001). β-Catenin knockdown blocked tumor growth and peritoneal metastasis in an OC xenograft model. These data strongly support the role of β-catenin-regulated ALDH1A1 in the maintenance of OC spheroids and propose new ALDH1A1 inhibitors targeting this cell population.

Rattermann M.J.,Indianapolis
Advances in School Mental Health Promotion | Year: 2014

This research presents data linking the impact of substance disorder to academic achievement, using data gathered at a recovery high school. Recovery schools provide recovery supports and a high-quality education to students with substance use disorders. The Global Appraisal of Individual Needs - Short Screener and the Northwest Evaluation Association Measures of Academic Progress were administered, and paired observations (Testing 1 (T1) vs. Testing 2 (T2)) were categorized based on information from the Global Appraisal of Individual Needs - Short Screen, as increased, decreased, or no change in substance disorder. Results confirm the impact of substance disorder on academic growth, with T1-T2 pairings in which substance disorder increased resulting in a decrease in academic growth, and T1-T2 pairings in which substance disorder decreased resulting in an increase in academic growth. The impact of no change in substance disorder from T1 to T2 varied by the time frame of the substance use, either in the past month or in the past year.

Agarwal R.,Indianapolis | Agarwal R.,Richard udebush Va Medical Center
Current Opinion in Nephrology and Hypertension | Year: 2010

Purpose of review: Circadian variation is commonly seen in healthy people; aberration in these biological rhythms is an early sign of disease. Impaired circadian variation of blood pressure (BP) has been shown to be associated with greater target organ damage and with an elevated risk of cardiovascular events independent of the BP load. The purpose of this review is to examine the physiology of circadian BP variation and propose a tripartite model that explains the regulation of circadian BP. Recent findings: The time-keeper in mammals resides centrally in the suprachiasmatic nucleus. Apart from this central clock, molecular clocks exist in most peripheral tissues including vascular tissue and the kidney. These molecular clocks regulate sodium balance, sympathetic function and vascular tone. A physiological model is proposed that integrates our understanding of molecular clocks in mice with the circadian BP variation among humans. The master regulator in this proposed model is the sleep-activity cycle. The equivalents of peripheral clocks are endothelial and adrenergic functions. Thus, in the proposed model, the variation in circadian BP is dependent upon three major factors: physical activity, autonomic function, and sodium sensitivity. Summary: The integrated consideration of physical activity, autonomic function, and sodium sensitivity appears to explain the physiology of circadian BP variation and the pathophysiology of disrupted BP rhythms in various conditions and disease states. Our understanding of molecular clocks in mice may help to explain the provenance of blunted circadian BP variation even among astronauts. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Jalal S.,Indianapolis | Earley J.N.,Indianapolis | Turchi J.J.,Indianapolis | Turchi J.J.,Indiana University
Clinical Cancer Research | Year: 2011

A critical link exists between an individual's ability to repair cellular DNA damage and cancer development, progression, and response to therapy. Knowledge gained about the proteins involved and types of damage repaired by the individual DNA repair pathways has led to the development of a variety of assays aimed at determining an individual's DNA repair capacity. These assays and their use in the analysis of clinical samples have yielded useful though somewhat conflicting data. In this review article, we discuss the majorDNArepair pathways, the proteins and genes required for each, assays used to analyze activity, and the relevant clinical studies to date. With the recent results from clinical trials targeting specific DNA repair proteins for the treatment of cancer, accurate, reproducible, and relevant analysis of DNA repair takes on an even greater significance. We highlight the strengths and limitations of these DNA repair studies and assays, with respect to the clinical assessment of DNA repair capacity to determine cancer development and response to therapy. ©2011 AACR.

Fatima H.,Indianapolis | Johnson C.S.,Indianapolis | Rex D.K.,Indianapolis
Gastrointestinal Endoscopy | Year: 2010

Background: There are few data evaluating how accurately patients can predict the quality of their colonoscopy preparation. Objective: The aim of this study was to assess whether patients' description of rectal effluent predicts preparation quality as assessed per endoscopist. Design: Prospective, cross-sectional. Setting: Three outpatient endoscopy units at Indiana University Medical Center. Patients: Patients undergoing colonoscopy were enrolled. Interventions: Patients were given a questionnaire assessing their preparation based on the description of their last rectal effluent. This was compared with endoscopists assessment of preparation. Main Outcome Measurements: Correlation between the patient's description of the last effluent and endoscopist's assessment of preparation. Results: Of the total 429 patients, 59% were male and 75% were white. There was only slight agreement between the patients' description of effluent and the endoscopists' description of preparation (Cohen kappa statistic, 0.067). However, patients reporting brown liquid or solid had a 54% chance of having fair or poor preparation. Ingestion of <90% of the preparation, male gender, use of medications associated with constipation, and comorbid conditions were independent predictors of fair or poor preparation. Limitations: No validated system to assess the quality of the bowel preparation or for patients to assess their preparation. Conclusion: Patients' description of last rectal effluent is not a reliable predictor of quality of preparation per the endoscopist, but patients reporting their last effluent as brown liquid or solid have a substantial likelihood of inadequate preparation. These patients may benefit from additional preparation, which may be particularly useful if it can be administered in the endoscopy unit followed by colonoscopy on the same day. © 2010 American Society for Gastrointestinal Endoscopy.

Molitoris B.A.,Indianapolis
Transactions of the American Clinical and Climatological Association | Year: 2014

Intravital 2-photon microscopy, along with the development of fluorescent probes and innovative software, has rapidly advanced the study of intracellular and intercellular processes at the organ level. Researchers can quantify the distribution, behavior, and dynamic interactions of up to four labeled chemical probes and proteins simultaneously and repeatedly in four dimensions (3D + time) with subcellular resolution in real time. Transgenic fluorescently labeled proteins, delivery of plasmids, and photo-activatable probes enhance these possibilities. Thus, multi-photon microscopy has greatly extended our ability to understand cell biology intra-vitally at cellular and subcellular levels. For example, evaluation of rat surface glomeruli and accompanying proximal tubules has shown the long held paradigm regarding limited albumin filtration under physiologic conditions is to be questioned. Furthermore, the role of proximal tubules in determining albuminuria under physiologic and disease conditions was supported by direct visualization and quantitative analysis.

Frost K.D.,Indianapolis
Journal of the Air and Waste Management Association | Year: 2014

An evaluation of the steady-state dispersion model AERMOD was conducted to determine its accuracy at predicting hourly ground-level concentrations of sulfur dioxide (SO2) by comparing model-predicted concentrations to a full year of monitored SO2 data. The two study sites are comprised of three coal-fired electrical generating units (EGUs) located in southwest Indiana. The sites are characterized by tall, buoyant stacks, flat terrain, multiple SO2 monitors, and relatively isolated locations. AERMOD v12060 and AERMOD v12345 with BETA options were evaluated at each study site. For the six monitor-receptor pairs evaluated, AERMOD showed generally good agreement with monitor values for the hourly 99th percentile SO2 design value, with design value ratios that ranged from 0.92 to 1.99. AERMOD was within acceptable performance limits for the Robust Highest Concentration (RHC) statistic (RHC ratios ranged from 0.54 to 1.71) at all six monitors. Analysis of the top 5% of hourly concentrations at the six monitor-receptor sites, paired in time and space, indicated poor model performance in the upper concentration range. The amount of hourly model predicted data that was within a factor of 2 of observations at these higher concentrations ranged from 14 to 43% over the six sites. Analysis of subsets of data showed consistent overprediction during low wind speed and unstable meteorological conditions, and underprediction during stable, low wind conditions. Hourly paired comparisons represent a stringent measure of model performance; however, given the potential for application of hourly model predictions to the SO2 NAAQS design value, this may be appropriate. At these two sites, AERMOD v12345 BETA options do not improve model performance. A regulatory evaluation of AERMOD utilizing quantile-quantile (Q-Q) plots, the RHC statistic, and 99th percentile design value concentrations indicates that model performance is acceptable according to widely accepted regulatory performance limits. However, a scientific evaluation examining hourly paired monitor and model values at concentrations of interest indicates overprediction and underprediction bias that is outside of acceptable model performance measures. Overprediction of 1-hr SO2 concentrations by AERMOD presents major ramifications for state and local permitting authorities when establishing emission limits. © 2014 Copyright 2014 A&WMA.

Konrad C.,Biochemistry and Molecular Biology | Wek R.C.,Indianapolis | Sullivan Jr. W.J.,Biochemistry and Molecular Biology | Sullivan Jr. W.J.,Indiana University
Eukaryotic Cell | Year: 2011

Toxoplasmosis is a significant opportunistic infection caused by the protozoan parasite Toxoplasma gondii, an obligate intracellular pathogen that relies on host cell nutrients for parasite proliferation. Toxoplasma parasites divide until they rupture the host cell, at which point the extracellular parasites must survive until they find a new host cell. Recent studies have indicated that phosphorylation of Toxoplasma eukaryotic translation initiation factor 2-alpha (TgIF2α) plays a key role in promoting parasite viability during times of extracellular stress. Here we report the cloning and characterization of a TgIF2 α kinase designated TgIF2K-D that is related to GCN2, a eukaryotic initiation factor 2 α (eIF2 α) kinase known to respond to nutrient starvation in other organisms. TgIF2K-D is present in the cytosol of both intra- and extracellular Toxoplasma parasites and facilitates translational control through TgIF2 α phosphorylation in extracellular parasites. We generated a TgIF2K-D knockout parasite and demonstrated that loss of this eIF2 α kinase leads to a significant fitness defect that stems from an inability of the parasite to adequately adapt to the environment outside host cells. This phenotype is consistent with that reported for our nonphosphorylatable TgIF2 α mutant (S71A substitution), establishing that TgIF2K-D is the primary eIF2α kinase responsible for promoting extracellular viability of Toxoplasma. These studies suggest that eIF2α phosphorylation and translational control are an important mechanism by which vulnerable extracellular parasites protect themselves while searching for a new host cell. Additionally, TgIF2α is phosphorylated when intracellular parasites are deprived of nutrients, but this can occur independently of TgIF2K-D, indicating that this activity can be mediated by a different TgIF2K. © 2011, American Society for Microbiology. All Rights Reserved.

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