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Item Association of Plasma Aflatoxin With Persistent Detection of Oncogenic Human Papillomaviruses in Cervical Samples From Kenyan Women Enrolled in a Longitudinal Study(BMC, 2023-06-06) Tong, Yan; Tonui, Philip; Orang’o, Omenge; Zhang, Jianjun; Maina, Titus; Muthoka, Kapten; Groopman, John; Smith, Joshua; Madeen, Erin; Ermel, Aaron; Loehrer, Patrick; Brown, Darron R.; Biostatistics, School of Public HealthBackground: Cervical cancer is caused by oncogenic human papillomaviruses (HR-HPV) and is common among Kenyan women. Identification of factors that increase HR-HPV persistence is critically important. Kenyan women exposed to aflatoxin have an increased risk of HR-HPV detection in cervical specimens. This analysis was performed to examine associations between aflatoxin and HR-HPV persistence. Methods: Kenyan women were enrolled in a prospective study. The analytical cohort for this analysis included 67 HIV-uninfected women (mean age 34 years) who completed at least two of three annual study visits and had an available blood sample. Plasma aflatoxin was detected using ultra-high pressure liquid chromatography (UHPLC)-isotope dilution mass spectrometry. Annual cervical swabs were tested for HPV (Roche Linear Array). Ordinal logistic regression models were fitted to examine associations of aflatoxin and HPV persistence. Results: Aflatoxin was detected in 59.7% of women and was associated with higher risk of persistent detection of any HPV type (OR = 3.03, 95%CI = 1.08-8.55, P = 0.036), HR-HPV types (OR = 3.63, 95%CI = 1.30-10.13, P = 0.014), and HR-HPV types not included in the 9-valent HPV vaccine (OR = 4.46, 95%CI = 1.13-17.58, P = 0.032). Conclusions: Aflatoxin detection was associated with increased risk of HR-HPV persistence in Kenyan women. Further studies, including mechanistic studies are needed to determine if aflatoxin synergistically interacts with HR-HPV to increase cervical cancer risk.Item Center for Urban and Multicultural Education IMPACT After-School Programs(Office of the Vice Chancellor for Research, 2011-04-08) Smith, JoshuaAs a partnership with a 21st Century Community Learning Centers grantee and the Center for Urban and Multicultural Education (CUME) within the IU School of Education at Indianapolis, the IMPACT project will showcase both research and evaluation reports and student work from the local Indianapolis schools within the IMPACT After-School Programs. The partnership has allowed both researchers and community members to collaborate around grant writing, methods and outcomes for program evaluation, and recommendations for program improvement that directly affect the local programs and elementary school students involved.Item Center for Urban and Multicultural Education’s Arts4Learning: Evaluation of an Early Childhood Arts Education Program(Office of the Vice Chancellor for Research, 2010-04-09) Smith, Joshua; Rittenhouse, Ashley; Guillot, Jerry; Pagdalian, PloiCUME is a research center located in the Indiana University School of Education at Indianapolis focused on (1) Engaged Urban Teaching and Learning, (2) Community-Campus Connections/Translational Research, (3) Academic Access and Success in Urban Contexts, and (4) Urban Curriculum Research. The Arts4Learning project embodies several CUME initiatives as it infuses arts education with literacy skills and reaches out to students in both Indianapolis and Lafayette.Item Detection and Concentration of Plasma Aflatoxin Is Associated With Detection of Oncogenic Human Papillomavirus in Kenyan Women(Oxford Academic, 2019-09-01) Zhang, Jianjun; Orang’o, Omenge; Tonui, Philip; Tong, Yan; Maina, Titus; Kiptoo, Stephen; Muthoka, Katpen; Groopman, John; Smith, Joshua; Madeen, Erin; Ermel, Aaron; Loehrer, Patrick; Brown, Darron R.; Department of Epidemiology, School of Public HealthAbstract Background Cervical cancer is common in Kenyan women. Cofactors in addition to infection with oncogenic human papillomavirus (HPV) are likely to be important in causing cervical cancer, because only a small percentage of HPV-infected women will develop this malignancy. Kenyan women are exposed to dietary aflatoxin, a potent carcinogen and immunosuppressive agent, which may be such a cofactor. Methods Demographics, behavioral data, plasma, and cervical swabs were collected from 88 human immunodeficiency virus-uninfected Kenyan women without cervical dysplasia. Human papillomavirus detection was compared between women with or without plasma aflatoxin B1-lysine (AFB1-lys) and evaluated in relation to AFB1-lys concentration. Results Valid HPV testing results were available for 86 women (mean age 34.0 years); 49 women (57.0%) had AFB1-lys detected and 37 (43.0%) had none. The AFB1-lys detection was not associated with age, being married, having more than secondary school education, home ownership, living at a walking distance to healthcare ≥60 minutes, number of lifetime sex partners, or age of first sex. The AFB1-lys detection and plasma concentrations were associated with detection of oncogenic HPV types. Conclusions The AFB1-lys positivity and higher plasma AFB1-lys concentrations were associated with higher risk of oncogenic HPV detection in cervical samples from Kenya women. Further studies are needed to determine whether aflatoxin interacts with HPV in a synergistic manner to increase the risk of cervical cancer.Item Diffuse Alveolar Hemorrhage(Springer Nature, 2019-07-24) Desai, Hem; Smith, Joshua; Williams, Mark Daren; Medicine, School of MedicineDiffuse alveolar hemorrhage[DAH] is a serious condition that can be life threatening. It can be caused by a constellation of disorders which presents with hemoptysis, anemia, and diffuse alveolar infiltrates. Respiratory failure from DAH can be so severe that it has been called an ARDS mimic/imitator. Early recognition is crucial because prompt diagnosis and treatment are required for survival. DAH should be distinguished from other causes of pulmonary hemorrhage caused by localized pulmonary abnormalities and the bronchial circulation. Early bronchoscopy with bronchoalveolar lavage (BAL) is generally required to confirm the diagnosis of DAH and rule out infection. Progressively bloody bronchoalveolar lavage samples can distinguish DAH. Systemic vasculitis is one of the most common causes of DAH and can be pathologically defined by the presence of cellular inflammation, vessel destruction, tissue necrosis, and eventually, organ dysfunction. Corticosteroids and immunosuppressive agents remain the gold standard for the treatment. The following case illustrates a patient who was dependent on dialysis, then presented with hemoptysis. Bronchoscopy demonstrated progressively bloody bronchoalveolar lavage samples consistent with diffuse alveolar hemorrhage. Serologic testing was consistent with microscopic polyangiitis. The patient experienced a clinical remission with cyclophosphamide and corticosteroids.Item Experiencing narrative pedagogy(2014-11) Bowles, Wendy S.; Sims, Sharon L.; Ironside, Pamela M.; Swenson, Melinda M.; Smith, JoshuaThe role of the nurse has changed dramatically in the past twenty years with increasing complexity of patient care and a rapidly changing health care environment. In addition to the challenges noted regarding patient care, problems with increasing medical errors were noted in the literature specific to graduates in their first year as a nurse. Research in particular to nursing education provides a way for nurse educators to become more astute at addressing problems pervading the role of the new nursing graduate. Narrative Pedagogy was identified as a research-based nursing pedagogy and has been researched and enacted for more than a decade. Out of the Narrative Pedagogy research, the Concernful Practices emerged identifying what was considered meaningful to nursing education by teachers, students, and clinicians. Listening was one of the Concernful Practices and became the focus of this study. The research question addressed the “How do nurse educators who enable Narrative Pedagogy experience Listening: knowing and connecting?” This was a hermeneutic phenomenological study in which ten nurse educators shared their experiences. The two themes that emerged from the study included: Listening as Dialogue and Listening as Attunement. The findings of this study provided a different way of thinking about teaching and learning that encompasses so much more than merely a strategy or outcome-based approach. The implications of this study offer nurse educators insight about opening a dialogue that draws attention to the realities of the role of the nurse responding to multiple patients with complex health conditions.Item Experiencing Narrative Pedagogy: Conversations with Nurse Educators(2013-04-01) Stoltzfus, Ruth A.; Swenson, Melinda M.; Sims, Sharon L.; Ironside, Pamela M.; Smith, JoshuaThe increasingly complex nature of health care requires nursing graduates, upon completion of their formal education, to be fully capable of providing safe and competent patient care. Accrediting bodies for schools of nursing have challenged nursing education to develop and implement innovative, research-based pedagogies that engage students in learning. Narrative Pedagogy is an innovative approach to teaching and learning developed by Nancy Diekelmann after many years of researching nursing education using Heideggerian hermeneutic phenomenology. As a new paradigm for teachers and students gathering in learning, Narrative Pedagogy is understood to be both a strategy and a philosophy of teaching. Narrative Pedagogy as a strategy provides an approach using the interpretation of clinical stories to better understand the experience of the patient, the nurse, and the family. Narrative Pedagogy as a philosophy of teaching offers Diekelmann’s Concernful Practices as a way of comportment for teachers and students as they gather in learning and teachers as they incline toward teaching narratively. This hermeneutic phenomenological study examined the experience of Nurse Educators with Narrative Pedagogy. Findings include overarching Pattern: Narrative Pedagogy as Bridge. Two themes are: 1) Students and teachers gathering in learning, and 2) Inclining toward teaching with Narrative Pedagogy. Positive teaching experiences and positive learning experiences with Narrative Pedagogy will advance the science of nursing education by adding to the body of knowledge of alternative pedagogies.Item Model for Gold Nanoparticle Synthesis: Effect of pH and Reaction Time(American Chemical Society, 2021-06-24) Yazdani, Saeed; Daneshkhah, Ali; Diwate, Abolee; Patel, Hardi; Smith, Joshua; Reul, Olivia; Cheng, Ruihua; Izadian, Afshin; Hajrasouliha, Amir Reza; Physics, School of ScienceThe synthesis of gold nanoparticles is dependent on both the concentration of trisodium citrate dihydrate and the time that it interacts with tetrachloroauric acid. A wide range of gold nanoparticles with various sizes and dispersity can be produced based on control variables, such as time of reaction and acid concentration, using a similar approach to that of the Turkevich model. In this model, the pH of the solution decreases slightly throughout the reaction (0.005 unit/min) due to the chemical interactions between trisodium citrate dihydrate and tetrachloroauric acid. Dicarboxy acetone is formed during citrate oxidization, resulting in gold nuclei formation over time. In addition, gold nanoparticle nucleation causes pH fluctuation over time based on gold nanoparticle sizes. An inverse correlation (coefficient of smaller than -0.97) was calculated between the pH and reaction time at different ratios of trisodium citrate dihydrate to tetrachloroauric acid. Regression analysis was used to develop a model for the prediction of the size of gold nanoparticles ranging from 18 to 38 nm based on the concentration of trisodium citrate dihydrate and the reaction time.