Open Access Policy Articles

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The IUPUI Faculty Council adopted an open access policy on October 7th, 2014 (available from: https://openaccess.indianapolis.iu.edu/). This policy shows IUPUI's commitment to disseminating the fruits of research and scholarship as widely as possible. Open access policies increase authors’ rights, readership and citation rates for scholarly articles. The opt out provision ensures that all faculty authors have the freedom to publish in the journal of their choice.

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Now showing 1 - 10 of 27131

Prevalence of Discrimination, Abuse, and Harassment in Emergency Medicine Residency Training in the US
(American Medical Association, 2021-08-02) Lall, Michelle D.; Bilimoria, Karl Y.; Lu, Dave W.; Zhan, Tiannan; Barton, Melissa A.; Hu, Yue-Yung; Beeson, Michael S.; Adams, James G.; Nelson, Lewis S.; Baren, Jill M.; Surgery, School of Medicine
Importance: The prevalence of workplace mistreatment and its association with the well-being of emergency medicine (EM) residents is unclear. More information about the sources of mistreatment might encourage residency leadership to develop and implement more effective strategies to improve professional well-being not only during residency but also throughout the physician's career. Objective: To examine the prevalence, types, and sources of perceived workplace mistreatment during training among EM residents in the US and the association between mistreatment and suicidal ideation. Design, setting, and participants: In this survey study conducted from February 25 to 29, 2020, all residents enrolled in EM residencies accredited by the Accreditation Council for Graduate Medical Education (ACGME) who participated in the 2020 American Board of Emergency Medicine computer-based In-training Examination were invited to participate. A multiple-choice, 35-item survey was administered after the examination asking residents to self-report the frequency, sources, and types of mistreatment experienced during residency training and whether they had suicidal thoughts. Main outcomes and measures: The types and frequency of workplace mistreatment and the sources of the mistreatment were identified, and rates of self-reported suicidality were obtained. Multivariable logistic regression models were used to examine resident and program characteristics associated with suicidal thoughts. Results: Of 8162 eligible EM residents, 7680 (94.1%) responded to at least 1 question on the survey; 6503 (79.7%) completed the survey in its entirety. A total of 243 ACGME-accredited residency programs participated, and 1 did not. The study cohort included 4768 male residents (62.1%), 2698 female residents (35.1%), 4919 non-Hispanic White residents (64.0%), 2620 residents from other racial/ethnic groups (Alaska Native, American Indian, Asian or Pacific Islander, African American, Mexican American, Native Hawaiian, Puerto Rican, other Hispanic, or mixed or other race) (34.1%), 483 residents who identified as lesbian, gay, bisexual, transgender, queer, or other (LGBTQ+) (6.3%), and 5951 residents who were married or in a relationship (77.5%). Of the total participants, 3463 (45.1%) reported exposure to some type of workplace mistreatment (eg, discrimination, abuse, or harassment) during the most recent academic year. A frequent source of mistreatment was identified as patients and/or patients' families; 1234 respondents (58.7%) reported gender discrimination, 867 (67.5%) racial discrimination, 282 (85.2%) physical abuse, and 723 (69.1%) sexual harassment from patients and/or family members. Suicidal thoughts occurring during the past year were reported by 178 residents (2.5%), with similar prevalence by gender (108 men [2.4%]; 59 women [2.4%]) and race/ethnicity (113 non-Hispanic White residents [2.4%]; 65 residents from other racial/ethnic groups [2.7%]). Conclusions and relevance: In this survey study, EM residents reported that workplace mistreatment occurred frequently. The findings suggest common sources of mistreatment for which educational interventions may be developed to help ensure resident wellness and career satisfaction.
Benzene in Benzoyl Peroxide – How Worried Should We Be?
(Elsevier, 2024-10) Barbieri, John S.; Streicher, Jenna L.; Rosmarin, David; Dermatology, School of Medicine
Benzoyl peroxide (BPO) is a foundational acne treatment that can also prevents the development of Cutibacterium acnes resistance to antibiotics.1 However, BPO has the potential to thermally decompose into benzene, a known carcinogen.2 Two recent reports released by the independent laboratory Valisure have suggested that common BPO products may contain concerning levels of benzene after incubation for days to weeks at temperatures of 37°C (99°F) and 50°C (122°F).2,3 In addition, these reports describe that some products had detectible levels of benzene when procured, but do not provide specific details beyond summary level data regarding the number of products with >2 (19/66) or >10 ppm (10/66) of benzene detected.3
Viruses of sulfur oxidizing phototrophs encode genes for pigment, carbon, and sulfur metabolisms
(Nature, 2023) Hesketh-Best, Poppy J.; Bosco-Santos, Alice; Garcia, Sofia L.; O'Beirne, Molly D.; Werne, Josef P.; Gilhooly, William P., III; Silveira, Cynthia B.; Earth Science, School of Science
Viral infections modulate bacterial metabolism and ecology. Here, we investigated the hypothesis that viruses influence the ecology of purple and green sulfur bacteria in anoxic and sulfidic lakes, analogs of euxinic oceans in the geologic past. By screening metagenomes from lake sediments and water column, in addition to publicly-available genomes of cultured purple and green sulfur bacteria, we identified almost 300 high and medium-quality viral genomes. Viruses carrying the gene psbA, encoding the small subunit of photosystem II protein D1, were ubiquitous, suggesting viral interference with the light reactions of sulfur oxidizing autotrophs. Viruses predicted to infect these autotrophs also encoded auxiliary metabolic genes for reductive sulfur assimilation as cysteine, pigment production, and carbon fixation. These observations show that viruses have the genomic potential to modulate the production of metabolic markers of phototrophic sulfur bacteria that are used to identify photic zone euxinia in the geologic past.
Clinician Attitudes Toward Referring Patients to Pharmacists for Tobacco Cessation Services
(Elsevier, 2024-09) Willcox, Alexander T.; Ellis Hilts, Katy; Thoma, Lynn; Corelli, Robin L.; Suchanek Hudmon, Karen; Health Policy and Management, School of Public Health
Background The role of pharmacists in tobacco cessation has grown substantially in recent years, now including the ability to prescribe medications in many states. Although pharmacists can fill a gap in care by helping patients quit, other clinicians’ perceptions regarding referring patients to pharmacists for these services have not been described. Objective To characterize clinicians’ current referral patterns to pharmacists for tobacco cessation services, intention to refer in the future, and perceived barriers to and facilitators of referrals. Methods A cross-sectional survey was administered within a network of federally qualified health centers (FQHCs), which provides care to underserved patients. Guided by the Consolidated Framework for Implementation Research (CFIR), the survey assessed (a) clinicians’ sociodemographics, (b) interactions with pharmacists and referral practices, and (c) perceived barriers to and facilitators of patient referrals to network pharmacists for cessation assistance. Results Of 51 respondents (80% response), one third (n = 17) reported referring one or more patients to a FQHC network pharmacist in the past for help with quitting tobacco. Most (84%) reported willingness to refer patients to pharmacists in the future, and 100% of the 17 clinicians who had previously referred patients strongly agreed that they would refer again in the future. For 8 of 12 CFIR measures (67%), significant differences were observed between clinicians who had previously referred patients to pharmacists and clinicians who had not. Conclusion Nonpharmacist clinicians in an FQHC expressed positive views toward a pharmacist-led tobacco cessation service, and prior experience with referrals was consistent with strong intentions for future referrals. Future studies should explore concerns regarding impact on workflow to identify and implement strategies for streamlining referrals for cessation services.
Culture media composition influences patient-derived organoid ability to predict therapeutic responses in gastrointestinal cancers
(American Society for Clinical Investigation, 2022-11-22) Hogenson, Tara L.; Xie, Hao; Phillips, William J.; Toruner, Merih D.; Li, Jenny J.; Horn, Isaac P.; Kennedy, Devin J.; Almada, Luciana L.; Marks, David L.; Carr, Ryan M.; Toruner, Murat; Sigafoos, Ashley N.; Koenig-Kappes, Amanda N.; Olson, Rachel Lo; Tolosa, Ezequiel J.; Zhang, Cheng; Li, Hu; Doles, Jason D.; Bleeker, Jonathan; Barrett, Michael T.; Boyum, James H.; Kipp, Benjamin R.; Mahipal, Amit; Hubbard, Joleen M.; Scheffler Hanson, Temperance J.; Petersen, Gloria M.; Dasari, Surendra; Oberg, Ann L.; Truty, Mark J.; Graham, Rondell P.; Levy, Michael J.; Zhu, Mojun; Billadeau, Daniel D.; Adjei, Alex A.; Dusetti, Nelson; Iovanna, Juan L.; Bekaii-Saab, Tanios S.; Ma, Wen Wee; Fernandez-Zapico, Martin E.; Anatomy, Cell Biology and Physiology, School of Medicine
BACKGROUND: A patient-derived organoid (PDO) platform may serve as a promising tool for translational cancer research. In this study, we evaluated PDO’s ability to predict clinical response to gastrointestinal (GI) cancers. METHODS: We generated PDOs from primary and metastatic lesions of patients with GI cancers, including pancreatic ductal adenocarcinoma, colorectal adenocarcinoma, and cholangiocarcinoma. We compared PDO response with the observed clinical response for donor patients to the same treatments. RESULTS: We report an approximately 80% concordance rate between PDO and donor tumor response. Importantly, we found a profound influence of culture media on PDO phenotype, where we showed a significant difference in response to standard-of-care chemotherapies, distinct morphologies, and transcriptomes between media within the same PDO cultures. CONCLUSION: While we demonstrate a high concordance rate between donor tumor and PDO, these studies also showed the important role of culture media when using PDOs to inform treatment selection and predict response across a spectrum of GI cancers.
National Evaluation of the Association Between Resident Labor Union Participation and Surgical Resident Well-being
(American Medical Association, 2021-09-01) Brajcich, Brian C.; Chung, Jeanette W.; Wood, Douglas E.; Horvath, Karen D.; Tolley, Philip D.; Yates, Elizabeth F.; Are, Chandrakanath; Ellis, Ryan J.; Hu, Yue-Yung; Bilimoria, Karl Y.; Surgery, School of Medicine
Importance: Labor unions are purported to improve working conditions; however, little evidence exists regarding the effect of resident physician unions. Objective: To evaluate the association of resident unions with well-being, educational environment, salary, and benefits among surgical residents in the US. Design, setting, and participants: This national cross-sectional survey study was based on a survey administered in January 2019 after the American Board of Surgery In-Training Examination (ABSITE). Clinically active residents at all nonmilitary US general surgery residency programs accredited by the American Council of Graduate Medical Education who completed the 2019 ABSITE were eligible for participation. Data were analyzed from December 5, 2020, to March 16, 2021. Exposures: Presence of a general surgery resident labor union. Rates of labor union coverage among non-health care employees within a region were used as an instrumental variable (IV) for the presence of a labor union at a residency program. Main outcomes and measures: The primary outcome was burnout, which was assessed using a modified version of the abbreviated Maslach Burnout Inventory and was defined as experiencing any symptom of depersonalization or emotional exhaustion at least weekly. Secondary outcomes included suicidality, measures of job satisfaction, duty hour violations, mistreatment, educational environment, salary, and benefits. Results: A total of 5701 residents at 285 programs completed the pertinent survey questions (response rate, 85.6%), of whom 3219 (56.5%) were male, 3779 (66.3%) were White individuals, 449 (7.9%) were of Hispanic ethnicity, 4239 (74.4%) were married or in a relationship, and 1304 (22.9%) had or were expecting children. Among respondents, 690 residents were from 30 unionized programs (10.5% of programs). There was no difference in burnout for residents at unionized vs nonunionized programs (297 [43.0%] vs 2175 [43.4%]; odds ratio [OR], 0.92 [95% CI, 0.75-1.13]; IV difference in probability, 0.15 [95% CI, -0.11 to 0.42]). There were no significant differences in suicidality, job satisfaction, duty hour violations, mistreatment, educational environment, salary, or benefits except that unionized programs more frequently offered 4 weeks instead of 2 to 3 weeks of vacation (27 [93.1%] vs 52 [30.6%]; OR, 19.18 [95% CI, 3.92-93.81]; IV difference in probability, 0.77 [95% CI, 0.09-1.45]) and more frequently offered housing stipends (10 [38.5%] vs 9 [16.1%]; OR, 2.15 [95% CI, 0.58-7.95]; IV difference in probability, 0.62 [95% CI 0.04-1.20]). Conclusions and relevance: In this evaluation of surgical residency programs in the US, unionized programs offered improved vacation and housing stipend benefits, but resident unions were not associated with improved burnout, suicidality, job satisfaction, duty hour violations, mistreatment, educational environment, or salary.
Myocardial Infarction and the Fine Balance of Iron
(Elsevier, 2021-07-26) Dharmakumar, Rohan; Nair, Anand R.; Kumar, Andreas; Francis, Joseph; Medicine, School of Medicine
Electronic structure of cobalt valence tautomeric molecules in different environments
(RSC, 2023-02) Mishra, Ezra; Ekanayaka, Thilini K.; Panagiotakopoulos, Theodoros; Le, Duy; Rahman, Talat S.; Wang, Ping; McElveen, Kayleigh A.; Phillips, Jared P.; Zaz, M. Zaid; Yazdani, Saeed; N'Diaye, Alpha T.; Lai, Rebecca Y.; Streubel, Robert; Cheng, Ruihua; Shatruk, Michael; Dowben, Peter A.; Physics, School of Science
Future molecular microelectronics require the electronic conductivity of the device to be tunable without impairing the voltage control of the molecular electronic properties. This work reports the influence of an interface between a semiconducting polyaniline polymer or a polar poly-D-lysine molecular film and one of two valence tautomeric complexes, i.e., [CoIII(SQ)(Cat)(4-CN-py)2] ↔ [CoII(SQ)2(4-CN-py)2] and [CoIII(SQ)(Cat)(3-tpp)2] ↔ [CoII(SQ)2(3-tpp)2]. The electronic transitions and orbitals are identified using X-ray photoemission, X-ray absorption, inverse photoemission, and optical absorption spectroscopy measurements that are guided by density functional theory. Except for slightly modified binding energies and shifted orbital levels, the choice of the underlying substrate layer has little effect on the electronic structure. A prominent unoccupied ligand-to-metal charge transfer state exists in [CoIII(SQ)(Cat)(3-tpp)2] ↔ [CoII(SQ)2(3-tpp)2] that is virtually insensitive to the interface between the polymer and tautomeric complexes in the CoII high-spin state.
Association of Individual and Community Factors With Hepatitis C Infections Among Pregnant People and Newborns
(American Medical Association, 2021-10-29) Patrick, Stephen W.; Dupont, William D.; McNeer, Elizabeth; McPheeters, Melissa; Cooper, William O.; Aronoff, David M.; Osmundson, Sarah; Stein, Bradley D.; Medicine, School of Medicine
Importance: The opioid crisis has increasingly affected pregnant people and infants. Hepatitis C virus (HCV) infections, a known complication of opioid use, grew in parallel with opioid-related complications; however, the literature informing individual and community risks associated with maternal HCV infection is sparse. Objectives: To determine (1) individual and county-level factors associated with HCV among pregnant people and their newborn infants, and (2) how county-level factors influence individual risk among the highest risk individuals. Design setting and participants: This time-series analysis of retrospective, repeated cross-sectional data included pregnant people in all US counties from 2009 to 2019. We constructed mixed-effects logistic regression models to explore the association between HCV infection and individual and county-level covariates. Analyses were conducted between June 2019 and September 2021. Exposures: Individual-level: race and ethnicity, education, marital status, insurance type; county-level: rurality, employment, density of obstetricians. Main outcomes and measures: Hepatitis C virus as indicated on the newborn's birth certificate. Results: Between 2009 and 2019, there were 39 380 122 pregnant people who met inclusion criteria, among whom 138 343 (0.4%) were diagnosed with HCV. People with HCV were more likely to be White (79.9% vs 53.5%), American Indian or Alaska Native (AI/AN) (2.9% vs 0.9%), be without a 4-year degree (93.2% vs 68.6%), and be unmarried (73.7% vs 38.8%). The rate (per 1000 live births) of HCV among pregnant people increased from 1.8 to 5.1. In adjusted analyses, the following factors were associated with higher rates of HCV: individuals identified as White (adjusted odds ratio [aOR], 7.37; 95% CI, 7.20-7.55) and AI/AN (aOR, 7.94; 95% CI, 7.58-8.31) compared with Black individuals, those without a 4-year degree (aOR, 3.19; 95% CI, 3.11-3.28), those with Medicaid vs private insurance (aOR, 3.27; 95% CI, 3.21-3.33), and those who were unmarried (aOR, 2.80; 95% CI, 2.76-2.84); whereas, rural residence, higher rates of employment, and greater density of obstetricians was associated with lower risk of HCV. Among individuals at the highest risk of HCV, higher levels of county employment, accounting for other factors, were associated with less of a rise in HCV infections over time. Conclusions and relevance: In this cross-sectional study, maternal and newborn HCV infections increased substantially between 2009 and 2019, disproportionately among White and AI/AN people without a 4-year degree. County-level factors, including higher levels of employment, were associated with lower individual risks of acquiring the virus.
Prenatal Predictors of Survival in Isolated Congenital Diaphragmatic Hernia: A Systematic Review and Meta-analysis
(Wolters Kluwer, 2024-09) Tofte, Alena; Aghajani, Faezeh; Jawwad, Mohammad; Flood, Anna; D’Antonio, Francesco; Khalil, Asma; Mustafa, Hiba; Obstetrics and Gynecology, School of Medicine
OBJECTIVE: To evaluate prenatal fetal imaging findings associated with survival to hospital discharge, persistent pulmonary hypertension (PH), and need for extracorporeal membrane oxygenation (ECMO) in fetuses with isolated congenital diaphragmatic hernia (CDH) that are undergoing prenatal expectant management. DATA SOURCES: A systematic search was conducted in MEDLINE through PubMed, EMBASE, Web of Science, and The Cochrane Central, and ClinicalTrials.gov from 2000 up to July 2023. METHODS OF STUDY SELECTION: Studies that reported on prenatal imaging in fetuses with isolated CDH that were undergoing expectant management were included. Primary outcomes were survival to hospital discharge, persistent PH within 28 days of age, and need for ECMO. The quality of studies was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed when at least two studies reported on the same prenatal imaging evaluation. Subgroup analyses were performed according to the side (left or right) of CDH. TABULATION, INTEGRATION, AND RESULTS: A total of 161 full-text articles were assessed for eligibility, with 48 studies meeting the inclusion criteria: 45 (N=3,977) assessed survival, eight (N=994) assessed persistent PH, and 12 (N=2,085) assessed need for ECMO. The pooled proportion was 2,833 of 3,977 (71.2%, 95% CI, 69.8–72.6%) for survival, 565 of 2,085 (27.1%, 95% CI, 25.2–29.1%) for need for ECMO, and 531 of 994 (53.4%, 95% CI, 50.3–56.6%) for need for persistent PH. Prenatal imaging findings that were significantly associated with survival included: total fetal lung volume (mean difference [MD] 13.42, 95% CI, 11.22–15.62), observed-to-expected (O-E) total fetal lung volume less than 30% (odds ratio [OR] 0.09, 95% CI, 0.05–0.17), O-E total fetal lung volume (MD 14.73, 95% CI, 11.62–17.84, I2 46%), liver/intrathoracic ratio (MD −9.59, 95% CI, −15.73 to −3.46), O-E lung/head ratio (MD 14.03, 95% CI, 12.69–15.36), O-E lung/head ratio less than 25% (OR 0.07, 95% CI, 0.04–0.13), mediastinal shift angle (MD −6.17, 95% CI, −7.70 to −4.64), stomach position in mid-chest (OR 0.14, 95% CI, 0.06–0.36), and intrathoracic liver (OR 0.23, 95% CI, 0.15–0.35). In subgroup analyses, findings for left-sided CDH remained significant in all the aforementioned findings. The only prenatal imaging finding that was significantly associated with persistent PH was intrathoracic liver (OR 1.96, 95% CI, 1.14–3.37), but this association was no longer significant in subgroup analyses. Prenatal imaging findings that were significantly associated with need for ECMO included: O-E total fetal lung volume (MD −10.08, 95% CI, −13.54 to −6.62), O-E lung/head ratio (MD −9.88, 95% CI, 14.44 to −5.33, I2 30%), subgroup analysis to the left-sided CDH remained significant, percentage of predicted lung volume (MD −9.81, 95% CI, −13.56 to −6.06, I2 34%), and intrathoracic liver (OR 2.70, 95% CI, 1.60–4.57, I2 0%), but this association was no longer significant in left-sided CDH subgroup analysis. CONCLUSION: Several prenatal imaging findings, including lung measurements, intrathoracic liver, and stomach position, were predictive of neonatal survival. Lung measurement was predictive of need for ECMO, and intrathoracic liver was significantly associated with persistent PH and need for ECMO.

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