Improving Reading Skills for Early Elementary Students

Research findings have indicated areas for improvement in early literacy programs in schools, and schools have been slow to respond, leaving students and teachers unsupported in the methods and knowledge needed for students to become fluent readers. Past studies have pointed to the need for teachers to have content knowledge of explicit instructional practices that focus on phonological and phonemic awareness. When students can manipulate sounds and letters, they are better able to decode and segment words, resulting in reading fluency. Using research findings, this school improvement plan was created to outline how to transition to explicit instructional methods while supporting the needs of teachers and students. This plan aims to increase oral reading fluency to improve literacy scores

Optimizing Ground Times for AMC Aircraft in Afghanistan

This research provides insight into the cargo unloading and loading process and times at three airfields in Afghanistan. Using a linear regression model and its prediction capability, a more stabilized environment is produced. This uses the times from seven historical months of continuous operations in Afghanistan and uses this information for the prediction expressions. Using this model, no throughput is lowered and early and late times are lowered by an average of seven minutes per mission. Over the course of a month, this increases planning stability by 74.1 hours. This not only impacts the planning at the downrange location, but also impacts worldwide operations and cargo movement

Antimicrobial stewardship practices in Virginia

The Society of Healthcare Epidemiology of America, the Centers for Disease Control and Prevention, and the President\u27s Council of Advisors on Science and Technology recognize the need to combat antimicrobial resistance through the promotion of antimicrobial stewardship programs. Health care facilities in Virginia were surveyed using a 23-item survey focused on facility characteristics and antimicrobial stewardship strategies. Antimicrobial stewardship activities were highly variable and many are missing key personnel and resources

Pharmacological Approaches For the Management of Patients with Moderately Elevated Triglycerides (150-499 mg/dL)

Hypertriglyceridemia, defined as serum triglyceride (TG) levels \u3e 150 mg/dL, now affects over one-quarter of the U.S. adult population and is associated with an increased risk of atherosclerotic cardiovascular disease. Available guidelines for managing hypertriglyceridemia vary with respect to triglyceride thresholds and severity of disease. Lifestyle modifications and management of secondary causes (e.g., diabetes) remain the first step in managing hypertriglyceridemia, with pharmacotherapy reserved to reduce the risk of pancreatitis and/or further reduce TG levels. Several classes of lipid-lowering agents are available with variable TG-lowering efficacy. While there is no consensus regarding the choice of initial TG-lowering pharmacotherapy, there is general agreement that the decision depends on the degree of hypertriglyceridemia and atherosclerotic cardiovascular disease risk. This review will discuss available and emerging lipid-lowering therapies for the management of moderately elevated TG, defined as TG 150-499 mg/dL

Evolving Role of Non-Statin Therapy for the Management of Dyslipidemia and Cardiovascular Risk Reduction: Past, Present, and Future

A plethora of evidence supports the use of statin therapy for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD), yet residual risk among high-risk patients receiving statin therapy remains high. Moreover, statin-associated muscle symptoms and other statin-associated adverse effects (e.g., increased risk of diabetes mellitus) limit the use of statins in high-risk patient populations. Of particular concern are individuals with established ASCVD, familial hypercholesterolemia (FH), or diabetes mellitus plus multiple ASCVD risk factors, all of whom require high-intensity statins, which are more commonly associated with an increased risk of adverse effects

Creating an Online Interprofessional Collaborative Team Simulation to Overcome Common Barriers of Interprofessional Education

Introduction: Coordinating student schedules, physical space, and faculty time are commonly reported barriers to successful interprofessional education. Use of online technologies to overcome these barriers and support online team simulation is a topic that deserves serious academic review. Methods: The Interprofessional Plan of Care - Simulated E-hEalth Delivery System (IPOC-SEEDS) is a student-directed online simulation where students experience a collaborative plan of care meeting with simultaneous team electronic health record utilization. The authors describe the IPOC-SEEDS simulation to serve as a model for replication or modification. IPOC-SEEDS objectives address Interprofessional Education Collaborative competencies (IPEC), electronic health record (EHR) navigation, simulation effectiveness, and technology utilization. Results: Overall, IPOC-SEEDS objectives were effectively met through simulation evaluations, student-led debriefing evaluations, in-person student feedback, and faculty feedback results supporting the online simulation and technology evolutions. The objectives, based on IPEC and informatics competencies, were achieved. Students from nursing, nutrition, pharmacy, occupational therapy, and health information management participated in the simulation using EHR and online meeting software, receiving valuable interprofessional practice. Technology utilization results were adequate, but did improve in subsequent simulations after modifying the technology selected. Discussion: The simulation provided an experience where students demonstrated interprofessional collaborative skills that they can use in their future practice. Online technologies can provide a platform for the high-quality interprofessional simulation to address common interprofessional education barriers and provide access to interprofessional education for distance-learning students and providers. Online simulation developers (hospitals, health departments, universities) can use the authors’ process steps as a model for online simulation replication

Effects of Sodium-Glucose Cotransporter 2 Inhibitors on 24-Hour Ambulatory Blood Pressure: A Systematic Review and Meta-Analysis

Background-—Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to their diuretic-like actions. Less known are the effects of this class on 24-hour ambulatory BP, which is a better predictor of cardiovascular risk than seated clinic BP. Methods and Results-—We performed a meta-analysis of randomized, double-blind, placebo-controlled trials to investigate the effects of SGLT2 inhibitors on 24-hour ambulatory BP. We searched all studies published before August 17, 2016, which reported 24-hour ambulatory BP data. Mean differences in 24-hour BP, daytime BP, and nighttime BP were calculated by a random-effects model. SGLT2 inhibitors significantly reduce 24-hour ambulatory systolic and diastolic BP by -3.76 mm Hg (95% CI, -4.23 to -2.34; I2=0.99) and -1.83 mm Hg (95% CI, -2.35 to -1.31; I2=0.76), respectively. Significant reductions in daytime and nighttime systolic and diastolic BP were also found. No association between baseline BP or change in body weight were observed. Conclusions-—This meta-analysis shows that the reduction in 24-hour ambulatory BP observed with SGLT2 inhibitors is a class effect. The diurnal effect of SGLT2 inhibitors on 24-hour ambulatory BP may contribute to their favorable effects on cardiovascular outcomes

CD20 and CD19 targeted vectors induce minimal activation of resting B lymphocytes

B lymphocytes are an important cell population of the immune system. However, until recently it was not possible to transduce resting B lymphocytes with retro- or lentiviral vectors, making them unsusceptible for genetic manipulations by these vectors. Lately, we demonstrated that lentiviral vectors pseudotyped with modified measles virus (MV) glycoproteins hemagglutinin, responsible for receptor recognition, and fusion protein were able to overcome this transduction block. They use either the natural MV receptors, CD46 and signaling lymphocyte activation molecule (SLAM), for cell entry (MV-LV) or the vector particles were further modified to selectively enter via the CD20 molecule, which is exclusively expressed on B lymphocytes (CD20-LV). It has been shown previously that transduction by MV-LV does not induce B lymphocyte activation. However, if this is also true for CD20-LV is still unknown. Here, we generated a vector specific for another B lymphocyte marker, CD19, and compared its ability to transduce resting B lymphocytes with CD20-LV. The vector (CD19ds-LV) was able to stably transduce unstimulated B lymphocytes, albeit with a reduced efficiency of about 10% compared to CD20-LV, which transduced about 30% of the cells. Since CD20 as well as CD19 are closely linked to the B lymphocyte activation pathway, we investigated if engagement of CD20 or CD19 molecules by the vector particles induces activating stimuli in resting B lymphocytes. Although, activation of B lymphocytes often involves calcium influx, we did not detect elevated calcium levels. However, the activation marker CD71 was substantially up-regulated upon CD20-LV transduction and most importantly, B lymphocytes transduced with CD20-LV or CD19ds-LV entered the G1b phase of cell cycle, whereas untransduced or MV-LV transduced B lymphocytes remained in G0. Hence, CD20 and CD19 targeting vectors induce activating stimuli in resting B lymphocytes, which most likely renders them susceptible for lentiviral vector transduction

Anticancer Gene Transfer for Cancer Gene Therapy

Gene therapy vectors are among the treatments currently used to treat malignant tumors. Gene therapy vectors use a specific therapeutic transgene that causes death in cancer cells. In early attempts at gene therapy, therapeutic transgenes were driven by non-specific vectors which induced toxicity to normal cells in addition to the cancer cells. Recently, novel cancer specific viral vectors have been developed that target cancer cells leaving normal cells unharmed. Here we review such cancer specific gene therapy systems currently used in the treatment of cancer and discuss the major challenges and future directions in this field