The Practice Environment for Nurse Anesthetists in Tennessee

Potential consequences of anesthesia provider shortages may include a reduction in health care access, poor patient outcomes, and increased costs to government funded agencies. Current leaders in the anesthesia profession need to establish a work environment that is embracing, supportive, and safe so that certified registered nurse anesthetists (CRNA) can remain healthy and productive. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to provide an overview of the current CRNA practice environment in Tennessee and advocate for policies to promote CRNA retention and enhance patient access to care. The overarching goal included gathering sufficient evidence regarding the positive and negative working environments of CRNA practice and presenting this evidence to the Tennessee Association of Nurse Anesthetist (TANA) executive committee. The evidence-informed health policy model (EIHP) was used to identify the policy problem as well as guide the development, implementation, and evaluation of a solution. After reviewing the literature, project members discovered seven working environment outcomes that impact retention and patient access to care. Project members presented the seven outcomes to the TANA executive committee and distributed a pre and post presentation survey to evaluate how the TANA organization was doing at promoting a positive work environment for CRNAs. Finally, to compare and analyze the survey responses, project members ran paired sample t-tests. Keywords: access, access to care, advanced practice registered nurse, barriers, certified registered nurse anesthetist, nurse anesthetist, and scope of practic

JWST's TEMPLATES for Star Formation: The First Resolved Gas-Phase Metallicity Maps of Dust-Obscured Star-Forming Galaxies at zz ∼\sim 4

We present the first spatially resolved maps of gas-phase metallicity for dust-obscured star-forming galaxies (DSFGs) at $z$ $\sim$ 4, from the JWST TEMPLATES Early Release Science program, derived from NIRSpec integral field unit spectroscopy of the H$\alpha$ and [NII] emission lines. Empirically derived literature optical line calibrations are used to determine that the sources are highly metal rich, with both appearing to display regions of supersolar metallicity, particularly in SPT2147-50. While we cannot rule out shocks or AGN in these regions, we suggest that the two systems have already undergone significant enrichment as a result of their extremely high star-formation rates. Utilising ALMA rest-frame 380$\mu$m continuum and [CI]($^3$P$_2$-$^3$P$_1$) line maps we compare metallicity and gas-to-dust ratio variations in the two galaxies, finding the two to be anticorrelated on highly resolved spatial scales, consistent with various literature studies of $z$ $\sim$ 0 galaxies. The data are indicative of the enormous potential of JWST to probe the enrichment of the interstellar medium on $\sim$kpc scales in extremely dust-obscured systems at $z$ $\sim$ 4 and beyond.Comment: 12 pages, 5 figures, submitted to Ap

JWST's TEMPLATES for Star Formation: The First Resolved Gas-phase Metallicity Maps of Dust-obscured Star-forming Galaxies at z ∼ 4

We present the first spatially resolved maps of gas-phase metallicity for two dust-obscured star-forming galaxies at z ∼ 4, from the JWST TEMPLATES Early Release Science program, derived from NIRSpec integral field unit spectroscopy of the Hα and [N ii] emission lines. Empirical optical line calibrations are used to determine that the sources are globally enriched to near-solar levels. While one source shows elevated [N ii]/Hα ratios and broad Hα emission consistent with the presence of an active galactic nucleus in a ≳1 kpc region, we argue that both systems have already undergone significant metal enrichment as a result of their extremely high star formation rates. Utilizing Atacama Large Millimeter/submillimeter Array rest-frame 380 μm continuum and [Ci](3P2–3P1) line maps we compare the spatial variation of the metallicity and gas-to-dust ratio in the two galaxies, finding the two properties to be anticorrelated on highly resolved spatial scales, consistent with various literature studies of z ∼ 0 galaxies. The data are indicative of the enormous potential of JWST to probe the enrichment of the interstellar medium on ∼kpc scales in extremely dust-obscured systems at z ∼ 4 and beyond

Identification of Novel Single Nucleotide Polymorphisms (SNPs) in Deer (Odocoileus spp.) Using the BovineSNP50 BeadChip

Single nucleotide polymorphisms (SNPs) are growing in popularity as a genetic marker for investigating evolutionary processes. A panel of SNPs is often developed by comparing large quantities of DNA sequence data across multiple individuals to identify polymorphic sites. For non-model species, this is particularly difficult, as performing the necessary large-scale genomic sequencing often exceeds the resources available for the project. In this study, we trial the Bovine SNP50 BeadChip developed in cattle (Bos taurus) for identifying polymorphic SNPs in cervids Odocoileus hemionus (mule deer and black-tailed deer) and O. virginianus (white-tailed deer) in the Pacific Northwest. We found that 38.7% of loci could be genotyped, of which 5% (n = 1068) were polymorphic. Of these 1068 polymorphic SNPs, a mixture of putatively neutral loci (n = 878) and loci under selection (n = 190) were identified with the FST-outlier method. A range of population genetic analyses were implemented using these SNPs and a panel of 10 microsatellite loci. The three types of deer could readily be distinguished with both the SNP and microsatellite datasets. This study demonstrates that commercially developed SNP chips are a viable means of SNP discovery for non-model organisms, even when used between very distantly related species (the Bovidae and Cervidae families diverged some 25.1−30.1 million years before present)

The Effects of a Relationship Status on Views of the Opposite Sex

It is human nature to notice those around us, and size them up by our own set of standards. This includes taking a measure of physical appearance and attractiveness. However, there are several factors that affect our perceptions of the world around us, and especially the people whom we see. Emotional states and a variety of emotions, play a strong role in dictating our behaviors and reactions (Most, Laurenceau, Graber, Belcher, & Smith, 2010). One factor that changes our human lives is the presence of romance. Intimacy, passion, and commitment are components associated with romance and relationships that take a toll on emotions and behaviors (Sternberg. 1986). The extent that these emotions alter our perceptions is essential to understanding the whole concept of love. When two people are committed to one another, do they start to view their environment differently? In the present study this question is investigated, and observed through self-report type measures. It was hypothesized that there would be a strong relation found between relationship status and ratings of the opposite sex. Individuals of different relationship statuses were given a questionnaire to disclose their relationship information and also given four photos of the opposite sex to rate on attractiveness. Their answers were then compared and analyzed in order to test the correlation a relationship status has on our visual perceptions of the opposite sex. Using an independent t-test for analysis the results showed no significance, but the descriptive data revealed interesting findings

Renal involvement in patients with mucolipidosis IIIalpha/beta: Causal relation or co-occurrence?

Mucolipidosis IIIalpha/beta (MLIIIalpha/beta) is a rare lysosomal storage disorder characterized by childhood onset of flexion contractures of fingers, joint stiffness in the shoulders, hips, and knees, and mild short stature. Recessive mutations in the GNPTAB gene have been associated with MLIIIalpha/beta. We present five children aged 9-16 years from a large kindred family whose serum activities of several lysosomal enzymes were significantly elevated. Whole exome sequencing followed by confirmation by Sanger sequencing identified a novel homozygous missense mutation (c.22 A>G; p.R8G) in the GNPTAB gene in all affected subjects. The five patients initially presented with flexion contractures of fingers followed by stiffnes of large joints. Only two affected boys also had a nephrotic-range proteinuria. Renal biopsy showed focal segmental glomerulosclerosis and foamy appearance of glomerular visceral epithelial cells which were compatible with storage disease. No other known causes of proteinuria could be detected by both laboratory and biopsy findings. There was no known family history of hereditary kidney disease, and healthy siblings and parents had normal renal function and urinalysis. These findings suggest that the renal involvement probably due to MLIIIalpha/beta, although it can still be present by coincidence in the two affected patients. (C) 2016 Wiley Periodicals, Inc