Increasing Knowledge and Self-Efficacy in Nurses Orienting to Cardiovascular Surgery Using A New Periop 202 Program

The operating room theater can be intimidating for new nurses, thus leading to a shortage of nurses who are comfortable working in this environment. Evidence supports that 50% of perioperative nurses in 2017 were between the age of 50 and 59. Additionally, no formal didactic courses are being offered in undergraduate programs and the challenging environment related directly to the future shortage of perioperative nurses. This negatively impacts the number of trained perioperative cardiovascular nurses. The project proposed a new didactic educational Perioperative (Periop) 202 program that aimed to increase nurses’ self-efficacy to function on the cardiovascular operating room (CVOR) team and their knowledge of protocols and guidelines of new nurses entering the CVOR with the goal of generating future perioperative nurses to care for of this patient population. The eight actionable items within the Periop 202 program were designed to increase knowledge of CVOR procedures and protocol and the self-efficacy of new perioperative cardiovascular nurses, as evidence supports the use of nurses to complete these essential educational interventions. The Periop 202 program was an evidenced based program that added value and solution to the CVOR market. The program increased nurses’ confidence level of what they already knew about OR nursing with their pre-course percentage scores of 63% to post-course percentage scores of 80% on the OR knowledge questionnaire. The SEIEL self-efficacy questionnaire reported an increase in communication and team collaboration. All nurse participants completed their CVOR competency validated by their preceptors. Through a partnership with the AORN, a CVOR program with online-learning modules, one on one meetings with the primary investigator, clinical experiences and exposure, and team involvement led to a successful training program. The implications of creating and implementing an evidenced based Periop 202 program will have a positive impact on recruitment strategies across the nation. Key words: nurse, education, environment, operating room, readiness to learn

2169 steel waveform experiments.

In support of LLNL efforts to develop multiscale models of a variety of materials, we have performed a set of eight gas gun impact experiments on 2169 steel (21% Cr, 6% Ni, 9% Mn, balance predominantly Fe). These experiments provided carefully controlled shock, reshock and release velocimetry data, with initial shock stresses ranging from 10 to 50 GPa (particle velocities from 0.25 to 1.05 km/s). Both windowed and free-surface measurements were included in this experiment set to increase the utility of the data set, as were samples ranging in thickness from 1 to 5 mm. Target physical phenomena included the elastic/plastic transition (Hugoniot elastic limit), the Hugoniot, any phase transition phenomena, and the release path (windowed and free-surface). The Hugoniot was found to be nearly linear, with no indications of the Fe-phase transition. Releases were non-hysteretic, and relatively consistent between 3- and 5-mm-thick samples (the 3 mm samples giving slightly lower wavespeeds on release). Reshock tests with explosively welded impactors produced clean results; those with glue bonds showed transient releases prior to the arrival of the reshock, reducing their usefulness for deriving strength information. The free-surface samples, which were steps on a single piece of steel, showed lower wavespeeds for thin (1 mm) samples than for thicker (2 or 4 mm) samples. A configuration used for the last three shots allows release information to be determined from these free surface samples. The sample strength appears to increase with stress from ~1 GPa to ~ 3 GPa over this range, consistent with other recent work but about 40% above the Steinberg model

The protein C pathway: implications for the design of the RESPOND study

The predictive value of plasma protein C level in sepsis has been demonstrated in a number of studies in which depressed protein C levels were associated with increased likelihood of negative outcome. Data from the PROWESS (Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis) trial indicate that administration of drotrecogin alfa (activated; DrotAA) leads to an increase in endogenous protein C levels in severe sepsis patients. In a group as heterogeneous as sepsis patients, the currently approved dose and duration of administration (24 μg/kg per hour for 96 hours) might not be optimal in some individuals. The RESPOND (Research Evaluating Serial Protein C levels in severe sepsis patients ON Drotrecogin alfa [activated]) trial is a phase II study being conducted to explore the use of endogenous protein C level as both a biomarker and a steering parameter for administration of DrotAA. Eligible patients will receive DrotAA either at the normal, currently approved dose and duration of administration ('standard therapy') or at a higher dose with variable infusion duration or variable infusion duration only ('alternative therapy'). The duration of DrotAA infusion in the alternative therapy arm depends on the individual response in terms of sustained increase in endogenous protein C. The ultimate aims of this and potential following studies are as follows: to establish serial plasma protein C measurement as a biomarker that will aid in the identification of severe sepsis patients who are most likely to benefit from DrotAA therapy, to enable adjustment of DrotAA therapy in individual patients (specifically, the possibility to use a higher dose and to adjust the infusion duration), and to provide guidance to the clinician regarding whether the patient is responding to DrotAA

Effects of financial crises on productivity, capital and employment

We examine the hypothesis that capacity can be permanently damaged by financial, particularly banking, crises. A model which allows a financial crisis to have both a short-run effect on the growth rate of labor productivity and a long-run effect on its level is estimated on 61 countries over 1954–2010. A banking crisis as defined by Reinhart and Rogoff reduces the long-run level of GDP per worker, and also that of capital per worker, by on average 1.1 percent, for each year that the crisis lasts; it also reduces the TFP level by 0.8%. The long run, negative effect on the level of GDP per capita, 1.8 percent, is substantially larger. So there is also a hit to employment. The effects on labor productivity, capital and TFP are larger in developing than in developed countries; the opposite is the case for employment

Studying NASA's Transition to Ka-Band Communications for Low Earth Orbit

As the S-band spectrum becomes crowded, future space missions will need to consider moving command and telemetry services to Ka-band. NASA's Space Communications and Navigation (SCaN) Testbed provides a software-defined radio (SDR) platform that is capable of supporting investigation of this service transition. The testbed contains two S-band SDRs and one Ka-band SDR. Over the past year, SCaN Testbed has demonstrated Ka-band communications capabilities with NASAs Tracking and Data Relay Satellite System (TDRSS) using both open- and closed-loop antenna tracking profiles. A number of technical areas need to be addressed for successful transition to Ka-band. The smaller antenna beamwidth at Ka-band increases the criticality of antenna pointing, necessitating closed loop tracking algorithms and new techniques for received power estimation. Additionally, the antenna pointing routines require enhanced knowledge of spacecraft position and attitude for initial acquisition, versus an S-band antenna. Ka-band provides a number of technical advantages for bulk data transfer. Unlike at S-band, a larger bandwidth may be available for space missions, allowing increased data rates. The potential for high rate data transfer can also be extended for direct-to-ground links through use of variable or adaptive coding and modulation. Specific examples of Ka-band research from SCaN Testbeds first year of operation will be cited, such as communications link performance with TDRSS, and the effects of truss flexure on antenna pointing

Genotype of CHO host cell line has higher impact on mAb production and quality than process strategy or cell culture medium

Chinese hamster ovary (CHO) cells comprise a variety of lineages, including CHO-DXB11, CHO-K1, CHO-DG44 and CHO-S. Despite the fact that CHO cell lines share a common ancestor, extensive mutagenesis and clonal selection have resulted in substantial genetic heterogeneity among them. Data from sequencing shows that different genes are lacking from individual CHO cell lines and that each cell line harbors a unique set of mutations that are relevant to the bioprocess. However, literature outlining how the observed genetic differences affect CHO cell performance during bioprocess operations remains scarce. In this study, we examined host cell-specific differences among three widely used CHO cell lines (CHO-K1, CHO-S and CHO-DG44) and recombinantly expressed the same monoclonal antibody (mAb) in an isogenic format in all cell lines by using bacterial artificial chromosomes (BACs) as transfer vector. Cell-specific growth, product formation and heavy and light chain mRNA levels were studied in batch, fed-batch and perfusion cultures. Furthermore, two different cell culture media were investigated. Product quality was studied through glycoprofiling, and the thermal denaturation was analyzed using differential scanning calorimetry (DSC). We found CHO cell line-specific preferences for mAb production or biomass synthesis that were determined by the host cell line rather than product-specific mRNA levels. Additionally, quality attributes of the expressed mAb were influenced by the host cell line and medium used

Registration of hard white winter wheat germplasms KS14U6380R5, KS16U6380R10, and KS16U6380R11 with adult plant resistance to stem rust

Resistance to the Ug99 group of races of the stem rust fungus Puccinia graminis f. sp. tritici is limited in winter wheat (Triticum aestivum L.) germplasm adapted to the Great Plains of the United States. Our objective was to generate regionally adapted hard winter wheat germplasm with combinations of adult plant resistance genes that are expected to provide durable resistance. KS14U6380R5 (Reg. no. GP-1043, PI 689115), KS16U6380R10 (Reg. no. GP-1044, PI 689116), and KS16U6380R11 (Reg. no. GP-1045, PI 689117) were derived from backcrosses of the hard white winter wheat germplasm KS05HW14 to the stem rust-resistant Kenyan spring wheat cultivar ‘Kingbird’. KS14U6380R5, KS16U6380R11, and KS16U6380R10 were developed by pedigree selection and were initially evaluated as U6380-11-2R-0A, U6380-210-2R-0A, and U6380-148-4R-2T, respectively. The germplasms were developed by the USDA-ARS and jointly released with the Kansas State University Agricultural Experiment Station. These germplasms provide parents for development of hard winter wheat cultivars with durable resistance to stem rust