Provider Perspectives on the Influence of Family on Nursing Home Resident Transfers to the Emergency Department: Crises at the End of Life.

Background. Nursing home (NH) residents often experience burdensome and unnecessary care transitions, especially towards the end of life. This paper explores provider perspectives on the role that families play in the decision to transfer NH residents to the emergency department (ED). Methods. Multiple stakeholder focus groups (n = 35 participants) were conducted with NH nurses, NH physicians, nurse practitioners, physician assistants, NH administrators, ED nurses, ED physicians, and a hospitalist. Stakeholders described experiences and challenges with NH resident transfers to the ED. Focus group interviews were recorded and transcribed verbatim. Transcripts and field notes were analyzed using a Grounded Theory approach. Findings. Providers perceive that families often play a significant role in ED transfer decisions as they frequently react to a resident change of condition as a crisis. This sense of crisis is driven by 4 main influences: insecurities with NH care; families being unprepared for end of life; absent/inadequate advance care planning; and lack of communication and agreement within families regarding goals of care. Conclusions. Suboptimal communication and lack of access to appropriate and timely palliative care support and expertise in the NH setting may contribute to frequent ED transfers

Self-folding nano- and micropatterned hydrogel tissue engineering scaffolds by single step photolithographic process

Current progress in tissue engineering is focused on the creation of environments in which cultures of relevant cells can adhere, grow and form functional tissue. We propose a method for controlled chemical and topographical cues through surface patterning of self-folding hydrogel films. This provides a conversion of 2D patterning techniques into a viable method of manufacturing a 3D scaffold. While similar bilayers have previously been demonstrated, here we present a faster and high throughput process for fabricating self-folding hydrogel devices incorporating controllable surface nanotopographies by serial hot embossing of sacrificial layers and photolithography

A CANDELS WFC3 Grism Study of Emission-Line Galaxies at z~2: A Mix of Nuclear Activity and Low-Metallicity Star Formation

We present Hubble Space Telescope Wide Field Camera 3 slitless grism spectroscopy of 28 emission-line galaxies at z~2, in the GOODS-S region of the Cosmic Assembly Near-infrared Deep Extragalactic Legacy Survey (CANDELS). The high sensitivity of these grism observations, with 1-sigma detections of emission lines to f > 2.5x10^{-18} erg/s/cm^2, means that the galaxies in the sample are typically ~7 times less massive (median M_* = 10^{9.5} M_sun) than previously studied z~2 emission-line galaxies. Despite their lower mass, the galaxies have OIII/Hb ratios which are very similar to previously studied z~2 galaxies and much higher than the typical emission-line ratios of local galaxies. The WFC3 grism allows for unique studies of spatial gradients in emission lines, and we stack the two-dimensional spectra of the galaxies for this purpose. In the stacked data the OIII emission line is more spatially concentrated than the Hb emission line with 98.1 confidence. We additionally stack the X-ray data (all sources are individually undetected), and find that the average L(OIII)/L(0.5-10 keV) ratio is intermediate between typical z~0 obscured active galaxies and star-forming galaxies. Together the compactness of the stacked OIII spatial profile and the stacked X-ray data suggest that at least some of these low-mass, low-metallicity galaxies harbor weak active galactic nuclei.Comment: ApJ accepted. 8 pages, 6 figure

The Student Movement Volume 107, Issue 9: Power (Outage) to the People: Students Frolic in Winter Wonderland

HUMANS Interview with the Speech Pathology Club, Interviewed by: Gloria Oh Meet The Chiefs of The Twin Cities, Nicholas C. Gunn Meet the Student Graduate Liaison of AUGSA, Natasha Richards, Interviewed by: Kavya Mohanram What Are AU Students Thankful For?, Interviewed by: Grace No ARTS & ENTERTAINMENT Anthony León Wins Placido Domingo\u27s Operailia 2022, Aiko J. Ayala Rios Currently..., Solana Campbell Thanks for Making Me Laugh: My Top Ten Thanksgiving Sitcom Episodes, Bella Hamann Top Gun Maverick: A SuperSonic Sequel, Leo Martins NEWS Honors Church: Lessons and Carols, Terika Williams Prime Minister after Prime Minister, Abigail Kim The Seatless Delegate: An Unfulfilled Promise to the Cherokee Nation, Julia Randall Innovation & Entrepreneurship: The Sole Full Winner of the Shark Tank Competition, Yoel Kim IDEAS A Reflect ion on Body Image, Elizabeth Getahun The Frenzy of Fast Fashion, Abby Shim The Scoop on Introverts: What Extroverts Need to Know, Isabelle Martinez To Bee or not to Bee: The Importance, Causes, and Impact of Bee Disappearance, Alexander Navarro PULSE All About AU Engage, Lexie Dunham Thoughts on Daylight Savings, Gloria Oh Thanksgiving and Our Heritage, Zothile Sibanda LAST WORD Romanticizing the Past, Alannah Tjhatrahttps://digitalcommons.andrews.edu/sm-107/1008/thumbnail.jp

Fc galactosylation follows consecutive reaction kinetics and enhances immunoglobulin G hexamerization for complement activation

Fc galactosylation is a critical quality attribute for anti-tumor recombinant immunoglobulin G (IgG)-based monoclonal antibody (mAb) therapeutics with complement-dependent cytotoxicity (CDC) as the mechanism of action. Although the correlation between galactosylation and CDC has been known, the underlying structure–function relationship is unclear. Heterogeneity of the Fc N-glycosylation produced by Chinese hamster ovary (CHO) cell culture biomanufacturing process leads to variable CDC potency. Here, we derived a kinetic model of galactose transfer reaction in the Golgi apparatus and used this model to determine the correlation between differently galactosylated species from CHO cell culture process. The model was validated by a retrospective data analysis of more than 800 historical samples from small-scale and large-scale CHO cell cultures. Furthermore, using various analytical technologies, we discovered the molecular basis for Fc glycan terminal galactosylation changing the three-dimensional conformation of the Fc, which facilitates the IgG1 hexamerization, thus enhancing C1q avidity and subsequent complement activation. Our study offers insight into the formation of galactosylated species, as well as a novel three-dimensional understanding of the structure–function relationship of terminal galactose to complement activation in mAb therapeutics

Functional redundancy of R7 RGS proteins in ON-bipolar cell dendrites

PURPOSE. In the G␤5 Ϫ/Ϫ mouse, the electroretinogram (ERG) b-wave is absent, and the R7 subfamily of regulators of G protein signaling (RGS), which includes RGS6, -7, -9, and -11, is downregulated. Mutant mouse strains deficient in RGS7 or -11 were characterized, and the SG711 strain which is deficient in both proteins was examined, to learn whether the loss of some of these RGS proteins causes the absence of the ERG b-wave. METHODS. Antibodies to RGS7 and -11 were generated to determine their expression levels and localizations in retinas with various genetic backgrounds by Western blot analysis and immunohistochemistry, respectively. The implicit times and amplitudes of ERG a-and b-waves were analyzed to examine photoreceptor and bipolar cell functions. RESULTS. RGS7 and -11 co-localized to the dendritic tips of the ON-bipolar cells. In the RGS11 Ϫ/Ϫ mouse, the level of RGS7 protein increased. However, the level of RGS11 protein remained unchanged in the RGS7 mutant mouse, where a truncated RGS7 protein was expressed due to the deletion of exon 10. In the SG711 mouse retina, the G␤5-S protein level was reduced. The ERG b-wave of SG711 mice was markedly delayed. In contrast, RGS11 Ϫ/Ϫ mice showed a moderately delayed b-wave, whereas the RGS7 mutant mice showed normal ERG responses. CONCLUSIONS. The data demonstrate the presence of a delayed ERG b-wave in SG711 mice and a functionally redundant role for RGS11 and -7 at the tips of ON-bipolar cell dendrites. These results suggest that RGS11 or -7 works as the major physiological GAP (GTPase acceleration protein) for G␣o1 in ON-bipolar cells. (Invest Ophthalmol Vis Sci. 2010;51:686 -693) DOI: 10.1167/iovs.09-4084 V ision begins at retinal photoreceptors, and encoded information is relayed to bipolar cells at the retinal outer plexiform layer (OPL). The phototransduction cascade responsible for transducing light into neural signals in photoreceptors is G-protein mediated, 1 as is the metabotropic glutamate receptor 6 (mGluR6) signaling pathway responsible for relaying visual information in the depolarizing bipolar cells (DBCs). 6 Akin to the knockout mouse deficient in mGluR6 or G␣o, 4,7 the TRPM1-knockout mouse lacks the ERG b-wave. Recently, several RGS proteins, including RGS7, RGS11, and Ret-RGS1, were postulated to participate in the mGluR6 signaling pathway. 8 -10 RGS functions inside a cell as a negative regulator of a subset of heterotrimeric G-proteins. 11 Members of the RGS protein family contain a conserved RGS domain roughly 120 amino acids in length and can be further classified into subgroups by their sizes as well as sequences outside the RGS domain. RGS9-1 was the first mammalian RGS protein identified to have a physiological function. It is essential for timely deactivation of transducin in photoreceptors in mice and humans. 12,13 RGS9-1 exists in complex with two other proteins: G␤5-L (long-splice form of the fifth member of the G-protein ␤ subunit) and RGS9 anchoring protein (R9AP). 12,17 Three additional RGS proteins contain the hallmark GGL domain: RGS6, -7, and -11. Together with RGS9, they constitute the R7 subfamily of RGS proteins. 11 Unlike RGS9-1, however, these three R7 RGS proteins interact with the short-splice form of G␤5 (G␤5-S), which is more broadly expressed in the nervous system. From th

In vivo confocal Raman microspectroscopy of the skin: Noninvasive determination of molecular concentration profiles

Confocal Raman spectroscopy is introduced as a noninvasive in vivo optical method to measure molecular concentration profiles in the skin. It is shown how it can be applied to determine the water concentration in the stratum corneum as a function of distance to the skin surface, with a depth resolution of 5 mum. The resulting in vivo concentration profiles are in qualitative and quantitative agreement with published data, obtained by in vitro X-ray microanalysis of skin samples. Semi-quantitative concentration profiles were determined for the major constituents of natural moisturizing factor (serine, glycine, pyrrolidone-5-carboxylic acid, arginine, ornithine, citrulline, alanine, histidine, urocanic acid) and for the sweat constituents lactate and urea. A detailed description is given of the signal analysis methodology that enables the extraction of this information from the skin Raman spectra. No other noninvasive in vivo method exists that enables an analysis of skin molecular composition as a function of distance to the skin surface with similar detail and spatial resolution. Therefore, it may be expected that in vivo confocal Raman spectroscopy will find many applications in basic and applied dermatologic research

The effect of correctional facility programming on nonviolent beliefs

Gemstone Team Peace in PrisonsTo date, little research has made an effort to pinpoint measurable changes in beliefs resulting from correctional facility programming. Peace in Prisons studied the effects of the programs at the Montgomery County Correctional Facility on the inmates' beliefs regarding violence. It was hypothesized that inmates participating in programs would undergo a greater reduction in violent beliefs over time than those not in programs. The team administered the Nonviolence Test to inmates three times over a 3-month period. The primary purpose was to observe differences between those in programs and those not in programs. The team also sought to analyze the effects of other factors, including type of program, age, education, and race. The results demonstrate changes in violent beliefs due to a variety of factors, including involvement in certain types of programs, age, and the jail setting itself. What is more, these findings suggest numerous avenues for further research

Baseline Gastrointestinal Eosinophilia Is Common in Oral Immunotherapy Subjects With IgE-Mediated Peanut Allergy

Rationale: Oral immunotherapy (OIT) is an emerging treatment for food allergy. While desensitization is achieved in most subjects, many experience gastrointestinal symptoms and few develop eosinophilic gastrointestinal disease. It is unclear whether these subjects have subclinical gastrointestinal eosinophilia (GE) at baseline. We aimed to evaluate the presence of GE in subjects with food allergy before peanut OIT.Methods: We performed baseline esophagogastroduodenoscopies on 21 adults before undergoing peanut OIT. Subjects completed a detailed gastrointestinal symptom questionnaire. Endoscopic findings were assessed using the Eosinophilic Esophagitis (EoE) Endoscopic Reference Score (EREFS) and biopsies were obtained from the esophagus, gastric antrum, and duodenum. Esophageal biopsies were evaluated using the EoE Histologic Scoring System. Immunohistochemical staining for eosinophil peroxidase (EPX) was also performed. Hematoxylin and eosin and EPX stains of each biopsy were assessed for eosinophil density and EPX/mm2 was quantified using automated image analysis.Results: All subjects were asymptomatic. Pre-existing esophageal eosinophilia (>5 eosinophils per high-power field [eos/hpf]) was present in five participants (24%), three (14%) of whom had >15 eos/hpf associated with mild endoscopic findings (edema, linear furrowing, or rings; median EREFS = 0, IQR 0–0.25). Some subjects also demonstrated basal cell hyperplasia, dilated intercellular spaces, and lamina propria fibrosis. Increased eosinophils were noted in the gastric antrum (>12 eos/hpf) or duodenum (>26 eos/hpf) in 9 subjects (43%). EPX/mm2 correlated strongly with eosinophil counts (r = 0.71, p < 0.0001).Conclusions: Pre-existing GE is common in adults with IgE-mediated peanut allergy. Eosinophilic inflammation (EI) in these subjects may be accompanied by mild endoscopic and histologic findings. Longitudinal data collection during OIT is ongoing

Seasonal cycle of CO2 from the sea ice edge to island blooms in the Scotia Sea, Southern Ocean

The Scotia Sea region contains some of the most productive waters of the Southern Ocean. It is also a dynamic region through the interaction of deep water masses with the atmosphere. We present a first seasonally-resolved time series of the fugacity of CO2 (fCO2) from spring 2006, summer 2008, autumn 2009 and winter (potential temperature minimum) along a 1000 km transect from the pack ice to the Polar Front to quantify the effects of biology and temperature on oceanic fCO2. Substantial spring and summer decreases in sea surface fCO2 occurred in phytoplankton blooms that developed in the naturally iron fertilised waters downstream (north) of South Georgia island (54-55S, 36-38W) and following sea ice melt (in the seasonal ice zone). The largest seasonal fCO2 amplitude (fCO2) of 159 uatm was found in the South Georgia bloom. In this region, biological carbon uptake dominated the seasonal signal, reducing the winter maxima in oceanic fCO2 by 257 uatm by the summer. In the Weddell-Scotia Confluence, the southern fringe of the Scotia Sea, the shift from wintertime CO2-rich conditions in ice covered waters to CO2 undersaturation in the spring blooms during and upon sea ice melt created strong seasonality in oceanic fCO2. Temperature effects on oceanic fCO2 ranged from fCO2sst of 55 uatm in the seasonal ice zone to almost double that downstream of South Georgia (98 uatm). The seasonal cycle of surface water fCO2 in the high-nutrient low-chlorophyll region of the central Scotia Sea had the weakest biological control and lowest seasonality. Basin-wide biological processes dominated the seasonal control on oceanic fCO2 (fCO2bio of 159 μatm), partially compensated (43%) by moderate temperature control (fCO2sst of 68 μatm). The patchwork of productivity across the Scotia Sea creates regions of seasonally strong biological uptake of CO2 in the Southern Ocean