Predictors of Support for a Woman President

In recent years, the number of women holding a higher political position is rising; additionally, more and more women are running for office. Furthermore, female politicians are increasingly being elected as the head of nations globally. Although the number of women in the government is increasing, they are still underrepresented politically compared to men and are still facing obstacles while running for office. The United States is one of the strongest countries around the world, with a successful democracy for hundreds of years. The country emphasizes liberty and equality; however, the United States has not yet had a female president. Scholars have wondered why the country has not yet elected a female president, and why the participation rate of women in office is still underrepresented. The present study relying on the 2012 American National Election Studies (ANES) explores the factors that influence the voting decision and public’s view toward women candidates. These factors include gender stereotypes and party affiliation. This study’s objective is to explore the predictors of support for a female president. Based on this information, I predicted that the U.S. citizens would not elect a female president within the next 20 years

Up to Code: Systematically Evaluating and Standardizing Legacy Repository Content

Rochester Institute of Technology implemented its first Open Access repository in 2002. An early effort to quickly populate and legitimize the repository, coupled with staff turnover, led to a collection of materials that was inconsistent, accompanied by insufficient metadata, and of dubious copyright status. While the system itself was re-evaluated and migrated to a new platform in 2012, much of the original content was batch imported without further inspection. In 2017, we underwent a systematic audit of all 2,500+ faculty works (student theses and dissertations were excluded from this project) to check for copyright compliance, as well as adherence to our current deposit policies. As a result, it was determined that almost half of our collection needed to be removed due to either policy violations or uncertainty about copyright permissions. Many of the articles we could retain required metadata updates in order to be complaint with publisher green Open Access policies and basic metadata standards in general. This project gave us insight into what is required to better sustain a digital repository collection in the long-term: documentation and succession planning, thorough standards and policies, consistent staff training, and attention to publisher Open Access requirements

Evaluation of candidemia prevalence and treatment cost comparison in a community-based hospital

Title: Evaluation of candidemia prevalence and treatment cost comparison in a community-based hospital Purpose: Candidemia is among the most common causes of nosocomial bloodstream infections in U.S. patients. It has been associated with high mortality rates and increased costs of care and duration of hospitalizations. The objective of this study is to evaluate the prevalence of candidemia in patients with risk factors as per the 2009 Infectious Diseases Society of America (IDSA) guidelines, to assess the appropriateness of therapy in patients with candidemia, and to compare the cost of fluconazole versus micafungin at initiation of therapy in our institution. Methods: This is a single-centered, retrospective chart review of all inpatients with a diagnosis of candidemia, treated with either fluconazole or micafungin, from January 2010 to December 2014, and approved by our health care system’s Institutional Review Board. A laboratory department generated blood culture report will be used to identify candidemia patients. All patients under the age of 18 will be excluded from this study. Patient electronic medical records will be reviewed to evaluate the following based on 2009 IDSA guidelines: risk factors, illness severity, strain of Candida isolate (albicans versus non-albicans), appropriate use of fluconazole versus micafungin upon initiation of therapy, and appropriate duration of therapy. An overall cost comparison of fluconazole versus micafungin will be conducted. Cost of appropriate treatment versus inappropriate treatment used at start of therapy will be compared. Data will be analyzed using descriptive statistics. Results: The prevalence of candidemia in our facility was predominately attributed to the use of implantable prosthetic devices, broad-spectrum antibiotics, and central venous catheters. On average, moderate to severely ill patients had a higher prevalence of candidemia. The most prevalent isolates were Candida albicans and parapsilosis. Of the 36.4% of patients that were inappropriately treated, one patient received antifungal therapy for 123 days and thus skewed our cost analysis. When assessing antifungal therapy, fluconazole and micafungin were inappropriately prescribed and dosed based on IDSA guidelines, at 40% and 20%; and at 25% and 2.5% respectively. The average length of treatment was 15 days. Conclusions: The results of this study will be presented at our Antimicrobial Stewardship Committee and Pharmacy & Therapeutics Committee. We will be conducting an educational campaign with our healthcare providers in order to reinforce appropriate prescribing criteria for candidemia based on IDSA guidelines

Polymerization In Nonaqueous Lyotropic Liquid Crystals With A Polymerizable Solvent

Lamellar liquid crystals of lecithin and 2-hydroxyethyl methacrylate (HEMA) were polymerized by using UV radiation. Optical microscopy, infrared spectroscopy, and small-angle X-ray diffraction were used to compare the structure prior to and after polymerization. The lamellar structure was retained after polymerization with increased interlayer spacing. © 1987, American Chemical Society. All rights reserved

Formation, crystal growth and colour appearance of Mimetic Tianmu glaze

WZZ thanks EPSRC for financial support on FEG-SEM equipment (EP/F019580/1).Mimetic Tianmu glaze has been synthesized and analysed by using X-ray diffraction, energy-dispersive X-ray spectroscopy, scanning electron microscopy and transmission electron microscopy. It was found that the main body of the glaze was amorphous aluminium silicate with many embedded polycrystalline spherical particles of metal oxides containing manganese, cobalt, vanadium, bismuth and tungsten. Two dimensional spinel dendrites crystals of manganese, cobalt and aluminium oxide formed on the surface of the glaze. The formation mechanism of the microstructures in the Tianmu glaze is proposed. The colour appearance of the glaze has also been discussed. It has been found that the crystal thickness dependant light interference could be an important factor for the appearance of rainbow-like colour in the glaze layer.PostprintPeer reviewe

Optimization of drug-drug interaction alerts in an effort to reduce pharmacist alert fatigue in a hospital system

Background/Purpose: A drug-drug interaction (DDI) occurs when one medication affects either the pharmacokinetics or pharmacodynamics of another medication. DDIs can result in preventable adverse drug events (ADEs), which can cause harm to patients. A clinical decision support (CDS) system is a health information technology system that assists with clinical decision-making tasks. CDS systems are capable of reducing the frequency of preventable ADEs. However, studies have demonstrated that only around 10% of the alerts fired by CDS systems are applicable in all the circumstances they fire, which can lead to clinician alert fatigue. Alert fatigue occurs when both important and non-important alerts are ignored due to the mental exhaustion and time required to evaluate too many alerts. There is a lack of evidence clearly defining which alerts should fire to clinicians, with the decisions often being made at the institutional level. The primary purpose of this study was to evaluate DDI alerts in an effort to reduce alert fatigue for pharmacists. Methodology: This was a prospective performance improvement study conducted within Baptist Health South Florida (BHSF). The primary objective was to identify common DDI alerts that were consistently being overridden by pharmacists. The secondary objectives were to decrease the quantity of clinically insignificant DDI alerts firing to pharmacists and to evaluate alert fatigue experienced by pharmacists during order entry/verification. These objectives were accomplished by using the Lights On Network®, which assisted us with identifying the top 50 DDI alerts in our system. These alerts were then reviewed by the Medication Safety and Clinical Optimization committees at BHSF. Once the final list of DDI alerts that were going to be removed was approved, the pharmacy informatics team turned off these alerts in Cerner. Pre and post-implementation surveys were completed by pharmacists to assess the impact of the implemented changes. Results: For the month of November 2019, the top 50 DDI alerts accounted for 73,873 out of 161,758 alerts (46%) fired in this month. The most commonly fired DDIs by class included: opioid analgesics with benzodiazepines and opioid analgesics with other opioid analgesics. Of the top 50 DDI alerts, 23 alerts were approved by the Medication Safety and Clinical Optimization committees to be removed. In the month of March 2020, the total number of DDI alerts accounted for 99,329 alerts fired, with the new top 50 accounting for only 23,182 (23%) of the total alerts. The average percentage of DDI alerts overridden decreased from 87% in November to 74% in March (13% decrease). The pre-implementation and post-implementation surveys included a total of 149 responses (94 from the pre-implementation group and 55 from the post-implementation group). The two main changes seen in the survey involved pharmacists’ perception regarding the amount of alerts firing in Cerner and their awareness that BHSF is currently optimizing DDI alerts. Pharmacists expressed no change in their perception of how many alerts they were overriding. Conclusions: There was a decrease in both the total number of alerts firing and the percentage of overridden alerts after implementation, yet pharmacist perception regarding the amount of alerts being overridden did not seem to change. Further optimization is needed within our healthcare system to decrease alert fatigue. Alerts with high override rates should be evaluated on an ongoing basis to determine whether they are beneficial to the pharmacists or contributing to alert fatigue

Transition from Fixed-dosing to Symptom-triggered Management of Alcohol Withdrawal Syndrome in the Intensive Care Unit of a Community Hospital

Background/Purpose: In the United States, 2 to 7% of heavy alcohol users admitted to the hospital for general medical care will develop severe alcohol withdrawal (AW) requiring treatment. The most dangerous complications of AW are delirium tremens and seizures. Benzodiazepines (BZD) are considered first-line therapy, with varying modality options available to providers. Fixed-dosing has historically been used to manage AW. However, studies suggest that symptom-triggered therapy (STT) can decrease length of stay and BZD duration of therapy. The purpose of this study was to evaluate the current fixed-dose protocol and outline the transition to STT in the intensive care unit (ICU) at South Miami Hospital. Methodology: This was a retrospective chart review of patients treated for AW with a fixed-dose BZD protocol at South Miami Hospital. Data was obtained from November 2017 through December 2019. Patients were included if they were admitted to the ICU and underwent treatment for AW with chlordiazepoxide or lorazepam (intravenous or oral). Patients were excluded if age less than 18 years, pregnant, or with an allergy to BZD. Primary outcomes included amount of BZD(s) used, duration of BZD therapy, and time to symptom control. The secondary objectives were incidence of adverse drug reactions (ADR) and length of stay in the critical care unit. Results: A total of 90 patients were reviewed, with 46 patients meeting inclusion criteria. Median chlordiazepoxide use was determined to be 75 mg daily. Sixty-five percent of patients received BZD therapy while asymptomatic, 26% continued BZDs after symptoms were controlled, and 9% used BZDs for the same duration as symptoms. The average duration of BZD therapy was 5.4 days, while time to symptom control was 4.25 days. BZD-related ADRs occurred in 46% of patients. In patients that experienced an ADR, 42% were receiving BZDs while asymptomatic or after symptoms were controlled. The length of stay in the ICU was 3 days, following which a majority of patients were transferred to a medical floor. Additional findings included 21% use of the AW PowerPlan and 30% use of the Clinical Institute Withdrawal Assessment of Alcohol Scale Revised (CIWAR-Ar). As a result, the institution will be transitioning to STT for the management of AW. The BZD of choice will be lorazepam and nurses will monitor response to therapy. The escalation or de-escalation of therapy will be based on predetermined parameters, taking into account the patient’s presentation and scale score. Conclusions: The current fixed-dose protocol led to patients receiving unnecessary treatment for AW and consequently, a large percentage of patients experienced an ADR. Areas for improvement for appropriate patient monitoring were identified, given the lack of use of the AW PowerPlan and poor documentation of CIWA-Ar scores

Scalable continuous evolution for the generation of diverse enzyme variants encompassing promiscuous activities

Enzyme orthologs sharing identical primary functions can have different promiscuous activities. While it is possible to mine this natural diversity to obtain useful biocatalysts, generating comparably rich ortholog diversity is difficult, as it is the product of deep evolutionary processes occurring in a multitude of separate species and populations. Here, we take a first step in recapitulating the depth and scale of natural ortholog evolution on laboratory timescales. Using a continuous directed evolution platform called OrthoRep, we rapidly evolve the Thermotoga maritima tryptophan synthase β-subunit (TmTrpB) through multi-mutation pathways in many independent replicates, selecting only on TmTrpB’s primary activity of synthesizing L-tryptophan from indole and L-serine. We find that the resulting sequence-diverse TmTrpB variants span a range of substrate profiles useful in industrial biocatalysis and suggest that the depth and scale of evolution that OrthoRep affords will be generally valuable in enzyme engineering and the evolution of biomolecular functions