Alien Registration- Glidden, Maude A. (Bradley, Penobscot County)

https://digitalmaine.com/alien_docs/9993/thumbnail.jp

Mitral Annular and Coronary Artery Calcification Are Associated with Mortality in HIV-Infected Individuals.

BackgroundHIV infection increases cardiovascular risk. Coronary artery calcification (CAC) and mitral annular calcification (MAC) identify patients at risk for cardiovascular disease (CVD). The purpose of this study was to examine the association between MAC, CAC and mortality in HIV-infected individuals.Methods and resultsWe studied 152 asymptomatic HIV-infected individuals with transthoracic echocardiography (TTE) and computed tomography (CT). MAC was identified on TTE using standardized criteria. Presence of CAC, CAC score and CAC percentiles were determined using the modified Agatston criteria. Mortality data was obtained from the Social Security and National Death Indices (SSDI/NDI). The median age was 49 years; 87% were male. The median duration of HIV was 16 years; 84% took antiretroviral therapy; 64% had an undetectable viral load. CVD risk factors included hypertension (35%), smoking (62%) and dyslipidemia (35%). Twenty-five percent of individuals had MAC, and 42% had CAC. Over a median follow-up of 8 years, 11 subjects died. Subjects with CAC had significantly higher mortality compared to those with MAC only or no MAC. The Harrell's C-statistic of CAC was 0.66 and increased to 0.75 when MAC was added (p = 0.05). MAC, prior CVD, age and HIV viral load were independently associated with higher age- and gender-adjusted CAC percentiles in an adjusted model (p < 0.05 for all).ConclusionIn HIV patients, the presence of MAC, traditional risk factors and HIV viral load were independently associated with CAC. Presence of CAC and MAC may be useful in identifying HIV-infected individuals at higher risk for death

The value of kinetic glomerular filtration rate estimation on medication dosing in acute kidney injury.

BackgroundIn acute kidney injury (AKI), medication dosing based on Cockcroft-Gault creatinine clearance (CrCl) or Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimated glomerular filtration rates (eGFR) are not valid when serum creatinine (SCr) is not in steady state. The aim of this study was to determine the impact of a kinetic estimating equation that incorporates fluctuations in SCrs on drug dosing in critically ill patients.MethodsWe used data from participants enrolled in the NIH Acute Respiratory Distress Syndrome Network Fluid and Catheters Treatment Trial to simulate drug dosing category changes with the application of the kinetic estimating equation developed by Chen. We evaluated whether kinetic estimation of renal function would change medication dosing categories (≥60, 30-59, 15-29, and <15mL/min) compared with the use of CrCl or CKD-EPI eGFR.ResultsThe use of kinetic CrCl and CKD-EPI eGFR resulted in a large enough change in estimated renal function to require medication dosing recategorization in 19.3% [95 CI 16.8%-21.9%] and 23.4% [95% CI 20.7%-26.1%] of participants, respectively. As expected, recategorization occurred more frequently in those with AKI. When we examined individual days for those with AKI, dosing discordance was observed in 8.5% of total days using the CG CrCl and 10.2% of total days using the CKD-EPI equation compared with the kinetic counterparts.ConclusionIn a critically ill population, use of kinetic estimates of renal function impacted medication dosing in a substantial proportion of AKI participants. Use of kinetic estimates in clinical practice should lower the incidence of medication toxicity as well as avoid subtherapeutic dosing during renal recovery

Helicobacter pylori test-and-treat intervention compared to usual care in primary care patients with suspected peptic ulcer disease in the United States

The Helicobacter pylori ( H. pylori ) “test-and-treat” strategy in uninvestigated dyspepsia is an effective alternative to prompt endoscopy. Our aims were to determine whether the combination of an educational session and availability of office-based H. pylori testing (test-and-treat intervention [TTI]) increases use of the test-and-treat strategy by primary care practitioners and whether it improves patient outcomes. Methods : We conducted a 1-yr prospective trial of patients with suspected peptic ulcer disease in six primary care centers, three with TTI and three designated as usual care controls (UCC). Results : H. pylori testing was performed in 81% of 54 TTI patients and in 49% of 39 UCC patients ( p = 0.004). TTI and UCC patients had similar gastroenterology referral rates (24% vs 33%, p = 0.33), endoscopy or upper GI radiography rates (30% vs 31%, p = 0.91), and primary care visits per patient (3.1 ± 2.8 vs 3.1 ± 2.6, p = 0.92). TTI patients were less likely than UCC patients to receive repeated antisecretory medication prescriptions (35% vs 66%, p = 0.003). Symptomatic status at 1 yr and satisfaction with medical care did not differ between groups. Median (and interquartile range) annualized disease-related expenditures per patient were $454 ($162–932) for TTI and $576 ($327–1435) for UCC patients ( p = 0.17). Conclusions : The combination of an educational session and availability of office-based H. pylori testing may increase acceptance of the test-and-treat strategy by primary care providers. It remains to be determined whether increased use of the test-and-treat strategy yields significant improvements in clinical and economic outcomes compared to usual care.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74830/1/j.1572-0241.2002.07118.x.pd

PREDOMINANTLY LOW METALLICITIES MEASURED IN A STRATIFIED SAMPLE OF LYMAN LIMIT SYSTEMS AT Z = 3.7

We measured metallicities for 33 z = 3.4–4.2 absorption line systems drawn from a sample of H i-selected-Lyman limit systems (LLSs) identified in Sloan Digital Sky Survey (SDSS) quasar spectra and stratified based on metal line features. We obtained higher-resolution spectra with the Keck Echellette Spectrograph and Imager, selecting targets according to our stratification scheme in an effort to fully sample the LLS population metallicity distribution. We established a plausible range of H i column densities and measured column densities (or limits) for ions of carbon, silicon, and aluminum, finding ionization-corrected metallicities or upper limits. Interestingly, our ionization models were better constrained with enhanced α-to-aluminum abundances, with a median abundance ratio of [α/Al] = 0.3. Measured metallicities were generally low, ranging from [M/H] = −3 to −1.68, with even lower metallicities likely for some systems with upper limits. Using survival statistics to incorporate limits, we constructed the cumulative distribution function (CDF) for LLS metallicities. Recent models of galaxy evolution propose that galaxies replenish their gas from the low-metallicity intergalactic medium (IGM) via high-density H i "flows" and eject enriched interstellar gas via outflows. Thus, there has been some expectation that LLSs at the peak of cosmic star formation (z ≈ 3) might have a bimodal metallicity distribution. We modeled our CDF as a mix of two Gaussian distributions, one reflecting the metallicity of the IGM and the other representative of the interstellar medium of star-forming galaxies. This bimodal distribution yielded a poor fit. A single Gaussian distribution better represented the sample with a low mean metallicity of [M/H] ≈ −2.5.Massachusetts Institute of Technology. Undergraduate Research Opportunities ProgramNational Science Foundation (U.S.) (Award AST-1109915

Assessing the programming efficacy of teachers through workshop learning combining drones and STEM activities

This program focused on work with the DJI (2023b) Tello EDU drone, which is programmable through an app or can be flown with an app or a controller. The DroneBlocks App (DroneBlocks, n.d.) was used for flying through drag-and-drop, block coding, and the DJI (2023a) Tello App was used for flying without programming. Each teacher self-evaluated knowledge and skills, before and after a multi-day workshop. Balogun and Miller (2022) developed, and pilot-tested, a drone club model for out-of-school STEM learning and career pathway exploration. K-12 educators and subject-matter experts provided feedback for revision. Feedback topics ranged from safety to instruction to assessment. Goodnough et al. (2019) collected data regarding teacher pedagogical content knowledge while presenting a unit using drones to study animal habitats. Teacher efficacy was strengthened as they created inquiry-based, classroom environments to engage learners in science. Tsai et al. (2019) developed a computer programming self-efficacy scale. The five subscales included Logical Thinking, Cooperation, Algorithm, Control, and Debug. During summer 2022 and spring 2023, 16 teachers provided survey data for the self-efficacy scale (Tsai et al., 2019) and responded to open-ended questions. The goal was to provide high-quality, teacher professional development to increase knowledge and instructional skills for integrating drones into the elementary, middle, and secondary grades classroom. Measurable objectives included: 1. There will be a statistically significant increase in teachers’ scores on a 16-item, computer programming self-efficacy survey, between administrations of the instrument. 2. There will be a statistically significant increase in teachers’ scores on the five sub-scales of the computer programming self-efficacy survey, between administrations of the instrument. 3. Responses to open-ended questions will be analyzed for trends. Results showed a significant increase in computer programming self-efficacy and significant increases in sub-scale scores. References Balogun, A. O., & Miller, J. (2022). Drone club: Exploring engineering and employability skills outside the classroom. TechTrends, 66, 923-930. DJI. (2023a). Download center. Retrieved February 21, 2023, from https://www.dji.com/downloads/djiapp/tello DJI. (2023b). Tello EDU. Retrieved February 21, 2023, from https://m.dji.com/product/tello-edu DroneBlocks. (n.d.). Download the DroneBlocks Apps. Retrieved February 21, 2023, from https://droneblocks.io/app Goodnough, K., Azam, S., & Wells, P. (2019). Adopting drone technology in STEM (science, technology, engineering, and mathematics): An examination of elementary teachers’ pedagogical content knowledge. Canadian Journal of Science, Mathematics and Technology Education, 19, 398-414. Tsai, M.-J., Wang, C.-Y., & Hsu, P.-F. (2019). Developing the computer programming self-efficacy scale for computer literacy education. Journal of Educational Computing Research, 56(8), 1345-1360

Preparing for Success through the Robert Noyce Teacher Scholarship Program: Student Survey 2022

The Noyce program is an induction program designed to help future teachers in various STEM fields get started in their careers. Induction programs such as this one have become more popular over the past few years These induction programs can have a variety of benefits for the participants, including providing financial support, mentorship from experienced teachers, and connections that can lead to field placements (Ingersoll, 2004). Studies have also shown that participation in these programs can lead to less career turnover for the teachers involved in them (Ingersoll, 2004). Other research conducted has shown that induction programs for new teachers can help improve attitudes toward teaching and improve their own level of content knowledge (Luft, 2009). During the spring of 2022, a survey was sent out to participants in the Noyce program in order to gather information on how participants viewed the program in which they are involved. The survey was developed internally and was composed of 12 questions designed to gauge perceptions in three primary areas. These areas include the following: (a) factors that lead to their participation in the Noyce program, (b) what their experiences were with various parts of the program, and (c) how successful they felt the program was in preparing them to teach. Three Noyce scholars responded to the survey. Results showed that two of the respondents were drawn to the program because of recruitment efforts through the university and because of the financial support that the program provided, while one was simply drawn to the program because of an inherent desire to teach. With regard to experiences within the program, all three respondents indicated that they had positive feelings toward the professors they worked with and that the teaching experiences offered through the program were all very helpful in preparing for their future career. Two respondents also reported that the program provided them with a lot of helpful resources, while one mentioned that they were not fully aware of what was available to them. Biology and psychology courses were reported as being particularly helpful in preparation, while mathematics courses were seen as more demanding than what would be required for background knowledge of a teacher. The respondents specifically indicated that they felt confident in both teaching within their content area and engaging their students. Overall, respondents felt well-prepared for their careers in teaching

HIV prevention trial design in an era of effective pre-exposure prophylaxis

Pre-exposure prophylaxis (PrEP) has demonstrated remarkable effectiveness protecting at-risk individuals from HIV-1 infection. Despite this record of effectiveness, concerns persist about the diminished protective effect observed in women compared with men and the influence of adherence and risk behaviors on effectiveness in targeted subpopulations. Furthermore, the high prophylactic efficacy of the first PrEP agent, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC), presents challenges for demonstrating the efficacy of new candidates. Trials of new agents would typically require use of non-inferiority (NI) designs in which acceptable efficacy for an experimental agent is determined using pre-defined margins based on the efficacy of the proven active comparator (i.e. TDF/FTC) in placebo-controlled trials. Setting NI margins is a critical step in designing registrational studies. Under- or over-estimation of the margin can call into question the utility of the study in the registration package. The dependence on previous placebo-controlled trials introduces the same issues as external/historical controls. These issues will need to be addressed using trial design features such as re-estimated NI margins, enrichment strategies, run-in periods, crossover between study arms, and adaptive re-estimation of sample sizes. These measures and other innovations can help to ensure that new PrEP agents are made available to the public using stringent standards of evidence

Learning Robotics Concepts with Lego Spike Essential: Data Collection 2021 with Pre-service Teachers

This program focused on work with Lego Spike Essential robotics, which is a kit for student use in grades 1 to 5. Each teacher self-evaluated knowledge and skills, before and after a 6-hour workshop. Though there were five workshops, each teacher completed the evaluation for only the first workshop attended. Xia and Zhong (2018) reviewed 22 papers on teaching and learning robotics content knowledge in K-12. Among the findings was that the questionnaire was one of the commonly-used assessment tools. Kim et al. (2015) studied preservice teachers’ STEM engagement, learning, and teaching via robotics. They found improvement in STEM engagement, as measured through emotional, behavioral, and cognitive factors. Tsai et al. (2019) developed a computer programming efficacy scale which can be applied to robotics education. The five subscales included Logical Thinking, Algorithm, Debug, Control, and Cooperation. During the fall semester of 2021, 20 teacher participants provided survey data for the efficacy scale (Tsai et al., 2019) and a Lego (2016) creativity self-report. The goal was to provide high-quality, teacher professional development to increase knowledge and instructional skills for integrating robotics into the elementary grades (1-5) classroom. The measurable objectives were the following: 1. There will be a statistically significant increase in teachers’ scores on a 16-item, computer programming efficacy survey, between administrations of the instrument. 2. There will be a statistically significant increase in teachers’ scores on the five sub-scales of the computer programming efficacy survey, between administrations of the instrument. 3. There will be a positive correlation between the post-test score on the computer programming efficacy survey and the Lego creativity self-report. Results showed a significant increase in computer programming efficacy and significant increases in sub-scale scores. There was a medium, positive correlation between the scores on the efficacy survey and the creativity self-report

Can Three-Body Recombination Purify a Quantum Gas?

Three-body recombination in quantum gases is traditionally associated with heating, but it was recently found that it can also cool the gas. We show that in a partially condensed three-dimensional homogeneous Bose gas three-body loss could even purify the sample, that is, reduce the entropy per particle and increase the condensed fraction η. We predict that the evolution of η under continuous three-body loss can, depending on small changes in the initial conditions, exhibit two qualitatively different behaviors-if it is initially above a certain critical value, η increases further, whereas clouds with lower initial η evolve towards a thermal gas. These dynamical effects should be observable under realistic experimental conditions