Sepsis Inservice and Video at an Urban Hospital in California

The emergency department at an urban hospital in California was performing below institutional goals related to sepsis protocols over the past few months. This intervention was targeted at nurses and was composed of a PowerPoint in-service on compliance to SEP-1 protocols and follow-along video on using the correct sepsis order set and documentation in the electronic health record (EHR). Goals included increased compliance to the SEP-1 protocol and documentation, (2) reduced time between the onset of symptoms, recognition, and intervention, (3) decline in sepsis rates and mortality rates, and (4) lower cost of care. Data was collected from the EHR to assess for correct documentation and treatment of septic patients. After the intervention, the following metrics reached 100%: (1) First vital to lactic acid result in 60 minutes, (2) lactic acid result to antibiotic administration within 60 minutes, and (3) antibiotic order to administration within 35 minutes. These results suggest that an in-service on SEP-1 protocols and follow-along video on documentation can improve SEP-1 compliance, documentation, and metrics

Bonggi language vitality and local interest in language-related efforts: A participatory sociolinguistic study

In Sabah, as in the rest of Malaysia, many indigenous languages are threatened by language shift to (Sabah) Malay. The present study examines to what extent Bonggi, an Austronesian language spoken on Banggi Island (Sabah State), is affected by these developments. One research objective was to investigate Bonggi language vitality, and explore local (church) interest in and priorities for Bonggi language-related efforts. To minimize the influence of outside researchers, the methodological approach was based on a participatory approach to language development planning. A second objective was to examine the usefulness and appropriateness of the chosen approach. Regarding the first research objective, the findings suggest that Bonggi language vitality is still vigorous in more remote parts of the island, while language vitality is weaker in the areas closer to the main town of the island. At the same time bilingualism in (Sabah) Malay appears to be pervasive throughout the Bonggi speech community. The findings also indicate that interest in Bonggi language work is rather limited. A few Bonggi church communities, however, expressed interest in creating Bonggi songs. Concerning the second research objective, the review of the methodology shows that the chosen approach is not appropriate in the context of research-driven sociolinguistic studies.National Foreign Language Resource Cente

Inactivation of presenilins causes pre-synaptic impairment prior to post-synaptic dysfunction

Synaptic dysfunction is widely thought to be a pathogenic precursor to neurodegeneration in Alzheimer’s disease (AD), and the extent of synaptic loss provides the best correlate for the severity of dementia in AD patients. Presenilins 1 and 2 are the major causative genes of early‐onset familial AD. Conditional inactivation of presenilins in the adult cerebral cortex results in synaptic dysfunction and memory impairment, followed by age‐dependent neurodegeneration. To characterize further the consequence of presenilin inactivation in the synapse, we evaluated the temporal development of pre‐synaptic and post‐synaptic deficits in the Schaeffer‐collateral pathway of presenilin conditional double knockout (PS cDKO) mice prior to onset of neurodegeneration. Following presenilin inactivation at 4 weeks, synaptic facilitation and probability of neurotransmitter release are impaired in PS cDKO mice at 5 weeks of age, whereas post‐synaptic NMDA receptor (NMDAR)‐mediated responses are normal at 5 weeks but impaired at 6 weeks of age. Long‐term potentiation induced by theta burst stimulation is also reduced in PS cDKO mice at 6 weeks of age. These results show that loss of presenilins results in pre‐synaptic deficits in short‐term plasticity and probability of neurotransmitter release prior to post‐synaptic NMDAR dysfunction, raising the possibility that presenilins may regulate post‐synaptic NMDAR function in part via a trans‐synaptic mechanism.This work was supported by the National Institute of Health NS041783 (to J.S.). We would like to thank Xiaoyan Zou and Huailong Zhao for technical assistance. (NS041783 - National Institute of Health)Published versio

An Active Learning Approach to Teaching Tough Topics in Law School

The classic image of the Law School classroom is Professor Kingsfield\u27s at the podium using the Socratic Method to interrogate quivering law students. This article advocates the incorporation of new methods: we argue that an integrated and interactive approach to teaching and learning legal topics is beneficial for law students and law professors alike. Although the article focuses on personal jurisdiction, the lessons here can apply to a tough topic in any course. The article begins by explaining why personal jurisdiction is difficult, as well as theory and data on traditional studying versus how to promote optimal learning. The article then explains how the authors have effectively enhanced student learning with a two-pronged approach of providing key context to personal jurisdiction, combined with an active learning approach that involves interactive learning of PJ before, during and after class. This process includes a variety of tools including videos, guided reading of PJ cases with key questions, interactive quizzes with explanations before and after class, as well as clicker questions during class. The article concludes that one or more of these methods could be successfully incorporated into any class with a tough topic by faculty with varying teaching and technology preferences.https://fuse.franklin.edu/ss2016/1022/thumbnail.jp

Multiple Alarms and Driving Situational Awareness

There is increasing interest in actively mitigating safety in vehicles beyond that of improving crash worthiness. According to the National Highway Transportation Safety Administration (NHTSA), there are more than 40,000 deaths on highways each year. This number may be decreasing with increasing active public concern and awareness for the use of safety restraints, but the numbers are still in excess of 40,000 deaths annually. Focusing on crash-worthiness as a measure of safety in vehicles will eventually reach a point of diminishing return, thus there is a need for automotive manufacturers to shift their safety focus to crash avoidance safety systems (Runge, 2002). In the public domain, significant progress and advancements have been made under the Intelligent Vehicles Initiative (IVI) set up by U.S. Department of Transportation to prevent motor vehicle crashes by assisting drivers in avoiding hazardous mistakes (U.S DOT, 1998). One IVI focus area is facilitating the rapid deployment of Collision Avoidance Systems (CAS) in vehicles. Collision Avoidance Systems are a subset of Advanced Vehicle Control Safety Systems (AVCSS) which come under the umbrella of Intelligent Transportation Systems (ITS). These Collision Avoidance Systems warn drivers of imminent collisions and can potentially help to save lives. Primary directions of research in CAS are determining implementation strategies and technologies in vehicles and roadway infrastructure, as well as optimizing the driving performance of different populations of drivers when using CAS. In CAS implementation, vehicles will communicate with other vehicles as well as with the roadway infrastructure via sensors and telecommunication networks. The data obtained can then be used in Collision Avoidance Systems. Vehicle-to-vehicle CAS include warnings that trigger when a vehicle is about to collide with another vehicle. Examples include Frontal Warning, Rear Warning and Blind Spot Detection Warnings. Vehicle-to-infrastructure CAS include warnings that trigger when a vehicle is about to have a collision with the roadway infrastructure. Examples include Intersection Warnings, Lane Departure Warnings, Curve Speed Warnings and Road-condition Warnings. Driving in a dynamic environment has become increasingly complex, such that drivers must visually track objects, monitor a constantly changing system, manage system information, to include the explosion of telematics, and make decisions in this dynamic and potentially high mental workload environment. Introducing Collision Avoidance Systems into vehicles could add to the complexity of this dynamic environment as different drivers will respond differently to Collision Avoidance Systems and there are many critical human factors issues that require investigation.Prepared for Ford Motor Co

Integrating Multiple Alarms & Driver Situation Awareness

This study addresses this gap in CAS and intelligent alarm research by examining whether or not a single master alarm warning versus multiple warnings for the different collision warning systems conveys adequate information to the drivers. Intelligent driver warning systems signaling impending frontal and rear collisions, as well as unintentional lane departures were used in this experiment, and all the warnings were presented to drivers through the auditory channel only. We investigated two critical research questions in this study: 1. Do multiple intelligent alarms as opposed to a single master alarm affect drivers’ recognition, performance, and action when they experience a likely imminent collision and unintentional lane departure? 2. Is driver performance and overall situation awareness under the two different alarm alerting schemes affected by reliabilities of the warning systems?Prepared For Ford Motor Compan

Single molecule, long-read Apoer2 sequencing identifies conserved and species-specific splicing patterns

Apolipoprotein E receptor 2 (Apoer2) is a synaptic receptor in the brain that binds disease-relevant ligand Apolipoprotein E (Apoe) and is highly alternatively spliced. We examined alternative splicing (AS) of conserved Apoer2 exons across vertebrate species and identified gain of exons in mammals encoding functional domains such as the cytoplasmic and furin inserts, and loss of an exon in primates encoding the eighth LDLa repeat, likely altering receptor surface levels and ligand-binding specificity. We utilized single molecule, long-read RNA sequencing to profile full-length Apoer2 isoforms and identified 68 and 48 unique full-length Apoer2 transcripts in the mouse and human cerebral cortex, respectively. Furthermore, we identified two exons encoding protein functional domains, the third EGF-precursor like repeat and glycosylation domain, that are tandemly skipped specifically in mouse. Our study provides new insight into Apoer2 isoform complexity in the vertebrate brain and highlights species-specific differences in splicing decisions that support functional diversity.Published versio

Assessing Glucose Uptake through the Yeast Hexose Transporter 1 (Hxt1)

The transport of glucose across the plasma membrane is mediated by members of the glucose transporter family. In this study, we investigated glucose uptake through the yeast hexose transporter 1 (Hxt1) by measuring incorporation of 2-NBDG, a non-metabolizable, fluorescent glucose analog, into the yeast Saccharomyces cerevisiae. We find that 2-NBDG is not incorporated into the hxt null strain lacking all glucose transporter genes and that this defect is rescued by expression of wild type Hxt1, but not of Hxt1 with mutations at the putative glucose-binding residues, inferred from the alignment of yeast and human glucose transporter sequences. Similarly, the growth defect of the hxt null strain on glucose is fully complemented by expression of wild type Hxt1, but not of the mutant Hxt1 proteins. Thus, 2-NBDG, like glucose, is likely to be transported into the yeast cells through the glucose transport system. Hxt1 is internalized and targeted to the vacuole for degradation in response to glucose starvation. Among the mutant Hxt1 proteins, Hxt1N370A and HXT1W473A are resistant to such degradation. Hxt1N370A, in particular, is able to neither uptake 2-NBDG nor restore the growth defect of the hxt null strain on glucose. These results demonstrate 2-NBDG as a fluorescent probe for glucose uptake in the yeast cells and identify N370 as a critical residue for the stability and function of Hxt1