Building Bridges to Overcome Widening Gaps: Challenges in Addressing the Need for Professional Preparation of Infant-Toddler Practitioners in Higher Education

As the professional qualifications for those working with infants, toddlers, and their families continue to expand, institutes of higher education (IHEs) play an increasingly vital role in training the infant/toddler workforce. However, IHEs face numerous programming and pedagogical issues that make meeting the needs of these professionals difficult. These issues are further complicated by persistent challenges within early care and education. In this paper, we examine these issues in detail and discuss the Collaborative for Understanding the Pedagogy of Infant/toddler Development (CUPID), a cross-institution partnership working to enhance the quality of infant/toddler professional preparation in higher education

Using Design Thinking to Spread iPACE™: An Interprofessional Medical Education Innovation in an Academic Medical Center

Problem Statement: The Interprofessional Partnership to Advance Care and Education (iPACE™) model and its core principles are spreading across the MaineHealth system. Thus, there is a need for a standardized approach that is adaptable and incorporates the requirements of diverse patient care settings. Background: In 2017, the original iPACE™ model was designed and piloted on a new teaching unit for adult internal medicine at Maine Medical Center. Analysis of the pilot data showed improved teaming, care team experiences, interprofessional collaborations, and patient satisfaction. Because the pilot model will require adaptation to be successfully implemented in other disciplines, the authors sought a framework to facilitate implementation of core iPACE™ principles in diverse clinical care settings. Application/Recommendation: The Design Thinking (DT) framework was selected as a structured, standardized approach to accelerate innovation and implementation of the iPACE™ model in a new patient care setting. The DT framework consists of 6 consecutive process steps and iteration loops: Understand, Observe, Point of View, Ideate, Prototype, and Test. This paper outlines specific metrics and activities in each step, as well as opportunities for tailoring each step based on the care setting

Multiscale Simulations Suggest a Mechanism for the Association of the Dok7 PH Domain with PIP-Containing Membranes

Dok7 is a peripheral membrane protein that is associated with the MuSK receptor tyrosine kinase. Formation of the Dok7/MuSK/membrane complex is required for the activation of MuSK. This is a key step in the complex exchange of signals between neuron and muscle, which lead to neuromuscular junction formation, dysfunction of which is associated with congenital myasthenic syndromes. The Dok7 structure consists of a Pleckstrin Homology (PH) domain and a Phosphotyrosine Binding (PTB) domain. The mechanism of the Dok7 association with the membrane remains largely unknown. Using multi-scale molecular dynamics simulations we have explored the formation of the Dok7 PH/membrane complex. Our simulations indicate that the PH domain of Dok7 associates with membranes containing phosphatidylinositol phosphates (PIPs) via interactions of the β1/β2, β3/β4, and β5/β6 loops, which together form a positively charged surface on the PH domain and interact with the negatively charged headgroups of PIP molecules. The initial encounter of the Dok7 PH domain is followed by formation of additional interactions with the lipid bilayer, and especially with PIP molecules, which stabilizes the Dok7 PH/membrane complex. We have quantified the binding of the PH domain to the model bilayers by calculating a density landscape for protein/membrane interactions. Detailed analysis of the PH/PIP interactions reveal both a canonical and an atypical site to be occupied by the anionic lipid. PH domain binding leads to local clustering of PIP molecules in the bilayer. Association of the Dok7 PH domain with PIP lipids is therefore seen as a key step in localization of Dok7 to the membrane and formation of a complex with MuSK

Electrically tunable Bragg gratings in single mode polymer optical fiber

We present what is to our knowledge the first demonstration of a tunable fiber Bragg grating device in polymer optical fiber that utilizes a thin-film resistive heater deposited on the surface of the fiber. The polymer fiber was coated via photochemical deposition of a Pd/Cu metallic layer with a procedure induced by vacuum-ultraviolet radiation at room temperature. The resulting device, when wavelength tuned via joule heating, underwent a wavelength shift of 2 nm for a moderate input power of 160 mW, a wavelength to input power coefficient of-13.4 pm/mW, and a time constant of 1.7 s-1

A semi-parametric approach to estimate risk functions associated with multi-dimensional exposure profiles: application to smoking and lung cancer

A common characteristic of environmental epidemiology is the multi-dimensional aspect of exposure patterns, frequently reduced to a cumulative exposure for simplicity of analysis. By adopting a flexible Bayesian clustering approach, we explore the risk function linking exposure history to disease. This approach is applied here to study the relationship between different smoking characteristics and lung cancer in the framework of a population based case control study

Effect of nitrous oxide on cisatracurium infusion demands: a randomized controlled trial

<p>Abstract</p> <p>Background</p> <p>Recent studies have questioned our previous understanding on the effect of nitrous oxide on muscle relaxants, since nitrous oxide has been shown to potentiate the action of bolus doses of mivacurium, rocuronium and vecuronium. This study was aimed to investigate the possible effect of nitrous oxide on the infusion requirements of cisatracurium.</p> <p>Methods</p> <p>70 ASA physical status I-III patients aged 18-75 years were enrolled in this randomized trial. The patients were undergoing elective surgery requiring general anesthesia with a duration of at least 90 minutes. Patients were randomized to receive propofol and remifentanil by target controlled infusion in combination with either a mixture of oxygen and nitrous oxide (Nitrous oxide/TIVA group) or oxygen in air (Air/TIVA group). A 0.1 mg/kg initial bolus of cisatracurium was administered before tracheal intubation, followed by a closed-loop computer controlled infusion of cisatracurium to produce and maintain a 90% neuromuscular block. Cumulative dose requirements of cisatracurium during the 90-min study period after bolus administration were measured and the asymptotic steady state rate of infusion to produce a constant 90% block was determined by applying nonlinear curve fitting to the data on the cumulative dose requirement during the study period.</p> <p>Results</p> <p>Controller performance, i.e. the ability of the controller to maintain neuromuscular block constant at the setpoint and patient characteristics were similar in both groups. The administration of nitrous oxide did not affect cisatracurium infusion requirements. The mean steady-state rates of infusion were 0.072 +/- 0.018 and 0.066 +/- 0.017 mg * kg-1 * h-1 in Air/TIVA and Nitrous oxide/TIVA groups, respectively.</p> <p>Conclusions</p> <p>Nitrous oxide does not affect the infusion requirements of cisatracurium.</p> <p>Trial registration</p> <p>ClinicalTrials.gov NCT01152905; European Clinical Trials Database at <url>http://eudract.emea.eu.int/2006-006037-41</url>.</p

Fibre Bragg grating sensors in polymer optical fibres

This review paper summarises the current state of research into polymer optical fibre grating sensors. The properties of polymers are explored to identify situations where polymers offer potential advantages over more conventional silica fibre sensing technology. Photosensitivity is discussed and the sensitivities of polymer fibre gratings to strain, temperature and water are described. Finally, applications are reported which utilise the unique properties of polymer fibres

Research activities arising from the University of Kent

In this paper I describe research activities in the field of optical fiber sensing undertaken by me after leaving the Applied Optics Group at the University of Kent. The main topics covered are long period gratings, neural network based signal processing, plasmonic sensors, and polymer fiber gratings. I also give a summary of my two periods of research at the University of Kent, covering 1985–1988 and 1991–2001

Auxiliary variables for Bayesian inference in multi-class queueing networks

Queueing networks describe complex stochastic systems of both theoretical and practical interest. They provide the means to assess alterations, diagnose poor performance and evaluate robustness across sets of interconnected resources. In the present paper, we focus on the underlying continuous-time Markov chains induced by these networks, and we present a flexible method for drawing parameter inference in multi-class Markovian cases with switching and different service disciplines. The approach is directed towards the inferential problem with missing data, where transition paths of individual tasks among the queues are often unknown. The paper introduces a slice sampling technique with mappings to the measurable space of task transitions between the service stations. This can address time and tractability issues in computational procedures, handle prior system knowledge and overcome common restrictions on service rates across existing inferential frameworks. Finally, the proposed algorithm is validated on synthetic data and applied to a real data set, obtained from a service delivery tasking tool implemented in two university hospitals