Undergraduate student led clinical skills events

Background: Undergraduate medical students frequently face limited opportunities to practice clinical skills and integrate these into patient encounters. They actively seek out practice opportunities for skills they perceive as integral to the practice of medicine. The current landscape of restricted patient access due to COVID 19, increasing competition for clinical placements with other health professional students, sicker patients and shorter inpatient stays all result in students looking for alternatives to improve their knowledge and skills. James Cook University (JCU) student associations and special interest groups offer student support and external opportunities for skills practice through guest speaker nights and student led clinical skills events. Summary of work: Development of these student skills events over the past 8+ years initially focused on providing practical skills exposure such as suturing using synthetic substitutes and urinary catheterisation using simulation trainers. With encouragement and academic staff expertise, these events have introduced high fidelity simulation in the form of case-based scenarios. These vary from simple ED management of chest pain through to paediatric near drowning scenarios. To support these events, a structured planning process incorporating regular meetings between academic, technical and student group representatives, staged completion of online documentation and full risk assessments is done. Formalising this process and integrating with student and university requirements fosters safe events, and just as importantly, mentors those student leaders with an interest in education. Summary of results: Students surveyed about their priorities for learning consistently score ‘increased opportunities for clinical skills practice’, and ‘participation in case-based simulation scenarios’ very highly in their feedback. Following a JCU Surgical Society event, (with staff supported practice sessions) JCU students earned third place in a state-wide competition involving theory, laparoscopic and suturing skill stations. Due to the multidisciplinary nature of some student interest groups, simulation scenarios have encouraged inter-professional interactions in an authentic, safe, and supported environment. This has helped students develop an understanding of different health professional roles without ‘real world’ stressors. Over the timeframe described, the number and variety of student led events has risen from 3 – 4 annually, to ten events in 2019. With the restrictions of COVID, that number is slowly returning with students very focussed on recouping some of the lost opportunities in clinical skills. Indicating their wish to be included in simulated patient focused, hybrid and high-fidelity simulation activities

Reusable LH2 tank technology demonstration through ground test

The paper presents the project plan to demonstrate, by March 1997, the reusability of an integrated composite LH2 tank structure, cryogenic insulation, and thermal protection system (TPS). The plan includes establishment of design requirements and a comprehensive trade study to select the most suitable Reusable Hydrogen Composite Tank system (RHCTS) within the most suitable of 4 candidate structural configurations. The 4 vehicles are winged body with the capability to deliver 25,000 lbs of payload to a circular 220 nm, 51.6 degree inclined orbit (also 40,000 lbs to a 28.5 inclined 150 nm orbit). A prototype design of the selected RHCTS is established to identify the construction, fabrication, and stress simulation and test requirements necessary in an 8 foot diameter tank structure/insulation/TPS test article. A comprehensive development test program supports the 8 foot test article development and involves the composite tank itself, cryogenic insulation, and integrated tank/insulation/TPS designs. The 8 foot diameter tank will contain the integrated cryogenic insulation and TPS designs resulting from this development and that of the concurrent lightweight durable TPS program. Tank ground testing will include 330 cycles of LH2 filling, pressurization, body loading, depressurization, draining, and entry heating

Owner Sex and Human–Canine Interactions at the Park

The purpose of this exploratory study was to investigate if and what types of differences exist between men and women when interacting with their dogs in a “natural” setting. In the case of this study, we defined “natural” as visiting a public park with their dog. To do this, we completed a series of 10-minute focal follows (n = 177) on human–canine dyads at local leashed and off-leash dog parks from December 2018 to March 2019. Data collection included counting incidences of 14 specific interactions (i.e., “baby talks to dog” or “scolds/speaks harshly to dog”), observable demographics (sex of owner, age cohort, sex of dog), and additional notes (i.e., extended play sessions, talking to other park visitors, cell phone use). Women were more likely to baby talk to their dog and speak gently/whisper to their dog, while young adults were more likely to use collar correction/jerk the leash. The results also suggest young adults may be more likely to throw toys/play with their dog, though more data are needed to confirm this. Given the increase in invested pet dog ownership, we suggest that sex differences in interactions with pet dogs mirror the literature on sex differences in human parenting. This is particularly relevant as decreasing birth rates and climbing pet ownership give rise to the practice of applying parenting strategies to pets, suggesting the need to better understand potential welfare concerns that may mirror those in the parenting literature

Thermal stability of simple tetragonal and hexagonal diamond germanium

Exotic phases of germanium, that form under high pressure but persist under ambient conditions, are of technological interest due to their unique optical and electrical properties. The thermal evolution and stability of two of these exotic Ge phases, the simple tetragonal (st12) and hexagonal diamond (hd) phases, are investigated in detail. These metastable phases, formed by high pressure decompression in either a diamond anvil cell or by nanoindentation, are annealed at temperatures ranging from 280 to 320 C for st12-Ge and 200 to 550 C for hd-Ge. In both cases, the exotic phases originated from entirely pure Ge precursor materials. Raman microspectroscopy is used to monitor the phase changes ex situ following annealing. Our results show that hd-Ge synthesized via a pure form of a-Ge first undergoes a subtle change in structure and then an irreversible phase transformation to dc-Ge with an activation energy of (4.3 6 0.2) eV at higher temperatures. St12-Ge was found to transform to dc-Ge with an activation energy of (1.44 6 0.08) eV. Taken together with results from previous studies, this study allows for intriguing comparisons with silicon and suggests promising technological applications.This work was supported by the Australian Research Council under the Discovery Project Scheme. L.Q.H. is supported by an Australian Government Research Training Program Scholarship. J.E.B. acknowledges the ARC for the award of a Future Fellowship. B.H. was supported through a Weinberg Fellowship (ORNL) and the Neutron Scattering User Facilities (ORNL), supported by the U.S. Department of Energy, Office of Sciences, Basic Energy Sciences. The ORNL is funded under DOE-BES Contract No. DE-AC05-00OR22725 and the Alvin M. Weinberg Fellowship by the ORNL LDRD scheme under Project No. 7620

Formation of an r8-Dominant Si Material

The rhombohedral phase of Si (r8-Si), a promising semiconducting material, is formed by indentation together with the body-centered cubic phase (bc8-Si). Using a novel sample preparation method, x-ray diffraction is used to determine the relative volume of these phases in indented Si and allow observation of a distorted unit cell along the direction of indentation loading. Theoretical calculations together with these observations suggest the indent contains an intrinsic compression of ∼4  GPa that stabilizes the r8 phase.We would like to acknowledge and thank Beamline Scientist Ruqing Xu for his help in obtaining the X-ray data. J. E. B. would like to acknowledge the Australian Research Council (ARC) (FT130101355). B. H. gratefully acknowledges funding through a Weinberg Fellowship sponsored by the Laboratory Directed Research and Development Program of Oak Ridge National Laboratory, managed by UT-Battelle, LLC, for the U.S. Department of Energy and ORNL’s Neutron Facilities, a DOE Office of Science User Facility operated by the Oak Ridge National Laboratory. A. M. acknowledges support from MINECO Project No. MAT2016-75586-C4-3-P (Spain)

Bilateral Polydactyly in a foal

The following case report describes the diagnosis and surgery of bilateral polydactyly of unknown origin in a colt. A 7-month-old Berber colt was referred for cosmetic and curative excision of supernumerary digits. Radiographic examination revealed bilateral polydactyly and well-developed first carpal bones. Surgery consisted of an osteotomy of both second metacarpal bones combined with an amputation of the supernumerary digits. The follow-up at 18 months after surgery revealed a sound horse with an excellent cosmetic outcome

Gilmore Terrace, Lee County, North Carolina : an action-oriented community diagnosis

This document details the steps and results of the Action Oriented Community Diagnosis (AOCD) conducted in the Gilmore Terrace public housing community located in Sanford, North Carolina. The AOCD was performed between September 2004 and May 2005 by six students from the University of North Carolina at Chapel Hill, School of Public Health’s Department of Health Behavior and Health Education in conjunction with residents and service providers of the Gilmore Terrace community. The purpose of an AOCD is to explore a community through participant observation and qualitative interviewing and to engage residents in a discussion of strategies to improve quality of life in the community. The student team interviewed both residents of Gilmore Terrace (insiders) and individuals who provide services to residents (outsiders). The interviews were analyzed to identify key themes, or ideas that were repeated by many interviewees (see Appendix I for a complete list of themes). The most important element of an AOCD is a community forum, where residents come together to discuss the themes and begin working towards solutions to issues facing the community. At the forum, the student team presented themes that were determined to be the most relevant and changeable (as determine by a planning committee of residents and service providers). These themes were: 1) there is a lack of established lines of communication between the residents of Gilmore Terrace and the Sanford Housing Authority (SHA); 2) Gilmore Terrace has higher rates of crime than other areas of Sanford, but much of that crime is attributed to nonresidents rather than residents; 3) residents of Gilmore Terrace do not have an official location to gather and hold community events since the neighborhood community center has been rented to the Boys and Girls Club and 4) community members and service providers are concerned that there is a lack of childcare and after-school activities that are affordable and easily accessible to youth and their parents. After the themes were presented to the community, forum participants divided into small groups to discuss what could be done to address these issues. First, a representative of Boys and Girls Club offered 50 summer scholarships to children living in Gilmore Terrace. Residents agreed to fill out applications and consider volunteering at the Club. Other action steps that came from small group discussions included: 1) forming a Resident Council to improve communication with the SHA; 2) working to have speed bumps installed in Gilmore Terrace and 3) converting a unit offline to use for community events. (See Appendix D9 for complete list of action steps.) It is the hope of the student team that the AOCD and enthusiasm generated by the community forum will only be the beginning to on-going collaborative relationship between residents and service organizations in Sanford to address issues in Gilmore Terrace.Master of Public Healt

SPARC preserves endothelial glycocalyx integrity, and protects against adverse cardiac inflammation and injury during viral myocarditis

Myocardial damage as a consequence of cardiotropic viruses leads to a broad variety of clinical presentations and is still a complicated condition to diagnose and treat. Whereas the extracellular matrix protein Secreted Protein Acidic and Rich in Cysteine or SPARC has been implicated in hypertensive and ischemic heart disease by modulating collagen production and cross-linking, its role in cardiac inflammation and endothelial function is yet unknown. Absence of SPARC in mice resulted in increased cardiac inflammation and mortality, and reduced cardiac systolic function upon coxsackievirus-B3 induced myocarditis. Intra-vital microscopic imaging of the microvasculature of the cremaster muscle combined with electron microscopic imaging of the microvasculature of the cardiac muscle uncovered the significance of SPARC in maintaining endothelial glycocalyx integrity and subsequent barrier properties to stop inflammation. Moreover, systemic administration of recombinant SPARC restored the endothelial glycocalyx and consequently reversed the increase in inflammation and mortality observed in SPARC KO mice in response to viral exposure. Reducing the glycocalyx in vivo by systemic administration of hyaluronidase, an enzyme that degrades the endothelial glycocalyx, mimicked the barrier defects found in SPARC KO mice, which could be restored by subsequent administration of recombinant SPARC.In conclusion, the secreted glycoprotein SPARC protects against adverse cardiac inflammation and mortality by improving the glycocalyx function and resulting endothelial barrier function during viral myocarditis